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1.
Epidemiologia (Basel) ; 5(2): 167-186, 2024 Apr 10.
Artigo em Inglês | MEDLINE | ID: mdl-38651389

RESUMO

Our goal was to determine the cellular immune response (CIR) in a sample of the Borriana COVID-19 cohort (Spain) to identify associated factors and their relationship with infection, reinfection and sequelae. We conducted a nested case-control study using a randomly selected sample of 225 individuals aged 18 and older, including 36 individuals naïve to the SARS-CoV-2 infection and 189 infected patients. We employed flow-cytometry-based immunoassays for intracellular cytokine staining, using Wuhan and BA.2 antigens, and chemiluminescence microparticle immunoassay to detect SARS-CoV-2 antibodies. Logistic regression models were applied. A total of 215 (95.6%) participants exhibited T-cell response (TCR) to at least one antigen. Positive responses of CD4+ and CD8+ T cells were 89.8% and 85.3%, respectively. No difference in CIR was found between naïve and infected patients. Patients who experienced sequelae exhibited a higher CIR than those without. A positive correlation was observed between TCR and anti-spike IgG levels. Factors positively associated with the TCR included blood group A, number of SARS-CoV-2 vaccine doses received, and anti-N IgM; factors inversely related were the time elapsed since the last vaccine dose or infection, and blood group B. These findings contribute valuable insights into the nuanced immune landscape shaped by SARS-CoV-2 infection and vaccination.

2.
Nat Plants ; 10(5): 760-770, 2024 May.
Artigo em Inglês | MEDLINE | ID: mdl-38609675

RESUMO

Perennial plants create productive and biodiverse hotspots, known as fertile islands, beneath their canopies. These hotspots largely determine the structure and functioning of drylands worldwide. Despite their ubiquity, the factors controlling fertile islands under conditions of contrasting grazing by livestock, the most prevalent land use in drylands, remain virtually unknown. Here we evaluated the relative importance of grazing pressure and herbivore type, climate and plant functional traits on 24 soil physical and chemical attributes that represent proxies of key ecosystem services related to decomposition, soil fertility, and soil and water conservation. To do this, we conducted a standardized global survey of 288 plots at 88 sites in 25 countries worldwide. We show that aridity and plant traits are the major factors associated with the magnitude of plant effects on fertile islands in grazed drylands worldwide. Grazing pressure had little influence on the capacity of plants to support fertile islands. Taller and wider shrubs and grasses supported stronger island effects. Stable and functional soils tended to be linked to species-rich sites with taller plants. Together, our findings dispel the notion that grazing pressure or herbivore type are linked to the formation or intensification of fertile islands in drylands. Rather, our study suggests that changes in aridity, and processes that alter island identity and therefore plant traits, will have marked effects on how perennial plants support and maintain the functioning of drylands in a more arid and grazed world.


Assuntos
Herbivoria , Solo , Solo/química , Plantas , Ecossistema , Clima Desértico , Animais
4.
Struct Dyn ; 10(5): 054502, 2023 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-37901681

RESUMO

Intense x-ray pulses can cause the non-thermal structural transformation of diamond. At the SACLA XFEL facility, pump x-ray pulses triggered this phase transition, and probe x-ray pulses produced diffraction patterns. Time delays were observed from 0 to 250 fs, and the x-ray dose varied from 0.9 to 8.0 eV/atom. The intensity of the (111), (220), and (311) diffraction peaks decreased with time, indicating a disordering of the crystal lattice. From a Debye-Waller analysis, the rms atomic displacements perpendicular to the (111) planes were observed to be significantly larger than those perpendicular to the (220) or (311) planes. At a long time delay of 33 ms, graphite (002) diffraction indicates that graphitization did occur above a threshold dose of 1.2 eV/atom. These experimental results are in qualitative agreement with XTANT+ simulations using a hybrid model based on density-functional tight-binding molecular dynamics.

5.
Univers Access Inf Soc ; : 1-19, 2023 Mar 24.
Artigo em Inglês | MEDLINE | ID: mdl-37361672

RESUMO

Cognitive accessibility aims to make content more accessible for people with cognitive impairments, such as the elderly and people with intellectual and learning disabilities. In this sense, it is possible to design an accessible user interface from a cognitive point of view. As a contribution, this article presents cognitive accessibility design patterns and their application in designing the Easier web system's user interface. The Easier web system provides a tool that assists in the understanding and readability of text content geared towards people with intellectual disabilities. It detects complex words and offers easier replacements and other resources such as a definition of the complex word. In addition to applying the design patterns, user tests with people with intellectual disabilities and older people have been carried out to evaluate the cognitive accessibility of the Easier system's interface. The results indicate that people with cognitive impairments know how to use the interfaces and have a satisfactory experience. In addition, a design proposal to provide a glossary mechanism to be used in web interfaces with simplified texts is presented and validated.

