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Background Computer use is a well-known source of chronic pain, leading to absenteeism and reduced productivity and well-being. This study evaluated the feasibility of conducting a full-scale randomised controlled trial. Several methodological variables defined trial feasibility. Materials and methods Thirty adults, daily computer users reporting pain, were recruited. Data collection took place at LABIOMEP. Participants were randomised into 1 of 3 parallel groups and received either osteopathic, sham or no treatment. Only the volunteers were blind to group assignments. The primary objective was to study the feasibility and acceptability of the protocol. Results Of 77 participants interested, 30 were included and randomised into three groups of ten. All participants concluded the study, and all the data was analysed. The feasibility outcomes were deemed appropriate. No adverse events or severe side effects were reported or identified. Conclusion Studying the efficacy of osteopathic consultation on computer users by conducting an RCT is feasible and safe. With adjustments, a full-scale study can be designed. Trial registration ClinicalTrials.gov with the identifier: NCT04501575. Date registered August 06, 2020.

Undernutrition as well as low levels of vitamin B12 and folic acid are common problems among older adults. However, recommended routine nutritional status assessment tools may result in inadequate vitamin serum levels to go unnoticed. Therefore, the aim of this study is to evaluate the inadequacy of serum levels of vitamin B12 and folic acid within Mini Nutritional Assessment (MNA) classification categories among older adults. A cross-sectional study was conducted with 97 older adults residing in care homes in Portugal. Undernutrition was identified through the MNA, and serum levels of vitamin B12 and folic acid were measured using chemiluminescence. Cognitive function, depressive symptoms and functional characteristics were also assessed using the Abbreviated Mental Test Score, the Epidemiologic Studies Depression Scale and the Barthel Index, respectively. The mean age of older adults was 82.2 (6.3) years; 3.1% were undernourished and 26.8% were at undernutrition risk. In the MNA normal nutritional status group, 11.8% presented vitamin B12 deficiency (

Salmonellosis remains one of the most frequent food-borne zoonoses, constituting a worldwide major public health concern. Currently, at a global level, the main sources of infection for humans include meat products, including the consumption of contaminated poultry meat, in spite of the success of Salmonella control measures implemented in food-animal production of industrialized countries. In recent years, a shift in Salmonella serotypes related to poultry and poultry production has been reported in diverse geographical regions, being particularly associated with the spread of certain well -adapted clones. Moreover, antimicrobial resistance in non-typhoidal Salmonella is considered one of the major public health threats related with food-animal production, including the poultry production chain and poultry meat, which is an additional concern in the management of salmonellosis. The circulation of the same multidrug-resistant Salmonella clones and/or identical mobile genetic elements encoding antibiotic resistance genes from poultry to humans highlights this scenario. The purpose of this review was to provide an overview of the role of poultry meat on salmonellosis at a global scale and the main problems that could hinder the success of Salmonella control measures at animal production level. With the increasing globalization of foodstuffs like poultry meat, new problems and challenges might arise regarding salmonellosis control, making new integrated intervention strategies necessary along the food chain. Clinical Microbiology and Infection

OBJECTIVE: To evaluate the prevalence of undernutrition in older adults aged >75 years living in communities and to identify the main factors independently associated with undernutrition. METHODS: A cross-sectional study was conducted using a random sample of family physicians' medical records of 86 older adults aged >75 years living in the community studied. Their nutritional status was evaluated using the Mini Nutritional Assessment. RESULTS: A total of 10.5% of the elderly were undernourished and 41.9% were at undernutrition risk. According to the logistic regression multivariable model, the following characteristics: being widowed (OR=6.7; 95%CI=1.8-24.6); being institutionalized (OR=12.6; 95%CI=1.7-90.5); or having a negative self-perception of health (OR=15.0; 95%CI=3.3-69.1) were independently associated with a significant increase of undernutrition risk. CONCLUSION: The current study shows that undernutrition is highly prevalent in Portuguese older adults aged >75 years living in communities. The major factors independently associated with their undernutrition are being widowed and institutionalized and having negative self-perception of health. The results obtained show that undernutrition and its associated factors are very serious problems for older adults and a challenge in their health care. OBJETIVO: Determinar a prevalência de desnutrição em idosos com 75 ou mais anos de idade que vivem em comunidades e identificar os possíveis fatores independentes associados à desnutrição. MÉTODOS: Foi realizado um estudo transversal numa amostra aleatória dos registos de médicos de família de idosos com idades >75 anos. O estado nutricional foi avaliado por meio da Miniavaliação Nutricional. RESULTADOS: Estavam desnutridos 10,5% dos idosos e 41,9% apresentavam risco de desnutrição. De acordo com o modelo de regressão logística multivariável, ser viúvo (OR=6,7; IC95%=1,8-24,6), estar institucionalizado (OR=12,6; IC95%=1,7-90,5) ou ter uma autoperceção de saúde negativa (OR=15,0; IC95%=3,3-69,1) demonstraram estar associados a um aumento significativo do risco de desnutrição. CONCLUSÃO: Segundo o presente estudo, a desnutrição tem uma prevalência elevada em idosos portugueses com idades >75 anos que vivem em comunidades. Os principais fatores associados com a desnutrição são a viuvez, a institucionalização e a autopercepção de saúde negativa. Esses resultados demonstram que a desnutrição e os fatores a ela associados representam um grave problema para os idosos e um desafio para os cuidados de saúde.

Needlestick injuries (NIs) are considered a substantial occupational health and safety hazard in contemporary health care practice. Unlike human medicine where much effort has been devoted to reduce the incidence of these events, the same aggressive approach has not been used in veterinary medicine. This study investigated the occurrence of blood-contaminated NIs in Portuguese veterinarians. Participants of a veterinary meeting were asked to complete a questionnaire-based survey. Differences in NI exposure rates by sex, years in practice, and animal interaction during childhood were evaluated using the chi-square test. Univariate and multivariate logistic regression analyses were performed to produce predicted probabilities for NI episodes in veterinarians. From the total of 373 enrolled veterinarians, 293 (78.5%) reported having had at least one NI during their professional life. Veterinarians working with dogs were more likely to have experienced a NI (adjusted odds ratio [aOR]: 145.74, P < .001). The high level of NIs observed in these professionals shows that NIs are a potential occupational health problem in Portuguese veterinarians, with the possibility for transmission of haematogenous zoonosis. This work was supported by the award number Ovislab ICT-2013-05-004-5314 ID-64757 from QREN/FEDER and the award number SFRH/BPD/64686/2009SFRH/BPD/64686/2009 from Fundação para a Ciência e Tecnologia (FCT).

BACKGROUND/OBJECTIVES: There is increasing evidence showing that handgrip strength (HGS) is an indicator of nutrition status and a promising undernutrition screening tool. However, HGS cutoff values for inpatient undernutrition screening remain to be studied. The present study aims to define gender- and age-specific HGS cutoff values for undernutrition screening of hospitalized patients at admission. SUBJECTS/METHODS: A cross-sectional study was conducted in a university hospital. Gender- and age-specific receiver operating characteristic curves were constructed to evaluate the performance of HGS for correctly screening undernourished patients on the basis of their classification by Patient-Generated Subjective Global Assessment. Sensitivity, specificity, areas under the curves (AUCs) and positive likelihood ratios (LRs) were calculated. RESULTS: The study sample was composed of 712 participants between the ages of 18 and 91 years old, median (interquartile range) of 58 (22) years. For women, HGS cutoff values, sensitivities and specificities were as follows: 18-44 years, 20.2 kgf, 0.741 and 0.556; 45-64 years, 19.2 kgf, 0.795 and 0.522. For men, these values were as follows: 18-44 years, 41.7 kgf, 0.923 and 0.520; 45-64 years, 37.9 kgf, 0.817 and 0.402; >= 65 years, 30.2 kgf, 0.736 and 0.567. The AUCs varied between 0.642 and 0.778 and LRs from 1.37 to 1.92. CONCLUSIONS: This study provides HGS cutoff values for men aged 18-91 years and for women aged 18-64 years.

