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- 3D assessment of mandibular buccal shelf geometry for optimal micro-implant placement site in Portuguese individuals : a retrospective cone-beam computed tomography studyPublication . Borga, Joana; Bugaighis, Iman; Proença, Luís; Pereira, François Durand; Costa, Helder Nunes; Pereira, Pedro MarianoObjectives: To determine the most favourable Micro-Implant (MI) insertion site along the mandibular buccal shelf (MBS), using Cone Beam Computed Tomography (CBCT). Methods: This retrospective study assessed CBCT scans from 90 Portuguese patients (32 males and 58 females, aged 14 to 40 years). Paired MBS sites were determined. Comparative and correlation analyses were performed at p < 0.05. Results: A significant increase in MBS width was observed from the mesial to the distal direction (p < 0.001). Conversely, both the MBS steepness and cortical bone thickness significantly decreased from mesial to distal (p < 0.001). Significant negative correlation was also found between age and cortical bone thickness adjacent to the distobuccal cusp and distal tangent of both mandibular second molars (r ≤ −0.373, p ≤ 0.007). Furthermore, significant asymmetric differences were identified between the right and left MBS steepness as well as in the paired cortical bone thickness at the mesiobuccal cusp, buccal groove, and distobuccal cusp of the mandibular second molar (p ≤ 0.016). Conclusions: The results indicate that although there are sufficient MBS width and cortical bone thickness, vestibular to the mandibular second molar for MI insertion, the sites towards the distal root of the mandibular second molar are more favourable when considering MBS steepness. These findings are consistent for both sexes and apply to young and old individuals.
- 3D assessment of the relationship of the mandibular buccal shelf with the mandibular canal : a CBCT retrospective studyPublication . Feliciano, Jéssica; Pereira, Pedro Mariano; Proença, Luís; Borga, Joana; Bugaighis, ImanObjective: This study aimed to evaluate the micro-implant safest insertion site on the mandibular buccal shelf (MBS) without compromising the integrity of the mandibular canal (MC). Methods: This retrospective investigation included cone-beam computed tomography (CBCT) of 96 Portuguese patients (58 females and 38 males, average age of 25.5±10.2 years). Measurements were taken in four bilateral MBS sites buccal to the mandibular second molar; tangent to the distal surface (7D), distobuccal cusp tip (7CD), buccal groove (7S) and mesiobuccal cusp tip (7CM). The transversal MBS midpoint was also determined, and the maximum angulation from the transversal MBS midpoint was extracted relative to the true vertical plane. Subsequently, the distance from the MBS midpoint to the MC was calculated at this angulation. Descriptive and inferential statistical analyses were performed at p<0.05 Results: Significant correlations were observed among several variables and age, sex and bilateral asymmetry (p<0.05). The MBS transversal width and the distance from the MBS midpoint to the MC progressively increased in the posterior direction while the angulation decreased. Conclusion: The most appropriate micro-implant insertion location compared to the other MBS investigated sites, in the absence of impacted third molars, is adjacent to the distal surface of the second molar. This finding is consistent across all age groups, sexes, and insertion sides. However, due to the demonstrated variability, taking a CBCT scan prior to mini-implant insertion might be considered to minimize the risk of injury to the inferior alveolar nerve.
