Person-centered practice in the Portuguese Healthcare Services: a scoping review protocol

Recognizing the importance of the international advancements on person-centered practice (PCP) with positive implementation outcomes at the varied levels of healthcare systems, this scoping review will examine the PCP in Portuguese healthcare services. The Joanna Briggs Institute (JBI) guidance for scoping reviews will be followed. The Population (P) Concept (C) Context (C) mnemonic will scaffold research questions, the inclusion and exclusion criteria, and the searching strategy. Literature reporting on person-centeredness domains at the macro-, meso-, and micro levels applied to Portuguese healthcare services in Portuguese and English will be considered for inclusion. Accordingly, MEDLINE, CINAHL, SCOPUS, LILACS, SCIELO, Open Access Scientific Repository of Portugal (RCAAP), and Open gray will be searched. The literature will be screened for eligibility by two independent reviewers, first by title and abstract and subsequently by full text. A data extraction matrix designed to answer the research questions will be used for the included literature. The charted data will be thematically analyzed and presented graphically, with a narrative description of the literature characteristics. The results are expected to inform healthcare stakeholders at varying levels about the PCP domains where further improvements might be required in order to raise the quality of care to the international gold standards.info:eu-repo/semantics/publishedVersio

Hipotiroxinemia em recém-nascidos pré-termo

Introdução: A hipotiroxinemia é a disfunção tiroideia mais frequente em recém-nascidos prematuros e foi implicada em défices do neurodesenvolvimento e aumento da morbimortalidade perinatal. Pode ser definida por níveis sanguíneos de tiroxina total (T4T) dois desvios-padrão (DP) abaixo da média, ou abaixo de um limiar de 6 μg/dL, com tirotropina (TSH) normal ou baixa. Objectivos: Determinar a prevalência da hipotiroxinemia e correlacioná-la com a morbilidade neonatal durante as primeiras semanas de vida. Métodos: Estudo retrospectivo que incluiu os neonatos consecutivos com peso de nascimento ≤ 1500 g e/ou idade gestacional ≤ 30 semanas, de Janeiro de 2006 a Setembro de 2007. Foram excluídos os nados em outras instituições ou falecidos antes dos três dias de vida. Foram analisados os processos clínicos. O rastreio metabólico (incluindo TSH e T4T) foi efectuado ao 3º e ao 15º dia de vida. Resultados: Foram incluídos 38 recém-nascidos (idade gestacional: 28 ± 2,3 semanas, peso ao nascimento: 1133 ± 254 gramas). Os valores de T4T (no 3º dia) foram de 5,53 ± 3,17 μg/dL e correlacionaram-se positivamente com a idade gestacional e peso. Não se encontrou correlação com a TSH. No 3º dia de vida, 60,5% dos recém-nascidos apresentaram T4T <6 μg/dL, com TSH normal ou baixa. Em relação ao resto da amostra, os prematuros com valores mais baixos de T4T evidenciaram diferenças significativas quanto a períodos de internamento mais longos, ventilação durante mais tempo e mais alterações na ecografia transfontanelar. Conclusões: Encontrou-se elevada prevalência de hipotiroxinemia em prematuros e associação com pior prognóstico neonatal. Assim, impõe-se a necessidade de estudos mais alargados e da avaliação sistemática da função tiroideia, por exemplo pela repetição do rastreio às duas semanas de vida.Background. Hypothyroxinemia is the most common thyroid dysfunction in preterm babies and it has been linked to neuro - developmental deficits and increased perinatal mortality and morbidity. It can be defined as blood total thyroxine (TT4) levels below two standard deviations (SD) under the mean, or under a cut-off value of 6 μg/dL, with normal or low thyro - tropin (TSH). Aims. Assess the prevalence of hypothyroxinemia and correlate it to neonatal morbidity during first weeks of life. Methods. Retrospective study including consecutive neonates with birth weight ≤ 1500 g and/or gestational age ≤ 30 weeks, between January 2006 and September 2007. We excluded those born in other institutions or deceased before 3 days of life. Clinical data recorded were analysed. Metabolic screening (including TSH and TT4) was performed at day three and day fifteen. Results. Were enrolled 38 newborns (gestational age: 28 ± 2.3 weeks, birth weight: 1133 ± 254 grams). TT4 levels (on day 3) were 5.53 ± 3.17 μg/dL. TT4 correlated positively with gestational age and birth weight but not TSH. TT4 levels < 6 μg/dL, with normal or low TSH, were found in 60.5% of the babies in day three. Comparing with the others, preterm infants with lower levels of TT4, had significantly longer periods of hospitalization, more days in ventilation and more cerebral US scan abnormalities. Conclusions. We found high prevalence of hypothyroxinemia of prematurity and association with bad neonatal prognosis. So a sufficiently powered study is required and also routine assessment of preterm thyroid function, for example by the recall of a second screening at two weeks of life

Avaliação da maturação de composto orgânico produzido com lixo orgânico urbano nos municípios de Barcarena e Moju, PA.

bitstream/item/27722/1/com.tec.104.pd

Efeito de composto orgânico em diferentes estádios de maturação na produção de matéria seca de milho.

bitstream/item/27948/1/com.tec.106.pd

Hemin availability induces coordinated DNA methylation and gene expression changes in Porphyromonas gingivalis.

