247 results on '"Models, Statistical"'
Search Results
2. Ambient air pollutants relate to hospital admissions for chronic obstructive pulmonary disease in Ganzhou, China
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Xingye Zhou, Chenwei Li, Yanfang Gao, Chuanfei Zhou, Lei Huang, and Xiaokang Zhang
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Pulmonary Disease, Chronic Obstructive, epidemiology ,Hospitalization ,Air Pollution, adverse effects ,Air Quality Standards ,Models, Statistical ,Public aspects of medicine ,RA1-1270 - Abstract
ABSTRACT OBJECTIVE To evaluate the relationship between ambient air pollutants and chronic obstructive pulmonary disease in relatively low-polluted areas in China. METHODS Atmospheric pollutants levels and meteorological data were obtained from January 2016 to December 2020. The medical database including daily hospital admissions for chronic obstructive pulmonary disease (ICD10: J44) was derived from the First Affiliated Hospital of Gannan Medical University. The generalized additive model was used to analyze the percentage change with 95% confidence interval in daily hospital admissions for chronic obstructive pulmonary disease associated with a 10 µg/m3 increase in atmospheric pollutants levels. RESULTS In total, occurred 4,980 chronic obstructive pulmonary disease hospital admissions (not including emergency department visits) during 2016–2020. The mean concentrations of daily PM2.5, PM10, SO2, NO2, O3, and CO were 37.5 μg/m3, 60.1 μg/m3, 18.7 μg/m3, 23.5 μg/m3, 70.0 μg/m3, and 1.2 mg/m3 in Ganzhou. Each 10 µg/m3 increment of PM2.5, PM10, NO2, and O3 were significantly associated with 2.8% (95%CI: 1.0–4.7), 1.3% (95%CI: 0.3–2.4), 2.8% (95%CI: 0.4–5.4), and 1.5% (95%CI: 0.2–2.7) elevation in daily chronic obstructive pulmonary disease hospital admissions. The estimates of delayed effects of PM2.5, PM10, NO2, and O3 were observed at lag6, lag6, lag8, lag1, respectively. The health effects of particulate pollutants (PM2.5 and PM10) may be independent of other pollutants. The adverse effects of air pollutants were more evident in the warm season (May–Oct) than in the cold season (Nov–Apr). CONCLUSION Our study demonstrated that elevated concentrations of atmospheric pollutant (PM2.5, PM10, NO2, and O3), especially particulate pollutants, can be associated with increased daily count of hospital admissions for chronic obstructive pulmonary disease , which may promote further understanding of the potential hazards of relatively low levels of air pollution on chronic obstructive pulmonary disease and other respiratory disorders.
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- 2022
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3. Multinomial model and zero-inflated gamma model to study time spent on leisure time physical activity: an example of ELSA-Brasil
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Aline Araújo Nobre, Marilia Sá Carvalho, Rosane Härter Griep, Maria de Jesus Mendes da Fonseca, Enirtes Caetano Prates Melo, Itamar de Souza Santos, and Dora Chor
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Motor Activity ,Leisure Activities ,Regression Analysis ,Models, Statistical ,Public aspects of medicine ,RA1-1270 - Abstract
ABSTRACT OBJECTIVE To compare two methodological approaches: the multinomial model and the zero-inflated gamma model, evaluating the factors associated with the practice and amount of time spent on leisure time physical activity. METHODS Data collected from 14,823 baseline participants in the Longitudinal Study of Adult Health (ELSA-Brasil – Estudo Longitudinal de Saúde do Adulto ) have been analysed. Regular leisure time physical activity has been measured using the leisure time physical activity module of the International Physical Activity Questionnaire. The explanatory variables considered were gender, age, education level, and annual per capita family income. RESULTS The main advantage of the zero-inflated gamma model over the multinomial model is that it estimates mean time (minutes per week) spent on leisure time physical activity. For example, on average, men spent 28 minutes/week longer on leisure time physical activity than women did. The most sedentary groups were young women with low education level and income CONCLUSIONS The zero-inflated gamma model, which is rarely used in epidemiological studies, can give more appropriate answers in several situations. In our case, we have obtained important information on the main determinants of the duration of leisure time physical activity. This information can help guide efforts towards the most vulnerable groups since physical inactivity is associated with different diseases and even premature death.
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- 2017
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4. Los cirujanos sobreestiman el riesgo de malignidad de los nódulos tiroideos, evaluación de los estimados subjetivos usando un análisis bayesiano
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Edgar Alfonso, Álvaro Sanabria, and Mario Castillo
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thyroid nodule, Bayes theorem, thyroid neoplasm ,models, statistical ,probability ,health knowledge, attitudes, practice ,Medicine ,Arctic medicine. Tropical medicine ,RC955-962 - Abstract
Introducción. Los nódulos tiroideos son la condición endocrina más frecuente para los cirujanos. El principio de la evaluación de un nódulo tiroideo es determinar si éste corresponde a un carcinoma. Las decisiones médicas sobre los nódulos tiroideos son influenciadas fuertemente por consideraciones subjetivas. Objetivo. Determinar las probabilidades subjetivas asignadas a las características clínicas de un paciente con un nódulo tiroideo, para evaluar el grado de influencia de estas probabilidades en la sospecha clínica final de un proceso maligno en comparación con los datos objetivos. Materiales y métodos. Se diseñó un análisis bayesiano para predecir el riesgo de un proceso maligno en un nódulo tiroideo, con base en la relación causal conocida de los factores clínicos y los demográficos durante la primera consulta. Se desarrolló un modelo con las variables clínicas y demográficas usando como expertos a los cirujanos. Resultados. La mayor probabilidad de un proceso maligno (94 %) se asignó al caso clínico de un hombre mayor de 60 años, con disfonía y disfagia, nódulo de crecimiento rápido, antecedentes de radioterapia cervical y familiar con cáncer de tiroides, con nódulos múltiples, mayores de 1 cm, de consistencia dura y con adenomegalias cervicales palpables. Para los casos de bajo riesgo, con nódulos sin características de un proceso maligno, la probabilidad de éste asignada por los clínicos fue de 33,59 % y para los de alto riesgo de 75,54 %. Conclusión. Los cirujanos toman decisiones diagnósticas basadas en creencias subjetivas que no necesariamente corresponden con los datos objetivos de las características de nódulos.
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- 2011
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5. Acurácia em métodos de relacionamento probabilístico de bases de dados em saúde: revisão sistemática Perfeccionamiento en métodos de relacionamiento probabilístico de bases de datos en salud: revisión sistemática Accuracy of probabilistic record linkage applied to health databases: systematic review
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Daniele Pinto da Silveira and Elizabeth Artmann
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Sistemas de Información ,Modelos Estadísticos ,Gerencia de la Información ,Bases de Datos Estadísticos ,Relaciones Interinstitucionales ,Revisión ,Sistemas de Informação ,Modelos Estatísticos ,Gerenciamento de Informação ,Bases de Dados Estatísticos ,Relações Interinstitucionais ,Revisão ,Information Systems ,Models, Statistical ,Information Management ,Statistical Databases ,Interinstitutional Relations ,Review ,Public aspects of medicine ,RA1-1270 - Abstract
OBJETIVO: Analisar a literatura nacional e internacional sobre validade de métodos de relacionamentos nominais de base de dados em saúde, com ênfase nas medidas de aferição da qualidade dos resultados. MÉTODOS: Revisão sistemática de estudos de coorte, caso-controles e seccionais que avaliaram a qualidade dos métodos de relacionamento probabilístico de base de dados em saúde. Foi utilizada metodologia Cochrane para revisões sistemáticas. As bases consultadas foram as mais amplamente utilizadas: Medline, LILACS, Scopus, SciELO e Scirus. Não foi utilizado filtro temporal e os idiomas considerados foram: português, espanhol, francês e inglês. RESULTADOS: As medidas sumárias da qualidade dos relacionamentos probabilísticos foram a sensibilidade, a especificidade e o valor preditivo positivo. Dos 202 estudos identificados, após critérios de inclusão, foram analisados 33 artigos. Apenas seis apresentaram dados completos sobre as medidas-sumárias de interesse. Observam-se como principais limitações a ausência de revisor na avaliação dos títulos e dos resumos dos artigos e o não-mascaramento da autoria dos artigos no processo de revisão. Estados Unidos, Reino Unido e Nova Zelândia concentraram as publicações científicas neste campo. Em geral, a acurácia dos métodos de relacionamento probabilístico de bases de dados variou de 74% a 98% de sensibilidade e 99% a 100% de especificidade. CONCLUSÕES: A aplicação do relacionamento probabilístico a bases de dados em saúde tem primado pela alta sensibilidade e uma maior flexibilização da sensibilidade do método, mostrando preocupação com a precisão dos dados a serem obtidos. O valor preditivo positivo nos estudos aponta alta proporção de pares de registros verdadeiramente positivos. A avaliação da qualidade dos métodos empregados tem se mostrado indispensável para validar os resultados obtidos nestes tipos de estudos, podendo ainda contribuir para a qualificação das grandes bases de dados em saúde disponíveis no País.OBJETIVO: Analizar la literatura nacional e internacional sobre validez de métodos de relacionamientos nominales de base de datos en salud, con énfasis en las medidas de confirmación de la calidad de los resultados. MÉTODOS: Revisión sistemática de estudios de cohorte, caso-controles y seccionales que evaluaron la calidad de los métodos de relacionamiento probabilístico de base de datos en salud. Fue utilizada metodología Cochrane para revisiones sistemáticas. Las bases consultadas fueron las más ampliamente utilizadas: Medline, LILACS, Scopus, SciELO y Scirus. No fue utilizado filtro temporal y los idiomas considerados fueron: portugués, español, francés e inglés. RESULTADOS: Las medidas rápidas de la calidad de los relacionamientos probabilísticos fueron la sensibilidad, la especificidad y el valor predictivo positivo. De los 202 estudios identificados, posterior a los criterios de inclusión, fueron analizados 33 artículos. Sólo seis presentaron datos completos sobre las medidas-rápidas de interés. Se observan como principales limitaciones la ausencia de revisor en la evaluación de los títulos y de los resúmenes de los artículos y el no-ocultamiento de la autoría de los artículos en el proceso de revisión. Estados Unidos, Reino Unido y Nueva Zelandia concentraron las publicaciones científicas en este campo. En general, el perfeccionamiento de los métodos de relacionamiento probabilístico de bases de datos varió de 74% a 98% de sensibilidad y 99% a 100% de especificidad. CONCLUSIONES: La aplicación de relacionamiento probabilístico a bases de datos en salud se ha priorizado por la alta sensibilidad y mayor flexibilización de la sensibilidad del método, mostrando preocupación con la precisión de los datos que se obtendrán. El valor predictivo positivo en los estudios apunta alta proporción de pares de registros verdaderamente positivos. La evaluación de la calidad de los métodos empleados se ha mostrado indispensable para validar los resultados obtenidos en estos tipos de estudios, pudiendo aún contribuir para la calificación de las grandes bases de datos en salud disponibles en el País.OBJECTIVE: To analyze both national and international literature on validity of record linkage procedure of health databases focusing on quality assessment of results. METHODS: A systematic review of cohort, case-control, and cross-sectional studies that evaluated quality of probabilistic record linkage of health databases was conducted. Cochrane methodology of systematic reviews was used. The following databases were widely searched: Medline, LILACS, Scopus, SciELO and Scirus. A time filter was not applied and articles were searched in the following languages: Portuguese, Spanish, French and English. RESULTS: Summary measures of the quality of probabilistic record linkage were sensitivity, specificity, and positive predictive value. There were identified 202 studies, and after applying the inclusion criteria, a total of 33 articles were reviewed. Only six had complete data on the summary measures of interest. The main limitations were: no reviewer to evaluate titles and abstracts; and no blinding of the article's authors in the review process. Most scientific publications in this field were from the United States, United Kingdom, and New Zealand. Overall, the accuracy of probabilistic record linkage of databases ranged from 74% to 98% sensitivity and 99% to 100% specificity. CONCLUSIONS: Probabilistic record linkage of health databases has notably been characterized by high sensitivity and greater flexibility of the procedure's sensitivity, indicating concern with data accuracy. The positive predictive value in studies shows a high proportion of truly positive record pairs. The quality assessment of these procedures has been proved essential for validating the results obtained in these studies, and can also contribute to improve large health databases available in Brazil.
