ESS2-Artigos (em revistas ou actas indexadas)
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Percorrer ESS2-Artigos (em revistas ou actas indexadas) por Objetivos de Desenvolvimento Sustentável (ODS) "09:Indústria, Inovação e Infraestruturas"
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- Commentary on: nurses’ perceptions of artificial intelligence (AI) integration into practice: an integrative reviewPublication . Xavier, Tânia; Oliveira, ClaudiaWe are writing this letter to congratulate you on the paper ‘Nurses’ perceptions of artificial intelligence (AI) integration into practice: An integrative review’ by Lora and Foran, recently published in your journal. In this paper the authors synthesise remarkable, valuable and challenging aspects of the new era of artificial intelligence (AI) in the clinical practice of nursing. AI has been introduced into the most diverse areas of knowledge, opening a vast range of possibilities. This integrative review makes a timely and relevant contribution to the growing body of literature on the intersection between nursing and AI. The authors show that the practice of nursing, especially in the perioperative environment, is no exception.
- Conventional, specific, and robotic instrumentation in total knee arthroplasty. How are we progressing in functional outcomes and patient satisfaction?Publication . de Almeida Fontes, Ana Paula; Sousa, João PauloIn recent years, technological advances in total knee arthroplasty (TKA) have made procedures more precise, reducing complications and accelerating recovery. Although the latest techniques offer several advantages, there are still doubts regarding their true functional efficacy and the level of patient satisfaction they provide. Methods: A retrospective study involving 1,076 patients, distributed as follows: 366 (34.0%) conventional instrumentation (CI), 591 (54.9%) Patient-Specific Instrumentation (PSI), and 119 (11.1%) robotics. All functional outcomes were assessed preoperatively and 90 days postoperatively. Bivariate analyses were performed using ANOVA and the Kruskal- Wallis test, with a significance level of p < 0.05. Results: At 90 days, the robotics maintained the greatest flexion range (p = 0.001) and outperformed the PSI and IC in the walking test (350.3 ± 102.1 vs. 312.5 ± 92.9 and 283.8 ± 84.8, respectively; p < 0.001). On the WOMAC test, PSI performed best (14.5 ± 10.6; p = 0.001), with IC and robotics showing similar results (p = 0.974). There was no difference between the groups in absolute gains. In terms of percentage gains, PSI was higher in WOMAC compared to IC (p=0.041) and robotics (p<0.001). Satisfaction was identical between the instrumentation methods (p=0.199). Conclusion: Absolute gains in functional evolution and satisfaction appear to be independent of the surgical technique, although PSI appears to offer improvements in functional activities. Given the still-limited experience with robotic surgery, the functional benefits and long-term satisfaction remain inconclusive.
- Early identification of bladder diverticula in pre-hospital settings using screening sonography: a case reportPublication . Miravent, Sérgio; Gomes, Carla; Basescu, Andrea; Martins, Ana; Lobo, Manuel Duarte; Almeida, RuiObjective: Bladder diverticula, while not exceptionally rare in clinical practice, presents a significant diagnostic challenge, particularly in remote pre-hospital emergencies where technological limitations and the absence of specialized medical expertise prevail. This report aims to emphasize the role of screening ultrasound in the pre-hospital setting, Case Presentation: A patient experiencing severe lower abdominal pain presented at a basic emergency service (BES) for the third time presenting the same symptoms. Renal and pelvic ultrasound screening was performed, revealing suspected bladder distention and adjacent fluidfilled cavities, consistent with multiple bladder diverticula. Subsequently, the patient was referred to a referral central hospital for management by medical experts. Comprehensive evaluation confirmed the findings of the BES. Conclusion: The results of the screening ultrasound enabled the BES team to initiate clinical interventions to mitigate the patient’s discomfort. Screening ultrasound was crucial in identifying imaging markers that provided the physician with clinical data for correct and prompt patient orientation.
