J. Silvaa , N. Hipolito b,c , P. Machadob , S. Florab , J. Cruza,b, *

Acknowledgements: This work is part of a project funded by FEDER - Fundo Europeu de Desenvolvimento Regional by COMPETE 2020 Programa Operacional Competitividade e Internacionalização (POCI) and national funds by Fundação ao para a Ciência e a Tecnologia (FCT), entitled ^ “OnTRACK project - Time to Rethink Activity Knowledge: a personalized mHealth coaching platform to tackle physical inactivity in COPD” (POCI-01-0145-FEDER-028446, PTDC/SAU-SER/28446/2017). SF and NH are being financially supported by PhD fellowships DFA/BD/6954/2020 and 2021.05188.BD, respectively, funded by FCT/MCTES, FSE, Por_Centro and UE. PM acknowledges the support provided by the FCT with the PhD fellowship. The authors acknowledge the financial support provided by FCT to their research unit Center for Innovative Care and Health Technology (UIDB/05704/2020).Pulmonology is the official journal of the Portuguese Society of Pulmonology (Sociedade Portuguesa de Pneumologia/SPP). The journal publishes 6 issues per year, mainly about respiratory system diseases in adults and clinical research. All articles published open access will be immediately and permanently free for everyone to read, download, copy and distribute.Introduction: Low physical activity (PA) levels have a negative impact on the health status of patients with Chronic Obstructive Pulmonary Disease (COPD). Smartphone applications (apps) focused on PA promotion may mitigate this problem; however, their effectiveness depends on patient adherence, which can be influenced by the technological features of the apps. This systematic review identified the technological features of smartphone apps aiming to promote PA in patients with COPD. Methods: A literature search was performed in the databases ACM Digital Library, IEEE Xplore, PubMed, Scopus and Web of Science. Papers including the description of a smartphone app for PA promotion in patients with COPD were included. Two researchers independently selected studies and scored the apps features based on a previously developed framework (38 possible features). Results: Twenty-three studies were included and 19 apps identified, with an average of 10 technological features implemented. Eight apps could be connected to wearables to collect data. The categories ‘Measuring and monitoring’ and ‘Support and Feedback’ were present in all apps. Overall, the most implemented features were ‘progress in visual format’ (n=13), ‘advice on PA’ (n=14) and ‘data in visual format’ (n=10). Only three apps included social features, and two included a web-based version of the app. Conclusions: The existing smartphone apps include a relatively small number of features to promote PA, which are mostly related to monitoring and providing feedback. Further research is warranted to explore the relationship between the presence/absence of specific features and the impact of interventions on patients’ PA levels.info:eu-repo/semantics/publishedVersio

End-users’ perspectives of an eHealth platform to promote physical activity in COPD: a qualitative study

Introduction: eHealth platforms can be used as a tool to promote physical activity (PA) in patients with COPD. When developing such platforms, a bottom-up approach is needed to ensure that patients’ and healthcare professionals’ (HCP) needs and expectations are addressed. Aim: To assess patients’ and HCP’ perspectives on the ideal eHealth platform (web application - app - for HCP + mobile app for patients) for PA promotion in patients with COPD. Methods: One focus group with 5 patients (68±8 yrs, FEV1 44±21pp) and 6 individual interviews with HCP (physicians and physiotherapist, 39±10 yrs) were conducted using a semi-structured interview guide. Interviews were recorded and transcripts were analysed using the Grounded Theory approach. Results: Participants considered an eHealth platform to promote patients' PA valuable. Both groups suggested that PA should be individualised according to patients’ characteristics. The main features for a mobile app included: shared goal setting, PA progress graphs, motivational messages and goal badges, notifications, a bi-directional communication system to support patients and information on breathing exercises. Both groups highlighted the importance of measuring steps, PA duration, SpO2, and dyspnoea on exertion. For the web app, the HCP highlighted the importance of a notification system to signal PA changes or non-compliance (e.g., colour scheme), as well as tabs for PA goal setting and monitoring. HCP recommended this platform for patients with stable or mild disease and/or those attending pulmonary rehabilitation. Conclusion: Findings provide guidance to the design of future eHealth platforms for PA promotion in COPD.publishe

