| 1. |
- Jacome, Cristina, et al.
(författare)
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Feasibility and Acceptability of an Asthma App to Monitor Medication Adherence : Mixed Methods Study
- 2021
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Ingår i: JMIR mhealth and uhealth. - : JMIR Publications. - 2291-5222. ; 9:5
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Tidskriftsartikel (refereegranskat)abstract
- Background: Poor medication adherence is a major challenge in asthma, and objective assessment of inhaler adherence is needed. The InspirerMundi app aims to monitor adherence while providing a positive experience through gamification and social support. Objective: This study aimed to evaluate the feasibility and acceptability of the InspirerMundi app to monitor medication adherence in adolescents and adults with persistent asthma (treated with daily inhaled medication). Methods: A 1-month mixed method multicenter observational study was conducted in 26 secondary care centers from Portugal and Spain. During an initial face-to-face visit, physicians reported patients' asthma therapeutic plan in a structured questionnaire. During the visits, patients were invited to use the app daily to register their asthma medication intakes. A scheduled intake was considered taken when patients registered the intake (inhaler, blister, or other drug formulation) by using the image-based medication detection tool. At 1 month, patients were interviewed by phone, and app satisfaction was assessed on a 1 (low) to 5 (high) scale. Patients were also asked to point out the most and least preferred app features and make suggestions for future app improvements. Results: A total of 107 patients (median 27 [P25-P75 14-40] years) were invited, 92.5% (99/107) installed the app, and 73.8% (79/107) completed the 1-month interview. Patients interacted with the app a median of 9 (P25-P75 1-24) days. At least one medication was registered in the app by 78% (77/99) of patients. A total of 53% (52/99) of participants registered all prescribed inhalers, and 34% (34/99) registered the complete asthma therapeutic plan. Median medication adherence was 75% (P25-P75 25%-90%) for inhalers and 82% (P25-P75 50%-94%) for other drug formulations. Patients were globally satisfied with the app, with 75% (59/79) scoring >= 4,; adherence monitoring, symptom monitoring, and gamification features being the most highly scored components; and the medication detection tool among the lowest scored. A total of 53% (42/79) of the patients stated that the app had motivated them to improve adherence to inhaled medication and 77% (61/79) would recommend the app to other patients. Patient feedback was reflected in 4 major themes: medication-related features (67/79, 85%), gamification and social network (33/79, 42%), symptom monitoring and physician communication (21/79, 27%), and other aspects (16/79, 20%). Conclusions: The InspirerMundi app was feasible and acceptable to monitor medication adherence in patients with asthma. Based on patient feedback and to increase the registering of medications, the therapeutic plan registration and medication detection tool were redesigned. Our results highlight the importance of patient participation to produce a patient-centered and engaging mHealth asthma app.
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| 2. |
- Jacome, Cristina, et al.
(författare)
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Monitoring Adherence to Asthma Inhalers Using the InspirerMundi App : Analysis of Real-World, Medium-Term Feasibility Studies
- 2021
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Ingår i: Frontiers in Medical Technology. - : Frontiers Media S.A.. - 2673-3129. ; 3
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Tidskriftsartikel (refereegranskat)abstract
- Background: Poor medication adherence is a major challenge in asthma and objective assessment of inhaler adherence is needed. InspirerMundi app aims to monitor inhaler adherence while turning it into a positive experience through gamification and social support.Objective: We assessed the medium-term feasibility of the InspirerMundi app to monitor inhaler adherence in real-world patients with persistent asthma (treated with daily inhaled medication). In addition, we attempted to identify the characteristics of the patients related to higher app use.Methods: Two real-world multicenter observational studies, with one initial face-to-face visit and a 4-month telephone interview, were conducted in 29 secondary care centers from Portugal. During an initial face-to-face visit, patients were invited to use the app daily to register their asthma medication intakes. A scheduled intake was considered taken when patients took a photo of the medication (inhaler, blister, or others) using the image-based medication detection tool. Medication adherence was calculated as the number of doses taken as a percentage of the number scheduled. Interacting with the app =30 days was used as the cut-off for higher app use.Results: A total of 114 patients {median 20 [percentile 25 to percentile 75 (P25-P75) 16-36] years, 62% adults} were invited, 107 (94%) installed the app and 83 (73%) completed the 4-month interview. Patients interacted with the app for a median of 18 [3-45] days, translated on a median use rate of 15 [3-38]%. Median inhaler adherence assessed through the app was 34 [4-73]% when considering all scheduled inhalations for the study period. Inhaler adherence assessed was not significantly correlated with self-reported estimates. Median adherence for oral and other medication was 41 [6-83]% and 43 [3-73]%, respectively. Patients with higher app use were slightly older (p = 0.012), more frequently taking medication for other health conditions (p = 0.040), and more frequently prescribed long-acting muscarinic antagonists (LAMA, p = 0.024). After 4 months, Control of Allergic Rhinitis and Asthma Test (CARAT) scores improved (p < 0.001), but no differences between patients interacting with the app for 30 days or less were seen.Conclusions: The InspirerMundi app was feasible to monitor inhaler adherence in patients with persistent asthma. The persistent use of this mHealth technology varies widely. A better understanding of characteristics related to higher app use is still needed before effectiveness studies are undertaken.
