Abstracts RISE Day 2025

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P1

Vulnerability to Death in 19th-Century Porto: Determination Through Cross-Referencing Nominative Sources

Rui Leandro Maia^1^, Paula Mota Santos^2^, Alexandra Esteves^3^, Francisca Alves Cardoso^4^

^1^RISE-Health, Faculty of Human and Social Sciences, Fernando Pessoa University, Fernando Pessoa Teaching and Culture Foundation, Porto, Portugal, ^2^Centro de Administração e Políticas Públicas (CAPP), Lisbon, Portugal, ^3^Laboratório de Paisagens, Património e Território (Lab2PT), Braga, Portugal, ^4^Centre for Research in Anthropology (CRIA), Lisbon, Portugal

Background: This study aims to analyze the determinants of vulnerability to death in the city of Porto during the second half of the 19th century, with a particular focus on pandemic crises such as cholera. The research is based on the cross-referencing of nominative sources preserved in the historical archive of the Venerável Ordem Terceira do Carmo—Porto, enabling the reconstruction of individual life courses and the examination of the influence of variables such as age, gender, causes of death, socioeconomic status, and housing conditions.

Methods: The main sources include the patient admission books (1869–1889), burial records (1819–1870), death registers from the hospital of the institution (1801–1875), and the Book of Catacombs (1845–1869). Quantitative treatment of these records will rely on variable association tests, allowing for the identification of mortality patterns and social inequalities in the face of disease.

Results: The expected findings include evidence of greater vulnerability among the poor and those living in precarious housing conditions, as well as significant disparities related to age and gender during epidemic outbreaks. Beyond characterizing risk profiles in 19th-century Porto, the study aims to propose an explanatory model of vulnerability to death.

Conclusion: Although rooted in a historical setting, this model retains contemporary relevance, offering comparative insights into public health crises such as the recent Covid-19 pandemic.

P2

Strategic Shifts in Science Communication: Inclusive Practices in Citizen Science for Health Research

Rosa Silva^1^, Elaine Santana^2^, Sílvia Silva^2^, Joana Bernardo^2^, João Apóstolo^2^

^1^RISE-Health, Escola Superior de Enfermagem do Porto, Portugal, ^2^Health Sciences Research Unit: Nursing, Nursing School of Coimbra, Coimbra, Portugal

Introduction: A substantial body of scientific knowledge remains confined to academic circles, limiting its societal impact. This study explores how international research institutions communicate science to citizens and examines the lexical strategies used to foster inclusive, participatory discourse.

Methods: A documentary analysis was conducted on 16 institutional websites and 21 associated texts. Thematic content analysis identified core strategies, while lexicographic analysis using IRAMUTEQ software examined discourse patterns and lexical structures used to engage the public.

Results: The findings indicate a paradigm shift from deficit-oriented communication toward participatory and dialogic models. Four main thematic domains emerged: interaction, involvement, accessibility, and empowerment. Institutions increasingly implement formats such as lay summaries, co-produced materials, interactive training, and informal engagement spaces (e.g., cafés, theatres). Lexical data support these findings, showing a growing emphasis on plain language, citizen feedback, and community-driven dissemination efforts.

Conclusion: The communication approaches move beyond merely informing the public, aiming instead to build trust, enhance scientific literacy, and integrate citizens as active contributors to knowledge generation and decision-making processes. These practices align with democratic science ideals and illustrate a move toward strategic, audience-centered communication. The study highlights the necessity of reshaping communication structures to strengthen health promotion and societal engagement with science.

P3

The Eyes of Those Who Care: Nurses' Experiences with Homeless Individuals

Adriana Neves^2,5^, João Lopes^2,5^, Joyce Oliveira^2,5^, Madyna Carvalho^2,5^, Rafael Ricardo^2,5^, Paula Sarreira de Oliveira^1,3,6^, Teresa Carneiro^2,5^, Helena Melo^2,5^, Lídia Moutinho^1,4,7^, Maria João Fernandes^1,2,5^

^1^RISE-Health, Portugal, ^2^Núcleo de Investigação em Ciências e Tecnologias da Saúde (NICiTeS), Lisbon, Portugal, ^3^Egas Moniz Center for Interdisciplinary Research (CiiEM), Caparica, Portugal, ^4^Centro de Investigação e Desenvolvimento em Enfermagem de Lisboa (CINDUR), Portugal, ^5^Escola Superior de Saúde Ribeiro Sanches/Instituto Politécnico da Lusofonia, Lisbon, Portugal, ^6^Escola Superior de Saúde Egas Moniz, Almada, Portugal, ^7^Escola Superior de Enfermagem de Lisboa, Portugal

Background: The significant increase in the number of homeless individuals, driven by the economic and financial crisis, has become a priority concern not only in terms of human rights but also as a matter of public health. Considering this and recognizing that the foundations supporting the health and well-being of this population are deeply weakened, it is crucial to understand the role of nursing in their care. The present study aimed to explore nurses’ perceptions regarding the provision of care to people experiencing homelessness.

Methods: A qualitative study was conducted using a descriptive, exploratory, and cross-sectional approach through semi-structured interviews with nurses who provide care to homeless individuals in the Lisbon district. Laurence Bardin's content analysis methodology was applied to the data, and collection was finalized once theoretical saturation was achieved.

Results: Seven interviews were carried out. The study highlights the heterogeneity among homeless individuals, particularly regarding gender, nationality, and the presence of pregnant women. This population faces challenges related to social integration and health vulnerabilities that require specific care. A shortage of human resources and adequate infrastructure, along with the fear of judgment, emerge as barriers to accessing healthcare for this group.

Conclusion: The study concludes that nursing interventions targeting homeless individuals are essential, alongside the establishment of infrastructures that provide basic hygiene and nutritional support. Equally indispensable is the availability of facilities dedicated to preventive healthcare, including vaccination and access to contraceptives. Moreover, investment in specialized training for healthcare professionals—particularly in the development of communication strategies—emerges as a critical requirement, given the cultural diversity within the homeless population.

P4

Bridging the Gap: The Role of Portuguese Municipalities in Informal Caregivers Support

Joana Martins^1,2^, José Manuel Silva^1,3^, Goreti Marques^1,3^

^1^Escola Superior de Saúde Santa Maria, Porto, Portugal, ^2^Instituto de Ciências Biomédicas Abel Salazar, University of Porto, Portugal, ^3^RISE-Health

Background: The growing burden of functional dependency associated with population ageing is increasingly sustained by informal caregivers, whose critical contributions remain largely undervalued within prevailing care policy frameworks. Although municipalities are positioned as key actors in promoting proximity-based responses, there is a lack of comprehensive data regarding the national landscape of local initiatives aimed at supporting informal caregivers in Portugal.

Methods: This study aimed to systematically map and analyze the programs and strategies implemented across all 308 Portuguese municipalities to support informal caregivers. Data were collected between July 1, 2024 and June 1, 2025. A mixed-methods approach combined official data analysis with direct municipal contact and validation procedures, ensuring national coverage.

Results: Findings show that only 25.3% of municipalities reported having dedicated initiatives for informal caregivers. Among these, comprehensive and sustained programs, such as caregiver respite services or structured psychosocial support, are scarce (5.2%), with most actions being ad hoc, small-scale, and focused on basic training or information dissemination. Marked regional asymmetries were observed, and collaboration with national programs or civil society actors remains limited.

Conclusion: The results expose critical gaps in territorial equity, care continuity, and strategic alignment with national health and social care policies. As informal care becomes an essential pillar of long-term care provision, a coordinated, multi-level governance approach is urgently needed to bridge municipal efforts with systemic responses. Strengthening the role of local authorities in this domain is essential for advancing integrated care, promoting caregiver well-being, and ensuring sustainable community-based care models.

P5

Roadmap for Research and Clinical Action on Climate Change and Mental Health in Europe

Francisco Sampaio^1^, Chiara Cadeddu^2^, Sílvia Luís^3^, Marie-Laure Parmentier^4^, Biljana Gjoneska^5^, Sanae Okamoto^6^, Ivana Tutić Grokša^7^, Matteo Innocenti^8,9^, Marija Jevtic^10^, Nidhi Nagabhatla^11^, Julius Burkauskas^12^, Sezin Öner^13^, António José Soares^14^, COST CliMent Action Network

^1^RISE-Health, Nursing School of Porto, Portugal, ^2^Erasmus School of Health Policy and Management, Erasmus University Rotterdam, The Netherlands, ^3^Universidade Lusófona, Hei-LAB, Portugal, ^4^Institute of Functional Genomics, University of Montpellier, CNRS, INSERM, France, ^5^Macedonian Academy of Sciences and Arts, Macedonia, ^6^United Nations University MERIT, The Netherlands, ^7^Adult Education Institution Dante, ^8^Italian Climate Change Anxiety Association, Italy, ^9^Section of Hygiene, University Department of Life Sciences and Public Health, Universita Cattolica del Sacro Cuore, Italy, ^10^Faculty of Medicine University of Novi Sad, Institute of Public Health of Vojvodina, Serbia, ^11^UNU CRIS Bruges and University of Ghent, Belgium, ^12^Laboratory of Behavioral Medicine, Neuroscience Institute, Lithuanian University of Health Sciences, Lithuania, ^13^Department of Psychology, Kadir Has University, Turkey, ^14^RISE-Health, Faculty of Medicine, University of Porto, Portugal

Background: Climate change is an urgent global challenge that affects mental health through multiple pathways, including trauma related to extreme weather events, ongoing psychological distress due to climate threats, and disruptions at the community level. Although awareness of these effects is increasing, research and clinical responses in Europe remain limited and fragmented.

Methods: To address this gap, the EU COST Action CliMent (CA23113) has developed a strategic roadmap to guide future research and practice in this emerging field.

