The general population is exposed to metals as trace amounts of metallic compounds are present in air, water, and food. Information on background exposures and biomarker concentrations of environmental chemicals in the general Portuguese population is limited. Therefore, the purpose of this study was to determine the levels of important nonessential metals with recognized toxicity cadmium (Cd) and lead (Pb) and essential metals copper (Cu), nickel (Ni), chromium (Cr), and zinc (Zn) in placentas of mothers living in south Portugal (Algarve). Due to the difficulty in establishing the effects of chemicals in a complex and variable environment, this study also aimed to examine the response of biomarkers, such as biochemical changes that occurs at subcellular levels in the presence of contaminants. The investigated biomarkers in placentas indicative of metal exposure or damage included the metallothioneins (MT), delta-aminolevulinic acid dehydratase (ALAD) (specific for Pb), and lipid peroxidation (LPO) as an index of oxidative stress damage. Moreover, HJ-BIPLOT was applied in order to identify and categorize mothers vulnerable to environmental contamination in this region. Metal concentrations in the placenta were not excessive but within the range found in most European studies. In general, the biomarkers MT and LPO were positively correlated with metal levels, while with ALAD the opposite occurred, indicating the selected battery of biomarkers were suitable to study the effects of metals on human placenta. Further, the application of multivariate analysis with HJ-BIPLOT showed that most significant factors contributing to maternal and fetal exposures via placenta were dietary and smoking habits.

Background: After onset of acute ischemic stroke (AIS), there is a limited time window for delivering acute reperfusion therapies (ART) aiming to restore normal brain circulation. Despite its unequivocal benefits, the proportion of AIS patients receiving both types of ART, thrombolysis and thrombectomy, remains very low. The organization of a stroke care pathway is one of the main factors that determine timely access to ART. The knowledge on organizational factors influencing access to ART is sparce. Hence, we sought to systematize the existing data on the type and frequency of pre-hospital and in-hospital organizational factors that determine timely access to ART in patients with AIS. Methodology: Literature review on the frequency and type of organizational factors that determine access to ART after AIS. Pubmed and Scopus databases were the primary source of data. OpenGrey and Google Scholar were used for searching grey literature. Study quality analysis was based on the Newcastle-Ottawa Scale. Results: A total of 128 studies were included. The main pre-hospital factors associated with delay or access to ART were medical emergency activation practices, pre-notification routines, ambulance use and existence of local/regional-specific strategies to mitigate the impact of geographic distance between patient locations and Stroke Unit (SU). The most common intra-hospital factors studied were specific location of SU and brain imaging room within the hospital, and the existence and promotion of specific stroke treatment protocols. Most frequent factors associated with increased access ART were periodic public education, promotion of hospital pre-notification and specific pre- and intra-hospital stroke pathways. In specific urban areas, mobile stroke units were found to be valid options to increase timely access to ART. Conclusions: Implementation of different organizational factors and strategies can reduce time delays and increase the number of AIS patients receiving ART, with most of them being replicable in any context, and some in only very specific contexts.

The Andes serve as natural laboratories where biomes shape faunal communities into mosaics of habitats prone to fragmentation, making protected areas such as the Chimborazo Reserve (RC) critical refuges in the face of climate change. Based on this premise, patterns of biotic specialization and inter-biome faunal connectivity were evaluated through the ordering and co-scaling of family-level taxa in factorial space. A geospatial design was employed, stratifying the area into 400 ha cells, which were distributed across the high-Andean tundra (T), paramo grassland (G), and Andean forest (F) biomes and selected via simple proportional random sampling. A validated database of 2511 occurrences was compiled for the classes reptilia, aves, mammalia, amphibia, and insecta, comprising a total of 48 families, integrating records from global platforms and field surveys. The resulting matrix of 102 sampling cells (across three biomes) with 48 taxonomic families was analyzed using principal component analysis (HJ-biplot), k-means clustering, and bidirectional biclustering. It was found that Cluster 3 reflected a marked ecotone effect and faunal connectivity between F and G, dominated by generalist families with high evolutionary success such as Thraupidae, Tyrannidae, and waterbirds. In contrast, Clusters 1 and 2 revealed structural discontinuities and high biogeographic specialization in response to abiotic stress in the tundra, isolating taxa adapted to extreme conditions (Tropiduridae, Cricetidae, and Thinocoridae). Biclustering confirmed that the heterogeneity of the terrain mitigates climatic severity at the forest edge, acting as a microclimatic refuge for specialized nectar-eaters (Trochilidae) associated with Chuquiraga jussieui. The zoological structure of the RC reflects a distinct and predictable faunal partition that is strongly influenced by the interaction between the altitudinal gradient and microtopography. The coexistence of zones of diffuse transitions that promote biotic connectivity alongside nuclei of maximum specialization and ecological isolation was confirmed, which is essential for planning conservation measures.