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Background & Aims: Tacrolimus has been associated with recurrence of primary biliary cholangitis (PBC) after liver transplantation (LT), which in turn may reduce survival. This study aimed to assess the association between the type of calcineurin inhibitor used and long-term outcomes following LT in patients with PBC. Methods: Survival analyses were used to assess the association between immunosuppressive drugs and graft or patient survival among adult patients with PBC in the European Liver Transplant Registry. Patients who received a donation after brain death graft between 1990 and 2021 with at least 1 year of event-free follow-up were included. Results: In total, 3,175 patients with PBC were followed for a median duration of 11.4 years (IQR 5.9–17.9) after LT. Tacrolimus (Tac) was registered in 2,056 (64.8%) and cyclosporin in 819 (25.8%) patients. Following adjustment for recipient age, recipient sex, donor age, and year of LT, Tac was not associated with higher risk of graft loss (adjusted hazard ratio [aHR] 1.07, 95% CI 0.92-1.25, p = 0.402) or death (aHR 1.06, 95% CI 0.90-1.24, p = 0.473) over cyclosporin. In this model, maintenance mycophenolate mofetil (MMF) was associated with a lower risk of graft loss (aHR 0.72, 95% CI 0.60-0.87, p

In the European Union, bioequivalence (BE) for narrow therapeutic index (NTI) drugs is currently demonstrated when the 90% confidence interval for the ratio of the population geometric means of the test and reference products for AUC, and in some cases for Cmax, falls within the acceptance range of 90.00% to 111.11%. However, meeting this requirement results in an increased difficulty of demonstrating BE and a need for clinical trials with larger subject sample sizes, especially for medium-to-high variability drugs. To address this challenge, a scaled average BE based on the reference product within-subject variability for narrowing the acceptance range of NTI drugs was recently proposed. However, this approach showed increased type I error (T1E), especially close to the cut-off point between the unscaled and scaled portions of the method. Based on simulations, this limitation can be overcome by predefining the protocol the path to be followed: either the fixed 90.00–111.11% acceptance range approach or the previously proposed scaled average BE approach with a slight adjustment of the one-sided significance level α to 0.042 for a 2 × 3 × 3 partial replicate design and without a lower cut-off point. This results in a mixed approach allowing to reduce the sample size whilst not inflating the T1E.

Abstract In this study, we analyze the lead-lag relationships between the US industry index and those of six other major countries from January 1973 to May 2021. We identify the leading role played by the US internationally by showing that the weekly returns of US industries, especially the US basic materials and energy industries, significantly Granger cause the returns of most other countries’ industries, suggesting that non-US industries react with some delay to new information. This delayed reaction is even more noticeable during periods of recession in the US when cross-country correlations are higher. This implies that the ability of the lagged returns of US industries to predict industries’ returns from other countries is even more pronounced when the US experienced an economic recession. A similar asymmetric relationship is found between the volatility of US industries and that of industries in other markets. The analysis of causality in the distribution of returns and volatility shows that causality runs mainly from the US to other countries, particularly in the presence of extreme negative shocks. Finally, we demonstrate that our predictions are valuable to real-world investors. Long-short strategies generate sizable and statistically significant alphas, and a constant relative risk-averse investor obtains certainty equivalent returns well above the risk-free rate.

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

Spontaneous muscle ruptures in young adults without previous diseases or risk factors are extremely rare. No previous reports describing simultaneous spontaneous ruptures of multiple muscles in the healthy young adult have been published, emphasizing the lack of protocolized rehabilitation programs. In this article, the authors report a case of simultaneous spontaneous multiple muscle tears in a healthy goalkeeper, proposing a rehabilitation approach. A 19-year-old male goalkeeper presented to the emergency department with intense acute low back pain initiated spontaneously after raising from bed and originating gait difficulties. Magnetic resonance imaging demonstrated muscle ruptures in the left iliacus, piriformis, and paravertebral. Investigation for systemic causes of muscle tears was negative. The patient pursued a customized and phased rehabilitation program for a total of 6 months. In the re-evaluation at the end of the rehabilitation program, the patient presented no pain, had full range of motion and full muscle strength, and presented great stability and coordination. He was referred to sports medicine to pursue reintegration as a goalkeeper with functional sports-specific training. Although no cause for the ruptures was identified, the patients' sports-related activity may lead to microtear formation and trigger spontaneous tears. Thus, sports biomechanics may explain the underlying pathogenesis of these injuries. This case also highlights that an individualized rehabilitation program optimizes activity, participation, and professional reintegration.

Objectives: Abiraterone Acetate (AA) is an important agent in the treatment of advanced prostate cancer. It was primarily approved for the treatment of metastatic castration-resistant prostate cancer (mCRPC) after failure of androgen deprivation therapy. There is still no avail-able strong data regarding the impact of early decline of prostate-specific antigen (PSA) in the overall survival. The aim of this study was to evaluate the clinical efficacy of an early prostate-specific antigen response as a predictor of overall sur-vival (OS) in metastatic castration-resistant prostate cancer when treated with Abiraterone Acetate. Materials and methods: A dual center, retrospective, cohort study on patients diagnosed with mCRPC treated with abi-raterone between 2013 and 2020 was performed. Primary end-point was to demonstrate the efficacy of AA, with the analysis of PSA decline, and the correlation with overall survival. Results: The cohort analysis consisted of 84 patients with a median age of 71 ± 9 years. A PSA response of > 30% and > 50% at 60 and 90 days was associated with improved OS. Multivariate analysis revealed that a 60 day PSA decline of > 30% was predictive of overall survival. Median OS of diag-nosed mCRPC patients was 28 months. Docetaxel pre-treatment was not associated with longer OS. The median duration of drug exposure for patients submitted to AA was found to be 14 months. Conclusions: Early PSA response rate can offer clinically mean-ingful information and can be considered a surrogate of longer OS. A > 30% or > 50% prostate-specific antigen decline at 60 and 90 days provided an important low-cost clinical tool to pre-dict subsequent events in mCRPC patients treated with abi-raterone.

Introdução – A doença pulmonar obstrutiva crónica é uma das principais causas de morbilidade e mortalidade, sendo a ventilação mecânica não invasiva (VMNI) um meio de intervenção. Tendo em conta a biomecânica da articulação, esta intervenção pode originar disfunção temporomandibular (DTM). Objetivo – Verificar a prevalência de DTM em indivíduos com doença pulmonar obstrutiva crónica. Secundariamente pretendeu-se avaliar a severidade de DTM associada ao número de horas/anos de utilização de VMNI, ao tipo de interface e ao modo ventilatório nesses doentes. Métodos – Estudo transversal constituído por 49 doentes com patologia obstrutiva. Foi aplicado o Questionário Anamnésico de Fonseca. Para o tratamento dos dados utilizou-se o coeficiente de Correlação de Spearman e o teste de Mann-Whitney com α=0,05. Resultados – Relativamente à severidade de DTM constatou-se que 15 indivíduos apresentavam DTM leve. Verificou-se uma associação positiva estatisticamente significativa entre o número de horas/anos de utilização de VMNI (r=0,422; p=0,01) e uma diferença estatisticamente significativa entre a severidade de DTM e modo ventilatório (p=0,018). Quanto à severidade de DTM em função do tipo de interface (p=0,833) constatou-se que não existem diferenças estatisticamente significativas. Conclusão – Concluiu-se que que a maioria dos doentes com doença pulmonar obstrutiva crónica apresentavam DTM e foram classificados como DTM leve. Verificou-se uma associação positiva entre o número de horas e de anos de utilização de VMNI nestes doentes.

