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O tratamento da micose do aparelho ungueal permanece um desafio nos dias de hoje. O foco infecioso encontra-se retido numa estrutura anatómica específica onde não se consegue por vezes uma resolução permanente, o que significa que a onicomicose se torna frequentemente uma condição crónica que retoma o estado ativo no intervalo de vários anos. A prioridade nos recentes desenvolvimentos da farmacoterapia da onicomicose foi atribuída à monoterapia tópica com o intuito da sua utilização em doentes que não toleram a medicação oral ou preferem um fármaco tópico e, com a vantagem adicional, de combiná-los com fármacos orais e/ou dispositivos médicos para expandir as possibilidades de tratamento atuais. Esta revisão engloba as opções terapêuticas da onicomicose no status quo. Dois novos fármacos tópicos, efinaconazol e tavaborol, foram aprovados no ano 2014 pela entidade reguladora competente Food and Drug Administration (FDA).

The COVID-19 pandemic has highly impacted our society, particularly educational professionals, on their daily routines and changing the way they work. COVID-19 spread quickly, and we had to take urgent action on closing schools so teachers would continue to teach their students and put stringent measures such as national lockdowns and social distancing initiatives. The present study aims to understand teachers' perceptions regarding the operationalization of Emergency Remote Learning in Portuguese schools. The study also seeks to measure differences in satisfaction level, attitudes, and challenges across teaching methodology adopted by teachers. It will be used as a quantitative study, using a survey as a technical procedure for data collection to meet the proposed objectives. Data collection lasted two months, implemented through the availability of the study online on social networks, for teachers to respond voluntarily. Findings show that the COVID-19 pandemic and social distancing requirement has presented undue challenges for all education stakeholders, especially teachers. The teachers felt exhausted, but they recognized that the Technology has made a significant contribution and showed a willingness to learn more to integrate technologies into their practice and recognize the importance of this being done effectively.

Higher education is one of the driving forces behind the social and economic development of countries, with the ultimate aim of providing quality academic training. At present, teaching-learning models in virtual environments face a number of important challenges, particularly in the current situation caused by COVID-19. Some of these challenges will be addressed in this study. We worked with 225 third-year undergraduate students in health science degrees over two academic years during the pandemic. The objectives were: (1) to ascertain whether there were significant differences in student satisfaction with the teaching process in the first year of the pandemic (e-learning teaching) vs. the second year (b-learning teaching); and (2) to determine whether there were significant differences in academic performance between the two groups. Quantitative research (using a 2x2 factorial design, ANOVA and ANCOVA) and qualitative research (using a comparative design with categorisation analysis) were carried out. The results indicate differences in some aspects of satisfaction and learning outcomes in favour of teaching in the second of the two years. Students rated the use of active methodologies and technological resources positively, although they concluded that their use required more work time. Future studies will seek to compare student satisfaction in other areas of knowledge.

IntroductionEnterococci are commensals of the gastrointestinal tract of humans and animals that evolved into opportunistic pathogens with high antimicrobial resistance and virulence. Multidrug-resistant Enterococcus is a major cause of hospital-acquired infections worldwide. For this reason, the characterization of non-clinical reservoirs of Enterococci and their epidemiological link to resistant hospital isolates is crucial for controlling their spread.MethodsA total of 295 samples collected from livestock (pigs and cows, n = 135) and environment (public buses, passengers hands, and urban environments, n = 160) were screened for Enterococcus spp. E. faecium antimicrobial resistance profiles, virulence potential, and clonal population were further characterized.ResultsEnterococci were detected in 90.5% (n = 267) of the samples, with a higher prevalence in livestock (100%) than the environment (82.5%, p

