| 1. |
- 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. ; 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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| 2. |
- Cano, Vitor, et al.
(författare)
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Novel bioelectrochemical processes focused on nitrogen in wastewater : Energy generation and resource recovery
- 2023. - 1
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Ingår i: Water Management and Circular Economy. - Amsterdam : Elsevier. - 9780323952804 - 9780323952811 ; , s. 233-272
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Bokkapitel (refereegranskat)abstract
- The discharge of nitrogen into nature results in environmental degradation and public health problems. Conventional processes applied in wastewater treatment plants (WWTPs) for nitrogen removal have high energy demand and chemical consumption. Hence, this chapter addresses the recent research development about more sustainable approaches involving bioelectrochemical systems (BES) focused on nitrogen. Among the content are novel and meaningful insights towards the main factors controlling nitrogen oxidation, reduction, and separation/recovery; potential applications in WWTP; limiting factors; and contributions towards the circular economy principles. Despite there are limiting factors such as costly materials, lack of knowledge on microbial ecology, and low removal rates, the current generated in autotrophic nitrifying and denitrifying BES ranges from 1.2 to 1175 mA/m2 and 14 to 371 A/m3, respectively. This can potentially increase WWTPs self-sufficiency in terms of energy and external carbon. Alternatively, nitrogen can be recovered in BES (struvite, NH4HCO3 crystals or NH4OH), but improvements in ammonia separation across ion exchange membranes are necessary. © 2023 Elsevier Inc. All rights reserved.
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| 3. |
- Cardoso Chrispim, Mariana, Postdoktor, 1990-, et al.
(författare)
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A framework for resource recovery from wastewater treatment plants in megacities of developing countries
- 2020
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Ingår i: Environmental Research. - Maryland Heights : Academic Press. - 0013-9351 .- 1096-0953. ; 188
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Tidskriftsartikel (refereegranskat)abstract
- In developing countries, there is often a lack of a comprehensive data set that supports the development of coherent policies on resource recovery from wastewater treatment. This paper aims to contribute to the elaboration of resource recovery projects by providing accurate and updated data from wastewater treatment plants such as those located in the region of the Macrometropolis of Sao Paulo. The authors discuss possibilities of improvement of resource recovery for this illustrative example. Comprehensive analyses were performed based on data from 143 municipal wastewater treatment plants to understand the situation regarding resource recovery implementation in this region. The results show that just 26% of the plants perform at least one resource recovery practice. The predominant resource recovery practice is internal water reuse, and recovery is concentrated more in large plants than in medium and small ones. The sludge is disposed in landfills except for three plants, which perform sludge recycling for compost. Some plant managers reported interest in recovering energy from biogas, in expanding water reuse and in recovering sludge for fertilizer production or for building materials. Several aspects that have been regarded as relevant to the implementation of resource recovery processes in previous literature are discussed, such as the size of the plant, related legislation as well as treatment technologies and configurations. Finally, the authors propose a generic framework with several steps that can help to achieve resource recovery implementation. Therefore, the results can provide support for planning of resource recovery projects for large cities in developing countries. © 2020 Elsevier Inc.
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| 4. |
- Cardoso Chrispim, Mariana, Postdoktor, 1990-, et al.
(författare)
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A Framework for Sustainable Planning and Decision-Making on Resource Recovery from Wastewater : Showcase for São Paulo Megacity
- 2020
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Ingår i: Water. - Basel : MDPI. - 2073-4441. ; 12:12
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Tidskriftsartikel (refereegranskat)abstract
- Currently, it is important to develop strategic frameworks to support the selection of sustainable resource recovery solutions. This study applies a new framework for planning, implementation, and assessment of resource recovery strategies for a full-scale wastewater treatment plant (WWTP) in São Paulo megacity. The framework comprises several steps based on case study-specific data and information from current literature. Data were collected from various sources: a survey with a wastewater treatment utility, national and regional databases, and review of local regulations and international literature. Treatment configuration, wastewater and by-products composition, potential demand (for water, energy, and phosphorus), stakeholder identification, and local legislation were thoroughly discussed regarding decision-making on resource recovery. Scenario analysis was used to explore suitable nutrient and energy recovery measures based on indicators. Biogas recovery and sewage sludge composting showed more favorable conditions due to similar experiences in the area and robust legislation. The proposed framework is a simplified tool, and its application can support managers to get information on resource recovery and how to plan such initiatives in easier ways to facilitate wiser decision-making, and better operation and management. The results on framework use and refinement can guide potential applications in other contexts and stimulate public policy formulation and further research.
