Reavaliação do Rastreio de Memória à Covilhã

Introdução: O Défice Cognitivo Ligeiro (DCL) é um processo patológico definido como um ponto intermédio entre o envelhecimento fisiológico e um estado de demência muito precoce. Entender a evolução natural deste estado, avaliando a deterioração cognitiva observada em pacientes com esta condição ao longo de um intervalo de dois anos pode ajudar a confirmar uma necessidade de intervenção terapêutica para evitar a sua progressão. Por outro lado, torna-se importante estudar a possibilidade de deteção rápida e mais precoce deste processo, através do eventual uso de outros testes como o Teste de Fluência Verbal e a Escala de queixas de memória subjetivas, mais práticos e simples que o MoCA, tradicionalmente usado para a sua deteção. Materiais e Métodos: A amostra final foi composta por 16 indivíduos que participaram no Rastreio Geriátrico à Covilhã de 2016 e cujo resultado na escala MoCA permitia identificar casos de possível DCL. Foram reavaliados os valores de MoCA, bem como do Teste de Fluência Verbal para avaliar a evolução ao longo dos dois anos. Foi também aplicada a Escala de Queixas de Memória Subjetivas a estes indivíduos. A análise estatística dos dados foi feita com recurso a técnicas de análise estatística descritiva e inferencial. Resultados: Observou-se entre as médias resultados do MoCA de 2016 e 2018 uma diminuição significativa de 2,688 ± 1,044 pontos (valor p=0,021). Em relação à fluência verbal, entre 2016 e 2018 verificou-se um aumento não significativo na média da pontuação no Teste de Fluência Verbal de 0,625 ± 0,779. A correlação entre os resultados do Teste de Fluência Verbal e do MoCA revelou-se positiva e fraca (Rs=0,451), sendo marginalmente significativa (valor-p=0,079). Não se encontrou qualquer correlação entre a Escala de Queixas Subjetivas de Memória e a pontuação do MoCA (Rs=0,095; valor-p=0,783). Conclusão: Parece haver uma tendência, concordante com outros estudos, de um declínio cognitivo por parte das pessoas com Défice Cognitivo Ligeiro. Na população estudada, a fluência verbal e as queixas subjetivas de memória não se apresentaram significativamente correlacionadas com os resultados no MoCA. A realização de novos estudos com amostras de maiores dimensões parece interessante para melhor comprovar estes resultados.Introduction: Mild Cognitive Impairment (MCI) is a pathologic process defined as an intermediate point between physiological aging and a very early state of dementia. Understanding this state’s natural evolution, by measuring cognitive decline observed in patients with this condition, in a two year interval, may help to confirm the necessity of therapeutic intervention, in order to avoid its progression. On the other hand, it becomes more important to study the possibility of earlier detection of this process, through the use of other tests, such as the Verbal Fluency Test and the Subjective Memory Complaints Scale, simpler and more practical, than the Montreal Cognitive Assessment Scale, traditionally used for its detection. Materials and Methods: The final sample was composed by 16 individuals that took part in the Geriatric Survey to Covilhã in 2016 and which results in the MoCA scale allowed for the establishment of a diagnosis of MCI. The values of MoCA, as well as those of the Verbal Fluency tests were reassessed, in order to evaluate the evolution in the course of the two years. The Subjective Memory Complaints Scale was also applied to these individuals. Statistical analysis was made with the program IBM SPSS Statistics version 25, with descriptive and inferential statistical analysis techniques. Results: Between the average results of the MoCA Scale of 2016 and 2018 it was observed a significant drop of 2,688 ± 1,044 points (p value=0,021). Regarding verbal fluency, between 2016 and 2018, a rise in the average result of 0,625 ± 0,779 was observed in the score of the Verbal Fluency Test, however it was not statistically significant. Correlation between the results of the Verbal Fluency Test and the MoCA Scale turned out weak (RS=0,451), this result being marginally significant (p value=0,079). No correlation was found between the Subjective Memory Complaints Scale and the MoCA scores (RS=0,095; p value=0,783). Conclusion: There seems to be a tendency, concordant with other studies, of a cognitive decline by the patients diagnosed with Mild Cognitive Impairment. In the present study, verbal fluency and subjective memory complaints did not show any significant correlation with the results in the MoCA scale. The realization of new studies with larger samples seems interesting to better prove these results

