Predictive methodology of the dynamics of the number of COVID-19 cases: application to China, Belgium, and South Korea

Objetivos: Se han desarrollado múltiples metodologías basadas en la teoría de la probabilidad para establecer predicciones de epidemias de dengue, malaria, VIH, obesidad, entre otras. Esta investigación tuvo como objetivo desarrollar un nuevo método de predicción de la dinámica del número de casos de COVID-19 para China, Bélgica y Corea del Sur, basado en la teoría de la probabilidad que permite evaluar y comparar su crecimiento.   Materiales y métodos: Se establecieron rangos de probabilidad del número de casos de COVID-19, los cuales fueron asignados a cada uno de los valores diarios del número de casos de COVID-19 reportados por China Bélgica y Corea del Sur evaluados durante 74, 50 y 50 días, respectivamente. Se calculó la frecuencia y probabilidad de cada rango diario para cada país. Se calculó su probabilidad total y la probabilidad de la dinámica en intervalos de 8 días consecutivos y se compararon los valores entre países para evaluar sus diferencias.   Resultados: se establecieron valores de probabilidad de 1.21E-30, 2.03E-22 y 3.15E-12 para China, Bélgica y Corea del Sur, lo que permite diferenciar cuantitativamente las características de su dinámica. Las diferencias de probabilidad de los subespacios de 8 días variaron de 0,003 a 1, lo que permitió evaluar los cambios temporales en la dinámica.   Conclusión: los rangos establecidos para la evaluación del número de casos de COVID-19 permiten diferenciar el comportamiento de las epidemias entre países y estratificar la severidad de la expansión, destacando un orden matemático subyacente para este fenómeno que permite predecir cuantitativamente su dinámica espacio-temporal y indirectamente, la eficacia de las políticas de salud pública implementadas para cada país.Objectives: Multiple methodologies based on probability theory have been developed to establish predictions of dengue, malaria, HIV, obesity epidemics, among others. This research aimed to develop a new method for predicting the dynamics of the number of COVID-19 cases for China, Belgium, and South Korea based on the probability theory that allows the evaluation and comparison of their increment. Material and methods: Probability ranges of the number of COVID-19 cases were established, which were assigned to each of the daily number of COVID-19 cases reported by China, Belgium, and South Korea that were evaluated during 74, 50, and 50 days respectively. The frequency and probability of each daily range for each country was calculated. Their total probability and the probability of the dynamics in intervals of 8 consecutive days were calculated, and the values between countries were compared to evaluate their differences. Results: Probability values of 1.21E-30, 2.03E-22, and 3.15E-12 were established for China, Belgium, and South Korea, which allows the quantitative differentiation of the characteristics of their dynamics. The probability differences of the 8-day subspaces ranged from 0.003 to 1, allowing the temporal changes in the dynamics to be evaluated. Conclusion: The ranges established for the evaluation of the number of COVID-19 cases allow to differentiate the behavior of epidemics between countries and to stratify the severity of expansion. Highlighting an underlying mathematical order for this phenomenon permitted quantitatively predict its spatiotemporal dynamic and indirectly, the efficacy of public health politics implemented for each country

Predictive methodology of the dynamics of the number of COVID-19 cases: application to China, Belgium, and South Korea