- Acute effects of commercial group exercise classes on arterial stiffness and cardiovagal modulation in healthy young and middle-aged adults : a crossover randomized trialPublication . Melo, Xavier; Lopes, Adma; Coelho, Raquel; Simão, Bruno; Oliveira, Isabel; Marôco, João L.; Laranjo, Sérgio; Fernhall, Bo; Santa-Clara, HelenaBackground: Arterial stiffness and cardiac autonomic function are crucial indicators of cardiovascular health. Acute exercise and age impact these parameters, but research often focuses on specific exercise activities, lacking ecological validity. Methods: We examined the acute effects of commercially available group fitness classes (indoor cycling, resistance training, combined exercise) on arterial stiffness and vagal-related heart rate variability (HRV) indices in twelve young and twelve middle-aged adults. Participants attended four sessions, including exercise and control conditions, with measurements taken at rest and during recovery. Results: Middle-aged, but not young adults, showed reductions in central and peripheral systolic blood pressure 20-min into recovery across all exercise modalities (range: -7 to -8 mmHg p < 0.05). However, arterial stiffness remained unchanged. Similarly, vagal-related HRV indices (range: -0.51 to -0.90 ms, p < 0.05) and BRS (-4.03, p < 0.05) were reduced immediately after exercise, with differences persisting 30 min into recovery only after indoor cycling. Resistance and combined exercise elicited similar cardiovagal modulation and delayed baroreflex sensitivity recovery to cycling exercise, despite higher energy expenditure during indoor cycling (+87 to +129 kcal, p < 0.05). Conclusion: Acute group fitness classes induce age-dependent alterations in blood pressure, but not in arterial stiffness or cardiovagal modulation. While the overall cardiovascular effects were generally consistent, differences in autonomic recovery were observed between exercise modes, with prolonged effects seen after indoor cycling. This suggests that exercise prescription should consider both age and exercise modality, as well as recovery time. The findings also emphasize the importance of ecological validity in exercise interventions, highlighting that acute effects on cardiovascular health in real-world settings may differ from those observed in controlled laboratory environments (ID: NCT06616428).
- Adaptation and validation of the Coping Behavior Inventory into European PortuguesePublication . Loureiro, Fernanda; Antunes, Ricardo; Antunes, VanessaBackground: Nursing students are exposed to stress during their nursing program, particularly during clinical practice. Identifying the coping strategies used during this period can help identify resources to mitigate the stress they face. Objective: To translate and validate the Coping Behavior Inventory (CBI) into European Portuguese. Methodology: Methodological study with a nonprobability sample of 113 students attending the four years of the nursing program. To assess the psychometric properties of the instrument, its validity was analyzed using the principal component analysis method and its internal consistency by calculat-ing Cronbach’s alpha coefficient. Results: Four common factors were extracted from the exploratory factor analysis, explaining 57.5% of the variance, with a Cronbach’s alpha value of 0.668 for the total scale. Conclusion: The European Portuguese version of the CBI has adequate psychometric characteristics and is a reliable tool for assessing the coping strategies used by nursing students.
- Adherence to physical rehabilitation in patients with delirium post neurosurgery : a study protocolPublication . Fernandes, Júlio Belo; Monteiro, Leonor; Rodrigues, Cristina; Monteiro, Marlene; Gonçalves, Ana; Pinto, Mónica; Fernandes, Sónia; Romão, Ana; Domingos, Josefa; Godinho, CatarinaDelirium is an acute neurocognitive disorder characterized by confusion, disorientation, and fluctuating levels of arousal. It is commonly observed in patients following neurosurgery. This condition can lead to various adverse outcomes, including cognitive and functional decline, prolonged hospital stays, and increased mortality rates. Physical rehabilitation is crucial for these patients’ recovery, as it promotes functional improvement, reducing long-term disability risks, and enhancing overall quality of life. While evidence supports rehabilitation’s value in delirium management, there is limited understanding of specific strategies to improve adherence to rehabilitation among post-neurosurgery patients experiencing delirium. This study explores the rehabilitation workforce’s perspectives on strategies to enhance adherence to physical rehabilitation in neurosurgery patients with delirium. This study will use a qualitative, descriptive exploratory design to investigate strategies that support adherence to rehabilitation. We will use purposive sampling to recruit a diverse group of rehabilitation professionals, including nurses, physiatrists, physiotherapists, speech and language therapists, and occupational therapists, from Lisbon, Portugal. Data will be collected through semi-structured interviews guided by an interview script and analyzed using thematic analysis. Demographic data will be processed with SPSS software, while QDA Miner Lite will assist with coding and qualitative analysis. Identifying effective strategies to promote adherence to rehabilitation in neurosurgery patients affected by delirium could improve patient recovery, reduce healthcare burdens, and inform evidence-based guidelines. The findings of this study may provide practical insights for healthcare providers, administrators, and policymakers, ultimately supporting higher-quality care for this patient population.
