Multiple Correspondence Analysis Research Articles

Machine Learning in Allergic Contact Dermatitis: Identifying (Dis)similarities between Polysensitized and Monosensitized Patients

Background: Allergic contact dermatitis (ACD) is a delayed hypersensitivity reaction occurring in sensitized individuals due to exposure to allergens. Polysensitization, defined as positive reactions to multiple unrelated haptens, increases the risk of ACD development and affects patients’ quality of life. The aim of this study is to apply machine learning in order to analyze the association between ACD, polysensitization, individual susceptibility, and patients’ characteristics. Methods: Patch test results and demographics from 400 ACD patients (Study protocol Nr. 3765/2022), categorized as polysensitized or monosensitized, were analyzed. Classic statistical analysis and multiple correspondence analysis (MCA) were utilized to explore relationships among variables. Results: The findings revealed significant associations between patient characteristics and ACD patterns, with hand dermatitis showing the strongest correlation. MCA provided insights into the complex interplay of demographic and clinical factors influencing ACD prevalence. Conclusion: Overall, this study highlights the potential of machine learning in unveiling hidden patterns within dermatological data, paving the way for future advancements in the field.

Potential suicide risk among the college student population: machine learning approaches for identifying predictors and different students’ risk profiles

BackgroundSuicide is one of the leading causes of death among young people and university students. Research has identified numerous socio-demographic, relational, and clinical factors as potential predictors of suicide risk, and machine learning techniques have emerged as promising ways to improve risk assessment.ObjectiveThis cross-sectional observational study aimed at identifying predictors and college student profiles associated with suicide risk through a machine learning approach.MethodsA total of 3102 students were surveyed regarding potential suicide risk, socio-demographic characteristics, academic career, and physical/mental health and well-being. The classification tree technique and the multiple correspondence analysis were applied to define students’ profiles in terms of suicide risk and to detect the main predictors of such a risk.ResultsAmong the participating students, 7% showed high potential suicide risk and 3.8% had a history of suicide attempts. Psychological distress and use of alcohol/substance were prominent predictors of suicide risk contributing to define the profile of high risk of suicide: students with significant psychological distress, and with medium/high-risk use of alcohol and psychoactive substances. Conversely, low psychological distress and low-risk use of alcohol and substances, together with religious practice, represented the profile of students with low risk of suicide.ConclusionsMachine learning techniques could hold promise for assessing suicide risk in college students, potentially leading to the development of more effective prevention programs. These programs should address both risk and protective factors and be tailored to students’ needs and to the different categories of risk.

Understanding the futsal game moments through the eyes of futsal coaches: a comparison of expert and novice coaches

ABSTRACT Coaches rely on the information detected in the performance environment to regulate the quantity and quality of the decisions made during matches. This study used an expert-novice paradigm to describe coaches’ gaze behavior in offensive and defensive game moments of futsal. Twenty coaches (ten expert and ten novices) participated in the study. The experimental conditions contrasted their gaze behavior when watching 71 video clips of the game, both when the team was attacking and when the team was defending. The dependent variables for gaze behaviour were organized in game moments and described using biplots from multiple correspondence analysis. Overall, the results revealed a relationship between the coaches’ level of expertise and the visual information searched at each futsal game moment. Expert coaches focused more on the information related to the players without the ball and the space, while novice coaches tended to focus their attention in the ball and in the attacker with the ball. It seemed clear that the process of visual exploration is specific for each game moment and that the level of coaches’ expertise shapes the visual information searched.

Liver Observation Segmentation on Contrast-Enhanced MRI: SAM and MedSAM Performance in Patients With Probable or Definite Hepatocellular Carcinoma.

