{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T01:16:04Z","timestamp":1760145364434,"version":"build-2065373602"},"reference-count":56,"publisher":"MDPI AG","issue":"14","license":[{"start":{"date-parts":[[2024,7,17]],"date-time":"2024-07-17T00:00:00Z","timestamp":1721174400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100011011","name":"Junta de Andaluc\u00eda","doi-asserted-by":"publisher","award":["PI-0041-2014","PIN-0394-2017","P18-TPJ-3074"],"award-info":[{"award-number":["PI-0041-2014","PIN-0394-2017","P18-TPJ-3074"]}],"id":[{"id":"10.13039\/501100011011","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Mutua Madrile\u00f1a Foundation","award":["PI-0041-2014","PIN-0394-2017","P18-TPJ-3074"],"award-info":[{"award-number":["PI-0041-2014","PIN-0394-2017","P18-TPJ-3074"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Sensors"],"abstract":"<jats:p>Muscle dysfunction and muscle atrophy are common complications resulting from Chronic Obstructive Pulmonary Disease (COPD). The evaluation of the peripheral muscles can be carried out through the assessment of their structural components from ultrasound images or their functional components through isometric and isotonic strength tests. This evaluation, performed mainly on the quadriceps muscle, is not only of great interest for diagnosis, prognosis and monitoring of COPD, but also for the evaluation of the benefits of therapeutic interventions. In this work, bioimpedance spectroscopy technology is proposed as a low-cost and easy-to-use alternative for the evaluation of peripheral muscles, becoming a feasible alternative to ultrasound images and strength tests for their application in routine clinical practice. For this purpose, a laboratory prototype of a bioimpedance device has been adapted to perform segmental measurements in the quadriceps region. The validation results obtained in a pseudo-randomized study in patients with COPD in a controlled clinical environment which involved 33 volunteers confirm the correlation and correspondence of the bioimpedance parameters with respect to the structural and functional parameters of the quadriceps muscle, making it possible to propose a set of prediction equations. The main contribution of this manuscript is the discovery of a linear relationship between quadriceps muscle properties and the bioimpedance Cole model parameters, reaching a correlation of 0.69 and an average error of less than 0.2 cm regarding the thickness of the quadriceps estimations from ultrasound images, and a correlation of 0.77 and an average error of 3.9 kg regarding the isometric strength of the quadriceps muscle.<\/jats:p>","DOI":"10.3390\/s24144648","type":"journal-article","created":{"date-parts":[[2024,7,17]],"date-time":"2024-07-17T16:35:58Z","timestamp":1721234158000},"page":"4648","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Smart Bioimpedance Device for the Assessment of Peripheral Muscles in Patients with COPD"],"prefix":"10.3390","volume":"24","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7636-2855","authenticated-orcid":false,"given":"David","family":"Naranjo-Hern\u00e1ndez","sequence":"first","affiliation":[{"name":"Biomedical Engineering Group, Department of Signal Theory and Communications, University of Seville, 41092 Seville, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6853-4899","authenticated-orcid":false,"given":"Javier","family":"Reina-Tosina","sequence":"additional","affiliation":[{"name":"Biomedical Engineering Group, Department of Signal Theory and Communications, University of Seville, 41092 Seville, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9221-0299","authenticated-orcid":false,"given":"Laura M.","family":"Roa","sequence":"additional","affiliation":[{"name":"Biomedical Engineering Group, Department of Signal Theory and Communications, University of Seville, 41092 Seville, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4383-9394","authenticated-orcid":false,"given":"Gerardo","family":"Barbarov-Rost\u00e1n","sequence":"additional","affiliation":[{"name":"Biomedical Engineering Group, Department of Signal Theory and Communications, University of Seville, 41092 Seville, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1902-0522","authenticated-orcid":false,"given":"Francisco","family":"Ortega-Ruiz","sequence":"additional","affiliation":[{"name":"Medical Surgical Unit of Respiratory Diseases, Virgen del Roc\u00edo University Hospital, 41013 Seville, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0939-5427","authenticated-orcid":false,"given":"Pilar","family":"Cejudo Ramos","sequence":"additional","affiliation":[{"name":"Medical Surgical Unit of Respiratory Diseases, Virgen del Roc\u00edo University Hospital, 41013 Seville, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2024,7,17]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"108635","DOI":"10.1016\/j.pharmthera.2024.108635","article-title":"Musculoskeletal crosstalk in chronic obstructive pulmonary disease and comorbidities: Emerging roles and therapeutic potentials","volume":"257","author":"Mou","year":"2024","journal-title":"Pharmacol. Ther."