Evaluation of inter- and intra-operator variability in a pulse wave velocity assessment device

Introdução – Os dispositivos de medição da velocidade de onda de pulso (VOP) são instrumentos valiosos na determinação do risco cardiovascular de cada indivíduo, sendo a VOP um dos parâmetros a aferir segundo as guidelines de avaliação da HTA. Para os dispositivos serem validados é necessária a verificação da sua reprodutibilidade, através da avaliação da variabilidade inter e intraoperador. O objetivo deste estudo foi classificar estas variabilidades no dispositivo de medição da VOP, Complior® SP. Metodologia – Estudo observacional descritivo e transversal numa amostra de 38 indivíduos com idades entre os 18 e os 30 anos de idade, sem fatores de risco cardiovasculares, realizado na Escola Superior de Tecnologia da Saúde de Lisboa. O procedimento para a obtenção de dados foi adaptado do protocolo da sociedade ARTERY em 2010 para validação de dispositivos de medição da VOP. Para avaliar a reprodutibilidade do dispositivo foram comparados os valores médios obtidos por dois operadores. A precisão do dispositivo classifica-se em excelente se a diferença dos valores médios for 1,5m/s. Resultados – Amostra constituída por 25 indivíduos do sexo feminino e 13 do sexo masculino com média de idades de 22,6±2,79 anos. Para o operador A (p=0,863), os valores médios da VOP foram de 6,018±0,88m/s e para o operador B (p=0,587) de 6,155±1,03m/s. A diferença de valores médios e do DP da VOP dos operadores A e B foi de 0,137±0,15m/s (p=0,245). Considerações finais – O dispositivo de medição Complior® SP possui uma excelente reprodutibilidade e reduzida variabilidade, tanto inter como intraoperador, considerando-se um dispositivo validado para avaliação do risco cardiovascular.ABSTRACT: Background – Pulsed wave velocity (PWV) assessment devices are valuable instruments for the determination of cardiovascular risk of each individual. PWV is one of the existing parameters in the guidelines for management of hypertension. It’s important to evaluate inter and intra-operator variability so the devices can increase their value. This study aims to classify inter and intra-operator variability of PWV assessment device, Complior® SP. Methods – Observational descriptive and transversal study was performed with a sample of 38 individuals aged between 18 and 30 years old, with no cardiovascular risk factors. The data collection was performed at the Lisbon School of Health Technology. The procedure was adapted from the ARTERY society protocol for the PWV measurement devices validation. To evaluate the reproducibility of the device, the mean values obtained by two operators were compared. The device precision is classified as excellent if the difference of the mean values is 1.5m/s. Results – Twenty-five female and 13 male individuals took part in this study with mean age of 22.6±2.79 years old. For operator A (p=0.863) the mean values of PWV were 6.018±0.88m/s and for operator B were 6.115±1.03m/s. The PWV mean difference values between and SD between operators was 0.137±0.15m/s (p=0.245). Conclusion – The Complior® SP has excellent reproducibility and reduced intra and inter-operator variability, being considered valid for cardiovascular risk assessment.info:eu-repo/semantics/publishedVersio

Self-reported difficulties with everyday function, cognitive symptoms, and cognitive function in people with HIV

