Long-COVID-19 impacts health-related quality of life (HR-QoL) but data is scarce. The aim of this study was to describe and prospectively assess the prevalence and risk factors for long-COVID-19 ...after hospital discharge, and to evaluate its impact on patient HR-QoL.
Single-centre longitudinal study including all COVID-19 patients discharged between December 2020 and February 2021. Patients were contacted remotely at three, six and nine months. Data were collected as follows: 1) Long-COVID-19 symptoms were self-reported; 2) HRQoL were assessed using the 3-level EuroQoL-5D (EQ-5D-3L) questionnaire. Pregnant women, demented, bedridden, and non-Portuguese-speaking patients were excluded.
The three-, six- and nine-month assessments were completed by 152, 117 and 110 patients (median age: 61 years; male sex: 56.6%). Long-COVID-19 (≥ 1 symptom) was reported by 66.5%, 62.4% and 53.6% of patients and HR-QoL assessment showed impairment of at least some domain in 65.8%, 69.2% and 55.4% of patients at three, six and nine months, respectively. Fatigue was the most common long-COVID-19 symptom. Anxiety/depression domain was the most frequently affected in all three time-points, peaking at six months (39%), followed by pain/discomfort and mobility domains. Long-COVID-19 was associated with the impairment of all EQ-5D-3L domains except for self-care domain at each time-point. Neither intensive care unit admission nor disease severity were associated with long-COVID-19 nor with impairment of any EQ-5D-3L domain. After adjusting for sex, age, frailty status, and comorbid conditions, long-COVID-19 remained significantly associated with HR-QoL impairment at three (OR 4.27, 95% CI 1.92 - 9.52, p < 0.001), six (OR 3.46, 95% CI 1.40 - 8.57, p = 0.007) and nine months (OR 4.13, 95% CI 1.62 - 10.55, p = 0.003) after hospital discharge. In a longitudinal analysis, patients reporting long-COVID-19 at three months had an EQ-5D-3L index value decreased by 0.14 per visit (p < 0.001) compared to those without long-COVID-19 and both groups had a non-significant change in mean EQ-5D-3L index over the nine-month period (time-point assessment, Z = 0.91, p = 0.364).
Clinical sequelae associated with long-COVID-19 can persist for at least nine months after hospital discharge in most patients and can impair long-term HR-QoL in more than half of patients regardless of disease severity, and clinicodemographic characteristics.
The Iberian Pyrite Belt (IPB) hosts world-class massive sulphide deposits, such as Neves-Corvo in Portugal and Rio Tinto in Spain. In Portugal, the Palaeozoic Volcanic-Sedimentary Complex (VSC) hosts ...these ore deposits, extending from the Grândola-Alcácer region to the Spanish border with a NW–SE to WNW–ESE trend. In the study area, between the Neves-Corvo mine region and Alcoutim (close to the Spanish border), the VSC outcrops only in a small horst near Alcoutim. Sparse exploration drill-hole data indicate that the depth to the top of the VSC varies from several 100 m to about 1 km beneath the Mértola Formation Flysch cover. Mapping of the VSC to the SE of Neves-Corvo mine is an important exploration goal and motivated the acquisition of six 2D seismic reflection profiles with a total length of approximately 82 km in order to map the hidden extension of the VSC. The data, providing information deeper than 10 km at some locations, were integrated in a 3D software environment along with potential-field, geological and drill-hole data to form a 3D structural framework model. Seismic data show strong reflections that represent several long Variscan thrust planes that smoothly dip to the NNE. Outcropping and previously unknown Late Variscan near-vertical faults were also mapped. Our data strongly suggest that the structural framework of Neves-Corvo extends south-eastwards to Alcoutim. Furthermore, the VSC top is located at depths that show the existence within the IPB of new areas with good potential to develop exploration projects envisaging the discovery of massive sulphide deposits of the Neves-Corvo type.
