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- Characterization of oral health determinants among a community of participants of a senior activity programPublication . Costa, Helder; Amaral, Odete; Correia, Maria José; Couto, Patrícia; Correia, Patrícia; Silva, Ana Margarida; Lopes, Pedro; López-Marcos, Joaquin Francisco; Veiga, Nélio JorgeBackground: High average life expectancy has caused an increase in the elderly population and with it the need to characterize this population regarding their health and in particular their oral health arises. The purpose of this study was to assess and characterize oral health, oral rehabilitation, oral health literacy and oral health perception and quality of life in a sample of elderly participants of a physical activity program. Methods: An observational cross-sectional study was designed with a group of 206 individuals. All the individuals were clinically assessed, and a questionnaire was applied, in the form of a "face-to-face" interview with questions related to the quality of life related to oral health (GOHAI index and the REALD-30 scale). Results: Of the 206 study participants, 90.3% admit brushing their teeth daily, 6.3% practice daily flossing, and 5.8% had a dental appointment in the last 12 months. Applying the REALD-30 scale, 22.7% have a low level (score 0–14), 43.7% a moderate level (score 15–22) and 33.6% a high level (score 23–29) of oral health literacy. The GOHAI scale reveals that 37.4% have a high self-perception of their oral health. Conclusions: A considerable prevalence of the sample studied present a moderate level of oral health literacy. Therefore, educate each person about their oral health when participating in a specific health program and develop proposals for oral health promotion activities should be widely considered as a strategy towards primary prevention.
- Virtual speech therapist: a clinician-in-the-loop AI speech therapy agent for personalized and supervised therapyPublication . Sheikh, Shakeel A.; Marmaroli, Patrick; Sahidullah, M. D.; Ouni, Slim; Hirsch, Fabrice; Leal, Gonçalo; Schuller, Björn W.This paper develops Virtual Speech Therapist (VST) , an intelligent agent-based platform that streamlines stuttering assessment and delivers customized therapy planning through automated and adaptive AI-driven workflows. VST integrates state-of-the-art deep learning–based stuttering classification, and multi-agent large language model (LLM) reasoning to support evidence-based clinical decision-making. The VST begins with the acquisition and feature extraction of patient speech samples, followed by robust classification of stuttering types. Building on these outputs, VST initiates an agentic reasoning process in which specialized LLM agents autonomously generate, critique, and iteratively refine individualized therapy plans. A dedicated critic agent evaluates all generated therapy plans to ensure clinical safety, methodological soundness, and alignment with peer-reviewed evidence and established professional guidelines. The resulting output is a comprehensive, patient-specific therapy draft intended for clinician review. Incorporating clinician feedback, the system then produces a finalized therapy plan suitable for patient delivery, thereby maintaining a clinician-in-the- loop paradigm. Experimental evaluation by expert speech therapists confirms that VST consistently generates high-quality, evidence-based therapy recommendations. These findings demonstrate the system’s potential to augment clinical workflows, reduce clinician burden, and improve therapeutic outcomes for individuals with speech impairments. An interactive user interface for the proposed system is available online at: https://vocametrix.com/ai/stuttering-therapy- planning-agent, facilitating real-time stuttering assessment and personalized therapy planning.
