Effect of virtual reality rehabilitation on motor function in patients with stroke : a narrative review

Trabalho Final do Curso de Mestrado Integrado em Medicina, Faculdade de Medicina, Universidade de Lisboa, 2021Introdução: O acidente vascular cerebral é uma das principais causas de morte e incapacidade no mundo, sendo descrita como uma epidemia global. Défices motores causados por esta etiologia, afetam as tarefas diárias, bem como, a atividade profissional destas pessoas, resultando num dia-a-dia repleto de obstáculos. Desta forma, a reabilitação tem um papel fulcral, na melhoria destas queixas e consequentemente na qualidade de vida. A realidade virtual é uma ferramenta, que nos recentes anos tem vindo a ganhar um papel cada vez de maior importância para estes doentes. Nesta revisão narrativa, pretendemos comparar a reabilitação convencional com a reabilitação baseada na realidade virtual e perceber, desta forma, se existe benefício na combinação de ambas. Métodos: A nossa estratégia de pesquisa consistiu na pesquisa de ensaios clínicos randomizados em três diferentes plataformas (PubMed, sci-Elo e medRxiv), publicados nos últimos 10 anos cujo objetivo primário se focasse na função motora dos membros superiores. Usamos as seguintes palavras-chave como ponto de partida para a pesquisa de artigos: “Virtual Reality”, “rehabilitation”, “stroke”. Após ser aplicada a estratégia de pesquisa acima mencionada, obtivemos um total de 100 artigos. Após análise destes mesmos 100 artigos, somente 26 tinham os critérios necessários para a sua utilização na revisão, com uma amostra total de 1382 pacientes envolvidos nesta revisão de narrativa. Resultados: Como referido previamente, dos 100 artigos, somente 26 foram utilizados para a construção desta revisão narrativa. Os 74 artigos foram excluídos por não preencherem os critérios necessários para a sua inclusão. O facto do artigo não se focar na função motora do membro superior, foi a principal causa de exclusão de artigos. Outras razões como duplicados, não ter acesso livre, não focar o seu estudo na reabilitação do acidente vascular cerebral e não focar no estudo da realidade virtual também foram motivos para exclusão. Conclusão: Devido a inúmeras variáveis entre os diferentes ensaios, é impossível a conclusão de possíveis conexões entre a intervenção e os resultados obtidos. Sugere-se a realização de estudos em que certas variáveis como a intervenção realizada ao grupo de intervenção, o número de sessões, a duração das mesmas, sejam homogeneizados.Introduction: Stroke is one of the leading causes of death and disability and has been described as a worldwide epidemic. Motor function deficits due to stroke affect the patients' performance in daily tasks as well as in their jobs, which results in an increased difficulty in their everyday life. This way, rehabilitation in these patients plays an important role trying to improve their motor function and therefore their quality of life. Virtual reality, in recent years, has been increasingly more popular in this type of patients. In this narrative review, we aim to compare conventional therapy versus virtual reality-based therapy and find out if there is any kind of benefit in combining conventional therapy with virtual reality-based therapy. Methods: Our search strategy consisted in searching for randomized controlled trials published in the last 10 years with the primary outcome focusing on upper limb motor function, in three different platforms (PubMed, sci-Elo and medRxiv) using the following keywords: “virtual reality”, “rehabilitation”, “stroke”. After applied our search strategy we ended up with a total of 100 articles. After analyzing the 100 trials, only 26 of them met the necessary criteria to take part of this review, with a total sample of 1382 patients involved in the narrative review. Results: As previously mentioned, of the 100 articles, only 26 were used to build this narrative review. 74 articles excluded for not meeting the necessary criteria to make part of this review. The fact that the article did not focus on the motor function of the upper limb was the main reason for the exclusion of articles. Other reasons such as duplicates, not having open access, not focusing their study on stroke rehabilitation and not focusing on the study on virtual reality were also reasons for exclusion. Conclusion: Due to numerous variables between the different trials, it is impossible to conclude possible connections between the intervention and the results obtained. It is suggested that studies should be carried out with certain variables, such as the intervention carried out in the intervention group, the number of sessions, the duration of the sessions, homogenized

Quantificando as vantagens dos carros elétricos: caso de estudo

Fundação para a Ciência e a Tecnologia pelo apoio através do projeto estratégico UID/FIS/04650/2019 e UID/QUI/00686/2019 (incluindo os fundos FEDER através do Programa COMPETE 2020 e Fundos Nacionais), projeto, PTDC/FIS-MAC/28157/2017, as bolsas SFRH/BD/140842/2018 (J.C.B.) e SFRH/BPD/112547/2015 (CMC) e investigador CEECIND/00833/2017 (R. G.). Também se agradece o apoio nanceiro do Departamento da Indústria do Governo Basco ao abrigo dos Programas ELKARTEK, HAZITEK e PIB

