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Abstract Cell membrane‐coated biomimetic nanosystems have been recognized as promising drug delivery vehicles in recent years for the management of diverse skin conditions. Nanoparticles (NPs) coated with biomembranes, derived from either cell membranes or subcellular structures (e.g., extracellular vesicles), offer an opportunity to combine the biological interfacial characteristics of the coating alongside with the internal core component at the nanoscale. The biomimetic coating enhances the biocompatibility of NPs and their interaction with the skin, improving skin affinity, contact, and retention. This coating also enables the controlled release of drugs and provides skin‐targeting capabilities, which collectively improve the effectiveness, safety, and stability of topical and transdermal formulations. In this context, the current review delves into the recent progress in using biomimetic NPs for skin therapeutics. Specifically, it examines the various types of coatings, including their origins, heterogeneous functions, and surface molecular repertoires, in great detail. Additionally, this review presents the methods of preparing and characterizing biomimetic‐coated NPs. Furthermore, the potential of bioinspired NPs in treating a range of skin‐related conditions has been meticulously explored. Last, the toxicological aspects of these NPs have been thoroughly examined to provide a thorough summary of the evolution of biomimetic‐coated nanosystems for skin applications.

Highlights • Empirical research on student participation in school management has increased significantly in recent years. • Countries have local and specific education policies that define student participation in school management. • Education policy defines places for student participation, but there are sociocultural barriers in the governance structure. • Student participation in school management is mostly in student councils, through class representatives, and only as an advisory body. • Students create new movements and initiatives, with practices beyond the conventional and formal at schools. Purpose: To know and study the participation of young students and their voice in decision-making in their schools in a competitive education regulated by excellence. To understand if and how students are involved in the democratic management of schools, given that these young people are involved globally, with an active participation in society. Design: A systematic literature review on student participation in democratic school management, identifying empirical studies from various countries with different theoretical frameworks and methodologies. Findings: There are several democratic practices and experiences of student participation in schools, despite sociocultural barriers in some countries. However, the participatory and democratic discourses identified in schools, including those in educational policy, do not directly impact the possibilities for students to participate in decision-making.

A patologia tiroideia, designadamente o hipotiroidismo, é uma situação comum e habitualmente gerida em cuidados de saúde primários. No seu estudo inicial é importante considerar a hipótese de tiroide lingual, ainda que se trate de anomalia rara. Utente do sexo feminino, 48 anos de idade, transferida recentemente de outra unidade de saúde, apresenta-se na sua primeira consulta programada. Refere que no início da sua adolescência, após realização de ecografia à tiroide, terá sido informada de que “nasceu sem tiroide” (sic), pelo que se encontra medicada com levotiroxina 0,175 mg uma vez por dia. Como antecedentes familiares de relevo menciona que a mãe e a sobrinha apresentam patologia tiroideia. Ao exame objetivo não se verificaram outras alterações para além de, à palpação cervical, não apresentar tecido tiroideu na sua normal localização pré-traqueal. A ecografia da tiroide realizada revelou ausência de tiroide na sua topografia habitual. O estudo analítico da função tiroideia não revelou alterações. Foi então solicitada cintigrafia da tiroide que demonstrou um foco de captação do radiofármaco na topografia do pavimento da boca sobre a linha média, compatível com tecido tiroideu funcionante em localização ectópica. A utente foi referenciada a consulta de cirurgia geral e proposta para cirurgia de ressecção da tiroide ectópica, a qual decorreu sem intercorrências. O médico de família tem uma posição privilegiada no estudo e orientação dos seus utentes, tendo sido, neste caso, fulcral a investigação desencadeada pela suspeição de uma entidade rara, mesmo anos após o diagnóstico inicial de hipotiroidismo.

Abstract Background Cognitive impairment is a critical aspect of our aging society. Yet, it receives inadequate intervention due to delayed or missed detection. Dual-task gait analysis is currently considered a solution to improve the early detection of cognitive impairment in clinical settings. Recently, our group proposed a new approach for the gait analysis resorting to inertial sensors placed on the shoes. This pilot study aimed to investigate the potential of this system to capture and differentiate gait performance in the presence of cognitive impairment based on single- and dual-task gait assessments. Methods We analyzed demographic and medical data, cognitive tests scores, physical tests scores, and gait metrics acquired from 29 older adults with mobility limitations. Gait metrics were extracted using the newly developed gait analysis approach and recorded in single- and dual-task conditions. Participants were stratified into two groups based on their Montreal Cognitive Assessment (MoCA) global cognitive scores. Statistical analysis was performed to assess differences between groups, discrimination ability, and association of gait metrics with cognitive performance. Results The addition of the cognitive task influenced gait performance of both groups, but the effect was higher in the group with cognitive impairment. Multiple dual-task costs, dual-task variability, and dual-task asymmetry metrics presented significant differences between groups. Also, several of these metrics provided acceptable discrimination ability and had a significant association with MoCA scores. The dual-task effect on gait speed explained the highest percentage of the variance in MoCA scores. None of the single-task gait metrics presented significant differences between groups. Conclusions Our preliminary results show that the newly developed gait analysis solution based on foot-worn inertial sensors is a pertinent tool to evaluate gait metrics affected by the cognitive status of older adults relying on single- and dual-task gait assessments. Further evaluation with a larger and more diverse group is required to establish system feasibility and reliability in clinical practice. Trial registration ClinicalTrials.gov (identifier: NCT04587895)

