Sexual dysfunction in breast cancer survivors: cross-cultural adaptation of the Sexual Activity Questionnaire for use in Portugal

"Introduction: The increasing survivor population of breast cancer has shifted research and practice interests into the impacts of the disease and treatment in quality of life aspects. The lack of tools available in Portuguese to objectively evaluate sexual function led to the development of this study, which aimed to cross-culturally adapt and validate the Sexual Activity Questionnaire for use in Portugal. Material and Methods: The questionnaire was translated and back-translated, refined following face-to-face interviews with seven breast cancer survivors, and then self-administered by a larger sample at baseline and a fortnight later to test validity and reliability. Results: Following cognitive debriefing (n = 7), minor changes were made and the Sexual Activity Questionnaire was then tested with 134 breast cancer survivors. A 3-factor structure explained 75.5% of the variance, comprising the Pleasure, Habit and Discomfort scales, all yielding good internal consistency (Cronbach’s α > 0.70). Concurrent validity with the FACt-An and the BCPT checklist was good (Spearman’s r > 0.65; p-value < 0.001) and reliability acceptable (Cohen’s k > 0.444). The Sexual Activity Questionnaire allowed the identification of 23.9% of sexually inactive women, for whom the main reasons were lack of interest or motivation and not having a partner. Discussion: Patient-reported outcomes led to a more comprehensive and improved approach to cancer, tackling areas previously abandoned. Future research should focus on the validation of this scale in samples with different characteristics and even in the overall population to enable generalizability of the findings. Conclusion: The adapted Sexual Activity Questionnaire is a valid tool for assessing sexual function in breast cancer survivors in Portugal."

Assessing canopy temperature patterns in two grapevine varieties subjected to deficit irrigation: a tool to optimize water management ?

A better understanding of grapevine responses to drought and high air temperatures can help to optimize vineyard management to improve water use efficiency, yield and berry quality. Faster and robust field phenotyping tools are needed in modern precision viticulture, in particular in dry and hot regions such as the Mediterranean. Canopy temperature (Tc) is commonly used to monitor water stress in plants/crops and to characterize stomatal physiology in different woody species including Vitis vinifera. Thermography permits remote determination of leaf surface or canopy temperature in the field and also to assess the range and spatial distribution of temperature from different parts of the canopies. Our hypothesis is that grapevine genotypes may show different Tc patterns along the day due to different stomatal behaviour and heat dissipation strategies. We have monitored the diurnal and seasonal course of Tc in two grapevine genotypes, Aragonez (syn. Tempranillo) and Touriga Nacional subjected to deficit irrigation under typical Mediterranean climate conditions. Temperature measurements were complemented by determination of the diurnal course of leaf water potential (ψleaf) and leaf gas exchange. Measurements were done in two seasons (2013 and 2014) at different phenological stages: i) mid-June (green berry stage), ii) mid-July (veraison), iii) early August (early ripening) and iv) before harvest (late ripening). Correlations between Tc and minimal stomatal conductance will be presented for the two genotypes along the day. Results are discussed over the use of thermal imagery to derive information on genotype physiology in response to changing environmental conditions and to mild water stress induced by deficit irrigation. Strategies to optimize the use of thermal imaging in field conditions are also proposed