This article presents causal recipes leading to high and low energy consumption efficiency performances using fuzzy set Qualitative Comparative Analysis (fsQCA). The study found that several causal conditions are sufficient for high energy efficiency performance, including several fiscal and financial incentive policies, a highly educated population, many completed dwellings, and low GDP. The study also found that high inequality in completed dwellings and completed reconstructions, coupled with a low GDP and a low number of policies, lead to high energy consumption efficiency performance. In addition, the analysis showed slight differences between the yearly consistencies, suggesting that time effects are not a concern. On the other hand, a low education level, Gini coefficient, few completed dwellings and reconstructions, coupled with a low number of fiscal and financial policies, are the causal conditions leading to low energy consumption efficiency performance. The study’s results suggest that policymakers and stakeholders should consider a combination of several causal conditions when implementing energy efficiency policies. The study also highlights the need for policies focusing on education, fiscal and financial incentives, completed dwellings, and reconstructions to achieve high energy efficiency performance.

In low-and middle-income countries, achieving universal health coverage remains challenging due to insufficient, temporary and fragmented funding as well as limited accessibility to quality healthcare. Leveraging a mobile health platform can be a powerful tool to address these problems. This paper demonstrates how analysing data collected from a mobile health platform helps optimize healthcare provider networks, monitor patient flows and assess the quality and equitability of access to care. The COVID-19 pandemic reinforces the importance of real-time data on health-seeking behaviour. Between 2018 and 2019, as a Kenyan universal health coverage pilot was being planned, Kisumu County, with support from PharmAccess Foundation, implemented household-level digital registration for healthcare and collected socio-economic and healthcare claims data using the M-TIBA platform. In total, 273,350 Kisumu households enrolled. The claims data showed many patients visit higher-level facilities for ailments, that can be treated at primary care levels, unnecessarily. High-level estimate of the disease burden at participating facilities revealed rampant overprescription of pertinent medicines for highly prevalent malaria and respiratory tract infections, exemplifying clinical management deficiencies. M-TIBA data allowed tracking of individual patient trajectories. Analyses of data are shown at the aggregate level. The paper shows how mobile health platforms can be used to generate valuable insights into access to and quality of care. Funding for healthcare can be united through mobile health platforms, limiting the fragmentation in funding. They can be useful for funders, health managers and policymakers to improve the implementation of universal health coverage programs in low-and middle-income countries.

As teses de doutoramento traduzem um ponto de encontro entre desafios contextuais (trazidos pelos doutorandos), interesses da academia e influências políticas. Contudo, não há conhecimento que as caraterize com profundidade e pondere o seu significado epistemológico: Que perspetivas sobre a natureza da realidade acolhem? Que realidades investigam? Através de que processos? Para responder, implementámos uma investigação no paradigma interpretativo, com abordagem mista e recurso à análise documental (teses em educação produzidas entre 2018-2020) e análise de conteúdo. Os resultados sugerem processos de produção de conhecimento tendencialmente interpretativos, por análise retrospetiva, com delimitação apriorística de temas, extensão temporal excessiva, focados em ambientes formais e nos alunos e professores. Conclui-se que as teses integram programas de investigação e podem anunciar a sua não progressividade; e que a tendência em investigar retrospetivamente pode não acolher as surpresas comuns à educação, sugerindo-se que a investigação está desafiada a integrar rituais de serendipidade.

ABSTRACT: Currarino triad is a rare syndrome, with less than 250 cases reported, and it includes a combination of sacrococcigeal bony abnormalities, anorectal malformations and the presence of a presacral mass. Here we present a case of a 48-year-old male patient with history of severe chronic constipation, who was incidentally diagnosed with a presacral during imagiological investigation, which was histologically proven to be a neurendocrine tumor.

ABSTRACT This paper examines stock returns and dividend growth predictability using dividend yields in seven developed markets: United States of America (US), United Kingdom (UK), Japan, France, Germany, Italy, and Spain. Altogether, these countries account for around 85% of the Morgan Stanley Capital International (MSCI) World Index. The use of the long time series with up-to-date data allows the comparison not only between countries, but also across periods, putting into perspective the existence or not of noticeable changes since the 1980’s. The majority of the literature on this topic is US-centered. This emphasis on the US is even more pronounced when it comes to examining the relationship between the dividend unpredictability and dividend smoothing. There is also the need to know if the relationships already documented for the post-Second World War (WWII) period still hold during the last three decades, when stock markets were subjected to a high level of turbulence worldwide. The relationship between dividend yields and returns and dividend growth is central to understand the functioning of capital markets, and has considerable implications for capital asset pricing and investment strategies. Overall, the results show that even for developed capital markets there is no clear pattern on the predictive ability of dividend yields on stock returns and dividend growth, instead these relationships seem to be time-dependent and country-specific. For each country, the predictive ability of the dividend yield is examined in a first-order structural VAR framework by applying bootstrap significance tests and the degree of dividend smoothing is assessed using four partial-adjustment models for the dividend behavior. Additionally, an out-of-sample analysis is conducted using pseudo-R2 and a normal mean squared prediction error (MSPE) adjusted statistic. For the post-WWII period, returns are predictable, but dividends are unpredictable in the US and the UK, while the opposite pattern is observed in Spain and Italy. In Germany, there is some evidence of short-term predictability for both returns and dividends, while in France only returns are predictable. In Japan, neither variable can be forecasted. The dividend smoothing results show that dividends are more persistent in the US and the UK, however, there is no clear connection between dividend smoothness and predictability for the other countries. An important conclusion to retain from the out-of-sample analysis is that the predictability of returns after the WWII, especially present in the US, appeared to have been missing in the last three decades, most probably due to the turmoil experienced by the stock markets during this last period.

Resumo: Introdução: O score EGSYS para avaliação do doente com síncope em contexto de urgência utiliza variáveis de ordem clínica e foi validado para diferenciar entre síncope de etiologia cardíaca (SC) ou não cardíaca (SNC). Este trabalho pretende determinar se o score tem a mesma aplicabilidade no contexto de consulta. Métodos: Estudo retrospetivo a partir dos registos eletrónicos dos doentes observados em consulta externa de síncope entre janeiro de 2015 e dezembro de 2016. Foi calculado o score EGSYS para cada doente e determinada a sensibilidade e especificidade para a predição de etiologia cardíaca em doentes com score 3. Resultados: Foram avaliados 224 doentes, com média de 64,3 ± 21,7 anos, 116 (51,8%) eram do sexo masculino. Nos 163 (72,7%) com síncope confirmada, o diagnóstico foi de SC em 27 (16,6%) e SNC em 136 (83,4%). O score EGSYS foi 3 em 40 (20,0%) doentes com SNC e em 13 (48,1%) com SC. Um score 3 teve uma sensibilidade de 48,2% (IC 95%: 28,7‐68,1), uma especificidade de 77,9% (CI 95%: 70,0‐84,6), um valor preditivo positivo e negativo de 30,2% (CI 95%: 20,8 – 41,8) e 88,3% (CI 95: 83,9 – 91,7) respetivamente. Conclusão: O score EGSYS tem utilidade limitada no contexto de consulta de síncope, que recebe doentes filtrados por avaliação médica prévia. Dada a sua elevada especificidade e valor preditivo negativo, poderá ter utilidade como tranquilizador do doente e parentes no contexto clínico apropriado. Abstract: Introduction: The EGSYS score uses clinical variables to predict which patients may have cardiac (CS) or non‐cardiac syncope (NCS) and has been validated in the emergency department setting. This study aims to determine whether the score has the same applicability in an outpatient setting. Methods: In this retrospective study of all patients observed in the outpatient setting of a hospital with a syncope unit between January 2015 and December 2016, the EGSYS score was calculated for each patient, and its sensitivity and specificity were determined for the prediction of CS in patients with score ≥3. Results: A total of 224 patients, mean age 64.3±21.7 years, 116 (51.8%) male, were analyzed. In the 163 (72.7%) patients with confirmed syncope, CS was diagnosed in 27 (16.6%) and NCS in 136 (83.4%). The EGSYS score was ≥3 in 40 (20.0%) patients with NCS and in 13 (48.1%) with CS. A positive score had a sensitivity of 48.2% (95% CI: 28.7‐68.1), a specificity of 77.9% (95% CI: 70.0‐84.6), and a positive and negative predictive value of 30.2% (95% CI: 20.8‐41.8) and 88.3% (95% CI: 83.9‐91.7), respectively. Conclusion: The EGSYS score has limited usefulness in an outpatient setting, where observed patients have already been been medically assessed. Given its high specificity and negative predictive value, it may be useful to reassure low‐risk patients and family members.

