Browsing by Issue Date, starting with "2025-04"
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- Controversies in myopia control treatment: what does it mean for future research?Publication . Lança, Carla; Repka, Michael X.; Grzybowski, AndrzejPurpose: Treatment of myopia has been informed by more than 3 decades of clinical trials and other observations. However, controversies regarding myopia control remain, such as when to stop treatment and what is the long-term efficacy of treatment. This perspective aims to describe clinically relevant and current controversies regarding myopia treatment. Design: Perspective. Methods: We reviewed clinical trial data and other studies regarding myopia control therapies. Results: Controversies in myopia treatment are related to the efficacy of low-dose atropine eyedrops and new lens design spectacles to reduce the progression of myopia substantially. In addition to efficacy, the safety of therapies including soft contact lenses, orthokeratology, and low-level red light remains a concern. The therapeutic role of outdoor time in reducing myopia progression also requires further investigation. More research is necessary to confirm treatment effectiveness, required treatment duration, tapering schedules, and when to begin and stop treatment. Conclusions: Myopia management is evolving and maintaining competency in the multiple approaches poses a challenge. Key challenges include identifying high-risk children who would benefit most from treatment, limited evidence supporting the effectiveness of myopia progression control treatments in certain populations, and concerns regarding the availability and cost of treatment, which may create socioeconomic barriers to access. The limitations of current methods to slow or stop myopia progression highlight the need for continuing rigorous investigation of new and improved strategies to reduce the burden of myopia.
- Comprehensive analysis of particulate matter, gaseous pollutants, and microbiological contamination in a clothing store from an international chain in EuropePublication . Furst, Leonardo; Cipoli, Yago; Galindo, Nuria; Yubero, Eduardo; Viegas, Carla; Gomes, Bianca; Cervantes, Renata; Nunes, Teresa; Feliciano, Manuel; Alves, CéliaIn this study, indoor air quality was assessed in a store belonging to one of Portugal's largest commercial retail groups. A variety of methodologies were used, including gravimetric analysis for particulate matter (PM), optical monitors for real-time PM measurements, gas sensors and analyzers for CO2 and other gaseous pollutants, diffusion tubes for VOCs, and passive deposition for microorganisms. The average PM10 concentration indoors was 16.5 ± 3.87 μg/m3, well below the exposure limits set by various international organizations. A significant portion of indoor PM10 – 69% - was originated from outdoor sources. Outdoor PM10 concentrations were substantially higher, averaging 29.4 ± 14.6 μg/m3. Metal concentrations were also higher outdoors than indoors, and the associated cancer risk and hazard quotient were not exceeded, indicating favorable air quality conditions within the store. Among VOCs, α-pinene and tetrachloroethylene were detected in notable concentrations. α-Pinene likely originated from cleaning products and fragrances, while tetrachloroethylene was attributed to emissions from a dry-cleaning establishment located in the same building, but did not exceed protection thresholds. Microbial analysis showed low concentrations of both fungi and bacteria. However, fungal species with clinical and toxigenic potential were found. The most common fungal species were Trichoderma sp. and Penicillium sp., depending on the culture media. Overall, the clothing store demonstrated good air quality. However, to further reduce the impact of outdoor pollutants on indoor air quality, enhancements to the ventilation system are recommended. These improvements can help create a healthier indoor environment by filtering and managing the intake of external contaminants more effectively.
- Dual-loaded chitosan-based nanoparticles: a novel approach for treating polymicrobial osteomyelitisPublication . Zegre, Miguel; Barros, J.; David, A. B.; Fialho, L.; Ferraz, M. P.; Monteiro, F. J.; Caetano, Liliana Aranha; Gonçalves, L.; Bettencourt, A.Developing innovative approaches to target osteomyelitis caused by polymicrobial infections remains a significant therapeutic challenge. In this study, monodispersed chitosan nanoparticles co-loaded with antibacterial (minocycline) and antifungal (voriconazole) agents were successfully prepared. Minocycline presented higher encapsulation efficiency as compared to voriconazole. Thermostability analysis suggested interactions between the co-loaded drugs within the dual-delivery system, potentially limiting voriconazole release. The dual-loaded chitosan nanoparticles exhibited significant in vitro anti-biofilm activity, achieving up to a 90% reduction in polymicrobial biofilms of S. aureus and C. albicans. Additionally, the nanoparticles showed cytocompatibility with a human osteoblast cell line. These findings highlight the potential of this dual-delivery chitosan-based nanoparticle system to address a critical gap in osteomyelitis treatment by targeting both bacterial and fungal pathogens.
