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- Abieta-7,13-Diene in Nematode-Infected Pinewood Pinus pinaster Branch Extracts: Isolation and the Elucidation and Characterization of Its StructurePublication . Gaspar, Marisa C.; Cruz, Pedro F.; Brito, Rui M. M.; Sousa, Hermínio C. de; Braga, Mara E. M.The oleoresin and volatile fraction produced by conifers, such as Pinus pinaster, play a crucial role in plant defence, acting as precursors to resin acids and adapting in response to environmental stress or pathogen attacks. Abietadiene (abieta-7,13-diene), the biosynthetic precursor to abietic acid, has been identified as the most abundant compound in extracts from pinewood nematode (PWN)-infected P. pinaster trees. As abietadiene is not commercially available, this study aimed to achieve, for the first time, its isolation, structure elucidation, and detailed characterization from readily available forestry residues. Abietadiene was successfully isolated using thin-layer chromatography (TLC), and its purity and identity were evaluated using multiple analytical techniques: gas chromatography (GC), liquid chromatography (LC), nuclear magnetic resonance (NMR), and Fourier-transform infrared spectroscopy (FTIR). GC analysis indicated a purity of over 70% for the isolated compound, while LC provided the higher purity value of 98%. The identity of abietadiene was unequivocally confirmed through LC, FTIR, and NMR analysis. This work represents the first isolation and comprehensive characterization of abietadiene from a natural source, making detailed chemical data on this compound available to the scientific community. These findings may be used for future studies on the biological interactions and ecological roles of abietadiene, particularly in the context of plant defence and pathogen resistance.
- Anthropometric and Body Composition Changes After Bariatric Surgery—The Effect of Sex, Age, and Type of SurgeryPublication . Guerra, Rita Soares; Pinho-Reis, Cíntia; Sousa, Ana Sofia; Mendes, Joana; Silva, CláudiaThe rise in obesity and its associated health problems increases the need for therapeutic approaches such as bariatric surgery. Therefore, this study aims to explore the changes in the anthropometric and body composition characteristics of patients undergoing bariatric surgery. A retrospective longitudinal study was conducted in subjects ≥ 18 y who underwent bariatric surgery and attended one nutrition appointment before and after surgery. Information on their sex, age, weight, fat mass (kg and %), fat-free mass (kg and %), and skeletal muscle mass, obtained using bioelectrical impedance, and on their waist circumferences was collected. Their BMIs and skeletal muscle mass indexes were calculated. The differences in the anthropometric and body composition parameters between pre- and post-surgery were also calculated. The participants were grouped by sex, age groups (18–44 y and 45–69), and type of surgery (Roux-en-Y gastric bypass and gastric sleeve). The variables are presented as n (%) and as means (SDs) or medians (interquartile ranges). Student’s t-test and the Mann–Whitney test were employed (p < 0.05). The sample consisted of 57 subjects (aged 18–69 years; 75% women). Between the pre- and post-surgical periods (63 (42) days), their weight (mean: 103.0 (SD: 16.3) kg vs. 91.2 (14.2) kg, p < 0.001); BMIs (37.9 (4.2) kg/m2 vs. 33.6 (4.1) kg/m2, p < 0.001); waist circumferences (116.2 (12.4) cm vs. 105.7 (12.3) cm, p < 0.001); % fat mass (45.5 (6.0) vs. 41.0 (8.0), p < 0.001); skeletal muscle mass (32.8 (7.4) kg vs. 30.3 (6.5) kg, p < 0.001); and skeletal muscle mass indexes (12.0 (1.8) kg/m2 vs. 11.1 (1.7) kg/m2, p < 0.001) decreased; meanwhile, their % fat-free mass increased (54.7 (6.0) vs. 59.0 (8.0), p < 0.001). Most of these changes occurred regardless of sex, age, or type of surgery. Shortly after bariatric surgery, patients show a better nutritional status and body composition.
