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- Adaptação cultural, tradução e avaliação psicométrica do questionário de estigma sobre a perturbação de hiperatividade e défice de atenção para países de língua portuguesaPublication . Couto, Beatriz; Trigueiro, Maria João; Simões-Silva, Vítor; Almeida, Raquel Simões de; Trigueiro, Maria João; Simões-Silva, Vitor; Simões de Almeida, RaquelApesar do crescente conhecimento sobre a Perturbação de Hiperatividade e Défice de Atenção (PHDA), estas pessoas ainda enfrentam estigmas da sociedade. A pesquisa sobre o estigma associado à PHDA é limitada pela falta de instrumentos válidos e fiáveis. Este estudo teve como objetivo validar o Questionário de Estigma sobre a PHDA (ASQ) para a população portuguesa e perceber os níveis de estigma numa amostra comunitária. A amostra consistiu em 762 indivíduos, com idades entre 11 e 64 anos (média = 32,41 ±14,59 anos). A validação incluiu a tradução e adaptação cultural da versão original e a análise das propriedades psicométricas: fiabilidade (teste-reteste e consistência interna), validade de conteúdo e de construto. A consistência interna do ASQ foi excelente (α = 0,93) e os valores de teste-reteste (r = 0,86) suportam a fiabilidade do instrumento. Na validade de construto, a análise fatorial explicou 50,25% da variância e indicou uma nova distribuição dos itens 2, 3, 9 e 15 no instrumento. As mulheres (p<0,001) e os residentes em áreas costeiras (p=0,015) apresentaram níveis mais elevados de estigma. A utilização do ASQ para a pesquisa e prática clínica em Portugal é adequadamente suportada pelas suas propriedades psicométricas. Campanhas direcionadas de literacia e estigma da PHDA podem ser uma via importante para melhorar as atitudes da comunidade em geral em relação à PHDA
- Adaptação de Laboratórios Remotos a Cenários de Ensino: Casos de Estudo com VISIR e RemotElectLabPublication . Fidalgo, André V.; Alves, Gustavo R.; Marques, Maria A.; Viegas, Maria C.; Costa-Lobo, Maria C.; Hernández-Jayo, Unai; García-Zubía, Javier; Gustavsson, Ingvar; Alves, Gustavo; Fidalgo, André; Marques, Maria Arcelina; Viegas, Clara; Costa Lobo, Cristina; Garcia-Zubia, JavierOs laboratórios remotos são uma ferramenta tecnológica e pedagógica com uso crescente em todos os níveis de educação, e sua utilização generalizada é uma parte importante do seu próprio aperfeiçoamento e evolução. Este artigo descreve vários problemas encontrados em aulas laboratoriais, em cursos de ensino superior, na utilização de laboratórios remotos baseados em sistemas PXI, utilizando o sistema VISIR ou uma solução alternativa. São identificados e explicados três problemas que foram relatados por professores que deram apoio aos estudantes na utilização dos laboratórios remotos. O primeiro problema prende-se com a necessidade de permitir aos alunos selecionar a localização específica onde um amperímetro deve ser inserido nos circuitos elétricos, mesmo que incorreta, replicando as dificuldades do mundo real. O segundo é causado por falhas de sincronismo quando são necessárias várias medições em intervalos curtos, como no ciclo de descarga de um condensador. E o último problema é provocado pelo uso de um multímetro em modo DC na leitura de grandezas em CA, um procedimento que colide com as definições do equipamento. Todos os cenários são apresentados e discutidos, incluindo a solução encontrada para cada caso. A conclusão que se retira do trabalho descrito é que a área de laboratórios remotos é um campo em expansão, onde a sua utilização prática permite o aperfeiçoamento e a evolução das soluções disponíveis, exigindo uma cooperação e partilha de informação entre todos os intervenientes, i.e. investigadores, professores e alunos.