The presence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in wastewater produced interest in its use for sentinel surveillance at a community level and as a complementary approach ...to syndromic surveillance. With this work, we set the foundations for wastewater-based epidemiology (WBE) in Portugal by monitoring the trends of SARS-CoV-2 RNA circulation in the community, on a nationwide perspective during different epidemiological phases of the pandemic. The Charité assays (E_Sarbecco, RdRP, and N_Sarbecco) were applied to monitor, over 32-weeks (April to December 2020), the dynamics of SARS-CoV-2 RNA at the inlet of five wastewater treatment plants (WWTP), which together serve more than two million people in Portugal. Raw wastewater from three Coronavirus disease 2019 (COVID-19) reference hospitals was also analyzed during this period. In total, more than 600 samples were tested.
For the first weeks, detection of SARS-CoV-2 RNA was sporadic, with concentrations varying from 103 to 105 genome copies per liter (GC/L). Prevalence of SARS-CoV-2 RNA increased steeply by the end of May into late June, mainly in Lisboa e Vale do Tejo region (LVT), during the reopening phase. After the summer, with the reopening of schools in mid-September and return to partial face-to-face work, a pronounced increase of SARS-CoV-2 RNA in wastewater was detected. In the LVT area, SARS-CoV-2 RNA load agreed with reported trends in hotspots of infection. Synchrony between trends of SARS-CoV-2 RNA in raw wastewater and daily new COVID-19 cases highlights the value of WBE as a surveillance tool, particularly after the phasing out of the epidemiological curve and when hotspots of disease re-emerge in the population which might be difficult to spot based solely on syndromic surveillance and contact tracing. This is the first study crossing several epidemiological stages highlighting the long-term use of WBE for SARS-CoV-2.
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•SARS-CoV-2 monitored over 32-weeks encompassing different epidemiological stages.•Five wastewater treatment plants, representing over two million people, were tested.•Trends of SARS-CoV-2 in wastewater followed trends of daily new cases in Portugal.•Sampling strategy may have a marked impact in the detection of SARS-CoV-2.•Long-term potential of WBE as a complementary tool to clinical surveillance demonstrated.
Despite their higher risk of developing severe disease, little is known about the burden of influenza in Portugal in children aged < 5 years old. This study aims to cover this gap by estimating the ...clinical and economic burden of severe influenza in children, in Portugal, during ten consecutive influenza seasons (2008/09-2017/18).
We reviewed hospitalizations in children aged < 5 years old using anonymized administrative data covering all public hospitals discharges in mainland Portugal. The burden of hospitalization and in-hospital mortality directly coded as due to influenza was supplemented by the indirect burden calculated from excess hospitalization and mortality (influenza-associated), estimated for four groups of diagnoses (pneumonia or influenza, respiratory, respiratory or cardiovascular, and all-cause), through cyclic regression models integrating the incidence of influenza. Means were reported excluding the H1N1pdm09 pandemic (2009/10).
The mean annual number of hospitalizations coded as due to influenza was 189 (41.3 cases per 100,000 children aged < 5 years old). Hospitalization rates decreased with increasing age. Nine-in-ten children were previously healthy, but the presence of comorbidities increased with age. Children stayed, on average, 6.1 days at the hospital. Invasive mechanical ventilation was used in 2.4% of hospitalizations and non-invasive in 3.1%. Influenza-associated excess hospitalizations between 2008 and 2018 were estimated at 1,850 in pneumonia or influenza, 1,760 in respiratory, 1,787 in respiratory or cardiovascular, and 1,879 in all-cause models. A total of 95 influenza-associated excess deaths were estimated in all-cause, 14 in respiratory or cardiovascular, and 9 in respiratory models. Over ten years, influenza hospitalizations were estimated to have cost the National Health Service at least €2.9 million, of which 66.5% from healthy children.
Influenza viruses led to a high number of hospitalizations in children. Most were previously healthy. Results should lead to a reflection on the adequate preventive measures to protect this age group.
