| 1. |
- Neves, Ana Luisa, et al.
(författare)
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Determinants of the Use of Health and Fitness Mobile Apps by Patients With Asthma : Secondary Analysis of Observational Studies
- 2021
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Ingår i: Journal of Medical Internet Research. - : JMIR Publications. - 1438-8871. ; 23:9
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Tidskriftsartikel (refereegranskat)abstract
- Background: Health and fitness apps have potential benefits to improve self-management and disease control among patients with asthma. However, inconsistent use rates have been reported across studies, regions, and health systems. A better understanding of the characteristics of users and nonusers is critical to design solutions that are effectively integrated in patients' daily lives, and to ensure that these equitably reach out to different groups of patients, thus improving rather than entrenching health inequities. Objective: This study aimed to evaluate the use of general health and fitness apps by patients with asthma and to identify determinants of usage. Methods: A secondary analysis of the INSPIRERS observational studies was conducted using data from face-to-face visits. Patients with a diagnosis of asthma were included between November 2017 and August 2020. Individual-level data were collected, including age, gender, marital status, educational level, health status, presence of anxiety and depression, postcode, socioeconomic level, digital literacy, use of health services, and use of health and fitness apps. Multivariate logistic regression was used to model the probability of being a health and fitness app user. Statistical analysis was performed in R. Results: A total of 526 patients attended a face-to-face visit in the 49 recruiting centers and 514 had complete data. Most participants were <= 40 years old (66.4%), had at least 10 years of education (57.4%), and were in the 3 higher quintiles of the socioeconomic deprivation index (70.1%). The majority reported an overall good health status (visual analogue scale [VAS] score>70 in 93.1%) and the prevalence of anxiety and depression was 34.3% and 11.9%, respectively. The proportion of participants who reported using health and fitness mobile apps was 41.1% (n=211). Multivariate models revealed that single individuals and those with more than 10 years of education are more likely to use health and fitness mobile apps (adjusted odds ratio [aOR] 2.22, 95%CI 1.05-4.75 and aOR 1.95, 95%CI 1.12-3.45, respectively). Higher digital literacy scores were also associated with higher odds of being a user of health and fitness apps, with participants in the second, third, and fourth quartiles reporting aORs of 6.74 (95%CI 2.90-17.40), 10.30 (95%CI 4.28-27.56), and 11.52 (95%CI 4.78-30.87), respectively. Participants with depression symptoms had lower odds of using health and fitness apps (aOR 0.32, 95%CI 0.12-0.83). Conclusions: A better understanding of the barriers and enhancers of app use among patients with lower education, lower digital literacy, or depressive symptoms is key to design tailored interventions to ensure a sustained and equitable use of these technologies. Future studies should also assess users' general health-seeking behavior and their interest and concerns specifically about digital tools. These factors may impact both initial engagement and sustained use.
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| 2. |
- Cachim, Afonso, et al.
(författare)
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Measuring adherence to inhaled control medication in patients with asthma : Comparison among an asthma app, patient self-report and physician assessment
- 2023
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Ingår i: Clinical and Translational Allergy. - : John Wiley & Sons. - 2045-7022 .- 2045-7022. ; 13:2
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Tidskriftsartikel (refereegranskat)abstract
- BackgroundPrevious studies have demonstrated the feasibility of using an asthma app to support medication management and adherence but failed to compare with other measures currently used in clinical practice. However, in a clinical setting, any additional adherence measurement must be evaluated in the context of both the patient and physician perspectives so that it can also help improve the process of shared decision making. Thus, we aimed to compare different measures of adherence to asthma control inhalers in clinical practice, namely through an app, patient self-report and physician assessment.MethodsThis study is a secondary analysis of three prospective multicentre observational studies with patients (≥13 years old) with persistent asthma recruited from 61 primary and secondary care centres in Portugal. Patients were invited to use the InspirerMundi app and register their inhaled medication. Adherence was measured by the app as the number of doses taken divided by the number of doses scheduled each day and two time points were considered for analysis: 1-week and 1-month. At baseline, patients and physicians independently assessed adherence to asthma control inhalers during the previous week using a Visual Analogue Scale (VAS 0–100).ResultsA total of 193 patients (72% female; median [P25–P75] age 28 [19–41] years old) were included in the analysis. Adherence measured by the app was lower (1 week: 31 [0–71]%; 1 month: 18 [0–48]%) than patient self-report (80 [60–95]) and physician assessment (82 [51–94]) (p < 0.001). A negligible non-significant correlation was found between the app and subjective measurements (ρ 0.118–0.156, p > 0.05). There was a moderate correlation between patient self-report and physician assessment (ρ = 0.596, p < 0.001).ConclusionsAdherence measured by the app was lower than that reported by the patient or the physician. This was expected as objective measurements are commonly lower than subjective evaluations, which tend to overestimate adherence. Nevertheless, the low adherence measured by the app may also be influenced by the use of the app itself and this needs to be considered in future studies.
