Effects of habitat disturbance on the morphology of ant assemblages

Dissertação de mestrado em Análises Clínicas, apresentada à Faculdade de Farmácia da Universidade de Coimbra.Introduction: Hepatitis E virus (HEV) belongs to the Hepevirus genus from the Hepeviridae family. HEV is a non-enveloped small icosahedral virus with 30-32 nm of diameter and a (+) ssRNA genome. There are four genotypes (1-4) of the virus, genotype 1 and 2 are associated with exclusive infection on humans, while genotype 3 and 4 can also infect pigs and other mammalians. HEV is responsible for a liver disease, generally an acute hepatitis, most frequent in developing countries, where the main way of transmission of HEV is fecaloral through the ingestion of contaminated water or food. In other regions genotypes 3 and 4 may be causing outbreaks of infection through its zoonotic potential. Aim: Evaluate the prevalence of HEV infection in wild boars and deer as well as to its presence in wastewaters, in order to evaluate the risk for the public health caused by HEV, in Portugal. Methods: Thirty samples of wild boar and deer feces, 28 bile samples of wild boars and 30 wastewaters samples (15 samples collected from the influent of the WWTP and 15 samples of the respective effluent of the WWTP) from across country, were submitted to nucleicacid extraction followed by RT-PCR Real Time amplifications aiming the detection of the viral genome of HEV. Results: No HEV-RNA was detected in all feces and bile samples from wild animals. Two (13.3%) out of the 15 influent WWTP samples revealed the presence of HEV-RNA, while the viral genome was not detected in any of the effluent samples. Conclusion: We find that HEV is not spread across the population of Portuguese wild boars. Nevertheless we acquired that HEV is in fact present in our country which can cause outbreaks by contaminated water ingestion. We must be alert to HEV infections, even if most of them are asymptomatic, there is a high risk for pregnant women and for immunosuppressed population, and until the moment no effective and risk free treatment is available either to a possible chronic infection or even to a clinical symptomatic infection for the general population.Introdução: O vírus da hepatite E (HEV) pertence ao género Hepevirus da família Hepeviridae. O HEV é um vírus não envelopado, pequeno e com forma icosaédrica com 30- 32 nm de diâmetro e genoma (+) ssRNA. Existem 4 genótipos do vírus (1-4). Os genótipos 1 e 2 estão associados a infecções exclusivamente humanas. Os genótipos 3 e 4 podem infectar suínos e outros mamíferos além dos humanos. O HEV é responsável por provocar geralmente uma hepatite aguda, sendo mais frequente em países em desenvolvimento. A principal via de transmissão do vírus é a via fecal-oral através da ingestão de águas ou alimentos contaminados. Nas regiões desenvolvidas os genótipos 3 e 4 podem ser responsáveis por focos de infecção devido ao potencial zoonótico. Objectivo: Avaliar a prevalência da infecção por HEV em javalis e veado de forma a testar a presença do vírus em águas residuais, de forma a avaliar o risco para a saúde pública causado pelo HEV, em Portugal. Métodos: Trinta amostras de fezes de javalis e veado, 28 amostras de bílis de javali e ainda 30 amostras de águas residuais (15 amostras da entrada da ETAR (Estação de Tratamento de Águas Residuais) e 15 amostras da saída da ETAR), de vários locais do país, foram submetidas a extração do ácido nucleico seguida por amplificação RT-PCR em Tempo Real, para detectar a presença do genoma viral do HEV. Resultados: Não foi encontrado RNA do HEV em nenhuma amostra de fezes ou de bílis nos animais em estudo. Nas águas, 2 (13.3%) das 15 amostras colhidas à entrada das ETARs revelaram-se positivas para a presença do genoma do HEV, mas não foi encontrado genoma viral em nenhuma das amostras colhidas à saída da ETAR. Conclusões: Os resultados do presente estudo sugerem que o HEV ainda não se encontra disseminado pela população de javalis de Portugal. No entanto o HEV está presente no sistema de águas de Portugal e poderá causar epidemias através da ingestão de água contaminada com o vírus. Devemos estar alerta para as infecções causadas por HEV ainda que a maioria delas seja assintomática, uma vez que existe um risco maior para grávidas e doentes imunodeprimidos. Este risco é acrescido por não existir ainda um tratamento eficaz e sem contra-indicações para combater possíveis infecções sintomáticas ou ainda infecções crónicas, quer nos indivíduos saudáveis quer em imunodeprimidos

Estimating the burden of disease in chronic pain with and without neuropathic characteristics: does the choice between the EQ-5D and SF-6D matter?

