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The Dysphagia Handicap Index (DHI) is a valid Health-related Quality of Life (HRQoL) 25-item questionnaire assessing the physical, functional, and emotional aspects of patients with oropharyngeal dysphagia (OD), of heterogeneous etiologies. The purpose of this study is to translate and validate the European Portuguese-DHI (EP-DHI). This is a prospective study that was carried out at Centro Hospitalar Universitário do Porto (CHUPorto). The generated EP-DHI was administered to 132 patients with OD and 112 healthy control subjects. 132 patients undergoing fiberoptic endoscopic examination of swallowing (FEES). 15 patients were contacted by phone, 2 or 3 weeks later after the first interview to repeat the questionnaire. The validity of concurrent criteria was evaluated by comparing the results of the EP-DHI score with the score attributed to the pathological findings found in FEES and, consequently, Functional Oral Intake Scale (FOIS). The internal consistency of EP-DHI was successful: Cronbach's alpha coefficient for total EP-DHI was 0.874. The test-retest reliability for the total and the three EP-DHI subscales obtained a Pearson's correlation coefficient ranged from 0.990 to 0.712. This study demonstrates that EP-DHI is a valid tool for self-assessment of the handicapping effect of dysphagia on physical, functional, and emotional aspects of patient's quality of life, among an European Portuguese sample.

We present a protocol that detects molecular conformational changes with two nitroxide electron-spin labels and a nitrogen-vacancy (NV) center in diamond. More specifically, we demonstrate that the NV can detect en- ergy shifts induced by the coupling between electron-spin labels. The protocol relies on the judicious application of microwave and radiofrequency pulses in a range of parameters that ensures stable nitroxide resonances. Fur- thermore, we demonstrate that our scheme is optimized by using nitroxides with distinct nitrogen isotopes. We develop a simple theoretical model that we combine with Bayesian inference techniques to demonstrate that our method enables the detection of conformational changes in ambient conditions including strong NV dephasing rates as a consequence of the diamond surface proximity and nitroxide thermalization mechanisms. Finally, we counter-intuitively show that with our method the small residual effect of random molecular tumbling becomes a resource that can be exploited to extract inter-label distances.

Introduction and objectives Congenital atresia of the external auditory canal (EAC) is a congenital defect present in one in every 10,000–20,000 births. It causes conductive hearing loss, with an air-bone gap of 50–60 dB. Early amplification is essential in bilateral cases to ensure normal language development. The aim of this study is to present the osseointegrated hearing implant as a treatment for bilateral EAC atresia, reviewing the audiometric results and the rate of complications. Material and methods Retrospective analysis of patients diagnosed with bilateral congenital EAC atresia under follow-up in the pediatric ENT clinic of the ENT and Head and Neck Surgery department of a Portuguese Tertiary Hospital, between 2003 and 2019. We reviewed the medical records and collected information on the assessment of the initial audiometric status. In the cases submitted for implantation with an osseointegrated hearing implant, we analyzed the details of follow-up, including immediate and long-term post-operative complications, as well as the audiometric results. Results We present 8 pediatric patients, 6 girls and 2 boys, with a diagnosis of bilateral congenital EAC atresia. The audiometric assessment revealed moderate to severe bilateral conductive hearing loss with a mean speech recognition threshold (SRT) of 51 dB. Six patients underwent osseointegrated hearing implantation. All 6 patients showed good audiometric results, with an average SRT of 20 dB and closure of the air-bone gap. Conclusions The osseointegrated hearing implant was an effective treatment option in these patients, without significant morbidity or complications. Osseointegrated hearing implantation should be considered first line treatment for children with bilateral congenital EAC atresia, as it presents good functional results and a high level of patient satisfaction.

