Evaluación de la viabilidad de distintas dietas para la producción de Lombrihumus con las especies Eisenia foetida y Eudrillus sp

The current environmental crisis has not left outside its scope the affectation to the health and fertility of the soil when causing an accelerated deterioration of its productive capacity directly affected to the agricultural yields at global level. In response and for the increase of the resilience of the agroecosystems to the unproductiveness of the soils the lombrihumus is used. In this study we test the adaptive and productive capacity of earthworms with different diets: fresh kitchen waste, wet paper, chopped grass and cow manure - control. Previously, the viability of care of the diets was determined with the characterization of waste produced by the campus canteen where the experiment was carried out. The red Californian (Eisenia foetida) and Cuban red (Eudrillus sp) species were used in canoes of one cubic meter (1 m3) where they were fed. The total production, the speed and percentage of assimilation of the diet were measured. In addition, the nutritional analysis of lombrihumus was performed for each treatment. The Variance Analysis (ANOVA) and the Minimum Significant Difference (DMS) were applied to the data obtained in the statistical program SPSS 23.0. The treatments T1 (fresh kitchen waste) and T2 (wet paper) showed significant results in the productive and nutritional aspects, so they can be used as a substitute for the T4 treatment (cow manure - control). The test should be repeated at different times of the year, variable environmental conditions, with a higher number of repetitions and a combination of treatments.La actual crisis medioambiental no ha dejado fuera de su alcance la afectación a la salud y fertilidad del suelo al causar un acelerado deterioro de su capacidad productiva afectado directamente a los rendimientos agrícolas a nivel global. En respuesta y para el aumento de la resiliencia de los agroecosistemas a la improductividad de los suelos se utiliza el lombrihumus. En este estudio testamos la capacidad de adaptación y productiva de las lombrices con distintas dietas: residuos frescos de cocina, papel húmedo, pasto picado y estiércol vacuno - testigo. Previamente se determinó la viabilidad de atención de las dietas con la caracterización de residuos producidos por el comedor universitario del campus donde se llevó el experimento. Se usaron las especies roja californiana (Eisenia foetida) y roja cubana (Eudrillus sp) en canoas de un metro cúbico (1 m3) donde se les suministro el alimento. Se midió la producción total, la velocidad y porcentaje de asimilación de la dieta. Complementariamente se realizó el análisis nutricional del lombrihumus por cada tratamiento. A los datos obtenidos se les aplico el Análisis de la Varianza (ANOVA) y la Diferencia Mínima Significativa (DMS) en el programa estadístico SPSS 23.0. Los tratamientos T1 (residuos frescos de cocina) y T2 (papel húmedo) mostraron resultados significativamente en los aspectos productivos y nutricionales, por ello pueden ser utilizados como sustito del tratamiento T4 (estiércol de vaca – testigo). Deben de repetirse el ensayo en distintas épocas del año, condiciones ambientales variables, con mayor número de repeticiones y combinación de los tratamientos

Perencanaan unit pengawasan mutu pabrik pembekuan udang windu block frozen (bf) head less (hl) dengan kapasitas bahan baku 15.000 kg/hari

