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Abstract The prevalence of mental disorders in adolescents has a considerable impact on daily life, restricting tasks and diminishing overall quality of life while potentially leading to stigmatization. This study aims to measure the impact of a mental health literacy intervention program, called “Bicho de 7 Cabeças” project, in b-learning format, on the increase of knowledge and the decrease of stigma in young people from Póvoa de Varzim, in Portugal. A quasi-experimental study was conducted, from November 2022 to May 2023, involving an experimental group (“Bicho de 7 Cabeças” protocol) and an active control group (informational brochures), utilizing a pre-test/post-test design. Mental Health Literacy Measure-MHLM, Mental Health Promoting Knowledge Scale-MHPK-10, Mental Illness Knowledge Schedule-MAKS, Reported and Intended Behaviour Scale-RIBS, and Community Attitudes toward People with Mental Illness-CAMI were used. A total of 504 young students from the 9th grade enroll in this study, with a mean age around 14 years old. There is a significant difference between stigma (p

Virtual reality (VR) for training helps minimize risks and costs by allowing more frequent and varied use of experiential training experiences, leading to active and improved learning. However, creating VR training experiences is costly and time-consuming, requiring software development experts. Additionally, current authoring tools are desktop-oriented, which detaches the process of creating the immersive experience from experiencing it in a situated context. This paper presents the development of an immersive authoring tool designed to create immersive virtual environments that can be used to train operatives. The authoring tool can record and replay animations of each action the user performed that can later be used to instruct other users how the task should be performed. Participants were divided into two groups, and the proposed authoring tool was evaluated using usability, satisfaction, presence and cybersickness. Between groups, Independent T-tests revealed that there were no significant differences between expert and non-expert groups in any of the studied variables. Also, the results showed that the authoring tool had high usability and satisfaction, average presence, and low probability of cybersickness symptoms.

Introdução: A utilização de substâncias psicadélicas ou psicoativas para tratar doenças mentais, como a Perturbação Obsessivo-Compulsiva (POC), é cada vez mais procurada. Há relatos de que opções alternativas de tratamento têm sido usadas para reduzir a sintomatologia, embora a investigação realizada seja escassa e dispersa, sendo necessário o mapeamento e identificação dos estudos realizados. Objetivo: Compreender melhor a extensão e o tipo de evidência disponível relativamente ao tratamento da POC com substâncias psicadélicas. Para além disso, a análise da forma como a investigação é conduzida neste domínio, a forma como as áreas geográficas estão representadas e as metodologias seguidas também devem ser consideradas. Metodologia: Foram seguidas as diretrizes da JBI e PRISMA ScR. As bases de dados PubMed, Web of Science, Springer, ScienceDirect e APA PsycNet foram consultadas de maio a junho de 2023. O software Rayyan foi usado para triagem de artigos. Quatro estudos preencheram os critérios de inclusão, apresentando alta heterogeneidade. A extração de dados e a síntese dos resultados foram efetuadas e os resultados foram analisados. Resultados: Esta revisão incluiu quatro artigos realizados entre 2013 e 2023. Os estudos examinaram o uso de canábis, nabilona e psilocibina para o tratamento da POC. O tamanho das amostras é reduzido, variando de um a 14 participantes. A Escala Obsessivo-Compulsiva de Yale-Brown (Y-BOCS) foi comummente usada para avaliação. As dosagens variaram de 1 mg a cerca de 800 mg. Conclusões: Os estudos analisados variaram em termos de adesão às guidelines de registo e comunicação da informação recolhida. A psilocibina apresentou resultados promissores, enquanto a canábis e a nabilona não. O número limitado de estudos e a dimensão reduzida das amostras limitam as conclusões. É necessária investigação mais rigorosa, com instrumentos de avaliação, dosagens e administração padronizados. São necessárias investigações futuras para estabelecer normas e guidelines para o uso de psicadélicos no tratamento da POC.

The trends of the 21st century are challenging the traditional production process due to the reduction in the life cycle of products and the demand for more complex products in greater quantities. Industry 4.0 (I4.0) was introduced in 2011 and it is recognized as the fourth industrial revolution, with the aim of improving manufacturing processes and increasing the competitiveness of industry. I4.0 uses technological concepts such as Cyber-Physical Systems, Internet of Things and Cloud Computing to create services, reduce costs and increase productivity. In addition, concepts such as Smart Factories are emerging, which use context awareness to assist people and optimize tasks based on data from the physical and virtual world. This article explores and applies the capabilities of context-aware applications in industry, with a focus on production lines. In specific, this paper proposes a context-aware application based on a microservices approach, intended for integration into a context-aware information system, with specific application in the area of manufacturing. The manuscript presents a detailed architecture for structuring the application, explaining components, functions and contributions. The discussion covers development technologies, integration and communication between the application and other services, as well as experimental findings, which demonstrate the applicability and advantages of the proposed solution.

Em novembro de 2015 ocorreu o rompimento da Barragem de Fundão, localizada no município de Mariana, em Minas Gerais, Brasil. Esse desastre tomou proporções enormes e, em relação aos danos causados as populações atingidas. Com objetivo de analisar a recuperação econômica de médio prazo (de 2016 a 2018) dos municípios atingido pelo desastre, foram estimados modelos de diferenças em diferenças canônicos e com efeitos dinâmicos para variáveis econômicas: PIB municipal; valor da produção animal; área colhida; valor da produção das lavouras de culturas temporárias e permanentes. Como grupo de controle foram utilizados todos os municípios pertencentes aos Estados de Minas Gerais e Espírito Santo, que não foram afetados pelo desastre. O grupo de tratamento é formado pelos municípios afetados direta e indiretamente pelo desastre. Os principais resultados apontaram para perdas nos municípios atingidos no que se refere ao valor da produção animal nos anos de 2016 e 2017 com uma recuperação já no ano de 2018. As estimações com efeitos dinâmicos para o valor da produção das lavouras também indicaram perdas dos municípios atingidos no ano de 2016, porém se observa uma trajetória de recuperação já a partir do ano de 2017 que se estende a 2018.

This study reports a dense, late summer phytoplankton bloom in the Southern Ocean that accumulated unusually high levels of organic matter and supported feeding hot spots for birds and whales. The authors show that this recurring open ocean bloom is driven by anomalies in easterly winds that push sea ice southwards and favour the upwelling of deep waters enriched in hydrothermal iron.

Currently, it is standard to use tracked handheld controllers for interaction in immersive virtual reality (VR). However, since VR interactions are becoming more natural with hand tracking, it is important to provide hands-free alternatives for selection and system control tasks. As such, this study aims to provide an exploratory evaluation of the effectiveness and efficiency of commonly used hands-free interfaces in selection and system control tasks. Nine interaction methods were evaluated while performing a Fitts’ law task with nine advanced users of VR in a within-subject experiment. We evaluated handheld controllers as a baseline, against head gaze, eye gaze, and voice commands for pointing at the targets, and dwell time and voice commands to confirm selections. We found that using eye gaze with a $\mathrm {500 ms}$ dwell time proved to be the hand-free method with the highest performance, matching the handheld controllers and being preferred by users. The evaluation also showed that using a multimodal approach to selection, especially using the voice, decreases performance, but increases effectiveness. Moreover, we verified that Fitts’ law can be applied to hands-free methods, but its usage is limited when the methods have very short travel times. We then suggest selections per minute as a more robust comparative performance metric. Further studies should expand the audience and interaction tasks and focus on the confirmatory method of selection.

