Primary Sjögren's Syndrome (pSS) is a systemic autoimmune disease that involves the exocrine glands and internal organs. pSS leads to destruction and loss of secretory function due to intense ...lymphoplasmacytic infiltration. Therapeutic options include mainly symptomatic and supportive measures, and traditional immunosuppressant drugs have shown no effectiveness in randomized trials. Rituximab (RTX) is a chimeric antibody anti-CD20 that leads to B cell depletion by diverse mechanisms. There is evidence that this drug may be effective for treating pSS. The objective of this systematic review was to evaluate Rituximab effectiveness and safety for treating pSS.
We conducted a systematic review of RCTs published until December 2015, with no language restriction. We registered a protocol on Plataforma Brasil (40654814.6.0000.5505) and developed search strategies for the following scientific databases: MEDLINE, EMBASE, CENTRAL and LILACS. We included adults with established pSS diagnosis and considered the use of Rituximab as intervention and the use of other drugs or placebo as control. Four studies met our eligibility criteria: three with low risk of bias and one with uncertain risk of bias. The total number of participants was 276 (145 RTX, 131 placebo). We assessed the risk of bias of each included study and evaluated the following as primary outcomes: lacrimal gland function, salivary gland function, fatigue improvement and adverse events. We found no significant differences between the groups in the Schirmer test at week 24 meta-analysis (MD 3.59, 95% CI -2.89 to 10.07). Only one study evaluated the lissamine green test and reported a statistically significant difference between the groups at week 24 (MD -2.00, 95% CI -3.52 to -0.48). There was a significant difference between the groups regarding salivary flow rate (MD 0.09, 95% CI 0.02 to 0.16) and improvement in fatigue VAS at weeks 6 (RR 3.98, 95% CI 1.61 to 9.82) and week 16 (RR 3.08, 95% CI 1.21 to 7.80).
According to moderate quality evidence, the treatment with a single RTX course in patients with SSp presents discrete effect for improving lacrimal gland function. Low-quality evidence indicates the potential of this drug for improving salivary flow. According to low quality evidence, no differences were observed in the evaluation after 24 weeks regarding fatigue reduction (30% VAS), serious adverse events occurrence, quality of life improvement and disease activity. With a very low level of evidence, there was no improvement in oral dryness VAS evaluation.
This study aimed to evaluate the effectiveness and safety of carbohydrate counting (CHOC) in the treatment of adult patients with type 1 diabetes mellitus (DM1).
We performed a systematic review of ...randomized studies that compared CHOC with general dietary advice in adult patients with DM1. The primary outcomes were changes in glycated hemoglobin (HbA1c), quality of life, and episodes of severe hypoglycemia. We searched the following electronic databases: Embase, PubMed, Lilacs, and the Cochrane Central Register of Controlled Trials. The quality of evidence was analyzed using the Grading of Recommendations Assessment, Development and Evaluation (GRADE).
A total of 3,190 articles were identified, and two reviewers independently screened the titles and abstracts. From the 15 potentially eligible studies, five were included, and 10 were excluded because of the lack of randomization or different control/intervention groups. Meta-analysis showed that the final HbA1c was significantly lower in the CHOC group than in the control group (mean difference, random, 95% CI: -0.49 (-0.85, -0.13), p = 0.006). The meta-analysis of severe hypoglycemia and quality of life did not show any significant differences between the groups. According to the GRADE, the quality of evidence for severe hypoglycemia, quality of life, and change in HbA1c was low, very low, and moderate, respectively.
The meta-analysis showed evidence favoring the use of CHOC in the management of DM1. However, this benefit was limited to final HbA1c, which was significantly lower in the CHOC than in the control group.
Since the last decade of the last century, it is known that many old grapevine varieties are descendants of other varieties through natural crossing. Portugal has an important program for the ...conservation of representative samples of intra-varietal variability of all autochthonous varieties, managed by the Portuguese Association for Grapevine Diversity (PORVID), which makes looking for genotypes with dubious identification an important activity from a perspective of its valorisation. This communication presents the results of the molecular analysis of 5,000 samples (accessions) from the PORVID’s collection, using nine microsatellite
loci
currently recommended by the International Organization of Vine and Wine (OIV) for genetic grapevine identification. The results obtained confirmed the molecular identity of 4,220 samples corresponding to 214 varieties present in the official list of Portuguese varieties. In 780 samples, 95 profiles with a plural number of accessions revealed not to be listed in the Vitis International Variety Catalogue (VIVC) database, corresponding to possible varieties either descendent from natural crossing from at least one known parental variety, or from undetermined origin. Furthermore, the need for a comprehensive strategy aimed at uncovering other hidden varieties is discussed to prevent their imminent loss, deepen understanding of their origin, and add economic value and sustainability to the vine and wine sector.
•In recent years virtual reality (VR) has been used alone and as an adjunct intervention in the treatment of patients with cerebral palsy (CP).•VR plus conventional rehabilitation can improve upper ...limb function and lower limb strength in patients with CP.•VR alone is no better than other treatments to improve upper and lower limb function in patients with CP.•VR alone can improve postural control, balance, and lower limb function in patients with CP.•Further research is needed to better define the effectiveness of VR in patients with CP.
