Estrategias de decisión para la selección de modelos de predicción

En este trabajo vamos a analizar los resultados obtenidos en la competición M4 por una combinación lineal de predicciones presentada al concurso. Para cada serie consideramos dos predicciones, obtenidas a partir de los datos sin transformar y transformados mediante logaritmo, combinando ambas mediante la inversa de sus errores de ajuste (sMAPE). El análisis del sMAPE a posteriori nos lleva a concluir que una selección más eficiente entre los tres tipos de predicciones propuestas para cada serie hubiera mejorado considerablemente dicho error. Hemos incluido también como posible opción el método Naïve. Se propone en este trabajo un árbol de decisión, a partir de los errores de ajuste y los parámetros asociados a cada tipo de predicción (basados en el sMAPE), para seleccionar la mejor opción posible de las 4 incluidas para cada serie. También se ha valorado el papel de otros parámetros como el estadístico U de Theil o el tamaño de la serieThis paper analyze the results obtained in the M4-Competition by a linear combination of predictions submitted to the competition. For each time series we consider two forecasts, obtained from the raw data and its log-transformed time series. A linear combination of both forecasts is built using as weights the inverse of the averaged fitting errors (sMAPE). The analysis of the sMAPE leads us to conclude that a more efficient selection among the three types of proposed forecasts for each series would have considerably improved this error. We have also included the Naïve method as a possible option. A conditional tree is proposed in this paper, based on the adjustment errors associated with each type of forecast (based on the sMAPE), to select the best possible option from the 4 included for each series. The role of other parameters such as Theil’s U statistic or the size of the series has also be assesse

Contributing factors for acute stress in healthcare workers caring for COVID-19 patients in Argentina, Chile, Colombia, and Ecuador

This study analyzed the frequency and intensity of acute stress among health professionals caring for COVID-19 patients in four Latin American Spanish-speaking countries during the outbreak. A cross-sectional study involved a non-probability sample of healthcare professionals in four Latin American countries. Participants from each country were invited using a platform and mobile application designed for this study. Hospital and primary care workers from different services caring for COVID-19 patients were included. The EASE Scale (SARS-CoV-2 Emotional Overload Scale, in Spanish named Escala Auto-aplicada de Sobrecarga Emocional) was a previously validated measure of acute stress. EASE scores were described overall by age, sex, work area, and experience of being ill with COVID-19. Using the Mann–Whitney U test, the EASE scores were compared according to the most critical moments of the pandemic. Univariate and multivariate analysis was performed to investigate associations between these factors and the outcome ‘acute stress’. Finally, the Kruskal–Wallis was used to compare EASE scores and the experience of being ill. A total of 1372 professionals responded to all the items in the EASE scale: 375 (27.3%) Argentines, 365 (26.6%) Colombians, 345 (25.1%) Chileans, 209 (15.2%) Ecuadorians, and 78 (5.7%) from other countries. 27% of providers suffered middle-higher acute stress due to the outbreak. Worse results were observed in moments of peak incidence of cases (14.3 ± 5.3 vs. 6.9 ± 1.7, p < 0.05). Higher scores were found in professionals in COVID-19 critical care (13 ± 1.2) than those in non-COVID-19 areas (10.7 ± 1.9) (p = 0.03). Distress was higher among professionals who were COVID-19 patients (11.7 ± 1) or had doubts about their potential infection (12 ± 1.2) compared to those not infected (9.5 ± 0.7) (p = 0.001). Around one-third of the professionals experienced acute stress, increasing in intensity as the incidence of COVID-19 increased and as they became infected or in doubt whether they were infected. EASE scale could be a valuable asset for monitoring acute stress levels among health professionals in Latin America.Fil: Martin Delgado, Jimmy. Universidad Catolica de Santiago de Guayaquil; EcuadorFil: Poblete, Rodrigo. Universidad de Santiago de Chile; ChileFil: Serpa, Piedad. Universidad Industrial Santander; ColombiaFil: Mula, Aurora. Hospital Universitario de Sant Joan D´alacant; EspañaFil: Carrillo, Irene. Universidad de Miguel Hernández; EspañaFil: Fernández, Cesar. Universidad de Miguel Hernández; EspañaFil: Vicente Ripoll, María Asunción. Universidad de Miguel Hernández; EspañaFil: Loudet, Cecilia. General José de San Martín de la Plata General Hospital; ArgentinaFil: Jorro, Facundo. Gobierno de la Ciudad de Buenos Aires. Hospital General de Niños Pedro Elizalde (ex Casa Cuna); ArgentinaFil: Garcia Elorrio, Ezequiel. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Parque Centenario. Centro de Investigaciones en Epidemiología y Salud Pública. Instituto de Efectividad Clínica y Sanitaria. Centro de Investigaciones en Epidemiología y Salud Pública; ArgentinaFil: Guilabert, Mercedes. Universidad de Miguel Hernández; EspañaFil: Mira, José Joaquín. Universidad de Miguel Hernández; Españ

