Do hospitals have a higher mortality rate on weekend admissions? An observational study to analyse weekend effect on urgent admissions to hospitals in Catalonia

Background 'Weekend effect' is a term used to describe the increased mortality associated with weekend emergency admissions to hospital, in contrast with admission on weekdays. The objective of the present study is to determine whether the weekend effect is present in hospitals in Catalonia. Methods We analysed all urgent admissions in Catalonia in 2018, for a group of pathologies. Two groups were defined (those admitted on a weekday and those admitted on a weekend). We obtained mortality at 3, 7, 15 and 30 days, and applied a proportions test to both groups. Additionally, we used Cox's regression for mortality at 30 days, using the admission on a weekend as the exposition, adjusting by socioeconomic and clinical variables. We used the hospital discharge database and the Central Registry of the Insured Population. Results 72 427 admissions for the selected pathologies during 2018 were found. No statistically significant differences in mortality at 30 days (p=0.524) or at 15 days (p=0.119) according to the day of admission were observed. However, significant differences were found in mortality at 7 days (p=0.025) and at 3 days (p=0.002). The hazard rate associated with the weekend was 1.13 (95% CI: 1.04 to 1.23). By contrast, the adjusted HR of the weekend interaction with time was 0.99 (95% CI: 0.99 to 1.00). Conclusions There is a weekend effect, but it is not constant in time. This could suggest the existence of dysfunctions in the quality of care during the weekend

DATA FUSION APPROACHES IN SPECTROSCOPIC CHARACTERIZATION AND CLASSIFICATION OF PDO WINE VINEGARS

Spain is one of the major producers of high-quality wine vinegars having three protected designations of origin (a.k.a. PDOs): "Vinagre de Jerez", "Vinagre de Condado de Huelva" and "Vinagre de Montilla-Moriles". Their high prices due to their high quality and their high production costs explain the need for developing an adequate quality control technique and the interest in extensive characterization in order to capture the identity of each denomination. In this framework, methodologies based on non-targeted techniques, such as spectroscopies, are becoming popular in food authentication. Thus, for improving vinegar quality assessment, fusion of data blocks obtained from the same samples but different analytical techniques could be a good strategy, since the quantity and quality of sample knowledge could be enhanced providing new insights into the differentiation of vinegars. Therefore, the aim of this manuscript is the development of a multi-platform methodology and a model able to classify the Spanish wine vinegar PDOs. Sixty-five PDO wine vinegars were analyzed by four spectroscopic techniques: Fourier transform mid-infrared spectroscopy (MIR), near infrared spectroscopy (NIR), multidimensional fluorescence spectroscopy (EEM) and proton nuclear magnetic resonance (1H-NMR). Two different data fusion strategies were evaluated: Mid-level data fusion with different preprocessing, and Common Component and Specific Weights analysis multiblock method. Exploratory and classification analysis on the data from individual techniques were also performed and compared with data fusion models. The data fusion models improved the classification, providing a more efficient differentiation, than the models based on single methods, and supporting the approach to combine these methods to achieve synergies for an optimized PDO differentiation

Mental impact of Covid-19 among Spanish healthcare workers: a large longitudinal survey

