Papers by Maria M Caramona
Journal of clinical hypertension (Greenwich, Conn.), 2018
Several scale reduction techniques to obtain short versions of questionnaires are described, 2 be... more Several scale reduction techniques to obtain short versions of questionnaires are described, 2 being the most prevalent those that
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Acta medica portuguesa, 2007
INTRODUCTION The large amount of information in the medical area creates management problems, bei... more INTRODUCTION The large amount of information in the medical area creates management problems, being necessary systematic methods for filing and retrieval. With information on the context of clinical records, methods must integrate controlled biomedical terminologies and desirable characteristics oriented to the structure, content and clinical results. The objective is to test the applicability and capacity for retrieval of a multidimensional system developed for classification and management of health information. METHODS Three hundred questions were randomly selected, by computerized method, from the questions received in six years (Medicine Information Service, Pharmaceutical Department, Coimbra University Hospitals). They were characterized and applicability evaluated by classified amount and need to alter the system, which is composed of various independent dimensions, incorporating concepts sometimes hierarchical. Questions retrieval was tested searching information in a dimens...
Resumo Objetivos: Avaliar o nível de implementação de cuidados farmacêuticos em Portugal; caracte... more Resumo Objetivos: Avaliar o nível de implementação de cuidados farmacêuticos em Portugal; caracterizar a equipa técnica, as infraestruturas e o tipo de serviços que as farmácias portuguesas oferecem; analisar a evolução destes indicadores entre 2006 e 2012. Tipo de estudo: Estudo observacional transversal. Local: Farmácias comunitárias portuguesas. População: Farmacêuticos comunitários a exercer em Portugal. Métodos: Realizou-se um estudo observacional transversal, que contou com a colaboração da Ordem dos Farmacêuticos no envio de um mailing aos farmacêuticos comunitários registados na sua base de da-dos (n=6797). O instrumento utilizado para recolha da informação foi uma versão adaptada da Behavioral Pharmaceutical Care Scale, questionário composto por duas secções. A secção A caracterizou a farmácia, os seus recursos (por exemplo, profissionais) e serviços prestados e a secção B avaliou o tipo de serviços prestados aos últimos doentes que entraram na farmácia, referindo-se a um p...
International Journal of Clinical Pharmacy, 2013
Task-parallel programming models with input annotationbased concurrency extraction at runtime pre... more Task-parallel programming models with input annotationbased concurrency extraction at runtime present a promising paradigm for programming multicore processors. Through management of dependencies, task assignments, and orchestration, these models markedly simplify the programming effort for parallelization while exposing higher levels of concurrency. In this paper we show that for multicores with a shared last-level cache (LLC), the concurrency extraction framework can be used to improve the shared LLC performance. Based on the input annotations for future tasks, the runtime instructs the hardware to prioritize data blocks with future reuse while evicting blocks with no future reuse. These instructions allow the hardware to preserve all the blocks for at least some of the future tasks and evict dead blocks. This leads to a considerable improvement in cache efficiency over what is achieved by hardware-only replacement policies, which can replace blocks for all future tasks resulting in poor hit-rates for all future tasks. The proposed hardwaresoftware technique leads to a mean improvement of 18% in application performance and a mean reduction of 26% in misses over a shared LLC managed by the Least Recently Used replacement policy for a set of input-annotated taskparallel programs using the OmpSs programming model implemented on the NANOS++ runtime. In contrast, the state-of-the-art thread-based partitioning scheme suffers an average performance loss of 2% and an average increase of 15% in misses over the baseline.
