Assessing the Predictive Performance of Probabilistic Caries Risk Assessment Models: The Importance of Calibration

Probabilistic caries risk assessment models (P-CRA), such as the Cariogram, are promising tools to planning treatments in order to control and prevent caries. The usefulness of these models for informing patients and medical decision-making depends on 2 properties known as discrimination and calibration. Current common assessment of P-CRA models, however, ignores calibration, and this can be misleading. The aim of this paper was to provide tools for a proper assessment of calibration of the P-CRA models and improve calibration when lacking. A combination of standard calibration tools (calibration plot, calibration in-the-large, and calibration slope) and 3 novel measures of calibration (the Calibration Index and 2 related metrics, E50 and E90) are proposed to evaluate if a P-CRA model is well calibrated. Moreover, an approach was proposed and validated using data from a previous follow-up study performed on children evaluated by means of a reduced Cariogram model; Platt scaling and isotonic regression were applied showing a lack of calibration. The use of the Cariogram overestimates the actual risk of new caries for forecast probabilities 0.6. Both Platt scaling and isotonic regression were able to significantly improve the calibration of the reduced Cariogram model, preserving its discrimination properties. The average specificity and sensitivity for both Platt scaling and isotonic regression using the cut-off point p= 0.5 were >83 and their sum well exceeded 160. The benefits of the proposed calibration methods are promising, but further research in this field is required

Soy responsable de mi salud oral : Salud oral para niños y jóvenes embarazadas en situación de riesgo

Introducción: El presente proyecto se inicia a partir de la demanda planteada por el Padre Miguel Hrymacz, Presidente de la Fundación Padre Miguel, quien solicita una construcción colectiva de un plan de acción, necesario para la resolución de problemas odontológicos de niños y adolescentes con residencia permanente en esta área de vacancia. Los propósitos fundamentales de la fundación son el impulso e investigación de la problemática vinculada a la minoridad marginada, a la maternidad adolescente en riesgo, con un enfoque multidisciplinario y trabajo en red con otras organizaciones comunitarias con el fin de lograr una eficaz inserción social. La organización posee 2 hogares convivenciales, uno con dedicación a jóvenes mujeres adolescentes en situación de riesgo asistencial y otro con población de niños/as en situación de riesgo. Luego de un trabajo de relevamiento y establecimiento de vínculos con los niños, niñas, jóvenes y adolescentes, se pudo observar que están afectados por caries y enfermedad gingival, por lo que se propone disminuir los niveles de infección a través de la educación para la salud, prácticas de técnicas no traumáticas y derivación y traslado oportuno a Centros extramuros de la FOLP.Facultad de Odontologí

Multiancestry analysis of the HLA locus in Alzheimer’s and Parkinson’s diseases uncovers a shared adaptive immune response mediated by HLA-DRB1*04 subtypes

Across multiancestry groups, we analyzed Human Leukocyte Antigen (HLA) associations in over 176,000 individuals with Parkinson’s disease (PD) and Alzheimer’s disease (AD) versus controls. We demonstrate that the two diseases share the same protective association at the HLA locus. HLA-specific fine-mapping showed that hierarchical protective effects of HLA-DRB1*04 subtypes best accounted for the association, strongest with HLA-DRB1*04:04 and HLA-DRB1*04:07, and intermediary with HLA-DRB1*04:01 and HLA-DRB1*04:03. The same signal was associated with decreased neurofibrillary tangles in postmortem brains and was associated with reduced tau levels in cerebrospinal fluid and to a lower extent with increased Aβ42. Protective HLA-DRB1*04 subtypes strongly bound the aggregation-prone tau PHF6 sequence, however only when acetylated at a lysine (K311), a common posttranslational modification central to tau aggregation. An HLA-DRB1*04-mediated adaptive immune response decreases PD and AD risks, potentially by acting against tau, offering the possibility of therapeutic avenues

A method to construct a points system to predict cardiovascular disease considering repeated measures of risk factors

