38 research outputs found

    Application of Supervised Machine Learning for Behavioral Biomarkers of Autism Spectrum Disorder Based on Electrodermal Activity and Virtual Reality

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    [EN] Objective: Sensory processing is the ability to capture, elaborate, and integrate information through the five senses and is impaired in over 90% of children with autism spectrum disorder (ASD). The ASD population shows hyper¿hypo sensitiveness to sensory stimuli that can generate alteration in information processing, affecting cognitive and social responses to daily life situations. Structured and semi-structured interviews are generally used for ASD assessment, and the evaluation relies on the examiner¿s subjectivity and expertise, which can lead to misleading outcomes. Recently, there has been a growing need for more objective, reliable, and valid diagnostic measures, such as biomarkers, to distinguish typical from atypical functioning and to reliably track the progression of the illness, helping to diagnose ASD. Implicit measures and ecological valid settings have been showing high accuracy on predicting outcomes and correctly classifying populations in categories. Methods: Two experiments investigated whether sensory processing can discriminate between ASD and typical development (TD) populations using electrodermal activity (EDA) in two multimodal virtual environments (VE): forest VE and city VE. In the first experiment, 24 children with ASD diagnosis and 30 TDs participated in both virtual experiences, and changes in EDA have been recorded before and during the presentation of visual, auditive, and olfactive stimuli. In the second experiment, 40 children have been added to test the model of experiment 1. Results: The first exploratory results on EDA comparison models showed that the integration of visual, auditive, and olfactive stimuli in the forest environment provided higher accuracy (90.3%) on sensory dysfunction discrimination than specific stimuli. In the second experiment, 92 subjects experienced the forest VE, and results on 72 subjects showed that stimuli integration achieved an accuracy of 83.33%. The final confirmatory test set (n = 20) achieved 85% accuracy, simulating a real application of the models. Further relevant result concerns the visual stimuli condition in the first experiment, which achieved 84.6% of accuracy in recognizing ASD sensory dysfunction. Conclusion: According to our studies¿ results, implicit measures, such as EDA, and ecological valid settings can represent valid quantitative methods, along with traditional assessment measures, to classify ASD population, enhancing knowledge on the development of relevant specific treatments.This work was supported by the Spanish Ministry of Economy, Industry, and Competitiveness-funded project Immersive Virtual Environment for the Evaluation and Training of Children with Autism Spectrum Disorder: T Room (IDI-20170912) and by the Generalitat Valenciana-funded project REBRAND (PROMETEU/2019/105).Alcañiz Raya, ML.; Chicchi-Giglioli, IA.; Marín-Morales, J.; Higuera-Trujillo, JL.; Olmos-Raya, E.; Minissi, ME.; Teruel García, G.... (2020). Application of Supervised Machine Learning for Behavioral Biomarkers of Autism Spectrum Disorder Based on Electrodermal Activity and Virtual Reality. Frontiers in Human Neuroscience. 