- Physiological characterization of pressure-strain loops indices as non-invasive surrogates for ventriculo-arterial coupling: a proof-of-concept studyPublication . Mendes, Lígia; Colaço, João; Pereira, João; Timóteo, Ana TeresaPressure–strain loop (PSL) analysis integrates myocardial deformation with estimated left-ventricular pressure and may provide a non-invasive approach to assess ventriculo-arterial coupling. However, its physiological behavior under controlled hemodynamic stress has not been systematically evaluated in humans. In this prospective physiologic study, healthy volunteers underwent standardized hemodynamic maneuvers. One cohort performed semi-supine exercise (contractility-dominant), while a second cohort underwent isometric handgrip followed by modified passive leg raising (afterload- and preloadmodulating maneuvers). Left-ventricular PSL indices were derived from speckle-tracking echocardiography combined with brachial pressure calibration. Five pre-specified PSL indices reflecting afterload (arterial elastance, end-systolic pressure), contractility (systolic strain rate, peak systolic strain), and myocardial work (global work index) were defined as co-primary endpoints. Within-subject changes were analyzed using paired tests with Holm–Bonferroni correction. Exercise produced large increases in contractility-sensitive indices (Cohen's dz 0.88–1.29, all adjusted p < 0.001), while pressure indices rose selectively with handgrip and modified passive leg raising (Cohen’s dz 0.77–1.21, adjusted p ≤ 0.001). These findings demonstrate that PSL analysis detects physiologically meaningful hemodynamic responses in humans and provides non-invasive indices consistent with established ventricular–arterial coupling dynamics.
- Long COVID recovery and exercise adherence: 32-month studyPublication . Rolo-Duarte, Ana; Prada, Daniela; Carvalho, Ana S. M.; Borges, Ana; Bettencourt, Paulo J. G.Objective To evaluate symptom progression in COVID-19 survivors, adherence to prescribed exercise therapy, and its association with pre-infection physical activity at 21 days (T0), 6 months (T1), and 32 months (T2) post-discharge. Design Retrospective longitudinal study in a hospital-based rehabilitation unit in Portugal. The cohort included 276 patients (mean age 56.6 ± 13.5 years) with confirmed SARS-CoV-2 infection. Results Adherence was higher among patients reporting prior physical activity (48.8%; p = .003). Symptom prevalence declined over time: dyspnea (T0 = 22.4%, T2 = 7.3%), fatigue (T0 = 32.4%, T2 = 14.5%), and pain (T0 = 17.6%, T2 = 4.8%). Asymptomatic cases increased from 27.4% (T0) to 54.5% (T2). Early adherence, particularly by day 15, was associated with continued participation at day 21, and adherence at day 21 correlated with reduced dyspnea at follow-up (p = .02). Importantly, patients who remained symptomatic at day 21 took significantly longer to recover (t = –6.386; p < .001), indicating this time point as a prognostic marker of delayed resolution of exercise-modifiable symptoms. Conclusion Early initiation of individualized, structured exercise proved safe, adaptable, and associated with reduced symptom burden, especially dyspnea. Persistence of symptoms at day 21 highlights the prognostic value of early follow-up and underscores the decisive role of timely rehabilitation engagement. Structured home-based and tele-rehabilitation programs supported adherence and accessibility, reinforcing exercise as a cornerstone of long COVID management and potentially applicable to other post-respiratory rehabilitation contexts.
- Referencing criteria for specialised consultation in complex wound carePublication . Miranda, Liliana Grilo; Lourenço, Óscar; Amado, João; Alves, PauloObjective: Validate a referential model for the nursing consultation for the treatment of patient with complex wounds. Methods: To validate a referencial model for the spe-cialised nursing consultation for complex wounds, bringing together a panel of nation-al and international experts in wound care, we did a Focus Group by a survey the main clinical guidelines and a Delphi panel. Results: Using these two consensus methods, the result was 14 referral criteria for specialised nursing consultations in the treatment of complex wounds. Conclusion: This study is relevant and innovative, facilitating the referral process according to the criteria identified. The most important criteria that we found for referring are Wound complexity, with exposure of fascia, exposure of surgical material, presence of non-viable tissue, vascular pathology and Need for in-novative advanced therapies (NPWT, topical oxygen therapy).
