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- General and abdominal adiposity and hypertension in eight world regions: a pooled analysis of 837 population-based studies with 7·5 million participantsPublication . NCD Risk Factor Collaboration (NCD-RisC); Brito, MiguelBackground: Adiposity can be measured using BMI (which is based on weight and height) and indices of abdominal adiposity. We examined the association between BMI and waist-to-height ratio (WHtR) within and across populations of different world regions. We quantified how well these two metrics discriminate between people with and without hypertension. Methods: We used data from studies carried out from 1990 to 2023 on BMI, WHtR, and hypertension in people aged 20-64 years in representative samples of the general population in eight world regions. We graphically compared the regional distributions of BMI and WHtR and calculated Pearson's correlation coefficients between BMI and WHtR within each region. We used mixed-effects linear regression to estimate the extent to which WHtR varies across regions at the same BMI. We graphically examined the prevalence of hypertension and the distribution of people who have hypertension both about BMI and WHtR, and we assessed how closely BMI and WHtR discriminate between participants with and without hypertension using C-statistic and net reclassification improvement (NRI). Findings: The correlation between BMI and WHtR ranged from 0·76 to 0·89 within different regions. After adjusting for age and BMI, mean WHtR was highest in South Asia for both sexes, followed by Latin America and the Caribbean and the region of central Asia, the Middle East, and North Africa. Mean WHtR was lowest in central and eastern Europe for both sexes, in the high-income western region for women, and Oceania for men. Conversely, to achieve an equivalent WHtR, the BMI of the population of South Asia would need to be, on average, 2·79 kg/m2 (95% CI 2·31-3·28) lower for women and 1·28 kg/m2 (1·02-1·54) lower for men than in the high-income western region. In every region, hypertension prevalence increased with both BMI and WHtR. Models with either of these two adiposity metrics had virtually identical C-statistics and NRIs for every region and sex, with C-statistics ranging from 0·72 to 0·81 and NRIs ranging from 0·34 to 0·57 in different region and sex combinations. When both BMI and WHtR were used, performance improved only slightly compared with using either adiposity measure alone. Interpretation: BMI can distinguish young and middle-aged adults with higher versus lower amounts of abdominal adiposity with moderate-to-high accuracy, and both BMI and WHtR distinguish people with or without hypertension. However, at the same BMI level, people in South Asia, Latin America, the Caribbean, and the region of central Asia, the Middle East, and North Africa have higher WHtR than in the other regions.
- Novel COVID-19 biomarkers identified through multi-omics data analysis: N-acetyl-4-O-acetylneuraminic acid, N-acetyl-L-alanine, N-acetyltriptophan, palmitoylcarnitine, and glycerol 1-myristatePublication . Cobre, Alexandre de Fátima; Alves, Alexessander Couto; Gotine, Ana Raquel; Domingues, Karime Zeraik; Lazo, Raul Edison; Ferreira, Luana Mota; Tonin, Fernanda; Pontarolo, RobertoThis study aims to apply machine learning models to identify new biomarkers associated with the early diagnosis and prognosis of SARS-CoV-2 infection. Plasma and serum samples from COVID-19 patients (mild, moderate, and severe), patients with other pneumonia (but with negative COVID-19 RT-PCR), and healthy volunteers (control) from hospitals in four different countries (China, Spain, France, and Italy) were analyzed by GC-MS, LC-MS, and NMR. Machine learning models (PCA and PLS-DA) were developed to predict the diagnosis and prognosis of COVID-19 and identify biomarkers associated with these outcomes. A total of 1410 patient samples were analyzed. The PLS-DA model presented a diagnostic and prognostic accuracy of around 95% of all analyzed data. A total of 23 biomarkers (e.g., spermidine, taurine, L-aspartic, L-glutamic, L-phenylalanine and xanthine, ornithine, and ribothimidine) have been identified as being associated with the diagnosis and prognosis of COVID-19. Additionally, we also identified for the first time five new biomarkers (N-Acetyl-4-O-acetylneuraminic acid, N-Acetyl-L-Alanine, N-Acetyltriptophan, palmitoylcarnitine, and glycerol 1-myristate) that are also associated with the severity and diagnosis of COVID-19. These five new biomarkers were elevated in severe COVID-19 patients compared to patients with mild disease or healthy volunteers. The PLS-DA model was able to predict the diagnosis and prognosis of COVID-19 around 95%. Additionally, our investigation pinpointed five novel potential biomarkers linked to the diagnosis and prognosis of COVID-19: N-Acetyl-4-O-acetylneuraminic acid, N-Acetyl-L-Alanine, N-Acetyltriptophan, palmitoylcarnitine, and glycerol 1-myristate. These biomarkers exhibited heightened levels in severe COVID-19 patients compared to those with mild COVID-19 or healthy volunteers.