FLOOD RISK ASSESSMENT UNDER HISTORICAL AND PREDICTED LAND USE CHANGE USING CONTINUOUS HYDROLOGIC MODELING

Current procedures for flood risk estimation assume flood distributions are stationary over time, meaning annual maximum flood (AMF) series are not affected by climatic variation, land use/land cover (LULC) change, or management practices. Thus, changes in LULC and climate are generally not accounted for in policy and design related to flood risk/control, and historical flood events are deemed representative of future flood risk. These assumptions need to be re-evaluated, however, as climate change and anthropogenic activities have been observed to have large impacts on flood risk in many areas. In particular, understanding the effects of LULC change is essential to the study and understanding of global environmental change and the consequent hydrologic responses. The research presented herein provides possible causation for observed nonstationarity in AMF series with respect to changes in LULC, as well as a means to assess the degree to which future LULC change will impact flood risk. Four watersheds in the Midwest, Northeastern, and Central United States were studied to determine flood risk associated with historical and future projected LULC change. Historical single framed aerial images dating back to the mid-1950s were used along with Geographic Information Systems (GIS) and remote sensing models (SPRING and ERDAS) to create historical land use maps. The Forecasting Scenarios of Future Land Use Change (FORE-SCE) model was applied to generate future LULC maps annually from 2006 to 2100 for the conterminous U.S. based on the four IPCC-SRES future emission scenario conditions. These land use maps were input into previously calibrated Soil and Water Assessment Tool (SWAT) models for two case study watersheds. In order to isolate effects of LULC change, the only variable parameter was the Runoff Curve Number associated with the land use layer. All simulations were run with daily climate data from 1978-1999, consistent with the 'base' model which employed the 1992 NLCD to represent 'current' conditions. Output daily maximum flows were converted to instantaneous AMF series and were subsequently modeled using a Log-Pearson Type 3 (LP3) distribution to evaluate flood risk. Analysis of the progression of LULC change over the historic period and associated SWAT outputs revealed that AMF magnitudes tend to increase over time in response to increasing degrees of urbanization. This is consistent with positive trends in the AMF series identified in previous studies, although there are difficulties identifying correlations between LULC change and identified change points due to large time gaps in the generated historical LULC maps, mainly caused by unavailability of sufficient quality historic aerial imagery. Similarly, increases in the mean and median AMF magnitude were observed in response to future LULC change projections, with the tails of the distributions remaining reasonably constant. FORE-SCE scenario A2 was found to have the most dramatic impact on AMF series, consistent with more extreme projections of population growth, demands for growing energy sources, agricultural land, and urban expansion, while AMF outputs based on scenario B2 showed little changes for the future as the focus is on environmental conservation and regional solutions to environmental issues.

Water Demand and Allocation in the Mara River Basin, Kenya/Tanzania in the Face of Land Use Dynamics and Climate Variability

The Mara River Basin (MRB) is endowed with pristine biodiversity, socio-cultural heritage and natural resources. The purpose of my study is to develop and apply an integrated water resource allocation framework for the MRB based on the hydrological processes, water demand and economic factors. The basin was partitioned into twelve sub-basins and the rainfall runoff processes was modeled using the Soil and Water Assessment Tool (SWAT) after satisfactory Nash-Sutcliff efficiency of 0.68 for calibration and 0.43 for validation at Mara Mines station. The impact and uncertainty of climate change on the hydrology of the MRB was assessed using SWAT and three scenarios of statistically downscaled outputs from twenty Global Circulation Models. Results predicted the wet season getting more wet and the dry season getting drier, with a general increasing trend of annual rainfall through 2050. Three blocks of water demand (environmental, normal and flood) were estimated from consumptive water use by human, wildlife, livestock, tourism, irrigation and industry. Water demand projections suggest human consumption is expected to surpass irrigation as the highest water demand sector by 2030. Monthly volume of water was estimated in three blocks of current minimum reliability, reserve (>95%), normal (80–95%) and flood (40%) for more than 5 months in a year. The assessment of water price and marginal productivity showed that current water use hardly responds to a change in price or productivity of water. Finally, a water allocation model was developed and applied to investigate the optimum monthly allocation among sectors and sub-basins by maximizing the use value and hydrological reliability of water. Model results demonstrated that the status on reserve and normal volumes can be improved to ‘low’ or ‘moderate’ by updating the existing reliability to meet prevailing demand. Flow volumes and rates for four scenarios of reliability were presented. Results showed that the water allocation framework can be used as comprehensive tool in the management of MRB, and possibly be extended similar watersheds.

Do health care providers use online patient ratings to improve the quality of care?

