Using artificial intelligence to reduce orthopedic surgical site infection surveillance workload: Algorithm design, validation, and implementation in 4 Spanish hospitals.

BACKGROUND: Surgical site infection (SSI) surveillance is a labor-intensive endeavor. We present the design and validation of an algorithm for SSI detection after hip replacement surgery, and a report of its successful implementation in 4 public hospitals in Madrid, Spain. METHODS: We designed a multivariable algorithm, AI-HPRO, using natural language processing (NLP) and extreme gradient boosting to screen for SSI in patients undergoing hip replacement surgery. The development and validation cohorts included data from 19,661 health care episodes from 4 hospitals in Madrid, Spain. RESULTS: Positive microbiological cultures, the text variable "infection", and prescription of clindamycin were strong markers of SSI. Statistical analysis of the final model indicated high sensitivity (99.18%) and specificity (91.01%) with an F1-score of 0.32, AUC of 0.989, accuracy of 91.27%, and negative predictive value of 99.98%. DISCUSSION: Implementation of the AI-HPRO algorithm reduced the surveillance time from 975 person/hours to 63.5 person/hours and permitted an 88.95% reduction in the total volume of clinical records to be reviewed manually. The model presents a higher negative predictive value (99.98%) than algorithms relying on NLP alone (94%) or NLP and logistic regression (97%). CONCLUSIONS: This is the first report of an algorithm combining NLP and extreme gradient-boosting to permit accurate, real-time orthopedic SSI surveillance.

[Surveillance and epidemiology of Herpes Zoster in Spain.] / Vigilancia y epidemiología del herpes zóster en España.

OBJECTIVE: Herpes Zoster (HZ) results from reactivation of latent varicella-zoster virus infection and is associated with immunosuppression and ageing. HZ is of increasing importance in advanced societies. Vaccination appears as a powerful tool to reduce HZ as well as postherpetic neuralgia, the main zoster complication. This study aims to describe the temporal trend, the age and sex distribution of cases, hospitalisations and deaths by zoster occurred in Spain between 1998 and 2018. METHODS: The available information for zoster in Spain were used: cases from National Surveillance System (2014-2018), registries from Spanish hospitalisation database (1998-2018) and deaths from the Spanish mortality statistics (1999-2018). Incidence, hospitalization (HR) and mortality (MR) rates per year and period were calculated. Rates by age group and sex as well as percentage and cumulative percentage for cases and hospitalisations by age group, were also calculated. RESULTS: The global HZ incidence was 351.6/100,000 inhabitants and 625.5/100,000 among population aged 50 and over. The incidence increases with age, especially from the age of 50-54 years (41% increase over the 45-49 age group) and is always higher in women. The global HR was 6.75/100,000 and 15.7/100,000 in persons aged 50 and over; HR increases with age, especially from 60-64 years onwards (50% increase over 54-59 age group) and is always higher in men. The 68.8% of cases and 80.2% of hospitalisations for HZ occurred from the age of 50. CONCLUSIONS: In Spain HZ is a frequent and severe entity in adults and elderly people requiring public health interventions. The demographic changes and the introduction of vaccination require continued monitoring of HZ behaviour in terms of incidence and severity.

OBJETIVO: El herpes zóster (HZ) aparece debido a la reactivación de la infección latente por el virus de la varicela-zóster y está asociado a la inmunosupresión y al envejecimiento. El HZ es de creciente importancia en las sociedades avanzadas. La vacunación se vislumbra como una potente herramienta para reducir el zóster y su principal complicación: la neuralgia postherpética. El objetivo de este estudio fue describir la tendencia temporal y la distribución por grupos de edad y sexo de los casos, hospitalizaciones y muertes por HZ en España entre 1998 y 2018. METODOS: Se analizaron los casos de HZ notificados a la Red Nacional de Vigilancia Epidemiológica entre 2014-2018, las hospitalizaciones por HZ del registro RAE-CMBD entre 1998-2018 y las muertes por HZ de la Estadística de Mortalidad del INE entre 1999-2018. Se calcularon: tasas de incidencia, hospitalización (TH) y mortalidad (TM) anual y de periodo; tasas globales y por grupos de edad y sexo, así como porcentaje y porcentaje acumulado de casos y hospitalizaciones por grupos de edad. RESULTADOS: La incidencia global de HZ se estimó en 351,6 por cada 100.000 habitantes y en 625,5 por cada 100.000 habitantes en personas de 50 años o más. La incidencia se incrementó con la edad, sobre todo a partir de los 50-54 años (incremento del 41% respecto al grupo de 45-49 años) y fue siempre más alta en mujeres. La TH global por HZ fue 6,75 por cada 100.000 habitantes y 15,7 por cada 100.000 habitantes en personas de 50 años o más. La TH fue creciendo con la edad, sobre todo a partir de los 60-64 años (incremento del 50% respecto al grupo de 54-59 años) y resultó siempre más alta en hombres. El 68,8% de casos y el 80,2% de hospitalizaciones por HZ ocurrieron a partir de los 50 años. CONCLUSIONES: En España, el HZ es una entidad frecuente y grave en adultos y personas mayores, que requiere intervenciones en Salud Pública. Los cambios demográficos y la incorporación de la vacunación exigen seguir monitorizando estrechamente el comportamiento del HZ en términos de incidencia y gravedad.

Manganese clusters derived from 2-pyridylcyanoxime: new topologies and a large spin ground state in pyridyloximate chemistry.

Series of manganese clusters derived from 2-pyridylcyanoxime with Mn3(II) (1), Mn4(II) (2a, b), Mn(II)4Mn(III)4 (3), Mn(II)2Mn(III)6Mn(IV)2 (4) and Mn(II)3Mn(III)6Mn(IV) (5) cores have been characterized. Dc magnetic measurements reveal antiferromagnetic coupling for 1-4 and dominant ferromagnetic interactions for 5 which shows the largest ground state reported to date in pyridyloximate chemistry (S = 14).

