Simulation of pandemics in real cities: enhanced and accurate digital laboratories.

This study develops a modelling framework for simulating the spread of infectious diseases within real cities. Digital copies of Birmingham (UK) and Bogotá (Colombia) are generated, reproducing their urban environment, infrastructure and population. The digital inhabitants have the same statistical features of the real population. Their motion is a combination of predictable trips (commute to work, school, etc.) and random walks (shopping, leisure, etc.). Millions of individuals, their encounters and the spread of the disease are simulated by means of high-performance computing and massively parallel algorithms for several months and a time resolution of 1 minute. Simulations accurately reproduce the COVID-19 data for Birmingham and Bogotá both before and during the lockdown. The model has only one adjustable parameter calculable in the early stages of the pandemic. Policymakers can use our digital cities as virtual laboratories for testing, predicting and comparing the effects of policies aimed at containing epidemics.

Hyaluronic acid-chondroitin sulfate: a potential factor to select pure stress urinary incontinence in patients with interstitial cystitis/painful bladder syndrome and mixed incontinence symptoms.

AIM: Aim of the study was to validate the Hyaluronic acid-Chondroitin sulfate (HA-CS) as ex adiuvantibus criteria to identified patients with urgency symptoms related to interstitial cystitis/painful bladder syndrome (IC/PBS) and to obtained a population of patients with pure stress urinary incontinence. METHODS: We retrospectively analysed clinical data of 17 patients with clinical suspect of IC/PBS, which received intravescical HA-CS to reduce pelvic pain and urgency symptoms waiting for surgical treatment for stress urinary incontinence. The main outcomes were reduction of urinary frequency, urgency, and bladder pain. RESULTS: Compared to baseline, a significant decrease in pain, urgency and frequency were observed. Of the 17 patients, 82.3% reported resolution of pain and urge symptoms and in patients with persistence of urge symptoms the urodynamic assessment showed an overactive bladder syndrome (OAB). CONCLUSION: HA-CS treatment induces an improvement in pain and urgency symptoms in patients with IC/PBS that referred also stress urinary incontinence. Therefore, HA-CS treatment could be use as clinical adjunctive parameter to select patients with pure stress urinary incontinence.

[Use of progesterone-releasing intra-uterine system in menhorragia relapse prevention after laparoscopic myomectomy]. / Impiedo della spirale medicate al progesterone nella prevenzione delle recidive menorragiche dopo miomectomia laparoscopica.

AIM: Abnormal uterine bleeding (AUB) affects about 30% of women in childbearing age with negative impact on patient's quality of life and uterine myomas represent one of the major cause of AUB. Laparoscopic myomectomy has proven to be efficient to reduce uterine bleeding and pelvic pain, but some patients presents postsurgery menhorragia with anemia. To reduce it, the combined use of levonorgestrel releasing intrauterine system (LNG-IUS) positioned at the end of surgery, seems to produce a clinically relevant decrease in AUB with a symptomatology improvement. The aim of this study was to retrospectively evaluate if postsurgery placement of LNG-IUS improves hematological outcomes (hemoglobin and ferritin level) in woman submitted to laparoscopic myomectomy. METHODS: We retrospectively collected data from 58 women who underwent laparoscopic myomectomy from September 2010 to September 2011. Twenty-six patients were treated by laparoscopic myomectomy followed by LNG-IUS positioning at the end of surgery (Experimental group) and thirty-two patients were treated by surgery alone (Control group). We compared blood hemoglobin and ferritin levels assessed preoperatively, in day one and 6, 12 and 18 months after surgery. RESULTS: There was a statistically significant improvement in terms of post-surgery hemoglobin and ferritin levels at 6 month follow up (P=0.02 and P=0.002 respectively) and 12 month follow-up (P=0.001 and P=0.001, respectively) in experimental group vs. control group and a positive trend, but not statistically significant, in ferritin levels at 18 month-follow-up (P=0.1). CONCLUSION: Our data suggest that combined treatment with laparoscopic myomectomy followed by LNG-IUS produces a clinically relevant improvement in hematological values.

Wild animals as sentinels of Paracoccidioides brasiliensis in the state of Rio Grande do Sul, Brazil.