We present the experimental implementation of a two-qubit phase gate, using a radio frequency (RF) controlled trapped-ion quantum processor. The RFdriven gate is generated by a pulsed dynamical decoupling sequence applied to the ions’ carrier transitions only. It allows for a tunable phase shift with high-fidelity results. The conditional phase shift is measured using a Ramsey-type measurement with an inferred fringe contrast of up to 99+1 −2%. We also prepare a Bell state using this laser-free gate. The phase gate is robust against common sources of error. We investigate the effect of the excitation of the center-of-mass (COM) mode, errors in the axial trap frequency, pulse area errors and errors in sequence timing. The contrast of the phase gate is not significantly reduced up to a COM mode excitation < 20 phonons, trap frequency errors of +10%, and pulse area errors of -8%. The phase shift is not significantly affected up to < 10 phonons and pulse area errors of -2%. Both, contrast and phase shift are robust to timing errors up to -30% and +15%. The gate implementation is resource efficient, since only a single driving field is required per ion. Furthermore, it holds the potential for fast gate speeds (gate times on the order of 100 μs) by using two axial motional modes of a two-ion crystal through improved setups.

BACKGROUND Vena cava anomalies are rare congenital defects due to incorrect development during fetal life, ranging from minor asymptomatic anatomic variations to complex life-threatening abnormalities. Echocardiography plays a fundamental role in the diagnosis, with advanced imaging techniques allowing detailed anatomic delineation. Invasive cardiology techniques are a promising therapeutic approach, but surgery is probably the best option when diffuse compromise of the systemic veins is present. CASE REPORT An 8-month-old infant presenting episodes of labial cyanosis and a failure to thrive was diagnosed with severe superior vena cava (SVC) stenosis at the right atrium ostium, with decompression via azygos vein and mild inferior vena cava (IVC) stenosis. The patient was referred for surgery, with IVC enlargement and removal of a fibromuscular tissue band on the anterior aspect of the SVC ostium. At a 6-month follow-up, the patient is asymptomatic, with excellent surgical outcome. To the authors' knowledge, only two cases of congenital SVC stenosis have been previously described.

Este relatório foi realizado no âmbito da unidade curricular de Estágio, para a obtenção do grau de Mestre em Exercício e Saúde pela Faculdade de Motricidade Humana (FMH) e aborda todas as atividades desenvolvidas durante o estágio na Câmara Municipal de Oeiras (CMO), mais especificamente, no Programa Fit Sénior. Este relatório tem como objetivo, apresentar a prática profissional e todas a as atividades desenvolvidas ao longo do decorrer do estágio, no ano letivo de 2020/2021. O relatório encontra-se dividido em quatro partes principais, mais anexos e referências utilizadas aquando da realização deste relatório. A primeira parte trata-se de uma breve introdução sobre o tema de trabalho (funcionamento físico), de modo a contextualizar o leitor. A segunda parte, retrata o local de estágio e a atividade desenvolvida, no decorrer do estágio. A terceira parte, consiste na análise e discussão dos resultados sobre o funcionamento físico, nos participantes do Programa Fit Sénior. A quarta parte, consiste numa breve conclusão sobre os ganhos de competência que o estágio proporcionou e a opinião do estagiário sobre o estágio e possíveis melhorias que acha pertinentes. This report was conducted within the scope of the Internship course unit for obtaining the Master's Degree in Exercise and Health from the Faculty of Human Motricity (FMH) and addresses all the activities developed during the internship at the Oeiras City Hall (CMO), more specifically, in the Senior Fit Program. This report aims to present the professional practice and all the activities developed during the internship, in the school year 2020/2021. The report is divided into four main parts, plus annexes and references used during the completion of this report. The first part is a brief introduction on the subject of work (physical functioning), in order to contextualize the reader. The second part depicts the internship site and all the activity developed during the internship. The third part is the analysis and discussion of the results about the physical functioning of the participants in the Senior Fit Program. The fourth part, consists of a brief conclusion on the gains in competence that the internship provided and the trainee's opinion on the internship and possible improvements that he finds pertinent.