Background: Physician-rating websites have become a popular tool to create more transparency about the quality of health care providers. So far, it remains unknown whether online-based rating websites have the potential to contribute to a better standard of care. Objective: Our goal was to examine which health care providers use online rating websites and for what purposes, and whether health care providers use online patient ratings to improve patient care. Methods: We conducted an online-based cross-sectional study by surveying 2360 physicians and other health care providers (September 2015). In addition to descriptive statistics, we performed multilevel logistic regression models to ascertain the effects of providers' demographics as well as report card-related variables on the likelihood that providers implement measures to improve patient care. Results: Overall, more than half of the responding providers surveyed (54.66%, 1290/2360) used online ratings to derive measures to improve patient care (implemented measures: mean 3.06, SD 2.29). Ophthalmologists (68%, 40/59) and gynecologists (65.4%, 123/188) were most likely to implement any measures. The most widely implemented quality measures were related to communication with patients (28.77%, 679/2360), the appointment scheduling process (23.60%, 557/2360), and office workflow (21.23%, 501/2360). Scaled-survey results had a greater impact on deriving measures than narrative comments. Multilevel logistic regression models revealed medical specialty, the frequency of report card use, and the appraisal of the trustworthiness of scaled-survey ratings to be significantly associated predictors for implementing measures to improve patient care because of online ratings. Conclusions: Our results suggest that online ratings displayed on physician-rating websites have an impact on patient care. Despite the limitations of our study and unintended consequences of physician-rating websites, they still may have the potential to improve patient care.

The use of motivational interviews by nurses to promote health behaviors in adolescents: developing a search strategy for this review

Introduction: The developmental changes during adolescence may affect subsequent risk for diseases and health-related behaviors. Motivational Interview (MI) may be taken as an essential tool in the provision of nursing care to adolescents, being itself a workspace with possible therapeutic effects. At this context, it is important to examine and map the use of MI by nurses in their clinical practice with adolescents to promote health behaviors. Objectives: A scoping review has been undertaking to find out what is the current extent of the use of nurse-led MI; which adolescents were included; in which contexts nurses use MI; which MI techniques/strategies are used and what outcomes have been reported. The first task was to develop a search strategy to identify relevant studies for this review. It is described here the experience in constructing the search strategy review. Methodology: This scoping review will be informed by JBI methodology. An initial search of MEDLINE and CINAHL was undertaken. An analysis of the text words contained in the title and abstract, and of the index terms used to describe the searched articles were retrieved and these were then used to construct a search strategy for use in Medline and Cinahl. Results: Analysis of the text words and the index terms generated 19 keywords: It was identified 5 synonyms for "Adolescents", 12 for "MI" and 2 for "nurse". A new research formula was designed using the text words identified. Adolescen*[Title/Abstract]) OR Younger*[Title/Abstract]) OR Youth*[Title/Abstract]) OR Teen*[Title/Abstract]) OR Adolescent[MeSH Terms])) AND (((((((((((("Motivational interview"[Title/Abstract]) OR "Motivational intervention"[Title/Abstract]) OR "Motivational interviews"[Title/Abstract]) OR "Motivational interventions"[Title/Abstract]) OR "motivational interviewing"[Title/Abstract]) OR "motivational counseling"[Title/Abstract]) OR "motivational support"[Title/Abstract]) OR "Motivational enhancement"[Title/Abstract]) OR "Brief intervention"[Title/Abstract]) OR "Brief interventions"[Title/Abstract]) OR Motivational Interviewing[MeSH Terms]) OR Directive Counseling[MeSH Terms])) AND ((nurs*[Text Word]) OR Nurses[MeSH Terms]). Limiters - Language: English, Portuguese, Spanish. In MEDLINE this research formula generated 125 results. Other 16 databases referenced at the protocol will be searched to identify additional studies. Articles identified from the final search will be assessed for relevance to the review, based on information provided in the title and abstract. The full article will be retrieved for all studies that meet the inclusion criteria of the review. Conclusions: It was presented here the initial results of this search. Next steps of this study will be to develop and refine the search strategy for use in other databases. It is expected that findings from this Scoping Review provide needed information to nurses related to the use of MI to promote health behaviors in adolescents and inform opportunities for future development in nursing practice.

Load Profile Analysis Tool for Electrical Appliances in Households

This paper presents a methodology to forecast the hourly and daily consumption in households. The methodology was validated for households in Lisbon region, Portugal. The paper shows that the forecast tool allows obtaining satisfactory results for forecasting. Models of demand response allow the support of consumer’s decision in exchange for an economic benefit by the redefinition of load profile or changing the appliance consumption period. It is also in the interest of electric utilities to take advantage of these changes, particularly when consumers have an action on the demand-side management or production. Producers need to understand the load profile of households that are connected to a smart grid, to promote a better use of energy, as well as optimize the use of micro-generation from renewable sources, not only to delivering to the network but also in self-consumption.