Paracoccidioides brasiliensis, a dimorphic pathogenic fungus, causes the principal form of systemic mycosis in Brazil. The literature furnishes only limited data on the ecology of this fungus in the state of Rio Grande do Sul, the southernmost state of Brazil. The purpose of this study was to evaluate the prevalence of fungal infection in wild animals, using serological tests and using the animals as sentinels of the presence of P. brasiliensis in three specified mesoregions of Rio Grande do Sul. A total of 128 wild animals from the three mesoregions were included in the study. The serum samples were evaluated by immunodiffusion and the enzyme-linked immunosorbent assay (ELISA) technique to detect anti-gp43 antibodies from P. brasiliensis. Two conjugates were tested and compared with the ELISA technique. Although no positive samples were detected by immunodiffusion, 26 animals (20%), belonging to 13 distinct species, were found to be seropositive by the ELISA technique. The seropositive animals were from two mesoregions of the state. The results were similar according to the gender, age, and family of the animals, but differed significantly according to the conjugate used (p < 0.001), showing more sensitivity to protein A-peroxidase than to protein G-peroxidase. The finding that wild animals from the state of Rio Grande do Sul are exposed to P. brasiliensis suggests that the fungus can be found in this region despite the often-rigorous winters, which frequently include below-freezing temperatures.

Time domain measures of inter-channel EEG correlations: a comparison of linear, nonparametric and nonlinear measures.

Correlations between ten-channel EEGs obtained from thirteen healthy adult participants were investigated. Signals were obtained in two behavioral states: eyes open no task and eyes closed no task. Four time domain measures were compared: Pearson product moment correlation, Spearman rank order correlation, Kendall rank order correlation and mutual information. The psychophysiological utility of each measure was assessed by determining its ability to discriminate between conditions. The sensitivity to epoch length was assessed by repeating calculations with 1, 2, 3, …, 8 s epochs. The robustness to noise was assessed by performing calculations with noise corrupted versions of the original signals (SNRs of 0, 5 and 10 dB). Three results were obtained in these calculations. First, mutual information effectively discriminated between states with less data. Pearson, Spearman and Kendall failed to discriminate between states with a 1 s epoch, while a statistically significant separation was obtained with mutual information. Second, at all epoch durations tested, the measure of between-state discrimination was greater for mutual information. Third, discrimination based on mutual information was more robust to noise. The limitations of this study are discussed. Further comparisons should be made with frequency domain measures, with measures constructed with embedded data and with the maximal information coefficient.

[Sex ratio in the offspring of pregnant women with polycystic ovary syndrome: effect of different phenotypes]. / Sex ratio nella prole di donne affette dalla sindrome dell'ovaio policistico: effetti dei differenti fenotipi.

AIM: The aim of this paper was to investigate the sex ratio in the offspring of pregnant patients with polycystic ovary syndrome (PCOS). METHODS: Analysis of 70 pregnant patients with PCOS who achieve a pregnancy without any kind of treatment, and having as controls 63 healthy pregnant women without any feature of PCOS. RESULTS: No significant difference in sex ratio was detected between PCOS and controls, even if it resulted significantly different in the full-blown and non-PCO phenotypes. CONCLUSION: The PCOS phenotypes influenced the sex ratio in the offspring, suggesting that environmental factors could play a role in determination of the offspring gender.

[A retrospective analysis comparing colposuspension and retropubic mid-urethral sling as preventive anti-incontinence measures during laparoscopic sacrocolpopexy]. / Analisi retrospettiva di confronto tra colposospensione e sling retropubica medio-uretrale come misure preventive anti-incontinenza in corso di sacrocolpopessia laparoscopica.

AIM: The aim of this paper was to compare two anti-incontinence procedures during laparoscopic sacrocolpopexy (LSC) to prevent postoperative stress urinary incontinence (SUI). METHODS: Retrospective analysis of 90 continent hysterectomized patients with vaginal vault prolapse treated with LSC plus colposuspension (group A, N.=30), LSC plus retropubic mid-urethral sling (group B, N.=30), or LSC alone (group C, N.=30). RESULTS: De novo SUI rate resulted significantly (P<0.05) lower in group B than C. No difference was detected regarding de novo urge urinary incontinence. Total reoperation rate resulted significantly (P<0.05) higher in group A than B and lower in group B than C. CONCLUSION: When associated to LSC for preventing SUI, colposuspension and retropubic mid-urethral sling are effective and safe, even if mid-urethral sling seems to provide the best risk/benefit profile.

