IgG+ Extracellular Vesicles Measure Therapeutic Response in Advanced Pancreatic Cancer

Funding Information: J.E. was supported by grant 765492 from H2020-MSCA-ITN-2017. J.M. was supported by “Fundação para a Ciência e a Tecnologia” (PD/BD/105866/2014). S.B. was supported by the EMBO Installation Grant 3921. This work was supported by the Champalimaud Foundation and grant LCF/PR/HR19/52160014 from “La Caixa” Foundation. M.O.’s research is partially supported by National Funds through FCT, Fundação para a Ciência e a Tecnologia, projects 343 UIDB/04674/2020 (CIMA) and H2020-MSCA-RISE-2020/101007950, with the title ”DecisionES—Decision Support for the Supply of Ecosystem Services under Global Change,” funded by the Marie Curie International Staff Exchange Scheme.(1) Background: Pancreatic ductal adenocarcinoma (PDAC) is expected to be the second-leading cause of cancer deaths by 2030. Imaging techniques are the standard for monitoring the therapy response in PDAC, but these techniques have considerable limits, including delayed disease progression detection and difficulty in distinguishing benign from malignant lesions. Extracellular vesicle (EV) liquid biopsy is an emerging diagnosis modality. Nonetheless, the majority of research for EV-based diagnosis relies on point analyses of EVs at specified times, while longitudinal EV population studies before and during therapeutic interventions remain largely unexplored. (2) Methods: We analyzed plasma EV protein composition at diagnosis and throughout PDAC therapy. (3) Results: We found that IgG is linked with the diagnosis of PDAC and the patient’s response to therapy, and that the IgG+ EV population increases with disease progression and reduces with treatment response. Importantly, this covers PDAC patients devoid of the standard PDAC seric marker CA19.9 expression. We also observed that IgG is bound to EVs via the tumor antigen MAGE B1, and that this is independent of the patient’s inflammatory condition and IgG seric levels. (4) Conclusions: We here propose that a population analysis of IgG+ EVs in PDAC plasma represents a novel method to supplement the monitoring of the PDAC treatment response.publishersversionpublishe

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

Predictors of cardiac involvement in idiopathic inflammatory myopathies

Copyright © 2023 Bandeira, Dourado, Melo, Martins, Fraga, Ferraro, Saraiva, Sousa, Parente, Soares, Correia, Almeida, Dinis, Pinto, Oliveira Pinheiro, Rato, Beirão, Samões, Santos, Mazeda, Chícharo, Faria, Neto, Lourenço, Brites, Rodrigues, Silva-Dinis, Dias, Araújo, Martins, Couto, Valido, Santos, Barreira, Fonseca and Campanilho-Marques. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.Objectives: Idiopathic inflammatory myopathies (IIM) are a group of rare disorders that can affect the heart. This work aimed to find predictors of cardiac involvement in IIM. Methods: Multicenter, open cohort study, including patients registered in the IIM module of the Rheumatic Diseases Portuguese Register (Reuma.pt/Myositis) until January 2022. Patients without cardiac involvement information were excluded. Myo(peri)carditis, dilated cardiomyopathy, conduction abnormalities, and/or premature coronary artery disease were considered. Results: 230 patients were included, 163 (70.9%) of whom were females. Thirteen patients (5.7%) had cardiac involvement. Compared with IIM patients without cardiac involvement, these patients had a lower bilateral manual muscle testing score (MMT) at the peak of muscle weakness [108.0 ± 55.0 vs 147.5 ± 22.0, p=0.008] and more frequently had oesophageal [6/12 (50.0%) vs 33/207 (15.9%), p=0.009] and lung [10/13 (76.9%) vs 68/216 (31.5%), p=0.001] involvements. Anti-SRP antibodies were more commonly identified in patients with cardiac involvement [3/11 (27.3%) vs 9/174 (5.2%), p=0.026]. In the multivariate analysis, positivity for anti-SRP antibodies (OR 104.3, 95% CI: 2.5-4277.8, p=0.014) was a predictor of cardiac involvement, regardless of sex, ethnicity, age at diagnosis, and lung involvement. Sensitivity analysis confirmed these results. Conclusion: Anti-SRP antibodies were predictors of cardiac involvement in our cohort of IIM patients, irrespective of demographical characteristics and lung involvement. We suggest considering frequent screening for heart involvement in anti-SRP-positive IIM patients.info:eu-repo/semantics/publishedVersio

