| 1. |
- Bousquet, Jean, et al.
(författare)
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Allergic Rhinitis and its Impact on Asthma (ARIA) Phase 4 (2018) : Change management in allergic rhinitis and asthma multimorbidity using mobile technology
- 2019
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Ingår i: Journal of Allergy and Clinical Immunology. - : Elsevier. - 0091-6749 .- 1097-6825. ; 143:3, s. 864-879
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Tidskriftsartikel (refereegranskat)abstract
- Allergic Rhinitis and its Impact on Asthma (ARIA) has evolved from a guideline by using the best approach to integrated care pathways using mobile technology in patients with allergic rhinitis (AR) and asthma multimorbidity. The proposed next phase of ARIA is change management, with the aim of providing an active and healthy life to patients with rhinitis and to those with asthma multimorbidity across the lifecycle irrespective of their sex or socioeconomic status to reduce health and social inequities incurred by the disease. ARIA has followed the 8-step model of Kotter to assess and implement the effect of rhinitis on asthma multimorbidity and to propose multimorbid guidelines. A second change management strategy is proposed by ARIA Phase 4 to increase self-medication and shared decision making in rhinitis and asthma multimorbidity. An innovation of ARIA has been the development and validation of information technology evidence-based tools (Mobile Airways Sentinel Network [MASK]) that can inform patient decisions on the basis of a self-care plan proposed by the health care professional.
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| 2. |
- Bousquet, Jean, et al.
(författare)
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ARIA digital anamorphosis : Digital transformation of health and care in airway diseases from research to practice
- 2021
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Ingår i: Allergy. European Journal of Allergy and Clinical Immunology. - : John Wiley & Sons. - 0105-4538 .- 1398-9995. ; 76:1, s. 168-190
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Forskningsöversikt (refereegranskat)abstract
- Digital anamorphosis is used to define a distorted image of health and care that may be viewed correctly using digital tools and strategies. MASK digital anamorphosis represents the process used by MASK to develop the digital transformation of health and care in rhinitis. It strengthens the ARIA change management strategy in the prevention and management of airway disease. The MASK strategy is based on validated digital tools. Using the MASK digital tool and the CARAT online enhanced clinical framework, solutions for practical steps of digital enhancement of care are proposed.
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| 3. |
- Bousquet, J. Jean, et al.
(författare)
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Next-generation ARIA care pathways for rhinitis and asthma : a model for multimorbid chronic diseases
- 2019
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Ingår i: Clinical and Translational Allergy. - : BMC. - 2045-7022 .- 2045-7022. ; 9
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Forskningsöversikt (refereegranskat)abstract
- Background: In all societies, the burden and cost of allergic and chronic respiratory diseases are increasing rapidly. Most economies are struggling to deliver modern health care effectively. There is a need to support the transformation of the health care system into integrated care with organizational health literacy.Main body: As an example for chronic disease care, MASK (Mobile Airways Sentinel NetworK), a new project of the ARIA (Allergic Rhinitis and its Impact on Asthma) initiative, and POLLAR (Impact of Air POLLution on Asthma and Rhinitis, EIT Health), in collaboration with professional and patient organizations in the field of allergy and airway diseases, are proposing real-life ICPs centred around the patient with rhinitis, and using mHealth to monitor environmental exposure. Three aspects of care pathways are being developed: (i) Patient participation, health literacy and self-care through technology-assisted "patient activation", (ii) Implementation of care pathways by pharmacists and (iii) Next-generation guidelines assessing the recommendations of GRADE guidelines in rhinitis and asthma using real-world evidence (RWE) obtained through mobile technology. The EU and global political agendas are of great importance in supporting the digital transformation of health and care, and MASK has been recognized by DG Sante as a Good Practice in the field of digitally-enabled, integrated, person-centred care.Conclusion: In 20 years, ARIA has considerably evolved from the first multimorbidity guideline in respiratory diseases to the digital transformation of health and care with a strong political involvement.
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| 4. |
- Carvalho, Joao, et al.
