As Termas da villa romana da Tourega (Évora, Portugal)

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Editorial: Glial plasticity in depression

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Deteção de linguagem tendenciosa em decisões judiciais

The linguistic expression of subjectivity is a complex phenomenon that has been the object of reflection by several sub-areas of Linguistics and, more recently, of Computational Linguistics. Linguistic subjectivity, in terms of the linguistic expression of the speaker's opinions and attitudes, affects all levels of discourse organization and is present, to different degrees, in diverse textual genres. Subjectivity and bias are connected, in the sense that the presence of bias in discourse has been related, both in Linguistics and Computational Linguistics, to the occurrence of signs of subjectivity. Court decisions are an argumentative text genre that may convey traces of subjectivity but should not be biased. As a discourse that represents the State's position on social matters, it should reflect the principle of Equality. Nonetheless, a preliminary analysis of cases of gender violence reveals that this is not always the case. The research proposed in this paper aims to study the linguistic formulations that convey subjectivity and bias in court decisions on gender violence against women. The goal is to develop a linguistic model to detect these instances of bias, with a future possibility of application in a tool for automatic detection of gender bias in discourse, fueled by Artificial Intelligence (AI) and Natural Language Processing (NLP) techniques. A corpus of court decisions on gender violence has been extracted from the public access database of Instituto de Gestão Financeira e Equipamentos da Justiça (IGFEJ), and has been subject to analysis. A set of examples has been compiled in the analytical section of this study, demonstrating the possibility of connecting certain linguistic features, such as mitigation and intensification mechanisms, evidential expressions and counter-argumentative movements, to the presence of subjectivity and bias in discourse

Phenotypic Effects of Wild-Type and Mutant SOD1 Expression in N9 Murine Microglia at Steady State, Inflammatory and Immunomodulatory Conditions

Accumulation of mutated superoxide dismutase 1 (mSOD1) in amyotrophic lateral sclerosis (ALS) involves injury to motor neurons (MNs), activation of glial cells and immune unbalance. However, neuroinflammation, besides its detrimental effects, also plays beneficial roles in ALS pathophysiology. Therefore, the targeting of microglia to modulate the release of inflammatory neurotoxic mediators and their exosomal dissemination, while strengthening cell neuroprotective properties, has gained growing interest. We used the N9 microglia cell line to identify phenotype diversity upon the overexpression of wild-type (WT; hSOD1WT) and mutated G93A (hSOD1G93A) protein. To investigate how each transduced cell respond to an inflammatory stimulus, N9 microglia were treated with lipopolysaccharide (LPS). Glycoursodeoxycholic acid (GUDCA) and dipeptidyl vinyl sulfone (VS), known to exert neuroprotective properties, were tested for their immunoregulatory properties. Reduced Fizz1, IL-10 and TLR4 mRNAs were observed in both transduced cells. However, in contrast with hSOD1WT-induced decreased of inflammatory markers, microglia transduced with hSOD1G93A showed upregulation of pro-inflammatory (TNF-α/IL-1β/HMGB1/S100B/iNOS) and membrane receptors (MFG-E8/RAGE). Importantly, their derived exosomes were enriched in HMGB1 and SOD1. When inflammatory-associated miRNAs were evaluated, increased miR-146a in cells with overexpressed hSOD1WT was not recapitulated in their exosomes, whereas hSOD1G93A triggered elevated exosomal miR-155/miR-146a, but no changes in cells. LPS stimulus increased M1/M2 associated markers in the naïve microglia, including MFG-E8, miR-155 and miR-146a, whose expression was decreased in both hSOD1WT and hSOD1G93A cells treated with LPS. Treatment with GUDCA or VS led to a decrease of TNF-α, IL-1β, HMGB1, S100B and miR-155 in hSOD1G93A microglia. Only GUDCA was able to increase cellular IL-10, RAGE and TLR4, together with miR-21, while decreased exosomal miR-155 cargo. Conversely, VS reduced MMP-2/MMP-9 activation, as well as upregulated MFG-E8 and miR-146a, while producing miR-21 shuttling into exosomes. The current study supports the powerful role of overexpressed hSOD1WT in attenuating M1/M2 activation, and that of hSOD1G93A in switching microglia from the steady state into a reactive phenotype with low responsiveness to stimuli. This work further reveals GUDCA and VS as promising modulators of microglia immune response by eliciting common and compound-specific molecular mechanisms that may promote neuroregeneration

