Mathematical modelling of kidney disease stages in patients diagnosed with diabetes mellitus II

[EN] The direct costs associated with diabetes mellitus represent 8% of total healthcare expenditure in Spain, amounting to around 6 billion euros per year [1]. The overall prevalence of diabetes in people over 18 years of age (adjusted for age and sex) is estimated at 13.8% in 2010 [2], with type 2 (T2DM) being the most common type of diabetes, accounting for 85-95% of all diabetes cases in high-income countries [3]. T2DM is associated with multiple diseases such as chronic kidney disease [4], retinopathy, pyelonephritis, heart attack or stroke [5]. It is estimated that 35% of patients with T2DM develop diabetic kidney disease [6]. Treatment of end-stage renal disease requires expensive treatments such as haemodialysis and kidney transplantation. The objective of this study is to evaluate in patients with T2DM the degree of renal damage and the risk of suffering complications according to their socio-demographic, clinical and morbidity characteristics and to obtain the weight of the variables that have most influence.Escobar Carrera, X.; González-De Julián, S.; Barrachina Martínez, I. (2021). Mathematical modelling of kidney disease stages in patients diagnosed with diabetes mellitus II. Universitat Politècnica de València. 96-100. http://hdl.handle.net/10251/1905669610

Markov Models for Economic Evaluation in Osteoporosis Treatment

[EN] Osteoporosis is frequent in elderly people, causing bone fractures and lowering their quality of life. The costs incurred by these fractures constitute a problem for public health. Markov chains were used to carry out an incremental cost-utility analysis of the four main drugs used in Spain to treat osteoporosis (alendronate, risedronate, denosumab and teriparatide). We considered 14 clinical transition states, from starting osteoporotic treatment at the age of 50 until death or the age of 100. Cost-effectiveness was measured by quality adjusted life years (QALYs). The values used in the Markov model were obtained from the literature. Teriparatide is the cost-effective alternative in the treatment of osteoporosis in patients with fractures from the age of 50, establishing a payment threshold of 20,000 EUR/QALY. However, it is the most expensive therapy, not appearing cost-effective in cases that do not present fracture and in ages over 80 years with fracture. Alendronate and denosumab therapies are presented as cost-effective osteoporosis treatment alternatives depending on the age of onset and duration of treatment. From the perspective of cost-effectiveness, establishing a payment threshold of 20,000 EUR/QALY, teriparatide is the cost-effective alternative in patients with fracture from the age of 50 to 70 years old in Spain.Osca Guadalajara, M.; Díaz-Carnicero, J.; González-De Julián, S.; Vivas-Consuelo, D. (2021). Markov Models for Economic Evaluation in Osteoporosis Treatment. Mathematics. 9(18):1-20. https://doi.org/10.3390/math9182331S12091

Predicting healthcare cost of diabetes using machine learning models

González-Rodríguez, J.; Díaz Carnicero, J.; Vivas-Consuelo, D.; González-De Julián, S.; Pinzón Espitia, OL. (2019). Predicting healthcare cost of diabetes using machine learning models. R. Company, J. C. Cortés, L. Jódar and E. López-Navarro. 99-104. http://hdl.handle.net/10251/180540S9910

COVID-19 Healthcare Planning: Predicting Mortality and the Role of the Herd Immunity Barrier in the General Population

