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The characterization of nanoparticle-based drug-delivery systems represents a crucial step in achieving a comprehensive overview of their physical, chemical, and biological features and evaluating their efficacy and safety in biological systems. We propose Raman Spectroscopy (RS) for the characterization of liposomes (LPs) to be tested for the control of neuroinflammation and microglial dysfunctions in Glioblastoma multiforme and Alzheimer’s disease. Drug-loaded LPs were functionalized to cross the blood–brain barrier and to guarantee localized and controlled drug release. The Raman spectra of each LP component were used to evaluate their contribution in the LP Raman fingerprint. Raman data analysis made it possible to statistically discriminate LPs with different functionalization patterns, showing that each molecular component has an influence in the Raman spectrum of the final LP formulation. Moreover, CLS analysis on Raman data revealed a good level of synthetic reproducibility of the formulations and confirmed their stability within one month from their synthesis, demonstrating the ability of the technique to evaluate the efficacy of LP synthesis using small amount of sample. RS represents a valuable tool for a fast, sensitive and label free biochemical characterization of LPs that could be used for quality control of nanoparticle-based therapeutics.

Dual functionalized liposomes were developed to cross the blood–brain barrier (BBB) and to release their cargo in a pathological matrix metalloproteinase (MMP)-rich microenvironment. Liposomes were surface-functionalized with a modified peptide deriving from the receptor-binding domain of apolipoprotein E (mApoE), known to promote cargo delivery to the brain across the BBB in vitro and in vivo; and with an MMP-sensitive moiety for an MMP-triggered drug release. Different MMP-sensitive peptides were functionalized at both ends with hydrophobic stearate tails to yield MMP-sensitive lipopeptides (MSLPs), which were assembled into mApoE liposomes. The resulting bi-functional liposomes (i) displayed a < 180 nm diameter with a negative ζ-potential; (ii) were able to cross an in vitro BBB model with an endothelial permeability of 3 ± 1 × 10−5 cm/min; (iii) when exposed to functional MMP2 or 9, efficiently released an encapsulated fluorescein dye; (iv) showed high biocompatibility when tested in neuronal cultures; and (v) when loaded with glibenclamide, a drug candidate with poor aqueous solubility, reduced the release of proinflammatory cytokines from activated microglial cells.

Glioblastoma (GBM) is a particularly challenging brain tumor characterized by a heterogeneous, complex, and multicellular microenvironment, which represents a strategic network for treatment escape. Furthermore, the presence of GBM stem cells (GSCs) seems to contribute to GBM recurrence after surgery, and chemo- and/or radiotherapy. In this context, intercellular communication modalities play key roles in driving GBM therapy resistance. The presence of tunneling nanotubes (TNTs), long membranous open-ended channels connecting distant cells, has been observed in several types of cancer, where they emerge to steer a more malignant phenotype. Here, we discuss the current knowledge about the formation of TNTs between different cellular types in the GBM microenvironment and their potential role in tumor progression and recurrence. Particularly, we highlight two prospective strategies targeting TNTs as possible therapeutics: (i) the inhibition of TNT formation and (ii) a boost in drug delivery between cells through these channels. The latter may require future studies to design drug delivery systems that are exchangeable through TNTs, thus allowing for access to distant tumor niches that are involved in tumor immune escape, maintenance of GSC plasticity, and increases in metastatic potential.

