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Osteomas are benign osteogenic tumors, and there are still no guidelines for their treatment in pediatric age. The guidelines taken into consideration are usually those of adults; however, a growing skull requires another type of care. Decisions must be made on a case‐by‐case basis.

O fumo de tabaco ambiental (FTA), resultante do consumo tabágico, tem sido alvo de um interesse crescente dentro da comunidade científica pelo potencial lesivo que lhe é atribuído. Com o objetivo de definir as patologias associadas à exposição ao FTA e os seus principais grupos de risco, efetuou-se uma pesquisa no site PubMed utilizando os termos “Environmental tobacco smoke” e “Second hand smoke”da qual resultou a seleção de 75 artigos relevantes sobre o tema.As crianças são os elementos mais vulneráveis à agressão pelos constituintes do FTA, fruto não só da sua imaturidade e características fisiológicas como pela dependência para com os progenitores, que representam o seu principal foco de exposição. O FTA demonstrou estar associado ao aumento da incidência de asma infantil, dificultando, também, o seu controlo. O aumento na incidência de infeções respiratórias, Síndrome da Morte Súbita do Lactente, redução do peso à nascença e malformações congénitas são-lhe, igualmente, atribuíveis.A exposição habitacional e laboral dos adultos ao FTA é responsável por um aumento da incidência de Carcinoma do Pulmão entre os não-fumadores, bem como pelo desenvolvimento de patologia asmática que, nestes indivíduos, apresenta uma evolução mais imprevisível e uma clínica habitualmente mais gravosa. Igualmente preocupantes são os resultados que apontam para uma forte associação entre o FTA e a Doença Cardíaca Isquémica, com estudos a demonstrarem, também, o papel ativo do FTA no aparecimento de Doença Pulmonar Obstrutiva Crónica e no Carcinoma do Colo do Útero.Permanecem, no entanto, as dúvidas quanto aos verdadeiros limites da agressão fetal pelo FTA, o seu papel nas alterações da função respiratória das crianças e a controversa associação com o aparecimento de Carcinoma da Mama em mulheres não-fumadoras.

Patient and Public Involvement, Engagement and Participation (PPIEP) is essential in asthma research due to the disease’s complexity. However, information regarding the characteristics of patients with asthma interested in engaging in PPIEP initiatives is scarce. We aimed to identify factors associated with the interest in PPIEP among patients with asthma. This is a secondary analysis of the EPI-ASTHMA nationwide asthma prevalence study, which included adult patients with asthma recruited from 38 primary healthcare centres from mainland Portugal. Demographic and clinical characteristics as well as interest in PPIEP were collected. A multivariable logistic regression model was built to explore associations between participants’ characteristics and PPIEP interest. A total of 502 participants with asthma (52 ± 15.9 years, 64.1% females) were analysed and 218 (43.4%) were interested in being involved in PPIEP. Having higher education (adjusted OR 2.29, 95%CI 1.47–3.57) and owning a smartphone (adjusted OR 4.63, 95%CI 2.51–8.55) were significantly associated with higher odds of being interested in PPIEP. Being female demonstrated a borderline significant association (adjusted OR 1.53, 95%CI 1.00–2.33). Participants experiencing higher quality of life were significantly associated with lower odds of being interested in PPIEP (adjusted OR 0.77, 95%CI 0.65–0.92). Two out of five patients with asthma were interested in participating in PPIEP initiatives. By understanding the characteristics of patients willing to participate in PPIEP, we can develop strategies to reach a wider audience and make PPIEP more inclusive. The identified associated factors need to be further investigated.

The continuous research and development regarding firefighters’ personal protective equipment (PPE) has led to significant improvements in recent decades. Despite the evolution of firefighters’ PPE, every year an undesirable number of firefighters are seriously burned during firefighting operations, with some of them eventually losing their lives. The protection given by firefighters’ PPE can be further increased with the incorporation of smart textiles in the personal protective equipment, namely, wearable electronics (i.e., integrated sensors to monitor diverse parameters: heart rate, oxygen saturation, carbon dioxide detector, and setting real-time communication with a command post) and advanced materials such as phase change materials (PCMs). The evolution of firefighters’ PPE has been followed by an evolution and update in the international and national standards that specify performance requirements for firefighters’ protective clothing for structural and wildland firefighting as well as technical rescue. This study will focus on the analysis of firefighters protective clothing evolution regarding the use and integration of advanced smart materials, namely, phase change materials, taking into consideration the evolution and requirements of international and European standards as well as national legislation for firefighters’ protective clothing.

Supplementing diets with rumen-protected lysine is a common strategy to meet the nutritional needs of high-producing dairy cows. This work addressed two separate but crucial issues: the lysine protection degree across the entire digestive tract as well as the production scalability of the proposed delivery systems. This was achieved by evaluating, in vitro or ex vivo, previously developed rumen-resistant lipid nanoparticles regarding their stability in the digestive tract and in the bloodstream of the dairy cow as well as how their production could be scaled-up. Results showed that the developed nanoparticles were able to resist digestion along the digestive tract but were degraded in the blood over 24 h. Thus, releasing their content to be used by the animal. In vitro viability assays were also performed, with the nanoparticles being found not to be inherently toxic when using nanoparticle concentrations up to 1 mg/mL. Results showed that neither the purity of the used lipids nor the production method significantly altered the nanoparticles’ properties or their ruminal resistance. Furthermore, the shelf-life of these nanoparticles was assessed, and they were found to retain their properties and remain usable after at least 1 month of storage. Moreover, a pilot-scale production allowed the production of nanoparticles with similar properties to the previous ones made using standard methods. To summarize, the proposed rumen-resistant nanoparticles presented potential as orally ingested lysine delivery systems for dairy cattle supplementation, being capable of a large-scale production using cheaper components while maintaining their properties and without any efficiency loss. It should however be noted that these results were obtained mainly in vitro and further in vivo bioavailability and production experiments are needed before this technology can be confirmed as a viable way of delivering lysine to dairy cows.

