Assessment of ecotoxicological effects of Fojo coal mine waste elutriate in aquatic species (Douro Coalfield, North Portugal).

Introduction: The exploitation of anthracite A in the Pejão mining complex (Douro Coalfield, North Portugal) resulted in the formation of several coal waste piles without proper environmental control. In 2017, a new pedological zonation emerged in the Fojo area, after the ignition and self-burning of some of the coal waste piles, namely: unburned coal waste (UW); burned coal waste, and a cover layer (BW and CL, respectively); uphill soil (US); mixed burned coal waste (MBW); downhill soil (DS). This study aimed to evaluate the toxic effects of 25 soil elutriates from different pedological materials. Methods: Allivibrio fischeri bioluminescence inhibition assay, Lemna minor growth inhibition assay, and Daphnia magna acute assay were used to assess the toxicity effects. Additionally, total chlorophyll and malondialdehyde (MDA) content and catalase (CAT) activity were also evaluated in L. minor. Results and Discussion: The results obtained from each endpoint demonstrated the extremely heterogeneous nature of soil properties, and the species showed different sensibilities to soil elutriates, however, in general, the species showed the same sensitivity trend (A. fischeri > L. minor > D. magna). The potentially toxic elements (PTE) present in the soil elutriates (e.g., Al, Pb, Cd, Ni, Zn) affected significantly the species understudy. All elutriates revealed toxicity for A. fischeri, while US1 and UW5 were the most toxic for L. minor (growth inhibition and significant alterations in CAT activity) and D. magna (100% mortality). This study highlights the importance of studying soil aqueous phase toxicity since the mobilization and percolation of bioavailable PTE can cause environmental impacts on aquatic ecosystems and biota.

Magnetic Ionic Liquids: Current Achievements and Future Perspectives with a Focus on Computational Approaches.

Magnetic ionic liquids (MILs) stand out as a remarkable subclass of ionic liquids (ILs), combining the desirable features of traditional ILs with the unique ability to respond to external magnetic fields. The incorporation of paramagnetic species into their structures endows them with additional attractive features, including thermochromic behavior and luminescence. These exceptional properties position MILs as highly promising materials for diverse applications, such as gas capture, DNA extractions, and sensing technologies. The present Review synthesizes key experimental findings, offering insights into the structural, thermal, magnetic, and optical properties across various MIL families. Special emphasis is placed on unraveling the influence of different paramagnetic species on MILs' behavior and functionality. Additionally, the Review highlights recent advancements in computational approaches applied to MIL research. By leveraging molecular dynamics (MD) simulations and density functional theory (DFT) calculations, these computational techniques have provided invaluable insights into the underlying mechanisms governing MILs' behavior, facilitating accurate property predictions. In conclusion, this Review provides a comprehensive overview of the current state of research on MILs, showcasing their special properties and potential applications while highlighting the indispensable role of computational methods in unraveling the complexities of these intriguing materials. The Review concludes with a forward-looking perspective on the future directions of research in the field of magnetic ionic liquids.

A simple and easy technique to overcome anatomic challenges of transradial access in STEMI patients.

BACKGROUND: Transradial access (TRA) is associated with fewer access-related complications, earlier discharge and lower mortality than transfemoral access (TFA), being the preferred route to perform primary percutaneous coronary interventions (PPCIs) in STEMI patients. However, the radial artery is smaller, more superficial and thinner than the femoral artery, which may make PPCIs difficult. PURPOSE: This study describes a practical solution to overcome several of the anatomical difficulties during the TRA, demonstrating its outcomes during clinical practice. METHODS: The authors reviewed the clinical records of 1510 STEMI patients who underwent PPCIs over seven years. Of these, 95 (6.3%) patients experienced problems in advancing a 6F guiding catheter and underwent to STR technique. This technique consists in the use of a longer 5Fr STR flush catheter, which can be used as a "child" type rapid exchange catheter inside the 6Fr guiding catheter, adopting a 5-in-6 Fr technique and creating a smooth distal tip transition of the 6Fr guiding catheter. RESULTS: In 89/95 patients (93.7%), this new technique was successful. The majority of these patients were female (51; 53.7%) and the mean age was 67 ± 14.3 years. The mean reperfusion time since arrival at the catheterization laboratory with STR technique was 24.5 ± 9.9 min, being statistically shorter than when a crossover to TFA was used (29.3 ± 9.5 min; p < 0.017). PPCIs were successfully completed in all different coronary arteries, without complications related to the procedure. CONCLUSIONS: The STR technique is a simple and useful approach that allowed more successful passage of guiding catheters through difficult TRA, allowing a reduction of crossover to TFA in this study to 2.4 %, which translates into a shorter reperfusion time.