Indonesia merupakan negara kepulauan yang kaya akan sumber daya alam di bidang perikanan. Salah satu contoh hasil perikanan Indonesia yang banyak diekspor ke luar negeri adalah udang tetapi udang mudah mengalami kerusakan (most perishable food) sehingga perlu dilakukan suatu proses yang dapat mempertahankan mutu bahan selama distribusi, yakni dengan pembekuan dalam bentuk Block Frozen (BF). Unit pengendalian mutu dibutuhkan agar mutu produk tetap bagus dan terjaga kualitasnya sehingga produk yang dihasilkan konsisten sesuai standar yang telah ditetapkan dan dapat diterima oleh konsumen. Unit pengawasan mutu direncanakan pada pabrik pembekuan udang windu block frozen head less dengan kapasitas bahan baku 15.000 kg/hari. Pengawasan mutu dilakukan terhadap bahan baku yang digunakan, proses produksi, serta produk akhir yang dihasilkan. Kelayakan suatu unit pengawasan mutu ditentukan oleh aspek teknis dan ekonomis. Aspek teknis meliputi sumber daya manusia, prosedur dan pelaksanaan kegiatan pengawasan mutu serta sarana dan prasarana yang digunakan. Aspek ekonomis meliputi total biaya unit pengawasan mutu yang direncanakan terhadap harga jual produk akhir. Perencanaan unit pengawasan mutu pembekuan udang windu block frozen head less dengan kapasitas bahan baku 15.000 kg/hari layak secara teknis karena sumber daya manusia yang digunakan berkualifikasi, prosedur dan pelaksanaan kegiatan pengawasan mutu sesuai dengan standar yang ditetapkan, letak ruang pengawasan mutu strategis sehingga kegiatan pengawasan mutu dapat berlangsung efektif dan efisien serta tersedianya sarana dan prasarana yang memadai dan lengkap. Unit pengawasan mutu dikatakan layak dari aspek ekonomis apabila tidak melebihi 4% dari total biaya produksi. Jadi, unit pengawasan mutu yang direncanakan dapat dikatakan layak secara ekonomis karena biaya unit pengawasan mutu per unit BF (1,814kg) adalah Rp. 264,99 dengan presentase sebesar 0,24% dari total biaya produksi

Mathematical modeling of food intake and insulin infusion in a patient with type 1 Ddabetes in closed loop

[EN] Diabetes mellitus type 1 is a condition in which the pancreas loses its ability to produce enough insulin, increasing the levels of blood glucose. This work presents the design of a mathematical model of the glucose - insulin dynamics of a type 1 diabetes patient, contemplating the contribution to the concentration of blood glucose by the intake of carbohydrates, fats and proteins. The model also includes the absorption dynamics of 5 insulin types, different administration methods of exogenous insulin, and the variation of insulin sensitivity during the day. The model was integrated into a closed-loop insulin regulation algorithm, in order to evaluate the performance of the model and the efficiency of closed-loop treatments, compared to open-loop therapies. The results show the response of the model to different situations of a real patient, and tests of the controller’s performance.[ES] La diabetes tipo 1 es una afección en la cual el páncreas pierde su capacidad de producir suficiente insulina, incrementando significativamente la concentración de glucosa en la sangre. En el presente trabajo se presenta el diseño de un modelo matemático de las dinámicas glucosa-insulina de un paciente con diabetes tipo 1, el cual contempla el aporte a la concentración de glucosa en la sangre por parte de la ingesta de carbohidratos, grasas y proteínas. El modelo incluye las dinámicas de absorción de 5 tipos de insulina, diferentes métodos de administración de la misma, y la variación de la sensibilidad a la insulina durante el día. Se integró el modelo a un algoritmo de regulación de insulina en lazo cerrado, con el fin de evaluar el desempeño del modelo y la eficacia de los tratamientos en lazo cerrado, en comparación con las terapias en lazo abierto. Los resultados muestran la respuesta del modelo ante distintas situaciones de un paciente real, y pruebas de funcionamiento del controlador.Manrique-Córdoba, J.; Romero-Ante, JD.; Vivas, A.; Vicente, J.; Sabater-Navarro, JM. (2020). Modelado matemático de ingestas de alimento e infusión de insulina en un paciente con diabetes tipo 1 en lazo cerrado. Revista Iberoamericana de Automática e Informática industrial. 