Introdução: A transição para a parentalidade envolve um conjunto de mudanças intra e interpessoal, que afeta todo o sistema familiar. Na família contemporânea os avós são evidenciados como figuras de destaque, considerados como a principal fonte de apoio e suporte para a família neste processo. Deste modo, importa analisar a sua influência na transição para a parentalidade. Objetivos: Mapear evidência científica disponível sobre o papel dos avós na transição para a parentalidade. Identificar lacunas de conhecimento na evidência científica disponível sobre o tema. Planear investigação primária.Metodologia: Elaboração de uma revisão scoping segundo metodologia do Joanna Briggs Institute (JBI), 2020, tendo como questão de investigação: Qual o papel dos avós na transição para a parentalidade? A pesquisa foi efetuada nas bases de dados CINAHL complete, MEDLINE e Scopus entre abril e maio 2022 e atualizada em julho 2023. Planeamento de um projeto de investigação primária que inclui um estudo exploratório e descritivo de natureza qualitativa. Resultados: Foram incluídos 11 estudos, 4 revisões da literatura e 7 estudos primários de abordagem qualitativa ou mista. Emergiram 4 categorias: os avós como fonte de suporte; os avós e a influência na nutrição das famílias e no aleitamento materno exclusivo; a ambivalência de sentimentos e o papel dos profissionais de saúde. Os avós podem assumir papéis de suporte instrumental, emocional, informativo e financeiro na transição para a parentalidade e podem influenciar no aleitamento materno exclusivo e na nutrição familiar. Emergiu uma escassez de artigos no que diz respeito às experiências dos pais na relação com os avós na transição para a parentalidade em Portugal, o que realça a importância da produção de conhecimento através de metodologia qualitativa. Conclusões: Tendo em vista uma prática baseada na evidência, foi desenhado um projeto de investigação primária de natureza qualitativa, que visa analisar as experiências dos pais na relação com os avós no processo da transição para a parentalidade.

When dealing with several years of daily data, such as the number of daily admissions to a hospital’s emergency department (ED), how complex does it get to forecast into the future? With that in mind, this study has two main goals: to explore the differences between several methodologies, considering both single and multiple-seasonal patterns; and to select the most suitable model for the administration of a Portuguese hospital to use while managing their ED. To that end, we first considered the data as a time series with a single weekly seasonal pattern. We then modelled the data using time series regression, linear regression with autoregressive integrated moving average (ARIMA) errors, seasonal ARIMA and exponential smoothing techniques. Second, the data was set to be a time series with weekly and annual seasonal patterns. Then, using Fourier terms, we applied time series regression, linear regression with ARIMA errors and trigonometric exponential smoothing state space models with Box–Cox transformation, ARMA errors, Trend and Seasonal components (TBATS) for the analysis. After selecting the best-fitting models using the Akaike Information Criteria (AIC) values, we forecasted into the future and compared the results using both training and test datasets’ root mean square error (RMSE), mean absolute error (MAE) and mean absolute percentage error (MAPE) values. The time series regression model based on seasonal variables and a weekly seasonal pattern gives the best results. However, we decided to use linear regression with ARIMA errors, seasonal variables, and both weekly and annual seasonal patterns. This produces similar results but allows for the annual seasonality to be considered, which is useful when more data is added.

In an unprecedented scenario, much of the research and interventions during the COVID-19 pandemic, which focused on young people, found themselves suspended. (1) Background: The goals of this project were to investigate (Study 1) social participation and positive development among young people in Cascais, Portugal, and to investigate (Study 2-a case study) the implementation of a program promoting active citizenship, social participation, and social entrepreneurship. At the same time, it was intended to constitute a resource and strategy to diminish the social alienation exacerbated by the pandemic. (2) Methods: SPSS v.26 software was used to analyze quantitative data from questionnaires used in the study of social participation, as well as the pre- and post-test impacts, and MAXQDA 2020 software was used to analyze qualitative data from YouTube discussions about youth needs and strategies for their problems, as well as from focus groups. (3) Results: In S1, it was evident that young people’s expectations of participation in the community were not defined and that their expected participation in the community was of a weekly nature. They considered themselves to have a good sense of belonging to the community or group and had reasonable social self-efficacy. Girls showed higher scores in Expectations of Community Participation and Active Participation. In their positive development, they did not have a defined evaluation of their competence, but their connection with others was evaluated as good. Boys showed higher levels of Competence. They said that every week they make 1 h of their day available to help others, and they did not frequently report feelings of social alienation. In S2, the evaluation of the impact of the project generally showed an improvement in the action research skills of the participants. At the end, six projects were proposed. In the analysis of the participants’ voices, the themes related to Substance Use, Social Capital, and Love and Sexuality stood out with higher participation and lower participation in the themes of Diversity, Culture and Housing. (4) Conclusions: The results suggest a need to encourage social participation, active citizenship, and entrepreneurship, along with their knowledge and skills for action. The promotion of debate and knowledge on issues related to young people’s lives seems to be a priority, especially issues related to Diversity, Culture and Housing. The Dream Teens model may prove to be an important strategy in this work, suggesting that this project may constitute a relevant model for future work.

Leishmania infantum, a zoonotic vector-born parasite, is endemic in the Mediterranean region, presenting mostly as visceral (VL), but also as cutaneous (CL) and mucosal leishmaniasis (ML). This study aimed to describe the epidemiological and clinical aspects of the CL and ML cases diagnosed in mainland Portugal between 2010 and 2020. Collaboration was requested from every hospital of the Portuguese National Health System. Cases were screened through a search of diagnostic discharge codes or positive laboratory results for Leishmania infection. Simultaneously, a comprehensive literature search was performed. Descriptive statistics and hypothesis testing were performed using IBM® SPSS® Statistics. A total of 43 CL and 7 ML cases were identified, with a predominance of autochthonous cases (86%). In CL, immunosuppressed individuals constituted a significant proportion of patients (48%), and in this group, disseminated CL (22%) and simultaneous VL (54%) were common. In autochthonous cases, lesions, mostly papules/nodules (62%), were frequently observed on the head (48%). The approach to treatment was very heterogeneous. ML cases were all autochthonous, were diagnosed primarily in older immunosuppressed individuals, and were generally treated with liposomal amphotericin B. The findings suggest a need for enhanced surveillance and reporting, clinical awareness, and diagnostic capacity of these forms of leishmaniasis to mitigate underdiagnosis and improve patient outcomes. A holistic One Health approach is advocated to address the multifaceted challenges posed by leishmaniases in Portugal and beyond.

