A review of relevant parameters for assessing indoor air quality in educational facilities.

Indoor air quality (IAQ) in educational facilities is crucial due to the extended time students spend in those environments, affecting their health, academic performance, and attendance. This paper aimed to review relevant parameters (building characteristics and factors related with occupancy and activities) for assessing IAQ in educational facilities, and to identify the parameters to consider when performing an IAQ monitoring campaign in schools. It also intended to identify literature gaps and suggest future research directions. A narrative literature review was conducted, focusing on seven key parameters: building location, layout and construction materials, ventilation and air cleaning systems, finishing materials, occupant demographics, occupancy, and activities. The findings revealed that carbon dioxide (CO2) levels were predominantly influenced by classroom occupancy and ventilation rates, while particulate matter (PM) concentrations were significantly influenced by the building's location, design, and occupant activities. Furthermore, this review highlighted the presence of other pollutants, such as trace metals, polycyclic aromatic hydrocarbons (PAHs), carbon monoxide (CO), nitrogen dioxide (NO2), ozone (O3), and radon, linking them to specific factors within the school environment. Different IAQ patterns, and consequently different parameters, were observed in various school areas, including classrooms, canteens, gymnasiums, computer rooms, and laboratories. While substantial literature exists on IAQ in schools, significant gaps still remain. This study highlighted the need for more studies in middle and high schools, as well as in other indoor microenvironments within educational settings beyond classrooms. Additionally, it underscored the need for comprehensive exposure assessments, long-term studies, and the impacts of new materials on IAQ including the effects of secondary reactions on surfaces. Seasonal variations and the implications of emerging technologies were also identified as requiring further investigation. Addressing those gaps through targeted research and considering the most updated standards and guidelines for IAQ, could lead to define more effective strategies for improving IAQ and safeguarding the students' health and performance.

Development and validation of a photograph-based instrument to assess nutrition literacy: The NUTLY project.

Most instruments measuring nutrition literacy evaluate theoretical knowledge, not necessarily reflecting skills relevant to food choices. We aimed to develop and validate a photograph-based instrument to assess nutrition literacy (NUTLY) among adults in Portugal. NUTLY assesses the ability to distinguish foods with different nutritional profiles; from each of several combinations of three photographs (two foods with similar contents and one with higher content) participants are asked to identify the food with the highest energy/sodium content. The NUTLY version with 79 combinations, obtained after experts/lay people evaluations, was applied to a sample representing different age, gender and education groups (n = 329). Dimensionality was evaluated through latent trait models. Combinations with negative or with positive small factor loadings were excluded after critical assessment. Internal consistency was measured using Cronbach's alpha and construct validity by comparing NUTLY scores with those obtained in the Medical Term Recognition Test and the Newest Vital Sign (NVS), and across education and training in nutrition/health groups. The cut-off to distinguish adequate/inadequate nutrition literacy was defined through ROC analysis using the Youden index criterion, after performing a Latent class analysis which identified a two-class model to have the best goodness of fit. Test-retest reliability was assessed after one month (n = 158). The final NUTLY scale was unidimensional and included 48 combinations (energy: 33; sodium: 15; α = 0.74). Mean scores (±standard deviation) were highest among nutritionists (39.9 ± 4.4), followed by health professionals (38.5 ± 4.1) and declined with decreasing education (p < 0.001). Those with adequate nutrition literacy according to NVS showed higher NUTLY scores (37.9 ± 4.3 vs. 33.9 ± 6.9, p < 0.001). Adequate nutrition literacy was defined as a NUTLY score≥35 (sensitivity: 89.3%; specificity: 93.7%). Test-retest reliability was high (ICC = 0.77). NUTLY is a valid and reliable nutrition literacy measurement tool.

Occupational exposure of firefighters to hazardous pollutants during prescribed fires in Portugal.

Firefighters perform high-risk activities and during the course of their functions are highly exposed to a wide range of occupational hazards, including air pollution. Thus, this study aimed to assess the exposure of firefighters in prescribed wildland fires and their occupational exposure, as well as to identify and chemically characterise the particles collected during wildland firefighting and inside fire stations. Exposure to wildfire smoke was evaluated in 7 prescribed fires in Portugal, 2 in the north and 5 in the south of Viseu district. The concentrations of PM2.5, NO2, SO2, CO and VOCs were monitored and exceedances to occupational exposure limit values were identified. Moreover, the chemical composition of PM2.5 was analysed. The results showed that firefighters were exposed to high concentrations of these pollutants during prescribed fires and that, in some cases, exceeded occupational exposure limits, both for time-weighted average concentrations for an 8-h working day (a time-weighted average, TWA) of PM2.5, and for short-term exposure values (STEL) of NO2 and SO2. Despite being exposed to very high concentrations of CO, no exceedances to the occupational exposure values were observed. FT-IR and SEM-EDS allowed to chemically characterise the composition of the particles collected inside the fire stations and also during wildland fires, identifying mainly quartz, aluminium and magnesium silicates, characteristic of earth's crust constituents. and also, fibres that have undergone combustion. Concluding, firefighters' exposure to high concentrations of harmful pollutants, can lead to the degradation of their respiratory health. It is therefore extremely important to increase existing knowledge and conduct further studies, especially longitudinal ones, that can assess their lung function. This will allow an understanding of the impacts of smoke on firefighters' health and develop effective strategies to protect them during wildland firefighting operations.

Factors Associated With Long Survival in Patients With Cancer Admitted to Palliative Care: An Exploratory Study.

