The Potential of Big Data Research in HealthCare for Medical Doctors’ Learning

The main goal of this article is to identify the main dimensions of a model proposal for increasing the potential of big data research in Healthcare for medical doctors’ (MDs’) learning, which appears as a major issue in continuous medical education and learning. The paper employs a systematic literature review of main scientific databases (PubMed and Google Scholar), using the VOSviewer software tool, which enables the visualization of scientific landscapes. The analysis includes a co-authorship data analysis as well as the co-occurrence of terms and keywords. The results lead to the construction of the learning model proposed, which includes four health big data key areas for MDs’ learning: 1) data transformation is related to the learning that occurs through medical systems; 2) health intelligence includes the learning regarding health innovation based on predictions and forecasting processes; 3) data leveraging regards the learning about patient information; and 4) the learning process is related to clinical decision-making, focused on disease diagnosis and methods to improve treatments. Practical models gathered from the scientific databases can boost the learning process and revolutionise the medical industry, as they store the most recent knowledge and innovative research

Design of bespoke lightweight cement mortars containing waste expanded polystyrene by experimental statistical methods

This work assesses the reuse of waste expanded polystyrene (EPS) to obtain lightweight cement mortars. The factors and interactions which affect the properties of these mortars were studied by ad-hoc designs based on the d-optimal criterion. This method allows multiple factors to be modified simultaneously, which reduces the number of experiments compared with classical design. Four factors were studied at several levels: EPS type (two levels), EPS content (two levels), admixtures mix (three levels) and cement type (three levels). Two types of aggregate were also studied. The workability, air content, compressive strength, adhesive strength, bulk density and capillary absorption were experimentally tested. The effect of factors and interactions on the properties was modelled and analysed. The results demonstrate how the factors and synergistic interactions can be manipulated to manufacture lightweight mortars which satisfy the relevant EU standards. These mortars contain up to 60% of waste EPS, low amounts of admixtures and low clinker content CEM III. Sustainable mortars containing silica sand gave flow table spread values between 168 and 180 ± 4 mm, bulk density between 1280 and 1110 ± 100 kg/m3, and C90 between 0.279 and 0.025 ± 0.07 kg/m2·min0.5, making them suitable for masonry, plastering and rendering applications.Spanish Ministry of Science and Innovation and European Union (FEDER) for project funding (BIA 2007-61170

Quantitative GC–TCD Measurements of Major Flatus Components: A Preliminary Analysis of the Diet Effect

The impact of diet and digestive disorders in flatus composition remains largely unexplored. This is partially due to the lack of standardized sampling collection methods, and the easy atmospheric contamination. This paper describes a method to quantitatively determine the major gases in flatus and their application in a nutritional intervention. We describe how to direct sample flatus into Tedlar bags, and simultaneous analysis by gas chromatography–thermal conductivity detection (GC–TCD). Results are analyzed by univariate hypothesis testing and by multilevel principal component analysis. The reported methodology allows simultaneous determination of the five major gases with root mean measurement errors of 0.8% for oxygen (O2), 0.9% for nitrogen (N2), 0.14% for carbon dioxide (CO2), 0.11% for methane (CH4), and 0.26% for hydrogen (H2). The atmospheric contamination was limited to 0.86 (95% CI: [0.7–1.0])% for oxygen and 3.4 (95% CI: [1.4–5.3])% for nitrogen. As an illustration, the method has been successfully applied to measure the response to a nutritional intervention in a reduced crossover study in healthy subjects. © 2022 by the authors. Licensee MDPI, Basel, Switzerland

A genealogical critique of Beauchamp and Childress' for principles approach to medical ethics

<bold>Part Three</bold> examines the development of Beauchamp and Childress 'four principles' approach to medical ethics from the 1<super> st</super> to the 6<super>th</super> Editions of <italic>Principles of Biomedical Ethics,</italic> arguing that it has, thanks to changes in the authors' conception of philosophical moral theory, been able to productively incorporate the views of many of its critics over this time; that it is also able to incorporate features of different ethical approaches such as virtue ethics, narrative ethics and ethics of care; and that, properly understood, it continues to provide a good framework both for moral reflection in medicine and the provision of concrete action-guides. The thesis concludes by considering this view of the four principles in the light of the earlier sections' approach, and attempting to demonstrate further demonstrate their value through two case-studies.EThOS - Electronic Theses Online ServiceGBUnited Kingdo

Mitochondrionopathy Phenotype in Doxorubicin-Treated Wistar Rats Depends on Treatment Protocol and Is Cardiac-Specific

