36 research outputs found
Methotrexate efficacy, but not its intolerance, is associated with the dose and route of administration
Plant trait and vegetation data along a 1314 m elevation gradient with fire history in Puna grasslands, Per\ufa
\ua9 2024. The Author(s). Alpine grassland vegetation supports globally important biodiversity and ecosystems that are increasingly threatened by climate warming and other environmental changes. Trait-based approaches can support understanding of vegetation responses to global change drivers and consequences for ecosystem functioning. In six sites along a 1314 m elevational gradient in Puna grasslands in the Peruvian Andes, we collected datasets on vascular plant composition, plant functional traits, biomass, ecosystem fluxes, and climate data over three years. The data were collected in the wet and dry season and from plots with different fire histories. We selected traits associated with plant resource use, growth, and life history strategies (leaf area, leaf dry/wet mass, leaf thickness, specific leaf area, leaf dry matter content, leaf C, N, P content, C and N isotopes). The trait dataset contains 3,665 plant records from 145 taxa, 54,036 trait measurements (increasing the trait data coverage of the regional flora by 420%) covering 14 traits and 121 plant taxa (ca. 40% of which have no previous publicly available trait data) across 33 families
Modified slash Birnbaum-Saunders distribution
CNPQ - CONSELHO NACIONAL DE DESENVOLVIMENTO CIENTÍFICO E TECNOLÓGICOIn this paper, we introduce an extension for the Birnbaum-Saunders (BS) distribution based on the modified slash (MS) distribution proposed by [12]. This new family of BS type distributions is obtained by replacing the usual normal distribution with the quotient of two independent random variables, one being a normal distribution in the numerator and the power of a exponential of parameter equal to two at the denominator. The resulting distribution is an extension of the BS distribution that has greater kurtosis values than the usual BS distribution and the slash Birnbaum-Saunders (SBS) distribution (see [7]). Moments and some properties are derived for the new distribution. Also, we draw inferences by the method of moments and maximum likelihood. A real data application is presented where the model fitting is implemented by using maximum likelihood estimation producing better results than the classic BS model and slash BS model.465969984CNPQ - CONSELHO NACIONAL DE DESENVOLVIMENTO CIENTÍFICO E TECNOLÓGICOCNPQ - CONSELHO NACIONAL DE DESENVOLVIMENTO CIENTÍFICO E TECNOLÓGICOsem informaçã
Simulation of suicide tendency by using machine learning
El texto completo de este trabajo no está disponible en el Repositorio Académico UPC por restricciones de la casa editorial donde ha sido publicado.Suicide is one of the most distinguished causes of death on the news worldwide. There are several factors and variables that can lead a person to commit this act, for example, stress, self-esteem, depression, among others. The causes and profiles of suicide cases are not revealed in detail by the competent institutions. We propose a simulation with a systematically generated dataset; such data reflect the adolescent population with suicidal tendency in Peru. We will evaluate three algorithms of supervised machine learning as a result of the algorithm C4.5 which is based on the trees to classify in a better way the suicidal tendency of adolescents. We finally propose a desktop tool that determines the suicidal tendency level of the adolescent.Revisión por pare
Inmunización materna : Maternal immunization: cobertura de vacunación antigripal y morbilidad asociada a la gripe en gestantes en Cataluña: el papel de los ginecólogos-obstetras y las matronas en la promoción de la inmunización materna = influenza vaccination uptake and influenza-associated morbidity among pregnant women in Catalonia: the role of obstetricians-gynecologists and midwives in promoting maternal immunization /
Objetivo: Estimar las coberturas de vacunación antigripal y la tasa de hospitalizaciones y de visitas ambulatorias por problemas cardiorrespiratorios atribuibles a la gripe en las gestantes de Cataluña durante las temporadas gripales de 2008-2009 a 2012-2013, y determinar los conocimientos y las prácticas de los ginecólogos-obstetras y las matronas respecto a la vacunación contra la gripe y la tosferina en las embarazadas. Método: Se han realizado cuatro estudios. El primero consistió en determinar las coberturas vacunales frente a la gripe en una cohorte de base poblacional formada por gestantes que realizaron el control prenatal en el Institut Català de la Salut entre los años 2008 y 2013. Las coberturas vacunales se estimaron utilizando el método clásico (número de mujeres vacunadas respecto al total de mujeres que estuvieron embarazadas durante el periodo de estudio) y, como método adicional, el cálculo de la densidad de incidencia de la vacunación. El segundo es un estudio transversal realizado mediante una encuesta anónima dirigida a ginecólogos-obstetras y matronas que