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Os níveis de produção no estado do Tocantins vêm tendo aumento significativo, o clima e o solo favorecem na qualidade dos frutos produzidos. Visando a economia na produção de melão o produtor busca novos compostos para a adubação, buscando por novas alternativas que atendam a essa procura, e que atendam às exigências nutricionais, testou-se a utilização da compostagem de cama de frango, buscando por resultados que promovam o desempenho produtivo da cultivar no estado. O experimento foi instalado e conduzido no período de março a junho de 2019 em casa de vegetação, no IFTO campus Dianópolis. O presente projeto teve por objetivo avaliar a produtividade de duas cultivares do meloeiro submetidas a três tipos de adubação, utilizando a compostagem feita com a cama de frango, submetendo as cultivares a três tratamentos (químico, orgânico e organomineral), comparando o melhor parâmetro de desenvolvimento, adubação e genótipo. A compostagem de cama de frango demonstrou ser um método eficiente de adubação. A variedade que apresentou melhor desenvolvimento agronômico foi o Melão Gaúcho. Os frutos de melão cultivados nos tratamentos orgânicos apresentaram menos incidência da doença por podridão por Fusarium.

A alface é uma hortaliça que pode ser produzida em diferentes sistemas de cultivo, como é caso da aquaponia. Dessa forma o objetivo deste trabalho foi testar diferentes doses de solução nutritiva no sistema de aquaponia no cultivo da alface. A pesquisa foi desenvolvida no município de Dianópolis, no Instituto Federal do Tocantins, localizado na região sudeste do Estado do Tocantins, as margens da TO 040, Km 349. O projeto foi realizado em casa de vegetação, utilizando 10 tanques de 500 litros, em cada tanque utilizado quatro barras de cano de PVC de 100 mm com três metros de comprimento, com altura de um metro e declividade de 5% para permitir a recirculação da água dos peixes por gravidade. O delineamento experimental utilizado, foi em blocos casualizado com 4 tratamentos e 4 repetições. As doses usadas foram: 0g, 125g, 250g, 375g e 500g. Deste modo, os parâmetros avaliados nesse trabalho refletiram no desenvolvimento da planta, que pode ser demostrado na aplicação da dose máxima de solução nutritiva.

In Brazil, 60% to 80% of cultivated pastures show some degradation level. Thus, the objective was to evaluate the variability of the horizontal structure and biomass of Massai grass in an agropastoral system as a diagnosis of degraded pasture. We performed the georeferencing in a 12m × 13m mesh, totaling 48 sampling stations, and evaluated grass's biomass and structural characteristics at each station. We submitted the data to descriptive statistics and geostatistical analysis. We observed a process of degradation of pasture in the experimental area.Under these conditions, most of the characteristics of the pasture's horizontal structure and the production of biomass showed spatial dependence with high variability. Geostatistics efficiently represented and understood the variability of the studied attributes, enabling developing a specific pasture recovery management plan. En Brasil, se estima que de 60% a 80% de las pastagens cultivadas apresentam algun nivel de degradacion. Desta forma, el objetivo es evaluar la variabilidade de la estrutura horizontal y biomasa de la hierba massai en un sistema agropastoril, como diagnóstico de pastos degradados. La georreferenciación se realizó en una malla de 12 m × 13 m, totalizando 48 puntos. En casa uno destes puntos, la biomasa y las características estruturais de lá hierba massai fueran evaluadas. Los datos fueron sometidos a estadística descriptiva y análisis geoestadístico. En el area experimental, se notó un proceso de degradacion del pasto, siendo que en estas condiciones la majoria de las características de la estrutura horizontal del pasto y de la producion de la biomasa apresentaran una dependencia espacial, con alta variabilidad. A geoestadística se mostró una herramienta eficiente en la representacion y comprensión de la variabilidad de los atributos estudiados, permitindo el desarrollo de un plan específico de manejo y recuperacion de pastos. No Brasil, estima-se que 60% a 80% das pastagens cultivadas apresentam algum grau de degradação. Assim, objetivou-se avaliar a variabilidade da estrutura horizontal e da biomassa do capim massai em um sistema agropastoril, como diagnóstico de pastagem degradada. O georreferenciamento foi realizado em malha de 12 m × 13 m, totalizando 48 pontos. Em cada ponto, a biomassa e as características estruturais do capim massai foram avaliadas. Os dados foram submetidos à estatística descritiva e análise geoestatística. Na área experimental, observou-se um processo de degradação da pastagem e, nessas condições, a maioria das características da estrutura horizontal do pasto e da produção de biomassa apresentaram dependência espacial com alta variabilidade. A geoestatística mostrou-se eficiente na representação e compreensão da variabilidade dos atributos estudados, possibilitando o desenvolvimento de um plano específico de manejo de recuperação de pastagens.