- Frailty and outcomes in elderly ICU patients: insights from a portuguese cohortPublication . Lourenço, Eva; Rodrigues, Isabel; Sampaio, Mário; da Costa, EmiliaBackground: Frailty is a key determinant of outcomes in critically ill elderly patients, but data from Portugal remain limited. To our knowledge, this is the first study to examine the prevalence and prognostic impact of frailty among elderly ICU patients in a Portuguese hospital setting. Objective: To determine the prevalence of frailty among elderly patients admitted to an intensive care unit (ICU) in southern Portugal and to examine its crude associations with illness severity, organ support, and mortality outcomes. Methods: We conducted a retrospective cohort study including 125 patients aged ≥ 65 years admitted to the polyvalent ICU of Hospital de Faro over the last six months of 2024. Data included demographics, comorbidities, Charlson Comorbidity Index (CCI), severity scores (SOFA, SAPS II, APACHE II), and frailty status assessed by the Clinical Frailty Scale (CFS). Outcomes were the need for organ support, ICU and hospital mortality, and length of stay. Results: Frailty (CFS ≥ 5) was identified in 30.4% of patients. Frail patients were older, had higher comorbidity burden (CCI), and presented with significantly higher severity scores at admission. They also required more invasive support, including vasopressors and invasive mechanical ventilation, while acute kidney injury (AKI) requiring renal replacement therapy (RRT) was similar between groups. ICU mortality was significantly higher among frail patients (50.0% vs. 31.0%), as was hospital mortality (76.3% vs. 33.3%). Length of ICU stay did not differ, although frail patients tended to have longer hospitalizations overall. Conclusions: Frailty was highly prevalent and strongly associated with increased severity, greater need for organ support, and higher mortality. Routine frailty assessment at ICU admission may enhance prognostic accuracy and support patient-centered decision-making.
- Game-based balance training in older adults: systematic review and meta-analysisPublication . Tome, Ana Maria; Castro, Sílvia; Rosa, Marlene; Tomás, Maria Teresa; de Almeida Fontes, Ana Paula; Pais, SandraFunctional decline in older adults is a major contributor to both falls and increased fall risk. Nevertheless, such decline may be mitigated through multidimensional interventions. Game-based and gamified interventions have emerged as promising alternative strategies. This study aimed to evaluate the effectiveness of these approaches in improving balance and reducing fall risk among community-dwelling adults aged 65 years and over. The research question was: Do serious games and gamification improve balance and reduce fall risk in community-dwelling older adults, compared with exercise programmes, non-gamified interventions, or control conditions? A systematic search of randomised controlled trials was conducted in accordance with PRISMA guidelines, resulting in the inclusion of nine studies from 634 records screened. Meta-analysis demonstrated significant improvements in the Functional Reach Test and the Berg Balance Scale. However, no significant overall effects were observed for the Timed Up and Go Test or the Single-Leg Stance Test. Although game-based interventions may improve specific dimensions of balance in community-dwelling older adults, the findings should be interpreted with caution. The limited number of studies, small sample sizes, heterogeneity of interventions, and reliance on balance-related surrogate outcomes rather than direct measures of fall incidence highlight the need for further high-quality research
- Gamification on mathematics engagement and motivation in secondary school and higher education: a systematic review and meta-analysisPublication . Ratinho, Elias; Figueiredo, Mauro; Estêvão, Maria Dulce da Mota Antunes de Oliveira ; Faísca, Luís; Martins, CátiaThis systematic review and meta-analysis examined the effects of gamification on students’ motivation and engagement in mathematics at the secondary and higher education levels. A literature search (April 2025) followed by an updated search (November 2025) across ten databases identified 45 studies for qualitative synthesis and 11 for meta-analysis. The review followed PRISMA 2020 guidelines with a pre-registered protocol, and study quality was appraised with the Mixed Methods Appraisal Tool. Meta-analytic results using a three-level Correlated and Hierarchical Effects model with robust variance estimation showed a significant small-to-moderate positive effect on motivation (g = .383, 95% CI [.11, .66], p = .0218). Motivation was assessed more consistently than engagement that could not be included in the meta-analysis due to the lack of validated measures. The systematic review indicates that gamification supports motivation and engagement, with only four studies reporting negative effects. Most interventions used digital platforms (e.g., Kahoot!; Classcraft) and common game elements such as points, leaderboards and instant feedback. Overall, gamification appears promising for enhancing motivation and engagement in mathematics when designs are aligned with students’ needs, balancing competition with mastery and cooperation. Therefore, educators should limit excessive competition and prioritize personal progress and cooperative tasks that foster social interaction. Future studies should employ validated measures, larger samples, and examine both motivation and engagement to strengthen the evidence base and guide effective implementation in education.
