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- How many strides are needed for reliable markerless gait analysis?Publication . Carvalho, Andreia; Vanrenterghem, Jos; Pataky, Todd C.; Robinson, Mark A.; Veloso, António P.; Moniz-Pereira, VeraBackground/aim: Markerless motion capture is an emerging tool for gait analysis. In some populations, e.g., older adults, traditional gait analysis poses practical challenges, such as reduced assessment tolerance, and the number of strides collected can be limited. This study aimed to investigate the influence of the number of strides on test-retest reliability and measurement error of markerless gait biomechanics in older adults. Methods: Twenty strides were extracted from 29 healthy older adults for each of two sessions. Lower-limb kinematics and kinetics were computed. Subsequently, non-consecutive random subsets of k = 2-19 strides were averaged within-subjects and within-sessions, including scenarios with unequal k between sessions. Integrated Intraclass Correlation Coefficients (iICCA,k) and Standard Errors of Measurement (SEM) were calculated for trajectory data. ICCA,k [Confidence Intervals] were computed for the range of motion and peaks. Two arbitrary thresholds for the minimally acceptable number of strides were combined: (1) the smallest k that yielded an ICC within 10 % of the maximum ICC across all k, and (2) an absolute ICC threshold of 0.75. SEM≤ 2º was deemed suitable for kinematics, and SEM%≤ 5 % for kinetics. Results: For joint angles and moments, iICC dropped less than 10 % from the highest iICC when using ≥ 7 strides with an equal number of strides across sessions, attaining iICCs≥ 0.75. Reducing the number of strides in one session had less impact than reducing both equally. Lower Confidence intervals were generally ≥ 0.75 for discrete parameters. Kinematic SEM rarely exceeds 2º. Globally, 4 strides are needed to have a kinetics SEM%≤ 5 %. Conclusion: A minimum of 7 strides contributing to the average observation is generally sufficient to achieve reliable markerless kinematics and kinetics in older adults. These results have particular relevance to populations who may experience limited tolerance for lengthy assessments. Allowing flexibility in stride number collected across sessions, while maintaining reliability, contributes to optimizing data collection strategies.
- Applicability of MRI-only technique in external beam radiotherapy: dosimetric evaluation, IGRT, and quality assurance (a systematic review)Publication . Pereira, Daniel; Pereira, Luís; Barbosa, J.; Caetano, MarcoIntroduction: Magnetic Resonance Imaging (MRI) provides superior soft tissue contrast compared to planning Computed Tomography (pCT). Although pCT remains the standard method in radiotherapy planning due to its provision of electron density information required for dose calculations, the MRI-only technique can replace pCT by generating synthetic CTs (sCTs) that supply the necessary density data. Methods: A systematic literature review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. The literature search was performed in April 2025 across the PubMed, Scopus, and Web of Science databases, applying inclusion and exclusion criteria defined using the PICOS model. The included studies were assessed using the "Appraising the Evidence: Reviewing Disparate Data Systematically" tool, and extracted data were synthesised in a narrative summary table. Results: A total of 41 studies were included, covering different anatomical regions. The studies reported non-significant differences in dose-volume histograms (DVH) between sCT and CT. Gamma analysis conformity evaluations showed pass rates >87.4 %. The deviations across various image registrations remained <2 mm for translational displacements and <1.2° for rotations. Discrepancies between sCT-CT and sCT-Cone Beam CT were ≤1 %. Conclusion: The MRI-only technique proved to be feasible for use in the central nervous system and pelvic regions, both in terms of dosimetry and image-guided verification. In head and neck oncology, the focus was exclusively on dosimetric planning. Further studies are required to validate and expand the applicability of this technique to other anatomical sites. Implications for practice: These findings reinforce the applicability and versatility of the MRI-only approach across multiple anatomical regions and therapeutic contexts, highlighting its potential to improve patient comfort and streamline clinical workflows.
