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Purpose The COVID-19 pandemic represents a unique challenge for public health worldwide. In this context, smartphone-based tracking apps play an important role in controlling transmission. However, privacy concerns may compromise the population’s willingness to adopt this mobile health (mHealth) technology. Based on the privacy calculus theory, this study aims to examine what factors drive or hinder adoption and disclosure, considering the moderating role of age and health status. Design/methodology/approach A cross-sectional survey was conducted in a European country hit by the pandemic that has recently launched a COVID-19 contact-tracing app. Data from 504 potential users was analyzed through partial least squares structural equation modeling. Findings Results indicate that perceived benefits and privacy concerns impact adoption and disclosure and confirm the existence of a privacy paradox. However, for young and healthy users, only benefits have a significant effect. Moreover, older people value more personal than societal benefits while for respondents with a chronical disease privacy concerns outweigh personal benefits. Originality/value The study contributes to consumer privacy research and to the mHealth literature, where privacy issues have been rarely explored, particularly regarding COVID-19 contact-tracing apps. The study re-examines the privacy calculus by incorporating societal benefits and moving from a traditional “self-focus” approach to an “other-focus” perspective. This study further adds to prior research by examining the moderating role of age and health condition, two COVID-19 risk factors. This study thus offers critical insights for governments and health organizations aiming to use these tools to reduce COVID-19 transmission rates.

Несмотря на то, что исследователи не достигли консенсуса касательно методологии изучения производительности, показатели эффективности в значительной мере зависят от регионов. В данной статье изучены эмпирические методики для достижения надежных результатов в анализе производственной эффективности, а также влияние расположения ферм на производительность. Цель работы - проверить, зависит ли производительность от развитости региона. Для точной оценки данных был применен метарегрессионный анализ на основе опубликованных в 2010-2017 гг. 166 наблюдений в области сельского хозяйства разных стран мира. Новизна исследования состоит в том, что критерии, разработанные для создания базы данных и реализации модели, не использовались ранее. Были проверены вариации среднего значения производительности, а также проведен анализ с использованием оценки квазимаксимального правдоподобия. Регрессии показали, что среднее значение производительности можно объяснить используемыми данными, переменными, эмпирическими моделями и регионом исследования. Проанализированные работы показали, что сельскохозяйственные фермы в развитых странах демонстрируют самый высокий средний показатель производительности, в то время как в развивающихся странах и странах с низким уровнем дохода наблюдается обратная ситуация. В статье представлены методологии, направленные на достижение надежных результатов, а также учитывающие региональные характеристики сельских хозяйств, которые могут быть применены в будущих исследованиях. While scientific studies have not reached a consensus on the methodology for examining Technical Efficiency (or Inefficiency), the influence of regions appears to be important for efficiency scores. Therefore, this research aims to investigate the empirical procedures for the achievement of more robust results in the analysis of productive efficiency, as well as to evaluate the effect of the location of farms on such efficiency. The goal was to check whether the most developed regions are the most efficient. Meta-regression analysis provides an adequate method for an accurate assessment of both situations. This technique was applied based on a database of 166 observations on the agricultural sector from countries around the world, published in the period 2010-2017. The criteria used for the database collection and for the conceived model were not previously used and, thereby, enrich the discussion on the topic. The procedure aims to check the variation in the Mean of Technical Inefficiency and conduct an analysis using Quasi-Maximum Likelihood Estimation. The regressions showed that the Mean of Technical Inefficiency could be mainly explained by data, variables, employed empirical models and the region of study. The studies that focus on farms of developed countries present the lowest Mean of Technical Inefficiency, while studies for developing or low-income countries exhibit the opposite. Therefore, for future research on productive analysis, we suggest empirical procedures aimed at achieving robust results that take into account specific regional characteristics of farms. Статья подготовлена в рамках исследовательского проекта INNOVINE & WINE — Vineyard and Wine Innovation Platform (NORTE-01–0145-FEDER-000038), софинансируемого европейскими фондами структурных инвестиций (FEDER) и Norte 2020 (Северная региональная операционная программа 2014/2020). The article has been prepared in the framework of the R&D Project INNOVINE & WINE — Vineyard and Wine Innovation Platform — Operation NORTE-01–0145-FEDER-000038, counded by the European and Structural Investment Funds (FEDER) and by Norte 2020 (Programa Operacional Regional do Norte 2014/2020).

Introdução: A Reabilitação Cardíaca (RC) é uma intervenção multifactorial, geralmente composta por exercício físico estruturado, apoio psicológico e educação para a saúde. A estruturação nas diferentes fases de RC para esta população específica não está profundamente estudada, existindo lacunas na evidência científica relativamente aos ganhos em saúde decorrentes de programas de RC. A literatura relativa ao cuidador/família é também escassa. O objetivo deste estudo é identificar em que domínios é que os enfermeiros especialistas de reabilitação poderão intervir de forma a desenvolver ganhos em saúde de pessoas transplantadas cardíacas e seu cuidador/família. Método: Para a operacionalização desta intervenção será utilizado o The Quality Health Outcomes Model, de Doran, na componente de resultados sensíveis aos cuidados de enfermagem. Serão efetuados de forma concorrente 2 estudos, um direcionado à reabilitação cardíaca da pessoa transplantada (fases 1, 2 e 3) e outro com enfoque na reabilitação cardíaca do cuidador/família. As metodologias utilizadas serão a scoping review, o relato de caso, o estudo exploratório e o estudo clínico randomizado (com grupo de intervenção e grupo de controlo). Discussão/Resultados Esperados: Será construído e implementado o programa Enfermagem de Reabilitação em Transplante Cardíaco (ERtxC), nas suas diferentes fases, durante os anos de 2021 e 2022. Estima-se que o programa possa ser acedido por 150 pessoas transplantadas cardíacas e respetivas famílias/cuidador. Conclusão: No final do ano de 2022 estima-se ter chegado ao final deste programa, com respetiva avaliação dos ganhos em saúde. Após validação deste programa, tentar-se-á criar em definitivo esta oferta de forma sistemática para todas pessoas submetidas a transplante cardíaco, em Portugal.

