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- Prognostic role and clinicopathological features of SMAD4 gene mutation in pancreatic cancer: a systematic review and meta-analysisPublication . Rodrigues, Tânia; Martins, João Paulo; Albuquerque, Joana; Cardoso, Joana; Coelho, José Luís Passos; Oliveira Martins, João PauloThe prognostic value of SMAD4 in pancreatic cancer has been evaluated in several studies. However, the conclusions remain controversial. Therefore, we aimed to evaluate the prognostic value of the SMAD4 gene in pancreatic cancer to aid in the design of therapeutic strategies. This review adhered to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) criteria and the proposed methodology was registered on PROSPERO. An electronic search was made in MEDLINE (via PubMed), Web of Science and Google Scholar to identify all relevant studies. Eligible studies were those written in English including patients with Pancreatic Ductal Adenocarcinoma (PDAC), who underwent pancreatic surgery with curative intent and provided data on SMAD4 gene status or SMAD4 protein expression and its association to prognosis, measured by overall survival (OS). The effect measure of interest was the hazard ratio (HR) for OS between PDAC with or without SMDA4 mutations. A total of 24 studies on SMAD4, with 4340 samples, were included in this systematic review and meta-analysis. Our pooled results demonstrated that patients with tumours with SMAD4 alteration had significantly worse prognosis for OS (HR= 1.43, 95% CI = 1.17–1.76, p-value = 0.002). This systematic review and meta-analysis support the use of driver mutations in the SMAD4 gene as a prognostic marker for pancreatic cancer.
- Prevalence of high-grade endometrioid endometrial cancer of no specific molecular profile (NSMP): A systematic review and meta-analysisPublication . Casanova, João; Ramos, Ana Sofia; Costa, Ana Gomes da; Babiciu, Alexandru; Serra, Sofia Silvério; Moutinho, Filipa; Costa, Teresa; Tripepi, Marta; Abu-Rustum, Nadeem R.; Martins, João Paulo; Lima, Jorge; Oliveira Martins, João PauloEndometrial cancer of no specific molecular profile (NSMP) represents the most prevalent molecular subtype of endometrial cancer, comprising over 50 % of all diagnoses. Although studies have explored the prevalence of the NSMP subtype, to our knowledge, no systematic review or meta-analysis has specifically targeted grade 3 (G3, high-grade) tumors. We aimed to determine the prevalence of G3 endometrioid endometrial cancer of NSMP and assess regional variations in this prevalence. We also sought to synthesize available data concerning oncologic outcomes, including overall survival, progression-free survival, and disease-specific survival. We conducted a systematic review following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines (PROSPERO No: CRD42024544247). We searched the electronic databases: PubMed/Medline, Scopus, Web of Science, Cochrane Library, and EMBASE. To estimate the overall prevalence of the NSMP subtype, we performed a meta-analysis using the proportions method with the Freeman-Tukey (arcsine) transformation. For estimating oncologic outcomes, we conducted a meta-analysis using hazard ratios (HRs) when available. In the absence of HRs, we utilized Kaplan-Meier curves. All pooled estimates and their corresponding 95% confidence intervals (CIs) were calculated using a random-effects model with the inverse variance method and restricted maximum likelihood estimator. We analyzed 31 studies, encompassing 2,660 patients. The pooled prevalence of NSMP within G3 endometrioid endometrial cancer was 0.29 (95 %CI: 0.23–0.34, I 2 = 80.8 %). This prevalence was highest in North America (0.43, 95 %CI: 0.17–0.71) and lowest in Europe (0.23, 95 %CI: 0.19–0.28). The random-effects pooled estimate indicated that the NSMP subtype was associated with intermediate oncologic outcomes compared to other molecular subtypes.
- A literature review on violence and discrimination against trans people in Portugal: Are we still living in a dictatorship?Publication . Neves, Sofia; Borges, Janete; Ferreira, Mafalda; Correia, Marta; Sousa, Edgar; Rocha, Helena; Silva, Lourenço; Allen, Paula; Vieira, Cristina P.; Borges, JaneteThis literature review presents a characterization of violence and discrimination against trans people in Portugal, offering a critical analysis of the national efforts aiming to protect trans people’s rights. Its main objective is to highlight and frame the oppression historically suffered by trans people in family and intimate relationships, social discrimination, school, medical care, and employment. Despite legal advances in Portugal in the conquest of rights for trans people during the last two decades, violence and discrimination are still a social problem that needs urgent academic research for its effective prevention and combat.
