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The expansion of the invasive Asian macroalgae Rugulopteryx okamurae along the coasts of the Azores represents a significant challenge for local marine biodiversity. A promising approach to managing the biomass produced by this alien alga is to valorize it in the context of the blue economy. This study characterizes and evaluates the potential of R. okamurae biomass for incorporation into cattle feed, with a focus on mitigating enteric methane production. The nutritional value of R. okamurae, its digestibility, and its potential as a mitigating agent for enteric methane production were analyzed in vitro. The results indicate that the inclusion of 5% R. okamurae in the diet significantly (p < 0.05) reduced accumulated methane production by 98% after 24 h of incubation. The addition of 1% algae over the same period resulted in a 38% reduction in methane production. However, a significant decrease (p < 0.05) in gas production of 57.02% and 73.5% was also observed in relation to control, with the inclusion of 1% and 5%, respectively, during 96 h. Nutritionally, R. okamurae was found to have a crude protein content of 18.68% and fiber (NDF) of 55.71% of DM. It is also worth highlighting the high content of ash (31.86%) that was identified in these brown macroalgae. In conclusion, the fresh biomass of R. okamurae could serve as a functional ingredient in cattle feed to mitigate enteric methane production, provided it is used in low percentages. However, it is important to emphasize that high concentrations in the first 12 h did not produce methane, which is also not recommended for enteric fermentation. However, before including it in animal feed, in vivo tests are needed to assess its toxicity.

Hepatitis delta virus (HDV) infection is the most severe form of viral hepatitis. Genotype 1 (HDV-1) is by far the most prevalent in Europe and globally, while HDV-5 predominates in Western Africa. Data about HDV seroprevalence in Portugal are scarce and genotyping studies have not been performed yet. We aimed to assess the seroprevalence and genotypes of HDV in a large cohort of HBsAg-positive patients followed in our Hepatology Unit between 2012 and 2022. The anti-HDV-positive patients were subjected to a cross-sectional analysis, including blood sample collection for HDV RNA testing and genotype determination. In the cohort of HBsAg-positive patients, 57.5% (480/835) were born in African countries and 665/835 (79.6%) had been screened for anti-HDV antibodies. The HDV seroprevalence obtained was 6.5% (43/665). Twenty-one patients (age 41.2 ± 9.9 years; 57.1% male) were included in further molecular analyses. HDV RNA was positive in 8/21 (38.0%) and classified as HDV-5 in 7 patients (6 from Guinea-Bissau and 1 from Cape Verde) and HDV-1 in 1 patient (from Ukraine). In the largest and most comprehensive study performed in Portugal regarding HDV epidemiology to date, seroprevalence and genotype distribution of HDV (with predominance of HDV-5) were strongly influenced by immigration, notably from African countries.

A 72-year-old male patient, hypertensive and a smoker, was admitted to an Internal Medicine Service for the evaluation of total dysphagia and acute bronchitis with a one week history, without hematemesis or abdominal pain. Thoracic and neck computed tomography revealed only esophageal wall prominence with edema. Angiography showed no vascular abnormalities. Upper gastrointestinal endoscopy revealed diffusely affected blackened esophagus (Figure 1). Esophageal biopsies showed fibrinonecrotic and fibrinoleukocytic exudate, with negative results for Cytomegalovirus and Herpes. He was initiated on esomeprazole 40mg twice daily and given a one week oral fasting period, which resulted in favorable endoscopic progression (Figures 2 and 3), allowing for a gradual reintroduction of an oral diet. A neoplasia evaluation yielded negative results. Vascular risk factors (hypertension and dyslipidemia) were assessed and controlled. He was discharged after three weeks on aspirin 100mg, perindopril 4mg and rosuvastatin 20mg. Acute esophageal necrosis, also known as "black esophagus" or acute necrotizing esophagitis, is a rare but severe condition characterized by diffuse circumferential darkening of the esophageal mucosa. The estimated incidence is 0.28%, predominantly in males, usually occurring around age 75 (1). The exact etiology is not fully understood, but it is believed to be multifactorial and secondary to hemodynamic compromise in patients with risk factors for vascular diseases and susceptibility to ischemic events (2). Common comorbidities include diabetes, hypertension, alcohol abuse and chronic kidney disease (3). Diagnosis is typically made through endoscopy, and the key aspects of treatment involve addressing the underlying cause, improving blood supply and suppressing gastric acid production (2).