17(2):156-168. https://doi.org/10.4995/riai.2019.11161OJS156168172Ackerman, E., Rosevear, J. W., McGuckin, W. F., 1964. A mathematical model of the glucose-tolerance test. Physics in medicine & Biology 9 (2), 203. https://doi.org/10.1088/0031-9155/9/2/307American Diabetes Association, 2017. [Online; accessed October 2018]. URL: http://www.diabetes.org/Apablaza, P., Soto, N., Codner, E., 2017. De la bomba de insulina y el monitoreo continuo de glucosa al páncreas artificial. Revista Médica de Chile,145 (5), 630-640. https://doi.org/10.4067/S0034-98872017000500011Barrio, R., Andia, V., Vazquez, F., Salgado, Y., Valverde, M., Jansa, M., Flores, M., 2012. Guía de educación terapéutica, al inicio de tratamiento con infusión subcutánea continua de insulina (ISCI). PardeDós. URL: https://diabetesmadrid.org/Beneyto, A., Bertachi, A., Bondia, J., Vehi, J., 2018. A new blood glucose control scheme for unannounced exercise in type 1 diabetic subjects. IEEE Transactions on Control Systems Technology, 1-8.Bergenstal, R. M., Garg, S., Weinzimer, S. A., Buckingham, B. A., Bode, B. W., Tamborlane, W. V., Kaufman, F. R., 2016. Safety of a hybrid closed-loop insulin delivery system in patients with type 1 diabetes. Jama 316 (13), 1407- 1408. https://doi.org/10.1001/jama.2016.11708Berger, M., Rodbard, D., 1989. Computer simulation of plasma insulin and glucose dynamics after subcutaneous insulin injection. Diabetes Care 12 (10), 725-736. https://doi.org/10.2337/diacare.12.10.725Binder, C., 1969. Absorption of injected insulin: A clinical-pharmacological study. Acta Pharmacologica et Toxicologica 27 (S2), 1-83. https://doi.org/10.1111/j.1600-0773.1969.tb03069.xBolie, V. W., 1961. Coefficients of normal blood glucose regulation. Journal of Applied Physiology 16 (5), 783-788. https://doi.org/10.1152/jappl.1961.16.5.783Breda, E., Cavaghan, M. K., Toffolo, G., Polonsky, K. S., Cobelli, C., 2001. Oral glucose tolerance test minimal model indexes of β-cell function and insulin sensitivity. Diabetes 50 (1), 150-158. https://doi.org/10.2337/diabetes.50.1.150Breton, M., Farret, A., Bruttomesso, D., Anderson, S., Magni, L., Patek, S., Dalla Man, C., Place, J., Demartini, S., Del Favero, S., 2012. Fully integrated artificial pancreas in type 1 diabetes: modular closed-loop glucose control maintains near normoglycemia. Diabetes 61, 2230-2237. https://doi.org/10.2337/db11-1445Bruttomesso, D., Farret, A., Costa, S., Marescotti, M. C., Vettore, M., Avogaro, A., Tiengo, A., Dalla Man, C., Place, J., Facchinetti, A., 2009. Closed-loop artificial pancreas using subcutaneous glucose sensing and insulin delivery and a model predictive control algorithm: preliminary studies in Padova and Montpellier. Journal of Diabetes Science and Technology 3, 1014-1021. https://doi.org/10.1177/193229680900300504Clarke, W. L., Anderson, S., Breton, M., Patek, S., Kashmer, L., Kovatchev, B., 2009. Closed-loop artificial pancreas using subcutaneous glucose sensing and insulin delivery and a model predictive control algorithm: the Virginia experience. Journal of Diabetes Science and Technology 3, 1031-1038. https://doi.org/10.1177/193229680900300506Clemens, A., Chang, P., Myers, R., 1977. The development of biostator, a glucose controlled insulin infusion system (GCIIS). Hormone and metabolic research 7, 23-33.Cobelli, C., Nucci, G., Del Prato, S., 1999. A physiological simulation model of the glucose-insulin system. Vol. 2.Colino, E., 2018. Fundación para la Diabetes. [Online; October 2018]. URL: http://www.fundaciondiabetes.org/Craig, T. P., 2010. Dietary Carnitine Supplementation as a potential modulator of insulin sensitivity. Master's Thesis, University of Stirling. URL: https://dspace.stir.ac.uk/Dalla Man, C., Breton, M. D., Cobelli, C., 2009. Physical activity into the meal glucose-insulin model of type 1 diabetes: in silico studies 3, 56-67. https://doi.org/10.1177/193229680900300107Dalla Man, C., Camilleri, M., Cobelli, C., 2006. A system model of oral glucose absorption: validation on gold standard data. IEEE Transactions on Biomedical Engineering 53 (12), 2472-2478. https://doi.org/10.1109/TBME.2006.883792Dalla Man, C., Micheletto, F., Lv, D., Breton, M., Kovatchev, B., Cobelli, C., 2014. The uva/padova type 1 diabetes simulator: new features. Journal of Diabetes Science and Technology 8 (1), 26-34. https://doi.org/10.1177/1932296813514502Dalla