Purpose: To evaluate factors impacting the Segment Anything Model (SAM) and variant MedSAM performance for segmenting liver observations on contrast-enhanced (CE) magnetic resonance imaging (MRI) in high-risk patients with probable hepatocellular carcinoma (HCC) (LR-4) and definite HCC (LR-5). Methods: A retrospective cohort of liver observations (LR-4/LR-5) on CE-MRI from 97 patients at high-risk for HCC was derived (2013-2018). Using bounding-boxes as prompts under 5-fold cross-validation, segmentation performance was evaluated at the model and liver observation-levels for: (1) model types: SAM versus MedSAM, (2) image sizes: 256 × 256 versus 512 × 512, (3) image channel composition: CE sequences at 3 phases of enhancement independently and combined, (4) liver observation size: >10 mm versus >20 mm, (5) certainty of diagnosis: LR-4 versus LR-5, and (6) contrast-agent type: hepatobiliary versus extracellular. Segmentation performance, quantified using Dice coefficient, were compared using univariate (Wilcoxon signed-rank and t-test) and multivariable analyses (multiple correspondence analysis and subsequent linear modelling). Results: MedSAM trained on 512 × 512 combined CE sequences performed best with mean Dice coefficient 0.68 (95% confidence interval 0.66, 0.69). Overall, all factors except contrast-agent type affected performance, with larger image size resulting in the highest performance improvement (512 × 512: 0.57, 256 × 256: 0.26, P < .001) at the model-level. Contrast-agents affected performance for patients with LR-4 observations using MedSAM-based models (P < .03). Larger observation size, image size, and higher certainty of diagnosis were associated with better segmentation on multivariable analysis. Conclusion: A variety of factors were found to impact SAM/MedSAM performance for segmenting liver observations in patients with probable and definite HCC on CE-MRI. Future models may be optimized by accounting for these factors.

Which support is provided in which country? Patterns among older adults in Europe

This paper proposes comparative research on support provided outside the household by older adults in Europe. In studying social support, the network perspective is widely used, investigating, in particular, the ego-centered support networks of individuals. The analysis is based on data from Wave 7 of the Survey of Health Ageing and Retirement in Europe (SHARE). It examines the characteristics of ego-support networks of individuals aged 65 and over in 12 European countries, which are grouped into a novel welfare regime typology. Through Multiple Correspondence Analysis, we jointly looked into the categorical variables describing the recipients (alters) of the support provided by older adults and the welfare regime classification. As a main result, countries grouped in “High degree of familialism by default” category specialized in supporting family-related alters, particularly with childcare or personal care. In contrast, the elders in countries belonging to “High degree of de-familialisation” typology provided a more varied but less demanding support, to non-relatives alters and less oriented to care. The analyses show that the SHARE provides a solid opportunity to face the topic.

Ancestry of the major long-range regulatory site of the α-globin genes in the Portuguese population with the common 3.7 kb α-thalassemia deletion

BackgroundThe α-Major Regulatory Element (α-MRE), also known as HS-40, is located upstream of the α-globin gene cluster and has a crucial role in the long-range regulation of the α-globin gene expression. This enhancer is polymorphic and several haplotypes were identified in different populations, with haplotype D almost exclusively found in African populations. The purpose of this research was to identify the HS-40 haplotype associated with the 3.7 kb α-thalassemia deletion (-α3.7del) in the Portuguese population, and determine its ancestry and influence on patients’ hematological phenotype.Methods and resultsWe selected 111 Portuguese individuals previously analyzed by Gap-PCR to detect the presence of the -α3.7del: 50 without the -α3.7del, 34 heterozygous and 27 homozygous for the -α3.7del. The HS-40 region was amplified by PCR followed by Sanger sequencing. Four HS-40 haplotypes were found (A to D). The distribution of HS-40 haplotypes and genotypes are significantly different between individuals with and without the -α3.7del, being haplotype D and genotype AD the most prevalent in patients with this deletion in homozygosity. Furthermore, multiple correspondence analysis revealed that individuals without the -α3.7del are grouped with other European populations, while samples with the -α3.7del are separated from these and found more closely related to the African population.ConclusionThis study revealed for the first time an association of the HS-40 haplotype D with the -α3.7del in the Portuguese population, and its likely African ancestry. These results may have clinical importance as in vitro analysis of haplotype D showed a decrease in its enhancer activity on α-globin gene.

Comparison between classification algorithms using a multiple correspondence analysis with python.