Phytotoxicity of coal waste elutriates (Douro Coalfield, North Portugal) in Lactuca sativa.

One of the most important mining areas in the Douro Carboniferous Basin is the Pejão Coalfield. In the summer of 2017, a wildfire promoted the ignition and self-burning some of the coal waste piles in the area and caused important environmental changes, promoting a new heterogenic pedological zonation. This study aims to assess the ecotoxicological effects of 25 soil elutriates from these different soil types in seed germination and individual (emergence, growth, and morphologic alterations) and subindividual parameters in Lactuca sativa. The different evaluated endpoints were differently affected regarding the soil elutriate revealing the high heterogeneity of soil characteristics. The presence of different potentially toxic elements (e.g., Cd, Cr, Pb, Zn) in soil elutriates, even in low concentrations, caused effects on L. sativa development. Unburned coal wastes and downhill soil elutriates were able to inhibit the germination of L. sativa and affect them individually and sub-individually (decrease in size, biomass, and presence of morphological alterations). Additionally, it was observed that all soil elutriates induce a decrease in root size. The results highlight the importance of using elutriate samples in phytotoxicity studies of coal mining waste, since the tailings lixiviate may reduce plant establishment and growth, affecting the terrestrial ecosystems. The integrated use of seed germination assays with the analysis of morphological and biochemical alterations in plants proved to be sensitive parameters to evaluate the phytotoxicity of coal mining wastes.

Reduced Chitosan as a Strategy for Removing Copper Ions from Water.

Toxic heavy metals are priority pollutants in wastewater, commonly present in dangerous concentrations in many places across the globe. Although in trace quantities copper is a heavy metal essential to human life, in excess it causes various diseases, whereby its removal from wastewater is a necessity. Among several reported materials, chitosan is a highly abundant, non-toxic, low-cost, biodegradable polymer, comprising free hydroxyl and amino groups, that has been directly applied as an adsorbent or chemically modified to increase its performance. Taking this into account, reduced chitosan derivatives (RCDs 1-4) were synthesised by chitosan modification with salicylaldehyde, followed by imine reduction, characterised by RMN, FTIR-ATR, TGA and SEM, and used to adsorb Cu(II) from water. A reduced chitosan (RCD3), with a moderate modification percentage (43%) and a high imine reduction percentage (98%), proved to be more efficient than the remainder RCDs and even chitosan, especially at low concentrations under the best adsorption conditions (pH 4, RS/L = 2.5 mg mL-1). RCD3 adsorption data were better described by the Langmuir-Freundlich isotherm and the pseudo-second-order kinetic models. The interaction mechanism was assessed by molecular dynamics simulations, showing that RCDs favour Cu(II) capture from water compared to chitosan, due to a greater Cu(II) interaction with the oxygen of the glucosamine ring and the neighbouring hydroxyl groups.

The impact of time-of-day reperfusion on remote ischemic conditioning in ST-elevation myocardial infarction: a RIC-STEMI substudy.

Daytime variation affects the tolerance of cardiomyocytes to ischemia-reperfusion injury (IRI). This study aims to evaluate the impact of time-of-day reperfusion on clinical outcomes of remote ischemic conditioning (RIC) as an adjuvant to primary percutaneous coronary intervention(PPCI) in ST-elevation myocardial infarction(STEMI) patients. A post-hoc analysis of a prospective, single-center parallel 1:1 randomized trial (RIC-STEMI) was performed. This analysis included 448 STEMI patients previously randomized to either PPCI alone (PPCI group) (n = 217) or RIC as an adjuvant to PPCI (RIC + PPCI group) (n = 231). Moreover, the sample was divided according to the time of PPCI: night-morning (22 h-11h59min) (n = 216) or afternoon (12 h-21h59min) (n = 232) groups. The primary follow-up endpoint was a composite of cardiac death and hospitalization due to heart failure. There were no significant differences in the clinical characteristics and the follow-up outcomes between groups. The afternoon period (HR = 0.474; 95% CI 0.230-0.977; p = 0.043) and RIC (HR = 0.423; 95% CI 0.195-0.917; p = 0.029) were independent predictors of the primary follow-up endpoint. An univariate analysis showed a lower frequency of primary follow-up endpoint, just in the afternoon period (10.3%vs0.9%; p = 0.002), in the RIC + PPCI group. A multivariate analysis revealed that RIC was an independent predictor of the primary follow-up endpoint in the afternoon group (HR = 0.098; 95% CI 0.012-0.785; p = 0.029), but not in the night-morning group. In addition, the afternoon period was not an independent predictor of the primary follow-up endpoint when the multivariate analysis was performed in the PPCI group. In conclusion, this study showed an important cardioprotective effect of RIC, namely in the afternoon period, suggesting that the afternoon period enhances the cardioprotection induced by RIC.

