Search

Abstract Fish age and growth data are crucial for understanding vital species’ traits and their populations. Boarfish is a pelagic species widely distributed in the Northeast Atlantic that is one of the most discarded non-commercial species on the Portuguese coast. Due to its potential valorisation as a new fishery in the Northeast Atlantic, boarfish has become object of interest in several published studies. However, since no age standard protocol has been implemented for boarfish, studies have used a variety of different otolith preparation techniques to estimate age, leading to contradicting and discrepant results. This research aims to consolidate biological insights into boarfish age and growth, lay the foundation for a standardized ageing protocol and serve as a benchmark study for the Portuguese west coast before commercial exploitation. Through the comparison of two otolith ageing methodologies, this study recommends using whole otoliths as the best method, revealing a maximum age of 15 years. The growth pattern estimated, indicated a biphasic growth pattern, with a faster initial growth rate that slows down at 2.4 years, the moment of change, when energy is allocated for sexual maturation. This finding was corroborated by a maturity ogive and analysis of fish size and otolith length relationship.

Abstract Drug screening based on in-vitro primary tumor cell culture has demonstrated potential in personalized cancer diagnosis. However, the limited number of tumor cells, especially from patients with early stage cancer, has hindered the widespread application of this technique. Hence, we developed a digital microfluidic system for drug screening using primary tumor cells and established a working protocol for precision medicine. Smart control logic was developed to increase the throughput of the system and decrease its footprint to parallelly screen three drugs on a 4 × 4 cm2 chip in a device measuring 23 × 16 × 3.5 cm3. We validated this method in an MDA-MB-231 breast cancer xenograft mouse model and liver cancer specimens from patients, demonstrating tumor suppression in mice/patients treated with drugs that were screened to be effective on individual primary tumor cells. Mice treated with drugs screened on-chip as ineffective exhibited similar results to those in the control groups. The effective drug identified through on-chip screening demonstrated consistency with the absence of mutations in their related genes determined via exome sequencing of individual tumors, further validating this protocol. Therefore, this technique and system may promote advances in precision medicine for cancer treatment and, eventually, for any disease.

Orthoses are commonly used for treating injuries to improve the quality of life of patients, with customized orthoses offering significant benefits. Additive manufacturing, especially fused deposition modelling, enhances these benefits by providing faster, more precise, and more comfortable orthoses. The present study evaluates nine polymeric materials printed in horizontal and vertical directions by assessing their performance through compressive, flexural, and tensile tests. Among all materials, polycarbonate, polylactic acid, and ULTEMTM 1010 showed the most promising results, not only because they had the highest mechanical values, but also due to their minimal or no difference in performance between printing directions, making them advantageous in orthoses fabrication. Based on this, a finite element model of an ankle–foot orthosis was developed to simulate the deformation, strain, and stress fields under static conditions. The findings aim to optimize material selection for orthotic fabrication, where ULTEMTM 1010 is presented as the material with improved performance and durability.

The increased fish consumption by the growing human population in the world translates into an increase in fish waste. The reintroduction of these fish by-products into food and feed chains presents economic benefits and contributes to counteracting their negative environmental impact. Under this context, the present study aimed to evaluate the effects of the dietary inclusion of fish hydrolysate and oil obtained from fish waste (experimental diet) in substitution of shrimp hydrolysate and salmon oil (control diet) mainly imported from third countries on palatability, apparent total tract digestibility, fecal characteristics and metabolites, blood fatty acid profile, flatulence, and coat quality of adult dogs. A two-bowl test was performed to evaluate palatability by the pairwise comparison between the two diets. A feeding trial was conducted according to a crossover design with two diets (control and experimental diets), six adult Beagle dogs per diet, and two periods of 6 weeks each. The replacement of shrimp hydrolysate and salmon oil with fish hydrolysate and oil did not affect the first diet approach and taste, as well as the intake ratio. Generally, the digestibility of dry matter, nutrients, and energy was not affected by diet, but the intake of digestible crude protein (CP) and ether extract was higher, respectively, with the control and the experimental diet. The higher intake of eicosapentaenoic acid and docosahexaenoic acid with the experimental diet was reflected in a higher content of these long-chain polyunsaturated fatty acids and the omega-3 index of red blood cells, but it did not affect coat quality. The significantly higher intake of digestible CP with the control diet might have contributed to the higher fecal ammonia-N and valerate concentrations. Daily fecal output and characteristics were similar between diets. Overall, results suggest that fish hydrolysate and oil from the agrifood industry might constitute sustainable functional ingredients for dog feeding while adding value for wild fisheries, aquaculture, and fish farming under a circular economy approach and reducing dependence on imports from third countries with a high carbon footprint.

Abstract Background This work aims to study the spatio-temporal evolution of a woman’s age at menarche in the central region of Portugal. One of the concerns of the study is early or late menarches; thus, we consider percentile regression to build the respective curves as opposed to the more traditional mean regression approach. Methods We analysed the data from $$N=452\,348$$ N = 452 348 women born in the period 1920–1973 who attended a free breast cancer screening program between 1990 and 2019. Distributional regression models inside the package GAMLSS in R were considered. These methods allowed us not only to model the location (mean) of the specific probability distribution of the age at menarche, but also allowed for the scale (variance) parameter of this distribution to depend on covariates. Additionally, a spatial random-effect was considered in order to capture the correlation at the regional level. The obtained clustered spatial effects were analysed to assess geographical differences among the percentiles of the age at menarche by year of birth. Results A decreasing trend in the age at menarche (about 1.5 years in 5 decades) and regional differences for all the considered percentiles were found. Women living in the north-central areas of the central region of Portugal tend to have menarche at older ages. Conclusion We obtained percentile estimates for the age at menarche by year of birth and region of residence and demonstrated that these two explanatory variables have an impact on the explanation about the decreasing trend in age at a woman’s first menstruation.

This study investigates how grapevines (Vitis vinifera L.) respond to shading induced by artificial nets, focusing on physiological and metabolic changes. Through a multidisciplinary approach, grapevines’ adaptations to shading are presented via biochemical analyses and hyperspectral data that are then combined with systems biology techniques. In the study, conducted in a ‘Moscatel Galego Branco’ vineyard in Portugal’s Douro Wine Region during post-veraison, shading was applied and predawn leaf water potential (Ψpd) was then measured to assess water stress. Biochemical analyses and hyperspectral data were integrated to explore adaptations to shading, revealing higher chlorophyll levels (chlorophyll a-b 117.39% higher) and increased Reactive Oxygen Species (ROS) levels in unshaded vines (52.10% higher). Using a self-learning artificial intelligence algorithm (SL-AI), simulations highlighted ROS’s role in stress response and accurately predicted chlorophyll a (R2: 0.92, MAPE: 24.39%), chlorophyll b (R2: 0.96, MAPE: 17.61%), and ROS levels (R2: 0.76, MAPE: 52.17%). In silico simulations employing flux balance analysis (FBA) elucidated distinct metabolic phenotypes between shaded and unshaded vines across cellular compartments. Integrating these findings provides a systems biology approach for understanding grapevine responses to environmental stressors. The leveraging of advanced omics technologies and precise metabolic models holds immense potential for untangling grapevine metabolism and optimizing viticultural practices for enhanced productivity and quality.

The present work consisted of an exploratory study aiming to evaluate in vitro the potential of AuNPs during Radiation Therapy (RT) in human pancreatic adenocarcinoma cells. AuNPs coated with hyaluronic and oleic acids (HAOA-AuNPs) or with bombesin peptides (BBN-AuNPs) were used. AuNPs were characterized by Atomic Force Microscopy (AFM) and Dynamic Light Scattering. BxPC-3 tumor cells were irradiated with a 6 MV X-rays beam, in the absence or presence of AuNPs. AFM showed that HAOA-AuNPs and BBN-AuNPs are spherical with a mean size of 83 ± 20 nm and 49 ± 12 nm, respectively. For RT alone, a reduction in cell viability of up to 33 ± 12% was obtained compared to the control (p ≤ 0.0001). HAOA-AuNPs alone at 200 and 400 μM showed a reduction in cell viability of 20 ± 4% and 35 ± 4%, respectively, while for BBN-AuNPs, at 50 and 200 μM, a reduction in cell viability of 25 ± 3% and 37 ± 3% was obtained, respectively, compared to the control (p < 0.0001). At 72 h post-irradiation, a decrease in cell viability of 26 ± 3% and 22 ± 2% between RT + HAOA-AuNPs at 400 μM and RT + BBN-AuNPs at 50 μM, compared to RT alone, was obtained (p < 0.004). The combination of RT with AuNPs led to a significant decrease in cell viability compared to the control, or RT alone, thus representing an improved effect.

