EM - Artigos Científicos
URI permanente para esta coleção:
Navegar
Entradas recentes
- Integrated micro-computed tomography and computational fluid dynamics analysis of stepwise enlargement in mesial root canals of mandibular molarsPublication . Furtado, Sofia Moura; Martins, Jorge N. R.; Silva, Emmanuel João Nogueira Leal; Pereira, Mário Rito; Versiani, Marco Aurélio; Ginjeira, AntónioIntroduction: To evaluate how stepwise enlargement in the mesial root canals of mandibular first molars affect shaping outcomes and irrigant dynamics. Methods: The shaping ability and irrigant flow patterns in mesial canals of mandibular first molars enlarged with ProTaper Next instruments (25/.06v, 30/.07v, 40/.06v) were evaluated using micro-computed tomography (micro-CT) and computational fluid dynamics (CFD). Instrument design and metallurgical properties were assessed by 3D scanning, scanning electron microscopy, energy-dispersive X-ray spectroscopy, and differential scanning calorimetry to ensure manufacturing consistency. An extracted mandibular molar with two curved mesial root canals was selected and scanned by micro-CT to generate 3D models for CFD simulation. Root canals were prepared stepwise with the ProTaper Next. Digital canal and needle geometries were reconstructed from micro-CT and scanning electron microscopy data. CFD simulations were conducted in ANSYS Fluent to calculate irrigant velocity, wall shear stress, and apical pressure. For shaping analysis, ten mesial canals from 5 mandibular molars were scanned before and after each preparation step. Canal volume, surface area, unprepared surfaces, and pericervical dentine thickness were quantified. Data were analyzed using repeated measures ANOVA with Bonferroni correction (P < .05). Results: Excluding for dimensions, all instruments shared similar metallurgical features and design characteristics, with minor surface imperfections. The open-ended needle consistently delivered irrigant to the working length, unlike the side-vented needle. Enlargement slightly increased apical velocity and irrigant density, particularly with the open-ended needle, which also generated higher wall shear stress and apical pressure. Canal volume and surface area increased significantly with larger files (P < .05), while unprepared areas decreased. Progressive canal enlargement significantly reduced minimal dentine thickness at the distal aspect of the mesial canals (most at 1–2 mm below the furcation), dropping from preoperative means of ∼1 mm to 0.60 mm after the 40/.06v instrument (P < .05), with the proportion of sections with dentine <0.5 mm increasing from 0% to 26%, while those >1 mm decreased markedly. Conclusions: Progressive apical enlargement improved shaping and irrigant dynamics, but additional increases offered limited benefits. Irrigant effectiveness was more influenced by needle design than by size alone, suggesting that optimizing delivery systems may enhance cleaning efficiency while minimizing unnecessary dentine removal.
- Impact of Sarcopenia on prognosis, treatment toxicity and surgical complications in locally advanced gastric cancerPublication . Dias, David da Silva; Luz, Paulo; Fortuna, Ana; Águas, Ana; Machado, Mafalda; Gosálbez, Beatriz; Farate, Rosa; Pinho, Rita Clemente; Valente, Ana Carmo; Mendes, José Leão; Seladas, Marta Maria; Trabulo, Carolina; Ravasco, PaulaBackground: Weight loss and skeletal muscle wasting are frequent in cancer and may influence treatment tolerance and outcomes. Computed tomography (CT) based body composition analysis at the third lumbar vertebra (L3) is an accurate method to quantify skeletal muscle in routine oncology care. Methods: We performed a multicenter retrospective cohort study including 202 adults with locally advanced (stage IB–III) gastric cancer treated in four Portuguese hospitals (January 2020–December 2022). Skeletal muscle area (SMA) was assessed on baseline CT at the L3 vertebral level, using Data Analysis Facilitation Suite (DAFS) software v3.11.2, and skeletal muscle index (SMI) was subsequently calculated. Patients with low muscle quantity were classified as sarcopenic (below sex-specific SMI mean). We evaluated associations with relapse-free survival (RFS), overall survival (OS), FLOT chemotherapy dose-limiting toxicities (DLTs), and postoperative complications after gastrectomy. Results: Mean age was 69 years, 65% had ECOG PS 0, 53% received FLOT chemotherapy protocol. Mean SMI was 49.6 cm2/m2 in males and 40.9 cm2/m2 in females and correlated positively, though moderately, with BMI (p < 0.01; r = 0.424). Sarcopenia was not significantly associated with RFS (p = 0.186) or OS (p = 0.168) at 30-month follow-up. Although numerical differences were observed (64% vs. 56% of patients did not relapse and 74% vs. 63% were alive, for non-sarcopenic vs. sarcopenic patients). Sarcopenia was associated with a higher risk of DLTs (p = 0.021; OR 2.56, 95% CI 1.15–5.73) and postoperative complications (p = 0.024; OR 2.16, 95% CI 1.11–4.21). Conclusions: Sarcopenia significantly increases the risk of chemotherapy toxicity and postoperative complications in locally advanced gastric cancer. However, its effect on OS and RFS was not statistically significant at 30-month follow-up. Standardization of CT-based sarcopenia cut-offs remains a major barrier to clinical implementation.
