Pressure ulcers during the COVID-19 pandemic in intensive care:A multicenter cohort study.

AIM: The objective of the present study is twofold: to describe the prevalence and incidence of pressure ulcers (PUs) among ICU patients during the COVID-19 pandemic, and to identify the risk factors associated with the development of PUs in this cohort of ICU patients. MATERIALS AND METHODS: Retrospective cohort study of adult critical care patients admitted in two general ICUs of two different countries (Sweden and Portugal) between March 1st, 2020, and April 30th, 2021, through the analysis of the electronic health record database. The prevalence and incidence were calculated, and a multivariate logistic-regression model was used to calculate odds ratios (ORs), of possible risk factors of PU development. RESULTS: The sample consisted of 1717 patients. The overall prevalence of PU was 15.3 %, and the incidence of ICU-acquired PUs was 14.1 %. Most of the pressure ulcers documented in this study were at the anterior part of the body (45.35 %) and regarding classification, Category 2 (38.40 %) and Category 3 (22.71 %) pressure ulcers together accounted for over fifty percent of the cases recorded. In the multivariate logistic regression model for PU, age, having COVID-19 (OR = 1.58, 95 % CI: 1.20-2.09), use of mechanical ventilation (OR = 1.49, 95 % CI: 1.13 = 1.97), use of vasopressors (OR = 1.31, 95 % CI: 1.00-1.70), having a Braden risk score ≤16 at admission (OR = 1.63; 95 % CI: 1.04-2.56), and length of stay (LOS) (OR = 1.43, 95 % CI 1.03-2.00 if LOS 90-260 h, OR = 2.34, 95 % CI: 1.63-3.35 if LOS >260 h) were associated with the likelihood of developing an ICU-acquired PUs. CONCLUSION: When adjusted for covariates patients with COVID-19 had a higher risk for PU development during the ICU stay compared to patients without COVID-19. Health care personnel in ICU may consider incorporating COVID-19, age, use of mechanical ventilation, vasopressors and estimated LOS in addition to a comprehensive risk assessment including both a risk score and clinical assessment.

Vulnerability in Children with Celiac Disease: Findings from a Scoping Review.

(1) Background: The scientific literature highlights that children diagnosed with celiac disease (CD) are at a heightened risk of experiencing physical, psychological, and social challenges, impacting their overall healthy childhood development. However, there remains a lack of a clear understanding regarding the factors that contribute to this vulnerability. The purpose of this study is to analyze and map the evidence on the sociopsychosomatic vulnerability of these children and identify gaps in this topic. (2) Methods: Following Joanna Briggs Institute's guidelines for scoping reviews, we executed a detailed search of key electronic databases and explored the grey literature to capture a broad spectrum of studies. Our focus was on identifying research that looked into the multiple dimensions of vulnerability-physical, psychological, and social-in children with CD. We included a diverse range of study designs as well as systematic reviews, ensuring a comprehensive analysis. The selection process was stringent, utilizing clearly defined inclusion and exclusion criteria. (3) Results: We identified 61 studies that met our inclusion criteria. The review highlighted significant adverse health outcomes in children with CD and elucidated various individual and environmental determinants that influenced these vulnerabilities. It also underscored the lack of assessment tools to evaluate the risk of health problems in this population. (4) Conclusions: The findings underscore a critical need for further research to deepen our understanding of the vulnerabilities associated with CD in children. Developing targeted assessment tools will be crucial in stratifying health risks and enhancing care strategies for this vulnerable population.

Effect of Myxoma Virus Species Jump on Iberian Hare Populations.

The myxoma virus species jump from European rabbits (Oryctolagus cuniculus) to Iberian hares (Lepus granatensis) has raised concerns. We assess the decline suffered by Iberian hare populations on the Iberian Peninsula and discuss the association between the effect of myxomatosis and the average abundance index, which we estimated by using hunting bags.

Impact of a daily legume-based meal on blood and anthropometric parameters in a group of omnivorous adults: A pilot study.