[EN] Using a mathematical model for COVID-19 incorporating data on excess of mortality compared to the corresponding period of the previous year obtained from the daily monitoring of mortality in Spain (MoMo), the prediction of total number of casualties in Spain for the first outbreak has been computed. From this figure, and following a stepwise meta-analysis of available reports, the case fatality rate (CFR) and the infectious case fatality rate (IFR) for the outbreak have been estimated. As the impact of age on these rates is notable, it is proposed to include an age-related adjusted fatality ratio in future comparative analyses between studies, calculated by adjusting the results by risk ratio to a reference age band (e.g., 60-69). From the casualty figures, and the corresponding CFR and IFR ratios, the forecast of serologically positive cases in the general Spanish population has been estimated at approximately 1% (0.87-1.3%) of the samples. If the data are confirmed by the ongoing study of the Carlos III Institute, until a vaccine is found, the immunity acquired in the general population after the infectious outbreak is far from the 65-70% herd immunity required as a barrier for COVID-19.Marco-Franco, JE.; Guadalajara Olmeda, MN.; González-De Julián, S.; Vivas-Consuelo, D. (2020). COVID-19 Healthcare Planning: Predicting Mortality and the Role of the Herd Immunity Barrier in the General Population. Sustainability. 12(13):1-10. https://doi.org/10.3390/su12135228S1101213Mathematical modeling draws more accurate picture of coronavirus cases 2020https://www.eurekalert.org/pub_releases/2020-04/mcog-mmd041020.phpRed Nacional de Vigilancia Epidemiológica-[Spanish epidemiological surveillance network]https://www.isciii.es/QueHacemos/Servicios/VigilanciaSaludPublicaRENAVE/EnfermedadesTransmisibles/Documents/INFORMES/Informes%20COVID-19/Informe%20nº%2022.%20Situación%20de%20COVID-19%20en%20España%20a%2013%20de%20abril%20de%202020.pdfJung, S., Akhmetzhanov, A. R., Hayashi, K., Linton, N. M., Yang, Y., Yuan, B., … Nishiura, H. (2020). Real-Time Estimation of the Risk of Death from Novel Coronavirus (COVID-19) Infection: Inference Using Exported Cases. Journal of Clinical Medicine, 9(2), 523. doi:10.3390/jcm9020523Linton, N., Kobayashi, T., Yang, Y., Hayashi, K., Akhmetzhanov, A., Jung, S., … Nishiura, H. (2020). Incubation Period and Other Epidemiological Characteristics of 2019 Novel Coronavirus Infections with Right Truncation: A Statistical Analysis of Publicly Available Case Data. Journal of Clinical Medicine, 9(2), 538. doi:10.3390/jcm9020538Rajgor, D. D., Lee, M. H., Archuleta, S., Bagdasarian, N., & Quek, S. C. (2020). The many estimates of the COVID-19 case fatality rate. The Lancet Infectious Diseases, 20(7), 776-777. doi:10.1016/s1473-3099(20)30244-9Mizumoto, K., Kagaya, K., Zarebski, A., & Chowell, G. (2020). Estimating the asymptomatic proportion of coronavirus disease 2019 (COVID-19) cases on board the Diamond Princess cruise ship, Yokohama, Japan, 2020. Eurosurveillance, 25(10). doi:10.2807/1560-7917.es.2020.25.10.2000180Wu, J. T., Leung, K., Bushman, M., Kishore, N., Niehus, R., de Salazar, P. M., … Leung, G. M. (2020). Estimating clinical severity of COVID-19 from the transmission dynamics in Wuhan, China. Nature Medicine, 26(4), 506-510. doi:10.1038/s41591-020-0822-7Hauser, A., Counotte, M. J., Margossian, C. C., Konstantinoudis, G., Low, N., Althaus, C. L., & Riou, J. (2020). Estimation of SARS-CoV-2 mortality during the early stages of an epidemic: a modeling study in Hubei, China, and six regions in Europe. doi:10.1101/2020.03.04.20031104Russell, T. W., Hellewell, J., Jarvis, C. I., van Zandvoort, K., Abbott, S., … Ratnayake, R. (2020). Estimating the infection and case fatality ratio for coronavirus disease (COVID-19) using age-adjusted data from the outbreak on the Diamond Princess cruise ship, February 2020. Eurosurveillance, 25(12). doi:10.2807/1560-7917.es.2020.25.12.2000256Wu, Z., & McGoogan, J. M. (2020). Characteristics of and Important Lessons From the Coronavirus Disease 2019 (COVID-19) Outbreak in China. JAMA, 323(13), 1239. doi:10.1001/jama.2020.2648Chen, N., Zhou, M., Dong, X., Qu, J., Gong, F., Han, Y., … Zhang, L. (2020). Epidemiological and clinical characteristics of 99 cases of 2019 novel coronavirus pneumonia in Wuhan, China: a descriptive study. The Lancet, 395(10223), 507-513. doi:10.1016/s0140-6736(20)30211-7Wang, X., Ma, Z., Ning, Y., Chen, C., Chen, R., Chen, Q., … Zhao, H. (2020). Estimating the case fatality ratio of the COVID-19 epidemic in China. doi:10.1101/2020.02.17.20023630Italian Task Force COVID-19. Epidemia COVID-19 [Covid-19 epidemic]https://www.epicentro.iss.it/coronavirus/bollettino/Bollettino-sorveglianza-integrata-COVID-19_26-marzo%202020.pdfUK coronavirus death toll reaches 1,789 amid data reporting concerns |World news| The Guardianhttps://www.theguardian.com/world/2020/mar/31/uk-coronavirus-death-toll-reaches-1789-amid-data-reporting-concernsCoronavirus-missing-deathshttps://www.nytimes.com/interactive/2020/04/21/world/coronavirus-missing-deaths.htmlLipsitch, M., Cohen, T., Cooper, B., Robins, J. M., Ma, S., James, L., … Murray, M. (2003). Transmission Dynamics and Control of Severe Acute Respiratory Syndrome. Science, 300(5627), 1966-1970. doi:10.1126/science.1086616Sanche, S., Lin, Y. T., Xu, C., Romero-Severson, E., Hengartner, N., & Ke, R. (2020). High Contagiousness and Rapid Spread of Severe Acute Respiratory Syndrome Coronavirus 2. Emerging Infectious Diseases, 26(7), 1470-1477. doi:10.3201/eid2607.200282WHO warns that few have developed antibodies to Covid-19https://www.theguardian.com/society/2020/apr/20/studies-suggest-very-few-have-had-covid-19-without-symptomsVerity, R., Okell, L. C., Dorigatti, I., Winskill, P., Whittaker, C., Imai, N., … Ferguson, N. M. (2020). Estimates of the severity of COVID-19 disease. doi:10.1101/2020.03.09.20033357Wong, J. Y., Kelly, H., Ip, D. K. M., Wu, J. T., Leung, G. M., & Cowling, B. J. (2013). Case Fatality Risk of Influenza A (H1N1pdm09). Epidemiology, 24(6), 830-841. doi:10.1097/ede.0b013e3182a67448Bendavid, E., Mulaney, B., Sood, N., Shah, S., Ling, E., Bromley-Dulfano, R., … Bhattacharya, J. (2020). COVID-19 Antibody Seroprevalence in Santa Clara County, California. doi:10.1101/2020.04.14.2006246

