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Percorrer ESSLei - Capítulos de livros por Objetivos de Desenvolvimento Sustentável (ODS) "17:Parcerias para a Implementação dos Objetivos"
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- Caffeine, Insulin Resistance, and HypertensionPublication . Guarino, Maria Pedro; Sacramento, Joana; Ribeiro, Maria João; Conde, Sílvia VilaresIn the last decades, we have witnessed a dramatic increase in the prevalence of obesity and obesity-associated diseases like type 2 diabetes and the metabolic syndrome. The role of caffeine in the pathogenesis of core features of these conditions―hypertension and insulin resistance―is still very controversial. A growing number of evidence shows that chronic caffeine intake has protective effects in the development of insulin resistance, glucose intolerance, and hypertension, in contrast with the effects of acute caffeine consumption, which are clearly deleterious. The mechanisms proposed for the protective effects of caffeine range from direct metabolic actions in the adipose tissue to more complex systemic effects mediated by inhibition of the carotid bodies. The discovery that caffeine modulates metabolic and vascular functions shed a new light into this field of research, which is currently a hot topic in the integrative approach to treat dysmetabolic states.
- Disorders of ConsciousnessPublication . Teixeira, Liliana; Blacker, Danielle; Rocha, NunoA disorder of consciousness (DoC) is a state where consciousness has been affected by damage to the brain. DoC range in the form of a hierarchy, including coma, vegetative state and minimally conscious state. The most common way to assess consciousness is to observe their responses to stimulation. However, observing these responses and detecting purposeful behaviours is extremely challenging. Several studies have shown that misdiagnosis is common. It is crucial to optimise the way consciousness assessments are performed. Clinical management of DoC patients, from treatment of pain to end-of-life decisions, depends on behavioural observations. In the present chapter, we review the challenges posed by the assessment of consciousness and the importance of combining clinical assessment with complementary methods of assessment, such as positron emission tomography, functional magnetic resonance imaging and electroencephalography. According to the diagnosis established, the patient will follow different care pathways. Although therapeutic options of DoC are still limited, basic therapies include artificial nutrition and hydration, physical and occupational therapies as well as sensory stimulation. Pharmacologic trials, deep brain stimulation and multisensory stimulations are some of the therapeutic options for DoCs. Recently, it was removed the requirement to obtain legal sanction for every decision to withdraw clinically assisted nutrition and hydration from people in DoCs. This has led to an entire paradigm shift, from a focus on the diagnosis to a focus on the patient's best interest. Although these decisions will spare the courts' involvement, one should never disregard reaching a correct diagnosis for this vulnerable population.
- Hyperbaric Oxygen Therapy Improves Glucose Homeostasis in Type 2 Diabetes Patients: A Likely Involvement of the Carotid BodiesPublication . Vera-Cruz, P.; Guerreiro, F.; Ribeiro, M.J.; Guarino M.P.; Conde, S.V.The carotid bodies (CBs) are peripheral chemoreceptors that respond to hypoxia increasing minute ventilation and activating the sympathetic nervous system. Besides its role in ventilation we recently described that CB regulate peripheral insulin sensitivity. Knowing that the CB is functionally blocked by hyperoxia and that hyperbaric oxygen therapy (HBOT) improves fasting blood glucose in diabetes patients, we have investigated the effect of HBOT on glucose tolerance in type 2 diabetes patients. Volunteers with indication for HBOT were recruited at the Subaquatic and Hyperbaric Medicine Center of Portuguese Navy and divided into two groups: type 2 diabetes patients and controls. Groups were submitted to 20 sessions of HBOT. OGTT were done before the first and after the last HBOT session. Sixteen diabetic patients and 16 control individual were included. Fasting glycemia was143.5 ± 12.62 mg/dl in diabetic patients and 92.06 ± 2.99 mg/dl in controls. In diabetic patients glycemia post-OGTT was 280.25 ± 22.29 mg/dl before the first HBOT session. After 20 sessions, fasting and 2 h post-OGTT glycemia decreased significantly. In control group HBOT did not modify fasting glycemia and post-OGTT glycemia. Our results showed that HBOT ameliorates glucose tolerance in diabetic patients and suggest that HBOT could be used as a therapeutic intervention for type 2 diabetes.
- Level up! How Gamed-Based Activities Transform Learning and Alleviate Stress in Institutionalized ElderlyPublication . Lacomba-Arnau, Elena; Ribeiro, Anaísa; Sabino, Raquel; Pinheiro, Rafael; Lopes, Susana; Gaspar, Marisa; Navarro-Mateos, Carmen; Sousa, Micael; Rosa, MarleneMental health issues are a critical concern for the elderly, as the inability to manage stress during stimulation activities can significantly impair their ability to accept and effectively learn new tasks, thereby affecting their performance in daily life activities. Serious games are increasingly recognized as valuable in the context of rehabilitation; however, there is a paucity of studies examining how elderly individuals manage stress and learn in regular practice using such games. In this study, 10 institutionalized elderly participants underwent 6 game-based stimulation sessions playing the serious games Ta!Ti! and Mexerico. Learning variables, including time and error rates, were assessed at baseline (T0), mid-point (T1), and the final session (T2), along with stress management indicators, specifically cortisol levels, at T0 and T2. The findings revealed that learning profiles improved throughout the program, with more pronounced gains observed initially. Additionally, stress levels decreased following each game-based session. The study identified significant relationships between stress management and learning profiles, suggesting that game-based activities can effectively enhance both learning outcomes and stress reduction in the elderly.