ABSTRACTObjective: Breast cancer is responsible for disruptive changes in women’s lives, causing them to experience diverse and intense negative emotions that can affect their perception of well-being. The present study aimed to characterize difficulties in emotion regulation (ER), according to Gratz and Roemer’s multidimensional assessment, in women with breast cancer and to relate them with General Well-Being and its different domains: Physical, Social/Familial, Emotional, and Functional.Method: Ninety-five Portuguese women with breast cancer aged between 32 and 75 years answered a sociodemographic and clinical questionnaire and the Portuguese versions of the Difficulties in Emotion Regulation Scale and the Functional Assessment of Cancer Therapy – General. Data were collected in an oncology public hospital.Results: In general, difficulties in ER presented negative correlations with General Well-Being and its domains. The multiple regression analysis findings indicated that two specific types of difficulties, Limited Access to ER Strategies and Lack of Emotional Clarity, play a significant role in predicting well-being, especially in the Emotional domain, which was most compromised in these patients.Conclusions: These difficulties should be approached within psycho-oncological interventions as they are essential contributors to improving emotional and general well-being and fostering psychological adaptation to breast cancer.

As alterações climáticas (AC) são a maior evidência da “metamorfose do mundo” e estão a mudar os regimes de temperatura e de pluviosidade, mas também os sistemas sociais, culturais e de saúde no planeta Terra. A imprevisibilidade dos fenómenos climáticos e os seus impactes multidimensionais na saúde humana e ambiental contribuem para tornar a nossa compreensão do mundo cada vez mais difícil. Além disso, a história provou que a tecnociência, sozinha, não é suficiente para lidar com estes problemas. Um apelo global está agora a despertar para que as humanidades e as ciências sociais também lidem com as questões humanas e não humanas levantadas pelas AC, nomeadamente através da sua integração com as áreas da saúde e da sustentabilidade. Este artigo tem como objetivo apresentar e discutir alguns dos primeiros resultados da rede transdisciplinar Compor Mundos: Humanidades, Bem-Estar e Saúde, que consiste numa rede de especialistas em humanidades, ciências sociais e da saúde que pensam sobre as questões do bem-estar e da saúde nas sociedades tecnológicas contemporâneas. A metodologia usada na primeira fase do projeto consistiu numa entrevista com perguntas abertas, construída de forma participativa pela rede de 12 investigadores. Tratou-se de uma pesquisa exploratória que utilizou a análise temática para identificar as ideias-chave originais de cada autor e a indução dos temas principais correspondentes. Os temas foram então organizados em grupos de correspondência semântica, ou clusters temáticos. Espera-se que alguns destes clusters contribuam para discutir como as AC já alteraram as nossas maneiras de ser, viver e pensar sobre o mundo, e contribuam também para lidar com os desafios relacionados com os riscos das AC na saúde e no bem-estar ao longo do século XXI.

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Abstract Body responsiveness refers to the tendency to be attuned to the body’s needs and use interoceptive information to guide behavior. Despite its potential beneficial effect on the development of positive body image, this construct is currently understudied. To boost research in this area, we examined the factor structure, gender invariance, and psychometric properties of a Portuguese translation of the Body Responsiveness Questionnaire (BRQ). A total of 650 men and women (aged 18–80 years) completed the Portuguese BRQ. To assess its convergent validity, participants also completed measures of body appreciation, emotion regulation, depression symptoms, and psychological quality of life. Exploratory factor analysis indicated a two-factor structure of the BRQ, which was upheld using confirmatory factor analysis: “Importance of Interoceptive Awareness” (ω = .85–.87) and “Perceived Connection” between body and mind (ω = .71–.74). BRQ scores had partial scalar invariance across gender, and no significant gender differences. Convergent and known-groups validity was supported. Participants with overweight/obesity (vs. normal weight) and middle-aged adults (vs. young adults) assigned higher importance to body signals to guide behavior. The Portuguese version of the BRQ is a psychometrically sound measure of body responsiveness and it may contribute to a comprehensive assessment of positive body image to guide intervention.

