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Gray Stephens C, Dias A, Skinner E, Brennan C, Middleton RG, Angel CK. Penthrox enables quicker management of fractures, dislocations and more: learning lessons from expedited care of trauma patients during the COVID-19 pandemic. Ann R Coll Surg Engl 2023; 105:S22-S27. [PMID: 35950512 PMCID: PMC10390238 DOI: 10.1308/rcsann.2021.0340] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/02/2023] Open
Abstract
INTRODUCTION Methoxyflurane is an historical anaesthetic agent that has undergone a renaissance with the introduction of a smaller dose in a handheld 'Penthrox' device. The benefits of Penthrox include its ease of use, with disposable individual packets, and the need for less monitoring and staff, when compared with deeper sedation. The literature acknowledges its use for analgesia and in the management of anterior shoulder dislocation but in no other procedural orthopaedic circumstance. METHODS Following institutional approval, we undertook a retrospective review of all incidences of Penthrox use to facilitate minor procedures within a 2-month period starting 24 March 2020. Time to procedure and success were recorded using the surrogate markers of patient attendance and x-Ray occurrence times. RESULTS Some 101 Penthrox doses were given to 89 patients over 97 unique episodes between 24 March and 26 May 2020. No complications were recorded following the use of Penthrox during this period. Patient demographics were explored. Fracture manipulations and casting (n=54) had a 100% success rate in achieving adequate and safe reduction. Joint dislocations (n=34) were treated with varying success. Native elbow dislocations were reduced most successfully (4/4, 100%). Native shoulder dislocations were seen in 17 patients and successful relocation was seen in 11 cases, giving a success rate of 65%. CONCLUSIONS This is the first study, outside anterior shoulder dislocations, to report on the efficacy of Penthrox within emergent orthopaedic scenarios. We have demonstrated Penthrox to be a safe tool for helping to manage trauma procedures in the emergency department.
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Affiliation(s)
| | - A Dias
- Royal Cornwall Hospitals NHS Trust, UK
| | - E Skinner
- Royal Cornwall Hospitals NHS Trust, UK
| | - C Brennan
- Royal Cornwall Hospitals NHS Trust, UK
| | | | - C K Angel
- Royal Cornwall Hospitals NHS Trust, UK
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Bernabeu AM, Plaza-Morlote M, Rey D, Almeida M, Dias A, Mucha AP. Improving the preparedness against an oil spill: Evaluation of the influence of environmental parameters on the operability of unmanned vehicles. Mar Pollut Bull 2021; 172:112791. [PMID: 34523429 DOI: 10.1016/j.marpolbul.2021.112791] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/19/2021] [Revised: 07/21/2021] [Accepted: 07/26/2021] [Indexed: 06/13/2023]
Abstract
When an oil spill occurs, a prompt response reduces significantly the impact. The preparedness and contingency plans are essential to identify the most appropriate technologies. Unmanned and autonomous vehicles (UAVs) is emerging as a powerful tool of strategic potential in the observation, oil tracking and damage assessment of an oil spill. The SpilLess project explored the suitability of these devices to be the first-line response to an oil spill. This work analyses the operational requirements related to environmental parameters following a two steps approach: 1) Environmental characterization from long wind and waves time series and modelling; 2) Definition of the optimal periods for operating each UAVs. We have defined the periods in which each of these facilities acts best, confirming that the operational limits of UAVs are not significantly more restrictive than the traditional operations. UAVs should be included in contingency plans as available tools to fight against oil spills.
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Affiliation(s)
- A M Bernabeu
- Centro de Investigación Mariña, Universidade de Vigo, GEOMA, 36310 Vigo, Spain.
| | - M Plaza-Morlote
- Centro de Investigación Mariña, Universidade de Vigo, GEOMA, 36310 Vigo, Spain
| | - D Rey
- Centro de Investigación Mariña, Universidade de Vigo, GEOMA, 36310 Vigo, Spain
| | - M Almeida
- CIIMAR - Interdisciplinary Centre of Marine and Environmental Research, University of Porto, Terminal de Cruzeiros do Porto de Leixões, Av. General Norton de Matos s/n, 4450-208 Matosinhos, Portugal
| | - A Dias
- INESC Technology and Science, Porto, Portugal; ISEP - School of Engineering of Porto Polytechnic Institute, Porto, Portugal
| | - A P Mucha
- CIIMAR - Interdisciplinary Centre of Marine and Environmental Research, University of Porto, Terminal de Cruzeiros do Porto de Leixões, Av. General Norton de Matos s/n, 4450-208 Matosinhos, Portugal; FCUP - Faculty of Sciences, University of Porto, Rua do Campo Alegre, s/n, 4169-007 Porto, Portugal
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3
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Ribeiro Da Silva M, Vilela E, Mosalina Manuel A, Barbosa A, Almeida J, Guerreiro C, Ribeiro Queiros P, Tavares A, Dias A, Caeiro D, Sousa O, Braga P, Rodrigues A, Teixeira M, Fontes-Carvalho R. The impact of mitral regurgitation grade on exercise capacity following cardiac rehabilitation program after transcatheter aortic valve implantation. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.2689] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Introduction
Severe aortic stenosis (AS) and mitral regurgitation (MR) often coexist. Transcatheter aortic valve implantation (TAVI) is becoming widely used for the treatment of patients (pts) with symptomatic severe AS. However, conflicting data reside concerning the impact of MR on outcomes after TAVI. Also, very few data exist regarding the benefits of a cardiac rehabilitation program (CRP) following TAVI in pts with MR.
Purpose
To evaluate the effect of a CRP in functional parameters after TAVI, particularly in pts with MR grade ≥ II.
Methods
Retrospective study which included all pts submitted to TAVI between 2014 and 2020 that completed a CRP following the procedure. Cardiopulmonary exercise tests (CPET) were performed after TAVI at baseline (pre-CRP) and post-CRP. We evaluated pre- and post-CRP peak oxygen consumption (pVO2), pVO2 at the anaerobic threshold (AT), respiratory exchange ratio (RER), VE/VCO2 and CPET duration. The exercise protocol included low/medium intensity exercises and consisted of sessions 3 times per week carried over 3 months. MR grading severity was assessed with transthoracic echocardiography performed after TAVI and was divided into 2 groups (grade < II vs grade ≥ II).
Results
Fifty-two pts were included, 59,6% were male, mean age of 78,6±8,6 years-old. Mean Society of Thoracic Surgery (STS) risk score was 4,9. Mean pre-TAVI aortic valve area was 0,68 cm2, with a mean gradient of 45,5 mmHg and a mean ejection fraction (EF) of 51%. The majority of pts implanted a self-expandable prosthesis (55,8%).
Twenty-seven (51,9%) pts had MR grade ≥ II. Baseline characteristics were similar between pts with MR grade < II vs MR grade ≥ II, with the exception of the prevalence of coronary artery disease which was higher in MR grade ≥ II (p=0,036). Patients with MR grade < II had higher maximum and median aortic gradients before TAVI (p<0,05 for all). The mean number of cardiac rehabilitation sessions was 21±7, without differences between both groups. In pts with MR grade ≥ II, there was an improvement in CPET duration after CRP (HF protocol from 03:57 min to 05:02 min; p=0,017 and modified Bruce protocol from 06:03 min to 06:41 min; p=0,049) but without significant changes in pVO2 (14,7 mL/kg/min to 14,9 mL/kg/min; p=0,990), RER or VEVCO2/VO2 ratio. Patients with MR grade < II significantly improved pVO2 (13,8 mL/kg/min to 14,7 mL/kg/min; p=0,015), and CPET duration with HF protocol from 05:04 min to 06:23 min; p=0,006 after CRP. There was also an improvement in VEVCO2/VO2 ratio, although not statically significant.
Conclusions
Patients with MR grade < II after TAVI who underwent a CRP significantly improved pVO2 and CPET duration. Although pts with MR grade ≥ II did not improved pVO2 after a CRP, an improvement in CPET duration may translate into a clinical benefit in these pts. These results highlight the importance of further research and personalization among this potentially higher risk subset of pts.
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
- M Ribeiro Da Silva
- Hospital Center of Vila Nova de Gaia/Espinho, Vila Nova de Gaia, Portugal
| | - E Vilela
- Hospital Center of Vila Nova de Gaia/Espinho, Vila Nova de Gaia, Portugal
| | - A Mosalina Manuel
- Hospital Center of Vila Nova de Gaia/Espinho, Vila Nova de Gaia, Portugal
| | - A Barbosa
- Hospital Center of Vila Nova de Gaia/Espinho, Vila Nova de Gaia, Portugal
| | - J Almeida
- Hospital Center of Vila Nova de Gaia/Espinho, Vila Nova de Gaia, Portugal
| | - C Guerreiro
- Hospital Center of Vila Nova de Gaia/Espinho, Vila Nova de Gaia, Portugal
| | - P Ribeiro Queiros
- Hospital Center of Vila Nova de Gaia/Espinho, Vila Nova de Gaia, Portugal
| | - A Tavares
- Hospital Center of Vila Nova de Gaia/Espinho, Vila Nova de Gaia, Portugal
| | - A Dias
- Hospital Center of Vila Nova de Gaia/Espinho, Vila Nova de Gaia, Portugal
| | - D Caeiro
- Hospital Center of Vila Nova de Gaia/Espinho, Vila Nova de Gaia, Portugal
| | - O Sousa
- Hospital Center of Vila Nova de Gaia/Espinho, Vila Nova de Gaia, Portugal
| | - P Braga
- Hospital Center of Vila Nova de Gaia/Espinho, Vila Nova de Gaia, Portugal
| | - A Rodrigues
- Hospital Center of Vila Nova de Gaia/Espinho, Vila Nova de Gaia, Portugal
| | - M Teixeira
- Hospital Center of Vila Nova de Gaia/Espinho, Vila Nova de Gaia, Portugal
| | - R Fontes-Carvalho
- Hospital Center of Vila Nova de Gaia/Espinho, Vila Nova de Gaia, Portugal
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Ramos SF, Dias A. Acceptance and commitment therapy for chronic pain: A systematic review. Eur Psychiatry 2021. [PMCID: PMC9475967 DOI: 10.1192/j.eurpsy.2021.1166] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
IntroductionChronic pain is common, costly, and associated with significant disability and negative effects on well-being and mental health. The treatment is challenging, requiring a multidisciplinary approach. Acceptance and commitment therapy (ACT) aims to help patients in engaging in a flexible and persistent pattern of values-directed behavior while in contact with continuing pain and discomfort.ObjectivesTo provide an updated review on the efficacy of ACT for the management of chronic pain.MethodsWe conducted a systematic review based on the PubMed® and EBSCO databases up to April 2020.ResultsFifteen trials were included. The results were in favour of ACT in pain acceptance, functioning and pain intensity with small to large effect sizes. Few studies evaluated quality of life, but half of those were favourable to ACT. We also focused our analysis on ACT online interventions, considering the current demands due to the COVID-19 pandemic.ConclusionsThe current systematic review points in favour of ACT for the management of chronic pain conditions, though the studies included suffered from methodological limitations, which may have led to overestimated effects. Methodologically robust trials are required to further understand the clinical efficacy of ACT for chronic pain and which patients most benefit from this intervention.
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Ribeiro Da Silva M, Rodrigues A, Guerreiro C, Mosalina Manuel A, Santos Silva G, Teixeira P, Ribeiro Queiros P, Brandao M, Ferreira D, Caeiro D, Dias A, Sousa O, Oliveira M, Primo J, Braga P. Early discharge after TAVI: should we still be afraid of conduction disturbances? Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.2603] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Introduction
Conduction disturbances (CD) after TAVI remains the most frequent complication of the procedure, frequently increasing the length of hospital stay. A lack of consensus exists regarding in-hospital management of CD post-TAVI.
Purpose
To evaluate if an early discharge (ED) protocol could be safely implemented in patients (pts) with CD post-TAVI.
Methods
Retrospective study of all pts submitted to TAVI between 2016 and 2018. Pts with prior permanent pacemaker (PP) and non-transfemoral approach were excluded. ECG data before, immediately after the procedure and at day 3 post-TAVI were collected, and continuous telemetry monitoring was recorded. We applied a recently proposed ED algorithm (adapted from Management of Conduction Disturbances Associated With Transcatheter Aortic Valve Replacement - JACC Scientific Expert Panel; JACC 2019; 74(8):1086–106) to identify which pts could have been candidates for ED. ED was defined as discharge in the first 72 hours (h) after the procedure. We evaluated if an ED strategy would have been safe at 1-year follow-up (FUP), as defined by the absence of need for PP, syncope and mortality.
