A score methodology to assess concept maps in medical education in the context of pathophysiology teaching

The main objective of pathophysiology teaching is to facilitate the learning of mechanisms of diseases and the understanding of their expressions in patients (symptoms, signs and tests). This objective requires the application of basic biomedical science to explain the abnormalities expressed by the patients. The capacity to integrate this new organization of knowledge is essential to the understanding of pathophysiological mechanisms, which explain expressions of specific diseases. Our group has a longstanding experience in the teaching of pathophysiology to medical students using problem-based learning (PBL) and concept mapping (CM). This semestral discipline has a yearly intake of 190 students, divided into 18 tutorial groups and supported by 14 tutors. The students’ learning progress is evaluated by their performance during the tutorial sessions and the CM methodology has been introduced as an additional tool to visualize the integration of knowledge and how it is displayed in the different pathophysiological mechanisms. Until now, the evaluation of CM has been qualitative and used as an additional assessment tool by the tutors. This study reports how we are changing this approach by training the tutors and developing a scoring methodology, which will be described in detail, together with a preliminary application in selected mapsFonseca, M.; Oliveira, B.; Carreiro-Martins, P.; Neuparth, N.; Rendas, A. (2020). A score methodology to assess concept maps in medical education in the context of pathophysiology teaching. En 6th International Conference on Higher Education Advances (HEAd'20). Editorial Universitat Politècnica de València. (30-05-2020):867-874. https://doi.org/10.4995/HEAd20.2020.11163OCS86787430-05-202

Social and civic benefits of higher education

The main objective of this study is to explore the impact that the successful completion of a course will have in the early years of adulthood in Portugal, in particular, in the civic and political participation, as well as in the respect for social values and norms, among others issues. A longitudinal methodology was applied in order to follow up students from the first years of primary school until the last years of the twenties, coinciding with the period of the Bologna Process. The sample was composed of 893 subjects, 445 of the 2nd grade and 448 of the 4th grade. Subsequently, the participants were divided into two groups (those who have completed a degree and those who did not) that were compared on several measures relating to the areas in question. Data were collected using a battery of instruments, including structured interviews and several instruments in order to evaluate: civic participation, community involvement, social development and adherence to norms and social values. We found significant differences with advantage to those that have concluded courses in the following aspects: community involvement and the importance given to community involvment. These scores include the level and the importance given to civic participation. The results confirm the existence of an effect, as reported in other countries, from higher education in the civic and political involvement of young adults, which is felt several years after finishing studies. An inference that can be drawn is that we should put more emphasis on education (formal or informal) directed to promote a school environment conducive to the development of skills, values, attitudes and behaviors that contribute to increasing the civic and political participation of students

A Consistência das Memórias da Infância

Retrospective self-reports are a common procedure in psychology. The aim of the present study was to analyze, in a large sample of not institutionalized young adults, the consistency of their reports on several childhood experiences (victimization, fears, learning difficulties), by contrasting them with concurrent reports provided by their parents and/or teachers. Results showed a significant relationship between participants` retrospective self-reports and concurrent information provided by other sources, with the exception of childhood fears. The size of that relationship varied between poor and average. Accordingly, it is recommended that studies using retrospective self-reports provide a measure of the relationship betweenreports, as well as a size measure, so that the quality of inferences based on these reports could be more easily evaluated.A coleta de relatos retrospetivos constitui um procedimento frequente em psicologia. Neste estudo, analisou-se, em uma amostra de adultos jovens não institucionalizados, a consistência desses relatos sobre diversas experiências da infância (vitimação, medos, dificuldades de aprendizagem), confrontando-os com os relatos atuais dos seus pais e/ou professores. Os resultados mostraram uma relação significativa entre os relatos retrospetivos dos próprios participantes e as informações atuais fornecidas pelas outras fontes, exceto para os medos na infância. A magnitude dessa relação variou entre pequena e média. Com base nesses resultados, sugere-se que, nos estudos que recorram a relatos retrospetivos e atuais,indiquem-se medidas de relação entre relatos, bem como a sua magnitude, de modo a melhor se avaliar a qualidade das inferências baseadas nesses relatos. Palavras-chave: memórias da infância, memória autobiográfica, consistência de recordações, auto-relat

Classification of chronic venous disorders using an ensemble optimization of convolutional neural networks