This article describes the adaptation of the adult Portuguese version of the General Nutrition Knowledge Questionnaire (GNKQ) for adolescents, and its validation. Respondents were 1,315 adolescents, who completed the questionnaire in two phases. A subsample of 73 adolescents was used to measure test-retest reliability. Concurrent validity was tested using a sample of 32 dietetic students. The adapted version showed high internal consistency (Cronbach's alpha = 0.92), test-retest reliability (R = 0.71) and concurrent validity (U = 22766.0; p < .01). Adolescents' nutrition knowledge can now be assessed with a valid and reliable instrument. Future validation works of this or others questionnaires for children and elderly are warranted. This work was supported by FCT- Portuguese Foundation for Science and Technology for the PROTEC project grant SFRH/PROTEC/49529/2009, conceded to the first author and project grant FCOMP-01-0124-FEDER-028619 (Ref. FCT: PTDC/DTP-DES/1328/2012). info:eu-repo/semantics/publishedVersion

Background: Fruit and vegetable intake in children remains below recommendations in many countries. The long-term effects of early parental feeding practices on fruit and vegetable intake are not clearly established. Objective: The purpose of the current study was to examine whether early feeding practices influence later fruit and vegetable intake in preschool children. Design: The study used data from 4 European cohorts: the British Avon Longitudinal Study of Parents and Children (ALSPAC), the French Etude des Determinants pre et postnatals de la santeet du developpement de l'Enfant study, the Portuguese Generation XXI Birth Cohort, and the Greek EuroPrevall study. Fruit and vegetable intake was assessed in each cohort by food-frequency questionnaire. Associations between early feeding practices, such as breastfeeding and timing of complementary feeding, and fruit and/or vegetable intake in 2-4-y-old children were tested by using logistic regres- sions, separately in each cohort, after adjustment for infant's age and sex and maternal age, educational level, smoking during preg- nancy, and maternal fruit and vegetable intake. Results: Large differences in early feeding practices were high- lighted across the 4 European cohorts with longer breastfeeding duration in the Generation XXI Birth Cohort and earlier introduc- tion to complementary foods in ALSPAC. Longer breastfeeding duration was consistently related to higher fruit and vegetable in- take in young children, whereas the associations with age of in- troduction to fruit and vegetable intake were weaker and less consistent across the cohorts. Mothers' fruit and vegetable intake (available in 3 of the cohorts) did not substantially attenuate the relation with breastfeeding duration. Conclusion: The concordant positive association between breast- feeding duration and fruit and vegetable intake in different cultural contexts favors an independent specific effect. Am J Clin Nutr doi: 10.3945/ajcn.112.057026.

ObjectiveTo develop a software to plan and evaluate school meals according to the main national and international standards for foods and nutrition.DesignDevelopment of software.SettingPublic schools, Portugal.SubjectsSchool meals for students.ResultsThe System of Planning and Evaluation of School Meals (SPARE) is a software that allows the planning of school meals in an effective and organized way, according to the main national and international standards for food and nutrition. The regular use of this tool enables the evaluation, monitoring and verification towards continuous improvement of the quality of school meals.ConclusionsThe SPARE software aims to promote healthy eating by focusing on the planning and production of safe and adequate meals in the school environment. This software can be adapted to different age groups and to different contexts, attending to specific nutritional and food standards.

ObjectiveTo examine the association between obesity and food group intakes, physical activity and socio-economic status in adolescents.DesignA cross-sectional study was carried out in 2008. Cole's cut-off points were used to categorize BMI. Abdominal obesity was defined by a waist circumference at or above the 90th percentile, as well as a waist-to-height ratio at or above 0·500. Diet was evaluated using an FFQ, and the food group consumption was categorized using sex-specific tertiles of each food group amount. Physical activity was assessed via a self-report questionnaire. Socio-economic status was assessed referring to parental education and employment status. Data were analysed separately for girls and boys and the associations among food consumption, physical activity, socio-economic status and BMI, waist circumference and waist-to-height ratio were evaluated using logistic regression analysis, adjusting the results for potential confounders.SettingPublic schools in the Azorean Archipelago, Portugal.SubjectsAdolescents (n 1209) aged 15–18 years.ResultsAfter adjustment, in boys, higher intake of ready-to-eat cereals was a negative predictor while vegetables were a positive predictor of overweight/obesity and abdominal obesity. Active boys had lower odds of abdominal obesity compared with inactive boys. Boys whose mother showed a low education level had higher odds of abdominal obesity compared with boys whose mother presented a high education level. Concerning girls, higher intake of sweets and pastries was a negative predictor of overweight/obesity and abdominal obesity. Girls in tertile 2 of milk intake had lower odds of abdominal obesity than those in tertile 1. Girls whose father had no relationship with employment displayed higher odds of abdominal obesity compared with girls whose father had high employment status.ConclusionsWe have found that different measures of obesity have distinct associations with food group intakes, physical activity and socio-economic status.

Background: Fruit and vegetable intake is crucial in health promotion and disease prevention. Inadequate intake is found among adult populations worldwide. Aims: To assess fruit and vegetable intake among Portuguese mothers and to examine its association with sociodemographic determinants. Methods: A national cross-sectional survey was performed in Portugal as part of the Pro Children study. Data from self-administrated precoded 24-hour recall and food frequency questionnaires answered by 1,853 mothers of 11- to 13-year-old children were analyzed. Descriptive analysis of the data was followed by logistic regression to assess associations between daily fruit and vegetable intake and sociodemographic determinants. Results: The mean fruit and vegetable intake was 221.2 and 170.0 g/day, respectively. Only 46% of the mothers met the WHO recommendations (≥400 g fruit and vegetables/day). Daily fruit intake was significantly higher among mothers who live with a spouse/partner, and who belong to a higher social class. For vegetables, daily intake was significantly higher among mothers with a higher education and social class. Conclusions: This study shows that the mean intake of fruit and vegetables among Portuguese mothers is far below international recommendations. Effective strategies to promote fruit and vegetable intake are needed, especially for mothers belonging to lower social classes and educational levels.

Personalised diets based on people’s existing food choices, and/or phenotypic, and/or genetic information hold potential to improve public dietary-related health. The aim of this analysis, therefore, has been to examine the degree to which factors which determine uptake of personalised nutrition vary between EU countries to better target policies to encourage uptake, and optimise the health benefits of personalised nutrition technology. A questionnaire developed from previous qualitative research was used to survey nationally representative samples from 9 EU countries (N = 9381). Perceived barriers to the uptake of personalised nutrition comprised three factors (data protection ; the eating context ; and, societal acceptance). Trust in sources of information comprised four factors (commerce and media ; practitioners ; government ; family and, friends). Benefits comprised a single factor. Analysis of Variance (ANOVA) was employed to compare differences in responses between the United Kingdom ; Ireland ; Portugal ; Poland ; Norway ; the Netherlands ; Germany ; and, Spain. The results indicated that respondents in Greece, Poland, Ireland, Portugal and Spain, rated the benefits of personalised nutrition highest, suggesting a particular readiness in these countries to adopt personalised nutrition interventions. Greek participants were more likely to perceive the social context of eating as a barrier to adoption of personalised nutrition, implying a need for support in negotiating social situations while on a prescribed diet. Those in Spain, Germany, Portugal and Poland scored highest on perceived barriers related to data protection. Government was more trusted than commerce to deliver and provide information on personalised nutrition overall. This was particularly the case in Ireland, Portugal and Greece, indicating an imperative to build trust, particularly in the ability of commercial service providers to deliver personalised dietary regimes effectively in these countries. These findings, obtained from a nationally representative sample of EU citizens, imply that a parallel, integrated, public-private delivery system would capture the needs of most potential consumers.

The concentrations of six urinary monohydroxyl metabolites (OH-PAHs) of polycyclic aromatic hydrocarbons, namely 1-hydroxynaphthalene, 1-hydroxyacenaphthene, 2-hydroxyfluorene, 1-hydroxyphenanthrene, 1-hydroxypyrene (1OHPy), and 3-hydroxybenzo[a]pyrene, were assessed in the post-shift urine of wildland firefighters involved in fire combat activities at six Portuguese fire corporations, and compared with those of non-exposed subjects. Overall, median levels of urinary individual and total OH-PAHs (ΣOH-PAHs) suggest an increased exposure to polycyclic aromatic hydrocarbons during firefighting activities with ΣOH-PAH levels in exposed firefighters 1.7-35 times higher than in non-exposed ones. Urinary 1-hydroxynaphthalene and/or 1-hydroxyacenapthene were the predominant compounds, representing 63-98% of ΣOH-PAHs, followed by 2-hydroxyfluorene (1-17%), 1-hydroxyphenanthrene (1-13%), and 1OHPy (0.3-10%). A similar profile was observed when gender discrimination was considered. Participation in fire combat activities promoted an increase of the distribution percentage of 1-hydroxynaphthalene and 1-hydroxyacenaphthene, while contributions of 1-hydroxyphenanthrene and 1OHPy decreased. The detected urinary 1OHPy concentrations (1.73×10(-2) to 0.152μmol/mol creatinine in exposed subjects versus 1.21×10(-2) to 5.44×10(-2)μmol/mol creatinine in non-exposed individuals) were lower than the benchmark level (0.5μmol/mol creatinine) proposed by the American Conference of Governmental Industrial Hygienists. This compound, considered the biomarker of exposure to PAHs, was the less abundant one from the six analyzed biomarkers. Thus the inclusion of other metabolites, in addition to 1OHPy, in future studies is suggested to better estimate firefighters' occupational exposure to PAHs. Moreover, strong to moderate Spearman correlations were observed between individual compounds and ΣOH-PAHs corroborating the prevalence of an emission source. This study was financed by European (FEDER funds through COMPETE) and National (Fundação para a Ciência e Tecnologia project UID/QUI/50006/2013) funds and in the scope of the P2020 Partnership Agreement Project POCI-01-0145-FEDER-006939 (Laboratory for Process Engineering, Environment, Biotechnology and Energy—LEPABE) funded by FEDER funds through COMPETE2020—Programa Operacional Competitividade e Internacionalização (POCI). Authors are also grateful to for the financial support through the fellowships (SFRH/BD/80113/2011 and SFRH/BPD/65722/2009).