14:1-16. https://doi.org/10.3389/fnhum.2020.00090S11614Allen, R., Davis, R., & Hill, E. (2012). The Effects of Autism and Alexithymia on Physiological and Verbal Responsiveness to Music. Journal of Autism and Developmental Disorders, 43(2), 432-444. doi:10.1007/s10803-012-1587-8Anagnostou, E., Zwaigenbaum, L., Szatmari, P., Fombonne, E., Fernandez, B. A., Woodbury-Smith, M., … Scherer, S. W. (2014). Autism spectrum disorder: advances in evidence-based practice. Canadian Medical Association Journal, 186(7), 509-519. doi:10.1503/cmaj.121756Ashwin, C., Chapman, E., Howells, J., Rhydderch, D., Walker, I., & Baron-Cohen, S. (2014). Enhanced olfactory sensitivity in autism spectrum conditions. Molecular Autism, 5(1), 53. doi:10.1186/2040-2392-5-53Baron-Cohen, S. (1990). Autism: A Specific Cognitive Disorder of & lsquo;Mind-Blindness’. International Review of Psychiatry, 2(1), 81-90. doi:10.3109/09540269009028274Baron-Cohen, S., Ashwin, E., Ashwin, C., Tavassoli, T., & Chakrabarti, B. (2009). Talent in autism: hyper-systemizing, hyper-attention to detail and sensory hypersensitivity. Philosophical Transactions of the Royal Society B: Biological Sciences, 364(1522), 1377-1383. doi:10.1098/rstb.2008.0337Barry, R. J., & James, A. L. (1988). Coding of stimulus parameters in autistic, retarded, and normal children: evidence for a two-factor theory of autism. International Journal of Psychophysiology, 6(2), 139-149. doi:10.1016/0167-8760(88)90045-1Bekele, E., Crittendon, J., Zheng, Z., Swanson, A., Weitlauf, A., Warren, Z., & Sarkar, N. (2014). Assessing the Utility of a Virtual Environment for Enhancing Facial Affect Recognition in Adolescents with Autism. Journal of Autism and Developmental Disorders, 44(7), 1641-1650. doi:10.1007/s10803-014-2035-8Benedek, M., & Kaernbach, C. (2010). A continuous measure of phasic electrodermal activity. Journal of Neuroscience Methods, 190(1), 80-91. doi:10.1016/j.jneumeth.2010.04.028Blascovich, J., Loomis, J., Beall, A. C., Swinth, K. R., Hoyt, C. L., & Bailenson, J. N. (2002). TARGET ARTICLE: Immersive Virtual Environment Technology as a Methodological Tool for Social Psychology. Psychological Inquiry, 13(2), 103-124. doi:10.1207/s15327965pli1302_01Boucsein, W. (2012). Electrodermal Activity. doi:10.1007/978-1-4614-1126-0Brunswik, E. (1955). Representative design and probabilistic theory in a functional psychology. Psychological Review, 62(3), 193-217. doi:10.1037/h0047470BUJNAKOVA, I., ONDREJKA, I., MESTANIK, M., VISNOVCOVA, Z., MESTANIKOVA, A., HRTANEK, I., … TONHAJZEROVA, I. (2016). Autism Spectrum Disorder Is Associated With Autonomic Underarousal. Physiological Research, S673-S682. doi:10.33549/physiolres.933528Chang, C.-C., & Lin, C.-J. (2011). LIBSVM. ACM Transactions on Intelligent Systems and Technology, 2(3), 1-27. doi:10.1145/1961189.1961199Chang, M. C., Parham, L. D., Blanche, E. I., Schell, A., Chou, C.-P., Dawson, M., & Clark, F. (2012). Autonomic and Behavioral Responses of Children With Autism to Auditory Stimuli. American Journal of Occupational Therapy, 66(5), 567-576. doi:10.5014/ajot.2012.004242CHAYTOR, N., SCHMITTEREDGECOMBE, M., & BURR, R. (2006). Improving the ecological validity of executive functioning assessment. Archives of Clinical Neuropsychology, 21(3), 217-227. doi:10.1016/j.acn.2005.12.002Chen, C. P., Keown, C. L., Jahedi, A., Nair, A., Pflieger, M. E., Bailey, B. A., & Müller, R.-A. (2015). Diagnostic classification of intrinsic functional connectivity highlights somatosensory, default mode, and visual regions in autism. NeuroImage: Clinical, 8, 238-245. doi:10.1016/j.nicl.2015.04.002Chita-Tegmark, M. (2016). Attention Allocation in ASD: a Review and Meta-analysis of Eye-Tracking Studies. Review Journal of Autism and Developmental Disorders, 3(3), 209-223. doi:10.1007/s40489-016-0077-xFenwick, T. (2014). Social Media and Medical Professionalism. Academic Medicine, 89(10), 1331-1334. doi:10.1097/acm.0000000000000436Delobel-Ayoub, M., Ehlinger, V., Klapouszczak, D., Maffre, T., Raynaud, J.