Author: "Portugal C" / Publication Year Range: Last 3 years - Searchworks@Jio Institute Digital Library Search Results

26 results on '"Portugal C"'

1. Global burden and strength of evidence for 88 risk factors in 204 countries and 811 subnational locations, 1990–2021: a systematic analysis for the Global Burden of Disease Study 2021

Author: Brauer, M, Roth, G, Aravkin, A, Zheng, P, Abate, K, Abate, Y, Abbafati, C, Abbasgholizadeh, R, Abbasi, M, Abbasian, M, Abbasifard, M, Abbasi-Kangevari, M, Abd ElHafeez, S, Abd-Elsalam, S, Abdi, P, Abdollahi, M, Abdoun, M, Abdulah, D, Abdullahi, A, Abebe, M, Abedi, A, Abegaz, T, Abeldaño Zuñiga, R, Abiodun, O, Abiso, T, Aboagye, R, Abolhassani, H, Abouzid, M, Aboye, G, Abreu, L, Abualruz, H, Abubakar, B, Abu-Gharbieh, E, Abukhadijah, H, Aburuz, S, Abu-Zaid, A, Adane, M, Addo, I, Addolorato, G, Adedoyin, R, Adekanmbi, V, Aden, B, Adetunji, J, Adeyeoluwa, T, Adha, R, Adibi, A, Adnani, Q, Adzigbli, L, Afolabi, A, Afolabi, R, Afshin, A, Afyouni, S, Afzal, M, Afzal, S, Agampodi, S, Agbozo, F, Aghamiri, S, Agodi, A, Agrawal, A, Agyemang-Duah, W, Ahinkorah, B, Ahmad, A, Ahmad, D, Ahmad, F, Ahmad, N, Ahmad, S, Ahmad, T, Ahmed, A, Ahmed, L, Ahmed, M, Ahmed, S, Ajami, M, Akalu, G, Akara, E, Akbarialiabad, H, Akhlaghi, S, Akinosoglou, K, Akinyemiju, T, Akkaif, M, Akkala, S, Akombi-Inyang, B, Al Awaidy, S, Al Hasan, S, Alahdab, F, AL-Ahdal, T, Alalalmeh, S, Alalwan, T, Al-Aly, Z, Alam, K, Alam, N, Alanezi, F, Alanzi, T, Albakri, A, Albataineh, M, Aldhaleei, W, Aldridge, R, Alemayohu, M, Alemu, Y, Al-Fatly, B, Al-Gheethi, A, Al-Habbal, K, Alhabib, K, Alhassan, R, Ali, A, Ali, B, Ali, I, Ali, L, Ali, M, Ali, R, Ali, S, Ali, W, Alicandro, G, Alif, S, Aljunid, S, Alla, F, Al-Marwani, S, Al-Mekhlafi, H, Almustanyir, S, Alomari, M, Alonso, J, Alqahtani, J, Alqutaibi, A, Al-Raddadi, R, Alrawashdeh, A, Al-Rifai, R, Alrousan, S, Al-Sabah, S, Alshahrani, N, Altaany, Z, Altaf, A, Al-Tawfiq, J, Altirkawi, K, Aluh, D, Alvis-Guzman, N, Alvis-Zakzuk, N, Alwafi, H, Al-Wardat, M, Al-Worafi, Y, Aly, H, Aly, S, Alzoubi, K, Al-Zyoud, W, Amaechi, U, Aman Mohammadi, M, Amani, R, Amiri, S, Amirzade-Iranaq, M, Ammirati, E, Amu, H, Amugsi, D, Amusa, G, Ancuceanu, R, Anderlini, D, Anderson, J, Andrade, P, Andrei, C, Andrei, T, Anenberg, S, Angappan, D, Angus, C, Anil, A, Anil, S, Anjum, A, Anoushiravani, A, Antonazzo, I, Antony, C, Antriyandarti, E, Anuoluwa, B, Anvari, D, Anvari, S, Anwar, S, Anwer, R, Anyabolo, E, Anyasodor, A, Apostol, G, Arabloo, J, Arabzadeh Bahri, R, Arafat, M, Areda, D, Aregawi, B, Aremu, A, Armocida, B, Arndt, M, Ärnlöv, J, Arooj, M, Artamonov, A, Artanti, K, Aruleba, I, Arumugam, A, Asbeutah, A, Asgary, S, Asgedom, A, Ashbaugh, C, Ashemo, M, Ashraf, T, Askarinejad, A, Assmus, M, Astell-Burt, T, Athar, M, Athari, S, Atorkey, P, Atreya, A, Aujayeb, A, Ausloos, M, Avila-Burgos, L, Awoke, A, Ayala Quintanilla, B, Ayatollahi, H, Ayestas Portugal, C, Ayuso-Mateos, J, Azadnajafabad, S, Azevedo, R, Azhar, G, Azizi, H, Azzam, A, Backhaus, I, Badar, M, Badiye, A, Bagga, A, Baghdadi, S, Bagheri, N, Bagherieh, S, Bahrami Taghanaki, P, Bai, R, Baig, A, Baker, J, Bakkannavar, S, Balasubramanian, M, Baltatu, O, Bam, K, Bandyopadhyay, S, Banik, B, Banik, P, Banke-Thomas, A, Bansal, H, Barchitta, M, Bardhan, M, Bardideh, E, Barker-Collo, S, Bärnighausen, T, Barone-Adesi, F, Barqawi, H, Barrero, L, Barrow, A, Barteit, S, Basharat, Z, Basiru, A, Basso, J, Bastan, M, Basu, S, Batchu, S, Batra, K, Batra, R, Baune, B, Bayati, M, Bayileyegn, N, Beaney, T, Behnoush, A, Beiranvand, M, Béjot, Y, Bekele, A, Belgaumi, U, Bell, A, Bell, M, Bello, M, Bello, O, Belo, L, Beloukas, A, Bendak, S, Bennett, D, Bennitt, F, Bensenor, I, Benzian, H, Beran, A, Berezvai, Z, Bernabe, E, Bernstein, R, Bettencourt, P, Bhagavathula, A, Bhala, N, Bhandari, D, Bhardwaj, N, Bhardwaj, P, Bhaskar, S, Bhat, A, Bhat, V, Bhatti, G, Bhatti, J, Bhatti, M, Bhatti, R, Bhuiyan, M, Bhutta, Z, Bikbov, B, Bishai, J, Bisignano, C, Biswas, A, Biswas, B, Biswas, R, Bjørge, T, Boachie, M, Boakye, H, Bockarie, M, Bodolica, V, Bodunrin, A, Bogale, E, Bolla, S, Boloor, A, Bonakdar Hashemi, M, Boppana, S, Bora Basara, B, Borhany, H, Botero Carvajal, A, Bouaoud, S, Boufous, S, Bourne, R, Boxe, C, Braithwaite, D, Brant, L, Brar, A, Breitborde, N, Breitner, S, Brenner, H, Briko, A, Britton, G, Brown, C, Browne, A, Brunoni, A, Bryazka, D, Bulamu, N, Bulto, L, Buonsenso, D, Burkart, K, Burns, R, Busse, R, Bustanji, Y, Butt, N, Butt, Z, Caetano dos Santos, F, Cagney, J, Cahuana-Hurtado, L, Calina, D, Cámera, L, Campos, L, Campos-Nonato, I, Cao, C, Cao, F, Cao, Y, Capodici, A, Cárdenas, R, Carr, S, Carreras, G, Carrero, J, Carugno, A, Carvalho, F, Carvalho, M, Castaldelli-Maia, J, Castañeda-Orjuela, C, Castelpietra, G, Catalá-López, F, Catapano, A, Cattaruzza, M, Caye, A, Cederroth, C, Cegolon, L, Cenderadewi, M, Cercy, K, Cerin, E, Chadwick, J, Chakraborty, C, Chakraborty, P, Chakraborty, S, Chan, J, Chan, R, Chandan, J, Chandika, R, Chaturvedi, P, Chen, A, Chen, C, Chen, H, Chen, M, Chen, S, Cheng, C, Cheng, E, Cherbuin, N, Chi, G, Chichagi, F, Chimed-Ochir, O, Chimoriya, R, Ching, P, Chirinos-Caceres, J, Chitheer, A, Cho, W, Chong, B, Chopra, H, Chowdhury, R, Christopher, D, Chu, D, Chukwu, I, Chung, E, Chung, S, Chutiyami, M, Cioffi, I, Cogen, R, Cohen, A, Columbus, A, Conde, J, Corlateanu, A, Cortese, S, Cortesi, P, Costa, V, Costanzo, S, Criqui, M, Cruz, J, Cruz-Martins, N, Culbreth, G, da Silva, A, Dadras, O, Dai, X, Dai, Z, Daikwo, P, Dalli, L, Damiani, G, D'Amico, E, D'Anna, L, Darwesh, A, Das, J, Das, S, Dash, N, Dashti, M, Dávila-Cervantes, C, Davis Weaver, N, Davitoiu, D, De la Hoz, F, de la Torre-Luque, A, De Leo, D, Debopadhaya, S, Degenhardt, L, Del Bo', C, Delgado-Enciso, I, Delgado-Saborit, J, Demoze, C, Denova-Gutiérrez, E, Dervenis, N, Dervišević, E, Desai, H, Desai, R, Devanbu, V, Dewan, S, Dhali, A, Dhama, K, Dhane, A, Dhimal, M, Dhingra, S, Dhulipala, V, Dhungana, R, Dias da Silva, D, Diaz, D, Diaz, L, Diaz, M, Dima, A, Ding, D, Dinu, M, Djalalinia, S, Do, T, do Prado, C, Dodangeh, M, Dohare, S, Dokova, K, Dong, W, Dongarwar, D, D'Oria, M, Dorostkar, F, Dorsey, E, Doshi, R, Doshmangir, L, Dowou, R, Driscoll, T, Dsouza, A, Dsouza, H, Dumith, S, Duncan, B, Duraes, A, Duraisamy, S, Dushpanova, A, Dzianach, P, Dziedzic, A, Ebrahimi, A, Echieh, C, Ed-Dra, A, Edinur, H, Edvardsson, D, Edvardsson, K, Efendi, F, Eftekharimehrabad, A, Eini, E, Ekholuenetale, M, Ekundayo, T, El Arab, R, El Sayed Zaki, M, El-Dahiyat, F, Elemam, N, Elgar, F, Elgohary, G, Elhabashy, H, Elhadi, M, Elmehrath, A, Elmeligy, O, Elshaer, M, Elsohaby, I, Emeto, T, Esfandiari, N, Eshrati, B, Eslami, M, Esmaeili, S, Estep, K, Etaee, F, Fabin, N, Fagbamigbe, A, Fagbule, O, Fahimi, S, Falzone, L, Fareed, M, Farinha, C, Faris, M, Faris, P, Faro, A, Fasina, F, Fatehizadeh, A, Fauk, N, Fazylov, T, Feigin, V, Feng, X, Fereshtehnejad, S, Feroze, A, Ferrara, P, Ferrari, A, Ferreira, N, Fetensa, G, Feyisa, B, Filip, I, Fischer, F, Fitriana, I, Flavel, J, Flohr, C, Flood, D, Flor, L, Foigt, N, Folayan, M, Force, L, Fortuna, D, Foschi, M, Franklin, R, Freitas, A, Friedman, S, Fux, B, G, S, Gaal, P, Gaihre, S, Gajdács, M, Galali, Y, Gallus, S, Gandhi, A, Ganesan, B, Ganiyani, M, Garcia, V, Gardner, W, Garg, R, Gautam, R, Gebi, T, Gebregergis, M, Gebrehiwot, M, Gebremariam, T, Gebremeskel, T, Gerema, U, Getacher, L, Getahun, G, Getie, M, Ghadirian, F, Ghafarian, S, Ghaffari Jolfayi, A, Ghailan, K, Ghajar, A, Ghasemi, M, Ghasempour Dabaghi, G, Ghasemzadeh, A, Ghassemi, F, Ghazy, R, Gholami, A, Gholamrezanezhad, A, Gholizadeh, N, Ghorbani, M, Gil, A, Gil, G, Gilbertson, N, Gill, P, Gill, T, Gindaba, E, Girmay, A, Glasbey, J, Gnedovskaya, E, Göbölös, L, Godinho, M, Goel, A, Golechha, M, Goleij, P, Golinelli, D, Gomes, N, Gopalani, S, Gorini, G, Goudarzi, H, Goulart, A, Gouravani, M, Goyal, A, Graham, S, Grivna, M, Grosso, G, Guan, S, Guarducci, G, Gubari, M, Guha, A, Guicciardi, S, Gulati, S, Gulisashvili, D, Gunawardane, D, Guo, C, Gupta, A, Gupta, B, Gupta, M, Gupta, R, Gupta, S, Gupta, V, Habibzadeh, F, Habibzadeh, P, Hadaro, T, Hadian, Z, Haep, N, Haghi-Aminjan, H, Haghmorad, D, Hagins, H, Haile, D, Hailu, A, Hajj Ali, A, Halboub, E, Halimi, A, Hall, B, Haller, S, Halwani, R, Hamadeh, R, Hamdy, N, Hameed, S, Hamidi, S, Hammoud, A, Hanif, A, Hanifi, N, Haq, Z, Haque, M, Harapan, H, Hargono, A, Haro, J, Hasaballah, A, Hasan, I, Hasan, M, Hasan, S, Hasani, H, Hasanian, M, Hashmeh, N, Hasnain, M, Hassan, A, Hassan, I, Hassan Zadeh Tabatabaei, M, Hassani, S, Hassanipour, S, Hassankhani, H, Haubold, J, Havmoeller, R, Hay, S, Hebert, J, Hegazi, O, Hegena, T, Heidari, G, Heidari, M, Helfer, B, Hemmati, M, Henson, C, Herbert, M, Herteliu, C, Heuer, A, Hezam, K, Hinneh, T, Hiraike, Y, Hoan, N, Holla, R, Hon, J, Hoque, M, Horita, N, Hossain, S, Hosseini, S, Hosseinzadeh, H, Hosseinzadeh, M, Hostiuc, M, Hostiuc, S, Hoven, H, Hsairi, M, Hsu, J, Hu, C, Huang, J, Huda, M, Hulland, E, Hultström, M, Hushmandi, K, Hussain, J, Hussein, N, Huynh, C, Huynh, H, Ibitoye, S, Idowu, O, Ihler, A, Ikeda, N, Ikuta, K, Ilesanmi, O, Ilic, I, Ilic, M, Imam, M, Immurana, M, Inbaraj, L, Irham, L, Isa, M, Islam, M, Ismail, F, Ismail, N, Iso, H, Isola, G, Iwagami, M, Iwu, C, Iwu-Jaja, C, J, V, Jaafari, J, Jacob, L, Jacobsen, K, Jadidi-Niaragh, F, Jahankhani, K, Jahanmehr, N, Jahrami, H, Jain, A, Jain, N, Jairoun, A, Jaiswal, A, Jakovljevic, M, Jalilzadeh