Predicting nationwide obesity from food sales using machine learning.

The obesity epidemic progresses everywhere across the globe, and implementing frequent nationwide surveys to measure the percentage of obese population is costly. Conversely, country-level food sales information can be accessed inexpensively through different suppliers on a regular basis. This study applies a methodology to predict obesity prevalence at the country-level based on national sales of a small subset of food and beverage categories. Three machine learning algorithms for nonlinear regression were implemented using purchase and obesity prevalence data from 79 countries: support vector machines, random forests and extreme gradient boosting. The proposed method was validated in terms of both the absolute prediction error and the proportion of countries for which the obesity prevalence was predicted satisfactorily. We found that the most-relevant food category to predict obesity is baked goods and flours, followed by cheese and carbonated drinks.

Is Banning Texturized Implants to Prevent Breast Implant-Associated Anaplastic Large Cell Lymphoma a Rational Decision? A Meta-Analysis and Cost-Effectiveness Study.

BACKGROUND: Breast implant-associated anaplastic large cell lymphoma (BIA-ALCL) is an emergent disease that threatens patients with texturized breast implants. Major concerns about the safety of these implants are leading to global changes to restrict the utilization of this product. The principal alternative is to perform breast augmentation utilizing smooth implants, given the lack of association with BIA-ALCL. The implications and costs of this intervention are unknown. OBJECTIVES: The authors of this study determined the cost-effectiveness of smooth implants compared with texturized implants for breast augmentation surgery. METHODS: A tree decision model was utilized to analyze the cost-effectiveness. Model input parameters were derived from published sources. The capsular contracture (CC) rate was calculated from a meta-analysis. Effectiveness measures were life years, avoided BIA-ALCL, avoided deaths, and avoided reoperations. A sensitivity analysis was performed to test the robustness of the model. RESULTS: For avoided BIA-ALCL, the incremental cost was $18,562,003 for smooth implants over texturized implants. The incremental cost-effectiveness ratio was negative for life years, and avoided death and avoided reoperations were negative. The sensitivity analysis revealed that to avoid 1 case of BIA-ALCL, the utilization of smooth implants would be cost-effective for a risk of developing BIA-ALCL equal to or greater than 1:196, and there is a probability of CC with smooth implants equal to or less than 0.096. CONCLUSIONS: The utilization of smooth implants to prevent BIA-ALCL is not cost-effective. Banning texturized implants to prevent BIA-ALCL may involve additional consequences, which should be considered in light of higher CC rates and more reoperations associated with smooth implants than with texturized implants.

A pilot study of an enhanced mental health assessment during routine and discharge medicals in the British Armed Forces.

OBJECTIVES: A pilot study to assess the practicality of introducing an enhanced mental health assessment (EMHA) into all routine and discharge medicals of the UK Armed Forces in order to facilitate treatment prior to and on return to civilian life. METHODS: A pilot study was conducted using an EMHA questionnaire with questions about depression, anxiety, post-traumatic stress disorder, alcohol use, sleep and anger/irritability. At pilot sites, the EMHA was completed during all routine and discharge medicals between May 2011 and July 2011. At the end of the study period, qualitative data were collected from participating medical officers and practice managers regarding their opinions about the pilot study. RESULTS: The quantitative data revealed an average pick-up rate for mental health (MH) problems. Out of the four military medical centres who participated and the 325 questionnaires collected, one referral to a Department of Community Mental Health was made. 26 (8%) patients were categorised as 'some concern and patient offered advice and/or reassurance'. The vast majority of patients were found to have no evidence of MH problems. However, using a validated alcohol screening tool, 64% of service personnel were found to have a score indicating 'higher risk drinking'. Analysis of the qualitative data suggests that the EMHA is an easy tool to implement with minimal additional time and resources needed. The interviewees pointed out a number of limitations and suggestions for possible further studies. CONCLUSIONS: The pilot study successfully demonstrated that the EMHA questionnaire is easy to administer, does not take up a large amount of additional resources or manpower and provides a useful check of MH status. The study picked up an average number of MH cases and the questions on alcohol consumption highlighted that military personnel may be at a 'higher risk of drinking'.

Aproximación al perfil de los directores de centros de salud de atención primaria en Chile / Description directors of health centers of primary care in Chile

Objetivo. Describir el perfil de los Directores de los Centros de Salud Rural, Centros de Salud Urbanos y Centros de Salud Familiar pertenecientes a la Atención Primaria de Salud en Chile. Metodología. Este es un estudio de tipo descriptivo, transversal, no experimental. La muestra es aleatoria, estratificada por región y se obtuvo desde un universo comprendido por 506 directores de CESFAM y CES de Chile. Los Datos se analizaron a través de medidas de frecuencia, tendencia central y asociación entre calidad laboral y post-formación a través de χ2 (p<0.05). Resultados . El promedio de edad de los directores a nivel nacional es de 45 años, siendo un 66,2 por ciento mujeres. Las profesiones con mayor frecuencia son: Medicina (21,2 por ciento), Enfermería (17,6 por ciento) y Obstetricia (16,2 por ciento); la mayoría se encuentra en su cargo como titular (76,6 por ciento). Sobre el tiempo de permanencia en el cargo, obtenemos una mediana de 29,5 meses y experiencia previa de 10 años; un 88,7 por ciento posee algún tipo de post-formación en gestión y/o salud pública. Conclusiones. En Chile contamos con directivos en los centros de salud primaria: consolidados, con experiencia previa y postformados lo cual constituye una masa técnica altamente positiva en este subsistema y un capital de importancia para los próximos desafíos sanitarios.