Objetivos: Se han desarrollado múltiples metodologías basadas en la teoría de la probabilidad para establecer predicciones de epidemias de dengue, malaria, VIH, obesidad, entre otras. Esta investigación tuvo como objetivo desarrollar un nuevo método de predicción de la dinámica del número de casos de COVID-19 para China, Bélgica y Corea del Sur, basado en la teoría de la probabilidad que permite evaluar y comparar su crecimiento.   Materiales y métodos: Se establecieron rangos de probabilidad del número de casos de COVID-19, los cuales fueron asignados a cada uno de los valores diarios del número de casos de COVID-19 reportados por China Bélgica y Corea del Sur evaluados durante 74, 50 y 50 días, respectivamente. Se calculó la frecuencia y probabilidad de cada rango diario para cada país. Se calculó su probabilidad total y la probabilidad de la dinámica en intervalos de 8 días consecutivos y se compararon los valores entre países para evaluar sus diferencias.   Resultados: se establecieron valores de probabilidad de 1.21E-30, 2.03E-22 y 3.15E-12 para China, Bélgica y Corea del Sur, lo que permite diferenciar cuantitativamente las características de su dinámica. Las diferencias de probabilidad de los subespacios de 8 días variaron de 0,003 a 1, lo que permitió evaluar los cambios temporales en la dinámica.   Conclusión: los rangos establecidos para la evaluación del número de casos de COVID-19 permiten diferenciar el comportamiento de las epidemias entre países y estratificar la severidad de la expansión, destacando un orden matemático subyacente para este fenómeno que permite predecir cuantitativamente su dinámica espacio-temporal y indirectamente, la eficacia de las políticas de salud pública implementadas para cada país.Objectives: Multiple methodologies based on probability theory have been developed to establish predictions of dengue, malaria, HIV, obesity epidemics, among others. This research aimed to develop a new method for predicting the dynamics of the number of COVID-19 cases for China, Belgium, and South Korea based on the probability theory that allows the evaluation and comparison of their increment. Material and methods: Probability ranges of the number of COVID-19 cases were established, which were assigned to each of the daily number of COVID-19 cases reported by China, Belgium, and South Korea that were evaluated during 74, 50, and 50 days respectively. The frequency and probability of each daily range for each country was calculated. Their total probability and the probability of the dynamics in intervals of 8 consecutive days were calculated, and the values between countries were compared to evaluate their differences. Results: Probability values of 1.21E-30, 2.03E-22, and 3.15E-12 were established for China, Belgium, and South Korea, which allows the quantitative differentiation of the characteristics of their dynamics. The probability differences of the 8-day subspaces ranged from 0.003 to 1, allowing the temporal changes in the dynamics to be evaluated. Conclusion: The ranges established for the evaluation of the number of COVID-19 cases allow to differentiate the behavior of epidemics between countries and to stratify the severity of expansion. Highlighting an underlying mathematical order for this phenomenon permitted quantitatively predict its spatiotemporal dynamic and indirectly, the efficacy of public health politics implemented for each country

Mathematical physical diagnosis of neonatal cardiac dynamics based on dynamic systems and fractal geometry: Clinical validation study

A mathematical evaluation of neonatal cardiac dynamics was developed. The purpose of this study is to confirm the diagnostic capacity of this methodology to differentiate normal neonatal cardiac and cardiac pathologies through a blind study. For this, 80 Holter records were taken, 10 with evaluation within the limits of normality and 70 with different cardiac pathologies. The conventional evaluations were masked, and the maximum and minimum heart rates were taken every hour and the number of beats/hours, during 21 hours. These values were used to generate the neonatal cardiac attractor, then their fractal dimension was calculated, their occupation spaces were quantified in the fractal space of Box-Counting, determining their physic mathematical diagnosis. The spaces of occupation of neonatal chaotic cardiac attractors measured according to the number of frames occupied by the Box Counting method, differentiate states of normality from acute pathologies, achieving a sensitivity and specificity of 100%, as well as a kappa coefficient of 1. The This study confirms the diagnostic capacity of the methodology developed, from which it is possible to establish geometric differences between the chaotic attractors of normal neonatal cardiac dynamics and with disease.https://scienti.minciencias.gov.co/cvlac/visualizador/generarCurriculoCv.do?cod_rh=0000343870https://orcid.org/0000-0001-7239-0763Introducción. -- Metodología. -- Resultados. -- Discusión. -- Conclusiones. -- Agradecimiento

