Explore the vast range of titles available.

The brown bear ( Ursus arctos ) populations are expanding in the Iberian Peninsula, particularly in the Cantabrian Mountains. This ongoing expansion and the species’ return to Portugal could be jeopardized by a lack of sustainable coexistence strategies. To shed light on how experiences with bears have shaped human perceptions and attitudes toward this species, we distributed online questionnaires ( n  = 441) across Portugal and Spain. In addition, we evaluated differences in attitudes and perceptions among regions with varying levels of exposure to bears: those with (BAS) or without (NBAS) bear presence in Spain and those with (BAP) or without (NBAP) the potential to sustain bears in Portugal. Despite observing overall positive attitudes toward bears, Spanish respondents showed stronger attachment and receptiveness toward the species. Respondents from BAS, having more interactions with wild bears, were also more favourable toward sharing territory with them. Conversely, Portuguese respondents showed more neutral attitudes toward bear presence, as well as higher perception of risk and lower perception of benefit than previously reported. Our findings highlight the importance of understanding the social landscape in bears’ expansion range. As human-bear interactions increase, this knowledge is key to adopt proactive and targeted socio-ecological measures to address local community’s concerns.

Partilha de território com animais selvagens tem sido um problema cada vez mais alarmante ao longo dos anos e que resultou no declínio acentuado de muitas espécies, especialmente grandes predadores e carnívoros. Este é o caso do jaguar (Panthera onca) em praticamente toda a sua área de distribuição na América, nomeadamente na floresta Amazónica. Várias áreas protegidas foram surgindo ao longo do tempo com foco na conservação da Natureza, florestas e vida selvagem, assim como vários esforços legislativos contra o tráfico de animais e suas partes. No entanto, ainda há falta de informação acerca de como as comunidades nativas respondem e interagem com a presença de jaguar. O objetivo deste estudo foi investigar a maneira como jovens entre 11 e 20 anos de idade percecionam o jaguar nas áreas protegidas da Reserva Nacional de Vida selvagem Amazónica de Manuripi, IPA de Santa Rosa del Abuná e Pampas del Yacuma, assim como no território indígena Tacana II, e compará-las com estudos anteriores em adultos. Os meus resultados mostraram que as perceções e sentimentos dos jovens (n = 477) estão em conformidade com estudos prévios, sendo maioritariamente negativas. Também identifiquei o território indigena Tacana II como sendo a menos tolerante ao jaguar, comparando os resultados com jovens com os de estudos prévios. Comparando resultados entre áreas, Pampas del Yacuma reportou perceções e sentimentos mais positivos em relação às outras, talvez devido à forte presença de ecoturismo na economia local. Rapazes, comparativamente com raparigas, reportaram sentimentos significativamente mais positivos em relação ao jaguar. As pessoas que tiveram um contacto direto com um jaguar no passado tendem a ter sentimentos mais positivos em relação à espécie e as opiniões relativamente à sua importância ecológica foram significativamente mais favoráveis à conservação com o aumento de sentimentos positivos. Baseado nos meus resultados, sugeri o desenvolvimento de projetos piloto para a implementação de ecoturismo e educação ecológica nas áreas protegidas em que o conflito com estes grandes felinos ainda é muito acentuado, incentivando as comunidades nativas a serem agentes ativos na mitigação deste problema.

BRCA1 and BRCA2 are key tumor suppressor genes involved in DNA repair, and their mutations significantly increase the risk of breast, ovarian, prostate, and pancreatic cancers. Despite international guidelines recommending genetic testing in patients meeting specific criteria, BRCA testing remains underutilized in Portugal, limiting early diagnosis and personalized treatment opportunities. This multicenter quality-improvement study aimed to characterize baseline BRCA testing practices and assess the impact of implementing a standardized testing protocol across three oncology centers: Unidade Local de Saúde (ULS) Lisboa Ocidental, ULS Amadora Sintra, and ULS Loures Odivelas. The intervention included baseline data collection, development of a protocol based on international best practices, dissemination to clinical teams, and post-implementation evaluation. At baseline, the three institutions requested an average of 14.16 BRCA tests per month. Following protocol implementation, the average rose to 29.66 monthly tests, representing a 109.4% increase. All centers showed improved testing rates, with the most significant relative rise at ULS Amadora Sintra (388.8%). Although differences between centers likely reflect institutional variation in awareness and resources, these findings support the effectiveness of a protocol-driven approach to improving adherence to genetic testing guidelines. This study presents the first multicenter real-world data on BRCA testing practices in Portugal and underscores the value of local engagement and standardization in advancing precision oncology.

