Plasma rich in growth factors (PRGF) technology as adjuvant to Ab Externo trabeculectomy.

PURPOSE: Plasma rich in growth factors (PRGF) technology creates blood-derived products with growth factors that promote wound healing and regeneration. The goal of this study was to assess the potential role of PRGF products as wound modulators in trabeculectomy. Our premise is that due to PRGF's regenerative and antifibrotic properties, its use in trabeculectomy may produce a more physiological bleb, without altering IOP reduction. METHODS: A retrospective, longitudinal study was conducted in a Hospital in Portugal. Patients with eyes with open angle glaucoma were included. Trabeculectomy was performed on all patients using PRGF membrane (mPRGF) under the conjunctiva, as adjuvant. Data regarding patients' demographics and number of medications used, was collected. Intraocular pressure (IOP) before surgery, 8 days, 1 month, 3 month, 6 month, 9 month and 1 year after surgery was recorded. Bleb morphology was classified according to Moorfields Bleb Grading System 6 months after surgery. RESULTS: Nine eyes of 9 patients were enrolled. Mean age was 71 ± 5.1 years old. Six were male. Mean IOP decreased from 24.0 ± 8.8 mmHg pre-surgery to 12.9 ± 2.6 mmHg at one year follow-up. The number of hypotensive drugs (mean ± SD) was 4.3 ± 0.9 preoperatively and 0.8 ± 1.1 at 1-year. Complete success was defined as IOP equal to or less than 21 mm Hg without ocular hypotensive medications and qualified success as IOP equal to or less than 21 mm Hg with medications. Complete success was 66.7% and qualified success was 100% at 1 year follow-up. CONCLUSION: In our study, trabeculectomy with mPRGF demonstrated both safety and efficacy. Low values of bleb height (1.6 ± 0.8) were recorded. mPRGF could improve wound healing and produce a more well-tolerated, favourable bleb, avoiding antimetabolite complications.

Monitoring Walker Assistive Devices: A Novel Approach Based on Load Cells and Optical Distance Measurements.

This paper presents a measurement system intended to monitor the usage of walker assistive devices. The goal is to guide the user in the correct use of the device in order to prevent risky situations and maximize comfort. Two risk indicators are defined: one related to force unbalance and the other related to motor incoordination. Force unbalance is measured by load cells attached to the walker legs, while motor incoordination is estimated by synchronizing force measurements with distance data provided by an optical sensor. The measurement system is equipped with a Bluetooth link that enables local supervision on a computer or tablet. Calibration and experimental results are included in the paper.

Higher reproductive success of small males and greater recruitment of large females may explain strong reversed sexual dimorphism (RSD) in the northern goshawk.

Reversed sexual dimorphism (RSD), which occurs when the female of a species is larger than the male, is the rule for most birds of prey but the exception among other bird and mammal species. The selective pressures that favour RSD are an intriguing issue in animal ecology. Despite the large number of hypotheses proposed to explain the evolution of RSD, there is still no consensus about the mechanisms involved and whether they act on one or both sexes, mainly because few intrapopulation studies have been undertaken and few raptor species have been investigated. Using the strongly size-dimorphic northern goshawk (Accipiter gentilis L.) as a model, we studied a population with one of the highest densities of breeding pairs reported in the literature in order to understand selective pressures that may favour RSD. We evaluated life-history processes, including recruitment of adult breeders and reproductive success, and we explored the mechanisms thought to act on each sex, including hunting efficiency, diet, body condition and mate choice. We found that smaller males produced more fledglings than larger ones, but there was no relationship between size and reproductive success for females. The mean body size of female breeders was larger than that of female fledglings, but male fledglings and breeders did not differ in size. Male body size was related to the type but not to the amount of prey captured during the nestling stage. We conclude that RSD may be favoured in this goshawk population because small males tend to enjoy higher reproductive success and large females greater recruitment. Our results do not support the hypotheses that evolutionary reduction in male size is driven by hunting efficiency, at least during the nestling stage, or the hypotheses that it is driven by greater recruitment. Our findings also suggest that increase in female size is driven by recruitment, rather than by reproductive success as previously postulated.

