The who-when-why triangle of complementary and alternative medicine use among Portuguese IBD patients

Background: The use of complementary and alternative medicines is increasing among chronic patients, particularly those afflicted with inflammatory bowel diseases. Aim: This study aimed to address the prevalence of complementary and alternative medicines use among Portuguese inflammatory bowel diseases' patients. Methods: Patients were invited to fill an anonymous questionnaire concerning the use of complementary and alternative medicines. Results: Thirty-one per cent of the patients reported having used complementary and alternative medicines in the past, whereas 12% were using them by the time the questionnaire was administered. Fifty-nine per cent of the users did not share this information with their physician, whereas 14% and 8% discontinued their medication and periodical examination, respectively. Steroids prescription (OR = 2.880) and a higher instruction level (OR = 3.669) were predictors of complementary and alternative medicines use in this cohort. Conclusions: Roughly a third of Portuguese IBD patients had used CAM. Steroid treatment and an academic degree are associated with CAM use. Given the potential side effects and interactions, patient information about the benefits and limitations of conventional and complementary treatments should be reinforced. (C) 2017 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.GEDII (Portuguese IBD Study Group)info:eu-repo/semantics/publishedVersio

Proanthocyanidin Polymer-Rich Fraction of Stryphnodendron adstringens Promotes in Vitro and in Vivo Cancer Cell Death via Oxidative Stress

Cervical cancer is the fourth most common cancer that affects women, mainly through human papilloma virus (HPV) infection with high-risk HPV16 and HPV18. The present study investigated the in vitro anticancer activity and mechanism of action of a proanthocyanidin polymer-rich fraction of Stryphnodendron adstringens (F2) in cervical cancer cell lines, including HeLa (HPV18-positive), SiHa (HPV16-positive), and C33A (HPV-negative) cells, and also evaluated in vivo anticancer activity. In vitro, cell viability was determined by the MTT assay. Cell migration was determined by the wound healing assay. The mechanism of action was investigated by performing ultrastructural analysis and evaluating reactive oxygen species (ROS) production, mitochondrial metabolism, lipoperoxidation, BCL-2 family expression, caspase expression, and DNA and cell membrane integrity. In vivo activity was evaluated using the murine Ehrlich solid tumor model. F2 time- and dose-dependently reduced cell viability and significantly inhibited the migration of cervical cancer cells. HeLa and SiHa cells treated with F2 (IC50) exhibited intense oxidative stress (i.e., increase in ROS and decrease in antioxidant species) and mitochondrial damage (i.e., mitochondrial membrane potential depolarization and a reduction of intracellular levels of adenosine triphosphate). Increases in the Bax/BCL-2 ratio and caspase 9 and caspase 3 expression, were observed, with DNA damage that was sufficient to trigger mitochondria-dependent apoptosis. Cell membrane disruption was observed in C33A cells (IC50 and IC90) and HeLa and SiHa cells (IC90), indicating progress to late apoptosis/necrosis. The inhibition of ROS production by N-acetylcysteine significantly suppressed oxidative stress in all three cell lines. In vivo, F2 significantly reduced tumor volume and weight of the Ehrlich solid tumor, and significantly increased lipoperoxidation, indicating that F2 also induces oxidative stress in the in vivo model. These findings indicate that the proanthocyanidin polymer-rich fraction of S. adstringens may be a potential chemotherapeutic candidate for cancer treatment

