Abstract Introduction: This study aimed to assess the clinical, economic, and humanistic impact of short-bowel syndrome/chronic intestinal failure (SBS/CIF) in Portugal. Methods: This is a retrospective multicenter cohort chart review study, with a cross-sectional component for quality-of-life (QoL) evaluation. Inclusion criteria comprised patients with SBS/CIF, aged ≥1 year, with stable parenteral nutrition (PN). Data collection included patient chart review over a 12-month period and patient/caregiver self-report and SF-36/PedsQL™ questionnaires. Main endpoints comprised clinical and PN characterization, healthcare resource use (HRU), direct costs, and patient QoL. Results: Thirty-one patients were included (11 adults and 20 children). Patients’ mean age (standard deviation [SD]) was 57.9 (14.3) years in adults and 7.5 (5.0) years in children, with a mean time since diagnosis of 10.2 (5.9) and 6.6 (4.2) years, respectively. PN was administered for a mean of 5.2 and 6.6 days/week in adults and children, respectively; home PN occurred in 81.8% of adults and 90.0% of children for a mean of 9.6 and 10.8 months/year, respectively. The mean annual number of hospitalizations was 1.9 and 2.0 which lasted for a mean of 34.0 and 29.4 days in adults and children, respectively. Twenty-one and forty hospitalization episodes were reported in adults and children, respectively, of which 71.4% and 85.0% were due to catheter-related complications. Mean annual direct costs per patient amounted to 47,857.53 EUR in adults and 74,734.50 EUR in children, with PN and hospitalizations as the main cost-drivers. QoL assessment showed a clinically significant impaired physical component in adults and a notable deterioration in the school functioning domain in children. Conclusion: In Portugal, SBS/CIF patient management is characterized by a substantial therapeutic burden and HRU, translating into high direct costs and a substantial impairment of the adults’ physical function and children’s school functioning.

Resumo Introdução: Este estudo teve como objetivo avaliar o impacto clínico, económico e social da síndrome do intestino curto/falência intestinal crónica (SIC/FIC) em Portugal. Métodos: Estudo de coorte retrospectivo e multicêntrico de revisão dos processos clínicos incluindo uma componente transversal para avaliação da qualidade de vida (QV). Os critérios de elegibilidade incluíram doentes com SIC/FIC, idade ≥1 ano, em nutrição parenteral (NP) e clinicamente estáveis. A recolha de dados incluiu a revisão dos processos clínicos ao longo de um período de 12 meses e a aplicação de questionários auto-administrados a doentes e cuidadores e de questionários de QV (SF-36/ PedsQL™). Os indicadores principais foram a caracterização clínica e da NP, a utilização de recursos de saúde, custos diretos e QV dos doentes. Resultados: Foram incluídos 31 doentes (11 adultos e 20 crianças). A idade média (desvio padrão: DP) foi de 57.9 (14.3) anos nos adultos e de 7.5 (5.0) nas crianças com um tempo médio desde o diagnóstico de 10.2 (5.9) e 6.6 (4.2) anos, respetivamente. A NP foi administrada durante uma média de 5.2 e 6.6 dias por semana, em adultos e crianças respetivamente, em 81.8% e 90.0% dos adultos/crianças foi feita em casa durante uma média de 9.6 ou 10.8 meses por ano, respetivamente. O número médio anual de hospitalizações foi de 1.9 (1.6) e 2.0 (1.5) com uma duração média de 34.0 (47.4) e 29.4 (32.3) dias, em adultos e crianças, respetivamente. Foram reportados 21 e 40 episódios de hospitalização em adultos/crianças, dos quais 71.4% e 85.0% foram devido a complicações relacionadas ao uso de cateter. Os custos diretos anuais médios por doente ascenderam a 47,857.53 EUR nos adultos e a 74,734.50 EUR nas crianças, sendo que os maiores responsáveis foram a NP e as hospitalizações. A avaliação da QV mostrou um comprometimento clinicamente significativo da componente física nos adultos e uma deterioração relevante da dimensão escolar nas crianças. Conclusões: A gestão dos doentes com SIC/FIC em Portugal é caracterizada por uma sobrecarga substancial a nível terapêutico e de utilização de recursos de saúde, o que se traduz em elevados custos diretos e comprometimento substancial da componente física nos adultos e do desempenho escolar nas crianças.

BACKGROUND: Given the increased usage of mobile apps among males when purchasing apparel, it is imperative that retailers develop mobile apps that align with the target market's needs. OBJECTIVES: This article aims to determine the mobile app intention and usage among young male adult consumers when purchasing apparel. METHOD: A positivistic, descriptive research design was followed, and data were collected from 310 young male adults. Structural equation modelling and moderation analysis were used to test the hypotheses. RESULTS: The study found that the behavioural intention of young adult males using mobile apps to purchase apparel is influenced by the perceived usefulness and attitude towards the app, while the attitude towards the app is influenced by perceived usefulness and ease of use. Perceived usefulness was also influenced by innovativeness and perceived ease of use, while ease of use is influenced by collectivism and innovativeness CONCLUSION: The study highlights the significance of perceived ease of use, perceived usefulness and innovativeness as stimuli of young male adult consumers' behavioural intentions towards using mobile apps when purchasing apparel online. It also informs apparel retailers of the role of collectiveness towards the perceived ease of use of mobile apps when purchasing apparel online. CONTRIBUTION: This study provides empirical evidence of the interrelationships between perceived usefulness, perceived ease of use, attitude and its influence on behavioural intention when purchasing menswear apparel via mobile apps. It validates that collectivism leads to lower perceived ease of use, indicating that a greater emphasis should be placed on elevating the perceived ease of use among consumers with collective behaviour.

