Lost life expectancy following a hypothetical urban radiological incident.

The consequences of mass radiological events, particularly those involving the activation of a radiological dispersion device (RDD), have been extensively studied by scientific groups. However, the critical initial period of such an event, usually spanning the first 100 h, can be characterized by a scarcity of information, potentially leading to delays in mitigating strategies. In response, a research group utilized computer simulations to generate solid, conservative analytical details that can aid decision-making and guide the prioritization of initial care based on variables such as age, sex, location, and local atmospheric stability conditions. The study estimates the Lost Life Expectancy (LLE) and provides relevant information to increase support for decision-making and allow evaluation of data closer to the lay public. The research team behind the study has been granted funding by the Brazilian National Council for Scientific and Technological Development (CNPq), and further simulations will be conducted utilizing codes that implement numerical models, specifically in atmospheric data forecasting. The methodology used to evaluate the LLE can be applied to any location, provided that the relevant variables are updated accordingly. Overall, this study offers critical insights into the impact of mass radiological events and enhances simulations' predictive capacity and precision.

Disentangling microstructure and environmental conditions in high-altitude Andean microbialite systems (Catamarca, Argentine Puna).

The study of microbialites development is a key tool to understand environmental pathways during deposition. We provide a detailed analysis of modern Central Andean microbialites from high-altitude lakes. The stratigraphic record of Turquesa Lake shows a significant short-term recolonization by microbialite-producing microorganisms during environmental stress. Far from a crisis paradigm, the coasts and paleocoasts of Turquesa lake exhibit three microbialitic buildups formed along different stages, providing a good study case of biological resilience of these systems in harsh environments. The MI and MII microbialite buildups occupied two paleocoasts. Both are composed of oncoids with micritic to microsparitic textures. Morphological, textural and mineralogical similarities between the two buildups suggest that they were formed at different times, but under very similar environmental conditions. The microorganisms that produced the microbialitic buildup MIII are currently colonizing the coast of this lake. The previous oncoid morphology change to a parallel micritic-spartic lamination. This remarkable changes in the microstructure can be explained by an important environmental change caused by the isolation of the Peinado Lake, and a subsequently microorganism adaptation. This microbialite structures can be proposed as an interesting modern analogue for environmental changes along the geological record.

Body Mass Index and Musculoskeletal Pain: A Cross-Sectional Study.

Introduction With obesity reaching pandemic proportions, its detrimental influence on many health-related conditions has recently become a focus of research. Musculoskeletal (MSK) pain is one of several disorders associated with obesity. Materials and methods This study was designed to identify MSK pain in individuals with severe obesity, recruited from a specialized obesity clinic, and to evaluate the correlation between the MSK symptoms and some individual criteria. Results In 466 patients (342 females and 124 males), with a mean BMI of 42,77 ± 5.64 kg/m², 90,3% reported MSK pain. Severe pain was reported by 57,8% of female vs 26,6% of male patients. Female patients showed higher mean pain level when compared with males. Body sites with a higher prevalence of pain were: knee (63.5%), lumbar region (46.8%), hip (29%) and ankle (23%), with a predominance of severe pain. BMI have shown a positive correlation to numeric rating scale score in female participants in three body regions: shoulder (P = 0.010), knee (P = 0.042) and ankle (P = 0.024). Body sites with higher pain prevalence were especially in areas of increased mechanical load. Conclusions Understanding the relationship between obesity and pain may provide insights into preventive measures and therapeutic strategies for MSK pain. Persistent MSK pain is a significant problem in obese patients that can have a negative relationship with quality of life and function. This fact highlights the importance that patients with obesity may have access to interdisciplinary care, for the prevention and rehabilitation of MSK disorders. To further understand this association, more robust studies are needed.

Proposal of a New Standardized Freeze-Thawing Technical Protocol for Leucocyte-Poor Platelet-Rich Plasma Preparation and Cryopreservation.

