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- Rosmarinic acid-eluting contact lenses as a multifunctional therapeutic system for diabetic ocular complicationsPublication . Duarte, Ana Centeno; Toffoletto, Nadia; Pais, Rita Martins; Monte, Zélia Lumack do; Salema-Oom, Madalena; Tenreiro, Sandra; Serro, Ana PaulaDrug-eluting contact lenses (CLs) offer a promising approach to treat diabetic eye diseases. Compared to conventional treatments such as eye drops, CLs enhance drug bioavailability and residence time on the eye, while addressing patient compliance issues. Additionally, CLs are a safer alternative to ocular injections. In this study, CLs were designed for the sustained release of rosmarinic acid (RA), a natural polyphenol known for its antioxidant, anti-inflammatory, antibacterial and neuroprotective properties, which has been proposed as an alternative therapy for diabetic ocular complications. Acrylic and silicone-based hydrogels were produced and pre-treated with vitamin E. A sustained release of RA for up to 24 h was achieved under hydrodynamic conditions, which is compatible with the use of this hydrogel as daily CLs. Comprehensive characterization confirmed that the hydrogel’s physicochemical properties met commercial CLs standards, while no signs of ocular irritation nor cytotoxicity were observed in vitro. Ex vivo studies demonstrated that the drug could permeate through ocular tissues. The ocular RA distribution after the CL application was estimated in silico. Finally, the neuroprotective effect of RA was evaluated ex vivo in porcine retinal explants, confirming the therapeutic relevance of the designed hydrogels in the treatment of the diabetic eye.
- Rheological and structural analysis of hyaluronic acid fillers used for chin augmentationPublication . Carbone, Ana Claudia; Neves, Maria Luiza Boechat Borges; Zinco, André Gaspar; Nayak, Vasudev Vivekanand; Mendes, Lucas Alexandre de Sousa; Assad, Andressa De Marchi El; Câmara-Souza, Mariana Barbosa; Teixeira, Stephanie; Machado Filho, Daniel Augusto; Murakami, Fabio Seigi; Canales, Giancarlo De la TorreIntroduction: Chin contouring and projection represent some of the most frequently requested procedures in aesthetic practice using hyaluronic acid (HA) fillers. Variations in the physicochemical and viscoelastic properties of HA fillers may directly influence clinical performance. This study aimed to compare four commercially available HA gels specifically indicated for chin projection: JUVÉDERM® VOLUX, RESTYLANE® LYFT, PERFECTHA® SUBSKIN, and RESTYLANE® SHAYPE. Methods: The samples were characterized using scanning electron microscopy, dynamic light scattering, zeta potential, and swelling factor (SF). Rheological assessments included frequency sweep, amplitude sweep, and cohesivity modulus (MOC). All tests were performed in triplicate. Results: JUVÉDERM® VOLUX exhibited the highest SF values (3.28–3.37), indicating greater swelling capacity, whereas RESTYLANE® LYFT showed the lowest (1.53–1.66), reflecting a denser and less expansive profile. Rheological analysis revealed that RESTYLANE® LYFT and RESTYLANE® SHAYPE had higher storage modulus (G′) values at elevated frequencies. MOC was significantly higher for RESTYLANE® SHAYPE and PERFECTHA® SUBSKIN compared with JUVÉDERM® VOLUX, suggesting greater resistance to deformation. Conclusions: Overall, RESTYLANE® SHAYPE demonstrated the most favorable balance, combining moderate SF, high G′ values, and elevated MOC. However, patient-specific anatomy, aesthetic goals, and injector expertise remain critical in determining the most appropriate product for chin contouring.
- Recurrent gastrointestinal bleeding caused by cytomegalovirus duodenitisPublication . Mendes, Ivo; Vara-Luiz, Francisco; Antunes, Sofia Carralas; Nunes, GonçaloA 78-year-old male hospitalized due to acute pneumonia presented with hematemesis, melena and hypotension. Past medical history was relevant for prostate cancer with bone and lung metastasis under systemic chemotherapy. Upper gastrointestinal endoscopy revealed a 50mm serpiginous ulcer in the second portion of the duodenum with a visible vessel (Forrest IIa). Hemostatic therapy with adrenaline, polidocanol and one clip placement was performed. Biopsies of the ulcer were also obtained. During hospitalization the patient developed recurrent gastrointestinal bleeding requiring several red blood cell transfusions and endoscopic reintervention. Further histopathologic evaluation revealed chronic duodenitis caused by cytomegalovirus (CMV) infection. Considering the poor performance status and successful hemostasis with ulcer healing, antiviral treatment was not initiated. The patient died a few weeks later due to neoplastic disease progression.
