Received: 8 October 2021 DOI: 10.1002/clt2.12089 ORIGINAL ARTICLE - - Revised: 3 December 2021 Accepted: 7 December 2021 Chronic urticaria patients are interested in apps to monitor their disease activity and control: A UCARE CURICT analysis Ivan Cherrez‐Ojeda1,2 | Emanuel Vanegas1,2 | Annia Cherrez2,3 | 1,2 4,5 4,5 Miguel Felix | Karsten Weller | Markus Magerl | 4,5 1,2 Rasmus Robin Maurer | Valeria L. Mata | Alicja Kasperska‐Zajac6 | 6 7,8 7 Agnieszka Sikora | Daria Fomina | Elena Kovalkova | Kiran Godse9 | 9 10,11 11 Nimmagadda Dheeraj Rao | Maryam Khoshkhui | Sahar Rastgoo | 12 13 Roberta F. J. Criado | Mohamed Abuzakouk | Deepa Grandon13 | 14 15 Martijn B. A. Van Doorn | Solange Oliveira Rodrigues Valle | Eduardo Magalhães De Souza Lima16 | Simon Francis Thomsen17 | German D. Ramón18 | Edgar E. Matos Benavides19 | Andrea Bauer20 | Ana M. Giménez‐Arnau21 | Emek Kocatürk22 | Carole Guillet23 | Jose Ignacio Larco24 | Zuo‐Tao Zhao25 | Michael Makris26 | 27 28 29 Carla Ritchie | Paraskevi Xepapadaki | Luis Felipe Ensina | Sofia Cherrez2,30 | Marcus Maurer4,5 1 Universidad Espíritu Santo, Samborondón, Ecuador 2 Respiralab, Respiralab Research Group, Guayaquil, Ecuador 3 Clinic and Policlinic for Dermatology and Venereology, University Medical Center Rostock, Rostock, Germany 4 Institute for Allergology, Charité ‐ Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt‐Universität zu Berlin, Berlin, Germany 5 Fraunhofer Institute for Translational Medicine and Pharmacology (ITMP), Allergology and Immunology, Berlin, Germany 6 European Center for Diagnosis and Treatment of Urticaria, Medical University of Silesia, Katowice, Poland 7 City Center of Allergy and Immunology, Clinical City Hospital #52, Moscow, Russia 8 Department of Allergology and Clinical Immunology, I.M. Sechenov First Moscow State Medical University, Moscow, Russian Federation 9 Department of Dermatology, D Y, Patil University School of Medicine and Hospital, Mumbai, India 10 Allergy Research Center, Mashhad University of Medical Sciences, Mashhad, Iran 11 Department of Allergy and Immunology, Mashhad University of Medical Sciences, Mashhad, Iran 12 Department of Dermatology, Faculdade de Medicina do ABC, São Paulo, Brazil 13 Allergy and Immunology Department, Cleveland Clinic Abu Dhabi, Abu Dhabi, UAE 14 Department of Dermatology, Erasmus MC, Rotterdam, The Netherlands 15 Department of Internal Medicine, Hospital Universitário Clementino Fraga Filho, Rio de Janeiro, Brazil 16 Faculty of Science and Health of Juiz de Fora ‐ SUPREMA ‐ Minas Gerais, Rio de Janeiro, Brazil 17 Department of Dermatology, Bispebjerg Hospital, University of Copenhagen, Biomedical Sciences, Copenhagen, Denmark 18 Instituto de Alergia e Inmunología del Sur, Bahía Blanca, Buenos Aires, Argentina 19 Centro de Referencia de Alergia, Asma e Inmunología ‐ Instituto Nacional del Niño, Lima, Peru This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, pro- vided the original work is properly cited. © 2021 The Authors. Clinical and Translational Allergy published by John Wiley & Sons Ltd on behalf of European Academy of Allergy and Clinical Immunology. Clin Transl Allergy. 2021;e12089. wileyonlinelibrary.com/journal/clt2 1 of 7 https://doi.org/10.1002/clt2.12089 2 of 7 - CHERREZ‐OJEDA ET AL. 20 Department of Dermatology, University Allergy Center, University Hospital Carl Gustav Carus, Technical University, Dresden, Germany 21 Department of Dermatology, Hospital del Mar, IMIM, Universitat Autònoma, Barcelona, Spain 22 Department of Dermatology, Koç University School of Medicine, Istanbul, Turkey 23 Department of Dermatology, University Hospital Zurich, Zurich, Switzerland 24 Allergy Department, Clinica San Felipe, Lima, Peru 25 Department of Dermatology and Venereology, Peking University First Hospital, Beijing, China 26 Allergy Unit, 2nd Department of Dermatology and Venereology, National and Kapodistrian University of Athens, “Attikon” University Hospital, Athens, Greece 27 Allergy