Current predictive models for cardiovascular disease based on points systems use the baseline situation of the risk factors as independent variables. These models do not take into account the variability of the risk factors over time. Predictive models for other types of disease also exist that do consider the temporal variability of a single biological marker in addition to the baseline variables. However, due to their complexity these other models are not used in daily clinical practice. Bearing in mind the clinical relevance of these issues and that cardiovascular diseases are the leading cause of death worldwide we show the properties and viability of a new methodological alternative for constructing cardiovascular risk scores to make predictions of cardiovascular disease with repeated measures of the risk factors and retaining the simplicity of the points systems so often used in clinical practice (construction, statistical validation by simulation and explanation of potential utilization). We have also applied the system clinically upon a set of simulated data solely to help readers understand the procedure constructed

New Insights on Alternative Hosts of <i>Xanthomonas vasicola</i> pv. <i>vasculorum</i>, the Causal Agent of Bacterial Leaf Streak of Maize

Bacterial leaf streak (BLS) of maize (Zea mays), caused by the bacterium Xanthomonas vasicola pv. vasculorum (Xvv), was first reported in Brazil in 2018. In this study, we evaluated 52 species of cultivated plants, cover crops, forage, and grasses that are used in succession or crop rotation with maize, and weeds with natural occurrence in maize-producing regions, to determine their potentials as alternative hosts for Xvv. We investigated (i) the pathogenicity of Xvv based on symptom development, (ii) epiphytic colonization of the bacterium in asymptomatic plants, and (iii) bacterial colonization in plant tissues using scanning electron microscopy (SEM) in symptomatic and asymptomatic species. Ten species, all belonging to the Poaceae family, presented symptoms after Xvv infection, including Avena sativa (cvs. IPR Afrodite and IPR Esmeralda), A. strigosa (cv. IPR 161), Hordeum vulgare (cv. BRS Cauê), Oryza sativa (cv. IPR 117), Brachiaria brizantha (Brizantha and cv. Marandu), Digitaria horizontalis, D. insularis, Echinochloa colonum, Eleusine indica, and Sorghum arundinaceum. Furthermore, epiphytic colonization by Xvv was observed in 23 asymptomatic species. Scanning micrographs revealed that Xvv cells and their aggregates were distributed throughout the leaf surface. In addition, bacterial colonization in the intercellular tissues of the substomatal chambers of white oat, black oat, and maize was observed across the tissue fractures. Despite showing typical symptoms of Xvv infection, SEM examination revealed evidence of Xvv colonization only on the leaf surface of rice. In asymptomatic species, such as rye, sorghum, and millet, a low number of bacterial cells were found on the leaf surface. However, no evidence of internal tissue colonization was observed in millet fractures, suggesting that Xvv survives only epiphytically in this species

Capital Humano-AH38-202101

La gestión del capital humano va más allá de captar y remunerar a las personas que laboran en una organización; pasa por la habilidad para seleccionarla, capacitarla, desarrollarla, motivarla y comprometerla, logrando alinear sus objetivos personales con las metas de la empresa. Este es el nuevo enfoque de la gestión del capital humano y, para lograrlo, es necesario que los administradores tengan la capacidad de incrementar el rendimiento de las personas a través de una eficiente gestión que genere valor

Capital Humano - AH38 - 202101

La gestión del capital humano va más allá de captar y remunerar a las personas que laboran en una organización; pasa por la habilidad para seleccionarla, capacitarla, desarrollarla, motivarla y comprometerla, logrando alinear sus objetivos personales con las metas de la empresa. Este es el nuevo enfoque de la gestión del capital humano y, para lograrlo, es necesario que los administradores tengan la capacidad de incrementar el rendimiento de las personas a través de una eficiente gestión que genere valor. 1 El curso de Capital Humano ha sido diseñado para permitir al futuro profesional entender y aplicar las distintas variables y procesos que intervienen en la gestión de personas dentro de las organizaciones. El curso es de carácter teórico-práctico dictado bajo la modalidad blended, que busca desarrollar la competencia general de la UPC, Comunicación Oral en nivel 2, y la competencia específica de la Facultad de Negocios, Dirección de Personas en nivel 1

