bluuebunny/crossref_metadata_2025_split huggingface dataset:
ADHEAR in Conductive Hearing Loss: a case study
Authors: Marques T , Carvalho A , Miguéis A 
Published: June 2020

Abstract
Introduction Bone conduction hearing systems can be applied through non-invasive devices, using soft bands that exert pressure on the skin, or they can be surgically implanted (Bone Anchored Hearing Aid - BAHA). However, these bone conduction devices are frequently not well accepted due to the pressure on the head. Therefore, a new non-surgical hearing system was developed not to exert pressure on the skin, the ADHEAR. The bone anchorage in ADHEAR is performed through an adhesive adapter and is indicated for patients with conductive hearing loss and normal inner ear function.
Objectives Evaluate the audiological performance with the adhesive bone conduction hearing device (ADHEAR) in a patient with conductive hearing loss.
Methodology The study was designed as a prospective single-subject repeated-measure study with the subject serving as his own control. A 29 year old female patient who had a primary surgery due to middle ear cholesteatoma, was adapted with unilateral non-invasive adhesive bone conduction system for the treatment of conductive hearing loss. Air and bone conduction thresholds, word recognition scores (WRS) and speech recognition thresholds (SRT) in quiet and noise were assessed to verify the inclusion criteria of the study. Aided and unaided pure tone audiometry at 0.5, 1, 2 and 4 kHz in free field and speech audiometry in quiet and noise were performed at baseline and after 4 weeks with the ADHEAR.
Results The functional gain with the ADHEAR averaged over 0.5, 1, 2, and 4 kHz after 4 weeks of usage of the adhesive hearing system, improved from 55 dB HL to 31dB HL. Speech perception in quiet and noise improved significantly in the aided situation, with SRT in quiet improving from 60 to 35 dB HL, when compared to the unaided condition. Similar results were found in noise. The patient evaluated the ADHEAR system as being useful, and without complaints of skin pressure. There was no adverse skin reaction.
Conclusion Hearing performance was significantly better with ADHEAR under all test conditions. Therefore, this transcutaneous hearing system seems to be an excellent alternative for patients who need a hearing solution for conductive hearing loss but for clinical reasons cannot undergo surgery or conventional hearing aids. Furthermore, it preserves skin over the mastoid and reduces the risk of infection. Otherwise it has benefits verified by absence of head pressure and improvement of patient’s quality of life.
Pharmacogenomics - the state of the art in drug prescription
Authors: Ferreira R , Gomes CA 
Published: June 2020

Abstract
Introduction The different response to various drugs by individuals has been increasingly debated, since it has been concluded that there are large differences in response and increasing occurrence of adverse reactions. This set of issues led to more and more research on the implementation of genetic testing in the very near future, leading to benefits for the patient. The purpose of pharmacogenetics is to analyse each individual’s genetic variability in response to therapy, increasing efficiency and safety. On the other hand, pharmacogenomics studies how the expression of a set of genes interferes in individual’s responses to drugs, taking into account pharmacokinetics and pharmacodynamics. This concept also seeks to reduce adverse reactions and toxicity, maximizing drug efficiency.
Objectives The present work aims at gathering information on the proposed theme, making the survey of drugs available on the market elucidating how it allows the adjustment of the dose to be administered to the patient according to their genetic profile.
Methodology Databases such as Pubmed, Science Direct and Google Scholar were consulted and data were collected from 2015 until 2019. Paper was selected first by abstract and after by full text reading of the article.
Results On this review we will list the drugs associated with each biomarker and the respective therapeutic area to which they belong, compiled by the Food and Drug Administration (FDA). This list includes the main therapeutic area: oncology, haematology, anaesthesiology and psychology. Biomarkers allow us to identify phenotype-associated variations in drug response, making it possible to understand whether drugs will have a beneficial effect, no effect or if there is a risk of toxicity.
Conclusion This question requires a risk-benefit assessment, since it involves social, ethical and economic problems.
Auditory training app validation
Authors: Maia F , Jesus V , Mateus C , Paulo S , Marcelino L , Serrano M 
Published: June 2020

Abstract
Introduction One of the main hearing complaints is the difficulty to perceive speech in noisy environments. This complaint gets worse with ageing at which cognitive processing speed slows and/or when hearing loss is present. An auditory training can improve speech perception in adverse environments. The use of auditory training software on various digital platforms is becoming a reality.
Objectives To validate the auditory training app in European Portuguese with individuals aged between 55 and 64 years old with an approximate average of 20dB of hearing thresholds.
Methodology The sample consists in two groups of seven individuals without cognitive problems. One of the groups performed eight auditory training sessions with the application for a period of four weeks and the other group (the control group) did not perform any auditory training session. The evaluation was made in all the individuals with the filtered speech test. The training group was evaluated before, immediately after and after four weeks of the auditory training sessions and the control group was evaluated after four weeks.
Results Statistically there is a significant difference between before and immediately after the auditory training in the filtered speech test (p = 0.018). Four weeks after the end of the training the performance of each individual was the same. In the control group there were no significant differences between the two evaluation moments.
Conclusion The EVOLLU auditory training app promotes an improvement in the perception of the word in adverse environments that continues even after some time. This is a sign that individuals are applying that learning into their day to day living. The Evollu application can and should be used in the auditory training of individuals aged between 55 to 64 years old.
Visual dependence after vestibular rehabilitation by virtual reality in individuals with unilateral peripheral vestibular dysfunction – one year of results
Authors: Cunha B 
Published: June 2020

