A Bayesian Functional Methodology for Dengue Risk Mapping in Latin America and the Caribbean.

Dengue fever has become one of the most outstanding infectious diseases in the world. Besides, the incidence and prevalence of dengue are increasing in the endemic areas of the tropical and subtropical regions. Space and time disease mapping models are common instruments to explain the patterns of disease counts, where hierarchical Bayesian models constitute a suitable framework for their formulation. These random events reflect interactions between nearby geographic locations, as well as correlations between close temporary instants. Functional data analysis techniques can better describe the evolution of disease mapping. In this paper, the risk of dengue in Mexico, Central and South America is studied from a Functional approach through a Bayesian estimation model focused on Hilbert-valued autoregressive processes combined with the Kalman filtering algorithm. Thus, the temporal functional evolution of spatial geographic patterns of incidence risk in disease mapping during 1998-2018 is approximated. Applying this methodology, the excess of smoothing that occurs with traditional models is avoided and the heterogeneity is conserved across the years. It improves the number of false positives created by noise and the number of false negatives as well. The results obtained with the application of this model are compared with those of previous models, corroborating the preceding statements and obtaining better results in the relative risk estimates, providing greater robustness and stability of disease risk estimates.

Colaboración de un centro sociosanitario y dos farmacias comunitarias en la revisión de la medicación y elaboración de sistemas personalizados de dosificación / Collaboration of a health and social services center and community pharmacies in reviewing medications and processing personalized dosing systems

Introducción: Los pacientes institucionalizados tienen, por sus características, más posibilidades de presentar problemas de seguridad con los medicamentos. La farmacia comunitaria puede ofrecer diferentes servicios, como es la revisión de la medicación. Para ello, contamos con los criterios STOPP, que detectan prescripciones potencialmente inapropiadas (PPI) y los START que detectan prescripciones potencialmente omitidas (PPO). Además de la revisión de la medicación, el farmacéutico comunitario dispone de los sistemas personalizados de dosificación (SPD). Objetivo: Facilitar la adherencia a la medicación prescrita en un centro sociosanitario con ayuda de los SPD realizados por los farmacéuticos comunitarios. Metodología: Estudio prospectivo realizado en dos farmacias comunitarias y en un centro sociosanitario (25 residentes) de Ondara (Alicante) durante ocho meses (enero-agosto 2017). En él participaron un médico, un enfermero y cuatro farmacéuticos comunitarios. Resultados: Se incluyeron 31 pacientes que generaron 62 revisiones de la medicación. La edad media fue de 83 años. Se detectaron 16 PPI y el médico aceptó el 50% de las intervenciones. El criterio STOPP más detectado fue el B9: diuréticos de asa para el tratamiento de la hipertensión con incontinencia urinaria. Se detectaron 25 criterios PPO y el facultativo aceptó el 28% de las intervenciones. El criterio START más detectado fue el E4: antirresortivos o anabolizantes óseos en pacientes con osteopororosis. Conclusiones: Se ha facilitado la administración de la medicación en el centro sociosanitario desde que se realizan los SPD por parte de los farmacéuticos comunitarios. Con la revisión de la medicación el farmacéutico comunitario ayudó al médico a optimizar la farmacoterapia de los pacientes ingresados

Introduction: Institutionalized patients have, by their characteristics, more possibilities of presenting security problems with medication. The community pharmacy can offer different services, such as medication review. For this, we have the STOPP criteria, which detect potentially inappropriate prescriptions (PPI) and the START that detect potentially omitted prescriptions (PPO). In addition to the medication review, the community pharmacist has personalized dispensation systems (SPD). Objective: Facilitate adherence to the prescribed medications in a social-health center with the help of the SPD carried out by community pharmacists. Methodology: Prospective study carried out in two community pharmacies and in a social health center (25 residents) of Ondara for eight months (January-August 2017). It involved a doctor, a nurse and four community pharmacists. Results: 31 patients were included, which generated 62 reviews of the medication. The average age was 83 years. 16 PPI were detected and the doctor accepted 50% of them. The most detected STOPP criterion was B9: loop diuretics for the treatment of hypertension with urinary incontinence. 25 PPO criteria were detected and the doctor accepted 28% of them. The most detected START criterion was E4: Antiresorptive or bone anabolic agents in patients with osteopororosis. Conclusions: The administration of medication in the social-health center has been facilitated since the MDSs were carried out by the community pharmacists. With the review of the medication the community pharmacist helped the doctor to optimize the pharmacotherapy of admitted patients

Effect of cooking method and rice type on arsenic concentration in cooked rice and the estimation of arsenic dietary intake in a rural village in West Bengal, India.

Arsenic (As) contamination of rice plants can result in high total As concentrations (t-As) in cooked rice, especially if As-contaminated water is used for cooking. This study examines two variables: (1) the cooking method (water volume and inclusion of a washing step); and (2) the rice type (atab and boiled). Cooking water and raw atab and boiled rice contained 40 microg As l(-1) and 185 and 315 microg As kg(-1), respectively. In general, all cooking methods increased t-As from the levels in raw rice; however, raw boiled rice decreased its t-As by 12.7% when cooked by the traditional method, but increased by 15.9% or 23.5% when cooked by the intermediate or contemporary methods, respectively. Based on the best possible scenario (the traditional cooking method leading to the lowest level of contamination, and the atab rice type with the lowest As content), t-As daily intake was estimated to be 328 microg, which was twice the tolerable daily intake of 150 microg.

Contribution of water and cooked rice to an estimation of the dietary intake of inorganic arsenic in a rural village of West Bengal, India.

Arsenic contamination of rice plants by arsenic-polluted irrigation groundwater could result in high arsenic concentrations in cooked rice. The main objective of the study was to estimate the total and inorganic arsenic intakes in a rural population of West Bengal, India, through both drinking water and cooked rice. Simulated cooking of rice with different levels of arsenic species in the cooking water was carried out. The presence of arsenic in the cooking water was provided by four arsenic species (arsenite, arsenate, methylarsonate or dimethylarsinate) and at three total arsenic concentrations (50, 250 or 500 microg l(-1)). The results show that the arsenic concentration in cooked rice is always higher than that in raw rice and range from 227 to 1642 microg kg(-1). The cooking process did not change the arsenic speciation in rice. Cooked rice contributed a mean of 41% to the daily intake of inorganic arsenic. The daily inorganic arsenic intakes for water plus rice were 229, 1024 and 2000 microg day(-1) for initial arsenic concentrations in the cooking water of 50, 250 and 500 microg arsenic l(-1), respectively, compared with the tolerable daily intake which is 150 microg day(-1).