A human platelet-rich plasma (PRP) concentrate can be defined as a preparation of autologous human plasma with increased platelet concentration produced by centrifugation of a larger volume of a patient's own blood. Platelets contain a plethora of growth factors in their α-granules that are concentrated through the centrifugation process in order to then be injected in supraphysiologic amounts to an injury site with the final aim of augmenting the natural healing process. Preparations of PRP concentrates can be further classified as leucocyte-rich (LR-PRP), defined as having a leucocyte concentration above baseline, and leucocyte-poor (LP-PRP), defined as having a leucocyte concentration below baseline. Although many preclinical and clinical trials have shown the ability of leucocyte-poor PRP concentrates to significantly improve symptomatic mild to moderate hip and/or knee osteoarthritis, to date there is no consensus on the optimal way of obtaining PRP preparations, specifically with respect to the concentration of blood components. In this technical report, we describe a new standardized freeze-thawing technique for leucocyte-poor PRP preparation and cryopreservation, which has been shown to be superior to currently available techniques based solely on centrifugation. By describing this technical protocol, which we have been using on a daily basis in the setting of a Regenerative Medicine Outpatient Clinic in a European tertiary university hospital center, we aim to contribute to a future consensus on the optimal way of obtaining and preserving leucocyte-poor PRP concentrates.

[Assessment of Time Allocated to Pedestrian Crossing: A Contribution for a More Inclusive Lisbon]. / Avaliação do Tempo Atribuído à Travessia de Peões: Contributo para uma Lisboa Mais Inclusiva.

INTRODUCTION: With progressive ageing of the Portuguese population, it is paramount that the conditions of outdoor accessibility and safety are adapted to this age group. The aim of this study was to assess whether the time allocated to pedestrian crossing in the crosswalks with pedestrian crossing lights between Curry Cabral Hospital and local public transport is enough to allow safe passage of the elderly. MATERIAL AND METHODS: We evaluated 100 ambulatory care patients from the Physical Medicine and Rehabilitation department. All of them answered a questionnaire, the Activities-Specific Balance Confidence Scale (Portuguese version) and performed a 10-meter walk test. All crosswalks with pedestrian crossing lights between the hospital and local public transport were analyzed, in a total of 26, and the gait speed required to perform a safe crossing was calculated. RESULTS: Mean age of patients was 75 years and the majority (73%) were female. The study showed that all patients could safely cross 17 (65%) crosswalks. The nine remaining crosswalks (35%) represented an obstacle to our sample. DISCUSSION: If the required gait speed as currently set in legislation for the disabled was implemented, 99% of the patients would have been able to cross the crosswalks safely. CONCLUSION: It is essential to apply the gait speed set in legislation, since non-compliance endangers elderly patients in Curry Cabral Hospital, increasing the likelihood of accidents and the feeling of insecurity on the streets.

Introdução: Com o envelhecimento progressivo da população portuguesa, é fundamental que as condições de acessibilidade e segurança na via pública estejam adaptadas a este grupo etário. O objectivo deste estudo foi avaliar se o tempo atribuído à travessia de peões nas passadeiras semaforizadas entre o Hospital de Curry Cabral e os transportes públicos locais é suficiente para permitir a travessia dos idosos em segurança.Material e Métodos: Foram avaliados 100 doentes seguidos em consulta externa no Serviço de Medicina Física e de Reabilitação. Todos responderam a um questionário, à escala de confiança no equilíbrio específica da atividade e executaram o teste de marcha de 10 metros. Foram analisadas todas as passadeiras semaforizadas dos percursos de marcha entre o hospital e os transportes públicos locais, num total de 26 e calculada a velocidade de marcha necessária para realizar a travessia das passadeiras em segurança.Resultados: A média de idade dos doentes foi de 75 anos, sendo a maioria do género feminino (73%). Concluímos que todos os doentes conseguem atravessar em segurança 17 (65%) passadeiras, representando as restantes nove (35%) um obstáculo para a nossa amostra.Discussão: Se o valor de velocidade de marcha nas passadeiras estipulado na legislação para os cidadãos com mobilidade condicionada fosse devidamente aplicado, 99% da amostra teria conseguido atravessar as passadeiras em segurança.Conclusão: É fundamental que o valor de velocidade de marcha nas passadeiras estipulado na legislação seja aplicado, pois o seu incumprimento coloca em risco os utentes idosos do Hospital de Curry Cabral, aumentando a probabilidade de acidentes e o sentimento de insegurança na via pública.