RESUMO Este trabalho aborda a variação denominativa e conceitual na terminologia de produtos para saúde. A análise concentra-se em três produtos que estão diretamente envolvidos na prevenção e na terapêutica da COVID-19: máscara, respirador e ventilador pulmonar. O objetivo é investigar os usos dos termos selecionados em publicações técnicas da área, tais como normas da ABNT e manuais de fabricantes desses produtos (discurso especializado), e em publicações destinadas ao público geral. A fundamentação teórica é baseada em trabalhos que versam sobre a variação terminológica denominativa e conceitual (como os de CABRÉ, 1999; KOSTINA, 2000; FAULSTICH, 2001; FREIXA, 2002, 2006 e 2013) e sobre acessibilidade textual e linguagem simples (FINATTO, 2020; FISCHER, 2020). Para a realização da pesquisa, constituíram-se dois corpora: o primeiro, formado por manuais de uso e normas da ABNT dos respectivos produtos para saúde; o segundo, formado por textos veiculados em formato digital por empresas da mídia jornalística brasileira, no período de março de 2020 até outubro de 2021. Na análise das ocorrências de variação denominativa e conceitual nos diferentes corpora, verificou-se que há uma falta de homogeneidade na denominação desses produtos. Mesmo em uma área restrita e sujeita a processos de normatização, é comum a presença de variação, tanto denominativa quanto conceitual, e ela se intensifica no processo de divulgação da ciência.

The intense rainfall is characterized by its peculiarly irregular temporal and spatial distribution. A maximum recorded during a 24-hour interval starting at any time will be set to a 24-hour maximum. It should not be confused with the 1-day classification which refers to the maximum classification observed in 1 day, always collected at the same time, considered here from 9:00 am to 9:00 am the following day. The objective of this work is to determine intense rainfall disaggregation constants for the state of Bahia from 19 historical rainfall series, comparing them with the coefficients obtained for other regions of Brazil. For modeling the frequency of heavy rains of different durations, the probability distribution was used. To determine the disaggregation constants, the duration relations method is used. This method consists of two aspects: a) the tendency of the probability curves of different durations to remain parallel to each other; and b) for different locations, there is a great similarity in the relationships between maximum mean precipitations of relationships. The following mean disaggregation constants for the state of Bahia were selected: h10min/h30min = 0.48; h20min/h30min = 0.79; h30min/h1h = 0.74; h40min/h1h = 0.87; h50min/h1h = 0.94; h1h/h24h = 0.59; h2h/h24h = 0.69; h3h/h24h = 0.76; h4h/h24h = 0.80; h6h/h24h = 0.85 e h12h/h24h = 0.92. Such constants are an important tool for applications that demand the estimation of intense rains of duration in the state of Bahia. Las lluvias intensas se caracterizan por su distribución temporal y espacial peculiarmente irregular. Un máximo registrado durante un intervalo de 24 horas que comienza en cualquier momento se establecerá en un máximo de 24 horas. No debe confundirse con la clasificación de 1 día que se refiere a la clasificación máxima observada en 1 día, recolectada siempre a la misma hora, considerada aquí de 9:00 am a 9:00 am del día siguiente. El objetivo de este trabajo es determinar las constantes de desagregación de lluvias intensas para el estado de Bahía a partir de 19 series históricas de lluvias, comparándolas con los coeficientes obtenidos para otras regiones de Brasil. Para modelar la frecuencia de lluvias intensas de diferentes duraciones, se utilizó la distribución de probabilidad. Para determinar las constantes de desagregación se utiliza el método de relaciones de duración. Este método consta de dos aspectos: a) la tendencia de las curvas de probabilidad de diferentes duraciones a permanecer paralelas entre sí; y b) para diferentes ubicaciones, existe una gran similitud en las relaciones entre las precipitaciones medias máximas de relaciones. Se seleccionaron las siguientes constantes medias de desagregación para el estado de Bahía: h10min / h30min = 0,48; h20 min / h30 min = 0,79; h30 min / h1 h = 0,74; h40 min / h1 h = 0,87; h50 min / h1 h = 0,94; h1 h / h24 h = 0,59; h2 h / h24 h = 0,69; h3 h / h24 h = 0,76; h4h / h24h = 0,80; h6h / h24h = 0,85 y h12h / h24h = 0,92. Tales constantes son una herramienta importante para aplicaciones que demandan la estimación de lluvias intensas de duración en el estado de Bahía. As chuvas intensas são caracterizadas por sua distribuição temporal e espacial peculiarmente irregular. A precipitação máxima registrada durante um intervalo de 24 horas, iniciando a qualquer momento, será definida como precipitação máxima de 24 horas. Não deve ser confundida com a precipitação de 1 dia que se refere à precipitação máxima observada em 1 dia, sempre coletada no mesmo horário, considerada aqui das 9h às 9h do dia seguinte. O objetivo deste trabalho é determinar constantes de desagregação de chuvas intensas para o estado da Bahia a partir de 19 séries históricas pluviográficas comparando-as com os coeficientes obtidos para outras regiões do Brasil. Para a modelagem da frequência das chuvas intensas de diferentes durações foi empregada a distribuição de probabilidades. Para a determinação das constantes de desagregação, utiliza-se o método das relações de durações. Este método consiste em dois aspectos: a) a tendência das curvas de probabilidade de diferentes durações manterem-se paralelas entre si; e b) para diferentes locais, existe uma grande similaridade nas relações entre precipitações médias máximas de diferentes relações. Foram obtidas as seguintes constantes de desagregação médias para o estado da Bahia: h10min/h30min = 0,48; h20min/h30min = 0,79; h30min/h1h = 0,74; h40min/h1h = 0,87; h50min/h1h = 0,94; h1h/h24h = 0,59; h2h/h24h = 0,69; h3h/h24h = 0,76; h4h/h24h = 0,80; h6h/h24h = 0,85 e h12h/h24h = 0,92. Tais constantes constituem-se em importante ferramenta para aplicações que demandem a estimativa de chuvas intensas de curta duração no estado da Bahia.