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- 2009
6. Uso de teorías y modelos en artículos de una revista latinoamericana de salud pública, 2000-2004 Uso de teorias e modelos em artigos de um periódico latino-americano em saúde pública, 2000 a 2004 Use of theories and models on papers of a Latin-American journal in public health, 2000 to 2004
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Gustavo Alonso Cabrera Arana
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Artículo de revista ,Modelos epidemiológicos ,Modelos estadísticos ,Modelos matemáticos ,Modelos teóricos ,Revisión ,Artigo de revista ,Modelos estatísticos ,Revisão ,Brasil ,Journal article ,Epidemiologic models ,Models, statistical ,Mathematical models ,Models, Theoretical ,Review ,Public aspects of medicine ,RA1-1270 - Abstract
OBJETIVO: Caracterizar la frecuencia y tipo de uso de teorías o modelos citados en artículos publicados en una revista latinoamericana de salud publica entre los años 2000 y 2004. MÉTODOS: Se escogió la Revista de Saúde Pública por su historia de publicación periódica sin interrupción e impacto actual en la comunicación científica del área. Se aplicó un procedimiento estándar para leer los artículos y clasificarlos en una tipología arbitraria de cuatro niveles según la profundidad del uso dado a los referentes teóricos o modelos citados en los textos para describir asuntos o problemas abordados, formular métodos y discutir a rigor los hallazgos comunicados. RESULTADOS: Se leyeron 482 artículos: 421 (87%) investigaciones, 42 (9%) revisiones o especiales y 19 (4%) textos de opinión o reflexión. En las 421 investigaciones, 286 (68%) tuvieron enfoque cuantitativo, 110 (26%) cualitativo y 25 (6%) mixtos. La cita de teorías o modelos fue infrecuente; 90 (19%) artículos revisados citan algun referente. Según la profundidad de uso 29 (6%) de los 90 fueron tipo I, 9 (1,9%) tipo II, 6 (1,3%) tipo III y 46 (9,5%), tipo IV. CONCLUSIONES: La citación de modelos fue nueve veces más frecuente que la de alguna teoría; el uso ideal, el tipo IV, ocurrió en apenas uno de cada diez artículos analizados. Hay relevancia de explicitar los marcos teóricos y modelos usados al abordar temas, formular hipótesis, diseñar métodos y discutir hallazgos en las contribuciones de las revistas científicas del área.OBJETIVO: Caracterizar a freqüência e tipo de uso de teorias ou modelos citados em artigos publicados em uma revista latino-americana de saúde pública entre os anos 2000 e 2004. MÉTODOS: A Revista de Saúde Pública foi escolhida por sua história de publicação ininterrupta e atual impacto na comunicação científica da área. Foi aplicado um procedimento padrão para ler e classificar os artigos de acordo com tipologia de quatro níveis, segundo a profundidade de uso dado aos referenciais teóricos ou modelos citados nos textos para descrever assuntos ou problemas abordados, formular métodos e discutir a rigor os achados comunicados. RESULTADOS: Foram lidos 482 artigos: 421 (87%) investigações, 42 (9%) revisões ou especiais e 19 (4%) textos de opinião ou reflexão. Nas 421 investigações, 286 (68%) tiveram enfoque quantitativo, 110 (26%) qualitativo e 25 (6%) mistos. A menção a teorias ou modelos não foi freqüente; apenas 90 (19%) dos artigos revisados citavam alguma teoria ou modelo. Segundo a profundidade de uso, 29 (6%) dos 90 foram tipo I, 9 (1,9%) tipo II, 6 (1,3%) tipo III e 46 (9,5%), tipo IV. CONCLUSÕES: A citação de modelos foi nove vezes mais freqüente do que de alguma teoria; o uso ideal, de tipo IV, ocorreu em apenas um de cada dez artículos analisados. É relevante explicitar os marcos teóricos e modelos usados ao abordar temas, formular hipóteses, desenhar métodos e discutir achados nas contribuições das revistas científicas da área.OBJECTIVE: To characterize frequency and type of use of theories or models on papers of a Latin-American journal in public health between 2000 and 2004. METHODS: The Revista de Saúde Pública was chosen because of its history of periodic publication without interruption and current impact on the scientific communication of the area. A standard procedure was applied for reading and classifying articles in an arbitrary typology of four levels, according to the depth of the use of models or theoretical references to describe problems or issues, to formulate methods and to discuss results. RESULTS: Of 482 articles included, 421 (87%) were research studies, 42 (9%) reviews or special contributions and 19 (4%) opinion texts or assays . Of 421 research studies, 286 (68%) had a quantitative focus, 110 (26%) qualitative and 25 (6%) mixed. Reference to theories or models is uncommon, only 90 (19%) articles mentioned a theory or model. According to the depth of the use, 29 (6%) were classified as type I, 9 (2%) as type II, 6 (1.3%) were type III and the 46 remaining texts (9.5%) were type IV. CONCLUSIONS: Reference to models was nine-fold more frequent than the use of theoretical references. The ideal use, type IV, occurred in one of every ten articles studied. It is of relevance to show theoretical and models frames used when approaching topics, formulating hypothesis, designing methods and discussing findings in papers.
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- 2007
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7. Economic burden of expected epidemiological changes in diseases related to tobacco, Mexico Impacto econômico das mudanças epidemiológicas esperadas nas doenças associadas ao tabaco, México
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Armando Arredondo, Carlos Carrillo, and Alexis Zuñiga
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Tabagismo ,Custos de cuidados de saúde ,Gastos em saúde ,Estudos de séries temporais ,México ,Modelos estatísticos ,Smoking ,Health care costs ,Health expenditures ,Time series studies ,Mexico ,Models, statistical ,Public aspects of medicine ,RA1-1270 - Abstract
OBJECTIVE: To determine health care costs and economic burden of epidemiological changes in diseases related to tobacco consumption. METHODS: A time-series analysis in Mexico (1994-2005) was carried out on seven health interventions: chronic obstructive pulmonary diseases, lung cancer with and without surgical intervention, asthma in smokers and non-smokers, full treatment course with nicotine gum, and full treatment course with nicotine patch. According with Box-Jenkins methodology, probabilistic models were developed to forecast the expected changes in the epidemiologic profile and the expected changes in health care services required for selected interventions. Health care costs were estimated following the instrumentation methods and validated with consensus technique. RESULTS: A comparison of the economic impact in 2006 vs. 2008 showed 20-90% increase in expected cases depending on the disease (pOBJETIVO: Avaliar os custos da atenção médica a doenças associadas ao tabagismo e o impacto econômico das mudanças epidemiológicas. MÉTODOS: Análise de série temporal no México (1994-2005) de sete intervenções médicas em relação a: doença pulmonar obstrutiva crônica, câncer de pulmão com e sem intervenção cirúrgica, asma bronquial em fumantes e não-fumantes, tratamento com adesivos para deixar de fumar, tratamento com goma de mascar. As mudanças epidemiológicas esperadas e as necessidades financeiras para atender a demanda de serviços foram avaliadas pelos modelos probabilísticos de Box-Jenkins. Os custos foram determinados de acordo com método de instrumentação e a técnica de consenso. RESULTADOS: A comparação do impacto das mudanças epidemiológicas previstas para 2006 e 2008 mostrou incremento de 20% a 90%, dependendo do tipo de intervenção. O incremento nos custos da atenção médica foi de 25% a 93%. Há indícios que a demanda de serviços de saúde para as intervenções investigadas continuarão aumentando. CONCLUSÕES: Em termos econômicos, o aumento na quantidade de casos esperados refletem um fenômeno de competição interna em relação ao uso dos recursos adicionais entre atividades de promoção e prevenção da saúde relacionada ao tabagismo. Se não houver mudanças nos programas de prevenção, haverão desafios econômicos de alto impacto no financiamento dos sistemas de saúde.
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- 2007
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8. Fatores determinantes da capacidade funcional entre idosos Determinant factors of functional status among the elderly
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Tereza Etsuko da Costa Rosa, Maria Helena D'Aquino Benício, Maria do Rosário Dias de Oliveira Latorre, and Luiz Roberto Ramos
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Idoso ,Envelhecimento ,Aptidão física ,Atividades cotidianas ,Saúde do idoso ,Fatores de risco ,Modelos estatísticos ,Capacidade funcional ,Elderly ,Aging ,Activities of daily living ,Risk factors ,Models, statistical ,Aging health ,Functional status ,Public aspects of medicine ,RA1-1270 - Abstract
OBJETIVO; Investigar a influência de fatores socioeconômicos e demográficos relativos à saúde, bem como os fatores ligados às atividades sociais e à avaliação subjetiva da saúde sobre a capacidade funcional dos idosos. MÉTODOS: Estudo transversal, integrante de estudo multicêntrico, em amostra representativa do município de São Paulo, realizado em 1989. A capacidade funcional foi avaliada através da escala de atividades da vida diária pessoal e instrumental e investigada como variável dicotômica: ausência de dependência - incapacidade/dificuldade em nenhuma das atividades versus presença de dependência moderada/grave - incapacidade/dificuldade em 4 ou mais atividades. Análise de regressão logística múltipla foi aplicada aos fatores hierarquicamente agrupados. RESULTADOS: As características que se associaram com a dependência moderada/grave foram analfabetismo, ser aposentado, ser pensionista, ser dona de casa, não ser proprietário da moradia, ter mais de 65 anos, ter composição familiar multigeracional, ter sido internado nos últimos 6 meses, ser "caso" no rastreamento de saúde mental, não visitar amigos, ter problemas de visão, ter história de derrame, não visitar parentes e ter avaliação pessimista da saúde ao se comparar com seus pares. CONCLUSÕES: As características identificadas que se associaram à dependência moderada/grave sugerem uma complexa rede causal do declínio da capacidade funcional. Pode-se supor, entretanto, que ações preventivas especificamente voltadas para certos fatores podem propiciar benefícios para o prolongamento do bem estar da população idosa.OBJECTIVE: To investigate the impact of health-related demographic and socioeconomic factors, as well as the impact of factors associated to social activity and the subjective health evaluation on the functional status of elderly people. METHODS: A cross-sectional multicentric study was conducted in a representative population sample in the city of São Paulo, Brazil, in 1989. Functional status was evaluated using a scale of activities of personal and instrumental daily living. It was studied as a dichotomous variable: absence of dependency - disability/difficulty in none of the activities in contrast with moderate/severe dependency - disability/difficulty in 4 or more activities. Multiple regression analysis was applied to hierarchically clustered factors. RESULTS: Those with the following features were more associated to moderate/severe dependency: illiterate, retired, pensioner, housekeeper, living in a rented home, age over 65 years, multigenerational family composition, hospitalization in the last 6 months, mental health screening case, no visiting friends, and having a pessimistic perception of his/her own health when compared to their peers. CONCLUSIONS: The identified features associated to moderate/severe dependency suggest a complex net of causes for the declining functional status. However, one can assume that preventive measures directed to specific factors can benefit these population by improving their well-being.
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- 2003
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9. A theoretical model of the evolution of virulence in sexually transmitted HIV/AIDS Modelo teórico da evolucão da virulência do HIV/AIDS transmitido sexualmente
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FAB Coutinho, E Massad, RX Menezes, and MN Burattini
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Síndrome de Imunodeficiência Adquirida ,Virulência ,Modelos estatísticos ,Acquired Inmunodeficiency Syndrome ,Virulence ,Models, statistical ,Public aspects of medicine ,RA1-1270 - Abstract
INTRODUCTION: The evolution of virulence in host-parasite relationships has been the subject of several publications. In the case of HIV virulence, some authors suggest that the evolution of HIV virulence correlates with the rate of acquisition of new sexual partners. In contrast some other authors argue that the level of HIV virulence is independent of the sexual activity of the host population. METHODS: Provide a mathematical model for the study of the potential influence of human sexual behaviour on the evolution of virulence of HIV is provided. RESULTS: The results indicated that, when the probability of acquisition of infection is a function both of the sexual activity and of the virulence level of HIV strains, the evolution of HIV virulence correlates positively with the rate of acquisition of new sexual partners. CONCLUSION: It is concluded that in the case of a host population with a low (high) rate of exchange of sexual partners the evolution of HIV virulence is such that the less (more) virulent strain prevails.INTRODUÇÃO: A evolução da virulência na relação hospedeiro-parasita tem sido objeto de várias publicações. No caso do HIV, alguns autores sugerem que a evolução da virulência do HIV correlaciona-se com a taxa de aquisição de novos parceiros sexuais. Por outro lado, outros autores argumentam que o nível de virulência do HIV é independente da atividade sexual da população hospedeira. MÉTODOS: Propõe-se um modelo matemático para estudar a influência potencial que o comportamento sexual humano possa ter na evolução da virulência do HIV. RESULTADOS: Os resultados indicam que, quando a probabilidade de aquisição da infecção pelo HIV é uma função tanto da atividade sexual da população humana quanto da virulência das cepas de HIV, a evolução da virulência do HIV correlaciona-se positivamente com a taxa de aquisição de novos parceiros sexuais. CONCLUSÃO: Concluiu-se que no caso de uma população hospedeira com uma baixa (alta) taxa de troca de parceiros sexuais a evolução da virulência do HIV é tal que a cepa menos (mais) virulenta predomina.
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- 1999
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10. A theoretical model of the evolution of virulence in sexually transmitted HIV/AIDS
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Coutinho FAB, Massad E, Menezes RX, and Burattini MN
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Acquired Inmunodeficiency Syndrome ,Virulence ,Models, statistical ,Public aspects of medicine ,RA1-1270 - Abstract
INTRODUCTION: The evolution of virulence in host-parasite relationships has been the subject of several publications. In the case of HIV virulence, some authors suggest that the evolution of HIV virulence correlates with the rate of acquisition of new sexual partners. In contrast some other authors argue that the level of HIV virulence is independent of the sexual activity of the host population. METHODS: Provide a mathematical model for the study of the potential influence of human sexual behaviour on the evolution of virulence of HIV is provided. RESULTS: The results indicated that, when the probability of acquisition of infection is a function both of the sexual activity and of the virulence level of HIV strains, the evolution of HIV virulence correlates positively with the rate of acquisition of new sexual partners. CONCLUSION: It is concluded that in the case of a host population with a low (high) rate of exchange of sexual partners the evolution of HIV virulence is such that the less (more) virulent strain prevails.
