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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. |
- Cachim, Afonso, et al.
(författare)
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Measuring adherence to inhaled control medication in patients with asthma : Comparison among an asthma app, patient self-report and physician assessment
- 2023
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Ingår i: Clinical and Translational Allergy. - : John Wiley & Sons. - 2045-7022. ; 13:2
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Tidskriftsartikel (refereegranskat)abstract
- BackgroundPrevious studies have demonstrated the feasibility of using an asthma app to support medication management and adherence but failed to compare with other measures currently used in clinical practice. However, in a clinical setting, any additional adherence measurement must be evaluated in the context of both the patient and physician perspectives so that it can also help improve the process of shared decision making. Thus, we aimed to compare different measures of adherence to asthma control inhalers in clinical practice, namely through an app, patient self-report and physician assessment.MethodsThis study is a secondary analysis of three prospective multicentre observational studies with patients (≥13 years old) with persistent asthma recruited from 61 primary and secondary care centres in Portugal. Patients were invited to use the InspirerMundi app and register their inhaled medication. Adherence was measured by the app as the number of doses taken divided by the number of doses scheduled each day and two time points were considered for analysis: 1-week and 1-month. At baseline, patients and physicians independently assessed adherence to asthma control inhalers during the previous week using a Visual Analogue Scale (VAS 0–100).ResultsA total of 193 patients (72% female; median [P25–P75] age 28 [19–41] years old) were included in the analysis. Adherence measured by the app was lower (1 week: 31 [0–71]%; 1 month: 18 [0–48]%) than patient self-report (80 [60–95]) and physician assessment (82 [51–94]) (p < 0.001). A negligible non-significant correlation was found between the app and subjective measurements (ρ 0.118–0.156, p > 0.05). There was a moderate correlation between patient self-report and physician assessment (ρ = 0.596, p < 0.001).ConclusionsAdherence measured by the app was lower than that reported by the patient or the physician. This was expected as objective measurements are commonly lower than subjective evaluations, which tend to overestimate adherence. Nevertheless, the low adherence measured by the app may also be influenced by the use of the app itself and this needs to be considered in future studies.
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| 4. |
- Rudke, Anderson Paulo, et al.
(författare)
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Land cover data of Upper Parana River Basin, South America, at high spatial resolution
- 2019
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Ingår i: International Journal of Applied Earth Observation and Geoinformation. - : Elsevier BV. - 1569-8432. ; 83
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Tidskriftsartikel (refereegranskat)abstract
- This study presents a new land cover map for the Upper Paraná River Basin (UPRB-2015), with high spatial resolution (30 m), and a high number of calibration and validation sites. To the new map, 50 Landsat-8 scenes were classified with the Support Vector Machine (SVM) algorithm and their level of agreement was assessed using overall accuracy and Kappa coefficient. The generated map was compared by area and by pixel with six global products (MODIS, GlobCover, Globeland30, FROM-GLC, CCI-LC and, GLCNMO). The results of the new classification showed an overall accuracy ranging from 67% to 100%, depending on the sub-basin (80.0% for the entire UPRB). Kappa coefficient was observed ranging from 0.50 to 1.00 (average of 0.73 in the whole basin). Anthropic areas cover more than 70% of the entire UPRB in the new product, with Croplands covering 46.0%. The new mapped areas of croplands are consistent with local socio-economic statistics but don't agree with global products, especially FROM-GLC (14,9%), MODIS (33.8%), GlobCover (71.2%), and CCI (67.8%). In addition, all global products show generalized spatial disagreement, with some sub-basins showing areas of cropland varying by an order of magnitude, compared to UPRB-2015. In the case of Grassland, covering 25.6% of the UPRB, it was observed a strong underestimation by all global products. Even for the Globeland30 and MODIS, which show some significant fraction of pasture areas, there is a high level of disagreement in the spatial distribution. In terms of general agreement, the seven compared mappings (including the new map) agree in only 6.6% of the study area, predominantly areas of forest and agriculture. Finally, the new classification proposed in this study provides better inputs for regional studies, especially for those involving hydrological modeling as well as offers a more refined LU/LC data set for atmospheric numerical models.
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| 5. |
- Simoes Cunha, Mafalda, et al.
(författare)
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Symptoms of anxiety and depression in patients with persistent asthma : a cross-sectional analysis of the INSPIRERS studies
- 2023
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Ingår i: BMJ Open. - : BMJ Publishing Group Ltd. - 2044-6055. ; 13:5
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Tidskriftsartikel (refereegranskat)abstract
- ObjectivesAnxiety and depression are relevant comorbidities in asthma, but, in Portugal and Spain, data on this topic are scarce. We assessed, in patients with asthma, the frequency of anxiety and depression using the Hospital Anxiety and Depression Scale (HADS) and the European Quality of Life Five Dimension Questionnaire (EQ-5D); the level of agreement between these questionnaires, and the factors associated with these symptoms.MethodsThis is a secondary analysis of the INSPIRERS studies. A total of 614 adolescents and adults with persistent asthma (32.6 +/- 16.9 years, 64.7% female) were recruited from 30 primary care centres and 32 allergy, pulmonology and paediatric clinics. Demographic and clinical characteristics, HADS and EQ-5D were collected. A score >= 8 on Hospital Anxiety and Depression Scale-Anxiety/Hospital Anxiety and Depression Scale-Depression or a positive answer to EQ-5D item 5 indicated the presence of these symptoms. Agreement was determined by Cohen's kappa. Two multivariable logistic regressions were built.ResultsAccording to HADS, 36% of the participants had symptoms of anxiety and 12% of depression. According to EQ-5D, 36% of the participants had anxiety/depression. The agreement between questionnaires in identifying anxiety/depression was moderate (k=0.55, 95% CI 0.48 to 0.62). Late asthma diagnosis, comorbidities and female gender were predictors of anxiety/depression, while better asthma control, health-related quality of life and perception of health were associated with lower odds for anxiety/depression.ConclusionAt least 1/3 of the patients with persistent asthma experience symptoms of anxiety/depression, showing the relevance of screening these disorders in patients with asthma. EQ-5D and HADS questionnaires showed a moderate agreement in the identification of anxiety/depression symptoms. The identified associated factors need to be further investigated in long-term studies.