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| 3. |
- Simoes Cunha, Mafalda, et al.
(författare)
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Symptoms of anxiety and depression in patients with persistent asthma : a cross-sectional analysis of the INSPIRERS studies
- 2023
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Ingår i: BMJ Open. - : BMJ Publishing Group Ltd. - 2044-6055. ; 13:5
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Tidskriftsartikel (refereegranskat)abstract
- ObjectivesAnxiety and depression are relevant comorbidities in asthma, but, in Portugal and Spain, data on this topic are scarce. We assessed, in patients with asthma, the frequency of anxiety and depression using the Hospital Anxiety and Depression Scale (HADS) and the European Quality of Life Five Dimension Questionnaire (EQ-5D); the level of agreement between these questionnaires, and the factors associated with these symptoms.MethodsThis is a secondary analysis of the INSPIRERS studies. A total of 614 adolescents and adults with persistent asthma (32.6 +/- 16.9 years, 64.7% female) were recruited from 30 primary care centres and 32 allergy, pulmonology and paediatric clinics. Demographic and clinical characteristics, HADS and EQ-5D were collected. A score >= 8 on Hospital Anxiety and Depression Scale-Anxiety/Hospital Anxiety and Depression Scale-Depression or a positive answer to EQ-5D item 5 indicated the presence of these symptoms. Agreement was determined by Cohen's kappa. Two multivariable logistic regressions were built.ResultsAccording to HADS, 36% of the participants had symptoms of anxiety and 12% of depression. According to EQ-5D, 36% of the participants had anxiety/depression. The agreement between questionnaires in identifying anxiety/depression was moderate (k=0.55, 95% CI 0.48 to 0.62). Late asthma diagnosis, comorbidities and female gender were predictors of anxiety/depression, while better asthma control, health-related quality of life and perception of health were associated with lower odds for anxiety/depression.ConclusionAt least 1/3 of the patients with persistent asthma experience symptoms of anxiety/depression, showing the relevance of screening these disorders in patients with asthma. EQ-5D and HADS questionnaires showed a moderate agreement in the identification of anxiety/depression symptoms. The identified associated factors need to be further investigated in long-term studies.
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| 4. |
- Salles-Filho, Sergio Luiz Monteiro, et al.
