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- Content and Delivery of Physical Therapy in Multiple Sclerosis across Europe: A SurveyPublication . Řasová, Kamila; Freeman, Jenny; Cattaneo, Davide; Jonsdottir, Johanna; Baert, Ilse; Smedal, Tori; Romberg, Anders; Feys, Peter; Alves-Guerreiro, José; Habek, Mario; Henze, Thomas; Santoyo-Medina, Carme; Beiske, Antonie; Asch, Paul Van; Bakalidou, Daphne; Salcı, Yeliz; Dimitrova, Erieta; Pavlíková, Markéta; Štětkářová, Ivana; Vorlíčková, Jana; Martinková, PatriciaBackground: Guidelines and general recommendations are available for multiple sclerosis rehabilitation, but no specific guidance exists for physical therapists. Describing aspects of physical therapy content and delivery in multiple sclerosis and its determinants and analysing whether general recommendations connected with physical therapy are implemented in practice is important for interpreting clinical and research evidence. Methods: An online cross-sectional survey of physical therapists specialized in multiple sclerosis (212 specialists from 26 European countries) was used. Results: There was distinct diversity in service delivery and content across Europe. Perceived accessibility of physical therapy varied from most accessible in the Western region, and least in the Southern region. Sixty-four physical therapists adjusted their approach according to different disability levels, less so in the Eastern region. Duration, frequency and dose of sessions differed between regions, being highest in Southern and Western regions. “Hands on treatment” was the most commonly used therapeutic approach in all apart from the Northern regions, where “word instruction” (providing advice and information) prevailed. Conclusions: The content and delivery of physical therapy differs across Europe. Recommendations concerning access to treatment and adjustment according to disability do not appear to be widely implemented in clinical practice.
- Nursing Interventions in the Prevention of Musculoskeletal Injuries in Adolescent Athletes: Integrative ReviewPublication . Bernardo, Joana; Martins, Rosa; Morgado, Camila; Carmo, Henrique; Aguiar, Luís; Santos, Teresa; Carvalho, Nélia; Loureiro, RicardoMusculoskeletal injuries are a growing concern among adolescent athletes, with significant physical and psychological consequences. This integrative literature review aimed to analyze the risk factors associated with musculoskeletal injuries in adolescents engaged in sports and to explore the role of nursing interventions in their prevention. A systematic search was conducted across four databases and one gray literature source, including studies published between 2014 and 2024. Three descriptive studies were included, with evidence levels ranging from 3 to 4, according to the Joanna Briggs Institute classification. The main findings highlight that risk factors for musculoskeletal injuries include excessive training loads, inadequate sports technique, lack of professional supervision, improper use of equipment, and failure to recognize early signs of discomfort. Preventive nursing interventions were shown to be effective, particularly those focused on health education, proprioceptive training, and continuous monitoring. Multidisciplinary collaboration between nurses, coaches, and other health professionals emerged as a key strategy in creating safe sporting environments. Despite limitations such as the scarcity of studies on nursing-specific interventions in diverse sports contexts, this review supports the potential of structured, evidence-based nursing actions to reduce musculoskeletal injuries incidence, promote safer sports practices, and enhance adolescent athletes’ health outcomes.
- On the development of diagnostic support algorithms based on CPET biosignals data via machine learning and waveletsPublication . Pinheiro, Rafael F.; Fonseca-Pinto, Rui; Brunello, AndreaFor preventing health complications and reducing the strain on healthcare systems, early identification of diseases is imperative. In this context, artificial intelligence has become increasingly prominent in the field of medicine, offering essential support for disease diagnosis. This article introduces an algorithm that builds upon an earlier methodology to assess biosignals acquired through cardiopulmonary exercise testing (CPET) for identifying metabolic syndrome (MS), heart failure (HF), and healthy individuals (H). Leveraging support vector machine (SVM) technology, a wellknown machine learning classification method, in combination with wavelet transforms for feature extraction, the algorithm takes an innovative approach. The model wastrained on CPETdatafrom 45participants, including 15 with MS, 15 with HF, and 15 healthy controls. For binary classification tasks, the SVM with a polynomial kernel and 5-level wavelet transform (SVM-POL-BW5) outperformed similar methods described in the literature. Moreover, one of the main contributions of this study is the development of a multi-class classification algorithm using the SVM employing a linear kernel and 3-level wavelet transforms (SVM-LIN-MW3), reaching an average accuracy of 95%. In conclusion, the application of SVM-based algorithms combined with wavelet transforms to analyze CPET data shows promise in diagnosing various diseases, highlighting their adaptability and broader potential applications in healthcare.