- “Can a chatbot be used in the full-text screening in a systematic review?”Publication . Martins, André Miguel; Juan, Luis Félix Valero; Oliveira, Adriana; Martins, João Paulo; Santos, Marlene; Santos, Marlene; Oliveira Martins, João PauloLarge language model–based artificial intelligence tools are increasingly explored to support systematic reviews, yet evidence regarding their reliability in full-text screening remains limited. This study evaluated the performance of two versions of ChatGPT (4.0 and 5.0) compared with human reviewers during article selection for a systematic review on influenza vaccine effectiveness. A total of 170 full-text articles were independently assessed for eligibility using predefined inclusion and exclusion criteria. Human reviewers served as the gold standard. ChatGPT 4.0 and 5.0 were prompted using standardized instructions mirroring the review protocol. Agreement with human decisions was evaluated using accuracy, sensitivity, specificity, precision, F1-score, and Cohen’s κ. Intra-model reproducibility was assessed for ChatGPT 5.0. Results: ChatGPT 4.0 achieved an accuracy of 0.71 (95% CI: 0.64–0.78) and a Cohen’s κ of 0.43, indicating moderate agreement with human reviewers. ChatGPT 5.0 demonstrated improved performance, with accuracy increasing 0.06 to 0.77 (95% CI: 0.70–0.83), sensitivity of 0.87, specificity of 0.70, and κ of 0.55, corresponding to moderate-to-substantial agreement. Intra-model reproducibility for ChatGPT 5.0 showed 80% agreement (κ = 0.60), indicating partial but imperfect consistency. ChatGPT 5.0 outperformed ChatGPT 4.0 in full-text screening accuracy and reproducibility, approaching but not matching human performance. These findings support the use of current LLMs as decision- support tools rather than autonomous reviewers in systematic reviews. Transparent reporting of model versions, prompts, and input quality is essential to ensure credible AI-assisted evidence synthesis.
- Health literacy of the higher education community in a European country: a cross-sectional surveyPublication . Ferreira, Pedro L.; Morais, Carminda; Pimenta, Rui; Ribeiro, Inês; Alves, Sandra M.; Pedro, Ana R.; Escoval, Ana; RALS; Alves, Sandra MariaHealth literacy is a dynamic and multidimensional concept. Examining health literacy among higher education students and teachers is crucial for promoting informed health decisions and encouraging healthier behaviors. Our study aimed to measure health literacy among higher education students and teachers, assess the impact of sociodemographic variables, and compare health literacy levels between these groups.
- Detection of physiological changes in knee cartilage using parametric T2 relaxation maps estimated with a dictionary methodPublication . Coelho, José M.; Fernandes, Tiago T.; Alves, Sandra M.; Vilaça, Adélio; Nunes, Rita G.; Nogueira, Luísa; Oliveira, António; Nogueira, Luisa; Alves, Sandra MariaTo investigate half-marathon running and recovery effects on knee articular cartilage (KAC) health in athletes, using dictionary-matching T2 maps, to detect changes and recovery patterns in KAC. Eleven asymptomatic volunteers (4 females, 7 males; mean age 40 ± 5 years, mean BMI 22.7 ± 1.4 kg/m2) completed a fixed-pace half-marathonwere studied. All were right-knee dominant and engaged in regular running. Sagittal T2-weighted Multi-Echo Spin-Echo images at 3 T were used to assess T2 values pre-run, post-run, and one week later for global and compartmental KAC. Recovery programme included low-intensity running, strength training and rest. Repeated measures ANOVA or equivalent non-parametric tests with post-hoc comparisons compared T2 values over time. Separate analyses were conducted based on laterality, gender and anatomical compartments. Significance was set at < 0.05. Post-run T2 values decreased significantly by 0.9 ms (− 2.0%, p < 0.001), with up to 5.3% reductions in medial tibial (MT) and femoral (MF) compartments. Recovery patterns varied by compartment, sex and laterality. Most compartments returned to baseline within one week; the lateral condyle (LatC) showed incomplete recovery (− 4.7%, Proportional Recovery Index (PRI) = − 0,1); the right knee’s MT exhibited overcompensation (6.3%, PRI = 2.6). Males showed higher baseline T2 values and more efficient recovery in the LatC compared to females (PRI = − 0.1 vs. − 0.4). Half-marathon running induces reversible reductions in KAC hydration, with most compartments recovering or overcompensating within one week. Dictionary-matching T2 mapping offers a robust approach for monitoring cartilage integrity and guiding individualised recovery strategies.