-P., Delpierre, C., & Arnaud, C. (2015). Socioeconomic Disparities and Prevalence of Autism Spectrum Disorders and Intellectual Disability. PLOS ONE, 10(11), e0141964. doi:10.1371/journal.pone.0141964Di Martino, A., Yan, C.-G., Li, Q., Denio, E., Castellanos, F. X., Alaerts, K., … Milham, M. P. (2013). The autism brain imaging data exchange: towards a large-scale evaluation of the intrinsic brain architecture in autism. Molecular Psychiatry, 19(6), 659-667. doi:10.1038/mp.2013.78Dudova, I., Vodicka, J., Havlovicova, M., Sedlacek, Z., Urbanek, T., & Hrdlicka, M. (2011). Odor detection threshold, but not odor identification, is impaired in children with autism. European Child & Adolescent Psychiatry, 20(7), 333-340. doi:10.1007/s00787-011-0177-1Fagius, J., & Wallin, B. G. (1980). Sympathetic reflex latencies and conduction velocities in normal man. Journal of the Neurological Sciences, 47(3), 433-448. doi:10.1016/0022-510x(80)90098-2Fenning, R. M., Baker, J. K., Baucom, B. R., Erath, S. A., Howland, M. A., & Moffitt, J. (2017). Electrodermal Variability and Symptom Severity in Children with Autism Spectrum Disorder. Journal of Autism and Developmental Disorders, 47(4), 1062-1072. doi:10.1007/s10803-016-3021-0Forscher, P. S., Lai, C. K., Axt, J. R., Ebersole, C. R., Herman, M., Devine, P. G., & Nosek, B. A. (2019). A meta-analysis of procedures to change implicit measures. Journal of Personality and Social Psychology, 117(3), 522-559. doi:10.1037/pspa0000160Francis, K. (2007). Autism interventions: a critical update. Developmental Medicine & Child Neurology, 47(7), 493-499. doi:10.1111/j.1469-8749.2005.tb01178.xFriston, K. J., Stephan, K. E., Montague, R., & Dolan, R. J. (2014). Computational psychiatry: the brain as a phantastic organ. The Lancet Psychiatry, 1(2), 148-158. doi:10.1016/s2215-0366(14)70275-5Gillberg, C., & Rasmussen, P. (1994). Brief report: Four case histories and a literature review of williams syndrome and autistic behavior. Journal of Autism and Developmental Disorders, 24(3), 381-393. doi:10.1007/bf02172235Hirstein, W., Iversen, P., & Ramachandran, V. S. (2001). Autonomic responses of autistic children to people and objects. Proceedings of the Royal Society of London. Series B: Biological Sciences, 268(1479), 1883-1888. doi:10.1098/rspb.2001.1724Hubert, B. E., Wicker, B., Monfardini, E., & Deruelle, C. (2009). Electrodermal reactivity to emotion processing in adults with autistic spectrum disorders. Autism, 13(1), 9-19. doi:10.1177/1362361308091649Hyde, K. K., Novack, M. N., LaHaye, N., Parlett-Pelleriti, C., Anden, R., Dixon, D. R., & Linstead, E. (2019). Applications of Supervised Machine Learning in Autism Spectrum Disorder Research: a Review. Review Journal of Autism and Developmental Disorders, 6(2), 128-146. doi:10.1007/s40489-019-00158-xJOSEPH, R. M., EHRMAN, K., MCNALLY, R., & KEEHN, B. (2008). Affective response to eye contact and face recognition ability in children with ASD. Journal of the International Neuropsychological Society, 14(6), 947-955. doi:10.1017/s1355617708081344Kandalaft, M. R., Didehbani, N., Krawczyk, D. C., Allen, T. T., & Chapman, S. B. (2012). Virtual Reality Social Cognition Training for Young Adults with High-Functioning Autism. Journal of Autism and Developmental Disorders, 43(1), 34-44. doi:10.1007/s10803-012-1544-6Kreibig, S. D. (2010). Autonomic nervous system activity in emotion: A review. Biological Psychology, 84(3), 394-421. doi:10.1016/j.biopsycho.2010.03.010Kylliäinen, A., & Hietanen, J. K. (2006). Skin