University of Cape Verde

Resumen En América Latina nacieron civilizaciones antiguas que han dejado una importante huella en la cultura hispana. En el desarrollo de toda civilización, la “lengua” es un elemento básico y un punto de apoyo importante de la identidad étnica y cultural. Este trabajo explora desde la perspectiva del lenguaje, combinada con la perspectiva de la historia y la antropología, la relevancia del lenguaje en la identidad cultural. Hace un análisis del lenguaje de la cultura “Maya” en México, de su relación con la gestión política y de la evolución de la relación entre la minoría étnica maya y la sociedad hispana mexicana. Se seleccionan tres períodos históricos importantes (siglo XV; 1860–1950; las dos primeras décadas del siglo XXI) para revisar la formación y desarrollo de las respectivas “lenguas indígenas y oficiales” de las dos culturas, así se deja en claro el papel dilemático de la lengua en la identidad étnica y cultural.

Background The evaluation of health services and care is an important tool to define health policies. This study aimed at assessing user satisfaction with healthcare services, provided by public and private health facilities in Cape Verde. It was also our objective to analyze the sensitivity of satisfaction scores in relation to the respondent’s sex. Methods A cross-sectional, with a quantitative approach, was conducted. The study included individuals aged over 18 years. Participants were visiting a health facility at the time of the interview. All subjects signed an informed consent. Data were collected using a standardized self-administered questionnaire. Descriptive and inferential statistical analyses were performed using SPSS software, version 29. Results A total of 3,445 subjects took part in the study, 72% were women. The 25–45 age group accounted for 55.1% of the participants, 71.1% of whom declared themselves single. In general terms, women always gave higher satisfaction values. Specifically, in relation to age, those between 25 and 35 years old, single and with secondary education were more satisfied with professionals, access and social action and support, especially in private care. Those who were 45 years old or older better evaluate the care process. Previous consultation experience had a positive effect on women’s satisfaction with professionals, facilities, access, social action and support and care process. On the contrary, the same areas of analysis, in hospitalization, were better evaluated by women without any previous experience. On the other hand, married or living together men were more satisfied with facilities and administrative services, and these services, as well as access, were better evaluated by those with less education. Men were also the most satisfied with the accessibility and costs on health centers, as well as hospital facilities. With regard to facilities and accessibility, the highest levels of satisfaction were found on the islands of Fogo and São Vicente. The highest level of dissatisfaction was found on the island of São Nicolau (facilities, access and social action and support), followed by the island of Sal (professionals and care process) and the island of Fogo (accessibility and administrative services). Conclusions Our study suggests that the quality of healthcare services can be significantly improved, especially regarding access and accessibility to healthcare, drug policy and recruitment of qualified professionals.

The paper presents the most comprehensive and large-scale global study to date on how higher education students perceived the use of ChatGPT in early 2024. With a sample of 23,218 students from 109 countries and territories, the study reveals that students primarily used ChatGPT for brainstorming, summarizing texts, and finding research articles, with a few using it for professional and creative writing. They found it useful for simplifying complex information and summarizing content, but less reliable for providing information and supporting classroom learning, though some considered its information clearer than that from peers and teachers. Moreover, students agreed on the need for AI regulations at all levels due to concerns about ChatGPT promoting cheating, plagiarism, and social isolation. However, they believed ChatGPT could potentially enhance their access to knowledge and improve their learning experience, study efficiency, and chances of achieving good grades. While ChatGPT was perceived as effective in potentially improving AI literacy, digital communication, and content creation skills, it was less useful for interpersonal communication, decision-making, numeracy, native language proficiency, and the development of critical thinking skills. Students also felt that ChatGPT would boost demand for AI-related skills and facilitate remote work without significantly impacting unemployment. Emotionally, students mostly felt positive using ChatGPT, with curiosity and calmness being the most common emotions. Further examinations reveal variations in students’ perceptions across different socio-demographic and geographic factors, with key factors influencing students’ use of ChatGPT also being identified. Higher education institutions’ managers and teachers may benefit from these findings while formulating the curricula and instructions/regulations for ChatGPT use, as well as when designing the teaching methods and assessment tools. Moreover, policymakers may also consider the findings when formulating strategies for secondary and higher education system development, especially in light of changing labor market needs and related digital skills development.