This pilot study aimed to assess the impact of substituting a traditional lunch for a vegetarian legume-based meal on blood and anthropometric parameters in a group of omnivorous adults. A one-group comparison, quasi-experimental dietary intervention was designed. A vegetarian legume-based meal was offered for 8 consecutive weeks (weekdays) to non-vegetarian individuals (n = 26), (28 years [P25 = 20.0, P75 = 35.5]; 21.9 kg/m2 [P25 = 21.3, P75 = 24.8]). Sociodemographic data, health status and lifestyle-related information were recorded. Three-day food records were used to collect food intake at baseline and at the end of the intervention. Anthropometric parameters were recorded and fasting blood analyses were performed following standard procedures. Wilcoxon signed-rank test was used for statistical comparisons. A p-value <0.05 was considered statistically significant. Participants showed a median intake of 79.8 g of cooked legumes per meal, meaning 13 (50.0%) subjects met the Portuguese daily legume intake recommendations during the intervention days. There were no statistically significant differences in anthropometric parameters. Transferrin concentration increased after 8 weeks (+12.5 mg/dL; p = 0.001). Total cholesterol concentration reduced after 8 weeks (-6 mg/dL; p = 0.041), as well as low-density lipoprotein (LDL) cholesterol (-7 mg/dL; p = 0.003). Triglycerides (+9 mg/dL; p = 0.046), fasting glucose (+2 mg/dL; p = 0.037) and HbA1c (+0.1 mg/dL; p = 0.010) concentration increased after the 2-month legume-based trial. Results suggest a cholesterol-lowering potential of legume-rich diets. However, unfavourable results regarding the impact on glucose metabolism-related biomarkers and triglyceride levels were observed. The study's limitations in design and sample size emphasise the importance of conducting further research with larger cohorts to attain more conclusive findings.

M.O.I.S.T. Concept for the Local Therapy of Chronic Wounds: An International Update.

Chronic wounds remain a significant clinical challenge both for those affected and for healthcare systems. The treatment is often comprised and complex. All patients should receive wound care that is integrated into a holistic approach involving local management that addresses the underlying etiology and provides for gold standard therapy to support healing, avoid complications and be more cost effective. There have been significant advances in medicine over the last few decades. The development of new technologies and therapeutics for the local treatment of wounds is also constantly increasing. To help standardize clinical practice with regard to the multitude of wound products, the M.O.I.S.T. concept was developed by a multidisciplinary expert group. The M stands for moisture balance, O for oxygen balance, I for infection control, S for supporting strategies, and T for tissue management. Since the M.O.I.S.T. concept, which originated in the German-speaking countries, is now intended to provide healthcare professionals with an adapted instrument to be used in clinical practice, and a recent update to the concept has been undertaken by a group of interdisciplinary experts to align it with international standards. The M.O.I.S.T. concept can now be used internationally both as an educational tool and for the practical implementation of modern local treatment concepts for patients with chronic wounds and can also be used in routine clinical practice.

Heel skin microclimate control: Secondary analysis of a self-controlled randomized clinical trial.

OBJECTIVE: this study was undertaken to evaluate the efficacy of multilayer polyurethane foam with silicone (MPF) compared to transparent polyurethane film (TPF) dressings in the control of heel skin microclimate (temperature and moisture) of hospitalized patients undergoing elective surgeries. METHOD: the study took of a secondary analysis of a randomized self-controlled trial, involving patients undergoing elective surgical procedure of cardiac and gastrointestinal specialties in a university hospital in southern Brazil, from March 2019 to February 2020. Patients served as their own control, with their heels randomly allocated to either TPF (control) or MPF (intervention). Skin temperature was measured using a digital infrared thermometer; and moisture determined through capacitance, at the beginning and end of surgery. The study was registered in the Brazilian Registry of Clinical Trials: RBR-5GKNG5. RESULTS: significant difference in the microclimate variables were observed when the groups (intervention and control) and the timepoint of measurement (beginning and end of surgery) were compared. When assessing temperature, an increase (+3.3 °C) was observed with TPF and a decrease (-7.4 °C) was recorded with MPF. Regarding skin moisture, an increase in moisture (+14.6 AU) was recorded with TPF and a slight decrease (-0.3 AU) with MPF. CONCLUSIONS: The findings of this study suggest that MPF is more effective than TPF in controlling skin microclimate (temperature and moisture) in heels skin of hospitalized patients undergoing elective surgeries. However, this control should be better investigated in other studies.

