Microbiological and Physicochemical Evaluation of Hydroxypropyl Methylcellulose (HPMC) and Propolis Film Coatings for Cheese Preservation.

Dairy products are highly susceptible to contamination from microorganisms. This study aimed to evaluate the efficacy of hydroxypropyl methylcellulose (HPMC) and propolis film as protective coatings for cheese. For this, microbiological analyses were carried out over the cheese' ripening period, focusing on total mesophilic bacteria, yeasts and moulds, lactic acid bacteria, total coliforms, Escherichia coli, and Enterobacteriaceae. Physicochemical parameters (pH, water activity, colour, phenolic compounds content) were also evaluated. The statistical analysis (conducted using ANOVA and PERMANOVA) showed a significant interaction term between the HPMC film and propolis (factor 1) and storage days (factor 2) with regard to the dependent variables: microbiological and physicochemical parameters. A high level of microbial contamination was identified at the baseline. However, the propolis films were able to reduce the microbial count. Physicochemical parameters also varied with storage time, with no significant differences found for propolis-containing films. Overall, the addition of propolis to the film influenced the cheeses' colour and the quantification of phenolic compounds. Regarding phenolic compounds, their loss was verified during storage, and was more pronounced in films with a higher percentage of propolis. The study also showed that, of the three groups of phenolic compounds (hydroxybenzoic acids, hydroxycinnamic acids, and flavonoids), hydroxycinnamic acids showed the most significant losses. Overall, this study reveals the potential of using HPMC/propolis films as a coating for cheese in terms of microbiological control and the preservation of physicochemical properties.

Promoting advanced medical services in the framework of 3PM-a proof-of-concept by the "Centro" Region of Portugal.

Multidisciplinary team from three universities based in the "Centro" Region of Portugal developed diverse approaches as parts of a project dedicated to enhancing and expanding Predictive, Preventive, and Personalized Medicine (3PM) in the Region. In a sense, outcomes acted as a proof-of-concept, in that they demonstrated the feasibility, but also the relevance of the approaches. The accomplishments comprise defining a new regional strategy for implementing 3PM within the Region, training of human resources in genomic sequencing, and generating good practices handbooks dedicated to diagnostic testing via next-generation sequencing, to legal and ethical concerns, and to knowledge transfer and entrepreneurship, aimed at increasing literacy on 3PM approaches. Further approaches also included support for entrepreneurship development and start-ups, and diverse and relevant initiatives aimed at increasing literacy relevant to 3PM. Efforts to enhance literacy encompassed citizens across the board, from patients and high school students to health professionals and health students. This focus on empowerment through literacy involved a variety of initiatives, including the creation of an illustrated book on genomics and the production of two theater plays centered on genetics. Additionally, authors stressed that genomic tools are relevant, but they are not the only resources 3PM is based on. Thus, they defend that other initiatives intended to enable citizens to take 3PM should include multi-omics and, having in mind the socio-economic burden of chronic diseases, suboptimal health status approaches in the 3PM framework should also be considered, in order to anticipate medical intervention in the subclinical phase. Supplementary Information: The online version contains supplementary material available at 10.1007/s13167-024-00353-9.

Prospective Evaluation of the Efficacy of Isolated Balloon Eustachian Tuboplasty: Short- and Medium-term Follow-up Results Based on Tubomanometry, ETDQ-7, Tympanometry, and Valsalva Maneuver.

Introduction Balloon eustachian tuboplasty (BET) allows the treatment of the main etiology of eustachian tube disfunction (ETD). Objective To evaluate the efficacy of isolated BET, through objective and subjective results, in the short and medium term, in patients with chronic obstructive ETD. Methods Adult patients diagnosed with chronic obstructive ETD who underwent BET between January 2018 and December 2020 were enrolled in the study. We performed a prospective observational study of BET efficacy, by comparing subjective data, based on the Eustachian Tube Dysfunction Questionnaire-7 (ETDQ-7), and objective data, obtained by tympanometry, objective Valsalva maneuver and tubomanometry, prior to BET with these outcome tools on postprocedure follow-up. Results In total, 30 BETs were performed and analyzed. There were no complications with the procedure. Analysis of BET efficacy was performed in the short-term (average of 7.5 weeks) and in the medium-term (average of 8 months). There was a significant reduction ( p < 0.0001) in the total ETDQ-7 score from baseline to both follow-up periods. A normalization of the ETDQ-7 score was observed in 60 and 83.3% of the performed procedures, in the short- and medium-term, respectively. In tubomanometry, we verified a significant improvement ( p < 0.0001) at all pressures, with a normalization of tubomanometry values in 53.3% and 43.3% of cases in the short- and medium-term, respectively. Tympanogram normalization occurred in 71.4% of patients with abnormal preoperative assessments. Conclusion As an isolated procedure, BET results in significant improvements in symptomatology and objective metric results. This, associated with its safety profile, currently makes BET the most indicated therapeutic option in refractory obstructive ETD.

