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As lithium-bearing minerals become critical raw materials for the field of energy storage and advanced technologies, the development of tools to accurately identify and differentiate these minerals is becoming essential for efficient resource exploration, mining, and processing. Conventional methods for identifying ore minerals often depend on the subjective observation skills of experts, which can lead to errors, or on expensive and time-consuming techniques such as Inductively Coupled Plasma Mass Spectrometry (ICP-MS) or Optical Emission Spectroscopy (ICP-OES). More recently, Raman Spectroscopy (RS) has emerged as a powerful tool for characterizing and identifying minerals due to its ability to provide detailed molecular information. This technique excels in scenarios where minerals have similar elemental content, such as petalite and spodumene, by offering distinct vibrational information that allows for clear differentiation between such minerals. Considering this case study and its particular relevance to the lithium-mining industry, this manuscript reports the development of an unsupervised methodology for lithium-mineral identification based on Raman Imaging. The deployed machine-learning solution provides accurate and interpretable results using the specific bands expected for each mineral. Furthermore, its robustness is tested with additional blind samples, providing insights into the unique spectral signatures and analytical features that enable reliable mineral identification.

Objectives: Chronic dyspnea, a distressing symptom in patients with complex chronic conditions, is linked to higher risks of mortality. This study aimed to identify nursing interventions that could improve self-management for complex chronic patients, thereby enhancing control over chronic dyspnea. The findings intend to guide nursing care strategies that promote self-management among this population. Methods: We searched the databases Medline, Scopus, Web of Science, CINAHL, Cochrane Database of Systematic Reviews (CDSR), and Joanna Briggs Institute (JBI) databases were searched in December 2023. We included adult patients with complex chronic conditions with chronic dyspnoea. The team screened articles collaboratively, using Rayyan software. A qualitative appraisal was performed according to JBI Critical Appraisal Checklist tools. The review protocol is registered under the number CRD42023456021. Results: Our review included 18 studies that explored a variety of interventions for chronic dyspnea. We identified pharmacological interventions (such as oxygen therapy and inhalation treatments) and non-pharmacological approaches (including educational programs, breathing exercises, fluid intake management, body awareness techniques, peer support, emotional intelligence training, and the use of web applications). Those interventions empower patients, improve their ability to fulfill life roles, mitigate emotional distress, and improve overall quality of life. Nursing care can be crucial in enabling individuals to achieve independence and autonomy in self-care. Conclusions: Promoting self-management for chronic dyspnea in complex chronic patients requires a holistic approach, encompassing multidisciplinary interventions, individualized self-care education, peer engagement, and technological support. Current research on self-management inadequately addresses interventions targeting patient behaviour change. It highlights the need to delve deeper into the self-management process. Further research is needed to expand the evidence base and refine these interventions.

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Firefighters’ occupational activity causes cancer, and the characterization of exposure during firefighting activities remains limited. This work characterizes, for the first time, firefighters’ exposure to (coarse/fine/ultrafine) particulate matter (PM) bound polycyclic aromatic hydrocarbons (PAHs) and metal(loid)s during prescribed fires, Fire 1 and Fire 2 (210 min). An impactor collected 14 PM fractions, the PM levels were determined by gravimetry, and the PM-bound PAHs and metal(loid)s were determined by chromatographic and spectroscopic methodologies, respectively. Firefighters were exposed to a total PM level of 1408.3 and 342.5 µg/m3 in Fire 1 and Fire 2, respectively; fine/ultrafine PM represented more than 90% of total PM. Total PM-bound PAHs (3260.2 ng/m3 in Fire 1; 412.1 ng/m3 in Fire 2) and metal(loid)s (660.8 ng/m3 versus 262.2 ng/m3), distributed between fine/ultrafine PM, contained 4.57–24.5% and 11.7–12.6% of (possible/probable) carcinogenic PAHs and metal(loid)s, respectively. Firefighters’ exposure to PM, PAHs, and metal(loid)s were below available occupational limits. The estimated carcinogenic risks associated with the inhalation of PM-bound PAHs (3.78 × 10−9 − 1.74 × 10−6) and metal(loid)s (1.50 × 10−2 − 2.37 × 10−2) were, respectively, below and 150–237 times higher than the acceptable risk level defined by the USEPA during 210 min of firefighting activity and assuming a 40-year career as a firefighter. Additional studies need to (1) explore exposure to (coarse/fine/ultrafine) PM, (2) assess health risks, (3) identify intervention needs, and (4) support regulatory agencies recommending mitigation procedures to reduce the impact of fire effluents on firefighters.