- HIV-1 late diagnosis : strategies to overcome the misclassification of individuals acutely infected with HIV-1 as individuals diagnosed latePublication . Miranda, Mafalda N. S.; Pimentel, Victor; Santos, André; Alemão, André; Gonçalves, Fátima; Cabanas, Joaquim; Costa, Inês; Diogo, Isabel; Fernandes, Sandra; Seabra, Sofia G.; Gomes, Perpétua; Pingarilho, Marta; Abecasis, Ana; on behalf of the Portuguese HIV-1 Resistance Study GroupObjectives: Late HIV diagnosis is associated with a higher impact on treatment outcomes and a potential for prolonged transmissibility of HIV-1 infection. The consensus definition for late HIV diagnosis is problematic. It was updated in 2022; however, this definition relies on information that might not be clinically available. This study aimed to assess late HIV diagnosis using alternative parameters, in addition to the definition of clusters of differentiation (CD4) cell count, namely, sequence ambiguity rate and estimated time of infection inferred through phylogenetic analysis. Methods: Clinical, socio-demographic, and genotypic information from 3668 antiretroviral therapy–naïve individuals living with HIV was retrieved from the REGA database. Individuals were classified according to three approaches: (i) CD4 cell count, (ii) sequence ambiguity rate, and (iii) phylogenetic reconstruction using TreeTime to estimate the time of most recent common ancestor (MRCA) as a proxy for time of infection. Results: Based on CD4 cell count, 53.8% of individuals had a late diagnosis and 46.2% had a non-late diagnosis. Based on sequence ambiguity rate, 57.8% had a chronic and 42.2% had a recent infection, and 86.4% had an estimated time of infection of more than 3 years, whereas 13.6% had less than 3 years. A total of 114 individuals were classified as diagnosed late by CD4 criteria and showed evidence of recent infection based on low ambiguity rates and MRCA estimates under 3 years. These individuals had significantly lower viral loads than those with true late diagnoses (median 61,358 vs 134,730 copies/ml; P <0.001). Overall, 41% of individuals were consistently classified across all three methods. Conclusions: The definition of late diagnosis remains a major challenge. Alternative and complementary methods, such as the use of viral loads, combined with some more clinical information, may improve the lack of baseline data.
- Hepatic hydrothorax : a comprehensive approach to diagnosis and managementPublication . Mendos, Ivo; Inácio, Ana Siopa; Urbano, Martim Costa; Calvinho, Paulo; Nunes, GonçaloBackground: Hepatic hydrothorax (HH) is an uncommon but serious complication of advanced cirrhosis, characterized by transudative pleural effusion in the absence of cardiopulmonary or renal pathology. Despite its relatively low prevalence, HH carries significant morbidity and mortality, often presenting complex diagnostic and therapeutic challenges. Summary: The pathogenesis of HH is multifactorial, primarily involving the passage of ascitic fluid through diaphragmatic defects, exacerbated by altered hemodynamics, hypoalbuminemia, and neurohormonal dysregulation. Diagnosis relies on identifying transudative pleural effusion and excluding alternative etiologies. Management requires a stepwise multidisciplinary approach. Initial therapy includes sodium restriction, diuretics, and paracentesis to control ascites. Refractory cases may require serial thoracenteses, transjugular intrahepatic portosystemic shunt (TIPS), or surgical interventions in selected cases. Liver transplantation remains the definitive treatment leading to survival outcomes comparable to other transplant indications. Conclusion: HH develops in advanced cirrhosis and predicts a poor prognosis, with median survival often less than 1 year without transplantation. Optimal care requires early recognition, individualized treatment planning, and close multidisciplinary coordination between hepatology, pulmonology, interventional radiology, and surgical teams. Further research is needed to refine risk stratification and establish standardized management algorithms to improve patient outcomes.