6.
Ecosystems ; 26(3): 585-596, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-37179798

RESUMO

Accumulating evidence suggests that warming associated with climate change is decreasing the total amount of soil organic carbon (SOC) in drylands, although scientific research has not given enough emphasis to particulate (POC) and mineral-associated organic carbon (MAOC) pools. Biocrusts are a major biotic feature of drylands and have large impacts on the C cycle, yet it is largely unknown whether they modulate the responses of POC and MAOC to climate change. Here, we assessed the effects of simulated climate change (control, reduced rainfall (RE), warming (WA), and RE + WA) and initial biocrust cover (low (< 20%) versus high (> 50%)) on the mineral protection of soil C and soil organic matter quality in a dryland ecosystem in central Spain for 9 years. At low initial biocrust cover levels, both WA and RE + WA increased SOC, especially POC but also MAOC, and promoted a higher contribution of carbohydrates, relative to aromatic compounds, to the POC fraction. These results suggest that the accumulation of soil C under warming treatments may be transitory in soils with low initial biocrust cover. In soils with high initial biocrust cover, climate change treatments did not affect SOC, neither POC nor MAOC fraction. Overall, our results indicate that biocrust communities modulate the negative effect of climate change on SOC, because no losses of soil C were observed with the climate manipulations under biocrusts. Future work should focus on determining the long-term persistence of the observed buffering effect by biocrust-forming lichens, as they are known to be negatively affected by warming. Supplementary Information: The online version contains supplementary material available at 10.1007/s10021-022-00779-0.

7.
PLoS One ; 18(4): e0283622, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-37043424

RESUMO

Thanks to technologies such as the Internet and devices now available to people, we have increasingly greater access to larger quantities of information. However, people with ageing disabilities or intellectual disabilities, non-native speakers, and others have difficulties reading and understanding information. For this reason, it is essential to provide text simplification mechanisms when accessing information. Natural Language Processing methods can be applied to simplify textual content and improve understanding. These methods often use machine learning algorithms and models which require resources, such as corpora, to be trained and tested. This article presents the EASIER corpus, a resource that can be used to build lexical simplification methods to process Spanish domain-independent texts. The EASIER corpus is composed of 260 annotated documents with 8,155 words labelled as complex and 5,130 words with at least one proposed context-aware synonym associated. Expert linguists in easy-to-read and plain language guidelines have annotated the corpus based on their experience adapting texts for people with intellectual disabilities. Sixteen annotation guidelines that discriminate between complex and simple words have been defined to help other groups of experts to generate new annotations. Additionally, an inter-annotator agreement test was performed to validate the corpus, obtaining a Fleiss Kappa coefficient of 0.641. Furthermore, a qualitative evaluation was conducted with 45 users (including people with intellectual disabilities, elderly people, and a control audience). Complex word identification tasks achieved moderate results, but the synonyms proposed to replace complex words achieved almost perfect ratings. This resource has been integrated into the EASIER platform, a tool that helps people with cognitive impairments and intellectual disabilities to read and understand texts more easily.


Assuntos
Disfunção Cognitiva , Deficiência Intelectual , Humanos , Idoso , Semântica , Idioma , Algoritmos , Processamento de Linguagem Natural
8.
Database (Oxford) ; 20232023 02 03.
Artigo em Inglês | MEDLINE | ID: mdl-36734300

RESUMO

This study presents the outcomes of the shared task competition BioCreative VII (Task 3) focusing on the extraction of medication names from a Twitter user's publicly available tweets (the user's 'timeline'). In general, detecting health-related tweets is notoriously challenging for natural language processing tools. The main challenge, aside from the informality of the language used, is that people tweet about any and all topics, and most of their tweets are not related to health. Thus, finding those tweets in a user's timeline that mention specific health-related concepts such as medications requires addressing extreme imbalance. Task 3 called for detecting tweets in a user's timeline that mentions a medication name and, for each detected mention, extracting its span. The organizers made available a corpus consisting of 182 049 tweets publicly posted by 212 Twitter users with all medication mentions manually annotated. The corpus exhibits the natural distribution of positive tweets, with only 442 tweets (0.2%) mentioning a medication. This task was an opportunity for participants to evaluate methods that are robust to class imbalance beyond the simple lexical match. A total of 65 teams registered, and 16 teams submitted a system run. This study summarizes the corpus created by the organizers and the approaches taken by the participating teams for this challenge. The corpus is freely available at https://biocreative.bioinformatics.udel.edu/tasks/biocreative-vii/track-3/. The methods and the results of the competing systems are analyzed with a focus on the approaches taken for learning from class-imbalanced data.