- Quality of life associated with breathlessness in the multinational Burden of Obstructive Lung Disease (BOLD) study: a cross-sectional analysisPublication . Müller, Alexander; Wouters, Emiel F.; Burney, Peter; Potts, James; Cardoso, Joao; Al Ghobain, Mohammed; Studnicka, Michael; Obaseki, Daniel; Elsony, Asma; Mortimer, Kevin; Mannino, David; Jögi, Rain; Ahmed, Rana; Nafees, Asaad; Hermínia Brites DiasIntroduction: Evidence of an association between breathlessness and quality of life from population-based studies is limited. We aimed to investigate the association of physical and mental quality of life with breathlessness across several low-, middle- and high-income countries. Methods: We analyzed data from 19,714 adults (31 sites, 25 countries) from the Burden of Obstructive Lung Disease (BOLD) study. We measured both mental and physical quality of life components using the SF-12 questionnaire and defined breathlessness as grade ≥2 on the modified Medical Research Council scale. We used multivariable linear regression to assess the association of each quality-of-life component with breathlessness. We pooled site-specific estimates using random-effects meta-analysis. Results: Both physical and mental component scores were lower in participants with breathlessness compared to those without. This association was stronger for the physical component (coefficient = -7.59; 95%CI -8.60, -6.58; I2 = 78.5%) than for the mental component (coefficient = -3.50; 95%CI -4.36, -2.63; I2 = 71.4%). The association between physical components and breathlessness was stronger in high-income countries (coefficient = -8.82; 95%CI -10.15, -7.50). Heterogeneity across sites was partly explained by sex and tobacco smoking. Conclusion: Quality of life is worse in people with breathlessness, but this association varies widely across the world.
- The international collaboration of pharmacy journal editors (ICPJE) formally constituted to foster quality around clinical and social pharmacy practice research publicationsPublication . Alves da Costa, Filipa; Fernandez-Llimos, Fernando; Desselle, Shane; Arnet, Isabelle; Abar, Zaheer; Bond, Christine; Cordina, Maria; Garcia Cardenas, Victoria; El Hajj, Maguy; Jacobsen, Ramune; Law, Anandi; Nørgaard, Lotte; Polidori, Carlo; Shcherbakova, Natalia; Stewart, Derek; Tonin, Fernanda; Weidmann, AnitaThe Granada statements were a result of the need to strengthen clinical, social, and administrative pharmacy practice as an area of knowledge that translates into practice, research, and policy. As a response, a group of clinical and social pharmacy practice journal editors launched an initiative in Granada in 2022 to discuss ways to improve the quality of publications in this area, which culminated in the Granada statements. Eighteen statements were developed, clustered into six main domains:1) the appropriate use of terminology; 2) developing impactful abstracts; 3) having the required peer reviews; 4) preventing journal scattering; 5) more effective and wiser use of journal and article performance metrics; and 6)authors' selection of the most appropriate pharmacy practice journal to submit their work. The full Granada statements have been published in 14 journals. These pioneering statements are rooted in similar endeavors undertaken by scholars in other health professions groups, fostering the concept of interdisciplinary consensus and advancing scientific paradigm.
