49 research outputs found

    Asymptomatic chronic type A aortic dissection

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    Valorização de resíduos da indústria corticeira na formulação de substratos para produção de plantas

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    Mestrado em Engenharia Agronómica - Instituto Superior de AgronomiaO presente trabalho teve como objetivo estudar a viabilidade do uso de resíduos provenientes da indústria corticeira na formulação de substratos alternativos para viveiros. No caso especifico dos viveiros florestais, a casca de pinheiro, um dos principais componentes dos substratos utilizados, poderá ser uma via de dispersão do fungo Fusarium circinatum (cancro-resinoso-do-pinheiro). Nestes viveiros, a utilização dos resíduos de cortiça (de uma espécie não hospedeira do fungo) reduzirá significativamente o risco de infeção das jovens plantas no viveiro. Foram formulados e testados dez substratos, contendo diferentes percentagens de dois resíduos de cortiça (“terras de cortiça” e “granulado ADT”), com as seguintes proporções de turfa:resíduo, em volume: 100:0; 75:25; 50:50; 25:75 e 0:100. Os substratos formulados foram caracterizados analiticamente e testados num ensaio de crescimento em vaso recorrendo a uma planta-teste (couve-chinesa). Os resíduos de cortiça originaram um aumento do arejamento dos substratos obtidos e uma redução da sua contratilidade, melhorando, significativamente, estas propriedades físicas. No entanto, para percentagens superiores a 50%, há uma redução da água disponível para as plantas, para valores inferiores aos recomendados. A adição dos resíduos de cortiça à turfa originou uma redução do crescimento da planta-teste, mais acentuado nas percentagens superiores a 50%, que poderá estar associada à redução de retenção de água disponível (“terras” e ADT), da fitotoxicidade (ADT) e de uma eventual imobilização de azoto (“terras de cortiça”). A couve-chinesa é utilizada como planta-teste por ser uma espécie bastante sensível. Com espécies mais rústicas e menos sensíveis, como as espécies florestais, nomeadamente os pinheiros, o decréscimo de crescimento observado na couve-chinesa poderá não ser tão pronunciado. Assim, os resultados deste trabalho indicam que os resíduos de cortiça estudados poderão ter potencial para serem utilizados na formulação de substratos, em percentagens até 50%, nomeadamente, na substituição da casca de pinheiro dos substratos utilizados nos viveiros florestaisN/

    Flexible use of IP gores on dynamically reconfigurable systems

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    The advantages of dynamic reconfiguration can only be exploited if devices, tools and design flows are available to support the partial reconfiguration of FPGA-based systems. For a number of applications, enabling the swap of cores at run-time, under software control, is an essential feature that allows tailoring the system response to the needs of different methods, standards and power/performance requirements. The paper proposes a method to support the exchange of intellectual property (IP) cores during system operation. The approach is based on the definition of a base system, with reserved or dynamic areas, where different cores may be plugged in, providing timesharing of the system resources. It is shown how bitstream-level IP cores can be used in a design flow that allows different cores to be used in one or more host areas, with minimal intervention from the designer. A demonstration system along with example applications are presented to illustrate the approach

    Osteoporosis management during the COVID-19 pandemic - Position paper

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    verCOVID-19 pandemic significantly increased the already large number of victims of osteoporosis in Portugal. Osteoporosis outpatient clinics were either closed or had limited presential appointments. Many hospitals reduced orthopaedic services to make space for patients with COVID-19. In addition, the volunteer or forced sedentarism, as imposed by the pandemic, increased the risk of falls and fractures drastically. It urges to intensify the current efforts to improve the management of bone health and to prioritize fragility fracture care and prevention. This paper addresses the challenges in osteoporosis management during the COVID-19 pandemic and provides guidance on osteoporosis management. This position paper is a joint initiative of several health professionals and patients dedicated to osteoporosis.publishersversionpublishe

    A Multifunctional Integrated Circuit Router for Body Area Network Wearable Systems

