Multivariate analysis in data science for the geospatial distribution of the breast cancer mortality rate in Colombia.

This research is framed in the area of biomathematics and contributes to the epidemiological surveillance entities in Colombia to clarify how breast cancer mortality rate (BCM) is spatially distributed in relation to the forest area index (FA) and circulating vehicle index (CV). In this regard, the World Health Organization has highlighted the scarce generation of knowledge that relates mortality from tumor diseases to environmental factors. Quantitative methods based on geospatial data science are used with cross-sectional information from the 2018 census; it's found that the BCM in Colombia is not spatially randomly distributed, but follows cluster aggregation patterns. Under multivariate modeling methods, the research provides sufficient statistical evidence in terms of not rejecting the hypothesis that if a spatial unit has high FA and low CV, then it has significant advantages in terms of lower BCM.

National Health Systems and COVID-19 Death Toll Doubling Time.

Coronavirus disease 2019 (COVID-19) has placed stress on all National Health Systems (NHSs) worldwide. Recent studies on the disease have evaluated different variables, namely, quarantine models, mitigation efforts, damage to mental health, mortality of the population with chronic diseases, diagnosis, use of masks and social distancing, and mortality based on age. This study focused on the four NHSs recognized by the WHO. These systems are as follows: (1) The Beveridge model, (2) the Bismarck model, (3) the National Health Insurance (NHI) model, and (4) the "Out-of-Pocket" model. The study analyzes the response of the health systems to the pandemic by comparing the time in days required to double the number of disease-related deaths. The statistical analysis was limited to 56 countries representing 70% of the global population. Each country was grouped into the health system defined by the WHO. The study compared the median death toll DT, between health systems using Mood's median test method. The results show high variability of the temporal trends in each group; none of the health systems for the three analyzed periods maintain stable interquartile ranges (IQRs). Nevertheless, the results obtained show similar medians between the study groups. The COVID-19 pandemic saturates health systems regardless of their management structures, and the result measured with the time for doubling death rate variable is similar among the four NHSs.

Reverse logistics models for the collection of plastic waste: A literature review.

To support the understanding of recycling models applied to plastics, the main objective of this work is to offer a literature review of the different reverse logistics (RL) models for collecting plastic waste (PW). The methodology used for processing the scientific literature was content analysis, using the google scholar search engine. The main keywords used were RL and PW. This article is divided into two parts: the first part discusses the development of circular economy models and RL networks and raises the conceptual framework of the research, and the second part presents mathematical models and exploratory studies, proposed as a solution for RL problems of PW. Articles published between years 2014 and 2019 were reviewed. In total, 102 references were used, 70 of them are part of the literature review. According to our findings, we can state that the most widely used solution method for mathematical modeling is mixed-integer linear programming, and for exploratory studies, it was evaluations. About 93% of studies evaluated raw materials related to PW; only 13% of studies had models with stochastic processes; and 88% of the investigations used continuous variables, being the multiobjective functions one of the most used to provide solutions to RL problems. Regarding the mathematical models, 49% were evaluations, 9% corresponded to multicriteria analysis, 29% to linear and nonlinear programming, and 4% to another type of evaluation or model.

New insights on the infection of pathogenic Leptospira species in American mink (Neovison vison) in southern Chile.

Leptospirosis is a zoonosis of global distribution, caused by the infection of pathogenic Leptospira, a group of bacteria capable of infecting both domestic and wild animals. Mink (Neovison vison) in southern Chile is recognized as a wild and synanthropic rodent predator (among various other prey), and Leptospira infection in them can be acquired through contact with the pathogen in the environment or by eating infected prey. Thus, the aim of this study was to provide more specifics regarding the source of the infection for the American mink under the conditions of Southern Chile. Minks were captured in the Los Ríos region, southern Chile, in an area with well-developed dairy farming. Two areas were selected for mink trapping, one with a high degree of dairy farming and a second with a low degree of dairy farming. Within them, 16 study sites were visited, and 45 American mink were trapped and euthanized to obtain kidney tissue and blood serum samples for bacteria isolation and determination of antibodies titers, respectively. Molecular characterization of the isolated strains was performed. Three minks from sites of high-dairy farming industry and only one from sites with low-degree dairy farming were detected as infected through molecular confirmation. This study shows evidence that confirms previous findings made in southern Chile, regarding mink as host of Leptospira interrogans serovar Hardjo-prajitno associated to cattle-farming areas. However, typing information ( Leptospira interrogans Copenhageni and Icterohaemorrhagiae ) suggests that the consumption of rodents may also be a potential source of infection.

