Submitted by CIBELE TAÍS PUATO DE ALMEIDA null (ctpdalmeida@alunos.fmb.unesp.br) on 2016-04-01T18:34:01Z No. of bitstreams: 1 Tese Cibele Tais Puato de Almeida.pdf: 839793 bytes, checksum: 01a41de5a6976ff81d2d379acd327e1f (MD5) / Approved for entry into archive by Ana Paula Grisoto (grisotoana@reitoria.unesp.br) on 2016-04-05T18:47:49Z (GMT) No. of bitstreams: 1 almeida_ctp_dr_bot.pdf: 839793 bytes, checksum: 01a41de5a6976ff81d2d379acd327e1f (MD5) / Made available in DSpace on 2016-04-05T18:47:49Z (GMT). No. of bitstreams: 1 almeida_ctp_dr_bot.pdf: 839793 bytes, checksum: 01a41de5a6976ff81d2d379acd327e1f (MD5) Previous issue date: 2016-02-26 / Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES) / A Diálise Peritoneal Contínua (DPC) e a Hemodiálise (HD) diária são opções para o tratamento de pacientes com Lesão Renal Aguda (LRA). A DPC pode causar alterações na função respiratória principalmente relacionadas ao aumento da Pressão Intra-Abdominal (PIA) e a HD pode levar a hipoxemia pelo contato do sangue com o circuito extracorpóreo e pela disfusão do CO2 no dialisato. No entanto, ambos os métodos podem melhorar a mecânica respiratória e a oxigenação pela retirada de líquidos e consequentemente redução do edema pulmonar. O objetivo principal deste estudo foi comparar os efeitos da DPC e da HD diária na mecânica ventilatória e oxigenação de pacientes com LRA sob Ventilação Mecânica Invasiva (VMI). Metodologia: Estudo tipo coorte prospectivo que avaliou 154 pacientes, sendo 37 em DPC e 94 em HD. Foram avaliados, por até 3 dias, os parâmetros de mecânica respiratória como Complacência Estática (Cest) e Resistência do Sistema Respiratório (Rsr) e também o Índice de Oxigenação (IO). Os pacientes foram avaliados nos momentos 1, 2 e 3 (pré-diálise) e 1, 2 e 3 (pós-diálise) em relação a Cest e Rsr e nos momentos 1, 2 e 3 em relação ao IO. Para comparação entre as características clínicas iniciais dos pacientes foram utilizados os testes t de student, qui-quadrado e exato de fisher. Para comparação das variáveis Cest, Rsr e IO no tempo foi utilizado o modelo Anova de medidas repetidas, seguido do teste de comparações múltiplas de Wald ou Tukey. Foi considerado um nível de significância de 5%. Resultados: Na comparação dos parâmetros clínicos iníciais entre os dois grupos, todas as características foram iguais, exceto a idade que foi maior entre aqueles em DPC (70,8±11,6 Vs 60±15,8 - p<0,0001). Nos dois grupos a Cest aumentou significativamente, sem difereça entre os grupos – Pré-Diálise (DPC: 40±17,4, 42,8±17,2,48±19; HD: 39,1±21,3, 39,5±18,9, 45,2±21) Pós-Diálise (DPC: 42,8±17,2, 48±19, 57,1±18,3; HD: 42±19, 45±18,5, 56±24,8). A Rsr permaneceu estável entre os pacientes em DPC (Pré-Diálise: 10,4±5,1, 13,3±7,7, 13,5±10,3; Pós-Diálise: 13,3±7,7, 13,5±10,3, 11,1±5,9) e diminuiu entre os pacientes em HD (Pré-Diálise: 10,4±5,1, 10,4±5,1, 10,4±5,1; Pós-Diálise: 10,5±6,8, 10±4,9, 8,9±4,2). Houve diferença estatística na Rsr entre os grupos, no pós-diálise 1 e 2 (p=0,03). O IO aumentou nos dois grupos (DPC: 260,7±119, 252,7±87,1, 287,3±88,4; HD: 228±85, 257±84, 312,1±111,5), sem diferença estatística entre eles. Conclusão: Os resultados obtidos no presente trabalho sugerem que pacientes com LRA, sob VMI, submetidos tanto a DPC quanto a HD Diária apresentam melhora da mecânica ventilatória e da oxigenação, sem diferença entre os grupos. / The Continuous Peritoneal Dialysis (CPD) and daily Hemodialysis (HD) are options for the treatment of Acute Kidney Injury (AKI) patients. The CPD can cause changes in respiratory function mainly related to increase Intra-Abdominal Pressure (IAP) and HD can lead to hypoxemia due to blood contact with the extracorporeal circuit and the diffusion of CO2 in the dialysate. However, both methods can improve respiratory mechanics and oxygenation due to the fluid removal and consequently reduced pulmonary edema. The aim of this study was to compare the effects of the CPD and daily HD on respiratory mechanics and oxygenation of AKI patients undergoing Invasive Mechanical Ventilation (IMV). Methodology: A prospective cohort study evaluated 154 patients, 37 on CPD and 94 on HD. The respiratory mechanics parameters such as Static Compliance (Cest) and Resistance of the Respiratory System (Rsr) and Oxygenation Index (OI) were assessed for three days. Patients were evaluated at moments 1, 2 and 3 (pre-dialysis) and 1, 2 and 3 (post-dialysis) in relation to Cest and Rsr and at times 1, 2 and 3 in relation to the IO. The student t test, chi-square and fisher exact were used to compare the baseline patients characteristics. ANOVA model for repeated measures was used to compare the variables Cest, Rsr and OI, followed by the multiple comparison Tukey or Wald Test. Significance level was 5%. Results: Comparing the initial clinical parameters between the two groups, all characteristics were similar except that the age that was higher among those on CPD (70.8 ± 11.6 vs 60 ± 15.8 - p <0.0001). In both groups, Cest increased significantly, with no difference between the two groups – Pre-Dialysis (CPD: 40 ± 17.4, 42.8 ± 17.2, 48 ± 19; HD: 39.1 ± 21.3, 39. 