Stepwise strategy to improve Cervical Cancer Screening Adherence (SCAN-CC): automated text messages, phone calls and face-to-face interviews: protocol of a population-based randomised controlled trial

Introduction Screening is highly effective for cervical cancer prevention and control. Population-based screening programmes are widely implemented in high-income countries, although adherence is often low. In Portugal, just over half of the women adhere to cervical cancer screening, contributing for greater mortality rates than in other European countries. The most effective adherence raising strategies are based on patient reminders, small/mass media and face-to-face educational programmes, but sequential interventions targeting the general population have seldom been evaluated. The aim of this study is to assess the effectiveness of a stepwise approach, with increasing complexity and cost, to improve adherence to organised cervical cancer screening: step 1a-customised text message invitation; step 1b-customised automated phone call invitation; step 2-secretary phone call; step 3-family health professional phone call and face-to-face appointment. Methods A population-based randomised controlled trial will be implemented in Portuguese urban and rural areas. Women eligible for cervical cancer screening will be randomised (1: 1) to intervention and control. In the intervention group, women will be invited for screening through text messages, automated phone calls, manual phone calls and health professional appointments, to be applied sequentially to participants remaining non-adherent after each step. Control will be the standard of care (written letter). The primary outcome is the proportion of women adherent to screening after step 1 or sequences of steps from 1 to 3. The secondary outcomes are: proportion of women screened after each step (1a, 2 and 3); proportion of text messages/phone calls delivered; proportion of women previously screened in a private health institution who change to organised screening. The intervention and control groups will be compared based on intention-to-treat and per-protocol analyses. Ethics and dissemination The study was approved by the Ethics Committee of the Northern Health Region Administration and National Data Protection Committee. Results will be disseminated through communications in scientific meetings and peer-reviewed journals.This work is supported by the groups of primary healthcare units involved in the study (ACeS Porto Ocidental and Marao e Douro Norte) and the Instituto de Saude Publica da Universidade do Porto (ISPUP). The groups of primary care units contribute with the human resources involved in the field work and data collection. The cost of text messages and phone calls are supported by ACeS Porto Ocidental and ISPUP

Gas-phase solvolysis type reactions of SiCl3+ cations

Gas-phase SiCl3+ ions undergo sequential solvolysis type reactions with water, methanol, ammonia, methylamine and propylene. Studies carried out in a Fourier Transform mass spectrometer reveal that these reactions are facile at 10-8 Torr and give rise to substituted chlorosilyl cations. Ab initio and DFT calculations reveal that these reactions proceed by addition of the silyl cation to the oxygen or nitrogen lone pair followed by a 1,3-H migration in the transition state. These transition states are calculated to lie below the energy of the reactants. By comparison, hydrolysis of gaseous CCl3+ is calculated to involve a substantial positive energy barrier

Translating Evidence into Practice: Insights on the Reporting of Trial Results to Health Professionals and Institutions

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The neuroinflammatory hypothesis of delirium

Delirium is a neuropsychiatric syndrome characterized by a sudden and global impairment in consciousness, attention and cognition. It is particularly frequent in elderly subjects with medical or surgical conditions and is associated with short- and long-term adverse outcomes. The pathophysiology of delirium remains poorly understood as it involves complex multi-factorial dynamic interactions between a diversity of risk factors. Several conditions associated with delirium are characterized by activation of the inflammatory cascade with acute release of inflammatory mediators into the bloodstream. There is compelling evidence that acute peripheral inflammatory stimulation induces activation of brain parenchymal cells, expression of proinflammatory cytokines and inflammatory mediators in the central nervous system. These neuroinflammatory changes induce neuronal and synaptic dysfunction and subsequent neurobehavioural and cognitive symptoms. Furthermore, ageing and neurodegenerative disorders exaggerate microglial responses following stimulation by systemic immune stimuli such as peripheral inflammation and/or infection. In this review we explore the neuroinflammatory hypothesis of delirium based on recent evidence derived from animal and human studies

A Hybrid-Telerehabilitation Versus a Conventional Program for Urinary Incontinence: a Randomized Trial during COVID-19 Pandemic

