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- Hippotherapy improves gross motor function in children with cerebral palsy: evidence from a systematic reviewPublication . Bernardino, Inês; Borges, Daniel Filipe; Casalta Lopes, João; Soares, Joana Isabel; Borges, Daniel Filipe"Hippotherapy uses horse movement to promote physical and psychosocial rehabilitation and may benefit children with cerebral palsy (CP). Standardised instruments such as the Activity Scale for Kids-Performance (ASK©), the Gross Motor Function Classification System (GMFCS) and the Gross Motor Function Measure (GMFM) are needed to quantify effects on motor function. To systematically review the effects of hippotherapy on gross motor skills in children with CP. Although autism spectrum disorder (ASD) was included in the search strategy, no eligible ASD studies were identified. Following PRISMA guidelines, six databases (PubMed, EMBASE, Web of Science, SCOPUS, Cochrane and SciELO) were searched for English, Portuguese or Spanish studies employing ASK©, GMFCS or GMFM. Two reviewers independently screened records, extracted data and assessed risk of bias. Twenty-five studies (602 participants, mean age 7.1 years, 3–14) met inclusion criteria; all involved CP, none ASD. Interventions lasted 8–24 weeks (1–3 sessions/week). Two ASK© studies showed significant motor gains (Hedges g=0.48–0.62). GMFM was used in 22 studies; 20 reported clinically relevant improvements, particularly in dimensions D (standing) and E (walking, running, jumping). The sole GMFCS study reported no change in classification. Methodological quality was moderate, limited by small samples and lack of blinding. Hippotherapy improves gross motor function in CP, best demonstrated with GMFM. Evidence for ASD is absent, highlighting a research gap. Broader application of ASK© and GMFCS is still needed to better define benefits across neurodevelopmental disorders."
- Assessing work-related musculoskeletal disorders and psychosocial risks in bus drivers: Insights from a municipal company case study in PortugalPublication . Silva, Tânia T.; Mendes, Tatiana R.; Lapa, Inês; Carvalho, Paulo; Rodrigues, Matilde A.; Rodrigues, Matilde; Carvalho, PauloThe public transport sector plays a crucial role in society, oering essential services and providing employment to a significant number of drivers. Despite the importance of this sector, it is essential to recognize that drivers are exposed to various occupational risks inherent to their daily work, which can have serious implications for their health. This study aims to characterize and analyse Work-Related Musculoskeletal Disorders (WMSD) and psychosocial risks in a public transport company. In the initial phase of the study, a questionnaire was administered to assess musculoskeletal symptoms and psychosocial risks. In the second phase, an inertial motion capture system was used to evaluate the risk of developing WMSD. The results revealed a significant and concerning prevalence of burnout, with over 60% of workers reporting high or severe levels across all dimensions (i.e., personal, work-related, and client-related burnout). Depression, anxiety, and stress were within typical ranges, though a relevant percentage of participants exhibited severe and extremely severe levels of depression (7.2%), anxiety (12.2%), and stress (8%). Musculoskeletal discomfort was highly prevalent, particularly in the lower back (68.3%) and neck regions (57.2%), regarding pain over the last 12 months. Additionally, the risk of developing WMSDs was high across the various microtasks, which were analyzed across dierent bus lines and routes, with Rapid Upper Limb Assessment (RULA) scores ranging from 4 (Medium Risk) to 7 (Very High Risk). Based on the results, varying bus types and routes is recommended. Programs should enhance wellbeing, and studies should assess interventions on health, stress, and occupational risks focused on enhancing worker wellbeing should be implemented, and future studies should assess the impact of interventions targeting health, stress, and occupational risks.