IntroductionPrecision monitoring maturity in climacteric fruits like tomato is crucial for minimising losses within the food supply chain and enhancing pre- and post-harvest production and utilisation.ObjectivesThis paper introduces an approach to analyse the precision maturation of tomato using hyperspectral tomography-like.MethodsA novel bi-directional spectral reconstruction method is presented, leveraging visible to near-infrared (Vis-NIR) information gathered from tomato spectra and their internal tissues (skin, pulp, and seeds). The study, encompassing 118 tomatoes at various maturation stages, employs a multi-block hierarchical principal component analysis combined with partial least squares for bi-directional reconstruction. The approach involves predicting internal tissue spectra by decomposing the overall tomato spectral information, creating a superset with eight latent variables for each tissue. The reverse process also utilises eight latent variables for reconstructing skin, pulp, and seed spectral data.ResultsThe reconstruction of the tomato spectra presents a mean absolute percentage error of 30.44 % and 5.37 %, 5.25 % and 6.42 % and Pearson’s correlation coefficient of 0.85, 0.98, 0.99 and 0.99 for the skin, pulp and seed, respectively. Quality parameters, including soluble solid content (%), chlorophyll (a.u.), lycopene (a.u.), and puncture force (N), were assessed and modelled with PLS with the original and reconstructed datasets, presenting a range of R2 higher than 0.84 in the reconstructed dataset. An empirical demonstration of the tomato maturation in the internal tissues revealed the dynamic of the chlorophyll and lycopene in the different tissues during the maturation process.ConclusionThe proposed approach for inner tomato tissue spectral inference is highly reliable, provides early indications and is easy to operate. This study highlights the potential of Vis-NIR devices in precision fruit maturation assessment, surpassing conventional labour-intensive techniques in cost-effectiveness and efficiency. The implications of this advancement extend to various agronomic and food chain applications, promising substantial improvements in monitoring and enhancing fruit quality.

ABSTRACTBackground Clinician’s choice of hypoallergenic formulas in the first-line management of cow’s milk protein allergy (CMPA) should be informed by evidence on clinical efficacy and cost-effectiveness.Objective We compare the cost-effectiveness of amino acid-based formula (AAF), extensively hydrolyzed casein formula with Lactobacillus rhamnosus Gorbach Goldin (EHCF+LGG), extensively hydrolyzed whey formula (EHWF), and rice hydrolyzed formula (RHF) in non-breastfed children in France.Methods Immunotolerance and atopic manifestations’ prevalence were based on a prospective non-randomized study with a 36-month follow-up. Resource utilization was sourced from a survey of French clinicians, and unit costs were based on national data. Costs and health consequences were discounted at 2.5% annually. Results were reported using the Collective and French National Health Insurance perspectives.Results Children receiving EHCF+LGG were predicted to require less healthcare resources, given their reduced prevalence of CMPA symptoms at 3 years. In the base case, EHCF+LGG led to savings of at least €674 per child compared to AAF, EHWF, and RHF at 3 years, from both perspectives. Nutrition had the highest economic burden in CMPA, driven by hypoallergenic formulas and dietetic replacements costs. Results were robust to one-way and probabilistic sensitivity analyses.Conclusions EHCF+LGG was associated with more symptom-free time, higher immune tolerance, and lower costs.

**Background:** Migraine is a highly prevalent and incapacitating neurological disorder associated with the highest global disability burden in people aged 15 to 49 years. Europe has the fourth-highest prevalence of migraine, after North America, South America, and Central America, and above Asia and Africa. Migraine leads to relatively modest direct healthcare expenditure but has substantial indirect costs due to reduced productivity. **Methods:** The economic burden of migraine was estimated in comparison with the general population of the United Kingdom (UK) using an analytical fiscal modeling framework applying the government cost perspective. Published measures of migraine’s impact on labor participation were applied to rates of economic activity/inactivity of the general population. The model estimates lifetime changes to earnings from employment, direct and indirect taxes paid, and financial support requirements over the life course. Incremental differences between those affected and unaffected by migraine are reported as net fiscal consequences to public accounts. Fiscal costs are reported as the discounted average per capita over a 20-year time horizon and for the entire annual UK cohort with prevalent migraine. **Results:** People affected by migraine are more likely to be absent from work, unemployed, and disabled, and to retire early. A 44-year-old individual affected by migraine was associated with £19 823 in excess fiscal costs to the UK government, £1379 per year living with the condition, compared with someone not affected by the disease. Annually, migraine was estimated to represent £12.20 billion to the public economy, approximately £130.63 per migraine episode. The model predicted annual productivity losses in the health and social care workforce to be £2.05 billion and total annual productivity losses to be over £5.81 billion. **Conclusions:** This fiscal analysis monetizes the occupational consequences of migraine to the UK government, both in terms of lost tax revenue and transfer payments. The findings are substantial and useful to characterize disease severity and to inform the body of evidence considered by decision makers appraising the cost-effectiveness of health technologies.

Abstract This work aims at studying the spatio-temporal evolution of the age at menopause in central Portugal since the early twentieth century. We analyzed $$N=320,444$$ N = 320 , 444 women that had already reached the menopause within a free breast cancer screening program between 1990 and 2018 and born in the period 1910–1960. One of the concerns was about early or late menopause thus we considered percentile regression to build the respective percentile curves inside the package GAMLSS in R. In order to capture the correlation at the regional level, a spatial random-effect was considered. The obtained clustered spatial effects were analyzed to assess geographical differences among the percentiles of the age at menopause by year of birth. An increasing trend in the median age at menopause and regional differences for all the considered percentiles were found. From 47.1 years in 1910 to 49.59 years in 1960 (about 2.49 years in 5 decades). Early and premature menopause (below percentile 5%) occur in the interior north (north-eastern). Late menopause (above percentile 95%) occur predominantly in the central-north and central-south areas.

The determination of grape quality parameters is intricately linked to the mineral composition of the fruit; this relationship is increasingly affected by the impacts of climate change. The conventional chemical methodologies employed for the mineral quantification of grape tissues are expensive and impracticable for widespread commercial applications. This paper utilized Laser-Induced Breakdown Spectroscopy (LIBS) to analyze the mineral constituents within the skin, pulp, and seeds of two distinct Vitis vinifera cultivars: a white cultivar (Loureiro) and a red cultivar (Vinhão). The primary objective was to discriminate the potential variations in the calcium (Ca), magnesium (Mg), and nitrogen (N) concentrations and water content among different grape tissues, explaining their consequential impact on the metabolic constitution of the grapes and, by extension, their influence on various quality parameters. Additionally, the study compared the mineral contents of the white and red grape cultivars across three distinct time points post veraison. Significant differences (p < 0.05) were observed between the Loureiro and Vinhão cultivars in Ca concentrations across all the dates and tissues and for Mg in the skin and pulp, N in the pulp and seeds, and water content in the skin and pulp. In the Vinhão cultivar, Ca differences were found in the pulp across the dates, N in the seeds, and water content in the skin, pulp, and seeds. Comparing the cultivars within tissues, Ca exhibited differences in the pulp, Mg in the skin and pulp, N in the pulp and seeds, and water content in the skin, pulp, and seeds. These findings provide insights into the relationship between the grape mineral and water content, climatic factors, and viticulture practices within a changing climate.

