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Kuchelkar SP, Dias A, Gomes E, Dias L. Study of the clinical manifestations and risk factors in people affected during the first Kyasanur Forest Disease outbreak in Goa, India: A mixed method study. J Vector Borne Dis 2024; 61:23-28. [PMID: 38648403 DOI: 10.4103/0972-9062.383650] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2023] [Accepted: 07/05/2023] [Indexed: 04/25/2024] Open
Abstract
BACKGROUND OBJECTIVES Kyasanur Forest Disease (KFD) is a tick-borne, zoonotic viral hemorrhagic fever, previously known to be endemic to the state of Karnataka, India. The first outbreak of KFD in Goa state was reported in the Sattari taluka, in North Goa in 2015. This study aimed to investigate the outbreak and report the clinical manifestations and risk factors in people diagnosed with KFD. METHODS A mixed methods approach was used, which included a case series report and 19 in-depth interviews (IDIs) conducted with people diagnosed with KFD. The recorded IDIs were transcribed and translated and themes were coded for the analysis. RESULTS There were 73 suspected cases of which 30 were confirmed to have KFD using RT-PCR. There were four suspected deaths of which two were confirmed by RT-PCR. Most of the affected individuals were found to be dependent on the forest for their livelihood. Most of the people in the region were engaged in cashew plantations and had to travel to the forest to fetch firewood and cashew, hence were at a higher risk. They lived near the forest. The lack of hemorrhagic manifestation was noteworthy in the current outbreak. INTERPRETATION CONCLUSION The 'One Health' approach should be implemented to control KFD. Tick bite prevention measures coupled with vaccination of high-risk groups and intensive health education should be carried out, especially before the transmission season. There is a need to have high clinical suspicion for KFD in the region bearing in mind the non-hemorrhagic manifestation in this outbreak.
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Affiliation(s)
| | - Amit Dias
- Department of Community Medicine, Goa Medical College, India
| | - Edwin Gomes
- Department of Geriatric Medicine, Goa Medical College, Goa, India
| | - Lydia Dias
- Department of Microbiology, Goa Medical College, Goa, India
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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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Chowdhary N, Barbui C, Anstey KJ, Kivipelto M, Barbera M, Peters R, Zheng L, Kulmala J, Stephen R, Ferri CP, Joanette Y, Wang H, Comas-Herrera A, Alessi C, Suharya Dy K, Mwangi KJ, Petersen RC, Motala AA, Mendis S, Prabhakaran D, Bibi Mia Sorefan A, Dias A, Gouider R, Shahar S, Ashby-Mitchell K, Prince M, Dua T. Reducing the Risk of Cognitive Decline and Dementia: WHO Recommendations. Front Neurol 2022; 12:765584. [PMID: 35082745 PMCID: PMC8784726 DOI: 10.3389/fneur.2021.765584] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2021] [Accepted: 12/07/2021] [Indexed: 11/23/2022] Open
Abstract
With population ageing worldwide, dementia poses one of the greatest global challenges for health and social care in the 21st century. In 2019, around 55 million people were affected by dementia, with the majority living in low- and middle-income countries. Dementia leads to increased costs for governments, communities, families and individuals. Dementia is overwhelming for the family and caregivers of the person with dementia, who are the cornerstone of care and support systems throughout the world. To assist countries in addressing the global burden of dementia, the World Health Organisation (WHO) developed the Global Action Plan on the Public Health Response to Dementia 2017–2025. It proposes actions to be taken by governments, civil society, and other global and regional partners across seven action areas, one of which is dementia risk reduction. This paper is based on WHO Guidelines on risk reduction of cognitive decline and dementia and presents recommendations on evidence-based, multisectoral interventions for reducing dementia risks, considerations for their implementation and policy actions. These global evidence-informed recommendations were developed by WHO, following a rigorous guideline development methodology and involved a panel of academicians and clinicians with multidisciplinary expertise and representing geographical diversity. The recommendations are considered under three broad headings: lifestyle and behaviour interventions, interventions for physical health conditions and specific interventions. By supporting health and social care professionals, particularly by improving their capacity to provide gender and culturally appropriate interventions to the general population, the risk of developing dementia can be potentially reduced, or its progression delayed.
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Affiliation(s)
- Neerja Chowdhary
- Department of Mental Health and Substance Use, World Health Organization, Geneva, Switzerland
| | - Corrado Barbui
- Department of Neuroscience, Biomedicine and Movement Sciences, WHO Collaborating Centre for Research and Training in Mental Health and Service Evaluation, University of Verona, Verona, Italy
| | | | - Miia Kivipelto
- Division of Clinical Geriatrics, Department of Neurobiology, Care Sciences and Society, Center for Alzheimer Research, Karolinska Institutet, Stockholm, Sweden.,The Ageing Epidemiology Research Unit, Imperial College London, School of Public Health, London, United Kingdom.,Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland.,Theme Inflammation and Aging, Karolinska University Hospital, Stockholm, Sweden
| | - Mariagnese Barbera
- The Ageing Epidemiology Research Unit, Imperial College London, School of Public Health, London, United Kingdom.,Department of Neurology, Institute of Clinical Medicine, University of Eastern Finland, Kuopio, Finland
| | - Ruth Peters
- University of New South Wales, Sydney, NSW, Australia.,Neuroscience Research Australia, Sydney, NSW, Australia
| | - Lidan Zheng
- University of New South Wales, Sydney, NSW, Australia.,Neuroscience Research Australia, Sydney, NSW, Australia
| | - Jenni Kulmala
- Division of Clinical Geriatrics, Department of Neurobiology, Care Sciences and Society, Center for Alzheimer Research, Karolinska Institutet, Stockholm, Sweden.,Population Health Unit, Finnish Institute for Health and Welfare, Helsinki, Finland.,Faculty of Social Sciences (Health Sciences) and Gerontology Research Centre (GEREC), Tampere University, Tampere, Finland
| | - Ruth Stephen
- Department of Neurology, Institute of Clinical Medicine, University of Eastern Finland, Kuopio, Finland
| | - Cleusa P Ferri
- Department of Psychiatry, Federal University of São Paulo, São Paulo, Brazil
| | - Yves Joanette
- Canadian Institutes of Health Research, Government of Canada, Ottawa, ON, Canada
| | - Huali Wang
- Dementia Care and Research Center, Peking University Institute of Mental Health, Beijing, China.,Beijing Dementia Key Laboratory, Beijing, China
| | - Adelina Comas-Herrera
- Department of Health Policy, Care Policy and Evaluation Centre, London School of Economics and Political Science, London, United Kingdom
| | | | | | - Kibachio J Mwangi
- Division of Non-communicable Diseases, Ministry of Health, Nairobi, Kenya
| | | | | | | | | | | | - Amit Dias
- Department of Preventive and Social Medicine, Goa Medical College, Goa, India
| | - Riadh Gouider
- Faculty of Medicine, Clinical Investigation Centre Neurosciences and Mental Health Razi University Hospital, Tunis, Tunisia.,Faculty of Medicine, University Tunis El Manar, Tunis, Tunisia
| | - Suzana Shahar
- Centre for Healthy Aging and Wellness, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | | | | | - Tarun Dua
- Department of Mental Health and Substance Use, World Health Organization, Geneva, Switzerland
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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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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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Livingston G, Huntley J, Sommerlad A, Ames D, Ballard C, Banerjee S, Brayne C, Burns A, Cohen-Mansfield J, Cooper C, Costafreda SG, Dias A, Fox N, Gitlin LN, Howard R, Kales HC, Kivimäki M, Larson EB, Ogunniyi A, Orgeta V, Ritchie K, Rockwood K, Sampson EL, Samus Q, Schneider LS, Selbæk G, Teri L, Mukadam N. Dementia prevention, intervention, and care: 2020 report of the Lancet Commission. Lancet 2020; 396:413-446. [PMID: 32738937 PMCID: PMC7392084 DOI: 10.1016/s0140-6736(20)30367-6] [Citation(s) in RCA: 3952] [Impact Index Per Article: 988.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/03/2019] [Revised: 01/31/2020] [Accepted: 02/07/2020] [Indexed: 02/06/2023]
Affiliation(s)
- Gill Livingston
- Division of Psychiatry, University College London, London, UK; Camden and Islington NHS Foundation Trust, London, UK.