Mid-life represents a pivotal period marked by profound physiological and metabolic transitions, increasing susceptibility to chronic diseases. This review explores the molecular and systemic underpinnings of mid-life transition by integrating insights from recent studies that elucidate aging-associated changes in the plasma proteome, immune system, adipose tissue remodeling, and cellular senescence. Nonlinear waves of proteomic alterations have been identified as critical mid-life transitions in inflammatory and hormonal pathways. In addition, sex-specific immune aging trajectories have linked adaptive immunity decline and innate immune activation to metabolic vulnerabilities in mid-life. Moreover, adipose tissue’s central role has been established in mid-life transitions as its early remodeling and inflammatory cytokine secretion drive the systemic aging and metabolic stress. Furthermore, Glb1-2A-mCherry reporter has been introduced to monitor systemic aging, identifying mid-life as a crucial phase for cardiac hypertrophy and senescence-induced inflammation. Collectively, these findings have established our understanding of mid-life transitions, underscoring the interplay between aging processes and metabolic health, with mid-life emerging as a critical window for intervention. This review also underscores biomarkers and therapeutic strategies to alleviate the metabolic challenges of mid-life, thereby promoting healthy aging.

Objective The objective of this review will be to evaluate the effect of prior aspiration versus non-aspiration during intramuscular injection on the occurrence of adverse effects in adult patients. Introduction Aspiration is a procedure conducted prior to the administration of intramuscular medications that aims to ensure that the needle tip is inserted in the proper place. Although aspiration is a common procedure, questions have been raised about adverse effects. Inclusion criteria This review will consider experimental and observational studies that include or evaluate the occurrence of any adverse effects following intramuscular injection, either with or without prior syringe aspiration, in adult patients. Adverse effects will include local pain, induration, puncture of blood vessels, decreased drug effect, hematoma, or abscess. The review will exclude studies on venipuncture, aspiration biopsies, or other invasive punctures of a diagnostic nature. Methods This review will be conducted in accordance with the JBI methodology for systematic reviews of effectiveness. Databases to be searched will include MEDLINE, Embase, CINAHL, Scopus, LILACS, and Web of Science, as well as sources of unpublished/gray literature, with no date or language limitations. Two independent reviewers will conduct study selection, critical appraisal, and data extraction. Studies will, where possible, be pooled in a statistical meta-analysis using the JBI System for the Unified Management, Assessment and Review of Information (SUMARI). The grading of the certainty of evidence will be determined using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach. Systematic review registration number PROSPERO CRD42021270432.

Cancer pain is a highly prevalent problem and one of the most distressing symptoms in cancer patients. The management of cancer pain is one of the most significant challenges in the care of these patients. Cancer pain must be treated quickly and effectively as it affects the quality of life and reduces the patient’s life expectancy. Major opioids are recognized by the World Health Organization (WHO) as first-line treatment for moderate to severe cancer pain, but their use is often hampered by individual variations, comorbidities, and complications associated with cancer. Since the simultaneous use of two major opioids has become frequent, a narrative review was conducted, whose main objectives were to evaluate whether the combination of two major opioids improves pain and quality of life in cancer patients, considering their pharmacodynamic and pharmacokinetic properties and evaluate the impact of this combination on the frequency and intensity of side effects. The search for information was carried out in evidence-based medicine databases, namely PubMed/MEDLINE, Cochrane Library, Database of Abstracts of Reviews of Effects, National Guideline Clearinghouse, NHS Evidence and Index das Revistas Médicas Portuguesas using the MeSH terms “opioids” and “quality of life”. Articles and documents published between 1 January 2010 and 1 June 2023, in English, Portuguese and Spanish, were considered, including original articles, meta-analyses, systematic reviews and clinical guidelines. A total of 342 articles were retrieved and of these, only 13 were selected for full reading. The combination of opioids is based on the principle that different opioids act through different mechanisms, which can reduce dose-related adverse effects. Simultaneous use of two major opioids may allow for more modest increases in the equivalent dose of the second opioid, providing better pain control and reduced side effects such as nausea, vomiting, and constipation. More studies on the combination of opioids are needed to improve cancer pain treatment. The lack of personalized therapies limits the effectiveness of opioids, and variability in treatment responses requires individualized approaches. Personalized medicine, based on pharmacogenomics, is one of the most promising strategies to optimize pain relief and reduce adverse effects.

