Reversion mutations in phosphoprotein P of a codon-pair-deoptimized human respiratory syncytial virus confer increased transcription, immunogenicity, and genetic stability without loss of attenuation

Recoding viral genomes by introducing numerous synonymous nucleotide substitutions that create suboptimal codon pairs provides new live-attenuated vaccine candidates. Because recoding typically involves a large number of nucleotide substitutions, the risk of de-attenuation is presumed to be low. However, this has not been thoroughly studied. We previously generated human respiratory syncytial virus (RSV) in which the NS1, NS2, N, P, M and SH ORFs were codon-pair deoptimized (CPD) by 695 synonymous nucleotide changes (Min A virus). Min A exhibited a global reduction in transcription and protein synthesis, was restricted for replication in vitro and in vivo, and exhibited moderate temperature sensitivity. Here, we show that under selective pressure by serial passage at progressively increasing temperatures, Min A regained replication fitness and lost its temperature sensitivity. Whole-genome deep sequencing identified numerous missense mutations in several genes, in particular ones accumulating between codons 25 and 34 of the phosphoprotein (P), a polymerase cofactor and chaperone. When re-introduced into Min A, these P mutations restored viral transcription to wt level, resulting in increased protein expression and RNA replication. Molecular dynamic simulations suggested that these P mutations increased the flexibility of the N-terminal domain of P, which might facilitate its interaction with the nucleoprotein N, and increase the functional efficiency of the RSV transcription/replication complex. Finally, we evaluated the effect of the P mutations on Min A replication and immunogenicity in hamsters. Mutation P[F28V] paradoxically reduced Min A replication but not its immunogenicity. The further addition of one missense mutation each in M and L generated a version of Min A with increased genetic stability. Thus, this study provides further insight into the adaptability of large-scale recoded RNA viruses under selective pressure and identified an improved CPD RSV vaccine candidate.

Synonymous recoding of viral genomes by codon-pair deoptimization (CPD) generates live-attenuated vaccines presumed to be genetically stable due to the high number of nucleotide substitutions. However, their actual genetic stability under selective pressure was largely unknown. In a recoded human respiratory syncytial virus (RSV) mutant called Min A, six of 11 ORFs were CPD, reducing protein expression and inducing moderate temperature sensitivity and attenuation. When passaged in vitro under selective pressure, Min A lost its temperature-sensitive phenotype and regained fitness by the acquisition of numerous mutations, in particular missense mutations in the viral phosphoprotein (P), a polymerase cofactor and a chaperone for soluble nucleoprotein. These P mutations increased RSV gene transcription globally, thereby increasing RSV protein expression, RNA replication, and virus particle production. Thus, the P mutations increased the efficiency of the RSV transcription/replication complex, compensating for the reduced protein expression due to CPD. In addition, introduction of the P mutations into Min A generated a live-attenuated vaccine candidate with increased genetic stability. Surprisingly, this vaccine candidate exhibited increased attenuation and, paradoxically, exhibited increased immunogenicity per plaque-forming unit in hamsters. This study provides insights into the adaptability of large-scale recoded RNA viruses and identified an improved CPD RSV vaccine candidate.

A single intranasal dose of a live-attenuated parainfluenza virus-vectored SARS-CoV-2 vaccine is protective in hamsters

Single-dose vaccines with the ability to restrict SARS-CoV-2 replication in the respiratory tract are needed for all age groups, aiding efforts toward control of COVID-19. We developed a live intranasal vector vaccine for infants and children against COVID-19 based on replication-competent chimeric bovine/human parainfluenza virus type 3 (B/HPIV3) that express the native (S) or prefusion-stabilized (S-2P) SARS-CoV-2 S spike protein, the major protective and neutralization antigen of SARS-CoV-2. B/HPIV3/S and B/HPIV3/S-2P replicated as efficiently as B/HPIV3 in vitro and stably expressed SARS-CoV-2 S. Prefusion stabilization increased S expression by B/HPIV3 in vitro. In hamsters, a single intranasal dose of B/HPIV3/S-2P induced significantly higher titers compared to B/HPIV3/S of serum SARS-CoV-2-neutralizing antibodies (12-fold higher), serum IgA and IgG to SARS-CoV-2 S protein (5-fold and 13-fold), and IgG to the receptor binding domain (10-fold). Antibodies exhibited broad neutralizing activity against SARS-CoV-2 of lineages A, B.1.1.7, and B.1.351. Four weeks after immunization, hamsters were challenged intranasally with 104.5 50% tissue-culture infectious-dose (TCID50) of SARS-CoV-2. In B/HPIV3 empty vector-immunized hamsters, SARS-CoV-2 replicated to mean titers of 106.6 TCID50/g in lungs and 107 TCID50/g in nasal tissues and induced moderate weight loss. In B/HPIV3/S-immunized hamsters, SARS-CoV-2 challenge virus was reduced 20-fold in nasal tissues and undetectable in lungs. In B/HPIV3/S-2P-immunized hamsters, infectious challenge virus was undetectable in nasal tissues and lungs; B/HPIV3/S and B/HPIV3/S-2P completely protected against weight loss after SARS-CoV-2 challenge. B/HPIV3/S-2P is a promising vaccine candidate to protect infants and young children against HPIV3 and SARS-CoV-2.

