Value creation wheel applied to Jerónimo Martins Distribuição de Produtos de Consumo and Whymob

This thesis focuses on the application of the Value Creation Wheel (VCW), a dynamic tool that enables companies to solve problems and create value while encouraging the participation of multiple stakeholders, both internal and external (Lages, 2016). First, literature is revisited to gain insight about the concepts being explored in this thesis. Then, it is introduced DIANA, VCW’s theoretical framework, and its main contributions to the fields of strategic management, innovation management, and value creation. Finally, are presented the findings from the application of TIAGO VCW’s practical tool at Jerónimo Martins Distribuição de Produtos de Consumo (JMD) and Whymob

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

Sarcoma ósseo secundário da Doença de Paget: Secondary bone sarcoma of Paget's disease

Resumo INTRODUÇÃO: A Doença de Paget é uma doença crônica inflamatória do osso. A degeneração sarcomatosa dessa doença é rara, chegando a 1% e o tipo histológico mais comum é o osteossarcoma. APRESENTAÇÃO DO CASO: Paciente com 66 anos, masculino, com diagnóstico de Doença de Paget há 20 anos, apresenta deformidade em fêmur direito, relata piora da dor há 5 meses. Radiografia com sinais de malignidade confirmados na RNM, na qual havia expansão das partes moles, ruptura da cortical óssea com osteólise agressiva. Histopatológico confirmando osteossarcoma. DISCUSSÃO: A Doença de Paget é um distúrbio ósseo crônico que resulta na renovação óssea acelerada e desordenada, acomete, principalmente, o esqueleto axial, o crânio, os fêmures e as tíbias. A maioria dos pacientes com Doença de Paget é assintomática, sendo o diagnóstico, muitas vezes, tardio e acidental. É a segunda doença osteometabólica mais comum, ficando atrás da osteoporose. A doença de Paget afeta cerca de 3-4% da população acima dos 40 anos de idade, sendo que sua prevalência aumenta com a idade. O osteossarcoma secundário à doença de Paget é raro, estima-se que ocorra em menos de 1% das pessoas com doença óssea de Paget. Dor, edema e fratura são manifestações iniciais. Achados radiográficos iniciais geralmente mostram uma lesão lítica em expansão no osso. O tratamento do osteossarcoma secundário à Doença de Paget é principalmente cirúrgico que pode envolver a combinação de quimioterapia. A presença de comorbidades em idosos limita o uso da quimioterapia. Quando indicada, a quimioterapia geralmente é neoadjuvante e em terapia adjuvante CONCLUSÃO: Compreende-se que a Doença de Paget acomete principalmente idosos e que o prognóstico é ruim tanto em pacientes sintomáticos como em assintomáticos, devido a inflamação óssea e risco de evolução para osteossarcoma, porém o diagnóstico precoce pode trazer benefícios aos pacientes no controle da dor e com tratamentos mais conservadores, evitando a necessidade de amputações, com melhoria na qualidade de vida

Síndrome de fraser : Fraser syndrome

Introdução: a Síndrome de Fraser é caracterizada por presença de criptoftalmo, sindactilia, anormalidades da genitália e outras malformações congênitas do nariz, ouvido ou laringe, defeitos esqueléticos, hérnia umbilical, agenesia renal e retardo mental. É uma expressão fenotípica que depende da consanguinidade dos pais. Apresentação do caso: paciente do sexo feminino, três meses de idade, em acompanhamento no centro de referência oftalmológica da Faculdade de Medicina da Universidade São Paulo. Na ultrassonografia de abdome total, foi apenas evidenciada presença de hérnia umbilical simples. Discussão: a prevalência é igual entre os sexos e a doença pode ser diagnosticada à ultrassonografia pré-natal e fetoscopia ou no momento do nascimento frente às alterações apresentadas pelo paciente, por critérios maiores e menores. O tratamento é multidisciplinar e dependente das malformações presentes, assim como o prognóstico, que é pior em casos de malformações urogenitais e laríngeas graves. Conclusão: os médicos devem estar atentos, para as manifestações clínicas e o diagnóstico preciso, oferecendo tratamento adequado e aconselhamento genético aos casais

Supplemental Material – Remote consultations in primary care across low-, middle- and high-income countries: Implications for policy and care delivery

Supplemental Material for Remote consultations in primary care across low-, middle- and high-income countries: Implications for policy and care delivery by Siân Williams, Amanda Barnard, Phil Collis, Jaime Correia de Sousa, Suraj Ghimire, Monsur Habib, Tessa Jelen, Frank Kanniess, Vince Mak, Sonia Martins, Ema Paulino, Hilary Pinnock, Miguel Roman, Hanna Sandelowsky, Ioanna Tsiligianni, Laurine van der Steen and Fabio Weber Donatelli in the Journal of Health Services Research & Policy.</p

NEOTROPICAL FRESHWATER FISHES: A dataset of occurrence and abundance of freshwater fishes in the Neotropics