- Published
- 1999
11. Which curve provides the best explanation of the growth in confirmed COVID-19 cases in Chile?
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Víctor Patricio Díaz-Narváez, David San-Martín-Roldán, Gonzalo Robledo-Veloso, Aracelis Calzadilla-Núñez, Alexander Parody-Muñoz, and Pablo San-Martín-Roldán
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Time Factors ,Epidemiology ,Pneumonia, Viral ,RT1-120 ,Nursing ,03 medical and health sciences ,Betacoronavirus ,0302 clinical medicine ,Infecções por Coronavírus ,Humans ,Epidemiología ,030212 general & internal medicine ,Chile ,Epidemiologia ,Pandemics ,Infecções por Coronavirus ,Pandemias ,Models, Statistical ,SARS-CoV-2 ,COVID-19 ,030208 emergency & critical care medicine ,Coronavirus ,Coronavírus ,2019-nCoV ,Original Article ,Coronavirus Infections ,Infecciones por Coronavirus - Abstract
Objetivo explorar o melhor tipo de curva ou modelo de tendência para explicar o comportamento epidemiológico do contágio por COVID-19 e derivar as possíveis causas que contribuem para explicar o modelo correspondente e as implicações em saúde que se podem inferir. Método os dados foram coletados nos relatórios da COVID-19 do Departamento de Epidemiologia, Ministério da Saúde do Chile. Os dados foram analisados através do ajustamento de curvas em quatro modelos diferentes: quadrático, exponencial, suavização exponencial simples e suavização exponencial dupla. O nível significância adotado foi de α≤0.05. Resultados a curva que mais se ajusta à evolução dos casos confirmados acumulados da COVID-19 no Chile é a curva com suavização exponencial dupla. Conclusão o número de infectados continuará aumentando e o Chile deve permanecer vigilante e ajustar suas estratégias em torno de medidas de prevenção e controle. O comportamento da população tem um papel fundamental. Sugerimos não relaxar quanto às restrições e seguir melhorando a vigilância epidemiológica. Devem ser feitos preparativos de emergência e mais recursos materiais devem ser adicionados para dar suporte ao sistema de saúde. Esta previsão é provisória e depende das variáveis intervenientes se manterem constantes e qualquer alteração modificará sua previsão. Objective to explore the best type of curve or trend model that could explain the epidemiological behavior of the infection by COVID-19 and derive the possible causes that contribute to explain the corresponding model and the health implications that can be inferred. Method data were collected from the COVID-19 reports of the Department of Epidemiology, Ministry of Health, Chile. Curve adjustment studies were developed with the data in four different models: quadratic, exponential, simple exponential smoothing, and double exponential smoothing. The significance level used was α≤0.05. Results the curve that best fits the evolution of the accumulated confirmed cases of COVID-19 in Chile is the doubly-smoothed exponential curve. Conclusion the number of infected patients will continue to increase. Chile needs to remain vigilant and adjust the strategies around the prevention and control measures. The behavior of the population plays a fundamental role. We suggest not relaxing restrictions and further improving epidemiological surveillance. Emergency preparations are needed and more resource elements need to be added to the current health support. This prediction is provisional and depends on keeping all intervening variables constant. Any alteration will modify the prediction. Objetivo explorar el mejor tipo de curva o modelo de tendencia que podría explicar el comportamiento epidemiológico del contagio por COVID-19 y derivar las posibles causas que contribuyan a explicar el modelo correspondiente y las implicaciones sanitarias que se pueden inferir. Método los datos fueron recogidos desde los informes COVID-19 del Departamento de Epidemiología, Ministerio de Salud, Chile. Los datos fueron sometidos a estudios de ajustes de curva en cuatro modelos diferentes: cuadrático, exponencial, exponencial suavizado simple y exponencial suavizado doble. El nivel de significación empleado fue de α≤0,05. Resultados la curva que más se ajusta a la evolución de los casos confirmados acumulados del COVID-19 en Chile es la curva doble exponencial suave. Conclusión el número de contagiados seguirá en aumento. Chile debe permanecer atento y ajustar las estrategias en torno a las medidas de prevención y control. El comportamiento poblacional juega un rol fundamental. Sugerimos no relajar las restricciones y seguir mejorando la vigilancia epidemiológica. Se deben hacer preparativos de emergencia y sumar más elementos de resorte al actual soporte sanitario. Esta predicción es tentativa y depende de que se mantengan todas las variables intervinientes constantes. Cualquier alteración modificará la predicción.
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- 2020
12. Time trend and spatial distribution of the cases of lethal violence against women in Brazil.
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Moroskoski M, Brito FAM, and Oliveira RR
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- Brazil epidemiology, Female, Humans, Models, Statistical, Spatial Analysis, Time Factors, Gender-Based Violence statistics & numerical data, Gender-Based Violence trends, Homicide statistics & numerical data, Homicide trends
- Abstract
Objective: to analyze the time trend and the spatial distribution of the cases of lethal violence against women in Brazil, according to age group and to race/skin color., Method: an ecological study of time series, with spatial distribution of the deaths of women victims of aggression, registered in the Mortality Information System, resident in Brazil, Brazilian geographic regions and states. Due to underreporting of deaths in some states, correction factors of the mortality rates were employed. For the trend analysis, we adopted the polynomial regression model. In addition to that, the mean rates and annual upward/downward trends were distributed considering the Brazilian federative units as analysis units., Results: the mean rate was 6.24 cases of lethal violence per 100,000 women, with a significant variation across the Brazilian regions and states. The main victims of violent death in Brazil are young, black-/brown-skinned and indigenous women, with a growing trend in these population segments. The North and Northeast regions stood out with the most significant mean annual increases (0.33; r2= 0.96 and 0.26; r2= 0.92, respectively)., Conclusion: there was a stable trend regarding lethal violence against women, with significant regional differences. Young, black-/brown-skinned and indigenous women are more vulnerable to violent death in Brazil.
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- 2022
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13. Apneas en lactantes con bronquiolitis: incidencia y factores de riesgo para un modelo de predicción
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Antonio Urda-Cardona, Mario Gutiérrez-Bedmar, David Moreno-Pérez, Lourdes Artacho-González, José Miguel Ramos-Fernández, Yasmina Martínez García, and María Ramírez-Álvarez
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Male ,Pediatrics ,medicine.medical_specialty ,Logistic regression model ,Apnea ,Caesarean delivery ,Modelo de regresión logística ,Logistic regression ,RJ1-570 ,03 medical and health sciences ,0302 clinical medicine ,Risk Factors ,Apnoea ,030225 pediatrics ,Management of Technology and Innovation ,medicine ,Humans ,030212 general & internal medicine ,Retrospective Studies ,Models, Statistical ,business.industry ,Incidence ,Incidence (epidemiology) ,Infant, Newborn ,Postmenstrual Age ,Infant ,Retrospective cohort study ,Bronquiolitis ,medicine.disease ,Low birth weight ,Bronchiolitis ,Acute Disease ,Female ,Lactantes ,medicine.symptom ,business ,Cesárea ,Infants ,Forecasting - Abstract
Introduction: The presence of apnoea in acute bronchiolitis (AB) varies between 1.2% and 28.8%, depending on the series, and is one of its most fearsome complications. The aim of this study is to determine the incidence of apnoea in hospitalised patients diagnosed with AB, and to define their associated risk factors in order to construct a prediction model. Patients and method: A retrospective observational study of patients admitted to a tertiary hospital in the last 5 years with a diagnosis of AB, according to the classic criteria. Data was collected on the frequency of apnoea and related clinical variables to find risk factors in a binary logistic regression model for the prediction of apnoea. A ROC curve was developed with the model. Results: Apnoea was recorded during the admission of 53 (4.4%) patients out of a total of 1.197 cases found. The risk factors included in the equation were: female (OR 0.6, 95% CI: 0.27–1.37), caesarean delivery (OR: 3.44, 95% CI: 1.5–7.7), postmenstrual age ≤43 weeks (OR: 6.62, 95% CI: 2.38–18.7), fever (OR: 0.33, 95% CI: 0.09–1.97), low birth weight (OR: 5.93, 95% CI: 2.23–7.67), apnoea observed by caregivers before admission (OR: 5.93, 95% CI: 2.64–13.3), and severe bacterial infection (OR: 3.98, 95% CI: 1.68–9.46). The optimal sensitivity and specificity of the model in the ROC curve was 0.842 and 0.846, respectively (P
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- 2018
14. Satisfacción con la atención en urgencias pediátricas: influencia del funcionamiento familiar y la alteración emocional
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Fernández-Castillo, Antonio and Vílchez-Lara, María J.
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Adult ,Male ,Parents ,Adolescent ,Urgencias ,Anger ,Alteración emocional ,Statistics, Nonparametric ,Young Adult ,Adaptation, Psychological ,Humans ,Family ,Child ,Emergency Treatment ,Aged ,Emotional disturbance ,Models, Statistical ,Ira ,Middle Aged ,Satisfacción del paciente ,Patient Satisfaction ,Spain ,Female ,Family Relations ,Emergencies ,Emergency Service, Hospital ,Relaciones familiares - Abstract
Resumen Este estudio aborda la relación entre dos elementos clave en la satisfacción con los servicios sanitarios de urgencias pediátricas: la afectación emocional y el funcionamiento familiar. El objetivo general es determinar si la cohesión, la adaptabilidad familiar y la ira pueden asociarse a niveles diferenciales de satisfacción en progenitores cuyos hijos eran atendidos en urgencias pediátricas. Se trata de un estudio descriptivo transversal para el que se trabajó con una muestra de 711 progenitores que habían sido atendidos en 6 servicios de urgencias pediátricas. Se utilizaron respectivamente las versiones españolas del Inventado de Expresión de Ira Estado-Rasgo-2 (STAXI-2), la Escala de Satisfacción con los Servicios Sanitarios y la Escala de Evaluación de la Cohesión y Adaptabilidad Familiar (Faces). El análisis de datos incluyó un análisis de correlaciones bivariadas de Spearman, pruebas de Kruskal Wallis, pruebas de Mann-Whitney y un path-analysis mediante un modelo de ecuaciones estructurales. Los resultados soportan la idea de que mayores niveles de cohesión y adaptabilidad familiar así como menores niveles de ira, se asocian a mayores niveles de satisfacción en los padres. Nuestros datos no reflejan diferencias significativas en ira entre padres y madres. Abstract This study addresses the relationship between two key elements in satisfaction with pediatric emergency services, namely emotional disturbance and family interaction. The main goal is to determine whether family cohesion and adaptability and anger may be associated with differential levels of satisfaction among parents whose children were attended in pediatric emergency units. It is a descriptive study for which a sample of 711 parents whose children were attended in 6 pediatric emergency services was studied. The Spanish version of the State-Trait Anger Expression Inventory-2 (Staxi-2), the Satisfaction with Healthcare Services Scale and the Family Adaptability and Cohesion Evaluation Scale (Faces) were used respectively. Data analysis included a Spearman bivariate correlations analysis, Kruskal Wallis, Mann-Whitney test and path-analysis using a structural equations model. The results support the hypothesis that higher levels of family cohesion and adaptability as well as lower levels of anger are associated with higher levels of satisfaction among parents.
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- 2018
15. Factores de riesgo oclusal en pacientes con disfunción temporomandibular Occlusal risk facts in patients with temporomandibular dysfunction
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Isabel Martínez Brito, Tomás Toledo Martínez, Ana Ma Prendes Rodríguez, Tahimí Saborit Carvajal, Ariel Delgado Ramos, and José M Morales Rigau
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TRASTORNOS DE LA ARTICULACIÓN TEMPOROMANDIBULAR ,MALOCLUSIÓN ,EPIDEMIOLOGÍA DESCRITIVA ,ESTUDIOS TRANSVERSALES ,MODELOS ESTADÍSTICOS ,HUMANOS ,NIÑO ,ADOLESCENCIA ,ADULTO ,TEMPOROMANDIBULAR JOINT DISORDERS ,MALOCCLUSION ,EPIDEMIOLOGY, DESCRIPTIVE ,CROSS-SECTIONAL STUDIES ,MODELS, STATISTICAL ,HUMANS ,CHILD ,ADOLESCENT ,ADULT ,Medicine - Abstract
La etiología de los trastornos temporomandibulares es de naturaleza compleja y se considera aún no resuelta. Entre los posibles factores de riesgo se citan las maloclusiones dentarias precisamente por las variaciones conque pueden presentarse, en ocasiones grandes discrepancias estructurales pueden provocar disturbios funcionales, con tendencia a agravarse cuando coexisten otros factores de riesgo. Este trabajo tiene como objetivo identificar factores de riesgo como las maloclusiones dentarias, y algunas características específicas como son el resalte y el sobrepase presentes en población de 7 a 44 años de edad con disfunción temporomandibular, los cuales fueron pesquisados en centros de enseñanza del municipio de Matanzas. El estudio realizado fue descriptivo y de corte transversal, cuya muestra fue seleccionada mediante la aplicación de un esquema probabilístico y multietápico, donde se seleccionaron 1,866 sujetos. Fue empleado el Test de Krogh Paulsen para el diagnóstico de disfunción. El 72% de los pacientes afectados con disfunción temporomandibular presentaron maloclusiones dentarias; el 40.9% alteraciones en el resalte y un 37.8% en relación al sobrepase, apreciándose un incremento de las mismas conjuntamente con las edades.The aetiology of temporomandibular disorders is complex and still unsolved. Among the possible risk facts are dental malocclusions precisely because of the variations they present. Occasionally, big structural discrepancies might provoke functional disturbances, with a tendency to get more serious when they coexist with other risk facts. The object of the current, descriptive and transversal study was identifying risk facts like dental malocclusions, and some specific characteristics like overjet and overpass in a 7-to-44 years-old population with temporomandibular dysfunction. They were investigated in schools of the municipality of Matanzas, applying a multistage, probabilistic method to select a sample of 1 866 persons. The Krogh Paulsen Test was used to diagnose the dysfunction. 72 % of the patients affected with temporomandibular dysfunctions had dental malocclusions; 40.9 % overjet and 37.8 % overpassing, finding an increase of them with age.
