eHealth and the Internet of Things

To respond to an ageing population, eHealth strategies offer significant opportunities in achieving a balanced and sustainable healthcare infrastructure. Advances in technology both at the sensor and device levels and in respect of information technology have opened up other possibilities and options. Of significance among these is what is increasingly referred to as the Internet of Things, the interconnection of physical devices to an information infrastructure. The paper therefore sets out to position the Internet of Things at the core of future developments in eHealt

Community Based Rehabilitation Program for People with Musculoskeletal Conditions

Community based rehabilitation program in people with musculoskeletal conditions was evaluated using Dartmouth COOP Functional Health Assessment Charts/WONCA (COOP/WONCA charts). The program consisted of educative and training protocol in a primary healthcare setting. It had two parts, both with six visits, in the first part three times a week and in the second part once a week. Clients with musculoskeletal conditions (N=204) were included if they agreed to take active part in the rehabilitation process. The first part of the program was completed by 77 clients, and complete program by 52 subjects. Positive changes on the COOP/ WONCA charts were achieved by more than 50% of the subjects that completed the program, in all categories but Social Activities. The program proved effective in terms of short-term evaluation with COOP/WONCA charts in those that complete the program. The high dropout rate and long-term efficiency have yet to be investigated

Community Based Rehabilitation Program for People with Musculoskeletal Conditions

Community based rehabilitation program in people with musculoskeletal conditions was evaluated using Dartmouth COOP Functional Health Assessment Charts/WONCA (COOP/WONCA charts). The program consisted of educative and training protocol in a primary healthcare setting. It had two parts, both with six visits, in the first part three times a week and in the second part once a week. Clients with musculoskeletal conditions (N=204) were included if they agreed to take active part in the rehabilitation process. The first part of the program was completed by 77 clients, and complete program by 52 subjects. Positive changes on the COOP/ WONCA charts were achieved by more than 50% of the subjects that completed the program, in all categories but Social Activities. The program proved effective in terms of short-term evaluation with COOP/WONCA charts in those that complete the program. The high dropout rate and long-term efficiency have yet to be investigated

Multimodal and multicontrast image fusion via deep generative models

Recently, it has become progressively more evident that classic diagnostic labels are unable to reliably describe the complexity and variability of several clinical phenotypes. This is particularly true for a broad range of neuropsychiatric illnesses (e.g., depression, anxiety disorders, behavioral phenotypes). Patient heterogeneity can be better described by grouping individuals into novel categories based on empirically derived sections of intersecting continua that span across and beyond traditional categorical borders. In this context, neuroimaging data carry a wealth of spatiotemporally resolved information about each patient's brain. However, they are usually heavily collapsed a priori through procedures which are not learned as part of model training, and consequently not optimized for the downstream prediction task. This is because every individual participant usually comes with multiple whole-brain 3D imaging modalities often accompanied by a deep genotypic and phenotypic characterization, hence posing formidable computational challenges. In this paper we design a deep learning architecture based on generative models rooted in a modular approach and separable convolutional blocks to a) fuse multiple 3D neuroimaging modalities on a voxel-wise level, b) convert them into informative latent embeddings through heavy dimensionality reduction, c) maintain good generalizability and minimal information loss. As proof of concept, we test our architecture on the well characterized Human Connectome Project database demonstrating that our latent embeddings can be clustered into easily separable subject strata which, in turn, map to different phenotypical information which was not included in the embedding creation process. This may be of aid in predicting disease evolution as well as drug response, hence supporting mechanistic disease understanding and empowering clinical trials

Revisión sistemática de las actitudes negativas hacia la comunidad LGBTQ+

El objetivo de esta investigación de revisión sistemática es explorar y describir las manifestaciones de las actitudes negativas hacia la comunidad LGBTQ+. Se ejecutó una búsqueda literaria en distintas bases de datos (Proquest, Redalyc, Scoopus y Science Direct), que tengan relación con la variable de investigación, de los cuales, a través de los filtros de criterio de inclusión - exclusión, así como la metodología PRISMA, se recaudó catorce trabajos de investigación. Los resultados indican que las principales manifestaciones negativas a la comunidad LGBTQ+ se encuentran latentes en la sociedad, las personas con una orientación sexual diferente a la heterosexualidad aún sienten temor de ser violentados, rechazados o ignorados. Se concluye con la sistematización de los trabajos elegidos, donde se encuentra que las manifestaciones negativas tienen una prevalencia mundial y que los aspectos sociodemográficos influyen en los niveles en el que se dan

