RCAAP Repository

Background: Cognitive difficulties contribute to patients' disability during migraine attacks and have been overlooked in migraine research. Neuropsychological studies performed during attacks have produced inconsistent findings due to design differences and limitations. Objective: Our objective is to document changes in cognitive performance of migraine patients during migraine attacks with a comprehensive battery of cognitive/behavioral tests, while controlling for potential confounders. Method: A prospective two-period, randomized, cross-over study compared within-subject neuropsychological evaluation in two conditions-during a naturally occurring untreated migraine attack and a headache-free period. Results: Thirty-nine patients with episodic migraine (37 females, average 38 years old) were included and 24 completed the study. Participants performed worse during the attack in the majority of cognitive tests, compared to the headache-free status, and significantly so in word reading speed (p = 0.013), verbal learning (p = 0.01), short-term verbal recall with (p = 0.01) and without (p = 0.013) semantic cueing and delayed recall with (p = 0.003) and without (p = 0.05) semantic cues. Differences found were unrelated to age, gender, literacy, condition order, interval between evaluations, anxiety, pain intensity or duration of the attack. Discussion: Cognitive performance decreases during migraine attacks, especially in reading and processing speed, verbal memory and learning, supporting patients' subjective complaints. These findings suggest the existence of a reversible brain dysfunction during attacks of migraine without aura, which can relate specifically to migraine or be a consequence of acute pain processing by the brain.

Introduction: Rheumatoid arthritis (RA) is a chronic inflammatory autoimmune disease that affects around 1% of the human population worldwide. RA diagnosis can be difficult as there is no definitive test for its detection. Therefore, the aim of this study was to identify biomarkers that could be used for RA diagnosis. Methods: Sera from a collagen-induced arthritis mouse model were used to select potential biomarkers for RA diagnosis by phage display technology. In silico and in vitro analyses were performed to characterize and validate the selected peptides. Samples were classified into three groups: RA; two other immune-mediated rheumatic diseases (systemic lupus erythematosus (SLE) and ankylosing spondylitis (AS)); and healthy controls (HC). Enzyme-linked immunosorbent assay (ELISA) was carried out to determine antibody levels, and diagnostic parameters were determined by constructing receiver operating characteristic curves. Mass spectrometry and Western blot were performed to identify the putative autoantigen that was mimicked by a highly reactive mimotope. Results: After three rounds of selection, 14 clones were obtained and tested for immunoreactivity analysis against sera from RA and HC groups. The phage-fused peptide with the highest immunoreactivity (M12) was synthesized, and was able to efficiently discriminate RA patients from SLE, AS and HCs (p < 0.0001) by ELISA. The specificity and sensitivity of anti-M12 antibodies for RA diagnosis were 91 % and 84.3 %, respectively. The M12 peptide was identified as one that mimics a predicted antigenic site of the carbonic anhydrase III (CAIII) protein, a ubiquitous biomarker that has been identified in patients with other diseases. Conclusion: M12 is the first peptide associated with the CAIII protein that may be used as an antigen for antibody detection to aid in RA diagnosis with high sensitivity and specificity.

Abnormally expanded DNA repeats are associated with several neurodegenerative diseases. In Friedreich's ataxia (FRDA), expanded GAA repeats in intron 1 of the frataxin gene (FXN) reduce FXN mRNA levels in averaged cell samples through a poorly understood mechanism. By visualizing FXN expression and nuclear localization in single cells, we show that GAA-expanded repeats decrease the number of FXN mRNA molecules, slow transcription, and increase FXN localization at the nuclear lamina (NL). Restoring histone acetylation reverses NL positioning. Expanded GAA-FXN loci in FRDA patient cells show increased NL localization with increased silencing of alleles and reduced transcription from alleles positioned peripherally. We also demonstrate inefficiencies in transcription initiation and elongation from the expanded GAA-FXN locus at single-cell resolution. We suggest that repressive epigenetic modifications at the expanded GAA-FXN locus may lead to NL relocation, where further repression may occur.