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"17534666231170813","DOI":"10.1177\/17534666231170813","article-title":"The effects of upper limb exercise training on upper limb muscle strength in people with chronic obstructive pulmonary disease: A systematic review and meta-analysis of randomized controlled trials","volume":"17","author":"Karagiannis","year":"2023","journal-title":"Ther. Adv. Respir. Dis."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"640","DOI":"10.4187\/respcare.11705","article-title":"Pulmonary Rehabilitation: Mechanisms of Functional Loss and Benefits of Exercise","volume":"69","author":"Nici","year":"2024","journal-title":"Respir. Care"},{"key":"ref_4","doi-asserted-by":"crossref","unstructured":"Tonga, K.O., and Oliver, B.G. (2023). Effectiveness of Pulmonary Rehabilitation for Chronic Obstructive Pulmonary Disease Therapy: Focusing on Traditional Medical Practices. J. Clin. Med., 12.","DOI":"10.3390\/jcm12144815"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"367","DOI":"10.1016\/j.ccm.2019.02.013","article-title":"The Relevance of Limb Muscle Dysfunction in Chronic Obstructive Pulmonary Disease: A Review For Clinicians","volume":"40","author":"Bui","year":"2019","journal-title":"Clin. Chest Med."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"e1766","DOI":"10.1002\/pri.1766","article-title":"Inspiratory muscle strength, diaphragmatic mobility, and body composition in chronic obstructive pulmonary disease","volume":"24","author":"Souza","year":"2019","journal-title":"Physiother. Res. Int."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"88","DOI":"10.1111\/ggi.13146","article-title":"Interdependence of physical inactivity, loss of muscle mass and low dietary intake: Extrapulmonary manifestations in older chronic obstructive pulmonary disease patients","volume":"18","author":"Yoshimura","year":"2018","journal-title":"Geriatr. Gerontol. Int."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"175","DOI":"10.1164\/rccm.201710-2140CI","article-title":"Skeletal muscle dysfunction in chronic obstructive pulmonary disease what we know and can do for our patients","volume":"198","author":"Jaitovich","year":"2018","journal-title":"Am. J. Respir. Crit. Care Med."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"1525","DOI":"10.2147\/COPD.S396728","article-title":"Impaired Skeletal Muscle in Patients with Stable Chronic Obstructive Pulmonary Disease (COPD) Compared with Non-COPD Patients","volume":"18","author":"Wu","year":"2023","journal-title":"Int. J. COPD"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"17534666231208633","DOI":"10.1177\/17534666231208633","article-title":"Role of Nrf2 and exercise in alleviating COPD-induced skeletal muscle dysfunction","volume":"17","author":"Jiang","year":"2023","journal-title":"Ther. Adv. Respir. Dis."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"703","DOI":"10.1183\/09031936.05.00139904","article-title":"From muscle disuse to myopathy in COPD: Potential contribution of oxidative stress","volume":"26","author":"Couillard","year":"2005","journal-title":"Eur. Respir. J."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"1105","DOI":"10.1152\/japplphysiol.00303.2022","article-title":"Lower-limb resistance training reduces exertional dyspnea and intrinsic neuromuscular fatigability in individuals with chronic obstructive pulmonary disease","volume":"134","author":"Brunton","year":"2023","journal-title":"J. Appl. Physiol."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"220","DOI":"10.4103\/lungindia.lungindia_103_19","article-title":"Ultrasonographic assessment of skeletal muscle mass and diaphragm function in patients with chronic obstructive pulmonary disease: A case-control study","volume":"37","author":"Ramachandran","year":"2020","journal-title":"Lung India"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"89","DOI":"10.1007\/s41999-018-0130-7","article-title":"Ultrasound assessment of rectus femoris muscle in rehabilitation patients with chronic obstructive pulmonary disease screened for sarcopenia: Correlation of muscle size with quadriceps strength and fat-free mass","volume":"10","author":"Ostiz","year":"2019","journal-title":"Eur. Geriatr. Med."