Division, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina 28 Allergy Department, 2nd Pediatric Clinic, National and Kapodistrian University of Athens, Athens, Greece 29 Federal University of São Paulo, São Paulo, Brazil 30 Department of Dermatology, SRH Zentralklinikum Suhl, Suhl, Germany Correspondence Ivan Cherrez Ojeda, Allergy, Immunology & Abstract Pulmonary Medicine, Medical and Research Background: Information/communication technologies such as mobile phone ap- Director of Respiralab, Research Professor at Espiritu Santo University (UEES), Respiralab, plications (apps) would enable chronic urticaria (CU) patients to self‐evaluate their Clinica Kennedy, Seccion Delta, Av 9na. Oeste disease activity and control. Yet, recently Antó et al (2021) reported a global paucity y Av. San Jorge, Samborondón, Ecuador. Email: ivancherrez@gmail.com of such apps for patients with CU. In this analysis, we assessed patient interest in using apps to monitor CU disease activity and control using questions from the Funding information chronic urticaria information and communication technologies (CURICT) study. This study was funded by the network of urticaria centers of reference and excellence Methods: The methodology for CURICT has been reported. Briefly, a 23‐item (UCARE,www.ga2len‐ucare.com) questionnaire was completed by 1841 CU patients from 17 UCAREs across 17 countries. Here, we analyzed patient responses to the CURICT questions on the use of apps for urticaria‐related purposes. Results: As previously published, the majority of respondents had chronic sponta- neous urticaria (CSU; 63%; 18% chronic inducible urticaria (CIndU) [CIndu]; 19% with both), were female (70%) and in urban areas (75%). Over half of patients were very/extremely interested in an app to monitor disease activity (51%) and control (53%), while only ∼1/10 were not. Patients with both urticaria types versus those with CSU only (odds ratio [OR], 1.36 [1.03–1.79]) and females versus males (OR [95% CI], 1.47 [1.17–1.85]) were more likely to be very to extremely interested in an app to assess disease control. Conclusions: Overall, half of the patients with CU were very to extremely interested in using an app to assess their disease activity and control. Development of well‐ designed apps, specific to disease types (CSU, CIndU, CSU + CIndU, etc), vali- dated by experts across platforms would help improve the management and possibly outcomes of CU treatment while providing important patient information to be used in future research. KEYWORDS apps, chronic inducible urticaria, chronic spontaneous urticaria, chronic urticaria, UCARE SCHLÜSSELWÖRTER apps, chronische induzierbare urtikaria, chronische spontane urtikaria, chronische urtikaria, UCARE CHERREZ‐OJEDA ET AL. - 3 of 7 1 | INTRODUCTION (75%) with a mean age of 41 years, and ∼4 years of disease duration.1,2 In the recent Urticaria Centers of Reference and Excellence (UCARE) study, chronic urticaria information and communication technologies (CURICT), we assessed use and interest in information 2.2 | Statistical analysis and communications technologies (ICTs) for patients with chronic urticaria (CU).1,2 We found that almost all CU patients had access The agreement scale was dichotomized as “agree‐to‐strongly agree” to ICTs and most were using these regularly to obtain health and (agree and strongly agree) and “not agree‐to‐strongly agree” disease‐related information.1 Specifically, most patients with CU (strongly disagree, disagree and undecided). Similarly, the interest were interested in ICTs to receive disease information and to scale was dichotomized as “very‐to‐extremely interested” (very communicate with their physicians and other patients about their interested and extremely interested) and “not very‐to‐extremely urticaria.2 interested” (not interested, slightly interested and moderately Information and communications technologies such as mobile interested). phone applications (apps) would enable patients to (i) self‐evaluate