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- Enhancing the performance of double-flush riveted joints through hybridization with adhesive bondingPublication . Alpendre, João M. B.; Rosado, Pedro M. S.; Sampaio, Rui F. V.; Pragana, João P. M.; Bragança, Ivo; Silva, Carlos M. A.; Martins, Paulo A. F.This paper explores the potential to enhance the mechanical performance of joints created through a new joining-by-forming technique called hybrid double-flush riveting. To achieve this, adhesive bonding is used to form hybrid lap joints with superior mechanical properties. The study focuses on high-strength steel sheets and starts by identifying the appropriate surface conditions necessary for producing strong adhesive-bonded joints. A similar strategy is applied to construct double-flush riveted joints, focusing on the geometric variables involved in the process. Hybrid joints are then created by integrating adhesive bonding with double-flush riveting, with the second carried out before or after curing is completed. The experimental development is supported by finite element analysis conducted with an in-house computer program. The mechanical performance of the hybrid joints is compared to that of purely adhesive-bonded and conventionally double-flush riveted joints through shear and peel destructive testing. Results demonstrate that hybrid joints ultimately provide greater joint strength for both solicitations. This allows showcasing the hybridization of double-flush riveting with adhesive bonding as an effective solution for applications where joint strength and continuity are essential.
- Association between lung function and dyspnoea and its variation in the multinational Burden of Obstructive Lung Disease (BOLD) studyPublication . Müller, A.; Wouters, E. F.; Koul, P.; Welte, T.; Harrabi, I.; Rashid, A.; Loh, L. C.; Al Ghobain, M.; Elsony, A.; Ahmed, R.; Potts, J.; Mortimer, K.; Rodrigues, F.; Paraguas, S. N.; Juvekar, S.; Agarwal, D.; Obaseki, D.; Gislason, T.; Seemungal, T.; Nafees, A. A.; Jenkins, C.; Dias, Hermínia Brites; Franssen, F. M.; Studnicka, M.; Janson, C.; Cherkaski, H. H.; El Biaze, M.; Mahesh, P. A.; Cardoso, João; Burney, P.; Hartl, S.; Janssen, D. J.; Amaral, A. F.Background: Dyspnoea is a common symptom of respiratory disease. However, data on its prevalence in general populations and its association with lung function are limited and are mainly from high-income countries. This study aimed to estimate the prevalence of dyspnoea across several world regions and to investigate the association of dyspnoea with lung function. Methods: Dyspnoea was assessed, and lung function was measured in 25,806 adult participants of the multinational Burden of Obstructive Lung Disease study. Dyspnoea was defined as ≥2 on the modified Medical Research Council (mMRC) dyspnoea scale. The prevalence of dyspnoea was estimated for each of the study sites and compared across countries and world regions. Multivariable logistic regression was used to assess the association of dyspnoea with lung function in each site. Results were then pooled using random-effects meta-analysis. Results: The prevalence of dyspnoea varied widely across sites without a clear geographical pattern. The mean prevalence of dyspnoea was 13.7 % (SD=8.2 %), ranging from 0 % in Mysore (India) to 28.8 % in Nampicuan-Talugtug (Philippines). Dyspnoea was strongly associated with both spirometry restriction (FVC
- Complexidades educacionaisPublication . Versuti , Andrea; Bonacho, FernandaNo panorama desta aceleração, propomos o debate desta obra, que reúne textos que se relacionam ao olhar retrotópico sobre a ecologia dos meios e os temas do livro. A partir de uma seleção rigorosa e realizada às cegas pelas coordenações, chegou-se à composição capitular. Espero, com este conteúdo, que pensamentos sobre o ecossistema em que vivemos sejam alavancados e soluções para um cotidiano eticamente saudável sejam encontradas. Boa leitura.
- Spatial frequency of environments and myopia: a systematic review on associated evidence and underlying mechanismsPublication . Li, Dan-Li; Lança, Carla; Zhang, Xiu-Juan; Grzybowski, Andrzej; He, Xian-Gui; Pan, Chen-WeiPurpose: Previous animal studies have found a relationship between spatial frequency and myopia. New research in humans suggests that reduced high spatial content of the visual environment may be a contributing factor to myopia development. This study aims to review the literature and elucidate the potential biological mechanisms linking spatial frequency and myopia. Methods: A systematic search was conducted across PubMed and Web of Science databases. The studies published from their inception to August 2024 have explored the connection between spatial frequency and myopia. Only full-text articles in English were included. PRISMA was used for data validity. Results: A total of 13 articles were included in this review, comprising seven animal model studies, four population-based studies, one pictorial analysis, and one study on research design. Epidemiological evidence is comparatively limited and has only begun to emerge in recent years. Mid- to high spatial frequencies were found to play an important role in the emmetropization process of the eye. Low spatial frequencies can increase the risk of myopia incidence. Furthermore, the potential mechanisms of how spatial frequency affects myopia are summarized as visual information processing characteristics, eye accommodation function, eye movements, contrast sensitivity, and relevant molecules involved in the pathway. Conclusion: The evidence suggests that indoor spatial frequency may be related to the development of myopia. Further studies are warranted to understand if the incorporation of changes in indoor environments is helpful in the prevention and control of myopia.
