Limitations and perceived delays for diagnosis and staging of lung cancer in Portugal: A nationwide survey analysis

Background We aimed to identify the perception of physicians on the limitations and delays for diagnosing, staging and treatment of lung cancer in Portugal. Methods Portuguese physicians were invited to participate an electronic survey (Feb-Apr-2020). Descriptive statistical analyses were performed, with categorical variables reported as absolute and relative frequencies, and continuous variables with non-normal distribution as median and interquartile range (IQR). The association between categorical variables was assessed through Pearson’s chi-square test. Mann-Whitney test was used to compare categorical and continuous variables (Stata v.15.0). Results Sixty-one physicians participated in the study (45 pulmonologists, 16 oncologists), with n = 26 exclusively assisting lung cancer patients. Most experts work in public hospitals (90.16%) in Lisbon (36.07%). During the last semester of 2019, responders performed a median of 85 (IQR 55–140) diagnoses of lung cancer. Factors preventing faster referral to the specialty included poor articulation between services (60.0%) and patients low economic/cultural level (44.26%). Obtaining National Drugs Authority authorization was one of the main reasons (75.41%) for delaying the begin of treatment. The cumulative lag-time from patients’ admission until treatment ranged from 42–61 days. Experts believe that the time to diagnosis could be optimized in around 11.05 days [IQR 9.61–12.50]. Most physicians (88.52%) started treatment before biomarkers results motivated by performance status deterioration (65.57%) or high tumor burden (52.46%). Clinicians exclusively assisting lung cancer cases reported fewer delays for obtaining authorization for biomarkers analysis (p = 0.023). Higher waiting times for surgery (p = 0.001), radiotherapy (p = 0.004), immunotherapy (p = 0.003) were reported by professionals from public hospitals. Conclusions Physicians believe that is possible to reduce delays in all stages of lung cancer diagnosis with further efforts from multidisciplinary teams and hospital administration.This work was supported by AstraZeneca. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript

A Data-mining-based Methodology to support MV Electricity Customers' Characterization

This paper presents an electricity medium voltage (MV) customer characterization framework supportedby knowledge discovery in database (KDD). The main idea is to identify typical load profiles (TLP) of MVconsumers and to develop a rule set for the automatic classification of new consumers. To achieve ourgoal a methodology is proposed consisting of several steps: data pre-processing; application of severalclustering algorithms to segment the daily load profiles; selection of the best partition, corresponding tothe best consumers’ segmentation, based on the assessments of several clustering validity indices; andfinally, a classification model is built based on the resulting clusters. To validate the proposed framework,a case study which includes a real database of MV consumers is performed

Populational analysis of Saccharomyces cerevisiae strains from different appellations of origin and grape varieties by microsatellite analysis.

The objective of the present study was to evaluate populational relationships among Saccharomyces cerevisiae strains isolated from some of the Portuguese most important grapevine varieties in different appellations of origin, using polymorphic microsatellites. 
One hundred ninety two grape samples were collected during the 2006 and 2007 harvest season in the Vinho Verde (grape varieties: Arinto, Alvarinho, Avesso, Loureiro, Touriga Nacional) Bairrada (grape varieties: Arinto, Baga, Castelão Francês, Maria Gomes, Touriga Nacional) Alentejo (grape varieties, Aragonês, Trincadeira, Touriga Nacional), Terras do Sado (grape variety Castelão) Bucelas (grape variety Arinto) and Estremadura (grape varieties: Arinto, Aragonês, Castelão, Trincadeira, Touriga Nacional) appellations of origin. From the final stage of spontaneous fermentations, 2820 yeast isolates were obtained, mainly belonging to the species S. cerevisiae. An initial genetic screen, based on mitochondrial DNA restriction fragment length polymorphism (mtDNA RFLP) and/or interdelta sequence analysis was followed by microsatellite analysis of strains with unique genetic profiles, using 10 highly polymorphic microsatellites. Our results showed that microsatellite analysis revealed a high resolution populational screen, showing that genetic differences and populational structures among S. cerevisiae populations derived from both “diagnostic” vineyard-, specific alleles and the accumulation of small allele-frequency differences across ten microsatellite loci. Heterozygosity was three to four times lower than the expected value, confirming the strong populational substructuring. The presented large-scale approach shows that each vineyard contains differentiated S. cerevisiae populations, showing the occurrence of specific native strains that can be associated with a terroir. 