The public transportation sector generates large volumes of sensor data that, if analyzed adequately, can help anticipate failures and initiate maintenance actions, thereby enhancing quality and productivity. This work contributes to a real-time data-driven predictive maintenance solution for Intelligent Transportation Systems. The proposed method implements a processing pipeline comprised of sample pre-processing, incremental classification with Machine Learning models, and outcome explanation. This novel online processing pipeline has two main highlights: (i) a dedicated sample pre-processing module, which builds statistical and frequency-related features on the fly, and (ii) an explainability module. This work is the first to perform online fault prediction with natural language and visual explainability. The experiments were performed with the Metro pt data set from the metro operator of Porto, Portugal. The results are above 98 % for f -measure and 99 % for accuracy. In the context of railway predictive maintenance, achieving these high values is crucial due to the practical and operational implications of accurate failure prediction. In the specific case of a high f -measure, this ensures that the system maintains an optimal balance between detecting the highest possible number of real faults and minimizing false alarms, which is crucial for maximizing service availability. Furthermore, the accuracy obtained enables reliability, directly impacting cost reduction and increased safety. The analysis demonstrates that the pipeline maintains high performance even in the presence of class imbalance and noise, and its explanations effectively reflect the decision-making process. These findings validate the methodological soundness of the approach and confirm its practical applicability for supporting proactive maintenance decisions in real-world railway operations. Therefore, by identifying the early signs of failure, this pipeline enables decision-makers to understand the underlying problems and act accordingly swiftly.

Research Type: Level 4 – Case series Introduction/Purpose: Background and Purpose: Focal cartilage lesions often cause significant functional impairment. Biological treatments have yielded suboptimal results in middle-aged patients, and previous studies on focal prosthetic inlay resurfacing have reported a higher risk of conversion to ankle fusion. A novel, customized implant (Episealer, Episurf, Stockholm, Sweden) has been developed to improve implant positioning and longevity. The primary objective was to assess subjective, objective function and implant survival at a one year after surgery. Methods: Materials and Methods: This is a multicenter study that analyzed consecutive patients undergoing Episealer implantation for symptomatic focal talar chondral defects, including lesions that have failed conservative or prior surgical management. Patient-reported outcome measures at one-year follow-up were compared with baseline data using the Foot and Ankle Outcome Score (FAOS) and the Numeric Rating Scale (NRS) for pain. Complication and revision rates were also assessed. Results: Results: Fifteen patients with one-year follow-up were included. Both NRS pain scores and FAOS demonstrated significant improvement (p ≤ 0.001). No revisions to ankle replacement were required. Conclusion: This customized focal ankle-resurfacing implant demonstrated favorable subjective outcomes, and low complication and revision rates at one-year follow-up.

Research Type Level 4 – Case series Introduction/Purpose Introduction: Nonprimary osteochondral lesions of the talus (OLT) pose a significant challenge in orthopaedics, with no definitive consensus on optimal surgical treatment. Purpose: To consolidate the most recent evidence on operative treatments for nonprimary OLT by assessing patient-reported outcomes (PROs), postoperative complications, and clinical failures. Methods Methods: This review adhered to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020 and PRISMA in Exercise, Rehabilitation, Sport medicine and Sports science guidelines. Searches were conducted in PubMed, Embase, and Cochrane Library databases through June 2023. Eligible studies evaluated operative outcomes in skeletally mature patients with nonprimary OLT after failed previous surgeries. Primary outcomes included clinical and functional PROs. Secondary outcomes included postoperative complications and clinical failures. Quantitative analyses involved weighted means, mean differences, minimal clinically important differences, success rates (95% binomial proportion confidence interval), and a pre-to-postoperative meta-analysis. Results Results: Out of 3992 identified records, 50 studies involving 806 ankles from 794 patients were included. All operative treatments significantly improved PROs (P < .05), except osteochondral allograft transplantation (OCA) for American Orthopaedic Foot and Ankle Society and pain (visual analog scale/numeric rating scale [VAS/NRS]) scores and HemiCAP for pain (VAS/NRS) scores. Autologous chondrocyte implantation (ACI) and osteochondral autologous transplantation (OAT) demonstrated the greatest PRO success rates, exceeding 80%. Postoperative complications occurred in 4% of cases, most frequently with HemiCAP. Clinical failures affected 22% of cases, particularly with autologous matrix-induced chondrogenesis, OAT, OCA, and HemiCAP. Conclusion Conclusion: Our systematic review demonstrated that ACI and OAT are promising treatments for nonprimary OLT, with ACI showing fewer clinical failures than OAT. Conversely, OCA and HemiCAP exhibited lower effectiveness and higher clinical failure rates, suggesting a need for reassessment.

