Alternativas na Colocação de Cateteres em Hemodiálise

Background: Although vascular access is essential for adequate haemodialysis delivery, the systematic use of a patient's venous patrimony may eventually lead to exhaustion of suitable sites for placement of a new vascular access. Case Report: We present two cases of such patients. In the first one we inserted a 55cm catheter through the left external iliac vein, and a 40cm translumbar catheter was placed in the second one. Both interventions were performed percutaneously under radiological guidance. Both patients were anticoagulated after the procedure. Conclusion: Unusual sites for haemodialysis catheter placement may be life saving in selected situations and offer safe and viable alternatives for adequate haemodialysis delivery

Efficacy of Percutaneous Transluminal Angioplasty on Dysfunctional Fistulae Because of Inflow Stenosis

PURPOSE: Autogenous fistulas are the preferential vascular access for hemodialysis. The aim of this retrospective study was to determine the efficacy of angioplasty for dysfunctional fistulas because of inflow dysfunction. 
 METHODS: We reviewed all the angiographic procedures performed on our institution between April 2007 and April 2009. Procedures performed in dysfunctional fistulas because of inflow stenoses were analyzed. Fistulas with stenoses out of these areas were excluded. The following data were collected: patient age and sex, fistula age at the time of intervention, location of fistula, number and location of stenosis, angiography referral criteria, clinical findings (presence or absence of thrills, bruits and pulsatility) and date of reintervention or failure. 
 RESULTS: During the study period 215 fistulas were submitted to angiography of which, seventy-one presented inflow stenosis (33%). Mean follow-up was 21.72±9.26 months, and average age was 7.03 months. Two groups were considered: 31 fistulas comprising ≤6 months old, and 40 fistulas >6 months old. Primary patency rates±SE for older fistulas at 6, 12, 18 and 24 months, respectively, was 91.3%± 0.04%, 80.7%± 0.07%, 53.8% ±0.10% and 34.2±0.1% versus 91.7±0.08%, 57.1±0.14%, 23±0.14%, 11.4%± 0.1% for younger fistulas (P=0.04). Fistulas ≤6 months old and multiple stenosis were associated with a poorer primary patency rate (P=0.005).
 CONCLUSIONS: Inflow stenosis is frequently associated with fistula dysfunction. In this study we only analyzed AVF with inflow stenosis and we have shown that angioplasty can have great patency results, particularly for single lesions in matured fistulas.info:eu-repo/semantics/publishedVersio

Orchestrating learning activities using the CADMOS learning design tool

This paper gives an overview of CADMOS (CoursewAre Development Methodology for Open instructional Systems), a graphical IMS-LD Level A & B compliant learning design (LD) tool, which promotes the concept of “separation of concerns” during the design process, via the creation of two models: the conceptual model, which describes the learning activities and the corresponding learning resources, and the flow model, which describes the orchestration of these activities. According to the feedback from an evaluation case study with 36 participants, reported in this paper, CADMOS is a user-friendly tool that allows educational practitioners to design flows of learning activities using a layered approach

Older adults looking at dog pictures - psychobiological effects

Dogs are often used therapeutically (e.g., Pets at Therapy - PAT dogs) to visit elderly residents and those in care to promote social engagement and quality of life. Earlier studies reported that mutual gaze between dogs and owners induces a mutual change in physiology, with the release of oxytocin being a crucial mediator. However, it is not exactly known which types of cues trigger this mechanism, in particular whether these beneficial effects necessarily derive from the direct eye contact when gazing at a real-life dog or if it can be caused by the visual stimulus of a dog's eyes only in a picture. Therefore, in this study we tested if looking at static dog images could have physiological and/or psychological effects in older adults, by collecting salivary oxytocin, heart rate, optimism scores, testing cooperativeness/competitiveness, and examining gaze patterns when looking at dog pictures in three conditions: dogs facing the observer, dogs facing sideways, or control pixelated pictures. Contrary to our main predictions, we did not find any significant changes in oxytocin, optimism scores, nor cooperation levels associated with the pictures per se. However, older participants made less competitive decisions after looking at the dog's face and men also experienced a reduction in heart rate when looking at these pictures. These results indicate that simply direct eye contact via a picture of a dog is sufficient for some significant effects, which may be gender dependent, but does not trigger the expected full psychobiological effects reported in previous studies with real-life dogs. © 2025 The Author(s

