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- Integrated continued care as a space for collective action: the strategic actor game in the era of artificial intelligencePublication . Soares Pinheiro Vieira Pescada, Susana; Teixeira, Fernando José Calado e Silva NunesPurpose – This study aims to explore the potential of artificial intelligence (AI) to reshape the governance and operations of the National Integrated Continued Care Network (NICCN) in Alentejo, Portugal. It addresses the dual challenge of population ageing and fragmented coordination between health and social care, assessing how AI-enabled solutions can foster more responsive, efficient and integrated care delivery. Design/methodology/approach – Using the Actors, Objectives, Power Relations Method (MACTOR), the research examines strategic influence and alignment among 27 institutional actors ranging from regional authorities and hospitals to primary care units and third-sector organisations. The study applies an AI-focused lens to assess its transformative role in organisational structures, professional responsibilities and decisionmaking processes within the NICCN. Findings – AI demonstrates clear potential to enhance patient monitoring, enable predictive planning and streamline administrative processes. Nonetheless, implementation is hindered by institutional silos and a high reliance on regional actors. Entities such as Private Social Solidarity Institutions and Continued Care Units are well placed to benefit from AI tools. However, effective deployment demands robust leadership to bridge digital skills gaps, manage workforce transitions and establish collaborative, technologysupported care pathways. Originality/value – By integrating strategic action theory with an AI-informed perspective, this study offers novel insights into the systemic transformation of integrated care governance. It provides practical recommendations for policymakers and health-care managers seeking to promote AI-enabled care models that are socially responsive and future-oriented.
- Thermal plasticity with physiological trade-offs in the invasive cichlid australoheros facetus under warming scenarios in mediterranean-type riversPublication . Santos, Emanuel; Gregorio, Silvia; Costa, Rita; Molina, Juan M.; Guerreiro, Pedro MiguelIntroduction: Climate warming and drought are intensifying thermal stress in Mediterranean freshwater systems, potentially favoring invasive fish with broad physiological tolerance. Extended environmental tolerance and increased aerobic scope are indicative of the potential to sustain, perform and disseminate in challenging conditions. Objective: We aimed to determine the thermal scope of the invasive Australoheros facetus inhabiting southern Portuguese drainages using an array of physiological proxies. Methodology: We evaluated the thermal biology of the species across a wide temperature gradient to test how warming affects metabolic performance, thermal tolerance, and biochemical status. Fish collected from Algarve watercourses were exposed to 5, 10, 15, 20, 25 and 35 °C (n = 15 per condition, 10–60 g) for at least a week, and intermittent respirometry was used to determine standard metabolic rate (SMR), maximum metabolic rate (MMR) and aerobic scope (AS). Group Q10 was derived from metabolic rates. Plasma and tissue biomarkers of energy metabolism and oxidative stress were analyzed. Critical thermal maximum (CTmax) was assessed in fish acclimated for a week at 10, 20 and 30 °C (n = 10) using a 1 °C/min thermal ramp. Results: Intermediate temperatures (15–25 °C) supported the best overall physiological performance, combining stronger aerobic capacity with higher antioxidant protection. In contrast, 30–35 °C imposed clear physiological costs: maintenance metabolism increased disproportionately, aerobic scope declined, and cellular protection weakened, indicating the onset of heat stress. Despite this, A. facetus showed marked thermal plasticity, with CTmax increasing significantly with acclimation temperature. Fish acclimated to 30 °C had higher CTmax than fish acclimated to 20 °C and 10 °C, although the thermal safety margin decreased progressively as the acclimation temperature rose. Liver antioxidant activity also peaked at intermediate temperatures and declined at the warmest treatments, reinforcing the mismatch between acute tolerance and sustained performance. Conclusions: These results show that A. facetus is highly heat tolerant but that tolerance comes with energetic and cellular trade-offs near upper thermal limits. Despite this limitation at extreme conditions, the combination of broad tolerance and functional performance under warm intermediate conditions may help to explain its invasion success and stand as a competitive advantage in increasingly hot low-flow Iberian freshwater ecosystems.
- Acute resilience, chronic costs: metabolic responses to warming and hypoxia in the sedentary lusitanian toadfish, halobatrachus didactylusPublication . Molina, Juan M.; Kunzmann, Andreas; Costa, Rita; Modesto, Teresa; Carvalho Alves, Alexandra; Guerreiro, Pedro MiguelCoastal fishes can adapt to water warming and hypoxia; however, acute tolerance does not necessarily predict longer-term performance and survival. This may be especially important in sedentary, site-faithful species with limited escape to escape increasingly unfavorable habitats. We assessed the climate-related stress responses of the Lusitanian toadfish, Halobatrachus didactylus, a benthic estuarine fish from the Northeast Atlantic, to water warming and hypoxia. Objectives: We aimed to determine the aerobic energy budget, thermal limits (CTmax), and critical oxygen tension (Pcrit), as well as blood indicators of metabolism, altered physiology and systemic stress, as proxies for whole-organism homeostatic state, thereby informing future ecophysiological assessments and bioindicator development in a context of environmental change. Methodology: We determined standard, routine, and maximum metabolic rates; aerobic scope; and critical thermal maximum (CTmax) and critical oxygen (Pcrit) thresholds on a set of 134 individuals ranging from 12 to 160 g in weight. On a different set of individuals (n = 48; 76.3 ± 2.6 g; 16.1 ± 0.18 cm), we simulated 30 days of seasonal scenarios combining low and high temperature with normoxia or hypoxia, followed by integrated metabolic, hematological, biochemical, and multivariate analyses. Results: Acute trials showed high short-term resilience: H. didactylus had an exceptionally low standard metabolic rate and routine metabolic rate, high CTmax (34.82 ± 0.66 °C), and strong hypoxia tolerance (Pcrit 0.59–1.97 mg O2 L−1), although smaller individuals were more sensitive. After 30 days, however, warming more than doubled standard and routine metabolic rates, while warm hypoxia reduced metabolic output relative to warm normoxia, consistent with metabolic depression under compounded stressors. This treatment also showed shifts in glucose, liver mass, red blood cell count, and hematocrit, identifying warm, oxygen-poor water as the most physiologically costly scenario for this species. Conclusions: Together, these results show that high acute tolerance does not guarantee resilience to climate change. In sedentary fishes, survival may depend less on surviving extremes than on maintaining energetic balance, oxygen transport capacity, and physiological homeostasis in increasingly warm, oxygen-poor coastal habitats.