Simplified Mathematical Modeling of Uncertainty: Cost-Effectiveness of COVID-19 Vaccines in Spain

[EN] When exceptional situations such as the COVID-19 pandemic arise and reliable data is not available at decision-making times, estimation using mathematical models can provide a reasonable reckoning for health planning. We present a simplified model (static but with two-time references) for estimating the cost-effectiveness of the Covid-19 vaccine. A simplified model provides quick assessment of the upper bound of cost-effectiveness, as we illustrated with data from Spain, and allows for easy comparisons between countries. It may also provide useful comparisons among different vaccines at the marketplace, from the perspective of the buyer. From analysis of this information, key epidemiological figures, and costs of the disease for Spain have been estimated, based on mortality. The fatality value is a robust data that can alternatively be obtained from death registers, funeral homes, cemeteries, and crematoria. Our model estimates the cost-effectiveness ratio (ICER) to be 5,132 € (4,926 ¿ 5,276) as of 17 February 2021, based on the following assumptions/inputs: an estimated cost of 30 euros per dose (plus transport, storing, and administration), two doses per person, efficacy of 70% and coverage of 70% of the population. Even considering the possibility of some bias, this simplified model provides confirmation that vaccination against COVID-19 is highly cost-effective.Marco-Franco, JE.; Pita-Barros, P.; González-De Julián, S.; Sabat, I.; Vivas-Consuelo, D. (2021). Simplified Mathematical Modeling of Uncertainty: Cost-Effectiveness of COVID-19 Vaccines in Spain. Mathematics. 9(5):1-15. https://doi.org/10.3390/math90505661159

Data Envelopment Analysis Applications on Primary Health Care Using Exogenous Variables and Health Outcomes