- Antithrombotic treatment following revascularization for chronic limb-threatening ischaemia: a scientific statement of the European Society of Cardiology Working Group on Aorta and Peripheral Vascular Diseases and the European Society of Cardiology Working Group on Cardiovascular PharmacotherapyPublication . Schlager, Oliver; De Carlo, Marco; Mazzolai, Lucia; Bura-Riviere, Alessandra; Heiss, Christian; Palomares, Jose Rodriguez; Morais, João C. A.; Steiner, Sabine; Brodmann, Marianne; Aboyans, Victor; Caterina, Raffaele DeChronic limb-threatening ischaemia (CLTI) is defined as ischaemic rest pain, or non-healing ulceration, requiring endovascular or surgical lower limb revascularization (LLR). Lower limb revascularization in CLTI entails a high risk of major adverse limb events (MALE) and major adverse cardiovascular events (MACE). This scientific statement addresses this risk based on a systematic review. A structured literature search was performed, and articles were independently evaluated by two investigators. In total, 1678 articles were identified, of which 34 were included in the final analysis. Only three randomized controlled trials (RCTs) addressed antithrombotic therapy in CLTI following LLR. None of these demonstrated superiority of any antithrombotic regimen over the other. Eight RCTs investigated antithrombotic therapy following LLR in populations with peripheral arterial disease including CLTI subgroups and suggest a benefit of dual antiplatelet therapy on limb events. One large RCT demonstrated that dual pathway inhibition with aspirin and vascular-dose rivaroxaban reduced the risk of MALE, MACE, and unplanned target limb revascularization. Data from 22 observational studies suggest a benefit of dual antiplatelet therapy on overall survival and amputation-free survival after LLR as compared with single antiplatelet therapy. Intensified antithrombotic treatment should be proposed in patients with CLTI following LLR to reduce the risk of MALE and MACE. Randomized controlled trials on antithrombotic therapy in patients with CLTI following LLR are scarce. Dual pathway inhibition is the only regimen for which an RCT demonstrated a reduction of MALE and MACE following LLR. Dual antiplatelet therapy appears to be associated with a reduced risk of MALE in CLTI following LLR.
- The Arabic Version of the Patient Health Questionnaire‐2 (PHQ‐2): Psychometric Evaluation Among Mothers of Children With Intellectual DisabilitiesPublication . Ali, Amira Mohammed; Al-Dossary, Saeed A; Aljaberi, Musheer A.; El-Gazar, Heba Emad; Laranjeira, Carlos; Khatatbeh, Haitham; Zoromba, Mohamed Ali; Alamer, Rasmieh; Amer, Faten; Pakai, Annamaria; Fekih-Romdhane, Feten; Lidoriki, EiriniAim: Mothers of children with intellectual disabilities are particularly vulnerable to mental distress due to demanding and exhausting caregiving. However, in the Arab world, they are seldom screened for depression because of limited diagnostic resources. Addressing the urgent need for brief and reliable screening tools, this study evaluated the psychometric properties of the Arabic version of the Patient Health Questionnaire-2 (PHQ-2) among 85 Saudi mothers. Design: A cross-sectional study. Methods: The construct, convergent, and divergent validity of the PHQ-2 was examined through a latent variable model (LVM), while its cutoff score was examined through receiver-operating characteristic (ROC) curve analysis. Results: The unidimensional PHQ-2 (item loadings > 0.7) was positively predicted by stress and negatively predicted by high mood and happiness, supporting its convergent and divergent validity. The PHQ-2 effectively predicted low mood, poor sleep quality, nightmares, high stress, low general physical health, and willingness to join a psychological support program (area under the curve [AUC] range = 0.72–0.84, p values < 0.001). The best balance between sensitivity and specificity was achieved at the PHQ-2 threshold ≥ 2.5, while the cutoff ≥ 3.5 demonstrated a higher positive predictive value (PPV) for all outcomes (range = 30.0–78.8 vs. 23.0–70.8). Conclusions: The PHQ-2 is a brief, valid tool, which at cutoffs ≥ 2.5 and ≥ 3.5 can reliably detect clinically significant depression and related psychological and physical adverse effects. Mothers scoring ≥ 3.5 may require a clinician-based examination for depression, and they may benefit from specific mental health literacy interventions. However, the results should be interpreted with caution given convenience sampling, a small sample size, and elevated distress levels in the current population. These limitations highlight the need to replicate the study with larger, randomly selected samples from more diverse populations. Implications for Practice: Nurses can efficiently screen for depression and its mental/physical sequelae, as well as monitor response to treatment using only two items. The study provided two well-interpreted cutoffs of the PHQ-2, with real-world implications for mental health screening in under-resourced settings. Reporting Method: The study adhered to STROBE guidelines. Patient or Public Contribution: No patient or public contribution. Copyright © 2025 Amira Mohammed Ali et al. Nursing Research and Practice published by John Wiley & Sons Ltd.