Efeitos de uma intervenção com universitários sobre como lidar com a ansiedade / Effects of an intervention with college students on how to deal with anxiety / Efectos de una intervención con universitarios sobre como lidiar con la ansiedad

Diante dos desafios que concernem a adaptação acadêmica, a ansiedade que se dá em meio às múltiplas dificuldades inerentes a este contexto é um aspecto considerável. Considerando diferentes potenciais fontes de ansiedade na experiência universitária, foram elaboradas duas oficinas em formato online, cada uma composta por cinco sessões, com o intuito de auxiliar estudantes universitários a lidar com a ansiedade em meio acadêmico. O estudo teve como objetivo avaliar a efetividade dessas oficinas. Participaram17 estudantes, dos quais, de acordo com o método de análise estatística utilizado, pautado no índice de mudança confiável, 14 apresentaram melhoras em seus quadros de ansiedade e, destes, dois apresentaram mudanças particularmente notáveis em termos estatísticos. Com os resultados apresentados, pode-se perceber que o desenvolvimento de intervenções com estudantes universitários em diferentes formatos pode ser de grande valia para essa população no que tange suas dificuldades de adaptação à universidade(AU).

Faced with the challenges related to academic adaptation, the anxiety that occurs amid the multiple difficulties inherent in this context is a considerable aspect. Considering different sources of anxiety in the university experience, two online workshops were developed, each consisting of five sessions, in order to help university students deal with anxiety in academia. The study aims to evaluate the effectiveness of the intervention. Participated in the workshops 17 students, of which, according to the statistical analysis method used, based on the index of reliable change, 14 showed improvements in their anxiety of these, two showed particularly remarkable changes in statistical terms. With the results presented, it is possible to see that the developmentof interventions with university students in different formats can be of great value to this population regarding their difficulties of adaptation to the university (AU).

Frente a los desafíos que afectan a la adaptación académica, la ansiedad que se da en medio de las múltiples dificultades inherentes a este contexto es un aspecto considerable. Considerando diferentes fuentes de ansiedad en la universidad, se elaboraron dos talleres en formato online, compuestos por cinco sesiones, con el fin de ayudar a estudiantes a lidiar con la ansiedad en medio académico. El estudio tuvo como objetivo evaluar la efectividad de la intervención. Participaron 17 estudiantes, de los cuales, de acuerdo con el método de análisis estadístico utilizado, pautado en el índice de cambio confiable, 14 presentaron mejoras en sus cuadros de ansiedad y, de ellos, dos presentaron cambios particularmente notables en términos estadísticos. Con los resultados presentados, se puede percibir que el desarrollo de intervenciones con estudiantes universitarios en diferentes formatos puede ser de gran valor para esa población en lo que respecta a sus dificultades de adaptación universitaria (AU).

Artificial Intelligence in Wound Care Education: Protocol for a Scoping Review.

As healthcare continues evolving in the age of digital technology, the integration of artificial intelligence has emerged as a powerful force, particularly in wound care. The education of healthcare professionals in wound care is crucial for ensuring they acquire the necessary knowledge and skills, optimizing patient outcomes. This paper outlines the protocol for a scoping review with the goal of mapping and analyzing the current scientific evidence regarding the potential impact of artificial intelligence in wound care education. The current protocol follows the JBI methodological framework. The search was conducted in December 2023 in the following databases: CINAHL Complete (via EBSCOhost), MEDLINE (via PubMed), Cochrane Library, Academic Search Complete, Scientific Electronic Library Online (Scielo), Scopus, and Web of Science. Electronics searches were conducted in the Scientific Open Access Scientific Repositories of Portugal (RCAAP) and ProQuest Dissertations and Theses, OpenAIRE, and Open Dissertations databases to access gray literature. Additionally, searches were performed on Google Scholar and specific journals such as the International Wound Journal, Skin Research and Technology, Journal of Wound Care, and Wound Repair and Regeneration. The initial database searches retrieved a total of 11,323 studies. After removing duplicates, a total of 6450 studies were submitted for screening. Currently, 15 studies are included in this review, and data charting and analysis are underway. The findings of this scoping review will likely provide insights into the application of artificial intelligence in wound care education.

Fluid handling by foam wound dressings: From engineering theory to advanced laboratory performance evaluations.

This article describes the contemporary bioengineering theory and practice of evaluating the fluid handling performance of foam-based dressings, with focus on the important and clinically relevant engineering structure-function relationships and on advanced laboratory testing methods for pre-clinical quantitative assessments of this common type of wound dressings. The effects of key wound dressing material-related and treatment-related physical factors on the absorbency and overall fluid handling of foam-based dressings are thoroughly and quantitively analysed. Discussions include exudate viscosity and temperature, action of mechanical forces and the dressing microstructure and associated interactions. Based on this comprehensive review, we propose a newly developed testing method, experimental metrics and clinical benchmarks that are clinically relevant and can set the standard for robust fluid handling performance evaluations. The purpose of this evaluative framework is to translate the physical characteristics and performance determinants of a foam dressing into achievable best clinical outcomes. These guiding principles are key to distinguishing desirable properties of a dressing that contribute to optimal performance in clinical settings.