ST-Segment Elevation Myocardial Infarction Differences between Genders - A Single Center Retrospective Analysis. / Diferenças entre os Sexos no Infarto Agudo do Miocárdio com Supradesnivelamento do Segmento ST ­ Análise Retrospectiva de um Único Centro.

BACKGROUND: Although outcomes in patients with ST-segment elevation myocardial infarction (STEMI) undergoing primary percutaneous coronary interventions (PCI) have improved, women show higher mortality. OBJECTIVES: To assess gender differences in presentation, management and in-hospital mortality, at 30-days, 6-months and 1-year after STEMI. METHODS: We retrospectively collected data from 809 consecutive patients treated with primary PCI and compared the females versus males at the local intervention cardiology database. The level of significance used was p<0.05. RESULTS: Women were older than man (69,1±14,6 vs. 58,5±12,7 years; p<.001) with higher prevalence of age over 75 years (36.7% vs. 11.7%; p<.001), diabetes (30,6% vs. 18,5%; p=.001), hypertension (60.5% vs. 45.9%; p=.001), chronic kidney disease (3.4% vs. 0.6%; p=.010) and acute ischemic stroke (6.8% vs. 3.0%; p=.021). At presentation, women had more atypical symptoms, less chest pain (p=.014) and were more frequently in cardiogenic shock (p=.011)). Women had longer time until reperfusion (p=.001) and were less likely to receive optimal medical therapy (p<0.05). In-hospital mortality (p=.001), at 30-days (p<.001), 6-months (p<.001) and 1-year (16.4% vs. p<.001) was higher in women. The multivariate analysis identified age over 75 years (HR=4.25; 95% CI[1.67-10.77];p=.002), Killip class II (HR=8.80; 95% CI[2.72-28.41];p<.001), III (HR=5.88; 95% CI [0.99-34.80]; p=.051) and IV (HR=9.60; 95% CI[1.86-48.59];p=.007), Acute Kidney Injury (HR=2.47; 95% CI[1.00-6.13];p=.051) and days of hospitalization (HR=1.04; 95% CI[1.01-1.08];p=.030) but not female gender (HR=0.83; 95% CI[0.33-2.10];p=.690) as independent prognostic factors of mortality. CONCLUSIONS: Compared to men, women with STEMI undergoing primary PCI have higher mortality rates. Women admitted for STEMI have a worse risk profile, are treated with a higher reperfusion time related with system delays and are less likely to receive the recommended therapy. Female gender was not an independent prognostic factor for mortality in the studied population.