Results
242 pts were included, 44,8% males, mean age 80,4 years, mean Euroscore II 5,4 and the majority implanted a self-expandable prosthesis (64,1%). Mean hospital stay after TAVI was 7,7 days. The most frequent CD after TAVI were: new onset left bundle brunch block (36%) and high degree atrioventricular block (HAVB) (16,3%). During hospital stay 21,6% needed PP, mainly because of HAVB (mainly implanted in the first 72h).
According to the proposed algorithm, 70,7% of our pts were ED-candidates. ED-candidates had lower prevalence of predilation (18,5% vs 36,8%, p=0,008) with no significant differences between type of prosthesis or baseline ECG. ED-candidates had smaller PR interval post-TAVI (184,5 vs 202,5 ms, p=0,044) and smaller PR and QRS at 72h (p<0,001 in both).
At 1-year FUP, only 2,3% of ED-candidates needed a PP (vs 37,7% non-ED, p<0,001). It is noteworthy that in those ED-candidates who needed a PP during FUP, the percentage of ventricular pacing was less than 2% at 6 months. In the FUP period, 3,2% of ED candidates presented at the ER because of syncope, with no significant differences to non-ED pts. No differences between groups were found in 30-days and 1-year ER presentation because of syncope or all-cause mortality.
Conclusions
According to the proposed algorithm for ED in pts with CD post-TAVI, pts with specific ECG characteristics and without rhythm events during continuous telemetry monitoring can be early discharged with long-term safety.
Funding Acknowledgement
Type of funding source: None
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Affiliation(s)
- M Ribeiro Da Silva
- Hospital Center of Vila Nova de Gaia/Espinho, Vila Nova de Gaia, Portugal
| | - A Rodrigues
- Hospital Center of Vila Nova de Gaia/Espinho, Vila Nova de Gaia, Portugal
| | - C Guerreiro
- Hospital Center of Vila Nova de Gaia/Espinho, Vila Nova de Gaia, Portugal
| | - A Mosalina Manuel
- Hospital Center of Vila Nova de Gaia/Espinho, Vila Nova de Gaia, Portugal
| | - G Santos Silva
- Hospital Center of Vila Nova de Gaia/Espinho, Vila Nova de Gaia, Portugal
| | - P Teixeira
- Hospital Center of Vila Nova de Gaia/Espinho, Vila Nova de Gaia, Portugal
| | - P Ribeiro Queiros
- Hospital Center of Vila Nova de Gaia/Espinho, Vila Nova de Gaia, Portugal
| | - M Brandao
- Hospital Center of Vila Nova de Gaia/Espinho, Vila Nova de Gaia, Portugal
| | - D Ferreira
- Hospital Center of Vila Nova de Gaia/Espinho, Vila Nova de Gaia, Portugal
| | - D Caeiro
- Hospital Center of Vila Nova de Gaia/Espinho, Vila Nova de Gaia, Portugal
| | - A Dias
- Hospital Center of Vila Nova de Gaia/Espinho, Vila Nova de Gaia, Portugal
| | - O Sousa
- Hospital Center of Vila Nova de Gaia/Espinho, Vila Nova de Gaia, Portugal
| | - M Oliveira
- Hospital Center of Vila Nova de Gaia/Espinho, Vila Nova de Gaia, Portugal
| | - J Primo
- Hospital Center of Vila Nova de Gaia/Espinho, Vila Nova de Gaia, Portugal
| | - P Braga
- Hospital Center of Vila Nova de Gaia/Espinho, Vila Nova de Gaia, Portugal
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Tsyganov D, Bundaleska N, Henriques J, Felizardo E, Dias A, Abrashev M, Kissovski J, Botelho do Rego AM, Ferraria AM, Tatarova E. Simultaneous Synthesis and Nitrogen Doping of Free-Standing Graphene Applying Microwave Plasma. Materials (Basel) 2020; 13:ma13184213. [PMID: 32972003 PMCID: PMC7560455 DOI: 10.3390/ma13184213] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/31/2020] [Revised: 09/10/2020] [Accepted: 09/21/2020] [Indexed: 11/16/2022]
Abstract
An experimental and theoretical investigation on microwave plasma-based synthesis of free-standing N-graphene, i.e., nitrogen-doped graphene, was further extended using ethanol and nitrogen gas as precursors. The in situ assembly of N-graphene is a single-step method, based on the introduction of N-containing precursor together with carbon precursor in the reactive microwave plasma environment at atmospheric pressure conditions. A previously developed theoretical model was updated to account for the new reactor geometry and the nitrogen precursor employed. The theoretical predictions of the model are in good agreement with all experimental data and assist in deeper understanding of the complicated physical and chemical process in microwave plasma. Optical Emission Spectroscopy was used to detect the emission of plasma-generated ‘‘building units’’ and to determine the gas temperature. The outlet gas was analyzed by Fourier-Transform Infrared Spectroscopy to detect the generated gaseous by-products. The synthesized N-graphene was characterized by Scanning Electron Microscopy, Raman, and X-ray photoelectron spectroscopies.
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Affiliation(s)
- D. Tsyganov
- Instituto de Plasmas e Fusão Nuclear, Instituto Superior Técnico, Universidade de Lisboa, 1049-001 Lisbon, Portugal; (D.T.); (J.H.); (E.F.); (A.D.); (E.T.)
| | - N. Bundaleska
- Instituto de Plasmas e Fusão Nuclear, Instituto Superior Técnico, Universidade de Lisboa, 1049-001 Lisbon, Portugal; (D.T.); (J.H.); (E.F.); (A.D.); (E.T.)
- Correspondence:
| | - J. Henriques
- Instituto de Plasmas e Fusão Nuclear, Instituto Superior Técnico, Universidade de Lisboa, 1049-001 Lisbon, Portugal; (D.T.); (J.H.); (E.F.); (A.D.); (E.T.)
| | - E. Felizardo
- Instituto de Plasmas e Fusão Nuclear, Instituto Superior Técnico, Universidade de Lisboa, 1049-001 Lisbon, Portugal; (D.T.); (J.H.); (E.F.); (A.D.); (E.T.)
| | - A. Dias
- Instituto de Plasmas e Fusão Nuclear, Instituto Superior Técnico, Universidade de Lisboa, 1049-001 Lisbon, Portugal; (D.T.); (J.H.); (E.F.); (A.D.); (E.T.)
| | - M. Abrashev
- Faculty of Physics, Sofia University, 1164 Sofia, Bulgaria; (M.A.); (J.K.)
| | - J. Kissovski
- Faculty of Physics, Sofia University, 1164 Sofia, Bulgaria; (M.A.); (J.K.)
| | - A. M. Botelho do Rego
- BSIRG, iBB, DEQ, Instituto Superior Técnico, Universidade de Lisboa, 1049-001 Lisbon, Portugal; (A.M.B.d.R.); (A.M.F.)
| | - A. M. Ferraria
- BSIRG, iBB, DEQ, Instituto Superior Técnico, Universidade de Lisboa, 1049-001 Lisbon, Portugal; (A.M.B.d.R.); (A.M.F.)
| | - E. Tatarova
- Instituto de Plasmas e Fusão Nuclear, Instituto Superior Técnico, Universidade de Lisboa, 1049-001 Lisbon, Portugal; (D.T.); (J.H.); (E.F.); (A.D.); (E.T.)
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Barreto A, Dias A, Duarte B, Pinto E, Almeida A, Trindade T, Soares AMVM, Hylland K, Loureiro S, Oliveira M. Biological effects and bioaccumulation of gold in gilthead seabream (Sparus aurata) - Nano versus ionic form. Sci Total Environ 2020; 716:137026. [PMID: 32036137 DOI: 10.1016/j.scitotenv.2020.137026] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/29/2019] [Revised: 01/28/2020] [Accepted: 01/29/2020] [Indexed: 06/10/2023]
Abstract
The question of whether gold (Au) is more toxic as nanoparticles or in its ionic form remains unclear and controversial. The present work aimed to clarify the effects of 96 h exposure to 4, 80 and 1600 μg·L-1 of 7 nm gold nanoparticles (AuNPs) - (citrate coated (cAuNPs) or polyvinylpyrrolidone coated (PVP-AuNPs)) - and ionic Au (iAu) on gilthead seabream (Sparus aurata). Effects at different levels of biological organization (behaviour, neurotransmission, biotransformation, oxidative stress/damage and genotoxicity) were assessed. cAuNPs induced oxidative stress and damage (lipid peroxidation increase), even at 4 μg·L-1, and reduced the ability of S. aurata to swim against a water flow at 1600 μg·L-1. Exposure to cAuNPs induced more adverse effects than exposure to PVP-AuNPs. All tested concentrations of Au (nano or ionic form) induced DNA breaks and cytogenetic damage in erythrocytes of S. aurata. Generally, iAu induced significantly more effects in fish than the nano form, probably associated with the significantly higher accumulation in the fish tissues. No fish mortality was observed following exposure to AuNPs, but mortality was observed in the group exposed to 1600 μg·L-1 of iAu.
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Affiliation(s)
- A Barreto
- Departamento de Biologia & CESAM, Universidade de Aveiro, 3810-193 Aveiro, Portugal.
| | - A Dias
- Departamento de Biologia & CESAM, Universidade de Aveiro, 3810-193 Aveiro, Portugal
| | - B Duarte
- Departamento de Biologia & CESAM, Universidade de Aveiro, 3810-193 Aveiro, Portugal
| | - E Pinto
- LAQV/REQUIMTE, Departamento de Ciências Químicas, Faculdade de Farmácia, Universidade do Porto, 4050-313 Porto, Portugal; Department of Environmental Health, School of Health, P.Porto. CISA/Research Center in Environment and Health, 4200-072 Porto, Portugal
| | - A Almeida
- LAQV/REQUIMTE, Departamento de Ciências Químicas, Faculdade de Farmácia, Universidade do Porto, 4050-313 Porto, Portugal
| | - T Trindade
- Departamento de Química & CICECO, Aveiro Instituto de Materiais, Universidade de Aveiro, 3810-193 Aveiro, Portugal
| | - A M V M Soares
- Departamento de Biologia & CESAM, Universidade de Aveiro, 3810-193 Aveiro, Portugal
| | - K Hylland
- Department of Biosciences, University of Oslo, PO Box 1066, N-0316 Oslo, Norway
| | - S Loureiro
- Departamento de Biologia & CESAM, Universidade de Aveiro, 3810-193 Aveiro, Portugal
| | - M Oliveira
- Departamento de Biologia & CESAM, Universidade de Aveiro, 3810-193 Aveiro, Portugal
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8
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Yan C, Nie W, Vogel AL, Dada L, Lehtipalo K, Stolzenburg D, Wagner R, Rissanen MP, Xiao M, Ahonen L, Fischer L, Rose C, Bianchi F, Gordon H, Simon M, Heinritzi M, Garmash O, Roldin P, Dias A, Ye P, Hofbauer V, Amorim A, Bauer PS, Bergen A, Bernhammer AK, Breitenlechner M, Brilke S, Buchholz A, Mazon SB, Canagaratna MR, Chen X, Ding A, Dommen J, Draper DC, Duplissy J, Frege C, Heyn C, Guida R, Hakala J, Heikkinen L, Hoyle CR, Jokinen T, Kangasluoma J, Kirkby J, Kontkanen J, Kürten A, Lawler MJ, Mai H, Mathot S, Mauldin RL, Molteni U, Nichman L, Nieminen T, Nowak J, Ojdanic A, Onnela A, Pajunoja A, Petäjä T, Piel F, Quéléver LLJ, Sarnela N, Schallhart S, Sengupta K, Sipilä M, Tomé A, Tröstl J, Väisänen O, Wagner AC, Ylisirniö A, Zha Q, Baltensperger U, Carslaw KS, Curtius J, Flagan RC, Hansel A, Riipinen I, Smith JN, Virtanen A, Winkler PM, Donahue NM, Kerminen VM, Kulmala M, Ehn M, Worsnop DR. Size-dependent influence of NO x on the growth rates of organic aerosol particles. Sci Adv 2020; 6:eaay4945. [PMID: 32518819 PMCID: PMC7253163 DOI: 10.1126/sciadv.aay4945] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/01/2019] [Accepted: 03/19/2020] [Indexed: 05/24/2023]
Abstract
Atmospheric new-particle formation (NPF) affects climate by contributing to a large fraction of the cloud condensation nuclei (CCN). Highly oxygenated organic molecules (HOMs) drive the early particle growth and therefore substantially influence the survival of newly formed particles to CCN. Nitrogen oxide (NOx) is known to suppress the NPF driven by HOMs, but the underlying mechanism remains largely unclear. Here, we examine the response of particle growth to the changes of HOM formation caused by NOx. We show that NOx suppresses particle growth in general, but the suppression is rather nonuniform and size dependent, which can be quantitatively explained by the shifted HOM volatility after adding NOx. By illustrating how NOx affects the early growth of new particles, a critical step of CCN formation, our results help provide a refined assessment of the potential climatic effects caused by the diverse changes of NOx level in forest regions around the globe.