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"281","DOI":"10.1042\/CS20080660","article-title":"Exercise and muscle dysfunction in COPD: Implications for pulmonary rehabilitation","volume":"117","author":"Man","year":"2009","journal-title":"Clin. Sci."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"69","DOI":"10.1186\/s13063-022-07058-2","article-title":"Pulmonary rehabilitation integrated coached exercise training for patients with COPD: A study protocol for a randomized controlled trial","volume":"24","author":"Jing","year":"2023","journal-title":"Trials"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"686","DOI":"10.4187\/respcare.11541","article-title":"Review of the Evidence for Pulmonary Rehabilitation in COPD: Clinical Benefits and Cost-Effectiveness","volume":"69","author":"Lamberton","year":"2024","journal-title":"Respir. Care"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"e000717","DOI":"10.1136\/bmjresp-2020-000717","article-title":"Diagnostic and clinical values of non-cardiac ultrasound in COPD: A systematic review","volume":"7","author":"Alqahtani","year":"2020","journal-title":"BMJ Open Respir. Res."},{"key":"ref_19","doi-asserted-by":"crossref","unstructured":"Jenkins, A., Gaynor-Sodeifi, K., Lewthwaite, H., Triandafilou, J., Belo, L., de Oliveira, M., and Jensen, D. (Eur. Respir. J., 2023). Efficacy of interventions to alter measures of fat-free mass in people with chronic obstructive pulmonary disease: A systematic review and meta-analysis, Eur. Respir. J., early access.","DOI":"10.1183\/23120541.00102-2023"},{"key":"ref_20","doi-asserted-by":"crossref","unstructured":"Jenkins, T., Patel, S., Edwards, G., Nolan, C., Canavan, J., Kon, S., Jones, S., Barker, R., Littlemore, H., and Maddocks, M. (Eur. Respir. J., 2024). Longitudinal change in ultrasound-derived rectus femoris cross-sectional area in COPD, Eur. Respir. J., early access.","DOI":"10.1183\/23120541.00123-2024"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"119","DOI":"10.1186\/1465-9921-13-119","article-title":"Ultrasound assessment of lower limb muscle mass in response to resistance training in COPD","volume":"13","author":"Menon","year":"2012","journal-title":"Respir. Res."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"726","DOI":"10.1136\/thoraxjnl-2020-215949","article-title":"Longitudinal changes to quadriceps thickness demonstrate acute sarcopenia following admission to hospital for an exacerbation of chronic respiratory disease","volume":"76","author":"Mcauley","year":"2021","journal-title":"Thorax"},{"key":"ref_23","doi-asserted-by":"crossref","unstructured":"Deng, M., Liang, C., Yin, Y., Shu, J., Zhou, X., Wang, Q., Hou, G., and Wang, C. (2021). Ultrasound assessment of the rectus femoris in patients with chronic obstructive pulmonary disease predicts poor exercise tolerance: An exploratory study. BMC Pulm. Med., 21.","DOI":"10.1186\/s12890-021-01663-8"},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"719","DOI":"10.1589\/rika.35.719","article-title":"Relationship between quadriceps muscle thickness and activities of daily living of patients with chronic respiratory failure","volume":"35","author":"Zenta","year":"2020","journal-title":"Rigakuryoho Kagaku"},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"79","DOI":"10.2147\/COPD.S222945","article-title":"Ultrasound evaluation of the quadriceps muscle contractile index in patients with stable chronic obstructive pulmonary disease: Relationships with clinical symptoms, disease severity and diaphragm contractility","volume":"15","author":"Poirier","year":"2020","journal-title":"Int. J. COPD"},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"2308","DOI":"10.1016\/j.clnu.2020.10.021","article-title":"Estimation of skeletal muscle mass by bioimpedance and differences among skeletal muscle mass indices for assessing sarcopenia","volume":"40","author":"Xu","year":"2021","journal-title":"Clin. Nutr."