[EN] A data envelopment analysis was used to evaluate the efficiency of 18 primary healthcare centres in a health district of the Valencian Community, Spain. Factor analysis was used as a first step in order to identify the most explanatory variables to be incorporated in the models. Included as variable inputs were the ratios of general practitioners, nurses, and costs; as output variables, those included were consultations, emergencies, avoidable hospitalisations, and prescription efficiency; as exogenous variables, those included were the percentage of population over 65 and a multimorbidity index. Confidence intervals were calculated using bootstrapping to correct possible biases. Efficient organisations within the set were identified, although the results depend on the models used and the introduction of exogenous variables. Pharmaceutical expenditure showed the greatest slack and room for improvement in its management. Data envelopment analysis allows an evaluation of efficiency that is focussed on achieving better results and a proper distribution and use of healthcare resources, although it needs the desired goals of the healthcare managers to be clearly identified, as the perspective of the analysis influences the results, as does including variables that measure the achievements and outcomes of the healthcare services.This research was funded by "Conselleria de Hacienda y Modelo Economico de la Comunitat Valenciana (Spain)", file number HIECPU/2019/1, in the context of the Project "Desarrollo de un Modelo para el analisis de la eficiencia en las Unidades Basicas de Salud de atencion primaria en un departamento de Salud perteneciente al mapa sanitario de la Comunidad Valenciana".González-De Julián, S.; Barrachina Martínez, I.; Vivas-Consuelo, D.; Bonet-Pla, Á.; Usó-Talamantes, R. (2021). Data Envelopment Analysis Applications on Primary Health Care Using Exogenous Variables and Health Outcomes. Sustainability. 13(3):1-18. https://doi.org/10.3390/su1303133711813

Validation of a New Telenursing Questionnaire: Testing the Test

Abstract: Background: Existing surveys on telenursing refer to specific areas of nursing after the implementation of a programme, but telenursing in general has not been fully evaluated from a prospective approach. Aim: Design and statistical validation of a telenursing questionnaire. Methods: A new questionnaire was designed with 18 paired (to avoid leading) questions (Likert-5) plus three dichotomous questions (randomly ordered, inspired by existing validated tests) to analyse the dimensions of: acceptance, usefulness and appropriateness of telenursing from the nursing point of view (7 min test). The questionnaire was validated by classical tests and item response tests (Rasch) using six computer-generated databases with different response profiles (tendency to be positioned against, neutral and positioned in favour) with two degrees of agreement between each pair of responses for each option. Results: Classical testing: Cronbach’s alphas (from 0.8 to 0.95), Kaiser–Meyer–Olkin (KMO) (0.93 to 0.95) and a significant p < 0.0001 for Bartlett’s test of sphericity were obtained. Rasch analysis: Reliability coefficients (0.94). Warm’s mean weighted likelihood estimates (0.94). Extreme infit-t and outfit-t values (+1.61 to −1.98). Conclusions: Both the classical test and the Rasch approaches confirm the usefulness of the new test for assessing nurses’ positioning in relation to telenursing.info:eu-repo/semantics/publishedVersio

COVID-19, Fake News, and Vaccines: Should Regulation Be Implemented?