Is stomatal conductance optimized over both time and space in plant crowns? A field test in grapevine (Vitis vinifera)

15 páginas.-- 13 figuras.-- 1 tabla.-- 64 referenciasCrown carbon gain is maximized for a given total water loss if stomatal conductance (gs) varies such that the marginal carbon product of water (∂A/∂E) remains invariant both over time and among leaves in a plant crown, provided the curvature of assimilation rate (A) versus transpiration rate (E) is negative. We tested this prediction across distinct crown positions in situ for the first time by parameterizing a biophysical model across 14 positions in four grapevine crowns (Vitis vinifera), computing optimal patterns of gs and E over a day and comparing these to the observed patterns. Observed water use was higher than optimal for leaves in the crown interior, but lower than optimal in most other positions. Crown carbon gain was 18% lower under measured gs than under optimal gs. Positive curvature occurred in 39.6% of cases due to low boundary layer conductance (gbw), and optimal gs was zero in 11% of cases because ∂A/∂E was below the target value at all gs. Some conclusions changed if we assumed infinite gbw, but optimal and measured E still diverged systematically in time and space. We conclude that the theory's spatial dimension and assumption of positive curvature require further experimental testingThis work was funded by the Spanish Ministry of Science and Innovation (research projects AGL2008-04525-C02-01, AGL2011-30408-C04-01 and AGL2009-11310/AGR). T.N.B. was supported by the US National Science Foundation (Award No. 1146514) and by the Grains Research and Development Corporation (GRDC). S.M. benefitted from a FPI grant BES-2009-016906 from the Spanish Ministry of Science and Innovation.Peer reviewe

Relationship of dietary pattern with body composition and symptoms in patients with COPD

This study explored the relationship of dietary patterns with body composition and symptoms in patients with COPD. Data collection included: dietary pattern – n. meals/day; period of the day of highest food intake (morning [6 AM–12 PM], afternoon [12–18 PM], and evening [18 PM–6 AM]); the time interval between meals (3-4h, 5-6h, 9-10h), and daily energy and nutrient intake using a semiquantitative food frequency questionnaire (last 12 months); body composition – body mass index (BMI), % fat mass (%FM), % fat-free mass (%FFM), % total muscle mass (%MM), fat-free mass index (FFMI) and visceral fat index (VAT) (SECA mBCA 525); symptoms – dyspnoea (modified Medical Research Council Dyspnea Scale, mMRC), fatigue (Checklist of Individual Strength, CIS20-P total score), impact of COPD (COPD Assessment Test, CAT). Pearson’s (r) or Spearman’s (ρ) correlations were conducted. 18 patients participated (16 males, 68±7 years old, FEV1 43±20% predicted, BMI 25±5kg/m2, FFMI 18±3kg/m2). Most participants reported having 3-4 meals/day (n=14, 78%) with a 3-4-hour interval (n=15, 83%). Moderate correlations were found between %FM and carbohydrates (ρ=-.501) and between FFMI and monosaturated fat (r=.476) (p.05). Energy and nutrient intake are related to COPD symptoms and body composition. The nature of these relationships should be explored.info:eu-repo/semantics/publishedVersio

Efficacy And Safety Of Implantable Loop Recorder: Experience Of A Center

Introduction: Symptoms like syncope or palpitations frequently present a diagnostic challenge. An implantable loop recorder (ILR) is an important aid in the management of these patients. Methods: A retrospective study of patients that underwent ILR implantation from November 2007 to 2014. For each patient the indication for implantation, baseline characteristics, previous study, complications, recorded tracing and interventions were evaluated. Results: A total of 62 patients were included, 50% men, with a mean age of 62.5±18.8 years old. Previously to ILR implantation 88.7% of patients had performed Holter, 17.7% external events recorder, 33.9% Tilt test and 29% an electrophysiological study. The implantation indications were recurrent syncope in 90.3%, palpitations 8.1% and ischemic stroke in one patient. Mean follow-up time was 17.1±16.3 months. Symptoms were reported in 66.1% of the patients, 46.8% of those yielding a diagnostic finding. In all cases of palpitation complaints with diagnosis we found atrial fibrillation (AF). In patients with syncope atrioventricular conduction disturbance was demonstrated in 19.6%, sinus node dysfunction in 16.1%, paroxysmal supra-ventricular tachycardia 7.1% and AF in 1.8%. These finding resulted in 19 pacemaker and one CRT-D implantation, introduction of anticoagulation in five patients and one ablation of accessory pathway. There were no major complications. Conclusion: ILR proved to be safe and efficient. It has enabled the identification or exclusion of serious rhythm disturbances in more than half of patients and provided a targeted therapeutic intervention.info:eu-repo/semantics/publishedVersio

