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RESUMEN. El objetivo de este estudio fue desarrollar una formulación optimizada de mermelada dietética, aplicando la metodología Taguchi. La razón que se tuvo para seleccionar dentro del diseño experimental esta metodología de trabajo fue demostrar las ventajas que tiene la aplicación de diseños factoriales ortogonales a problemas que ocurren con bastante frecuentes en la industria alimentaria especialmente en el área de desarrollo de productos, cuando la respuesta que se busca depende de la influencia de múltiples variables. En esta ocasión se desarrolló una formulación de mermelada de damasco de bajocontenido energético tratando de obtener la mejor combinación de múltiples variables para lograr una calidad sensorial óptima. Se trabajó simultáneamente con cinco factores de control: acidez, espesante, edulcorante, aromatizante y tiempo, así como posibles interacciones entre algunas de ellas, aplicando el diseño ortogonal L8 (2(7)). Se elaboraron ocho formulaciones experimentales que se analizaron sensorialmente aplicando el test de puntaje compuesto y una escala descriptiva cuantitativa desde "1= Malo hasta 5= Muy bueno". El análisis estadístico permitió comprobar que los factores espesante, edulcorante y aromatizante afectaban significativamente "(pSUMMARY. Development of an optimized dietetic formulation of damask marmalade using the taguchi methodology. The goal of this present study was the development of an optimized formula of damask marmalade low in calories applying taguchi methodology to improve the quality of this product. The selection of this methodoly lies on the fact that in real life conditions the result of an experiment frequently depends on the influence of several variables, therefore, one expedite way to solve this problem is utilizing factorial designs. The influence of acid, thickener, sweetener and aroma additives, as well as time of cooking, and possible interactions among some of them, were studied trying to get the best combination of these factors to optimize the sensorial quality of an experimental formulation of dietetic damask marmalade. An orthogonal arrayL8(2(7)) was applied in this experience, as well as level average analysis was carried out according taguchi methodology to determine the suitable working levels of the design factors previously choiced, to achieve a desirable product quality. A sensory trained panel was utilized to analyze the marmalade samples using a composite scoring test with a descriptive cuantitative scale ranging from 1= Bad, 5= Good. It was demonstrated that the design factors sugar/aspartame, pectin and damask aroma had a significant effect(p

Abstract Background Text-based patient medical records are a vital resource in medical research. In order to preserve patient confidentiality, however, the U.S. Health Insurance Portability and Accountability Act (HIPAA) requires that protected health information (PHI) be removed from medical records before they can be disseminated. Manual de-identification of large medical record databases is prohibitively expensive, time-consuming and prone to error, necessitating automatic methods for large-scale, automated de-identification. Methods We describe an automated Perl-based de-identification software package that is generally usable on most free-text medical records, e.g., nursing notes, discharge summaries, X-ray reports, etc. The software uses lexical look-up tables, regular expressions, and simple heuristics to locate both HIPAA PHI, and an extended PHI set that includes doctors' names and years of dates. To develop the de-identification approach, we assembled a gold standard corpus of re-identified nursing notes with real PHI replaced by realistic surrogate information. This corpus consists of 2,434 nursing notes containing 334,000 words and a total of 1,779 instances of PHI taken from 163 randomly selected patient records. This gold standard corpus was used to refine the algorithm and measure its sensitivity. To test the algorithm on data not used in its development, we constructed a second test corpus of 1,836 nursing notes containing 296,400 words. The algorithm's false negative rate was evaluated using this test corpus. Results Performance evaluation of the de-identification software on the development corpus yielded an overall recall of 0.967, precision value of 0.749, and fallout value of approximately 0.002. On the test corpus, a total of 90 instances of false negatives were found, or 27 per 100,000 word count, with an estimated recall of 0.943. Only one full date and one age over 89 were missed. No patient names were missed in either corpus. Conclusion We have developed a pattern-matching de-identification system based on dictionary look-ups, regular expressions, and heuristics. Evaluation based on two different sets of nursing notes collected from a U.S. hospital suggests that, in terms of recall, the software out-performs a single human de-identifier (0.81) and performs at least as well as a consensus of two human de-identifiers (0.94). The system is currently tuned to de-identify PHI in nursing notes and discharge summaries but is sufficiently generalized and can be customized to handle text files of any format. Although the accuracy of the algorithm is high, it is probably insufficient to be used to publicly disseminate medical data. The open-source de-identification software and the gold standard re-identified corpus of medical records have therefore been made available to researchers via the PhysioNet website to encourage improvements in the algorithm.

