Search

Beach–dune systems are highly dynamic features of the coastal system, the evolution of which is influenced by several processes that occur at very different spatial and temporal scales. To mitigate shoreline retreat that threatens extensive coastal areas worldwide, coastal erosion mitigation measures are implemented, aiming to make coastal areas resilient to the effects induced by coastal erosion and the anticipated climate change related to storms, flood events and sea level rise. Numerical modelling can support planned and sustainable coastal management from a medium-to-long-term perspective (decades). This research focuses on presenting contributions regarding the numerical modelling of subaerial beach dynamics (berm width and dune systems interactions) from a medium-term perspective. The method applied is based on a combination of the results of two simplified numerical models (the LTC and CS-Model). The results demonstrate the potential of the proposed combined model for medium-term projections, allowing for the interpretation of beach–dune dynamics and the evaluation of the importance of longshore and cross-shore sediment transport processes. [ABSTRACT FROM AUTHOR]

Purpose: To evaluate the progression of chorioretinal atrophic areas associated with myopic choroidal neovascularization (CNV) in high myopic patients followed by a minimum period of 10 years. Patients and Methods: Patients with myopic CNV lesions that achieved clinical and structural remissions over 10 years of follow-up were included. Medical records were reviewed for CNV characterization and treatment, best-corrected visual acuity at baseline (BCVA0), immediately after the last treatment (BCVA1) and at the latest visit (BCVA2). Fundus autofluorescence (FAF) was used to quantify the amount of atrophic area increase per year associated with the treated myopic CNV lesion. The first FAF performed after treatment suspension (FAF1) was compared with the most recent exam (FAF2). Results: Thirty-six eyes from 36 patients were included. Mean total follow-up was 12.38 ± 2.68 years. Mean number of intravitreal injections (IVI) was 12.50 ± 12.40 and 25% of the eyes had previous treatment with photodynamic therapy (PDT). Mean improvement between BCVA0 and BCVA1 was 5.58 ± 15.98 letters (p < 0.001). However, a drop of 8.03 ± 12.25 letters was noticed between BCVA1 and BCVA2. FAF1 was 6.34 ± 4.92mm2 and increased to 9.88 ± 7.56mm2 (3.54 ± 3.79mm2 variation p < 0.001). The mean growth rate of the atrophic area was 0.89 ± 0.84mm2 per year. BCVA2 negatively correlated with FAF2 (k = − 0.498, p = 0.002) being worse in patients with higher atrophic area growth rate (k = − 0.341, p = 0.042). Eyes treated with PDT needed less IVI (5.89 ± 5.21 vs 14.70 ± 13.36, p = 0.008) but had larger FAF1 (9.80 ± 5.33 vs 5.19 ± 4.27, p = 0.013) and FAF2 (16.05 ± 7.10 vs 7.83 ± 6.63, p = 0.003). Hypothyroidism was associated with higher atrophy growth rate (1.55 ± 1.15 vs 0.73 ± 0.67, p = 0.016). Conclusion: This research demonstrates the importance of chorioretinal atrophy progression after myopic CNV lesions regression and its impact on visual prognosis, reporting a mean yearly growth of 0.89 mm2 in atrophic areas. Previous treatment with PDT and hypothyroidism were identified as risk factors associated with larger atrophic areas and worse visual outcomes. [ABSTRACT FROM AUTHOR]

Purpose: To report the 4-year outcomes of transepithelial accelerated corneal collagen crosslinking (TE-ACXL) in the treatment of eyes with progressive keratoconus (KC). Methods: Eyes of patients who underwent TE-ACXL (6mW/cm2 for 15 minutes) for progressive KC and presented 48 months of follow-up were included. Corrected distance visual acuity (CDVA), keratometry measurements (Kmax, maximum keratometry, Kmean, mean keratometry and Astg, corneal astigmatism), thinnest corneal thickness (PachyMin), and topographic, and tomographic indices (specifically the posterior radius of curvature from the 3.0 mm centered on the thinnest point of the cornea (PRC), and the D-index) were analysed preoperatively and every 12 months after TE-ACXL, up to 48 months. Progression after TE-ACXL was considered when eyes presented ≥ 1 criteria: (1) increase of ≥ 1D in Kmax or increase of ≥ 0.75D in Kmean or increase of ≥ 1D in Astg; (2) reduction of ≥ 0.085 mm in PRC; (3) decrease ≥ 5% in PachyMin. Results: 41 eyes from 30 patients were included, with a mean age at crosslinking of 20.90± 4.69 years. There was a significant increase in Kmean (+0.64± 1.04 D, p< 0.001; +0.98 ± 1.49 D, p< 0.001; +1.27± 2.01 D, p< 0.001; +1.13± 2.00 D, p=0.006) and a significant decrease in PRC throughout follow-up (− 0.12± 0.22, p=0.002; − 0.15± 0.24, p< 0.001; − 0.17± 0.43, p=0.021; − 0.16± 0.43, p=0.027). PachyMin decreased significantly at 36 and 48 months (− 8.50± 15.93 μm, p=0.004; − 7.82± 18.37, p=0.033). According to our progression criteria, there was a major progression rate throughout follow-up (57.1%, 61.1%, 58.8%, and 67.9%, respectively). Surgery and follow-up were uneventful in all subjects. Eleven eyes (26.8%) required further procedures, ≥ 36 months after the initial TE-ACXL, due to persistent progressive disease. Conclusion: TE-ACXL proved to be a safe therapeutic option for progressive KC. However, its efficacy is deemed unsatisfactory, as a notable proportion of affected eyes may continue to advance within a 4-year timeframe, necessitating additional procedures to halt the disease's course. [ABSTRACT FROM AUTHOR]

