RCAAP Repository

Ao longo dos tempos tem-se verificado uma correlação entre obesidade e infertilidade feminina, ambas com prevalências muito significativas na atualidade. As mulheres obesas apresentam maior tempo até à conceção, menos gestações espontâneas, mais disfunções menstruais e, apesar de maior procura de técnicas de procriação medicamente assistida, piores resultados nas mesmas. A fisiopatologia da infertilidade ligada à obesidade não é clara e assenta numa desregulação hormonal e de todas as etapas do sistema reprodutor feminino, desde do eixo hipotálamo-hipófise-ovário até ao próprio endométrio. Esta desregulação apresenta várias causas como alterações nas concentrações de insulina, leptina e adiponectina, bem como uma inflamação crónica sistémica, lipotoxicidade e hiperglicemias presentes no organismo de mulheres obesas. A melhor terapêutica a implementar nestas doentes passa pela perda de peso através de modificações do estilo de vida, de agentes farmacológicos ou mesmo de cirurgia bariátrica dado que além da infertilidade, as mulheres obesas apresentam piores outcomes obstétricos. Assim, com este trabalho pretende-se expor, sob a forma de revisão bibliográfica, os mecanismos fisiopatológicos segundo os quais a obesidade em mulheres em idade fértil origina, por si só, infertilidade, excluindo situações relacionadas com a síndrome do ovário poliquístico. Propõe-se, ainda, uma pequena revisão de diversos estudos focados na perda de peso em mulheres obesas inférteis e na melhoria da fertilidade após a mesma.

O cancro da Cabeça e Pescoço ocorre num número significativo de doentes, que têm um prognóstico pouco favorável e opções terapêuticas limitadas, apesar dos avanços médicos correntes. Tanto no cenário paliativo como curativo, o controlo dos sintomas é um dos principais objetivos do tratamento, pela agressividade biológica do cancro da Cabeça e Pescoço a nível loco-regional. Está comprovado que a integração precoce de ações paliativas melhora as queixas reportadas pelos doentes, incluindo sintomas, qualidade de vida, depressão, coping e entendimento da doença, para além do impacto que tem na sobrevida global. Assim, estima-se que cerca de 60% dos doentes necessitem de terapia paliativa durante o curso da doença. Um acesso à mesma é necessário de forma a assegurar uma boa qualidade de vida e uma morte digna. No entanto, apesar de comprovados benefícios, estas ações ainda são subutilizadas. A decisão precoce de optar por ações paliativas deverá envolver o doente e os seus familiares. Deve ser desenvolvido um plano individualizado com recomendações para avaliações de rotina, análises laboratoriais e consultas, sendo identificados os sinais e sintomas que prejudiquem a saúde física e mental do doente, permitindo guiar e informar sobre as melhores estratégias de coping a adotar. Num futuro próximo, torna-se imprescindível o investimento numa melhoria e generalização de ações paliativas, através de programas de formação pré e pós-graduada, elaboração de normas e guias de boas práticas e alocação de recursos assistenciais neste sentido.

Atualmente o cannabis é a droga de abuso mais plantada, traficada e consumida na sociedade atual. O seu consumo tem aumentado substancialmente nas últimas décadas, principalmente nos países desenvolvidos, onde a sua legalização assim como a descriminalização do seu consumo, têm contribuído para o crescente aumento do número de consumidores de cannabis a nível mundial. Os seus benefícios medicinais têm sido um dos motores primários para a sua legalização tendo, indiscutivelmente, um papel de deveras importância em determinadas patologias. No entanto, os seus efeitos deletérios, associados ao seu consumo, não podem nem devem ser ignorados. Dado que a via mais comum de administração é por inalação, é de extrema relevância tentar perceber qual é o possível impacto do consumo de cannabis em ORL, tanto para os profissionais de saúde, como para os consumidores desta droga.