Consideraciones diagnósticas de los trastornos del espectro autista. Experienia de un servicio / Diagnostic Considerations in autism spectrum disorders: experience of a department

El proceso diagnóstico de los Trastornos Generalizados del Desarrollo (TGD) es un camino arduo para la mayoria de las familias. El tiempo hasta el diagnóstico influye en el acceso al tratamiento especifico, en el pronóstico y en el nivel de estrés familiar. Objetivo: describir la población de niños con o sin diagnóstico previo de TGD que consultaron a nuestro servicio, así como también describir el proceso del diagnóstico a través del análisis de algunas variables como: tiempo entre preocupación paterna y diagnóstico, número de profesionales consultados, conducta pediatríca y sintomas más prevalentes como motivo de consulta. Métodos: estudio transversal y retrospectivo. Se incluyeron las historias clínicas de los 76 niños atendidos en el servidio de clínicas Interdisciplinarias del Hospital Garrahan desde enero de 2004 hasta mayo de 2006. Resultados: 76 niños; relación sexo masculino; femenino 3.75:1. Los padres notaron los síntomas a los 25.5 más menos 9,1 meses y se preocuparon a los 28,2 más menos 13,5 meses. La edad de la primera consulta a un profesional fue a los 32 más menos 13.6 meses. El pedíatra fue el primer profesional que consultaron en 67,1 por ciento. La conducta del pediatra, luego de la consulta de los padres fue en el 57,6 por ciento derivar a otros profesionales y 42,4 por ciento adoptaron conducta expectante. Los padres consultaron a 3 más menos 2,3 profesionales hasta el diagnóstico definitivo. Los niños llegaron a nuestro consultorio por primera vez a la edad de 48,8 más menos 15,9 meses, variando de 25 hasta 85 meses. En 73,6 por ciento de los casos consultaron por trastornos en la comunicación, en 50 por ciento por trastornos en la socialización, en 42,1 por ciento por trastornos en la conducta y en el 32,9 por ciento por trastornos asociados. En nuestro análisis encontramos que los padres llevaron un promedio de 20 más menos 14,8 meses hasta el diagnóstico.

Statistical validation of mutual information calculations: comparison of alternative numerical algorithms.

Given two time series X and Y , their mutual information, I (X,Y) = I (Y,X) , is the average number of bits of X that can be predicted by measuring Y and vice versa. In the analysis of observational data, calculation of mutual information occurs in three contexts: identification of nonlinear correlation, determination of an optimal sampling interval, particularly when embedding data, and in the investigation of causal relationships with directed mutual information. In this contribution a minimum description length argument is used to determine the optimal number of elements to use when characterizing the distributions of X and Y . However, even when using partitions of the X and Y axis indicated by minimum description length, mutual information calculations performed with a uniform partition of the XY plane can give misleading results. This motivated the construction of an algorithm for calculating mutual information that uses an adaptive partition. This algorithm also incorporates an explicit test of the statistical independence of X and Y in a calculation that returns an assessment of the corresponding null hypothesis. The previously published Fraser-Swinney algorithm for calculating mutual information includes a sophisticated procedure for local adaptive control of the partitioning process. When the Fraser and Swinney algorithm and the algorithm constructed here are compared, they give very similar numerical results (less than 4% difference in a typical application). Detailed comparisons are possible when X and Y are correlated jointly Gaussian distributed because an analytic expression for I (X,Y) can be derived for that case. Based on these tests, three conclusions can be drawn. First, the algorithm constructed here has an advantage over the Fraser-Swinney algorithm in providing an explicit calculation of the probability of the null hypothesis that X and Y are independent. Second, the Fraser-Swinney algorithm is marginally the more accurate of the two algorithms when large data sets are used. With smaller data sets, however, the Fraser-Swinney algorithm reports structures that disappear when more data are available. Third, the algorithm constructed here requires about 0.5% of the computation time required by the Fraser-Swinney algorithm.

Comment on "Performance of different synchronization measures in real data: a case study on electroencephalographic signals".

Quian Quiroga et al. [Phys. Rev. E 65, 041903 (2002)] reported a similar performance of several linear and nonlinear measures of synchronization when applied to the rat electrocorticogram (ECoG). However, they found that the mutual information measure did not produce robust estimates of synchronization when compared to other measures. We reexamined their data using a histogram method with adaptive partitioning and found the mutual information to be a useful measure of regional ECoG interdependence.