5 ± 18.9, 45.2 ± 21) Post-Dialysis (CPD: 42.8 ± 17.2, 48 ± 19, 57.1 ± 18.3; HD: 42 ± 19, 45 ± 18.5, 56 ± 24.8). The Rsr remained stable among patients on CPD (Pre-Dialysis: 10.4 ± 5.1, 13.3 ± 7.7, 13.5 ± 10.3, Post-Dialysis: 13.3 ± 7.7, 13.5 ± 10.3, 11.1 ± 5.9) and decreased among HD patients (Pre-Dialysis: 10.4 ± 5.1, 10.4 ± 5.1, 10.4 ± 5, 1, Post-Dialysis: 10.5 ± 6.8, 10 ± 4.9, 8.9 ± 4.2) There was significant statistically difference in Rsr between the two groups at the post-dialysis moments 1 and 2 (p = 0.03). OI increased in both groups (CPD: 260.7 ± 119, 252.7 ± 87.1, 287.3 ± 88.4; HD: 228 ± 85, 257 ± 84, 312.1 ± 111.5), although there was not significant statistically difference between them. Conclusion: This study showed that AKI patients undergoing IMV and daily HD or CPD had improvement in the mechanical ventilation and oxygenation, with no difference between the two groups.

Made available in DSpace on 2016-06-02T20:18:16Z (GMT). No. of bitstreams: 1 4019.pdf: 2106068 bytes, checksum: 932a130726834c5d08398e67e560bd4d (MD5) Previous issue date: 2011-12-02 / Universidade Federal de Sao Carlos / Objectives: To compare the metabolic demand ( O2/ O2peak), ventilatory demand ( E/MVV), dyspnea, fatigue on lower limbs (LL), oxygen peripheral saturation (SpO2) and functional capacity (number of climbs in step and work efficiency) at the peak of the six minutes step test (ST6) among patients with chronic obstructive pulmonary disease (COPD) stages II and III; Verify that there is relation of number of climbs in step with the first second forced expiratory volume (FEV1), BODE index, SpO2 and oxygen consumption ( O2) peak obtained in TD6, as well as with the distance walked in the six minutes walk test (6MWT) and in incremental symptom-limited cardiopulmonary test (CPT). Methods: Were evaluated 19 patients with stage II of COPD (50% &#61603; forced expiratory volume in one second (FEV1) &#61500;80%), composing the Group 1 (G1) and 16 with stage III of COPD (30% &#61603; FEV1 &#61500; 50%), constituting the Group 2 (G2) through ST6, 6MWT and CPT. Results: Were observed values significantly greater than dyspnea obtained at the peak of ST6 for G2, as well as significantly lower values of SpO2 at the peak of this test to the same group, as well as the number of climbs in step and distance walked in 6MWT and CPT. The number of climbs in step showed positive correlation with the SpO2 for G2, with r = 0.85. Conclusion: The patients with COPD stage III provided greater perception of dyspnea and desaturation in the ST6. In addition the same demonstrated reduced functional capacity when compared to patients with COPD stage II. And with relationship of number of climbs in ST6 with several variables, noted strong correlation with the SpO2 for patients with COPD stage III. / Objetivos: Comparar a demanda metabólica ( O2/ O2pico), demanda ventilatória ( E/VVM), dispnéia, fadiga nos membros inferiores (MMII), saturação periférica de oxigênio (SpO2) e capacidade funcional (número de subidas no degrau e eficiência de trabalho) no pico do teste do degrau de seis minutos (TD6) entre os pacientes com doença pulmonar obstrutiva crônica (DPOC) estádios II e III; verificar se há relação do número de subidas no degrau com o índice BODE, volume expiratório forçado no primeiro segundo (VEF1), SpO2 e consumo de oxigênio ( O2) pico obtidos no TD6, bem como com a distância percorrida no teste de caminhada de seis minutos (TC6) e no teste cardiopulmonar incremental limitado por sintomas (TCP). Métodos: Foram avaliados 19 pacientes com DPOC estádio II, compondo o Grupo II (G1) e 16 com DPOC estádio III, constituindo o Grupo III (G2) por meio do TD6, TC6 e TCP. Resultados: Observou-se valores significativamente maiores de dispnéia obtida no pico do TD6 para o G2, assim como valores significativamente menores de SpO2 no pico deste teste para o mesmo grupo, bem como do número de subidas no degrau e da distância percorrida no TC6 e no TCP. O número de subidas no degrau mostrou correlação positiva com a SpO2 para o G2, com r= 0,85. Conclusão: Os pacientes com DPOC estádio III apresentaram maior percepção de dispnéia e dessaturação ao executarem o TD6. Cabe também ressaltar que os mesmos demonstraram reduzida capacidade funcional quando comparados aos pacientes com DPOC estádio II. E quanto à relação do número de subidas no TD6 com diversas variáveis, observou-se correlação forte com a SpO2 para os pacientes com DPOC estádio III.