Prevalência de pé diabético e fatores associados nas unidades de saúde da família da cidade do Recife, Pernambuco, Brasil, em 2005 Prevalence of diabetic foot and associated factors in the family health units of the city of Recife, Pernambuco State, Brazil, in 2005

Uma das mais importantes complicações crônicas do diabetes mellitus é o pé diabético. Por sua gravidade, pode levar a amputações de extremidades inferiores. Entretanto, por apresentar uma evolução lenta, permite o desenvolvimento de ações de prevenção e controle. A abrangência do Programa Saúde da Família, quanto a possibilidade de diagnóstico precoce tanto do diabetes como desta complicação favorece a condução de estudos epidemiológicos visando conhecer sua magnitude. Este artigo objetivou determinar a proporção de portadores de pé diabético atendidos nas unidades de saúde da família da cidade do Recife, Pernambuco, Brasil. Desenvolveu-se um levantamento epidemiológico, com amostra probabilística dos prontuários de pacientes com diabetes cadastrados nos seis distritos sanitários do município. Foram analisadas relações entre as variáveis sócio-econômicas, condições de saúde e ocorrência de amputação a partir de 1.374 prontuários. Observou-se uma prevalência de 9% de portadores de pé diabético. Encontrou-se associação positiva e estatisticamente significativa com as variáveis: alcoolismo e ocorrência de amputação (p < 0,001). A prevalência de amputações em extremidades inferiores foi de 25,6% dentre os portadores da complicação e de 2,3% do total da amostra.<br>One of the most important chronic complications of diabetes mellitus is diabetic foot. Severe progression of diabetes can lead to lower limb amputations. However, since evolution of the disease is slow, it is possible to implement prevention and control measures. The scope of the Family Health Program (in terms of the possibility of early diagnosis of diabetes mellitus and diabetic foot) favors epidemiological studies to determine the problem's magnitude. This article aimed to identify the proportion of individuals with diabetic foot treated at family health units in the city of Recife, Pernambuco State, Brazil. An epidemiological survey was conducted with a probabilistic sample of medical charts of diabetic patients (N = 1,374) enrolled in six health districts in the city, analyzing relations between socioeconomic variables, health conditions, and the occurrence of amputation. Diabetic foot was observed in 9% of the sample. There was a positive and statistically significant association with the variables alcoholism and amputation (p < 0.001). The prevalence of lower limb amputations was 25.6% among individuals with complications and 2.3% of the total sample

Diagnosis and management of asymptomatic bacteriuria in kidney transplant recipients: a survey of current practice in Europe

International audienceBackgroundAsymptomatic bacteriuria is frequent in kidney transplant recipients (KTRs). However, there is no consensus on diagnosis or management. We conducted a European survey to explore current practice related to the diagnosis and management of asymptomatic bacteriuria in adult KTRs.MethodsA panel of experts from the European Renal Association–European Dialysis Transplant Association/Developing Education Science and Care for Renal Transplantation in European States working group and the European Study Group for Infections in Compromised Hosts of the European Society of Clinical Microbiology and Infectious Diseases designed this cross-sectional, questionnaire-based, self-administered survey. Invitations to participate were e-mailed to European physicians involved in the care of KTRs.ResultsTwo hundred and forty-four participants from 138 institutions in 25 countries answered the survey (response rate 30%). Most participants [72% (176/244)] said they always screen for asymptomatic bacteriuria in KTRs. Six per cent (15/240) reported never treating asymptomatic bacteriuria with antibiotics. When antimicrobial treatment was used, 24% of the participants (53/224) said they would start with empirical antibiotics. For an episode of asymptomatic bacteriuria caused by a fully susceptible microorganism and despite no contraindications, a majority of participants (121/223) said they would use a fluoroquinolone (n = 56), amoxicillin/clavulanic acid (n = 38) or oral cephalosporins (n = 27).ConclusionsScreening for and treating asymptomatic bacteriuria are common in KTRs despite uncertainties around the benefits and harms. In an era of antimicrobial resistance, further studies are needed to address the diagnosis and management of asymptomatic bacteriuria in these patients