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- 2009
16. [Corrections to daily excess mortality estimates in Spain during the COVID-19 pandemic.]
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Equiza-Goñi J
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- Humans, Models, Statistical, Spain epidemiology, Time Factors, COVID-19 mortality, Mortality, Pandemics
- Abstract
Objective: MoMo is a mortality monitoring system that guides public health policy in Spain. The COVID-19 pandemic worsened death notification delays, thus biasing downwards the daily (cumulative) excess mortality estimates produced by MoMo. The goal of this study is to find the best model to correct these estimates for the effect of death notification delays., Methods: The process followed was: 1) estimates for the excess mortality accumulated in Spain since the beginning of the COVID-19 pandemic are published daily by MoMo and gathered in this study for the period 15/04/2020-25/05/2020. 2) the intensity of daily revisions is computed as the ratio of the estimate published each day divided by the estimate published the day before. 3) Adjusted excess mortality estimates result from applying to these ratios five different correcting models (a simple arithmetic mean or a weighted average, as well as linear, quadratic and cubic regressions). 4) The performance of these corrected estimates is compared with the definite values using the root mean square error (RMSE)., Results: The intensity of daily revisions for the cumulative excess of deaths fell to 1 (no revision) as the publication date left behind the date of death. The correcting estimates based on polynomial regressions reduced the error with respect to the definite observed values by 18-25%., Conclusions: To improve the validity of the daily estimates for the cumulative excess of deaths from MoMo, it is recommended to correct the notification delay of deaths using polynomial regression models estimated with data on previous revisions., Competing Interests: Disclosure The authors report no conflicts of interest in this work.
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- 2021
17. COVID-19 in Chile: The usefulness of simple epidemic models in practice.
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Canals M, Cuadrado C, and Canals A
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- Chile epidemiology, Forecasting, Humans, COVID-19 epidemiology, Models, Statistical
- Abstract
Objectives: The purpose of this article is to describe and develop the predictive value of three models during the COVID-19 epidemic in Chile, providing knowledge for decision-making in health., Methods: We developed three models during the epidemic: a discrete model to predict the maximum burden on the health system in a short time framea basic SEIR (susceptible-exposed-infected-removed) model with discrete equations; a stochastic SEIR model with the Monte Carlo method; and a Gompertz-type model for metropolitan city of Santiago., Results: The maximum potential burden model has been useful throughout the monitoring of the epidemic, providing an upper bound for the number of cases, intensive care unit occupancy, and deaths. Deterministic and stochastic SEIR models were very useful in predicting the rise of cases and the peak and onset of case decline; however, they lost utility in the current situation due to the asynchronous recruitment of cases in the regions and the persistence of a strong endemic. The Gompertz model had a better fit in the decline since it best captures the epidemic curves asymmetry in Santiago., Conclusions: The models have shown great utility in monitoring the epidemic in Chile, with different objectives in different epidemic stages. They have complemented empirical indicators such as reported cases, fatality, deaths, and others, making it possible to predict situations of interest and visualization of the short and long-term local behavior of this pandemic.
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- 2021
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18. [Predictive modeling to estimate the demand for intensive care hospital beds nationwide in the context of the COVID-19 pandemic].
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Peña VH and Espinosa A
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- COVID-19, Chile epidemiology, Humans, Pandemics, Coronavirus Infections epidemiology, Hospital Bed Capacity statistics & numerical data, Intensive Care Units supply & distribution, Models, Statistical, Pneumonia, Viral epidemiology
- Abstract
Introduction: SARS CoV-2 pandemic is pressing hard on the responsiveness of health systems worldwide, notably concerning the massive surge in demand for intensive care hospital beds., Aim: This study proposes a methodology to estimate the saturation moment of hospital intensive care beds (critical care beds) and determine the number of units required to compensate for this saturation., Methods: A total of 22,016 patients with diagnostic confirmation for COVID-19 caused by SARS-CoV-2 were analyzed between March 4 and May 5, 2020, nationwide. Based on information from the Chilean Ministry of Health and ministerial announcements in the media, the overall availability of critical care beds was estimated at 1,900 to 2,000. The Gompertz function was used to estimate the expected number of COVID-19 patients and to assess their exposure to the available supply of intensive care beds in various possible scenarios, taking into account the supply of total critical care beds, the average occupational index, and the demand for COVID-19 patients who would require an intensive care bed., Results: A 100% occupancy of critical care beds could be reached between May 11 and May 27. This condition could be extended for around 48 days, depending on how the expected over-demand is managed., Conclusion: A simple, easily interpretable, and applicable to all levels (nationwide, regionwide, municipalities, and hospitals) model is offered as a contribution to managing the expected demand for the coming weeks and helping reduce the adverse effects of the COVID-19 pandemic.
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- 2020
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19. Development of a model for predicting major infection following pediatric heart surgery.
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Jauregui AM, Urrunaga PV, Gonzales JA, Silva LE, Pasupuleti V, Steyerberg EW, Hernandez AV, and Silva EW
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- Child, Female, Humans, Male, Models, Statistical, Retrospective Studies, Risk Factors, Cardiac Surgical Procedures adverse effects, Surgical Wound Infection epidemiology
- Abstract
Objective: The aim of this study was to develop a risk prediction model for major postoperative infection (MPI) after pediatric heart surgery and to validate the model of the Society of Thoracic Surgeons (STS)., Materials and Methods: We analyzed a retrospective cohort of 1,025 children who underwent heart surgery with cardiopulmonary bypass (CPB) from 2000 to 2010. We used a logistic regression model, which was validated., Results: Of the 1,025 patients, 59 (5.8%) had at least one episode of MPI (4.8% had sepsis, 1% had mediastinitis, 0% had endocarditis). Hospital mortality (63% vs. 13%; p < 0.001), as well as duration of postoperative ventilation (301.6 vs. 34.3 hours; p < 0.001) and intensive care unit stay (20.9 vs. 5.1 days; p < 0.001) were higher in patients with MPI. The predictive factors found were age, sex, weight, cyanotic heart disease, RACHS-1 3-4, Ross-modified functional class IV, previous hospital stay, and previous history of mechanical ventilation. The proposed model had a c-statistic of 0.80 (95% CI: 0.74-0.86) and was considered as clinically useful. The STS model showed a c-statistic of 0.78 (95% CI: 0.71-0.84) and a Hosmer-Lemeshow of 18.2 (P = 0.020). A comparison between the two models was made using an accurate Fisher test., Conclusion: A model with good performance and calibration was developed to preoperatively identify children at high risk for severe infection after cardiac surgery with CPB. The STS model was also validated and was found to have a moderate discrimination performance.
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- 2020
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20. Height growth study of healthy children and adolescents from Córdoba, Argentina.
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Cuestas ME, Cieri ME, Ruiz Brünner MLM, and Cuestas E
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- Adolescent, Argentina, Child, Child, Preschool, Cross-Sectional Studies, Female, Humans, Male, Models, Statistical, Prospective Studies, Reference Values, Sex Factors, Adolescent Development physiology, Body Height physiology, Child Development physiology, Growth Charts
- Abstract
Objective: Based on a sample of children and adolescents of both genders, our objective is to des cribe height growth, estimate the peak age at growth spurt, growth rate at this point, the final adult height expected, and differential patterns Subjects and Method: A cross-sectional study was conduc ted using demographic, clinical, and anthropometric data collected prospectively from children and adolescents of both sexes between 2015 and 2016. Height percentiles were calculated using the LMS (skewness, median, and coefficient of variation) method and then adjusted using the Preece-Baines model 1., Results: We evaluated 861 participants (484 girls, 377 boys), aged between 2 and 18 years. The estimated peak age at growth spurt (he) was 13.6 years in boys and 11.0 years in girls, with a peak growth rate (V2) at this point of 6.4 cm/year for both sexes. The mean expected adult height (h1) was 173.7 cm in boys and 160.0 cm in girls., Conclusions: Preece-Baines model 1 provides satisfactory estimates for the peak age at growth spurt, peak growth rate at this point, and final expected adult height.
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- 2020
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21. [Principles of Bayesian statistics and its relationship with applied pharmacokinetics].
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Cáceres Guido P, Humberto Pavan C, Otamendi E, and Bramuglia GF
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- Adolescent, Child, Child, Preschool, Drug Monitoring methods, Drug Monitoring statistics & numerical data, Humans, Infant, Infant, Newborn, Pharmacology, Clinical statistics & numerical data, Bayes Theorem, Data Interpretation, Statistical, Models, Statistical, Pharmacokinetics, Pharmacology, Clinical methods, Research Design
- Abstract
If one knows the probability of an event occurring in a population, Bayesian statistics allows mo difying its value when there is new individual information available. Although the Bayesian and frequentist (classical) methodologies have identical fields of application, the first one is increasin gly applied in scientific research and big data analysis. In modern pharmacotherapy, clinical phar macokinetics has been used for the expansion of monitoring, facilitated by technical-analytical and mathematical-statistical developments. Population pharmacokinetics has allowed the identification and quantification of pathophysiological and treatment characteristics in a specific patient popu lation, especially in the pediatric and neonatal population and other vulnerable groups, explaining interindividual variability. Likewise, Bayesian estimation is important as a statistical tool applied in pharmacotherapy optimization software when pharmacological monitoring is based on clinical phar macokinetic interpretation. With its advantages and despite its limitations, pharmacotherapeutic op timization based on Bayesian estimation is increasingly used, becoming the reference method today. This characteristic is particularly convenient for routine clinical practice due to the limited number of samples required from the patient and the flexibility it shows regarding blood sampling times for drug quantification. Therefore, the application of Bayesian principles to the practice of clinical phar macokinetics has led to the improvement of pharmacotherapeutic care.
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- 2020
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22. [Mathematical approach of the SIR epidemiological model for the comprehension of the containment measures against the Covid-19.]
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Wilches Visbal JH and Castillo Pedraza MC
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- Betacoronavirus, COVID-19, Cities, Colombia epidemiology, Coronavirus Infections prevention & control, Disease Outbreaks, Humans, Pandemics prevention & control, Pneumonia, Viral prevention & control, SARS-CoV-2, Communicable Disease Control, Coronavirus Infections epidemiology, Models, Statistical, Pneumonia, Viral epidemiology
- Abstract
In December 2019, an acute respiratory disease outbreak from zoonotic origin was detected in the city of Wuhan, China. The outbreak's infectious agent was a type of coronavirus never seen. Thenceforth, the Covid-19 disease has rapidly spread to more than 200 countries around the world. To minimize the devastating effects of the virus, the States have adopted epidemiological measures of various kinds that involved enormous economic expenses and the massive use of the media to explain the measures to the entire population. For the prediction and mitigation of infectious events, various epidemiological models, such as SIR, SEIR, MSIR and MSEIR, are used. Among them, the most widely used is the SIR model, which is based on the analysis of the transition of individuals susceptible to infection (S) to the state of infected individuals that infect (I) and, finally, to that of recovered (cured or deceased) (R), by using differential equations. The objective of this article was the mathematical development of the SIR model and its application to predict the course of the Covid-19 pandemic in the city of Santa Marta (Colombia), in order to understand the reason behind several of the measures of containment adopted by the States of the world in the fight against the pandemic.
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- 2020
23. [Statistical and Mathematical Modeling in the Coronavirus Epidemic: Some Considerations to Minimize Biases in the Results].
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Matabuena M, Madrid Padilla OH, and Gonzalez-Barcala FJ
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- Asymptomatic Infections epidemiology, Bias, COVID-19, Coronavirus Infections prevention & control, Data Collection, Humans, Models, Statistical, Pandemics prevention & control, Pneumonia, Viral prevention & control, SARS-CoV-2, Betacoronavirus, Coronavirus Infections epidemiology, Models, Theoretical, Pneumonia, Viral epidemiology
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- 2020
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24. Polygenic risk score as a key factor in cardiovascular clinical prediction models.
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Brion M, González-Juanatey JR, and Carracedo Á
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- Genome-Wide Association Study, Humans, Prognosis, Risk Factors, Models, Statistical, Multifactorial Inheritance genetics
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- 2020
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25. [Covid-19 and child health: confinement and its impact according to child professionals.]