The composition of the lipid, protein and mineral fractions of quail breast meat obtained from wild and farmed specimens of Common quail (Coturnix coturnix) and farmed Japanese quail (Coturnix japonica domestica)

The present study was intended to answer 2 scientific hypotheses: 1) the quail species has a significant influence in quail breast meat composition; 2) the wild quail's meat presents healthier composition than their farmed counterparts.

An analysis of the pectoral muscles of wild and captive common quails (Coturnix coturnix) and domestic quails (Coturnix japonica domestica) was performed. The content of fatty acids (FA), amino acids, total cholesterol, and vitamin E, some basic macro- and microminerals in the pectoral muscles of the 2 species of the genus Coturnix were analyzed.

Regarding the quail species influence on meat composition, Japanese Quail (JQ) revealed better lipid composition, characterized by lower saturated FA (SFA; less 3.17 g/100 g of total fatty acids), higher polyunsaturated FA contents (PUFA; more 5.5 g/100 g of total fatty acids) and healthier polyunsaturated FA/saturated FA (P/S) and n-6/n-3 ratios and TI value (1.08, 9.54 and 0.60 vs. 0.76, 12.58, and 0.75, correspondingly). The absence of differences observed on amino acids partial sums and ratios reveals equality between species on protein nutritional quality. On the other hand, Common Quail (CQ) proved to be a better source of copper (0.181 mg/100 g of meat), iron (2.757 mg/100 g of meat), manganese (0.020 mg/100 g of meat), and zinc (0.093 mg/100 g of meat) than JQ.

The comparison of farmed and wild specimens within CQ, showed that wild birds presented lower total cholesterol (less 8.32 mg/g of fresh meat) and total PUFA (less 4.26 g/100 g of total fatty acids), and higher n-3 PUFA contents (more 1.53 g/100 g of total fatty acids), which contributed to healthier P/S and n-6/n-3 ratios, but worst PI (1.60, 8.08, and 113.1 vs. 0.76, 12.58, and 100.8, respectively). The wild species revealed higher α-tocopherol content (2.40 vs. 1.49 µg/g of fresh meat. Differences observed on their mineral composition counterbalance each other.

Under intensive production system and similar feeding and management conditions, the CQ develops better nutritional qualities than JQ. The comparison of wild and farmed species within CQ reveals more similarities than differences. Quail´s meat presents good nutritional quality and introduces variability to human's diet, which is much valued by consumers.

Influence of past infection with SARS-CoV-2 on the response to the BNT162b2 mRNA vaccine in health care workers: Kinetics and durability of the humoral immune response

BACKGROUND

SARS-CoV-2 vaccines are an invaluable resource against COVID-19. Current vaccine shortage makes it necessary to prioritize distribution to the most appropriate segments of the population.

METHODS

This is a prospective cohort study of 63 health care workers (HCWs) from a General Hospital. We compared antibody responses to two doses of BNT162b2 mRNA COVID-19 vaccine between HCWs with previous SARS-CoV-2 infection (experienced HCWs) and HCWs without previous infection (naïve HCWs).

FINDINGS

Seven days after the first vaccine dose, HCWs with previous infection experienced a 126-fold increase in antibody levels (p<0·001). However, in the HCW naïve group, response was much lower and only five showed positive antibody levels (>50 AU). After the second dose, no significant increase in antibody levels was found in experienced HCWs, whereas in naïve HCWs, levels increased by 16-fold (p<0·001). Approximately two months post-vaccination, antibody levels were much lower in naïve HCWs compared to experienced HCWs (p<0·001).