INTRODUÇÃO: A ventilação não invasiva (VNI) tem sido amplamente utilizada na prática clínica para o tratamento de insuficiência respiratória aguda (IRpA) e crônica. OBJETIVO: Observar longitudinalmente a rotina da utilização da VNI e estimar o seu impacto sobre os desfechos dos pacientes internados em UTI. METODOS: Estudo de coorte prospectivo de pacientes admitidos consecutivamente em 10 UTIs de um grande hospital público universitário. Durante 9 meses, foram estudados todos os pacientes com idade >= 18 anos, submetidos a VNI durante a permanência na UTI. RESULTADOS: Um total de 392 pacientes foram incluídos. A média (DP) de idade foi 56 (19) anos e 55% eram do sexo masculino. A média (DP) escore SAPS II foi de 36 (14). As indicações de VNI foram: pós-extubação (44%), IRpA (27%), fisioterapia respiratória(18%). A média do IPAP e do EPAP no último dia da VNI foi de 14 cmH2O e 8,8 cmH2O, respectivamente. A máscara facial foi utilizada em 93% dos casos e a máscara facial total em apenas 6%. A incidência de pneumonia foi de 5%. No desfecho do estudo, foi observado falência da VNI em 35% dos casos, taxa de mortalidade em 25% e o tempo de internação na UTI com uma mediana de 10 dias. CONCLUSÕES: A VNI pode ser bem sucedida se usada em pacientes selecionados. Muitos fatores foram associadas ao fracasso NIV: idade, SAPS II, IPAP, EPAP e valores FiO2 no último dia da VNI e presença de tosse e da necessidade de aspiração traqueal. A taxa de mortalidade e tempo de UTI foi maior no grupo que fracassou na VNI. / CONTEXT: Noninvasive ventilation (NIV) has been widely used in clinical practice in order to treat acute or chronic respiratory failure. OBJECTIVE: To observe the routine use of NIV and estimate the outcomes of this population. METHODS: A prospective cohort study of consecutively admitted patients in 10 ICUs of a large public university affiliated hospital. Over a 9 months period, we studied all patients with age >= 18 years, submitted to NIV during ICU stay. RESULTS: A total of 392 patients were included in this study. The mean (SD) age was 56(19) years, and 55% were males. The mean (SD) SAPS II Score was 36 (14). NIV indications were: post extubation (44%), acute respiratory failure (ARF)(27%), and chest physiotherapy (18%). The mean IPAP and EPAP at the last day of NIV was 14 cmH2O and 8.8 cmH2O respectively. The full face mask was used in 93% of cases, only 6% used total face mask. The incidence of pneumonia was 5%. The NIV failure rate was 35%, ICU mortality rate 25% and the median ICU stay 10 days. CONCLUSIONS: NIV can be successful in selected patients. Many factors were associated to NIV failure: age, and SAPS II, IPAP, EPAP and FiO2 values at the last day of NIV and presence of cough and the need for tracheal aspiration. Mortality rate and ICU length of stay were higher in NIV failure group.

O fungo Aspergillus fumigatus é o segundo maior causador de infecções fúngicas invasivas em pacientes imunocomprometidos e a principal espécie causadora da aspergilose invasiva, doença de alta taxa de mortalidade que atinge principalmente os pulmões e que pode se disseminar pelo organismo. Durante o processo de infecção, o fungo precisa adaptar-se ao organismo do hospedeiro e um dos obstáculos encontrados é a mudança na concentração de dióxido de carbono (CO2), que, de 0,033% no ambiente, chega a até 6% no interior do hospedeiro. As anidrases carbônicas são enzimas envolvidas na hidratação reversível do CO2 e já foram apontadas como importantes na virulência de patógenos como Plasmodium falciparum, Mycobacterium tuberculosis, Helicobacter pylori, Cryptococcus neoformans e Candida albicans. Esse trabalho teve como objetivo avaliar o papel da enzima anidrase carbônica no desenvolvimento e virulência do fungo A. fumigatus, que apresenta quatro homólogos desta enzima (cafA, cafB, cafC e cafD). Para isso, foram utilizadas linhagens de A. fumigatus com os homólogos da enzima deletados (?cafA, ?cafB, ?cafC, ?cafD e ?cafA?cafB) e a linhagem selvagem (?akuBku80), da qual foram originadas as mutantes. Foram realizadas avaliações fenotípicas da estrutura dos conidióforos das diferentes linhagens, determinação da sensibilidade frente a diferentes agentes estressantes (antifúngicos, promotores de apoptose, estresse iônico, nitroativo, oxidativo, e de parede celular) e determinação da expressão gênica global em diferentes concentrações de CO2. Foi verificado que a deleção de cada um dos homólogos da anidrase carbônica de A. fumigatus não interfere na estrutura dos conidióforos deste fungo. Por outro lado, a deleção induziu alteração da sensibilidade do fungo frente a alguns compostos estressantes (ácido acético e peróxido de hidrogênio). Ainda, a análise da expressão gênica revelou um gene envolvido na adaptação do fungo ao aumento da concentração de CO2, o gene cipC, que não apresenta homólogos nas células de mamíferos. Este gene foi caracterizado neste trabalho por meio de sua deleção na linhagem selvagem (?akuBku80) de A. fumigatus e avaliação fenotípica microscópica e de sensibilidade a agentes estressantes (antifúngicos, promotores de apoptose, estresse iônico, nitroativo, oxidativo, e de parede celular). A deleção do gene não interferiu na estrutura do fungo, porém aumentou sua sensibilidade a alguns compostos (calcoflúor e menadiona). Foram realizados, ainda, testes de virulência em modelo animal utilizando-se o mutante ?cipC, os quais revelaram que a deleção deste gene atenua a virulência do fungo. Assim, foi possível concluir que as anidrases carbônicas não são relevantes para o desenvolvimento e virulência de A. fumigatus; porém, este fungo modifica a expressão de seus genes de modo a adaptar-se às variações na concentração atmosférica de CO2. O gene cipC está envolvido nesse processo de adaptação e é importante para o desenvolvimento do fungo e sua virulência, tornando-se um alvo para o estudo de novas terapias para o tratamento da aspergilose invasiva. / The fungus Aspergillus fumigatus is the second cause of fungal infections in immunocompromised patients and it is the main specie which causes invasive aspergillosis, a disease with high mortality rate that mainly affects