Desplastificar atividades e mentalidades

Desplastificar Atividades e Mentalidades A temática do plástico como “lixo”, especialmente em meio aquático, passou, recentemente, a estar em primeiro plano, tanto na comunicação social como nos meios educativos. É, sem qualquer dúvida, um sinal e um legado da nossa sociedade. Estamos dependentes deste material tanto como estamos dos combustíveis fósseis e quase tanto como estamos da eletricidade. Atualmente, com a aprovação da Diretiva Europeia, que visa reduzir drasticamente o plástico “de uso único” e que tem dois anos para ser transposta pelos Estados Membros, é provável que as pessoas se sintam inseguras quanto às alternativas, quer materiais quer comportamentais, que terão de adotar. Desde sempre na escola se trabalhou esta problemática e se fizeram atividades onde se produzem objetos, mais ou menos úteis ou artísticos, com materiais a que costumamos chamar “lixo”. No entanto, e apesar de manifesta boa vontade e intuito educativo, é frequente estas atividades abordarem o problema de forma muito superficial ou, por vezes, até errada. UUm Centro Ciência Viva tem, como principal vocação e objetivo, levar o conhecimento científico às comunidades e, de forma privilegiada, à comunidade escolar, seja aos alunos diretamente, seja aos professores. Desde há já alguns anos, o Centro Ciência Viva do Algarve (CCVAlg) tem feito um esforço muito grande para reduzir ao máximo a utilização de plásticos descartáveis. Este esforço não se ficou pela adaptação das nossas atividades e substituição de materiais. Desde há quatro anos que foram reconvertidas atividades que, de alguma forma, abordavam esta problemática e que foram criadas outras, especificamente dedicadas à sensibilização ou a técnicas simplificadas de amostragem e análise dentro deste tema. Para além de uma oferta educativa onde estas atividades estão abrangidas, o CCVAlg esteve e está envolvido atualmente em vários projetos dedicados à questão do lixo marinho ou áreas relacionadas, ou em projetos onde optamos por usar esta temática como ponto central. Seja como dinamizador, recorrendo a um enorme leque de parceiros que vai desde escolas e municípios, a entidades estatais e universidades, passando por associações e empresas, seja como parceiro de outras entidades proponentes, esta é batalha que assumimos e em que temos como objetivo transmitir conhecimento e mudar atitudes e mais do que tudo, pelo exemplo dado. Esta apresentação dará conta da forma como estamos a fazer este esforço e de como nos estamos a adaptar a uma nova e incontornável realidade. O nosso objetivo ao partilhar este testemunho é, primeiro que tudo, fomentar o diálogo e a ação entre os professores e restante comunidade educativa. Para além disso, espera-se que esta comunicação possa sensibilizar para a real premência e gravidade do problema e servir de base a outras e inovadoras iniciativas por parte dos docentes e das escolas.info:eu-repo/semantics/publishedVersio

NLP based model for individual plant dispatch in long term hydrothermal planning

This paper presents a method to the hydrothermal dispatch using optimization techniques based on non linear programming techniques. To do so, the expected cost-to-go functions from a long term operation plannning strategic decision model are used. This decision model is based on stochastic dual dynamic programming and energy equivalent reservoirs. The proposed method considers a set of historical water inflow scenarios to the hydroelectric reservoirs. Those scenarios are used to simulate the long term operation planning to a given horizon. The results obtained from this disaggregation model (MIUH) are compared with those from the model officially adopted in the Brazilian power system, SUISHI-O. The latter is based on operation heuristics aiming at operating the reservoir maintaining the water storag e in similar levels, that is, trying to operate them in parallel.Este trabalho apresenta um modelo de despacho hidrotérmico à usinas individualizadas, utilizando métodos de otimização baseados em programação não linear. Para tanto, considera-se funções de custo futuro geradas por um modelo de decisão estratégica baseado em programação dinâmica e sistemas equivalentes de energia. O modelo proposto considera diversos cenários históricos de afluências hidrológicas às usinas hidrelétricas, os quais são simulados para um horizonte de planejamento da operação de médio/longo prazo. Os resultados obtidos através do modelo proposto, denominado Modelo Individualizado de Usinas Hidráulicas (MIUH), são comparados com os resultados obtidos a partir da utilização do modelo SUISHI-O adotado pelo Operador Nacional do Sistema Elétrico Brasileiro (ONS)

Detection of anti-infliximab antibodies is impacted by antibody titer, infliximab level and IgG4 antibodies: a systematic comparison of three different assays

Background: There is scant information on the accuracy of different assays used to measure anti-infliximab antibodies (ADAs), especially in the presence of detectable infliximab (IFX). We thus aimed to evaluate and compare three different assays for the detection of IFX and ADAs and to clarify the impact of the presence of circulating IFX on the accuracy of the ADA assays.Methods: Blood samples from 79 ulcerative colitis (UC) patients treated with infliximab were assessed for IFX levels and ADAs using three different assays: an in-house assay and two commercial kits, Immundiagnostik and Theradiag. Sera samples with ADAs and undetectable levels of IFX were spiked with exogenous IFX and analyzed for ADAs.Results: The three assays showed 81-96% agreement for the measured IFX level. However, the in-house assay and Immundiagnostik assays detected ADAs in 34 out of 79 samples, whereas Theradiag only detected ADAs in 24 samples. Samples negative for ADAs with Theradiag, but ADA-positive in both the in-house and Immundiagnostik assays, were positive for IFX or IgG4 ADAs. In spiking experiments, a low concentration of exogenous IFX (5 mu g/ml) hampered ADA detection with Theradiag in sera samples with ADA levels of between 3 and 10 mu g/ml. In the Immundiagnostik assay detection interference was only observed at concentrations of exogenous IFX higher than 30 mu g/ml. However, in samples with high levels of ADAs (> 25 mu g/ml) interference was only observed at IFX concentrations higher than 100 mu g/ml in all three assays. Binary (IFX/ADA) stratification of the results showed that IFX+/ADA and IFX-/ADAs + were less influenced by the assay results than the double-positive (IFX+/ADAs+) and double-negative (IFX-/ADAs-) combination.Conclusions: All three methodologies are equally suitable for measuring IFX levels. However, erroneous therapeutic decisions may occur when patients show double-negative (IFX-/ADAs) or double-positive (IFX+/ADAs+) status, since agreement between assays is significantly lower in these circumstances