This study was performed with the aim to investigate and compare the level of food safety knowledge among food handlers in three different countries, Serbia, Greece and. Portugal, in different food establishments, namely restaurants, take-away places and catering companies. Total of 377 food handlers were involved in this study with 115 food handlers from Serbia (30.5%), 180 food handlers from Greece (47.7%) and 82 food handlers from Portugal (21.8%). For each participant, the knowledge score (KS) was calculated by dividing the sum of correct answers by the total number of questions. The average KS for all participants was 70.5%, with best overall KS that was obtained for Portuguese food handlers (72.6%), followed by Serbian (71.3%), whereas Greek food handlers showed lower scores (69.1%, p lt 0.05). The biggest knowledge gaps that have been identified in relation to temperature control, source of contamination of foods and food-stuffs and high-risk foods can be used as a foundation for further improvements in food safety trainings.

Background: The population of Portugal is aging. The lack of data on older adults’ nutritional status and the lack of nutrition knowledge amongst health professionals, caregivers, and older adults themselves, remains a challenge. Objective: The Nutrition UP 65 study aims to reduce nutritional inequalities in the older Portuguese adult population and improve knowledge regarding older Portuguese adults’ nutritional status, specifically relating to undernutrition, obesity, sarcopenia, frailty, hydration, sodium, and vitamin D statuses. Methods: A representative sample of older Portuguese adults was selected. Sociodemographic, lifestyle, anthropometric, functional, and clinical data were collected. Sodium excretion, hydration, and vitamin D statuses were assessed. Results: Data collection (n=1500) took place between December, 2015 and June, 2016. Results will be disseminated in national and international scientific journals, and via Portuguese media. Conclusions: Nutrition UP 65 results will provide evidence for the design and implementation of effective preventive public health strategies regarding the elderly. These insights may represent relevant health gains and costs savings.

Aims Exercise-stimulated myokine secretion into circulation may be related with browning in white adipose tissue (WAT), representing a positive metabolic effect on whole-body fat mass. However, limited information is yet available regarding the impact of exercise on myokine-related modulation of adipocyte phenotype in WAT from obese rats. Main methods Sprague-Dawley rats (n = 60) were divided into sedentary and voluntary physical activity (VPA) groups and fed with standard (35 kcal% fat) or high-fat (HFD, 71 kcal% fat)-isoenergetic diets. The VPA-groups had unrestricted access to wheel running throughout the protocol. After-9 weeks, half of sedentary standard (SS) and sedentary HFD (HS)-fed animals were exercised on treadmill (endurance training, ET) for 8-weeks while maintaining the dietary treatments. Key findings The adipocyte hypertrophy induced by HFD were attenuated by VPA and ET. HFD decreased 5′ AMP-activated protein kinase (AMPK) activity in muscle as well as peroxisome proliferator-activated receptor gamma coactivator-1α (PGC-1α) and uncoupling protein 1 (UCP1) proteins in eWAT, while not affecting circulating irisin. VPA increased eWAT Tmem26 mRNA levels in the standard diet-fed group, whereas ET increased AMPK, interleukin 6 (IL-6) and fibronectin type III domain-containing protein 5 (FNDC5) protein expression in muscle, but had no impact on circulating irisin protein content. In eWAT, ET increased bone morphogenetic protein 7 (Bmp7), Cidea and PGC-1α in both diet-fed animals, whereas BMP7, Prdm16, UCP1 and FNDC5 only in standard diet-fed group. Significance Data suggest that ET-induced myokine production seems to contribute, at least in part, to the “brown-like” phenotype in WAT from rats fed a HFD.

Gender bias consists in different practices for men and women. It has been suggested that gender biases in medicine occur at various levels, reflected in the way gender issues are included in medical curricula, equity between sexes in academic course and professional career, research and scientific publications, definition of pathologies, clinical practice and health policies. A review of the literature about gender bias in medicine was carried out, particularly in terms of reseach and clinical practice. The available evidence on this phenomenon and its effects is discussed, and proposals to its reduction are presented. There is a large body of scientific evidence on the existence of gender biases in medicine, leading mostly to greater inadequacy of clinical care provided to female patients. The proposals of several authors may contribute to the reduction of these effects and, consequently, to greater acuity of research and better adequacy of health care. In addition to the larger study of gender bias, we emphasize social, political and educational measures, the regard of participants' sex in the design of clinical trials and the inclusion of the study of gender theories and discussion of attitudes about gender in academic curricula. Gender bias consists in different practices for men and women. It has been suggested that gender biases in medicine occur at various levels, reflected in the way gender issues are included in medical curricula, equity between sexes in academic course and professional career, research and scientific publications, definition of pathologies, clinical practice and health policies. A review of the literature about gender bias in medicine was carried out, particularly in terms of reseach and clinical practice. The available evidence on this phenomenon and its effects is discussed, and proposals to its reduction are presented. There is a large body of scientific evidence on the existence of gender biases in medicine, leading mostly to greater inadequacy of clinical care provided to female patients. The proposals of several authors may contribute to the reduction of these effects and, consequently, to greater acuity of research and better adequacy of health care. In addition to the larger study of gender bias, we emphasize social, political and educational measures, the regard of participants' sex in the design of clinical trials and the inclusion of the study of gender theories and discussion of attitudes about gender in academic curricula.

INTRODUCTION: Monitoring tobacco consumption patterns is essential to define and evaluate strategies to control the tobacco epidemic. We aimed to quantify the use of smoked (manufactured/hand-rolled cigarettes) and smokeless (snuff/chew) tobacco, according to sociodemographic characteristics, in adult Mozambicans. METHODS: A national representative sample (n = 3,323) of subjects aged 25-64 years was evaluated in 2005 following the World Health Organization Stepwise Approach to Chronic Disease Risk Factor Surveillance (STEPS), which included the assessment of tobacco consumption with the quantification of each type of tobacco used daily. We computed prevalences, and age- and education-adjusted prevalence ratios (PRs), with 95% CIs. RESULTS: Daily smoking was reported by 9.1% (95% CI = 5.0-13.1) of women (manufactured, 3.4%; hand-rolled, 5.6%) and 33.6% (95% CI = 29.3-38.0) of men (manufactured, 18.7%; hand-rolled, 14.8%). Daily manufactured cigarette smoking was significantly more frequent in men (urban: PR = 14.62, 95% CI = 7.59-28.55; rural: PR = 4.32, 95% CI = 2.42-7.71). Daily hand-rolled cigarette smoking was three- to fourfold more frequent among men and nearly 80% less frequent in urban areas, regardless of sex. The prevalence of daily smokeless tobacco use was 7.4% (95% CI = 4.6-10.2) in women (chew, 6.4%; snuff, 1.0%) and 3.4% (95% CI = 1.7-5.2) in men (chew, 1.6%; snuff, 1.8%). Daily smokeless tobacco consumption was significantly less frequent in urban areas only among men (PR = 0.05, 95% CI = 0.01-0.33). CONCLUSIONS: Despite the relatively low levels of manufactured cigarette smoking, traditional forms of tobacco consumption are frequent, especially among women and in rural settings, showing the need for control measures to target specifically different patterns of consumption.

Saccharomyces yeast biomass is the second major by-product from brewing industry. It can be of value as a raw material with different uses, however, it is still underutilized, mostly, for swine and ruminant feed. This review aims to give a brief overview on applications for this agro-industrial by-product as a source of nutrients for human and fish nutrition, microbial growth, production and industrial use of brewer's yeast components and highlight the needs for further investigations and research, especially in the areas of production of ingredients for functional foods and the use of brewer's yeast as agents of detoxifying effluents containing heavy metals.

