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Augmented reality is one of the technologies that with a high frequency is involved in the theme of Industry 4.0 for its benefits, however, it is applied more frequently in entertainment areas, when it is a tool that allows to show data, pieces, statistics, technical data sheets of industrial equipment thus revolutionizing the manufacturing industry and to another way to show of data in this field. This article shows the exploration of the combination of augmented reality, with a CMMS with the purpose of serving as a strategic information system for decision giving the manufacturing company the concept of intelligent factory in the ecosystem of the industry 4.0. The CMMS is developed first, then the augmented reality application is created and finally the study is done to verify if they are compatible and if the presented information is useful for the company. The contribution of this study is to propose a methodology for the development of a new type of strategic information system 4.0 in which a new way of displaying data (AR) and an information system such as CMMS is mixed.

Background: The number of elderly patients undergoing pacemaker (PM) implantation is constantly growing. However, information on survival and prognostic factors of this particular patient group is scarce. The objective of this study was to determine the survival of elderly and very elderly patients undergoing PM implantation, as well as to investigate prognostic factors of mortality. Methods: This is a retrospective observational study of a single center. Patients ≥ 80 years of age, that underwent PM implantation between January 2017 and December 2018 in our center, were included for chart review. Very elderly patients were defined as those with ≥ 90 years of age. Results: A total of 269 patients were included in the study with a mean age of 85 (±4.1) years. 53 patients were ≥ 90 years of age. 52% of the patients were male. 24.5% of the elderly patients and 41.5% of the very elderly patients received a single chamber PM. Median follow-up time was 28 (14-30) months, with no significant differences between the two groups of patients. The mortality rate for elderly patients was 15.7% for the elderly and 32.1% for the very elderly (p = 0.002). Generating multivariate Cox regression models, the following parameters showed to be significant predictors of all-cause mortality: Age (1.37 (1.02-1.29), p = 0.005), chronic kidney disease (5.57 (2.47-12.56), p

Traditionally, advanced age has been considered a major factor for increased LOS and healthcare costs. However, recent studies suggest that comorbidity may have an equal, if not greater, effect on LOS and mortality as age in a variety of clinical scenarios. The elderly are the most rapidly growing part of the population in developed countries and pacemakers (PM) are commonly implanted in this population. In this retrospective study, we aimed to evaluate the impact of comorbidity on LOS and mortality, as compared to age, in patients undergoing new PM implantation. 257 elective and non-elective patients that underwent new PM implantation were included in the study. The median follow-up time was 20 (15-25) months. A Charlson comorbidity index (CCI) > 1 resulted to be a significant predictor for the excess of LOS, whereas age did not significantly predict excess of LOS. Elderly patients (age > 75 years) with low comorbidity burden (CCI < 1) showed no significant differences with regards to LOS and mortality when compared to younger patients. Considering the findings of our study, when considering patients for PM implantation, comorbidity burden rather than age should be the driving factor in the approach of indication of PM implantation.

Introduction: The infection with SARS-CoV-2 that affects the entire world has been shown to be more severe in patients with comorbidities The object of this study was to know the survival of renal transplant patients infected with this coronavirus Material and methods: Eligible were renal transplant patients with SARS-CoV-2 infection requiring hospitalization (moderate and severe degree) from the start of the pandemic to September 28, 2020 Survival analysis was performed with Kaplan-Meier tables in days, using statistical package SPSSw v25 Results: Data was collected for 66 patients from 4 renal transplant facilities;the mean age was 39 5 years (IQR 30 0-49 5);global survival was 59 10% Difference of 67 50% vs 46 15% was observed between receivers from living and dead donors respectively (without Log Rank significance of 0 068);70 25% survival in patients with low immunological risk and 44 82% for high risk (Log Rank 0 034) Conclusions: Comorbidities and immunosuppression greatly influence mortality in renal transplant patients immunological risk presents an important determinant of patient survival [ABSTRACT FROM AUTHOR] Copyright of Trends in Transplantation is the property of Publicidad Permanyer SLU and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission However, users may print, download, or email articles for individual use This abstract may be abridged No warranty is given about the accuracy of the copy Users should refer to the original published version of the material for the full abstract (Copyright applies to all Abstracts )