Assuntos
Mineração de Dados , Processamento de Linguagem Natural , Humanos , Mineração de Dados/métodos
9.
Epidemiologia (Basel) ; 4(1): 63-73, 2023 Jan 28.
Artigo em Inglês | MEDLINE | ID: mdl-36810454

RESUMO

Our objective was to estimate the incidence of COVID-19 and the ABO blood Groups in the mass-gathering events (MGEs) during the Falles Festival in Borriana (Spain) from 6-10 March 2020. We conducted a population-based retrospective cohort study and measured anti-SARS-CoV-2 antibodies and the ABO of participants. We performed laboratory COVID-19 tests and obtained the ABO in 775 subjects (72.8% of the original exposed cohort): O-group (45.2%), A-group (43.1%), B-group (8.5%) and AB-group (3.4%). Adjusted for confounding factors, including COVID-19 exposure during the MGEs, attack rates of COVID-19 for each ABO group were 55.4%, 59.6%, 60.2%, and 63.7%. The adjusted relative risks were for O-group 0.93 (95% Confidence Interval [CI] 0.83-1.04), for A-group 1.06 (95% CI 0.94-1.18), for B-group 1.04 (95%CI 0.88-1.24), and for AB-group 1.11 (95% CI 0.81-1.51) with no significant differences. Conclusions: Our results suggest no effect of ABO on COVID-19 incidence. We observed weak but not significant protection of the O-group and not a significantly greater infection risk for the remaining groups compared with the O-group. More studies are needed to resolve the controversies regarding the association between ABO and COVID-19.

10.
Aten. prim. (Barc., Ed. impr.) ; 55(2): 102529-102529, Feb. 2023. tab
Artigo em Espanhol | IBECS | ID: ibc-215145

RESUMO

Objetivo: Conocer los elementos que formarían parte de una adecuada asistencia sociosanitaria a personas mayores viviendo en centros residenciales, identificar barreras y facilitadores a dicha asistencia y el papel de la Atención Primaria. Diseño: Metodología cualitativa con un enfoque fenomenológico. Emplazamiento: Centro de salud urbano y centro residencial concertado adscrito en la zona sureste de la Comunidad de Madrid. Participantes: Personas mayores residentes, sus familiares y profesionales de la residencia y del Equipo de Atención Primaria. Método: Se realizaron 5 grupos focales entre noviembre de 2019 y enero de 2020, con entrevista semiestructurada a partir de las variables de análisis y dimensiones de interés para los objetivos. Las sesiones fueron grabadas y transcritas. Se realizó una codificación abierta y axial para identificar las categorías y una triangulación de los datos. Resultados: Los elementos de una adecuada asistencia son la atención a la persona, la promoción de la autonomía, la información adecuada a residentes y familiares, la calidad de los servicios, la coordinación entre profesionales y unos cuidados continuos en el final de la vida. Son barreras el déficit de profesionales, las diferencias de expectativas entre usuarios y trabajadores y la brecha organizativa entre el sistema sanitario y la asistencia propia en residencias sanitarizadas. El papel de la Atención Primaria queda definido por su función burocrática. Conclusiones: Es necesario continuar explorando estos elementos y perfilar el papel de la Atención Primaria en entornos residenciales de diferentes características.(AU)


Aim: To identify the elements involved in adequate health and social care for old people living in nursing homes, determine their possible barriers and enablers and define primary care's role in it. Design: Qualitative study with phenomenological approach. Setting: State funded private nursing home and its corresponding primary care center in the southeastern urban area of Madrid. Participants: Elderly residents, their relatives, and professionals from the nursing home and the primary care center. Method: Five focus groups were conducted between November 2019 and January 2020, with semi-structured interviews based on the variables of analysis and themes related to the objectives. The sessions were recorded and transcribed. An open and axial coding was performed to identify categories after a triangulation of the data. Results: The elements of adequate care identified are individualized care, promotion of autonomy, adequate information to residents and relatives, quality of services, coordination between professionals, and a continuous end of life care. The main barriers are the deficit of professionals, the differences in expectations between users and workers, and the organizational gap between the healthcare system and nursing homes providing healthcare services. The role identified for primary care is mostly bureaucratic. Conclusions: It is necessary to continue exploring these elements and to outline the role of primary care in nursing homes with different characteristics.(AU)