Therapeutic Drug Monitoring, 1999
The individualization of anticonvulsant therapy regimens can contribute to the implementation of ... more The individualization of anticonvulsant therapy regimens can contribute to the implementation of appropriate carbamazepine (CBZ) maintenance doses in epileptic patients. An accurate method for the prediction of concentrations based on a determination of parameters and serum concentrations could be of clinical relevance in the management of epilepsy. In this study, we retrospectively evaluated the predictive performance in an adult outpatient population of six different methods, representing six sets of CBZ pharmacokinetic parameters selected according to the literature using a Bayesian computer program (PKS System; Abbott Laboratories, Abbott Park, IL, USA). The study involved 50 patients with two or more available concentrations selected under several inclusion criteria. The patients were taking CBZ (between 200 and 1600 mg/d) in monotherapy or polytherapy regimens and had no hepatic or renal disease. Steady state concentrations were predicted according to the use of prior information and using one and two feedback patient concentrations. Accuracy and precision were assessed by mean prediction error (ME), mean squared prediction error (MSE) and root mean squared prediction error (RMSE). The analysis showed CL = 0.067 L/hour/kg and Vd = 1.19 L/kg as the most accurate and precise set of pharmacokinetic parameters, presenting the highest percentage of clinically acceptable estimates (error < 2 microg/mL). Additionally, predictions based on one measured feedback concentration were found to be more accurate and precise than prior population-based predictions; the use of two previous patient concentrations further improved predictive capacity but failed to show a significant difference when compared with predictions based on one measured feedback concentration. In conclusion, the adoption of the previously mentioned set of parameters as population estimates and the use of at least one feedback concentration through the Bayesian approach seems to be essential for a better CBZ use in clinical practice. Finally, despite the obtained results, we believe that the Portuguese pharmacokinetic parameter determination of antiepileptics should be carried out to improve the rationale and cost-effectiveness of anticonvulsant therapy.
Naunyn-Schmiedeberg's Archives of Pharmacology, 1992
Longitudinal strips were prepared from human uterine arteries obtained at hysterectomy. The arter... more Longitudinal strips were prepared from human uterine arteries obtained at hysterectomy. The artery had a low content of noradrenaline and dopamine, contrasting with a high content of the deaminated catechols, dihydroxyphenylglycol (DOPEG) and dihydroxymandelic acid (DOMA), which together represented 98% of endogenous catechols. When incubated with 3H-noradrenaline (0.1 gmol/1), the uterine artery removed, accumulated and metabolized noradrenaline. Deaminated metabolites predominated, DOMA being the most abundant metabolite. Cocaine markedly reduced the accumulation of 3Hnoradrenaline and abolished 3H-DOPEG formation, but did not change 3H-DOMA. Selective monoamine oxidase (MAO) inhibitors (clorgyline, selegiline and 2-amino ethyl carboxamide derivatives) caused a marked decrease in the amounts of 3H-DOPEG, 3H-DOMA and 3H-O-methylated and deaminated metabolites (OMDA) formed by the tissue and an increase in 3H-normetanephrine (NMN) formation. Inhibition of catechol-O-methyltransferase suppressed NMN formation and reduced that of OMDA; hydrocortisone slightly depressed the formation of DOMA and OMDA. Homogenates of the uterine artery deaminated 3H-5-HT, 14C-phenylethylamine and 3H-tyramine; inhibition curves of the deamination of 3H-tyramine by clorgyline and selegiline were compatible with the presence of both MOA A and MOA B. Exposure of the strips to 6-hydroxydopamine (1.5 mmol/1 for 20 rain; 3 exposure periods followed by washout periods of 15,15 and 30 min) resulted in complete and selective chemical denervation of the arterial tissue. This chemical denervation had effects which were similar to those of cocaine. The 2-amino ethyl carboxamide derivatives markedly reduced the formation of deaminated metabolites by the denervated strips. The semicarbazide-sensitive amine oxidase inhibitor semicarbazide reduced the formation of 3H-DOMA and 3H-DOPEG in intact strips, but was devoid of action in the denervated ones. It is concluded that, in the human uterine artery, deamination predominates over O-methylation and that extraneuronal deamination, leading to the formation of DOMA (and of OMDA) plays a major role in the metabolism even of low concentrations of exogenous noradrenaline.
European Journal of Pharmacology, 2003
The aims of the present research were to characterize the plasma and brain concentration-time pro... more The aims of the present research were to characterize the plasma and brain concentration-time profiles of lamotrigine after its acute administration and to establish the relationship between these profiles and the anticonvulsant effect of lamotrigine in rats. Adult male Wistar rats were given 10 mg/kg of lamotrigine intraperitoneally. The lamotrigine profiles in plasma and brain were determined at predetermined times over 120-h post-dose. The anticonvulsant profile against maximal electroshock seizure stimulation was determined over 48 h after dosing. After injection, lamotrigine rapidly appeared in both plasma and brain, suggesting ready penetration of the blood-brain barrier. A linear relationship was established between lamotrigine plasma and brain levels. A linear relationship was also defined between lamotrigine brain levels and the anticonvulsant response. The correspondent plasma levels were also well correlated with the anticonvulsant effect from the moment that the plasma-brain system had reached equilibrium.