ABC transporters of the A subfamily: potential prognostic markers and candidates for antibody selection from phage-display libraries for therapeutic use in Ewing sarcoma

The prognostic value of ABC transporters in Ewing sarcoma is still poorly explored and controversial. We described for the first time the impact of various ABCs on Ewing sarcoma prognosis by assessment of their gene expression in two independent cohorts of patients. Unexpected associations with favourable outcomes were observed for two ABCs of the A-subfamily, ABCA6 and ABCA7, whereas no associations with the canonical multidrug ABC transporters were identified. The ABCs of the A-subfamily are involved in cholesterol/phospholipids transportation and efflux from cells. Our clinical data support the drug-efflux independent contribution to cancer progression of the ABCAs, which has been confirmed in PDX-derived cell lines. The impact of these ABCA transporters on tumor progression seems to be mediated by lowering intracellular cholesterol, supporting the role of these proteins in lipid transport. In addition, the gene expression of ABCA6 and ABCA7 is regulated by transcription factors which control lipid metabolism: ABCA6 was induced by the binding of FoxO1/FoxO3a to its promoter and repressed by IGF1R/Akt signaling, whereas the expression of ABCA7 was regulated by p53. The data point to ABCA6 and ABCA7 as potential prognostic markers in Ewing sarcoma and suggest the IGF1/ABCA/lipid axis as an intriguing therapeutic target. Agonist monoclonal antibodies towards ABCA6/7 or inhibitors of cholesterol biosynthesis, such as statins or aminobiphoshonates, may be investigated as therapeutic options in combination with chemotherapy. Considering that no monoclonal antibodies selectively targeting extracellular domains of ABCA6/7 are available, the second part of the project has been dedicated to the generation of human antibody phage-display libraries as tools for selecting monoclonal antibodies. A novel synthetic human antibody phage-display library has been designed, cloned and characterized. The library takes advantages of the high variability of a designed naïve repertoire to be a useful tool for isolating antibodies towards all potential antigens, including the ABCAs.

Embryo transfer as a tool to disseminate k-casein BB genotype and improve milk clotting properties

Dairy industries are asked to be increasingly competitive and efficient. Despite the increasing trend in milk yield and protein content during the last decade genetic selection, milk coagulation ability has diminished and even if the absolute amount of cheese produced has increased, the relative cheese yield from a set amount of milk, has decreased. As casein content and variants, along with milk clotting properties (MCP) are determined to a large extent at DNA level, genetic selection and embryo transfer can provide efficacious tools to reverse this trend and achieve improvements. The aim of the proposed research was to determine how rapidly and to what extent milk coagulation properties could be improved by using embryo transfer (ET) as a tool to increase the frequency of k-casein BB genotype cattle and reducing A and E variants in an Italian Holstein herd with a low prevalence of the favourable genotype. In the effort to optimize superovulation protocols and results, synchronization of wave emergence was performed through manual transrectal ablation of the largest (dominant) ovarian follicle on days 7 or 8 of the cycle (estrus = day 0); different drugs and dosage for the superstimulation protocol were experimented trying to overcome the negative effects of stress and the perturbance of LH secretion in superovulated highly producing lactating cows and the use of SexedULTRA™ sex-sorted semen, for artificial insemination of superovulated cows was reported for the first time. The selection program carried out in this research, gave evidence and gathered empirical data of feasible genetic improvements in cheesemaking ability of milk by means of k-casein BB selection. In conclusion, in this project, selection of k-casein BB genotype markedly enhanced cheese-making properties of milk, providing an impetus to include milk coagulation traits in genetic selection and breeding programs for dairy cattle.

Evaluation of the theranostic use of miRNAs in correlation to the radiopharmaceutical 64CuCl2 in glioblastoma