Conductance Responses to Another Person’s Gaze in Children with Autism. Journal of Autism and Developmental Disorders, 36(4), 517-525. doi:10.1007/s10803-006-0091-4Kylliäinen, A., Wallace, S., Coutanche, M. N., Leppänen, J. M., Cusack, J., Bailey, A. J., & Hietanen, J. K. (2012). Affective-motivational brain responses to direct gaze in children with autism spectrum disorder. Journal of Child Psychology and Psychiatry, 53(7), 790-797. doi:10.1111/j.1469-7610.2011.02522.xLedoux, K., Coderre, E., Bosley, L., Buz, E., Gangopadhyay, I., & Gordon, B. (2015). The concurrent use of three implicit measures (eye movements, pupillometry, and event-related potentials) to assess receptive vocabulary knowledge in normal adults. Behavior Research Methods, 48(1), 285-305. doi:10.3758/s13428-015-0571-6Leekam, S. R., Nieto, C., Libby, S. J., Wing, L., & Gould, J. (2006). Describing the Sensory Abnormalities of Children and Adults with Autism. Journal of Autism and Developmental Disorders, 37(5), 894-910. doi:10.1007/s10803-006-0218-7Levy, A., & Perry, A. (2011). Outcomes in adolescents and adults with autism: A review of the literature. Research in Autism Spectrum Disorders, 5(4), 1271-1282. doi:10.1016/j.rasd.2011.01.023Li, B., Sharma, A., Meng, J., Purushwalkam, S., & Gowen, E. (2017). Applying machine learning to identify autistic adults using imitation: An exploratory study. PLOS ONE, 12(8), e0182652. doi:10.1371/journal.pone.0182652Liu, W., Li, M., & Yi, L. (2016). Identifying children with autism spectrum disorder based on their face processing abnormality: A machine learning framework. Autism Research, 9(8), 888-898. doi:10.1002/aur.1615Lord, C., Risi, S., DiLavore, P. S., Shulman, C., Thurm, A., & Pickles, A. (2006). Autism From 2 to 9 Years of Age. Archives of General Psychiatry, 63(6), 694. doi:10.1001/archpsyc.63.6.694Lord, C., Rutter, M., & Le Couteur, A. (1994). Autism Diagnostic Interview-Revised: A revised version of a diagnostic interview for caregivers of individuals with possible pervasive developmental disorders. Journal of Autism and Developmental Disorders, 24(5), 659-685. doi:10.1007/bf02172145Loth, E., Spooren, W., Ham, L. M., Isaac, M. B., Auriche-Benichou, C., Banaschewski, T., … Murphy, D. G. M. (2015). Identification and validation of biomarkers for autism spectrum disorders. Nature Reviews Drug Discovery, 15(1), 70-70. doi:10.1038/nrd.2015.7Louwerse, A., van der Geest, J. N., Tulen, J. H. M., van der Ende, J., Van Gool, A. R., Verhulst, F. C., & Greaves-Lord, K. (2013). Effects of eye gaze directions of facial images on looking behaviour and autonomic responses in adolescents with autism spectrum disorders. Research in Autism Spectrum Disorders, 7(9), 1043-1053. doi:10.1016/j.rasd.2013.04.013Lydon, S., Healy, O., Reed, P., Mulhern, T., Hughes, B. M., & Goodwin, M. S. (2014). A systematic review of physiological reactivity to stimuli in autism. Developmental Neurorehabilitation, 19(6), 335-355. doi:10.3109/17518423.2014.971975McCarthy, C., Pradhan, N., Redpath, C., & Adler, A. (2016). Validation of the Empatica E4 wristband. 2016 IEEE EMBS International Student Conference (ISC). doi:10.1109/embsisc.2016.7508621McCormick, C., Hessl, D., Macari, S. L., Ozonoff, S., Green, C., & Rogers, S. J. (2014). Electrodermal and Behavioral Responses of Children With Autism Spectrum Disorders to Sensory and Repetitive Stimuli. Autism Research, 7(4), 468-480. doi:10.1002/aur.1382Miller, L. J., Anzalone, M. E., Lane, S. J., Cermak, S. A., & Osten, E. T. (2007). Concept Evolution in Sensory Integration: A Proposed Nosology for Diagnosis. American Journal of Occupational Therapy, 61(2), 