The application of DNA metabarcoding to dietary analysis of trophic generalists requires using multiple markers in order to overcome problems of primer specificity and bias. However, limited attention has been given to the integration of information from multiple markers, particularly when they partly overlap in the taxa amplified, and vary in taxonomic resolution and biases. Here, we test the use of a mix of universal and specific markers, provide criteria to integrate multi‐marker metabarcoding data and a python script to implement such criteria and produce a single list of taxa ingested per sample. We then compare the results of dietary analysis based on morphological methods, single markers, and the proposed combination of multiple markers. The study was based on the analysis of 115 faeces from a small passerine, the Black Wheatears (Oenanthe leucura). Morphological analysis detected far fewer plant taxa (12) than either a universal 18S marker (57) or the plant trnL marker (124). This may partly reflect the detection of secondary ingestion by molecular methods. Morphological identification also detected far fewer taxa (23) than when using 18S (91) or the arthropod markers IN16STK (244) and ZBJ (231), though each method missed or underestimated some prey items. Integration of multi‐marker data provided far more detailed dietary information than any single marker and estimated higher frequencies of occurrence of all taxa. Overall, our results show the value of integrating data from multiple, taxonomically overlapping markers in an example dietary data set.

Background and study aims Previous studies have suggested a high prevalence of musculoskeletal injuries (MI) in endoscopists. Little evidence has come from European countries. Our main aim was to evaluate the prevalence, type, and impact of MI among Portuguese endoscopists. We also sought to identify risk factors for the development, severity and number of endoscopy-related MI. Material and methods A 48-question electronic survey was developed by a multidisciplinary group. The electronic survey was sent to all members of Portuguese Society of Gastroenterology (n = 705) during May 2019. Study data were collected and managed using REDCap electronic data capture tools hosted at SPG – CEREGA. Results The survey was completed by 171 endoscopists (response rate of 24.3 %), 55.0 % female with a median age of 36 years (range 26–78). The prevalence of at least one MI related to endoscopy was 69.6 % (n = 119), the most frequent being neck pain (30.4 %) and thumb pain (29.2 %). The median time for MI development was 6 years (range 2 months-30 years). Severe pain was reported by 19.3 %. Change in endoscopic technique was undertaken by 61.3 % and reduction in endoscopic caseload was undertaken by 22.7 %. Missing work was reported by 10.1 %, with the median time off from work being 30 days (range 1–90). Female gender and ≥ 15 years in practice were independently associated with MI and severe pain. Years in practice, weekly-time performing endoscopy, and gender were significant predictors of the number of MI. Conclusions Prevalence of MI was significant among Portuguese endoscopists and had a relevant impact on regular and professional activities.

Although sexual dietary differentiation is well known in birds, it is usually linked with significant morphological dimorphism between males and females, with lower differentiation reported in sexually monomorphic or only slightly dimorphic species. However, this may be an artifact of poor taxonomic resolution achieved in most conventional dietary studies, which may be unable to detect subtle intraspecific differentiation in prey consumption. Here, we show the power of multi‐marker metabarcoding to address these issues, focusing on a slightly dimorphic generalist passerine, the black wheatear Oenanthe leucura . Using markers from four genomic regions (18S, 16S, COI, and trn L), we analyzed fecal droppings collected from 93 adult black wheatears during the breeding season. We found that sexes were rather similar in bill and body features, though males had a slightly thicker bill and longer wings and tail than females. Diet was dominated in both sexes by a very wide range of arthropod species and a few fleshy fruits, but the overall diet diversity was higher for males than females, and there was a much higher frequency of occurrence of ants in female (58%) than male (29%) diets. We hypothesize that the observed sexual differentiation was likely related to females foraging closer to their offspring on abundant prey, while males consumed a wider variety of prey while foraging more widely. Overall, our results suggest that dietary sexual differentiation in birds may be more widespread than recognized at present and that multi‐marker DNA metabarcoding is a particularly powerful tool to unveiling such differences.

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Introduction. This study compared the balance by center of pressure (COP) and its relationship with gait parameters and functional independence in left (LH) and right (RH) chronic stroke patients. Methods. In this cross-sectional study, twenty-one hemiparetic stroke patients were assessed for Functional Independence Measure (FIM), balance with a force platform, and gait in the Motion Analysis Laboratory. Results. The amplitudes of the COP in the anteroposterior and mediolateral directions were similar in both groups. The anteroposterior direction was greater than the mediolateral direction. Only the temporal parameters showed any statistically significant differences. The LH showed a significant correlation between stride length, step length, and gait velocity with COP velocity sway for the healthy and paretic lower limbs. In both groups, the area of COP was significantly correlated with stride length. Motor FIM was significantly correlated with the COP in the LH group. Conclusion. There was no difference in the performance of balance, gait, and functional independence between groups. The correlation of the COP sway area with stride length in both groups can serve as a guideline in the rehabilitation of these patients where training the static balance may reflect the improvement of the stride length.

