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Esteves S.,Instituto Portugues Of Oncologia Of Lisbon | Castel-Branco M.,Higher School of Tourism and Hospitality Studies, Estoril | Stummer W.,University of Munster
Neurosurgery | Year: 2015

BACKGROUND: High-grade gliomas are aggressive, incurable tumors characterized by extensive diffuse invasion of the normal brain parenchyma. Novel therapies at best prolong survival; their costs are formidable and benefit is marginal. Economic restrictions thus require knowledge of the cost-effectiveness of treatments. Here, we show the cost-effectiveness of enhanced resections in malignant glioma surgery using a well-characterized tool for intraoperative tumor visualization, 5-aminolevulinic acid (5-ALA). OBJECTIVE: To evaluate the cost-effectiveness of 5-ALA fluorescence-guided neurosurgery compared with white-light surgery in adult patients with newly diagnosed high-grade glioma, adopting the perspective of the Portuguese National Health Service. METHODS: We used a Markov model (cohort simulation). Transition probabilities were estimated with the use of data from 1 randomized clinical trial and 1 noninterventional prospective study. Utility values and resource use were obtained from published literature and expert opinion. Unit costs were taken from official Portuguese reimbursement lists (2012 values). The health outcomes considered were quality-adjusted life-years, life-years, and progression-free life-years. Extensive 1-way and probabilistic sensitivity analyses were performed. RESULTS: The incremental cost-effectiveness ratios are below €10 000 in all evaluated outcomes, being around €9100 per quality-adjusted life-year gained, €6700 per life-year gained, and €8800 per progression-free life-year gained. The probability of 5-ALA fluorescence-guided surgery cost-effectiveness at a threshold of €20000 is 96.0% for quality-adjusted life-year, 99.6% for life-year, and 98.8% for progression-free life-year. CONCLUSION: 5-ALA fluorescence-guided surgery appears to be cost-effective in newly diagnosed high-grade gliomas compared with white-light surgery. This example demonstrates cost-effectiveness analyses for malignant glioma surgery to be feasible on the basis of existing data. © 2015 by the Congress of Neurological Surgeons.


Lamy E.,University of Évora | Lamy E.,Higher School of Tourism and Hospitality Studies, Estoril | Lamy E.,University of Aveiro | Mau M.,King's College London
Journal of Proteomics | Year: 2012

Saliva is an extraordinary fluid in terms of research and diagnostic possibilities. Its composition in electrolytes, hormones and especially its proteome contains information about feeding status, nutritional requirements and adaptations to diet and environment, and also about health status of animals. It is easy to collect on a non-invasive and routine basis without any need for special training. Therefore, the analysis of salivary proteomes is going to emerge into a field of high interest with the future goal to maintain and improve livestock productivity and welfare. Moreover, the comprehensive analysis and identification of salivary proteins and peptides in whole and glandular saliva is a necessary pre-requisite to identify animal disease biomarkers and a powerful tool to better understand animal physiology. This review focuses on the different approaches used to study the salivary proteomes of farm animals, in respect to the physiology of nutrition and food perception in relation to food choices. The potential of animal saliva as a source of disease biomarkers will also be pointed out. Special emphasis is laid on the 'ruminating triad' - cattle, goat and sheep - as well as swine as major species of animal production in Western and Southern Europe. This article is part of a Special Issue entitled: Farm animal proteomics. © 2012 Elsevier B.V.


Zarrilli L.,University of Chieti Pescara | Brito M.,Higher School of Tourism and Hospitality Studies, Estoril
Geojournal of Tourism and Geosites | Year: 2013

Tourists recently awarded Lisbon as the best city break destination in Europe. This article analyses the various types of tourist experience in the city of Lisbon. The research method is the questionnaire, aimed at investigating the choices of tourists in the area of mobility, their perception of the quality of life and their level of appreciation of neighbourhoods, landmarks and infrastructures. There is an obvious link between the quality of life and the quality of the tourist experience but it is difficult to measure it. Through this questionnaire, we hope to have made a small contribution to the understanding of the perceptive sphere of the individual and his choices in terms of behaviour, which are an essential element of any strategy for tourism marketing.


