Differences in results and related factors between hospital-at-home modalities in Catalonia: a cross-sectional study

This is the final version. Available on open access from MDPI via the DOI in this record. Hospital-at-home (HaH) is a healthcare modality that provides active treatment by healthcare staff in the patient's home for a condition that would otherwise require hospitalization. The aims were to describe the characteristics of different types of hospital-at-home (HaH), assess their results, and examine which factors could be related to these results. A cross-sectional study based on data from all 2014 HaH contacts from Catalonia was designed. The following HaH modalities were considered-admission avoidance (n = 7,214; 75.1%) and early assisted discharge (n = 2,387; 24.9%). The main outcome indicators were readmission, mortality, and length of stay (days). Multivariable models were fitted to assess the association between explanatory factors and outcomes. Hospital admission avoidance is a scheme in which, instead of being admitted to acute care hospitals, patients are directly treated in their own homes. Early assisted discharge is a scheme in which hospital in-care patients continue their treatment at home. In the hospital avoidance modality, there were 8.3% readmissions, 0.9% mortality, and a mean length of stay (SD) of 9.6 (10.6) days. In the early assisted discharge modality, these figures were 7.9%, 0.5%, and 9.8 (11.1), respectively. In both modalities, readmission and mean length of stay were related to comorbidity and type of hospital, and mortality with age. The results of HaH in Catalonia are similar to those observed in other contexts. The factors related to these results identified might help to improve the effectiveness and efficiency of the different HaH modalities

Determinación del volumen tiroideo por ecografía en población adulta asintomática de la ciudad de Pereira – Colombia

Introducción: el aumento del volumen tiroideo puede presentarse tanto en hipertiroidismo como en hipotiroidismo. Los valores de referencia en la población colombiana de acuerdo con grupos etarios no se han establecido, lo que obliga a usar fuentes de otra población de características diferentes. Lo anterior genera errores en la práctica clínica diaria y conlleva a conductas equívocas, por lo que es importante obtener valores de referencia normales del tamaño tiroideo en la población. El objetivo de este estudio fue estimar los valores de referencia para el volumen tiroideo normal en la población adulta de la ciudad de Pereira sin anomalía tiroidea. Métodos: estudio observacional de corte trasversal realizado en la Clínica Comfamiliar Risaralda, con población masculina y femenina mayor de 18 años sin patología tiroidea previa. Se estimaron las ecuaciones de regresión en polinomios fraccionales para los valores medios y su correspondiente variabilidad en el volumen tiroideo en función de la edad; se obtuvieron los centiles por edad. Resultados: se incluyó un total de 170 pacientes al estudio. El volumen total promedio de la glándula tiroides en la población fue de 6,5 ± 2,1 mL, siendo mayor en el sexo masculino (media 7,9 ± 1,7 mL) que en el femenino (media: 6,0 ± 2,0 mL). Se identificó una tendencia estable del volumen tiroideo hasta los 51 años (p50: 6,54 mL) con una posterior tendencia al incremento hasta los 69 años (p50: 9,64 mL). Conclusiones: se obtuvieron valores de referencia normales de volumen tiroideo en la población pereirana adulta sana

Differences in results and related factors between hospital-at-home modalities in Catalonia: a cross-sectional study

Average stay; Cross-sectional study; Hospital-at-home; MortalityEstancia media; Estudio transversal; Hospital en casa; MortalidadEstada mitjana; Estudi transversal; Hospital a casa; MortalitatHospital-at-home (HaH) is a healthcare modality that provides active treatment by healthcare staff in the patient's home for a condition that would otherwise require hospitalization. The aims were to describe the characteristics of different types of hospital-at-home (HaH), assess their results, and examine which factors could be related to these results. A cross-sectional study based on data from all 2014 HaH contacts from Catalonia was designed. The following HaH modalities were considered-admission avoidance (n = 7,214; 75.1%) and early assisted discharge (n = 2,387; 24.9%). The main outcome indicators were readmission, mortality, and length of stay (days). Multivariable models were fitted to assess the association between explanatory factors and outcomes. Hospital admission avoidance is a scheme in which, instead of being admitted to acute care hospitals, patients are directly treated in their own homes. Early assisted discharge is a scheme in which hospital in-care patients continue their treatment at home. In the hospital avoidance modality, there were 8.3% readmissions, 0.9% mortality, and a mean length of stay (SD) of 9.6 (10.6) days. In the early assisted discharge modality, these figures were 7.9%, 0.5%, and 9.8 (11.1), respectively. In both modalities, readmission and mean length of stay were related to comorbidity and type of hospital, and mortality with age. The results of HaH in Catalonia are similar to those observed in other contexts. The factors related to these results identified might help to improve the effectiveness and efficiency of the different HaH modalities