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Affiliation(s)
- C. Yan
- Institute for Atmospheric and Earth System Research/INAR–Physics, Faculty of Science, University of Helsinki, 00560 Helsinki, Finland
| | - W. Nie
- Joint International Research Laboratory of Atmospheric and Earth System Sciences, School of Atmospheric Sciences, Nanjing University, Nanjing, China
| | - A. L. Vogel
- CERN, CH-1211, Geneva, Switzerland
- Laboratory of Atmospheric Chemistry, Paul Scherrer Institute, 5232 Villigen, Switzerland
| | - L. Dada
- Institute for Atmospheric and Earth System Research/INAR–Physics, Faculty of Science, University of Helsinki, 00560 Helsinki, Finland
| | - K. Lehtipalo
- Institute for Atmospheric and Earth System Research/INAR–Physics, Faculty of Science, University of Helsinki, 00560 Helsinki, Finland
- Laboratory of Atmospheric Chemistry, Paul Scherrer Institute, 5232 Villigen, Switzerland
- Finnish Meteorological Institute, Erik Palménin aukio 1, 00560 Helsinki, Finland
| | - D. Stolzenburg
- University of Vienna, Faculty of Physics, Boltzmanngasse 5, 1090 Wien, Austria
| | - R. Wagner
- Institute for Atmospheric and Earth System Research/INAR–Physics, Faculty of Science, University of Helsinki, 00560 Helsinki, Finland
| | - M. P. Rissanen
- Institute for Atmospheric and Earth System Research/INAR–Physics, Faculty of Science, University of Helsinki, 00560 Helsinki, Finland
| | - M. Xiao
- Laboratory of Atmospheric Chemistry, Paul Scherrer Institute, 5232 Villigen, Switzerland
| | - L. Ahonen
- Institute for Atmospheric and Earth System Research/INAR–Physics, Faculty of Science, University of Helsinki, 00560 Helsinki, Finland
| | - L. Fischer
- University of Innsbruck, Institute for Ion and Applied Physics, 6020 Innsbruck, Austria
| | - C. Rose
- Institute for Atmospheric and Earth System Research/INAR–Physics, Faculty of Science, University of Helsinki, 00560 Helsinki, Finland
| | - F. Bianchi
- Institute for Atmospheric and Earth System Research/INAR–Physics, Faculty of Science, University of Helsinki, 00560 Helsinki, Finland
- Aerosol and Haze Laboratory, Beijing Advanced Innovation Center for Soft Matter Science and Engineering, Beijing University of Chemical Technology, Beijing, China
| | - H. Gordon
- CERN, CH-1211, Geneva, Switzerland
- University of Leeds, Leeds LS2 9JT, UK
| | - M. Simon
- Goethe University Frankfurt, Institute for Atmospheric and Environmental Sciences, Altenhöferallee 1, 60438 Frankfurt am Main, Germany
| | - M. Heinritzi
- Goethe University Frankfurt, Institute for Atmospheric and Environmental Sciences, Altenhöferallee 1, 60438 Frankfurt am Main, Germany
| | - O. Garmash
- Institute for Atmospheric and Earth System Research/INAR–Physics, Faculty of Science, University of Helsinki, 00560 Helsinki, Finland
| | - P. Roldin
- Division of Nuclear Physics, Department of Physics, Lund University, P. O. Box 118, SE-221 00 Lund, Sweden
| | - A. Dias
- CERN, CH-1211, Geneva, Switzerland
- CENTRA and FCUL, Universidade de Lisboa, Campo Grande, 1749-016 Lisboa, Portugal
| | - P. Ye
- Carnegie Mellon University Center for Atmospheric Particle Studies, 5000 Forbes Ave., Pittsburgh, PA 15213, USA
- Aerodyne Research Inc., Billerica, MA 01821, USA
| | - V. Hofbauer
- Carnegie Mellon University Center for Atmospheric Particle Studies, 5000 Forbes Ave., Pittsburgh, PA 15213, USA
| | - A. Amorim
- CENTRA and FCUL, Universidade de Lisboa, Campo Grande, 1749-016 Lisboa, Portugal
| | - P. S. Bauer
- University of Vienna, Faculty of Physics, Boltzmanngasse 5, 1090 Wien, Austria
| | - A. Bergen
- Goethe University Frankfurt, Institute for Atmospheric and Environmental Sciences, Altenhöferallee 1, 60438 Frankfurt am Main, Germany
| | - A.-K. Bernhammer
- University of Innsbruck, Institute for Ion and Applied Physics, 6020 Innsbruck, Austria
| | - M. Breitenlechner
- University of Innsbruck, Institute for Ion and Applied Physics, 6020 Innsbruck, Austria
| | - S. Brilke
- University of Vienna, Faculty of Physics, Boltzmanngasse 5, 1090 Wien, Austria
- Goethe University Frankfurt, Institute for Atmospheric and Environmental Sciences, Altenhöferallee 1, 60438 Frankfurt am Main, Germany
| | - A. Buchholz
- University of Eastern Finland, Department of Applied Physics, P.O. Box 1627, 70211 Kuopio, Finland
| | - S. Buenrostro Mazon
- Institute for Atmospheric and Earth System Research/INAR–Physics, Faculty of Science, University of Helsinki, 00560 Helsinki, Finland
| | | | - X. Chen
- Institute for Atmospheric and Earth System Research/INAR–Physics, Faculty of Science, University of Helsinki, 00560 Helsinki, Finland
| | - A. Ding
- Joint International Research Laboratory of Atmospheric and Earth System Sciences, School of Atmospheric Sciences, Nanjing University, Nanjing, China
| | - J. Dommen
- Laboratory of Atmospheric Chemistry, Paul Scherrer Institute, 5232 Villigen, Switzerland
| | - D. C. Draper
- Department of Chemistry, University of California, Irvine, CA 92697, USA
| | - J. Duplissy
- Institute for Atmospheric and Earth System Research/INAR–Physics, Faculty of Science, University of Helsinki, 00560 Helsinki, Finland
| | - C. Frege
- Laboratory of Atmospheric Chemistry, Paul Scherrer Institute, 5232 Villigen, Switzerland
| | - C. Heyn
- Laboratory of Atmospheric Chemistry, Paul Scherrer Institute, 5232 Villigen, Switzerland
| | - R. Guida
- CERN, CH-1211, Geneva, Switzerland
| | - J. Hakala
- Institute for Atmospheric and Earth System Research/INAR–Physics, Faculty of Science, University of Helsinki, 00560 Helsinki, Finland
| | - L. Heikkinen
- Institute for Atmospheric and Earth System Research/INAR–Physics, Faculty of Science, University of Helsinki, 00560 Helsinki, Finland
| | - C. R. Hoyle
- Laboratory of Atmospheric Chemistry, Paul Scherrer Institute, 5232 Villigen, Switzerland
| | - T. Jokinen
- Institute for Atmospheric and Earth System Research/INAR–Physics, Faculty of Science, University of Helsinki, 00560 Helsinki, Finland
| | - J. Kangasluoma
- Institute for Atmospheric and Earth System Research/INAR–Physics, Faculty of Science, University of Helsinki, 00560 Helsinki, Finland
- Aerosol and Haze Laboratory, Beijing Advanced Innovation Center for Soft Matter Science and Engineering, Beijing University of Chemical Technology, Beijing, China
| | - J. Kirkby
- CERN, CH-1211, Geneva, Switzerland
- Goethe University Frankfurt, Institute for Atmospheric and Environmental Sciences, Altenhöferallee 1, 60438 Frankfurt am Main, Germany
| | - J. Kontkanen
- Institute for Atmospheric and Earth System Research/INAR–Physics, Faculty of Science, University of Helsinki, 00560 Helsinki, Finland
| | - A. Kürten
- Goethe University Frankfurt, Institute for Atmospheric and Environmental Sciences, Altenhöferallee 1, 60438 Frankfurt am Main, Germany
| | - M. J. Lawler
- Department of Chemistry, University of California, Irvine, CA 92697, USA
| | - H. Mai
- California Institute of Technology, 210-41, Pasadena, CA 91125, USA
| | | | - R. L. Mauldin
- Carnegie Mellon University Center for Atmospheric Particle Studies, 5000 Forbes Ave., Pittsburgh, PA 15213, USA
- Department of Chemistry and Biochemistry, University of Colorado, Boulder, CO 80309, USA
| | - U. Molteni
- Laboratory of Atmospheric Chemistry, Paul Scherrer Institute, 5232 Villigen, Switzerland
| | - L. Nichman
- School of Earth and Environmental Science, University of Manchester, Manchester M13 9PL, UK
| | - T. Nieminen
- Institute for Atmospheric and Earth System Research/INAR–Physics, Faculty of Science, University of Helsinki, 00560 Helsinki, Finland
| | - J. Nowak
- Aerodyne Research Inc., Billerica, MA 01821, USA
| | - A. Ojdanic
- University of Vienna, Faculty of Physics, Boltzmanngasse 5, 1090 Wien, Austria
| | | | - A. Pajunoja
- University of Eastern Finland, Department of Applied Physics, P.O. Box 1627, 70211 Kuopio, Finland
| | - T. Petäjä
- Institute for Atmospheric and Earth System Research/INAR–Physics, Faculty of Science, University of Helsinki, 00560 Helsinki, Finland
- Joint International Research Laboratory of Atmospheric and Earth System Sciences, School of Atmospheric Sciences, Nanjing University, Nanjing, China
| | - F. Piel
- Goethe University Frankfurt, Institute for Atmospheric and Environmental Sciences, Altenhöferallee 1, 60438 Frankfurt am Main, Germany
| | - L. L. J. Quéléver
- Institute for Atmospheric and Earth System Research/INAR–Physics, Faculty of Science, University of Helsinki, 00560 Helsinki, Finland
| | - N. Sarnela
- Institute for Atmospheric and Earth System Research/INAR–Physics, Faculty of Science, University of Helsinki, 00560 Helsinki, Finland
| | - S. Schallhart
- Institute for Atmospheric and Earth System Research/INAR–Physics, Faculty of Science, University of Helsinki, 00560 Helsinki, Finland
| | | | - M. Sipilä
- Institute for Atmospheric and Earth System Research/INAR–Physics, Faculty of Science, University of Helsinki, 00560 Helsinki, Finland
| | - A. Tomé
- IDL Universidade da Beira Interior, Covilhã, Portugal
| | - J. Tröstl
- Laboratory of Atmospheric Chemistry, Paul Scherrer Institute, 5232 Villigen, Switzerland
| | - O. Väisänen
- University of Eastern Finland, Department of Applied Physics, P.O. Box 1627, 70211 Kuopio, Finland
| | - A. C. Wagner
- Goethe University Frankfurt, Institute for Atmospheric and Environmental Sciences, Altenhöferallee 1, 60438 Frankfurt am Main, Germany
| | - A. Ylisirniö
- University of Eastern Finland, Department of Applied Physics, P.O. Box 1627, 70211 Kuopio, Finland
| | - Q. Zha
- Institute for Atmospheric and Earth System Research/INAR–Physics, Faculty of Science, University of Helsinki, 00560 Helsinki, Finland
| | - U. Baltensperger
- Laboratory of Atmospheric Chemistry, Paul Scherrer Institute, 5232 Villigen, Switzerland
| | | | - J. Curtius
- Goethe University Frankfurt, Institute for Atmospheric and Environmental Sciences, Altenhöferallee 1, 60438 Frankfurt am Main, Germany
| | - R. C. Flagan
- California Institute of Technology, 210-41, Pasadena, CA 91125, USA
| | - A. Hansel
- Institute for Atmospheric and Earth System Research/INAR–Physics, Faculty of Science, University of Helsinki, 00560 Helsinki, Finland
- University of Innsbruck, Institute for Ion and Applied Physics, 6020 Innsbruck, Austria
- IONICON GesmbH, Innsbruck, Austria
| | - I. Riipinen
- Department of Environmental Science and Analytical Chemistry (ACES) and Bolin Centre for Climate Research, Stockholm University, 10691 Stockholm, Sweden
| | - J. N. Smith
- Department of Chemistry, University of California, Irvine, CA 92697, USA
| | - A. Virtanen
- University of Eastern Finland, Department of Applied Physics, P.O. Box 1627, 70211 Kuopio, Finland
| | - P. M. Winkler
- University of Vienna, Faculty of Physics, Boltzmanngasse 5, 1090 Wien, Austria
| | - N. M. Donahue
- Carnegie Mellon University Center for Atmospheric Particle Studies, 5000 Forbes Ave., Pittsburgh, PA 15213, USA
| | - V.-M. Kerminen
- Institute for Atmospheric and Earth System Research/INAR–Physics, Faculty of Science, University of Helsinki, 00560 Helsinki, Finland
| | - M. Kulmala
- Institute for Atmospheric and Earth System Research/INAR–Physics, Faculty of Science, University of Helsinki, 00560 Helsinki, Finland
- Joint International Research Laboratory of Atmospheric and Earth System Sciences, School of Atmospheric Sciences, Nanjing University, Nanjing, China
- Aerosol and Haze Laboratory, Beijing Advanced Innovation Center for Soft Matter Science and Engineering, Beijing University of Chemical Technology, Beijing, China
- Helsinki Institute of Physics, FI-00014 Helsinki, Finland
| | - M. Ehn
- Institute for Atmospheric and Earth System Research/INAR–Physics, Faculty of Science, University of Helsinki, 00560 Helsinki, Finland
| | - D. R. Worsnop
- Institute for Atmospheric and Earth System Research/INAR–Physics, Faculty of Science, University of Helsinki, 00560 Helsinki, Finland
- Aerodyne Research Inc., Billerica, MA 01821, USA
- University of Eastern Finland, Department of Applied Physics, P.O. Box 1627, 70211 Kuopio, Finland
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9
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Velasco AV, González-Andrade D, Herrero-Bermello A, Luque-González JM, Halir R, Wangüemert-Pérez JG, Ortega-Moñux A, Dias A, Molina-Fernández I, Cheben P. Ultra-broadband silicon photonics devices based on subwavelength metamaterials -INVITED. EPJ Web Conf 2020. [DOI: 10.1051/epjconf/202023801002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Subwavelength structured waveguides provide tailorable optical properties that can be leveraged to overcome bandwidth limitations in a wide range of photonic devices. In this invited talk, we present an overview of recent developments on subwavelength engineered building blocks, including phase shifters, mode multiplexers, polarization beam splitters and zero-birefringence waveguides.