K- and L-shell theoretical fluorescence yields for the Fe isonuclear sequence

Funding Information: This research was funded in part by FCT (Portugal) under research center grant UID/FIS/04559/2020 (LIBPhys). This work was also funded through the project PTDC/FIS-AQM/31969/2017, “Ultra-high-accuracy X-ray spectroscopy of transition metal oxides and rare earths”. F.G. acknowledges support from FCT, Portugal through contract UI/BD/151000/2021 . J. M and J.P.S acknowledge the support of EMPIR, Germany , under Contract No. 20FUN04 PrimA-LTD. The EMPIR initiative is co-funded by the European Union’s Horizon 2020 research and innovation programme and the EMPIR, Germany participating States. Part of this work has been carried out under the High Performance Computing Chair - a R&D infrastructure (based at the University of Évora; PI: M. Avillez), endorsed by Hewlett Packard Enterprise (HPE), and involving a consortium of higher education institutions (University of Algarve, University of Évora, NOVA University Lisbon, and University of Porto), research centres (CIAC, CIDEHUS, CHRC), enterprises (HPE, ANIET, ASSIMAGRA, Cluster Portugal Mineral Resources, DECSIS, FastCompChem, GeoSense, GEOtek, Health Tech, Starkdata), and public/private organizations (Alentejo Tourism-ERT, KIPT Colab). Funding Information: This research was funded in part by FCT (Portugal) under research center grant UID/FIS/04559/2020 (LIBPhys). This work was also funded through the project PTDC/FIS-AQM/31969/2017, “Ultra-high-accuracy X-ray spectroscopy of transition metal oxides and rare earths”. F.G. acknowledges support from FCT, Portugal through contract UI/BD/151000/2021. J. M and J.P.S acknowledge the support of EMPIR, Germany, under Contract No. 20FUN04 PrimA-LTD. The EMPIR initiative is co-funded by the European Union's Horizon 2020 research and innovation programme and the EMPIR, Germany participating States. Part of this work has been carried out under the High Performance Computing Chair - a R&D infrastructure (based at the University of Évora; PI: M. Avillez), endorsed by Hewlett Packard Enterprise (HPE), and involving a consortium of higher education institutions (University of Algarve, University of Évora, NOVA University Lisbon, and University of Porto), research centres (CIAC, CIDEHUS, CHRC), enterprises (HPE, ANIET, ASSIMAGRA, Cluster Portugal Mineral Resources, DECSIS, FastCompChem, GeoSense, GEOtek, Health Tech, Starkdata), and public/private organizations (Alentejo Tourism-ERT, KIPT Colab). Publisher Copyright: © 2022 The Author(s)In this work, we present K- and L- shell fluorescence yield values of the full isonuclear sequence of Fe ions, using a state-of-the-art multiconfiguration Dirac–Fock approach. These results may be of importance for spectral fitting and plasma modeling, both in laboratory and astrophysical studies, where Fe is an important benchmark element. The K-shell fluorescence yields were found to be very similar up to the removal of 14 electrons.publishersversionpublishe

Genetic ablation of inositol 1,4,5-Trisphosphate receptor type 2 (IP3R2) fails to modify disease progression in a mouse model of Spinocerebellar Ataxia type 3

Spinocerebellar ataxia type 3 (SCA3) is a rare neurodegenerative disease caused by an abnormal polyglutamine expansion within the ataxin-3 protein (ATXN3). This leads to neurodegeneration of specific brain and spinal cord regions, resulting in a progressive loss of motor function. Despite neuronal death, non-neuronal cells, including astrocytes, are also involved in SCA3 pathogenesis. Astrogliosis is a common pathological feature in SCA3 patients and animal models of the disease. However, the contribution of astrocytes to SCA3 is not clearly defined. Inositol 1,4,5-trisphosphate receptor type 2 (IP3R2) is the predominant IP3R in mediating astrocyte somatic calcium signals, and genetically ablation of IP3R2 has been widely used to study astrocyte function. Here, we aimed to investigate the relevance of IP3R2 in the onset and progression of SCA3. For this, we tested whether IP3R2 depletion and the consecutive suppression of global astrocytic calcium signalling would lead to marked changes in the behavioral phenotype of a SCA3 mouse model, the CMVMJD135 transgenic line. This was achieved by crossing IP3R2 null mice with the CMVMJD135 mouse model and performing a longitudinal behavioral characterization of these mice using well-established motor-related function tests. Our results demonstrate that IP3R2 deletion in astrocytes does not modify SCA3 progression.This work has been funded by National funds, through the Foundation for Science and Technology (FCT)—project UIDB/50026/2020 and UIDP/50026/2020, PTDC/NEUNMC/3648/2014 and COMPETE-FEDER (POCI-01-0145-FEDER-016818); fellowships to DCG (2021.08121.BD), DMF (SFRH/BD/147947/2019), JSC (SFRH/BD/140624/2018), ANC (SFRH/BPD/118779/2016), AVF (UMINHO/BIL-CNCG/2022/11), SGG (SFRH/BD/101298/2014), and JFV (2020.05109.BD); FCT Scientific Employment Stimulus (CEEC)—Individual Call position to SDS (CEECIND/00685/2020); grants from the Bial Foundation (037/18) and “the la Caixa” Foundation (LCF/PR/HR21/52410024) to JFO; and by the projects NORTE-01-0145-FEDER-000013 and NORTE-01-0145-FEDER-000023, supported by the Norte Portugal Regional Operational Programme (NORTE 2020), under the PORTUGAL 2020 Partnership Agreement, through the European Regional Development Fund (ERDF). It was also supported by grants from the ICVS Scientific Microscopy Platform, a member of the national infrastructure PPBI—Portuguese Platform of Bioimaging (PPBI-POCI-01-0145-FEDER-022122 and national funds through the Foundation for Science and Technology (FCT)