We investigate the impact of labour market concentration on two dimensions of job quality, namely wages and job security. We leverage rich administrative linked employer-employee data from Denmark, France, Germany, Italy, Portugal and Spain in the 2010s to provide the first comparable cross-country evidence in the literature. Controlling for productivity and local product market concentration, we show that the elasticities of wages with respect to labour market concentration are strikingly similar across countries: increasing labour market concentration by 10% reduces wages by 0.19% in Germany, 0.22% in France, 0.25% in Portugal and 0.29% in Denmark. Regarding job security, we find that an increase in labour market concentration by 10% reduces the probability of being hired on a permanent contract by 0.46% in France, 0.51% in Germany and 2.34% in Portugal. While not affecting this probability in Italy and Spain, labour market concentration significantly reduces the probability of being converted to a permanent contract once hired on a temporary one. Our results suggest that considering only the effect of labour market concentration on wages underestimates its overall impact on job quality and hence the resulting welfare loss for workers.

Abnormal distribution may put coronary arteries at risk of damage during valvular surgery, especially if it is not identified during a preoperative examination. In this case report, we describe an approach to an anomalous right coronary artery during aortic valve replacement.

En este artículo presentamos un ejercicio de evaluación causal en el contexto del perfilado estadístico aplicado a un programa de empleo creado por la Fundación “La Caixa” y denominado Incorpora. Este programa consiste en un mecanismo de apoyo y recolocación en el mercado de trabajo de personas en riesgo de exclusión. Nuestros resultados apuntan a que la formación impartida dentro del programa contribuye a una mejora general de la empleabilidad media de los participantes en el programa, pero se observa cómo este efecto decae en el tiempo que el beneficiario está desempleado. Por otra parte, encontramos que el programa Incorpora mejora la probabilidad de encontrar y retener el empleo, así como el tiempo trabajado e incluso el salario una vez reempleado, para todos los colectivos analizados sin importar el género, nacionalidad, sector previo de empleo o experiencia laboral previa. Concretamente, la empleabilidad aumenta entre 3 y 4 puntos porcentuales gracias al programa y el efecto sobre el número de meses acumulados en el empleo se sitúa, dependiendo de la cohorte, entre 3 y 4 meses tres años después de salir del mismo.

Background Chylothorax in neonates results from leakage of lymph from thoracic lymphatic ducts and is mainly congenital or posttraumatic. The clinical course of the effusion is heterogeneous, and consensus on treatment, timing, and modalities of measures has not yet been established. This review aims to present, along with levels of evidence and recommendation grades, all current therapeutic possibilities for the treatment of chylothorax in neonates. Methods An extensive search of publications between 1970 and 2020 was performed in the PubMed, Cochrane Database of Systematic Reviews, and UpToDate databases. A stepwise approach algorithm was proposed for both congenital and traumatic conditions to guide the clinician in a rational and systematic way for approaching the treatment of neonates with chylothorax. Discussion and conclusion The treatment strategy for neonatal chylothorax generally involves supportive care and includes drainage and procedures to reduce chyle flow. A stepwise approach starting with the least invasive method is advocated. Progression in the invasiveness of treatment options is determined by the response to previous treatments. A practical stepwise approach algorithm is proposed for both, congenital and traumatic chylothoraces.

Introduction and Objectives: COVID-19 pandemic forced a change in health care resources and provision due to the emergence of a new group of patients, requiring extraordinary protective measures and the adoption of new organization for the treatment of urgent or priority COVID-19 negative patients. We reviewed our practice during the first pandemic period to evaluate our surgical outcomes and identify if patients COVID-19 negative submitted to thoracic surgery had an increased risk of being infected or die. Methods: We retrospectively reviewed our surgical results between 11th March and 15th May 2020. Thirty patients underwent thoracic surgery at the Department of Cardiothoracic Surgery of Centro Hospitalar Universit��rio de S��o Jo��o. Results: None of the patients was COVID-19 positive and cross-transmission of the disease was not recognized. The majority of patients were admitted from home, with a high priority indication, namely an oncological disease. There was only one case of in-hospital mortality. Conclusion: During the first wave of the pandemic it was safe to be admitted and submitted to thoracic surgery at CHUSJ. Our patients, including oncological patients, received the adequate surgical treatment without an increase of risk of death or infection., Portuguese Journal of Cardiac Thoracic and Vascular Surgery, Vol. 28 No. 2 (2021): April - June