Ceftazidime-Avibactam Combination Therapy Compared to Ceftazidime-Avibactam Monotherapy for the Treatment of Severe Infections Due to Carbapenem-Resistant Pathogens: A Systematic Review and Network Meta-Analysis

Ceftazidime-avibactam (CZA) is a novel beta-lactam beta-lactamase inhibitor combination approved for the treatment of complicated urinary tract infections, complicated intra-abdominal infections, and for hospital-acquired/ventilator-associated pneumonia. The aim of this systematic review (PROSPERO registration number: CRD42019128927) was to evaluate the effectiveness of CZA combination therapy versus CZA monotherapy in the treatment of severe infections. The databases included in the search, until February 12th, 2020, were MEDLINE by PubMed, EMBASE, and The Cochrane Central Register of Controlled Trials. We included both randomized controlled trials (RCTs) and non-randomized studies published in peer-reviewed journals and in the English language. The primary outcome was all-cause mortality (longest follow-up) evaluated in patients with the diagnosis of infection with at least one pathogen; secondary outcomes were clinical and microbiological improvement/cure. Thirteen studies were included in the qualitative synthesis: 7 RCTs and 6 retrospective studies All the six retrospective studies identified carbapenamase-producing Enterobacteriaceae (CRE) as the cause of infection and for this reason were included in the network meta-analysis (NMA); the quality of the studies, assessed using the New Castle-Ottawa Scale, was moderate-high. In all the six retrospective studies included in the NMA, CZA was used in large part for off-label indications (mostly blood stream infections: 80-100% of patients included). No difference in mortality rate was observed in patients undergoing CZA combination therapy compared to CZA monotherapy [n = 503 patients, direct evidence OR: 0.96, 95% CI: 0.65-1.41]

Ceftolozane-Tazobactam Combination Therapy Compared to Ceftolozane-Tazobactam Monotherapy for the Treatment of Severe Infections: A Systematic Review and Meta-Analysis

Ceftolozane-tazobactam (C/T) is a combination of an advanced-generation cephalosporin (ceftolozane) with a β-lactamase inhibitor (tazobactam). It is approved for the treatment of complicated urinary-tract/intra-abdominal infections and hospital-acquired/ventilator-associated pneumonia. This systematic review and meta-analysis (registered prospectively on PROSPERO, no. CRD42019134099, on 20 January 2020) aimed to evaluate the effectiveness of C/T combination therapy compared to C/T monotherapy for the treatment of severe infections and to describe the prevalence of microorganisms in the included studies. We retrieved literature from PubMed, EMBASE, and CENTRAL, until 26 November 2020. Eligible studies were both randomised trials and nonrandomised studies with a control group, published in the English language and peer-reviewed journals. The primary outcome was all-cause mortality; secondary outcomes were (i) clinical improvement and (ii) microbiological cure. Eight nonrandomised studies were included in the qualitative synthesis: Seven retrospective cohort studies and one case-control study. The meta-analysis of the four studies evaluating all-cause mortality (in total 148 patients: 87 patients treated with C/T alone and 61 patients treated with C/T combination therapy) showed a significant reduction of mortality in patients receiving C/T combination therapy, OR: 0.31, 95% CI: 0.10-0.97, p = 0.045. Conversely, the meta-analysis of the studies evaluating clinical improvement and microbiological cure showed no differences in C/T combination therapy compared to C/T monotherapy. The most consistent data come from the analysis of the clinical improvement, n = 391 patients, OR: 0.97, 95% CI: 0.54-1.74, p = 0.909. In 238 of the 391 patients included (60.8%), C/T was used for the treatment of infections caused by Pseudomonas aeruginosa

Auditory mismatch impairments are characterized by core neural dysfunctions in schizophrenia

Reduced mismatch negativity is a well-established phenomenon in schizophrenia, but its underlying mechanisms are unclear. Using fMRI, Gaebler et al. reveal that auditory mismatch stimuli trigger multiple neural dysfunctions associated with schizophrenia. The fMRI response enables diagnostic separation of patients and controls with high accuracy, suggesting biomarker potentia