Browsing by Author "Pereira, Mariana"
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- AIRDOC: Smart mobile application for individualized support and monitoring of respiratory function and sounds of patients with chronic osbtructive diseasePublication . Almeida, Rute; Amaral, Rita; Jácome, Cristina; Martinho, Diogo; Vieira-Marques, Pedro; Jacinto, Tiago; Ferreira, Ana; Almeida, Ana; Martins, Constantino; Pereira, Mariana; Pereira, Ana; Valente, José; Almeida, Rafael; Vieira, Ana; Amaral, Rita; Sá-Sousa, Ana; Gonçalves, Ivânia; Rodrigues, Pedro; Alves-Correia, Magna; Freitas, Alberto; Marreiros, GoretiCurrent tools for self-management of chronic obstructive respiratory diseases (CORD) are difficult to use, not individualized and requiring laborious analysis by health professionals, discouraging their use in healthcare. There is an opportunity for cost-effective and easy-to-disseminate advanced technological solutions directed to patients and attractive to different stakeholders. The strategy of AIRDOC is to develop and integrate self-monitoring and self-managing tools, making use of the smartphone's presence in everyday life. AIRDOC intends to innovate on: i) technologies for remote monitoring of respiratory function and computerized lung auscultation; ii) coaching solutions, integrating psychoeducation, gamification and disease management support systems; and iii) management of personal health data, focusing on security, privacy and interoperability. It is expected that AIRDOC results will contribute for the innovation in CORD healthcare, with increased patient involvement and empowerment while providing quality prospective information for better clinical decisions, allowing more efficient and sustainable healthcare delivery.
- Automatic quality assessment of a forced expiratory manoeuvre acquired with the tablet microphonePublication . Almeida, Rute; Bernardo, Pinho; Jácome, Cristina; Teixeira, João Fonseca; Amaral, Rita; Gonçalves, Ivânia; Lopes, Filipa; Pinheiro, Ana Catarina; Jacinto, Tiago; Paixão, Cátia; Pereira, Mariana; Marques, Alda; Fonseca, João AlmeidaEvaluation of lung function is central to the management of chronic obstructive respiratory diseases. It is typically evaluated with a spirometer by a specialized health professional, who ensures the correct execution of a forced expiratory manoeuvre (FEM). Audio recording of a FEM using a smart device embedded microphone can be used to self-monitor lung function between clinical visits. The challenge of microphone spirometry is to ensure the validity and reliability of the FEM, in the absence of a health professional. In particular, the absence of a mouthpiece may allow excessive mouth closure, leading to an incorrect manoeuvre. In this work, a strategy to automatically assess the correct execution of the FEM is proposed and validated. Using 498 FEM recordings, both specificity and sensitivity attained were above 90%. This method provides immediate feedback to the user, by grading the manoeuvre in a visual scale, promoting the repetition of the FEM when needed.
- Development and validation of a digital image processing-based pill detection tool for an oral medication self-monitoring systemPublication . Holtkötter, Jannis; Amaral, Rita; Almeida, Rute; Jácome, Cristina; Cardoso, Ricardo; Pereira, Ana; Pereira, Mariana; Chon, Ki H.; Fonseca, João AlmeidaLong-term adherence to medication is of critical importance for the successful management of chronic diseases. Objective tools to track oral medication adherence are either lacking, expensive, difficult to access, or require additional equipment. To improve medication adherence, cheap and easily accessible objective tools able to track compliance levels are necessary. A tool to monitor pill intake that can be implemented in mobile health solutions without the need for additional devices was developed. We propose a pill intake detection tool that uses digital image processing to analyze images of a blister to detect the presence of pills. The tool uses the Circular Hough Transform as a feature extraction technique and is therefore primarily useful for the detection of pills with a round shape. This pill detection tool is composed of two steps. First, the registration of a full blister and storing of reference values in a local database. Second, the detection and classification of taken and remaining pills in similar blisters, to determine the actual number of untaken pills. In the registration of round pills in full blisters, 100% of pills in gray blisters or blisters with a transparent cover were successfully detected. In the counting of untaken pills in partially opened blisters, 95.2% of remaining and 95.1% of taken pills were detected in gray blisters, while 88.2% of remaining and 80.8% of taken pills were detected in blisters with a transparent cover. The proposed tool provides promising results for the detection of round pills. However, the classification of taken and remaining pills needs to be further improved, in particular for the detection of pills with non-oval shapes.