ABSTRACT Objective We aim to identify retrospectively surgically treated patients with an ankylosed spine who sustained a vertebral fracture. Our goal is to evaluate the main outcomes and complications. Methods We selected patients through the database of surgical interventions in the setting of fractures of an ankylosed spine segment between January 1st 2008 and June 30th 2018. We collected data from digital medical records. The parameters analyzed include hospital length of stay, Intensive Care Unit (ICU) admission, perioperative and postoperative complications as well as neurological evolution. Results Fractures occurred in 14 patients with ankylosing spondylitis (82%) and 3 patients with diffuse idiopathic skeletal hyperostosis (18%). All patients were male and the mean age was 69 years. Fourteen fractures occurred after minor trauma (83%), of which 11 were due to falls from standing height or lower (65%). The cervical spine represents the majority of the levels involved (65%). Seven patients were admitted to the ICU (41%) and 11 suffered neurological damage. There was improvement of neurological status in less than 50% and there were high percentages of post-operative complications. Conclusion Patients with ankylosed spine diseases are at higher risk for vertebral fracture, even after minor trauma, and these are located predominantly in the cervical spine. The surgical treatment of these conditions is effective as it allows improvement of the patient’s neurological status. However, they still present higher morbidity and mortality, as well as increased post-op complications. Prevention of falls may drastically change patients’ outcome, neurological function and independence in activities of daily living. Level of evidence IV; A case series therapeutic study.

Integrons are genetic elements that capture and express antimicrobial resistance genes within arrays, facilitating horizontal spread of multiple drug resistance in a range of bacterial species. The aim of this study was to estimate prevalence for class 1, 2, and 3 integrons in Scottish cattle and examine whether spatial, seasonal or herd management factors influenced integron herd status. We used fecal samples collected from 108 Scottish cattle herds in a national, cross-sectional survey between 2014 and 2015, and screened fecal DNA extracts by multiplex PCR for the integrase genes intI1, intI2, and intI3. Herd-level prevalence was estimated [95% confidence interval (CI)] for intI1 as 76.9% (67.8–84.0%) and intI2 as 82.4% (73.9–88.6%). We did not detect intI3 in any of the herd samples tested. A regional effect was observed for intI1, highest in the North East (OR 11.5, 95% CI: 1.0–130.9, P = 0.05) and South East (OR 8.7, 95% CI: 1.1–20.9, P = 0.04), lowest in the Highlands. A generalized linear mixed model was used to test for potential associations between herd status and cattle management, soil type and regional livestock density variables. Within the final multivariable model, factors associated with herd positivity for intI1 included spring season of the year (OR 6.3, 95% CI: 1.1–36.4, P = 0.04) and watering cattle from a natural spring source (OR 4.4, 95% CI: 1.3–14.8, P = 0.017), and cattle being housed at the time of sampling for intI2 (OR 75.0, 95% CI: 10.4–540.5, P < 0.001). This study provides baseline estimates for integron prevalence in Scottish cattle and identifies factors that may be associated with carriage that warrant future investigation.

This study investigated the effect of technology and government policies on carbon dioxide (CO2) emissions in 36 Organisation for Economic Co-operation and Development (OECD) countries from 1994 to 2015. This empirical investigation uses econometric models, such as panel quantile regression and ordinary least squares (OLS). The research uses the method proposed by Lin and Ng in 2015 to deal with parameter heterogeneity across countries that identified two separate groups. The empirical results indicated that Gross Domestic Product (GDP), fossil fuel consumption, industrialisation and taxation to GDP intensify CO2 emissions. In contrast, urbanisation (% of the total population), environmental patents, and environmental tax as a percentage of total tax reduce CO2 gas emissions. Estimates with homogeneity preserve the signs of the parameters but reveal substantial differences in intensity and that environmental tax revenues (as % of GDP and % of tax) are only statistically significant for our studied group 1. The conclusions of this study have important policy implications. The effect of industrialisation on environmental degradation is an observable fact. When the country reaches the allowable thresholds, it needs to maximize energy consumption. Policymakers should design policies that help them to promote environmentally sustainable economic growth by imposing and accumulating environmental taxes. In addition, environmental taxes, the discharge system and credit could support the modification of in-industrial structures and modes of economic growth. Policymakers should also use policies that encourage trade in nuclear-generated electricity to neighbouring OECD countries.

Bioequivalence (BE) of products containing narrow therapeutic index (NTI) drugs in the European Union is currently established by demonstrating that the 90% confidence interval for the ratio of the population geometric means of the test compared to the reference product’s AUC, and in certain cases Cmax, is included within the tighter acceptance range of 90.00–111.11%. An alternative criterion, consisting of narrowed limits based on the within-subject variability of the reference product, was recently proposed. Its performance for a three-period partial replicate design was tested by simulation in terms of power to show BE, type I error (T1E) and sample size requirements. A new condition, a constraint on the test-to-reference geometric mean ratio (cGMR) to be contained within the range of 90.00–111.11%, was also tested. The probability of showing BE when the products differ more than 10% was increased, but only if the reference product’s within-subject variability was moderate-to-high. The inclusion of the additional cGMR limited this. An increase in the T1E (

The present study aimed to determine which of the neuromuscular status (NMS) monitoring tests (1: Counter-movement jump, CMJ; 2: back squat with additional load) is the most sensitive and effective for evaluating the state of fatigue in futsal players during the preseason. Seventeen professional futsal players were recruited for this study (age: 23.07 ± 6.76 years; height: 1.75 ± 0.06 m; body mass: 75.47 ± 7.47 kg; playing experience in elite: 5.38 ± 2.03 years). All of them were evaluated during the preseason phase in two tests (CMJ and back squat with additional load) before and after each training session (pre- vs. post-test). A jump platform was used to extract jump height during CMJ, while a linear position transducer was used to extract mean velocity (MV) and mean propulsive velocity (MPV) during the back squat exercise. Significant differences were obtained for intra-subject analysis for MV and MPV in loaded back squat exercise (p < 0.001), finding lower values during the post-test. In conclusion, the monitoring of NMS through the back squat provides greater sensitivity and objectivity in comparison with CMJ, due to a more direct neuromuscular extrapolation to the physical demands of futsal.