| | - Jonathan Huntley
- Division of Psychiatry, University College London, London, UK; Camden and Islington NHS Foundation Trust, London, UK
| | - Andrew Sommerlad
- Division of Psychiatry, University College London, London, UK; Camden and Islington NHS Foundation Trust, London, UK
| | - David Ames
- National Ageing Research Institute and Academic Unit for Psychiatry of Old Age, University of Melbourne, Royal Melbourne Hospital, Parkville, VIC, Australia
| | | | - Sube Banerjee
- Faculty of Health: Medicine, Dentistry and Human Sciences, University of Plymouth, Plymouth, UK
| | - Carol Brayne
- Cambridge Institute of Public Health, University of Cambridge, Cambridge, UK
| | - Alistair Burns
- Department of Old Age Psychiatry, University of Manchester, Manchester, UK
| | - Jiska Cohen-Mansfield
- Department of Health Promotion, School of Public Health, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel; Heczeg Institute on Aging, Tel Aviv University, Tel Aviv, Israel; Minerva Center for Interdisciplinary Study of End of Life, Tel Aviv University, Tel Aviv, Israel
| | - Claudia Cooper
- Division of Psychiatry, University College London, London, UK; Camden and Islington NHS Foundation Trust, London, UK
| | - Sergi G Costafreda
- Division of Psychiatry, University College London, London, UK; Camden and Islington NHS Foundation Trust, London, UK
| | - Amit Dias
- Department of Preventive and Social Medicine, Goa Medical College, Goa, India
| | - Nick Fox
- Dementia Research Centre, UK Dementia Research Institute, University College London, London, UK; Institute of Neurology, National Hospital for Neurology and Neurosurgery, University College London Hospitals NHS Foundation Trust, London, UK
| | - Laura N Gitlin
- Center for Innovative Care in Aging, Johns Hopkins University, Baltimore, MA, USA
| | - Robert Howard
- Division of Psychiatry, University College London, London, UK; Camden and Islington NHS Foundation Trust, London, UK
| | - Helen C Kales
- Department of Psychiatry and Behavioral Sciences, UC Davis School of Medicine, University of California, Sacramento, CA, USA
| | - Mika Kivimäki
- Department of Epidemiology and Public Health, University College London, London, UK
| | - Eric B Larson
- Kaiser Permanente Washington Health Research Institute, Seattle, WA, USA
| | | | - Vasiliki Orgeta
- Division of Psychiatry, University College London, London, UK
| | - Karen Ritchie
- Inserm, Unit 1061, Neuropsychiatry: Epidemiological and Clinical Research, La Colombière Hospital, University of Montpellier, Montpellier, France; Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, UK
| | - Kenneth Rockwood
- Centre for the Health Care of Elderly People, Geriatric Medicine Dalhousie University, Halifax, NS, Canada
| | - Elizabeth L Sampson
- Division of Psychiatry, University College London, London, UK; Barnet, Enfield, and Haringey Mental Health Trust, London, UK
| | - Quincy Samus
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University, Baltimore, MA, USA
| | - Lon S Schneider
- Department of Psychiatry and the Behavioural Sciences and Department of Neurology, Keck School of Medicine, Leonard Davis School of Gerontology of the University of Southern California, Los Angeles, CA, USA
| | - Geir Selbæk
- Norwegian National Advisory Unit on Ageing and Health, Vestfold Hospital Trust, Tønsberg, Norway; Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway; Geriatric Department, Oslo University Hospital, Oslo, Norway
| | - Linda Teri
- Department Psychosocial and Community Health, School of Nursing, University of Washington, Seattle, WA, USA
| | - Naaheed Mukadam
- Division of Psychiatry, University College London, London, UK; Camden and Islington NHS Foundation Trust, London, UK
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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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11
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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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12
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Narvencar K, Favas TT, Dias A. Epidemiology and Clinical Profile of Snakebites in Goa and Surrounding Areas. J Assoc Physicians India 2020; 68:28-32. [PMID: 32138479] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
BACKGROUND Clinico-epidemiological profile of snake envenomation varies in different regions; however, data from India is inadequate. This study was planned to obtain such data from Goa, to help in quick identification of envenomation, prompt treatment and help in building a national database. METHODS In this prospective observational study,all patients presenting to emergency department between April 2016 to August 2017 with history of snakebite and meeting inclusion and exclusion criteria were enrolled and analysed. RESULTS 236 patients were screened, 156 were eligible. Mean age was 39.5±15.6; majority (n=122, 78.2%) were in the age group of 20-59 years; 119 (76.3%) were males. Seasonal variation was noted, highest number being in June, July and between September and December. Bites occurred commonly in housewives, students and retired personnel (n=108, 69.23%). 120 patients (76.9%) had hemotoxicity, 7 (4.5%) had neurotoxicity, 29 (18.6%) had only local reaction. Clinical features seen were bleeding (n= 40, 25.6%) , vomiting (n=15, 9.6%), giddiness/syncope (n=14, 9%), breathlessness (n=5, 3.2%), diplopia (n= 5,3.2%), ptosis (n=7, 4.5%), dysarthria (n=1, 0.6%), altered sensorium (n=7, 4.5%), oliguria (n=2, 1.3%), and chest pain (n=1, 0.6%). Majority (n= 117, 78.5%) received antivenom within 6 hours of bite. 31 patients (20.8%) developed reactions to antivenom, most were febrile reactions (n=12, 8.05%). Anaphylaxis occurred in 4 (2.68%) patients. CONCLUSION Snakebite is a common medical emergency in Goa, with distinct seasonal variation. There was no association between occupation and risk of bite. Hemotoxic and local cytotoxic features predominate in this area. Antivenom reactions though common, are usually mild.
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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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14
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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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15
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Azariah F, Sequeira M, Cohen A, Dias A, Morse JQ, Anderson SJ, Cuijpers P, Patel V, Reynolds CF. Problem-Solving Therapy for Older Adults at Risk for Depression: A Qualitative Analysis of the Depression in Later Life Trial. Am J Psychother 2019; 72:88-94. [PMID: 31813228 DOI: 10.1176/appi.psychotherapy.20190009] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
OBJECTIVE As a sequel to the Depression in Later Life trial of lay counselor-delivered problem-solving therapy for depression prevention among older adults in Goa, India, this qualitative study aimed to explore participant experiences to illuminate the reasons for the trial's positive findings and implications for further efforts at depression prevention in low-resource settings. METHODS In-depth interviews were conducted with 19 participants (21% of those randomly assigned to the original intervention). Two independent raters coded the data and organized narratives according to broad themes. RESULTS Most participants valued their relationship with the lay counselor, learned self-care strategies to cope with illnesses, and increased engagement in pleasurable social and physical activities. Some participants reported needing assistance with managing financial strain and family conflicts. CONCLUSIONS The lay-counselor-delivered intervention was well received. The relationship with the counselor and behavioral activation toward better self-care and more-pleasurable activities may have been keys to the intervention's success.