Objective: Some patients with cancer admitted to palliative care have relatively long survivals of 1 year or more. The objective of this study was to find out factors associated with prolonged survival. Methods: Retrospective case-control study comparing the available data of patients with cancer who survived more than 1 year after admission in a palliative care service with patients with cancer who survived 6 months or less. The intended proportion was 4 controls for each case. Patients were identified through electronic records from 2012 until 2018. Results: And 1721 patients were identified. Of those patients, 111 (6.4%) survived for at least 1 year, and 363 (21.1%) were included as controls according to the established criteria. The intended proportion could not be reached; the proportion was only 3.3:1. The median survival of cases was 581 days (range: 371-2763), and the median survival of controls was 57 days (range: 1-182). In the multivariable analysis, patients with a hemoglobin ≥ 10.6 g/dL and a creatinine level >95 µmol/L had a higher probability of living more than 1 year. In contrast, patients with abnormal cognition, pain, anorexia, liver metastases, an Eastern Cooperative Oncology Group performance status >1, and a neutrophil/lymphocyte ratio ≥ 3.43 had a low probability of living more than 1 year. Conclusion: Several factors were statistically associated positively or negatively with prolonged survival. However, the data of this study should be confirmed in other studies.

Microsatellites' mutation modeling through the analysis of the Y-chromosomal transmission: Results of a GHEP-ISFG collaborative study.

The Spanish and Portuguese Speaking Working Group of the International Society for Forensic Genetics (GHEP-ISFG) organized a collaborative study on mutations of Y-chromosomal short tandem repeats (Y-STRs). New data from 2225 father-son duos and data from 44 previously published reports, corresponding to 25,729 duos, were collected and analyzed. Marker-specific mutation rates were estimated for 33 Y-STRs. Although highly dependent on the analyzed marker, mutations compatible with the gain or loss of a single repeat were 23.2 times more likely than those involving a greater number of repeats. Longer alleles (relatively to the modal one) showed to be nearly twice more mutable than the shorter ones. Within the subset of longer alleles, the loss of repeats showed to be nearly twice more likely than the gain. Conversely, shorter alleles showed a symmetrical trend, with repeat gains being twofold more frequent than reductions. A positive correlation between the paternal age and the mutation rate was observed, strengthening previous findings. The results of a machine learning approach, via logistic regression analyses, allowed the establishment of algebraic formulas for estimating the probability of mutation depending on paternal age and allele length for DYS389I, DYS393 and DYS627. Algebraic formulas could also be established considering only the allele length as predictor for DYS19, DYS389I, DYS389II-I, DYS390, DYS391, DYS393, DYS437, DYS439, DYS449, DYS456, DYS458, DYS460, DYS481, DYS518, DYS533, DYS576, DYS626 and DYS627 loci. For the remaining Y-STRs, a lack of statistical significance was observed, probably as a consequence of the small effective size of the subsets available, a common difficulty in the modeling of rare events as is the case of mutations. The amount of data used in the different analyses varied widely, depending on how the data were reported in the publications analyzed. This shows a regrettable waste of produced data, due to inadequate communication of the results, supporting an urgent need of publication guidelines for mutation studies.

Lung cancer screening in clinical practice: identification of high-risk chronic obstructive pulmonary disease patients

SUMMARY OBJECTIVE: The NELSON study demonstrated a positive association between computed tomography scanning and reduced mortality associated with lung cancer. The COPD-LUCSS-DLCO is a tool designed to improve screening selection criteria of lung cancer for chronic obstructive pulmonary disease patients. The aim of this study was to examine and compare the discriminating value of both scores in a community-based cohort of chronic obstructive pulmonary disease patients. METHODS: A retrospective study of chronic obstructive pulmonary disease patients followed in pulmonology consultation for a period of 10 years (2009-2019) was conducted. The NELSON criteria and COPD-LUCSS-DLCO score were calculated for each patient at the time of the study inclusion. The lung cancer incidence was calculated for each of the subgroups during the follow-up period. RESULTS: A total of 103 patients were included in the study (mean age 64.7±9.2 years, 88.3% male). Applying the COPD-LUCSS-DLCO score, high-risk patients have a 5.9-fold greater risk of developing lung cancer versus the low risk. In contrast, there was no significant association between NELSON selection criteria and lung cancer incidence. The area under the curve was 0.69 for COPD-LUCSS-DLCO and 0.59 for NELSON criteria. Comparing test results showed no differences. CONCLUSIONS: The use of the COPD-LUCSS-DLCO score in clinical practice can help to detect chronic obstructive pulmonary disease patients in greater risk of developing lung cancer with better performance than NELSON criteria. Therefore, models that include a risk biomarker strategy can improve selection criteria and consequently can enhance a better lung cancer prediction.

Estudo compativo de alguns valores cefalométricos da análise de steiner em adolescentes brasileiros, nordestinos, brancos, portadores de oclusão normal / A comparative study of some cephalometric values of steiner's analysis in brazilians teenagers, northeastern people, white men, carriers of normal occlusion

O objetivo deste estudo foi avaliar o posicionamento antero-posterior da maxila e da mandíbula e o padrão de crescimento facial, por meio de telerradiografias de perfil de 29 jovens leucodermas portadores de oclusão normal, de ambos os sexos e com idades variando entre 12 anos e um mês e 16 anos e dois meses. Foram utilizadas as medidas cefalométricas SNA, SNB, ANB, SND, SN.GoGn e SN.Gn e tomados como referência os valores da análise de Steiner. A partir da comparação feita entre esses valores, pode-se concluir que há diferença estatisticamente significante para as medidas mencionadas acima, onde para as quatro primeiras medidas, os valores encontrados foram maiores que os de Steiner e para SN.GoGn e SN.Gn os valores foram menores.