Assuntos
Humanos , Masculino , Feminino , Idoso , Atenção Primária à Saúde , Instituições Residenciais , Família , Instituição de Longa Permanência para Idosos , Assistência Terminal , Serviços de Saúde , 25783 , Inquéritos e Questionários , Espanha
11.
Aten Primaria ; 55(2): 102529, 2023 02.
Artigo em Espanhol | MEDLINE | ID: mdl-36565598

RESUMO

AIM: To identify the elements involved in adequate health and social care for old people living in nursing homes, determine their possible barriers and enablers and define primary care's role in it. DESIGN: Qualitative study with phenomenological approach. SETTING: State funded private nursing home and its corresponding primary care center in the southeastern urban area of Madrid. PARTICIPANTS: Elderly residents, their relatives, and professionals from the nursing home and the primary care center. METHOD: Five focus groups were conducted between November 2019 and January 2020, with semi-structured interviews based on the variables of analysis and themes related to the objectives. The sessions were recorded and transcribed. An open and axial coding was performed to identify categories after a triangulation of the data. RESULTS: The elements of adequate care identified are individualized care, promotion of autonomy, adequate information to residents and relatives, quality of services, coordination between professionals, and a continuous end of life care. The main barriers are the deficit of professionals, the differences in expectations between users and workers, and the organizational gap between the healthcare system and nursing homes providing healthcare services. The role identified for primary care is mostly bureaucratic. CONCLUSIONS: It is necessary to continue exploring these elements and to outline the role of primary care in nursing homes with different characteristics.


Assuntos
Atenção à Saúde , Casas de Saúde , Humanos , Idoso , Pesquisa Qualitativa , Atenção Primária à Saúde , Apoio Social
12.
Glob Chang Biol ; 29(2): 522-532, 2023 01.
Artigo em Inglês | MEDLINE | ID: mdl-36305858

RESUMO

Soil micronutrients are capital for the delivery of ecosystem functioning and food provision worldwide. Yet, despite their importance, the global biogeography and ecological drivers of soil micronutrients remain virtually unknown, limiting our capacity to anticipate abrupt unexpected changes in soil micronutrients in the face of climate change. Here, we analyzed >1300 topsoil samples to examine the global distribution of six metallic micronutrients (Cu, Fe, Mn, Zn, Co and Ni) across all continents, climates and vegetation types. We found that warmer arid and tropical ecosystems, present in the least developed countries, sustain the lowest contents of multiple soil micronutrients. We further provide evidence that temperature increases may potentially result in abrupt and simultaneous reductions in the content of multiple soil micronutrients when a temperature threshold of 12-14°C is crossed, which may be occurring on 3% of the planet over the next century. Altogether, our findings provide fundamental understanding of the global distribution of soil micronutrients, with direct implications for the maintenance of ecosystem functioning, rangeland management and food production in the warmest and poorest regions of the planet.


Assuntos
Poluentes do Solo , Solo , Ecossistema , Micronutrientes/análise , Poluentes do Solo/análise , Mudança Climática
13.
Rev Esp Enferm Dig ; 115(7): 400-401, 2023 07.
Artigo em Inglês | MEDLINE | ID: mdl-36353960

RESUMO

A 76-year-old man presented with dysphagia, epigastric pain and weight loss for the last two months. Heavy sweating was also presented. Past medical conditions included type 2 diabetes. He had no evidence of any immunosupressive disease including HIV infection. Physical examination only revealed low-grade fever. Laboratory data showed leukocytosis. Gastroscopy evidenced a complete esophageal stenosis starting at 30 cm, with a severely friable mucosa of malignant appearance. The results of biopsies were insufficient for diagnosis of malignancy. Computed tomography demonstrated a 10-cm irregular tumor located in the distal and middle thirds of the esophagus, which resulted in narrowing of the lumen. Involving tracheal carina, bronchus, and descending aorta were observed. Perforation signs were also seen. Distant metastases were not found. Empirical treatment with piperacillin/tazobactan was started. A surgical gastrostomy to allows nutritional support was performed. Two other gastroscopies were performed resulting in an inconclusive diagnosis. Finally, flow cytometry performed in samples obtained by endobronchial ultrasound-guided biopsy evidenced prominent clonal B-cell populations consistent with extranodal diffuse large B-cell lymphoma exhibing CD10 expression. A treatment with Rituximab in combination with cyclophosphamide, doxorubicin, vincristine, and prednisone (R-CHOP) was started. Primary esophageal diffuse large B-cell lymphoma (DLBCL), a variant of non-Hodgkin's lymphoma, accounts for less than 1% of all cases of gastrointestinal lymphomas.