(författare)
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Monitoring and Evaluation as a Way to Complete and to Implement a Policy : The Case of Brazilian National Innovation Policy
- 2022
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Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- The present National Innovation Policy (henceforth called PNI) was instituted in Brazil by Decree No. 10.537, of October 28, 2020, within the federal public administration. The policy's objective is to guide, coordinate and articulate strategies, programs, and actions across several public entities to foster innovation in the productive sector. Thus, it aims to increase the productivity and competitiveness of companies and other institutions throughout the innovation process. The policy is structured around six axes: funding innovation, innovation culture, technological background, market development, educational systems, and intellectual property. Objectives and guidelines are defined for each of these Axes. However, neither a previous Theory of Change, a Logical Framework, nor a monitoring and evaluation system was established to guide the implementation. Operationally speaking, the policy was implemented by gathering ongoing actions from eighteen different federal ministries and agencies and then assigning them to the axes above. It was an ad hoc measure to put the policy into practice. As can be inferred, the selected actions did not emerge as a breakdown from axes. In 2021 the design and implementation of a monitoring and evaluation model (M&E) were commissioned to an independent evaluation group. The objective was to develop an original methodology and indicators for monitoring and evaluating outputs, outcomes and impacts of the PNI. The challenge of the model is twofold: to adjust the matching amongst actions, axes, and the policy's objectives, and to implement a common framework for M&E able to coordinate the involved agencies. A Theory of Change and a Logical Framework were ex-post designed and validated, and based on these references, the model was conceived. It defined a classical template for monitoring the ongoing actions (using flags and lights according to execution), adding indicators of outcomes and impacts. It is an integrated M&E model that, once implemented, will require that new actions be justified not only in terms of their outputs but also on the expected outcomes and impacts. Standard indicators of science, technology and innovation outcomes and impacts from different sources as for OECD, UNESCO, Global Innovation Index and Sustainable Development Goals (SDG/UN) have been gathered and organized to be employed in the M&E process. Non-standard indicators are also foreseen so that the model can measure internationally comparable and specific indicators. The whole model is now under development and validation among stakeholders. We expect this process to go beyond the domain of M&E and influences the way priorities are defined, and governance is established and run. By involving different actors, incorporating the SDGs into the policy's core, the evaluation process facilitated the policy's implementation and coordination. Furthermore, the articulation between the different stakeholders, promoted by the M&E, minimized fragmentation and uncoordinated actions within the scope of the policy's formulation. It is in this sense that the evaluation process is a way to transform the policy itself
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| 5. |
- Attermeyer, Katrin, et al.
(författare)
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Carbon dioxide fluxes increase from day to night across European streams
- 2021
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Ingår i: Communications Earth & Environment. - : Springer Nature. - 2662-4435. ; 2:1
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Tidskriftsartikel (refereegranskat)abstract
- Globally, inland waters emit over 2 Pg of carbon per year as carbon dioxide, of which the majority originates from streams and rivers. Despite the global significance of fluvial carbon dioxide emissions, little is known about their diel dynamics. Here we present a large-scale assessment of day- and night-time carbon dioxide fluxes at the water-air interface across 34 European streams. We directly measured fluxes four times between October 2016 and July 2017 using drifting chambers. Median fluxes are 1.4 and 2.1mmolm(-2) h(-1) at midday and midnight, respectively, with night fluxes exceeding those during the day by 39%. We attribute diel carbon dioxide flux variability mainly to changes in the water partial pressure of carbon dioxide. However, no consistent drivers could be identified across sites. Our findings highlight widespread day-night changes in fluvial carbon dioxide fluxes and suggest that the time of day greatly influences measured carbon dioxide fluxes across European streams. Diel patterns can greatly impact total stream carbon dioxide emissions, with 39% greater carbon dioxide flux during the night-time relative to the day-time, according to a study of 34 streams across Europe.
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| 6. |
- Basso, Marcos Fernando, et al.