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10
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Tsyganov D, Bundaleska N, Dias A, Henriques J, Felizardo E, Abrashev M, Kissovski J, do Rego AMB, Ferraria AM, Tatarova E. Microwave plasma-based direct synthesis of free-standing N-graphene. Phys Chem Chem Phys 2020; 22:4772-4787. [PMID: 32066999 DOI: 10.1039/c9cp05509f] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Scheme of ethanol/ammonia plasma driven decomposition pathways considering injection of the nitrogen precursor in “hot” and “mild” plasma zone.
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11
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Goncalves Teixeira PM, Passos Silva M, Mbala D, Ana Canelas M, Varela M, Raquel Barbosa A, Guerreiro C, Mosalina A, Dias T, Queiros P, Fontes-Carvalho R, Ponte M, Dias A, Caeiro D, Braga P. P5739Venoarterial Extracorporeal Membrane Oxygenation in Cardiogenic Shock: exploring prognostic variables and risk prediction tools. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz746.0679] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Abstract
Introduction
The use of venoarterial extracorporeal membrane oxygenation (VA-ECMO) to support patients in cardiogenic shock has been increasing in Portugal over the past few years. Nonetheless, epidemiologic, prognostic and clinical outcome data are scarce.
Purpose
We aim to identify clinical variables with prognostic significance in this challenging population, as well as the performance of various risk scores in mortality prediction.
Methods
All patients that underwent VA-ECMO support at our Cardiac ICU between 2011 and 2018 were included in the analysis. Logistic regression analysis was used to assess the relationship between clinical variables and outcomes.
Results
Short-term mechanical support with VA-ECMO was given to 40 patients, with a mean age of 52±11 years. At the time of the implant, the mean SOFA score was 11.2±4.0, and mean SAVE score was −4.75±4.6. Mean ECMO support duration was 116±96 hours. In 70% (N=28) of patients, VA-ECMO was successfully weaned. In-hospital mortality was observed in 52.5% of patients, which was in accordance with the predicted mortality by SOFA score (22.5% to 82% in our population risk range) and by SAVE score (60 to 70%). Those who placed the VA-ECMO as a bridge to transplant or to long-term mechanical LV assist device had greater in-hospital mortality rates (91.6 vs 41.9%, p=0.013), as well as those under ≥2 inotropic/vasopressors (69.2 vs 21.4%, p=0.012) or when adrenaline use was needed (100% vs 44.1%, p=0.01). No other between-group differences were observed in what concerns short-term mortality. After logistic regression analysis, independent predictors of in-hospital mortality included AMI setting, number of vasoactive amines used, and necessity of a LV venting device. SAVE score had the greater predictive ability in these patients (AUC = 0.638) among the most utilized clinical risk scores (SOFA score AUC = 0.37; APACHE II score AUC = 0.59; SAPS II score AUC = 0.54).
Conclusion
In our analysis, patients in profound cardiogenic shock on VA-ECMO support had slightly better survival rates than predicted by classical Risk Scores. The SAVE score may be the most accurate tool to predict in-hospital mortality in this specific, and yet heterogeneous, clinical subset. Other well recognized clinical markers of severity may also help refine short-term prognosis, and potentially improve organ transplant or other destination therapy prioritization.
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Affiliation(s)
| | - M Passos Silva
- Hospital Center of Vila Nova de Gaia/Espinho, Cardiology, Vila Nova de Gaia, Portugal
| | - D Mbala
- Hospital Center of Vila Nova de Gaia/Espinho, Cardiology, Vila Nova de Gaia, Portugal
| | - M Ana Canelas
- Hospital Center of Vila Nova de Gaia/Espinho, Internal Medicine, Vila Nova de Gaia, Portugal
| | - M Varela
- Faro Hospital, Intensive Care Medicine, Faro, Portugal
| | - A Raquel Barbosa
- Hospital Center of Vila Nova de Gaia/Espinho, Cardiology, Vila Nova de Gaia, Portugal
| | - C Guerreiro
- Hospital Center of Vila Nova de Gaia/Espinho, Cardiology, Vila Nova de Gaia, Portugal
| | - A Mosalina
- Hospital Center of Vila Nova de Gaia/Espinho, Cardiology, Vila Nova de Gaia, Portugal
| | - T Dias
- Hospital Center of Vila Nova de Gaia/Espinho, Cardiology, Vila Nova de Gaia, Portugal
| | - P Queiros
- Hospital Center of Vila Nova de Gaia/Espinho, Cardiology, Vila Nova de Gaia, Portugal
| | - R Fontes-Carvalho
- Hospital Center of Vila Nova de Gaia/Espinho, Cardiology, Vila Nova de Gaia, Portugal
| | - M Ponte
- Hospital Center of Vila Nova de Gaia/Espinho, Cardiology, Vila Nova de Gaia, Portugal
| | - A Dias
- Hospital Center of Vila Nova de Gaia/Espinho, Cardiology, Vila Nova de Gaia, Portugal
| | - D Caeiro
- Hospital Center of Vila Nova de Gaia/Espinho, Cardiology, Vila Nova de Gaia, Portugal
| | - P Braga
- Hospital Center of Vila Nova de Gaia/Espinho, Cardiology, Vila Nova de Gaia, Portugal
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12
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Alves JG, Sarmento S, Pereira JS, Pereira MF, Sousa MJ, Cunha L, Dias A, Oliveira AD, Cardoso JV, Santos LM, Lencart J, Gouvêa M, Santos JAM. Dose to the interventional radiologist in CTF-guided procedures. Radiat Environ Biophys 2019; 58:373-384. [PMID: 30993431 DOI: 10.1007/s00411-019-00792-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/30/2018] [Accepted: 04/06/2019] [Indexed: 06/09/2023]
Abstract
The aim of this work was to assess the occupational dose received by an interventional radiologist (IR) during computed tomography fluoroscopy (CTF)-guided procedures; to identify the most exposed areas of the body including the hands and fingers; to suggest recommendations for individual monitoring; and to improve radiation safety of the practice. A total of 53 CTF-guided procedures were studied. Twelve whole-body dosimeters were worn by the IR in each procedure for the assessment of the personal dose equivalent, Hp(10), on the chest, waist, and back, both over and under the lead apron, as well as the personal dose equivalent, Hp(0.07), on both arms, knees, and feet. Special gloves with casings to fit extremity dosimeters were prepared to assess Hp(0.07) to the fingers. The measured chest dose values were higher than those on the waist and back; the dominant hand or the left side was the most exposed. In general, the ring, middle, and index fingers of the dominant hand were the most exposed (maximum in the 36-39 mSv range), while wrist dose was negligible compared to finger doses. Based on the results obtained the following recommendations are suggested: protective devices (lead aprons, thyroid shield, and goggles) should be worn; Hp(10) should be assessed at the chest level both above and below the lead apron; finger doses can be measured on the basis of each middle finger; the arm closer to the beam should be monitored; and finally, a wrist dosimeter will not provide useful information.
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Affiliation(s)
- J G Alves
- Instituto Superior Técnico (IST), Laboratório de Proteção e Segurança Radiológica (LPSR), Universidade de Lisboa (UL), Estrada Nacional 10 (ao km 139,7), 2695-066, Bobadela LRS, Portugal.
- Departamento de Engenharia e Ciências Nucleares (DECN), Centro de Ciências e Tecnologias Nucleares (C2TN), UL-IST, Bobadela LRS, Portugal.