The Neotropical region hosts 4225 freshwater fish species, ranking first among the world's most diverse regions for freshwater fishes. Our NEOTROPICAL FRESHWATER FISHES data set is the first to produce a large-scale Neotropical freshwater fish inventory, covering the entire Neotropical region from Mexico and the Caribbean in the north to the southern limits in Argentina, Paraguay, Chile, and Uruguay. We compiled 185,787 distribution records, with unique georeferenced coordinates, for the 4225 species, represented by occurrence and abundance data. The number of species for the most numerous orders are as follows: Characiformes (1289), Siluriformes (1384), Cichliformes (354), Cyprinodontiformes (245), and Gymnotiformes (135). The most recorded species was the characid Astyanax fasciatus (4696 records). We registered 116,802 distribution records for native species, compared to 1802 distribution records for nonnative species. The main aim of the NEOTROPICAL FRESHWATER FISHES data set was to make these occurrence and abundance data accessible for international researchers to develop ecological and macroecological studies, from local to regional scales, with focal fish species, families, or orders. We anticipate that the NEOTROPICAL FRESHWATER FISHES data set will be valuable for studies on a wide range of ecological processes, such as trophic cascades, fishery pressure, the effects of habitat loss and fragmentation, and the impacts of species invasion and climate change. There are no copyright restrictions on the data, and please cite this data paper when using the data in publications

Neotropical freshwater fisheries : A dataset of occurrence and abundance of freshwater fishes in the Neotropics

The Neotropical region hosts 4225 freshwater fish species, ranking first among the world's most diverse regions for freshwater fishes. Our NEOTROPICAL FRESHWATER FISHES data set is the first to produce a large-scale Neotropical freshwater fish inventory, covering the entire Neotropical region from Mexico and the Caribbean in the north to the southern limits in Argentina, Paraguay, Chile, and Uruguay. We compiled 185,787 distribution records, with unique georeferenced coordinates, for the 4225 species, represented by occurrence and abundance data. The number of species for the most numerous orders are as follows: Characiformes (1289), Siluriformes (1384), Cichliformes (354), Cyprinodontiformes (245), and Gymnotiformes (135). The most recorded species was the characid Astyanax fasciatus (4696 records). We registered 116,802 distribution records for native species, compared to 1802 distribution records for nonnative species. The main aim of the NEOTROPICAL FRESHWATER FISHES data set was to make these occurrence and abundance data accessible for international researchers to develop ecological and macroecological studies, from local to regional scales, with focal fish species, families, or orders. We anticipate that the NEOTROPICAL FRESHWATER FISHES data set will be valuable for studies on a wide range of ecological processes, such as trophic cascades, fishery pressure, the effects of habitat loss and fragmentation, and the impacts of species invasion and climate change. There are no copyright restrictions on the data, and please cite this data paper when using the data in publications

NEOTROPICAL FRESHWATER FISHES: A dataset of occurrence and abundance of freshwater fishes in the Neotropics

The Neotropical region hosts 4225 freshwater fish species, ranking first among the world's most diverse regions for freshwater fishes. Our NEOTROPICAL FRESHWATER FISHES data set is the first to produce a large-scale Neotropical freshwater fish inventory, covering the entire Neotropical region from Mexico and the Caribbean in the north to the southern limits in Argentina, Paraguay, Chile, and Uruguay. We compiled 185,787 distribution records, with unique georeferenced coordinates, for the 4225 species, represented by occurrence and abundance data. The number of species for the most numerous orders are as follows: Characiformes (1289), Siluriformes (1384), Cichliformes (354), Cyprinodontiformes (245), and Gymnotiformes (135). The most recorded species was the characid Astyanax fasciatus (4696 records). We registered 116,802 distribution records for native species, compared to 1802 distribution records for nonnative species. The main aim of the NEOTROPICAL FRESHWATER FISHES data set was to make these occurrence and abundance data accessible for international researchers to develop ecological and macroecological studies, from local to regional scales, with focal fish species, families, or orders. We anticipate that the NEOTROPICAL FRESHWATER FISHES data set will be valuable for studies on a wide range of ecological processes, such as trophic cascades, fishery pressure, the effects of habitat loss and fragmentation, and the impacts of species invasion and climate change. There are no copyright restrictions on the data, and please cite this data paper when using the data in publications

NEOTROPICAL FRESHWATER FISHES: A dataset of occurrence and abundance of freshwater fishes in the Neotropics

The Neotropical region hosts 4225 freshwater fish species, ranking first among the world's most diverse regions for freshwater fishes. Our NEOTROPICAL FRESHWATER FISHES data set is the first to produce a large-scale Neotropical freshwater fish inventory, covering the entire Neotropical region from Mexico and the Caribbean in the north to the southern limits in Argentina, Paraguay, Chile, and Uruguay. We compiled 185,787 distribution records, with unique georeferenced coordinates, for the 4225 species, represented by occurrence and abundance data. The number of species for the most numerous orders are as follows: Characiformes (1289), Siluriformes (1384), Cichliformes (354), Cyprinodontiformes (245), and Gymnotiformes (135). The most recorded species was the characid Astyanax fasciatus (4696 records). We registered 116,802 distribution records for native species, compared to 1802 distribution records for nonnative species. The main aim of the NEOTROPICAL FRESHWATER FISHES data set was to make these occurrence and abundance data accessible for international researchers to develop ecological and macroecological studies, from local to regional scales, with focal fish species, families, or orders. We anticipate that the NEOTROPICAL FRESHWATER FISHES data set will be valuable for studies on a wide range of ecological processes, such as trophic cascades, fishery pressure, the effects of habitat loss and fragmentation, and the impacts of species invasion and climate change. There are no copyright restrictions on the data, and please cite this data paper when using the data in publications