- Article Title: Impact of Dysphagia on Quality of Life in Machado-Joseph DiseasePublication . Mota, Joana Paz; Rodrigues, Inês Tello; Rodrigues, Inês Tello; Ferreira, Ana Filipa; Melo, Ana Rosa Vieira; Pires, Paula; Lopes, Pedro; Vasconcelos, João; Raposo, Mafalda; Lima, ManuelaDysphagia is a frequent symptom of spinocerebellar ataxia type 3 (SCA3)/Machado-Joseph disease (MJD), being associated with alterations in nutritional intake and hydration, as well as an increased risk of aspiration pneumonia. This study aims to evaluate the impact of self-perceived dysphagia and its relationship with quality of life in SCA3/MJD mutation carriers. 41 SCA3/MJD mutation carriers from the Azorean cohort were recruited. The Swallowing Quality-of-Life Questionnaire (SWAL-QOL), the Eating Assessment Tool (EAT-10), the Functional Oral Intake Scale (FOIS), the Volume-Viscosity Swallow Test (V-VST), the Scale for the Assessment and Rating of Ataxia (SARA), the Inventory of Non-Ataxia Signs (INAS), and the Activities of Daily Living (ADL) were applied. Dysphagia was confirmed in 40% SCA3/MJD patients, whose SWAL-QOL was significantly decreased when compared to participants without dysphagia (p = 0.001). As expected, SCA3/MJD carriers with worse SWAL-QOL showed a high risk of dysphagia (p < 0.01), a worse functional oral intake of food and liquids (p < 0.01) and more severe ataxia (p < 0.01). Additionally, high severity of dysphagia reported on the INAS scale, (p < 0.01) and high frequency of swallowing disorders, perceived by SCA3/MJD carriers (p < 0.01) were observed in SCA3/MJD carriers with worse SWAL-QOL. Our findings confirm that dysphagia negatively impacts the quality of life of SCA3/MJD carriers, highlighting the need for permanent support by specialized healthcare professionals during disease progression. Additionally, we recommend that SCA3/MJD carriers with a score of 1 or higher on both the INAS dysphagia item and the ADL swallowing item be referred for specialized healthcare support in swallowing disorders.
- Assessment of potentially motivating factors to follow time-restricted eating protocols in a population of adults living in PortugalPublication . Lages, Marlene; Carmo Silva, Sara; Barros, Renata; Guarino, MariaChrononutrition is a growing field that has been attracting significant attention for its potential benefits in metabolic health and body weight regulation. Among chrononutrition strategies, time-restricted eating (TRE) is the most extensively investigated approach in clinical studies. TRE intends to synchronise eating and fasting cycles with the human circadian rhythms. However, larger and longer randomised clinical trials are still needed to establish the effectiveness and long-term health outcomes of TRE interventions. Furthermore, it is crucial to explore whether individuals in free-living conditions, outside controlled clinical settings, can successfully adopt TRE principles into their daily routines to achieve potential health benefits. This study aimed to investigate the association between daily routines and potential adherence to TRE protocols, as well as to identify factors that can potentially predict adherence to these protocols in a sample of adults living in Portugal. A cross-sectional study was conducted using an online questionnaire to assess dietary and sleeping habits, daily routines and the likelihood of adherence to various restrictions in daily eating windows. Associations between variables were analysed using the Spearman correlation coefficient and the Chi-Square test, while an ordinal logistic regression was performed to identify predictive factors. Statistical analyses were conducted on IBM SPSS Statistics version 29.0. The questionnaire was filled out by 130 participants (80 % women) with a mean age of 37.9 ± 13.59 years. On workdays, 71.6 % of participants reported a daily eating window of 12 to 14 h, while on free days, the highest percentage (46.6 %) reported between 10 and 12 h. A significant inverse correlation was observed between willingness to adhere to a TRE protocol based on perceived health benefits and both age (ρ = -0.356, p < 0.001) and sex (ρ = -0.321, p < 0.001). Moderate correlations were also found between the willingness to follow a TRE protocol on workdays (ρ = 0.538) and free days (ρ = 0.598) and the potential health benefits of this type of intervention (p < 0.001). Additionally, sex was associated with potential adherence to the TRE protocol (χ²(2) = 10.644, p = 0.005), with a tendency for men to show lower willingness for adherence. Associations were also identified between body weight management and reducing the eating window by 1 to 2 h (χ²(12) = 24.883, df = 12, p = 0.015) and 2 to 3 h (χ²(12) = 22.367, p = 0.034). Moreover, the perceived importance of income, body weight management and cooking knowledge were significant predictors of the likelihood of adherence to a TRE protocol with a 3 to 4 h restriction in the eating window on workdays (p < 0.005). These results provide valuable insights that should be considered when translating research into clinical practice, specifically in an adult population, as individuals’ willingness and motivation to adopt TRE protocols in free-living conditions are influenced by multiple factors.