| | - S Sarmento
- Instituto Português de Oncologia do Porto Francisco Gentil, EPE (IPOPFG E.P.E.), Serviço de Física Médica, Rua Dr. António Bernardino de Almeida, 4200-072, Porto, Portugal
- Centro de Investigação, IPOPFG E.P.E., Porto, Portugal
| | - J S Pereira
- Instituto Superior Técnico (IST), Laboratório de Proteção e Segurança Radiológica (LPSR), Universidade de Lisboa (UL), Estrada Nacional 10 (ao km 139,7), 2695-066, Bobadela LRS, Portugal
- Departamento de Engenharia e Ciências Nucleares (DECN), Centro de Ciências e Tecnologias Nucleares (C2TN), UL-IST, Bobadela LRS, Portugal
| | - M F Pereira
- Instituto Superior Técnico (IST), Laboratório de Proteção e Segurança Radiológica (LPSR), Universidade de Lisboa (UL), Estrada Nacional 10 (ao km 139,7), 2695-066, Bobadela LRS, Portugal
- Departamento de Engenharia e Ciências Nucleares (DECN), Centro de Ciências e Tecnologias Nucleares (C2TN), UL-IST, Bobadela LRS, Portugal
| | - M J Sousa
- Serviço de Radiologia de Intervenção, IPOPFG E.P.E., Porto, Portugal
| | - L Cunha
- Instituto Português de Oncologia do Porto Francisco Gentil, EPE (IPOPFG E.P.E.), Serviço de Física Médica, Rua Dr. António Bernardino de Almeida, 4200-072, Porto, Portugal
- Centro de Investigação, IPOPFG E.P.E., Porto, Portugal
| | - A Dias
- Instituto Português de Oncologia do Porto Francisco Gentil, EPE (IPOPFG E.P.E.), Serviço de Física Médica, Rua Dr. António Bernardino de Almeida, 4200-072, Porto, Portugal
- Centro de Investigação, IPOPFG E.P.E., Porto, Portugal
| | - A D Oliveira
- Instituto Superior Técnico (IST), Laboratório de Proteção e Segurança Radiológica (LPSR), Universidade de Lisboa (UL), Estrada Nacional 10 (ao km 139,7), 2695-066, Bobadela LRS, Portugal
- Departamento de Engenharia e Ciências Nucleares (DECN), Centro de Ciências e Tecnologias Nucleares (C2TN), UL-IST, Bobadela LRS, Portugal
| | - J V Cardoso
- Instituto Superior Técnico (IST), Laboratório de Proteção e Segurança Radiológica (LPSR), Universidade de Lisboa (UL), Estrada Nacional 10 (ao km 139,7), 2695-066, Bobadela LRS, Portugal
| | - L M Santos
- Instituto Superior Técnico (IST), Laboratório de Proteção e Segurança Radiológica (LPSR), Universidade de Lisboa (UL), Estrada Nacional 10 (ao km 139,7), 2695-066, Bobadela LRS, Portugal
| | - J Lencart
- Instituto Português de Oncologia do Porto Francisco Gentil, EPE (IPOPFG E.P.E.), Serviço de Física Médica, Rua Dr. António Bernardino de Almeida, 4200-072, Porto, Portugal
| | - M Gouvêa
- Serviço de Radiologia, IPOPFG E.P.E., Porto, Portugal
| | - J A M Santos
- Instituto Português de Oncologia do Porto Francisco Gentil, EPE (IPOPFG E.P.E.), Serviço de Física Médica, Rua Dr. António Bernardino de Almeida, 4200-072, Porto, Portugal
- Centro de Investigação, IPOPFG E.P.E., Porto, Portugal
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13
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Teixeira-Lopes F, Cysneiros A, Dias A, Durão V, Costa C, Paula F, Serrado M, Nunes B, Diniz A, Froes F. Intra-hospital mortality for community-acquired pneumonia in mainland Portugal between 2000 and 2009. Pulmonology 2019; 25:66-70. [DOI: 10.1016/j.pulmoe.2018.06.004] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2017] [Revised: 03/22/2018] [Accepted: 06/02/2018] [Indexed: 10/28/2022] Open
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14
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Pedro PI, Maia Santos L, Braço Forte C, Dias A, Cruz C, Rodrigues F. Benefits of pulmonary rehabilitation in patients with chronic obstructive pulmonary disease and interstitial lung disease with the same dyspnea severity. Pulmonology 2019; 25:117-118. [PMID: 30755382 DOI: 10.1016/j.pulmoe.2019.01.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2018] [Revised: 12/11/2018] [Accepted: 01/09/2019] [Indexed: 10/27/2022] Open
Affiliation(s)
- P I Pedro
- Pulmonology Department, Hospital Garcia de Orta, Almada, Portugal.
| | - L Maia Santos
- Pulmonology Department, Hospitais da Universidade de Coimbra, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
| | - C Braço Forte
- Pulmonology Department, Hospital de São Bernardo, Centro Hospitalar de Setúbal, Setúbal, Portugal
| | - A Dias
- Pulmonology Department, Centro Hospitalar Universitário Lisboa Norte, Lisboa, Portugal
| | - C Cruz
- Pulmonary Rehabilitation Unit, Hospital Pulido Valente, Centro Hospitalar Universitário Lisboa Norte, Lisboa, Portugal
| | - F Rodrigues
- Pulmonology Department, Centro Hospitalar Universitário Lisboa Norte, Lisboa, Portugal; Pulmonary Rehabilitation Unit, Hospital Pulido Valente, Centro Hospitalar Universitário Lisboa Norte, Lisboa, Portugal; Universidade de Lisboa, Faculdade de Medicina, Instituto de Saúde Ambiental (ISAMB), Portugal
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15
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Manuel A, Guerreiro C, Ribeiro J, Melica B, Barbosa AR, Teixeira P, Fonseca M, Dias A, Caeiro D, Fontes-Carvalho R, Sampaio F, Braga P, Teixeira M, Gama V. P2796Percutaneous treatment of severe mitral regurgitation with mitraclip device: potential role of NT-proBNP in prognosis assessment. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy565.p2796] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- A Manuel
- Hospital Center Vila Nova Gaia, Cardiology, Porto, Portugal
| | - C Guerreiro
- Hospital Center Vila Nova Gaia, Cardiology, Porto, Portugal
| | - J Ribeiro
- Hospital Center Vila Nova Gaia, Cardiology, Porto, Portugal
| | - B Melica
- Hospital Center Vila Nova Gaia, Cardiology, Porto, Portugal
| | - A R Barbosa
- Hospital Center Vila Nova Gaia, Cardiology, Porto, Portugal
| | - P Teixeira
- Hospital Center Vila Nova Gaia, Cardiology, Porto, Portugal
| | - M Fonseca
- Hospital Center Vila Nova Gaia, Cardiology, Porto, Portugal
| | - A Dias
- Hospital Center Vila Nova Gaia, Cardiology, Porto, Portugal
| | - D Caeiro
- Hospital Center Vila Nova Gaia, Cardiology, Porto, Portugal
| | | | - F Sampaio
- Hospital Center Vila Nova Gaia, Cardiology, Porto, Portugal
| | - P Braga
- Hospital Center Vila Nova Gaia, Cardiology, Porto, Portugal
| | - M Teixeira
- Hospital Center Vila Nova Gaia, Cardiology, Porto, Portugal
| | - V Gama
- Hospital Center Vila Nova Gaia, Cardiology, Porto, Portugal
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16
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Xavier Fontes A, Montenegro Sa F, Passos Silva M, Caeiro D, Dias A, Santos L, Rodrigues JA, Tavares A, Braga P. P4659Evolution in the use of intra-aortic balloon pump in patients with cardiogenic shock. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy563.p4659] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- A Xavier Fontes
- Hospital Divino Espirito Santo, Cardiology, Ponta Delgada, Portugal
| | | | - M Passos Silva
- Hospital Center of Vila Nova de Gaia/Espinho, Cardiology, Vila Nova de Gaia, Portugal
| | - D Caeiro
- Hospital Center of Vila Nova de Gaia/Espinho, Cardiology, Vila Nova de Gaia, Portugal
| | - A Dias
- Hospital Center of Vila Nova de Gaia/Espinho, Cardiology, Vila Nova de Gaia, Portugal
| | - L Santos
- Hospital Center of Vila Nova de Gaia/Espinho, Cardiology, Vila Nova de Gaia, Portugal
| | - J A Rodrigues
- Hospital Center of Vila Nova de Gaia/Espinho, Cardiology, Vila Nova de Gaia, Portugal
| | - A Tavares
- Hospital Divino Espirito Santo, Cardiology, Ponta Delgada, Portugal
| | - P Braga
- Hospital Center of Vila Nova de Gaia/Espinho, Cardiology, Vila Nova de Gaia, Portugal
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Dias A, Muñoz F, Alvarez A, Moreno-Zárate P, Atienzar J, Urbieta A, Fernandez P, Pardo M, Serna R, Solis J. Femtosecond laser writing of photonic devices in borate glasses compositionally designed to be laser writable. Opt Lett 2018; 43:2523-2526. [PMID: 29856420 DOI: 10.1364/ol.43.002523] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/15/2018] [Accepted: 04/23/2018] [Indexed: 06/08/2023]
Abstract
The design and performance of borate glass samples compositionally pre-designed to be femtosecond laser writable via laser-induced ion migration is reported in this Letter. It is demonstrated that borate glasses modified on purpose with small amounts of La2O3 and Na2O can be straightforwardly used to produce high-index contrast (Δn) waveguides by femtosecond-laser-assisted ion migration. The positive Δn of the waveguides is caused by the local enrichment of La2O3 in the guiding region with a slope of 8·10-3(mol.%)-1. The value of this is consistent with numerical aperture measurements of the waveguides and local compositional measurements at the guiding region performed by energy-dispersive x-ray micro-analysis. The maximum achievable Δn values can be controlled through the initial La2O3 content of the glass. Maximum Δn values >10-2 for samples with just 5.5 mol. % of La2O3 have been produced. This compositional design approach could be potentially used to produce highly efficient femtosecond laser writeable glasses in other glass families.
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Bundaleska N, Tsyganov D, Dias A, Felizardo E, Henriques J, Dias FM, Abrashev M, Kissovski J, Tatarova E. Microwave plasma enabled synthesis of free standing carbon nanostructures at atmospheric pressure conditions. Phys Chem Chem Phys 2018; 20:13810-13824. [DOI: 10.1039/c8cp01896k] [Citation(s) in RCA: 44] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Schematic representation of the physico-chemical processes involved in the formation of carbon nanostructures in the microwave plasma environment.
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Affiliation(s)
- N. Bundaleska
- Instituto de Plasmas e Fusão Nuclear
- Instituto Superior Técnico
- Universidade de Lisboa
- 1049-001 Lisbon
- Portugal
| | - D. Tsyganov
- Instituto de Plasmas e Fusão Nuclear
- Instituto Superior Técnico
- Universidade de Lisboa
- 1049-001 Lisbon
- Portugal
| | - A. Dias
- Instituto de Plasmas e Fusão Nuclear
- Instituto Superior Técnico
- Universidade de Lisboa
- 1049-001 Lisbon
- Portugal
| | - E. Felizardo
- Instituto de Plasmas e Fusão Nuclear
- Instituto Superior Técnico
- Universidade de Lisboa
- 1049-001 Lisbon
- Portugal
| | - J. Henriques
- Instituto de Plasmas e Fusão Nuclear
- Instituto Superior Técnico
- Universidade de Lisboa
- 1049-001 Lisbon
- Portugal
| | - F. M. Dias
- Instituto de Plasmas e Fusão Nuclear
- Instituto Superior Técnico
- Universidade de Lisboa
- 1049-001 Lisbon
- Portugal
| | - M. Abrashev
- Faculty of Physics
- University of Sofia
- Sofia
- Bulgaria
| | - J. Kissovski
- Faculty of Physics
- University of Sofia
- Sofia
- Bulgaria
| | - E. Tatarova
- Instituto de Plasmas e Fusão Nuclear
- Instituto Superior Técnico
- Universidade de Lisboa
- 1049-001 Lisbon
- Portugal
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Dias A, Faria I, Santos AC, Bárbara C. Thinking outside the thorax for patients difficult to wean from non-invasive ventilation: amyotrophic lateral sclerosis diagnosis and management in a Respiratory Intermediate Care Unit. Pulmonology 2017; 24:S2173-5115(17)30161-6. [PMID: 29290577 DOI: 10.1016/j.rppnen.2017.11.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2017] [Revised: 10/20/2017] [Accepted: 11/05/2017] [Indexed: 11/30/2022] Open
Affiliation(s)
- A Dias
- Chest Department, Centro Hospitalar Lisboa Norte, Lisboa, Portugal.