Introdução: O objetivo deste estudo foi traduzir e adaptar o questionário de avaliação padronizada do paciente com secura ocular para a língua portuguesa, bem como avaliar o desempenho psicométrico da escala da versão traduzida, incluindo a sua repetibilidade e concordância entre medidas. Material e Métodos: O questionário original Standardized Patient Evaluation of Eye Dryness – SPEED foi traduzido e adaptado à cultura portuguesa, seguindo uma metodologia cientificamente válida e habitualmente utilizada no processo de adaptação de ferramentas a outras culturas e línguas. O questionário resultante da tradução para a nova língua foi sujeito a um pré-teste onde se registaram os comentários dos participantes e estes foram considerados para a versão final do questionário. Para a validação da escala da versão final do questionário traduzido participaram 89 indivíduos de uma população não clínica, com idades compreendidas entre os 18 e os 84 anos, dos quais 61% eram mulheres. Uma semana depois, o mesmo questionário foi preenchido pela segunda vez por 63 indivíduos. A confiabilidade interna do questionário foi analisada pelo alfa de Cronbach, a estabilidade temporal pelo teste-reteste e a análise da concordância entre medidas pelo método Bland-Altman. Resultados: A consistência interna do questionário traduzido, SPEED-vP, foi alta (α = 0,871) e todos os itens do questionário contribuíram para um aumento deste índice. Esta consistência confirmou-se também alta no reteste (α = 0,856) e quando a amostra foi estratificada por idades e por sexo. O questionário SPEED-completo também apresentou alta consistência (α = 0,88). A repetibilidade do instrumento foi alta (ICC 0,933; 95% IC: 0,899 e 0,960) e o gráfico de Bland-Altman revela boa concordância entre medidas. Conclusão: O questionário Standardized Patient Evaluation of Eye Dryness, na língua portuguesa (SPEED-vP) demonstrou boas propriedades psicométricas na população portuguesa. Consequentemente, a versão traduzida do questionário SPEED poderá ser usada para medir quantitativamente a presença de sintomas de olho seco, na população portuguesa.

Chestnut forests are undergoing increasing heat stress due to the current global warming, but little is known about the physiology and biochemistry responses of Castanea sativa Mill. to heat or whether differences exist between populations. Six-month-old seedlings from three climatically contrasting populations of C. sativa (from the north, centre, and south of Spain) were subjected to control and heat stress conditions for 7 days. The effects of heat stress on seedlings and their recovery (10 days after heat stress) were described by assessment of visible symptoms, growth, mortality, and leaf gas exchange of plants, quantification of compounds involved in the primary and secondary metabolism, and 2,2-diphenyl-1-picrylhydrazyl (DPPH) free radical scavenging. In response to stress, plant biomass decreased, and plant biochemistry altered depending on the tissue and the population. Major alterations in the primary metabolism of stressed plants occurred in leaves, characterized by increased levels of soluble sugars, nitrogen, and proline, and depletion of starch. Increased levels of soluble sugars and starch depletion occurred mostly in seedlings from the southern population, while proline increase occurred only in the northern population. Secondary metabolism of seedlings experienced the highest variation below ground, and roots of heat-stressed plants increased the content of phenolic compounds. LC-MS analysis permitted identification and quantification of six compounds induced by heat, five of which were detected in the roots. Differential biochemistry responses to heat stress were observed among populations. At recovery, most of the altered parameters had returned to control conditions, suggesting high resilience to heat stress in this Mediterranean tree species. This is the first study to address the effects of heat stress on the physiology and biochemistry of C. sativa and their interpopulation variability. Most parameters were significantly influenced by the interaction of population and heat treatment, indicating that genetic differentiation controlled the phenotypic differences of C. sativa in response to heat stress. Extensive genetic variation in plasticity in physiological and biochemical parameters in response to heat stress reveals an opportunity for chestnut for global warming-mediated selection.

Ficha de tesis de doctorado

Reseña de Francisco de Moraes, Palmeirim de Inglaterra (Partes I-II), introducción de Aurelio Vargas Díaz-Toledo, ed. Aurelio Vargas Díaz-Toledo y Pedro Álvarez Cifuentes, Madrid, Sial Pigmalión, 2021 (colección «Universo de Almourol», n. 1). Isabel Correia, Palmeirim de Inglaterra (Partes I-II). Material de apoio à leitura, Madrid, Sial Pigmalión, 2021.

Strawberry tree (Arbutus unedo) is a small resilient species with a circum-Mediterranean distribution, high ecological relevance in southern European forests and with several economical applications. As most orchards are usually installed on marginal lands where plants usually face severe drought, selecting plants that can better cope with water restriction is critical, and a better understanding of the tolerance mechanisms is required. Strawberry tree plants under drought follow a typical isohydric strategy, by limiting transpiration through stomata closure. However, the contribution of genotype and its bio-geographic origin on plant performance needs clarification, as well as the involvement of a specific metabolic reactions associated with the mechanical response. To test this hypothesis, several eco-physiological and biochemical parameters were assessed on different genotypes, and the metabolic profiles studied, including important stress-related phytohormones, on plants under different water regimes (plants watered to 70% and 18% field capacity) and a recovery assay. A contrasting drought tolerance was found in plants from different genotypes, associated with physiological and metabolic responses. Metabolomics revealed more than 500 metabolic features were differentially accumulated, including abscisic and salicylic acids, for the genotype with better performance under drought (A4). This genotype also recovered faster when the imposed stress was interrupted, thus indicating the relevance of metabolic adaptation under water deficit conditions. By correlating carbon assimilation with identified metabolites, some proved to be satisfactory predictors of plant performance under drought and might be used for marker assisted breeding. Therefore, our study proves the importance of genotype as a major selection criterion of resistant plants to drought and provides empirical knowledge of the metabolic response involved. We also hypothesized the involvement of phenolics on response mechanisms under drought, which is worth to be explored to shed light on the metabolic pathways involved in plant response to water stress.

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.

Proper evaluation of realism in immersive virtual experiences is crucial to ensure optimisation of resources. This way, we can take better decisions while designing realistic immersive experiences, prioritising factors that have a higher impact on the perceived realism of the virtual experience. This systematic review aims to provide readers with an overview of methodologies used throughout the literature to evaluate realism in immersive virtual, augmented and mixed reality. A total of 79 from 1300 gathered articles met the eligibility criteria and were analysed. Results have shown that virtual reality is by far the platform where realism studies were performed. Head-mounted displays are by far the preferred equipment for such studies. Visual realism is the most researched, followed by audiovisual. The majority of methodologies consisted of subjective, as well as a combination of objective and subjective measures. The most used evaluation instrument is questionnaires where many of which are custom and non-validated. Presence questionnaires are the most used ones and are often used to evaluate the presence, perceived realism and involvement. Cybersickness evaluation is consistently assessed by one self-report questionnaire.