Aims In Portugal, in the last 5 years, no study has published recent data regarding outcomes of patients with acute decompensated heart failure (ADHF). We aimed to determine the characteristics and outcomes of a large contemporaneous Portuguese cohort of ADHF patients admitted to our emergency department (ED). Methods and results We conducted a retrospective, study of all 1024 patients admitted to our ED with a discharge diagnosis of ADHF from November 2016 to December 2017. Baseline clinical data and outcomes {in‐hospital, 30 day, and follow‐up all‐cause mortality, and readmissions; median follow‐up, 5 months; interquartile range [(IQR), 3–11 months]} were determined. Mean age was 78 ± 10 years, and 53% were male; of the 1024 patients, 554 (54%) were hospitalized. The median hospitalization length was 9 (IQR, 5–15) days, and in‐hospital mortality was 12.7%. Hospitalized patients were predominantly men (56% vs. 47%; P

Short frenulum, or ankyloglossia, may lead to breastfeeding problems, with an impact on infant development, nipple damage, and early abandonment of breastfeeding. There are currently no homogeneous diagnostic criteria, thus leading to both overdiagnosis and underdiagnosis and associated clinical consequences. The challenge to approach this condition lies in establishing whether it is a normal anatomical variation or a lingual frenulum without a functional impact and when breastfeeding difficulties which are typically attributed to it are actually caused by the frenulum. Approximately 50% of ankyloglossia cases do not result in breastfeeding problems or these can be resolved with support and advice. Surgery may be proposed for the rest of the cases. This article offers an update on the classification and treatment of ankyloglossia, which will help health care providers to provide an adequate management to these patients.El frenillo lingual corto, o anquiloglosia, puede generar problemas durante la lactancia con repercusión en el desarrollo del lactante, daño en el pezón de la madre y abandono precoz de la lactancia. Actualmente no existe homogeneidad en los criterios diagnósticos, lo que ocasiona tanto sobrediagnóstico como infradiagnóstico de esta alteración, con las consecuencias clínicas que ello conlleva. La dificultad en el abordaje radica en saber cuándo se trata de variantes anatómicas normales o de un frenillo lingual sin repercusión funcional, y cuándo los problemas de lactancia, que clásicamente se le atribuyen, se deben realmente al frenillo. Alrededor del 50 % de los niños con frenillo lingual corto no presenta problemas de lactancia o estos se resuelven con apoyo y asesoramiento. En el resto de casos se puede recurrir a tratamiento quirúrgico. En este artículo se ha realizado una actualización de la clasificación y tratamiento de la anquiloglosia que permitirá a los profesionales un manejo adecuado de estos pacientes.

Background Neonatal sepsis is a condition with high mortality and morbidity that contributes to high rates of antibiotic therapy at birth. In addition, very low birth weight newborns (VLBWN) are particularly vulnerable. Interleukin 6 (IL-6) seems to be an early and effective marker that could help a better selection of patients to be treated. This study aimed to evaluate the use of antibiotics in the first 72 hours of life in VLBW infants before and after using IL-6 as an infection marker. Also, we wanted to analyze the differences in morbidity and mortality during admission and other factors associated with the decision to start antibiotic treatment. Methods We conducted a cohort retrospective study. We included VLBWN born in our hospital or admitted before 72 hours of life in two two-year periods (2007-2008 and 2011-2012). Results Antibiotics use during the first 72 hours of life was analyzed as the primary variable, which was reduced by 20% on the second period (p = 0.002). Regarding the analysis of secondary variables, we found no significant differences in mortality during hospital admission and the incidence of nosocomial sepsis, enterocolitis, or invasive fungal infection. The multivariate analysis indicated extreme prematurity and the study group as the most strongly related factors to the start of antibiotic therapy. Conclusions IL-6 was a useful marker of infection to reduce the use of antibiotic therapy in VLBW infants without increasing mortality.

Hydrocephalus is a clinical condition that consists of an accumulation of cerebrospinal fluid around the brain; Dandy- Walker syndrome is a rare cause of it. We present the case of a newborn with prenatal diagnose of hydrocephalus due to a Dandy-Walker malformation, as well as ambiguous genitalia. After birth, diagnosis of Dandy-Walker malformation associated with uncommon extracranial manifestations is confirmed. Specifically, the baby presents interscrotal hypospadias and coronary sinus dilatation due to the persistence of the left superior vena cava. With the exposition of this case, we bring Malformacion de Dandy-Walker asociada a malformaciones extracraneales en un neonato Dandy-Walker malformation associated with extracranial abnormalities in a newborn out the complexity of the Dandy-Walker syndrome due to the malformations associated with it; the ones that will determine the prognosis and the need of a multidisciplinary treatment.

The detailed palynostratigraphic study of four boreholes in the Muaradzi sub-basin, Moatize-Minjova Coal Basin (MMCB) southeast of Moatize, allowed the assignment of relative ages to the stratigraphic units. Three assemblages were studied in detail and are assigned to the Lopingian. Assemblage L1 is characterized by the rich occurrence of Guttulapollenites and Weylandites. Assemblage L2 is defined on the first occurrence (FO) of abundant Thymospora pseudothiessenii together with Indotriradites niger, Kraeuselisporites spp., Polypodiisporites mutabilis and Polypodiidites sp. Assemblage L3 is characterized by the first occurrence of Osmundacidites senectus together with the taxa described from the previous assemblages. Palynological correlation with other Karoo basins is discussed and three distinct palynostratigraphic events emerge based on the FO and abundance of key taxa (as for instance, FO of G. hannonicus, T pseudothiensenii and O. senectus). A close palynological correlation between Mozambique (Moatize-Minjova Basin), Tanzania (Selous Basin), Zambia (mid-Zambezi Basin) and Madagascar palynoevents is established. This major region can be assigned to the northern Karoo-aged basins of south-central Africa and the palynoevents can be correlated with Lopingian assemblages of Pakistan, India and some basins of East Antarctica. The southern Karoo-aged basins of south-central Africa, including South Africa and Zimbabwe, show different Lopingian palynoevents and a direct correlation is demanding. These palynological data may open new perspectives for coal exploration in the MMCB as the coal deposits show a wider stratigraphic distribution, reaching until the latest Lopingian. (C) 2019 Elsevier B.V. All rights reserved. project PALEOCLIMOZ [PTDC/CTA-GEO/30082/2017] info:eu-repo/semantics/publishedVersion