Prevalence of Performance-Enhancing Substance Use and Associated Factors among Portuguese Gym/Fitness Users.

Background: Nowadays, doping is not confined to elite sport, it is also spread throughout gymnasia and fitness centers, and it is seen as a public health concern. Studies focusing on performance-enhancing substances (PES) use among gym users are few and mostly concern the practice of bodybuilding and the use of anabolic-androgenic steroids (AAS), without providing information about social indicators to further explore why this specific population use these substances. Objectives: To investigate the extent of PES use and examine the way social indicators, exercise profile and gym modalities influence the use of these substances among a sample of gym users. Methods: Cross-sectional descriptive study, among a convenience sample of 453 Portuguese gym users, recruited directly by five institutional gyms´ email and Facebook. Data were collected via a structured web-based survey, between October and November 2017. Multiple binary logistic regression, the Chi-Square test or Monte Carlo Simulation or Fisher's Exact test were used. The odds ratios and their respective 95% confidence intervals were calculated. Results: 11,1% of gym users reported the use of prohibited PES, which varies significantly according to gender, education, exercise profile and type of practice. Gender was associated with the class of PES used. Polypharmacy was a common practice among users, increasing the risk of side-effects. Peer effect and media appear to be strikingly important in the misuse of PES. Conclusion: Results provide precise insight into the specific factors associated with PES use, which could support prevention strategies in gym/fitness context.

Psychosocial factors and performance enhancing substances in gym users: A systematic review / Factores psicosociales y sustancias que mejoran el rendimiento en usuarios de gimnasios: Una revisión sistemática / Fatores Psicossociais e Substâncias que Melhoram o Desempenho em Usuários de Ginásio: Uma Revisão Sistemática

The use of performance-enhancing substances (PES) occurs among gym/fitness center users. This systematic review aimed to analyze studies describing prevalence, attitudes, beliefs, and knowledge, as conceptualized in the Theory of Planned Behavior (TPB), influenced by the use of PES by this population. Twenty-six articles were identified from a systematic approach following the PRISMA statement via electronic databases (SPORTDiscusTM, PubMed, Scopus, Web of Science, B-On and Psychology and Behavioral Science Collection) and hand-searching bibliographies of reference lists. Only peer-reviewed primary research published in English, Portuguese and Spanish (1997-2016), focusing on gym/fitness center users and providing information on psychosocial factors (e.g., attitudes, beliefs, intention, social influence/ peer pressure) towards using PES, were included. It was concluded that the most prevalent substance used were anabolic-androgenic steroids (AAS). Attitudes of male bodybuilders using AAS as the prevalent drug are mainly related to aesthetic issues. Important influences come from groups (e.g., friends, training colleagues) and instructors. Although some AAS users indicated a general lack of knowledge of the potentially harmful effects of these drugs, others were aware of the side effects. The TPB illustrated a relationship between psychosocial factors influencing gym users to use PES

El uso de sustancias que mejoran el rendimiento (PES) ocurre entre los practicantes de gimnasio / fitness. Esta revisión sistemática tuvo como objetivo analizar estudios que describen la prevalecía, las actitudes, las creencias y el conocimiento, de acuerdo con el conceptualizado en la Teoría del Comportamiento Planeado (TPB), influenciado por el uso de PES en esta población. Veintiséis artículos fueron identificados a partir de un enfoque sistemático, utilizando el PRISMA a través de bases de datos electrónicas (SPORTDiscusTM, PubMed, Scopus, Web of Science, B-On and Psychology and Behavioral Science Collection) e búsquedas manuales de bibliografías a partir de listas de referencia. Sólo los estudios primarios revisados por pares, publicado en inglés, portugués y español (1997-2016), cuya población de estudio fueron la práctica de gimnasia /fitness y proporcionar información sobre los factores psicosociales (e.g., actitudes, creencias, intención, influencia social /presión de grupo) para el uso de PES, se incluyeron. Se concluyó que la PES más prevalente eran los esteroides anabolizantes (AAS). Las actitudes positivas ante el consumo de AAS, por parte de los culturistas están relacionadas principalmente con cuestiones estéticas. Importantes influencias provienen de grupos (e.g., amigos, compañeros de entrenamiento) e instructores. Aunque algunos consumidores de AAS indicaban una falta general de conocimiento sobre los efectos potencialmente nocivos de estas drogas, otros estaban conscientes de los efectos colaterales. La TPB demostró una relación entre los factores psicosociales que influencian a los practicantes de gimnasio / fitness para usar PES