INTERPRETATION

The study shows that at least ten months post-COVID-19 infection, the immune system is still capable of producing a rapid and powerful secondary antibody response following one single vaccine dose. Additionally, we found no further improvement in antibody response to the second dose in COVID-19 experienced HCWs. Nonetheless, two months later, antibody levels were still higher for experienced HCWs. These data suggest that immune memory persists in recovered individuals; therefore, the second dose of the COVID-19 vaccine in this group could be postponed until immunization of the remaining population is complete.

Rehabilitation after proximal interphalangeal joint replacement: A structured review of the literature

Proximal interphalangeal (PIP) joint arthroplasty is an unsolved biomechanical challenge despite advances in materials and new implant designs. This leads to a high rate of complications. Moreover, there is heterogeneity in postoperative management according to the literature. The present structured review examined the therapeutic strategies utilized by physiotherapists to restore a functional finger chain and prevent postoperative complications following PIP joint replacement. Patients undergoing primary total PIP joint arthroplasty of the index, ring, middle or little finger were included. Articles published from 2008 onwards, in French or English, and reporting on PIP joint replacement and postoperative management, were included. Therapeutic strategies were organized according to the surgical approach. Details of splint strategies, mobilization and muscle strengthening and management of postoperative complications were collected. Forty-eight studies, 3 of which provided a description of surgical techniques, were included. In relation to hand function, most authors advocated joint mobilization (n = 45) and some recommended muscle strengthening (n = 4). Static (n = 43) and dynamic splints (n = 14) and buddy taping (n = 12) were frequently recommended to prevent and manage postoperative complications. Few studies (n = 13) reported wound assessment or control of postoperative edema. Precise recommendations concerning therapeutic strategies following PIP joint arthroplasty cannot be made based on available evidence. Specific protocols for rehabilitation following PIP joint replacement need to be clarified in future research.

The practice of sedation in palliative care for oncologic patients: Fantasies reported by a nursing team in a specialized hospital in Brazil: A qualitative study

Introduction

CONTEXTUALIZATION: Palliative sedation is a resource used to control symptoms of terminal patients in general. It is considered that it should be discussed by the professionals involved in the process, based on the competence of each one, as well as with family members and patients when possible.

Objectives

AIM: To understand symbolic meanings attributed by nursing professionals who provide assistance to the terminal patient regarding to the act of the palliative sedation.

Methods

Strategies: Clinical-qualitative design, semi-directed interview of open questions in depth. Nine oncologist nurses participated in the study; sample closed by the criterion of theoretical information saturation. Interviews were audio recorded, transcribed fully, categorized by qualitative content analysis. The results were discussed by colleagues of the Laboratory of Clinical Qualitative Research at the University of Campinas.

Results

FINDINGS: The treatment of the data led to 6 emerging categories: (1) death maintains its ambivalent values in our culture; (2) serving the death symbolically on a tray; (3) the act of sedation and its “unfortunate coincidences”; (4) palliative sedation: agent of a pious death; (5) late sedation: cause for distress to the professional; (6) the professional’s self-comfort considering certain psychological strength from the patient and family.

Conclusions

Final considerations: palliative sedation takes a general and individual meanings for the professional and even in case of experienced professionals regard to palliative sedation, the death phenomenon conduct them to expresses multiple and peculiar emotional issues, not ever perceveid.

Disclosure

No significant relationships.

Implementation of balint group for a team who care patients with head and neck cancer in a service in Brazil: A proposal post qualitative research

Introduction

The Balint group emerged at the Tavistock Clinic in London in the early 1950s. Its creator was a doctor and psychoanalyst Michael Balint. It consisted of a group process, with meetings among general practitioners, in which non-conscious aspects of the professional-patient relationship were approached. We present how a proposal for implementation of a Balint Group has emerged, specifically for physicians and nurses who care for cancer patients. Is is a consequence of results obtained from a qualitative study conducted by a student of the professional master’s degree linked to a Clinical Oncology.

Objectives

To present a technical product, as required in a Brazilian professional master’s degree, as a result of research that studied reports of doctors and nurses who deal with usual difficulties of handling patients with HNC.

Methods

The group work is triggered by the report of a case brought by a participant, presenting a problem-situation in the management of his patient. The meeting leader seeks to understand the reactions reported by the presenter in the light of a psychodynamic approach.

Results

Expected results: the holding of a Balint group, perhaps monthly, in charge of a colleague who has knowledge in applied psychoanalysis, will allow insights to the participants who will bring them conditions to perceive “neurotic elements” in the relationship with their patient.