- Adherence to treatment in allergic rhinitis during the pollen season in Europe: A MASK‐air StudyPublication . Bousquet, Jean; Amaral, RitaAdherence to rhinitis treatment has been insufficiently assessed. We aimed to use data from the MASK-airmHealth app to assess adherence to oral antihistamines (OAH), intra-nasal corticosteroids (INCS) or azelastine-fluticasone inpatients with allergic rhinitis. We included regular European MASK-air users with self-reported allergic rhinitis and reporting at least 1 day of OAH,INCS or azelastine-fluticasone. We assessed weeks during which patients answered the MASK-air questionnaire on all days. Werestricted our analyses to data provided between January and June, to encompass the pollen seasons across the different assessedcountries. We analysed symptoms using visual analogue scales (VASs) and the combined symptom-medication score (CSMS),performing stratified analyses by weekly adherence levels. Medication adherence was computed as the proportion of days inwhich patients reported rhinitis medication use. Sensitivity analyses were performed considering all weeks with at most 1 day ofmissing data and all months with at most 4 days of missing data. We assessed 8212 complete weeks (1361 users). Adherence (use of medication > 80% days) to specific drug classesranged from 31.7% weeks for azelastine-fluticasone to 38.5% weeks for OAH. Similar adherence to rhinitis medication was foundin users with or without self-reported asthma, except for INCS (better adherence in asthma patients). VAS and CSMS levelsincreased from no adherence to full adherence, except for INCS. A higher proportion of days with uncontrolled symptoms was observed in weeks with higher adherence. In full adherence weeks, 41.2% days reported rhinitis co-medication. The sensitivityanalyses displayed similar results. A high adherence was found in patients reporting regular use of MASK-air. Different adherence patterns werefound for INCS compared to OAH or azelastine-fluticasone that are likely to impact guidelines.
- Age-related influence on reliability and learning effect in the assessment of lower limb strength using sit-to-stand tests: A cross-sectional studyPublication . Vilarinho, Rui; Montes, António Mesquita; Melo, Cristina; Mesquita Montes, AntónioDecreased muscle strength, especially in the muscles of lower limbs, is an important risk factor for early age‐related decline in physical function, morbidity, hospitalization, and mortality.1 This evidence should be a stimulus for healthcare professionals to include the assessment of muscular strength as a priority in the community due to its substantial value in predicting future health status.2 For this purpose, sit‐to‐stand tests represent one of the simple and valid options to quantify lower limb strength,3 and two of the most used are the 1‐min sit‐to‐stand (1MSTS)4 and the 5 times sit‐to‐stand (5TSTS).5 To standardize the use of 1MSTS and 5TSTS, it is important to explore whether a similar reliability and learning effect exist between adults and older adults in community settings. Since aging may cause a significant reduction in motor skill acquisition,6 it is important to carefully consider whether performances on these tests are the same for repeated measurement over time (test‐retest) and if a practice test is needed according to age. Another reason to establish the reliability and learning effect, before recommending the use of the sit‐to‐stand tests for adults and older adults, is because significantly different performances have been found between these populations.7,8 With this research, we aimed to determine the within‐day test‐ retest reliability and the learning effect of the 1MSTS and 5TSTS in adults (
- An evolutionary perspective on the relationship between kinetochore size and CENP-E dependence for chromosome alignmentPublication . Almeida, Ana C.; Almeida, Ana C.; Rocha, Hélder; Rocha, Hélder; Raas, Maximilian W. D.; Raas, Maximilian W. D.; Witte, Hanh; Witte, Hanh; Sommer, Ralf J.; Sommer, Ralf J.; Snel, Berend; Snel, Berend; Kops, Geert J. P. L.; Kops, Geert J. P. L.; Gassmann, Reto; Gassmann, Reto; Maiato, Helder; Maiato, HelderChromosome alignment during mitosis can occur as a consequence of bi-orientation or is assisted by the CENP-E (kinesin-7) motor at kinetochores. We previously found that Indian muntjac chromosomes with larger kinetochores bi-orient more efficiently and are biased to align in a CENP-E-independent manner, suggesting that CENP-E dependence for chromosome alignment negatively correlates with kinetochore size. Here, we used targeted phylogenetic profiling of CENP-E in monocentric (localized centromeres) and holocentric (centromeres spanning the entire chromosome length) clades to test this hypothesis at an evolutionary scale. We found that, despite being present in common ancestors, CENP-E was lost more frequently in taxa with holocentric chromosomes, such as Hemiptera and Nematoda. Functional experiments in two nematodes with holocentric chromosomes in which a CENP-E ortholog is absent (Caenorhabditis elegans) or present (Pristionchus pacificus) revealed that targeted expression of human CENP-E to C. elegans kinetochores partially rescued chromosome alignment defects associated with attenuated polar-ejection forces, whereas CENP-E inactivation in P. pacificus had no detrimental effects on mitosis and viability. These data showcase the dispensability of CENP-E for mitotic chromosome alignment in species with larger kinetochores.