Introduction: In November 2014, an extended-spectrum beta-lactamase producing Klebsiella pneumoniae outbreak was detected in the neonatal intensive care unit of a tertiary care hospital. Objective: Our aim was to determine the clinical, epidemiological and microbiological characteristics of the outbreak, to analyse the identified risk factors and to describe the preventive and control measures implemented for its eradication. Methods: We conducted a case-control study. We performed univariate and bivariate analyses, defining statistical significance as a P-value of less than 0.05. The implemented preventive and control measures were aimed at establishing the magnitude of the outbreak, effective communication, the evaluation of health care processes and education on patient safety. Clinical samples were collected for molecular and phenotypic characterisation. Findings: The sample consisted of 51 newborns, of who 17 were cases and the remaining 34 controls. The distribution of cases by birth weight was: 2 cases (11.8%) greater than 2500 g, 4 cases (23.5%) between 1500 and 2500 g, 5 cases (29.4%) between 1000 and 1500 g, and 5 cases (29.4%) less than 1000 g. In one case, the birth weight was not documented in the health record. The following risk factors for colonisation or infection were statistically significant in our study: presence of a central venous catheter (OR, 5.0 [95% CI, 1.4–17.8]; P = .016); parenteral nutrition (OR, 6.8 [95% CI, 1.8–25.7]; P = .006); urinary catheterization (OR, 5.9 [95% CI, 1.2–30.0]; P = .028) and birth weight (P = .035). We found statistically significant differences in the mean total length of stay in hospital (P = .004) and length of stay in the NICU (P = .002). All 17 cases presented antimicrobial resistance with presence of extended-spectrum beta-lactamase type CTX-M-14. Conclusion: Workplace interventions focused on patient safety need to be reinforced, especially those concerning practices with the potential to increase the extrinsic risk of colonisation or infection by extended-spectrum beta-lactamase-producing K. pneumoniae in the NICU, such as the insertion, care and maintenance of central venous catheter, parenteral nutrition and urinary catheterization. Resumen: Introducción: En noviembre de 2014, se detectó un brote de Klebsiella pneumoniae productora de betalactamasas de espectro extendido en la unidad de cuidados intensivos neonatales de un hospital terciario. Objetivo: El objetivo fue describir las características clínicas, epidemiológicas y microbiológicas del brote, analizar los factores de riesgo asociados y presentar las medidas preventivas y de control implementadas para su erradicación. Métodos: Estudio de casos y controles. Se realizaron análisis univariantes y bivariantes, considerándose estadísticamente significativo un valour de p < 0,05. Las medidas preventivas y de control se centraron en la necesidad de determinar la magnitud del problema, en la comunicación efectiva, la evaluación de los procedimientos sanitarios y la educación sobre la seguridad del paciente. Se realizó caracterización molecular y fenotípica de muestras clínicas. Resultados: La muestra de estudio consistió en 51 neonatos, de los que 17 fueron casos y los 34 restantes controles. La distribución de casos por peso al nacer fue: 2 con peso > 2.500 g (11,8%), 4 con peso de 1.500–2.500 g (23,5%), 5 con peso de 1.000–1.500 g (29,4%) y 5 con peso < 1.000 g (29,4%). En un caso no se había registrado el peso al nacer en la historia clínica. Los factores de riesgo estadísticamente significativos para la colonización/infección fueron: presencia de catéter venoso (OR = 5,0 [IC 95% 1,4–17,8]; p = 0,016); nutrición parenteral (OR = 6,8 [IC 95%: 1,8–25,7]; p = 0,006); sondaje vesical (OR = 5,9 [IC 95% 1,2–30,0]; p = 0,028) y peso al nacer (p = 0,035). Encontramos diferencias estadísticamente significativas en la estancia hospitalaria media (p = 0,004) y los días de estancia en la unidad de cuidados intensivos neonatales (p = 0,002). Se encontró resistencia a antimicrobianos tipo betalactamasas de espectro extendido CTX-M-14 en los 17 casos. Conclusión: Han de reforzarse las iniciativas de trabajo sobre la seguridad de los pacientes, especialmente aquellas aplicables a intervenciones con el potencial de aumentar el riesgo de colonización/infección por K. pneumoniae productora de betalactamasas de espectro extendido en la unidad de cuidados intensivos neonatales, como las asociadas a la inserción, cuidado y mantenimiento de catéter venoso, la nutrición parenteral y el sondaje vesical.

The clinician’s concept of mitral stenosis (MS) is often based around the model of rheumatic disease in younger patients. In such rheumatic patients, management is generally clear and current guide...

Renal cell carcinoma (RCC) is the most common and lethal tumor of the urological system. Curative treatment of localized RCC includes nephrectomy, radio-ablation, and active surveillance, whereas metastatic RCC (mRCC) requires a combination of surgery and systemic therapy. Response to conventional therapy is limited but, recently, many novel therapies for mRCC have emerged, including targeted therapies and new immunotherapeutic agents. Nevertheless, development of resistance and limited durable responses demand new anticancer candidates with improved selectivity and efficacy. In this review, we summarize recent preclinical studies of novel natural and synthetic compounds to treat RCC, detailing their mechanisms of action and anticancer activities.

Antimicrobial resistance (AMR) is an urgent and complex problem worldwide, exacerbated by the frequently inappropriate use of antibiotics. The purpose of this study was to survey the levels of knowledge and awareness about antibiotic use and stewardship, among human and veterinary health professionals or students in Portugal, and the associations between antibiotic knowledge factors and socio-professional groups. In cross-sectional survey design, a total of 449 online structured questionnaires were completed in 2018–2019. The statistical analysis was performed dividing the respondents into four groups, A (undergraduate students), B (PhD students and researchers), C (lecturers), and D (technicians and other occupation). Among all respondents, 17% (n = 75) revealed some gap in knowledge about antibiotic resistance and the antibiotics that should be administered for different infection types (bacterial, viral, or fungal). Of the 159 pet owners among the respondents, only half had administered antibiotics to their animal and 64% (n = 102) knew that veterinary prescription is mandatory when administering antibiotics to animals. All groups statistically agreed that the AMR is a major public health problem and the antibiotics should be administrated for bacterial infections and used until the whole pack has been finished (p = 0.00). As expected, only groups B and C demonstrated a higher level of knowledge to recognize the antibiotic name and their active ingredient than undergraduate students (p = 0.00). About the antibiotic use on pets, only group B was statistically significant to no used antibiotics on their pets (p = 0.00). However, groups A, C, and D were statistically significant for the knowledge about the mandatory veterinarian prescription and groups C and D were significantly statistics for fully aware of the transmission of bacteria between animals and humans. In conclusion, in matters related to AMR, the behavior, education, and training of the general public and health professionals, including those who prescribe antibiotics for humans and animals, need to be improved.

Triple-negative breast cancer (TNBC) is considered the most aggressive breast cancer subtype, shows a poor response to the currently available therapy, and has no targeted therapy. Chemotherapy, surgery and radiation are the current therapeutic options to treat patients with TNBC, however, response to these therapeutic approaches is very poor and has significant side effects. Thus, there is an urgent need to search for new anti-TNBC agents, more effective and safer than current therapy. A wide range of synthetic chromene derivatives have been explored as anticancer agents in different cancer models, with promising results, and some of them already reached the clinical setting. Especially in TNBC, most of the available studies are conducted in in vitro models, with limited results in vivo. It is important the activity of any new compound that reaches clinical studies is supported by solid pre-clinical data. Thus, in the present study, we review and analyze the studies that use chromene-based compounds using in vivo models of TNBC. The results of this systematic review can add value to ongoing chromene-based studies.

Mucormycosis is a rare fungal infection caused by Mucorales order fungi. The rhino-cerebral form of mucormycosis is most commonly seen in patients with diabetes mellitus, whereas, pulmonary mucormycosis is a rare manifestation in patients with haematological malignancy and transplant recipients. We report a case of pulmonary mucormycosis presenting with a late acute onset diabetes on a patient immunosuppressed with a low dose of steroids. We aim to illustrate the need for a high clinical suspicion for the diagnosis of mucormycosis and to report the importance of early and aggressive inhiation of antifungal therapy.