Man, C., Raimondo, D. M., Rizza, R. A., Cobelli, C., 2007a. GIM, simulation software of meal glucose insulin model. Journal of Diabetes Science and Technology 1, 323-330. https://doi.org/10.1177/193229680700100303Dalla Man, C., Rizza, R. A., Cobelli, C., 2007b. Meal simulation model of the glucose-insulin system. IEEE Transactions on Biomedical Engineering 54 (10), 1740-1749. https://doi.org/10.1109/TBME.2007.893506Haidar, A., 2016. The artificial pancreas: How close-loop control is revolutionizing diabetes. IEEE Condtrol Systems 36 (5), 28-47. https://doi.org/10.1109/MCS.2016.2584318International Diabetes Federation, 2017. IDF diabetes atlas, 8th Edition. URL: http://www.diabetesatlas.org/IRICOM, 2018. Sociedad Española de Diabetes. [Online; October 2018]. URL: http://www.sediabetes.org/Kadish, A. H., 1963. Automation control of blood sugar a servomechanism for glucose monitoring and control. ASAIO Journal 9 (1), 363-367.Manrique, J., Romero, J. D., Sabater, J. M., Vivas, O. A., Vicente, J. M., 2018. Simulador de paciente T1D en tiempo real. Actas de las XXXIX Jornadas de Automática, Badajoz, 64-71. 'Mauseth, R., Hirsch, I. B., Bollyky, J., Kircher, R., Matheson, D., Sanda, S., Greenbaum, C., 2013. Use of a "fuzzy logic" controller in a closed-loop artificial pancreas. Diabetes Technology & Therapeutics 15 (8), 628-633. https://doi.org/10.1089/dia.2013.0036Murillo, M. D., Fernandez, F., Tuneu, L., 2004. Guía de seguimiento farmacoterapéutico sobre diabetes. Grupo de Investigación en Atención Farmacéutica (GIAF). URL: http://www.ugr.es/National Center for Biotechnology Information, 2018. Insulin aspart. Pub Chem Compound Database, [Online; October 2018]. URL: https://pubchem.ncbi.nlm.nih.gov/compound/16132418Nimri, R., Atlas, E., Ajzensztejn, M., Miller, S., Oron, T., Phillip, M., 2012. Feasibility study of automated overnight closed-loop glucose control under md-logic artificial pancreas in patients with type 1 diabetes: the dream project. Diabetes Technology & Therapeutics 14 (8), 728-735. https://doi.org/10.1089/dia.2012.0004Nucci, G., Cobelli, C., 2000. Models of subcutaneous insulin kinetics. a critical review. Computer Methods and Programs in Biomedicine 62 (3), 249-257. https://doi.org/10.1016/S0169-2607(00)00071-7OpenAPS Community, 2015. Openaps. OpenAPS.org, [Online; October 2018]. URL: https://openaps.org/Renard, E., Place, J., Cantwell, M., Chevassus, H., Palerm, C. C., 2010. Closedloop insulin delivery using a subcutaneous glucose sensor and intraperitoneal insulin delivery: feasibility study testing a new model for the artificial pancreas. Diabetes Care 33 (1), 121-127. https://doi.org/10.2337/dc09-1080Segre, G., Turco, G., Vercellone, G., 1973. Modeling blood glucose and insulin kinetics in normal, diabetic and obese subjects. Diabetes 22 (2), 94-103. https://doi.org/10.2337/diab.22.2.94Steil, G. M., Palerm, C. C., Kurtz, N., Voskanyan, G., Roy, A., Paz, S., Kandeel, F. R., 2011. The effect of insulin feedback on closed loop glucose control. The Journal of Clinical Endocrinology & Metabolism 96 (5), 1402-1408. https://doi.org/10.1210/jc.2010-2578Toffolo, G., Bergman, R. N., Finegood, D. T., Bowden, C. R., Cobelli, C., 1980. Quantitative estimation of beta cell sensitivity to glucose in the intact organism: a minimal model of insulin kinetics in the dog. Diabetes 29 (12), 979-990. https://doi.org/10.2337/diab.29.12.979Trajanoski, Z., Wach, P., Kotanko, P., Ott, A., Skraba, F., 1993. Pharmacokinetic model for the absorption of subcutaneously injected soluble insulin and monomeric insulin-analogues. Biomedizinische Technik Biomedical Engineering 38 (9), 224-231. https://doi.org/10.1515/bmte.1993.38.9.224Turksoy, K., Cinar, A., 2014. Adaptive control of artificial pancreas systems-a review. Journal of Healthcare Engineering 5 (1), 1-22. https://doi.org/10.1260/2040-2295.5.1.1Weinzimer, S. A., Sherr, J. L., Cengiz, E., Kim, G., Ruiz, J. L., Carria, L., Voskanyan, G., Roy, A., Tamborlane, W. V., 2012. Effect of pramlintide on prandial glycemic excursions during closed-loop control in adolescents and young adults with type 1 diabetes. Diabetes Care. URL: http://care.diabetesjournals.org https://doi.org/10.2337/dc12-0330Yoldi, C., Mayo 2018. Las grasas y las proteínas también cuentan. Guía Diabetes tipo 1, [Online; October 2018]. URL: https://www.diabetes-cidi.org