The potential of cloud computing systems as a support tool for novel and meaningful knowledge creation, storage, and distribution within the context of higher education is recognised and so is the impact to which the global dimension imposes inherent ethical issues and social impacts within local contexts (glocality). Hitherto, mainstream literature debates on ethical issues like equity or cultural sensitivity, disregarding existent social dilemmas related to organizational innovation. This paper aims to promote a philosophical and empirical argument within contextual determinants; therefore, it reflects upon the key ethical issues and social dilemmas that cloud-based systems pose to distributed knowledge systems in the dialectic process of higher education diversity (global versus local). In this regard, an e-University strategic implementation framework interacting with ethics and culture (developed by the first co-author) will help two research objectives: to understand current e-learning practices in higher education and to suggest potential future guidelines for the dialectical process between the global and local.

Introduction: Although normotensive cancer patients with acute pulmonary embolism (PE) are a heterogeneous population, most validated clinical prognostic scores classify these patients as high-risk individuals, which limits their usefulness in this setting. In this study, we aimed to identify readily available clinical predictors of overall 30-day and one-year mortality in normotensive cancer patients with PE. Methods and Results: We performed a retrospective single-center study that included all normotensive cancer patients with PE diagnosed by multidetector computed tomography (MDCT) during emergency department stay between January 2010 and December 2011. Clinical, MDCT and laboratory variables were collected for all patients. A total of 69 patients were included. All-cause mortality was 28% and 55% at 30 days and one year of follow-up, respectively. Lower mean arterial pressure, higher lactate level and a higher Shock Index (SI) at hospital admission were associated with increased all-cause mortality at 30 days and one year of follow-up. The simplified Pulmonary Embolism Severity Index was not a predictor of short- or long-term mortality. An SI of ≥0.7 was found to be associated with lower event-free survival in both short- and long-term follow-up (hazard ratio 7.20 [95% CI, 1.66-31.21, p

O presente artigo analisa os padrões de avaliação de 161 IPOs que ocorreram entre 2009 e 2017 nos mercados Euronext de Amesterdão, Bruxelas, Lisboa e Paris. Em média, para todos os IPOs, o primeiro dia do evento apresenta um retorno de 1,4% e um retorno ajustadoao setor de 1,2%. Após um ano, os retornos médios são ligeiramente maiores, cerca de4,5%, enquanto os retornos médios ajustados são negativos, cerca de ‑2,7%.Os retornos doprimeiro dia são menores enquanto os retornos de longo prazo são maiores do que aquelesapresentados noutros estudos, em particular naqueles que consideram um período que sesobrepõe, pelo menos em parte, àquele utilizado na presente análise. O setor dos Cuidadosde Saúde é aquele que apresenta uma maior subavaliação inicial, com um retorno ajustadoao setor de 2,3%, enquanto os IPOs no sector Tecnológico apresentam o pior desempenhoanual, com um retorno ajustado de ‑29,5%.Os resultados suportam as hipóteses de condiçõesde mercado e de sentimento do investidor, de acordo com as quais, quando as condiçõesde mercado são más (crises), os investidores não‑informadosnão são tão ativos e otimistasno mercado dos IPOs, o que resulta numa subavaliação inicial e num subdesempenho delongo prazo menores. Uma explicação possível para estes resultados é que a crise financeiraglobal reduziu persistentemente a atividade e o otimismo dos investidores não‑informadosno mercado de IPOs, mesmo quando o mercado acionista europeu e a economia em geraljá se encontravam numa fase subsequente de recuperação.

Various studies report that the ability of industry indexes to predict the broad market disappeared during the most recent years. I revisit this theme using more flexible switching models and imposing economically motivated constraints on the predictions. My results show that traditional constant coefficients linear models are unable to forecast the stock market over the period considered, but restricting the equity premium to be non-negative, five industries predict the market. I also show that the Markov-switching models exhibit a dismal performance, which is even worse than the ones from the constant coefficients model. Finally, I test a model with two regimes- recession and expansion- which are identified in real-time through the Arouba-Diebold-Scotti Business Conditions Index. Using this model, I find that 8 out of 33 industries can successfully forecast the market. Furthermore, a mean-variance investor who bases his decisions on it obtains sizeable utility gains, relative to another investor who uses, exclusively, the historical returns.

Proximity sensing approaches with a wide array of sensors available for use in precision viticulture contexts can nowadays be considered both well-know and mature technologies. Still, several in-field practices performed throughout different crops rely on direct visual observation supported on gained experience to assess aspects of plants’ phenological development, as well as indicators relating to the onset of common plagues and diseases. Aiming to mimic in-field direct observation, this paper presents VineInspector: a low-cost, self-contained and easy-to-install system, which is able to measure microclimatic parameters, and also to acquire images using multiple cameras. It is built upon a stake structure, rendering it suitable for deployment across a vineyard. The approach through which distinguishable attributes are detected, classified and tallied in the periodically acquired images, makes use of artificial intelligence approaches. Furthermore, it is made available through an IoT cloud-based support system. VineInspector was field-tested under real operating conditions to assess not only the robustness and the operating functionality of the hardware solution, but also the AI approaches’ accuracy. Two applications were developed to evaluate VineInspector’s consistency while a viticulturist’ assistant in everyday practices. One was intended to determine the size of the very first grapevines’ shoots, one of the required parameters of the well known 3–10 rule to predict primary downy mildew infection. The other was developed to tally grapevine moth males captured in sex traps. Results show that VineInspector is a logical step in smart proximity monitoring by mimicking direct visual observation from experienced viticulturists. While the latter traditionally are responsible for a set of everyday practices in the field, these are time and resource consuming. VineInspector was proven to be effective in two of these practices, performing them automatically. Therefore, it enables both the continuous monitoring and assessment of a vineyard’s phenological development in a more efficient manner, making way to more assertive and timely practices against pests and diseases.

Warming up prior to competition is a widely accepted strategy to increase players’ readiness and achieve high performances. However, pre-match routines are commonly based on empirical knowledge and strongly influenced by models emerging from elite team practices. The aim of the present study was to identify and analyze current pre-match warm-up practices in elite futsal. Forty-three elite players were analyzed during their pre-match warm-up routines during the Portuguese Futsal Cup Final 8. Warm-up tasks were classified according to duration, type of activity, sequence, and structure. External load variables included the total distance covered, total distance covered per minute, running distance per minute, sprinting distance per minute, number of accelerations per minute, and number of decelerations per minute. Results highlighted that warm-up routines lasted for 27.5 ± 9.2 min and included nine major different tasks. Open-skill activities were prioritized by coaches; competitive and non-competitive futsal-specific tasks were included in 90% of the total warm-up routines, with higher focus on non-competitive tasks (68% of total time). The intensity progressively increased during warm-ups, mainly because of the higher number of accelerations and decelerations per minute. Pre-match warm-up routines strongly endorse futsal-specific and representative tasks in order to establish pre-match settings able to prepare players for the upcoming game. When designing pre-match warm-up routines, coaches should be aware that duration, sequence, and type of tasks may affect players’ acute performance and readiness.

