Test de aleatoriedad para procesos puntuales espaciales basado en el cálculo de la dimensión fractal

El estudio de procesos puntuales espaciales un área de la estadística espacial permite modelar y analizar la distribución de eventos que ocurren en una región. En la práctica, el primer paso para su análisis consiste en evaluar la hipótesis de Aleatoriedad Espacial Completa (AEC). En este trabajo se propone una prueba basada en la dimensión fractal por el método de Box Counting para evaluar dicha hipótesis. Los resultados encontrados, con datos simulados y reales indican que la prueba tiene un buen desempeño.Abstract: The study of spatial point patterns, as an area of spatial statistics, allows modelling and analyzing the distribution of events recorded in a region of interest. In practical applications, the first step for analysis is evaluate the hypothesis of complete spatial randomness (CSR). In this work a test based on fractal dimension by Box Counting method is proposed in order to evaluate that hypothesis. The results shows an good performance with real and simulated datasets.Maestrí

Caracterización de la relación entre calidad y tamaño de la familia para el área urbana de bogotá D.C., en 2014

Articulo de investigació

Walkability index for the city of Bogotá

La movilidad peatonal es un aspecto recurrente en los discursos de la ciudad actual. Se espera que en las ciudades se generen espacios urbanos que fomenten la caminabilidad y, de esta manera, se promueva la reducción de la movilidad vehicular y la recuperación de la calidad ambiental, a fin de mejorar la calidad de vida de los ciudadanos. De esta manera, es necesario evaluar en términos cuantitativos las diferentes condiciones que permitan tener desplazamientos a pie, y con ello servir de base para la implementación de políticas de movilidad y espacio público que aporten a la generación de entornos más amigables. Para el caso de Bogotá se plantea la construcción y medición del índice de caminabilidad basado en cinco componentes: calidad ambiental, densidad, confort, proximidad y entropía aplicados en las Unidades de Planeamiento Zonal (UPZ), mediante el análisis de bases de datos espaciales y herramientas de sistemas de información geográfica (SIG). Se construye el índice entendiendo que es un indicador relativo de qué tan bien está el entorno construido en diferentes áreas para caminar, y qué condiciones de entorno propician dicho comportamiento. Se logra diagnosticar cuáles son los grados de caminabilidad por cada UPZ, y se distinguen diversas condiciones en los sectores analizados.A mobilidade de pedestres é um aspecto recorrente nos discursos da cidade atual. Espera-se que, nas cidades, sejam gerados espaços urbanos que fomentem a caminhabilidade e, dessa maneira, seja promovida a redução da mobilidade veicular e a recuperação da qualidade ambiental a fim de melhorar a qualidade de vida dos cidadãos. Assim, é necessário avaliar, em termos quantitativos, as diferentes condições que permitem ter deslocamentos a pé e, com isso, servir de base para implantar políticas de mobilidade e espaço público que contribuam para gerar ambientes mais amigáveis. Para o caso de Bogotá, Colômbia, são propostas a construção e a mediação do índice de caminhabilidade baseado em cinco componentes: qualidade ambiental, densidade, conforto, proximidade e entropia aplicados nas Unidades de Planejamento Zonal (UPZ), mediante a análise de bases de dados espaciais e ferramentas de sistemas de informação geográfica (SIG). Foi construído o índice entendendo que é um indicador relativo de quão bem está o ambiente construído em diferentes áreas para caminhar e quais condições de entorno propiciam esse comportamento. Pode-se diagnosticar quais são os graus de caminhabilidade por cada UPZ e foram diferenciadas as condições nos setores analisados.Pedestrian mobility has been a recurrent aspect in discourses on the contemporary city. It is expected that cities generate urban spaces that encourage walkability, promoting thus the reduction of vehicular mobility and the recovery of environmental quality, seeking to improve the quality of life of citizens. For this reason, it is necessary to quantitatively evaluate different conditions that allow citizens to have displacements on foot, and to use this as a basis for the implementation of mobility and public space policies that allow generating more pedestrian-friendly environments. In the case of Bogotá and its administrative divisions, the paper proposes the construction and measurement of a walkability index based on five components (environmental quality, density, comfort, proximity, and entropy) at the level of Zonal Planning Units (UPZ), through the analysis of spatial databases and Geographic Information System tools. This index is a relative indicator of how well the environment is constructed in different areas with respect to walking and what environmental conditions favor such behavior. It helps to diagnose the degree of walkability for each UPZ, as well as to distinguish diverse conditions in the analyzed areas

Primary care randomized clinical trial: manual therapy effectiveness in comparison with TENS in patients with neck pain