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Valero Alzaga E, Martín Roncero U, and Domínguez-Rodríguez A
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- Algorithms, Betacoronavirus, COVID-19, Child, Child Health Services, Cross-Sectional Studies, Family, Health Status, Humans, Internet, Models, Statistical, Pandemics, SARS-CoV-2, Spain epidemiology, Surveys and Questionnaires, Tobacco Smoke Pollution, Child Health, Coronavirus Infections complications, Coronavirus Infections epidemiology, Pneumonia, Viral complications, Pneumonia, Viral epidemiology, Quarantine, Social Isolation
- Abstract
Objective: The Covid-19 pandemic led to the establishment of the state of alarm in Spanish and the initial lockdown of the entire population. The aim of this study is to analyse the assessment of professionals working with children on the impact of quarantine on the health and health inequalities of the child population, as well as the importance given to the intermediate factors that can modulate the impact of the experience of lockdown on children's health., Methods: A cross-sectional study was made according to an online questionnaire to professionals in health and socio-educational fields working with children (n=214) with questions concerning the potential effects of lockdown and the dimensions that could modulate those effects. For the analysis, descriptive statistics were calculated together with Chi-square tests and comparison of means to analyse differences according to professional field., Results: 86% of the experts pointed out the potential negative impact of quarantine on the health of children, especially that of the most vulnerable, highlighting the adverse effects of conflict at home and exposure to tobacco smoke in this experience, which were scored in importance with more than 9 and 8.5 respectively., Conclusions: The results show how, according to child professionals, lockdown can have an impact on the health of the child population that goes beyond the direct effect of Covid-19., Competing Interests: Disclosure The authors report no conflicts of interest in this work.
- Published
- 2020
26. [Analysis of costs and consequences related to the persistence of Mirabegron and antimuscarinic treatments and their impact on quality of life in patients with overactive bladder in Spain: Results of a probabilistic model.]
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Arlandis Guzmán S, Jiménez Cidre MÁ, Rubio-Rodríguez D, Rubio-Terrés C, Landeira M, and Blanco N
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- Acetanilides, Humans, Models, Statistical, Spain, Thiazoles, Muscarinic Antagonists therapeutic use, Quality of Life, Urinary Bladder, Overactive drug therapy
- Abstract
Objective: To evaluate whether the lower dropout rate of the treatment of overactive bladde r(OAB) with mirabegron could generate cost savings to the National Health System (NHS) and lead to quality-adjusted life years (QALYs) gains, compared to the most commonly prescribed antimuscarinics (AM) in Spain (tolterodine, fesoterodine, oxybutynin, solifenacin)., Methods: A probabilistic model (second order Monte Carlo simulation) in a hypothetical cohort of 1,000 patients with OAB and a time horizon of 1 year was carried out. Discontinuation and persistence rates for both mirabegron and AM were obtained from a Spanish observational study in 1798 patients. Unit costs (€ 2018) and utility loss associated with treatment discontinuation were obtained from Spanish public prices and literature, respectively., Results: Persistence rates in patients treated with mirabegron were twice as high compared to AM, leading to a QALY gain of 0.0151 ± 0.0007 per year. Treatment with mirabegron could generate savings of 80.74 ±4.61 € per patient per year compared to AM, assuming 100% probability of saving. The hypothetical substitution of AM treatment for mirabegron could potentially generate savings of 6.6 million euros (95% CI 3.9-10.1 million euros) to the NHS and 1,238 QALYs gains (CI95%731; 1,885 QALYs) within a period of 1 year., Conclusions: The probabilistic model presented showed a greater persistence in patients treated with mirabegron compared to AM, leading to a positive impactin patients quality of life, as well cost savings to the NHS in Spain.
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- 2020
27. Which curve provides the best explanation of the growth in confirmed COVID-19 cases in Chile?
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Díaz-Narváez V, San-Martín-Roldán D, Calzadilla-Núñez A, San-Martín-Roldán P, Parody-Muñoz A, and Robledo-Veloso G
- Subjects
- COVID-19, Chile epidemiology, Humans, Models, Statistical, SARS-CoV-2, Time Factors, Betacoronavirus, Coronavirus Infections epidemiology, Pandemics statistics & numerical data, Pneumonia, Viral epidemiology
- Abstract
Objective: to explore the best type of curve or trend model that could explain the epidemiological behavior of the infection by COVID-19 and derive the possible causes that contribute to explain the corresponding model and the health implications that can be inferred., Method: data were collected from the COVID-19 reports of the Department of Epidemiology, Ministry of Health, Chile. Curve adjustment studies were developed with the data in four different models: quadratic, exponential, simple exponential smoothing, and double exponential smoothing. The significance level used was α≤0.05., Results: the curve that best fits the evolution of the accumulated confirmed cases of COVID-19 in Chile is the doubly-smoothed exponential curve., Conclusion: the number of infected patients will continue to increase. Chile needs to remain vigilant and adjust the strategies around the prevention and control measures. The behavior of the population plays a fundamental role. We suggest not relaxing restrictions and further improving epidemiological surveillance. Emergency preparations are needed and more resource elements need to be added to the current health support. This prediction is provisional and depends on keeping all intervening variables constant. Any alteration will modify the prediction.
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- 2020
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28. Estimation and prediction of COVID-19 cases in Brazilian metropolises.
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Sousa GJB, Garces TS, Cestari VRF, Moreira TMM, Florêncio RS, and Pereira MLD
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- Algorithms, Brazil epidemiology, COVID-19, Cities epidemiology, Coronavirus Infections mortality, Coronavirus Infections transmission, Humans, Models, Statistical, Models, Theoretical, Pneumonia, Viral mortality, Pneumonia, Viral transmission, SARS-CoV-2, Time Factors, Betacoronavirus, Coronavirus Infections epidemiology, Pandemics statistics & numerical data, Pneumonia, Viral epidemiology
- Abstract
Objective: to estimate the transmission rate, the epidemiological peak, and the number of deaths by the new coronavirus., Method: a mathematical and epidemiological model of susceptible, infected, and recovered cases was applied to the nine Brazilian capitals with the highest number of cases of the infection. The number of cases for the 80 days following the first case was estimated by solving the differential equations. The results were logarithmized and compared with the actual values to observe the model fit. In all scenarios, it was considered that no preventive measures had been taken., Results: the nine metropolises studied showed an upward curve of confirmed cases of COVID-19. The prediction data point to the peak of the infection between late April and early May. Fortaleza and Manaus had the highest transmission rates (≥2·0 and ≥1·8, respectively). Rio de Janeiro may have the largest number of infected people (692,957) and Florianópolis the smallest (24,750)., Conclusion: the estimates of the transmission rate, epidemiological peak, and number of deaths from coronavirus in Brazilian metropolises presented expressive and important numbers the Brazilian Ministry of Health needs to consider. The results confirm the rapid spread of the virus and its high mortality in the country.
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- 2020
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29. A machine learning-based model for 1-year mortality prediction in patients admitted to an Intensive Care Unit with a diagnosis of sepsis.
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García-Gallo JE, Fonseca-Ruiz NJ, Celi LA, and Duitama-Muñoz JF
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- Aged, Area Under Curve, Critical Illness mortality, Female, Humans, Intensive Care Units, Male, Middle Aged, ROC Curve, Registries, Retrospective Studies, Severity of Illness Index, Time Factors, Algorithms, Forecasting methods, Machine Learning, Models, Statistical, Sepsis mortality
- Abstract
Introduction: Sepsis is associated to a high mortality rate, and its severity must be evaluated quickly. The severity of illness scores used are intended to be applicable to all patient populations, and generally evaluate in-hospital mortality. However, patients with sepsis continue to be at risk of death after hospital discharge., Objective: To develop a model for predicting 1-year mortality in critical patients diagnosed with sepsis., Patients: The data corresponding to 5650 admissions of patients with sepsis from the Medical Information Mart for Intensive Care (MIMIC-III) database were evaluated, randomly divided as follows: 70% for training and 30% for validation., Design: A retrospective register-based cohort study was carried out. The clinical information of the first 24h after admission was used to develop a 1-year mortality prediction model based on Stochastic Gradient Boosting (SGB) methodology. Variable selection was addressed using Least Absolute Shrinkage and Selection Operator (LASSO) and SGB variable importance methodologies. The predictive power was evaluated using the area under the ROC curve (AUROC)., Results: An AUROC of 0.8039 (95% confidence interval (CI): [0.8033 0.8045]) was obtained in the validation subset. The model exceeded the predictive performances obtained with traditional severity of disease scores in the same subset., Conclusion: The use of assembly algorithms, such as SGB, for the generation of a customized model for sepsis yields more accurate 1-year mortality prediction than the traditional scoring systems such as SAPS II, SOFA or OASIS., (Copyright © 2018 Elsevier España, S.L.U. y SEMICYUC. All rights reserved.)
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- 2020
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30. Experiential avoidance and excessive smartphone use: a Bayesian approach.
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Ruiz-Ruano AM, López-Salmerón MD, and López Puga J
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- Adult, Female, Humans, Male, Surveys and Questionnaires, Behavior, Addictive psychology, Models, Statistical, Smartphone trends, Social Networking
- Abstract
The smartphone is a common tool in our everyday lives. However, recent research suggests that using the smartphone has both positive and negative consequences. Although there is no agreement on the concept or the term to label it, researchers and clinical practitioners are worried about the negative consequences derived from excessive smartphone usage. This study aims to analyse the relationship between smartphone addiction and experiential avoidance. A sample of 1176 participants (828 women) with ages ranging from 16 to 82 (M = 30.97; SD = 12.05) was used. The SAS-SV scale was used to measure smartphone addiction and the AAQ-II to assess experiential avoidance. To model the relationship between variables, Bayesian inference and Bayesian networks were used. The results show that experiential avoidance and social networks usage are directly related to smartphone addiction. Additionally, the data suggests that sex is playing a mediating role in the observed relationship between these variables. These results are useful for understanding healthy and pathological interaction with smartphones and could be helpful in orienting or planning future psychological interventions to treat smartphone addiction.
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- 2020
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31. Number of COVID-19 cases in Chile at 120 days with data at 21/03/2020 and threshold of daily effort to flatten the epi-curve.
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Córdova-Lepe F, Gutiérrez-Aguilar R, and Gutiérrez-Jara JP
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- COVID-19, Chile epidemiology, Humans, Pandemics, Prevalence, SARS-CoV-2, Betacoronavirus, Coronavirus Infections epidemiology, Disease Outbreaks, Models, Statistical, Pneumonia, Viral epidemiology
- Abstract
We present a straightforward projection with data up to 21/03/2020 of the evolution of the number of COVID-19 cases per day in Chile using data from the Ministry of Health. Assuming an arithmetical growth in the second variation of the data, we present a cubic adjustment model in which we estimate over 100 000 cases at 120 days consistent with the data recorded to date. Furthermore, we use an exponential total case model to represent (using a parameter) the daily effort to reduce a high initial daily growth rate. We simulate this model with different numerical scenarios of feasibility and desired future prevalence.
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- 2020
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32. [SIR model of the COVID-19 pandemic in Colombia].
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Manrique-Abril FG, Agudelo-Calderon CA, González-Chordá VM, Gutiérrez-Lesmes O, Téllez-Piñerez CF, and Herrera-Amaya G
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- Humans, Pandemics, SARS-CoV-2, Epidemiological Models, Colombia epidemiology, Models, Statistical, COVID-19 epidemiology
- Abstract
Objective: To develop a prognostic SIR model of the COVID-19 pandemic in Colombia., Materials and Methods: A SIR model with a deterministic approach was used to forecast the development of the COVID-19 pandemic in Colombia. The states considered were susceptible (S), infectious (i) and recovered or deceased (R). Population data were obtained from the National Administrative Department of Statistics (DANE) - Population Projections 2018-2020, released in January 2020-, and data on daily confirmed cases of COVID-19 from the National Institute of Health. Different models were proposed varying the basic reproduction number (R0)., Results: Based on the cases reported by the Ministry of Health, 4 simulated environments were created in an epidemiological SIR model. The time series was extended until May 30, the probable date when 99% of the population will be infected. R0=2 is the basic reproduction number and the closest approximation to the behavior of the pandemic during the first 15 days since the first case report; the worst scenario would occur in the first week of April with R0=3., Conclusions: Further mitigation and suppression measures are necessary in the containment and sustained transmission phases, such as increased diagnostic capacity through testing and disinfection of populated areas and homes in isolation.
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- 2020
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33. Validation of the CUETO scoring model for predicting recurrence and progression in T1G3 urothelial carcinoma of the bladder.