Blastic Plasmacytoid Dendritic Cell Neoplasm: A Rare Entity in Clinical Practice.

Blastic plasmacytoid dendritic cell neoplasm (BPDCN) is an exceedingly rare and aggressive hematologic malignancy. In the current World Health Organization classification, it is classified among histiocytic/dendritic cell neoplasms. This report describes the case of an 85-year-old female with a complex medical history, including rheumatoid arthritis, who presented with a one-month history of low-grade fever, anorexia, and unexplained weight loss. The diagnosis of BPDCN was confirmed following an immunophenotyping analysis of a bone marrow aspirate. With this report, the authors intend to shed some light on BPDCN's clinical presentation, diagnostic journey, therapeutic approaches, and patient outcomes, and denote the significance of early detection and interdisciplinary collaboration in enhancing patient care.

Sphenoid Meningoencephalocele Correction Through a Transpterygoid Approach.

Sphenoid meningoencephaloceles are rare, and their treatment is challenging. In this report, we describe two clinical cases of sphenoid meningoencephalocele, in which one patient presented with a cerebrospinal fluid leak after repeated head trauma, while in the other, sphenoid meningoencephalocele was detected during the study of memory impairment as the patient was otherwise asymptomatic. The CT scans showed bony dehiscence on the lateral wall of the sphenoid sinus filled with soft tissue that was confirmed by MRI as being herniated brain tissue. A transpterygoid endoscopic endonasal approach was performed with a multilayer reconstruction of the defect with success in both cases without perioperative complications. Imaging techniques are fundamental for diagnosis and surgical planning. Treatment using an endoscopic endonasal approach is efficient with very low morbidity.

Broken silence: 22,841 predicted deleterious synonymous variants identified in the human exome through computational analysis.

Synonymous single nucleotide variants (sSNVs) do not alter the primary structure of a protein, thus it was previously accepted that they were neutral. Recently, several studies demonstrated their significance to a range of diseases. Still, variant prioritization strategies lack focus on sSNVs. Here, we identified 22,841 deleterious synonymous variants in 125,748 human exomes using two in silico predictors (SilVA and CADD). While 98.2% of synonymous variants are classified as neutral, 1.8% are predicted to be deleterious, yielding an average of 9.82 neutral and 0.18 deleterious sSNVs per exome. Further investigation of prediction features via Heterogeneous Ensemble Feature Selection revealed that impact on amino acid sequence and conservation carry the most weight for a deleterious prediction. Thirty nine detrimental sSNVs are not rare and are located on disease associated genes. Ten distinct putatively non-deleterious sSNVs are likely to be under positive selection in the North-Western European and East Asian populations. Taken together our analysis gives voice to the so-called silent mutations as we propose a robust framework for evaluating the deleteriousness of sSNVs in variant prioritization studies.

AN ANATOMICAL STUDY OF THE THORACIC LIMB OF THE GIANT ANTEATER (MYRMECOPHAGA TRIDACTYLA) COMPARED WITH THE DOMESTIC DOG TO GUIDE SURGICAL APPROACHES TO THE HUMERUS AND RADIUS.