Introdução - A infância e a adolescência são património determinante, que acompanha o percurso vital da pessoa. Atualmente a evidência científica revela que cerca de 20% dos jovens com menos de 18 anos de idade, apresenta uma perturbação mental, pelo que, segundo esta realidade, a saúde mental na infância e na adolescência não deve ser menosprezada, tornando-se numa prioridade. As perturbações relacionadas com a ansiedade podem ter início na infância ou na adolescência. Objetivos – Avaliar os níveis de ansiedade dos adolescentes a frequentar o 11º ano do Agrupamento de Escolas de Montemor-o-Velho, promover o autocontrolo da ansiedade desta população e reduzir os níveis de ansiedade nos adolescentes quando confrontados com situações de stresse. Método - Neste contexto, a Unidade de Cuidados na Comunidade de Montemor-o-Velho, com a colaboração da Escola Superior de Enfermagem de Coimbra e da Escola Superior de Saúde de Leiria, criou o Projeto RelaxaMente Plus que visa ensinar e treinar uma técnica de relaxamento, do tipo imaginação guiada, em sala de aula. Foi construído um guião em formato áudio, disponibilizado aos professores para treinarem regularmente em sala de aula ao longo do ano com os alunos. Adicionalmente, o guião foi também colocado no YouTube e fornecido juntamente com um código QR aos alunos, de forma a que estes possam manter o treino do relaxamento em casa, de forma autónoma. A sessão de apresentação e treino inicial da técnica foi realizada nos dias 4 e 5 de novembro de 2021, a quatro turmas do 11º ano de escolaridade, do Agrupamento de Escolas de Montemor-o-Velho, num total de 79 alunos. Nesta sessão foi realizada uma avaliação dos níveis de ansiedade, usando como instrumento de avaliação o Inventário de Ansiedade Estado e Traço (STAI na forma Y1 e forma Y2) no início e no final da sessão após o relaxamento. Este instrumento, será de novo aplicado no final do ano letivo. Resultados – Após havermos apresentado e treinado a técnica, nesta primeira sessão, o valor da média da Ansiedade Estado (STAI Y1) oscilou entre 46.79 e 49.10 e o valor da média da Ansiedade Traço (STAI Y2 oscilou entre 47.2 e 49.8. Conclusão – Apesar de obtidos apenas os resultados decorrentes da aplicação de uma única sessão de relaxamento, os valores iniciais das escalas aplicadas traduzem níveis de ansiedade elevados, tendo havido uma resposta positiva, ainda que ténue, à aplicação da técnica, o que nos leva a justificar a continuidade do projeto no sentido de avaliar a eficácia de ensinar e treinar uma técnica de relaxamento ao longo do ano escolar, com vista a obter ganhos na promoção em saúde mental escolar a longo prazo.

Background: This research was developed to study the epidemiology of anisometropia. It aims to estimate the prevalence of anisometropia in Portuguese children and adolescents at various educational stages, studying its association with sociodemographic variables. Methods: Observational cross sectional study envolving 749 children and adolescents (from 3 to 16 years old) from the central region of Portugal. The refraction was performed with a paediatric, open field auto refractometer (PlusOptix), without cycloplegia and under binocular conditions, to determine the rate of anisometropia and its association with gender, study cycle and area of residence. Results: The prevalence of anisometropia in the studied sample was 6.1%, varying from 2.9% in pre-school education to 9.4% in the 3rd study cycle. Myopic anisometropia was the most prevalent and hyperopic and astigmatic anisometropia showed identical proportions of occurrence. No statistical differences were found between genders or between areas of residence regarding the rate of anisometropia. Regarding spherical equivalent anisometropia, there was a pattern of variation that increased with the cycle of studies (p = 0.012), with myopic anisometropia being the main contributor to this variation. Conclusions: This study found an increase in anisometropia with the educational stage. The high rate of anisometropia found in adolescents (9.4%) as well as the progressive increase in this rate throughout school progress (from 2.9% to 9.4%) suggests the need to extend the detection strategies of this condition beyond childhood.

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.

O município de Novo Repartimento, Pará, passou por um processo desordenado de expansão urbana, devido a intensificação das atividades agropecuárias, que desencadeou a ocupação de áreas ambientalmente frágeis. Essa ocupação acentuou impactos negativos causados pelo desmatamento alterando as paisagens. Com isso, o objetivo do estudo foi analisar e avaliar a evolução de uso e ocupação da terra com ênfase nas áreas desmatadas. Os procedimentos consistiram na elaboração e cruzamento de mapas temáticos, a fim de estabelecer classes hierárquicas da variável desmatamento; análise multitemporal da evolução das classes de uso e ocupação entre dois períodos distintos: 2000 e 2019, com auxílio das geotecnologias. Utilizou-se dados cartográficos disponíveis no banco de dados do Instituto Brasileiro de Geografia e Estatística, do Projeto MapBiomas e do Google Earth Engine. Os resultados demonstraram a importância do uso das geotecnologias para o planejamento sustentável da ocupação na terra em que, observa-se que o desmatamento no município é crescente, sendo que dentro das principais variáveis e correlações, destaca-se o setor agropecuário e madeireiro.

Introduction and Objectives: Atrial fibrillation (AF) is the most common form of arrhythmia worldwide and a significant health burden. Edoxaban, a recent novel oral anticoagulant (NOAC), is being investigated in the European real-world ETNA-AF study of patients with non-valvular atrial fibrillation (NVAF). The aim of this study was to characterize the Iberian edoxaban-treated cohort of ETNA-AF at baseline and to compare it with previously retrieved Portuguese data. Methods: Patients with NVAF treated with edoxaban and followed in Portuguese and Spanish centers were consecutively enrolled between June 2017 and January 2018. Only patients with a previous clinical decision to receive edoxaban were included. Patients’ baseline demographic and clinical parameters, medical history, and AF-related characteristics were retrieved. Results: A total of 892 NVAF patients, with a mean age of 73.9 years, were included, 75.3% of whom received high-dose (60 mg) and 24.7% low-dose (30 mg) edoxaban. Most patients (55.9%) were male. Of the patients receiving 30 mg and 60 mg edoxaban, 55.9% and 37.9%, respectively, had an estimated CHA2DS2-VASc score ≥4. Previous bleeding event rates were low, with a predominance of clinically relevant non-major bleeding (1.9%). Most patients (47.5%) with NVAF had paroxysmal AF, followed by 26.4% with permanent AF. Median overall CHA2DS2-VASc score was 3.0 and median HAS-BLED score was 2.0. Previous treatments mostly included vitamin K antagonists (35.7%). A considerably higher proportion of patients on low-dose edoxaban required dose adjustments (71.4% vs. 8.6%). Overall adherence to label dosing recommendations was 86.5%. Conclusions: This study provides valuable data on disease and patient profiles and will provide valuable insights into disease management and progression, as well as the safety, effectiveness, and patterns of cardiovascular events associated with edoxaban. Resumo: Introdução e objetivos: A fibrilhação auricular (FA) é a arritmia mais comum globalmente e associa-se a um substancial ónus de saúde. O novo anticoagulante oral (NOAC) edoxabano está a ser investigado no estudo europeu de vida real ETNA-AF em doentes com fibrilhação auricular não valvular (FANV). O objetivo deste estudo é caracterizar a coorte ibérica do ETNA-AF na base de dados e compará-la com dados portugueses prévios. Métodos: Doentes com FANV tratados com edoxabano e seguidos em centros portugueses e espanhóis foram consecutivamente incluídos no estudo entre junho de 2017 e janeiro de 2018. Apenas doentes com indicação prévia para receber edoxabano foram incluídos e os seus dados clínicos e demográficos, história clínica e características relacionadas com a FA foram registados. Resultados: Fora, incluídos 892 doentes com FANV, com média de 73,9 anos, 75,3% dos quais receberam a dose elevada (60 mg) e 24,7% a dose reduzida (30 mg) de edoxabano. A maioria dos doentes (55,9%) era do sexo masculino. Dos doentes que receberam 30 mg e 60 mg de edoxabano, 55,9% e 37,9%, respetivamente, tinham CHA2DS2-VASc estimado ≥ 4. As taxas de eventos hemorrágicos prévios foram baixas, com predominância de hemorragia não major clinicamente relevante (1,9%). A maioria (47,5%) dos doentes com FANV tinha FA paroxística, seguidos de 26,4% com FA permanente. A mediana de CHA2DS2-VASc global foi 3,0 e a mediana de HAS-BLED, 2,0. Os tratamentos prévios incluíram sobretudo VKAs (35,7%). Uma proporção consideravelmente maior de doentes a receber dose reduzida de edoxabano necessitou de ajustes de dose (71,4% versus 8,6%). A adesão global às recomendações de dose foi de 86,5%. Conclusões: Este estudo fornece dados importantes sobre a doença e o perfil dos doentes e possibilitará considerações futuras acerca da gestão e progressão da doença, bem como de segurança, efetividade e padrões de eventos cardiovasculares associados a edoxabano.

