EM - Artigos Científicos
Permanent URI for this collection
Browse
Recent Submissions
- Promoting physical activity in older adults with type 2 Diabetes via an anthropomorphic conversational agent : development of an evidence and theory-based multi-behavior interventionPublication . Pimenta, Nuno; Félix, Isa Brito; Monteiro, Diogo; Marques, Marta Moreira; Guerreiro, Mara PereiraIntroduction: Anthropomorphic conversational agents (ACA) are a promising digital tool to support self-management of type 2 diabetes (T2D), albeit little explored. There is a dearth of literature on the detailed content of these interventions, which may limit effectiveness and replication. Our aim is to describe the development of an evidence and theory-based intervention to improve physical activity in older adults with T2D, subsumed in a multi-behavior intervention via a mobile application with an ACA. Methods: Overall decisions on the multi-behavior intervention design, such as the use of standardized behavior change techniques (BCTTv1), guided the development of the physical activity component. Firstly, recommendations on ambulatory activity were used to select the target behavior (walking). Meta-research on effective behavior change techniques (BCTs) was then identified. One meta-analysis linked effective BCTs with the three basic psychological needs of the self-determination theory (SDT). This meta-analysis, taken together with additional evidence on SDT, led to the selection of this theory to inform the design. BCTs were extracted from meta-research; we selected the most appropriate to be operationalized via the conversational agent through multidisciplinary discussions. Rules governing the dialogue flow and BCTs tailoring, taking the form “if some conditions hold then execute some action,” were derived based on the Basic Psychological in Exercise Scale (competence, autonomy, and relatedness scores), in conjunction with published evidence and multidisciplinary discussions. Results: Thirteen BCTs were implemented in the prototype via the ACA (e.g., goal setting behavior 1.1). Six if-then rules were derived and depicted in the dialogue steps through process flow diagrams, which map how the system functions. An example of a rule is “If competence score ≤ 10 then, apply BCT 1.1 with 500 steps increments as options for the daily walking goal; If competence score > 10 then, apply BCT 1.1 with 1,000 steps increments as options for the daily walking goal.” Conclusion: Evidence and SDT were translated into a mobile application prototype using an ACA to promote physical activity in older adults with T2D. This approach, which includes 13 BCTs and six if-then rules for their tailoring, may leverage the efforts of others in developing similar interventions.
- Profile of cognitive impairment in late-stage Parkinson's diseasePublication . Sousa, Catarina Severiano e; Fabbri, Margherita; Godinho, Catarina; Simões, Rita Moiron; Chendo, Inês; Coelho, Miguel; Martins, Isabel Pavão; Ferreira, Joaquim J.Introduction: The profile of cognitive impairment associated with the late stages of Parkinson's disease (LSPD) is rarely reported. Its characterization is necessary to better understand the cognitive changes that occur as the disease progresses and to better contribute to its management. Methods: In this cross-sectional study, we characterized the cognitive profile of LSPD patients using the comprehensive assessment methodology proposed by the International Parkinson and Movement Disorders Society Task Force. The association of clinical and demographic variables with dementia diagnosis was also investigated using binary logistic regression analysis. Results: Eighty-four LSPD patients were included (age 75.4 ± 6.9; disease duration 16.9 ± 7.5). Fifty-four (64.3%) were classified as demented and presented a global impairment cognitive profile. In the nondemented group (N = 30), 25 (83.3%) LSPD patients met the diagnostic criteria for mild cognitive impairment, mostly with multiple domain impairment (96.0%) and a heterogeneous profile. Memory was the most frequent and severely impaired cognitive domain in both groups. Disease disability, orientation, complex order comprehension, verbal learning, and visuoconstructive abilities were significantly associated with dementia diagnosis (p < .05). Conclusions: Cognitive impairment in multiple domains was common in LSPD patients. The most frequent and prominent deficits were in the memory domain, with a strong interference from attention impairment. Disease disability, orientation, complex order comprehension, verbal learning, and visuoconstructive abilities proved to be important determinants for dementia diagnosis.
