Construction of Empirical Care Pathways Process Models from Multiple Real-World Datasets

Care pathways (CPWs) are "multidisciplinary care plans that detail essential care steps for patients with specific clinical problems." While CPWs impact on health or cost outcomes is vastly studied, an in-depth analysis of the real-world implementation of the CPWs is an area that still remains underexplored. The present work describes how to apply an existing process mining methodology to construct the empirical CPW process models. These process models are a unique piece of information for health services research: for example to evaluate their conformance against the theoretical CPW described on clinical guidelines or to evaluate the impact of the process in health outcomes. To this purpose, this work relies on the design and implementation of a solution that a) synthesizes the expert knowledge on how health care is delivered within and across providers as an activity log, and b) constructs the CPW process model from that activity log using process mining techniques. Unlike previous research based on ad hoc data captures, current approach is built on the linkage of various heterogeneous real-world data (RWD) sets that share a minimum semantic linkage. RWD, defined as secondary use of routinely collected data as opposite to ad hoc data extractions, is a unique source of information for the CPW analysis due to its coverage of the caregiving activities and its wide availability. The viability of the solution is demonstrated by constructing the CPW process model of Code Stroke (Acute Stroke CPW) in the Aragon region (Spain)

Propuesta de sonda periodontal didáctica para la realización del sondaje periodontal en las prácticas de simulación odontológica de pregrado de la Fundación Universitaria del Área Andina

19 páginasDesde que se crearon las diferentes especialidades o ramas de la odontología, se han ido creando necesidades para estas mismas como materiales e instrumentales. En el caso de la especialidad de periodoncia uno de los métodos diagnósticos mas importantes ha sido la sonda periodontal (SP), ya que ha permitido de manera exacta y prematura el diagnóstico de enfermedades periodontales (EP). Nuestro estudio experimental busca la creación o confección de un instrumento innovador para odontología, específicamente en la especialidad de la periodoncia, para la realización del sondaje periodontal que sea amigable para la utilización en las escuelas de pregrado de odontología y postgrado de periodoncia.Periodontics is the speciality that is responsible for preventing, diagnosing, or treating diseases that affect the peridentals tissues. Periodontitis is a disease that consists of inflammation and therefore the decrease of the tissues surrounding and supporting the tooth. In Colombia, we can say that at least 60% of the people have some periodontitis, the periodontal probe, is The mechanism or the instrument to aid in the diagnosis of periodontitis. This proposal aims to design a more friendly and easy to manipulate periodontal probe so that the operator can make a more effective diagnosis

ESTUDIO ELECTROQUÍMICO DE LA ADSORCIÓN SUPERFICIAL DE FOSFATOS SOBRE MEZCLAS DE ÁCIDO POLILÁCTICO CON VIDRIO BIOACTIVO Y ÁCIDO POLILÁCTICO CON HIDROXIAPATITA

RESUMEN Se evaluó la interacción entre hidroxiapatita, vidrio bioactivo y ácido poliláctico, los cuales fueron sintetizados por métodos de precipitación acuosa, sol – gel y policondensación, respectivamente; y caracterizados mediante FTIR, DRX, DSC. Se obtuvieron probetas con diferentes porcentajes de polímero - cerámico para estudiar su capacidad de adsorber fosfatos, y de esta manera reconocer cuál de estas mezclas presenta una mejor respuesta a la oseointegración en presencia de fluido corporal simulado. Las probetas fueron sumergidas en el medio con diferentes relaciones de Ca/P y su capacidad de adsorción fue evaluada mediante EIS. Los parámetros electroquímicos obtenidos permitieron estimar los elementos resistivos y capacitivos de un circuito equivalente que relacionan los parámetros termodinámicos asociados al fenómeno de adsorción experimentado. Finalmente se determinó la cantidad de iones adsorbidos mediante AAS.  Palabras clave: Biomateriales, recubrimientos, oseointegración   ABSTRACT The interaction between hydroxyapatite, bioactive glass and polylactic acid was evaluated, which were synthesized by aqueous precipitation methods, sol - gel and polycondensation respectively, and they were characterized by FTIR, XRD, DSC. Samples with different percentages of polymer and ceramic were obtained to study their ability to absorb phosphate, and later to identify which of these samples of materials present a better response to osseointegration in the presence of simulated body fluid. Samples were immersed in that fluid with different relations of Ca/P and their adsorption capacity was evaluated by EIS. The electrochemical parameters obtained allowed to estimate the resistive and capacitive elements of an equivalent circuit linking the thermodynamic parameters associated with adsorption phenomena experienced. Finally, the amount of adsorbed ions was determined by AAS. Keywords: Biomaterials, coatings, osseointegration