Background At present only monoclonal EIA (enzyme-immunoassay) stool antigen-tests have obtained optimal accuracy in the diagnosis of Helicobacter pylori. Our aim was to evaluate the accuracy of two stool antigen-tests, the validated Premier Platinum HpSA PLUS (EIA test) and the newly available ImmunoCard STAT! HpSA HD (rapid test) for the initial diagnosis and the confirmation of eradication of H. pylori infection. Patients and methods Patients with indication of H. pylori diagnosis, or confirmation after treatment were included. Data were coded to protect personal data and ensure blindness between tests. Accuracy was considered as coincident diagnosis with the gold standard (13C-urea breath test, UBT). The EIA was used as a bench standard. All stool tests were performed in duplicate. Results 264 patients completed the protocol (100 naive, 164 post-eradication). Average age was 52 years, 61% women, 11% ulcer. Positive diagnoses by UBT were 41% for naive and 17% for post-eradication. Overall ImmunoCard and EIA accuracies were respectively 91% (95% C . I . = 88–94%) and 89% (86–93%), sensitivities 72% (67–78%) and 72% (67–78%), and specificities 98% (96–100%), and 95% (92–97%). Concordance between ImmunoCard and EIA was 95% (93–98%). Discussion Our results indicate that the newly available ImmunoCard rapid stool antigen-test achieves 90% accuracy, with high specificity but suboptimal sensitivity. The ImmunoCard attained equivalent accuracies as the EIA bench standard, with 95% concordance.

BACKGROUND: HPV-based cervical screening detects women at an increased risk of cervical cancer and precancer. To differentiate among HPV-positive women those with (pre)cancer, triage testing is necessary. The detection of cancer-associated host-cell DNA methylation (FAM19A4 and hsa-mir124-2) in cervical samples has shown valuable as triage test. This multicenter study from 6 collaborating European laboratories and one reference laboratory was set out to determine the intra- and inter-laboratory agreement of FAM19A4/mir124-2 DNA methylation analysis utilizing the QIAsure Methylation Test.METHODS: Agreement analysis for the QIAsure Methylation Test was assessed on high-risk HPV-positive cervical specimens (n = 1680) both at the level of the assay and at the full workflow, including bisulfite conversion.RESULTS: Intra- and inter-laboratory assay agreement were 91.4% (534/584; 95% CI 88.9-93.5; κ = 0.82) and 92.5% (369/399; 95% CI 90.0-94.7; κ = 0.83), respectively. The inter-laboratory workflow (bisulfite conversion and assay combined) agreement was 90.0% (627/697; 95% CI 87.5%-92.0%; κ = 0.76).CONCLUSION: These data show that the QIAsure Methylation Test performs robust and reproducible in different laboratory contexts. These results support the use of the QIAsure Methylation Test for full molecular screening for cervical cancer, including primary HPV testing and triage testing by methylation analysis.

Background: Anti-epidermal-growth-factor-receptor (EGFR) therapies in combination with radiotherapy are being studied on de-escalation clinical trials for HPV-related oropharyngeal cancer (OPC) patients. The HPV16-E5 oncoprotein increases recycling of activated EGFR to the cell surface, enhancing factor signal transduction. Our aim was to evaluate viral HPV16-E5 oncogene expression as well as EGFR and phosphorylated-EGFR (pEGFR), protein levels as biomarkers for clinical outcome in a retrospective cohort of OPC patients. Methods: Formalin-fixed-paraffin-embedded OPCs were collected from 1990 to 2013. OPC samples containing HPV-DNA were subject to viral E6* I mRNA detection and p16(INK4a) immunohistochemistry (IHC). HPV16-positive cases were evaluated for HPV16-E5 (RT-PCR) and EGFR/pEGFR (IHC). A stratified and matched random sample of HPV-negative samples was used as control and evaluated for EGFR/pEGFR. Overall survival (OS) and disease free survival (DFS) estimates were assessed for locally advanced OPC patients (stage III, IVa, b 7th edition). Results: Among 788 OPC patient samples, 53 were double positive for HPV16-DNA/p(16INK4a). HPV16-E5 expression was found in 41 of 53 samples (77.4%). EGFR expression was observed in 37.7 vs 70.8% of HPV16-positive vs HPV-negative samples, respectively; (adjusted OR = 0.15) 5% CI = 0.04-0.56]). Expression of pEGFR followed an inverse pattern with 39.6 and 24.9% detection in HPV16-positive and HPV-negative samples; (adjusted OR = 1.58 [95% CI = 0.48-5.17]). Within HPV16-positive cases, no association between HPV16-E5/EGFR nor pEGFR was observed. With a median follow-up of 39.36 months (min = 0.03 - max = 272.07), the combination of HPV status and EGFR or pEGFR expression were predictors of better OS (p < 0.001, for both) and DFS (p < 0.001 for EGFR and p = 0.003 for pEGFR). Conclusions: HPV16-E5 is highly expressed on HPV16-positive OPCs. Interestingly, HPV16-positive cases expressed significantly more pEGFR while HPV-negative cases expressed more EGFR. The combinations of HPV status and EGFR or pEGFR may be useful biomarkers for evaluating prognosis outcome in OPC patients.

