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- Activity induced genes expression is impaired in polyglutamine spinocerebellar ataxiasPublication . Torquato Afonso, Inês; Vilhena Catarino Brito, David; Bading, Hilmar; Nóbrega, ClévioPolyglutamine Spinocerebellar ataxias (SCAs) are a group of 6 incurable genetic disorders, caused by an expansion of the trinucleotide cytosine-adenine-guanine in their causative genes, which produces a protein with an expanded glutamine region. This project focuses on the study of Spinocerebellar ataxia type 2 (SCA2) and type 3 (SCA3) (1), which are rare dominantly inherited disorders that primarily impair the cerebellum therefore leading to motor ataxia. Activity-induced inhibitor of death (AID), are a group of pro-survival 9 genes which were found to be neuroprotector in several neurological disorders, including stroke, glaucoma, AD, HD, and ALS (2). In this project, we aim to investigate about the relevance of the expression of AID genes for cerebellum function and whether their expression levels are impaired in SCA2 and SCA3
- AI-enhanced adaptive testing with cognitive diagnostic feedback and its association with performance in undergraduate surgical education: a pilot studyPublication . Gonçalves, Nuno Silva; Collares, Carlos; Pêgo, José MiguelBackground: Effective feedback in the cognitive domain is essential for surgical education but often limited by resource constraints and traditional assessment formats. Artificial Intelligence (AI) has emerged as a catalyst for innovation, enabling automated feedback, real-time cognitive diagnostics, and scalable item generation, thereby transforming how future surgeons learn and are assessed. Methods: An item bank of 150 multiple-choice questions was developed using AI-assisted item generation and difficulty estimation. A formative Computerized Adaptive Testing (CAT), balanced across three cognitive domains (memory, analysis, and decision) and surgical topics, was delivered via QuizOne® 3–5 days before the summative Progress Test. A total of 147 students participated, of whom 116 completed the formative CAT. Performance correlations, group comparisons, analysis of covariance (ANCOVA), and regression analyses were conducted. Results: Students who voluntarily completed CAT showed higher Progress Test scores, though causality cannot be established due to self-selection bias (p = 0.021), with the effect persisting after adjusting for prior academic performance (ANCOVA p = 0.041). Memory skills were the strongest predictors of summative outcomes (R2 = 0.180, β = 0.425), followed by analysis (R2 = 0.080, β = 0.283); decision was not significant (R2 = 0.029, β = 0.170). Conclusion: AI-enhanced CAT–Cognitive Diagnostic Modeling (CDM) represents a promising formative approach in undergraduate surgical education, being associated with higher summative performance and providing individualized diagnostic feedback. Refining feedback presentation and enhancing decisionmaking assessment could further optimize its educational impact.
- Análise Bioinformática da Via Hedgehog em Cancros Humanos: Expressão, Metilação e Impacto Prognóstico no KIRC e LGGPublication . Aguiar, Diogo Gonçalo Ribeiro Paulo e Soares; Tavares, ÁlvaroO cancro é um dos maiores desafios da saúde global, resultando de alterações genéticas, epigenéticas e da desregulação de vias de sinalização. Esta tese centrou-se na via Hedgehog (HH), conservada evolutivamente e crucial no desenvolvimento embrionário, frequentemente desregulada em vários tipos de neoplasias. O objetivo principal foi analisar a expressão diferencial dos genes da via HH e associados em diversos cancros, com foco no carcinoma renal de células claras (KIRC) e no glioma de baixo grau (LGG), avaliando também o seu impacto prognóstico e potenciais mecanismos regulatórios. Utilizando abordagens bioinformáticas e bases de dados públicas (TCGA, GTEx, GEPIA2, cBioPortal, MethSurv, STRING, TIMER2.0, UCSC Xena Browser e UALCAN), foram analisados dados de expressão génica, metilação de DNA, mutações, infiltração imune e interações moleculares. Verificaram-se diferenças relevantes na expressão de CDON e LRP2 (KIRC) e de KIF7, BOC, CSNK1A1, CSNK1G3, PTCH1, GAS1, SMO e SUFU (LGG) entre tecidos tumorais e normais. A expressão elevada de LRP2 e CDON associou-se a melhor sobrevivência em KIRC, enquanto SUFU e PTCH1 mostraram efeito protetor em LGG. Por outro lado, SMO e GAS1 foram associados a pior prognóstico em LGG. Foi ainda observada hipermetilação dos promotores de CDON e LRP2 em KIRC, sugerindo regulação epigenética, enquanto em LGG a desregulação parece ocorrer por mecanismos não mutacionais. As redes de coexpressão revelaram interações com vias como Wnt e PI3K/AKT. Conclui-se que a via HH tem impacto distinto consoante o subtipo tumoral, e alguns genes, como LRP2 e CSNK1A1, podem constituir biomarcadores ou alvos terapêuticos promissores, reforçando a importância de análises multi-ómicas aplicadas à oncologia de precisão.