Resumo: Nos últimos anos, temos assistido a um aumento do número de doentes com necessidade de cuidados cardíacos agudos, com patologia cardiovascular progressivamente mais complexa, muitas vezes complicada por comorbilidades não cardiovasculares agudas ou crónicas, com impacto na abordagem e prognóstico destes doentes. As unidades coronárias têm evoluído para unidades de cuidados intensivos cardíacos, caracterizadas por cuidados de saúde altamente especializados ao doente cardíaco crítico. Tendo em conta que os recursos humanos e técnicos nesta área são limitados, considerámos ser urgente uma reflexão profunda sobre o modelo de organização dos cuidados ao doente cardíaco agudo, incluindo a definição do nível de cuidados, a constituição e formação da equipa e a criação de redes de referenciação.Paralelamente, é fundamental um investimento claro dos serviços nesta área central da cardiologia, de forma a alavancar o desenvolvimento contínuo e sustentado de outras áreas cardiológicas essenciais, nomeadamente a eletrofisiologia e a cardiologia de intervenção, assegurando cuidados de excelência e de elevada diferenciação a todos os doentes cardíacos críticos. Abstract: In recent years, the number of patients requiring acute cardiac care has increased, with progressively more complex cardiovascular conditions, often complicated by acute or chronic non‐cardiovascular comorbidities, which affects the management and prognosis of these patients. Coronary care units have evolved into cardiac intensive care units, which provide highly specialized health care for the critical heart patient. In view of the limited human and technical resources in this area, we consider that there is an urgent need for an in‐depth analysis of the organizational model for acute cardiac care, including the definition of the level of care, the composition and training of the team, and the creation of referral networks. It is also crucial to establish protocols and to adopt safe clinical practices to improve levels of quality and safety in the treatment of patients. Considering that acute cardiac care involves conditions with very different severity and prognosis, it is essential to define the level of care to be provided for each type of acute cardiovascular condition in terms of the team, available techniques and infrastructure. This will lead to improvements in the quality of care and patient prognosis, and will also enable more efficient allocation of resources.

Virtual Reality (VR) through head-mounted displays (HMDs) can be delivered via multiple setups such as smartphones, standalone VR or VR Workstations. The VR Workstation setup delivers the best performance of them all; however, as a drawback up until recently, it required cables to power up the VR equipment. The introduction of wireless solutions for VR Workstations came to solve one of the disadvantages of this setup. However, the impact of the wireless solution versus the HMD cables was not yet properly investigated. In this paper, we study the impact of using a wired vs wireless HMD on Presence, Cybersickness, and Game Experience. We conducted a quasi-experimental between-subjects study with 68 participants assigned to the following three groups that were balanced regarding gender and sample size: Cable (participants used a wired HMD), Cable + Help (a researcher assisted the participants with the HMD cable during the experience to reduce the participants' awareness of it), and Wireless (untethered HMD). Results showed no significant differences in presence and cybersickness. The game experience was significantly different, with Cable + Help performing better than Cable and Wireless. We conclude that sense of presence using wireless solutions is equated to wired HMD solutions.

Background: This research was developed to study the epidemiology of anisometropia. It aims to estimate the prevalence of anisometropia in Portuguese children and adolescents at various educational stages, studying its association with sociodemographic variables. Methods: Observational cross sectional study envolving 749 children and adolescents (from 3 to 16 years old) from the central region of Portugal. The refraction was performed with a paediatric, open field auto refractometer (PlusOptix), without cycloplegia and under binocular conditions, to determine the rate of anisometropia and its association with gender, study cycle and area of residence. Results: The prevalence of anisometropia in the studied sample was 6.1%, varying from 2.9% in pre-school education to 9.4% in the 3rd study cycle. Myopic anisometropia was the most prevalent and hyperopic and astigmatic anisometropia showed identical proportions of occurrence. No statistical differences were found between genders or between areas of residence regarding the rate of anisometropia. Regarding spherical equivalent anisometropia, there was a pattern of variation that increased with the cycle of studies (× 2 (3)= 10.918; p = 0.012), with myopic anisometropia being the main contributor to this variation. Conclusions: This study found an increase in anisometropia with the educational stage. The high rate of anisometropia found in adolescents (9.4%) as well as the progressive increase in this rate throughout school progress (from 2.9% to 9.4%) suggests the need to extend the detection strategies of this condition beyond childhood.

Background: This research was developed to study the epidemiology of anisometropia. It aims to estimate the prevalence of anisometropia in Portuguese children and adolescents at various educational stages, studying its association with sociodemographic variables. Methods: Observational cross sectional study envolving 749 children and adolescents (from 3 to 16 years old) from the central region of Portugal. The refraction was performed with a paediatric, open field auto refractometer (PlusOptix), without cycloplegia and under binocular conditions, to determine the rate of anisometropia and its association with gender, study cycle and area of residence. Results: The prevalence of anisometropia in the studied sample was 6.1%, varying from 2.9% in pre-school education to 9.4% in the 3rd study cycle. Myopic anisometropia was the most frequent and hyperopic and astigmatic anisometropia showed identical proportions of occurrence. No statistical differences were found between genders or between areas of residence regarding the rate of anisometropia. Regarding spherical equivalent anisometropia, there was a pattern of variation that increased with the cycle of studies (×2(3)= 10.918; p = 0.012), with myopic anisometropia being the main contributor to this variation. Conclusions: An increase in anisometropia with the educational stage, was found in this study. The high rate of anisometropia found in adolescents (9.4%) as well as the progressive increase in this rate throughout school progress (from 2.9% to 9.4%) suggests the need to extend the detection strategies of this condition beyond childhood.

Monitoring the ecological status of marine coastal lagoons requires the integration of multiple indices. However, the efficacy of monitoring programs is complicated by the diverse array of habitats that conform coastal lagoons. In this study, we compared four sampling methods (25-m and 50-m beach seines, beam trawl and Riley push net) in the Ria Formosa coastal lagoon (South Portugal) for assessing fish assemblage and diversity. We compared species richness and assemblage structure with species accumulation curves and multivariate analysis, and assessed diversity patterns using taxonomic, phylogenetic and functional diversity indices. Variation in fish assemblage structure was mostly explained by gear type, and almost all diversity metrics varied not only according to sampling method but also depending on habitat characteristics and season. Based on operational costs and diversity patterns captured by each gear, we conclude that the combined use of 25-m beach seine and beam trawl is the preferred approach. The proposed methodology will provide the data necessary for assessment of ecological status of coastal lagoons.

Abstract Under conditions of starvation, normal and tumor epithelial cells can rewire their metabolism toward the consumption of extracellular proteins, including extracellular matrix‐derived components as nutrient sources. The mechanism of pericellular matrix degradation by starved cells has been largely overlooked. Here it is shown that matrix degradation by breast and pancreatic tumor cells and patient‐derived xenograft explants increases by one order of magnitude upon amino acid and growth factor deprivation. In addition, it is found that collagenolysis requires the invadopodia components, TKS5, and the transmembrane metalloproteinase, MT1‐MMP, which are key to the tumor invasion program. Increased collagenolysis is controlled by mTOR repression upon nutrient depletion or pharmacological inhibition by rapamycin. The results reveal that starvation hampers clathrin‐mediated endocytosis, resulting in MT1‐MMP accumulation in arrested clathrin‐coated pits. The study uncovers a new mechanism whereby mTOR repression in starved cells leads to the repurposing of abundant plasma membrane clathrin‐coated pits into robust ECM‐degradative assemblies.