135-140. doi:10.5014/ajot.61.2.135Montague, P. R., Dolan, R. J., Friston, K. J., & Dayan, P. (2012). Computational psychiatry. Trends in Cognitive Sciences, 16(1), 72-80. doi:10.1016/j.tics.2011.11.018Möricke, E., Buitelaar, J. K., & Rommelse, N. N. J. (2015). Do We Need Multiple Informants When Assessing Autistic Traits? The Degree of Report Bias on Offspring, Self, and Spouse Ratings. Journal of Autism and Developmental Disorders, 46(1), 164-175. doi:10.1007/s10803-015-2562-yMurphy, D., & Spooren, W. (2012). EU-AIMS: a boost to autism research. Nature Reviews Drug Discovery, 11(11), 815-816. doi:10.1038/nrd3881Nakai, Y., Takiguchi, T., Matsui, G., Yamaoka, N., & Takada, S. (2017). Detecting Abnormal Word Utterances in Children With Autism Spectrum Disorders. Perceptual and Motor Skills, 124(5), 961-973. doi:10.1177/0031512517716855Nikula, R. (1991). Psychological Correlates of Nonspecific Skin Conductance Responses. Psychophysiology, 28(1), 86-90. doi:10.1111/j.1469-8986.1991.tb03392.xNosek, B. A., Hawkins, C. B., & Frazier, R. S. (2011). Implicit social cognition: from measures to mechanisms. Trends in Cognitive Sciences, 15(4), 152-159. doi:10.1016/j.tics.2011.01.005Palkovitz, R. J., & Wiesenfeld, A. R. (1980). Differential autonomic responses of autistic and normal children. Journal of Autism and Developmental Disorders, 10(3), 347-360. doi:10.1007/bf02408294Parsons, S. (2016). Authenticity in Virtual Reality for assessment and intervention in autism: A conceptual review. Educational Research Review, 19, 138-157. doi:10.1016/j.edurev.2016.08.001Parsons, T. D. (2016). Telemedicine, Mobile, and Internet-Based Neurocognitive Assessment. Clinical Neuropsychology and Technology, 99-111. doi:10.1007/978-3-319-31075-6_6Paulhus, D. L. (1991). Measurement and Control of Response Bias. Measures of Personality and Social Psychological Attitudes, 17-59. doi:10.1016/b978-0-12-590241-0.50006-xPicard, R. W., Fedor, S., & Ayzenberg, Y. (2015). Multiple Arousal Theory and Daily-Life Electrodermal Activity Asymmetry. Emotion Review, 8(1), 62-75. doi:10.1177/1754073914565517Reaven, J. A., Hepburn, S. L., & Ross, R. G. (2008). Use of the ADOS and ADI-R in Children with Psychosis: Importance of Clinical Judgment. Clinical Child Psychology and Psychiatry, 13(1), 81-94. doi:10.1177/1359104507086343Redish, A. D., & Gordon, J. A. (Eds.). (2016). Computational Psychiatry. doi:10.7551/mitpress/9780262035422.001.0001Riby, D. M., Whittle, L., & Doherty-Sneddon, G. (2012). Physiological reactivity to faces via live and video-mediated communication in typical and atypical development. Journal of Clinical and Experimental Neuropsychology, 34(4), 385-395. doi:10.1080/13803395.2011.645019Rogers, S. J., & Ozonoff, S. (2005). Annotation: What do we know about sensory dysfunction in autism? A critical review of the empirical evidence. Journal of Child Psychology and Psychiatry, 46(12), 1255-1268. doi:10.1111/j.1469-7610.2005.01431.xSchmidt, L., Kirchner, J., Strunz, S., Broźus, J., Ritter, K., Roepke, S., & Dziobek, I. (2015). Psychosocial Functioning and Life Satisfaction in Adults With Autism Spectrum Disorder Without Intellectual Impairment. Journal of Clinical Psychology, 71(12), 1259-1268. doi:10.1002/jclp.22225Schoen, S. A. (2009). Physiological and behavioral differences in sensory processing: a comparison of children with Autism Spectrum Disorder and Sensory Processing Disorder. Frontiers in Integrative Neuroscience, 3. doi:10.3389/neuro.07.029.2009Schölkopf, B., Smola, A. J., Williamson, R. C., & Bartlett, P. L. (2000). New Support Vector Algorithms. Neural Computation, 12(5), 