Impact of COVID-19 lockdown measures on a cohort of eating disorders patients

BackgroundLockdown implemented to prevent the COVID-19 spread resulted in marked changes in the lifestyle. The objective of the current study was to assess the impact of lockdown measures on a cohort of eating disorder (ED) patients being followed as part of an ongoing naturalistic treatment study.MethodsNinety-nine patients aged 18 or older, currently or previously, in treatment at a Portuguese specialized hospital unit were contacted by phone and invited to participate in the current survey. Fifty-nine agreed to be interviewed by phone, and 43 agreed to respond to a set of self-report measures of ED symptoms, emotion regulation difficulties, clinical impairment, negative urgency, and COVID-19 impact, during the week after the end of the lockdown period.ResultsData showed that of the 26 patients currently in treatment: 8 remained unchanged (31%), 7 deteriorated (27%), and 11 reliably improved (42%). Of the 17 participants not currently in treatment: 3 deteriorated (18%), 9 remained unchanged (53%), and 5 (29%) improved after the lockdown period. The Coronavirus Impact Scale showed that most patients considered their routines moderately or extremely impacted, experienced stress related to coronavirus, and showed difficulty in maintaining physical exercise and feeding routines. Results suggest that higher impact of COVID-19 lockdown was significantly correlated with eating disorder symptoms and associated psychopathology, impulsivity, difficulties in emotion regulation and clinical impairment measured at post-lockdown. In addition, the impact of COVID-19 and lockdown measures on clinical impairment was mediated by difficulties in emotion regulation.ConclusionsFindings suggest that some ED patients may experience worsening of their condition, especially if associated with difficulties in emotion regulation, and these difficulties might be exacerbated in the context of a stressful crisis and lockdown measures, highlighting the need for intervention strategies to mitigate its negative impact.This work was conducted at the Psychology Research Centre (PSI/01662), School of Psychology, University of Minho, and partially supported by the Portuguese Foundation for Science and Technology and the Portuguese Ministry of Science, Technology and Higher Education (UID/PSI/01662/2019), through the national funds (PIDDAC); and a grant by the Portuguese Foundation for Science and Technology and the Portuguese Ministry of Science, Technology and Higher Education through national funds and cofinanced by FEDER through COMPETE2020 under the PT2020 Partnership Agreement (POCI-01-0145-FEDER-028145) to P. Machado PI)

Multimorbidity profile of COVID-19 deaths in Portugal during 2020

Background: COVID-19 is caused by SARS-CoV-2 infection and has reached pandemic proportions. Since then, several clinical characteristics have been associated with poor outcomes. This study aimed to describe the morbidity profile of COVID-19 deaths in Portugal. Methods: A study was performed including deaths certificated in Portugal with “COVID-19” (ICD-10: U07.1 or U07.2) coded as the underlying cause of death from the National e-Death Certificates Information System between 16 March and 31 December 2020. Comorbidities were derived from ICD-10 codes using the Charlson and Elixhauser indexes. The resident Portuguese population estimates for 2020 were used. Results: The study included 6701 deaths (death rate: 65.1 deaths/100,000 inhabitants), predominantly males (72.1). The male-to-female mortality ratio was 1.1. The male-to-female mortality rate ratio was 1.2; however, within age groups, it varied 5.0–11.4-fold. COVID-19 deaths in Portugal during 2020 occurred mainly in individuals aged 80 years or older, predominantly in public healthcare institutions. Uncomplicated hypertension, uncomplicated diabetes mellitus, congestive heart failure, renal failure, cardiac arrhythmias, dementia, and cerebrovascular disease were observed among COVID-19 deceased patients, with prevalences higher than 10%. A high prevalence of zero morbidities was registered using both the Elixhauser and Charlson comorbidities lists (above 40.2%). Nevertheless, high multimorbidity was also identified at the time of COVID-19 death (about 36.5%). Higher multimorbidity levels were observed in men, increasing with age up to 80 years old. Zero-morbidity prevalence and high multimorbidity prevalences varied throughout the year 2020, seemingly more elevated in the mortality waves’ peaks, suggesting variation according to the degree of disease incidence at a given period. Conclusions: This study provides detailed sociodemographic and clinical information on all certificated deaths from COVID-19 in Portugal during 2020, showing complex and extreme levels of morbidity (zero-morbidity vs. high multimorbidity) dynamics during the first year of the pandemic in Portugal.info:eu-repo/semantics/publishedVersio