Chronic Venous Disorders (CVD) of lower limbs are one of the most prevalent medical conditions, affecting 35% of adults in Europe and North America. The early diagnosis of CVD is critical, however, the diagnosis relies on a visual recognition of the various venous disorders which is time- consuming and dependent on the physician's expertise. Thus, automatic strategies for the classification of the CVD severity are claimed. This paper proposed an automatic ensemble-based strategy of Deep Convolutional Neural Networks (DCNN) for the classification of CVDs severity from medical images. First, a clinical dataset containing 1376 images of patients' legs with CVD of 5 different levels of severity was constructed. Then, the constructed dataset was randomly split into training, testing, and validation datasets. Subsequently, a set of DCNN were individually applied to the images for classification. Finally, instead of a traditional voting ensemble strategy, extracted feature vectors from each DCNN were concatenated and fed into a new ensemble optimization network. Experiments showed that the proposed strategy achieved a classification with 93.8%, 93.4%, 92.4% of accuracy, precision, and recall, respectively. Moreover, compared to the traditional ensemble strategy, improvement in the accuracy of ~2% was registered. The proposed strategy showed to be accurate and robust for the diagnosis of CVD severity from medical images. Nevertheless, further research using an extensive clinical database is required to validate the potential of this strategy.The authors acknowledge Fundação para a Ciência e a Tecnologia (FCT), Portugal and the European Social Found, European Union, for funding support through the “Programa Operacional Capital Humano” (POCH) in the scope of the PhD grants SFRH/BD/136721/2018 (B. Oliveira) and SFRH/BD/136670/2018 (H. Torres). Moreover, authors gratefully acknowledge the funding of the projects "NORTE-01-0145-FEDER000045” and "NORTE-01-0145-FEDER-000059", supported by Northern Portugal Regional Operational Programme (NORTE 2020), under the Portugal 2020 Partnership Agreement, through the European Regional Development Fund (FEDER). It was also funded by national funds, through the FCT and FCT/MCTES in the scope of the project LASI-LA/P/0104/2020, UIDB/00319/2020, UIDB/05549/2020 and UIDP/05549/2020

Carbon Nanotubes – Interactions with Biological Systems

his book chapter discusses the prospective biomedical applications of carbon nanotubes based materials, the impact of carbon nanotubes properties in the interaction with biological systems. Protein adsorption, impact on cell viability and cytokine production are explored. Potential respiratory and dermal toxicity are reviewed, as the difficulties on studying the biological response. In face of recent studies, special attention is drawn upon promising orthopaedic use

Stress no trabalho e indicadores fisiológicos: um estudo com wearable sensors

A saúde ocupacional tem sido uma preocupação crescente, podendo ser monitorizada através de dispositivos tecnológicos que longitudinalmente recolhem dados de bem-estar psicológico e de indicadores fisiológicos. Pretende-se investigar a relação entre perceção de stress, ritmo cardíaco, horas de sono e número de passos no trabalho, numa amostra de profissionais de empresas de tecnologia e área financeira. Em 3 empresas do distrito de Braga, 40 profissionais durante um mês avaliaram no final de cada dia de trabalho a perceção de stress e de motivação, e através da pulseira Xiaomi Miband3® as horas de sono leve/profundo, ritmo cardíaco e nº de passos. Semanalmente, avaliaram a qualidade do sono, perceção de stress (PSS) e fontes de stress específicas da empresa (total de 804 registos). Encontraram-se diariamente moderada motivação, stress e cansaço emocional/físico/cognitivo. A média do nº de passos foi de 4954, de sono profundo 118 e de sono leve 305 minutos. Semanalmente, a perceção de stress e a qualidade/quantidade de sono foram moderadas. As fontes de stress específicas mais referidas foram os prazos, volume/multiplicidade de tarefas, reuniões e falta de autonomia/recursos. O sono profundo correlaciona-se positivamente com mais cansaço emocional/cognitivo diários e com qualidade/tempo de sono semanal. São necessários mais estudos de saúde ocupacional longitudinais que rentabilizem as vantagens de novas tecnologias na avaliação do bem-estar psicológico/fisiológico dos trabalhadores.info:eu-repo/semantics/publishedVersio

