Tuberculosis and COVID-19 Related Stigma: Portuguese Patients Experiences

Background: Tuberculosis (TB)-related stigma has been well-documented. Since the emergence of the coronavirus disease 2019 (COVID-19), different organizations have been alerted to the fact that stigma could arise again. Due to stigma's negative effects, this qualitative study aimed to explore the stigma felt by patients by evaluating the fol-lowing: COVID-19 stigma and its temporal progression through the pandemic; stigma perceived by different patients with TB before and during COVID-19 pandemic; and dif- ference perceived by individuals who contracted both diseases.Methods: A semi-structured interview was developed according to the available lit-erature on the theme. It was performed individually in 2022 upon receiving signed informed consent. Participants were recruited with a purposive sampling approach by searching medical records. Those who currently or previously had pulmonary TB and/ or COVID-19 were included. Data were subjected to thematic analysis.Results: Nine patients were interviewed, including six (66.7%) females. The median age of patients was 51 & PLUSMN;14.7 years. Four participants (44.4%) had completed high school and four (44.4%) were never smokers. Three had both TB and COVID-19. Four only had TB and two only had COVID-19. Interviews identified eight main themes: knowledge and beliefs, with several misconceptions identified; attitudes towards the disease, vary- ing from social support to exclusion; knowledge and education, assumed as of extreme importance; internalized stigma, with self-rejection; experienced stigma, with discrim- ination episodes; anticipated stigma, modifying actions for avoiding stigma; perceived stigma, with judgment by others prevailed; and temporal evolution of stigma. Conclusion: Individuals expressed strong stigma for both diseases. De-stigmatization of respiratory infectious diseases is crucial for limiting stigma's negative impact.This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors. Ana Aguiar holds a PhD Grant (reference: 2020.09390.BD) , funded by the Fundacao para a Ciencia e a Tecnologia (FCT) and the Fundo Social Europeu (FSE) Program

Complete blood count parameters as biomarkers of retinopathy of prematurity: a Portuguese multicenter study

Purpose: To evaluate complete blood count (CBC) parameters in the first week of life as predictive biomarkers for the development of retinopathy of prematurity (ROP). Methods: Multicenter, prospective, observational study of a cohort of preterm infants born with gestational age (GA) < 32 weeks or birth weight < 1500 g in eight Portuguese neonatal intensive care units. All demographic, clinical, and laboratory data from the first week of life were collected. Univariate logistic regression was used to assess risk factors for ROP and then multivariate regression was performed. Results: A total of 455 infants were included in the study. The median GA was 29.6 weeks, and the median birth weight was 1295 g. One hundred and seventy-two infants (37.8%) developed ROP. Median values of erythrocytes (p < 0.001), hemoglobin (p < 0.001), hematocrit (p < 0.001), mean corpuscular hemoglobin concentration (p < 0.001), lymphocytes (p = 0.035), and platelets (p = 0.003) of the group of infants diagnosed with ROP any stage were lower than those without ROP. Mean corpuscular volume (MCV) (p = 0.044), red blood cell distribution width (RDW) (p < 0.001), erythroblasts (p < 0.001), neutrophils (p = 0.030), neutrophils-lymphocytes ratio (p = 0.028), and basophils (p = 0.003) were higher in the ROP group. Higher values of MCV, erythroblasts, and basophils remained significantly associated with ROP after multivariate regression. Conclusion: In our cohort, the increase in erythroblasts, MCV, and basophils in the first week of life was significantly and independently associated with the development of ROP. These CBC parameters may be early predictive biomarkers for ROP.info:eu-repo/semantics/publishedVersio

Non-homogeneous displacement jumps in strong embedded discontinuities

In this paper, strong discontinuities are embedded in finite elements to describe fracture in quasi-brittle materials. A new numerical formulation is introduced in which the displacement jumps do not need to be homogeneous within each finite element. Both the crack path and the displacement jumps are continuous across element boundaries. This formulation is compared with the discrete approach, in which interface elements are inserted to model the discontinuities, as well as with other embedded discontinuity approaches and with the partition of unity method. Numerical results have been obtained with relatively coarse meshes, which compare well with experimental results and with the results obtained from analyzes with interface elements

Ureids from carob bean syrup in animal feeding

info:eu-repo/semantics/publishedVersio

Modelling fracture due to corrosion and mechanical loading in reinforced concrete

