Microparticles for delivering therapeutic peptides and proteins to the lumen of the small intestine

Several different peptides and proteins, such as the pancreatic trypsin inhibitor, growth factors and trefoil peptides, are known to play important roles in maintaining the structure and function of the gastrointestinal wall. With the advent of recombinant biotechnology, it has become feasible to test some of these proteins as therapeutics in different inflammatory conditions of the intestines. However, the harsh pH and enzymatic conditions of the stomach can lead to their inactivation. This research was aimed at the development of particulate, gastric-resistant pharmaceutical forms, incorporating those bioactive molecules. Mixtures of proteins in powder form were coated with cellulose acetate phthalate, Eudragit® S100 or Eudragit® RS PO, using simple preparation techniques based on single emulsion/solvent evaporation. Using aprotinin as a model drug, it was found that these procedures were effective in microencapsulating protein in the solid form without affecting its biological activity. Furthermore, and in particular with the first two polymers above, particles showed adequate in vitro release patterns for the applications envisioned

Por um design inclusivo / For an inclusive design

O conceito e o entendimento sobre o que é a deficiência está, assim como a própria cultura, em processo de evolução, bem como a compreensão da atuação dos profissionais e serviços de tecnologia. Portando, é nesse sentido que o design, como ferramenta criativa e tecnológica, pode está a serviço da ampliação das bases de reinserção da inclusão social e da construção de equidade. Esse ensaio busca, por meio de uma interpretação bibliográfica, analisar como o processo criativo e o design inclusivo podem contribuir na democratização e acesso ao uso de bens e serviços por pessoas com deficiência. Como hipótese, acreditamos que, por apresentar um amplo campo interdisciplinar no processo criativo, o design pode tornar o mundo com suas variadas criações mais acessível. 

A software platform for evolutionary computation with pluggable parallelism and quality assurance

This paper proposes the Java Evolutionary Computation Library (JECoLi), an adaptable, flexible, extensible and reliable software framework implementing metaheuristic optimization algorithms, using the Java programming language. JECoLi aims to offer a solution suited for the integration of Evolutionary Computation (EC)-based approaches in larger applications, and for the rapid and efficient benchmarking of EC algorithms in specific problems. Its main contributions are (i) the implementation of pluggable parallelization modules, independent from the EC algorithms, allowing the programs to adapt to the available hardware resources in a transparent way, without changing the base code; (ii) a flexible platform for software quality assurance that allows creating tests for the implemented features and for user-defined extensions. The library is freely available as an open-source project.Fundação para a Ciência e a Tecnologia (FCT) - PTDC/EIA-EIA/115176/2009, Programa COMPET

Probable Person-to-Person Transmission of Legionnaires’ Disease

Correspondence to the Editor.Legionnaires’ disease is an often severe form of pneumonia that is typically acquired by susceptible persons (e.g., elderly persons and smokers) through inhalation of aerosols that contain legionella species.1-4 A cluster of cases of this disease occurred in Vila Franca de Xira, Portugal, in 2014

Clinical Screening Prediction in the Portuguese National Health Service: Data Analysis, Machine Learning Models, Explainability and Meta-Evaluation

This paper presents an analysis of the calls made to the Portuguese National Health Contact Center (SNS24) during a three years period. The final goal was to develop a system to help nurse attendants select the appropriate clinical pathway (from 59 options) for each call. It examines several aspects of the calls distribution like age and gender of the user, date and time of the call and final referral, among others and presents comparative results for alternative classification models (SVM and CNN) and different data samples (three months, one and two years data models). For the task of selecting the appropriate pathway, the models, learned on the basis of the available data, achieved F1 values that range between 0.642 (3 months CNN model) and 0.783 (2 years CNN model), with SVM having a more stable performance (between 0.743 and 0.768 for the corresponding data samples). These results are discussed regarding error analysis and possibilities for explaining the system decisions. A final meta evaluation, based on a clinical expert overview, compares the different choices: the nurse attendants (reference ground truth), the expert and the automatic decisions (2 models), revealing a higher agreement between the ML models, followed by their agreement with the clinical expert, and minor agreement with the reference.This research work was funded by FCT—Fundação para a Ciência e a Tecnologia, I.P, within the project SNS24.Scout.IA—Aplicação de Metodologias de Inteligência Artificial e Processamento de Linguagem Natural no Serviço de Triagem, Aconselhamento e Encaminhamento do SNS24 (ref. DSAIPA/AI/0040/2019)

Burnout and dropout intention in medical students: the protective role of academic engagement