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Krajewski W, Rodríguez-Faba O, Breda A, Pisano F, Poletajew S, Tukiendorf A, Zdrojowy R, Kołodziej A, and Palou J
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- Aged, Carcinoma, Transitional Cell epidemiology, Carcinoma, Transitional Cell pathology, Disease Progression, Female, Humans, Male, Middle Aged, Neoplasm Recurrence, Local epidemiology, Neoplasm Staging, Prognosis, Retrospective Studies, Urinary Bladder Neoplasms epidemiology, Urinary Bladder Neoplasms pathology, Adjuvants, Immunologic therapeutic use, BCG Vaccine therapeutic use, Carcinoma, Transitional Cell drug therapy, Models, Statistical, Urinary Bladder Neoplasms drug therapy
- Abstract
Introduction and Objectives: Various studies tried to validate Club Urológico Español de Tratamiento Oncológico (CUETO) tables, yet, none of this papers focused on the high and very high risk bladder cancers. The aim of the study was to externally validate the CUETO model for predicting disease recurrence and progression in group of T1G3 tumors treated with BCG immunotherapy., Patients or Materials and Methods: Data from 414 patients with primary T1G3 bladder cancer were analysed. To evaluate the model discrimination, Cox proportional hazard regression models were created and concordance indexes were calculated., Results: The median follow-up was 68 months. The recurrence was observed in 212 (51.2%) and 64 patients (15.5%) experienced the recurrence more than once during the study follow-up. Progression of the cancer was observed in 106 patients (25.6%). Radical cystectomy was performed in 115 patients (27.8%) and there were 64 (15.5%) cancer specific deaths. For recurrence and progression probability, the concordance index of the CUETO models was 0.633 and 0.697 respectively. CUETO tables underestimated significantly the risk of recurrence and marginally the risk of progression in the first year of observation. For 5 years of observation, the trend for the recurrence was much less clear. On the contrary, there was slight overestimation in the risk of progression. The study is limited by retrospective nature., Conclusions: It was shown that the CUETO risk tables exhibit a fair discrimination for both disease recurrence and progression in T1G3 patients treated with BCG. CUETO scoring model underestimates the risk of tumor recurrence, but predicts well risk of progression., (Copyright © 2019 AEU. Publicado por Elsevier España, S.L.U. All rights reserved.)
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- 2019
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34. MBIS: Multivariate Bayesian Image Segmentation Tool
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Oscar Esteban, Maria J. Ledesma-Carbayo, Jean-Philippe Thiran, Subrahmanyam Gorthi, Andres Santos, Meritxell Bach-Cuadra, and Gert Wollny
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FOS: Computer and information sciences ,Adult ,Aging ,Multivariate statistics ,Computer science ,Matemáticas ,Medicina ,Computer Vision and Pattern Recognition (cs.CV) ,Computer Science - Computer Vision and Pattern Recognition ,Scale-space segmentation ,62P10, 62F15 ,Health Informatics ,Multivariate normal distribution ,CIBM-SPC ,computer.software_genre ,Reproducible research ,Young Adult ,Image Interpretation, Computer-Assisted ,Cluster Analysis ,Humans ,Segmentation ,Cluster analysis ,Aged ,Aged, 80 and over ,Image segmentation ,Telecomunicaciones ,Models, Statistical ,Segmentation-based object categorization ,LTS5 ,Brain ,Bayes Theorem ,Organ Size ,Middle Aged ,Magnetic Resonance Imaging ,Markov Chains ,Computer Science Applications ,ITK ,Multivariate Analysis ,Graph-cuts ,Data mining ,Hidden Markov random field ,Multivariate ,computer ,Algorithms ,Software - Abstract
We present MBIS (Multivariate Bayesian Image Segmentation tool), a clustering tool based on the mixture of multivariate normal distributions model. MBIS supports multichannel bias field correction based on a B-spline model. A second methodological novelty is the inclusion of graph-cuts optimization for the stationary anisotropic hidden Markov random field model. Along with MBIS, we release an evaluation framework that contains three different experiments on multi-site data. We first validate the accuracy of segmentation and the estimated bias field for each channel. MBIS outperforms a widely used segmentation tool in a cross-comparison evaluation. The second experiment demonstrates the robustness of results on atlas-free segmentation of two image sets from scan-rescan protocols on 21 healthy subjects. Multivariate segmentation is more replicable than the monospectral counterpart on T1-weighted images. Finally, we provide a third experiment to illustrate how MBIS can be used in a large-scale study of tissue volume change with increasing age in 584 healthy subjects. This last result is meaningful as multivariate segmentation performs robustly without the need for prior knowledge. (C) 2014 Elsevier Ireland Ltd. All rights reserved.
- Published
- 2014
35. Predictability of pharmaceutical spending in primary health services using Clinical Risk Groups
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Isabel Barrachina-Martínez, José Luis Trillo-Mata, Laia Buigues-Pastor, David Vivas-Consuelo, Ruth Usó-Talamantes, and María Caballer-Tarazona
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Male ,ECONOMIA APLICADA ,Health Status ,Population ,Context (language use) ,Pharmacy expenditure ,Drug Costs ,Sex Factors ,Drug Therapy ,Dummy variable ,Primary health ,Medicine ,Humans ,Predictability ,education ,education.field_of_study ,Actuarial science ,Models, Statistical ,Primary Health Care ,business.industry ,Health Policy ,Clinical Risk Groups ,Age Factors ,ECONOMIA, SOCIOLOGIA Y POLITICA AGRARIA ,Test (assessment) ,Risk adjustment ,One Health ,Spain ,Chronic Disease ,Predictive power ,Female ,business ,WHO-ATC-Code - Abstract
Background: Risk adjustment instruments applied to existing electronic health records and administrative datasets may contribute to monitoring the correct prescribing of medicines. Objective: We aim to test the suitability of the model based on the CRG system and obtain specific adjusted weights for determined health states through a predictive model of pharmaceutical expenditure in primary health care. Methods: A database of 261,054 population in one health district of an Eastern region of Spain was used. The predictive power of two models was compared. The first model (ATC-model) used nine dummy variables: sex and 8 groups from 1 to 8 or more chronic conditions while in the second model (CRG-model) we include sex and 8 dummy variables for health core statuses 2-9. Results: The two models achieved similar levels of explanation. However, the CRG system offers higher clinical significance and higher operational utility in a real context, as it offers richer and more updated information on patients. Conclusions: The potential of the CRG model developed compared to ATC codes lies in its capacity to stratify the population according to specific chronic conditions of the patients, allowing us to know the degree of severity of a patient or group of patients, predict their pharmaceutical cost and establish specific programmes for their treatment. (C) 2014 Elsevier Ireland Ltd. All rights reserved., This study was financed by a grant from the Fondo de Investigaciones de la Seguridad Social Instituto de Salud Carlos III, the Spanish Ministry of Health (FIS PI12/0037). The authors would like to thank members (Juan Bru and Inma Sauri) of the Pharmacoeconomics Office of the Valencian Health Agency. The opinions expressed in this paper are those of the authors and do not necessary reflect those of the afore-named. Any errors are the authors' responsibility. We would also like to thank John Wright for the English editing.
- Published
- 2014
36. Distribution and habitat suitability index model for the Andean catfish Astroblepus ubidiai (Pisces: Siluriformes) in Ecuador
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Luis A. Vélez-Espino
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habitat inventory ,Conservation of Natural Resources ,habitat suitability ,Population ,Population Dynamics ,Biology ,fragmentación ,preñadilla ,Species Specificity ,Abundance (ecology) ,fragmentation ,Vegetation type ,Animals ,Biomass ,calidad del hábitat ,education ,lcsh:QH301-705.5 ,Catfishes ,Ecosystem ,Population Density ,Biomass (ecology) ,education.field_of_study ,Models, Statistical ,Behavior, Animal ,Ecology ,Substrate (marine biology) ,Habitat ,lcsh:Biology (General) ,Biological dispersal ,Conservation biology ,Ecuador ,Seasons ,General Agricultural and Biological Sciences ,inventario del habitat ,Astroblepus ubidiai - Abstract
In conservation biology there is a basic need to determine habitat suitability and availability. Astroblepus ubidiai (Siluriforms), the only native fish in the highlands of Imbabura province in the Ecuadorian Andes, was abundant in the past in the Imbakucha watershed and adjacent drainages, but currently it is restricted to a few isolated refuges. Conservation actions are needed if this unique fish is to persist. A Habitat Suitability Index (HSI) for the species has been developed in order to aid management decisions. In this HIS model biomass density (B) was selected as a better indicator of habitat quality than either abundance or density. A population well-being index (PI) was constructed with the combination of B and an indicator of fish health (proportion of fish in the population with parasites and deformities). Based in other models of benthic fish the habitat variables current velocity, flow, depth, width, cover, invertebrate composition, vegetation type, terrestrial vegetation, land use, substrate, temperature, pH, TDS, oxygen, altitude, and slope were included in the analysis. An anthropogenic perturbation index (H) and a fragment isolation index (FII) were developed and included as habitat variables as well. The HSI model was applied to refuges and a sample of 15 aquatic bodies without fish populations within the study region. From the sampled sites without A. ubidiai 26.6% presented low quality, and the remaining 73.3% had medium quality according to the HSI estimated. Good quality habitat for dispersal, escape or translocations is rare in the region. The low HSIs estimated in some of the refuges suggests that current populations are not settled in the most favorable habitat but in the habitat least favorable to the agents of decline. Rev. Biol. Trop. 54(2): 623-638. Epub 2006 Jun 01.Astroblepus ubidiai (Siluriformes), el único pez nativo de las alturas de Imbabura, en los Andes Ecuatorianos, era un recurso abundante en el pasado. Actualmente su distribución está limitada a unos cuantos refugios aislados. Se necesitan acciones de conservación para que esta especie perdure. Se desarrolló un modelo para estimar el índice de calidad de hábitat (ICH) que ayude en futuras decisiones de manejo. En este ICH la densidad de biomasa (B) fue seleccionada como un mejor indicador de calidad de hábitat, comparada con el uso común de abundancia o densidad incorporado en otros modelos. Se generó un índice de bienestar poblacional (IP) basado en B y en un indicador de salud poblacional (SP) derivado de la proporción de peces en la población con parásitos y malformaciones. Diecinueve variables físicas, biológicas y geográficas fueron evaluadas dentro del modelo, el cual fue aplicado a una muestra de 15 sitios sin poblaciones de A. ubidiai dentro del área de estudio. De esta muestra, 26.6% de los sitios presentó baja calidad de hábitat, y el restante 73.3% presentó calidad media de acuerdo a la evaluación con el modelo. En la región hay escasos hábitats de buena calidad para dispersión, escape y reubicación de este pez.
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- 2014
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37. Confidence interval reporting for measures of association in multivariable regression models in observational studies.
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González-Marrón A, Real J, Forné C, Roso-Llorach A, Navarrete-Muñoz EM, and Martínez-Sánchez JM
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- Multivariate Analysis, Regression Analysis, Confidence Intervals, Models, Statistical, Observational Studies as Topic statistics & numerical data
- Abstract
Background/objectives: To assess the adherence to reporting confidence intervals (CI) for measures of association in multivariable regression models (MRM) in articles with observational design indexed in MEDLINE., Material and Methods: A literature search was conducted using the MEDLINE bibliographic database to obtain a representative sample of studies with observational design and applying MRM (logistic, linear, and Cox regression) (n=428). Proportions and 95% CI of articles reporting CI for measures of association in MRM were calculated. Percentage ratios (PRs) were also calculated to describe the change in CI reporting before and after the publication of the STROBE statement., Results: 188 of the 236 abstracts with measures of association (79.7%; 95% CI 74.5, 84.8) and 360 of the 428 main texts (84.1%; 80.6, 87.6) were provided with CI. A non-significant increase of 1% in the abstract, PR=1.01 (0.77, 1.29), and 7% in the main text, PR=1.07 (0.87, 1.28), occurred in the CI reporting after the publication of the STROBE guideline., Conclusions: The STROBE guideline recommendation on reporting CI should be more thoroughly followed., (Copyright © 2018 Elsevier España, S.L.U. All rights reserved.)
- Published
- 2019
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38. Serosurveillance for vaccine-preventable diseases: A look inside the pertussis experience
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Hincapié D, Acevedo M, Hoyos MC, Ochoa J, González C, Pérez PA, Molina A, Restrepo BI, Arrubla M, Echeverri AP, Almanza RE, González LD, Santacruz-Sanmartín E, Orrego NE, Arango D, Gutiérrez AM, Londoño OL, Toro LM, Ríos M, Villada O, Mejía LA, Arenas PA, García D, and Osorio E
- Subjects
- Antibodies, Bacterial blood, Bordetella pertussis immunology, Colombia epidemiology, Female, Fetal Blood immunology, Humans, Immunity, Herd, Infant, Newborn, Models, Statistical, Pregnancy, Pregnancy Complications, Infectious epidemiology, Pregnancy Complications, Infectious immunology, Sampling Studies, Seroepidemiologic Studies, Urban Population, Vaccination Coverage, Vaccine-Preventable Diseases blood, Vaccine-Preventable Diseases prevention & control, Whooping Cough blood, Whooping Cough prevention & control, Population Surveillance, Vaccine-Preventable Diseases epidemiology, Whooping Cough epidemiology
- Abstract
Introduction: Serological surveillance (serosurveillance) provides the most direct measure of herd immunity of vaccine-preventable diseases. Little is known about the opportunities and challenges of serosurveillance experiences, particularly pertussis., Objective: To describe the process of serosurveillance for vaccine-preventable diseases with an emphasis on the experience of pertussis in the metropolitan area of Antioquia (Valle de Aburrá) in 2015 and 2016 and analyze the contributions and challenges for its sustainability., Materials and Methods: We described the planning and conduction of serosurveillance of pertussis antibodies of mothers and in the umbilical cord at the time of delivery in eight hospitals based on random sampling and their capacity to advance the serosurveillance periodically. We compared the contributions and the challenges of this experience with other probabilistic and non-probabilistic programs., Results: We achieved the participation of hospitals and mothers respecting the delivery care process. We established a serum bank following ethical and technical guidelines. This program based on the random selection of hospitals and mothers has enabled the estimation of antibodies prevalence in mothers and in the umbilical cord, which has been possible given the high coverage of hospital care during childbirth at a lower cost and fewer risks than a population-based survey in conflictive areas. The main challenges for the sustainability of this program are the creation of stable jobs and access to funding and legal and methodological long-term frameworks., Conclusions: Hospital serosurveillance as described is an option to monitor the impact of vaccination on the population. Our experience could be reproduced in other regions under similar conditions if the above-mentioned challenges are solved.