- Advancements in diagnostic methods and imaging technologies in dentistry : a literature review of emerging approachesPublication . Magalhães, Ana Amélia de; Santos, Ana TeresaIntroduction: Recent advancements in diagnostic imaging technologies have significantly improved the field of dental medicine. This review examines these new imaging techniques and their impact on enhancing accuracy, enabling early detection, and facilitating effective treatment planning in dentistry. Methods: A bibliometric and content analysis was conducted on 61 peer-reviewed articles retrieved from the Scopus database, published between 2019 and 2024. The selection criteria focused on studies exploring advances in dental diagnosis through innovative imaging methods and personalized techniques for identifying oral pathologies. The bibliometric approach analyzed publication trends, while content analysis categorized emerging technologies and their clinical applications. Results: Our findings indicate a notable shift towards integrating cutting-edge technologies, including Cone Beam Computed Tomography (CBCT), artificial intelligence (AI), and biosensors. These advancements have significantly improved diagnostic accuracy, particularly in complex cases such as periodontal diseases, dental fractures, and oral infections. Studies demonstrate that molecular diagnostics and AI-driven algorithms enhance the personalization of treatment plans, optimizing patient outcomes. Conclusions: Emerging diagnostic technologies have the potential to enhance both the quality and efficiency of dental care. However, their implementation is challenged by high costs, the need for specialized training, and disparities in access. Future research should focus on refining AI-driven diagnostic models, addressing regulatory considerations, and expanding the clinical validation of novel imaging tools. As these technologies evolve, they are expected to increase diagnostic specificity, leading to more precise, patient-centered treatment approaches. Ultimately, these advancements offer substantial opportunities to transform dental practice by providing faster, less invasive, and more reliable diagnoses.
- Advances in digital technologies in dental medicine : enhancing precision in virtual articulatorsPublication . Lobo, Sofia; Argolinha, Inês; Machado, Vanessa; Botelho, João; Rua, João; Li, Junying; Mendes, José JoãoPrecision in diagnosis is essential for achieving optimal outcomes in prosthodontics, orthodontics, and orthognathic treatments. Virtual articulators provide a sophisticated digital alternative to conventional methods, integrating intraoral scans, facial scans, and cone beam computed tomography (CBCT) to enhance treatment predictability. This review examines advancements in virtual articulator technology, including digital workflows, virtual facebow transfer, and occlusal analysis, with a focus on Artificial Intelligence (AI)-driven methodologies such as machine learning and artificial neural networks. The clinical implications, particularly in condylar guidance and sagittal condylar inclination, are investigated. By streamlining the acquisition and articulation of digital dental models, virtual articulators minimize material handling errors and optimize workflow efficiency. Advanced imaging techniques enable precise alignment of digital maxillary models within computer-aided design and computer-aided manufacturing systems (CAD/CAM), facilitating accurate occlusal simulations. However, challenges include potential distortions during digital file integration and the necessity for robust algorithms to enhance data superimposition accuracy. The adoption of virtual articulators represents a transformative advancement in digital dentistry, with promising implications for diagnostic precision and treatment outcomes. Nevertheless, further clinical validation is essential to ensure the reliable transfer of maxillary casts and refine digital algorithms. Future developments should prioritize the integration of AI to enhance predictive modeling, positioning virtual articulators as a standard tool in routine dental practice, thereby revolutionizing treatment planning and interdisciplinary collaboration. This review explores advancements in virtual articulators, focusing on their role in enhancing diagnostic precision, occlusal analysis, and treatment predictability. It examines digital workflows, AI-driven methodologies, and clinical applications while addressing challenges in data integration and algorithm optimization.