Background Poor medication adherence is a major challenge in asthma, and objective assessment of inhaler adherence is needed. The InspirerMundi app aims to monitor adherence while providing a positive experience through gamification and social support. Objective This study aimed to evaluate the feasibility and acceptability of the InspirerMundi app to monitor medication adherence in adolescents and adults with persistent asthma (treated with daily inhaled medication). Methods A 1-month mixed method multicenter observational study was conducted in 26 secondary care centers from Portugal and Spain. During an initial face-to-face visit, physicians reported patients’ asthma therapeutic plan in a structured questionnaire. During the visits, patients were invited to use the app daily to register their asthma medication intakes. A scheduled intake was considered taken when patients registered the intake (inhaler, blister, or other drug formulation) by using the image-based medication detection tool. At 1 month, patients were interviewed by phone, and app satisfaction was assessed on a 1 (low) to 5 (high) scale. Patients were also asked to point out the most and least preferred app features and make suggestions for future app improvements. Results A total of 107 patients (median 27 [P25-P75 14-40] years) were invited, 92.5% (99/107) installed the app, and 73.8% (79/107) completed the 1-month interview. Patients interacted with the app a median of 9 (P25-P75 1-24) days. At least one medication was registered in the app by 78% (77/99) of patients. A total of 53% (52/99) of participants registered all prescribed inhalers, and 34% (34/99) registered the complete asthma therapeutic plan. Median medication adherence was 75% (P25-P75 25%-90%) for inhalers and 82% (P25-P75 50%-94%) for other drug formulations. Patients were globally satisfied with the app, with 75% (59/79) scoring ≥4,; adherence monitoring, symptom monitoring, and gamification features being the most highly scored components; and the medication detection tool among the lowest scored. A total of 53% (42/79) of the patients stated that the app had motivated them to improve adherence to inhaled medication and 77% (61/79) would recommend the app to other patients. Patient feedback was reflected in 4 major themes: medication-related features (67/79, 85%), gamification and social network (33/79, 42%), symptom monitoring and physician communication (21/79, 27%), and other aspects (16/79, 20%). Conclusions The InspirerMundi app was feasible and acceptable to monitor medication adherence in patients with asthma. Based on patient feedback and to increase the registering of medications, the therapeutic plan registration and medication detection tool were redesigned. Our results highlight the importance of patient participation to produce a patient-centered and engaging mHealth asthma app.