Introduction and hypothesis This study aimed to compare the effectiveness of a hybrid telerehabilitation program with a traditional face to face model in women with stress urinary incontinence (SUI) and mixed incontinence (MUI) with a predominance of SUI. The authors hypothesized that home pelvic floor muscle training (PFMT) would have a similar benefit to outpatient PFMT. Methods Parallel randomized controlled trial including 58 patients consecutively admitted to a tertiary academic hospital for pelvic floor rehabilitation consultation from 1 January to 30 April 2021 for conservative treatment of UI. Participants randomized to the intervention were submitted to a 12-week PFMT program: (1) a hybrid telerehabilitation program of two individual face-to-face sessions followed by 2-weekly sessions of video-telerehabilitation with a follow-up by a specialized physiotherapist, including one individual face-to-face session at 8 weeks; (2) a re-evaluation teleconsultation at 6 and 16 weeks; (3) a face-to-face consultation at 12 weeks. The control group had two initial individual sessions followed by twice-weekly group classes, and consultations were face to face. The primary outcome measure (at baseline and 12 weeks) was UI-related quality of life using the Portuguese Version of the King's Health Questionnaire. Results At baseline the intervention (n = 18) and control (n = 17) groups were similar. UI-related quality of life significantly improved in both the intervention and control groups betweenbaseline (T0) and the end of the 12-week PFMT program (T12) (p = 0.002, p < 0.001, respectively), although the magnitude of the improvement was not significantly different between groups (–10.0 vs. –9.5 points, p = 0.918, respectively). Conclusion This hybrid telerehabilitation protocol showed effectiveness comparable to the traditional model in improving UI-related quality of life. Trial registration at www.ClinicalTrials.gov, no. NCT05114395

BIM4OHS observatory: central repository to monitor the status of BIM implementation for OSH: purposed architecture

DOI livro: 10.24840/978-972-752-309-2Key Technological Developments (KTDs), in recent years, have led to a step change in dealing with Occupational Safety and Health (OSH) risk management. Building Information Modelling (BIM), part of a wider trend of applying digital technology in the Architecture, Engineering, Construction and Operation (AECO) sector, has the potential to optimize the management of risks and costs of accidents at work and occupational diseases. Understanding the way OSH management can be improved using BIM is important as new processes and standards need to be created and existing procedures adapted. Currently there is no centralized sharing mechanism where countries, companies or projects can share lessons learned to help their implementation. Furthermore, there is no formal mechanism to observe and monitor trends and dynamics in the use of BIM for OSH at National, European or industry levels. Digital4OSH is a research group comprised of multidisciplinary academics and industry partners whose aim is to encourage the use of KTDs to improve OSH outcomes. Following a pilot study carried in a complex infrastructure megaproject in UK, this group proposes the development of an Observatory to overcome these gaps. The Observatory would be built on a web-based platform that can be used to obtain statistical longitudinal OSH data and provide information about the progress of national and European implementation of BIM for OSH (through dashboards); to capture, centralize and share (through factsheets) lessons learned from previous projects; to create a repository of technical and scientific information

DNA fluorescence probes based on side-chain chlorinated benzo[a]phenoxazinium chlorides

Several side chain chlorinated benzo[a]phenoxazinium chlorides functionalized with various types of terminals at the 5- and 9-amino positions of the heteroaromatic ring were used in photophysical studies with DNA. It was found that the functionalised terminal has a dramatic influence on the type of interaction with the amino group at the 9-amino position greatly promoting intercalation.Thanks are due to Fundação para a Ciência e Tecnologia (Portugal) for its financial support of a BPD to B. R. Raju (SFRH/BPD/62881/2009), CQUM and CFUM

A retrospective study in tumour characteristics and clinical outcomes of overweight and obese women with breast cancer

Introduction Obesity and breast cancer are two major pathologies closely associated with increasing incidence and mortality rates, especially amongst women. The association between both diseases have been thoroughly discussed but much is still to uncover. Aim The aim of this study is to analyse tumour characteristics and clinical outcomes of overweight and obese women to disclosure potential associations and better understand the impact of obesity in breast cancer. Materials and methods Clinicopathological information of 2246 women were extracted from the institutional database of comprehensive cancer centre in Portugal diagnosed between 2012 and 2016. Women were stratified according to body mass index as normal, overweight, and obese. Patients’ demographic information and tumour features (age, family history, topographic localization, laterality, histological type, and receptor status) were taken as independent variables and overall survival, tumour stage, differentiation grade and bilaterality were considered clinical outcomes. Results The main results reveal that overweight and obesity are predominantly associated with worse outcomes in breast cancer patients. Obese patients present larger (p-value: 0.002; OR 1.422; 95% CI 1.134–1.783) and more poorly differentiated tumours (p-value: 0.002; OR 1.480; 95% CI 1.154–1.898) and tend to have lower overall survival although without statistical significance (p-value: 0.117; OR 1.309; 95% CI 0.934–1.833). Overweighted women are more likely to have bilateral breast cancer (p-value: 0.017; OR 3.076; 95% CI 1.225–7.722) than obese women. The results also reveal that overweight women present less distant metastasis (p-value: 0.024; OR 0.525; 95%CI 0.299–0.920). Topographic localization and laterality did not achieve statistical significance.Open access funding provided by FCT|FCCN (b-on). Author C.L. has received research support by “FCT—Fundação para a Ciência e Tecnologia” (Grant number [SFRH/BD/146489/2019])