We present a rare case of a levoatrial cardinal vein identified during the work-up of a patient with coarctation of the aorta. Early diagnosis and repair in the neonatal period prevented future manifestations of left-to-right shunt and the need for reoperations, in contrast with the later-age presentation of this congenital anomaly. An integrative approach was crucial for prompt detection, intraoperative confirmation and complete one-stage repair. Resumo: Os autores apresentam um caso raro de diagnóstico de uma veia levoatriocardinal identificada na avaliação incial de um recém-nascido com coartação da aorta. O diagnóstico e tratamento no período neonatal permitiram evitar as manifestações de shunt esquerdo-direito tardias e a necessidade de reintervenção no futuro. A abordagem multi-imagem integrada foi essencial para o diagnóstico precoce desta malformação congénita, confirmação intraoperatória e reparação completa num único procedimento.

Our objective was to examine the results of ECMO post cardiotomy in Centro Hospitalar Universitário S. João (CHUSJ).Between 2011 and 2019, 13 patients were cannulated for refractory cardiogenic shock post-cardiotomy; 8 (61,5%) male and 5 (38,5%) female. Patients under 18 years old were excluded. Data was collected from hospital archives concerning preoperative comorbidities, open-heart surgery procedure, dates of ECMO cannulation and decannulation, postoperative complications, hospital mortality and cause of death. Follow-up was obtained by review of the last outpatient observation. The outcomes investigated were hospital mortality and survival at 12, 36 and 60 months.After a median ECMO-VA therapy of 6 days (1-16 days), 7 (53,8%) patients were successfully decannulated; from these 2 succumbed from stroke and septic shock, one is still in intermediate care convalescing steadily and 4 were discharged. Overall 8 (61,5%) patients died. 5 (38,5%) survived, 4 were discharged home and 1 is still in intermediate care. Survival (after discharge) at 12, 36 and 60 months was respectively 25%, 16,7% and 8,3%. Regarding postoperative complications, reoperation for bleeding was necessary in 5 (38.5%), stroke was diagnosed in 2 (15,4%), dialysis in 6 (46,2%), leg ischemia affected 5 (38,5%) and mediastinitis occurred in 1 (7,7%).VA ECMO saves a life in each three patients suffering from refractory cardiogenic shock after cardiac surgery. Despite risks associated with advanced cardiopulmonary support, survivors maintain good health condition.

During valvular surgery, abnormal coronary distribution, especially if unidentified by preoperative exams, may put coronary arteries at risk of damage. In this case report, we describe the approach to an anomalous right coronary artery during aortic valve replacement.

7 pags., 3 figs., 1 app., Quantum sensors typically translate external fields into a periodic response whose frequency is then determined by analyses performed in Fourier space. This allows for a linear inference of the parameters that characterize external signals. In practice, however, quantum sensors are able to detect fields only in a narrow range of amplitudes and frequencies. A departure from this range, as well as the presence of significant noise sources and short detection times, lead to a loss of the linear relationship between the response of the sensor and the target field, thus limiting the working regime of the sensor. Here we address these challenges by means of a Bayesian inference approach that is tolerant to strong deviations from desired periodic responses of the sensor and is able to provide reliable estimates even with a very limited number of measurements. We demonstrate our method for an 171Yb+ trapped-ion quantum sensor but stress the general applicability of this approach to different systems., We acknowledge financial support from the Spanish Government via PGC2018-095113-B-I00 (MCIU/AEI/FEDER, UE) and EUR2020-112117, the Basque Government via IT986-16, as well as from QMiCS (820505) and OpenSuperQ (820363) of the EU Flagship on Quantum Technologies, and the EU FET Open Grant Quromorphic. J.C. acknowledges the Ramón y Cajal program (RYC2018- 025197-I) and support from the UPV/EHU through the grant EHUrOPE. M.B.P. acknowledges support from the ERC Synergy Grant HyperQ, the EU Flagship project AsteriQs, and the BMBF projects Nanospin and DiaPol. J.F.H. acknowledges support from the Alexander von Humboldt Foundation in the form of a FeodorLynen Fellowship. R.P. and M.P. acknowledge support from the SFI-DfE Investigator Programme (Grant No. 15/IA/2864). M.P. acknowledges the H2020 Collaborative Project TEQ (Grant Agreement No. 766900), the Leverhulme Trust Research Project Grant UltraQuTe (Grant No. RGP-2018-266), the Royal Society Wolfson Fellowship (RSWF/R3/183013), and the UK EPSRC (Grant No. EP/T028106/1).

