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The development of sustainable shellfish aquaculture is highly dependent on the provision of reliable monitoring and predictive information on the occurrence of harmful algal blooms (HABs). The Portuguese HAB early warning system and shellfish closures presented here is a prototype, developed in the ASIMUTH project. It relies on weekly monitoring data composed of observations of HAB species and toxin concentrations within shellfish, and ocean circulation forecasts generated by an operational oceanographic model. The shellfish harvesting areas comprise coastal areas, estuaries + rías and coastal lagoons. The weekly bulletin characterizes the current shellfish closure situation and next week's forecasts for potentially impacted areas. The period analyzed ranged from 27 July 2013 to 17 March 2014, and describes the first skill assessment of the warning system. The forecast accuracy was evaluated, considering the number of forecasts that were verified to be correct the following week (85%) as well as the number of events not forecasted (false negatives, 12%) and those expected but did not occur (false positives, 3%). Variations were most visible in the first weeks of bulletin implementation and during autumn–winter months. The complementary use of field data, remote sensing and operational models led to more accurate predictions of blooms and range of the event. [ABSTRACT FROM AUTHOR]

Cohesive sediment dynamics in estuarine systems is a major issue in water quality and engineering problems. Numerical models can help to assess the complex dynamics of cohesive sediments, integrating the information collected in monitoring studies. Following a numerical approach we investigated the main factors that influence the cohesive sediment dynamics in an estuarine system composed of large mudflats (Tagus estuary, Portugal). After a spin up period of the bottom layer and considering the combined effect of waves and currents on the bottom shear stress, the dynamics of cohesive sediment during the fortnightly and daily erosion–sedimentation cycle was properly reproduced by the model. The results of cohesive suspended sediments were validated with data from sixteen monitoring stations located along the estuary and turbidity data measured by two multiparametric probes. The hydrodynamics were previously validated by harmonic analysis and with ADCP data. Although tidal currents are the major cause of cohesive sediment erosion, the results suggest that wind waves also play an important role. The simulated sediment mass involved in the fortnightly tidal cycle was in the same order of magnitude of the annual load from the rivers, as observed in previous studies based on field data. [ABSTRACT FROM AUTHOR]

Introduction Rivastigmine is the only approved transdermal therapy for Alzheimer’s disease (AD). Reduced drug concentration variability compared to oral formulations may improve tolerability and optimize treatment effectiveness. Objectives The EXEPT study evaluated patient compliance, caregiver treatment preference and clinical outcomes in patients with mild to moderate AD initiating oral monotherapy (OM) or transdermal monotherapy (TM) with approved AD drugs. Methods EXEPT was a Portuguese observational multicentre trial that prospectively evaluated two cohorts of patients over 6 months (± 3 months): OM and TM, to which patients were assigned according to clinical criteria. Endpoints included patient compliance (evaluated by caregivers on a 0-10 scale), caregiver treatment preference and change in Mental State Examination (MMSE) and Neuropsychiatric Inventory domains scores. Results Eighteen investigators recruited 190 patients (63.5% female, mean age 75.99 [± 7.67]), of which 69.5% were initiated on TM. Patient compliance at study end was significantly higher in the TM group (9.4 versus 8.6 points, p<0.001); 95.3% of caregivers in TM cohort preferred this formulation. MMSE increased by a median of 2.0 points in both cohorts (p<0.001 versus baseline) but no difference was observed between groups (p=0.790). A higher proportion of patients on TM showed reduced agitation/aggression (30.9% versus 15.4%, p=0.035); after controlling for baseline MMSE and use of antipsychotics this difference remained significant (OR=2.795; p=0.030). Conclusions Transdermal rivastigmine was associated with higher compliance and caregiver preference and reduced agitation/aggression compared to OM. These findings may impact treatment decisions in AD patients with agitation and aggression and high caregiver burden. [ABSTRACT FROM AUTHOR]

Objective: To evaluate the use of external cephalic version (ECV) in Portuguese public hospitals with maternity services, as well as exploring the main motives for not offering the technique., Methods: A cross-sectional observational study was conducted involving an online survey with 34 questions, accessed via an email addressed to all Heads of Department of Portuguese state-owned hospitals with maternity services. In centers where the technique was performed, information was requested on success rates, contraindications for the procedure, and practical aspects related to its use. In centers where ECV was not offered, the underlying reasons for this were queried., Results: Answers were received from 41 out of the 43 state hospitals with maternity services (95.3%). Sixteen hospitals perform the technique (39%), with reported annual numbers ranging from 3 to 51, and success rates ranging from 25% to 85% (12 respondents). The main reasons for not offering the technique were lack of experience and lack of conditions to perform it safely. Most centers (87.8%) reported that they would welcome hands-on training in ECV., Conclusion: ECV is used in a minority of Portuguese state-owned hospitals. Efforts are needed to achieve a wider implementation of the technique, with a particular focus on simulation-based training., (© 2022 International Federation of Gynecology and Obstetrics.)