B:Glioblastoma multiforme(GBM) is one of the most prevalent and aggressive malignant primary brain tumors in adult patients. 64CuCl2 is an innovative radiopharmaceutical investigated as theranostic agent in GBM patients. The therapeutic scheme is still under evaluation, therefore the research focused on the possibility of radioresistance development. The actors responsible for modulating radioresistance could be miRNAs, thus their potential use was investigated both in radioresistant cell lines and in GBM patients plasma samples. M:Radioresistant cell lines were generated by exposing U87MG, U373MG lines to increasing doses of radiation for 32 weeks. Cell membrane permeability alterations and DNA damage were assessed to characterize the lines. Moreover, 64Cu cell incorporation and subcellular distribution were investigated measuring gamma-radiation emission. miRNA expression was evaluated: in parental and radioresistant cell lines, both in cell pellet and media exosomes; in plasma samples of GBM patients using TaqMan Array MicroRNA Cards. R:Radioresistant lines exhibited reduction in membrane permeability and in DNA DSBs indicating the capability to skip the drug killing effect. Cell uptake assays showed internalization of 64Cu both in the sensitive and radioresistant lines. Radioresistant lines showed a different miRNA expression profile compared to the parental lines. 5 miRNAs were selected as possible biomarkers of response to treatment (miR-339-3p, miR-133b, miR-103a-3p, miR-32-5p, miR-335-5p) and 6 miRNAs as possible predictive biomarkers of response to treatment (let-7e-5p, miR-15a-5p, miR-29c-3p, miR-495, miR-146b-5p, miR-199a-5p). miR-32-5p was selected as possible molecule to be used to restore 64CuCl2 responsiveness in the radioresistant cell lines. C: This is the first study describing the development and characterization of 64CuCl2 radioresistant cell lines useful to implement the approach for dosimetric analysis to avoid radioresistance uprising. miRNAs could bring to a better understanding of 64CuCl2 treatment, becoming a useful tool both in detection of treatment response and both as molecule that could restore responsiveness to 64CuCl2 treatment.

Practical assessment on the run – iPads as an effective mobile and paperless tool in physical education and teaching

This paper investigates the use of iPads in the assessment of predominantly second year Bachelor of Education (Primary/Early Childhood) pre-service teachers undertaking a physical education and health unit. Within this unit, practical assessment tasks are graded by tutors in a variety of indoor and outdoor settings. The main barriers for the lecturer or tutor for effective assessment in these contexts include limited time to assess and the provision of explicit feedback for large numbers of students, complex assessment procedures, overwhelming record-keeping and assessing students without distracting from the performance being presented. The purpose of this pilot study was to investigate whether incorporating mobile technologies such as iPads to access online rubrics within the Blackboard environment would enhance and simplify the assessment process. Results from the findings indicate that using iPads to access online rubrics was successful in streamlining the assessment process because it provided pre-service teachers with immediate and explicit feedback. In addition, tutors experienced a reduction in the amount of time required for the same workload by allowing quicker forms of feedback via the iPad dictation function. These outcomes have future implications and potential for mobile paperless assessment in other disciplines such as health, environmental science and engineering.

Protostrongylids nematodes as a tool to study the biogeography of wild mammals

The European brown hare (Lepus europaeus Pallas, 1778) is an important game species, distributed across Europe and introduced in other regions. Recently, a geographically isolated population, closely related to an ancestral lineage of Lepus europaeus meridiei, was found on Pianosa Island, off the coast of Tuscany, Italy (Mengoni et al., 2018). Thus, the unique opportunity to explore the evolution and genetic structure of its helminth parasites was added to its exceptional isolation condition. Various lungworm species within the genus Protostrongylus (Nematoda: Protostrongylidae) are described in European brown hares. Our aim was to analyze the parasite population through morphological and molecular approaches in order to study the biogeography of the European brown hares (L. e. meridiei) population from Pianosa Island. Moreover, we investigated the morphology of a monospecific genus, i.e. Orthostrongylus, considering its quite intrigant descriptive history and its still unclear and debated classification. Nuclear and mitochondrial markers were used based on their resolution power and expected polymorphism; the whole Internal Transcribed Spacer 1 and 2 (ITS), including the 5.8S rRNA sequence and the Large Subunit (28S) were used, as nuclear genes, for confirmation of the species identification. Conversely, the cytochrome oxidase c subunit I (COI) was used, as mithocondrial genes, to assess interspecific genetic relationships. Molecular analysis corroborated the morphological identification since all the generated ITS and LSU sequences were 100% consistent with the species Protostrongylus oryctolagi and Orthostrongylus macrotis. The paucity of molecular data existent about this genus of parasites underlines the need for more insight’s studies. An in-depth analysis of broncho-pulmonary parasites and the host-parasites relationships along with the improvement of the use of mitochondrial genes, as well as the assessment of new polymorphic markers could contribute to an extensive understanding of parasites fauna and taxonomy, as well as their relationship with wild mammals’ hosts.