- O uso de smart speakers na incapacidade: Uma scoping reviewPublication . Tavares, Rafael; Sousa, Helena; Ribeiro, JaimeIntrodução: Os smart speakers (SS), como o Amazon Echo e o Google Nest, estão estabelecidos no mercado mundial e disponíveis para a população geral. A inteligência artificial programada nestes dispositivos de conversação e a sua compatibilidade com diferentes redes cria oportunidades para a criação de intervenções em diferentes populações com incapacidade aplicáveis num contexto de casa inteligente. Objetivos: Compreender como os SS estão a ser utilizados por indivíduos com incapacidade, revelar o seu potencial e possibilidades de intervenção. Métodos: Em fevereiro de 2021 foi realizada uma scoping review baseada em artigos das bases de dados PubMed/Medline, B-On, Scopus e Web of Science. Foram considerados artigos publicados desde 2016 até 2021, escritos em português e inglês e revistos por pares. Foram incluídos estudos focados na utilização de SS disponíveis no mercado geral (Google Nest / Home, Amazon Echo, Invoke, HomePod) como agente de intervenção no ambiente residencial ou ECU, em populações com condições diversas, abrangendo indivíduos com deficiências sensoriais, cognitivas, emocionais e motoras. Resultados: Foram identificadas diferentes abordagens e exigências dos utilizadores. Os dispositivos foram aplicados como uma solução singular ou como um elemento de sistemas de maior complexidade, interagindo com outros dispositivos ou softwares. Conclusões: A identificação de diferentes intervenções para diferentes incapacidades sublinha o potencial de intervenção destes dispositivos com melhorias funcionais observadas em incapacidades físicas, cognitivas, sensoriais e emocionais. Estes dispositivos podem substituir dispositivos dispendiosos criados para nichos de população e sistemas fechados, dirigidos para formas concretas de incapacidade. Sendo a personalização uma característica relevante, a aplicação de SS não dispensa o acompanhamento técnico no processo.
- Physical activity in Duchenne muscular dystrophyPublication . Honório, Samuel; Batista, Marco; Martins, Júlio; Ribeiro, JaimeThere are a number of basic interventions using light, intensive activity to relieve the symptoms of Duchenne Muscular Dystrophy. These interventions relieve any pain caused, address malformations and maintain some basic functional skills such as: 1) Maintaining and / or improving muscle strength to perform everyday activities such as climbing stairs, 2) to reduce and / or mitigate the development of weakness and contractures in order to prolong the clinic process, 3) maintain cardio-respiratory efficiency and 4) maintain muscle strength and posture to prevent scoliosis. A number of authors have warned about the detrimental effect associated with forceful, repeated high intensity activities which can be extremely harmful, Emery (2000). Moreover, the lack of regular physical activity can promote rapid loss of functionin in the cardiac and respiratory systems. Physical activity programming based on thorough functional assessments for DMD patients is crucial to maintain the quality of life of these children, used in conjunction with other associated resources whenever possible, Guerrero (2007).
- STM-GNN: Space-Time-and-Memory Graph Neural Networks for Predicting Multi-Drug Resistance Risks in Dynamic Patient NetworksPublication . Geissbuhler, Damien; Bornet, Alban; Marques, Catarina; Anjos, André; Pereira, Sónia; Teodoro, DouglasHospital-acquired infections (HAIs), particularly those caused by multidrug-resistant (MDR) bacteria, pose significant risks to vulnerable patients. Accurate predictive models are important for assessing infection dynamics and informing infection prediction and control (IPC) programmes. Graph-based methods, including graph neural networks (GNNs), offer a powerful approach to model complex relationships between patients and environments but often struggle with data sparsity, irregularity, and heterogeneity. We propose the space-time-and-memory (STM)-GNN, a temporal GNN enhanced with recurrent connectivity designed to capture spatiotemporal infection dynamics. STM-GNN effectively integrates sparse, heterogeneous data combining network information from patient-environment interactions and internal memory from historical colonization and contact patterns. Using a unique IPC dataset containing clinical and environmental colonization information collected from a long-term healthcare unit, we show that STM-GNN effectively addresses the challenges of limited and irregular data in an MDR prediction task. Our model reaches 0.84 AUROC, and achieves the most balanced performance overall compared to classic machine learning algorithms, as well as temporal GNN approaches.