- Toxicogenic fungi and mycotoxins seasonality in poultry farms: implications for animal health and food safetyPublication . Gomes, Bianca; Dias, Marta; Cervantes, Renata; Pena, Pedro; Twarużek, Magdalena; Kosicki, Robert; Grajewski, Jan; Carolino, Elisabete; Viegas, Susana; Viegas, CarlaPoultry farms are hostpost for fungi and mycotoxins proliferation. Still, seasonal dynamics of these hazards on the farm and their impacts on animals/workers' health, and lastly on food safety, remain unexplored. This study provides the first comprehensive assessment of seasonal (summer/winter) fungal/mycotoxin exposure in poultry farm environments (Electrostatic dust cloths (EDC), feed, bed) and broiler chicken tissues (breast, liver) to identify potential exposure risks for broiler chickens/workers' health and food safety. Viable mycotoxigenic fungi and mycotoxins profile (LC-MS/MS) was characterized, and cytotoxicity assessment was performed using A549 (human alveolar epithelial) and SK (swine kidney) cells. Zootechnical parameters were also measured to evaluate broiler chickens’ growth performance. Summer conditions favour the proliferation of mycotoxigenic fungi belonging to the Penicillium and Aspergillus genera, where co-contamination of hazardous mycotoxins (ZEN/TRCs/FBs) was prevalent. Considering cytotoxicity assessment, EDC samples induced high toxicity in 47 % of A549 cells during summer, whereas on bed samples, high toxicity was obtained during winter on both cell lines (100 % SK cells; 83 % A549 cells). Our results evidence diverse exposure pathways (inhalation, dermal contact) and seasonal health risks. Regarding mycotoxins in biological samples, ZEN was detected in 53.3 % of liver samples, highlighting chronic exposure risks. Thus, future research should focus on toxicokinetics/toxicodynamics of co-occurring mycotoxins in animal production environments and their subsequent human exposure through the food chain. Given that climate change may exacerbate seasonal fungal/mycotoxin contamination, understanding these interactions is crucial for improving risk assessment frameworks and implementing protection measures on the farm level and along the food chain.
- Methodological quality of pulmonary arterial hypertension treatment evidence-based guidelines: a systematic review using the AGREE II and AGREE REX toolsPublication . Vilela, Ana Paula; Deffert, Flávia; Lucchetta, Rosa Camila; Pires, Yara Maria; Mainka, Felipe Fernando; Tonin, Fernanda; Pontarolo, RobertoPurpose: Pulmonary arterial hypertension (PAH) is a progressive disease with a poor prognosis, and its management should be grounded in well-developed clinical practice guidelines (CPG). Thus, we critically assess the methodological quality of the available CPG for pharmacological treatments for PAH. Methods: A systematic review (CRD42023387168) was performed in PubMed, Cochrane, Embase, and Tripdatabase (Jan-2023). Eligible records were appraised by four reviewers using the Appraisal of Guidelines, Research, and Evaluation Collaboration tool (AGREE II) and the complementary tool for assessing recommendations' quality and certainty, AGREE REX. Descriptive statistics were used to summarize the data. Results: Overall, 31 guidelines, mainly authored by professional societies (90%), targeting only physicians as primary users (84%), were identified. Guidelines presented a moderate overall quality (scores of 63% and 51% in AGREE II and AGREE REX, respectively), with a few domains showing slight improvements over the years. AGREE II "Scope and Purpose" (94%) and "Presentation Clarity" (99%) domains obtained the highest scores. The items related to "Stakeholder involvement," "Editorial independence," and "Clinical applicability" (AGREE REX) were fairly reported. Conversely, CPG lacks rigor in development (32% score, AGREE II), scarcely discusses the role of stakeholders, and provides deficient data on the implementation of recommendations (scores of 35% and 46% in AGREE II and AGREE REX, respectively). No differences in the quality of guidelines published by different developers or countries were observed (p > 0.05). Conclusion: Methodological weaknesses are common among guidelines addressing PAH treatment, especially regarding scientific rigor, stakeholders' values and preferences, and facilitators and barriers to implementability. Particular attention should be given to developing future guidelines.
