Main and moderated effects of multimorbidity and depressive symptoms on cognition

Objective: Multimorbidity, or the occurrence of two or more chronic conditions, is a global challenge, with implications for mortality, morbidity, disability, and life quality. Psychiatric disorders are common among the chronic diseases that affect patients with multimorbidity. It is still not well understood whether psychiatric symptoms, especially depressive symptoms, moderate the effect of multimorbidity on cognition. Methods: We used a large (n=2,681) dataset to assess whether depressive symptomatology moderates the effect of multimorbidity on cognition using structural equation modelling. Results: It was found that the more depressive symptoms and chronic conditions, the worse the cognitive performance, and the higher the educational level, the better the cognitive performance. We found a significant but weak (0.009; p = 0.04) moderating effect. Conclusion: We have provided the first estimate of the moderating effect of depression on the relation between multimorbidity and cognition, which was small. Although this moderation has been implied by many previous studies, it was never previously estimated

CIDACS-RL: a novel indexing search and scoring-based record linkage system for huge datasets with high accuracy and scalability

Background: Record linkage is the process of identifying and combining records about the same individual from two or more different datasets. While there are many open source and commercial data linkage tools, the volume and complexity of currently available datasets for linkage pose a huge challenge; hence, designing an efficient linkage tool with reasonable accuracy and scalability is required. Methods: We developed CIDACS-RL (Centre for Data and Knowledge Integration for Health – Record Linkage), a novel iterative deterministic record linkage algorithm based on a combination of indexing search and scoring algorithms (provided by Apache Lucene). We described how the algorithm works and compared its performance with four open source linkage tools (AtyImo, Febrl, FRIL and RecLink) in terms of sensitivity and positive predictive value using gold standard dataset. We also evaluated its accuracy and scalability using a case-study and its scalability and execution time using a simulated cohort in serial (single core) and multi-core (eight core) computation settings. Results: Overall, CIDACS-RL algorithm had a superior performance: positive predictive value (99.93% versus AtyImo 99.30%, RecLink 99.5%, Febrl 98.86%, and FRIL 96.17%) and sensitivity (99.87% versus AtyImo 98.91%, RecLink 73.75%, Febrl 90.58%, and FRIL 74.66%). In the case study, using a ROC curve to choose the most appropriate cut-off value (0.896), the obtained metrics were: sensitivity = 92.5% (95% CI 92.07–92.99), specificity = 93.5% (95% CI 93.08–93.8) and area under the curve (AUC) = 97% (95% CI 96.97–97.35). The multi-core computation was about four times faster (150 seconds) than the serial setting (550 seconds) when using a dataset of 20 million records. Conclusion: CIDACS-RL algorithm is an innovative linkage tool for huge datasets, with higher accuracy, improved scalability, and substantially shorter execution time compared to other existing linkage tools. In addition, CIDACS-RL can be deployed on standard computers without the need for high-speed processors and distributed infrastructures

qSCMS: Post-quantum certificate provisioning process for V2X

Security and privacy are paramount in the field of intelligent transportation systems (ITS). This motivates many proposals aiming to create a Vehicular Public Key Infrastructure (VPKI) for managing vehicles’ certificates. Among them, the Security Credential Management System (SCMS) is one of the leading contenders for standardization in the US. SCMS provides a wide array security features, which include (but are not limited to) data authentication, vehicle privacy and revocation of misbehaving vehicles. In addition, the key provisioning process in SCMS is realized via the so-called butterfly key expansion, which issues arbitrarily large batches of pseudonym certificates in response to a single client request. Although promising, this process is based on classical elliptic curve cryptography (ECC), which is known to be susceptible to quantum attacks. Aiming to address this issue, in this work we propose a post-quantum butterfly key expansion process. The proposed protocol relies on lattice-based cryptography, which leads to competitive key, ciphertext and signature sizes. Moreover, it provides low bandwidth utilization when compared with other lattice-based schemes, and, like the original SCMS, addresses the security and functionality requirements of vehicular communication

Proposition of integrated electrical mechanism and facial prosthesis for eyelid motion on prosthetic oculopalpebral rehabilitation: technical note

Surgical reconstruction of large facial defects may not be always possible, therefore extraoral maxillofacial prosthesis is a good restorative option. The oculopalpebral prosthesis has a natural appearance however it can be easily noticed because its eyelids do not move. For esthetic purposes, it is desirable that the prosthetic eyelids open and close synchronously with the contralateral eye, which provides a challenge to the prosthetic reconstruction of the oculopalpebral region. To improve the esthetic outcome, an oculopalpebral prosthesis prototype with mechanical and electric features allowing synchronization of the eyelid motion with the sound eye was planned, designed, and built. An oculopalpebral prosthesis was made in thermoactivated acrylic resin. A gap was created to accommodate an electrical system and allow free motion of a thin eyelid made of silicone attached to the appliance. The movable eyelid was made with medical grade silicone (SILASTIC® MDX4-4210) and connected to an electrical and electronic system responsible to command the opening and closing movements. This mechanical and electrical prototype with the system connected to a sensor, successfully captured the eyelid motion of the contralateral sound eye. The proposed mechanical and electrical system attached to an oculopalpebral prosthesis could successfully establish and synchronize the eyelid movements with the sound eye

