Using Bayesian optimization and wavelet decomposition in GPU for arterial blood pressure estimation

Continuous monitoring of arterial blood pressure (ABP) of patients in hospital is currently carried out in an invasive way, which could represent a risk for them. In this paper, a noninvasive methodology to optimize ABP estimators using electrocardiogram and photoplethysmography signals is proposed. For this, the XGBoost machine learning model, optimized with Bayesian techniques, is executed in a Graphics Processing Unit, which drastically reduces execution time. The methodology is evaluated using the MIMIC-III Waveform Database. Systolic and diastolic pressures are estimated with mean absolute error values of 15.85 and 11.59 mmHg, respectively, similar to those of the state of the art. The main advantage of the proposed methodology with respect to others of the current state of the art is that it allows the optimization of the estimator model to be performed automatically and more efficiently at the computational level for the data available. Clinical Relevance— This approach has the advantage of using noninvasive methods to continuously monitor patient's arterial blood pressure, reducing the risk for patientsAgencia Gallega de Innovación | Ref. IN845D-2020/29Agencia Gallega de Innovación | Ref. IN607B-2021/1

Health-related quality of life, direct medical and societal costs among children with moderate or severe haemophilia in Europe: multivariable models of the CHESS-PAEDs study.

From Europe PMC via Jisc Publications RouterHistory: ppub 2022-04-01, epub 2022-04-04Publication status: PublishedFunder: SanofiBackgroundHaemophilia bears substantial humanistic and economic burden on children and their caregivers. Characterising the differential impact of severe versus moderate paediatric haemophilia is important for clinical and health policy decisions. We analysed health-related quality of life (HRQoL), annual direct medical (excluding factor treatment costs), non-medical and societal costs among children and adolescents with moderate and severe haemophilia A or B without inhibitors from the European CHESS-PAEDs study. Information was reported by physicians and caregivers; patients aged ≥ 8 years self-reported their HRQoL. Descriptive statistics summarised demographic and clinical characteristics, costs, and HRQoL scores (EQ-5D-Y). Regression models estimated differences in HRQoL and costs for moderate versus severe haemophilia adjusting for age, body mass index z-score, country, number of comorbidities, and weight-adjusted annual clotting factor consumption.ResultsThe analytic sample comprised 794 patients with a mean age of 10.5 years; most had haemophilia A (79%) and 58% had severe haemophilia. Mean predicted direct medical costs in moderate patients were two-thirds of the predicted costs for severe disease (€3065 vs. €2047; p ConclusionChildren with haemophilia and their caregivers displayed a significant economic and humanistic burden. While severe patients showed the highest direct medical and societal costs, and worse HRQoL, the burden of moderate haemophilia on its own was substantial and far from negligible

Differential humanistic and economic burden of mild, moderate and severe haemophilia in european adults: a regression analysis of the CHESS II study.

From Europe PMC via Jisc Publications RouterHistory: ppub 2022-04-01, epub 2022-04-04Publication status: PublishedFunder: Sanofi; Grant(s): SanofiBackgroundThe lifelong nature of haemophilia makes patient-centred and societal assessments of its impact important to clinical and policy decisions. Quantifying the humanistic and economic burden by severity is key to assessing the impact on healthcare systems. We analysed the annual direct medical (excluding factor replacement therapy costs) and non-medical costs as well as societal costs and health-related quality of life (HRQoL) of mild, moderate and severe disease among adults with haemophilia A or B without inhibitors in Europe. Participants in the CHESS II study reported their HRQoL, non-medical costs, and work impairment; physicians provided costs and consultation history from the medical chart. Descriptive statistics summarized patient characteristics, costs, and HRQoL scores. Regression models estimated differences in outcomes for moderate and severe versus mild disease, adjusting for age, body mass index, country, comorbidities, weight-adjusted factor consumption and education.ResultsThe analytic sample included 707 patients with a mean age of 38 years; the majority of patients had haemophilia A (81%), and 47% had severe disease, followed by moderate (37%) and mild disease (16%). Patients with severe or moderate disease had on average higher direct costs, €3105 and €2469 respectively, versus mild disease. Societal costs were higher for patients with severe and moderate disease by €11,115 and €2825, respectively (all P ConclusionSeverity of haemophilia is predictive of increasing economic and humanistic burden. The burden of moderate disease, as measured by direct costs and HRQoL, did not appear to be substantially different than that observed among patients with severe haemophilia

Differential humanistic and economic burden of mild, moderate and severe haemophilia in european adults: a regression analysis of the CHESS II study