Results: Drawing on a multidisciplinary network of experts, the roadmap identifies three key priorities: first, systematic assessment of mental health impacts, including the development of valid measures and identification of vulnerable populations; second, implementation of adaptive responses, such as evidence-based interventions tailored to climate-related stressors; and third, promotion of resilience through behavioural change, education, and integration of mental health into climate and environmental policies. This framework results from expert consensus within the CliMent network, reflecting both scientific evidence and contextual realities across Europe. It underscores the importance of collaboration among researchers, clinicians, policymakers, and community stakeholders to foster innovation and equitable access to care.

Conclusion: The roadmap highlights the urgency of involving early-career researchers and affected communities to ensure inclusive, sustainable progress. By consolidating efforts and addressing structural disparities, the initiative positions Europe to lead global efforts in protecting mental health in the face of environmental disruption, ultimately promoting both individual and collective well-being.

P6

SARS-CoV-2 Vaccination and Immune Trends from a Portuguese University Cohort Study: One-Year of Hematological Findings

Patrícia Manarte-Monteiro^1,2^, Lígia Pereira da Silva^1^, Gabriella Marques^1^, Dina Alves^1^, Mary Duro^1^, Joana Domingues^1^, Sandra Gavinha^1,2^, Liliana Teixeira^1^

^1^Instituto de Investigação, Inovação e Desenvolvimento Fundação Fernando Pessoa (FP-I3ID), Porto, Portugal, ^2^RISE-Health, Faculty of Health Sciences, Fernando Pessoa University, Porto, Portugal

Background: SARS-CoV-2 seroprevalence among healthcare workers has been widely studied, yet data on oral-health professionals remain limited. This study assessed SARS-CoV-2 infection, vaccination status, immune response, and hematological changes among dentists/academic professors over one year.

Methods: A prospective study was conducted at University Fernando Pessoa (UFP) from July 2021 to June 2022, involving the dentist/academic professors (n=62). Ethical approval was obtained from the UFP-Ethics Committee prior to study initiation. Forty-seven participants (95% CI; 7.09% margin of error), aged 27-52 years, completed a self-reported survey on SARS-CoV-2 exposure and vaccination, and provided plasma samples for ELISA-based quantification of anti-S1-RBD IgM and IgG antibodies (reactive ≥1 AU/mL). Erythrogram, leucogram, and platelet indices were also assessed.

Results: SARS-CoV-2 exposure rose from 8.5% to 48.9%; 8.5% reported reinfection. Vaccination coverage increased from 91.5% to 93.6%. IgG seropositivity rose from 91.5% to 95.7% and was significantly associated with younger age (<50 years; P=0.009) and number of vaccine doses (1–3; P=0.003). In females, haemoglobin and related erythrogram parameters decreased (−0.04 g/dL; laboratory reference units), whereas in males they increased (0.07 g/dL). Both genders exhibited mean declines in leukocyte count (males: −19.5 × 10^9^ g/L; females: −209.4 × 10^9^ g/L), platelet count (males: −5.6 × 10^9^ g/L; females: −16.9 × 10^9^ g/L) and mean platelet volume (males: −0.2 U/mL; females: −0.153 U/mL).

Conclusion: Oral-health professionals exhibited high and increasing rates of SARS-CoV-2 exposure, vaccination, and IgG seropositivity over 12 months. Age and vaccine dosage were associated with immune response. Observed hematological trends suggest physiological adaptations that warrant further investigation into the dynamics of immune response in occupationally exposed populations.

P7

Assessment of the Physical Health and Nutritional Status of Bus Drivers in Northern Portugal

Tânia T. Silva^1,2,3^, Tatiana R. Mendes^3^, D. Filipa Ferreira^1,2,3^, Paulo Carvalho^1^, Nélson Costa^2^, Matilde A. Rodrigues^1,2,3^

^1^RISE-Health, Center for Translational Health and Medical Biotechnology Research (TBIO), E2S, Polytechnic of Porto, Porto, Portugal, ^2^ALGORITMI Research Center/LASI, University of Minho, Guimarães, Portugal, ^3^Department of Environmental Health, School of Health, Polytechnic of Porto, Porto, Portugal

Background: Bus drivers face an increased risk of obesity due to prolonged sitting, irregular schedules, and limited access to healthy food. This study evaluated the nutritional and health status of 56 drivers (53 males and 3 females) in northern Portugal.

Methods: Data collection included sociodemographic information, anthropometric measurements, body composition analysis using a segmental body composition scale (considering the level of physical activity), and blood pressure evaluation.

Results: The mean age of participants was 45±9 years. Most individuals (53.57%) reported being moderately active, while 25.0% were inactive and 21.43% engaged in intense physical activity. The average waist circumference was 99.5±14.2 cm, average height was 1.74±0.07 m, and mean body weight was 85.03±16.01 Kg. The average Body Mass Index was 28.09±4.57 Kg/m^2^, placing most drivers in the overweight category. Mean body fat percentage was 24.19±10.00%, and average muscle mass was 60.57±11.03 Kg. Elevated visceral fat levels were found in 14.29% of participants. Additionally, 53.57% of the drivers had a metabolic age exceeding their chronological age. Estimated daily caloric intake averaged 3,370±633 kcal. Blood pressure values revealed an average systolic pressure of 131±14 mmHg and diastolic pressure of 80±10 mmHg, with 67.86% of the sample showing pre-hypertensive or hypertensive readings.

Conclusion: These findings underline critical health risks associated with the bus driving profession in this region. There is an urgent need for preventive strategies, including tailored health promotion programs focusing on diet, physical activity, and regular health screening, to improve overall well-being and reduce the risk of chronic diseases among drivers.

P8

Diagnosis of the Community Process for Epidemiological Surveillance of Nursing Diagnoses—A Mixed Study in an Island Health Unit on the Azores

Pedro Melo^1^, Renata Silva^1,2^, Flávio Vieira^1,2^, Susana Barbeitos^1,2^, Susana Figueiredo^1,2^, Sandra Silva^1,2^

^1^RISE-Health, MAIEC Lab, Escola Superior de Enfermagem da Universidade do Porto, Porto, Portugal, ^2^Secretaria Regional da Saúde e Segurança Social da Região Autónoma dos Açores, Angra do Heroísmo, Portugal

Background: The Community Assessment, Intervention and Empowerment Model (MAIEC) is a prescriptive middle-range theory oriented towards the community as a unit of care for nurses. In the MAIEC Lab, based at RISE-Health, there is a Main Thematic Area “MAIEC and Public Health” related to the Epidemiological Surveillance of Nursing Diagnoses (ESND). ESND is a postmodern epidemiology, oriented towards the analysis of Nursing Diagnoses in the population context, with epidemiological analysis methods. The objective of this stage of the study is to identify the nursing diagnosis in the domain “Community process” for the promotion of ENSD at the Island Health Unit (IHU).

Methods: The study was mixed, cross-sectional, and descriptive in nature. Through a focus group, the priority nursing focuses for ESND at the IHU were determined, considering the analysis of the Local Health Profile. The “MAIEC Questionnaire”, which allows diagnosing the “community process”, was applied online between September 25, 2024 and February 28, 2025, to the community of Primary Care Nurses at the IHU. The project was approved by the IHU ethics committee and the Board of Directors.

Results: 42% of nurses population answered the questionnaire. Community Leadership was committed in 42% of the nurses; Community Participation was committed in 73% and Community Coping was committed in 80% of the participants.

Conclusion: A diagnosis of “Commited Community Process” was identified according to the MAIEC clinical decision matrix, and it will be necessary to initiate a process of interventions in the community of nurses at the IHU to enhance ESND.

P9

(Un)Healthy Lifestyles in Portugal: Contributions Related to the Environment

Rute F. Meneses ^1,2^

^1^Faculdade de Ciências Humanas e Sociais da Universidade Fernando Pessoa (FCHS-UFP), Porto, Portugal, ^2^RISE-Health, Portugal

Background: Research in diverse fields has consistently shown intimate relationships between the environment and health. In this context, two projects on adult health are worth mentioning. The first, “(Self-)Healthcare practices in Portugal and associated factors” (P1; 2020-2024), aimed to characterize knowledge of and experience with conventional and non-conventional practices (including those used to manage stress). The second project, “Well-being, leisure and associated factors in Portuguese adults” (P2; since 2024), studies the respondents' psychological and spiritual well-being and leisure activities. Both projects also aim to explore the relationships between the main variables and self-reported health and sociodemographic variables.

Methods: P1 involved 578 adults, including health professionals, and P2 has so far included 109 participants. Both studies were approved by UFP's Ethics Committee. All participants were contacted through social media (snowball technique) and answered via Google Forms.

Results: P1 led to 4 master dissertations (2 in Clinical and Health Psychology and 2 in Dentistry) and another in the final stage, 1 article, 2 proceedings, 2 invited presentations, 8 oral presentations, and 1 poster. Regarding P2, 1 submission was accepted for oral presentation, and 2 dissertations are in their final stage.

Conclusion: The combined results indicate the need to educate the population about the risks and benefits of non-conventional health practices, promote stress management training, foster leisure education, and disseminate techniques that enhance well-being. The results also reveal sociodemographic and clinical profiles in greater need of these interventions. The studies' limitations do not preclude the identification of effective and sustainable strategies to increase adults' health and well-being.