The aim of this study is to evaluate the quality of different interpolators for the spatial distribution of soil chemical attributes in banana cultivation. Soil samples were collected at 10 different points, at depths of 0.0-0.20 m and 0.20-0.40 m. For spatialization of the chemical attributes of the soil, the performance of the Ordinary Kriging (KO) and Inverse Distance Power (IPD) interpolators were evaluated through cross validation, and the KO had the spherical, exponential and Gaussian models evaluated, as well as the IPD had its performance evaluated in exponents 2, 3 and 5. It was found, through asymmetry and kurtosis, values between 0 and 3, thus indicating the normality of the data. The lowest coefficients of variation were found for the attributes pH and V% (depth of 0.00-0.20 m) and Ca2+ (depth of 0.20-0.40 m). For all other attributes, the variation coefficients found were above 20%. Higher values were presented for the attributes Mg2+, K, H + Al3+. Among the interpolators chosen with the best performance, it can be said that 20% of the results demonstrate that the IPD-2 interpolator stood out, as well as the IPD-3. The IPD-5 showed the best performance in 40% of the results. The geostatistical interpolators did not perform satisfactorily, and the interpolator KO Spherical model, at no time behaved with the best performance among all the interpolators tested. The KO model Exponential interpolator had the best performance in 15% of the results, and the KO Gaussian model excelled in only 5% of the results. El objetivo de este estudio fue evaluar la calidad de diferentes interpoladores para la distribución espacial de los atributos químicos del suelo en cultivos de banano. Fueran recolectadas muestras de suelo en 10 puntos diferentes, a una profundidad de 0.0-0.20 m y 0.20-0.40 m. Para la espacialización de atributos químicos se evaluó el desempeño de los interpoladores Ordinary Kriging (KO) y Distance Power Inverse (IPD) usando validación cruzada, teniendo el KO evaluado los modelos esférico, exponencial y gaussiano, así como el IPD el desempeño se evaluó en los exponentes 2, 3 y 5. Los valores entre 0 y 3 se verificaron mediante asimetría y curtosis, indicando así la normalidad de los datos. Los coeficientes de variación más bajos se encontraron para los atributos pH y V% (profundidad de 0.00-0.20 m) y Ca2+ (profundidad de 0.20-0.40 m). Para el resto de los atributos, los coeficientes de variación encontrados fueron superiores al 20%. Las mayores variaciones fueron encontradas en los atributos K, H + Al3+. Entre los interpoladores elegidos con mejor desempeño, se puede decir que el 20% de los resultados demuestran que se destacó el interpolador IPD-2, así como el IPD-3. El IPD-5 mostró el mejor desempeño en el 40% de los resultados. Los interpoladores geoestadísticos no tuvieron desempeño satisfactorio, y el interpolador KO modelo esférico, en ningún momento se comportó con el mejor desempeño entre todos los interpoladores probados. El interpolador exponencial del modelo KO tuvo el mejor desempeño en el 15% de los resultados, y el modelo Gaussiano KO sobresalió en solo el 5% de los resultados. O objetivo deste estudo foi avaliar a qualidade de diferentes interpoladores para a distribuição espacial dos atributos químicos do solo na cultura de banana. Foram coletadas amostras de solo em 10 pontos diferentes, nas profundidades de 0,0-0,20 m e 0,20-0,40 m. Para espacialização dos atributos químicos, foram avaliados por meio da validação cruzada o desempenho dos interpoladores Krigagem Ordinária (KO) e Inverso da Potência da Distância (IPD), sendo que a KO teve os modelos esférico, exponencial e gaussiano avaliados, assim como o IPD teve o desempenho avaliado nos expoentes 2, 3 e 5. Verificou-se por meio da assimetria e curtose, valores entre 0 e 3, indicando assim, a normalidade dos dados. Os menores coeficientes de variação foram encontrados para os atributos pH e V% (profundidade de 0,00-0,20 m) e Ca2+ (profundidade de 0,20-0,40 m). Para todos os outros atributos, os coeficientes de variação encontrados foram acima de 20%. Maiores valores apresentados foram para os atributos Mg2+, K, H + Al3+. Dentre os interpoladores escolhidos com melhor desempenho, pode-se afirmar que 20% dos resultados demonstram que o interpolador IPD-2 se sobressaiu, assim como o IPD-3. O IPD-5 foi o que apresentou melhor desempenho em 40% dos resultados. Os interpoladores geoestatísticos não tiveram um desempenho satisfatório, sendo que o interpolador KO modelo Esférico, em nenhum momento comportou-se com o melhor desempenho dentre todos os interpoladores testados. O interpolador KO modelo Exponencial teve o melhor desempenho em 15% dos resultados, e o KO modelo Gaussiano se sobressaiu em apenas 5% dos resultados.

Background Health and fitness apps have potential benefits to improve self-management and disease control among patients with asthma. However, inconsistent use rates have been reported across studies, regions, and health systems. A better understanding of the characteristics of users and nonusers is critical to design solutions that are effectively integrated in patients’ daily lives, and to ensure that these equitably reach out to different groups of patients, thus improving rather than entrenching health inequities. Objective This study aimed to evaluate the use of general health and fitness apps by patients with asthma and to identify determinants of usage. Methods A secondary analysis of the INSPIRERS observational studies was conducted using data from face-to-face visits. Patients with a diagnosis of asthma were included between November 2017 and August 2020. Individual-level data were collected, including age, gender, marital status, educational level, health status, presence of anxiety and depression, postcode, socioeconomic level, digital literacy, use of health services, and use of health and fitness apps. Multivariate logistic regression was used to model the probability of being a health and fitness app user. Statistical analysis was performed in R. Results A total of 526 patients attended a face-to-face visit in the 49 recruiting centers and 514 had complete data. Most participants were ≤40 years old (66.4%), had at least 10 years of education (57.4%), and were in the 3 higher quintiles of the socioeconomic deprivation index (70.1%). The majority reported an overall good health status (visual analogue scale [VAS] score>70 in 93.1%) and the prevalence of anxiety and depression was 34.3% and 11.9%, respectively. The proportion of participants who reported using health and fitness mobile apps was 41.1% (n=211). Multivariate models revealed that single individuals and those with more than 10 years of education are more likely to use health and fitness mobile apps (adjusted odds ratio [aOR] 2.22, 95%CI 1.05-4.75 and aOR 1.95, 95%CI 1.12-3.45, respectively). Higher digital literacy scores were also associated with higher odds of being a user of health and fitness apps, with participants in the second, third, and fourth quartiles reporting aORs of 6.74 (95%CI 2.90-17.40), 10.30 (95%CI 4.28-27.56), and 11.52 (95%CI 4.78-30.87), respectively. Participants with depression symptoms had lower odds of using health and fitness apps (aOR 0.32, 95%CI 0.12-0.83). Conclusions A better understanding of the barriers and enhancers of app use among patients with lower education, lower digital literacy, or depressive symptoms is key to design tailored interventions to ensure a sustained and equitable use of these technologies. Future studies should also assess users’ general health-seeking behavior and their interest and concerns specifically about digital tools. These factors may impact both initial engagement and sustained use.