- Assessing the importance of deltaC mRNA 3’utr for zebrafish somitogenesisPublication . Rodrigues, Leonardo Abraão da Silva; Andrade, Raquel P.; Carraco, GilSomitogenesis is a critical process in early vertebrate development, leading to the periodic formation of somites from the presomitic mesoderm (PSM) along the rostral-caudal axis during body elongation. These somites, which serve as embryonic precursors to the axial skeleton, are crucial for the proper development of vertebrae and other segmented structures. While the periodicity of somite formation can vary significantly between species, it remains highly constant within each species. This periodicity is driven by the embryo clock (EC), an intrinsic mechanism in PSM cells that relies on oscillations of gene expression, regulated through negative feedback loops, requiring short-lived mRNA transcripts. The stability of these transcripts is influenced by regulatory regions (RR) within the mRNA 3’ Untranslated Region (3’UTR). Proper somite formation requires synchronization between PSM cells, facilitated by Notch-Delta signaling, which coordinates cellular division and differentiation. This work investigated the role of the 3’UTR of the zebrafish deltaC clock gene in somite formation periodicity. Various zebrafish mutant lines were generated using CRISPR/Cas9. A previously generated mutant line (RR2) was characterized, assessing somite number, size, periodicity of formation, as well as the expression of EC genes. The comparison between the RR2 mutant and wildtype embryos showed no differences in somite size or number. Also, deltaC and her7 clock gene expression were unaltered. However, the RR2 mutant showed a slight decrease in the periodicity of somite formation. In conclusion, this work describes new animal model systems to study the embryo clock and provided new data on the importance of deltaC mRNA 3’UTR for somite formation.
- Associação entre o infiltrado linfoide e expressão de KI-67 com diversos fatores clínico-patológicos em cancro da mama luminalPublication . Almeida, Érica Filipa Pinto de; Borralho, Paula; Tavares, ÁlvaroAtualmente o cancro da mama continua a ter uma grande importância a nível mundial, particularmente no que respeita à sua incidência e mortalidade. Neste contexto, o diagnóstico correto e precoce apresentam um valor imensurável, contribuindo assim para a cura deste tumor. Muitos são os estudos realizados que procuram encontrar fatores preditivos e de prognóstico, de modo a auxiliar a tarefa árdua de diagnosticar, orientar a terapêutica e avaliar o prognóstico do cancro da mama. No entanto, atualmente este tema ainda carece de respostas para muitas questões. Com o intuito de encontrar algumas respostas, no presente estudo foram analisadas correlações entre várias variáveis clínicas, histológicas e biológicas, a fim de validar determinados biomarcadores, como fatores preditivos e de prognóstico. Neste projeto, foi nosso objetivo comparar duas coortes de carcinoma da mama de tipos histológicos diferentes (carcinoma lobular invasivo e carcinoma sem tipo especial), mas com grau de diferenciação e estádios clínicos e patológicos sobreponíveis. Foram selecionados 60 casos de carcinoma da mama, dos quais 30 carcinomas lobulares e 30 carcinomas de tipo NST e foram recolhidas as características específicas de cada tipo de tumor, bem como os dados clínicos relevantes. Foram comparadas variáveis clínicas (idade, a presença ou ausência de metástases, recidiva e por fim, seguimento) e variáveis histológicas e biológicas (expressão de recetores hormonais, amplificação de HER2, expressão de Ki-67 e densidade da infiltração linfocitária) entre as duas coortes e correlacionadas estas variáveis entre si e com os dados de seguimento. Um total de 8 correlações foram identificadas, em ambos os carcinomas, entre os vários parâmetros de interesse. Evidencia-se a correlação da expressão de Ki-67 com a infiltração linfocitária peritumoral e intratumoral, que revelaram relações ligeiramente superiores às restantes correlações efetuadas.