Objective: To describe the profile of Directors of the Rural Health Centers, Health Centers and Urban Family Health Centers belonging to Primary Health Care in Chile. Materials and methods: Descriptive, cross-sectional, non experimental study. The stratified, random sample was extracted from region, with a universe of 506 directors. The data was analyzed by measures of frequency, central tendency and association between job quality and post-training through χ2 (p <0.05).Results: The average age of directors nationwide is 45 years old, and the 66.2 percent are women. The most frequent professions are: Medicine (21.2 percent), nursing (17.6 percent) and obstetrics (16.2 percent), most are in their positions as titular directors (76.6 percent). About how long they’ve been in their position, we get a median of 29.5 months, and 10 years of previous experience, 88.7 percent have some type of post-training in management and /or public health. Conclusions: In Chile we have managers in Primary Health Centers consolidated with previous experience and post-trained, so we have a highly technical specialized mass in this subsystem and it’s also a great capital for the next health challenges of our country.

Multiresolution permutation filter implementations based on acyclic connected graphs.

Permutation filters are a broad class of nonlinear selection filters that utilize the complete spatial and rank order information of observation samples. This use of joint spatial-rank information has proven useful in numerous applications. The application of permutation filters, however, is limited by the factorial growth in the number of spatial-rank orderings. Although M-permutation filters have been developed to address the growth in orderings, their a priori uniform selection of samples is not appropriate in most cases. Permutation filter implementations based on acyclic connected graphs provide a more general approach that allows the level of ordering information utilized to automatically adjust to the problem at hand. In addition to developing and analyzing graph implementations of permutation filters this paper presents a LNE based optimization of the graph structure and filter operation. Simulation results illustrating the performance of the optimization technique and the advantages of the graph implementation are presented.

Uso de estradiol transdérmico continuo y medroxiprogesterona oral trimestral / Continous transdermal estradiol use and medroxiprogesterone oral quarterly

Uno de los métodos para reducir o evitar los efectos colaterales de los progestágenos y así mejorar el cumplimiento de la hormonoterapia de reemplazo(HTR) es el agregado de dichos esteroides a los estrógenos en esquemas no diarios en esquemas no mensuales. El objetivo de este estudio fue evaluar el uso de uno de estos esquemas alternativos: estrógeno continuo y progrestágeno cada tres meses sobre los síntomas climatéricos, el sangrado uterino, la presión arterial, el peso corporal, los lípidos en sangre, la histología endometrial y su aceptabilidad. Ciento siete pacientes posmenopáusicas recibieron 50 mcg de estradiol transdérmico en forma continua durante seis meses y 10 mg de acetato de medroxiprogesterona (AMP) por vía oral durante 14 días cada tres meses.En síntesis, el uso de estradiol transdérmico continuo y AMP oral trimestral mostró ser un tratamiento eficaz los síntomas climatéricos, inducir un sangrado uterino aceptable, siendo bien tolerado por las pacientes y sin provocar lesiones de riesto en el endometrio(AU)

Uso de estradiol transdérmico continuo y medroxiprogesterona oral trimestral / Continous transdermal estradiol use and medroxiprogesterone oral quarterly

Uno de los métodos para reducir o evitar los efectos colaterales de los progestágenos y así mejorar el cumplimiento de la hormonoterapia de reemplazo(HTR) es el agregado de dichos esteroides a los estrógenos en esquemas no diarios en esquemas no mensuales. El objetivo de este estudio fue evaluar el uso de uno de estos esquemas alternativos: estrógeno continuo y progrestágeno cada tres meses sobre los síntomas climatéricos, el sangrado uterino, la presión arterial, el peso corporal, los lípidos en sangre, la histología endometrial y su aceptabilidad. Ciento siete pacientes posmenopáusicas recibieron 50 mcg de estradiol transdérmico en forma continua durante seis meses y 10 mg de acetato de medroxiprogesterona (AMP) por vía oral durante 14 días cada tres meses.En síntesis, el uso de estradiol transdérmico continuo y AMP oral trimestral mostró ser un tratamiento eficaz los síntomas climatéricos, inducir un sangrado uterino aceptable, siendo bien tolerado por las pacientes y sin provocar lesiones de riesto en el endometrio