- Health professionals’ knowledge and attitudes towards baby led weaning : a cross-sectional, exploratory, and observational studyPublication . Sarreira-de-Oliveira, Paula; Ramalho, Renata; Antunes, Ricardo; Antunes, Vanessa; Loureiro, FernandaBaby Led Weaning (BLW) is a type of infant feeding that allows babies to feed themselves and has gain popularity among parents in recent years. Health professionals’ (HP) knowledge and attitudes towards BLW is less explored. We conducted a cross-sectional, exploratory, and observational study, with a web-based instrument, that aimed to determine the knowledge and attitudes of HP familiar to BLW regarding the use of this method in complementary feeding. In our sample of 118 HP, HP who were women or younger (23–39 years) had a more positive perception of BLW. We found that acceptance and positive attitudes towards BLW were consistent among HP. It is essential to improve the training of HP in the specifics of implementing this approach and to develop clear guidelines to guide practice.
- Glyphosate in the Iberian Peninsula : evaluating risks to Iberian wildlifePublication . Baptista, Catarina Jota; Marques, Gonçalo Nogueira; Gonçalves, Luísa Lima; Assunção, Ricardo; Martinez-Haro, MónicaGlyphosate [N-(phosphonomethyl)glycine] (GlyP) is an herbicide extensively used worldwide, including the Iberian Peninsula. It is mainly used in agricultural landscapes but also in urban areas, in railways, and even in water bodies. Despite glyphosate’s large use, there is a paucity of research on its exposure and its potential effects on wildlife living treated environments. In recent years, an increasing number of studies have warned about the effects of this herbicide namely, on oxidative stress, and on liver and kidney in different taxa. Additionally, some studies also suggested endocrine disruption capacity in reptiles or genotoxicity in fish. Most of these studies have been carried out on experimental animals, in laboratory conditions, so the real exposure and potential effects on wildlife is largely unknown. In this context, this review is intended to help understand the ecological consequences that glyphosate may be exerting on wildlife that inhabit the Iberian Peninsula.
- Get a grip! – Baseline handgrip strength and sarcopenia as predictors of survival in patients with head and neck squamous cell carcinomaPublication . Orell, Helena; Pohju, Anne; Ravasco, Paula; Schwab, Ursula; Osterlund, Pia; Mäkitie, Antti A.Background: Low handgrip strength (HGS) and sarcopenia are common in patients with head and neck squamous cell carcinoma (HNSCC). This study aimed to explore associations between baseline HGS, fat-free mass index (FFMI), nutritional indices, and survival. Methods: This was a prospective observational sub-study of a randomized nutritional intervention trial, including 50 male patients with HNSCC undergoing curative-intent treatment (surgery and/or (chemo)radiotherapy). Sarcopenia was defined as low HGS (<27 kg) and FFMI (<17 kg/m2). Chi-square, Kaplan–Meier, and Cox analyses were used. Results: Low HGS was observed in 16%, low FFMI in 46%, and sarcopenia in 12%. Patients with low HGS had lower body weight, BMI, and FFMI, alongside more malnutrition, elevated CRP, and heavy smoking. Low HGS and sarcopenia were associated with shorter overall survival (HR 3.7, [95% CI 1.5–9.1] and 5.5, [2.2–14.5], respectively); FFMI was not. Adjustment removed significance. Findings should be interpreted cautiously due to the small, all-male cohort size. Conclusion: In this small exploratory cohort HGS may serve as a simple screening surrogate for sarcopenia and survival.
