Improvements in the learnability of smartphone haptic interfaces for visually impaired users.

We report the results of a study on the learnability of haptic icons used as alerts or notifications in smartphones. The aim was to explore the feasibility of using haptic icons to create assistive technologies for people with visual impairments. We compared the performance and satisfaction of users with different visual capacities (visually impaired vs. sighted) and using different learning processes (with or without a reinforcement learning stage). The reinforcement learning stage improves the recognition rate in both types of users, although the improvement obtained by the visually impaired users is even better as their recognition rates become very similar to those obtained by the sighted users. Finally, it was observed that the better recognized haptic icons are those assigned to the most employed applications by the user.

Real-world short-term effectiveness of ustekinumab in 305 patients with Crohn's disease: results from the ENEIDA registry.

BACKGROUND: There are limited data of ustekinumab administered according to the doses recommended in the UNITI studies. AIM: To assess the real-world, short-term effectiveness of ustekinumab in refractory Crohn's disease (CD) METHODS: Multicentre study of CD patients starting ustekinumab after June 2017 at the recommend dose (260, 390 or 520 mg based on weight ~6 mg/kg IV week 0 and 90 mg subcutaneously week 8). Values for Harvey-Bradshaw Index (HBI), C-reactive protein (CRP) and faecal calprotectin (FC) were recorded at baseline and at weeks 8 and 14. Demographic and clinical data, previous treatments, AEs and hospitalisations were documented. Possible predictors of clinical remission were examined. RESULTS: Three hundred and five patients were analysed (≥2 previous anti-TNFα therapies 64% and vedolizumab 29%). At baseline, 217 (72%) had an HBI >4 points. Of these, 101 (47%) and 126 (58%) achieved clinical remission at weeks 8 and 14, respectively. FC levels returned to normal (<250 µg/g) in 46% and 54% of the patients at weeks 8 and 14 respectively. CRP returned to normal (<3 mg/L) in the 35% and 41% of the patients at week 8 and 14 respectively. AEs were recorded in 38, and 40 patients were hospitalised. Intolerance to the most recent anti-TNF agent and fewer previous anti-TNF agents were associated with clinical remission at week 14. Endoscopic severity was associated with poor response. CONCLUSION: This is the first study to show the real-world effectiveness and safety of ustekinumab administered according to the recommended induction regimen in a cohort of highly refractory CD patients.

Phenotype and natural history of elderly onset inflammatory bowel disease: a multicentre, case-control study.

BACKGROUND: Onset during old age has been reported in upto 10% of total cases of inflammatory bowel disease (IBD). AIM: To evaluate phenotypic characteristics and the use of therapeutic resources in patients with elderly onset IBD. METHODS: Case-control study including all those patients diagnosed with IBD over the age of 60 years since 2000 who were followed-up for >12 months, identified from the IBD databases. Elderly onset cases were compared with IBD patients aged 18 to 40 years at diagnosis, matched by year of diagnosis, gender and type of IBD (adult-onset). RESULTS: One thousand three hundred and seventy-four elderly onset and 1374 adult-onset cases were included (62% ulcerative colitis (UC), 38% Crohn's disease (CD)). Among UC patients, elderly onset cases had a lower proportion of extensive disease (33% vs 39%; P < 0.0001). In CD, elderly onset cases showed an increased rate of stenosing pattern (24% vs 13%; P < 0.0001) and exclusive colonic location (28% vs 16%; P < 0.0001), whereas penetrating pattern (12% vs 19%; P < 0.0001) was significantly less frequent. Regarding the use of therapeutic resources, there was a significantly lower use of corticosteroids (P < 0.0001), immunosuppressants (P < 0.0001) and anti-TNFs agents (P < 0.0001) in elderly onset cases. Regarding surgery, we found a significantly higher surgery rate among elderly onset UC cases (8.3% vs 5.1%; P < 0.009). Finally, elderly onset cases were characterised by a higher rate of hospitalisations (66% vs 49%; P < 0.0001) and neoplasms (14% vs 0.5%; P < 0.0001). CONCLUSIONS: Elderly onset IBD shows specific characteristics and they are managed differently, with a lower use of immunosuppressants and a higher rate of surgery in UC.