Manifestaciones clínicas y factores de riesgo asociados a la infección por Cryptosporidium en pacientes de Barranquilla y tres municipios del Atlántico (Colombia)

Resumen Objetivos: Caracterizar manifestaciones clínicas y factores de riesgo asociados a Cryptos- poridiosis. Materiales y métodos: Se realizó un estudio descriptivo transversal en 423 pacientes, con análisis macroscópico y microscópico de muestras fecales, para identificar manifestaciones clínicas y factores de riesgo asociados a Cryptosporidiosis en tres municipios del Atlántico y su capital en un período de 4 meses. Se identificaron ooquistes de Cryptosporidium spp. después de teñirse con Ziehl-Neelsen modificado. Se comparó el método de concentración NaCl saturado con el método en fresco, para la detección de parásitos intestinales en 279/423 (66.0%) pacientes. El análisis estadístico se realizó usando EPI-INFO 6.04. Resultados: La prevalencia de Cryptosporidium spp. fue 1.9% (8/423). Se encontraron asociaciones estadísticas entre cryptosporidiosis y fiebre (p=0.01), sangre en muestras fe- cales (p=0.01) y presencia de animales domiciliarios (p=0.02). La mayoría de los pacientes (267/423:20.3 %) fueron positivos para parásitos intestinales. Los parásitos identificados con mayor frecuencia fueron protozoos no enteropatógenos, Entamoeba coli (118/423: 27.9%) y Endolimax nana (86/423: 20.3%), seguido de Blastocystis hominis (76/423: 18%), Entamoeba histolytica/dispar (28/423: 6.6%) y Giardia lamblia (23/423: 5.4%). Ascaris lumbricoides (6/423: 1.4%) fue el helminto identificado con mayor frecuencia. Una sensibilidad/especificidad de 99.45/95.2% y 87.5%/99.6% se obtuvo para protozoos y helmintos respectivamente usando el método de NaCl saturado. Conclusiones: Los pacientes con cryptosporidosis tuvieron fiebre y muestras fecales san- guinolentas. Probablemente fueron infectados por animales domésticos. Microscópicamente, la utilización de la tinción Ziehl Neelsen modificado fue esencial para la identificación de ooquistes de Cryptosporidium spp. El método de NaCl saturado concentró eficientemente los parásitos. Palabras claves: Cryptosporidium spp., Ziehl-Neelsen modificado, parasitosis in- testinales. Abstract Objectives: To characterize the clinical manifestations and risk factors associated with cryptosporidiosis. Materials and methods: A descriptive study was performed on 423 patients, with mac- roscopic and microscopic faecal sample analyses, to identify the clinical manifestations and risk factors associated with cyptosporidiosis in 3 towns and the principal city in Atlantico (Colombia) over a 4-month period. Cryptosporidium spp oocysts were identified after stain- ing with modified Ziehl-Neelsen. A saturated NaCl parasite-concentration method was also compared with wet-mount method for the detection of all intestinal parasites in 279/423 (66.0%) patients. Statistical analyses were performed using EPI-INFO 6.04. Results: The prevalence of Cryptosporidium spp. was 1.9% (8/423). Statistical associations were found between cryptosporidiosis infections and fever (p=0.01), blood in the faecal samples (p=0.01) and the presence of household animals (p=0.02). Most of the patients (267/423: 63.1%) were positive for intestinal parasites. The most commonly identified parasites were the non-pathogenic protozoa, Entamoeba coli (118/423: 27.9%) and Endoli- max nana (86/423: 20.3%), followed by Blastocystis hominis (76/423: 18%), Entamoeba histolytica/dispar (28/423: 6.6%) and Giardia lamblia (23/423: 5.4%). Ascaris lumbricoi- des (6/423: 1.4%) was the most common helminth identified. Sensitivities/specificities of 99.4%/95.2% and 87.5%/99.6% were obtained for protozoa and helminths respectively using the saturated NaCl method. Conclusions: Patients with cryptosporidiosis had fever and bloody faecal samples, and were probably infected by domestic animals. Microscopy, using the modified Ziehl-Neelsen stain, was essential for Cryptosporidium spp. oocyst identification. The saturated NaCl method efficiently concentrated the parasites. Key words: Cryptosporidium spp., modified Ziehl-Neelsen stain, intestinal parasi- tesis