Traumatic injuries are the leading cause of mortality in individuals aged 1-44 years, and brain injury significantly contributes to the outcome in nearly one half of all deaths from trauma. At the intestinal level, traumatic brain injury (TBI) induces profound effects, including gastrointestinal mucosa ischaemia and motility dysfunction. However, nothing is known concerning the effect of TBI on the intestinal absorption of glucose. Hence, the aim of this study was to investigate the effect of TBI on the intestinal absorption of glucose by investigating the effect of TBI on the jejunal mucosal-to-serosal apparent permeability (AP-to-BL P(app)) to two glucose model substrates, (3)H-2-deoxy-D-glucose ((3)H-DG) and (3)H-3-O-methyl-D-glucose ((3)H-OMG), and to (14)C-sorbitol. Additionally, we tested if gadopentetate dimeglumine administration could prevent any of the changes observed after TBI. Traumatic brain injury induced an increase in the AP-to-BL P(app) to (3)H-DG. After a 100-min. perfusion of the jejunum, the AP-to-BL P(app) to (3)H-DG in TBI rats was almost 70% higher than in the control rats. There was no change, however, in the AP-to-BL P(app) to neither (3)H-OMG nor (14)C-sorbitol. Interestingly enough, gadopentetate dimeglumine was able to prevent the increase in the AP-to-BL P(app) to (3)H-DG observed after TBI. Given the differences in transport characteristics between (3)H-DG and (3)H-OMG, our results point to the possibility of the Na(+)-independent glucose transporter 2 (GLUT2) being activated by TBI (as the P(app) to (3)H-DG, a GLUT2 substrate, was increased) and the Na(+)-dependent glucose co-transporter (SGLT1) being inhibited by TBI (as the P(app) to (3)H-OMG, a GLUT2 and SGLT1 substrate, remained unchanged). Moreover, gadopentetate dimeglumine prevented these changes associated with TBI.

Leptin is an adipocyte-secreted hormone which plays a key role in energy homeostasis. Our aim was to determine the relationship between serum leptin and clinical and biochemical features in overweight children and adolescents. Overweight children and adolescents followed in this Unit with serum leptin ascertained were included. Clinical, biochemical and abdominal ultrasound data were analysed. Statistical analysis was performed by t test, χ2, Pearson's correlation and linear regression. One outlier of serum leptin was excluded to perform correlation and regression. Serum leptin was determined in 357 patients. At the first visit, the mean age was 9·5 (sd 3·2) years and mean BMI z-score was 1·72 (sd 1·34) (girls 1·71 (sd 1·16); boys 1·72 (sd 1·11)). Serum leptin levels were significantly related to: sex (mean: girls 48·0 ng/ml, boys 34·4 ng/ml; P = 0·003); Tanner stage (mean: I–II 37·0 ng/ml, III–V 45·2 ng/ml; P = 0·035); systolic blood pressure (mean: normal 41·3 ng/ml, high 44·0 ng/ml; P = 0·009); BMI z-score (r 0·136; P = 0·010); C-peptide (r 0·17; P = 0·002); insulin (r 0·34; P r 0·25; P r − 0·12; P = 0·023). In the multivariate analysis (with leptin as the dependent variable and sex, Tanner stage, BMI z-score, systolic blood pressure, aspartate aminotransferase, C-peptide, insulin and HOMA-IR as independent variables), sex and BMI were determinant factors. The present study in overweight children and adolescents showed that being female and greater BMI were significantly and independently associated with increased serum leptin. In this large cohort other associations with leptin described in the literature can be discharged.

Magalhaes, J., R. Ferreira, F. Marques, E. Olivera, J. Soares, and A. Ascensko. Indoor Climbing Elicits Plasma Oxidative Stress. Med. Sci. Sports Exerc., Vol. 39, No. 6, pp. 955-963, 2007. Purpose: Indoor climbing is a worldwide sport with particular physiological and physical demands. The purpose of this study was to analyze the effect of sustained indoor climbing until exhaustion on plasma oxidative stress markers, and to relate it to whole-body dynamic exercise performed at the same percentage of maximal oxygen uptake (VO2max). Methods: Fourteen male indoor climbers continuously climbed a competition-style route until exhaustion. Oxygen consumption and heart rate were continuously monitored during the climbing exercise. One week later, subjects performed a treadmill running protocol with the same duration and percentage Of VO2max a. as that of climbing exercise. Blood samples were collected at rest, immediately after, and 1h after both exercise protocols to analyze plasma levels of reduced (GSH) and oxidized (GSSG) glutathione, malondialdehyde (MDA), protein sulfhydryl (-SH) and carbonyl (CG) groups, total antioxidant status (TAS) and uric acid (UA), and total blood leukocytes, neutrophil, and lymphocyte counts. Results: Compared with running, climbing significantly increased the %GSSG, MDA, CG, TAS, and UA and decreased the GSH and -SH content. Blood counts of total leukocytes and neutrophils increased immediately after and 1h after both running and climbing (P < 0.05), although counts were higher in climbing than in running (P < 0.05). Lymphocytes significantly increased from baseline to 0 h, although they decreased below baseline 1h after climbing (P < 0.05). Conclusion: Data demonstrate that indoor climbing induces plasma oxidative stress. Moreover, results suggest that an ischemia-reperfusion prooxidant-based mechanism related to climbers' sustained and intermittent isometric forearm muscle contractions might have significantly contributed to observed plasma oxidative stress.

Aim: To analyse the effect of an off-road motocross heat on plasma levels of oxidative stress and damage, blood leucocyte counts and urine catecholamine concentration. Methods: Plasma contents of total, reduced and oxidised (GSSG) glutathione, %GSSG, malondialdehyde (MDA), protein carbonyl and sulphydryl groups, total antioxidant status (TAS), uric acid, and blood neutrophil and lymphocyte counts were evaluated in 10 male top-level riders before, immediately after (0 h) and 1 h after a simulated competitive motocross race. 24-h urine adrenaline, noradrenaline and dopamine concentrations were also measured. Results: The motocross heat resulted in an increase in plasma oxidative stress and damage (p < 0.05). This was shown by a significant increase in %GSSG, TAS, MDA and carbonyls, and by a decrease in sulphydryl groups after the race. There was a significant increase in both plasma uric acid and urine catecholamine concentration after the race (p < 0.05). Blood neutrophil counts increased at 0 and 1 h after exercise (p < 0.05). Lymphocyte count increased from baseline to 0 h, although it decreased from baseline and 0 to 1 h after exercise (p < 0.05). Conclusion: The data reinforce the marked metabolic and hormonal demands imposed by motocross, resulting in a condition of enhanced plasma oxidative stress and damage.

Background Undernutrition has been associated with longer length of hospital stay (LOS). However, an analysis that investigates the association of recommended undernutrition diagnostic and screening indicators with LOS conducted in patients with a varied spectrum of pathologies and considering confounders would help to clarify their clinical value. Objective We aimed to quantify the association of being undernourished as evaluated by different methodologies with LOS and their validity in predicting inpatient LOS. Design A prospective observational study was conducted. Undernutrition was evaluated by the Academy of Nutrition and Dietetics-American Society for Parental and Enteral Nutrition recommended clinical characteristics of malnutrition (AA-CCM) tool, the Patient-Generated Subjective Global Assessment (PG-SGA), the Nutritional Risk Screening (NRS-2002) tool, and the Malnutrition Universal Screening tool (MUST). Handgrip strength (HGS) quartiles by sex and phase angle (PA) categories were also used as indicators of undernutrition. Participants and setting Six hundred eighty-two inpatients from a Portuguese university hospital participated between 2011 and 2013. Main outcome measures LOS was determined between the date of hospital admission and discharge. Statistical analyses performed Kaplan-Meier and adjusted Cox proportional hazard ratio (HR) methods were applied. Results Moderate or severe undernutrition by AA-CCM (HR 0.58, 95% CI 0.49 to 0.69), by PG-SGA (moderate or suspected: HR 0.60, 95% CI 0.49 to 0.73 and severe: HR 0.52, 95% CI 0.42 to 0.64), risk of undernutrition assessed by NRS-2002 (HR 0.61, 95% CI 0.52 to 0.73), by MUST (medium: HR 0.75, 95% CI 0.60 to 0.95 and high: HR 0.67, 95% CI 0.55 to 0.81), HGS quartile (second: HR 0.64, 95% CI 0.50 to 0.80 and first [lowest]: HR 0.50, 95% CI 0.39 to 0.64) and nutritional risk defined by low PA (HR 0.62, 95% CI 0.48 to 0.81) were all independently associated with lower probability of being discharged from the hospital. Conclusions Despite assessing different dimensions of nutritional status, undernutrition by AA-CCM and PG-SGA, risk of undernutrition assessed by NRS-2002 and MUST, and low HGS and PA independently predict longer LOS in hospitalized patients. All these methodologies share a similar validity in predicting LOS.