- Improving the quality of publications in and advancing the paradigms of clinical and social pharmacy practice research: the Granada statementsPublication . Fernandez-Llimos, Fernando; Desselle, Shane; Stewart, Derek; Garcia-Cardenas, Victoria; Babar, Zaheer-Ud-Din; Bond, Christine; Dago, Ana; Jacobsen, Ramune; Nørgaard, Lotte Stig; Polidori, Carlo; Sanchez-Polo, Manuel; Santos-Ramos, Bernardo; Shcherbakova, Natalia G.; Tonin, FernandaPharmacy and pharmaceutical sciences embrace a series of different disciplines. Pharmacy practice has been defined as 'the scientific discipline that studies the different aspects of the practice of pharmacy and its impact on healthcare systems, medicine use, and patient care'. Thus, pharmacy practice studies embrace both clinical pharmacy and social pharmacy elements. Like any other scientific discipline, clinical and social pharmacy practice disseminates research findings using scientific journals. Clinical pharmacy and social pharmacy journal editors have a role in promoting the discipline by enhancing the quality of the articles published. As has occurred in other healthcare areas (ie, medicine and nursing), a group of clinical and social pharmacy practice journal editors gathered in Granada, Spain to discuss how journals could contribute to strengthening pharmacy practice as a discipline. The result of that meeting was compiled in these Granada Statements, which comprise 18 recommendations gathered into six topics: the appropriate use of terminology, impactful abstracts, the required peer reviews, journal scattering, more effective and wiser use of journal and article performance metrics, and authors' selection of the most appropriate pharmacy practice journal to submit their work.
- Persistence with medical glaucoma therapy in newly diagnosed patientsPublication . Menino, Joana; Camacho, Pedro; Coelho, AndréBackground: Monotherapy, age, and side effects are significant risk factors for the discontinuation of antiglaucoma therapy. Long-term therapy persistence is crucial for slowing disease progression and preventing irreversible blindness. Therefore, it is essential to identify patients at higher risk of discontinuation. In this study, we aimed to evaluate the real-world persistence of antiglaucoma therapy in patients diagnosed with glaucoma in the primary healthcare units of the Lisbon and Tagus Valley regions. Methods: We conducted a retrospective longitudinal study by collecting data from the prescription records of new antiglaucoma drug users diagnosed with glaucoma between 2012 and 2013 in the Primary Health Care Units of the Lisbon and Tagus Valley Region. These patients were followed over 3 years. Therapy persistence was measured as the proportion of patients remaining on any antiglaucoma drug, regardless of any modifications or switching of drugs over time. Persistence was assessed at three time points: the end of the first, second, and third years of the observation period. Results: A total of 2138 patients treated using new antiglaucoma drugs (867 [40.6%] male patients; 1271 [59.4%] female patients) were included in the study. Over the observation period, the overall persistence rate decreased from 91.9% (n = 1965) in the first year to 67.3% (n = 1439) in the third year. Older patients (≥ 65 years) showed higher persistence rates, although there was a decrease over the 3-year follow-up period (from 1481 [92.7%] to 1124 [70.4%]). Additionally, participants initially treated with monotherapy showed higher persistence rates, ranging from 92.4% (n = 1186) in the first year to 70.2% (n = 901) in the third year. Conclusions: The findings highlight the importance of patient follow-up over time, as almost one in three new antiglaucoma therapy users completely discontinued treatment, potentially risking disease progression. This could be mitigated with proper use of these drugs. Further studies should utilize recent health information systems to explore the impact of medication adherence and persistence on the functional and structural outcomes in patients with glaucoma.
- A moda, e não só, no último quartel do século XX: revisões da matéria dadaPublication . Morais-Alexandre, PauloFalar da evolução da Moda e da indumentária implica falar da evolução dos tempos, das mentalidades, da cultura, da economia, dos costumes, da liberdade ou falta dela, da música que se ouve, dos filmes, da televisão, dos que influenciam. Tudo isto influencia a Moda, tudo isto a Moda reflete. A propósito da comemoração dos cinquenta anos da Galera, uma das mais emblemáticas lojas da segunda metade do século XX em Cascais, ensaia-se, à vol d’oiseau, uma revisão dos mais significativos movimentos da Moda ao longo do último quartel do século XX.