Identifying vulnerable marine habitats is fundamental to promote evidence-based management and a sustainable use of our oceans. Although progress in the mapping of marine benthic habitats has been made, complex ecosystems such as submarine canyons remain largely unexplored, hampering evidence-based management from taking place in these ubiquitous features worldwide. Data from a remotely operated vehicle (ROV) survey in the upper São Vicente Submarine Canyon in southwestern Portugal from 2011, was analysed to carry out a comprehensive assessment of megabenthic habitats, particularly those of conservation concern occuring between 90 and 560 m. Underwater videos from three exploratory dives, covering a total of 8.8 kilometers, were analyzed through multivariate and visual assessments, and the identified habitats were assessed against a set of criteria derived from current definitions of priority habitats. Thirteen potential priority habitats were characterized, out of which four distinct “coral gardens” and one “deep-sea sponge aggregation” are aligned with OSPAR definitions of priority habitats, and one corresponds to the habitat of a strictly protected sea urchin listed in the Habitats Directive. Three circalittoral sponge aggregations were also suggested based on the abundance of indicator species. The specific composition and diversity of priority habitats as described here, has not yet been described in any other canyon in the NE Atlantic region. Depth was revealed to be particularly important for the distribution of habitats, followed by relief and substratum. The approach presented in this study contributes to improve the understanding about submarine canyons, which is paramount to implement knowledge-based protection measures. Furthermore, it can be used to support future mapping efforts of deep-sea environments such as submarine canyons.

Resumo: A prevalência da diabetes mellitus tipo 2 (DMT2) continua a aumentar e a sua associação com a doença cardiovascular (CV) tem levado à incorporação e valorização de endpoints CV nos ensaios clínicos sobre o tratamento da DMT2.Este artigo faz uma revisão dos vários ensaios já realizados e em desenvolvimento, neste âmbito, com especial enfoque no estudo EMPA‐REG OUTCOME. Neste estudo, a empagliflozina, um inibidor do cotransportador tipo 2 de sódio/glicose (iSGLT2), demonstrou efeitos benéficos na redução do risco CV em doentes com DMT2 e doença CV estabelecida, para além de segurança CV e diminuição dos valores de HbA1c, representando uma mudança de paradigma com impacto ao nível das recomendações internacionais para o tratamento da DMT2. Estes resultados mantiveram‐se em análises de subgrupos posteriores, nomeadamente na insuficiência cardíaca, doença renal crónica e doença arterial periférica, ainda que muitas questões se coloquem sobre os mecanismos envolvidos nestes efeitos – se efeitos hemodinâmicos, efeitos metabólicos ou se a diminuição das concentrações de sódio citoplasmático no miocárdio.Com a diminuição do risco de eventos CV major em doentes com DMT2, os resultados do estudo EMPA‐REG OUTCOME demonstraram, pela primeira vez, proteção CV associada ao efeito de um fármaco anti‐hiperglicémico e iniciaram uma nova era no tratamento e gestão da DMT2. Este estudo levou ao desenvolvimento de outros ensaios, ainda a decorrer, que permitirão estabelecer quais os doentes que mais beneficiarão desta terapêutica, nomeadamente na relação à existência de comorbilidades. Abstract: The prevalence of type 2 diabetes (T2D) continues to increase, and its association with cardiovascular (CV) disease has led to the inclusion of CV endpoints in clinical trials on the treatment of T2D.This article explores the various trials already performed and under development in this field, with particular focus on the EMPA‐REG OUTCOME trial. In this trial, empagliflozin, a sodium‐glucose co‐transporter 2 inhibitor, demonstrated a reduction in CV risk in patients with T2D and established CV disease, in addition to CV safety and a decrease in glycated hemoglobin. This represents a paradigm shift that has led to changes in the international guidelines for the treatment of T2D. These results were maintained in subsequent subgroup analysis for heart failure, chronic kidney disease and peripheral arterial disease, although there are many questions concerning the mechanisms involved in these effects, including whether they are hemodynamic, metabolic or due to decreased myocardial cytoplasmic sodium concentrations.With this reduction in risk for major CV events in patients with T2D, the EMPA‐REG OUTCOME trial demonstrated CV protection from a hypoglycemic drug for the first time, and opened a new era in the treatment and management of T2D. This study has led to the development of ongoing trials that will establish which patients will benefit most from this therapy, particularly with regard to comorbidities. Palavras‐chave: Empagliflozina, Diabetes, Doença cardiovascular, Insuficiência cardíaca, Keywords: Empagliflozin, Diabetes, Cardiovascular disease, Heart failure

Abstract Background Non-vitamin K antagonist (VKA) oral anticoagulants (NOACs) have substantially improved anticoagulation therapy for prevention of stroke and systemic embolism in patients with atrial fibrillation (AF). The available routine care data have demonstrated the safety of different NOACs; however, such data for edoxaban are scarce. Here, we report baseline characteristics of 13,638 edoxaban-treated patients with AF enrolled between November 2016 and February 2018. Methods ETNA-AF-Europe is a multinational, multi-centre, post-authorisation, observational study conducted in 825 sites in 10 European countries. Patients will be followed up for four years. Results Overall, 13,980 patients were enrolled of which 342 patients were excluded from the analysis. Mean patient age was 73.6 years with an average creatinine clearance of 69.4 mL/min. 56.6% were male. The calculated CHA2DS2-VASc and HAS-BLED mean scores were 3.1 and 2.6, respectively. Overall, 3.3, 14.6 and 82.0% of patients had low (CHA2DS2-VASc = 0), intermediate (CHA2DS2-VASc = 1) and high (CHA2DS2-VASc≥2) risks of stroke, respectively. High-risk patients (those with prior stroke, prior major bleeding, prior intracranial bleed or CHA2DS2-VASc ≥4) comprised 38.4% of the overall population. For 75.1% of patients edoxaban was their first anticoagulant prescription, whilst 16.9% switched from a VKA and 8.0% from another NOAC. A total of 23.4% of patients in ETNA-AF-Europe received the reduced dose of edoxaban 30 mg. Overall, 83.8% of patients received an edoxaban dose in line with the criteria outlined in the label. Conclusion Edoxaban was predominantly initiated in older, often anticoagulation-naïve, unselected European patients with AF, with a good overall adherence to the approved label. Trial registration NCT02944019; Date of registration: October 24, 2016.

Although selection menus are widely used for interaction, their use on 3D virtual reality applications needs to be objectively assessed. The focus of this study is to evaluate a traditional panel and a radial menu in two distinct virtual environment placements (i.e. fixed on the wall and following the users' hands). Fifty-one participants used two different menus of the four possible combinations. To evaluate the menus' effectiveness and efficiency, we measured usability (System Usability Scale Questionnaire), user satisfaction (After-Scenario Questionnaire), time to finish the tasks (in seconds) and the number of unnecessary steps (errors) performed by the users. Overall results showed a clear preference for the traditional panel menu type and the fixed wall placement of the menu. We conclude that all menu types perform well, despite different user preferences, and that fixing the menu to the wall gives users a better overview of both the menu and the virtual environment, improving their ability to perceive their actions on the menu.

The destruction caused by forest fires generates social impacts, environmental impacts, and extremely important economic impacts caused by the destruction of a wide range of infrastructures and essential goods. Therefore, as it is impossible to remove all the infrastructures from the forest and wildland–urban interface, the design of protection systems is essential. The main objective of this work is the development of a low-cost protection system, with rigid panels, requiring a simple installation, in order to protect outdoor infrastructures such as telecommunications stations, shelters, roadside enclosures, power cabinets, and other structures. A study was carried out on panels that could be used for protection in order to determine whether the protective material would be more appropriate. Taking into account the fire resistance behavior, thermal and structural properties and cost, the panels selected were the magnesium oxide fiberglass reinforced. The protection was constructed, installed on a telecommunication cabinet, and experimentally laboratory tested in a wind combustion tunnel. To collect the data InfraRed and video cameras, heat flux sensors, and thermocouples were used to determine the fire propagation, heat flux, and temperatures, respectively. The experimental data show that the low-cost protection is effective for protecting telecommunication cabinets and similar infrastructures against forest fires.

