Background: Around 15% of patients die or become dependent after cerebral vein and dural sinus thrombosis (CVT). Method: We used the International Study on Cerebral Vein and Dural Sinus Thrombosis (ISCVT) sample (624 patients, with a median follow-up time of 478 days) to develop a Cox proportional hazards regression model to predict outcome, dichotomised by a modified Rankin Scale score >2. From the model hazard ratios, a risk score was derived and a cut-off point selected. The model and the score were tested in 2 validation samples: (1) the prospective Cerebral Venous Thrombosis Portuguese Collaborative Study Group (VENOPORT) sample with 91 patients; (2) a sample of 169 consecutive CVT patients admitted to 5 ISCVT centres after the end of the ISCVT recruitment period. Sensitivity, specificity, c statistics and overall efficiency to predict outcome at 6 months were calculated. Results: The model (hazard ratios: malignancy 4.53; coma 4.19; thrombosis of the deep venous system 3.03; mental status disturbance 2.18; male gender 1.60; intracranial haemorrhage 1.42) had overall efficiencies of 85.1, 84.4 and 90.0%, in the derivation sample and validation samples 1 and 2, respectively. Using the risk score (range from 0 to 9) with a cut-off of ≥3 points, overall efficiency was 85.4, 84.4 and 90.1% in the derivation sample and validation samples 1 and 2, respectively. Sensitivity and specificity in the combined samples were 96.1 and 13.6%, respectively. Conclusions: The CVT risk score has a good estimated overall rate of correct classifications in both validation samples, but its specificity is low. It can be used to avoid unnecessary or dangerous interventions in low-risk patients, and may help to identify high-risk CVT patients.

Background: It is essential to study the effect of potential co-factors on the risk of death in patients infected by COVID-19. The identification of risk factors is important to allow more efficient public health and health services strategic interventions with a significant impact on deaths by COVID-19. This study aimed to identify factors associated with COVID-19 deaths in Portugal. Methods: A national dataset with the first 20,293 patients infected with COVID-19 between 1 January and 21 April 2020 was analyzed. The primary outcome measure was mortality by COVID-19, measured (registered and confirmed) by Medical Doctors serving as health delegates on the daily death registry. A logistic regression model using a generalized linear model was used for estimating Odds Ratio (OR) with 95% confidence intervals (95% CI) for each potential risk indicator. Results: A total of 502 infected patients died of COVID-19. The risk factors for increased odds of death by COVID-19 were: sex (male: OR = 1.47, ref = female), age ((56–60) years, OR = 6.01; (61–65) years, OR = 10.5; (66–70) years, OR = 20.4; (71–75) years, OR = 34; (76–80) years, OR = 50.9; (81–85) years, OR = 70.7; (86–90) years, OR = 83.2; (91–95) years, OR = 91.8; (96–104) years, OR = 140.2, ref = (0–55)), Cardiac disease (OR = 2.86), Kidney disorder (OR = 2.95), and Neuromuscular disorder (OR = 1.58), while condition (None (absence of precondition); OR = 0.49) was associated with a reduced chance of dying after adjusting for other variables of interest. Conclusions: Besides age and sex, preconditions justify the risk difference in mortality by COVID-19.

Monthly sampling for ichthyoplankton was conducted at three stations very near to the coast (near to shore shallow stations before the surf zone in direction to the shoreline) of Atlantic northwestern Portugal within contrasting localities: rocky shore, in front of a sandy beach receiving an estuary and a fishing port with heavy anthropogenic impact. Sampling was conducted from August 2002 to October 2003, always at full moon, at low tide and high tide in daylight hours, at the water column using a 48 cm diameter plankton net with 335 mm mesh. Analysis of the physico-chemical parameters pointed out the spatial (horizontal) homogeneity of the sampling area. Fish larvae from 41 taxa belonging to 17 families were identified; Blenniidae, Labridae, Ammodytidae, Clupeidae, Gobiidae, Soleidae and Gobiesocidae were the most representative during the study period. Parablennius gattorugine, Ammodytes tobianus, Symphodus melops, Sardina pilchardus, Lipophrys pholis and Coryphoblennius galerita were the most representative species (percentage contribution to total abundance). Peak abundance of fish eggs occurred during May, June and August 2003 and fish larvae occurred during May and July 2003 and August 2002; there was a pronounced winter/early spring (March 2003) peak in larval abundance dominated by the small sandeel A. tobianus. This study identifies the occurrence of a conspicuous assemblage of larval fishes at very nearshore shallow environments of a variety of species with different adult habitats: the fish larvae assemblage was dominated by intertidal species. The present study has shown that temporal and spatial variations in the larval fish assemblage are related to environmental conditions and biological dynamics: the results suggest that abiotic conditions mediate biotic parameters, and that both abiotic and biotic characteristics regulated the larval fishes at very nearshore shallow environments.