Chaotic genetic algorithm and the effects of entropy in performance optimization.

This work proposes a new edge about the Chaotic Genetic Algorithm (CGA) and the importance of the entropy in the initial population. Inspired by chaos theory, the CGA uses chaotic maps to modify the stochastic parameters of Genetic Algorithm. The algorithm modifies the parameters of the initial population using chaotic series and then analyzes the entropy of such population. This strategy exhibits the relationship between entropy and performance optimization in complex search spaces. Our study includes the optimization of nine benchmark functions using eight different chaotic maps for each of the benchmark functions. The numerical experiment demonstrates a direct relation between entropy and performance of the algorithm.

Prevalence, Incidence, and Sex Ratio of Transsexualism in the Autonomous Region of Madrid (Spain) According to Healthcare Demand.

In recent years, different studies have provided estimates of the prevalence of transsexualism with very diverse results. The purpose of this study was to ascertain the prevalence, incidence, and sex ratio of transsexualism in the autonomous region of Madrid (Spain). A total of 1234 patients who attended from 2007 to the end of 2015 in the only Gender Identity Unit (GIU) in Madrid were analyzed. Sixty-three patients were excluded for various reasons; thus, 1171 could be included: 803 male-to-female (MtF) and 368 female-to-male (FtM) transsexual patients. Transsexualism was diagnosed based on the ICD-10, World Health Organization, 1992, and/or gender identity disorder based on the DSM-IV-TR, American Psychiatric Association, 2000. The demographic statistics were calculated on the basis of the population over 15 years old of Madrid. Based on healthcare demand, the prevalence of transsexualism was 22.1 in 100,000 inhabitants: 31.2 for MtF and 12.9 for FtM, making the MtF/FtM ratio approximately 2.2:1. The incidence rate was 2.5 in 100,000 inhabitants, representing an annual average of 130 demands. Although transsexualism occurs in all countries with different rates of prevalence, in our area, this prevalence was higher than reported from other European countries. We believe that two main circumstances might influence this high prevalence: the easy accessibility and the absence of a waiting list to the GIU, and the permissive social and legal climate and openness of Spain, especially in Madrid.

Building a Decision Support System for Inpatient Admission Prediction With the Manchester Triage System and Administrative Check-in Variables.

The usage of decision support tools in emergency departments, based on predictive models, capable of estimating the probability of admission for patients in the emergency department may give nursing staff the possibility of allocating resources in advance. We present a methodology for developing and building one such system for a large specialized care hospital using a logistic regression and an artificial neural network model using nine routinely collected variables available right at the end of the triage process.A database of 255.668 triaged nonobstetric emergency department presentations from the Ramon y Cajal University Hospital of Madrid, from January 2011 to December 2012, was used to develop and test the models, with 66% of the data used for derivation and 34% for validation, with an ordered nonrandom partition. On the validation dataset areas under the receiver operating characteristic curve were 0.8568 (95% confidence interval, 0.8508-0.8583) for the logistic regression model and 0.8575 (95% confidence interval, 0.8540-0. 8610) for the artificial neural network model. χ Values for Hosmer-Lemeshow fixed "deciles of risk" were 65.32 for the logistic regression model and 17.28 for the artificial neural network model. A nomogram was generated upon the logistic regression model and an automated software decision support system with a Web interface was built based on the artificial neural network model.

Emergency Department Visit Forecasting and Dynamic Nursing Staff Allocation Using Machine Learning Techniques With Readily Available Open-Source Software.

Although emergency department visit forecasting can be of use for nurse staff planning, previous research has focused on models that lacked sufficient resolution and realistic error metrics for these predictions to be applied in practice. Using data from a 1100-bed specialized care hospital with 553,000 patients assigned to its healthcare area, forecasts with different prediction horizons, from 2 to 24 weeks ahead, with an 8-hour granularity, using support vector regression, M5P, and stratified average time-series models were generated with an open-source software package. As overstaffing and understaffing errors have different implications, error metrics and potential personnel monetary savings were calculated with a custom validation scheme, which simulated subsequent generation of predictions during a 4-year period. Results were then compared with a generalized estimating equation regression. Support vector regression and M5P models were found to be superior to the stratified average model with a 95% confidence interval. Our findings suggest that medium and severe understaffing situations could be reduced in more than an order of magnitude and average yearly savings of up to €683,500 could be achieved if dynamic nursing staff allocation was performed with support vector regression instead of the static staffing levels currently in use.