SARS-CoV-2 introductions and early dynamics of the epidemic in Portugal

Genomic surveillance of SARS-CoV-2 in Portugal was rapidly implemented by the National Institute of Health in the early stages of the COVID-19 epidemic, in collaboration with more than 50 laboratories distributed nationwide. Methods By applying recent phylodynamic models that allow integration of individual-based travel history, we reconstructed and characterized the spatio-temporal dynamics of SARSCoV-2 introductions and early dissemination in Portugal. Results We detected at least 277 independent SARS-CoV-2 introductions, mostly from European countries (namely the United Kingdom, Spain, France, Italy, and Switzerland), which were consistent with the countries with the highest connectivity with Portugal. Although most introductions were estimated to have occurred during early March 2020, it is likely that SARS-CoV-2 was silently circulating in Portugal throughout February, before the first cases were confirmed. Conclusions Here we conclude that the earlier implementation of measures could have minimized the number of introductions and subsequent virus expansion in Portugal. This study lays the foundation for genomic epidemiology of SARS-CoV-2 in Portugal, and highlights the need for systematic and geographically-representative genomic surveillance.We gratefully acknowledge to Sara Hill and Nuno Faria (University of Oxford) and Joshua Quick and Nick Loman (University of Birmingham) for kindly providing us with the initial sets of Artic Network primers for NGS; Rafael Mamede (MRamirez team, IMM, Lisbon) for developing and sharing a bioinformatics script for sequence curation (https://github.com/rfm-targa/BioinfUtils); Philippe Lemey (KU Leuven) for providing guidance on the implementation of the phylodynamic models; Joshua L. Cherry (National Center for Biotechnology Information, National Library of Medicine, National Institutes of Health) for providing guidance with the subsampling strategies; and all authors, originating and submitting laboratories who have contributed genome data on GISAID (https://www.gisaid.org/) on which part of this research is based. The opinions expressed in this article are those of the authors and do not reflect the view of the National Institutes of Health, the Department of Health and Human Services, or the United States government. This study is co-funded by Fundação para a Ciência e Tecnologia and Agência de Investigação Clínica e Inovação Biomédica (234_596874175) on behalf of the Research 4 COVID-19 call. Some infrastructural resources used in this study come from the GenomePT project (POCI-01-0145-FEDER-022184), supported by COMPETE 2020 - Operational Programme for Competitiveness and Internationalisation (POCI), Lisboa Portugal Regional Operational Programme (Lisboa2020), Algarve Portugal Regional Operational Programme (CRESC Algarve2020), under the PORTUGAL 2020 Partnership Agreement, through the European Regional Development Fund (ERDF), and by Fundação para a Ciência e a Tecnologia (FCT).info:eu-repo/semantics/publishedVersio

A complex scenario of tuberculosis transmission is revealed through genetic and epidemiological surveys in Porto

Tuberculosis (TB) incidence is decreasing worldwide and eradication is becoming plausible. In low-incidence countries, intervention on migrant populations is considered one of the most important strategies for elimination. However, such measures are inappropriate in European areas where TB is largely endemic, such as Porto in Portugal. We aim to understand transmission chains in Porto through a genetic characterization of Mycobacterium tuberculosis strains and through a detailed epidemiological evaluation of cases.This work was developed under the scope of the project NORTE-01-0145-FEDER-000013, supported by the Northern Portugal Regional Operational Programme (NORTE 2020), under the Portugal 2020 Partnership Agreement, through the European Regional Development Fund (FEDER), and supported by contributions from Iceland, Liechtenstein and Norway through the European Economic Area Grants under the Public Health Initiative programme, (PT06, Project 000138DT1). TR is supported by the Portuguese Foundation for Science and Technology (FCT) through a post-doctoral grant (SFRH/BPD/108126/2015)info:eu-repo/semantics/publishedVersio

2 nd Brazilian Consensus on Chagas Disease, 2015

Abstract Chagas disease is a neglected chronic condition with a high burden of morbidity and mortality. It has considerable psychological, social, and economic impacts. The disease represents a significant public health issue in Brazil, with different regional patterns. This document presents the evidence that resulted in the Brazilian Consensus on Chagas Disease. The objective was to review and standardize strategies for diagnosis, treatment, prevention, and control of Chagas disease in the country, based on the available scientific evidence. The consensus is based on the articulation and strategic contribution of renowned Brazilian experts with knowledge and experience on various aspects of the disease. It is the result of a close collaboration between the Brazilian Society of Tropical Medicine and the Ministry of Health. It is hoped that this document will strengthen the development of integrated actions against Chagas disease in the country, focusing on epidemiology, management, comprehensive care (including families and communities), communication, information, education, and research