The increasing demand for unscheduled care of patients with acute minor illnesses represents a challenge for health systems in many countries (Gill, Dawes, Sharpe, & Mayou, 1998; Kocher & Asplin, 2013). Many health systems have therefore developed specific programs to favor the attention of patients with acute minor illnesses in primary care. The ideal system should be timely, accessible, and meet patients' needs and expectations. However, the issue is complex because primary care centers are usually overworked since they have to provide care to an increasingly higher number of patients with chronic diseases, often in the setting of a limited number of healthcare professionals (Bodenheimer & Pham, 2010). As a result, a number of healthcare systems have implemented programs in which the unscheduled acute care of adult patients with minor illnesses is delivered by nurse practitioners. The rationale of these programs is based on a large body of evidence indicating that nurse practitioners are able to provide patients with minor illnesses at a high standard of care similar to that provided by general practitioners. A systematic review of 11 randomized and 23 observational studies comparing nurse practitioners and physicians providing care at the first point of contact in a primary care setting showed no differences in quality of care delivered, as estimated by prescriptions, return consultations, or referrals between the two groups, whereas patients' satisfaction was higher with nurse practitioners (Horrocks, Anderson, & Salisbury, 2002).The current study was aimed at assessing the feasibility and efficacy of a program of nurse management for unscheduled consultations of children with acute minor illnesses. Earlier reports of nursing care for children with acute minor illnesses derive from the Pediatric Nurse-Practitioner Program. This was a program developed in the late 1960s at the University of Colorado aimed at providing total health care for children living in medically deprived communities (Silver, Ford, & Day, 1968; Silver, Ford, & Stearly, 1967). Nurses provided care to well children as well as sick children with acute or chronic conditions. Children with acute minor illnesses were cared for by nurses using a pre-established plan of management, while children severely ill were referred to a physician for immediate medical care. Although similar programs for children with acute minor illnesses have since then been established, there is limited information on the effectiveness of such programs in current nursing practice (Campbell, Kearsley, Herdman, & Maric, 1995; Schiff, Fraser, & Walters, 1969; Yousey & Carr, 2005). Knowledge about the effectiveness of programs of nurse practitioner management of children with acute minor illnesses is important because acute conditions in the pediatric population are very common and differ from those in adults. In two randomized controlled trials of nurse practitioner care versus general practitioner care for patients requesting same day consultation, 896 out of the 2,660 patients included in the study were children (Kinnerseley, Anderson, Parry, Clement, Archard, & Turton, 2000; Venning, Durie, Roland, Roberts, & Leese, 2000). In both studies, patients' satisfaction was higher with nurse practitioners but no other specific analyses were reported for the pediatric population. Although to our knowledge there are no specific studies assessing the frequency of unscheduled consultations in the pediatric population in primary care, they probably represent a major workload for health systems in a manner similar to that for the adult population (Bodenheimer & Pham, 2010; Kocher & Asplin, 2013). Due to this limited of information, we report an observational study assessing the results of a program of nurse management for unscheduled consultations of children with acute minor illnesses in primary care in a large geographical area in Catalonia, northwest Spain. …