Monitoring of species' genetic diversity in Europe varies greatly and overlooks potential climate change impacts.

Genetic monitoring of populations currently attracts interest in the context of the Convention on Biological Diversity but needs long-term planning and investments. However, genetic diversity has been largely neglected in biodiversity monitoring, and when addressed, it is treated separately, detached from other conservation issues, such as habitat alteration due to climate change. We report an accounting of efforts to monitor population genetic diversity in Europe (genetic monitoring effort, GME), the evaluation of which can help guide future capacity building and collaboration towards areas most in need of expanded monitoring. Overlaying GME with areas where the ranges of selected species of conservation interest approach current and future climate niche limits helps identify whether GME coincides with anticipated climate change effects on biodiversity. Our analysis suggests that country area, financial resources and conservation policy influence GME, high values of which only partially match species' joint patterns of limits to suitable climatic conditions. Populations at trailing climatic niche margins probably hold genetic diversity that is important for adaptation to changing climate. Our results illuminate the need in Europe for expanded investment in genetic monitoring across climate gradients occupied by focal species, a need arguably greatest in southeastern European countries. This need could be met in part by expanding the European Union's Birds and Habitats Directives to fully address the conservation and monitoring of genetic diversity.

Integrating factors associated with complex wound healing into a mobile application: Findings from a cohort study.

Complex, chronic or hard-to-heal wounds are a prevalent health problem worldwide, with significant physical, psychological and social consequences. This study aims to identify factors associated with the healing process of these wounds and develop a mobile application for wound care that incorporates these factors. A prospective multicentre cohort study was conducted in nine health units in Portugal, involving data collection through a mobile application by nurses from April to October 2022. The study followed 46 patients with 57 wounds for up to 5 weeks, conducting six evaluations. Healing time was the main outcome measure, analysed using the Mann-Whitney test and three Cox regression models to calculate risk ratios. The study sample comprised various wound types, with pressure ulcers being the most common (61.4%), followed by venous leg ulcers (17.5%) and diabetic foot ulcers (8.8%). Factors that were found to impair the wound healing process included chronic kidney disease (U = 13.50; p = 0.046), obesity (U = 18.0; p = 0.021), non-adherence to treatment (U = 1.0; p = 0.029) and interference of the wound with daily routines (U = 11.0; p = 0.028). Risk factors for delayed healing over time were identified as bone involvement (RR 3.91; p < 0.001), presence of odour (RR 3.36; p = 0.007), presence of neuropathy (RR 2.49; p = 0.002), use of anti-inflammatory drugs (RR 2.45; p = 0.011), stalled wound (RR 2.26; p = 0.022), greater width (RR 2.03; p = 0.002), greater depth (RR 1.72; p = 0.036) and a high score on the healing scale (RR 1.21; p = 0.001). Integrating the identified risk factors for delayed healing into the assessment of patients and incorporating them into a mobile application can enhance decision-making in wound care.

Arte, corpo e humanidades na formação do profissional em saúde / Art, body, and humanities in the formation of the health professional / Arte, cuerpo y humanidades en la formación de los profesionales de la salud

Resumo O presente artigo teve por objetivo principal explicitar os fundamentos teórico-metodológicos de uma experiência pedagógica realizada na Faculdade de Medicina da Universidade Federal da Bahia, no campo das 'humanidades médicas'. Trata-se da disciplina 'Arte e saúde', ministrada desde 2016, na qual se procurou desenvolver uma estratégia de ensino que explicita e discute, na prática médica, questões relacionadas a corporeidade, gênero e cuidado à saúde. Nessa perspectiva, procurou-se explorar a potencialidade transgressora da arte como uma forma de problematizar um conjunto de pressupostos, princípios e valores subjacentes às relações sociais que, usualmente, são estabelecidas nos encontros entre terapeutas e pacientes. Neste artigo, discutimos apenas sobre um módulo dessa disciplina: aquele em que usamos exemplos de performances artísticas para refletir a dimensão corporal da experiência humana (corporeidade) e o mundo da vida cotidiana.