Breast cancer diagnosis using radar-based medical MicroWave Imaging (MWI) has been studied in recent years. Realistic numerical and physical models of the breast are needed for simulation and experimental testing of MWI prototypes. We aim to provide the scientific community with an online repository of multiple accurate realistic breast tissue models derived from Magnetic Resonance Imaging (MRI), including benign and malignant tumours. Such models are suitable for 3D printing, leveraging experimental MWI testing. We propose a pre-processing pipeline, which includes image registration, bias field correction, data normalisation, background subtraction, and median filtering. We segmented the fat tissue with the region growing algorithm in fat-weighted Dixon images. Skin, fibroglandular tissue, and the chest wall boundary were segmented from water-weighted Dixon images. Then, we applied a 3D region growing and Hoshen-Kopelman algorithms for tumour segmentation. The developed semi-automatic segmentation procedure is suitable to segment tissues with a varying level of heterogeneity regarding voxel intensity. Two accurate breast models with benign and malignant tumours, with dielectric properties at 3, 6, and 9 GHz frequencies have been made available to the research community. These are suitable for microwave diagnosis, i.e., imaging and classification, and can be easily adapted to other imaging modalities.

Rainfall is considered the most important physical process for landslide triggering in Portugal. It is expected that changes in the precipitation regimes in the region, as a direct consequence of climate change, will have influence in the occurrence of extreme rainfall events that will be more frequently, throughout the century. The aim of this study relied on the assessment of the projected future changes in the extreme precipitation over Portugal mainland and quantifying the correlation between extreme rainfall events and landslide events through Rainfall Triggering Thresholds (RTTs). This methodology was applied for two specific locations within two Portuguese areas of great geomorphological interest. To analyze the past frequency of landslide events, we resorted to the DISASTER database. To evaluate the possible projected changes in the extreme precipitation, we used the Iberia02 dataset and the EURO-CORDEX models’ runs at a 0.11° spatial resolution. It was analyzed the models’ performance to simulate extreme values in the precipitation series. The simulated precipitation relied on RCM-GCM models’ runs, from EURO-CORDEX, and a multimodel ensemble mean. The extreme precipitation assessment relied on the values associated to the highest percentiles, and to the values associated to the RTTs’ percentiles. To evaluate the possible future changes of the precipitation series, both at the most representative percentiles and RTTs’ percentiles, a comparison was made between the simulated values from EURO-CORDEX historical runs (1971–2000) and the simulated values from EURO-CORDEX future runs (2071–2100), considering two concentration scenarios: RCP 4.5 and RCP 8.5. In the models’ performance, the multimodel ensemble mean appeared to be within the best representing models. As for the projected changes in the extreme precipitation for the end of the century, when following the RCP 4.5 scenario, most models projected an increase in the extreme values, whereas, when following the RCP 8.5 scenario, most models projected a decrease in the extreme values.

In the context of the growing global middle class, and the ageing of the baby boomer generation, an increasing number of migrants with accumulated wealth from advanced economies are relocating to economically less developed or more peripheral countries to improve their quality of life. Migration of the middle-classes and the relatively affluent is embedded in the same globalising processes and social transformations in production and processes of accumulation that have reshaped labour migration (Hayes, 2021; Castles, 2010). Privileged mobilities are part of wider migration systems, however, what distinguishes lifestyle migrants from other migrants, who are also in pursuit of a better quality of life, is the ease with which they can relocate due to relative privilege in terms of citizenship and financial or cultural capital.

Background: Currently, assessment of symptoms associated with Parkinson's disease is mainly performed in the clinic. However, these assessments have limitations because they provide only a snapshot of the condition. Methods: The feasibility and usability of an objective, continuous and relatively unobtrusive system (SENSE-PARK System), which consists of wearable sensors (three worn during the day and one worn at night), a smartphone-based App, a balance board and computer software, was tested 24/7 over 12 weeks in a study including 22 PD patients. During the first four weeks of the study, patients did not get feedback about their performance, during the last eight weeks they did. The study included seven clinical visits with standardized interviews, and regular phone contact. The primary outcome was the number of drop-outs during the study. As secondary outcomes, the Post-Study System Usability Questionnaire (PSSUQ), score and information obtained from the standardized interviews were used to evaluate the usability of the system. Results: All patients completed the study. The participants rated the usability of the SENSE-PARK System with a mean score of 2.67 (±0.49) on the PSSUQ. The interviews revealed that most participants liked using the system and appreciated that it signaled changes in their health condition. Conclusions: This 12 week controlled study demonstrates that the acceptance level of PD patients using the SENSE-PARK System as a home-based 24/7 assessment is very good. Particular emphasis should be given to a user-friendly design. Motivation to wear such a system can be increased by providing direct feedback about the individual health condition.