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Affiliation(s)
- Fredric Azariah
- Sangath, Goa, India (Azariah, Sequeira, Dias, Patel); Department of Public Health, London School of Hygiene and Tropical Medicine, London (Cohen); Department of Preventive and Social Medicine, Goa Medical College, Goa, India (Dias); School of Health Sciences, Chatham University, Pittsburgh (Morse); Department of Biostatistics, University of Pittsburgh Graduate School of Public Health, Pittsburgh (Anderson); Department of Developmental, Neuro-, and Clinical Psychology, Free University of Amsterdam, Amsterdam (Cuijpers); Department of Global Health and Social Medicine, Harvard Medical School, Boston (Patel); Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh (Reynolds)
| | - Miriam Sequeira
- Sangath, Goa, India (Azariah, Sequeira, Dias, Patel); Department of Public Health, London School of Hygiene and Tropical Medicine, London (Cohen); Department of Preventive and Social Medicine, Goa Medical College, Goa, India (Dias); School of Health Sciences, Chatham University, Pittsburgh (Morse); Department of Biostatistics, University of Pittsburgh Graduate School of Public Health, Pittsburgh (Anderson); Department of Developmental, Neuro-, and Clinical Psychology, Free University of Amsterdam, Amsterdam (Cuijpers); Department of Global Health and Social Medicine, Harvard Medical School, Boston (Patel); Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh (Reynolds)
| | - Alex Cohen
- Sangath, Goa, India (Azariah, Sequeira, Dias, Patel); Department of Public Health, London School of Hygiene and Tropical Medicine, London (Cohen); Department of Preventive and Social Medicine, Goa Medical College, Goa, India (Dias); School of Health Sciences, Chatham University, Pittsburgh (Morse); Department of Biostatistics, University of Pittsburgh Graduate School of Public Health, Pittsburgh (Anderson); Department of Developmental, Neuro-, and Clinical Psychology, Free University of Amsterdam, Amsterdam (Cuijpers); Department of Global Health and Social Medicine, Harvard Medical School, Boston (Patel); Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh (Reynolds)
| | - Amit Dias
- Sangath, Goa, India (Azariah, Sequeira, Dias, Patel); Department of Public Health, London School of Hygiene and Tropical Medicine, London (Cohen); Department of Preventive and Social Medicine, Goa Medical College, Goa, India (Dias); School of Health Sciences, Chatham University, Pittsburgh (Morse); Department of Biostatistics, University of Pittsburgh Graduate School of Public Health, Pittsburgh (Anderson); Department of Developmental, Neuro-, and Clinical Psychology, Free University of Amsterdam, Amsterdam (Cuijpers); Department of Global Health and Social Medicine, Harvard Medical School, Boston (Patel); Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh (Reynolds)
| | - Jennifer Q Morse
- Sangath, Goa, India (Azariah, Sequeira, Dias, Patel); Department of Public Health, London School of Hygiene and Tropical Medicine, London (Cohen); Department of Preventive and Social Medicine, Goa Medical College, Goa, India (Dias); School of Health Sciences, Chatham University, Pittsburgh (Morse); Department of Biostatistics, University of Pittsburgh Graduate School of Public Health, Pittsburgh (Anderson); Department of Developmental, Neuro-, and Clinical Psychology, Free University of Amsterdam, Amsterdam (Cuijpers); Department of Global Health and Social Medicine, Harvard Medical School, Boston (Patel); Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh (Reynolds)
| | - Stewart J Anderson
- Sangath, Goa, India (Azariah, Sequeira, Dias, Patel); Department of Public Health, London School of Hygiene and Tropical Medicine, London (Cohen); Department of Preventive and Social Medicine, Goa Medical College, Goa, India (Dias); School of Health Sciences, Chatham University, Pittsburgh (Morse); Department of Biostatistics, University of Pittsburgh Graduate School of Public Health, Pittsburgh (Anderson); Department of Developmental, Neuro-, and Clinical Psychology, Free University of Amsterdam, Amsterdam (Cuijpers); Department of Global Health and Social Medicine, Harvard Medical School, Boston (Patel); Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh (Reynolds)
| | - Pim Cuijpers
- Sangath, Goa, India (Azariah, Sequeira, Dias, Patel); Department of Public Health, London School of Hygiene and Tropical Medicine, London (Cohen); Department of Preventive and Social Medicine, Goa Medical College, Goa, India (Dias); School of Health Sciences, Chatham University, Pittsburgh (Morse); Department of Biostatistics, University of Pittsburgh Graduate School of Public Health, Pittsburgh (Anderson); Department of Developmental, Neuro-, and Clinical Psychology, Free University of Amsterdam, Amsterdam (Cuijpers); Department of Global Health and Social Medicine, Harvard Medical School, Boston (Patel); Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh (Reynolds)
| | - Vikram Patel
- Sangath, Goa, India (Azariah, Sequeira, Dias, Patel); Department of Public Health, London School of Hygiene and Tropical Medicine, London (Cohen); Department of Preventive and Social Medicine, Goa Medical College, Goa, India (Dias); School of Health Sciences, Chatham University, Pittsburgh (Morse); Department of Biostatistics, University of Pittsburgh Graduate School of Public Health, Pittsburgh (Anderson); Department of Developmental, Neuro-, and Clinical Psychology, Free University of Amsterdam, Amsterdam (Cuijpers); Department of Global Health and Social Medicine, Harvard Medical School, Boston (Patel); Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh (Reynolds)
| | - Charles F Reynolds
- Sangath, Goa, India (Azariah, Sequeira, Dias, Patel); Department of Public Health, London School of Hygiene and Tropical Medicine, London (Cohen); Department of Preventive and Social Medicine, Goa Medical College, Goa, India (Dias); School of Health Sciences, Chatham University, Pittsburgh (Morse); Department of Biostatistics, University of Pittsburgh Graduate School of Public Health, Pittsburgh (Anderson); Department of Developmental, Neuro-, and Clinical Psychology, Free University of Amsterdam, Amsterdam (Cuijpers); Department of Global Health and Social Medicine, Harvard Medical School, Boston (Patel); Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh (Reynolds)
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16
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Thiyagarajan JA, Araujo de Carvalho I, Peña-Rosas JP, Chadha S, Mariotti SP, Dua T, Albanese E, Bruyère O, Cesari M, Dangour A, Dias A, Guerra M, Keeffe J, Kerse N, Khan QUA, Liu CJ, Murthy GVS, Ndegwa SN, Reginster JY, Robledo LMFG, Tremblay K, Woo J, Prince M, Beard JR. Redesigning care for older people to preserve physical and mental capacity: WHO guidelines on community-level interventions in integrated care. PLoS Med 2019; 16:e1002948. [PMID: 31626651 PMCID: PMC6799894 DOI: 10.1371/journal.pmed.1002948] [Citation(s) in RCA: 42] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Islene Araujo de Carvalho and coauthors discuss the WHO guidelines on integrated care for older people.