BackgroundTo monitor the prevalence of antimicrobial resistance (AMR), methods for interpretation of susceptibility phenotypes of bacteria are needed. Reference limits to declare resistance are generally based on or dominated by data from human bacterial isolates and may not reflect clinical relevance or wild type (WT) populations in livestock or other hosts.MethodsWe compared the observed prevalence of AMR using standard and bespoke interpretations based on clinical breakpoints or epidemiological cut-offs (ECOFF) using gram positive (Staphylococcus aureus) and gram negative (Escherichia coli) bacteria from sheep as exemplars. Isolates were obtained from a cross-sectional study in three lowland sheep flocks in Scotland, and from a longitudinal study in one flock in Norway. S. aureus (n = 101) was predominantly isolated from milk or mammary glands whilst E. coli (n = 103) was mostly isolated from faecal samples. Disc diffusion testing was used to determine inhibition zone diameters, which were interpreted using either clinical breakpoints or ECOFF, which distinguish the bacterial wild type population from bacteria with acquired or mutational resistance to the compound of interest (non-wild type). Standard ECOFF values were considered as well as sheep-specific values calculated from the data using Normalized Resistance Interpretation (NRI) methodology.ResultsThe prevalence of AMR as measured based on clinical breakpoints was low, e.g. 4.0% for penicillin resistance in S. aureus. Estimation of AMR prevalence based on standard ECOFFs was hampered by lack of relevant reference values. In addition, standard ECOFFS, which are predominantly based on human data, bisected the normal distribution of inhibition zone diameters for several compounds in our analysis of sheep isolates. This contravenes recommendations for ECOFF setting based on NRI methodology and may lead to high apparent AMR prevalence. Using bespoke ECOFF values based on NRI, S. aureus showed non-wild type for less than 4% of isolates across 13 compounds, and ca. 13% non-wild type for amoxicillin and ampicillin, while E. coli showed non-wild type for less than 3% of isolates across 12 compounds, and ca. 13% non-wild type for tetracyclines and sulfamethoxazole-trimethoprim.ConclusionThe apparent prevalence of AMR in bacteria isolated from sheep is highly dependent on interpretation criteria. The sheep industry may want to establish bespoke cut-off values for AMR monitoring to avoid the use of cut-offs developed for other host species. The latter could lead to high apparent prevalence of resistance, including to critically important antimicrobial classes such as 4th generation cephalosporins and carbapenems, suggesting an AMR problem that may not actually exist.

The effect of energy policies on the energy performance of residential properties/houses in nineteen Portuguese districts from 2014 to 2021 was investigated. A linear random-effects model regression was used as the method in this empirical investigation. The empirical results indicated that the income per capita has a negative effect on residential properties with high energy efficiency certificates (e.g., A+, A, and B) and a positive impact on residential properties with low energy efficiency certificates (e.g., C, D, E, and F); the codes and standards energy policies for energy efficiency have a positive effect on residential properties with high energy efficiency certificates (e.g., A, B, and B−) and residential properties with low energy efficiency certificates (e.g., C, D, E, and F); the fiscal and financial incentive policies for energy efficiency have a positive effect on residential properties with high energy efficiency certificates (e.g., A+, A, and B) and a negative effect on residential properties with B− energy certificate, and also a negative effect on residential properties with low energy efficiency certificates (e.g., C and D) and a positive effect on residential properties with an F energy certificate; the information and education policies of energy efficiency have a positive effect on residential properties with high energy efficiency certificates (e.g., A+, A, and B) and residential properties with low energy efficiency certificates (e.g., C, D, and E); and, finally, the consumer credit per capita has a positive effect on residential properties with high energy efficiency certificates (e.g., A+, A, and B) and a negative effect on residential properties with low energy efficiency certificates (e.g., C, D, and F), as well as a positive effect on residential properties with an F energy certificate.

Inflammatory fibroid polyps are rare, benign pseudotumors of the gastrointestinal tract of unknown etiology, which may rarely present as bowel intussusception and obstruction. The authors describe the clinical, radiologic, and pathologic features of 2 patients with ileal inflammatory fibroid polyps presenting as small bowel intussusception.

This paper reviews recent progress on different high-speed optical short- and medium-reach transmission systems. Furthermore, a comprehensive tutorial on high-performance, low-cost, and advanced optical transceiver (TRx) paradigms is presented. In this context, recent advances in high-performance digital signal processing algorithms and innovative optoelectronic components are extensively discussed. Moreover, based on the growing increase in the dynamic environment and the heterogeneous nature of different applications and services to be supported by the systems, we discuss the reconfigurable and sliceable TRxs that can be employed. The associated technical challenges of various system algorithms are reviewed, and we proffer viable solutions to address them.

Spatial and temporal variability characterization in Precision Agriculture (PA) practices is often accomplished by proximity data gathering devices, which acquire data from a wide variety of sensors installed within the vicinity of crops. Proximity data acquisition usually depends on a hardware solution to which some sensors can be coupled, managed by a software that may (or may not) store, process and send acquired data to a back-end using some communication protocol. The sheer number of both proprietary and open hardware solutions, together with the diversity and characteristics of available sensors, is enough to deem the task of designing a data acquisition device complex. Factoring in the harsh operational context, the multiple DIY solutions presented by an active online community, available in-field power approaches and the different communication protocols, each proximity monitoring solution can be regarded as singular. Data acquisition devices should be increasingly flexible, not only by supporting a large number of heterogeneous sensors, but also by being able to resort to different communication protocols, depending on both the operational and functional contexts in which they are deployed. Furthermore, these small and unattended devices need to be sufficiently robust and cost-effective to allow greater in-field measurement granularity 365 days/year. This paper presents a low-cost, flexible and robust data acquisition device that can be deployed in different operational contexts, as it also supports three different communication technologies: IEEE 802.15.4/ZigBee, LoRa/LoRaWAN and GRPS. Software and hardware features, suitable for using heat pulse methods to measure sap flow, leaf wetness sensors and others are embedded. Its power consumption is of only 83 μA during sleep mode and the cost of the basic unit was kept below the EUR 100 limit. In-field continuous evaluation over the past three years prove that the proposed solution—SPWAS’21—is not only reliable but also represents a robust and low-cost data acquisition device capable of gathering different parameters of interest in PA practices.

Background. In clinical practice, it is assumed that a severe rise in transaminases is caused by ischemic, viral or toxic hepatitis. Nevertheless, cases of biliary obstruction have increasingly been associated with significant hypertransaminemia. With this study, we sought to determine the true etiology of marked rise in transaminases levels, in the context of an emergency department.Material and methods. We retrospectively identified all patients admitted to the emergency unit at Centro Hospitalar e Universitário de Coimbra between 1st January 2010 and 31st December 2010, displaying an increase of at least one of the transaminases by more than 15 times. All patient records were analyzed in order to determine the cause of hypertransaminemia.Results. We analyzed 273 patients – 146 males, mean age 65.1 ± 19.4 years. The most frequently etiology found for marked hypertransaminemia was pancreaticobiliary acute disease (n = 142;39.4%), mostly lithiasic (n = 113;79.6%), followed by malignancy (n = 74;20.6%), ischemic hepatitis (n = 61;17.0%), acute primary hepatocellular disease (n = 50;13.9%) and muscle damage (n = 23;6.4%). We were not able to determine a diagnosis for 10 cases. There were 27 cases of recurrence in the lithiasic pancreaticobiliary pathology group. Recurrence was more frequent in the group of patients who had not been submitted to early cholecystectomy after the first episode of biliary obstruction (p = 0.014). The etiology of hypertransaminemia varied according to age, cholestasis and glutamic-pyruvic transaminase values.Conclusion. Pancreaticobiliary lithiasis is the main cause of marked hypertransaminemia. Hence, it must be considered when dealing with such situations. Not performing cholecystectomy early on, after the first episode of biliary obstruction, may lead to recurrence.