Está bem demonstrada uma forte correlação entre a ingestão de sódio e a tensão arterial. Porém, o papel do sal na patogénese da hipertensão arterial não está completamente compreendido. Apesar do paradigma atual relativamente à homeostasia do sódio postular que o sódio total do corpo é regulado predominantemente pela variação do volume extracelular, colocando o rim no centro da regulação da tensão arterial a longo-prazo, ao longo dos anos emergiu o papel de outros tecidos, notavelmente a pele. Estudos apoiam a existência de um compartimento de armazenamento não osmótico de sódio. O conteúdo de sódio elevado tem sido associado com uma variedade de condições patológicas, porém, o efeito do armazenamento cutâneo do sódio na tensão arterial e no risco cardiovascular ainda se encontra por determinar. Vários autores questionam as ferramentas atualmente aceites utilizadas para a investigação clínica e epidemiológica da ingestão de sal, nomeadamente a amostra única de sódio urinário, propondo abordagens alternativas. Estas questões suportam consequências essenciais à luz da homeostasia do sódio e da regulação da pressão arterial e requerem mais investigação de forma a serem identificadas novas opções de tratamento.

O objectivo da Newsletter do Instituto de Saúde Baseado na Evidência (ISBE) é a disponibilização de informação sobre áreas relevantes para a prática clínica, baseada na melhor evidência científica. São localizados estudos relevantes e de alta qualidade, criticamente avaliados pela sua validade, importância dos resultados e aplicabilidade prática e resumidos numa óptica de suporte à decisão clínica. É dada prioridade aos estudos de causalidade – revisões sistemáticas, ensaios clínicos, estudos de coorte prospectivos/retrospectivos, estudos seccionais cruzados e caso‐controlo – incluindo‐se ainda, quando justificado, estudos qualitativos considerados de elevada qualidade metodológica e importância clínica.