The incidence of metabolic disorders, as well as of neurodegenerative diseases—mainly the sporadic forms of Alzheimer’s and Parkinson’s disease—are increasing worldwide. Notably, obesity, diabetes, and hypercholesterolemia have been indicated as early risk factors for sporadic forms of Alzheimer’s and Parkinson’s disease. These conditions share a range of molecular and cellular features, including protein aggregation, oxidative stress, neuroinflammation, and blood-brain barrier dysfunction, all of which contribute to neuronal death and cognitive impairment. Rodent models of obesity, diabetes, and hypercholesterolemia exhibit all the hallmarks of these degenerative diseases, and represent an interesting approach to the study of the phenotypic features and pathogenic mechanisms of neurodegenerative disorders. We review the main pathological aspects of Alzheimer’s and Parkinson’s disease as summarized in rodent models of obesity, diabetes, and hypercholesterolemia.

Background Microdiscectomy is the most commonly performed spine surgery and the first transitioning for outpatient settings. However, this transition was never studied, in what comes to cost-utility assessment. Accordingly, this economic study aims to access the cost-effectiveness of outpatient lumbar microdiscectomy when compared with the inpatient procedure. Methods This is a cost utility study, adopting the hospital perspective. Direct medical costs were retrieved from the assessment of 20 patients undergoing outpatient lumbar microdiscectomy and 20 undergoing inpatient lumbar microdiscectomy Quality-adjusted life-years were calculated from Oswestry Disability Index values (ODI). ODI was prospectively assessed in outpatients in pre and 3- and 6-month post-operative evaluations. Inpatient ODI data were estimated from a meta-analysis. A probabilistic sensitivity analysis was performed and incremental cost-effectiveness ratio (ICER) calculated. Results Outpatient procedure was cost-saving in all models tested. At 3-month assessment ICER ranged from €135,753 to €345,755/QALY, higher than the predefined threshold of €60,000/QALY gained. At 6-month costs were lower and utilities were higher in outpatient, overpowering the inpatient procedure. Probabilistic sensitivity analysis showed that in 65% to 73% of simulations outpatient was the better option. The savings with outpatient were about 55% of inpatient values, with similar utility scores. No 30-day readmissions were recorded in either group. Conclusion This is the first economic study on cost-effectiveness of outpatient lumbar microdiscectomy, showing a significant reduction in costs, with a similar clinical outcome, proving it cost-effective.

Introduction Patient and public involvement (PPI) initiatives involving patients with chronic respiratory disease (CRD) are rare. Therefore, this study aimed to explore the perspectives of patients with CRD, carers and interested citizens regarding the relevance and need for a PPI network and suggestions for its implementation. Methods A qualitative study based on focus groups was conducted. Recruitment occurred through invitations on social media platforms and to patients who have participated in previous asthma studies of the team. Three focus groups were conducted, via video conference, using a semi‐structured guide. Thematic analysis was performed by two independent researchers and discussed with the extended team. Results Fifteen patients with CRD, one carer and one interested citizen (13 females, median 36 (range: 18–72) years) participated. All participants acknowledged the importance of implementing a collaborative network and demonstrated interest in being integrated. Participants acknowledged the importance of their involvement in several phases of the research cycle. The main aim identified for this network was to facilitate communication between patients and researchers. Participants regarded the integration of patients, carers, researchers and healthcare professionals from different scientific areas as relevant. The use of digital platforms to attract members and support the work, together with group dynamics and regular meetings, were some of the most relevant practical considerations for implementing the network. The identified facilitators for their engagement were sharing experiences, researchers' and healthcare professionals' support and feedback and schedule flexibility. The identified barriers included the amount of time dedicated, low health/digital literacy and the potential detachment of nondiagnosed patients or those with low symptom impact in daily life. Conclusion Patients, carers and citizens acknowledged the relevance of implementing a collaborative network and demonstrated interest in active participation in every stage of the health research cycle. A deeper knowledge of the barriers and facilitators identified in this study could support implementing these initiatives in Portugal. Patient or Public Contribution This study was designed by a research team that included one patient with asthma and one carer. They were specifically involved in building the study protocol and the interview guide. They also gave feedback regarding the electronic consent form and the short sociodemographic questionnaire created, namely by removing noncontributing words or phrases and rewording expressions. The lay summary was written by another patient with asthma. All participants of this study were invited to implement and integrate the ConectAR network—a collaborative network of research in respiratory health. Public Summary In Portugal, chronic respiratory patients do not have an active role as ‘coinvestigators’. This study aimed to acknowledge if patients and citizens considered a patient and public involvement network useful, whose main purpose would be to facilitate communication between patients and researchers. A study based on online group interviews was carried out with patients with chronic respiratory diseases and interested citizens, both recruited on social media platforms. Participants considered that bringing together patients, carers, researchers and healthcare professionals is valuable because sharing different experiences and perspectives may help patients to improve their daily lives and increase research quality. In conclusion, patients agree that implementing a collaborative network with researchers and healthcare professionals and participating in the health research cycle is quite preponderant. Acknowledging what can help and deter this network may be beneficial to implementing this type of initiative in Portugal.