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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.
- 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).
- 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.
- 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.
- 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.
- 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.
- 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.
- Avaliação do programa de inclusão no Ensino Superior: Estudo de caso no Politécnico de LeiriaPublication . Vicente, Luís; Pocinho, Ricardo; Migueláñez, Susana Olmos“Todos os seres humanos nascem livres e iguais em dignidade e em direitos.” (ONU, 1948). A Declaração Universal dos Direitos Humanos coloca todo e qualquer ser humano em pé de igualdade em relação a direitos e deveres, inclusive “…o acesso aos estudos superiores deve estar aberto a todos em plena igualdade, em função do seu mérito” (ONU, 1948). A Direção-Geral de Estatísticas da Educação e Ciência (DGEEC), a partir do ano letivo 2017/2018 iniciou uma investigação à evolução dos estudantes com necessidades específicas (ENE) nas instituições de ensino superior (IES). O aumento gradual do número de estudantes é a consequência do reconhecimento de que o acesso à educação superior é um direito de todos (Rodrigues, 2004) e a formação académica é basilar para a formação profissional e a empregabilidade (Correia, 2019). Este estudo surge como uma investigação de avaliação aplicada sobre um caso particular: o Projeto 100% IN® do Politécnico de Leiria que iniciou o seu desenvolvimento em setembro de 2018, numa parceria entre o Politécnico de Leiria e o Instituto Padre António Vieira (IPAV). Estas parcerias entre as duas instituições resultaram num projeto-piloto, único em Portugal que pretende contribuir para a integração e inclusão dos estudantes com necessidades específicas nas instituições de ensino superior.
- Baixa Visão Adquirida Antes do Ingresso no Ensino Superior – Estudo de CasoPublication . Faria, Inês; Vicente, LuísA nível nacional, foram encontradas dificuldades na obtenção de informação estatística relativa a pessoas com deficiência visual no ensino superior, uma vez que o Instituto Nacional de Estatística (INE), nos Censos de 2021, utilizou o modelo de recolha e apuramento dos resultados sobre a prevalência de incapacidade, designado “Washington Group Short Set on Functioning” em conformidade com o recomendado pela Comissão Económica das Nações Unidas para a Europa (UNECE). Este modelo carateriza as limitações das pessoas através da observação do grau de dificuldade que estas sentem na execução de determinadas atividades, ou seja, considera a funcionalidade e a incapacidade como resultado das ações entre a pessoa e os contextos, excluindo a avaliação baseada em diagnósticos médicos de deficiência. A investigação baseia-se no estudo de caso de um jovem com Baixa Visão (BV) sendo que com este estudo pretende-se identificar quais os produtos de apoio que melhor auxiliam um estudante do ensino superior com baixa visão, bem como a adaptação e desenvolvimento do mesmo aos dispositivos e novo ambiente. Encontra-se ainda numa fase prematura, pelo que não será possível apresentar os resultados deste estudo.
- Circadian and Biological Rhythms in Shift Workers—A Firefighter’s StudyPublication . Duarte, I.F.; Pereira, J.; Lima, JPM.; Simões, H.; Pereira, T.; Conde, J.Shift Work contribute to dysregulation of the typical sleep and awake periods that cause circadian distortions, increasing the risk of cardiovascular mortality and morbidity and developing metabolic diseases. Firefighting is a career that demands much of individuals and has a great impact on their health, making it a high-risk job. Objectives: This study aims to characterize shift workers’ blood pressure profiles in an attempt to understand the repercussions of shift work on the circadian blood pressure rhythm in a sample of professional firefighters. Materials and methods: Participants were classified based on their dipping status: dipper drop of 10–20%; non-dipper 0–10%; invert-dipper when there is a rise in BP; extreme-dipper superior to 20%. Results: Abnormal dipping was found in 55.6% of the participants, and there was a marked difference in gender in percentage where dipping is concerned, with 66.7% of women having abnormal dipping against 50% of the men. It was proved that men had a slower heart rate than women (p-value = 0.029) and that dippers had a higher 24 h DBP compared with those of abnormal dipping (p-value = 0.049). Conclusions: Shift work is a high-risk module of labor, and its consequences require a more thorough examination. Abnormal dip- ping prevailed in firefighters, and the differences between genders need to be better characterized in future studies. © The Author(s), under exclusive license to Springer Nature Switzerland AG 2024.