Resumo A calcificação do anel mitral (CAM) é um processo fibrótico crônico e degenerativo comumente observado da base da valva mitral, geralmente considerado um achado incidental. Embora inicialmente a CAM fosse considerada uma consequência de um processo degenerativo relacionado à idade, achados recentes sugerem outros mecanismos contributivos independentes, como aterosclerose e metabolismo anormal de cálcio-fósforo. A calcificação caseosa do anel mitral (cCAM) é uma variante raramente descrita da CAM, caracterizada por uma massa ovoide, focal, com calcificações internas semelhantes a líquido caseoso e detritos. Diferenciar um cCAM de outras massas cardíacas aderidas ao anel mitral pode ser um desafio. Uma única modalidade de imagem, como o ecocardiograma transtorácico, pode não ser suficiente para um diagnóstico claro. Portanto, uma abordagem de imagem multimodal é necessária, incluindo tomografia computadorizada cardíaca e ressonância magnética cardíaca (RMC). A CAM e a cCAM afetam tipicamente o anel mitral posterior, com poucos casos na literatura descrevendo o envolvimento do anel anterior. Apresentamos um caso raro de calcificação caseosa do anel mitral anterior encontrado em uma RMC realizada para avaliar uma massa atrial esquerda identificada em um ecocardiograma transtorácico.

Abstract Mitral annular calcification (MAC) is a commonly observed chronic and degenerative fibrotic process of the base of the mitral valve, usually deemed as an incidental finding. Although initially, MAC was thought to be a consequence of an age-related degenerative process, recent findings suggest other independent contributive mechanisms, such as atherosclerosis and abnormal calcium-phosphorus metabolism. Caseous calcification of the mitral annulus (cMAC) is a rarely described variant of MAC, characterized by an ovoid, focal mass with internal caseous fluid-like calcifications and debris. Differentiating a cMAC from other cardiac masses attached to the mitral annulus may be challenging. A single imaging modality, such as transthoracic echocardiography, may not be sufficient for a clear diagnosis. Therefore, a multimodal imaging approach is necessary, including cardiac tomography computerized imaging and cardiac magnetic resonance (CMR). MAC and cMAC typically affect the posterior mitral annulus, with very few cases in the literature describing the involvement of the anterior annulus. We present a rare case of an anterior mitral annulus caseous calcification found in a CMR performed to evaluate a left atrial mass identified on a transthoracic echocardiogram.

Abstract A 72-year-old woman was admitted for acute heart failure. The echocardiography revealed moderate depression of the left ventricular ejection fraction. Coronary disease was excluded by coronarography. Cardiac magnetic resonance showed predominantly left ventricular septal hypertrophy and severe depression of the left ventricular systolic function. There was also a bright, multifocal and patchy late gadolinium enhancement with subendocardial, mesocardial and subepicardial involvement, suggestive of sarcoidosis. Biochemical study, thoracic computed tomography and positron emission tomography were inconclusive for extra-cardiac sarcoidosis. Therefore, an endomyocardial biopsy was performed. The procedure was complicated by the development of complete atrioventricular block, requiring implantation of a cardiac resynchronization pacing device. A few days after device implantation, the patient developed fever. The echocardiography revealed extensive vegetations, and thus the diagnosis of a device-associated infective endocarditis was made. Even though antibiotic therapy was promptly started, the patient ended up dying. Biopsy results revealed lymphocytic myocarditis. This case is paradigmatic because it shows how the etiologic diagnosis of dilated cardiomyopathy can be challenging. Non-invasive diagnostic exams may not provide a definite diagnosis, requiring an endomyocardial biopsy. However, the benefits versus risks of such procedure must always be carefully weighted.

O solo e o clima regional influenciam os mecanismos fisiológicos da oliveira (Olea europaea L.) com reflexo na produção oleícola e na potencial localização dos olivais; esta depende também das modificações do clima local, ainda pouco conhecidas, nas suas vertentes aplicadas. O objetivo da presente investigação é ensaiar uma metodologia de avaliação das potencialidades agroclimáticas locais para a olivicultura na região de Alvega passível de extrapolação para outras culturas agrícolas e regiões. A metodologia assenta na espacialização da aptidão e dos constrangimentos agroclimáticos locais da olivicultura. A carta das potencialidades olivícolas de origem climática local na região de Alvega constitui uma ferramenta passível de aplicação no ordenamento, planeamento e gestão agrícola do território.

The regional soil and climate influence the physiological mechanisms of the olive tree (Olea europaea L.) as reflected in their oil production and the potential location of olive groves; that also depends on the local climate changes, still little known in its applied aspects. The purpose of this research is to test a methodology for assessing the local agroclimatic potential for oliviculture in the Alvega region capable of extrapolation to other crops and regions. The methodology is based on the spatial distribution of the local agroclimatic suitability and constraints of oliviculture. The map of local agroclimatic potential for oliviculture in the Alvega region is a tool that can be applied in spatial planning and management of agricultural land.