- Professionals’ self-reported difficulties towards integrating dual task training in care for people with Parkinson’s diseasePublication . Domingos, Josefa; Dean, John; Fernandes, Júlio Belo; Godinho, CatarinaBackground: Despite the growing use of dual task training (DTT) in clinical practice with people with Parkinson Disease (PD), there is still limited evidence on how to best implement it. Data regarding professionals’ difficulties when integrating such practices are critical as a first step to generate further guidance on how to apply it. The aim of this study was to identify the difficulties perceived by professionals to integrate dual task in their practice. Methods: A descriptive, observational and cross-sectional study was conducted using a web-based survey. Convenience sampling was used to recruit exercise and healthcare professionals working with people with PD through various social media channels. Data were collected and then analyzed thematically using the method of constant comparisons. The study report follows the consolidated criteria for reporting qualitative research (COREQ) checklist. Results: Of the 205 eligible responses, 68.8% were Physiotherapist. The majority of the participants reported having Parkinson-specific training (91.7%) and 59.0% applied DTT in individual one-on-one sessions. We identified ten categories of difficulties faced by professionals. Conclusions: Professionals struggle to integrate DTT into PD clinical care. Challenges were identified and the most significant refer to difficulties in managing the chronicity of the disease and lack of patient compliance with home exercises. Understanding current challenges towards dual task exercise will help to reflect upon strategies to be applied effectively and safe.
- Predictors of pornography use : difficulties in emotion regulation and lonelinessPublication . Cardoso, Jorge; Ramos, Catarina; Brito, José; Almeida, Telma C.Background: Pleasure-seeking reasons are the main drivers of pornography use (PU), but the regulation of unpleasant states, namely distraction from or suppression of negative emotions and stress relief, are other potential predictors of this behavior. Aim: Our main objective is to develop an explanatory model of problematic PU, assessing difficulties in emotion regulation, loneliness, perceived stress, as well as age and gender as predictors. Methods: A cross-sectional study was conducted that included a total of 340 participants (M = 28.50 years, SD = 10.32). Self-report inventories were administered that measured problematic PU (PPCS), difficulties in emotion regulation (DERS-SF), loneliness (UCLALS-3), and perceived stress (PSS-10). Results: The findings were indicative of recreational PU, with only a small number of participants (4.6%) reporting a possible problematic PU. There were statistically significant gender differences (F(1,337) = 33.306, P ≤ .001), namely that men were more likely to report problematic PU (M = 36.03, SD = 21.30) than women (M = 25.32, SD = 9.24). Problematic PU was significantly and positively correlated either with difficulties in emotion regulation, loneliness, perceived stress and age. Stepwise multiple linear regression analysis showed that difficulties in emotion regulation (β = 0.259, P ≤ .001), loneliness (β = 0.209, P = .001), and gender (β = -0.377, P ≤ .001) define the best subset of predictors of problematic PU. Age and perceived stress were not selected as predictors in this subset. Clinical Translation: The promotion of better emotion regulation abilities and strategies for adaptive coping with loneliness must be taken into consideration, namely in cases of problematic PU or compulsive sexual behavior disorder. Strengths & Limitations: Being a cross-sectional study with a convenience sample and the fact that these variables explain only a part of the explained variance of the problematic PU are the main limitations. Despite the limitations, the principal contribution of this study is the understanding that gender, difficulties in emotion regulation, and loneliness remain as main predictors of problematic PU, even when combined in the explanatory model. Conclusion: The current study provides a better understanding of the predictors of problematic PU related with the reduction or avoidance of unpleasant states. Emotion regulation, loneliness, and perceived stress, studied simultaneously, provide a better understanding of the complex relationships between these factors and problematic PU. Difficulties in emotion regulation and loneliness are predictors of higher problematic PU, as well as the expected gender effect.