- The immune tumor microenvironment in gliomas: may CITED2 play a role?Publication . Teotónio Fernandes, Mónica AlexandraGliomas are the most common brain cancers, resulting from transformed glial cells. CITED2 is a co-transcriptional regulator previously implicated in several types of cancer, affecting both cellintrinsic processes and the microenvironment. Because in breast cancer it was shown to contribute to the recruitment of macrophages and their polarization to an immunosuppressive phenotype, a potential similar role was explored in gliomas. By analyzing publicly available databases using a set of bioinformatics tools, it was found that CITED2 is overexpressed in higher-grade gliomas and contributes to an adverse prognosis. In addition, CITED2 expression correlates with macrophage infiltration and a M2 phenotype.
- Impact of bariatric and metabolic surgery on sarcopenia-related parameters according to the EWGSOP2 consensus criteria in persons living with obesityPublication . Cardoso, Paulo Alexandre e Castro; Santos, Tânia V.; Ramon-Krauel, Marta; Pais, Sandra; De Sousa-Coelho, Ana LuísaAlthough bariatric and metabolic surgery (BS) has proved effective in the treatment of obesity based on the reduction in fat mass and the remission of comorbidities, there is also loss of lean mass after BS which could compromise muscle functionality. According to the European Working Group on Sarcopenia in Older People (EWGSOP), sarcopenia is a disease associated with loss of muscle mass, strength, and function. Through a comprehensive review of the literature, we identified a range of studies focusing on evaluating sarcopenia-related parameters according to the EWGSOP2 consensus criteria, before and after BS. Although most studies reported reductions in skeletal muscle mass and absolute muscle strength after surgery, improvements in muscle functionality were generally achieved, independent of the type of BS.
- On the run—comparing bioimpedance analysis (BIA) using portable devicesPublication . Dias, Carina Vieira; Dias, Joana C.; Laranjo, Céu; Cardoso, Paulo; De Sousa-Coelho, Ana LuísaBioelectrical impedance analysis (BIA) is a non-invasive indirect method that allows for measurement of lean and fat body mass. The main goal of this exploratory study was to compare the results from two different portable BIA devices. We found that only fat-free mass and body fat mass were directly comparable between InBodyS10 (Teprel, Porto, Portugal) and seca mBCA 525 (Bacelar, Porto, Portugal) medical portable BIA devices.
- Patterns, advances, and gaps in using ChatGPT and similar technologies in nursing education: a PAGER scoping reviewPublication . Amankwaa, Isaac; Ekpor, Emmanuel; Cudjoe, Daniel; Kobiah, Emmanuel; Diebieri, Maximous; Fuseini, Abdul-Karim Jebuni; Gyamfi, Sebastian; Brownie, SharonBackground and aim: Generative AI (GenAI) can transform nursing education and modernise content delivery. However, the rapid integration of these tools has raised concerns about academic integrity and teaching quality. Previous reviews have either looked broadly at artificial intelligence or focused narrowly on single tools like ChatGPT. This scoping review uses a structured framework to identify patterns, advances, gaps, evidence, and recommendations for implementing GenAI in nursing education. Methods: This scoping review followed the JBI methodology and PRISMA-ScR guidelines. We searched PubMed, CINAHL, SCOPUS, ERIC, and grey literature (October to November 2024). Data synthesis utilised the PAGER framework as a mapping tool to organise and describe patterns, advances, gaps, evidence for practice, and recommendations. Results: Analysis of 107 studies revealed GenAI implementation across four key domains: assessment and evaluation, clinical simulation, educational content development, and faculty/student support. Three distinct implementation patterns emerged: restrictive, integrative, and hybrid approaches, with hybrid models demonstrating superior adoption outcomes. Technical advances showed significant improvement from GPT-3.5 (75.3 % accuracy) to GPT-4 (88.67 % accuracy) in NCLEX-style assessments, with enhanced capabilities in multilingual assessment, clinical scenario generation, and adaptive content creation. Major gaps included limited methodological rigour (29.0 % of empirical studies), inconsistent quality control, verification challenges, equity concerns, and inadequate faculty training. Geographic distribution showed North American (42.1 %) and Asian (29.9 %) dominance, with ChatGPT representing 83.2 % of tool implementations. Key recommendations include developing institutional policies, establishing quality verification protocols, enhancing faculty training programs, and addressing digital equity concerns to optimise GenAI integration in nursing education. Conclusions: GenAI has transformative potential in nursing education. To realise its full potential and ensure responsible use, research should focus on developing standardised governance frameworks, empirically validating outcomes, developing faculty in AI literacy, and improving technical infrastructure for low-income contexts. Such efforts should involve international collaboration, highlighting the importance of the audience's role in the global healthcare community.