P10

CDHR5 and UPB1 Epigenetically Regulated in Clear Cell Renal Cell Carcinoma with Sarcomatoid Differentiation

Fernanda Fernandes-Pontes^1,2,3^, Vera Constâncio^1,2,4^, João Lobo^1,2,5,6^, Maria Alzamora^1,2,5^, Rui Silva-Santos^1,2,5^, Rui Henrique^1,2,5,6^, Vera Miranda-Gonçalves^1,2^, Carmen Jerónimo^1,2,6^

^1^Cancer Biology and Epigenetics Group, IPO Porto Research Center of IPO Porto (CI-IPOP), Portuguese Oncology Institute of Porto (IPO Porto), Portugal, ^2^Porto Comprehensive Cancer Center Raquel Seruca (Porto.CCC) Porto, Portugal, ^3^Master Program in Oncology, ICBAS—School of Medicine and Biomedical Sciences, University of Porto, Porto, Portugal, ^4^Doctoral Program in Biomedical Sciences, ICBAS—School of Medicine and Biomedical Sciences—University of Porto, Porto, Portugal, ^5^Department of Pathology, Portuguese Oncology Institute of Porto (IPO Porto), Portugal, ^6^Department of Pathology and Molecular Immunology, ICBAS—School of Medicine and Biomedical Sciences, University of Porto, Porto, Portugal

Background: Clear cell renal cell carcinoma (ccRCC), the most common renal cell carcinoma (RCC) subtype, presents 25% of cases with metastasis at diagnosis and 20% of these with sarcomatoid features, driving tumor aggressiveness and poor prognosis. It is known that DNA methylation is altered throughout ccRCC progression; however, its role in the development of sarcomatoid features remains unknown. This study aims to investigate new DNA methylation biomarkers that can accurately identify sarcomatoid features in ccRCC.

Methods: In silico analyses were performed to assess differentially methylated genes in sarcomatoid ccRCC (sccRCC). Promoter methylation and expression were validated for the candidate genes in a tissue sample set (54 ccRCC; 34 sccRCC), using Mann-Whitney U test to compare methylation and transcript levels between sarcomatoid ccRCC and ccRCC groups and plotting Receiver Operator Characteristics (ROC) with the respective biomarker performance estimates.

Results: CDHR5 and UPB1 promoter methylation was significantly higher in sccRCC than in ccRCC, while the respective transcript levels were significantly reduced both in The Cancer Genome Atlas (TCGA) and IPO Porto cohorts. When combining both CDHR5me and UPB1me levels, sccRCC tumors were discriminated from ccRCC with a combined specificity of 78.7% and a sensitivity of 63%. Moreover, CDHR5me increased levels are significantly associated with metastatic dissemination at diagnosis in sarcomatoid patients.

Conclusion: CDHR5 and UPB1 methylation is recognized as a feasible hallmark to identify sarcomatoid features in ccRCC and may serve as a biomarker to this end. To validate the clinical utility of these findings, further validation in liquid biopsies should be performed.

P11

Beyond Weight Loss: Could Vitamin E Unlock Insulin Sensitivity and Diabetes Remission Post-Bariatric Surgery?

Joana Alves^1,2^, Fernando Mendonça^3,4^, Pietra Soares^5^, Ana Rita Leite^3^, Mafalda Maia^1^, João Sérgio Neves^3,6^, Carla Luís^1,2,7^, Ilda Rodrigues^1,2^, Liliana Carvalho^1,2^, Beatriz Fonseca^1^, Beatriz Sá Pinto^1^, Beatriz Silva^1^, Joana Barbosa^1^, Luísa Couto^1^, Telma Moreno^3^, Marta Canha^3^, Jorge Pedro^3,4^, Diana Festas^3,4^, Ana Varela^3,4^, Ana Oliveira^8^, Teresa Faria^8^, Ana Fernandes^9^, Sónia Vieira^10^, Altin Ndrio^10^, João Tiago Guimarães^1,10,11^, Eduardo L. Costa^4^, Grupo CRIO^4^, Raquel Soares^1,2^, Paula Freitas^2,4^

^1^Unidade de Bioquímica, Departamento de Biomedicina, Faculdade de Medicina, Universidade do Porto, Porto, Portugl, ^2^i3S—Instituto de Investigação e Inovação em Saúde, Universidade do Porto, Porto, Portugal, ^3^Departamento de Endocrinologia, Diabetes e Metabolismo, ULS São João, Porto, Portugal, ^4^Grupo CRIO (Centro de Responsabilidade Integrada de Obesidade), ULS São João, Porto, Portugal, ^5^Unidade Local de Saúde de Matosinhos, Porto, Portugal, ^6^Departamento de Cirurgia e Fisiologia, Faculdade de Medicina, Universidade do Porto, Porto, Portugal, ^7^Escola de Medicina e Ciências Biomédicas, Universidade Fernando Pessoa, Porto, Porugal, ^8^Departamento de Medicina Nuclear, ULS São João, Porto, Portugal, ^9^CINTESIS.UFP@RISE—Centro de Investigação em Tecnologias e Serviços de Saúde, Rede de Investigação em Saúde, Universidade Fernando Pessoa, Porto, Portugal, ^10^Departamento de Patologia Clínica, ULS São João, Porto, Portugal, ^11^EPIUnit, Instituto de Saúde Pública, Universidade do Porto, Porto, Portugal

Background: Bariatric surgery (BS) promotes weight loss and remission of comorbidities but may lead to vitamin E deficiency, a modulator of oxidative stress and inflammation implicated in insulin resistance. The role of vitamin E in post-surgical metabolic improvements remains unclear.

Methods: We aimed to investigate the association between vitamin E and insulin response and inflammation in BS patients, and explore their predictive potential for Diabetes remission. A total of 162 women undergoing BS were recruited. Anthropometric and biochemical parameters were assessed before surgery and at 1- and 2-year follow-ups. Statistical analysis included bivariate (Spearman) correlations and binary logistic regression for diabetes remission, performed using SPSS (P ≤ 0.05).

Results: At 2 years, absolute levels of vitamin E were positively correlated with BMI and negatively correlated with the c-peptide variation. Vitamin E variation across the follow-up was negatively correlated with insulin variation and positively correlated with baseline insulin. No predictive associations with diabetes remission were found.

Conclusion: Vitamin E showed consistent associations with BMI, supporting the hypothesis that its decline reflects fat mass loss after BS. Additionally, lower vitamin E levels were linked to greater c-peptide decline, while greater vitamin E reduction across the follow-up was associated with smaller insulin variation, suggesting a reduced and more stable insulin production as sensitivity improves. These findings indicate that vitamin E may serve as a marker of adiposity reduction and indirectly of insulin improvement after BS. However, further studies are required to confirm this hypothesis and clarify the underlying mechanisms.

P12

Cardiac Remodeling Induced by a High-Fat Diet Is Mitigated by Sulfur Amino Acid Restriction Primarily via FGF21-Independent Mechanisms

Filipe Pinheiro^1,2^, Hannah Lail^2,3^, João Sérgio Neves^4,5^, Rita Negrão^1^, Desiree Wanders^2^

^1^Department of Biomedicine, RISE-Health, Faculty of Medicine, University of Porto, Portugal, ^2^Department of Nutrition, Georgia State University, Atlanta, GA, USA, ^3^Department of Chemistry, Georgia State University, Atlanta, GA, USA, ^4^Department of Endocrinology, Diabetes and Metabolism, University Hospital Center of São João, Porto, Portugal, ^5^Department of Surgery and Physiology, RISE-Health, Faculty of Medicine, University of Porto, Porto, Portugal

Background: Dietary sulfur amino acid restriction (SAAR) was shown to elicit multiple health benefits in both preclinical and clinical studies, with several effects mediated by fibroblast growth factor 21 (FGF21). However, research on SAAR's effects on the heart is limited and presents mixed findings.

Methods: This study aimed to investigate the effects of SAAR on cardiac remodeling and to determine if these effects are mediated by FGF21. Male C57BL/6J wild-type and FGF21 knockout mice were randomized into four dietary regimens for five weeks: normal-fat or high-fat diets (HFDs), with or without SAAR. Physiological and metabolic assessments included body weight, visceral adiposity, serum FGF21 concentrations, and systemic insulin sensitivity. Cardiac molecular markers related to metabolism, cellular stress, and structural integrity were analyzed using Western blot and RT-PCR.

Results: SAAR significantly reduced body weight and visceral adiposity while increasing insulin sensitivity and serum FGF21 levels. In the heart, SAAR induced metabolic alterations consistent with enhanced energy metabolism, while eliciting opposing effects on cardiac FGF21 and adiponectin gene expression. Regarding cellular stress, SAAR mitigated the HFD-induced increase in the cardiac expression of genes involved in oxidative stress, inflammation, and apoptosis, while upregulating antioxidative genes. Structurally, SAAR did not induce markers of cardiac hypertrophy and counteracted the HFD-induced fibrotic gene expression. Most of these alterations were independent of FGF21, except for those related to lipid utilization and glucose uptake.

Conclusion: Overall, SAAR promotes a cardiac phenotype indicative of physiological, rather than pathological, remodeling in response to HFD-induced stress, primarily through FGF21-independent mechanisms.

P13

“Me at 80 Years Old”: Preparing Students for Intervening with Older Persons Through Photovoice

Lia Araújo^1,2^, Liliana Sousa^1,3^

^1^RISE-Health, ^2^Instituto Politécnico de Viseu, Viseu, Portugal, ^3^Universidade de Aveiro, Aveiro, Portugal

Background: In an increasingly aging society, it becomes crucial to prepare future professionals in the field of aging. This study aimed to analyze the impact of a pedagogical project based on the photovoice that worked Social Education students' stereotypes toward older adults and their willingness to work in this field.

Methods: Twenty-five undergraduate Social Education students, aged 19 to 46, were challenged to present in the classroom photographs taken by themselves and by a person aged 50+ years old in response to the topic “Me at 80 years old.” Photographs and narratives were analyzed with main themes revealing the importance of (i) social connectedness, (ii) having a purpose in life, and (iii) active ageing (with cognitive and physical activities) for both students and adults. Before and after the program, students completed the Negative Stereotypes toward Aging Questionnaire (CENVE; Blanca et al., 2005) and answered a set of questions about their interest in the aging professional area.

Results: The results indicate that stereotypes toward older people decreased significantly (P < 0.001) from the beginning of the project (mean total score = 29.76, SD = 7.0) to the end (25.96, SD = 5.6). Additionally, the percentage of students expressing a strong desire to work with older adults in the future increased from 28% to 44% (P < 0.001).