Yengejeh, R, Jamora, R, Jatau, A, Javadov, S, Javaheri, T, Jayaram, S, Jeganathan, J, Jeswani, B, Jiang, H, Johnson, C, Jokar, M, Jomehzadeh, N, Jonas, J, Joo, T, Joseph, A, Joseph, N, Joshi, V, Joshua, C, Jozwiak, J, Jürisson, M, Kaambwa, B, Kabir, A, Kabir, Z, Kadashetti, V, Kahn, E, Kalani, R, Kaliyadan, F, Kalra, S, Kamath, R, Kanagasabai, T, Kanchan, T, Kandel, H, Kanmiki, E, Kanmodi, K, Kansal, S, Kapner, D, Kapoor, N, Karagiannidis, E, Karajizadeh, M, Karakasis, P, Karanth, S, Karaye, I, Karch, A, Karim, A, Karimi, H, Karmakar, S, Kashoo, F, Kasraei, H, Kassahun, W, Kassebaum, N, Kassel, M, Katikireddi, S, Kauppila, J, Kawakami, N, Kaydi, N, Kayode, G, Kazemi, F, Keiyoro, P, Kemmer, L, Kempen, J, Kerr, J, Kesse-Guyot, E, Khader, Y, Khafaie, M, Khajuria, H, Khalaji, A, Khalil, M, Khalilian, A, Khamesipour, F, Khan, A, Khan, M, Khanmohammadi, S, Khatab, K, Khatatbeh, H, Khatatbeh, M, Khatib, M, Khavandegar, A, Khayat Kashani, H, Khidri, F, Khodadoust, E, Khormali, M, Khorrami, Z, Khosla, A, Khosrowjerdi, M, Khreis, H, Khusun, H, Kifle, Z, Kim, K, Kim, M, Kim, Y, Kimokoti, R, Kisa, A, Kisa, S, Knibbs, L, Knudsen, A, Koh, D, Kolahi, A, Kompani, F, Kong, J, Koren, G, Korja, M, Korshunov, V, Korzh, O, Kosen, S, Kothari, N, Koul, P, Koulmane Laxminarayana, S, Krishan, K, Krishnamoorthy, V, Krishnamoorthy, Y, Krishnan, B, Krohn, K, Kuate Defo, B, Kucuk Bicer, B, Kuddus, M, Kugbey, N, Kuitunen, I, Kulimbet, M, Kulkarni, V, Kumar, A, Kumar, N, Kumar, V, Kundu, S, Kurmi, O, Kusnali, A, Kusuma, D, Kutluk, T, La Vecchia, C, Ladan, M, Laflamme, L, Lahariya, C, Lai, D, Lal, D, Lallukka, T, Lám, J, Lan, Q, Lan, T, Landires, I, Lanfranchi, F, Langguth, B, Lansingh, V, Laplante-Lévesque, A, Larijani, B, Larsson, A, Lasrado, S, Lauriola, P, Le, H, Le, L, Le, N, Le, T, Leasher, J, Ledda, C, Lee, M, Lee, P, Lee, S, Lee, Y, Legrand, K, Leigh, J, Leong, E, Lerango, T, Lescinsky, H, Leung, J, Li, M, Li, W, Li, Y, Li, Z, Ligade, V, Lim, L, Lim, S, Lin, R, Lin, S, Liu, C, Liu, G, Liu, J, Liu, R, Liu, S, Liu, W, Liu, X, Livingstone, K, Llanaj, E, Lohiya, A, López-Bueno, R, Lopukhov, P, Lorkowski, S, Lotufo, P, Lozano, R, Lubinda, J, Lucchetti, G, Luo, L, Lv, H, M Amin, H, Ma, Z, Maass, K, Mabrok, M, Machairas, N, Machoy, M, Mafhoumi, A, Magdy Abd El Razek, M, Maghazachi, A, Mahadeshwara Prasad, D, Maharaj, S, Mahmoud, M, Mahmoudi, E, Majeed, A, Makram, O, Makris, K, Malasala, S, Maled, V, Malhotra, K, Malik, A, Malik, I, Malinga, L, Malta, D, Mamun, A, Manda, A, Manla, Y, Mansour, A, Mansouri, B, Mansouri, P, Mansourian, M, Mansournia, M, Mantovani, L, Manu, E, Marateb, H, Maravilla, J, Marsh, E, Martinez, G, Martinez-Piedra, R, Martini, S, Martins-Melo, F, Martorell, M, Marx, W, Maryam, S, Mathangasinghe, Y, Mathioudakis, A, Matozinhos, F, Mattumpuram, J, Maugeri, A, Maulik, P, Mayeli, M, Mazidi, M, Mazzotti, A, Mcgrath, J, Mckee, M, Mckowen, A, Mclaughlin, S, Mcphail, M, Mcphail, S, Mechili, E, Mehmood, A, Mehmood, K, Mehrabani-Zeinabad, K, Mehrabi Nasab, E, Meier, T, Mejia-Rodriguez, F, Mekene Meto, T, Mekonnen, B, Menezes, R, Mengist, B, Mensah, G, Mensah, L, Mentis, A, Meo, S, Meretoja, A, Meretoja, T, Mersha, A, Mesfin, B, Mestrovic, T, Mettananda, K, Mettananda, S, Miazgowski, T, Micha, G, Michalek, I, Micheletti Gomide Nogueira de Sá, A, Miller, T, Mirarefin, M, Mirghafourvand, M, Mirica, A, Mirijello, A, Mirrakhimov, E, Mirshahi, A, Mirzaei, M, Mishra, A, Mishra, V, Mitchell, P, Mithra, P, Mittal, C, Moazen, B, Moberg, M, Mocciaro, G, Mohamadkhani, A, Mohamed, A, Mohamed, J, Mohamed, M, Mohamed, N, Mohammadi, E, Mohammadi, S, Mohammadian-Hafshejani, A, Mohammadifard, N, Mohammed, H, Mohammed, M, Mohammed, S, Mokdad, A, Monasta, L, Mondello, S, Moni, M, Moodi Ghalibaf, A, Moore, C, Moradi, M, Moradi, Y, Moraga, P, Morawska, L, Moreira, R, Morovatdar, N, Morrison, S, Morze, J, Mosaddeghi Heris, R, Mossialos, E, Motappa, R, Mougin, V, Mousavi, P, Msherghi, A, Mubarik, S, Muccioli, L, Mueller, U, Mulita, F, Mullany, E, Munjal, K, Murillo-Zamora, E, Murlimanju, B, Musina, A, Mustafa, G, Muthu, S, Muthupandian, S, Muthusamy, R, Muzaffar, M, Myung, W, Nafei, A, Nagarajan, A, Nagaraju, S, Nagel, G, Naghavi, M, Naghavi, P, Naik, G, Nainu, F, Nair, T, Najdaghi, S, Nakhostin Ansari, N, Nanavaty, D, Nangia, V, Narasimha Swamy, S, Narimani Davani, D, Nascimento, B, Nascimento, G, Nashwan, A, Natto, Z, Nauman, J, Navaratna, S, Naveed, M, Nayak, B, Nayak, V, Ndejjo, R, Nduaguba, S, Negash, H, Negoi, I, Negoi, R, Nejadghaderi, S, Nejjari, C, Nematollahi, M, Nepal, S, Neupane, S, Ng, M, Nguefack-Tsague, G, Ngunjiri, J, Nguyen, D, Nguyen, N, Nguyen, P, Nguyen, V, Nguyen Tran Minh, D, Niazi, R, Nicholson, S, Nie, J, Nikoobar, A, Nikpoor, A, Ningrum, D, Nnaji, C, Noman, E, Nomura, S, Noroozi, N, Norrving, B, Noubiap, J, Nri-Ezedi, C, Ntaios, G, Ntsekhe, M, Nunemo, M, Nurrika, D, Nutor, J, Oancea, B, O'Connell, E, Odetokun, I, O'Donnell, M, Oduro, M, Ogunfowokan, A, Ogunkoya, A, Oh, I, Okati-Aliabad, H, Okeke, S, Okekunle, A, Okonji, O, Olagunju, A, Olasupo, O, Olatubi, M, Oliveira, A, Oliveira, G, Olorukooba, A, Olufadewa, I, Olusanya, B, Olusanya, J, Oluwafemi, Y, Omar, H, Omar Bali, A, Omer, G, Ong, K, Ong, S, Onwujekwe, O, Onyedibe, K, Oppong, A, Ordak, M, Orish, V, Ornello, R, Orpana, H, Ortiz, A, Ortiz-Prado, E, Osman, W, Ostroff, S, Osuagwu, U, Otoiu, A, Otstavnov, N, Otstavnov, S, Ouyahia, A, Owolabi, M, Oyeyemi, I, Oyeyemi, O, P A, M, Pacheco-Barrios, K, Padron-Monedero, A, Padubidri, J, Pal, P, Palicz, T, Pan, F, Pan, H, Pana, A, Panda, S, Panda-Jonas, S, Pandey, A, Pandi-Perumal, S, Pangaribuan, H, Pantazopoulos, I, Pantea Stoian, A, Papadopoulou, P, Parent, M, Parija, P, Parikh, R, Park, S, Parsons, N, Pashaei, A, Pasovic, M, Passera, R, Patil, S, Patoulias, D, Patthipati, V, Paudel, U, Pawar, S, Pazoki Toroudi, H, Peden, A, Pedersini, P, Peng, M, Pensato, U, Pepito, V, Peprah, E, Peprah, P, Peres, M, Perianayagam, A, Perico, N, Perna, S, Pesudovs, K, Petcu, I, Petermann-Rocha, F, Pham, H, Philip, A, Phillips, M, Pickering, B, Pierannunzio, D, Pigeolet, M, Pigott, D, Piracha, Z, Piradov, M, Pisoni, E, Piyasena, M, Plass, D, Plotnikov, E, Poddighe, D, Polkinghorne, K, Poluru, R, Pond, C, Popovic, D, Porru, F, Postma, M, Poudel, G, Pour-Rashidi, A, Pourshams, A, Pourtaheri, N, Prabhu, D, Prada, S, Pradhan, J, Pradhan, P, Prasad, M, Prates, E, Purnobasuki, H, Purohit, B, Puvvula, J, Qasim, N, Qattea, I, Qazi, A, Qian, G, Qiu, S, Rabiee Rad, M, Radfar, A, Radhakrishnan, R, Radhakrishnan, V, Raeisi Shahraki, H, Rafferty, Q, Rafiei, A, Raggi, A, Raghav, P, Raheem, N, Rahim, F, Rahim, M, Rahimifard, M, Rahimi-Movaghar, V, Rahman, M, Rahmani, A, Rahmani, B, Rahmanian, M, Rahmanian, N, Rahmanian, V, Rahmati, M, Rahmawaty, S, Raimondo, D, Rajaa, S, Rajendran, V, Rajput, P, Ramadan, M, Ramasamy, S, Ramasubramani, P, Ramazanu, 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Abstract: Background: Understanding the health consequences associated with exposure to risk factors is necessary to inform public health policy and practice. To systematically quantify the contributions of risk factor exposures to specific health outcomes, the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2021 aims to provide comprehensive estimates of exposure levels, relative health risks, and attributable burden of disease for 88 risk factors in 204 countries and territories and 811 subnational locations, from 1990 to 2021. Methods: The GBD 2021 risk factor analysis used data from 54 561 total distinct sources to produce epidemiological estimates for 88 risk factors and their associated health outcomes for a total of 631 risk–outcome pairs. Pairs were included on the basis of data-driven determination of a risk–outcome association. Age-sex-location-year-specific estimates were generated at global, regional, and national levels. Our approach followed the comparative risk assessment framework predicated on a causal web of hierarchically organised, potentially combinative, modifiable risks. Relative risks (RRs) of a given outcome occurring as a function of risk factor exposure were estimated separately for each risk–outcome pair, and summary exposure values (SEVs), representing risk-weighted exposure prevalence, and theoretical minimum risk exposure levels (TMRELs) were estimated for each risk factor. These estimates were used to calculate the population attributable fraction (PAF; ie, the proportional change in health risk that would occur if exposure to a risk factor were reduced to the TMREL). The product of PAFs and disease burden associated with a given outcome, measured in disability-adjusted life-years (DALYs), yielded measures of attributable burden (ie, the proportion of total disease burden attributable to a particular risk factor or combination of risk factors). Adjustments for mediation were applied to account for relationships involving risk
Published: 2024

