Metabolic Syndrome, Thyroid Function and Autoimmunity - The PORMETS Study

Background: The prevalence of thyroid dysfunction and autoimmunity in the Portuguese population has not yet been estimated. However, the national prevalence of the metabolic syndrome remains high. The association of thyroid pathology with cardiovascular risk has been addressed but is still unclear. Our study aimed to evaluate the prevalence of thyroid dysfunction and autoimmunity and to assess the associations of thyroid-stimulating hormone and thyroid hormones and antibodies with metabolic syndrome, its components, and other possible determinants in a national sample. Material and Methods: The present study included a subsample of 486 randomly selected participants from a nationwide cross-sectional study sample of 4095 adults. A structured questionnaire was administered on past medical history and socio-demographic and behavioural characteristics. Blood pressure and anthropometric measurements were collected, and the serum lipid profile, glucose, insulin, hs- CRP, TSH, FT4, FT3 and thyroid antibodies were measured. Results: In our sample, the prevalence of hypothyroidism, hyperthyroidism and undiagnosed dysfunction was 4.9%, 2.5% and 72.2%, respectively. Overall, the prevalence of positivity for the thyroid peroxidase and thyroglobulin antibodies was 11.9% and 15.0%, respectively. A positive association was found between free triiodothyronine and metabolic syndrome (OR: 2.019; 95% CI: 1.196, 3.410). Additionally, thyroid peroxidase antibodies had a negative association with metabolic syndrome (OR: 0.465; 95% CI: 0.236, 0.917) and its triglyceride component (OR: 0.321; 95% CI: 0.124, 0.836). Conclusion: The prevalence of undiagnosed thyroid dysfunction and autoimmunity was high. Thyroid peroxidase antibodies were negatively associated with metabolic syndrome and its triglyceride component, whereas the free triiodothyronine level was positively associated with metabolic syndrome

The Importance of Design in the Development of a Portable and Modular Iot-Based Detection Device for Clinical Applications

The integration of human factors engineering methods within the medical device design and development process has been highlighted by international standards organizations. Such methods are contributing to the development of safer medical devices, more suitable to users' needs. Errors during device operation might hamper effective patient diagnosis and treatment, or eventually lead to injury or death. Thus, the designing process of a medical device is indeed crucial to user experience and safety operation. This paper presents a human-centred design analysis of a novel IoT-based screening prototype (iLoF) based on Artificial Intelligence algorithms built-in in a patented-photonics system developed by a deep tech startup. The influence of the design process during the development of the prototype was addressed, based on a human-centred design methodology and considering the device's application environment. iLoF's prototype on-field applicability was evaluated considering a single case-study carried out at one of the main hospitals in Portugal through interviews to ten healthcare professionals with high experience in laboratorial testing. A benchmark assessment and a comparison matrix along with the market products are also presented to fully understand the technology state and to find new solutions that can influence iLoF's product development. © Published under licence by IOP Publishing Ltd

Fatigue detection through physiological assessment during real-life occupational situations: Preliminary results

Background: Fatigue is a significant health and safety-related problem among workers. In general, it decreases performance and physical strength, causing incidents and accidents in operational situations. During military activities, soldiers often encounter severe conditions, which combined lead to fatigue manifestations affecting their health and performance. Continuous monitoring of their overall health status would prevent its adverse effects. Objective: This work aimed to present the preliminary results of a retrospective assessment of military training physiological recordings using an alert-based fatigue detection algorithm to validate its accurate functioning. Methods: Three case studies from soldiers participating in military training tests were recruited for evaluation. The referred algorithm was developed to manage fatigue through the combined assessment of physiological variables and determine different fatigue levels warnings to advisetimely interventions and prevent potential health impact. Each examined case included the continuous recording of heart rate, breathing rate and core temperature. The algorithm translated physiological sensory data into minute alarms according to fatigue levels determined through the conjunction of normative and related research criteria. Results and Discussion: Outcomes revealed that the algorithm could evidence the different stages of training and the resulting physical demands on soldiers using their physiological response throughout the exercises. Retrieved fatigue alarms showed the high physiological cost of military practices and helped to overview the impact of each training period. Finally, results also demonstrated the importance of individual and contextualised assessment for accurately characterise the subject's fatigue status. Conclusions: It is concluded that the developed decision model can improve the management of real-time fatigue, allowing early detection of potential indicators of further physical impairments. Furthermore, it can lead to the enhancement of work-rest cycles, not only for tactical personnel but also for any safety-sensitive occupation. For future work, its validity will be tested through more participants, and other variableswill be added to improve its accuracy.</jats:p