Although doxorubicin (DOX) is a very effective antineoplastic agent, its clinical use is limited by a dose-dependent, persistent and cumulative cardiotoxicity, whose mechanism remains to be elucidated. Previous works in animal models have failed to use a multi-organ approach to demonstrate that DOX-associated toxicity is selective to the cardiac tissue. In this context, the present work aims to investigate in vivo DOX cardiac, hepatic and renal toxicity in the same animal model, with special relevance on alterations of mitochondrial bioenergetics. To this end, male Wistar rats were sub-chronically (7 wks, 2 mg/Kg) or acutely (20 mg/Kg) treated with DOX and sacrificed one week or 24 hours after the last injection, respectively. Alterations of mitochondrial bioenergetics showed treatment-dependent differences between tissues. No alterations were observed for cardiac mitochondria in the acute model but decreased ADP-stimulated respiration was detected in the sub-chronic treatment. In the acute treatment model, ADP-stimulated respiration was increased in liver and decreased in kidney mitochondria. Aconitase activity, a marker of oxidative stress, was decreased in renal mitochondria in the acute and in heart in the sub-chronic model. Interestingly, alterations of cardiac mitochondrial bioenergetics co-existed with an absence of echocardiograph, histopathological or ultra-structural alterations. Besides, no plasma markers of cardiac injury were found in any of the time points studied. The results confirm that alterations of mitochondrial function, which are more evident in the heart, are an early marker of DOX-induced toxicity, existing even in the absence of cardiac functional alterations

Desenvolvimento de Um Sistema Web Para Gestão de Simulações Dosimétricas Para Radiodiagnóstico / Development of a Web System to Manage Dosimetric Simulations for Radiodiagnosis

Este trabalho descreve a implementação de uma plataforma Web de forma automatizada para a criação, gestão, acompanhamento e análise de simulações dosimetricas para Radiodiagnóstico. Utilizando o codigo GATE/Geant4 baseado em Monte Carlo o sistema realiza simulações computacionais de exames médicos envolvendo raios-X. A estrutura da plataforma permeteu uma redução do tempo de geração e processamento das simulações. O sistema proporsiona no final as dosis aos quais os pacientes são submetidos em radiodiagnóstico, magnitude necesaria para a evaluação do risco de câncer radioinduzido com exames que utilizam raios-X

The alpha-galactosidase A p.Arg118Cys variant does not cause a Fabry disease phenotype: data from individual patients and family studies

Acessível em: www.ncbi.nlm.nih.gov/pmc/articles/PMC4423738/Lysosomal α-galactosidase A (α-Gal) is the enzyme deficient in Fabry disease (FD), an X-linked glycosphingolipidosis caused by pathogenic mutations affecting the GLA gene. The early-onset, multi-systemic FD classical phenotype is associated with absent or severe enzyme deficiency, as measured by in vitro assays, but patients with higher levels of residual α-Gal activity may have later-onset, more organ-restricted clinical presentations. A change in the codon 118 of the wild-type α-Gal sequence, replacing basic arginine by a potentially sulfhydryl-binding cysteine residue - GLA p.(Arg118Cys) -, has been recurrently described in large FD screening studies of high-risk patients. Although the Cys118 allele is associated with high residual α-Gal activity in vitro, it has been classified as a pathogenic mutation, mainly on the basis of theoretical arguments about the chemistry of the cysteine residue. However its pathogenicity has never been convincingly demonstrated by pathology criteria. We reviewed the clinical, biochemical and histopathology data obtained from 22 individuals of Portuguese and Spanish ancestry carrying the Cys118 allele, including 3 homozygous females. Cases were identified either on the differential diagnosis of possible FD manifestations and on case-finding studies (n=11; 4 males), or on unbiased cascade screening of probands' close relatives (n=11; 3 males). Overall, those data strongly suggest that the GLA p.(Arg118Cys) variant does not segregate with FD clinical phenotypes in a Mendelian fashion, but might be a modulator of the multifactorial risk of cerebrovascular disease. The Cys118 allelic frequency in healthy Portuguese adults (n=696) has been estimated as 0.001, therefore not qualifying for "rare" condition

Cilengitide down-modulates invasiveness and vasculogenic mimicry of neuropilin-1 expressing melanoma cells through the inhibition of αvβ5 integrin.

During melanoma progression, tumour cells show increased adhesiveness to the vascular wall, invade the extracellular matrix (ECM) and frequently form functional channels similar to vascular vessels (vasculogenic mimicry). These properties are mainly mediated by the interaction of integrins with ECM components. Since we had previously identified neuropilin 1 (NRP-1), a coreceptor of vascular endothelial growth factor A (VEGF-A), as an important determinant of melanoma aggressiveness, aims of this study were to identify the specific integrins involved in the highly invasive phenotype of NRP-1 expressing cells and to investigate their role as targets to counteract melanoma progression. Melanoma aggressiveness was evaluated in vitro as cell ability to migrate through an ECM layer and to form tubule-like structures using transfected cells. Integrins relevant to these processes were identified using specific blocking antibodies. The αvβ5 integrin was found to be responsible for about 80% of the capability of NRP-1 expressing cells to adhere on vitronectin. In these cells αvβ5 expression level was twice higher than in low-invasive control cells and contributed to the ability of melanoma cells to form tubule-like structures on matrigel. Cilengitide, a potent inhibitor of αν integrins activation, reduced ECM invasion, vasculogenic mimicry and secretion of VEGF-A and metalloproteinase 9 by melanoma cells. In conclusion, we demonstrated that ανβ5 integrin is involved in the highly aggressive phenotype of melanoma cells expressing NRP-1. Moreover, we identified a novel mechanism that contributes to the antimelanoma activity of the αv integrin inhibitor cilengitide based on the inhibition of vasculogenic mimicry