Advances using hydroxyapatite as a biomaterial in bone regeneration

Objectivo: A presente monografia tem como objectivo a análise e discussão de novas estratégias de preenchimento ósseo, utilizando como matriz-base a hidroxiapatite, que promovam um comportamento bioactivo e consequentemente a regeneração. Também englobará a comparação destas novas abordagens com abordagens mais convencionais. Pretende-se dar resposta a várias questões, tais como: quais os mediadores que promovem/participam na regeneração óssea, de que forma estes mediadores permitem a regeneração óssea, bem como as possíveis vantagens do uso de modelos tridimensionais com a forma exacta do defeito que se pretende reconstruir. Metodologia: Foi efectuada uma pesquisa bibliográfica do estado da arte, analisando estudos publicados nos últimos 5 anos de investigação de produtos em fase clínica de desenvolvimento e de novas metodologias ainda em fase pré-clinica (estudos in-vitro e in-vivo). A componente prática deste trabalho irá consistir na análise de materiais de preenchimento ósseo comerciais (ex: Cerabone®, Bio-Oss® and NuOss®), por Microscopia Electrónica de Varrimento, Difracção de Raios X, Espectroscopia de Energia Dispersiva e Área superficial especifica. Resultados: A caracterização dos biomateriais compostos por matriz óssea bovina inorgânica revelou que estas se trataram de matrizes ósseas com excesso de cálcio. As diferenças da razão molar Ca/P não foram significativas. As amostras revelaram diferenças quanto ao aspecto cristalino da superfície, uma vez que o Cerabone® apresentava aspecto cristalino relativamente aos restantes substitutos ósseos. Foi estabelecida uma relação entre o grau de cristalinidade com a temperatura de processamento. Relativamente a incorporação de biomoléculas em scaffolds de HA os resultados globais mostram que levam a melhor bioactividade e diferenciação osteogénica, melhorando a proliferação e diferenciação celular, estimulam a formação óssea mais rápida, com baixa taxa de reabsorção. Este último fato tem uma importância crucial, pois a reabsorção lenta mantém o volume levando a uma boa dimensão do novo osso. Conclusão: A incorporação de biomoléculas em matrizes ósseas osteocondutoras melhora o processo de osteogénese.Objective: This thesis aims at analyzing and discussing new strategies for bone filling, using hydroxyapatite as a template, which is able to promote a bioactive behavior and consequently regeneration. The new approaches using hydroxyapatite will be compared with the more conventional strategies. This thesis intends also to answer several questions such as: what are the mediators that promote/participate in bone regeneration, how these mediators allow bone regeneration, as well as the possible advantages of using three-dimensional models with the exact shape of the defect that needs to be filled. Methodology: A bibliographic search of the state of the art was performed, examining studies published in the last 5 years of research, products in clinical phase of development and new methodologies still in pre-clinical phase (in vitro and in vivo studies). The practical component of this thesis will consist in the analysis of commercial bone filling hydroxyapatite material (eg, Bio-Oss ®) by Scanning Electron Microscopy (SEM), Energy Dispersive Spectroscopy (EDS), X-Ray Diffraction (XRD) and Specific surface area. Results: The characterization of biomaterials composed of bovine bone inorganic matrix revealed that those are bony matrix with excess of calcium. The differences in the molar ratio Ca / P were not significant. The samples showed differences in the crystalline surface appearance, since Cerabone® presented a crystalline appearance comparatively to the remaining bone substitutes. A relationship between the degree of crystallinity and the processing temperature has been established. The overall results showed that the incorporation of biomolecules in HA scaffolds lead to better bioactivity and osteogenic differentiation by improving cell proliferation and differentiation which stimulates faster bone formation with low rate resorption. This last fact has a crucial importance because the slow resorption keeps the volume leading to a good dimension of the new bone. Conclusion: The incorporation of biomolecules in bone osteoconductive matrix improves the process of osteogenesi

Proteolytic systems and AMP-activated protein kinase are critical targets of acute myeloid leukemia therapeutic approaches

