Browsing by Author "Gomes, Margarida"
Now showing 1 - 4 of 4
Results Per Page
Sort Options
- A methodology to empower citizens towards a low-carbon economy: the potential of schools and sustainability indicatorsPublication . Lizana, Jesus; Manteigas, Vítor; Chacartegui, Ricardo; Lage, Joana; Becerra, Jose A.; Blondeau, Patrice; Rato, Ricardo; Silva, Filipe; Gamarra, Ana R.; Herrera, Israel; Gomes, Margarida; Fernandez, Amaia; Berthier, Celine; Gonçalves, Karla; Alexandre, Jose L.; Almeida-Silva, Marina; Almeida, Susana MartaEnvironmental empowering to control resource consumption and environmental impacts is critical to engage citizens to adopt more sustainable habits. This study demonstrates the potential benefits of innovative approaches based on sustainability indicators towards a low-carbon economy. A methodology to measure and promote sustainability in schools has been proposed and evaluated, aiming at showing the environmental performance and informing of potential environmental savings. The methodology, titled ClimACT, has two main purposes: measuring the environmental performance of schools through a school sustainability index based on measurable indicators in the areas of transport, procurement, green spaces, indoor air quality, energy, water and waste; and encouraging students, teachers and families towards an energy-efficient and low-carbon pathway through a structural procedure based on roles, activities and progress evaluation. The approach, applied to 39 pilot schools from Portugal, Spain, France and Gibraltar, achieved promising and encouraging results. All schools deployed the methodology successfully, achieving measurable environmental benefits in 95% of cases, with an average improvement of 10% in the global performance of schools after one year. Moreover, the 5112 surveys applied to school communities, before and after the methodology implementation, highlighted how the sustainable indicators had a significant influence on the daily lives of families, leading to improvements of their behaviour, with an average increase of 20% in indicators regarding good practices in transport, energy, water, waste and citizenship. The environmental empowering through measurable indicators is a step forward a low-carbon economy. This methodology is open and adaptable to all sectors and requirements.
- Mobility patterns of scholar communities in Southwestern European countriesPublication . Lage, Joana; d’Espiney, Ana; Canha, Nuno; Manteigas, Vítor; Alexandre, José Luís; Gonçalves, Karla; Chacartegui, Ricardo; Lizana, Jesus; Lechón, Yolanda; Gamarra, Ana Rosa; Fernandez, Amaia; Blondeau, Patrice; Gomes, Margarida; Almeida, Susana MartaThe present study aimed to provide an in-depth assessment of the commuting patterns of scholar communities of southwestern European countries and to identify measures to improve their sustainable performance regarding mobility. The adopted methodology characterized the mobility pattern of students as a sustainability indicator and the availability of related infrastructures and local public transport networks. Data were gathered by qualitative (behavioral questionnaires) and quantitative (technical audits) approaches, based on measurable indicators (key performance indicators and scores (ranging between 0–5)). Overall, French schools showed the best sustainable performance regarding mobility (2.0) and Gibraltar had the lowest (1.2). The existence of bike parking and electric car charging points were the main weaknesses founds (with their related mean scores being 0.6 and 0.2, respectively). The score associated with annual CO2 emissions due to students’ mobility had the best performance, where all countries managed to obtain an average of 3.1. The global score, which assessed the sustainable performance of scholar communities regarding mobility, had a mean value of 1.5 for all studied countries, which highlights the potential for improvement of the studied schools, mainly targeting the public transport network optimization and the enhancement of scholar infrastructures concerning bicycle parking and electric cars.