Chirality, 2008
The stereoselective disposition of S-licarbazepine (S-Lic) and R-licarbazepine (R-Lic) was invest... more The stereoselective disposition of S-licarbazepine (S-Lic) and R-licarbazepine (R-Lic) was investigated in plasma, brain, liver, and kidney tissues after their individual administration (350 mg/kg) to mice by oral gavage. Plasma, brain, liver, and kidney concentrations of licarbazepine enantiomers and their metabolites were determined over the time by a validated chiral HPLC-UV method. The mean concentration data, attained at each time point, were analyzed using a non-compartmental model. S-Lic and R-Lic were rapidly absorbed from gastrointestinal tract of mouse and immediately distributed to tissues supplied with high blood flow rates. Both licarbazepine enantiomers were metabolized to a small extent, each parent compound being mainly responsible for the systemic and tissue drug exposure. The stereoselectivity in the metabolism and distribution of Sand R-Lic was easily identified. An additional metabolite was detected following R-Lic administration and S-Lic showed a particular predisposition for hepatic and renal accumulation. Stereoselective processes were also identified at the blood-brain barrier, with the brain exposure to S-Lic almost twice that of R-Lic. Another finding, reported here for the first time, was the ability of the mouse to perform the chiral inversion of Sand R-Lic, albeit to a small extent.
Annals of Pharmacotherapy, 2004
Documentation forms for patients with asthma: an evaluation TO THE EDITOR: The focus of pharmacy ... more Documentation forms for patients with asthma: an evaluation TO THE EDITOR: The focus of pharmacy practice is moving from being centered on dispensing to being focused on the patient. Professional organizations are promoting patient-centered care as routine, for which systematic and consistent documentation is essential. We report on an evaluation of the use of various documentation methods by community pharmacists managing patients with asthma, with a view to developing documentation in Portuguese pharmacy practice. Methods. The study was based in 5 community pharmacies during February and March 2002. Patients using the pharmacy who were prescribed asthma medication were invited to participate in the study. Patients agreed to participate following receipt of a leaflet explaining the study and signed a consent form. The pharmacists' interventions in managing these patients were documented using various data collection forms. These included a questionnaire to predict respiratory conditions in adults (IUALTD) 1 ; a form to document patient data, the drugs prescribed, and drug-related problem (DRP) classification 2 ; the Mini-Asthma Quality of Life Questionnaire 3 ; a checklist to assess patients' inhaler techniques 4 ; a questionnaire to assess the patients' knowledge of their drugs and condition 5 ; and a patient information leaflet developed by the research team. Before the study, pharmacists attended a training session to familiarize themselves with the documentation. The pharmacists' opinions of the use and utility of the documentation were evaluated using a 5-point scale. Descriptive and inferential statistics (SPSS for Windows, release 10) were used to analyze the collected data. Results. The participating pharmacists developed opinions about the documentation tools after using them over the 2-month study period on 24 patients. Every tool was considered generally useful (Table 1). However, the DRP classification was useful but not very simple to use and generated considerable workload. The lowest scores were obtained for the diagnostic tool and the knowledge and quality of life questionnaire (x-= 3.0), both of which are often used in research studies and therefore may need to be reviewed if research is to be fully implemented in practice. While the inhaler technique checklist was considered useful and simple, it created extra workload. Three of the piloted tools were regarded as able to be incorporated in daily practice. Pharmacists ranked the patient information leaflets highest (4.9), considering them to be very useful and simple while generating no extra workload. The use of peak flow meters was also ranked very positively (4.3), viewed as very useful and quite simple to use, even though they generated some extra workload. The patient profile forms were ranked quite positively (3.9); they were useful and simple, while creating some workload. The limitations of this study include the small sample and the convenience sampling process used. The study may not be widely generalizable; however, it is important to report on such feasibility studies to help with understanding how best to target such implementation strategies. It seems that most of the methods of documentation are considered usable in daily practice and could be made part of the documentation processes being implemented in professional activities in Portugal. Funding for the study was provided by Faculdade de Farmácia da Universidade de Lisboa and Associação Nacional das Farmácias; GlaxoSmithKline provided the IUALTD and the peak flow meters. We thank patients and pharmacists who actively participated in the study.
