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Funding Information: This work was funded by: i) national funds through FCT - Portuguese Foundation for Science and Technology, under the scope of the Cardiovascular R&D Center - UnIC (UIDB/00051/2020 and UIDP/00051/2020); ii) “la Caixa” Banking Foundation and FCT under the project code LCF/PR/HP17/52190002”; iii) the QREN project 2013/30196; and iv) the European Structural and Investment Funds (ESIF), under the Lisbon Portugal Regional Operational Program and National Funds through FCT [POCI-01-0145-FEDER-030985]. RNG and TLL were funded by the FCT individual fellowships [SFRH/BD/144490/2019] and [PD/BD/127997/2016], respectively. Funding sources had no interference in the design of the study, study governance, data collection and analysis, nor in manuscript writing or its scientific and intellectual content. Publisher Copyright: 2023 Raposo, Cerqueira, Leite, Moreira-Costa, Laundos, Miranda, Mendes-Ferreira, Coelho, Gomes, Pinto-do-Ó, Nascimento, Lourenço, Cardim and Leite-Moreira. Background: Human umbilical cord matrix-mesenchymal stromal cells (hUCM-MSC) have demonstrated beneficial effects in experimental acute myocardial infarction (AMI). Reperfusion injury hampers myocardial recovery in a clinical setting and its management is an unmet need. We investigated the efficacy of intracoronary (IC) delivery of xenogeneic hUCM-MSC as reperfusion-adjuvant therapy in a translational model of AMI in swine. Methods: In a placebo-controlled trial, pot-belied pigs were randomly assigned to a sham-control group (vehicle-injection; n = 8), AMI + vehicle (n = 12) or AMI + IC-injection (n = 11) of 5 × 105 hUCM-MSC/Kg, within 30 min of reperfusion. AMI was created percutaneously by balloon occlusion of the mid-LAD. Left-ventricular function was blindly evaluated at 8-weeks by invasive pressure-volume loop analysis (primary endpoint). Mechanistic readouts included histology, strength-length relationship in skinned cardiomyocytes and gene expression analysis by RNA-sequencing. Results: As compared to vehicle, hUCM-MSC enhanced systolic function as shown by higher ejection fraction (65 ± 6% vs. 43 ± 4%; p = 0.0048), cardiac index (4.1 ± 0.4 vs. 3.1 ± 0.2 L/min/m2; p = 0.0378), preload recruitable stroke work (75 ± 13 vs. 36 ± 4 mmHg; p = 0.0256) and end-systolic elastance (2.8 ± 0.7 vs. 2.1 ± 0.4 mmHg*m2/ml; p = 0.0663). Infarct size was non-significantly lower in cell-treated animals (13.7 ± 2.2% vs. 15.9 ± 2.7%; Δ = −2.2%; p = 0.23), as was interstitial fibrosis and cardiomyocyte hypertrophy in the remote myocardium. Sarcomere active tension improved, and genes related to extracellular matrix remodelling (including MMP9, TIMP1 and PAI1), collagen fibril organization and glycosaminoglycan biosynthesis were downregulated in animals treated with hUCM-MSC. Conclusion: Intracoronary transfer of xenogeneic hUCM-MSC shortly after reperfusion improved left-ventricular systolic function, which could not be explained by the observed extent of infarct size reduction alone. Combined contributions of favourable modification of myocardial interstitial fibrosis, matrix remodelling and enhanced cardiomyocyte contractility in the remote myocardium may provide mechanistic insight for the biological effect. publishersversion published

Copyright © 2022 Sociedade Portuguesa de Cardiologia. Publicado por Elsevier España, S.L.U. All rights reserved. INTRODUCTION AND OBJECTIVES: Obstructive coronary artery disease (CAD) remains the most common etiology of heart failure with reduced ejection fraction (HFrEF). However, there is controversy whether invasive coronary angiography (ICA) should be used initially to exclude CAD in patients presenting with new-onset HFrEF of unknown etiology. Our study aimed to develop a clinical score to quantify the risk of obstructive CAD in these patients. METHODS: We performed a cross-sectional observational study of 452 consecutive patients presenting with new-onset HFrEF of unknown etiology undergoing elective ICA in one academic center, between January 2005 and December 2019. Independent predictors for obstructive CAD were identified. A risk score was developed using multivariate logistic regression of designated variables. The accuracy and discriminative power of the predictive model were assessed. RESULTS: A total of 109 patients (24.1%) presented obstructive CAD. Six independent predictors were identified and included in the score: male gender (2 points), diabetes (1 point), dyslipidemia (1 point), smoking (1 point), peripheral arterial disease (1 point), and regional wall motion abnormalities (3 points). Patients with a score ≤3 had less than 15% predicted probability of obstructive CAD. Our score showed good discriminative power (C-statistic 0.872; 95% CI 0.834-0.909: p