Background: Handgrip strength (HGS) is a useful indicator of nutrition status in adults, but evidence is lacking in pediatric patients. The aim of this study was to describe the association between undernutrition and HGS in pediatric patients at hospital admission, quantifying the modifying effect of disease severity, anthropometrics, and other patient characteristics on HGS. Materials and Methods: Eighty-nine inpatients aged >= 6 years consecutively admitted were recruited in a longitudinal study. Nutrition status was evaluated using body mass index (BMI) z scores, and HGS was evaluated at admission and discharge. Results: In the total sample, 30.3% of patients were undernourished at admission, and 64% lost HGS during the hospital stay. This study showed that HGS at admission was independently associated with undernutrition defined by BMI z scores (beta = 0.256, P = .037). In this multivariate analysis, sex, age, height, and BMI z scores explained 67.1% of HGS at hospital admission. Conclusion: Lower HGS may be a potential marker of undernutrition in hospitalized pediatric patients, although HGS data should be interpreted according to sex, age, and height of the patient.

The present study aimed to evaluate the association between the consumption of energy-dense foods at 2 years of age and the consumption of foods and diet quality at 4 years of age. The sample included 705 children evaluated at 2 and 4 years of age, as part of the population-based birth cohort Generation XXI (Porto, Portugal). Data on sociodemographic and lifestyle factors of both children and mothers were collected by face-to-face interviews. The weight and height of children were measured by trained professionals. Based on FFQ, four energy-dense food groups were defined: soft drinks; sweets; cakes; salty snacks. A healthy eating index was developed using the WHO dietary recommendations for children (2006) aged 4 years. The associations were evaluated through Poisson regression models. After adjustment for maternal age and education, child's carer, child's siblings and child's BMI, higher consumption of energy-dense foods at 2 years of age was found to be associated with higher consumption of the same foods 2 years later. An inverse association was found between the intake ( ≥ median) of soft drinks (incidence rate ratio (IRR) = 0·74, 95 % CI 0·58, 0·95), salty snacks (IRR = 0·80, 95 % CI 0·65, 1·00) and sweets (IRR = 0·73, 95 % CI 0·58, 0·91) at 2 years of age and the consumption of fruit and vegetables at 4 years of age ( ≥ 5 times/d). Weekly and daily consumption of energy-dense foods at 2 years of age was associated with a lower healthy eating score at 4 years of age (IRR = 0·75, 95 % CI 0·58, 0·96; IRR = 0·56, 95 % CI 0·41, 0·77, respectively). The consumption of energy-dense foods at young ages is negatively associated with the diet quality of children a few years later.

Several studies have pointed adverse effects of long term migration on eating habits. Research is needed to understand if this effect occurs also with a short length of migration, as is the case of international students. Our aim was to evaluate the effect of short and long term migration on eating habits of Portuguese university students. Participants were 46 English and 55 Portuguese students from universities in London, United Kingdom. The findings from this study highlight the difficulties that Portuguese students faced in maintaining a traditional Mediterranean diet after moving to a Northern European environment.

Summary Background & aims Undernutrition has been associated with an increased length of hospital stay which may reflect the patient prognosis. The aim of this study was to quantify and compare the association between nutritional status and handgrip strength at hospital admission with time to discharge in cancer patients. Methods An observational prospective study was conducted in an oncology center. Patient-Generated Subjective Global Assessment, Nutritional Risk Screening 2002 and handgrip strength were conducted in a probabilistic sample of 130 cancer patients. The association between baseline nutritional status, handgrip strength and time to discharge was evaluated using survival analysis with discharge alive as the outcome. Results Nutritional risk ranged from 42.3 to 53.1% depending on the tool used. According to Patient-Generated Subjective Global Assessment severe undernutrition was present in 22.3% of the sample. The association between baseline data and time to discharge was stronger in patients with low handgrip strength (adjusted hazard ratio, low handgrip strength: 0.33; 95% confidence interval: 0.19–0.55), compared to undernourished patients evaluated by the other tools; Patient-Generated Subjective Global Assessment: (adjusted hazard ratio, severe undernutrition: 0.45; 95% confidence interval: 0.27–0.75) and Nutritional Risk Screening 2002: (adjusted hazard ratio, with nutritional risk: 0.55; 95% confidence interval: 0.37–0.80). Conclusions An approximate 3-fold decrease in probability of discharge alive was observed in patients with low handgrip strength. Decreasing handgrip strength tertiles allowed to discriminate between patients who will have longer hospital stay, as well as undernutrition and nutritional risk assessed by Patient-Generated Subjective Global Assessment and Nutritional Risk Screening 2002.

There is a paucity of dietary data in football referees. In this study, 23 elite main and assistant referees (34.4 +/- 5.6 years) completed a 7-day dietary record during the competitive season. No nutritional intake differences were observed between main and assistant referees. Referees' mean daily energy intake (DEI) was 2819 +/- 279 kcal. The intake of proteins (1.7 +/- 0.2 g . kg(-1)), carbohydrates (4.1 +/- 0.8 g . kg(-1)) and fats (1.4 +/- 0.2 g . kg(-1)) represented, respectively, 18.4 +/- 1.5%, 44.4 +/- 4.4% and 34.6 +/- 4.1% of the DEI. Carbohydrate intakes before, during and after exercise were 66 +/- 42, 7 +/- 15 and 120 +/- 62 g. Daily carbohydrate, fibre, polyunsaturated fat and water intakes were below recommendations, while fat, saturated fat, cholesterol and sodium intakes were above recommended values. The prevalence of inadequate intake was high for vitamin E (96%), folate (74%), vitamin A (61%), vitamin C (39%), magnesium (26%) and calcium (22%). Carbohydrate intake before, during and after exercise were far from achieving the minimum recommended values. Most referees demonstrated a negligent behaviour of hydration during exercise. Referees would benefit from dietary education in order to optimise performance and health.

Background:The aim of the current study was to verify if physical activity (PA) behavior (steps/day) was associated with environmental features that may be able to promote PA and walking in a sample of Portuguese adolescents living in the Azorean Archipelago.Methods:The sample comprised 948 adolescents aged 15–18 years (543 girls) from the Azorean Physical Activity Health Study II. PA was objectively measured with pedometers. Participants were classified as active if they belong to percentile 75th (by age and gender) or more. Environmental perceptions were assessed with a questionnaire. Binary logistic regression analyzed relationships between PA and environmental perceptions controlling for age, body mass index, gender and socioeconomic status.Results:Regression analysis showed that participants with a positive overall perception in the transportation dimension were 44.2% (OR = 1.442, P = .025) more likely to be classified as active than those with a negative overall perception. No significant results were found for safety, aesthetics and facilities dimensions.Conclusions:A positive overall perception of the transportation dimension was positively associated with PA in Azorean Adolescents. Future health promotion strategies aimed to increase PA in this population should consider the environmental features that are associated with PA levels.

BACKGROUND: Chronic illnesses are diseases of long duration and generally of slow progression. They cause significant quality of life impairment. The aim of this study was to analyse psychosocial predictors of quality of life and of subjective well-being in chronic Portuguese patients. METHODS: Chronic disease patients (n = 774) were recruited from central Portuguese Hospitals. Participants completed self-reported questionnaires assessing socio-demographic, clinical, psychosocial and outcome variables: quality of life (HRQL) and subjective well-being (SWB). MANCOVA analyses were used to test psychosocial factors as determinants of HRQL and SWB. RESULTS: After controlling for socio-demographic and clinical variables, results showed that dispositional optimism, positive affect, spirituality, social support and treatment adherence are significant predictors of HRQL and SWB. Similar predictors of quality of life, such as positive affect, treatment adherence and spirituality, were found for subgroups of disease classified by medical condition. CONCLUSIONS: The work identifies psychosocial factors associated with quality of life. The predictors for the entire group of different chronic diseases are similar to the ones found in different chronic disease subgroups: positive affect, social support, treatment adherence and spirituality. Patients with more positive affect, additional social support, an adequate treatment adherence and a feel-good spirituality, felt better with the disease conditions and consequently had a better quality of life. This study contributes to understanding and improving the processes associated with quality of life, which is relevant for health care providers and chronic diseases support. This study was supported by a grant from the Fundação para a Ciência e Tecnologia (PTDC/PSI/71635/2006, PTDC/PSI/ 73175/2006, SFRH/PROTEC/49284/2008)

Background and Objective: Handgrip strength is a relevant marker of functional status and is also a component of nutrition assessment. The simplicity of this measurement supports its usefulness as a tool to predict who will likely take longer to hospital discharge. The aim of this study was to quantify the association between sex-specific handgrip strength at hospital admission and time to discharge alive. We intended to include a group of diverse diagnoses and to compare medical and surgical wards, taking into account the potential confounders' effect of patients' characteristics and severity of disease. Subjects and Methods: Prospective study in 2 public acute-care general hospitals in Porto, Portugal, in 2004. Handgrip strength was evaluated using a handgrip dynamometer in a probability sample of 425 patients from medical and surgical wards. The association between baseline handgrip strength and time to discharge was evaluated using survival analysis with discharge alive as the outcome and deaths and transfers being censored. Results: In medical wards, women with high admission handgrip strength had a very short hospital stay (all had been discharged by the sixth day), and among men, patients with low handgrip strength had a particularly longer stay (approximately 50% were discharged after 15 days of hospitalization). In surgical wards, an increasing length of stay with decreasing handgrip strength quartiles was also observed in both sexes. Conclusions: Lower handgrip strength at hospital admission was associated with a longer time in the hospital, in patients of both sexes, in medical and surgical wards. Although this association was explained in part by age, height, education level, cognitive status, and disease severity, its direction remained unchanged regardless of the aforementioned factors.

