A decision support system for on-line leakage localization

This paper describes a model-driven decision-support system (software tool) implementing a model-based methodology for on-line leakage detection and localization which is useful for a large class of water distribution networks. Since these methods present a certain degree of complexity which limits their use to experts, the proposed software tool focuses on the integration of a method emphasizing its use by water network managers as a decision support system. The proposed software tool integrates a model-based leakage localization methodology based on the use of on-line telemetry information, as well as a water network calibrated hydraulic model. The application of the resulting decision support software tool in a district metered area (DMA) of the Barcelona distribution network is provided and discussed. The obtained results show that the leakage detection and localization may be performed efficiently reducing the required time. © 2014 Elsevier Ltd.The authors wish to thank the support received by the AM0901 project funded by R+i Alliance (Suez Environnement) and by the EFFINET grant FP7-ICT-2012-318556 of the European Commission.Peer Reviewe

ViDa1: The Development and Validation of a New Questionnaire for Measuring Health-Related Quality of Life in Patients with Type 1 Diabetes

IGTPAltres ajuts: Funding was provided by the Canarian Agency for Research,Innovation and Information Society (ACIISI) (DA predoctoralfellowship TESIS20120050) and the V Guido Ruffino Grantfor Research in Therapeutic Education for Diabetes (SpanishDiabetes Society 2015)This study describes the development of a new questionnaire to measure health-related quality of life (HRQoL) in patients with type 1 diabetes (the ViDa1 questionnaire) and provides information on its psychometric properties. For its development, open interviews with patients took place and topics relevant to patients' HRQoL were identified and items were generated. Qualitative analysis of items, expert review, and refinement of the questionnaire followed. A pilot study (N = 150) was conducted to explore the underlying structure of the 40-item ViDa1 questionnaire. A Principal Component Analysis (PCA) was performed and six of the items that did not load on any of the factors were eliminated. The results supported a four-dimensional structure for ViDa1, the dimensions being Interference of diabetes in everyday life, Self-care, Well-being, and Worry about the disease. Subsequently, the PCA was repeated in a larger sample (N = 578) with the reduced 34-item version of the questionnaire, and a Confirmatory Factor Analysis (CFA) was performed (N = 428). Overall fit indices obtained presented adequate values which supported the four-factor model initially proposed [(2(df =554) = 2601.93) (p < 0.001); Root Mean Square Error of Approximation = 0.060 (CI = 0.056 −0.064)]. As regards reliability, the four dimensions of the ViDa1 demonstrated good internal consistency, with Cronbach's alphas ranging between 0.71 and 0.86. Evidence of convergent-discriminant validity in the form of high correlations with another specific HRQoL questionnaire for diabetes and low correlations with other constructs such as self-efficacy, anxiety, and depression were presented. The ViDa1 also discriminated between different aspects of clinical interest such as type of insulin treatment, presence of chronic complications, and glycemic control, temporal stability, and sensitivity to change after an intervention. In conclusion, the ViDa1 questionnaire presents adequate psychometric properties and may represent a good alternative for the evaluation of HRQoL in type 1 diabetes

Adaptación a los cambios ambientales y territoriales

En este libro se abordan temáticas que destacan la adaptación de los distintos sectores de población a los cambios ambientales y territoriales, la cual muestra las respuestas a la incidencia de los estímulos del entorno, económico, social y ambiental. Así, se destaca la exposición de la población a los efectos destructivos de las amenazas y peligros naturales, lo que ha despertado interés en conocer sus causas, prevenir y mitigar el daño. A través de la revisión de estudios se induce la aprehensión de un tema que adquiere importancia en el contexto de los impactos globales, regionales y locales que se producen como consecuencia de la vulnerabilidad estructural característica de los países en desarrollo.En este libro se proponen estrategias de prevención ante la ocurrencia periódica de inundación en San Mateo Atenco, Estado de México y se analizan los factores sociales que inciden en el deterioro del bosque templado en San Lorenzo Huitzitzilapan. También se exponen soluciones para que se mejoren la condición del bosque y la calidad de vida de la población.Proyecto realizado con financiamiento de la Secretaría de Educación Pública-Subsecretaría de Educación Superior-Dirección General de Educación Superior Universitaria. Número del convenio con la SEP: 2017-15-001-017

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

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 middle-income 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 low-income 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 low-income, 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

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

ÍNDICE DE HIGIENE ORAL COMUNITARIO EN ESCOLARES DE 12 AÑOS

Objetivos: El objetivo de esta investigación fue determinar el índice de higiene oral en escolares de 12 años de la parroquia El Vecino en la ciudad de Cuenca - Ecuador, 2016. Material y Métodos: Se realizó un estudio descriptivo, documental, retrospectivo, cuantitativo a partir de los datos epidemiológicos de 185 escolares de 12 años, de la parroquia El Vecino, aplicando el IHO-S de Greene y Vermillion. Se utilizaron fichas epidemiológicas que cuentan con consentimientos y asentimientos debidamente firmados, las cuales reposan en el archivo del departamento de investigación de la carrera de Odontología de la UCACUE. Los valores pesquisados fueron vertidos en fichas digitales, que se almacenaron en una base de datos en el programa EPI INFO ver 7.2 y posteriormente se tabularon en el programa Excel. Resultados: El IHO-S parroquial promedio se estableció en 1,09, donde el 61,62% (114 escolares) mostró un nivel bueno, no existiendo diferencia estadísticamente significativa entre los géneros. El 84,32% (156 escolares) presentó un nivel bueno de placa bacteriana blanda, mientras que el 61,08% (113 escolares) mostró ausencia de placa bacteriana calcificada. Las unidades educativas presentaron un IHO-S promedio entre 0,93 – 1,29. Conclusiones: La mayoría de los escolares presentan un buen nivel de higiene oral, no encontrándose diferencia estadísticamente significativa entre los géneros. El nivel bueno predominó en el índice de placa bacteriana blanda, mientras que en la placa bacteriana calcificada prevaleció su ausencia. Casi la totalidad de las unidades educativas presentaron un nivel bueno de Índice de Higiene Oral