BACKGROUND: We determined factors associated with self-reported decline in activities of daily living (ADLs) and symptoms of cognitive impairment in HIV positive (HIV+) adults in five European clinics. METHODS: HIV+ adults underwent computerized and pen-and-paper neuropsychological tests and questionnaires of cognitive symptoms and ADLs. We considered cognitive function in five domains, psychosocial factors and clinical parameters as potentially associated with symptoms. Separate regression analyses were used to determine factors associated with decline in ADL (defined as self-reported decline affecting ≥2 ADLs and attributed to cognitive difficulties) and self-reported frequency of symptoms of cognitive impairment. We also estimated the diagnostic accuracy of both questionnaires as tests for cognitive impairment. RESULTS: 448 patients completed the assessments (mean age 45.8 years, 84% male, 87% white, median CD4 count 550 cells/mm, median time since HIV diagnosis 9.9 years, 81% virologically suppressed [HIV-1 plasma RNA <50 copies/mL]). Ninety-six (21.4%) reported decline in ADLs and attributed this to cognitive difficulties. Self-reported decline in ADLs and increased symptoms of cognitive impairment were both associated with worse performance on some cognitive tests. There were also strong associations with financial difficulties, depressive and anxiety symptoms, unemployment, and longer time since HIV diagnosis. Both questionnaires performed poorly as diagnostic tests for cognitive impairment. CONCLUSION: Patients' own assessments of everyday function and symptoms were associated with objectively-measured cognitive function. However, there were strong associations with other psychosocial issues including mood and anxiety disorders and socioeconomic hardship. This should be considered when assessing HIV-associated cognitive impairment in clinical care or research studies

Blood Supply to the Integument of the Abdomen of the Rat: A Surgical Perspective

BACKGROUND: Many fundamental questions regarding the blood supply to the integument of the rat remain to be clarified, namely the degree of homology between rat and humans. The aim of this work was to characterize in detail the macro and microvascular blood supply to the integument covering the ventrolateral aspect of the abdominal wall of the rat. METHODS: Two hundred five Wistar male rats weighing 250-350 g were used. They were submitted to gross anatomical dissection after intravascular colored latex injection (n = 30); conversion in modified Spalteholz cleared specimens (n=10); intravascular injection of a Perspex solution, and then corroded, in order to produce vascular corrosion casts of the vessels in the region (n = 5); histological studies (n = 20); scanning electron microscopy of vascular corrosion casts (n = 10); surgical dissection of the superficial caudal epigastric vessels (n = 100); and to thermographic evaluation (n = 30). RESULTS: The ventrolateral abdominal wall presented a dominant superficial vascular system, which was composed mainly of branches from the superficial caudal epigastric artery and vein in the caudal half. The cranial half still received significant arterial contributions from the lateral thoracic artery in all cases and from large perforators coming from the intercostal arteries and from the deep cranial epigastric artery. CONCLUSIONS: These data show that rats and humans present a great deal of homology regarding the blood supply to the ventrolateral aspect of the abdominal integument. However, there are also significant differences that must be taken into consideration when performing and interpreting experimental procedures in rats.info:eu-repo/semantics/publishedVersio

A Model of Free Tissue Transfer: The Rat Epigastric Free Flap

Free tissue transfer has been increasingly used in clinical practice since the 1970s, allowing reconstruction of complex and otherwise untreatable defects resulting from tumor extirpation, trauma, infections, malformations or burns. Free flaps are particularly useful for reconstructing highly complex anatomical regions, like those of the head and neck, the hand, the foot and the perineum. Moreover, basic and translational research in the area of free tissue transfer is of great clinical potential. Notwithstanding, surgical trainees and researchers are frequently deterred from using microsurgical models of tissue transfer, due to lack of information regarding the technical aspects involved in the operative procedures. The aim of this paper is to present the steps required to transfer a fasciocutaneous epigastric free flap to the neck in the rat. This flap is based on the superficial epigastric artery and vein, which originates from and drain into the femoral artery and vein, respectively. On average the caliber of the superficial epigastric vein is 0.6 to 0.8 mm, contrasting with the 0.3 to 0.5 mm of the superficial epigastric artery. Histologically, the flap is a composite block of tissues, containing skin (epidermis and dermis), a layer of fat tissue (panniculus adiposus), a layer of striated muscle (panniculus carnosus), and a layer of loose areolar tissue. Succinctly, the epigastric flap is raised on its pedicle vessels that are then anastomosed to the external jugular vein and to the carotid artery on the ventral surface of the rat's neck. According to our experience, this model guarantees the complete survival of approximately 70 to 80% of epigastric flaps transferred to the neck region. The flap can be evaluated whenever needed by visual inspection. Hence, the authors believe this is a good experimental model for microsurgical research and training.info:eu-repo/semantics/publishedVersio