Aim: To estimate the proportion of Mozambicans eligible for pharmacological treatment for hypertension, according to single risk factor and total cardiovascular risk approaches. Methods: A representative sample of Mozambicans aged 40-64 years (n¼1116) was evaluated according to the WHO STEPwise Approach to Chronic Disease Risk Factor Surveillance (STEPS). We measured blood pressure (BP) and 12-h fasting blood glucose levels and collected data on sociodemographic characteristics, smoking, and use of antidiabetic and antihypertensive drugs. We estimated the 10-year risk of a fatal or nonfatal major cardiovascular event (WHO/International Society of Hypertension risk prediction charts), and computed the proportion of untreated participants eligible for pharmacological treatment for hypertension, according to BP values alone and accounting also for the total cardiovascular risk (WHO guidelines for assessment and management of cardiovascular diseases). Results: Among the Mozambicans aged 40-64 years and not taking antihypertensive drugs, less than 4% were classified as having cardiovascular risk at least 20% whereas the prevalence of SBP/DBP at least 140/90mmHg was nearly 40%. A total of 19.8% of 40-64-year-olds would be eligible for pharmacological treatment of hypertension according to the WHO guidelines, all of whom had SBP/DBP at least 160/100mmHg. Conclusion: Among the Mozambicans aged 40-64 years not taking antihypertensive drugs and having SBP/DBP at least 140/90 mmHg, only half were eligible for pharmacological treatment according to the WHO guidelines. Taking the latter into account, when defining strategies to control hypertension at a population level, may allow a more efficient use of the scarce resources available in developing settings. Keywords: diabetes mellitus, hypertension, Mozambique, risk assessment, smoking Abbreviations: BP, blood pressure; FBG, fasting blood glucose; ISH, International Society of Hypertension; STEPS, STEPwise Approach to Chronic Disease Risk Factor Surveillance; USD, United States Dollar

Purpose and methods Acute acalculous cholecystitis (AAC) is an uncommon condition related to serious clinical conditions, such as surgery, trauma, burn injuries and sepsis. The diagnosis of AAC remains challenging to make, since it generally occurs as a secondary event in acutely ill patients with another disease. Imaging evaluation is crucial, and welknown criteria are accepted for the diagnosis. To our knowledge, only case reports of AAC related to 12 malaria adult patients have been published. In this series, seven cases of AAC from a cohort of 42 adult patients with severe imported falciparum malaria [according to the World Health Organization (WHO) criteria] are presented. The aim is to report the cases and look for malaria conditions that may affect the incidence of this unusual malaria complication. Results Ultrasonography revealed gallbladder with wall thickening in all patients, plus other(s) major criteria. Each patient presented five to nine WHO severe malaria criteria: all had hyperparasitaemia and hyperbilirubinaemia. All patients developed renal failure, six pulmonary oedema/ acute respiratory distress syndrome (ARDS) (five were mechanically ventilated) and five shock. Treatment was non-operative in five patients, cutaneous cholecystostomy was done in two and the outcome was favourable in all. Conclusions Patients with AAC have significantly more commonly five or more criteria of severe malaria: renal insufficiency, pulmonary oedema/ARDS, parasitaemia higher than 30 %, nosocomial infection and a prolonged intensive care unit (ICU) stay. Increased awareness for this unusual and potentially severe complication of malaria is needed.

Background: Growth trends have never been studied inadolescents of the Autonomous Region of Madeira, Portugal.Aims: To analyse growth trends in weight, height, body massindex (BMI), waist circumference (WC), mid-upper armcircumference (MUAC) and triceps skin-fold thickness (TST) ofadolescents (10-17 years old) of the Autonomous Region ofMadeira between 1996- 1998 and 2007-2009.Subjects and methods: A cross-sectional study was carried outbetween 2007- 2009, including 4314 adolescents, 2237 girlsand 2077 boys (10- 17 years old). To study secular growthtrends, data were compared with a sample from 1996 -1998,comparing the means for each anthropometric variable by ageand sex using the independent-sample t-test.Results: An average increase was found in weight of 5.8 kg inboys and 6.3 kg in girls; in height of 3.0 cm in boys and 3.7 cmin girls; in BMI of 1.5 kg/m2in boys and 1.7 kg/m2in girls; in WCa difference of 5.6 cm and 4.9 cm for boys and girls,respectively, and for MUAC a difference of 2.7 cm in boys and2.0 cm in girls. No differences were found in TST in boys, but ingirls an increase of 1.2 mm was observed.Conclusions: A general increase in anthropometricmeasurements, more marked in weight, BMI, WC and MUACand at younger ages, was observed.

Background It is important to understand the psycho-social context of obesity to inform prevention and treatment of obesity at both the individual and public health level. Methods Representative samples of middle-aged adults aged ≥43 years were recruited in Great Britain (GB) (n = 1182) and Portugal (n = 540) and interviewed to explore associations between body mass index (BMI), waist circumference (WC), demographic factors, physical activity, dietary habits (FFQ), life events (LES), Resilience (RS11), Mood (MS), Hopelessness (BDI) and Perceived Stress (PSS4). BMI (kg/m2) and WC (cm) were dependent variables in separate multiple linear regression models for which predictors were entered in 4 blocks: 1. demographic factors; 2. stressful life events; 3. diet/activity; and, 4. psychological measures. Results In the GB sample, BMI (kg/m2) was predicted by less education, illness in a close friend or relative, frequent alcohol consumption and sedentary behaviour. Among the Portuguese, higher BMI (kg/m2) was predicted by lower resilience. Being male and less education were independent predictors of having a larger WC (cm) in both countries. Within GB, not working, illness in a close friend or relative, sedentary lifestyle and lower resilience were also independent predictors of a larger WC (cm). Conclusions These data suggest that intervention to treat and/or prevent obesity should target males, particularly those who have left education early and seek to promote resilience. In GB, targeting those with high alcohol consumption and encouraging physical activity, particularly among those who have experienced illness in a close friend or relative may also be effective in reducing obesity.

This paper describes the BiomedTK software framework, created to perform massive explorations of machine learning classifiers configurations for biomedical data analysis over distributed Grid computing resources. BiomedTK integrates ROC analysis throughout the complete classifier construction process and enables explorations of large parameter sweeps for training third party classifiers such as artificial neural networks and support vector machines, offering the capability to harness the vast amount of computing power serviced by Grid infrastructures. In addition, it includes classifiers modified by the authors for ROC optimization and functionality to build ensemble classifiers and manipulate datasets (import/export, extract and transform data, etc.). BiomedTK was experimentally validated by training thousands of classifier configurations for representative biomedical UCI datasets reaching in little time classification levels comparable to those reported in existing literature. The comprehensive method herewith presented represents an improvement to biomedical data analysis in both methodology and potential reach of machine learning based experimentation.