Physiology and fertility of two gull species in relation to plastic additives' exposure.

Understanding the impact of plastic and its additives on wild species is crucial as their presence in the environment increases. Polybrominated diphenyl ethers (PBDEs), once used as flame retardants, were restricted due to known toxic effects, but are still detected in the environment. Naturally occurring methoxylated PBDEs (MeO-BDEs) can result from PBDE transformation and may cause similar hazardous effects. Yellow-legged gulls (Larus michahellis, YLG) and Audouin's gulls (Ichthyaetus audouinii, AG) are highly susceptible to plastic additives, due to their distribution, trophic position, and behaviour. In this study, we assessed PBDEs and MeO-BDEs uptake in different tissues and their effects on physiological and reproductive parameters. Findings indicate that, apart from annual differences, adult AG accumulated more MeO-BDEs than YLG in a natural breeding habitat (Deserta), while the latter had lower PBDE levels than YLG breeding in the city of Porto. In relation to chicks, only YLG from Deserta showed higher PBDE concentrations than AG chicks. Individual analysis of each physiological parameter revealed impacts only for adult YLG from Deserta, with neurofunction and immune system inhibition at higher MeO-BDE concentrations. For chicks, AG showed impaired neurofunction, while YLG chicks from Porto exhibited potential genotoxicity effects triggered by higher MeO-BDE levels. Overall health analysis showed activation of antioxidant defences and compromised immune system in YLG adults from Porto due to high values of PBDEs, while chicks from Deserta exhibited inflammation and oxidative stress with high concentrations of MeO-BDEs in the same species. Fertility parameters showed significant differences for sperm counts though suggesting individuals may be able to compensate any exposure effects. This study confirms the widespread presence of plastic-associated compounds and their harmful effects on gulls, particularly on neurofunction, immune system, oxidative balance and fertility, especially due to the presence of MeO-BDEs.

Hypoxia-induced immortalization of primary cells depends on Tfcp2L1 expression.

Cellular senescence is a stress response mechanism that induces proliferative arrest. Hypoxia can bypass senescence and extend the lifespan of primary cells, mainly by decreasing oxidative damage. However, how hypoxia promotes these effects prior to malignant transformation is unknown. Here we observed that the lifespan of mouse embryonic fibroblasts (MEFs) is increased when they are cultured in hypoxia by reducing the expression of p16INK4a, p15INK4b and p21Cip1. We found that proliferating MEFs in hypoxia overexpress Tfcp2l1, which is a main regulator of pluripotency and self-renewal in embryonic stem cells, as well as stemness genes including Oct3/4, Sox2 and Nanog. Tfcp2l1 expression is lost during culture in normoxia, and its expression in hypoxia is regulated by Hif1α. Consistently, its overexpression in hypoxic levels increases the lifespan of MEFs and promotes the overexpression of stemness genes. ATAC-seq and Chip-seq experiments showed that Tfcp2l1 regulates genes that control proliferation and stemness such as Sox2, Sox9, Jarid2 and Ezh2. Additionally, Tfcp2l1 can replicate the hypoxic effect of increasing cellular reprogramming. Altogether, our data suggest that the activation of Tfcp2l1 by hypoxia contributes to immortalization prior to malignant transformation, facilitating tumorigenesis and dedifferentiation by regulating Sox2, Sox9, and Jarid2.

A method to produce a flexible and customized fuel models dataset.

Simulation of vegetation fires very often resorts to fire-behavior models that need fuel models as input. The lack of fuel models is a common problem for researchers and fire managers because its quality depends on the quality/availability of data. In this study we present a method that combines expert- and research-based knowledge with several sources of data (e.g. satellite and fieldwork) to produce customized fuel models maps. Fuel model classes are assigned to land cover types to produce a basemap, which is then updated using empirical and user-defined rules. This method produces a map of surface fuel models as detailed as possible. It is reproducible, and its flexibility relies on juxtaposing independent spatial datasets, depending on their quality or availability. This method is developed in a ModelBuilder/ArcGis toolbox named FUMOD that integrates ten sub-models. FUMOD has been used to map the Portuguese annual fuel models grids since 2019, supporting regional fire risk assessments and suppression decisions. Datasets, models and supplementary files are available in a repository (https://github.com/anasa30/PT_FuelModels). •FUMOD is a flexible toolbox with ten sub-models included that maps updated Portuguese fuel models.