- Sextortion: caracterização dogmática e delimitação da imputação criminal em PortugalPublication . Ramalho, Joaquim; Ramalho, SusanaO sextortion, tal como o cibercrime em geral, é um crime que tem vindo a sofrer um aumento da prevalência, manifestando o Direito dificuldades na sua tipificação e diferenciação em relação a outros tipos de crime. Deste modo, este artigo visa realizar uma abordagem reflexiva sobre a imputação da responsabilidade criminal em Portugal, procurando uniformizar a sua tipificação e evitar divergências doutrinais. Na imputação, partindo de uma conceção stricto sensu, o crime de sextortion subsume-se à posse autorizada das imagens da vítima e, através da ameaça de partilha das mesmas no ciberespaço, procurar obter vantagem financeira, novos conteúdos íntimos e encontros presenciais.
- Prevalence of the use of dosimeters for ionizing radiation from fluoroscopy − a systematic literature review and meta-analysisPublication . Videira, Sara; Rodrigues, Matilde; Santos, Joana; Guedes, Joana; Martins, João; Silva, Manuela Vieira da; Vieira da Silva, Manuela; Rodrigues, MatildeThis study aims to assess the prevalence of individual dosimeter use among workers exposed to ionizing radiation during fluoroscopy-guided procedures. Additionally, factors contributing to its use were identified. Studies were identified through searches in five databases on 13 April 2024. Additionally, snowballing techniques were employed. The review followed PRISMA guidelines and the CoCoPop model. A narrative synthesis, bibliometric analysis, and meta-analysis were performed. Study quality was assessed using the Joanna Briggs Institute checklist for prevalence studies. Fifty studies involving 11,067 individuals were included. Orthopedics/traumatology was the most studied specialty (46 %). Median use rates were: 24 %(IQR = 44 %) for eye lens dosimeters, 15 %(IQR = 13 %) for electronic real-time dosimeters, 27 %(IQR = 42 %) for wrist/finger dosimeters, 25 %(IQR = 23 %) for collar/ thyroid dosimeters and 5 % for ankle dosimeter; 15 %(IQR = 78 %) reported no monitoring device. In 15 studies (30 %) with 4,188 individuals (38 %), the overall prevalence of “always” using whole-body dosimeters was 43 % [95 %CI:24–62]. By continent, the highest prevalence was found in Africa (75 %[95 % CI: 46–95]), while the lowest was in the “Americas” (33 %[95 % CI: 16–52]). Significant moderator effects were found: higher prevalence in “Africa” (p = 0.04), “gastroenterology” (p = 0.04), and “involving radiology” (p = 0.01); lower in “orthopedics” (p = 0.01) and “physicians” (p = 0.03). No significant moderator effects were found: “very high Human Development Index” (p = 0.72) and “high Human Development Index” (p = 0.69). Studies showed moderate risk of bias (6/9), with little evidence of publication bias. Exposure doses may be underestimated due to the low prevalence of dosimeter use. Interventions targeting individual and organizational factors are needed to promote consistent use and improve safety.
- Cone beam CT (CBCT) in radiotherapy: Assessment of doses using a pragmatic setup in an international settingPublication . Djukelic, Mario; Sá, Ana CravoThe imaging modality kV CBCT on linear accelerators (linacs) is utilised to verify positioning and anatomy in cancer patients undergoing radiotherapy treatment. There is a need for optimisation of radiological protection in kV CBCT imaging protocols to avoid unnecessarily high exposures to normal tissues surrounding the target. A network of ICRP mentees from 23 countries were surveyed for available dosimetry equipment. Standardised measurements on CBCT linac imaging systems were conducted using a cone beam dose index (CBDI) devised as a straightforward measurement for wide beam doses. Measurements were made with (a) 100 mm ionisation chambers or (b) 0.6 cc Farmer ionisation chambers and cylindrical CT PMMA phantoms, and (c) an alternative setup of Farmer chambers and cubical phantoms comprised of slabs of water equivalent material readily available in radiotherapy centres. The measurements were compared with Monte Carlo (MC) simulations. The survey showed limited availability for the reference setup using 100 mm chambers and CT phantoms. Correction factors were derived to convert normalised CBDI from alternative setups to the reference setup and are on average within 2% of MC simulations. The slab phantom in combination with a Farmer chamber provides an alternative to quantify CBCT radiation dose indices from linac-based image-guided radiotherapy using materials accessible in most centres worldwide. A method is presented to use correction factors for Varian Truebeam linacs if traditional 100 mm chambers and cylindrical CT phantoms are not available. This will enable most radiotherapy centres across the world to engage in meaningful imaging dose measurement and optimisation.