Avoidable adverse events in primary care: retrospective cohort study to determine their frequency and severity

Seguridad del paciente; Errores médicos; Atención Primaria; Calidad asistencial; Estudio de cohortesSeguretat del pacient; Errors mèdics; Atenció Primària; Qualitat assistencial; Estudi de cohortsPatient safety; Medical errors; Primary Care; Care quality; Cohort studyObjetivo Determinar la frecuencia de eventos adversos evitables (EAE) en atención primaria (AP). Diseño Estudio retrospectivo de cohortes. Emplazamiento consultas de medicina de familia y pediatría de Andalucía, Aragón, Castilla La Mancha, Cataluña, Madrid, Navarra y Comunidad Valenciana. Participantes Se determinó revisar un mínimo de 2.397 historias clínicas (nivel de confianza del 95% y una precisión del 2%). La muestra se estratificó por grupos de edad de forma proporcional a su frecuentación y con revisión paritaria de historias de hombres y mujeres. Mediciones principales Número y gravedad de los EAE identificados entre febrero de 2018 y septiembre de 2019. Resultados Se revisaron un total de 2.557 historias clínicas (1.928, 75.4% de pacientes adultos y 629, 24.6% pediátricos). Se identificaron 182 EAE que afectaron a 168 pacientes (7,1%, IC 95% 6,1-8,1%); en adultos 7,6% (IC 95% 6,4-8,8%) y 5,7% (IC 95% 3,9-7,5%) en pacientes pediátricos. Las mujeres sufrieron más EAE que los hombres (p = 0,004). La incidencia de EAE en niños y niñas fue similar (p = 0,3). 6 (4.1%) de los EAE supusieron un daño permanente en pacientes adultos. Conclusiones Buscar fórmulas para incrementar la seguridad en AP, particularmente en pacientes mujeres, debe seguir siendo un objetivo prioritario incluso en pediatría. Uno de cada 24 EAE supone un daño grave y permanente en el adulto.Objective To determine the frequency of avoidable adverse events (AAEs) in Primary Care (PC). Design Retrospective cohort study. Location Family medicine and paediatric clinics in Andalusia, Aragon, Castilla-La Mancha, Catalonia, Madrid, Navarre, and Valencia. Participants A review was performed on a designated sample of 2,397 medical records (95% confidence level and 2% accuracy). The sample was stratified by age group as regards the frequency of physician consultations and considering equal distribution of male and female patients. Main measurements Number and severity of identified AAEs from February 2018 to September 2019. Results A total of 2,557 medical records were reviewed (1,928, 75.4% of adult patients, and 629, 24.6% paediatrics). A total of 182 (7.1%, 95% CI 6.1-8.1%) AAEs that affected 168 patients were identified, which included 7.6% (95% CI 6.4-8.8%) in adults and 5.7% (95% CI 3.9-7.5%) in paediatric patients. The number of AAEs in women was higher than in men (P = 0.006). The incidence of AAEs in boys and girls was similar (P = 0.3). Permanent damage was caused by AAEs in 6 (4.1%) adult patients. Conclusions Seeking formulas to increase patient safety in PC should remain a priority objective, particularly in female patients and in paediatrics. One in 24 AAEs causes serious and permanent damage in adults

Mini CRISPR screen of Interferons and interferon-like genes in search of ISAV resistance in SHK-1 cell line

Infectious salmon anemia (ISA) is a bothersome epidemy in commercially farmed Atlantic salmon (Salmo salar), caused by the influenza-like Infectious salmon anemia virus (ISAV). It causes severe anemia in farmed Atlantic salmon, resulting in high death rates and great economical losses if left untreated. The infectious disease has demanded a lot of resources in the science and aquaculture communities since its discovery. Many countermeasures, such as infection control guidelines and vaccines, have been tried out, but with varying result in the field. To this day ISAV outbreaks are still common in most counties commercially farming Atlantic salmon, though not as frequent and severe as before. Previous research on the salmon immune system indicates that interferons play an important role in the salmons first line of defense against virus infections. Salmon has a great repertoire of such interferons and interferon-like genes, that have been studied to varying degree. These interferons and interferon-like genes are therefore of great interest in the search for better virus immune response in farmed Atlantic salmon, both for ISA resistance and for virus resistance in general. The aim of this thesis was to shed some light on what genes contribute to the natural immune response of Atlantic salmon. Specifically, which, if any, interferons or interferon-like genes contribute to ISA virus resistance. To achieve this, it will be attempted to utilize the high sequence similarity of Atlantic salmon interferons and interferon-like genes to design a CRISPR knockout experiment, intended to knock out multiple high-similarity genes.submittedVersionM-BIOTE

Availability of personal protective equipment and diagnostic and treatment facilities for healthcare workers involved in COVID-19 care: A cross-sectional study in Brazil, Colombia, and Ecuador.