Rice is a significant staple food in the basic diet of the global population that is considered to have a high glycaemic index. The study of the physical and chemical parameters in rice that are related to the starch digestion process, which allows us to quickly predict the glycaemic index of varieties, is a major challenge, particularly in the classification and selection process. In this context, and with the goal of establishing a relationship between physicochemical properties and starch digestibility rates, thus shedding light on the connections between quality indicators and their glycaemic impact, we evaluated various commercial rice types based on their basic chemical composition, physicochemical properties, cooking parameters, and the correlations with digestibility rates. The resistant starch, the gelatinization temperature and the retrogradation (setback) emerge as potent predictors of rice starch digestibility and estimated glycaemic index, exhibiting robust correlations of r = −0.90, r = −0.90, and r = −0.70 (p ≤ 0.05), respectively. Among the rice types, Long B and Basmati stand out with the lowest estimated glycaemic index values (68.44 and 68.10), elevated levels of resistant starch, gelatinization temperature, and setback values. Furthermore, the Long B showcases the highest amylose, while the Basmati with intermediate, revealing intriguingly strong grain integrity during cooking, setting it apart from other rice varieties.

Gurnards are a valuable by-catch of mixed demersal fisheries and are commercially important in European waters, but they are often discarded, reported under “mixed gurnards” and with incomplete biological information by species. In the present work, a total of 558 piper gurnard specimens of between 10.9 and 44.4 cm (1 to 11 years) and 425 red gurnard specimens of between 10.2 and 42.1 cm (0 to 9 years) from the northeast Atlantic (Portuguese) coast were used to study age and growth. The von Bertalanffy growth parameters for piper gurnard were estimated through the combination of whole-otolith readings and back-calculation (L∞=44.7 cm, k=0.16 yr–1 and t0=–2.781 yr). For red gurnard the same growth parameters were estimated using whole-otolith readings (L∞=40.2 cm, k=0.28 yr–1 and t0=–1.074 yr). The results indicate that the red gurnard reaches a smaller length, although it grows faster than the piper gurnard. Natural, instantaneous and fishing mortalities were estimated as well as the exploitation rate for both species. For the Portuguese coast, the red gurnard showed a higher fishing mortality and exploitation rate than the piper gurnard, raising concerns about its sustainable management.

Objective Stepping exergames designed to stimulate physical and cognitive skills can provide important information concerning individuals’ performance. In this study, we investigated the potential of stepping and gameplay metrics to assess the motor-cognitive status of older adults. Methods Stepping and gameplay metrics were recorded in a longitudinal study involving 13 older adults with mobility limitations. Game parameters included games’ scores and reaction times. Stepping parameters included length, height, speed, and duration, measured by inertial sensors placed on the shoes while interacting with the exergames. Parameters measured on the first gameplay were correlated against standard cognitive and mobility assessments, including the Montreal Cognitive Assessment (MoCA), gait speed, and the Short Physical Performance Battery. Based on MoCA scores, patients were then stratified into two groups: cognitively impaired and healthy controls. The differences between the two groups were visually inspected, considering their within-game progression over the training period. Results Stepping and gameplay metrics had moderate-to-strong correlations with cognitive and mobility performance indicators: faster, longer, and higher steps were associated with better mobility scores; better cognitive games’ scores and reaction times, and longer and faster steps were associated with better cognitive performance. The preliminary visual analysis revealed that the group with cognitive impairment required more time to advance to the next difficulty level, also presenting slower reaction times and stepping speeds when compared to the healthy control group. Conclusion Stepping exergames may be useful for assessing the cognitive and motor status of older adults, potentially allowing assessments to be more frequent, affordable, and enjoyable. Further research is required to confirm results in the long term using a larger and more diverse sample.

Marine Protected Areas (MPAs) are a tool to safeguard marine natural systems, yet their effectiveness depends on how well they are integrated into the existing socioeconomic context. Stakeholder engagement in MPA design can contribute to increasing integration. This study focuses on the co-design of an MPA between researchers, public administration, the private sector, and non-governmental organizations. The proposed MPA is in Portugal and includes an area that is a hotspot for biodiversity and economic activities. This is the first MPA proposal in mainland Portugal co-designed using a participatory approach. This study highlights the steps of the zoning process and synthesizes the eight main lessons learned, useful for other cases, particularly for relatively small coastal MPAs with multiple socioeconomic activities. Three zoning proposals were developed and discussed within the participatory process. The proposals considered the best scientific and local knowledge available and were defined using ecological, socioeconomic, and shape-area guiding principles. In an iterative manner and following a participatory approach, compromises with stakeholders were achieved, and a final proposal, scientifically sound and socially accepted by most stakeholders, was delivered to the government. The final zoning plan will achieve ambitious conservation goals, including the largest fully protected area to be declared in mainland Portugal, while minimizing the impacts on the existing economic activities and promoting its sustainability. This process resulted in valuable lessons that may be applied elsewhere and guide future MPA implementation or rezoning of existing ones. These transdisciplinary and participatory processes can be time and resource-consuming but are vital for ensuring MPA effectiveness.