Building of a novel Mn12 Single Molecule Magnet by assembly of anisotropic {Mn3(µ3-O)(salox)3}+ triangles.

Assembly of triangular {Mn(III)(3)(O)(salox)(3)}(+) fragments mediated by azido ligands, results in the dodecanuclear [Mn(12)O(4)(salox)(12)(N(3))(4)(MeOH)(4)(H(2)O)(2)] complex with S = 8 ground state and SMM response.

Anionic tuning of the dimensionality in copper oximato chemistry.

Control of the dimensionality and nuclearity in pyraziloximatocopper(II) chemistry has been achieved by tuning of the donor properties of the counteranions.

Manganese clusters derived from a 2,6-diacetylpyridine dioximato ligand: structure and magnetic study.

Reactions of 2,6-diacetylpyridine dioxime (dapdoH2) with Mn(NO3)2 or Mn(SO3CF3)2 under a variety of conditions or co-ligands yield compounds with the formula [Mn6O2(OMe)2(dapdo)2(dapdoH)4](X)2 in which X = NO3⁻ (1) or SO3CF3⁻ (2), [Mn8O2(dapdo)6(NO3)2]·H2O (3) and [Mn(dapdoH2)(N3)2](n) (4). Compounds 1, 3 and 4 were structurally characterized and equivalent structures for 1 and 2 were inferred from spectroscopic and analytical results. Compounds 1 and 2 consist of hexanuclear Mn2(II)Mn4(III) complexes whereas 3 consists of an octanuclear Mn6(II)Mn2(III) cluster in which the manganese atoms exhibit a rare bicapped elongated octahedral topology. Compound 4 consists of a 1D system bridged by double end-on azido ligands. Variable temperature magnetic studies were performed between 2-300 K, confirming the ground state S = 5 for 1 and 2, S = 0 for 3 and ferromagnetic response for 4.

Covalent radii revisited.

A new set of covalent atomic radii has been deduced from crystallographic data for most of the elements with atomic numbers up to 96. The proposed radii show a well behaved periodic dependence that allows us to interpolate a few radii for elements for which structural data is lacking, notably the noble gases. The proposed set of radii therefore fills most of the gaps and solves some inconsistencies in currently used covalent radii. The transition metal and lanthanide contractions as well as the differences in covalent atomic radii between low spin and high spin configurations in transition metals are illustrated by the proposed radii set.

Palladium catalyzed Suzuki C-C couplings in an ionic liquid: nanoparticles responsible for the catalytic activity.

A new family of functionalized ligands derived from norborn-5-ene-2,3-dicarboxylic anhydride has been used in Suzuki C-C cross-couplings between aryl boronic acids and aryl bromide derivatives in [BMI][PF(6)] (BMI=1-n-butyl-3-methyl-imidazolium), using palladium acetate as catalytic precursor. High conversions and yields are obtained when amine ligands containing hydroxy groups are involved. TEM analyses after catalysis show the formation of small nanoparticles, in contrast to the agglomerates observed when nanoparticles are intentionally preformed, with a consequent decrease in the catalytic activity in the latter case. Some tests, including the correlation effect between solvent and ligand, are carried out to try to identify the true nature of the catalyst. All the results obtained suggest that formation of nanoparticles is required to lead to a catalytically active system.

[Allozymatic variation in crustacea Artemia franciscana (Anostraca: Artemiidae) of Freat Salt Lake in different experimental conditions]. / Variación alozimática en el crustáceo Artemia franciscana (Anostraca: Artemiidae) del Gran Lago Salado en varias condiciones experimentales.

Starch gel electrophoresis was used to analyze the allelic variability of four polymorphic loci (Lap-2, Lap-3, Pgm and Gpi) from a single population of Artemia franciscana (Kellogg, 1906) from the Great Salt Lake (Utah, USA), cultured under eight different experimental conditions. The organisms were cultured to the adult stage under a 2 x 2 x 2 experimental design (22 and 30 degrees C; 30 and 60 ppt salinity; and Dunaliella sp. and Spirulina sp. as food). There were significant differences in allele frequencies at each locus and the mean expected heterozygosity (He) varied from 0.236 to 0.447. Therefore, the hypothesis of no allelic differences among treatments is rejected. With relation to a possible correlation between genetic variability and the phenotypic characteristics, the results show that there is probably a synergic effect between the different salinities and temperatures on the survival of heterozygous organisms in the different loci.

Variación alozimática en el crustáceo Artemia franciscana (Anostraca: Artemiidae) del Gran Lago Salado en varias condiciones experimentales / Allozymatic variation in crustacea Artemia franciscana (Anostraca: Artemiidae) of Freat Salt Lake in different experimental conditions]

Starch gel electrophoresis was used to analyze the allelic variability of four polymorphic loci (Lap-2, Lap-3, Pgm and Gpi) from a single population of Artemia franciscana (Kellogg, 1906) from the Great Salt Lake (Utah, USA), cultured under eight different experimental conditions. The organisms were cultured to the adult stage under a 2 x 2 x 2 experimental design (22 and 30 degrees C; 30 and 60 ppt salinity; and Dunaliella sp. and Spirulina sp. as food). There were significant differences in allele frequencies at each locus and the mean expected heterozygosity (He) varied from 0.236 to 0.447. Therefore, the hypothesis of no allelic differences among treatments is rejected. With relation to a possible correlation between genetic variability and the phenotypic characteristics, the results show that there is probably a synergic effect between the different salinities and temperatures on the survival of heterozygous organisms in the different loci.