A multivariate method for meta-analysis and comparison of diagnostic tests.

We present here an extension of the classic bivariate random effects meta-analysis for the log-transformed sensitivity and specificity that can be applied for two or more diagnostic tests. The advantage of this method is that a closed-form expression is derived for the calculation of the within-studies covariances. The method allows the direct calculation of sensitivity and specificity, as well as, the diagnostic odds ratio, the area under curve and the parameters of the summary receiver operator's characteristic curve, along with the means for a formal comparison of these quantities for different tests. There is no need for individual patient data or the simultaneous evaluation of both diagnostic tests in all studies. The method is simple and fast; it can be extended for several diagnostic tests and can be fitted in nearly all statistical packages. The method was evaluated in simulations and applied in a meta-analysis for the comparison of anti-cyclic citrullinated peptide antibody and rheumatoid factor for discriminating patients with rheumatoid arthritis, with encouraging results. Simulations suggest that the method is robust and more powerful compared with the standard bivariate approach that ignores the correlation between tests. Copyright © 2016 John Wiley & Sons, Ltd.

Analyzing pathways from childhood maltreatment to internalizing symptoms and disorders in children and adolescents (AMIS): a study protocol.

BACKGROUND: Effective interventions for maltreated children are impeded by gaps in our knowledge of the etiopathogenic mechanisms leading from maltreatment to mental disorders. Although some studies have already identified individual risk factors, there is a lack of large-scale multilevel research on how psychosocial, neurobiological, and genetic factors act in concert to modulate risk of internalizing psychopathology in childhood following maltreatment. To help close this gap, we aim to delineate gender-specific pathways from maltreatment to psychological disorder/resilience. To this end, we examine the interplay of specific maltreatment characteristics and psychological, endocrine, metabolomic, and (epi-)genomic stress response patterns as well as cognitive-emotional/social processes as determinants of developmental outcome. Specifically, we will explore endocrine, metabolomic, and epigenetic mechanisms leading from maltreatment to a higher risk of depression and anxiety disorders. METHODS/DESIGN: Four large samples amounting to a total of N = 920 children aged 4-16 years will be assessed: Two cohorts with prior internalizing psychopathology and controls will be checked for maltreatment and two cohorts with substantiated maltreatment will be checked for internalizing (and externalizing) psychopathology. We will apply a multi-source (interview, questionnaires, official records), multi-informant strategy (parents, children, teachers) to assess maltreatment characteristics (e.g., subtypes, developmental timing, chronicity) and psychopathological symptoms, supplemented with multiple measurements of risk and protective factors and cutting-edge laboratory analyses of endocrine, steroid metabolomic and epigenetic factors. As previous assessments in the two largest samples are already available, longitudinal data will be generated within the three year study period. DISCUSSION: Our results will lay the empirical foundation for (a) detection of early biopsychosocial markers, (b) development of screening measures, and

Global systems for mobile position tracking using Kalman and Lainiotis filters.

We present two time invariant models for Global Systems for Mobile (GSM) position tracking, which describe the movement in x-axis and y-axis simultaneously or separately. We present the time invariant filters as well as the steady state filters: the classical Kalman filter and Lainiotis Filter and the Join Kalman Lainiotis Filter, which consists of the parallel usage of the two classical filters. Various implementations are proposed and compared with respect to their behavior and to their computational burden: all time invariant and steady state filters have the same behavior using both proposed models but have different computational burden. Finally, we propose a Finite Impulse Response (FIR) implementation of the Steady State Kalman, and Lainiotis filters, which does not require previous estimations but requires a well-defined set of previous measurements.

Coastal Water Quality Modelling Using E. coli, Meteorological Parameters and Machine Learning Algorithms.

