92 research outputs found
Evaluation of impact of one dose varicella vaccine on the incidence of chickenpox in Argentina.
INTRODUCTION: Varicella, also known as chickenpox is one of the most common immunizable diseases. In 1998, the World Health Organization (WHO) recommended to incorporate this vaccine in the national immunization programs, which Argentina did in 2015. OBJECTIVES: To describe the behavior of the varicella time series for the 2005-2017 period, and to evaluate the impact of the vaccine in Argentina. METHODOLOGY: An ecological observational study was performed, using the varicella cases reported in the National Health Monitoring System, and the data of the National census as secondary data sources. A model based time series analysis of the notified varicella cases in Argentina was performed, using a Negative Binomial Mixed Model. For the verification of the vaccine impact, the 2005-2014 period was selected, and a prognosis for the following years was performed. Impact was evaluated by comparing the rates and confidence intervals between the predicted and observed values. RESULTS: Argentina reported 1,775,587 varicella cases for the 2005-2017 period. The series exhibited seasonality, and, a decreasing trend in the number of cases was observed in 2016 and 2017. A reduction of the incidence rate after the implementation of the vaccine was observed. The transmission risk decreased in the country after vaccine implementation. CONCLUSIONS: This study is the first concrete evidence of the varicella incidence decline after the implementation of a single dose application program in Argentina
Learning fuzzy measures for aggregation in fuzzy rule-based models
Comunicación presentada al 15th International Conference on Modeling Decisions for Artificial Intelligence, MDAI 2018 (15 - 18 october 2018).Fuzzy measures are used to express background knowledge of the information sources. In fuzzy rule-based models, the rule confidence gives an important information about the final classes and their relevance. This work proposes to use fuzzy measures and integrals to combine rules confidences when making a decision. A Sugeno $$\lambda $$ -measure and a distorted probability have been used in this process. A clinical decision support system (CDSS) has been built by applying this approach to a medical dataset. Then we use our system to estimate the risk of developing diabetic retinopathy. We show performance results comparing our system with others in the literature.This work is supported by the URV grant 2017PFR-URV-B2-60, and by the Spanish research projects no: PI12/01535 and PI15/01150 for (Instituto de Salud Carlos III and FEDER funds). Mr. Saleh has a Pre-doctoral grant (FI 2017) provided by the Catalan government and an Erasmus+ travel grant by URV. Prof. Bustince acknowledges the support of Spanish project TIN2016-77356-P
Association of retinal neurodegeneration with the progression of cognitive decline in Parkinson’s disease
Retinal thickness may serve as a biomarker in Parkinson’s disease (PD). In this prospective longitudinal study, we aimed to determine if PD patients present accelerated thinning rate in the parafoveal ganglion cell-inner plexiform layer (pfGCIPL) and peripapillary retinal nerve fiber layer (pRNFL) compared to controls. Additionally, we evaluated the relationship between retinal neurodegeneration and clinical progression in PD. A cohort of 156 PD patients and 72 controls underwent retinal optical coherence tomography, visual, and cognitive assessments between February 2015 and December 2021 in two Spanish tertiary hospitals. The pfGCIPL thinning rate was twice as high in PD (β [SE] = −0.58 [0.06]) than in controls (β [SE] = −0.29 [0.06], p < 0.001). In PD, the progression pattern of pfGCIPL atrophy depended on baseline thickness, with slower thinning rates observed in PD patients with pfGCIPL below 89.8 µm. This result was validated with an external dataset from Moorfields Eye Hospital NHS Foundation Trust (AlzEye study). Slow pfGCIPL progressors, characterized by older at baseline, longer disease duration, and worse cognitive and disease stage scores, showed a threefold increase in the rate of cognitive decline (β [SE] = −0.45 [0.19] points/year, p = 0.021) compared to faster progressors. Furthermore, temporal sector pRNFL thinning was accelerated in PD (β time x group [SE] = −0.67 [0.26] μm/year, p = 0.009), demonstrating a close association with cognitive score changes (β [SE] = 0.11 [0.05], p = 0.052). This study suggests that a slower pattern of pfGCIPL tissue loss in PD is linked to more rapid cognitive decline, whereas changes in temporal pRNFL could track cognitive deterioration
Modelo de negocio para un sistema de seguridad, respaldo y verificaci?n digital basado en el Blockchain para la gesti?n documental de notar?as en Lima Moderna
