On the minimal thermal habitability conditions in low income dwellings in Spain for a new definition of fuel poverty

Fuel poverty can be defined as “the inability to afford adequate warmth in the home”. The concept was firstly developed due to health risks related to cold among low income households. However, in the last few decades, especially since the summer heat wave of 2003 that caused 35,000 deaths across Europe, a lot of research has been conducted about the health risks related to high temperatures. Along with advances in knowledge related to the health risks associated with inadequate temperatures, several directives of the European Commission related to energy regulation urge Member States to develop their own fuel poverty definitions. This need of a methodological development for new definitions poses several questions. First, what should be the temperature thresholds for the overheated season? But, furthermore, are existing temperature baselines adequate for the Spanish context and climate? This paper presents a preliminary approach to define these new temperature thresholds for the Spanish context through the adaptive comfort model criteria. For that purpose, a statistically representative dwelling building typology of vulnerable household spaces was used to analyze indoor thermal temperatures and hence, to establish minimal energy requirements so as to achieve minimal habitability conditions

Bayesian variable selection and survival modeling: assessing the Most important comorbidities that impact lung and colorectal cancer survival in Spain

ancer survival represents one of the main indicators of interest in cancer epidemiology. However, the survival of cancer patients can be affected by several factors, such as comorbidities, that may interact with the cancer biology. Moreover, it is interesting to understand how different cancer sites and tumour stages are affected by different comorbidities. Identifying the comorbidities that affect cancer survival is thus of interest as it can be used to identify factors driving the survival of cancer patients. This information can also be used to identify vulnerable groups of patients with comorbidities that may lead to worst prognosis of cancer. We address these questions and propose a principled selection and evaluation of the effect of comorbidities on the overall survival of cancer patients. In the first step, we apply a Bayesian variable selection method that can be used to identify the comorbidities that predict overall survival. In the second step, we build a general Bayesian survival model that accounts for time-varying effects. In the third step, we derive several posterior predictive measures to quantify the effect of individual comorbidities on the population overall survival. We present applications to data on lung and colorectal cancers from two Spanish population-based cancer registries. The proposed methodology is implemented with a combination of the R-packages mombf and rstan. We provide the code for reproducibility at https://github.com/migariane/BayesVarImpComorbiCancer

Social Media for the Promotion of Holistic Self-Participatory Care: An Evidence Based Approach

Objectives: As health information is becoming increasingly accessible, social media offers ample opportunities to track, be informed, share and promote health. These authors explore how social media and holistic care may work together; more specifically however, our objective is to document, from different perspectives, how social networks have impacted, supported and helped sustain holistic self-participatory care. Methods: A literature review was performed to investigate the use of social media for promoting health in general and complementary alternative care in particular. We also explore a case study of an intervention for improving the health of Greek senior citizens through digital and other means. Results: The Health Belief Model provides a framework for assessing the benefits of social media interventions in promoting comprehensive participatory self-care. Some interventions are particularly effective when integrating social media with real-world encounters. Yet not all social media tools are evidence-based and efficacious. Interestingly, social media is also used to elicit patient ratings of treatments (e.g., for depression), often demonstrating the effectiveness of complementary treatments, such as yoga and mindfulness meditation. Conclusions: To facilitate the use of social media for the promotion of complementary alternative medicine through self-quantification, social connectedness and sharing of experiences, exploration of concrete and abstract ideas are presented herewithin. The main mechanisms by which social support may help improve health - emotional support, an ability to share experiences, and non-hierarchal roles, emphasizing reciprocity in giving and receiving support – are integral to social media and provide great hope for its effective us

Evaluation of a Diagnostic Decision Support System for the Triage of Patients in a Hospital Emergency Department

One of the biggest challenges for the management of the emergency department (ED) is to expedite the management of patients since their arrival for those with low priority pathologies selected by the classification systems, generating unnecessary saturation of the ED. Diagnostic decision support systems (DDSS) can be a powerful tool to guide diagnosis, facilitate correct classification and improve patient safety. Patients who attended the ED of a tertiary hospital with the preconditions of Manchester Triage system level of low priority (levels 3, 4 and 5), and with one of the five most frequent causes for consultation: dyspnea, chest pain, gastrointestinal bleeding, general discomfort and abdominal pain, were interviewed by an independent researcher with a DDSS, the Mediktor system. After the interview, we compare the Manchester triage and the final diagnoses made by the ED with the triage and diagnostic possibilities ordered by probability obtained by the Mediktor system, respectively. In a final sample of 214 patients, the urgency assignment made by both systems does not match exactly, which could indicate a different classification model, but there were no statistically significant differences between the assigned levels (S = 0.059, p = 0.442). The diagnostic accuracy between the final diagnosis and any of the first 10 Mediktor diagnoses was of 76.5%, for the first five diagnoses was 65.4%, for the first three diagnoses was 58%, and the exact match with the first diagnosis was 37.9%. The classification of Mediktor in this segment of patients shows that a higher level of severity corresponds to a greater number of hospital admissions, hospital readmissions and emergency screenings at 30 days, although without statistical significance. It is expected that this type of applications may be useful as a complement to the triage, to accelerate the diagnostic approach, to improve the request for appropriate complementary tests in a protocolized action model and to reduce waiting times in the ED

Clinical significance of the isolation of Staphylococcus epidermidis from bone biopsy in diabetic foot osteomyelitis