RESUMO: A coagulação intravascular disseminada (CID) é uma entidade clínica relativamente incomum, caraterizada por extensa ativação da coagulação que resulta na deposição intravascular de fibrina em vasos de pequeno e médio calibre. Podem resultar importantes perturbações hemodinâmicas, disfunção de múltiplos órgãos e grave diátese hemorrágica. As situações não traumáticas que mais vezes se complicam de CID são as infeções graves com sepsis e diversas doenças de foro oncológico. Os aneurismas aórticos (AA) associam-se raramente a CID. Podem ser reconhecidos pela primeira vez na investigação desta coagulopatia. Em regra só a reparação cirúrgica do AA permite a resolução da CID concomitante. Apresentamos neste artigo o caso clínico de um homem de 96 anos com CID crónica associada a AA inoperável. ABSTRACT: Disseminated intravascular coagulation (DIC) is an uncommon clinical entity, characterized by widespread activation of the coagulation process, which results in intravascular deposition of fibrin in small and medium-sized vessels. Important hemodynamic trouble, multiorganic dysfunction and severe hemorrhagic diathesis can follow. The most common non-traumatic situations associated with DIC are sepsis or disseminated serious infections and neoplastic diseases. Aortic aneurysms (AA) are rarely associated with DIC. Sometimes they are first recognized in the investigation of this coagulopathy. Surgical repair is usually required for the resolution of concomitant DIC. We present in this case-report a 96-years-old patient with chronic DIC with an underlying inoperable AA.

Bullous pemphigoid is an autoimmune disease characterized by subepidermal blister formation. Can be self-limiting but when necessary treatment includes the use of corticosteroids, immunosuppressants, and biological agents. We present the case of a 37 year old patient with a severe and refractory presentation of bullous pemphigoid. After about a month of treatment with various first line drugs and with no response, we chose to start rituximab and clear improvement of the lesions was observed. The authors aim to highlight the usefulness and effectiveness of this drug in this disease.

Protection issue is identified as the main drawback of emerging multi-terminal HVDC grids. Multi-terminal HVDC grid demands fast short circuit fault current interruption. Fast DC circuit breakers as a promising solution can be implemented as either bidirectional or unidirectional devices. In addition to less implementation cost, the unidirectional DC circuit breakers have less power losses as compared to the bidirectional devices. A protection strategy for multi-terminal HVDC grid based on unidirectional breaking devices is discussed and assessed in this paper. The performance of unidirectional protection strategy is examined under different fault scenarios in a fourterminal MMC-HVDC grid model. Furthermore, the impacts of unidirectional protection strategy on power converters and also current interruption and surge arrester ratings of the DC circuit breakers are discussed.

Currently, climate change poses a global threat, which may compromise the sustainability of agriculture, forestry and other land surface systems. In a changing world scenario, the economic importance of Remote Sensing (RS) to monitor forests and agricultural resources is imperative to the development of agroforestry systems. Traditional RS technologies encompass satellite and manned aircraft platforms. These platforms are continuously improving in terms of spatial, spectral, and temporal resolutions. The high spatial and temporal resolutions, flexibility and lower operational costs make Unmanned Aerial Vehicles (UAVs) a good alternative to traditional RS platforms. In the management process of forests resources, UAVs are one of the most suitable options to consider, mainly due to: (1) low operational costs and high-intensity data collection; (2) its capacity to host a wide range of sensors that could be adapted to be task-oriented; (3) its ability to plan data acquisition campaigns, avoiding inadequate weather conditions and providing data availability on-demand; and (4) the possibility to be used in real-time operations. This review aims to present the most significant UAV applications in forestry, identifying the appropriate sensors to be used in each situation as well as the data processing techniques commonly implemented.

Careful urban planning is of extreme importance in Mozambique, a developing country with a fast-growing population. Strategic Environmental Assessment (SEA) and Environmental and Social Impact Assessment (ESIA) are environmental management tools that can greatly benefit the planning process of sustainable urban spaces. This paper presents the contribution of SEA and ESIA to the environmental management of a new city in Mozambique, south of the Capital, Maputo, in the Katembe District. Katembe City’s environmental impact assessment process highlighted the particularities of this territory and identified the critical constraints for urban development and the requirements for minimization and monitorization of adverse impacts. The assessment process was developed sequentially, from a regional level to a local urban section level. In the preliminary assessment, major potential negative impacts were avoided and specific environmental and social detailed studies were defined, to be addressed in detailed urban plans. Following this, the detailed plans included all the necessary environmental requirements to avoid and mitigate several negative impacts, such as flooding, coastal erosion, biodiversity loss and habitat fragmentation. This case study emphasized the importance of SEA and ESIA in the planning process of the new city, resulting in a more sound and sustainable urban project.

Aquapuncture (AqP) consists of a water or saline solution injection into acupoints. This study aimed to evaluate the effect of aquapuncture on post-operative analgesia in bitches submitted to elective ovariohysterectomy (OHE). The study was prospective, randomised, and blinded for pain assessment. Sixteen dogs were randomly distributed in two groups of eight animals each. All animals were sedated with 0.05 mg kg-1 of acepromazine intramuscularly (IM), 30 minutes prior to induction of anaesthesia with propofol and maintenance with isoflurane. Eight animals underwent bilateral acupoint injection with 0.1 ml of 0.9% saline (AqP) at Gall Bladder 34, Stomach 36, Liver 3 and Spleen 6 acupoints 15 minutes after sedation. Pain score was investigated after 0.5, 1, 2, 5, 8 and 24 hours post-operatively and was compared with a control untreated group of eight animals. Morphine, at 0.5 mg kg-1 IM, was administered when the numerical rating scale was above 33% of the maximum value, in order to control post-operative pain in both groups. There were no differences in cardiorespiratory variables and pain and sedation scores between the groups. Seven (87.5%) animals from the control group required rescue analgesia at the first two postoperative hours and five (62.5%) animals treated with AqP required rescue analgesia, however, only one (12.5%) animal was treated at the first two hours and the remaining animals were treated from 5 hours after surgery. Aquapuncture produced residual analgesia up to 5 h after surgery and may be an option for post-operative analgesia in bitches undergoing OHE, providing that pain is assessed and rescue analgesia administered if necessary.

Xanthones are a class of heterocyclic compounds characterized by a dibenzo-γ-pyrone nucleus. Analysis of their mode of action in cells, namely uncovering alterations in gene expression, is important because these compounds have potential therapeutic applications. Thus, we studied the transcriptional response of the filamentous fungus Neurospora crassa to a group of synthetic (thio)xanthone derivatives with antitumor activity using high throughput RNA sequencing. The induction of ABC transporters in N. crassa, particularly atrb and cdr4, is a common consequence of the treatment with xanthones. In addition, we found a group of genes repressed by all of the tested (thio)xanthone derivatives, that are evocative of genes downregulated during oxidative stress. The transcriptional response of N. crassa treated with an acetophenone isolated from the soil fungus Neosartorya siamensis shares some features with the (thio)xanthone-elicited gene expression profiles. Two of the (thio)xanthone derivatives and the N. siamensis-derived acetophenone inhibited the growth of N. crassa. Our work also provides framework datasets that may orientate future studies on the mechanisms of action of some groups of xanthones.