Introduction: We examined national estimates of breast, cervical, and colorectal cancer (CRC) screening test use and compared them with Healthy People 2030 national targets. Test use in 2021 was compared with prepandemic estimates., Methods: In 2022, we used 2021 National Health Interview Survey (NHIS) data to estimate proportions of adults up to date with US Preventive Services Task Force recommendations for breast (women aged 50-74 y), cervical (women aged 21-65 y), and CRC screening (adults aged 50-75 y) across sociodemographic and health care access variables. We compared age-standardized estimates from the 2021 and 2019 NHIS., Results: Percentages of adults up to date in 2021 were 75.7% (95% CI, 74.4%-76.9%), 75.2% (95% CI, 73.9%-76.4%), and 72.2% (95% CI, 71.2%-73.2%) for breast, cervical, and CRC screening, respectively. Estimates were below 50% among those without a wellness check in 3 years (all screening types), among those without a usual source of care or insurance (aged <65 y) (breast and CRC screening), and among those residing in the US for less than 10 years (CRC screening). Percentages of adults who were up to date with breast and cervical cancer screening and colonoscopy were similar in 2019 and 2021. Fecal occult blood/fecal immunochemical test (FOBT/FIT) use was modestly higher in 2021 (P < .001)., Conclusions: In 2021, approximately 1 in 4 adults of screening age were not up to date with breast, cervical, and CRC screening recommendations, and Healthy People 2030 national targets were not met. Disparities existed across several characteristics, particularly those related to health care access. Breast, cervical, and colonoscopy test use within recommended screening intervals approximated prepandemic levels. FOBT/FIT estimates were modestly higher in 2021.

Objective-This report presents national estimates of telemedicine use for U.S. children in the 12 months before the interview, and because of the coronavirus pandemic., (All material appearing in this report is in the public domain and may be reproduced or copied without permission; citation as to source, however, is appreciated.)

Objective-This report describes how problems paying medical bills and forgone medical care vary by family composition among families with at least one older adult (aged 65 and over). Methods-Data from families in the 2017-2018 National Health Interview Survey that included at least one older adult were analyzed (n = 19,471). Bivariate and multivariate analyses, adjusted for selected family characteristics that may put families at financial risk, were conducted for both outcome measures and shown by family composition. The family compositions examined were one older adult living alone, two older adults, one younger (aged 18-64) and one older adult, three or more adults (where at least one was an older adult), and two or more adults (where at least one was an older adult) and at least one child (under age 18 years). Results-About 8.6% of families with older adults experienced problems paying medical bills, and 8.9% had forgone medical care. The most common composition for older-adult families was one older adult living alone (39.7%). Older-adult families consisting of only two older adults were the least likely to have experienced problems paying medical bills (4.0%) and to have forgone medical care (3.8%) compared with other family compositions. Older-adult families with at least one child were the most likely to experience problems paying medical bills (21.3%) and to have forgone medical care (18.4%). After adjusting for selected family characteristics in multivariate analyses, the odds of experiencing problems paying medical bills and forgone medical care weakened for all family compositions but remained significantly lower for families with two older adults. Conclusion-Among families with older adults, financial burdens of medical care vary based on family composition., (All material appearing in this report is in the public domain and may be reproduced or copied without permission; citation as to source, however, is appreciated.)

T. vaginalis infection (trichomoniasis) is the most common curable sexually transmitted infection (STI) in the U.S. It is associated with increased HIV risk and adverse pregnancy outcomes. Trichomoniasis surveillance data do not exist for either national or local populations. The Monitoring STIs Survey Program (MSSP) collected survey data and specimens which were tested using nucleic acid amplification tests to monitor trichomoniasis and other STIs in 2006-09 among a probability sample of young adults (N = 2,936) in Baltimore, Maryland--an urban area with high rates of reported STIs. The estimated prevalence of trichomoniasis was 7.5% (95% CI 6.3, 9.1) in the overall population and 16.1% (95% CI 13.0, 19.8) among Black women. The overwhelming majority of infected men (98.5%) and women (73.3%) were asymptomatic. Infections were more common in both women (OR = 3.6, 95% CI 1.6, 8.2) and men (OR = 9.0, 95% CI 1.8, 44.3) with concurrent chlamydial infection. Trichomoniasis did not vary significantly by age for either men or women. Women with two or more partners in the past year and women with a history of personal or partner incarceration were more likely to have an infection. Overall, these results suggest that routine T vaginalis screening in populations at elevated risk of infection should be considered.