| | - I Faria
- Chest Department, Centro Hospitalar Lisboa Norte, Lisboa, Portugal
| | - A C Santos
- Chest Department, Centro Hospitalar Lisboa Norte, Lisboa, Portugal
| | - C Bárbara
- Chest Department, Centro Hospitalar Lisboa Norte, Lisboa, Portugal; Institute of Environmental Health (ISAMB), Faculty of Medicine, University of Lisbon, Portugal
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von Amann B, Dias A, Dias M, Escaleira M, Martinho C, Basto RP, Pinto P, Bárbara C. Effectiveness of the follow-up of patients with obstructive sleep apnea undergoing CPAP treatment in primary care units. Sleep Med 2017. [DOI: 10.1016/j.sleep.2017.11.1002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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21
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Marques B, Silvana Alves M, Silva Filho A, Dias A. Phytochemical profiles and antioxidant activity of Baccharis dracunculifolia and Baccharis trimera ethanolic extracts. Am J Transl Res 2017. [DOI: 10.1055/s-0037-1608548] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- B Marques
- CITAB-Centre for the Research and Technology of Agro-Environmental and Biological Sciences, Department of Biology, University of Minho, Campus de Gualtar, 4710 – 057 Braga, Portugal, Braga, Portugal
| | - M Silvana Alves
- Faculdade de Farmácia e Bioquímica, Departamento Farmacêutico, Universidade Federal de Juiz de Fora, Juiz de Fora, MG – Brasil, Juiz de Fora, Brazil
| | - A Silva Filho
- Faculdade de Farmácia e Bioquímica, Departamento Farmacêutico, Universidade Federal de Juiz de Fora, Juiz de Fora, MG – Brasil, Juiz de Fora, Brazil
| | - A Dias
- CITAB-Centre for the Research and Technology of Agro-Environmental and Biological Sciences, Department of Biology, University of Minho, Campus de Gualtar, 4710 – 057 Braga, Portugal, Braga, Portugal
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Castro V, Gomes A, Botelho C, Dias A. Evaluation of antioxidant potential and cytotoxic effects of alcoholic extracts of Diospyros kaki leaves. Am J Transl Res 2017. [DOI: 10.1055/s-0037-1608185] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- V Castro
- DYNAMIKLIZARD LDA, Avenida Alves Figueiredo, 1100. 4780 – 163 Santo Tirso, Santo Tirso, Portugal
- Centre for the Research and Technology of Agro-Environment and Biological Sciences (CITAB-UM), AgroBioPlant Group, Department of Biology, University of Minho, Portugal, Braga, Portugal
| | - A Gomes
- CBMA – Centro de Biologia Molecular e Ambiental, Department of Biology, University of Minho, Braga, Portugal, Braga, Portugal
| | - C Botelho
- CBMA – Centro de Biologia Molecular e Ambiental, Department of Biology, University of Minho, Braga, Portugal, Braga, Portugal
| | - A Dias
- Centre for the Research and Technology of Agro-Environment and Biological Sciences (CITAB-UM), AgroBioPlant Group, Department of Biology, University of Minho, Portugal, Braga, Portugal
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Castro V, Aierken A, Zhang X, Dias A. Comparative study of antioxidant potential and cytotoxic effects of methanolic extracts from Lycium barbarum and Lycium ruthenicum berries. Am J Transl Res 2017. [DOI: 10.1055/s-0037-1608592] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Affiliation(s)
- V Castro
- DYNAMIKLIZARD LDA, Avenida Alves Figueiredo, 1100. 4780 – 163 Santo Tirso, Santo Tirso, Portugal
| | - A Aierken
- College of Veterinary Medicine, Northwest A&F University, Yangling, Shaanxi, 712100 China, Yangling, Shaanxi, China
| | - X Zhang
- College of Veterinary Medicine, Northwest A&F University, Yangling, Shaanxi, 712100 China, Yangling, Shaanxi, China
| | - A Dias
- Centre for the Research and Technology of Agro-Environment and Biological Sciences (CITAB-UM), AgroBioPlant Group, Department of Biology, University of Minho, Portugal, Braga, Portugal
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Laranjeira I, Apolinário E, Amorim D, Silva-Filho A, Pinto-Ribeiro F, Dias A. Baccharis dracunculifolia decreases nociception, depressive-like behaviour and supraspinal activated microglia in rats with experimental monoarthritis. Am J Transl Res 2017. [DOI: 10.1055/s-0037-1608306] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- I Laranjeira
- CITAB-Centre for the Research and Technology of Agro-Environmental and Biological Sciences, Department of Biology, University of Minho, Campus de Gualtar, 4710 – 057 Braga, Portugal, Braga, Portugal
| | - E Apolinário
- CITAB-Centre for the Research and Technology of Agro-Environmental and Biological Sciences, Department of Biology, University of Minho, Campus de Gualtar, 4710 – 057 Braga, Portugal, Braga, Portugal
| | - D Amorim
- Life and Health Sciences Research Institute (ICVS), School of Medicine, Campus de Gualtar, University of Minho, 4710 – 057 Braga, Portugal, Braga, Portugal
- ICVS/3B's – PT Government Associate Laboratory, Braga/Guimarães, Portugal, Braga, Portugal
| | - A Silva-Filho
- Faculdade de Farmácia e Bioquímica, Departamento Farmacêutico, Universidade Federal de Juiz de Fora, Juiz de Fora, MG – Brasil, Braga, Portugal
| | - F Pinto-Ribeiro
- Life and Health Sciences Research Institute (ICVS), School of Medicine, Campus de Gualtar, University of Minho, 4710 – 057 Braga, Portugal, Braga, Portugal
- ICVS/3B's – PT Government Associate Laboratory, Braga/Guimarães, Portugal, Braga, Portugal
| | - A Dias
- CITAB-Centre for the Research and Technology of Agro-Environmental and Biological Sciences, Department of Biology, University of Minho, Campus de Gualtar, 4710 – 057 Braga, Portugal, Braga, Portugal
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Tatarova E, Dias A, Henriques J, Abrashev M, Bundaleska N, Kovacevic E, Bundaleski N, Cvelbar U, Valcheva E, Arnaudov B, do Rego AMB, Ferraria AM, Berndt J, Felizardo E, Teodoro OMND, Strunskus T, Alves LL, Gonçalves B. Towards large-scale in free-standing graphene and N-graphene sheets. Sci Rep 2017; 7:10175. [PMID: 28860575 PMCID: PMC5579263 DOI: 10.1038/s41598-017-10810-3] [Citation(s) in RCA: 56] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2017] [Accepted: 08/15/2017] [Indexed: 11/09/2022] Open
Abstract
One of the greatest challenges in the commercialization of graphene and derivatives is production of high quality material in bulk quantities at low price and in a reproducible manner. The very limited control, or even lack of, over the synthesis process is one of the main problems of conventional approaches. Herein, we present a microwave plasma-enabled scalable route for continuous, large-scale fabrication of free-standing graphene and nitrogen doped graphene sheets. The method's crucial advantage relies on harnessing unique plasma mechanisms to control the material and energy fluxes of the main building units at the atomic scale. By tailoring the high energy density plasma environment and complementarily applying in situ IR and soft UV radiation, a controllable selective synthesis of high quality graphene sheets at 2 mg/min yield with prescribed structural qualities was achieved. Raman spectroscopy, scanning electron microscopy, high resolution transmission electron microscopy, X-ray photoelectron spectroscopy and Near Edge X-ray-absorption fine-structure spectroscopy were used to probe the morphological, chemical and microstructural features of the produced material. The method described here is scalable and show a potential for controllable, large-scale fabrication of other graphene derivatives and promotes microwave plasmas as a competitive, green, and cost-effective alternative to presently used chemical methods.
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Affiliation(s)
- E Tatarova
- Instituto de Plasmas e Fusão Nuclear, Instituto Superior Técnico, Universidade de Lisboa, Lisboa, 1049, Portugal.
| | - A Dias
- Instituto de Plasmas e Fusão Nuclear, Instituto Superior Técnico, Universidade de Lisboa, Lisboa, 1049, Portugal
| | - J Henriques
- Instituto de Plasmas e Fusão Nuclear, Instituto Superior Técnico, Universidade de Lisboa, Lisboa, 1049, Portugal
| | - M Abrashev
- Faculty of Physics, Sofia University, 1164, Sofia, Bulgaria
| | - N Bundaleska
- Instituto de Plasmas e Fusão Nuclear, Instituto Superior Técnico, Universidade de Lisboa, Lisboa, 1049, Portugal
| | - E Kovacevic
- GREMI UMR 7344 CNRS and Université d'Orléans, Orleans Cedex 2, France
| | - N Bundaleski
- Departamento de Física, Faculdade de Ciências e Tecnologia, Universidade Nova de Lisboa, Lisboa, 2829-516, Portugal
| | - U Cvelbar
- Department for Surface Engineering and Optoelectronics F4, Jozef Stefan Institute, Ljubljana, 1000, Slovenia
| | - E Valcheva
- Faculty of Physics, Sofia University, 1164, Sofia, Bulgaria
| | - B Arnaudov
- Faculty of Physics, Sofia University, 1164, Sofia, Bulgaria
| | - A M Botelho do Rego
- Centro de Química-Física Molecular and IN, Instituto Superior Técnico, Universidade de Lisboa, Lisboa, 1049, Portugal
| | - A M Ferraria
- Centro de Química-Física Molecular and IN, Instituto Superior Técnico, Universidade de Lisboa, Lisboa, 1049, Portugal
| | - J Berndt
- GREMI UMR 7344 CNRS and Université d'Orléans, Orleans Cedex 2, France
| | | | - O M N D Teodoro
- Departamento de Física, Faculdade de Ciências e Tecnologia, Universidade Nova de Lisboa, Lisboa, 2829-516, Portugal
| | - Th Strunskus
- Institute for Materials Science, Christian Albrechts Universitaet zu Kiel, Kiel, Germany
| | - L L Alves
- Instituto de Plasmas e Fusão Nuclear, Instituto Superior Técnico, Universidade de Lisboa, Lisboa, 1049, Portugal
| | - B Gonçalves
- Instituto de Plasmas e Fusão Nuclear, Instituto Superior Técnico, Universidade de Lisboa, Lisboa, 1049, Portugal
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Manuel A, Almeida J, Guerreiro C, Barbosa A, Ribeiro J, Dias A, Fonseca M, Caeiro D, Sousa O, Oliveira M, Goncalves H, Primo J, Rodrigues A, Braga P, Gama V. P6391Impact of transcatheter aortic valve implantation on cardiac electrical conduction: the “all or nothing” effect? Eur Heart J 2017. [DOI: 10.1093/eurheartj/ehx493.p6391] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Nouraei SAR, Makmur E, Dias A, Butler CR, Nandi R, Elliott MJ, Hewitt R. Validation of the Airway-Dyspnoea-Voice-Swallow (ADVS) scale and Patient-Reported Outcome Measure (PROM) as disease-specific instruments in paediatric laryngotracheal stenosis. Clin Otolaryngol 2017; 42:283-294. [PMID: 27542317 DOI: 10.1111/coa.12729] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/02/2016] [Indexed: 01/07/2023]
Abstract
OBJECTIVE To validate the Airway-Dyspnoea-Voice-Swallow (ADVS) instrument as a disease-specific Patient-Reported Outcome Measure in paediatric laryngotracheal stenosis. DESIGN Prospective observational study. SETTING A quaternary referral centre for complex airway disease. PARTICIPANTS Forty-eight patients (30 males) with a mean age of 49 ± 49 months who underwent laryngotracheal surgery or microlaryngoscopy and bronchoscopy (MLB) following laryngotracheal surgery. MAIN OUTCOME MEASURES Airway-Dyspnoea-Voice-Swallow summary scale and Patient-Reported Outcome Measure (PROM), Paediatric Quality of Life (PedsQL) scale, Paediatric Voice Handicap Index (pVHI) and Lansky performance scale were administered to patients before and 6-8 weeks following airway examination/surgery. RESULTS Most patients (73%) had intubation-related subglottic stenosis, and 60% of patients had prior airway treatments. The majority of patients (77%) had more than one major chronic morbidity, and the commonest procedures were diagnostic MLB (49%), followed by airway dilation (29%). Cronbach-α value for the ADVS PROM was 0.71 overall and 0.85, 0.86 and 0.64 for the dyspnoea, voice and swallow domains, respectively. Rank correlations between Dyspnoea, Voice and Swallow summary scale and PROM scores were 0.83, 0.71 and 0.81, respectively (P < 0.0001). For those patients undergoing diagnostic MLB, pre- and post-examination scores were highly correlated (intraclass correlations >0.75). There was a significant rank correlation between ADVS PROM score and Lansky performance score (r = -0.68; P < 0.0001). There were significant correlations between PROM score and PedsQL (r = -0.57; P < 0.0001) and between voice domain of the PROM and pVHI (r = 0.78; P < 0.0001). There were strong correlations between Myer-Cotton stenosis severity and dyspnoea scale and PROM score (r = 0.68; P < 0.0001). There were significant differences in voice and swallow ADVS scales and PROM scores between patients with and without concomitant laryngeal/oesophageal pathology. Patient age and presence of high dyspnoea and swallowing PROM scores were independently associated with poorer quality of life and performance status. CONCLUSIONS These series of observations validate the ADVS instrument as a disease-specific outcome measure for paediatric laryngotracheal stenosis. Dyspnoea and swallowing dysfunction appear to have the greatest impact on quality of life. More widespread adoption of the ADVS instrument could help create a shared language for outcomes communication and benchmarking for children with this complex condition.