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| 6. |
- Wimmer, Daniela, et al.
(författare)
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Ground-based observation of clusters and nucleation-mode particles in the Amazon
- 2018
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Ingår i: Atmospheric Chemistry And Physics. - : Copernicus GmbH. - 1680-7316 .- 1680-7324. ; 18:17, s. 13245-13264
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Tidskriftsartikel (refereegranskat)abstract
- We investigated atmospheric new particle formation (NPF) in the Amazon rainforest using direct measurement methods. To our knowledge this is the first direct observation of NPF events in the Amazon region. However, previous observations elsewhere in Brazil showed the occurrence of nucleation-mode particles. Our measurements covered two field sites and both the wet and dry season. We measured the variability of air ion concentrations (0.8-12 nm) with an ion spectrometer between September 2011 and January 2014 at a rainforest site (T0t). Between February and October 2014, the same measurements were performed at a grassland pasture site (T3) as part of the GoAmazon 2014/5 experiment, with two intensive operating periods (IOP1 and IOP2 during the wet and the dry season, respectively). The GoAmazon 2014/5 experiment was designed to study the influence of anthropogenic emissions on the changing climate in the Amazon region. The experiment included basic aerosol and trace gas measurements at the ground, remote sensing instrumentation, and two aircraft-based measurements. The results presented in this work are from measurements performed at ground level at both sites. The site inside the rainforest (T0t) is located 60 km NNW of Manaus and influenced by pollution about once per week. The pasture (T3) site is located 70 km downwind from Manaus and influenced by the Manaus pollution plume typically once per day or every second day, especially in the afternoon. No NPF events were observed inside the rainforest (site T0t) at ground level during the measurement period. However, rain-induced ion and particle bursts (hereafter, rain events) occurred frequently (643 of 1031 days) at both sites during the wet and dry season, being most frequent during the wet season. During the rain events, the ion concentrations in three size ranges (0.8-2, 2-4, and 4-12 nm) increased up to about 10(4)-10(5) cm(-3). This effect was most pronounced in the intermediate and large size ranges, for which the background ion concentrations were about 10-15 cm(-3) compared with 700 cm(-3) for the cluster ion background. We observed eight NPF events at the pasture site during the wet season. We calculated the growth rates and formation rates of neutral particles and ions for the size ranges 2-3 and 3-7 nm using the ion spectrometer data. The observed median growth rates were 0.8 and 1.6 nm h(-1) for 2-3 nm sized ions and particles, respectively, with larger growth rates (13.3 and 7.9 nm h(-1)) in the 3-7 nm size range. The measured nucleation rates were of the order of 0.2 cm(-3) s(-1) for particles and 4-9 x 10(-3) cm(-3) s(-1) for ions. There was no clear difference in the sulfuric acid concentrations between the NPF event days and nonevent days (similar to 9 x 10(5) cm(-3)). The two major differences between the NPF days and nonevent days were a factor of 1.8 lower condensation sink on NPF event days (1.8 x 10(-3) s(-1)) compared to nonevents (3.2 x 10(-3) s(-1)) and different air mass origins. To our knowledge, this is the first time that results from ground-based sub-3 nm aerosol particle measurements have been obtained from the Amazon rainforest.
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| 7. |
- Xavier, Ana Carolina Freitas, et al.
(författare)
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Stationary and non-stationary detection of extreme precipitation events and trends of average precipitation from 1980 to 2010 in the Paraná River basin, Brazil
- 2020
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Ingår i: International Journal of Climatology. - : Wiley. - 0899-8418 .- 1097-0088. ; 40:2, s. 1197-1212
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Tidskriftsartikel (refereegranskat)abstract
- The main objective of this study was to investigate the trends on average and extreme events in time series of daily precipitation from 1980 to 2010 in the Paraná River basin, Brazil. The nonparametric Mann–Kendall test was applied to detect monotonic trend in the precipitation series. The occurrence of extreme values was analysed based on three generalized extreme values (GEV) models: Model 1 (stationary), Model 2 (non-stationary for location parameter), and Model 3 (non-stationary for location and scale parameters). The GEV parameters were estimated by the Generalized Maximum Likelihood method (GMLE) and for the non-stationary models, the parameters were estimated as linear functions of time. To choose the most suitable model, the maximum likelihood ratio test (D) was used. From the results observed at the monthly scale, it was possible to infer that the months with the highest probability of an extreme weather event occurrence are February (climates Aw and Cfa), July (Cfa and Cfb), and October (Aw, Cfa, and Cfb). Approximately 90% of the 1,112 stations presented no trend regarding the GEV parameters. The non-stationarity showed by other stations (Models 2 and 3) might be associated with several factors, such as the alteration of land use due to the north expansion of the agricultural border of the Paraná River basin.
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