Problematic Eating Behaviors after Bariatric Surgery: A National Study with a Portuguese Sample

Introdução: A cirurgia bariátrica é o método mais eficaz para o tratamento da obesidade mórbida. No entanto, o desenvolvimento de psicopatologia alimentar e o aparecimento de comportamentos alimentares problemáticos têm sido relatados na literatura. Este estudo transversal teve como objetivo a caracterização da população pós-cirurgia bariátrica em termos da frequência de comportamentos alimentares problemáticos ao longo do tempo e a compreensão das características psicológicas associadas. Material e Métodos: A amostra foi constituída por 155 doentes sujeitos a cirurgia bariátrica que responderam a instrumentos de au-torrelato destinados a avaliar psicopatologia alimentar, comportamentos alimentares problemáticos, ansiedade, depressão e stress e comportamento impulsivo.Resultados: Os resultados mostram que o petisco contínuo, a ingestão alimentar compulsiva, a preocupação com o peso e com a forma e a urgência negativa são significativamente mais frequentes 24 meses após a cirurgia bariátrica (comparativamente com momentos pós-operatórios mais precoces). A psicopatologia alimentar e a presença de comportamentos alimentares problemáticos correlacionam-se significativa e positivamente com níveis de ansiedade, depressão, stress e urgência negativa. Este estudo reforça ainda o papel mediador da urgência negativa na relação entre tempo decorrido desde a cirurgia e distress psicológico, e comporta-mentos alimentares problemáticos, explicando 32,3% e 27,2% da variância, respectivamente.Discussão: Os resultados apontam para uma tendência crescente de doentes a reportar comportamentos alimentares problemáticos e níveis de impulsividade ao longo do tempo.Conclusão: Tendo em conta a evidência estabelecida do seu impacto na perda e aumento ponderal, a identificação precoce de comportamentos alimentares problemáticos e de doentes com tendência para agir impulsivamente em situações de emocionalidade negativa deve ser central no acompanhamento do doente sujeito a cirurgia bariátrica.Introduction: Bariatric surgery is the most effective method for the treatment of morbid obesity. However, the development of eating psychopathology and the emergence of problematic eating behaviours have been reported in the literature. The aim of this cross-sectional study was to characterize the post-bariatric population in terms of the frequency of problematic eating behaviours over time and to understand the related psychological features.Material and Methods: This sample was composed of 155 bariatric patients that responded to several self-reported instruments assessing eating psychopathology, problematic eating behaviours, anxiety, depression and stress and impulsive behaviour.Results: Results showed that grazing, binge eating, concerns about body weight and shape, and negative urgency are significantly more frequent at 24 months after bariatric surgery (when compared to earlier postoperative assessments). Correlational analyses showed that eating psychopathology and problematic eating behaviours were significantly and positively associated with levels of anxiety, depression, stress and negative urgency. This study also reinforces the mediating role of negative urgency in the relationship between time elapsed since surgery and psychological distress, and problematic eating behaviours, accounting for a total of 32.3% and 27.2% of its variance, respectively.Discussion: The results suggest a growing trend of problematic eating behaviours and levels of impulsivity being reported by bariatric patients over time.Conclusion: Given the established evidence that supports its impact on weight variability, early identification of problematic eating behaviours and of patients with a tendency to act impulsively in situations of negative emotionality should be a central concern in the follow-up of the bariatric populationEste estudo foi suportado pela Fundação para a Ciência e a Tecnologia, um programa de financiamento da União Europeia COMPETE a Eva Conceição (IF/01219/2014) e bolsa de doutoramento (SFRH/BD/104159/2014) a Ana Pinto-Bastos, (SFRH/BD/104182/2014), Sofia Ramalho e (SFRH/BPD/94490/2013), Ana Vaz. Este trabalho foi conduzido no Centro de Investigação em Psicologia (UID/PSI/01662/2013), Universidade do Minho e parcialmente apoiado pela Fundação para a Ciência e a Tecnologia e pelo Ministério da Ciência, Tecnologia e Ensino Superior através de fundos nacionais, tendo sido ainda co-financiado pelo FEDER através do COMPETE2020 sob o PT2020 Compro-misso para a Ciência (POCI-01-0145-FEDER-007653