Abstract Background Due to contradictory results in current research, whether age at menopause is increasing or decreasing in Western countries remains an open question, yet worth studying as later ages at menopause are likely to be related to an increased risk of breast cancer. Using data from breast cancer screening programs to study the temporal trend of age at menopause is difficult since especially younger women in the same generational cohort have often not yet reached menopause. Deleting these younger women in a breast cancer risk analyses may bias the results. The aim of this study is therefore to recover missing menopause ages as a covariate by comparing methods for handling missing data. Additionally, the study makes a contribution to understanding the evolution of age at menopause for several generations born in Portugal between 1920 and 1970. Methods Data from a breast cancer screening program in Portugal including 278,282 women aged 45–69 and collected between 1990 and 2010 are used to compare two approaches of imputing age at menopause: (i) a multiple imputation methodology based on a truncated distribution but ignoring the mechanism of missingness; (ii) a copula-based multiple imputation method that simultaneously handles the age at menopause and the missing mechanism. The linear predictors considered in both cases have a semiparametric additive structure accommodating linear and non-linear effects defined via splines or Markov random fields smoothers in the case of spatial variables. Results Both imputation methods unveiled an increasing trend of age at menopause when viewed as a function of the birth year for the youngest generation. This trend is hidden if we model only women with an observed age at menopause. Conclusion When studying age at menopause, missing ages must be recovered with an adequate procedure for incomplete data. Imputing these missing ages avoids excluding the younger generation cohort of the screening program in breast cancer risk analyses and hence reduces the bias stemming from this exclusion. In addition, imputing the not yet observed ages of menopause for mostly younger women is also crucial when studying the time trend of age at menopause otherwise the analysis will be biased.

Laser-induced breakdown spectroscopy (LIBS) is a technique that leverages atomic emission towards element identification and quantification. While the potential of the technology is vast, it still struggles with obstacles such as the variability of the technique. In recent years, several methods have exploited modifications to the standard implementation to work around this problem, mostly focused on the laser side to increase the signal-to-noise ratio of the emission. In this paper, we explore the effect of pulse duration on the detected signal intensity using a tunable LIBS system that consists of a versatile fiber laser, capable of emitting square-shaped pulses with a duration ranging from 10 to 100 ns. Our results show that, by tuning the duration of the pulse, it is possible to increase the signal-to-noise ratio of relevant elemental emission lines, an effect that we relate with the computed plasma temperature and associated density for the ion species. Despite the limitations of the work due to the low-resolution and small range of the spectrometer used, the preliminary results pave an interesting path towards the design of controllable LIBS systems that can be tailored to increase the signal-to-noise ratio and thus be useful for the deployment of more sensitive instruments both for qualitative and quantitative purposes.

Abstract The meat industry generates large amounts of by-products that are costly to be treated and discarded ecologically; moreover, they could be used to extract high added-value compounds. In this work, we present an innovative combined process which allowed the parallel extraction of both organic and mineral compounds; more specifically protein hydrolysates and single-phase hydroxyapatite were obtained. The protein hydrolysates, extracted through an enzymatic hydrolysis with alcalase, showed a degree of hydrolysis of 53.3 ± 5.1%; moreover, they had a high protein content with peptides with molecular weight lower than 1.2 kDa. Their antioxidant activities, measured with ABTS and ORAC tests, were 21.1 ± 0.5 mg ascorbic acid equivalent/g of dry extract and 87.7 ± 6.3 mg Trolox equivalent/g of dry extract, respectively. Single-phase hydroxyapatite, obtained with a simple calcination at 700 °C on the residues of the hydrolysis process, showed a Ca/P ratio close to the stoichiometric one (1.65 vs. 1.67) and presented a nanometric structure. This study reports a simple and feasible process for the valorization of porcine by-products in a large-scale up generating products with potential applications for environment remediation, biomedicine, nutrition and catalysis/bioenergy. Graphic Abstract

Sustainable and efficient agricultural production is a growing priority in modern society. Viticulture, an important agricultural and food sector, also faces this challenge. Precision Viticulture (PV) has gained prominence as it aims to foster high-quality, efficient, and environmentally sustainable practices. The Soluble Solids Content (SSC) is essential for assessing grape ripeness and quality in the winemaking process. Conventional methods for determining SSC values (expressed in °Brix) are invasive, expensive, and labour-intensive, necessitating sample preparation, making large-scale analysis impractical. In response to these limitations, this study presents an innovative approach within the field of Precision Viticulture. It focuses on the non-invasive prediction of SSC using low-cost proximal hyperspectral optical sensors. These sensors rely on spectral reflectance measurements in the range of 340–850 nm. This study was conducted in a commercial vineyard in the Demarcated Douro Region, Cima-Corgo sub-region, Portugal, over six weeks during ripening. In total, 169 grape berries from Touriga Nacional vines were analysed under three irrigation regimes (no irrigation, 30% ETc, and 60% ETc). After organising and preprocessing the data, machine learning algorithms, namely Partial Least Squares Regression (PLS), Random Forest (RF), and the Generalised Linear Model (GLM), were applied to predict SSC values. These models’ performance was thoroughly evaluated using cross-validation techniques. The performance of different models was evaluated, showing significant differences according to the metrics used (R2, RMSE, and MAPE). The RF model demonstrated effectiveness and precision. A high R² value of 0.9312, coupled with low RMSE (0.9199 °Brix) and MAPE (3.88%), signifies a strong fit to the data and accurate predictive capabilities. The results of this benchmarking study on predictive models of SSC provide valuable insights into the performance of various models, aiding winegrowers and winemakers in decision making.

Predawn leaf water potential (Ψpd) is the main parameter to determine plant water status, and it has been broadly used to support irrigation management. However, the Scholander pressure chamber methodology is laborious, time-consuming and invasive. This study examined a low-cost hyperspectral proximal sensor to estimate the Ψpd in grapevine (Vitis vinifera L.). For this, both the Ψpd and spectral reflectance (340–850 nm) were accessed in grapevines in a commercial vineyard located in the Douro Wine Region, northeast Portugal. A machine-learning algorithm was tested and validated to assess grapevine’s water status. The experiment was performed in a randomized design with 12 grapevines (cv. Touriga Nacional) per irrigation treatment: non-irrigated, 30% crop evapotranspiration (Etc), and 60% Etc. The dataset was analyzed using Principal Component Analysis (PCA), and the machine-learning regression algorithm applied was Extreme Gradient Boosting (Xgboost). Results from the validation dataset (n = 108) for the Xgboost tested exhibited a root mean square error (RMSE) of 0.23 MPa, a mean absolute error (MAPE) of 16.57% and an R² value of 0.95. These results demonstrate that the hyperspectral sensor and Xgboost algorithm show potential for predicting the Ψpd in vineyards, regardless of a plant’s water status.

Laser-induced breakdown spectroscopy (LIBS) was explored to assess the element constituents (Ca, Mg and N) in the skin, pulp, and seed of two Vitis vinifera cultivars—a white (Loureiro) and a red (Vinhão) cultivar. This study compares the two grape cultivars chosen and the characterisation of Ca, Mg and N in the skin, pulp and seed on three dates after veraison. Significant differences (p < 0.05) were found in the Ca, Mg and N in the skin, pulp and seed of both grape cultivars during the three assessment dates considered. The results of this study could provide insights into the element composition of grapes, offering a fast, accurate, and cost-effective alternative to traditional element quantification methods.

This scientific paper delves into the effects of water stress on grapevines, specifically focusing on gene expression and polyphenol production. We conducted a controlled greenhouse experiment with three hydric conditions and analyzed the expression of genes related to polyphenol biosynthesis. Our results revealed significant differences in the expression of ABCC1, a gene linked to anthocyanin metabolism, under different irrigation treatments. These findings highlight the importance of anthocyanins in grapevine responses to abiotic stresses. By integrating genomics, metabolomics, and systems biology, this study contributes to our understanding of grapevine physiology under water stress conditions and offers insights into developing sensor technologies for real-world applications in viticulture.

