The upside of cumulative conceptual interference on exemplar-level mnemonic discrimination.

Although long-term visual memory (LTVM) has a remarkable capacity, the fidelity of its episodic representations can be influenced by at least two intertwined interference mechanisms during the encoding of objects belonging to the same category: the capacity to hold similar episodic traces (e.g., different birds) and the conceptual similarity of the encoded traces (e.g., a sparrow shares more features with a robin than with a penguin). The precision of episodic traces can be tested by having participants discriminate lures (unseen objects) from targets (seen objects) representing different exemplars of the same concept (e.g., two visually similar penguins), which generates interference at retrieval that can be solved if efficient pattern separation happened during encoding. The present study examines the impact of within-category encoding interference on the fidelity of mnemonic object representations, by manipulating an index of cumulative conceptual interference that represents the concurrent impact of capacity and similarity. The precision of mnemonic discrimination was further assessed by measuring the impact of visual similarity between targets and lures in a recognition task. Our results show a significant decrement in the correct identification of targets for increasing interference. Correct rejections of lures were also negatively impacted by cumulative interference as well as by the visual similarity with the target. Most interestingly though, mnemonic discrimination for targets presented with a visually similar lure was more difficult when objects were encoded under lower, not higher, interference. These findings counter a simply additive impact of interference on the fidelity of object representations providing a finer-grained, multi-factorial, understanding of interference in LTVM.

Morphobiometry of the scleral ossicle rings in Chelonia mydas sea turtles.

OBJECTIVE: Scleral ossicle rings of reptiles have endoskeletal functions that are not completely understood. Moreover, descriptive reports on the anatomy of those rings are scarce. We tried to make an anatomical description that could contribute to a better understanding of their functions. ANIMAL STUDIED AND PROCEDURES: We quantified, histologically characterized and evaluated the morphobiometry of the scleral ossicles, and measured the aditus orbitae of 25 sea turtle (Chelonia mydas) heads. RESULTS: The aditus orbitae represented about one-third of the total head length and the mean area of the internal opening of each ring was up to 8.37% of the aditus orbitae area. The mean internal diameter of the rings (6.32 mm) was characteristic of scotopic species and the most frequent number of ossicles per ring varied between 11 and 12. Two new classifications were proposed for the ossicle types: plus-Verzahnung (+V) and minus-Verzahnung (-V). The bone tissue revealed a lamellar arrangement typical of compact and resistant bones. CONCLUSION: The obtained data may be used to support and expand the understanding of functions, animal activity patterns, distinctions between taxa and taphonomic interpretations.

Rehabilitation after cervical and lumbar spine surgery.

The total number of spine surgeries is increasing, with a variable percentage of patients remaining symptomatic and functionally impaired after surgery. Rehabilitation has been widely recommended, although its effects remain unclear due to lack of research on this matter. The aim of this comprehensive review is to resume the most recent evidence regarding postoperative rehabilitation after spine surgery and make recommendations. The effectiveness of cervical spine surgery on the outcomes is moderate to good, so most physiatrists and surgeons agree that patients benefit from a structured postoperative rehabilitation protocol and despite best timing to start rehabilitation is still unknown, most programs start 4-6 weeks after surgery. Lumbar disc surgery has shown success rates between 78% and 95% after 2 years of follow-up. Postoperative rehabilitation is widely recommended, although its absolute indication has not yet been proven. Patients should be educated to start their own postoperative rehabilitation immediately after surgery until they enroll on a rehabilitation program usually 4-6 weeks post-intervention. The rate of lumbar interbody fusion surgery is increasing, particularly in patients over 60 years, although studies report that 25-45% of patients remain symptomatic. Despite no standardized rehabilitation program has been defined, patients benefit from a cognitive-behavioral physical therapy starting immediately after surgery with psychological intervention, patient education and gradual mobilization. Formal spine rehabilitation should begin at 2-3 months postoperatively. Rehabilitation has benefits on the recovery of patients after spine surgery, but further investigation is needed to achieve a standardized rehabilitation approach.