Características de los casos de violencia contra la mujer de Asunción y Gran Asunción, Paraguay (2008-2012) / Characteristics of cases of violence against women from Asunción and Gran Asunción, Paraguay (2008-2012)

La violencia contra la mujer constituye"todo acto de violencia basado en el género que tiene como resultado posible o real un daño físico, sexual o psicológico", constituyendo un problema de violación de los derechos humanos y de salud pública. El objetivo fuedescribir las características de los casos de violencia contra las mujeres provenientes de Asunción y Gran Asunción, registrados en el Museo de la Justicia, desde el 1 de enero del 2008 al 30 de junio del 2012. Fueron analizadas 1.722 fichas de los juzgados de paz de Asunción y Gran Asunción, remitidos al Museo de la Justicia.Elpromedio de edad de la víctima fue de 35 ± 11,5 años (rango 15 a 87); victimarios 37 ± 10,6 años (rango 14 a 87).Tanto las víctimas como los agresores eran de Asunción, casados, estudios primarios. Las víctimas eran amas de casa 55,1%, (949) y los agresores dependientes (44,9%, 773). El 56,1% (966) tenían hijos y de estos 39,7% (683) sufrieron algún tipo de agresión. El 63,4%(1.092) recibió más de un tipo de violencia, siendo la psíquica las más frecuente (25%, 430). El 50,3%(867) recibió agresiones con una frecuencia de 1 a 5 veces en el último año, 50,2% (864) realizó denuncias previas. Otros factores fueron el alcohol 24,9% (428) y factores culturales como los celos, el machismo, etc. Se encontraron diferencias estadísticamente significativas con la profesión y la violencia. La violencia contra la mujer constituye un grave problema que debe ser visualizado para su prevención. Palabras claves: Violencia contra la mujer; Violencia; mujer; Asunción; Gran Asunción.

Violence against women constitutes in "any genderbased act of violence that results in physical, sexual or psychological harm" resulting in the violation of human rights and public health. The objective was to describe the characteristics of cases of violence against women from Asunción and Gran Asunción, registered in the Museum of Justice, from January 1, 2008 to June 30, 2012. 1,722 files sent to the Museum of Justice were analyzed from Asuncion and Gran Asunción's peace courts. The average age of the victims was between 35 ± 11.5 years (range 15-87); perpetrators 37 ± 10.6 years (range 14 to 87). Both the victims and the perpetrators were of Asunción, married, primary studies. The victims were housewives (55.1%, 949) and the dependent aggressors (44.9%, 773). 56.1% (966) had children and of these, 39.7% (683) suffered some form of aggression. 63.4% (1,092) received more than one type of violence, being the psychic the most frequent one (25%, 430). 50.3% (867) received assaults with a frequency of 15 times in the last year, 50.2% (864) made previous complaints. Other factors were alcohol 24.9% (428) and cultural factors such as jealousy, male chauvinism, etc. Statistically significant differences were found with the profession and violence. Violence against women is a serious problem that must be visualized for its prevention. Key words: Violence against women; violence; woman; Asuncion; Gran Asunción.

Patrones de excreción urinaria de Sodio en población adulta en muestras de orina espontánea / Urinary sodium excretion patterns in adult population in spot urine samples

Introducción: El presente estudio describe los patrones de natriuresis según las características clínicas y sociodemográficas en una población adulta de Asunción. Métodos: Estudio transversal tipo encuesta y toma de muestra de orina a personas que acudieron al Mercado de Abasto y al Policlínico Municipal durante los meses de junio-setiembre del 2014. Se estimó natriuria en muestras de orina espontánea a primera hora de la mañana y en ayunas. Se incluyeron sujetos de 18 a 65 años. Se compararon las medianas de los valores de natriuria en mmol/L, utilizándose el test U de Mann-Whitney para comparar las variables de dos categorías y Kruskal-Wallis para las que tienen más de dos categorías. Resultados: Se aplicó la encuesta y se tomó muestra de orina a 463 personas. El 69,5% (322) eran mujeres. La media de edad fue 50,5 años (DE: 14,2). El 26,6% (123) negó antecedentes patológicos. La mediana de natriuria global fue 97,5 mmol/L (RIC: 59,3­139,3). Los niveles de natriuria no presentaron diferencias por sexo. Las personas menores de 30 años, con bajo consumo de verduras y mayor consumo de frituras presentaron valores de natriuria altos y estadísticamente significativos. El grupo de sujetos sanos mostró mayor excreción de sodio que los que refirieron diabetes o hipertensión arterial. Conclusiones: La mayor excreción de sodio en orina observada se presenta en personas jóvenes, sin antecedentes patológicos y, al mismo tiempo son los que también presentan los peores hábitos alimenticios. Estos resultados muestran la necesidad de intervención en el ámbito de la salud pública a fin de prevenir la patología cardiovascular y renal del futuro.