Innovation for resilience

Last decade is characterized by different types of crises and shocs in the socioeconomic systems, creating a turbulent context and calling for a better understanding of what the dynamic perspective of change is. For countries, regions and cities a better understanding of governance urges and calls for action

Show your beaks and we tell you what you eat: Different ecology in sympatric Antarctic benthic octopods under a climate change context

Sympatry can lead to higher competition under climate change and other environmental pressures, including in South Georgia, Antarctica, where the two most common octopod species, Adelieledone polymorpha and Pareledone turqueti, occur side by side. Since cephalopods are typically elusive animals, the ecology of both species is poorly known. As beaks of cephalopods are recurrently found in top predator's stomachs, we studied the feeding ecology of both octopods through the evaluation of niche overlapping and specific beak adaptations that both species present. A multidisciplinary approach combining carbon (δ13C) and nitrogen (δ15N) stable isotope signatures, mercury (Hg) analysis and biomaterials' engineering techniques was applied to investigate the beaks. An isotopic niche overlap of 95.6% was recorded for the juvenile stages of both octopod species, dropping to 19.2% for the adult stages. Both A. polymorpha and P. turqueti inhabit benthic ecosystems around South Georgia throughout their lifecycles (δ13C: −19.21 ± 1.87‰, mean ± SD for both species) but explore trophic niches partially different during adult life stages (δ15N: 7.01 ± 0.40‰, in A. polymorpha, and 7.84 ± 0.65‰, in P. turqueti). The beaks of A. polymorpha are less dense and significantly less stiff than in P. turqueti. Beaks showed lower mercury concentration relative to muscle (A. polymorpha - beaks: 0.052 ± 0.009  μg g−1, muscle: 0.322 ± 0.088  μg g−1; P. turqueti - beaks: 0.038 ± 0.009  μg g−1; muscle: 0.434 ± 0.128  μg g−1). Overall, both octopods exhibit similar habitats but different trophic niches, related to morphology/function of beaks. The high Hg concentrations in both octopods can have negative consequences on their top predators and may increase under the present climate change context.British Antarctic Survey for assisting in the collection of the specimens for this work. Many thanks to 3B's Research Group (University of Minho) and MAREFOZ who were responsible for analysing the physical properties of beaks and stable isotope signatures. A special thank you to our colleague José Queirós from MARE-UC (Coimbra, Portugal) for his suggestions and guidance. A debt of gratitude is also owed to Dr. A. Louise Allcock (NUI Galway) for her useful guidelines. This work is an international effort under the Scientific Committee on Antarctic Research (SCAR) associated programs, expert and action groups, namely SCAR AnT-ERA, SCAR EGBAMM and ICED. J.C. Xavier was supported by the Investigator Programme (IF/00616/2013) of the Foundation for Science and Technology (FCT-Portugal) and PROPOLAR, and F.R. Ceia was supported by a postdoctoral fellowship (SFRH/BPD/95372/2013) attributed by FCT-Portugal and the European Social Fund (POPH, EU). This study benefited from the strategic program of MARE, financed by FCT-Portugal (MARE- UID/MAR/04292/2019). We also acknowledge FCT-Portugal through a PhD grant to J. Seco (SRFH/PD/BD/113487