1207-1245. doi:10.1162/089976600300015565Slater, M. (2009). Place illusion and plausibility can lead to realistic behaviour in immersive virtual environments. Philosophical Transactions of the Royal Society B: Biological Sciences, 364(1535), 3549-3557. doi:10.1098/rstb.2009.0138Slater, M., & Wilbur, S. (1997). A Framework for Immersive Virtual Environments (FIVE): Speculations on the Role of Presence in Virtual Environments. Presence: Teleoperators and Virtual Environments, 6(6), 603-616. doi:10.1162/pres.1997.6.6.603Stevens, S., & Gruzelier, J. (1984). Electrodermal activity to auditory stimuli in autistic, retarded, and normal children. Journal of Autism and Developmental Disorders, 14(3), 245-260. doi:10.1007/bf02409577Tomchek, S. D., & Dunn, W. (2007). Sensory Processing in Children With and Without Autism: A Comparative Study Using the Short Sensory Profile. American Journal of Occupational Therapy, 61(2), 190-200. doi:10.5014/ajot.61.2.190Tomchek, S. D., Huebner, R. A., & Dunn, W. (2014). Patterns of sensory processing in children with an autism spectrum disorder. Research in Autism Spectrum Disorders, 8(9), 1214-1224. doi:10.1016/j.rasd.2014.06.006Van Engeland, H., Roelofs, J. W., Verbaten, M. N., & Slangen, J. L. (1991). Abnormal electrodermal reactivity to novel visual stimuli in autistic children. Psychiatry Research, 38(1), 27-38. doi:10.1016/0165-1781(91)90050-yVan Hecke, A. V., Stevens, S., Carson, A. M., Karst, J. S., Dolan, B., Schohl, K., … Brockman, S. (2013). Measuring the Plasticity of Social Approach: A Randomized Controlled Trial of the Effects of the PEERS Intervention on EEG Asymmetry in Adolescents with Autism Spectrum Disorders. Journal of Autism and Developmental Disorders, 45(2), 316-335. doi:10.1007/s10803-013-1883-yVolkmar, F. R., State, M., & Klin, A. (2009). Autism and autism spectrum disorders: diagnostic issues for the coming decade. Journal of Child Psychology and Psychiatry, 50(1-2), 108-115. doi:10.1111/j.1469-7610.2008.02010.xWang, X.-J., & Krystal, J. H. (2014). Computational Psychiatry. Neuron, 84(3), 638-654. doi:10.1016/j.neuron.2014.10.018Wang, Y., Hensley, M. K., Tasman, A., Sears, L., Casanova, M. F., & Sokhadze, E. M. (2015). Heart Rate Variability and Skin Conductance During Repetitive TMS Course in Children with Autism. Applied Psychophysiology and Biofeedback, 41(1), 47-60. doi:10.1007/s10484-015-9311-zWhite, M. P., Yeo, N., Vassiljev, P., Lundstedt, R., Wallergård, M., Albin, M., & Lõhmus, M. (2018). A prescription for “nature” – the potential of using virtual nature in therapeutics. Neuropsychiatric Disease and Treatment, Volume 14, 3001-3013. doi:10.2147/ndt.s179038White, S. W., Mazefsky, C. A., Dichter, G. S., Chiu, P. H., Richey, J. A., & Ollendick, T. H. (2014). Social‐cognitive, physiological, and neural mechanisms underlying emotion regulation impairments: understanding anxiety in autism spectrum disorder. International Journal of Developmental Neuroscience, 39(1), 22-36. doi:10.1016/j.ijdevneu.2014.05.012Wing, L., Gould, J., & Gillberg, C. (2011). Autism spectrum disorders in the DSM-V: Better or worse than the DSM-IV? Research in Developmental Disabilities, 32(2), 768-773. doi:10.1016/j.ridd.2010.11.003Yan, K., & Zhang, D. (2015). Feature selection and analysis on correlated gas sensor data with recursive feature elimination. Sensors and Actuators B: Chemical, 212, 353-363. doi:10.1016/j.snb.2015.02.025Zahn, T. P., Rumsey, J. M., & Van Kammen, D. P. (1987). Autonomic nervous system activity in autistic, schizophrenic, and normal men: Effects of stimulus significance. Journal of Abnormal Psychology, 96(2), 135-144. doi:10.1037/0021-843x.96.2.13

