Search Results (10)

Severe asthma is a subset of difficult-to-treat asthma that requires the verification of inhaler technique, the correction of modifiable risk factors, as well as diagnosis and comorbidity review. When severe asthma is suspected, patients should undergo proper phenotyping (T2-high or T2-low) and be referred to a specialized severe asthma clinic. The current biologics for severe asthma treatment include omalizumab (anti-IgE), mepolizumab and reslizumab (anti-IL-5), benralizumab (anti-IL-5 receptor), dupilumab (anti-IL-4/IL-13), and tezepelumab (anti-TSLP). The outcomes to evaluate are the reduction in systemic corticosteroid use, the reduction in exacerbations and healthcare use, and improvement in symptoms and lung function. Comorbidities should be carefully considered, and if possible, addressed with the same biologic. Dupilumab, mepolizumab, and omalizumab are also approved for chronic rhinosinusitis with nasal polyps (CRSwNP), the most common asthma comorbidity. There are currently several clinical trials on biologics for severe asthma. Depemokimab is an ultra-long-acting anti-IL-5 antibody with promising results in phase III trials as a twice-yearly biologic for T2-high asthma. Verekitug follows a similar dosing concept, targeting TSLP, but is still undergoing phase II trials. Itepekimab and astegolimab are two anti-IL-33 antibodies that could have a role in the future treatment of severe asthma. Tezepelumab is in a phase III clinical trial for CRSwNP. Besides new drugs, there is still a need for major research into biologics in severe asthma cases, namely with comparative studies, better biomarkers for predicting response, and the determination of optimal treatment duration. Full article

The commercial space launch sector is currently undergoing a significant shift, with increasing competition and demand for launch services, as well as growing concerns about the environmental impact of rocket launches. To address these challenges, within the New Space Portugal project scope, a multidisciplinary framework for designing and optimizing new launch vehicles is proposed. Creating a more resilient and responsible space industry can be achieved by combining technological innovation and environmental sustainability, as emphasized by the framework. The main scope of the framework was to couple all the disciplines relevant to the space vehicle design in a modular way. Significant emphasis was placed on the infusion of ecodesign principles, including Life Cycle Assessment (LCA) considerations. Optimization techniques were employed to enhance the design and help designers conduct trade-off studies. In general, this multidisciplinary framework aims to provide a comprehensive approach to designing next-generation launch vehicles that meet the demands of a rapidly changing market while also minimizing their environmental impact. A methodology that leverages the strengths of both genetic and gradient-based algorithms is employed for optimizations with the objectives of maximizing the apogee altitude and minimizing the Global Warming Potential (GWP). Despite only being tested at the moment for sounding rockets, the framework has demonstrated promising results. It has illuminated the potential of this approach, leading to the identification of three optimal designs: one for maximizing the apogee, another for minimizing GWP, and a compromise design that strikes a balance between the two objectives. The outcomes yielded a maximum apogee of $6.41$ km, a minimum GWP of $9.06$ kg ${\mathrm{CO}}_{2_{eq}}$, and a balanced compromise design featuring an apogee of $5.75$ km and a GWP of $25.64$ kg ${\mathrm{CO}}_{2_{eq}}$. Full article

Early-life gut dysbiosis has been associated with an increased risk of inflammatory, metabolic, and immune diseases later in life. Data on gut microbiota changes in infants undergoing intestinal surgery requiring enterostomy are scarce. This prospective cohort study examined the enterostomy effluent of 29 infants who underwent intestinal surgery due to congenital malformations of the gastrointestinal tract, necrotizing enterocolitis, or spontaneous intestinal perforation. Initial effluent samples were collected immediately after surgery and final effluent samples were collected three weeks later. Gut microbiota composition was analysed using real-time PCR and 16S rRNA gene sequencing. Three weeks after surgery, an increase in total bacteria number (+21%, p = 0.026), a decrease in Staphylococcus (−21%, p = 0.002) and Candida spp. (−16%, p = 0.045), and an increase in Lactobacillus (+3%, p = 0.045) and in less abundant genera belonging to the Enterobacteriales family were found. An increase in alpha diversity (Shannon’s and Simpson’s indexes) and significant alterations in beta diversity were observed. A correlation of necrotizing enterocolitis with higher Staphylococcus abundance and higher alpha diversity was also observed. H2-blockers and/or proton pump inhibitor therapy were positively correlated with a higher total bacteria number. In conclusion, these results suggest that positive changes occur in the gut microbiota profile of infants three weeks after intestinal surgery. Full article