Robust and high-precision quantum control is crucial but challenging for scalable quantum computation and quantum information processing. Traditional adiabatic control suffers severe limitations on gate performance imposed by environmentally induced noise because of a quantum system's limited coherence time. In this work, we experimentally demonstrate an alternative approach {to quantum control} based on deep reinforcement learning (DRL) on a trapped $^{171}\mathrm{Yb}^{+}$ ion. In particular, we find that DRL leads to fast and robust {digital quantum operations with running time bounded by shortcuts to adiabaticity} (STA). Besides, we demonstrate that DRL's robustness against both Rabi and detuning errors can be achieved simultaneously without any input from STA. Our experiments reveal a general framework of digital quantum control, leading to a promising enhancement in quantum information processing., 9 pages, 7 figures with Supplementary Material

To determine cut-off points in auto-assessment questionnaires to predict the presence and extent of presbylarynx signs.This case control, prospective, observational, and cross-sectional study was carried out on consecutive subjects observed by Otorhinolaryngology, in a tertiary center, in 2020. Each subject underwent fiberoptic videolaryngoscopy with stroboscopy, and presbylarynx was considered when it was identified two or more of the following endoscopic findings: vocal fold bowing, prominence of vocal processes in abduction, and a spindle-shaped glottal gap. Each subject completed three questionnaires: the Voice Handicap Index (VHI), with 30 and 10 questions, and the "Screening for voice disorders in older adults questionnaire" (RAVI).The studied population included 174 Caucasian subjects (60 males; 114 females), with a mean age of 73.99 years (standard deviation = 6.37; range 65-95 years). Presbylarynx was identified in 71 patients (41%). Among patients with presbylarynx, a glottal gap was identified in 22 patients (31%). The mean score of VHI-30 between "no presbylarynx" and "presbylarynx" groups was statistically different (P0.001), with a higher score for subjects with signs of presbylarynx. The presence of glottal gap was associated to a higher mean score of VHI-30 (41.64 ± 11.87) (P0.001). The mean score of VHI-10 between "no presbylarynx" and "presbylarynx" groups was statistically different (P0.001), with a higher score for subjects with signs of presbylarynx. Among patients with presbylarynx, the presence of glottal gap was associated to higher mean score of VHI-10 (14.04 ± 3.91) (P0.001). There was a strong positive correlation between VHI-30 and VHI-10 (rs = 0.969; P0.001). The mean score of RAVI between "no presbylarynx" and "presbylarynx" groups was statistically different (P0.001), with a higher score for subjects with signs of presbylarynx. Among patients with presbylarynx, the presence of glottal gap was associated to a higher mean score of RAVI (11.68 ± 1.61) (P0.001). There was a strong positive correlation not only between RAVI and VHI-30 (rs = 0.922; P0.001), but also between RAVI and VHI-10 (rs = 0.906; P0.001). The optimal cut-off points to discriminate "no presbylarynx" from "presbylarynx", obtained by the Youden' index, were 3.5 for RAVI, 4.5 for VHI-30 and 1.5 for VHI-10. RAVI had the highest sensitivity and specificity. The optimal cut-off points to predict glottal gap, obtained by the Youden' index, were 9.5 for RAVI, 21 for VHI-30 and 7.5 for VHI-10.The optimal cut-off points do discriminate "no presbylarynx" from "presbylarynx" were 3.5 for RAVI, 4.5 for VHI-30 and 1.5 for VHI-10. RAVI had the highest sensitivity and specificity, probably because it was designed specifically for vocal complaints of the elderly. Among patients with presbylarynx, cut-off points of 9.5 for RAVI, 21 for VHI-30 and 7.5 for VHI-10 were determined to predict patients with and without glottal gap. It was found a strong positive correlation between RAVI, VHI-30 and VHI-10. Thus, VHI-10 can be preferred to VHI-30 to assess voice impairment in clinical practice, because for elderly patients it is easier to answer. However, to predict endoscopic signs of presbylarynx, RAVI should be preferred.