FUNDAMENTO: Embora os resultados em pacientes com infarto do miocárdio com supradesnivelamento do segmento ST (IAMCSST) submetidos a intervenções coronárias percutâneas (ICP) primárias tenham melhorado, as mulheres apresentam maior mortalidade. Objetivos: Avaliar as diferenças de gênero na apresentação, manejo e mortalidade hospitalar, em 30 dias, 6 meses e 1 ano após IAMCSST. MÉTODOS: Coletamos retrospectivamente dados de 809 pacientes consecutivos tratados com ICP primária e comparamos mulheres versus homens no banco de dados de cardiologia de intervenção local. O nível de significância utilizado foi p<0,05. RESULTADOS: As mulheres eram mais velhas que os homens (69,1±14,6 vs. 58,5±12,7 anos; p<0,001) com maior prevalência de idade acima de 75 anos (36,7% vs. 11,7%; p<0,001), diabetes (30,6% vs. 18,5%; p=0,001), hipertensão (60,5% vs. 45,9%; p=0,001), doença renal crônica (3,4% vs. 0,6%; p= 0,010) e acidente vascular cerebral isquêmico agudo (6,8% vs. 3,0%; p=0,021). Na apresentação, as mulheres apresentavam mais sintomas atípicos, menos dor torácica (p=0,014) e estavam mais frequentemente em choque cardiogênico (p=0,011)). As mulheres tinham mais tempo até a reperfusão (p=0,001) e eram menos propensas a receber terapia médica ideal (p<0,05). A mortalidade intra-hospitalar (p=0,001), em 30 dias (p<0,001), 6 meses (p<0,001) e 1 ano (16,4% vs. p<0,001) foi maior nas mulheres. A análise multivariada identificou idade acima de 75 anos (HR=4,25; IC 95%[1,67-10,77];p=0,002), classe Killip II (HR=8,80; IC 95%[2,72-28,41];p<0,001), III (HR=5,88; IC95% [0,99-34,80]; p=0,051) e IV (HR=9,60; IC 95%[1,86-48,59];p=0,007), Lesão Renal Aguda (HR=2,47; IC 95% [1,00-6,13];p=0,051) e dias de hospitalização (HR=1,04; IC 95%[1,01-1,08];p=0,030), mas não o sexo feminino (HR=0,83; IC95% [0,33-2,10];p=0,690) como fatores prognósticos independentes de mortalidade. CONCLUSÕES: Comparadas aos homens, as mulheres com IAMCSST submetidas à ICP primária apresentam maiores taxas de mortalidade. Mulheres hospitalizadas por IAMCSST têm pior perfil de risco, são tratadas com maior tempo de reperfusão relacionado a atrasos do sistema e têm menor probabilidade de receber a terapia recomendada. O sexo feminino não foi fator prognóstico independente para mortalidade na população estudada.

Impact of door in-door out time on total ischemia time and clinical outcomes in patients with ST-elevation myocardial infarction.

INTRODUCTION: Patients with ST-elevation myocardial infarction (STEMI) requiring inter-hospital transfer for primary percutaneous coronary intervention (PCI) often have delays in reperfusion. The door in-door out (DIDO) time is recommended to be less than 30 min. OBJECTIVES: To assess the DIDO time of hospitals that transfer patients with STEMI to a PCI center and to assess its impact on total ischemia time and clinical outcomes in patients with STEMI. METHODS: We performed a retrospective study of 523 patients with STEMI transferred to a PCI center for primary PCI between January 1, 2013 and June 30, 2017. RESULTS: Median DIDO time was 82 min (interquartile range, 61-132 min). Only seven patients (1.3%) were transferred in ≤30 min. Patients with DIDO times over 60 min had significantly longer system delays (207.3 min vs. 112.7 min; p<0.001) and total ischemia time (344.2 min vs. 222 min; p<0.001) than patients transferred in ≤60 min. Observed in-hospital mortality was significantly higher among patients with DIDO times >60 min vs. ≤60 min (5.1% vs. 0%; p=0.006; adjusted odds ratio for in-hospital mortality, 1.27 [95% CI 1.062-1.432]). By the end of follow-up, patients belonging to the >60 min group had a higher mortality (p=0.016), and survival time was significantly shorter (p=0.011). CONCLUSION: A DIDO time ≤30 min was observed in only a small proportion of patients transferred for primary PCI. DIDO times of ≤60 min were associated with shorter delays in reperfusion, lower in-hospital mortality and longer survival times.

Syncope in the athlete - Minor changes, major diagnosis!

We report the case of a 17-year-old athlete who resorted to the emergency department for palpitations and dizziness while exercising. He mentioned two exercise-associated episodes of syncope in the last six months. He was tachycardic and hypotensive. The electrocardiogram showed regular wide complex tachycardia, left bundle branch block morphology with superior axis restored to sinus rhythm after electrical cardioversion. In sinus rhythm, it showed T-wave inversion in V1-V5. Transthoracic echocardiography revealed mild dilation and dysfunction of the right ventricle (RV) with global hypocontractility. Cardiac magnetic resonance (CMR) revealed a RV end diastolic volume indexed to body surface area of 180 ml/m2, global hypokinesia and RV dyssynchrony, subepicardial late enhancement in the distal septum and in the middle segment of the inferoseptal wall. The patient underwent a genetic study which showed a mutation in the gene that encodes the desmocolin-2 protein (DSC-2), which is involved in the pathogenesis of arrhythmogenic right ventricular cardiomyopathy (ARVC). According to the modified Task Force Criteria for this diagnosis, the patient presented four major criteria for ARVC. Thus, a subcutaneous cardioverter was implanted, and the patient was followed up at the cardiology department. Arrhythmogenic right ventricular cardiomyopathy diagnosis is based on structural, functional, electrophysiological and genetic criteria reflecting underlying histological changes. This case depicts the essential characteristics for disease recognition.