- Genomic insights and bioconversion potential in the Black Soldier fly (Hermetia illucens) : current advances and future directionsPublication . Oliveira, Joana; Guilgur, Leonardo Gaston; Assunção, Ricardo; Murta, Daniel; Trindade, AlexandreThe global population continues to rise, placing increasing pressure on the agri-food sector and leading to the accelerated generation of urban organic waste, factors that collectively intensify climate stress and environmental instability. Insects are recognised for their remarkable capacity to transform substrates into valuable products, with the black soldier fly larvae (BSFL) emerging as one of the most efficient and widely utilised species for this purpose. Beyond recycling organic matter, BSFL can also mitigate microbial contamination, effectively reducing bacterial and fungal loads in waste substrates. Understanding and manipulating the genome could provide tools to improve BSFL bioconversion process and contribute to sustainability. In this review, we provide an overview of recent advances in black soldier fly genomics and genome-editing technologies. Although research in this subject remains limited, recent studies have clarified its origin, characterised its genome, and established the foundation for targeted genetic improvements to enhance by-product conversion, nutrient recovery, and environmental sustainability.
- Game over : unraveling the prevalence and associations between bruxism, TMD and psychosocial factors in the Esports arenaPublication . Cardoso, Flávia Paula Da Silva; Barjandi, Golnaz; Flores, Dyanne Medina; Poluha, Rodrigo Lorenzi; Christidis, Nikolaos; Canales, Giancarlo De la TorreBackground: The professionalization of electronic sports (Esports) and streaming has introduced new challenges to players' physical and mental health, including chronic stress, sleep disruption and pain-related dysfunction. These factors are linked to bruxism and temporomandibular disorders (TMD), yet their prevalence and psychosomatic correlations within this community remain unknown. This study aimed to investigate the occurrence of bruxism and TMD among Esports players and streamers as well as their associations with psychosomatic and gaming-related variables. Methods: This cross-sectional study included 97 Esports players and streamers that completed validated self-report instruments screening for TMD (TMD pain-screener), bruxism, sociodemographic data, oral behaviors, sleep quality, perceived stress, anxiety, somatic symptoms, pain vigilance, and gaming/streaming habits. In addition to standard statistical tests, orthogonal partial least squares-discriminant analysis (OPLS-DA) were applied to identify group differences and multivariate associations. Results: Nearly half of the participants screened positive for TMD (49.5 %) and 78.4 % reported self-reported bruxism. Increased daily gaming hours correlated significantly with higher perceived stress and oral parafunctions. Multivariate analyses further showed that anxiety, somatic symptoms, poor sleep and perceived stress were key factors distinguishing participants with TMD from those without, and those with combined sleep and awake bruxism from those with only awake bruxism. Conclusion: TMD and bruxism are highly prevalent among Esports players and streamers, with greater daily gaming exposure linked to psychosomatic stress and oral parafunctions. Digital athletes with combined sleep and awake bruxism and/or TMD, experience greater psychosocial distress, indicating a subgroup that needs closer attention through early screening and targeted preventive strategies.
- From waste to resource : performance of Black Soldier fly larvae reared on restaurant food waste at an industrial scalePublication . Oliveira, Joana; Ligeiro, Carolina; Fantatto, Rafaela; Souza, Clarice Silva e; Machado, Maria Ana; Guilgur, Leonardo Gaston; Trindade, Alexandre; Assunção, Ricardo; Murta, DanielFood waste poses significant environmental, economic and public health challenges. The black soldier fly (Hermetia illucens) larvae (BSFL) represent a promising solution for organic waste valorisation, converting substrates into protein-rich biomass for animal feed and organic fertiliser. However, the use of food waste as an insect substrate remains prohibited in the European Union due to regulatory and safety concerns. This study evaluated the suitability of heterogeneous food waste for BSFL rearing under industrial conditions by comparing larval performance on a standard Gainesville diet (control) and a blend derived from local restaurant waste (test). The 14-day bioconversion assay assessed bioconversion rate (BCR), feed conversion ratio (FCR), survival rate, average growth rate, and nutritional composition. Compared with the control, the test group showed significantly improved (p < 0.001) BCR (18.34% vs. 11.02%), FCR (5.48 vs. 9.09 kg/kg), survival (69.29% vs. 51.30%), and growth (8.38 vs. 6.59 mg/day). Larvae reared on food waste also exhibited significantly higher protein (19.70% vs. 16.80%), fat (13.70% vs. 7.20%), ash (6.97% vs. 3.51%), carbohydrates (7.00% vs. 3.60%), and fibre (5.20% vs. 2.90%). Overall, heterogeneous food waste is a suitable substrate for BSFL, supporting agrifood sustainability; however, future research should focus on standardisation of these substrates.