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- 2019
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39. [Perceived self-efficacy in patients after a cardiac rehabilitation programme in primary care: A new model of attention.]
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Madueño Caro AJ, Mellado Fernández ML, Pardos Lafarga M, Muñoz Ayllón M, Martín-López C, and Gómez-Salgado J
- Subjects
- Academic Medical Centers, Aged, Attention, Depression diagnosis, Female, Heart Diseases psychology, Humans, Male, Middle Aged, Models, Statistical, Patient Participation, Psychiatric Status Rating Scales, Reproducibility of Results, Severity of Illness Index, Spain epidemiology, Cardiac Rehabilitation methods, Community Health Services organization & administration, Heart Diseases rehabilitation, Primary Health Care methods, Self Efficacy
- Abstract
Objective: The literature points to the possibility of carrying out an intervention, from primary prevention to rehabilitation after a cardiac event, towards decreasing the incidence of such cardiac events and facilitating the return to daily life. The objective was to determine the effect of a cardiac rehabilitation intervention over perceived selfefficacy for patients who have suffered a cardiac event., Methods: A community clinical trial, open, controlled, and randomised, was designed, and performed in primary care. To determine the sample size, the research team used the General Self-Efficacy Scale by Baessler and Schwarzer. The mean difference between groups considered of clinical relevance was of at least 6 points in the aforementioned General Self-Efficacy Scale. A precision of 95% and a test power of 80% were accepted. The result proposed a sample of 44 subjects in each group. Over 12 months, all subjects of legal age (N = 104), both sexes, that had concluded phase II in the cardiac rehabilitation unit of the university Hospital Puerta del Mar (Cadiz) were offered to participate in the study. The patients were informed about the study development, asking for their participation and providing them with a written informed consent. The subjects were randomly assigned to the intervention or control group through blind allocation (in a sealed envelope to the researcher), on a pre-set 2:1 ratio (two patients assigned to the intervention group to one assigned to the control group). A non-response or rejection to participate in the study record was made for the non-response analysis., Results: A total of 89 subjects were included in the statistical analysis (response rate of 85.57%), with an average age of 63.01 years (SD: 8.75). The main dependent variable was the scores difference between groups, comparing means before and after the intervention, through the General Self-Efficacy Scale by Baessler & Schwarner. A mean difference of 6.0972 points was obtained between the intervention and the control groups (p<0.0053; 95% CI -4.1950 to -10.29), as a result of a 3.3750 mean points increase (standard deviation: 7.01) in the intervention group and a 3.3750 mean points decrease (standard deviation: 7.19) in the control group. In relation to the possible changes to be detected through the Hamilton anxiety scale and the Beck's depression inventory, after finishing the intervention, an estimate and contrast of population means was made between groups for the scores difference in the Hamilton scale, determined on the final visit, with no significant differences found (t-student 0.1211; p <0.9 43). Similarly, no significant differences were found between the groups for the means obtained in the variable "Beck's depression inventory scores difference" (t-student -0.1281; p<0.8987)., Conclusions: The inclusion in cardiac rehabilitation programmes carried out in primary care improves the general perceived self-efficacy of patients who have suffered cardiac events., Competing Interests: Disclosure The authors report no conflicts of interest in this work.
- Published
- 2019
40. [Application of alternative parametric models for the survival analysis of cancer patients].
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Valencia-Orozco A, Parra-Lara LG, Martínez JW, and Tovar-Cuevas JR
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- Humans, Kaplan-Meier Estimate, Survival Analysis, Colonic Neoplasms pathology, Models, Statistical, Neoplasms pathology
- Abstract
This article describes a methodology that allows an approach to alternative right-censored probabilistic models for the analysis of survival, different to those usually studied (exponential, gamma, Weibull, and log-normal distribution) since it is possible that the data do not always fit with sufficient precision due to existing distributions. The methodology used allows for greater flexibility when modeling extreme observations, generally located in the right tail of data distribution, which admits that some events still have the probability of occurring, which is not the case with traditional models and the Kaplan-Meier estimator, which estimates for the longest times, survival probabilities approximately equal to zero. To show the usefulness of the methodological proposal, we considered an application with real data that relates survival times of patients with colon cancer (CC).
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- 2019
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41. [Comparison of predictive models for the selection of high-complexity patients].
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Estupiñán-Ramírez M, Tristancho-Ajamil R, Company-Sancho MC, and Sánchez-Janáriz H
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- Adult, Cross-Sectional Studies, Female, Forecasting, Humans, Male, Risk Assessment, Spain, Models, Statistical, Patient Admission statistics & numerical data, Patients classification, Systems Analysis
- Abstract
Objective: To compare the concordance of complexity weights between Clinical Risk Groups (CRG) and Adjusted Morbidity Groups (AMG). To determine which one is the best predictor of patient admission. To optimise the method used to select the 0.5% of patients of higher complexity that will be included in an intervention protocol., Method: Cross-sectional analytical study in 18 Canary Island health areas, 385,049 citizens were enrolled, using sociodemographic variables from health cards; diagnoses and use of healthcare resources obtained from primary health care electronic records (PCHR) and the basic minimum set of hospital data; the functional status recorded in the PCHR, and the drugs prescribed through the electronic prescription system. The correlation between stratifiers was estimated from these data. The ability of each stratifier to predict patient admissions was evaluated and prediction optimisation models were constructed., Results: Concordance between weights complexity stratifiers was strong (rho = 0.735) and the correlation between categories of complexity was moderate (weighted kappa = 0.515). AMG complexity weight predicts better patient admission than CRG (AUC: 0.696 [0.695-0.697] versus 0.692 [0.691-0.693]). Other predictive variables were added to the AMG weight, obtaining the best AUC (0.708 [0.707-0.708]) the model composed by AMG, sex, age, Pfeiffer and Barthel scales, re-admissions and number of prescribed therapeutic groups., Conclusions: strong concordance was found between stratifiers, and higher predictive capacity for admission from AMG, which can be increased by adding other dimensions., (Copyright © 2017 SESPAS. Publicado por Elsevier España, S.L.U. All rights reserved.)
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- 2019
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42. Severity scores in trauma patients admitted to ICU. Physiological and anatomic models.
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Serviá L, Badia M, Montserrat N, and Trujillano J
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- APACHE, Adult, Age Factors, Aged, Calibration, Chi-Square Distribution, Female, Humans, Male, Middle Aged, Prospective Studies, ROC Curve, Simplified Acute Physiology Score, Injury Severity Score, Intensive Care Units, Models, Anatomic, Models, Biological, Models, Statistical, Wounds and Injuries mortality
- Abstract
Introduction: The goals of this project were to compare both the anatomic and physiologic severity scores in trauma patients admitted to intensive care unit (ICU), and to elaborate mixed statistical models to improve the precision of the scores., Methods: A prospective study of cohorts. The combined medical/surgical ICU in a secondary university hospital. Seven hundred and eighty trauma patients admitted to ICU older than 16 years of age. Anatomic models (ISS and NISS) were compared and combined with physiological models (T-RTS, APACHE II [APII], and MPM II). The probability of death was calculated following the TRISS method. The discrimination was assessed using ROC curves (ABC [CI 95%]), and the calibration using the Hosmer-Lemeshoẃs H test. The mixed models were elaborated with the tree classification method type Chi Square Automatic Interaction Detection., Results: A 14% global mortality was recorded. The physiological models presented the best discrimination values (APII of 0.87 [0.84-0.90]). All models were affected by bad calibration (P<.01). The best mixed model resulted from the combination of APII and ISS (0.88 [0.83-0.90]). This model was able to differentiate between a 7.5% mortality for elderly patients with pathological antecedents and a 25% mortality in patients presenting traumatic brain injury, from a pool of patients with APII values ranging from 10 to 17 and an ISS threshold of 22., Conclusions: The physiological models perform better than the anatomical models in traumatic patients admitted to the ICU. Patients with low scores in the physiological models require an anatomic analysis of the injuries to determine their severity., (Copyright © 2017 Elsevier España, S.L.U. y SEMICYUC. All rights reserved.)
- Published
- 2019
- Full Text
- View/download PDF
43. Adults discharged after an epileptic seizure: a model of 30-day risk for adverse outcomes.
- Author
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Alonso Avilés R, Fernández Alonso C, Liñán López M, González Martínez F, Fuentes Ferrer ME, and Gros Bañeres B
- Subjects
- Adult, Aged, Humans, Middle Aged, Patient Readmission, Prospective Studies, Recurrence, Registries, Time Factors, Emergency Service, Hospital statistics & numerical data, Models, Statistical, Patient Discharge statistics & numerical data, Risk, Seizures mortality
- Abstract
Objectives: To develop a risk model to predict adverse outcomes within 30 days of discharge in adults attended by hospital emergency departments for an epileptic seizure., Methods: ACESUR (Acute Epileptic Seizures in the Emergency Department) is a prospective multicenter, multipurpose registry of cases obtained by systematic sampling. We made follow-up telephone calls to registered patients 30 days after discharge. Clinical variables for the index visit were extracted from the register and variables at 30 days were collected by telephone. The main outcome variable was the occurrence of any adverse outcome (seizure recurrence, emergency department revisit, hospitalization, or death) within 30 days of discharge., Results: Of the patients from the ACESUR registry discharged from 18 hospitals, we included 489 (74%) with complete follow-up information. The median (interquartile range) age was de 48 (34-66) years. One hundred forty-four patients (29.4%) experienced an adverse outcome within 30 days of discharge. Factors included in the ACESUR risk model were generalized nonconvulsive tonic-clonic epileptic seizure as the reason for the index visit (odds ratio [OR], 2.42; 95% CI, 1.49-3.90; P<.001), ongoing use of 3 or more medications (OR, 1.98; 95% CI, 1.28-3.07; P=.002), and an emergency visit for any reason in the 6 months prior to the index event (OR, 2.34; 95% CI, 1.47-3.70; P<.001). Each factor contributed 1 point to the risk score. A score of 3 was associated with a 62.2% risk of an adverse outcome within 30 days, a score of 2 was associated with a 38.5% risk, a score of 1 with a 25.9% risk, and a score of 0 with a 10.9% risk. The area under the curve receiver operating characteristic curve was 0.72 (95% CI, 0.675-0.772; P=.025)., Conclusion: The ACESUR risk model may provide a useful score for identifying patients at high risk of an adverse outcome within 30 days of emergency department discharge after an epileptic seizure.
- Published
- 2019
44. Trend and seasonality of community-acquired Escherichia coli antimicrobial resistance and its dynamic relationship with antimicrobial use assessed by ARIMA models.
- Author
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Asencio Egea MÁ, Huertas Vaquero M, Carranza González R, Herráez Carrera Ó, Redondo González O, and Arias Arias Á
- Subjects
- Community-Acquired Infections drug therapy, Community-Acquired Infections epidemiology, Drug Utilization statistics & numerical data, Escherichia coli Infections epidemiology, Humans, Models, Statistical, Retrospective Studies, Anti-Bacterial Agents pharmacology, Anti-Bacterial Agents therapeutic use, Drug Resistance, Bacterial, Escherichia coli drug effects, Escherichia coli Infections drug therapy, Seasons
- Abstract
Introduction: We studied the trend and seasonality of community-acquired Escherichia coli resistance and quantified its correlation with the previous use of certain antibiotics., Methods: A time series study of resistant community-acquired E. coli isolates and their association with antibiotic use was conducted in a Primary Health Care Area from 2008 to 2012. A Poisson regression model was constructed to estimate the trend and seasonality of E. coli resistance., Results: A significant increasing trend in mean E. coli resistance to cephalosporins, aminoglycosides and nitrofurantoin was observed. Seasonal resistance to ciprofloxacin and amoxicillin-clavulanic acid was significantly higher in autumn-winter. There was a delay of 7, 10 and 12 months between the use of cotrimoxazole (P<0.038), fosfomycin (P<0.024) and amoxicillin-clavulanic acid (P<0.015), respectively, and the occurrence of E. coli resistance., Conclusions: An average delay of 10 months between the previous use of amoxicillin-clavulanic acid, cotrimoxazole and fosfomycin and the appearance of resistant community-acquired E. coli strains was detected., (Copyright © 2017 Elsevier España, S.L.U. and Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica. All rights reserved.)