ESTUDIO ELECTROQUÍMICO DE LA ADSORCIÓN SUPERFICIAL DE FOSFATOS SOBRE MEZCLAS DE ÁCIDO POLILÁCTICO CON VIDRIO BIOACTIVO Y ÁCIDO POLILÁCTICO CON HIDROXIAPATITA

RESUMEN Se evaluó la interacción entre hidroxiapatita, vidrio bioactivo y ácido poliláctico, los cuales fueron sintetizados por métodos de precipitación acuosa, sol – gel y policondensación, respectivamente; y caracterizados mediante FTIR, DRX, DSC. Se obtuvieron probetas con diferentes porcentajes de polímero - cerámico para estudiar su capacidad de adsorber fosfatos, y de esta manera reconocer cuál de estas mezclas presenta una mejor respuesta a la oseointegración en presencia de fluido corporal simulado. Las probetas fueron sumergidas en el medio con diferentes relaciones de Ca/P y su capacidad de adsorción fue evaluada mediante EIS. Los parámetros electroquímicos obtenidos permitieron estimar los elementos resistivos y capacitivos de un circuito equivalente que relacionan los parámetros termodinámicos asociados al fenómeno de adsorción experimentado. Finalmente se determinó la cantidad de iones adsorbidos mediante AAS.  Palabras clave: Biomateriales, recubrimientos, oseointegración   ABSTRACT The interaction between hydroxyapatite, bioactive glass and polylactic acid was evaluated, which were synthesized by aqueous precipitation methods, sol - gel and polycondensation respectively, and they were characterized by FTIR, XRD, DSC. Samples with different percentages of polymer and ceramic were obtained to study their ability to absorb phosphate, and later to identify which of these samples of materials present a better response to osseointegration in the presence of simulated body fluid. Samples were immersed in that fluid with different relations of Ca/P and their adsorption capacity was evaluated by EIS. The electrochemical parameters obtained allowed to estimate the resistive and capacitive elements of an equivalent circuit linking the thermodynamic parameters associated with adsorption phenomena experienced. Finally, the amount of adsorbed ions was determined by AAS. Keywords: Biomaterials, coatings, osseointegration

Detección de Fasciola hepatica por medio de ELISA indirecto en ovinos y caprinos de Boavita, Colombia

The aim of this study was to determine the seroprevalence of Fasciola hepatica by indirect ELISA in sheep and goats from Boavita (Boyaca, Colombia). A descriptive cross-sectional study with simple random sampling was carried out. A total of 297 blood samples from sheep and 337 from goats of different breeds and age groups were collected. The sera were analyzed by the indirect ELISA technique with the commercial ELISA kit BIO K 211 - Monoscreen AbELISA F. hepatica. Additionally, an epidemiological survey was carried out. The seroprevalence of F. hepatica was 67.34% (200/297) in sheep and 59.94% (202/337) in goats. Likewise, seroprevalence was higher in males (sheep: 77.78%, 21/27; goats: 63.89%, 23/36), in sheep older than 3 years (83.33%, 50/60) and in goats less than 1 year of age. (69.77%, 60/86), as well as in Creole breed (sheep: 69.84%; goats: 61.79%). Sheep over 3 years of age were determined as a risk factor, while in goats the Creole breed variables and extensive grazing were identified as risk factors.El objetivo del estudio fue determinar la seroprevalencia de Fasciola hepatica por medio de ELISA indirecto en ovinos y caprinos de Boavita (Boyacá, Colombia). Se realizó un estudio descriptivo de corte transversal con muestreo aleatorio simple. Se colectaron 297 muestras de sangre de ovinos y 337 de caprinos de diferentes grupos raciales y etarios. Los sueros fueron analizados mediante la técnica ELISA indirecta con el kit comercial ELISA BIO K 211 - Monoscreen AbELISA F. hepatica. Adicionalmente se realizó una encuesta epidemiológica. La seroprevalencia de F. hepatica fue de 67.34% (200/297) en ovinos y de 59.94% (202/337) en caprinos. Asimismo, la seroprevalencia fue mayor en los machos (ovinos: 77.78%. 21/27; caprinos: 63.89%, 23/36), en ovinos mayores de 3 años (83.33%, 50/60) y en caprinos menores de 1 año (69.77%, 60/86), así como en los de raza criolla (ovinos: 69.84%; caprinos: 61.79%). Los ovinos mayores de 3 años se determinaron como factor de riesgo, en tanto que en los caprinos las variables raza criolla y el pastoreo extensivo se identificaron como factores de riesgo. El estudio demuestra una alta seropositividad de la enfermedad en la zona

Work like a Doc: a comparison of regulations on residents' working hours in 14 high-income countries