Analytica Chimica Acta, 2007
Herein is reported, for the first time, a simple and reliable chiral reversed-phase liquid chroma... more Herein is reported, for the first time, a simple and reliable chiral reversed-phase liquid chromatographic method coupled to ultraviolet (UV) detection for simultaneous determination of eslicarbazepine acetate (ESL) and its metabolites, S-licarbazepine (S-LC), R-licarbazepine (R-LC) and oxcarbazepine (OXC), in mouse plasma and brain, liver and kidney tissue homogenates. All analytes and the internal standard were extracted from plasma and tissue homogenates by a solid-phase extraction procedure using Waters Oasis ® hydrophilic-lipophilic balance cartridges. The chromatographic separation was performed by isocratic elution with water/methanol (88:12, v/v), pumped at a flow rate of 0.7 mL min −1 , on a Lichro-CART 250-4 ChiraDex (-cyclodextrin, 5 m) column at 30 • C. The UV detector was set at 225 nm. Calibration curves were linear (r 2 ≥ 0.996) in the ranges 0.4-8 g mL −1 , 0.1-1.5 g mL −1 and 0.1-2 g mL −1 for ESL and OXC and in the ranges 0.4-80 g mL −1 , 0.1-15 g mL −1 and 0.1-20 g mL −1 for R-LC and S-LC in plasma, brain and liver/kidney homogenates, respectively. The overall precision not exceeded 11.6% (%CV) and the accuracy ranged from −3.79 to 3.84% (%bias), considering all analytes in all matrices. Hence, this method will be a useful tool to characterize the pharmacokinetic disposition of ESL in mice.
Pharmacy World & Science, 2007
Aim: To evaluate the performance of eight different sets of gentamicin populational pharmacokinet... more Aim: To evaluate the performance of eight different sets of gentamicin populational pharmacokinetic parameters, regarding potential implementation in clinical pharmacokinetic software as prior information. Methods: The study involved 49 patients of 31.3±4.1 weeks of gestational age (GA), receiving gentamicin, and for whom peak and trough concentrations were obtained. Accuracy and precision were assessed by mean prediction error (ME), mean squared prediction error (MSE) and root mean squared prediction error (RMSE). Weighted prediction-error analysis was carried out in order to evaluate peak and trough concentrations together (ME w , MSE w and RMSE w). Results: The analysis showed CL=0.036 l/h/kg (<34 weeks GA) or CL=0.051 l/h/kg (‡34 weeks GA), and V d =0.5 l/kg (£37 weeks GA) or V d =0.4 l/kg (>37 weeks of GA) as the most accurate and precise set of pharmacokinetic parameters (Set 4), presenting the highest percentage of clinically acceptable estimates (Error Peak <1 lg/ml, and Error Trough <0.375 lg/ml). Conclusion: The adoption of the previously mentioned set of parameters as population estimates seems to be the best option, bearing in mind the obtained results. However, we strongly believe that pharmacokinetic parameter determination of gentamicin should be carried out whenever possible in order to improve the rationale and cost-effectiveness of therapy.
Pharmacy World & Science, 1995
The usefulness of Sandimmun*(Cyclosporin (CsA)), is limited in liver transplant recipients during... more The usefulness of Sandimmun*(Cyclosporin (CsA)), is limited in liver transplant recipients during the early postoperative period, due to poor drug absorption resulting from gastrointestinal disturbances and biliary system disruptions. It has been suggested that ...
Mediators of …, 2001
In this work, we studied the mechanisms by which diphenyleneiodonium chloride (DPI) inhibits nitr... more In this work, we studied the mechanisms by which diphenyleneiodonium chloride (DPI) inhibits nitric oxide (NO) synthesis induced by the proinflammatory cytokine interleukin-1b (IL-1) in bovine articular chondrocytes. To achieve this, we evaluated the ability of DPI to inhibit the expression and activity of the inducible isoform of the NO synthase (iNOS) induced by IL-1. We also studied the ability of DPI to prevent IL-1-induced NF-k B activation and reactive oxygen species (ROS) production. Results: Northern and Western blot analysis, respectively, showed that DPI dose-dependently inhibited IL-1-induced iNOS mRNA and protein synthesis in primary cultures of bovine articular chondrocytes. DPI effectively inhibited NO production (IC 5 0 = 0.03 ± 0.004 m M), as evaluated by the method of Griess. Nuclear factor-kappa B (NF-k B) activation, as evaluated by electrophoretic mobility shift assay, was inhibited by DPI (1Ð10 m M) in a dose-dependent manner. IL-1-induced ROS production, as evaluated by measurement of dichlorofluorescein fluorescence, was inhibited by DPI at concentrations that also prevented NF-k B activation and iNOS expression. Conclusions: DPI inhibits IL-1-induced NO production in chondrocytes by two distinct mechanisms: (i) by inhibiting NOS activity, and (ii) by preventing iNOS expression through the blockade of NF-k B activation. These results also support the involvement of reactive oxygen species in IL-1-induced NF-k B activation and expression of NF-k B-dependent genes, such as iNOS.