The presence of the sea in Portuguese museums, monuments and sites is formidable, a multifaceted heritage providing experiences transposing history, exploration, industry, commerce, lifestyles, ...technologies, architecture, popular and fine arts. muSEAum focused on management competencies for the competitive exploration of museums’ characteristics, environment, and collection. The co-innovation project with a nationwide sample of sea-themed museological institutions – not just maritime or marine museums -- addressed the definition, management and communication of the museum brand, the benefits of a Sea Museum of Portugal collective brand, visitor experience technologies, national and international reach and awareness, spirit of belonging, new learning partnerships, and local tourism. Research on audiences and management practices provided a solid evaluation basis. Notwithstanding some noteworthy, good practices, most institutions suffer from insufficient funding and administrative autonomy. Promotional efforts are geared towards local constituencies leading to residual national and international visibility, affecting particularly those off tourist circuits. Incipient or inexistant brands, inefficient or non-existent websites, inconspicuous SEO and digital marketing activities, own domain names a rarity keep many museums absconded in the internet maelstrom.
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•Li-rich aplite-pegmatites are abundant in the Central Iberian Zone.•They are related to the extreme fractionation of Variscan granitic melts.•A model for the petrogenetic links among ...granites and pegmatites is proposed.•The most likely parental granitic series are determined.•The model may be extended to the rest of the European Variscan Belt.
The Central Iberian Zone (CIZ) is characterised by a large volume of Variscan granitic intrusions, which can be grouped into five types: (1) two-mica peraluminous leucogranites (S1); (2) P-rich highly peraluminous granites (S2); (3) P-poor moderately peraluminous granites (S3); (4) moderately to low peraluminous granites (S4); and (5) I-type low peraluminous granites (I). Though not as abundant as granites, aplite-pegmatite rocks are nonetheless widespread in this region, occurring either as fields of aplite-pegmatite dykes or as leucogranitic cupolas. They are commonly enriched in Li-(F-P) minerals such as spodumene, petalite, micas, and phosphates of the amblygonite-montebrasite and triphylite-lithiophilite series. Many of the Li-rich bodies show an aplitic texture, frequently with the development of layered units. Coarse crystals are also common, but are mostly smaller than 12 cm long. They usually do not show internal fractionation, zoning or a quartz-core, and often have high values in Li2O (>1.3 wt%), and high Na, F and P contents. Evidence in support of a petrogenetic link among peraluminous granites and aplite-pegmatite bodies is provided by field relationships and geochemical affinities. The Li-(F-P)-mineralisation is closely related to the S1 series in the northern CIZ realm, whereas in the southern portion of the CIZ the parental granites correspond to the S2 series. The granites of the S3 and S4 series, and the I-type granite suite are not related to the Li mineralisation. The S1 and S2 granites are interpreted to derive mainly from the partial melting of highly peraluminous, Ca-poor and P-rich Neoproterozoic metasediments during the Variscan orogeny. The melts are presumed to evolve favoured by a high content in fluxing components, such as P, F, B, Li, and H2O, which contributed to the lowering of viscosity, solidus temperature and polymerisation degree. This is in parallel to the increasing of the diffusion rates and mobility of the highly fractionated melts. The residual melts, enriched in incompatible elements such as Li and F, as well as B, Sn and other rare elements, tend to accumulate at the top of the granitic cupolas. Therefore, Li-rich dykes as observed in many aplite-pegmatite fields of the CIZ are arguably the result of the opening of the system, whereas Li-rich granitic cupolas form when the system remains closed. Lithium-rich rocks, comparable to those of the CIZ, are found in other parts of the European Variscan Belt also related to P-rich, Ca-poor, highly peraluminous S-type granites originated during the Variscan Orogeny. Accordingly, we postulate the existence of an extense Li-metallogenetic province including mainly the CIZ in Spain and Portugal, the Massif Central in France, the Bohemian Massif in the Czech Republic and Germany, the western Carpathians in the Slovak Republic, and the Cornwall region in the south west of England.