This review explores the diverse landscape of integrating nutrition and physical activity education into medical school curricula, focusing on the imperative role of physicians in promoting health through lifestyle changes. By examining global medical education structures, we uncovered disparities in nutrition and physical activity training, and highlighted the need for a shared framework to address international and regional challenges. Despite acknowledging the importance of both nutrition and physical activity, studies have consistently uncovered deficiencies in medical school curricula, especially in skills related to providing lifestyle advice and behavioral counseling. Survey studies among medical students have illuminated various perceptions and knowledge gaps, emphasizing the need for more comprehensive and mandatory nutrition and physical activity training. While acknowledging progress, challenges, such as time constraints, resource availability, and faculty expertise, persist. Integrating lifestyle education results in resistance, a demand for strategic communication, and faculty buy-ins. These findings underscore the importance of a holistic approach that balances theoretical knowledge, practical skills, and confidence that medical students need to promote effective nutrition and physical activity in healthcare.

Ambient noise correlation analyses are largely used to monitor temporal medium changes generally associated with stress field variations and/or fluid movement. Here, we analyze the 2021 eruption of La Palma, the most active island in the Canary archipelago, to study its effects on the structure in a post-eruptive stage. To date, most of the studies, whether in volcanic environments or other geological systems, focus on determining seismic velocity changes that can be associated with precursory signals. In our study, we are interested in localizing the medium changes that permit constraining the depth of the most affected structure and suggesting possible mechanisms capable of inducing such alterations. The auto- and cross-correlation functions were computed using the phase cross-correlation strategy. The correlations were linearly stacked using a 3-day sliding window. The combination of these two approaches proved to render the best results. The analysis of 3 years of data resulted in the detection of occasional decorrelation before the eruption, followed by a well-defined decoherence period after the eruption. In addition, the relationship between the waveform correlation and lag time, using autocorrelations from before and after the eruption, permits identifying phase shifts and waveform distortion, which are sensitive to different parameters and, thus, have great importance in inferring the possible mechanism. Phase shifts occur when there is only velocity change without changing the structure, whereas waveform distortion is caused by a structural (geological) change. We also inferred the depths at which the most significant medium alterations occur. We observed that the decorrelation occurs at lag times corresponding to changes localized in depth. The surface structure appears to not have undergone significant medium changes for depths until approximately 8 km, either before or after the eruption.

Introduction: Despite being a widely used screening questionnaire, there is no consensus on the most appropriate measurement model for the Alcohol Use Disorders Identification Test (AUDIT). Furthermore, there have been limited studies on its measurement invariance across cross-cultural subgroups, genders, and sexual orientations. Aims: The present study aimed to examine the fit of different measurement models for the AUDIT and its measurement invariance across a wide range of subgroups by country, language, gender, and sexual orientation. Methods: Responses concerning past-year alcohol use from the participants of the cross-sectional International Sex Survey were considered (N = 62,943; Mage: 32.73; SD = 12.59). Confirmatory factor analysis, as well as measurement invariance tests were performed for 21 countries, 14 languages, three genders, and four sexual-orientation subgroups that met the minimum sample size requirement for inclusion in these analyses. Results: A two-factor model with factors describing ‘alcohol use’ (items 1–3) and ‘alcohol problems’ (items 4–10) showed the best model fit across countries, languages, genders, and sexual orientations. For the former two, scalar and latent mean levels of invariance were reached considering different criteria. For gender and sexual orientation, a latent mean level of invariance was reached. Conclusions: In line with the two-factor model, the calculation of separate alcohol-use and alcohol-problem scores is recommended when using the AUDIT. The high levels of measurement invariance achieved for the AUDIT support its use in cross-cultural research, capable also of meaningful comparisons among genders and sexual orientations.

Understanding the dynamics of stability/plasticity balances during adulthood is pivotal for learning, disease, and recovery from injury. However, the brain-wide topography of sensory remapping remains unknown. Here, using a first-of-its-kind setup for delivering patterned visual stimuli in a rodent magnetic resonance imaging (MRI) scanner, coupled with biologically inspired computational models, we noninvasively mapped brain-wide properties-receptive fields (RFs) and spatial frequency (SF) tuning curves-that were insofar only available from invasive electrophysiology or optical imaging. We then tracked the RF dynamics in the chronic visual deprivation model (VDM) of plasticity and found that light exposure progressively promoted a large-scale topographic remapping in adult rats. Upon light exposure, the initially unspecialized visual pathway progressively evidenced sharpened RFs (smaller and more spatially selective) and enhanced SF tuning curves. Our findings reveal that visual experience following VDM reshapes both structure and function of the visual system and shifts the stability/plasticity balance in adults.

Chemotherapy-induced nausea and vomiting (CINV) negatively impact cancer patients’ quality of life and treatment outcomes. This study evaluated the achievement of complete response to CINV prophylaxis during the first five days after chemotherapy in adult outpatient cancer clinics with solid malignant tumours receiving Moderate or Highly Emetogenic Chemotherapy (MEC or HEC) in Portugal. During the study, patients completed three evaluations, and nausea severity and CINV impact on patients’ daily life was assessed. A complete response (no emetic episodes, no use of rescue antiemetic medication, and no more than mild nausea) was observed in 72% of the cycles (N = 161) throughout the five days after chemotherapy. Amongst the patient population, 25% classified their CINV episodes as severe. Though more than half of the patients achieved a complete response, suggesting that a therapeutic effort is being made to minimise this side effect, the overall scenario is barely optimistic. Significantly, new CINV-control measures in MEC/HEC patients should be adopted, specifically avoiding the single use of dexamethasone and 5-HT3 and raising awareness of using NK1-RAs. Thus, it is critical to improve CINV prophylactic treatment and implement practical international antiemetic guidelines in Portuguese clinical practice, envisaging the improvement of supportive care for cancer patients.