Resumo Fundamento A cardiomiopatia hipertrófica (CMH) e a hipertrofia ventricular esquerda (HVE) secundária à hipertensão arterial sistêmica (HAS) podem estar associadas a anormalidades funcionais do átrio esquerdo (AE). Objetivos Caracterizar a mecânica do AE na CMH e na HAS e avaliar qualquer correlação com a extensão da fibrose ventricular esquerda medida por ressonância magnética cardíaca (RMC) em pacientes com CMH. Métodos A função longitudinal do AE derivada do ecocardiograma bidimensional com speckle tracking foi adquirida a partir de cortes apicais de 60 pacientes com CMH e 34 indivíduos controles, pareados por idade. Pacientes com CMH também foram submetidos à RMC, com medida da extensão do realce tardio por gadolínio. A associação com parâmetros de strain do AE foi analisada. Valores p < 0,05 foram definidos como estatisticamente significativos. Resultados A média da fração de ejeção do ventrículo esquerdo não foi diferente entre os grupos. A razão E/e’ estava comprometida no grupo CMH e preservada no grupo controle. A mecânica do AE estava significativamente reduzida na CMH em comparação aos pacientes com HAS. O strain rate do AE nas fases de reservatório (SRrAE) e na fase contrátil (SRctAE) foram os melhores parâmetros de discriminação de CMH com uma área sob a curva (AUC) de 0,8, seguido do strain do AE na fase de reservatório (SrAE) (AUC 0,76). O SRrAE e o SRctAE apresentaram elevada especificidade (89% e 91%, respectivamente), e o SrAE apresentou sensibilidade de 80%. Um decréscimo de 2,79% no strain rate do AE na fase de condução (SRcdAE) foi preditor de um aumento de 1 cm na extensão do RT pelo gadolínio (r2=0,42, β 2,79, p=0,027). Conclusões O SRrAE e o SRctAE foram os melhores fatores de discriminação de HVE secundária à CMH. O SRcdAE foi preditor do grau de fibrose ventricular esquerda avaliada por RMC. Esses achados sugerem que a mecânica do AE pode ser um potencial preditor de gravidade de doença na CMH.

Summary: Iron recycling prevents the development of anemia under homeostatic conditions. Whether iron recycling was co-opted as a defense strategy to prevent the development of anemia in response to infection is unclear. We find that in severe Plasmodium falciparum malaria, the onset of life-threatening anemia is associated with acute kidney injury (AKI), irrespective of parasite load. Using a well-established experimental rodent model of malaria anemia, we identify a transcriptional response that endows renal proximal tubule epithelial cells (RPTECs) with the capacity to store and recycle iron during P. chabaudi chabaudi (Pcc) infection. This response encompasses the induction of ferroportin 1/SLC40A1, which exports iron from RPTECs and counteracts AKI while supporting compensatory erythropoiesis and preventing the onset of life-threatening malarial anemia. Iron recycling by myeloid cells is dispensable to this protective response, suggesting that RPTECs provide an iron-recycling salvage pathway that prevents the pathogenesis of life-threatening malarial anemia.

**Background:** Cow’s milk protein allergy is very common in early childhood. Extensively hydrolyzed formulas are recommended in the first-line management of cow’s milk protein allergy in non-breastfed children. Choice of formulas should be informed by efficacy and cost data. **Objectives:** This study aims to compare the cost-effectiveness of extensively hydrolyzed casein formula with _Lacticaseibacillus rhamnosus_ Gorbach Goldin (EHCF+LGG), extensively hydrolyzed whey formula (EHWF), amino acid formula, and soy formula in the first-line management of cow’s milk protein allergy in non-breastfed children in Indonesia. **Methods:** A trial-based decision analytic cohort model was adapted to simulate the occurrence of cow’s milk protein allergy symptoms or being symptom free. The model was based on a prospective nonrandomized study that followed up children for 36 months. Costs and health consequences were discounted at 3% annually. Resources required to manage cow’s milk protein allergy and unit costs for clinical appointments and exams were based on a panel of 15 clinicians, from a private payers’ perspective. Other unit costs were based on publicly available national data. Results were reported as cost per additional child free from allergic manifestations or per additional immunotolerant child at 3 years, and per life-years under the same conditions. Uncertainty was assessed using deterministic and probabilistic sensitivity analysis. **Results:** Children receiving EHCF+LGG were associated with more symptom-free time, a higher probability of cow’s milk tolerance at 3 years, and lower healthcare resources and transportation use when compared with children receiving other formulas (with 38%-49% lower costs). Formula costs were lower for soy, but EHCF+LGG was predicted to save 9% and 54% of overall costs compared with extensively hydrolyzed whey formula and amino acid formula, respectively. Results were robust to sensitivity analyses. **Conclusion:** Use of EHCF+LGG resulted in more symptom-free time and the highest 3-year probability of cow’s milk tolerance. It also led to healthcare resource and transportation savings when compared with other hypoallergenic milk formulas. Soy formula remained an alternative if formula price represents a major constraint.

Abstract Background Tacrolimus is given post-kidney transplant to suppress the immune system, and the amount of drug in the body is measured frequently. Higher variability over time may be indicative of poor drug adherence, leading to more adverse events. It is important to account for the variation in Tacrolimus, not just the average change over time. Methods Using data from the University of Colorado, we compare methods of assessing how the variability in Tacrolimus influences the hazard of de novo Donor Specific Antibodies (dnDSA), an early warning sign of graft failure. We compare multiple joint models in terms of fit and predictive ability. We explain that the models that account for the individual-specific variability over time have the best predictive performance. These models allowed each patient to have an individual-specific random error term in the longitudinal Tacrolimus model, and linked this to the hazard of dnDSA model. Results The hazard for the variance and coefficient of variation (CV) loading parameter were greater than 1, indicating that higher variability of Tacrolimus had a higher hazard of dnDSA. Introducing the individual-specific variability improved the fit, leading to more accurate predictions about the individual-specific time-to-dnDSA. Conclusions We showed that the individual’s variability in Tacrolimus is an important metric in predicting long-term adverse events in kidney transplantation. This is an important step in personalizing the dosage of TAC post-transplant to improve outcomes post-transplant.

Abstract Background Aortic valve stenosis (AS) is the most common primary valvular heart disease leading to surgical or percutaneous aortic valve replacement (AVR) in Europe and its prevalence keeps growing. While other risk factors in severe AS are well documented, little is known about the prognostic value of left atrial (LA) function in AS. Our aim is to clarify the relationship between LA function measured at severe AS diagnosis (evaluated by means of volumetric assessment) and all-cause mortality during follow-up. Methods We retrospectively evaluated patients diagnosed with severe AS for the first time at our echocardiography laboratory. We evaluated LA reservoir, conduit and pump function by measuring LA volumes at different timings of cardiac cycle. Treatment strategy was decided according to heart team consensus and patient decision. We divided patients into groups according to terciles of LA reservoir, conduit and pump function. Primary outcome was defined by the occurrence of all-cause mortality during follow-up. Results A total of 408 patients were included in the analysis, with a median follow-up time of 45 months (interquartile range 54 months). 57.9% of patients underwent AVR and 44.9% of patients registered the primary outcome during follow-up. Left atrial emptying fraction (LAEF) was the best LA functional parameter and the best overall parameter in discriminating primary outcome (AUC 0.845, 95%CI 0.81–0.88, P

Fish viscera are usually discarded as waste, causing environmental problems, or as low-value by-products. This study describes a self-sufficient and zero waste approach to obtain enzymes and protein hydrolysates from fish by-products. Firstly, recovery steps of viscera enzymatic extract were applied, and the resulting raw extract was stable at a pH range of 8–9 and at temperatures between 40 and 50 °C. The application of the extracted enzymes and alcalase on fish by-products hydrolysis was also determined. The selected conditions for the enzymatic hydrolysis were 10% (E/S) for 6 h using viscera enzymatic extract and 3% (E/S) for 2 h using alcalase. Fish protein hydrolysates (FPH) proved to have a notable antioxidant capacity with similar activity, ~11 mg ascorbic acid/g dry extract (ABTS assay) and ~150 mg Trolox/g dry extract (ORAC assay). FPH were also able to inhibit the angiotensin-converting enzyme, however, alcalase hydrolysates revealed a higher antihypertensive potential, IC50 of 101 µg of protein/mL. In general, FPH obtained by both enzymes systems maintained these bioactivities after the passage throughout a simulated gastrointestinal tract. The hydrolysates also displayed important technological properties, namely oil absorption capacity (~1 g oil/g sample) and emulsifying property (~40%). Therefore, it will be conceivable to use fish by-products based on a circular economy approach to generate added value compounds for animal and human nutrition.