Communication preferences and perceptions of cancer patient during their first medical oncology appointment

© 2023 The Authors. Psycho-Oncology published by John Wiley & Sons Ltd. This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.Background: The first medical oncology appointment serves as a platform for patients to comprehend their diagnosis and prognostic implications of cancer. This study aimed to determine patients' communication preferences during their first medical oncology appointment and to assess the disparities between patients' preferences and perceptions. Methods: A total of 169 cancer patients participated by completing the Communication in First Medical Oncology Appointment Questionnaire (C-FAQ), a two-section questionnaire designed to assess patients' preferences and perceptions regarding Content (information provided and its extent), Facilitation (timing and location of information delivery), and Support (emotional support) during their first medical oncology appointment. A comparative analysis was conducted to assess the variations between preferences and perceptions. Results: Content emerged as the most significant dimension compared to Facilitation and Support. The physician's knowledge, honesty, and ability to provide clear information were considered the most important attributes. Patients evaluated most of their preferences as "very important". Patients' perception of the communication dimensions present during their appointment was below preferences for 11 items, indicating significant discrepancies in clinical practice. Conclusions: Patients highly valued their preferences concerning Content, Facilitation, and Support dimensions of communication. However, patient preferences were more prominently oriented towards the Content dimension. The discrepancies between preferences and perceptions should be viewed as an opportunity for enhancing communication skills through training.info:eu-repo/semantics/publishedVersio

Predictors of right atrial dilatation and long-term function after right ventricular outflow tract surgical repair: Quantification of restrictive physiology matters

Right diastolic dysfunction; Right atrium function; Restrictive physiologyDisfunción diastólica derecha; Función de la aurícula derecha; Fisiología restrictivaDisfunció diastòlica dreta; Funció de l'aurícula dreta; Fisiologia restrictivaRight ventricular (RV) diastolic dysfunction in patients with a surgically-repaired RV outflow tract (RVOT) obstruction merits further studies. Right atrial (RA) dilation and function may be related to (RV) diastolic dysfunction in this setting. The end-diastolic forward flow (EDFF) in the pulmonary artery (PA) has been suggested as a non-invasive marker of poor RV compliance, however, there is controversy regarding its true significance; EDFF quantification may help elucidate this controversy. Objective to study predictors of RA enlargement and dysfunction in patients with a surgically-repaired RVOT obstruction and its relationship with quantitative EDFF. Methods In 81 consecutive patients (mean age: 37.5 (±7) years), transthoracic echocardiography (Echo) and cardiac magnetic resonance (CMR) were performed. Echo parameters: RA size (indexed RA area (iRAA)), RA function (RA global strain (RAGS)) and maximum EDFF velocity-time integral (VTI-EDFF) obtained during a whole respiratory cycle. CMR-indexed RA area (imRAA) was also obtained. Patients were divided into three groups according to iRAA, imRAA and RAGS; bivariate analysis was performed. A multivariate model was then applied using variables that were found to be statistically significant in the bivariate analysis. Results Upon multivariate analysis, higher VTI-EDFF values and the presence of significant tricuspid regurgitation proved to be independent factors associated with increased iRAA and imRAA and lower RAGS, whereas RV volumes, function and pulmonary regurgitant fraction were not. Conclusion VTI-EDFF linearly correlated with the degree of RA dilation and deformation; EDFF quantification as against qualitative assessment may be considered a non-invasive tool for diastolic RV dysfunction

Motivos de exclusão para a cirurgia de estimulação cerebral profunda na doença de Parkinson

Abstract de comunicação apresentada no Congresso SPDMov 2022 - Parkinsonismos Atípicos: Clássicos e Atípicos. Luso, 1-2 Abril 2022N/

MAMMALS IN PORTUGAL : A data set of terrestrial, volant, and marine mammal occurrences in P ortugal