ResumoA análise de células orais esfoliadas permite a avaliação de biomarcadores para dano genómico, potencial proliferativo e morte celular, adquirindo particular relevância em indivíduos com inflamação crónica do epitélio oral. O objetivo deste trabalho foi elaborar um estudo piloto para caracterização dos tipos celulares da mucosa oral em indivíduos com diferentes graus de saúde periodontal. Para o efeito, procedeu-se à análise de mil células orais esfoliadas em dez participantes (não fumadores, entre os 50-65 anos e sem antecedentes pessoais de cancro) divididos de acordo com o seu estado periodontal: 5 controlos (periodonto saudável/ periodontite leve) e 5 casos (periodontite moderada/ grave). Nesta análise observou-se um maior número de células basais, cariolíticas e células com micronúcleos nos indivíduos com periodontite moderada/grave. Estes resultados revestem-se de grande interesse, uma vez que não existem estudos publicados que relacionem a frequência destes tipos celulares com o estado de saúde periodontal dos indivíduos.AbstractThe characterization of oral exfoliated cells evaluates genomic damage, proliferative potential and/or cell death and is of great interest, namely in individuals with oral mucosa chronic inflammation. Our aim was to set up a pilot study to characterize the cell types of the buccal mucosa according to periodontal status. For this purpose, we analyzed different cell types obtained per one thousand exfoliated buccal cells in 10 selected participants (non-smokers, aged between 50-65 years, without history of cancer) divided according to their periodontal status: 5 controls (with healthy periodontium/mild periodontitis) and 5 cases (with moderate/severe periodontitis). Our data showed an increased number of micronuclei, basal and karyolytic cells in the group with moderate/severe periodontitis. These results are very interesting since, to our knowledge, there are no studies relating the frequency of different cell types in the buccal mucosa with periodontal health status.

ObjectiveThere are no percentile curves for BMI, waist circumference (WC) or waist-to-height ratio (WHtR) available for Portuguese children and adolescents. The purpose of the present study was to develop age- and sex-specific BMI, WC and WHtR percentile curves for a representative sample of adolescents living in the Portuguese islands of Azores, one of the poorest regions of Europe, and to compare them with those from other countries.DesignCross-sectional school-based study. Weight, height and WC were objectively measured according to standard procedures. Smoothed percentile curves were estimated using Cole's LMS method.SettingAzores, Portugal.SubjectsProportionate stratified random sample of 1500 adolescents, aged 15–18 years.ResultsResults showed some sex differences in the shape of the BMI curves: in girls, the upper percentile values tend to decrease by the age of 16 and 17 years; whereas in boys, the upper percentiles tend to be flat between 15 and 16 years and then increase until the age of 18 years. In both sexes, the upper percentile values of both WC and WHtR decreased slightly by the age of 16 years and then increased steeply. In both sexes, the Azorean values for the 50th and 90th WC percentiles were higher than those reported for adolescents from the majority of other countries.ConclusionsThe reference curves presented herein provide baseline data for the long-term surveillance of Azorean adolescents, as well as for national and international comparisons.

Background Several studies have demonstrated an association between the exposure to indoor air pollution (IAP) and childhood asthma. Evidence is suggesting that several air pollutants may contribute to both exacerbation and development of asthma, but some uncertainty remains concerning the specific causative role of IAP. This paper reports an epidemiologic study aiming to reduce the existing lacks on the association between long-term exposure to pollution mixtures and the development and exacerbation of childhood asthma. Methods/design Based on the implementation of the study in 8 nurseries and 8 primary schools, from which, 2 nurseries and 2 primary schools in sites influenced by traffic and other 2 nurseries and 2 primary schools in background sites at urban and rural areas, the study will analyse the exposure to both urban and rural pollution as well as to traffic emissions (some homes of the children will be included in the study). Furthermore, based on the answers to validated questionnaires (as those used in the International Study of Asthma and Allergies in Childhood - ISAAC) filled in by the parents and on medical exams, the study will assess the prevalence, incidence and exacerbation of asthma, thus considering both short and long-term effects. The approximate number of children in the study will never be less than 600, guaranteeing 80% of study power (significant at a 5% level). Discussion This study intends to contribute for the understanding of the role of environmental factors, namely indoor air pollution, on asthma considering a risk group of different ages, and for the development of preventive measures, which are considered priority issues by the European Commission, according to the European Environmental Agency and the World Health Organization.

European consumer willingness to purchase fat-modified foods was surveyed as part of the LIPGENE study. Representative samples of consumers ( n = 5967) were interviewed in six countries (France, Great Britain, Portugal, Germany, Poland, and Italy). Of these 2025 were considered as “reporters” who indicated having at least one of: high cholesterol; high blood pressure; central obesity; and/or high blood sugar. Perceived risk from these conditions was also assessed on a 10-point scale. Principal component analysis suggested that those who perceived themselves at greater risk of conditions associated with metabolic syndrome, and those who were reporters, more frequently indicated willingness to purchase “healthy” fat-modified food products. The most preferred ‘vehicles’ for fat modification were fish and cheese. Acceptance of fat-modified fish, red meat and cheese product concepts, both standard and GM was positively associated with perceived risk of conditions associated with metabolic syndrome. Over 20% of reporters were willing to purchase GM fat-modified fish and cheese products. Our results indicate that if standard and GM fat-modified food products can be shown to ameliorate the risks presented by conditions associated with metabolic syndrome, there is a ready market for such foods.

Rats were daily exposed (eight hours/day) for a period of four weeks to the same high-intensity wideband noise that was recorded before in a large textile plant. Histologic observation of liver sections of the rats was used to perform quantitative comparison of hepatic connective tissue (dyed by Masson trichromic staining) between the noise-exposed and control animals. For that, we have photographed at random centrolobular areas of stained rat liver sections. We found that noise exposure resulted in significant enhancement in the area of collagen-rich connective tissue present in the centrolobular domain of the rat liver. Our data strengthen previous evidence showing that fibrotic transformation is a systemic effect of chronic exposure of rodents and humans to industrial wideband noise.

Objective: The aim of this study was to verify the influence of a specific exercise program on the strength and resistance levels of lumbar flexors and extensors in warehouse workers. Materials and Methods: The population used in this randomized controlled trial included 557 warehouse male workers from a food distribution company in Oporto/Portugal. Upon the application of the selection criteria, 98 workers deemed eligible were randomized in two groups: 57 were assigned to the intervention group and 41 to the control group. The intervention included 9 easily-executed exercises to promote stretching and strengthening of the lumbar region, to be executed daily, at the beginning of the working time, at the company facilities and lasting 8'. Trunk muscles' voluntary strength and resistance were measured using an isometric electronic dynamometer (Globus Ergometer, Globus, Codigne, Italy) at baseline and eleven months after implementing the exercise program. The data was analyzed using SPSS (R), version 17.0. Results: After implementation of the exercise program, in the intervention group, all variables increased, significant differences were observed as for the muscle strength and resistance values (p = 0.014 and p = 0.006, respectively), as well as in the ratio extensors/flexors (p = 0.037). In the control group, all variables decreased, with a statistically significant decrease of the trunk flexors strength level (p = 0.009). Conclusion: The results of this study suggest that a specific exercise intervention program can increase trunk extensors strength and resistance.

ObjectiveTo assess the association between sugar-sweetened beverage (SSB) consumption and overweight in children from a Mediterranean country.DesignThe children’s dietary intake was measured using a semi-quantitative FFQ completed by the parents. Overall, 2512 questionnaires were returned and 837 children were removed, leaving a final sample of 1675 children, aged between 5 and 10 years. Height and weight were measured according to international standards, and BMI was calculated. The definition of overweight and obesity was based on average centiles according to the International Obesity Task Force cut-offs. To determine the magnitude of the association between SSB consumption and overweight, OR estimates, including CI, were computed using unconditional logistic regression, adjusting for confounders.SettingElementary schools throughout the city of Porto, Portugal.SubjectsWe invited 5867 children, randomly selected, and their parents to participate in the study. Of those schools that agreed to take part, 3391 parents signed and returned the fully filled out consent form.ResultsThe prevalence of overweight (including obesity) was 36·6 % for girls and 38·8 % for boys. With regard to SSB consumption (serving/d), no differences between with overweight and non-overweight children were found even after adjustment for confounders (1–2 servings/d: OR = 1·67, 95 % CI 0·76, 3·66, in girls; OR = 1·63, 95 % CI 0·76, 3·47, in boys; and >2 servings/d: OR = 0·63, 95 % CI 0·33, 1·22, in girls; OR = 0·64, 95 % CI 0·33, 1·52, in boys).ConclusionsThe intake of SSB was not associated with increased risk of overweight in Portuguese schoolchildren.