Abstract
Introduction One of the most common approaches in individuals with unilateral peripheral vestibular dysfunction (UPVD) is vestibular rehabilitation (RV). Many factors can negatively affect the result of RV. Virtual reality based treatment may represent an important tool in the solution of these problems. In individuals with UPVD there is a decrease in the reception of vestibular stimuli and there is an adjustment in the reception of visual and proprioceptive stimuli. They use more visual cues to minimise the decrease in vestibular stimuli – visual dependence (VD). Although the importance and results of virtual reality as a tool in improving balance in individuals with UPVD have already been demonstrated, we intend to demonstrate that virtual reality allows significant improvements in the decrease in VD.
Objectives The aim of the study is to compare VD levels in individuals with UPVD after RV program by virtual reality.
Methodology For the evaluation of VD, dynamic posturography was performed with the Balance Rehabilition Unit equipment for 39 people with UPVD, before and after the RV program by virtual reality. Ten conditions were tested, with different visual and propriocetive stimuli. The parameters considered were the oscillation area of the pressure centre and the sway velocity.
Results In the parameter of the oscillation area of the pressure centre, statistically significant results were found in the 10 conditions tested. In the sway velocity parameter, statistically significant results were found in the condition 1, 2, 3, 4, 5 e 10.
Conclusion Virtual reality incorporated in the RV programs presents itself as an important tool in improving VD in individuals with UPVD.
Biomechanical Device for Strength Control in Dental Restorations
Authors: Esteves M , Falacho R , Silva M , Roseiro L 
Published: June 2020

Abstract
Introduction In the dentistry field, restoration of a damaged tooth using indirect restorations is a common activity. In the restoration process with cementing agents, there is a need to apply force to the insertion of the part that will rehabilitate the tooth. This force becomes essential to cause the flow of the cementitious material, thus improving the prognosis and longevity of the restoration-tooth assembly. Excessive force can cause damage and a little intensity force will not be enough for the correct seating of the piece. However, the applied force is dependent on the sensitivity of the dentist, and there are no tools that guarantee the aid in its monitoring.
Objectives The biomechanical device must be able to monitor the forces applied on teeth restoration and has its importance based in clinical environment use, but above all will be a relevant tool in the learning process for dental medicine students.
Methodology The developed device is based on some commonly used dental systems for dental restorations. A geometry was created using a computer aided design software and calculated by the finite element method. The developed solution uses the structural information for force control with strain gauges. The equipment interacts with the user using incorporated sound and light signals powered by a battery, but also can be wired to a computer.
Results The medical team performed some tests in ceramic teeth samples, in order to ensure the reality of the tests. The device operation reveals an easy and stable force application as well as a correct sound and light feedback. After the sample’s analysis, the cement thickness and strength are within ideal parameters.
Conclusion From this work resulted the invention of a functional biomechanical equipment that will be used in student learning process and in clinical context. The device had a good acceptance and feedback by the medical team, promising to revolutionize the way dental restorations are performed.
Association among fatigue, sleep disorders and other clinical parameters in Parkinson’s disease
Authors: Asano A , Asano N , Mota D , Gondim I , Aroxa F , Coriolano M , Lins O 
Published: June 2020

