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The aim of this systematic review with meta-analysis was to determine the effect of caffeine gum (Caff-gum) on exercise performance-related outcomes. Several databases were searched for studies assessing the effect of Caff-gum in placebo-controlled protocols involving healthy adults. Random-effects meta-analyses using standardized mean differences (SMD) were performed to determine the effect of Caff-gum on exercise outcomes with several sub-analyses (training status, exercise type, timing and dose) for potential modifying factors. 14 studies were included, totalling 200 participants. There was a significant overall effect of Caff-gum compared to placebo (SMD = 0.21, 95%CI: 0.10–0.32; p = 0.001). Subgroup analysis showed improved performance for trained (SMD = 0.23, 95%CI: 0.08–0.37; p = 0.004), but not for untrained (SMD = 0.14, 95%CI: −0.02–0.29; p = 0.07) individuals. Caff-gum improved both endurance (SMD = 0.27, 95%CI: 0.12–0.42; p = 0.002) and strength/power (SMD = 0.20, 95%CI: 0.03–0.37; p = 0.03) performance outcomes. Caff-gum was ergogenic when consumed within 15 min prior to initiating exercise (SMD = 0.27, 95%CI: 0.07–0.4; p = 0.01), but not when provided >15 min prior (SMD = −0.48, 95%CI = −1.7–0.82; p = 0.25). There was no significant effect of Caff-gum with doses <3 mg/kg body mass (BM) (SMD = 0.20, 95%CI: −0.03–0.43; p = 0.07), but there was a significant effect when the dose was ≥3 mg/kg BM (SMD = 0.22, 95%CI: 0.07–0.37; p = 0.01). Caff-gum supplementation may be an effective ergogenic strategy for trained athletes involved in both endurance and strength/power exercise, using a recommended dose of ≥3 mg/kg BM consumed within 15 min of initiating exercise. Highlights This study determined the effect of Caff-gum on exercise performance, using a systematic review and meta-analysis. Fourteen studies, totalling 200 participants performing a variety of endurance and strength/power exercise tests were included. The relative Caff-gum dose ranged from 1.27-4.26 mg/kg BM and timing ranged from 120 min prior to exercise up to intra-test application. Caff-gum was shown to be an effective ergogenic aid for trained individuals involved in both endurance and strength/power exercise. Supplement dose and timing modified the efficacy of Caff-gum. Supplementation with Caff-gum was effective when provided in doses ≥3 mg/kg BM and within 15 min prior to initiating exercise. Trained endurance or strength/power athletes seeking to benefit from caffeine in the form of chewing gum should supplement within 15 min prior to initiating an exercise task, in doses ≥3 mg/kg BM. [ABSTRACT FROM AUTHOR]

People engaged in informal employment are not insured by any labour or social protection. Welfare state regimes could affect the relationship between informal employment and health. This study aimed to assess the relationship between informal employment and health status in the non-agricultural working population in Central America, by welfare state regime and gender. Based on a sample of 8680 non-agricultural workers (First Central American Survey of Working Conditions and Health), we conducted Poisson regression models with robust variance to obtain prevalence ratios (PR) and their confidence intervals (95% CI) of poor health status (self-perceived and mental health) of workers with informal employment versus those with formal employment. Models were adjusted by age and occupation and stratified by welfare state regime and gender. We found that prevalence of poor health status was highest among women and workers in informal employment. Positive associations between informal employment and poor self-perceived health were found in familialist and highly familialist countries for both genders, being highest in women in familialist countries (PR: 1.39, 95% CI: 1.08–1.80). Significant associations were only found for poor mental health among women in familialist countries (PR: 1.24, 95% CI: 1.01–1.53) and men in highly familialist countries (PR: 1.34, 95% CI: 1.00–1.79). Our results suggest that universal social protection policies could reduce the negative effects of informal employment on health status for both women and men. Future development of labour and social policies integrating a gender perspective might be crucial to address health inequalities related to informal employment in Latin American countries. [ABSTRACT FROM AUTHOR]