    Efficacy of long-lasting insecticidal nets with declining physical and chemical integrity on Aedes aegypti (diptera : culicidae)

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    Fitting long-lasting insecticidal nets (LLIN) as screens on doors and windows has a significant impact on indoor adult Aedes aegypti, with entomological reductions measured in a previous study being significant for up to two years post-installation, even in the presence of pyrethroid-resistant Aedes populations. The study used bioassays (0, 6, and 12 months), which confirmed that LLIN residual activity decreased over time. However, the study demonstrates that the remaining chemical effect after field conditions still contributes to killing/repelling mosquitoes. LLIN screening from the neighborhood Juan Pablo II in Merida (Yucatan State, Mexico) were randomly selected. Merida is highly endemic for dengue and other Aedes-borne viruses

    Experiencias en el aula: cuarto encuentro de prácticas pedagógicas innovadoras.

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    Cuarto encuentro de prácticas pedagógicas innovadoras, evento que se llevo a cabo los días 7 y 8 de Octubre de 2019

    Experiencias en el aula: cuarto encuentro de prácticas pedagógicas innovadoras.

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    Cuarto encuentro de prácticas pedagógicas innovadoras, evento que se llevo a cabo los días 7 y 8 de Octubre de 2019

    Why Are Outcomes Different for Registry Patients Enrolled Prospectively and Retrospectively? Insights from the Global Anticoagulant Registry in the FIELD-Atrial Fibrillation (GARFIELD-AF).

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    Background: Retrospective and prospective observational studies are designed to reflect real-world evidence on clinical practice, but can yield conflicting results. The GARFIELD-AF Registry includes both methods of enrolment and allows analysis of differences in patient characteristics and outcomes that may result. Methods and Results: Patients with atrial fibrillation (AF) and ≥1 risk factor for stroke at diagnosis of AF were recruited either retrospectively (n = 5069) or prospectively (n = 5501) from 19 countries and then followed prospectively. The retrospectively enrolled cohort comprised patients with established AF (for a least 6, and up to 24 months before enrolment), who were identified retrospectively (and baseline and partial follow-up data were collected from the emedical records) and then followed prospectively between 0-18 months (such that the total time of follow-up was 24 months; data collection Dec-2009 and Oct-2010). In the prospectively enrolled cohort, patients with newly diagnosed AF (≤6 weeks after diagnosis) were recruited between Mar-2010 and Oct-2011 and were followed for 24 months after enrolment. Differences between the cohorts were observed in clinical characteristics, including type of AF, stroke prevention strategies, and event rates. More patients in the retrospectively identified cohort received vitamin K antagonists (62.1% vs. 53.2%) and fewer received non-vitamin K oral anticoagulants (1.8% vs . 4.2%). All-cause mortality rates per 100 person-years during the prospective follow-up (starting the first study visit up to 1 year) were significantly lower in the retrospective than prospectively identified cohort (3.04 [95% CI 2.51 to 3.67] vs . 4.05 [95% CI 3.53 to 4.63]; p = 0.016). Conclusions: Interpretations of data from registries that aim to evaluate the characteristics and outcomes of patients with AF must take account of differences in registry design and the impact of recall bias and survivorship bias that is incurred with retrospective enrolment. Clinical Trial Registration: - URL: http://www.clinicaltrials.gov . Unique identifier for GARFIELD-AF (NCT01090362)

    Risk profiles and one-year outcomes of patients with newly diagnosed atrial fibrillation in India: Insights from the GARFIELD-AF Registry.