The purpose of this study was to evaluate the potential impact of the pesticides detected in the Alqueva reservoir (Guadiana Basin, South Iberian Peninsula) on the aquatic organisms belonging to this ...ecosystem. For this purpose, the occurrence and risk assessment of 25 pesticides and of a number of their degradation products were determined in the Alqueva surface waters. The areas (sampling stations) most polluted by pesticides were Sra. Ajuda, Lucefecit and Álamos in the northern and in the middle portions of the reservoir, respectively. The aquatic risk assessment revealed that from the various compounds analysed terbuthylazine, chlorfenvinphos and diazinon presented non-acceptable risk when maximum concentrations were used as the measured environmental concentrations (MEC). The locations that had more samples with risk quotients higher than 1 (high risk) were Sra. Ajuda followed by Lucefécit. The use of risk assessment allowed us to conclude that, despite that the pesticides' concentrations in the water column fulfil the European environmental quality standards, a number of the compounds show a high ecotoxicological risk for the aquatic organisms in the Alqueva ecosystem. The results thereby demonstrate that to have an efficient risk management process, the regulatory authorities of each country must consider an integrative chemical and ecotoxicological approach.
•Increasing amounts of bentazone, terbuthylazine and metolachlor•The north part of the reservoir is the most contaminated•All pesticides concentrations complied with the EQS•Terbuthylazine, chlorfenvinphos and diazinon showed high risk for aquatic species•Water resource management must integrate chemical and ecotoxicological evaluation.
Microplastic ingestion has been reported for several marine species, but the level of contamination in transitional systems and associated biota is less known. The aim of this study was to assess the ...occurrence of microplastic ingestion in three commercial fish species: the sea bass (Dicentrarchus labrax), the seabream (Diplodus vulgaris) and the flounder (Platichthys flesus) from the Mondego estuary (Portugal). Microplastics were extracted from the gastrointestinal tract of 120 individuals by visual inspection and digestion solution. A total of 157 particles were extracted from 38% of total fish (96% fibers), with 1.67 ± 0.27 (SD) microplastics per fish. Significantly higher amount of ingested microplastics was recorded for D. vulgaris (73%). The dominant polymers identified by μ-FTIR were polyester, polypropylene and rayon (semi-synthetic fiber). It is reported for the first time the presence of this pollutant in fish populations from the Mondego estuary raising concerns on their potential negative effects.
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•Microplastics occurred in 38% of three fish species from the Mondego estuary.•The highest abundance of microplastics was recorded in Diplodus vulgaris.•Fibers represented 96% of microplastics found in all analysed fish•Polyester, rayon and polypropylene were the dominant polymers identified by μ-FTIR.
El enoturismo, en España y Portugal, viene ganando espacio entre las formas de turismo más tradicionales. Al mismo tiempo, la adopción de herramientas tecnológicas por parte del sector turístico es ...un proceso continuo y significativo que se refleja en una creciente presencia online de los consumidores que planifican sus viajes, siendo los sitios web cruciales para las empresas, ya que funcionan como puente de enlace directo entre los turistas, organizaciones y turistas. Con el fin de comprender cómo las bodegas pertenecientes a las tres rutas del vino de Extremadura (España), Alentejo y Região Centro (Portugal) utilizan Internet para potenciar su actividad y promocionar el enoturismo, en este artículo presentamos los resultados obtenidos a partir de la aplicación de una matriz de evaluación desarrollada con este fin. Del análisis de 100 sitios web, se verificó que la mayoría de las bodegas tienen sitios web muy estáticos, que ofrecen la mínima cantidad de información, demostrando que la mayoría de las bodegas no entiende el potencial real de Internet como herramienta de marketing para incrementar su actividad enoturística, sus servicios y su presencia en el mercado.
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