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| 3. |
- Carvalho, Joao, et al.
(författare)
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A drill-hole, geological and geophysical data-based 3D model for target generation in Neves-Corvo mine region, Portugal
- 2022
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Ingår i: International journal of earth sciences. - : Springer Nature. - 1437-3254 .- 1437-3262. ; 111, s. 403-424
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Tidskriftsartikel (refereegranskat)abstract
- The Neves-Corvo world class Iberian Pyrite Belt volcanogenic massive sulphide (VMS) deposit located in southern Portugal, constitutes an important Cu-Zn-Pb active mine. Seven deposits are currently known, among which the Lombador deposit alone has estimated 150 Mt of massive sulphides. The life-time of the mine is dependent on the discovery of new exploration targets and it is vital to have accurate 3D geological models, not only to guide drilling campaigns but also to drive a winning/new strategy, which in the past has led to Semblana and Monte Branco discoveries: geophysical inversion and modelling. Furthermore, 3D geological models can contribute to the understanding of the tectonic and stratigraphic evolution of the region. Therefore, the goal of this study is to produce a realistic 3D geological model of the Neves-Corvo region, as only one model is presently publicly available: the PROMINE model, which includes the study area of this work and extends from Aljustrel to the border with Spain. Lundin Mining has also produced two unpublished, confidential models in 2007 and 2017. The latest Lundin model incorporates the same geophysical data used in this work (2D and 3D seismic reflection and time-domain electromagnetic (TEM) ground loop data) and approximately 7500 surface and underground drill-holes. The model presented in this research has much more detail than the 2012 PROMINE model in the Neves-Corvo region and uses an updated and revised drill-hole database with approximately 8000 drill-holes, revised geological cross-sections built from surface geology and drill-hole logs, new geological outcrop data, petrophysical and reprocessed geophysical data, and is therefore more detailed and accurate than any of the previous models, in particular the 2007 and PROMINE models. Land gravimetric and aeromagnetic data are also available in the study area but were not directly used to build the geological model but rather to investigate and check the model produced. Modelling was performed with industry standard software and the 3D curves resulting from the geological/geophysical interpretation were interpolated using different approaches to respect the hard data (interpretation lines and drill-holes). The resulting 3D stratigraphic surfaces required strong manual editing to respect the interpretation, due to the presence of folds, thrusts and tectonic nappes in the study area. The surfaces were afterwards tied to the drill-holes, resulting in a 3D model with great accuracy and detail in the near mining area and covering a larger area than previously available 3D geological models. The model has three major stratigraphic layers: the Mertola Flysch Formation and the Volcano-Sedimentary Complex (VSC), overlying the Phyllite-Quartzite Formation basement, and also the known VMS deposits (underlying the top of the Lower VSC) geometries according to drill-hole data. In the central part of the study area, where more drill-holes are available, the top of the Lower VSC sequence surface was also built. This approach will contribute to a better exploration drill-hole planning and the generation of new targets for exploration.
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| 4. |
- Marto, João Pedro, et al.
(författare)
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Safety and Outcome of Revascularization Treatment in Patients With Acute Ischemic Stroke and COVID-19: The Global COVID-19 Stroke Registry.