Abstract The degree to which the adult human visual cortex retains the ability to functionally adapt to damage at the level of the eye remains ill-understood. Previous studies on cortical neuroplasticity primarily focused on the consequences of foveal visual field defects (VFD), yet these findings may not generalize to peripheral defects such as occur in glaucoma. Moreover, recent findings on neuroplasticity are often based on population receptive field (pRF) mapping, but interpreting these results is complicated in the absence of appropriate control conditions. Here, we used fMRI-based neural modeling to assess putative changes in pRFs associated with glaucomatous VFD. We compared the fMRI-signals and pRF in glaucoma participants to those of controls with case-matched simulated VFD. We found that the amplitude of the fMRI-signal is reduced in glaucoma compared to control participants and correlated with disease severity. Furthermore, while coarse retinotopic structure is maintained in all participants with glaucoma, we observed local pRF shifts and enlargements in early visual areas, relative to control participants. These differences suggest that the adult brain retains some degree of local neuroplasticity. This finding has translational relevance, as it is consistent with VFD masking, which prevents glaucoma patients from noticing their VFD and seeking timely treatment.

In Portugal, during the training programme in Paediatrics, trainees have a training supervisor (TS) that guides them through their residency.

Abstract Small RNA (sRNA) profiling of Extracellular Vesicles (EVs) by Next‐Generation Sequencing (NGS) often delivers poor outcomes, independently of reagents, platforms or pipelines used, which contributes to poor reproducibility of studies. Here we analysed pre/post‐sequencing quality controls (QC) to predict issues potentially biasing biological sRNA‐sequencing results from purified human milk EVs, human and mouse EV‐enriched plasma and human paraffin‐embedded tissues. Although different RNA isolation protocols and NGS platforms were used in these experiments, all datasets had samples characterized by a marked removal of reads after pre‐processing. The extent of read loss between individual samples within a dataset did not correlate with isolated RNA quantity or sequenced base quality. Rather, cDNA electropherograms revealed the presence of a constant peak whose intensity correlated with the degree of read loss and, remarkably, with the percentage of adapter dimers, which were found to be overrepresented sequences in high read‐loss samples. The analysis through a QC pipeline, which allowed us to monitor quality parameters in a step‐by‐step manner, provided compelling evidence that adapter dimer contamination was the main factor causing batch effects. We concluded this study by summarising peer‐reviewed published workflows that perform consistently well in avoiding adapter dimer contamination towards a greater likelihood of sequencing success.

Background: Disability related to incurable cancer affects over a million Europeans each year and people with cancer rank loss of function among the most common unmet supportive care needs. Objectives: To test the clinical and cost-effectiveness of an integrated short-term palliative rehabilitation intervention, to optimise function and quality of life in people affected by incurable cancer. Design: This is a multinational, parallel group, randomised, controlled, assessor blind, superiority trial. Methods: The INSPIRE consortium brings together leaders in palliative care, oncology and rehabilitation from partner organisations across Europe, with complementary expertise in health service research, trials of complex interventions, mixed-method evaluations, statistics and economics. Partnership with leading European civil society organisations ensures citizen engagement and dissemination at the highest level. We will conduct a multinational randomised controlled trial across five European countries, recruiting participants to assess the effectiveness of palliative rehabilitation for people with incurable cancer on the primary outcome – quality of life – and secondary outcomes including disability, symptom burden and goal attainment. To support trial conduct and enhance analysis of trial data, we will also conduct: comparative analysis of current integration of rehabilitation across oncology and palliative care services; mixed-method evaluations of equity and inclusivity, processes and implementation for the intervention, at patient, health service and health system levels. Finally, we will conduct an evidence synthesis, incorporating INSPIRE findings, and a Delphi consensus to develop an international framework for palliative rehabilitation practice and policy, incorporating indicators, core interventions, outcomes and integration methods. Scientific contribution: If positive, the trial could produce a scalable and equitable intervention to improve function and quality of life in people with incurable cancer and reduce the burden of care for their families. It could also upskill the practitioners involved and motivate future research questions. The intervention could be adapted and integrated into different health systems using existing staff and services, with little or no additional cost.