Discovery of the Optical Transient of the Gamma Ray Burst 990308

The optical transient of the faint Gamma Ray Burst 990308 was detected by the QUEST camera on the Venezuelan 1-m Schmidt telescope starting 3.28 hours after the burst. Our photometry gives $V = 18.32 \pm 0.07$, $R = 18.14 \pm 0.06$, $B = 18.65 \pm 0.23$, and $R = 18.22 \pm 0.05$ for times ranging from 3.28 to 3.47 hours after the burst. The colors correspond to a spectral slope of close to $f_{\nu} \propto \nu^{1/3}$. Within the standard synchrotron fireball model, this requires that the external medium be less dense than $10^{4} cm^{-3}$, the electrons contain $> 20$ of the shock energy, and the magnetic field energy must be less than 24% of the energy in the electrons for normal interstellar or circumstellar densities. We also report upper limits of $V > 12.0$ at 132 s (with LOTIS), $V > 13.4$ from 132-1029s (with LOTIS), $V > 15.3$ at 28.2 min (with Super-LOTIS), and a 8.5 GHz flux of $< 114 \mu Jy$ at 110 days (with the Very Large Array). WIYN 3.5-m and Keck 10-m telescopes reveal this location to be empty of any host galaxy to $R > 25.7$ and $K > 23.3$. The lack of a host galaxy likely implies that it is either substantially subluminous or more distant than a red shift of $\sim 1.2$.Comment: ApJ Lett submitted, 5 pages, 2 figures, no space for 12 coauthor

Measurement of health-related quality by multimorbidity groups in primary health care

[EN] Background: Increased life expectancy in Western societies does not necessarily mean better quality of life. To improve resources management, management systems have been set up in health systems to stratify patients according to morbidity, such as Clinical Risk Groups (CRG). The main objective of this study was to evaluate the effect of multimorbidity on health-related quality of life (HRQL) in primary care. Methods: An observational cross-sectional study, based on a representative random sample (n = 306) of adults from a health district (N = 32,667) in east Spain (Valencian Community), was conducted in 2013. Multimorbidity was measured by stratifying the population with the CRG system into nine mean health statuses (MHS). HRQL was assessed by EQ-5D dimensions and the EQ Visual Analogue Scale (EQ VAS). The effect of the CRG system, age and gender on the utility value and VAS was analysed by multiple linear regression. A predictive analysis was run by binary logistic regression with all the sample groups classified according to the CRG system into the five HRQL dimensions by taking the ¿healthy¿ group as a reference. Multivariate logistic regression studied the joint influence of the nine CRG system MHS, age and gender on the five EQ-5D dimensions. Results: Of the 306 subjects, 165 were female (mean age of 53). The most affected dimension was pain/discomfort (53%), followed by anxiety/depression (42%). The EQ-5D utility value and EQ VAS progressively lowered for the MHS with higher morbidity, except for MHS 6, more affected in the five dimensions, save self-care, which exceeded MHS 7 patients who were older, and MHS 8 and 9 patients, whose condition was more serious. The CRG system alone was the variable that best explained health problems in HRQL with 17%, which rose to 21% when associated with female gender. Age explained only 4%. Conclusions: This work demonstrates that the multimorbidity groups obtained by the CRG classification system can be used as an overall indicator of HRQL. These utility values can be employed for health policy decisions based on cost-effectiveness to estimate incremental quality-adjusted life years (QALY) with routinely e-health