Filling the gap: Cloze probability and sentence constraint norms for 807 European Portuguese sentences.

Sentence processing is affected by the sentence context and word expectancy. To investigate sentence comprehension experimentally, it is useful to have sentence completion norms with both context constraint and word expectancy measures. In this study, two experiments were conducted to collect norms for completion of 807 European Portuguese sentences. Context constraint was measured through type-token ratio and proportion idiosyncratic responses, while word expectancy was assessed by cloze probability. Besides establishing norms for a large sample of sentences, the study investigated the impact of the production procedure and method of analysis. In Experiment 1, a single-production procedure was used, i.e., participants completed each sentence fragment with only a single response, whereas in Experiment 2, a multiple-production procedure was used, i.e., participants have to provide up to three completion words for each sentence fragment. In Experiment 2, the analyses were obtained using two distinct methods: first-response analysis and combined-response analysis. The results showed that cloze and context measures are comparable between production paradigms and that the results from both analysis methods were correlated. The advantages of each production procedure and analysis method are discussed.

ObScene database: Semantic congruency norms for 898 pairs of object-scene pictures.

Research on the interaction between object and scene processing has a long history in the fields of perception and visual memory. Most databases have established norms for pictures where the object is embedded in the scene. In this study, we provide a diverse and controlled stimulus set comprising real-world pictures of 375 objects (e.g., suitcase), 245 scenes (e.g., airport), and 898 object-scene pairs (e.g., suitcase-airport), with object and scene presented separately. Our goal was twofold. First, to create a database of object and scene pictures, normed for the same variables to have comparable measures for both types of pictures. Second, to acquire normative data for the semantic relationships between objects and scenes presented separately, which offers more flexibility in the use of the pictures and allows disentangling the processing of the object and its context (the scene). Along three experiments, participants evaluated each object or scene picture on name agreement, familiarity, and visual complexity, and rated object-scene pairs on semantic congruency. A total of 125 septuplets of one scene and six objects (three congruent, three incongruent), and 120 triplets of one object and two scenes (in congruent and incongruent pairings) were built. In future studies, these objects and scenes can be used separately or combined, while controlling for their key features. Additionally, as object-scene pairs received semantic congruency ratings along the entire scale, researchers may select among a wide range of congruency values. ObScene is a comprehensive and ecologically valid database, useful for psychology and neuroscience studies of visual object and scene processing.

Stress Cardiomyopathy as a Complication of SARS-CoV-2 Infection.

The worldwide spread of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in early 2020 led to the coronavirus disease 2019 (COVID-19) pandemic. Acute lung diseases, such as COVID-19 pneumonia, can trigger stress cardiomyopathy, raising concerns about potential cardiovascular complications related to these diseases. The current case involved a 72-year-old man with SARS-CoV-2 infection who was experiencing dyspnea, desaturation, and oppressive retrosternal chest pain. On his admission to the hospital, an electrocardiogram demonstrated sinus tachycardia, negative T waves in leads V4-V6, and slight ST-segment elevation in the same precordial leads. The patient also had an increased troponin I value and worsening of his baseline respiratory failure, which required starting noninvasive ventilation. The echocardiogram showed moderately depressed left ventricular systolic function and apical ballooning. The echocardiographic changes resolved during hospitalization without directed therapeutic intervention. We diagnosed Takotsubo syndrome associated with SARS-CoV-2 infection; however, the pathophysiological disruption remains to be clarified.

Memory footprint: Predictors of flashbulb and event memories of the 2016 Euro Cup final.

