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Percorrer CIMO por Domínios Científicos e Tecnológicos (FOS) "Ciências Médicas::Outras Ciências Médicas"
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- Association between handgrip strength and mortality in individuals undergoing hemodialysis: A retrospective cohort studyPublication . Klippel, Leticia de Paiva Souza; Martins, Cleodice Alves; Barbosa, Karen dos Santos; Leandro, Larissa Vitória Batista; Cattafesta, Monica; Cunha, Alexandre Cardoso da; Soares, Ana Cristina de Oliveira; Prado, Camila Bruneli do; Ferreira, Júlia Rabelo Santos; Peterle, Fernanda Zobole; Almeida-de-Souza, Juliana; Haraguchi, Fabiano Kenji; Furtado, Elane Viana Hortegal; Neto, Edson Theodoro dos Santos; Salaroli, Luciane BrescianiHandgrip strength offers a valuable method to detect changes and reduced muscle strength and frailty and can help improve prognosis by early diagnosis. Therefore, the aim of the study was to evaluate the association between reduced muscle strength and mortality in individuals undergoing hemodialysis. Retrospective cohort study with 994 individuals. Sociodemographic, clinical, and lifestyle variables were obtained from a 2019 study. Mortality data were sourced from death certificates recorded from 2019 to 2022 in the Mortality Information System. Muscle strength was classified based on the following cut-off values: <27 kg for men and <16 kg for women. Survival curves were constructed using the Kaplan-Meier method and Cox Regression was used to evaluate the effect of handgrip strength and age on the time. More than 65 % of individuals in the sample show depleted strength, most of which were older adults (43.25 %, p < 0.001) and men (41.32 %, p = 0.008). Older adults with depleted strength showed a significantly higher number of observed deaths than expected ones (p < 0.001). After adjustment, HGS remained a significant predictor, associated with a 49 % increased risk of death (95 % CI: 1.16-1.91, p = 0.002). Having more than 11 years of formal education demonstrated a protective effect, reducing the risk of death by 1.6 times (95 % CI: 0.41-0.88, p = 0.009). Diabetes was found to be associated with almost a twofold increase in the risk of mortality (95 % CI: 1.54-2.49, p < 0.001). The decrease in handgrip strength predicts mortality in individuals undergoing hemodialysis with the risk being higher among older adults, those with diabetes and individuals with fewer than 11 years of education. (c) 2025 European Society for Clinical Nutrition and Metabolism. Published by Elsevier Ltd. All rights are reserved, including those for text and data mining, AI training, and similar technologies.
- Developing epidemiological preparedness for a plant disease invasion: Modelling citrus huánglóngbìng in the European UnionPublication . Ellis, John; Lázaro, Elena; Duarte, Beatriz; Magalhães, Tomás; Duarte, Amílcar; Benhadi-Marín, Jacinto; Pereira, José Alberto; Vicent, Antonio; Parnell, Stephen; Cunniffe, Nik J.Societal Impact Statement Huánglóngbìng (HLB) is a bacterial disease of citrus that has significantly impacted Brazil and the United States, although citrus production in the Mediterranean Basin remains unaffected. By developing a mathematical model of spread in Spain, we tested surveillance and control strategies before any future HLB entry in the EU. We found while some citrus production might be maintained by roguing, this requires extensive surveillance and significant chemical control, perhaps also including testing of psyllids (which spread the pathogen) for bacterial DNA. Our work highlights the key importance of early detection (including asymptomatic infection) and vector control for HLB management. Summary • Huánglóngbìng (HLB; citrus greening) is the most damaging disease of citrus worldwide. While citrus production in the United States and Brazil have been affected for decades, HLB has not been reported in the European Union (EU). However, a HLB vector, the African citrus psyllid, is already in Portugal and Spain. In 2023, the major vector, the Asian citrus psyllid, was first reported in Cyprus. • We develop a landscape-scale, epidemiological model, accounting for heterogeneous citrus cultivation and vector dispersal, as well as climate and disease management. We use our model to predict HLB dynamics for an epidemic vectored by the African citrus psyllid in high-density citrus areas in Spain, assessing detection and control strategies. • Without disease management, we predict large areas infected within 10–20 years. Even with significant visual surveillance, any epidemic will be widespread on first detection, making eradication unlikely. Nevertheless, increased inspection and roguing following first detection, particularly if coupled with intensive insecticide use, could sustain some citriculture for a decade or more, albeit with reduced production. However, effective control may require chemical application rates and/or active substances no longer authorised in the EU. Strategies targeting asymptomatic infection will be more successful. Detection of bacteriliferous vectors—sometimes possible long before plants show symptoms—could reduce lags before disease management commences. If detection of HLB-positive vectors were followed by intensive insecticide sprays, this may greatly improve outcomes. • Our work highlights modelling as a key component of developing epidemiological preparedness for a pathogen invasion that is, at least somewhat, predictable in advance.
- A Quantitative Risk Assessment Model for Listeria monocytogenes in Ready-to-Eat CantaloupePublication . Guillier, Laurent; Gonzales-Barron, Ursula; Pouillot, Régis; Mota, Juliana De Oliveira; Allende, Ana; Kovacevic, Jovana; Guldimann, Claudia; Fazil, Aamir; Al-Qadiri, Hamzah; Dong, Qingli; Hasegawa, Akio; Cadavez, Vasco; Sanaa, MoezThis study introduces a farm-to-fork quantitative risk assessment (QRA) model for invasive listeriosis from ready-to-eat diced cantaloupe. The modular model comprises seven stages-preharvest (soil and irrigation contamination), harvest (cross-contamination and survival), pre-processing (brushing), processing (flume tank washing, dicing and equipment cross-contamination), lot testing, cold-chain transport and retail growth, and consumer storage/handling. Each stage employs stochastic functions to simulate microbial prevalence and concentration changes (growth, inactivation, removal, partitioning, cross-contamination) using published data. In a reference scenario-good agricultural practices (soil barriers, no preharvest irrigation), hygienic processing and proper cold storage-the model predicts low lot- and pack-level contamination, with few packs >10 CFU/g and most servings below detection; the mean risk per serving is very low. "What-if" analyses highlight critical control points: the absence of soil barriers with preharvest irrigation can increase the risk by 10,000-fold; flume tank water contamination has a greater impact than harvest-stage cross-contamination; and poor consumer storage can raise the risk by up to 500-fold. This flexible QRA framework enables regulators and industry to evaluate and optimize interventions-from improved agricultural measures to targeted sampling plans and consumer guidance-to mitigate listeriosis risk from RTE diced cantaloupe.