Conclusions

Final consideration: having accumulated decades of positive experience, Balint Groups must remain as an updated proposal for the work on emotional issues of professional teams, with emphasis on clinical services with the management of so-called “difficult patients”.

Disclosure

No significant relationships.

Why does transcultural consultation matter?

Introduction

Psychiatrists should be aware of the new challenges and needs that globalization poses.

Objectives

To highlight the need for a culturally sensitive approach to mental health.

Methods

Non-systematic review of “cultural consultation” on PubMed.

Results

Most people assume a direct connection between pathophysiology and clinical symptoms. However, evidence shows that the translation of pathophysiology and psychopathology into specific symptoms is mediated by cognitive processes and social interactions, which reflect models/practices specific to our culture. Patients focus on specific aspects of being sick, reinforced by cultural narratives or to fit expectations. Thus, people from different cultural backgrounds might have trouble communicating; cultural idioms of distress can be misinterpreted. The role of structural violence bestowed upon cultural minorities, which leads to discrimination and social exclusion, has extensively been studied as a risk factor for mental illness. Furthermore, ignoring cultural differences and diversity has been shown to contribute to healthcare disparities, hampering access to care and diminishing the quality of care received. In Canada, the Cultural Consultation Model provides cultural expertise, either by evaluating patients (preferably accompanied by the referring doctor, a translator and cultural mediator) for 1-3 sessions, providing recommendations to the referring doctor; or providing consulting to a referring doctor or organisation, through general guidance or discussion of specific cases.

Conclusions

In an evergrowing globalization process, we will inevitably have more contact with patients from culturally distinct backgrounds. To provide the best care, we must be aware of the ways in which culture can shape symptom expression, and take into account cultural explanations and preferences.

Disclosure

No significant relationships.

Dementia and suicide: What relationship to establish and what risks to consider?

Introduction

Given the marked population aging in the world, the incidence of dementia has significantly increased, becoming a growing health care problem. Suicide is a considerable health issue throughout the life span, being prevalent in older adults, and in many countries the highest suicide rates are found in the elderly. Thus far, the relationship between dementia and suicide remains poorly understood and inconsistent.

Objectives

The aim of this study is to do a non-systematic review of the current literature regarding the association between suicide risk and dementia.

Methods

We conducted a research using the Medline database, through the Pubmed search engine, using the following key-words: “dementia”, “suicide” and “risk factors”.

Results

Overall, the risk of suicide in people with dementia appears to be the same as that of age-matched general population. However, studies point to the existence of a number of factors that can increase this risk, such as: early age of dementia diagnosis, recent diagnosis, disease awareness and depression, hopelessness, male gender, failure to respond to anti-dementia medication, history of inpatient psychiatric hospitalizations, concurrent medical comorbidities.

Conclusions

Studies have reported mixed results as to whether dementia itself is an independent risk factor for suicide. Despite these findings, understanding the risk factors for suicide among people with dementia is crucial and suicide prevention efforts should be carried out in this population.

What is the best approach for patients with prolonged duration of untreated psychosis (DUP) - about 2 clinical cases with dup longer than 10 years

Introduction

Studies have consistently found that many individuals with psychosis experience significant delays before receiving treatment. DUP refers to the period between the emergence of psychotic symptoms and the initiation of appropriate clinical treatment.

Objectives

To review current knowledge on the best approach for patients with schizophrenia (SCZ) and prolonged DUP.

Methods

Non-systematic review of literature through search on PubMed database, following the terms “DUP and treatment” and “impact of longer DUP”. Two clinical cases are described.

Results

The clinical cases describe patients with SCZ with DUPs older than 10 years, in whom we could not achieve complete clinical remission after several therapeutic trials and whose prognosis was admitted as reserved. Longer DUP is an independent predictor of poorer outcome in SCZ, including the poor response to treatment and difficulty in achieving remission, predicting treatment resistance. Identifying treatment-resistant patients is crucial due to the importance of initiating clozapine as early as possible since the chances of responding are higher.

Conclusions

DUP is a key prognostic variable in psychosis, revealing the significance of early treatment. Patients with long DUP should be regarded as at high risk of poor recovery. The detection of these patients enables clinicians to avoid unnecessary exposure to ineffective treatments while effective interventions are delayed. However, in view of adverse side effects of clozapine, future studies need to examine relevant predictors to detect accurately non-responders. We also suggest further studies to understand if there is correspondence between DUP and different stages of the disease that justify these results.