The Muscleblind-like (MBNL) family is a highly conserved set of RNA-binding proteins (RBPs) that regulate RNA metabolism during the differentiation of various animal tissues. Functional insufficiency of MBNL affects muscle and central nervous system development, and contributes to the myotonic dystrophies (DM), a set of incurable multisystemic disorders. Studies on the regulation of MBNL genes are essential to provide insight into the gene regulatory networks controlled by MBNL proteins and to understand how dysregulation within these networks causes disease. In this study, we demonstrate the evolutionary conservation of an autoregulatory mechanism that governs the function of MBNL proteins by generating two distinct protein isoform types through alternative splicing. Our aim was to further our understanding of the regulatory principles that underlie this conserved feedback loop in a whole-organismal context, and to address the biological significance of the respective isoforms. Using an alternative splicing reporter, our studies show that, during development of the Caenorhabditis elegans central nervous system, the orthologous mbl-1 gene shifts production from long protein isoforms that localize to the nucleus to short isoforms that also localize to the cytoplasm. Using isoform-specific CRISPR/Cas9-generated strains, we showed that expression of short MBL-1 protein isoforms is required for healthy neuromuscular function and neurodevelopment, while expression of long MBL-1 protein isoforms is dispensable, emphasizing a key role for cytoplasmic functionalities of the MBL-1 protein. Furthermore, RNA-seq and lifespan analyses indicated that short MBL-1 isoforms are crucial regulators of miRNA expression and, in consequence, required for normal lifespan. In conclusion, this study provides support for the disruption of cytoplasmic RNA metabolism as a contributor in myotonic dystrophy and paves the way for further exploration of miRNA regulation through MBNL proteins during development and in disease models.

Background: The world’s population changed with the emergence of the SARS-CoV-2 pandemic. Burnout arises due to overwork, prolonged work periods, a lack of human and material resources, etc. Several studies have reported the incidence of burnout syndrome in nurses that work in intensive care units (ICUs). The aim was to map the scientific evidence related to nurses’ burnout in the ICU, namely the repercussions of SARS-CoV-2 in terms of burnout among nurses. Methods: A scoping review followed the Joanna Briggs Institute methodology guidelines to search for and synthesise studies published between 2019 and 2022. The databases searched were MEDLINE, CINAHL, LILACS, SCOPUS, PsycINFO and OPEN GREY. A total of fourteen articles were eligible to be included. Results: A content analysis of the selected articles was carried out, and three categories emerged that corresponded to the dimensions of burnout according to Maslach and Leiter: emotional exhaustion, depersonalisation dimension and a lack of personal accomplishment. It was evident that nurses who worked in the ICU during the pandemic showed high levels of burnout. Conclusions: It is recommended that hospital administrations hire health professionals, namely nurses, as a strategic and operational management strategy to reduce the risk of increased burnout during pandemic outbreaks.

Background: The SARS-CoV-2 pandemic has brought multiple challenges for health institutions and their professionals. The requirement of this disease forced nurses to confront organizational and clinical challenges to maintain the quality standards of care they provide. These requirements may have contributed to increased burnout symptoms. This study aims to map the scientific evidence related to nurses’ burnout in intensive care units. Methods: A scoping review will be conducted according to the Joanna Briggs Institute methodology. Relevant databases will be used as well as grey literature, where the following words will be used: burnout, nurses, intensive care units and SARS-CoV-2. Results: This scoping review will include all types of studies—quantitative, qualitative and mixed—and all types of reviews that focus on the objective of this review. Conclusions: It is vital to determine the impact of the burnout caused by the pandemic of SARS-CoV-2 to assess amending measures of risk and protection factors. This will help in the implementation of guidelines according to the available evidence. Additionally, this will help to improve the skills of these professionals as well as to reduce their emotional and physical exhaustion. This protocol is registered with the Open Science Framework.

Mental health is on the agenda, especially in times of pandemic due to the COVID-19 virus. Nowadays, psychological problems, such as anxiety and depression, have been more discussed and have become even more critical during confinement. This paper proposes the development process of an innovative product whose active ingredient - ellagic acid, extracted from the chestnut shell - has anxiolytic properties and can be potentially used in consumers' daily lives, preventing this type of illness. The product presented, Do Nut Stress – Acid ellagic enriched pancakes for anxiety control, consists of a pancake powder, considered a healthy and nutritious meal.

Enquadramento: O cancro representa uma experiência dramática na vida de qualquer pessoa, perturbando a sua homeostasia. Dado o envelhecimento da população e a sobrevivência mais prolongada destes doentes, é essencial melhorar a sua qualidade de vida. Objetivo: Desenvolver e implementar um modelo de acompanhamento em enfermagem centrado nas vulnerabilidades dos doentes com cancro da próstata, a fim de melhorar a sua qualidade de vida. Metodologia: Estudo piloto realizado através da aplicação das escalas QLQ-INFO25 e HADS e de uma entrevista, na consulta de ambulatório de um hospital privado, a seis doentes com cancro da próstata. Resultados: Alterações nas dimensões da qualidade de vida relacionada com a saúde. A implementação do modelo de acompanhamento permitiu concluir que "educação em saúde, autoconfiança e atitude "são aspetos essenciais no trabalho dos enfermeiros com estes doentes. O trabalho direcionado às vulnerabilidades dos doentes melhorou a sua qualidade de vida. Conclusão: O modelo contribui para a promoção da saúde e do bem-estar, prevenção de complicações e aumento da satisfação. O trabalho individualizado da equipa melhora a qualidade de vida destes doentes.