(författare)
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Overexpression of a soybean Globin (GmGlb1-1) gene reduces plant susceptibility to Meloidogyne incognita
- 2022
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Ingår i: Planta. - : SPRINGER. - 0032-0935 .- 1432-2048. ; 256:4
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Tidskriftsartikel (refereegranskat)abstract
- Non-symbiotic globin class #1 (Glb1) genes are expressed in different plant organs, have a high affinity for oxygen, and are related to nitric oxide (NO) turnover. Previous studies showed that soybean Glb1 genes are upregulated in soybean plants under flooding conditions. Herein, the GmGlb1-1 gene was identified in soybean as being upregulated in the nematode-resistant genotype PI595099 compared to the nematode-susceptible cultivar BRS133 during plant parasitism by Meloidogyne incognita. The Arabidopsis thaliana and Nicotiana tabacum transgenic lines overexpressing the GmGlb1-1 gene showed reduced susceptibility to M. incognita. Consistently, gall morphology data indicated that pJ2 nematodes that infected the transgenic lines showed developmental alterations and delayed parasitism progress. Although no significant changes in biomass and seed yield were detected, the transgenic lines showed an elongated, etiolation-like growth under well-irrigation, and also developed more axillary roots under flooding conditions. In addition, transgenic lines showed upregulation of some important genes involved in plant defense response to oxidative stress. In agreement, higher hydrogen peroxide accumulation and reduced activity of reactive oxygen species (ROS) detoxification enzymes were also observed in these transgenic lines. Thus, based on our data and previous studies, it was hypothesized that constitutive overexpression of the GmGlb1-1 gene can interfere in the dynamics of ROS production and NO scavenging, enhancing the acquired systemic acclimation to biotic and abiotic stresses, and improving the cellular homeostasis. Therefore, these collective data suggest that ectopic or nematode-induced overexpression, or enhanced expression of the GmGlb1-1 gene using CRISPR/dCas9 offers great potential for application in commercial soybean cultivars aiming to reduce plant susceptibility to M. incognita.
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| 7. |
- De Marco, O., et al.
(författare)
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The messy death of a multiple star system and the resulting planetary nebula as observed by JWST
- 2022
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Ingår i: Nature Astronomy. - : Springer Science and Business Media LLC. - 2397-3366. ; 6:12, s. 1421-1432
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Tidskriftsartikel (refereegranskat)abstract
- Planetary nebulae—the ejected envelopes of red giant stars—provide us with a history of the last, mass-losing phases of 90% of stars initially more massive than the Sun. Here we analyse images of the planetary nebula NGC 3132 from the James Webb Space Telescope (JWST) Early Release Observations. A structured, extended hydrogen halo surrounding an ionized central bubble is imprinted with spiral structures, probably shaped by a low-mass companion orbiting the central star at about 40–60 au. The images also reveal a mid-infrared excess at the central star, interpreted as a dusty disk, which is indicative of an interaction with another closer companion. Including the previously known A-type visual companion, the progenitor of the NGC 3132 planetary nebula must have been at least a stellar quartet. The JWST images allow us to generate a model of the illumination, ionization and hydrodynamics of the molecular halo, demonstrating the power of JWST to investigate complex stellar outflows. Furthermore, new measurements of the A-type visual companion allow us to derive the value for the mass of the progenitor of a central star with excellent precision: 2.86 ± 0.06 M⊙. These results serve as pathfinders for future JWST observations of planetary nebulae, providing unique insight into fundamental astrophysical processes including colliding winds and binary star interactions, with implications for supernovae and gravitational-wave systems.
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| 8. |
- dos Santos Paes, Luiz Eduardo, et al.
(författare)
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Understanding the behavior of laser surface remelting after directed energy deposition additive manufacturing through comparing the use of iron and Inconel powders
- 2021
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Ingår i: Journal of Manufacturing Processes. - : Elsevier BV. - 1526-6125. ; 70, s. 494-507
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Tidskriftsartikel (refereegranskat)abstract
- Laser directed energy deposition with powder (pDED-L) is one of the most popular techniques for additive manufacturing. However, for some applications, the resulting surface finish requires post-processing machining. Laser remelting processing has been cited as a means of decreasing machining needs in other applications. The objective of this study was to assess the performance and gain a better physical understanding of the laser remelting process as an alternative to the conventional post-processing techniques applied after pDED-L. pDED-L and remelting were performed using a 10 kW fiber laser source and iron and Inconel 625 powders as feedstock to compare the surface roughness and waviness under different processing conditions (three heat input levels). Through 2D and 3D surface measurements, as well as scanning electron microscopy (SEM), surface features were qualified and quantified. SEM and optical microscopy (OM) were also employed for metallurgical characterization of the roughness. The surface micro-notch effect was assessed through the stress concentration factor (kt). The results indicated attenuation of the average roughness (Ra) by around 30% for iron and 70% for Inconel when laser remelting was employed. In addition, kt presented a 31% reduction for iron and 29% reduction for Inconel. The performance varied according to the type of material used and was mainly related to differences in thermal diffusivity and electrical resistivity. It was concluded that laser remelting is a promising technology for coupling with pDED-L aimed at producing 3D metal components with superior quality while allowing a faster production rate in comparison to current practices.