Future data-intensive intelligent applications are required to traverse across the cloud-to-edge-to-IoT continuum, where cloud and edge resources elegantly coordinate, alongside sensor networks and data. However, current technical solutions can only partially handle the data outburst associated with the IoT proliferation experienced in recent years, mainly due to their hierarchical architectures. In this context, this paper presents a reference architecture of a meta-operating system (RAMOS), targeted to enable a dynamic, distributed and trusted continuum which will be capable of facilitating the next-generation smart applications at the edge. RAMOS is domain-agnostic, capable of supporting heterogeneous devices in various network environments. Furthermore, the proposed architecture possesses the ability to place the data at the origin in a secure and trusted manner. Based on a layered structure, the building blocks of RAMOS are thoroughly described, and the interconnection and coordination between them is fully presented. Furthermore, illustration of how the proposed reference architecture and its characteristics could fit in potential key industrial and societal applications, which in the future will require more power at the edge, is provided in five practical scenarios, focusing on the distributed intelligence and privacy preservation principles promoted by RAMOS, as well as the concept of environmental footprint minimization. Finally, the business potential of an open edge ecosystem and the societal impacts of climate net neutrality are also illustrated.

**Background:** Cow’s milk protein allergy (CMPA) is the most common food allergy in early childhood. In most children CMPA resolves by age 5 or 6; however, if not treated correctly can provoke nutritional deficiency resulting in poor growth. Management consists of excluding cow’s milk from the diet, with hypoallergenic formulas (or non-dairy alternatives) being introduced to meet nutritional requirements. **Objectives:** To compare the cost-effectiveness of hypoallergenic formulas in reducing allergic manifestations and promoting immune tolerance in infants with immunoglobulin E (IgE)-mediated symptoms of CMPA. **Methods:** A trial-based decision analytic cohort model was developed to simulate the occurrence of urticaria, eczema, asthma, rhinoconjunctivitis, or being symptom-free in infants with CMPA in the United Kingdom. Amino acid-based formula (AAF), extensively hydrolysed casein formula containing Lactobacillus rhamnosus Gorbach Goldin (EHCF+LGG), extensively hydrolysed whey formula (EHWF), and soy formula (SF) were compared using the National Health Service (NHS) perspective, 3-year time horizon and 3.5% discount rate for cost and health consequences. Hypoallergenic formulas comparative efficacy was sourced from a prospective cohort study. Resources required to manage allergic symptoms were sourced from published literature, validated by a UK clinician, and applied to UK cost resources. Results were reported as cost per additional child free from allergic manifestations at 3 years and cost per additional immune tolerant child at 3 years. **Results:** In the base case, infants receiving EHCF+LGG were associated with lower NHS resource use and improved CMPA tolerance. Over the 3-year treatment period, savings of £119, £476, and £2645 were achieved with EHCF+LGG compared to SF, EHWF and AAF, respectively. Infant formula accounted for the largest proportion of resource consumption averaging 47% for all comparators, with a minimum of 31% for SF and a maximum of 69% for AAF over 3 years. General practitioners’ visits constituted the second highest cost component, approximately 16% of total costs across comparators. The results were robust to deterministic and probabilistic sensitivity analyses. **Conclusions:** Compared to AAF, SF, and EHWF hypoallergenic formulas, EHCF+LGG was the most cost-effective, associated with lower total costs and contributing to a higher proportion of children being symptom-free and developing immune tolerance 3-years after diagnosis.

**Background:** Individuals experiencing osteoarthritis (OA) pain can pose significant costs for governments due to reduced work activity in these individuals and increasing reliance on public support benefits. In this analysis we capture the broader economic impact of OA pain by applying a government perspective, public economic framework to assess controlled and uncontrolled pain. **Methods:** We used a Markov model to compare labour market participation in people with uncontrolled OA hip or knee pain compared to a cohort with controlled OA pain. The likelihood of employment, long-term sickness, disability, and early retirement in those with controlled pain used publicly available UK data. The relative effect of uncontrolled OA pain on fiscal outcomes is drawn from peer reviewed publications reporting reduced work activity and reliance on public benefits for people with uncontrolled OA pain. Lost tax revenue was derived using UK tax rates and national insurance contributions applied to annual earnings. Social benefit rules were applied to calculate government financial support to individuals. Health-care costs were calculated based on estimates from an UK observational study. The base case analysis compared the projected lost tax revenue and transfer payments for a 50-year-old cohort with severe OA pain, retiring at age 65. **Results:** For a 50-year-old individual with moderate uncontrolled OA pain with 15-years remaining work expectancy, the model estimated a £62 383 reduction in employment earnings, a £24 307 reduction in tax contributions and a need for £16 034 in government benefits, compared to a person with controlled OA pain. In people with severe uncontrolled OA pain incremental foregone earnings were estimated to be £126 384, £44 925 were not paid through taxation and £25 829 were received in public benefits, compared to the controlled pain cohort. Health-care costs represented 13% and 12% of all OA-related fiscal cost in the moderate uncontrolled OA pain and severe uncontrolled OA pain comparison, respectively. **Conclusions:** For governments, maintaining an active workforce is paramount to maintaining economic growth and reducing spending on government programs. The approach described here can be used to augment cost-effectiveness models to inform a range of stakeholders of benefits attributed to controlled OA pain.

Abstract Background There is limited information regarding left atrial (LA) mechanics in aortic valve stenosis (AS). We assessed LA mechanics in AS through speckle-tracking echocardiography (STE) according to severity and prognosis. Methods We included 102 patients diagnosed with severe AS (sAS) and 80 patients with moderate AS (mAS), all with preserved ejection fraction and no coronary artery disease. LA mechanics and left ventricular global longitudinal strain (LV-GLS) were assessed by STE. The cohort was followed-up for a median of 30 (IQR 12.6–50) months, and outcomes were determined (combined outcome of HF, death, and aortic valve replacement). Results In our sample set, values of LV-GLS (− 18.5% vs − 17.1, p = 0.025), E/e’ ratio (15.8 vs 18.4, p = 0.03), and global LA mechanics (LA ɛsys, 23% vs 13.8%, p

Objective: The ferritin heavy/heart chain (FTH) gene encodes the ferroxidase component of the iron (Fe) sequestering ferritin complex, which plays a central role in the regulation of cellular Fe metabolism. Here we tested the hypothesis that ferritin regulates organismal Fe metabolism in a manner that impacts energy balance and thermal homeostasis. Methods: We developed a mouse strain, referred herein as FthR26 fl/fl, expressing a tamoxifen-inducible Cre recombinase under the control of the Rosa26 (R26) promoter and carrying two LoxP (fl) sites: one at the 5′end of the Fth promoter and another the 3' end of the first Fth exon. Tamoxifen administration induces global deletion of Fth in adult FthR26Δ/Δ mice, testing whether FTH is required for maintenance of organismal homeostasis. Results: Under standard nutritional Fe supply, Fth deletion in adult FthR26Δ/Δ mice led to a profound deregulation of organismal Fe metabolism, oxidative stress, inflammation, and multi-organ damage, culminating in death. Unexpectedly, Fth deletion was also associated with a profound atrophy of white and brown adipose tissue as well as with collapse of energy expenditure and thermogenesis. This was attributed mechanistically to mitochondrial dysfunction, as assessed in the liver and in adipose tissue. Conclusion: The FTH component of ferritin acts as a master regulator of organismal Fe homeostasis, coupling nutritional Fe supply to organismal redox homeostasis, energy expenditure and thermoregulation. Keywords: Iron metabolism, Redox homeostasis, Adipose tissue, Energy expenditure, Adipose tissue, Mitochondria

Pseudomonas syringae pv. actinidiae (Psa) has been responsible for numerous epidemics of bacterial canker of kiwi (BCK), resulting in high losses in kiwi production worldwide. Current diagnostic approaches for this disease usually depend on visible signs of the infection (disease symptoms) to be present. Since these symptoms frequently manifest themselves in the middle to late stages of the infection process, the effectiveness of phytosanitary measures can be compromised. Hyperspectral spectroscopy has the potential to be an effective, non-invasive, rapid, cost-effective, high-throughput approach for improving BCK diagnostics. This study aimed to investigate the potential of hyperspectral UV–VIS reflectance for in-situ, non-destructive discrimination of bacterial canker on kiwi leaves. Spectral reflectance (325–1075 nm) of twenty plants were obtained with a handheld spectroradiometer in two commercial kiwi orchards located in Portugal, for 15 weeks, totaling 504 spectral measurements. Several modeling approaches based on continuous hyperspectral data or specific wavelengths, chosen by different feature selection algorithms, were tested to discriminate BCK on leaves. Spectral separability of asymptomatic and symptomatic leaves was observed in all multi-variate and machine learning models, including the FDA, GLM, PLS, and SVM methods. The combination of a stepwise forward variable selection approach using a support vector machine algorithm with a radial kernel and class weights was selected as the final model. Its overall accuracy was 85%, with a 0.70 kappa score and 0.84 F-measure. These results were coherent with leaves classified as asymptomatic or symptomatic by visual inspection. Overall, the findings herein reported support the implementation of spectral point measurements acquired in situ for crop disease diagnosis.