- Association between living setting and malnutrition among older adults: The PEN-3S studyPublication . Madeira, Teresa; Peixoto-Plácido, Catarina; Sousa-Santos, Nuno; Santos, Osvaldo; Costa, Joana; Alarcão, Violeta; Nicola, Paulo Jorge; Severo, Milton; Lopes, Carla; Clara, João GorjãoObjectives: Malnutrition is frequent among older adults, especially those living in nursing homes, but the association between residential setting and nutritional status is controversial. The aim of this study was to examine the association between living setting (nursing home versus community) and malnutrition while adjusting for demographic, socioeconomic, health-related, and psychosocial factors. Methods: This cross-sectional study included a randomly selected representative sample of Portuguese adults ≥65 y of age. Interviewers collected data regarding demographic and socioeconomic characteristics, nutritional status, physical activity, energy intake, cognitive function, self-reported general health, functional status, symptoms of depression, and loneliness. Logistic regression models were used to estimate the association between residential setting and malnutrition. Results: Participants were 1186 nursing home residents (72.8% women, 49.2% ≥85 y of age) and 1120 community dwellers (49% women, 21.3% ≥85 y of age). Following Mini Nutritional Assessment (MNA®) criteria, 29.6% of nursing home residents and 14.1% of community dwellers were at risk of malnutrition, whereas 2.3% and 0.3%, respectively, were malnourished. The living setting was not significantly associated with malnutrition after adjusting for functional status, symptoms of depression, and feelings of loneliness (odds ratio, 1.03; 95% confidence interval, 0.67–1.58). Conclusions: Risk of malnutrition and malnutrition are more prevalent among nursing home residents than community dwellers. Physical (functional status) and mental health (symptoms of depression and loneliness) seems more relevant to nutritional status than residential setting by itself. These findings should be taken into account when designing public health policies to tackle malnutrition among older adults.
- Burnout protective patterns among oncology nurses: a cross-sectional study using machine learning analysisPublication . Rocha, Ana; Costeira, Cristina; Barbosa, Raul; Gonçalves, Florbela; Castelo-Branco, Miguel; Viana, Joaquim; Gaudêncio, Margarida; Ventura, FilipaBackground Oncology nurses face unique and intense demands due to the nature of their work, caring for patients with life-threatening illnesses. The emergence of professional burnout among these nurses is influenced by several factors, highlighting the importance of identifying protective and risk factors to mitigate its impact. This study aims to identify burnout profiles and protective socio-demographic and work-related patterns associated with reduced burnout among oncology nurses. Methods A cross-sectional study was conducted with 150 oncology nurses at a specialized hospital exclusively dedicated to adult oncology treatment in Portugal. Data collection included a self-administered questionnaire incorporating the validated Portuguese version of Maslach Burnout Inventory (MBI). Statistical analyses were performed using SPSS and machine learning tools, specifically KMeans clustering and Random Forest algorithms. Results Six protective patterns against burnout were identified, characterized by conditions of permanent contracts, work-life balance, and supportive work environments. Moreover, factors such as holding management roles and being a parent of two or more children might even be protective in some circumstances, suggesting a nuanced relation between personal and professional factors. Machine learning analyses made apparent the unpredictability of burnout and highlighted the critical role of protective factors in mitigating its impact. Conclusions This study underscores the importance of resilience-building strategies and promoting protective factors, such as job stability, learned experience, and adequate rest, to reduce burnout risk among oncology nurses. Future research should validate these findings through hypothesis-driven analyses to inform targeted and context-specific burnout prevention programs.