- Nursing interventions to ensure the safety of critically ill patients in intrahospital transportation : a scoping reviewPublication . Lemos, Ana Filipa; Vareta, DianaBackground: Intrahospital transportation of critically ill patients is a high-risk process, frequently linked to complications and increased vulnerability to adverse events. Ensuring safety requires nursing interventions that uphold the standards of care provided in critical care units. Objective: To identify nursing interventions that promote patient safety during intrahospital transportation. Methods: A scoping review was conducted following Arksey and O’Malley’s framework. The search was performed in 2024 across PubMed and EBSCOhost (CINAHL Complete, MEDLINE Complete, Nursing & Allied Health Collection: Comprehensive, and Cochrane Central Register of Controlled Trials). Results: Seven publications met the criteria. All studies emphasized the need for strategies to prevent complications during transport. Four categories of interventions emerged: identification and management of adverse events, use of checklists, continuous nurse training, and effective communication. Conclusions: Nurses play a pivotal role in maintaining safety and quality of care. By applying evidence-based strategies, they minimize risks and ensure safer intrahospital transportation.
- Mental health, shame, and resilience : a study of victims and non-victims of nonconsensual intimate image sharingPublication . Almeida, Telma Catarina; Ifrim, Ionela Catalina; Matos, Ana FranciscaNonconsensual intimate image sharing (NCIIS) is a type of online violence that happens through Information and communication technologies. The consequences of NCIIS cause great suffering to victims. Some studies indicate that symptoms are alleviated in resilient victims. This quantitative study aims to analyze the relationship between NCIIS and shame, symptomatology, and resilience in adults’ lives, to compare the group of victims with non-victims of NCIIS concerning those variables, and to analyze the predictors of shame. The sample comprises 220 Portuguese participants aged 18 to 62 years (M = 24.9, SD = 6.58). About 38.2% of the participants are victims of NCIIS. Participants responded to the sociodemographic questionnaire, the Impact of Event Scale-Revised (IES-R), the Brief Symptom Inventory (BSI), and the Resilience Scale-10 (RS-10). The results indicate statistically significant positive correlations between the IES-R and the BSI, and statistically significant negative correlations between the RS-10 and all IES-R and BSI subscales. Victims of NCIIS show higher rates of shame and symptomatology and less resilience. NCIIS victimization, sex, and BSI significantly predict shame. Victims of NCIIS suffer several mental health consequences, and it is crucial to establish prevention plans, considering the impact of this victimization.
- Growth performance, bioconversion efficiency, and nutritional quality of yellow mealworm larvae reared on formulated diets based on local agro-industrial by-productsPublication . Loiotine, Z.; Oddon, S. Bellezza; Resconi, A.; Murta, Daniel; Ribeiro, T.; Biasato, I.; Gasco, L.Studies on yellow mealworm (YM, Tenebrio molitor) have mainly used feeding substrates with heterogeneous nutritional composition. In this study, three multi-ingredient agro-industrial diets (YM1, YM2, YM3), formulated to be nutritionally comparable in terms of CP (19.0–19.6% DM), ether extract (EE 3.0–3.2% DM), and gross energy (17.7–18.5 MJ/Kg DM), were tested to evaluate their effects on larval growth, bioconversion, chemical composition, and economic affordability. Diet YM1 included wheat middlings, wafer dough cooked, dry distillery stillage, coffee silvery film, breading waste and feed waste. Diet YM2 was based on feed waste and breading waste, with minor inclusions of wafer dough cooked and sweet preparation, whereas YM3 consisted of feed waste, breading waste and rice by-products (rice husk, chaff and bran). Wheat bran (WB; CP 20.5%, EE 4.2%, gross energy 18.6 MJ/kg, DM) served as environmental control. Diet costs (€/ton) calculated from by-product inclusion level and market price were 87.80 (YM1), 83.30 (YM2), and 95.50 (YM3), when compared to €250.00/tonne for WB. Four-week-old YM larvae (10 000/tray) were reared on 3 kg of diet per replicate and sampled weekly until growth differences between consecutive samplings were < 50% (week 9 of age, 35 days). Agar (25 g/L) was supplied three times weekly. At the end of the larval growth and biomass, development time, survival, growth rate (GR, mg/day), specific growth rate (SGR, %/day), feed conversion ratio, efficiency of conversion of ingested food (%), feed intake and water intake (%) were recorded. Statistical analyses were performed using IBM SPSS (v.20.0; P < 0.05). Rearing tray was the experimental unit with four replicates per treatment. A one-way ANOVA with Tukey’s post-hoc test was applied for all the tested parameters. At 9 weeks of age, larvae fed YM2 and YM3 showed significantly higher final average weight (139 mg for both YM diets), GR (3.90–3.91 mg), and SGR (11.90% for both) than those fed YM1 (118 mg; 3.31 mg–11.40%, respectively; P < 0.001), with no differences between YM2 and YM3 (P > 0.05). Larval composition varied across treatments (P < 0.05), with higher DM and EE in YM1 (36.50−37.90%, respectively) than YM3 (35.40–35.0%), while YM2 showed no significant differences (36.0–37.3%). Ash content was higher in YM3 (4.02%) than in YM1 and YM2 (3.34–3.45%; P < 0.05). In conclusion, nutritionally comparable multi-ingredient agro-industrial diets supported YM growth and bioconversion, while reducing feed costs when compared to the WB diet.