Submitted by Jeferson Carlos da Veiga Rodrigues (jveigar@unisinos.br) on 2022-12-02T15:16:43Z No. of bitstreams: 1 Luís Guilherme Rangel Raposo_PROTEGIDO.pdf: 769724 bytes, checksum: e048ca422116376ee07f5a1c3e4eb9d5 (MD5) Made available in DSpace on 2022-12-02T15:16:43Z (GMT). No. of bitstreams: 1 Luís Guilherme Rangel Raposo_PROTEGIDO.pdf: 769724 bytes, checksum: e048ca422116376ee07f5a1c3e4eb9d5 (MD5) Previous issue date: 2022-08-01 Nenhuma A presente pesquisa objetivou analisar as causas do aumento dos custos de transação ex-post em aquisições públicas realizadas por pregão eletrônico de Sistema de Registro de Preços, e para tal fundamentou-se na Teoria Custos de Transação (TCT). Foi delimitado o período de 2018 a 2020, e estabelecido que seriam observadas as compras de gêneros alimentícios efetuadas pelo Comando da 3ª Região Militar. Utilizou-se uma abordagem quantitativa, na qual foram consideradas 461 Atas de Registros de Preços e adotada regressão logística como técnica de análise para serem testadas as três hipóteses de pesquisa formuladas. A regressão logística buscou verificar se o aumento de custos de transação ex-post nas aquisições governamentais, neste caso representados por tentativas de renegociação, tem maior probabilidade de ocorrer quando se referem a fornecedores que menos vezes assinaram ata com o órgão estudado, que possuem maior histórico de problemas no contexto de aquisições públicas e/ou que ofereceram maior descontos em seus lances vencedores da licitação. Os achados não puderam confirmar que frequência e reputação afetam no aumento dos custos de transação, apesar de serem indicados como dimensões e fatores relevantes no contexto da TCT. Já os descontos obtidos por intermédio dos lances do pregão, quanto menores, mostraram ter forte relação com a tentativa de renegociação, contrariando as premissas teóricas revisadas. Outros aspectos que se mostraram significantes e se apresentaram como prováveis causas para aumentos desses custos transacionais foram a distância em que a empresa está sediada do munícipio em que o material deve ser entregue, a experiência que a empresa possui no mercado e o Regime de Tributação em que está enquadrada. The present research aimed to analyze the causes of the increase in ex-post transaction costs in public acquisitions carried out by electronic trading of the Price Registration System, and for this it was based on the Transaction Costs Theory (TCT). The period from 2018 to 2020 was delimited, and it was established that purchases of foodstuffs made by the Command of the 3rd Military Region would be observed. A quantitative approach was used, in which 461 Minutes of Price Records were considered and logistic regression was adopted as an analysis technique to test the three formulated research hypotheses. The logistic regression sought to verify whether the increase in ex-post transaction costs in government acquisitions, in this case represented by renegotiation attempts, is more likely to occur when referring to suppliers who have less often signed minutes with the body studied, who have greater history of problems in the context of public procurement and/or that offered greater discounts on their winning bids. The findings could not confirm that frequency and reputation affect the increase in transaction costs, despite being indicated as relevant dimensions and factors in the context of TCT. The discounts obtained through the auction bids, the smaller they were, showed a strong relationship with the renegotiation attempt, contrary to the revised theoretical premises. Other aspects that proved to be significant and presented as probable causes for increases in these transactional costs were the distance in which the company is headquartered from the municipality where the material must be delivered, the experience that the company has in the market and the Taxation Regime in that is framed.

© 2022 Sociedade Portuguesa de Cardiologia. Published by Elsevier España, S.L.U. INTRODUCTION: During the Covid-19 pandemic there has been a general belief that hospital admissions for non-infectious causes, especially cardiovascular disease, have fallen. OBJECTIVES: To assess the impact of the pandemic on admissions for ST-elevation myocardial infarction (STEMI) during the first pandemic wave. METHODS: We performed a multicenter retrospective analysis of consecutive patients presenting with STEMI in two Portuguese hospital centers in two sequential periods - P1 (March 1 to April 30) and P2 (May 1 to June 30). Patients' clinical data and hospital outcomes were compared between the two periods for the years 2017 to 2019 and for 2020. RESULTS: During P1 in 2020, a reduction in the number of STEMI patients was observed in comparison with previous years (26.0±4.2 vs. 16.5±4.9 cases per month; p=0.033), as well as an increase in the number of mechanical complications (0.0% vs. 3.0%; p=0.029). Percutaneous coronary interventions in the setting of failed thrombolysis were more frequent (1.9% vs. 9.1%; p=0.033). An overall trend for longer delays in key timings of STEMI care bundles was noted. Mortality was higher during P1 compared to previous years (1.9% vs. 12.1%; p=0.005). CONCLUSIONS: During the first Covid-19 wave fewer patients presented with STEMI at the catheterization laboratory for percutaneous coronary intervention. These patients presented more mechanical complications and higher mortality. publishersversion published

Submitted by Joaquim Rodrigues dos Santos (joaquimr.santos@letras.ulisboa.pt) on 2021-06-02T16:10:26Z No. of bitstreams: 1 Em_Defesa_da_Ermida.pdf: 1041610 bytes, checksum: 9a1fbd5519de6d2f3c7bd74e23ccd716 (MD5) Approved for entry into archive by Manuel Botelheiro Moreno (manuelmoreno@campus.ul.pt) on 2021-06-17T10:32:06Z (GMT) No. of bitstreams: 1 Em_Defesa_da_Ermida.pdf: 1041610 bytes, checksum: 9a1fbd5519de6d2f3c7bd74e23ccd716 (MD5) Made available in DSpace on 2021-06-17T10:33:11Z (GMT). No. of bitstreams: 1 Em_Defesa_da_Ermida.pdf: 1041610 bytes, checksum: 9a1fbd5519de6d2f3c7bd74e23ccd716 (MD5) Previous issue date: 2020-06-18 info:eu-repo/semantics/publishedVersion