INTRODUCTION: The performance of endoscopy is characterized by frequent and repetitive activities. Endoscopists often report musculoskeletal injuries (MI). The widespread use of endoscopy and the execution of more technically challenging procedures may lead to higher rates of repetitive stress injuries. Despite previous American and Asian reports, little evidence has come from Europe. We aimed to determine the prevalence, risk factors and impact of MI among Portuguese endoscopists. METHODS: A 48-question electronic survey was developed by a multidisciplinary group. The electronic survey was sent to all members of Portuguese Society of Gastroenterology (SPG, n = 705) during May 2019. Study data were collected and managed using REDCap electronic data capture tools hosted at SPG–CEREGA. RESULTS: The survey was completed by 171 endoscopists (response rate of 24.3%), 55.0% female, with a median age of 36 years (31-50). The majority of the respondents were consultants (77.8%; trainees 22.2%), with 97.7% currently performing endoscopy. The median time of endoscopic practice was 9 years (5-22). Regarding practice setting, 52.0% worked in academic centers, 41.5% in community centers and 63.9% in private practice. The median weekly-working time was 50 hours (45-60), 50% (37.5-62.5%) performing endoscopy. The prevalence of reported MI was 69.6% (n = 119). The median time for MI development was 6 years (3-16). The most common sites of injury were neck (42.9%) and thumb (42.0%). In 45.4%, the pain was evident both in work and daily activities and 22.7% referred pain even at rest. In the respondents with MI, 34.5% changed practice and/or reduced working activity and 33.6% reduced work-unrelated physical activity. Missing work was reported by 10.1% [median 30 days (4-45)]. The most common treatments were NSAIDs (57.1%) and physiotherapy (30.3%) but surgery was required in 1.7%. In the multivariate logistic regression, endoscopic practice >15 years (OR 3.514, P = 0.004), female gender (OR 2.443, P = 0.018) and higher percentage of time performing upper endoscopy (OR 0.974, P = 0.026) were independently associated with MI. CONCLUSION: Musculoskeletal injuries were reported by over two thirds of the portuguese endoscopists that completed our survey. These injuries had a significant impact on regular and professional activities. Female endoscopists and those with a minimum of 15 years of practice are at higher risk. The identification of these risk factors may result in practice changes to reduce the burden of the injuries.

ObjectiveThe present study was aimed at evaluating the contribution of transrectal prostate ultrasound in the screening for prostate neoplasias and in the guidance of prostate biopsies.Materials and MethodsProspective study developed over a one-year period. All the patients with indication for prostate biopsy were evaluated. Regardless of PSA values, the patients underwent ultrasound in order to identify suspicious nodules (confirmed by two observers). Sextant biopsy was subsequently performed. In cases of finding suspicious nodules, an additional puncture directed to such nodules was done.ResultsIn a total of 155 cases the prevalence of malignancy was of 53%. Suspicious nodules were detected in 34 patients, and 25 where malignant (positive predictive value of 74%). The specificity and sensitivity for suspicious nodules were 88% and 31% respectively. Comparatively with the randomly obtained sextant specimens, the rate of findings of neoplasia was higher in the specimens obtained with puncture directed to the nodule (p = 0.032). No statistically significant difference was observed in the Gleason score for both types of specimens (p = 0.172).ConclusionThe high positive predictive value and the high rate of findings of neoplasia in specimens of suspicious nodules should be taken into consideration in the future. The authors suggest a biopsy technique similar to the one described in the present study (sextant biopsy plus puncture directed to the suspicious nodule).

Head and neck cancers, and cardiovascular disease have been described as late effects of low dose radiation (LDR) exposure, namely in tinea capitis cohorts. In addition to radiation dose, gender and younger age at exposure, the genetic background might be involved in the susceptibility to LDR late effects. The -174 G>C (rs1800795) SNP in IL6 has been associated with cancer and cardiovascular disease, nevertheless this association is still controversial. We assessed the association of the IL6-174 G>C SNP with LDR effects such as thyroid carcinoma, basal cell carcinoma and carotid atherosclerosis in the Portuguese tinea capitis cohort. The IL6-174 G>C SNP was genotyped in 1269 individuals formerly irradiated for tinea capitis. This sampling group included thyroid cancer (n = 36), basal cell carcinoma (n = 113) and cases without thyroid or basal cell carcinoma (1120). A subgroup was assessed for atherosclerosis by ultrasonography (n = 379) and included matched controls (n = 222). Genotypes were discriminated by real-time PCR using a TaqMan SNP genotyping assay. In the irradiated group, we observed that the CC genotype was significantly associated with carotid plaque risk, both in the genotypic (OR = 3.57, CI = 1.60–7.95, p-value = 0.002) and in the recessive (OR = 3.02, CI = 1.42–6.42, p-value = 0.004) models. Irradiation alone was not a risk factor for carotid atherosclerosis. We did not find a significant association of the IL6-174 C allele with thyroid carcinoma or basal cell carcinoma risk. The IL6-174 CC genotype confers a three-fold risk for carotid atherosclerotic disease suggesting it may represent a genetic susceptibility factor in the LDR context.