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| 5. |
- Cardoso Chrispim, Mariana, Postdoktor, 1990-, et al.
(författare)
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Avaliação Comparativa Entre Veículos Elétricos E Veículos Convencionais No Contexto De Mitigação Das Mudanças Climáticas
- 2019
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Ingår i: Revista Gestão & Sustentabilidade Ambiental. - São Paulo : Universidade Nove de Julho. - 2238-8753 .- 2238-8753. ; 8:1, s. 127-148
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Tidskriftsartikel (refereegranskat)abstract
- Atualmente, os veículos elétricos (VE) têm sido apontados como tendência futura da indústria automotiva. Dentre as motivações dos países para isto estão: reduzir a dependência de petróleo e seus derivados, promover o uso mais eficiente de energia e causar menores impactos ambientais, em especial os correlatos à emissão de Gases de Efeito Estufa (GEE). Os automóveis híbridos e elétricos não representam uma inovação tecnológica recente, apesar disso os mesmos contam com uma participação marginal na história do automóvel desde a década de 30. Aliás, vale ressaltar que os VE não são isentos de impactos ambientais, sobretudo na etapa de produção dos mesmos. Neste artigo, espera-se contribuir com informações acerca de características do desempenho ambiental de VE em relação aos veículos convencionais movidos à combustão interna (MCI), analisando quais suas vantagens e desvantagens, quais os impactos ambientais causados em todo o ciclo de vida e como essa tecnologia poderia contribuir para a mitigação das mudanças climáticas. Além disso, também se discute quais os impactos da expansão dos VE na demanda de energia final. Para tanto, empreendeu-se revisão da literatura sistêmica com base em pesquisas recentes e naquelas basilares focadas nos VE. Um dos resultados principais indicou que, quanto maior a participação de energias renováveis na oferta de energia elétrica, maior será a redução das emissões de GEE pelos VE, sendo que em alguns casos pode haver um aumento das emissões no balanço total do ciclo de vida desta tecnologia comparada à convencional.
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| 6. |
- Cardoso Chrispim, Mariana, Postdoktor, 1990-, et al.
(författare)
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Biogas recovery for sustainable cities : A critical review of enhancement techniques and key local conditions for implementation
- 2021
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Ingår i: Sustainable cities and society. - Amsterdam : Elsevier. - 2210-6707. ; 72
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Forskningsöversikt (refereegranskat)abstract
- There is great potential to apply energy recovery from municipal wastewater treatment plants (WWTP) to achieve better energy efficiency and greenhouse gas emissions abatement. However, in most of the wastewater treatment plants that produce biogas through sludge digestion, there is no thermal energy recovery or electricity generation, and the biogas is flared and wasted, particularly in developing countries. This paper discusses the recent technological advances related to biogas recovery from wastewater treatment besides identifying research gaps and local conditions, which affect implementation. Techniques for enhancement of biogas production such as co-digestion and microalgae systems for energy recovery were reviewed in terms of performance and context for application. This paper provides an assessment of how local conditions promote or hinder biogas recovery from WWTP in megacities of developing countries. The lack of government subsidies and a biogas market that is not well developed and regulated hinder biogas recovery implementation in the studied megacities. Infrastructure and electricity prices are also discussed. Strategies to promote energy recovery are recommended based on successful examples of energy self-sufficient WWTP. The findings may not only support planning on energy recovery but also guide technological development and research on this topic, aligned with the sustainable development goals.