Abstract The primary focus of this article was to elucidate the theoretical and methodological underpinnings of a unique and innovative pedagogical endeavor undertaken at the Faculdade de Medicina of Universidade Federal da Bahia, Brazil, within the realm of 'medical humanities.' This is the domain of 'Art and Health,' introduced in 2016, where our aim was to devise a teaching approach that delves into and deliberates, in the context of medical practice, on issues pertaining to corporeality, gender, and health care. From this standpoint, we endeavored to harness the transformative power of art as a means of questioning a set of assumptions, principles, and values that underlie social interactions typically observed in therapeutic encounters. This article specifically delves into one module of this course: a module that employs instances of artistic performances to contemplate the physical aspect of human existence (corporeality) and the realm of everyday life.

Resumen Este artículo tiene como objetivo principal exponer los fundamentos teóricos y metodológicos de una experiencia pedagógica llevada a cabo en la Faculdade de Medicina of Universidade Federal da Bahia, Brasil, en el ámbito de las 'humanidades médicas'. Se trata de la asignatura 'Arte y Salud', que se imparte desde 2016, con el objetivo de desarrollar una estrategia didáctica que evidencie y discuta cuestiones relacionadas con la corporalidad, el género y el cuidado de la salud en la práctica médica. Desde esta perspectiva, se buscó explorar el potencial transgresor del arte como una manera de problematizar un conjunto de presupuestos, principios y valores subyacentes a las relaciones sociales que suelen establecerse en los encuentros entre terapeutas y pacientes. En este artículo, hablaremos de un solo módulo de esta asignatura: aquel en el que utilizamos ejemplos de representaciones artísticas para reflexionar sobre la dimensión corporal de la experiencia humana (corporeidad) y el mundo de la vida cotidiana.

Performance evaluate of different chemometrics formalisms used for prostate cancer diagnosis by NMR-based metabolomics.

INTRODUCTION: In general, two characteristics are ever present in NMR-based metabolomics studies: (1) they are assays aiming to classify the samples in different groups, and (2) the number of samples is smaller than the feature (chemical shift) number. It is also common to observe imbalanced datasets due to the sampling method and/or inclusion criteria. These situations can cause overfitting. However, appropriate feature selection and classification methods can be useful to solve this issue. OBJECTIVES: Investigate the performance of metabolomics models built from the association between feature selectors, the absence of feature selection, and classification algorithms, as well as use the best performance model as an NMR-based metabolomic method for prostate cancer diagnosis. METHODS: We evaluated the performance of NMR-based metabolomics models for prostate cancer diagnosis using seven feature selectors and five classification formalisms. We also obtained metabolomics models without feature selection. In this study, thirty-eight volunteers with a positive diagnosis of prostate cancer and twenty-three healthy volunteers were enrolled. RESULTS: Thirty-eight models obtained were evaluated using AUROC, accuracy, sensitivity, specificity, and kappa's index values. The best result was obtained when Genetic Algorithm was used with Linear Discriminant Analysis with 0.92 sensitivity, 0.83 specificity, and 0.88 accuracy. CONCLUSION: The results show that the pick of a proper feature selection method and classification model, and a resampling method can avoid overfitting in a small metabolomic dataset. Furthermore, this approach would decrease the number of biopsies and optimize patient follow-up. 1H NMR-based metabolomics promises to be a non-invasive tool in prostate cancer diagnosis.

Locomotion behavior testing as a complementary tool in Collembola avoidance assays with neurotoxic insecticides.

This study aimed (1) to assess the ability of collembolans Folsomia candida to avoid soils contaminated with three seed dressing insecticides imidacloprid, clothianidin, and fipronil; (2) to assess the effects of the insecticides on collembolans' locomotion behavior; (3) to check if changes in the locomotion behavior would explain the avoidance/preference responses; and (4) to evaluate the possibility to use locomotion behavior as toxicity biomarker of the tested insecticides. Avoidance and locomotion behavior assays with collembolans F. candida were performed with commercial seed dressing formulations of three insecticides (imidacloprid, clothianidin, and fipronil). Results showed no avoidance behavior at any concentration, while a "preference" was observed with increasing concentrations of the three tested insecticides. Significant reductions in the locomotion of exposed collembolans were observed at ≥ 1 mg kg-1 for imidacloprid (18-38%) and fipronil (29-58%) and ≥ 4 mg kg-1 for clothianidin (10-47%). At the higher insecticide concentrations, the collembolans had their trajectories restricted to smaller areas, with a tendency for circular movements. Our results confirm that the "preference" for contaminated soils with neurotoxic substances is likely due to locomotion inhibition impairing the ability of organisms to escape. This effect highlights that only avoidance assays may be not sufficient to assure the safety of some substances and confirm the potential of locomotion behavior as a sensitive toxicity biomarker for neurotoxic insecticides.