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Affiliation(s)
| | | | - Juan Pablo Peña-Rosas
- Department of Nutrition for Health and Development, World Health Organization, Geneva, Switzerland
| | - Shelly Chadha
- Department for Management of Noncommunicable Diseases, Disability, Violence and Injury Prevention, World Health Organization, Geneva, Switzerland
| | - Silvio Paolo Mariotti
- Department for Management of Noncommunicable Diseases, Disability, Violence and Injury Prevention, World Health Organization, Geneva, Switzerland
| | - Tarun Dua
- Department of Mental Health and Substance Abuse, World Health Organization, Geneva, Switzerland
| | - Emiliano Albanese
- World Health Organization Collaborating Center for Research and Training in Mental Health, University of Geneva, Geneva, Switzerland
| | - Olivier Bruyère
- World Health Organization Collaborating Center for Public Health Aspects of Musculoskeletal Health and Aging, University of Liège, Liège, Belgium
| | - Matteo Cesari
- Geriatric Unit, Fondazione IRCCS Ca’ Granda–Ospedale Maggiore Policlinico, Università di Milano, Milan, Italy
| | - Alan Dangour
- London School of Hygiene & Tropical Medicine, London, United Kingdom
| | | | - Mariella Guerra
- Institute of Memory, Depression and Related Disorders, Lima, Peru
| | - Jill Keeffe
- World Health Organization Collaborating Centre for Prevention of Blindness, LV Prasad Eye Institute, Hyderabad, India
| | | | | | - Chiung-ju Liu
- Indiana University, Indianapolis, Indiana, United States of America
| | - Gudlavalleti V. S. Murthy
- London School of Hygiene & Tropical Medicine, London, United Kingdom
- Indian Institute of Public Health, Hyderabad, Madhapur, India
| | | | - Jean-Yves Reginster
- World Health Organization Collaborating Center for Public Health Aspects of Musculoskeletal Health and Aging, University of Liège, Liège, Belgium
| | | | - Kelly Tremblay
- University of Washington, Seattle, United States of America
| | - Jean Woo
- The Chinese University of Hong Kong, Hong Kong, China
| | - Martin Prince
- Institute of Psychiatry, Psychology & Neuroscience, King’s College London, London, United Kingdom
| | - John R. Beard
- Department of Ageing and Life Course, World Health Organization, Geneva, Switzerland
- ARC Centre of Excellence on Population Ageing Research, University of New South Wales, Sydney, New South Wales, Australia
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17
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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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18
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Dias A, Azariah F, Sequeira M, Krishna R, Morse JQ, Cohen A, Cuijpers P, Anderson S, Patel V, Reynolds CF. Adaptation of problem-solving therapy for primary care to prevent late-life depression in Goa, India: the 'DIL' intervention. Glob Health Action 2019; 12:1420300. [PMID: 31104614 PMCID: PMC6534247 DOI: 10.1080/16549716.2017.1420300] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Abstract
Background: Depression in late life is a major, yet unrecognized public health problem in low- and middle-income countries (LMICs). The dearth of specialist resources, together with the limited ability of current depression treatments to avert years lived with disability, underscores the need for preventive interventions that can be delivered by lay health workers in primary care settings. We describe the development of an intervention for the indicated prevention of depression in older adults at risk due to subsyndromal symptoms, attending rural and urban public primary care clinics in Goa, India. Objectives: (1) to describe a mixed-methods approach (qualitative and quantitative)to the development of ‘DIL,’ an intervention for preventing the onset of major depression in older adults living with subsyndromal symptoms in Goa, India; (2) to describe resulting components of the ‘DIL’ intervention; and (3) to present data on the feasibility, acceptability, and benefit of DIL to participants. Methods: We followed a mixed-methods design, including in-depth interviews, focus group discussions, a theory of change workshop to develop a logic model, and an open-case series. Results: The mixed-method approach led to the development and adaptation of the DIL (Depression in Later Life) intervention for the indicated prevention of depression in older adults. The intervention was delivered by lay health counselors (LHCs). ‘DIL’ is a hybrid model of simple behavioral strategies grounded in Problem-solving Therapy for Primary Care, improved self-management of common, co-occurring medical disorders such as diabetes mellitus, and pragmatic assistance in navigating to needed social services. The use of ‘DIL’ in an open-case series with 19 participants led to a moderate reduction in symptoms of depression and anxiety on the General Health Questionnaire. A pictorial flipchart was developed to assist in delivering the intervention to participants with low levels of literacy. High rates of participant retention and satisfaction were achieved. Conclusion: The DIL intervention was adapted to the local context for delivery by lay health counselors and was found to be acceptable and feasible among the elderly participants in the study.
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Affiliation(s)
- Amit Dias
- a Goa Medical College , Goa , India.,b Sangath , Goa , India
| | - Fredric Azariah
- a Goa Medical College , Goa , India.,b Sangath , Goa , India
| | - Miriam Sequeira
- a Goa Medical College , Goa , India.,b Sangath , Goa , India
| | - Revathi Krishna
- a Goa Medical College , Goa , India.,b Sangath , Goa , India
| | - Jennifer Q Morse
- c Graduate Psychology Program, School of Health Sciences , Chatham University , Pittsburgh , PA , USA
| | - Alex Cohen
- d Department of Population Health , London School of Hygiene and Tropical Medicine , London , UK
| | - Pim Cuijpers
- e Department of Developmental, Neuro-, and Clinical Psychology , Free University of Amsterdam , Amsterdam , Netherlands
| | - Stewart Anderson
- f Department of Biostatistics, Graduate School of Public Health , University of Pittsburgh , Pittsburgh , USA , PA
| | - Vikram Patel
- g Department of Global Health and Social Medicine , Harvard Medical School , Boston , MA , USA
| | - Charles F Reynolds
- h Department of Psychiatry , The University of Pittsburgh School of Medicine , Pittsburgh , PA , USA
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19
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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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20
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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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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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22
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Dias A, Azariah F, Anderson SJ, Sequeira M, Cohen A, Morse JQ, Cuijpers P, Patel V, Reynolds CF. Effect of a Lay Counselor Intervention on Prevention of Major Depression in Older Adults Living in Low- and Middle-Income Countries: A Randomized Clinical Trial. JAMA Psychiatry 2019; 76:13-20. [PMID: 30422259 PMCID: PMC6583466 DOI: 10.1001/jamapsychiatry.2018.3048] [Citation(s) in RCA: 58] [Impact Index Per Article: 11.6] [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: 12/11/2022]
Abstract
IMPORTANCE Preventing depression in older adults living in low- and middle-income countries is important because of the scarcity of treatment resources and the risk of disability, suicide, and dementia. OBJECTIVE To assess whether an intervention for depression prevention provided by lay counselors is effective in older adults from low- and middle-income countries. DESIGN, SETTING, AND PARTICIPANTS This parallel-group randomized clinical trial with masked outcome assessment was performed in 181 older adults (≥60 years) with subsyndromal depressive symptoms at rural and urban primary care clinics in Goa, India. The first participant entered the trial on March 31, 2015, and the last exited on June 2, 2017. Data analysis used the intention-to-treat approach. INTERVENTIONS Lay counselors provided problem-solving therapy, brief behavioral treatment for insomnia, education in self-care of common medical disorders such as diabetes, and assistance in accessing medical and social programs. MAIN OUTCOMES AND MEASURES The main outcome was incidence of major depressive episodes. The study also assessed symptom change during 12 months (12-item General Health Questionnaire [GHQ-12]; score range of 0 to 12, with higher scores indicating greater symptoms of depression and anxiety), functional status (World Health Organization Disability Assessment Schedule 2.0; score range of 12 to 60, with higher scores indicating greater disability), cognition (Hindi Mini-Mental State Examination; score range of 0 to 30, with higher scores indicating better cognitive functioning), blood pressure, and body mass index to provide further clinical context. RESULTS The study enrolled 181 participants (mean [SD] age, 69.6 [7.2] years; 114 [63.0%] female): 91 to the intervention arm (depression in later life [DIL] intervention) and 90 to care as usual (CAU). Incident episodes of major depression were lower in the DIL intervention than in the CAU group (4.40% vs 14.44%; log-rank P = .04; number needed to treat, 9.95; 95% CI, 5.12-182.43). The 12-month Kaplan-Meier estimates of percentage of depression-free participants were 95.1% (95% CI, 90.5%-99.9%) in the DIL group vs 87.4% (95% CI, 80.4%-95.1%) in the CAU group. The incidence of depressive symptoms (GHQ-12) was also less (12-month mean difference, -1.18; 95% CI, -2.03 to -0.31; group × time interaction P < .001). There were no changes in measures of disability or cognition. The DIL intervention was associated with a significantly greater lowering of systolic blood pressure (12-month mean difference, -6.98; 95% CI, -11.96 to -2.01; group × time interaction P < .001) and change in body mass index (12-month mean difference, 0.23; 95% CI, -0.97 to 1.43; P = .04). CONCLUSIONS AND RELEVANCE The DIL intervention is effective for preventing episodes of major depression in older persons with subsyndromal symptoms. If replicated, the DIL intervention may be effective in older adults living in low- and middle-income countries. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT02145429.