Non-expanded adipose stromal vascular fraction cell therapy for multiple sclerosis.

The stromal vascular fraction (SVF) of adipose tissue is known to contain mesenchymal stem cells (MSC), T regulatory cells, endothelial precursor cells, preadipocytes, as well as anti-inflammatory M2 macrophages. Safety of autologous adipose tissue implantation is supported by extensive use of this procedure in cosmetic surgery, as well as by ongoing studies using in vitro expanded adipose derived MSC. Equine and canine studies demonstrating anti-inflammatory and regenerative effects of non-expanded SVF cells have yielded promising results. Although non-expanded SVF cells have been used successfully in accelerating healing of Crohn's fistulas, to our knowledge clinical use of these cells for systemic immune modulation has not been reported. In this communication we discuss the rationale for use of autologous SVF in treatment of multiple sclerosis and describe our experiences with three patients. Based on this rationale and initial experiences, we propose controlled trials of autologous SVF in various inflammatory conditions.

Reducción del colesterol y aumento de la capacidad antioxidante por el consumo crónico de maíz morado (zea mays L) en ratas hipercolesterolémicas / Cholesterol reduction and increase of antioxidant capacity by chronic consupmtion of andean purle corn (zea mays L) in hypercholesterolemic rats

Objetivos: Determinar la actividad hipocolesterolémica y antioxidante del consumo crónico del extracto hidroalcohólico atomizado del maíz morado (Zea mays L) en ratas hipercolesterolémicas. Materiales y métodos: Se utilizaron cincogrupos de seis ratas Holtzmann cada uno, uno sin hipercolesterolemia (control negativo), y cuatro con hipercolesterolemia inducida por consumo de colesterol puro vía oral durante 60 días: control positivo y tres para las dosis de 250, 500 y 1000 mg/kg, respectivamente. En el día 60 se determinaron los niveles séricos de colesterol total, triglicéridos ycolesterol HDL (mg/dL), así como de malondialdehido (mmol/L) para determinar la actividad antioxidante. Se comparó la diferencias de medias con ANOVA y test de Tukey. Resultados: Se observó una disminución del colesterol total en las ratas hipercolesterolémicas que consumieron dosis de 250 y 500 mg/kg en relación con el grupo control positivo (reducción de 21,5 y 11,2 por ciento respectivamente, p menor que 0,01). No se observaron diferencias significativas sobre los niveles de triglicéridos y colesterol HDL. A mayor dosis se maíz morado se encontró una mayor reducción de radicales libres, conla dosis de 1000 mg/kg se redujo en 56,4 por ciento los niveles de malondialdehido (p menor que menor que 0,01). Conclusiones: En condiciones experimentales, el consumo crónico del extracto hidroalcohólico atomizado de maíz morado disminuye los niveles decolesterol total y aumenta la capacidad antioxidante.

Objetives: To determine the hypocholesterolemic antioxidant activity of the Andean purple corn (Zea mays L)hydroalcoholic extract atomized chronic consumption in hypercholesterolemic rats. Material and methods: Five groupsof six Holtzmann rats each were used, one without hypercholesterolemia (negative control), and four with inducedhypercholesterolemia by oral intake of pure cholesterol by 60 days: positive control and three for doses of 250, 500 y1000 mg/kg, respectively. In 60 day were determin the seric levels of total cholesterol, triglycerides and HDL cholesterol (mg/dL), as well as malondialdehyde (mmol/L) to determine the antioxidant activity. We compared the mean differneceswith ANOVA and Tukey test. Results: We observed a decrease in total cholesterol in hypercholesterolemic rats thatconsumed Andean purple corn doses of 250 and 500 mg/kg in compared whit positive control group (reduction of 21,5y 11,2 percentage respectively, pminor than 0,01). No significant differences in levels of triglycerides and HDL cholesterol were observed. A higher dose is purple corn was a further reduction of free radicals, with a dose of 1000 mg/kg decreased by 56.4 porcentage, levels of malondialdehyde (p minor than 0,01). Conclusions: In experimental conditions, the chronic consumption of the hydroalcoholic atomized extract of Andean purple corn decreased total cholesterol and increased the antioxidant capacity.

