Goal-oriented adaptivity for a conforming residual minimization method in a dual discontinuous Galerkin norm

We propose a goal-oriented mesh-adaptive algorithm for a finite element method stabilized via residual minimization on dual discontinuous-Galerkin norms. By solving a saddle-point problem, this residual minimization delivers a stable continuous approximation to the solution on each mesh instance and a residual projection onto a broken polynomial space, which is a robust error estimator to minimize the discrete energy norm via automatic mesh refinement. In this work, we propose and analyze a goal-oriented adaptive algorithm for this stable residual minimization. We solve the primal and adjoint problems considering the same saddle-point formulation and different right-hand sides. By solving a third stable problem, we obtain two efficient error estimates to guide goal oriented adaptivity. We illustrate the performance of this goal-oriented adaptive strategy on advection-diffusion reaction problems

Robust Variational Physics-Informed Neural Networks

We introduce a Robust version of the Variational Physics-Informed Neural Networks method (RVPINNs). As in VPINNs, we define the quadratic loss functional in terms of a Petrov-Galerkin-type variational formulation of the PDE problem: the trial space is a (Deep) Neural Network (DNN) manifold, while the test space is a finite-dimensional vector space. Whereas the VPINN’s loss depends upon the selected basis functions of a given test space, herein, we minimize a loss based on the discrete dual norm of the residual. The main advantage of such a loss definition is that it provides a reliable and efficient estimator of the true error in the energy norm under the assumption of the existence of a local Fortin operator. We test the performance and robustness of our algorithm in several advection-diffusion problems. These numerical results perfectly align with our theoretical findings, showing that our estimates are sharp

Feasibility and Reliability of a Questionnaire to Assess the Mode, Frequency, Distance and Time of Commuting to and from School: The PACO Study

Active commuting to and from school has several health implications. Self-reporting is the most common assessment tool, but there is a high heterogeneity of questionnaires in the scientific literature. The purpose of this study was to analyse the feasibility and reliability of the Spanish “New Version of Mode and Frequency of Commuting To and From School” questionnaire in children and adolescents. A total of 635 children (5–12 years old) and 362 adolescents (12–18 years old) filled out the questionnaire twice (14 days apart). Feasibility was evaluated using an observational checklist. The test-retest reliability of the “New Version of Mode and Frequency of Commuting To and From School” questionnaire and the distance and time to school were examined using the kappa and weight kappa coefficient (κ). No misunderstanding of questions was reported. The time to complete the questionnaire was 15 ± 3.62 and 9 ± 2.26 min for children and adolescents, respectively. The questionnaire showed substantial and almost perfect kappa coefficients for the overall six items (k = 0.61–0.94) in children and adolescents. The “New Version of Mode and Frequency of Commuting To and From School” questionnaire is a feasible and reliable questionnaire in Spanish children and adolescents.Spanish Ministry of Economy, Industry and CompetitivenessEuropean Union (EU) DEP2016-75598-RUniversity of Granada, Plan Propio de Investigacion 2016, excellence actions: Units of ExcellenceUnit of Excellence on Exercise and Health (UCEES)Junta de AndaluciaConsejeria de Conocimiento, Investigacion y UniversidadesEuropean Union (EU) SOMM17/6107/UGREuropean Social Fund (ESF

Genomic epidemiology supports multiple introductions and cryptic transmission of Zika virus in Colombia