Estimativa de potenciais técnicos de energia renovável em Portugal: eólico, solar fotovoltaico, solar concentrado, biomassa e oceanos

Executive Summary: There is a clear need to accelerate the energy transition, including the implementation of renewable electricity production plants, as well as the increase in consumption of other renewable energy carriers in buildings, industry, transport and other sectors. This work provides key information to make this transition possible, that is, the technical renewable energy potentials for Portugal. The aim is thus to contribute to policy support, as well as to decision-making by various Portuguese stakeholders (public and private) in the domains of energy, energy transition and greenhouse gases emissions mitigation. The work presents the technical renewable energy potentials for Portugal to: (i) decentralized solar photovoltaic (PV) plants in artificialized (or built-up) areas; (ii) centralized solar PV plants in non-artificialized (or natural) areas; (iii) concentrated solar power; (iv) onshore wind; (v) offshore wind (floating and fixed); (vi) bioenergy, and (vii) solar thermal. The wave energy primary energy resource potential is also presented (not the technical potential). The technical potential values of renewable energy sources (RES) presented are dynamic values, given the substantial uncertainty associated with their estimation. The study identifies technical RES potentials i.e., the technically viable energy generation achievable from a specific technology, considering the primary energy resource available and the geographic, environmental and land use limitations. RES economic potentials represent the fraction of RES technical potential that is economically viable, but they are not presented in this work. Likewise, this report does not address market potential, that translate the capacity and energy generation that the market effectively manages to implement. The presented RES technical potentials include the total capacity currently installed in the country. The technical potentials are estimated mostly for mainland Portugal, in most cases with a spatial disaggregation of at least NUT2 and sometimes for NUT5 and/or type of building. Despite adopting an approach based on a territorial analysis in which some areas of the country are excluded, this potential does not correspond to the work done in mapping less-sensitive areas towards future definition of RES “Go-To Areas”. The decentralized solar PV potential in artificialized areas is divided into 6 area types: industrial areas; commercial buildings; residential and mixed-use buildings; villas; health, education, cultural, tourist and military buildings, and other land uses (including parking lots and patios, ports, waste and wastewater treatment infrastructure, sports facilities, among others). It is estimated a technical potential of 23.33 GW that could generate up to 36.84 TWh/year. This potential is distributed throughout the entire territory of mainland Portugal but is higher in the North and Center regions. The RES technical potential for centralized solar PV was estimated as a range of values that translate the uncertainty associated with using different levels of concern in excluding certain areas in which solar PV can be deployed (for example to safeguard ecosystems, water resources, agriculture or archaeological heritage). The centralized solar PV potential varies between 168.82 GW and 45.63 GW. The maximum threshold of installed capacity could generate 278.11 TWh/year of electricity. The value is high and reflects on the one hand, the excellence of the solar resource throughout the country, and on the other, the large size of the considered areas. The CSP potential is 62.6 GW with a corresponding electrical production potential of 183.61 TWh/year. It is mainly located in the Alentejo region, although other areas have also been identified in other regions of the country. The wind onshore technical potential is 15.7 GW, that could generate 37.13 TWh/year, taking into account the safeguarding of various areas for the protection of ecosystems and also social acceptability issues. In the case of offshore wind and considering a capacity density of 4 MW/km2 for floating offshore and 5.5 MW/km2 for fixed offshore, a total of 36 GW and 2 GW are obtained, respectively. This capacity could generate up to 126.14 TWh/year (floating offshore) or 6.31 TWh/year (fixed offshore). The solar thermal energy potential focused residential and service buildings (such as nursing homes, barracks, etc., tourism, hospitals, indoor swimming pools and other sports facilities). The potential is of 0.95 GWt and 0.95 TWh/year for service buildings, 7.26 GWt and 5.84 TWh/year for residential buildings. For industry there is a potential of 1.06 GWt, which could generate up to 1.15 TWh/year for applications up to 160 ºC. The total technical potential of solar thermal is 9.25 GWt and 7.93 TWh/year of thermal energy generated, with a substantial weight of residential buildings in the total value. Potential values are disaggregated by NUTS III and type of building. In terms of biomass and bioenergy potential, annual values of forest biomass, agricultural biomass, agro-industrial waste, urban waste and wastewater treatment are estimated, totaling around 58 TWh/year. Regarding the production of biofuels (HVO and FAME) it is estimated that the annual production of domestic used oils and other similar residues is 1.4 TWh/year. The use of oils from food crops such as soybean, sunflower and rapeseed is limited by European (and national) policy guidelines and is 2.1 TWh/year. Regarding wave energy, the resource potential is estimated between 1.4 GW for 80 m bathymetry and 4.8 for 20 m bathymetry. There are substantial uncertainties associated with the presented values, inherent to the methodological approach considered. Nevertheless, these estimates are a valuable starting point to be refined and improved in subsequent updates.N/