A binomial logistic regression analysis was performed to their disease activity, impact, and control, (ii) improve self‐ predict the likelihood of being very to extremely interested or not management and (iii) optimize their therapy including allergic in app development described above given the effects of age, comorbidities. Yet, very recently, Antó et al (2021) reported a gender, educational level, region, living area, economy according global paucity of such apps for patients with CU.3 To date, the to the World Bank data, urticaria type and years with diagnosis. unmet need for suitable apps from the patient's point of view re- All data were analyzed using SPSS version 24.0 software (SPSS mains unknown. Inc.). 1.1 | Objective 2.3 | Ethical considerations Using questions from the CURICT study, we assessed patient interest This study was approved by the ethics committee “Comité de ética e in using apps to monitor CU disease activity and control. Investigación en Seres Humanos” (CEISH), Guayaquil, Ecuador (IRB number HCK‐CEISH‐19‐0059) and by a committee for each partici- pating UCARE center. Each participant provided consent to 2 | METHODS completion of the anonymous survey, and confidentiality was main- tained throughout the study. 2.1 | Study design and population The scope, methodology, conduct, and other results of the CURICT 3 | RESULTS study have been previously reported.1,2 Patients were ≥12 years old and previously diagnosed with chronic spontaneous urticaria 3.1 | More than half of patients with CU are very to (CSU) or chronic inducible urticaria (CIndU) by a physician; those extremely interested in an app to monitor disease with other dermatological diseases or intellectual disabilities were activity and control excluded. A 23‐item questionnaire, designed, evaluated, and reviewed by an expert panel of physicians that collected de- Over half of patients were very or extremely interested in the mographic (age, gender, education level, living area, etc) and clin- development of an app to monitor disease activity (51%; n = 946) and ical information (urticaria type, years with diagnosis, etc.) from control (53%; n = 967), while only ∼1/10 were not interested at all in each patient. Furthermore, participants were asked to quantify apps to assess such parameters (urticaria activity, 12.8%, n = 236; their interest using a scale (not interested, slightly interested, urticaria control, 12.0%, n = 221). moderately interested, very interested, and extremely interested).1,2 Here, we analyzed patient responses to the CURICT questions 3.2 | Comorbid CIndU in patients with CSU is linked on the use of apps for urticaria‐related purposes. As previously to higher levels of interest in the use of an app to published, the 23‐item questionnaire2 was completed by 1841 CU assess disease control patients from 17 UCAREs across 17 countries. The majority of re- spondents had chronic spontaneous urticaria (CSU; 63%; 18% Patients with both urticaria types reported a greater likelihood of CIndU; 19% with both), were female (70%) and lived in urban areas being very to extremely interested in app development to assess 4 of 7 - CHERREZ‐OJEDA ET AL. disease control (odds ratio [OR], 1.36 [1.03–1.79]) versus those with [0.96–0.98]; 0.97 [0.96–0.98], respectively). Furthermore, patients CSU only. residing in upper middle‐income countries were less likely to be interested in app development to measure disease outcomes versus those in high income countries. 