Purpose: To evaluate whether repeated intravitreal injections (IVI) with an anti-vascular endothelial growth factor (anti-VEGF) agent are associated with glaucomatous progression in eyes with glaucoma spectrum diseases (GSD).Methods: Single-center, retrospective, longitudinal study of patients with bilateral and similar GSD who: (1) received ≥ 8 IVI in only one eye during the study period; (2) had ≥ 2 retinal nerve fiber layer thickness (RNFL) measurements obtained by spectral-domain optical coherence tomography (SD-OCT) at least 12 months apart. The primary outcome was the absolute RNFL thickness change, comparing injected and fellow uninjected eyes. Linear mixed effects models were constructed, including a multivariable model.Results: Sixty-eight eyes from 34 patients were included, 34 injected and 34 fellow uninjected eyes. Average baseline age was 67.68± 21.77 years with a follow-up of 3.66± 1.89 years and 25.12± 14.49 IVI. RNFL thickness decreased significantly from 80.92± 15.78 to 77.20± 17.35 μm (p< 0.001; − 1.18± 1.93 μm/year) in injected eyes and from 79.95± 17.91 to 76.61± 17.97 μm (p< 0.001; − 1.07± 0.98 μm/year) in uninjected eyes. In a multivariable linear mixed model of injected eyes, only higher baseline RNFL thickness (p < 0.001) significantly predicted higher absolute RNFL thickness loss. Neither absolute RNFL thickness variation (p=0.716) nor RNFL rate (p=0.779) was significantly different between paired injected and uninjected eyes. Absolute IOP variation was not significantly different between groups (16.62± 4.77 to 15.09± 4.34 mmHg in injected eyes and 17.68± 5.01 to 14.50± 3.39 mmHg in fellow uninjected eyes; p=0.248). The proportion of eyes receiving glaucoma medical treatment increased significantly in both groups (55.9% to 76.5% in injected eyes; p=0.039; 58.8% to 76.5% in uninjected eyes; p = 0.031). The number of glaucoma medications also increased significantly in both groups (1.03± 1.11 to 1.59± 1.18 glaucoma medications in injected eyes; p=0.003; 1.09± 1.11 to 1.56± 1.19 glaucoma medications in uninjected eyes; p=0.003).Conclusion: Repeated IVI do not seem to accelerate glaucomatous progression. Future studies with a longer follow-up are needed. [ABSTRACT FROM AUTHOR]

The artificial sand bypassing systems are coastal interventions designed to transfer sediments from areas of accretion to areas where erosion is observed. The goal of these systems is to reduce the littoral drift gradients where sediment transport is interrupted (vicinity of river mouths or port structures) and maintain a balanced sediment distribution along the shoreline. However, these systems present high initial investment costs as well as ongoing expenses for operation and maintenance. To assess the feasibility of sand bypassing systems in mitigating coastal erosion from a long-term perspective (decades), a comprehensive understanding of their performance is necessary, considering both physical and economic aspects. Thus, a cost–benefit assessment numerical tool, COAST, is applied to evaluate and discuss the effectiveness of bypassing systems during their life cycle. First, a comprehensive analysis is conducted for a generic study area, and then, the feasibility of the systems is discussed for two real study areas of the Portuguese West coast (Barra-Vagueira and Figueira da Foz-Leirosa). The generic results demonstrate as the importance of systems location or transposed flow volumes. On the other hand, the analysis of the two real case studies revealed that, under similar conditions, the results of the cost–benefit analysis can be contradictory. For the Barra-Vagueira stretch, the work indicates that the bypass system is not economically viable, whereas for Figueira da Foz-Leirosa, it is cost-effective. The study shows the importance of the site-specific conditions to evaluate the best option for a medium to long-term planned coast, highlighting the relevance of the proposed approach to assess the physical and economic feasibility of sand bypassing systems. [ABSTRACT FROM AUTHOR]

