CODAP: um Consenso Multidisciplinar sobre a Definição, Diagnóstico e Tratamento da Dislipidemia Aterogénica em Portugal

Introduction and aims: Atherogenic dyslipidemia is an important contributor to residual cardiovascular (CV) risk, but it is underdiagnosed and undertreated. This study aimed to assess the opinion of Portuguese experts to generate a consensus concerning the diagnosis and treatment of atherogenic dyslipidemia, as well as to contribute toward standardization of clinical practice in this disorder. Methods: The study consisted in the application of a questionnaire to an expert panel, following a modified Delphi methodology. Results: The majority (88.4%) of the proposed items were found to be consensual. The expert panel recognized the importance of the atherogenic dyslipidemia phenotype, the role played by low-density lipoprotein cholesterol and non-high-density lipoprotein cholesterol as risk markers and therapeutic targets, the choice of statins as first-line lipid-lowering drugs, and the value of associating statins with fenofibrate as a means to reduce residual CV risk. However, the role played by triglycerides in CV risk and the therapeutic value of fibrates lacked consensus. Taking into consideration the state of the art and the opinions expressed in this study, the scientific committee developed a treatment algorithm aimed to improve the perception and treatment of atherogenic dyslipidemia. Conclusions: The experts involved in this study were shown to be familiar with the concept and the importance of atherogenic dyslipidemia. The few situations in which a consensus could not be found were mainly related to the interpretation and/or relevance of the available evidence.info:eu-repo/semantics/publishedVersio

Seroconversion Rate Following HBV Vaccination in Clinical Practice: The Role of Age and DMT Treatment

HBV screening and immunization is recommended in all MS patients and is mandatory before the start of some DMT. However, studies evaluating the immune response to HBV vaccine in MS patients are scarce. We aimed to evaluate the seroprotection rate following HBV immunization in MS patients and to assess if older age and DMT-treatment influenced seroprotection. We conducted a cohort study between 2016 and 2020 and compared the immune response to HBV vaccine in MS patients under different DMTs and in patients 50 years old or younger and older than 50. We found that patients under non-injectable DMT presented lower rates of seroprotection comparing to patients under injectable DMT's or without treatment. In patients older than 50, although the seroprotection rate was similar to the remaining patients, the antibody anti-HBV surface antigen titers following HBV immunization were lower and patients were more likely to require a 4th dose of the vaccine to achieve seroprotection. Our findings highlight to need to consider HBV immunization in MS patients early in the disease course, in order to ensure a proper immune response to the vaccine.info:eu-repo/semantics/publishedVersio

Nonketotic Hyperglycinemia: A Report of Two Infants Treated with Dextromethorphan and Sodium Benzoate

A hiperglicinémia não cetótica é um erro inato da degradação da glicina, resultando na sua excessiva acumulação nos tecidos corporais, designadamente no sistema nervoso central. Trata-se de uma doença muito grave e uma das terapêuticas recentemente propostas consiste na associação do dextrometorfano com o benzoato de sódio em altas doses. Admite-se a possibilidade de o dextrometorfano bloquear o complexo-canal receptor de N-metil-D-aspartato, implicado na toxicidade da hiperglicinémia ao nível do cérebro e de o benzoato reduzir os níveis de glicina, pela sua conjugação e eliminação como hipurato. Relatamos dois casos clínicos de crianças com hiperglicinémia não cetótita, actualmente com mais de 15 meses de idade, as quais foram medicadas com dextrometorfano e benzoato de sódio desde as primeiras semanas após o parto. Não obstante se ter verificado sobrevivência para além do período neonatal e aquisição de autonomia respiratória, a evolução neurológica, até à data, não tem sido satisfatória, porventura devido ao atraso no início da terapêutica

Medical Students’ Perceptions of Peer Assessment in a Problem-based Learning Curriculum