Objectives Anxiety and depression are relevant comorbidities in asthma, but, in Portugal and Spain, data on this topic are scarce. We assessed, in patients with asthma, the frequency of anxiety and depression using the Hospital Anxiety and Depression Scale (HADS) and the European Quality of Life Five Dimension Questionnaire (EQ-5D); the level of agreement between these questionnaires, and the factors associated with these symptoms.Methods This is a secondary analysis of the INSPIRERS studies. A total of 614 adolescents and adults with persistent asthma (32.6±16.9 years, 64.7% female) were recruited from 30 primary care centres and 32 allergy, pulmonology and paediatric clinics. Demographic and clinical characteristics, HADS and EQ-5D were collected. A score ≥8 on Hospital Anxiety and Depression Scale-Anxiety/Hospital Anxiety and Depression Scale-Depression or a positive answer to EQ-5D item 5 indicated the presence of these symptoms. Agreement was determined by Cohen’s kappa. Two multivariable logistic regressions were built.Results According to HADS, 36% of the participants had symptoms of anxiety and 12% of depression. According to EQ-5D, 36% of the participants had anxiety/depression. The agreement between questionnaires in identifying anxiety/depression was moderate (k=0.55, 95% CI 0.48 to 0.62). Late asthma diagnosis, comorbidities and female gender were predictors of anxiety/depression, while better asthma control, health-related quality of life and perception of health were associated with lower odds for anxiety/depression.Conclusion At least 1/3 of the patients with persistent asthma experience symptoms of anxiety/depression, showing the relevance of screening these disorders in patients with asthma. EQ-5D and HADS questionnaires showed a moderate agreement in the identification of anxiety/depression symptoms. The identified associated factors need to be further investigated in long-term studies.

There is growing interest on the topic of Sexual Violence (SV) perpetrated by community samples; movements, as the Me Too, have triggered such focus. Researching the validity of core SV measures is now fundamental. Accordingly, this study aimed to assess the structure of the Portuguese version of the Sexually Aggressive Behaviors Scale (SABS-PT) while testing for measurement invariance across gender. The SABS-PT was tested among a sample of 2540 Portuguese college students (48.5% males and 51.5% females). All participants identified as heterosexual, and their ages ranged between 18 and 39 years old. To assess the construct validity and test for measurement invariance across gender, single and multigroup Confirmatory Factor Analyses were performed. Results support the internal consistency and convergent/discriminant validity of the SABS-PT in relation to external variables. Overall, the findings suggest a good fit of data to the model. The partial scalar invariance of the measurement was obtained and further analyses on latent means differences indicated that men scored higher on SV compared to women. The SABS-PT may constitute a useful instrument for screening sexual initiation by aggressive means and associated risk factors and may play an important role as an outcome measure in programs preventing sexual violence.

Abstract Background Falls are associated with cognitive and physical function deterioration. Attention decline, inaccurate affordance perception, and balance impairment are considered to be risk factors for falls. Furthermore, few studies have reported psychomotor intervention as a fall prevention program. This study aimed to investigate the effects of two multimodal programs on attention, perceptual and stepping-forward boundaries, and balance in community-dwelling older adults at risk of falling. Methods Fifty-one community-dwelling older adults were recruited to participate in a 24-week randomized controlled trial. Participants (75.4 ± 5.6 years) were randomly assigned to one of three groups: the 1) multimodal psychomotor program [EG1], 2) combined program (multimodal psychomotor program + whole-body vibration program) [EG2], and 3) control group. Participants were assessed at baseline, at post-intervention, and after a 12-week no-intervention follow-up period. Results The within-group comparisons showed significant improvements in attention and balance in EG1 and EG2 after the intervention (p

Ocean island volcanism provides a unique window into the nature of mantle composition, dynamics and evolution. The four Macaronesian archipelagos–Cape Verde, the Canaries, Madeira and the Azores–are the main magmatic systems of the Central-East Atlantic Ocean with volcanic activity that in some islands poses significant risk for the population. The recent development of regional seismic networks in these settings has provided an important step forward in mapping the underlying mantle. However, difficulties in resolving the small-scale structure with geophysical techniques persist leading to discrepancies in the interpretation of the mechanisms responsible for volcanism. Here we review results from a number of studies on the seismic mantle structure beneath the Macaronesian archipelagos including seismic tomography, receiver functions, precursors and shear-wave splitting. Several regional models show low-velocity features in the asthenosphere below the islands, a relatively thinned transition zone and complex anisotropic patterns and attribute the volcanism to mantle plumes. This inference is supported by whole-mantle tomography models, which find broad low-velocity anomalies in the lower mantle below the Central-East Atlantic. Other models call for alternative mechanisms associated with shallower mantle upwellings and purely plate tectonism. Thus, there is still no generally accepted mechanism that explains volcanism in the Macaronesia region. Future research requires improvements in the resolving power of seismic techniques to better illuminate the velocity structure at a much higher resolution than the currently achieved and ultimately define the mechanisms controlling the ocean island volcanism.