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| 7. |
- Cardoso Chrispim, Mariana, Postdoktor, 1990-
(författare)
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Evaluation of decentralized approaches to wastewater treatment systems as alternative to environmental impacts and indication of sustainable solution for water conservation in cities
- 2017. - 1
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Ingår i: Proceedings of the Regional Workshop Wastewater Treatment and Reuse for Metropolitan Regions and Small Cities in Developing Countries. - Göttingen : Cuvillier Verlag. - 9783736994546 ; , s. 28-37
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Konferensbidrag (refereegranskat)abstract
- The Millennium Development Goals aim to achieve the sustainable development and to contribute improving access to water supply, sanitation, and energy, and to reduce hunger in the world. Energy and water are essential resources for food production, however, are becoming scarce. In this context an integration of the complete water management cycle includes water conservation and reclamation, storage of reclaimed water and rainwater, and wastewater treatment mainly in decentralized models. Wastewater treatment systems can generate products such as: renewable energy, fertilizers and water. This study focuses on the relations between wastewater treatment systems and its environmental impacts, besides to indicate potential solutions. In addition, it is also presented results from an experimental greywater treatment system operated at the university. The objective of this study was to address some Brazilian experiences of centralized wastewater treatment plant (large scale) and decentralized wastewater treatment plant (small scale). We expect that the results of this study can offer a review of strategies of wastewater treatment to implement in urban areas in Brazil, and to create subsidies for the planning of new wastewater treatment plants with low environmental impacts, including sustainable solutions (e.g., water reuse).
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| 8. |
- Cardoso Chrispim, Mariana, Postdoktor, 1990-, et al.
(författare)
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Greywater treatment using a moving bed biofilm reactor at a university campus in Brazil
- 2017
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Ingår i: Journal of Cleaner Production. - Amsterdam : Elsevier. - 0959-6526 .- 1879-1786. ; 142:Part 1, s. 290-296
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Tidskriftsartikel (refereegranskat)abstract
- Water reuse can contribute as an important approach and practice to the reduction of the pressures on water resources lowering the demand for potable water for purposes that do not require water's high quality. However the greywater reuse has been rarely applied in Brazil. Therefore, the main objective of this study was to evaluate a greywater collection and treatment system from lavatories, showers and washing machine aiming the non-potable reuse. The objectives were to characterize the quality and quantity of greywater from different sources, to monitor a pilot system for synthetic greywater treatment and to analyze the quality of the effluent after treatment. The pilot system implemented in a building at University of Sao Paulo allowed to segregate greywater collection and characterization. To evaluate the greywater production water flow meters were installed in the water inlet of each greywater source. The treatment system included a moving bed biofilm reactor and a settling tank at pilot scale. The evaluation of greywater treatment was conducted based on the monitoring of physicochemical and microbiological water quality parameters during the operation of the experimental system. Based on the results, amongst the three greywater sources, the water from showers had the highest E. coli concentration while the lavatories water had the highest total coliforms concentration. The removal efficiencies of BOD and COD were 59% e 70% respectively. The phosphorus removal during the experimental period was low. Nevertheless the water quality produced is viable to be applied for outdoor purposes - landscape and garden irrigation in household, commercial and institutional buildings and the results were satisfactory according to Brazilian standard. The treatment showed stability and reliability ensuring the potential for a safe reuse if appropriate operation and monitoring of the treatment system is performed.
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| 9. |
- Cardoso Chrispim, Mariana, Postdoktor, 1990-, et al.
(författare)
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Perception and awareness of circular economy within water-intensive and bio-based sectors : Understanding, benefits and barriers
- 2024
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Ingår i: Journal of Cleaner Production. - Amsterdam : Elsevier. - 0959-6526 .- 1879-1786. ; 464
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Tidskriftsartikel (refereegranskat)abstract
- Perception and awareness can affect behaviour and decision-making, for example, how companies implement Circular Economy (CE) practices. However, there is limited empirical research about this topic. Thus, we investigated the perception and awareness of representatives from water-intensive and bio-based sectors regarding the CE concept based on interviews and a survey with 10 companies in Sweden. Our results indicate that CE is understood mainly as zero waste and its key principles are resource efficiency and ecodesign. Missing (or partially addressed) important elements of CE are consumption, social aspects, regenerative role of CE, collaboration, and Industrial Symbiosis. The main benefit from implementing circular strategies is economic, and the main barrier is the lack of financial resources. The bio-based companies have a broader understanding of CE and its benefits than the water-intensive companies. Overall, more clarification and standardisation of the CE concept is necessary to avoid misunderstanding with other concepts such as sustainability. © 2024 The Authors
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| 10. |
- Cardoso Chrispim, Mariana, Postdoktor, 1990-, et al.