In recent years, the installation of residential Distributed Energy Resources (DER) that produce (mainly rooftop photovoltaics usually bundled with battery system) or consume (electric heat pumps, controllable loads, electric vehicles) electric power is continuously increasing in Low Voltage (LV) distribution networks. Several technical challenges may arise through the massive integration of DER, which have to be addressed by the distribution grid operator. However, DER can provide certain degree of flexibility to the operation of distribution grids, which is generally performed with temporal shifting of energy to be consumed or injected. This work advances a horizon optimization control framework which aims to efficiently schedule the LV network’s operation in day-ahead scale coordinating multiple DER. The main objectives of the proposed control is to ensure secure LV grid operation in the sense of admissible voltage bounds and rated loading conditions for the secondary transformer. The proposed methodology leans on a multi-period three-phase Optimal Power Flow (OPF) addressed as a nonlinear optimization problem. The resulting horizon control scheme is validated within an LV distribution network through multiple case scenarios with high microgeneration and electric vehicle integration providing admissible voltage limits and avoiding unnecessary active power curtailments.

OBJETIVO: Garantir o equilíbrio sagital e pélvico depois de correção cirúrgica de deformidade lombar tem sido alvo de atenção crescente na literatura. Estudos recentes demonstraram uma relação entre o equilíbrio espinopélvico e o resultado pós-operatório. Com a progressão da deformidade degenerativa, as alterações correspondentes dos parâmetros pélvicos são evidentes. Assim, os autores pretendem estudar a influência do equilíbrio espinopélvico nos resultados clínicos e funcionais após cirurgia de espondilolistese degenerativa (ED). MÉTODOS: Estudo retrospectivo. Amostra com 29 indivíduos com ED submetidos a descompressão e artrodese instrumentada entre 2006 e 2010. Média de idade 65,45 (± 8,15) anos. 20 mulheres e 9 homens. Acompanhamento médio - 2,1 anos. Avaliação clínica, funcional e radiológica. VAS, satisfação global, Oswestry Disability Index modificado. Cálculo de incidência pélvica, inclinação sacral, versão pélvica e lordose lombar. Dois grupos de estudo: A (n = 14): sem melhoria da versão pélvica (aumentada ou inalterada) no pós-operatorio. B (n = 15): com melhoria da versão pélvica (diminuída). Estudo estatístico com SPSS®. RESULTADOS: A cirurgia é benéfica, reduz significativamente a dor e melhora a qualidade de vida. Os pacientes do grupo B (restituição do balanço original) apresentam melhores resultados clínicos e funcionais (p < 0,05) e valores superiores de incidência pélvica relativamente ao grupo A. CONCLUSÃO: Este trabalho confirma a importância do equilíbrio espinopélvico como objetivo no planeamento cirúrgico e que a restituição do equilíbrio original parece obter melhores resultados.

I assume that Participatory Budget (PB) can function as a strategy within a city interested in citizenship education , in favor of practices that embody participatory democratic actions. Consequently, I show how the PB has rooted social practices that permeate citizen participation in local governance, proving its plasticity in the process of inclusion of different visions and values for the social and cultural (de)construction of the city. PB has aslo been unveiled as a mechanism that has allowed additional readings of the world, not only for the local power, but also for ordinary citizens. New understandings and hermeneutics that trigger new knowledge, new alternative ways of inclusion, present themselves through the success and diffusion of practices, as knowledge-emancipation. PB is presented as a mechanism that from the city governance´s perspective, acts on behalf of social justice.The closeness that is developed between the executive of the city and the citizens who inhabit it, generate very strong dialogical processes triggering calls for the negotiation of the city's cultural competence.In a moment (in the history of societies) where the dichotomy between global and local is becoming more acute by the blurring of social, cultural and geographical boundaries, PB presents itself as a social movement that generates an environmentally (de)constructed epistemic framework that, by allowing the humanization of the oppressed, becomes essential to research. By the dialogical relationship instituted, as well as the negotiation processes it faces, PB presents itself as a movement that contributes to the learning of citizenship education.

Os estudos produzidos nos níveis nacional e internacional no âmbito da investigação científica da Liderança e da sua relação com a Ética, entendida esta como a fundamentação teórica da Moral, apontam, na sua generalidade, para a emergência da necessidade do reforço do seu envolvimento na (re)contribuição da sustentabilidade do desempenho eficaz das organizações educativas. Na senda dos problemas que afectam as organizações educativas, designadamente aqueles que elegem as pessoas como objecto central e em que se coloca(m) em discussão e em causa as formas de actuação e a sua relação com os resultados produzidos, assiste-se também ao surgimento de vários contributos científicos da História, da Sociologia e da Filosofia que, confinadas aos seus campos de investigação, reconhecem a necessidade de uma reflexão mais holística e, consequentemente, de um envolvimento interdisciplinar efectivo na (des)construção e no (re)desenho da(s) liderança(s) em acção. Assumimos o princípio da gestão estratégica das organizações aplicado à escola, em particular, como recurso necessário à transformação, mudança e inovação do espaço educativo. Em síntese, pretende-se que esta reflexão possa participar do aprofundamento do conhecimento nos domínios associados às problemáticas que o justificam, tendo como pano de fundo a inteligência moral, enquanto espaço de eficácia sustentável das lideranças escolares.

OBJETIVO: Avaliar a incidência e as características das lesões tipo SCIWORA nos indivíduos até os 16 anos, da área de um hospital central entre 1989 e 2009, após traumatismo cervical. MÉTODOS: Estudo retrospectivo de consulta processual. RESULTADOS: Nove (10,5%) de 86 crianças apresentavam achados clínicos e radiológicos compatíveis com o diagnóstico de SCIWORA. A média de idades foi de 10,7 anos. A causa mais frequente foi o acidente de trânsito. Seis indivíduos eram classificáveis como Frankel D. Os restantes três casos eram Frankel C. Em três doentes a RMN mostrou imagem de lesão. Sete efetuaram metilprednisolona endovenosa e todos mantiveram imobilização com colar cervical até a primeira consulta de seguimento, às 2 semanas. Na alta, os seis doentes que apresentavam Frankel D à entrada melhoraram para um grau E. Dos doentes com Frankel C à entrada, um melhorou até Frankel D e os restantes dois mantiveram-se inalterados em Frankel C. CONCLUSÃO: Em um hospital de referência traumatológica, SCIWORA representa cerca de 10% das lesões cervicais pediátricas. Os défices neurológicos à entrada e a RMN têm valor prognóstico de recuperação. A corticoterapia em dose elevada não está formalmente indicada e não é consensual o tempo de utilização de imobilização ou a sua indicação em todos os SCIWORA.OBJETIVO: Evaluar la incidencia y las características de las lesiones tipo SCIWORA en los individuos de hasta 16 años de edad, del área de un hospital central, entre 1989 y 2009, después de traumatismo cervical. MÉTODOS: Estudio retrospectivo de consulta procesal. RESULTADOS: nueve (10,5%) de 86 niños presentaban hallazgos clínicos y radiológicos compatibles con el diagnóstico de SCIWORA. El promedio de edades fue 10,7 años. La causa más frecuente fue el accidente de tránsito. Seis individuos eran clasificables como Frankel D. Los restantes tres casos eran Frankel C. En tres pacientes, la RMn mostró imagen de lesión. Siete recibieron metilprednisolona endovenosa y todos mantuvieron inmovilización con collar cervical hasta la primera consulta de seguimiento, después de 2 semanas. En la alta, los seis pacientes, que presentaban Frankel D a la entrada, mejoraron para un grado E. De los pacientes con Frankel C a la entrada, uno mejoró hasta Frankel D y los otros dos se mantuvieron, sin alteraciones, en Frankel C. Conclusión: En un hospital de referencia traumatológica, SCIWORA representa cerca de 10% de las lesiones cervicales pediátricas. Los déficits neurológicos a la entrada y a RMn tienen valor de pronóstico de recuperación. La corticoterapia en dosis alta no está indicada formalmente y no es consensual el tiempo de utilización de inmovilización o su indicación en todos los SCIWORA.OBJECTIVE: To assess the incidence and characteristics of SCIWORA in individuals under 16 years, from the area of a Level 1 Trauma Center between 1989 and 2009 after cervical trauma. METHODS: Retrospective study of clinical charts consultation. RESULTS: nine (10.5%) of 86 children had clinical features compatible with the radiological diagnosis of SCIWORA. The mean age was 10.7 years. The most frequent cause was traffic accident. Six individuals were classified as Frankel D. The remaining three cases were Frankel C. In three patients the MRI showed an image of lesion. Seven had intravenous methylprednisolone done and all remained with cervical collar immobilization until the first follow-up visit at 2 weeks. At discharge six patients who had Frankel D at entrance improved to a grade E. Of the patients with Frankel C at entry, one improved to Frankel D and the other two remained unchanged in Frankel C. CONCLUSION: In a level 1 Trauma Center SCIWORA represents nearly 10% of all spine injuries. neurological deficits at entry and MRI have prognostic value for recovery. High dosage corticosteroids is not formally indicated and there is no consensus as to how long cervical immobilization should be prescribed or its indication at all in SCIWORA patients.