This study aimed to assess the quality of life (QOL) experienced by adolescents and young adults with congenital heart disease (CHD) and to determine which factors negatively affect adjustment and which factors increase resilience. The participants in the study were 74 patients with CHD (41 males and 33 females) ranging in age from 12 to 26 years (mean age, 18.76 ± 3.86 years). Demographic information and a complete clinical history were obtained. The participants were interviewed regarding topics such as social support, family educational style, self-image, and physical limitations. They responded to questions in a standardized psychiatric interview (SADS-L) and completed a self-report questionnaire (WHOQOL-BREF) for assessment of QOL. Compared with the Portuguese population as a whole, the study patients had better QOL, especially with regard to the environmental dimension (t = 3.754; P = 0.000) and social relationships (t = 2.333; P = 0.022). Patients who had undergone surgery experienced poorer QOL in the physical dimension (t = -1.989; P = 0.050), in social relationships (t = -2.012; P = 0.048) and overall (Mann-Whitney U = 563.000; P = 0.037). Social support played a positive role in the QOL of the patients, both in the physical dimension (t = 3.287; P = 0.002) and in social relationships (t = 3.669; P = 0.000). A higher school achievement also was associated with higher levels of QOL overall (Mann-Whitney U = 457.000; P = 0.046) as well as in the physical (t = 2.045; P = 0.045) and environmental (t = 2.413; P = 0.018) dimensions. Physical limitations had a detrimental impact on general QOL (Mann-Whitney U = 947.500; P = 0.001) and on the physical (t = -2.910; p = 0.005) and psychological (t = -2,046; P = 0.044) dimensions. Patients with CHD tended to perceive QOL as better when their social networks were supportive.

Western-type diets (WD) constitute risk factors for disease but may have distinct effects in heart failure (HF) with cardiac cachexia (CC). We evaluated hemodynamic, metabolic, and inflammatory effects of short-term WD intake in pulmonary hypertension (PH) with CC. Male VVistar rats randomly received 60 mg . kg(-1) monocrotaline (M) or vehicle (C) and consumed either a 5.4-kcal . g(-1) WD (35% animal fat, 35% simple carbohydrate, 20% protein, 0.4% Na(+)) or a 2.9-kcal . g(-1) (3% vegetable fat, 60% complex carbohydrate, 16% protein, 0.25% Na(+)) normal diet (ND) for 5 wk. Mortality, energy intake, body weight (BW), metabolism, hemodynamics, histology, apoptosis, gene expression, transcription factors, and plasma cytokines were evaluated. Compared with the C-ND group, the M-ND group had PH, HF, and mortality that were significantly attenuated in M-WD. The extent of myocardial remodeling and apoptosis was higher in M-ND than in C-ND but lower in M-WD than in M-ND, while conversely, energy intake, BW, cholesterol, and TG plasma concentrations were lower in M-ND than in C-ND but higher in M-WD than in M-ND. M-ND had increased myocardial NF-kappa B transcription factor activity, endothelin-1, and cytokine overexpression and higher circulating cytokine concentrations than C-ND, which were lower in M-WD than in M-ND. PPAR alpha activity, however, was lower in M-ND, but not in M-WD, compared with the respective C groups. WD attenuated PH and CC, ameliorating survival, myocardial function, metabolism, and inflammation, through transcription factor modulation, suggesting a beneficial role in CC. J. Nutr. 141: 1954-1960, 2011.

This study aimed to describe alcohol consumption in Mozambique, discriminating binge drinking behaviour and the weekday variation in drinking patterns, and to quantify the association between socio-demographic characteristics and alcohol intake. A representative sample of 3265 Mozambicans aged 25–64 years was evaluated in 2005 following the World Health Organization Stepwise approach to Chronic Disease Risk Factor Surveillance (STEPS). The consumption of any type of alcoholic beverage, during life and in the previous year, was recorded. Current drinkers were also asked about the number of standard drinks consumed in each day of the previous week. The overall prevalence of current dinking was 28.9% [95% confidence interval (95% CI): 22.6–35.2] in women and 57.7% (95% CI: 49.8–65.7) in men. Forty percent of the current drinkers reported to have had at least one binge drinking occasion in the previous week. The prevalence of current drinking increased with age and education among women and with income among men. No consistent pattern was observed in binge drinking by education in both genders and by annual income among men, but it was significantly less frequent among the more affluent women. Both drinking and binge drinking peaked at the weekend. Knowing the drinking patterns in Mozambique enables the planning of interventions according to the local needs. Future surveys should also include non-adult populations as risk factors for chronic diseases occurs as early as childhood and adolescence, and are associated with increased risk of disease later in life.

Excess weight may be related to the development of adverse cardiometabolic risk factors in children. The aim of this study was to evaluate the effect of a lifestyle intervention program (nutrition and exercise counseling) on anthropometric parameters and metabolic syndrome (MS) components in Portuguese overweight/obese children. A total of 83 overweight/obese children aged 7-9 years were assigned to a 1-year individual or group-based treatment (GT); 61 children (z-score BMI (zBMI): 1.93 +/- A 0.28; 27 boys and 34 girls) completed the program. Anthropometric and biochemical parameters were assessed at baseline, at 6 months and at 1 year. The overweight/obese children, compared to normal-weight ones, presented significantly higher blood pressure, total-cholesterol, total-cholesterol/high density lipoprotein cholesterol (HDL) ratio, triglycerides, Apolipoprotein B and C-reactive protein levels, while HDL and Apolipoprotein A-I were significantly lower. At baseline, the prevalence of MS was 16.4% in overweight/obese and 0% in normal-weight children. The number of components of MS was significantly higher in children with higher zBMI. Lifestyle intervention led to a significant improvement in zBMI, waist circumference/height ratio, HDL, triglycerides, Apolipoprotein A-I, and Apolipoprotein B levels. The prevalence of MS decreased to 14.8%. The GT intervention seems to be more successful, with a significant decrease in zBMI and an increase in HDL and a lower drop-out rate. Overweight/obese children have multiple risk factors associated with the MS. Lifestyle intervention, both individual and group-based treatment, led to an improvement in the degree of overweight/obesity and in MS components. Excess weight may be related to the development of adverse cardiometabolic risk factors in children. The aim of this study was to evaluate the effect of a lifestyle intervention program (nutrition and exercise counseling) on anthropometric parameters and metabolic syndrome (MS) components in Portuguese overweight/obese children. A total of 83 overweight/obese children aged 7-9 years were assigned to a 1-year individual or group-based treatment (GT); 61 children (z-score BMI (zBMI): 1.93 +/- A 0.28; 27 boys and 34 girls) completed the program. Anthropometric and biochemical parameters were assessed at baseline, at 6 months and at 1 year. The overweight/obese children, compared to normal-weight ones, presented significantly higher blood pressure, total-cholesterol, total-cholesterol/high density lipoprotein cholesterol (HDL) ratio, triglycerides, Apolipoprotein B and C-reactive protein levels, while HDL and Apolipoprotein A-I were significantly lower. At baseline, the prevalence of MS was 16.4% in overweight/obese and 0% in normal-weight children. The number of components of MS was significantly higher in children with higher zBMI. Lifestyle intervention led to a significant improvement in zBMI, waist circumference/height ratio, HDL, triglycerides, Apolipoprotein A-I, and Apolipoprotein B levels. The prevalence of MS decreased to 14.8%. The GT intervention seems to be more successful, with a significant decrease in zBMI and an increase in HDL and a lower drop-out rate. Overweight/obese children have multiple risk factors associated with the MS. Lifestyle intervention, both individual and group-based treatment, led to an improvement in the degree of overweight/obesity and in MS components.

As recently described, adherence to the Mediterranean diet is associated with improved asthma control. However, evidence of how specific nutrients such as fatty acids and antioxidants may affect this relationship remains largely unknown. We aimed to examine the association between dietary intake of fatty acids and antioxidants and asthma control. A cross-sectional study was developed in 174 asthmatics, mean age of 40 (sd 15) years. Dietary intake was obtained by a FFQ, and nutritional content was calculated using Food Processor Plus™ software (ESHA Research, Inc., Salem, OR, USA). Good asthma control was defined by the combination of forced expiratory volume during the first second, exhaled NO (eNO) and Asthma Control Questionnaire (ACQ) score (control: forced expiratory volume in the first second ≥ 80 %; eNO ≤ 35 ppb; ACQ n-6:n-3 PUFA ratio predicted high eNO, whereas high intakes of n-3 PUFA, α-linolenic acid (ALA) and SFA were associated with low eNO. Odds for controlled asthma improved along with an increased intake of n-3 PUFA (OR 0·14, 95 % CI 0·04, 0·45; P for trend = 0·001), SFA (OR 0·36, 95 % CI 0·13, 0·97; P for trend = 0·047) and ALA (OR 0·18, 95 % CI 0·06, 0·58; P for trend = 0·005). A high n-6:n-3 PUFA ratio increased the odds for uncontrolled asthma (OR 3·69, 95 % CI 1·37, 9·94; P for trend = 0·009), after adjusting for energy intake, sex, age, education and use of inhaled corticosteroids. Higher intakes of n-3 PUFA, ALA and SFA were associated with good asthma control, while the risk for uncontrolled asthma increased with a higher n-6:n-3 PUFA ratio. The present results introduce a protective effect of ALA in asthma control, independent of marine n-3 fatty acids, and provide a rationale to dietary intervention studies in asthma.