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Allostatic load (AL) is a multi-system composite index for quantifying physiological dysregulation caused by life course stressors. For over 30 years, an extensive body of research has drawn on the AL framework but has been hampered by the lack of a consistent definition. This study analyses data for 67,126 individuals aged 40-111 years participating in 13 different cohort studies and 40 biomarkers across 12 physiological systems: hypothalamic-pituitary-adrenal (HPA) axis, sympathetic-adrenal-medullary (SAM) axis, parasympathetic nervous system functioning, oxidative stress, immunological/inflammatory, cardiovascular, respiratory, lipidemia, anthropometric, glucose metabolism, kidney, and liver. We use individual-participant-data meta-analysis and exploit natural heterogeneity in the number and type of biomarkers that have been used across studies, but a common set of health outcomes (grip strength, walking speed, and self-rated health), to determine the optimal configuration of parameters to define the concept. There was at least one biomarker within 9/12 physiological systems that was reliably and consistently associated in the hypothesised direction with the three health outcomes in the meta-analysis of these cohorts: dehydroepiandrosterone sulfate (DHEAS), low frequency-heart rate variability (LF-HRV), C-reactive protein (CRP), resting heart rate (RHR), peak expiratory flow (PEF), high density lipoprotein cholesterol (HDL-C), waist-to-height ratio (WtHR), HbA1c, and cystatin C. An index based on five biomarkers (CRP, RHR, HDL-C, WtHR and HbA1c) available in every study was found to predict an independent outcome - mortality - as well or better than more elaborate sets of biomarkers. This study has identified a brief 5-item measure of AL that arguably represents a universal and efficient set of biomarkers for capturing physiological 'wear and tear' and a further biomarker (PEF) that could usefully be included in future data collection.

Metal nanoparticles (M-NP) are among the most widely used nanomaterials in consumer products available in the market. Thus, human exposure to these nanosized materials is increasing, which raises serious concerns regarding their environmental and human safety. Biological barriers are important lines of defence to xenobiotics, thus expected targets for M-NP. The present study aimed at evaluating the in vitro toxicity of different M-NPs in two cell models of biological barriers: human intestinal (Caco-2) and trophoblastic (BeWo clone b30) epithelial cells. Cells were exposed for 24 h to varied concentrations (0.8-48 µg/cm2) of M-NP of different chemical composition (Au, Ag, TiO2), primary size (10, 30 and 60 nm), capping (citrate, PEG) and crystal structure (rutile, anatase) and toxicity assessed by determining changes in cell morphology, metabolic activity, plasma membrane integrity, generation of intracellular reactive oxygen species (ROS) and intracellular ATP levels. Our data show that the toxicity potential of the tested M-NP is similar in both cell lines with AgNPs > AuNPs > TiO2 NPs, being the effects more visible at higher concentrations. The influence of the size in the cytotoxic-induced effects was more evident for AgNP than for AuNP, with the smaller NP causing more toxicity, being the BeWo cells more sensitive to these M-NP. In addition, PEG-capping effectively attenuated AuNP-induced toxicity in both barrier models. In addition, only cells exposed to AgNP exhibited significant increased levels of ROS. Thus, our data support that the physicochemical properties of M-NP are an important determinant of their cytotoxicity and that intestinal and trophoblastic cells exhibit different sensitivity to the tested M-NP. Future studies would be useful to further explore the effects of M-NP in the human barriers. Este trabalho foi desenvolvido com o apoio do Programa Operacional Competitividade e Internacionalização através dos Fundos Europeus de Desenvolvimento Regionais (FEDER / FNR) e através dos fundos nacionais (FCT/OE). NanoBioBarriers (PTDC/MED‐TOX/31162/2017) N/A