- Predictive modelling in clinical bioinformatics : key concepts for startupsPublication . Pais, Ricardo J.Clinical bioinformatics is a newly emerging field that applies bioinformatics techniques for facilitating the identification of diseases, discovery of biomarkers, and therapy decision. Mathematical modelling is part of bioinformatics analysis pipelines and a fundamental step to extract clinical insights from genomes, transcriptomes and proteomes of patients. Often, the chosen modelling techniques relies on either statistical, machine learning or deterministic approaches. Research that combines bioinformatics with modelling techniques have been generating innovative biomedical technology, algorithms and models with biotech applications, attracting private investment to develop new business; however, startups that emerge from these technologies have been facing difficulties to implement clinical bioinformatics pipelines, protect their technology and generate profit. In this commentary, we discuss the main concepts that startups should know for enabling a successful application of predictive modelling in clinical bioinformatics. Here we will focus on key modelling concepts, provide some successful examples and briefly discuss the modelling framework choice. We also highlight some aspects to be taken into account for a successful implementation of cost-effective bioinformatics from a business perspective.
- Precision medicine : the use of tailored therapy in primary immunodeficienciesPublication . Pinto, Marta Valente; Neves, João FarelaPrimary immunodeficiencies (PID) are rare, complex diseases that can be characterised by a spectrum of phenotypes, from increased susceptibility to infections to autoimmunity, allergy, auto-inflammatory diseases and predisposition to malignancy. With the introduction of genetic testing in these patients and wider use of next-Generation sequencing techniques, a higher number of pathogenic genetic variants and conditions have been identified, allowing the development of new, targeted treatments in PID. The concept of precision medicine, that aims to tailor the medical interventions to each patient, allows to perform more precise diagnosis and more importantly the use of treatments directed to a specific defect, with the objective to cure or achieve long-term remission, minimising the number and type of side effects. This approach takes particular importance in PID, considering the nature of causative defects, disease severity, short- and long-term complications of disease but also of the available treatments, with impact in life-expectancy and quality of life. In this review we revisit how this approach can or is already being implemented in PID and provide a summary of the most relevant treatments applied to specific diseases.
- Characterization of lipid extracts from the Hermetia illucens larvae and their bioactivities for potential use as pharmaceutical and cosmetic ingredientsPublication . Almeida, Cíntia; Murta, Daniel; Nunes, Rui; Baby, André Rolim; Fernandes, Ângela; Barros, Lillian; Rijo, Patricia; Rosado, CatarinaThere is an increasingly growing demand for the use of natural and sustainable bioactives in the field of the pharmaceutical and cosmetic industries. The biomass from black soldier fly larvae (Hermetia illucens) can be viewed as an innovative source of compounds with high aggregate value and marketing potential due to the sustainable organic matter bioconversion process used as substrate for its development. This insect can be a source of lipid compounds with high added value, mainly due to its high content in fatty acids (FA) with potential applicability in the pharmaceutical and cosmetic industry. In this context, in this work different extraction methods were tested (decoction, microwaves, maceration and ultrasound), using water, acetone, n-hexane as extraction solvents, to evaluate yields of the BSF larvae lipid extracts, as well as their lipid profile, and a preliminary safety screening was conducted. Results show that despite using different extraction techniques and solvents, similar FA composition profiles were obtained. The lauric acid content (C12: 0) is elevated in all the extracts in relation to the other FA, ranging 37%–62%. The contents in palmitic (C16: 0) and oleic (C18: 1n-9) acids, were also high in all applied extraction methods. The omega-6 FA (ω-6 PUFAs), mainly linoleic acid (C18: 2n6c), were also identified in the lipid fraction of BSF larvae biomass, with a content variation between 4.5% and 17.7%, while the omega-3 group, namely α-Linolenic acid (C18: 3n3), presented values between 0.66% and 1.95%. None of the extracts presented toxicity in preliminary tests with the Artemia salina model. Through this study, it was possible to confirm that BSF larvae oil can be obtained by sustainable methods, containing a broad mixture of FA and being highly rich in lauric acid, with a promising skin care applicability.