Assuntos
Diabetes Mellitus Tipo 2 , Infecções por HIV , Linfoma Difuso de Grandes Células B , Masculino , Humanos , Idoso , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Linfoma Difuso de Grandes Células B/diagnóstico por imagem , Linfoma Difuso de Grandes Células B/tratamento farmacológico , Rituximab , Vincristina/uso terapêutico , Ciclofosfamida/uso terapêutico , Prednisona/uso terapêutico , Doxorrubicina/uso terapêutico
15.
Arch. pediatr. Urug ; 93(2): e205, dic. 2022. graf, tab
Artigo em Espanhol | LILACS, UY-BNMED, BNUY | ID: biblio-1383652

RESUMO

En marzo de 2020 se confirma el primer caso de enfermedad por coronavirus en Uruguay, recomendándose un confinamiento social. La atención sanitaria se redujo a servicios de urgencia y emergencia (SE). Objetivo: analizar las características de las consultas pediátricas en los SE del subsector público y privado en Uruguay, durante los primeros 4 meses de la pandemia por SARS-CoV-2. Metodología: estudio descriptivo, retrospectivo, multicéntrico. Resultados: participaron 23 SE de todas las regiones del país. Período 1 prepandemia: 14/03/19-29.07.19, período 2: 14/03/20-29/07/20 Consultas: período 1 n=121.116, período 2 n=33.099 (desciende 73%). Hospitalizaciones desde el SE: período 1 n= .6649 (tasa 5,5%). Período 2: n=2.948 (tasa 9,5%). Diagnósticos período 1: infección respiratoria aguda (IRA) alta 39.892 (33%), IRA baja 86.56 (7%), trauma menor 8.651 (7%), gastroenteritis 8.044 (6,6%), crisis asmática/CBO 7.974 (6,5%), lesiones 4.389 (3,6%), dolor abdominal 3.528 (3%), problemas de salud mental 859 (0,7%), convulsiones 758 (0,7%), patología social 678 (0,5%). Diagnósticos 2020: IRA alta 5.168 (16%), trauma menor 2.759 (8%), lesiones 2.652 (8%), dolor abdominal 1.494 (4,5%), gastroenteritis 1.296 (4%), asma/CBO 1.095 (3,3%), IRA baja 700 (2,1%), patología social 522 (1,6%), problemas de salud mental 471 (1,4%), convulsiones 408 (1,2%). Conclusiones: en los primeros meses de la pandemia hubo una reducción sostenida y significativo de consultas pediátricas en los SE. No hubo aumento en frecuencia absoluta de ninguno de los diagnósticos. Se registró un descenso histórico de las IRA bajas y las hospitalizaciones por esta causa en todo el país. Mantener una vigilancia de las consultas en los SE permitiría identificar e intervenir oportunamente si se produjeran cambios o situaciones de riesgo hasta el momento no detectadas.


In March 2020 the first case of coronavirus disease was confirmed in Uruguay, and lockdown was recommended. Health care services were reduced to Urgency and Emergency Services (ES). Objectives: to analyze the epidemiological characteristics of pediatric visits to the ES of the public and private subsector in Uruguay, during the first 4 months of the SARS-CoV-2 pandemic. Methods: descriptive, retrospective. Results: 23 institutions participated. 2 periods were considered: 1) pre-pandemic, 03/14/19 to 07/29/19, 2) 03/14/20 to 07/29/20. Visits: period 1: n=121,116 (< 15 years), period 2: n=33.099 (73% decrease). Hospital admissions: period 1: n=6,649 (rate 5.5). Period 2: n=2.948 (rate 9,5). Diagnoses period 1: High acute respiratory infection 39,892 (33%), low acute respiratory infection 8,656 (7%), minor trauma 8,651 (7%), gastroenteritis 8,044 (6,6%), asthmatic crisis/CBO 7.974 (6,5%), injuries 4,389 (3,6%), abdominal pain (3,528) 3%, mental health problems 859 (0.7%), seizures 758 (0.7%), social pathology 678 (0.5% ). 2020 diagnoses: high acute respiratory infection 5.168 (16%), minor trauma 2,759 (8%), injuries 2,652 (8%), abdominal pain 1,494 (4.5%), gastroenteritis 1,296 (4%), asthma/CBO 1,095 (3,3%), low acute respiratory infection 700 (2,1%), social pathology 522 (1,6%), mental health problems 471 (1,4%), seizures 408 (1,2%). Conclusions: in the first months of the pandemic there was a sustained and significant reduction in pediatric consultations in ES. There was no increase in absolute frequency of any of the diagnoses. There was a historical decrease in low respiratory infections and hospitalizations due to this cause in the whole country. Maintaining a surveillance of the visits in the ES would enable practitioners to identify and take action in case of changes or previously undetected risk situations.