[EN] We analysed issues concerning the establishment of compulsory vaccination against COVID-19, as well as the role of misinformation as a disincentive-especially when published by health professionals-and citizen acceptance of measures in this regard. Data from different surveys revealed a high degree of hesitation rather than outright opposition to vaccines. The most frequent complaint related to the COVID-19 vaccination was the fear of side effects. Within the Spanish and European legislative framework, both compulsory vaccination and government regulation of FN (Fake News) appear to be feasible options, counting on sufficient legal support, which could be reinforced by additional amendment. However, following current trends of good governance, policymakers must have public legitimation. Rather than compulsory COVID-19 vaccination, an approach based on education and truthful information, persuading the population of the benefits of a vaccine on a voluntary basis, is recommended. Disagreements between health professionals are positive, but they should be resolved following good practice and the procedures of the code of ethics. Furthermore, citizens do not support the involvement of government authorities in the direct control of news. Collaboration with the media and other organizations should be used instead.Marco-Franco, JE.; Pita-Barros, P.; Vivas-Orts, D.; González-De Julián, S.; Vivas-Consuelo, D. (2021). COVID-19, Fake News, and Vaccines: Should Regulation Be Implemented?. International Journal of Environmental research and Public Health (Online). 18(2):1-11. https://doi.org/10.3390/ijerph18020744S111182Reuters Institute Digital News Report 2020https://reutersinstitute.politics.ox.ac.uk/sites/default/files/2020-06/DNR_2020_FINAL.pdfMerck CEO Ken Frazier Discusses a COVID Cure, Racism, and Why Leaders Need to Walk the Talkhttps://hbswk.hbs.edu/item/merck-ceo-ken-frazier-speaks-about-a-covid-cure-racism-and-why-leaders-need-to-walk-the-talkDe las Heras-Pedrosa, C., Rando-Cueto, D., Jambrino-Maldonado, C., & Paniagua-Rojano, F. J. (2020). Exploring the Social Media on the Communication Professionals in Public Health. Spanish Official Medical Colleges Case Study. International Journal of Environmental Research and Public Health, 17(13), 4859. doi:10.3390/ijerph17134859Page, B. I., & Shapiro, R. Y. (1983). Effects of Public Opinion on Policy. American Political Science Review, 77(1), 175-190. doi:10.2307/1956018Public Opinion Surveys as Input to Administrative Reformhttp://www.oecd.org/officialdocuments/publicdisplaydocumentpdf/?cote=CCNM/SIGMA/PUMA(98)48&docLanguage=EnJacobs, L. R. (1992). The Recoil Effect: Public Opinion and Policymaking in the U.S. and Britain. Comparative Politics, 24(2), 199. doi:10.2307/422278The Statistics Portal for Market Data, Market Research and Market Studieshttps://www.statista.com/Flash Eurobarometer 464: Fake News and Disinformation Onlinehttps://op.europa.eu/en/publication-detail/-/publication/2d79b85a-4cea-11e8-be1d-01aa75ed71a1/language-enState of Vaccine Confidence in the EU 2018https://ec.europa.eu/health/sites/health/files/vaccination/docs/2018_vaccine_confidence_en.pdfGlobal Attitudes on a COVID-19 Vaccine, 2020https://www.ipsos.com/sites/default/files/ct/news/documents/2020-09/global-attitudes-on-a-covid-19-vaccine-ipsos-survey-for-wef-2020.pdfEffects and Consequences of the Coronavirus (II): Advance Results. Tabulation by Sociodemographic Variableshttp://datos.cis.es/pdf/Es3302marMT_A.pdfNeumann-Böhme, S., Varghese, N. E., Sabat, I., Barros, P. P., Brouwer, W., van Exel, J., … Stargardt, T. (2020). Once we have it, will we use it? A European survey on willingness to be vaccinated against COVID-19. The European Journal of Health Economics, 21(7), 977-982. doi:10.1007/s10198-020-01208-6Gallup-Knight Foundation: Americans see Media As Key to Democracy But Increasingly Don’t Trust Ithttps://knightfoundation.org/press/releases/gallup-knight-foundation-report-americans-see-media-as-key-to-democracy-but-increasingly-don-t-trust-it/“Fake News” Threat to Media; Editorial Decisions, Outside Actors at Faulthttps://www.monmouth.edu/polling-institute/reports/monmouthpoll_us_040218/Insider NJ Monmouth National—America Takes Sides in Social Media Warhttps://www.insidernj.com/press-release/monmouth-national-america-takes-sides-social-media-war/International Study of Valueshttps://www.fbbva.es/wp-content/uploads/2019/09/Presentacion_Estudio_Valores_2019.pdfCoronavirus Special Reportshttps://www.agcom.it/osservatorio-sulla-disinformazione-onlineWhich Media Are Responsible for Spreading False or Inaccurate Information Regarding the Coronavirus (COVID-19) and Its Impact?https://www.statista.com/statistics/1111877/opinions-on-fake-news-sources-about-the-coronavirus-by-macro-region-italy/Covid-19 