To analyse the data of a survey questionnaire we apply multiple correspondence analysis “MCA” as a method to help us convert data into a scatter plot, but it is difficult to study it and get good results, so we need to make a classification to facilitate the study. Among the most usable classification methods, hierarchical ascending classification and k-means. To compare them, we conducted a questionnaire on distance studies during the Corona crisis, which included the opinions of 304 university professors from most universities in Algeria; in our application, we used the Python programming language.

Clinical Manifestations of Dengue in Children and Adults in a Hyperendemic Region of Colombia.

Dengue is the most common arboviral disease in the world. Traditionally, it has affected more adults, but the incidence in children has increased in recent years. Colombia is no stranger to this change; therefore, we aimed to find the differences in signs, symptoms, and clinical, hematological, and hemogram characteristics between children under 12 years old and individuals aged 12 years and older in an endemic region of Colombia in 2020-2022. The analyses were conducted with baseline data, corresponding to a cross-sectional design. Multiple correspondence analysis was used for general, dermatological, and clinical symptom profiles. Discriminant analysis was used for laboratory profiles. Multiple correspondence analysis was applied to nominal categorical data, employing Euclidean distances to analyze age groups. Discriminant analysis was applied to a training sample and validated on a test sample. The overall agreement of the model's discrimination, sensitivity, specificity, and fit indicators was calculated. The results indicated that individuals under 12 years exhibited distinct dermatological and clinical features, including rash, pruritus, hypotension, lymphocyte count, and platelet count, compared with those aged 12 years and older. In contrast, those 12 years and older were profiled for general and clinical symptoms such as pain (back pain, retro-orbital pain, headache), dizziness, chills, hematuria, tachypnea, and elevated/high hematocrit, hemoglobin, and basophil values. These findings are crucial to understanding the high incidence in children; they also facilitate rapid understanding of the disease in clinical care settings and differentiate it from other febrile outbreaks. This will affect disease control, particularly in severe cases, and reduce mortality.

Clinical Profile of Patients with Primary Sjögren's Syndrome with Non-Identified Antinuclear Autoantibodies.

Objectives-The aim of the present study was to characterize the clinical phenotype of patients with primary Sjögren's syndrome (pSS) with non-identified antinuclear antibodies (ANA) in comparison with that of patients with pSS with negative ANA, positive typical ANA (anti-Ro/SSA and/or La/SSB) and positive atypical ANA. Methods-We conducted an observational, retrospective monocentric study at the Erasme University Hospital (Brussels, Belgium). Two hundred and thirty-three patients fulfilling the 2002 American-European Consensus Group criteria for pSS were included in this study. The patients were subdivided according to their ANA profile and demographics. The clinical and biological data of each subgroup were compared. Moreover, the relationships between these data and the ANA profiles were determined by multiple correspondence analysis. Results-In our cohort, 42 patients (18%) presented a non-identified ANA-positive profile. No statistically significant difference could be observed between non-identified ANA patients and ANA-negative patients in terms of age and/or ESSDAI score at diagnosis. There were significantly more frequent articular manifestations, positive rheumatoid factor (RF), and the use of corticosteroids in anti-Ro/SSA-positive patients compared to ANA-negative (p ≤ 0.0001) and non-identified ANA-positive patients (p ≤ 0.01). However, a significantly higher proportion of RF positivity and corticosteroid treatment was observed in non-identified ANA-positive patients compared to ANA-negative patients (p < 0.05). Conclusions-For the first time to our knowledge, our study has characterized the clinical phenotype of patients with pSS with non-identified ANA at diagnosis. The non-identified ANA-positive patients featured mostly a clinical phenotype similar to that of the ANA-negative patients. On the other hand, the non-identified ANA-positive patients were mainly distinguished from the ANA-negative patients by a greater proportion of RF positivity and the need for corticosteroid use due to articular involvement.

How Professional and Market Logics and the Conflict between Institutional Demands Affect Hospital Accreditation Compliance: A Multiple-Case Study in Brazil.