Financially supported by the programs POCI 2010 (FEDER/FCT, POCTI/AGR/56102/2004) and AGRO (ENOSAFE, Nº 762).
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Microsatellite analysis reveals populational structures of saccharomyces cerevisiae strains from different appellations of origin and grape varieties

The objective of the present study was to evaluate populational relationships among Saccharomyces cerevisiae strains isolated from some of the Portuguese most important grapevine varieties in different appellations of origin, using polymorphic microsatellites. One hundred ninety two grape samples were collected during the 2006 and 2007 harvest season in the Vinho Verde (grape varieties: Arinto, Alvarinho, Avesso, Loureiro, Touriga Nacional) Bairrada (grape varieties: Arinto, Baga, Castelão Francês, Maria Gomes, Touriga Nacional) Alentejo (grape varieties, Aragonês, Trincadeira, Touriga Nacional), Terras do Sado (grape variety Castelão) Bucelas (grape variety Arinto) and Estremadura (grape varieties: Arinto, Aragonês, Castelão, Trincadeira, Touriga Nacional) appellations of origin. From the final stage of spontaneous fermentations, 2820 yeast isolates were obtained, mainly belonging to the species S. cerevisiae. An initial genetic screen, based on mitochondrial DNA restriction fragment length polymorphism (mtDNA RFLP) and/or interdelta sequence analysis was followed by microsatellite analysis of strains with unique genetic profiles, using 10 highly polymorphic microsatellites. Our results showed that microsatellite analysis revealed a high resolution populational screen, showing that genetic differences and populational structures among S. cerevisiae populations derived from both “diagnostic” vineyard-, specific alleles and the accumulation of small allele-frequency differences across ten microsatellite loci. Heterozygosity was three to four times lower than the expected value, confirming the strong populational substructuring. The presented large-scale approach shows that each vineyard contains differentiated S. cerevisiae populations, showing the occurrence of specific native strains that can be associated with a terroirFinancially supported by the programs POCI 2010 (FEDER/FCT, POCTI/AGR/56102/2004

Experience and Learning from the COVID-19 Pandemic in Portugal: Perceptions of Community Pharmacy Professionals

Background: During the COVID-19 pandemic, community pharmacy (CP) professionals were among those who experienced the greatest risk of contracting SARS-CoV-2, which forced major adaptations. Objectives: The objectives of the study were to describe the changes implemented in CP professionals during the pandemic, understand the perception of professionals about their experience, and explore changes to remain. Methods: An observational and cross-sectional study was conducted via an online questionnaire (June-September 2020). The target population was CP professionals working in Portugal for >2 years and serving the public during the pandemic. Results: Of a total of 353 participants, 84% were female (mean age of 37.6 years), and 81% were pharmacists (mean professional experience of 12.9 years). In the management and organizational dimensions, the most mentioned changes were adaptation to legislative changes (90%), fluctuations in the treasury (82%), and reduction of working hours (46%). Only 2% resorted to simplified layoff. In the back office, there was a need to adapt stock management (93%) and purchase personal protective equipment (99%). In the front office, there was a change in service policies - wicket or conditional opening (92%), routes of the arrival of user requests (91%), and home delivery (82%). Physical changes occurred in 100% of pharmacies. The most frequently implemented procedures were the use of protection systems and PPE, articulation with hospital pharmacies for dispensing in proximity (75%), and training in this area (55%). Regarding interpersonal climate, improvements in the connection between team members are evident: increase in mutual help (57%), solidarity (54%), and group cohesion (50%); in the relationship with clients, the majority indicated the replacement of the usual user by third parties (71%), and changes in communication channels (increase in use of technological means 68%). Conclusions: Results illustrate the profound impact of the pandemic on CP professionals, both professionally and personally. It also highlights the importance of their roles in proximity and community support. © 2023 S. Karger AG. All rights reserved.This work was funded by 4IE project (0499_4IE_PLUS_4_E) funded by the Interreg V-A España-Portugal (POCTEP) 2017/2022 ( https://4ie.eu/ )

Portuguese Consensus and Recommendations for Acquired Coagulopathic Bleeding Management (CCBM)