3.3 | Female patients and those with higher education are significantly more likely to use apps for disease control 5 | DISCUSSION Female patients were more likely than males to be very/extremely In this study, across all strata, patients with CU demonstrated very/ interested in the development of an app to monitor disease control extreme interest in using an app for monitoring their disease activity (Table 1). The two highest levels of education (undergraduate and and control. Being female, higher education, and having both CSU postgraduate studies) presented the highest odds of being very to and CIndU were important drivers of this interest. extremely interested in the use of an app to assess disease activity Other recent studies assessing app use in chronic allergic con- (OR [95% CI], 3.60 [2.37–5.48] and 2.56 [1.64–3.99], respectively) ditions have demonstrated high patient interest/satisfaction as well and control (OR, 2.82 [1.88–4.23] and 2.36 [1.53–3.64], respectively). compliance and subjective improvements in their disease across age groups.4‐6 Glattacker et al found that adults patients with allergic rhinitis were adherent with over half using the app for >6 months. 4 | OLDER AGE WAS IDENTIFIED AS A Patients also reported subjective improvements due to app use SIGNIFICANT PREDICTOR FOR LESS INTEREST IN including greater knowledge of their allergies, improved QoL, and APP DEVELOPMENT FOR DISEASE ACTIVITY AND greater allergy self‐management.4 In a study assessing the impact of CONTROL ASTHMAXcell Adventures, a gamified, guideline‐based, pediatric app, Hsia et al, found that children were highly satisfied with an app and Even though older age was identified as a significant predictor for that its use improved asthma control, knowledge, and QoL while less interest in app development for disease activity and control, the reducing emergency department visit and prednisone use.5 In young ORs approached but did not exceed the unit value of 1.0 (OR, 0.97 adults with asthma, Murphy et al discovered that use of an app may TABLE 1 Adjusted logistic regression reporting patient interest in app development to assess urticaria activity and control Disease activity Disease control Variable Very to extremely interested in app development Very to extremely interested in app development OR (95% CI) OR (95% CI) Age 0.97 (0.96–0.98) 0.97 (0.96–0.98) a Gender Female 1.24 (0.98–1.56) 1.47 (1.17–1.85) b Education level Secondary/Highschool 2.33 (1.53–3.53) 1.75 (1.17–2.62) Undergraduate/college 3.60 (2.37–5.48) 2.82 (1.88–4.23) Postgraduate studies 2.56 (1.64–3.99) 2.36 (1.53–3.64) c Economy Upper middle income 0.52 (0.38–0.73) 0.47 (0.34–0.66) d Urticaria type Both (CSU & CIndU) 1.26 (0.95–1.67) 1.36 (1.03–1.79) Note: Regression analyses were adjusted for variables such as age, gender, education level, region, living area, economy, urticaria type and years with urticaria. Bolded values are significant at 0.05 significance level. Abbreviations: CI, confidence interval; CIndU, chronic inducible urticaria; CSU, chronic spontaneous urticaria; OR, odds ratio a Reference gender category is “female”. b Reference education level category is “No education/Primary school”. c Reference economy category is “high income”. Categories are defined according to the World Bank data. This classification changes the thresholds to define each category based on the gross national income per capita of each country, which is the dollar value of a country's final income year divided by its population. Currently the thresholds are: Low income (<1046), Lower‐middle income (1046‐4095), Upper‐middle income (4096‐12,625), High income (>12,535). d Reference urticaria type is CSU. CHERREZ‐OJEDA ET AL. - 5 of 7 support adherence in inhaled corticosteroid use.6 Moreover, Pharmaceuticals, Moxie, Novartis, Pharming, and Shire/Takeda. Bousquet et al, were able to identify phenotype differences between Rasmus Robin Maurer has no conflicts of interest. Valeria L Mata 7 a priori‐defined rhinitis groups using the MASK‐rhinitis app. This has no conflicts of interest. Alicja Kasperska‐Zajac has no conflicts suggests that research questions for chronic diseases may be better of interest. Agnieszka Sikora has no conflicts of interest. Daria and more easily identified using app technology. Fomina is or recently was a speaker and/or advisor for, and/or Given our findings, there is a clear unmet need for well‐ has received research funding from: AstraZeneca, CSL Behring, developed apps, particular