Profilaxis analgésica en estomatología / Prophylactic analgesic in stomatology

La profilaxis analgésica es un nuevo concepto como método para prevenir el dolor postoperatorio. Se revisan conceptos del proceso inflamatorio, así como también el papel que desempeñan los mediadores químicos del dolor y la inflamación como las prostaglandinas catalizadas por la enzima COX-2 una isoforma de la enzima Ciclooxigenas. Se han considerado estudios clínicos de eficacia analgésica seguridad de los AINESs utilizados para este propósito. Los resultados obtenidos en estos estudios evidencian que la profilaxis analgésica es tan efectiva como el control del dolor postoperatorio, pero con muchas ventajas como una mayor disminución del edema postoperatorio y una menor ingesta de medicamentos con la consecuente disminución de los efectos adversos inherentes a estos fármacos.

Analgesic prophylaxis is a new concept as a method to prevent the postoperative pain. Concepts in inflammatory process, are revied as well as the function in the pain and inflammation of chemical factors like prostaglandins catalyzed by the COX-2 enzyme an isoform of cyclooxygenase. Analgesic efficacy and AINESs safety clinic assay, have been considered. The results obtained in these studies evidence that analgesic prophylaxis is as effective as postoperative pain control, but with many vantages like a less facial swelling postoperative and a less drugs intake with a less appearance of adverse effect proper of these drugs.

Trypanocidal constituents in plants 5. Evaluation of some Mexican plants for their trypanocidal activity and active constituents in the seeds of Persea americana.

Crude extracts of Mexican medicinal plants were screened for trypanocidal activity against Trypanosoma cruzi, which is the etiological agent for Chagas' disease, one of the most serious protozoan diseases in Latin America. There were 71 kinds of methanolic and other organic extracts from 65 plants, which were newly examined by a preliminary screening test to observe immobilization of epimastigotes and trypomastigotes of T. cruzi in vitro. The MeOH extract of seeds of Persea americana (avocado) showed moderate activity against epimastigotes. In order to identify the principal compounds for the activity, the MeOH extract was subjected to bioassay-guided fractionation. From the active fractions, six 1,2,4-trihydroxyheptadecane derivatives and two 1,2,4-trihydroxynonadecane derivatives including a new one were isolated. These compounds showed moderate activity against epimastigotes and trypomastigotes.

Short-term retention properties of cements for retrievable implant-supported prostheses.

This in vitro study compared the retentive ability of 11 materials used to cement cast crowns on one implant system. The crowns were cemented to the abutments and the tensile load necessary to remove each casting was measured 30 minutes after cementation in a dry condition at 22 degrees C and after storage for 72 hours in saline solution at 37 degrees C. The results provide a ranking order of the tested materials according to their ability to retain implant restorations. This information, along with studies that better represent the effect of aging, may assist the clinician in selecting a material that is retentive enough to withstand occlusal forces, yet weak enough to allow easy retrieval of cement-retained implant restorations.

An interdisciplinary approach for improved esthetic results in the anterior maxilla.

This clinical report describes an interdisciplinary (orthodontic, periodontic, and prosthodontic) approach for the coordinated treatment of a patient diagnosed with peg-shaped maxillary lateral incisors, diastemata, short clinical crowns, excessive gingival display, and orthodontic malocclusion. The patient's specific esthetic expectations for the anterior maxilla were successfully met through phased treatment, including orthodontic tooth movement, provisional restorations, periodontal surgery for lengthening of the clinical crown, porcelain laminate veneers, and direct composite restorations. Such coordinated interdisciplinary evaluation and treatment are necessary for improved esthetic results in maxillary anterior areas esthetically compromised in several aspects.