Um Universo Interdisciplinar chamado C?lculo Diferencial e Integral: Concep??es e Aplica??es

A busca pela motiva??o quanto a contextualiza??o as concep??es e aplica??es do C?lculo Diferencial e Integral (C.D.I.) nos conduziu a apresentar neste trabalho ideias acerca do estudo de limites, derivadas e integral. Neste texto falaremos de forma sucinta sobre a hist?ria do (C.D.I.) trazendo abordagens desde a Idade Antiga at? a Idade Moderna juntamente a algumas concep??es dos principais precursores e idealizadores, bem como de forma breve e resumida uma compila??o do que s?o abordados em artigos, disserta??es, teses ou livros did?ticos sobre defini??es, propriedades, teoremas, concep??es e aplica??es. Ainda ser?o apresentadas algumas aplica??es ou apenas motiva??es de algumas ?reas do conhecimento com um foco central na Geometria e algumas constru??es no software din?mico educacional - GeoGebra, tentando assim contribuir com algumas produ??es para o meio acad?mico. Pretendemos aqui abordar um estudo para um p?blico que j? estuda os objetos de conhecimento citados j? h? algum tempo e tem interesses ou motiva??es pelo tema j? com um certo conhecimento pr?vio. A empatia com os t?picos ligados ao estudo de comprimento de arcos, ?rea e volume de s?lidos aparecer? de uma forma um pouco mais abrangente nesse texto. A ideia principal ? trazer possibilidades nesse universo t?o grandioso, contudo destacamos o qu?o dif?cil foi sintetizar aquilo que gostar?amos de abrangi centenas de laudas, por se tratar de um trabalho de conclus?o de curso, assim n?o o podemos fazer

Astigmatism management in cataract surgery with Precizon(®) toric intraocular lens: a prospective study

PURPOSE: The purpose of this study was to evaluate the visual and refractive outcomes and rotational stability of the new aspheric Precizon(®) toric intraocular lens (IOL) for the correction of corneal astigmatism in cataract surgery. SETTING: Department of Ophthalmology, Hospital Geral de Santo António - Centro Hospitalar do Porto, EPE and Hospital de Pedro Hispano, Matosinhos, Portugal. DESIGN: This was a prospective clinical study. PATIENTS AND METHODS: A total of 40 eyes of 27 patients with corneal astigmatism greater than 1.0 diopter (D) underwent cataract surgery with implantation of Precizon(®) toric IOL. IOL power calculation was performed using optical coherence biometry (IOLMaster(®)). Outcomes of uncorrected (UDVA) and best-spectacle corrected distance visual acuities (BCDVA), refraction, and IOL rotation were analyzed at the 1st week, 1st, 3rd, and 6th month's evaluations. RESULTS: The median postoperative UDVA was better than preoperative best-spectacle corrected distance visual acuity (0.02 [0.06] logMAR vs 0.19 [0.20] logMAR, P<0.001). At 6 months, postoperative UDVA was 0.1 logMAR or better in 95% of the eyes. At last follow-up, the mean spherical equivalent was reduced from -3.35±3.10 D to -0.02±0.30 D (P<0.001) with 97.5% of the eyes within ±0.50 D of emmetropia. The mean preoperative keratometric cylinder was 2.34±0.95 D and the mean postoperative refractive cylinder was 0.24±0.27 D (P<0.001). The mean IOL rotation was 2.43°±1.55°. None of the IOLs required realignment. CONCLUSION: Precizon(®) toric IOL revealed very good rotational stability and performance regarding predictability, efficacy, and safety in the correction of preexisting regular corneal astigmatism associated with cataract surgery.info:eu-repo/semantics/publishedVersio