The therapeutic strategies against acute myeloid leukemia (AML) have hardly been modified over four decades. Although resulting in a favorable outcome in young patients, older individuals, the most affected population, do not respond adequately to therapy. Intriguingly, the mechanisms responsible for AML cells chemoresistance/ susceptibility are still elusive. Mounting evidence has shed light on the relevance of proteolytic systems (autophagy and ubiquitin-proteasome system, UPS), as well as the AMPK pathway, in AML biology and treatment, but their exact role is still controversial. Herein, two AML cell lines (HL-60 and KG-1) were exposed to conventional chemotherapeutic agents (cytarabine and/or doxorubicin) to assess the relevance of autophagy and UPS on AML cells’ response to antileukemia drugs. Our results clearly showed that the antileukemia agents target both proteolytic systems and the AMPK pathway. Doxorubicin enhanced UPS activity while drugs’ combination blocked autophagy specifically on HL-60 cells. In contrast, KG-1 cells responded in a more subtle manner to the drugs tested consistent with the higher UPS activity of these cells. In addition, the data demonstrates that autophagy may play a protective role depending on AML subtype. Specific modulators of autophagy and UPS are, therefore, promising targets for combining with standard therapeutic interventions in some AML subtypes.We would like to acknowledge Dr. Agostinho Carvalho and Dr. Manuel Guerreiro (Hospital da Arrabida, Vila Nova de Gaia, Portugal) for the critical review and discussion of the manuscript and for the work support. This work was supported by FCT - Fundacao para a Ciencia e Tecnologia (PTDC/BIA-MIC/114116/2009). A.F., O.P. and B.S.M. have fellowships from FCT (SFRH/BD/51991/2012, SFRH/BD/52292/2013, and SFRH/BPD/90533/2012, respectively). M.M.A. was supported by CCDR-N (QREN) in the scope of the project "Integration of cutting-edge health science research and ground-breaking technologies for the development of new clinically useful therapies, tissue regeneration strategies, advanced prophylactic measures and diagnosis methods - (N-01-01-01-24-01-07) - RL5" (UMINHO/BI/245/2013)

Comparative analysis of impacted upper canines : panoramic radiograph vs cone beam computed tomography

Background: The use of CBCT exam in the study of IMC is not new. However, it?s still not known in what specific aspects CBCT exam shows a better result than then conventional exams. The aim of this study was to compare and conclude in what way the opinion regarding upper canine impaction differed when observing a panoramic image compared to the observation of a set of CBCT reconstructions. Materials and Methods: Twenty patients (10 males and 10 females) with a total of 28 impacted maxillary canines were identified from the database of the Department of Dentistry, Faculty of Medicine, University of Coimbra. For each canine, two different images were available: a panoramic image and a set of CBCT reconstructions. After a random distribution of both groups images, nine orthodontists completed a questionnaire where they were asked to evaluate ten different questions regarding canine impaction. Statistic analysis was performed using Cronbach?s alpha statistics, Kappa statistics and McNemar test, considering p<0,05 statistically significant. Results: This study showed differences between the two images regarding tooth position. A statistical significant poor agreement was found between the two methods for the mesio-distal position of the apex (k=0,388, p<0,001) and for the labio-palatal tip cusp position (k=0,035, p=0,114). The adjacent root resorption showed a poor and very poor agreement between the two methods. Every other items were scored with an agreement between modalities ranging from moderate to strong. Conclusions: The analyses of panoramic images versus CBCT images reconstructions provided different information regarding tooth position (especially concerning the mesio-distal apex position and the labio-palatal cusp position) but also in the assessment of root resorption. Further investigation should be done to determine in what cases CBCT exam has a clear advantage over conventional 2D exams, justifying its us

Patient-physician discordance in assessment of adherence to inhaled controller medication: a cross-sectional analysis of two cohorts

We aimed to compare patient's and physician's ratings of inhaled medication adherence and to identify predictors of patient-physician discordance.(SFRH/BPD/115169/2016) funded by Fundação para a Ciência e Tecnologia (FCT); ERDF (European Regional Development Fund) through the operations: POCI-01-0145-FEDER-029130 ('mINSPIRERS—mHealth to measure and improve adherence to medication in chronic obstructive respiratory diseases—generalisation and evaluation of gamification, peer support and advanced image processing technologies') cofunded by the COMPETE2020 (Programa Operacional Competitividade e Internacionalização), Portugal 2020 and by Portuguese Funds through FCT (Fundação para a Ciência e a Tecnologia).info:eu-repo/semantics/publishedVersio

Innovation for resilience

Last decade is characterized by different types of crises and shocs in the socioeconomic systems, creating a turbulent context and calling for a better understanding of what the dynamic perspective of change is. For countries, regions and cities a better understanding of governance urges and calls for action

Measuring adherence to inhaled control medication in patients with asthma: Comparison among an asthma app, patient self‐report and physician assessment

Background Previous studies have demonstrated the feasibility of using an asthma app to support medication management and adherence but failed to compare with other measures currently used in clinical practice. However, in a clinical setting, any additional adherence measurement must be evaluated in the context of both the patient and physician perspectives so that it can also help improve the process of shared decision making. Thus, we aimed to compare different measures of adherence to asthma control inhalers in clinical practice, namely through an app, patient self-report and physician assessment. Methods This study is a secondary analysis of three prospective multicentre observational studies with patients (≥13 years old) with persistent asthma recruited from 61 primary and secondary care centres in Portugal. Patients were invited to use the InspirerMundi app and register their inhaled medication. Adherence was measured by the app as the number of doses taken divided by the number of doses scheduled each day and two time points were considered for analysis: 1-week and 1-month. At baseline, patients and physicians independently assessed adherence to asthma control inhalers during the previous week using a Visual Analogue Scale (VAS 0–100). Results A total of 193 patients (72% female; median [P25–P75] age 28 [19–41] years old) were included in the analysis. Adherence measured by the app was lower (1 week: 31 [0–71]%; 1 month: 18 [0–48]%) than patient self-report (80 [60–95]) and physician assessment (82 [51–94]) (p 0.05). There was a moderate correlation between patient self-report and physician assessment (ρ = 0.596, p < 0.001). Conclusions Adherence measured by the app was lower than that reported by the patient or the physician. This was expected as objective measurements are commonly lower than subjective evaluations, which tend to overestimate adherence. Nevertheless, the low adherence measured by the app may also be influenced by the use of the app itself and this needs to be considered in future studies.info:eu-repo/semantics/publishedVersio