Exponential law of chaotic cardiac dynamics applied to 18 hours

Introduction: The application of an exponential law for chaotic dynamic cardiac systems has been reduced to 18 hours for Holter analysis, quantifying normal and pathological cardiac dynamics, as well as the evolution between these states. Methodology: 80 electrocardiographic records were analyzed, 15 with normal dynamics and 65 with different pathologies. A chaotic attractor was constructed for each cardiac dynamic based on the simulation of the cardiac frequency sequence for 18 hours, after the fractal dimension of each attractor and its spatial occupation were found. The differentiating parameters of the chaotic exponential law were applied differentiating normal cardiac dynamics from those pathological, finally the sensitivity, specificity and Kappa coefficient were calculated. Results: The normal dynamics presented occupancy spaces above 200 in the Kp grid, and for the Kg grid above 67. In the cases of acute disease, the values in the Kp and Kg grids were below 73 and 22 respectively. The values of sensitivity and specificity were 100% and the Kappa coefficient was 1. Conclusion: The application of the exponential law for 18 hours showed that it was possible to characterize mathematically the cardiac dynamics, allowing reducing the time of evaluation.    Introducción: La aplicación de una ley exponencial para los sistemas dinámicos caóticos cardiacos ha sido reducida a 18 horas para el análisis del Holter, cuantificando las dinámicas cardiacas normales y patológicas, así como la evolución entre estos estados. Metodología: Se analizaron 80 registros electrocardiográficos, 15 con dinámicas normales y 65 con diferentes patologías. Se construyó un atractor caótico para cada dinámica cardiaca a partir de la simulación de la secuencia de las frecuencias cardiacas durante 18 horas, posteriormente se halló la dimensión fractal de cada atractor y su ocupación espacial. Los parámetros diferenciadores de la ley caótica exponencial fueron aplicados diferenciando dinámicas cardiacas normales de aquellas patológicas, finalmente se calculó la sensibilidad, especificidad y coeficiente Kappa. Resultados: Las dinámicas normales presentaron espacios de ocupación por encima de 200 en la rejillla Kp, y para la rejilla Kg por encima de 67. Para los casos de enfermedad aguda los valores en las rejillas Kp y Kg estuvieron por debajo de 73 y 22 respectivamente. Los valores de sensibilidad y especificidad fueron de 100% y el coeficiente Kappa fue de 1. Conclusión: La aplicación de la ley exponencial durante 18 horas mostro que fue posible caracterizar matemáticamente las dinámicas cardiacas, permitiendo reducir el tiempo de evaluación.&nbsp

Software para la dinámica cardíaca adulta mediante sistemas dinámicos

The normal and abnormal behavior of an adult heart dynamics and its state of evolution towards one of these two states has been characterized successfully in the context of the theory of dynamic systems and probability. The diagnostic methodology of clinical application designed under these two theories has managed to evaluate in an objective and reproducible way the cardiac dynamics from the values of the frequency of the Holter registers. The automation of this methodology through the design of a software that can be docked in any operating system for PC, and contributes as a diagnostic aid tool to generate more timely responses to the patient's clinical condition. Additionally, the values of the probability of these spaces occupied by the attractor, calculated by the Software, allow using an interface that can be consulted by the specialist to evaluate how far a cardiac dynamic is from normality, analyzing in this way the effectiveness of the treatment.A través de la teoría de la probabilidad y de los sistemas dinámicos se ha construido una metodología para evaluar la dinámica cardíaca –recientemente automatizada– mediante un software que puede ser acoplado a cualquier sistema operativo para PC. El software permite mediante una interfaz consultar la dinámica cardíaca por un especialista del área clínica y así evaluar qué tan alejada se encuentra una dinámica cardiaca de la normalidad. En este estudio se hizo uso de dicho software para desarrollar un estudio de concordancia diagnóstica para confirmar su capacidad como herramienta de evaluación a nivel clínico. Para ello se parte de la medición de: 120 registros Holter, 100 patológicos y 20 normales, durante 21 horas; con los cuales se toman los valores de la frecuencia cardíaca y numero de latidos; en base a esta información el software elabora secuencias pareadas y construye atractores con los cuales cuantifica la dimensión fractal, los espacios de ocupación en el espacio fractal de Box Counting, y los valores de la probabilidad de los espacios ocupados por el atractor. De lo anterior se encontró que este proceso permite diferenciar la normalidad de la patología aguda y su evolución, obteniendo valores de sensibilidad y especificidad del 100%. Dado este contexto, es de destacar que el proceso permite analizar de una manera objetiva y reproducible la efectividad de los tratamientos médico

Mortality from gastrointestinal congenital anomalies at 264 hospitals in 74 low-income, middle-income, and high-income countries: a multicentre, international, prospective cohort study