Revista Brasileira …, 2006
A indometacina, antiinflamatório não-esteróide, é praticamente insolúvel em água. A hidroxipropil... more A indometacina, antiinflamatório não-esteróide, é praticamente insolúvel em água. A hidroxipropil-b-ciclodextrina confere aos fármacos nela incluídos melhores características de solubilidade. A formação de complexos com indometacina protege da hidrólise, ...
Journal of Public Health, 2008
Background/objective Cardiovascular diseases (CVD) are the leading cause of mortality in European... more Background/objective Cardiovascular diseases (CVD) are the leading cause of mortality in European countries. This study aimed at estimating the 10-year risk of fatal CVD in Portuguese adults and to assess the prevalence of major cardiovascular risk factors, according to the SCORE® risk prediction system. Subjects and methods A cross-sectional survey was carried out in 60 community pharmacies (CP) from October 2005 to January 2006 in a sample of CP users (≥40 and ≤65 years). Data were collected by patient interviews using a structured questionnaire applied by a trained pharmacist. Results A total of 1,043 individuals were enrolled in the study (participation rate: 91%). The mean age was 53.7 years (SD: 7.1) with a ratio men/women of 0.68. The average risk in the sample was 1.94 (minimum 0, maximum 28, SD =2.69). About 20% of the studied adults were at high risk, of which 39.4% were asymptomatic. CV risk was significantly higher in the oldest age group and in men (p < 0.05). The pr...
Journal of clinical hypertension (Greenwich, Conn.), Jan 24, 2017
The Maastricht Utrecht Adherence in Hypertension (MUAH) questionnaire provides clinicians with in... more The Maastricht Utrecht Adherence in Hypertension (MUAH) questionnaire provides clinicians with information about the causes of a patient's poor adherence to antihypertensive drugs. In this study, the authors aimed to develop and validate a short version of the MUAH questionnaire. After an exploratory factor analysis, the number of MUAH items was reduced. The original MUAH questionnaire (model 1) was compared with the 16-item MUAH short version (model 2). Next, this short version of MUAH (MUAH-16) with all factors correlated (model 2a) was compared with the short version of MUAH with four subscales that contribute to a global factor of adherence (model 2b). Model 1 had a poor fit to the data (χ(2) 269 = 663.41, P < .001, comparative fit index = 0.695, root mean square error of approximation = 0.06), and model 2 had a very good fit to the data (χ(2) 100 = 171.07, P < .001, comparative fit index = 0.92, root mean square error of approximation = 0.04). When comparing model 2a ...
Revista Brasileira …, 2005
A terapêutica farmacológica em recém-nascidos confronta-se, por um lado, com um organismo sujeito... more A terapêutica farmacológica em recém-nascidos confronta-se, por um lado, com um organismo sujeito a marcadas alterações biológicas, resultantes da composição orgânica e da maturação funcional, que decorre a diferentes graus em crianças com a mesma idade, ...