Mammals are threatened worldwide, with 26% of all species being includedin the IUCN threatened categories. This overall pattern is primarily associatedwith habitat loss or degradation, and human persecution for terrestrial mam-mals, and pollution, open net fishing, climate change, and prey depletion formarine mammals. Mammals play a key role in maintaining ecosystems func-tionality and resilience, and therefore information on their distribution is cru-cial to delineate and support conservation actions. MAMMALS INPORTUGAL is a publicly available data set compiling unpublishedgeoreferenced occurrence records of 92 terrestrial, volant, and marine mam-mals in mainland Portugal and archipelagos of the Azores and Madeira thatincludes 105,026 data entries between 1873 and 2021 (72% of the data occur-ring in 2000 and 2021). The methods used to collect the data were: live obser-vations/captures (43%), sign surveys (35%), camera trapping (16%),bioacoustics surveys (4%) and radiotracking, and inquiries that represent lessthan 1% of the records. The data set includes 13 types of records: (1) burrowsjsoil moundsjtunnel, (2) capture, (3) colony, (4) dead animaljhairjskullsjjaws, (5) genetic confirmation, (6) inquiries, (7) observation of live animal (8),observation in shelters, (9) photo trappingjvideo, (10) predators dietjpelletsjpine cones/nuts, (11) scatjtrackjditch, (12) telemetry and (13) vocalizationjecholocation. The spatial uncertainty of most records ranges between 0 and100 m (76%). Rodentia (n=31,573) has the highest number of records followedby Chiroptera (n=18,857), Carnivora (n=18,594), Lagomorpha (n=17,496),Cetartiodactyla (n=11,568) and Eulipotyphla (n=7008). The data setincludes records of species classified by the IUCN as threatened(e.g.,Oryctolagus cuniculus[n=12,159],Monachus monachus[n=1,512],andLynx pardinus[n=197]). We believe that this data set may stimulate thepublication of other European countries data sets that would certainly contrib-ute to ecology and conservation-related research, and therefore assisting onthe development of more accurate and tailored conservation managementstrategies for each species. There are no copyright restrictions; please cite thisdata paper when the data are used in publications.info:eu-repo/semantics/publishedVersio

Lo glocal y el turismo. Nuevos paradigmas de interpretación.

El estudio del turismo se realiza desde múltiples escalas y enfoques, este libro aborda muchos temas que es necesario discutir desde diversas perspectivas; es el caso de la reflexión sobre la propia disciplina y sus conceptos, así como los asuntos específicos referidos al impacto territorial, los tipos de turismo, las cuestiones ambientales, el tema de la pobreza, la competitividad, las políticas públicas, el papel de las universidades, las áreas naturales protegidas, la sustentabilidad, la cultura, el desarrollo, la seguridad, todos temas centrales documentados y expuestos con originalidad y dominio del asunto. Lo multiescalar es básico para la comprensión del sistema turístico, sistema formado de procesos globales, regionales y locales. El eje de discusión del libro es lo glocal, esa interacción entre lo nacional y local con lo global

Pervasive gaps in Amazonian ecological research

Biodiversity loss is one of the main challenges of our time,1,2 and attempts to address it require a clear un derstanding of how ecological communities respond to environmental change across time and space.3,4 While the increasing availability of global databases on ecological communities has advanced our knowledge of biodiversity sensitivity to environmental changes,5–7 vast areas of the tropics remain understudied.8–11 In the American tropics, Amazonia stands out as the world’s most diverse rainforest and the primary source of Neotropical biodiversity,12 but it remains among the least known forests in America and is often underrepre sented in biodiversity databases.13–15 To worsen this situation, human-induced modifications16,17 may elim inate pieces of the Amazon’s biodiversity puzzle before we can use them to understand how ecological com munities are responding. To increase generalization and applicability of biodiversity knowledge,18,19 it is thus crucial to reduce biases in ecological research, particularly in regions projected to face the most pronounced environmental changes. We integrate ecological community metadata of 7,694 sampling sites for multiple or ganism groups in a machine learning model framework to map the research probability across the Brazilian Amazonia, while identifying the region’s vulnerability to environmental change. 15%–18% of the most ne glected areas in ecological research are expected to experience severe climate or land use changes by 2050. This means that unless we take immediate action, we will not be able to establish their current status, much less monitor how it is changing and what is being lostinfo:eu-repo/semantics/publishedVersio

Estimating the global conservation status of more than 15,000 Amazonian tree species

Estimates of extinction risk for Amazonian plant and animal species are rare and not often incorporated into land-use policy and conservation planning. We overlay spatial distribution models with historical and projected deforestation to show that at least 36% and up to 57% of all Amazonian tree species are likely to qualify as globally threatened under International Union for Conservation of Nature (IUCN) Red List criteria. If confirmed, these results would increase the number of threatened plant species on Earth by 22%. We show that the trends observed in Amazonia apply to trees throughout the tropics, and we predict thatmost of the world’s >40,000 tropical tree species now qualify as globally threatened. A gap analysis suggests that existing Amazonian protected areas and indigenous territories will protect viable populations of most threatened species if these areas suffer no further degradation, highlighting the key roles that protected areas, indigenous peoples, and improved governance can play in preventing large-scale extinctions in the tropics in this century