In recent years, an increased interest in marine macroalgae bioactive compounds has been recorded due to their benefits to human health and welfare. Several of their bioactivities have been demonstrated, such as anti-inflammatory, antioxidant, anticarcinogenic, antibacterial and antiviral behavior. However, there still lacks a clear definition regarding how these compounds exert their bioactive properties. Of all the bioactive compounds derived from marine macroalgae, attention has been focused on phenolic compounds, specifically in phlorotannins, due to their potential for biomedical applications. Phlorotannins are a diverse and wide group of phenolic compounds, with several structural variations based on the monomer phloroglucinol. Among the diverse phlorotannin structures, the eckol-family of phlorotannins demonstrates remarkable bioactivity, notably their anti-tumoral properties. However, the molecular mechanisms by which this activity is achieved remain elusive and sparse. This review focuses on the described molecular mechanisms of anti-tumoral effects by the eckol family of compounds and the future prospects of these molecules for potential application in oncology therapies.

Introduction: Guidewire fracture is a rare complication of percutaneous coronary intervention (PCI). Retained fragments can cause thrombosis, dissection, perforation of the vessel or embolize. When is impossible to withdraw or to trap the fragment during the procedure, management is debatable between surgical removal or conservative approach. When choosing to leave the fragment in place, the patient remains at risk for all of the aforementioned complications. Clinical Case: 65-year-old male patient submitted to PCI with stenting of distal right coronary artery in 2017. A proximal optimization technique was performed, with a guidewire placed in the posterior descending artery (PDA). After stenting, the protection guidewire became entrapped and after several retrieval attempts, it fractured. Wire fragment remained within the RCA and ascending aorta with a free mobile distal part in the beginning of the innominate artery. Multiple attempts went in vain for wire retrieval and a conservative approach was adopted. Two and a half years later, the patient felt a sudden chest pain and then collapsed. He was transferred to our Hospital for emergent surgery due to cardiac tamponade. Intra-operatively, cardiac surgeons found the guidewire perforating the posterior descending artery. When trying to pull it out, the guidewire fractured again. Post-intervention CTA revealed migration of the fragmented guidewire now it was entrapped in a tortuous initial portion of the right internal carotid artery and a small pseudoaneurysm was visible at the distal portion of the wire. Surgical approach was performed revealing the presence of the wire within the carotid medial wall, in a subintimal plane. The 7 cm fragment was successfully withdrawn, through a common carotid transverse incision. Pseudoaneurismectomy was performed and carotid artery bifurcation reconstruction with internal carotid artery re-implantation into the bifurcation, end-to-end anastomosis. The patient had an uneventful postoperative course. Conclusion: Although leaving the wire in place remains an option, coronary guidewire fractured fragments can be associated not only with immediate complications but also with potential adverse events in the long run.

En este estudio se pretende explorar la ligación entre la memoria, los hechos caballerescos y la imitación en el Memorial das Proezas da Segunda Távola Redonda. A lo largo del texto, se enfatiza varias veces esta articulación, atestiguando en qué medida la memoria escrita (sea verídica o ficticia) es imprescindible para acreditar los hechos prodigiosos de los mejores caballeros, transmitir sus valores y persuadir a los receptores de los textos a imitar tales hechos. El objetivo es presentar cómo esta estructura retórica es tematizada de forma general en este texto, recurriendo a las más recientes teorías de la memoria, al mismo tiempo que se procurará averiguar la importancia de las representaciones de la memoria y del plan de instrucción presente en la obra.

La pesca experimental se llevó a cabo frente al puerto de Quarteira (sur de Portugal), de octubre de 2016 a febrero de 2017, utilizando redes de trasmallo estándar y redes modificadas con una red de protección llamada “faldón”. Las capturas comerciales de redes de trasmallo equipadas con una red de protección fueron 46.1% y 38.0% menores que las de la red estándar en número y valor económico. Sin embargo, hubo significativamente menos descartes comerciales en biomasa en las redes de trasmallo modificadas (68.2%) y la abundancia de las capturas secundarias y su biomasa también fueron menores en las redes modificadas (41.8% y 17.3% menos respectivamente). Para las dos principales especies de la captura secundaria de peces, la red modificada capturó un 62.2% menos de arete oscuro (C. obscurus) y un 33.1% menos de araña (T. draco) que las redes estándar. El tiempo necesario para quitar las especies principales de las redes reveló ahorros en el tiempo asociados con el uso de redes modificadas. Sin embargo, hubo el doble de daño neto en las redes modificadas en comparación con las redes estándar, lo que probablemente contribuyó a la reducción de las capturas comerciales. Los resultados indican que las redes de trasmallo con la red de protección reducen la captura fortuita y los descartes y ahorran tiempo, pero es poco probable que sean adoptadas por los pescadores que buscan lenguados debido a los mayores costos de las redes modificadas y las pérdidas en las capturas comerciales y las ganancias.

Infective celiac artery aneurysm is an extremely rare diagnosis, with few reported cases in the literature. We present the case of a rapidly expanding celiac artery aneurysm involving the ostia, probably infectious, successfully treated in an urgent setting by aneurysm exclusion resorting to the chimney technique. On follow-up, computed tomography angiography revealed complete aneurysm thrombosis and patent celiac artery. Previous reports of endovascular treatment of infective celiac artery aneurysm involved its embolization. This is the first reported case of chimney technique used to exclude a celiac artery aneurysm, with a clinical suspicion of infectious etiology, preserving celiac artery patency. Short-term results are encouraging, but implantation of prosthetic material in an infected environment is a concern. Keywords: Aneurysm, Infected, Celiac artery, Endovascular procedures

The ability of cancer cells to migrate through small, constricted areas is limited by nuclear stiffness. Here the authors show that in turn nuclear stiffness stimulates the delivery of enzymes important for the degradation of the extracellular matrix and the formation of invadopodia in association with fibers thus opposing nuclear movement.

Resumo: Introduçã e objetivo: A fibrilhação auricular (FA) é um dos mais importantes problemas de saúde pública em Portugal, representa simultaneamente um importante fator e marcador de risco cardiovascular. Avaliar, numa população representativa com 65 ou mais anos, a prevalência, epidemiologia e caracterização clínica e terapêutica da FA. Métodos: Foram avaliados 7500 indivíduos de 65 anos ou mais, recrutados em todas as regiões administrativas e representativos da população idosa residente em Portugal continental. A todos eles foi feito um ECG e, na ausência de FA, um subgrupo fez ainda Holter de 24 h ou implantou um registador de eventos durante sete dias. Em toda essa população foram avaliados dados epidemiológicos, clínicos e farmacológicos. Resultados: A população estudada (41,9% do sexo masculino e 58,1% feminino), com média de 68,9 anos, apresentou uma prevalência global de FA de 9,0%. Desses 35,9% desconheciam ter FA e 18,6% apresentavam FA paroxística. Nessa população, a prevalência de HTA foi de 85,3%, de dislipidemia foi de 75,4% e de diabetes de 22,7%. O valor mediano do score de Chads‐vasc foi de 3,5 +/‐1,2. Em termos de abordagem terapêutica, 56,3% dos doentes não estavam anticoagulados (29,8% dos doentes estavam antiagregados) e, de entre os medicados com antivitamínicos K, o valor médio de TTR foi de 41,7%. Conclusões: Este estudo mostra a muito elevada prevalência de FA na população idosa portuguesa, bem como uma taxa subótima de diagnóstico, anticoagulação e controlo efetivo dos fatores de risco cardiovasculares. Abstract: Introduction and Aim: Atrial fibrillation (AF) is a common arrhythmia and an important risk factor for ischemic stroke. The current ESC guidelines state that all patients aged 65 and over should be regularly screened for AF. The SAFIRA study aimed to determine the prevalence, epidemiology and clinical and therapeutic characterization of AF in the Portuguese elderly population. Methods: The study population (7500 subjects) were recruited from all Portuguese administrative regions. Demographic, clinical and drug treatment data were collected, risk scores were calculated, and an electrocardiogram (ECG) was performed in all subjects. In those not found to have AF on the resting ECG, a randomized subset (400 subjects) underwent 24‐hour Holter monitoring and 200 subjects were fitted with an event recorder for two weeks, in order to identify patients with paroxysmal AF. The primary endpoint was AF prevalence; secondary endpoints (in the AF population) included prevalence of paroxysmal AF, mean and median CHA2DS2‐VASc and HAS‐BLED scores, rates of anticoagulant and antiplatelet therapy, previous stroke, previous stroke/transient ischemic attack, previous bleeding, and time in therapeutic range (if on vitamin K antagonists). Results: The prevalence of AF was 9.0%. Of these, 35.9% were unaware of the diagnosis and 18.6% had paroxysmal AF. Median CHA2DS2‐VASc score was 3.5±1.2 and 56.3% of patients were not anticoagulated. In the AF subpopulation, the stroke rate was 11.2%. Overall, only 25.8% of the anticoagulated patients were considered to be adequately treated. Conclusions: This study shows the high prevalence of AF in the elderly population, as well as suboptimal rates of diagnosis, anticoagulation and effective control of cardiovascular risk factors. Palavras‐chave: Epidemiologia, Fibrilhação auricular, Idosos, Keywords: Epidemiology, Atrial fibrillation, Elderly