Conclusion: Photovoice is a valuable pedagogical tool to address stereotypes about older adults and enhance their willingness to pursue a career in aging.

P14

Extension and Citizen Involvement in Health Research: Strengthening Science and Health Outcomes

Elaine Santana^1^, Sílvia Silva^1,2^, Iria Dobarrio-Sanz^1^, Fernanda Lanza^1,3^, Rosa Silva^4,5^, João Apóstolo^1,2^, Armando Silva^1,2^, Maria Sá^1,2^

^1^Unidade de Investigação em Ciências da Saúde: Enfermagem (UICISA: E) da Escola de Enfermagem da Universidade de Coimbra, Portugal, ^2^Escola de Enfermagem da Universidade de Coimbra, Portugal, ^3^Universidade Federal de São João Del-Rei, Minas Gerais, Brazil, ^4^Escola de Enfermagem da Universidade do Porto, Portugal, ^5^RISE-Health, Portugal

Background: Citizen Science (CS) has increasingly established itself as an innovative approach to bridging science and community by promoting the active involvement of citizens in the construction of scientific knowledge. In the field of health—particularly in nursing research—this involvement is especially relevant for developing solutions that are better aligned with the real needs of populations and for enhancing scientific and health literacy. Such involvement fosters more informed and conscious health decisions, while also strengthening public trust and the social appropriation of science.

Methods: This work aims to describe the strategies implemented under the strategic axis “Extension and Citizen Involvement” of the Health Sciences Research Unit: Nursing (UICISA: E) at the Nursing School of Coimbra. It is a descriptive study based on the analysis of initiatives designed to promote CS.

Results: The actions developed are structured around three key dimensions: (i) raising awareness and strengthening the link between science and society, through participation in four editions of the European Researchers' Night and organization of four editions of the Social Science Festival, initiatives that brought together hundreds of participants and reinforced dialogue between citizens and researchers; (ii) capacity building and co-creation, through the promotion of participatory workshops and more than 30 co-creation sessions, including the production of the informative leaflets “Science for Citizens”; and (iii) active involvement in research projects, achieved by integrating citizens into different phases of ongoing projects and by creating a volunteer registry that strengthens the relationship between the community and UICISA: E.

Conclusion: This experience demonstrates how CS can help consolidate a more inclusive, socially engaged, and relevant scientific practice, reinforcing the social mission of higher education institutions and contributing to improved health through dialogue between science and community.

P15

Citizen Science: Implementing Citizen Science in a Research Unit

Sílvia Silva^1,2^, Elaine Santana^2^, Iria Dobarrio-Sanz^2^, Fernanda Lanza^3^, Rosa Silva^4,5^, Armando Silva^1,2^, Maria Sá^1,2^, João Apóstolo^1,2^

^1^Escola de Enfermagem da Universidade de Coimbra, Portugal, ^2^Unidade de Investigação em Ciências da Saúde: Enfermagem (UICISA: E), Coimbra, Portugal, ^3^Universidade Federal de São João Del-Rei, Minas Gerais, Brazil, ^4^Escola de Enfermagem da Universidade do Porto, Portugal, ^5^RISE-Health, Portugal

Background: Citizen involvement in research is a well-established international practice, but remains recent in nursing research in Portugal. Based on the Citizen Science (CS) principles, involving citizens in research processes generates new knowledge and mutual understanding. The objective is to promote citizen involvement in research at the Health Sciences Research Unit: Nursing (UICISA: E) by implementing a Structuring Project (SP) aligned with CS principles.

Methods: In order to achieve this in 2022, UICISA:E initiated the SP “Citizen involvement in research processes and knowledge extension to society”. This project includes two complementary strategies: one targeting researchers and the other targeting citizens. It supports Associated Study Projects (ASP) focused on creating and validating methodologies to facilitate citizen involvement in research, and on identifying citizens' needs, experiences, and motivations.

Results: The implementation of the SP enabled the development of six associated projects aimed at investigating CS, while the projects are carried out in accordance with CS principles. These projects led to the establishment of co-creation methodologies with citizens, the inclusion of citizens as researchers in the projects and as co-authors in publications; a study of researchers' perceptions of CS and raising awareness/training of researchers in CS; an assessment of the inclusion of CS in the research unit's projects and monitoring of that involvement.

Conclusion: This growing area is driving significant changes in how science is designed, developed, and communicated. The innovative potential of citizen involvement represents a new research paradigm that encourages social innovation, democratisation of science, and improvement of scientific and health literacy. The SP at UICISA:E aligns with international research paradigms and contributes to strengthening nursing research in Portugal.

P16

Impact of Acrobatic Gymnastics on the Well-Being of Children/Adolescents 8 to 12: Coach's Perception

Carla Albuquerque^2,5^, Cátia Silva^2,5^, Diana Zhalba^2,5^, Lara Abreu^2,5^, Rita Garcia^2,5^, Teresa Carneiro^2,5^, Helena Melo^2,5^, Paula Sarreira de Oliveira^1,3,6^, Lídia Moutinho^1,4,7^, Maria João Fernandes^1,2,5^

^1^RISE-Health, Portugal, ^2^Núcleo de Investigação em Ciências e Tecnologias da Saúde (NICiTeS), Lisbon, Portugal, ^3^Egas Moniz Center for Interdisciplinary Research (CiiEM), Caparica, Portugal, ^4^Centro de Investigação e Desenvolvimento em Enfermagem de Lisboa (CINDUR), Lisbon, Portugal, ^5^Escola Superior de Saúde Ribeiro Sanches/Instituto Politécnico da Lusofonia, Lisbon, Portugal, ^6^Escola Superior de Saúde Egas Moniz, Almada, Portugal, ^7^Escola Superior de Enfermagem de Lisboa, Lisbon, Portugal

Background: The existing literature reveals limited knowledge regarding the impact of acrobatic gymnastics on the development of children/adolescents. Additionally, the child/adolescent health surveillance program lacks technical guidelines that ensure a nursing response tailored to the specific needs of this population. This study aims to explore how the practice of acrobatic gymnastics influences the well-being of children aged 8 to 12 years.

Methods: A qualitative, exploratory, descriptive, and cross-sectional study design was employed. The sample consisted of eight coaches, selected through non-probabilistic snowball sampling. Data were collected in September 2024 through semi-structured interviews. Content analysis was conducted following Bardin’s methodology.

Results: The findings suggest that acrobatic gymnastics provides benefits at the physical level (e.g., strength, endurance, and flexibility), psychological level (e.g., emotional maturity), and social level (e.g., improved communication and peer interaction). However, practicing this sport may also be associated with risks, including injuries, nutritional imbalances, stress, and anxiety. Coaches play a critical role as positive influences, often acting as mentors and motivators. In contrast, parents can exert negative pressure on young athletes despite their supportive role. Nurses remain absent from both training and competition contexts.

Conclusion: The well-being of 8- to 12-year-old children who engage in this sport may be enhanced through regular developmental monitoring, paying particular attention to nutritional needs, emotional health, and injury prevention. Integrating a nurse in the athlete–parent–coach triad may strengthen the capacity to meet these young athletes’ specific health and developmental needs.

P17

Volatile Organic Profiles as Phenotypic Markers in Environmental Fungal Screening

Sofia Relvas^1,2^, Mónica Vieira^1,2^, João Cavaleiro Rufo^1,2,3^

^1^Escola Superior de Saúde do Porto (E2S), Porto, Portugal, ^2^Rise-Health, Centro de Investigação em Saúde Translacional e Biotecnologia Médica, Porto, Portugal, ^3^Instituto de Saúde Pública da Universidade do Porto (ISPUP), Porto, Portugal

Background: Phenotypic identification of fungi species for environmental assessment is a time-consuming process. Fungi release volatile organic compounds (VOCs) through their metabolism, which differs in terms of genus and species. Therefore, we hypothesized that these VOCs could be used for a rapid screening of environmental fungi. This study aimed to measure the VOC profiles associated with the metabolism of 5 fungal species and assess the method’s effectiveness for phenotypic identification.

Methods: Five fungi cultures of interest were used to measure their VOC profiles using a proprietary electronic nose system. Three glass tubes containing YEPD broth were inoculated per species, keeping three sterile tubes as controls. The tubes were incubated at 25 °C. VOCs were analyzed for each tube at 0, 1, 2, 3, 6, 24, 48 and 72h of incubation, followed by counting colony-forming units (CFUs). Principal component analysis (PCA), hierarchical clustering and chi-square tests were used for data analysis.

Results: PCA showed a significant differentiation in VOC profiles at 48h after inoculation based on the most relevant component (P < 0.001). At this point, inoculated samples were effectively differentiated from controls with 77% sensitivity and 100% specificity. Alternaria sp was not discernible from controls. However, Penicillium sp was completely differentiated from all other samples (AUC = 1.0, P < 0.001), having the highest number of CFUs. VOC profiles of Penicillium sp featured higher concentrations of ketones and, to a lesser extent, alkanes and aromatic hydrocarbons.

Conclusion: These preliminary results suggest a promising future for the effective screening of environmental fungi using VOC analysis.

P18

PBPK Modeling of Repurposed HIV Drugs in Prostate Cancer and the Influence of Patient Physiology

Mariana Pereira^1,2,3^, Nuno Vale^1,2,4^

^1^PerMed Research Group, RISE-Health, Faculty of Medicine, University of Porto, Porto, Portugal, ^2^RISE-Health, Department of Community Medicine, Health Information and Decision (MEDCIDS), Faculty of Medicine, University of Porto, Porto, Portugal, ^3^Institute of Biomedical Sciences Abel Salazar (ICBAS), University of Porto, Porto, Portugal, ^4^Laboratory of Personalized Medicine, Department of Community Medicine, Health Information and Decision (MEDCIDS), Faculty of Medicine, University of Porto, Porto, Portugal

Background: Drug repurposing offers a cost-effective and accelerated pathway for cancer therapy development by utilizing compounds with well-established pharmacological and safety profiles. Efavirenz (EFV), etravirine (ETV), and saquinavir (SAQ), antiretroviral drugs originally approved for HIV treatment, have demonstrated promising anticancer properties in preclinical models, including activity against prostate cancer. Given the physiological and metabolic alterations associated with cancer, particularly in prostate tissue, understanding the pharmacokinetic (PK) behavior of these drugs in oncological settings is critical for guiding effective repurposing strategies.

