Análisis del riesgo de exclusión social en el medio rural: el índice Z como solución «lowcost» a la falta de indicadores sintéticos municipales

After the 2008 crisis, the study of social exclusion merits even more attention in rural research. However, common approaches usually employ macro analysis perspective (such as AROPE rate), which may not be appropriate, as rural areas are heterogeneous. Heterogeneity should be acknowledged in order to accomplish the social inclusion of the individuals and / or families who are excluded. Therefore, research should point out territorial differences of social exclusion problems at a micro-level. To this end, we work with the delimitation of the rurality used in the PDR, and we take as cases of study the municipalities of the GAL-LEADER of the province of Valencia. To maintain a multidimensional approach to social exclusion and operate in an efficient way (using free access official statistics) we did develop a «Z-index» with available recent data (2016) from an economic, social and spatial point of view. Basic results do confirm what was expected: rural territories analysed show a plurality of exclusion situations and social inclusion at municipal level. Especially in the most negative cases, where spatial variable turns out to be a critical vulnerability that affects rural society, even more than unemployment.Tras la crisis de 2008 el estudio de la exclusión social resulta un objeto recurrente para las investigaciones rurales. Pero las aproximaciones habituales suelen emplear perspectivas de análisis macro (como la tasa AROPE), algo inadecuado cuando el medio rural se caracteriza por su heterogeneidad. Si no reconocemos esta, difícilmente se puede lograr la inclusión social de los individuos y/o familias excluidas en este. Luego resulta clave evidenciar las diferencias territoriales de los fenómenos de exclusión social a nivel micro. Para ello trabajamos con la delimitación que de ruralidad emplean los PDR, y tomamos como casos de estudio los municipios de los GAL-LEADER de la provincia de Valencia. Para mantener el enfoque multidimensional de la exclusión social y operar con sencillez (emplear la estadística oficial de libre acceso), desarrollamos un «índice Z» con la información más reciente posible (2016) desde un punto de vista económico, social y espacial. Los resultados básicos confirman lo esperado: los territorios rurales analizados evidencian una pluralidad de situaciones de exclusión e inclusión social a nivel municipal. Sobre todo, en los casos más negativos, donde la variable espacial aparece con una vulnerabilidad crítica que afecta a la sociedad rural más que incluso el desempleo

Discovering HIV related information by means of association rules and machine learning

Acquired immunodeficiency syndrome (AIDS) is still one of the main health problems worldwide. It is therefore essential to keep making progress in improving the prognosis and quality of life of affected patients. One way to advance along this pathway is to uncover connections between other disorders associated with HIV/AIDS-so that they can be anticipated and possibly mitigated. We propose to achieve this by using Association Rules (ARs). They allow us to represent the dependencies between a number of diseases and other specific diseases. However, classical techniques systematically generate every AR meeting some minimal conditions on data frequency, hence generating a vast amount of uninteresting ARs, which need to be filtered out. The lack of manually annotated ARs has favored unsupervised filtering, even though they produce limited results. In this paper, we propose a semi-supervised system, able to identify relevant ARs among HIV-related diseases with a minimal amount of annotated training data. Our system has been able to extract a good number of relationships between HIV-related diseases that have been previously detected in the literature but are scattered and are often little known. Furthermore, a number of plausible new relationships have shown up which deserve further investigation by qualified medical experts

Pseudomonas aeruginosa antibiotic susceptibility profiles, genomic epidemiology and resistance mechanisms: a nation-wide five-year time lapse analysisResearch in context

Summary: Background: Pseudomonas aeruginosa healthcare-associated infections are one of the top antimicrobial resistance threats world-wide. In order to analyze the current trends, we performed a Spanish nation-wide high-resolution analysis of the susceptibility profiles, the genomic epidemiology and the resistome of P. aeruginosa over a five-year time lapse. Methods: A total of 3.180 nonduplicated P. aeruginosa clinical isolates from two Spanish nation-wide surveys performed in October 2017 and 2022 were analyzed. MICs of 13 antipseudomonals were determined by ISO-EUCAST. Multidrug resistance (MDR)/extensively drug resistance (XDR)/difficult to treat resistance (DTR)/pandrug resistance (PDR) profiles were defined following established criteria. All XDR/DTR isolates were subjected to whole genome sequencing (WGS). Findings: A decrease in resistance to all tested antibiotics, including older and newer antimicrobials, was observed in 2022 vs 2017. Likewise, a major reduction of XDR (15.2% vs 5.9%) and DTR (4.2 vs 2.1%) profiles was evidenced, and even more patent among ICU isolates [XDR (26.0% vs 6.0%) and DTR (8.9% vs 2.6%)] (p < 0.001). The prevalence of Extended-spectrum β-lactamase/carbapenemase production was slightly lower in 2022 (2.1%. vs 3.1%, p = 0.064). However, there was a significant increase in the proportion of carbapenemase production among carbapenem-resistant strains (29.4% vs 18.1%, p = 0.0246). While ST175 was still the most frequent clone among XDR, a slight reduction in its prevalence was noted (35.9% vs 45.5%, p = 0.106) as opposed to ST235 which increased significantly (24.3% vs 12.3%, p = 0.0062). Interpretation: While the generalized decrease in P. aeruginosa resistance, linked to a major reduction in the prevalence of XDR strains, is encouraging, the negative counterpart is the increase in the proportion of XDR strains producing carbapenemases, associated to the significant advance of the concerning world-wide disseminated hypervirulent high-risk clone ST235. Continued high-resolution surveillance, integrating phenotypic and genomic data, is necessary for understanding resistance trends and analyzing the impact of national plans on antimicrobial resistance. Funding: MSD and the Instituto de Salud Carlos III, Ministerio de Ciencia e Innovación and Unión Europea—NextGenerationEU