RESUMO A nutrição parentérica (NP) desempenha um papel vital em doentes críticos, sendo muitas vezes necessária a sua preparação personalizada, ajustada às necessidades de doentes com carências específicas. A manipulação de NP poderá ser realizada de forma manual ou automatizada, requerendo sempre condições asséticas e pessoal treinado. A implementação de um sistema automatizado requer uma análise cuidada da sua necessidade/justificação, de forma a que, baseado em fundamentação adequada, se estruture um plano exequível. A monitorização do desempenho do sistema automatizado é um processo fundamental de validação farmacêutica. Nos Serviços Farmacêuticos (SF) do Centro Hospitalar e Universitário de São João (CHUSJ), elaborou-se um estudo de controlo de qualidade gravimétrico antes e após implementação do sistema automatizado, no sentido de monitorizar a precisão dos resultados obtidos para este ensaio de verificação. Como resultados estatísticos, o método de enchimento automatizado relacionou-se com a menor média para o desvio ao peso teórico, assim como menor desvio padrão, corroborando uma menor percentagem de erro e também uma menor dispersão dos resultados. Da análise dos resultados obtidos concluiu-se que a implementação da automatização se traduziu em melhorias a nível de precisão de resultados para o controlo gravimétrico das bolsas nutritivas, aumentando a segurança das misturas produzidas e, consequentemente, a qualidade dos cuidados prestados ao doente. É de elevada importância que se implementem procedimentos de validação do desempenho do sistema automatizado, como foi o caso, sendo que deverão ser complementados com outro tipo de avaliações, preferencialmente realizadas por entidades externas à instituição em causa.

Background Guidelines for improving the quality of maternal health services emphasise women's involvement in care. However, evidence about migrant and ethnic minorities' preferences for participation in maternal care remains unsystematised. Understanding these populations' experiences with and preferred forms of involvement in care provision is crucial for imbuing policies and guidelines with sensitivity to diversity and for implementing people-centred care. This paper presents a narrative synthesis of empirical studies of involvement in maternal health care by migrants and ethnic minorities based on four key dimensions: information, communication, expression of preferences and decision-making. Methods Studies indexed in PubMed and Scopus published until December 2019 were searched. Original quantitative, qualitative and mixed methods studies written in English and reporting on migrant and ethnic minority involvement in maternal care were included. Backward reference tracking was carried out. Three researchers conducted full-text review of selected publications. Results In total, 22 studies met the inclusion criteria. The majority of studies were comparative and addressed only one or two dimensions of involvement, with an emphasis on the information and communication dimensions. Compared to natives, migrants and ethnic minorities were more likely to (1) lack access to adequate information as a result of health care staff's limited time, knowledge and misconceptions about women's needs and preferences; (2) report suboptimal communication with care staff caused by language barriers and inadequate interpreting services; (3) be offered fewer opportunities to express preferences and to have preferences be taken less into account; and (4) be less involved in decisions about their care due to difficulties in understanding information, socio-cultural beliefs and previous experiences with care provision less attuned with playing an active role in decision-making and care staff detracting attitudes. Conclusion Constraints to adequate and inclusive involvement in maternal care can hinder access to quality care and result in severe negative health outcomes for migrant and ethnic minority women. More research is needed into how to tailor the dimensions of involvement to migrant and ethnic minorities' needs and preferences, followed by provision of the resources necessary for effective implementation (e.g. sufficient time for consultations, optimal interpreter systems, health care staff training). info:eu-repo/semantics/publishedVersion

Source at https://doi.org/10.18632/aging.101900. Differences in health status by socioeconomic position (SEP) tend to be more evident at older ages, suggesting the involvement of a biological mechanism responsive to the accumulation of deleterious exposures across the lifespan. DNA methylation (DNAm) has been proposed as a biomarker of biological aging that conserves memory of endogenous and exogenous stress during life. We examined the association of education level, as an indicator of SEP, and lifestyle-related variables with four biomarkers of age-dependent DNAm dysregulation: the total number of stochastic epigenetic mutations (SEMs) and three epigenetic clocks (Horvath, Hannum and Levine), in 18 cohorts spanning 12 countries. The four biological aging biomarkers were associated with education and different sets of risk factors independently, and the magnitude of the effects differed depending on the biomarker and the predictor. On average, the effect of low education on epigenetic aging was comparable with those of other lifestyle-related risk factors (obesity, alcohol intake), with the exception of smoking, which had a significantly stronger effect. Our study shows that low education is an independent predictor of accelerated biological (epigenetic) aging and that epigenetic clocks appear to be good candidates for disentangling the biological pathways underlying social inequalities in healthy aging and longevity.