Methods: This study aimed to evaluate the pharmacokinetics of EFV, ETV, and SAQ under prostate cancer conditions using physiologically based pharmacokinetic (PBPK) modeling. Virtual models were developed in GastroPlus to simulate drug disposition in both healthy and cancer-modified prostate tissues, and across virtual populations stratified by age (30 and 65 years) and body weight (70 and 95 kg). The simulations incorporated standard tissue physiology as well as altered parameters representing prostate cancer pathology, using PEAR (Population Estimates for Age-Related Physiology) models to reflect realistic demographic variability.

Results: The simulations revealed that individual characteristics, particularly age and body weight, significantly influenced systemic drug exposure, while prostate-specific tissue changes had negligible effects on pharmacokinetics. EFV and ETV showed increased plasma concentrations in older and lighter individuals, likely due to decreased hepatic metabolic activity and a lower volume of distribution in these groups. Conversely, SAQ demonstrated the highest peak concentration (Cmax) in younger, lighter individuals, but the greatest total drug exposure (AUC_0_–T) in older, heavier individuals, consistent with age-related decline in drug clearance. These results align with the known metabolism of all three drugs via hepatic cytochrome P450 enzymes, with minimal contribution from prostate tissue to drug elimination. Importantly, the findings suggest that intrinsic alterations in prostate tissue due to cancer are unlikely to require dosing adjustments. Instead, patient-specific factors, particularly age and body weight, which are common comorbidities and modifiers in prostate cancer, should be key considerations when optimizing treatment regimens involving EFV, ETV, or SAQ in oncology.

Conclusion: This work supports the feasibility of repurposing antiretroviral agents for cancer treatment and underscores the utility of PBPK modeling in predicting drug behavior across diverse patient populations, ultimately contributing to safer and more effective individualized therapies.

P19

Ketones: a New Hope for a Failing Heart

Alexandre Gonçalves^1,2^, Inês N Alves^1,2^, Cláudia Mendes^1,2^, Daniela Miranda^1,2^, Glória Conceição^2,3^, João Almeida-Coelho^1,2^, Diana Martins^1,2^, Isabel Miranda^1,2^, Alexandre Rodrigues^1,2^, Carolina Silva^1,2^, Sandra Marisa Oliveira^1,2^, José Sereno^4^, Maria João Ferreira^4,5^, Henrique Girão^5,6^, Adelino F. Leite-Moreira^1,2^, Vasco Sequeira^7^, Inês Falcão-Pires^1,2^

^1^RISE-Health—Health Research and Innovation, Portugal, ^2^Faculdade de Medicina da Universidade do Porto (FMUP), Porto, Portugal, ^3^Cardiovascular Regeneration Program, Centro Nacional de Investigaciones Cardiovasculares (CNIC), Spain, ^4^Instituto de Ciências Nucleares Aplicadas à Saúde (ICNAS), Coimbra, Portugal, ^5^Faculdade de Medicina da Universidade do Coimbra (FMUC), Coimbra, Portugal, ^6^Coimbra Institute for Clinical and Biomedical Research (iCBR), Coimbra, Portugal, ^7^Universitätsklinikum Würzburg, Germany

Background: Heart failure with preserved ejection fraction (HFpEF) remains a major problem with limited effective therapies.

Methods: This study evaluated the therapeutic impact of ketone-based interventions—ketogenic diet (KD) and ketone salts (KS)—on cardiovascular and systemic outcomes in two preclinical rat models: ZSF1 obese rats (HFpEF) and monocrotaline (MCT)-induced right ventricular heart failure (RVHF). ZSF1 rats (n=60) were assigned to a control diet, KD, or KS; MCT or vehicle-treated Wistar rats (n=67) received either a control diet or KD. Functional assessments included echocardiography, effort testing, metabolic profiling, histology, respirometry, and molecular analyses.

Results: In the HFpEF model, both KD and KS reduced cardiac hypertrophy and fibrosis, and improved cardiomyocyte contractility and calcium handling. KS uniquely restored diastolic function and normalized cellular stiffness. Although in vivo diastolic metrics remained unchanged, cellular function was significantly enhanced. In RVHF, KD improved right ventricular output, reduced pulmonary pressure and remodeling, and lowered mortality by 44.5%, though cellular dysfunction persisted. Both interventions improved glycemia and lipid profiles, with KD further reducing cholesterol and enhancing VO_2_max in RVHF. NT-proBNP levels and pulmonary congestion were reduced in both models. Mitochondrial effects included enhanced oxidative phosphorylation with KD and structural remodeling with KS.

Conclusion: These findings suggest that ketone-based strategies, particularly exogenous ketone salts, may offer targeted therapeutic benefits in HFpEF and RVHF, warranting further clinical investigation.

P20

Improving Individualized Salbutamol Treatment: A Population Pharmacokinetic Model for Oral Salbutamol in Virtual Patients

Lara Marques^1,2^, Nuno Vale^1,2,3^

^1^PerMed Research Group, RISE-Health, Faculty of Medicine, University of Porto, Porto, Portugal, ^2^RISE-Health, Department of Community Medicine, Health Information and Decision (MEDCIDS), Faculty of Medicine, University of Porto, Porto, Portugal, ^3^Laboratory of Personalized Medicine, Department of Community Medicine, Health Information and Decision (MEDCIDS), Faculty of Medicine, University of Porto, Porto, Portugal

Background: Salbutamol, a short-acting β2-adrenergic agonist widely used in asthma management, is available in several formulations, including inhalers, nebulized solutions, oral tablets, and parenteral preparations. Each route of administration displays distinct pharmacokinetic (PK) and pharmacodynamic (PD) properties that influence therapeutic efficacy and incidence of adverse effects. Although inhalation remains the preferred method due to its rapid onset and reduced systemic exposure, oral salbutamol remains relevant in specific clinical scenarios, particularly in pediatric or resource-limited settings. Understanding how individual patient characteristics affect drug pharmacokinetics is crucial for optimizing therapy and minimizing risks.

Methods: This study aimed to evaluate the impact of patient-specific covariates, such as age, weight, sex, body surface area (BSA), cytochrome P450 (CYP) expression levels, race, and health status, on the PK of orally administered salbutamol using population pharmacokinetic (popPK) modeling. This preliminary in silico study included a virtual cohort of 40 patients, generated through physiologically based pharmacokinetic (PBPK) simulation, reflecting the administration of a single 4 mg oral dose. The best-fit model was a two-compartment structure with first-order absorption and elimination, incorporating a transit compartment to accurately capture the plasma concentration–time profile.

Results: Covariate analysis identified significant influences: sex affected both mean transit time (MTT) and clearance (Cl); weight and BSA influenced Cl and central volume of distribution (V1); and health status had a marked impact on Cl. These findings underscore pharmacokinetic variability associated with demographic and physiological factors. Notably, while oral salbutamol is currently discouraged in many treatment guidelines, the results suggest that selecting patient subgroups, particularly children, may derive greater benefits from oral formulations than previously assumed. Furthermore, the analysis identified patient characteristics linked to a heightened risk of salbutamol toxicity, emphasizing the importance of dose individualization or alternative routes of administration in vulnerable populations.

Conclusion: Overall, this study highlights the utility of popPK modeling using PBPK-generated data as a fully in silico approach to evaluate drug behavior across diverse patient profiles. These insights may support personalized and effective asthma treatment strategies, ultimately improving patient outcomes and medication safety.

P21

Community-Based Pilot Study of Chlamydia Trachomatis and Neisseria Gonorrhoeae Urogenital Infections Among Young Adults in the North and Central Coast of Portugal

Rafaela Rodrigues^1,2,3^, Sónia Loureiro^3^, Inês João^4^, Inês Jordão^5^, Maria José Borrego^4^, Carlos Catalão^6^, Ana Rita Silva^1,3^, Carlos Sousa^1,3^, Nuno Vale^1,2,7^

^1^PerMed Research Group, RISE-Health, Faculty of Medicine, University of Porto, Porto, Portugal, ^2^RISE-Health, Department of Community Medicine, Health Information and Decision (MEDCIDS), Faculty of Medicine, University of Porto, Porto, Portugal, ^3^Molecular Diagnostics Laboratory, Unilabs Portugal, Leça do Balio, Portugal, ^4^National Reference Laboratory (NRL) for Sexually Transmitted Infections (STI), Department of Infectious Diseases, National Institute of Health Doutor Ricardo Jorge, Lisboa, Portugal, ^5^Department of Medical Sciences, University of Aveiro, Aveiro, Portugal, ^6^Roche Sistemas de Diagnósticos, Amadora, Portugal, ^7^Laboratory of Personalized Medicine, Department of Community Medicine, Health Information and Decision (MEDCIDS), Faculty of Medicine, University of Porto, Porto, Portugal

Background: Chlamydia trachomatis (CT) and Neisseria gonorrhoeae (NG) are the most prevalent bacterial sexually transmitted infections (STIs) worldwide, with the highest incidence observed among individuals under the age of 25. In response to the growing burden of STIs in Europe and the frequently asymptomatic nature of these infections, we conducted a pilot study to explore the feasibility of estimating the prevalence of CT and NG genital infections among young adults aged 18–25 years, through a screening initiative in the Northern and Central Coastal regions of Portugal.

