Exploring spatial patterns and drivers of forest fires in Portugal (1980-2014)

Information on the spatial incidence of fire ignition density and burnt area, trends and drivers of wildfires is vitally important in providing support for environmental and civil protection policies, designing appropriate prevention measures and allocating firefighting resources. The key objectives of this study were to analyse the geographical incidence and temporal trends for wildfires, as well as the main drivers of fire ignition and burnt area in Portugal on a municipal level. The results show that fires are not distributed uniformly throughout Portuguese territory, both in terms of ignition density and burnt area. One spot in the north-western area is well defined, covering 10% of the municipalities where more than one third of the total fire ignitions are concentrated. In >80% of Portuguese municipalities, ignition density has registered a positive trend since the 1980s. With regard to burnt area, 60% of the municipalities had a nil annual trend, 35% showed a positive trend and 5%, located mainly in the central region, revealed negative trends. Geographically weighted regression proved more efficient in identifying the most relevant physical and anthropogenic drivers of municipal wildfires in comparison with simple linear regression models. Topography, density of population, land cover and livestock were found to be significant in both ignition density and burnt area, although considerable variations were observed in municipal explanatory power.

Declines in highly active antiretroviral therapy initiation at CD4 cell counts ≤ 200 cells/μL and the contribution of diagnosis of HIV at CD4 cell counts ≤ 200 cells/μL in British Columbia, Canada

OBJECTIVES

The aim of the study was to examine trends in initiating highly active antiretroviral therapy (HAART) with a CD4 count ≤ 200 cells/μL and the contribution of having a CD4 count ≤ 200 cells/μL at the time of diagnosis to these trends, in British Columbia (BC), Canada.

METHODS

We included in the analysis treatment-naïve BC residents aged ≥ 19 years who initiated HAART from 2003 to 2012. Participants were classified as follows: Group 1: diagnosed and initiated HAART with a CD4 count > 200 cells/μL; Group 2: diagnosed with a CD4 count > 200 cells/μL and initiated HAART with a CD4 count ≤ 200 cells/μL; and Group 3: diagnosed and initiated HAART with a CD4 count ≤ 200 cells/μL. We measured trends in initiating HAART with a CD4 count ≤ 200 cells/μL and used logistic regression models to measure factors associated with initiating HAART with a CD4 count ≤ 200 cells/μL, stratified by having a CD4 count ≤ 200 cells/μL or > 200 cells/μL at the time of diagnosis.

RESULTS

Between 2003 and 2012, 3506 BC residents initiated HAART. Of these, 44% (1558 of 3506) initiated HAART with a CD4 count ≤ 200 cells/μL. This proportion declined from 69% (198 of 287) in 2003 to 21% (81 of 330) in 2012 (P < 0.001). The proportion of those in Group 3 increased from 49% (97 of 198) in 2003 to 69% (56 of 81) in 2012 (P < 0.001). Overall, 56% (1948), 22% (776) and 22% (782) made up Groups 1, 2, and 3, respectively. In adjusted analyses, seeing a specialist was significantly associated with being in Group 3. Using injection drugs and seeing a specialist were associated with being in Group 2.

CONCLUSIONS

In recent years, among individuals who ever initiated HAART in BC, being diagnosed with low CD4 cell counts has become a greater contributor to initiating HAART with low CD4 cell counts.

Brain insulin resistance and Alzheimer's disease: a systematic review

The disability of cells to react to insulin, causing glucose intolerance and hyperglycemia, is referred to as insulin resistance. This clinical condition, which has been well-researched in organs such as adipose tissue, muscle, and liver, has been linked to neurodegenerative diseases like Alzheimer's disease (AD) when it occurs in the brain.

Objective

The authors aimed to gather data from the current literature on brain insulin resistance (BIR) and its likely repercussions on neurodegenerative disorders, more specifically AD, through a systematic review.

Methods

A comprehensive search was conducted in multiple medical databases, including the Cochrane Central Register of Controlled Trials, EMBASE, Medical Literature Analysis and Retrieval System Online (Medline), and PubMed®, employing the descriptors: "insulin resistance", "brain insulin resistance", "Alzheimer's disease", "neurodegeneration", and "cognition". The authors focused their search on English-language studies published between 2000 and 2023 that investigated the influence of BIR on neurodegenerative disorders or offered insights into BIR's underlying mechanisms. Seventeen studies that met the inclusion criteria were selected.

Results

The results indicate that BIR is a phenomenon observed in a variety of neurodegenerative disorders, including AD. Studies suggest that impaired glucose utilization and uptake, reduced adenosine triphosphate (ATP) production, and synaptic plasticity changes caused by BIR are linked to cognitive problems. However, conflicting results were observed regarding the association between AD and BIR, with some studies suggesting no association.

Conclusion

Based on the evaluated studies, it can be concluded that the association between AD and BIR remains inconclusive, and additional research is needed to elucidate this relationship.

[Schwannoma of duodenum: a case report]

We report a case of malignant schwannoma of the duodenum, a neural tumor, which rarely occurs in the gastroduodenal tract. The diagnosis was done after an hemorragic episode of the upper gastrointestinal tract and the treatment done was a local resection. Two years later the patient had no symptoms, but the control endoscopy showed a recurrence of the tumor in the second portion of the duodenum and the patient was submitted to a gastroduodenopancreatectomy. The authors reported the case and make a revision on intestinal schwannomas.