News and Information: Consumption and Attitudeshttps://www.ofcom.org.uk/research-and-data/tv-radio-and-on-demand/news-media/coronavirus-news-consumption-attitudes-behaviourHow to Report Misinformation Onlinehttps://www.who.int/campaigns/connecting-the-world-to-combat-coronavirus/how-to-report-misinformation-online?gclid=EAIaIQobChMIj_bv-tqx7QIV5hoGAB1REwetEAAYASAAEgLpjPD_BwECovid-19 Pandemichttps://www.ecdc.europa.eu/en/covid-19-pandemicFighting Disinformationhttps://ec.europa.eu/info/live-work-travel-eu/coronavirus-response/fighting-disinformation_enTackling Online Disinformationhttps://ec.europa.eu/digital-single-market/en/tackling-online-disinformationFunded Projects in the Fight against Disinformationhttps://ec.europa.eu/info/live-work-travel-eu/coronavirus-response/fighting-disinformation/funded-projects-fight-against-disinformation_enSocial Observatory for Disinformation and Social Media Analysishttps://cordis.europa.eu/project/id/825469European Court of Human Rights European Convention on Human Rights; 1950 with Ammendshttps://www.echr.coe.int/documents/convention_eng.pdfThe Legal Framework to Address “Fake News”: Possible Policy Actions at the EU Levelhttps://www.europarl.europa.eu/RegData/etudes/IDAN/2018/619013/IPOL_IDA(2018)619013_EN.pdfCoronavirus: EU Strengthens Action to Tackle Disinformationhttps://ec.europa.eu/commission/presscorner/detail/en/ip_20_1006EEAS Special Report Update: Short Assessment of Narratives and Disinformation around the Covid-19 Pandemic (Update May–November)https://euvsdisinfo.eu/eeas-special-report-update-short-assessment-of-narratives-and-disinformation-around-the-covid-19-pandemic-update-may-november/Fighting Disinformation—COVID-19 Vaccineshttps://www.consilium.europa.eu/en/policies/coronavirus/fighting-disinformation/Calling of an International Conference on Freedom of Informationhttps://digitallibrary.un.org/record/209774?ln=esUniversal Declaration of Human Rightshttps://www.un.org/en/ga/search/view_doc.asp?symbol=A/RES/217(III)WMA Declaration of Genevahttps://www.wma.net/policies-post/wma-declaration-of-geneva/Hendriks. (1997). Convention for the Protection of Human Rights and Dignity of the Human Being with Regard to the Application of Biology and Medicine: Convention on Human Rights and Biomedicine. European Journal of Health Law, 4(1), 89-100. doi:10.1163/15718099720521896Code of Medical Ethics Guide to Medical Ethicshttps://www.cgcom.es/sites/default/files/codigo_deontologia_medica.pdfCase-law STS 1639/2016—ECLI: ES:TS:2016:1639http://www.poderjudicial.es/search/AN/openCDocument/f9caf3b37c843044ddaedeee43551672cfe231e21f03965aCharter of Fundamental Rights of the European Unionhttps://eur-lex.europa.eu/eli/treaty/char_2012/ojRoope, L. S. J., Buckell, J., Becker, F., Candio, P., Violato, M., Sindelar, J. L., … Clarke, P. M. (2020). How Should a Safe and Effective COVID-19 Vaccine be Allocated? Health Economists Need to be Ready to Take the Baton. PharmacoEconomics - Open, 4(4), 557-561. doi:10.1007/s41669-020-00228-5Ding, Y., Du, X., Li, Q., Zhang, M., Zhang, Q., Tan, X., & Liu, Q. (2020). Risk perception of coronavirus disease 2019 (COVID-19) and its related factors among college students in China during quarantine. PLOS ONE, 15(8), e0237626. doi:10.1371/journal.pone.0237626Dryhurst, S., Schneider, C. R., Kerr, J., Freeman, A. L. J., Recchia, G., van der Bles, A. M., … van der Linden, S. (2020). Risk perceptions of COVID-19 around the world. Journal of Risk Research, 23(7-8), 994-1006. doi:10.1080/13669877.2020.1758193Wise, T., Zbozinek, T. D., Michelini, G., Hagan, C. C., & Mobbs, D. (2020). Changes in risk perception and self-reported protective behaviour during the first week of the COVID-19 pandemic in the United States. Royal Society Open Science, 7(9), 200742. doi:10.1098/rsos.200742Olivares-Delgado, F., Iglesias-Sánchez, P. P., Benlloch-Osuna, M. T., Heras-Pedrosa, C. de las, & Jambrino-Maldonado, C. (2020). Resilience and Anti-Stress during COVID-19 Isolation in Spain: An Analysis through Audiovisual Spots. International Journal of Environmental Research and Public Health, 17(23), 8876. doi:10.3390/ijerph17238876Bavel, J. J. V., Baicker, K., Boggio, P. S., Capraro, V., Cichocka, A., Cikara, M., … Willer, R. (2020). Using social and behavioural science to support COVID-19 pandemic response. Nature Human Behaviour, 4(5), 460-471. doi:10.1038/s41562-020-0884-zBaldassarre, A., Giorgi, G., Alessio, F., Lulli, L., Arcangeli, G., & Mucci, N. (2020). Stigma and Discrimination (SAD) at the Time of the SARS-CoV-2 Pandemic. International Journal of Environmental Research and Public Health, 17(17), 6341. doi:10.3390/ijerph17176341Betsch, C. (2020). How behavioural science data helps mitigate the COVID-19 crisis. Nature Human Behaviour, 4(5), 438-438. doi:10.1038/s41562-020-0866-