Mitochondrial K_ATP Channel and Dopaminergic Vulnerability Neurons in Parkinson’s Disease

The motor deficiency control commonly characterizes Parkinson’s disease (PD), resulting in impairment of neuromuscular command, because of basal ganglia nuclei degeneration and late formation of Lewy’s bodies in the remaining dopaminergic (DA) neurons. Motor signals are triggered in high cortical motor areas and go toward the midbrain regions, where the final tuning movement takes place. PD is characterized primarily by the death of dopaminergic neurons in the regions known as substantia nigra compacta (STNc). Mutations in a couple of genes, such as Parkin1 and DJ1, correspond to the usual familial form of the disease, due to its association with oxidative stress and depolarization of mitochondrial membrane. However, this form does not explain the selective pattern of apoptosis between the neuronal dopaminergic areas of midbrain regions. In this chapter, we are putting forward the hypothesis of oxidative stress and mitochondrial changes as the apparent most relevant cause in PD, as well as the neuroprotective role played by Kir6.2, a potassium-ATP channel and calcium voltage-gated v1.3

Cohort profile: the 100 million Brazilian cohort

The creation of The 100 Million Brazilian Cohort was motivated by the availability of high quality but dispersed social and health databases in Brazil and the need to integrate data and evaluate the impact of policies aiming to improve the social determinants of health (e.g. social protection policies) on health outcomes, overall and in subgroups of interest in a dynamic cohort. • The baseline of The 100 Million Brazilian Cohort comprises 131 697 800 low-income individuals in 35 358 415 families from 2011 to 2018. The Cohort population is mostly composed of children and young adults, with a higher proportion of females than the general Brazilian population, who identify themselves as Brown and live in the urban area of the country. • Exposure to social protection and the follow-up of individuals are obtained through: (i) deterministic linkage using the Social Identification Number (NIS) to link the Cohort baseline to social protection programmes and to periodically renewed socioeconomic information in Cadatro U ́ nico datasets; and/or (ii) non-deterministic linkage using the CIDACS-RL non-deterministic linkage tool, to link the Cohort baseline to administrative health care datasets such as mortality (Mortality Information System, SIM), disease notification (Information System for Notifiable Diseases, SINAN), birth information (Live Birth Information System, SINASC) and nutrition status (Food and Nutrition Surveillance System, SISVAN). • So far, studies have used The 100 Million Brazilian Cohort to investigate the socioeconomic and demographic determinants of leprosy, leprosy treatment outcomes and low birthweight and to evaluate the impact of the Bolsa Familia Programme (BFP) on leprosy and child mortality. Other studies are now being conducted that are of utmost relevance to the health inequalities of Brazil and many low- and middle-income countries, and many research opportunities are being opened up with the linkage of a range of health outcomes

Defining positioning in a core ontology for robotics

Unambiguous definition of spatial position and orientation has crucial importance for robotics. In this paper we propose an ontology about positioning. It is part of a more extensive core ontology being developed by the IEEE RAS Working Group on ontologies for robotics and automation. The core ontology should provide a common ground for further ontology development in the field. We give a brief overview of concepts in the core ontology and then describe an integrated approach for representing quantitative and qualitative position information.3-7 November 201

Mortality inequalities measured by socioeconomic indicators in Brazil: a scoping review

OBJECTIVE Summarize the literature on the relationship between composite socioeconomic indicators and mortality in different geographical areas of Brazil. METHODS This scoping review included articles published between January 1, 2000, and August 31, 2020, retrieved by means of a bibliographic search carried out in the Medline, Scopus, Web of Science, and Lilacs databases. Studies reporting on the association between composite socioeconomic indicators and all-cause, or specific cause of death in any age group in different geographical areas were selected. The review summarized the measures constructed, their associations with the outcomes, and potential study limitations. RESULTS Of the 77 full texts that met the inclusion criteria, the study reviewed 24. The area level of composite socioeconomic indicators analyzed comprised municipalities (n = 6), districts (n = 5), census tracts (n = 4), state (n = 2), country (n = 2), and other areas (n = 5). Six studies used composite socioeconomic indicators such as the Human Development Index, Gross Domestic Product, and the Gini Index; the remaining 18 papers created their own socioeconomic measures based on sociodemographic and health indicators. Socioeconomic status was inversely associated with higher rates of all-cause mortality, external cause mortality, suicide, homicide, fetal and infant mortality, respiratory and circulatory diseases, stroke, infectious and parasitic diseases, malnutrition, gastroenteritis, and oropharyngeal cancer. Higher mortality rates due to colorectal cancer, leukemia, a general group of neoplasms, traffic accident, and suicide, in turn, were observed in less deprived areas and/or those with more significant socioeconomic development. Underreporting of death and differences in mortality coverage in Brazilian areas were cited as the main limitation. CONCLUSIONS Studies analyzed mortality inequalities in different geographical areas by means of composite socioeconomic indicators, showing that the association directions vary according to the mortality outcome. But studies on all-cause mortality and at the census tract level remain scarce. The results may guide the development of new composite socioeconomic indicators for use in mortality inequality analysis