- Exploring senior nursing students’ perspectives on humanizing care for patients in isolation : a qualitative studyPublication . Fernandes, Júlio Belo; Castro, Cidália; Simões, Aida; Vareta, Diana; Barros, Inês; Benatti, Luiza; Hall, Steven; Fernandes, SóniaBackground: Isolation units play a vital role in controlling disease transmission and ensuring the safety of both patients and healthcare professionals. However, the experience of isolation can lead to feelings of loneliness and anxiety that negatively affect patients’ wellbeing and recovery. Given this, making care more humanized in these settings should be a key priority in healthcare. This study explores nursing students’ perspectives on interventions that contribute to humanizing care for patients in isolation units. Methods: A theory-informed qualitative descriptive study was conducted with 19 senior nursing students completing clinical placements in isolation units across five hospitals. Interviews were transcribed and analyzed using Braun and Clarke’s six-step thematic analysis. Watson’s Theory of Human Caring was used as a sensitizing framework to support data interpretation. Results: The study identified several nursing interventions that enhance the humanization of patient care in isolation units. These interventions were classified into two main dimensions based on Watson’s theory. The instrumental dimension included interventions focused on symptom management, physical comfort, infection prevention and control, continuity of care, and discharge planning. The expressive dimension encompassed strategies directed at establishing a therapeutic relationship, individualized care planning, emotional and psychosocial support, relaxation and entertainment, patient empowerment, and family involvement. Conclusion: Categorizing these interventions within the framework of the Theory of Human Caring provides valuable insight into various approaches to humanizing care in isolation units. These findings can contribute to the development of patient-centered care models, encouraging healthcare professionals to deliver more comprehensive and compassionate care that addresses the holistic needs of isolated patients.
- Exploring preferences and priorities in advanced Parkinson’s disease : a discrete choice experimentPublication . Arija, Pablo; Domingos, Josefa; Malaty, Irene A.; Pahwa, Rajesh; Chaudhuri, K. Ray; Antonini, Angelo; Penton, Hannah; Heisen, Marieke; Yan, Connie H.; Kukreja, Pavnit; Shirneshan, Elaheh; Lee, Inyoung; Shah, Megha; Parra, Juan Carlos; Boeri, MarcoIntroduction: Treatments for advanced Parkinson’s disease (aPD) are differentiated by efficacy, safety, and modality-related characteristics. As the disease progresses and motor fluctuations worsen, many patients require more frequent dosing or consideration of device-aided therapies, including subcutaneous infusions, intestinal gel delivery systems, or deep brain stimulation. Assessing treatment preferences is valuable to ensure people with aPD (PwP) and care partners (CPs) are satisfied with a treatment’s impact on both motor function and quality of life, potentially increasing adherence and effectiveness. Methods: A total of 304 participants (223 PwP, 81 CPs) from the USA, UK, and Germany were included in the study. A discrete choice experiment (DCE) was used to elicit preferences over treatment characteristics. In the DCE, respondents were presented with a series of choice tasks, each consisting of two hypothetical treatments described by varying levels of seven attributes: daily hours of ON time without troublesome dyskinesia (ONwoTD), frequency of early morning OFF time (EMO), risk of mild-to-moderate skin reactions, risk of severe side effects requiring hospitalization, route of administration (ROA), frequency of pill regimen, and frequency of device maintenance. Analyses with a random parameter logit model were used to estimate attribute conditional relative importance (CRI) and explore how people would trade off across attributes. Results: The average PwP age was 65.7 years (SD 8.6), time since diagnosis was 10.0 years (SD 4.4), and self-reported OFF time was 4.0 h/day (SD 2.4). Within the survey design, ROA emerged as the most important attribute (CRI 35.3), followed by hours of ONwoTD (CRI 26.4). All other attributes were of similar importance. Nonsurgical treatments were strongly preferred, with oral pills being the most preferred, followed by infusion device without surgery (subcutaneous infusion). Conclusions: PwP prioritized efficacy (ONwoTD) and ROA when considering treatment options. Understanding these preferences may enhance informed and meaningful decision-making between healthcare providers and PwP.