Farmacoterapia en mujeres gestantes y durante la lactancia / Drug therapy in pregnant women and during breastfeeding

El embarazo representa un proceso de organogénesis, maduración y crecimiento de un embrión, desde el momento de la fecundación hasta que éste nace. El proceso dura cerca de 280 días contados a partir del final de la última menstruación. Durante este período, debemos de tener en cuenta que se establece una comunicación íntima entre la vida de la madre y la del hijo, lo cual comprende además una donación de nutrientes a partir de la madre. Si bien es cierto, la comunicación sanguínea que se establece no estotalmente íntima, es porque existe una membrana o barrera que separa tanto a la circulación materna como a la embrionario o fetal: la barrera placentaria o placenta. Cualquier sustancia que ingrese al organismo de la gestante, pasará en mayor o menor medida a través de la placenta, ocasionanado probablemente daño embrionario o fetal, dependiendo de la naturaleza de la sustancia

El botiquín de emergencias: nuestro seguro en la dificultad / The medicine kit of emergencies: our insurance in the difficulty

Las emergencias que se presentan durante los tratamientos odontológicos no solamente se relacionan al empleo de medicamentos, sino también pueden ser el resultado de complicaciones del estado de salud general de los pacientes, tan diversos como asma bronquial, infarto agudo de miocardio, etc., por lo que el planeamiento y tratamiento de estas situaciones pasan por contar con un adecuado botiquín de emergencias. El diagnóstico, tratamiento y la confección y mantenimiento de nuestro botiquín son revisados en este artículo.

Anestesia epidural con linmdocaina epinefrina: efectos de la adicion fentanyl y/o bicarbonato de sodio / Epidural anesthesia with lidocaine epinephrine: effects of the combination with fentanyl and for sodium bicarbonale

Se analizaron las características de la anestesia epidural en 4 grupos de pacientes: Grupo 1: lidocaína 2% con epinefrina, 3 mg/kg; Grupo III: Lidocaína 2% con epinefrina, 3 mg/kg más citrato de fentanil 3 ug/kg; Grupo III: Lidocaína al 2% con epinefrina 3 mg/kg más bicarbonato de sodio; Grupo IV: lidocaína al 2% con epinefrina, 3 mg/kg más citrato de fentanil 3 ug/kg más bicarbonato de sodio. La adición de bicarbonato de sodio y/o fetanil a la solución de lidocaína epinefrina redujo la latencia e incrementó significativamente la intensidade del efecto anestésico. La duración del efectos anestésico fue significativamente mayor en los grupos de las soluciones anestésicas que contenían fentanil, además la ausencia de bloqueo motor en estas soluciones, contrastó con el bloqueo parcial o total de las soluciones que no contenían fentanil. No ocurrió hipotensión en los grupos II, III o IV. Se sustenta la possibilidad de modificar las características de la anestesia epidural mediante la adicion de fentanyl y/o bicarbonato de sodio a la solución de lidocaína-epinefrina para administración epidural

Efectos del dehidro benzoperidol y del clorhidrato de diazepam sobre la actividad epileptoide inducida por el citrato de fentanyl en humanos / Effects of droperidol and diazepam upon epileptoid activity induced by fentanyl in humans

La presencia y características de fenómenos electroencefalográficos de actividad epileptoide se estudiaron en tres grupos de 8 pacientes durante 30 minutos a partir de la administración de los siguientes fármacos: Grupo I, citrato de fentanil 30 nM/Kg (15 mcg/Kg.) IV; Grupo II, citrato de fentanil 30 mM/Kg (15 mcg./Kg) IV y dehidrobenzoperidol 263 nM/Kg. (100 mcg./Kg.) IV; Grupo III, citrato de fentanil 30 nM/Kg. (15 MCG./Kg.) IV y clorhidrato de diazepam 877 nM/KG.) IV.). En 7 de los 8 pacientes del grupo I se registraron espigas aisladas y poliespigas (4-6 por segundo), predominantes en las derivaciones temporo-occipitales durante los 30 minutos de registro. En los grupos II y III, la incidencia de estos fenómenos electroencefalográficos epileptoides se redujo a 2 de 8 pacientes de cada grupo (P<0.02.X2 de Pearson para cada grupo comparado con el grupo I) y, en estos casos desaparecieron dentro de los 15 minutos inmediatos a la administración de los fármacos. El EEG de los pacientes de estos grupos II y III se caracterizó asimismo por la presencia de grupos de ondas theta hipersincrónicas. La asociación de dehidrobenzoperidol o clorhidrato de diazepam, con citrato de fentanil es conveniente en los procedimientos anestésicos para neurocirugía