Two years after Portugal won the UEFA European Championship, we examined what the Portuguese remember of this momentous occasion. We investigated if flashbulb memories (FBMs) and event memories (EMs) were determined by distinct factors, and whether EM was a predictor of FBM. Participants responded to an online questionnaire about their FBM, EM and set of predictors. Structural equation modeling revealed that FBM and EM were associated with different pathways. Interest in football predicted importance which triggered emotional intensity which predicted personal rehearsal, a direct determinant of FBMs. On the other pathway, interest determined knowledge about football, the main predictor of EMs. Importantly, EM was a causal determinant of FBM which shows that the memory trace for the original event enhances memory for the reception context. The findings suggests that even though the two types of memories are determined by independent factors, they interact very closely.

Semantic cognition in healthy ageing: Neural signatures of representation and control mechanisms in naming typical and atypical objects.

Effective use of conceptual knowledge engages semantic representation and control processes to access information in a goal-driven manner. Neuropsychological findings of patients presenting either degraded knowledge (e.g., semantic dementia) or disrupted control (e.g., semantic aphasia) converge with neuroimaging evidence from young adults, and delineate the neural segregation of representation and control mechanisms. However, there is still scarce research on the neurofunctional underpinnings of such mechanisms in healthy ageing. To address this, we conducted an fMRI study, wherein young and older adults performed a covert naming task of typical and atypical objects. Three main age-related differences were found. As shown by age group and typicality interactions, older adults exhibited overactivation during naming of atypical (e.g., avocado) relative to typical concepts in brain regions associated to semantic representation, including anterior and medial portions of left temporal lobe (respectively, ATL and MTG). This provides evidence for the reorganization of neural activity in these brain regions contingent to the enrichment of semantic repositories in older ages. The medial orbitofrontal gyrus was also overactivated, indicating that the processing of atypical concepts (relative to typical items) taxes additional control resources in the elderly. Increased activation in the inferior frontal gyrus (IFG) was observed in naming typical items (relative to atypical ones), but only for young adults. This suggests that naming typical items (e.g., strawberry) taxes more on control processes in younger ages, presumably due to the semantic competition set by other items that share multiple features with the target (e.g., raspberry, blackberry, cherry). Together, these results reveal the dynamic nature of semantic control interplaying with conceptual representations as people grow older, by indicating that distinct neural bases uphold semantic performance from young to older ages. These findings may be explained by neural compensation mechanisms coming into play to support neurocognitive changes in healthy ageing.

Typicality in the brain during semantic and episodic memory decisions.

Concept typicality is a key semantic dimension supporting the categorical organization of items based on their features, such that typical items share more features with other members of their category than atypical items, which are more distinctive. Typicality effects manifest in better accuracy and faster response times during categorization tasks, but higher performance for atypical items in episodic memory tasks, due to their distinctiveness. At a neural level, typicality has been linked to the anterior temporal lobe (ATL) and the inferior frontal gyrus (IFG) in semantic decision tasks, but patterns of brain activity during episodic memory tasks remain to be understood. We investigated the neural correlates of typicality in semantic and episodic memory to determine the brain regions associated with semantic typicality and uncover effects arising when items are reinstated during retrieval. In an fMRI study, 26 healthy young subjects first performed a category verification task on words representing typical and atypical concepts (encoding), and then completed a recognition memory task (retrieval). In line with previous literature, we observed higher accuracy and faster response times for typical items in the category verification task, while atypical items were better recognized in the episodic memory task. During category verification, univariate analyses revealed a greater involvement of the angular gyrus for typical items and the inferior frontal gyrus for atypical items. During the correct recognition of old items, regions belonging to the core recollection network were activated. We then compared the similarity of the representations from encoding to retrieval (ERS) using Representation Similarity Analyses. Results showed that typical items were reinstated more than atypical ones in several regions including the left precuneus and left anterior temporal lobe (ATL). This suggests that the correct retrieval of typical items requires finer-grained processing, evidenced by greater item-specific reinstatement, which is needed to resolve their confusability with other members of the category due to their higher feature similarity. Our findings confirm the centrality of the ATL in the processing of typicality while extending it to memory retrieval.

Prospective study of loss of health-related quality adjusted life years in children and their families due to uncomplicated and hospitalised varicella.