- Ketamine alone or combined with midazolam or dexmedetomidine does not affect anxiety-like behaviours and memory in adult Wistar ratsPublication . Magalhães, Ana; Valentim, Ana; Venâncio, Carlos; Pereira, Mariana; Melo, Pedro; Summavielle, Teresa; Antunes, LuisKetamine administration has been associated with controversial behavioural impairments and psychotic episodes. Even though ketamine alone and in combination with midazolam or dexmedetomidine are frequently used in laboratory animals, the side-effects of such protocols are not well known. Therefore, our aim was to evaluate the effects of ketamine alone and in combination with midazolam or dexmedetomidine on emotional reactivity, as well as the effects on learning and memory in adult rats at least 48 h after anaesthesia. The evaluation of the potential influence of 100 mg/kg ketamine administered alone and in combination with midazolam (5 mg/kg), or dexmedetomidine (0.25 mg/kg) on spatial learning and recognition memory was studied in adult Wistar rats using the radial maze as well as object recognition and location tests. The influence of these combinations on emotional reactivity was investigated using the new exploration test and the elevated plus maze. Results showed that ketamine alone or in combination with midazolam or dexmedetomidine affected neither spatial and recognition memory, nor emotional reactivity. These results reinforce the safe clinical use of ketamine and its combinations in rats in a research context since the administration of these anaesthetic combinations did not produce significant changes with regard to spatial and recognition memory or emotional reactivity. Furthermore, these results indicate that the quality of scientific data produced in adult rat neurobehavioural research is not jeopardized by the use of these anaesthetic protocols.
- Multidisciplinary development and initial validation of a clinical knowledge base on chronic respiratory diseases for mHealth decision support systemsPublication . Pereira, Ana Margarida; Jácome, Cristina; Jacinto, Tiago; Amaral, Rita; Pereira, Mariana; Sá-Sousa, Ana; Couto, Mariana; Vieira-Marques, Pedro; Martinho, Diogo; Vieira, Ana; Almeida, Ana; Martins, Constantino; Marreiros, Goreti; Freitas, Alberto; Almeida, Rute; Fonseca, João A.Most mobile health (mHealth) decision support systems currently available for chronic obstructive respiratory diseases (CORDs) are not supported by clinical evidence or lack clinical validation. The development of the knowledge base that will feed the clinical decision support system is a crucial step that involves the collection and systematization of clinical knowledge from relevant scientific sources and its representation in a human-understandable and computer-interpretable way. This work describes the development and initial validation of a clinical knowledge base that can be integrated into mHealth decision support systems developed for patients with CORDs. A multidisciplinary team of health care professionals with clinical experience in respiratory diseases, together with data science and IT professionals, defined a new framework that can be used in other evidence-based systems. The knowledge base development began with a thorough review of the relevant scientific sources (eg, disease guidelines) to identify the recommendations to be implemented in the decision support system based on a consensus process. Recommendations were selected according to predefined inclusion criteria: (1) applicable to individuals with CORDs or to prevent CORDs, (2) directed toward patient self-management, (3) targeting adults, and (4) within the scope of the knowledge domains and subdomains defined. Then, the selected recommendations were prioritized according to (1) a harmonized level of evidence (reconciled from different sources); (2) the scope of the source document (international was preferred); (3) the entity that issued the source document; (4) the operability of the recommendation; and (5) health care professionals’ perceptions of the relevance, potential impact, and reach of the recommendation. A total of 358 recommendations were selected. Next, the variables required to trigger those recommendations were defined (n=116) and operationalized into logical rules using Boolean logical operators (n=405). Finally, the knowledge base was implemented in an intelligent individualized coaching component and pretested with an asthma use case. Initial validation of the knowledge base was conducted internally using data from a population-based observational study of individuals with or without asthma or rhinitis. External validation of the appropriateness of the recommendations with the highest priority level was conducted independently by 4 physicians. In addition, a strategy for knowledge base updates, including an easy-to-use rules editor, was defined. Using this process, based on consensus and iterative improvement, we developed and conducted preliminary validation of a clinical knowledge base for CORDs that translates disease guidelines into personalized patient recommendations. The knowledge base can be used as part of mHealth decision support systems. This process could be replicated in other clinical areas.
- Quality assessment and feedback of Smart Device Microphone Spirometry executed by childrenPublication . Almeida, Rute; Pinho, Bernardo; Jácome, Cristina; Teixeira, Joao Fonseca; Amaral, Rita; Lopes, Filipa; Jacinto, Tiago; Guedes, Rui; Pereira, Mariana; Goncalves, Ivania; Fonseca, Joao AlmeidaSmart device microphone spirometry, based on the audio recording of forced expiratory maneuver (FEM), can be a simple, ubiquitous and easy tool for patients to self-monitor their asthma. Automatic validity assessment is crucial to guarantee that the global effort of the FEM fulfil the admissible minimum or if the maneuver needs to be repeated. In this work an automatic method to classify the sounds from FEM with respect to global effort was developed and evaluated using data from 54 children (5-10 years). The method proposed was able to correctly classify the microphone spirometry with respect to admissible minimum of effort with an accuracy of 86% (specificity 87% and sensitivity 86%). This method can be used to provide immediate feedback of the correct execution of the maneuver, improving the clinical value and utility of this self-monitoring tool.