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Affiliation(s)
- Amit Dias
- Department of Preventive and Social Medicine, Goa Medical College, Bambolim, Goa, India,Sangath, Goa, India
| | | | - Stewart J. Anderson
- Department of Biostatistics, University of Pittsburgh Graduate School of Public Health, Pittsburgh, Pennsylvania
| | | | - Alex Cohen
- Department of Population Health, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Jennifer Q. Morse
- Graduate Psychology Programs, School of Health Sciences, Chatham University, Pittsburgh, Pennsylvania
| | - Pim Cuijpers
- Department of Developmental, Neuro-, and Clinical Psychology, Amsterdam Public Health Research Institute, Free University of Amsterdam, Amsterdam, the Netherlands
| | - Vikram Patel
- Department of Global Health and Social Medicine, Harvard Medical School, Boston, Massachusetts
| | - Charles F. Reynolds
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
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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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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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Narang R, Saxena A, Desai A, Ramakrishnan S, Thangjam RS, Kulkarni S, Narvencar K, E Costa AKJ, Dias A, Sukharamwala R, Cleland J. Prevalence and determinants of hypertension in apparently healthy schoolchildren in India: A multi-center study. Eur J Prev Cardiol 2018; 25:1775-1784. [PMID: 30043628 DOI: 10.1177/2047487318790056] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Background Hypertension in children is often under recognized, especially in developing countries. Data from rural areas of developing countries is particularly lacking. Objectives To study prevalence of hypertension and its determinants in apparently health school children from predominantly rural populations of India. Methods Apparently healthy schoolchildren ( n = 14,957) aged 5-15 years (mean (standard deviation) age 10.8 (2.8) years; 55.5% boys) at four predominantly rural sites in separate states of India were studied. Systolic and diastolic blood pressures were recorded by trained staff in addition to age, gender, height, weight, type of school and season. Waist circumference was also recorded in 12,068 children. Geographic location and type of school (government, government-aided or private) were used to determine socio-economic status. Results Systolic and/or diastolic hypertension was present in 3443 (23%) children. Systolic hypertension was present in 13.6%, diastolic hypertension in 15.3% and both in 5.9%. Isolated systolic hypertension was present in 7.7% while isolated diastolic hypertension was present in 9.4%. On univariate analysis, age, gender, geographical location, socio-economic status, season and anthropometric parameters (z-scores of height, weight and waist circumference, waist/height ratio and body mass index) were all significantly related to risk of hypertension ( p < 0.0001 for each). Similar association was observed with weight group (normal, overweight and obese). Multiple regression analysis showed lower age, female gender, richer socio-economic status, certain geographical locations, higher weight and larger waist circumference to be independently associated with a greater risk of hypertension. Conclusion There is a high prevalence of hypertension in apparently healthy schoolchildren even in predominantly rural areas of India. Screening and management programs targeted to high risk groups identified may prove cost-effective.
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Affiliation(s)
- Rajiv Narang
- 1 Department of Cardiology, All India Institute of Medical Sciences, India
| | - Anita Saxena
- 1 Department of Cardiology, All India Institute of Medical Sciences, India
| | - Ankush Desai
- 2 Department of Medicine and Department of Preventive & Social Medicine, Goa Medical College, Bambolim, Goa, India
| | | | - Rajendra S Thangjam
- 3 Department of Medicine, Jawaharlal Nehru Institute of Medical Sciences, Imphal, Manipur, India
| | | | - Kedareshwar Narvencar
- 2 Department of Medicine and Department of Preventive & Social Medicine, Goa Medical College, Bambolim, Goa, India
| | - Ana K Jacques' E Costa
- 2 Department of Medicine and Department of Preventive & Social Medicine, Goa Medical College, Bambolim, Goa, India
| | - Amit Dias
- 2 Department of Medicine and Department of Preventive & Social Medicine, Goa Medical College, Bambolim, Goa, India
| | | | - John Cleland
- 5 Robertson Centre for Biostatistics and Clinical Trials, University of Glasgow, UK
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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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Cohen A, Dias A, Azariah F, Krishna RN, Sequeira M, Abraham S, Cuijpers P, Morse JQ, Reynolds CF, Patel V. Aging and well-being in Goa, India: a qualitative study. Aging Ment Health 2018; 22:168-174. [PMID: 27689842 PMCID: PMC5374050 DOI: 10.1080/13607863.2016.1236239] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
OBJECTIVES The population of India is aging rapidly. This demographic shift brings with it a host of challenges to the health and well-being of older adults, including the increased prevalence of non-communicable diseases, among them depressive disorders. In this paper, we report on qualitative research intended to inform the development of a locally acceptable and appropriate intervention to improve the well-being of older adults in Goa, India and, specifically, to prevent late-life depression. METHOD Semi-structured interviews with 20 individuals, aged 60 years and older, attending two primary care clinics in Goa, India. Transcripts were reviewed to identify emerging themes, a coding scheme was developed and thematic analyses were conducted. RESULTS Analyses of the interview transcripts revealed the following key themes: (1) notions of old age tended to be negative and there were widespread fears of becoming widowed or incapacitated; (2) the most frequently reported health conditions were joint pain, diabetes and heart disease; (3) emotional distress was described using the terms 'tension', 'stress', 'worry' and 'thinking'; (4) family issues often involved financial matters, difficult relationships with daughters-in-law and conflicted feelings about living with the family or independently; (5) other than a pension scheme, participants did not know of community resources available to older adults. CONCLUSIONS Our findings are in general agreement with those of previous research, and with our experiences of working with older adults in Pittsburgh and the Netherlands. This research will inform the development of an intervention to prevent depression in older adults in Goa.