INTRODUCTION AND AIMS: Although usually benign, varicella can lead to serious complications and sometimes long-term sequelae. Vaccines are safe and effective but not yet included in immunisation programmes in many countries. We aimed to quantify the impact on health-related quality of life (HRQoL) in terms of quality-adjusted life years (QALY) in children with varicella and their families, key to assessing cost-utility in countries with low mortality due to this infection. METHODS: Children with varicella in the community and admitted to hospitals in Portugal were included over 18 months from January 2019. Children's and carers' HRQoL losses were assessed prospectively using standard multi-attribute utility instruments for measuring HRQoL (EQ-5D and CHU9D), from presentation to recovery, allowing the calculation of QALYs. RESULTS: Among 109 families with children with varicella recruited from attendees at a pediatric emergency service (community arm), the mean HRQoL loss/child was 2.0 days (95 % CI 1.9-2.2, n = 101) (mean 5.4 QALYs/1000 children (95 % CI 5.3-6.1) and 1.3 days/primary carer (95 % CI 1.2-1.6, n = 103) (mean 3.6 QALYs /1000 carers (95 % CI 3.4-4.4). Among 114 families with children admitted to hospital because of severe varicella or a complication (hospital arm), the mean HRQoL loss/child was 9.8 days (95 % CI 9.4-10.6, n = 114) (mean 26.8 QALYs /1000 children (95 % CI 25.8-29.0) and 8.5 days/primary carer (95 % CI 7.4-9.6, n = 114) (mean 23.4 QALYs/1000 carers (95 % CI 20.3-26.2). Mean QALY losses/1000 patients were particularly high for bone and joint infections [67.5 (95 % CI 43.9-97.6)]. Estimates for children's QALYs lost using the CHU9D tool were well correlated with those obtained using EQ-5D, but substantially lower. CONCLUSIONS: The impact of varicella on HRQoL is substantial. We report the first measurements of QALYs lost in hospitalised children and in the families of children both in the community and admitted to hospital, providing important information to guide vaccination policy recommendations.

An eye on the Shih Tzu dog: Ophthalmic examination findings and ocular surface diagnostics.

OBJECTIVE: To characterize the ocular surface parameters and determine the prevalence of ocular pathology in Shih Tzu dogs. ANIMAL STUDIED: Fifty Shih Tzu dogs (28 male, 22 female). PROCEDURES: Each dog underwent a complete ophthalmic examination (recording any pathology) and a series of diagnostics, allowing for a 10 min-interval between tests: intraocular pressure (IOP), blink rate, palpebral fissure length (PFL), corneal tactile sensation (CTS), Schirmer tear test and nasolacrimal reflex without (STT-1, NL-STT1) and with topical anesthesia (STT-2, NL-STT2), tear ferning, strip meniscometry test (SMT), tear film breakup time (TFBUT), and punctate fluorescein staining (PFS) of the cornea. RESULTS: Mean ± SD test values were as follows: IOP (17.9 ± 3.7 mmHg), blink rate (2.4 ± 1.4 blinks/min), PFL (23.8 ± 1.8 mm), CTS (1.8 ± 0.7 cm), STT-1 (22.0 ± 5.5 mm/min), NL-STT1 (24.2 ± 4.7 mm/min), STT-2 (16.9 ± 6.5 mm/min), NL-STT2 (18.5 ± 7.5 mm/min), SMT (7.5 ± 3.5 mm/5 s), TFBUT (5.3 ± 2.4 s), tear ferning (1.3 ± 0.7), and PFS (1.6 ± 0.6). PFL was significantly greater in male vs. female Shih Tzus (p< .001). Age was negatively correlated with TFBUT results (r = -0.31, p = .027). Lagophthalmos was observed in 82% eyes. Ocular surface pathology was common, including adnexal abnormalities (100% eyes with caruncular trichiasis and medial lower lid entropion) and corneal opacification (27% pigmentation, 20% fibrosis, 12% neovascularization). CONCLUSIONS: Qualitative tear film deficiency (low TFBUT), along with several anatomical abnormalities that promote ocular irritation and reduce globe protection, together help explain the concerningly high prevalence of ocular surface disease in the Shih Tzu breed. Prophylactic measures (e.g., medial canthoplasty, topical lubrication) could be considered to improve ocular health in Shih Tzus.

