Viabilidad Financiera de los Hogares en el Sistema de Atención a la Dependencia en España: Evidencia Regional

One of the most extensively analysed issues in recent decades has been financial catastrophe due to out-of pocket payments (OOP) made by households to access and use health systems. This paper has two main objectives. The first is to predict the rates of financial catastrophe and determine the importance of the chosen variables for predicting the rates of catastrophe for high, medium and low income levels in the different Spanish regions. To this end, a comparison will be made between two machine learning algorithms, one based on elastic-net regressions to estimate generalised linear models; and another based on random forest algorithms, which makes it possible to capture the possible non-linearities and interactions that may occur in the data. The results show that the random forest is more appropriate. Based on these results, the second objective is to establish a ranking of the different regions by income level for the different categories of financial catastrophic expenditure rates, using a discrete multi-criteria decision model (PROMETHEE method). Uno de los temas más analizados en las últimas décadas ha sido el catastrofismo financiero debido a los Pagos de Bolsillo (PDB) que realizan los hogares por el acceso y utilización de los sistemas de salud. En este trabajo se persiguen fundamentalmente dos objetivos. El primero, se centra en predecir la tasa de catastrofismo financiero y obtener la importancia de las variables para predecir la tasa de catastrofismo para un nivel de renta alto, medio o bajo de las diferentes Comunidades Autónomas. Para ello, se establecerá una comparativa entre dos algoritmos machine learning, uno basado en regresiones elastic-net para estimar modelos lineales generalizados; y, otro basado en algoritmos random forest, que permite captar las posibles no linealidades e interacciones que se pueden producir en los datos. Los resultados muestran que es más adecuado el random forest. A partir de estos resultados, el segundo objetivo, se centra en establecer un ordenamiento entre las diferentes Comunidades Autónomas según su nivel de renta para las diferentes categorías de las tasas de catastrofismo mediante la utilización de un modelo de decisión multicriterio discreto (método PROMETHEE)

Rankings in the euro zone based on macroeconomic information

One consequence of the Great Recession that began in 2008 has been the sovereign debt crisis within the European Monetary Union (EMU) and the increasing risk premium associated with government debt of peripheral countries (primarily, Greece, Ireland, Portugal and Spain). Firstly, this paper analyses what macroeconomic variables are more related with the evolution of the risk premium, using panel data estimation. Secondly, we also try to sort the countries belonging to the monetary union in terms of their likelihood of experiencing an increase in the risk premium. To this purpose, we use discrete multicriteria decision aid methods

The Classification of Profiles of Financial Catastrophe Caused by Out-Of-Pocket Payments: A Methodological Approach

The financial catastrophe resulting from the out-of-pocket payments necessary to access and use healthcare systems has been widely studied in the literature. The aim of this work is to predict the impact of the financial catastrophe a household will face as a result of out-of-pocket payments in long-term care in Spain. These predictions were made using machine learning techniques such as LASSO (Least Absolute Shrinkage and Selection Operator) penalized regression and elastic-net, as well as algorithms like k-nearest neighbors (KNN), MARS (Multivariate Adaptive Regression Splines), random forest, boosted trees and SVM (Support Vector Machine). The results reveal that all the classification methods performed well, with the complex models performing better than the simpler ones and showing no evidence of overfitting. Detecting and defining the profiles of individuals and families most likely to suffer from financial catastrophe is crucial in enabling the design of financial policies aimed at protecting vulnerable groups

Management of fibro-osseous lesions of the craniofacial area: presentation of 19 cases and review of the literature