- Cardiovascular involvement in Sweet’s syndrome: A practical reviewPublication . Cabral, Margarida; Santos, Luís Graça; Ruivo, Catarina; Morais, JoãoSweet’s syndrome, also referred to as acute febrile neutrophilic dermatosis, presents a constellation of clinical features including fever, tender erythematous skin lesions, peripheral neutrophilia, and a predominant dermal infiltrate of neutrophils. This uncommon condition may arise through drug-induced mechanisms, as a secondary condition to malignant diseases, or idiopathically. Importantly, extracutaneous manifestations, including cardiovascular involvement such as arteritis, acute myocarditis, or coronary artery disease, frequently contribute to the intricacy of the clinical presentation. Despite its significance, the literature on Sweet’s syndrome with cardiovascular implications remains sparse, leading to ambiguity in clinical management. In this context, we highlight the need for a heightened index of suspicion to establish a diagnosis of Sweet’s syndrome with concurrent cardiovascular involvement, alongside considerations for treatment approaches and post-diagnostic monitoring strategies.
- Characteristics of respiratory rehabilitation programs for people with Parkinson’s disease: a scoping reviewPublication . Loureiro, Ricardo Filipe de Moura; Santana, Elaine dos Santos; Duque, Filipa Margarida Gonçalves; Bernardes, Rafael Alves; Ventura, Filipa Isabel Quaresma; Silva, Rosa Carla Gomes da; Oliveira, Albertina Lima de; Lima, Margarida Pedroso de; Almeida, Maria de Lurdes Ferreira de; Cardoso, Daniela Filipa Batista; Cardoso, Ana Filipa dos Reis Marques; Aromataris, EdoardoObjective: The objective of this review was to map the characteristics of respiratory rehabilitation programs for people with Parkinson's disease. Introduction: Parkinson's disease is a progressive and heterogeneous neurodegenerative disease. Respiratory dysfunction is highly prevalent in people with Parkinson's disease and is a major contributor to morbidity and mortality. People with Parkinson's disease may experience respiratory dysfunction such as ineffective coughing and dyspnea. Complications, such as atelectasis and respiratory infections, significantly impact their self-care and quality of life. To mitigate its impact on people's lives, various respiratory rehabilitation programs have been developed and implemented. Many studies have examined this topic, yet respiratory rehabilitation programs vary significantly in structure and evaluated outcomes. Eligibility criteria: We considered studies focused on respiratory rehabilitation programs implemented to prevent or target one or more symptoms for adults (18 years and older) with Parkinson's disease, regardless of the disease stage. The programs could be provided by any health professional in any health care setting. Methods: We followed JBI methodology for conducting the scoping review, and the results were reported in line with the Preferred Reporting Items for Systematic Reviews and Meta-Analysis extension for Scoping Reviews (PRISMA-ScR). A literature search was conducted across PubMed, CINAHL Complete (EBSCOhost), Cochrane Central Register of Controlled Trials (EBSCOhost), the Cochrane Database of Systematic Reviews (EBSCOhost), Scielo, Scopus, PEDro, and ClinicalTrials.gov. Unpublished studies were identified via Google Scholar, DART-Europe, and MedNar. All search strategies were conducted on April 24, 2023. Sources published in English, Spanish, and Portuguese were included and no date restrictions were applied. Study selection and data extraction were conducted independently by 2 reviewers using a standardized extraction tool. Results: Thirty-three studies published between 2001 and 2023 were included. Studies were conducted in the USA, Brazil, Turkey, Chile, Australia, Taiwan, Czechia, Italy, Republic of Korea, Germany, India, and Israel. The sample sizes ranged from 1 participant to 75 participants. The combined sample size of all studies was 1007 participants. Most programs integrated respiratory muscle strength training using devices, targeting people with Parkinson´s disease in Hoehn and Yahr scale stages 1-3. Speech-language pathologists, physiotherapists, and medical doctors were the health professionals responsible for delivering these programs in home-based or clinical settings. A broad spectrum of outcomes related to respiratory function was reported. Additionally, the studies assessed other outcomes such as quality of life, functional capacity, motor symptoms, and fatigue. Conclusions: Respiratory rehabilitation programs for people with Parkinson's disease have predominantly targeted respiratory muscle strength training, without a multidisciplinary approach. More research is needed emphasizing inclusive studies in terms of exercises/interventions in respiratory rehabilitation programs, stages of disease progression, and with the adoption of a multidisciplinary approach. Review registration: OSF https://osf.io/hgajt. Supplemental digital content: A translation of the abstract of this review is available in Portuguese at http://links.lww.com/SRX/A107 .