A Rare Case of Rhabdomyolysis.

Rhabdomyolysis is a pathological condition presenting with symptoms of localized or generalized myalgia and weakness, associated with an increase in serum creatine kinase level and, often leading to myoglobinuria and acute kidney injury. It has a wide range of etiologies. Immune-mediated necrotizing myopathy (IMNM) is a rare type of inflammatory myopathy, that leads to rhabdomyolysis, and it is divided into three different subtypes: anti-3-hydroxy-3-methylglutaryl-coA reductase (anti-HMGCR, anti-signal recognition particle (anti-SRP), and seronegative. There are slight differences in incidence, age of onset, clinical course, and prognosis between these subtypes. We describe the case of a 67-year-old female with myalgias and weakness of the thighs for six weeks. Laboratory findings showed marked rhabdomyolysis and severe acute kidney injury. The workup led to the diagnosis of seronegative immune-mediated necrotizing myopathy (IMNM) and treatment with corticosteroid and methotrexate was introduced, which led to marked clinical improvement.

Imprinting fidelity in mouse iPSCs depends on sex of donor cell and medium formulation.

Reprogramming of somatic cells into induced Pluripotent Stem Cells (iPSCs) is a major leap towards personalised approaches to disease modelling and cell-replacement therapies. However, we still lack the ability to fully control the epigenetic status of iPSCs, which is a major hurdle for their downstream applications. Epigenetic fidelity can be tracked by genomic imprinting, a phenomenon dependent on DNA methylation, which is frequently perturbed in iPSCs by yet unknown reasons. To try to understand the causes underlying these defects, we conducted a thorough imprinting analysis using IMPLICON, a high-throughput method measuring DNA methylation levels, in multiple female and male murine iPSC lines generated under different experimental conditions. Our results show that imprinting defects are remarkably common in iPSCs, but their nature depends on the sex of donor cells and their response to culture conditions. Imprints in female iPSCs resist the initial genome-wide DNA demethylation wave during reprogramming, but ultimately cells accumulate hypomethylation defects irrespective of culture medium formulations. In contrast, imprinting defects on male iPSCs depends on the experimental conditions and arise during reprogramming, being mitigated by the addition of vitamin C (VitC). Our findings are fundamental to further optimise reprogramming strategies and generate iPSCs with a stable epigenome.

Occurrence of polycyclic aromatic hydrocarbons, microplastics and biofilms in Alqueva surface water at touristic spots.

Freshwater pollution is a huge concern. A study aiming to evaluate physico-chemical characteristics, microbiota, occurrence of two groups of persistent environmental pollutants with similar chemical properties (polycyclic aromatic hydrocarbons- PAHs and microplastics - MPs) in Alqueva's surface water was performed during 2021. Water samples were collected at three spots related to touristic activities (two beaches and one marina) during the Winter, Spring, Summer and Autumn seasons. In addition, the presence of biofilms on plastic and natural materials (stone, wood/ vegetal materials) were assessed and compared. Water quality based on physicochemical parameters was acceptable with a low eutrophication level. PAHs concentration levels were lower than the standard limits established for surface waters by international organizations. However, carcinogenic compounds were detected in two sampling locations, which can pose a problem for aquatic ecosystems. PAHs profiles showed significant differences when comparing the dry seasons with the rainy seasons, with a higher number of different compounds detected in Spring. Low molecular weigh compounds, usually associated with the atmospheric deposition and petroleum contamination, were more prevalent. MPs were detected in all samples except one during the Winter season. The polymers detected were poly(methyl-2-methylpropenoate), polystyrene, polyethylene terephthalate, polyamide, polypropylene, styrene butadiene, polyvinyl chloride and low /high density polyethylene with the last being the most frequent. Biofilms were more often detected on plastics than on natural materials. In addition, biofilms detected on plastics were more complex with higher microbial diversity (e.g., bacteria, fungi/yeast and phytoplancton organisms) and richer in extrapolymeric material. Based on morphological analysis a good agreement between microbiota and microorganism present in the biofilms was found. Among microbiota were identified microorganisms previously linked to plastic and PAHs detoxification suggesting the need for further studies to evaluate the viability of using biofilms as part of a green bioremediation strategy to mitigate water pollution.