Hábitos Alimentares das Pessoas com Diabetes Mellitus Tipo 2 em Portugal: Um Estudo Transversal

Introdução: A nutrição é uma área de intervenção na prevenção e gestão da diabetes mellitus; por isso, é fulcral promover a capacitação da população para a adoção de hábitos alimentares saudáveis. Ainda que existam alguns estudos nesta área, não se conhecem os principais erros nos hábitos alimentares das pessoas com diabetes em Portugal. Os objetivos deste estudo foram identificar os principais erros nos hábitos alimentares das pessoas com diabetes mellitus tipo 2 em Portugal e avaliar a sua relação com variáveis sociodemográficas. Métodos: Estudo transversal multicêntrico, em amostra de conveniência de pessoas com diabetes mellitus tipo 2 seguidas em Unidades de Cuidados de Saúde Primários. Aplicação do UK Diabetes and Diet Questionnaire (UKDDQ) – traduzido e adaptado, de julho a outubro de 2022. Análise estatística descritiva e inferencial. Resultados: Amostra de 550 participantes, 52,2% do sexo feminino, 68,3% com 65 anos ou mais, 55,8% com nível de escolaridade igual ou inferior ao 1.º ciclo do ensino básico, 24,7% com insuficiência económica e tempo desde o diagnóstico médio de 10,60 ± 8,13 anos. Apenas 36,2% da amostra obteve um score UKDDQ considerado saudável. Menos de 50% obteve scores saudáveis para os itens “arroz ou massa ricos em fibras”, “pão integral”, “manteiga, margarina e óleos vegetais” e “vegetais e leguminosas”. Somente 8,9% da amostra obteve score saudável para o consumo de fibras. Cerca de 70,4% obteve score saudável para o consumo de açúcares livres e 54,7% para o consumo de ácidos gordos saturados. Verificou-se a existência de uma correlação com significado estatístico positiva fraca entre o score UKDDQ e a idade (ρ = 0,201, p < 0,001), com escolha mais frequente de alimentos saudáveis com o aumentar da idade. As pessoas do sexo feminino reportaram hábitos alimentares mais saudáveis, particularmente no consumo de fibras e ácidos gordos saturados. Conclusão: A maior parte da nossa amostra não usufruiu do potencial efeito positivo de uma alimentação saudável. Individualizam-se grupos de alimentos cujos consumos devem ser enfatizados ou desencorajados, particularmente, a necessidade de incentivar o consumo de alimentos ricos em fibra. Ações educacionais dirigidas devem ter especial foco em pessoas mais jovens e/ou do sexo masculino

O que as revisões sistemáticas dizem sobre o impacto da cirurgia robótica na neurocirurgia?

Introduction: Neurosurgery, with its intricate complexities and demands for extreme precision, has been shaped and transformed over the years by the constant evolution of medical technology. Methodology: The methodology adopted for this work involved a systematic literature review focused on specific MESH descriptors, conducted in the PUBMED database. The period considered for article searches spanned from 2017 to 2023, aiming to capture the latest contributions to the topic. The selected MESH descriptors to outline the research were "Robotic Surgical Procedures," "Neurosurgery," and "Minimally Invasive Surgical Procedures." Results: Systematic reviews present a comprehensive overview of recent advances in robotic surgery and its applications in various areas. The promising landscape outlined by these analyses not only validates the progress made but also underscores the ongoing need for research and development to further enhance surgical practices. Conclusion: The learning curve, the need for specialized training, and economic considerations are crucial aspects shaping the practical implementation of robotic surgery in the neurosurgical scenario.Introdução: A neurocirurgia, com suas complexidades intricadas e demandas por precisão extrema, tem sido moldada e transformada ao longo dos anos pela constante evolução da tecnologia médica. Metodologia: A metodologia adotada para este trabalho compreendeu uma revisão sistemática de literatura, focada em descritores MESH específicos, realizada no banco de dados PUBMED. O período considerado para a busca de artigos abrangeu de 2017 a 2023, visando capturar as mais recentes contribuições à temática. Os descritores MESH selecionados para delinear a pesquisa foram "Robotic Surgical Procedures", "Neurosurgery" e "Minimally Invasive Surgical Procedures". Resultado: As revisões sistemáticas apresentam um panorama abrangente dos avanços recentes na cirurgia robótica e suas aplicações em diversas áreas. O cenário promissor delineado por essas análises não apenas valida os progressos alcançados, mas também ressalta a necessidade contínua de pesquisa e desenvolvimento para aprimorar ainda mais as práticas cirúrgicas. Conclusão: A curva de aprendizado, a necessidade de treinamento especializado e as considerações econômicas são aspectos cruciais que moldam a implementação prática da cirurgia robótica no cenário neurocirúrgico