Hepatitis delta virus (HDV) infection is the most severe form of viral hepatitis. Genotype 1 (HDV-1) is by far the most prevalent in Europe and globally, while HDV-5 predominates in Western Africa. Data about HDV seroprevalence in Portugal are scarce and genotyping studies have not been performed yet. We aimed to assess the seroprevalence and genotypes of HDV in a large cohort of HBsAg-positive patients followed in our Hepatology Unit between 2012 and 2022. The anti-HDV-positive patients were subjected to a cross-sectional analysis, including blood sample collection for HDV RNA testing and genotype determination. In the cohort of HBsAg-positive patients, 57.5% (480/835) were born in African countries and 665/835 (79.6%) had been screened for anti-HDV antibodies. The HDV seroprevalence obtained was 6.5% (43/665). Twenty-one patients (age 41.2 ± 9.9 years; 57.1% male) were included in further molecular analyses. HDV RNA was positive in 8/21 (38.0%) and classified as HDV-5 in 7 patients (6 from Guinea-Bissau and 1 from Cape Verde) and HDV-1 in 1 patient (from Ukraine). In the largest and most comprehensive study performed in Portugal regarding HDV epidemiology to date, seroprevalence and genotype distribution of HDV (with predominance of HDV-5) were strongly influenced by immigration, notably from African countries. [ABSTRACT FROM AUTHOR]

Informal caregivers of people with neurocognitive disorders (NCDs) may play a decisive role in guaranteeing partners’ participation in community-based physical exercise interventions. However, little is still known about their perspective on being involved in such programs that are specifically designed for their partners. This study aimed to explore the views of caregivers of people with NCDs about taking part in a multicomponent physical exercise intervention with their partners and to explore the perceived impact of this program on those caregivers who enrolled in it. An exploratory qualitative study was conducted with 20 caregivers (67.5 ± 13.94 years; seven female) from the “Body & Brain” project. Ten took part in the physical exercise sessions (active-participating caregivers), and the others did not (social-participating caregivers). Data retrieved from semi-structured interviews were analyzed following a thematic analysis approach. Regardless of their participation level, all caregivers reported their inclusion to be important in enhancing their partners’ initiation and engagement in the sessions; also, they all identified personal gains. Active-participating caregivers reported exercise-related benefits on general health, enjoyment, and social connectedness. Social-participating caregivers considered this intervention an opportunity for respite and appreciated being involved only occasionally (i.e., occasional gatherings or telephone contacts). The findings support the inclusion of caregivers in physical exercise interventions designed for partners with NCDs, considering their decisive role in the partners’ adherence and engagement and due to the perceived gains. Future community-based interventions designed for people with NCDs should consider giving caregivers the opportunity to choose whether they want or not to be actively involved in the exercise sessions. Further studies with larger samples are needed to verify these results, comparing caregivers’ point of view at baseline and post-intervention.

Abstract Background To examine the effects of a 6-month multicomponent (MT) exercise intervention in the functional capacity and ability to independently perform activities of daily living (ADL) of individuals diagnosed with neurocognitive disorder (NCD). Methods A quasi-experimental controlled trial with a parallel design study was conducted in multicentered community-based settings. Forty-three individuals (N Female: 30) were allocated to an exercise group (EG; N: 23; mean 75.09, SD = 5.54 years) or a control group (CG; N:20; mean 81.90, SD = 1.33 years). The EG engaged in a 6-month MT program (60-min sessions, twice a week). Exercise sessions were divided into a warm-up, specific training (e.g., coordination and balance, lower and upper body strength, and aerobics), and cool down. Lower body function, mobility, and gait speed were evaluated through Short Physical Performance Battery (SPPB), Timed-Up and Go test (TUG) and 6-Meter Walk test, respectively. The Barthel Index (BI) was administered to assess individuals’ ADL independence. Evaluations were performed before and after the 6-month intervention. Results Linear Mixed Models revealed a statistically significant interaction (time X group) effect factor on SPPB (B = 2.33, 95% CI: 1.39–3.28, p

