AL - HAMA: Metodologia de integração das águas subterrâneas no planeamento e gestão sustentáveis de paisagens urbanas - o caso de estudo de Bairro de Alfama, Lisboa

Relatório Final / DesenhosN/

Variação sazonal e influência de fatores meteorológicos na incidência de descolamentos regmatógenos da retina na zona centro de Portugal e na Madeira

Objetivos: Analisar a variação sazonal e a influência de fatores meteorológicos na incidência a 5 anos de descolamento regmatógeno da retina (DRR), na região centro do país e região autónoma da Madeira (RAM). Métodos: Série de casos consecutiva, retrospetiva e multicêntrica. Incluíram-se doentes submetidos a cirurgia de DRR no Centro Hospitalar e Universitário de Coimbra e Hospital Doutor Nélio Mendonça entre Janeiro’10 e Dezembro’14. A seleção de casos foi feita através codificação ICD-9-CM e os critérios de inclusão foram: 1)idade ≥18 anos; 2)DRR de novo; 3)reparação cirúrgica do DRR. Consideraram-se critérios de exclusão: 1)DR tracional, exsudativo ou misto; 2)DR antigo ou re-descolamento; 3)soluções de continuidade ou lesões regmatógenas tratadas apenas com laser. Os dados meteorológicos diários das estações de Coimbra, Leiria, Aveiro, Viseu, Guarda, Castelo Branco e Funchal, foram utilizados na análise estatística. Resultados: Foram incluídos 1013 olhos (914 da região centro e 99 da RAM), com idade média 61,84±14,00 anos. Através de um modelo cronológico de regressão linear constatou-se a presença de sazonalidade com picos nos meses de Maio e Setembro. A temperatura média apresentou uma associação marginalmente significativa com a incidência de DRR num modelo biológico de regressão linear considerando os mais fortes preditores de DRR da amostra. Conclusões: Os nossos resultados demonstram que a incidência de DRR se associa a um padrão sazonal significativo que parece ser explicado pela temperatura. Este estudo alerta para a necessidade de um eficaz planeamento em saúde que deverá passar por uma gestão harmoniosa de recursos humanos em épocas de maior incidência

Complete blood count parameters as biomarkers of retinopathy of prematurity: a Portuguese multicenter study

Purpose: To evaluate complete blood count (CBC) parameters in the first week of life as predictive biomarkers for the development of retinopathy of prematurity (ROP). Methods: Multicenter, prospective, observational study of a cohort of preterm infants born with gestational age (GA) < 32 weeks or birth weight < 1500 g in eight Portuguese neonatal intensive care units. All demographic, clinical, and laboratory data from the first week of life were collected. Univariate logistic regression was used to assess risk factors for ROP and then multivariate regression was performed. Results: A total of 455 infants were included in the study. The median GA was 29.6 weeks, and the median birth weight was 1295 g. One hundred and seventy-two infants (37.8%) developed ROP. Median values of erythrocytes (p < 0.001), hemoglobin (p < 0.001), hematocrit (p < 0.001), mean corpuscular hemoglobin concentration (p < 0.001), lymphocytes (p = 0.035), and platelets (p = 0.003) of the group of infants diagnosed with ROP any stage were lower than those without ROP. Mean corpuscular volume (MCV) (p = 0.044), red blood cell distribution width (RDW) (p < 0.001), erythroblasts (p < 0.001), neutrophils (p = 0.030), neutrophils-lymphocytes ratio (p = 0.028), and basophils (p = 0.003) were higher in the ROP group. Higher values of MCV, erythroblasts, and basophils remained significantly associated with ROP after multivariate regression. Conclusion: In our cohort, the increase in erythroblasts, MCV, and basophils in the first week of life was significantly and independently associated with the development of ROP. These CBC parameters may be early predictive biomarkers for ROP.info:eu-repo/semantics/publishedVersio

The Perception of quality and the performance in primary health Care of central Alentejo – Portugal