(författare)
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Phosphorus recovery from municipal wastewater treatment : Critical review of challenges and opportunities for developing countries
- 2019
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Ingår i: Journal of Environmental Management. - Amsterdam : Elsevier. - 0301-4797 .- 1095-8630. ; 248
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Forskningsöversikt (refereegranskat)abstract
- The aim of this paper is to provide guidance in selecting phosphorus recovery options within the municipal wastewater treatment sector regarding developing countries. This critical review includes a brief contextualization of the resource-oriented sanitation paradigm, the discussion of processes for phosphorus recovery based on methods at full-scale, pilot-scale and laboratory-scale, and a concise discussion of the environmental impacts and benefits associated with phosphorus recovery strategies. Finally, the main challenges related to the implementation of resource recovery strategies, especially for phosphorous, were identified and discussed. According to the results, some of the main drivers for phosphorus recovery are the limited availability of phosphorus, increasing cost of phosphate fertilizers and reduction of maintenance costs. Currently, most of the operational processes are based on crystallization or precipitation from the digester supernatant. Struvite is the most common recovered product. The recovery rate of phosphorus from the liquid phase is lower (10–60% from wastewater treatment plant influent), than from sludge (35–70%) and from sludge ashes (70–98%). Phosphorus recovery remains challenging, and some barriers identified were the integration between stakeholders and institutions, public policies and regulations as well as public acceptance and economic feasibility. In developing countries, the implementation of nutrient recovery systems is challenging, because the main concern is on the expansion of sanitation coverage. Resource recovery approaches can provide benefits beyond the wastewater treatment sector, not only improving the sustainability of wastewater treatment operations, but generating revenue for the utility provider.
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| 11. |
- Cardoso Chrispim, Mariana
(författare)
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Resource recovery from wastewater treatment: challenges, opportunities and guidance for planning and implementation
- 2021
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Considering the current resources scarcity, Wastewater Treatment Plants (WWTP) should be adapted to become more sustainable. For example, it is possible to recover resources present in municipal wastewater. However, regional studies about integration of resource recovery processes at different scales or about the main barriers to implementation in developing countries are missing in the literature. Also, there is a need for planning methodologies to identify the most sustainable solution in each context. Understanding the current situation is an essential step to support planning and accelerate resource recovery implementation. To address these issues this thesis aims to guide planning, technology and policy development towards resource recovery from municipal WWTP in large cities of developing countries. This thesis presents a comprehensive knowledge base for wastewater treatment plant managers and decision-makers leading to a better understanding of resource recovery solutions and the actions needed to facilitate implementation. The methodology comprised critical literature reviews and two case studies. Secondary data from literature and primary data (obtained through questionnaires) were collected and analysed. Megacities in developing countries are analysed in the papers, with the focus on the Macrometropolis of Sao Paulo, which is the most populous area in the Southern Hemisphere. The current situation shows a low implementation of resource recovery practices in the region, and local conditions affect the implementation of water reuse, and nutrients and energy recovery. A framework consisting of eleven steps is proposed to support planning and decision-making on resource recovery from wastewater. This new tool was tested and can be applied by decision-makers in wastewater sector for better operation and management. Market, legislation, local economic development, and cooperation with stakeholders are relevant aspects covered in the analysis. There is a great potential to expand wastewater treatment integrated with nutrient and energy recovery strategies in developing countries. Potentials for phosphorus and energy recovery were estimated and some recovery scenarios are recommended. In conclusion, the findings can help planning and elaboration of resource recovery projects in wastewater treatment in urban areas and stimulate creation of public policies. The main research gaps identified in this thesis can guide further research and technological development in this field.
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| 12. |
- Cardoso Chrispim, Mariana, Postdoktor, 1990-, et al.
(författare)
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The sanitation and urban agriculture nexus : urine collection and application as fertilizer in São Paulo, Brazil
- 2017
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Ingår i: Journal of Water, Sanitation and Hygiene for Development. - London : IWA Publishing. - 2043-9083 .- 2408-9362. ; 7:3, s. 455-465
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Tidskriftsartikel (refereegranskat)abstract
- Separately collected urine is an attractive potential fertilizer because of its high nutrient content, low cost, and inherent linkage of urban wastewater management and peri-urban agriculture. Urine from waterless urinals was applied to corn and lettuce plants to examine the impact of urine application rates and frequency on plant growth and soil parameters. In both corn and lettuce experiments, urine application significantly (p < 0.05) increased growth and leaf production relative to control plants. More frequent applications led to lower soil cation exchange capacities for corn and higher soil nitrogen content for both crops. Based on preliminary implementation calculations, waterless urinals at the University of São Paulo (USP), School of Arts, Sciences, and Humanities campus could lead to over 1,500 m3 of water saved and 360 m3 of urine produced on an annual basis. These experiments and modeling results are discussed in the context of scaling up urban urine collection, transport, and fertilization in São Paulo, Brazil.