Macroalgae are a biological group that has mainly been used in Asian countries; however, the interest shown by Western society is recent, its application in the industrial sector having increased in the last few decades. Seaweeds are filled with properties which are beneficial to our health. To use them as food and enhance these properties, heat has been used on them. This process alters the bioactive compounds. If we study the levels of moisture, they can vary according to the drying methods used. High values of moisture can lead to a short shelf life due to oxidation, microbial or enzyme activity, so controlling these values is highly recommended. Heat causes enzymatic activity as well as oxidation, which leads to degradation of phenolic compounds in comparison with freeze-drying, which causes fewer losses of these components. Due to the same occurrences, lipid content can also vary, modifying the bioactive compounds and their benefits. Pigments are some of the components most affected by heat, since, through this process, seaweeds or seaweed products can suffer a change in color. Iodine in macroalgae can decrease drastically; on the other hand, protein yield can be greatly enhanced. Some studies showed that the amount of arsenic in raw seaweeds was higher than when they were heat processed, and that arsenic values varied when different heat treatments were applied. Additionally, another study showed that heat can alter protein yield in specific species and have a different effect on other species.

Introduction: Most mental disorders have a chronic evolution and therefore a certain amount of psychiatric readmissions are inevitable. Several studies indicate that over 25% of child and adolescent inpatients were readmitted within one year of discharge. Several risk factors for psychiatric readmissions have been reported in the literature, but the history of repeated readmissions is the most consistent risk factor. Our aim is to calculate the readmission rates at 30 days and 12 months after discharge and to identify associated risk factors. Material and Methods: The authors consulted the clinical files of patients admitted to the Inpatient Unit between 2010 and 2013, in order to calculate the readmission rates at 30 days and at 12 months. The demographic and clinical characteristics of the readmitted patients were analyzed and compared with a second group of patients with no hospital readmissions, in order to investigate possible predictors of readmission. Results: A total of 445 patients were admitted to our inpatient unit between 2010 and 2013. Six adolescents were readmitted in a 30 days period (1.3%) and 52 were readmitted in a 12 month period after discharge (11.5%). Duration of the hospitalization and the previous number of mental health admissions were significant predictors of future hospital readmissions (p = 0.04 and p = 0.014). Discussion: The low readmission rates may reflect the positive clinical and sociofamilial support being provided after discharge. Conclusion: Rehospitalisation is considered a fundamental target for intervention concerning prevention and intervention in mental healthcare. Thus, knowledge regarding their minimisation is crucial.

Introduction: Intermediate-high risk pulmonary embolism (IHR-PE) has a poor prognosis, but is under-represented in trials of direct oral anticoagulants (DOACs) in venous thromboembolic disease (VTE). We aimed to assess whether the administration of DOACs was equivalent to the conventional (CONV) treatment of low-molecular weight heparin bridged with warfarin for treating IHR-PE. Methods: We conducted a retrospective cohort study including 59 consecutive patients admitted with IHR-PE and followed for up to three months after discharge. Two groups were created based on the anticoagulant strategy: CONV (n=35) and DOAC (n=24). The efficacy endpoints were death, recurrent PE, estimated pulmonary artery systolic pressure (PASP), right ventricular systolic function (RVSF) at discharge, and length of stay; the safety endpoint was major bleeding. Results: The two groups were similar regarding demographics, PE etiology and markers of clinical severity. There were four in-hospital deaths in the CONV group and none in the DOAC group. No recurrent PE or major bleeding event was recorded in either group. At discharge, neither PASP nor RVSF was different between the groups. Patients in the DOAC group were discharged 1.7 days earlier on average than patients in the CONV group (4.7±2.4 vs. 3.0±1.5 days, p=0.002). Conclusions: The adoption of a DOAC treatment strategy in this real-world cohort of IHR-PE patients was associated with similar efficacy and safety to the CONV approach. The fact that monitoring of anticoagulation effect was unnecessary probably led to the significant reduction in length of stay. Resumo: Introdução: O tromboembolismo pulmonar de risco intermédio-elevado (TEP-IE) condiciona um prognóstico mais agravado, mas se encontra sub-representado nos ensaios dos anticoagulantes orais diretos (ACOd) na doença tromboembólica venosa (DTV). Avaliamos se a administração de ACOd foi equivalente à estratégia terapêutica convencional (CONV) (heparina de baixo peso molecular (HBPM) + varfarina) no tratamento do TEP-IE. Métodos: Fez-se um estudo de coorte retrospetivo com 59 doentes consecutivos internados por TEP-IE, seguidos até três meses após a alta. Criaram-se dois grupos, baseados na estratégia terapêutica anticoagulante: CONV (n = 35) e DOAC (n = 24) (ACOd). Os desfechos de eficácia foram a morte, o TEP recorrente, a pressão sistólica na artéria pulmonar (PSAP), a função ventricular direita (FVD) e a duração do internamento; o desfecho de segurança foi a hemorragia major. Resultados: Os grupos eram comparáveis relativamente aos aspetos demográficos, à etiologia do TEP e aos marcadores de gravidade clínica. Ocorreram quatro mortes intra-hospitalares no grupo CONV e nenhuma no grupo DOAC. Nenhum evento de TEP recorrente ou hemorragia major ocorreu em qualquer dos grupos. À data de alta, quer a PSAP quer a FVD não diferiram entre os dois grupos. A alta ocorreu 1,7 dia mais cedo no grupo DOAC do que no grupo CONV (4,7±2,4 versus 3,0±1,5 dias, p = 0,002). Conclusões: A adoção de uma estratégia de tratamento com ACOd associou-se a um perfil de eficácia e segurança semelhante à abordagem convencional. A ausência da necessidade de monitoração do efeito anticoagulante provavelmente motivou a redução na duração de internamento. Keywords: Anticoagulants, Venous thromboembolism, Real world, Pulmonary embolism, Intermediate-high risk, Warfarin, Palavras-chave: Anticoagulantes, Tromboembolismo venoso, Mundo real, Embolia pulmonar, Risco intermédio a elevado, Varfarina

Introduction: Infectious celiac artery aneurysm (ICAA) is an extremely rare diagnosis, and only a few cases have been reported in the literature to date. We aimed to review this rare clinical entity, focusing on diagnosis and treatment strategies. Methods: A systematic literature review was performed using MEDLINE database according to the PRISMA guidelines. Results: A total of 11 cases of ICAA were identified in the literature to date. Treatment options were extremely variable and included both open and endovascular surgery. Open surgery included aneurysm ligation or aneurysmectomy with or without revascularization with bypass. Endovascular options are increasingly used and include embolization of the aneurysm and collaterals, stentgraft exclusion of the ICAA and in one case report, Chimney technique was used to exclude the aneurysm maintaining celiac trunk patency. Unsurprisingly, antibiotherapy was consistently an essential part of the treatment strategy. Conclusions: Due to the rarity of ICAA, natural history is unclear. Still, surgical treatment is unanimous regardless of aneurysm size. Short term results of endovascular treatment are encouraging, but endovascular implantation of prosthetic material in an infected environment is a concern, so lifelong antibiotherapy and close monitoring are advisable.