Anal infection by cutaneous Human Papillomaviruses (HPV) has been rarely investigated. We aimed to assess the prevalence, genotype diversity, and determinants of mucosal (alpha) and cutaneous (beta and gamma) anal HPV infection in men who have sex with men (MSM).Anal samples were collected with a Dacron swab. Alpha HPVs were detected using the Linear Array HPV genotyping test, while beta and gamma HPVs using a PCR combined with Luminex technology.A total of 609 MSM (437 HIV-uninfected and 172 HIV-infected, most of which were undergoing cART) were enrolled. Alpha, beta, and gamma HPVs were detected in 78.0%, 27.6% and 29.3% of the participants. Only alpha HPV prevalence was significantly higher among HIV-infected compared to uninfected MSM (93.0% vs. 72.1%, p 0.0001). Beta2 and gamma10 represented the most frequent cutaneous HPV species, with no significant differences between HIV-infected and uninfected individuals. The most common alpha, beta, and gamma genotypes were HPV16, HPV111, HPV121, respectively. Alpha HPV infection was significantly associated with lifetime number of partners, receptive anal sex, and HIV status. Beta and/or gamma HPV infection showed no significant association with HIV status, socio-demographic or sexual behavioral factors.A wide spectrum of mucosal and cutaneous HPV types is present in the anal canal. Only mucosal HPV prevalence increased significantly in cases of concomitant HIV infection.

Knowledge of human papillomavirus (HPV) type distribution in populations at risk for anal cancer is needed. Here, we describe the anal HPV genotype distribution in a large Spanish cohort (Cohort of the Spanish HIV Research Network HPV [CoRIS-HPV]) of HIV-positive men who have sex with men (MSM) according to geographical origin, age, and cytological status. A cross-sectional analysis of baseline data from 1,439 HIV-infected MSM (2007 to 2012) was performed. Anal HPV genotyping was performed using the Linear Array HPV genotyping test. Descriptive analyses of subject characteristics, prevalences, and 95% confidence intervals (CI) were performed. The global prevalences of HPV, high-risk HPV (HR-HPV), and low-risk HPV (LR-HPV) types were 95.8%, 83.0%, and 72.7%, respectively. Among the HR-HPV types, HPV16 was the most common, followed by HPV59, -39, -51, -18, and -52. The prevalence of multiple HR-HPV infections was 58.5%. There were no differences in the crude analyses between Spanish and Latin-American MSM for most HPV types, and a peak in prevalence for most HPV types was seen in patients in their late thirties. Globally and by specific HPV groups, men with abnormal anal cytologies had a higher prevalence of infection than those with normal cytologies. This study has the largest number of HIV-positive MSM with HPV genotype data analyzed according to cytological status as far as we know. The information gained from this study can help with the design of anal cancer prevention strategies in HIV-positive patients.

Background Despite the increasing incidence of laryngeal squamous cell carcinoma (LSCC) in Algeria, scarce information is available on the importance of the preventable etiological factors which may drive the disease. Remarkably, a significant number of cases occur in nonsmoker and nondrinker patients; hence, suggesting that alternative risk factors, like Human papillomavirus (HPV), might be etiologically involved. To gain more insight on the risk factors associated with the disease in the country, we evaluated the etiological fraction of HPV in comparison to tobacco and alcohol intake in LSCC patients. Methods To evaluate the etiopathologic fraction (EF) for HPV compared to history of tobacco and alcohol in LSCC, HPV DNA presence in 46 invasive and 3 non-invasive formalin-fixed paraffin-embedded laryngeal tumors was screened using the SPF10-DEIA-LiPA25 Assay. Demographic data and information related to exposure to the risk factors were gathered through interviewer-assisted questionnaires. Results We observed that 40.8% of all LSCC cases were associated with smoking, 40.8% had combined tobacco and alcohol exposure history, and 14.3% did not show prior exposure to either risk factor. 1 out of 3 in-situ carcinoma cases was positive for HPV-6. HPV prevalence was null in the invasive tumors. HPV DNA was detected in 2.38% for all studied cases. 10.2% of LSCC patients did not associate with any of the studied risk factors. Conclusion Here we show that HPV etiological fraction in LSCC Algerian patients is low and smoking and alcohol remain the principal etiopathologic risk for LSCC burden in Algeria.