- Interventions to chemotherapy and radiotherapy induced oral mucositis: A Systematic Review and Meta-analysisPublication . Pereira, Cristiana Palmela; Marques, Inês; Martins, João Paulo; Oliveira Martins, João PauloOral mucositis is a common adverse effect of chemotherapy and radiotherapy, characterized by erythematous lesions, edema, ulceration, atrophy, or even hemorrhage. Current evidence highlights the complexity of its management and the importance of tailoring therapeutic approaches to the individual patient profile in order to improve quality of life during cancer treatment. To access the efficacy of pharmacological and non-pharmacological interventions for the prevention and treatment of chemotherapy- and/or radiotherapy-induced oral mucositis. A systematic review with meta-analysis of 27 articles published between 2019 and 2024 was also performed, aiming to characterize and contextualize therapeutic interventions for oral mucositis. This systematic review and meta-analysis suggests that various non-pharmacological interventions (such as cryotherapy and photobiomodulation) and pharmacological interventions, particularly natural agents (such as honey, curcumin, green tea), are effective for the prevention and treatment of oral mucositis. Oral mucositis is a highly prevalent adverse effect in patients undergoing chemotherapy and/or radiotherapy, with significant functional, nutritional, and treatment adherence implications. The systematic review with meta-analysis demonstrated the efficacy of non-pharmacological and natural interventions.
- Sexual harassment in institutions of higher education: Some critical insights based on the case of PortugalPublication . Neves, Sofia; Ferreira, Mafalda; Topa, Joana; Silva, Estefânia; Correia, Ariana; Sousa, Mafalda; Borges, Janete; Borges, JaneteAs Portugal lived under a dictatorship for almost 50 years, policies and legislation on women’s rights began to be developed only after the instauration of democracy in 1975 (Monteiro and Ferreira, 2016). In the second half of the 20th century, especially after the feminist movement gained strength, broader discussions about sexual harassment (SH) in Portugal began to emerge. A greater awareness of SH as a form of gender-based violence and discrimination resulted from the increased consciousness surrounding issues of gender equality and women’s rights during the 1960s and 1970s. In the 80s and 90s, the debate on this issue intensified, driven by social movements and international legislation, such as the Convention on the Elimination of All Forms of Discrimination Against Women (United Nations, 1979), to which Portugal has been a signatory since 1980.
- Dating violence and gender beliefs legitimizing dating violence among Cape Verdean university studentsPublication . Neves, Sofia; Borges, Janete; Antunes, Arimery; Borges, JaneteThe present study analyses the association between victimization and perpetration of dating violence and gender beliefs legitimizing dating violence among Cape Verdean university students. The sample consisted of 301 Cape Verdean university students, 220 female (73.1%) and 80 male (26.6%), with an average age of 23.86 years old (SD = 6.112). An online survey with sociodemographic characterization, the Inventory of Gender Beliefs, and the Inventory of Violent Juvenile Relationships were completed by each participant. Findings reveal high levels of dating violence, with 61.1% (n = 184) and 46.8% (n = 141) of students admitting having been exposed to or perpetrated, respectively, at least one act of violence. Female participants showed higher rates of victimization when compared to male participants, while males presented a higher level of beliefs legitimizing dating violence when compared to females. Education policy recommendations for dating violence prevention and combat are provided.
- Perceptions of adverse childhood experiences among lesbian, gay, bisexual, trans and intersex people victims of domestic violence by their families: A portuguese qualitative studyPublication . Neves, Sofia; Ferreira, Mafalda; Sousa, Edgar; Topa, Joana; Borges, Janete; Vieira, Cristina P.; Borges, JaneteResearch shows lesbian, gay, bisexual, trans and intersex (LGBTI) people are vulnerable to more adverse childhood experiences (ACEs). The research focused on the perceptions of experiencing ACEs among 36 Portuguese LGBTI people who were exposed to domestic violence by their parents or other family members (M = 34.11; SD = 10.77). Semi-structured individual interviews were conducted and data were subjected to thematic analysis. Results reveal a great exposure to different types of domestic violence, such as psychological, physical and sexual abuse, corrective practices and home expulsion. Affirmative and trauma-informed approaches, especially in counseling, are required to address LGBTI children’s needs.