Portuguese multidisciplinary recommendations for non-pharmacological and non-surgical interventions in patients with rheumatoid arthritis

BACKGROUND: Patients with rheumatoid arthritis (RA) report significant levels of disease impact, which are improved, but not fully abrogated by immunosuppressive therapy, even when remission is achieved. This imposes the need for adjuvant interventions targeting the uncontrolled domains of disease impact. Non-pharmacological interventions are widely used for this purpose, but they have not been the object of professional recommendations or guidelines. OBJECTIVE: To propose multidisciplinary recommendations to inform clinical care providers regarding the employment of non-pharmacological and non-surgical interventions in the management of patients with RA. METHODS: The EULAR standardized operating procedures for the development of recommendations were followed. First, a systematic literature review was performed. Then, a multidisciplinary Technical Expert Panel (TEP) met to develop and discuss the recommendations and research agenda. For each developed recommendation i) the level of evidence and grade of recommendation were determined, and ii) the level of agreement among TEP members was set. A recommendation was adopted if approved by ≥75% of the TEP members, and the level of agreement was considered high when ≥8. All relevant national societies were included in this construction process to attain their endorsement. RESULTS: Based on evidence and expert opinion, the TEP developed and agreed on five overarching principles and 12 recommendations for non-pharmacological and non-surgical interventions in patients with RA. The mean level of agreement between the TEP members ranged between 8.5 and 9.9. The recommendations include a broad spectrum of intervention areas, such as exercise, hydrokinesiotherapy, psychological interventions, orthoses, education, general management of comorbidities, among others; and they set the requirements for their application. CONCLUSIONS: These recommendations are based on the consensus judgment of clinical experts from a wide range of disciplines and patients' representatives from Portugal. Given the evidence for effectiveness, feasibility and safety, non-pharmacological and non-surgical interventions should be an integral part of standard care for people with RA. It is hoped that these recommendations should be widely implemented in clinical practice. The target audience for these recommendations includes all health professionals involved in the care of patients with RA. The target patient population includes adult Portuguese people with RA.publishersversionpublishe

Unidade de Internamento Psiquiátrico para Jovens dos 15 aos 25 Anos: Um Estudo de Follow-up