Anomalies on road pavement cause discomfort to drivers and passengers, and may cause mechanical failure or even accidents. Governments spend millions of Euros every year on road maintenance, often causing traffic jams and congestion on urban roads on a daily basis. This paper analyses the difference between the deployment of a road anomalies detection and identification system in a “conditioned” and a real world setup, where the system performed worse compared to the “conditioned” setup. It also presents a system performance analysis based on the analysis of the training data sets; on the analysis of the attributes complexity, through the application of PCA techniques; and on the analysis of the attributes in the context of each anomaly type, using acceleration standard deviation attributes to observe how different anomalies classes are distributed in the Cartesian coordinates system. Overall, in this paper, we describe the main insights on road anomalies detection challenges to support the design and deployment of a new iteration of our system towards the deployment of a road anomaly detection service to provide information about roads condition to drivers and government entities.

In this paper, we test the existence of predictability in eleven Eurozone stock markets, using both regressions with constant coefficients and with time-varying coefficients. Our results show that there is statistical evidence of predictability in some countries. The economic value of the forecasting models is much stronger than what could be inferred, based on the statistical tests. A meanvariance investor could have obtained substantial utility gains in most countries. Overall, models with time-varying parameters perform slightly better than models with constant coefficients. http://dx.doi.org/10.14195/2183‑203X_41_4

OBJETIVO: Avaliação dos resultados a longo prazo da artroplastia de disco cervical (ADC) e comparação com fusão no tratamento da hérnia discal. MÉTODOS: Seleccionados pacientes com radiculopatia por hérnia discal cervical a um nível sucessivamente submetidos a ADC entre Junho de 2003 e Julho de 2006 (grupo artroplastia). Realizada avaliação radiográfica e clínica no pré-operatório, ao fim de um ano, e pelo menos cinco anos após o procedimento. Como controlo foi utilizado grupo submetido a descompressão e artrodese anterior, operado no mesmo período (grupo fusão), avaliado no tempo final de seguimento. RESULTADOS: 22 pacientes do grupo artroplastia e 12 do grupo fusão, com tempo de seguimento médio de 5.4 anos. Na primeira avaliação obteve-se uma mobilidade média de 8,8º (2,2º-22º), tendo esta diminuído em média 3,6º (-18º-3,8º) à data final de seguimento. À data de seguimento final, 28% dos doentes inicialmente submetidos a artroplastia perderam a mobilidade pretendida; o NDI foi de 21% no grupo artroplastia vs 36,5% no grupo fusão (p=0,008); registou-se tendência para EVA cervical (2,9 vs 4,6) e braquial (2,8 vs 4,9) mais baixo no grupo artroplastia (p>0,05). Não se verificaram diferenças estatisticamente significativas entre as duas artroplastias utilizadas no que respeita a mobilidade, scores funcionais, ou complicações. Todos os pacientes do grupo artroplastia repetiriam o procedimento para apenas 67% do grupo fusão (p=0,021). CONCLUSÕES: Ambas as técnicas demonstraram ser seguras e eficazes no tratamento da hérnia discal cervical. A perda da mobilidade não teve repercussão clínica. O grupo artroplastia demonstrou ligeira superioridade nos resultados funcionais.

Área Científica de Desporto e Bem-Estar da Escola Superior de Educação de Castelo Branco implementou, desde o início (2007) do Curso de Desporto e Atividade Física um modelo de formação.Objetivo: Esta comunicação visa apresentar uma vertente do modelo de formação no âmbito da unidade curricular de Desporto, módulo de Desportos na Natureza.Pretendemos ilustrar este modelo de formação à luz dos princípios da integração das competências profissionais na formação inicial. Deste modo procuraremos fundamentar e justificar algumas das opções metodológicas no que respeita aos objetivos e tarefas que a unidade curricular propõe.

Our paper intends to describe the main pedagogical assumptions underlying the attainment of a pilot project on the theme of participation and its consequences in the education of children more socially responsible. This project is framed by two movements that inspired these kind of processes which promote and articulate citizenship participation: “Educating Cities” and “Child Friendly Cities”. The team set as starting point the exploration and reflection of the document “Convention of the Children's Rights” betting further on the rights regarding their participation.The project was held at the Primary School of Batudes (Palmela, 2011/2012) having as main objectives the following: to promote spaces where children could experience the intrinsic values of participatory democracy and, with their creativity (de)construct social relationships and community intervention; bring children closer to existing participation mechanisms and local authorities. In conclusion, the desired objectives have been achieved. However, the pilot project allowed teachers' critical reflection about their educational practice and with it the potential involvement of children in school management processes. It became apparent that the ability to work the curriculum from the point of view of the involvement of students in enhancing the process of teaching and learning, dialogically (de)constructed, is a necessary reality for motivation and stimulation of children to the world of school.

Background/Objectives: This study aimed to compare the cost and time implications for implant-supported prosthesis comparing three digital impression techniques: digitization with an intraoral scanner, digitization of the conventional impression (without dental casts) and digitization of the stone models. Methods: To assess the time and cost of digital impression techniques on implants, time records on intraoral scans were consulted and three models were created with one, two and six implants to assess extraoral procedures time. Costs were evaluated based on material consumption, time expenditure and operator-related expenses. Time was recorded in three stages: (1) impression-taking, (2) model fabrication and (3) overall workflow completion. Statistical analysis was performed using ANOVA to compare cost and time differences across workflows. Results: Intraoral scanning presented a reduction in chair-side time between 4 and 20% when compared to extraoral techniques. For the three clinical situations evaluated, the intraoral scanning always presented the lowest cost. The extraoral digitization of impressions showed a reduction between 51.9% and 53.6% in laboratory time and between 3.5% and 7.6% in total cost compared to stone models digitization. Conclusions: The findings of this study indicate that intraoral scanning is a more cost-effective and time-efficient alternative to traditional impression methods, providing advantages in terms of reduced material use and shorter procedural durations.