Linfoma primário bilateral da suprarrenal

ResumoOs linfomas não Hodgkin extranodais atingem o sistema endócrino em apenas 3% dos casos. A tiroide é o órgão mais frequentemente atingido, sendo a glândula suprarrenal raramente afetada.Descreve‐se o caso de uma doente de 88 anos, referindo, com um mês de evolução, quadro de náuseas, vómitos, letargia, perda de peso e febre. Como antecedentes pessoais, a salientar, HTA, asma e glaucoma. À observação: hipotensão, ausência de adenopatias ou massas abdominais palpáveis. Laboratorialmente: hemoglobina 8,8g/dL (12‐15), glicemia 106mg/dL (70‐110), sódio 125nmol/L (136‐145), potássio 3,5nmol/L (3,5‐5,1) e proteína C reativa 15mg/dL (<0,5). Da restante avaliação: ACTH 49,8pg/mL (<46), cortisol sérico 10,9μg/dL (5‐25), aldosterona plasmática <1,1ng/dL (1‐16), SDHEA <15μg/dL (35‐430), testosterona total <20ng/dL (<43), cromogranina A 5,5nmol/L (<4,0), cortisol urinário 8,7μg/24h (20‐90) e metanefrinas urinárias 13μg/24h (<350). A TC abdominal mostrou aumento bilateral das suprarrenais, a esquerda com 11cm e a direita com 8cm de maior diâmetro. A insuficiência primária da suprarrenal foi confirmada pela prova de estimulação com tetracosactídeo (ACTH sintético 250mcg). A doente iniciou terapêutica com hidrocortisona 20mg/dia. As TC torácica e pélvica não mostraram linfadenopatias. Procedeu‐se a biópsia da suprarrenal direita guiada por TC e a histologia revelou um linfoma não Hodgkin B difuso de grandes células. A doente desencadeou quadro de insuficiência respiratória e derrame pleural à esquerda, tendo sido efetuada drenagem cujo líquido não revelou atipias. Faleceu por pneumonia nosocomial, antes do início da quimioterapia.Em 70% dos casos de linfoma primário das suprarrenais ocorre atingimento bilateral. A primeira manifestação pode ser insuficiência suprarrenal. Dado o mau prognóstico desta patologia, é fundamental a suspeição clínica para um diagnóstico atempado.AbstractThe endocrine system's involvement in extra nodal non‐Hodgkin lymphomas occurs only in 3% of the cases. Thyroid gland is the organ most commonly affected, while adrenal gland is rarely affected.We report a case of an 88 years old woman presenting with a history of nausea, vomiting, lethargy, weight loss and fever a month long. There was a past history of arterial hypertension, asthma and glaucoma. Physical exam at admission showed hypotension, normoglycemia and no evidence of palpable lymphadenopathy or abdomen mass. Laboratory workout revealed hemoglobin 8,8g/dL (12 ‐ 15), sodium 125nmol/L (136 ‐ 145) and c reactive protein 15mg/dL (normal range <0,5). Abdominal CT scan disclosed bilateral adrenal enlargement, the left gland with 11cm and the right with 8cm of greatest diameter. At biochemistry analysis ACTH 49,8pg/mL (<46), serum cortisol 10,9μg/dL (5 ‐ 25), plasma aldosterone <1,1ng/dL (1 ‐16), DHEA‐S <15μg/dL (35 – 430), total testosterone <20 ng/dL (<43), chromogranin 5,5nmol/L (<4,0), urine cortisol 8,7μg/24‐hours (20 – 90) and urine metanephrines 13μg/24‐hours (<350). Primary adrenal failure was confirmed with a high‐dose ACTH stimulation test and 20mg/day of hydrocortisone was administered to maintain adrenal function. Thoracic and pelvic CT scan showed no evidence of lymphadenopathies. CT guided needle biopsy of right gland was performed, and histology revealed a non‐Hodgkin diffuse large B‐cell lymphoma. A left pleural effusion was drained and there were no atypical lymphocytes. Patient died of nosocomial pneumonia before chemotherapy was started.In 70% of the cases of primary non‐Hodgkin adrenal lymphoma both glands are affected. First clinical manifestation might be adrenal failure. This disease had a poor prognosis. High degree of suspicion is needed in order to obtain an accurate and fast diagnosis

Characterization of the workspace and limits of operation of laser treatments for vascular lesions of the lower limbs

The increase of the aging population brings numerous challenges to health and aesthetic segments. Here, the use of laser therapy for dermatology is expected to increase since it allows for non-invasive and infection-free treatments. However, existing laser devices require doctors’ manually handling and visually inspecting the skin. As such, the treatment outcome is dependent on the user’s expertise, which frequently results in ineffective treatments and side effects. This study aims to determine the workspace and limits of operation of laser treatments for vascular lesions of the lower limbs. The results of this study can be used to develop a robotic-guided technology to help address the aforementioned problems. Specifically, workspace and limits of operation were studied in eight vascular laser treatments. For it, an electromagnetic tracking system was used to collect the real-time positioning of the laser during the treatments. The computed average workspace length, height, and width were 0.84 ± 0.15, 0.41 ± 0.06, and 0.78 ± 0.16 m, respectively. This corresponds to an average volume of treatment of 0.277 ± 0.093 m3. The average treatment time was 23.2 ± 10.2 min, with an average laser orientation of 40.6 ± 5.6 degrees. Additionally, the average velocities of 0.124 ± 0.103 m/s and 31.5 + 25.4 deg/s were measured. This knowledge characterizes the vascular laser treatment workspace and limits of operation, which may ease the understanding for future robotic system development.The authors acknowledge Fundação para a Ciência e a Tecnologia (FCT), Portugal and the European Social Fund, European Union, for funding support through [the “Programa Operacional Capital Humano” (POCH) in the scope of the PhD], grants number [SFRH/BD/136721/2018 (B. Oliveira) and SFRH/BD/136670/2018 (H. Torres)]. Moreover, authors gratefully acknowledge the funding of the projects “NORTE-01-0145-FEDER-000045” and “NORTE-01-0145-FEDER-000059”, supported by [Northern Portugal Regional Operational Programme (NORTE 2020), under the Portugal 2020 Partnership Agreement, through the European Regional Development Fund (FEDER)]. It was also funded by [national funds, through the FCT and FCT/MCTES in the scope of the projects UIDB/05549/2020, UIDP/05549/2020, and LASI-LA/P/0104/2020]