Can we learn from errors? Retrieval facilitates the correction of false memories for pragmatic inferences.

Errorful learning suggests that, when perfect learning has not yet been attained, errors can enhance future learning if followed by corrective feedback. Research on memory updating has shown that after retrieval, memory becomes more malleable and prone to change. Thus, retrieval of a wrong answer might provide a good context for the incorporation of feedback. Here, we tested this hypothesis using sentences including pragmatic sentence implications, commonly used for the study of false memories. Across two experiments with young adults, we hypothesized that corrective feedback would be more efficient at reducing false memories if provided immediately after retrieval, when memory is more malleable than after being exposed to the material. Participants' memory was assessed as a function of the type of learning task (Experiment 1: retrieval vs. restudy; and Experiment 2: active vs. passive recognition); and whether participants received corrective feedback or not. In both experiments, we observed that retrieval not only improved correct recall (replicating the testing effect) but also promoted the correction of false memories. Notably, corrective feedback was more effective when given after errors that were committed during retrieval rather than after restudy (Experiment 1) or after passive recognition (Experiment 2). Our results suggest that the benefits of retrieval go beyond the testing effect since it also facilitates false memories correction. Retrieval seems to enhance memory malleability, thus improving the incorporation of feedback, compared to the mere presentation of the information. Our results support the use of learning strategies that engage in active and explicit retrieval because, even if the retrieved information is wrong-when immediate feedback is provided-memory updating is promoted and errors are more likely to be corrected.

Generation and characterization of induced pluripotent stem cell line (IBBISTi004-A) from an Angelman syndrome patient carrying a class II deletion of the maternal chromosome 15q11.2-q13.

Angelman Syndrome is a rare neurodevelopmental disorder caused by several (epi)genetic alterations. The patients present strong neurological impairment due to the absence of a functional maternal UBE3A gene in neurons. Here, we generated and characterized a new induced pluripotent stem cell (iPSC) line from a female child with Angelman syndrome harbouring a class II deletion. iPSCs were reprogrammed from fibroblasts using Sendai viruses. The new iPSCs express pluripotency markers, are capable of trilineage in vitro differentiation and have the expected imprinting status of Angelman syndrome. These iPSCs are a valuable tool to elucidate the pathophysiological mechanisms associated with this disease.

Embracing the Nutritional Assessment in Cerebral Palsy: A Toolkit for Healthcare Professionals for Daily Practice.

BACKGROUND: Nutritional status assessment (NSA) can be challenging in children with cerebral palsy (CP). There are high omission rates in national surveillance reports of weight and height information. Alternative methods are used to assess nutritional status that may be unknown to the healthcare professionals (HCP) who report these children. Caregivers experience challenges when dealing with feeding problems (FP) common in CP. Our aim was to assess the difficulties in NSA which are causing this underreport and to create solutions for registers and caregivers. METHODS: An online questionnaire was created for registers. Three meetings with HCP and caregivers were held to discuss problems and solutions regarding NSA and intervention. RESULTS: HCP mentioned difficulty in NSA due to a lack of time, collaboration with others, equipment, and childrens' motor impairment. Caregivers experienced difficulty in preparing nutritious meals with adapted textures. The creation of educational tools and other strategies were suggested. A toolkit for HCP was created with the weight and height assessment methods described and other for caregivers to deal with common FP. CONCLUSIONS: There are several difficulties experienced by HCP that might be overcome with educational tools, such as a toolkit. This will facilitate nutritional assessment and intervention and hopefully reduce underreporting.