BACKGROUND: Social inequalities in the prevalence of childhood overweight and obesity are well-established, but less is known about when the social gradient first emerges and how it evolves across childhood and adolescence.OBJECTIVE: This study examines maternal education differentials in children's body mass trajectories in infancy, childhood and adolescence using data from four contemporary European child cohorts.METHODS: Prospective data on children's body mass index (BMI) were obtained from four cohort studies-Generation XXI (G21-Portugal), Growing Up in Ireland (GUI) infant and child cohorts, and the Millennium Cohort Study (MCS-UK)-involving a total sample of 41,399 children and 120,140 observations. Children's BMI trajectories were modelled by maternal education level using mixed-effect models.RESULTS: Maternal educational inequalities in children's BMI were evident as early as three years of age. Children from lower maternal educational backgrounds were characterised by accelerated BMI growth, and the extent of the disparity was such that boys from primary-educated backgrounds measured 0.42 kg/m2 (95% CI 0.24, 0.60) heavier at 7 years of age in G21, 0.90 kg/m2 (95% CI 0.60, 1.19) heavier at 13 years of age in GUI and 0.75 kg/m2 (95% CI 0.52, 0.97) heavier in MCS at 14 years of age. The corresponding figures for girls were 0.71 kg/m2 (95% CI 0.50, 0.91), 1.31 kg/m2 (95% CI 1.00, 1.62) and 0.76 kg/m2 (95% CI 0.53, 1.00) in G21, GUI and MCS, respectively.CONCLUSIONS: Maternal education is a strong predictor of BMI across European nations. Socio-economic differentials emerge early and widen across childhood, highlighting the need for early intervention.

This study evaluated the influence of the geometry of ceramic specimens (disc vs. square plate) on the biaxial flexural strength (BFS) using an experimental set and finite element analysis (FEA). Leucite glass-ceramic blocks were used in the preparation of disc (D; n=14) and square plate (S; n=13) specimens with the same lower (tensile) surface area. The specimens were subjected to a piston-on-three-ball flexural test (ISO 6872:2008). To calculate the BFS of the S group, the specimen radius, indicated by the ISO 6872:2008 formula for discs, was replaced by half of the side length. FEA compared the pattern of stress distribution and the first principal stress between D and S specimens having the same and different lower (tensile) surface area. Student’s t-test showed no difference (p=0.85) in the BFS between D (95.0±9.6 MPa) and S (84.3±10.3 MPa). FEA indicated a similar pattern of stress distribution, with almost no difference in the first principal stress of discs and square plates with the same lower (tensile) surface area. In the experimental condition investigated, square plate ceramic specimens can be used in piston-on-three-ball tests. For the calculation of the BFS, the specimen radius may be replaced by half side length of the square specimen. Resumo O presente estudo avaliou a influência da geometria do corpo de prova cerâmico (disco vs. quadrado) na resistência flexural biaxial (RFB), por meio de ensaio experimental e análise de elementos finitos (AEF). Blocos de vitrocerâmica reforçada por leucita foram utilizados na confecção de corpos de prova no formato de discos (D; n=14) e quadrados (Q; n=13), com mesma área na superfície inferior (superfície sujeita à tração durante o ensaio). Os corpos de prova foram submetidos a ensaio de flexão biaxial pistão sobre três esferas (ISO 6872:2008). Para calcular a RFB do grupo Q, o raio do corpo de prova, indicado pela fórmula da ISO 6872:2008 para discos, foi substituído por metade do lado do quadrado. AEF foi empregada para comparar o padrão de distribuição de tensões e a primeira tensão principal entre D e Q, com áreas iguais e diferentes na superfície inferior (tração). Teste t de Student não mostrou diferença (p=0,85) na RFB entre D (95,0±9,6 MPa) e Q (84,3±10,3 MPa). AEF indicou um padrão similar de distribuição de tensões, com quase nenhuma diferença na primeira tensão principal entre D e Q com mesma área na superfície inferior (tração). Na condição experimental testada, corpos de prova cerâmicos no formato de quadrado podem ser usados em ensaio de flexão biaxial pistão sobre três esferas. Para o cálculo da RFB, o raio do espécime pode ser substituído por metade do lado do quadrado.