Introduction: The scope of medical education (ME) as an autonomous field of study is still under debate. The present study aimed to identify publications addressing the topic of ME, published in international medical journals, by Portuguese authors, alone or in collaboration with foreign colleagues. Methods: Publications were retrieved from Scopus and Web of Science, between 2013 and 2022. Each publication was identified by title, name, and affiliation of the corresponding author. Affiliation of all authors was also taken into consideration to detect networks. Titles were used to identify subjects, complemented by keywords and abstract. Journal Citation Reports and Scimago Journal Rank indexed journals in the education category were identified and from these ME journals were selected.We chose 29 journals from which 17 had publications from Portuguese’s authors in a total of 80 publications. Results: The top journals in terms of productivity were BMC Medical Education, Medical Teacher, and Advances in Health Sciences Education. The Portuguese international cooperation involved Europe (United Kingdom, Spain, the Netherlands, and Ireland), North America (USA and Canada) and Oceania (Australia). Outside the Northen Hemisphere, cooperation involved mostly Brazil. Nationally, the dominant networks involved the Universities of Porto and Minho.Five core areas were identified namely “medical education”, “medical student”, “health care personnel”, “medical school”, and “undergraduate medical education”. Conclusion: Despite the limitations of this study because the search was only focused on ME journals it showed a trend towards internationalisation of some Portuguese authors, particularly those who were also involved in established national networks. Resumen: Introducción: El alcance de la educación médica como campo de estudio autónomo sigue siendo objeto de debate. El presente estudio tuvo como objetivo identificar las publicaciones que abordan el tema de la educación médica (EM), publicadas en revistas médicas internacionales, por autores portugueses, solos o en colaboración con colegas extranjeros. Métodos: Las publicaciones fueron recuperadas de Scopus y Web of Science, entre 2013 y 2022. Cada publicación fue identificada por título, nombre y afiliación del autor correspondiente. También se tuvo en cuenta la afiliación de todos los autores para detectar redes. Los títulos se utilizaron para identificar los temas, complementados por las palabras clave y el resumen. Se identificaron las revistas indexadas en Journal Citation Reports y Scimago Journal Rank en la categoría de educación y de ellas se seleccionaron las revistas de EM.Se seleccionaron 29 revistas de las cuales 17 tenían publicaciones de autores portugueses en un total de 80 publicaciones. Resultados: Las principales revistas en términos de productividad fueron BMC Medical Education, Medical Teacher y Advances in Health Sciences Education. La cooperación internacional portuguesa se centró en Europa (principalmente Reino Unido, España, Países Bajos e Irlanda), Norteamérica (EE.UU. y Canadá) y Oceanía (Australia). Fuera del hemisferio norte, la cooperación se centró principalmente en Brasil. A nivel nacional, las redes predominantes son las de las universidades de Oporto y Minho.

This study aims to analyze how visual tools, labeled as maps, are built, and used in medical education. Based on the educational model of concept maps (CMs), proposed by Novak and Cañas (2008), and adapted to medicine by Daley and Torre (2010), we are currently analyzing the results of a scoping review following the PRISMA extension methodology, specifically for these purposes. Other visual tools, such as knowledge maps (KMs) and mind maps (MMs), used in medical education, were also included. The search was made through the databases EBSCO, PubMed/MEDLINE, PsycINFO, Scopus, and Eric, using the following items: “concept map*”, “knowledge map*”, “mind map*” and “medical education”. Only articles in English were considered and exclusively in medical education, from undergraduate to resident training. The analysis of selected articles included the following features: construction rules (if they followed Novakian instructions), teaching area, student level (undergraduate, postgraduate/residents), and use for assessment. Other features were the capacity to relate basic science knowledge to clinical concepts, the use of maps with other educational methods, such as problem-based learning (PBL), and providing feedback to students. From a quantitative perspective, the use of CMs is dominant in all phases of medical education. A failure to follow Novakian rules was found in around half of the articles labeled as CMs and KMs. As for MMs, which follow different rules for construction and use, they were considered relevant in helping students to summarize and retain information. Simultaneous use with other educational methods was only found with CMs.