Nonalcoholic fatty liver disease (NAFLD) is a major public health problem and the most common form of chronic liver disease, affecting 25% of the global population. Although NAFLD is closely linked with obesity, insulin resistance, and type 2 diabetes mellitus, knowledge on its pathogenesis remains incomplete. Emerging data have underscored the importance of Rho-kinase (Rho-associated coiled-coil-containing kinase [ROCK]) action in the maintenance of normal hepatic lipid homeostasis. In particular, pharmacological blockade of ROCK in hepatocytes or hepatic stellate cells prevents the progression of liver diseases such as NAFLD and fibrosis. Moreover, mice lacking hepatic ROCK1 are protected against obesity-induced fatty liver diseases by suppressing hepatic de novo lipogenesis. Here we review the roles of ROCK as an indispensable regulator of obesity-induced fatty liver disease and highlight the key cellular pathway governing hepatic lipid accumulation, with focus on de novo lipogenesis and its impact on therapeutic potential. Consequently, a comprehensive understanding of the metabolic milieu linking to liver dysfunction triggered by ROCK activation may help identify new targets for treating fatty liver diseases such as NAFLD.

Objectives The aim of this study was to estimate the prevalence and causes of vision impairment (VI) in Portugal.Setting Information about people with VI was obtained from primary care centres, blind association (ACAPO) and from hospitals (the PCVIP study) in the Northwest of Portugal during a period spanning years 2014–2015. Causes of VI were obtained from hospitals.Participants Administrative and medical records of people with visual acuity in the better seeing eye of 0.5 decimal (0.30logMAR) or worse and/or visual field less than 20° were investigated. Capture–recapture with log-linear models was applied to estimate the number of individuals missing from lists of cases obtained from available sources.Primary and secondary outcome measures Log-linear models were used to estimate the crude prevalence and the category specific prevalence of VI.Results Crude prevalence of VI was 1.97% (95% CI 1.56% to 2.54%), and standardised prevalence was 1% (95% CI 0.78% to 1.27%). The age-specific prevalence was 3.27% (95% CI 2.36% to 4.90%), older than 64 years, 0.64% (95% CI 0.49% to 0.88%), aged 25–64 years, and 0.07% (95% CI 0.045% to 0.13%), aged less than 25 years. The female-to-male ratio was 1.3, that is, higher prevalence among females. The five leading causes of VI were diabetic retinopathy, cataract, age-related macular degeneration, glaucoma and disorders of the globe.Conclusions The prevalence of VI in Portugal was within the expected range and in line with other European countries. A significant number of cases of VI might be due to preventable cases and, therefore, a reduction of the prevalence of VI in Portugal seems possible. Women and old people were more likely to have VI and, therefore, these groups require extra attention. Future studies are necessary to characterise temporal changes in prevalence of VI in Portugal.

ObjectiveIn the last years, changes in dietary habits have contributed to the increasing prevalence of metabolic disorders, such as non-alcoholic fatty liver disease (NAFLD) and type 2 diabetes mellitus (T2DM). The differential burden of lipids and fructose on distinct organs needs to be unveiled. Herein, we hypothesized that high-fat and high-fructose diets differentially affect the metabolome of insulin-sensitive organs such as the liver, muscle, and different adipose tissue depots.MethodsWe have studied the impact of 12 weeks of a control (11.50% calories from fat, 26.93% from protein, and 61.57% from carbohydrates), high-fat/sucrose (HFat), or high-fructose (HFruct) feeding on C57Bl/6J male mice. Besides glucose homeostasis, we analyzed the hepatic levels of glucose and lipid-metabolism-related genes and the metabolome of the liver, the muscle, and white (WAT) and brown adipose tissue (BAT) depots.ResultsHFat diet led to a more profound impact on hepatic glucose and lipid metabolism than HFruct, with mice presenting glucose intolerance, increased saturated fatty acids, and no glycogen pool, yet both HFat and HFruct presented hepatic insulin resistance. HFat diet promoted a decrease in glucose and lactate pools in the muscle and an increase in glutamate levels. While HFat had alterations in BAT metabolites that indicate increased thermogenesis, HFruct led to an increase in betaine, a protective metabolite against fructose-induced inflammation.ConclusionsOur data illustrate that HFat and HFruct have a negative but distinct impact on the metabolome of the liver, muscle, WAT, and BAT.

Marine Protected Areas (MPAs) require effective indicators to assess their performance, in compliance with the goals of relevant national and international commitments. Achieving and prioritizing shortlists of multidisciplinary indicators demands a significant effort from specialists to depict the multiple conservation and socioeconomic interests, and the large complexity of natural systems. The present paper describes a structured expert-based methodology (process and outputs) to co-define a list of multidisciplinary MPA performance indicators. This work was promoted by the management authority of coastal MPAs in mainland Portugal to gather a consensual and feasible list of indicators that would guide the design of a future national monitoring program. Hence, Portuguese coastal MPAs served as a case study to develop such a process between 2019 and 2020. In the end, participants (1) agreed on a shortlist of prioritized indicators (i.e., environmental, governance, and socioeconomic indicators) and (2) defined minimum monitoring frequencies for the indicators in this list, compatible with the potential replicability of the associated survey methods. The present approach recommends that management plans incorporate monitoring procedures and survey methods, with a validated list of indicators and associated monitoring periodicity, agreed among researchers, MPA managers and governance experts. The proposed methodology, and the lessons learned from it, can support future processes aiming to define and prioritize MPA performance indicators.