},{"key":"ref_27","doi-asserted-by":"crossref","unstructured":"Jeon, K., Kim, S.Y., Jiang, F., Chung, S., Ambegaonkar, J., Park, J.H., Kim, Y.J., and Kim, C.H. (2020). Prediction equations of the multifrequency standing and supine bioimpedance for appendicular skeletal muscle mass in korean older people. Int. J. Environ. Res. Public Health, 17.","DOI":"10.3390\/ijerph17165847"},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"3288","DOI":"10.1016\/j.clnu.2020.10.056","article-title":"Development and validation of a multifrequency bioimpedance spectroscopy equation to predict appendicular skeletal muscle mass in hemodialysis patients","volume":"40","author":"Lin","year":"2021","journal-title":"Clin. Nutr."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"1946","DOI":"10.1038\/s41598-022-05887-4","article-title":"Performance of bioelectrical impedance analysis compared to dual X-ray absorptiometry (DXA) in Veterans with COPD","volume":"12","author":"Goldstein","year":"2022","journal-title":"Sci. Rep."},{"key":"ref_30","first-page":"9210258","article-title":"Fundamentals, recent advances, and future challenges in bioimpedance devices for healthcare applications","volume":"2019","author":"Min","year":"2019","journal-title":"J. Sens."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"1962","DOI":"10.1021\/acsbiomaterials.0c01570","article-title":"Bioimpedance Spectroscopy: Basics and Applications","volume":"7","author":"Stupin","year":"2021","journal-title":"ACS Biomater. Sci. Eng."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"111745","DOI":"10.1016\/j.exger.2022.111745","article-title":"Segmental bioelectrical impedance spectroscopy: A novel field assessment of muscle size and quality in normal weight and obese older men","volume":"162","author":"Arieta","year":"2022","journal-title":"Exp. Gerontol."},{"key":"ref_33","first-page":"23","article-title":"Bioimpedance Spectroscopy Compared to Ultrasound-derived Measures of Quadriceps Muscle Quality","volume":"2","author":"Wohlgemuth","year":"2023","journal-title":"Int. J. Exerc. Sci."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"104103","DOI":"10.1016\/j.medengphy.2024.104103","article-title":"Can segmental bioelectrical impedance be used as a measure of muscle quality?","volume":"124","author":"Wohlgemuth","year":"2024","journal-title":"Med Eng. Phys."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"E15","DOI":"10.1164\/rccm.201402-0373ST","article-title":"An official American thoracic society\/european respiratory society statement: Update on limb muscle dysfunction in chronic obstructive pulmonary disease","volume":"189","author":"Maltais","year":"2014","journal-title":"Am. J. Respir. Crit. Care Med."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"1269","DOI":"10.1513\/AnnalsATS.201505-278PS","article-title":"Why and how limb muscle mass and function should be measured in patients with chronic obstructive pulmonary disease","volume":"12","author":"Nyberg","year":"2015","journal-title":"Ann. Am. Thorac. Soc."},{"key":"ref_37","doi-asserted-by":"crossref","unstructured":"Naranjo-Hern\u00e1ndez, D., Reina-Tosina, J., Roa, L., Barbarov-Rost\u00e1n, G., Arest\u00e9-Fosalba, N., Lara-Ruiz, A., Cejudo-Ramos, P., and Ortega-Ruiz, F. (2020). Smart bioimpedance spectroscopy device for body composition estimation. Sensors, 20.","DOI":"10.3390\/s20010070"},{"key":"ref_38","unstructured":"Roa, L., Reina-Tosina, J., Naranjo-Hern\u00e1ndez, D., and Estudillo-Valderrama, M. (2015). Intelligent Bioimpedance Sensor for Biomedical Applications. (2537351), ES Patent."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"A1","DOI":"10.1088\/0967-3334\/16\/3A\/001","article-title":"Tissue impedance: A historical overview","volume":"16","author":"McAdams","year":"1995","journal-title":"Physiol. Meas."},{"key":"ref_40","doi-asserted-by":"crossref","unstructured":"Zhang, M., Xing, X., and Wang, W. (2024). Smart Sensor-Based Monitoring Technology for Machinery Fault Detection. Sensors, 24.","DOI":"10.3390\/s24082470"},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"643","DOI":"10.1007\/s11517-015-1355-y","article-title":"Extraction of Cole parameters from the electrical bioimpedance spectrum using stochastic optimization algorithms","volume":"54","author":"Bolic","year":"2016","journal-title":"Med Biol. Eng. Comput."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"S111","DOI":"10.1088\/0967-3334\/29\/6\/S10","article-title":"Genetic and least squares algorithms for estimating spectral EIS parameters of prostatic tissues","volume":"29","author":"Halter","year":"2008","journal-title":"Physiol. Meas."