Torrefaction is an option for improving biomass properties for fuel application. Biomass undergoes chemical changes reflected on the upgrading of its properties as a biofuel, such as higher calorific power, lower O/C and H/C ratios, lower higroscopicity or better grindability. Objectives of this experimental study were to analyze the effects of torrefaction, under standart conditions of 265 °C, and residence time of 15 min in a nitrogen atmosphere and during a total 1h45m heating period, on a set of sixteen woody biomasses provenient from poplar short rotation coppice (SRC) and other Portuguese roundwoods. Average mass loss was higher than 40%. The set of poplar clones and common broom provided torrefied products with higher quality than the set of roundwood forest species. The results on other parameters for proximate and ultimate analysis corroborate this global picture. Correlation analysis showed a higher degree of interconnectedness between LHV and proximate analysis results, for poplar clones and common broom, comparatively with roundwood biomasses. [ABSTRACT FROM AUTHOR]

Ohmic heating (OH) allows a natural synergy between thermal and electrical effects, appearing as an efficient approach to the thermal extraction of biocompounds. Different electrical field intensities (e.g., 12 and 217 V/cm), treatment temperatures (from 50 to 100 °C) and heating strategies (continuous and pulsed heating) were combined to enhance for the first time the extraction of nutrients from microalgae Coelastrella sp. LFR1 , which is highly adapted to extreme survival conditions. Results showed that OH applied at 217 V/cm, through a fast and single heating pulse (OHP), and at maximum peak temperature of approximately 100 °C (with <1 s of holding time), resulted in the maximum recovery of 50% of chlorophyll a (e.g., 1.02 mg/g DW) and 20.4% of proteins (29.4 mg/g DW) from biomass; lipids and carbohydrates were equally extracted resulting on extraction of 40 and 52%, respectively. OHP allowed to obtain nutrient rich extracts from Coelastrella sp. LFR1 with a significant radical scavenging activity ranging from 20 to 60%. • Coaestrella sp. biomass is a novel source of pigments and proteins. • Electrical fields increase the extraction rate of chlorophyll a and protein fraction. • High temperature and short-time processing enhanced sequential extraction. • Obtained extracts presented antioxidant capacity. • Ohmic heating significantly affects morphological integrity of microalgae cells. [ABSTRACT FROM AUTHOR]

Introduction: Cognitive rehabilitation interventions (CRIs) for cancer-related cognitive impairment (CRCI) have shown promising results. However, the acceptability of CRIs in the context of CRCI treatment has not yet been assessed among cancer survivors. Due to the absence of suitable instruments designed to assess the acceptability of CRIs in this population, we developed the Acceptability regarding Cognitive Rehabilitation Interventions Survey for Cancer Survivors (ACRIS-CS). Objectives: This study aimed to develop and test the psychometric properties of the newly created instrument, ACRIS-CS. Methods: The study was conducted in two stages: (1) the creation of scale items derived from a comprehensive literature review, considering the Theoretical Framework of Acceptability (TFA); and (2) the assessment of the scale's psychometric properties with cancer survivors. At the end of stage 1, the questionnaire was revised by four clinicians and researchers with expertise in the field of CRCI, and the final item selection was determined by the authors, considering redundancy, item relevance, and face validity. The final scale comprised 11 items, answered on a 5-point Likert scale (ranging from "strongly disagree" to "strongly agree"). Higher scores indicated more positive perceptions related to the acceptability of CRIs. Data were collected online and analyzed using IBM SPSS Statistics (version 28.0). Construct validity (exploratory factor analysis, EFA) and reliability (internal consistency) analyses were performed. Results: In this study, 154 cancer survivors were included. The Kaiser-Meyer-Olkin (KMO) measure of 0.847 confirmed the adequacy of sampling (KMO>0.5), and Bartlett's test of sphericity yielded statistical significance (Χ² (55) = 864.431, p < 0.001), validating the structure of the correlation matrix. The EFA results indicated the presence of three factors, each with eigenvalues exceeding the Kaiser criterion of 1. The scree plot confirmed the existence of three factors beyond the inflection point. All items demonstrated factor loadings higher than 0.40, indicating their relevance to the identified factors. This factor structure was conceptually justifiable. These factors were labeled as follows: 1) Affective attitude and effectiveness (6 items); 2) Perceived benefits and self-efficacy (3 items); and 3) Perceived burden (2 items). Collectively, these factors accounted for 68.7% of the total variance. The ACRIS-CS total scale and subscales demonstrated good internal consistency, with Cronbach's alpha coefficients ranging from 0.727 to 0.848. Conclusions: The results of the EFA and internal consistency analysis were satisfactory. The ACRIS-CS appears to be a valid and reliable scale for assessing the acceptability of CRIs among cancer survivors. Disclosure of Interest: None Declared [ABSTRACT FROM AUTHOR]