Objectives: Peer assessment (PA) is believed to support learning and help students develop both professionally and personally. The aim of this study was to examine medical students’ perceptions of intragroup PA in a problem-based learning (PBL) setting. Methods: This study was carried out between September and November 2014 and involved six random groups of fourth-year undergraduate medical students (n = 60) enrolled at the Arabian Gulf University in Manama, Bahrain. While working on set tasks within a curriculum unit, each student evaluated a randomly selected peer using an English language adapted assessment tool to measure responsibility and respect, information processing, critical analysis, interaction and collaborative skills. At the end of the unit, students’ perceptions of PA were identified using a specifically-designed voluntary and anonymous selfadministered questionnaire in English. Results: A total of 55 students participated in the study (response rate: 92%). The majority of students reported that their learning (60%), attendance (67%), respect towards group members (70%) and participation in group discussions (71%) improved as a result of PA. Regarding problem analysis skills, most participants believed that PA improved their ability to analyse problems (65%), identify learning needs (64%), fulfil tasks related to the analysis of learning needs (72%) and share knowledge within their group (74%). Lastly, a large proportion of students reported that this form of assessment helped them develop their communication (71%) and self-assessment skills (73%), as well as collaborative abilities (75%). Conclusion: PA was well accepted by the students in this cohort and led to self-reported improvements in learning, skills, attitudes, engagement and other indicators of personal and professional development. PA was also perceived to have a positive impact on intragroup attitudes

Continuous EB welding of the reinforcement of the CMS conductor

The Compact Muon Solenoid (CMS) is one of the general-purpose detectors to be provided for the LHC project at CERN. The design field of the CMS superconducting magnet is 4 T, the magnetic length is 12.5 m and the free bore is 6 m. In order to withstand the electro-mechanical forces during the operation of the CMS magnet, the superconducting cable embedded in a 99.998% pure aluminum matrix is reinforced with two sections of aluminum alloy EN AW-6082 assembled by continuous Electron Beam Welding (EBW). A dedicated production line has been designed by Techmeta, a leading company in the field of EBW. The production line has a total length of 70 m. Non-stop welding of each of the 20 lengths of 2.5 km, required to build the coil, will last 22 hours. EBW is the most critical process involved in the production line. The main advantage of the EBW process is to minimize the Heat Affected Zone; this is particularly important for avoiding damage to the superconducting cable located only 4.7 mm from the welded joints. Two welding guns of 20 kW each operate in parallel in a vacuum chamber fitted with dynamic airlocks. After welding, the conductor is continuously machined on the four faces and on each corner to obtain the required dimensions and surface finish. Special emphasis has been put on quality monitoring. All significant production parameters are recorded during operation and relevant samples are taken from each produced length for destructive testing purposes. In addition, a continuous phased array ultrasonic checking device is located immediately after the welding unit for the continuous welding quality control, along with a dimension laser measurement unit following the machining. (8 refs)

The CMS conductor

The Compact Muon Solenoid (CMS) is one of the experiments, which are being designed in the framework of the Large Hadron Collider (LHC) project at CERN, the design field of the CMS magnet is 4 T, the magnetic length is 13 m and the aperture is 6 m. This high magnetic field is achieved by means of a 4 layer, 5 modules superconducting coil. The coil is wound from an Al-stabilized Rutherford type conductor. The nominal current of the magnet is 20 kA at 4.5 K. In the CMS coil the structural function is ensured, unlike in other existing Al-stabilized thin solenoids, both by the Al-alloy reinforced conductor and the external former. In this paper the retained manufacturing process of the 50-km long reinforced conductor is described. In general the Rutherford type cable is surrounded by high purity aluminium in a continuous co-extrusion process to produce the Insert. Thereafter the reinforcement is joined by Electron Beam Welding to the pure Al of the insert, before being machined to the final dimensions. During the manufacture the bond quality between the Rutherford cable and the high purity aluminium as well as the quality of the EB welding are continuously controlled by a novel ultrasonic phased array system. The dimensions of the insert and the final conductor are measured by laser micrometer. (8 refs)

Late Holocene climatic oscillations traced by clay mineral assemblages and other palaeoceanographic proxies in Ria de Vigo (NW Spain)