- An overview of the clinical uses, pharmacology, and safety of modafinilPublication . Murillo-Rodríguez, Eric; Veras, André Barciela; Rocha, Nuno Barbosa; Budde, Henning; Machado, Sérgio; Rocha, NunoModafinil (MOD) is a wakefulness-inducing compound prescribed for treatment of excessive daytime sleepiness as a consequence of sleep disturbances such as shift work sleep disorder, obstructive sleep apnea, restless leg syndrome, or narcolepsy. While providing effective results in patients with sleepiness, MOD also produces positive outcomes in the management of fatigue associated with different conditions including depression, cancer, or tiredness in military personnel. Although there is clear evidence of the stimulant effects of MOD, current data also show that administration of this drug apparently induces positive neurobiological effects, such as improvement in memory. However, serious concerns have been raised since some reports have suggested MOD dependence. Taken together, these findings highlight the need to characterize the changes induced by MOD which have been observed in several neurobiological functions. Moreover, further work should follow up on the likely long-term effects of this drug if used for treatment of drowsiness and tiredness. Here, we review and summarize recent findings of the medical uses of MOD in the management of sleepiness and fatigue associated with depression or cancer as well as exhaustion in military personnel. We also discuss the available literature related with the cognitive enhancing properties of this stimulant, as well as what is known and unknown about MOD addiction.
- An overview of the recent advances in antimicrobial resistancePublication . Oliveira, Manuela; Antunes, Wilson; Mota, Salete; Carvalho, Áurea Madureira; Oliveira, Ricardo Jorge Dinis; Silva,Diana Dias daAntimicrobial resistance (AMR), frequently considered a major global public health threat, requires a comprehensive understanding of its emergence, mechanisms, advances, and implications. AMR’s epidemiological landscape is characterized by its widespread prevalence and constantly evolving patterns, with multidrug-resistant organisms (MDROs) creating new challenges every day. The most common mechanisms underlying AMR (i.e., genetic mutations, horizontal gene transfer, and selective pressure) contribute to the emergence and dissemination of new resistant strains. Therefore, mitigation strategies (e.g., antibiotic stewardship programs—ASPs—and infection prevention and control strategies—IPCs) emphasize the importance of responsible antimicrobial use and surveillance. A One Health approach (i.e., the interconnectedness of human, animal, and environmental health) highlights the necessity for interdisciplinary collaboration and holistic strategies in combating AMR. Advancements in novel therapeutics (e.g., alternative antimicrobial agents and vaccines) offer promising avenues in addressing AMR challenges. Policy interventions at the international and national levels also promote ASPs aiming to regulate antimicrobial use. Despite all of the observed progress, AMR remains a pressing concern, demanding sustained efforts to address emerging threats and promote antimicrobial sustainability. Future research must prioritize innovative approaches and address the complex socioecological dynamics underlying AMR. This manuscript is a comprehensive resource for researchers, policymakers, and healthcare professionals seeking to navigate the complex AMR landscape and develop effective strategies for its mitigation.
- Análise de repetição de exames em radiologia convencionalPublication . Freitas, Artur; Pereira, José Manuel; Pereira, José ManuelA Radiologia Convencional é o método de primeira linha no diagnóstico de diversas patologias e avaliação da anatomia. A repetição de exames relaciona-se com o não cumprimento de critérios de boa realização que resultem em ausência/insuficiência de valor diagnóstico. A diminuição da taxa de repetição representa um fator importante na área da radiologia e da saúde comunitária, contribuindo para a diminuição da dose recebida pelos doentes e profissionais de saúde. O objetivo principal deste estudo foi determinar os exames de radiologia convencional mais suscetíveis de serem repetidos pelos técnicos de radiologia, e causas associadas. Realizou-se um estudo analítico, observacional e transversal. Os dados foram colhidos através da aplicação online de um inquérito por questionário aos participantes no estudo. A população em estudo consistiu em técnicos de radiologia portugueses, licenciados em radiologia ou imagem médica e radioterapia, a exercer funções em Portugal ou no estrangeiro. Para o estudo de associações entre variáveis, utilizaram-se os testes estatísticos de Correlação de Pearson e Qui-quadrado da independência. A amostra foi constituída por 228 participantes, dos quais 176 (77,2%) do sexo feminino, com média de idade de 33.93 (±10.37) anos e tempo médio de experiência profissional de 10.58 (±10.34) anos. O exame ao joelho (61%) foi considerado pelos participantes como o mais provável de ser repetido, seguido do tórax (29.4%) e ombro (24.6%). Os participantes apontaram como erro técnico mais comum o posicionamento incorreto, sendo a não colaboração do doente, o principal fator preditor de erro técnico. Observou-se uma correlação negativa de fraca amplitude entre o tempo de experiência dos profissionais e a frequência com que repetem exames radiológicos. Os exames realizados ao joelho, ombro e tórax, são aqueles que apresentam maior taxa de repetição, sendo o erro mais comum o posicionamento incorreto do doente. O fator que mais contribui para o erro é a não colaboração do doente. Os participantes realçam a necessidade do desenvolvimento de programas de formação contínua e a introdução de pequenas pausas durante os turnos.