Em março de 2020, foi confirmado o primeiro caso de doença por coronavírus no Uruguai, recomendando o confinamento. A assistência à saúde foi reduzida a serviços de urgência e emergência (SE). Objetivo: analisar as características das consultas pediátricas no SE do subsetor público e privado no Uruguai, durante os primeiros 4 meses da pandemia de SARS-CoV-2. Metodologia: estudo descritivo, retrospectivo, multicêntrico. Resultados: participaram 23 SEs de todas as regiões do país. Período pré-pandemia 1: 14/03/19-29/07/19, período 2: 14/03/20-29/07/20 Consultas: período 1 n=121.116, período 2 n=33.099 (redução de 73%) . Internações da SE: período 1 n= 0,6649 (taxa 5,5%). Período 2: n=2.948 (taxa de 9,5%). Diagnósticos do período 1: infecção respiratória aguda alta (IRA) 39.892 (33%), LRA baixa 86,56 (7%), trauma menor 8.651 (7%), gastroenterite 8.044 (6,6%), crise asmática/CBO 7.974 (6, 5% ), lesões 4.389 (3,6%), dor abdominal 3.528 (3%), problemas de saúde mental 859 (0,7%), convulsões 758 (0,7%), patologia social 678 (0,5%). Diagnósticos 2020: IRA alta 5.168 (16%), trauma leve 2.759 (8%), lesões 2.652 (8%), dor abdominal 1.494 (4,5%), gastroenterite 1.296 (4%), asma/CBO 1.095 (3, 3%), IRA baixa 700 (2,1%), patologia social 522 (1,6%), problemas de saúde mental 471 (1,4%), convulsões 408 (1,2%). Conclusões: nos primeiros meses da pandemia houve uma redução sustentada e significativa das consultas pediátricas no SE. Não houve aumento na frequência absoluta de nenhum dos diagnósticos. Foi registrado um decréscimo histórico de IRAs baixas e internações por essa causa em todo o país. A manutenção de uma vigilância das consultas no SE permitiria identificar e intervir atempadamente nos casos de alterações ou situações de risco que até agora não tinham sido detectadas.


Assuntos
Humanos , Masculino , Feminino , Recém-Nascido , Lactente , Pré-Escolar , Criança , Adolescente , Saúde da Criança/estatística & dados numéricos , Cuidados Médicos , Serviço Hospitalar de Emergência/estatística & dados numéricos , Pandemias , COVID-19/epidemiologia , Uruguai/epidemiologia , Estudos Retrospectivos , Estudo Multicêntrico , Setor Público , Setor Privado , Distribuição por Idade e Sexo
16.
Science ; 378(6622): 915-920, 2022 11 25.
Artigo em Inglês | MEDLINE | ID: mdl-36423285

RESUMO

Grazing represents the most extensive use of land worldwide. Yet its impacts on ecosystem services remain uncertain because pervasive interactions between grazing pressure, climate, soil properties, and biodiversity may occur but have never been addressed simultaneously. Using a standardized survey at 98 sites across six continents, we show that interactions between grazing pressure, climate, soil, and biodiversity are critical to explain the delivery of fundamental ecosystem services across drylands worldwide. Increasing grazing pressure reduced ecosystem service delivery in warmer and species-poor drylands, whereas positive effects of grazing were observed in colder and species-rich areas. Considering interactions between grazing and local abiotic and biotic factors is key for understanding the fate of dryland ecosystems under climate change and increasing human pressure.