Methods: Over a six-month period, 152 urine samples were collected and tested using the cobas 4800 CT/NG assay (Roche Molecular Systems), a nucleic acid amplification test (NAAT) known for its high sensitivity and specificity. CT-positive samples were further genotyped using the Sanger sequencing method to identify the major urogenital genotypes (D–K) based on ompA gene variability, providing insights into the circulating strains in the study regions. Participants provided informed consent and completed an anonymous questionnaire addressing sociodemographic characteristics, sexual behaviors, and STI-related knowledge. All samples were anonymized and matched with the corresponding questionnaire data.

Results: Among the 152 samples, six tested positive for CT, including one case of co-infection with NG; an additional sample tested positive solely for NG. Genotyping revealed ompA-genotype E in three CT-positive samples. Notably, none of the infected participants reported symptoms, underscoring the importance of routine STI screening.

Conclusion: Despite limitations including sample size and convenience sampling, this pilot study provides preliminary insights into infection patterns and underscores the need for broader screening strategies, site-specific sampling, and culture-based diagnostics to inform evidence-based public health interventions for CT and NG infections in Portugal.

P22

Mapping the Risk of WMSDs of Critical Tasks in Fish and Checkout Sections of the Food Retail Sector

Inês Lapa^1,2,3^, Nélson Costa^2^, Matilde A. Rodrigues^1,2,3^

^1^RISE-Health, Center for Translational Health and Medical Biotechnology Research (TBIO), E2S, Polytechnic of Porto, Portugal, ^2^ALGORITMI Research Center/LASI, University of Minho, Guimarães, Portugal, ^3^Department of Environmental Health, School of Health, Polytechnic of Porto, Portugal

Background: Work-related Musculoskeletal Disorders (WMSDs) are a leading cause of occupational health complaints in the food retail sector, where repetitive tasks, awkward postures, and manual handling are common. Two high-risk areas within a supermarket are the fish department and the checkout counters. This study aims to characterize the most representative tasks in these sections and assess the associated biomechanical and organizational risks, as these are key contributing factors to the development of WMSDs, thereby supporting targeted preventive control measures.

Methods: The research was conducted in one of Portugal’s largest food retail chains and involved analysing and filtering microtasks, retaining the most representative. Of these, 30 of 49 were in the fish department, and 3 of 21 were in checkout. Risk levels for different body regions were assessed using different risk assessment methods, including RULA, REBA, and XSENS motion capture, and harmonized into a unified risk scale. To strengthen the findings, data were triangulated using the Nordic Musculoskeletal Questionnaire.

Results: The results showed that, in the checkout, the most affected body regions were wrists, shoulders, and lower back, due to repetitive item handling and prolonged standing. In the fish department, very high risks were observed in the shoulders, elbow, neck and lower back due to forceful and repetitive tasks such as cleaning.

Conclusion: This study provides an initial structured approach to identifying biomechanical and organizational facilitating preventive strategies and supporting improved occupational health outcomes. Future work will expand the analysis to a larger scale and include further validation.

P23

Evaluating the Impact of a Speech-Language Therapist-Led Breastfeeding Intervention Among Migrant Mothers in Primary Healthcare: A Randomized Controlled Trial

Ana Cláudia Lopes^1^, Marisa Lousada^1,2^

^1^RISE-Health, University of Aveiro, Aveiro, Portugal, ^2^School of Health Sciences (ESSUA), University of Aveiro, Aveiro, Portugal

Background: As more migrant women give birth in Portugal, accessible and culturally sensitive breastfeeding support becomes increasingly vital. Despite their expertise in infant feeding, speech-language therapists remain underrecognized in maternal care. This randomized controlled trial aimed to evaluate the effectiveness of a culturally adapted speech and language therapist-led breastfeeding intervention.

Methods: Seventy-four migrant women from 15 nationalities and four continents recruited from primary healthcare settings in Lisbon were randomly assigned to either a control group (n=37) or an intervention group (n=37). The control group received standard care, whereas the intervention group received a culturally adapted program that included a prenatal group breastfeeding workshop, early feeding assessment, and individualized counselling to support breastfeeding. The intervention was interdisciplinary, integrating other healthcare professionals to ensure comprehensive care when necessary. Pre- and post-workshop questionnaires were used to assess changes in participants' knowledge, attitudes, beliefs, and practices regarding breastfeeding in the intervention group. All participants were followed up at 1, 3, and 6 months postpartum. At each assessment moment, standardized measures were administered, using the Neonatal Oral-Motor Assessment Scale, the Breastfeeding Self-Efficacy Scale, and the Maternal Postpartum Quality of Life Questionnaire.

Results: Results show that maternal self-efficacy, postpartum quality of life, and exclusive breastfeeding rates were consistently higher in the intervention group. At one month, 91.9% of women in the intervention group were exclusively breastfeeding versus 51.4% in the control group (RR = 1.79, 95% CI: 1.29–2.48, P < 0.001). At three months, rates were 91.9% versus 27.0% (RR = 3.40, 95% CI: 1.99–5.82, P < 0.001), and at six months, 91.9% versus 18.9% (RR = 4.86, 95% CI: 2.48–9.53, P < 0.001). Odds ratios showed an even stronger association (OR = 10.7, 30.3, and 47.6 at 1, 3, and 6 months, respectively).

Conclusion: These findings are expected to contribute to a growing body of evidence on culturally adapted interventions that reduce inequalities in breastfeeding.

P24

WinWORK: Co-creating Healthy Work Environments with Stakeholders to Improve Occupational Health

Mariana Ferraz^1^, Joana Carvalho dos Santos^1,2^, Ana Pinto^3^, Telma Margarida Alves^3^, Inés Farfán^4^, José C. Sánchez Garcia^4^, Luis Polo Ferrero^4^, Roberto Méndez Sánchez^4^

^1^RISE-Health, Center for Translational Health and Medical Biotechnology Research (TBIO), E2S, Polytechnic of Porto, Porto, Portugal, ^2^Associated Laboratory for Energy, Transports and Aeronautics (INEGI/PROA/LAETA), Faculty of Engineering, University of Porto, Porto, Portugal, ^3^Universidade de Coimbra, Coimbra, Portugal, ^4^Universidade de Salamanca, Spain

Background: Promoting health and well-being in the workplace is increasingly recognized as essential for employee satisfaction, productivity, and long-term organizational success. The WinWORK project aims to develop healthier, more inclusive work environments through a multidisciplinary intervention based on ergonomics, mental health, and physical activity, implemented in the cross-border region between Portugal and Spain.

Methods: The methodology was based on co-creation workshops involving workers and organizational leaders from multiple companies. In total, six workshops were conducted with 90 participants, identifying key strengths and challenges in their work settings.

Results: Workers emphasized positive aspects such as teamwork, good communication, and access to personal protective equipment (PPE), but also reported concerns, including manual load handling, prolonged static postures, noise, stress, and inadequate footwear. Leaders recognized institutional support but highlighted challenges like resistance to change, workstation layout, and thermal discomfort. Based on the findings, shared priorities for intervention included task rotation, ergonomic adjustments, postural support tools, improved exercise routines, and strategies to support mental well-being.

Conclusion: The co-creation approach proved essential in aligning scientific knowledge with real-world practices, ensuring that proposed solutions were both viable and sustainable. WinWORK demonstrated that engaging stakeholders is crucial for translating evidence into action. The project has already informed policy adjustments in participating institutions and fostered the adoption of preventive occupational health measures, contributing to more resilient and sustainable work environments.

ORAL COMMUNICATIONS

O1

European Portuguese Version of the Michigan Hand Outcomes Questionnaire (MHQ): Cross-Cultural Adaptation and Electronic Format Validation

Eugénio Moita Gonçalves^1,2,3^, Maria Catarina Silva^2^, Henrique Ribeiro^1,3^, Mariana Almeida^1,3^, Bernardo Filipe^1,3^, Sandra Branco^1,3^, Filipa Henriques^1,3^, Lilibeth Campos^1,3^, Ana Campolargo^1,3^, Pedro Cantista^4^, Miguel Bernardes^5,6^, Cristina Jácome^2^

^1^Physical Medicine and Rehabilitation Department, Unidade Local de Saúde de Gaia e Espinho, Porto, Portugal, ^2^RISE-Health, Department of Community Medicine, Information and Health Decision Sciences, Faculty of Medicine, University of Porto, Porto, Portugal, ^3^Clinical Academic Center Egas Moniz Health Alliance, Aveiro, Portugal, ^4^Physical Medicine and Rehabilitation Department, Unidade Local de Saúde de Santo António, Porto, Portugal, ^5^Rheumatology Department, Unidade Local de Saúde do São João, Porto, Portugal, ^6^Department of Medicine, Faculty of Medicine, University of Porto, Portugal

Background: The Michigan Hand Outcomes Questionnaire (MHQ) is an instrument for assessing hand conditions, and no version exists in European Portuguese. This study aimed to translate, culturally adapt, and validate the MHQ for European Portuguese and compare the measurement properties and equivalence of its paper and electronic versions.

Methods: A three-phase observational study was followed. Phase 1 involved translation and expert panel review. Phase 2 refined the instrument through cognitive interviews. In Phase 3, 81 adult patients with hand conditions were recruited and randomly assigned to complete either the paper or electronic version first, followed by the alternate version after a one-week interval. Measurement properties included internal consistency (Cronbach's α), convergent validity (Spearman's rho), test–retest reliability (intraclass correlation coefficient, ICC), and agreement. The electronic version was evaluated using the System Usability Scale (SUS), and participants indicated their preferences.

Results: The European Portuguese MHQ version demonstrated excellent internal consistency (Cronbach's α = 0.85-0.98). However, the original six-factor structure could not be confirmed, and exploratory factor analysis revealed differing structures between the paper and electronic versions. While the two formats showed strong comparability at a group level (ICC = 0.76–0.95), Bland-Altman analysis revealed wide limits of agreement, preventing their interchangeability for individual patient monitoring. The electronic version demonstrated superior measurement precision (lower SEM) and acceptable usability (median SUS score = 70), and was the preferred format for most participants (58.1%).