La Ley del Notariado D.S. 1049, establece que las notar?as, deben contar con: ? Una infraestructura f?sica, que permita una ?ptima conservaci?n del archivo notarial. ? Una infraestructura tecnol?gica que permita la interconexi?n y la informatizaci?n que facilite la prestaci?n de servicios notariales. Por lo expuesto se determina la necesidad de las notar?as de buscar soluciones que le permitan cumplir con lo determinado por la ley en lo referente a la conservaci?n de los documentos, salvaguardarlos de forma que asegure su inmutabilidad, permitiendo tener un respaldo adicional al f?sico. Esta plataforma permitir? a las notar?as escanear todos los documentos que emitan (protocolares y extra protocolares). Se emitir? una copia digital que ser? almacenada en el sistema de blockchain, al cual tambi?n se le a?adir? un sello de certificaci?n digital. Las copias digitales guardadas en el sistema de seguridad con blockchain, dar? a los usuarios de las notar?as certeza de que los documentos que han suscrito o legalizado en dicha notar?a no podr?n ser alterados, borrados o eliminados, adem?s de que con la certificaci?n digital ser? recibido como un documento totalmente formal y v?lido, que podr? ser abierto utilizando un c?digo QR
Patterns of eukaryotic diversity from the surface to the deep-ocean sediment
Remote deep-ocean sediment (DOS) ecosystems are among the least explored biomes on Earth. Genomic assessments of their biodiversity have failed to separate indigenous benthic organisms from sinking plankton. Here, we compare global-scale eukaryotic DNA metabarcoding datasets (18S-V9) from abyssal and lower bathyal surficial sediments and euphotic and aphotic ocean pelagic layers to distinguish plankton from benthic diversity in sediment material. Based on 1685 samples collected throughout the world ocean, we show that DOS diversity is at least threefold that in pelagic realms, with nearly two-thirds represented by abundant yet unknown eukaryotes. These benthic communities are spatially structured by ocean basins and particulate organic carbon (POC) flux from the upper ocean. Plankton DNA reaching the DOS originates from abundant species, with maximal deposition at high latitudes. Its seafloor DNA signature predicts variations in POC export from the surface and reveals previously overlooked taxa that may drive the biological carbon pump
Retinal Optical Coherence Tomography Features Associated With Incident and Prevalent Parkinson Disease
Background and objectives: Cadaveric studies have shown disease-related neurodegeneration and other morphological abnormalities in the retina of individuals with Parkinson disease (PD), however it remains unclear whether this can be reliably detected with in vivo imaging. We investigated inner retinal anatomy, measured using optical coherence tomography (OCT), in prevalent PD and subsequently assessed the association of these markers with the development of PD using a prospective research cohort.//
Methods: This cross-sectional analysis used data from two studies. For the detection of retinal markers in prevalent PD, we used data from AlzEye, a retrospective cohort of 154,830 patients aged 40 years and over attending secondary care ophthalmic hospitals in London, UK between 2008 and 2018. For the evaluation of retinal markers in incident PD, we used data from UK Biobank, a prospective population-based cohort where 67,311 volunteers aged 40-69 years were recruited between 2006 and 2010 and underwent retinal imaging. Macular retinal nerve fibre layer (mRNFL), ganglion cell-inner plexiform layer (GCIPL), and inner nuclear layer (INL) thicknesses were extracted from fovea--centred OCT. Linear mixed effects models were fitted to examine the association between prevalent PD and retinal thicknesses. Hazard ratios for the association between time to PD diagnosis and retinal thicknesses were estimated using frailty models.//
Results: Within the AlzEye cohort, there were 700 individuals with prevalent PD and 105,770 controls (mean age 65.5 ± 13.5 years, 51.7% female). Individuals with prevalent PD had thinner GCIPL (-2.12 μm, 95% confidence interval: -3.17, -1.07, p = 8.2 × 10⁻⁵) and INL (-0.99 μm, 95% confidence interval: -1.52, -0.47, p = 2.1 × 10⁻⁴). The UK Biobank included 50,405 participants (mean age 56.1 ± 8.2 years, 54.7% female), of whom 53 developed PD at a mean of 2653 ± 851 days. Thinner GCIPL (hazard ratio: 0.62 per standard deviation increase, 95% confidence interval: 0.46, 0.84, p=0.002) and thinner INL (hazard ratio: 0.70, 95% confidence interval: 0.51, 0.96, p=0.026) were also associated with incident PD.//
Discussion: Individuals with PD have reduced thickness of the INL and GCIPL of the retina. Involvement of these layers several years before clinical presentation highlight a potential role for retinal imaging for at-risk stratification of PD
Retinal optical coherence tomography features associated with incident and prevalent parkinson disease
Background and Objectives: Cadaveric studies have shown disease-related neurodegeneration and other morphological abnormalities in the retina of individuals with Parkinson disease (PD); however, it remains unclear whether this can be reliably detected with in vivo imaging. We investigated inner retinal anatomy, measured using optical coherence tomography (OCT), in prevalent PD and subsequently assessed the association of these markers with the development of PD using a prospective research cohort.
