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- Executive function in gambling disorder: A meta-analysis on neuropsychological evidencePublication . Peixoto, Miguel; Dores, Artemisa; Monteiro, Maria; Marques, António; Barbosa, Fernando; Pereira da Silva Marques, António José; Dores, Artemisa; de Faria Távora Moreira Peixoto, MiguelGambling disorder (GD) is associated with defcits in various cognitive functions. Specifcally for executive function (EF), previous fndings are inconsistent, despite defcits being reported for shifting, inhibition, planning, and working memory domains. Although a worse performance in EF measures related to GD severity is often reported, there is a need to clarify current evidence. This study aims to systematically review and perform a meta-analysis to clarify the association between EF defcits and GD. The current study followed the preferred reporting items for systematic reviews and meta-analyses protocols. The meta-analysis used a random efects model and robust variance estimation to analyze the data, using Hedge’s g to report efect sizes. A total of 21 studies were systematically reviewed, of which 17 were included for meta-analysis. Meta-analysis was performed for shifting, inhibition, planning, and verbal fuency. Due to a lower number of studies, working memory data was systematically reviewed, but no meta-analysis was performed. Significant efect sizes were found for shifting and inhibition, indicative of defcits in participants with GD. No signifcant defcits were found for the other EF domains. Working memory results revealed inconsistent evidence, even when divided into verbal and visuospatial modalities. There is enough evidence of defcits in shifting and inhibition in participants with GD. However, better sample characterization should be considered in future studies to better understand the sources of potential heterogeneity. Consideration of gambling severity as a continuous variable could allow for a more detailed analysis of EF alterations across the various degrees of GD.
- Neuroscience of exercise: Association among neurobiological mechanisms and mental healthPublication . Machado, Sérgio; Paes, Flávia; Rocha, Nuno Barbosa Ferreira; Yuan, Ti-Fei; Mura, Gioia; Arias-Carrión, Oscar; Nardi, Antonio Egidio; Rocha, NunoNeuroscience is an emergent research field that comprises many multidisciplinary investigations, searches for explanations about the relationship between the body and the brain. Here, we will give a little summary of this field showing the main current findings. We discuss the lack of consistent data about the relationship among exercise for neurodegenerative diseases and psychiatric disorders, sports performance and rehabilitation, and therefore, the difficult to describe cause-effect associations or to describe in detail the neurobiological mechanisms underlying these associations.
- Systemic injections of Cannabidiol enhance Acetylcholine levels from basal forebrain in ratsPublication . Murillo‑Rodríguez, Eric; Arankowsky‑Sandoval, Glória; Rocha, Nuno Barbosa; Peniche‑Amante, Rodrigo; Veras, André Barciela; Machado, Sérgio; Budde, Henning; Rocha, NunoCannabis sativa is a plant that contains more than 500 components, of which the most studied are Δ9-tetrahydrocannabinol (Δ9-THC) and cannabidiol (CBD). Several studies have indicated that CBD displays neurobiological effects, including wake promotion. Moreover, experimental evidence has shown that injections of CBD enhance wake-related compounds, such as monoamines (dopamine, serotonin, epinephrine, and norepinephrine). However, no clear evidence is available regarding the effects of CBD on additional wake-related neurochemicals such as acetylcholine (ACh). Here, we demonstrate that systemic injections of CBD (0, 5, 10 or 30 mg/kg, i.p.) at the beginning of the lights-on period, increase the extracellular levels of ACh collected from the basal forebrain and measured by microdialysis and HPLC means. Moreover, the time course effects on the contents of ACh were present 5 h post-injection of CBD. Altogether, these data demonstrate that CBD increases ACh levels in a brain region related to wake control. This study is the first to show the effects of ACh levels in CBD-treated rats and suggests that the basal forebrain might be a site of action of CBD for wakefulness modulation.
- 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.
- Interventions based on biofeedback systems to improve workers’ psychological well-being, mental health and safety: a systematic literature reviewPublication . Ferreira, Simão; Rodrigues, Matilde A.; Mateus, Catarina; Rodrigues, Pedro Pereira; Rocha, Nuno Barbosa; Ferreira, Simão; Rodrigues, Matilde; Mateus, Catarina; Rocha, NunoIn modern, high-speed work settings, the significance of mental health disorders is increasingly acknowledged as a pressing health issue, with potential adverse consequences for organizations, including reduced productivity and increased absenteeism. Over the past few years, various mental health management solutions, such as biofeedback applications, have surfaced as promising avenues to improve employees' mental well-being. To gain deeper insights into the suitability and effectiveness of employing biofeedback-based mental health interventions in real-world workplace settings, given that most research has predominantly been conducted within controlled laboratory conditions. A systematic review was conducted to identify studies that used biofeedback interventions in workplace settings. The review focused on traditional biofeedback, mindfulness, app-directed interventions, immersive scenarios, and in-depth physiological data presentation. The review identified nine studies employing biofeedback interventions in the workplace. Breathing techniques showed great promise in decreasing stress and physiological parameters, especially when coupled with visual and/or auditory cues. Future research should focus on developing and implementing interventions to improve well-being and mental health in the workplace, with the goal of creating safer and healthier work environments and contributing to the sustainability of organizations.