BACKGROUND: Colombia was the second most affected country during the American Zika virus (ZIKV) epidemic, with over 109,000 reported cases. Despite the scale of the outbreak, limited genomic sequence data were available from Colombia. We sought to sequence additional samples and use genomic epidemiology to describe ZIKV dynamics in Colombia. METHODS: We sequenced ZIKV genomes directly from clinical diagnostic specimens and infected Aedes aegypti samples selected to cover the temporal and geographic breadth of the Colombian outbreak. We performed phylogeographic analysis of these genomes, along with other publicly-available ZIKV genomes from the Americas, to estimate the frequency and timing of ZIKV introductions to Colombia. RESULTS: We attempted PCR amplification on 184 samples; 19 samples amplified sufficiently to perform sequencing. Of these, 8 samples yielded sequences with at least 50% coverage. Our phylogeographic reconstruction indicates two separate introductions of ZIKV to Colombia, one of which was previously unrecognized. We find that ZIKV was first introduced to Colombia in February 2015 (95%CI: Jan 2015 - Apr 2015), corresponding to 5 to 8 months of cryptic ZIKV transmission prior to confirmation in September 2015. Despite the presence of multiple introductions, we find that the majority of Colombian ZIKV diversity descends from a single introduction. We find evidence for movement of ZIKV from Colombia into bordering countries, including Peru, Ecuador, Panama, and Venezuela. CONCLUSIONS: Similarly to genomic epidemiological studies of ZIKV dynamics in other countries, we find that ZIKV circulated cryptically in Colombia. More accurately dating when ZIKV was circulating refines our definition of the population at risk. Additionally, our finding that the majority of ZIKV transmission within Colombia was attributable to transmission between individuals, rather than repeated travel-related importations, indicates that improved detection and control might have succeeded in limiting the scale of the outbreak within Colombia

Biopsychosocial factors related to the length of hospital stay in older people

This study aimed to know what variables influence increased length of hospital stay. A descriptive, cross-sectional study was conducted through an integrated geriatric assessment of 81 people over 65 years of age, admitted to a tertiary acute care hospital. Data were collected through the Pfeiffer Scale, Barthel Index, Goldberg Questionnaire, Family APGAR and Gijón Scale. The length of hospital stay increased in people over 80 years, people living alone or in a retirement home, patients with great physical dependence and those with a risk or problem of social exclusion. The most influential variable for longer hospitalization was cognitive impairment (pEste estudio tuvo como objetivo conocer qué variables influyen en el aumento de la duración de la estancia hospitalaria. Se trata de un estudio descriptivo transversal en el que se realizó una Valoración Geriátrica Integral a 81 personas mayores de 65 años de edad que ingresaron en un hospital de agudos de tercer nivel. Para ello, los datos fueron recogidos por medio de la Escala de Pfeiffer, el Índice de Barthel, el Cuestionario de Goldberg, el APGAR familiar y la Escala de Gijón. Se observó un aumento de la duración de la estancia hospitalaria entre los mayores de 80 años, las personas que vivían solas o en una residencia geriátrica, los pacientes que presentaban gran dependencia física y también, entre quienes tenían un riesgo o problema de exclusión social. La variable que más influyó en la mayor duración de la hospitalización fue el deterioro cognitivo (pEste estudo teve como objetivo conhecer quais as variáveis que influenciam o aumento do tempo de internação hospitalar. Trata-se de estudo descritivo e transversal, conduzido mediante ampla avaliação geriátrica de 81 pessoas com mais de 65 anos, internadas em hospital terciário de cuidados agudos. Os dados foram coletados através da Escala Pfeiffer, Índice de Barthel, Questionário de Goldberg, Apgar da Família e Escala de Gijón. Observou-se aumento no tempo de internação entre pessoas com mais de 80 anos, pessoas que vivem sozinhas ou em lar de idosos, pacientes que tinham grande dependência física, e entre aqueles com algum risco ou problema de exclusão social. A variável mais influente, para a maior duração da hospitalização, foi a deterioração cognitiva (p<0,05), em comparaç��o à maior colaboração do paciente sem essa condição ou ao seu desejo de superar a fase aguda da patologia que levou à internação hospitalar

Antimicrobial resistance among migrants in Europe: a systematic review and meta-analysis