- Therapeutic importance of exercise in neuroplasticity in adults with neurological pathology: systematic reviewPublication . Cardoso, Sara Valverde; Fernandes, Sofia Rita; Tomás, Maria TeresaNeuroplasticity is an essential mechanism by which the nervous system shapes and adapts according to functional requirements. Evidence suggests that physical exercise induces a cascade of cellular processes that favors brain plasticity. The Brain-Derived Neurotrophic Factor (BDNF) is a neurotrophin closely linked to neuroplasticity that can be increased due to exercise. To verify the effects of therapeutic exercise on neuroplasticity and/or peripheral BDNF levels in neurological conditions in adults, such as stroke, Parkinson’s and Alzheimer’s diseases, and mild cognitive impairment, and address its clinical relevance in the treatment of neurological dysfunctions. A systematic review was carried out using PUBMED, Web of Science, and Scopus databases. Inclusion criteria were: randomized controlled trials or pilot studies; humans age > 18 yrs with a neurological condition; English language; score ≥ 6 on the PEDro Scale (moderate to high quality). Reviews, meta-analyses, and other articles that did not meet the criteria were excluded. The PRISMA methodology was applied for the studies’ selection. A total of 9 studies were selected for a systematic and comprehensive analysis. According to these studies, moderate to high-intensity aerobic exercise (AE), increases the level of peripheral BDNF and positively influences functional gains in neurological conditions. Larger outcomes are observed in protocols with a minimum session duration of 30 minutes, frequency of 3 times/week, and intervention duration of 4 weeks. Current evidence shows that moderate to high-intensity AE induces neuroplasticity in neurological patients, thus being a fundamental therapeutic strategy to include in interventions aiming to repair/delay neurological dysfunctions.
- Indoor air quality in a home improvement store: gaseous pollutants, bioburden and particle-bound chemical constituentsPublication . Furst, Leonardo; Cipoli, Yago; Yubero, Eduardo; Galindo, Nuria; Viegas, Carla; Dias, Marta; Nunes, T.; Igrejas, Getúlio; Feliciano, Manuel; Alves, CéliaEnsuring good air quality is essential for safeguarding human health, requiring monitoring to comprehend air composition and formulate effective interventions. This study focused on indoor and outdoor air quality monitoring within a home improvement and gardening franchise store in northeastern Portugal. Real-time optical monitors recorded levels of particulate matter below 10 µm (PM10), while PM10 gravimetric sampling was performed to analyse carbonaceous constituents and metal(loid)s. Continuous monitoring also included CO2 and comfort parameters. Volatile organic compounds (VOCs), bacteria, and fungi were passively sampled. During labour hours, indoor PM10 concentrations exceeded the national protection threshold, reaching 45.4 ± 15.2 μg/m3, compared to 27.1 ± 9.96 μg/m3 outdoors. The presence of elements from tyre and brake wear and road dust resuspension suggested that outdoor particles were mainly from non-exhaust traffic emissions. Indoors, the abundance of soil-related elements points to the resuspension of mineral dust as an important source of PM10. Also, anthropogenic constituents associated with activities (e.g., wood sawing) and products sold in the store contributed to indoor particle levels. Dominant indoor VOCs were α-pinene, limonene, and hexanal. The most abundant elements in PM10 indoors were Ca, Fe and Zn, with values of 658 ± 297, 273 ± 141, 172 ± 67.4 ng/m3, respectively. Common fungi included Trichoderma sp. and Penicillium sp., while colony-forming bacterial units were most prevalent in the gardening and heating sections. This comprehensive study highlights the need to implement indoor air quality monitoring strategies in commercial spaces, particularly with regard to particulate matter and associated pollutants.