Introdução: As infecções associadas aos cuidados de saúde apresentam custos elevados e aumento da taxa de mortalidade, reduzindo a qualidade de vida das pessoas. Objetivo: Mapear os fatores que influenciam a adesão às precauções padrão entre/pelos enfermeiros. Métodos: Recorrer-se-á à metodologia de Joanna Briggs Institute. A pesquisa considerou os critérios definidos e adaptados às bases de dados incluídas na identificação de estudos relevantes. As bases de dados consultadas CINAHL® Plus with Full Text e Nursing & Allied Health Collection via EBSCO, MEDLINE® via PubMed. Proceder-se-á à análise dos artigos pelo título e resumo eliminando os que não cumpram os critérios definidos. Os dados serão extraídos por dois revisores independentes. Os critérios de inclusão serão os estudos redigidos em português, inglês e espanhol publicados nos últimos cinco anos e extraídos para a plataforma Rayyan QCRIÒ. Dois revisores independentes irão proceder à análise de relevância dos artigos, extração e síntese dos dados, com elaboração do respetivo fluxograma. Resultados: O mapeamento das evidências permitirá analisar e conhecer os fatores que influenciam a adesão às precauções padrão entre/pelos enfermeiros. Os resultados serão apresentados com recurso a uma tabela de evidências segundo os objetivos. Conclusão: Prevê-se que esta revisão constitua um ponto de partida para a análise crítica dos estudos relativos aos fatores que influenciam o conhecimento na adesão às precauções padrão dos enfermeiros, contribuindo para otimizar a prática e promover a investigação e disseminação do conhecimento.

Alterations in cis-regulatory elements (CREs) can contribute to pancreatic diseases. Here the authors combine chromatin profiling and interaction points with in vivo reporter assays in zebrafish to uncover functionally equivalent human CREs, helping to predict disease-relevant enhancers.

The present study investigates how adult native speakers of two null subject Romance languages, European Portuguese (EP) and Italian, interpret null and overt pronominal subjects in intrasentential contexts. Participants were 30 speakers of EP and 30 of Italian. Each language group was administered two multiple-choice tasks (speeded and untimed), which crossed the following variables: ‘animacy of the matrix object’ ([+ human] vs. [- human]) and ‘type of pronominal embedded subject’ (overt vs. null). Our results show that there is microvariation in the resolution of overt pronominal subjects in EP and in Italian: the position of the antecedent is the most relevant factor in EP, whereas, in Italian, the animacy of the antecedent is the preponderant factor. Moreover, our results reveal that the resolution of null subjects is an area of microvariation: the bias for subject antecedents is weaker in Italian than in EP. Possible reasons for the observed microvariation are discussed in detail.

A retrospective study was conducted to analyze prescription pattern of clozapine in dual diagnosis inpatients' and to find out if there was any association between clozapine prescription and acute relapses either from psychiatric symptoms or from substance use disorder. All patients admitted at Lisbon's Psychiatric Hospital Center during a 4 months' period for psychiatric inpatient treatment with a dual diagnosis at discharge were selected and their clinical files were screened. From 536 patients, 17,5% had a dual diagnosis at discharge. Most frequent psychiatric diagnosis associated with substance use disorder was schizophrenia (50%), followed by major depression disorder (17%) and bipolar disorder (10,6%). Most frequent substance of abuse was alcohol, followed by cannabinoids, nicotine, cocaine, and opiates. At least one antipsychotic drug was prescribed to 85,1% patients, and clozapine was prescribed to 22,3%. There was a statistically significant association between clozapine prescription and prevention of acute relapses of psychiatric symptoms in dual diagnosis patients. Although there was no significant association between prescription of clozapine versus other antipsychotic drugs in the prevention of relapses of substance use, there was a larger than expected number of patients in clozapine that didn't have a relapse of substance use.

A motivação do doente tem conhecidas implicações no seu processo de adesão ao projeto terapêutico. Na prática clínica, a parca motivação do utente dificulta a sua proatividade. Consequentemente, interfere negativamente com o cumprimento da medicação ou a adoção de estilos de vida saudáveis, prejudicando a abordagem de diversas patologias, sobretudo das crónicas. De um modo geral, os estudos revelam que a motivação do utente é um conceito largamente utilizado pelos profissionais de saúde, embora com uma definição imprecisa. Maioritariamente é encarada como um traço caracterial, que se traduz na dicotomia entre doente motivado/doente desmotivado, com um enviesamento para a segunda categorização. Esta perspetiva deposita apenas do lado do doente a capacidade da mudança, com consequências negativas para ambos os intervenientes da relação médico-doente. Porém, desde a publicação do Modelo da Entrevista Motivacional (EM), na década de 1980, têm sido documentadas técnicas específicas para aceder ao estado motivacional dos doentes, com vista à sua modificação. Tradicionalmente aplicados às perturbações de uso de substâncias, estes modelos têm mostrado benefício em diversos programas reabilitativos de doenças crónicas. O entendimento do estado motivacional do utente enquanto percurso dinâmico, permeável à modificação externa e passível de modelação por parte do profissional de saúde, aliado ao treino de competências nesta área, poderá melhorar prognósticos, aumentar a satisfação do utente e do profissional e reduzir gastos financeiros nos sistemas de saúde.