Parkinson’s disease (PD) is a common neurodegenerative disorder characterized by symptoms such as bradykinesia, resting tremor, and rigidity, primarily driven by the degradation of dopaminergic (DA) neurons in the substantia nigra. A significant contributor to familial autosomal dominant PD cases is mutations in the LRRK2 gene, making it a primary therapeutic target. This study explores the role of microRNAs (miRNAs) in regulating the proteomic stress responses associated with neurodegeneration in PD using C. elegans models. Our focus is on miR-71, a miRNA known to affect stress resistance and act as a pro-longevity factor in C. elegans. We investigated miR-71’s function in C. elegans models of PD, where mutant LRRK2 expression correlates with dopaminergic neuronal death. Our findings reveal that miR-71 overexpression rescues motility defects and slows dopaminergic neurodegeneration in these models, suggesting its critical role in mitigating the proteotoxic effects of mutant LRRK2. Conversely, miR-71 knockout exacerbates neuronal death caused by mutant LRRK2. Additionally, our data indicate that miR-71’s neuroprotective effect involves downregulating the toll receptor domain protein tir-1, implicating miR-71 repression of tir-1 as vital in the response to LRRK2-induced proteotoxicity. These insights into miR-71’s role in C. elegans models of PD not only enhance our understanding of molecular mechanisms in neurodegeneration but also pave the way for potential research into human neurodegenerative diseases, leveraging the conservation of miRNAs and their targets across species.

Assuming the evident relationship between innovation and technology, and the corresponding impact in the educational field, this article contemplates a systematic review on the resource on flipped classroom model in non-tertiary education. 181 studies were reviewed with the purpose of establishing and apprehending the connections between the flipped learning and its potential to promote curriculum innovation. Data analysis allowed the building of a three-level model in which the relations of the flipped classroom model and curriculum are organized in terms of (i) outcomes support, (ii) institutional change and (iii) classroom instruction modus operandi. Results suggest substantial potential of the flipped model to flip the curriculum and even the school culture. To meet such end, innovation must be perceived as an institutional strategy, making sure all stakeholders hold a part in the adaptative process of fostering change. Moreover, there is evidence that the model can ease the articulation and consolidation of constructivist approaches in schooling, a perspective that enhances the movement for student-centred logics in education. The review novelty lies on its building of a model that can work as a guide for reflecting on the approach and for underpinning future action.

Objective This study aimed to estimate the incidence of giant cell arteritis (GCA) in Spain and to analyse its clinical manifestations, and distribution by age group, sex, geographical area and season.Methods We included all patients diagnosed with GCA between 1 June 2013 and 29 March 2019 at 26 hospitals of the National Health System. They had to be aged ≥50 years and have at least one positive results in an objective diagnostic test (biopsy or imaging techniques), meet 3/5 of the 1990 American College of Rheumatology classification criteria or have a clinical diagnosis based on the expert opinion of the physician in charge. We calculated incidence rate using Poisson regression and assessed the influence of age, sex, geographical area and season.Results We identified 1675 cases of GCA with a mean age at diagnosis of 76.9±8.3 years. The annual incidence was estimated at 7.42 (95% CI 6.57 to 8.27) cases of GCA per 100 000 people ≥50 years with a peak for patients aged 80–84 years (23.06 (95% CI 20.89 to 25.4)). The incidence was greater in women (10.06 (95% CI 8.7 to 11.5)) than in men (4.83 (95% CI 3.8 to 5.9)). No significant differences were found between geographical distribution and incidence throughout the year (p=0.125). The phenotypes at diagnosis were cranial in 1091 patients, extracranial in 337 patients and mixed in 170 patients.Conclusions This is the first study to estimate the incidence of GCA in Spain at a national level. We found a predominance among women and during the ninth decade of life with no clear variability according to geographical area or seasons of the year.