We aimed to determine how Portuguese physicians handle major bleeding. We also aim to establish global diagnostic and therapeutic recommendations to be followed in clinical practice by using a step-wise approach of evidence generation. This study followed a three-step process: a steering committee desk review, a Delphi technique, an expert panel meeting. A modified 3-round Delphi including 31 statements was performed. Questions were answered in a five-point Likert-type scale. Consensus threshold was established as a percentage of agreement among participants >= 90% in the first round, and >= 85% in the second and third rounds. The level of consensus achieved by panelists was discussed with the scientific committee (January-2020). Fifty-one physicians participated in the study (compliance rate >90%). Analyzing the three rounds, consensus was reached on 20 items (64.5%) in the first, 4/11 items (36.4%) in the second and 6/7 items (85.7%) in the third. One statement about administration of clotting factor concentrates for bleeding control did not reach consensus. A high level of consensus was reached toward the need for implementing Patient Blood Management strategies in Portuguese hospitals, reduce exposure to allogeneic blood components, to use goal directed therapies for acquired bleeding management, and the need for evaluating blood transfusion indirect costs. A final version with 12 recommendations was built, according to the Grading of Recommendations Assessment, Development and Evaluation (GRADE). Our results provide critically appraised and updated evidence on bleeding coagulopathies management in Portugal. Additional studies, mainly about indirect costs of blood transfusion, are needed

Entepreneurship Education and Entrepreneurial Intention: the Case of Portugal

Entrepreneurship promotes job creation, increase of competitiveness and new forms of economic development and growth of countries or regions. The research aims to understand how it has influenced the intention and entrepreneurial skills of the trainees of the project Apreender 3.0. It is important to examine how various factors, including entrepreneurship education, family background, prior experience/vocational training and propensity to take the risks, will condition the entrepreneurial intention of the respondents of this study. Based on these variables, we formulated four hypotheses. For this empirical analysis of research hypotheses, we used primary data in a form of a sample of 150 responses, collected through the online survey application. We opted for the method of the Exploratory Factor Analysis (EFA), also called Common Factor Analysis (CFA), which can provide important information on the multivariate structure of this study, identifying the theoretical constructs. The obtained results allowed us to conclude that the entrepreneurship education and propensity to take risks influence positively the entrepreneurial intention. As for the factors of family background and prior experience/ vocational training, the research did not provide satisfactory results that would allow us to confirm their influence on the entrepreneurial intention. © Ramos D., Madeira M. J., Duarte F. A. P. Text. 2020.The article has been prepared with the support of NECE-UBI and National Funds provided by FCT - Foundation for Science and Technology through the project UID/GES/04630/2013

Yeast diversity related with Touriga Nacional Grape variety

The diversity of yeast species related with the grape variety Touriga Nacional was evaluated at four distinct vineyards of three Portuguese wine regions. Samples were collected 48 h after crushing, and when the loss of CO2 reached 70 g/L. Restriction profiles analysis of 26S rDNA region with the endonucleases HaeIII, CfoI, HinfI, ApaI and MseI was used to characterize the five hundred and nine isolates obtained. A total of twenty yeast species were found. As expected higher species diversity was obtained for the initial sampling time. The most representative species was Hanseniaspora uvarum, which was detected in grape must from all the vineyards, followed by Candida zemplinina. Some species like Pichia membranifaciens, Pichia kluyveri var kluyveri, Candida railenensis, Saccharomycopsis vini, Candida diversa, among others, were only detected in grape must from one vineyard. None of the isolates belonged to the species Saccharomyces cerevisiae.Fundação para a Ciência e a Tecnologia (FCT

Optimizing the use of systemic corticosteroids in severe asthma (ROSA II project): a national Delphi consensus study

Although the prevalence of severe asthma is not high (5–10% of patients), it is responsible for a large part of the overall disease burden and costs (50–60% of total costs), especially if the condition remains uncontrolled (which occurs in around 40% of cases). Currently, for patients without disease control or presenting frequent exacerbations despite optimal therapy, add-on treatments, traditionally long-acting anticholinergics, oral corticosteroids (OCS), or biologic agents (monoclonal antibodies) are recommended. Nonetheless, the long-term use of oral/systemic corticosteroids (CS) is significantly associated with adverse effects, acute and chronic complications that may decrease health-related quality of life and worsen prognosis, thus requiring additional monitoring and management. Conversely, target therapies (i.e., omalizumab, mepolizumab, reslizumab, benralizumab, and more recently, dupilumab) have been developed grounded on the different phenotypes and endotypes of severe asthma, and are gradually reducing the reliance on OCS (i.e., greater specificity for achieving disease control by reducing the risk of exacerbations and requirements for rescue medication and OCS, with limited adverse events).This work was supported by AstraZeneca.info:eu-repo/semantics/publishedVersio