Choroidal Binarization Analysis: Clinical Application

Introduction: Image processing of optical coherence tomography scans through binarization techniques represent a non-invasive way to separately asses and measure choroidal components, in vivo. In this review, we systematically search the scientific literature regarding binarization studies published so far. Methods: A systematic research was conducted at PubMed database, including English literature articles for all of the following terms in various combinations: binarization, choroid/al, enhanced depth spectral domain/swept source optic coherence tomography, and latest publications up to November 2018 were reviewed. Results: Thirty-seven articles were included and analyzed regarding studied disease, binarization method, studied variables, and outcomes. Most of the studies have focused on the more common retinal pathologies, such as age-related macular degeneration, central serous chorioretinopathy and diabetic retinopathy but binarization techniques have also been applied to the study of choroidal characteristics in ocular inflammatory diseases, corneal dystrophies and in postsurgical follow-up. Advantages and disadvantages of binarization techniques are also discussed. Conclusion: Binarization of choroidal images seems to represent a promising approach to study choroid subcomponents in an increasingly detailed manner.info:eu-repo/semantics/publishedVersio

Frondose and turf-dominated marine habitats support distinct trophic pathways: evidence from ¹⁵N and ¹³C stable isotope analyses

Marine vegetation plays an important structuring role, delivering key functions and services to coastal systems the extent of which depends on the foundation species and their architecture. In increasingly urbanised coastlines, turf-forming macroalgae are replacing frondose morphotypes. Trophic relationships within these systems can be studied through stable isotope analysis of the different food web compartments. In the present study, we investigated trophic pathways in two distinct macroalgal assemblages: one dominated by small brown frondose algae, and one dominated by low-lying turf-forming species. ¹⁵N and ¹³C isotopic signatures were determined for selected macroalgae and sedentary animals from distinct trophic levels, collected from two habitats on São Miguel Island (Azores, Portugal). In frondose habitats macroalgae appeared to make up the primary carbon source for the entire food web, whilst in turf-dominated habitats there was a decouple between macroalgae and higher trophic levels. Because canopy replacement by algal turf may affect the structure of the littoral food webs, coastal biodiversity conservation strategies should give priority to natural areas rich in canopy-forming algae.This research was supported by the European Commission BEST Preparatory Action, under the project “ECOSUBVEG – Changes in submersed vegetation: assessing loss in ecosystems services from frondose to depauperate systems dominated by opportunistic vegetation”, ref. 07.032700/2012/635752/SUB/B2. The research was also partially supported by Portuguese National Funds, through FCT – Fundação para a Ciência e a Tecnologia, within the projects UID/BIA/00329/2013, 2015 - 2018, UID/BIA/00329/2019 and UID/BIA/00329/2020-2023. Logistic support was also provided by CIRN/UAc (Centre of natural Resources of University of the Azores) and by CVARG (Centro de Vulcanologia e Avaliação de Riscos Geológicos). GMM was supported by a post-doctoral grant awarded by FCT (SFRH/BDP/63040/2009 and SFRH/BDP/108114/2015).info:eu-repo/semantics/publishedVersio

Corneal Sub‐Basal Nerve Plexus Assessment and its Association with Phenotypic Features and Lymphocyte Subsets in Sjögren's Syndrome