From Springer Nature via Jisc Publications RouterHistory: received 2021-12-01, accepted 2022-03-22, registration 2022-03-23, pub-electronic 2022-04-04, online 2022-04-04, collection 2022-12Publication status: PublishedFunder: Sanofi; doi: http://dx.doi.org/10.13039/100004339; Grant(s): SanofiAbstract: Background: The lifelong nature of haemophilia makes patient-centred and societal assessments of its impact important to clinical and policy decisions. Quantifying the humanistic and economic burden by severity is key to assessing the impact on healthcare systems. We analysed the annual direct medical (excluding factor replacement therapy costs) and non-medical costs as well as societal costs and health-related quality of life (HRQoL) of mild, moderate and severe disease among adults with haemophilia A or B without inhibitors in Europe. Participants in the CHESS II study reported their HRQoL, non-medical costs, and work impairment; physicians provided costs and consultation history from the medical chart. Descriptive statistics summarized patient characteristics, costs, and HRQoL scores. Regression models estimated differences in outcomes for moderate and severe versus mild disease, adjusting for age, body mass index, country, comorbidities, weight-adjusted factor consumption and education. Results: The analytic sample included 707 patients with a mean age of 38 years; the majority of patients had haemophilia A (81%), and 47% had severe disease, followed by moderate (37%) and mild disease (16%). Patients with severe or moderate disease had on average higher direct costs, €3105 and €2469 respectively, versus mild disease. Societal costs were higher for patients with severe and moderate disease by €11,115 and €2825, respectively (all P < 0.01). HRQoL scores were also significantly worse for severe and moderate patients versus those with mild disease. Conclusion: Severity of haemophilia is predictive of increasing economic and humanistic burden. The burden of moderate disease, as measured by direct costs and HRQoL, did not appear to be substantially different than that observed among patients with severe haemophilia

Health-related quality of life, direct medical and societal costs among children with moderate or severe haemophilia in Europe: multivariable models of the CHESS-PAEDs study

From Springer Nature via Jisc Publications RouterHistory: received 2021-12-01, accepted 2022-03-22, registration 2022-03-23, pub-electronic 2022-04-04, online 2022-04-04, collection 2022-12Publication status: PublishedFunder: Sanofi; doi: http://dx.doi.org/10.13039/100004339Abstract: Background: Haemophilia bears substantial humanistic and economic burden on children and their caregivers. Characterising the differential impact of severe versus moderate paediatric haemophilia is important for clinical and health policy decisions. We analysed health-related quality of life (HRQoL), annual direct medical (excluding factor treatment costs), non-medical and societal costs among children and adolescents with moderate and severe haemophilia A or B without inhibitors from the European CHESS-PAEDs study. Information was reported by physicians and caregivers; patients aged ≥ 8 years self-reported their HRQoL. Descriptive statistics summarised demographic and clinical characteristics, costs, and HRQoL scores (EQ-5D-Y). Regression models estimated differences in HRQoL and costs for moderate versus severe haemophilia adjusting for age, body mass index z-score, country, number of comorbidities, and weight-adjusted annual clotting factor consumption. Results: The analytic sample comprised 794 patients with a mean age of 10.5 years; most had haemophilia A (79%) and 58% had severe haemophilia. Mean predicted direct medical costs in moderate patients were two-thirds of the predicted costs for severe disease (€3065 vs. €2047; p < 0.001; N = 794), while societal costs were more than half of the predicted costs for children with severe haemophilia (€6950 vs. €3666; p < 0.001; N = 220). Mean predicted HRQoL scores were 0.74 and 0.69 for moderate and severe disease, respectively (p < 0.05; N = 185). Conclusion: Children with haemophilia and their caregivers displayed a significant economic and humanistic burden. While severe patients showed the highest direct medical and societal costs, and worse HRQoL, the burden of moderate haemophilia on its own was substantial and far from negligible

ESTRESSORES LABORAIS ENTRE ENFERMEIROS QUE TRABALHAM EM UNIDADES DE URGÊNCIA E EMERGÊNCIA

O estudo objetivou avaliar os estressores laborais entre enfermeiros que trabalham em unidades de urgência e emergência. Trata-se de uma pesquisa descritiva, desenvolvida em dois hospitais públicos de complexidade diferente, com 49 enfermeiros. Os dados foram coletados no período de junho a setembro de 2011. Para a avaliação dos estressores, a partir das atividades realizadas pelos enfermeiros, foi utilizada a Escala Bianchi de Stress, composta por seis domínios: Relacionamento, Funcionamento da unidade, Administração de pessoal, Assistência de enfermagem, Coordenação da unidade e Condições de trabalho. Os dados foram analisados por estatística descritiva e realização do teste de Mann-Whitney. As atividades mais estressantes para os enfermeiros do hospital de alta complexidade (A) estão relacionadas ao domínio Assistência de enfermagem, e, para os de média complexidade (B), ao domínio Administração de pessoal. Os enfermeiros do hospital A perceberam como atividades mais estressantes as relacionadas ao cuidado, e os do B, as relacionadas à área administrativa

Niveles de ansiedad de estudiantes frente a situaciones de exámenes: Cuestionario CAEX