for CU disease type, that could compre- Glaxo SmithKline, MSD, Novartis, Sanofi, and Shire/Takeda. Elena hensively document patients' daily disease activity (triggers, QoL, Kovalkova has no conflicts of interest. Kiran Godse has no conflicts comorbidities, consequences) and accurately account for disease of interest. Nimmagadda Dheeraj Rao has no conflicts of interest. control or lack thereof. Apps could also provide detailed and unique Maryam Khoshkhui has no conflicts of interest. Sahar Rastgoo has data about each patient, which would enable practitioners to develop no conflicts of interest. Roberta FJ Criado has no conflicts of in- and implement individualized treatment plans and adapt quickly ac- terest. Mohamed Abuzakouk has no conflicts of interest. Deepa cording to disease course. Yet, while most CU patients are very Grandon has no conflicts of interest. Martijn BA van Doorn is or interested in using apps to document their condition, suitable ones recently was a speaker and/or advisor for, and/or has received which would thoroughly assess their condition are limited in number, research funding from Abbvie, BMS, Celgene, Janssen Cilag, LEO function, geographical reach, and none covered comorbidities; Pharma, Lilly, MSD, Novartis, Pfizer, and Sanofi‐Genzyme. Solange importantly only one app noted by Anto et al assessed disease Oliveira Rodrigues Valle has no conflicts of interest. Eduardo control.3 Magalhães de Souza Lima has no conflicts of interest. Simon Francis Our study included a large sample of patients and utilized a Thomsen is or recently was a speaker and/or advisor for, and/or has network of researchers across the world. However, the study design received research funding from: Abbvie, AstraZeneca, Celgene, Eli was cross‐sectional and therefore cause‐and‐effect relationships Lilly, Janssen, LEO Pharma, Novartis, Pierre Fabre, Roche, Sanofi, and could not be detected; in addition, while the questionnaire was UCB. German D Ramón has no conflicts of interest. Edgar E Matos developed by experts worldwide, it has not been confirmed in vali- Benavides has no conflicts of interest. Andrea Bauer is or recently dation studies to date. Also, we did not record the disease severity was a speaker and/or advisor for, and/or has received research and control, and as such, we cannot identify if these variables could funding from Novartis, Sanofi, Genentech, Leo Pharma and Shire/ affect the outcomes of interest. Takeda. Ana M Giménez‐Arnau has held roles as a Medical Advisor for Sanofi, Uriach, Genentech, Novartis, Amgen, ThemoFisher, Roche, Almirall, and has research grants supported by Instituto Carlos III‐ 6 | CONCLUSIONS FEDER, Novartis, and Uriach; she also participates in educational activities for Almirall, Genentech, Glaxo SmithKline, LEO Pharma, Overall, over half of patients with CU were very to extremely Menarini, MSD, Novartis, Sanofi, Avene and Uriach. Emek Kocatürk interested in using an app to assess their disease activity and control. is or recently was a speaker and/or advisor for Bayer, Novartis, and Development of well‐designed apps, specific to disease types (CSU, Sanofi. Carole Guillet has no conflicts of interest. Jose Ignacio Larco CIndU, CSU + CIndU, etc), validated by experts across platforms is or recently was a speaker and/or advisor for: FAES, Novartis, and would help improve the management and possibly outcomes of CU Sanofi. Zuo‐Tao Zhao has no conflicts of interest. Michael Makris is treatment while providing important patient information to be used or recently was a speaker and/or advisor for, and/or has received in future research. research funding from AstraZeneca, Chiesi, Glaxo SmithKline, Novartis, and Sanofi. Carla Ritchie has no conflicts of interest. A CK N O WL ED GM E N T S Paraskevi Xepapadak reports personal fees from Galenica Greece, The authors would like to thank all of the study participants as well Glaxo SmithKline, Nestle, Novartis, Nutricia, and Uriach, outside the as Leonard