the lungs and it can spread through the body. During the infectious process, the fungus must adapt to the host and one of the obstacles is the drastic change of the carbon dioxide (CO2) concentration, which is 0.033% in the environment and until 6% inside the host. The carbonic anhydrases are enzymes which are involved in the reversible hydration of carbon dioxide and they have been pointed as important in the virulence of pathogens such as Plasmodium falciparum, Mycobacterium tuberculosis, Helicobacter pylori, Cryptococcus neoformans and Candida albicans. This work aimed to evaluate the role of the enzyme carbonic anhydrase in the development and virulence of the fungus A. fumigatus, which has four homologues of this enzyme (cafA, cafB, cafC e cafD). Therefore, strains, which have the homologues of the enzyme deleted (?cafA, ?cafB, ?cafC, ?cafD and ?cafA?cafB) were used in parallel with the wild strain (?akuBku80), which originated the mutant ones. We did structure phenotypic evaluations of the different strains of conidiophores, sensibility determination against different stressors (antifungal agents, apoptosis, ionic, nitrosative, oxidative, and cell wall stress promoters) and global gene expression determination at different carbon dioxide concentrations. It was verified that the carbonic anhydrases homologues deletion of A. fumigatus did not interfere on the n structure (conidiophore) of this fungus, in the tested conditions. On the other hand, the deletion caused a change in sensibility of the fungus against some stressors (acetic acid and hydrogen peroxide). The gene expression experiments showed a gene involved in the adaptation to the increase of CO2 concentration, the cipC gene. This gene does not have homologues in the mammalian cells. The cipC gene was characterized in this work by its deletion in the A. fumigatus wild strain (?akuBku80) and microscopic phenotypic evaluation and sensibility tests against stressors (antifungal agents, apoptosis, ionic, nitrosative, oxidative, and cell wall stress promoters). The gene deletion did not interfere on the fungus conidiophore structure but increase its sensibility to some compounds (calcoflúor white and menadione). Virulence tests in animal model using the ?cipC mutant were done and they showed that the deletion of this gene attenuates the fungus virulence. In conclusion, the carbonic anhydrases are not relevant to development and virulence of the fungus, which modifies the gene expression to adapt to the variations of atmospheric CO2 concentration. Besides, the cipC gene seems to be involved in this adaptation process. Moreover, the cipC gene showed to be important to the development of the fungus and its virulence, which makes the gene a target for the study of new therapies for the treatment of invasive aspergillosis.

Invasiva främmande arter är ett av de största hoten mot biologisk mångfald samt att de medför stora ekonomiska kostnader. Kommunerna spelar en viktig roll gällande tillsyn och bekämpning av invasiva främmande arter då de ofta är fastighetsägare och ansvarar för stora arealer. Med ett varmare klimat kan många arter som varit ett problem i varmare länder och i södra delarna av Sverige bli ett problem även på nordligare breddgrader. Det kan därför vara viktigt att kommunerna har ett väl fungerande arbete med etablerade arter och en beredskapsplan mot de arter som kan komma att bli ett problem i framtiden.  Syftet med denna studie var att identifiera vilka invasiva främmande arter som förekom i Värmlands län, samt vilka potentiella problemarter som skulle kunna etablera sig med ett förändrat klimat. Studiens avsikt var även att undersöka kommunernas arbete med de invasiva främmande arter som var etablerade på kommunal mark samt identifiera hinder för agerande mot dessa. För kartläggning av artförekomst i Värmland användes data från SLU ArtDatabankens Artportal. För att undersöka vilka arter som kunde bli ett problem i Värmland med ett varmare klimat användes också Artportalen för att identifiera artförekomst i de södra delarna av Sverige (Skåne). Data mellan åren 2016–2021 analyserades och visualiserades i kartor. Värmlands arbete med arterna undersöktes genom en semistrukturerad intervju med naturvårdshandläggare på länsstyrelsen samt att enkäter sändes ut till samtliga kommuner.   Resultatet visade att av de arter som var med på EU:s förordning fanns förekomster av sex arter i Värmland. Utöver arterna på förordningen fanns andra problemarter som även dessa räknades som invasiva. Enligt data i artportalen hade Skåne, som historiskt sett haft en varmare medeltemperatur, en större förekomst av invasiva arter. Ett varmare klimat skulle kunna gynna etablering av dessa arter även i Värmland, dessutom skulle spridningsintervallen på redan etablerade arter kunna öka.  Merparten av kommunerna hade dock inget förebyggande arbete mot potentiella problemarter. Undersökningen gav intrycket att arbetet är på uppgång men att det fortfarande fanns en utvecklingspotential. Det fanns ett behov för samverkan mellan kommunerna och tydligare och frekvent information till allmänheten. Det fanns även ett behov för fler resurser. / Invasive alien species are one of the biggest threats to biodiversity and they entail large economic costs. Since 2015, there is an EU regulation on the prevention and management of the introduction and spread of invasive alien species. The municipalities' work has a central role in the control of invasive species as they are often property owners and responsible for large areas. With a warmer climate, many species that have been a problem in warmer countries and in the southern parts of Sweden can become a problem even in more northern latitudes. It may therefore be important that the municipalities have a well-functioning work with established species and a contingency plan against the species that may become a problem in the future. The purpose of this study was to identify which invasive alien species occurred in Värmland County and which potential problem species that could establish with a changing climate. The purpose of the study was also to examine the municipalities' work