El propósito del estudio fue comparar los niveles ansiedad de estudiantes secundarios de quinto año de secundaria de dos instituciones educativas privadas. El estudio es de un enfoque cuantitativo, tipo de estudio sustantiva, de nivel descriptivo comparativo y de diseño no experimental transversal, la población estuvo constituida por 400 estudiantes de dos colegios privados, los estudiantes en referencia cursan el quinto año de secundaria. El instrumento utilizado fue el cuestionario de evaluación de problemas de ansiedad ante los exámenes (CAEX). cuestionario elaborado específicamente para recoger la variedad de respuestas motoras, verbales, cognitivas o fisiológicas que suelen acompañar estos problemas, junto con la tipología de exámenes más frecuentes. Como consecuencia del estudio  podemos concluir según el valor del estadístico U de Mann Whitney con p valor &lt;0,05, nos indica que existen diferencias  significativas en los niveles de ansiedad de los estudiantes de las dos Instituciones educativa privadas en estudio, concluyendo que los estudiantes  de la dos Instituciones Educativas privadas  presentan  niveles altos grados de ansiedad ante los examenes  ,situación que puede afectar su estado emocional que son hasta peligrosos para la salud (Grave presencia de ansiedad)

Intoxicaciones agudas en pediátricos

Acute poisoning in children is one of the main serious medical emergencies and is considered a growing public health problem worldwide, but it also represents fatal events in our country in many cases, which is why the management of a pediatric patient intoxicated has a unique approach due to the diagnostic challenge it represents. The objective of this research is to present a general approach for the intoxicated pediatric patient in terms of initial management, approach, and clinical data that can guide us in the emergency department before an intoxicated pediatric patient, as a result it was obtained that the attention timely and systematized treatment of a pediatric patient in the context of poisoning, can represent the success of timely care, correct assessment and an adequate process of care. It is concluded that the most frequent route of intoxication is the oral route, but it can also be by contact or inhalation.Las intoxicaciones agudas en pediátricos, es una de las principales emergencias médicas grave y son consideradas un problema de salud pública creciente a nivel mundial, pero así mismo representan en muchos casos eventos fatídicos en nuestro país, es por esto que el manejo de un paciente pediátrico intoxicado tiene un enfoque único debido al desafío diagnóstico que representa. Esta investigacion tienen como objetivo, presentar un enfoque general para el paciente pediátrico intoxicado en cuanto al manejo inicial, el abordaje, y los datos clínicos que nos puedan orientar en el servicio de urgencias ante un paciente pediátrico intoxicado, como resultado se obtuvo que la atención oportuna y sistematizada de un paciente pediátrico en el contexto de una intoxicación, puede representar el éxito de la atención oportuna, correcta valoración correcta y un adecuado proceso de atención. &nbsp;Se concluye que la vía más frecuente de intoxicación es la vía oral, pero también puede ser por contacto o inhalación

Development of a Panel of Genome-Wide Ancestry Informative Markers to Study Admixture Throughout the Americas

Most individuals throughout the Americas are admixed descendants of Native American, European, and African ancestors. Complex historical factors have resulted in varying proportions of ancestral contributions between individuals within and among ethnic groups. We developed a panel of 446 ancestry informative markers (AIMs) optimized to estimate ancestral proportions in individuals and populations throughout Latin America. We used genome-wide data from 953 individuals from diverse African, European, and Native American populations to select AIMs optimized for each of the three main continental populations that form the basis of modern Latin American populations. We selected markers on the basis of locus-specific branch length to be informative, well distributed throughout the genome, capable of being genotyped on widely available commercial platforms, and applicable throughout the Americas by minimizing within-continent heterogeneity. We then validated the panel in samples from four admixed populations by comparing ancestry estimates based on the AIMs panel to estimates based on genome-wide association study (GWAS) data. The panel provided balanced discriminatory power among the three ancestral populations and accurate estimates of individual ancestry proportions (R2>0.9 for ancestral components with significant between-subject variance). Finally, we genotyped samples from 18 populations from Latin America using the AIMs panel and estimated variability in ancestry within and between these populations. This panel and its reference genotype information will be useful resources to explore population history of admixture in Latin America and to correct for the potential effects of population stratification in admixed samples in the region

A regulated deficit irrigation strategy for hedgerow olive orchards with high plant density

Background & Aims There is not a consensus on the best irrigation approach for super-high density (SHD) olive orchards. Our aim was to design and test a regulated deficit irrigation (RDI) strategy for a sustainable balance between water saving, tree vigour and oil production. Methods We tested our RDI strategy for 3 years in an ‘Arbequina’ orchard with 1,667 trees ha−1. Two levels of irrigation reduction were applied, 60RDI and 30RDI, scaled to replacing 60 % and 30 %, respectively, of the of irrigation needs (IN). We also had a full irrigation (FI) treatment as control, with IN totalling 4,701 m3 ha−1 Results The 30RDI treatment showed the best balance between water saving, tree vigour and oil production. With a yearly irrigation amount (IA) of 1,366 m3 ha−1, which meant 72 % water saving as compared to FI, the reduction in oil yield was 26 % only. Conclusions Our results, together with recent knowledge on the effect of water stress on fruit development, allowed us to suggest a potentially improved RDI strategy for which a total IA of ca. 2,100 m3 ha−1 was calculated. Both some management details and the benefits of this suggested RDI strategy are still to be tested