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

MAMMALS IN PORTUGAL : A data set of terrestrial, volant, and marine mammal occurrences in P ortugal

Mammals are threatened worldwide, with 26% of all species being includedin the IUCN threatened categories. This overall pattern is primarily associatedwith habitat loss or degradation, and human persecution for terrestrial mam-mals, and pollution, open net fishing, climate change, and prey depletion formarine mammals. Mammals play a key role in maintaining ecosystems func-tionality and resilience, and therefore information on their distribution is cru-cial to delineate and support conservation actions. MAMMALS INPORTUGAL is a publicly available data set compiling unpublishedgeoreferenced occurrence records of 92 terrestrial, volant, and marine mam-mals in mainland Portugal and archipelagos of the Azores and Madeira thatincludes 105,026 data entries between 1873 and 2021 (72% of the data occur-ring in 2000 and 2021). The methods used to collect the data were: live obser-vations/captures (43%), sign surveys (35%), camera trapping (16%),bioacoustics surveys (4%) and radiotracking, and inquiries that represent lessthan 1% of the records. The data set includes 13 types of records: (1) burrowsjsoil moundsjtunnel, (2) capture, (3) colony, (4) dead animaljhairjskullsjjaws, (5) genetic confirmation, (6) inquiries, (7) observation of live animal (8),observation in shelters, (9) photo trappingjvideo, (10) predators dietjpelletsjpine cones/nuts, (11) scatjtrackjditch, (12) telemetry and (13) vocalizationjecholocation. The spatial uncertainty of most records ranges between 0 and100 m (76%). Rodentia (n=31,573) has the highest number of records followedby Chiroptera (n=18,857), Carnivora (n=18,594), Lagomorpha (n=17,496),Cetartiodactyla (n=11,568) and Eulipotyphla (n=7008). The data setincludes records of species classified by the IUCN as threatened(e.g.,Oryctolagus cuniculus[n=12,159],Monachus monachus[n=1,512],andLynx pardinus[n=197]). We believe that this data set may stimulate thepublication of other European countries data sets that would certainly contrib-ute to ecology and conservation-related research, and therefore assisting onthe development of more accurate and tailored conservation managementstrategies for each species. There are no copyright restrictions; please cite thisdata paper when the data are used in publications.info:eu-repo/semantics/publishedVersio

Mammals in Portugal: a data set of terrestrial, volant, and marine mammal occurrences in Portugal