Atrial cardiopathy in young adults with embolic stroke of undetermined source: a myocardial deformation imaging analysis.

BACKGROUND: Atrial cardiopathy (AC) has emerged as a potential pathological thrombogenic atrial substract of embolic stroke of undetermined source (ESUS), even in the absence of atrial fibrillation. Left atrium (LA) myocardial deformation analysis may be of value as a subclinical marker of AC and a predictor of ESUS. AIMS: To compare LA mechanical function between ESUS cases and age and sex-matched controls. METHODS: A single-center analytical study with case-control design was performed. Case group was composed by young patients admitted in the Neurology department from January 2017 to June 2021. Control group was composed by age and sex matched controls recruited from the community. All participants performed echocardiogram and a smaller sample underwent cardiac magnetic resonance. RESULTS: We recruited 31 ESUS patients aged between 18 and 65 years and 31 age and sex matched controls. ESUS patients had a significantly higher prevalence of cardiovascular risk factors and patent foramen ovale (PFO). The prevalence of AC was not different between groups. Echocardiogram parameters, including strain analysis, were similar between groups, except for LA appendage (LAA) ostium variation which was significantly lower in ESUS patients (absolute: 6.5vs8.7mm, p<0.001; relative: 44.5%vs53.4%, p=0.002). After exclusion of patients with PFO, all the results were statistically similar. Regarding cardiac magnetic resonance analysis, there were no statistically significant differences between groups. CONCLUSION: This study shows that in our population atria cardiopathy and atrial function was not associated with ESUS.LAA structural and functional abnormalities may play a major role. The role of LAA in ESUS warrants further studies.

TEMPO enables sequential genetic labeling and manipulation of vertebrate cell lineages.

During development, regulatory factors appear in a precise order to determine cell fates over time. Consequently, to investigate complex tissue development, it is necessary to visualize and manipulate cell lineages with temporal control. Current strategies for tracing vertebrate cell lineages lack genetic access to sequentially produced cells. Here, we present TEMPO (Temporal Encoding and Manipulation in a Predefined Order), an imaging-readable genetic tool allowing differential labeling and manipulation of consecutive cell generations in vertebrates. TEMPO is based on CRISPR and powered by a cascade of gRNAs that drive orderly activation and inactivation of reporters and/or effectors. Using TEMPO to visualize zebrafish and mouse neurogenesis, we recapitulated birth-order-dependent neuronal fates. Temporally manipulating cell-cycle regulators in mouse cortex progenitors altered the proportion and distribution of neurons and glia, revealing the effects of temporal gene perturbation on serial cell fates. Thus, TEMPO enables sequential manipulation of molecular factors, crucial to study cell-type specification.

Diferenças entre os Sexos no Infarto Agudo do Miocárdio com Supradesnivelamento do Segmento ST - Análise Retrospectiva de um Único Centro / ST-Segment Elevation Myocardial Infarction Differences between Genders - A Single Center Retrospective Analysis