- Biomarkers for predicting malignant transformation of premalignant lesions of the larynx: a systematic reviewPublication . Rodrigo, Juan P.; Lima-Souza, Reydson Alcides de; López, Fernando; Stenman, Göran; Agaymy, Abbas; Quer, Miquel; Paleri, Vinidh; Leivo, Ilmo; Nadal, Alfons; Zidar, Nina; Mariano, Fernanda V.; Hellquist, Henrik; Gale, Nina; Ferlito, AlfioBackground/Objectives: Premalignant laryngeal lesions carry a variable risk of malignant transformation to squamous cell carcinoma. Identifying reliable biomarkers that predict malignant transformation could improve patient management and surveillance strategies. The objective of this work is to perform a systematic review of the literature on biomarkers that predict malignant transformation of premalignant laryngeal lesions. Methods: We conducted a systematic review following PRISMA 2020 guidelines. The PubMed, Scopus and Embase databases, and Google Scholar were searched for studies published between January 2011 and November 2025. Studies investigating biomarkers that predict malignant transformation of histopathologically confirmed premalignant laryngeal lesions were included. Risk of bias was assessed using the ROBINS-I tool. Results: From 166 initially identified records, 11 studies met the inclusion criteria, including 730 patients. These studies investigated diverse biomarker categories such as protein markers (cortactin, FAK, NANOG, SOX2, CSPG4), immune markers (tumor-infiltrating lymphocytes, immune gene signatures), microRNAs (miR-183-5p, miR-155-5p, miR-106b-3p), and genetic markers (chromosomal instability, PIK3CA amplification and mutations, FGFR3 mutations). Five studies provided adequate follow-up data on transformation outcomes. Most studies showed a moderate to serious risk of bias primarily due to limited confounder control and incomplete reporting. Conclusions: While several promising biomarker candidates have been identified, the evidence base remains limited due to small sample sizes, heterogeneous methodologies, and inadequate follow-up data. Cortactin/FAK protein expression and immune signatures are the most promising but require validation in larger, well-designed prospective cohorts.
- Caracterização da expressão do gene ZFP36L1 associado a mecanismos de patogénese da osteoartrose e osteoporosePublication . Lázaro, Mafalda Guela; Simão, MárcioO organelo sem membrana, designado como grânulo TIS, é caracterizado pela interação da proteína ZFP36 ring finger protein like 1 (ZFP36L1), também conhecida como TIS11B, com mRNAs que codificam proteínas membranares. ZFP36L1 promove o enriquecimento ou exclusão de transcritos, dependendo do tamanho dos seus 3'UTR e número de elementos ricos em adeninas (A) e uracilos (U) (AREs). A associação de grânulos TIS à superfície do retículo endoplasmático cria um microambiente que favorece a tradução e localização de proteínas específicas na superfície da membrana das células. ZFP36L1 também é conhecido por regular a estabilidade e degradação de transcritos de vários genes alvo, como é o caso de vários intermediários inflamatórios, o que sugere um papel duplo para o ZFP36L1, favorecendo a transcrição de proteínas membranares e destabilizando outros alvos. Para além dos marcadores de inflamação, também regula os intermediários da via de sinalização das BMPs e está envolvido em mecanismos de senescência o impacto do ZFP36L1 nas células precursoras de osteoblastos e de condrócitos e na sua diferenciação terminal é praticamente desconhecido. Recentemente, o ZFP36L1 tem sido implicado na promoção da diferenciação de osteoblastos e a sua expressão foi identificada como sendo diminuída em ratinhos mais idosos, resultando numa diferenciação preferencial das células mesenquimais para a linhagem adipocitária. Também foi publicado que o aumento da expressão de ZFP36L1 está associado aos mecanismos de progressão da osteoartrose. Este projeto tem como objetivo a identificação, compilação e discussão de estudos publicados que descrevem a expressão de ZFP36L1 em contextos patológicos associados ao desenvolvimento de osteoporose e osteoartrose, focando a discussão dos resultados obtidos no impacto que ZFP36L1 pode ter no metabolismo do osso e da cartilagem. Através da pesquisa da base de dados Gene Expression Omnibus (https://www.ncbi.nlm.nih.gov/geoprofiles) e bibliografia associada vai-se procurar compilar e comparar dados relativos à expressão de ZFP36L1 em experiências usando tecidos de humano e de ratinho. Com base nesses resultados vai-se procurar contextualizar a expressão desta proteína nos mecanismos associados ao desenvolvimento de osteoartrose e osteoporose. Serão igualmente estudadas (i) as relações filogenéticas destes genes nas principais espécies utilizadas como modelos biológicos em ciências biomédicas, e (ii) a presença de polimorfismos no gene que codifica para a ZFP36L1 e possam ser associados a patologias no sistema musculoesquelético e contextualizar os resultados relativamente às funções das proteínas codificadas.
