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    WGO Guideline—Endoscope Disinfection Update
    (2022)
    Tony Speer
    ;
    Michelle Alfa
    ;
    Dianne Jones
    ;
    Karen Vickery
    ;
    Helen Griffiths
    Scopus© Citations 10
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    Modelling cost-effectiveness of syphilis detection strategies in prisoners: exploratory exercise in a Chilean male prison
    (2021)
    CASTILLO LABORDE, CARLA CECILIA  
    ;
    Pedro Gajardo
    ;
    Manuel Nájera-De Ferrari
    ;
    MATUTE WILLEMSEM, MARIA ISABEL  
    ;
    Macarena Hirmas-Adauy
    <jats:title>Abstract</jats:title><jats:sec> <jats:title>Background</jats:title> <jats:p>Syphilis, together with other sexually transmitted infections, remains a global public health problem that is far from controlled. People deprived of liberty are a vulnerable population. Control activities in prisons rely mostly on passive case detection, despite the existence of affordable alternatives that would allow switching to active case-finding strategies. Our objective was to develop a mathematical modelling framework for cost-effectiveness evaluation, from a health system perspective, of different approaches using rapid tests for the detection of syphilis in inmates' populations and to explore the results based on a Chilean male prison population.</jats:p> </jats:sec><jats:sec> <jats:title>Methods</jats:title> <jats:p>A compartmental model was developed to characterize the transmission dynamics of syphilis inside a prison with the ongoing strategy (passive case detection, with VRDL + FTA-ABS), considering the entrance and exit of inmates over a 40 year period. The model allows simulation of the implementation of a reverse algorithm for the current situation (rapid test + VDRL), different screening strategies (entry point, massive periodically; both with rapid test + VDRL) and treatment of detected cases. The parameters for the exploratory exercise were obtained from systematic searches of indexed and grey literature and field work (EQ-5D questionnaire application and key actors interviews). Probabilistic sensitivity analysis was conducted to account for uncertainty in relevant parameters.</jats:p> </jats:sec><jats:sec> <jats:title>Results</jats:title> <jats:p>The proposed framework allows the evaluation of different detection strategies. In this study, all the strategies were cost-effective in the baseline scenario when considering an ICER threshold of 1 Chilean GDP per capita (US$15,000). The strategies most likely to be cost-effective (over 80% probability) were: current situation with reverse algorithm, entry point screening and mass screening every two years; the latter was the most effective, achieving the lowest prevalence (0.7% and 1.7% over the period versus the 3% prevalence in the current situation).</jats:p> </jats:sec><jats:sec> <jats:title>Conclusions</jats:title> <jats:p>Mathematical modelling that considers the performance of different tests and detection strategies could be a useful tool for decision making. The exploratory results show the efficiency of adopting both the use of the rapid tests and performing active case detection to significantly reduce the burden of syphilis in Chilean prisons in the near future.</jats:p> </jats:sec>
    Scopus© Citations 5  1
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    Expert Arguments for Trends of Psychiatric Bed Numbers: A Systematic Review of Qualitative Data
    (2021)
    Adrian P. Mundt
    ;
    Sabine Delhey Langerfeldt
    ;
    Enzo Rozas Serri
    ;
    Mathias Siebenförcher
    ;
    Stefan Priebe
    <jats:p><jats:bold>Introduction:</jats:bold> Mental health policies have encouraged removals of psychiatric beds in many countries. It is under debate whether to continue those trends. We conducted a systematic review of expert arguments for trends of psychiatric bed numbers.</jats:p><jats:p><jats:bold>Methods:</jats:bold> We searched seven electronic databases and screened 15,479 papers to identify expert opinions, arguments and recommendations for trends of psychiatric bed numbers, published until December 2020. Data were synthesized using thematic analysis and classified into arguments to maintain or increase numbers and to reduce numbers.</jats:p><jats:p><jats:bold>Results:</jats:bold> One hundred six publications from 25 countries were included. The most common themes arguing for reductions of psychiatric bed numbers were inadequate use of inpatient care, better integration of care and better use of community care. Arguments to maintain or increase bed numbers included high demand of psychiatric beds, high occupancy rates, increasing admission rates, criminalization of mentally ill, lack of community care and inadequately short length of stay. Cost effectiveness and quality of care were used as arguments for increase or decrease.</jats:p><jats:p><jats:bold>Conclusions:</jats:bold> The expert arguments presented here may guide and focus future debate on the required psychiatric bed numbers. The recommendations may help policymakers to define targets for psychiatric bed numbers. Arguments need careful local evaluation, especially when supporting opposite directions of trends in different contexts.</jats:p>
      4Scopus© Citations 10
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    Tobacco control policies in the 21st century: achievements and open challenges
    (2021)
    PERUGA URREA, ARMANDO  
    ;
    María José López
    ;
    Cristina Martinez
    ;
    Esteve Fernández
      1Scopus© Citations 95
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    Scopus© Citations 1  4
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      9Scopus© Citations 7
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    Scopus© Citations 1  1
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    Multi-feature computational framework for combined signatures of dementia in underrepresented settings
    (2022)
    Sebastian Moguilner
    ;
    Agustina Birba
    ;
    Sol Fittipaldi
    ;
    Cecilia Gonzalez-Campo
    ;
    Enzo Tagliazucchi
    <jats:title>Abstract</jats:title> <jats:p> <jats:italic>Objective.</jats:italic> The differential diagnosis of behavioral variant frontotemporal dementia (bvFTD) and Alzheimer’s disease (AD) remains challenging in underrepresented, underdiagnosed groups, including Latinos, as advanced biomarkers are rarely available. Recent guidelines for the study of dementia highlight the critical role of biomarkers. Thus, novel cost-effective complementary approaches are required in clinical settings. <jats:italic>Approach</jats:italic>. We developed a novel framework based on a gradient boosting machine learning classifier, tuned by Bayesian optimization, on a multi-feature multimodal approach (combining demographic, neuropsychological, magnetic resonance imaging (MRI), and electroencephalography/functional MRI connectivity data) to characterize neurodegeneration using site harmonization and sequential feature selection. We assessed 54 bvFTD and 76 AD patients and 152 healthy controls (HCs) from a Latin American consortium (ReDLat). <jats:italic>Main results</jats:italic>. The multimodal model yielded high area under the curve classification values (bvFTD patients vs HCs: 0.93 (±0.01); AD patients vs HCs: 0.95 (±0.01); bvFTD vs AD patients: 0.92 (±0.01)). The feature selection approach successfully filtered non-informative multimodal markers (from thousands to dozens). <jats:italic>Results</jats:italic>. Proved robust against multimodal heterogeneity, sociodemographic variability, and missing data. <jats:italic>Significance</jats:italic>. The model accurately identified dementia subtypes using measures readily available in underrepresented settings, with a similar performance than advanced biomarkers. This approach, if confirmed and replicated, may potentially complement clinical assessments in developing countries.</jats:p>
    Scopus© Citations 19  1  3
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    24/7 Physical Therapy Intervention With Adult Patients in a Chilean Intensive Care Unit: A Cost-Benefit Analysis in a Developing Country
    (2020)
    Catalina Merino-Osorio
    ;
    Mónica Velásquez
    ;
    Roberto Reveco
    ;
    José Ignacio Marmolejo
    ;
    Carolina Fu
      2Scopus© Citations 7