Depression; Epidemiology; Mental healthDepressió; Epidemiologia; Salut mentalDepresión; Epidemiología; Salud mentalAims Longitudinal data on the mental health impact of the coronavirus disease 2019 (Covid-19) pandemic in healthcare workers is limited. We estimated prevalence, incidence and persistence of probable mental disorders in a cohort of Spanish healthcare workers (Covid-19 waves 1 and 2) -and identified associated risk factors. Methods 8996 healthcare workers evaluated on 5 May–7 September 2020 (baseline) were invited to a second web-based survey (October–December 2020). Major depressive disorder (PHQ-8 ≥ 10), generalised anxiety disorder (GAD-7 ≥ 10), panic attacks, post-traumatic stress disorder (PCL-5 ≥ 7), and alcohol use disorder (CAGE-AID ≥ 2) were assessed. Distal (pre-pandemic) and proximal (pandemic) risk factors were included. We estimated the incidence of probable mental disorders (among those without disorders at baseline) and persistence (among those with disorders at baseline). Logistic regression of individual-level [odds ratios (OR)] and population-level (population attributable risk proportions) associations were estimated, adjusting by all distal risk factors, health care centre and time of baseline interview. Results 4809 healthcare workers participated at four months follow-up (cooperation rate = 65.7%; mean = 120 days S.D. = 22 days from baseline assessment). Follow-up prevalence of any disorder was 41.5%, (v. 45.4% at baseline, p < 0.001); incidence, 19.7% (S.E. = 1.6) and persistence, 67.7% (S.E. = 2.3). Proximal factors showing significant bivariate-adjusted associations with incidence included: work-related factors [prioritising Covid-19 patients (OR = 1.62)], stress factors [personal health-related stress (OR = 1.61)], interpersonal stress (OR = 1.53) and financial factors [significant income loss (OR = 1.37)]. Risk factors associated with persistence were largely similar. Conclusions Our study indicates that the prevalence of probable mental disorders among Spanish healthcare workers during the second wave of the Covid-19 pandemic was similarly high to that after the first wave. This was in good part due to the persistence of mental disorders detected at the baseline, but with a relevant incidence of about 1 in 5 of HCWs without mental disorders during the first wave of the Covid-19 pandemic. Health-related factors, work-related factors and interpersonal stress are important risks of persistence of mental disorders and of incidence of mental disorders. Adequately addressing these factors might have prevented a considerable amount of mental health impact of the pandemic among this vulnerable population. Addressing health-related stress, work-related factors and interpersonal stress might reduce the prevalence of these disorders substantially. Study registration number: NCT0455656

Busulfan and melphalan as conditioning regimen for autologous hematopoietic stem cell transplantation in acute myeloid leukemia in first complete remission

Vinte e dois pacientes consecutivos portadores de leucemia mielóide aguda (LMA) em primeira remissão completa (1ªRC) submetidos a transplante de células-tronco hematopoéticas autogênico (TCTH Auto) condicionados com bussulfano e melfalano (Bu/Mel) foram selecionados entre 1993 e 2006. A probabilidade de sobrevida global (SG) pelo método de Kaplan-Meier foi de 57,5% após 36 meses, com "plateau" aos 20 meses após o transplante. Fatores como sexo, classificação Franco-Americana-Britânica (FAB) da LMA, tratamento de indução, consolidação intensiva, remissão após o primeiro ciclo de indução e fonte de células não tiveram impacto na sobrevida. Pela análise citogenética, um paciente de mau prognóstico submetido ao procedimento, foi a óbito um ano após o transplante. Nove pacientes foram a óbito, oito por recidiva e um por hemorragia. Morte antes dos 100 dias ocorreu em dois pacientes, um por recidiva e outro por hemorragia decorrente da plaquetopenia refratária, relacionada ao procedimento. Concluímos que o regime de condicionamento Bu/Mel é opção válida ao uso de outros regimes de condicionamento, apresentando excelente taxa da sobrevida.Twenty-two consecutive patients with acute myeloid leukemia in first complete remission submitted to autologous hematopoietic stem cells transplantation conditioned with busulfan and melphalan were evaluated between 1993 and 2006. The overall survival, according to the Kaplan-Meier curve, was 57.5% at 36 months, with a "plateau" at 20 months after transplant. Factors such as gender, French-American-British (FAB) classification of acute myeloid leukemia, induction therapy, intensive consolidation, remission after the first cycle of induction and source of cells had no impact on survival. One patient with poor prognosis before the procedure died a year after transplantation. Nine patients died, eight by relapse and one because of bleeding. Death before 100 days occurred for two patients, one due to relapse and the other bleeding caused by refractory thrombocytopenia related to the procedure. In conclusion, the conditioning regiment with busulfan and melphalan is a valid option compared to the other conditioning regimens, with an excellent overall survival

A New Type of Supramolecular Fluid Based on H₂O-Alkylammonium/Phosphonium Solutions