This study investigated effectiveness of manual therapy (MT) with transcutaneous electrical nerve stimulation (TENS) to reduce pain intensity in patients with mechanical neck disorder (MND). A randomized multi-centered controlled clinical trial was performed in 12 Primary Care Physiotherapy Units in Madrid Region. Ninety patients were included with diagnoses of subacute or chronic MND without neurological damage, 47 patients received MT and 43 TENS. The primary outcome was pain intensity measured in millimeters using the Visual Analogue Scale (VAS). Also disability, quality of life, adverse effects and sociodemographic and prognosis variables were measured. Three evaluations were performed (before, when the procedure ?nished and six months after). Seventy-one patients (79%) completed the follow-up measurement at six months. In more than half of the treated patients the procedure had a clinically relevant ?short term? result after having ended the intervention, when either MT or TENS was used. The success rate decreased to one-third of the patients 6 months after the intervention. No differences can be found in the reduction of pain, in the decrease of disability nor in the quality of life between both therapies. Both analyzed physiotherapy techniques produce a short-term pain reduction that is clinically relevant.Ministerio de SanidadInstituto de Salud Carlos II

Population-based multicase-control study in common tumors in Spain (MCC-Spain): rationale and study design

Introduction: We present the protocol of a large population-based case-control study of 5 common tumors in Spain (MCC-Spain) that evaluates environmental exposures and genetic factors. Methods: Between 2008-2013, 10,183 persons aged 20-85 years were enrolled in 23 hospitals and primary care centres in 12 Spanish provinces including 1,115 cases of a new diagnosis of prostate cancer, 1,750 of breast cancer, 2,171 of colorectal cancer, 492 of gastro-oesophageal cancer, 554 cases of chronic lymphocytic leukaemia (CLL) and 4,101 population-based controls matched by frequency to cases by age, sex and region of residence. Participation rates ranged from 57% (stomach cancer) to 87% (CLL cases) and from 30% to 77% in controls. Participants completed a face-to-face computerized interview on sociodemographic factors, environmental exposures, occupation, medication, lifestyle, and personal and family medical history. In addition, participants completed a self-administered food-frequency questionnaire and telephone interviews. Blood samples were collected from 76% of participants while saliva samples were collected in CLL cases and participants refusing blood extractions. Clinical information was recorded for cases and paraffin blocks and/or fresh tumor samples are available in most collaborating hospitals. Genotyping was done through an exome array enriched with genetic markers in specific pathways. Multiple analyses are planned to assess the association of environmental, personal and genetic risk factors for each tumor and to identify pleiotropic effects. Discussion: This study, conducted within the Spanish Consortium for Biomedical Research in Epidemiology & Public Health (CIBERESP), is a unique initiative to evaluate etiological factors for common cancers and will promote cancer research and prevention in Spain.The study was partially funded by the “Accion Transversal del Cancer”, approved on the Spanish Ministry Council on the 11th October 2007, by the Instituto de Salud Carlos III-FEDER (PI08/1770, PI08/0533, PI08/1359, PS09/00773, PS09/01286, PS09/01903, PS09/02078, PS09/01662, PI11/01403, PI11/01889, PI11/00226, PI11/01810, PI11/02213, PI12/00488, PI12/00265, PI12/01270, PI12/00715, PI12/00150), by the Fundación Marqués de Valdecilla (API 10/09), by the ICGC International Cancer Genome Consortium CLL, by the Junta de Castilla y León (LE22A10-2), by the Consejería de Salud of the Junta de Andalucía (PI-0571), by the Conselleria de Sanitat of the Generalitat Valenciana (AP 061/10), by the Recercaixa (2010ACUP 00310), by the Regional Government of the Basque Country by European Commission grants FOOD-CT- 2006-036224-HIWATE, by the Spanish Association Against Cancer (AECC) Scientific Foundation, by the The Catalan Government DURSI grant 2009SGR1489

Clonal chromosomal mosaicism and loss of chromosome Y in elderly men increase vulnerability for SARS-CoV-2

The pandemic caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2, COVID-19) had an estimated overall case fatality ratio of 1.38% (pre-vaccination), being 53% higher in males and increasing exponentially with age. Among 9578 individuals diagnosed with COVID-19 in the SCOURGE study, we found 133 cases (1.42%) with detectable clonal mosaicism for chromosome alterations (mCA) and 226 males (5.08%) with acquired loss of chromosome Y (LOY). Individuals with clonal mosaic events (mCA and/or LOY) showed a 54% increase in the risk of COVID-19 lethality. LOY is associated with transcriptomic biomarkers of immune dysfunction, pro-coagulation activity and cardiovascular risk. Interferon-induced genes involved in the initial immune response to SARS-CoV-2 are also down-regulated in LOY. Thus, mCA and LOY underlie at least part of the sex-biased severity and mortality of COVID-19 in aging patients. Given its potential therapeutic and prognostic relevance, evaluation of clonal mosaicism should be implemented as biomarker of COVID-19 severity in elderly people. Among 9578 individuals diagnosed with COVID-19 in the SCOURGE study, individuals with clonal mosaic events (clonal mosaicism for chromosome alterations and/or loss of chromosome Y) showed an increased risk of COVID-19 lethality

The evolution of the ventilatory ratio is a prognostic factor in mechanically ventilated COVID-19 ARDS patients