We present a series of new open-source deep-learning algorithms to accelerate Bayesian full-waveform point source inversion of microseismic events. Inferring the joint posterior probability distribution of moment tensor components and source location is key for rigorous uncertainty quantification. However, the inference process requires forward modelling of microseismic traces for each set of parameters explored by the sampling algorithm, which makes the inference very computationally intensive. In this paper we focus on accelerating this process by training deep-learning models to learn the mapping between source location and seismic traces for a given 3D heterogeneous velocity model and a fixed isotropic moment tensor for the sources. These trained emulators replace the expensive solution of the elastic wave equation in the inference process. We compare our results with a previous study that used emulators based on Gaussian processes to invert microseismic events. For fairness of comparison, we train our emulators on the same microseismic traces and using the same geophysical setting. We show that all of our models provide more accurate predictions, ∼ 100 times faster predictions than the method based on Gaussian processes, and a O(105) speed-up factor over a pseudo-spectral method for waveform generation. For example, a 2 s long synthetic trace can be generated in ∼ 10 ms on a common laptop processor, instead of ∼ 1 h using a pseudo-spectral method on a high-profile graphics processing unit card. We also show that our inference results are in excellent agreement with those obtained from traditional location methods based on travel time estimates. The speed, accuracy, and scalability of our open-source deep-learning models pave the way for extensions of these emulators to generic source mechanisms and application to joint Bayesian inversion of moment tensor components and source location using full waveforms. [ABSTRACT FROM AUTHOR]

This document is a response to a letter regarding the potential damaging effects of repeated intravitreal anti-VEGF injections on glaucoma progression. The authors of the response state that previous studies on this topic have presented conflicting results and questionable methodologies. In their own study, they compared the rate of retinal nerve fiber layer (RNFL) thickness change in regularly injected eyes with their fellow uninjected eyes, finding no significant differences between the two groups. However, both groups did experience a significant thinning of the RNFL over time, indicating the need for regular monitoring and early intervention. The authors suggest that future studies with larger sample sizes and longer follow-ups are necessary. [Extracted from the article]

We present a series of new open source deep learning algorithms to accelerate Bayesian full waveform point source inversion of microseismic events. Inferring the joint posterior probability distribution of moment tensor components and source location is key for rigorous uncertainty quantification. However, the inference process requires forward modelling of micro-seismic traces for each set of parameters explored by the sampling algorithm, which makes the inference very computationally intensive. In this paper we focus on accelerating this process by training deep learning models to learn the mapping between source location and seismic traces, for a given 3D heterogeneous velocity model, and a fixed isotropic moment tensor for the sources. These trained emulators replace the expensive solution of the elastic wave equation in the inference process. We compare our results with a previous study that used emulators based on Gaussian Processes to invert microseismic events. For fairness of comparison, we train our emulators on the same microseismic traces and using the same geophysical setting. We show that all of our models provide more accurate predictions and ~100 times faster predictions than the method based on Gaussian Processes, and a O(105) speed-up factor over a pseudo-spectral method for waveform generation. For example, a 2-s long synthetic trace can be generated in ~10 ms on a common laptop processor, instead of ~1 hr using a pseudo-spectral method on a high-profile Graphics Processing Units card. We also show that our inference results are in excellent agreement with those obtained from traditional location methods based on travel time estimates. The speed, accuracy and scalability of our open source deep learning models pave the way for extensions of these emulators to generic source mechanisms and application to joint Bayesian inversion of moment tensor components and source location using full waveforms. [ABSTRACT FROM AUTHOR]

INTRODUCTION: The ECAS (Entrepreneurial Cultural Affinity Spaces) framework seeks to transform social design theory and practice, through an emergent instructional paradigm of heritage-led, local learning ecosystem approaches, to leverage on diverse assets of people in community settings. OBJECTIVES: This paper addresses the theoretical backdrop of how such ecosystems can be co-designed, implemented, and evaluated, to include disadvantaged and underrepresented groups. METHODS: We seek to introduce the ECAS framework and how it can present an inclusive and open instructional paradigm that improves design for social change, innovation, and entrepreneurship in practice. RESULTS: In this paper, we address implementation through an Erasmus Plus, Adult Education research project, discussing the framework, conditions, and support mechanisms developed. CONCLUSION: Reconfiguration of design for social change and our collective mind-set, will create the conditions for more dynamic and powerful collaborations that stimulate and enable social innovation, entrepreneurship and inclusion. [ABSTRACT FROM AUTHOR]