Abstract Background Falls in older adults are considered a major public health problem. Declines in cognitive and physical functions, as measured by parameters including reaction time, mobility, and dual-task performance, have been reported to be important risk factors for falls. The aim of this study was to investigate the effects of two multimodal programs on reaction time, mobility, and dual-task performance in community-dwelling older adults at risk of falling. Methods In this randomized controlled trial, fifty-one participants (75.4 ± 5.6 years) were allocated into two experimental groups (EGs) (with sessions 3 times per week for 24 weeks), and a control group: EG1 was enrolled in a psychomotor intervention program, EG2 was enrolled in a combined exercise program (psychomotor intervention program + whole-body vibration program), and the control group maintained their usual daily activities. The participants were assessed at baseline, after the intervention, and after a 12-week no-intervention follow-up period. Results The comparisons revealed significant improvements in mobility and dual-task performance after the intervention in EG1, while there were improvements in reaction time, mobility, and dual-task performance in EG2 (p ≤ 0.05). The size of the interventions’ clinical effect was medium in EG1 and ranged from medium to large in EG2. The comparisons also showed a reduction in the fall rate in both EGs (EG1: -44.2%; EG2: − 63.0%, p ≤ 0.05) from baseline to post-intervention. The interventions’ effects on reaction time, mobility, and dual-task performance were no longer evident after the 12-week no-intervention follow-up period. Conclusions The results suggest that multimodal psychomotor programs were well tolerated by community-dwelling older adults and were effective for fall prevention, as well as for the prevention of cognitive and physical functional decline, particularly if the programs are combined with whole-body vibration exercise. The discontinuation of these programs could lead to the fast reversal of the positive outcomes achieved. Trial registration ClinicalTrials.gov Identifier: NCT03446352. Date of registration: February 07, 2018.

Technological advances have highly facilitated the accession of health-related information. As the public search on hospital websites for information and services is increasing, hospitals need to upgrade their websites to meet the high standards and demands of health-care consumers. Today, many hospital websites use a patient-centric approach to promote engagement and encourage interaction for better health-related decision making. However, little is known about the current state of hospital websites in Portugal. This study aims to assess hospital websites in Portugal and offer improvement insights. In this paper, the websites of 132 selected hospitals were thoroughly examined and assessed according to a predefined list of indicators and sub indicators, based on four criteria: technology, content, services and community interaction, defined in the Health Sector Website Assessment Index (HSWAI) instrument. Most of the websites scored satisfactorily in the technology criterion, performed fairly well in providing fundamental content, but showed shortcomings in quality metrics data and online patient services, and most of them fell short in community interaction elements. Overall, the results show that each hospital website must be improved in specific features in order to become effective and efficient. Several of the identified assessment elements (indicators/sub indicators) fall under Sustainable Development Goal (SDG) 3, United Nations health-focused goal, and could be used by governments to assess their progress toward achieving that specific goal. Therefore, this study not only provides a comprehensive and systematic approach that quantitatively measures hospital websites' overall performance, but also contributes to practical applications in terms of worthwhile recommendations for a website that meets patient's demands and hospital's operational needs.

Advanced aging is associated with cognitive decline. To decrease the healthcare system and socio-economic burdens as well as to promote better quality of life, is important to uncover the factors that may be related to the delay of cognitive impairments in older adults. This study investigated the relationship between physical activity levels, sedentary behavior and cardiorespiratory fitness with cognitive functioning in healthy older adults. Furthermore, it examined the mediating role of processing speed on the association between physical activity and executive functions and long-term memory. Thirty-two individuals aged between 63 and 77 years (M = 68.16, SD = 3.73) underwent measurements of maximal oxygen uptake (VO2peak), 1-week of PA accelerometer measurement and a comprehensive cognitive assessment. Significant associations were observed between MVPA and cognitive processing speed. Equally, a significant positive indirect effect of MVPA on executive functioning and long-term memory was mediated by processing speed. Also, MVPA levels differentiated cognitive functioning in older adults – the physical active group outperformed the physical inactive group in processing speed, executive functions, and language abilities. Our results contribute to the literature on the MVPA levels as an important tool to promote healthier cognitive aging.

Transfer RNA fragments (tRFs) have gene silencing effects similarly to miRNAs, can be sorted into extracellular vesicles (EVs) and are emerging as potential circulating biomarkers for cancer diagnoses. We aimed at analyzing the expression of tRFs in gastric cancer (GC) and understanding their potential as biomarkers. We explored miRNA datasets from gastric tumors and normal adjacent tissues (NATs) from TCGA repository, as well as proprietary 3D-cultured GC cell lines and corresponding EVs, in order to identify differentially represented tRFs using MINTmap and R/Bioconductor packages. Selected tRFs were validated in patient-derived EVs. We found 613 Differentially Expressed (DE)-tRFs in the TCGA dataset, of which 19 were concomitantly upregulated in TCGA gastric tumors and present in 3D cells and EVs, but barely expressed in NATs. Moreover, 20 tRFs were expressed in 3D cells and EVs and downregulated in TCGA gastric tumors. Of these 39 DE-tRFs, 9 tRFs were also detected in patient-derived EVs. Interestingly, the targets of these 9 tRFs affect neutrophil activation and degranulation, cadherin binding, focal adhesion and the cell–substrate junction, highlighting these pathways as major targets of EV-mediated crosstalk with the tumor microenvironment. Furthermore, as they are present in four distinct GC datasets and can be detected even in low quality patient-derived EV samples, they hold promise as GC biomarkers. By repurposing already available NGS data, we could identify and cross-validate a set of tRFs holding potential as GC diagnosis biomarkers.