Hospital accreditation has become ubiquitous in developing countries. While research acknowledges that accreditation can enhance healthcare quality, efficiency, and safety, concerns persist regarding hospitals' management of conflicts stemming from the diverse institutional logic inherent in this process. Therefore, this study aimed to investigate how professional and market logic, alongside conflicts arising from institutional demands, affect compliance with hospital accreditation. To this end, we conducted a multiple-case study in four Brazilian hospitals employing in-depth interviews and on-site observations. The triangulation of narrative analysis and the outcomes of multiple correspondence analysis revealed that when professional logic predominates, there is a greater propensity to tailor accredited activities by segmenting the tasks between physicians and nurses with the intention of mitigating existing conflicts. Conversely, when conflicts occur over established goals between professionals and orientated marked logic executives, the accreditation process is impeded, resulting in non-compliance. Ultimately, the findings underscore the alignment between the pursuit of legitimacy and efficiency within the accreditation process. We conclude by delineating the theoretical and practical implications of scrutinizing the internal dynamics of institutional logic.

Artificial intelligence and sustainable development during the pandemic: An overview of the scientific debates

The current work aims to analyze the main themes related to artificial intelligence (AI) and sustainable development during the pandemic period. This study provides an overview of the specialized literature related to AI and sustainability from the beginning of the pandemic through 2023. The present paper analyses scientific literature emphasizing both artificial intelligence's positive and negative impacts on sustainable development objectives (SDGs). To conduct the research, we employed bibliometric analysis and text-mining techniques to identify the major themes in the literature indexed in the Web of Science and Scopus databases. Firstly, we used descriptive measures to identify the authors' impact, the article production by country, the main keywords used, and other descriptive data. We further used data reduction methods based on co-word analysis (such as multiple correspondence analysis) on authors' keywords to show patterns in the themes explored in the literature. Bibliometric analysis was supplemented by text mining using Latent Dirichlet allocation (LDA) and structural topic modeling on abstracts to provide a comprehensive view of scientific debates on AI and sustainable development. Our research has identified various themes in the literature related to AI and sustainable development. These themes include social sustainability, health-related issues, AI technologies for energy efficiency, sustainability in industry and innovation, IoT technologies for smart and sustainable cities, urban planning, technologies for education and knowledge production, and the impact of technologies on SDGs. We also found that there is a significant positivity bias in the literature when discussing the impact of AI on sustainable development. Despite acknowledging certain risks, the literature tends to focus on the potential benefits of AI across various sectors. In addition, the analysis shows a growing emphasis on energy efficiency, which is facilitated by the use of AI technologies. Our study contributes to a better understanding of current scholarly discussion trends and emerging scientific avenues regarding AI and sustainable development. It also highlights the areas where research is needed and the implications for practitioners and policymakers.

POLICE’S PSYCHO-SOCIAL PROFILE IN COLOMBIAN ACTUAL SCENES: A PERSPECTIVE FROM THE CITIZENRY/POPULATION. CASE: JURISDICTION OF PUENTE ARANDA, BOGOTÁ

Objective: The objective of this article is to analyze the Psychosocial Profile (PP) of police officers from a citizen perspective. Theoretical Framework: The PP is a tool to reveal the service that is provided daily according to effective, respectful, adaptable, communicative and assertive actions, continuous learning and leadership, among other causal competencies, which ratify an effective service that responds to the institutional mission. Method: The esearch is qualitative and quantitative, exploratory and descriptive, structured with a phenomenological design, which is based on the identification of characteristics of the PP, based on six competencies: personal, interpersonal, cognitive, institutional, community and physical. To obtain the information for the research, a population focus conformed of the inhabitants of the Town of Puente Aranda and a random sample of 384 people, was studied and interviewed. Results and Discussion: The characteristics of the PP constitute the concordance between direct and linear associations according to the categories: psychosocial profile, commitment, vocation, behavioral criteria and the profile of the leadership of the police service in relation to the citizen and the fulfillment of the institutional mission. Research Implications: This is evidenced according to the multiple correspondence analyses between the singular competencies and the community’s socio-demographic variables according to the provision of the police service. Originality/Value: The importance of optimizing the psychosocial profile of the police officer is established based on their contextualized and active social interaction, taking into account personal, interpersonal, cognitive, physical, institutional, leadership and teamwork skills to fulfill their service mission. to the citizens.