Machado-Joseph disease (MJD) or Spinocerebellar ataxia type 3 (SCA3) is a progressive neurodegenerative disorder that affects movement coordination leading to a premature death. Despite several efforts, no disease-modifying treatment is yet available for this disease. Previous studies pinpointed the modulation of serotonergic signaling, through pharmacological inhibition of the serotonin transporter SERT, as a promising therapeutic approach for MJD/SCA3. Here, we describe the 5-HT1A receptor as a novel therapeutic target in MJD, using a C. elegans model of ATXN3 proteotoxicity. Chronic and acute administration of befiradol (also known as NLX-112), a highly specific 5-HT1A agonist, rescued motor function and suppressed mutant ATXN3 aggregation. This action required the 5-HT1A receptor orthologue in the nematode, SER-4. Tandospirone, a clinically tested 5-HT1A receptor partial agonist, showed a limited impact on animals' motor dysfunction on acute administration and a broader receptor activation profile upon chronic treatment, its effect depending on 5-HT1A but also on the 5-HT6/SER-5 and 5-HT7/SER-7 receptors. Our results support high potency and specificity of befiradol for activation of 5-HT1A/SER-4 receptors and highlight the contribution of the auto- and hetero-receptor function to the therapeutic outcome in this MJD model. Our study deepens the understanding of serotonergic signaling modulation in the suppression of ATXN3 proteotoxicity and suggests that a potent and selective 5-HT1A receptor agonist such as befiradol could constitute a promising therapeutic agent for MJD.

Objetivos: Realizar uma revisão sobre adesão à terapêutica na população portuguesa visando descrever o âmbito (quantidade, foco e natureza) da atividade de investigação original. Fontes de dados: Foram pesquisados estudos sobre adesão à terapêutica na MEDLINE, Web of Science, SciELO e B-on. Métodos de revisão: A revisão foi realizada em dezembro de 2014. Nas fontes de dados foram pesquisados estudos sobre adesão à terapêutica na população portuguesa cuja recolha de dados fosse igual ou posterior a 2005 e/ou se a publicação ocorreu até ao final de 2014. Resultados: Obtiveram-se 82 publicações, das quais foram selecionadas 26. Os resultados indicam um maior número de estudos em populações do Norte e da região de Lisboa e Vale do Tejo; a aparente inexistência de estudos sobre iniciação do tratamento e apenas um estudo sobre descontinuação; uma variabilidade nos métodos de recolha de dados e nas medidas utilizadas para avaliar a adesão à terapêutica, com os inquéritos dirigidos aos doentes como a principal fonte de informação; taxas de adesão entre os 41,6% e os 89%, dependentes da doença ou condição estudada. Conclusões: Os diferentes métodos de recolha de dados e medidas de avaliação da adesão, os curtos períodos de recolha de dados, a análise quase exclusiva da implementação do tratamento, não analisando os fatores que influenciam a sua iniciação e descontinuação, dificultam a monitorização da adesão à terapêutica na população portuguesa Aim: To conduct a structured literature review describing the scope (quantity, focus, and nature) of published original research on medication adherence in the Portuguese population. Data sources: Studies on medication adherence were searched on MEDLINE, Web of Science, SciELO, and B-on. Methods: The scoping review was conducted in December 2014 using the data sources, searching for studies on medication adherence in the Portuguese population, conducted after 2005, and/or published until the end of 2014. Results: We identified 82 publications and 26 were selected for this review. Most studies were conducted on populations in the North and in the Lisbon and Tagus Valley Region. There were no studies on initiation of treatment and only one study on discontinuation. There was variability on the methods used for data collection and measures used for evaluation of adherence. Questionnaires were the main source of information. Adherence rates varied from 41.6% to 89%, depending on the disease or condition studied. Conclusions: The different methods used for data collection and evaluation of adherence, the short periods of time for data collection, and the exclusive analysis of the implementation of treatment disregarding the factors that determine initiation and discontinuation of treatment, hinder the study of medication adherence in the Portuguese population using recently published research

1.Executive SummaryThis survey and data analysis were conducted by the European Network of Postdoctoral Associations (ENPA) with the aim of assessing the current research and work conditions, aspirations and support received by postdoctoral researchers working in Europe.The Results section is structured into three main parts. The first one describes the study sample of European postdoctoral researchers, including participants’ demographics, funding sources and income, research outputs, and teaching opportunities. The second section focuses on their professional aspirations and institutional support provided. The third part describes the level of engagement of postdoctoral researchers and their institutions in working towards better research conditions and career development, and what initiatives are emerging within this community.Our Conclusions section pulls together this comprehensive analysis, highlighting some of the most concerning issues currently affecting postdoctoral researchers in Europe. We also make a number of recommendations that would significantly improve the career expectations and aspirations of postdoctoral researchers. These are listed below.Conclusions and recommendationsLonger postdoctoral periods in Southern Europe despite higher publication metricsRecommendation Institutions in Southern Europe should develop clear criteria to support postdoctoral researchers’ career progression.Southern and Eastern Europe pay the lowest salaries and have the lowest number of foreign postdoctoral researchersRecommendation The salary differences across European countries should be addressed as this could be a barrier to mobility and knowledge exchange from higher to lower pay regions.Lack of access to funding is a significant concern of postdoctoral researchersRecommendation Discrepancies in access to funding should be minimized across the different European areas.Postdoctoral researchers in Europe work longer hours than required by contractRecommendation The culture of overwork in the research environment should be addressed in order to protect researchers against the risks associated with long hours at work.The majority of full-time postdoctoral work contracts includes an exclusivity clauseRecommendation Inclusion of exclusivity clauses in contracts for postdoctoral researchers should be optional in order to allow them to enhance their employability outside academia.Postdoctoral researchers’ career development is poorly supported by their institutionsRecommendation Postdoctoral researchers’ career prospects and career management should be much more supported by institutions in coordination with postdoctoral associations.Lack of postdoctoral representation in governance is linked to unclear institutional duties and rightsRecommendation Institutional governance bodies should include postdoctoral researcher representatives. This would ensure that the views of this vital staff group are heard, as well as making postdoctoral researchers feel more engaged with their own institutions. A flexible and proactive communication strategy at the institution and research group level should be developed, taking into account the sometimes transient nature of postdoctoral researchers’ posts.Researchers show higher engagement with their local postdoctoral associations than with workers’ unionsRecommendation Postdoctoral associations are an essential way to advocate for postdoctoral researchers at the governance level. Institutions should engage with, promote and support the work of postdoctoral associations.

