Aromatase Inhibitors in Male Adolescents with Idiopathic Short Stature

Introdução: O efeito dos fármacos inibidores da aromatase (IA) na estatura de jovens do sexo masculino com baixa estatura idiopática (BEI) tem vindo a ser estudado desde que foi evidenciado o papel dos estrogénios na paragem do crescimento linear. Os ensaios clínicos aleatorizados, duplamente cegos, de caso-controlo com letrozol indicam impacto positivo na previsão de estatura final em jovens do sexo masculino com BEI, com ou sem atraso constitucional do crescimento e puberdade. Por persistirem aspetos de segurança a requerer melhor estudo, a sua utilização terapêutica continua a ser off label. Objetivos: Tendo em vista a implementação de um ensaio clínico sobre a terapêutica com IA em jovens do sexo masculino com BEI procedeu-se a uma revisão sistemática da literatura, na qual se fundamenta a proposta de protocolo apresentada. Métodos: Pesquisa na base de dados eletrónica Medline de revisões sistemáticas, ensaios clínicos alea-torizados controlados e referências bibliográficas dos artigos seleccionados, publicados entre Janeiro de 2001 e Dezembro de 2012. Conclusões: A terapêutica com um IA de terceira geração (letrozol) poderá ser considerada em jovens do sexo masculino com BEI, altura inferior a pelo menos −2,0 SDS para a idade ou previsão de altura final pelo menos 2,0 SDS abaixo da estatura média parental, desde que já tenha sido iniciada a puberdade e a idade óssea seja inferior a 14 anos. Os principais aspectos de segurança ainda sob discussão na literatura referem-se a potenciais efeitos a nível ósseo. A utilização de medicamentos off-label deve obedecer a critérios estritos de prescrição e seguimento das crianças, de forma a minimizar os riscos e obter resultados fiáveis e comparáveis. Apresenta-se proposta de sistematização de monitorização clínica, imagiológica e laboratorial, bem como critérios de término ou suspensão da mesma

Reclaiming public space in Kuwait’s residential neighbourhoods: an applied policy-oriented approach

Kuwait’s population is expanding rapidly and accommodating this growth through sustainable urban development will be a challenge for the small emirate. This calls for a shift in current urbanisation patterns that are contributing to high levels of motorisation, public space neglect, physical inactivity and health and environmental problems.1 These negative externalities are coupled with unsustainable and profit-driven regeneration schemes that neglect the relationship between everyday behaviour and public space. Consequently, re-evaluating the relationship between urban growth and public space standards becomes vital. This applied policy-oriented research expands on the limited qualitative studies on public space in Kuwait and challenges state top-down design standards used in planning its residential neighbourhoods. It explores the impact that planning, design, and behavioural factors have on public space use. Building on the existing literature, it also adds a socio-spatial dimension to public space studies and contributes a qualitative policy-oriented approach that is environmentally sustainable and one that leads to healthier social and individual behaviour. A comparative case study method guided the investigation on two local streets in residential neighbourhoods in Kuwait with divergent urban characteristics: 4th Street, Qortuba and AlDimna Street, Salmiya. A qualitative user-centred analysis based on Gehl’s public survey tools2 was then used ‘to measure public space and public life’.3 The findings highlight that an overlap in responsibilities at state planning authorities and limited user-centred policies have hindered the successful use of public space in Kuwait. However, and as this investigation illustrates, public space improvement cannot be achieved with isolated measures. Design improvements to public space must also take into account the cultural and climatic impact of users’ social negotiations that take place in the public space of residential neighbourhoods in Kuwait. This investigation uses the selected case studies to address these different factors. The aim is to explore the impact of qualitative methods of analysis in understanding public space and to use the collected data to generate evidence-based policies that could then be applied on a much larger scale to the sustainable urban development of Kuwait. Effective urban policies and management will promote the necessary change that will help create more vibrant communities

Paraovarian tumor of borderline malignancy: a case report

A case of a 23-year-old woman with a paraovarian tumor is presented. The patient complained of pelvic pain and abdominal swelling. Cystectomy was the initial surgical treatment, but after the histological diagnosis, a staging surgery was carried out. The clinical aspects and subsequent management of related cases are discussed, and a literature review is made

Determinants of the Use of Health and Fitness Mobile Apps by Patients With Asthma: Secondary Analysis of Observational Studies