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Affiliation(s)
- Alex Cohen
- London School of Hygiene & Tropical Medicine, Faculty of Epidemiology & Population Health, Department of Population Health, London, United Kingdom
| | - Amit Dias
- Department of Preventive and Social Medicine, Goa Medical College, Goa, India
- Sangath, Goa, INDIA
| | | | | | | | | | - Pim Cuijpers
- Department of Clinical Psychology, VU-University Amsterdam, Amsterdam, the Netherlands
| | - Jennifer Q. Morse
- Graduate Psychology Programs, Chatham University, Pittsburgh, PA 15232, USA
| | - Charles F. Reynolds
- Department of Psychiatry, University of Pittsburgh School of Medicine; and Department of Behavioral and Community Health Sciences, University of Pittsburgh Graduate School of Public Health, Pittsburgh, PA, USA
| | - Vikram Patel
- London School of Hygiene & Tropical Medicine, Faculty of Epidemiology & Population Health, Department of Population Health, London, United Kingdom
- Sangath, Goa, INDIA
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Abstract
According to the 2001 census, India is home to more than 76 million people aged 60 years and over. This age-group, currently only 7.4% of the population, is expected to grow dramatically in the coming few decades. Analysis of the census data shows substantial variation in the rate of demographic ageing across India: at present, 10.5% of Kerala's population is older than 60 years, while in Dadra and Nagarhaveli this proportion is only 4%. Regions with more favourable health indicators seem to be ageing faster and the demand for specialist services will soon be evident in such places. There is a growing realisation that the care of older people with disabilities makes enormous demands on their carers. Terms such as ‘dementia’ and ‘Alzheimer's disease’ are now better understood. This was not the case when the Alzheimer's and Related Disorders Society of India (ARDSI) initiated awareness programmes. However, dementia remains a largely hidden problem in those disadvantaged parts of India where poverty and illiteracy remain prevalent.
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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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Reynolds CF, Dias A, Cohen A, Morse J, Anderson SJ, Cuijpers P, Patel V. Preventing Late-Life Depression: Lessons in Intervention Development From Goa, India. Innov Aging 2017; 1:igx030. [PMID: 30480121 PMCID: PMC6243671 DOI: 10.1093/geroni/igx030] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2017] [Indexed: 11/16/2022] Open
Abstract
We describe the development of an intervention strategy for the indicated prevention of depression in older adults living in Goa, India. Of particular novelty, the intervention is deliverable by lay health counselors and is grounded in problem solving therapy for primary care and brief behavioral treatment for insomnia. We have named the intervention "DIL" (the Hindi word for "heart" and an acronym for "depression in late life.") Additional DIL strategies include psychoeducation in self-management of co-occurring medical disorders such as diabetes mellitus, together with assistance in navigation to needed social and economic resources. We present the results of a preliminary open-trial case series involving 21 participants with subsyndromal symptoms of depression, demonstrating feasibility, acceptability, and benefit to participants. We then present the design of a larger confirmatory trial into which 181 participants have been enrolled. "DIL" is a novel and large depression prevention trial conducted with lay health counselors in a low-resource country. Its results are likely to have implications for depression prevention in older adults in other low- and middle-income countries and to inform contemporary models of the staging of depressive illness in later life.
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Affiliation(s)
- Charles F Reynolds
- School of Medicine, University of Pittsburgh, Pennsylvania
- Graduate School of Public Health, University of Pittsburgh, Pennsylvania
| | - Amit Dias
- Goa Medical College, Goa, India
- Sangath, Goa, India
| | - Alex Cohen
- London School of Hygiene and Tropical Medicine, UK
| | - Jennifer Morse
- School of Medicine, University of Pittsburgh, Pennsylvania
- Chatham University, Pittsburgh, Pennsylvania
| | - Stewart J Anderson
- Graduate School of Public Health, University of Pittsburgh, Pennsylvania
| | - Pim Cuijpers
- Department of Psychology, Free University of Amsterdam, the Netherlands
| | - Vikram Patel
- Sangath, Goa, India
- Harvard Medical School, Boston, Massachusetts
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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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Saxena A, Desai A, Narvencar K, Ramakrishnan S, Thangjam RS, Kulkarni S, Jacques' E Costa AK, Mani K, Dias A, Sukharamwala R. Echocardiographic prevalence of rheumatic heart disease in Indian school children using World Heart Federation criteria - A multi site extension of RHEUMATIC study (the e-RHEUMATIC study). Int J Cardiol 2017; 249:438-442. [PMID: 28966041 DOI: 10.1016/j.ijcard.2017.09.184] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/12/2017] [Revised: 08/18/2017] [Accepted: 09/20/2017] [Indexed: 11/25/2022]
Abstract
OBJECTIVES Rheumatic heart disease (RHD) continues to be major public health burden in developing world. Echocardiographic screening in school children has shown that subclinical RHD cases are several times more than clinical cases. Recent reports have used World Heart Federation (WHF) criteria. Objective of present study was to determine RHD prevalence using WHF criteria in Indian children. METHODS Children (5-15years) from randomly selected schools across four sites were included. After focused clinical evaluation, echocardiography was performed using WHF criteria in all children. Images/loops of abnormal cases were analyzed independently by an additional experienced cardiologist. Children with murmur and confirmatory echocardiography were categorized 'clinical RHD'; those with abnormal echocardiography alone were labeled 'subclinical RHD'. RESULTS Among 16,294 children included, mean age was 10.8 ± 2.9years; 55.1% were males; 11,405 (70%) were from rural areas and 3978 (24.4%) were from government schools. We detected RHD by echocardiography in 125 children [prevalence: 7.7/1000 (95% CI 6.3, 9.0)]. Borderline RHD was present in 93 children (5.7/1000, 95% CI 4.6, 6.9), definite RHD in 32 (2/1000, 95% CI 1.2, 2.6), and clinical RHD in six [0.36/1000, 95% CI: 0.1-0.7]. On univariate analysis, older age, female gender, and higher waist circumference were associated while on multivariate analysis, older age (OR 1.18, 95% CI: 1.09, 1.26) and female gender (OR 1.61, 95% CI: 1.13, 2.3) were associated with RHD. CONCLUSION RHD prevalence varies in different parts of India. Echocardiographic prevalence is several times higher than clinical and underscores importance of echocardiographic screening in community.
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Affiliation(s)
- Anita Saxena
- Department of Cardiology, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, India.
| | - Ankush Desai
- Department of Medicine, Goa Medical College, Bambolim, Goa, India
| | | | | | - Rajendra Singh Thangjam
- Department of Medicine, Jawaharlal Nehru Institute of Medical Sciences, Imphal, Manipur, India
| | | | | | - Kalaivani Mani
- Department of Biostatistics, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, India
| | - Amit Dias
- Department of Preventive & Social Medicine, Goa Medical College, Bambolim, Goa, India
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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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Bhan N, Millett C, Subramanian SV, Dias A, Alam D, Williams J, Dhillon PK. Socioeconomic patterning of chronic conditions and behavioral risk factors in rural South Asia: a multi-site cross-sectional study. Int J Public Health 2017; 62:1019-1028. [PMID: 28756464 DOI: 10.1007/s00038-017-1019-9] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [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: 11/10/2016] [Revised: 07/06/2017] [Accepted: 07/10/2017] [Indexed: 10/19/2022] Open
Abstract
OBJECTIVES Our aim was to examine relationships between markers of socioeconomic status and chronic disease risks in rural South Asia to understand the etiology of chronic diseases in the region and identify high-risk populations. METHODS We examined data from 2271 adults in Chennai, Goa and Matlab sites of the Chronic Disease Risk Factor study in South Asia. We report age-sex adjusted odds ratios for risk factors (tobacco, alcohol, fruit-vegetable use and physical activity) and common chronic conditions (hypertension, diabetes, overweight, depression, impaired lung and vision) by education, occupation and wealth. RESULTS Respondents with greater wealth and in non-manual professions were more likely to be overweight [OR = 2.48 (95% CI 1.8,3.38)] and have diabetes [OR = 1.88 (95% CI 1.02,3.5)]. Wealth and education were associated with higher fruit and vegetable [OR = 1.89 (95% CI 1.48,2.4)] consumption but lower physical activity [OR = 0.52 (95% CI 0.39,0.69)]. Non-manual workers reported lower tobacco and alcohol use, while wealthier respondents reported better vision and lung function. CONCLUSIONS Ongoing monitoring of inequalities in chronic disease risks is needed for planning and evaluating interventions to address the growing burden of chronic conditions.