- Analytical strategies based on tandem mass spectrometry detection for quantification of bioactive compounds in biological matricesPublication . Barreiros, Luisa; Fernandes, Sara R.; Machado, Sandia; Silva, Eduarda M. P.; Segundo, Marcela A.Fast and accurate analysis, providing reliable results at trace concentration levels, is a current demand of the modern world. This pressure is justifiable in limit situations but also in our daily life, for instance when waiting for a diagnosis based on lab results in a hospital or when wondering about the quality of water running from our taps. During the last years, tandem mass spectrometry (MS/MS) based techniques have become the method of choice for determination of chemical compounds in complex matrices due to their inherent high sensitivity and selectivity. MS/MS techniques allow the achievement of low limits of detection and therefore prompt for the quantification of trace analyte levels generally present in environmental and biological samples. The majority of applications rely on the coupling to a separative technique prior to MS/MS detection. In this work, relevant applications of the association HPLC-MS/MS for quantification of bioactive compounds in biological matrices will be critically discussed. The steps of sample preparation and analytical determination will be addressed. Moreover, the main analytical features of each developed method, including selectivity, accuracy, precision, limits of detection (LOD) and quantification (LOQ), stability and matrix effects will be highlighted. First, despite the recognition of tranexamic acid (TXA) as an important antifibrinolytic drug, there is a lack of pharmacokinetic and pharmacodynamic data concerning variable age groups undergoing surgeries with high blood loss. Clinical trials performed so far suggest a wide variability in response to TXA and, therefore, the implementation of a methodology based on UHPLC-MS/MS for monitoring TXA in human plasma samples at sub-microgram per milliliter levels was pursued.1 In a different context, millions of people worldwide live with human immunodeficiency virus (HIV) infection raising the continuous search for new prevention and treatment strategies, including topical microbicide products combining antiretroviral drugs such as tenofovir (TFV) and efavirenz (EFV). An HPLC-MS/MS method was developed targeting the quantification of antiretrovirals in mice tissue and fluid samples recovered from a pharmacokinetics study with nanoparticles and it was fully validated for the different biological matrices.2 Finally, BIBP 3226 is a potent and selective neuropeptide Y Y1 receptor antagonist that has been successfully used in in vitro studies showing a positive impact in bone turnover and thus providing good perspectives towards its application as a pharmacological tool for bone regeneration. Having in mind the therapeutic potential of BIBP 3226 and also the need to elucidate receptor-antagonist internalization mechanisms, the challenge was to develop a methodology based on HPLC-MS/MS that permitted to quantify the low quantities of antagonist expected to be internalized by cells.
- Application of CytoPath®easy vials in Cervical Cancer screening: Self‑sampling approachPublication . Fernandes, Sílvia P. M.; Vilarinho, Ana Sofia; Frutuoso, Amaro; Teixeira, Cidália; Silva, Regina Augusta A. P."CytoPath®Easy kit (DiaPath S.p.A.) offers a major advantage compared to other commercially available kits available for the screening of cervical cancer, as it does not require additional equipment for sample processing. Using this methodology, collected epithelial cells are immersed in a preservative liquid before setting as a thin layer on a slide via gravity sedimentation. Aims: To evaluate the suitability of the CytoPath®Easy kit for the processing of cervicalsamples, detection of pre‑neoplastic lesions, and nucleic preservation and extraction for HR‑HPV diagnosis. A total of 242 self‑sampled cervicalspecimens were utilized, with 192 collected in CytoPath®Easy vials and 50 collected and processed using the ThinPrepTM for comparative analysis. The samples underwent processing, Papanicolaou staining, and microscopic evaluation for morphological parameters. The extracted nucleic acids were assessed for purity and integrity, and the detection of high‑risk human papillomavirus (HR‑HPV) was carried out using the Alinitym HR HPV system kit (Abbott Laboratórios Lda). Both methods demonstrated effective performance, enabling the morphological assessment of the cervical epithelium. Statistical analysis indicated that ThinPrepTM yielded significantly better results in terms of cellularity. Conversely, CytoPath®Easy exhibited superior performance in terms of the quantity of extracted DNA and its degree of purification. Concerning the time consumed during processing, both methods were comparable, with the CytoPath®Easy methodology standing out for its cost‑effectiveness, as it does not necessitate additional instruments and consumables. The novel CytoPath®Easy methodology proves effective in preserving both nucleic acids and cell morphology characteristics, two crucial features for cervical cancer screening."