Methods: This cross-sectional analysis used data from 2 studies. For the detection of retinal markers in prevalent PD, we used data from AlzEye, a retrospective cohort of 154,830 patients aged 40 years and older attending secondary care ophthalmic hospitals in London, United Kingdom, between 2008 and 2018. For the evaluation of retinal markers in incident PD, we used data from UK Biobank, a prospective population-based cohort where 67,311 volunteers aged 40–69 years were recruited between 2006 and 2010 and underwent retinal imaging. Macular retinal nerve fiber layer (mRNFL), ganglion cell–inner plexiform layer (GCIPL), and inner nuclear layer (INL) thicknesses were extracted from fovea-centered OCT. Linear mixed-effects models were fitted to examine the association between prevalent PD and retinal thicknesses. Hazard ratios for the association between time to PD diagnosis and retinal thicknesses were estimated using frailty models.
Results: Within the AlzEye cohort, there were 700 individuals with prevalent PD and 105,770 controls (mean age 65.5 ± 13.5 years, 51.7% female). Individuals with prevalent PD had thinner GCIPL (−2.12 μm, 95% CI −3.17 to −1.07, p = 8.2 × 10−5) and INL (−0.99 μm, 95% CI −1.52 to −0.47, p = 2.1 × 10−4). The UK Biobank included 50,405 participants (mean age 56.1 ± 8.2 years, 54.7% female), of whom 53 developed PD at a mean of 2,653 ± 851 days. Thinner GCIPL (hazard ratio [HR] 0.62 per SD increase, 95% CI 0.46–0.84, p = 0.002) and thinner INL (HR 0.70, 95% CI 0.51–0.96, p = 0.026) were also associated with incident PD.
Discussion: Individuals with PD have reduced thickness of the INL and GCIPL of the retina. Involvement of these layers several years before clinical presentation highlight a potential role for retinal imaging for at-risk stratification of PD
Effective refractive error coverage in adults aged 50 years and older: estimates from population-based surveys in 61 countries
Background: In 2021, WHO Member States endorsed a global target of a 40-percentage-point increase in effective refractive error coverage (eREC; with a 6/12 visual acuity threshold) by 2030. This study models global and regional estimates of eREC as a baseline for the WHO initiative. Methods: The Vision Loss Expert Group analysed data from 565 448 participants of 169 population-based eye surveys conducted since 2000 to calculate eREC (met need/[met need + undermet need + unmet need]). A binary logistic regression model was used to estimate eREC by Global Burden of Disease (GBD) Study super region among adults aged 50 years and older. Findings: In 2021, distance eREC was 79·1% (95% CI 72·4–85·0) in the high-income super region; 62·1% (54·7–68·8) in north Africa and Middle East; 49·5% (45·0–54·0) in central Europe, eastern Europe, and central Asia; 40·0% (31·7–48·2) in southeast Asia, east Asia, and Oceania; 34·5% (29·4–40·0) in Latin America and the Caribbean; 9·0% (6·5–12·0) in south Asia; and 5·7% (3·1–9·0) in sub-Saharan Africa. eREC was higher in men and reduced with increasing age. Global distance eREC increased from 2000 to 2021 by 19·0%. Global near vision eREC for 2021 was 20·5% (95% CI 17·8–24·4). Interpretation: Over the past 20 years, distance eREC has increased in each super region yet the WHO target will require substantial improvements in quantity and quality of refractive services in particular for near vision impairment. Funding: WHO, Sightsavers, The Fred Hollows Foundation, Fondation Thea, Brien Holden Vision Institute, Lions Clubs International Foundation
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