The perceptions of fishers towards the Arrábida Marine Park, a marine protected area (MPA) in the west coast of Portugal, were studied through face-to-face interviews in two different moments of the MPA life cycle. Fishers' perceptions about the MPA and the impact it had on the fishing activity over time were identified just before the full implementation of the zoning and regulations of the management plan and 10 years later. This study aimed to investigate fishers' knowledge, acceptance and perceptions about the MPA changed with time, if support for the MPA was linked to the impact of the MPA on the fishing activity, and if fishers' perceptions about the impact of the MPA on the fishing activity match with local landings trends. Results show that although knowledge about the marine park significantly improved over time, fishers' acceptance did not. A decrease on fishers' support was not substantial but occurred. Issues such as the disagreement with regulations reinforced concerns raised during the implementation of the marine park, particularly in relation to the top-down decision-making, which commonly confers minor participation, recognition and legitimacy to fishers. Apparently, fisheries benefits were still not perceived by local fishers, though they are central for fishers' support. Further, the perceived negative impacts of the park seemed to be more related to social aspects and individual interests than to impacts on catches. Addressing adequate management, enforcement and participation of local fishers is still possible and are advocated here as to contribute to the expected socioecological outcomes and respective support, leading to the future successful performance of the Arrábida Marine Park. Assessing fishers’ perceptions towards an MPA over time is central and should be included on periodical socioecological monitoring and inform an effective adaptive management.

Nanomaterials use in cosmetics is markedly enhancing, so their exposure and toxicity are important parameters to consider for their risk assessment. This review article provides an overview of the active cosmetic ingredients used for cosmetic application, including dermal cosmetics and also hair dye cosmetics, as well as their safety assessment, enriched with a compilation of the safety assessment tests available to evaluate the different types of toxicity. In fact, despite the increase in research and the number of papers published in the field of nanotechnology, the related safety assessment is still insufficient. To elucidate the possible effects that nanosized particles can have on living systems, more studies reproducing similar conditions to what happens in vivo should be conducted, particularly considering the complex interactions of the biological systems and active cosmetic ingredients to achieve newer, safer, and more efficient nanomaterials. Toward this end, ecological issues and the toxicological pattern should also be a study target.

Transfer RNAs (tRNAs) are widely known for their roles in the decoding of the linear mRNA information into amino acid sequences of proteins. They are also multifunctional platforms in the translation process and have other roles beyond translation, including sensing amino acid abundance, interacting with the general stress response machinery, and modulating cellular adaptation, survival, and death. In this mini-review, we focus on the emerging role of tRNA genes in the organization and modification of the genomic architecture of yeast and the role of tRNA misexpression and decoding infidelity in genome stability, evolution, and adaption. We discuss published work showing how quickly tRNA genes can mutate to meet novel translational demands, how tRNAs speed up genome evolution, and how tRNA genes can be sites of genomic instability. We highlight recent works showing that loss of tRNA decoding fidelity and small alterations in tRNA expression have unexpected and profound impacts on genome stability. By dissecting these recent evidence, we hope to lay the groundwork that prompts future investigations on the mechanistic interplay between tRNAs and genome modification that likely triggers genome evolution.

No-take areas are key instruments to promote the effectiveness of Marine Protected Areas (MPAs), particularly concerning the protection of endangered species such as the dusky grouper (Epinephelus marginatus). However, despite the establishment of no-take areas and the prohibition of catching this species in a southwestern Portuguese MPA (SACVMP—‘Sudoeste Alentejano’ and ‘Costa Vicentina’ Marine Park) since 2011, there is still no evidence of population recovery. By using acoustic biotelemetry, this work aimed to evaluate the feasibility of restocking hatchery-reared adult dusky groupers in two no-take areas within the SACVMP. In 2019 and 2021, thirty groupers were tagged with acoustic transmitters and the site attachment and movements of the groupers were assessed in the releasing sites (no-take areas). None of the tagged fish settled down in either of the areas, leaving the no-take areas mainly at dusk and night. Some individuals displayed extended movements of more than a hundred kilometers along the Portuguese coast which was rarely reported for this species. At least in some coastal stretches, those movements were performed close to the shore, which may evidence the importance of coastal MPAs to protect and promote the connectivity of species more associated with rocky reef habitats. Following studies should focus on the conditions that promote site attachment and fidelity by hatchery-reared dusky groupers so that future large-scale restocking programs can be successful in MPAs with appropriate habitats.

The Six Transmembrane Epithelial Antigen of the Prostate (STEAP1) is an oncogene overexpressed in several human tumors, particularly in prostate cancer (PCa). However, the mechanisms involved in its overexpression remain unknown. It is well known that epigenetic modifications may result in abnormal gene expression patterns, contributing to tumor initiation and progression. Therefore, this study aimed to analyze the methylation pattern of the STEAP1 gene in PCa versus non-neoplastic cells. Bisulfite amplicon sequencing of the CpG island at the STEAP1 gene promoter showed a higher methylation level in non-neoplastic PNT1A prostate cells than in human PCa samples. Bioinformatic analysis of the GEO datasets also showed the STEAP1 gene promoter as being demethylated in human PCa, and a negative association with STEAP1 mRNA expression was observed. These results are supported by the treatment of non-neoplastic PNT1A cells with DNMT and HDAC inhibitors, which induced a significant increase in STEAP1 mRNA expression. In addition, the involvement of HDAC in the regulation of STEAP1 mRNA expression was corroborated by a negative association between STEAP1 mRNA expression and HDAC4,5,7 and 9 in human PCa. In conclusion, our work indicates that STEAP1 overexpression in PCa can be driven by the hypomethylation of STEAP1 gene promoter.