Abstract
Introduction Fatigue and sleep disorders are common in Parkinson disease (PD) patients. Fatigue is not always clinically recognized because of its subjective character manifested by feelings of extreme tiredness. These non-motor symptoms can occur from the early stages of the disease and tend to persist.
Objectives To evaluate fatigue in patients with PD and the possible association with sleep disorders and other clinical parameters of the PD; and to evaluate the impact of fatigue on quality of life
Methodology A cross-sectional study with 123 patients with PD was implemented. The following instruments were used: Mini Mental State Examination, the Hoehn-Yarh Scale, Beck Depression Inventory, Parkinson’s Disease Quality of Life Questionnaire, Parkinson’s Disease Sleep Scale, Epworth Sleepiness Scale, and Parkinson’s Disease Fatigue Scale.
Results Fatigue was found in 48% of patients. Patients with fatigue presented longer duration of illness, depressive symptoms, cognitive impairment, severity of motor symptoms, excessive daytime sleepiness and nocturnal sleep disorder. Fatigue combined with sleep disorder occurred in 21% of the total sample, being more frequent in females (32% vs 15%) and in patients at more advanced stages of the disease (52% in HY3). The multiple logistic regression analysis indicated that the significant independent variables for the presence of fatigue were: cognition (OR = 1.19 P = 0.02), nocturnal sleep disorder (OR = 1.03 P = 0.0001); among PDSS domains, nocturnal motor symptoms (OR = 1.09 P = 0.0005) and sleep refreshment (OR = 1.11 P = 0.02); among PDQ-39 domains, mobility (OR = 0.9323 P &lt; 0.0001) and body discomfort (OR = 0.9767 P = 0.0428).
Conclusion Fatigue is common in PD, especially in the more advanced stages, and it seems to be associated with the female gender, nocturnal sleep disorder and cognition, having thus a negative impact on the quality of life.
Lung function in wind instrument players of philharmonic bands
Authors: Cunha I , Gonçalves L 
Published: June 2020

Abstract
Introduction In order to play a wind instrument one must have a good breathing control with rhythm variation, control of inspiratory and expiratory volume as well as a good control of the airflow transmitted by the musician through the different mouthpieces. The pulmonary function of the different wind instrument players has been scarcely studied generating divergent conclusions.
Objectives To characterize and compare lung function and functional capacity of musicians of different wind instruments.
Methodology One hundred and one individuals from five philharmonic bands from Aveiro and Porto districts were studied. Smokers or ex-smokers for less than one year, respiratory pathology, history of chronic pulmonary or cardiac disease were exclusion criteria. The sample was divided into three groups: "Air reed", "Reeds" and "Metals". Pulmonary function was assessed by spirometry: forced vital capacity (FVC), forced expiratory volume in first second (FEV1), Tiffeneau index (TI), peak expiratory flow (PEF) and maximal voluntary ventilation (MVV). Functional capacity was assessed using the six-minute walk test (6-MWT). Data analysis was performed in the Statistical Package for the Social Sciences with a 95% confidence interval. Chi-square test, Mann-Whitney U test, ANOVA test and Kruskal-Wallis test were used.
Results All spirometric parameters with the exception of TI were increased in "Metals" group with significant decrease in the "Air reed" parameters of FEV1 (p = 0.045) and MVV (p = 0.004). A negative correlation between FEV1 and 6-MWT was noticed in male musicians (r=-0.291; p = 0.022).
Conclusion Musicians from the “Metals” group showed better lung function when compared to other groups. There was no positive correlation between lung function and functional capacity of the studied musicians. However, there was a weak negative correlation between FEV1 of male musicians and their functional capacity.
Obstructive Sleep Apnea Syndrome - Predictive Indicators of Severity
Authors: Castro J , Silva H , Coelho P , Pereira T 
Published: June 2020

Abstract
Introduction Obstructive Sleep Apnea Syndrome (OSAS) is a public health issue, due to its increasing prevalence and associated morbidity and mortality, worsened by the underestimated diagnosis of this entity in clinical practice.
Objectives To correlate clinical, demographic and anthropometric indicators, and elaborate a predictive equation for OSAS severity and prevalence, in males and females.
Methodology In this cross-sectional study, all the included patients performed a type I Polysomnography in ULSM – HPH Neurophysiology Laboratory, between July 2011 and December 2017. Patient’s weight, height, body mass index (BMI), waist circumference (WC) and neck circumference (NC) were assessed. Daytime excessive sleepiness was rated through the Epworth Sleepiness Scale (ESS). The apnea-hypopnea index and the snoring presence were obtained through the polygraphic recording. Demographic, anthropometric, clinical variables and ESS punctuation were correlated with the presence of OSAS and its severity through a multivariable regression model.
Results The study included 472 patients (275 males and 197 females). OSAS prevalence was 65,7% (75,3% in males and 52,3% in females), being the males related to the most severe forms of OSAS (p &lt; 0,001), the same happening with the age group 60-69 years. OSAS severity correlated directly with NC, WC, BMI and ESS increase. Snoring was present in 92,8% of the cases and did not correlate with OSAS severity. In females, severity correlated directly with age and BMI. Age and NC were identified as the strongest independent OSAS predictors (p-value=0,011 and p-value=0,006, respectively).
Conclusion In this study, OSAS severity predictors were gender, age, NC, WC, BMI, snoring and ESS result (NC and age were the strongest independent predictors). These findings should be confirmed in more robust studies, to identify patients at risk of severe OSAS, to allow earlier diagnostic evaluation and therefore preventing OSAS associated complications.
eLearning Technologies on the follow-up of Young People with Chronic Diseases
Authors: Pascual J , García S , Pedrosa I , Lapuente I , Lapuente B , Delgado A , Azema D , Raupp A , Oliveira M , Berthier A , Bastier S , Lapeyre Y , Teixeira P 
Published: June 2020