Comparative Study Of Implementing The On-Premises and Cloud Business Intelligence On Business Problems In a Multi-National Software Development Company

Internship Report presented as the partial requirement for obtaining a Master's degree in Information Management, specialization in Knowledge Management and Business IntelligenceNowadays every enterprise wants to be competitive. In the last decade, the data volumes are increased dramatically. As each year data in the market increases, the ability to extract, analyze and manage the data become the backbone condition for the organization to be competitive. In this condition, organizations need to adapt their technologies to the new business reality in order to be competitive and provide new solutions that meet new requests. Business Intelligence by the main definition is the ability to extract analyze and manage the data through which an organization gain a competitive advantage. Before using this approach, it’s important to decide on which computing system it will base on, considering the volume of data, business context of the organization and technologies requirements of the market. In the last 10 years, the popularity of cloud computing increased and divided the computing Systems into On-Premises and cloud. The cloud benefits are based on providing scalability, availability and fewer costs. On another hand, traditional On-Premises provides independence of software configuration, control over data and high security. The final decision as to which computing paradigm to follow in the organization it’s not an easy task as well as depends on the business context of the organization, and the characteristics of the performance of the current On-Premises systems in business processes. In this case, Business Intelligence functions and requires in-depth analysis in order to understand if cloud computing technologies could better perform in those processes than traditional systems. The objective of this internship is to conduct a comparative study between 2 computing systems in Business Intelligence routine functions. The study will compare the On-Premises Business Intelligence Based on Oracle Architecture with Cloud Business Intelligence based on Google Cloud Services. A comparative study will be conducted through participation in activities and projects in the Business Intelligence department, of a company that develops software digital solutions to serve the telecommunications market for 12 months, as an internship student in the 2nd year of a master’s degree in Information Management, with a specialization in Knowledge Management and Business Intelligence at Nova Information Management School (NOVA IMS)

A review

Funding Information: PhD grant PD/BDE/150627/2020 was financed by Fundação para a Ciência e Tecnologia (FCT - Portugal) and Volkswagen Autoeuropa. Funding Information: The authors would like to thank Fundação para a Ciência e Tecnologia (FCT - Portugal), and Volkswagen Autoeuropa for co-financing the doctoral grant PD/BDE/150627/2020. Publisher Copyright: © 2023 The AuthorsIon Mobility Spectrometry (IMS) has gained relevance in the field of analytical techniques over the past decades. If compared with well-established techniques like mass spectrometry or infrared spectroscopy, IMS is considerably less developed or employed in specific fields but presents promising results and a substantial margin for improvements. Its outstanding sensitivity and selectivity, analytical flexibility, instrumental versatility and almost real-time results capacity have contributed to elevate IMS among the main analytical techniques for the detection of volatile organic compounds. Due to its growth potential, it is mandatory to assess in which scientific fields IMS has played a relevant role in the past years of academic research and understand in which areas it can become equally important in the near future. For this purpose, hundreds of scientific works from the past ten years were addressed and the most relevant were reviewed in this work. Three main categories of IMS applications were defined to group the reviewed articles: Environmental and Safety Research, Health Research and Food Research. In addition, some original studies were specifically developed for this review paper, to act as elucidative examples. The working principle of the IMS is included for clarification purposes. A glossary of all the mentioned compounds was also included. Throughout the text, it is clear how relevant IMS has become and how diverse its applicability can be, ranging from simpler topics like fraud detection to more complex ones like pathologies diagnosis. It is safe to say that IMS has been, step by step, gaining relevance as an analytical technique and its potential for supporting many diverse scientific fields is evident.publishersversionpublishe