- 2023
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Ingår i: Neurology. - 1526-632X. ; 100:7
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Tidskriftsartikel (refereegranskat)abstract
- COVID-19-related inflammation, endothelial dysfunction, and coagulopathy may increase the bleeding risk and lower the efficacy of revascularization treatments in patients with acute ischemic stroke (AIS). We aimed to evaluate the safety and outcomes of revascularization treatments in patients with AIS and COVID-19.This was a retrospective multicenter cohort study of consecutive patients with AIS receiving intravenous thrombolysis (IVT) and/or endovascular treatment (EVT) between March 2020 and June 2021 tested for severe acute respiratory syndrome coronavirus 2 infection. With a doubly robust model combining propensity score weighting and multivariate regression, we studied the association of COVID-19 with intracranial bleeding complications and clinical outcomes. Subgroup analyses were performed according to treatment groups (IVT-only and EVT).Of a total of 15,128 included patients from 105 centers, 853 (5.6%) were diagnosed with COVID-19; of those, 5,848 (38.7%) patients received IVT-only and 9,280 (61.3%) EVT (with or without IVT). Patients with COVID-19 had a higher rate of symptomatic intracerebral hemorrhage (SICH) (adjusted OR 1.53; 95% CI 1.16-2.01), symptomatic subarachnoid hemorrhage (SSAH) (OR 1.80; 95% CI 1.20-2.69), SICH and/or SSAH combined (OR 1.56; 95% CI 1.23-1.99), 24-hour mortality (OR 2.47; 95% CI 1.58-3.86), and 3-month mortality (OR 1.88; 95% CI 1.52-2.33). Patients with COVID-19 also had an unfavorable shift in the distribution of the modified Rankin score at 3 months (OR 1.42; 95% CI 1.26-1.60).Patients with AIS and COVID-19 showed higher rates of intracranial bleeding complications and worse clinical outcomes after revascularization treatments than contemporaneous non-COVID-19 patients receiving treatment. Current available data do not allow direct conclusions to be drawn on the effectiveness of revascularization treatments in patients with COVID-19 or to establish different treatment recommendations in this subgroup of patients with ischemic stroke. Our findings can be taken into consideration for treatment decisions, patient monitoring, and establishing prognosis.The study was registered under ClinicalTrials.gov identifier NCT04895462.
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| 5. |
- Amaral, Rita, et al.
(författare)
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Profiling Persistent Asthma Phenotypes in Adolescents : A Longitudinal Diagnostic Evaluation from the INSPIRERS Studies
- 2021
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Ingår i: International Journal of Environmental Research and Public Health. - : MDPI. - 1661-7827 .- 1660-4601. ; 18:3
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Tidskriftsartikel (refereegranskat)abstract
- We aimed to identify persistent asthma phenotypes among adolescents and to evaluate longitudinally asthma-related outcomes across phenotypes. Adolescents (13-17 years) from the prospective, observational, and multicenter INSPIRERS studies, conducted in Portugal and Spain, were included (n = 162). Latent class analysis was applied to demographic, environmental, and clinical variables, collected at a baseline medical visit. Longitudinal differences in clinical variables were assessed at a 4-month follow-up telephone contact (n = 128). Three classes/phenotypes of persistent asthma were identified. Adolescents in class 1 (n = 87) were highly symptomatic at baseline and presented the highest number of unscheduled healthcare visits per month and exacerbations per month, both at baseline and follow-up. Class 2 (n = 32) was characterized by female predominance, more frequent obesity, and uncontrolled upper/lower airways symptoms at baseline. At follow-up, there was a significant increase in the proportion of controlled lower airway symptoms (p < 0.001). Class 3 (n = 43) included mostly males with controlled lower airways symptoms; at follow-up, while keeping symptom control, there was a significant increase in exacerbations/month (p = 0.015). We have identified distinct phenotypes of persistent asthma in adolescents with different patterns in longitudinal asthma-related outcomes, supporting the importance of profiling asthma phenotypes in predicting disease outcomes that might inform targeted interventions and reduce future risk.
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| 6. |
- Ramos Do Prado, Samira B., et al.
(författare)
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Physiological Degradation of Pectin in Papaya Cell Walls : Release of Long Chains Galacturonans Derived from Insoluble Fractions during Postharvest Fruit Ripening
- 2016
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Ingår i: Frontiers in Plant Science. - : Frontiers Media S.A.. - 1664-462X. ; 7
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Tidskriftsartikel (refereegranskat)abstract
- Papaya (Carica papaya L.) is a fleshy fruit that presents a rapid pulp softening during ripening. However, the timeline on how papaya pectinases act in polysaccharide solubilization and the consequent modification of the cell wall fractions during ripening is still not clear. In this work, the gene expression correlations between, on one hand, 16 enzymes potentially acting during papaya cell wall disassembling and, on the other hand, the monosaccharide composition of cell wall fractions during papaya ripening were evaluated. In order to explain differences in the ripening of papaya samplings, the molecular mass distribution of polysaccharides from water-soluble and oxalate-soluble fractions (WSF and OSF, respectively), as well as the oligosaccharide profiling from the WSF fraction, were evaluated by high performance size exclusion chromatography coupled to a refractive index detector and high performance anion-exchange chromatography coupled to pulse amperometric detection analyses, respectively. Results showed that up-regulated polygalacturonase and β-galactosidase genes were positively correlated with some monosaccharide profiles. In addition, an overall increase in the retention time of high molecular weight (HMW) and low molecular weight (LMW) polysaccharides in WSF and OSF was shown. The apparent disappearance of one HMW peak of the OSF may result from the conversion of pectin that were crosslinked with calcium into more soluble forms through the action of PGs, which would increase the solubilization of polysaccharides by lowering their molecular weight. Thus, the results allowed us to propose a detailed process of papaya cell wall disassembling that would affect sensorial properties and post-harvesting losses of this commercially important fruit.
