Valuation and modeling of EQ-5D-5L health states using a hybrid approach

Background: The EQ-5D instrument is the most widely used preference-based health-related quality of life questionnaire in cost-effectiveness analysis of health care technologies. Recently, a version called EQ-5D-5L with 5 levels on each dimension was developed. This manuscript explores the performance of a hybrid approach for the modeling of EQ-5D-5L valuation data. Methods: Two elicitation techniques, the composite time trade-off, and discrete choice experiments, were applied to a sample of the Spanish population (n=1000) using a computer-based questionnaire. The sampling process consisted of 2 stages: stratified sampling of geographic area, followed by systematic sampling in each area. A hybrid regression model combining composite time trade-off and discrete choice data was used to estimate the potential value sets using main effects as starting point. The comparison between the models was performed using the criteria of logical consistency, goodness of fit, and parsimony. Results: Twenty-seven participants from the 1000 were removed following the exclusion criteria. The best-fitted model included 2 significant interaction terms but resulted in marginal improvements in model fit compared to the main effects model. We therefore selected the model results with main effects as a potential value set for this methodological study, based on the parsimony criteria. The results showed that the main effects hybrid model was consistent, with a range of utility values between 1 and -0.224. Conclusion: This paper shows the feasibility of using a hybrid approach to estimate a value set for EQ-5D-5L valuation data.</p

Use of Data Mining to Predict the Influx of Patients to Primary Healthcare Centres and Construction of an Expert System

In any productive sector, predictive tools are crucial for optimal management and decision-making. In the health sector, it is especially important to have information available in advance, as this not only means optimizing resources, but also improving patient care. This work focuses on the management of healthcare resources in primary care centres. The main objective of this work is to develop a model capable of predicting the number of patients who will demand health care in a primary care centre on a daily basis. This model is integrated into a decision support system that is accessible and easy to use by the manager through a web application. In this case, data from a primary care centre in the city of Jaén, Spain, were used. The model was estimated using spatial-temporal training data, the daily health demand data in that centre for five years, and a series of meteorological data. Different regression algorithms have been employed. The workflow requires selecting the parameters that influence the health demand prediction and discarding those that distort the model. The main contribution of this research is the daily prediction of the number of patients attending the health centre with absolute errors better than 3%, which is crucial for decision-making on the sizing of health resources in a primary care health centre

Optimising Health Emergency Resource Management from Multi-Model Databases

The health care sector is one of the most sensitive sectors in our society, and it is believed that the application of specific and detailed database creation and design techniques can improve the quality of patient care. In this sense, better management of emergency resources should be achieved. The development of a methodology to manage and integrate a set of data from multiple sources into a centralised database, which ensures a high quality emergency health service, is a challenge. The high level of interrelation between all of the variables related to patient care will allow one to analyse and make the right strategic decisions about the type of care that will be needed in the future, efficiently managing the resources involved in such care. An optimised database was designed that integrated and related all aspects that directly and indirectly affected the emergency care provided in the province of Jaén (city of Jaén, Andalusia, Spain) over the last eight years. Health, social, economic, environmental, and geographical information related to each of these emergency services was stored and related. Linear and nonlinear regression algorithms were used: support vector machine (SVM) with linear kernel and generated linear model (GLM), and the nonlinear SVM with Gaussian kernel. Predictive models of emergency demand were generated with a success rate of over 90%

Síndrome de burnout en colaboradores de una empresa de comercialización de bienes de capital y provisión de servicios de minería, Moquegua, 2022

La investigación tuvo como objetivo determinar la frecuencia del Síndrome de Burnout en colaboradores de una empresa de comercialización de bienes de capital y provisión de servicios de minería en Moquegua, 2022; contando con una población de 229 trabajadores de ambos sexos con edades de 23 a 55 años. Para la medición del síndrome de Burnout se utilizó “Maslach Burnout Inventory” (1977) a través de un cuestionario online, encontrando que la población estudiada solo el 6% presenta Síndrome de Burnout. Asimismo, por cada dimensión se encontraron los siguientes resultados: Agotamiento Emocional el 31% presentó un nivel alto, Despersonalización solo el 16% evidenció un nivel alto y por último en Realización Personal el 37% presentó un nivel bajo

Identification and characterization of the PhhR regulon in Pseudomonas putida

Pseudomonas putida is a soil microorganism that utilizes aromatic amino acids present in root exudates as a nitrogen source. We have previously shown that the PhhR transcriptional regulator induces phhAB genes encoding a phenylalanine hydroxylase. In this study we show, using microarray assays and promoter fusions, that PhhR is a global regulator responsible for the activation of genes essential for phenylalanine degradation, phenylalanine homeostasis and other genes of unknown function. Recently, it has been shown that phenylalanine catabolism occurs through more than one pathway. One of these possible pathways involves the metabolism of phenylalanine via tyrosine, p-hydroxyphenylpyruvate, and homogentisate. We identified two genes within this pathway that encode an acyl-CoA transferase involved in the metabolism of acetoacetate. All genes in this pathway were induced in response to phenylalanine in a PhhR-proficient background. The second potential degradative pathway involves the degradation of phenylalanine to produce phenylpyruvate, which seems to be degraded via phenylacetyl-CoA. A number of mutants in the paa genes encoding phenylacetyl-CoA degradation enzymes fail to grow on phenylpyruvate or phenylacetate, further supporting the existence of this second pathway. We found that the PhhR regulon also includes genes involved in the biosynthesis of aromatic amino acids that are repressed in the presence of phenylalanine, suggesting the possibility of feedback at the transcriptional level. In addition, we found that PhhR modulates the level of expression of the broad-substrate-specificity MexEF/OprN efflux pump. Expression from this pump is under the control of mexT gene product because phenylalanine-dependent transcription from the mexE promoter does not occur in a mexT mutant background. These results place PhhR as an important regulator in the control of bacterial responses to aromatic amino acids

Regression of established subcutaneous B16-F10 murine melanoma tumors after gef gene therapy via the mitochondrial apoptotic pathway

ovel treatment modalities, including gene therapy, are needed for patients with advanced melanoma. We evaluated whether the gef gene, a suicide gene from Escherichia coli, had a significant cytotoxic impact on melanoma in vivo. First, we used a non-viral gene delivery approach (pcDNA3.1/gef) to study the inhibition of melanoma cells (B16-F10) proliferation in vitro. Secondly, we used direct intra-tumoral injection of pcDNA3.1/gef complexed with jetPEI to deliver gef cDNA to rapidly growing murine melanomas. We demonstrated that gef gene not only has an antiproliferative effect on B16-F10 cells in vitro, but also induces an important decrease in melanoma tumor volume (77.7% in 8 days) in vivo. Interestingly, after gef gene treatment, melanoma showed apoptosis activation associated with the mitochondrial pathway, suggesting that the induction of this death mechanism may be an effective strategy for its treatment. Our in vivo results indicate that gef gene might become a suitable therapeutic strategy for patients with advanced melanoma

T35: a small automatic telescope for long-term observing campaigns

The T35 is a small telescope (14") equipped with a large format CCD camera installed in the Sierra Nevada Observatory (SNO) in Southern Spain. This telescope will be a useful tool for the detecting and studying pulsating stars, particularly, in open clusters. In this paper, we describe the automation process of the T35 and show also some images taken with the new instrumentation.Comment: 13 pages, 9 figures. Accepted for publication in the special issue "Robotic Astronomy" of Advances of Astronom