Clinical prediction models and risk tools for early detection of patients at risk of surgical site infection and surgical wound dehiscence: a scoping review.

OBJECTIVE: Despite advances in surgical techniques, intraoperative practice and a plethora of advanced wound therapies, surgical wound complications (SWCs), such as surgical site infection (SSI) and surgical wound dehiscence (SWD), continue to pose a considerable burden to the patient and healthcare setting. Predicting those patients at risk of a SWC may give patients and healthcare providers the opportunity to implement a tailored prevention plan or potentially ameliorate known risk factors to improve patient postoperative outcomes. METHOD: A scoping review of the literature for studies which reported predictive power and internal/external validity of risk tools for clinical use in predicting patients at risk of SWCs after surgery was conducted. An electronic search of three databases and two registries was carried out with date restrictions. The search terms included 'prediction surgical site infection' and 'prediction surgical wound dehiscence'. RESULTS: A total of 73 records were identified from the database search, of which six studies met the inclusion criteria. Of these, the majority of validated risk tools were predominantly within the cardiothoracic domain, and targeted morbidity and mortality outcomes. There were four risk tools specifically targeting SWCs following surgery. CONCLUSION: The findings of this review have highlighted an absence of well-developed risk tools specifically for SSI and/or SWD in most surgical populations. This review suggests that further research is required for the development and clinical implementation of rigorously validated and fit-for-purpose risk tools for predicting patients at risk of SWCs following surgery. The ability to predict such patients enables the implementation of preventive strategies, such as the use of prophylactic antibiotics, delayed timing of surgery, or advanced wound therapies following a procedure.

The Metabolic and Analytical Changes of Healthy Volunteers upon Intake of Portuguese Extra Virgin Olive Oil: A Comparison Study between Pre- and Post-Intervention.

(1) Background: Extra virgin olive oil (EVOO) is studied mostly for its health benefits in preventing non-communicable chronic diseases, particularly within a Mediterranean dietary pattern. However, few studies have addressed the effect of EVOO in healthy individuals, prior to an established disease. This study aims to evaluate the impact of Northern Portuguese polyphenol-rich EVOO (NPPR-EVOO) consumption on various important clinical parameters in healthy adult volunteers. (2) Methods: This quasi-experimental intervention study assessed the impact of NPPR-EVOO for a period of 100 days. Serum total cholesterol, HbA1c, HDL-c, LDL-c, and CRP, and anthropometric measures-waist and hip perimeters, hand grip strength, and body fat-were assessed and food logs were analyzed. (3) Results: Serum HbA1c (5.12 ± 0.32%; 4.93 ± 0.24, p = 0.000) and LDL-c (96.50 ± 28.57 mg/dL; 87.41 ± 31.38 mg/dL, p = 0.017) significantly decreased following NPPR-EVOO. Also, daily energy significantly increased, but no changes in other dietary parameters, or anthropometry, were seen. Adherence to the Mediterranean diet did not explain the differences found in individuals regarding serum lipid profile and HbA1c, reinforcing the role of EVOO's effect. (4) Conclusions: NPPR-EVOO lowered the serum levels of LDL cholesterol and HbA1c, providing clues on the effect of EVOO-putative health benefits. These results pave the way for a deeper exploration of EVOO as a functional food.

Validación para la población portuguesa de la “international consultation on incontinence questionnaire-urinary incontinence short form” (ICIQ-UI SF) / Validação para a população portuguesa do “international consultation on incontinence questionnaire-urinary incontinence short form” (ICIQ-UI SF) / Validation of the “International Consultation on Incontinence Questionnaire – Urinary Incontinence Short form (ICIQ-UISF) for the Portuguese population