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| 7. |
- Scalon, Lucas, et al.
(författare)
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Assessing the Donor-Acceptor Nature and the Electrochemical Stability of a Fluorene-Diketopyrrolopyrrole-Thiophene-Based Copolymer
- 2021
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Ingår i: ACS Applied Polymer Materials. - : American Chemical Society (ACS). - 2637-6105. ; 3:8, s. 4223-4233
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Tidskriftsartikel (refereegranskat)abstract
- Organic dyes have been studied for applications in large-area, flexible, cheap, and efficient organic electronic devices. Among them, diketopyrrolopyrrole (DPP) has gained attention thanks to its planar structure, photochemical and thermal stability, and easy processability. Also, the electron-withdrawing nature of DPP makes its application attractive in the synthesis of donor-acceptor (D-A) copolymers, with appealing features such as the tunable energy levels and photophysical and electrochemical properties. Inspired by these exciting characteristics, a copolymer was developed based on DPP, thiophene, and fluorene (PFDPP2T). Photophysical and electrochemical studies using both experimental and theoretical approaches were performed aiming to understand the properties of this material, such as, for instance, the D-A characteristic and the outstanding electrochemical stability upon oxidation that enables more than 400 cycles of p-doping. The outcomes unveil fundamental aspects of this class of copolymers, reinforcing their suitability for photo-electrochemical and optoelectronic applications.
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| 8. |
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| 9. |
- Araujo, Jefferson, et al.
(författare)
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Characterizing complex mineral structures in thin sections of geological samples with a scanning hall effect microscope
- 2019
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Ingår i: Sensors. - : MDPI AG. - 1424-8220. ; 19:7
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Tidskriftsartikel (refereegranskat)abstract
- We improved a magnetic scanning microscope for measuring the magnetic properties of minerals in thin sections of geological samples at submillimeter scales. The microscope is comprised of a 200 µm diameter Hall sensor that is located at a distance of 142 µm from the sample; an electromagnet capable of applying up to 500 mT DC magnetic fields to the sample over a 40 mm diameter region; a second Hall sensor arranged in a gradiometric configuration to cancel the background signal applied by the electromagnet and reduce the overall noise in the system; a custom-designed electronics system to bias the sensors and allow adjustments to the background signal cancelation; and a scanning XY stage with micrometer resolution. Our system achieves a spatial resolution of 200 µm with a noise at 6.0 Hz of 300 nT rms /(Hz) 1/2 in an unshielded environment. The magnetic moment sensitivity is 1.3 × 10 −11 Am 2 . We successfully measured the representative magnetization of a geological sample using an alternative model that takes the sample geometry into account and identified different micrometric characteristics in the sample slice.
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| 10. |
- Araújo, José, et al.
(författare)
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Self-triggered control for industrial wireless sensor and actuator networks
- 2011
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Konferensbidrag (refereegranskat)abstract
- Energy and communication bandwidth are scarceresources in wireless sensor and actuator networks. Recentresearch efforts considered the control of physical processes oversuch resource limited networks. Most of the existing literatureaddressing this topic is dedicated to periodically sampled controlloops and scheduled communication, because it simplifies theanalysis and the implementation. We propose instead an aperiodicnetwork transmission scheme that reduces the number oftransmission instances for the sensor and control nodes, therebyreducing energy consumption and increasing network lifetime,without sacrificing control performance. As an added benefit,we show the possibility of dynamically allocating the networkbandwidth based on the physical system state and the availableresources. In order to allow timely, reliable, and energy efficientcommunication, we propose a new co-design framework forthe wireless medium access control, compatible with the IEEE802.15.4 standard. Furthermore, we validate our approach in areal wireless networked control implementation.
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