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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- 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.
- 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.
- 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.
- Valorisation of gilthead seabream by-products through recovery of antimicrobial proteins for active biopolymer formulationsPublication . Maurizzi, Enrico; Anjos Guerreiro, Liliana Isabel Tomé; Bigi, Francesco; Quartieri, Andrea; Mateus, Ana Patrícia; Volpelli, Luisa Antonella; Pulvirenti, Andrea; Power, Deborah MaryIn the seafish sector, industrial processing and by-catch currently lead to the waste of over 36 % of global fish production by weight. This is largely due to insufficient revalorization of by-products and the underdevelopment of sustainable practices to manage these discarded volumes, which are often disposed of or released into the environment, contributing to pollution. In this study, antimicrobial proteins were extracted from fish by-products for incorporation into biopolymer formulations. Specifically, the focus was on lysozyme, which was targeted using a molecular-proteomic approach. Protein extractions were conducted at various pH levels from Gilthead seabream (Sparus aurata) tissues (skin with scales and mucus, liver, and intestine) normally discarded during processing, to assess recovery of proteins from the selected tissues. The extracted proteins were separated using mild ion-exchange chromatography, followed by quantification and qualitative analysis via SDS-PAGE. The expression levels of lysozyme types-g and-c were quantified through Real-Time qPCR. The antimicrobial activity of the extracted proteins was assessed against Gram-positive (Listeria monocytogenes) and Gram-negative (Escherichia coli) bacteria using a Minimal Inhibitory Concentration (MIC) assay. The proteins were subsequently incorporated into biodegradable film-forming solutions based on hydroxypropyl methylcellulose/chitosan and hydroxypropyl methylcellulose/guar gum mixtures. These films were further tested against the same human pathogens. The results demonstrate the feasibility of extracting proteins from fish by-products using a non-targeted buffer pH extraction approach, which, even without further chromatographic purification, exhibited promising intrinsic antimicrobial activity for potential applications in the food industry.