The giant anteater (Myrmecophaga tridactyla) is a neotropical mammal considered to be vulnerable to extinction. Recent increased interest in veterinary care in the giant anteater has prompted renewed interest in anatomical descriptions in this species. The terrestrial habits and slow movements of the giant anteater contribute to its susceptibility to vehicular trauma on highways, which is a significant cause of mortality in the species. This study describes the muscular anatomy of the thoracic limb and variations of the long bones with emphasis on the structures surrounding the humerus and radius. It also describes the possible surgical approaches for the management of fractures of humerus and radius, comparing these with the surgical approaches described in dogs (Canis lupus familiaris). Three giant anteater and three domestic dog cadavers, from deaths not related to this project, were used. The medial approach to the humeral diaphysis of the giant anteater resulted in the least tissue trauma, and provided access to the flattest surface for implant attachment. The lateral approach to the radius proved challenging, requiring total detachment of the extensor carpi radialis muscle and incision of the very robust abductor digitorum longus muscle to access the distal diaphysis. Although the giant anteater shares many similarities of the thoracic limb anatomy with the domestic dog, important differences exist. This comparative knowledge will allow veterinary practitioners to directly apply the principles of fracture repair in these species. Safe access to these bones for possible osteosynthesis is essential to allow implant placement and minimize postoperative complications in this species.

Multiple criteria decision analysis to support the design of safe and sustainable chemicals and materials.

The development of safe and sustainable chemicals and materials is essential to achieve the Zero-Pollution Ambition for a Toxic Free Environment stated in the EU Green Deal. For that, criteria need to be defined and considered since early stage of development. A Safe and Sustainable by Design (SSbD) framework is proposed in an EU Recommendation suggesting the assessment of multiple safety and sustainability aspects of chemicals and materials leaving open how the evaluation and selection of the preferable option should be done. This paper presents a proposal with different options for the use of multiattribute aggregation in an evaluation procedure for the SSbD assessment of chemicals and materials. This proposal is based on i) a review of the literature focusing on Multi-Criteria Decision Analysis (MCDA) application in the SSbD context (i.e. applications considering simultaneously safety and sustainability attributes) and ii) the definition of requisites for MCDA to be applied to the SSBD framework. In the latter, an absolute rather than a relative assessment is preferred as it should be possible for an organization developing a new chemical or material to assess if it is SSbD, without needing to obtain data on all of its possible competitors. Moreover, rank-reversals caused by the introduction of other options are avoided, i.e., assessments of one alternative that depends on other alternatives being assessed simultaneously are not the most adequate. Different options for the aggregation of attributes at different levels are discussed as well as for the consideration of data quality in the evaluation procedure. Regardless the approach selected, the use of multiattribute aggregation does not rule out a richer dashboard presenting not only the overall aggregate result, but also the results obtained in other levels of the hierarchy. Such complementary information is important to understand the strengths and weaknesses that an aggregate result might hide.

Melipona scutellaris Geopropolis: Chemical Composition and Bioactivity.

Geopropolis has been used in traditional medicine for centuries. In this study, the botanical origin, physicochemical profile, and biological activities of geopropolis from Melipona scutellaris harvested during rainy and dry seasons were investigated. Palynological analysis identified over 50 pollen types, with Schinus terebinthifolius and Cecropia being the predominant types. The analytical results were in line with those reported in the literature. Rainy-season geopropolis exhibited higher total phenol and flavonoid content (determined using High Performance Liquid Chromatography-25.13% and 3.92%, respectively) compared to the dry season (19.30% and 2.09%); the major peaks (naringin, gallic acid, and catechin) were similar among samples. Antioxidant capacity was assessed via DPPH, reducing power, and ß-carotene/linoleic acid discoloration assays. Rainy-season samples displayed superior antioxidant activity across methods. Antimicrobial effects were determined using microdilution, while the impact on the cholinesterase enzyme was quantified using 5-thio-2-nitrobenzoic acid accumulation. Anti-inflammatory and antimutagenic activities were assessed through hyaluronidase enzyme inhibition and by utilizing Saccharomyces cerevisiae ATCC-20113 cells. Both samples exhibited anti-inflammatory and antimutagenic properties. Moreover, a significant inhibition of acetylcholinesterase was observed, with IC50 values of 0.35 µg/mL during the rainy season and 0.28 µg/mL during the dry season. Additionally, the geopropolis displayed antimicrobial activity, particularly against Staphylococcus aureus. These findings suggest the therapeutic potential of M. scutellaris geopropolis in the context of inflammatory, oxidative, and infectious diseases.

