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Thoracic endovascular aortic repair (TEVAR) results have been studied in short-term time frames. This study aimed to evaluate midterm and long-term outcomes of TEVAR, emphasizing postoperative aortic remodeling and need for reintervention.This is an institutional retrospective review of TEVAR for isolated descending thoracic aortic aneurysms. Data were collected from 2004 to 2018. Primary outcomes studied included aneurysm sac remodeling, freedom from reintervention, and all-cause mortality. Other outcomes studied include endoleak rates, neurologic complication rates, and any overall postoperative complication rates.During the study period, 219 patients underwent TEVAR for descending thoracic aortic aneurysms. The median effect of TEVAR on sac diameter was a 0.7-cm decrease in size (interquartile range, -1.4 to 0.0 cm). During the study period, 80% (n = 147) of patients experienced aneurysm sac regression or stability. Perioperative neurologic complications occurred in 16% (n = 34) of patients. Significant predictors of sac growth were endoleak (odds ratio [OR], 65; P .001), preoperative carotid-subclavian bypass (OR, 8; P = .003), and graft oversizing 20% (OR, 15; P = .046). Every 1-mm increase in aortic diameter at the proximal TEVAR landing zone led to an increased odds of endoleak (OR, 2; P = .049). Access complications (OR, 8) and subclavian artery coverage (OR, 6) significantly increased the odds of reintervention, whereas every percentage of graft oversizing protected against reintervention (OR, 0.005). Life-table analysis revealed an overall survival of 78% (71%-83%) at median follow-up. At 3 years, survival was 88% (80%-93%) for those with aneurysm sac stability or regression, whereas it was 70% (49%-84%) for those with aneurysm sac growth (P = .0402). Cox proportional hazards model showed that the only protective factor for mortality was percentage oversizing, with every 1% of oversizing having a hazard ratio (HR) of .001 (P = .032). This was counterbalanced by the fact that patients with graft oversizing30% had an increased odds of mortality with HR10 (P = .049). Other significant factors that increased the odds of mortality included endoleak (HR, 3.6; P = .033), diabetes (HR, 4.1; P = .048), age (every 1-year increase in age; HR, 1.2; P = .002), year of surgery (every year subsequent to 2004; HR, 1.3; P = .012), and peripheral artery disease (HR, 5.2; P = .041).The majority of patients (80%) experience sac stability or regression after TEVAR, which offers a clear survival advantage. Endoleaks are predictive of sac growth, conferring increased mortality. Rigorous surveillance is necessary to prevent future aortic events through reintervention.

Introduction: Evidence based radiography (EBR) is the logical development of evidence based practice applied to radiography. The aim of this study was to investigate the opinion of a cohort of Portuguese radiographers in Southern Portugal working in public hospitals regarding evidence based practice (EBP), namely about the levels of knowledge about EBR, how they access information and how they use it within daily practice. Methods: A self-administered questionnaire was applied to a sample of 40 radiographers in the Portuguese region of Algarve. This questionnaire was validated for Portuguese speakers using the translationretranslation method. Results: The final response rate was 69% (40/58). Results suggest that most radiographers trained EBR during their undergraduate training. Although, no statistically significant correlations were found in the practice of EBR against participant gender, age, training, career level, reading papers and workplace. The most frequent reason to read papers is the "interest" to do so, and national professional journals are read more often. It was found that radiographers that read scientific papers more frequently know more about research (p = 0.005), understand the importance of research for the professional activity (p = 0.023), and know more on how to conduct research papers (p = 0.034). Conclusion: EBR within radiography is not yet well established, and radiographers' have varying viewpoints. Radiographers that read scientific papers more frequently understand better the philosophy behind this concept but it is very important to deepen the knowledge on this area. Implications for practice: When practicing radiography based on the best available scientific knowledge, professionals are ensuring the best for patients and for profession. To achieve this, and before taking any action, it is important to evaluate the current situation, and this research presents a way to do so. (c) 2019 The College of Radiographers. Published by Elsevier Ltd. All rights reserved. info:eu-repo/semantics/publishedVersion

In South Africa, traditional medicine remains a key source of health care, however majority of the plants used as medicines by traditional health care practitioners have not been investigated for their in vitro biological activity. The purpose of the present study was to examine the antityrosinase, anti-acne, antioxidant and cytotoxic potential of 25 ethanolic extracts from 16 different plant families which were collected in the Jongilanga community in the Mpumalanga province. The tyrosinase inhibitory activity was evaluated using the mushroom tyrosinase enzyme to determine potential plant extracts that could treat skin hyperpigmentation. Six of the plant extracts showed a fifty percent inhibitory concentration (IC50) lower than 200 μg/mL, of which Acacia nilotica (L.) Delile (12.97 ± 1.07 μg/mL) showed the highest activity, followed by Schotia brachypetala Sond. (35.07 ± 0.71 μg/mL) and Combretum collinum Fresen. (47.92 ± 1.13 μg/mL). The anti-acne potential of the extracts was evaluated by determining their antibacterial activity against Cutibacterium acnes. The highest activity was noted for Harpagophytum procumbens (Burch.) with a minimum inhibitory concentration (MIC) of 31.25 μg/mL, followed by S. brachypetala (125 μg/mL) and C. collinum, Ozoroa sphaerocarpa R. Fern & A. Fern and Pterocarpus rotundifolius DC. which all showed MIC values of 250 μg/mL. The antioxidant studies revealed that the majority of the plant extracts showed strong DPPH radical scavenging activity. The 2,3-Bis-(2-methoxy-4-nitro-5-sulfophenyl)-2H-tetrazolium-5-carboxyanilide salt (XTT) method was used to assess the cytotoxic effect of the plant extracts, of which only two extracts showed strong cytotoxicity against the non-cancerous human keratinocyte (HaCat) cell line namely; H. procumbens and Ipomoea oblongata Hook. The remaining extracts showed low to moderate cytotoxicity. The promising antityrosinase activity of A. nilotica, S. brachypetala and C. collinum as well as the promising antibacterial activity of O. spaerocarpa, P. rotundifolius and S. brachypetala, together with their low to moderate cytotoxicity against HaCat cells, merits further investigation of these species.