A gas chromatography–ion mobility spectrometry applicability study

The authors acknowledge NMT. S. A. for supplying the GC-IMS device and additional resources. Publisher Copyright: © The Author(s) 2023.Contemporary life is mostly spent in indoor spaces like private houses, workplaces, vehicles and public facilities. Nonetheless, the air quality in these closed environments is often poor which leads to people being exposed to a vast range of toxic and hazardous compounds. Volatile organic compounds (VOCs) are among the main factors responsible for the lack of air quality in closed spaces and, in addition, some of them are particularly hazardous to the human organism. Considering this fact, we conducted daily in situ air analyses over 1 year using a gas chromatography–ion mobility spectrometry (GC-IMS) device in an indoor location. The obtained results show that 10 VOCs were consistently present in the indoor air throughout the entire year, making them particularly important for controlling air quality. All of these compounds were successfully identified, namely acetic acid, acetone, benzene, butanol, ethanol, isobutanol, propanoic acid, propanol, 2-propanol and tert-butyl methyl ether. The behaviour of the total VOCs (tVOCs) intensity during the period of analysis and the relative variation between consecutive months were studied. It was observed that the overall trend of tVOCs closely mirrored the variation of air temperature throughout the year suggesting their strong correlation. The results obtained from this study demonstrate the high quality and relevance of the data, highlighting the suitability of GC-IMS for in situ long-term air quality assessment in indoor environments and, consequently, for identifying potential health risks for the human organism in both short-term and long-term exposure scenarios.publishersversionpublishe

Optimization of an Arterialized Venous Fasciocutaneous Flap in the Abdomen of the Rat

BACKGROUND: Although numerous experimental models of arterialized venous flaps (AVFs) have been proposed, no single model has gained widespread acceptance. The main aim of this work was to evaluate the survival area of AVFs produced with different vascular constructs in the abdomen of the rat. METHODS: Fifty-three male rats were divided into 4 groups. In group I (n = 12), a 5-cm-long and 3-cm-wide conventional epigastric flap was raised on the left side of the abdomen. This flap was pedicled on the superficial caudal epigastric vessels caudally and on the lateral thoracic vein cranially. In groups II, III, and IV, a similar flap was raised, but the superficial epigastric artery was ligated. In these groups, AVFs were created using the following arterial venous anastomosis at the caudal end of the flap: group II (n = 13) a 1-mm-long side-to-side anastomosis was performed between the femoral artery and vein laterally to the ending of the superficial caudal epigastric vein. In group III (n = 14), in addition to the procedure described for group II, the femoral vein was ligated medially. Finally, in group IV (n = 14), the superficial caudal epigastric vein was cut from the femoral vein with a 1-mm-long ellipse of adjacent tissue, and an end-to-side arterial venous anastomosis was established between it and the femoral artery. RESULTS: Seven days postoperatively, the percentage of flap survival was 98.89 ± 1.69, 68.84 ± 7.36, 63.84 ± 10.38, 76.86 ± 13.67 in groups I-IV, respectively. CONCLUSION: An optimized AVF can be produced using the vascular architecture described for group IV.info:eu-repo/semantics/publishedVersio