- The effects of benralizumab on lung volumes and airway resistance in severe eosinophilic asthma: a real-world studyPublication . Gerardo, António Madeira; Alves, Carolina da Silva; Gomes, Margarida; Pardal, Cecília; Sokolova, Anna; Liberato, Hedi; Mendes, Ana; Tonin, Fernanda; Duarte-Ramos, Filipa; Lopes, CarlosIntroduction: Add-on biological monoclonal antibodies such as benralizumab (anti-IL-5Ra) are recommended by international guidelines to reduce exacerbations in severe eosinophilic asthma (SEA). However, few studies have assessed the impact of these therapies on lung function-related outcomes. Our goal was to evaluate the effectiveness of benralizumab on lung function, including lung volumes and airway resistance, in SEA patients in Portugal. Methods: This was a real-world, observational, prospective, multicentric study including adult patients diagnosed with SEA (January-June 2023). Spirometry and plethysmography were performed at baseline (T0) and after six months of treatment (T6) with benralizumab to assess: total lung capacity (TLC), residual volume (RV), forced expiratory volume in one second (FEV1), forced vital capacity (FVC), mean forced expiratory flow between 25% and 75% of FVC (mFEF-25/75), intrathoracic gas volume (ITGV), and respiratory airway resistance (Raw). Descriptive statistics (with categorical variables described as frequencies and continuous values as mean and standard deviation (SD)) and paired t-test and Cohen's d effect size were calculated (analyses performed in StataCorp v.15.1; StataCorp LLC, TX, USA). Results: Overall, 30 SEA patients were evaluated, mostly women (n=18, 60.0%), with atopy (n=22, 73.3%), a mean age of 58.4 years (SD 11.7), and assisted by pulmonology (n=19, 63.3%) or immunology-allergology (n=11, 36.7%) services. Mean eosinophilia at baseline was 1103.57 cells/mcL (SD 604.88; minimum-maximum 460-2400); after the use of benralizumab, the count dropped to zero. After six months of treatment, a significant increase (p<0.0001) in FVC (15.3%), FEV1 (22.6%), and mFEF-25/75 (17.7%) were observed from baseline (Cohen's d between 0.78 and 1.11). ITGV, RV, RV/TLC, and Raw significantly decreased (p<0.0001) during the study period (-17.3%, -29.7%, -8.9%, and -100.6%, respectively) (Cohen's d between -0.79 and -1.06). No differences in TLC were obtained (p=0.173). No differences between sexes were observed for any measure. Patients with more significant eosinophilia (>900 cells/mcL count; n=15) presented better responses in FEV1 (p=0.001) and mFEF-25/75 (p=0.007). Conclusions: A notable eosinophil depletion with add-on benralizumab led to significant improvements in SEA patients' respiratory function (static lung volumes and airway resistance) in real-world settings after six months. The significant deflating effect of benralizumab on patients' hyperinflated lungs led to enhanced expiratory flow (increased FEV1 and mFEF-25/75) and air trapping (decreased RV/TLC), suggesting this antibody improves bronchial obstruction, lung hyperinflation, and airway resistance. Further studies in a larger population are required to confirm these findings.
- The role of benralizumab in eosinophilic immune dysfunctions: a case report-based literature reviewPublication . Gomes, Margarida; Mendes, Ana; Ferreira, Filipa; Branco, Joana; Tonin, Fernanda; Pedro, M. ElisaIn the past years, the knowledge of eosinophils playing a primary pathophysiologic role in several associated conditions has led to the development of biologics targeting therapies aiming at normalizing the immune response, reducing chronic inflammation, and preventing tissue damage. To better illustrate the potential relationship between different eosinophilic immune dysfunctions and the effects of biological therapies in this scenario, here, we present a case of a 63-year-old male first referred to our department in 2018 with a diagnosis of asthma, polyposis, and rhinosinusitis and presenting a suspicion of nonsteroidal anti-inflammatory drugs' allergy. He also had a past medical history of eosinophilic gastroenteritis/duodenitis (eosinophilia counts >50 cells/high-power field HPF). The use of multiple courses of corticosteroid therapy failed to completely control these conditions. In October 2019, after starting benralizumab (an antibody directed against the alpha chain of the IL-5 cytokine receptor) as an add-on treatment for severe eosinophilic asthma, important clinical improvements were reported both in the respiratory (no asthma exacerbations) and gastrointestinal systems (eosinophilia count 0 cells/HPF). The patient's quality of life also increased. Since June 2020, systemic corticosteroid therapy was reduced without worsening gastrointestinal symptoms or eosinophilic inflammation. This case warns of the importance of early recognition and appropriate individualized treatment of eosinophilic immune dysfunctions and suggests the conduction of further larger studies on the use of benralizumab in gastrointestinal syndromes aiming at better understanding its relying mechanisms of action in the intestinal mucosa.