Serum Levels of Vitamin D and Dental Caries in 7-Year-Old Children in Porto Metropolitan Area

Vitamin D deficiency has been associated with significant changes in dental structures. In children, it can induce enamel and dentin defects, which have been identified as risk factors for caries. This study aimed to assess the association between low serum 25-hydroxyvitamin D (25(OH) D) levels ( 0), and advanced caries (d3–6mft/D3–6MF > 0). Serum 25(OH) D was measured using a competitive electrochemiluminescence immunoassay protein-binding assay. Bivariate analysis and multivariate logistic regression were used. Advanced caries in permanent teeth was significantly associated with children’s vitamin D levels <30 ng/mL, gastrointestinal disorders, higher daily intake of cariogenic food, and having had a dental appointment at ≤7 years old. Optimal childhood levels of vitamin D may be considered an additional preventive measure for dental caries in the permanent dentition.Generation XXI was funded by Programa Operacional de Saúde (Regional Department of Ministry of Health). It has support from the Portuguese Foundation for Science and Technology (FCT) and from the Calouste Gulbenkian Foundation. Ana Cristina Santos holds a FCT Investigator contract info:eu-repo/grantAgreement/FCT/Investigador FCT/IF/01060/2015/CP1319/CT0001/PT. The authors received no specific funding for this work

The INOVMineral Projects Contribution to Mineral Exploration A WebGIS Integration and Visualization of Spectral and Geophysical Properties of the Aldeia LCT Pegmatite Spodumene Deposit

Due to the energetic transition at course, new geological exploration technologies are needed to discover mineral deposits containing critical materials such as lithium (Li). The vast majority of European Li deposits are related to LiCsTa (LCT) pegmatites. Literature review indicates that conventional exploration campaigns are dominated by geochemical surveys and related exploration tools. However, other exploration techniques must be evaluated namely remote sensing (RS) and geophysics. This work presents the results of the INOVMINERAL4.0 project obtained through alternative approaches to traditional geochemistry that were gathered and integrated into a webGIS application. The specific objectives were to: (i) assess the potential of high-resolution elevation data; (ii) evaluate geophysical methods, particularly radiometry; (iii) establish a methodology for spectral data acquisition and build a spectral library; (iv) compare obtained spectra with Landsat 9 data for pegmatite identification; and (v) implement a user-friendly webGIS for data integration and visualization. Radiometric data acquisition using geophysical techniques effectively discriminated pegmatites from host rocks. The developed spectral library provided valuable insights for space-based exploration. Landsat 9 data accurately identified known LCT pegmatite targets, compared to Landsat 8. The user-friendly webGIS facilitated data integration, visualization, and sharing, supporting potential users in similar exploration approaches.</jats:p

Healthy excessive weight in Portuguese women 4years after delivery of a liveborn

OBJECTIVE: To quantify the prevalence of healthy excessive weight and determinants of metabolic profile, considering women's reproductive life. METHODS: We evaluated 1847 mothers of a birth cohort assembled after delivery and reevaluated 4years later. A healthy profile was defined as the absence of hypertension, diabetes, dyslipidemia, C-reactive protein <3mg/l and being below the second tertile of HOMA-IR. Adjusted odds ratios (OR) and confidence intervals (95% CI) were computed using multinomial logistic regression, taking women with normal BMI as the reference category of the outcome. RESULTS: Four years after delivery, 47% of women had normal BMI, 33% were overweight and 20% obese. In each BMI class, 61%, 33% and 12% presented a healthy metabolic profile, respectively. Family history of CVD/cardiometabolic risk factors was associated with a higher probability of obesity with a not healthy metabolic profile (OR=1.39 95% CI: 0.98-1.98). Women who breastfed the enrolled child for >26weeks and practiced physical exercise were less likely to be obese and metabolically unhealthy (OR=0.39 95% CI: 0.23-0.68; OR=0.48 95% CI: 0.33-0.70, respectively), with no effect on healthy excessive weight. CONCLUSIONS: These results support the existence of a healthy excessive weight phenotype in women after motherhood, influenced by anthropometrics, genetic and lifestyles characteristics