- Hand eczema, risk factors and microbial skin contamination in the Norwegian waste sorting industry: a cross-sectional studyPublication . Alfonso, Jose Hernán; Graff, Pål; Viegas, Carla; Lossius, Astrid Haaskjold; Eriksen, ElkeIntroduction: Hand eczema, skin barrier function, and skin microbial contamination among waste workers are underexplored. This study aims to assess: (1) the prevalence and risk factors of hand eczema, (2) the levels of transepidermal water loss (TEWL), and (3) skin microbial contamination in waste sorting workers. Methods: Using the Nordic Occupational Skin Questionnaire-2002, data were collected from 69 waste sorting workers and 25 office personnel. TEWL was measured with a Tewameter (TM 300, Courage+ Khazaka Electronic, Köln). Microbial skin samples were collected from the left dorsal hand with sterile swabs (Copan, Italy) and cultured. Analyses included descriptive statistics and multivariate logistic regression. Results: The hand eczema prevalence was 25% among waste workers and 40% in office personnel. The prevalence of hand eczema was significantly lower among exposed workers compared to controls (p = 0.012). TEWL and fungal concentrations were comparable across groups. Atopic dermatitis (AD) and nicotine use were significant predictors of HE. The prevalence of hand eczema experienced during the past week was significantly associated with elevated bacterial concentrations (p value = 0.05) in both groups. Conclusions: Waste sorting workers had up to 2.4 times higher prevalence of hand eczema compared with the general population, but a lower prevalence than office workers in the same industry. These findings may reflect a potential healthy worker effect. The potential role of bacterial concentrations in the occurrence of hand eczema warrants further investigation.
- Association between waist circumference, diabetes mellitus, hypertension and dyslipidemia in a population in Northern AngolaPublication . Vita, Carmel Helena; Francisco, António Hélder; Morais, Humberto; Pedro, João de Almeida; Brito, Miguel; Gonçalves, MauerObesity, particularly when it is centrally located, is an important risk factor for the development of cardiovascular diseases. This study aimed to assess the relationship between waist circumference and the presence of diabetes mellitus, hypertension, and dyslipidaemia. A community-based cross-sectional study was conducted as a sub-analysis of CardioBengo in the municipality of Dande, Bengo Province, involving 2,244 individuals aged 18– 84 years. The study included a structured questionnaire and the collection of sociodemographic, anthropometric, hemodynamic, and biochemical data. Analyses were carried out using correlation methods, the construction of ROC (Receiver Operating Characteristic) curves, and the determination of optimal cut-off points according to the Youden index. Waist circumference was positively associated with metabolic risk factors, particularly hypertension, in both sexes. It demonstrated moderate sensitivity and specificity (area under the curve (AUC): 0.725 in men and 0.612 in women). Waist circumference also proved to be a moderate predictor of diabetes mellitus (AUC: 0.648 in men and 0.596 in women) and hypercholesterolaemia (AUC: 0.673 in men and 0.612 in women), with cut-off points varying between 71.5 cm and 89 cm depending on gender. For hypertriglyceridaemia, however, the association was weak (AUC: 0.557 and 0.503). Waist circumference can be used as an indicator of the risk of developing metabolic factors, highlighting its usefulness in predicting hypertension in the Angolan population.
- Corporate social responsibility and corporate reputation in SMEs of the construction sectorPublication . Cabrera-Gala, Ramsés; Lopes Miranda, Sandra MarisaSMEs in the construction sector are immersed in an industry that can be volatile and controversial. Therefore, taking care of the perceptions and what is said about them in this sector is increasingly relevant. For this, it is necessary to implement Corporate Social Responsibility (CSR) actions, which is essential. The objective of this research was to determine the CSR strategies that build corporate reputation for the SME's of the construction sector. Also, the case method with a qualitative approach, being the purposive sampling the one used for this research, that is, a non-probabilistic sampling was used and the data collection was given through written interviews to eight respondents belonging to different stakeholders, including managers, employees, suppliers and customers of two SMEs in the construction sector, one of which is located in Mexico and the other in Bulgaria. This chapter determined seven integral CSR Strategies that impact on the Corporate Reputation,. Additionally, future research opportunities are discussed.