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    A multifunctional router IC to be included in the nodes of a wearable body sensor network is described and evaluated. The router targets different application scenarios, especially those including tens of sensors, embedded into textile materials and with high data-rate communication demands. The router IC supports two different functionality sets, one for sensor nodes and another for the base node, both based on the same circuit module. The nodes are connected to each other by means of woven thick conductive yarns forming a mesh topology with the base node at the center. From the standpoint of the network, each sensor node is a four port router capable of handling packets from destination nodes to the base node, with sufficient redundant paths. The adopted hybrid circuit and packet switching scheme significantly improve network performance in terms of end-to-end delay, throughput and power consumption. The IC also implements a highly precise, sub-microsecond one-way time synchronization protocol which is used for time stamping the acquired data. The communication module was implemented in a 4-metal, 0.35 μm CMOS technology. The maximum data rate of the system is 35 Mbps while supporting up to 250 sensors, which exceeds current BAN applications scenarios.This work was supported in part by the Fundação para a Ciéncia e a Tecnologia (FCT) (Portuguese Foundation for Science and Technology) under Project PROLIMB PTDC/EEAELC/103683/2008 and through the Ph.D. Grant SFRH/BD/75324/2010, and in part by the CREaTION, FCT/MEC through national funds and co-funded by the FEDER-PT2020 partnership agreement under Project UIDB/EEA/50008/2020, Project CONQUEST (CMU/ECE/030/2017), Project COST CA15104, and ORCIP. (Corresponding author: Fardin Derogarian Miyandoab.)info:eu-repo/semantics/publishedVersio

    Comparative effectiveness and predictors of response to tumour necrosis factor inhibitor therapies in rheumatoid arthritis

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    Funding Information: positions on two Pfizer sponsored trials and has directed an educational course supported by Bristol Myers Squibb. He serves as an epidemiology consultant to CORRONA. J.A.P.S. has received honoraria as a speaker or consultant and benefited from research support from several pharmaceutical companies involved in the production of biologic agents (Abbott, Amgen, MSD, Pfizer and Roche), always at sums less than E10 000. All other authors have declared no conflicts of interest. Funding Information: Funding: This work was supported by a grant from Harvard-Portugal Program HMSP-ICS/SAU-ICT/0002/ 2010.Objectives: Adalimumab, etanercept and infliximab are effective TNF inhibitors (TNFis) in the treatment of RA, but no randomized clinical trials have compared the three agents. Prior observational data are not consistent. We compared their effectiveness over 1 year in a prospective cohort.Methods: Analyses were performed on subjects' first episode of TNFi use in the Rheumatic Diseases Portuguese Register, Reuma.pt. The primary outcome was the proportion of patients with European League Against Rheumatism good response sustained at two consecutive observations separated by 3 months during the first year of TNFi use. Comparisons were performed using conventional adjusted logistic regression, as well as matching subjects across the three agents using a propensity score. In addition, baseline predictors of treatment response to TNFi were identified.Results: The study cohort included 617 RA patients, 250 starting etanercept, 206 infliximab and 161 adalimumab. Good response was achieved by 59.6% for adalimumab, 59.2% for etanercept and 51.9% for infliximab (P = 0.21). The modelled probability of good response did not significantly differ across agents (etanercept vs adalimumab OR = 0.97, 95% CI 0.55, 1.71; etanercept vs infliximab OR = 1.25, 95% CI 0.74, 2.12; infliximab vs adalimumab OR = 0.80, 95% CI 0.47, 1.36). Matched propensity score analyses also showed no significant treatment response differences. Greater educational attainment was a predictor of better response, while smoking, presence of ACPA, glucocorticoid use and worse physician assessment of disease activity at baseline each predicted a reduced likelihood of treatment response.Conclusion: Over 1 year, we found no difference in effectiveness between adalimumab, etanercept and infliximab.publishersversionpublishe

    TRAF1/C5 but Not PTPRC Variants Are Potential Predictors of Rheumatoid Arthritis Response to Anti-Tumor Necrosis Factor Therapy