- The effects of nutritional supplementation for children and adolescents with sickle cell disease: a systematic review and meta-analysesPublication . Orsi, Bruna C.; Gorski, Daniela; Krul, Naila E.; Wiens, Astrid; Brito, Miguel; Tonin, Fernanda; Pontarolo, RobertoBackground & aims: Sickle cell disease (SCD), a neglected chronic genetic blood disorder that severely impacts the pediatric population, often leading to premature death, is associated with compromised nutritional status. This study aimed to evaluate the effect of nutritional supplementation on SCD-related complications. Methods: A systematic review with searches in PubMed, Scopus, and Web of Science was performed. Randomized controlled trials (RCT) assessing diet or supplements as a complementary therapy for children and adolescents with SCD were included (PROSPERO: CRD42024532369). The data for outcomes of interest (efficacy, safety) were pooled using pairwise and network meta-analyses with ranking (p-score) analysis. The results were presented as odds ratio or mean differences with 95 % confidence intervals (NMAstudio2.0). Results: Twenty RCTs were included (2002–2023) (n = 2058), analyzing 9 dietary supplements on different regimens. All patients use hydroxyurea as an active treatment. Supplementation with fatty acids (n = 3 studies) and l-arginine (n = 4) presented higher efficacy and safety, significantly improving pain intensity, vaso-occlusive crises (VOC), and inflammation when compared to usual care/placebo (p < 0.05). Vitamin D3 (n = 6) at different dosages may reduce respiratory complications and length of hospital stay, yet further studies are needed to confirm its significant effects. Evidence is limited and of poor quality regarding the effects of add-on vitamin A (n = 2), magnesium sulfate (n = 2), and zinc (n = 4) for this population. Conclusions: The complementary use of certain supplements (fatty acids, l-arginine, vitamin D3) can enhance the management of VOC and improve patients' physiological functions. These supplements are often affordable and can contribute towards the reduction of opioid use and shorten patients' hospital stays - especially in low/middle-income countries where resources are scarce. Although further studies are needed to refine these findings (e.g., appropriate doses/regimens), practical guidelines and decision-makers may benefit from updated evidence.
- Highly porous NiFe nanofoams synthesized by dynamic hydrogen bubble template for hydrogen evolution in alkaline mediaPublication . Carvalho, Gabriel Garcia; do Nascimento, Ricardo Espingardas; Morais Silva, Teresa; Montemor, Maria de FátimaWhen coupled with renewable energy sources, alkaline electrolysis (AEL) is a clean technology to produce hydrogen. The conventional electrodes that have been established as the commercial standard for AEL are perforated nickel plates, which have low surface area and high mass loads of active material. The use of Ni has been associated with the adsorption of protons and their recombination into H2 molecules, assisting and enabling the hydrogen evolution reactions. Due to the rising Ni price, there is a demand for less expensive electrode materials with identical, or better, performance. Thus, this work explores new alternative electrode materials and combines Ni with a cheaper and also electroactive metal, iron. For this purpose, highly porous bimetallic nanofoams are produced through the dynamic hydrogen bubble template. NiFe electrodes of different compositions are characterized by scanning electron microscopy, energy-dispersive spectroscopy, linear sweep voltammetry, and chronopotentiometry analysis. The results allow obtaining key parameters that are essential for the optimization of the electrode's response considering overpotentials, Tafel slopes, and other electrochemically relevant parameters.
- Validation of binocular vision and ocular surface assessment tools in digital eye strain syndrome: the DESIROUS studyPublication . Barata, Maria João; Aguiar, Pedro; Grzybowski, Andrzej; Lança, Carla; jMoreira-Rosário, AndréBackground: To understand if binocular vision disorders are associated with Digital Eye Strain Syndrome (DESS), a study protocol is needed to ensure consistency across observational studies. This study aims to test the feasibility of a protocol to assess DESS, screen time, binocular vision, and dry eye. Methods: DESIROUS is an observational cross-sectional study among Polytechnic students at the Lisbon School of Health Technology, Portugal. The protocol includes three questionnaires (Computer Vision Syndrome Questionnaire [CVS-Q], Convergence Insufficiency Symptom Survey [CISS], and Dry Eye Questionnaire version 5 [DEQ-5]), an assessment of visual acuity and binocular vision (cover test for near and distance, stereopsis, near point convergence (NPC), near point accommodation (NPA), accommodative facility, vergence), and the ocular surface break-up tear (BUT) test. The questionnaires were validated using Cronbach’s alpha. Interobserver variability for BUT was assessed using Cohen’s Kappa, Intraclass Correlation Coefficient (ICC), and Bland–Altman analysis involving three observers (A, B, and C), compared against an expert as the gold standard. Results: A total of 18 students were included in the validation phase (mean age: 21.50 ± 0.62 years; females: 77.8%). The internal consistency of the CVS-Q (α = 0.773) and the CISS (α = 0.756) was considered good, while the DEQ-5 showed a reasonable internal consistency (α = 0.594). Observer A had the highest agreement with the gold standard (Cohen’s Kappa = 0.710 and p < 0.001; ICC = 0.924, p < 0.001). Conclusions: We provide a protocol to assess binocular vision and the ocular surface, with an emphasis on objective measures while integrating other assessment approaches. Further studies are necessary to validate this protocol, potentially incorporating new measures to enhance its validity across different populations.