},{"key":"ref_43","doi-asserted-by":"crossref","unstructured":"Albulbul, A. (2016). Evaluating major electrode types for idle biological signal measurements for modern medical technology. Bioengineering, 3.","DOI":"10.3390\/bioengineering3030020"},{"key":"ref_44","doi-asserted-by":"crossref","unstructured":"Zhuang, J., Zhu, C., Han, R., Steuer, A., Kolb, J.F., and Shi, F. (2022). Uncertainty Quantification and Sensitivity Analysis for the Electrical Impedance Spectroscopy of Changes to Intercellular Junctions Induced by Cold Atmospheric Plasma. Molecules, 27.","DOI":"10.3390\/molecules27185861"},{"key":"ref_45","doi-asserted-by":"crossref","unstructured":"Martinsen, \u00d8.G., and Heiskanen, A. (2023). Bioimpedance and Bioelectricity Basics, Elsevier. [4th ed.].","DOI":"10.1016\/B978-0-12-819107-1.00004-2"},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"166","DOI":"10.1111\/1744-9987.13554","article-title":"Association of bioimpedance-derived 50-kHz phase angle as marker of body composition with electrical parameters regarding the Cole-Cole model","volume":"25","author":"Yashiro","year":"2021","journal-title":"Ther. Apher. Dial."},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"769","DOI":"10.1007\/s40846-017-0269-6","article-title":"Use of Electrical Impedance Spectroscopy in vivo to Distinguish Active and Rest Stages of Salivary Glands","volume":"37","author":"Moqadam","year":"2017","journal-title":"J. Med Biol. Eng."},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"1055","DOI":"10.1007\/978-981-15-2780-7_110","article-title":"Modified biological model of meat in the frequency range from 50 Hz to 1 MHz","volume":"1125","author":"Phan","year":"2020","journal-title":"Adv. Intell. Syst. Comput."},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"418","DOI":"10.1136\/thx.2008.103986","article-title":"Ultrasound measurement of rectus femoris cross-sectional area and the relationship with quadriceps strength in COPD","volume":"64","author":"Seymour","year":"2009","journal-title":"Thorax"},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"527","DOI":"10.1002\/mus.880140607","article-title":"Ultrasound imaging of the quadriceps muscle in elderly athletes and untrained men","volume":"14","author":"Sipila","year":"1991","journal-title":"Muscle Nerve"},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"20230008","DOI":"10.2490\/prm.20230008","article-title":"Reliability and Validity of Quadriceps Muscle Thickness Measurements in Ultrasonography: A Comparison with Muscle Mass and Strength","volume":"8","author":"Ogawa","year":"2023","journal-title":"Prog. Rehabil. Med."},{"key":"ref_52","doi-asserted-by":"crossref","unstructured":"Abdulsalam, A.J., Kara, M., and \u00d6z\u00e7akar, L. (J. Nephrol., 2024). Ultrasound is mightier than bioimpedance spectrometry but not ad lib, J. Nephrol., in press.","DOI":"10.1007\/s40620-024-01943-6"},{"key":"ref_53","doi-asserted-by":"crossref","first-page":"61","DOI":"10.1186\/s40560-019-0416-y","article-title":"Monitoring of muscle mass in critically ill patients: Comparison of ultrasound and two bioelectrical impedance analysis devices","volume":"7","author":"Nakanishi","year":"2019","journal-title":"J. Intensive Care"},{"key":"ref_54","doi-asserted-by":"crossref","unstructured":"Carrasco-Garrido, P., de Miguel-D\u00edez, J., Rejas-Gutierrez, J., Mart\u00edn-Centeno, A., Gobartt-V\u00e1zquez, E., Hernandez-Barrera, V., Gil de Miguel, A., and Jimenez-Garcia, R. (2009). Characteristics of chronic obstructive pulmonary disease in Spain from a gender perspective. BMC Pulm. Med., 9.","DOI":"10.1186\/1471-2466-9-2"},{"key":"ref_55","doi-asserted-by":"crossref","first-page":"1737","DOI":"10.1016\/j.clnu.2023.06.031","article-title":"Sex related differences in muscle health and metabolism in chronic obstructive pulmonary disease","volume":"42","author":"Engelen","year":"2023","journal-title":"Clin. Nutr."},{"key":"ref_56","doi-asserted-by":"crossref","first-page":"84","DOI":"10.1016\/j.arbr.2019.03.021","article-title":"Social Profile of Patients Admitted for COPD Exacerbations. A Gender Analysis","volume":"56","year":"2020","journal-title":"Arch. Bronconeumol."}],"container-title":["Sensors"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1424-8220\/24\/14\/4648\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T15:18:36Z","timestamp":1760109516000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1424-8220\/24\/14\/4648"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,7,17]]},"references-count":56,"journal-issue":{"issue":"14","published-online":{"date-parts":[[2024,7]]}},"alternative-id":["s24144648"],"URL":"https:\/\/doi.org\/10.3390\/s24144648","relation":{},"ISSN":["1424-8220"],"issn-type":[{"type":"electronic","value":"1424-8220"}],"subject":[],"published":{"date-parts":[[2024,7,17]]}}}