An FPGA Implementation to Detect Selective Cationic Antibacterial Peptides

Exhaustive prediction of physicochemical properties of peptide sequences is used in different areas of biological research. One example is the identification of selective cationic antibacterial peptides (SCAPs), which may be used in the treatment of different diseases. Due to the discrete nature of peptide sequences, the physicochemical properties calculation is considered a high-performance computing problem. A competitive solution for this class of problems is to embed algorithms into dedicated hardware. In the present work we present the adaptation, design and implementation of an algorithm for SCAPs prediction into a Field Programmable Gate Array (FPGA) platform. Four physicochemical properties codes useful in the identification of peptide sequences with potential selective antibacterial activity were implemented into an FPGA board. The speed-up gained in a single-copy implementation was up to 108 times compared with a single Intel processor cycle for cycle. The inherent scalability of our design allows for replication of this code into multiple FPGA cards and consequently improvements in speed are possible. Our results show the first embedded SCAPs prediction solution described and constitutes the grounds to efficiently perform the exhaustive analysis of the sequence-physicochemical properties relationship of peptides

Extreme and long-term drought in the La Plata Basin: event evolution and impact assessment until September 2022

The current drought conditions across the Parana-La Plata Basin (LPB) in Brazil-Argentina have been the worst since 1944. While this area is characterized by a rainy season with a peak from October to April, the hydrological year 2020-2021 was very deficient in rainfall, and the situation extended into the 2021-2022 hydrological year. Below-normal rainfall was dominant in south-eastern Brazil, northern Argentina, Paraguay, and Uruguay, suggesting a late onset and weaker South American Monsoon and the continuation of drier conditions since 2021. In fact, in 2021 Brazilian south and south-east regions faced their worst droughts in nine decades, raising the spectre of possible power rationing given the grid dependence on hydroelectric plants. The Paraná-La Plata Basin drought induced damages to agriculture and reduced crop production, including soybeans and maize, with effects on global crop markets. The drought situation continued in 2022 in the Pantanal region. Dry meteorological conditions are still present in the region at the end of September 2022 with below-average precipitation anomalies. Soil moisture anomaly and vegetation conditions are worst in the lower part of the La Plata Basin, in the southern regions. Conversely, upper and central part of the basin show partial and temporary recovery

Disentangling signatures of selection before and after European colonization in latin Americans

Throughout human evolutionary history, large-scale migrations have led to intermixing (i.e., admixture) between previously separated human groups. Although classical and recent work have shown that studying admixture can yield novel historical insights, the extent to which this process contributed to adaptation remains underexplored. Here, we introduce a novel statistical model, specific to admixed populations, that identifies loci under selection while determining whether the selection likely occurred post-admixture or prior to admixture in one of the ancestral source populations. Through extensive simulations, we show that this method is able to detect selection, even in recently formed admixed populations, and to accurately differentiate between selection occurring in the ancestral or admixed population. We apply this method to genome-wide SNP data of ∼4,000 individuals in five admixed Latin American cohorts from Brazil, Chile, Colombia, Mexico, and Peru. Our approach replicates previous reports of selection in the human leukocyte antigen region that are consistent with selection post-admixture. We also report novel signals of selection in genomic regions spanning 47 genes, reinforcing many of these signals with an alternative, commonly used local-ancestry-inference approach. These signals include several genes involved in immunity, which may reflect responses to endemic pathogens of the Americas and to the challenge of infectious disease brought by European contact. In addition, some of the strongest signals inferred to be under selection in the Native American ancestral groups of modern Latin Americans overlap with genes implicated in energy metabolism phenotypes, plausibly reflecting adaptations to novel dietary sources available in the Americas