Understanding microplastic presence in different wastewater treatment processes: Removal efficiency and source identification

Municipal effluents discharged from wastewater treatment plants (WWTPs) are a considerable source of microplastics in the environment. The dynamic profiles of microplastics in treatment units in WWTPs with different treatment processes remain unclear. This study quantitatively analyzed microplastics in wastewater samples collected from different treatment units in two tertiary treatment plants with distinct processes. The influents contained an average of 15.5 ± 3.5 particles/L and 38.5 ± 2.5 particles/L in the two WWTPs with in the oxidation ditch process and the integrated fixed-film activated sludge process, respectively. Interestingly, microplastic concentrations in the influent were more influenced by the population density in the served area than sewage volume or served population equivalent. Throughout the treatment process, concentrations were reduced to 1.5 ± 0.5 particles/L and 1.0 ± 1.0 particles/L in the final effluents, representing an overall decrease of 90% and 97%, in WWTPs with the oxidation ditch process and integrated fixed-film activated sludge process, respectively. A significant proportion of the microplastics were removed during the primary treatment stage in both WWTPs, with better performance for foam, film, line-shaped and large-sized microplastics. Most microplastics were accumulated in activated sludge, indicating its key role as the primary sink in WWTPs. The multiple correspondence analysis identified laundry washing and daily necessities such as packaging and containers as the major contributors to microplastics in WWTPs. The study proposed recommendations for upgrading WWTPs, modifying designs, and implementing strategies to reduce microplastic sources, aiming to minimize the release of microplastics into the environment. These findings can shed lights on the sources of microplastics in WWTPs, and advance our understanding of the mechanisms for more effective microplastic removals in wastewater treatment technologies in future applications.

Effects of Family Culture and Marital Decisions of the Business Owners on Access to Financing of Very Small Businesses

Purpose: This study seeks to examine the effects of family culture (presence during family meetings, assistance in important family events, and strong family bonds) as well as marital decisions (mutual participation, joint savings decisions, and joint ventures) on access to financing of very small businesses in the North West Region of Cameroon. Methods: The study used a series of exogenous and control variables adapted from the model of Gikonyo, Agwata, &amp; Anyango (2011) who proposed a strategic model for quantitative research. Primary data were collected through convenient sampling from 293 very small business owners in each divisional headquarters of the North West Region of Cameroon. We used the multiple correspondence analysis to construct indexes for family culture, marital decisions as well as access to financing of very small businesses. The hypotheses of the study were then tested using the ordinary least square estimation technique. Results: The results obtained showed in aggregate, a positive and significant effect of family culture and marital decisions on access to financing. More precisely, the coefficients of presence during family meetings, assistance in important family events as well as strong family bonds are positive. These results were statistically significant at 1% level. Implications: This study has significant practical implications on the financial health of very small businesses in the context of developing countries like Cameroon in general and the North West Region of Cameroon in particular plagued by the crisis and COVID-19. The study therefore concluded that if very small business owners can improve on the respect of family cultures and can jointly decide on their financial actions with their spouses, they will have better access to financing, especially in developing countries like Cameroon and more particularly in the North West Region of the country.

Dimensionality Reduction problem: a Comprehensive Exploration of Disjoint Principal Component Analysis (DPCA) and Disjoint Multiple Correspondence Analysis (DMCA)

This paper delves into the realm of advanced data analysis, focusing on two powerful dimensionality reduction methods: Disjoint Principal Component Analysis (DPCA) and Disjoint Multiple Correspondence Analysis (DMCA). Methodological marvels in their own right, these approaches are scrutinized for their unique properties and applications across diverse domains. We navigate through the intricacies of their algorithms and explore how they unveil patterns within complex datasets. The comparative analysis highlights the strengths and weaknesses of DPCA and DMCA, shedding light on their distinct contributions to the analytical landscape. This paper serves as a comprehensive guide for researchers and analysts seeking deeper insights into these cutting-edge techniques for dimensional reduction.