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| 13. |
- Cardoso Chrispim, Mariana, Postdoktor, 1990-, et al.
(författare)
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The underrepresented key elements of Circular Economy : A critical review of assessment tools and a guide for action
- 2023
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Ingår i: Sustainable Production and Consumption. - Amsterdam : Elsevier. - 2352-5509. ; 35, s. 539-558
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Tidskriftsartikel (refereegranskat)abstract
- The measurement of progress towards Circular Economy (CE) within a company is crucial for identifying opportunities and designing circular practices. However, most of the existing tools do not consider the systemic view and principles of CE. The aim of this paper is to assess the contributions and limitations of CE assessment tools regarding the key elements: social dimension, stakeholder engagement, R-imperatives and industrial symbiosis. Also, the aim is to offer guidance for improvements towards a CE transition. The methodology was an integrative literature review; then based on the critical assessment of tools a guide was created. Thirty-eight tools were thoroughly analysed and our results show that there is a limited number of multidisciplinary tools (only 10), that is including all CE key elements, and in some cases partly. Social dimension is not fully explored; only 6 tools have indicators related to society, local community, customers, and workers. Recommendations for future tools development include to offer training for possible users of the tools and to develop tools for the service sector. Finally, we conclude that all the key elements of CE are interconnected. The proposed guide-ACTION (Assessing Circular Transition In Organisations Now)- includes the key elements, databases, tools, and indicators, and is aligned with the CE principles to help the assessment. © 2022 The Author(s)
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| 14. |
- Cardoso Pereira, Cássio, et al.
(författare)
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Subtle structures with not-so-subtle functions : A data set of arthropod constructs and their host plants
- 2022
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Ingår i: Ecology. - : Wiley. - 0012-9658 .- 1939-9170. ; 103:4
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Tidskriftsartikel (refereegranskat)abstract
- The construction of shelters on plants by arthropods might influence other organisms via changes in colonization, community richness, species composition, and functionality. Arthropods, including beetles, caterpillars, sawflies, spiders, and wasps often interact with host plants via the construction of shelters, building a variety of structures such as leaf ties, tents, rolls, and bags; leaf and stem galls, and hollowed out stems. Such constructs might have both an adaptive value in terms of protection (i.e., serve as shelters) but may also exert a strong influence on terrestrial community diversity in the engineered and neighboring hosts via colonization by secondary occupants. Although different traits of the host plant (e.g., physical, chemical, and architectural features) may affect the potential for ecosystem engineering by insects, such effects have been, to a certain degree, overlooked. Further analyses of how plant traits affect the occurrence of shelters may therefore enrich our understanding of the organizing principles of plant-based communities. This data set includes more than 1000 unique records of ecosystem engineering by arthropods, in the form of structures built on plants. All records have been published in the literature, and span both natural structures (91% of the records) and structures artificially created by researchers (9% of the records). The data were gathered between 1932 and 2021, across more than 50 countries and several ecosystems, ranging from polar to tropical zones. In addition to data on host plants and engineers, we aggregated data on the type of constructs and the identity of inquilines using these structures. This data set highlights the importance of these subtle structures for the organization of terrestrial arthropod communities, enabling hypotheses testing in ecological studies addressing ecosystem engineering and facilitation mediated by constructs. There are no copyright restrictions and please cite this paper when using the data in publications.
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| 15. |
- Frias Martinez, Maria Alejandra, et al.