Abstract Zebra mussel (Dreissena polymorpha) is considered as one of the 100 most harmful IAS in the world. Traditional detection methods have limitations, and PCR based environmental DNA detection has provided interesting results for early warning. However, in the last years, the development of isothermal amplification methods has received increasing attention. Among them, loop-mediated isothermal amplification (LAMP) has several advantages, including its higher tolerance to the presence of inhibitors and the possibility of naked-eye detection, which enables and simplifies its potential use in decentralized settings. In the current study, a real-time LAMP (qLAMP) method for the detection of Dreissena polymorpha was developed and tested with samples from the Guadalquivir River basin, together with two real-time PCR (qPCR) methods using different detection chemistries, targeting a specific region of the mitochondrial gene cytochrome C oxidase subunit I. All three developed approaches were evaluated regarding specificity, sensitivity and time required for detection. Regarding sensitivity, both qPCR approaches were more sensitive than qLAMP by one order of magnitude, however the qLAMP method proved to be as specific and much faster being performed in just 9 min versus 23 and 29 min for the qPCR methods based on hydrolysis probe and intercalating dye respectively.

Diffusion MRI (dMRI) provides unique insights into the neural tissue milieu by probing interactions between diffusing molecules and tissue microstructure. Most dMRI techniques focus on white matter (WM) tissues, nevertheless, interest in gray matter characterizations is growing. The Soma and Neurite Density MRI (SANDI) methodology harnesses a model incorporating water diffusion in spherical objects (assumed to be associated with cell bodies) and in impermeable “sticks” (assumed to represent neurites), which potentially enables the characterization of cellular and neurite densities. Recognising the importance of rodents in animal models of development, aging, plasticity, and disease, we here employ SANDI for in-vivo preclinical imaging and provide a first validation of the methodology by comparing SANDI metrics with cellular density reflected by the Allen mouse brain atlas. SANDI was implemented on a 9.4T scanner equipped with a cryogenic coil, and in-vivo experiments were carried out on N = 6 mice. Pixelwise, ROI-based, and atlas comparisons were performed, magnitude vs. real-valued analyses were compared, and shorter acquisitions with reduced the number of b-value shells were investigated. Our findings reveal good reproducibility of the SANDI parameters, including the sphere and stick fractions, as well as sphere size (CoV < 7%, 12% and 3%, respectively). Additionally, we find a very good rank correlation between SANDI-driven sphere fraction and Allen mouse brain atlas contrast that represents cellular density. We conclude that SANDI is a viable preclinical MRI technique that can greatly contribute to research on brain tissue microstructure.

Abstract Background Dementia is a leading cause of death and disability that was declared as one of the greatest health and social care challenges of the twenty-first century. Regular physical activity and exercise have been proposed as a non-pharmacological strategy in disease prevention and management. Multicomponent Training (MT) combines aerobic, strength, balance and postural exercises and might be an effective training to improve both functional capacity and cognitive function in individuals with dementia (IwD). Nevertheless, data on the effects of MT in IwD are still limited and the extent to which IwD can retain improvements after an exercise intervention still needs to be elucidated. The aim of “Body & Brain” study is to investigate the effects of a 6-month MT intervention and 3-month detraining on the physical and cognitive function of IwD. Additionally, we aim to explore the impact of this intervention on psychosocial factors and physiologic markers related to dementia. Methods This study is a quasi-experimental controlled trial using a parallel-group design. The study sample consists of community-dwelling individuals aged ≥60 years who are clinically diagnosed with dementia or major neurocognitive disorder. Participants will be either allocated into the intervention group or the control group. The intervention group will participate in MT biweekly exercise sessions, whereas the control group will receive monthly sessions regarding physical activity and health-related topics for 6 months. The main outcomes will be physical function as measured by the Short Physical Performance Battery (SPPB) and cognitive function evaluated using the Alzheimer Disease Assessment Scale – Cognitive (ADAS-Cog) at baseline, after 6-months and 3-months after the end of intervention. Secondary outcomes will be body composition, physical fitness, daily functionality, quality of life, neuropsychiatric symptoms and caregiver’s burden. Cardiovascular, inflammatory and neurotrophic blood-based biomarkers, and arterial stiffness will also be evaluated in subsamples. Discussion If our hypothesis is correct, this project will provide evidence regarding the efficacy of MT training in improving physical and cognitive function and give insights about its impact on novel molecular biomarkers related to dementia. This project may also contribute to provide guidelines on exercise prescription for IwD. Trial registration ClinicalTrials.gov – identifier number NCT04095962 ; retrospectively registered on 19 September 2019.

Targeting self-renewing cancer cells without deleterious side effects in normal tissues has proven challenging. Here, the authors show that the well-tolerated HDAC inhibitor Quisinostat safely inhibits tumor maintenance and disease relapse by restoring high levels of histone H1.0.