Introduction: Coagulase-negative staphylococci are considered as microorganisms with little virulence and usually as contaminants. In order to establish the role of Staphylococcus epidermidis as a pathogen in diabetic foot osteomyelitis, in addition to the isolation of the sole bacterium from the bone it will be necessary to demonstrate the histopathological changes caused by the infection. Methods: A consecutive series of 222 diabetic patients with foot osteomyelitis treated surgically in the Diabetic Foot Unit at La Paloma Hospital (Las Palmas de Gran Canaria, Canary Islands, Spain) between 1 October 2002 and 31 October 2008. From the entire series including 213 bone cultures with 241 isolated organisms, we have analyzed only the 139 cases where Staphylococci were found. We analyzed several variables between the two groups: Staphylococcus aureus versus Staphylococcus epidermidis. Results: Of the 134 patients included in this study, Staphlylococcus epidermidis was found as the sole bacterium isolated in 11 cases and accompanied by other bacteria in 12 cases. Staphlylococcus aureus was found as the sole bacterium isolated in 72 cases and accompanied by other bacteria in 39 cases. Histopathological changes were found in the cases of osteomyelitis where Staphylococcus epidermidis was the sole bacterium isolated. Acute osteomyelitis was found to a lesser extent when Staphylococcus epidermidis was the sole bacterium isolated but without significant differences with the cases where Staphylococcus aureus was the sole bacterium isolated. Conclusion: Staphylococcus epidermidis should be considered as a real pathogen, not only a contaminant, in diabetic patients with foot osteomyelitis when the bacterium is isolated from the bone. No differences in the outcomes of surgical treatment have been found with cases which Staphlylococcus aureus was isolated

Phenoloxidase activity acts as a mosquito innate immune response against infection with semliki forest virus

Several components of the mosquito immune system including the RNA interference (RNAi), JAK/STAT, Toll and IMD pathways have previously been implicated in controlling arbovirus infections. In contrast, the role of the phenoloxidase (PO) cascade in mosquito antiviral immunity is unknown. Here we show that conditioned medium from the Aedes albopictus-derived U4.4 cell line contains a functional PO cascade, which is activated by the bacterium Escherichia coli and the arbovirus Semliki Forest virus (SFV) (Togaviridae; Alphavirus). Production of recombinant SFV expressing the PO cascade inhibitor Egf1.0 blocked PO activity in U4.4 cell- conditioned medium, which resulted in enhanced spread of SFV. Infection of adult female Aedes aegypti by feeding mosquitoes a bloodmeal containing Egf1.0-expressing SFV increased virus replication and mosquito mortality. Collectively, these results suggest the PO cascade of mosquitoes plays an important role in immune defence against arboviruses

Association of VAV2 and VAV3 polymorphisms with cardiovascular risk factors

Hypertension, diabetes and obesity are cardiovascular risk factors closely associated to the development of renal and cardiovascular target organ damage. VAV2 and VAV3, members of the VAV family proto-oncogenes, are guanosine nucleotide exchange factors for the Rho and Rac GTPase family, which is related with cardiovascular homeostasis. We have analyzed the relationship between the presence of VAV2 rs602990 and VAV3 rs7528153 polymorphisms with cardiovascular risk factors and target organ damage (heart, vessels and kidney) in 411 subjects. Our results show that being carrier of the T allele in VAV2 rs602990 polymorphism is associated with an increased risk of obesity, reduced levels of ankle-brachial index and diastolic blood pressure and reduced retinal artery caliber. In addition, being carrier of T allele is associated with increased risk of target organ damage in males. On the other hand, being carrier of the T allele in VAV3 rs7528153 polymorphism is associated with a decreased susceptibility of developing a pathologic state composed by the presence of hypertension, diabetes, obesity or cardiovascular damage, and with an increased risk of developing altered basal glycaemia. This is the first report showing an association between VAV2 and VAV3 polymorphisms with cardiovascular risk factors and target organ damage

Staircase Quantum Dots Configuration in Nanowires for Optimized Thermoelectric Power

The performance of thermoelectric energy harvesters can be improved by nanostructures that exploit inelastic transport processes. One prototype is the three-terminal hopping thermoelectric device where electron hopping between quantum-dots are driven by hot phonons. Such three-terminal hopping thermoelectric devices have potential in achieving high efficiency or power via inelastic transport and without relying on heavy-elements or toxic compounds. We show in this work how output power of the device can be optimized via tuning the number and energy configuration of the quantum-dots embedded in parallel nanowires. We find that the staircase energy configuration with constant energy-step can improve the power factor over a serial connection of a single pair of quantum-dots. Moreover, for a fixed energy-step, there is an optimal length for the nanowire. Similarly for a fixed number of quantum-dots there is an optimal energy-step for the output power. Our results are important for future developments of high-performance nanostructured thermoelectric devices

Phenotypic redshifts with self-organizing maps: A novel method to characterize redshift distributions of source galaxies for weak lensing

Wide-field imaging surveys such as the Dark Energy Survey (DES) rely on coarse measurements of spectral energy distributions in a few filters to estimate the redshift distribution of source galaxies. In this regime, sample variance, shot noise, and selection effects limit the attainable accuracy of redshift calibration and thus of cosmological constraints. We present a new method to combine wide-field, few-filter measurements with catalogs from deep fields with additional filters and sufficiently low photometric noise to break degeneracies in photometric redshifts. The multi-band deep field is used as an intermediary between wide-field observations and accurate redshifts, greatly reducing sample variance, shot noise, and selection effects. Our implementation of the method uses self-organizing maps to group galaxies into phenotypes based on their observed fluxes, and is tested using a mock DES catalog created from N-body simulations. It yields a typical uncertainty on the mean redshift in each of five tomographic bins for an idealized simulation of the DES Year 3 weak-lensing tomographic analysis of $\sigma_{\Delta z} = 0.007$, which is a 60% improvement compared to the Year 1 analysis. Although the implementation of the method is tailored to DES, its formalism can be applied to other large photometric surveys with a similar observing strategy.Comment: 24 pages, 11 figures; matches version accepted to MNRA