- The association between Mediterranean diet: related health literacy, cooking skills and Mediterranean diet adherence in the Spanish populationPublication . Casucci, Maria Giulia; Muñoz-Martínez, Júlia; Caneda-Ferrón, Begoña; Salinas-Roca, Blanca; Orta-Ramirez, Alicia; Vidal, Eulàlia; Rodríguez-Monforte, Míriam; Costa, Inês M.; Costa, Vânia; Renzi, Sofia; Carrillo-Álvarez, ElenaBackground/Objectives: Even with solid proof of its benefits for cardiovascular health and metabolism, adherence to the Mediterranean Diet (MD) in Spain has noticeably declined in recent years. The socioeconomic changes occurring in recent decades have prompted shifts in cooking habits and in how food is socially experienced, particularly among children and adolescents. The MD is more than just food: it is a cultural tradition and a lifestyle, rich in food and cooking skills, and food wisdom passed down over generations. When these practices fade, it affects both health and the environment, making them vital components in strengthening support for food knowledge, cooking abilities, and a healthier lifestyle. Considering these shifting dietary patterns and the growing need for targeted educational strategies, the present study aimed to investigate the association between cooking skills, MD-related health literacy, and adherence to the Mediterranean Diet across different developmental stages: childhood, adolescence, and adulthood in a sample of the Spanish population. Additionally, a secondary objective was to identify potential critical windows for intervention based on the strength of these associations. Methods: This cross-sectional study included 832 Spanish participants grouped by age: children and early adolescents (n = 408), older adolescents (n = 136), and adults (n = 288). Cooking skills were assessed using CooC11 for children and FCSk for older groups. Adults also completed Lit_MEDiet to assess MD-related health literacy. Adherence was measured with KIDMED (children/adolescents) and MEDAS (adults). Spearman correlations and standardized linear regressions were used. All statistical tests were two-sided, and statistical significance was set at p < 0.05. Results: In children, no significant association was found between cooking skills (CooC11) and KIDMED scores (β = 0.008; p = 0.875). Among adolescents, a strong positive association emerged between FCSk and KIDMED (β = 0.313; p < 0.001; ρ = 0.371), indicating a large, standardized effect and suggesting that this stage is particularly sensitive to food skills. In adults (18+), both food and cooking skills (FCSk) (β = 0.189; p = 0.001) and MD-related health literacy (Lit_MEDiet) (β = 0.187; p = 0.004) were moderately associated with MEDAS scores. Conclusions: These findings suggest that mid-adolescence could represent a favourable developmental window where food skills may hold potential to influence positive dietary behaviours. Regarding adults, the results indicate that combining practical and educational components appears to beneficial for dietary quality. Overall, this study supports the relevance of age-tailored public health strategies to potentially enhance long-term adherence to the Mediterranean Diet.
- The comet assay as a tool in human biomonitoring exposure to volatile organic compounds: a systematic review and meta-analysisPublication . Giovannelli, Lisa; Møller, Peter; Gajski, Goran; Stopper, Helga; Azqueta, Amaya; Bankoglu, Ezgi Eyluel; Haveric, Anja; Gerić, Marko; Collins, Andrew; Ladeira, CarinaExposure to volatile organic compounds (VOCs) such as benzene, styrene, toluene, and formaldehyde is associated with genotoxicity and increased risk of cancer. In this systematic review and meta-analysis, we have assessed the effects of VOCs exposure on levels of DNA strand breaks in leukocytes, measured by the comet assay, in human biomonitoring studies. The literature search led to 57 studies included in the review. Of these, 50 studies met the criteria to be used in the meta-analysis. Using standardized mean difference and 95 % confidence interval (CI), the meta-analyses show increased levels of DNA strand breaks in subjects exposed to benzene (1.59, 95 % CI: 0.94, 2.24), styrene (0.87, 95 % CI: 0.23, 1.51), formaldehyde (0.39, 95 % CI: −0.15, 0.92) and other organic solvents (2.14, 95 % CI: 1.48, 2.81). Results originate mainly from studies on workers, with only a few studies on environmental benzene exposure. Subgroup analysis indicates that all studies combined from middle-income countries have a higher effect size (1.81, 95 % CI: 1.26, 2.36, n = 28) than studies from high-income countries (0.87, 95 % CI: 0.49, 1.24, n = 22). This difference between middle- and high-income countries may be due to differences in exposure levels or exposure assessment. However, this might not be the only reason, as sensitivity analysis indicates that effect sizes are at risk of comet assay measurement bias, as 78 % (39 out of 50 studies) and 60 % (30 studies) have not reported the use of assay controls and blinded analysis of samples, respectively. Relatively few studies have a high risk of bias due to an inadequate comet assay procedure description (14 %, 7 studies) and exposure misclassification (16 %, 8 studies). Limitations of the study were the differences in protocols, comet descriptors, exposure assessment, and control for confounding factors among the studies. In conclusion, this systematic review and meta-analysis show that exposure to VOCs – benzene, styrene, formaldehyde, and others – is associated with increased levels of DNA strand breaks in human leukocytes.