Atmospheric plasma spraying is applied at industrial scale to produce high-resistance coatings of metallic surfaces. Due to the high energies applied, it is a known source of nanoparticles (NP) which are released to workplace air and impact worker exposure in industrial facilities. NP emissions in this kind of scenario are characterized in terms of particle number concentrations, mean diameter and size distribution (Viana et al., 2017; Salmatonidis et al., under review), but data are lacking regarding the chemical properties and toxicity of these particles. In this framework, this work aimed to characterize the chemical composition of course, fine and ultrafine aerosols emitted during plasma spraying in a real-world setting, with the ultimate goal to support ongoing toxicity assessments of the same aerosols. Two different scenarios (Booths #1 and #3) were assessed. Particles were sampled onto Teflon filters and in suspension using an aerosol concentration enrichment system (VACES; Kim et al., 2001), and analyzed by means of ICP-MS, ICP-OES and XRF. An inter-comparison between analytical methods was used for quality assurance. Results evidenced a major enrichment in potentially health hazardous metals (Cr, Ni, W) sourcing directly from the feedstock in both scenarios, as well as in major elements (Al, Ca, Fe) with different possible source origins (including outdoor infiltration). The elements with the highest enrichments in the ultrafine fraction were Zn, As, Sb and Ni in Booth#1, and Cd, Sb and Pb in Booth #3, highlighting the potential health risks linked to exposure to this kind of aerosols. Aerosol chemical properties were correlated with bulk material composition, to understand the relationship between bulk composition and NP emissions in the three size fractions analysed. Toxicity assessments will provide further quantitative insights into the health hazards of this kind of exposure

Three strains of the toxic benthic dinoflagellate Prorocentrum hoffmannianum were isolated in the Canary Islands (north-east Atlantic Ocean, Spain). The identity of the strains was determined by phylogenetic analyses of partial LSU rDNA (D1-D2 regions) but their morphology based on SEM images corresponded to P. maculosum. Their toxin profiles were analyzed by liquid chromatography and high resolution mass spectrometry analysis (LC–HRMS) on cell extracts and culture media. Okadaic acid and three analogs were detected in all strains. Rather, in culture media the detected compounds were variable among strains, two of them being okadaic acid analogs not found on cell extracts. As a result, the taxonomy of the species was revised and P. maculosum is proposed as a junior synonym of P. hoffmannianum whose description is emended.

Childhood is the most important period of development during life course, highly sensitive to external influences and with a profound impact on children’s well-being. During this period, the foundations for every individual’s physical and mental health capacities and attainment are laid, influencing children’s lives throughout adolescence, adulthood and aging. Violence is one of the most traumatic experiences that can impact the healthy development of the child, compromising its growth and future health. Although violence assessment in the scope of a cohort study comprises methodological and ethical challenges, a life-course perspective allows researchers to understand the effects of multiple forms of violence by distinguishing between repetitive violence over time and isolated incidents, the occurrence of violent experiences in different contexts and settings, as well as the interconnection between different experiences of trauma. This chapter aims to demonstrate the importance of a life-course perspective to understand the detrimental relationship between early exposure to violence and worse health in the first years of life.

Book of Abstracts of CEB Annual Meeting 2017, [Excerpt] The development of injectable bone substitutes (IBS) have garnered great importance in the bone regeneration field, as a strategy to reach areas of the body using minimally invasive procedures, and showing the ability of perfect fitting according to irregularities of bone tissue defects. In this context, the combination of injectable hydrogels and ceramic granules is emerging as a well-established trend. Particularly, in situ gelation hydrogels have arisen as a new IBS generation. [...], info:eu-repo/semantics/publishedVersion

Background: In 2011, WHO member states signed up to the 25 × 25 initiative, a plan to cut mortality due to non-communicable diseases by 25% by 2025. However, socioeconomic factors influencing non-communicable diseases have not been included in the plan. In this study, we aimed to compare the contribution of socioeconomic status to mortality and years-of-life-lost with that of the 25 × 25 conventional risk factors. Methods: We did a multicohort study and meta-analysis with individual-level data from 48 independent prospective cohort studies with information about socioeconomic status, indexed by occupational position, 25 × 25 risk factors (high alcohol intake, physical inactivity, current smoking, hypertension, diabetes, and obesity), and mortality, for a total population of 1 751 479 (54% women) from seven high-income WHO member countries. We estimated the association of socioeconomic status and the 25 × 25 risk factors with all-cause mortality and cause-specific mortality by calculating minimally adjusted and mutually adjusted hazard ratios [HR] and 95% CIs. We also estimated the population attributable fraction and the years of life lost due to suboptimal risk factors. Findings: During 26·6 million person-years at risk (mean follow-up 13·3 years [SD 6·4 years]), 310 277 participants died. HR for the 25 × 25 risk factors and mortality varied between 1·04 (95% CI 0·98–1·11) for obesity in men and 2 ·17 (2·06–2·29) for current smoking in men. Participants with low socioeconomic status had greater mortality compared with those with high socioeconomic status (HR 1·42, 95% CI 1·38–1·45 for men; 1·34, 1·28–1·39 for women); this association remained significant in mutually adjusted models that included the 25 × 25 factors (HR 1·26, 1·21–1·32, men and women combined). The population attributable fraction was highest for smoking, followed by physical inactivity then socioeconomic status. Low socioeconomic status was associated with a 2·1-year reduction in life expectancy between ages 40 and 85 years, the corresponding years-of-life-lost were 0·5 years for high alcohol intake, 0·7 years for obesity, 3·9 years for diabetes, 1·6 years for hypertension, 2·4 years for physical inactivity, and 4·8 years for current smoking. Interpretation: Socioeconomic circumstances, in addition to the 25 × 25 factors, should be targeted by local and global health strategies and health risk surveillance to reduce mortality. European Commission, Swiss State Secretariat for Education, Swiss National Science Foundation, the Medical Research Council, NordForsk, Portuguese Foundation for Science and Technology.