Assuntos
Biodiversidade , Herbivoria , Gado , Mudança Climática , Solo
17.
Methods Inf Med ; 61(S 01): e28-e34, 2022 06.
Artigo em Inglês | MEDLINE | ID: mdl-35104909

RESUMO

BACKGROUND: Abbreviations are considered an essential part of the clinical narrative; they are used not only to save time and space but also to hide serious or incurable illnesses. Misreckoning interpretation of the clinical abbreviations could affect different aspects concerning patients themselves or other services like clinical support systems. There is no consensus in the scientific community to create new abbreviations, making it difficult to understand them. Disambiguate clinical abbreviations aim to predict the exact meaning of the abbreviation based on context, a crucial step in understanding clinical notes. OBJECTIVES: Disambiguating clinical abbreviations is an essential task in information extraction from medical texts. Deep contextualized representations models showed promising results in most word sense disambiguation tasks. In this work, we propose a one-fits-all classifier to disambiguate clinical abbreviations with deep contextualized representation from pretrained language models like Bidirectional Encoder Representation from Transformers (BERT). METHODS: A set of experiments with different pretrained clinical BERT models were performed to investigate fine-tuning methods on the disambiguation of clinical abbreviations. One-fits-all classifiers were used to improve disambiguating rare clinical abbreviations. RESULTS: One-fits-all classifiers with deep contextualized representations from Bioclinical, BlueBERT, and MS_BERT pretrained models improved the accuracy using the University of Minnesota data set. The model achieved 98.99, 98.75, and 99.13%, respectively. All the models outperform the state-of-the-art in the previous work of around 98.39%, with the best accuracy using the MS_BERT model. CONCLUSION: Deep contextualized representations via fine-tuning of pretrained language modeling proved its sufficiency on disambiguating clinical abbreviations; it could be robust for rare and unseen abbreviations and has the advantage of avoiding building a separate classifier for each abbreviation. Transfer learning can improve the development of practical abbreviation disambiguation systems.


Assuntos
Aprendizado Profundo , Processamento de Linguagem Natural , Humanos , Armazenamento e Recuperação da Informação
19.
BMC Bioinformatics ; 22(Suppl 1): 601, 2021 Dec 17.
Artigo em Inglês | MEDLINE | ID: mdl-34920703

RESUMO

BACKGROUND: The volume of biomedical literature and clinical data is growing at an exponential rate. Therefore, efficient access to data described in unstructured biomedical texts is a crucial task for the biomedical industry and research. Named Entity Recognition (NER) is the first step for information and knowledge acquisition when we deal with unstructured texts. Recent NER approaches use contextualized word representations as input for a downstream classification task. However, distributed word vectors (embeddings) are very limited in Spanish and even more for the biomedical domain. METHODS: In this work, we develop several biomedical Spanish word representations, and we introduce two Deep Learning approaches for pharmaceutical, chemical, and other biomedical entities recognition in Spanish clinical case texts and biomedical texts, one based on a Bi-STM-CRF model and the other on a BERT-based architecture. RESULTS: Several Spanish biomedical embeddigns together with the two deep learning models were evaluated on the PharmaCoNER and CORD-19 datasets. The PharmaCoNER dataset is composed of a set of Spanish clinical cases annotated with drugs, chemical compounds and pharmacological substances; our extended Bi-LSTM-CRF model obtains an F-score of 85.24% on entity identification and classification and the BERT model obtains an F-score of 88.80% . For the entity normalization task, the extended Bi-LSTM-CRF model achieves an F-score of 72.85% and the BERT model achieves 79.97%. The CORD-19 dataset consists of scholarly articles written in English annotated with biomedical concepts such as disorder, species, chemical or drugs, gene and protein, enzyme and anatomy. Bi-LSTM-CRF model and BERT model obtain an F-measure of 78.23% and 78.86% on entity identification and classification, respectively on the CORD-19 dataset. CONCLUSION: These results prove that deep learning models with in-domain knowledge learned from large-scale datasets highly improve named entity recognition performance. Moreover, contextualized representations help to understand complexities and ambiguity inherent to biomedical texts. Embeddings based on word, concepts, senses, etc. other than those for English are required to improve NER tasks in other languages.


Assuntos
Idioma , Redação , Aprendizado de Máquina
20.
An. Facultad Med. (Univ. Repúb. Urug., En línea) ; 8(2): e602, dic. 2021. ilus, graf, tab
Artigo em Espanhol | LILACS, UY-BNMED, BNUY | ID: biblio-1358268