Escolas transformadoras. Guia de integração da Educação para o Desenvolvimento e para a Cidadania Global na ESE-IPVC: 2019-2020

A Escola Superior de Educação do Instituto Politécnico de Viana do Castelo, no âmbito do projeto "Escolas Transformadoras”, intensificou a sua ação de integração da Educação para o Desenvolvimento e para a Cidadania Global (ED/ECG) na sua oferta educativa, nomeadamente em diversas Unidades Curriculares. A publicação apresenta exemplos desta integração, partilhando experiências, atividades e recursos resultantes das mesmas.Co-financiado por: Camões - Instituto da Cooperação e da LínguaC917-B3FD-1A62 | Maria Luísa Vieira das Nevesinfo:eu-repo/semantics/publishedVersio

Alfabetização Baseada na Ciência: Manual do Curso ABC

info:eu-repo/semantics/publishedVersio

Alfabetização baseada na ciência: manual do curso ABC

O presente manual faz parte do projeto ABC – Alfabetização Baseada na Ciência, fruto de um Acordo de Cooperação Internacional celebrado entre a Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES), a Faculdade de Psicologia e de Ciências da Educação da Universidade do Porto (FPCEUP), o Instituto Politécnico do Porto (IPP) e a Universidade Aberta de Portugal (UAb). Essa importante parceria tem o objetivo de contribuir para a formação continuada dos profissionais da educação brasileiros que atuam na área de alfabetização, somando-se aos vários esforços que têm sido envidados pelo Ministério da Educação (MEC) para elevar a qualidade dos processos de alfabetização no Brasil e, consequentemente, os seus resultados. A formação de professores tem sido um dos pilares da Política Nacional de Alfabetização (PNA), instituída pelo MEC por meio do Decreto 9.765/19, a qual destaca entre seus princípios a fundamentação de programas e ações em evidências provenientes das ciências cognitivas, bem como a adoção de referenciais de políticas públicas exitosas, nacionais e estrangeiras, baseadas em evidências científicas.info:eu-repo/semantics/publishedVersio

Identification of clusters of asthma control: A preliminary analysis of the inspirers studies

This work was funded by ERDF (European Regional Development Fund) through the operations: POCI- -01-0145-FEDER-029130 (“mINSPIRERS—mHealth to measure and improve adherence to medication in chronic obstructive respiratory diseases - generalisation and evaluation of gamification, peer support and advanced image processing technologies”) co-funded by the COMPETE2020 (Programa Operacional Competitividade e Internacionalização), Portugal 2020 and by Portuguese Funds through FCT (Fundação para a Ciência e a Tecnologia).© 2020, Sociedade Portuguesa de Alergologia e Imunologia Clinica. All rights reserved. Aims: To identify distinct asthma control clusters based on Control of Allergic Rhinitis and Asthma Test (CARAT) and to compare patients’ characteristics among these clusters. Methods: Adults and adolescents (≥13 years) with persistent asthma were recruited at 29 Portuguese hospital outpatient clinics, in the context of two observational studies of the INSPIRERS project. Demographic and clinical characteristics, adherence to inhaled medication, beliefs about inhaled medication, anxiety and depression, quality of life, and asthma control (CARAT, >24 good control) were collected. Hierarchical cluster analysis was performed using CARAT total score (CARAT-T). Results: 410 patients (68% adults), with a median (percentile 25–percentile 75) age of 28 (16-46) years, were analysed. Three clusters were identified [mean CARAT-T (min-max)]: cluster 1 [27(24-30)], cluster 2 [19(14-23)] and cluster 3 [10(2-13)]. Patients in cluster 1 (34%) were characterised by better asthma control, better quality of life, higher inhaler adherence and use of a single inhaler. Patients in clusters 2 (50%) and 3 (16%) had uncontrolled asthma, lower inhaler adherence, more symptoms of anxiety and depression and more than half had at least one exacerbation in the previous year. Further-more, patients in cluster 3 were predominantly female, had more unscheduled medical visits and more anxiety symp-toms, perceived a higher necessity of their prescribed inhalers but also higher levels of concern about taking these inhalers. There were no differences in age, body mass index, lung function, smoking status, hospital admissions or specialist physician follow-up time among the three clusters. Conclusion: An unsupervised method based on CARAT--T, identified 3 clusters of patients with distinct, clinically meaningful characteristics. The cluster with better asthma control had a cut-off similar to the established in the validation study of CARAT and an additional cut-off seems to distinguish more severe disease. Further research is necessary to validate the asthma control clusters identified.publishersversionpublishe