with the invasive alien species that were established and to identify obstacles to action against them. Data from SLU ArtDatabanken's Art Portal were used to map species occurrence in Värmland. To investigate which species could be a problem with a warmer climate, the Species Portal was also used to identify species occurrences in the southern parts of Sweden (Skåne). Data between the years 2016–2021 were analyzed and visualized in maps. Värmland's work with the species was investigated through a semi-structured interview with nature conservation officers at the County Administrative Board and questionnaires were sent out to all municipalities. The results showed that of the species that were included in the EU regulation, there were occurrences of six species. In addition to the species in the regulation, there were other problem species that were also considered invasive. According to data in the species portal, Skåne, which had a warmer average temperature, had a greater incidence of invasive species. A warmer climate could favour the establishment of these species also in Värmland. Most of the municipalities, however, had no preventive work against potential problem species. The survey gave the impression that the work has started but that there was still a development potential. There was a need for collaboration between the municipalities and more frequent information to the public. There was also a need for more resources.

Parkslide är en främmande invasiv växt som ohämmat sprider sig på bekostnad av närliggande vegetation och den biologiska mångfalden. Genom att undersöka möjligheten att ta vara på Parkslides egenskaper och skapa någonting användbart för vårt samhälle, utan negativ påverkan på människa, djur och framtid, så kan det i sin tur skapa en möjlighet för en hållbar utveckling. Ett annat sätt att se på befintligt råmaterial, som en del i en cirkulär ekonomi. Rapporten diskuterar resurs och värde med intention att minska användandet av nya material och byta ut dessa till mer hållbara lösningar.Genom faktainsamling och en materialdriven designprocess utforskas Parkslide som material, vilket resulterar i materialprover som öppnar upp möjligheterna för framtida marknader. / Japanese knotweed is an Invasive Alien plant that is widely spread, at the expense of nearby vegetation, which has a negative impact on the biodiversity. By examining the possibilities to use Japanese Knotweed and its characteristics, as something valuable and useful, it can result in opportunities for a sustainable development in the society. We can change the way we view the plant and possibly make it a part of a circular economy. This work will discuss resource and value with the intention to reduce the use of new materials and switch those to a more sustainable solution.Through literature studies, interviews, survey and a Material Driven Design process I will explore Japanese Knotweed as a material, which results in material samples and discussion. This opens up the possibilities for future markets.

Biodiversity is the prerequisite for well-functioning ecosystem services that are crucial, like clean water and clean air. Invasive alien species (IAS) are a serious and long-term issue that is actively threatening the genetic diversity within ecosystems. In Sweden, 20 percent of 2000 alien species is estimated to be invasive or potentially invasive. One of the species that is assessed to be an IAS is garden lupine (Lupinus polyphyllus), which today is widely spread over big parts of Europe and it is established and reproducing in Sweden. The aim of the study was to find out wether the occurence of garden lupine in Jämtland (last 30 years) has an association with a certain type of land cover and soil moisture, and wether reported findings have increased over the years. This analysis was carried out by first statistically testing the association between the number of lupine observations and the reporting year. After that, a 5m-radius buffer was created around the reported species observations, to then compare the area of each class from National Land Cover Database (NMD) and SLU Soil Moisture Map within the buffer against the total area for each class within Jämtland County. The results of the study showed that the occurence of garden lupine can be associated with the type of land cover and soil moisture that is found on the place of occurence, and that the reports of occurence has increased over the years. The area of the land cover classes within the buffer was not proportional to the total area of those classes in Jämtland County. Lupine occured most commonly within land cover classes exploited land (50%; mainly "exploited land road/railway"), forest (30%), and other open land (20%). As for soil moisture, the garden lupine was only observed within two classes, and the area for these classes within the buffer was not proportional to the area of the same classes in Jämtland County. The soil moisture class with the highest percentage of reported occurence was the class "mesic-dry". These results are in agreeance with the literature describing nonnative habitats for garden lupine, however they do not reflect the facultative status it has received in native habitats. The spread of garden lupine can in other words be linked to the land cover and soil moisture that is found in the place of occurence. Future efforts that are needed are continous monitoring of garden lupine, harmonization of data through standardized inventory methods and validation of data. / Biologisk mångfald är förutsättningen för att avgörande ekosystemtjänster som rent vatten och ren luft ska fungera väl. Invasiva främmande arter (IAS) är ett allvarligt och långsiktigt problem som aktivt hotar den genetiska variationen inom ekosystem. I Sverige bedöms 20 procent av de 2000 främmande arterna vara invasiva eller potentiellt invasiva. En av de arter som klassas som IAS är blomsterlupin (Lupinus polyphyllus), vilken idag är vitt sprid över stora delar av Europa samt är bofast och reproducerande i Sverige. Syftet med studien var att ta reda på huruvida förekomst av blomsterlupin i Jämtland över 30 år har ett samband med