Summary Background Congenital anomalies are the fifth leading cause of mortality in children younger than 5 years globally. Many gastrointestinal congenital anomalies are fatal without timely access to neonatal surgical care, but few studies have been done on these conditions in low-income and middle-income countries (LMICs). We compared outcomes of the seven most common gastrointestinal congenital anomalies in low-income, middle-income, and high-income countries globally, and identified factors associated with mortality. Methods We did a multicentre, international prospective cohort study of patients younger than 16 years, presenting to hospital for the first time with oesophageal atresia, congenital diaphragmatic hernia, intestinal atresia, gastroschisis, exomphalos, anorectal malformation, and Hirschsprung’s disease. Recruitment was of consecutive patients for a minimum of 1 month between October, 2018, and April, 2019. We collected data on patient demographics, clinical status, interventions, and outcomes using the REDCap platform. Patients were followed up for 30 days after primary intervention, or 30 days after admission if they did not receive an intervention. The primary outcome was all-cause, in-hospital mortality for all conditions combined and each condition individually, stratified by country income status. We did a complete case analysis. Findings We included 3849 patients with 3975 study conditions (560 with oesophageal atresia, 448 with congenital diaphragmatic hernia, 681 with intestinal atresia, 453 with gastroschisis, 325 with exomphalos, 991 with anorectal malformation, and 517 with Hirschsprung’s disease) from 264 hospitals (89 in high-income countries, 166 in middleincome countries, and nine in low-income countries) in 74 countries. Of the 3849 patients, 2231 (58·0%) were male. Median gestational age at birth was 38 weeks (IQR 36–39) and median bodyweight at presentation was 2·8 kg (2·3–3·3). Mortality among all patients was 37 (39·8%) of 93 in low-income countries, 583 (20·4%) of 2860 in middle-income countries, and 50 (5·6%) of 896 in high-income countries (p<0·0001 between all country income groups). Gastroschisis had the greatest difference in mortality between country income strata (nine [90·0%] of ten in lowincome countries, 97 [31·9%] of 304 in middle-income countries, and two [1·4%] of 139 in high-income countries; p≤0·0001 between all country income groups). Factors significantly associated with higher mortality for all patients combined included country income status (low-income vs high-income countries, risk ratio 2·78 [95% CI 1·88–4·11], p<0·0001; middle-income vs high-income countries, 2·11 [1·59–2·79], p<0·0001), sepsis at presentation (1·20 [1·04–1·40], p=0·016), higher American Society of Anesthesiologists (ASA) score at primary intervention (ASA 4–5 vs ASA 1–2, 1·82 [1·40–2·35], p<0·0001; ASA 3 vs ASA 1–2, 1·58, [1·30–1·92], p<0·0001]), surgical safety checklist not used (1·39 [1·02–1·90], p=0·035), and ventilation or parenteral nutrition unavailable when needed (ventilation 1·96, [1·41–2·71], p=0·0001; parenteral nutrition 1·35, [1·05–1·74], p=0·018). Administration of parenteral nutrition (0·61, [0·47–0·79], p=0·0002) and use of a peripherally inserted central catheter (0·65 [0·50–0·86], p=0·0024) or percutaneous central line (0·69 [0·48–1·00], p=0·049) were associated with lower mortality. Interpretation Unacceptable differences in mortality exist for gastrointestinal congenital anomalies between lowincome, middle-income, and high-income countries. Improving access to quality neonatal surgical care in LMICs will be vital to achieve Sustainable Development Goal 3.2 of ending preventable deaths in neonates and children younger than 5 years by 2030