No question remains regarding our need to change toward sustainable agriculture. When ranking the industries that have more prevalent environmental impacts, agriculture holds a considerable share of responsibility. However, as sustainability is an ambiguous concept surrounded by controversy and debate, rather than attempt to describe its meaning through a single universal definition, we instead stressed the need to delineate a set of fundamental principles. With the goal of putting the sustainable-agriculture concept into practice, an inductive qualitative content analysis was employed based on multivariate methods on hundreds of different definitions, theories, notions and sustainability indicators gathered through a deep-structured literature review. Through this novel approach, we were able to identify four fundamental principles for sustainable agriculture (integrated management, dynamic balance, regenerative design, and social development), and concluded that in order to shift our current agricultural systems into more efficient and sustainable ones, we need to start making better use of natural and human resources. This work provides guidelines for reference that can be used by anyone whenever they make a decision regarding sustainable agriculture or apply a methodology to assess a particular behavior, process or situation.

Prescription patterns of non-vitamin K antagonist oral anticoagulants (NOACs) are unknown among primary care physicians, where most patients with nonvalvular atrial fibrillation (NVAF) are diagnosed and followed up. The goal of this study was to evaluate overdosing and underdosing of NOACs in patients with NVAF followed up in primary care and determine their clinical predictors.This multicenter cross-sectional study included all patients with NVAF followed up in 13 primary care units in the center region of Portugal. Patients receiving antithrombotic regimens other than NOACs and patients with missing data were excluded.The study included 858 patients with NVAF on an NOAC regimen. Overall, 30.3% were prescribed an off-label dosage (25.4% with infratherapeutic dosing [ITD] and 4.9% with supratherapeutic dosing). Chronic kidney disease (odds ratio, 14.0; 95% CI, 5.4-36.5; P 0.001) and female sex (odds ratio, 2.6; 95% CI, 1.2-5.7; P 0.001) were independent predictors of supratherapeutic dosing. We also found a significant effect of chronic kidney disease on ITD (odds ratio, 0.22; 95% CI, 0.258-0.678; P 0.001).In primary care, NOACs are frequently prescribed with unadjusted dosages, generally infratherapeutic. Attention should be paid to women and patients with chronic kidney disease.

Gastric volvulus is an uncommon cause of gastric obstruction. It can be classified as primary when no underlying condition is identified as the cause for the rotation. An acute presentation includes typical symptoms and is frequently detected by imaging studies. Chronic cases present with intermittent vague symptoms and imaging studies may be normal during the symptomatic interval. The lack of specific symptoms and signs delays the diagnosis of chronic volvulus. However, appropriate treatment demands prompt diagnosis. We report two cases of primary gastric volvulus, with chronic or subacute symptoms and normal imaging studies during the asymptomatic periods. Both were treated surgically and had an uneventful follow-up.

Bipolar disorder (BD) is a chronic psychiatric illness with an unknown etiology. Lithium is considered the cornerstone in the management of BD, though about 50-60 % of patients do not respond sufficiently to chronic treatment. Insulin-like growth factor 1 (IGF1) has been identified as a candidate gene for BD susceptibility, and its low expression has been suggested as a putative biomarker for lithium unresponsiveness. In this study, we examined the in vitro effects of insulin-like growth factor 1 (IGF-1) on lithium sensitivity in lymphoblastoid cell lines (LCLs) from lithium responder (R) and non-responder (NR) bipolar patients. Moreover, we evaluated levels of microRNA let-7c, a small RNA predicted to target IGF1. We found that exogenous IGF-1 added to serum-free media increased lithium sensitivity selectively in LCLs from NR BD patients. However, no significant differences were observed when comparing let-7c expression in LCLs from R vs. NR BD patients. Our data support a key role for IGF-1 in lithium resistance/response in the treatment of bipolar disorder.

Introduction Several studies analyzed the possible relationships between semen parameters and assisted reproductive technologies (ART) treatments. However, none could establish a threshold to guide in the decision of which treatment technique will be better facing spermiogram values. Objectives A database with spermiogram and clinical parameters was built in order to search for relevant interactions between semen parameters and different ART treatment techniques. Materials and methods A general statistical analysis evaluated semen parameters, followed by correlations to study their influence on the pregnancy rate for each type of treatment technique. Results A predominance of teratozoospermia and asthenozoospermia was observed, with strong positive correlations between age and total motility, as well as obvious correlations between concentration and motility. Of the studied population, 41.8% went for ART consultations and presented a mean time of infertility of 2.9 years, a mean male age of 33.4 years and a mean female age of 31.9 years. Of these, 17.1% achieved a spontaneous pregnancy. Of the treatment cycles, 13.1% were by intra-uterine insemination (10.2% of clinical pregnancy rate, CP, with six newborn, NB), 24.9% by in vitro-fertilization (21.7 CP, 18 NB) and 44.9% by intracytoplasmic sperm injection (25.3% CP, 40 NB). From the analysis between semen parameters and the pregnancy rates, per type of ART technique, a significant positive correlation between techniques was found, revealing thresholds associated with the probability of a successful clinical pregnancy. Conclusions The present results suggest that spermiogram reference limits can be developed for each treatment technique that are associated with a higher probability of achieving a clinical pregnancy.

Rural and livestock population evolution in the inner north of Portugal has demonstrated a great regression with consequences for environment and nature conservation. In this context, and taking into account that pastoral activity has shaped the natural areas of mountain territories since its beginning and that territories are currently part of Natura 2000 network, rethinking the importance of such activity has become vital. The constraints affecting daily tasks performed by shepherds and livestock breeders as well as the installed social segregation are a strong limitation. However, current research developed in the context of nature conservation has demonstrated the importance of the landscape mosaic promoted by grazing in the preservation of priority habitats. In this way, it is urgent to assess the issue of shepherds and livestock breeders’ image in terms of their roles, relationships and concerns, as well as to assess pastoralism socioeconomics in regard to self-consumption, market and rural self-sufficiency. In this perspective, this work presents an analysis of the adaptation of grazing to current times, perceiving its limitations and success potential. This work is supported by European Structural and Investment Funds, FEDER component, through the Operational Competitiveness and Internationalization Programme (COMPETE 2020) [Project No. 006971 (UID/SOC/04011)], and national funds, through FCT, Portuguese Foundation for Science and Technology under project UID/SOC/04011/2013. info:eu-repo/semantics/publishedVersion

Submucosal lesions are mass-like protuberances into the gastrointestinal lumen covered by normal mucosa. Making a definitive diagnosis is difficult because of the number of benign and malignant lesions and extrinsic compression. Here we report the case of a 42-year-old woman referred for colon polypectomy. Colonoscopy revealed a polypoid formation with externalization from the appendicular orifice covered by normal mucosa and another formation at the sigmoid colon. The histopathology of both lesions was normal. Endoscopic ultrasound showed a hypoechoic lesion that was slightly heterogeneous in the fourth layer, and CT colonography confirmed the findings. Surgical therapy with ileocolic resection and resection of the sigmoid lesion was performed. Surgical specimens revealed an appendicular intussusception by endometriosis and endometrial foci in the sigmoid. Intestinal endometriosis may have several presentations, but it should always be considered in the differential diagnosis of a submucosal lesion in the colon.