The high genetic variability of HIV-1 and the emergence of transmitted drug resistance (TDR) can impact treatment efficacy. In this study, we investigated the prevalent HIV-1 genotypes and drug-resistance-associated mutations in drug-naïve HIV-1 individuals in Cabo Verde. The study, conducted between 2018 and 2019, included drug-naïve HIV-1 individuals from the São Vicente, Boa Vista, Fogo, and Santiago islands. The HIV-1 pol gene was sequenced using Sanger sequencing. TDR was identified using the Stanford Calibrated Population Resistance tool, and resistance levels to different drugs were interpreted with the Stanford HIV database. The genetic diversity of HIV-1 was determined through phylogenetic analysis, and epidemiological and behavioural data were collected via questionnaires. Of the 73 participants, the majority were male (52.1%). The CRF02_AG recombinant form predominated (41.1%), followed by subtype G (37.0%). The overall prevalence of TDR was 9.6%. Nucleoside Reverse Transcriptase Inhibitor (NRTI) mutations occurred in 2.7% of individuals, while Non-Nucleoside Reverse Transcriptase Inhibitor (NNRTI) mutations occurred in 9.6%. The most prevalent mutations were K103N (5.5%) and M184V (2.7%). No protease- or integrase-associated mutations were found. The high levels of resistance to NNRTIs found demonstrate the need for surveillance of resistance mutations to ensure the efficacy and durability of the current therapeutic regimen, which includes Dolutegravir.

Introduction: Uncontrolled symptoms are widely recognized as one of the main challenges in oncology palliative care patients. The central aim of palliative care is to improve the patient's quality of life. In recent years, there has been a growing use of patient-reported outcome measures in palliative care, particularly to evaluate symptoms, quality of care, and well-being. Aim: To evaluate the sociodemographic and clinical profile, symptom distress, and perceived quality of life in oncology palliative care patients admitted to a specialized palliative care unit in Portugal. Methods: This study was cross-sectional, descriptive, and correlational, carried out in the inpatient setting of the palliative care unit at a tertiary oncology hospital (at admission). The evaluated protocol included a sociodemographic and clinical questionnaire, as well as two measurement instruments: the Edmonton Symptom Assessment Scale (ESAS) and the Palliative Care Outcome Scale (POS), both filled out by the patients. Data analysis was conducted using IBM SPSS ® Statistics version 25.0, with a significance level set at 5% (p < 0.05). Results: The majority of participants in this sample were male (61.7%), with a mean age of around 72 years. More than half of the patients admitted (n = 34; 56.7%) were being monitored in outpatient care. Digestive and head and neck cancers were the most commonly found in the sample (41.7% and 20%, respectively). A significant correlation was found between high symptom intensity and poorer quality of life and care (p < 0.01). This association was particularly pronounced for symptoms such as pain, weakness, depression, anxiety, and anorexia. Conclusions: This study revealed a positive correlation between overall symptom severity and a perceived deterioration in quality of life, well-being, and quality of care. Future studies should consider utilizing alternative assessment tools for evaluating symptoms and quality of care. Additionally, including non-cancer palliative patients in similar studies may provide further valuable insights.

In this present paper, we concern an extension of some results of the calculus of variations to the theory of pseudo-operators. We prove the Euler-Lagrange equations, the D’Alembert principle in differential form, and Noether’s theorem. In this sense, comments and some examples regarding the problems of the calculus of variations conclude the paper.

The European Union-China-Africa trilogue unveils challenges and opportunities for the convergence of investment strategies to reposition Africa as a leader in future trilogues. The EU faces criticism for its failure to lead Africa's development in the political, economic, and humanitarian cooperation scenario, as well as in conflict prevention and the fight against illegal immigration and organized crime. Several voices have criticized the EU for poor vision, courage, and competence. They defend the design of a common strategy for cooperation with Africa and the commitment to empowering democratic frameworks whilst aligning core values such as transparency and participation of all actors, citizens, and politicians. It is also worth noting the enormous difficulties that African countries have in attracting FDI, stemming from issues such as political instability, inadequate infrastructure, and limited access to capital markets. China gains an advantage in this line of thought because it resorts to preferential cooperation and development aid strategies. Despite the ongoing economic crisis resulting from the Covid-19 pandemic impacting China's financial commitments to major projects in Africa through the BRI, as Chinese resources are redirected towards combating the Coronavirus domestically, this scenario could create an opening for the European Union to assume a more prominent role in Africa's short- and medium-term economic development. This study signifies to answer the following question: How can the convergence of China's and the EU's strategies in Africa reposition the African continent in future trilogues? It is believed that the EU, China, and Africa's know-how and field experience can materialize into closer political relations with Africa as long as a progressive free trade zone is established, thus nurturing and strengthening the prospects of economic and financial cooperation and fostering regional cooperation.