Early detection of interstitial lung disease in rheumatic diseases: A joint statement from the Portuguese Pulmonology Society, the Portuguese Rheumatology Society, and the Portuguese Radiology and Nuclear Medicine Society.

INTRODUCTION: Interstitial lung disease (ILD) contributes significantly to morbidity and mortality in connective tissue disease (CTD). Early detection and accurate diagnosis are essential for informing treatment decisions and prognosis in this setting. Clear guidance on CTD-ILD screening, however, is lacking. OBJECTIVE: To establish recommendations for CTD-ILD screening based on the current evidence. METHOD: Following an extensive literature research and evaluation of articles selected for their recency and relevance to the characterization, screening, and management of CTD-ILD, an expert panel formed by six pulmonologists from the Portuguese Society of Pulmonology, six rheumatologists from the Portuguese Society of Rheumatology, and six radiologists from the Portuguese Society of Radiology and Nuclear Medicine participated in a multidisciplinary discussion to produce a joint statement on screening recommendations for ILD in CTD. RESULTS: The expert panel achieved consensus on when and how to screen for ILD in patients with systemic sclerosis, rheumatoid arthritis, mixed connective tissue disease, Sjögren syndrome, idiopathic inflammatory myopathies and systemic lupus erythematous. CONCLUSIONS: Despite the lack of data on screening for CTD-ILD, an expert panel of pulmonologists, rheumatologists and radiologists agreed on a series of screening recommendations to support decision-making and enable early diagnosis of ILD to ultimately improve outcomes and prognosis in patients with CTD.

Estimating efficiency in automatic milking systems.

Milking data of 34 single automatic milking system (AMS) units on 29 Galician dairy farms were analyzed to determine the system capacity in each farm under actual working conditions. Number of cows, milk yield, milkings per cow per day, actual milking time, rejected milking time, cleaning time, and machine downtime were used to determine the number of cows milked per AMS unit to obtain the optimal values of milkings per cow and milk production. Multiple linear regression data analysis was used to model the linear relationship between the dependent variable, milk yield per AMS per year, and the predictor variables: number of cows per AMS, milkings per cow per day, milk flow rate, and rejections per AMS per year. An AMS unit milked 52.7±9.0 cows daily at 2.69±0.28 milkings per cow, with a total milking downtime of 1,947±978 h/yr and a milk yield of 549,734±126,432 kg/yr. The predictor variables cow and milk flow rate had a greater level of influence on the milk yield per AMS than milkings per cow and rejections, and explained the 87% of the variation. The AMS in Galician dairy farms could facilitate an increase of 16±8.5 cows per AMS without impairing milking performance; in this way, the quantity of milk obtained per robot annually could be increased (185,460±137,460 kg). This would make it possible to recoup the cost of the system earlier. In the present situation, the daily milking throughput could be maximized at 2.4 to 2.6 milkings per cow.

Predicting lung nodules malignancy.

BACKGROUND: It is critical to developing an accurate method for differentiating between malignant and benign solitary pulmonary nodules. This study aimed was to establish a predicting model of lung nodules malignancy in a real-world setting. METHODS: The authors retrospectively analysed the clinical and computed tomography (CT) data of 121 patients with lung nodules, submitted to percutaneous CT-guided transthoracic biopsy, between 2014 and 2015. Multiple logistic regression was used to screen independent predictors for malignancy and to establish a clinical prediction model to evaluate the probability of malignancy. RESULTS: From a total of 121 patients, 75 (62%) were men and with a mean age of 64.7 years old. Multivariate logistic regression analysis identified six independent predictors of malignancy: age, gender, smoking status, current extra-pulmonary cancer, air bronchogram and nodule size (p<0.05). The area under the curve (AUC) was 0.8573. CONCLUSIONS: The prediction model established in this study can be used to assess the probability of malignancy in the Portuguese population, thereby providing help for the diagnosis of lung nodules and the selection of follow-up interventions.