viss typ av marktäcke och markfuktighet, samt om inrapporterade fynd har ökat med åren. Denna analys genomfördes genom att först statistiskt testa sambandet mellan inrapporteringar och rapporteringstillfälle. Därefter konstruerades en buffert med en radie på 5 meter runt inrapporterade artobservationer, för att sedan jämföra arean av respektive klass från Nationell Marktäckedata (NMD) och SLU Markfuktighetskarta inom bufferten mot den totala arean av respektive klass i hela Jämtland. Studiens resultat visade att blomsterlupinens förekomst kan associeras med vilken typ av marktäcke och markfuktighet som finns på platsen, samt att inrapporteringen av arten har ökat över åren. Arean av markatäckeklasserna inom bufferten för artobservation var inte proportionell mot den totala arean av respektive markatäckeklass i Jämtlands län. Lupin förekom vanligast inom marktäckeklasser exploaterad mark (50%; framförallt ”exploaterad mark väg/järnväg”), skog (30%) och övrig öppen mark (20%). Vad gäller markfuktighet så observerades endast blomsterlupin på två klasser, och arean för dessa klasser inom bufferten var inte proportionell mot arean för samma klasser i Jämtlands län. Markfuktighetsklassen som hade störst procentuell andel av inrapporterade fynd var klassen ”torr-frisk”. Dessa resultat överensstämmer med litteraturen som beskriver icke inhemska habitat, däremot reflekterar inte dessa resultat den fakultativa statusen som blomsterlupin har fått i dess inhemska habitat. Mina resultat visar att blomsterlupinens utbredning kan kopplas till den marktäcke och markfuktighet som finns på fyndplatsen. Framtida insatser som behövs är fortsatt övervakning av blomsterlupin, harmonisering av data genom standardiserade inventeringsmetoder och validering av data.

[ES] La fibrilación auricular (FA) es una de las arritmias más comunes en la práctica clínica cuyos mecanismos, hasta ahora, no han sido comprendidos en su totalidad. El estudio de dichos mecanismos mediante el estudio de la información clínica, la metodología de estudios computacionales y los algoritmos de inteligencia artificial (IA) que permiten la identificación de nuevos patrones para la personalización de los tratamientos es clave para desvelar las características de la arritmia. Actualmente, el tratamiento de preferencia para los pacientes con FA que ha presentado mayores ratios de efectividad ha sido la ablación cardiaca. Este procedimiento invasivo utiliza un catéter para ablacionar o quemar el área del tejido cardiaco que es responsable del mantenimiento de la arritmia. Para poder identificar dicha área, es indispensable realizar un estudio electrofisiológico para evaluar las señales eléctricas intracavitarias. En el campo de las simulaciones por ordenador, varios estudios han presentado abordajes personalizados que intentan establecer una plataforma complementaria para la planificación de la ablación. En este ámbito, la electrocardiografía por imagen se ha utilizado para la estratificación y caracterización previa de pacientes antes del procedimiento de ablación. Finalmente, los estudios observacionales clínicos permiten la caracterización de la población de FA, ayudando a recoger, no solo datos electrofisiológicos, sino también biomarcadores clínicos directamente relacionados con la prognosis del paciente. Dada toda la información producida durante este tipo de estudios, la IA se ha introducido paulatinamente en este tipo de estudios con el objetivo de identificar patrones o biomarcadores que permitan caracterizar a estos pacientes incluyendo toda la información recogida. Además, los algoritmos de predicción, que permiten estimar el éxito del tratamiento y la prognosis del paciente, han sido desarrollados. Debido a todas estas razones, estos campos han sido estudiados durante el desarrollo de este trabajo. En primer lugar, se realizaron simulaciones por ordenador utilizan-do una población de modelos que permitía evaluar la inducibilidad y mantenimiento de la arritmia en diferentes escenarios. Teniendo en cuenta la gran cantidad de datos derivados de las simulaciones, que incluían la variabilidad introducida en la población y diferentes fármacos, se implementaron algoritmos de IA que extrajeron patrones de los perfiles más proarrítmicos. En segundo lugar, se realizaron simulaciones personalizadas en una cohorte de pacientes, incluyendo las anatomías de las aurículas y considerando diferentes escenarios arrítmicos. Estos experimentos se realizaron con una carga computacional menor comparado con otros estudios y permitieron identificar un biomarcador obtenido de dichos datos que caracterizaba la actividad en la zona de las venas pulmonares y la comparaba con la evolución del paciente 12 meses tras el procedimiento de ablación. Finalmente, se analizó el estudio observacional STRATIFY-AF utilizando la información obtenida del ECGi y combinándola con datos clínicos. Como resultado, se obtuvo un score electrofisiológico que per-mite predecir el tratamiento más exitoso para cada paciente. Los resultados presentados en esta tesis ilustran un claro ejemplo de combinación de diferentes tecnologías, como las simulaciones in silico, con datos clínicos y algoritmos de IA, que pueden ser de gran utilidad para investigar los mecanismos de la arritmia cardiaca. / [CA] La fibril·lació auricular (FA) és una de les arítmies més comunes. En la pràctica clínica els mecanismes de la qual, fins ara, no han sigut compresos en la seua totalitat. L'estudi dels dits mecanismes per mitjà de l'estudi de la informació clínica, la metodologia d'estudis computacionals i els algoritmes d'intel·ligència artificial (IA) que permeten la identificació de nous patrons per a la personalització dels tractaments és clau per a desvelar les característiques de l'arítmia. Actualment, el tractament de preferència per als pacients amb FA que ha presentat majors ràtios d'efectivitat ha sigut l'ablació cardíaca. Este procediment invasiu utilitza un catèter per a ablacionar o cremar l'àrea del teixit cardíac que és responsable del manteniment de l'arítmia. Per a poder identificar la dita àrea, és indispensable realitzar un estudi electrofisiologia per a avaluar