Artigo disponível em português e inglês em: www.scielo.br/rsp Factores associados à hipertensão a... more Artigo disponível em português e inglês em: www.scielo.br/rsp Factores associados à hipertensão arterial nos utentes de farmácias em Portugal* Factors associated with arterial hypertension in pharmacy users in Portugal RESUMO OBJETIVO: Estimar a prevalência, tratamento e controlo da hipertensão e identifi car factores associados em utentes de farmácias comunitárias. MÉTODOS: Estudo transversal com 1.042 utentes de 40 a 65 anos em 60 farmácias comunitárias de Portugal Continental entre outubro de 2005 e janeiro de 2006. Os dados foram obtidos pela aplicação de questionário e medição de parâmetros biológicos. Foram realizadas três regressões logísticas sequenciais para verifi car associação entre as variáveis. RESULTADOS: A idade média foi de 53,7 anos e a razão homem/mulher foi 0,68. A prevalência da hipertensão arterial foi de 54,8%. Cerca de 70% dos hipertensos encontravam-se sob tratamento anti-hipertensivo e, destes, 47,7% estavam controlados. A hipertensão esteve positivamente associada à idade mais elevada, sexo masculino, ser casado, apresentar índice de massa corporal e nível de colesterol total mais alto, ser diabético, ter doença cardiovascular pessoal ou familiar precoce e reportar mais consultas médicas por ano. A hipertensão tratada mostrou-se positivamente associada a ser mulher, não casado, ser diabético, viver numa área urbana e reportar mais de três consultas médicas por ano. Nos hipertensos tratados, estar controlado foi positivamente associado a ter comportamento aderente à terapêutica anti-hipertensiva (auto-reporte), percepcionar o efeito desta medicação e ser de baixo risco cardiovascular. Os modelos preditivos apresentaram áreas sob as respectivas curvas ROC entre 0,72 e 0,78, com capacidade discriminatória aceitável. CONCLUSÕES: A prevalência da hipertensão foi elevada, mas similar à encontrada em outros estudos realizados em Portugal. A proporção de doentes tratados foi satisfatória, em contraste com o nível insufi ciente de controlo. DESCRITORES: Hipertensão, epidemiologia. Farmácias, utilização. Fatores de Risco. Estudos Transversais. Artigos Originais No entanto, estudos confi rmam que a percentagem de tratamento e controlo dos hipertensos está longe do desejado, mesmo nos países mais desenvolvidos. 8,16 A hipertensão tem prevalência elevada também em Portugal, ultrapassando 40% na população adulta. O ABSTRACT OBJECTIVE: To estimate the prevalence, treatment and control of hypertension, and to identify factors associated in community pharmacy users. METHODS: A cross-sectional study was conducted with 1,042 pharmacy users, aged between 40 and 65 years, in 60 community pharmacies of continental Portugal, between October 2005 and January 2006. Data were obtained with the application of a questionnaire and measurement of biological parameters. A total of three sequential logistic regressions were performed to verify an association among variables. RESULTS: Mean age was 53.7 years and the male/female ratio was 0.68. Prevalence of arterial hypertension was 54.8%. Approximately 70% of hypertensive individuals were undergoing antihypertensive treatment and, of these, 47.7% were controlled. Hypertension was positively associated with older age, male sex, being married, higher body mass index and higher total cholesterol level, being a diabetic, having a family or personal history of premature cardiovascular disease, and reporting more medical visits per year. When treated, hypertension was found to be positively associated with the female sex, not being married, being a diabetic, living in an urban area, and reporting more than three medical visits per year. In hypertensive users who were treated, being controlled was positively associated with self-reporting adherent behavior towards antihypertensive treatment, perceiving the effect of these drugs and having a low cardiovascular risk. The predictive models showed areas under the respective ROC curves between 0.72 and 0.78, with an acceptable discriminatory power. CONCLUSIONS: The prevalence of hypertension was high, although similar to that found in other studies conducted in Portugal. The proportion of hypertensive individuals under treatment was satisfactory, in contrast to an insuffi cient level of control.
Drugs & Aging, 2001
This study aimed to measure the outcomes of a harmonised, structured pharmaceutical care programm... more This study aimed to measure the outcomes of a harmonised, structured pharmaceutical care programme provided to elderly patients (> or =65 years of age) by community pharmacists in a multicentre international study performed in 7 European countries. The study was a randomised, controlled, longitudinal, clinical trial with repeated measures performed over an 18-month period. A total of 104 intervention and 86 control pharmacy sites participated in the research and 1290 intervention patients and 1164 control patients were recruited into the study. A general decline in health-related quality of life over time was observed in the pooled data; however, significant improvements were achieved in patients involved in the pharmaceutical care programme in some countries. Intervention patients reported better control of their medical conditions as a result of the study and cost savings associated with pharmaceutical care provision were observed in most countries. The new structured service w...
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Papers by Maria M Caramona