Introduction: The present study describes natriuresis patterns according to clinical and sociodemographic characteristics in adult population of Asuncion. Methods: Cross-sectional study of convenience sampling to people who attended the Mercado de Abasto and the Municipal Polyclinic during June to September 2014. People from 18 to 65 years old were included. Sodium was estimated from urine samples of spot urine taken in the morning and fasting. Median values of natriuresis in mmol/L were compared using the test Mann-Whitney and Kruskal-Wallis. Results: 463 people participated. 69.5% (322) were women. The mean age was 50.5 years (SD 14.2). 26.6% (123) denied pathological medical history. The median overall natriuresis was 97.5 mmol/L (IQR: 59.3-139.3). Natriuresis levels did not differ by sex. High values with statistically significant were presented in people under 30 years old, with low consumption of vegetables and increased consumption of fried food. The group of healthy subjects showed increased sodium excretion than those who reported diabetes or high blood pressure. Conclusions: The increased natriuresis occurs in young people without having pathological medical history and also having the worst eating habits. Public health policies must focus at this level to prevent future cardiovascular and renal disease it is at this level where public health must intervene to prevent future cardiovascular and renal disease.

Epidemiologia de la obesidad en el Paraguay / Epidemiology of obesity in Paraguay

Introducción: Paraguay no escapa a la epidemia global de obesidad. Este estudio describió la prevalencia y los determinantes sociodemográficos, clínicos y conductuales asociados en el país. Métodos: Estudio transversal tipo encuesta poblacional con representatividad nacional, incluyó personas entre edades de 15 y 74 años. El muestreo fue probabilístico, trietápico sin reemplazo. STEPSwise fue la metodología y encuesta aplicada durante junio-setiembre 2011. Se consideró obesidad un índice de masa (IMC) corporal >=30. Este valor se distribuyó según las variables sociodemográficas, clínicas y conductuales. Por regresión logística se estimó asociación entre las variables, en odd ratios (OR) con intervalos de confianza del 95%(IC95%). Resultados: Se incluyeron 2501 participantes. Fueron obesos 23,5% de la población, 20,2% y 26,0% hombres y mujeres, respectivamente. Además del sexo, mostraron diferencias significativas: tener >35 años 3,17(2,11-4,76) que los menores; hombres con residencia urbana 1,94(1,35-2,79) veces más que los del área rural. Los hombres en pareja 2,52(1,80-3,53) veces más obesos que los solteros; funcionario público 2,57(1,57-4,26) veces más que otros trabajos. Baja actividad física presentó obesidad 1,75(1,19-2,57) veces más que tener una actividad física mínimamente aceptable. En hombres el quintil de ingreso superior presentó 3,87(2,17-6,92) más obesidad que el quintil inferior. En mujeres el bajo nivel educativo es 2,01(1,43-2,83) veces más que un mayor nivel. Conclusiones: El patrón observado de la distribución de la obesidad describe entornos y conductas más obesogénicos que otros en Paraguay. Estos resultados sirven para tomar decisiones e intervenciones específicas en salud pública, más allá de las medidas poblacionales.

Introduction: Paraguay has not escaped from the global epidemic of obesity. This study described the prevalence and socio-demographic, clinical and behavioral determinants associated to obesity. Methods: Cross-sectional study with a nationally representative survey, included people among 15 and 74 years old. The sampling was probabilistic, three-stage without replacement. STEPSwise was the methodology and survey applied during June-September 2011. Obesity was considered a body mass index (BMI) >=30 kg/m2. This value was distributed by sociodemographic, clinical, and behavioral variables. A logistic regression among obesity and variables was estimated for obtain odd ratios (OR) with confidence intervals of 95% (95% CI) of association. Results: 2501 participants were included. Were obese 23.5%, men and women were 20.2% and 26.0%, respectively. In addition to gender, showed significant differences: >35 years-old 3.17(2.11-4.76) than younger; men in urban residence 1.94(1.35-2.79) odds more than those in rural areas. No single men 2.52(1.80-3.53) odds more obese than single; civil servants 2.57(1.57-4.26) odds more than other jobs. Low physical activity 1.75(1.19-2.57) odds were more obese than a acceptable physical activity. In mans with the top income quintile showed 3.87(2.17-6.92) more obesity than the bottom quintile. In women, low educational level was 2.01(1.43-2.83) odds more than a higher. Conclusions: The observed pattern of obesity distribution in Paraguay described some behaviors and obesogenic environments. These results serve to take decisions and specific interventions in public health, beyond the population measures.