els senyals elèctrics intracavitarias. En el camp de les simulacions per ordinador, diversos estudis han presentat abordatges personalitzats que intenten establir una plataforma complementària per a la planificació de l'ablació. En este àmbit, l'electrocardiografia per imatge s'ha utilitzat per a l'estratificació i caracterització prèvia de pacients abans del procediment d'ablació. Finalment, els estudis observacionals clínics permeten la caracterització de la població de FA, ajudant a arreplegar, no sols dades electrofisiològiques, sinó també biomarcadores clínics directament relacionats amb la prognosi del pacient. Donada tota la informació produïda durant este tipus d'estudis, la IA s'ha introduït gradualment en este tipus d'estudis amb l'objectiu d'identificar patrons o biomarcadores que permeten caracteritzar estos pacients incloent tota la informació arreplegada. A més, els algoritmes de predicció, que permeten estimar l'èxit del tractament i la prognosi del pacient, han sigut desenrotllats. A causa de totes estes raons, estos camps han sigut estudiats durant el desenrotllament d'este treball. En primer lloc, es van utilitzar simulacions per ordinador utilitzant una població de models que permetia avaluar la inducibilidad i manteniment de l'arítmia en diferents escenaris. Donada la variabilitat introduïda en la població, en combinació amb diferents fàrmacs, els algoritmes d'IA es van utilitzar per a extraure patrons que identificaven els perfils més proarítmics. En segon lloc, es van realitzar simulacions personalitzades en una cohort de pacients, incloent les anatomies de les aurícules i considerant diferents escenaris arítmics. Estos experiments es van realitzar amb una càrrega computacional menor comparat amb altres estudis i van permetre identificar un biomarcador obtingut de les dits dades que caracteritzava l'activitat en la zona de les venes pulmonars i la comparava amb l'evolució del pacient 12 mesos després del procediment d'ablació. Finalment, l'estudi observacional STRATIFY-AF es va analitzar utilitzant la informació obtinguda de l'ECGi i combinant-la amb dades clíniques. Com resultat, es va obtindre un score electrofisiològic que permet predir el tractament més reeixit per a cada pacient. Els resultats presentats en esta tesi il·lustren, per tant, que la combinació de les tecnologies in silico, junt amb les dades clíniques i el processament de dades disponibles gràcies als algoritmes d'IA poden ser de gran utilitzar per a investigar els mecanismes de l'arítmia cardíaca. / [EN] Atrial Fibrillation (AF) is one of the most common arrhythmias in clinical practice and thus far, the electrophysiological mechanisms underlying its initiation and maintenance are not fully understood. The study of such mechanism including clinical information, computational models and artificial intelligence (AI) algorithms that enable the identification of new patterns for the personalization of the treatments is key to unveil the characteristics of the arrhythmia. At the present, the treatment of choice for AF patients with higher effectiveness has proved to be cardiac ablation. This invasive procedure uses a catheter to ablate or burn the area of the cardiac tissue that is responsible for the maintenance of the arrhythmia. In order to find this specific area, it is indispensable to perform an electrophysiological study to evaluate the intracavitary electrical signals. In the computational field, several studies have presented personalized approaches that aim to stablish a complimentary platform for ablation planning. In this area, electrocardiographic imaging has also been used for the stratification and prior characterization of patients before the ablation procedure. Finally, observational studies enable the characterization of the AF population, enabling to collect, not only electrophysiological data but clinical biomarkers that can be related with the prognosis of the patients. Due to all the information produced during this type of studies, AI has been recently incorporated into these studies, with the main objective of identifying patterns or biomarkers that are able to characterize these patients including all the collected information. In addition, prediction algorithms, that allow to estimate the success of the treatment and prognosis of the patient have also been developed. For this purpose, these three fields of study were explored in this thesis. First, computational simulations using a population of models were performed to evaluate arrhythmia inducibility and maintenance under different scenarios. Due to the variability introduced in the population of models in combination with different drugs, AI algorithms were applied to extract patterns that identified the most proarrhythmic profiles. Secondly, personalized simulations were performed in a cohort of patients including their anatomical cardiac geometries and considering different arrhythmic scenarios. These experiments were achieved with a lowered computational costs and included the identification of a biomarker extracted from the simulation analysis that characterized the activity in the pulmonary vein area and evaluating it with the 12-month ablation outcome. Finally, the STRATIFY-AF observational study was analyzed, using the ECGi information from the patients combined with clinical infor-mation. As a results, a stratification score was obtained to predict the most successful treatment for each of the patients. The results presented in this thesis illustrate that the combination of in silico technologies with clinical data and processing algorithms can be of great utility to further investigate the arrhythmic mechanisms. / Sánchez De La Nava, AM. (2022). Definition of a Sensitivity Profile for Drug Treatment and Identification on Clinical Biomarkers in Atrial Fibrillation [Tesis doctoral]. Universitat Politècnica de València. https://doi.org/10.4995/Thesis/10251/184778