Gait performance is an important marker of motor and cognitive decline in older adults. An instrumented gait analysis resorting to inertial sensors allows the complete evaluation of spatiotemporal gait parameters, offering an alternative to laboratory-based assessments. To estimate gait parameters, foot trajectories are typically obtained by integrating acceleration two times. However, to deal with cumulative integration errors, additional error handling strategies are required. In this study, we propose an alternative approach based on a deep recurrent neural network to estimate heel and toe trajectories. We propose a coordinate frame transformation for stride trajectories that eliminates the dependency from previous strides and external inputs. Predicted trajectories are used to estimate an extensive set of spatiotemporal gait parameters. We evaluate the results in a dataset comprising foot-worn inertial sensor data acquired from a group of young adults, using an optical motion capture system as a reference. Heel and toe trajectories are predicted with low errors, in line with reference trajectories. A good agreement is also achieved between the reference and estimated gait parameters, in particular when turning strides are excluded from the analysis. The performance of the method is shown to be robust to imperfect sensor-foot alignment conditions.

No presente artigo produzem-se algumas reflexões e considerações segundo as experiências e intervenções no estágio curricular na direção de um Agrupamento de Escolas público, no âmbito do Mestrado em Ciências da Educação. O enfoque deste estágio, percebido no primeiro mês de observações, é o trabalho de assessoria à direção, entre processos de mediação e promoção do diálogo e do trabalho comum entre os órgãos de gestão e administração e os/as estudantes, enquanto possibilidade destes participarem e influenciarem efetivamente as decisões tomadas na escola. Este estágio permitiu perceber a necessidade de os/as alunos/as desenvolverem uma Cidadania Criativa, possível através de práticas e oportunidades participativas, percebendo-se a influência de opiniões e pontos de vistas no que é decidido.The Possibilities of a Student Profile as a Creative CitizenThis article presents some reflections and considerations according to the experiences and interventions made possible in the curricular internship in the direction of a Public School, within the scope of the Master in Educational Sciences. The focus of this internship, perceived in the first month of observations, is the work of advising the management, between processes of mediation and promotion of dialogue and common work between the management and the students, as a possibility of these participate in and effectively influence decisions made at school. This internship made it possible to perceive the need for students to develop a Creative Citizenship, which is possible through participatory practices and opportunities, perceiving the influence of opinions and points of view on what is decided.Key-words: Democratic Management; Student Participation; Creative Citizenship.Data de receção: 30/06/2019Decisão Final: 14/10/2019

Background: The identification of poor outcome predictors is essential if we are to prevent therapeutic failure. Ambivalence – defined as a conflictual relationship between two positions of the self: one favoring change and another one favoring problematic stability – has been consistently associated with poor outcomes. However, the precise relationship between ambivalence and clients’ symptomatology remains unclear.Objective: This study aims at assessing ambivalence’s power to predict symptomatology, using a longitudinal design.Methods: The complete 305 sessions of 16 narrative and cognitive-behavioral cases have been analyzed with the Ambivalence Coding System and outcome measures have been used for each session.Results: Ambivalence emerged as a significant predictor of subsequent symptomatology suggesting that ambivalence is not only related to treatment outcomes, but that it represents a strong predictor of subsequent symptomatology.Discussion: The implications of ambivalence’s power to predict outcomes for research and clinical practice are discussed.

Joint modelling of longitudinal and survival data has received much attention in the recent years and is becoming increasingly used in clinical studies. When the longitudinal outcome and survival endpoints are associated, the many well-established models with different specifications proposed to analyse separately longitudinal and time-to-event outcomes are not suitable to analyse such data and a joint modelling approach is required. Although some joint models were adapted in order to allow for competing endpoints, this methodology has not been widely disseminated. The present study has as main objective to model jointly longitudinal and survival data in a competing risk context, discussing the different parameterisations of systematic implementations of these models in the R, using a real data set as an example for the comparison between the different model approaches. The relevance of this issue is associated with the need to draw attention of the users of this statistical software to the different interpretations of model parameters when fitting these models. To reinforce the relevance of these models in clinical research, we give an example of a data set on peritoneal dialysis that was analysed in this context, where death/transfer to haemodialysis was the event of interest and renal transplant was the competing event. Joint modelling results were also compared to separate analysis for these data.

Inertial sensors can potentially assist clinical decision making in gait-related disorders. Methods for objective spatio-temporal gait analysis usually assume the careful alignment of the sensors on the body, so that sensor data can be evaluated using the body coordinate system. Some studies infer sensor orientation by exploring the cyclic characteristics of walking. In addition to being unrealistic to assume that the sensor can be aligned perfectly with the body, the robustness of gait analysis with respect to differences in sensor orientation has not yet been investigated—potentially hindering use in clinical settings. To address this gap in the literature, we introduce an orientation-invariant gait analysis approach and propose a method to quantitatively assess robustness to changes in sensor orientation. We validate our results in a group of young adults, using an optical motion capture system as reference. Overall, good agreement between systems is achieved considering an extensive set of gait metrics. Gait speed is evaluated with a relative error of −3.1±9.2 cm/s, but precision improves when turning strides are excluded from the analysis, resulting in a relative error of −3.4±6.9 cm/s. We demonstrate the invariance of our approach by simulating rotations of the sensor on the foot.

Newborn screening enables the diagnosis of treatable disorders at the early stages, and because of its countless benefits, conditions have been continuously added to screening panels, allowing early intervention, aiming for the prevention of irreversible manifestations and even premature death. Mucopolysaccharidoses (MPS) are lysosomal storage disorders than can benefit from an early diagnosis, and thus are being recommended for newborn screening. They are multisystemic progressive disorders, with treatment options already available for several MPS types. MPS I was the first MPS disorder enrolled in the newborn screening (NBS) panel in the USA and a few other countries, and other MPS types are expected to be added. Very few studies about NBS for MPS in Latin America have been published so far. In this review, we report the results of pilot studies performed in Mexico and Brazil using different methodologies: tandem mass spectrometry, molecular analysis, digital microfluidics, and fluorimetry. These experiences are important to report and discuss, as we expect to have several MPS types added to NBS panels shortly. This addition will enable timely diagnosis of MPS, avoiding the long diagnostic odyssey that is part of the current natural history of this group of diseases, and leading to a better outcome for the affected patients.