Modulation of persistent current in graphene quantum rings.

We investigate the effect of long-range impurity potentials on the persistent current of graphene quantum rings in the presence of an uniform perpendicular magnetic field. The impurity potentials are modeled as finite regions of the ring with a definite length. We show that, due to the relativistic and massless character of the charge carriers in graphene, the effect of such non-uniform potentials on the energy spectrum and on the persistent current of the rings can be reliably modeled by assuming a non-perturbed ring and including an additional phase due to the interaction of the charge carriers with the potential. In addition, the results show the presence of localized states in the impurity regions. Moreover, we show that for the case of a potential created by a p-n-p junction, the persistent current can be modulated by controlling the voltage at the junction.

Approaching the airway in prehospital emergency is a common and potentially life-saving practice.

Management by the environment is complex, which means a much higher percentage of difficult airways than in a regulated environment such as the operating room. Failure or prolonged attempt to tracheal intubation is associated with unfavorable outcomes and serious complications. Acute epiglottitis is a life-threatening disorder, classified as a medical emergency within the diseases of the upper respiratory airway and characterized by its sudden and deadly evolution if rapid intubation is not achieved to allow oxygenation of the patient. We describe a 36-year-old male patient with stridor, dyspnea e hypoxemia due to total obstruction of airway, caused by an acute epiglottitis. We aim to highlight this unusual injury and its management from the prehospital until discharge illustrating the severity of the clinical presentation, current treatment and outcome.

Burnout among Portuguese radiographers during the COVID-19 pandemic.

INTRODUCTION: The COVID-19 pandemic has had a global impact, including in health services, placing health professionals under enormous tension, pressure, and stress. Professionals involved in the care, diagnosis, and treatment of COVID-19-infected patients have been subject to emotional and physical distress that can potentially enhance the development of occupational diseases. The aim of this study was to assess the impact of the COVID-19 pandemic on the incidence of burnout among Portuguese radiographers. METHODS: This was a cross-sectional, quantitative study. Burnout levels were estimated using the Maslach Burnout Inventory-Human Services Survey, composed of 22 questions. Specific questions were developed to characterize the socio-demographic situation and the impact of the pandemic on the radiographers. Data were descriptively analyzed and Mann-Whitney and Kruskal-Wallis tests were used for correlation analysis. RESULTS: The study sample comprised 386 radiographers, 68.7% of whom where female and 31.3% male. The mean sample age was 36.3 (±9.1) years. A total of 43.5% and 45.5% of subjects had a high level of emotional exhaustion and depersonalization, respectively, and 59.8% experienced low personal accomplishment. Altogether, 23.3% of study participants were at high risk of burnout in the three dimensions assessed and 77.2% in at least one. CONCLUSION: Study results showed that radiographers were at high risk of developing burnout in the COVID-19 pandemic setting. Health institutions should actively monitor these professional's mental health and develop restorative strategies that enable their emotional wellbeing, preventing absenteeism and increasing patients' quality of care. IMPLICATIONS FOR PRACTICE: Burnout of health professionals has a strong impact on health services organization, resulting in increased absenteeism and error probability, frequent work delays, low productivity and job satisfaction, inter- and intra-professional conflicts, high job turnover, high job quit, and decreased quality of care perceived by users.

Gate potential-controlled current switching in graphene Y-junctions.

In this work we investigate the ballistic transport of electrons through three-terminal graphene-based devices. The system consists of a Y-shaped junction formed by three armchair-edged graphene nanoribbons with a rectangular gate potential applied to one of the output branches, whereby current control can be established by the controlling of the refractive index in graphene p-n junctions. Transport properties are obtained by using the Landauer-Büttiker formalism and the tight-binding model within the nearest-neighbor approximation, which allows the calculation of the conductance as function of the Fermi energy, the applied potential, and the system size, as well as the current density. The results demonstrate that the applied electric field can tune the current transmission between the input and two output leads and, consequently, the proposed system acts as a current switch.

Approaching the airway in prehospital emergency is a common and potentially life-saving practice. / Entorno prehospitalario y manejo en UCI de epiglotitis en un adulto.