The EQ-5D and Short Form (SF)12 are widely used generic health-related quality of life (HRQoL) questionnaires. They can be used to derive health utility index scores, on a scale where 0 is equivalent to death and 1 represents full health, with scores less than zero representing states "worse than death." We compared EQ-5D or SF-6D health utility index scores in patients with no chronic pain, and chronic pain with and without neuropathic characteristics (NC), and to explore their discriminant ability for pain severity. Self-reported health and chronic pain status was collected as part of a UK general population survey (n=4451). We found moderate agreement between individual dimensions of EQ-5D and SF-6D, with most highly correlated dimensions found for mental health and anxiety/depression, role limitations and usual activities, and pain and pain/discomfort. Overall 43% reported full health on the EQ-5D, compared with only 4.2% on the SF-6D. There were significant differences in mean utilities for chronic pain with NC (EQ-5D 0.47 vs SF-6D 0.62) and especially for severe pain (EQ-5D 0.33 vs SF-6D 0.58). On the EQ-5D, 17% of those with chronic pain with NC and 3% without NC scored "worse than death," a state which is not possible using the SF-6D. Health utilities derived from EQ-5D and SF-12/36 can discriminate between group differences for chronic pain with and without NC and greater pain severity. However, the instruments generate widely differing HRQoL scores for the same patient groups. The choice between using the EQ-5D or SF-6D matters greatly when estimating the burden of disease

What nonpharmacological interventions are effective for treating fatigue in adolescents? A systematic review of randomised controlled trials

Poster presentation for the PsyPAG 2021 Conferenc

HadISD: a quality-controlled global synoptic report database for selected variables at long-term stations from 1973--2011

[Abridged] This paper describes the creation of HadISD: an automatically quality-controlled synoptic resolution dataset of temperature, dewpoint temperature, sea-level pressure, wind speed, wind direction and cloud cover from global weather stations for 1973--2011. The full dataset consists of over 6000 stations, with 3427 long-term stations deemed to have sufficient sampling and quality for climate applications requiring sub-daily resolution. As with other surface datasets, coverage is heavily skewed towards Northern Hemisphere mid-latitudes. The dataset is constructed from a large pre-existing ASCII flatfile data bank that represents over a decade of substantial effort at data retrieval, reformatting and provision. These raw data have had varying levels of quality control applied to them by individual data providers. The work proceeded in several steps: merging stations with multiple reporting identifiers; reformatting to netCDF; quality control; and then filtering to form a final dataset. Particular attention has been paid to maintaining true extreme values where possible within an automated, objective process. Detailed validation has been performed on a subset of global stations and also on UK data using known extreme events to help finalise the QC tests. Further validation was performed on a selection of extreme events world-wide (Hurricane Katrina in 2005, the cold snap in Alaska in 1989 and heat waves in SE Australia in 2009). Although the filtering has removed the poorest station records, no attempt has been made to homogenise the data thus far. Hence non-climatic, time-varying errors may still exist in many of the individual station records and care is needed in inferring long-term trends from these data. A version-control system has been constructed for this dataset to allow for the clear documentation of any updates and corrections in the future.Comment: Published in Climate of the Past, www.clim-past.net/8/1649/2012/. 31 pages, 23 figures, 9 pages. For data see http://www.metoffice.gov.uk/hadobs/hadis

The CAREGIVERSPRO-MMD Platform as an Online Informational and Social Support Tool for People Living With Memory Problems and Their Carers: An Evaluation of User Engagement, Usability and Usefulness

People living with dementia or cognitive impairment (PwD) and their carers often have unmet needs for informational and social support postdiagnosis. Web-based platforms have the potential to address these needs, although few have been developed for use by both PwD and carers. The CAREGIVERSPRO-MMD platform was developed to provide both user groups with informational and peer-to-peer social support. Platform logging data were analyzed to assess the extent to which PwD (n = 37) and carers (n = 37) engaged with the platform and its social/informational features in their daily lives. Participants also provided feedback on the usefulness and usability of the platform. The majority of PwD and carers found the platform and its social/informational features useful and usable, and significant subsets of both groups utilized the platform regularly. However, carers engaged with the informational and social features to a greater extent than PwD, and users highlighted that PwD typically required regular support to use the platform

Clinical diagnostic model for sciatica developed in primary care patients with low back-related leg pain