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| 9. |
- Garcia, Catarina, et al.
(författare)
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Royleanone Derivatives From Plectranthus spp. as a Novel Class of P-Glycoprotein Inhibitors
- 2020
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Ingår i: Frontiers in Pharmacology. - : Frontiers Media SA. - 1663-9812. ; 11
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Tidskriftsartikel (refereegranskat)abstract
- Cancer is among the leading causes of death worldwide. One of the most challenging obstacles in cancer treatment is multidrug resistance (MDR). Overexpression of P-glycoprotein (P-gp) is associated with MDR. The growing incidence of cancer and the development of MDR drive the search for novel and more effective anticancer drugs to overcome the MDR problem. Royleanones are natural bioactive compounds frequently found in Plectranthus spp. The cytotoxic diterpene 6,7-dehydroroyleanone (1) is the main component of the P. madagascariensis (Pers.) Benth. essential oil, while 7α-acetoxy-6β-hydroxyroyleanone (2) can be isolated from acetonic extracts of P. grandidentatus Gürke. The reactivity of the natural royleanones 1 and 2 was explored to obtain a small library of new P-gp inhibitors. Four new derivatives (6,7-dehydro-12-O-tert-butyl-carbonate-royleanone (20), 6,7-dehydro-12-O-methylroyleanone (21), 6,7-dehydro-12-O-benzoylroyleanone (22), and 7α-acetoxy-6β-hydroxy-12-O-benzoylroyleanone (23) were obtained as pure with overall modest to excellent yields (21–97%). P-gp inhibition potential of the derivatives 20–23 was evaluated in human non-small cell lung carcinoma NCI-H460 and its MDR counterpart NCI-H460/R with the P-gp overexpression, through MTT assay. Previously prepared diterpene 7α-acetoxy-6β-benzoyloxy-12-O-(4-chloro)benzoylroyleanone (4), has also been tested. The P-gp inhibiting effects of compounds 1–4 were also assessed through a Rhodamine 123 accumulation assay. Derivatives 4 and 23 have significant P-gp inhibitory potential. Regarding stability and P-gp inhibition potential, results suggest that the formation of benzoyl esters is a more convenient approach for future derivatives with enhanced effect on the cell viability decrease. Compound 4 presented higher anti-P-gp potential than the natural diterpenes 1, 2, and 3, with comparable inhibitory potential to Dexverapamil. Moreover, derivative 4 showed the ability to sensitize the resistant NCI-H460/R cells to doxorubicin.
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| 10. |
- Graca, Marisa, et al.
(författare)
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Designing urban green spaces for climate adaptation : A critical review of research outputs
- 2022
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Ingår i: Urban Climate. - : Elsevier. - 2212-0955. ; 42
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Forskningsöversikt (refereegranskat)abstract
- Urban green spaces provide important contributions to enhance climate adaptation, and therefore research in this area has increased exponentially in the last decades. While several studies showed that the morphology and type of living and built elements of urban green spaces greatly affect their performance, a persistent gap between theory and practice continues to pervade the design of green spaces. This study conducts a semi-systematic review of research published in the last decade to investigate to what extent recent research has produced evidence-based outputs relevant to practitioners concerning the design of outdoor urban green spaces in the context of climate adaptation. An innovative design-oriented approach is subsequently applied to critically review evidence-based research outputs considering a comprehensive spectrum of climate impacts and adaptation measures. Our specific objectives are to: i) identify evidence-based research outputs of relevance to practitioners according to type of climatic impact; ii) assess the level of relevance and geographical transferability of such outputs to support the design of urban green spaces; and iii) identify key challenges that might hinder the implementation of evidence-based guidelines. Our results support a call to align research to confront the wicked gap between scientific research and implementation in design practice.
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