Summary: Nucleotide repeat expansions are a hallmark of over 40 neurodegenerative diseases and cause RNA toxicity and multisystemic symptoms that worsen with age. Through an unclear mechanism, RNA toxicity can trigger severe disease manifestation in infants if the repeats are inherited from their mother. Here we use Caenorhabditis elegans bearing expanded CUG repeats to show that this asymmetric intergenerational inheritance of toxicity contributes to disease pathogenesis. In addition, we show that this mechanism is dependent on small RNA pathways with maternal repeat-derived small RNAs causing transcriptomic changes in the offspring, reduced motility, and shortened lifespan. We rescued the toxicity phenotypes in the offspring by perturbing the RNAi machinery in the affected hermaphrodites. This points to a novel mechanism linking maternal bias and the RNAi machinery and suggests that toxic RNA is transmitted to offspring, causing disease phenotypes through intergenerational epigenetic inheritance.

Introdução: Quando os consumidores excessivos crónicos de álcool, particularmente os indivíduos com o diagnóstico de perturbação de uso de álcool, suspendem abruptamente o consumo de bebidas alcoólicas, pode surgir um quadro clínico denominado síndrome de abstinência alcoólica. Nestes casos, é necessário muitas vezes instituir tratamento farmacológico para aliviar os sintomas e prevenir as complicações da abstinência. O tratamento farmacológico da síndrome de abstinência alcoólica é utilizado em unidades especializadas no tratamento de perturbação de uso de álcool, mas também pode ser necessário em serviços médico-cirúrgicos, quando esta síndrome se manifesta em doentes com perturbação de uso de álcool internados por patologias orgânicas. Métodos: Revisão de guidelines disponíveis na literatura sobre tratamento da síndrome de abstinência alcoólica com o objetivo de determinar qual o tratamento farmacológico recomendado. Resultados: Foram analisadas as quatro guidelines sobre tratamento farmacológico da síndrome de abstinência alcoólica (National Institute for Health and Care Excellence, American Society of Addiction Medicine, World Federation of Societies of Biological Psychiatry e American Psychiatric Association), em relação às suas recomendações e evidência da eficácia dos fármacos para tratamento da síndrome de abstinência alcoólica. Esta análise foi ainda complementada pela consulta das guidelines de Maudsley. Discussão: As guidelines analisadas recomendam, como tratamento de primeira linha, o uso de benzodiazepinas. A associação de anticonvulsivantes, agonistas adrenérgicos alfa-2, betabloqueantes e antipsicóticos com benzodiazepinas está recomendada para controlo sintomático em quadros de privação mais exuberantes. É recomendado administrar tiamina para profilaxia da encefalopatia de Wernicke-Korsakoff a todos os doentes. Caso existam desequilíbrios hidroelectrolíticos, estes deverão ser corrigidos. Conclusão: É fundamental manter um nível elevado de suspeita para o eventual aparecimento da síndrome de abstinência alcoólica em todos os contextos clínicos. Nesses casos, importa saber intervir precocemente.

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Introdução: A prevalência da obesidade na infância tem implicações futuras na saúde e a televisão tem sido citada como um fator contribuinte, seja por incentivar o consumo de alimentos calóricos ou por conduzir ao sedentarismo. O estatuto socioeconómico dos encarregados de educação tem sido apontado como um determinante do comportamento alimentar, influenciando a prevalência do excesso de peso infantil. Objetivo: Analisar o impacto da exposição televisiva e das características sociodemográficas no Índice de Massa Corporal (IMC) infantil. Material e métodos: Estudo quantitativo, transversal e analítico, realizado numa amostra de 208 crianças, com uma média de idades de 7,99 ± 1,33. Foi aplicado um questionário adaptado de Vicente-Rodriguez et al (2011), e foi realizada uma avaliação antropométrica a todas as crianças. Resultados: Constatou-se que 57,3% das crianças visualizam televisão todos os dias e que 65,9% não possuem aparelho televisivo nos quartos. Observou-se uma correlação estatisticamente significativa entre o rendimento familiar e as horas de exposição televisiva à semana, no género masculino (p=0,018); entre o nível de instrução do encarregado de educação e o IMC, em ambos os géneros (p=0,043 no género masculino; e p=0,009 no género feminino); e entre o IMC e o número de elementos do agregado familiar, no género masculino (p=0,001). Conclusão: Nesta amostra de crianças, não houve correlações significativas entre o IMC e os dias ou horas de visualização televisiva, contudo, é necessário o estímulo de atividades que promovam um estilo de vida ativo, tendo em conta que a prevalência da obesidade infantil é elevada, na maioria dos países desenvolvidos. Observou-se uma relação estatisticamente significativa entre as características sociodemográficas e o IMC, comprovando que são determinantes na saúde infantil.