Corrosion in reinforced concrete is an important feature which can lead to increased deformation and cracking, as well as to premature failure. In the present work, macro-mechanical modelling of corrosion is performed, namely the degradation of bond–slip between concrete and steel. A mixed-mode damage model is adopted, in which the interaction between the bond–slip law and the stress acting in the neighbourhood of the concrete–steel bar interface is taken into account. Bond–slip degradation is modelled using an evolutionary bond–slip relationship, which depends on the level of corrosion. Different relevant loading cases are studied. Special attention is given to the evolution of corrosion in time, under constant load. This is done by adopting a Total Iterative Approach, in which the structure is reevaluated each time step, upon damage increase due to corrosion. Pullout tests are presented to illustrate the performance of the model. Bending tests are also performed to evaluate the influence of corrosion at structural level.Materials- Mechanics- Management & Desig

A comparative study on the modelling of discontinuous fracture by means of enriched nodal and element techniques and interface elements

In this paper, three different approaches used to model strong discontinuities are studied: a new strong embedded discontinuity technique, designated as the discrete strong embedded discontinuity approach (DSDA), introduced in Dias-da-Costa et al. (Eng Fract Mech 76(9):1176–1201, 2009); the generalized finite element method, (GFEM), developed by Duarte and Oden (Tech Rep 95-05, 1995) and Belytschko and Black (Int J Numer Methods Eng 45(5):601–620, 1999); and the use of interface elements (Hillerborg et al. in Cem Concr Res 6(6): 773–781, 1976). First, it is shown that all three descriptions are based on the same variational formulation. However, the main differences between these models lie in the way the discontinuity is represented in the finite element mesh, which is explained in the paper. Main focus is on the differences between the element enrichment technique, used in the DSDA and the nodal enrichment technique adopted in the GFEM. In both cases, global enhanced degrees of freedom are adopted. Next, the numerical integration of the discretised equations in the three methods is addressed and some important differences are discussed. Two types of numerical tests are presented: first, simple academic examples are used to emphasize the differences found in the formulations and next, some benchmark tests are computed.Design and ConstructionCivil Engineering and Geoscience

The Perception of quality and the performance in primary health Care of central Alentejo – Portugal

AbstractQuality and performance are current issues and a strategic priority for the Portuguese National Health Service. Currently, there is a lack of studies in primary health care (PHC) that assess the relationship between the quality and the level of performance of the Primary Health Care Teams. In Portugal, those teams are monitored through the Global Performance Index (GPI), which demonstrates, through a score, the procedures and results obtained by electronic records and the metrics defined for each indicator. This paper aims to analyze the relationship between the perception of the quality of health professionals (service culture; leadership; service strategy; infrastructure and external resources; information and knowledge; processes; service management; human resource planning and skills development, commitment; conditions, satisfaction, performance, and recognition; and results) in the different Primary Health Care teams of the PHC of Central Alentejo—Portugal, and the level of performance of the given teams (care performance; professional training; organizational quality; and services). Self-Perception of Quality Questionnaire for Primary Health Care (SPQQ4PHC) was used as an assessment tool. The population comprises 324 health professionals (Family Doctors, Nurses, and Medical Secretaries) distributed over 34 Primary Health Care Teams. When analyzing the global correlation of the variables in the SPQQ4PHC questionnaire with the GPI, it´s possible to confirm that twenty-one out of twenty-five correlates with the GPI. Thus, this study allowed us to conclude that, as health professionals perceive the quality of the variables increases, the GPI also increases, demonstrating that the dimensions of quality and performance are closely related

Hepatitis Delta Virus histone mimicry drives the recruitment of chromatin remodelers for viral RNA replication

Hepatitis Delta virus (HDV) is a satellite of Hepatitis B virus with a single-stranded circular RNA genome. HDV RNA genome synthesis is carried out in infected cells by cellular RNA polymerases with the assistance of the small hepatitis delta antigen (S-HDAg). Here we show that S-HDAg binds the bromodomain (BRD) adjacent to zinc finger domain 2B (BAZ2B) protein, a regulatory subunit of BAZ2B-associated remodeling factor (BRF)&nbsp;ISWI chromatin remodeling complexes. shRNA-mediated silencing of BAZ2B or its inactivation with the BAZ2B BRD inhibitor GSK2801 impairs HDV replication in HDV-infected human hepatocytes. S-HDAg contains a short linear interacting motif (SLiM) KacXXR, similar to the one recognized by BAZ2B BRD in histone H3. We found that the integrity of the S-HDAg SLiM sequence is required for S-HDAg interaction with BAZ2B BRD and for HDV RNA replication. Our results suggest that S-HDAg uses a histone mimicry strategy to co-activate the RNA polymerase II-dependent synthesis of HDV RNA and sustain HDV replication