Rheumatoid arthritis (RA) is a chronic, systemic autoimmune disease of unknown aetiology that affects around 1% of the world population. RA is characterized by symmetric polyarthritis associated with pain and swelling in multiple joints. If left untreated, RA leads to joint destruction, functional disability, comorbidity and reduced life expectancy. Many autoimmune diseases are B-cell dependent, mainly through the production of autoantibodies. Previous studies have documented the importance of B cells in RA pathogenesis through diverse mechanisms. B cells produce autoantibodies, such as rheumatoid factor (RF) and anti-citrullinated protein antibodies (ACPA). These autoantibodies can form immune complexes that deposit in the joints, causing inflammation. Additionally, B cells can function as antigen presenting cells and activate T cells; release cytokines once activated and participate in ectopic lymphoid organogenesis. The discovery that B cell depletion therapy with rituximab (RTX) was effective in RA patients reinforced B cells key position in this autoimmune disease and placed them in the central stage of research. Nevertheless, the majority of the studies on this field have been focused in established RA patients, while the knowledge on B cell dependent immune mechanisms involved in RA onset is still very scarce. The main goal of this work was to study the role of B cells in the very early phase of RA. In order to achieve this, a cohort of untreated polyarthritis patients with less than six weeks of disease duration was prospectively followed up. A full characterization of peripheral blood B cell subpopulations, serum cytokine and chemokine environment, and B-cell gene expression profile analysis was performed. The follow up of these patients allowed the identification of a subgroup that evolved into RA. Thus, these patients were classified as very early RA (VERA) patients. The remaining patients either had self-limited forms of arthritis or evolved into other chronic inflammatory joint diseases. VERA patients were evaluated at baseline and after short-term therapy with corticosteroids and methotrexate (MTX) to analyze the possible influence of treatment in the development of B-cell mediated immune processes in the first weeks of RA. We found that VERA patients had disturbances in circulating memory B cells, namely a decrease in the pre-switch memory (IgD+CD27+) subpopulation; had increased serum levels of cytokines related with B cell recruitment and activation, in particular interleukin (IL)-6, A proliferation-inducing ligand (APRIL) and B-cell activating factor (BAFF); and had alterations in the expression of genes relevant for B cell homeostasis, development and survival, namely BAFF and its receptors. Of note, treatment with corticosteroids and MTX, although clinically effective in reducing inflammatory manifestations, did not seem to affect peripheral B cells or cytokine content in circulation. Additionally, a second cohort of RA patients with established disease and under B cell depletion therapy with RTX was also analyzed. Considering the important role that BAFF has in B cell maturation and survival, it was hypothesized that the balance between BAFFreceptor (BAFF-R) expression and soluble BAFF could influence the relationship between returning B-cell subpopulations and clinical relapse after B cell depletion therapy. Therefore, serum BAFF levels, a phenotypic characterization of the newly emergent circulating B cell subpopulations during B cell reconstitution and the surface BAFF-R expression were analyzed in circulating B cell subsets before and after RTX treatment. During B cell repopulation, after B cell depletion therapy, the majority of circulating B cells had a naïve phenotype and simultaneously there was a decrease in the frequency of memory B cells in circulation, as expected. Interestingly, we found that BAFF-R expression was significantly reduced on both naïve and memory B cells in patients at clinical relapse, however, no differences were detected in patients in remission. In addition, BAFF serum levels were within normal range in patients before RTX and significantly increased after RTX treatment. Nevertheless, the reduction in BAFF-R expression was not correlated with B cell numbers or serum BAFF levels. The increased frequency of postswitch memory B cells (IgD-CD27+) observed in the blood of relapsing patients in comparison with patients in remission might suggest that the re-establishment of active disease can be associated with an increase in class-switch recombination process. Therefore, the results observed in RA patients after B cell depletion therapy suggest that factors responsible for BAFF-R downregulation might be closely linked with altered thresholds in autoreactive B-cell generation and disease re-establishment. In conclusion, the results in this thesis support the existence of alterations in the mechanisms associated with B cells’ physiopathology since the first weeks of RA onset, which can eventually contribute to RA development. Furthermore, an earlier introduction of B-cell directed therapies, such as B cell depletion, or indirect B-cell targeted therapies affecting B cell receptors or its ligands, might be of beneficial clinical use to induce early remission in RA patients.

Due to its novelty, the recent pandemic of the coronavirus disease (COVID-19), which is associated with the spread of the new severe acute respiratory syndrome coronavirus (SARS-CoV-2), triggered the public’s interest in accessing information, demonstrating the importance of obtaining and analyzing credible and updated information from an epidemiological surveillance context. For this purpose, health authorities, international organizations, and university institutions have published online various graphic and cartographic representations of the evolution of the pandemic with daily updates that allow the almost real-time monitoring of the evolutionary behavior of the spread, lethality, and territorial distribution of the disease. The purpose of this article is to describe the technical solution and the main results associated with the publication of the COMPRIME_COMPRI_MOv dashboard for the dissemination of information and multi-scale knowledge of COVID-19. Under two rapidly implementing research projects for innovative solutions to respond to the COVID-19 pandemic, promoted in Portugal by the FCT (Foundation for Science and Technology), a website was created. That website brings together a diverse set of variables and indicators in a dynamic and interactive way that reflects the evolutionary behavior of the pandemic from a multi-scale perspective, in Portugal, constituting itself as a system for monitoring the evolution of the pandemic. In the current situation, this type of exploratory solutions proves to be crucial to guarantee everyone’s access to information while simultaneously emerging as an epidemiological surveillance tool that is capable of assisting decision-making by public authorities with competence in defining control policies and fight the spread of the new coronavirus