Lionnet, PhD for providing medical writing assistance. submitted work. Luis Felipe Ensina is or recently was a speaker and/or This study was funded by the network of urticaria centers of refer- advisor for, and/or has received research funding from Novartis, ence and excellence (UCARE, www.ga2len‐ucare.com). Sanofi, and Takeda. Sofia Cherrez has no conflicts of interest. Marcus Maurer is or recently was a speaker and/or advisor for, and/or has C O N F LI C T O F IN T ER E S T received research funding from: Allakos, Alnylam, Aralez, AstraZe- Ivan Cherrez‐Ojeda has no conflicts of interest. Emanuel Vanegas neca, Biocryst, Blueprint, CSL Behring, FAES, Genentech, Kalvista has no conflicts of interest. Annia Cherrez has no conflicts of in- Pharmaceuticals, LEO Pharma, Menarini, Moxie, MSD, Novartis, terest. Miguel Felix has no conflicts of interest. Karsten Weller is or Pharming, Pharvaris, Roche, Sanofi, Shire/Takeda, UCB, and Uriach. recently was a speaker and/or advisor for, and/or has received research funding from: Biocryst, CSL Behring, Dr. Pfleger, FAES, A U T H O R C O N T R I B U T I O NS Moxie, Novartis, Shire/Takeda, and Uriach. Markus Magerl is or Ivan Cherrez‐Ojeda: Conceptualization; Data curation; Formal recently was a speaker and/or advisor for, and/or has received analysis; Funding acquisition; Investigation; Methodology; Project research funding from Biocryst, CSL Behring, Kalvista administration; Resources; Software; Supervision; Validation; 6 of 7 - CHERREZ‐OJEDA ET AL. Visualization; Writing – original draft; Writing – review & editing. curation; Formal analysis; Investigation; Methodology; Resources; Emanuel Vanegas: Data curation; Formal analysis; Investigation; Writing – original draft; Writing – review & editing. Andrea Bauer: Methodology; Writing – original draft; Writing – review & editing. Data curation; Formal analysis; Investigation; Methodology; Annia Cherrez: Data curation; Formal analysis; Methodology; Validation; Writing – original draft; Writing – review & editing. Ana M. Validation; Writing – original draft; Writing – review & editing. Giménez‐Arnau: Conceptualization; Data curation; Formal analysis; Miguel Felix: Data curation; Formal analysis; Investigation; Funding acquisition; Investigation; Methodology; Project Methodology; Writing – original draft; Writing – review & editing. administration; Resources; Software; Supervision; Validation; Karsten Weller: Data curation; Formal analysis; Investigation; Visualization; Writing – original draft; Writing – review & editing. Methodology; Validation; Writing – original draft; Writing – review & Emek Kocatürk: Conceptualization; Data curation; Formal analysis; editing. Markus Magerl: Data curation; Formal analysis; Investigation; Methodology; Project administration; Supervision; Investigation; Methodology; Writing – original draft; Writing – Validation; Writing – original draft; Writing – review & editing. review & editing. Rasmus Robin Maurer: Data curation; Formal Carole Guillet: Data curation; Formal analysis; Investigation; analysis; Investigation; Methodology; Software; Validation; Writing – Methodology; Writing – original draft; Writing – review & editing. original draft; Writing – review & editing. Valeria L. Mata: Data Jose Ignacio Larco: Data curation; Formal analysis; Investigation; curation; Formal analysis; Investigation; Methodology; Validation; Methodology; Validation; Writing – original draft; Writing – Writing – original draft; Writing – review & editing. Alicja Kasperska‐ review & editing. Zuo‐Tao Zhao: Data curation; Formal analysis; Zajac: Data curation; Formal analysis; Investigation; Methodology; Investigation; Methodology; Validation; Writing – original draft; Validation; Writing – original draft; Writing – review & editing. Writing – review & editing. Michael Makris: Data curation; Formal Agnieszka Sikora: Data curation; Formal analysis; Investigation; analysis; Investigation; Methodology; Validation; Writing – original