- Age-related decline in intestinal villus length : a cross-sectional study on the human gutPublication . Vara-Luiz, Francisco; Palma, Carolina; Mendes, Ivo; Piçarra, Francisco; Teles, Ana Elisa; Nogueira, Filipe; Costa-Santos, Inês; Nunes, Gonçalo; Patita, Marta; Mocanu, Irina; Pires, Sara; Meira, Tânia; Vieira, Ana; Pinto-Marques, Pedro; Mascarenhas, Paulo; Leskiv, Iryna; Gomes-Pinto, Daniel; Fonseca, JorgeBackground/Objectives: There is widespread agreement that age is a significant predictor of impaired response to nutritional support. This is generally attributed to anabolic resistance, with impaired absorption considered irrelevant/non-existent. However, animal models demonstrate age-related structural changes in the intestinal mucosa that may reduce absorptive capacity. We aimed to evaluate potential histological changes in the duodenal mucosa associated with aging. Methods: We conducted a single-center observational cross-sectional study. Ambulatory younger (18–45 years) and older (≥70 years) adults referred for upper endoscopy were included and underwent duodenal biopsies. Those biopsies were analyzed and compared for histological/histomorphometric changes, including villus length. Clinical and laboratory data were also recorded. Results: One hundred patients were included (46 men/54 women), 50 aged 18–45 years and 50 aged ≥70 years. There were no duodenal endoscopic changes. The median villus length was 0.35 mm (IQR 0.32–0.41 mm) in older people, lower than in younger adults (0.57 mm; IQR 0.47–0.68 mm) (p < 0.001). In a multivariable regression model including age, sex, and Charlson comorbidity index, age remained inversely associated with villus length (p < 0.001). Older participants also exhibited lower hemoglobin, iron, folate, vitamin B12, albumin and vitamin D levels, despite normal inflammatory markers. Conclusions: Aging is associated with histological changes in the intestinal mucosa, including villus shortening. These findings support the concept of mucosal aging as a distinct biological process. Villus shortening may reflect reduced absorptive surface area and could contribute to age-related nutritional vulnerability, although its functional implications remain to be determined.
- Age-related decline of gastric secretion : facts and controversiesPublication . Vara-Luiz, Francisco; Mendes, Ivo; Palma, Carolina; Mascarenhas, Paulo; Nunes, Gonçalo; Patita, Marta; Fonseca, JorgeAging is associated with structural and functional changes in the gastrointestinal tract; however, its impact on gastric secretion remains unclear. This scoping review examines whether gastric secretion declines with age and explores its clinical implications. Following the PRISMA guidelines, PubMed, Web of Science, Embase, and Google Scholar were systematically searched from inception to December 2024. Fifteen studies (both animal and human) met the inclusion criteria: they were written in English, directly relevant to aging and gastric secretion, and had a clearly stated methodology. Evidence strength was assessed using the GRADE framework, revealing predominantly low to moderate certainty due to small sample sizes and observational study designs. Animal studies have demonstrated reduced acid secretion in older rats, which is attributed to mucosal atrophy and diminished responsiveness to gastrin. Recent human studies suggest that aging does not directly reduce acid output, as reduced acid secretion may result from a higher prevalence of atrophic gastritis, Helicobacter pylori infection, and the widespread use of proton pump inhibitors. Antisecretory therapy may lack benefits in older adult patients with hypochlorhydria/achlorhydria and increase the risk of adverse effects. Pepsin output declines with aging due to reduced chief cell function, although its clinical impact on digestion is unclear. Since intrinsic factor secretion far exceeds the amount necessary for its physiological function, even low amounts seem to be sufficient to prevent cobalamin deficiency. Age-related decline in gastric secretion is mostly attributed to age-associated disorders; however, impairment of secretory function in older people is frequent. Future research should prioritise longitudinal studies, larger cohorts, and histology-stratified analysis.