Purpose Higher education system has a critical role to play in educating environmentally aware and participant citizens about global climate change (CC). And, as shown by the 21st Conference of the Parties of the UN Convention on Climate Change – COP 21, held in Paris in December 2015, there is still a path to be followed regarding the role played by universities in the negotiations and in influencing decision-making on a matter of such global importance. The purpose of this first study conducted within Portuguese (Europe), Mexican (Spanish-speaking North America University) and Mozambican (Africa) universities is to investigate higher education system students’ perceptions on CC. Design/methodology/approach The data were collected through a questionnaire aiming at characterising students from the socio-demography, and from their perceptions, motivations, attitudes and knowledge relating to the topic of CC. Statistical analysis was used to compare and characterise the three national groups under study. Findings This study did not show significant perception differences among the analysed subsamples, although there was a tendency for Mexican students to express lesser belief that CC was happening, and for Mozambicans to show a greater belief in CC issues and motivation to mitigate its effects which may be related to the specifics contexts. The results show that relevant differences among nationalities mostly concerned the magnitude of choices (e.g. most respondents of each nationality expressed interest in CC issues, but the magnitude of this expression differed according to nationality). The principal component analysis (second and third components) clearly embodied nationality profiles (discussed in the context of different cultures, educational structures and CC impacts). Research limitations/implications Further research is warranted to understand the integration of CC into higher education curriculum to improve and target educational efforts to suit students’ needs. Practical implications How CC perceptions vary cross-nationally and how research studies that examine the integration of CC into higher education curriculum are areas for which more research is needed. Originality/value The results highlight the importance of socio-cultural dimensions of each country in relation to the understanding or perception of CC issues, namely, in what concerns aspects related with gender roles, age, active learning and citizenship. This study’s data evidenced that despite the surveyed students being familiarized with CC phenomena, this knowledge does not translate necessarily into concrete mitigation practices and behaviours.

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The aim of this study was to analyse alexithymia and deficits in emotional awareness, in heroin addicts, and their relationship with perceptions of early parental interactions. The sample included 99 opiate dependent outpatients and 43 healthy controls. Assessment was performed using the Toronto Alexithymia Scale, the Levels of Emotional Awareness Scale, the Inventory for Assessing Memories of Parental Rearing Behavior, the Mini-Mental State Examination and the Hospital Anxiety and Depression Scale. Findings suggest parental representations, which were mostly characterized by emotional unavailability and a rejection interaction pattern, significantly related to alexithymia. Emotional awareness was associated with the number of years of drug use and methadone level. Negative affect was associated with alexithymia but not to emotional awareness. Regression analyses emphasized the influence of perceived dysfunctional parenting behaviors in alexithymia and difficulties in identifying feelings, particularly an interaction with paternal rejection, moderated by self-reported anxiety. These results are discussed addressing comprehensive issues of emotion regulation and treatment strategies in heroin dependence.Keywords Alexithymia . Emotional awareness . Parental rearing behaviors . Heroin dependence . Negative affect Alexithymia has been studied over the past decades in healthy subjects and in a large number of psychiatric disorders, and it seems to be well established as a personality trait that influences Int J Ment Health Addiction

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IntroductionSleep related breathing disorders (SRBD) cause sleep fragmentation, intermittent hypoxia or a combination of both leading to homeostasis perturbations, including in the immune system. We investigated whether SRBD patients with or without intermittent hypoxia show substantial differences in perforin and granzyme-B positive peripheral blood lymphocytes.MethodsA total of 87 subjects were included and distributed as follows: 24 controls (C), 19 patients with respiratory effort related arousals due to increased upper airway resistance (UAR) without hypoxic events, 24 obese patients with obstructive sleep apnea (OSA) (oOSA), and 20 without obesity (noOSA). After polysomnographic recording, we analyzed in fasting blood samples routine hematologic and biochemical parameters and the percentage of lymphocytes containing the proteins perforin and granzyme-B (GrB). Kruskal-Wallis tests and a posteriori multiple comparisons were applied for statistical analysis of results.ResultsPerforin-positive γδ-cells revealed significant differences between groups (p = 0.017), especially between the Control group and the oOSA (p-value = 0.04); the remaining SRBD groups also showed differences from the control (C vs UAR: p = 0.08; C vs noOSA = 0.09), but they did not raise to statistical significance. There were no differences among the SRBD groups. Granzyme-B cells were decreased in SRBD patients, but the differences were not statistically significant. No additional statistical significant result was found in the other investigated lymphocyte subsets.ConclusionsObstructive sleep-disordered breathing is associated with a decrease in perforin-positive CD3+γδ-T cells. Although this finding was detected in lean patients without intermittent hypoxia, the reduction was only statistically significant in obese patients with severe OSA. Because CD3+γδ-T cells play an important role in the control of tumor cells, our findings are directly relevant for the study of the association of OSA and cancer.Electronic supplementary materialThe online version of this article (10.1007/s11325-017-1602-6) contains supplementary material, which is available to authorized users.