Summary: Adaptor chimeric antigen receptor (CAR) T‐cell therapy offers solutions for improved safety and antigen escape, which represent main obstacles for the clinical translation of CAR T‐cell therapy in myeloid malignancies. The adaptor CAR T‐cell platform 'UniCAR' is currently under early clinical investigation. Recently, the first proof of concept of a well‐tolerated, rapidly switchable, CD123‐directed UniCAR T‐cell product treating patients with acute myeloid leukaemia (AML) was reported. Relapsed and refractory AML is prone to high plasticity under therapy pressure targeting one single tumour antigen. Thus, targeting of multiple tumour antigens seems to be required to achieve durable anti‐tumour responses, underlining the need to further design alternative AML‐specific target modules (TM) for the UniCAR platform. We here present the preclinical development of a novel FMS‐like tyrosine kinase 3 (FLT3)‐directed UniCAR T‐cell therapy, which is highly effective for in vitro killing of both AML cell lines and primary AML samples. Furthermore, we show in vivo functionality in a murine xenograft model. PET analyses further demonstrate a short serum half‐life of FLT3 TMs, which will enable a rapid on/off switch of UniCAR T cells. Overall, the presented preclinical data encourage the further development and clinical translation of FLT3‐specific UniCAR T cells for the therapy of AML. [ABSTRACT FROM AUTHOR]

Fish waste, seaweed and pine bark were composted to obtain a stable product rich in organic matter and nutrients for use in organic agriculture. The compost was assessed as an organic fertilizer for potato crops. The influence of three different compost rates (viz., C1 = 32 t ha, C2 = 43 t ha and C3 = 65 t ha) on potato production and the chemical composition of potato tuber, petiole and foliole was compared with that of a mineral fertilizer (M), a certified organic fertilizer consisting of dehydrated broiler litter (BL) and a control treatment involving no fertilizer (C). The compost exhibited a substantial fertilizing effect and even surpassed the mineral fertilizer in this respect. The C3 treatment increased total production by 53 and 30% relative to C and M, respectively, and was similar to BL in this respect; also, it considerably reduced non-commercial production (calibre <35 mm according to Spanish regulation RD 31/2009) relative to C. Only the C3 treatment altered the chemical composition of the tubers (specifically, it increased the content in reducing sugars). Therefore, the compost is useful as a fertilizer for organic potato crops. [ABSTRACT FROM AUTHOR]

Aortic aneurysm, chronic renal failure, and kidney transplantation are common clinical entities that rarely coexist. The increased number of kidney transplant patients, their greater survival, and the sharing of risk factors for aortic aneurysms, suggest the emergence of a larger number of diagnoses of aortic aneurysms among kidney transplant patients. These patients cases present the particularities of immunosuppression that can alter the healing of the wounds or the development of infections. There is a need to protect the kidney during aortic clamping and several co-morbidities that increase the surgical morbidity and mortality. The advent in 1991 of the endovascular aortic aneurysm repair (EVAR), with less physiologic aggression, brought a new therapeutic perspective that minimizes these problems. Our experience with renal transplantation began in 1987 and with EVAR in 2001. During this period we had the opportunity to treat aortic aneurysms in three kidney transplanted patients using EVAR. [Copyright &y& Elsevier]

An increased number of aortic aneurysms are expected to be diagnosed in chronic renal failure patients awaiting kidney transplantation because of its strong association with atherosclerosis. The development of endovascular aortic aneurysm repair in the 1990s, which is characterized by low morbidity as well as shorter operative time and length of hospital stay, is particularly suited to these patients who are at high risk for conventional surgery. Herein we describe a case of a 58-year-old, man who was diagnosed with a 5.5-cm aortic aneurysm in 2001 and treated with a Gore Excluder (WL Gore and Assoc, Flagstaff, Ariz) aorto-iliac stent-graft. In 2004, he underwent uneventful deceased donor kidney transplantation in the right iliac fossa. With a follow-up of 6 and 9 years, respectively, there is no evidence of an endoleak. The renal function remains normal. This promising new surgical technique has been the subject of only a few published cases. At our center, endovascular aortic aneurysm repair is the first-intention treatment for these patients, as long as it is possible to preserve the iliac arteries for the renal anastomoses and the anatomic conditions are suitable for stent-graft deployment. [Copyright &y& Elsevier]