Periodontal disease is a chronic inflammatory disease in which the oral pathogen Porphyromonas gingivalis plays an important role. Porphyromonas gingivalis expresses virulence determinants in response to higher hemin concentrations, but the underlying regulatory processes remain unclear. Bacterial DNA methylation has the potential to fulfil this mechanistic role. We characterized the methylome of P. gingivalis, and compared its variation to transcriptome changes in response to hemin availability. Porphyromonas gingivalis W50 was grown in chemostat continuous culture with excess or limited hemin, prior to whole-methylome and transcriptome profiling using Nanopore and Illumina RNA-Seq. DNA methylation was quantified for Dam/Dcm motifs and all-context N6-methyladenine (6mA) and 5-methylcytosine (5mC). Of all 1,992 genes analyzed, 161 and 268 were respectively over- and under-expressed with excess hemin. Notably, we detected differential DNA methylation signatures for the Dam "GATC" motif and both all-context 6mA and 5mC in response to hemin availability. Joint analyses identified a subset of coordinated changes in gene expression, 6mA, and 5mC methylation that target genes involved in lactate utilization and ABC transporters. The results identify altered methylation and expression responses to hemin availability in P. gingivalis, with insights into mechanisms regulating its virulence in periodontal disease. IMPORTANCE DNA methylation has important roles in bacteria, including in the regulation of transcription. Porphyromonas gingivalis, an oral pathogen in periodontitis, exhibits well-established gene expression changes in response to hemin availability. However, the regulatory processes underlying these effects remain unknown. We profiled the novel P. gingivalis epigenome, and assessed epigenetic and transcriptome variation under limited and excess hemin conditions. As expected, multiple gene expression changes were detected in response to limited and excess hemin that reflect health and disease, respectively. Notably, we also detected differential DNA methylation signatures for the Dam "GATC" motif and both all-context 6mA and 5mC in response to hemin. Joint analyses identified coordinated changes in gene expression, 6mA, and 5mC methylation that target genes involved in lactate utilization and ABC transporters. The results identify novel regulatory processes underlying the mechanism of hemin regulated gene expression in P. gingivalis, with phenotypic impacts on its virulence in periodontal disease

Host genetic and environmental factors shape the human gut resistome

BACKGROUND: Understanding and controlling the spread of antimicrobial resistance is one of the greatest challenges of modern medicine. To this end many efforts focus on characterising the human resistome or the set of antibiotic resistance determinants within the microbiome of an individual. Aside from antibiotic use, other host environmental and genetic factors that may shape the resistome remain relatively underexplored. METHODS: Using gut metagenome data from 250 TwinsUK female twins, we quantified known antibiotic resistance genes to estimate gut microbiome antibiotic resistance potential for 41 types of antibiotics and resistance mechanisms. Using heritability modelling, we assessed the influence of host genetic and environmental factors on the gut resistome. We then explored links between gut resistome, host health and specific environmental exposures using linear mixed effect models adjusted for age, BMI, alpha diversity and family structure. RESULTS: We considered gut microbiome antibiotic resistance to 21 classes of antibiotics, for which resistance genes were detected in over 90% of our population sample. Using twin modelling, we estimated that on average about 25% of resistome variability could be attributed to host genetic influences. Greatest heritability estimates were observed for resistance potential to acriflavine (70%), dalfopristin (51%), clindamycin (48%), aminocoumarin (48%) and the total score summing across all antibiotic resistance genes (38%). As expected, the majority of resistome variability was attributed to host environmental factors specific to an individual. We compared antibiotic resistance profiles to multiple environmental exposures, lifestyle and health factors. The strongest associations were observed with alcohol and vegetable consumption, followed by high cholesterol medication and antibiotic usage. Overall, inter-individual variation in host environment showed modest associations with antibiotic resistance profiles, and host health status had relatively minor signals. CONCLUSION: Our results identify host genetic and environmental influences on the human gut resistome. The findings improve our knowledge of human factors that influence the spread of antibiotic resistance genes and may contribute towards helping to attenuate it

Modest effects of dietary supplements during the COVID-19 pandemic: Insights from 445 850 users of the COVID-19 Symptom Study app

OBJECTIVE: Dietary supplements may ameliorate SARS-CoV-2 infection, although scientific evidence to support such a role is lacking. We investigated whether users of the COVID-19 Symptom Study app who regularly took dietary supplements were less likely to test positive for SARS-CoV-2 infection. DESIGN: App-based community survey. SETTING: 445 850 subscribers of an app that was launched to enable self-reported information related to SARS-CoV-2 infection for use in the general population in the UK (n=372 720), the USA (n=45 757) and Sweden (n=27 373). MAIN EXPOSURE: Self-reported regular dietary supplement usage (constant use during previous 3 months) in the first waves of the pandemic up to 31 July 2020. MAIN OUTCOMES MEASURES: SARS-CoV-2 infection confirmed by viral RNA reverse transcriptase PCR test or serology test before 31 July 2020. RESULTS: In 372 720 UK participants (175 652 supplement users and 197 068 non-users), those taking probiotics, omega-3 fatty acids, multivitamins or vitamin D had a lower risk of SARS-CoV-2 infection by 14% (95% CI (8% to 19%)), 12% (95% CI (8% to 16%)), 13% (95% CI (10% to 16%)) and 9% (95% CI (6% to 12%)), respectively, after adjusting for potential confounders. No effect was observed for those taking vitamin C, zinc or garlic supplements. On stratification by sex, age and body mass index (BMI), the protective associations in individuals taking probiotics, omega-3 fatty acids, multivitamins and vitamin D were observed in females across all ages and BMI groups, but were not seen in men. The same overall pattern of association was observed in both the US and Swedish cohorts. CONCLUSION: In women, we observed a modest but significant association between use of probiotics, omega-3 fatty acid, multivitamin or vitamin D supplements and lower risk of testing positive for SARS-CoV-2. We found no clear benefits for men nor any effect of vitamin C, garlic or zinc. Randomised controlled trials are required to confirm these observational findings before any therapeutic recommendations can be made