A utilização de substâncias que melhoram o desempenho (PES) ocorre entre os utilizadores de ginásios e centros de fitness. Esta revisão sistemática teve como objetivo analisar estudos que descrevem prevalências, atitudes, crenças e conhecimentos, conforme o preconizado na Teoria do Comportamento Planeado (TPB), influenciados pela utilização de PES nesta população específica. Vinte e seis artigos foram identificados a partir de uma abordagem sistemática seguindo o método PRISMA através de bases de dados eletrónicas (SPORTDiscusTM, PubMed, Scopus, Web of Science, B-On e Psicologia e Behavioral Science Collection) e pesquisa manual de bibliografia nas listas de referências. Foram apenas incluídos artigos de pesquisa primária revistos por pares e publicados em inglês, português e espanhol (1997-2016), cuja população em estudo fossem utilizadores de ginásios e centros de fitness e fornecessem informações acerca de fatores psicossociais (ex., atitudes, crenças, intenções, influência social / pressão dos colegas) para a utilização de PES. Concluiu-se que as substâncias mais utilizadas foram os esteroides anabólicos androgénicos (EAA). As atitudes dos praticantes de musculação masculinos que utilizam EAA como droga prevalente estão relacionadas principalmente com questões estéticas. Os grupos (ex., amigos, colegas de treino) e instrutores têm uma influência importante na utilização deste tipo de substâncias. Embora alguns utilizadores de EAA indiquem uma falta geral de conhecimento dos efeitos potencialmente prejudiciais dessas substâncias, outros estão cientes dos efeitos colaterais. A TPB permitiu demostrar que existe uma relação entre os fatores psicossociais que influenciam os utilizadores de ginásios a usar PES

Two distinct phenotypes of asthma in elite athletes identified by latent class analysis.

INTRODUCTION: Clusters of asthma in athletes have been insufficiently studied. Therefore, the present study aimed to characterize asthma phenotypes in elite athletes using latent class analysis (LCA) and to evaluate its association with the type of sport practiced. METHODS: In the present cross-sectional study, an analysis of athletes' records was carried out in databases of the Portuguese National Anti-Doping Committee and the Norwegian School of Sport Sciences. Athletes with asthma, diagnosed according to criteria given by the International Olympic Committee, were included for LCA. Sports practiced were categorized into water, winter and other sports. RESULTS: Of 324 files screened, 150 files belonged to asthmatic athletes (91 Portuguese; 59 Norwegian). LCA retrieved two clusters: "atopic asthma" defined by allergic sensitization, rhinitis and allergic co-morbidities and increased exhaled nitric oxide levels; and "sports asthma", defined by exercise-induced respiratory symptoms and airway hyperesponsiveness without allergic features. The risk of developing the phenotype "sports asthma" was significantly increased in athletes practicing water (OR = 2.87; 95% CI [1.82-4.51]) and winter (OR = 8.65; 95% CI [2.67-28.03]) sports, when compared with other athletes. CONCLUSION: Two asthma phenotypes were identified in elite athletes: "atopic asthma" and "sports asthma". The type of sport practiced was associated with different phenotypes: water and winter sport athletes had three- and ninefold increased risk of "sports asthma". Recognizing different phenotypes is clinically relevant as it would lead to distinct targeted treatments.

Impact of changes in anti-doping regulations (WADA Guidelines) on asthma care in athletes.