BACKGROUND Poor medication adherence is a major challenge in asthma, and objective assessment of inhaler adherence is needed. The InspirerMundi app aims to monitor adherence while providing a positive experience through gamification and social support. OBJECTIVE This study aimed to evaluate the feasibility and acceptability of the InspirerMundi app to monitor medication adherence in adolescents and adults with persistent asthma (treated with daily inhaled medication). METHODS A 1-month mixed method multicenter observational study was conducted in 26 secondary care centers from Portugal and Spain. During an initial face-to-face visit, physicians reported patients’ asthma therapeutic plan in a structured questionnaire. During the visits, patients were invited to use the app daily to register their asthma medication intakes. A scheduled intake was considered taken when patients registered the intake (inhaler, blister, or other drug formulation) by using the image-based medication detection tool. At 1 month, patients were interviewed by phone, and app satisfaction was assessed on a 1 (low) to 5 (high) scale. Patients were also asked to point out the most and least preferred app features and make suggestions for future app improvements. RESULTS A total of 107 patients (median 27 [P25-P75 14-40] years) were invited, 92.5% (99/107) installed the app, and 73.8% (79/107) completed the 1-month interview. Patients interacted with the app a median of 9 (P25-P75 1-24) days. At least one medication was registered in the app by 78% (77/99) of patients. A total of 53% (52/99) of participants registered all prescribed inhalers, and 34% (34/99) registered the complete asthma therapeutic plan. Median medication adherence was 75% (P25-P75 25%-90%) for inhalers and 82% (P25-P75 50%-94%) for other drug formulations. Patients were globally satisfied with the app, with 75% (59/79) scoring ≥4,; adherence monitoring, symptom monitoring, and gamification features being the most highly scored components; and the medication detection tool among the lowest scored. A total of 53% (42/79) of the patients stated that the app had motivated them to improve adherence to inhaled medication and 77% (61/79) would recommend the app to other patients. Patient feedback was reflected in 4 major themes: medication-related features (67/79, 85%), gamification and social network (33/79, 42%), symptom monitoring and physician communication (21/79, 27%), and other aspects (16/79, 20%). CONCLUSIONS The InspirerMundi app was feasible and acceptable to monitor medication adherence in patients with asthma. Based on patient feedback and to increase the registering of medications, the therapeutic plan registration and medication detection tool were redesigned. Our results highlight the importance of patient participation to produce a patient-centered and engaging mHealth asthma app.

BACKGROUND Health and fitness apps have potential benefits to improve self-management and disease control in patients with asthma. However, inconsistent use rates have been reported across studies, regions and health systems. A better understanding of the characteristics of users and non-users is critical to design solutions that are effectively integrated in patients daily life, and to ensure that these equitably reach out to different groups of patients, improving rather than entrenching health inequities. OBJECTIVE To evaluate the use of general health and fitness apps by patients with asthma and to identify determinants of usage. METHODS A secondary analysis of Inspirers observational studies was conducted using face-to-face visits. Patients with a diagnosis of asthma were included between November 2017 and August 2020. Individual-level data were collected, including age, gender, marital status, educational level, health status, presence of anxiety and/or depression, postcode, socio-economic index, digital literacy, health services use, and use of health and fitness apps. Multivariate logistic regression was used to model the probability of being a health and fitness app user. Statistical analysis was performed in R. RESULTS A total of 526 patients attended a face-to-face visit in the 49 recruiting centers and 514 had complete data. Most participants were 40 years or less (66.4%), had at least 10 years of education (57.4%) and were in the three higher quintiles of the socio-economic deprivation index (70.1%). The majority reported an overall good health status (visual analogue scale-VAS > 70 in 93.1%) and the prevalence of anxiety and depression was, respectively, 34.3% and 11.9%. The proportion of participants that reported using health and fitness mobile apps was 41.1% (n=211). The multivariate models revealed that single individuals and those with more than 10 years of education are more likely to use health and fitness mobile apps (adjusted OR 2.22 (95%CI [1.05-4.75]) and 1.95 (95%CI [1.12-3.45]), respectively). Higher digital literacy scores were also associated with higher odds of being a user of health and fitness apps, with participants in the second, third and fourth quartiles showing, respectively, adjusted ORs of 6.74 (95%CI [2.90-17.40]), 10.30 (95%CI [4.28-27.56]), and 11.52 (95%CI [4.78-30.87]). Participants with depression symptoms had lower odds of using mobile health and fitness apps (adjusted OR 0.32, 95%CI [0.12-0.83]). CONCLUSIONS A better understanding of the barriers and enhancers of app use by patients with lower education, lower digital literacy, or with depressive symptoms, is key to design tailored interventions to improve a sustained and equitable use of these technologies. Future studies should also assess users’ general health-seeking behavior, as well as their interest and concerns about digital tools specifically. These factors may impact both initial engagement and sustained use. CLINICALTRIAL

InspirerMundi app aims to transform adherence into a positive experience through gamification and social support, while allowing objective monitoring of inhaler adherence. We explored patients’ engagement with this app. Adolescents and adults with persistent asthma, followed in 24 Portuguese hospital outpatient clinics, were invited by their physicians to use the InspirerMundi app daily for 4 months and register medication and symptoms. To stimulate engagement, the app includes a gamification component (point and badge system with a storyline of a warrior evolving to an Inspirer-advanced player that can motivate warriors to improve adherence). During the study period, patients received 3 phone interviews for additional data collection and 6 text messages to promote app engagement. Usage rate (days with app uses/total days) during weeks that followed a contact (phone/message) were compared to weeks with no contacts. A total of 77 patients (27±13y) were recruited and 72 used the app a median[P25-P75] of 48[24-114] days (usage rate 60[32-83]%).Total use period was >30 days for 2/3 of patients and >90 days for 1/3. Sixty-four patients registered ≥1 medication; 66 patients answered a median of 14[4-35] symptom questionnaires; 63 received ≥1 badge; and 9 achieved Inspirers level. Text messages did not seem to influence usage rate (p=.386), while phone calls seemed to have a negative effect (p=.003). 16 (22%) users continued to use the app after the end of the study. The usage rate of InspirerMundi app was higher than usage reported for other health apps. These results might be related to the app engagement features and to the recommendation of use by a physician. Additional contacts do not seem to improve app usage rate.