Lamy E.,University of Évora | Lamy E.,Higher School of Tourism and Hospitality Studies, Estoril | Da Costa G.,New University of Lisbon | Santos R.,University of Lisbon | And 5 more authors.
Journal of Animal Physiology and Animal Nutrition | Year: 2011

Saliva appears as a defence mechanism, against potential negative effects of tannins, in some species of animals which have to deal with these plant secondary metabolites in their regular diets. This study was carried out to investigate changes in parotid saliva protein profiles of sheep (Ovis aries) and goats (Capra hircus), induced by condensed tannin ingestion. Five Merino sheep and five Serpentina goats were maintained on a quebracho tannin enriched diet for 10 days. Saliva was collected through catheters inserted on parotid ducts and salivary proteins were separated by two-dimensional gel electrophoresis. Matrix-assisted Laser desorption ionization - time of flight (MALDI-TOF) and liquid chromatography tandem mass spectrometry (LC-MS/MS) were used to identify the proteins whose expression levels changed after tannin consumption. Although no new proteins appeared, quebracho tannin consumption increased saliva total protein concentration and produced changes in the proteome of both species. While some proteins were similarly altered in both species parotid salivary protein profile, sheep and goats also presented species-specific differences in response to tannin consumption. © 2010 Blackwell Verlag GmbH.


Machado A.,Higher School of Tourism and Hospitality Studies, Estoril | Andre I.,University of Lisbon
Finisterra | Year: 2012

The socio-territorial innovation of contemporary cities is forged, to a large extent, in its public spaces. It is mainly there that urban creative milieus are produced. This article discusses the urban creativity generated in urban public space, seen as symbolic resource of local identity as well as a place for meeting, debate, confrontation of ideas and practices. The classic metaphor of the door, which should always be open to allow communication and interaction, is of particular significance in the context of the Parisian Marais neighbourhood, where the public space actually seems to have the door opened, ie, to be the essence of creative milieus developed there. We propose a reading of Marais that emphasizes the sociocultural diversity and tolerance as key factors in the production of relational capital and local socioeconomic dynamics. We stress the intense neighbourly relationships, stimulated by the characteristics of public space, by the creative activities that take place in it and by the modes of governance configuring the neighbourhood. We further underline the important role of virtual social networks in empowerment, recognition and cohesion of the local community.


Lamy E.,Higher School of Tourism and Hospitality Studies, Estoril | Lamy E.,University of Évora | Graca G.,ITQB Institute Tecnologia Quimica e Biologica | da Costa G.,ITQB Institute Tecnologia Quimica e Biologica | And 5 more authors.
Proteome Science | Year: 2010

Background: Previous studies suggested that dietary tannin ingestion may induce changes in mouse salivary proteins in addition to the primarily studied proline-rich proteins (PRPs). The aim of the present study was to determine the protein expression changes induced by condensed tannin intake on the fraction of mouse whole salivary proteins that are unable to form insoluble tannin-protein complexes. Two-dimensional polyacrylamide gel electrophoresis protein separation was used, followed by protein identification by mass spectrometry.Results: Fifty-seven protein spots were excised from control group gels, and 21 different proteins were identified. With tannin consumption, the expression levels of one α-amylase isoform and one unidentified protein increased, whereas acidic mammalian chitinase and Muc10 decreased. Additionally, two basic spots that stained pink with Coomassie Brilliant Blue R-250 were newly observed, suggesting that some induced PRPs may remain uncomplexed or form soluble complexes with tannins.Conclusion: This proteomic analysis provides evidence that other salivary proteins, in addition to tannin-precipitating proteins, are affected by tannin ingestion. Changes in the expression levels of the acidic mammalian chitinase precursor and in one of the 14 salivary α-amylase isoforms underscores the need to further investigate their role in tannin ingestion. © 2010 Lamy et al; licensee BioMed Central Ltd.


Almeida I.F.M.,Direccao Geral de Veterinaria | Guerra M.M.,Higher School of Tourism and Hospitality Studies, Estoril | Martins H.M.L.,Inrb Laboratorio Nacional Of Investigacao Veterinaria | Costa J.M.G.,Direccao Geral de Veterinaria | Bernardo F.M.A.,Polo Universitario da Ajuda
Mycotoxin Research | Year: 2013

This paper presents 3 years of data (2009-2011) on the occurrence of two mycotoxins, aflatoxin B1 (AFB1) and zearalenone (ZEA), in samples of feedstuff for dairy cows (n = 963), ewes (n = 42), and goats (n = 131) produced in Portugal. AFB1 was found in 15 samples of cow feed (1.6 %), 3 samples of ewe feed (2.3 %) and in 2 samples of goat feed (4.8 %). All but two samples contained AFB1 at levels below the European Union maximum level (5 μg/kg). Nearly half (45 %) of the samples were contaminated with ZEA, but its levels were relatively low, at 5-136.9 μg/kg, well below the European Union guidance value (500 μg/kg). © 2013 Society for Mycotoxin Research and Springer-Verlag Berlin Heidelberg.