(författare)
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Surface roughness of titanium disks influences the adhesion, proliferation and differentiation of osteogenic properties derived from human
- 2020
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Ingår i: International Journal of Implant Dentistry. - : Springer. - 2198-4034. ; 6:1
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Tidskriftsartikel (refereegranskat)abstract
- Purpose The aim of this study was to investigate the response of osteogenic cell lineage and gingival fibroblastic cells to different surface treatments of grade IV commercially pure Titanium (cpTi) disks. Material and methods Grade IV cpTi disks with different surfaces were produced: machined (M), sandblasting (B), sandblasting and acid subtraction (NP), and hydrophilic treatment (ACQ). Surface microtopography characteristics and chemical composition were investigated by scanning electron microscopy (SEM) and energy dispersive x-ray spectrometry (EDS). Adhesion and proliferation of SC-EHAD (human surgically-created early healing alveolar defects) and HGF-1 (human gingival fibroblasts) on Ti disks were investigated at 24 and 48 h, and osteogenic differentiation and mineralization were evaluated by assessing alkaline phosphatase (ALP) activity and alizarin red staining, respectively. Results No significant differences were found among the various surface treatments for all surface roughness parameters, except for skewness of the assessed profile (Rsk) favoring M (p= 0.035 ANOVA). M disks showed a slightly higher (p> 0.05; Kruskal-Wallis/Dunn) adhesion of HGF-1 (89.43 +/- 9.13%) than SC-EHAD cells (57.11 +/- 17.72%). ACQ showed a significantly higher percentage of SC-EHAD (100%) than HGF-1 (69.67 +/- 13.97%) cells adhered at 24 h. SC-EHAD cells expressed increased ALP activity in osteogenic medium at M (213%) and NP (235.04%) surfaces, but higher mineralization activity on ACQ (54.94 +/- 4.80%) at 14 days. Conclusion These findings suggest that surface treatment influences the chemical composition and the adhesion and differentiation of osteogenic cells in vitro.
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| 16. |
- Garbellini, Lucas Renan, et al.
(författare)
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(Eco)toxicological impact potential from inorganic substances in biosolids : Real data-based suggestions for regulatory improvements
- 2023
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Ingår i: Environmental Nanotechnology, Monitoring & Management. - Amsterdam : Elsevier. - 2215-1532. ; 20
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Tidskriftsartikel (refereegranskat)abstract
- Sewage sludge (SS) can be applied in soil for its nutrient recycling in agriculture and forestry, but the presence of toxic substances may prompt environmental and human health risks. Brazilian Resolution (CONAMA 498/2020) establishes thresholds for biosolid (i.e., treated sludge) quality for application in soils. We have evaluated the (eco)toxicological impact potential of such practice regarding the mentioned thresholds, and the concentration of inorganic substances in sludge from three different Wastewater Treatment Plants (WWTP) in São Paulo, Brazil. The assessment relied on USEtox®, a model that estimates the potential toxicological impact on humans and ecosystems. According to the evaluation of the regulatory thresholds, Zn are responsible for an ecotoxicological impact potential of 2.33E + 02 PAF.m3.day/kg (potentially affected species), which represents 48.2% of the aggregated impact for the scenario, while Hg potential is of 1.25E-04 cases/kg for non-cancerous diseases in humans – corresponding to 54% of this scenario. The assessment of the SS samples has confirmed to be critical for Zn, Hg, and Cr, and indicated potential ecotoxicological risks for concentrations found of Fe and Al, which do not have regulatory thresholds. Results were discussed along with related literature and international regulation. The study supports sustainable management of sewage in Brazil, and the analytical framework is replicable in other regions. © 2023 Published by Elsevier B.V.
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| 17. |
- Holtkötter, Jannis, et al.
(författare)
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Development and Validation of a Digital Image Processing-Based Pill Detection Tool for an Oral Medication Self-Monitoring System
- 2022
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Ingår i: Sensors. - : MDPI AG. - 1424-8220. ; 22:8
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Tidskriftsartikel (refereegranskat)abstract
- Long-term adherence to medication is of critical importance for the successful management of chronic diseases. Objective tools to track oral medication adherence are either lacking, expensive, difficult to access, or require additional equipment. To improve medication adherence, cheap and easily accessible objective tools able to track compliance levels are necessary. A tool to monitor pill intake that can be implemented in mobile health solutions without the need for additional devices was developed. We propose a pill intake detection tool that uses digital image processing to analyze images of a blister to detect the presence of pills. The tool uses the Circular Hough Transform as a feature extraction technique and is therefore primarily useful for the detection of pills with a round shape. This pill detection tool is composed of two steps. First, the registration of a full blister and storing of reference values in a local database. Second, the detection and classification of taken and remaining pills in similar blisters, to determine the actual number of untaken pills. In the registration of round pills in full blisters, 100% of pills in gray blisters or blisters with a transparent cover were successfully detected. In the counting of untaken pills in partially opened blisters, 95.2% of remaining and 95.1% of taken pills were detected in gray blisters, while 88.2% of remaining and 80.8% of taken pills were detected in blisters with a transparent cover. The proposed tool provides promising results for the detection of round pills. However, the classification of taken and remaining pills needs to be further improved, in particular for the detection of pills with non-oval shapes.