The therapeutic options in otosclerosis are limited to medications (acute disease/active symptoms) as well as the rehabilitation of the hearing loss (HL).Rehabilitation can be with hearing aids (HA),stapedectomy,middle ear devices,osseointegrated implants and even with cochlear implants,depending on the HL degree. Conventional HA stimulates the hearing acoustically, with sound amplification,so there are feedback limitations,distortions,limited auditory gain,eczema of the external auditory canal,and other disadvantages. HA advantages remains on aesthetic aspects (intracanal/retroauricular, small dimensions),it does not require any surgical approach,which less morbidity. In MHL,the ideal is to combine technologies to achieve a complete improvement of hearing.Therefore, the option of middle ear/osseointegrated implants is a great solution, already well established in the world medical literature as one of the gold standard treatments for the correction of mixed/moderate hearing loss.Such devices achieve great auditory benefits in cases of MHL of mild/moderate degree,because of the power of a mechanical auditory stimulation technology.This allows them to provide a great auditory gain without sound distortion and with great sound quality.Their disadvantages lies in not being as aesthetic compared to HA,and the need for the patient to undergo surgery, which implies obvious risks. The therapeutic options in your health and health, as well as the rehabilitation of your hearing. The patient can be rehabilitated only with hearing aids, stapedectomy surgery, middle ear or osseointegrated implants and even with cochlear implants, one dependent on the degree of deafness and involvement of his hearing. It is worth mentioning that conventional hearing aids stimulate hearing in an acoustic way, with an amplification of the children, on the other with limitations of feedback, distortions, difficulty in obtaining adequate auditory gain, eczema of the external auditory canal, within other limitations. Its advantages are more aesthetic (it can be intracanal, retroauricular) and does not require any surgical surgery, which greatly reduces the risks for the patientThe therapeutic options in otosclerosis are limited to medications (when the disease is in its acute stage, with active symptoms) as well as the rehabilitation of its hearing. Materials and Methods used: To evaluate the Surgical and clinical outcomes of the Treatment for MHL in Otosclerosis with Stapedectomy & VSB.All patients receive a SP(short process) coupler of VSB/Medel and a stepedectomy (teflon prostheses/0.4 mm). Results: Five patients underwent to surgery (stapedectomy with VSB SP) for treating MHL in Otosclerosis.All patients get closed the air-bone gap wiht the stapedectomy and get normal pure tone thresholds after activation of the VSB. Excellent vocal and speech outcomes. There were no surgical or audiological complications untill now.The follow up time is 16 months. Conclusion: Stapedectomy & VSB is a good option for surgical rehabilitantion for treating MHL in Otosclerosis. [ABSTRACT FROM AUTHOR]

The objective of this study was to determine the prevalence of antimicrobial resistance (AMR) exhibited by enterococci isolated from faeces of pets and its underlying risk factors. From September 2009 to May 2012, rectal swabs were collected from 74 dogs and 17 cats, selected from the population of animals visiting the Veterinary Hospital of University of Porto, UPVet, through a systematic random procedure. Animal owners answered a questionnaire about the risk factors that could influence the presence of AMR in faecal enterococci. Enterococci isolation, identification and antimicrobial (AM) susceptibility testing were performed. Data analyses of multilevel, univariable and multivariable generalised linear mixed models were conducted. From all enterococci isolated (n=315), 61 per cent were considered multidrug-resistant, whereas only 9.2 per cent were susceptible to all AMs tested. Highest resistance was found to tetracycline (67.0 per cent), rifampicin (60.3 per cent), azithromycin (58.4 per cent), quinupristin/dalfopristin (54.0 per cent) and erythromycin (53.0 per cent). Previous fluoroquinolone treatments and coprophagic habits were the features more consistently associated with the presence of AMR for three (chloramphenicol, ciprofloxacin and azithromycin) and seven (tetracycline, rifampicin, gentamicin, chloramphenicol, ciprofloxacin, erythromycin and azithromycin), respectively, out of nine AMs assessed. Evaluating risk factors that determine the presence of drugresistant bacteria in pets, a possible source of resistance determinants to human beings, is crucial for the selection of appropriate treatment guidelines by veterinary practitioners. [ABSTRACT FROM AUTHOR]

