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HIV/AIDS length of stay in Portugal under financial constraints: a longitudinal study for public hospitals, 2009–2014
Publication . Augusto, Gonçalo; Abrantes, Alexandre V.; Martins, Maria R.; Dias, Sara
The global financial crisis and the economic and financial adjustment programme (EFAP) forced the Portuguese government to adopt austerity measures, which also included the health sector. The aim of this study was to analyse factors associated with HIV/AIDS patients' length of stay (LOS) among Portuguese hospitals, and the potential impact of the EFAP measures on hospitalizations among HIV/AIDS patients. METHODS: Data used in this analysis were collected from the Portuguese database of Diagnosis Related Groups (DRG). We considered only discharges classified under MCD 24 created for patients with HIV infection. A total of 20,361 hospitalizations occurring between 2009 and 2014 in 41 public hospitals were included in the analysis. The outcome was the number of days between hospital admission and discharge dates (LOS). Hierarchical Poisson regression model with random effects was used to analyse the relation between LOS and patient, treatment and setting characteristics. To more effectively analyse the impact of the EFAP implementation on HIV/AIDS hospitalizations, yearly variables, as well as a variable measuring hospitals' financial situation (current ratio) was included. RESULTS: For the 5% level, having HIV/AIDS as the principal diagnosis, the number of secondary diagnoses, the number of procedures, and having tuberculosis have a positive impact in HIV/AIDS LOS; while being female, urgent admission, in-hospital mortality, pneumocystis pneumonia, hepatitis C, and hospital's current ratio contribute to the decrease of LOS. Additionally, LOS between 2010 and 2014 was significantly shorter in comparison to 2009. Differences in LOS across hospitals are significant after controlling for these variables. CONCLUSION: Following the EFAP, a number of cost-containment measures in the health sector were implemented. Results from our analysis suggest that the implementation of these measures contributed to a significant decrease is LOS among HIV/AIDS patients in Portuguese hospitals
The X++2X→X2++X reaction rate constant for Ar, Kr and Xe, at 300 K
Publication . Neves, P. N. B.; Conde, C. A. N.; Távora, L. M. N.
The X++2X → X+2X- reaction rate constants were measured for Ar, Kr and Xe, at 300 K, using a new experimental technique. The results for Ar, kAr=(1.2 ± 0.2) × 10 -31 cm6 Kr, kKr=(2.1 ± 0.9) × 10-31 cm and Xe, kxe=(1.48 ± 0.18) x 10 -31 cm6S-1 are discussed and compared with those of other authors using different techniques.
Recognition of human activity based on sparse data collected from smartphone sensors
Publication . Gordalina, Goncalo; Correia, Pedro; Pires, Gabriel; Oliveira, Luis; Figueiredo, Maria João; Martinho, Ricardo; Rijo, Rui, Rui Pedro Charters Lopes; Assunção, Pedro; Seco, Maria Alexandra Abreu Henriques; Fonseca-Pinto, Rui
This paper proposes a method of human activity monitoring based on the regular use of sparse acceleration data and GPS positioning collected during smartphone daily utilization. The application addresses, in particular, the elderly population with regular activity patterns associated with daily routines. The approach is based on the clustering of acceleration and GPS data to characterize the user’s pattern activity and localization for a given period. The current activity pattern is compared to the one obtained by the learned data patterns, generating alarms of abnormal activity and unusual location. The obtained results allow to consider that the usage of the proposed method in real environments can be beneficial for
activity monitoring without using complex sensor networks.
Late-Night Salivary Cortisol: Cut-Off Definition and Diagnostic Accuracy for Cushing’s Syndrome in a Portuguese Population
Publication . Lages, Adriana De Sousa; Oliveira, Diana; Paiva , Isabel; Oliveira, Patrícia; Rebelo-Marques, Alexandre; Carrilho, Francisco; Frade, João Gonçalo Leal de Oliveira e Silva
Introduction: Diagnosis of Cushing’s syndrome remains a challenge in clinical endocrinology. Even though late-night salivary cortisol is used as screening tool, individualized cut-off levels for each population must be defined.Material and Methods: Three groups of subjects were studied: normal subjects, suspected and proven Cushing’s syndrome. Salivary cortisol was measured using an automated electrochemiluminescence assay. The functional sensitivity of the assay is 0.018 μg/dL. The diagnostic cut-off level was defined by Receiver Operating Characteristic curve and Youden’s J index.Results: We studied 127 subjects: 57 healthy volunteers, 39 patients with suspected and 31 with proven Cushing’s syndrome. 2.5th- 97.5th percentile of the late-night salivary cortisol concentrations in normal subjects was 0.054 to 0.1827 μg/dL. Receiver Operating Characteristic curve analysis showed an area under the curve of 0.9881 (p < 0.0001). A cut-off point of 0.1 μg/dL provided a sensitivity of 96.77% (95% CI 83.3 - 99.92%) and specificity of 91.23% (95% CI 80.7 - 97.09%). There was a significant correlation between late-night salivary cortisol and late-night serum cortisol (R = 0.6977; p < 0.0001) and urinary free cortisol (R = 0.5404; p = 0.0025) in proven Cushing’s syndrome group.Discussion: The mean ± SD late-night salivary cortisol concentration in patients with proven Cushing’s syndrome (0.6798 ± 0.52 μg/dL) was significantly higher (p < 0.0001). In our population, the late-night salivary cortisol cut-off was 0.1 μg/dL with high sensitivity and specificity.Conclusion: Late-night salivary cortisol has excellent diagnostic accuracy, making it a highly reliable, noninvasive, screening tool for outpatient assessment. Given its convenience and diagnostic accuracy, late-night salivary cortisol may be added to other traditional screening tests on hypercortisolism
Response of fabric insert injection overmolding PP based composites subjected to single and muti-impact
Publication . Ferreira, José; Febra, Tiago; Costa, José; Capela, Carlos
This paper presents the results of a current study on the development and impact response of composite plates manufactured by injection overmolding on the two sides of a single reinforcement fibre mat. The injection polymer is a talc-filled polypropylene, nowadays used for structural purposes. Three configurations with different insert fibre mats were used: Kevlar, biaxial and multiaxial glass fibre mats. The parameters studied were the fibre mat type and the impact energy. For single impact tests, it was concluded that the highest impact energy required to achieve impactor perforation is obtained with Kevlar insert, while the highest percentage of energy recovered is achieved with biaxial glass fibre netting. Kevlar insert also allows for the maximum impact stiffness. For the multi-impact tests, the recovered energy and the dynamic stiffness show the same tendencies of the single impact tests. On low energy impacts, the effect of the insert fibre and of the previous impact are quite reduced, while for impact energies above 6J, previous impacts reduce significantly the recovered energy and the impact energy for which the perforation was achieved.