Spatial and Temporal Variations in the Annual Pollen Index Recorded by Sites Belonging to the Portuguese Aerobiology Network

This study presents the findings of a 10-year survey carried out by the Portuguese Aerobiology Network (RPA) at seven pollen-monitoring stations: five mainland stations (Oporto, Coimbra, Lisbon, Évora and Portimão) and two insular stations [Funchal (Madeira archipelago) and Ponta Delgada (Azores archipelago)]. The main aim of the study was to examine spatial and temporal variations in the Annual Pollen Index (API) with particular focus on the most frequently recorded pollen types. Pollen monitoring (2003–2012) was carried out using Hirst-type volumetric spore traps, following the minimum recommendations proposed by the European Aerobiology Society Working Group on Quality Control. Daily pollen data were examined for similarities using the Kruskal–Wallis nonparametric test and multivariate regression trees. Simple linear regression analysis was used to describe trends in API. The airborne pollen spectrum at RPA stations is dominated by important allergenic pollen types such as Poaceae, Olea and Urticaceae. Statistically significant differences were witnessed in the API recorded at the seven stations. Mean API is higher in the southern mainland cities, e.g. Évora, Lisbon and Portimão, and lower in insular and littoral cities. There were also a number of significant trends in API during the 10-year study. This report identifies spatial and temporal variations in the amount of airborne pollen recorded annually in the Portuguese territory. There were also a number of significant changes in API, but no general increases in the amount of airborne pollen

Catalytic Enantioselective Cross-Couplings of Secondary Alkyl Electrophiles with Secondary Alkylmetal Nucleophiles: Negishi Reactions of Racemic Benzylic Bromides with Achiral Alkylzinc Reagents

We have developed a nickel-catalyzed method for the asymmetric cross-coupling of secondary electrophiles with secondary nucleophiles, specifically, stereoconvergent Negishi reactions of racemic benzylic bromides with achiral cycloalkylzinc reagents. In contrast to most previous studies of enantioselective Negishi cross-couplings, tridentate pybox ligands are ineffective in this process; however, a new, readily available bidentate isoquinoline–oxazoline ligand furnishes excellent ee’s and good yields. The use of acyclic alkylzinc reagents as coupling partners led to the discovery of a highly unusual isomerization that generates a significant quantity of a branched cross-coupling product from an unbranched nucleophile

A rede dos centros locais de aprendizagem da Universidade Aberta ao serviço de desenvolvimento social e territorial em Portugal

Os Centros Locais de Aprendizagem (CLA) da Universidade Aberta (UAb) são núcleos que, a par das Delegações, integram os serviços desconcentrados desta Universidade. Fazem parte da sua estrutura orgânica e têm estado em funcionamento progressivamente desde setembro de 2008. Neste texto apresentamos os atuais eixos que sustentam o seu programa de trabalho e as principais linhas estratégicas de ação desta rede no futuro no ano em que comemora dez anos de existência.info:eu-repo/semantics/publishedVersio

A Study on the Effects of Unwanted Air Infiltration on Thermal Comfort at an Airport Terminal