2. OP020 [Comfort Management » Sedation]: REDUCTION IN BENZODIAZEPINE, OPIOID AND ANTIPSYCHOTIC USE AFTER A PROTOCOL IMPLEMENTATION IN A BRAZILIAN PEDIATRIC INTENSIVE CARE UNIT

Author: Portugal, C. A., primary, Malfará, M. R., additional, Rocha, M. E., additional, Volpe, D. D., additional, Volpon, L. C., additional, and Carlotti, A. P., additional
Published: 2022
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3. POS0966 DEVELOPMENT AND VALIDATION OF AN ANKYLOSING SPONDYLITIS RISK PREDICTION MODEL USING LONGITUDINAL REAL-WORLD DATA FROM A LARGE INTEGRATED HEALTHCARE DELIVERY SYSTEM

Author: Kawatkar, A., primary, Yi, E., additional, Estrada, E., additional, Pio, J., additional, Portugal, C., additional, Yi, D., additional, Habeshian, T., additional, Wei, D., additional, and Lee, S., additional
Published: 2022
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4. REDUCTION IN BENZODIAZEPINE, OPIOID AND ANTIPSYCHOTIC USE AFTER A PROTOCOL IMPLEMENTATION IN A BRAZILIAN PEDIATRIC INTENSIVE CARE UNIT.