Comparative study of embedding methods.

Embedding experimental data is a common first step in many forms of dynamical analysis. The choice of appropriate embedding parameters (dimension and lag) is crucial to the success of the subsequent analysis. We argue here that the optimal embedding of a time series cannot be determined by criteria based solely on the time series itself. Therefore we base our analysis on an examination of systems that have explicit analytic representations. A comparison of analytically obtained results with those obtained by an examination of the corresponding time series provides a means of assessing the comparative success of different embedding criteria. The assessment also includes measures of robustness to noise. The limitations of this study are explicitly delineated. While bearing these limitations in mind, we conclude that for the examples considered here, the best identification of the embedding dimension was achieved with a global false nearest neighbors argument, and the best value of lag was identified by the mutual information function.

Immunity to poliomyelitis: situation in northern Italy and in some other European population groups.

The aim of the program to eradicate poliomyelitis is expected to be achieved in the space of very few years and therefore, as they approach this goal, countries find themselves faced with various problems to be tackled. Among these is the decision about how and when to stop polio vaccination, which also depends on seroepidemiological evaluations, necessary because of the possible persistence of circulating strains of poliovirus of vaccine origin which might continue even after the suspension of vaccination. For this reason, the results of seroepidemiological surveys carried out in some European countries in different periods of time and on various samples of the population are discussed. Although the status of immune coverage is satisfactory, a few situations of susceptibility were found; these should be better monitored and, if necessary, corrected to guarantee a homogeneous and lasting resistance of the European population towards polioviruses.

Screening for anxiety and depression in early adolescence.

OBJECTIVE: To examine the level of diagnostic and discriminative accuracy of three dimensional rating scales for detecting anxiety and depressive disorders in a school-based survey of 9th grade youths. METHOD: Classroom screening instruments, the Center for Epidemiologic Studies-Depression Scale (CES-D), the Revised Children's Manifest Anxiety Scale (RCMAS), and the Multidimensional Anxiety Scale for Children (MASC) were administered to 632 youths from three sites in 1998. On the basis of rating scale results, samples of high-scoring and non-high-scoring youths were invited to participate in a diagnostic interview conducted within 2 months of the screening sessions. RESULTS: MASC scores were most strongly associated with individual anxiety disorders, particularly among females, whereas the CES-D composite score was associated with a diagnosis of major depression, after controlling for comorbid disorders. The RCMAS was least successful in discriminating anxiety and depression. When receiver operator characteristic curves were examined, diagnostic accuracy was moderate. CONCLUSIONS: The ability of the MASC and CES-D to discriminate within and between categorically defined diagnostic groups has important implications for the accurate identification of youths in need of services.

Current trends in the understanding and treatment of social phobia in youth.

Social phobia is a common psychiatric problem in children and adolescents that has recently gained serious attention in clinical practice and research. This article describes the clinical presentation of social phobia and reviews several emergent areas of related research to social phobia in children and adolescents. We begin with a summary of research regarding the developmental pathways of childhood social anxiety into social phobia, highlighting normative developmental factors, behavioral inhibition, pathophysiology, genetics, and parenting/environmental factors. This is followed by a critical review of findings from studies providing evidence for and against the existence of subtypes of social phobia. Common comorbid disorders and sequelae of social phobia in children and adolescents are discussed, bringing to attention the critical need for effective treatments, the current status of which is reviewed in the final section. In sum, this review demonstrates that through research in multiple disciplines, scientists are now developing a better understanding of the risk and protective factors of social phobia in children and adolescents, ultimately leading to improvements in primary prevention and intervention efforts for children at serious risk for long-term problems with education, employment, social relationships, and independent adult functioning.

Cognitive-behavioral group therapy for social phobia in female adolescents: results of a pilot study.

OBJECTIVES: To examine the efficacy of cognitive-behavioral group therapy for adolescents (CBGT-A) in females with social phobia and the effect of this treatment on the risk for major depression. METHOD: Female adolescents with social phobia (N = 35) were randomly assigned to treatment (n = 12) or no treatment (n = 23) groups. Assessments were conducted at baseline, after treatment, and at a 1-year follow-up. RESULTS: Eleven subjects completed treatment. Sixteen weeks of treatment produced a significant improvement in interference and reduction in symptoms of social anxiety. There was a significant reduction in the number of subjects meeting DSM-IV criteria for social phobia in the CBGT-A versus the untreated group; however, at the 1-year follow-up there were no significant differences by treatment condition. There was also suggestive evidence that treatment of social phobia lowers the risk for relapse of major depression among those with a history of major depression. Combining social phobia and major depression as the outcome produced more robust treatment effects in the 1-year follow-up. CONCLUSIONS: This pilot study provides evidence for a moderate short-term effect of CBGT-A for treating female adolescents suffering from social phobia and indicates that treatment of social phobia may result in a reduction of major depression.