Introducción: La Incontinencia urinaria puede considerarse una condición común asociada con el proceso de envejecimiento con síntomas extremadamente incapacitantes, siendo de dos a tres veces más frecuente en mujeres que en hombres. El uso de instrumentos validados para el diagnóstico inicial de la incontinencia urinaria es fundamental para obtener uniformidad y sistematización en la valoración de esta condición. Objetivo: Adaptar y validar el International Consultation Questionnaire Urinary Incontinence Short Form (ICIQ-UI SF) para la población portuguesa. Método: Dos traducciones independientes del ICIQ-UI SF fueron realizadas por traductores portugueses con fluidez en inglés. Después de armonizarlos, la traducción resultante fue retrotraduzida de forma independiente por dos traductores ingleses que hablan portugués con fluidez. La versión final del ICIQ-UI SF al portugués se aplicó a 90 usuarios de la consulta externa de urología, ingresados de urología y consulta de ginecología de un hospital ubicado en Gaia. Se evaluaron las propiedades psicométricas y la fiabilidad del cuestionario. Resultados: No se observaron cambios en el formato original del ICIQ-UI SF al final del proceso de traducción y adaptación del instrumento. La edad promedio de los participantes fue de 55 años. La consistencia interna fue alta, como lo demuestra el coeficiente alfa de Cronbach (0,85). El coeficiente de Pearson para las preguntas 3 y 4 fue de 0,88 y para las preguntas 4 y 5 fue de 0,82. La evaluación se consideró satisfactoria y estadísticamente significativa. Conclusión: La versión portuguesa del ICIQ-UI SF se validó con éxito, lo que permitió aplicarlo a la población portuguesa con confiabilidad y validez de constructo satisfactorias. (AU)

Introduction: Urinary incontinence can be considered a common condition associated with the aging process with extremely disabling symptoms, being two to three times more prevalent in women than in men. The use of validated instruments for the initial diagnosis of urinary incontinence is essential to obtain uniformity and systematization in the assessment of this condition. Objective: To adapt and validate the International Consultation Questionnaire Urinary Incontinence Short Form (ICIQ-UI SF) for the Portuguese population. Methodology: Two independent translations of the ICIQ-UI SF were performed by Portuguese translators fluent in English. After harmonizing them, the resulting translation was independently back translated by two English translators fluent in Portuguese. The final version of the ICIQ-UI SF into Portuguese was applied to 90 users of the outpatient urology, urology and gynecology inpatient clinic of a hospital located in Gaia. The psychometric properties and reliability of the questionnaire were evaluated. Results: No changes to the original format of the ICIQ-UI SF were observed at the end of the instrument's translation and adaptation process. The average age of participants was 55 years. Internal consistency was high, as demonstrated by Cronbach's alpha coefficient (0.85). Pearson's coefficient for questions 3 and 4 was 0.88 and for questions 4 and 5 it was 0.82. The evaluation was considered satisfactory and statistically significant. Conclusion: The Portuguese version of the ICIQ-UI SF was successfully validated, making it possible to apply it to the Portuguese population with satisfactory reliability and construct validity. (AU)

Introdução: A incontinência urinária pode ser considerada como uma condição comum associada ao processo de envelhecimento com sintomas extremamente incapacitantes, sendo duas a três vezes mais prevalente nas mulheres do que nos homens. A utilização de instrumentos validados para o diagnóstico inicial da incontinência urinária, é fundamental para obter uma uniformização e sistematização na avaliação desta condição. Objetivo: Adaptar e validar para a população portuguesa o International Consultation Questionnaire Urinary Incontinence Short Form (ICIQ-UI SF)Metodologia: Foram realizadas duas traduções independentes do ICIQ-UI SF por tradutores portugueses, fluentes na língua inglesa. Após harmonização das mesmas, a tradução resultante foi retrotraduzida de forma independente por dois tradutores ingleses, fluentes em português. A versão final do ICIQ-UI SF para o português foi aplicado a 90 utentes da consulta externa de urologia, internamento de urologia e de ginecologia de um hospital, localizado em Gaia. Foram avaliadas as propriedades psicométricas e a confiabilidade do questionário. Resultados: Nenhuma alteração ao formato original do ICIQ-UI SF foi observada no final do processo de tradução e adaptação do instrumento. A idade média dos participantes foi de 55 anos. A consistência interna foi alta, como demonstrado pelo coeficiente de alfa de Cronbach (0,85). O coeficiente de Pearson para as perguntas 3 e 4 foi de 0,88 e para as perguntas 4 e 5 foi de 0,82. A avaliação foi considerada satisfatória e estatisticamente significativa. Conclusão: A versão para português do ICIQ-UI SF foi validada com sucesso tornando possível a sua aplicação na população portuguesa com satisfatória confiabilidade e validade de construto. (AU)

Phylogenomic analysis supports Mycobacterium tuberculosis transmission between humans and elephants.