- Drug-related glomerular phenotypes: a global pharmacovigilance perspectivePublication . Baptista, Alexandre; Macedo, Ana M.; Marreiros, Ana; Coelho, André; Perazella, Mark A.Introduction: Adverse drug reactions are a significant problem in modern society, stemming from the increase in prescribed medications, over-the-counter drugs, and overall polypharmacy. Glomerular disorders are one of the frequently reported renal conditions associated with medication use. VigiBase is a significant tool for evaluating events associated with drug use, and, to the authors’ knowledge, no study has yet assessed this database to identify the primary medications associated with glomerular disorders. Materials and Methods: We collected data from VigiBase for 54 years and evaluated data based on global frequencies, disproportionality (IC025 values), nephrotoxic potential, and physiopathological mechanisms. Results: Over the evaluation period, 33.932.051 spontaneous notifications of adverse drug reactions reported in VigiBase were assessed, from which 106.775 notifications of drug-associated glomerular disorders were extracted. The isolated medications were classified as ‘potential nephrotoxins’ (47.0%), with 40% of the medications lacking scientific references to report any association with the development of glomerular disorders. Among the evaluated medications, Inotersen (IC025 of 8.3), Penicillamine (IC025 6.8), Bevacizumab (IC025 5.9) and Lenvatinib (IC025 5.4) were identified as having the strongest association with these glomerular disorders. For medications classified as ‘non-nephrotoxic’, a high disproportionality index was observed, suggesting drugs that might be considered as new potential nephrotoxins. Conclusions: Drug-induced glomerular disorders were significantly associated with medications that had no established nephrotoxic role but demonstrated a high disproportionality index in VigiBase. These newly alleged nephrotoxic drugs warrant further evaluation in dedicated studies to assess their true nephrotoxic potential.
- Markerless three-dimensional gait analysis in healthy older adults: test–retest reliability and measurement errorPublication . Carvalho, Andreia; Vanrenterghem, Jos; Cabral, Sílvia; Assunção, Ana; Fernandes, Rita; Veloso, António P.; Moniz-Pereira, VeraIn older adults, gait analysis may detect changes that signal early disease states, yet challenges in biomechanical screening limit widespread use in clinical or community settings. Recently, a markerless method from multi-camera video data has become accessible, making screenings less challenging. This study evaluated the test-retest reliability and measurement error of markerless gait kinematics and kinetics in healthy older adults. Twenty-nine healthy older adults performed gait analysis on two occasions, at preferred walking speed, using their everyday clothes. Lower limb angles and moments were averaged from 8 gait cycles. Integrated pointwise indices [Intraclass Correlation Coefficient (ICCA,K) and Standard Error of Measurement (SEM)] were calculated for curve data, as well as ICCA,K, and SEM [95 % confidence intervals] for selected peaks. Generally, kinematic ICCs were good (>0.75) and reasonably stable throughout the gait cycle, except for the hip kinematics during the swing phase in the sagittal plane and pelvis tilt and rotation. The integrated and peaks SEM were <2.4°. The reliability of kinetics was similar (ICC>0.75), except for the transverse hip moment and abduction peak, fluctuating more during the swing than through the stance phase. SEM were < 0.07Nm/Kg. In conclusion, these results showed good overall test-retest reliability for markerless gait kinematics and kinetics for the hip, knee, and ankle joints, moderate for the pelvis angles, and error levels of ≤5°, and SEM%≤5% for the sagittal plane. This supports this method's use in assessing gait in healthy older adults, including kinetics, for which reliability data from markerless systems is difficult to find reported.
- Lower indoor spatial frequency increases the risk of myopia in childrenPublication . Li, Dan-Lin; Dong, Xing-Xuan; Yang, Jin-Liu-Xing; Lança, Carla; Grzybowski, Andrzej; Pan, Chen-WeiBackground/aims: Animal models have shown that the absence of high-frequency visual information can precipitate the onset of myopia, but this relationship remains unclear in humans. This study aims to explore the association between the spatial frequency content of the visual environment and myopia in children. Methods: Images from the rooms of children and their frequently visited outdoor areas were taken by their parents and collected by the researcher through questionnaires. The spatial frequency was quantified using Matlab. Cycloplegic refraction was used to measure the spherical equivalent (SE), and IOL Master was used to measure axial length (AL) and corneal radius (CR). AL/CR ratio was calculated. Results: The study included 566 children with an average age of (8.04±1.47) years, of which 270 were girls (47.7%), and the average SE was (0.70±1.21) D. Image analysis revealed that indoor spatial frequency slope was lower than that of the outdoor environment (-1.43±0.18 vs -1.11±0.23, p<0.001). There were 79 myopic individuals (14.0%). Images from indoor content of myopic children had a lower spatial frequency slope than non-myopic children (-1.47±0.16 vs 1.43±0.18, p=0.03) while there was no significant difference in outdoor spatial frequency slope. Regression analysis indicated that the indoor spatial frequency slope was positively associated with SE value (β=0.60, p=0.02) and inversely related to myopia (OR=0.24, p<0.05). Conclusion: The spatial frequency of the outdoor environment is significantly higher than that of the indoor environment. Indoor spatial frequency is related to children's refractive status, with lower indoor spatial frequency being associated with a higher degree of myopia.