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    Background. The aim of our work was to replicate, in a Southern European population, the association reported in Northern populations between PTPRC locus and response to anti-tumor necrosis factor (anti-TNF) treatment in rheumatoid arthritis (RA). We also looked at associations between five RA risk alleles and treatment response. Methods. We evaluated associations between anti-TNF treatment responses assessed by DAS28 change and by EULAR response at six months in 383 Portuguese patients. Univariate and multivariate linear and logistic regression analyses were performed. In a second step to confirm our findings, we pooled our population with 265 Spanish patients. Results. No association was found between PTPRC rs10919563 allele and anti-TNF treatment response, neither in Portuguese modeling for several clinical variables nor in the overall population combining Portuguese and Spanish patients. The minor allele for RA susceptibility, rs3761847 SNP in TRAF1/C5 region, was associated with a poor response in linear and logistic univariate and multivariate regression analyses. No association was observed with the other allellic variants. Results were confirmed in the pooled analysis. Conclusion. This study did not replicate the association between PTPRC and the response to anti-TNF treatment in our Southern European population. We found that TRAF1/C5 risk RA variants potentially influence anti-TNF treatment response.This work was supported by a grant from Harvard-Portugal Program HMSP-ICS/SAU-ICT/0002/2010. Daniel H. Solomon received support for this work from the NIH (K24-AR-055989). Elizabeth W. Karlson received support for this work from NIH (K24-AR-AR0524). Reuma.pt received unrestricted grants from Abbott, Bristol-Myers Squibb, Merck Sharp and Dohme, Pfizer, Roche, and UCB Pharma

    Portuguese multidisciplinary recommendations for non-pharmacological and non-surgical interventions in patients with rheumatoid arthritis

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    BACKGROUND: Patients with rheumatoid arthritis (RA) report significant levels of disease impact, which are improved, but not fully abrogated by immunosuppressive therapy, even when remission is achieved. This imposes the need for adjuvant interventions targeting the uncontrolled domains of disease impact. Non-pharmacological interventions are widely used for this purpose, but they have not been the object of professional recommendations or guidelines. OBJECTIVE: To propose multidisciplinary recommendations to inform clinical care providers regarding the employment of non-pharmacological and non-surgical interventions in the management of patients with RA. METHODS: The EULAR standardized operating procedures for the development of recommendations were followed. First, a systematic literature review was performed. Then, a multidisciplinary Technical Expert Panel (TEP) met to develop and discuss the recommendations and research agenda. For each developed recommendation i) the level of evidence and grade of recommendation were determined, and ii) the level of agreement among TEP members was set. A recommendation was adopted if approved by ≥75% of the TEP members, and the level of agreement was considered high when ≥8. All relevant national societies were included in this construction process to attain their endorsement. RESULTS: Based on evidence and expert opinion, the TEP developed and agreed on five overarching principles and 12 recommendations for non-pharmacological and non-surgical interventions in patients with RA. The mean level of agreement between the TEP members ranged between 8.5 and 9.9. The recommendations include a broad spectrum of intervention areas, such as exercise, hydrokinesiotherapy, psychological interventions, orthoses, education, general management of comorbidities, among others; and they set the requirements for their application. CONCLUSIONS: These recommendations are based on the consensus judgment of clinical experts from a wide range of disciplines and patients' representatives from Portugal. Given the evidence for effectiveness, feasibility and safety, non-pharmacological and non-surgical interventions should be an integral part of standard care for people with RA. It is hoped that these recommendations should be widely implemented in clinical practice. The target audience for these recommendations includes all health professionals involved in the care of patients with RA. The target patient population includes adult Portuguese people with RA.publishersversionpublishe

    Score CTo-aBCDE : um novo score preditor de sucesso nas CTOs

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    © 2020 Sociedade Portuguesa de Cardiologia. Published by Elsevier España, S.L.U. This is an open access article under the CC-BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).Introduction: Patient selection for percutaneous coronary intervention (PCI) in chronic total occlusions (CTOs) is crucial to procedural success. Our aim was to identify independent predictors of success in CTO PCI in order to create an accurate score. Methods: In a single-center observational registry of CTO PCI, demographic and clinical data and anatomical characteristics of coronary lesions were recorded. Linear and logistic regression analysis were used to identify predictors of success. A score to predict success was created and its accuracy was measured by receiver operating curve analysis. Results: A total of 377 interventions were performed (334 patients, age 68±11 years, 75% male). The success rate was 65% per patient and 60% per procedure. Predictors of success in univariate analysis were absence of active smoking (OR 2.02, 95% CI 1.243-3.29; p=0.005), presence of tapered stump (OR 5.2, 95% CI 2.7-10.2; p8 with high probability (95%). Conclusion: In our sample only anatomical characteristics were predictors of success. The creation of a score to predict success, with good accuracy, may enable selection of cases that can be treated by any operator, those in which a dedicated operator will be desirable, and those with an extremely low probability of success, which should be considered individually for conservative management, surgical revascularization or PCI by a team experienced in CTO.info:eu-repo/semantics/publishedVersio
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