BACKGROUND: Rates of antimicrobial resistance (AMR) are rising globally and there is concern that increased migration is contributing to the burden of antibiotic resistance in Europe. However, the effect of migration on the burden of AMR in Europe has not yet been comprehensively examined. Therefore, we did a systematic review and meta-analysis to identify and synthesise data for AMR carriage or infection in migrants to Europe to examine differences in patterns of AMR across migrant groups and in different settings. METHODS: For this systematic review and meta-analysis, we searched MEDLINE, Embase, PubMed, and Scopus with no language restrictions from Jan 1, 2000, to Jan 18, 2017, for primary data from observational studies reporting antibacterial resistance in common bacterial pathogens among migrants to 21 European Union-15 and European Economic Area countries. To be eligible for inclusion, studies had to report data on carriage or infection with laboratory-confirmed antibiotic-resistant organisms in migrant populations. We extracted data from eligible studies and assessed quality using piloted, standardised forms. We did not examine drug resistance in tuberculosis and excluded articles solely reporting on this parameter. We also excluded articles in which migrant status was determined by ethnicity, country of birth of participants' parents, or was not defined, and articles in which data were not disaggregated by migrant status. Outcomes were carriage of or infection with antibiotic-resistant organisms. We used random-effects models to calculate the pooled prevalence of each outcome. The study protocol is registered with PROSPERO, number CRD42016043681. FINDINGS: We identified 2274 articles, of which 23 observational studies reporting on antibiotic resistance in 2319 migrants were included. The pooled prevalence of any AMR carriage or AMR infection in migrants was 25·4% (95% CI 19·1-31·8; I2 =98%), including meticillin-resistant Staphylococcus aureus (7·8%, 4·8-10·7; I2 =92%) and antibiotic-resistant Gram-negative bacteria (27·2%, 17·6-36·8; I2 =94%). The pooled prevalence of any AMR carriage or infection was higher in refugees and asylum seekers (33·0%, 18·3-47·6; I2 =98%) than in other migrant groups (6·6%, 1·8-11·3; I2 =92%). The pooled prevalence of antibiotic-resistant organisms was slightly higher in high-migrant community settings (33·1%, 11·1-55·1; I2 =96%) than in migrants in hospitals (24·3%, 16·1-32·6; I2 =98%). We did not find evidence of high rates of transmission of AMR from migrant to host populations. INTERPRETATION: Migrants are exposed to conditions favouring the emergence of drug resistance during transit and in host countries in Europe. Increased antibiotic resistance among refugees and asylum seekers and in high-migrant community settings (such as refugee camps and detention facilities) highlights the need for improved living conditions, access to health care, and initiatives to facilitate detection of and appropriate high-quality treatment for antibiotic-resistant infections during transit and in host countries. Protocols for the prevention and control of infection and for antibiotic surveillance need to be integrated in all aspects of health care, which should be accessible for all migrant groups, and should target determinants of AMR before, during, and after migration. FUNDING: UK National Institute for Health Research Imperial Biomedical Research Centre, Imperial College Healthcare Charity, the Wellcome Trust, and UK National Institute for Health Research Health Protection Research Unit in Healthcare-associated Infections and Antimictobial Resistance at Imperial College London

Tree mode of death and mortality risk factors across Amazon forests

The&nbsp;carbon sink capacity of tropical forests&nbsp;is substantially affected by tree mortality. However, the main drivers of tropical&nbsp;tree death remain largely unknown. Here we present a pan-Amazonian assessment of how and why trees die, analysing over 120,000 trees representing &gt; 3800 species from 189 long-term&nbsp;RAINFOR forest plots. While tree mortality rates vary greatly Amazon-wide, on average trees are as likely to die standing as they are broken or uprooted—modes of death with different ecological consequences. Species-level growth rate is the single&nbsp;most important predictor of tree death in Amazonia, with faster-growing species being at&nbsp;higher risk. Within species, however, the slowest-growing trees are at greatest risk while the effect of tree size varies across the basin. In the driest Amazonian region&nbsp;species-level bioclimatic distributional patterns also predict the risk of death, suggesting that these forests are experiencing climatic conditions beyond their adaptative limits. These results provide not only a&nbsp;holistic pan-Amazonian picture of tree death but large-scale&nbsp;evidence for the overarching importance of the growth–survival trade-off in driving tropical&nbsp;tree mortality

Consenso colombiano de atención, diagnóstico y manejo de la infección por SARS-COV-2/COVID-19 en establecimientos de atención de la salud Recomendaciones basadas en consenso de expertos e informadas en la evidencia

The “Asociación Colombiana de Infectología” (ACIN) and the “Instituto de Evaluación de Nuevas Tecnologías de la Salud” (IETS) created a task force to develop recommendations for Covid 19 health care diagnosis, management and treatment informed, and based, on evidence. Theses reccomendations are addressed to the health personnel on the Colombian context of health services. © 2020 Asociacion Colombiana de Infectologia. All rights reserved