Santos C.M.,University of The Azores | Ambrosio V.,Higher School of Tourism and Hospitality Studies, Estoril | Correia A.,University of Algarve | Peres R.,Higher School of Tourism and Hospitality Studies, Estoril
World Review of Entrepreneurship, Management and Sustainable Development | Year: 2013

The number of tourists visiting tourism destinations during religious festivities have been steadily increasing over the years. They are very important for destinations managers' officers (DMOs) in many places developing aggressive marketing and management strategies targeting religious festivities. Therefore, for destination management purposes it is important to identify the different characteristics of the different types of tourists that attend these festivities and the appropriate marketing strategies used to attract them more efficiently. This paper analyses the segmentation of tourists that attend the Ecce Homo religious festivities (EHF) in the island of S. Miguel, Azores. The island of S. Miguel is one of the nine islands of the Azores, an emergent tourism destination in Portugal. The research findings have some policy implications, particularly those related to the tourists' loyalty, the maximisation of tourism spending in the destination, the decrease in seasonality and the implementation of the right marketing strategies. Copyright © 2013 Inderscience Enterprises Ltd.


Viegas C.A.C.L.,Higher School of Tourism and Hospitality Studies, Estoril | Torgal J.,New University of Lisbon | Graca P.,University of Porto | Martins M.D.R.O.,New University of Lisbon
Revista de Nutricao | Year: 2015

Objective High blood pressure is a major rick factor for cardiovascular disease, and it is closely associated with salt intake. Schools are considered ideal environments to promote health and proper eating habits. Therefore the objective of this study was to evaluate the amount of salt in meals served in school canteens and consumers' perceptions about salt. Methods Meals, including all the components (bread, soup, and main dish) were retrieved from school canteens. Salt was quantified by a portable salt meter. For food perception we constructed a questionnaire that was administered to high school students. Results A total of 798 food samples were analysed. Bread had the highest salt content with a mean of 1.35 g/100 g (SD=0.12). Salt in soups ranged from 0.72 g/100 g to 0.80 g/100 g (p=0.05) and, in main courses, from 0.71 g/100 to 0.97 g/100g (p=0.05). The salt content of school meals is high with a mean value of 2.83 to 3.82 g of salt per meal. Moreover, a high percentage of students consider meals neither salty nor bland, which shows they are used to the intensity/amount of salt consumed. Conclusion The salt content of school meals is high, ranging from 2 to 5 times more than the Recommended Dietary Allowances for children, clearly exceeding the needs for this population, which may pose a health risk. Healthy choices are only possible in environments where such choices are possible. Therefore, salt reduction strategies aimed at the food industry and catering services should be implemented, with children and young people targeted as a major priority.


PubMed | Higher School of Tourism and Hospitality Studies, Estoril
Type: Comparative Study | Journal: Neurosurgery | Year: 2015

High-grade gliomas are aggressive, incurable tumors characterized by extensive diffuse invasion of the normal brain parenchyma. Novel therapies at best prolong survival; their costs are formidable and benefit is marginal. Economic restrictions thus require knowledge of the cost-effectiveness of treatments. Here, we show the cost-effectiveness of enhanced resections in malignant glioma surgery using a well-characterized tool for intraoperative tumor visualization, 5-aminolevulinic acid (5-ALA).To evaluate the cost-effectiveness of 5-ALA fluorescence-guided neurosurgery compared with white-light surgery in adult patients with newly diagnosed high-grade glioma, adopting the perspective of the Portuguese National Health Service.We used a Markov model (cohort simulation). Transition probabilities were estimated with the use of data from 1 randomized clinical trial and 1 noninterventional prospective study. Utility values and resource use were obtained from published literature and expert opinion. Unit costs were taken from official Portuguese reimbursement lists (2012 values). The health outcomes considered were quality-adjusted life-years, life-years, and progression-free life-years. Extensive 1-way and probabilistic sensitivity analyses were performed.The incremental cost-effectiveness ratios are below &OV0556;10000 in all evaluated outcomes, being around &OV0556;9100 per quality-adjusted life-year gained, &OV0556;6700 per life-year gained, and &OV0556;8800 per progression-free life-year gained. The probability of 5-ALA fluorescence-guided surgery cost-effectiveness at a threshold of &OV0556;20000 is 96.0% for quality-adjusted life-year, 99.6% for life-year, and 98.8% for progression-free life-year.5-ALA fluorescence-guided surgery appears to be cost-effective in newly diagnosed high-grade gliomas compared with white-light surgery. This example demonstrates cost-effectiveness analyses for malignant glioma surgery to be feasible on the basis of existing data.

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