Background: Mortality due to COVID-19 is high, especially in patients requiring mechanical ventilation. The purpose of the study is to investigate associations between mortality and variables measured during the first three days of mechanical ventilation in patients with COVID-19 intubated at ICU admission. Methods: Multicenter, observational, cohort study includes consecutive patients with COVID-19 admitted to 44 Spanish ICUs between February 25 and July 31, 2020, who required intubation at ICU admission and mechanical ventilation for more than three days. We collected demographic and clinical data prior to admission; information about clinical evolution at days 1 and 3 of mechanical ventilation; and outcomes. Results: Of the 2,095 patients with COVID-19 admitted to the ICU, 1,118 (53.3%) were intubated at day 1 and remained under mechanical ventilation at day three. From days 1 to 3, PaO2/FiO2 increased from 115.6 [80.0-171.2] to 180.0 [135.4-227.9] mmHg and the ventilatory ratio from 1.73 [1.33-2.25] to 1.96 [1.61-2.40]. In-hospital mortality was 38.7%. A higher increase between ICU admission and day 3 in the ventilatory ratio (OR 1.04 [CI 1.01-1.07], p = 0.030) and creatinine levels (OR 1.05 [CI 1.01-1.09], p = 0.005) and a lower increase in platelet counts (OR 0.96 [CI 0.93-1.00], p = 0.037) were independently associated with a higher risk of death. No association between mortality and the PaO2/FiO2 variation was observed (OR 0.99 [CI 0.95 to 1.02], p = 0.47). Conclusions: Higher ventilatory ratio and its increase at day 3 is associated with mortality in patients with COVID-19 receiving mechanical ventilation at ICU admission. No association was found in the PaO2/FiO2 variation

CIBERER : Spanish national network for research on rare diseases: A highly productive collaborative initiative

Altres ajuts: Instituto de Salud Carlos III (ISCIII); Ministerio de Ciencia e Innovación.CIBER (Center for Biomedical Network Research; Centro de Investigación Biomédica En Red) is a public national consortium created in 2006 under the umbrella of the Spanish National Institute of Health Carlos III (ISCIII). This innovative research structure comprises 11 different specific areas dedicated to the main public health priorities in the National Health System. CIBERER, the thematic area of CIBER focused on rare diseases (RDs) currently consists of 75 research groups belonging to universities, research centers, and hospitals of the entire country. CIBERER's mission is to be a center prioritizing and favoring collaboration and cooperation between biomedical and clinical research groups, with special emphasis on the aspects of genetic, molecular, biochemical, and cellular research of RDs. This research is the basis for providing new tools for the diagnosis and therapy of low-prevalence diseases, in line with the International Rare Diseases Research Consortium (IRDiRC) objectives, thus favoring translational research between the scientific environment of the laboratory and the clinical setting of health centers. In this article, we intend to review CIBERER's 15-year journey and summarize the main results obtained in terms of internationalization, scientific production, contributions toward the discovery of new therapies and novel genes associated to diseases, cooperation with patients' associations and many other topics related to RD research

Role of age and comorbidities in mortality of patients with infective endocarditis

[Purpose]: The aim of this study was to analyse the characteristics of patients with IE in three groups of age and to assess the ability of age and the Charlson Comorbidity Index (CCI) to predict mortality. [Methods]: Prospective cohort study of all patients with IE included in the GAMES Spanish database between 2008 and 2015.Patients were stratified into three age groups:<65 years,65 to 80 years,and ≥ 80 years.The area under the receiver-operating characteristic (AUROC) curve was calculated to quantify the diagnostic accuracy of the CCI to predict mortality risk. [Results]: A total of 3120 patients with IE (1327 < 65 years;1291 65-80 years;502 ≥ 80 years) were enrolled.Fever and heart failure were the most common presentations of IE, with no differences among age groups.Patients ≥80 years who underwent surgery were significantly lower compared with other age groups (14.3%,65 years; 20.5%,65-79 years; 31.3%,≥80 years). In-hospital mortality was lower in the <65-year group (20.3%,<65 years;30.1%,65-79 years;34.7%,≥80 years;p < 0.001) as well as 1-year mortality (3.2%, <65 years; 5.5%, 65-80 years;7.6%,≥80 years; p = 0.003).Independent predictors of mortality were age ≥ 80 years (hazard ratio [HR]:2.78;95% confidence interval [CI]:2.32–3.34), CCI ≥ 3 (HR:1.62; 95% CI:1.39–1.88),and non-performed surgery (HR:1.64;95% CI:11.16–1.58).When the three age groups were compared,the AUROC curve for CCI was significantly larger for patients aged <65 years(p < 0.001) for both in-hospital and 1-year mortality. [Conclusion]: There were no differences in the clinical presentation of IE between the groups. Age ≥ 80 years, high comorbidity (measured by CCI),and non-performance of surgery were independent predictors of mortality in patients with IE.CCI could help to identify those patients with IE and surgical indication who present a lower risk of in-hospital and 1-year mortality after surgery, especially in the <65-year group

Characterization of the relationship between quality and size of the family for the urban area of Bogotá D.C., in 2014

Teorías económicas y demográficas, exponen la interacción entre la demanda de hijos y los costos de producción de cada hijo al interior de cada familia, definidos en términos de variables sociales y económicas, que son particulares para cada familia. El pEconomic and demographic theories expose the interaction between the demand for children and the production costs of each child within each family, defined in terms of social and economic variables, which are particular to each family. The present work,