Incarceration has been extensively linked with HIV and sexually transmitted infections (STIs). While a great deal of attention has been given to the risk behaviors of people who have been incarcerated, examination of the behaviors of partners of incarcerated individuals is also needed to understand the direct and indirect links between incarceration and HIV and to identify prevention avenues. In the present study, we hypothesize that incarceration is associated with risk behavior through attitudes and norms. The purpose of this paper is: (1) to describe the attitudes and norms about sexual behaviors that women have when a sexual partner is incarcerated; and (2) to examine the association between attitudes and norms with the behavior of having other sex partners while a main partner is incarcerated. In our sample (n = 175), 50 % of women reported having other sex partners while their partner was incarcerated. Our findings show that attitudes, descriptive norms (i.e., norms about what other people do), and injunctive norms (i.e., norms about what others think is appropriate) were associated with having other partners. Interventions designed for couples at pre- and post-release from prison are needed to develop risk reduction plans and encourage HIV/STI testing prior to their reunion.

Background: Chlamydia trachomatis (Ct) is the most frequently reported infectious disease in the United States. This article reports population and subpopulation prevalence estimates of Ct and correlates of infection among 15- to 35-year-olds in Baltimore, MD., Methods: The Monitoring STIs Survey Program (MSSP) monitored sexually transmitted infection (STI) prevalence among probability samples of residents of Baltimore, a city with high STI rates. MSSP respondents completed telephone audio computer-assisted self-interviews and provided biospecimens for STI testing., Results: Among 2120 Baltimore residents aged 15 to 35 years, the estimated prevalence of chlamydia was 3.9% (95% confidence interval [CI]: 2.8, 5.0). Prevalence was 5.8% (95% CI: 4.1, 7.6) among black MSSP respondents versus 0.7% (95% CI: 0.0, 1.4) among nonblack respondents; all but 4 infections detected were among black respondents. Sexual behaviors and other factors associated with infection were far more prevalent among black than nonblack Baltimore residents. Racial disparities persisted after adjustment for sociodemographic, behavioral, and health factors., Conclusion: The MSSP highlights a higher Ct prevalence among young people in Baltimore than in the United States overall, with notable racial disparities in infection and associated risk behaviors. Public health efforts are needed to improve the diagnosis and treatment of asymptomatic infections in this population.

Background: This study assesses the impact of Telephone Audio Computer-Assisted Self-Interviewing (T-ACASI) on the reporting of sensitive (mainly heterosexual) behaviours., Methods: A randomized experiment was embedded in a telephone survey that drew probability samples of the populations of the USA (N = 1543) and Baltimore city (N = 744). Respondents were randomly assigned to have questions asked either by a T-ACASI computer or by a human telephone interviewer., Results: Compared with interviewer-administered telephone surveys, T-ACASI obtained more frequent reporting of a range of mainly heterosexual behaviours that were presumed to be sensitive, including recency of anal sex [adjusted odds ratio (A-OR) = 2.00, P < 0.001), sex during menstrual period (A-OR = 1.49, P < 0.001), giving oral sex (A-OR = 1.40, P = 0.001) and receiving oral sex (A-OR = 1.36, P = 0.002), and sexual difficulties for the respondent (A-OR = 1.45, P = 0.034) and their main sex partner (A-OR = 1.48, P = 0.0). T-ACASI also obtained less frequent reporting that respondent had a 'main sex partner' (A-OR = 0.56, P = 0.011) and discussed contraception prior to first sex with that sex partner (A-OR = 0.82, P = 0.094). For both males and females, T-ACASI obtained more frequent reports of first vaginal sex occurring at early ages (before ages 12 through 15). 'For males only', T-ACASI also elicited more frequent reports that first vaginal sex had 'not' occurred at later ages (i.e. by ages 20 through 24)., Conclusion: T-ACASI increases the likelihood that survey respondents will report sensitive heterosexual behaviours.