- Published
- 2018
- Full Text
- View/download PDF
45. Uso de la distribución geométrica como aproximación a la confiabilidad de un servicio de soporte técnico desde la perspectiva del usuario
- Author
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Pérez Rave, Jorge Iván, Parra Mesa, Carlos Marío, and Universidad de Antioquia
- Subjects
Models, Statistical ,modelo probabilístico de fallas ,Servicios ,confiabilidad de servicios ,Modelos Estadísticos ,Services ,Geometry ,dimensiones de calidad ,Quality ,Geométrica ,satisfacción del cliente ,distribución geométrica ,agrovoc:c_6989 ,Calidad - Abstract
RESUMEN: En este artículo se exhibe una propuesta metodológica para evaluar y analizar la confiabilidad de bienes intangibles mediante su aplicación al caso del servicio de soporte técnico de la Facultad de Ingeniería de la Universidad de Antioquia (Colombia). En ella se concibe el servicio como un sistema en serie conformado por componentes intangibles independientes entre sí, denominados dimensiones de calidad, y se emplea la distribución geométrica para modelar su comportamiento. Dicha metodología integra elementos de estadística multivariable, teoría de la probabilidad, investigación cualitativa, así como herramientas de la confiabilidad. Su aplicación le posibilita a una organización de servicios reflexionar sobre la posición que ocupa en cuanto a confiabilidad se refiere, establecer objetivos retadores e implementar directrices de mejoramiento que permitan garantizar en el tiempo la satisfacción de las necesidades de los clientes. ABSTRACT: In this paper a methodological proposal is presented to evaluate and analyze the reliability of intangible goods by applying such methodology to the case of the technical support service provided in the Faculty of Engineering of the University of Antioquia (Colombia). In this methodology, service is conceived as a serial system consisting of intangible, independent components, known as quality dimensions. Geometric distribution is used to simulate its behavior. Such methodology integrates elements of multivariable statistics, theory of probability, qualitative research, as well as reliability tools. The use of this methodology allows service companies to think about its reliability ranking, to establish challenging objectives and to implement improvement guidelines that guarantee, in the long run, the satisfaction of the customer’s needs. COL0058541
- Published
- 2009
46. Uso de teorías y modelos en artículos de una revista latinoamericana de salud pública, 2000-2004
- Author
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Cabrera Arana,Gustavo Alonso
- Subjects
Revisión ,Mathematical models ,Brasil ,Modelos epidemiológicos ,Artigo de revista ,Review ,Revisão ,Models, Theoretical ,Artículo de revista ,Modelos estatísticos ,Modelos matemáticos ,Modelos estadísticos ,Modelos teóricos ,Models, statistical ,Journal article ,Epidemiologic models - Abstract
OBJETIVO: Caracterizar la frecuencia y tipo de uso de teorías o modelos citados en artículos publicados en una revista latinoamericana de salud publica entre los años 2000 y 2004. MÉTODOS: Se escogió la Revista de Saúde Pública por su historia de publicación periódica sin interrupción e impacto actual en la comunicación científica del área. Se aplicó un procedimiento estándar para leer los artículos y clasificarlos en una tipología arbitraria de cuatro niveles según la profundidad del uso dado a los referentes teóricos o modelos citados en los textos para describir asuntos o problemas abordados, formular métodos y discutir a rigor los hallazgos comunicados. RESULTADOS: Se leyeron 482 artículos: 421 (87%) investigaciones, 42 (9%) revisiones o especiales y 19 (4%) textos de opinión o reflexión. En las 421 investigaciones, 286 (68%) tuvieron enfoque cuantitativo, 110 (26%) cualitativo y 25 (6%) mixtos. La cita de teorías o modelos fue infrecuente; 90 (19%) artículos revisados citan algun referente. Según la profundidad de uso 29 (6%) de los 90 fueron tipo I, 9 (1,9%) tipo II, 6 (1,3%) tipo III y 46 (9,5%), tipo IV. CONCLUSIONES: La citación de modelos fue nueve veces más frecuente que la de alguna teoría; el uso ideal, el tipo IV, ocurrió en apenas uno de cada diez artículos analizados. Hay relevancia de explicitar los marcos teóricos y modelos usados al abordar temas, formular hipótesis, diseñar métodos y discutir hallazgos en las contribuciones de las revistas científicas del área. OBJECTIVE: To characterize frequency and type of use of theories or models on papers of a Latin-American journal in public health between 2000 and 2004. METHODS: The Revista de Saúde Pública was chosen because of its history of periodic publication without interruption and current impact on the scientific communication of the area. A standard procedure was applied for reading and classifying articles in an arbitrary typology of four levels, according to the depth of the use of models or theoretical references to describe problems or issues, to formulate methods and to discuss results. RESULTS: Of 482 articles included, 421 (87%) were research studies, 42 (9%) reviews or special contributions and 19 (4%) opinion texts or assays . Of 421 research studies, 286 (68%) had a quantitative focus, 110 (26%) qualitative and 25 (6%) mixed. Reference to theories or models is uncommon, only 90 (19%) articles mentioned a theory or model. According to the depth of the use, 29 (6%) were classified as type I, 9 (2%) as type II, 6 (1.3%) were type III and the 46 remaining texts (9.5%) were type IV. CONCLUSIONS: Reference to models was nine-fold more frequent than the use of theoretical references. The ideal use, type IV, occurred in one of every ten articles studied. It is of relevance to show theoretical and models frames used when approaching topics, formulating hypothesis, designing methods and discussing findings in papers. OBJETIVO: Caracterizar a freqüência e tipo de uso de teorias ou modelos citados em artigos publicados em uma revista latino-americana de saúde pública entre os anos 2000 e 2004. MÉTODOS: A Revista de Saúde Pública foi escolhida por sua história de publicação ininterrupta e atual impacto na comunicação científica da área. Foi aplicado um procedimento padrão para ler e classificar os artigos de acordo com tipologia de quatro níveis, segundo a profundidade de uso dado aos referenciais teóricos ou modelos citados nos textos para descrever assuntos ou problemas abordados, formular métodos e discutir a rigor os achados comunicados. RESULTADOS: Foram lidos 482 artigos: 421 (87%) investigações, 42 (9%) revisões ou especiais e 19 (4%) textos de opinião ou reflexão. Nas 421 investigações, 286 (68%) tiveram enfoque quantitativo, 110 (26%) qualitativo e 25 (6%) mistos. A menção a teorias ou modelos não foi freqüente; apenas 90 (19%) dos artigos revisados citavam alguma teoria ou modelo. Segundo a profundidade de uso, 29 (6%) dos 90 foram tipo I, 9 (1,9%) tipo II, 6 (1,3%) tipo III e 46 (9,5%), tipo IV. CONCLUSÕES: A citação de modelos foi nove vezes mais freqüente do que de alguma teoria; o uso ideal, de tipo IV, ocorreu em apenas um de cada dez artículos analisados. É relevante explicitar os marcos teóricos e modelos usados ao abordar temas, formular hipóteses, desenhar métodos e discutir achados nas contribuições das revistas científicas da área.
- Published
- 2007
47. A note on ENDOG: a computer program for analysing pedigree information
- Author
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Juan Pablo Gutiérrez and Félix Goyache
- Subjects
Computer science ,Producción animal ,Pedigree information ,Population ,Food Animals ,Effective population size ,Statistics ,Animals ,Inbreeding ,Genetic variability ,education ,Genetics ,education.field_of_study ,Models, Statistical ,Models, Genetic ,Computer program ,General Medicine ,Genética ,Founder Effect ,Pedigree ,F-statistics ,Animal Science and Zoology ,Software ,Founder effect - Abstract
The aim of this note is to describe the program endog (v.3.0). The program handles pedigree information to conduct several demographic and genetic analyses including: (a) the individual inbreeding and average relatedness coefficients; (b) effective population size; (c) parameters characterizing the concentration of both gene and individuals origin such as the effective number of founders and ancestors, the effective number of founder herds; (d) F statistics and paired genetic distances for each subpopulation under study; (e) descriptors of the genetic importance of the herds in a population and (f) generation intervals. The program will help breeders and researchers to monitor the changes in genetic variability and population structure with limited costs of preparing datasets. The program, user’s guide and example file can be downloaded free of charge from the World Wide Web at http://www.ucm.es/ info/prodanim/Endog30.zip.
- Published
- 2005
48. [Neuroticism and suicidal thoughts: a meta-analytic study].
- Author
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García Herrero AM, Sánchez-Meca J, Álvarez Muñoz FJ, Rubio-Aparicio M, and Navarro-Mateu F
- Subjects
- Humans, Models, Psychological, Models, Statistical, Risk Factors, Neuroticism, Suicidal Ideation
- Abstract
Background: There are conflicting results on the relationship between neuroticism and suicidal ideation in community population. The objectives of this study were to estimate the magnitude and direction of the association between neuroticism and suicide ideation, and to analyze the influence of moderator variables on the effect size., Methods: A systematic review and a meta-analysis were carried out. The search for studies was conducted in PubMed/MEDLINE, IME, Lilacs, CINAHL, and EMBASE, until January 2015. A manual search was also carried out and main researchers were contacted. The inclusion criteria were: (a) studies of the association between neuroticism and suicidal ideation; (b) observational and descriptive studies; (c) studies carried out with community population over 18 years; (d) in any geographic region; and (e) written in English, Spanish, French, Portuguese or Italian. The random-effects model was applied to obtain the mean effect size and to explore moderators., Results: Thirteen articles focused on the association between neuroticism and suicide ideation were included in the meta-analysis. The mean effect size was r+ = 0.446 (IC 95%: 0.266-0.595). Publication bias was discarded as a threat against the validity of the results. A predictive model was stablished with two moderator variables: gender and type of self-report to measure neuroticism., Conclusions: Neuroticism can be considered as a risk factor for suicide ideation. This result is important to prevent both suicidal ideation and suicide behavior.
- Published
- 2018
49. Analysis of causality from observational studies and its application in clinical research in Intensive Care Medicine.
- Author
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Coscia Requena C, Muriel A, and Peñuelas O
- Subjects
- Humans, Models, Statistical, Biomedical Research, Causality, Critical Care, Observational Studies as Topic, Propensity Score
- Abstract
Random allocation of treatment or intervention is the key feature of clinical trials and divides patients into treatment groups that are approximately balanced for baseline, and therefore comparable covariates except for the variable treatment of the study. However, in observational studies, where treatment allocation is not random, patients in the treatment and control groups often differ in covariates that are related to intervention variables. These imbalances in covariates can lead to biased estimates of the treatment effect. However, randomized clinical trials are sometimes not feasible for ethical, logistical, economic or other reasons. To resolve these situations, interest in the field of clinical research has grown in designing studies that are most similar to randomized experiments using observational (i.e. non-random) data. Observational studies using propensity score analysis methods have been increasing in the scientific papers of Intensive Care. Propensity score analyses attempt to control for confounding in non-experimental studies by adjusting for the likelihood that a given patient is exposed. However, studies with propensity indexes may be confusing, and intensivists are not familiar with this methodology and may not fully understand the importance of this technique. The objectives of this review are: to describe the fundamentals of propensity index methods; to present the techniques to adequately evaluate propensity index models; to discuss the advantages and disadvantages of these techniques., (Copyright © 2018 Elsevier España, S.L.U. y SEMICYUC. All rights reserved.)
- Published
- 2018
- Full Text
- View/download PDF
50. MUL+DO: a multicomponent index for the quick diagnosis of peritonitis in peritoneal dialysis patients.
- Author
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Núñez Moral M, Martínez-Camblor P, Méndez González A, Rodríguez Suárez C, and Sánchez Álvarez JE
- Subjects
- Female, Hemodialysis Solutions, Humans, Leukocytes, Male, Middle Aged, Models, Statistical, Reagent Strips, Time Factors, Peritoneal Dialysis, Peritonitis diagnosis, Peritonitis microbiology
- Abstract
Peritoneal infection is a common problem that has a negative impact on the survival of patients and the technique. The early administration of peritoneal infection treatment reduces complications. The goal of this study is to propose a multicomponent index (MUL+DO) for the quick and efficient diagnosis of peritoneal infection. We selected a training cohort of peritoneal effluent samples which were analysed by Multistix ® 10 SG Siemens test strips for leukocyte detection. Then, each sample was examined according to the gold standard: number of leukocytes, polymorphonuclear percentage and microbiological culture. We constructed the MUL+DO index by adding one point to the MULTISTIX [0-1-2-3] modified chromatic scale if the patient reported pain. The MUL+DO index ranged from 0 to 4. A model validation cohort was then created. MUL+DO was applied to each sample and leukocytes and polymorphonuclear percentage were also assessed. The training cohort ultimately included 134 samples, 34 of which with infection (25.4% [17.6-33.1]). Samples with a MUL+DO value greater than 1 presented a sensitivity and specificity of 100%. The validation cohort included 100 samples with 16 infections (16% [8.3-23.7]). Assuming a sample with a MUL+DO value greater than 1 to be positive, we obtained a sensitivity of 100% and a specificity of 95.2%. The MUL+DO index applied to the training cohort showed a perfect separation of the positive and negative populations. All positive patients presented a score ≥2. In the validation cohort, the MUL+DO reported a sensitivity of 100% and a specificity of 95.2%., (Copyright © 2017 Sociedad Española de Nefrología. Published by Elsevier España, S.L.U. All rights reserved.)
- Published
- 2018
- Full Text
- View/download PDF
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