Summary Neural circuit mapping is generating datasets of tens of thousands of labeled neurons. New computational tools are needed to search and organize these data. We present NBLAST, a sensitive and rapid algorithm, for measuring pairwise neuronal similarity. NBLAST considers both position and local geometry, decomposing neurons into short segments; matched segments are scored using a probabilistic scoring matrix defined by statistics of matches and non-matches. We validated NBLAST on a published dataset of 16,129 single Drosophila neurons. NBLAST can distinguish neuronal types down to the finest level (single identified neurons) without a priori information. Cluster analysis of extensively studied neuronal classes identified new types and unreported topographical features. Fully automated clustering organized the validation dataset into 1,052 clusters, many of which map onto previously described neuronal types. NBLAST supports additional query types, including searching neurons against transgene expression patterns. Finally, we show that NBLAST is effective with data from other invertebrates and zebrafish. Video Abstract, Highlights • NBLAST is a fast and sensitive algorithm to measure pairwise neuronal similarity • NBLAST can distinguish neuronal types at the finest level without training • Automated clustering of 16,129 Drosophila neurons identifies 1,052 classes • Online search tool for databases of single neurons or genetic driver lines, Thousands of single-neuron images are being generated by efforts to map circuits and define neuronal types. Costa et al. validate a new neuronal similarity algorithm, NBLAST, demonstrating that it can distinguish neuronal types and organize huge datasets.

Microbial monitoring of constructed wetlands (CWs) treating domestic wastewater is generally scarce, despite the need of more knowledge about its biocenosis. The sanitation quality of a wastewater treated in a CW is a crucial aspect, mainly when the receiving water body is used as a swimming and/or recreation area. The present study was carried out in a horizontal subsurface flow CW planted with Phragmites australis receiving pre-treated domestic wastewater (mean flow 50 m(3) day(-1)), from a population of about 300 inhabitants. The monitoring programme undertaken during the first year operation, revealed removal efficiencies of 61% BOD5, 44% COD, and 65% TSS for inlet water with ca. 90 mg L-1 BOD5, 157 mg L-1 COD, and 17 mg L-1 TSS. Total Coliform (TC) and Faecal Coliform (FC) bacteria were removed from wastewater (mean inlet values of 5 x 10(6) CFU 100 mL(-1) TC and of 9 x 10(5)CFU 100 mL(-1) FC), with efficiencies of 92 and 97%, respectively. The dynamics of microbial communities established in the system assessed by polymerase chain reaction-denaturing gradient gel electrophoresis (PCR-DGGE), had revealed a high bacterial diversity within the system, with no relevant differences in composition at the CW inlet and outlet but exhibiting temporal differences in bacterial communities., Isabel A-P. Mina wishes to thank Aguas do Ave S.A., for the permission to carry out this study on Parada do Bouro Treatment Plant, and for the financial support conceded.Cristina S.C. Calheiros wishes to thank a research grant from Fundacao para a Ciencia e Tecnologia (FCT), Portugal (SFRH/BPD/63204/2009).

Objectives To establish reference values in cord blood of the following new sepsis markers: pro-adrenomedullin (MR-proADM), pro-endothelin (CT-proET-1), and pro-atrial natriuretic peptide (MR-proANP). Methods MR-proADM, CT-proET-1, MR-proANP, and procalcitonin (PCT) were measured in cord blood of newborn infants by Time Resolved Amplified Cryptate Emission (TRACE) technology. The inclusion criteria in the control group ( n = 194) was the absence of any clinical sign or risk factor of sepsis. A group of 73 newborn infants presenting with risk factors of sepsis at delivery was also studied. Results The median values (reference interval) of CT-proET-1, MR-pro-ADM, and MR-proANP measured in cord blood plasma were 72 pmol/L (39–115), 0.84 nmol/L (0.5–1.38), and 163 pmol/L (76–389), respectively. The PCT reference interval was not significantly different from that previously described in cord blood serum. Conclusions The reference intervals established will serve as a starting point for further clinical investigations aimed to elucidate the potential prognostic/diagnostic value of these markers in neonatal sepsis management.

Background: A new interleukin-6 (IL-6) electrochemiluminescent immunoassay (ECLIA, Roche Diagnostics) was evaluated and compared to a previous semiquantitative immunoassay (Milenia Biotec). Reference ranges for cord blood plasma were also calculated. Methods: The new IL-6 ECLIA test was performed using a Cobas E601 analyzer (Roche Diagnostics). The comparison method (Milenia Biotec) was a semiquantitative lateral flow immunoassay, coupled to a digital image capture system (PicoScan). Healthy at term newborns were recruited to establish reference ranges for IL-6 in cord blood plasma. Results: Total imprecision ranged from 3.7% to 8.0% depending on the IL-6 concentrations. The calculated limit of detection for IL-6 measured by ECLIA was 2.63 pg/mL, almost twice as high as that claimed by the manufacturer (1.5 pg/mL). The linearity of the method was verified to 5000 pg/mL. The IL-6 reference limit, obtained from 148 cord blood samples, was 30 pg/mL (90% confidence interval: 19–48 pg/mL). Conclusions: The new quantitative ECLIA method showed good reproducibility, linearity and functional sensitivity. Additional clinically based studies are needed to elucidate the usefulness of the IL-6 reference limit, calculated here for the first time by ECLIA in cord blood plasma, to aid in the diagnosis of vertical transmission of sepsis. Clin Chem Lab Med 2010;48:835–8.

Following acute and chronic neurodegenerative disorders, a cascade of pathological events including inflammatory response, excitotoxicity and oxidative stress induces secondary tissue loss in both gray and white matter. Axonal damage and demyelination are important components of the white matter demise during these diseases. In spite of this, a few studies have addressed the patterns of inflammatory response, axonal damage and demyelination following focal ischemic damage to the central nervous system (CNS). In the present study, we describe the patterns of inflammatory response, axonal damage and myelin impairment following microinjections of 10 pmol of endothelin-1 into the rat striatum. Animals were perfused at 1 day, 3 days and 7 days after injection. 20 mum sections were stained by hematoxylin and immunolabeled for neutrophils (anti-MBS-1), activated macrophages/microglia (anti-ED1), damaged axons (anti-betaAPP) and myelin (anti-MBP). The evolution of acute inflammation was quantitatively assessed by cell counts in different survival times. There was recruitment of both neutrophils and macrophages to the damaged striatal parenchyma with maximum recruitment at 1 day and 7 days, respectively. Progressive myelin impairment in the striatal white matter tracts has been observed mainly at later survival times. beta-APP+ endbulbs were not present in all evaluated time points. These results suggest that progress myelin impairment in the absence of damage to axonal cylinder is a feature of white matter pathology following endothelin-1-induced focal striatal ischemia.