(författare)
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A drill-hole, geological and geophysical data-based 3D model for target generation in Neves-Corvo mine region, Portugal
- 2022
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Ingår i: International journal of earth sciences. - : Springer Nature. - 1437-3254 .- 1437-3262. ; 111, s. 403-424
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Tidskriftsartikel (refereegranskat)abstract
- The Neves-Corvo world class Iberian Pyrite Belt volcanogenic massive sulphide (VMS) deposit located in southern Portugal, constitutes an important Cu-Zn-Pb active mine. Seven deposits are currently known, among which the Lombador deposit alone has estimated 150 Mt of massive sulphides. The life-time of the mine is dependent on the discovery of new exploration targets and it is vital to have accurate 3D geological models, not only to guide drilling campaigns but also to drive a winning/new strategy, which in the past has led to Semblana and Monte Branco discoveries: geophysical inversion and modelling. Furthermore, 3D geological models can contribute to the understanding of the tectonic and stratigraphic evolution of the region. Therefore, the goal of this study is to produce a realistic 3D geological model of the Neves-Corvo region, as only one model is presently publicly available: the PROMINE model, which includes the study area of this work and extends from Aljustrel to the border with Spain. Lundin Mining has also produced two unpublished, confidential models in 2007 and 2017. The latest Lundin model incorporates the same geophysical data used in this work (2D and 3D seismic reflection and time-domain electromagnetic (TEM) ground loop data) and approximately 7500 surface and underground drill-holes. The model presented in this research has much more detail than the 2012 PROMINE model in the Neves-Corvo region and uses an updated and revised drill-hole database with approximately 8000 drill-holes, revised geological cross-sections built from surface geology and drill-hole logs, new geological outcrop data, petrophysical and reprocessed geophysical data, and is therefore more detailed and accurate than any of the previous models, in particular the 2007 and PROMINE models. Land gravimetric and aeromagnetic data are also available in the study area but were not directly used to build the geological model but rather to investigate and check the model produced. Modelling was performed with industry standard software and the 3D curves resulting from the geological/geophysical interpretation were interpolated using different approaches to respect the hard data (interpretation lines and drill-holes). The resulting 3D stratigraphic surfaces required strong manual editing to respect the interpretation, due to the presence of folds, thrusts and tectonic nappes in the study area. The surfaces were afterwards tied to the drill-holes, resulting in a 3D model with great accuracy and detail in the near mining area and covering a larger area than previously available 3D geological models. The model has three major stratigraphic layers: the Mertola Flysch Formation and the Volcano-Sedimentary Complex (VSC), overlying the Phyllite-Quartzite Formation basement, and also the known VMS deposits (underlying the top of the Lower VSC) geometries according to drill-hole data. In the central part of the study area, where more drill-holes are available, the top of the Lower VSC sequence surface was also built. This approach will contribute to a better exploration drill-hole planning and the generation of new targets for exploration.
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| 5. |
- Dias, Pedro, et al.
(författare)
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Geophysical investigation of the down-dip extension of the Lombador massive sulphide deposit, Neves-Corvo, Portugal
- 2021
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Ingår i: International journal of earth sciences. - : Springer Nature. - 1437-3254 .- 1437-3262. ; 110:3, s. 911-922
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Tidskriftsartikel (refereegranskat)abstract
- The 150 Mt Lombador massive sulphide deposit is one of the seven known deposits of the Neves-Corvo mine. The deposit dips approximately 30o-35o to the NE and is open down dip, with current exploitation reaching down at 1 km depth. To investigate the possible downwards continuation of the deposit, a 1D constrained inversion of time-domain electromagnetic (TEM) ground loop data was conducted, followed by 3D electromagnetic (EM) forward modeling and a constrained 3D gravimetric inversion over the same area. To perform the EM and gravity modeling/inversion, a 3D geologic model was built using a density database comprising of approximately 300 drill-holes, and an electrical conductivity database with measurements from resistivity surveys and 1D inversion of the TEM data. The EM modeling shows that the Neves Formation shales are a regional conductive layer extending down to approximately 1.6 km depth in the Lombador area. This layer, often topped by massive sulphides, has an average density of 2.83 g/cm(3), whereas stockwork and massive sulphide reach on average 3.1 g/cm(3) and 4.5 g/cm(3), respectively. The 3D constrained gravity inversion results do not support the hypothesis of the presence of massive sulphides located in the down-dip direction of the Lombador deposit in the immediate vicinity of the known deposit. The lack of spatial resolution of the gravity grid, the study area limited size and the lack of information from within the basement suggest further studies are required to confirm the presence and amount of stockwork mineralization down-dip the Lombador deposit inside the Neves-Formation or the Phyllite-Quartzite basement.