Due to cell heterogeneity, the differences among individual cells are averaged out in bulk analysis methods, especially in the analysis of primary tumor biopsy samples from patients. To deeply understand the cell-to-cell variation in a primary tumor, single-cell culture and analysis with limited amount of cells are in high demand. Microfluidics has been an optimum platform to address the issue given its small reaction volume requirements. Digital microfluidics, which utilizes an electric signal to manipulate individual droplets has shown promise in cell-culture with easy controls. In this work, we realize single cell trapping on digital microfluidic platform by fabricating 3D microstructures on-chip to form semi-closed micro-wells. With this design, 20% of 30 x 30 array can be occupied by isolated single cells. We also use a low evaporation silicon oil and a fluorinated surfactant to lower the droplet actuation voltage and prevent the drop from evaporation, while allowing cell respiration during the long term of culture (24 h). The main steps for single cell trapping on digital microfluidics, as illustrated in this protocol, include 3D microstructures design, 3D microstructures construction on chip and oil film with surfactant for single cell trapping on chip.

In this work, X-ray fluorescence (XRF) and Laser-induced breakdown spectroscopy (LIBS) analyses were applied to samples of quartz, montebrasite, and turquoise hydrothermal veins in the Argemela Tin Mine (Central Portugal). Montebrasite (LiAl(PO4)(OH,F)) is potentially the main ore mineral; with its alteration, lithium (Li) can disseminate into other minerals. A hand sample was cut and analyzed by XRF and LIBS for several elements of interest including Cu, P, Al, Si, and Li. Although XRF cannot measure Li, results from its analysis are effective for distinguishing turquoise from montebrasite. LIBS analysis complemented this study, making it possible to conclude that turquoise does not contain any significant Li in its structure. The difference in spot size between the techniques (5 mm vs. 300 µm for XRF and LIBS, respectively) resulted in a poorer performance by XRF in accurately identifying mixed minerals. A thin section was petrographically characterized and mapped using LIBS. The mapping results demonstrate the possibility of the successful identification of minerals and their alterations on a thin section. The results of XRF analysis and LIBS mapping in petrographic sections demonstrate the efficacy of these methods as tools for element and mineral identification, which can be important in exploration and mining phases, complementing more traditional techniques.

The agricultural sector plays a fundamental role in our society, where it is increasingly important to automate processes, which can generate beneficial impacts in the productivity and quality of products. Perception and computer vision approaches can be fundamental in the implementation of robotics in agriculture. In particular, deep learning can be used for image classification or object detection, endowing machines with the capability to perform operations in the agriculture context. In this work, deep learning was used for the detection of grape bunches in vineyards considering different growth stages: the early stage just after the bloom and the medium stage where the grape bunches present an intermediate development. Two state-of-the-art single-shot multibox models were trained, quantized, and deployed in a low-cost and low-power hardware device, a Tensor Processing Unit. The training input was a novel and publicly available dataset proposed in this work. This dataset contains 1929 images and respective annotations of grape bunches at two different growth stages, captured by different cameras in several illumination conditions. The models were benchmarked and characterized considering the variation of two different parameters: the confidence score and the intersection over union threshold. The results showed that the deployed models could detect grape bunches in images with a medium average precision up to 66.96%. Since this approach uses low resources, a low-cost and low-power hardware device that requires simplified models with 8 bit quantization, the obtained performance was satisfactory. Experiments also demonstrated that the models performed better in identifying grape bunches at the medium growth stage, in comparison with grape bunches present in the vineyard after the bloom, since the second class represents smaller grape bunches, with a color and texture more similar to the surrounding foliage, which complicates their detection.

The assent procedure reflects an effort to enable the minor to understand, to the degree they are capable of, what their participation in the decision making process would involve. Aims: To evaluate the minors’ ability to understand the information provided to them when obtaining assent and to evaluate the opinion of the parents regarding the importance of asking the child’s assent. Methods: The sample included a total of 52 minors aged between 10 and 17 years who underwent exercise echocardiogram. The Quality of Informed Consent is divided into two parts: Part A was used to measure objective understanding and part B to measure subjective understanding. Results: The results show that the minors have a high capacity to understand the information given to them when asking for assent. A positive relationship was found between the two parts of the questionnaire. No statistically significant relationship was found between age and sex and part A and part B or between both age groups (

From birth onward, the lungs are exposed to the external environment and therefore harbor a complex immunological milieu to protect this organ from damage and infection. We investigated the homeostatic role of the epithelium-derived alarmin interleukin-33 (IL-33) in newborn mice and discovered the immediate upregulation of IL-33 from the first day of life, closely followed by a wave of IL-13-producing type 2 innate lymphoid cells (ILC2s), which coincided with the appearance of alveolar macrophages (AMs) and their early polarization to an IL-13-dependent anti-inflammatory M2 phenotype. ILC2s contributed to lung quiescence in homeostasis by polarizing tissue resident AMs and induced an M2 phenotype in transplanted macrophage progenitors. ILC2s continued to maintain the M2 AM phenotype during adult life at the cost of a delayed response to Streptococcus pneumoniae infection in mice. These data highlight the homeostatic role of ILC2s in setting the activation threshold in the lung and underline their implications in anti-bacterial defenses.

No âmbito dos períodos de programação comunitários, no contexto da região Centro de Portugal, destacamos as iniciativas apoiadas por fundos comunitários, entre 1994 e 1999, que procuraram responder às preocupações europeias de coesão territorial, em particular de valorização do património cultural e turístico existente na região. No passado recente, no contexto Quadro Comunitário de Apoio designado de MaisCentro (2007-2013) identificamos, inclusivamente, o apoio a programas de ação vocacionados para a promoção e valorização do património classificados pela UNESCO (United Nations Educational, Scientific and Cultural Organization). Estes programas incluíram projetos, materiais e imateriais, de dinamização da rede de Mosteiros Património da Humanidade de Portugal, onde se inclui o Mosteiro de Santa Maria de Alcobaça, o Mosteiro de Santa Maria da Vitória da Batalha, o Convento de Cristo de Tomar. Na atualidade, no âmbito do período de programação comunitária 2014-2020, encontram-se também previstos apoios financeiros para os investimentos em património cultural que visem promover a conservação e valorização do património cultural, enquanto instrumento de sustentabilidade dos territórios e da sua valorização turística. Como prioridades no Programa Operacional Regional do Centro designado de Centro 2020, foram definidas como prioridades estratégicas a valorização turística de Monumentos Nacionais inscritos na lista do Património Mundial (UNESCO) e Monumentos Nacionais e o contributo para a dinamização económica local, através da criação de emprego e de riqueza, e a programação cultural em rede. As entidades beneficiárias aos fundos comunitários neste âmbito são os municípios, as Comunidades Intermunicipais, a Direção-Geral do Património Cultural, a Direção Regional de Cultura do Centro, entre entidades promotoras. A presente comunicação procura identificar, na região Centro de Portugal, os investimentos já realizados e os projetos a realizar e a sua relação com a atratividade da região, a dinamização económica e turística, a diminuição das assimetrias e o reforço da coesão territorial, bem como a salvaguarda e promoção do património histórico e cultural com elevado interesse turístico (incluindo aquele que já é Património Reconhecido pela UNESCO) e identitário.