Many affected counties have had experienced a shortage of personal protective equipment (PPE) during the coronavirus disease (COVID-19) pandemic. We aimed to investigate the needs of healthcare professionals and the technical difficulties faced by them during the initial outbreak. A cross-sectional web-based survey was conducted among the healthcare workforce in the most populous cities from three Latin American countries in April 2020. In total, 1,082 participants were included. Of these, 534 (49.4%), 263 (24.3%), and 114 (10.5%) were physicians, nurses, and other professionals, respectively. At least 70% of participants reported a lack of PPE. The most common shortages were shortages in gown coverall suits (643, 59.4%), N95 masks (600, 55.5%), and face shields (569, 52.6%). Professionals who performed procedures that generated aerosols reported shortages more frequently (p<0.05). Professionals working in the emergency department and primary care units reported more shortages than those working in intensive care units and hospital-based wards (p<0.001). Up to 556 (51.4%) participants reported the lack of sufficient knowledge about using PPE. Professionals working in public institutions felt less prepared, received less training, and had no protocols compared with their peers in working private institutions (p<0.001). Although the study sample corresponded to different hospital centers in different cities from the participating countries, sampling was non-random. Healthcare professionals in Latin America may face more difficulties than those from other countries, with 7 out of 10 professionals reporting that they did not have the necessary resources to care for patients with COVID-19. Technical and logistical difficulties should be addressed in the event of a future outbreak, as they have a negative impact on healthcare workers. Clinical trial registration: NCT04486404

the ERNST study

The COVID-19 pandemic led to the implementation of interventions to provide emotional and psychological support to healthcare workers in many countries. This ecological study aims to describe the strategies implemented in different countries to support healthcare professionals during the outbreak. Data were collected through an online survey about the measures to address the impact of the pandemic on the mental health of healthcare workers. Healthcare professionals, researchers, and academics were invited to respond to the survey. Fifty-six professionals from 35 countries contributed data to this study. Ten countries (28.6%) reported that they did not launch any national interventions. Both developed and developing countries launched similar initiatives. There was no relationship between the existence of any type of initiative in a country with the incidence, lethality, and mortality rates of the country due to COVID-19, and per capita income in 2020. The 24 h hotline for psychological support was the most frequent intervention. Tools for self-rescue by using apps or websites were extensively used, too. Other common interventions were the development of action protocols, availability of regular and updated information, implantation of distance learning systems, early detection of infection programs for professionals, economic reinforcements, hiring of staff reinforcement, and modification of leave and vacation dates.publishersversionpublishe

Mar sin fronteras. Antologia liquida di poesia spagnola contemporanea

Mar sin fronteras è un’antologia di poesia spagnola contemporanea inedita dedicata al mare come spazio di condivisione profonda, di rotte tracciate e tracciabili, di naufragi e approdi inaspettati, spazio di viaggiatori e sognatori con lo sguardo aperto verso l’orizzonte. I testi – tutti inediti e in lingua originale – raccolti nel volume (con traduzione italiana a fronte) sono firmati da circa quaranta poeti, scelti tra le voci più significative dell’attuale poesia spagnola e offrono, nel loro insieme così variegato per stili e prospettive, la viva immagine di un oceano di parole mutevole, cangiante e senza confini; uno spazio di poesia liquido e sorprendente come le correnti e le vite che attraversano il mare

Gastrointestinal symptoms and complications in patients hospitalized due to COVID-19, an international multicentre prospective cohort study (TIVURON project).

Retrospective studies suggest that coronavirus disease (COVID-19) commonly involves gastrointestinal (GI) symptoms and complications. Our aim was to prospectively evaluate GI manifestations in patients hospitalized for COVID-19. This international multicentre prospective cohort study recruited COVID-19 patients hospitalized at 31 centres in Spain, Mexico, Chile, and Poland, between May and September 2020. Patients were followed-up until 15 days post-discharge and completed comprehensive questionnaires assessing GI symptoms and complications. A descriptive analysis as well as a bivariate and multivariate analysis were performer using binary logistic regression. p Eight hundred twenty-nine patients were enrolled; 129 (15.6%) had severe COVID-19, 113 (13.7%) required ICU admission, and 43 (5.2%) died. Upon admission, the most prevalent GI symptoms were anorexia (n=413; 49.8%), diarrhoea (n=327; 39.4%), nausea/vomiting (n=227; 27.4%), and abdominal pain (n=172; 20.7%), which were mild/moderate throughout the disease and resolved during follow-up. One-third of patients exhibited liver injury. Non-severe COVID-19 was associated with ≥2 GI symptoms upon admission (OR 0.679; 95% CI 0.464-0.995; p=0.046) or diarrhoea during hospitalization (OR 0.531; 95% CI 0.328-0.860; p=0.009). Multivariate analysis revealed that worse hospital outcomes were not independently associated with liver injury or GI symptoms. GI symptoms were more common than previously documented, and were mild, rapidly resolved, and not independently associated with COVID-19 severity. Liver injury was a frequent complication in hospitalized patients not independently associated with COVID-19 severity