- Use of digital technologies to promote sexual health in young adults: a narrative reviewPublication . Cunha-Oliveira, Aliete Cristina Gomes Dias Pedrosa da; Cantarino, Sagrario Gómez; Santos, Diana Gabriela Simões Marques Dos; Oliveira, Beatriz Filipa Pinto; Marinho, Bernardo; Ribeiro, Carolina Dias; Rodrigues, Filipe dos Santos; Gomes, José Hermínio; Menino, Eva Patrícia da Silva Guilherme; Reis, Renata Karina; Barbosa, Dulce; Fernandes, Ana FátimaObjective: To map the evidence in the literature on the use of digital technologies to promote sexual health in young adults. Methods: Narrative literature review. Data were extracted, analyzed, and synthesized by three independent reviewers. Results: After the selection process, four studies were included. The articles reveal that the use of digital technologies (mobile phones/applications) translates into increased knowledge and improved sexual attitudes and behaviors among young adults. Final considerations: The use of digital technologies promotes the sexual health of young adults, so these strategies should be implemented by health professionals.
- Exploring the Association between Health Literacy and Diabetes Risk in Adults: Insights from a Pilot Study in LeiriaPublication . Batalha, Maria João; Gabriel, Tiago; Alves, Bartolomeu; Soledade, Ana; Passadouro, Rui; Dias, Sara SimõesIntroduction: Low levels of health literacy (HL) are related to behaviors that increase the risk of developing type 2 diabetes (T2D). However, in Europe, there is still little knowledge about this relationship, and whether improving HL could be an effective strategy for preventing the disease. Therefore, this study aims to measure the association between HL and the risk of developing T2D in adults living in the municipality of Leiria. Methods: Data from the Longitudinal Health Literacy Study of the Municipality of Leiria were used. The sample (pilot study) consists of 175 individuals aged 18 or over. The Finnish Diabetes Risk Score was used to determine an individual’s risk of developing T2D. The short version of the European Health Literacy Questionnaire was applied to assess participants’ HL levels. Descriptive statistics were calculated to describe participants’ sociodemographic characteristics (sex, age, education, and monthly income). The analysis of the relationship between the level of HL and FINDRISC score was performed using a multivariate linear analysis. The analysis was conducted in three nested Received: June 28, 2024 Accepted: March 24, 2025 Published online: June 24, 2025 c statistical models, and adjusted for age, sex, and educational level. Results: According to the FINDRISC, 35.7% of respondents have a low risk, 26.8% a slightly moderate risk, 8.3% a moderate risk, 24.2% a high risk, and 5.1% a very high risk of developing T2D diabetes in the next 10 years. In the statistical model adjusted for age, sex, and education, individuals with inadequate levels of HL presented an average of 4.62 points more on the FINDRISC scale than individuals with excellent levels of HL (95% confidence interval: 0.558–8.677). Discussion/ Conclusion: The risk of developing T2D is increased in people with lower levels of HL. It is important to invest in public health programs that empower citizens with knowledge to better manage their health.
- A memory failure computational model in Alzheimer-like disease via continuous delayed Hopfield network with Lurie control system based healingPublication . Pinheiro, Rafael Fernandes; Colón, Diego; Fonseca-Pinto, RuiAlzheimer’s disease (AD) is a degenerative neurological condition that impacts millions of individuals across the globe and remains without a healing. In the search for new possibilities of treatments for this terrible disease, this work presents the improved Alzheimer-like disease (IALD) model for memory failure and connects it to a new control technique that establishes a cure for the memory lost, either in biological or in artificial neural networks. For the IALD model, continuous Hopfield neural networks (HNN) with time delay are used. From the healing side, a robust control technique is used, which is based on new discoveries in Lurie control systems. In addition, this paper reviews the development of Alzheimer-like disease (ALD) model, as well as, the relationship of HNN with Lurie system. Simulations are executed to validate the model and to show the efficacy of applying a new theorem from Lurie problem. With the results presented, this work proposes a new conceptual paradigm that could potentially be applied in memory failure treatments in AD, as well as in hardware implemented HNN under adversarial attacks or adverse environmental conditions.