Evaluation of objective and subjective indicators of death in a period of one year in a sample of prevalent patients under regular hemodialysis

<p>Abstract</p> <p>Background</p> <p>To identify objective and subjective indicators of death in prevalent hemodialysis (HD) patients in a follow-up study of 12 months.</p> <p>Methods</p> <p>The study included end-stage renal disease patients undergoing HD and analyzed demographic and laboratory data from the dialysis unit's records. Baseline data concerning socioeconomic status, comorbidity, quality of life level, coping style and depression were also assessed. For variables that differed in the comparison between survivors and non-survivors, Cox proportional hazards for death were calculated.</p> <p>Results</p> <p>The mortality rate was 13.0%. Non-survivors differed in age, comorbidity, inclusion on the transplant waiting list and physical functioning score. The hazard ratios of death were 8.958 (2.843-28.223; <it>p </it>< 0.001) for comorbidity, 3.992 (1.462-10.902; <it>p </it>= 0.007) for not being on the transplant waiting list, 1.038 (1.012-1.066; <it>p </it>= 0.005) for age, and 0.980 (0.964-0.996; <it>p </it>= 0.014) for physical functioning.</p> <p>Conclusions</p> <p>Comorbidity, not being on the transplant waiting list, age and physical functioning, which reflects physical status, must be seen as risk indicators of death among patients undergoing HD.</p

Clinical effectiveness and cost-effectiveness of foot orthoses for people with established rheumatoid arthritis: an exploratory clinical trial

Objectives: Foot orthoses are commonly prescribed as an intervention for people with rheumatoid arthritis (RA). Data relating to the cost-effectiveness of foot orthoses in people with RA are limited. The aim was to evaluate the clinical and cost-effectiveness of two types of foot orthoses in people with established RA. Method: A single-blind randomized controlled trial was undertaken to compare custom-made foot orthoses (CMFOs) and simple insoles (SIs) in 41 people with established RA. The Foot Function Index (FFI) was used to measure foot pain, disability, and functional limitation. Costs were estimated from the perspective of the UK National Health Service (NHS), societal (patient and family) perspective, and secondary care resource use in terms of the intervention and staff time. Effects were assessed in terms of health gain expressed as quality-adjusted life years (QALYs). Results: At baseline, 20 participants received a CMFO and 21 participants received an SI. After 16 weeks foot pain improved in both the CMFOs (p = 0.000) and the SIs (p < 0.01). However, disability scores improved for CMFOs (p < 0.001) but not for SIs (p = 0.40). The cost-effectiveness results demonstrated no difference in cost between the arms (CMFOs: £159.10; SIs: £79.10; p = 0.35), with the CMFOs being less effective in terms of cost per QALY gain (p < 0.001). Conclusions: In people with established RA, semi-rigid customized foot orthoses can improve pain and disability scores in comparison to simple insoles. From a cost-effectiveness perspective, the customized foot orthoses were far more expensive to manufacture, with no significant cost per QALY gain

Optimization of the Kinematic Chain of the Thumb for a Hand Prosthesis Based on the Kapandji Opposition Test

Ponènica presentada a International Symposium on Computer Methods in Biomechanics and Biomedical Engineering - CMBBE 2019The thumb plays a key role in the performance of the hand for grasp-ing and manipulating objects. In artificial hands the complex thumb’s kinematic chain (TKC) is simplified and its five degrees of freedom are reduced to only one or two with the consequent loss of dexterity of the hand. The Kapandji op-position test (KOT) has been clinically used in pathological human hands for evaluating the thumb opposition and it has also been employed in some previ-ous studies as reference for the design of the TKC in artificial hands, but with-out a clearly stated methodology. Based on this approaches, in this study we present a computational method to optimize the whole TKC (base placement, link lengths and joint orientation angles) of an artificial hand based on its per-formance in the KOT. The cost function defined for the optimization (MPE) is a weighted mean position error when trying to reproduce the KOT postures and can be used also as a metric to quantify thumb opposition in the hand. As a case study, the method was applied to the improvement of the TKC of an artificial hand developed by the authors and the MPE was reduced to near one third of that of the original design, increasing significantly the number of reachable po-sitions in the KOT. The metric proposed based on the KOT can be used directly or in combination with other to improve the kinematic chain of artificial hands