Recent data suggest a close association between positive body image (PBI) and eating disorder recovery. Nevertheless, the specific mechanisms through which PBI may facilitate recovery from anorexia nervosa (AN) remain unknown. To advance understanding of these mechanisms, this study examined core indices of PBI within AN, exploring its association with emotion regulation and well-being outcomes. Data were collected from 159 female participants, 64 with AN diagnosis and 95 healthy controls (HCs), who completed measures of PBI (body appreciation, functionality appreciation, and body responsiveness), emotion regulation, and psychological well-being (depression, anxiety, stress, and psychological quality of life). The AN group reported lower levels of PBI and psychological well-being, along with greater difficulties in regulating emotions, relative to HCs. PBI variables significantly predicted emotion regulation and psychological well-being in AN, accounting for 36% to 72% of the variance, with body appreciation emerging as the strongest predictor. These findings lend credence to the view that PBI can serve as a catalyst for psychological health. We hypothesize that enhancing PBI can improve interoceptive awareness, which is crucial for emotion regulation and reducing maladaptive food-related coping. Emphasizing a mind–body connection in lifestyle could be a relevant element to consider for both treating and preventing AN.

While it is well known that the Weibull distribution is a good model for wind-speed measurements and can be explained through simple statistical arguments, how such a model holds for shorter time periods is still an open question. In this paper, we present a systematic investigation of the accuracy of the Weibull distribution to wind-speed measurements, in comparison with other possible “cousin” distributions. In particular, we show that the Gaussian distribution enables one to predict wind-speed histograms with higher accuracy than the Weibull distribution. Two other good candidates are the Nakagami and the Rice distributions, which can be interpreted as particular cases of the Weibull distribution for particular choices of the shape and scale parameters. These findings hold not only when predicting next-point values of the wind speed but also when predicting the wind energy values. Finally, we discuss such findings in the context of wind power forecasting and monitoring for power-grid assessment.

One of the most challenging problems when diagnosing autism spectrum disorder (ASD) is the need for long sets of data. Collecting data during such long periods is challenging, particularly when dealing with children. This challenge motivates the investigation of possible classifiers of ASD that do not need such long data sets. In this paper, we use eye-tracking data sets covering only 5 s and introduce one metric able to distinguish between ASD and typically developed (TD) gaze patterns based on such short time-series and compare it with two benchmarks, one using the traditional eye-tracking metrics and one state-of-the-art AI classifier. Although the data can only track possible disorders in visual attention and our approach is not a substitute to medical diagnosis, we find that our newly introduced metric can achieve an accuracy of 93% in classifying eye gaze trajectories from children with ASD surpassing both benchmarks while needing fewer data. The classification accuracy of our method, using a 5 s data series, performs better than the standard metrics in eye-tracking and is at the level of the best AI benchmarks, even when these are trained with longer time series. We also discuss the advantages and limitations of our method in comparison with the state of the art: besides needing a low amount of data, this method is a simple, understandable, and straightforward criterion to apply, which often contrasts with “black box” AI methods.

The precise mathematical description of gaze patterns remains a topic of ongoing debate, impacting the practical analysis of eye-tracking data. In this context, we present evidence supporting the appropriateness of a Lévy flight description for eye-gaze trajectories, emphasizing its beneficial scale-invariant properties. Our study focuses on utilizing these properties to aid in diagnosing Attention-Deficit and Hyperactivity Disorder (ADHD) in children, in conjunction with standard cognitive tests. Using this method, we found that the distribution of the characteristic exponent of Lévy flights statistically is different in children with ADHD. Furthermore, we observed that these children deviate from a strategy that is considered optimal for searching processes, in contrast to non-ADHD children. We focused on the case where both eye-tracking data and data from a cognitive test are present and show that the study of gaze patterns in children with ADHD can help in identifying this condition. Since eye-tracking data can be gathered during cognitive tests without needing extra time-consuming specific tasks, we argue that it is in a prime position to provide assistance in the arduous task of diagnosing ADHD.