Human papillomavirus (HPV) infection is a necessary but not sufficient factor for the development of invasive cervical cancer (ICC) and high-grade intraepithelial lesion (HSIL). Oxidative stress is known to play a crucial role in HPV infection and carcinogenesis. In this study, we comprehensively investigate the modulation of HPV infection, HSIL and ICC, and ICC through an exploration of oxidative stress-related genes: CβS, MTHFR, NOS3, ACE1, CYBA, HAP, ACP1, GSTT1, GSTM1, and CYP1A1. Notably, the ACE1 gene emerges as a prominent factor with the presence of the I allele offering protection against HPV infection. The association of NOS3 with HPV infection is perceived with the 4a allele showing a protective effect. The presence of the GSTT1 null mutant correlates with increased susceptibility to HPV infection, HSIL and ICC, and ICC. This study also uncovers intriguing epistatic interactions among some of the genes that further accentuate their roles in disease modulation. Indeed, the epistatic interactions between the BB genotype (ACP1) and DD genotype (ECA1) were shown to increase the risk of HPV infection, and the interaction between BB (ACP1) and 0.0 (GSTT1) was associated with HPV infection and cervical lesions. These findings underscore the pivotal role of four oxidative stress-related genes in HPV-associated cervical lesions and cancer development, enriching our clinical understanding of the genetic influences on disease manifestation. The awareness of these genetic variations holds potential clinical implications. Full article

Patients with polycythaemia vera (PV) are at increased risk of thrombosis and haemorrhages. Although hydroxyurea (HU) has been the frontline therapy for patients at high risk of vascular complications, about 25% of patients develop resistance/intolerance to this therapy. The aim of this non-interventional, multicentre cohort study was to understand the clinical characteristics and HU treatment response of Portuguese PV patients. HU resistance/intolerance was defined according to adjusted European LeukemiaNet (ELN) criteria. In total, 134 PV patients with a mean (SD) disease duration of 4.8 (5.0) years were included and followed up for 2 years. At baseline, most patients were ≥60 years old (83.2%), at high risk for thrombotic events (87.2%), and receiving HU therapy (79.1%). A total of 10 thrombotic events and 8 haemorrhagic events were reported, resulting in a 5-year probability of thrombo-haemorrhagic events of 17.2%. Haematocrit (p = 0.007), haemoglobin (p = 0.012) and MPN10 symptom score (12.0 (11.6) vs. 10.3 (9.1); p = 0.041) decreased significantly at the 24-month visit compared to baseline. Overall, 75.9% of patients met at least one of the adjusted ELN criteria for HU resistance, and 14.4% of patients remained on HU throughout the study. The results from this real-world study may help identify the subset of patients at higher risk for disease sequelae who may benefit from earlier second-line treatment. Full article

Parenting sense of competence refers to parents’ perception about their ability to perform the parenting role, one of the key dimensions in family dynamics. This construct is even more important in families at psychosocial risk, where the exercise of parenting can be more challenging. The Parenting Sense of Competence scale (PSOC) is a self-report measure that aims to assesses one’s perceived efficacy and satisfaction with parenting. In this cross-sectional and instrumental study, we aimed to examine the psychometric properties of the PSOC among a Portuguese sample of community (n = 205) and at-psychological-risk (n = 273) parents. Participants completed the PSOC, the Enrich Marital Satisfaction Scale, the Parenting Stress Index, and the Parenting Alliance Inventory. Results from confirmatory factor analysis showed that a two-factor revised model obtained the best fit, with some items being removed. Our data confirmed that the PSOC has good psychometric properties, with acceptable reliability and validity and measurement invariance across the community and the at-risk samples. Findings of this psychometric exploration provided evidence that the PSOC is a reliable measure of easy application and interpretation for assessing the perceived competence of Portuguese parents. Full article