I'm a traditionalist, I Don't like pizza and street food: The relationship between cultural consumption habits and food preferences

According to the stratification theory by Bourdieu, music taste, literary genres read and taste-related patterns such as eating constitute the determinants of cultural consumption of individuals based on their position in their social class and also function as a criterion set to separate or differentiate themselves from other individuals in the same social class. This study aims to investigate the relationship between the cultural consumption patterns of individuals and food preferences within the scope of the stratification theory. This research adopted a multi-methodical research method for this purpose and determined the food consumption preferences of individuals by categorizing them performing clustering analysis within the framework of the stratification theory, and then the cultural consumption patterns of the obtained groups were revealed using multiple correspondence analysis. As a result of the analyses, participants’ food preferences were grouped as traditionalists, yes-sayers, modernists, hedonists and weight controllers. When the results regarding the relationship between cultural consumption and their food preferences are examined, the food group that the traditionalists have been avoiding is pizza and street tastes, while they do not prefer/dislike classical western music, Latin and heavy metal out of music genres, poetry out of literary genres. The individuals in the weight controllers group liked rock music and classical Western music, while they did not like arabesque music and religious music genres. Modernists prefer international cuisine products and fish. While yes-sayers liked religious music in the cluster, they did not like Turkish folk music. Hedonists, on the other hand, avoided from arabesque and protest music genre.

An exploratory study of mainland Chinese parents’ ideologies about bilingualism and bilingual education

ABSTRACT The current study investigates mainland Chinese parents’ ideologies on bilingualism and biliteracy, specifically for those who chose Mandarin-English bilingual education for their children. We explored children’s language and literacy usage at home as they attend school with Mandarin and English as the instructional languages. Three hundred and eight survey responses were collected from parents in Shanghai, China. Results from an exploratory factor analysis showed that parents generally held positive attitudes toward both bilingualism and bidialectalism. Additionally, multiple correspondence analyses demonstrated that parents who reported more multilingual usage in daily conversation at home with their children generally aspired for their children to develop an identity of being a global citizen, whereas parents who reported more Mandarin literacy activities engagement typically expected their children to (a) have a flexible mind for learning regardless of the instructional language, (b) become internationally competitive, and (c) be communicative within diverse social groups. It is suggested that parental perceptions of the importance of bilingualism and bidialectalism should be taken into consideration in curriculum planning and language policy making. Understanding parents’ perception of bilingualism may facilitate schools to partner with parents and devise responsive language education goals in schools.

ASOCIACIÓN DE LA ABUNDANCIA DE HUEVOS Y NINFAS DE PRIMER INSTAR DE Diaphorina citri CON EL TAMAÑO DE BROTE VEGETATIVO DEL CULTIVO DE NARANJA VALENCIA (Citrus sinensis (L.) Osbeck).