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| 18. |
- 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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| 19. |
- 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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| 20. |
- Lederman, Judith S., et al.
(författare)
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Completing the progression establishing an international baseline of primary, middle and secondary students’ views of scientific inquiry
- 2023
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Ingår i: International Journal of Science Education. - : Routledge. - 0950-0693 .- 1464-5289.
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Tidskriftsartikel (refereegranskat)abstract
- Knowledge of scientific inquiry (SI) is considered essential to the development of an individual's Scientific Literacy (SL) and therefore, SI is included in many international science education reform documents. Two previous large scale international studies assessed the SI understandings of students entering middle school and secondary students at the end of their formal K-12 science education. The purpose of this international project was to use the VASI-E to collect data on what primary level students have learned about SI in their first few years of school. This study adds to previous research to bridge the landscape of SI understandings now with representation from primary, middle and high school samples. A total of 4,238 students from 35 countries/regions spanning six continents participated in the study. The results show that globally, primary students are not adequately informed about SI for their age group. However, when compared with the students in the previous international studies (grades seven and 12), the primary students' understandings were surprisingly closer to the levels of understanding of SI of the secondary school students than those in the seventh grade study.
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| 21. |
- Perry, William Bernard, et al.
(författare)
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Cross-continental comparative experiences of wastewater surveillance and a vision for the 21st century
- 2024
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Ingår i: Science of the Total Environment. - Amsterdam : Elsevier. - 0048-9697 .- 1879-1026. ; 919
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Tidskriftsartikel (refereegranskat)abstract
- The COVID-19 pandemic has brought the epidemiological value of monitoring wastewater into sharp focus. The challenges of implementing and optimising wastewater monitoring vary significantly from one region to another, often due to the array of different wastewater systems around the globe, as well as the availability of resources to undertake the required analyses (e.g. laboratory infrastructure and expertise). Here we reflect on the local and shared challenges of implementing a SARS-CoV-2 monitoring programme in two geographically and socio-economically distinct regions, São Paulo state (Brazil) and Wales (UK), focusing on design, laboratory methods and data analysis, and identifying potential guiding principles for wastewater surveillance fit for the 21st century. Our results highlight the historical nature of region-specific challenges to the implementation of wastewater surveillance, including previous experience of using wastewater surveillance, stakeholders involved, and nature of wastewater infrastructure. Building on those challenges, we then highlight what an ideal programme would look like if restrictions such as resource were not a constraint. Finally, we demonstrate the value of bringing multidisciplinary skills and international networks together for effective wastewater surveillance. © 2024. Published by Elsevier B.V.
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| 22. |
- Pires, Ana Elisabete, et al.
(författare)
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The curious case of the Mesolithic Iberian dogs : An archaeogenetic study
- 2019
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Ingår i: Journal of Archaeological Science. - : Elsevier BV. - 0305-4403 .- 1095-9238. ; 105, s. 116-129
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Tidskriftsartikel (refereegranskat)abstract
- We investigated the genetic composition of six Canis remains from western Iberia, directly radiocarbon dated to 7,903-7,570 years (cal BP). They were identified as dogs via their archaeological and depositional context, osteometry, and a high percentage of aquatic diet shared with humans. For comparison, genetic data were obtained from an additional 37 Iberian dog remains from the Neolithic to Late Antiquity, as well as two Palaeolithic and a Chalcolithic Canis identified as wolves. Previous data indicated that dog mtDNA haplogroup A (HgA) is prevalent in extant European dogs ( > 50%), in the Near East and Asia, but rare or absent ( < 10%) in European Canis older than 3,000 years (cal BP). We found a high frequency (83%) of dog HgA in Mesolithic Iberian dog remains. This is the first report of a high frequency of dog HgA in pre-Neolithic Europe. We show that, contrary to the current view, Canis with HgA did not necessarily arrive in Europe from East-Asia. This phylogeographical difference in HgA frequency demonstrates that genetic differentiation was high prior to, or as a consequence of, domestication which may be linked with pre-Neolithic local processes for Iberian wolf domestication. Our results emphasize that knowledge of both ancient wolves' and early dogs' genetic profiles from the European periphery should improve our understanding of the evolution of the European dog.