Conclusion: The European Portuguese MHQ is a reliable instrument suitable for group-level assessment in clinical research, enabling standardized hand outcomes assessment in Portuguese-speaking populations. However, its factor structure requires further investigation. Due to significant measurement error between formats, a single version must be used consistently for longitudinal monitoring. Given its superior precision, lack of missing data, and user preference, the electronic version is recommended for clinical and research applications.

O2

Citizen Involvement in Secondary Research: Towards More Transparent, Relevant and Societally-Oriented Evidence

Rosa Silva^1^, Elaine Santana^2^, Joana Bernardo^2^, Teresa Loureiro^3^, Paulo Marques^1^, Sílvia Silva^2^

^1^RISE-Health, Escola Superior de Enfermagem do Porto, ^2^Health Sciences Research Unit: Nursing, Nursing School of Coimbra, Coimbra, Portugal, ^3^Citizen Science Consultant, Project “Ciência Cidadã: do fazer ao comunicar ciência na ótica do cidadão”

Background: Citizen involvement in research has emerged as a powerful strategy to promote more transparent, relevant, and community-oriented scientific outcomes. Although widely promoted in primary research, its application in secondary research—such as systematic reviews—has been less explored. This study aims to identify international methodological recommendations for citizen involvement in secondary research and reflect on its contribution to aligning science with community health needs.

Methods: A documentary analysis was conducted on international guidelines and frameworks addressing public involvement in secondary research, particularly systematic reviews. Additionally, a citizen with previous experience in research engagement was actively involved in the article that supports this abstract (Silva, et al., 2025), contributing to editing, identifying complex terms for lay translation, and preparing the lay summary.

Results: The analysis highlighted several practical recommendations for citizen inclusion throughout the systematic review process, including planning, protocol development, data interpretation, and dissemination. The citizen partner's involvement proved valuable in refining scientific language and ensuring accessibility of content, illustrating the practical benefits of a collaborative approach.

Conclusion: Involving citizens in secondary research not only meets the ethical and social demands of citizen science but also strengthens the alignment between health research and community priorities.

O3

The Unseen Burden of a Smile: Why Oral Health Deserves a Place in Universal Health Coverage

Ekta Pandey^1,2^, Rui Amaral Mendes^1,2^

^1^Faculty of Medicine, University of Porto, Porto, Portugal, ^2^RISE-Health, Porto, Portugal

Background: Oral health is a neglected public health challenge in India, affecting nearly 70% of the population. Conditions such as dental caries and periodontitis have significant impacts on overall health, productivity, and quality of life. Despite this, oral health remains largely excluded from India’s Universal Health Coverage (UHC) initiatives like Ayushman Bharat. This study aims to quantify the economic burden of untreated oral diseases to support their inclusion in UHC policies.

Methods: Using secondary data from the National Sample Survey Organisation, Global Burden of Disease study, National Family Health Survey, and relevant literature, we estimated the direct costs, including out-of-pocket expenses, and indirect costs related to productivity loss measured through disability-adjusted life years (DALYs). Logistic regression was employed to identify socioeconomic factors influencing dental care utilization, while equity metrics assessed disparities across income, education, gender, and geographic location.

Results: Findings indicate a substantial economic burden on individuals and the health system, with disproportionate effects on low-income and rural populations. Productivity losses were especially high among working-age adults and women. Barriers to dental care access were strongly associated with income, insurance coverage, and educational attainment. The combined direct and indirect costs of untreated oral diseases are estimated. The hospitalization expenditure median value was estimated to be 125 US$ as per the NSSO 75th round dataset.

Conclusion: This research underscores the critical need to integrate oral health services into India’s UHC agenda. Expanding basic dental care within primary health care can reduce health inequities, lower economic losses, and improve overall population health. The findings also offer insights relevant to other low- and middle-income countries confronting similar challenges.

O4

Therapeutic Relationship in Mental Health Nursing: an Assessment Instrument from the Patient's Perspective

Joana Coelho^1,2,3^, Joana Ribeiro^4^, Ana Rita Ribeiro^4^, Ana Carolina Trindade^4^, Carlos Sequeira^2,5^, Juan Roldán-Merino^6,7^, Antonio Moreno Poyato^8,9^, Francisco Sampaio^2,5^

^1^Northern Health Higher School of the Portuguese Red Cross, Oliveira de Azeméis, Portugal, ^2^RISE-Health, Nursing School of Porto (ESEP), Porto, Portugal, ^3^Faculty of Medicine, University of Porto, Porto, Portugal, ^4^Psychiatry Department, Gaia and Espinho Local Health Unit, Vila Nova de Gaia, Portugal, ^5^Nursing School of Porto, Porto, Portugal, ^6^Nursing School of Barcelona, Campus Docent Sant Joan de Déu-Private Foundation, University of Barcelona, Barcelona, Spain, ^7^Grup de Recerca en Cures Infermeres de Salut Mental, Psicosocials i de Complexitat NURSEARCH—2021 SGR 1083, Barcelona, Spain, ^8^Department of Public Health, Mental Health and Maternal and Child Health Nursing, Faculty of Nursing, Universitat de Barcelona, L'Hospitalet de Llobregat, Spain, ^9^Grup de Recerca en Cures Infermeres de Salut Mental, L'Hospitalet de Llobregat, Spain

Background: The therapeutic relationship plays a pivotal role in mental health care, exerting a significant influence on treatment outcomes and the recovery process. Despite its recognised importance, there is no validated instrument to assess this relationship from the patient’s perspective. This study aimed to develop and psychometrically evaluate an assessment tool designed to measure the quality of the therapeutic relationship as perceived by patients.

Methods: An e-Delphi study involving mental health nursing experts was conducted to identify and reach consensus on the most relevant items for the instrument. A subsequent psychometric evaluation was carried out with a sample of 240 adults diagnosed with a mental disorder, in order to assess internal consistency, construct validity, and reliability. Internal consistency was examined using Cronbach's alpha and Omega coefficients, while test-retest reliability was evaluated via the intraclass correlation coefficient (ICC).

Results: The resulting instrument, the Therapeutic Relationship Assessment Scale-Patient (TRAS-Patient), demonstrated robust psychometric properties. The final version comprises 24 items distributed across two factors, accounting for 64.2% of the total variance. Cronbach’s alpha was 0.94 and the Omega coefficient 0.96, indicating excellent internal consistency. The ICC was 0.84 (95% CI: 0.66–0.92), reflecting high reliability.

Conclusion: The TRAS-Patient constitutes a scientifically sound and clinically relevant instrument for assessing the therapeutic relationship from the patient's viewpoint. It promotes a person-centred approach, facilitating a deeper understanding of patient needs and experiences. Its use may support mental health professionals in strengthening therapeutic engagement and tailoring interventions that foster active patient involvement in care and recovery pathways.

O5

Molecular Tool for Early Gastric Cancer Detection and Surveillance: Developing a Novel Gene Expression Signature

Catarina Lopes^1,2,3^, Andreia Brandão^4^, Sofia Paulino^5^, Mário Dinis-Ribeiro^1,6^, Carina Pereira^1^

^1^Precancerous Lesions and Early Cancer Management Group, Research Center of IPO Porto (CI-IPOP)/CI-IPOP@RISE (Health Research Group), Portuguese Oncology Institute of Porto (IPO Porto)/Porto Comprehensive Cancer Center Raquel Seruca (Porto.CCC), Porto, Portugal, ^2^Center for Health Technology and Services Research (CINTESIS@RISE), University of Porto, Porto, Portugal, ^3^ICBAS—School of Medicine and Biomedical Sciences, University of Porto, Porto, Portugal, ^4^Cancer Genetics Group, Research Center of IPO Porto (CI-IPOP)/CI-IPOP@RISE (Health Research Group), Portuguese Oncology Institute of Porto (IPO Porto)/Porto Comprehensive Cancer Center Raquel Seruca (Porto.CCC), Porto, Portugal, ^5^Department of Pathology, Portuguese Oncology Institute of Porto, Portugal, ^6^Department of Gastroenterology, Portuguese Oncology Institute of Porto, Portugal

Background: When detected early, gastric cancer (GC) can be treated endoscopically, with improved survival rates and quality of life. Nevertheless, patients require intensive surveillance due to a 10-20% risk of developing metachronous gastric lesions (MGL).

Methods: This study aimed to identify and validate a gene expression signature capable of detecting early GC and to assess its utility for predicting MGLs during post-treatment surveillance following curative endoscopic submucosal dissection (ESD). Using RNA sequencing data from formalin-fixed paraffin-embedded tissue samples, including 23 controls with histologically normal mucosa and 28 cases with low-/high-grade dysplasia or adenocarcinoma, machine learning methods identified a seven-gene panel with three upregulated and four downregulated genes in patients with gastric lesions. The signature was validated by real-time PCR in a larger cohort of 279 samples (123 controls, 156 cases), randomly split into discovery and validation sets.

Results: Logistic regression models incorporating gene expression, age, and sex achieved excellent performance in distinguishing lesions from normal tissue (AUC = 0.96; sensitivity 90%; specificity 94%). While the original model did not predict MGL development, a new model trained exclusively on cases showed promising diagnostic accuracy (AUC = 0.74; sensitivity 85%; specificity 72%).

Conclusion: These findings support the potential of a new gene expression signature for the early GC detection and individualized management in Western populations.