The ability to infer the authenticity of other’s emotional expressions is a social cognitive process taking place in all human interactions. Although the neurocognitive correlates of authenticity recognition have been probed, its potential recruitment of the peripheral autonomic nervous system is not known. In this work, we asked participants to rate the authenticity of authentic and acted laughs and cries, while simultaneously recording their pupil size, taken as proxy of cognitive effort and arousal. We report, for the first time, that acted laughs elicited higher pupil dilation than authentic ones and, reversely, authentic cries elicited higher pupil dilation than acted ones. We tentatively suggest the lack of authenticity in others’ laughs elicits increased pupil dilation through demanding higher cognitive effort; and that, reversely, authenticity in cries increases pupil dilation, through eliciting higher emotional arousal. We also show authentic vocalizations and laughs (i.e. main effects of authenticity and emotion) to be perceived as more authentic, arousing and contagious than acted vocalizations and cries, respectively. In conclusion, we show new evidence that the recognition of emotional authenticity can be manifested at the level of the autonomic nervous system in humans. Notwithstanding, given its novelty, further independent research is warranted to ascertain its psychological meaning.

The vascular bioactivity/safety of nanomaterials is typically evaluated by animal testing, which is of low throughput and does not account for biological differences between animals and humans such as ageing, metabolism and disease profiles. The development of personalized human in vitro platforms to evaluate the interaction of nanomaterials with the vascular system would be important for both therapeutic and regenerative medicine. A library of 30 nanoparticle (NP) formulations, in use in imaging, antimicrobial and pharmaceutical applications, was evaluated in a reporter zebrafish model of vasculogenesis and then tested in personalized humanized models composed of human-induced pluripotent stem cell (hiPSC)-derived endothelial cells (ECs) with ‘‘young’’ and ‘‘aged’’ phenotypes in 3 vascular network formats: 2D (in polystyrene dish), 3D (in Matrigel) and in a blood vessel on a chip. As a proof of concept, vascular toxicity was used as the main readout. The results show that the toxicity profile of NPs to hiPSC-ECs was dependent on the ‘‘age’’ of the endothelial cells and vascular network format. hiPSC-ECs were less susceptible to the cytotoxicity effect of NPs when cultured in flow than in static conditions, the protective effect being mediated, at least in part, by glycocalyx. Overall, the results presented here highlight the relevance of in vitro hiPSC-derived vascular systems to screen vascular nanomaterial interactions.

Através da revisão de conceitos importados dos rituais, este livro sobre João Garcia Miguel oferece uma visão particular sobre o uso do corpo no teatro deste criador como pilar da sua obra e, sobretudo, na tríade Yerma; Los Negros e os Deuses do Norte; La Vida Es Sonho (todos com Sara Ribeiro). Questões como o erotismo e o êxtase partilhados entre os performers e o público, são abordadas numa transversalidade entre a biografia e as sexualidades que o corpo apresentado e os corpos representados sugerem de modo mais ou menos evidente. O que o corpo pode fazer e a mente não permite, é a ideia principal que resulta deste livro.

En este estudio, partiendo del papel del Museo Nacional de Arte Romano como centro de investigación de Lusitania, se presentan las líneas que definen el proyecto arqueológico de la ciudad romana de Ammaia. Tras la primera campaña de excavación, y con los resultados obtenidos, se presentan las acciones de presente y futuras líneas de investigación, centradas esencialmente en los espacios públicos de la ciudad, zona del foro y área de espectáculos.

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Entre las transformaciones que definen la evolución de la urbe clásica a la ciudad tardoantigua se encuentra la desarticulación del callejero ortogonal típicamente romano. En el presente estudio pretendemos ofrecer una visión sucinta de los cambios que afectaron a la trama urbana de las tres capitales provinciales de la Hispania altoimperial, abarcando en este análisis un amplio marco temporal que va desde el siglo I al VI d.C., aunque haciendo hincapié en la Antigüedad Tardía. Fenómenos como la ocupación de pórticos y calzadas, la desaparición de las pavimentaciones pétreas bajo nuevos pisos de tierra, la inutilización progresiva de la red de cloacas y el empleo de spolia, marcan una transformación común, aunque variable, que afectará en tiempos y modos diferentes al callejero de estas tres ciudades.