Introdução: A Síndrome Linfoproliferativa Autoimune (ALPS) é doença rara, genética, decorrente de mutações nos genes da via Fas e que ocasionam defeitos na apoptose linfocitária, levando a anemia hemolítica autoimune, linfoadenomegalia, esplenomegalia, hipergamaglobulinemia, elevação exagerada da vitamina B12 e propensão para transformação linfomatosa. Relato do caso: Lactente com 5 meses, gênero feminino, admitida para investigar anemia, esplenomegalia e episódios repetitivos de infecções. Exames laboratoriais mostraram anemia hemolítica autoimune, hipergamaglobulinemia e elevação sérica da vitamina B12. A citometria de fluxo evidenciou população de linfócitos T anormal: TCR-αβ/C3+/CD4-/CD8-. O estudo histopatológico do linfonodo revelou hiperplasia paracortical com células T transformadas, CD3+/CD4-/CD8-. A análise citogenética por bandeamento G na medula óssea mostrou cariótipo normal (46,XX) e técnica de FISH em núcleos interfásico afastou a ocorrência da monossomia do cromossomo 7. O sequenciamento do gene Fas revelou presença da variante patogênica de substituição em heterozigose, no sítio de splicing do íntron 4 (IVS4+1G>A). A paciente foi diagnosticada como ALPS e tratada com corticosteroide, houve regressão significante da esplenomegalia e estabilização da anemia hemolítica, teste de Coombs negativo. Atualmente está estável, em uso de baixas doses de corticosteroide. Comentários: Os autores chamam atenção para necessidade da investigação da ALPS em pacientes pediátricos que cursam com anemia hemolítica, esplenomegalia e infecções de repetição.

The ocean plays a vital role in the global climate system and biosphere, providing crucial resources for humanity including water, food, energy, and raw materials. There is a compelling need to develop an integrated basin-scale ocean observing system to support of ocean management. We articulate a vision for basin-scale ocean observing – A comprehensive All-Atlantic Ocean Observing Systems that benefits all of us living, working and relying on the ocean. Until now, basin-scale ocean observation has been conducted through loosely-aligned arrangements of national and international efforts. The All-Atlantic Ocean Observing System (AtlantOS) is an integrated concept for a forward-looking framework and basin-scale partnership to establish a comprehensive ocean observing system for the Atlantic Ocean as a whole. The system will be sustainable, multi-disciplinary, multi-thematic, efficient, and fit-for-purpose. Platforms, networks, and systems do already exist that operate at various maturity levels. AtlantOS will go beyond the status quo by bringing together the observing communities and countries of the Atlantic basin, providing the opportunity to join and support the system. AtlantOS will build upon the coordinated work of the Global Ocean Observing System (GOOS) and the Group on Earth Observations (GEO), two international bodies that support and coordinate global ocean observing. AtlantOS will complement those efforts and offers a new approach to organizing ocean observing at the basin-scale. AtlantOS will focus not only on the physics but also the biology, ecology and biogeochemistry of the ocean and seafloor and will enhance new partnerships among governments, science, civil society and the private sector.

ObjectivesTo present the technical background and the development of a procedure that enriches the semantics of Health Level Seven version 2 (HL7v2) messages for software-intensive systems in telemedicine trauma care.MethodsThis study followed a multilevel model-driven approach for the development of semantically interoperable health information systems. The Pre-Hospital Trauma Life Support (PHTLS) ABCDE protocol was adopted as the use case. A prototype application embedded the semantics into an HL7v2 message as an eXtensible Markup Language (XML) file, which was validated against an XML schema that defines constraints on a common reference model. This message was exchanged with a second prototype application, developed on the Mirth middleware, which was also used to parse and validate both the original and the hybrid messages.ResultsBoth versions of the data instance (one pure XML, one embedded in the HL7v2 message) were equally validated and the RDF-based semantics recovered by the receiving side of the prototype from the shared XML schema.ConclusionsThis study demonstrated the semantic enrichment of HL7v2 messages for intensive-software telemedicine systems for trauma care, by validating components of extracts generated in various computing environments. The adoption of the method proposed in this study ensures the compliance of the HL7v2 standard in Semantic Web technologies.

Seaweeds have attracted high interest in recent years due to their chemical and bioactive properties to find new molecules with valuable applications for humankind. Phenolic compounds are the group of metabolites with the most structural variation and the highest content in seaweeds. The most researched seaweed polyphenol class is the phlorotannins, which are specifically synthesized by brown seaweeds, but there are other polyphenolic compounds, such as bromophenols, flavonoids, phenolic terpenoids, and mycosporine-like amino acids. The compounds already discovered and characterized demonstrate a full range of bioactivities and potential future applications in various industrial sectors. This review focuses on the extraction, purification, and future applications of seaweed phenolic compounds based on the bioactive properties described in the literature. It also intends to provide a comprehensive insight into the phenolic compounds in seaweed.

The effects of two different slipping methods on the survival, physical and physiological response of sardines, Sardina pilchardus, captured in a purse-seine fishery were investigated in southern Portugal. Sardines were collected and transferred into holding tanks onboard a commercial fishing vessel after being captured, crowded and deliberately released using two slipping procedures: standard and modified. The standard slipping procedure aggregated fish at high densities and made them "roll over" the floatline, while the modified procedure aggregated the fish at moderate densities and enabled them to escape through an opening created by adding weights to the floatline. Both slipping methods were compared with minimally harmed non-slipped sardines (sardines collected from the loose pocket of the purse seine). Survival rates were monitored in captivity over 28 days using three replicates for each treatment. The estimated survival of sardines was 43.6% for the non-slipped fish, 44.7% for the modified slipping and 11.7% for the standard slipping treatments. Scale loss indicated the level of physical impact experienced, with dead fish from the non-slipped and modified slipping technique showing significantly lower scale loss than those fish from the standard slipping treatment within the same period. Of the physiological indicators of stress measured, cortisol, glucose, lactate and osmolality attained peak values during slipping and up to the first hours after introduction to captivity. This work indicates that although delayed mortality after release may be substantial, appropriately modified slipping techniques significantly enhance survival of slipped sardines.

This work presents a restructuring of taxes in the automotive sector in Brazil in order to foster sustainable development. Personal vehicles, trucks or buses emit gases that contribute to global warming and cause human health problems. There are policies in Brazil to reduce the emission of air pollutants from vehicles; however, these neither punish the polluter nor provide for damage compensation. The Tax Law, with the Constitutional Polluter Pays Principle, is an efficient instrument for State intervention in the economy. The work compared environmental and economic views regarding fuel and both personal and public vehicles. We estimated the environmental benefits of recycling vehicles in use more than 10 years, taking into consideration pollution engendered in the manufacture of a new vehicle. Finally, we propose to unify vehicular taxation when the vehicle is acquired, by ending the ICMS and PIS / COFINS taxes on fuels and instead taxing CIDE-fuels, without reducing overall collection by the Brazilian government. The ensuing revenue would be used for repairing environmental damages. We have also made suggestions for the improvement of public policies to control emissions of atmospheric pollutants.