The liver is a fundamental organ to ensure whole-body homeostasis, allowing for a proper increase in insulin sensitivity from the fast to the postprandial status. Hepatic regulation of glucose metabolism is crucial and has been shown to be modulated by glutathione (GSH) and nitric oxide (NO). However, knowledge of the metabolic action of GSH and NO in glucose homeostasis remains incomplete. The current study was designed to test the hypothesis that treatment with S-nitrosoglutathione is sufficient to revert insulin resistance induced by a high-sucrose diet. Male Wistar rats were divided in a control or high-sucrose group. Insulin sensitivity was determined: (i) in the fast state; (ii) after a standardized test meal; (iii) after GSH + NO; and after (iv) S-nitrosoglutathione (GSNO) administration. The fasting glucose level was not different between the control and high-sucrose group. In the liver, the high-sucrose model shows increased NO and unchanged GSH levels. In control animals, insulin sensitivity increased after a meal or administration of GSH+NO/GSNO, but this was abrogated by sucrose feeding. GSNO was able to revert insulin resistance induced by sucrose feeding, in a dose-dependent manner, suggesting that they have an insulin-sensitizing effect in vivo. These effects are associated with an increased insulin receptor and Akt phosphorylation in muscle cells. Our findings demonstrate that GSNO promotes insulin sensitivity in a sucrose-induced insulin-resistant animal model and further implicates that this antioxidant molecule may act as a potential pharmacological tool for the treatment of insulin resistance in obesity and type 2 diabetes.

Numerous studies over the last decades have focused on marine protected areas (MPAs) and their effects on fish communities. However, there is a knowledge gap regarding how species that live associated with soft-substrates (e.g., sand, mud) respond to spatial protection. We analyzed abundance, biomass and total lengths of the soft-bottom fishes in a multiple-use MPA in the north-eastern Atlantic, the Luiz Saldanha Marine Park (Portugal), during and after the implementation of its management plan. Data were collected by experimental fishing in areas with three different levels of protection, during the implementation period and for three years after full implementation of the MPA. Univariate analysis detected significant biomass increases between the two periods. Fish assemblages were mainly structured by depth and substrate, followed by protection level. Community composition analyses revealed significant differences between protection levels and between the two periods. Species exhibited a broad variation in their response to protection, and we hypothesize that factors such as species habitat preferences, body size and late maturity might be underlying determinants. Overall, this study provides some evidence of protection effectiveness in soft-bottom fish communities, supported by the significant increase in biomass in the protected areas and the positive trends of some species.

The increasingly aging society in developed countries has raised attention to the role of technology in seniors’ lives, namely concerning isolation-related issues. Independent seniors that live alone frequently neglect meals, hydration and proper medication-taking behavior. This work aims at eating and drinking recognition in free-living conditions for triggering smart reminders to autonomously living seniors, keeping system design considerations, namely usability and senior-acceptance criteria, in the loop. To that end, we conceived a new dataset featuring accelerometer and gyroscope wrist data to conduct the experiments. We assessed the performance of a single multi-class classification model when compared against several binary classification models, one for each activity of interest (eating vs. non-eating; drinking vs. non-drinking). Binary classification models performed consistently better for all tested classifiers (k-NN, Naive Bayes, Decision Tree, Multilayer Perceptron, Random Forests, HMM). This evidence supported the proposal of a semi-hierarchical activity recognition algorithm that enabled the implementation of two distinct data stream segmentation techniques, the customization of the classification models of each activity of interest and the establishment of a set of restrictions to apply on top of the classification output, based on daily evidence. An F1-score of 97% was finally attained for the simultaneous recognition of eating and drinking in an all-day acquisition from one young user, and 93% in a test set with 31 h of data from 5 different unseen users, 2 of which were seniors. These results were deemed very promising towards solving the problem of food and fluids intake monitoring with practical systems which shall maximize user-acceptance.

Falls are one of the most common problems in the elderly population. Therefore, each year more solutions for automatic fall detection are emerging. This paper proposes a single accelerometer algorithm for wearable devices that works for three different body locations: chest, waist and pocket, without a calibration step being required. This algorithm is able to be fully executed on a wearable device and no external devices are necessary for data processing. Additionally, a study of the accelerometer sampling rate, that allows the algorithm to achieve a better performance, was performed. The algorithm was validated with a continuous dataset with daily living activities and 272 simulated falls. Considering the trade-off between sensitivity and the number of false alarms the most suitable sampling rate found was 50 Hz. The proposed algorithm was able to achieve a trade-off of no false alarms and 89.5% of fall detection rate when wearing the sensor on the user’s waist with a medium sensitivity level of the algorithm. In conclusion, this paper presents a reliable solution for automatic fall detection that can be adapted to different usages and conditions, since it can be used in different body locations and its sensitivity can be adapted to different subjects according to their physical activity level.

Despite the importance of maintaining an adequate hydration status, water intake is frequently neglected due to the fast pace of people’s lives. For the elderly, poor water intake can be even more concerning, not only due to the damaging impact of dehydration, but also since seniors’ hydration regulation mechanisms tend to be less efficient. This work focuses on the recognition of the pre-drinking hand-to-mouth movement (a drink trigger) with two main objectives: predict the occurrence of drinking events in real-time and free-living conditions, and assess the potential of using this method to trigger an external component for estimating the amount of fluid intake. This shall contribute towards the efficiency of more robust multimodal approaches addressing the problem of water intake monitoring. The system, based on a single inertial measurement unit placed on the forearm, is unobtrusive, user-independent, and lightweight enough for real-time mobile processing. Drinking events outside meal periods were detected with an F-score of 97% in an offline validation with data from 12 users, and 85% in a real-time free-living validation with five other subjects, using a random forest classifier. Our results also reveal that the algorithm first detects the hand-to-mouth movement 0.70 s before the occurrence of the actual sip of the drink, proving that this approach can have further applications and enable more robust and complete fluid intake monitoring solutions.