trabajaban en los servicios de Atención a la Salud Sexual y Reproductiva de Atención Primaria de Cataluña en 2014, para explorar los conocimientos, las actitudes y las prácticas en relación con la inmunización materna. En el tercer estudio se estimaron las tasas de hospitalización y las tasas de visitas ambulatorias debidas a procesos respiratorios y cardiacos en una cohorte de gestantes de base poblacional de Cataluña durante tres periodos (periodo no gripal, periodo de gripe no epidémica y periodo de gripe epidémica) y en cada uno de los tres trimestres del embarazo. Se realizó la comparación de la tasa de dichos eventos clínicos durante el periodo de gripe epidémica con los otros dos periodos de estudio, así como durante cada uno de los trimestres del embarazo, frente a las tasas en dichas mujeres en el año previo al embarazo. Finalmente, el cuarto estudio consistió en una revisión narrativa del papel de los profesionales de atención materna en la vacunación de las embarazadas. Resultados: Las coberturas de vacunación antigripal estacional de 2008-2009 a 2012-2013 fueron del 3,7%, 5,2%, 4,8%, 5,6% y 4,6%, respectivamente, y para la vacunación en temporada pandémica fue del 8,3%. Las hazard ratios de vacunación comparando las gestantes previamente vacunadas con las no vacunadas fueron de 10 al inicio y 1,3 al final de las campañas de vacunación frente a gripe estacional; al comparar el segundo y el tercer trimestres frente al primer trimestre fueron de 2,8 y 2,3, respectivamente, al inicio de las campañas de vacunación. Las principales barreras identificadas entre los ginecólogos-obstetras y matronas de Cataluña en cuanto a la inmunización materna fueron el temor a posibles efectos adversos de la vacuna (25,6%) y la falta de hábito en la administración de vacunas (24,6%). Durante las temporadas de «gripe epidémica», la tasa de visitas ambulatorias fue más alta en gestantes en el primer y el segundo trimestres del embarazo (131 y 153 por 10.000 mujeres-mes, respectivamente) en comparación con las mismas temporadas en el año previo al embarazo (113,2 por 10.000 mujeres-mes). De manera similar, la tasa de hospitalizaciones fue más alta en gestantes en el tercer trimestre (1,6 por 10.000 mujeres-mes) que antes de la gestación (0,8 por 10.000 mujeres-mes). La comorbilidad estuvo asociada a una mayor tasa de ambos eventos clínicos. Conclusión: La gripe se asocia a una mayor carga de visitas y hospitalizaciones en las mujeres embarazadas en comparación con las no embarazadas en Cataluña. Sin embargo, las coberturas de vacunación antigripal en gestantes son muy bajas. Es necesario mejorar la formación de ginecólogos-obstetras y matronas, e incorporar la inmunización materna como parte de los objetivos del control prenatal.Background: Maternal immunization can provide significant protection against several infectious diseases not only to the woman and the fetus, but also to the newborn and the infant during the first months of life. For this reason, it provides an innovative strategy with a significant impact on reducing maternal morbidity and mortality as well as neonatal and infant morbidity and mortality. Objective: This doctoral thesis aimed to estimate the coverage of influenza vaccination and the rate of hospitalizations and outpatient visits attributable to influenza in pregnant women in Catalonia during the influenza seasons from 2008-2009 to 2012-2013. We also determined the knowledge and practices of obstetricians and midwives regarding influenza and pertussis vaccination among pregnant women. Method: Four studies were carried out. The first study consisted of estimating vaccination coverage against influenza in a populationbased cohort of pregnant women under prenatal care at the Catalan Health Institute from 2008 to 2013. Vaccination coverage was estimated using the "classic" method (number of women vaccinated with respect to all women who were pregnant during the study period) and as an additional method, the calculation of the vaccination incidence density. The second study is a crosssectional anonymous survey for obstetricians-gynecologists and midwives who worked in the Attention to Sexual and Reproductive Health Service of Primary Care of Catalonia during 2014 to explore knowledge, attitudes and practices regarding maternal immunization. In the third study, we estimated the hospitalization rates and ambulatory visit rates due to respiratory and cardiovascular illness in a population-based cohort of pregnant women in Catalonia during three periods (non-influenza period, non-epidemic influenza period, and epidemic influenza period) and during each trimester of pregnancy. In addition, we compared the rate of clinical events during the period of epidemic influenza versus the other study periods, as well as the rate of clinical events during each trimester of pregnancy versus the rates among non-pregnant 12 women. Finally, the fourth study consisted of a narrative review of the role of maternal care providers regarding maternal immunization. Results: Seasonal influenza vaccination coverage rates from 2008-09 to 2012-13 were 