Background: Medical residents work long, continuous hours. Working in conditions of extreme fatigue has adverse effects on the quality and safety of care, and on residents' quality of life. Many countries have attempted to regulate residents’ work hours. Objectives: We aimed to review residents’ work hours regulations in different countries with an emphasis on night shifts. Methods: Standardized qualitative data on residents’ working hours were collected with the assistance of experts from 14 high-income countries through a questionnaire. An international comparative analysis was performed. Results: All countries reviewed limit the weekly working hours; North-American countries limit to 60–80 h, European countries limit to 48 h. In most countries, residents work 24 or 26 consecutive hours, but the number of long overnight shifts varies, ranging from two to ten. Many European countries face difficulties in complying with the weekly hour limit and allow opt-out contracts to exceed it. Conclusions: In the countries analyzed, residents still work long hours. Attempts to limit the shift length or the weekly working hours resulted in modest improvements in residents’ quality of life with mixed effects on quality of care and residents’ education

Earth system data cubes unravel global multivariate dynamics

Understanding Earth system dynamics in light of ongoing human intervention and dependency remains a major scientific challenge. The unprecedented availability of data streams describing different facets of the Earth now offers fundamentally new avenues to address this quest. However, several practical hurdles, especially the lack of data interoperability, limit the joint potential of these data streams. Today, many initiatives within and beyond the Earth system sciences are exploring new approaches to overcome these hurdles and meet the growing interdisciplinary need for data-intensive research; using data cubes is one promising avenue. Here, we introduce the concept of Earth system data cubes and how to operate on them in a formal way. The idea is that treating multiple data dimensions, such as spatial, temporal, variable, frequency, and other grids alike, allows effective application of user-defined functions to co-interpret Earth observations and/or model- data integration. An implementation of this concept combines analysis-ready data cubes with a suitable analytic interface. In three case studies, we demonstrate how the concept and its implementation facilitate the execution of complex workflows for research across multiple variables, and spatial and temporal scales: (1) summary statistics for ecosystem and climate dynamics; (2) intrinsic dimensionality analysis on multiple timescales; and (3) model-data integration. We discuss the emerging perspectives for investigating global interacting and coupled phenomena in observed or simulated data. In particular, we see many emerging perspectives of this approach for interpreting large-scale model ensembles. The latest developments in machine learning, causal inference, and model-data integration can be seamlessly implemented in the proposed framework, supporting rapid progress in data-intensive research across disciplinary boundaries

Cyclic potentiodynamic polarization on titanium alloys anodizing in alkaline solutions

Titanium alloys are used in different industries such as biomedical, aerospace, aeronautic, chemical, and naval. Those industries have high requirements with few damage tolerances. The aim of this work was to study the corrosion behavior of titanium alloys anodizing and non-anodizing in alkaline (KOH and NaOH) solutions, exposed in 3.5%wt. NaCl and 3.5% wt. H2SO4 solutions at room temperature using cyclic potentiodynamic polarization (CPP) according to standards in order to obtain electrochemical parameters as the passivation range (PR), corrosion type, passive layer persistence, corrosion potential (Ecorr), and corrosion rate. The alloy Ti Beta-C anodized presented better corrosion resistance than Ti-6Al-4V in both media. The smallest corrosion rate is presented in Beta-C samples (4.72 E-8 A/cm2) and the highest corrosion rate is CP2 (1.61 E-5 A/cm2

Association of candidate gene polymorphisms with chronic kidney disease : Results of a case-control analysis in the NEFRONA cohort

Chronic kidney disease (CKD) is a major risk factor for end-stage renal disease, cardiovascular disease and premature death. Despite classical clinical risk factors for CKD and some genetic risk factors have been identified, the residual risk observed in prediction models is still high. Therefore, new risk factors need to be identified in order to better predict the risk of CKD in the population. Here, we analyzed the genetic association of 79 SNPs of proteins associated with mineral metabolism disturbances with CKD in a cohort that includes 2,445 CKD cases and 559 controls. Genotyping was performed with matrix assisted laser desorption ionization-time of flight mass spectrometry. We used logistic regression models considering different genetic inheritance models to assess the association of the SNPs with the prevalence of CKD, adjusting for known risk factors. Eight SNPs (rs1126616, rs35068180, rs2238135, rs1800247, rs385564, rs4236, rs2248359, and rs1564858) were associated with CKD even after adjusting by sex, age and race. A model containing five of these SNPs (rs1126616, rs35068180, rs1800247, rs4236, and rs2248359), diabetes and hypertension showed better performance than models considering only clinical risk factors, significantly increasing the area under the curve of the model without polymorphisms. Furthermore, one of the SNPs (the rs2248359) showed an interaction with hypertension, being the risk genotype affecting only hypertensive patients. We conclude that 5 SNPs related to proteins implicated in mineral metabolism disturbances (Osteopontin, osteocalcin, matrix gla protein, matrix metalloprotease 3 and 24 hydroxylase) are associated to an increased risk of suffering CKD