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Affiliation(s)
- Nandita Bhan
- Public Health Foundation of India, Gurgaon, India.
| | - Christopher Millett
- Public Health Foundation of India, Gurgaon, India.,School of Public Health, Imperial College London, London, UK
| | - S V Subramanian
- Department of Social & Behavioral Sciences, Harvard TH Chan School of Public Health, Harvard University, Boston, USA
| | - Amit Dias
- Department of Preventive Medicine, Goa Medical College and Sangath, Goa, India
| | - Dewan Alam
- School of Kinesiology & Health Sciences, York University, Toronto, Canada
| | | | - Preet K Dhillon
- Centre for Control of Chronic Conditions, Public Health Foundation of India, Gurgaon, India
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Dias A, Azariah F, Cohen A, Anderson S, Morse J, Cuijpers P, Sequeira M, Gaude V, Soares S, Patel V, Reynolds CF. Intervention development for the indicated prevention of depression in later life: the "DIL" protocol in Goa, India. Contemp Clin Trials Commun 2017; 6:131-139. [PMID: 29057368 PMCID: PMC5647889 DOI: 10.1016/j.conctc.2017.04.006] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2016] [Revised: 03/23/2017] [Accepted: 04/08/2017] [Indexed: 11/17/2022] Open
Abstract
Because depression is a major source of the global burden of illness- related disability, developing effective strategies for reducing its incidence is an important public health priority, especially in low-income countries, where resources for treating depression are scarce. We describe in this report an intervention development project, funded by the US National Institute of Mental Health, to address "indicated" prevention of depression in older adults attending rural and urban primary care clinics in Goa, India. Specifically, participants in the "DIL" ("Depression in Later Life") trial were older adults living with mild, subsyndromal symptoms of depression and anxiety and thus at substantial risk for transitioning to fully syndromal major depression and anxiety disorders. Building upon the MANAS treatment trial ("Promoting Mental Health") led by Patel et al in the same locale, we present here lessons learned in the development and implementation of a protocol utilizing lay health counsellors (LHCs) who deliver a multi-component depression prevention intervention organized conceptually around Problem Solving Therapy for Primary Care (PST), with additional components addressing brief behavioural treatment of sleep disturbances such as insomnia, meeting basic social casework needs, and education in self- management of prevalent comorbid chronic diseases, such as diabetes mellitus. To our knowledge, DIL is the first randomized clinical trial addressing the prevention of depressive disorders ever conducted in a low- or middle-income country.
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Affiliation(s)
- Amit Dias
- SANGATH and Goa Medical College, India
| | | | - Alex Cohen
- London School of Hygiene and Tropical Medicine, United Kingdom
| | | | | | | | | | | | | | - Vikram Patel
- London School of Hygiene and Tropical Medicine, United Kingdom
- Harvard Medical School, USA
| | - Charles F. Reynolds
- University of Pittsburgh School of Medicine and Graduate School of Public Health, USA
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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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Jotheeswaran AT, Dias A, Philp I, Patel V, Prince M. Calibrating EASY-Care independence scale to improve accuracy. Age Ageing 2016; 45:890-893. [PMID: 27496925 PMCID: PMC5105821 DOI: 10.1093/ageing/afw106] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2015] [Accepted: 05/06/2016] [Indexed: 11/22/2022] Open
Abstract
Background there is currently limited support for the reliability and validity of the EASY-Care independence scale, with little work carried out in low- or middle-income countries. Therefore, we assessed the internal construct validity and hierarchical and classical scaling properties among frail dependent older people in the community. Objective we assessed the internal construct validity and hierarchical and classical scaling properties among frail dependent older people in the community. Methods three primary care physicians administered EASY-Care comprehensive geriatric assessment for 150 frail and/or dependent older people in the primary care setting. A Mokken model was applied to investigate hierarchical scaling properties of EASY-Care independence scale, and internal consistency (Cronbach's alpha) of the scale was also examined. Results we found that EASY-Care independence scale is highly internally consistent and is a strong hierarchical scale, hence providing strong evidence for unidimensionality. However, two items in the scale (unable to use telephone and manage finances) had much lower item Loevinger H coefficients than others. Exclusion of these two items improved the overall internal consistency of the scale. Conclusions the strong performance of the EASY-Care independence scale among community-dwelling frail older people is encouraging. This study confirms that EASY-Care independence scale is highly internally consistent and a strong hierarchical scale.
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Affiliation(s)
- A. T. Jotheeswaran
- Indian Institute of Public Health, Hyderabad, Hyderabad, Telangana 500033, India
- Institute of Psychiatry, King's College London, London SE58AF, UK
| | - Amit Dias
- Department of Preventive and Social Medicine, Goa Medical College, Goa, India
| | - Ian Philp
- Hull and East Yorkshire Hospitals NHS Trust, Hull, UK
| | - Vikram Patel
- London School of Hygiene and Tropical Medicine, Centre for Global Mental Health, London, UK
- Sangath, Goa, India
| | - Martin Prince
- Health Service and Population Research Department, Institute of Psychiatry, Psychology & Neuroscience, and Centre for Global Mental Health, King's College London, London, UK
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Shridhar K, Millett C, Laverty AA, Alam D, Dias A, Williams J, Dhillon PK. Prevalence and correlates of achieving recommended physical activity levels among children living in rural South Asia-A multi-centre study. BMC Public Health 2016; 16:690. [PMID: 27485010 PMCID: PMC4970267 DOI: 10.1186/s12889-016-3353-x] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2016] [Accepted: 07/22/2016] [Indexed: 01/27/2023] Open
Abstract
Background We report the prevalence of recommended physical activity levels (RPALs) and examine the correlates of achieving RPALs in rural South Asian children and analyse its association with anthropometric outcomes. Methods This analysis on rural South Asian children aged 5–14 years (n = 564) is a part of the Chronic Disease Risk Factor study conducted at three sites in India (Chennai n = 146; Goa n = 218) and Bangladesh (Matlab; n = 200). Data on socio-demographic and lifestyle factors (physical activity (PA); diet) were collected using an interviewer-administered questionnaires, along with objective anthropometric measurements. Multivariate logistic regression models were used to examine whether RPALs (active travel to school (yes/no); leisure-time PA ≥ 1 h/day; sedentary-activity ≤ 2 h/day) were associated with socio-demographic factors, diet and other forms of PA. Multivariate linear regression models were used to investigate associations between RPALs and anthropometrics (BMI- and waist z-scores). Results The majority of children (71.8 %) belonged to households where a parent had at least a secondary education. Two-thirds (66.7 %) actively travelled to school; 74.6 % reported ≥1 h/day of leisure-time PA and 55.7 % had ≤2 h/day of sedentary-activity; 25.2 % of children reported RPALs in all three dimensions. Older (10–14 years, OR = 2.0; 95 % CI: 1.3, 3.0) and female (OR = 1.7; 95 % CI: 1.1, 2.5) children were more likely to travel actively to school. Leisure-time PA ≥ 1 h/day was more common among boys (OR = 2.5; 95 % CI: 1.5, 4.0), children in Matlab, Bangladesh (OR = 3.0; 95 % CI: 1.6, 5.5), and those with higher processed-food consumption (OR = 2.3; 95 % CI: 1.2, 4.1). Sedentary activity ≤ 2 h/day was associated with younger children (5–9 years, OR = 1.6; 95 % CI: 1.1, 2.4), children of Goa (OR = 3.5; 95 % CI: 2.1, 6.1) and Chennai (OR = 2.5; 95 % CI: 1.5, 4.3) and low household education (OR = 2.1; 95 % CI: 1.1, 4.1). In multivariate analyses, sedentary activity ≤ 2 h/day was associated with lower BMI-z-scores (β = −0.3; 95 % CI: −0.5, −0.08) and lower waist-z-scores (β = −1.1; 95 % CI: −2.2, −0.07). Conclusion Only one quarter of children in these rural areas achieved RPAL in active travel, leisure and sedentary activity. Improved understanding of RPAL in rural South Asian children is important due to rapid socio-economic transition.