Cowden syndrome (CS) is a rare dominantly inheritedmultisystemdisorder, characterized by an extraordinarymalignant potential. In 80% of cases, the human tumor suppressor gene phosphatase and tensin homolog (PTEN) is mutated. We present a case of a 17-year-old boy with genetically confirmed CS and Graves' disease (GD). At the age of 15, he presented with intention tremor, palpitations, andmarked anxiety. On examination, he hadmacrocephaly, coarse facies, slight prognathism, facial trichilemmomas, abdominal keratoses, leg hemangioma, and a diffusely enlarged thyroid gland. He started antithyroid drug (ATD) therapy with methimazole and, after a 2-year treatment period without achieving a remission status, a total thyroidectomy was performed. Diagnosis and management of CS should be multi disciplinary. Thyroid disease is frequent, but its management has yet to be fully defined. The authors present a case report of a pediatric patient with CS and GD and discuss treatment options. [ABSTRACT FROM AUTHOR]

Background. Ulcerative colitis (UC) is associated with an increased risk of colorectal cancer (CRC). Aberrant crypt foci (ACF) are important biomarkers of sporadic CRC risk. Their correlation with the risk of intraepithelial neoplasia (IN) in UC remains unclear. Aims. To assess whether ACF are a risk factor for IN in long-standing UC and to investigate any correlation between the clinico-epidemiological characteristics and prevalence/number of ACF in these patients. Methods. Seventy-six patients with long-standing UC were prospectively screened by colonoscopy with chromoendoscopy-guided endomicroscopy. ACF were sought in the lower rectum. Results. Eight INs were detected in seven (9.2%) patients. The ACF prevalence and mean number were 60.5% and 2.4 ± 2.8, respectively. The number of ACF was independently associated with the risk of having IN (odds ratio = 1.338; 95% confidence interval 1.030-1.738). ACF number revealed a good calibration (area under the receiver operating characteristic curve = 0.829) and discriminative ability ( p = 0.205, Hosmer-Lemeshow test) for the prediction of synchronous IN. Patients with ≥3 ACF have a significantly higher prevalence of IN than patients with <3 ACF (22.6% vs. 0%, p = 0.001). Using this cut-off value, the performance of ACF in predicting the presence of IN was as follows: sensitivity = 100%, specificity = 65.2%, positive predictive value = 22.6%, and negative predictive value = 100%. Age >40 years, family history of CRC, and increased body mass index (BMI) were associated with a significantly higher number of ACF. Conclusion. Long-standing UC patients with ≥3 ACF have a significantly higher likelihood of having IN. Age >40 years, family history of CRC, and increased BMI have significant positive associations with the number of ACF. [ABSTRACT FROM AUTHOR]

Background: Audit Trails (AT) are fundamental to information security in order to guarantee access traceability but can also be used to improve Health information System's (HIS) quality namely to assess how they are used or misused. This paper aims at analysing the existence and quality of AT, describing scenarios in hospitals and making some recommendations to improve the quality of information. Methods: The responsibles of HIS for eight Portuguese hospitals were contacted in order to arrange an interview about the importance of AT and to collect audit trail data from their HIS. Five institutions agreed to participate in this study; four of them accepted to be interviewed, and four sent AT data. The interviews were performed in 2011 and audit trail data sent in 2011 and 2012. Each AT was evaluated and compared in relation to data quality standards, namely for completeness, comprehensibility, traceability among others. Only one of the AT had enough information for us to apply a consistency evaluation by modelling user behaviour. Results: The interviewees in these hospitals only knew a few AT (average of 1 AT per hospital in an estimate of 21 existing HIS), although they all recognize some advantages of analysing AT. Four hospitals sent a total of 7 AT - 2 from Radiology Information System (RIS), 2 from Picture Archiving and Communication System (PACS), 3 from Patient Records. Three of the AT were understandable and three of the AT were complete. The AT from the patient records are better structured and more complete than the RIS/PACS. Conclusions: Existing AT do not have enough quality to guarantee traceability or be used in HIS improvement. Its quality reflects the importance given to them by the CIO of healthcare institutions. Existing standards (e.g. ASTM: E2147, ISO/TS 18308:2004, ISO/IEC 27001:2006) are still not broadly used in Portugal. [ABSTRACT FROM AUTHOR]