The Portuguese Severe Asthma Registry (RAG) is a national web-based disease registry of adult and pediatric patients with severe asthma. Since its launch, plans for collaborative research were established. This study aims to describe the baseline characteristics of the patients included in RAG and the planned research activities. RAG collects real-life data patients with severe asthma followed at specialized care centres (Global Initiative for Asthma step 4/5). RAG’s data are collected at the time of routine medical appointments. A total of 68 patients were included by 22 physicians. The median age was 55 yrs (P25-P75, 48-63), two patients were The management of severe asthma is still an unmet need. Further characterization of patients, treatments and asthma phenotypes may improve disease-related knowledge and ultimately optimize care pathways.

Unsupervised methods may unveil the potential of the INSPIRERS studies to comprehend the heterogeneous characteristics of asthma. Therefore, we aimed to identify distinct classes of asthma among the participants, using latent class analysis (LCA), and to compare their characteristics across classes. We applied LCA to 308 adults (≥18 years) with persistent asthma (treated with daily inhaled medication) participants in the observational and prospective INSPIRERS studies, conducted in 26 secondary care outpatient clinics from Portugal and Spain. The classifying variables included asthma-related demographics, unscheduled healthcare use, Control of Allergic Rhinitis and Asthma Test (CARAT), and EuroQol 5 dimensions (EQ-5D) questionnaires. A three-class model was identified. Class 1 (21%) and Class 2 (26%) were characterized by highly symptomatic and uncontrolled asthma, with concomitant upper airways symptoms and reporting problems across all EQ-5D dimensions; they differed on high unscheduled healthcare use (Class 1) and early asthma onset (Class 2). Class 3 (53%): early asthma onset, controlled asthma with upper airways symptoms and without problems in EQ-5D dimensions. Compared to other classes, Class 1 had a higher proportion of subjects with FEV1 Three distinct and clinically meaningful unsupervised classes of asthma were identified among participants of the INSPIRERS studies, revealing the studies’ potential to support and enable patient-centered care and further research.

We assessed the feasibility of the InspirerMundi app to monitor medication adherence in adolescents and adults with persistent asthma (treated with daily inhaled medication). A 1-month multicentre observational study was conducted in 26 hospital outpatient clinics from Portugal and Spain. During medical visits (T0), 107 patients were invited to use the app daily to register their asthma medication intakes. A scheduled intake was considered taken when patients presented the medication (inhaler, blister or other recipients) to an app image detection tool. Physicians reported patients’ asthma therapeutic plan at T0. At 1-month, patients were interviewed by phone and app satisfaction was assessed on a 1(low)-5(high) scale. A total of 99 patients (29±13 years) installed the app (93%) and 79 (74%) completed the 1-month interview. At least one medication was registered in the app by 77 patients (72%): 73 ≥1 inhaler and 42 at least another medication, e.g., pills, nasal spray. Almost 90% of patients registered in the app at least 50% of medications of the therapeutic plan, with 71% registering all prescribed inhalers and 52% all other prescribed medication. Median medication adherence was 75[25-90]% for inhalers and 82[50-94]% for other types. Most patients were satisfied with the features of medication adherence monitoring (70% scored ≥4), but less with the inhaler detection tool (53% ≥4). Half of the patients (53%) stated that the app had motivated them to better adhere to inhaled medication. InspirerMundi app was feasible to monitor medication adherence in patients with asthma. These results led to the redesign of the therapeutic plan registration and of the inhaler detection tool.

Over the past 40 years, Clinical Engineering in Brazil has evolved in many significant ways. Much of this advance has occurred because of the investment in human resources training. But still, many challenges need to be overcome. Nonetheless, there is still much to be done in order to ensure that the gains seen technologically can reach to even most remote regions of Brazil’s vast territorial expanse.

The objective of the research was to evaluate the effects of saline stress on the initial growth and physiological parameters of three varieties of cotton plants, being two cultivars of colored fiber (BRS Topazio and BRS Verde) and one of white fiber (BRS 286). The experiment was conducted under greenhouse conditions. After chemical depletion with sulfuric acid, five seeds were seeded in polyethylene pots of 20 kg, leaving only one plant per pot after thinning. The experimental design was completely randomized, with a factorial scheme of 3 × 5, with five replications, totaling 75 plots, being three cotton varieties and five saline stress treatments—1.1; 3.1; 5.1; 7.1; 9.1 dS m−1. The evaluations occurred at 15 and 30 days after the beginning of the treatments (DAT) for growth variables (plant height, stem diameter, number of leaves and leaf area) and gas exchange (stomatal conductance, net photosynthesis rate and transpiration. The variety that was most resistant to the salt stress levels studied was BRS 286, followed by BRS Topazio and BRS Verde.