2-Deoxy-2-fluoroglycosyl iodides are privileged glycosyl donors for the stereoselective preparation of 1-Nu-β-fluorosugars, which are useful reagents for chemical site-selective protein glycosylation. Ready access to such β-fluorosugars enables the mild and efficient construction of well-defined fluoroglycoproteins.

As part of environmental health surveillance programs related to solid waste incinerators located near Lisbon and on Madeira Island, human biomonitoring projects have been implemented in Portugal, some of them focused on crosssectional surveys of heavy metals in blood. One of the general aims of these programs is to provide Portuguese data on the extent and pattern of human exposure to the pollutants potentially released in the stack gases from the incinerators, namely heavy metals. The present investigation reports information specifically on blood lead levels of newborn– mother pairs living in the vicinity of the incinerators under study, as well as of statistically similar participants living outside the exposed area. For Lisbon, lead levels determined at the baseline period (T0), as well as three subsequent evaluations of potential specific impacts of the incinerator (T1, T2 and T3) are described in order to investigate spatial and temporal trends of human exposure to lead. Available data for Madeira, namely lead levels in blood from the study population before the incinerator started operation, is also described. For Lisbon, analyses showed a statistically significant decrease of lead concentrations in maternal and umbilical cord blood during the whole monitoring period. Practically ‘‘overt’’ transplacental exposure to lead was observed only in the Lisbon biomonitoring project and for some cross-sectional surveys. Baseline levels for Madeira were the lowest found in all observations already performed in both programs (maternal and umbilical cord mean lead levels of 0.4 mg/dl and 0.3 mg/dl, respectively). No statistical associations have been found between lead levels in blood and age neither for global populations from Lisbon and Madeira nor for specific groups included in the different observational periods.

Mechanosensory hair cells (HCs) are the primary receptors of our senses of hearing and balance. Elucidation of the transcriptional networks regulating HC fate determination and differentiation is crucial not only to understand inner ear development but also to improve cell replacement therapies for hearing disorders. Here, we show that combined expression of the transcription factors Gfi1, Pou4f3 and Atoh1 can induce direct programming towards HC fate, both during in vitro mouse embryonic stem cell differentiation and following ectopic expression in chick embryonic otic epithelium. Induced HCs (iHCs) express numerous HC-specific markers and exhibit polarized membrane protrusions reminiscent of stereociliary bundles. Transcriptome profiling confirms the progressive establishment of a HC-specific gene signature during in vitro iHC programming. Overall, this work provides a novel approach to achieve robust and highly efficient HC production in vitro, which could be used as a model to study HC development and to drive inner ear HC regeneration.

Purpose: This prospective cohort study aimed to investigate the short-term soft tissue clinical outcomes and recommendation for evaluation and follow-up after a new hybrid All-on-4 rehabilitation. Methods: Forty consecutively included patients rehabilitated in the complete edentulous atrophic maxillae through a hybrid All-on-4 treatment concept (4 immediate function implants in a combination between zygomatic and conventional implants). Periimplant conditions at zygomatic and conventional implants were compared. Four clinical levels (CLs) were used to classify the presence and severity of periimplant conditions. Results: Four patients withdrew from the study. No significant differences were found for periimplant conditions at zygomatic and conventional implants. The distribution was 28, 2, 1, and 9 patients with CL1, CL2, CL3, and CL4, respectively. Conclusions: Soft tissue clinical outcomes of extramaxillary zygomatic implants and conventional implants seem to follow a similar distribution. The proposed classification system stratifies patients, supports decision making, and with further validation may elucidate recommendations for frequency of recall appointments and intervention to enhance long-term success.

Background: Essential tremor (ET) is a very common movement disorder that has no diagnostic markers. Differentiation with Parkinson's disease (PD) can be clinically challenging in some cases, with a high rate of misdiagnosis. Magnetic resonance imaging (MRI) studies have been able to identify neuromelanin changes in the substantia nigra (SN) of PD patients, but they have thus far not been investigated in ET. In this study, we aimed to characterize neuromelanin-MR signal changes in ET and evaluate its diagnostic accuracy in the differential diagnosis with PD. Methods: The inclusion criteria were patients with ET and untreated "de novo" PD patients; in addition, age-matched controls were enrolled. These were studied with a high-resolution T1-weighted MRI sequence at 3.0 Tesla to visualize neuromelanin. The primary outcomes were the area and width of the SN region with high signal. Results: A total of 15 ET patients and 12 "de novo" PD patients were evaluated. The area and width of the T1 high signal in the SN region were markedly decreased in the PD group compared with the ET and age-matched controls, and a greater decrease was seen in the ventrolateral segment. The neuromelanin measures in the ET group, although slightly lower, were not significantly different from the healthy control group. We obtained a sensitivity of 66.7% and a specificity of 93.3% in discriminating ET from early-stage PD. Conclusions: Neuromelanin-sensitive MRI techniques can discriminate ET from early-stage tremor-dominant PD and can be a useful clinical tool in the evaluation of tremor disorders. © 2015 International Parkinson and Movement Disorder Society.