This study aimed was to assess the effects of three different training protocols in quadriceps and hamstrings isokinetic muscle strength of independent elderly women. Eighty women were recruited for this study and divided into four groups of twenty subjects: the control group, the multicomponent group, the muscle power group, and the muscular resistance strength group. The isokinetic strength was measured in both lower limbs with a dynamometer at 60°/s and 180º/s. The multivariate analysis (ANOVA) and the Bonferroni test assessed the group and time effect. Significant and positive effects were observed in the time and group interaction in the power group at 180°/s and 60°/s knee flexion in the dominant (p = 0.004, respectively) and non-dominant (p = 0.046 and p = 0.041, respectively) lower limbs. The Control group had significant and negative effect on the time x group interaction at 180°/s and 60°/s on the extension of the dominant knee (p = 0.008 and p = 0.001, respectively) and non-dominant (p = 0.003 and p< 0.001, respectively). The muscle power training seems to be the most effective to increase the isokinetic strength in older independent women. All the training programs appear to contribute to decreasing the age-related loss on isokinetic strength.

Wilson's disease is a rare autosomal recessive condition. A defect on the copper carrier protein ATP7B prevents the excretion of copper, which then accumulates in several organs. The prognosis of Wilson's disease is favourable if the diagnosis is made early. The Leipzig criteria standardized phenotypic classification and diagnostic criteria, thus simplifying the diagnostic approach. A search for ATP7B mutations is not necessary for diagnostic purposes and studies of genotype–phenotype correlation have not produced any conclusive evidence so far. More information is needed to reliably assess the prognosis for each patient. Here we describe a young patient with a combination of two mutational variants: c.3402del and c.3061-12T>A. To our knowledge, this is the first report of this compound heterozygote genotype.

The risk of dehydration in older adults with neurocognitive disorder (NCD) is controversial. The purpose of this study was to assess hydration status, its determinants, and water intake sources in older adults with NCD. A sample of 30 participants (≥60 years) was included. Sociodemographic, clinical data and one 24-h urine sample were collected. Urinary osmolality, sodium, potassium, volume, and creatinine were quantified. Inadequate hydration status corresponded to urine osmolality > 500 mOsm/Kg, or a negative Free Water Reserve (FWR). Two 24-h food recalls were used to assess dietary intake and water sources. The adequacy of total water intake (TWI) was estimated according to EFSA. The contribution of food and beverages to TWI was calculated, and their associations with the urinary osmolality median were tested. Of the total number of participants, 30% were classified as having inadequate hydration status, with no differences between sexes. Regarding TWI, 68.4% of women and 77.8% of men did not reach the reference values. Water (23%), followed by soup (17%), contributed the most to TWI, while vegetables (2%) and alcoholic/other beverages (3%) contributed the least. According to the median urinary osmolality, there was no significant difference in sociodemographic/clinical characteristics. It is critical not to overlook hydration in this vulnerable population.

Data concerning the combined effect of diet and exercise interventions on overall health in the elderly are scarce. The MED-E project’s primary aim is to assess the effect of the different 3-month sustainable healthy diet (SHD) and multicomponent training (MT) interventions on several health outcomes in the elderly. A quasi-experimental study assigned older adults into four groups: (1) SHD, (2) MT, (3) SHD + MT, or (4) control group (CG). The SHD intervention included a weekly offer of a mixed food supply and individual and group nutritional sessions on the principles of an SHD. The MT groups were submitted to 50-min exercise sessions three times a week. The primary outcomes were blood biomarkers and metabolic profile alterations that were assessed pre- and post-intervention. Additionally, data on dietary intake and nutritional adequacy, physical fitness, body composition and anthropometry, cognitive function, quality of life, and geographical data were assessed at the same time points. The MED-E project’s study protocol and future results will add to knowledge about the importance and beneficial contribution of combined SHD and MT interventions on healthy ageing policies.

Miniaturization of DNA-based techniques can bring interesting advantages for food analysis, such as portability of complex analytical procedures. In the olive oil industry, miniaturization can be particularly interesting for authenticity and traceability applications, through in situ control of raw materials before production and/or the final products. However, variety identification is challenging, and implementation on miniaturized settings must be carefully evaluated, starting from the selected analytical approach. In this work, SSR- and SNP-based genotyping strategies were investigated for the identification and differentiation of two olive varieties from the Northwest of Spain. For the selected SNPs two genotyping methods were tested: real-time allele-specific PCR and high resolution melting analysis. These methods were compared and evaluated regarding their potential for integration in a microfluidic device. Both SNP-based methods proved to be successful for identification of the selected varieties, however real-time allele-specific PCR was the one that achieved the best results when analyzing mixtures, allowing the identification of both monovarietal samples and mixtures of the varieties tested with up to 25%.