Introduction: Fibro-osseous lesions constitute a rare benign type of pathology with a non-odontogenic lineage that affect the craniofacial area. According to Waldrom's classification, these lesions are divided into: fibrous dysplasia (FD), cemento-ossifying fibroma (COF) and desmoplastic fibroma (DF). Material and Methods: A retrospective study was performed on patients diagnosed with fibro-osseous lesions of the craniofacial area at the Hospital Universitario La Fe, Valencia, during 1987-2009. A total of 19 cases were collected: 15 cases compatible with an FD diagnosis, 3 cases with a COF diagnosis and 1 case with a DF diagnosis. Results: In the differential diagnosis, entities having similar clinical manifestations in the maxillofacial area with possible involvement of teeth or manifestations present as an asymptomatic radiolucent image should be ruled out. We hereby present the management and development of patients treated in our hospital for fibro-osseous lesions. Conclusions: Fibro-osseous lesions share many clinical and radiological characteristics in common, with histological features confirming the nature of the lesion. Management of patients should be individualized and casespecific, assessing the clinical evolution of each case and taking into account the benign nature and growth behavior of this type of tumors

In Vitro Antimicrobial Susceptibilities of Francisella tularensis subsp. holarctica Isolates from Tularemia Outbreaks That Occurred from the End of the 20th Century to the 2020s in Spain

[EN] A collection of 177 Francisella tularensis subsp. holarctica clinical isolates (29 from humans and 148 from animals, mainly hares and voles) was gathered from diverse tularemia outbreaks in the Castilla y León region (northwestern Spain) that occurred from the end of the 20th century to the 2020s. Along with four F. tularensis subsp. holarctica reference strains, all of these clinical isolates were tested using a broth microdilution method to determine their susceptibility to 22 antimicrobial agents, including β-lactams, aminoglycosides and one member each of the tetracycline, glycylcycline, quinolone and sulphonamide classes. Many multi-resistance profiles were found among the tested isolates, but especially among those of human origin (all but two isolates showed resistance to at least 13 of 18 antimicrobial agents). Even so, all human isolates were susceptible to gentamicin and tobramycin, while more than 96% of animal isolates were susceptible to these two aminoglycosides. Ciprofloxacin showed activity against more than 92% of animal and human isolates. However, almost 21% of human isolates were resistant to tetracycline, and more than 65% were resistant to tigecycline. Finally, a quite similar activity to other F. tularensis subsp. holarctica isolates collected 20 years earlier in Spain was observedSIThis study was supported by a contract—project, “Caracterización de posibles resistencias antimicrobianas y estudios de virulencia de las cepas aisladas de Francisella tularensis. Contexto One Health” financed by the Consejería de Agricultura, Ganadería y Desarrollo Rural, Junta de Castilla y León. The 181 F. tularensis isolates were owned by the Laboratorio Regional de Sanidad Animal, León, Spain, or by the Hospital Clínico Veterinario, Valladolid, Spai

Enfoques metodológicos en el proceso de enseñanza-aprendizaje de la revisión de traducciones

Se presenta la memoria del Proyecto de Innovación docente sobre actividades y métodos para enseñar a los estudiantes de Traducción e Interpretación a auto revisar y corregir sus traducciones

An evaluation of pipelines for DNA variant detection can guide a reanalysis protocol to increase the diagnostic ratio of genetic diseases