Design of a Holter Monitor for the Diagnosis of Neonatal Cardiac Dynamics

Cada año se reportan aproximadamente 4 millones de muertes neonatales y aproximadamente el 98% de los cuales ocurren en los países en desarrollo, donde el riesgo es 6 veces mayor que en los países desarrollados países. Por este motivo, se necesitan métodos de detección y diagnóstico precoz de alteraciones potencialmente mortales para evitar estos desenlaces. Recientemente, una metodología para la Se ha desarrollado una evaluación de la dinámica cardíaca neonatal, que ayuda a diferenciar de la dinámica cardíaca anormal contando los espacios ocupados por los atractores cardíacos caóticos. Para automatizar este método, se diseñó y construyó un monitor Holter para recién nacidos, junto con una herramienta de software que realiza pruebas de función cardíaca. Finalmente, se realizaron pruebas con el monitor Holter y el software desarrollado para evaluar la dinámica cardíaca de 100 pacientes, que validado el correcto funcionamiento de los dispositivos diseñados. De esta manera, la utilidad potencial de este desarrollo tecnológico está asociado a una disminución de la mortalidad neonatal ya que permite la detección de alteraciones en la dinámica cardíaca a través de un dispositivo ECG (electrocardiograma) y un método matemático que es independiente de la evaluación clínica.Every year, approximately 4 million neonatal deaths are reported, and approximately 98% of which occur in developing countries, where the risk is 6-fold higher than that in developed countries. For this reason, methods for the early detection and diagnosis of potentially lifethreatening alterations are needed to avoid these outcomes. Recently, a ethodology for the assessment of neonatal cardiac dynamics has been developed, which helps differentiate normal from abnormal cardiac dynamics by counting the spaces occupied by the chaotic cardiac attractors. In order to automate this method, a Holter monitor for newborn infants was designed and built, along with a software tool that performs cardiac function tests. Finally, tests were performed using the Holter monitor and software developed to assess the cardiac dynamics of 100 patients, which validated the proper functioning of the devices designed. In this way, the potential usefulness of this technological development is associated with a decrease in neonatal mortality as it allows for the detection of alterations in cardiac dynamics through an ECG (electrocardiogram) device and a mathematical method that is independent of the clinical assessment.https://co.linkedin.com/in/jaime-alberto-paez-paez-49548823https://www.researchgate.net/profile/Jairo-Cortes-Mendezhttps://orcid.org/0000-0002-7312-0180INSIGHTJaime.paez@[email protected]@campusucc.edu.cohttps://scholar.google.com.co/citations?user=QnZg_mkAAAAJ&hl=enhttps://scholar.google.es/citations?hl=es&user=dhHrDtQAAAAJ&view_op=list_works&sortby=pubdatehttps://scholar.google.com/citations?user=7SOhB48AAAAJ&hl=e

Análisis de la cardiotocografía anteparto mediante las relaciones S/k y la probabilidad en 20 minutos / Analysis of antepartum cardiotocography based on S/k proportions and probability in 20 minutes

Aproximadamente 4 millones de bebés que nacen anualmente presentan asfixia perinatal, de los cuales casi 900.000 mueren por esta causa. En el contexto clínico se realizan varias mediciones como el perfil biofísico, el perfil biofísico modificado, la medición del índice de líquido amniótico, el Doppler de la arteria umbilical, entre otras, que sirven para evaluar el bienestar fetal y por lo tanto potencialmente puede evitar la aparición de este desenlace al detectar tempranamente alteraciones que pueden ser intervenidas oportunamente. Sin embargo, es la cardiotocografía la que se utiliza en el ingreso de mujeres embarazadas en los servicios de urgencias de hospitales de todo el mundo1. El monitoreo cardiotocográfico es un examen aceptado en la práctica obstétrica que consiste en el registro continuo impreso o electrónico de la frecuencia cardíaca fetal y las contracciones uterinas maternas a través de un monitor colocado en la pared abdominal de la madre, que integra medidas de transmisión de presión y ultrasonido para detectar las contracciones uterinas y la frecuencia cardíaca fetal, respectivamente.2 El análisis de este examen generalmente implica la observación de parámetros de trazado cardiotocográfico, como la línea de base o la presencia de aceleraciones y desaceleraciones que, en conjunto, proporcionan una base para clasificar los registros como normales, sospechosos o anormales, aunque los términos y criterios varían. entre las instituciones médicas que establecen pautas para la interpretación de la cardiotocografía.3,4Approximately 4 million babies born annually present perinatal asphyxia, of which almost 900,000 die from this cause. Several measurements are performed in the clinical context such as the biophysical profile, the modified biophysical profile, the measurement of the amniotic fluid index, and the Doppler of the umbilical artery, among others, that serve to assess fetal well-being and therefore potentially they can avoid the appearance of this outcome by detecting early alterations that can be intervened in a timely manner. However, it is cardiotocography that is used in the admission of pregnant women in the emergency services of hospitals around the world.1 Cardiotocographic monitoring is an accepted examination in obstetric practice that consists of continuous printed or electronic recording of the fetal heart rate and maternal uterine contractions through a monitor placed on the abdominal wall of the mother, which integrates pressure and ultrasound transmission measurements to detect uterine contractions and fetal heart rate, respectively.2Analysis of this exam typically involves observation of cardiotocographic tracing parameters such as baseline or the presence of accelerations and decelerations that together provide a basis for classifying the recordings as normal, suspicious, or abnormal, although the terms and criteria vary among medical institutions that establish guidelines for the interpretation of cardiotocography.3,4https://scholar.google.es/citations?user=dhHrDtQAAAAJ&hl=eshttps://orcid.org/0000-0002-7312-0180https://co.linkedin.com/in/[email protected]