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    BACKGROUND: The Global Anticoagulant Registry in the FIELD-Atrial Fibrillation (GARFIELD-AF) is an ongoing prospective noninterventional registry, which is providing important information on the baseline characteristics, treatment patterns, and 1-year outcomes in patients with newly diagnosed non-valvular atrial fibrillation (NVAF). This report describes data from Indian patients recruited in this registry. METHODS AND RESULTS: A total of 52,014 patients with newly diagnosed AF were enrolled globally; of these, 1388 patients were recruited from 26 sites within India (2012-2016). In India, the mean age was 65.8 years at diagnosis of NVAF. Hypertension was the most prevalent risk factor for AF, present in 68.5% of patients from India and in 76.3% of patients globally (P < 0.001). Diabetes and coronary artery disease (CAD) were prevalent in 36.2% and 28.1% of patients as compared with global prevalence of 22.2% and 21.6%, respectively (P < 0.001 for both). Antiplatelet therapy was the most common antithrombotic treatment in India. With increasing stroke risk, however, patients were more likely to receive oral anticoagulant therapy [mainly vitamin K antagonist (VKA)], but average international normalized ratio (INR) was lower among Indian patients [median INR value 1.6 (interquartile range {IQR}: 1.3-2.3) versus 2.3 (IQR 1.8-2.8) (P < 0.001)]. Compared with other countries, patients from India had markedly higher rates of all-cause mortality [7.68 per 100 person-years (95% confidence interval 6.32-9.35) vs 4.34 (4.16-4.53), P < 0.0001], while rates of stroke/systemic embolism and major bleeding were lower after 1 year of follow-up. CONCLUSION: Compared to previously published registries from India, the GARFIELD-AF registry describes clinical profiles and outcomes in Indian patients with AF of a different etiology. The registry data show that compared to the rest of the world, Indian AF patients are younger in age and have more diabetes and CAD. Patients with a higher stroke risk are more likely to receive anticoagulation therapy with VKA but are underdosed compared with the global average in the GARFIELD-AF. CLINICAL TRIAL REGISTRATION-URL: http://www.clinicaltrials.gov. Unique identifier: NCT01090362

    Temas sobre la educación media superior y superior en México: casos, tendencias y reflexiones

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    En esta obra se concentran temáticas diversas para explicar el acontecer actual de la educación superior en México. Los capítulos muestran los resultados de investigación que analizan los procesos que se viven, específicamente, en la Universidad Autónoma del Estado de México y en la Universidad Autónoma de Baja California

    First scientific observations with MEGARA at GTC

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    On June 25th 2017, the new intermediate-resolution optical IFU and MOS of the 10.4-m GTC had its first light. As part of the tests carried out to verify the performance of the instrument in its two modes (IFU and MOS) and 18 spectral setups (identical number of VPHs with resolutions R=6000-20000 from 0.36 to 1 micron) a number of astronomical objects were observed. These observations show that MEGARA@GTC is called to fill a niche of high-throughput, intermediateresolution IFU and MOS observations of extremely-faint narrow-lined objects. Lyman-α absorbers, star-forming dwarfs or even weak absorptions in stellar spectra in our Galaxy or in the Local Group can now be explored to a new level. Thus, the versatility of MEGARA in terms of observing modes and spectral resolution and coverage will allow GTC to go beyond current observational limits in either depth or precision for all these objects. The results to be presented in this talk clearly demonstrate the potential of MEGARA in this regard
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