Cerebral palsy (CP) is one of the main causes of disability in childhood. Virtual reality (VR) has been used as a treatment option in this population, however its effectiveness is unclear.
To evaluate the effectiveness of VR in patients with CP.
We conducted electronic searches in EMBASE, MEDLINE, Cochrane library, PEDro, AMED, PsycoINFO, and LILACS databases and trial site registries such as ClinicalTrials.gov and ICTRP. We included randomized controlled trials that tested the use of VR alone or in combination with other interventions compared to more conventional rehabilitation or usual care in individuals with CP. The primary outcomes were upper and lower limb function, postural control, and balance. The secondary outcomes included global motor function, perception, cognition and spatial functions, motivation, motor learning, and adverse events. Two independent reviewers extracted and assessed included articles for risk of bias using the Cochrane risk of bias tool. We use a meta-analysis with random effect model whenever possible. We analyzed the quality of evidence using theGRADE approach.
We included 38 trials (pooled n = 1233 participants) in this review. There is very low quality of evidence that VR plus conventional rehabilitation is better than conventional rehabilitation for upper limb function. There is also very low quality evidence that VR alone is no better than conventional rehabilitation for upper and lower limb function. No adverse events were observed among the 10 trials that provided information on this outcome.
At present we have very limited to limited confidence in effect estimation for utilization of VR in this population. Future studies may change our confidence in results and effect estimates.
PROSPERO CRD 42018102759.
Leadership characteristics and digital transformation Porfírio, José António; Carrilho, Tiago; Felício, José Augusto ...
Journal of business research,
January 2021, 2021-01-00, 20210101, Letnik:
124
Journal Article
Recenzirano
Odprti dostop
Digital transformation (DT) is essential for all companies and industries, depending crucially on systems, IT, strategy, and people. In this research, we analyse how firms’ characteristics, ...associated with management characteristics, promote DT in Portuguese companies. The model considers the relationship between digital strategy and corporate and business strategy, according to firm and management characteristics. We use a multilevel analysis, applying fsQCA to data obtained from 47 Portuguese firms. The results represent an important step forward in the knowledge of the conditions to promote higher stages of DT, especially regarding leadership and management associated with certain firms’ characteristics. The conclusions support the crucial role of leadership and especially the importance of managers’ coherence towards companies’ mission to promote more advanced stages of DT. At the same time, it contributes to develop knowledge about the best possible combination of firms’ and management characteristics to promote DT.
This study explores family business succession. In this study, succession is compared to the concept of opportunity versus necessity entrepreneurship. The motivations of successors when they enter ...the succession process are examined to identify different conditions for family business success and sustainability. The influence of context is also considered. This study is based on multilevel research and a multidisciplinary perspective. Fuzzy-set qualitative comparative analysis (fsQCA) is applied to a sample of 383 observations from 6 countries (Portugal, Italy, Greece, Cyprus, North Macedonia, and Bulgaria) spanning 2 regions: southern European Mediterranean countries (Portugal, Italy, Greece, and Cyprus) and southern Slavic countries (North Macedonia and Bulgaria). The interplay between personal characteristics of the successor, organizational characteristics of the family business, and context produces different patterns that lead to different outcomes in the succession processes of family businesses. The results are important to strengthen family business theory and identify the conditions that best promote the future growth and sustainability of family businesses. The results are also important to promote country-specific public policies that may create better conditions for successors in family businesses to succeed.
From a young age, entrepreneurship intentions depend heavily on the culture of countries and the entrepreneurial contexts that will shape entrepreneurial archetypes about what defines an ...entrepreneur, and the influence of role models. All these aspects depend on the would-be entrepreneurs’ personal characteristics, and are influenced by the entrepreneurship education they receive when they are young.
Most of the studies on youth entrepreneurship focus on university students. However, it is in adolescence that the personal characteristics of entrepreneurs are formed. This may be the reason why these studies mostly reach contradictory results about the importance of these programs.
From our sample of 1750 Portuguese students, we confirm the importance of entrepreneurial culture and education to promote entrepreneurial self-efficacy and develop entrepreneurial intentions.
Our results contribute to ascertaining the importance of entrepreneurial educational programs delivered in adolescence, adapted to the specific characteristics of the target populations (potential entrepreneurs) on the development of entrepreneurship intentions. Thus, it helps with the subsequent definition of educational policies to foster entrepreneurship development from adolescence.
Provider: - Institution: - Data provided by Europeana Collections- Monografia- Entrevista Manuel Ramirez_Diferenças dos negócios Familiares_Projeto FABUSS- Neste vídeo apresenta-se uma parte da ...entrevista realizada ao Sr. Manuel Ramirez, acerca das especificidades e o contexto de gestão das empresas familiares. Para além da abordagem concreta à situação das Conservas Ramirez, é desenvolvido um enquadramento e contexto da gestão das empresas familiares em geral, focando-se nas diferenças de gestão entre as empresas familiares, e o problema da sucessão- Monographic bibliographic item- All metadata published by Europeana are available free of restriction under the Creative Commons CC0 1.0 Universal Public Domain Dedication. However, Europeana requests that you actively acknowledge and give attribution to all metadata sources including Europeana
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