AbstractQuality and performance are current issues and a strategic priority for the Portuguese National Health Service. Currently, there is a lack of studies in primary health care (PHC) that assess the relationship between the quality and the level of performance of the Primary Health Care Teams. In Portugal, those teams are monitored through the Global Performance Index (GPI), which demonstrates, through a score, the procedures and results obtained by electronic records and the metrics defined for each indicator. This paper aims to analyze the relationship between the perception of the quality of health professionals (service culture; leadership; service strategy; infrastructure and external resources; information and knowledge; processes; service management; human resource planning and skills development, commitment; conditions, satisfaction, performance, and recognition; and results) in the different Primary Health Care teams of the PHC of Central Alentejo—Portugal, and the level of performance of the given teams (care performance; professional training; organizational quality; and services). Self-Perception of Quality Questionnaire for Primary Health Care (SPQQ4PHC) was used as an assessment tool. The population comprises 324 health professionals (Family Doctors, Nurses, and Medical Secretaries) distributed over 34 Primary Health Care Teams. When analyzing the global correlation of the variables in the SPQQ4PHC questionnaire with the GPI, it´s possible to confirm that twenty-one out of twenty-five correlates with the GPI. Thus, this study allowed us to conclude that, as health professionals perceive the quality of the variables increases, the GPI also increases, demonstrating that the dimensions of quality and performance are closely related

A comparative study on the modelling of discontinuous fracture by means of enriched nodal and element techniques and interface elements

In this paper, three different approaches used to model strong discontinuities are studied: a new strong embedded discontinuity technique, designated as the discrete strong embedded discontinuity approach (DSDA), introduced in Dias-da-Costa et al. (Eng Fract Mech 76(9):1176–1201, 2009); the generalized finite element method, (GFEM), developed by Duarte and Oden (Tech Rep 95-05, 1995) and Belytschko and Black (Int J Numer Methods Eng 45(5):601–620, 1999); and the use of interface elements (Hillerborg et al. in Cem Concr Res 6(6): 773–781, 1976). First, it is shown that all three descriptions are based on the same variational formulation. However, the main differences between these models lie in the way the discontinuity is represented in the finite element mesh, which is explained in the paper. Main focus is on the differences between the element enrichment technique, used in the DSDA and the nodal enrichment technique adopted in the GFEM. In both cases, global enhanced degrees of freedom are adopted. Next, the numerical integration of the discretised equations in the three methods is addressed and some important differences are discussed. Two types of numerical tests are presented: first, simple academic examples are used to emphasize the differences found in the formulations and next, some benchmark tests are computed.Design and ConstructionCivil Engineering and Geoscience

Réplication du génome du virus de l’hépatite delta. un rôle pour la petite protéine delta S-HDAg [Hepatitis delta virus replication and the role of the small hepatitis delta protein S-HDAg]

Hepatitis delta virus (HDV) is a mammalian defective virus. Its genome is a small single-stranded circular RNA of approximately 1,680 nucleotides. To spread, HDV relies on hepatitis B virus envelope proteins that are needed for viral particle assembly and egress. Severe clinical features of HBV-HDV infection include acute fulminant hepatitis and chronic liver fibrosis leading to cirrhosis and hepatocellular carcinoma. One uniqueness of HDV relies on its genome similarity to viroids, small plant infectious uncoated RNAs. Devoid of viral replicase activity, HDV has to use host DNA-dependant RNA Pol II to replicate its genomic RNA. Thus, one can ask how does this replication occur? We describe first here the major steps of the viral RNA transcription and replication and then we detail the role of the Small HD protein in these processes, especially with regard to the Pol II recruitment

Hepatitis Delta Virus histone mimicry drives the recruitment of chromatin remodelers for viral RNA replication

Hepatitis Delta virus (HDV) is a satellite of Hepatitis B virus with a single-stranded circular RNA genome. HDV RNA genome synthesis is carried out in infected cells by cellular RNA polymerases with the assistance of the small hepatitis delta antigen (S-HDAg). Here we show that S-HDAg binds the bromodomain (BRD) adjacent to zinc finger domain 2B (BAZ2B) protein, a regulatory subunit of BAZ2B-associated remodeling factor (BRF)&nbsp;ISWI chromatin remodeling complexes. shRNA-mediated silencing of BAZ2B or its inactivation with the BAZ2B BRD inhibitor GSK2801 impairs HDV replication in HDV-infected human hepatocytes. S-HDAg contains a short linear interacting motif (SLiM) KacXXR, similar to the one recognized by BAZ2B BRD in histone H3. We found that the integrity of the S-HDAg SLiM sequence is required for S-HDAg interaction with BAZ2B BRD and for HDV RNA replication. Our results suggest that S-HDAg uses a histone mimicry strategy to co-activate the RNA polymerase II-dependent synthesis of HDV RNA and sustain HDV replication