People spend one third of their life sleeping, but the bedroom, as a specific micro-environment, is often neglected when assessing human exposure to air pollutants. However, exposure during sleep may be significant in the long-term to the integrated individual exposure. This study aimed to assess the exposure during sleep, focusing on a multi-pollutant approach (comfort parameters, carbon dioxide – CO2, carbon monoxide – CO, formaldehyde (CH2O), total volatile organic compounds (VOCs), particulate matter – PM2.5 and PM10 – and ultrafine particles, particle number concentrations – PNC - and lung deposited surface area - LDSA). For that, the air quality during sleep (in real conditions) was monitored using real-time devices in 12 bedrooms of urban (Lisbon and Vila Franca de Xira) and rural (Ponte de Sor) areas of Portugal for one night. Volunteers were smokers and non-smokers. Considering the Portuguese legislation for indoor air quality (IAQ), 67% of the bedrooms registered CO2 levels above the limit value, while CH2O, VOC, PM10 and PM2.5 thresholds were exceeded in 30, 100, 36, and 45% of cases, respectively. Regarding ultrafine parameters, LDSA and PNC ranged from 7.3 to 95.2 μm2/cm3 and from 0.6 to 4.8 × 103/cm3, respectively. Even with no smoking indoors, smokers' bedrooms were found to have significant higher levels of CO, CH2O, PM2.5, PM10 and LDSA than non-smokers’ bedrooms, showing the effect of thirdhand smoke, exhalation of pollutants after smoking and infiltration on the degradation of the air quality in the bedroom. A recent new model of real-time monitor was also used for a wide set of IAQ parameters. Its performance to measure PM2.5 and CO2 was assessed, showing its applicability in real conditions. Although often neglected, these micro-environments should be considered in the integrated individual exposure to air pollutants and further studied. Main findings of the work Several pollutants (CO2, PM, VOCs and CH2O) exceeded the guidelines during sleep; smokers are exposed to higher levels of CO, CH2O, PM, and LDSA than non-smokers while sleeping.

Herpesvirus (HVs) infection has already been reported in cetaceans, but available information on its epidemiology is scarce. In this study we surveyed a total of 179 cetaceans belonging to 6 different species. Samples were obtained from cetaceans stranded along the Portuguese coastline, belonging to populations that roam the north-east region of the Atlantic Ocean. Detection of HVs was performed by conventional nested PCR. Amplicons were sequenced by Sanger's method and sequences used to construct phylogenetic trees by Maximum Likelihood method. Our results show that prevalence of positive samples, among fresh carcasses, reached 14.3% (10/70) and both alpha and gammaherpesvirus were detected. Histopathology showed that herpesvirus infection varied from absence of signs compatible with disease, localized genital lesions and systemic disease. Phylogenetic analysis revealed three clusters within the alphaherpesvirus family; within the gammaherpesvirus no subdivision was detected. All clusters included animals from different species and geographic origins. In seven of the positive HVs samples, co-infections with other agents such as morbillivirus and toxoplasma gondii were detected. The viral nucleotide sequences were not assigned to a specific animal species, nor presented a given geographic distribution, which may imply a wider distribution of herpesvirus in these animal populations. Our results are also the first report of herpesvirus infection in common dolphins (Delphinus delphis), with both alpha and gammaherpesvirus detected.

The present study aims to investigate the sources of particulate pollution in indoor and outdoor environments, with focus on determining their contribution to the exposure of children to airborne particulate matter (PM). To this end, parallel indoor and outdoor measurements were carried out for a selection of 40 homes and 5 schools between September 2017 and October 2018. PM2.5 and PM2.5-10 samples were collected during five days in each microenvironment (ME) and analysed by X-Ray Fluorescence (XRF), for the determination of elements, and by a thermal-optical technique, for the measurement of organic and elemental carbon. The source apportionment analysis of the PM composition data, by means of the receptor model SoFi (Source Finder) 8 Pro, resulted in the identification of nine sources: exhaust and non-exhaust emissions from traffic, secondary particles, heavy oil combustion, industry, sea salt, soil, city dust, and an indoor source characterized by high levels of organic carbon. Integrated daily exposure to PM2.5 was on average 21 μg/m

Distribution systems are undergoing structural and topological changes, mainly due to the influence of the new distributed energy resources inserted along the feeders. In this context, the growth of the Smart Grids requires the evolution of the control and operation tools, since the decision-making should promote proactive actions. In this sense, the present paper proposes a method for subdividing the distribution system into grid functional blocks, associated to a method of forecasting of distributed electric quantities. The functional blocks allow the assets to be organized in a way to provide sufficient information to perform advanced analyzes of a geoelectric region. The proactive decisions, in the grid functional blocks, are taken from the very short term forecast of variables (voltage, current, active power and reactive power). These forecasts are based on an innovative method of selection of forecasting techniques, which takes into account the online and historical information for the performance ranking of forecasting techniques. The developed methodologies by authors provide greater flexibility for the Smart Grids regarding to the dynamic changes that occur in the distribution grids in the presence of distributed flexible resources, demand management, Volt-VAR Optimization, Conservation Voltage Reduction, protection, automatic reconfiguration, self-healing, storage and electric vehicles.