Quantum platforms based on trapped ions are main candidates to build a quantum hardware with computational capacities that largely surpass those of classical devices. Among the available control techniques in these setups, pulsed dynamical decoupling (pulsed DD) revealed as a useful method to process the information encoded in ion registers, whilst minimising the environmental noise over them. In this work, we incorporate a pulsed DD technique that uses random pulse phases, or correlated pulse phases, to significantly enhance the robustness of entangling spin-spin dynamics in trapped ions. This procedure was originally conceived in the context of nuclear magnetic resonance for nuclear spin detection purposes, and here we demonstrate that the same principles apply for robust quantum information processing in trapped-ion settings., 10 pages, 4 figures

Background Covid‐19 was declared a pandemic by the World Health Organization (WHO) on 11 March 2020. Responses to this crisis integrated resource allocation for the increased amount of infected patients while maintaining an adequate response to other severe and life‐threatening diseases. Though cardiothoracic patients are at high risk for Covid‐19 severe illness, postponing surgeries would translate to increased mortality and morbidity. We reviewed our practice during the initial time of the pandemic, with emphasis on safety protocols. Methods From 11 March to 15 May 2020, 148 patients underwent surgery at the Department of Cardiothoracic Surgery of Centro Hospitalar Universitário de São João. The clinical characteristics of the patients were retrospectively registered, along with novel containment and infection prevention measures targeting the new coronavirus. Results The majority of adult cardiac patients were operated on an emergency basis. Hospital mortality was 1.9% (n = 2 patients). Most adult thoracic patients were admitted from home, with a diagnosis of neoplastic disease in 60% of patients. Hospital mortality was 3.3% (1 patient). Fifteen children underwent cardiothoracic surgery. There was no mortality. The infection prevention procedures applied, totally excluded the transmission of Covid‐19 in the department. Conclusion While guaranteeing a prompt response to emergent, urgent, and high priority cases, novel safety measures in individual protection, patients circuits, and preoperative diagnoses of symptomatic and asymptomatic infection were adopted. The surgical results corroborate that it was safe to undergo cardiothoracic surgery during the initial time of the Covid‐19 pandemic. The new policies will be maintained while the virus stays in the community.

8 pags., 5 figs., The quantum perceptron is a fundamental building block for quantum machine learning. This is a multidisciplinary feld that incorporates abilities of quantum computing, such as state superposition and entanglement, to classical machine learning schemes. Motivated by the techniques of shortcuts to adiabaticity, we propose a speed-up quantum perceptron where a control feld on the perceptron is inversely engineered leading to a rapid nonlinear response with a sigmoid activation function. This results in faster overall perceptron performance compared to quasi-adiabatic protocols, as well as in enhanced robustness against imperfections in the controls., We acknowledge fnancial support from Spanish Government via PGC2018-095113-B-I00 (MCIU/AEI/FEDER, UE), Basque Government via IT986-16, as well as from QMiCS (820505) and OpenSuperQ (820363) of the EU Flagship on Quantum Technologies, and the EU FET Open Grant Quromorphic (828826). J. C. acknowledges the Ramón y Cajal program (RYC2018- 025197-I) and the EUR2020-112117 Project of the Spanish MICINN,as well as support from the UPV/EHU through the Grant EHUrOPE. X. C. acknowledges NSFC (12075145), SMSTC (2019SHZDZX01-ZX04, 18010500400 and 18ZR1415500), the Program for Eastern Scholar and the Ramón y Cajal program of the Spanish MICINN (RYC-2017-22482). E. T. acknowledges support from Project PGC2018-094792-B-I00 (MCIU/AEI/FEDER,UE), CSIC Research Platform PTI-001, and CAM/FEDER Project No. S2018/TCS-4342 (QUITEMAD-CM).