Introduction: Neonatal brain abscess is an uncommon intracranial suppuration that usually occurs as a complication of bacterial meningitis or septicaemia. Staphylococcus aureus rarely causes brain abscesses during the first months of life. Case presentation: A case of a premature infant who developed cerebellar, left temporal and left occipital lobe abscesses after S. aureus sepsis is presented. The pus provided the same S. aureus strain of the sepsis. The patient was treated with vancomycin for 37 days, accompanied by extraction of the purulent material. The abscesses resolved and no sequelae remained. Conclusion: It appears that long antibiotic treatment regimes, when associated with early pus drainage, are effective in resolving infection and abscesses caused by S. aureus in neonates.

Appendicular intussusception is an uncommon entity, with a reported incidence of 0.01%. The diagnosis is difficult and often only performed at the time of surgery. Intussusception has multiple causes including tumours, foreign bodies and polyps. The definitive treatment is surgical, and the extent of resection is determined by the underlying pathology and degree of invagination. Endometriosis is a rare cause of appendicular intussusception, with 194 cases described in the English literature. We report a case of a 42-year-old woman who presented with chronic abdominal pain in the lower right quadrant. A mass at the caecum was identified during investigations for renal stones by CT. Colonoscopy showed a polypoid lesion, with presumed origin in the appendix. Ileocaecal resection was performed because an appendicular tumour was suspected. Pathological examination identified endometriosis of the appendix and associated peritoneum with invagination of the caecum. The patient was discharged 7 days after surgery and is currently asymptomatic.

This study estimated the number of HCWs with protective antibody levels 5 and 10 years after HBV vaccination. Kaplan-Meier probabilities of protective levels were 0.95 at 60 days after vaccination, 0.87 at 5 years, and 0.79 at 10 years. Those without protective levels displayed good response 7 and 30 days after a booster

e13039 Background: Oral and pharyngeal cancer is the 11th most common malignancy worldwide. Although the oral cavity is a potentially accessible site for examination, up to 50% of oral cancers are detected at advanced stage. The Mobile Unit of Stomatology and Dental Medicine (UMEMD) of the Portuguese League Against Cancer (LPCC) and of the Portuguese Association of Hospital Dental Medicine (APMDH) has developed oral cancer early diagnosis consultations. This consultations were performed by a team of 50 doctors specialized in oral cancer diagnosis. Once a month the team of UMEMD went to a different region of the North of Portugal. Early oral cancer diagnosis consultations were also performed twice a week at the Portuguese League Against Cancer at Oporto.We present the experience of UMEMD in the early diagnosis consultation of oral cancer, since its foundation in August 2012 until the end of 2016. Methods: We performed a retrospective evaluation of medical records of patients observed in the early diagnosis consultation of oral cancer of UMEMD between August 2012 and December 2016. We assessed the demographic characteristics, risk factors, cancer history, likely diagnosis and the referral of patients. Results: 6,231 new patients were observed; median age of patients was 63 years-old [1;102], 93 patients were younger than 18 years-old. There was information about smoking habits of the majority of patients n = 4,521(72.6%): 597(9.6%) were smokers and 653(10.5%) former smokers. 228 (3.6%) patients had previous cancer. We detected: 963 lesions (15.5%); the majority of the lesions were at the tongue n = 263 (4.2%).The patients with suspicious lesions (n = 638; 10.2%) were referred to: Portuguese Institute of Oncology of Oporto: n = 146 (2.3%); Faculty of Dental Medicine of the University of Oporto: n = 353 (5.7%); Physicians at other hospitals: n = 139 (2.2%). Conclusions: Consultations for oral cancer early diagnosis performed by an experienced team has enabled the detection of suspicious lesions in 10.2% of the patients. Cooperation with other institutions, through protocols, allowed the referral and early treatment of these patients.

The single objective—profit maximization—has been the classical and neoclassic model for farmer’s decision making. Nowadays, it is recognized that other and conflictual objectives are important concerns to the process, making the multi-criteria methodologies more suitable to the agricultural reality. This chapter aims to identify and find the objectives and priorities of the Azorean dairy farmer’s decision making. The proposed methodology is based on multi-criteria models, by simulation of the dairy farmers’ behavior through data of the Farm Accountancy Data Network. This allows to define a surrogate utility function for a dairy farm typology, regarding the different grazing systems. Five main objectives were previously considered: profit maximization, risk minimization, labor seasonality minimization, leisure maximization, and also deviations to the goal of total labor minimization. The results show that in any group of Azorean dairy farms, the decision making process seems to be influenced by three conflictual objectives: profit maximization, labor seasonality, and risk minimization. Also, the farms’ objectives depend on the intensity of grazing systems and by other socioeconomic factors. That is, farmers’ behavior is not always explained by profit (exception in the low intensity grazing systems), which is unusual under the traditional paradigm. Some explanations may be appointed for this situation and one is related to the dairy farms income that can be enough to maintain the farm and family income. If the economic objectives are satisfied, then the farmers can have other priorities.

Solitary fibrous tumor is a rare neoplasm of mesenchymal origin that usually arise within the pleura. Its origin in abdominal wall is extremely rare, with only 15 cases described in the English literature. We report the case of a 55-year-old woman presented with a mass located at the left lower quadrant of the abdominal wall. Microscopic studies revealed histologic and immunohistochemicalfeatures consistent with a SFT. Eighteen months after surgical excision of the mass followed by adjuvant radiotherapy, the patient is alive and disease-free. The authors discuss the clinicopathological features of SFTs, differential diagnosis and treatment options.

Bipolar disorder (BD) is a lifelong severe psychiatric condition with high morbidity, disability and excess mortality. The longitudinal clinical trajectory of BD is significantly modified by pharmacological treatment(s), both in acute and in long-term stages. However, a large proportion of BD patients have inadequate response to pharmacological treatments. Pharmacogenomic research may lead to the identification of molecular predictors of treatment response. When integrated with clinical information, pharmacogenomic findings may be used in the future to determine the probability of response/nonresponse to treatment on an individual basis. Here we present a selective review of pharmacogenomic findings in BD. In light of the evidence suggesting a genetic effect of lithium reponse in BD, we focused particularly on the pharmacogenomic literature relevant to this trait. The article contributes a detailed overview of the current status of pharmacogenomics in BD and offers a perspective on the challenges that can hinder its transition to personalized healthcare.

Aim of study: This paper aims to test a participatory methodology to draw parallels and paradoxes as to how some forest sector-related entities and local communities view the Montemuro Mountain forest, namely in terms of its characteristics, the offered opportunities, its problems and the likely solutions for its management as well as the role played by stakeholders, which can be replicated in other case studies and can also facilitate the forest policy making process.Area of study: The Natura 2000 Network “Montemuro Mountain” Site in Portugal.Material and methods: This study combined several consultation and citizen participation techniques.Main results: The perceptions shared by the stakeholders are some similar, others not similar and others still quite paradoxical regarding forest characteristics and the opportunities they offer. The study has shown that it is possible to implement and improve citizen participation methodologies. This can be a viable way towards more effective forest management and fire prevention as this may help blunt conflicts of interest in forest space management. However, for participation to be truly effective and representative, a policy regarding training and awareness of the importance of information is necessary.Research highlights: The stakeholder perceptions on forests and forest management are assessed; forest fires and agrarian abandonment are central for territory’s development; depopulation, old age and absenteeism emphasize degradation of forest areas; Conscious citizen participation benefit policymaking and forest management.Abbreviations used: ZIF: Forest Intervention Zones; GAL: Local Follow-up Group; GTFs: Technical Bureaus of Forestry.