- How useful is mixed reality in surgical treatment? - a Delphi StudyPublication . Magalhães, Renato; Lima, Ana Carolina; Marques, António; Pereira, Javier; Pereira da Silva Marques, António José; Magalhães, RenatoMixed reality (MR) is a tool that integrates elements from both the real and virtual worlds. Its potential applications are manifold, with promising developments observed in diverse fields, including healthcare, particularly in the context of surgical procedures. A number of studies have been conducted on mixed reality headsets, including the Microsoft HoloLens 2®, which may be employed in surgical training, planning, and navigation. It is imperative to ascertain whether medical professionals consider this technology indispensable in their professional lives. This study employs the Delphi method to assess the utility of MR in surgical settings and utilizes the Welphi online platform to facilitate this process. Furthermore, a PRISMA-like approach is employed to analyze the results of the initial round. The objective of this study is to examine the feasibility and advantages of mixed reality technology in surgical contexts. The findings are intended to inform and direct healthcare professionals, researchers, and developers in the advancement of mixed reality integration in surgical environments, with the ultimate goal of optimizing the quality and safety of treatments. A Delphi approach comprising of three rounds was implemented to ascertain consensus on the utility of MR surgical treatment. Participants were purposefully selected from experts with professional experience with technologies that provide a more immersive or interactive experience, such as virtual reality (VR), augmented reality (AR), 3D laparoscopy, robotics, and other similar technologies applied in the surgical field. The initial round of the study was designed to allow surgeons to provide their insights into the potential applications of MR in surgical procedures. This phase employed a structured approach, with open-ended questions organized into five distinct sections. In the second round, the questions were derived from the analysis of the first round and organized according to main and sub-topics for hierarchical structuring. In the third round, the questions were identical to those posed in the second round, including the percentage results obtained in the previous round. This afforded the experts the opportunity to review their previous responses. A consensus round was subsequently conducted. In the analysis, Kendall's tau-b coefficient for correlation analysis was employed and significant correlations between distinct aspects were identified. Twenty-two of the invited experts provided responses in both the initial and subsequent rounds, representing a 100% response rate. In the third round and consensus round, 20 experts participated, representing 91% response rate. The consensus round was conducted to present the results that had achieved a level of majority consensus of 95% on the usefulness of MR in surgical treatment. The objective was to have experts validate the results. The primary benefits of MR in surgery were identified as surgical navigation (with 75% of consensus), surgical planning (with 75% of consensus), and teaching and training (with 70% of consensus). According to the Delphi study, the areas where MR technology is most beneficial in surgical contexts are surgical navigation, training, and planning. However, the costs and investments required for implementation may present a potential limitation for the integration of this technology in surgical procedures. Moreover, it is of crucial importance to comprehend the ethical implications associated with this matter, which may have implications for the security of patients.
- Mixed reality in the operating room: A systematic reviewPublication . Magalhães, Renato; Oliveira, Ana; Terroso, David; Vilaça, Adélio; Veloso, Rita; Marques, António; Pereira, Javier; Pereira da Silva Marques, António José; Magalhães, RenatoMixed Reality is a technology that has gained attention due to its unique capabilities for accessing and visualizing information, becoming a valuable tool for medicine, particularly for the operating room and surgical learning; A systematic review was conducted following the PRISMA guidelines to answer the research questions established using the PICO framework; Although implementation of Mixed Reality applications in the operations room presents some challenges, when used appropriately, it can yield remarkable results. It can make learning easier, flatten the learning curve for several procedures, and facilitate various aspects of the surgical processes; Technical complexity, equipment costs, and steep learning curves present significant obstacles to the widespread adoption of Mixed Reality and computer-assisted evaluation. The possibility of integration of distinct medical imaging modalities and innovative functionalities holds promise for clinical applications. However, it is important to consider issues related to usability, bias, and statistical analyses need consideration. Mixed Reality offers significant benefits, but there are still open challenges such as ergonomic issues, limited field of view, and battery autonomy that must be addressed to ensure widespread acceptance.