Author: Portugal, C. A., Malfará, M. R., Rocha, M. E., Volpe, D. D., Volpon, L. C., and Carlotti, A. P.
Published: 2022

5. Experience from a regional percutaneous coronary intervention center: Aiming to assess and improve quality of care.

Author: Dias Claúdio F, Carias M, Almeida A, Paralta M, Viana R, Serrano M, Russo C, Sá Mendes G, Rocha R, Brás D, Neves D, Bento Â, Fernandes R, Trinca M, and Patrício L
Subjects: Humans, Male, Female, Middle Aged, Aged, Retrospective Studies, Time-to-Treatment, Percutaneous Coronary Intervention, ST Elevation Myocardial Infarction surgery, ST Elevation Myocardial Infarction diagnosis, ST Elevation Myocardial Infarction therapy, Quality Improvement
Abstract: Introduction and Objectives: Ischemic heart disease is the single most common cause of death in Europe. Mortality in patients presenting with ST-elevation myocardial infarction (STEMI) is associated with many factors, one of which is the time delay to treatment. The purpose of this work is to analyze the coronary pathway in our region in terms of timing, taking into consideration the place of first medical contact (FMC)., Methods: Consecutive patients admitted to our center with STEMI to undergo percutaneous coronary intervention (PCI) between 2013 and 2022 were analyzed. Age, gender, and time delays were collected. Analysis was performed with IBM SPSS version 28 for a significance level of 0.05., Results: We found that non-PCI centers had a significantly greater FMC to diagnosis delay and diagnosis to wire delay compared to other places of origin. Only 2.2% of patients met the 10-min FMC to diagnosis target; 44.8% met the target of 90 min from diagnosis to wire in transferred patients, while 40.6% met the 60-min target for patients admitted to a PCI center. Median patient, electrocardiogram (ECG) and logistic delays are 92.0±146.0 min, 19.0±146.0 min and 15.5±46.3 min, respectively., Conclusion: A significant difference between state-of-the-art targets and reality was found, depending on the place of FMC, with the worst delays in non-PCI centers. Patient delay, ECG delay, FMC to diagnosis and logistic delay are identified as key areas in which to intervene., (Copyright © 2024 Sociedade Portuguesa de Cardiologia. Publicado por Elsevier España, S.L.U. All rights reserved.)
Published: 2024
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6. Distribution of Chlamydia trachomatis ompA -genotypes over three decades in Portugal.

Author: Lodhia Z, Cordeiro D, Correia C, João I, Carreira T, Vieira L, Nunes A, Ferreira R, Schäfer S, Aliyeva E, Portugal C, Monge I, Pessanha MA, Toscano C, Côrte-Real R, Antunes M, Gomes JP, Borges V, and José Borrego M
Abstract: Objectives: Chlamydia trachomatis is classified into 15 major genotypes, A to L3, based on the diversity of ompA gene. Here, we evaluated and characterised the distribution and diversity of ompA -genotypes over 32 years (1990-2021) in Portugal., Methods: The collection of the Portuguese National Reference Laboratory for Sexually Transmitted Infections includes 5824 C . trachomatis -positive samples that were successfully ompA -genotyped between 1990 and 2021. An in-depth analysis of ompA -genotypes distribution across the years, as well as by biological sex, age and anatomical site of infection was performed., Results: ompA -genotype E was consistently the most frequently detected across the years, with a median frequency of 34.6%, followed by D/Da (17.6%), F (14.3%) and G (10.7%). The prevalence of lymphogranuloma venereum (LGV) genotypes (mostly L2, 62.0%, followed by L2b, 32.1%) increased since 2016, reaching the highest value in 2019 (20.9%). LGV, G and Da genotypes were associated with biological sex, specifically with being male, and were the most frequent among anorectal specimens (37.7%, 19.4% and 17.7%, respectively). Notably, LGV ompA -genotypes represented 38.9% of the male anorectal specimens since 2016, and were also detected among oropharynx and urogenital samples. ompA -genotype E was the most frequently detected at the oropharynx (28.6%) and urogenital (33.9%) sites during the study period, followed by D/Da (17.4%) and F (16.0%) in the urogenital specimens, and by G (26.1%) and D/Da (25.7%) in oropharynx specimens. Our data also highlight the emergence of the recombinant L2b/D-Da strain since 2017 (representing between 2.0% and 15.5% of LGV cases per year) and the non-negligible detection of ompA -genotype B in urogenital and anorectal specimens., Conclusions: This study provides a comprehensive landscape of C. trachomatis molecular surveillance in Portugal, highlighting the continued relevance of ompA -genotyping as a complement to rapid LGV-specific detection tests. It also contributes to a deeper understanding of C. trachomatis epidemiology, diversity and pathogenicity., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2024. No commercial re-use. See rights and permissions. Published by BMJ.)
Published: 2024
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7. The impact of cholesteryl ester transfer protein on the progression of cutaneous leishmaniasis.

Author: Batista-Dantas FE, Ozaki CY, Santana KG, Nunes VS, Uscata BA, Siess-Portugal C, Reis LC, Yamashiro-Kanashiro EH, Tafuri WL, Duarte-Neto AN, Sotto MN, Goto H, and Cazita PM
Subjects: Animals, Mice, Humans, Disease Progression, Disease Models, Animal, Cholesterol Ester Transfer Proteins genetics, Cholesterol Ester Transfer Proteins metabolism, Leishmaniasis, Cutaneous immunology, Leishmaniasis, Cutaneous parasitology, Leishmaniasis, Cutaneous metabolism, Mice, Transgenic, Macrophages immunology, Macrophages metabolism, Macrophages parasitology, Mice, Inbred C57BL
Abstract: Introduction: Pathogenesis of cutaneous leishmaniases involves parasite growth, persistent inflammation, and likely participation of lipoproteins (LP). The cholesteryl ester transfer protein (CETP), involved in LP remodeling, has been shown to participate in the inflammatory response and the evolution of infectious conditions., Methods: We evaluated the impact of the presence of CETP on infection by Leishmania (L.) amazonensis in an experimental model of cutaneous leishmaniasis using C57BL6/J mice transgenic for human CETP (CETP), having as control their littermates that do not express the protein, wild-type (WT) mice. The progression of the lesion after infection in the footpad was monitored for 12 weeks. Two groups of animals were formed to collect the plantar pad in the 4th and 12th week post-infection., Results: The lesion increased from the 3rd week onwards, in both groups, with a gradual decrease from the 10th week onwards in the CETP group compared to the WT group, showing a reduction in parasitism and an improvement in the healing process, a reduction in CD68+ cells, and an increase in CD163+ and CD206, characterizing a population of M2 macrophages. A reduction in ARG1+ cells and an increase in INOS+ cells were observed. During infection, the LP profile showed an increase in triglycerides in the VLDL fraction in the CETP group at 12 weeks. Gene expression revealed a decrease in the CD36 receptor in the CETP group at 12 weeks, correlating with healing and parasite reduction. In vitro , macrophages derived from bone marrow cells from CETP mice showed lower parasite load at 48 h and, a reduction in arginase activity at 4 h accompanied by increased NO production at 4 and 24 h compared to WT macrophages, corroborating the in vivo findings., Discussion: The data indicate that the presence of CETP plays an important role in resolving Leishmania (L.) amazonensis infection, reducing parasitism, and modulating the inflammatory response in controlling infection and tissue repair., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2024 Batista-Dantas, Ozaki, Santana, Nunes, Uscata, Siess-Portugal, Reis, Yamashiro-Kanashiro, Tafuri, Duarte-Neto, Sotto, Goto and Cazita.)
Published: 2024
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8. Bibliometric analysis of global research trends on biomimetics, biomimicry, bionics, and bio-inspired concepts in civil engineering using the Scopus database.