- Challenges and insights in the measurement of clinical reasoning skills: Implications for instructional design and assessmentPublication . Collares, CarlosDear Editor Among the original contributions in the recent paper from Hornos et al. (2024), the introduction of cognitive diagnostic modelling (CDM) as an alternative to unidimensional item response theory (IRT) for evaluating clinical reasoning skills was a truly innovative step. Unidimensional IRT analysis of the data collected by Hornos et al. (2024) revealed a low percentage of explained variance, echoing a previous concern about its inherent reductionism (Collares, 2023). While IRT is suitable for ranking students and adjusting scores to different difficulty levels, it falls short in providing nuanced insights compared to CDM. CDM’s ability to offer skill-specific feedback and accommodate the multidimensional complexity of clinical reasoning makes it a compelling choice.
- Characterization of knowledge, attitudes, comfort, and perception of discrimination regarding sexual and/or gender minoritized people: comparison between two cohorts of medical students - 2018–2023Publication . Macedo, Ana; Ferreira, João; Gutierrez, Ana Rita; Gato, JorgeObjectives: Despite progress made in the medical field to address the health concerns ofsexual and gender minoritized identities, LGBTQIAþ individuals continue to experience dis-crimination in healthcare. This study aims to evaluate the effects of incorporating a seminaron gender identity and sexual orientation into the medical curriculum of a PortugueseMedical School, after 5 years. The study’s main objective was to compare the changes in stu-dents’ knowledge, attitudes, comfort, and perception of discrimination against LGBTQIAþ,pre and post-intervention.Methods: A total of 313 students in their third, fourth, fifth, and sixth year at a PortugueseMedical School were assessed in 2018 (pre-intervention) and 2023 (post-intervention). Thedata collected were analyzed regarding age, gender identity, sexual orientation, number offriends or family members who identify themselves as LGBTQIAþ, and level of religiosity.Results: The overall knowledge regarding LGBTQIAþ people specific health aspects improvedfrom the 2018 cohort to the 2023 cohort, with significant differences in questions regardinggender identity (OR ¼ 2.0, p ¼ .007), sexual orientation (OR ¼ 2.9, p <.001), and mentalhealth (OR ¼ 3.2, p <.001). The perceived discrimination against homosexual patients wassimilar in both cohorts, with approximately 60% of respondents from both groups agreeingthat homosexual patients were discriminated against in healthcare.Conclusion: Although the perception of discrimination against LGBTQIAþ people in health-care remained high across the two cohorts, positive changes were observed regarding stu-dents’ overall knowledge of LGBTQIAþ individuals’ health, clinical preparation and comfortin treating LGBTQIAþ people, and attitudes toward lesbian women and gay men. Theseresults reinforce the need to develop training and information strategies targeting medicalstudents, promoting greater knowledge and, above all, increasing contact and clinical prac-tice with LGBTQIAþ people, since relationships and personal contact are the most differenti-ating aspects for nondiscrimination.
- Chromenone derivatives as CRM1 inhibitors for targeting glioblastomaPublication . Princiotto, Salvatore; Jiménez, Lucía; Domínguez, Lucía; Sequeira, João G. N.; Mourato Paulo, Cristiana Isabel; Orea-Soufi, Alba; da Silva Santos, Bruno Filipe; Dallavalle, Sabrina; Machuqueiro, Miguel; Ferreira, Bibiana; Link, WolfgangGlioblastoma (GBM) is one of the most aggressive and deadly cancers. Due to the complexity and redundancy within signaling networks in GBM, targeted inhibitors of specific pathways have shown only limited success. The nuclear export receptor chromosome region maintenance 1 (CRM1) has recently emerged as a promising therapeutic target, as its inhibition can simultaneously disrupt multiple key oncogenic drivers. Herein, whether chromenone derivatives, known for detecting thiol-containing molecules, can function as CRM1 inhibitors is explored. Several chromenonebased derivatives are synthesized and it is demonstrated that they inhibit CRM1-driven nuclear export in a structure- and dose-dependent manner. A preliminary structure–activity relationship is established, providing a rationale for selective CRM1 binding based on molecular docking studies. Additionally, it is showed that the active chromenone derivatives effectively inhibit the nuclear export of endogenous nuclear export signal-containing substrates in GBM cells. Several of these compounds exhibit selective cytotoxicity againstGBM cell lines, highlighting their potential as targeted therapies for GBM.