The Energy Systems Laboratory at Texas A&M University is currently studying ways to make improvements in thermal comfort at the Terminal E building at DFW airport. Airport terminal building HVAC systems are generally known to consume large amounts of energy to provide an environment that is comfortable for the employees and travelers. Wind direction, the shape and orientation of the building with respect to the prevailing wind can have a deleterious effect on the HVAC system ability to provide the comfort levels that people have become accustomed to in public buildings. Airport terminal buildings, such as the one in this study, built before the current energy awareness that is prevalent today have many problems associated with air infiltration primarily due to openings in the building structure to permit a smooth flow of passengers and luggage toward their destination. Entry ways that allow for easy egress generally use sliding door vestibules that are self closing based on sensors and timers to provide the building user an unimpeded path into and out of the building. During peak traffic periods, these doors are open for relatively long periods of time and can cause significant loss of building pressure. If the shape of the terminal building is such that the gate doors to the aircraft are opposing the egress entryways, air flows can develop within the building that blow across the width of the building, causing drafts that can either be cold or hot based on the outside air temperature. The shape of the building in this study is C-shaped with the opening of the “C” facing toward the West. Weather data will be analyzed along with hot and cold calls within the terminal building to correlate the effect of wind direction on indoor thermal comfort. Unwanted air infiltration flow pathways will be identified using smoke testers and analyzed with efforts to reduce entry into the building envelope

Osteoarthritis:Mechanistic Insights, Senescence, and Novel Therapeutic Opportunities

Osteoarthritis (OA) is the most common joint disease. In the last years, the research community has focused on understanding the molecular mechanisms that led to the pathogenesis of the disease, trying to identify different molecular and clinical phenotypes along with the discovery of new therapeutic opportunities. Different types of cell-to-cell communication mechanisms have been proposed to contribute to OA progression, including mechanisms mediated by connexin43 (Cx43) channels or by small extracellular vesicles. Furthermore, changes in the chondrocyte phenotype such as cellular senescence have been proposed as new contributors of the OA progression, changing the paradigm of the disease. The use of different drugs able to restore chondrocyte phenotype, to reduce cellular senescence and senescence-associated secretory phenotype components, and to modulate ion channel activity or Cx43 appears to be promising therapeutic strategies for the different types of OA. In this review, we aim to summarize the current knowledge in OA phenotypes related with aging and tissue damage and the new therapeutic opportunities currently available

Physiotherapists’ barriers and facilitators to the implementation of a behaviour change-informed exercise intervention to promote the adoption of regular exercise practice in patients at risk of recurrence of low back pain: a qualitative study

Background: Recurrences of low back pain (LBP) are frequent and associated with high levels of disability and medical costs. Regular exercise practice may be an effective strategy to prevent recurrences of LBP, however, the promotion of this behaviour by physiotherapists seems to be challenging. This study aims to explore physiotherapists' perceived barriers and facilitators to the implementation of a behaviour change-informed exercise intervention to promote the adoption of regular exercise practice by patients at risk of recurrence of low back pain. Methods: Two focus groups with primary healthcare physiotherapists were conducted, based on a semi-structured interview schedule informed by the Behaviour Change Wheel, including the Capability, Opportunity, Motivation-Behaviour (COM-B) model and the Theoretical Domains Framework (TDF). All focus groups were held through videoconference, audio and video recorded and transcribed verbatim. A deductive content analysis, using a coding matrix based on the COM-B and TDF, was performed by two independent researchers. A third researcher was approached to settle disagreements. Results: In total, 14 physiotherapists participated in the focus groups. The analysis revealed a total of 13 barriers (4 COM-B components and 7 TDF domains) and 23 facilitators (5 COM-B and 13 TDF) to physiotherapists' implementation of a behaviour change-informed exercise intervention. The most common barriers were the lack of skills and confidence to implement the proposed intervention. These were explained by the fact that it differs from the usual practice of most participants and requires the learning of new skills applied to their contexts. However, for those who had already implemented other similar interventions or whose rationale is aligned with the new intervention, there seemed to exist more positive determinants, such as potential benefits for physiotherapists and the profession, improvement of quality of care and willingness to change clinical practice. For others who did not previously succeed in implementing these types of interventions, more context-related barriers were mentioned, such as lack of time to implement the intervention, schedule incompatibilities and lack of material and human resources. Conclusions: This study identified modifiable barriers and facilitators to physiotherapists' implementation of a behaviour change-informed exercise intervention for patients at risk of recurrence of LBP in primary healthcare. The findings of this study will allow the systematic and theory-based development of a behaviour change-informed training programme, aimed at physiotherapists and supporting the successful implementation of the exercise intervention.info:eu-repo/semantics/publishedVersio