Background: Health and fitness apps have potential benefits to improve self-management and disease control among patients with asthma. However, inconsistent use rates have been reported across studies, regions, and health systems. A better understanding of the characteristics of users and nonusers is critical to design solutions that are effectively integrated in patients' daily lives, and to ensure that these equitably reach out to different groups of patients, thus improving rather than entrenching health inequities. Objective: This study aimed to evaluate the use of general health and fitness apps by patients with asthma and to identify determinants of usage. Methods: A secondary analysis of the INSPIRERS observational studies was conducted using data from face-to-face visits. Patients with a diagnosis of asthma were included between November 2017 and August 2020. Individual-level data were collected, including age, gender, marital status, educational level, health status, presence of anxiety and depression, postcode, socioeconomic level, digital literacy, use of health services, and use of health and fitness apps. Multivariate logistic regression was used to model the probability of being a health and fitness app user. Statistical analysis was performed in R. Results: A total of 526 patients attended a face-to-face visit in the 49 recruiting centers and 514 had complete data. Most participants were ≤40 years old (66.4%), had at least 10 years of education (57.4%), and were in the 3 higher quintiles of the socioeconomic deprivation index (70.1%). The majority reported an overall good health status (visual analogue scale [VAS] score>70 in 93.1%) and the prevalence of anxiety and depression was 34.3% and 11.9%, respectively. The proportion of participants who reported using health and fitness mobile apps was 41.1% (n=211). Multivariate models revealed that single individuals and those with more than 10 years of education are more likely to use health and fitness mobile apps (adjusted odds ratio [aOR] 2.22, 95%CI 1.05-4.75 and aOR 1.95, 95%CI 1.12-3.45, respectively). Higher digital literacy scores were also associated with higher odds of being a user of health and fitness apps, with participants in the second, third, and fourth quartiles reporting aORs of 6.74 (95%CI 2.90-17.40), 10.30 (95%CI 4.28-27.56), and 11.52 (95%CI 4.78-30.87), respectively. Participants with depression symptoms had lower odds of using health and fitness apps (aOR 0.32, 95%CI 0.12-0.83). Conclusions: A better understanding of the barriers and enhancers of app use among patients with lower education, lower digital literacy, or depressive symptoms is key to design tailored interventions to ensure a sustained and equitable use of these technologies. Future studies should also assess users' general health-seeking behavior and their interest and concerns specifically about digital tools. These factors may impact both initial engagement and sustained use.info:eu-repo/semantics/publishedVersio

Engineering education in a technology-dependent world

Education is the core of any nation development, of a community or personal. It is for sure a society that is depending on technology for deployment of information, communication, and network in real time. In a short period of time, social technologies have given social interactions the speed and scale of the Internet. It affects the way people work, live and make business.This work intends just to show a little of INTERTECH an event that is happening for more than 24 years and its contributions for engineering and technology education. An endeavor of manyscientists in order to provide a breeding ground for discussions about engineering and technology education so important aspects for the formation of professionals and researchers prepared to face the future. The theme of the congress is Engineering Education in a Technology-Dependent World and it has raised a considerable amount of papers of great valuable

Envisioning a Marine Biodiversity Observation Network

Humans depend on diverse ocean ecosystems for food, jobs, and sustained well-being, yet many stressors threaten marine life. Extensive research has demonstrated that maintaining biodiversity promotes ocean health and service provision; therefore, monitoring the status and trends of marine biodiversity is important for effective ecosystem management. However, there is no systematic sustained program for evaluating ocean biodiversity. Coordinating existing monitoring and building a proactive marine biodiversity observation network will support efficient, economical resource management and conservation and should be a high priority. A synthesis of expert opinions suggests that, to be most effective, a marine biodiversity observation network should integrate biological levels, from genes to habitats; link biodiversity observations to abiotic environmental variables; site projects to incorporate environmental forcing and biogeography; and monitor adaptively to address emerging issues. We summarize examples illustrating how to leverage existing data and infrastructure to meet these goals

First Incidence and Progression Study for Diabetic Retinopathy in Portugal, the RETINODIAB Study: Evaluation of the Screening Program for Lisbon Region

PURPOSE: To estimate the 5-year incidence and progression of diabetic retinopathy (DR) among persons with type 2 diabetes mellitus (DM). DESIGN: Population-based, prospective, cohort study. PARTICIPANTS: The RETINODIAB (Study Group for Diabetic Retinopathy Screening) program was implemented in the Lisbon and Tagus Valley area between July 2009 and December 2014. A total of 109 543 readable screening examinations were performed and corresponded to 56 903 patients who attended the screening program at entry. A total of 30 641 patients (53.85%) had at least 1 further screening event within the study period and were included in the analysis. METHODS: Participants underwent two 45° nonstereoscopic retinal digital photographs per eye according to RETINODIAB protocol. All images were graded according to the International Clinical Diabetic Retinopathy Scale. Referable diabetic retinopathy (RDR) was defined for all patients graded as moderate nonproliferative DR (NPDR), severe NPDR, or proliferative DR (PDR), with or without maculopathy or mild NPDR with maculopathy. Nonparametric estimates of the annual and cumulative incidences were obtained by Turnbull's estimator. Associations between the potential risk factors and the time to onset/progression of retinopathy were assessed through a parametric survival analysis for interval-censored data. MAIN OUTCOME MEASURES: The authors estimated the onset and progression incidence rates of DR. RESULTS: Yearly incidence of any DR in patients without retinopathy at baseline was 4.60% (95% confidence interval [CI], 3.96-4.76) in the first year, decreasing to 3.87% (95% CI, 2.57-5.78) in the fifth year. In participants with mild NPDR at baseline, the progression rate to RDR in year 1 was 1.18% (95% CI, 0.96-1.33). Incidence of any DR and RDR and DR progression rate were associated with known duration of diabetes, age at diagnosis, and use of insulin treatment. CONCLUSIONS: This longitudinal epidemiologic study provides the first Portuguese incidence DR data in a large-scale population-based cohort of type 2 diabetes after a 5-year follow-up. Duration of diabetes, age at diagnosis, and insulin treatment were associated with increasing risk of incidence and progression of DR. A personalized schedule distribution of screening intervals according to the individual patient's profile should be implemented, with resulting benefits in terms of health costs.info:eu-repo/semantics/publishedVersio

