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Background and Objective: Patient activation is a concept that refers to the willingness to manage one's health and medical care. To assess it, a patient activation measure (PAM) has been developed and validated. Several studies report low activation in patients with chronic diseases. However, information on activation in hemodialysis patients is scarce. The aim of the present study is to describe the activation level of patients on chronic treatment in an HD unit and its relationship with disease control parameters., Materials and Methods: Cross-sectional observational study in patients with advanced chronic kidney disease on chronic HD treatment. Ninety-six patients were included. Activation was measured with the PAM-13 questionnaire. Its relationship with descriptive variables (age, sex, comorbidity, studies, habitat) and disease control variables (vascular access, blood flow, potassaemia, phosphataemia, interdialytic gain) was studied. For this purpose, Spearman's correlation test, multiple linear regression model and logistic model were used as statistical methods., Results: The mean (SD) PAM-13 score was 63.19 (15.21). Activation was significantly associated with vascular access (P = 0.003), blood flow (P = 0.024), and interdialytic gain of patients (P = 0.008)., Conclusions: Activation in patients on chronic hemodialysis treatment is low. Higher activation is related having an arteriovenous fistula, higher blood flow and lower interdialytic gain. Future studies are needed to confirm and apply our results., (Copyright © 2023 Sociedad Española de Nefrología. Published by Elsevier España, S.L.U. All rights reserved.)

In March 2020, the Philippine Department of Health (DOH) designed and rapidly implemented a national surveillance system for the utilization of hospital beds by patients with coronavirus disease (COVID-19) to produce complete and timely data for use by various levels of governance in response to the COVID-19 pandemic. The DOH launched the DOH DataCollect (DDC) Bed Tracker system, a web-based application that collects information from all 1906 public and private hospitals and infirmaries across the country using a modular data collection tool. Data on the maximum number of occupied COVID-19-designated beds ( n  = 28 261), hospital bed utilization rate (71.7%), and mechanical ventilator number ( n  = 1846) and utilization rate (58.5%) were recorded in September 2021 during the Delta surge of cases in the Philippines. Data on human resources, personal protective equipment and supplies, and other operational indicators were added to the system during various modifications. Information from the DDC was used to inform the COVID-19 response and operations at national and local levels and facilitated research at academic and nongovernmental agencies. The development of the DDC system demonstrates that an effective surveillance system for use by all health-care facilities is achievable through strong national leadership, the use of available technology and adaptive information systems, and the establishment of networks across different health facilities and stakeholders., Competing Interests: The authors have no conflicts of interest to declare., ((c) 2023 The authors; licensee World Health Organization.)

Site selection of health facilities is critical in ensuring universal access to basic healthcare services. However, in many low and middle-income countries (LMICs) like the Philippines, site selection is traditionally based on political and pragmatic considerations. Moreover, literature that demonstrates the application of facility location models in the Philippine healthcare setting remains scarce, and their usage in actual facility planning is even more limited. In this study, we proposed a variation of cooperative covering maximal models to identify the optimal location of primary care facilities. We demonstrated the feasibility of implementing such a model by using open source data on an actual city in the Philippines. Our results generated multiple candidate locations of primary care facilities depending on the equity and efficiency parameters. This approach could be used as one of the critical considerations in evidence-based, multi-criterion health facility location decisions of governments, and can also be adapted in other industries, given the model's use of readily available open source datasets., Competing Interests: The authors have declared that no competing interests exist.

Solute and particulate elemental concentrations (C) exhibit different responses to changes in discharge (Q), and those relationships are not well understood in subtropical agricultural environments. The objective is to describe the transport processes of different chemical elements during a set of contrasted rainfall events (2011-2015) that occurred in a small rural catchment under subtropical climate. The study was carried out in the Lajeado Ferreira Creek catchment (1.23 km 2 ), southern Brazil. To this end, the concentrations in dissolved organic carbon (DOC), Cl - , NO 3 - , SO 4 - , ten chemical elements (in either dissolved or particulate forms) and suspended sediment concentrations (SSC) were determined. Metric indices were then calculated to characterize their transport patterns: (i) the best fit slope between log-C and log-Q (β), (ii) the coefficient of variation of C and Q, (iii) shape of the hysteresis loop and hysteresis index, and (iv) the flushing index. All particulate elements along with the dissolved inorganic phosphorus (PO 4 -3 ) were shown to be controlled by the sediment dynamics. Geogenic elements (Fe 2+ , Zn 2+ , Cu 2+ , Mn 2+ , Si 4+ ) showed a dilution effect with increasing Q values, likely because they were mainly transported with subsurface and base flow. Dissolved elements that are mainly supplied with fertilizers (Na + and Cl - ) as well as DOC showed a dilution effect, although they were mainly transported by surface runoff. Finally, a chemostatic behavior was found for those chemical elements (Mg 2+ , K + , Ca 2+ , NO 3 - and SO 4 2- ) that are supplied by more than one flow pathways. The results demonstrate that under subtropical climate conditions, the transport of essential nutrients including PO 4 -3 and metals (in particulate form), are mainly transported with surface runoff. Accordingly, runoff control on cultivated hillslopes should be improved to reduce the potential contaminant supply to the river and to reduce the potentially deleterious impacts that they may cause in downstream regions., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2020 Elsevier B.V. All rights reserved.)

Brain metastases are occasionally detected before diagnosing their primary site of origin. In these cases, simple visual examination of medical images of the metastases is not enough to identify the primary cancer, so an extensive evaluation is needed. To avoid this procedure, a radiomics approach on magnetic resonance (MR) images of the metastatic lesions is proposed to classify two of the most frequent origins (lung cancer and melanoma). In this study, 50 T1-weighted MR images of brain metastases from 30 patients were analyzed: 27 of lung cancer and 23 of melanoma origin. A total of 43 statistical texture features were extracted from the segmented lesions in 2D and 3D. Five predictive models were evaluated using a nested cross-validation scheme. The best classification results were achieved using 3D texture features for all the models, obtaining an average AUC > 0.9 in all cases and an AUC = 0.947 ± 0.067 when using the best model (naïve Bayes).