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Introdução: A doença degenerativa cervical é uma condição relacionada com a idade, apresentando sinais e/ou sintomas numa minoria dos casos. Este relato de caso tem como objetivo alertar para a importância em reconhecer a Mielopatia Espondilótica Cervical como um diagnóstico diferencial perante quadros arrastados de diminuição progressiva da força muscular dos membros inferiores e alterações do padrão da marcha. Descrição do caso: Paciente do sexo masculino, 64 anos, observado em consulta programada por um quadro de alteração do padrão habitual da marcha com cerca de 3 anos de evolução. Ao exame físico, apresentava marcha de base alargada e sinais compatíveis com atingimento do neurónio motor superior: paraparésia espástica com hiperreflexia dos membros inferiores e sinal de Babinski positivo bilateralmente. Do estudo efetuado, destacou-se a presença de alterações degenerativas espondilodiscais da coluna cervical com compromisso medular, evidenciando a presença de um quadro de Mielopatia Espondilótica Cervical. Submetido a laminectomia descompressiva cervical, encontra-se atualmente inserido em programa de reabilitação fisiátrica com recuperação praticamente total do seu padrão de marcha. Comentário: A Mielopatia Espondilótica Cervical é a condição clínica que representa a principal causa de mielopatia nos adultos. Poderá representar um desafio diagnóstico, quer pela ausência de achados específicos quer pelo elevado número de diagnósticos diferenciais. A sua suspeita aumenta na presença de alterações progressivas da marcha associado a queixas sensoriais ou motoras nos membros superiores em indivíduos com mais de 55 anos.

The present article aims to address some solutions to the problems of 2D and 3D graphical documentation in contemporary art objects. The garden bench by Júlio Resende in the Parnaso building located in the city of Porto was selected as a case study. With the combination of some systems of representation, it was intended to collect a comprehensive set of information that would enable the characterization of the object, as well as to establish the relation of applicability of the documentation methodology to the specific issues of the work with emphasis on support in the definition of intervention criteria and methods and, consequently, to present a documentation methodology for contemporary art. Starting from these premises the survey will be approached in different ways through 2D graphic registration, photogrammetry and 3D computer graphics.

Enantioselective chromatography is one of the most used techniques for the separation and purification of enantiomers. The most important issue for a specific successful enantioseparation is the selection of the suitable chiral stationary phase (CSP). Different synthetic approaches have been applied for the preparation of CSPs, which embrace coating and immobilization methods. In addition to the classical and broadly applied coating and immobilization procedures, innovating strategies have been introduced recently. In this review, an overview of different methods for the preparation of coated and immobilized CSPs is described. Updated examples of CSPs associated with the various strategies are presented. Considering that after the preparation of a CSP its characterization is fundamental, the methods used for the characterization of all the described CSPs are emphasized.

The common house mosquito, Culex pipiens s. l. is part of the morphologically hardly or non-distinguishable Culex pipiens complex. Upcoming molecular methods allowed us to identify members of mosquito populations that are characterized by differences in behavior, physiology, host and habitat preferences and thereof resulting in varying pathogen load and vector potential to deal with. In the last years, urban and surrounding periurban areas were of special interest due to the higher transmission risk of pathogens of medical and veterinary importance. Recently, surveys of underground habitats were performed to fully evaluate the spatial distribution of rare members of the Cx. pipiens complex in Europe. Subterranean environments and their contribution to mosquito-borne pathogen transmission are virtually unknown. Herein, we review the underground community structures of this species complex in Europe, add new data to Germany and provide the first reports of the Cx. pipiens complex and usually rarely found mosquito taxa in underground areas of Luxembourg. Furthermore, we report the first finding of Culiseta glaphyroptera in Luxembourg. Our results highlight the need for molecular specimen identifications to correctly and most comprehensively characterize subterranean mosquito community structures.

The “floppy infant” is a well-recognized entity characterized by general­ized hypotonia presenting at birth or in early life. Hypotonia represents a diagnostic challenge because it may be the presentation sign of numerous diseases, as central or peripheral nervous system abnormalities, myopathies, genetic disorders, endocrinopathies, metabolic diseases and acute/chronic illness. Prader-Willi syndrome (PWS) is a complex neurodevelopmental disorder that results from an abnormality in chromosome 15. Diagnosis is often delayed because clinical findings are relatively nonspecific and the dysmorphism is often subtle. We describe three term male newborns admitted in the first day of life for hypotonia and feeding difficulties. Pregnancy and familiar history were unremarkable. Clinical examination revealed marked global hypotonia, few active movements, weak cry, poor suck reflex, micrognathia, cryptorchidism, facial dysmorphic features: almond-shaped eyes with short palpebral fissures, narrow bifrontal diameter and short neck. Laboratory evaluations were normal. Brain ultrasound and magnetic resonance had no alterations. Cardiac and metabolic evaluations were irrelevant. PWS was suspected and genetic evaluation was performed. The methylation analysis specific for PWS confirmed the diagnosis. In the three cases it was observed development milestones delay, with progressive improvement after multidisciplinary approach. At last follow-up visit, all of them walk alone, explore the surrounding environment, understand simple language and say some words. These reports reinforce the idea that PWS should be considered in the presence of newborn hypotonia, and feeding difficulties, even in absence of typical facial features. Detecting PWS at neonatal age is important because it allows early intervention and better management of such infants.