The second version of the Schedule of Growing Skills (SGS-II) was standardized using a sample of 348 UK children, ages 0 to 5 years. It examined ten psychomotor development areas in 14 age ranges. The Portuguese version of SGS-II was published in 2003, re-edited in 2011, and re-published in 2012, but its psychometric properties remained untested. The aim of this study was to evaluate the psychometric properties of the Portuguese version of SGS-II, comparing them with the results of the UK version. A sample of 364 Portuguese children, 193 boys and 172 girls, with an average age of 34.45 months (±18.62) was assessed with the SGS-II. The results have shown suitable psychometric properties of the SGS-II Portuguese version, adequate for the screening of children development. The internal consistency coefficients ranged from adequate to excellent (≥.7) and similar correlation results among the scale’s versions (English and Portuguese) were positive, high, and significant.

Introdução: Os pensamentos de morte são fenómenos comuns nos idosos, verificando-se que em diversos países o maior grupo de risco para o suicídio corresponde a essa faixa etária. Para além da maior letalidade das tentativas de suicídio nos idosos, estes passam mais provavelmente ao acto, concretizando assim o suicídio. Reconhecem-se que são vários os factores que contribuem para o desenvolvimento de ideação suicida. Objectivos: A presente revisão visa analisar as características, os factores de risco e os programas de prevenção relacionados com o suicídio no idoso, de modo a alertar os vários técnicos de saúde para esta situação. Métodos: Foi realizada uma revisão bibliográfica no PubMed, utilizando as expressões “elderly”, “aging” e “suicide”. Foram ainda consultados relatórios das Nações Unidas e livro de texto. Resultados: O suicídio nos idosos apresenta uma etiologia multifactorial. Verifica-se que 46 a 86 % dos idosos que morrem por suicídio apresentavam perturbação afectiva nas semanas precedentes, nomeadamente depressão. Outros factores associados são um nível de escolaridade elevado, sexo masculino, ansiedade, características de personalidade obsessivas, fraca integração do idoso na sociedade, eventos adversos de vida, nomeadamente a morte do conjugue, e ainda, a presença de doença física ou disfunção neurocognitiva. Conclusões: Os programas de prevenção do suicídio no idoso não se devem focar apenas na presença de depressão, devendo ter em conta todos os factores discutidos, promovendo o aumento da resiliência do idoso, o envelhecimento positivo e o envolvimento da família e comunidade, além do controlo das comorbilidades médicas.

O estudo pretendeu identificar e explorar o impacto de duas disciplinas envolvendo vivências de mediação corporal em alunos de Dança (D) e de Reabilitação Psicomotora (RPM). Participaram 29 alunos do 1.º ano das Lic. de D e RMP, antes e após a frequência das disciplinas. Os instrumentos utilizados foram a Escala de Inteligência Emocional, Questionário de Competências Sociais e Questionário de Traços Psicológicos. Principais resultados indicam: níveis acima do valor médio de inteligência emocional; diferenças significativas entre os alunos de D e RPM; diminuição na perceção de competências sociais, particularmente nos alunos de D entre o primeiro e segundo momento de avaliação. Quanto aos traços psicológicos os alunos de D preferiram o eixo, ser-sentimental-sentir os factos, enquanto os alunos de RPM optaram preferencialmente pelo eixo saber-racional-analisar. Verificou-se um aumento na escolha do eixo ser-sentimental-sentir os factos, nos alunos de D e RPM.

Resumo: Introdução e objetivos: A cardioembolia representa uma das causas mais frequentes de lesões cerebrovasculares isquémicas, com prevalência estimada de 20-30% e implicações terapêuticas diretas que obrigam à sua correta avaliação. Apesar de a validação das escalas de risco cardioembólico (CHADS2 e, mais recentemente, CHA2DS2-VASc) em populações heterogéneas de doentes com fibrilhação furicular, desconhece-se ainda a sua validade em contexto de prevenção secundária cerebrovascular.É objetivo deste trabalho estudar a sensibilidade e especificidade diferencial das escalas de risco cardioembólico como preditoras de fonte cardioembólica documentada por ecocardiograma transesofágico (ETE) numa população de doentes com AVC isquémico. Métodos: Aplicámos as escalas CHADS2 e CHA2DS2-VASc a todos os doentes internados por evento cerebrovascular isquémico na Unidade de AVC/Enfermaria de Neurologia de um hospital central português com diagnóstico de fibrilhação auricular (prévio ou obtido durante/após o internamento), que realizaram ETE entre janeiro e agosto de 2011.Definimos como presença de fonte cardioembólica a observação em ETE de autocontraste espontâneo na aurícula e apêndice auricular esquerdo ou trombos nas cavidades cardíacas esquerdas. Resultados: Analisámos 94 doentes, 66,0% do sexo masculino, idade média: 64,4 anos (desvio padrão: 14,2). Foi detetada fonte cardioembólica em 20 doentes. A análise de curva Receiver Operating Characteristic (ROC) identifica como preditores de fonte cardioembólica pontuação CHADS2 ≥ 4; sensibilidade: 75,0%, especificidade: 66,0%, p = 0,014 e pontuação CHA2DS2-VASc ≥ 5; sensibilidade: 83,3%, especificidade: 58,0%, p = 0,009. Conclusões: Ambas as escalas apresentam sensibilidade significativa como preditoras de risco cardioembólico em contexto de prevenção secundária cerebrovascular. A escala CHA2DS2-VASc possui uma sensibilidade superior à CHADS2, sendo, no entanto, menos específica. Abstract: Introduction and objectives: Cardioembolism is one of the most common causes of ischemic stroke, with an estimated prevalence of 20-30%, and correct diagnosis is essential given the therapeutic implications. Although stroke risk scores (CHADS2 and more recently CHA2DS2-VASc) have been validated in heterogeneous populations of patients with atrial fibrillation, their accuracy has not been ascertained for secondary stroke prevention. We set out to assess the sensitivity and specificity of the CHADS2 and CHA2DS2-VASc stroke risk scores as predictors of cardioembolic sources, documented by transesophageal echocardiography (TEE) in a population with ischemic stroke. Methods: The CHADS2 and CHA2DS2-VASc scores were applied to all patients admitted to the stroke unit/neurology ward of a Portuguese tertiary hospital with atrial fibrillation (diagnosed previously or during or after admission) who underwent TEE between January and August 2011.The presence of a cardioembolic source was defined as the observation by TEE of spontaneous echo contrast in the left atrium and atrial appendage or thrombi in the left cardiac chambers. Results: We studied 94 patients, 66.0% male, mean age 64.4 years (standard deviation 14.2). A cardioembolic source was detected in 20 patients. ROC curve analysis identified as predictors of cardioembolic source CHADS2 score ≥4 (sensitivity of 75.0%, specificity of 66.0%, p=0.014) and CHA2DS2-VASc score ≥5 (sensitivity of 83.3%, specificity of 58.0%, p=0.009). Conclusions: Both scores showed acceptable sensitivity as predictors of embolic risk in the context of secondary prevention of cardioembolic stroke. The CHA2DS2-VASc score has higher sensitivity than CHADS2 but lower specificity. Palavras-chave: Acidente vascular cerebral, Fibrilhação auricular, Tromboembolismo, Ecocardiografia, Anticoagulação, Keywords: Stroke, Atrial fibrillation, Thromboembolism, Echocardiography, Anticoagulation

Project MOEEBIUS focus is the reduction of the gap between predicted and actual energy performances in buildings. This project will introduce a Holistic Energy Performance Optimization Framework with new tools and methodologies that enhance current building energy performance simulation tools and current modelling approaches. This strategy aims to deeply grasp and describe real-life building operation complexities and introduce continuous optimization of building energy performance in real-time or through retrofitting.