Family migration is the term used to categorise the international movement of people who migrate due to new or established family ties. People moving for family reasons constitute the largest group of migrants entering OECD countries, ahead of labour and humanitarian migration (OECD, 2017). The study of migrant families cuts across the available legal definitions of family and brings to light emerging forms of living together, gender roles, sexualities, kinship ties, and caregiving practices. This chapter selectively synthesises recent scholarship on family migration, providing insights on the institutionalisation of the field, outlining its approaches and methodologies, and highlighting emerging topics for future research. These include transnational families and how they stay in contact; separated families and deportation; the impact of family migration policies; marriage migration and multi-sited and longitudinal studies used in studying the transformation and diversification of family forms.

Student mobility or student migration? The international (and internal) movement of students displays an equivocal terminology, although the editor of this volume, in presenting us with the title of our chapter, prefers the broader term ‘mobilities’ in contrast to the titles of the other chapters in this section, which are all forms of ‘migration’. So why is it that, when students move—either internationally, or within their own countries—they are not usually seen as ‘migrants’, but as something else? This chapter aims to reflect further on the emergence of the twin concepts of migration and mobility as applied to the movement of students—how the concepts have been deployed in various situations and how they have been conditioned (or not) by different theoretical and methodological approaches to the subject of students’ spatial moves. Given that migration and mobility both connote geographical movement across space and over a range of periods of time, we ‘play’ with this notion of movement and propose the alternative term of student movementation. The chapter is structured in three parts. The first develops the definitional, terminological, and conceptual discussion introduced above. In the second section we survey the various directions in past and ongoing research on international student movementation. The conclusion reflects on gaps in our knowledge in this field. Throughout our account we try to give evidence of the empirical richness of research on students’ international moves by referring to a wide body of literature.

Microwave Imaging (MWI) has been studied to aid early breast cancer detection. Current prototypes in more advanced stages of development include both monostatic or multistatic setups. However, multistatic configurations usually include a high number of antennas which consequently require complex and computationally-intensive signal processing algorithms to ensure a good target detection. We previously presented a novel approach using a dielectric lens which reduces the signal processing burden of multistatic setups, while ensuring good spatial resolution. In this paper, we evaluate this novel setup using an anatomically realistic breast phantom and its capability of selecting targets inside the breast. We show a successful detection of the targets using an artefact removal algorithm based on singular value decomposition when the Bessel beam is centered at the target location.

Esta Newsletter (NL) resulta de uma parceria entre o Instituto de Saúde Baseada na Evidência e a Cochrane Portugal, e tem como objectivo disponibilizar informação sobre áreas importantes para a prática clínica, com base na melhor evidência científica disponível. São incluídos estudos relevantes, criticamente avaliados pela sua validade, importância dos resultados e aplicabilidade prática, resumidos numa óptica de suporte à decisão. É dada prioridade a estudos de causalidade incluindo-se ainda, quando justificado, estudos qualitativos e metodológicos, assim como revisões científicas. O conteúdo da NL é da exclusiva responsabilidade do(s) seu(s) autor(es).

The development of integrated decision-support tools, able to assess multiple hazards at the regional and local scales, is a fundamental step to enhance the preparedness of urban areas to mitigate present and future risks arising from climate change. Understanding multi-hazard risk can help prioritize resilience-increasing actions and disaster prevention measures and form the basis for exploring institutional adjustments that improve stakeholders’ capacities to manage risk. Within this framework, the present research work aims to identify and analyze a set of exposure and buildings’ vulnerability indicators to be used as input to a multi-hazard risk assessment methodology. Exposure is to be measured using a dimensionless score resulting from the quantitative identification of the elements at risk. Regarding the physical vulnerability of buildings, it is to be evaluated on a hazard-by-hazard basis using a large-scale parametric-based vulnerability assessment approach. Finally, the obtained exposure and physical vulnerability indicators are to be put together in order to create different data layers, which are then used to identify hotspot risk areas. The Metropolitan Area of Lisbon, Portugal, is used as a pilot study area to discuss the applicability and potential of the proposed indicators.