In this study, machine learning models were implemented to predict the classification of coastal waters in the region of Eastern Macedonia and Thrace (EMT) concerning Escherichia coli (E. coli) concentration and weather variables in the framework of the Directive 2006/7/EC. Six sampling stations of EMT, located on beaches of the regional units of Kavala, Xanthi, Rhodopi, Evros, Thasos and Samothraki, were selected. All 1039 samples were collected from May to September within a 14-year follow-up period (2009-2021). The weather parameters were acquired from nearby meteorological stations. The samples were analysed according to the ISO 9308-1 for the detection and the enumeration of E. coli. The vast majority of the samples fall into category 1 (Excellent), which is a mark of the high quality of the coastal waters of EMT. The experimental results disclose, additionally, that two-class classifiers, namely Decision Forest, Decision Jungle and Boosted Decision Tree, achieved high Accuracy scores over 99%. In addition, comparing our performance metrics with those of other researchers, diversity is observed in using algorithms for water quality prediction, with algorithms such as Decision Tree, Artificial Neural Networks and Bayesian Belief Networks demonstrating satisfactory results. Machine learning approaches can provide critical information about the dynamic of E. coli contamination and, concurrently, consider the meteorological parameters for coastal waters classification.

Clinical validation of optimised RT-LAMP for the diagnosis of SARS-CoV-2 infection.

We have optimised a reverse transcription-loop-mediated isothermal amplification (RT-LAMP) assay for the detection of SARS-CoV-2 from extracted RNA for clinical application. We improved the stability and reliability of the RT-LAMP assay by the addition of a temperature-dependent switch oligonucleotide to reduce self- or off-target amplification. We then developed freeze-dried master mix for single step RT-LAMP reaction, simplifying the operation for end users and improving long-term storage and transportation. The assay can detect as low as 13 copies of SARS-CoV2 RNA per reaction (25-µL). Cross reactivity with other human coronaviruses was not observed. We have applied the new RT-LAMP assay for testing clinical extracted RNA samples extracted from swabs of 72 patients in the UK and 126 samples from Greece and demonstrated the overall sensitivity of 90.2% (95% CI 83.8-94.7%) and specificity of 92.4% (95% CI 83.2-97.5%). Among 115 positive samples which Ct values were less than 34, the RT-LAMP assay was able to detect 110 of them with 95.6% sensitivity. The specificity was 100% when RNA elution used RNase-free water. The outcome of RT-LAMP can be reported by both colorimetric detection and quantifiable fluorescent reading. Objective measures with a digitized reading data flow would allow for the sharing of results for local or national surveillance.

[Ovarian cancer in the province of Palermo (Italy): data from 2003 to 2005]. / Il carcinoma ovarico nella provincia di Palermo: dati del triennio 2003-2005.

Ovarian cancer is characterized by a low incidence of disease and a high mortality. To correctly analyze the epidemiology of this disease it is therefore necessary to obtain data from population-based tumor registries. From 2003 to 2005, 251 new cases were registered in the tumor registry of the province of Palermo. Cases were identified from various sources, mainly hospital discharge forms, pathology reports and death certificates.The distribution of incident cases was analysed by age, type of diagnosis, disease stage, and treatment. Survival was calculated at one, three and five years. Morphologically, epithelial tumors were the most common frequent. The disease was more frequent in older age groups, with the highest incidence observed in the age group 55-69 years. Incidence and mortality rates were similar to those reported by the pool of Italian tumor registries. Disease stage was found to be related to patient age. Survival was related to stage of disease, age at diagnosis and type of treatment. Younger patients had a longer survival while advanced staging was the most unfavorable prognostic factor. Regarding the type of treatment, treatment of ovarian cancer is complex and requires close integration and coordination of the various healthcare professionals involved.

A Collaboration to Teach US MPH Students about Cuba's Health Care System.