- N-Acetylcysteine treatment may compensate motor impairments through dopaminergic transmission modulation in a striatal 6-Hydroxydopamine Parkinson’s disease rat modelPublication . Caridade-Silva, Rita; Araújo, Bruna; Martins-Macedo, Joana; Teixeira, Fábio G.Preventing degeneration and the loss of dopaminergic neurons (DAn) in the brain while mitigating motor symptoms remains a challenge in Parkinson’s Disease (PD) treatment development. In light of this, developing or repositioning potential disease-modifying approaches is imperative to achieve meaningful translational gains in PD research. Under this concept, N-acetylcysteine (NAC) has revealed promising perspectives in preserving the dopaminergic system capability and modulating PD mechanisms. Although NAC has been shown to act as an antioxidant and (neuro)protector of the brain, it has yet to be acknowledged how this repurposed drug can improve motor symptomatology and provide disease-modifying properties in PD. Therefore, in the present work, we assessed the impact of NAC on motor and histological deficits in a striatal 6-hydroxydopamine (6-OHDA) rat model of PD. The results revealed that NAC enhanced DAn viability, as we found that it could restore dopamine transporter (DAT) levels compared to the untreated 6-OHDA group. Such findings were positively correlated with a significant amelioration in the motor outcomes of the 6-OHDA-treated animals, demonstrating that NAC may, somehow, be a modulator of PD degenerative mechanisms. Overall, we postulated a proof-of-concept milestone concerning the therapeutic application of NAC. Nevertheless, it is extremely important to understand the complexity of this drug and how its therapeutical properties interact with the cellular and molecular PD mechanisms.
- Glial-restricted precursors stimulate endogenous cytogenesis and effectively recover emotional deficits in a model of cytogenesis ablationPublication . Martins-Macedo, Joana; Araújo, Bruna; Anjo, Sandra I.; Silveira-Rosa, Tiago; Patrício, Patrícia; Alves, Nuno Dinis; Silva, Joana M.; Teixeira, Fábio G.; Manadas, Bruno; Rodrigues, Ana J.; Lepore, Angelo C.; Salgado, António J.; Gomes, Eduardo D.; Pinto, Luísa; Gomes, EduardoAdult cytogenesis, the continuous generation of newly-born neurons (neurogenesis) and glial cells (gliogenesis) throughout life, is highly impaired in several neuropsychiatric disorders, such as Major Depressive Disorder (MDD), impacting negatively on cognitive and emotional domains. Despite playing a critical role in brain homeostasis, the importance of gliogenesis has been overlooked, both in healthy and diseased states. To examine the role of newly formed glia, we transplanted Glial Restricted Precursors (GRPs) into the adult hippocampal dentate gyrus (DG), or injected their secreted factors (secretome), into a previously validated transgenic GFAP-tk rat line, in which cytogenesis is transiently compromised. We explored the long-term effects of both treatments on physiological and behavioral outcomes. Grafted GRPs reversed anxiety-like deficits and demonstrated an antidepressant-like effect, while the secretome promoted recovery of only anxiety-like behavior. Furthermore, GRPs elicited a recovery of neurogenic and gliogenic levels in the ventral DG, highlighting the unique involvement of these cells in the regulation of brain cytogenesis. Both GRPs and their secretome induced significant alterations in the DG proteome, directly influencing proteins and pathways related to cytogenesis, regulation of neural plasticity and neuronal development. With this work, we demonstrate a valuable and specific contribution of glial progenitors to normalizing gliogenic levels, rescuing neurogenesis and, importantly, promoting recovery of emotional deficits characteristic of disorders such as MDD.