Background: Propolis is a resin collected by bees from plant buds and exudates, which is further processed through the activity of bee enzymes. Propolis has been shown to possess many biological and pharmacological properties, such as antimicrobial, antioxidant, immunostimulant and antitumor activities. Due to this bioactivity profile, this resin can become an alternative, economic and safe source of natural bioactive compounds. Antitumor action has been reported in vitro and in vivo for propolis extracts or its isolated compounds; however, Portuguese propolis has been little explored. The aim of this work was to evaluate the in vitro antitumor activity of Portuguese propolis on the human colon carcinoma cell line HCT-15, assessing the effect of different fractions (hexane, chloroform and ethanol residual) of a propolis ethanol extract on cell viability, proliferation, metabolism and death. Methods: Propolis from Angra do Heroísmo (Azores) was extracted with ethanol and sequentially fractionated in solvents with increasing polarity, n-hexane and chloroform. To assess cell viability, cell proliferation and cell death, Sulforhodamine B, BrDU incorporation assay and Anexin V/Propidium iodide were used, respectively. Glycolytic metabolism was estimated using specific kits. Results: All propolis samples exhibited a cytotoxic effect against tumor cells, in a dose- and time-dependent way. Chloroform fraction, the most enriched in phenolic compounds, appears to be the most active, both in terms of inhibition of viability and cell death. Data also show that this cytotoxicity involves disturbance in tumor cell glycolytic metabolism, seen by a decrease in glucose consumption and lactate production. Conclusion: Our results show that Portuguese propolis from Angra do Heroísmo (Azores) can be a potential therapeutic agent against human colorectal cancer. [ABSTRACT FROM AUTHOR]

Serious erosion problems related to significant negative sediments budgets in the coastal systems are referred worldwide. Artificial nourishments are a coastal erosion mitigation strategy that allow for a decrease in those negative budgets by adding sediment to the coastal system. Thus, it is essential to understand and adequately model the shoreline response after a nourishment operation, in order to support the definition of the best intervention scenarios. The main goal of this work was to study the artificial nourishment effects on the longshore sediment transport and consequently on the morphological evolution at the intervention site and nearby areas, in a time horizon of 5 years. The longshore transport of the nourished sediments was evaluated, aiming to contribute to the evaluation of the sediment's permanence at the deposition site and the frequency required for new nourishments. The shoreline evolution numerical long-term configuration (LTC) model was applied in order to evaluate the spatial and temporal distribution of the nourished sediments along the coast, considering different types of beaches and incident wave climates. The adopted approach is generic and supported by simple numerical models, which can be useful for preliminary site-specific evaluations. The results show that the nourishment impact is mainly observed nearby the intervention site. It is highlighted that higher longshore sediment transport rates are associated with more energetic wave climates, but not necessarily with incident waves more oblique to the shoreline. [ABSTRACT FROM AUTHOR]

Background: Audit Trails (AT) are fundamental to information security in order to guarantee access traceability but can also be used to improve Health information System's (HIS) quality namely to assess how they are used or misused. This paper aims at analysing the existence and quality of AT, describing scenarios in hospitals and making some recommendations to improve the quality of information.Methods: The responsibles of HIS for eight Portuguese hospitals were contacted in order to arrange an interview about the importance of AT and to collect audit trail data from their HIS. Five institutions agreed to participate in this study; four of them accepted to be interviewed, and four sent AT data. The interviews were performed in 2011 and audit trail data sent in 2011 and 2012. Each AT was evaluated and compared in relation to data quality standards, namely for completeness, comprehensibility, traceability among others. Only one of the AT had enough information for us to apply a consistency evaluation by modelling user behaviour.Results: The interviewees in these hospitals only knew a few AT (average of 1 AT per hospital in an estimate of 21 existing HIS), although they all recognize some advantages of analysing AT. Four hospitals sent a total of 7 AT - 2 from Radiology Information System (RIS), 2 from Picture Archiving and Communication System (PACS), 3 from Patient Records. Three of the AT were understandable and three of the AT were complete. The AT from the patient records are better structured and more complete than the RIS/PACS.Conclusions: Existing AT do not have enough quality to guarantee traceability or be used in HIS improvement. Its quality reflects the importance given to them by the CIO of healthcare institutions. Existing standards (e.g. ASTM:E2147, ISO/TS 18308:2004, ISO/IEC 27001:2006) are still not broadly used in Portugal. [ABSTRACT FROM AUTHOR]