Survival ability of cytotoxic strains of motile Aeromonas spp. in different types of water.

The ability of motile Aeromonas spp. to survive in drinking water (mineral and tap water) and in sea water was experimentally tested. Clinically isolated cytotoxic strains of A. hydrophila, A. caviae and A. sobria were selected for this study. After contamination of water samples, the survival of Aeromonas strains was studied for at least three months using viable counts. The results obtained show that the survival of the Aeromonas spp. varies considerably depending on species and water type. For all three species, the survival time was longest in mineral water, where viable bacteria of each strain were still detected after 100 d. Moreover, A hydrophila and A. caviae also re-grew on the first day. In tap water all strains showed marked survival, although to a lesser extent than in mineral water. Aeromonas cells showed a rapid decline in sea water (90% reduction in viable cells after about two d) and thus seem to be more sensitive to saline/marine stress than chlorination.

Long-term follow up of a randomized, controlled trial on prophylactic sclerotherapy of small oesophageal varices in liver cirrhosis.

BACKGROUND: In order to evaluate the prophylactic impact of sclerotherapy of small varices in patients with cirrhosis and no endoscopic signs suggesting risk of haemorrhage, a randomized clinical trial was performed. METHODS: Seventy-one hospitalized patients met the inclusion criteria of diagnosis of cirrhosis with no previous bleeding and small varices. Due to exclusion criteria of: gastroduodenal ulcers (n = 5), diverticulosis (n = 1), hepatic insufficiency (n = 10), hepatocellular carcinoma (n = 4), death before randomization (n = 6), age over 70 (n = 1) and denial of consent to participate in the study (n = 1), 43 patients could be randomized, 21 for sclerotherapy and 22 for the control group. Two patients (one in each group) were lost to follow up, and another patient, although not lost, refused sclerotherapy after randomization. Ethanolamine oleate was used as the sclerosing agent. All patients were followed up for a mean time of 60 months, initially every 2 months for the first 2 years and clinical and endoscopic controls were performed each 6-12 months thereafter. RESULTS AND CONCLUSIONS: During the first 2 years clinical assessment showed that there were five bleedings in the sclerotherapy group and none in the control group, but mortality was similar in both groups. Long-term follow up continued to show a higher prevalence of bleeding in the sclerotherapy group but that mortality was not different from the control group.

Subtypes of social phobia in adolescents.

Thirty-three social phobic adolescents were asked to name their ten most feared social situations. Two independent judges classified each situation reported by the participants into one of four situational domains: formal speaking/interactions, informal speaking/interactions, observation by others, and assertion. Fifteen participants (45.5%) were assigned a generalized subtype of social phobia because they endorsed at least moderate anxiety in all four situational domains. This subgroup scored higher on self-report measures of anxiety and depression than the rest of the sample. These results provide empirical support for the existence of subtypes of social phobia in adolescents.

Cross-informant agreement in the assessment of social phobia in youth.

In the present study involving children and adolescents with a principal diagnosis of social phobia, we measured parent-child agreement regarding social anxiety symptoms. Additionally, we examined variables related to the severity of the children's social phobia symptoms as reported by children and as rated by clinicians. Examination of cross-informant agreement indicated little difference between mean parent and children ratings of the children's social fears. In contrast, there was a significant difference in parent and children ratings of the children's avoidance, with parents endorsing greater degrees of social avoidance. Children's report of social avoidance was negatively related to scores on a measure of self-presentational concerns (i.e., social desirability). Clinicians' determination of the severity of the children's social phobia was also influenced by the children's self-presentation as well as parent report of social avoidance and children's depression scores. Thus, this differential weighting by the clinician of parent versus child report may be related to the finding that children's self-reported social avoidance was negatively related to their concerns regarding positive self-presentation. Results suggest the need to consider the impact of social desirability when examining clinical characteristics of children and adolescents with social phobia.