Aims: To study the incidence of perinatal stroke in a level-III maternity as well as potential risk factors, clinical presentation, neuroimaging, classification and clinical outcome of children with a minimum follow-up of 24 months. Methods: Historical prospective follow-up of all term and late preterm newborns diagnosed with perinatal stroke from January 2008 to December 2013. Results: Fifteen perinatal strokes were diagnosed in a total of 17,056 newborns (incidence 0.9/1,000). Thirteen had potential risk factors and fourteen were symptomatic. Median age at diagnosis was two days. Seizures were the most frequent symptom (14/15), being three focal-clonic, one multifocal-clonic, two generalized-tonic, three focal-tonic and five subtle. Cerebral ultrasound was performed in eleven newborns at an early stage, suggesting the diagnosis in six. Cerebral magnetic resonance imaging (MRI) confirmed the diagnosis in fifteen. Six had an arterial ischemic stroke, eight a cerebral venous thrombosis and one a hemorrhagic stroke. An electroencephalogram was obtained in all newborns with seizures revealing epileptic activity in eight. Search for prothrombotic disorders (in newborn and both parents) showed four newborns heterozygous methylene tetrahydrofolate reductase mutation and two neonatal alloimune thrombocytopenia. No recurrence of stroke was reported. Formal development evaluation was performed in thirteen and was normal in eleven, while in two revealed delayed psychomotor development, both of which with epilepsy. On the neonatology outpatient clinic follow-up, the current median age is 3 years and 11 months. Conclusions: This study reinforces the need to maintain high level of suspicion for perinatal stroke and the importance of MRI in the classification and etiological study. Our follow-up supported a good outcome of perinatal stroke.

This paper seeks to identify the conditions which a clause-initial X phrase (XP) must satisfy to license locative inversion. Three SVO (subject-verb-object) languages with distinct degrees of word order flexibility are considered: English, French and European Portuguese (EP). We show that these languages only permit locative inversion with preposed XPs which are stage topics (sTOPs), i.e. presupposed XPs that define a (spatio-temporal) location. We further show that being a sTOP is both a necessary and sufficient condition for an XP to license this type of inversion. In addition to the structures typically classified as locative inversion, cases of “absolute inversion” in French, “free” inversion in sentence-focus contexts in EP, and inversion structures with preposed participial and adjectival phrases in English and French are argued to be licensed by (c)overt sTOPs and, thus, constitute forms of (covert) locative inversion. We conclude that there is a strong correlation between sTOPs and subject-verb inversion cross-linguistically.

The planning and development of new chiral stationary phases (CSPs) for liquid chromatography (LC) are considered as continuous and evolutionary issues since the introduction of the first CSP in 1938. The main objectives of the development strategies were to attempt the improvement of the chromatographic enantioresolution performance of the CSPs as well as enlarge their versatility and range of applications. Additionally, the transition to ultra-high-performance LC were underscored. The most recent strategies have comprised the introduction of new chiral selectors, the use of new materials as chromatographic supports or the reduction of its particle size, and the application of different synthetic approaches for preparation of CSPs. This review gathered the most recent developments associated to the different types of CSPs providing an overview of the relevant advances that are arising on LC.