Modelling Deprivation Level and Multimorbidity in a Health District

[EN] Deprivation is associated with an increased risk of developing chronic health conditions and with worse outcomes in multimorbidity. The goal of our study was to develop an integrated population index of deprivation (IPID) to observe the influence of deprivation on morbidity and the subsequent use of healthcare resources in one health district, using the socioeconomic, clinical and geographical data from its administrative health records. Eight socioeconomic indicators were identified and weighted using the methodology of two-phase principal component analysis, providing an index that allowed each census section to be classified into seven deprivation groups. Secondly, the possible relation between the IPID and the variables for multimorbidity and healthcare resources was analysed using the theory of multiple comparisons. It was observed that places with a greater proportion of healthy people presented lower values of deprivation and that, at lower levels of deprivation, there were fewer hospital admissions. The results show that living in an area with a higher deprivation index is associated with greater consumption of healthcare resources and disease burden. Identifying areas of sociosanitary vulnerability can help to identify health inequalities and allow intervention by clinical practices and healthcare management to reduce them.Botija Yagüe, MP.; Sorbet-Santiago, S.; Díaz-Carnicero, J.; González-De Julián, S.; Usó-Talamantes, R. (2022). Modelling Deprivation Level and Multimorbidity in a Health District. Mathematics. 10(4):1-14. https://doi.org/10.3390/math1004065911410

Modeling of autosomal-dominant retinitis pigmentosa in Caenorhabditis elegans uncovers a nexus between global impaired functioning of certain splicing factors and cell type-specific apoptosis

Retinitis pigmentosa (RP) is a rare genetic disease that causes gradual blindness through retinal degeneration. Intriguingly, seven of the 24 genes identified as responsible for the autosomal-dominant form (adRP) are ubiquitous spliceosome components whose impairment causes disease only in the retina. The fact that these proteins are essential in all organisms hampers genetic, genomic, and physiological studies, but we addressed these difficulties by using RNAi in Caenorhabditis elegans. Our study of worm phenotypes produced by RNAi of splicing-related adRP (s-adRP) genes functionally distinguishes between components of U4 and U5 snRNP complexes, because knockdown of U5 proteins produces a stronger phenotype. RNA-seq analyses of worms where s-adRP genes were partially inactivated by RNAi, revealed mild intron retention in developing animals but not in adults, suggesting a positive correlation between intron retention and transcriptional activity. interestingly, RNAi of s-adRP genes produces an increase in the expression of atl-1 (homolog of human ATR), which is normally activated in response to replicative stress and certain DNA-damaging agents. The up-regulation of atl-1 correlates with the ectopic expression of the pro-apoptotic gene egl-1 and apoptosis in hypodermal cells, which produce the cuticle, but not in other cell types. Our model in C. elegans resembles s-adRP in two aspects: The phenotype caused by global knockdown of s-adRP genes is cell type-specific and associated with high transcriptional activity. Finally, along with a reduced production of mature transcripts, we propose a model in which the retina-specific cell death in s-adRP patients can be induced through genomic instability