TonoVet Plus®: Higher reliability and repeatability compared with Tono-Pen XL™ and TonoVet® in rabbits.

OBJECTIVE: To evaluate the accuracy and repeatability of the Tono-Pen XL™, TonoVet® and TonoVet Plus® tonometers by manometric evaluation, and to establish adjustment equations for intraocular pressure (IOP) estimates in rabbits. ANIMAL STUDIED: Rabbits. PROCEDURES: A postmortem study was conducted on seven rabbit eyes to verify the correlation between manometry and tonometry with an artificial incremental increase in IOP from 5 and 60 mmHg. A clinical study was conducted to evaluate accuracy and to establish reference values for the species, with measurement of IOP in 17 animals, for 2 consecutive days, with the same tonometers and calibrations used in the postmortem evaluations. RESULTS: There were strong linear trends for all evaluated tonometers. In the in-vivo evaluation, the mean IOP values were: 14.23 ± 1.75 (Tono-Pen XL™); 13.89 ± 2.07 (TonoVet® calibration mode 'd'); 8.88 ± 1.24 (TonoVet calibration mode 'p'); 18.59 ± 1.94 (Tonovet Plus®). There was a significant difference in the two evaluation times for the two TonoVet® calibration modes. The adjustment equations generated from the manometry for the evaluated tonometers were: Y = 0.2570X + 2.219 (Tono-Pen XL™), Y = 0.2289X + 2.389 (TonoVet® 'd'), Y = 0.4043X + 4.062 (TonoVet® 'p'), Y = 0.1233X + 0.3644 (TonoVet Plus®) (X is device-estimated IOP). CONCLUSIONS: All evaluated tonometers were well correlated with the manometry, with an underestimation of IOP by all devices. Applying adjustment formulas may compensate for systematic errors. TonoVet Plus® was well tolerated, and showed better repeatability and reliability in successive evaluations.

Knowledge and Patterns of Use of Emergency Oral Contraception among Portuguese Female Users of Healthcare Services.

INTRODUCTION: The lack of knowledge about the existence, effectiveness, and supply of emergency contraception as well as access to it, its effective duration and the lack of recognition of the need for its use can prevent women from using it. The aim of this study was to ascertain the attitudes, experience, level of knowledge and information sources about emergency contraception of Portuguese female users of healthcare services. MATERIAL AND METHODS: We conducted a multicentre, cross-sectional, observational study among 280 Portuguese women users of health care services through an original and anonymous questionnaire composed of 30 questions. RESULTS: The mean age of the women who replied to the questionnaire was 33.83 ± 8.76 years. Of the observed sample, 27.7% used EC, 50% of whom with no counselling. Despite 92.1% of women claiming knowledge about emergency contraception, only 31.2% of these answered 8 - 10 questions correctly (14 in total). The media were the most frequent source of information (63.4%). Most participants (67.5%) considered that emergency contraception is associated with severe adverse reactions. Furthermore, 76% did not know the time range of effectiveness after unprotected sexual intercourse. Youngest age (p = 0.038), higher education level (p < 0.001), increasing parity (p = 0.051) and previous use of emergency contraception (p = 0.011) were identified as the determinant sociodemographic factors for a higher level of knowledge about emergency contraception. DISCUSSION: The use of emergency contraception after counselling by healthcare professionals was lower than reported in the literature. CONCLUSION: This study showed that female users of healthcare services were aware of the existence of emergency contraception, but they demonstrated a low level of knowledge about it, especially regarding the correct period of use, place of acquisition and safety issues.