Resumo Fundamento Embora os resultados em pacientes com infarto do miocárdio com supradesnivelamento do segmento ST (IAMCSST) submetidos a intervenções coronárias percutâneas (ICP) primárias tenham melhorado, as mulheres apresentam maior mortalidade. Objetivos: Avaliar as diferenças de gênero na apresentação, manejo e mortalidade hospitalar, em 30 dias, 6 meses e 1 ano após IAMCSST. Métodos Coletamos retrospectivamente dados de 809 pacientes consecutivos tratados com ICP primária e comparamos mulheres versus homens no banco de dados de cardiologia de intervenção local. O nível de significância utilizado foi p<0,05. Resultados As mulheres eram mais velhas que os homens (69,1±14,6 vs. 58,5±12,7 anos; p<0,001) com maior prevalência de idade acima de 75 anos (36,7% vs. 11,7%; p<0,001), diabetes (30,6% vs. 18,5%; p=0,001), hipertensão (60,5% vs. 45,9%; p=0,001), doença renal crônica (3,4% vs. 0,6%; p= 0,010) e acidente vascular cerebral isquêmico agudo (6,8% vs. 3,0%; p=0,021). Na apresentação, as mulheres apresentavam mais sintomas atípicos, menos dor torácica (p=0,014) e estavam mais frequentemente em choque cardiogênico (p=0,011)). As mulheres tinham mais tempo até a reperfusão (p=0,001) e eram menos propensas a receber terapia médica ideal (p<0,05). A mortalidade intra-hospitalar (p=0,001), em 30 dias (p<0,001), 6 meses (p<0,001) e 1 ano (16,4% vs. p<0,001) foi maior nas mulheres. A análise multivariada identificou idade acima de 75 anos (HR=4,25; IC 95%[1,67-10,77];p=0,002), classe Killip II (HR=8,80; IC 95%[2,72-28,41];p<0,001), III (HR=5,88; IC95% [0,99-34,80]; p=0,051) e IV (HR=9,60; IC 95%[1,86-48,59];p=0,007), Lesão Renal Aguda (HR=2,47; IC 95% [1,00-6,13];p=0,051) e dias de hospitalização (HR=1,04; IC 95%[1,01-1,08];p=0,030), mas não o sexo feminino (HR=0,83; IC95% [0,33-2,10];p=0,690) como fatores prognósticos independentes de mortalidade. Conclusões Comparadas aos homens, as mulheres com IAMCSST submetidas à ICP primária apresentam maiores taxas de mortalidade. Mulheres hospitalizadas por IAMCSST têm pior perfil de risco, são tratadas com maior tempo de reperfusão relacionado a atrasos do sistema e têm menor probabilidade de receber a terapia recomendada. O sexo feminino não foi fator prognóstico independente para mortalidade na população estudada.

Abstract Background Although outcomes in patients with ST-segment elevation myocardial infarction (STEMI) undergoing primary percutaneous coronary interventions (PCI) have improved, women show higher mortality. Objectives To assess gender differences in presentation, management and in-hospital mortality, at 30-days, 6-months and 1-year after STEMI. Methods We retrospectively collected data from 809 consecutive patients treated with primary PCI and compared the females versus males at the local intervention cardiology database. The level of significance used was p<0.05. Results Women were older than man (69,1±14,6 vs. 58,5±12,7 years; p<.001) with higher prevalence of age over 75 years (36.7% vs. 11.7%; p<.001), diabetes (30,6% vs. 18,5%; p=.001), hypertension (60.5% vs. 45.9%; p=.001), chronic kidney disease (3.4% vs. 0.6%; p=.010) and acute ischemic stroke (6.8% vs. 3.0%; p=.021). At presentation, women had more atypical symptoms, less chest pain (p=.014) and were more frequently in cardiogenic shock (p=.011)). Women had longer time until reperfusion (p=.001) and were less likely to receive optimal medical therapy (p<0.05). In-hospital mortality (p=.001), at 30-days (p<.001), 6-months (p<.001) and 1-year (16.4% vs. p<.001) was higher in women. The multivariate analysis identified age over 75 years (HR=4.25; 95% CI[1.67-10.77];p=.002), Killip class II (HR=8.80; 95% CI[2.72-28.41];p<.001), III (HR=5.88; 95% CI [0.99-34.80]; p=.051) and IV (HR=9.60; 95% CI[1.86-48.59];p=.007), Acute Kidney Injury (HR=2.47; 95% CI[1.00-6.13];p=.051) and days of hospitalization (HR=1.04; 95% CI[1.01-1.08];p=.030) but not female gender (HR=0.83; 95% CI[0.33-2.10];p=.690) as independent prognostic factors of mortality. Conclusions Compared to men, women with STEMI undergoing primary PCI have higher mortality rates. Women admitted for STEMI have a worse risk profile, are treated with a higher reperfusion time related with system delays and are less likely to receive the recommended therapy. Female gender was not an independent prognostic factor for mortality in the studied population.

Dissecção espontânea da artéria coronária, uma doença multifatorial: perspectivas da experiência de um centro / Spontaneous coronary artery dissection, a multifactorial disease: insights from a center experience