RESUMO

El proceso de docencia-aprendizaje de las disciplinas clínicas tiene entre sus desafíos la adquisición de habilidades del estudiante con el paciente. Las oportunidades de prácticas clínicas se han reducido. La menor cantidad de consultas pediátricas en el año 2020 durante la pandemia por Coronoavirus exacerbó este hecho. Objetivo: Comunicar la experiencia de simulación in situ y madre simulada realizada por docentes del Departamento de Emergencia Pediátrica del Centro Hospitalario Pereira Rossell, dirigida al entrenamiento de estudiantes de la Unidad Curricular Pediatría (Facultad de Medicina-UdelaR), en la realización de la anamnesis de un paciente con patología respiratoria. Metodología: estudio descriptivo. Madre simulada: docentes/residentes. Simulador: lactante-tecnología intermedia. Participantes del escenario: 2 estudiantes. Lugar: DEP-CHPR. Período: setiembre-diciembre 2020. Resultados: Participaron de la simulación 327 estudiantes, 255 contestaron el censo. Utilidad de la simulación: 53,2% muy útil/excelente, poco o nada útil 24,8%, no contesta 22%. Credibilidad: aceptable 38%, muy creíble/excelente 27,5%, 12,5% poco o nada creíble, 22% no contesta. Participación grupal en el debriefing 64,5%, participación parcial 11,4%, sin debriefing 2,1%, no contesta 22%.Discusión: De los 327 estudiantes que realizaron la simulación al menos 24,% la percibió como poco o nada útil. La falta de información previa, la participación en el escenario de 2 estudiantes por grupo y la poca interacción en el debriefing en algunos grupos pudo haber influído. Conclusiones: La experiencia comunicada generó nuevas oportunidades de docencia aprendizaje. Se identificaron aspectos metodológicos que pueden mejorarse.


The teaching-learning process in clinical disciplines includes amongst its challenges the acquisition of the student's skills with the patient. Opportunities for clinical practice have diminished. A smaller number of pediatric visits in 2020 during the Coronavirus pandemic increased this fact. Objective: to communicate the experience of in situ simulation and simulated mother carried out by the faculty of the Pediatric Emergency Department of the Pereira Rossell Hospital Center, address to students in the Pediatrics Curricular Unit (School of Medicine- UdelaR), in the case of an infant patient with respiratory pathology. Methods: Descriptive study. Simulated mother: faculty members/residents. Simulator: intermediate technology infant. Participants in the scenario: 2 students. Location: DPE.PRHC. Period: September- December 2020.Results: 327 students participated in the simulation, 255 answered the census. Usefulness of the simulation: 53.2% very useful / excellent, little or not at all useful 24.8%, no answer 22%. Credibility: acceptable 38%, very credible / excellent 27.5%, 12.5% ​​little or not at all credible, 22% do not answer. Group participation in the debriefing 64.5%, partial participation 11.4%, without debriefing 2.1%, no answer 22%. Discussion: Of the 327 students who carried out the simulation at least 24,8 % perceived it as little or not useful. The lack of previous information, the participation in the scenario of 2 students per group and the little interaction in the debriefing in some groups could have influenced. Conclusions: The communicated experience generated new teaching-learning opportunities. Methodological aspects that can be improved were identified.


O processo de ensino-aprendizagem de disciplinas clínicas tem entre seus desafios a aquisição de habilidades do aluno com o paciente. As oportunidades de estágio clínico foram reduzidas. O menor número de consultas pediátricas em 2020 durante a pandemia de Coronoavirus exacerbou esse fato. Objetivo: Comunicar a experiência de simulação in situ e simulação materna realizada pela docentes do Serviço de Urgência Pediátrica do Centro Hospitalar Pereira Rossell, com alunos da Unidade Curricular Pediatria (Faculdade de Medicina-UdelaR), na anamnese de paciente com doença respiratória. Metodologia: estudo descritivo. Mãe simulada: professores / residentes. Simulador: lactente de tecnologia intermédia. Participantes do cenário: 2 alunos. Local: DEP-CHPR. Período: setembro a dezembro de 2020. Resultados: 327 alunos participaram da simulação, 255 responderam a pesquisa. Utilidade da simulação: 53,2% muito útil / excelente, pouco ou nada útil 24,8%, sem resposta 22%. Credibilidade: aceitável 38%, muito credível / excelente 27,5%, 12,5% pouco ou nada credível, 22% não respondem. Participação do grupo no debriefing 64,5%, participação parcial 11,4%, sem debriefing 2,1%, sem resposta 22%. Discussão: Dos 327 alunos que realizaram a simulação, pelo menos 24,% a perceberam como pouco ou nada útil. A falta de informação prévia, a participação no cenário de 2 alunos por grupo e a pouca interação no debriefing em alguns grupos podem ter influenciado. Conclusões: A experiência comunicada gerou novas oportunidades de ensino-aprendizagem. Aspectos metodológicos que podem ser melhorados foram identificados.


Assuntos
Humanos , Pediatria/educação , Estudantes de Medicina , Treinamento com Simulação de Alta Fidelidade , Anamnese , Estudos Retrospectivos
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