In 2011, the US Department of the Treasury changed its regulations to allow US students to participate in short-term education programs in Cuba. Beginning in 2012, and each year thereafter, Cuba's National School of Public Health and the Colorado School of Public Health have jointly taught a class on the Cuban public health system. The program goals are to provide US students with an opportunity to learn about the Cuban national health system's focus on 1) prevention and primary health care services; 2) financial and geographic access to services and health equity; 3) continuum of care across the home, family doctor-and-nurse offices, polyclinics and hospitals; 4) data collection at all levels to understand health risks, including outbreaks, and to guide resource allocation; 5) assessing patients' health and risks using a comprehensive definition of health; 6) multisectoral collaborations between the Ministry of Public Health and other Cuban agencies and organizations to address population health risks; 7) disaster preparedness, response and recovery; and 8) provision of international health assistance. The class incorporates information about health systems in Latin American and other Caribbean countries to provide context for understanding the Cuban health system. The course includes: 1) seminars, online readings and discussions before travel to Cuba; 2) seminars at Cuba's National School of Public Health, visits to Cuban national health institutions at all levels, from community-based family doctor-and-nurse offices and multispecialty clinics (polyclinics) to internationally recognized national health institutions, and guided visits and activities about Cuban culture and history during their 12 days in Cuba; and 3) followup course work upon return to the USA in which students integrate what they learned into their final class reports and presentations. During time spent planning, implementing and revising the program, both institutions have learned from each other about global health teaching methodologies and have laid a foundation for future teaching and research collaborations. To date, 49 individuals have participated in the program. KEYWORDS Medical education, public health system, collaboration, Cuba, USA.

El deber de actuar por la salud bucal y la felicidad / The commitment to act for oral health and happiness

La salud bucal y la felicidad requieren acción social. El buen estado de salud es uno de los principales determinantes de la felicidad, pues produce alegría y se expresa habitualmente a través de la sonrisa o risa que pudieran resultar inhibidas por afecciones bucales. La campaña "Unidos por la salud bucal", impulsada por la Federación Dental Internacional a nivel mundial, hace un llamado a decisores, profesionales y a la población para que asuman compromisos orientados a reducir la carga global de las enfermedades bucales. El establecimiento de compromisos y las acciones consecuentes pueden contribuir a mejoras en la salud bucal, aunque para ello es necesario establecer acciones sistemáticas. En el contexto cubano, es una fortaleza que la estrategia de la estomatología sea nacional y tenga un enfoque de salud pública, si bien se hace necesario reforzar el seguimiento y evaluación del impacto de las acciones, estimular la creatividad, la comunicación dialogada y revisar cuáles compromisos deben ser consolidados para contribuir a la salud bucal y, por consiguiente, a la felicidad(AU)

Oral health and happiness require social action. The good health is one of the main determinants of happiness, since it produces joy and is usually expressed through a smile or laughter that could be inhibited by oral conditions. The International Dental Federation's "United for Oral Health" Campaign in 2020 aims to make commitments for decision-makers, professionals and the population to reduce the global burden of oral diseases. Establishing commitments and consequent actions can contribute to improvements in oral health, making it necessary to establish systematic actions. In the Cuban context, it is a strength that the stomatology strategy is national and has a public health focus, although it is necessary to reinforce the monitoring and evaluation of the impact of the actions, stimulate creativity, dialogue communication, and review which commitments they must be consolidated to contribute to oral health and therefore to happiness."(AU)

Comunicación dialogada en la toma de decisiones informadas en la atención estomatológica / Dialogue communication in the informed decision making in dental care

Para alcanzar la calidad en la atención estomatológica, debe lograrse una interrelación entre el profesional y el individuo, en que este último tenga responsabilidad y autonomía en el proceso. Para esto es imprescindible que el estomatólogo desarrolle habilidades en la comunicación. En este trabajo nos proponemos sensibilizar a los estomatólogos sobre la importancia de la comunicación dialogada para la toma de decisiones informadas en la atención estomatológica(AU)

To attain quality in dental care, there must be an interrelation between the professional and the individual, in which the latter has responsibility and autonomy in the process. To this end, it is indispensable that the dentist develops communication skills. In this paper, we propose ourselves to sensitize dentists to the importance of the dialogue communication to make informed decisions in dental care(AU)