Validation of a new method for human nerve decellularization: toward a new tool in peripheral nerve reconstructive surgery.

Defects of the peripheral nervous system are extremely frequent in trauma and surgeries and have high socioeconomic costs. In case of peripheral nerve injury, the first approach is primary neurorrhaphy, which is direct nerve repair with epineural microsutures of the two stumps. However, this is not feasible in case of stump retraction or in case of tissue loss (gap > 2 cm), where the main surgical options are autologous grafts, allogenic grafts, or nerve conduits. While the gold standard is the autograft, it has disadvantages related to its harvesting, with an inevitable donor site morbidity and functional deficit. Fresh nerve allografts have therefore become a viable alternative option, but they require immunosuppression, which is often contraindicated. Acellular Nerve Allografts (ANA) represent a valid alternative, they do not need immunosuppression and appear to be safe and effective based on recent studies. The purpose of this study is to propose and develop an innovative method of nerve decellularization (Rizzoli method), conforming to cleanroom requirements in order to perform the direct tissue manipulation step and the nerve decellularization process within five hours, so as to accelerate the detachment of myelin and cellular debris, without detrimental effects on nerve architecture. In this study, the safety and the efficacy of the new method are evaluated in vitro and in vivo by histological, immunohistochemical, and histomorphometric studies in rabbits and humans. The new method is rapid, safe, and cheaper if compared with available commercial ANAs. The present study shows that the method, previously optimized in vitro and in vivo on animal model presented by our group, can be applied on human nerve samples. This work represents the first step in providing a novel, safe, and inexpensive tool for use by European tissue banks to democratize the use of nerve tissue transplantation for nerve injury reconstruction.

Sensory analysis as a tool to improve the quality of aquaculture products

Sensory analysis is a scientific discipline used to evoke, measure, analyse and interpret the responses to products that are perceived by the senses of sight, smell, taste, touch and hearing. This science is used to highlight the strengths and characteristics of a product, such as in the case of research and development products where alternative ingredients, food waste or by-products are used. It can also be used to evaluate the same characteristics over time, to highlight alterations in one of the sensory components at a given time or over time. This doctoral thesis deals with the valorisation, through characterisation, of various aquaculture fish products. In particular, the products covered by this study were analysed, depending on the objective pursued, with different sensory methods using trained judges and in one case consumers. Therefore, the sensory characterisation of the products was useful for investigating the foods considered in this doctoral research. In particular, specific research topics were taken: 1. The study of alternative ingredients, such as the outcomes of different levels of inclusion of insect larvae (Hermetia illucens) meal on the quality of sea bream (Sparus aurata) fillets. 2. The study of consumer expectations and perceptions on the use of insect meal as a feed for aquaculture products. In particular, this study was done after the characterisation by Quantitative Descriptive analysis (QDA) of the products to exclude sensory differences. 3. Development of a non-destructive and cheap device based on dielectric spectroscopy for assessing fish freshness. In particular in this study, the developed device was evaluated in correlation with a sensory method for assessing the freshness of fish product, the Quality Index Method (QIM)

Mocku for change: an explorative study on the use of “mockumentary” as a new language for climate change education

In the ‘society of acceleration and uncertainty’ (Rosa, 2013), the young are struggling to interpret our complex and fast-changing world. The entity and the velocity of changes are so enormous that we need new narratives or languages to conceptualise them. Among those changes “Climate Change” is placed in a particular difficult position. As the writer A. Ghosh said: “The current climate crisis is also a crisis of culture, and thus of the imagination”. In fact, in today’s literature and cinema a strong dichotomy exists between fictional and non-fictional works, but none of those extremities seems suitable to picture an “adequate representation” of climate change issues, particularly those that are related to future. The main goal of my study, carried out within FEDORA EU project, was to understand to what extent the hybrid film form called “mockumentary” (a language that adopts the aesthetics of factual production to give an illusion of truth to invented stories) could inspire and help students in overcoming the mentioned dichotomy, working as a tool to foster the development of argumentative and imaginative skills needed to picture “immaginary yet realistic” climate change scenarios.