Urban green spaces (UGS) deliver a wide range of regulating, provisioning and cultural ecosystem services (CES), relevant to support the achievement of some United Nations Sustainable Development Goals (e.g., Goal 11: sustainable cities and communities, and Goal 3: good health and well-being). However, knowledge of preferences and uses of UGS by urban dwellers is still lacking. This study assesses the CES perceived by different users in five distinct urban parks located in Coimbra, Portugal: Manuel Braga (secular park), Botanical garden, Choupal national forest, Mondego green park (large area placed next to the river), and Vale das Flores (linear park located in a residential area). A questionnaire survey was performed in each park to investigate the activities performed and their relevance for the users, users' motivations to develop the activities on that specific UGS, the perceived benefits regarding physical and emotional well-being and social interactions, and users' perception about disservices. The results showed that walking, meeting people, practicing and doing activities with children are the activities performed by most users and are perceived as beneficial for physical and emotional well-being. Multifunctionality is a characteristic of all parks and highly appreciated by the users. Significant differences in socio-demographic characteristics of the users and motivations are recorded between parks. The tranquillity of space and landscape beauty are the main motivations to use Manuel Braga Park and the Botanical garden. Distance to the park and transportation means are particularly important for Botanical garden and Vale das Flores park users. Age group and average monthly income were associated in both Choupal national forest, Mondego green park and Vale das Flores park, denoting that older and wealthier users are more able to enjoy these parks. Users' problems or ecosystem disservices were not identified, although plagues (e.g., mosquitoes) and dangerous animals recorded average concerns in the Choupal national forest and in the Vale das Flores and Mondego green parks. This work's findings can help decision-makers better understand users' needs and expectations, thus improving UGS design and management to attract more citizens., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2021 The Authors. Published by Elsevier B.V. All rights reserved.)

Radiological monitoring is fundamental for compliance with radiological protection policies in the aftermath of radiological events, such as nuclear accidents, terrorism, and out-of-commission uranium mines. An effective strategy for radiation monitoring is to use radiation detectors coupled with Unmanned Aerial Vehicles (UAVs), enabling for quicker surveillance of large areas without involving the need of human presence in the target area. The main aim of this study was to formulate the parameters for a UAV flight strategy in preparation for future field measurements using Geiger-Muller Counters (GMC) and Cadmium Zinc Telluride (CZT) spectrometers. As a proof of concept, the prepared flight strategy will be used to survey out-of-commission uranium mines in northern Portugal. Procedures to assure the calibration of the CZT and verification of the GMCs were conducted, as well as a sensitivity analysis of the sensors considering different acquisition times, distance to source, and detector response time. This article reports specific parameters, such as UAV distance to ground, time of exposition, speed, and the methodology to perform the identification and calculate the activity of possible radioactive sources. An effective flight strategy is also presented, aiming to use radiation detectors coupled with UAVs to undertake extensive monitoring of areas with enhanced levels of environmental radiation, which is of prime importance due to the lasting hazardous effects of enhanced environmental radiation in the nearby ecosystem and population.

Purpose: Glaucoma leads as the first cause of irreversible blindness. The number of patients will greatly increase in upcoming years and changes will have to be accomplished to cope with those numbers. As such, data are important to understand the effect of new policies introduced in glaucoma management. Only few countries have described their glaucoma surgical profile and, in Europe, only the United Kingdom described the last 15 years. The aim of this study is to assess the glaucoma surgical profile and its changes in mainland Portugal from 2000 to 2015., Methods: Retrospective database analysis of inpatient and surgical outpatients' episodes of all public hospitals in mainland Portugal was performed. The annual absolute numbers of ophthalmic procedures, as well as their surgical rate (per 100,000 inhabitants) were calculated., Results: Glaucoma patients undergoing glaucoma procedures were 67±14 years old and 50% were female. During the study period there was an increase in the number and surgical rate of glaucoma procedures. Trabeculectomy showed a stable surgical rate (7 per 100,000 inhabitants) despite a reduction in terms of relative weight among glaucoma procedures. At the same time, the surgical rate of glaucoma drainage devices and cyclophotoablation increased, while remaining stable for cyclocryoablation., Conclusions: In Portugal, trabeculectomy had a stable surgical rate throughout the study period, being the most performed glaucoma surgical procedure. Other surgeries, like glaucoma drainage devices and cyclophotoablation are gaining ground among glaucoma specialists. Our results match what has been published by other countries worldwide and can be used to achieve a better health planning.

Purpose: To determine the frequency of epiretinal membranes (ERM) in eyes with primary open-angle glaucoma subjected to trabeculectomy., Methods: We conducted a retrospective study on patients subjected to trabeculectomy with at least a 6-month follow-up. Ophthalmologic examination and spectral-domain optical coherence tomography (SD-OCT) were analyzed. Eyes with previous surgical or laser treatments or other pathologies (other than glaucoma and ERM) were excluded., Results: A total of 50 eyes (40 patients) were included in this study. The mean follow-up time after surgery was 27.8 months. After surgery, 9 eyes (18%) had preretinal macular fibrosis and 19 eyes (38%) had cellophane macular reflex. Of the 16 eyes with a preoperative macular SD-OCT, 3 (18.8%) developed ERM and 4 (25%) progressed from cellophane macular reflex to preretinal macular fibrosis, after surgery. The ERM frequency did not differ significantly between eyes subjected to trabeculectomy with or without the use of antimetabolites (P=0.08), or between eyes subjected to simple or combined surgery (phacotrabeculectomy) (P=0.09)., Conclusion: Trabeculectomy may predispose one to the appearance and progression of ERM. Further studies are needed to clarify this intriguing relation.