Here we show that by adjusting the concentration of tetrabutyl ammonium and phosphonium salts in water (approximate to 1.5-2.0 m), hydrophobic solvation triggers the formation of a unique, highly incompressible supramolecular liquid, with a dynamic structure similar to clathrates, involving essentially all H2O molecules of the solvent. Despite the increasing local order, the thermal diffusivity, and compressibility of these supramolecular liquids is strongly decreased with respect to bulk water due to slower relaxation dynamics. The results presented in this paper open an avenue to design a new family of supramolecular fluids, stable under atmospheric conditions, which can find important technological applications in energy storage and conversion

Absence of disparities in anthropometric measures among Chilean indigenous and non-indigenous newborns

<p>Abstract</p> <p>Background</p> <p>Studies throughout North America and Europe have documented adverse perinatal outcomes for racial/ethnic minorities. Nonetheless, the contrast in newborn characteristics between indigenous and non-indigenous populations in Latin America has been poorly characterized. This is due to many challenges, including a lack of vital registration information on ethnicity. The objective of this study was to analyze trends in anthropometric measures at birth in Chilean indigenous (Mapuche) and non-indigenous children over a 5-year period.</p> <p>Methods</p> <p>We examined weight and length at birth using information available through a national data base of all birth records for the years 2000 through 2004 (n = 1,166.513). Newborns were classified ethnically according to the origins of the parents' last names.</p> <p>Result</p> <p>The average birthweight was stable over the 5 year period with variations of less than 20 g in each group, and with mean values trivially higher in indigenous newborns. The proportion weighing less than 2500 g at birth increased modestly from 5.2% to 5.6% in non-indigenous newborns whereas the indigenous births remained constant at 5.2%. In multiple regression analyses, adjusting flexibly for gestational age and maternal characteristics, the occurrence of an indigenous surname added only 14 g to an average infant's birthweight while holding other factors constant. Results for length at birth were similar, and adjusted time trend variation in both outcomes was trivially small after adjustment. Anthropometric indexes at birth in Chile are quite favorable by international standards.</p> <p>Conclusion</p> <p>There is only a trivial degree of ethnic disparity in these values, in contrast to conditions for ethnic minorities in other countries. Moreover, these values remained roughly constant over the 5 years of observation in this study.</p

Gestión educativa en Latinoamérica desde la investigación y su normativa aplicable

This article presents the results of an analysis of the scientific production on educational management in Latin America published in journals indexed in the Scielo database in the period 2015-2019, as well as the regulations that regulate educational management in different countries. For this, a bibliometric study was carried out that analyzed 57 citable articles published in journals indexed in the Scielo database in the period from 2015 to 2019, in which the bibliometric structures and dimensions of educational management were described through metadata. It was found that Chile, Colombia, and Brazil are countries with the highest production; The most researched dimension of educational management is the pedagogical one, and the most used methodology is the qualitative one. It can be concluded that scientific research on educational management is developed predominantly in theoretical analyses. Even so, many applied studies are identified that show the methodological maturity that the subject studied is reaching.Este artículo presenta los resultados de un análisis de la producción científica sobre gestión educativa en Latinoamérica publicada en revistas indexadas en la base de datos Scielo, en el periodo 2015 – 2019 así como las normas que regulan la gestión educativa en diferentes países. Para esto se realizó un estudio bibliométrico que analizó 57 artículos citables publicados en revistas indexadas en la base de datos Scielo en el periodo de 2015 a 2019, en ellos se describieron a través de los metadatos las estructuras bibliométricas y las dimensiones de la gestión educativa. Se encontró que Chile, Colombia y Brasil son países de mayor producción; la dimensión de gestión educativa más investigada es la pedagógica y la metodología más utilizada es la cualitativa. Se puede concluir que la investigación científica sobre gestión educativa se desarrolla predominantemente en los análisis teóricos, aun así, se identifican gran cantidad de estudios aplicados que evidencia la madurez metodológica que está alcanzando la temática estudiada