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Affiliation(s)
- S A R Nouraei
- Department of Otolaryngology - Head and Neck Surgery, Great Ormond Street Hospital, London, UK
- Department of Ear Nose and Throat Surgery, Auckland City Hospital, Auckland, New Zealand
- Academic Department of Surgery, University of Auckland, Auckland, New Zealand
| | - E Makmur
- The Medical School, University College London, London, UK
| | - A Dias
- Department of Ear Nose and Throat Surgery, Auckland City Hospital, Auckland, New Zealand
| | - C R Butler
- Academic Department of Surgery, University of Auckland, Auckland, New Zealand
| | - R Nandi
- Department of Anaesthesia, Great Ormond Street Hospital, London, UK
| | - M J Elliott
- Department of Cardiothoracic Surgery, Great Ormond Street Hospital, London, UK
| | - R Hewitt
- Department of Otolaryngology - Head and Neck Surgery, Great Ormond Street Hospital, London, UK
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Dias A, Franco E, Janzer S, Koshkelashvili N, Bhalla V, Rubio M, Amanullah S, Hebert K, Figueredo VM. Incidence and predictors of stroke during the index event in an ethnically diverse Takotsubo cardiomyopathy population. Funct Neurol 2017; 31:157-62. [PMID: 27678209 DOI: 10.11138/fneur/2016.31.3.157] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
Takotsubo cardiomyopathy (TTS) is a peculiar clinical condition often affecting postmenopausal women after a stressful trigger. The underlying mechanisms have not been completely elucidated but several hypotheses have been advanced, with catecholamine cardiotoxicity, microvascular dysfunction and coronary artery spasm each suggested to play a role. The incidence of stroke after TTS appears to range from 0% to 7.7%, and interestingly TTS has been described as both a cause and a complication of stroke. We sought to assess the incidence and predictors of stroke during the index event (peri-index event stroke) in a heterogeneous TTS population. We conducted a retrospective descriptive study reviewing patients who were discharged with a diagnosis of TTS from the Einstein Medical Center, Philadelphia, PA and Danbury Hospital, Danbury, CT in the period between 2003 and 2014. A total of Incidence and predictors of stroke during the index event in an ethnically diverse Takotsubo cardiomyopathy population 206 patients met the modified Mayo Clinic criteria and were included in the study. The patients' overall mean age was 67.8 years; 87% (n=179) were females and 25% (n=53) were African Americans. The following incidence rates were found: stroke 7%, in-hospital heart failure 26.7%, and in-hospital death 7%. On multivariate analysis independent predictors (expressed as odds ratios with 95% confidence intervals) of periindex event stroke were: i) African American race (OR 3.2, 95% CI 1.2-10.2, p=0.048); ii) hypertension (OR 10.5, 95% CI 1.3-88, p=0.03). ACE inhibitor use was a protective factor for developing peri-index event stroke (OR 0.15, 95% CI 0.04-0.5, p=0.001). There was a trend towards dual antiplatelet therapy (DAPT) being protective for stroke (OR 0.3, 95% CI 0.05-1.1, p=0.08). The incidence of peri-index event stroke was 7%. African American race and hypertension were found to be independent predictors of peri-index event stroke. Prospective clinical trials are needed to confirm these findings and to better determine the impact of hypertension as a risk factor for stroke and to assess the role of DAPT in preventing it.
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Nouraei SAR, Dias A, Kanona H, Vokes D, O'Flynn P, Clarke PM, Middleton SE, Darzi A, Aylin P, Jallali N. Impact of the method and success of pharyngeal reconstruction on the outcome of treating laryngeal and hypopharyngeal cancers with pharyngolaryngectomy: A national analysis. J Plast Reconstr Aesthet Surg 2017; 70:628-638. [PMID: 28325565 DOI: 10.1016/j.bjps.2016.12.009] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2016] [Revised: 12/20/2016] [Accepted: 12/23/2016] [Indexed: 11/15/2022]
Abstract
BACKGROUND Surgical treatment of cancers that arise from or invade the hypopharynx presents major reconstructive challenges. Reconstructive failure exposes the airway and neck vessels to digestive contents. METHODS We performed a national N = near-all analysis of the administrative dataset to identify pharyngolaryngectomies in England between 2002 and 2012. Information about morbidity, pharyngeal closure method and post-operative complications was derived. RESULTS There were 1589 predominantly male (78%) patients whose mean age at surgery was 62 years. The commonest morbidities were hypertension (24%) and ischemic heart disease (11%). For 232 (15%) patients, pharyngolaryngectomy was performed during an emergency admission. The pharynx was closed primarily in 551 patients, with skin or muscle free or pedicled flaps in 755 patients and with jejunum and gastric pull-up in 123 and 160 patients, respectively. In-hospital mortality rate was 6% and was significantly higher in the gastric pull-up group (11%). Reconstructive failure had an odds ratio of 6.2 [95% confidence interval (CI) 2.4-16.1] for in-hospital death. The five-year survival was 57% and age, morbidities, emergency surgery, gastric pull-up, major acute cardiovascular events, renal failure and reconstructive failure independently worsened prognosis. Patients who underwent pharyngeal reconstruction with radial forearm or anterolateral thigh flaps had lower mortality rates than patients who had jejunum flap reconstruction (hazard ratio = 1.50 [95% CI 1.03-2.19]) or gastric pull-up (hazard ratio = 1.92 [95% CI 1.32-2.80]). CONCLUSIONS Pharyngolaryngectomy carries a high degree of risk of morbidity and mortality. Reconstructive failure worsens short- and long-term prognosis, and the use of cutaneous free flaps appears to improve survival.
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Affiliation(s)
- S A R Nouraei
- Department of Ear Nose and Throat Surgery, Auckland City Hospital, Grafton, Auckland, New Zealand.
| | - A Dias
- Department of Ear Nose and Throat Surgery, University College Hospital NHS Foundation Trust, 250 Euston Road, London, UK
| | - H Kanona
- Department of Ear Nose and Throat Surgery, University College Hospital NHS Foundation Trust, 250 Euston Road, London, UK
| | - D Vokes
- Department of Ear Nose and Throat Surgery, Auckland City Hospital, Grafton, Auckland, New Zealand
| | - P O'Flynn
- Department of Ear Nose and Throat Surgery, University College Hospital NHS Foundation Trust, 250 Euston Road, London, UK
| | - P M Clarke
- Department of Ear Nose and Throat Surgery, Charing Cross Hospital, Fulham Palace Road, London, UK
| | | | - A Darzi
- Academic Surgical Unit, Department of Surgery & Cancer, Imperial College Healthcare Trust, St Mary's Hospital, Praed Street, London, UK
| | - P Aylin
- Dr Foster Unit at Imperial College, Department of Primary Care and Public Health, Imperial College London, Dorset Rise, London, UK
| | - N Jallali
- Department of Plastic & Reconstructive Surgery, Charing Cross Hospital, Fulham Palace Road, London, W6 8RF, UK
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Oliveira-Santos M, Santos JA, Soares J, Dias A, Quaresma M. Influence of meteorological conditions on RSV infection in Portugal. Int J Biometeorol 2016; 60:1807-1817. [PMID: 27059367 DOI: 10.1007/s00484-016-1168-1] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/28/2015] [Revised: 02/29/2016] [Accepted: 04/03/2016] [Indexed: 06/05/2023]
Abstract
Acute viral bronchiolitis is a common cause for infant hospital admissions. Of all etiological agents, respiratory syncytial virus (RSV) is commonly the most frequent. The present study assesses relationships between atmospheric factors and RSV infections in under 3-year-old patients admitted to the Inpatient Paediatric Service of Vila Real (North of Portugal). For this purpose, (1) clinical files of children admitted with a diagnosis of acute bronchiolitis from September 2005 to December 2015 (>10 years) were scrutinised and (2) local daily temperature/precipitation series, as well as six weather types controlling meteorological conditions in Portugal, were used. Fifty-five percent of all 770 admitted children were effectively infected with a given virus, whilst 48 % (367) were RSV+, i.e. 87 % of virus-infected children were RSV+. The bulk of incidence is verified in the first year of age (82 %, 302), slightly higher in males. RSV outbreaks are typically from December to March, but important inter-annual variability is found in both magnitude and shape. Although no clear connections were found between monthly temperatures/precipitation and RSV outbreaks apart from seasonality, a linkage to wintertime cold spells is apparent on a daily basis. Anomalously low minimum temperatures from the day of admittance back to 10 days before are observed. This relationship is supported by anomalously high occurrences of the E and AA weather types over the same period, which usually trigger dry and cold weather. These findings highlight some predictability in the RSV occurrences, revealing potential for modelling and risk assessments.
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Affiliation(s)
- M Oliveira-Santos
- Department of Psychiatry and Mental Health, Centro Hospitalar de Trás-os-Montes e Alto Douro EPE, CHTMAD, Vila Real, Portugal.
| | - J A Santos
- Centre for the Research and Technology of Agro-environmental and Biological Sciences, CITAB, Universidade de Trás-os-Montes e Alto Douro, UTAD, Vila Real, Portugal
| | - J Soares
- Paediatric Department, Centro Hospitalar de Trás-os-Montes e Alto Douro EPE, CHTMAD, Vila Real, Portugal
| | - A Dias
- Paediatric Department, Centro Hospitalar de Trás-os-Montes e Alto Douro EPE, CHTMAD, Vila Real, Portugal
| | - M Quaresma
- Paediatric Department, Centro Hospitalar de Trás-os-Montes e Alto Douro EPE, CHTMAD, Vila Real, Portugal
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Dias A, Claudino W, Sinha R, Perez C, Jain D. Human epidermal growth factor antagonists and cardiotoxicity—A short review of the problem and preventative measures. Crit Rev Oncol Hematol 2016; 104:42-51. [DOI: 10.1016/j.critrevonc.2016.04.015] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2015] [Revised: 03/09/2016] [Accepted: 04/27/2016] [Indexed: 01/21/2023] Open
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Dias A, Rodríguez A, Martínez-Calderón M, Gómez-Aranzadi M, Olaizola SM. Ultrafast laser inscription of volume phase gratings with low refractive index modulation and self-images of high visibility. Opt Express 2015; 23:26683-26688. [PMID: 26480181 DOI: 10.1364/oe.23.026683] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
Ultrafast laser inscription of volume phase gratings with low index contrast and self-images with visibility of 0.96 is demonstrated. It is also demonstrated that phase differences of π/2 for visible light are achievable with only one layer of structures induced in bulk borosilicate glass by direct laser writing. The fabrication method avoids the stitching of several layers of structures and significantly reduces the time of process. The increment of visibility with the induced phase difference is proved and results are compared with the expected for planar phase gratings.
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Zarili TFT, Castanheira ERL, Dias A, Alves Rocha S, Nunes LO, Nemes MIB. Changes in Quality Indicators Relating to Organization of Primary Care Services between 2007 and 2010 in São Paulo State, Brazil. Int J Epidemiol 2015. [DOI: 10.1093/ije/dyv096.312] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Dias GA, Santini ACM, Vianna LS, Santos ES, Dias A. Risk Factors of Carpal Tunnel Syndrome in Pregnancy. Int J Epidemiol 2015. [DOI: 10.1093/ije/dyv096.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Siqueira F, Magalhães DM, Calderon IM, Dias A. Streptococcus Agalactiae
Colonization in Pregnant Women Living in the Brazilian Federal District Area. Int J Epidemiol 2015. [DOI: 10.1093/ije/dyv096.306] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Vianna LS, Santini ACM, Dias GA, Santos ES, Assis LC, Dias A. Associated Factors with Low Back Pain in Pregnant Women. Int J Epidemiol 2015. [DOI: 10.1093/ije/dyv096.127] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Dias A, Santini ACM, Vianna LS, Assis LC, Dias GA. Gestational Diabetes Mellitus and Risk Factors Associated with Urinary Incontinence in Pregnancy. Int J Epidemiol 2015. [DOI: 10.1093/ije/dyv097.258] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Ramos S, Nogueira A, Dias A, Gonçalves AF, Gaio AR, Duarte R. Tuberculosis screening in patients receiving biological therapy. Acta Reumatol Port 2015; 40:234-240. [PMID: 26337776] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
AIM Biological therapies are a risk factor for tuberculosis (TB). Portuguese recommendations recommend universal baseline screening for TB before starting biologics (2006) and annually thereafter if screened negative (2012 update). The gain with re-screening remains unknown. We aimed to i)identify the risk of latent TB infection at baseline screening among patients candidates to initiate biologics ii)present follow-up results for patients receiving different biological therapies and analyse intolerance or toxicity related to preventive therapy, conversions of immunodiagnostic tests under biological therapy and development of active TB. METHODS Patients screened for TB at a reference centre before starting biological therapy between 2008-2012 were identified. Medical files were retrospectively reviewed. Demographic data, screening and follow-up results and information on biological therapy were collected. EXCLUSION CRITERIA unavailable information on initiation of biological therapy. RESULTS 183 patients were included in the study, with 115 starting biological therapy. The baseline screening was positive in 52(45,2%) patients - 50(96,2%) were proposed for preventive treatment (2 had abnormal liver enzymes). Mild hepatotoxicity occurred in 4(8%) patients without need to interrupt TB prophylaxis. No cases of active TB occurred during follow-up in patients with positive baseline screening. Among the 63(54,8%) patients who screened negative, 2(3,2%) developed active TB (under infliximab and adalimumab) more than one year after initiation of biologics. 26(41,3%) patients were re-screened at the TB centre. 5(19,2%) had tuberculin skin test (TST) conversion and one concomitantly undetermined IGRA. No IGRA conversions were observed. The follow-up period was 4,0 years. TB baseline screening's negative predictive value (NPV) was 96,8% (95%CI: 89,0% to 99.5%). A low rate of re-screening was observed. CONCLUSION The rate of latent TB at baseline screening was higher than expected. Preventive treatment was well tolerated. No patients with positive baseline screening developed active TB. Efforts should be made to raise awareness concerning the risk of TB exposure, specially considering that the active TB cases were compatible with new infection. The rate of re-screening suggests a low awareness regarding current recommendations Nation-wide studies are necessary to evaluate the efficacy of the re-screening strategy and to clarify what risk groups most benefit from it.