AIM: To analyze the clinical impact of preformed antiHLA-Cw vs antiHLA-A and/or -B donor-specific antibodies (DSA) in kidney transplantation. METHODS: Retrospective study, comparing 12 patients transplanted with DSA exclusively antiHLA-Cw with 23 patients with preformed DSA antiHLA-A and/or B. RESULTS: One year after transplantation there were no differences in terms of acute rejection between the two groups (3 and 6 cases, respectively in the DSA-Cw and the DSA-A-B groups; P = 1). At one year, eGFR was not significantly different between groups (median 59 mL/min in DSA-Cw group, compared to median 51 mL/min in DSA-A-B group, P = 0.192). Moreover, kidney graft survival was similar between groups at 5-years (100% in DSA-Cw group vs 91% in DSA-A-B group, P = 0.528). The sole independent predictor of antibody mediated rejection (AMR) incidence was DSA strength (HR = 1.07 per 1000 increase in MFI, P = 0.034). AMR was associated with shortened graft survival at 5-years, with 75% and 100% grafts surviving in patients with or without AMR, respectively (Log-rank P = 0.005). CONCLUSION: Our data indicate that DSA-Cw are associated with an identical risk of AMR and impact on graft function in comparison with "classical" class I DSA. info:eu-repo/semantics/publishedVersion

Evaluating sustainable development is, at present, an essential prerequisite for promoting sustainable agriculture. The approaches for building sustainable farming systems presented in the next chapters of this book use various methods and procedures to assess the sustainability of farming systems. In that sense, this chapter presents some useful elements regarding those initiatives: Arbre de l’Exploitation Agricole Durable (ARBRE), Framework for the Evaluation of Sustainable Land Management (FESLM), Indicateur de Durabilite des Exploitacions Agricoles (IDEA), Indicator of Sustainable Agricultural Practice (ISAP), Multiscale Methodological Framework (MMF), diagnostic de durabilite du Reseau de l’Agriculture Durable (RAD), Response-Inducing Sustainability Evaluation (RISE), Sustainability Assessment of the Farming and the Environment (SAFE), and the Sustainability Solution Space for Decision Making (SSP) method.

This chapter constitutes an assay of a sustainable farming model for the Montemuro mountain (Portugal), a protected area of Natura 2000 network. The model integrates a strategy to reverse the trend of abandonment of this territory, promotes the conservation of natural values through the active management of traditional systems and needs to be economically viable, socially attractive and conducive to more environmental gains. The planning of the farming system was carried having for base the multiobjective programming (noninferior set estimation method complemented with compromise programming). Two objectives were considered to the mathematical formulation of the model: an economic objective – maximising the gross value added – and the second target regarded the environmental scope, minimising energy costs. As results, it is verified that the balance between the selected objectives was established by the selection of a particular set of vegetable activities and always by selecting bovine of trunk Friesian breed and sheep. Bovines of local breed (Arouquesa) are also an option to consider in most of the situations but in smaller numbers.

Food sufficiency, environmental preservation, socio-economic viability and equity are the major components of sustainable farming. However, establishing the definitions and operational methodologies that enable their application in the decision-making process and in the sustainability assessment processes has proved to be a very difficult task. It is necessary to select, from among the various approaches, the methods of evaluation on which decision-making is based. In this chapter, there are briefly presented the needs for building farming systems enclosed in the main objectives of this book. In the final part of the chapter, the book organization and a short summary of the highlights for each of the chapters focusing on the methodologies used are presented.

Background: Measurement of C-peptide under standardized conditions provides a sensitive and well-established assessment of β-cell function. We describe the analytical and clinical validation of an automated, microparticle-based chemiluminescent immunoassay method. The assay is designed to measure C-peptide in human serum, plasma and urine. Methods: Assay performance characteristics such as precision and recovery were measured according to protocols established by the Clinical Laboratory Standards Institute (CLSI). A reference range study was conducted. Analytical sensitivity and specificity, interfering substances, recovery, and linearity studies were performed. Method comparison, against the ADVIA Centaur C-Peptide assay (Siemens), was evaluated with clinical specimens from patients with abnormal insulin secretion. Results: The detection limit for this assay was 0.01 ng/mL. Functional sensitivity (inter-assay imprecision ≤20%) was 0.015 ng/mL at a coefficient of variation (%CV) of 11.2%. Total imprecision was below 6.5% CV. The assay was linear upon dilution. Comparison with the ADVIA Centaur C-Peptide assay yielded a correlation coefficient (r) of 0.99. Conclusions: The ARCHITECT C-Peptide assay measures C-peptide rapidly, accurately, and precisely in human serum, plasma and urine. It provides useful improvements for β-cell function testing and for evaluating the clinical status of a patient in combination with other diabetes markers. Clin Chem Lab Med 2009;47:834–41.

One of the biggest challenges in system development is the definition of its architecture. A proper architectural definition facilitates not only the system design as a whole but also the development and reuse of components. Component technologies provides a number of advantages for the development of e-learning systems, including modularization, reduced development time, and increased degree of interoperability, portability and maintainability. This paper aims at investigating the application of an architectural model in the development of component-based e-learning systems. We illustrate the use of this architectural model in the development of a collaborative electronic voting system

During collaborative learning activities, factors such as students’ prior knowledge, motivation,roles, language, behavior and interaction dynamics interact with each other in unpredictable ways, making it very difficult to predict and measure learning effects. This may be one reason why the focus of collaborative learning research shifted in the nineties from studying group characteristics and products to studying group process. With an interest in having an impact on the group process in modern distance learning environments, the focus has recently shifted again – this time from studying group processes to identifying computational strategies that positively influence group learning. This shift toward mediating and supporting collaborative learners is fundamentally grounded in our understanding of the interaction described by our models of collaborative learning interaction. In this workshop, we will explore the advantages, implications, and support possibilities afforded by the various types of computational models of collaborative learning processes.

A main issue in collaborative learning is providing support and monitoring both the individual learners and the group activities. In this sense, there is a variety of functions that might be accomplished by a collaborative learning support system. Some examples are: knowledge diagnosis and evaluation, group and individual feedback, student and group modelling, and so on. LeCS (Learning from Case Studies) is a collaborative case study system that provides a set of tools and accomplishes some functions that together support learners during the development of a case study solution. This paper gives an overview of LeCS, focusing on the system design and architecture. The LeCS design is based on our model of supporting the learning from case studies method in a computer-based environment and in a distance learning context. The LeCS architecture is agent-based and includes three kinds of agents.