- Anuário científico da Escola Superior de Tecnologia da Saúde de Lisboa - 2024Publication . Biblioteca da ESTeSLÉ com grande entusiasmo que apresentamos a 14.ª edição do Anuário Científico da Escola Superior de Saúde de Lisboa (ESSL). Esta edição reafirma o papel da nossa Escola como um espaço onde a investigação, a inovação e a prática se cruzam para gerar conhecimento com impacto real na saúde e na sociedade. Mais do que um registo científico, este Anuário é um testemunho da vitalidade e do compromisso da nossa comunidade académica. Ao longo de 2024, estudantes, docentes, investigadores e profissionais desenvolveram trabalhos que refletem rigor, criatividade e responsabilidade científica. As contribuições reunidas — desde livros, capítulos, artigos e comunicações até projetos realizados no âmbito dos cursos de 1.º e 2.º ciclo — evidenciam a diversidade e profundidade das áreas que integram a ESSL e mostram como o conhecimento teórico e aplicado se articula para responder aos desafios contemporâneos da saúde.
- O impacto dos sistemas de lembrete na redução da não comparência dos utentes às consultas externas: revisão de âmbitoPublication . Barão, Sónia; Coelho, AndréIntrodução – A não comparência dos utentes às consultas externas é um problema prevalente e sistemático que impacta negativamente tanto na efetividade dos sistemas de saúde como na saúde dos utentes. Os sistemas de lembrete emergiram como uma solução promissora para mitigar esse problema. Objetivo – Sintetizar a evidência disponível sobre o impacto dos sistemas de lembrete na taxa de não comparência (Tx.NC) dos utentes às consultas externas. Métodos – Sustentada na metodologia do Joanna Briggs Institute, a pesquisa realizou-se nas bases de dados PubMed, Scopus e Web of Science, utilizando palavras-chave como no-show patients, non-attendance e reminder systems, combinadas com operadores booleanos. O desenho do estudo seguiu os itens do PRISMA-ScR para Scoping Reviews, tendo sido incluídos apenas artigos de investigação original com foco nos sistemas de lembrete aplicados no âmbito de consultas externas. Resultados – Foram identificados 429 artigos, dos quais 15 foram incluídos na análise após aplicação dos critérios de elegibilidade. A implementação de sistemas de lembrete reduziu a Tx.NC dos utentes às consultas externas até 40-50%. Embora o SMS tenha sido a estratégia mais observada, foi a chamada telefónica, com confirmação de consulta, que revelou maior efetividade na redução da Tx.NC. Conclusão – Esta revisão evidencia a importância dos sistemas de lembrete na redução da Tx.NC às consultas externas, contribuindo ativamente para a efetividade dos sistemas de saúde.
- O papel da Inteligência Artificial no rastreio automatizado da retinopatia diabéticaPublication . Brito, Gabriel Bertosin Silva; Ventura, Luiza Ferreira; Burjack, Izabella do Vale; Oliveira, Cláudia Santos de; Oliveira, Salomão Antonio; Menezes Júnior, Eumar Evangelista de; Silva, Sandro Dutra eA retinopatia diabética (RD) é uma complicação microvascular grave da diabetes mellitus e uma das principais causas de cegueira evitável em adultos. Este estudo analisa o impacto da Inteligência Artificial (IA) no rastreio automatizado da RD, destacando sua capacidade de melhorar a precisão e a eficiência das triagens. A IA permite a detecção precoce da doença, com a redução da dependência de especialistas e o aumento do acesso a cuidados em regiões com poucos recursos. As tecnologias discutidas incluem algoritmos avançados de aprendizagem profunda e técnicas de explicabilidade, que ajudam a interpretar os resultados clínicos. Apesar dos avanços, barreiras como a falta de padronização de dados, questões éticas e limitações na generalização das estruturas de IA precisam ser superadas. O estudo conclui que a IA representa uma ferramenta promissora no manejo da RD, com potencial para transformar a identificação da doença e prevenir complicações visuais graves em diferentes contextos socioeconômicos.
- Closing remarksPublication . Antunes, Maria LuzThe project you presented so clearly and, in such detail, made me reflect on what has been done in Portugal regarding health literacy aimed at disadvantaged populations. Actually, the Directorate-General of Health, which is a governmental institution, developed a national Health Literacy Action Plan since 2019 and carried out a representative national survey using the short-form of the HLS₁₉‑Q12 under the larger M-POHL consortium (the European Network for Measuring Population and Organizational Health Literacy). We identified that specific community-level interventions have targeted vulnerable and marginalized groups — like migrants and socially excluded individuals — to improve their access to health information, reduce obstacles, and increase empowerment. Furthermore, there are initiatives aimed at specific high-risk demographics. Among these are academic and public health programs focused on migrants, individuals experiencing homelessness, and individuals utilizing social welfare services. These initiatives include community-based interventions, capacity-building activities in local settings, and adapted materials (such as plain language or culturally appropriate resources). Examples and case studies have been published in institutional repositories. And, of course, all these interventions produced practical guides and tools designed for use by health services and community partners.