Objetivos: Pretendemos conhecer os fatores associados à não realização e as recomendações do médico de medicina geral e familiar (MGF) e do pediatra acerca destas vacinas. Tipo de estudo: observacional, transversal, descritivo. Local: USF da zona norte do País (Braga – USF de Ruães). População: Crianças com idades compreendidas entre os 2 e os 4 anos de idade; pediatras e MGF de Braga. Métodos: Consulta do processo clínico eletrónico da criança juntamente com um questionário realizado por via telefónica, respondido pelos pais ou encarregados de educação, no período de agosto de 2014 a janeiro de 2015. Para avaliação das recomendações dos médicos MGF e pediatra foi aplicado um questionário eletrónico, de resposta online, a médicos de pediatria e MGF. Os dados foram analisados com recurso ao programa Statistical Package for the Social Sciences (SPSS®, Chicago, IL, USA), versão 17.0 para Microsoft Windows®. Resultados: Amostra de 180 crianças, dos 2-4 anos de idade. A taxa de cobertura vacinal contra Streptococcus pneumoniae 13-valente foi de 81,7%. Não se encontrou relação estatisticamente significativa entre o desemprego e a não realização das vacinas extra-PNV. Verificamos uma maior vacinação contra Neisseria meningitidis do serogrupo B e contra o vírus da hepatite A (VHA) na ausência de insuficiência económica (p value de Fisher=0,008 e p=0,046, respetivamente). Verificou-se uma associação entre a realização da vacina contra o rotavírus e frequência de infantário (p=0,029). Observou-se também uma associação estatisticamente significativa entre as crianças cuja escolaridade do pai ou da mãe era licenciatura/bacharelato e a realização das vacinas contra o rotavírus e anti-VHA. O elemento informador das vacinas extra-PNV foi o médico de família em 46%. A realização de todas as vacinas extra-PNV (exceto gripe sazonal) foi superior nas crianças que eram ou tinham sido seguidas por pediatra. Quanto ao questionário aplicado aos médicos obtivemos uma amostra total de 30 MGF e 30 pediatras. Revelou que a vacina mais aconselhada em ambos os grupos foi a contra Streptococcus pneumoniae. A ordem de importância atribuída às vacinas extra-PNV foi a mesma entre os dois grupos de profissionais. A principal razão para nem sempre aconselharem a vacina contra Streptococcus pneumoniae foi o preço. Conclusões: Para a maioria destas vacinas, desemprego e insuficiência económica não são fundamentais na decisão de não vacinar, o que salienta o esforço por parte dos pais em garantir a vacinação. É urgente a tomada de medidas que permitam um acesso mais justo às diferentes opções vacinais.

Aneurysmal bone cysts (ABCs) are benign, expansible, nonneoplastic lesions of the bone, characterized by channels of blood and spaces separated by fibrous septa, which occur in young patients and, occasionally, with aggressive behavior. Giant ABC is an uncommon pathological lesion and can be challenging because of the destructive effect of the cyst on the bones and the pressure on the nearby structures, especially on weight-bearing bones. In this scenario, en bloc resection is the mainstay treatment and often demands complex reconstructions. This paper reports a difficult case of an unusual giant aneurysmal bone cyst, which required extensive resection and a knee fusion like reconstruction with tibia allograft.

Background: Osteoarthritis is a widespread chronic disease seen as a continuum of clinical occurrences within several phases, which go from synovial inflammation and microscopic changes of bone and cartilage to painful destructive changes of all the joint structures. Being the most common joint disease, it is the leading cause of disability in working individuals above 50 years of age. In some cases, conventional treatments produce just a mild and brief pain reduction and have considerable side-effects. Contemporary Traditional Chinese Medicine (TCM) is a model of systems biology based on a logically accessible theoretical background. It integrates several therapeutic approaches, among them acupuncture, which has shown effective results in the treatment of knee and hip osteoarthritis, minimizing pain, improving functionality and consequently leading to a better quality of life. Methods: The present case study included two patients with clinical signs of osteoarthritis and diagnosis of medial pain, as defined by the Heidelberg Model of TCM. Over 6 weeks, those patients were treated with acupuncture, with a frequency of one session a week. The sessions lasted for thirty minutes and were based on the needling of 4 local acupoints. Before and after each session, pain and mobility assessments were performed. Results: The results were positive, with significant reduction of pain and increased knee joint flexion amplitude and mobility. Conclusion: Acupuncture was effective as an alternative or complementary treatment of knee osteoarthritis, with high levels of improvement within a modest intervention period.

Introdução: As causas secundárias de hipertensão arterial podem ser identificadas numa proporção muito pequena de doentes hipertensos. A patologia renal, nomeadamente a estenose da artéria renal e a patologia do parênquima, é um dos principais motivos de hipertensão arterial secundária. Relata-se de seguida um caso de uma paciente de 18 anos, na qual o estudo da hipertensão revelou a presença de uma obstrução da junção pieloureteral unilateral. Descrição do caso: Paciente do sexo feminino, 18 anos de idade, que recorreu a uma consulta de apoio por um quadro de ansiedade com dois dias de evolução sem fator desencadeante identificado. Ao exame objetivo apresentava apenas valores de tensão arterial elevados e taquicardia, tendo sido medicada com um ansiolítico pelo seu estado de ansiedade. Por manter valores de tensão arterial elevados em ambulatório foi iniciada terapia anti-hipertensiva e estudo de causas secundárias de hipertensão. Do estudo destacou-se a presença de obstrução da junção pieloureteral e hidronefrose à esquerda. Referenciada posteriormente aos cuidados de saúde hospitalares e submetida a cirurgia urológica, encontra-se atualmente assintomática e com valores de tensão arterial controlados sem recurso a medicação. Comentário: A obstrução da junção pieloureteral unilateral é uma causa rara de hipertensão arterial. Define-se pela diminuição da passagem de urina da pélvis renal para o ureter, com consequente dilatação do sistema urinário coletor e lesão do parênquima renal. Atualmente, devido ao uso generalizado da ecografia obstétrica nas gravidezes vigiadas, grande parte são diagnosticados ainda no período perinatal sendo raros os casos detetados apenas na adolescência ou idade adulta.