- Nature-based interventions targeting elderly people’s health and well-being: an evidence mapPublication . Catissi, Giulia; Gouveia, Gabriela; Savieto, Roberta Maria; Silva, Cristiane Pavanello Rodrigues; Almeida, Raquel Simões de; Borba, Gustavo Benvenutti; Rosario, Kaue Alves; Leão, Eliseth Ribeiro; Simões de Almeida, RaquelHealthy aging encompasses more than the absence of disease, emphasizing the preservation of functional abilities for enhanced well-being and quality of life. Nature-based interventions are scientifically proven contributors to healthy aging. To develop an evidence map showcasing nature-based interventions targeting older individuals’ health and well-being. The evidence map was developed through critical analysis of systematic reviews and clinical trials utilizing the tools AMSTAR2 and CONSORT. A systematic search spanning the past decade was conducted across databases: Cochrane, SCOPUS, PubMed, Web of Science, Embase, and LILACS. Twelve articles met the eligibility criteria. Nature-based interventions such as forest bathing, hiking, therapeutic gardens, virtual reality, and forest sounds were identified. Outcomes were categorized into physical aspects (cardiovascular and pulmonary; neuro-immuno-endocrinological) and mental/behavioral aspects. The final map integrated interventions, outcomes, and quality assessments. The survey highlights the positive impact of nature-based interventions on the health of the elderly. This study provides insights across various domains, fostering the development of programs and policies in management to promote healthy aging. Regarding healthcare, it encourages discourse among professionals regarding the integration of nature-based practices for equitable care in both individual and group settings. Furthermore, it underscores the need for research in the Southern Hemisphere, particularly in Brazil, where the study was conducted.
- The use of digital technologies to promote physical activity in mental healthcare settings: A scoping reviewPublication . Almeida, Raquel Simões de; Soutelo, Ana Paula; Portugal, Paula; Marques, António; Pereira da Silva Marques, António José; Simões de Almeida, Raquel; Soutelo, Ana Paula; Portugal, PaulaOver the past decade, there has been an increase in the number of digital technologies available for mental health purposes. At the same time, engaging in regular physical activity has been shown to promote mental health and well-being, but activity levels are still low in people with mental illness due to several factors. The aim of this study is to identify and better understand what digital technologies are available for physical activity promotion in mental healthcare contexts. A scoping review was conducted in accordance with the Arksey and O’Malley scoping review framework and the PRISMA-ScR guidelines. Systematic literature searches of PsycINFO, Academic Search Complete, Web of Science, and PubMed was performed with a focus on the last ten years. Overall, 11 papers were included. Data was charted and synthesized, and a narrative synthesis was conducted. This scoping review provides a broad overview of the digital tools or technologies that are being used, such virtual reality, wearable devices and mobile applications, and the health benefits or barriers associated with their use for people with mental illness in clinical settings. The results also show that digital technologies could promote willingness to engage in physical activity. Conclusions: These findings could guide further research on how digital technologies for physical activity promotion can be effectively integrated into psychosocial rehabilitation settings and support mental health and recovery.
- Using immersive environments in e-mental health rehabilitation programs directed to future health professionals to promote empathy and health literacy about SchizophreniaPublication . Gomes, Paulo Veloso; Marques, António; Pereira, Javier; Pimenta, Rui; Donga, João; Almeida, Raquel Simões de; Machado Veloso Gomes, Paulo Sérgio; Pereira da Silva Marques, António José; Pimenta, Rui; Rucha das Dores da Costa Donga, João Paulo; Simões de Almeida, RaquelRehabilitation involves all types of patients, including people with schizophrenia. Schizophrenia is considered a complex syndrome characterized in general by fundamental and characteristic distortions of thinking and perception. The quality of life of a person with schizophrenia can be compromised by difficulty in carrying out their daily tasks and by the social stigma of their condition. The importance of training and sensitizing students in rehabilitation areas to this type of problem to improve the rehabilitation processes in which they will participate as future professionals involves empathy and the ability to communicate with these populations. It is possible through virtual reality to create immersive environments to simulate some psychotic symptoms characteristic of people with schizophrenia, such as visual hallucinations and hearing voices. The aim of this study was to test the effect of exposure to experiences characteristic of schizophrenia through two different types of immersive environments, graphical computational virtual reality and 360° video, on students from areas of social rehabilitation regarding empathy, social distance, and attitudes towards people with schizophrenia. Although the results were positive for the three parameters under study, no significant differences were found for each of them between the environments to which the participants were exposed. This study concluded that the choice between the two types of immersive environments should be based on the project’s objectives, the target audience’s needs, and available resources, rather than the type of environment itself, as their impact was similar.