data. Patients under 65 years with multimorbidity perceived worse HRQL than older patients or disease severity. Knowledge of multimorbidity with a stronger impact can help primary healthcare doctors to pay attention to these population groups.The authors would like to thank the Conselleria de Sanitat Universal i Sanitat Pública of the Generalitat Valenciana (the Regional Valencian Health Government) for providing the study data. We would also like to thank Helen Warbuton for editing the English.Milá-Perseguer, M.; Guadalajara Olmeda, MN.; Vivas-Consuelo, D.; Usó-Talamantes, R. (2019). Measurement of health-related quality by multimorbidity groups in primary health care. Health and Quality of Life Outcomes. 17(8):1-10. https://doi.org/10.1186/s12955-018-1063-zS110178Ministerio de Sanidad SS, Igualdad e. Indicadores de Salud 2013. Evolución de los indicadores del estado de salud en España y su magnitud en el contexto de la Unión Europea. Madrid: Ministerio de Sanidad, Servicios Sociales e Igualdad; 2014.OECD/EU: Health at a Glance: Europe 2016 – State of Health in the EU Cycle, OECD Publishing, Paris. In.; 2016.WHO: Disability and health. In. Edited by WHO; 2017.Nicholson K, Makovski TT, Griffith LE, Raina P, Stranges S, van den Akker M. Multimorbidity and comorbidity revisited: refining the concepts for international health research. J Clin Epidemiol. 2018.Palmer K, Marengoni A, Forjaz MJ, Jureviciene E, Laatikainen T, Mammarella F, Muth C, Navickas R, Prados-Torres A, Rijken M, et al. 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Interventions for the control of Aedes aegypti in Latin America and the Caribbean: systematic review and meta-analysis

Objective: To determine the effectiveness and degree of implementation of interventions for the control of Aedes aegypti in Latin America and the Caribbean (LAC) as reported in scientific literature. Methods: We searched MEDLINE, EMBASE, CENTRAL, SOCINDEX, and LILACS, for experimental and observational studies, economic assessments and qualitative experiences carried out in LAC from 2000 to 2016. We assessed incidence and morbimortality of Aedes aegypti-related diseases and entomological indices: Breteau (containers), House, and Pupae per Person. We used GRADE methodology for assessing quality of evidence. Results: Of 1826 records retrieved, 75 were included and 9 cluster randomised clinical trials could be meta-analysed. We did not identify any intervention supported by a high certainty of evidence. In consistency with qualitative evidence, health education and community engagement probably reduces the entomological indices, as do the use of insecticide-treated materials, indoor residual spraying and the management of containers. There is low certainty of evidence supporting the use of ovitraps or larvitraps, and the integrated epidemiological surveillance strategy to improve indices and reduce the incidence of dengue. The reported degree of implementation of these vector control interventions was variable and most did not extend to whole cities and were not sustained beyond 2 years. Conclusions: We found a general lack of evidence on effectiveness of vector control in the region, despite a few interventions that showed moderate to low certainty of evidence. It is important to engage and educate the community, apart from achieving the implementation of integrated actions between the health and other sectors at national and regional level.Fil: Bardach, Ariel Esteban. 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: García Perdomo, Herney Andrés. Universidad del Valle; ColombiaFil: Alcaraz, Andrea. Instituto de Efectividad Clínica y Sanitaria; ArgentinaFil: Tapia López, Elena. Instituto de Efectividad Clínica y Sanitaria; ArgentinaFil: Ruano Gandara, Ruth Amanda. Instituto de Efectividad Clínica y Sanitaria; ArgentinaFil: Ruvinsky, Silvina. Gobierno de la Ciudad de Buenos Aires. Hospital de Pediatría "Juan P. Garrahan"; ArgentinaFil: Ciapponi, Agustín. 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; Argentin