Introdução: Embora seja uma doença pouco conhecida, a dissecção espontânea da artéria coronária é uma causa importante e frequentemente subdiagnosticada da síndrome coronariana aguda não aterosclerótica, principalmente em mulheres. O objetivo deste estudo foi caracterizar uma amostra consecutiva de pacientes diagnosticados com dissecção espontânea da artéria coronária quanto a fatores predisponentes e desencadeadores; quadro clínico e angiográfico; abordagem terapêutica; ocorrência de eventos cardíacos adversos; recorrência e dissecção espontânea de artéria coronária de novo. Métodos: Estudo retrospectivo observacional longitudinal, unicêntrico, que incluiu pacientes diagnosticados com dissecção espontânea da artéria coronária (n=60) admitidos entre janeiro de 2010 e dezembro de 2020. Resultados: A mediana da idade foi de 55 anos, e 83% eram mulheres. A maioria dos pacientes (60%) não apresentava nenhum ou tinha apenas um fator de risco cardiovascular. O infarto agudo do miocárdio sem supradesnivelamento do segmento ST foi o quadro clínico em 67% dos casos. A artéria coronária mais frequentemente envolvida foi a descendente anterior (47%). A maioria das lesões (77%) aparecia na angiografia como dissecção espontânea da artéria coronária tipo 2. O tratamento conservador foi selecionado como abordagem inicial na maioria dos pacientes (72%). A incidência geral de dissecção espontânea da artéria coronária de novo não foi significativamente diferente entre os pacientes tratados primeiramente com revascularização, em comparação com os que receberam tratamento conservador (p=0,953). No entanto, a recidiva da dissecção espontânea da artéria coronária ocorreu no vaso originalmente envolvido em 3 dos 15 pacientes tratados com revascularização, em comparação com apenas um entre os 43 pacientes que foram tratados de forma conservadora (p<0,05). Conclusão: A dissecção espontânea da artéria coronária é mais frequente em mulheres jovens. O infarto agudo do miocárdio sem supradesnivelamento do segmento ST foi o quadro clínico mais observado, envolvendo principalmente a artéria descendente anterior. A revascularização não protegeu da recorrência.

Background: Although it is a poorly known disease, spontaneous coronary artery dissection is an important and frequently underdiagnosed cause of non-atherosclerotic acute coronary syndrome, particularly in women. The objective of this study was to characterize a consecutive sample of patients diagnosed with spontaneous coronary artery dissection with respect to predisposing and precipitating factors; clinical and angiographic presentation; management; occurrence of adverse cardiac events; recurrence; and de novo spontaneous coronary artery dissection. Methods: Longitudinal, observational, retrospective, single-centre study, including patients diagnosed with spontaneous coronary artery dissection (n=60) admitted between January 2010 and December 2020. Results: Median age was 55 years, and 83% were women. Most patients (60%) presented without any or just one cardiovascular risk factor. Non-ST-segment elevation acute myocardial infarction accounted for 67% of clinical presentations. The most frequently affected coronary artery was the left anterior descending (47%). Most lesions (77%) appeared on angiography as type 2 spontaneous coronary artery dissection. Conservative management was chosen as the initial approach in most patients (72%). The overall incidence of de novo spontaneous coronary artery dissection was not significantly different among patients initially managed with revascularization as compared to conservative treatment (p=0.953). However, spontaneous coronary artery dissection recurrence occurred in the originally involved vessel in 3 of 15 patients initially managed with revascularization, as compared to only one among 43 patients treated conservatively (p<0.05). Conclusion: Spontaneous coronary artery dissection occurs more often in young women. Non- ST-segment elevation acute myocardial infarction was the most frequent clinical presentation involving mainly the left anterior descending artery. Revascularization did not protect from recurrence.

The Gaze Dialogue Model: Nonverbal Communication in HHI and HRI.

When humans interact with each other, eye gaze movements have to support motor control as well as communication. On the one hand, we need to fixate the task goal to retrieve visual information required for safe and precise action-execution. On the other hand, gaze movements fulfil the purpose of communication, both for reading the intention of our interaction partners, as well as to signal our action intentions to others. We study this Gaze Dialogue between two participants working on a collaborative task involving two types of actions: 1) individual action and 2) action-in-interaction. We recorded the eye-gaze data of both participants during the interaction sessions in order to build a computational model, the Gaze Dialogue, encoding the interplay of the eye movements during the dyadic interaction. The model also captures the correlation between the different gaze fixation points and the nature of the action. This knowledge is used to infer the type of action performed by an individual. We validated the model against the recorded eye-gaze behavior of one subject, taking the eye-gaze behavior of the other subject as the input. Finally, we used the model to design a humanoid robot controller that provides interpersonal gaze coordination in human-robot interaction scenarios. During the interaction, the robot is able to: 1) adequately infer the human action from gaze cues; 2) adjust its gaze fixation according to the human eye-gaze behavior; and 3) signal nonverbal cues that correlate with the robot's own action intentions.

Infective endocarditis: Epidemiology and prognosis.