- Posttraumatic growth among childhood cancer survivors and their caregivers : associations with rumination and beliefs challengePublication . Peloso, Franciele Cristiane; Gonçalves, Tonantzin; Armiliato, Maria Júlia; Gregianin, Lauro; Ramos, Catarina; Castro, Elisa Kern deThe main purpose of the study was to assess the relationship between PTG, challenge to core beliefs, intrusive and deliberate rumination in a sample of 43 dyads of childhood cancer survivors and their caregivers. Methods: Survivors (mean age = 17.04; SD=3.67) and caregivers (mean age = 46.84; SD = 8.32) completed the Posttraumatic Growth Inventory (PTGI), the Core Beliefs Inventory (CBI) and the Event-related Rumination Inventory (ERRI). Results: Results showed a positive and high correlation among PTG, CBI, and ERRI in both groups, separately. CBI was the main predictor of PTG both among survivors (β=0.826; t=9.393; R²=0.683; p≤0.001) and caregivers (β=0.552; t=4.235; R²=0.304; p≤0.001). Caregivers reported higher scores than survivors in PTG (t=-2.999 p≤0.01) and its dimensions Relationship with others (t=2.498; p≤0.05), Spiritual change (t=-15.823; p≤0.001), Life appreciation (t=-3.129;
- Phylogeography of hepatitis B virus : the role of Portugal in the early dissemination of HBV worldwidePublication . Marcelino, Rute; Ezeonwumelu, Ifeanyi Jude; Janeiro, André; Mimoso, Paula; Matos, Sónia; Briz, Veronica; Pimentel, Victor; Pingarilho, Marta; Marinho, Rui Tato; Marcelino, José Maria; Taveira, Nuno; Abecasis, AnaIn Portugal, the genetic diversity, origin of HBV and the Portuguese role in the dissemination of HBV worldwide were never investigated. In this work, we studied the epidemic history and transmission dynamics of HBV genotypes that are endemic in Portugal. HBV pol gene was sequenced from 130 patients followed in Lisbon. HBV genotype A was the most prevalent (n = 54, 41.5%), followed by D (n = 44, 33.8%), and E (n = 32, 24.6%). Spatio-temporal evolutionary dynamics was reconstructed in BEAST using a Bayesian Markov Chain Monte Carlo method, with a GTR nucleotide substitution model, an uncorrelated lognormal relaxed molecular clock model, a Bayesian skyline plot, and a continuous diffusion model. HBV subgenotype D4 was the first to be introduced in Portugal around 1857 (HPD 95% 1699–1931) followed by D3 and A2 a few decades later. HBV genotype E and subgenotype A1 were introduced in Portugal later, almost simultaneously. Our results indicate a very important role of Portugal in the exportation of subgenotypes D4 and A2 to Brazil and Cape Verde, respectively, in the beginning of the XX century. This work clarifies the epidemiological history of HBV in Portugal and provides new insights in the early and global epidemic history of this virus.
- pH analysis of still and carbonated bottled water : potential influence on dental erosionPublication . Morgado, Mariana; Ascenso, Carla; Carmo, Joana; Mendes, José João; Manso, Ana CristinaObjective: To assess pH values to characterize bottled water in Portugal, being able to provide information for both patients and clinicians about its erosive potential, as a tool to prevent the ingrowing prevalence of dental erosion and its progression, especially in patients who are at greater risk, such as those with dry mouth syndrome, making the dissemination of this knowledge a fundamental tool for clinical decision. Materials and Methods: One hundred and five common brands of bottled water (n = 105), commercialized in Portugal, were analyzed. Of these, 73 were smooth water (Group A) and 32 carbonated water (Group B). All pH values were assessed by potentiometric measurement with a calibrated electrode. For each brand, five independent measurements were recorded at 25°C for further calculation of the mean pH value and standard deviation. Results: Focusing on the mean pH values from Group A, one had a pH mean value lower than 5.2, four between 5.2 and 5.5, thirty-seven between 5.5 and 6.8, and thirty-one higher than 6.8. In Group B, ten had a mean pH value lower than 5.2, ten between 5.2 and 5.5, twelve between 5.5 and 6.8, and none above 6.8. Conclusions: Bottled water, commercialized in Portugal, has different mean pH values, some below the critical threshold of enamel and/or dentin, suggesting that they may have a greater risk of consumption than others, only with respect to the pH parameter of erosive potential. Further investigation concerning this area is needed for wider conclusions.