Introduction: The infuence of burnout, academic engagement, and their interaction in dropout intention among medical students should be further studied. Current research shows its consequences are relevant, however, there is little understanding on burnout and academic engagement moderation in dropout intention. The current study tested a model that relates the efects of coping strategies, social support satisfaction, general distress on academic engagement, burnout, and dropout intention, on medical students. Methods: Through an online survey a non-probabilistic sample of one Medical Faculty’s 1st- and 2nd-year students was recruited. Cross-sectional data were collected using psychometric instruments (Maslach Burnout Inventory – Student Survey, Social Support Satisfaction Scale for College Students, Brief COPE Scale for College Students, University Student Engagement Inventory, and Depression, Anxiety and Stress Scale), sociodemographic and academic variables, and analyzed using structural equation modeling. Results: 532 students (76% response rate) enrolled in the study. Latent variables structural model presented a satisfactory ft to the data and confrmed the expected negative path between burnout and dropout intention (βDI<-SB=0.430; p<.001) and the latent moderation burnout x engagement (βDI<-SB*SE=-0.218; p<.001). Conclusion: Academic engagement attenuates the impact of burnout on dropout intention, working as a protective factor. Social support satisfaction and adaptive coping are associated with increased levels of academic engagement, and general distress and maladaptive coping are associated with burnout. Medical Schools should develop interventions to prevent dropout intention, tackle students’ stress and academic challenges, and develop their academic engagement levels.Fundação para a Ciência e Tecnologia - FCTinfo:eu-repo/semantics/publishedVersio

SARCOPÉNIA NO CANCRO GÁSTRICO E MODIFICAÇÕES DA COMPOSIÇÃO CORPORAL PÓS-GASTRECTOMIA

Sarcopenia is the phenomenon of loss of muscle strength, muscle performance and muscle mass due to either age (primary sarcopenia) or other illnesses such as cancer (secondary sarcopenia). Sarcopenia has often been defined in the literature as low muscle mass. Sarcopenia among gastric cancer patients has been shown to carry a higher risk of post-operative complications and a higher overall and disease-specific mortality. Our study included 86 patients who underwent surgery for gastric cancer at our institution. Muscle mass was assessed by CT scan (L3 Muscle Index). A subgroup analysis was then performed of 39 patients who had had CT scans 12 months postoperatively. We collected demographic, clinical and body composition data. Sarcopenia was defined by the L3 Muscle Mass Index according to cut-off values previously defined in the literature. We found a prevalence of sarcopenia of 40.7% among gastric cancer patients undergoing gastrectomy. Sarcopenia was associated with a higher overall mortality. Nutritional risk and percentage of body weight lost did not identify sarcopenic patients. 51.4% of sarcopenic patients were overweight, 2.9% were obese. At 12 months post-operatively, 82.1% of patients lost weight and BMI and 76.9% of patients lost muscle mass (lower L3 muscle index) after gastrectomy. We did not find a significant association between the change in muscle mass, BMI or weight. We found that total gastrectomy was significantly associated to muscle mass loss compared to subtotal gastrectomy. We also found a significant association between advanced gastric cancer stage and muscle mass loss. We concluded that while sarcopenia is highly prevalent among gastric cancer patients after gastrectomy, the vast majority of patients lose weight and muscle mass. Since most patients will not improve muscle mass postoperatively it is crucial to implement prehabilitation strategies early on.A Sarcopénia é o fenómeno da perda de força, performance e massa muscular. Pode ser primário (relacionado com a idade) ou secundário (por exemplo a neoplasia) e tem sido definida na literatura como massa muscular baixa. A Sarcopénia nos doentes com cancro gástrico acarreta um aumento do risco de complicações pós-operatórias e da mortalidade específica e global. O nosso estudo incluiu 86 doentes submetidos a gastrectomia por cancro gástrico, cuja massa muscular foi avaliada por TC (Índice L3). Realizou-se uma subanálise de 39 doentes que tinham realizado TC também aos 12 meses pós-operatórios. Foram analisados &nbsp;dados demográficos, clínicos e de composição corporal. A Sarcopénia foi definida pelo Índice de Massa Muscular em L3, de acordo com valores previamente definidos na literartura. Verificámos uma prevalência de Sarcopénia de 40.7% em doentes submetidos a gastrectomia. A Sarcopénia relacionou-se com uma mortalidade global mais elevada. O Risco Nutricional e a percentagem de peso perdido não identificaram os doentes sarcopénicos. 51.4% dos doentes sarcopénicos tinham excesso de peso, 2.9% eram obesos. Aos 12 meses após gastrectomia, 82.1% dos doentes tinham diminuído de peso e IMC e 79.6% dos doentes tinham perdido massa muscular. Não encontrámos uma associação significativa entre a modificação na massa muscular e no peso ou IMC. Verificámos que a gastrectomia total se associava a uma perda de massa muscular significativamente superior à da gastrectomia subtotal. Verificámos que estadio avançado da neoplasia gástrica se associava a uma maior perda de massa muscular. Concluímos que a prevalência de Sarcopénia em doentes com cancro gástrico é elevada e que, após gastrectomia, a maior parte desses doentes perde peso e massa muscular. Dado que a maioria dos doentes não irão aumentar a sua massa muscular no pós-operatório, é crucial implementar estratégias de pré-habilitação precocemente

A metoclopramida prejudica a cicatrização de anastomoses do cólon esquerdo de ratos?