Diagnostic methodology for the neonatal cardiac system based on dynamic systems

Fractal geometry and nonlinear systems have shown to be useful to diagnose and predict the behavior of cardiac dynamics in adults with promising applications, but studies in neonates are lacking. The objective of this study is to apply a chaotic methodology to diagnose heart dynamics of neonates. 70 electrocardiographic records were taken from newborn patients, 10 normal and 60 pathological. Then, the minimum and maximum heart rates as well as the number of heartbeats/hour were taken for at least 21 hours; a sequence of heart rates was generated and, based on that sequence, chaotic attractors were constructed. Their fractal dimension was calculated as well as their occupation in the Box-Counting space and the mathematical diagnosis was determined based on the limits established in the induction. A blind study was developed for statistical validation against the Gold Standard diagnosis. It was found that the spatial occupation of neonatal cardiac chaotic attractors in the Box-Counting fractal space allowed the differentiation between normality and disease, reaching the highest values of sensitivity, specificity and diagnostic concordance against Gold Standard. Hence, it is concluded that fractal geometry allows to diagnose and differentiate normal from abnormal heart dynamics of neonates independent of the clinical scenarios, corroborating its utility at clinical level.Introducción. -- Métodos. -- Resultados. -- Discusión. -- Agradecimientos. -- Referencias.https://scienti.minciencias.gov.co/cvlac/visualizador/generarCurriculoCv.do?cod_rh=0000343870https://orcid.org/[email protected]

Software para la dinámica cardíaca adulta mediante sistemas dinámicos

The normal and abnormal behavior of an adult heart dynamics and its state of evolution towards one of these two states has been characterized successfully in the context of the theory of dynamic systems and probability. The diagnostic methodology of clinical application designed under these two theories has managed to evaluate in an objective and reproducible way the cardiac dynamics from the values of the frequency of the Holter registers. The automation of this methodology through the design of a software that can be docked in any operating system for PC, and contributes as a diagnostic aid tool to generate more timely responses to the patient's clinical condition. Additionally, the values of the probability of these spaces occupied by the attractor, calculated by the Software, allow using an interface that can be consulted by the specialist to evaluate how far a cardiac dynamic is from normality, analyzing in this way the effectiveness of the treatment.A través de la teoría de la probabilidad y de los sistemas dinámicos se ha construido una metodología para evaluar la dinámica cardíaca –recientemente automatizada– mediante un software que puede ser acoplado a cualquier sistema operativo para PC. El software permite mediante una interfaz consultar la dinámica cardíaca por un especialista del área clínica y así evaluar qué tan alejada se encuentra una dinámica cardiaca de la normalidad. En este estudio se hizo uso de dicho software para desarrollar un estudio de concordancia diagnóstica para confirmar su capacidad como herramienta de evaluación a nivel clínico. Para ello se parte de la medición de: 120 registros Holter, 100 patológicos y 20 normales, durante 21 horas; con los cuales se toman los valores de la frecuencia cardíaca y numero de latidos; en base a esta información el software elabora secuencias pareadas y construye atractores con los cuales cuantifica la dimensión fractal, los espacios de ocupación en el espacio fractal de Box Counting, y los valores de la probabilidad de los espacios ocupados por el atractor. De lo anterior se encontró que este proceso permite diferenciar la normalidad de la patología aguda y su evolución, obteniendo valores de sensibilidad y especificidad del 100%. Dado este contexto, es de destacar que el proceso permite analizar de una manera objetiva y reproducible la efectividad de los tratamientos médico