Na atual configuração cultural, política e económica mundial, é largamente conhecido o debate em torno de temáticas que abarcam a “Educação” ou o “Desenvolvimento inclusivo”. Tanto no campo da investigação pura quanto no da investigação aplicada, ou simplesmente na prática quotidiana da educação (família, escola, sociedade), questões têm sido levantadas visando entender o alcance que as expressões “Educação” e “Desenvolvimento inclusivo” têm atingido. Se parece haver um consenso alargado sobre a importância da educação e das línguas num mundo cada vez mais globalizado, a dimensão que elas cobrem já nem sempre merece acordo generalizado. Em Cabo Verde, a “Educação” assumiu, desde os primórdios da formação da sociedade crioula, um papel decisivo na história do povo cabo-verdiano, surgindo como uma alavanca para potencializar o recurso até hoje apontado como o mais valioso – os recursos humanos. A situação da língua em Cabo Verde, até hoje, suscita acesos debates, prova de que ainda há um longo caminho a percorrer até se chegar a um consenso sobre qual será a melhor via a escolher. Nesta comunicação, apoiando-me na evolução do conceito de “Educação” e na discussão da situação linguística do país, procurarei discutir os possíveis caminhos para se alcançar o “Desenvolvimento inclusivo”.

Background: We tested whether providing BCG vaccine to healthcare workers (HCWs) could reduce non-planned absenteeism and thereby reduce the potential impact of the COVID-19 pandemic on healthcare systems in Africa. Methods: We conducted a multicenter, single-blinded, placebo-controlled randomized trial in Guinea-Bissau and Mozambique between December 2020 and June 2022. Participants were randomized 1:1 to BCG vaccine or placebo (saline) and followed by biweekly telephone calls for 6 mo. The incidence of unplanned absenteeism due to illness was analyzed using Bayesian negative binomial regression yielding relative RRs. Secondary outcomes included infectious disease episodes, COVID-19 infection and all-cause hospitalizations. Results: We enrolled 668 HCWs (Guinea-Bissau, n=503; Mozambique, n=165). The RR for absenteeism of BCG vs placebo was 1.29 (0.81 to 1.94) with comparable effects by country. No protection against infectious disease episodes (HR=1.18 [0.97 to 1.45]) or COVID-19 infection (HR=1.19 [0.80 to 1.75]) was observed. Two trial deaths (1 BCG, 1 control) were registered and nine admissions (3 BCG, 6 control), the all-cause admission HR being 0.51 (0.13 to 2.03). Conclusions: With 64% of the planned sample size and unplanned absenteeism rates lower than expected, BCG did not reduce self-reported absenteeism due to illness. Rather, BCG tended to increase the risk of self-reported absenteeism, infectious disease episodes and COVID-19 infections. Short summary: This was a randomized control trial assessing non-specific effects of BCG vaccination in healthcare workers. There was no beneficial effect on self-reported absenteeism due to illness within 6 mo of follow-up during the COVID-19 pandemic, but a trend towards fewer all-cause hospital admissions.

Despite the high global impacts of canine vector-borne diseases (CVBD) due to their wide distribution and zoonotic potential, the current epidemiological situation of CVBD in many tropical and subtropical regions remains unknown. This study examines the seroprevalence and molecular prevalence of Ehrlichia canis and other pathogens causing CVBDs (Leishmania infantum, Dirofilaria immitis, Babesia spp., Anaplasma spp. and Hepatozoon canis) in dogs living on the island of Boa Vista (Cape Verde Republic). Blood samples and infesting ticks were taken from 150 dogs across the island (stray, shelter, and pet dogs). Serum samples were tested using a rapid immunochromatographic test (Uranotest® Quattro) that detects antibodies against E. canis, L. infantum, Anaplasma spp. and D. immitis antigen. Levels of serum antibodies against E. canis were measured using the immunofluorescence antibody test (IFAT). In addition, tick-borne pathogens in blood samples (Anaplasma spp., Babesia spp., Hepatozoon spp., and Ehrlichia canis) were detected by microscopy observation and/or PCR plus sequencing. The seroprevalence of E. canis was extremely high at 82% (123/150), as revealed by both immunochromatography and IFAT. Most dogs returning a seropositive test result (82.92%; 102/123) had antibody titres > 1:1280 but showed no clinical signs or notable laboratory abnormalities. Of the 123 animals testing seropositive for E. canis, 67 (54.47%) also presented antibodies against Anaplasma spp., and 13 (10.56%) showed the presence of Hepatozoon spp. gamonts in the blood smear. Ehrlichia canis infection was detected in 17.1% (25/146) of dogs tested by direct sequencing of polymerase chain reaction (PCR) products. Co-infections were detected in seven of these dogs: four dogs tested PCR-positive for both E. canis and A. platys, two dogs tested positive for E. canis and Hepatozoon spp., and one dog tested positive for E. canis, A. platys and Hepatozoon spp. Rhipicephalus sanguineus sensu lato was the only tick species found infesting the canine study population. The high prevalence of tick-borne pathogens detected in dogs from Boa Vista Island highlights a need for improved control measures designed to prevent the transmission of these pathogens. Graphical Abstract