Clinical exome (CE) sequencing has become a first-tier diagnostic test for hereditary diseases; however, its diagnostic rate is around 30–50%. In this study, we aimed to increase the diagnostic yield of CE using a custom reanalysis algorithm. Sequencing data were available for three cohorts using two commercial protocols applied as part of the diagnostic process. Using these cohorts, we compared the performance of general and clinically relevant variant calling and the efficacy of an in-house bioinformatic protocol (FJD-pipeline) in detecting causal variants as compared to commercial protocols. On the whole, the FJD-pipeline detected 99.74% of the causal variants identified by the commercial protocol in previously solved cases. In the unsolved cases, FJD-pipeline detects more INDELs and non-exonic variants, and is able to increase the diagnostic yield in 2.5% and 3.2% in the re-analysis of 78 cancer and 62 cardiovascular cases. These results were considered to design a reanalysis, filtering and prioritization algorithm that was tested by reassessing 68 inconclusive cases of monoallelic autosomal recessive retinal dystrophies increasing the diagnosis by 4.4%. In conclusion, a guided NGS reanalysis of unsolved cases increases the diagnostic yield in genetic disorders, making it a useful diagnostic tool in medical geneticsWe want to thank the participants for consenting to the use of their data for the study. We would like to thank all technical staff in the genetics service of the Fundación Jiménez Díaz University Hospital for conducting the sequencing and segregation analysis. We also thank Oliver Shaw (IIS-FJD) for editorial assistance. This work was supported by the Instituto de Salud Carlos III (ISCIII) of the Spanish Ministry of Health (FIS; PI16/00425, PI19/00321, PI18/00579 and PI20/00851), Centro de Investigación Biomédica en Red Enfermedades Raras (CIBERER, 06/07/0036), IIS-FJD BioBank (PT13/0010/0012), Comunidad de Madrid (CAM, RAREGenomics Project, B2017/BMD-3721), Ramón Areces Foundation (4019/012), Conchita Rábago Foundation, and the University Chair UAM-IIS-FJD of Genomic Medicine. R.R. is supported by a postdoctoral fellowship of the Comunidad de Madrid (2019-T2/BMD-13714), L.d.l.F. is supported by the platform technician contract of ISCIII (CA18/00017), IPR is supported by a PhD studentship from the predoctoral program from ISCIII (FI17/ 00192), I.F.I. is supported by a grant from the Comunidad de Madrid (CAM, PEJ-2017- AI/BMD7256), G.N.M. is supported by a grant from the Comunidad de Madrid (PEJ2020-AI/BMD-18610), A.D. is supported by a PhD studentship from the predoctoral program from ISCIII (FI18/00123), B.A. is supported by a Juan Rodes program from ISCIII (JR17/00020), C.R. is supported by a PhD studentship from the Conchita Rabago Foundation and PM and MC are supported by a Miguel Servet program contract from ISCIII (CP16/00116 and CPII17/00006, respectively). The funders played no role in study design, data collection, data analysis, manuscript preparation, and/or publication decision

Tularemia Outbreaks in Spain from 2007 to 2020 in Humans and Domestic and Wild Animals

[EN] In this study, tularemia outbreaks associated with humans and several domestic and wild animals (Iberian hares, wild rabbits, voles, mice, grey shrews, sheep, dogs, foxes, wolves, ticks, and river crayfish) are reported in Spain from 2007 to 2020. Special attention was paid to the outbreaks in humans in 2007-2009 and 2014-2015, when the most important waves occurred. Moreover, positive rates of tularemia in lagomorphs were detected in 2007-2010, followed by negative results in 2011-2013, before again returning to positive rates in 2014 and in 2017 and in 2019-2020. Lagomorphs role in spreading Francisella tularensis in the epidemiological chain could not be discarded. F. tularensis is described for the first time infecting the shrew Crocidura russula worldwide, and it is also reported for the first time infecting wild rabbits (Oryctolagus cuniculus) in Spain. Serological positives higher than 0.4% were seen for sheep only from 2007-2009 and again in 2019, while serological rates greater than 1% were revealed in dogs in 2007-2008 and in wild canids in 2016. F. tularensis were detected in ticks in 2009, 2014-2015, 2017, and 2019. Lastly, negative results were achieved for river crayfish and also in environmental water samples from 2007 to 2020SIThis research received no external funding but was supported by the contract-project called Caracterización molecular de las cepas de Francisella tularensis aisladas en lagomorfos y roedores de Castilla y León, financed by the Dirección General de Producción Agropecuaria e Infraestructuras, Servicio de Sanidad Animal, Consejería de Agricultura y Ganadería de la Junta de Castilla y León. All the isolates are owned by the Junta de Castilla y Leó

BDinnova – Formación del profesorado en herramientas de manejo, análisis y visualización de BigData geolocalizado

Depto. de GeografíaFac. de Geografía e HistoriaFALSEsubmitte