- From peripheral to central (Neuro)degeneration: Is heart-kidney a new axial paradigm for Parkinson’s disease?Publication . Teixeira, Catarina; Caridade-Silva, Rita; Martins-Macedo, Joana; Araújo, Bruna; Gomes, Eduardo; Vilela, Cristiana; Soares-Guedes, Carla; Pires, Inês Falcão; Alencastre, Inês; G. Teixeira, Fábio; Gomes, EduardoParkinson’s Disease (PD) is primarily characterized by the accumulation of alpha-synuclein (αSyn) and the loss of dopaminergic neurons (DAn). The most evident repercussions of the disease include sympathetic and parasympathetic dysfunction, decreased dopamine (DA) levels, and impaired voluntary movements. Given the multifactorial nature of PD, it is now recognized that several systemic diseases may predispose individuals to the onset and progression of PD as well as influence its therapeutic outcomes. Recent studies have highlighted that patients with cardiovascular disease (CVD) and chronic kidney disease (CKD) face an increased risk of developing PD, independent of the shared risk factors. Indeed, substantial evidence supports the connections between the brain, heart, and kidneys. Elements such as the dopaminergic system, blood pressure regulation, inflammation, autophagy, oxidative stress, and calcium (Ca2+) signaling are recognized as crucial for the functioning of each organ individually. However, these factors may also significantly impact the overall health of the triad. Understanding the interconnection between the brain, heart, and kidneys would be groundbreaking in enhancing our knowledge about their interactions, enabling prompt interventions in the early stages of the disease. With this perspective, this review analyzes the current understanding of the brain-heart-kidney axis as a potential new paradigm for diagnosing and managing PD.
- Competências de escrita manual e processamento sensorial em crianças dos 6 aos 7 anos e 11 mesesPublication . Oliveira, Ana Sofia Sousa; Reis, Helena Silva; Reis, Claúdia Sofia Góis Ribeiro SilvaNeste estudo, investigou-se a relação entre o processamento sensorial e as competências de escrita manual em crianças de 6 a 7 anos e 11 meses, integradas no ensino regular. A amostra incluiu 191 crianças, avaliadas com o Questionário das Competências de Escrita Manual, desenvolvido e validado especificamente para este estudo, e a Sensory Processing Measure (SPM) – Forma Sala de Aula.
- Estrogen receptor beta agonist influences presynaptic NMDA receptor distribution in the paraventricular hypothalamic nucleus following hypertension in a mouse model of perimenopausePublication . Sommer, Garrett; López, Claudia Rodríguez; Hirschkorn, Adi; Calimano, Gianna; Marques-Lopes, Jose; Milner, Teresa A.; Glass, Michael J.As women transition to menopause (i.e., perimenopause), they become more susceptible to hypertension. Animal studies using a mouse model of peri-menopause (peri-AOF) have revealed that hypertension susceptibility is associated with increased postsynaptic glutamatergic NMDA receptor plasticity in the paraventricular hypothalamic nucleus (PVN), a brain area critical for blood pressure regulation. The aim of this study was to determine if presynaptic NMDA receptors also play a role in neural plasticity in peri-AOF hypertension susceptibility. For comparison, males were also studied. Following slow pressor Angiotensin II (AngII), both peri-AOF and male mice became hypertensive; however, peri-AOF females showed higher cytoplasmic NMDA receptor levels. To determine the involvement of estrogen signaling in AngII-induced hypertension, an estrogen receptor beta (ERß) agonist was co-administered. In peri-AOF females, but not males, activation of ERß blocked hypertension and increased NMDA receptors on the membrane of axon terminals where it would be more available for binding of glutamate. These results indicate that sex-dependent recruitment of presynaptic NMDA receptors in the PVN is influenced by ERß signaling in a mouse model of perimenopause.