Goodbye Hartmann trial: a prospective, international, multicenter, observational study on the current use of a surgical procedure developed a century ago

Background: Literature suggests colonic resection and primary anastomosis (RPA) instead of Hartmann's procedure (HP) for the treatment of left-sided colonic emergencies. We aim to evaluate the surgical options globally used to treat patients with acute left-sided colonic emergencies and the factors that leading to the choice of treatment, comparing HP and RPA. Methods: This is a prospective, international, multicenter, observational study registered on ClinicalTrials.gov. A total 1215 patients with left-sided colonic emergencies who required surgery were included from 204 centers during the period of March 1, 2020, to May 31, 2020. with a 1-year follow-up. Results: 564 patients (43.1%) were females. The mean age was 65.9 ± 15.6&nbsp;years. HP was performed in 697 (57.3%) patients and RPA in 384 (31.6%) cases. Complicated acute diverticulitis was the most common cause of left-sided colonic emergencies (40.2%), followed by colorectal malignancy (36.6%). Severe complications (Clavien-Dindo ≥ 3b) were higher in the HP group (P &lt; 0.001). 30-day mortality was higher in HP patients (13.7%), especially in case of bowel perforation and diffused peritonitis. 1-year follow-up showed no differences on ostomy reversal rate between HP and RPA. (P = 0.127). A backward likelihood logistic regression model showed that RPA was preferred in younger patients, having low ASA score (≤ 3), in case of large bowel obstruction, absence of colonic ischemia, longer time from admission to surgery, operating early at the day working hours, by a surgeon who performed more than 50 colorectal resections. Conclusions: After 100&nbsp;years since the first Hartmann's procedure, HP remains the most common treatment for left-sided colorectal emergencies. Treatment's choice depends on patient characteristics, the time of surgery and the experience of the surgeon. RPA should be considered as the gold standard for surgery, with HP being an exception

Optimisation of Perioperative Cardiovascular Management to Improve Surgical Outcome II (OPTIMISE II) trial: study protocol for a multicentre international trial of cardiac output-guided fluid therapy with low-dose inotrope infusion compared with usual care in patients undergoing major elective gastrointestinal surgery.

INTRODUCTION: Postoperative morbidity and mortality in older patients with comorbidities undergoing gastrointestinal surgery are a major burden on healthcare systems. Infections after surgery are common in such patients, prolonging hospitalisation and reducing postoperative short-term and long-term survival. Optimal management of perioperative intravenous fluids and inotropic drugs may reduce infection rates and improve outcomes from surgery. Previous small trials of cardiac-output-guided haemodynamic therapy algorithms suggested a modest reduction in postoperative morbidity. A large definitive trial is needed to confirm or refute this and inform widespread clinical practice. METHODS: The Optimisation of Perioperative Cardiovascular Management to Improve Surgical Outcome II (OPTIMISE II) trial is a multicentre, international, parallel group, open, randomised controlled trial. 2502 high-risk patients undergoing major elective gastrointestinal surgery will be randomly allocated in a 1:1 ratio using minimisation to minimally invasive cardiac output monitoring to guide protocolised administration of intravenous fluid combined with low-dose inotrope infusion, or usual care. The trial intervention will be carried out during and for 4 hours after surgery. The primary outcome is postoperative infection of Clavien-Dindo grade II or higher within 30 days of randomisation. Participants and those delivering the intervention will not be blinded to treatment allocation; however, outcome assessors will be blinded when feasible. Participant recruitment started in January 2017 and is scheduled to last 3 years, within 50 hospitals worldwide. ETHICS/DISSEMINATION: The OPTIMISE II trial has been approved by the UK National Research Ethics Service and has been approved by responsible ethics committees in all participating countries. The findings will be disseminated through publication in a widely accessible peer-reviewed scientific journal. TRIAL REGISTRATION NUMBER: ISRCTN39653756.The OPTIMISE II trial is supported by Edwards Lifesciences (Irvine, CA) and the UK National Institute for Health Research through RMP’s NIHR Professorship

Nurses' perceptions of aids and obstacles to the provision of optimal end of life care in ICU

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