A dual high-energy radiography platform with 15 μm resolution at the National Ignition Facility

To study matter at extreme densities and pressures, we need mega laser facilities such as the National Ignition Facility as well as creative methods to make observations during timescales of a billionth of a second. To facilitate this, we developed a platform and diagnostic to characterize a new point-projection radiography configuration using two micro-wires irradiated by a short pulse laser system that provides a large field of view with up to 3.6 ns separation between images. We used tungsten-carbide solid spheres as reference objects and inferred characteristics of the back-lighter source using a forward-fitting algorithm. The resolution of the system is inferred to be 15 μm (using 12.5 μm diameter wires). The bremsstrahlung temperature of the source is 70-300 keV, depending on laser energy and coupling efficiency. By adding the images recorded on multiple stacked image plates, the signal-to-noise of the system is nearly doubled. The imaging characterization technique described here can be adapted to most point-projection platforms where the resolution, spectral contrast, and signal-to-noise are important.

Automated HIV screening in the emergency department –earlier diagnosis, improved clinical outcomes

Background

HIV/AIDS is a public health problem worldwide because undiagnosed patients maintain onward transmission. To stop viral transmission an upscale in diagnostics is needed so that more patients start treatment; patients on treatment and with undetectable viral load do not transmit the virus to other persons (“Treatment as Prevention”).

Objectives

We aimed at identifying more HIV infections in the emergency Department (ED) and at doing so earlier in the course of disease.

Methods

we designed an automated and clinician independent HIV screening project in the ED. Electronic Medical Record (EMR) automatically generates a request for HIV antibody (HIV Ab) test when a patient: a) is 18-65 years of age and has a request for any blood test; b) is not identified in the EMR as being HIV infected; c) does not have an HIV Ab in the EMR in the previous year. Nursing staff receive a visual warning of patients' eligibility for screening and an extra tube label is printed out for HIV testing. The patient is informed of screening at the moment of blood drawing and an &lt;&lt;opt-out &gt;&gt; strategy is applied (optional verbal informed consent or &lt;&lt;opt-out &gt;&gt; of screening).

Results

In 16 months, a total of 21.487 people were eligible for screening. 18.072 HIV Ab screening tests were done. The opt-out rate was 6.3% and there were 44 new HIV diagnostics (prevalence rate 0.24%). Late presenting patients (baseline CD4 counts &lt;350) dropped from an average of 56% in the previous 6 years at our institution to 36.3%. Median CD4 count at diagnostics went up from 192 to 388 cells/mm³.

Conclusions

An automated and clinician independent HIV screening program in the ED proved to be successful at identifying more HIV patients and at tackling the problem of late presentation. Diagnosing early in the course of infection is beneficial for the individual patient, but also represents a gain in general public health because onward transmission is stopped by starting antiretroviral treatment.

Key messages

Early diagnosis through universal screening. Treatment as prevention.

Process modelling of organized screening programs – breast cancer

Breast cancer is the most frequent cancer among women and one of the principal causes of cancer related death in women worldwide, being a public health problem. Oncology screenings allow its early detection and reduce its mortality. Business process management (BPM) is a management field that leads an organization into continuously improvement with increase of efficiency. The processes of the healthcare system are complex what makes the application of BPM techniques harder, however their usage has been increasing in this sector.

The main objective of this study is the identification and modelling of BPM processes for the Portuguese breast cancer screening.

The current processes and the entities (actors, systems and documents) involved in the Breast Cancer Organized Screening performed by the Portuguese League Against Cancer were identified through interviews to the employees. With the information retrieved and using Bizagi the related As-Is diagrams were developed.

In this work 5 processes within the Breast Cancer Organized Screening were identified: Process “Patients' invitation”; Process “Screening”; Process “Reading of the exam”; Process “Check-up Consultation” and Process “Sending Results”. Through the analysis of the As-Is diagrams and of the available information, a critical analysis was made. As for example, in the process “Patients' invitation” an invitation letter is sent 15 days earlier to the patient but no telephone contact is done before the screening. An improvement could be sending a message in the day before the screening, remembering the appointment, avoiding forgetfulness absences.

With this work the mainly processes of the breast cancer organized screening were modelled as “As-Is” diagrams and, in a macroscopic way, some of the problems were identified and improvement suggestions were made in order to achieve the main objective of the process, the early detection of breast cancer, while optimizing the process.

Key messages

This work represents an important contribution to the Breast Cancer Organized Screening since, through the use of BPM, a set of actions is proposed with an impact on its effectiveness and efficiency. This work represents an example of what the BPM techniques can do to help in the optimization of all the processes of the healthcare sector, from screening to diagnosis and treatment.