Methodology; Validation; Writing – original draft; Writing – review & draft; Writing – review & editing. Carla Ritchie: Data curation; editing. Daria Fomina: Data curation; Formal analysis; Investigation; Investigation; Methodology; Validation; Writing – original draft; Methodology; Validation; Writing – original draft; Writing – review & Writing – review & editing. Paraskevi Xepapadaki: Data curation; editing. Elena Kovalkova: Data curation; Investigation; Methodology; Formal analysis; Investigation; Methodology; Validation; Writing – Validation; Writing – original draft; Writing – review & editing. Kiran original draft; Writing – review & editing. Luis Felipe Ensina: Data Godse: Data curation; Formal analysis; Investigation; Methodology; curation; Investigation; Methodology; Validation; Writing – original Validation; Writing – original draft; Writing – review & editing. draft; Writing – review & editing. Sofia Cherrez: Data curation; Nimmagadda Dheeraj Rao: Data curation; Formal analysis; Formal analysis; Investigation; Methodology; Software; Investigation; Methodology; Writing – original draft; Writing – Supervision; Validation; Writing – original draft; Writing – review & editing. Maryam Khoshkhui: Data curation; Formal review & editing. Marcus Maurer: Conceptualization; Data curation; analysis; Investigation; Methodology; Validation; Writing – original Formal analysis; Funding acquisition; Investigation; Methodology; draft; Writing – review & editing. Sahar Rastgoo: Data curation; Project administration; Resources; Software; Supervision; Validation; Formal analysis; Investigation; Methodology; Validation; Writing – Visualization; Writing – original draft; Writing – review & editing. original draft; Writing – review & editing. Roberta F. J. Criado: Data curation; Formal analysis; Investigation; Methodology; Validation; O R CI D Writing – original draft; Writing – review & editing. Mohamed Ivan Cherrez‐Ojeda https://orcid.org/0000-0002-1610-239X Abuzakouk: Data curation; Formal analysis; Investigation; Emanuel Vanegas https://orcid.org/0000-0001-8314-5595 Methodology; Validation; Writing – original draft; Writing – review & Annia Cherrez https://orcid.org/0000-0002-1597-9915 editing. Deepa Grandon: Data curation; Formal analysis; Miguel Felix https://orcid.org/0000-0002-2243-3646 Investigation; Methodology; Validation; Writing – original draft; Karsten Weller https://orcid.org/0000-0003-4437-0313 Writing – review & editing. Martijn B. A. Van Doorn: Data curation; Markus Magerl https://orcid.org/0000-0001-9218-5468 Formal analysis; Investigation; Methodology; Validation; Writing – Rasmus Robin Maurer https://orcid.org/0000-0003-3827-6072 original draft; Writing – review & editing. Solange Oliveira Rodrigues Valeria L. Mata https://orcid.org/0000-0003-3089-6306 Valle: Data curation; Formal analysis; Investigation; Methodology; Alicja Kasperska‐Zajac https://orcid.org/0000-0002-2000-0070 Writing – original draft; Writing – review & editing. Eduardo Agnieszka Sikora https://orcid.org/0000-0003-0365-8636 Magalhães De Souza Lima: Data curation; Formal analysis; Daria Fomina https://orcid.org/0000-0002-6341-7810 Investigation; Methodology; Writing – original draft; Writing – Elena Kovalkova https://orcid.org/0000-0002-1212-3767 review & editing. Simon Francis Thomsen: Formal analysis; Kiran Godse https://orcid.org/0000-0002-0550-5871 Investigation; Methodology; Validation; Writing – original draft; Nimmagadda Dheeraj Rao https://orcid.org/0000-0002-6004-078X Writing – review & editing. German D. Ramón: Data curation; Maryam Khoshkhui https://orcid.org/0000-0002-0363-6536 Formal analysis; Investigation; Methodology; Writing – original draft; Sahar Rastgoo https://orcid.org/0000-0002-8888-8459 Writing – review & editing. Edgar E. Matos Benavides: Data Roberta F. J. Criado https://orcid.org/0000-0003-2482-3047 CHERREZ‐OJEDA ET AL. - 7 of 7 Mohamed Abuzakouk https://orcid.org/0000-0003-0802-8342 2. 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