Introdução: A falta de conhecimento sobre a existência, eficácia e fornecimento da contraceção de emergência, bem como a sua acessibilidade, prazo efetivo e a falta de reconhecimento da possibilidade da sua utilização podem impedir as mulheres de a utilizarem. O objetivo do estudo foi conhecer a experiência, atitudes, as fontes de informação e nível de conhecimento sobre a contraceção de emergência entre mulheres portuguesas utilizadoras dos cuidados de saúde. Material e Métodos: Foi desenvolvido um estudo observacional, transversal e multicêntrico em 280 mulheres portuguesas utilizadoras dos cuidados de saúde, através da aplicação de um questionário original e anónimo constituido por 30 questões. Resultados: A idade média das mulheres que responderam ao questionário situou-se nos 33,83 ± 8,76 anos. Da amostra em estudo, 27,7% referiram utilização prévia de contraceção de emergência, das quais 50% sem aconselhamento. Apesar de 92,1% afirmar conhecer esta opção, apenas 35,9% respondeu corretamente a entre oito a 10 questões de avaliação de conhecimento (total de 14). Os media constituiram a fonte de informação mais frequente (63,4%). A maioria das participantes (67,5%) considera que a contraceção de emergência está associada a efeitos adversos graves e 76% desconhece o intervalo de tempo de eficácia da contraceção de emergência após relações sexuais desprotegidas. A idade jovem (p = 0,038), maior nível de escolaridade (p < 0,001), o aumento da paridade (p = 0,051) e a utilização prévia de contraceção de emergência (p = 0,031) foram os fatores sociodemográficos associados a maior nível de conhecimento sobre a mesma. Discussão: O uso de contraceção de emergência após aconselhamento por profissionais de saúde foi inferior ao descrito na literatura. Conclusão: O estudo demonstrou que apesar das utilizadoras dos cuidados de saúde de afirmarem ter conhecimento da existência da contraceção de emergência, revelaram baixo nível de conhecimento sobre este tipo de contraceção, particularmente em relação ao período correto de utilização, local de aquisição e questões de segurança.

Birefringence Analyses Reveal Differences in Supramolecular Characteristics of Corneal Stromal Collagen Fibrils Between Falconiformes and Strigiformes.

This study aimed to assess the birefringent properties of corneal stromal collagen fibrils in birds of the orders Falconiformes (diurnal) and Strigiformes (predominantly nocturnal) to compare their supramolecular organizations. In total, 22 corneas of Falconiformes (Caracara plancus, n = 8; Rupornis magnirostris, n = 10; and Falco sparverius, n = 4) and 28 of Strigiformes (Tyto furcata, n = 16; Pseudoscops clamator, n = 6; and Athene cunicularia, n = 6) were processed histotechnically into 8-µm thick sections. Corneal optical retardation (OR) values related to the form and intrinsic fractions of the total birefringence of collagen fibrils were measured using a polarized light microscope equipped with phase compensators. In addition, the coherence coefficients that inform the local orientation of the fibrils were calculated through video image analysis. All assessments were conducted both in the anterior and posterior stroma of the cornea. Differences were significant when P < 0.05. The results showed supraorganizational differences between fibrils in the anterior stroma of Falconiformes and Strigiformes. The OR values were greater (P < 0.0001) for Falconiformes, indicating that the corneas of these birds contain more collagen fibrils or more aggregated collagen fibrils. In contrast, the coherence coefficients were higher (P = 0.016) for Strigiformes, indicating that the corneal collagen fibers in these birds are highly aligned and have few undulations. A multivariate data matrix constructed for Euclidean distance calculations showed that the dissimilarity between Falconiformes and Strigiformes corneas, in terms of the supraorganization of stromal collagen fibrils, was 4.56%. In conclusion, it is possible that the supraorganizational differences reported in this study may be sources of variation in the visual quality of Falconiformes and Strigiformes. This study provides the necessary evidence to encourage further research associating corneal optical performance to supramolecular characteristics of corneal stromal collagen.