INTRODUCTION: Infective endocarditis (IE) is associated with high morbidity and mortality, despite advances in diagnosis and treatment. OBJECTIVE: To assess changes in the epidemiological profile of IE, to perform a time-trend analysis and to define short-term and long-term prognostic predictors of IE. METHODS: Retrospective analysis of 173 patients admitted with a diagnosis of IE to a Portuguese level II Hospital between January 1998 and December 2013. The patients were divided into two groups according to the period of occurrence of the IE episode (1998-2007 vs. 2008-2013). The clinical event studied was the occurrence of death or the need for urgent surgery during hospitalization, and death in the follow-up period. Independent predictors of short-term and long-term prognosis were identified. RESULTS: In the first portion of the study, IE occurred in younger individuals, often drug addicts, users of intravenous drugs and with gastrointestinal disease, human immunodeficiency virus and hepatitis B infection. In the second portion of the study, IE occurred more frequently in individuals of an older age with concomitant cardiovascular disease; enterococcus was isolated more frequently. The independent predictors of in-hospital death or need for urgent valve surgery were septic shock and the occurrence of peri-annular complications. The independent predictors of long-term mortality were age, chronic kidney disease and IE due to multidrug-resistant microorganisms. CONCLUSION: Differences were found in the epidemiological profile of IE during the study period. Referral for valve surgery increased slightly, but mortality remained high.

The Clinical Management of Pompe Disease: A Pediatric Perspective.

Pompe disease (PD) is an inherited metabolic disorder caused by a deficiency of acid α-glucosidase (GAA), leading to lysosomal accumulation of glycogen, mainly in skeletal and cardiac muscles as well as the nervous system. Patients with PD develop cellular dysfunction and muscle damage. PD can be classified into two classic forms, namely infantile-onset PD (IOPD) and late-onset PD (LOPD). Delayed treatment, particularly in IOPD, would result in significant organ damage and early death. Nonetheless, early diagnosis and timely treatment are often hampered by the rarity of PD and its wide variety of, but overlapping, symptoms. This article reviews the common clinical presentations of PD and outlines the essentials of PD management. In particular, the implications of newborn screening (NBS) and clinical performance of enzyme replacement therapy (ERT) are highlighted.

Tracing and Manipulating Drosophila Cell Lineages Based on CRISPR: CaSSA and CLADES.

Cell lineage defines the mitotic connection between cells that make up an organism. Mapping these connections in relation to cell identity offers an extraordinary insight into the mechanisms underlying normal and pathological development. The analysis of molecular determinants involved in the acquisition of cell identity requires gaining experimental access to precise parts of cell lineages. Recently, we have developed CaSSA and CLADES, a new technology based on CRISPR that allows targeting and labeling specific lineage branches. Here we discuss how to better exploit this technology for lineage studies in Drosophila, with an emphasis on neuronal specification.

Intermolecular Forces: From Atoms and Molecules to Nanostructures.

Intermolecular forces, determined by the critical balance of interacting components having physical and chemical natures, control most of the static and dynamic properties of matter such as their existence in solid, liquid and gaseous phases, with their relative stability, and their chemical reactivity [...].

Thermodynamic Signatures of Structural Transitions and Dissociation of Charged Colloidal Clusters: A Parallel Tempering Monte Carlo Study.

Computational simulation of colloidal systems make use of empirical interaction potentials that are founded in well-established theory. In this work, we have performed parallel tempering Monte Carlo (PTMC) simulations to calculate heat capacity and to assess structural transitions, which may occur in charged colloidal clusters whose effective interactions are described by a sum of pair potentials with attractive short-range and repulsive long-range components. Previous studies on these systems have shown that the global minimum structure varies from spherical-type shapes for small-size clusters to Bernal spiral and "beaded-necklace" shapes at intermediate and larger sizes, respectively. In order to study both structural transitions and dissociation, we have organized the structures appearing in the PTMC calculations by three sets according to their energy: (i) low-energy structures, including the global minimum; (ii) intermediate-energy "beaded-necklace" motifs; (iii) high-energy linear and branched structures that characterize the dissociative clusters. We observe that, depending on the cluster, either peaks or shoulders on the heat-capacity curve constitute thermodynamics signatures of dissociation and structural transitions. The dissociation occurs at T=0.20 for all studied clusters and it is characterized by the appearance of a significant number of linear structures, while the structural transitions corresponding to unrolling the Bernal spiral are quite dependent on the size of the colloidal system.