Management by the environment is complex, which means a much higher percentage of difficult airways than in a regulated environment such as the operating room. Failure or prolonged attempt to tracheal intubation is associated with unfavorable outcomes and serious complications. Acute epiglottitis is a life-threatening disorder, classified as a medical emergency within the diseases of the upper respiratory airway and characterized by its sudden and deadly evolution if rapid intubation is not achieved to allow oxygenation of the patient. We describe a 36-year-old male patient with stridor, dyspnea e hypoxemia due to total obstruction of airway, caused by an acute epiglottitis. We aim to highlight this unusual injury and its management from the prehospital until discharge illustrating the severity of the clinical presentation, current treatment and outcome.

Metabolizable amino acids and energy requirements of Nellore and crossbred Angus × Nellore bulls fed rations of different crude protein concentrations.

Growth rate of cattle depends on their genetic makeup and nutrient intake. Moreover, increased growth rate may lead to increased amino acid (AA) requirements. Therefore, we evaluated the AA content of the empty body and estimated the net AA and energy requirements of purebred and crossbred beef bulls fed rations of different dietary CP concentrations. We performed a comparative slaughter experiment with 24 Nellore and 24 Angus × Nellore (A × N) bulls (8 months; initial shrunk BW: Nellore = 208.0 ±â€¯12.78 kg; A × N = 221.9 ±â€¯14.16 kg). Eight bulls (four Nellore and four A × N) were designated as the reference group, eight bulls (four Nellore and four A × N) were fed to maintenance level and 32 bulls (16 Nellore and 16 A × N) were fed ad libitum. The 32 bulls fed ad libitum were distributed using a completely randomized design in a 2 × 3 factorial scheme with two genetic groups (Nellore or A × N) and three dietary CP contents (100, 120 or 140 g CP/kg DM), being four groups with five bulls and two groups with six bulls. The experimental period lasted for 224 days. There were no interactions (P ≥ 0.056) between the dietary CP contents and genetic groups for any of the response variables. The dietary CP contents did not affect (P ≥ 0.062) the AA content in the empty body (g/kg empty BW [EBW]), with exception for Tryptophan (P = 0.027, linear effect). The dietary CP contents did not affect (P ≥ 0.051) AA content in the empty body (g/100 g of CP), with exception for Alanine (P = 0.013) that responded quadratically to dietary CP increase. The equations to estimate the net Lysine (Lys) and Methionine (Met) requirements (g/100 g of CP) were: Lys = 5.1 × EBW0.0594 and Met = 1.7 × EBW0.0255. Metabolizable Lys and Met to metabolizable energy (ME) ratios decreased as bulls EBW increased. Also, the metabolizable protein to ME ratio decreased as bulls EBW increased. In conclusion, the present study provides useful information regarding net and metabolizable requirements of AA of purebred and crossbred beef bulls. In the future, after the validation of the equations, these results can be used to calculate the AA requirements for growth of purebred and crossbred beef bulls. Nevertheless, it is important to highlight that the small sample size was one limitation of this present experiment.

Twenty-first century droughts have not increasingly exacerbated fire season severity in the Brazilian Amazon.

Biomass burning in the Brazilian Amazon is modulated by climate factors, such as droughts, and by human factors, such as deforestation, and land management activities. The increase in forest fires during drought years has led to the hypothesis that fire activity decoupled from deforestation during the twenty-first century. However, assessment of the hypothesis relied on an incorrect active fire dataset, which led to an underestimation of the decreasing trend in fire activity and to an inflated rank for year 2015 in terms of active fire counts. The recent correction of that database warrants a reassessment of the relationships between deforestation and fire. Contrasting with earlier findings, we show that the exacerbating effect of drought on fire season severity did not increase from 2003 to 2015 and that the record-breaking dry conditions of 2015 had the least impact on fire season of all twenty-first century severe droughts. Overall, our results for the same period used in the study that originated the fire-deforestation decoupling hypothesis (2003-2015) show that decoupling was clearly weaker than initially proposed. Extension of the study period up to 2019, and novel analysis of trends in fire types and fire intensity strengthened this conclusion. Therefore, the role of deforestation as a driver of fire activity in the region should not be underestimated and must be taken into account when implementing measures to protect the Amazon forest.