Biomechanical evaluation of four surgical techniques for ventral stabilization of the atlantoaxial joint in dogs.

PURPOSE: This study compared, through biomechanical evaluation under ventral flexion load, four surgical techniques for ventral stabilization of the atlantoaxial joint in dogs. METHODS: In total, 28 identical atlantoaxial joint models were created by digital printing from computed tomography images of a dog, and the specimens were divided into four groups of seven. In each group, a different technique for ventral stabilization of the atlantoaxial joint was performed: transarticular lag screws, polyaxial screws, multiple screws and bone cement (polymethylmethacrylate-PMMA), and atlantoaxial plate. After the stabilization technique, biomechanical evaluation was performed under ventral flexion load, both with a predefined constant load and with a gradually increasing load until stabilization failure. RESULTS: All specimens, regardless of stabilization technique, were able to support the predefined load without failing. However, the PMMA method provided significant more rigidity (p ≤ 0.05) and also best resisted the gradual increase in load, supporting a significantly higher maximum force (p ≤ 0.05). There was no statistical difference in flexural strength between the transarticular lag screws and plate groups. The polyaxial screws method was significantly less resistant to loading (p ≤ 0.05) than the other groups. CONCLUSIONS: The PMMA technique had biomechanical advantages in ventral atlantoaxial stabilization over the other evaluated methods.

Assessing the climate change adaptability of sustainable land management practices regarding water availability and quality: A case study in the Sorraia catchment, Portugal.

In Mediterranean catchments, such as the Sorraia catchment in Portugal, it is expected that climate change will increase drought stress and the deterioration of water quality in reservoirs. Sustainable land management (SLM) practices are seen as an adaption measure for those problems, but the effectiveness on improving climate change impacted water availability and quality on catchment scale is still poorly understood. Therefore, this study aims to evaluate the effectiveness of SLM practices in adapting the impacts of climate change on water availability and quality of the Montargil and Maranhão reservoirs in the Sorraia catchment. A well-calibrated Soil Water Assessment Tool model is used to simulate four scenarios (2041-2071 and 2071-2100; representative climate pathways 4.5 and 8.5), to investigate the effects of climate change on total phosphorus load (TP) in streams, reservoir volume, irrigation use and water exploitation index (WEI). Results showed that WEI will not exceed any water stress level while reservoir water quality will worsen. In particular since the TP load in streams flowing into the reservoirs increases and the volume decreases, it is likely that the existing P limitation for eutrophication will be counteracted. Nevertheless, tested SLM practices were able to decrease the TP load in those streams and increase the reservoir volume under future climates. Overall, this study shows that the SLM practices are effective in adapting to the climate change effects regarding reservoir water quality, without worsening the water availability; thus, it is a promising tool that should be investigated further for application by e.g. local land-users and decision makers.

Comparative Methods to Evaluate the Antioxidant Capacity of Propolis: An Attempt to Explain the Differences.

Propolis is a natural product produced by bees that contains a complex mixture of compounds, including phenolic compounds and flavonoids. These compounds contribute to its biological activities, such as antioxidant capacity. This study analysed the pollen profile, total phenolic content (TPC), antioxidant properties, and phenolic compound profile of four propolis samples from Portugal. The total phenolic compounds in the samples were determined by six different techniques: four different Folin-Ciocalteu (F-C) methods, spectrophotometry (SPECT), and voltammetry (SWV). Of the six methods, SPECT allowed the highest quantification, while SWV achieved the lowest. The mean TPC values for these methods were 422 ± 98 and 47 ± 11 mg GAE/g sample, respectively. Antioxidant capacity was determined by four different methods: DPPH, FRAP, original ferrocyanide (OFec), and modified ferrocyanide (MFec). The MFec method gave the highest antioxidant capacity for all samples, followed by the DPPH method. The study also investigated the correlation between TPC and antioxidant capacity with the presence of hydroxybenzoic acid (HBA), hydroxycinnamic acid (HCA), and flavonoids (FLAV) in propolis samples. The results showed that the concentrations of specific compounds in propolis samples can significantly impact their antioxidant capacity and TPC quantification. Analysis of the profile of phenolic compounds by the UHPLC-DAD-ESI-MS technique identified chrysin, caffeic acid isoprenyl ester, pinocembrin, galangin, pinobanksin-3-O-acetate, and caffeic acid phenyl ester as the major compounds in the four propolis samples. In conclusion, this study shows the importance of the choice of method for determining TPC and antioxidant activity in samples and the contribution of HBA and HCA content to their quantification.