A decision support system for on-line leakage localization

This paper describes a model-driven decision-support system (software tool) implementing a model-based methodology for on-line leakage detection and localization which is useful for a large class of water distribution networks. Since these methods present a certain degree of complexity which limits their use to experts, the proposed software tool focuses on the integration of a method emphasizing its use by water network managers as a decision support system. The proposed software tool integrates a model-based leakage localization methodology based on the use of on-line telemetry information, as well as a water network calibrated hydraulic model. The application of the resulting decision support software tool in a district metered area (DMA) of the Barcelona distribution network is provided and discussed. The obtained results show that the leakage detection and localization may be performed efficiently reducing the required time.Peer ReviewedPostprint (published version

Oxidative Stress State Is Associated with Left Ventricular Mechanics Changes, Measured by Speckle Tracking in Essential Hypertensive Patients

The oxidative stress state is characterized by an increase in oxygen reactive species that overwhelms the antioxidant defense; we do not know if these pathological changes are correlated with alterations in left ventricular mechanics. The aim was correlating the oxidative stress state with the left ventricular global longitudinal strain (GLS) and the left ventricular end diastolic pressure (LVEDP). Twenty-five patients with essential hypertension and 25 controls paired by age and gender were studied. All of the participants were subjected to echocardiography and biochemical determination of oxidative stress markers. The hypertensive patients, compared with control subjects, had significantly (p<0.05) higher levels of oxidized proteins (5.03±1.05 versus 4.06±0.63 nmol/mg), lower levels of extracellular superoxide dismutase (EC-SOD) activity (0.045±0.02 versus 0.082±0.02 U/mg), higher LVEDP (16.2±4.5 versus 11.3±1.6 mm Hg), and lower GLS (−12% versus −16%). Both groups had preserved ejection fraction and the results showed a positive correlation of oxidized proteins with GLS (r=0.386, p=0.006) and LVEDP (r=0.389, p=0.005); we also found a negative correlation of EC-SOD activity with GLS (r=-0.404, p=0.004) and LVEDP (r=-0.347, p=0.014)

A decision support system for on-line leakage localization

This paper describes a model-driven decision-support system (software tool) implementing a model-based methodology for on-line leakage detection and localization which is useful for a large class of water distribution networks. Since these methods present a certain degree of complexity which limits their use to experts, the proposed software tool focuses on the integration of a method emphasizing its use by water network managers as a decision support system. The proposed software tool integrates a model-based leakage localization methodology based on the use of on-line telemetry information, as well as a water network calibrated hydraulic model. The application of the resulting decision support software tool in a district metered area (DMA) of the Barcelona distribution network is provided and discussed. The obtained results show that the leakage detection and localization may be performed efficiently reducing the required time.Peer Reviewe

ViDa1: The Development and Validation of a New Questionnaire for Measuring Health-Related Quality of Life in Patients with Type 1 Diabetes

IGTPAltres ajuts: Funding was provided by the Canarian Agency for Research,Innovation and Information Society (ACIISI) (DA predoctoralfellowship TESIS20120050) and the V Guido Ruffino Grantfor Research in Therapeutic Education for Diabetes (SpanishDiabetes Society 2015)This study describes the development of a new questionnaire to measure health-related quality of life (HRQoL) in patients with type 1 diabetes (the ViDa1 questionnaire) and provides information on its psychometric properties. For its development, open interviews with patients took place and topics relevant to patients' HRQoL were identified and items were generated. Qualitative analysis of items, expert review, and refinement of the questionnaire followed. A pilot study (N = 150) was conducted to explore the underlying structure of the 40-item ViDa1 questionnaire. A Principal Component Analysis (PCA) was performed and six of the items that did not load on any of the factors were eliminated. The results supported a four-dimensional structure for ViDa1, the dimensions being Interference of diabetes in everyday life, Self-care, Well-being, and Worry about the disease. Subsequently, the PCA was repeated in a larger sample (N = 578) with the reduced 34-item version of the questionnaire, and a Confirmatory Factor Analysis (CFA) was performed (N = 428). Overall fit indices obtained presented adequate values which supported the four-factor model initially proposed [(2(df =554) = 2601.93) (p < 0.001); Root Mean Square Error of Approximation = 0.060 (CI = 0.056 −0.064)]. As regards reliability, the four dimensions of the ViDa1 demonstrated good internal consistency, with Cronbach's alphas ranging between 0.71 and 0.86. Evidence of convergent-discriminant validity in the form of high correlations with another specific HRQoL questionnaire for diabetes and low correlations with other constructs such as self-efficacy, anxiety, and depression were presented. The ViDa1 also discriminated between different aspects of clinical interest such as type of insulin treatment, presence of chronic complications, and glycemic control, temporal stability, and sensitivity to change after an intervention. In conclusion, the ViDa1 questionnaire presents adequate psychometric properties and may represent a good alternative for the evaluation of HRQoL in type 1 diabetes