Determinants of the current and future distribution of the West Nile virus mosquito vector Culex pipiens in Spain

Changes in environmental conditions, whether related or not to human activities, are continuously modifying the geographic distribution of vectors, which in turn affects the dynamics and distribution of vector-borne infectious diseases. Determining the main ecological drivers of vector distribution and how predicted changes in these drivers may alter their future distributions is therefore of major importance. However, the drivers of vector populations are largely specific to each vector species and region. Here, we identify the most important human-activity-related and bioclimatic predictors affecting the current distribution and habitat suitability of the mosquito Culex pipiens and potential future changes in its distribution in Spain. We determined the niche of occurrence (NOO) of the species, which considers only those areas lying within the range of suitable environmental conditions using presence data. Although almost ubiquitous, the distribution of Cx. pipiens is mostly explained by elevation and the degree of urbanization but also, to a lesser extent, by mean temperatures during the wettest season and temperature seasonality. The combination of these predictors highlights the existence of a heterogeneous pattern of habitat suitability, with most suitable areas located in the southern and northeastern coastal areas of Spain, and unsuitable areas located at higher altitude and in colder regions. Future climatic predictions indicate a net decrease in distribution of up to 29.55%, probably due to warming and greater temperature oscillations. Despite these predicted changes in vector distribution, their effects on the incidence of infectious diseases are, however, difficult to forecast since different processes such as local adaptation to temperature, vector-pathogen interactions, and human-derived changes in landscape may play important roles in shaping the future dynamics of pathogen transmission.info:eu-repo/semantics/acceptedVersio

Cirugía robótica en patología quirúrgica benigna y maligna (urología, cirugía general y digestiva, cirugía cardiotorácica, ginecología, endocrinología, oftalmología y cirugía de cabeza y cuello). Capítulo I: cirugía cardiotorácica, endocrina, oftalmológica y cirugía de cabeza y cuello

Cirurgia robòtica; Tècniques quirúrgiques; InnovacióCirugía robótica; Técnicas quirúrgicas; InnovaciónRobotic surgery; Surgical techniques; InnovationAquest estudi té l’objectiu de determinar si la cirurgia assistida per robot, quan aquesta és el tractament indicat en una sèrie de patologies benignes o malignes, ha de ser incorporada en la cartera comuna bàsica de serveis assistencials del SNS i, per tant, convertir-se en una tecnologia finançada a través de fons públics. Per fer-ho s’ha avaluat l’eficàcia o l’efectivitat, la seguretat i l’eficiència de la cirurgia assistida per robot en comparació amb la cirurgia oberta o endoscòpica en un grup d’indicacions de patologia benigna o maligna en les especialitats de cirurgia cardiotoràcica, endocrina, oftalmològica, de cap i coll.El estudio tiene el objetivo de determinar si la cirugía asistida por robot, cuando la cirugía es el tratamiento indicado en una serie de patologías benignas o malignas, debe ser incorporada en la cartera común básica de servicios asistenciales del SNS y, por tanto, convertirse en una tecnología financiada a través de fondos públicos. Para ello se ha evaluado la eficacia o la efectividad, la seguridad y la eficiencia de la cirugía asistida por robot en comparación con la cirugía abierta o endoscópica en un grupo de indicaciones de patología benigna o maligna en las especialidades de cirugía cardiotorácica, endocrina, oftalmológica y de cabeza y cuello.The aim of the report is to determine whether robot-assisted surgery —when surgery is the indicated treatment for a series of benign or malignant pathologies— should be included in the basic common portfolio of the SNS healthcare services and thus become a publicly funded technology. To this end, the efficacy or effectiveness, safety and efficiency of robot-assisted surgery has been evaluated in comparison with open or endoscopic surgery in a group of indications of benign or malignant pathology in the specialities of cardiothoracic surgery, endocrine surgery, ophthalmological surgery, head and neck surgery