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Affiliation(s)
- Krithiga Shridhar
- Centre for Chronic Conditions and Injuries, Public Health Foundation of India, 4th Floor, Plot.No.47, Sector 44, Gurgaon, 122002, Haryana, India.
| | - Christopher Millett
- Department of Primary Care and Public Health, Imperial College, Reynolds Building, Charing Cross Campus, London, UK
| | - Anthony A Laverty
- Department of Primary Care and Public Health, Imperial College, Reynolds Building, Charing Cross Campus, London, UK
| | - Dewan Alam
- Centre for Global Health Research, Li KaShing Knowledge Institute, St. Michael's Hospital, Toronto, Canada
| | - Amit Dias
- Goa Medical College, Sangath, Bardez, Goa, India
| | | | - Preet K Dhillon
- Centre for Chronic Conditions and Injuries, Public Health Foundation of India, 4th Floor, Plot.No.47, Sector 44, Gurgaon, 122002, Haryana, India
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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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Ankush, Dias A, Gomes E, Dessai A. Complications in Advanced Diabetics in a Tertiary Care Centre: A Retrospective Registry-Based Study. J Clin Diagn Res 2016; 10:OC15-9. [PMID: 27190861 DOI: 10.7860/jcdr/2016/15268.7583] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [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: 06/27/2015] [Accepted: 03/18/2016] [Indexed: 11/24/2022]
Abstract
INTRODUCTION Diabetes is a major public health problem in our country and complications of diabetes are a major cause of morbidity and mortality. There is a need to quantify the complications in order to improve our strategies for prevention and management. AIM To measure the prevalence of complications in type 2 diabetics following up at a tertiary care centre and to study its association with the socio-demographic and clinical parameters. MATERIALS AND METHODS A retrospective record based study was conducted on 3261 type 2 diabetic patients on insulin therapy, recorded in the diabetic registry maintained at Goa Medical College from Aug 2009 to May 2012. Data on anthropometric measurements, demographic characteristics, complications and other details were extracted from these records. RESULTS Out of the 3261 patients 1025 (31.4%) had macrovascular complications and 1122 (34.4%) had at least one microvascular complication. The prevalence of peripheral vascular disease, coronary artery disease and stroke were 6.7%, 21.3% and 6.6% respectively and were significantly higher in males. The prevalence of diabetic retinopathy, nephropathy and neuropathy were 16.7%, 16.5% and 16.3% respectively with diabetic nephropathy being significantly higher in males. Trend analysis showed significant association of rising prevalence of all complications with age (p<0.05). Duration of diabetes also showed significantly positive trend for all complications (p<0.05) except stroke. CONCLUSION The study presents the prevalence of diabetic complications in patients reporting to a tertiary hospital in Goa. Coronary artery disease was found to be the most common complication. As age and duration of diabetes were found to be significantly associated, efforts should be made towards promoting earlier diagnosis of diabetes so as to improve management and decrease the chances of complications.
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Affiliation(s)
- Ankush
- Project Co-ordinator, Goa Medical College , Bambolim, Goa, India
| | - Amit Dias
- Assistant Professor, Department of Preventive and Social Medicine, Goa Medical College , Bambolim, Goa, India
| | - Edwin Gomes
- Professor and Head, Department of Medicine, Goa Medical College , Bambolim, Goa, India
| | - Ankush Dessai
- Consultant Endocrinologist, Department of Medicine, Goa Medical College , Bambolim, Goa, India
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Fernandes L, Mesquita AM, Vadala R, Dias A. Reference Equation for Six Minute Walk Test in Healthy Western India Population. J Clin Diagn Res 2016; 10:CC01-4. [PMID: 27437206 DOI: 10.7860/jcdr/2016/17643.7714] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2015] [Accepted: 01/28/2016] [Indexed: 11/24/2022]
Abstract
INTRODUCTION The Six Minute Walk Test (6MWT) is used to assess disease progression and survival in chronic cardiopulmonary disorders. However, variability is noted in the six minute walk test distance (6MWD) in different populations. AIM We aimed to develop a reference equation for 6MWD in healthy Western India population and compare the results with previously published Indian and Caucasian reference equations. MATERIALS AND METHODS Total 174 healthy subjects between 25 to 75 years performed the 6MWT. Variables assessed were age, height, weight, body mass index and sex. Predicted equations were derived using multiple linear regression and compared with the equations for North Indian male, South Indian and Caucasian population using Bland - Altman method. RESULTS The 6MWD mean (SD) was 512.38 (67.84) m for men and 457.27 (56.75) m for women with p=0.001. The 6MWD correlated with age (r=-0.44), height (r=0.43), weight (r=0.21) in univariate analysis. Stepwise multiple regression analysis showed age and sex to be independent predictors of 6MWD, R(2) =0.307. The reference equation for healthy Western India population is 553.289 + (-2.11 x age) + (45.323 x sex; men=1 and women =0). Bland Altman analysis showed that the mean bias was 50.87m (95% limits of agreement 134.77 to - 33.0) for North Indian male equation, 50.75m (95% limits of agreement 105.72 to - 4.22) for South Indian equation and 122.72m (95%limits of agreement 254.11 to - 8.67) for Enright and Sherrill's equation. CONCLUSIONS The North Indian male, South Indian and Caucasian equations significantly over-estimated the predicted walk distance for our healthy population. Hence, there is a need to develop subgroup population specific reference equations.
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Affiliation(s)
- Lalita Fernandes
- Professor, Department of Pulmonary Medicine, Goa Medical College , Goa, India
| | | | - Rohit Vadala
- Registrar, Critical Care Unit, Apollo Hospital , Chennai, India
| | - Amit Dias
- Assistant Professor, Department of Preventive and Social Medicine, Goa Medical College , Goa, India
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