OBJECTIVE: To investigate how changes to the World Anti-Doping Agency (WADA) guidelines on asthma medication requests have impacted the management of asthmatic athletes in Portugal. DESIGN: Retrospective analysis of asthma medication requests submitted in 2008 to 2010. SETTING: Portuguese Anti-Doping Authority database. PARTICIPANTS: Athletes requesting the use of inhaled corticosteroids and/or ß2-agonists. INDEPENDENT VARIABLES: Demographic, therapeutic, and diagnostic test data. MAIN OUTCOME MEASURES: Yearly changes in number of asthma medication requests and diagnostic procedures. RESULTS: We analyzed 326 requests: 173 abbreviated Therapeutic Use Exemptions (TUEs) in 2008 (objective tests not required), 9 Declaration of Use (DoU) and 76 TUEs in 2009, and 39 DoU and 29 TUEs in 2010. Spirometry was performed in 87% and 37% of athletes in 2009 and 2010, respectively; the corresponding figures for bronchoprovocation were 59% and 16%, almost all positive in both years. CONCLUSIONS: Applications for inhaler use have decreased by approximately half since objective asthma testing became mandatory. Our findings show that WADA guidelines have an impact on asthmatic athletes care: In 2009 a more rigorous screening was possible, leading to withdrawal of unnecessary medication. Constant changes, however, jeopardize this achievement and nowadays introduce safety issues stemming from the unsupervised use of inhaled ß2-agonists.

Identification of fibroblast growth factor 1 (FGF-1) in a black market product.

The use of growth factors for accelerated healing of sports injuries is restricted under the terms of the World Anti-Doping Agency (WADA) anti-doping code. Cheating athletes have used the black market as a source of performance-enhancing substances. Drugs that currently undergo clinical trials are frequently offered--despite the unknown health risks associated with the administration of unapproved pharmaceuticals. Recently, a new growth factor (referred to as fibroblast growth factor 1/FGF-1) with known effects on the repair and regeneration of damaged tissue was detected in an unlabelled black market product confiscated by the German customs. The identification of the protein was achieved by one- and two-dimensional polyacrylamide gel electrophoresis (SDS-PAGE and 2D-PAGE), different proteolytic digestions, immunological methods and nano-liquid chromatography high-resolution/high-accuracy Orbitrap mass spectrometry. The SDS-PAGE analysis revealed slight differences concerning the molecular weight of recombinant human and black market FGF-1. Using in-gel proteolysis, a truncation or modification located at the N-terminus of the protein was suggested. These findings demonstrate that drug candidates without clinical approval can be readily obtained from the black market, regardless of potential dangerous consequences for the consumer, which corroborates the necessity of proactive and preventive doping control approaches. In that regard, physiological concentrations of blood and urine specimens collected from healthy individuals were analyzed and were found to range below 28 pg/ml in urine, while there was no detectable FGF-1 in plasma.

Skeletal age in youth soccer players: implication for age verification.

OBJECTIVE: To evaluate variation in skeletal age (SA) within single-year chronological age (CA) groups of soccer players aged 11 to 17 years in the context of using SA for age verification in age-group competitions. DESIGN: Cross sectional. SETTING: Regional and elite youth soccer programs. PARTICIPANTS: Five hundred ninety-two male players from Portugal and Spain. INDEPENDENT VARIABLES: Skeletal age assessed with the Fels method. MAIN OUTCOME MEASURES: Skeletal age and maturity status (late, average, early, or mature). RESULTS: Chronological age and SA overlapped in players aged 11 to 12 years, but SA was advanced relative to CA in players aged 14 to 16 years. The majority of players between 11 and 12 years of age were on time in skeletal maturity and percentages of late and early maturers did not differ. The majority of players between 13 and 14 years of age were also on time, but early maturers were 4 times more frequent than late maturers. Percentages of late maturers were low among players aged 14 to 16 years. Among 200 players aged 15 to 16 years, 80 (40%) were advanced in SA by > 1 year and 27 (14%) were skeletally mature, whereas among 23 players aged 17 years, 9 (39%) were skeletally mature. CONCLUSIONS: Among adolescent soccer player, boys advanced in SA for CA are overrepresented and those later in SA for CA are underrepresented with increasing CA. If Fels SA was used to verify CA in this sample of youth for under-17 competition, 36 skeletally mature players aged 15 to 17 years (16%) would be disqualified. The results for this sample of male soccer players question the utility of SA or magnetic resonance imaging as a valid estimate of CA in youth sport competitions.