3.7%, 5.2%, 4.8%, 5.6% and 4.6%, and 8.3% during the influenza pandemic season. The hazard ratios for vaccination of previously vaccinated pregnant women versus non-previously vaccinated pregnant women were 10 at the start and 1.3 at the end of the seasonal influenza campaigns. Comparing the second and third gestational trimesters versus the first trimester, those figures were 2.8 and 2.3, respectively, at the start of the seasonal vaccination campaigns. The main barriers identified among obstetricians and midwives in Catalonia regarding maternal immunization were the concern related to potential adverse effects of vaccination (25.6%) and the lack of habit administering vaccines during pregnancy (24.6%). During the seasons of "epidemic influenza", the rate of outpatient visits was higher among pregnant women during the first and second trimesters (131 and 153 per 10,000 woman-months, respectively) compared to non-pregnant women (113.2 per 10,000 woman-months). Similarly, the hospitalization rate was higher among pregnant women during third trimester (1.6 per 10,000 woman-months) versus non-pregnant women (0.8 per 10,000 woman-months). Comorbidity was associated with a higher rate of both clinical events among the study cohort of pregnant women. Conclusion: Influenza carries a greater burden of outpatient visits and hospitalizations among pregnant compared to non-pregnant women in Catalonia. However, influenza vaccine uptake among pregnant women is still very low. It is important to improve the training of obstetricians-gynecologists and midwives, as well as to integrate maternal immunization as part of an adequate antenatal care
Predictors of poor response to methotrexate in polyarticular-course juvenile idiopathic arthritis: analysis of the PRINTO methotrexate trial
OBJECTIVES: To determine whether baseline demographic, clinical, articular and laboratory variables predict methotrexate (MTX) poor response in polyarticular-course juvenile idiopathic arthritis.
METHODS: Patients newly treated for 6 months with MTX enrolled in the Paediatric Rheumatology International Trials Organization (PRINTO) MTX trial. Bivariate and logistic regression analyses were used to identify baseline predictors of poor response according to the American College of Rheumatology pediatric (ACR-ped) 30 and 70 criteria.
RESULTS: In all, 405/563 (71.9%) of patients were women; median age at onset and disease duration were 4.3 and 1.4 years, respectively, with anti-nuclear antibody (ANA) detected in 259/537 (48.2%) patients. With multivariate logistic regression analysis, the most important determinants of ACR-ped 70 non-responders were: disease duration > 1.3 years (OR 1.93), ANA negativity (OR 1.77), Childhood Health Assessment Questionnaire (CHAQ) disability index > 1.125 (OR 1.65) and the presence of right and left wrist activity (OR 1.55). Predictors of ACR-ped 30 non-responders were: ANA negativity (OR 1.92), CHAQ disability index > 1.14 (OR 2.18) and a parent's evaluation of child's overall well-being < or = 4.69 (OR 2.2).
CONCLUSION: The subgroup of patients with longer disease duration, ANA negativity, higher disability and presence of wrist activity were significantly associated with a poorer response to a 6-month MTX course
Differences between influenza and pertussis vaccination uptake in pregnancy: A multi-center survey study in Italy
Background: A suboptimal maternal vaccination coverage in 2017-18 has been reported in Italy. The study aims were to (i) assess changes in maternal influenza and tetanus, diphtheria and acellular pertussis vaccination coverage during 2018-19 influenza season compared to the previous season (ii) estimate influenza vaccine coverage among maternal care providers (MCPs) and (iii) explore the characteristics of vaccine delivery to pregnant women. Methods: We conducted a cross-sectional survey among pregnant women and MCPs about influenza and pertussis immunization during pregnancy. We also collected information regarding prenatal care characteristics and vaccine delivery among four centers in Italy. Results: We recruited 483 pregnant women and 452 MCPs. The influenza and pertussis vaccine uptake among pregnant women for the season 2018-19 was 14.9% and 60.9%, respectively. MCPs' influenza vaccine uptake was 33.6%. Knowing that the flu vaccine was safe for mothers and their infants and being vaccinated in the previous influenza season were associated with higher vaccine uptake. Regarding pertussis, being a housewife was associated to lower vaccine uptake, while knowing the vaccine is effective and safe for mothers and newborns were associated with higher pertussis vaccine uptake. The single most important factor associated to higher coverage of both influenza and pertussis vaccines was receiving a health-care provider's vaccine advice. Most pregnant women (69.4%) stated that they preferred to be vaccinated in their same prenatal care setting. Conclusions: Receiving a health-care provider's vaccine advice and the availability of vaccines during prenatal care visits might improve vaccination coverage among pregnant women