This study aimed to assess the effect of Hermetia illucens meal (HM) dietary inclusion on meagre oxidative status. Thus, fish were fed a fishmeal-based diet (CTR diet) and three other diets with increasing levels of HM inclusion, namely 10%, 20%, and 30% (diets HM10, HM20, and HM30, respectively). At the end of the trial, hepatic and intestine superoxide dismutase, catalase, and glucose-6-phosphate dehydrogenase activities and malondialdehyde concentration were unaffected by the diet composition. Liver glutathione peroxidase activity was higher in the fish fed the HM20 diet than in the fish fed the CTR and HM30 diets, and glutathione reductase activity linearly increased with the dietary HM level. The hepatic total glutathione and reduced glutathione contents were significantly lower in fish fed the HM20 diet than in fish fed the CTR and HM10 diets. In the intestine, the oxidized glutathione (GSSG) content and oxidative stress index linearly increased with the increase in dietary HM level, with the GSSG content of fish fed the HM20 diet being significantly higher than of fish fed the CTR diet. In conclusion, 30% HM might be included in meagre diets without negatively affecting hepatic and intestine oxidative status. Full article

Marital satisfaction is a key construct in the assessment of a couple’s relationship, and it encompasses aspects such as the feelings of affection, trust, and companionship that arise from the exchanges between spouses. The ENRICH Marital Satisfaction (EMS) Scale has been widely used as a reliable measure to assess marital satisfaction. In the present study, we aimed to analyze the psychometric properties and the factor structure of the EMS Scale in a sample of Portuguese parents. A total of 205 mothers and fathers participated; 107 were women (52%), and 98 were men (48%), and the mean age was 38.39 years (SD = 5.85). The majority were two-parent families (89.3%), with children between the ages of 1 and 13 years (M = 6.90), 53% of whom were boys. The participants completed the EMS Scale together with the Parenting Stress Index Short Form and the Parenting Alliance Inventory. The results from a confirmatory factor analysis corroborate the two-dimensional structure of the instrument, with internal validity and reliability values that were suitable for application in the Portuguese population. The EMS Scale can be an important resource, with good psychometric quality, for professionals and researchers, which can be used in assessment and intervention programs, both at the individual and couple levels. Full article

The nutritional quality of kiwifruit has been highlighted by several studies, while its peel is typically discarded as a by-product with no commercial value. This study was carried out to optimize the ultrasound-assisted extraction (UAE) of phenolic compounds from kiwi peel. Three independent variables (time (t), ultrasonic power (P) and ethanol concentration (EtOH)) were combined in a five-level central composite rotatable design coupled with the response surface methodology (RSM). The extraction yield determined gravimetrically and the content of phenolic compounds identified by HPLC-DAD-ESI/MSⁿ (namely two quercetin glycosides, one catechin isomer and one B-type (epi)catechin dimer) were the experimental responses used in the optimization. The polynomial models were successfully fitted to the experimental data and used to determine the optimal UAE conditions. The sonication of the sample at 94.4 W for 14.8 min, using 68.4% ethanol, resulted in a maximum of 1.51 ± 0.04 mg of flavonoids per g of extract, a result that allowed the experimental validation of the predictive model. The kiwi peel extract obtained under optimized conditions showed somehow promising bioactive properties, including antioxidant and antimicrobial effects, and no toxicity to Vero cells. Overall, this study contributes to the valorization of kiwi peel as a low-cost raw material for the development of natural ingredients (such as food preservatives) and also to the resource-use efficiency and circular bioeconomy. Full article

The most relevant nutrients and bioactive compounds (soluble sugars, dietary fiber, ascorbic acid and organic acids, individual phenolic compounds, fatty acids, and tocopherols) as well as antioxidant activity have been characterized in three extra early varieties of clementine (Citrus clementina Hort ex Tan. Basol, Clemensoon and Clemenrubí) cultivated in Valencia (Spain). Clementines are a relevant source of bioactive compounds, such as vitamin C (values around 80 mg/100 g), allowing to satisfy the recommended daily intake with the consumption of a normal portion. Sucrose was the most abundant sugar, and potassium the main mineral while manganese was the least. Fat content was very low (<0.5 mg/100 g), with palmitic acid and α-tocopherol the most abundant fatty acid and vitamin E form, respectively. Flavonoids were the predominant phenolic compounds, with narirutin/naringin and (neo)hesperidin the best represented ones. The antioxidant capacity evaluated by reducing power, DPPH, and β-carotene bleaching inhibition assays was satisfactory with values similar to those reported in other citrus fruits. Thus, this fruit is a relevant source of bioactive compounds with antioxidant properties of interest for consumers and the food industry. Full article