PET-TAC con 18F-FDG en el diagnóstico de la arteritis de Takayasu y la valoración del tratamiento / PET-CT with 18F-FDG in the diagnosis of Takayasu's arteritis and the assessment of response to therapy

Presentamos un caso clínico de una paciente sin síntomas específicos de vasculitis, con reactantes de fase aguda normales, pero con el diagnóstico anatomopatológico de arteritis de Takayasu que nos fue remitida para realizar un PET-TAC con 18F-FDG. Los hallazgos de la exploración permitieron constatar actividad inflamatoria en las paredes vasculares de la aorta y tras la instauración del tratamiento adecuado, una segunda exploración con 18F-FDG, valoró la respuesta terapéutica correctamente. Se discute las aportaciones de la PET-TAC con 18F-FDG en el manejo de esta entidad patológica (AU)

We present a patient without specific symptoms of vasculitis, with normal acute phase reactants, but with the pathological diagnosis of Takayasu’ arteritis that was referred for a PET-CT with 18F-FDG. Scan findings showed inflammatory activity in the vessel walls of the aorta and after the appropriate treatment, a second scan with 18F-FDG, correctly assessed the therapeutic response. We discuss the contributions of PET-CT with 18F-FDG in the management of this pathological entity (AU)

[PET-CT with ¹8F-FDG in the diagnosis of Takayasu's arteritis and the assessment of response to therapy]. / PET-TAC con ¹8F-FDG en el diagnóstico de la arteritis de Takayasu y la valoración del tratamiento.

We present a patient without specific symptoms of vasculitis, with normal acute phase reactants, but with the pathological diagnosis of Takayasu' arteritis that was referred for a PET-CT with (18)F-FDG. Scan findings showed inflammatory activity in the vessel walls of the aorta and after the appropriate treatment, a second scan with (18)F-FDG, correctly assessed the therapeutic response. We discuss the contributions of PET-CT with (18)F-FDG in the management of this pathological entity.

Prevalence of diabetes mellitus and associated cardiovascular risk factors in an adult urban population in Paraguay.

A cross-sectional study was conducted on a 20-74-year-old population in an urban white-Hispanic population in Paraguay to determine the prevalence of diabetes mellitus (DM), impaired glucose tolerance (IGT), and associated cardiovascular disease (CVD) risk factors. In total 1606 subjects completed the study (response rate 80.3%; 1094 women, 512 men). The overall prevalences were: DM 6.5%, IGT 11.3%, hypertension 17.1%, and obesity 31.6% with more obesity in women (35.7% vs 22.8%, p < 0.05). Age-standardized prevalences were: DM 6.5%, IGT 13.5% in females and DM 5.5%, IGT 7.2% in males. DM and IGT subjects had two or more CV risk factors significantly more often than the normal population. In conclusion, DM, IGT, hypertension, and obesity are common in this South American Hispanic urban population, particularly in women. Public health measures, such as lifestyle education, are required to decrease these noncommunicable diseases.

Intergenotypic effect of isopropanol ingestion in the further detoxification of ethanol and isopropanol in Drosophila melanogaster.

The effect of isopropanol ingestion on a further tolerance to ethanol and isopropanol, and its relationship with the Adh locus, have been studied using Drosophila melanogaster selected for tolerance to ethanol. For this purpose, AdhF AdhF, AdhF AdhS and AdhS AdhS flies were independently pretreated with 2 per cent isopropanol and then further exposed to solutions of 10 per cent ethanol or of 2 per cent isopropanol. Afterwards, the ability to tolerate both alcohols, and the ADH activities of the surviving flies were compared with those of flies not pretreated with isopropanol. After isopropanol ingestion, the flies of all three Adh genotypes shown much higher sensitivity to ethanol than to isopropanol although the opposite results were observed in flies not pretreated with isopropanol. Isopropanol treatment decreased the ADH activity in flies of all three genotypes within a range varying from 73 per cent (females FF) to 93 per cent (males FS), the remaining ADH activity being between 2 to 3 times higher in FF than in FS and SS flies. The reduction in ADH activity was associated with the phenomenon of ADH isozyme interconversion. After the isopropanol pretreatment, the most isopropanol tolerant flies (FF) were also the most ADH active ones. Therefore, the adaptative significance of the isozyme conversion is questioned.

Relation between tolerance to ethanol and alcohol dehydrogenase (ADH) activity in Drosophila melanogaster: selection, genotype and sex effects.

The suggestion of Oakeshott et al. (1984) that selection at the Adh locus, as a response to ethanol, is restricted to D. melanogaster laboratory-adapted populations, is tested in this paper with the "Lagar de los Reyes" (LR) lines. For this purpose, homozygous lines for the AdhF and the AdhS alleles were maintained on food supplemented with ethanol. After the selection, the ethanol tolerance and the ADH activity of the selected flies (LRSeF and LRSeS) were determined and compared with those of the control flies (LRCF and LRCS), maintained on standard medium. Then, the effects of the selection, genotype and sex, and the relation between ethanol tolerance and ADH activity were analysed. Our results fail to show a consistent correlation between ethanol tolerance and ADH activity in the adults of LR lines. Our findings also indicate that adaptation of D. melanogaster to ethanol-containing food could be accomplished without significant changes on the ADH activity in the adults. The possibility that the adaptation of D. melanogaster to environmental ethanol could be independent of the Adh locus is discussed.