Mammals are threatened worldwide, with ~26% of all species being included in the IUCN threatened categories. This overall pattern is primarily associated with habitat loss or degradation, and human persecution for terrestrial mammals, and pollution, open net fishing, climate change, and prey depletion for marine mammals. Mammals play a key role in maintaining ecosystems functionality and resilience, and therefore information on their distribution is crucial to delineate and support conservation actions. MAMMALS IN PORTUGAL is a publicly available data set compiling unpublished georeferenced occurrence records of 92 terrestrial, volant, and marine mammals in mainland Portugal and archipelagos of the Azores and Madeira that includes 105,026 data entries between 1873 and 2021 (72% of the data occurring in 2000 and 2021). The methods used to collect the data were: live observations/captures (43%), sign surveys (35%), camera trapping (16%), bioacoustics surveys (4%) and radiotracking, and inquiries that represent less than 1% of the records. The data set includes 13 types of records: (1) burrows | soil mounds | tunnel, (2) capture, (3) colony, (4) dead animal | hair | skulls | jaws, (5) genetic confirmation, (6) inquiries, (7) observation of live animal (8), observation in shelters, (9) photo trapping | video, (10) predators diet | pellets | pine cones/nuts, (11) scat | track | ditch, (12) telemetry and (13) vocalization | echolocation. The spatial uncertainty of most records ranges between 0 and 100 m (76%). Rodentia (n =31,573) has the highest number of records followed by Chiroptera (n = 18,857), Carnivora (n = 18,594), Lagomorpha (n = 17,496), Cetartiodactyla (n = 11,568) and Eulipotyphla (n = 7008). The data set includes records of species classified by the IUCN as threatened (e.g., Oryctolagus cuniculus [n = 12,159], Monachus monachus [n = 1,512], and Lynx pardinus [n = 197]). We believe that this data set may stimulate the publication of other European countries data sets that would certainly contribute to ecology and conservation-related research, and therefore assisting on the development of more accurate and tailored conservation management strategies for each species. There are no copyright restrictions; please cite this data paper when the data are used in publications

Portuguese Consensus on the Diagnosis and Management of Lewy Body Dementia (PORTUCALE)

Lewy body dementia is a common cause of dementia leading to the progressive deterioration of cognitive function and motor skills, behavioral changes, and loss of autonomy, impairing the quality of life of patients and their families. Even though it is the second leading cause of neurodegenerative dementia, diagnosis is still challenging, due to its heterogenous clinical presentation, especially in the early stages of the disease. Accordingly, Lewy body dementia is often misdiagnosed and clinically mismanaged. The lack of diagnostic accuracy has important implications for patients, given their increased susceptibility to the adverse effects of certain drugs, such as antipsychotics, which may worsen some symptoms associated with Lewy body dementia. Therefore, a specialist consensus based on the analysis of the most updated and relevant literature, and on clinical experience, is useful to all professionals involved in the care of these patients. This work aims to inform and provide recommendations about the best diagnostic and therapeutic approaches in Lewy body dementia in Portugal. Moreover, we suggest some strategies in order to raise the awareness of physicians, policy makers, and the society at large regarding this disease.A demência com corpos de Lewy é uma causa comum de demência, provocando a perda progressiva de funções cognitivas e capacidades motoras, alterações comportamentais, e perda de autonomia, com compromisso da qualidade de vida dos doentes e seus familiares. Apesar de ser a segunda causa mais frequente de demência neurodegenerativa, o diagnóstico mantém-se um desafio, devido à sua apresentação clínica heterogénea, sobretudo nas fases iniciais da doença. Por conseguinte, a demência com corpos de Lewy é frequentemente mal diagnosticada e clinicamente gerida de forma insuficiente. A falta de acuidade diagnóstica tem implicações significativas para os doentes, dada a maior suscetibilidade aos efeitos adversos de determinados fármacos, tais como os antipsicóticos, que podem agravar alguns sintomas associados à demência com corpos de Lewy. Por conseguinte, um consenso de especialistas, baseado na análise da literatura mais atual e relevante, e na experiência clínica, é útil para todos os profissionais envolvidos no cuidado destes doentes. O objetivo deste trabalho é informar e gerar recomendações acerca das melhores abordagens diagnóstica e terapêutica da demência com corpos de Lewy em Portugal. Além disso, sugerimos estratégias para aumentar a sensibilização dos médicos, dos decisores políticos e da sociedade em geral em relação a esta doença.Este trabalho foi parcialmente financiado pela GE Healthcare Espanha para apoio à logística da realização da reunião de consenso e para apoio de medical writing no âmbito da preparação deste artigo. A GE Healthcare Espanha não teve qualquer papel no desenho do consenso, recolha, análise e interpretação de literatura, redação do manuscrito, nem na decisão de submeter o artigo para publicação. As opiniões expressas no artigo são da responsabilidade dos autores e não são necessariamente as da GE Healthcare Espanha.info:eu-repo/semantics/publishedVersio