An observational retrospective study of odontogenic cyst´s and tumours over an 18-year period in a Portuguese population according to the new WHO Head and Neck Tumour classification

Odontogenic cysts and tumours of the jaws represent one of the most prevalent groups of oral-maxillofacial lesions. We aimed to evaluate the clinical and pathological characteristics of a cohort of odontogenic cysts (OC) and odontogenic tumours (OT) of the jaws in a Portuguese population. This observational retrospective study analysed patients diagnosed with either an OC or OT of the jaws at a central hospital of Oporto, Portugal, between 1988 and 2006. Data collected from patients? files included demographic, clinical, radiological and histopathological information. Recurrence was evaluated using univariate and multivariate analysis. The sample consisted of 397 patients, 231 males (58.2%) and 166 females (41.8%), with a mean-age of 36.7±17 years. Twenty-seven patients (6.8%) presented with more than one lesion providing a total of 433 lesions. There were 396 (91.5%) OC, mostly represented by radicular cysts (n=257;59.4%), dentigerous cysts (n=79;18.2%), or odontogenic keratocysts (n=50;11.5%). There were 37 (8.5%) OT, mostly represented by ameloblastomas (n=16;3.7%), and odontomas (n=9;2.1%). The most common initial clinical manifestation was swelling (n=224;51.7%). Recurrence was observed in 30 cases (6.9%), mostly in ameloblastomas (n=6;37.5%) and odontogenic keratocysts (n=12;24%). In the multivariate analysis the diagnosis classification of the lesion was the only independent and significant variable related with the recurrence (P=0.04). Radicular cysts were the most commonly occurring type of OC and ameloblastomas the most commonly occurring OT. Amelobastomas and odontogenic keratocysts were the lesions with the highest rates of recurrence. This large sample provides useful information about the frequency profile and characteristics of OC and OT over a period of 18 years, allowing valuable comparison with data from other countries

Surface water microbial community response to the biocide 2-2-dibromo-3-nitrilopropionamide used in unconventional oil and gas extraction.

Production of unconventional oil and gas continues to rise, but the effects of high-density hydraulic fracturing (HF) activity near aquatic ecosystems are not fully understood. A commonly used biocide in HF, 2,2-dibromo-3-nitrilopropionamide (DBNPA), was studied in microcosms of HF-impacted vs. HF-unimpacted surface water streams to (1) compare the microbial community response, (2) investigate DBNPA degradation products based on past HF exposure, and (3) compare the microbial community response differences and similarities between the HF biocides DBNPA and glutaraldehyde. The microbial community responded to DBNPA differently in HF-impacted vs. HF-unimpacted microcosms in terms of 16S rRNA gene copies quantified, alpha and beta diversity, and differential abundance analyses of microbial community composition through time. The difference in microbial community changes affected degradation dynamics. HF-impacted microbial communities were more sensitive to DBNPA, causing the biocide and byproducts of the degradation to persist for longer than in HF-unimpacted microcosms. Seventeen DBNPA byproducts were detected, many of them not widely known as DBNPA byproducts. Many of the believed to be uncharacterized brominated byproducts detected may pose environmental and health impacts. Similar taxa were able to tolerate glutaraldehyde and DBNPA, however DBNPA was not as effective for microbial control as indicated by a smaller overall decrease of 16S rRNA gene copies/mL after exposure to the biocide and a more diverse set of taxa was able to tolerate it. These findings suggest that past HF activity in streams can affect the microbial community response to environmental perturbation such as the biocide DBNPA

Time dependent action in ϕ6\phi^6 potential

The false vacuum decay in field theory from a coherently oscillating initial state is studied for $\phi^6$ potential. An oscillating bubble solution is obtained. The instantaneous bubble nucleation rate is calculated.Comment: 15 pages, Accepted for publication in Communications in Theoretical Physics. arXiv admin note: text overlap with arXiv:hep-th/960415