This work aims to study recent climatic oscillations and their influence on sedimentation in the Ria de Vigo, a coastal embayment in Galicia, NW Spain. It is based on the study of clay mineral assemblages, in conjunction with other proxies (granulometric, geochemical, geochronological and microfaunal), in the core KSGX 24. A Benthic Foraminifera High Productivity (BFHP) proxy was used to determine changes in the flux of organic matter (OM) at the bottom of the study area. Total organic carbon (TOC) content is not a suitable proxy to estimate changes in the past supply of OM due to diagenetic processes.The sedimentation was finest in 3 sections: ~ 230–214 cm, ~ 185–73 cm and ~ 20–0 cm. These muddy sections are characterised, in general, by higher proportions of detrital minerals, concentrations of several chemical elements related to lithogenic sources and BFHP values. In addition, these sections are impoverished in carbonates, Ca, Sr and La when compared with the layers with the highest sand content.The clay mineral assemblage of the studied site, characterised by the dominance of illite, intermediate concentrations of kaolinite and minor amounts of smectite and chlorite, reveals the prevalence of a typical temperate humid climate in the last 3 ka BP, the estimated age for the core base. However, the quantities of illite and chlorite increase in the muddy layers. The characteristics of these muddy layers were interpreted as representing relatively cold climatic oscillations associated with the strengthening of northerly winds and the prevalence of an upwelling regime corresponding to wellknown periods, such as the first cold period of the Upper Holocene (~ 2.9 ka cal BP), the Dark Ages (between ~ 2.2 - 1.2 ka cal BP) and the Little Ice Age (~ 0.6 ka cal BP)

Phylogenetic relationships and phylogeography of relevant lineages within the complex Campanulaceae family in Macaronesia

Original ResearchMacaronesia has long been recognized as a natural model for studying evolutionary processes in plant diversification. Several studies have attempted to focus on single lineages, and few have covered the diversification of a family across all the archipelagos. We used a comprehensive sample to clarify the phylogenetic relationships and the biogeographic history of the Macaronesian Campanulaceae. Hypotheses related to the colonization of these archipelagos will be used to examine the diversification patterns of different lineages. We sequenced the ITS region and six cpDNA markers (atpB, matK, petD, rbcL, trnL-F, and psbA-trnH) from 10 Campanulaceae species, including seven endemic species in Macaronesia. The phylogeny of these taxa was reconstructed using maximum parsimony, maximum likelihood, and Bayesian inference. To study the relationships within each lineage, haplotype networks were calculated using NeighborNet and TCS algorithms. Moreover, data were combined with fossil information to construct time-calibrated trees for the Macaronesian Campanulaceae species. The phylogenetic analyses are largely congruent with current taxon circumscriptions, and all the endemic genera formed monophyletic clades, namely Azorina in Azores; Musschia in Madeira; and Campanula in Cape Verde. The Azorina clade and the Cape Verde endemic Campanula may share a common ancestor in North Africa, and the divergence was dated ca. 12.3 million years ago (Mya). The divergence of the Musschia clade began in the Pliocene ca. 3.4 Mya. Moreover, several examples of intraspecific variation were revealed among the native species with a clear geographic structured patterns, suggesting that cryptic diversity might exist within the native Macaronesian Campanulaceae when compared to the close mainland taxa (e.g., Campanula erinus, Trachelium caeruleum), but additional studies are needed to support the molecular data. This study highlights the power of combining data (e.g., phylogeny and divergence times, with species distribution data) for testing diversification hypotheses within the unique Macaronesian flora, providing useful information for future conservation efforts.info:eu-repo/semantics/publishedVersio

Photoluminescence studies of a perceived white light emission from a monolithic InGaN/GaN quantum well structure

In this work we demonstrate by photoluminescence studies white light emission from a monolithic InGaN/GaN single quantum well structure grown by metal organic chemical vapour deposition. As-grown and thermally annealed samples at high temperature (1000 °C, 1100 °C and 1200 °C) and high pressure (1.1 GPa) were analysed by spectroscopic techniques, and the annealing effect on the photoluminescence is deeply explored. Under laser excitation of 3.8 eV at room temperature, the as-grown structure exhibits two main emission bands: a yellow band peaked at 2.14 eV and a blue band peaked at 2.8 eV resulting in white light perception. Interestingly, the stability of the white light is preserved after annealing at the lowest temperature (1000 °C), but suppressed for higher temperatures due to a deterioration of the blue quantum well emission. Moreover, the control of the yellow/blue bands intensity ratio, responsible for the white colour coordinate temperatures, could be achieved after annealing at 1000 °C. The room temperature white emission is studied as a function of incident power density, and the correlated colour temperature values are found to be in the warm white range: 3260–4000 K