As chuvas intensas são caracterizadas por sua distribuição temporal e espacial peculiarmente irregular. A precipitação máxima registrada durante um intervalo de 24 horas, iniciando a qualquer momento, será definida como precipitação máxima de 24 horas. Não deve ser confundida com a precipitação de 1 dia que se refere à precipitação máxima observada em 1 dia, sempre coletada no mesmo horário, considerada aqui das 9h às 9h do dia seguinte. O objetivo deste trabalho é determinar constantes de desagregação de chuvas intensas para o estado da Bahia a partir de 19 séries históricas pluviográficas comparando-as com os coeficientes obtidos para outras regiões do Brasil. Para a modelagem da frequência das chuvas intensas de diferentes durações foi empregada a distribuição de probabilidades. Para a determinação das constantes de desagregação, utiliza-se o método das relações de durações. Este método consiste em dois aspectos: a) a tendência das curvas de probabilidade de diferentes durações manterem-se paralelas entre si; e b) para diferentes locais, existe uma grande similaridade nas relações entre precipitações médias máximas de diferentes relações. Foram obtidas as seguintes constantes de desagregação médias para o estado da Bahia: h10min/h30min = 0,48; h20min/h30min = 0,79; h30min/h1h = 0,74; h40min/h1h = 0,87; h50min/h1h = 0,94; h1h/h24h = 0,59; h2h/h24h = 0,69; h3h/h24h = 0,76; h4h/h24h = 0,80; h6h/h24h = 0,85 e h12h/h24h = 0,92. Tais constantes constituem-se em importante ferramenta para aplicações que demandem a estimativa de chuvas intensas de curta duração no estado da Bahia.

Background Chronic urticaria is defined as the appearance of urticarial lesions and/or angioedema during a period of more than six weeks. We aimed at developing the Portuguese version of the Chronic Urticaria Quality of Life Questionnaire (CU-Q2oL) and at testing its reliability and the content, construct and criterion validity. Methods The forward-backward approach to a linguistic equivalence was followed, after which a clinical review and a cognitive debriefing with patients were performed. The intraclass correlation coefficient checked test-retest reliability with patients filling the same questionnaire with one week apart and the Cronbach’s alpha indicator assessed the internal consistency. Construct validity was tested by an exploratory factor analysis and by hypothesis tests involving sociodemographic and clinical patient characteristics, including the urticaria control test (UCT). On the other hand, criterion validity was tested through correlations with the Short-Form Health Survey SF-36, EQ-5D-5 L, and the Dermatology Quality of Life Index (DLQI). Results A total of 162 patients from seven hospital units were included. The mean (standard deviation) age was 42.6 (13.3) and 81.6% were female. CU-Q2oL was entirely filled by all respondents. Internal consistency was 0.947 for the overall score, ranging from 0.661 (limits) to 0.899 (sleep problems) and the corresponding reproducibility indicator was 0.910, based on 23 patients and ranging from 0.711 (swelling) and 0.957 (looks). Exploratory factor analysis in general confirmed the original structure originally obtained by the authors. All CU-Q2oL dimensions were highly correlated with DLQI Index and differentiated well between males and females, and between different levels of wheals and pruritus. In addition, moderate negative correlations were found between Cu-Q2oL scores and the dimensions from SF-36 and EQ-5D-5 L. Conclusions The satisfactory metric properties confirmed the cultural adaptation and validity of CU-Q2oL into Portuguese population, providing the clinicians with a valid tool to evaluate the impact of chronic urticaria on patient’s QoL and therefore adjust their treatment. Trial registration number Not applicable.

Objective: We aimed to compare patient's and physician's ratings of inhaled medication adherence and to identify predictors of patient-physician discordance. Design: Baseline data from two prospective multicentre observational studies. Setting: 29 allergy, pulmonology and paediatric secondary care outpatient clinics in Portugal. Participants: 395 patients (≥13 years old) with persistent asthma. Measures: Data on demographics, patient-physician relationship, upper airway control, asthma control, asthma treatment, forced expiratory volume in one second (FEV1) and healthcare use were collected. Patients and physicians independently assessed adherence to inhaled controller medication during the previous week using a 100 mm Visual Analogue Scale (VAS). Discordance was defined as classification in distinct VAS categories (low 0-50; medium 51-80; high 81-100) or as an absolute difference in VAS scores ≥10 mm. Correlation between patients' and physicians' VAS scores/categories was explored. A multinomial logistic regression identified the predictors of physician overestimation and underestimation. Results: High inhaler adherence was reported both by patients (median (percentile 25 to percentile 75) 85 (65-95) mm; 53% VAS>80) and by physicians (84 (68-95) mm; 53% VAS>80). Correlation between patient and physician VAS scores was moderate (rs=0.580; p