- Assessing the quality and reliability of ChatGPT’s responses to radiotherapy-related patient queries: comparative study with GPT-3.5 and GPT-4Publication . Grilo, Ana; Marques, Catarina; Corte-Real, Maria; Carolino, Elisabete; Caetano, MarcoBackground: Patients frequently resort to the internet to access cancer information. However, these websites often lack content accuracy and readability. Recently, ChatGPT, an artificial intelligence-powered chatbot, has signified a potential paradigm shift in how patients with cancer can access vast amounts of medical information, including insights into radiotherapy. However, the quality of the information provided by ChatGPT remains unclear. This is particularly significant given the general public's limited knowledge of this treatment and concerns about its possible side effects. Furthermore, evaluating the quality of responses is crucial, as misinformation can foster a false sense of knowledge and security, lead to noncompliance, and result in delays in receiving appropriate treatment. Objective: This study aims to evaluate the quality and reliability of ChatGPT's responses to common patient queries about radiotherapy, comparing the performance of ChatGPT's two versions: GPT-3.5 and GPT-4. Methods: We selected 40 commonly asked radiotherapy questions and entered the queries in both versions of ChatGPT. Response quality and reliability were evaluated by 16 radiotherapy experts using the General Quality Score (GQS), a 5-point Likert scale, with the median GQS determined based on the experts' ratings. Consistency and similarity of responses were assessed using the cosine similarity score, which ranges from 0 (complete dissimilarity) to 1 (complete similarity). Readability was analyzed using the Flesch Reading Ease Score, ranging from 0 to 100, and the Flesch-Kincaid Grade Level, reflecting the average number of years of education required for comprehension. Statistical analyses were performed using the Mann-Whitney test and effect size, with results deemed significant at a 5% level (P=.05). To assess agreement between experts, Krippendorff α and Fleiss κ were used. Results: GPT-4 demonstrated superior performance, with a higher GQS and a lower number of scores of 1 and 2, compared to GPT-3.5. The Mann-Whitney test revealed statistically significant differences in some questions, with GPT-4 generally receiving higher ratings. The median (IQR) cosine similarity score indicated substantial similarity (0.81, IQR 0.05) and consistency in the responses of both versions (GPT-3.5: 0.85, IQR 0.04; GPT-4: 0.83, IQR 0.04). Readability scores for both versions were considered college level, with GPT-4 scoring slightly better in the Flesch Reading Ease Score (34.61) and Flesch-Kincaid Grade Level (12.32) compared to GPT-3.5 (32.98 and 13.32, respectively). Responses by both versions were deemed challenging for the general public. Conclusions: Both GPT-3.5 and GPT-4 demonstrated the capability to address radiotherapy concepts, with GPT-4 showing superior performance. However, both models present readability challenges for the general population. Although ChatGPT demonstrates potential as a valuable resource for addressing common patient queries related to radiotherapy, it is imperative to acknowledge its limitations, including the risks of misinformation and readability issues. In addition, its implementation should be supported by strategies to enhance accessibility and readability.
- From knowledge to action: how Portuguese higher education students engage with circular economy principlesPublication . Pardal, Ana; Moreira, Anabela; Galacho, Cristina; Mateus, Dina; Viegas, Laura; Gaspar, Marcelo; Teixeira, Margarida Ribau; Manteigas, Vítor; Dinis, Maria Alzira PimentaThis study investigates the perceptions and practices of Portuguese higher education students regarding the circular economy (CE), emphasising their knowledge, attitudes, and behaviours toward sustainable resource management. Carried out by the Working Group on Circular Economy and Waste Management of the Portuguese Sustainable Campus Network (RCS), the research used an online survey targeting students from 20 higher education institutions (HEIs), resulting in 400 responses. The findings indicate that while students generally hold positive views of the CE, their understanding of its practical applications, such as waste reduction and resource efficiency, remains limited. Only a small proportion of students reported exposure to CE-related topics in their curriculum, revealing a gap in academic integration. This study also identifies significant demographic variations in CE awareness and practices, influenced by factors such as age, field of study, and employment status. These insights underscore the need for HEIs to strengthen CE education and actively involve students in hands-on sustainability initiatives, fostering a generation equipped to drive the transition toward a circular economy.