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Ramakrishnan P, Rane A, Dias A, Bhat J, Shukla A, Lakshmi S, Ansari BK, Ramaswamy RS, Reddy RA, Tribulato A, Agarwal AK, SatyaPrasad N, Mushtaq A, Rao PH, Murthy P, Koenig HG. Indian health care professionals' attitude towards spiritual healing and its role in alleviating stigma of psychiatric services. J Relig Health 2014; 53:1800-1814. [PMID: 24430129 DOI: 10.1007/s10943-014-9822-6] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
Persons with mental illnesses in India and rest of developing world continue to consult religious/spiritual (R/S) healers or traditional, complementary and alternative medicine (TCAM) professionals prior to seeking psychiatric services that are devoid of spiritual components of care. We aim to understand TCAM and allopathic professionals' perspectives on patients' R/S needs within mental health services, cross-sectional study was conducted at five TCAM and two allopathic tertiary care hospitals in three different Indian states; 393 participants completed RSMPP, a self-administered, semi-structured survey questionnaire. Perspectives of TCAM and allopathic health professionals on role of spirituality in mental health care were compared. Substantial percentage, 43.7 % TCAM and 41.3 % allopathic, of participants believe that their patients approach R/S or TCAM practitioners for severe mental illness; 91.2 % of TCAM and 69.7 % of allopaths were satisfied with R/S healers (p = 0.0019). Furthermore, 91.1 % TCAM and 73.1 % allopaths (p = 0.000) believe that mental health stigma can be minimized by integrating with spiritual care services. Overall, 87 % of TCAM and 73 % of allopaths agreed to primary criterion variable: 'spiritual healing is beneficial and complementary to psychiatric care.' A quarter of allopaths (24.4 %) and 38 % of TCAM physicians reportedly cross-refer their grieving patients to religious/TCAM healer and psychiatrist/psychologist, respectively; on logistic regression, significant (p < 0.05) predictors were clinical interactions/references to r/s healers. Providing spiritual care within the setup of psychiatric institution will not only complement psychiatric care but also alleviate stigma against mental health services. Implications on developing spiritual care services like clinical chaplaincy are discussed.
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Affiliation(s)
- P Ramakrishnan
- AdiBhat Foundation, R-90, Greater Kailash-I, New Delhi, 110048, India,
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Ramakrishnan P, Dias A, Rane A, Shukla A, Lakshmi S, Ansari BKM, Ramaswamy RS, Reddy AR, Tribulato A, Agarwal AK, Bhat J, SatyaPrasad N, Mushtaq A, Rao PH, Murthy P, Koenig HG. Perspectives of Indian traditional and allopathic professionals on religion/spirituality and its role in medicine: basis for developing an integrative medicine program. J Relig Health 2014; 53:1161-1175. [PMID: 23625126 DOI: 10.1007/s10943-013-9721-2] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
Allopathic medical professionals in developed nations have started to collaborate with traditional, complementary, and alternative medicine (TCAM) to enquire on the role of religion/spirituality (r/s) in patient care. There is scant evidence of such movement in the Indian medical community. We aim to understand the perspectives of Indian TCAM and allopathic professionals on the influence of r/s in health. Using RSMPP (Religion, Spirituality and Medicine, Physician Perspectives) questionnaire, a cross-sectional survey was conducted at seven (five TCAM and two allopathic) pre-selected tertiary care medical institutes in India. Findings of TCAM and allopathic groups were compared. Majority in both groups (75% of TCAM and 84.6% of allopathic practitioners) believed that patients' spiritual focus increases with illness. Up to 58% of TCAM and allopathic respondents report patients receiving support from their religious communities; 87% of TCAM and 73% of allopaths believed spiritual healing to be beneficial and complementary to allopathic medical care. Only 11% of allopaths, as against 40% of TCAM, had reportedly received 'formal' training in r/s. Both TCAM (81.8%) and allopathic (63.7%) professionals agree that spirituality as an academic subject merits inclusion in health education programs (p = 0.0003). Inclusion of spirituality in the health care system is a need for Indian medical professionals as well as their patients, and it could form the basis for integrating TCAM and allopathic medical systems in India.
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Affiliation(s)
- P Ramakrishnan
- AdiBhat Foundation, R-90, Greater Kailash-I, New Delhi, 110048, India,
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de Carvalho M, Casanova I, Dias A, Brum M, Conceição I. P854: Motor excitability measurements in familial amyloid polyneuropathy: the influence of tafamidis treatment. Clin Neurophysiol 2014. [DOI: 10.1016/s1388-2457(14)50884-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Ulian C, Fernandes S, Ramos P, Dias A, Lourenço M, Chiacchio S. Avaliação da absorção colostral em neonatos ovinos da raça Bergamácia. ARQ BRAS MED VET ZOO 2014. [DOI: 10.1590/1678-41625864] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Objetivou-se determinar o período de absorção das macromoléculas colostrais e a transferência de imunidade passiva em cordeiros da raça Bergamácia. Avaliou-se o proteinograma sérico dos cordeiros antes da ingestão de colostro até 48 horas de vida e das frações colostrais ao nascimento e 12 horas pós-parto. Foi avaliada a concentração de proteína total no soro por refratometria e sua relação com a densidade e quantidade de gamaglobulinas presentes no colostro. A concentração sérica de gamaglobulina nos cordeiros variou de 0,111±0,07g/dL antes da ingestão de colostro a 1,609±0,72g/dL às 48 horas. Nas amostras de colostro, a concentração variou de 3,125±1,27g/dL, imediatamente após o parto, para 1,378±0,82g/dL, 12 horas após. A concentração de proteína sérica total teve acréscimo de 4,46±0,58g/dL para 5,61±0,75g/dL entre o nascimento e após 48 horas, apresentando correlação positiva com a densidade e a proteína total colostral. A absorção colostral pelo cordeiro foi ascendente até 24 horas subsequentes ao parto, quando, então, iniciou-se sua estabilização. A quantificação da proteína sérica, com uso de refratômetro nos cordeiros, pode ser usada como método para avaliar a transferência de imunidade passiva, pois está diretamente relacionada com a absorção de gamaglobulina colostral.
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Teixeira TPF, Aquino SF, Pereira SI, Dias A. Use of calcined layered double hydroxides for the removal of color and organic matter from textile effluents: kinetic, equilibrium and recycling studies. Braz J Chem Eng 2014. [DOI: 10.1590/s0104-66322014000100003] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Affiliation(s)
| | | | | | - A. Dias
- Universidade Federal de Ouro Preto, Brazil
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Ortlieb S, Dias A, Gorzelniak L, Nowak D, Karrasch S, Peters A, Kuhn KA, Horsch A, Schulz H. Körperliche Aktivität bei anamnestisch Lungengesunden im höheren Alter: Ergebnisse der KORA-Age-Studie. Pneumologie 2014. [DOI: 10.1055/s-0034-1367885] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Dias A, Gorzelniak L, Schultz K, Wittmann M, Rudnik J, Jörres R, Horsch A. Classification of exacerbation episodes in chronic obstructive pulmonary disease patients. Methods Inf Med 2014; 53:108-14. [PMID: 24515082 DOI: 10.3414/me12-01-0108] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2012] [Accepted: 12/01/2013] [Indexed: 11/09/2022]
Abstract
BACKGROUND Chronic obstructive pulmonary disease (COPD) is a progressive disease affecting the airways, which constitutes a major cause of chronic morbidity and a significant economic and social burden throughout the world. Despite the fact that in COPD patients exacerbations are common acute events causing significant and often fatal worsening of symptoms, an accurate prognostication continues to be difficult. OBJECTIVES To build computational models capable of distinguishing between normal life days from exacerbation days in COPD patients, based on physical activity measured by accelerometers. METHODS We recruited 58 patients suffering from COPD and measured their physical activity with accelerometers for 10 days or more, from August 2009 to March 2010. During this period we recorded six exacerbation episodes in the patients, accounting for 37 days. We were able to analyse data for 52 patients (369 patient days), and extracted three distinct sets of features from the data, one set of basic features such as average, one set based on the frequency domain and the last exploring the cross-information among sensors pairs. These were used by three machine-learning techniques (logarithmic regression, neural networks, support vector machines) to distinguish days with exacerbation events from normal days. RESULTS The support vector machine classifier achieved an AUC of 90% ± 9, when supplied with a set of features resulting from sequential feature selection method. Neu- ral networks achieved an AUC of 83% ± 16 and the logarithmic regression an AUC of 67% ± 15. CONCLUSIONS None of the individual feature sets provided robust for reasonable classification of PA recording days. Our results indicate that this approach has the potential to extract useful information for, but are not robust enough for medical application of the system.
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Affiliation(s)
- A Dias
- André Dias, Department of Computer Science, University of Tromsø, Breivika Campus, 9010 Tromsø, Norway, E-mail:
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Siqueira K, Soares J, Granado E, Bittar E, de Paula A, Moreira R, Dias A. Synchrotron X-ray diffraction and Raman spectroscopy of Ln3NbO7 (Ln=La, Pr, Nd, Sm-Lu) ceramics obtained by molten-salt synthesis. J SOLID STATE CHEM 2014. [DOI: 10.1016/j.jssc.2013.10.015] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Dias A, César M. Museums as spaces and times for learning and social participation. Psych Rus 2014. [DOI: 10.11621/pir.2014.0402] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
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Silva AGM, Rodrigues TS, Dias A, Fajardo HV, Gonçalves RF, Godinho M, Robles-Dutenhefner PA. Ce1−xSmxO1.9−δ nanoparticles obtained by microwave-assisted hydrothermal processing: an efficient application for catalytic oxidation of α-bisabolol. Catal Sci Technol 2014. [DOI: 10.1039/c3cy00788j] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Leme DES, Souza DH, Mercado G, Pastene E, Dias A, Moretti-Ferreira D. Assessment of clinical scoring systems for the diagnosis of Williams-Beuren syndrome. Genet Mol Res 2013; 12:3407-11. [PMID: 24065682 DOI: 10.4238/2013.september.4.7] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Williams-Beuren syndrome (WBS) is a genetic disorder characterized by physical and intellectual developmental delay, associated with congenital heart disease and facial dysmorphism. WBS is caused by a microdeletion on chromosome 7 (7q11.23), which encompasses the elastin (ELN) gene and about 27 other genes. The gold standard for WBS laboratory diagnosis is FISH (fluorescence in situ hybridization), which is very costly. As a possible alternative, we investigated the accuracy of three clinical diagnostic scoring systems in 250 patients with WBS diagnosed by FISH. We concluded that all three systems could be used for the clinical diagnosis of WBS, but they all gave a low percentage of false-positive (6.0-9.2%) and false-negative (0.8-4.0%) results. Therefore, their use should be associated with FISH testing.
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Affiliation(s)
- D E S Leme
- Serviço de Aconselhamento Genético, Departamento de Genética, Instituto de Biociências de Botucatu, Universidade Estadual Paulista, Botucatu, SP, Brasil
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Dolan R, O'Duffy F, Seoighe D, Dias A, Earley M, O'Dwyer T. Novel use of a supraclavicular transverse cervical artery customised perforator flap: A paediatric emergency. J Plast Reconstr Aesthet Surg 2013; 66:1138-41. [DOI: 10.1016/j.bjps.2012.12.021] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2012] [Accepted: 12/18/2012] [Indexed: 11/30/2022]
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