O6

Levosimendan and 5-FU Synergy in Cancer Cells: Targeting Viability and Migration with Minimal Toxicity

Eduarda Ribeiro^1,2,3^, Nuno Vale^1,2,4^

^1^PerMed Research Group, RISE-Health, Faculty of Medicine, University of Porto, Porto, Portugal, ^2^RISE-Health, Department of Community Medicine, Health Information and Decision (MEDCIDS), Faculty of Medicine, University of Porto, Porto, Portugal, ^3^Institute of Biomedical Sciences Abel Salazar (ICBAS), University of Porto, Porto, Portugal, ^4^Laboratory of Personalized Medicine, Department of Community Medicine, Health Information and Decision (MEDCIDS), Faculty of Medicine, University of Porto, Porto, Portugal

Background: Cancer therapy is frequently hindered by drug resistance and systemic toxicity, underscoring the need for more effective and safer treatment strategies. Drug repurposing presents a promising approach to address these challenges by uncovering novel oncological applications for existing compounds. This study explored the therapeutic potential of combining 5-fluorouracil (5-FU) with vasodilator agents, with a particular focus on levosimendan, in lung and urological cancer models.

Results: In vitro experiments using A549 lung cancer cells demonstrated that levosimendan alone reduced cell viability by approximately 40% (P < 0.01), while its combination with 5-FU significantly enhanced cytotoxicity and suppressed clonogenicity by up to 60% (P < 0.001). Comparable synergistic effects were observed in urological cancer cell lines, where the co-treatment more effectively impaired viability, migration, and proliferation compared to monotherapies. Mechanistically, levosimendan's anti-tumor activity may involve modulation of intracellular cAMP levels and nitric oxide signaling, contributing to its anti-migratory and anti-proliferative effects. Importantly, these effects appeared to be selective for malignant cells, suggesting limited toxicity toward non-cancerous counterparts.

Conclusion: Collectively, these findings highlight the therapeutic value of repurposing levosimendan in combination with 5-FU to enhance anticancer efficacy and potentially mitigate chemotherapy-associated toxicity. This strategy offers a compelling direction for the development of innovative combination regimens in oncology and warrants further mechanistic and translational investigation.

O7

Fetal Programming of Obesity: Effect of Maternal Stevia Consumption

Isabella Bracchi^1,2^, Margarida Barbosa^3^, Maria Inês Vieira^3^, Ana Carolina Esteves^3^, Carina Martins^4^, Inês Rocha^5,6^, Diogo Pestana^7^, Rita Negrão^1^, Elisa Keating^1^

^1^RISE-Health, Department Biomedicine, Unit of Biochemistry, Faculty of Medicine, University of Porto, Porto, Portugal, ^2^ESS, Polytechnic of Porto, Porto, Portugal, ^3^Department Biomedicine, Unit of Biochemistry, Faculty of Medicine, University of Porto, Porto, Portugal, ^4^Faculty of Nutrition and Food Sciences, University of Porto, Porto, Portugal, ^5^Faculty of Health Sciences, Fernando Pessoa University, Porto, Portugal, ^6^Nutrition & Metabolism, NOVA Medical School, FCM, NOVA University Lisbon, Lisbon, Portugal, ^7^CHRC, Nutrition and Metabolism, NOVA Medical School, FCM, NOVA University Lisbon, Lisbon, Portugal

Background: The consumption of non-sugar sweeteners (NSS) by pregnant women has increased in recent decades. Stevia is a natural NSS, with Rebaudioside A (RebA) being one of its main sweetener components. Recently, the WHO discouraged the consumption of NSS, highlighting the need to assess their safety during the early stages of development. This study aims to investigate if maternal RebA consumption is a fetal programming factor for metabolic dysfunction of offspring.

Methods: Female Sprague Dawley dams received RebA in the drinking water (4 mg steviol equivalents/kg body weight/day, the EFSA’s ADI) from 4 weeks before mating until weaning (RebA, n=8), or water as control (C, n=8). Female offspring (G1) were weaned onto a standard diet until 8 months of age, when they either continued or switched to a high-fat diet until 10 months. G1 morphometry, food and water intake, adipose tissue morphology (H&E staining), and blood levels of adiponectin (ELISA) were evaluated.

Results: Early-life exposure to RebA increased body weight from 8 months of age and onwards (P=0.0165 vs. controls); however, no differences were found in food and water intake. Additionally, maternal consumption of RebA induced adipocyte hypertrophy in adult female offspring (P=0.0271) and reduced blood adiponectin levels (P<0.0001), changing the evolution of its concentration from 2 to 10 months of age (P=0.0279).

Conclusion: Maternal consumption of RebA programmed female offspring to an increased body weight and to adipocyte hypertrophy in adulthood. This study also suggests that adiponectin may represent an early marker of metabolic dysfunction, as evidenced by its decreased levels at 2 months of age in G1-RebA.

O8

Age-Dependent Effects of Water-Avoidance Stress in a Rat Model of Interstitial Cystitis/Bladder Pain Syndrome

Mariana Santos-Pereira^1^, Susana M Silva^2^, Liliana Santos-Leite^3^, Francisco Cruz^4^, Ana Charrua^5^

^1^Departamento de Biomedicina, Unidade de Biologia Experimental, Faculdade de Medicina da Universidade do Porto, Porto, Portugal, ^2^RISE-Health, Departamento de Biomedicina, Unidade de Anatomia, Faculdade de Medicina da Universidade do Porto, Porto, Portugal, ^3^Departamento de Recursos Comuns, Centro de Recurso Animais, Faculdade de Medicina da Universidade do Porto, Porto, Portugal, ^4^RISE-Health, Departamento de Cirurgia e Fisiologia, Faculdade de Medicina da Universidade do Porto, Porto, Portugal, ^5^RISE-Health@FMUP, Departamento de Biomedicina, Unidade de Biologia Experimental, Faculdade de Medicina da Universidade do Porto, Porto, Portugal

Background: Animal models are fundamental for investigating interstitial cystitis/bladder pain syndrome (IC/BPS). However, the water-avoidance stress (WAS) paradigm has never been assessed across different age groups, despite clear age-dependent phenotypes observed in patients.

Methods: We evaluated the response of adult (6-month), mature (15-month), and aged (23-month) female Wistar rats to a 10-day WAS protocol (1h/day on a platform in water), using age-matched naïve controls on a dry platform. Pain-related behavior (grimace scale and von Frey mechanical thresholds) and bladder function (voiding-spot assay) were assessed before and after stress, whereas anxiety-like coping (marble burying) and reflex cystometry were compared in a between-subjects design. Data (mean ± SD or median [IQR]) were analyzed by paired/unpaired t-tests, Wilcoxon tests, one-way ANOVA with Fisher's LSD, and Fisher's exact test.

Results: Only 6-month-old rats exhibited a significant grimace increase (Cohen's d = 1.71), L6–S1 mechanical sensitization (Cliff's d = 7.10) and bladder hyperactivity versus controls (0.82 ± 0.11 vs. 0.48 ± 0.13 voids/min). There was a non-significant trend toward increased small-volume voiding spots and marble burying in the 6-month group only. In contrast, 15- and 23-month-old animals showed no changes in any parameter.

Conclusion: These findings indicate that WAS elicits pain-behavior, urinary urgency, and anxiety-like responses exclusively in young-adult females, whereas stress reactivity is blunted with age. Consequently, age must be considered when using the WAS model for IC/BPS research, and alternative paradigms (e.g., cyclophosphamide-induced cystitis) may better capture disease-relevant phenotypes in older animals. Moreover, voiding-spot assay parameters (e.g., observation duration) warrant refinement for sensitive detection of bladder changes.

O9

Reforming Research Assessment: the Path and Challenges of the Portuguese National Chapter of CoARA

Eugénio Campos Ferreira

Centre of Biological Engineering, University of Minho, Braga, Portugal

The establishment of the Portuguese National Chapter of CoARA - Coalition for Advancing Research Assessment—marks a milestone in the national reflection on research assessment models. The Chapter currently brings together more than twenty Portuguese institutions, including universities, associated laboratories, research units, and FCT, that have endorsed the Agreement on Reforming Research Assessment. This international commitment, signed by over 700 institutions across more than 50 countries, advocates for the adoption of more qualitative, inclusive, and open science–aligned assessment practices, fostering a culture that values the diversity of research careers, contributions, and impacts. The Portuguese National Chapter of CoARA is structured around three main areas of action: mapping and disseminating best practices; implementing pilot projects and research on research activities; and promoting mutual learning and collaboration among institutions. This collective effort aims to align assessment reform with the diversity and context of the national research system, fostering synergies between policies, funding agencies, and universities. The presentation will highlight the main achievements so far, the ongoing action plan, and the challenges of transitioning from a metric-driven assessment model towards one that is more qualitative, contextualized, and focused on the scientific and societal impact of research.

O10

Practice-Based Research Networks in Primary Care: Building an Infrastructure for Discovery, Improvement and System Change

Onil Bhattacharyya ^1,2^

^1^Frigon Blau Chair, Family Medicine Research, Women's College Hospital, Toronto, Canada, ^2^Department of Family and Community Medicine, University of Toronto, Toronto, Canada

Strong primary care systems have a substantial impact on population health, experience of care, per capita costs, and equity of health outcomes. However, there is a limited evidence base generated in primary care to inform practice and organization of care, since most research is conducted in hospitals and specialized care settings. Primary care is inherently difficult to study, since the organizations are small, have limited resources, and a workforce focused on care delivery rather than research. Research networks have been used to facilitate the growth of specialized research areas, but have enormous potential in primary care. This presentation will describe the key pillars of effective primary care research networks. This includes practice-based research networks (primary care practices that participate in studies), large databases of electronic medical records and patient-reported measures, and systems for coordinating observational studies or trials. It will describe the formation and structure of the Canadian Primary Care Research Consortium in relation to comparable structures in other countries. It will then highlight examples of different emphasis for practice-based research networks, such as community engagement, clinical quality improvement, research or informing policy. The presentation will conclude with strategic choices for countries and researchers establishing primary care research networks to strengthen the foundation of health systems.