Background Height is regarded as a marker of early-life illness, adversity, nutrition and psychosocial stress, but the extent to which differences in height are determined by early-life socioeconomic circumstances, particularly in contemporary populations, is unclear. This study examined socioeconomic differences in children’s height trajectories from birth through to 21 years of age in four European countries. Methods Data were from six prospective cohort studies Generation XXI, Growing Up in Ireland (infant and child cohorts), Millennium Cohort Study, EPITeen and Cardiovascular Risk in Young Finns Study—comprising a total of 49 492 children with growth measured repeatedly from 1980 to 2014. We modelled differences in children’s growth trajectories over time by maternal educational level using hierarchical models with fixed and random components for each cohort study. Results Across most cohorts at practically all ages, children from lower educated mothers were shorter on average. The gradient in height was consistently observed at 3 years of age with the difference in expected height between maternal education groups ranging between −0.55 and −1.53 cm for boys and −0.42 to −1.50 cm for girls across the different studies and widening across childhood. The height deficit persists into adolescence and early adulthood. By age 21, boys from primary educated maternal backgrounds lag the tertiary educated by −0.67 cm (Portugal) and −2.15 cm (Finland). The comparable figures for girls were −2.49 cm (Portugal) and −2.93 cm (Finland). Conclusions Significant differences in children’s height by maternal education persist in modern child populations in Europe.

Background: In 2011, WHO member states signed up to the 25 × 25 initiative, a plan to cut mortality due to non-communicable diseases by 25% by 2025. However, socioeconomic factors influencing non-communicable diseases have not been included in the plan. In this study, we aimed to compare the contribution of socioeconomic status to mortality and years-of-life-lost with that of the 25 × 25 conventional risk factors. Methods: We did a multicohort study and meta-analysis with individual-level data from 48 independent prospective cohort studies with information about socioeconomic status, indexed by occupational position, 25 × 25 risk factors (high alcohol intake, physical inactivity, current smoking, hypertension, diabetes, and obesity), and mortality, for a total population of 1 751 479 (54% women) from seven high-income WHO member countries. We estimated the association of socioeconomic status and the 25 × 25 risk factors with all-cause mortality and cause-specific mortality by calculating minimally adjusted and mutually adjusted hazard ratios [HR] and 95% CIs. We also estimated the population attributable fraction and the years of life lost due to suboptimal risk factors. Findings: During 26·6 million person-years at risk (mean follow-up 13·3 years [SD 6·4 years]), 310 277 participants died. HR for the 25 × 25 risk factors and mortality varied between 1·04 (95% CI 0·98–1·11) for obesity in men and 2 ·17 (2·06–2·29) for current smoking in men. Participants with low socioeconomic status had greater mortality compared with those with high socioeconomic status (HR 1·42, 95% CI 1·38–1·45 for men; 1·34, 1·28–1·39 for women); this association remained significant in mutually adjusted models that included the 25 × 25 factors (HR 1·26, 1·21–1·32, men and women combined). The population attributable fraction was highest for smoking, followed by physical inactivity then socioeconomic status. Low socioeconomic status was associated with a 2·1-year reduction in life expectancy between ages 40 and 85 years, the corresponding years-of-life-lost were 0·5 years for high alcohol intake, 0·7 years for obesity, 3·9 years for diabetes, 1·6 years for hypertension, 2·4 years for physical inactivity, and 4·8 years for current smoking. Interpretation: Socioeconomic circumstances, in addition to the 25 × 25 factors, should be targeted by local and global health strategies and health risk surveillance to reduce mortality.