Purpose: To assess and compare corneal sub-basal nerve plexus morphology with circulating lymphocyte subsets, immunologic status and disease activity in Sjögren syndrome (SjS) patients. Methods: Fifty-five SjS patients, 63 Sicca patients (not fulfilling SjS criteria), 18 rheumatoid arthritis (RA) patients and 20 healthy controls (HC) were included. Systemic disease activity in SjS was assessed with the ESSDAI score. Lymphocyte subpopulations were studied with flow cytometry. Corneal confocal microscopy and ImageJ software were used to characterize corneal sub-basal nerve plexus in terms of nerve density (CNFD), length (CNFL) and tortuosity (CNFT). Conventional dry eye tests were also performed. Results: CNFL and CNFD were lower in SjS, Sicca and RA groups, compared to HC (p < 0.001 for both SjS and Sicca); CNFL p = 0.005, CNFD p = 0.018 in RA). CNFT was higher in SjS, followed by Sicca, RA and HC. A negative correlation was found between ESSDAI score and CNFL (r=-0.735, p = 0.012). CNFL correlated negatively with IL21+ CD8+ T cells (r=-0.279, p = 0.039) and a positively with total memory (r = 0.299, p = 0.027), unswitched memory (r = 0.281, p = 0.038) and CD24Hi CD27+ (r = 0.278, p = 0.040) B cells. CNFD showed a tendency to significance in its negative correlation with ESSDAI (r=-0.592, p = 0.071) and in its positive correlation with switched memory B cells (r = 0.644, p = 0.068). Conclusions: This is the first study aiming to correlate ocular findings with lymphocyte subsets in SjS. The associations founded between CNFL and CNFD and disease activity, IL21+ follicular T cells and some B-cell subsets suggest that corneal nerve damage may parallel systemic disease activity and inflammatory cells' dynamics.info:eu-repo/semantics/publishedVersio

Polaron effects in electron channels on a helium film

Using the Feynman path-integral formalism we study the polaron effects in quantum wires above a liquid helium film. The electron interacts with two-dimensional (2D) surface phonons, i.e. ripplons, and is confined in one dimension (1D) by an harmonic potential. The obtained results are valid for arbitrary temperature ($T$), electron-phonon coupling strength ($\alpha$), and lateral confinement ($\omega_{0}$). Analytical and numerical results are obtained for limiting cases of $T$, $\alpha$, and $\omega_{0}$. We found the surprising result that reducing the electron motion from 2D to quasi-1D makes the self-trapping transition more continuous.Comment: 6 pages, 7 figures, submitted to Phys. Rev.

Consensus Document on Magnetic Resonance Imaging in Patients with Cardiac Implanted Electronic Devices

Magnetic resonance imaging (MRI) is currently considered an essential complementary method for diagnosis in many conditions. Exponential growth in its use is expected due to the aging population and a broader spectrum of clinical indications. Growth in its use, coupled with an increasing number of pacemaker implants, implantable cardioverter-defibrillators and cardiac resynchronization therapy, has led to a frequent clinical need for this diagnostic modality in patients with cardiac implantable electronic devices (CIED). This clinical need has fueled the development of devices specifically designed and approved for use in a magnetic resonance (MR) environment under certain safety conditions (MR-conditional devices). More than a decade after the introduction of the first MR-conditional pacemaker, there are now several dozen MR-conditional devices with different safety specifications. In recent years, increasing evidence has indicated there is a low risk to MRI use in conventional (so-called non-MR-conditional) CIED patients in the right circumstances. The increasing number, as well as the greater diversity and complexity of implanted devices, justify the need to standardize procedures, by establishing institutional agreements that require close collaboration between cardiologists and radiologists. This consensus document, prepared jointly by the Portuguese Society of Cardiology and the Portuguese Society of Radiology and Nuclear Medicine, provides general guidelines for MRI in patients with CIED, ensuring the safety of patients, health professionals and equipment. In addition to briefly reviewing the potential risks of MRI in patients with CIED and major changes to MRI-conditional devices, this article provides specific recommendations on risk-benefit analysis, informed consent, scheduling, programming strategies, devices, monitoring and modification of MRI sequences. The main purpose of this document is to optimize patient safety and provide legal support to facilitate easy access by CIED patients to a potentially beneficial and irreplaceable diagnostic technique.info:eu-repo/semantics/publishedVersio