Background Identification of sciatica may assist timely management but can be challenging in clinical practice. Diagnostic models to identify sciatica have mainly been developed in secondary care settings with conflicting reference standard selection. This study explores the challenges of reference standard selection and aims to ascertain which combination of clinical assessment items best identify sciatica in people seeking primary healthcare. Methods Data on 394 low back-related leg pain consulters were analysed. Potential sciatica indicators were seven clinical assessment items. Two reference standards were used: (i) high confidence sciatica clinical diagnosis; (ii) high confidence sciatica clinical diagnosis with confirmatory magnetic resonance imaging findings. Multivariable logistic regression models were produced for both reference standards. A tool predicting sciatica diagnosis in low back-related leg pain was derived. Latent class modelling explored the validity of the reference standard. Results Model (i) retained five items; model (ii) retained six items. Four items remained in both models: below knee pain, leg pain worse than back pain, positive neural tension tests and neurological deficit. Model (i) was well calibrated (p = 0.18), discrimination was area under the receiver operating characteristic curve (AUC) 0.95 (95% CI 0.93, 0.98). Model (ii) showed good discrimination (AUC 0.82; 0.78, 0.86) but poor calibration (p = 0.004). Bootstrapping revealed minimal overfitting in both models. Agreement between the two latent classes and clinical diagnosis groups defined by model (i) was substantial, and fair for model (ii). Conclusion Four clinical assessment items were common in both reference standard definitions of sciatica. A simple scoring tool for identifying sciatica was developed. These criteria could be used clinically and in research to improve accuracy of identification of this subgroup of back pain patients

Stratifying workers on sick leave due to musculoskeletal pain: Translation, cross-cultural adaptation and construct validity of the Norwegian Keele STarT MSK tool

ObjectivesStratified care using prognostic models to estimate the risk profiles of patients has been increasing. A refined version of the popular STarT Back tool, the Keele STarT MSK tool, is a newly developed model for matched treatment across a wide range of musculoskeletal pain presentations. The aim of this study was to translate and culturally adapt the Keele STarT MSK tool into Norwegian, examine its construct validity and assess the representativeness of the included sample.MethodsThe Keele STarT MSK tool was formally translated into Norwegian following a multistep approach of forward and backward translation. A pre-final version was tested in 42 patients. Minor changes were implemented. To assess its construct validity, an online survey was conducted among workers aged 18–67 years who were on sick leave (>4 weeks) due to musculoskeletal disorders. Construct validity was evaluated in terms of convergent and discriminant validity using Pearson’s correlation coefficient, and known-group validity by comparing risk subgroups as suggested by the COSMIN checklist. The representativeness of the sample was assessed by comparing demographic and sick leave information of participants to eligible non-participants (n=168,137).ResultsA representative sample of 549 workers participated in the validity assessment; 74 participants (13.5%) were categorised as low risk, 314 (57.2%) as medium risk and 161 (29.3%) as high risk. The construct validity was found sufficient, with 90.9% and 75.0% of the pre-defined hypotheses confirmed for convergent and discriminant validity, and known-group validity, respectively. Floor or ceiling effects were not found.ConclusionsThe Keele STarT MSK tool was successfully translated into Norwegian. The construct validity of the tool was acceptable in a representative cohort of workers on sick leave as a result of musculoskeletal pain. However, the analyses raised concerns as to whether one of the questions captures the construct it is intended to measure

Novel approach to characterising individuals with low back-related leg pain: cluster identification with latent class analysis and 12-month follow-up

Traditionally, low back-related leg pain (LBLP) is diagnosed clinically as referred leg pain or sciatica (nerve root involvement). However, within the spectrum of LBLP, we hypothesised that there may be other unrecognised patient subgroups. This study aimed to identify clusters of patients with LBLP using latent class analysis and describe their clinical course. The study population was 609 LBLP primary care consulters. Variables from clinical assessment were included in the latent class analysis. Characteristics of the statistically identified clusters were compared, and their clinical course over 1 year was described. A 5 cluster solution was optimal. Cluster 1 (n = 104) had mild leg pain severity and was considered to represent a referred leg pain group with no clinical signs, suggesting nerve root involvement (sciatica). Cluster 2 (n = 122), cluster 3 (n = 188), and cluster 4 (n = 69) had mild, moderate, and severe pain and disability, respectively, and response to clinical assessment items suggested categories of mild, moderate, and severe sciatica. Cluster 5 (n = 126) had high pain and disability, longer pain duration, and more comorbidities and was difficult to map to a clinical diagnosis. Most improvement for pain and disability was seen in the first 4 months for all clusters. At 12 months, the proportion of patients reporting recovery ranged from 27% for cluster 5 to 45% for cluster 2 (mild sciatica). This is the first study that empirically shows the variability in profile and clinical course of patients with LBLP including sciatica. More homogenous groups were identified, which could be considered in future clinical and research settings