Within the enhancement of technology and its ongoing integration into formal education setting, learning environments have been challenged to operationalize and arrange systems that engage pedagogy and technology together. The nature of this ongoing transformation is closely related to the paradigms that reign in the twenty-first century, in a scenario of what is now called a Fourth Industrial Revolution. School, despite losing its monopoly on knowledge diffusion, still plays a central role in educating new generations, therefore, it holds key responsibility in addressing contemporary logics of learning, living and becoming a citizen. Amidst the course of change and the ultimate calls for innovation in education, we encounter veteran teachers, professionals with a long teaching history, whose challenges include becoming familiar with new devices in order to fulfil their work demands. In this article, we then explore how central veteran teachers are for the progression to a smarter education scenario, through debating a training carried out in Portugal with 38 teachers from pre-school and k-12, aimed at promoting their digital migration. Data strengthen ties regarding teachers' perceptions and attitudes in relation to technology and consequent resource on it as pedagogical tools. Also, the overall discussion of the training provides clues on how teacher-oriented actions might address their identity if meaningful output is desired, in order to support a real change of practice.

Measurement(s) Gaze position Technology Type(s) eye tracking device Factor Type(s) Luminosity • Screen distance Sample Characteristic - Organism Human eye Sample Characteristic - Environment laboratory facility Sample Characteristic - Location Municipality of Oslo

ABSTRACT: Objectives: In this study, we aimed to assess the extent of dissemination of methicillin-resistant Mammaliicoccus sciuri in animal farms in Tunisia and evaluate the distribution of virulence and methicillin resistance genes in the M. sciuri population. Methods: Staphylococci and mammaliicocci isolated from unhealthy animals and healthy humans from adjacent farms in Tunisia were characterized for antimicrobial susceptibility, biofilm formation, agglutination, and hemolysis abilities. Mammaliicoccus sciuri relatedness and content in antibiotic resistance and virulence genes were analyzed by whole-genome sequencing (WGS). Results: Mammaliicoccus sciuri was the most prevalent species (46.2%), showing the highest resistance rates to fusidic acid (94.6%), oxacillin (73%), penicillin (40.5%), clindamycin (37%), ciprofloxacin (27%), and cefoxitin (24.3%). Some isolates carried genes encoding resistance to nine different antibiotic classes. mecA was found in 35% of M. sciuri and mecC in 16.2%. All isolates carrying mecC were of S. sciuri subspecies carnaticus and carried the hybrid element SCCmec-mecC. Mammaliicoccus sciuri were able to produce strong biofilm (27%) and have clumping ability (16%). Additionally, they carried genes for capsule production (cap8, 100%), iron-regulated surface determinants (isdE, 24%; isdG, 3%), and virulence regulation (clpC and clpP, 100%). Single nucleotide polymorphisms (SNPs) analysis showed that 17 M. sciuri cross-transmission events probably occurred between different animal species and farms. Moreover, SCCmec was estimated to have been acquired five times by S. sciuri subsp. carnaticus. Conclusion: Multidrug resistant and pathogenic M. sciuri were frequently disseminated between different animal species within the farm environment. mecA and mecC can be disseminated by both frequent acquisition of the SCCmec element and clonal dissemination.

We report the case of a 42-year-old woman with rheumatoid arthritis undergoing treatment with subcutaneous tocilizumab for the past 6 months. Three days after the administration, an asymptomatic inflammatory annular plaque of 4 cm with discrete whitish scales at the inner border margin developed at the injection site in the left iliac fossa. A smaller plaque in the left groin appeared soon after. The mycological exam was negative. Histology showed a lymphoplasmacytic superficial and deep perivascular, and periadnexal, dermal infiltrate, without epidermal changes. Lesions spontaneously regressed in 4 months. The diagnosis was clinically and histologically consistent with erythema annulare centrifugum, following the exclusion of other differential diagnoses. Erythema annulare centrifugum represents a delayed-type hypersensitivity reaction generally considered idiopathic or otherwise related to numerous triggers, including drugs such as biologics. We describe the first reported case of tocilizumab-induced erythema annulare centrifugum. This case should alert dermatologists to this relatively rare and complex entity and should raise awareness to cutaneous biologic drug reactions.

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