Introduction: Tuberculosis is an infectious disease caused by a group of acid-fast bacilli known as Mycobacterium tuberculosis complex (MTC), which has a major impact on humans. Transmission of MTC across the human-animal interface has been demonstrated by several studies. However, the reverse zoonotic transmission from humans to animals (zooanthroponosis) has often been neglected. Methods: In this study, we used Nanopore MinION and Illumina MiSeq approaches to sequence the whole genome of M. tuberculosis strains isolated from two deceased Asian elephants (Elephas maximus) and one human in Chitwan, Nepal. The evolutionary relationships and drug resistance capacity of these strains were assessed using the whole genome data generated by the stand-alone tool Tb-Profiler. Phylogenomic trees were also constructed using a non-synonymous SNP alignment of 2,596 bp, including 94 whole genome sequences representative of the previously described M. tuberculosis lineages from elephants worldwide (lineages 1 and 4) and from humans in Nepal (lineages 1, 2 and 3). Results and Discussion: The new genomes achieved an average coverage of 99.6%, with an average depth of 55.67x. These M. tuberculosis strains belong to lineage 1 (elephant DG), lineage 2 (elephant PK) and lineage 4 (human), and none of them were found to have drug-resistant variants. The elephant-derived isolates were evolutionarily closely related to human-derived isolates previously described in Nepal, both in lineages 1 and 2, providing additional support for zooanthroponosis or bidirectional transmission between humans and elephants. The human-derived isolate clustered together with other published human isolates from Argentina, Russia and the United Kingdom in the lineage 4 clade. This complex multi-pathogen, multi-host system is challenging and highlights the need for a One Health approach to tuberculosis prevention and control at human-animal interface, particularly in regions where human tuberculosis is highly endemic.

Dynamics of Humoral Immunity to Myxoma and Rabbit Hemorrhagic Disease Viruses in Wild European Rabbits Assessed by Longitudinal Semiquantitative Serology.

Myxoma virus (MYXV) and rabbit hemorrhagic disease virus (RHDV) are important drivers of the population decline of the European rabbit, an endangered keystone species. Both viruses elicit strong immune responses, but the long-term dynamics of humoral immunity are imperfectly known. This study aimed to assess the determinants of the long-term dynamics of antibodies to each virus based on a longitudinal capture-mark-recapture of wild European rabbits and semiquantitative serological data of MYXV and RHDV GI.2-specific IgG. The study included 611 indirect enzyme-linked immunosorbent assay (iELISA) normalized absorbance ratios for each MYXV and RHDV GI.2 from 505 rabbits from 2018 to 2022. Normalized absorbance ratios were analyzed using log-linear mixed models, showing a significant positive relationship with the time since the first capture of individual rabbits, with monthly increases of 4.1% for antibodies against MYXV and 2.0% against RHDV GI.2. Individual serological histories showed fluctuations over time, suggesting that reinfections boosted the immune response and likely resulted in lifelong immunity. Normalized absorbance ratios significantly increased with the seroprevalence in the population, probably because of recent outbreaks, and with body weight, highlighting the role of MYXV and RHDV GI.2 in determining survival to adulthood. Juvenile rabbits seropositive for both viruses were found, and the dynamics of RHDV GI.2 normalized absorbance ratios suggest the presence of maternal immunity up to 2 months of age. Semiquantitative longitudinal serological data provide epidemiological information, otherwise lost when considering only qualitative data, and support a lifelong acquired humoral immunity to RHDV GI.2 and MYXV upon natural infection. IMPORTANCE This study addresses the long-term dynamics of humoral immunity to two major viral pathogens of the European rabbit, an endangered keystone species of major ecological relevance. Such studies are particularly challenging in free-ranging species, and a combination of longitudinal capture-mark-recapture and semiquantitative serology was used to address this question. Over 600 normalized absorbance ratios of iELISA, obtained from 505 individual rabbits in 7 populations over 5 years, were analyzed using linear mixed models. The results support a lifelong acquired humoral immunity to myxoma virus and rabbit hemorrhagic disease virus upon natural infection and suggest the presence of maternal immunity to the latter in wild juvenile rabbits. These results contribute to understanding the epidemiology of two viral diseases threatening this keystone species and assist in developing conservation programs.