Author: Sedira N, Pinto J, Bentes I, and Pereira S
Subjects: Engineering, Databases, Factual, Research trends, Biomimetics, Bibliometrics, Bionics trends
Abstract: This paper presents a bibliometrics analysis aimed at discerning global trends in research on 'biomimetics', 'biomimicry', 'bionics', and 'bio-inspired' concepts within civil engineering, using the Scopus database. This database facilitates the assessment of interrelationships and impacts of these concepts within the civil engineering domain. The findings demonstrate a consistent growth in publications related to these areas, indicative of increasing interest and impact within the civil engineering community. Influential authors and institutions have emerged, making significant contributions to the field. The United States, Germany, and the United Kingdom are recognised as leaders in research on these concepts in civil engineering. Notably, emerging countries such as China and India have also made considerable contributions. The integration of design principles inspired by nature into civil engineering holds the potential to drive sustainable and innovative solutions for various engineering challenges. The conducted bibliometrics analysis grants perspective on the current state of scientific research on biomimetics, biomimicry, bionics, and bio-inspired concepts in the civil engineering domain, offering data to predict the evolution of each concept in the coming years. Based on the findings of this research, 'biomimetics' replicates biological substances, 'biomimicry' directly imitates designs, and 'bionics' mimics biological functions, while 'bio-inspired' concepts offer innovative ideas beyond direct imitation. Each term incorporates distinct strategies, applications, and historical contexts, shaping innovation across the field of civil engineering., (Creative Commons Attribution license.)
Published: 2024
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9. Brave new world: expanding home care in stem cell transplantation and advanced therapies with new technologies.

Author: Romon I, Gonzalez-Barrera S, Coello de Portugal C, Ocio E, and Sampedro I
Subjects: Humans, Immunotherapy, Adoptive methods, Artificial Intelligence, Home Care Services, Hematopoietic Stem Cell Transplantation methods
Abstract: Hematopoietic stem cell transplantation and cell therapies like CAR-T are costly, complex therapeutic procedures. Outpatient models, including at-home transplantation, have been developed, resulting in similar survival results, reduced costs, and increased patient satisfaction. The complexity and safety of the process can be addressed with various emerging technologies (artificial intelligence, wearable sensors, point-of-care analytical devices, drones, virtual assistants) that allow continuous patient monitoring and improved decision-making processes. Patients, caregivers, and staff can also benefit from improved training with simulation or virtual reality. However, many technical, operational, and above all, ethical concerns need to be addressed. Finally, outpatient or at-home hematopoietic transplantation or CAR-T therapy creates a different, integrated operative system that must be planned, designed, and carefully adapted to the patient's characteristics and distance from the hospital. Patients, clinicians, and their clinical environments can benefit from technically improved at-home transplantation., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2024 Romon, Gonzalez-Barrera, Coello de Portugal, Ocio and Sampedro.)
Published: 2024
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10. Age and race/ethnicity differences in decisional conflict in women diagnosed with ductal carcinoma in situ.

Author: Portugal C, Farias AJ, Estrada EL, and Kawatkar AA
Subjects: Humans, Female, Aged, Middle Aged, Ethnicity, Cross-Sectional Studies, Surveys and Questionnaires, Decision Making, Carcinoma, Intraductal, Noninfiltrating therapy
Abstract: Purpose: Women diagnosed with ductal carcinoma in situ (DCIS) face confusion and uncertainty about treatment options. The objective of this study was to determine whether there are differences in decisional conflict about treatment by age and race/ethnicity., Methods: A cross-sectional survey was conducted of women (age ≥ 18) diagnosed with DCIS enrolled at Kaiser Permanente of Southern California. The Decisional Conflict Scale (DCS) measured personal perceptions of decision uncertainty, values clarity, and effective decision-making. We used a multivariable regression to study whether age, race, and ethnicity were associated with patient-reported DCS., Results: 45% (N = 1395) of women who received the online survey, participated. The mean age was 56 (± 9.6) years, the majority were white. Compared to women younger than 50, women aged 60-69 reported lower overall DCS scores (-5.4; 95% CI -1.5 to -9.3). Women > 70 had lower values clarity scores (-9.0; 95% CI -2.8 to -15.2) about their treatment compared to women aged 50-59 and 60-69 (-7.1; 95% CI -2.9 to -11.3 and - 7.2; 95% CI -2.9 to -11.5) and likewise, lower effective decision-making scores (-5.4; 95% CI -1.7 to -9.2 and - 5.2; 95% CI -1.4 to -9.0) compared to women < 50. Compared to whites, blacks reported lower decision conflict (-4.4; 95% CI 0.04 to -8.8) and lower informed decision (-5.2; 95% CI -0.18 to -10.3) about DCIS treatment., Conclusion: Younger women reported higher decisional conflict about DCIS treatment, compared to older women (> 70). Age based tailored discussions about treatment options, health education, and supportive decision-making interventions/tools may reduce decision conflict in future DCIS patients., Trade Registration: The IRB number is 10678., (© 2024. This is a U.S. Government work and not under copyright protection in the US; foreign copyright protection may apply.)
Published: 2024
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11. SARS-CoV-2 Serology Did Not Predict Risk of Breakthrough Infection During the Omicron BA.1 and BA.2 Surge.

Author: Bruxvoort KJ, Shi J, Song H, Narwaney K, Glanz JM, Binswanger I, Lam JA, Chang JM, Portugal C, Watanabe C, Aragones M, and Palmer-Toy DE
Subjects: Humans, SARS-CoV-2, Breakthrough Infections, COVID-19
Published: 2024
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12. Adenomyosis in women undergoing hysterectomy for abnormal uterine bleeding associated with uterine leiomyomas.

Author: Lonky NM, Chiu V, Portugal C, Estrada EL, Chang J, Fischer H, Vora JB, Harrison LI, Peng L, and Munro MG
Subjects: Humans, Female, Retrospective Studies, Hysterectomy, Uterine Hemorrhage diagnostic imaging, Uterine Hemorrhage surgery, Adenomyosis complications, Adenomyosis diagnostic imaging, Adenomyosis surgery, Uterine Diseases pathology, Leiomyoma complications, Leiomyoma diagnostic imaging, Leiomyoma surgery, Uterine Neoplasms complications, Uterine Neoplasms diagnostic imaging, Uterine Neoplasms surgery, Menorrhagia complications, Menorrhagia surgery
Abstract: Background: Uterine leiomyomas and adenomyosis are both common and often associated with abnormal uterine bleeding (AUB), including the symptom of heavy menstrual bleeding (HMB). Understanding the prevalence of adenomyosis in women with uterine leiomyomas could inform clinicians and patients in a way that may improve therapeutic approaches., Objective: To explore the prevalence of adenomyosis in a group of women who underwent hysterectomy for AUB-L, to determine the prevalence of submucous leiomyomas, and to examine the utility of preoperative ultrasound to detect the presence of adenomyosis., Methods: The Kaiser Permanente Hysterectomy Database (KPHD) was searched for women aged 18-52 undergoing hysterectomy for leiomyoma-associated chronic AUB (AUB-L) in 2018 and 2019. A target sample of 400 comprised those with at least 3 years in the Health System. Radiologists evaluated preoperative pelvic ultrasound images to determine leiomyoma size and level 2 FIGO type (submucous or other), and the linked electronic medical record abstracted for clinical features, including histopathological evidence of adenomyosis., Results: Of the 370 subjects that met the study criteria, adenomyosis was identified via histopathology in 170 (45.9%). There was no difference in the adenomyosis prevalence with (47.1%) and without (43.0%) at least one submucous leiomyoma. Subgroup analysis of ultrasound images by an expert radiologist for the presence of adenomyosis demonstrated a positive predictive value of 54.0% and a negative predictive value of 43.4%., Conclusions: Adenomyosis was present in almost half of this AUB-L cohort undergoing hysterectomy and was equally prevalent in those with and without submucous leiomyomas as determined by sonographic evaluation. The imaging findings are in accord with prior investigators and demonstrate that 2-D ultrasound is insensitive to the presence of adenomyosis when the uterus is affected by leiomyomas. Further research is necessary to determine the impact of various adenomyosis phenotypes on the presence and severity of the symptom of HMB., Competing Interests: Dr. Lonky reports a consultancy agreement with AbbVie following conclusion of this research, research support from AbbVie and Merk & Co. is the founder/shareholder of Histologics LLC. Dr Munro reports consultancy agreements with AbbVie Inc, American Regent, Daiichi Sankyo, Hologic Inc, Myovant Inc, Pharmacosmos, and Vifor Pharmaceuticals. He has also received indirect grant support from AbbVie Inc and Pharmacosmos. This does not alter our adherence to PLOS ONE policies on sharing data and materials., (Copyright: © 2023 Lonky et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)
Published: 2023
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13. Water consumption assessment and classification in industrial buildings - The case study of Continental Advanced Antenna, Vila Real, Portugal.

Author: Matos C, Nogueira P, Magalhães P, Santos C, and Bentes I
Abstract: Water abstraction for the industrial, domestic, and agricultural sectors increased from 0.67 trillion m 3 /year in the 1900s to 3.79 trillion m 3 /year in 2000, and it is expected to increase by 55 % in 2050 when the majority of the world's population will live in urban areas. Concerning the industrial sector, despite the efforts to a more sustainable use, water is still an essential and irreplaceable resource, and this situation tends to increase due to modern industrial installations that require large-scale and complex water distribution systems. Usually, industries consume a large volume of water, however due to more and severer regulations, it is necessary to propose strategies for the aid of water conservation. This article presents a methodology to analyse, classify and optimize water consumption in industrial installations, using a real case study located in Vila Real, Portugal. The daily water consumption per worker, the daily record of use of each type of device and the hourly usage pattern were analysed and a classification was achieved according to the ANQIP (National Association for Quality in Building Installations) calculator. The case study revealed a great opportunity of improvement in what concerns to water efficient use. Some measures to improve the efficiency of water use in the building were pointed out, such as the use of rainwater harvesting systems, the use of aerators and replacements of taps and faucets when possible. The methodology is expeditious and user-friendly, and easy to replicate in similar cases, however it reveals some difficulties (especially in the data collection process that is made by inquiry, once it is always dependent on the respondent sensibility and willingness)., Competing Interests: Declaration of competing interest For all intents and purposes the authors state that there are no any actual or potential conflict of interest including any financial, personal or other relationships with other people or organizations within three years of beginning the submitted work that could inappropriately influence, or be perceived to influence, their work., (Copyright © 2023 The Authors. Published by Elsevier B.V. All rights reserved.)
Published: 2023
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14. Investigating the Architecture and Characteristics of Asian Hornet Nests: A Biomimetics Examination of Structure and Materials.