- Evaluating reporting completeness in oral health clinical guidelines : a meta-research studyPublication . Lancry, P.; Lyra, P.; Mendes, José João; Nascimento, G. G.; Machado, Vanessa; Botelho, JoãoBackground: To assess the adherence to clinical practice guidelines (CPGs) reporting guidelines for oral health. Methods: A literature search was carried out in PubMed, Embase and Web of Science from March 2016 to December 2023, selecting CPGs related to oral health. The study selection and data extraction were conducted independently by 2 researchers. Guidelines were cross-checked against the 23-item Appraisal of Guidelines, Research, and Evaluation (AGREE). The results were then collected, and the overall adherence and adherence to each AGREE item and section were calculated. Regression analyses were performed considering journal characteristics, such as quartile, year, and publishing options in journals’ guideline endorsement. There were no language restrictions. Results: Twenty-one CPGs were included in this study. The mean overall AGREE adherence was 48.7%. The results showed considerable variability in the rates of compliance with the reporting guidelines. Three areas appear to have (much) higher levels of compliance than the others, notably “Clarity of Presentation” (83.6%, 95% confidence interval [CI]: 75.4%–91.8%), “Scope and Purpose” (74.0%, 95% CI: 67.1%–80.9%), and “Stakeholder Involvement” (54.5%, 95% CI: 43.4%–65.7%). The lowest level of agreement was found in “Applicability,” with a level of agreement of 18.5% (95% CI: 11.4%–25.6%). Four of the 6 domains had a complete lack (0.0%) of adherence. Journal quartiles were significant, as guidelines published in the second- (B = −27.3%; standard error [SE] = 6.1) and third-quartile (B= −22.8%; SE = 10.6) impact factor journals displayed a lower overall adherence than those published in first-quartile journals. Guideline endorsement by journals was also a significant variable (B = −20.9%, SE = 5.9). Conclusion: Reporting completeness in dental/oral CPGs is suboptimal and is associated with the journal’s quartile and guideline endorsement. Increasing awareness of CPG reporting guidelines and ensuring their rigorous application are decisive toward better adherence.
- Enhancing preclinical proficiency in aesthetic medicine and cosmetic dermatology : an evidence-based review of interactive visual simulation techniquesPublication . Khalil, Hassan; Pereira, Inês Novo; Shatta, Bashar; Magrin, Anna Maria Fenech; Hassan, HaidarBackground: Unlike many clinical disciplines where simulation is already embedded in curricula, aesthetic medicine and cosmetic dermatology present distinctive training challenges. Interactive visual simulation techniques offer immersive, risk-free environments for developing technique-dependent competencies, but their evidence base within this specific field remains comparatively limited. Aims: To identify the key features and potential value of interactive visual simulation techniques for aesthetic medicine and cosmetic dermatology, and to provide evidence-based insights for integrating these technologies into academic training programs. Methods: An evidence-based review using the Best Bets methodology was conducted. Two independent reviewers searched PubMed and Google Scholar (October 2024–February 2025) for literature published between 2015 and 2025. Evidence was graded using the Oxford Centre for Evidence-Based Medicine (OCEBM) 2011 Levels of Evidence, and quality was assessed using Critical Appraisal Skills Programs (CASP) checklists. Results: Thirteen studies met the inclusion criteria, encompassing 897 reported participants across nine simulation modalities: virtual reality (n = 2), augmented/mixed reality (n = 1), 3D-printed models (n = 2), 3D digital simulation (n = 1), hands-on simulation (n = 2), simulation-based education (n = 2), haptic feedback (n = 1), smartphone applications (n = 1), and AI applications (n = 1). Three of the 13 studies were cross-disciplinary (general dermatological suturing, smartphone adoption patterns, and AI-assisted patient education) and were retained as contextual evidence rather than as direct tests of aesthetic-specific training efficacy. Evidence was predominantly low-level: Level II (n = 2), Level III (n = 3), Level IV (n = 2), and Level V (n = 6). Risk of bias was high across the majority. Reported outcomes clustered at Kirkpatrick Levels 1–2a (learner satisfaction and confidence), with only one study demonstrating objective skill improvement (Level 2b). Despite these limitations, simulation-based techniques consistently demonstrated potential to improve self-reported procedural knowledge and trainee confidence. Conclusion: Simulation-based training shows promise for aesthetic medicine and cosmetic dermatology. Although favorable outcomes were reported, these were predominantly confidence-based (Kirkpatrick Level 2a) rather than objective skill measures. These results cautiously support integration of simulation technologies into training programs but underscore the urgent need for rigorous, randomized controlled trials with objective competence outcomes to establish long-term efficacy and generalizability.