- The comet assay as a tool in human biomonitoring exposure to combustion-derived air pollution: a systematic review and meta-analysisPublication . Møller, Peter; Gajski, Goran; Gerić, Marko; Haveric, Anja; Stopper, Helga; Bankoglu, Ezgi Eyluel; Azqueta, Amaya; Giovannelli, Lisa; Collins, Andrew; Ladeira, CarinaHumans are exposed to environmental or occupational air pollution from combustion emissions in outdoor and indoor environments. Irrespective of the sources, combustion emissions are characterized by being a complex mixture of particles, volatile compounds and gases. The present systematic review summarizes results on DNA strand breaks measured by the comet assay in leukocytes, from studies on human exposure to traffic-related vehicle exhaust, biomass combustion and coke oven work environments. These exposures have in common the combustion of fuel, which generates particles and polycyclic aromatic hydrocarbons. Standardized mean differences (SMDs) have been calculated by random effects models. Meta-analyses show increased levels of DNA strand breaks in studies on traffic-related exhausts (SMD = 0.62, 95 % CI: 0.36, 0.89, n = 21), biomass combustion (1.73, 95 % CI: 0.72, 2.74, n = 10) and coke oven emission (0.84, 95 % CI: 0.30, 1.37, n = 10). Studies from high-income countries have reported much smaller differences in DNA strand break levels than have studies from middle-income countries. These differences may be attributed to higher exposures related to less strict emission control, and more susceptible populations in middle-income populations; unrecognized confounding despite efforts to match subjects on traditional confounders; or higher risk of comet assay measurement bias and exposure misclassification. In conclusion, this systematic review and meta-analysis show that exposure to combustion-derived air pollution, with clear exposure gradients in terms of particulate matter or polycyclic aromatic hydrocarbons, is associated with increased levels of DNA strand breaks in human leukocytes.
- Além do teto de vidro: liderança no feminino – da perceção externa às implicações organizacionaisPublication . Telo, Ana Paula; Nunes, CarlosEsta investigação analisa os traços distintivos da liderança feminina, percecionados externamente às organizações. Para esse efeito, utiliza uma metodologia que combina entrevistas e análise de dados, delineada a partir de uma revisão da literatura sobre o tema. Apresenta e interpreta detalhadamente os resultados das entrevistas, com vista à identificação dos elementos singulares da liderança feminina, em comparação com o quadro teórico existente. Além disso, explora o impacto desta perceção externa da liderança feminina nas organizações em geral e culmina em reflexões finais e propostas para futuras investigações.
- Orthoptic treatment after strabismus surgery in child intermittent divergent strabismusPublication . Lino, Pedro; Aguiar, Pedro Varques de; Cunha, João PauloPurpose: To evaluate short-term motor and sensory-motor outcomes following postoperative OT in children with IXT after strabismus surgery. Methods: This prospective before-and-after observational study included children with IXT who underwent bilateral lateral rectus recession and were referred for postoperative OT based on predefined clinical criteria. A structured 12-week OT plan was initiated approximately six months after surgery. Outcome measures included angle of deviation (prism diopters, PD), near point of convergence (cm), positive fusional vergence amplitudes (PD), and convergence amplitudes at distance and near (PD). Pre- and post-therapy changes were analysed using paired-samples t-tests with effect sizes calculated using Cohen's d. Final postoperative alignment was additionally compared cross-sectionally between children who underwent OT and those managed without OT. Results: Eighty-eight children had complete paired motor and sensory-motor data and were included in the analyses. Changes in static ocular alignment were small, with mean residual deviation improving from -7.02 ± 6.91 PD to -5.22 ± 6.60 PD after OT (mean change +1.80 PD; p < 0.01; d ≈ 0.30). No significant difference in final postoperative alignment was observed between the OT and non-OT groups (p = 0.827). In contrast, marked improvements were observed in sensory-motor outcomes. Positive fusional vergence amplitude increased from 7.30 ± 8.33 PD to 22.19 ± 9.26 PD (p < 0.001; d ≈ 1.5). Distance convergence amplitude improved from 7.30 ± 8.33 PD to 22.19 ± 9.26 PD, and near convergence amplitude from 10.95 ± 12.50 PD to 33.29 ± 13.89 PD (both p < 0.001; d ≈ 1.5). The near point of convergence showed a modest but significant improvement. Conclusions: Postoperative OT was associated with substantial short-term improvements in sensory-motor function, particularly fusional and convergence capacities, while changes in static ocular alignment were small and of limited clinical relevance. These findings support the role of OT as a functional adjunct to surgery, aimed at enhancing binocular control and postoperative sensory-motor stability in children with IXT.
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