O número de setembro deste ano da revista Lancet Global Health publica um artigo original1 baseado num ensaio randomizado, realizado na Índia, que mostra o efeito favorável da correção da presbiopia na produtividade de trabalhadores das plantações de chá. Os autores efetuaram detalhadas revisões da literatura, a partir de julho de 1975 e até novembro de 2017, não tendo encontrado qualquer estudo randomizado desta natureza em países de baixo e médio rendimento (low-income and medium-income countries). Numa altura em que o mundo se encontra a tentar reequacionar o conceito e as consequências da globalização e em que enfrenta problemas complexos de desenvolvimento sustentável, vale a pena assinalar estes projetos científicos, ligados à saúde, que utilizam metodologias internacionalmente aceites para provar, de uma forma clara, aquilo que muitos profissionais da saúde sabem ser incontestável nos respetivos espaços de intervenção. As mesmas convicções têm sido assumidas relativamente aos 17 Objetivos de Desenvolvimento Sustentável que as Nações Unidas promovem desde 2016. Todos concordamos que, até 2030, é essencial: erradicar a pobreza, erradicar a fome, garantir uma saúde e uma educação de qualidade, alcançar a igualdade de género, garantir água potável e saneamento, garantir fontes de energia renováveis e fiáveis, promover o trabalho digno e o crescimento económico, promover a industrialização inclusiva e fomentar a inovação, reduzir as desigualdades, garantir padrões de consumo e de produção sustentáveis, adotar medidas urgentes para combater as alterações climáticas, proteger a vida marinha e a vida terrestre, promover a paz, a justiça e construir instituições eficazes, reforçar parcerias para o desenvolvimento sustentável. No entanto, a questão de fundo é saber como vão ser postas em prática estas iniciativas e por quem. O estudo acima mencionado aborda um problema de saúde, agravado com o envelhecimento, que é global e que afeta a qualidade de vida de uma percentagem crescente de habitantes de qualquer continente do nosso planeta. A relação com a produtividade, avaliada neste caso num contexto agrícola, pode ser extrapolada para outras sociedades mais “avançadas” até à “aldeia digital”. Medir o impacto destas intervenções, que melhoram a qualidade de vida, junto de cada indivíduo e em grupos profissionais bem caraterizados, será essencial para provar como se podem cumprir, com rigor, as metas definidas nos 17 Objetivos de Desenvolvimento Global. Neste caso são visados os objetivos 1 (pobreza), 3 (saúde), 5 (igualdade de género) e 8 (trabalho digno e crescimento económico). Um outro objetivo que este estudo demonstra é a importância do trabalho científico em parceria porque o grupo de investigadores engloba elementos de prestigiadas instituições médicas e de saúde situadas nos seguintes países: Índia, Estados Unidos da América, China e Canadá. Investigar nas áreas da medicina e da saúde é, cada vez mais, uma atividade destinada não só a estimular as descobertas científicas mas também a promover a melhoria da qualidade de vida das pessoas em qualquer local do mundo onde se encontrem. António Rendas Nova Medical School, Faculdade de Ciências Médicas, Universidade Nova de Lisboa. Referências: 1. Reddy PA, Congdon N, MacKenzie G, Gogate P, Wen Q, Jan C, et al. Effect of providing near glasses on productivity among rural health Indian tea workers with presbyopia (PROSPER): a randomized trial. Lancet Global Health. 2018;6:1019-27.

RESUMO: Estudamos o controle da respiração com a finalidade primordial de avaliar a dispneia. A presente abordagem deve ser feita a vários niveis, uma vez que o centro respiratório pode estar integro mas os efectores a nivel dos circuitos neuronais podan eocontrar-se comprometidos. Utilizamos um estímulo hipercápnico para o centro respiratorio e medimos a resposta venrilatoria, a pressão de oclusão e escalas analógicas visuais. Tambem avaliamos as pressões respiratorias maximas e os movimentos toraco-abdominais utilizando plerismografia por variação de inductancia. Com esta metodologia somos capazes de localizar qual o efector responsável pela dispneia e avaliar a integridade do centro respiratório em doentes com patologia cardiac ou respiratória.REV PORT PNEUMOL 1999; V (2): 237-246 ABSTRACT: We evaluate the control of breathing mainly to assess dyspnea. This assessment must be done at several levels, once the respiratory center could be intact but the effectors of the neural drive could be damaged. We use an hypercapnic stimulus to the respiratory center and measure the ventilatory response, the occlusion pressure and visual analogue scales. We also evaluate the maximal repiratory pressures and the thoraco-abdominal movements using the respiratory induced plethysmoaraphy. With this methodology we are able to locate what is the effector that could be responsible for dyspnea and assess the intearity of the respiratory center in patients with cardiac or respiratory pathology.REV PORT PN EUMOL 1999; V (2): 237-246 Palavras-chave: Pressão de oclusão, Estimulacão da respirayao com CO2, Plensmografia por variação de inductancia, Pressões respiratórias maximas, Escalas analógicas visuais, Key-words: Occlusion pressure, Stimulation of breathing with CO2, Respiratory induced plethysmography, Maximal respiratory pressures, Visual analogue scales