Radiation-Induced Lumbosacral Plexopathy.

Lumbosacral plexopathy (LSP) encompasses a group of disorders affecting post-ganglionic fibers derived from the L1-S4 roots. The differential diagnosis is challenging and includes other neuropathies of medullary, radicular, or peripheral origin. Defining the etiology is equally crucial, as LSP management relies on its cause. A thorough clinical history should address potential neoplastic disease (new-onset, progression, or relapse), diabetes mellitus, lumbar or pelvic trauma, and previous exposure to radiation. This is the case of a 78-year-old male, with a history of prostatic adenocarcinoma, treated with image-guided radiation therapy and hormone therapy five years before, with no evidence of relapse on follow-up. The patient presented with bilateral weakness, numbness, and paresthesia of lower limbs, gradually progressing over a three-month period, and followed by an acute worsening with inability to stand or walk. He also referred to distal mild edema, episodic hematuria, and urinary incontinence. Physical examination revealed paraparesis affecting proximal and distal leg muscles, along with bilateral hypoesthesia, impaired deep tendon reflexes, and proprioception below knee level. Pelvic, dorsal, and lumbosacral MRI excluded neoplastic lesions but identified somatic fracture of L5 without medullary or conus medullaris compromise. These findings did not explain the clinical picture. Further neurophysiologic studies characterized sensory-motor deficits as post-ganglionic, with specific spontaneous discharges of the muscle fibers, known as myokymia. These findings were consistent with radiation-induced LSP and were supported by MRI. Radiation-induced cystitis was also documented in pelvic MRI and urethral cystoscopy. This case highlights the clinical picture and differential diagnosis of radiation-induced LSP. Despite more typical symptoms and course, a neoplastic origin should always be carefully investigated and excluded. Radiation protocol should be carefully accessed, and its complications should not be overlooked, as they might cause severe morbidity.

A multi-criteria assessment of the implementation of innovative technologies to achieve different levels of microplastics and macroplastics reduction.

This paper proposes and applies a multicriteria decision analysis framework tailored to assess measures for reducing the concentration of microplastics and macroplastics in seas, by implementing ground-breaking clean-up technologies and addressing different types of pollutant sources. Environmental, socio-economic and financial impacts are considered to provide a ranking of these measures for better-informed decision making. The data required to evaluate the performance of the technologies in different locations and scales are analyzed to understand the consequences of the different measures in terms of plastic pathways and sites, and the amounts accumulated, using innovative simulation models. The framework is applied to the Mediterranean Sea, providing insights for designing measures to respond to the challenges of cleaning seas and fulfill the EU marine strategy. The results for the best ranked alternatives show that dealing with microplastics is much more expensive (by one order of magnitude) than dealing with macroplastics.

Pacemaker Reuse in Portuguese Speaking Countries: A Clinical Reflection. / Reprocessamento de Marca-Passos em Países de Língua Portuguesa: Uma Reflexão Clínica.

There is a gap between high-income countries and others in terms of access to medical cardiac devices, such as pacemakers and implantable cardioverter defibrillators. Costs are one of the main barriers to the use of cardiac devices in these countries. There are international initiatives that aim to reduce the gap. The reuse of pacemakers has been discussed as a possible alternative to this problem. The concept of reusing pacemakers is not new; however, recent studies have proven to be safe, ethical, and effective for those who need cardiac implantable electronic devices and cannot afford them. Part of the Portuguese-speaking countries, especially in Africa, need an immediate response that benefits their countless patients who suffer from treatable arrhythmias.

Há uma enorme disparidade entre os países de alta renda e outros em termos de acesso a dispositivos médicos cardíacos, como marca-passos e desfibriladores implantáveis. Os custos são uma das principais barreiras ao uso de dispositivos cardíacos nesses países. Existem iniciativas internacionais que visam reduzir essa disparidade, e o reuso de marca-passos tem sido discutido como uma possível alternativa. O conceito de reutilização de marca-passos não é novo; entretanto, estudos recentes têm se mostrado seguros, éticos e eficazes para aqueles que precisam de dispositivos eletrônicos cardíacos implantáveis e não tem como adquiri-los. Parte dos países de língua portuguesa, especialmente na África, precisam de uma resposta imediata que beneficie seus inúmeros pacientes que sofrem de arritmias tratáveis.