- The effect of home palliative care on patient dignity: a scoping reviewPublication . Valentim, Flávia de Araújo Cordeiro; Oliveira, Nádia Marisa Sotério de; Alves, Vicente Paulo; Capelas, Manuel LuísIntroduction: Home-based palliative care plays a vital role in preserving the dignity of terminally ill patients and their families. However, the factors influencing this experience from the perspective of patients, family caregivers, and healthcare professionals are not fully understood. Aim: To map existing evidence on the effects of home-based palliative care on patient dignity, considering the perspectives of patients, family caregivers, and health professionals. Methods: A literature search was conducted in PubMed, Scopus, Web of Science, Cochrane, CINAHL, and PsycINFO, including studies published until December 2024. Eligible studies addressed dignity in the context of home-based palliative care. Opinion reports, case reports, and gray literature were excluded. Results: Five studies that used qualitative methods were included. Key factors supporting the preservation of dignity include patient autonomy and self-determination, family support, effective symptom management, and supportive care environments. Challenges include caregiver burden, organizational barriers, and lack of infrastructure in home care services. Conclusion: Home-based palliative care can contribute to preserving patient dignity when structured support is provided and patient autonomy is respected. However, structural and organizational challenges remain significant barriers. Future research should explore strategies to enhance health service integration and caregiver support to promote humane and equitable home-based palliative care.
- Recommendations and statements of good practice for risk assessment of pressure injuries in adults admitted to intensive care unitsPublication . Picoito, Ricardo; Manuel, Tânia; Vieira, Sofia; Azevedo, Rita; Alves, Paulo; Nunes, ElisabeteBackground: the prevention of pressure injuries depends on early and correct assessment of at-risk patients. Since risk assessment is more than identifying it using a risk factor instrument, we intend to map the existing recommendations and statements of good practice for pressure injury risk assessment in adults admitted to intensive care units, as well as identifying the strengths of evidence and recommendations. Methods: scoping review, by Joanna Briggs Institute, adopting the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews as a guide for writing the study. Results: the search was carried out in six databases, resulting in 741 studies, of which 15 were included. The recommendations and statements of good practice were grouped into five categories: risk assessment instruments, skin assessment, medical device surveillance, other alternatives to risk assessment and implement the best practices in clinical settings. The strengths of evidence and recommendation were identified, when available in the literature. Conclusions: the mapping showed that the evidence is sufficient to indicate the recommendations and statements of good practice to risk assessment of pressure injuries in adults admitted to an intensive care unit. The protocol was retrospectively registered in the Open Science Framework on the 4th of august of 2023 (https:
- Do clear aligners release toxic chemicals? - a systematic reviewPublication . Ferreira, Mariana; Costa, Hélder; Veiga, Nélio; Correia, Maria J.; Gomes, Ana T. P. C.; Lopes, Pedro C.The use of advanced polymer materials in clear aligners, such as polyurethane and PET-G, has gained widespread acceptance due to their mechanical properties, biocompatibility and aesthetic appeal. However, concerns persist regarding their potential to release chemical compounds. Our goal is to understand the impact of the toxicity of clear aligners on oral cavity of orthodontic patients. An extensive systematic search was conducted in electronic databases PubMed, Scopus and Cochrane, to identify articles with relevant data. This systematic review will be conducted following the Preferred Reporting Items for Systematic reviews and Meta-analysis guidelines to answer a question formulated according to the Population, Intervention, Com-parison and Outcomes strategy. Four hundred and thirteen articles potentially relevant were identified and after applying PRISMA guidelines 7 articles were included in this review. Our results suggest that clear aligners are generally safe, concerns remain regarding the chemical leaching of thermoplastic materials, bacterial accumulation due to reduced saliva flow, and mild inflammatory responses. Our review empha-sizes that although most materials are biocompatible, some exhibit moderate cytotoxicity, underscoring the need for continued research and improvements in material composition.
- O papel da nutrição na prevenção e tratamento de feridasPublication . Borges, Cátia; Albuquerque, Luísa; Alves, Paulo; Ramos, Paulo; Teixeira, Abílio; Magalhães, Bruno; Mendes, Diana
- (Des)cobrir a ferida malignaPublication . Rocha, Ana; Moura, Anabela; Vicente, Helena; Matos, Marisa; Alves, Paulo; Ramos, Paulo; Carvalhal, Sara; Gomes, Sylvie
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