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| 23. |
- Razavi-Shearer, Devin M., et al.
(författare)
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Adjusted estimate of the prevalence of hepatitis delta virus in 25 countries and territories
- 2024
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Ingår i: JOURNAL OF HEPATOLOGY. - 0168-8278 .- 1600-0641. ; 80:2, s. 232-242
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Tidskriftsartikel (refereegranskat)abstract
- Background & Aims: Hepatitis delta virus (HDV) is a satellite RNA virus that requires the hepatitis B virus (HBV) for assembly and propagation. Individuals infected with HDV progress to advanced liver disease faster than HBV-monoinfected individuals. Recent studies have estimated the global prevalence of anti-HDV antibodies among the HBV-infected population to be 5-15%. This study aimed to better understand HDV prevalence at the population level in 25 countries/territories. Methods: We conducted a literature review to determine the prevalence of anti-HDV and HDV RNA in hepatitis B surface antigen (HBsAg)-positive individuals in 25 countries/territories. Virtual meetings were held with experts from each setting to discuss the findings and collect unpublished data. Data were weighted for patient segments and regional heterogeneity to estimate the prevalence in the HBV-infected population. The findings were then combined with The Polaris Observatory HBV data to estimate the anti-HDV and HDV RNA prevalence in each country/territory at the population level. Results: After adjusting for geographical distribution, disease stage and special populations, the anti-HDV prevalence among the HBsAg+ population changed from the literature estimate in 19 countries. The highest anti-HDV prevalence was 60.1% in Mongolia. Once adjusted for the size of the HBsAg+ population and HDV RNA positivity rate, China had the highest absolute number of HDV RNA+ cases. Conclusions: We found substantially lower HDV prevalence than previously reported, as prior meta-analyses primarily focused on studies conducted in groups/regions that have a higher probability of HBV infection: tertiary care centers, specific risk groups or geographical regions. There is large uncertainty in HDV prevalence estimates. The implementation of reflex testing would improve estimates, while also allowing earlier linkage to care for HDV RNA+ individuals. The logistical and economic burden of reflex testing on the health system would be limited, as only HBsAg+ cases would be screened.
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| 24. |
- Sator, Lea, et al.
(författare)
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Overdiagnosis of COPD in Subjects With Unobstructed Spirometry A BOLD Analysis
- 2019
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Ingår i: Chest. - : Elsevier BV. - 0012-3692 .- 1931-3543. ; 156:2, s. 277-288
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: There are several reports on underdiagnosis of COPD, while little is known about COPD overdiagnosis and overtreatment. We describe the overdiagnosis and the prevalence of spirometrically defined false positive COPD, as well as their relationship with overtreatment across 23 population samples in 20 countries participating in the BOLD Study between 2003 and 2012.METHODS: A false positive diagnosis of COPD was considered when participants reported a doctor's diagnosis of COPD, but postbronchodilator spirometry was unobstructed (FEV1/FVC > LLN). Additional analyses were performed using the fixed ratio criterion (FEV1/FVC < 0.7).RESULTS: Among 16,177 participants, 919 (5.7%) reported a previous medical diagnosis of COPD. Postbronchodilator spirometry was unobstructed in 569 subjects (61.9%): false positive COPD. A similar rate of overdiagnosis was seen when using the fixed ratio criterion (55.3%). In a subgroup analysis excluding participants who reported a diagnosis of "chronic bronchitis" or "emphysema" (n = 220), 37.7% had no airflow limitation. The site-specific prevalence of false positive COPD varied greatly, from 1.9% in low- to middle-income countries to 4.9% in high-income countries. In multivariate analysis, overdiagnosis was more common among women, and was associated with higher education; former and current smoking; the presence of wheeze, cough, and phlegm; and concomitant medical diagnosis of asthma or heart disease. Among the subjects with false positive COPD, 45.7% reported current use of respiratory medication. Excluding patients with reported asthma, 34.4% of those with normal spirometry still used a respiratory medication.CONCLUSIONS: False positive COPD is frequent. This might expose nonobstructed subjects to possible adverse effects of respiratory medication.
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| 25. |
- Studnicka, Michael, et al.
(författare)
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COPD : Should Diagnosis Match Physiology?
- 2020
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Ingår i: Chest. - : Elsevier BV. - 0012-3692 .- 1931-3543. ; 157:2, s. 473-475
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Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)
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