Mediterranean diet, sociodemographic factors and ultra-processed food consumption in Portugal

Background

Mediterranean diet has been shown to promote beneficial effects on health, while ultra-processed food (UPF) consumption has been associated with lower diet quality and higher risk for non-communicable diseases. Our aims were to explore the adherence to a Mediterranean dietary pattern (MDP) in Portugal and its association with sociodemographic factors and UPF consumption.

Methods

Participants were from the Portuguese National Food, Nutrition and Physical Activity Survey 2015-2016, aged 18-84y (n = 3,852). CAPI face-to-face interviews were used including 2 dietary 24-h recalls. UPF were identified using NOVA classification. Adherence to MDP was defined by the Mediterranean Diet Score (MDS), which may vary from 0 to 9. MDS≥6 was considered as high adherence. Weighted multivariate logistic regression analysis was used to explore associations of high adherence to MDP with sex, age, region, educational level, family income and dietary share of UPF groups.

Results

High adherence to MDP was observed for 19.6% of participants and was inversely associated with higher consumption of UPF, namely, sugar-sweetened beverages (OR = 0.924; 95%CI 0.883-0.966), confectionery (OR = 0.893; 95%CI 0.816-0.977), sweet snacks (OR = 0.953; 95%CI 0.923-0.985), cakes/desserts (OR = 0.956; 95%CI 0.934-0.978) and meat products (OR = 0.922; 95%CI 0.874-0.972). Being female (OR = 0.629; 95%CI 0.471-0.841) and not from the North or Alentejo regions were inversely associated with high adherence to MDP. There was no relation between income and adherence to MDP. The higher the level of education or age, the higher the odds of high adherence to MDP (OR = 2.573; 95%CI 1.741-3.803 and OR = 1.028; 95%CI 1.020-1.037, respectively).

Conclusions

Actions to improve adherence to MDP in Portugal should consider discouraging UPF consumption and be addressed to specific subgroups.

Funding

POCI-01-0145-FEDER-032090 (FCT/FEDER); FAPESP 2018/07391-9, 2019/05972-7 (MCR), 2016/14302-7 (FR).

Key messages

High adherence to a Mediterranean dietary pattern was observed for near 20% of Potuguese over 18 years old. The higher the level of education or age, the higher the odds of high adherence to MDP. High adherence to a Mediterranean dietary pattern was inversely associated with higher consumption of sugar-sweetened beverages, confectionery, sweet snacks, cakes/desserts and meat products.

Landscape Analysis for the Specimen Data Refinery

This report reviews the current state-of-the-art applied approaches on automated tools, services and workflows for extracting information from images of natural history specimens and their labels. We consider the potential for repurposing existing tools, including workflow management systems; and areas where more development is required. This paper was written as part of the SYNTHESYS+ project for software development teams and informatics teams working on new software-based approaches to improve mass digitisation of natural history specimens.

The effect of climate change on domestic Rainwater Harvesting

One of the main strategies that are being applied to improve the efficiency of water consumption in buildings is the use of non-potable water for pavement washing, toilet flushing, irrigation, and others. According to several guidelines, the design and assessment of a Rainwater Harvesting System (RWHS) should be made using recent official records of precipitation. However, there is not an indication whether historical or future projections should be used, leaving space for the designer to choose. This article presents the study of RWHS in southern Europe, namely in Portugal, considering two case studies (a dwelling in Oporto and an apartment in Vila Real). The main goal was to explore the impacts that climate change will have on these systems and, for that purpose, a daily simulation using future rainfall data was performed for both cases considering two scenarios: RCP 4.5 which is more optimistic, and RCP 8.5 which is more pessimistic. The RWHS in Oporto showed a better performance in the future decades, comparing with simulations based on recent decades, for both scenarios. However, the savings will not have a significant variation (less than 5 €/year). In the future, this system will provide around 47 (±2.4) m³ of rainwater per year to the selected non-potable purposes, leading to savings of around 66 (±3.3) €/year. Vila Real case study also revealed a slight improvement of the system's efficiency in the future decades but the results for rainwater collected and used are so similar to the recent ones that it can be concluded that the performance will be sustained. This system will provide around 50 (±2.5) m³ of rainwater per year to the selected non-potable purposes, leading to savings of around 200 (±10.2) €/year. It can be concluded that there will be no significant changes in RWHS performance in the future, in the studied areas.