O fenómeno da marginalia pessoana, as formas que assume e a intenção que lhe está inerente é o tema deste trabalho, que pretende não só dar a conhecer a intensidade emotiva que caracterizou o processo de leitura de uma vasta biblioteca, como mostrar que as anotações de cada livro são um elemento valioso para a construção de uma identidade literária e que tornam possível aceder aos processos mentais do leitor / anotador em que Pessoa se tornou e aos momentos de interacção com os autores de cada exemplar lido. A análise exaustiva da marginalia de Fernando Pessoa nos livros da sua biblioteca poderá provar ser um auxílio precioso para a reconstrução dos percursos de leitura do poeta, já que os pensamentos expressos nos diversos volumes anotados reflectem preocupações estéticas e literárias que o poeta português manifestaria ao longo da vida na sua própria produção textual. Com este trabalho pretende-se também reconstituir algumas experiências pessoais e uma memória literária e intertextual, demonstrando a intensidade emotiva que caracterizou o processo de leitura dinâmica que Pessoa realizou e apresentando-nos este autor como pensador e interlocutor de cada livro que lia e anotava e como construtor de um percurso de raciocínio e reflexão que foi evoluindo ao longo do tempo e determinou a sua progressão como homem e artista.

As a part of environmental health surveillance programs related to Portuguese solid waste incinerators (SWI), two biomonitoring projects have been established to investigate additional exposure to lead in children under the age of 6 years living in the vicinity of those facilities. The above-mentioned programs, being the only ones in the country that integrate systematic observations on human exposure to heavy metals, have to provide systematic data from Portuguese regions on the extent and pattern of human exposure to heavy metals, namely to lead. The present paper is the third of a series of papers prepared to accomplish that objective in regards to lead exposure as evaluated by measuring lead levels in children under the age of 6 years. Altogether, 250 children from Lisbon and 247 from Madeira Island have already been involved in the investigation. The present study evaluates spatial and temporal trends of lead exposure, based on comparisons of children’s blood lead levels, either stratified by living area (exposed and control groups), or by time of exposure (T0, the baseline time, and T1, after approximately 2 years of regular operation of the facilities). The results obtained correspond to a relatively reduced number of individuals. Possibly for this reason, they are not fully conclusive in relation to whether living in the vicinity of SWI represents an additional risk of higher exposure to lead. Time trends of lead exposure as evaluated by blood lead levels in children also do not show any clear pattern. These conclusions and the fact that altogether around 3% of children from the whole group have blood lead levels X10 mg/dl warrant further investigation in order to clarify the contribution of incinerator emissions to the levels of lead in children and to identify alternative sources for preventive purposes, taking into consideration the relevance of even low lead exposure from a public health perspective, mainly in relation to children.

Cervical cancer is the fourth most common cancer affecting women worldwide, according to the latest IARC release with 528 000 new cases every year. Infection by high-risk human papillomavirus (HPV) is necessary but not sufficient for progression to cancer. Epithelial tissues, the target of HPV infection, are heavily exposed to reactive oxygen species (ROS). Hypochlorous acid (HOCl) is a very potent ROS, and it is produced by myeloperoxidase (MPO). MPO, a lysosomal enzyme expressed in polymorphonuclear neutrophils (PMN), has the potential to kill HPV transformed cells, as a component of an intercellular induced-apoptosis pathway. This enzyme catalyzes the production of HOCl in the presence of hydrogen peroxide (H2O2). The H2O2 produced by the Doderlein's bacillus will interact with MPO, contributing to the intercellular induced-apoptosis pathway. We studied a functional polymorphism in the promoter region of MPO (G463A) and how it may affect the risk of developing cervix cancer. A sample of 100 patients with invasive cervical cancer and 122 control women were genotyped for MPO polymorphism by PCR-RFLP method. The statistical method used was χ(2). We found that women with the GG genotype had lower risk for cervical cancer than the women who displayed the heterozygous genotype GA (OR = 0.546, 95 % CI = 0.315-0.939, p = 0.028, OR = 2.210, 95 % CI = 1.257-3.886, p = 0.008, respectively). The genotype that leads to a higher concentration of ROS (GG) presents itself as a protection factor in comparison to the homozygous genotype (AA). This can be explained by the interaction of HOCl and superoxide of transformed cells that will generate apoptosis-inducing hydroxyl radicals.