Cisplatin (CP) is a chemotherapy drug widely prescribed to treat various neoplasms. Although fundamental for the therapeutic action of the drug, its cytotoxic mechanisms trigger adverse effects in several tissues, such as the kidney, liver, and heart, which limit its clinical use. In this sense, studies point to an essential role of damage to nuclear and mitochondrial DNA associated with oxidative stress, inflammation, and apoptosis in the pathophysiology of tissue injuries. Due to the limitation of effective preventive and therapeutic measures against CP-induced toxicity, new strategies with potential cytoprotective effects have been studied. Therefore, this article is timely in reviewing the characteristics and main molecular mechanisms common to renal, hepatic, and cardiac toxicity previously described, in addition to addressing the main validated strategies for the current management of these adverse events in clinical practice. We also handle the main promising antioxidant substances recently presented in the literature to encourage the development of new research that consolidates their potential preventive and therapeutic effects against CP-induced cytotoxicity.

Background: Nonprimary osteochondral lesions of the talus (OLT) pose a significant challenge in orthopaedics, with no definitive consensus on optimal surgical treatment. Purpose: To consolidate the most recent evidence on operative treatments for nonprimary OLT by assessing patient-reported outcomes (PROs), postoperative complications, and clinical failures. Study Design: Systematic review; Level of evidence, 4. Methods: This review adhered to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020 and PRISMA in Exercise, Rehabilitation, Sport medicine and Sports science guidelines. Searches were conducted in PubMed, Embase, and Cochrane Library databases through June 2023. Eligible studies evaluated operative outcomes in skeletally mature patients with nonprimary OLT after failed previous surgeries. Primary outcomes included clinical and functional PROs. Secondary outcomes included postoperative complications and clinical failures. Quantitative analyses involved weighted means, mean differences, minimal clinically important differences, success rates (95% binomial proportion confidence interval), and a pre-to-postoperative meta-analysis. Results: Out of 3992 identified records, 50 studies involving 806 ankles from 794 patients were included. All operative treatments significantly improved PROs (P < .05), except osteochondral allograft transplantation (OCA) for American Orthopaedic Foot and Ankle Society and pain (visual analog scale/numeric rating scale [VAS/NRS]) scores and HemiCAP for pain (VAS/NRS) scores. Autologous chondrocyte implantation (ACI) and osteochondral autologous transplantation (OAT) demonstrated the greatest PRO success rates, exceeding 80%. Postoperative complications occurred in 4% of cases, most frequently with HemiCAP. Clinical failures affected 22% of cases, particularly with autologous matrix-induced chondrogenesis, OAT, OCA, and HemiCAP. Conclusion: Our systematic review demonstrated that ACI and OAT are promising treatments for nonprimary OLT, with ACI showing fewer clinical failures than OAT. Conversely, OCA and HemiCAP exhibited lower effectiveness and higher clinical failure rates, suggesting a need for reassessment.

Stress fractures of the medial malleolus are uncommon and considered high-risk due to potential complications such as progression to complete fracture, delayed union, nonunion, and chronic pain. Identified risk factors include varus alignment of the lower limb, chronic anteromedial impingement, excessive pronation/supination, broad talar neck, and ankle instability. To our knowledge, no reports of recurrence after surgical treatment have been reported. An 18-year-old male professional football player presented with medial right ankle pain. He was diagnosed with a medial malleolar stress fracture and underwent surgical treatment with cannulated screw fixation. After a full recovery, he experienced a recurrence of the fracture after discontinuing the use of custom-made foot insoles. A second surgery using a malleolar plate and bone graft was performed, and the patient resumed his sports career successfully with continued use of the foot soles. Surgical treatment is the best treatment for medial malleolar stress fractures in high-demanding athletes, without any known case of recurrence. Lower limb malalignment, particularly the cavovarus foot, may also play a role in recurrence, as observed in this case. Varus limb malalignment has been associated with this fracture type and could be a contributing factor to recurrence. Recurrent medial malleolar stress fractures are rare, and this case presents a unique scenario of treatment failure due to biomechanical alterations. The surgical treatment yielded successful outcomes when combined with custom-made foot soles for lower limb alignment support. However, further research and reports on recurrence are needed to fully comprehend the risk factors for these challenging fractures in high-demanding athletes.

Primary synovial osteochondromatosis (PSO), a seldom-seen synovial proliferative disease involving chondral metaplasia, presents a unique challenge when affecting the ankle joint. Controversy exists regarding whether a combined posterior-anterior approach with total synovectomy is necessary to avert recurrence or malignancy. An 18-year-old Caucasian male presented to the outpatient clinic with clinical and imaging findings indicative of a stage III PSO. The surgical intervention involved a combined posterior-anterior arthroscopic approach with the removal of multiple loose bodies and complete synovectomy, resulting in complete relief of symptoms without recurrence at the 12-month follow-up. Pathological examination confirmed the diagnosis. The management of PSO in the ankle joint using a combined posterior-anterior arthroscopic approach with complete synovectomy demonstrated effectiveness in this case. Regular follow-ups are essential for monitoring long-term outcomes and detecting potential recurrence or malignant transformation.