Author: Sedira N, Pinto J, Ginja M, Gomes AP, Nepomuceno MCS, and Pereira S
Abstract: This study investigates the internal architecture of Asian hornet nests (AHNs) using advanced imaging techniques, such as CT scanning and X-ray radiography, to understand their construction and function. The primary objective and significance of this study centre on drawing inspiration from the creative way Asian hornets construct their nests, with a particular focus on the architecture, design, functionality, and building materials of these nests. The architectural principles governing the construction of these nests, such as the arrangement of hexagonal cells, pedicels for load bearing, and adhesive materials, serve as a source of inspiration for innovative and sustainable design practices. The pedicels in Asian hornet nests play a crucial role in transferring load and ensuring stability. Additionally, AHNs' adhesion to tree branches is essential for preventing collapse, and the pedicels provide necessary structural support. The knowledge gained from studying AHNs' internal architecture could be applied directly to the architecture and civil engineering fields to improve structure stability and durability. The microstructure analysis of the paper-like material that hornets produce to build their nests indicates a complex and heterogeneous structure, composed of various plant fragments and fibres. This unique composition creates intricate grooves and pores, which are essential for regulating temperature and humidity levels within the outer envelope of the nest. The study of Asian hornet nests' internal structure demonstrated that nature's engineering principles inspire the design of durable and resilient structures in the construction industry. Civil engineers can incorporate similar principles into their designs to enhance the structural integrity and performance of buildings, bridges, and other infrastructure.
Published: 2023
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15. Clinical Outcomes of Direct Oral Anticoagulants vs Warfarin for Extended Treatment of Venous Thromboembolism.

Author: Fang MC, Reynolds K, Fan D, Prasad PA, Sung SH, Portugal C, Garcia E, and Go AS
Subjects: Adult, Humans, Female, Cohort Studies, Anticoagulants adverse effects, Hemorrhage chemically induced, Hemorrhage epidemiology, Warfarin adverse effects, Venous Thromboembolism drug therapy, Venous Thromboembolism epidemiology
Abstract: Importance: Extending the duration of oral anticoagulation for venous thromboembolism (VTE) beyond the initial 3 to 6 months of treatment is often recommended, but it is not clear whether clinical outcomes differ when using direct oral anticoagulants (DOACs) or warfarin., Objective: To compare rates of recurrent VTE, hospitalizations for hemorrhage, and all-cause death among adults prescribed DOACs or warfarin whose anticoagulant treatment was extended beyond 6 months after acute VTE., Design, Setting, and Participants: This cohort study was conducted in 2 integrated health care delivery systems in California with adults aged 18 years or older who received a diagnosis of incident VTE between 2010 and 2018 and completed at least 6 months of oral anticoagulant treatment with DOACs or warfarin. Patients were followed from the end of the initial 6-month treatment period until discontinuation of anticoagulation, occurrence of an outcome event, health plan disenrollment, or end of the study follow-up period (December 31, 2019). Data were obtained from the Kaiser Permanente Virtual Data Warehouse and electronic health records. Data analysis was conducted from March 2022 to January 2023., Exposure: Dispensed prescriptions of DOACs or warfarin after a 6-month initial treatment for VTE., Main Outcomes and Measures: The primary outcomes were rates per 100 person-years of recurrent VTE, hospitalizations for hemorrhage, and all-cause death. Comparison of DOAC and warfarin outcomes were performed using multivariable Cox proportional hazards regression., Results: A total of 18 495 patients (5477 [29.6%] aged ≥75 years; 8973 women [48.5%]) with VTE who were treated with at least 6 months of anticoagulation were identified, of whom 2134 (11.5%) were receiving DOAC therapy and 16 361 (88.5%) were receiving warfarin therapy. Unadjusted event rates were lower for patients receiving DOAC therapy than warfarin therapy for recurrent VTE (event rate per 100 person-years, 2.92 [95% CI, 2.29-3.54] vs 4.14 [95% CI, 3.90-4.38]), hospitalizations for hemorrhage (event rate per 100 person-years, 1.02 [95% CI, 0.66-1.39] vs 1.81 [95% CI, 1.66-1.97]), and all-cause death (event rate per 100 person-years, 3.79 [95% CI, 3.09-4.49] vs 5.40 [95% CI, 5.13-5.66]). After multivariable adjustment, DOAC treatment was associated with a lower risk of recurrent VTE (adjusted hazard ratio [aHR], 0.66; 95% CI, 0.52-0.82). For patients prescribed DOAC treatment, the risks of hospitalization for hemorrhage (aHR, 0.79; 95% CI, 0.54-1.17) and all-cause death (aHR, 0.96; 95% CI, 0.78-1.19) were not significantly different than those for patients prescribed warfarin treatment., Conclusions and Relevance: In this cohort study of patients with VTE who continued warfarin or DOAC anticoagulation beyond 6 months, DOAC treatment was associated with a lower risk of recurrent VTE, supporting the use of DOACs for the extended treatment of VTE in terms of clinical outcomes.
Published: 2023
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16. Understanding Barriers and Facilitators of Pre-exposure Prophylaxis (PrEP) Among Transgender and Gender Diverse Adults in an Integrated Health Care System.

Author: Bruxvoort K, Portugal C, Munis M, Pak K, and Hechter R
Subjects: Humans, Adult, Qualitative Research, Transgender Persons, Pre-Exposure Prophylaxis methods, Anti-HIV Agents therapeutic use, HIV Infections epidemiology, HIV Infections prevention & control, HIV Infections drug therapy, Delivery of Health Care, Integrated
Abstract: Transgender and gender diverse individuals face health disparities such as higher HIV prevalence, but limited studies have found low PrEP uptake among these populations. To understand both patient and provider perspectives regarding PrEP care for transgender and gender diverse individuals, we conducted a mixed-methods study at Kaiser Permanente Southern California from September 2020 to October 2021. Transgender and gender diverse adults (N = 396) participated in a web-based survey, and qualitative interviews were subsequently conducted with a subset of survey respondents (N = 32) and healthcare providers (N = 8). Among survey respondents, > 75% were familiar with PrEP, and > 40% reported at least one HIV risk factor, but < 5% had taken PrEP. Interview themes included increasing providers' inclusivity in primary care for transgender and gender diverse patients, and reducing logistical barriers and costs associated with PrEP-related visits. To improve PrEP uptake among transgender and gender diverse individuals, barriers across patient, provider, and health system levels must be addressed., (© 2023. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)
Published: 2023
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17. Optimized Placement of Frost-Measuring Sensors in Heat Exchangers via Image Processing of Frost Formation Pattern.

Author: Aguiar M, Gaspar PD, and Silva PD
Abstract: Heat exchangers (HXs) play a critical role in maintaining human thermal comfort and ensuring product safety and quality in various industries. However, the formation of frost on HX surfaces during cooling operations can significantly impact their performance and energy efficiency. Traditional defrosting methods primarily rely on time-based control of heaters or HX operation, overlooking the actual frost formation pattern across the surface. This pattern is influenced by ambient air conditions (humidity and temperature) and surface temperature variations. To address this issue, frost formation sensors can be strategically placed within the HX. However, the non-uniform frost pattern poses challenges in sensor placement. This study proposes an optimized sensor placement approach using computer vision and image processing techniques to analyze the frost formation pattern. Through creating a frost formation map and evaluating various sensor locations, frost detection can be optimized to control defrosting operations with higher accuracy, thereby enhancing the thermal performance and energy efficiency of HXs. The results demonstrate the effectiveness of the proposed method in accurately detecting and monitoring frost formation, providing valuable insights for sensor placement optimization. This approach presents significant potential in enhancing the overall performance and sustainability of the operation of HXs.
Published: 2023
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18. Health Literacy and Treatment Satisfaction Among Patients with Venous Thromboembolism.