Abstract
Introduction Non-communicable diseases are increasing worldwide due mainly to rapidly changing lifestyles and socio-economic status affecting the well-being and the lives of young people along their whole life. Hence, there is a need to provide adequate and useful measures to support patients living with those diseases in order to foster youth emotional and physical health and improve their daily life.
Objectives The aim of this presentation is to demonstrate the use of eLearning content to empower families, communities and young patients in dealing with the daily routine of chronic diseases.
Methodology Based on a human centred design, 176 youngsters with asthma, obesity, and diabetes aged between 3-16 years old were assessed to gather information about perceived needs and preferences in relation to disease management. Ineffective communication, lack of knowledge/skills, poor adherence to treatment and low acceptance of the disease were the main aspects highlighted. Based on those results, participants were fully involved participating in the iterative development of eLearning package to face these needs, gathering specific information about its content, design and usability.
Results The project has generated eLearning modules, using Articulate technologies, providing practical information and learning content in three languages, in partnership with health research centres, hospitals and patient associations in Portugal, Spain and France. There are lots of packages: obesity, respiratory diseases and diabetes. In each of these, the content is provided using gamification strategies and role models. eLearning is one of the components of the follow up process, being complemented by a mobile application with an interactive support chat and fun games.
Conclusion ELearning tools, along with other online tools, contribute to generate a more positive perspective on the control of the disease and to support families and patients to get reliable information and connect with medical assistance.
Association between functional physical fitness and health status of the elderly
Authors: Batista A , Flores G , Carvalho S , Sampaio M , Patrício C 
Published: June 2020

Abstract
Introduction Portugal currently has one of the most aging populations in Europe. Aging is usually associated with increased inactivity, decreased physical capacity and a higher incidence of disease, all of which leads to a reduction in functional changes and, consequently, loss of independence. Therefore, it is necessary to ensure that this population maintains a satisfactory level of physical and mental skills, emotional well-being and especially independence to perform day-to-day activities, and, to that end, measures are needed to promote health and allow a better quality of life.
Objectives To verify if the physical fitness components are determinant for the health status of the elderly.
Methodology A cross-sectional study was carried out on non-institutionalized elderly. For data collection, a questionnaire with sociodemographic data, the SF-12 questionnaire, to assess health status (physical and mental component), and the Senior Fitness Test (strength of lower and upper limbs, agility / balance, flexibility of the lower and upper limbs and cardiorespiratory ﬁtness) to assess functional physical fitness were conducted.
Results The sample is composed of 439 individuals, aged between 65 and 95 years old, mostly women. The set of physical fitness components: cardiorespiratory ﬁtness, agility / balance, body mass index, lower and upper limb strength, explained by 35% of the variation in physical component from SF-12. The cardiorespiratory ﬁtness and upper limb strength predict 9% of mental health status.
Conclusion Some physical fitness components determine elderly health status, especially the physical dimension. Thus, for the elderly population the training of these components of the physical fitness is recommended in order to improve their health status.
Forssman Prevalence in a Portuguese Donor Population
Authors: Mourato C , Corpuz A , Sousa J , Martins D , Pereira C , Tomaz J , Barreira R , Rocha C , Mendes F 
Published: June 2020

Abstract
Introduction Discovered in 1911 by Frederick Forssman, the Forssman (Fs) antigen (Ag) expression varies among species, being rarely present on human red blood cells (RBC). In 1987 three unrelated English families were identified with a phenotype designed Apae which was later classified as the 31st blood group: FORS. Since antibodies (Ab) anti-Fs has natural occurrence and the expression of the Ag occurs on the surface of the RBC, body fluids and organs, raises a potential role for this antigen in transfusion and transplantation implications.
Objectives Our main goals were to evaluate the prevalence of anti-Fs Ab and clarify its impact in transfusional medicine by classifying the type of immunoglobulin (Ig) involved.
Methodology 3-5% sheep RBC suspension with positive expression for Fs Ag was used to evaluate the presence of Ab anti-Fs in plasma samples from a Portuguese population of blood donor and classify the immunoglobulin involved. Standard tube technique was used in all the experiments.
Results From a total of 11877 donors, 117 (0,99%) showed weak reactions (between 0 and 1 in a scale from 0 to 4). All these samples would be further studied to evaluate the presence of the Arg296Gln in the GBGT1 gene. Also, from the 192 samples studied to classify the Ab involved, 52% revealed to be only IgM, being the rest a mixture between IgG and IgM.
Conclusion The population studied revealed few samples with negative reaction against the sheep RBC confirm the low-prevalence of this blood group. The majority from the Ab to be IgM was also corroborated although the presence of an IgG portion can be clinically significant once it can cross the placental barrier.