Many municipalities around Sweden use public access spatial data from Artportalen to track and fight invasive species, but anyone can upload data to Artportalen and not all of it becomes verified. They could potentially enhance their efforts by incorporating street view technology for more reliable data. One municipality that uses Artportalen data is Jönköping, which suffers from Reynoutria japonica. I randomly selected 50 areas around Jönköping with reports of R. japonica and went through them using Street View. The purpose of this study is to test if Street View can be used to improve the reliability of Artportalen data and if it can fully replace other methods to do so. I counted each individual of R. japonica I could identify and compared it to the number of reports in each area. Among the 50 areas only 26 were reachable in Google Street View and some plants were impossible to identify if they were R. japonica or not. When looking at the areas that could be reached it showed no difference between Reports in Artportalen and what was found in Street View if you included the unidentifiable plants. When excluding unidentified plants or when including areas that could not be reached it showed a significant difference. Using Google Street View to complement Artportalen data for R. japonica comes with benefits and limitations. Many areas were impossible to reach, but where accessible, it proved effective in identifying misreports and finding unreported plants without the need to visit the location. Street View data can enhance the reliability of distribution data used for monitoring invasive species without ever needing to travel, however it cannot fully replace other methods of enhancement and for the best reliability, a combination of Street View and on-site visits is necessary. / Många kommuner runt om i Sverige använder offentligt tillgängliga geodata från Artportalen för att spåra och bekämpa invasiva arter, men vem som helst kan ladda upp data till Artportalen och inte all data blir verifierad. Kommunerna skulle potentiellt kunna förbättra sina insatser genom att använda Street View teknologi för att få mer tillförlitliga data. En kommun som använder sig av data från Artportalen är Jönköping, som lider av den invasiva växten Reynoutria japonica. Syftet med den här rapporten är att testa om Street View kan användas för att komplimentera data från Artportalen och om det kan helt byta ut andra metoder att göra samma sak. Jag valde slumpmässigt ut 50 områden runt Jönköping med rapporter om R. japonica och gick igenom dem med Street View. Jag räknade varje individ av R. japonica jag kunde identifiera och jämförde det med antalet rapporter i varje område. Bland de 50 områdena var det bara 26 som kunde nås med Google Street View och vissa växter var omöjliga att identifiera om de var R. japonica eller inte. När man tittade på de områden som kunde nås visade det ingen skillnad i antal växter mellan rapporterna i Artportalen och vad som hittades i Street View om man inkluderade de oidentifierbara växterna. När man exkluderade oidentifierade växter eller när man inkluderade områden som inte kunde nås visade det en signifikant skillnad. Att använda Google Street View för att komplettera Artportalen-data för R. japonica har både fördelar och begränsningar. Många områden var omöjliga att nå, men där de var 2 tillgängliga visade det sig effektivt för att identifiera felrapporter och hitta orapporterade växter utan att behöva besöka platsen. Street View-data kan förbättra tillförlitligheten av distributionsdata som används för att övervaka invasiva arter utan att man någonsin behöver resa, men det kan inte fullt byta ut andra metoder att öka tillförlighet och för bästa resultat är en kombination av Street View och platsbesök nödvändig.

Den invasiva blomsterlupinens (Lupinus polyphyllus) spridning i Sverige är ett hot mot många inhemska växtarters överlevnad. Det är oklart hur den pågående globala uppvärmningen kan komma påverka artens invasionsframgångar. I det här kandidatarbetet har jag därför studerat hur blomsterlupinens tillväxt och fenologi varierar längs latitud i Europa i syfte med att avgöra om arten visar fitnesskillnader beroende på temperatur. Tjugo populationer från Trier (Tyskland) i söder till Umeå (Sverige) i norr följdes under en växtsäsong och data på blomsterlupinplantornas höjd samt blomställningarnas längd samlades in. Regressionsanalysen visade att det inte fanns något signifikant skillnad mellan latitud och ovanjordisk biomassa eller blomställningens längd. Däremot utvecklades den reproduktiva biomassan tidigare i växtsäsongen i de lägre breddgraderna i Europa jämfört med de högre. Studien ger en indikation om att ett varmare klimat kan ha en viss positiv påverkan på blomsterlupinens reproduktion och spridning. De lokala mikroklimatiska effekterna verkar dock ha en stor påverkan på dess relativa fitness, vilket betyder att vissa populationer kan gynnas mer än andra. Utbredningsområdet kan komma utökas mer norrut när stigande temperaturer och färre frostdagar gör nya områden tillgängliga för arten. / The spread of the invasive garden lupin (Lupinus polyphyllus) in Sweden threatens the survival of many native plant species. It is unclear how ongoing global warming may affect the species' invasion success. In this Bachelors essay I have therefore studied how the growth and phenology of the garden lupin varies with latitude in Europe to determine if the species shows any fitness differences depending on the temperature. Twenty garden lupin populations from Trier (Germany) in the south to Umeå (Sweden) in the north were followed during a single growing season and data on the plant’s height and the length of the inflorescences were collected. Regression analysis showed that there was no relationship between latitude and aboveground biomass or length of inflorescence. Reproductive biomass, on the other hand, developed earlier in the growing season at lower latitudes than at higher ones. The study indicates that a warmer climate may have a positive effect on the reproduction and spread of the garden lupin. Local microclimatic effects appear to have a major impact on its relative fitness though, which means that some populations may benefit more than others. The species’ range may expand further north as rising temperatures and fewer frost days make new areas available for the species.