Introduction: Adolescence and early adulthood are life stages characterized by significant physical, psychological, and social transformations. The transitional age, between 15 and 25 years old, is considered a high-risk period for the development of psychopathology, representing a critical period of opportunities and challenges for mental health intervention. Our objective was to do 4-year follow-up study was conducted on young individuals who were hospitalized during the year 2018 in the acute psychiatric inpatient unit Unidade Partilhada, dedicated to individuals aged 15 to 25 years old. The aim was to assess the sociodemographic and clinical characteristics of the sample, inpatient characteristics, rehospitalization rate, psychopathological status, quality of life, satisfaction with the provided care, and maintenance of follow-up appointments; establishing relationships between the mentioned variables. Methods: Standardized telephone interviews were conducted using the reduced version of the Mental Health Inventory (MHI) and the World Health Organization’s Abbreviated Instrument for Quality of Life Assessment. Clinical records were also consulted. Results: There was a higher percentage of female patients (52.1%). The discharge diagnosis of mood disorders (54.3%) was significantly higher in females, while psychotic disorders (23.4%) were significantly higher in males (Fisher = 40; p<0.001). The duration of hospitalization (average=16.1 days; SD=13.6 days) was significantly longer for psychotic disorders compared to mood disorders (p=0.009). A percentage of 41.5% of young individuals were readmitted, with 6.3% readmitted within 30 days and 35.2% readmitted within 365 days. At the time of the follow-up interview, 80.9% considered themselves “better,” and 62.7% reported being “satisfied” or “very satisfied” with their lives. A percentage of 74.5% continued to receive outpatient care, with significantly lower MHI scores observed among individuals without current follow‐up. A percentage of 37.2% reported being “very satisfied” or “extremely satisfied” with the care provided. Conclusion: Obtaining knowledge and data that allow for the characterization of psychiatric hospitalization during the transitional age is fundamental for the planning, organization, and optimization of care provided to this population. Valuing patient opinions and fostering closer relationships between healthcare professionals and young patients promotes treatment adherence.Introdução: A adolescência e início da idade adulta, são fases do ciclo de vida marcadas por grandes transformações físicas, psicológicas e sociais. A faixa etária de transição, entre os15 e 25 anos, é considerada uma idade de risco para o desenvolvimento de psicopatologia, representando um período crítico de oportunidades e desafios para a intervenção em saúde mental. O nosso objetivo foi realizar um estudo de follow-up a 4 anos dos jovens internados durante o ano de 2018 na unidade de internamento agudo psiquiátrico Unidade Partilhada, destinado a jovens dos 15 aos 25anos de idade; pretendeu‐se avaliar as características sociodemográficas e clínicas da amostra, as características do internamento, a taxa de reinternamento, o estado psicopatológico, qualidade de vida, grau de satisfação com os cuidados prestados e manutenção do seguimento em consulta; estabelecendo relações entre as variáveis mencionadasMétodos: Entrevista telefónica padronizada, com aplicação da versão reduzida do Mental Health Inventory (MHI) e o Instrumento Abreviado de Avaliação da Qualidade de Vida da Organização Mundial de Saúde; consulta de processo clínico.Resultados: Há uma maior percentagem de doentes do sexo feminino (52,1%). O diagnóstico de alta de perturbaçãodo humor (54,3%) foi significativamente superior no sexo feminino e o de perturbação psicótica (23,4%) foi significativamente superior no sexo masculino (Fisher= 40; p<0,001). A duração do internamento (média=16,1 dias; DP=13,6 dias) foi significativamente superior para as perturbações psicóticas em comparação com as perturbações do humor (p=0,009). Dos jovens, 41,5% foram readmitidos, 6,3% num período inferior a 30 dias e 35,2% num período inferior a 365 dias. À data da entrevista de follow-up, 80,9% consideram estar “melhor”; e 62,7% estar “satisfeitos”ou “muito satisfeitos” com a sua vida. Mantêm acompanhamento em consulta 74,5%, sendo a pontuação do MHI significativamente inferior nos jovens sem seguimento atual. Referem estar “muito satisfeitos” ou “mais que muito” com o atendimento prestado, 37,2%.Conclusão: O conhecimento e obtenção de dados que permitam a caracterização do internamento psiquiátrico em idade de transição é fundamental para a planificação, organização e otimização dos cuidados prestados a esta população. A valorização da opinião do doente e a aproximação entre profissionais de saúde e doentes jovens, favorece a adesão ao tratamento

Livro Verde dos Montados

O Livro Verde dos Montados apresenta diversos objectivos que se interligam: Em primeiro lugar, o Livro Verde pretende reunir e sistematizar, de uma forma simples e acessível ao público, o conhecimento produzido em Portugal pelos investigadores e técnicos de várias instituições de investigação ou de gestão que estudam o Montado. Assume-se como uma oportunidade de caracterizar o sistema tendo em conta as suas várias dimensões, identificando as principais ameaças à sua preservação assim como os caminhos que podem ajudar à sua sustentabilidade. Não sendo um documento científico, baseia-se no conhecimento científico e pretende constituir a base para uma plataforma de organização, tanto dos investigadores como do conhecimento científico actualmente produzido em Portugal sobre o Montado.Em segundo lugar, o Livro Verde deverá contribuir para um entendimento partilhado do que é o Montado, por parte do público, de técnicos e de especialistas, conduzindo a uma classificação mais clara do que pode ser considerado Montado e de quais os tipos distintos de Montados que podem ser identificados. Em terceiro lugar, o Livro Verde estabelece as bases para uma estratégia coordenada de disponibilização de informação sobre o sistema Montado, visando o seu conhecimento, apreciação e valorização pela sociedade portuguesa no seu conjunto. Deste modo, o Livro Verde poderá constituir um instrumento congregador e inspirador para a realização de acções de sensibilização e informação sobre o Montado. Em quarto lugar, pretende-se que o Livro Verde contribua para um maior reconhecimento e valorização do Montado como sistema, a nível do desenho das políticas nacionais por parte dos vários sectores envolvidos.Finalmente, o Livro Verde constituirá um documento parceiro do Livro Verde das Dehesas, produzido em Espanha em 2010, de forma a reforçar o reconhecimento e a devida valorização destes sistemas silvo-pastoris no desenho das estratégias e políticas relevantes pelas instituições europeias. Em suma, os autores pretendem que o Livro Verde dos Montados se afirme como o primeiro passo para uma efectiva definição e implementação de uma estratégia nacional para os Montados