Objetivo: Avaliar os efeitos da metoclopramida sobre a formação de aderências e a cicatrização de anastomoses de cólon esquerdo de ratos. Métodos: 40 ratos distribuídos em dois grupos contendo 20 animais, para administração de metoclopramida (grupo experimental - E) ou solução de NaCl 0,9% (grupo controle - C). Cada grupo foi dividido em subgrupos contendo 10 animais, para eutanásia no terceiro (E3 e C3) ou sétimo dia (E7 e C7) de pós-operatório. Os ratos foram submetidos à secção do cólon esquerdo e anastomose término-terminal. No dia da relaparotomia foi avaliada a quantidade total de aderências e removido um segmento colônico contendo a anastomose para análise da força de ruptura e concentração de hidroxiprolina. Resultados: Não houve mortes ou deiscências no 3° dia de pós-operatório. No grupo E7 ocorreram uma morte e uma deiscência de anastomose bloqueada. Não houve diferença significativa entre os grupos em relação à evolução clínica, quantidade de aderências intra-cavitárias ou à anastomose e resistência tênsil no 3° ou 7° pós-operatório. A concentração de hidroxiprolina foi maior no grupo metoclopramida no 3° (p=0,006) mas não no 7° dia de pósoperatório (p=0,241) Conclusão: A metoclopramida não apresenta efeito deletério sobre a cicatrização de anastomoses intestinais em ratos. _________________________________________________________________________________ ABSTRACTPurpose: To evaluate the effects of metoclopramide on the formation of adhesion and the healing of left colonic anastomoses in rats. Methods: Forty rats underwent sectioning of the left colon and end-to-end anastomosis and were divided into two groups of 20 animals for the administration of metoclopramide (experimental group - E) or saline solution (control group - C). Each group was divided into subgroups of 10 animals each to be killed on the third (E3 and C3) or seventh postoperative day (E7 and C7). Adhesion was assessed, and a colonic segment containing the anastomosis was removed for analysis of breaking strength and hydroxyproline concentration. Results: There were no deaths or dehiscence on the 3rd postoperative day. There was one death and one blocked anastomotic dehiscence in the E7 group. No significant differences between groups were found in the analysis of clinical outcome, intra-cavity adhesion, adhesion to the anastomosis or breaking strength on the 3rd and 7th postoperative day. Hydroxyproline concentration was higher in the control group on the 3rd (p=0.006) but not on the 7th postoperative day (p=0.241). Conclusion: Metoclopramide did not have harmful effects on the healing of intestinal anastomoses in rats

A Clinical Decision Support System for Remote Monitoring of Cardiovascular Disease Patients: A Clinical Study Protocol

Funding: This work was partially supported by the Center for Innovative Care and Health Technology (ciTechcare), Polytechnic of Leiria, Portugal. The work of FV was funded by the Portuguese Foundation for Science and Technology (FCT), CEECINST/00103/2018. The funder had no role in the clinical study protocol.Introduction: Cardiovascular diseases (CVD) are the leading cause of death globally, taking an estimated 17. 9 million lives each year. Cardiac rehabilitation is shown to reduce mortality and hospital readmissions, while improving physical fitness and quality of life. Despite the recommendations and proven benefits, acceptance and adherence remain low. Mobile health (mHealth) solutions may contribute to more personalized and tailored patient recommendations according to their specific needs. This study protocol aims to assess the effectiveness of a user-friendly, comprehensive Clinical Decision Support System (CDSS) for remote patient monitoring of CVD patients, primarily on the reduction of recurrent cardiovascular events. Methods and Analysis: The study will follow a multicenter randomized controlled design involving two cardiology units in the Center Region of Portugal. Prospective CVD patients will be approached by the healthcare staff at each unit and checked for eligibility according to the predefined inclusion/exclusion criteria. The CDSS will suggest a monitoring plan for the patient, will advise the mHealth tools (apps and wearables) adapted to patient needs, and will collect data. The clinical study will start in January 2023. Discussion: The success of the mHeart.4U intervention will be a step toward the use of technological interfaces as an integrating part of CR programs. Ethics and Dissemination: The study will undergo ethical revision by the Ethics Board of the two hospital units where the study will unfold. The study was registered in ClinicalTrials.gov on 18th January 2022 with the number NCT05196802. The study findings will be published in international peer-reviewed scientific journals and encounters and in a user-friendly manner to the society.info:eu-repo/semantics/publishedVersio