Nas primeiras fases da ontogénese, quando o funcionamento relacional da díade mãe bebé, constitui o suporte do desenvolvimento, a criança vai organizando os alicerces do seu Eu, partindo de uma simbiose fisiológica e afectiva, numa relação onde predomina o diálogo tónico-emocional. A presença ou ausência do outro, a dinâmica de aproximação/ afastamento, a dinâmica postural e gestual, as actividades de contenção, as sincronias rítmicas, o contacto térmico, constituem suportes essenciais à organização primária do psiquismo. Quando estes processos são inadequados, podem provocar problemas de individuação e afirmação de identidade, ligados a ausências ou carências na relação primordial entre a mãe e o bébé. Esta perspectiva, leva-nos a equacionar a importância da corporalidade nos processos precoces de comunicação, quando esta é mediatizada essencialmente por processos tónico-emocionais de comunicação, impregnados de afectos, desejos e emoções. Estes processos são essenciais para a constituição dos modelos internos dinâmicos que nessa fase pré-linguística, asseguram o sentimento de identidade e a possibilidade de individuação e diferenciação em relação ao objecto materno. Quando existem perturbações nesta dinâmica evolutiva, a terapia psicomotora constitui um recurso privilegiado, possibilitando um espaço seguro e contentor, no qual, através do jogo espontâneo e simbólico, as crianças podem transformar as sensações, os atos e os afetos em pensamentos, projetos e palavras. Uma relação de vinculação desejada, permite experienciar novas formas de expressão e resolução de conflitos, melhorando a regulação emocional e comportamental, e promovendo a capacidade de mentalização e as funções executivas, como a atenção, a memória de trabalho, o planeamento e a inibição de impulsos.

Phagocytosis and inflammation within the lungs is crucial for host defense during bacterial pneumonia. Triggering receptor expressed on myeloid cells (TREM)-2 was proposed to negatively regulate TLR-mediated responses and enhance phagocytosis by macrophages, but the role of TREM-2 in respiratory tract infections is unknown. Here, we established the presence of TREM-2 on alveolar macrophages (AM) and explored the function of TREM-2 in the innate immune response to pneumococcal infection in vivo. Unexpectedly, we found Trem-2(-/-) AM to display augmented bacterial phagocytosis in vitro and in vivo compared to WT AM. Mechanistically, we detected that in the absence of TREM-2, pulmonary macrophages selectively produced elevated complement component 1q (C1q) levels. We found that these increased C1q levels depended on peroxisome proliferator-activated receptor-δ (PPAR-δ) activity and were responsible for the enhanced phagocytosis of bacteria. Upon infection with S. pneumoniae, Trem-2(-/-) mice exhibited an augmented bacterial clearance from lungs, decreased bacteremia and improved survival compared to their WT counterparts. This work is the first to disclose a role for TREM-2 in clinically relevant respiratory tract infections and demonstrates a previously unknown link between TREM-2 and opsonin production within the lungs.

O Marketing Social tem como finalidade a mudança de comportamentos, o estimular da consciência social em cada indivíduo, obrigando à adoção de novos hábitos, importantes para a pessoa e para a sociedade. O seu crescimento torna-se maior e tão mais importante, quanto maior é a preocupação com os problemas sociais, como é o caso da infeção por VIH/SIDA. Este é um dos temas que mais preocupa a sociedade atual, não só pelas proporções que tem tomado ao longo do tempo, com o aumento da morbilidade, mas também por todos os custos económicos e socias gerados por ela. Estudos recentes revelam um aumento exponencial desta síndrome na população com mais de 50 anos, podendo, o marketing social, ser utilizado como estratégia para dirimir este facto. A investigação em curso teve como objetivo principal discutir e obter informação sobre a relação das duas componentes abordadas, o Marketing Social e a infeção por VIH/SIDA, nos cidadãos comuns com mais de 50 anos, tendo chegado à conclusão que os comportamentos de risco são superiores ao expectável, sendo a educação para a saúde, a consciencialização da doença e a mudança de comportamentos e atitudes as ferramentas mais eficazes para o seu controlo, conseguindo-as facilmente através do marketing social.

O primeiro surto psicótico é actualmente um tema extensamente investigado, atendendo a que a intervenção precoce nestes casos pode significar uma melhoria do prognóstico dos mesmos. Assim, este estudo procurou avaliar e caracterizar e evolução destes primeiros surtos na Unidade de Internamento de Doentes Agudos do Departamento de Psiquiatria e Saúde Mental, Hospital São Francisco de Xavier, uma vez que só conhecendo a realidade assistencial se pode promover a qualidade e adequação da prestação de cuidados de saúde e criar estruturas assistenciais que respondam às necessidades reais. O presente estudo, naturalístico e retrospectivo, avaliou os primeiros surtos psicóticos de doentes internados na Unidade de Internamento de Doentes Agudos, através de variáveis sócio-demográficas e clínicas e reavaliou a evolução destes pacientes 8 anos após o internamento, através da informação registada nos processos clínicos. Forma incorporados nos estudo 25 doentes. Os principais resultados encontrados consistiram num elevado número de abandonos da consulta, só permanecendo em seguimento 20% dos doentes, num elevado número de consumo de substâncias (48% dos doentes), num elevado número de reinternamentos e num discreto agravamento da situação sócio-profissional. Salienta-se também que 20% dos doentes vieram a evoluir para diagnóstico de esquizofrenia. O estudo permite alertar os profissionais de saúde para esta realidade e salientar a necessidade de desenvolver estratégias de prevenção secundária que promovam uma atitude pró-activa dos técnicos, no sentido de obter uma maior adesão a um projecto terapêutico.

Descrição do caso clínico de um paciente com síndrome de Brown-Séquard por hérnia de disco cervical em duplo nível, 40 anos, do sexo masculino, sem história de patologia prévia da coluna cervical; teve início insidioso de paresia nos membros direitos, associada à diminuição da sensibilidade dolorosa e térmica do hemicorpo esquerdo, após mergulho que ocasionou trauma indireto da coluna cervical. A RM da coluna cervical mostrou hérnias discais paramedianas direitas nos níveis C4-C5 e C5-C6 com compressão da metade direita do cordão medular e hiperintensidade em T2. Foi realizada descompressão por via anterior e artrodese dos níveis afetados. O paciente recuperou-se parcialmente dos déficits neurológicos, após um longo programa de reabilitação funcional. O tratamento cirúrgico e um programa de reabilitação precoce são da maior importância para a recuperação neurológica de paciente com síndrome de Brown-Séquard por hérnia de disco cervical.Descripción del caso clínico de un paciente con síndrome de Brown-Séquard por hernia de disco cervical en nivel doble, 40 años, del sexo masculino, sin historial de patología previa de la columna cervical; tuvo inicio insidioso de paresia en los miembros derechos, vinculada con la disminución de la sensibilidad dolorosa y térmica del hemicuerpo izquierdo, después de zambullida que ocasionó traumatismo indirecto de la columna vertebral. La RM de la columna cervical mostró hernias discales paramedianas derechas, en los niveles C4-C5 y C5-C6, con compresión de la mitad derecha del cordón medular e hiperintensidad en T2. Se realizó descompresión por vía anterior y artrodesis de los niveles afectados. El paciente se recuperó, parcialmente, de los déficits neurológicos, después de un programa prolongado de rehabilitación funcional. El tratamiento quirúrgico y un programa de rehabilitación precoz son de máxima importancia para la recuperación neurológica del paciente con síndrome de Brown-Séquard por hernia de disco cervical.This article presents a case in which Brown-Séquard syndrome resulted from a double level cervical disc herniation. A 40-year-old man without previous history of cervical pathology, presented with insidious right arm and leg paresis associated with associated with decreased pain and thermal sensitivity in the left hemibody after diving which caused indirect trauma of the cervical spine. Magnetic resonance imaging of the cervical spine showed double level disc herniation in C4-C5 and C5-6 with compression of the right half of spinal cord and hyperintensity in T2-weighted images. After a complete decompression of neural structures, a double level interbody fusion was performed. There was partial recovery of neurological status after a long period of physical therapy. Early surgical intervention and prompt rehabilitation are paramount to achieve neurological recovery in patients with Brown-Séquard syndrome resulting from a cervical disc herniation.