- New pharmacological agents and novel cardiovascular pharmacotherapy strategies in 2024Publication . Tamargo, Juan; Agewall, Stefan; Ambrosio, Giuseppe; Borghi, Claudio; Cerbai, Elisabetta; Dan, Gheorghe A; Drexel, Heinz; Ferdinandy, Péter; Grove, Erik Lerkevang; Klingenberg, Roland; Morais, João; Parker, William; Rocca, Bianca; Sulzgruber, Patrick; Semb, Anne Grete; Sossalla, Samuel; Kaski, Juan Carlos; Dobrev, DobromirDespite substantial advances in cardiovascular pharmacotherapy and devices in recent years, prevention and treatment of many cardiovascular diseases (CVDs) remain limited, thus reflecting the need for more effective and safer pharmacological strategies. In this review, we summarize the most relevant studies in cardiovascular pharmacotherapy in 2024, including the approval of first-in-class drugs for the treatment of resistant hypertension and pulmonary arterial hypertension, label expansions for bempedoic acid and semaglutide, and the results of major randomized clinical trials (RCTs) that have met the pre-specified primary endpoints, thereby filling some gaps in knowledge and opening new perspectives in the management of CVD, and those RCTs whose results did not confirm the proposed research hypotheses. We also include a section on drug safety, where we describe the newest data on adverse reactions and drug–drug interactions that may complicate treatment and/or reduce drug adherence with the consequent decrease in drug effectiveness. Finally, we present the most important ongoing phase 2 and phase 3 clinical trials assessing the efficacy and safety of cardiovascular drugs for the prevention and treatment of CVD.
- 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 .
- Pre-Exposure to α-Linolenic Acid Reduces Virulence of Cronobacter sakazakii in Galleria mellonella Infection ModelPublication . Phair, Katie; Curtis, Aaron; Pereira, Sónia G.; Kealey, Carmel; Kavanagh, Kevin; Brady, DamienCronobacter sakazakii is a food-borne pathogen with infections notifiable in those under 12 months old. Current inhibition methods rely on manufacture and reconstitution guidelines. Fatty acids (FA) are a possible method of control, with reports showing FAs can be bactericidal and regulate virulence mechanisms such as biofilm formation. This research explores the efficacy of the long-chain FA α-linolenic (ALA) to reduce C. sakazakii virulence in vivo. Galleria mellonella larvae were injected with FA pre-treated C. sakazakii and viability monitored every 24 h over a total of 96 h. To show the interaction between the host immune system and C. sakazakii, haemocytes and bacterial cells were mixed and enumerated following incubation. To investigate the impact on antimicrobial resistance (AMR), 24 antibiotics were tested against C. sakazakii pretreated with ALA. Kaplan–Meier survival curves generated showed a dose-dependent increase in larval survival upon increased FA concentration. Regarding the immune evasion assay, data generated show increased C. sakazakii and decreased haemocyte counts in the same sample. From the AMR results, there was no statistically significant difference in inhibition zones when compared to the control, indicating no contraindications for current treatment options. α-linolenic acid is a common component of the human diet and is shown here to directly reduce virulence mechanisms including immune system evasion. Pre-treatment with ALA reduces the virulence of C. sakazakii, resulting in increased survival of G. mellonella larvae. This suggests that ALA may serve as a candidate for further evaluation as a potential agent against C. sakazakii.
- How does a storybook impact preschool children’s willingness to try vegetables? An experimental study from the Veggies4myHeart projectPublication . Braga-Pontes, Cátia; Borges, Mariana; Rosa, Tiago Araújo; Novo, Rita; Vieito, Leonel; Lages, Marlene; Guarino, Maria P.; Dias, Sara Simões; Minicucci, Marcos; Amancio, OlgaBackground Vegetable consumption among children is below recommended. Given the critical role of vegetable consumption in health, it is essential to identify effective strategies to promote this intake. This study aimed to test the efficacy of a superhero’s storybook (SB) as a nutrition education strategy on the willingness to try (WTT) 10 different vegetables in preschool children and relate WTT with food neophobia, preferences, age, and body mass index. Methods This is an experimental study conducted in three Portuguese preschools. The intervention consisted of 20-min educational sessions once a week for 5 weeks, using a SB for nutrition education, to 178 children aged 2 to 6 years. A baseline and a post-test were conducted to determine the impact of the nutrition education strategy on the WTT ten vegetables. WTT was assessed using the Farfan-Ramirez WTT (FR-WTT) scale. Kruskal–Wallis H test, Spearman correlation, and Wilcoxon test were used for statistical analysis. Results The mean FR-WTT total score at baseline was significantly lower than the mean FR-WTT total score at post-test [M = 22.79 (S.D. = 11.85) versus M = 24.39 (S.D. = 11.77)], respectively. The intervention promoted a significant increase in the WTT of half of the vegetables offered and the total FR-WTT score. Conclusion The storybook from the Veggies4myHeart project demonstrated positive results in increasing WTT vegetables. However, it is essential to understand the project’s impact at home and in the long term. It is necessary to find valuable strategies to increase vegetable consumption in different contexts, including schools and at home.