Abstract: The classical form of late infantile neuronal ceroid lipofuscinosis (LINCL) is a childhood hereditary neurodegenerative disease usually fatal in the first decade of life. The underlying gene, CLN2, encodes the lysosomal soluble enzyme tripeptidyl-peptidase 1 (TPP1). In a Portuguese patient with juvenile form of the disease, the histochemical study revealed the presence of curvilinear inclusions typical of LINCL. In vitro TPP1 activity was deficient in patient’s cells. CLN2 gene analysis revealed the transition IVS7-10A>G (g.4196A>G) in both alleles. In silico analysis suggested that A-to-G change in the A-rich region of intron 7 could cause aberrant splicing of exon 8 by creating a novel acceptor splice site. However, because the wild-type acceptor of intron 7 is weak and it was not apparently affected, the severity of this mutation could not be established through sequencing data of gDNA. Normal level of spliced CLN2/mRNA was observed in patient’s fibroblasts. In the cDNA, the 9-nt retention of intronic sequence (c.886_887ins9) was observed. The mutation is predicted to result in a protein with three extra amino acids between proline 295 and glycine 296. In patient’s fibroblasts the level of mutant CLN2p was reduced to about 60% but the migration pattern was similar to the wild-type protein, suggesting that it was correctly targeted to the lysosomes. Taken together, these findings suggest that the first “ag” is selected for splicing and the mutant protein must retain some residual catalytic activity, thus explaining the late onset and the delayed progression of the disease. [Copyright &y& Elsevier]

Background Acne is a disease that affects almost all teenagers (60–90%), and it is the pathology exhibiting the highest morbidity in the 10–24 year-olds age group. There are no consistent data at national level by which we can evaluate the preponderance of this pathology in the Portuguese population. Objective To estimate the prevalence of acne in teenage school students (10–12 year-olds). Study design A study was carried out involving all 8 regions in the north of Portugal. One school per region was selected at random. Results As expected, the figure we obtained for the prevalence of this pathology was high (82.4%) with males being the most affected. Nevertheless, only 44% of the affected treated their acne, although the face is the part of the body most affected. In the females high androgenization (which is manifested by the presence of hair on the upper lip and on the side of the face) doubles the median of the degree of acne registered. Regional asymmetry was found in relation to information about the disorder. The degrees of acne are higher in schools in the interior. In the more rural areas, the pharmacist still plays an important role in prescribing treatment. Conclusion As a rule, individuals are correctly informed about acne, confirming that the search for treatment and awareness of its value are generally helping to gradually eliminate some of the stigmas from the past. [ABSTRACT FROM AUTHOR]

Introduction: The responses of health care and social services to an increasingly aging population emerge as a social imperative in a scenario of demographic transition. The geriatric assessment includes the physical, mental, cognitive, emotional and social functions, allowing for, a concrete understanding of the realities and a better health planning. Objectives: To assess: [a)] the use and need for health services and social support by the elderly, related with their functional status in five areas (social resources, economic resources, mental health, physical health and activities of daily living); [b)] assessment of the use of and need for the services. Aims: a) to provide information on the functional status and the use/need for services; b) improve the quality of care, adapting the training of nurses to this new social and health reality. Methods: Cross-sectional study. Randomly sample composed of individuals aged ≥75 (N≈11279; n≈1128) representative according to age and gender. Data collection using the QAFMI/OARS. Results: Innovative results should emerge in two areas: among the technicians and health policy makers. This study may represent, at a central level, a basis for the improvement of the planning of health and social policies; and, at a local level, a more inclusive planning by the health and social support entities. Conclusions: Interventions at two levels will emerge from the work suggesting: [a)] health care data provision; [b)] resources allocation definition. This allows for the social and health intervention policies, providing data which enables the coordination of the services aimed. [ABSTRACT FROM AUTHOR]

An abstract of the article "Keratinophilic Fungi: Their Environmental and Clinical Implications," by L. Rosado and colleagues is presented.