Author: Mefford MT, Zhou H, Fan D, Fang MC, Prasad PA, Go AS, Portugal C, Chang JM, and Reynolds K
Subjects: Humans, Retrospective Studies, Patient Satisfaction, Anticoagulants, Venous Thromboembolism drug therapy, Venous Thromboembolism epidemiology, Health Literacy
Abstract: Background: Venous thromboembolism (VTE) treatment requires complex management, and patients with limited health literacy (HL) may perceive higher burden and lower benefits associated with their treatment., Objective: To examine the association of HL with treatment satisfaction among patients with VTE., Design: Retrospective cohort study PARTICIPANTS: Kaiser Permanente Southern and Northern California members who were taking oral anticoagulants (OAC) for incident VTE between 2015 and 2018 were surveyed. Main Measures HL was assessed using a 3-item HL assessment and dichotomized as having adequate or limited HL. High treatment burden and low treatment benefit were defined as Anti-Clot Treatment Scale (ACTS) scores below the 25th percentile of the distributions for ACTS Burdens and Benefits survey components, respectively. Using Poisson regression, multivariable adjusted risk ratios (RR) and 95% confidence intervals (CI) were calculated for the association of HL with high treatment burden and low treatment benefits., Results: Among 2154 respondents, 397 (18.4%) had limited HL. Patients with limited vs adequate HL were older (47.9% vs 27.5% aged ≥ 75 years, p<0.001), more likely to use a non-English language when discussing their health (10.8% vs 1.7%, p<0.001), to have less than high school education (10.1% vs 1.7%, p<0.001), and to self-rate their health as fair or poor (47.6% vs 25.5%, p<0.001). After multivariable adjustment, patients with limited HL were more likely to have higher perceived treatment burden (RR 1.24, 95% CI 1.07, 1.45) and lower perceived treatment benefits (RR 1.21, 95% CI 1.08, 1.37)., Conclusions: Limited HL was associated with lower OAC treatment satisfaction, though absolute differences in satisfaction scores were small. Further examination of the intersection of HL with VTE treatment satisfaction and compliance among older and non-English speaking patients is warranted., (© 2022. The Author(s), under exclusive licence to Society of General Internal Medicine.)
Published: 2023
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19. A Chromatic Enzymatic Time-Temperature Integrator Device Based on the Degradation of Phenolic Compounds for the Real-Time Prediction of the Quality and Shelf Life of Cherries.

Author: Gaspar PD, Alves J, Quelhas AS, Domingos C, and Caio S
Abstract: The particular characteristics of cherries, such as color, firmness, and palate increase their demand, as does, among other things, their antioxidant properties that benefit human health. However, their high perishability leads to a reduced shelf life and consequently generates undesirable changes in the cherry flow chain. To ensure food quality and safety and prevent food waste, a smart device prototype is proposed. The concepts related to the formulation and design of the enzymatic-type chromatic time-temperature integrator (TTI) device used to monitor the real-time quality of cherries are described. The kinetic parameters for thermal inactivation of cultivar Santina cherries were determined based on the degradation of phenolic compounds that are substrates of the polyphenol oxidase enzyme, whose hydroxylation reaction of a monophenol to o-diphenol leads to the oxidation in o-quinone. The proposed device concept aims to help retailers and consumers decide upon selling and buying according to the remaining shelf life, thus promoting sustainability related to food processes.
Published: 2023
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20. Assessment of the Risk of Venous Thromboembolism in Nonhospitalized Patients With COVID-19.

Author: Fang MC, Reynolds K, Tabada GH, Prasad PA, Sung SH, Parks AL, Garcia E, Portugal C, Fan D, Pai AP, and Go AS
Subjects: Adult, Humans, Male, Female, Cohort Studies, Retrospective Studies, COVID-19 Testing, Venous Thromboembolism epidemiology, Venous Thromboembolism etiology, Venous Thromboembolism prevention & control, COVID-19 complications, COVID-19 epidemiology
Abstract: Importance: Patients hospitalized with COVID-19 have higher rates of venous thromboembolism (VTE), but the risk and predictors of VTE among individuals with less severe COVID-19 managed in outpatient settings are less well understood., Objectives: To assess the risk of VTE among outpatients with COVID-19 and identify independent predictors of VTE., Design, Setting, and Participants: A retrospective cohort study was conducted at 2 integrated health care delivery systems in Northern and Southern California. Data for this study were obtained from the Kaiser Permanente Virtual Data Warehouse and electronic health records. Participants included nonhospitalized adults aged 18 years or older with COVID-19 diagnosed between January 1, 2020, and January 31, 2021, with follow-up through February 28, 2021., Exposures: Patient demographic and clinical characteristics identified from integrated electronic health records., Main Outcomes and Measures: The primary outcome was the rate per 100 person-years of diagnosed VTE, which was identified using an algorithm based on encounter diagnosis codes and natural language processing. Multivariable regression using a Fine-Gray subdistribution hazard model was used to identify variables independently associated with VTE risk. Multiple imputation was used to address missing data., Results: A total of 398 530 outpatients with COVID-19 were identified. The mean (SD) age was 43.8 (15.8) years, 53.7% were women, and 54.3% were of self-reported Hispanic ethnicity. There were 292 (0.1%) VTE events identified over the follow-up period, for an overall rate of 0.26 (95% CI, 0.24-0.30) per 100 person-years. The sharpest increase in VTE risk was observed during the first 30 days after COVID-19 diagnosis (unadjusted rate, 0.58; 95% CI, 0.51-0.67 per 100 person-years vs 0.09; 95% CI, 0.08-0.11 per 100 person-years after 30 days). In multivariable models, the following variables were associated with a higher risk for VTE in the setting of nonhospitalized COVID-19: age 55 to 64 years (HR 1.85 [95% CI, 1.26-2.72]), 65 to 74 years (3.43 [95% CI, 2.18-5.39]), 75 to 84 years (5.46 [95% CI, 3.20-9.34]), greater than or equal to 85 years (6.51 [95% CI, 3.05-13.86]), male gender (1.49 [95% CI, 1.15-1.96]), prior VTE (7.49 [95% CI, 4.29-13.07]), thrombophilia (2.52 [95% CI, 1.04-6.14]), inflammatory bowel disease (2.43 [95% CI, 1.02-5.80]), body mass index 30.0-39.9 (1.57 [95% CI, 1.06-2.34]), and body mass index greater than or equal to 40.0 (3.07 [1.95-4.83])., Conclusions and Relevance: In this cohort study of outpatients with COVID-19, the absolute risk of VTE was low. Several patient-level factors were associated with higher VTE risk; these findings may help identify subsets of patients with COVID-19 who may benefit from more intensive surveillance or VTE preventive strategies.
Published: 2023
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21. What is the role of active packaging in the future of food sustainability? A systematic review.

Author: Alves J, Gaspar PD, Lima TM, and Silva PD
Subjects: Food Preservation, Antioxidants, Food Packaging, Anti-Infective Agents
Abstract: Nowadays, the strong increase in products consumption, the purchase of products on online platforms as well as the requirements for greater safety and food protection are a concern for food and packaging industries. Active packaging brings huge advances in the extension of product shelf-life and food degradation and losses reduction. This systematic work aims to collect and evaluate all existing strategies and technologies of active packaging that can be applied in food products, with a global view of new possibilities for food preservation. Oxygen scavengers, carbon dioxide emitters/absorbers, ethylene scavengers, antimicrobial and antioxidant active packaging, and other active systems and technologies are summarized including the products commercially available and the respective mechanisms of action. © 2022 Society of Chemical Industry., (© 2022 Society of Chemical Industry.)
Published: 2023
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22. Innovative processes in smart packaging. A systematic review.

Author: Fernandez CM, Alves J, Gaspar PD, Lima TM, and Silva PD
Subjects: Food Supply, Environmental Pollution, Meat, Food Packaging, Food Preservation
Abstract: Smart packaging provides one possible solution that could reduce greenhouse gas emissions. In comparison with traditional packaging, which aims to extend the product's useful life and to facilitate transport and marketing, smart packaging allows increased efficiency, for example by ensuring authenticity and traceability from the product's origin, preventing fraud and theft, and improving security. Consequently, it may help to reduce pollution, food losses, and waste associated with the food supply chain. However, some questions must be answered to fully understand the advantages and limitations of its use. What are the most suitable smart packaging technologies for use in agro-industrial subsectors such as meat, dairy, fruits, and vegetables, bakery, and pastry? What are the opportunities from a perspective of life extension, process optimization, traceability, product quality, and safety? What are the future challenges? An up-to-date, systematic review was conducted of literature relevant to the application of indicator technologies, sensors, and data carriers in smart packaging, to answer these questions. © 2022 Society of Chemical Industry., (© 2022 Society of Chemical Industry.)
Published: 2023
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23. The anticoagulation length of therapy and risk of new adverse events in venous thromboembolism (ALTERNATIVE) study: Design and survey results.

Author: Portugal C, Fang MC, Go AS, Zhou H, Chang J, Prasad P, Fan D, Garcia EA, Sung SH, and Reynolds K
Subjects: Humans, Adolescent, Middle Aged, Quality of Life, Venous Thromboembolism drug therapy, Health Literacy
Abstract: The Anticoagulation Length of Therapy and Risk of New Adverse Events In Venous Thromboembolism (ALTERNATIVE) study was designed to compare the benefits and harms of different treatment options for extended treatment of venous thromboembolism (VTE). In this paper, we describe the study cohort, survey data collection, and preliminary results. We identified 39,605 adult patients (age ≥ 18 years) from two large integrated health care delivery systems who were diagnosed with incident VTE and received initial anticoagulation therapy of 3 months or longer. A subset of the cohort (12,737) was invited to participate in a survey. Surveys were completed in English, Spanish or Mandarin via a mailed questionnaire, an online secure web link, or telephone. The survey domains included demographics, personal medical history, anticoagulant treatment history, anticoagulant treatment satisfaction, health-related quality of life and health literacy. A total of 5,017 patients participated in the survey for an overall response rate of 39.4%. The mean (SD) age of the survey respondents was 63.0 (14.5) years and self-reported race was 76.0% White/European, 11.1% Black/African American, and 3.8% Asian/Pacific Islander and 14.0% reported Hispanic ethnicity. Sixty percent of respondents completed the web survey, while 29.0% completed the mail-in paper survey, and 11.0% completed the survey via telephone. The ALTERNATIVE Study will address knowledge gaps by comparing several treatment alternatives for the extended management of VTE so that this information could be used by patients and clinicians to make more informed, patient-centered treatment choices., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2022 Portugal et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)
Published: 2022
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24. Identifying hypertensive disorders of pregnancy, a comparison of two epidemiologic definitions.

