Budget impact analysis of cervical cancer screening in Portugal: comparison of cytology and primary HPV screening strategies

BACKGROUND: Primary Human Papilloma Virus (HPV) testing is the currently recommended cervical cancer (CxCa) screening strategy by the Portuguese Society of Gynecology (SPG) clinical consensus. However, primary HPV testing has not yet been adopted by the Portuguese organized screening programs. This modelling study compares clinical benefits and costs of replacing the current practice, namely cytology with ASCUS HPV triage, with 2 comparative strategies: 1) HPV (pooled) test with cytology triage, or 2) HPV test with 16/18 genotyping and cytology triage, in organized CxCa screenings in Portugal. METHODS: A budget impact model compares screening performance, clinical outcomes and budget impact of the 3 screening strategies. A hypothetical cohort of 2,078,039 Portuguese women aged 25-64 years old women is followed for two screening cycles. Screening intervals are 3 years for cytology and 5 years for the HPV strategies. Model inputs include epidemiological, test performance and medical cost data. Clinical impacts are assessed with the numbers of CIN2-3 and CxCa detected. Annual costs, budget impact and cost of detecting one CIN2+ were calculated from a public healthcare payer's perspective. RESULTS: HPV testing with HPV16/18 genotyping and cytology triage (comparator 2) shows the best clinical outcomes at the same cost as comparator 1 and is the most cost-effective CxCa screening strategy in the Portuguese context. Compared to screening with cytology, it would reduce annual CxCa incidence from 9.3 to 5.3 per 100,000, and CxCa mortality from 2.7 to 1.1 per 100,000. Further, it generates substantial cost savings by reducing the annual costs by €9.16 million (- 24%). The cost of detecting CIN2+ decreases from the current €15,845 to €12,795. On the other hand, HPV (pooled) test with cytology triage (comparator 1) reduces annual incidence of CxCa to 6.9 per 100,000 and CxCa mortality to 1.6 per 100,000, with a cost of €13,227 per CIN2+ detected with annual savings of €9.36 million (- 24%). The savings are mainly caused by increasing the length of routine screening intervals from three to five years. CONCLUSION: The results support current clinical recommendations to replace cytology with HPV with 16/18 genotyping with cytology triage as screening algorithm.info:eu-repo/semantics/publishedVersio

Structural and functional stabilization of glycomacropeptide via encapsulation within multiple emulsions

Bovine glycomacropeptide (GMP), derived from whey proteins, has been demonstrated to possess an interesting bioactivity that has attracted a lot of attention over the last few years. In particular, its ability to bind Vibrio cholerae and Escherichia coli enterotoxins, inhibit bacterial and viral adhesion, suppress gastric secretions, promote bifidobacterial growth and modulate immune system responses. Of these, protection against toxins, bacteria and viruses, and modulation of the immune system, are the most promising applications for this bioactive dairy macropeptide. The development of strategies that may allow its structural and functional stabilization via nanoencapsulation within multiple emulsions may increase its food and biopharmaceutical applicabilities. In this research effort, bovine GMP was (thermodynamically) stabilized via entrapment within water-in-oil-in-water (W/O/W) multiple emulsions aiming at mimicking the multifunctional design of biology, with several lipid matrices, and stabilizing layer compositions. Due to their compartimentalized internal structure, multiple emulsions are ideal for encapsulation since they can carry both polar and non-polar (bio)molecules. The composition of the stabilizing layer of the nanosystem was changed by using different poloxamers and proportions of lecithin. Physicochemical characterization of the optimized GMP-encasing nanovesicle formulations encompassed determination of Zeta potential and particle hydrodynamic size over storage time, surface morphology via CRYO-SEM, and microcalorimetric analysis via DSC

The knowledge domain of affective computing: a scientometric review

Purpose – The aim of this study is to investigate the bibliographical information about Affective Computing identifying advances, trends, major papers, connections, and areas of research. Design/methodology/approach – A scientometric analysis was applied using CiteSpace, of 5,078 references about Affective Computing imported from the Web-of-Science Core Collection, covering the period of 1991-2016. Findings – The most cited, creative, burts and central references are displayed by areas of research, using metrics and througout-time visualization. Research limitations/implications – Interpretation is limited to references retrieved from theWeb-of-Science Core Collection in the fields of management, psychology and marketing. Nevertheless, the richness of bibliographical data obtained, largely compensates this limitation. Practical implications – The study provides managers with a sound body of knowledge on Affective Computing, with which they can capture general public emotion in respect of their products and services, and on which they can base their marketing intelligence gathering, and strategic planning. Originality/value – The paper provides new opportunities for companies to enhance their capabilities in terms of customer relationships.info:eu-repo/semantics/acceptedVersio

Continuous dynamic monitoring of bridges: different perspectives of application

This paper makes a brief characterisation of some aspects related with the extensive research activity of the Laboratory of Vibrations and Structural Monitoring (ViBest) of the Faculty of Engineering of the University of Porto (FEUP) in the field of Continuous Dynamic Monitoring of Bridges and Special Structures, selecting four examples where large high quality databases have been created since 2007, namely Infante D. Henrique bridge, Pedro e Ines footbride, FEUP Campus stress-ribbon footbridge and Trezoi railway bridge

Controlling parenting and executive functioning in children born preterm

This study investigated the relations between mothers’ and fathers’ controlling behaviors and the executive functioning of children born preterm. Sixty-eight preterm children and their parents were assessed when the children were 3 ½ years old. The executive functioning was measured using the Headto-Toes-Task and controlling parenting behaviors were measured through a standardized observation of a parent-child interaction. Hierarchical regression analysis showed that both mothers’ and fathers’ controlling behaviors were associated with worse child executive functioning performance, after controlling for the child’s cognitive ability. Findings suggest that both mothers and fathers play an important role in the development of executive functioning of children born prematurely, highlighting the need to consider both parents in the study of and intervention with these children.info:eu-repo/semantics/publishedVersio