Despite elevated incidence and recurrence rates for Primary Spontaneous Pneumothorax (PSP), little is known about its etiology, and the genetics of idiopathic PSP remains unexplored. To identify genetic variants contributing to sporadic PSP risk, we conducted the first PSP genome-wide association study. Two replicate pools of 92 Portuguese PSP cases and of 129 age- and sex-matched controls were allelotyped in triplicate on the Affymetrix Human SNP Array 6.0 arrays. Markers passing quality control were ranked by relative allele score difference between cases and controls (|RASdiff|), by a novel cluster method and by a combined Z-test. 101 single nucleotide polymorphisms (SNPs) were selected using these three approaches for technical validation by individual genotyping in the discovery dataset. 87 out of 94 successfully tested SNPs were nominally associated in the discovery dataset. Replication of the 87 technically validated SNPs was then carried out in an independent replication dataset of 100 Portuguese cases and 425 controls. The intergenic rs4733649 SNP in chromosome 8 (between LINC00824 and LINC00977) was associated with PSP in the discovery (P = 4.07E-03, ORC[95% CI] = 1.88[1.22-2.89]), replication (P = 1.50E-02, ORC[95% CI] = 1.50[1.08-2.09]) and combined datasets (P = 8.61E-05, ORC[95% CI] = 1.65[1.29-2.13]). This study identified for the first time one genetic risk factor for sporadic PSP, but future studies are warranted to further confirm this finding in other populations and uncover its functional role in PSP pathogenesis.

Recent years have shown an increasing use of lean manufacturing (LM) principles and tools in several industrial sectors. Already a well-established management philosophy, it has shown numerous successful applications even outside production environments. This work presents the application of some LM tools, and the corresponding shift in philosophy, in two Portuguese companies of the food and beverage industries. Main implementation issues are presented and discussed; followed by the results obtained from the application of LM tools in the production system of these companies. Significant gains are obtained in both companies and, more importantly, it instills a continuous improvement culture and increases production flexibility while reducing lead times.

Allied to an epidemiological study of population of the Senology Unit of Braga’s Hospital that have been diagnosed with malignant breast cancer, we describe the progression in time of repeated measurements of tumor marker Carcinoembryonic antigen (CEA). Our main purpose is to describe the progression of this tumor marker as a function of possible risk factors and, hence, to understand how these risk factors influences that progression. The response variable, values of CEA, was analyzed making use of longitudinal models, testing for different correlation structures. The same covariates used in a previous survival analysis were considered in the longitudinal model. The reference time used was time from diagnose until death from breast cancer. For diagnostic of the models fitted we have used empirical and theoretical variograms. To evaluate the fixed term of the longitudinal model we have tested for a changing point on the effect of time on the tumor marker progression. A longitudinal model was also fitted only to the subset of patients that died from breast cancer, using the reference time as time from date of death until blood test.

Subarachnoid hemorrhage (SAH) is a life-threatening event that most frequently leads to severe disability and death. Its most frequent cause is the rupture of a saccular intracranial aneurysm (IA), which is a blood vessel dilation caused by disease or weakening of the vessel wall. Although the genetic contribution to IA is well established, to date no single gene has been unequivocally identified as responsible for IA formation or rupture. We aimed to identify IA susceptibility genes in the Portuguese population through a pool-based multistage genome-wide association study. Replicate pools were allelotyped in triplicate in a discovery dataset (100 IA cases and 92 gender-matched controls) using the Affymetrix Human SNP Array 6.0. Top SNPs (absolute value of the relative allele score difference between cases and controls |RASdiff|≥13.0%) were selected for technical validation by individual genotyping in the discovery dataset. From the 101 SNPs successfully genotyped, 99 SNPs were nominally associated with IA. Replication of technically validated SNPs was conducted in an independent replication dataset (100 Portuguese IA cases and 407 controls). rs4667622 (between UBR3 and MYO3B), rs6599001 (between SCN11A and WDR48), rs3932338 (214 kilobases downstream of PRDM9), and rs10943471 (96 kilobases upstream of HTR1B) were associated with IA (unadjusted allelic chi-square tests) in the datasets tested (discovery: 6.84E-04≤P≤1.92E-02, replication: 2.66E-04≤P≤2.28E-02, and combined datasets: 6.05E-05≤P≤5.50E-04). Additionally, we confirmed the known association with IA of rs1333040 at the 9p21.3 genomic region, thus validating our dataset. These novel findings in the Portuguese population warrant further replication in additional independent studies, and provide additional candidates to more comprehensively understand IA etiopathogenesis.

In longitudinal studies subjects are measured for one or more response variable, over time. Although the underlying evolution of such response variables is continuous in time, in practice the measurements are observed at discrete time points. In longitudinal clinical trials it is also common to observe relevant events, generating time-to-event data. If both types of data are available, we might be interested in the association between the two processes, longitudinal and time-to-event. Commonly, when death is considered the event, the observation sequence of longitudinal measurements is terminated by the event process. When the two observed processes are related, the analysis of the data set should be suited to the specific objectives. We distinguish three situations: if the interest is to analyse the longitudinal outcome response variable with drop-out at the time-to-event; to analyse time-to-event, whilst exploiting correlation with a noisy version of a time-varying risk factor; or to analyse the relationship between the two processes. Joint models assume a full distribution for the joint distribution of longitudinal and time-to-event processes, which includes a description of the relation between the two processes.