For commercial oyster aquaculture, triploidy has significant advantages. To produce triploids, the principal technology uses diploid X tetraploid crosses. The development of tetraploid brood stock for this purpose has been successful, but as more is understood about tetraploids, it seems clear that chromosome instability is a principal feature in oysters. This paper is a continuation of work to investigate chromosome instability in polyploid Crassostrea virginica. We established families between tetraploids--apparently stable (non-mosaic) and unstable (mosaic)--and normal reference diploids, creating triploid groups, as well as tetraploids between mosaic and non-mosaic tetraploids. Chromosome loss was about the same for triploid juveniles produced from either mosaic or non-mosaic tetraploids or from either male or female tetraploids. However, there was a statistically significant difference in chromosome loss in tetraploid juveniles produced from mosaic versus non-mosaic parents, with mosaics producing more unstable progeny. These results confirm that chromosome instability, as manifested in mosaic tetraploids, is of little concern for producing triploids, but it is clearly problematic for tetraploid breeding. Concordance between the results from cytogenetics and flow cytometry was also tested for the first time in oysters, by assessing the ploidy of individuals using both techniques. Results between the two were non-concordant. Key words: Crassostrea virginica, aneuploidy, polyploidy, mitotic instability, cytogenetics, flow cytometry. En ostreiculture commerciale, la triploidie presente des avantages significatifs. Pour produire des triploides, la principale technologie consiste a effectuer des croisements diploide x tetraploide. Le developpement de geniteurs tetraploides pour ces fins a connu du succes, mais au fur et a mesure que les connaissances sur les tetraploides s'accroissent, il est devenu clair que l'instabilite chromosomique est une caracteristique importante chez les huitres. Ce travail constitue la suite d'une investigation sur l'instabilite chromosomique chez le Crassostrea virginica polyploide. Les auteurs ont produit des descendances en croisant des tetraploides--en apparence stables (sans mosaicisme) et instables (avec mosaicisme)--avec des diploides de reference, creant ainsi des triploides, ainsi qu'en croisant des tetraploides avec et sans mosaicisme. La perte de chromosomes etait semblable chez des juveniles triploides issus de croisements impliquant des tetraploides avec ou sans mosaicisme, de meme qu'entre ceux issus de croisements ou le tetraploide etait employe comme parent male ou femelle. Cependant, une difference statistiquement significative a ete obtenue en matiere de perte de chromosomes chez des juveniles tetraploides produits a partir de parents avec ou sans mosaicisme, ceux avec mosaicisme presentant une plus grande instabilite. Ces resultats confirment que l'instabilite chromosomique, tel qu'observee chez des tetraploides avec mosaicisme, ne presente pas de problemes pour la production de triploides mais est clairement problematique dans le contexte de l'amelioration genetique des tetraploides. La concordance entre les resultats d'analyses cytogenetiques et de cytometrie en flux a ete examinee pour la premiere fois chez les huitres en mesurant la ploidie d'individus au moyen des deux techniques. Les resultats de ces deux approches ne concordaient pas. [Traduit par la Redaction] Mots-cles : Crassostrea virginica, aneuploidie, polyploidie, instabilite mitotique, cytogenetique, cytometrie en flux., Introduction Polyploids, organisms having more than two chromosome sets, possess some advantages compared to diploids (Comai 2005). One of the advantages, hybrid vigor, can be obtained in organisms with more [...]

Several studies have examined early development in oysters, but few have reported the normal (expected) behavior of meiosis and early mitosis or of the organization of the spindle by the centrosomes. To establish this baseline, normal development of fertilized eggs in Crassostrea virginica from meiosis until the four--cell stage using confocal microscopy was documented. To visualize the centrosomes and microtubules, eggs were stained with antibodies for [gamma]- and [alpha]-tubulin. In addition to establishing normal development, two additional features of early development were documented. First, centrosome behavior was documented. The centrosome associated with the female pronucleus disappeared after polar body formation. The single centrosome associated with the male pronucleus duplicated by late anaphase of meiosis II to eventually form the spindle for mitosis I, thus the two centrosomes in the first cleavage were derived from the sperm. Second, linkage between the cell and centrosome cycles was established. In the first and second mitosis, centrosome duplication began at early anaphase. At late anaphase, the centrosomes duplicated and were observed as two distinct units at each pole. Asynchrony was also observed at the four--cell stage between the large and small blastomeres, with chromatin and centrosome duplication showing more advanced stages in the large blastomere. This documentation will serve as a baseline for future studies on chromosome loss in polyploid oysters. KEY WORDS: oyster, Crassostrea virginica, centrosome. microtubule, meiosis, cleavage, INTRODUCTION Chromosome loss in Crassostrea species had been documented for both diploids (Thiriot-Quievreux et al. 1992, Leitao et al. 2001, de Sousa et al. 2011) and polyploids (Allen et al. [...]