Background HIV-1 infections remain a global public health concern. Scaled-up antiretroviral treatment (ART) is crucial for reducing morbidity and mortality related to HIV/AIDS. The emergence of drug-resistance mutations (DRMs) compromises viral suppression and contributes to the continued HIV-1 transmission. Several reports indicate a recent increase in acquired (ADR) and transmitted (TDR) drug resistance in Africa, probably linked to the lack of implementation of HIV drug resistance (HIVDR) testing and suboptimal treatment adherence. Herein, we will develop a low-cost protocol using third-generation sequencing (Oxford Nanopore Technology) for HIV-1 surveillance in Portuguese-speaking African Countries - PALOP [Angola (AO), Cape Verde (CV), Mozambique (MZ), and Sao Tome & Principe (STP)]. Methods This is a multicentric cross-sectional study that includes around 600 adult patients newly diagnosed with HIV-1 in the PALOP. An epidemiological questionnaire previously validated by our research team will be used to collect sociodemographic and clinical data. Also, whole blood samples will be collected and the plasma samples will be subjected to drug resistance testing using an in-house low-cost NGS protocol. Data analysis will involve bioinformatics, biostatistics and machine learning techniques to generate accurate and up-to-date information about HIV-1 genetic diversity, ADR and TDR. Discussion The implementation of this low-cost NGS platform for HIV-1 surveillance in the PALOP will allow: (i) to increase DRM surveillance capacity in resource-limited settings; (ii) to understand the pattern and determinants of dissemination of resistant HIV-1 strains; and (iii) to promote the development of technical and scientific skills of African researchers for genomic surveillance of viral pathogens and bioinformatics analysis. These objectives will contribute to reinforcing the capacity to combat HIV infection in Africa by optimizing the selection of ART regimens, improving viral suppression, and reducing ADR or TDR prevalence in PALOPs, with relevant implications for public health.

This work considers the existence of solutions of the heteroclinic type in nonlinear second-order differential equations with ϕ-Laplacians, incorporating generalized impulsive conditions on the real line. For the construction of the results, it was only imposed that ϕ be a homeomorphism, using Schauder’s fixed-point theorem, coupled with concepts of L1-Carathéodory sequences and functions along with impulsive points equiconvergence and equiconvergence at infinity. Finally, a practical part illustrates the main theorem and a possible application to bird population growth.

Sickle cell anemia (SCA) results from a mutation in the β-globin gene, leading to the production of mutant hemoglobin, known as hemoglobin S (HbS). Despite being a genetic disorder, the phenotype of SCA can be influenced by the level of fetal hemoglobin (HbF), which is associated with beta S-globin haplotypes. In this study, we conducted newborn screening (NBS) using samples collected from umbilical cord blood in two hospitals on Santiago Island, Cape Verde. In newborns, HbS was detected using high-performance liquid chromatography (HPLC) on dried blood spot, with confirmation through polymerase chain reaction (PCR) and restriction fragment length polymorphism (RFLP). In addition, we assessed the hematological and clinical characteristics of a second population group consisting of patients diagnosed with SCA. Haplotype determination was performed on both newborns with HbS and patients with SCA. Beta S-globin haplotypes were determined using PCR-RFLP. Hematological values were analyzed using standard methods. Out of 346 newborns, 21 (6%) were carriers of the sickle cell trait (HbAS) while none were identified as homozygous for sickle cell disease (HbSS). Among both groups of individuals, four haplotypes were identified: Senegal, Arabi-Indian, Bantu, and Benin. The Senegal haplotype was the most prevalent, possibly reflecting the ethnic origin of the mutations observed. Hematological values did not differ significantly among haplotypes. However, higher levels of HbF were associated with better hematological values. These findings suggest a positive impact of elevated HbF levels on reducing the severity of SCA. Finally, we demonstrated how the combination of technics, HPLC and molecular analysis, provided a consistent and reproducible results that can be used for NBS for SCA.