Author: Cheetham TC, Shortreed SM, Avalos LA, Reynolds K, Holt VL, Easterling TR, Portugal C, Zhou H, Neugebauer RS, Bider Z, Idu A, and Dublin S
Abstract: Introduction: Studies of hypertension in pregnancy that use electronic health care data generally identify hypertension using hospital diagnosis codes alone. We sought to compare results from this approach to an approach that included diagnosis codes, antihypertensive medications and blood pressure (BP) values., Materials and Methods: We conducted a retrospective cohort study of 1,45,739 pregnancies from 2009 to 2014 within an integrated healthcare system. Hypertensive pregnancies were identified using the "BP-Inclusive Definition" if at least one of three criteria were met: (1) two elevated outpatient BPs, (2) antihypertensive medication fill plus an outpatient hypertension diagnosis, or (3) hospital discharge diagnosis for preeclampsia or eclampsia. The "Traditional Definition" considered only delivery hospitalization discharge diagnoses. Outcome event analyses compared rates of preterm delivery and small for gestational age (SGA) between the two definitions., Results: The BP-Inclusive Definition identified 14,225 (9.8%) hypertensive pregnancies while the Traditional Definition identified 13,637 (9.4%); 10,809 women met both definitions. Preterm delivery occurred in 20.9% of BP-Inclusive Definition pregnancies, 21.8% of Traditional Definition pregnancies and 6.6% of non-hypertensive pregnancies; for SGA the numbers were 15.6, 16.3, and 8.6%, respectively ( p < 0.001 for all events compared to non-hypertensive pregnancies). Analyses in women meeting only one hypertension definition (21-24% of positive cases) found much lower rates of both preterm delivery and SGA., Conclusion: Prevalence of hypertension in pregnancy was similar between the two study definitions. However, a substantial number of women met only one of the study definitions. Women who met only one of the hypertension definitions had much lower rates of adverse neonatal events than women meeting both definitions., Competing Interests: SS reports receiving research funding from Synoos Health that represents a consortium of pharmaceutical companies. TE has done consulting for DiabetOmics Inc., Alynylam Pharmaceuticals, and Ferring Pharmaceuticals. LA has received research funding from Bausch Health Companies. SD has received research funding from GSK pharmaceuticals. The remaining authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2022 Cheetham, Shortreed, Avalos, Reynolds, Holt, Easterling, Portugal, Zhou, Neugebauer, Bider, Idu and Dublin.)
Published: 2022
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25. Health-related quality of life associated with warfarin and direct oral anticoagulants in venous thromboembolism.

Author: Fang MC, Go AS, Prasad PA, Zhou HX, Parks AL, Fan D, Portugal C, Sung SH, and Reynolds K
Subjects: Administration, Oral, Adult, Anticoagulants therapeutic use, Female, Hemorrhage drug therapy, Humans, Male, Quality of Life, Retrospective Studies, Venous Thromboembolism drug therapy, Warfarin adverse effects
Abstract: Introduction: Venous thromboembolism (VTE) is commonly treated with oral anticoagulants, including warfarin or direct oral anticoagulants (DOACs). Although DOACs are associated with favorable treatment satisfaction, few studies have assessed whether quality of life differs between DOAC and warfarin users., Materials and Methods: We invited adults enrolled in two California-based integrated health care delivery systems and with a history of VTE between January 1, 2015 and June 30, 2018 to complete a survey on their experience with anticoagulants. Health-related quality of life (QOL) was assessed using the RAND 36-item Short Form Health Survey (SF-36), which measures QOL in 2 general component scores (physical and mental). We used multivariable linear regression to compare mean QOL component scores between DOAC-users and warfarin-users, adjusting for patient and clinical characteristics., Results: Overall, 2230 patients (43.1 % women and 31.8 % >75 years of age) taking anticoagulants answered at least 1 question on the SF-36, 975 taking DOACs and 1255 taking warfarin. After adjustment for patient-level factors, there were no significant differences in either physical component scores (39.2 v 38.3, p = 0.24) or mental component scores (48.5 v 49.0, p = 0.42) between DOAC and warfarin users., Conclusions: Health-related QOL did not significantly differ between DOAC and warfarin users with a history of VTE., (Copyright © 2022 The Authors. Published by Elsevier Ltd.. All rights reserved.)
Published: 2022
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26. On the global time evolution of the Covid-19 pandemic: Logistic modeling.

Author: Devezas T and Miranda LCM
Abstract: In this article it is presented a multi-logistic model to describe the time evolution of the Covid-19 pandemics. The model is not intended as paragon for the accurate prediction of the future number of people infected, but instead as a useful phenomenological approach for a comprehensive understanding of the pandemic development, able to uncover some hidden aspects of its unfolding. Our results, using OWID data of total cases and daily cases of Covid-19 from March 12, 2020, up to September 27, 2021, brought to light that the pandemic has unfolded globally as a multi-step logistic, namely six logistic phases, each with its own characteristic duration and intensity. Moreover, it is demonstrated how differently the pandemics spread among different countries and continents. The methodology is tested regarding its ability of forecasting, and is demonstrated that it works well in the range of circa 30 days within a margin of less than 3% error while a given phase is still in development. The case study of Portugal demonstrates the benefit of preventive sanitary measures, as well as shows how disastrous it may be the absence of such measures due to hesitations and/or political positions. Completing the article, a qualitative analysis is presented to scrutinize the possible causes of the asymmetry observed in the diffusion of Covid-19 among the different continents and countries., (© 2021 Elsevier Inc. All rights reserved.)
Published: 2022
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26 results on '"Portugal C"'

1. Global burden and strength of evidence for 88 risk factors in 204 countries and 811 subnational locations, 1990–2021: a systematic analysis for the Global Burden of Disease Study 2021

2. OP020 [Comfort Management » Sedation]: REDUCTION IN BENZODIAZEPINE, OPIOID AND ANTIPSYCHOTIC USE AFTER A PROTOCOL IMPLEMENTATION IN A BRAZILIAN PEDIATRIC INTENSIVE CARE UNIT

3. POS0966 DEVELOPMENT AND VALIDATION OF AN ANKYLOSING SPONDYLITIS RISK PREDICTION MODEL USING LONGITUDINAL REAL-WORLD DATA FROM A LARGE INTEGRATED HEALTHCARE DELIVERY SYSTEM

4. REDUCTION IN BENZODIAZEPINE, OPIOID AND ANTIPSYCHOTIC USE AFTER A PROTOCOL IMPLEMENTATION IN A BRAZILIAN PEDIATRIC INTENSIVE CARE UNIT.

5. Experience from a regional percutaneous coronary intervention center: Aiming to assess and improve quality of care.

6. Distribution of Chlamydia trachomatis ompA -genotypes over three decades in Portugal.

7. The impact of cholesteryl ester transfer protein on the progression of cutaneous leishmaniasis.

8. Bibliometric analysis of global research trends on biomimetics, biomimicry, bionics, and bio-inspired concepts in civil engineering using the Scopus database.

9. Brave new world: expanding home care in stem cell transplantation and advanced therapies with new technologies.

10. Age and race/ethnicity differences in decisional conflict in women diagnosed with ductal carcinoma in situ.

11. SARS-CoV-2 Serology Did Not Predict Risk of Breakthrough Infection During the Omicron BA.1 and BA.2 Surge.

12. Adenomyosis in women undergoing hysterectomy for abnormal uterine bleeding associated with uterine leiomyomas.

13. Water consumption assessment and classification in industrial buildings - The case study of Continental Advanced Antenna, Vila Real, Portugal.

14. Investigating the Architecture and Characteristics of Asian Hornet Nests: A Biomimetics Examination of Structure and Materials.

15. Clinical Outcomes of Direct Oral Anticoagulants vs Warfarin for Extended Treatment of Venous Thromboembolism.

16. Understanding Barriers and Facilitators of Pre-exposure Prophylaxis (PrEP) Among Transgender and Gender Diverse Adults in an Integrated Health Care System.

17. Optimized Placement of Frost-Measuring Sensors in Heat Exchangers via Image Processing of Frost Formation Pattern.

18. Health Literacy and Treatment Satisfaction Among Patients with Venous Thromboembolism.

19. A Chromatic Enzymatic Time-Temperature Integrator Device Based on the Degradation of Phenolic Compounds for the Real-Time Prediction of the Quality and Shelf Life of Cherries.

20. Assessment of the Risk of Venous Thromboembolism in Nonhospitalized Patients With COVID-19.

21. What is the role of active packaging in the future of food sustainability? A systematic review.

22. Innovative processes in smart packaging. A systematic review.

23. The anticoagulation length of therapy and risk of new adverse events in venous thromboembolism (ALTERNATIVE) study: Design and survey results.

24. Identifying hypertensive disorders of pregnancy, a comparison of two epidemiologic definitions.

25. Health-related quality of life associated with warfarin and direct oral anticoagulants in venous thromboembolism.

26. On the global time evolution of the Covid-19 pandemic: Logistic modeling.

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26 results on '"Portugal C"'

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