Registration accuracy for VBM studies varies according to region and degenerative disease grouping.

Voxel-based morphometry studies are frequently cited as having the advantage of being objective compared to region-of-interest methods. This statement assumes, however, that all regions are treated equally both in controls and diseased cohorts. This study aimed to test whether this statement is correct by analyzing fiducial landmarks in controls, Alzheimer's disease (as a model of mild generalized atrophy model); Frontotemporal Dementia (focal atrophy model) and Semantic Dementia (extreme focal atrophy model). Standard SPM5 and DARTEL were evaluated using either raw or skull-stripped/bias corrected scans. The results indicated that with all methods there was variability in the degree of misregistration across regions and that there was a disease grouping interaction-most severely in the extreme focal atrophy model (Semantic Dementia). Preprocessing improved VBM outputs both with standard SPM and DARTEL. In the latter case, this occurred to an extreme degree-DARTEL using raw data was grossly insensitive to a ground truth (manually verified hippocampal atrophy in AD) whereas DARTEL after preprocessing yielded excellent results with respect to this yardstick.

Electrostatically confined quantum rings in bilayer graphene.

We propose a new system where electron and hole states are electrostatically confined into a quantum ring in bilayer graphene. These structures can be created by tuning the gap of the graphene bilayer using nanostructured gates or by position-dependent doping. The energy levels have a magnetic field (B(0)) dependence that is strikingly distinct from that of usual semiconductor quantum rings. In particular, the eigenvalues are not invariant under a B(0) --> -B(0) transformation and, for a fixed total angular momentum index m, their field dependence is not parabolic, but displays two minima separated by a saddle point. The spectra also display several anticrossings, which arise due to the overlap of gate-confined and magnetically confined states.

Chest CT imaging features of COVID-19 pneumonia: First radiological insights from Porto, Portugal.

INTRODUCTION: The outbreak of a highly infectious respiratory disease - COVID-19 - has spread globally and a novel type of coronavirus (SARS-CoV-2) was identified as its cause. Chest CT findings have been described as an aid for COVID-19 diagnosis and management. We aimed to describe the CT imaging characteristics in a group of COVID-19 patients while we also intended to assess if any of these radiological features were associated with short-term prognosis. MATERIALS AND METHODS: CT examinations from 164 consecutive patients with at least one positive RT-PCR nucleic acid assay for SARS-CoV-2 were retrospectively analyzed. Numerous CT imaging features were recorded independently by two radiologists. Patients were grouped according to their status 14 days after the initial CT scan in either discharged/hospitalized in a non-ICU ward (favorable prognosis group) versus deceased/admitted to an intensive care unit (unfavorable prognosis group). RESULTS: Ground-glass opacities (89.0 %) and consolidations (73.2 %) with multilobar involvement were the predominant imaging findings, while a nodular pattern (3.7 %) and cavitation (1.2 %) were uncommon. Mean age was higher in the mortality/ICU group. Ground-glass opacities and consolidations were dominant in both groups, but distribution pattern of abnormalities was different, being more often diffuse in the mortality/ICU group. Linear opacities and opacities that were rounded in shape were more frequently observed in the favorable prognosis group. CT severity index was significantly higher in the mortality/ICU group. For assessing unfavorable prognosis, the best cut-off for CT severity index was 24 (sensitivity 78 %; specificity 59 %). Interobserver agreement for all CT findings was excellent. CONCLUSION: COVID-19 pneumonia in Porto, Portugal, manifests as multilobar ground-glass opacities and consolidations. Older age, diffuse distribution and increasing CT severity index are associated with worse short-term prognosis while linear opacities resembling organizing pneumonia and rounded opacities herald a more favorable prognosis.

Current modulation in graphene p-n junctions with external fields.

In this work we describe a proposal for a graphene-based nanostructure that modulates electric current even in the absence of a gap in the band structure. The device consists of a graphene p-n junction that acts as a Veselago lens that focuses ballistic electrons on the output lead. Applying external (electric and magnetic) fields changes the position of the output focus, reducing the transmission. Such device can be applied to low power field effect transistors, which can benefit from graphene's high electronic mobility.