Na Faculdade de Letras da Universidade de Lisboa, uma equipa interdisciplinar está a desenvolver um projeto europeu sobre dunas costeiras. Estes ambientes vistos geralmente como simples “montes de areias” são ecossistemas importantíssimos na dinâmica litoral e têm muitas histórias para contar. Com o objetivo de contribuir para a disseminação da ciência e fomentar a educação ambiental, foi proposto aos professores de uma turma do ensino básico a realização de um trabalho conjunto, para abordar o tema das dunas e desenvolver conteúdos que permitam a sua divulgação nas escolas. O que se apresenta neste artigo é justificação dessa proposta e os materiais que vão ser trabalhados. Espera-se que a experiência, depois de testada, possa ser replicada com outras turmas e grupos etários.

Coastal sand dunes are multifunctional landscapes with rich biodiversity and provide ecological goods and services. They play a dual role as a sediment sink or a source to maintain the long-term stability of a coastal system. These landscapes have been affected by human settlements, economic activities and recreational purposes. Sand dunes in the Manawatu-Wanganui region, in New Zealand, have been subjected to such forcings during Maori settlements and, in particular, since the establishment of Europeans since 1840. Consequently, dunes have evolved from a transgressive system to a parabolic one, while the rate of dune drifting is still observed to be one of the highest in the world. Because this was a problem for populations living in the area, there were several attempts to arrest dune drifting. Using the Driver-Pressure-State-Impact-Response (DPSIR) cyclic framework, we analyzed these interventions during two-time frames: 1) from the 19th to 20th century and 2) during the early 21st century. We checked for data in historical records and literature including the Parliamentary debates of New Zealand. Historical evolutionary trends were inferred by analyzing a series of maps since 1773. The present-day impacts were derived from a series of georeferenced google images from 1983 using the ESRI ArcGIS tools. The coastal management responses were obtained through scientific literature and reports of the Horizon Regional Council. According to the analysis, drivers of dune drift before the 21st century were 1) settlements resulting in burning shrubs, deforestation, grazing, agriculture, mining, and building, 2) introduction of non-native animals. The pressures were: 1) mobile dunes and 2) blowouts. The assessment of the state of the environment included: 1) soil fertility, 2) habitat quality, 3) river navigability and 4) air quality. The assessed impacts were 1) increase of wasteland and loss of fertility, 2) foredune erosion, 3) impact on transportation and 4) creation of swamps as river mouths were closed. The management responses included 1) introduction of 1903 and 1908 Sand Drift acts for reclamation of affected areas, 2) introduction of exotic vegetation (e.g. Marram grass) and 3) foredune building using sand trapping fences. The main drivers of the 21st century are 1) intensive urbanization, 2) introduction of exotic vegetation and 3) global fossil fuel burning. The invasive character of marram resulted in the loss of biodiversity. The coastline erosion due to sea-level rise during the 21st century will be moderated due to its progradational nature. The study revealed a significant spatial variability of the rate of dune drift. The responses include 1) a consolidated “One Plan” as mandated by 1991 Resource Management Act; 2) removal of exotic vegetation to support native biodiversity by enhancing natural processes of dunes (a paradigm shift in dune management); 3) enhancing awareness while encouraging the public participation in mitigating measures. In conclusion, historical data combined with DPSIR framework tools showed that management interventions should be implemented considering long-term and interdisciplinary analysis to better understand the systems’ evolution and the full consequences of human actions.