The paper version of CARAT (pCARAT) is valid to assess asthma control over a 4-week period. For follow-up purposes, assessment through mobile apps (aCARAT) or telephone (tCARAT) may be useful alternatives. We explored the psychometric properties of the aCARAT and tCARAT. Patients with asthma were recruited at secondary care outpatient clinics. During medical visits, patients filled in the pCARAT and were invited to complete the aCARAT in the following days using the app of project Inspirers (InspirerMundi). After 1 week, tCARAT was collected. Patients completing the 3 CARAT versions within 28 days were analysed. CARAT scores (0-worst, 30-best) were calculated. The internal consistency (Cronbach’s α), convergent validity (Spearman correlation-rs) and reliability (intraclass correlation coefficient-ICC, Bland-Altman analysis) were determined. 55 patients (21 male; median 19 [interquartile range 17-37]y) were included. The aCARAT was completed by 82% of patients within 1 week of pCARAT; and by 78% within 1 week of tCARAT. The median pCARAT score was 21[17-24], the aCARAT 21[18-26], and the tCARAT 23[21-26]. Internal consistency was good for all versions (α=.73-.77). pCARAT was more strongly correlated with aCARAT than with tCARAT. Reliability was better for aCARAT than for tCARAT (table 1). App and telephonic CARAT versions are valid and reliable, exhibiting comparable psychometric properties to the paper version. These new CARAT versions are promising alternatives for assessing control in patients with asthma.

This research aimed to evaluate the production of Potiguar maize fertirrigated with human urine and, cassava wastewater associated with mineral fertilization with NPK. A completely randomized design was used, consisting of eight treatments (1 - control without fertigation, 2 - fertigations with NPK, 3 - only human urine, 4 - only cassava wastewater, 5 - cassava wastewater plus human urine, 6 - human urine plus PK; - cassava wastewater plus NP, and 8 - human urine, cassava wastewater and P) and five replicates. At 110 days after emergence were evaluated the length and diameter of the spike, number of grain per spike, rows of grain per spike, grain per row, dry mass of the aerial part, dry mass of the spike with and without straw, dry mass of the grains and mass dry of 100 grains. Except for the dry matter of 100 grains, there was a statistically significant difference between treatments and between analyzed means. Human urine can substitute the nitrogen fertilization and the cassava wastewater applied via fertirrigation substitute the potassium in the maize crop. The association of these effluents has the potential to replace the mineral fertilization required by the maize crop. With the exception of treatments 1 and 4, the others can be indicated as the best treatments.&nbsp, Esta pesquisa objetivou avaliar a produção de milho Potiguar fertirrigado com urina humana e manipueira associadas à adubação mineral com NPK. Adotou-se delineamento inteiramente casualizados, composto por oito tratamentos (1 - testemunha sem fertirrigação; 2 - fertirrigações com NPK; 3 - apenas urina humana; 4 - apenas manipueira; 5 - urina humana mais manipueira; 6 - urina humana mais PK; 7 - manipueira mais NP; e 8 - urina humana, manipueira e P) e cinco repetições. Aos 110 dias após emergência foram avaliados comprimento e diâmetro da espiga, número de grão por espiga, fileiras de grãos por espigas, grãos por fileira, massa seca da parte aérea, massa seca da espiga com e sem palha,massa seca dos grãos e massa seca de 100 grãos. Com exceção da massa seca de 100 grãos, houve diferença estatística significativa entre tratamentos e entre médias analisadas. Urina humana pode substituir a adubação nitrogenada e a manipueira a potássica aplicada via fertirrigação na cultura do milho. A associação destes efluentes tem potencial para substituir a adubação mineral requerida pela cultura do milho. Com exceção dos tratamentos 1 e 4, os demais podem ser indicados como os melhores tratamentos.

Trabalho Final do Curso de Mestrado Integrado em Medicina, Faculdade de Medicina, Universidade de Lisboa, 2019 Submitted by Sofia Amador (sofiamador@fm.ul.pt) on 2020-04-28T09:41:13Z No. of bitstreams: 1 JoseCPereira.pdf: 1044977 bytes, checksum: d8265b3388f8d55970af8ff13c95bd9f (MD5) Made available in DSpace on 2020-04-28T13:16:22Z (GMT). No. of bitstreams: 1 JoseCPereira.pdf: 1044977 bytes, checksum: d8265b3388f8d55970af8ff13c95bd9f (MD5) Previous issue date: 2019

Aims: To establish the optimal dose of Phleum pratense subcutaneous immunotherapy (SCIT) in patients with allergic rhinoconjunctivitis with/without asthma. Materials & methods: One hundred and fifty-one patients were randomized to receive SCIT 0.25, 0.5, 1.0, 2.0 or 4.0 skin-prick test units (SPT) or placebo. The primary end point was the variation in the concentration of Phleum pratense extract needed to produce a positive nasal provocation test from baseline (V0) to final visit (FV). Results: After 17 weeks, a dose-dependent trend was apparent in the concentration of P. pratense extract needed to produce a positive nasal provocation response. Systemic adverse reactions occurred with 3.2% of administered doses. Grade III (n = 2) and IV (n = 2) events were observed only at the two highest doses. Conclusion: P. pratense depot SCIT showed signs of clinical and immunological efficacy by dose-dependently decreasing the allergen sensitization rate. Risk-benefit favored doses below 1.0 SPT units for confirmatory trials.