A university campus case study

Funding Information: The authors would like to thank Fundação para a Ciência e Tecnologia (FCT - Portugal), Volkswagen Autoeuropa and NMT, S. A. for co-financing of PhD grant PD/BDE/150627/2020, from Doctoral NOVA I4H Program. Funding Information: The author(s) disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: This work was supported by Fundação para a Ciência e Tecnologia FCT – Portugal and Volkswagen Autoeuropa - Portugal, which co-financed the PhD grant PD/BDE/150627/2020 from Doctoral NOVA I4H Program; and NMT, S. A. – Portugal for the supply of the GC-IMS device and additional resources. Publisher Copyright: © The Author(s) 2022.Society’s concerns about the citizens’ exposure to possibly dangerous environments have recently risen; nevertheless, the assessment of indoor air quality still represents a major contemporary challenge. The volatile organic compounds (VOCs) are among the main factors responsible for deteriorating air quality conditions. These analytes are very common in daily-use environments and they can be extremely hazardous to human health, even at trace concentrations levels. For these reasons, their quick detection, identification, and quantification are crucial tasks, especially for indoor and heavily-populated scenarios, where the exposure time is usually quite long. In this work, a Gas Chromatography – Ion Mobility Spectrometry (GC-IMS) device was used for continuous monitoring indoor and ambient air environments at a large-scale, due to its outstanding levels of sensibility, selectivity, analytical flexibility, and almost real-time monitoring capability. A total of 496 spectra were collected from 15 locations of a university campus and posteriorly analysed. Overall, 23 compounds were identified among the 31 detected. Some of them, like Ethanol and 2-Propanol, were reported as being very hazardous to the human organism, especially in indoor environments. The achieved results confirmed the suitability of GC-IMS technology for air quality assessment and monitoring of VOCs and, more importantly, proved how dangerous indoor environments can be in scenarios of continuous exposure.publishersversionpublishe

Tuberculosis-related mortality in people living with HIV in Europe and Latin America: an international cohort study

BACKGROUND: Management of tuberculosis in patients with HIV in eastern Europe is complicated by the high prevalence of multidrug-resistant tuberculosis, low rates of drug susceptibility testing, and poor access to antiretroviral therapy (ART). We report 1 year mortality estimates from a multiregional (eastern Europe, western Europe, and Latin America) prospective cohort study: the TB:HIV study. METHODS: Consecutive HIV-positive patients aged 16 years or older with a diagnosis of tuberculosis between Jan 1, 2011, and Dec 31, 2013, were enrolled from 62 HIV and tuberculosis clinics in 19 countries in eastern Europe, western Europe, and Latin America. The primary endpoint was death within 12 months after starting tuberculosis treatment; all deaths were classified according to whether or not they were tuberculosis related. Follow-up was either until death, the final visit, or 12 months after baseline, whichever occurred first. Risk factors for all-cause and tuberculosis-related deaths were assessed using Kaplan-Meier estimates and Cox models. FINDINGS: Of 1406 patients (834 in eastern Europe, 317 in western Europe, and 255 in Latin America), 264 (19%) died within 12 months. 188 (71%) of these deaths were tuberculosis related. The probability of all-cause death was 29% (95% CI 26-32) in eastern Europe, 4% (3-7) in western Europe, and 11% (8-16) in Latin America (p<0·0001) and the corresponding probabilities of tuberculosis-related death were 23% (20-26), 1% (0-3), and 4% (2-8), respectively (p<0·0001). Patients receiving care outside eastern Europe had a 77% decreased risk of death: adjusted hazard ratio (aHR) 0·23 (95% CI 0·16-0·31). In eastern Europe, compared with patients who started a regimen with at least three active antituberculosis drugs, those who started fewer than three active antituberculosis drugs were at a higher risk of tuberculosis-related death (aHR 3·17; 95% CI 1·83-5·49) as were those who did not have baseline drug-susceptibility tests (2·24; 1·31-3·83). Other prognostic factors for increased tuberculosis-related mortality were disseminated tuberculosis and a low CD4 cell count. 18% of patients were receiving ART at tuberculosis diagnosis in eastern Europe compared with 44% in western Europe and 39% in Latin America (p<0·0001); 12 months later the proportions were 67% in eastern Europe, 92% in western Europe, and 85% in Latin America (p<0·0001). INTERPRETATION: Patients with HIV and tuberculosis in eastern Europe have a risk of death nearly four-times higher than that in patients from western Europe and Latin America. This increased mortality rate is associated with modifiable risk factors such as lack of drug susceptibility testing and suboptimal initial antituberculosis treatment in settings with a high prevalence of drug resistance. Urgent action is needed to improve tuberculosis care for patients living with HIV in eastern Europe. FUNDING: EU Seventh Framework Programme