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| 6. |
- Sousa-Pinto, Bernardo, et al.
(författare)
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Comparison of rhinitis treatments using MASK-air® data and considering the minimal important difference
- 2022
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Ingår i: Allergy. European Journal of Allergy and Clinical Immunology. - : John Wiley & Sons. - 0105-4538 .- 1398-9995. ; 77:10, s. 3002-3014
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Tidskriftsartikel (refereegranskat)abstract
- Background: Different treatments exist for allergic rhinitis (AR), including pharmacotherapy and allergen immunotherapy (AIT), but they have not been compared using direct patient data (i.e., “real-world data”). We aimed to compare AR pharmacological treatments on (i) daily symptoms, (ii) frequency of use in co-medication, (iii) visual analogue scales (VASs) on allergy symptom control considering the minimal important difference (MID) and (iv) the effect of AIT.Methods: We assessed the MASK-air® app data (May 2015–December 2020) by users self-reporting AR (16–90 years). We compared eight AR medication schemes on reported VAS of allergy symptoms, clustering data by the patient and controlling for confounding factors. We compared (i) allergy symptoms between patients with and without AIT and (ii) different drug classes used in co-medication.Results: We analysed 269,837 days from 10,860 users. Most days (52.7%) involved medication use. Median VAS levels were significantly higher in co-medication than in monotherapy (including the fixed combination azelastine-fluticasone) schemes. In adjusted models, azelastine-fluticasone was associated with lower average VAS global allergy symptoms than all other medication schemes, while the contrary was observed for oral corticosteroids. AIT was associated with a decrease in allergy symptoms in some medication schemes. A difference larger than the MID compared to no treatment was observed for oral steroids. Azelastine-fluticasone was the drug class with the lowest chance of being used in co-medication (adjusted OR = 0.75; 95% CI = 0.71–0.80).Conclusion: Median VAS levels were higher in co-medication than in monotherapy. Patients with more severe symptoms report a higher treatment, which is currently not reflected in guidelines.
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| 7. |
- Sousa-Pinto, Bernardo, et al.
(författare)
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Consistent trajectories of rhinitis control and treatment in 16,177 weeks : the MASK-air® longitudinal study
- 2023
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Ingår i: Allergy. European Journal of Allergy and Clinical Immunology. - : John Wiley & Sons. - 0105-4538 .- 1398-9995. ; 78:4, s. 968-983
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Tidskriftsartikel (refereegranskat)abstract
- Introduction: Data from mHealth apps can provide valuable information on rhinitis control and treatment patterns. However, in MASK-air®, these data have only been analyzed cross-sectionally, without considering the changes of symptoms over time. We analyzed data from MASK-air® longitudinally, clustering weeks according to reported rhinitis symptoms. Methods: We analyzed MASK-air® data, assessing the weeks for which patients had answered a rhinitis daily questionnaire on all 7 days. We firstly used k-means clustering algorithms for longitudinal data to define clusters of weeks according to the trajectories of reported daily rhinitis symptoms. Clustering was applied separately for weeks when medication was reported or not. We compared obtained clusters on symptoms and rhinitis medication patterns. We then used the latent class mixture model to assess the robustness of results. Results: We analyzed 113,239 days (16,177 complete weeks) from 2590 patients (mean age ± SD = 39.1 ± 13.7 years). The first clustering algorithm identified ten clusters among weeks with medication use: seven with low variability in rhinitis control during the week and three with highly-variable control. Clusters with poorly-controlled rhinitis displayed a higher frequency of rhinitis co-medication, a more frequent change of medication schemes and more pronounced seasonal patterns. Six clusters were identified in weeks when no rhinitis medication was used, displaying similar control patterns. The second clustering method provided similar results. Moreover, patients displayed consistent levels of rhinitis control, reporting several weeks with similar levels of control. Conclusions: We identified 16 patterns of weekly rhinitis control. Co-medication and medication change schemes were common in uncontrolled weeks, reinforcing the hypothesis that patients treat themselves according to their symptoms.
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