Development and application of a composite circularity index.

Resource depletion and environmental pollution are increasingly a matter of concern for their adverse effects on ecosystems, human health, and the economy. Circular Economy (CE) practices can help us address these challenges. This paper proposes a composite circularity index (CI) to assess the level of implementation of CE practices. The main advantage of the proposed index is its ability to combine multiple indicators of circularity for different units operating in a given sector (given as inputs), using a 'Benefit of the Doubt' model. This new model is innovative in the manner it deals with ordinal scales and also by considering both relative and absolute performance indices. These indices are computed using mathematical programming tools, building on ideas from Data Envelopment Analysis models. Although the model can be applied to any sector, this work addresses the hotel industry in particular. The selection of indicators for this CI was based on seven blocks of the Circular Economy Action Plan and a literature review of circular practices. An application of the proposed index is performed by using data from Portuguese and Spanish hotels. The proposed CI allows the identification of the organizations with the best and worst performance in implementing the CE practices and clarifying the benchmarks they could follow to improve their level of circularity. Moreover, the index analysis also provides specific targets for improvement, indicating which circular practices should be improved for the lower performers to reach the implementation levels of the best performers.

Shedding light on the physical nature of ion pair interactions involving carba-closo-dodecaborate anions. Insights from computation.

closo-Carboranes are structures that have been studied for many decades due to their vast applicability in medicine, catalysis, and energy storage. In order to go deeper into the physics behind the interactions of oppositely charged ions, which have potential applications in electrical energy storage and conversion devices, the present work aims to shed light on the physical nature of the interactions involving (R-CB11H11-, R = H, F, CH3, CF3) and Mq+ = Li+, Na+, Mg2+, Zn2+ ions. The bonding situations are evaluated in light of both canonical Kohn-Sham energy decomposition, EDA-NOCV, and local energy decomposition, LED, analyses. Electron and hole transports are also evaluated through charge transfer integrals. The findings reveal that such complexes present not only more significant electrostatic, but also non-negligible orbital contributions. Both energy decomposition analyses EDA-NOCV and DLPNO-LED confirm that the strength of ionic pair interactions (R-CB11H11- ↔ Mq+) is much more dependent on the nature of the cation employed than on the substituent R used. The results also reveal that charge transfers are not significant in such interacting systems.

Functional and patient-reported outcomes of bone-anchored hearing aids (BAHA): A prospective case series study.

Objective: The purpose of this study was to evaluate the functional and patient-reported outcomes, and their correlation, after percutaneous bone-anchored hearing aid (BAHA) implantation. Methods: A prospective study was conducted between January 2018 and December 2020 in a tertiary care center. All adult patients who were implanted with a percutaneous BAHA device during this evaluation period were included in the study. Complete auditory function and patients reported outcome measures (PROMs) were assessed in the preoperative period and 6 months after the implant activation. The PROMs included a generic form (Medical Outcome Study 36 Short Form Healthy Survey (MOS SF-36)), and three disease-specific forms (Hearing Handicap Inventory (HHI), Satisfaction with Amplification in Daily Life Scale (SADLS), and Tinnitus Handicap Inventory (THI)). Results: Twenty-two patients with an average age of 53 years were included in the study. The overall functional gain with the BAHA in sound-field pure tone average (PTA) was 29 dB, with no statistically significant differences according to surgical indication (F(3,18) = 2.319, p = 0.110). The greater the preoperative air-bone gap, the greater the functional gain obtained (r = 0.505, p < 0.05). In the PROMs, we found a significant improvement in HHI scores (p < 0.005) and a significant increase in overall SADLS scores (p < 0.05) with the use of percutaneous BAHA devices. We did not verify any statistically significant correlation between functional and PROMs results. Conclusions: The BAHA is a safe and effective alternative hearing rehabilitation option in selected patients. The PROMs results prove patient's overall satisfaction.