Numerous studies have shown that audio-computer-assisted self-interviewing (audio-CASI) and telephone audio-CASI (T-ACASI) technologies yield increased reporting of sensitive and stigmatized objective phenomena such as sexual and drug use behaviors. Little attention has been given, however, to the impact of these technologies on the measurement of subjective phenomena (attitudes, opinions, feelings, etc.). This article reports results for the seven subjective measurements included in the National STD and Behavior Measurement Experiment (NSBME). NSBME drew probability samples of USA and Baltimore adults (Ns = 1,543 and 744, respectively) and randomized these respondents to be interviewed by T-ACASI or telephone interviewer-administered questioning (T-IAQ). Response distributions for all subjective measurements obtained by T-ACASI diverge from those obtained by human telephone interviewers. For six of our seven ordinal-scaled measurements, this divergence involved shifting responses directionally along the ordinal scale, as opposed to a nondirectional redistribution among response categories. When interviewed by T-ACASI, respondents were more supportive of traditional gender roles and corporal punishment, less supportive of integrated neighborhoods and same-gender sex, and more likely to agree that occasional marijuana use is harmless and to describe themselves as attractive. The majority of these results suggest that telephone survey respondents may provide more "tolerant" and "socially liberal" responses to human interviewers than to a T-ACASI computer. Similarly, although the evidence is not entirely consistent, the impact of T-ACASI appears to increase with the social vulnerability of the population surveyed.

Well-conducted telephone surveys provide an economical means of estimating the prevalence of sexual and reproductive behaviors in a population. There is, however, a nontrivial potential for bias since respondents must report sensitive information to a human interviewer. The National STD and Behavior Measurement Experiment (NSBME) evaluates a new survey technology-telephone audio computer-assisted self-interviewing (T-ACASI)-that eliminates this requirement. The NSBME embedded a randomized experiment in a survey of probability samples of 1,543 U.S. and 744 Baltimore adults ages 18 to 45. Compared with NSBME respondents interviewed by human interviewers, respondents interviewed by T-ACASI were 1.5 to 1.6 times more likely to report same-gender sexual attraction, experience, and genital contact. The impact of T-ACASI was more pronounced (odds ratio = 2.5) for residents of locales that have historically been less tolerant of same-gender sexual behaviors and for respondents in households with children (odds ratio = 3.0).

Objectives: To examine whether audio computer assisted survey interviewing (ACASI) influenced responses to sensitive HIV risk behaviour questions, relative to interviewer administration of those questions (IAQ), among patients attending a sexually transmitted infection (STI) clinic and whether the impact of interview mode on reporting of risk behaviours was homogeneous across subgroups of patients (defined by age, sex, and previous STI clinic experience)., Methods: 1350 clinic patients were assigned to complete a detailed behavioural survey on sexual risk practices, previous STIs and symptoms, condom use, and drug and alcohol use using either ACASI or IAQ., Results: Respondents assigned to ACASI were more likely to report recent risk behaviours such as sex without a condom in the past 24 hours (adjusted OR = 1.9), anal sex (adjusted OR = 2.0), and one or more new partners in the past 6 months (adjusted OR = 1.5) compared to those interviewed by IAQ. The impact of ACASI varied by sex but, contrary to expectations, not by whether the patient had previously visited an STI clinic. Mode of survey administration made little difference within this population in reports of STI knowledge, previous STIs, STI symptoms, or illicit drug use., Conclusion: ACASI provides a useful tool for improving the quality of behavioural data in clinical environments.

Objectives: This pilot test assessed the feasibility of a cost effective population based approach to STI monitoring using automated telephone interviews, urine specimen collection kits sent out and returned by US Postal Service mail, and monetary incentives to motivate participation., Methods: 100 residents of Baltimore, MD, USA, completed an automated telephone survey and agreed to mail in a urine specimen to be tested for chlamydia and gonorrhoea. Participants were paid dollar 10 for completing the survey and dollar 40 for mailing the specimen., Results: 86% of survey participants mailed in a urine specimen for testing., Conclusions: Automated telephone surveys linked with testing of mailed-in urine specimens may be a feasible lower cost (relative to household surveys) method of estimating infection prevalences in a population.