The Thesis focuses on the analysis of the academic profession under the influence of the government policies for Higher Education and it is theoretically streamlined in the framework of Sociology of Higher Education and Sociology of the Professions The main aim is to describe and analyze the reconfiguration of the academic profession over the on going scenario of changes in Higher Education. The study is based on two fundamental premises: firstly the reconfiguration of the academic profession under the influence of policies and secondly, university teachers, as important social actors in policy implementation, are not passive individual. By giving voice to teachers, the study focuses on understanding how they experience changes in academic work and respond to the policies, what strategies they adopt to deal with constraints, their modes to be in the profession, the dilemmas they face and the strategies they use to respond. The documental research was focused on documents related to Higher Education, the Bologna Process, International Reports, documents guiding the policies of Higher Education in Brazil and Summary on Higher Education Census in Brazil, to capture their ideas-force on the changes in the university world, in special the ones relating to university teachers’ work. The empirical research was conducted in universities located in the Brazilian Amazon with the application of mixed methods of methodological approaches, with a sequential exploratory strategy in two phases: semi-structured interviews and a survey questionnaire. The empirical evidence suggests that university teachers have relative control over their work, find ways to practice the profession and reconcile their interests with the demands of academic work. Although the constraints stemming from the policies in academic work and working conditions, they would remain in the profession, they use strategies to deal with the impacts of policies. Despite these evidences, academic profession has many complex faces and deal with ambiguous challenges that are reshaping or reconfiguring the academic work and profession. The reconfiguration is contradictory and the responses ambivalent.

Desde Quinhentos que a escrita está presente como manuscrito e como impresso e, com ela, a leitura. A modernidade é impensável sem a cultura letrada das elites e sem a aplicação da escrita a novos domínios materiais, simbólicos, de governo e administração, socio-culturais, como também sem a aculturação escrita de novos públicos. Tendo a escrita como motivo central, "Escritas e Cultura na Europa e no Atlântico Modernos" desvela o mundo dos textos, ilustra os campos autoral, editorial, do leitor, comunicacional, intrínsecos à cultura escrita, toma a escrita como campo simbólico, de representação, poder e mobilização. E, enfim, apresenta a cultura escrita como constitutiva da Europa e do Atlântico modernos. Incidindo sobre uma realidade complexa e multidimensional, este livro traz a historicidade e a perspectiva histórica para o centro dos estudos humanísticos, sociais, culturais, educacionais.

“Historiografia e Memórias” reúne textos de comunicações apresentadas num seminário realizado na Faculdade de Letras da Universidade de Lisboa em 24 e 25 de Janeiro de 2011, com a participação de investigadores nacionais e estrangeiros. Neste encontro desenvolveram‑se reflexões sobre temas que se prendem com a construção das memórias nacionais, regionais e individuais, convocando múltiplos pontos de vista teóricos e abordagens: historiografia, antropologia, memorialismo, autobiografia e ensaísmo. Foram questionados diversos tipos de fontes e materiais oriundos de variados âmbitos de intervenção dos indivíduos nas sociedades, nomeadamente da cultura, da política e da actividade académica. Procurou‑se assim atravessar campos e fronteiras do saber, com o objectivo de aprofundar o debate sobre problemas e concepções que estão no centro das relações entre historiografia, memória e sociedade.

Rock art dating has been one of the major challenges since its discovery and recognition. The methods have evolved through the last century, beginning with the study of superpositions and style until to the application of numeric methods since the 1990s. The aim of this paper is to evaluate and publish an up-to-date database of all of the numerical dates currently available for Iberian prehistoric rock art sites. For this purpose, the manuscript reviews all the methods applied so far to Iberian rock art discussing the limits, the sampling involved, and the problems affecting the results. After that, we present and discuss the most relevant results related to each cultural graphic tradition (Palaeolithic, Levantine, Schematic and Megalithic rock art) assessing their value and limitations. Finally, we reflect on the future of rock art dating: unfortunately most of the motifs are not dateble in numeric terms, meaning we still have to combine traditional with numerical methods; but also, we need to keep working on the problems affecting these methods to be able to create a more reliable chronological framework of use to address other issues such as group mobility, cultural networks, and reutilisation of symbolic elements, to name a few.