&lt;p&gt;&lt;strong&gt;Background&lt;/strong&gt;: Currently, there is little information on the abundance of &lt;em&gt;Diaphorina citri&lt;/em&gt; Kuwayama (Hemiptera: Liviidae) eggs and nymphs in the size of vegetative shoots. Such information is relevant for the control of D. citri in early stages of development. &lt;strong&gt;Objective&lt;/strong&gt;: To associate the abundance of eggs and N1 nymphs of &lt;em&gt;D. citri&lt;/em&gt; with the size of the vegetative shoots of the Valencia orange (&lt;em&gt;Citrus sinensis&lt;/em&gt; (L.) Osbeck) crop. &lt;strong&gt;Methodology&lt;/strong&gt;: The study was carried out in the Valencia orange crop in the municipality of Güémez, Tamaulipas. In the field, five categories of shoots were selected under a randomized experimental design. Thirty shoots of each size were confined in a teal tulle bag and 30 shoots of each size were cut to one side of the confined shoot. The number of eggs and N1 nymphs was recorded at 3, 5 and 7 days in each shoot size. The result obtained was subjected to a multivariate analysis of multiple correspondence. &lt;strong&gt;Results:&lt;/strong&gt; In the confined outbreaks, 9 to 27 eggs were recorded in the V2 and V3 outbreaks at three days, and from 71 to 213 eggs in the V4 outbreak at five days. At seven days the number of eggs was like that recorded on day five. In the control shoots, at three and five days, 1 to 3 eggs were recorded in the V5 shoot. At seven days, the number of eggs recorded in shoots V2, V3, V4 and V5 was like that recorded at three and five days. In the confined shoots, at three days no N1 nymphs were recorded in the V5 and V1 shoots. On day five, nine N1 nymphs were recorded in the V2 shoot. While, on day seven the number of N1 nymphs was like that recorded on days three and five. In the control shoots, at three, five and seven days, 1 to 71 N1 nymphs were recorded in the V3 shoot. &lt;strong&gt;Implications:&lt;/strong&gt; The results of this study are useful input for the development of management strategies targeting &lt;em&gt;D. citri&lt;/em&gt; eggs and nymphs to suppress the presence of adults. &lt;strong&gt;Conclusion:&lt;/strong&gt; According to the results, the trials allowed the identification of those categories of vegetative shoots preferential for N1 nymphs and oviposition of adults. This preference may be related to the quality and quantity of photo assimilates present in the different developmental stages of vegetative shoots, which are essential for insect development. &lt;/p&gt;

Severe leptospirosis in tropical and non-tropical areas: A comparison of two french, multicentre, retrospective cohorts.

Leptospirosis is an anthropozoonosis that occurs worldwide but is more common in tropical regions. Severe forms may require intensive care unit (ICU) admission. Whether the clinical patterns and outcomes differ between tropical and non-tropical regions with similar healthcare systems is unclear. Our objective here was to address this issue by comparing two cohorts of ICU patients with leptospirosis managed in mainland France and in the overseas French department of Réunion, respectively. We compared two retrospective cohorts of patients admitted to intensive care for severe leptospirosis, one from Reunion Island in the Indian Ocean (tropical climate) and the other from metropolitan France (temperate climate). Chi-square and Student's t tests were used for comparisons. After grouping the two cohorts, we also performed multiple correspondence analysis and hierarchical clustering to search for distinct clinical phenotypes. The Réunion and Metropolitan France cohorts comprised 128 and 160 patients respectively. Compared with the Réunion cohort, the metropolitan cohort had a higher mean age (42.5±14.1 vs. 51.4±16.5 years, p<0.001). Severity scores, length of stay and mortality did not differ between the two cohorts. Three phenotypes were identified: hepato-renal leptospirosis (54.5%) characterized by significant hepatic, renal and coagulation failure, with a mortality of 8.3%; moderately severe leptospirosis (38.5%) with less severe organ failure and the lowest mortality rate (1.8%); and very severe leptospirosis (7%) manifested by neurological, respiratory and cardiovascular failure, with a mortality of 30%. The outcomes of severe leptospirosis requiring ICU admission did not differ between tropical and temperate regions with similar healthcare access, practices, and resources, despite some differences in patient characteristics. The identification of three different clinical phenotypes may assist in the early diagnosis and management of severe leptospirosis.

Assessment of the Sustainability of Productive Systems in Nariño, Colombia

Human development must ensure the welfare and survival of an ever-growing population. To assess the impact of agroecosystems on sustainability in Nariño (Colombia), variables related to sustainable development were evaluated through a semi-structured survey conducted with 122 producers from 6 municipalities in the Nariño department. The association between the categorical variables associated with the pillars of sustainability was analyzed using multiple correspondence analysis (MCA). From the MCA, 23 indicators were selected, representing quantitative information on the economic, social, and environmental characteristics of the participants. The municipalities were characterized according to the needs and strengths of the producers. Five groups encompass most characteristics of the producers, which are largely independent of geopolitical conditions. On the other hand, the population characterization indicates that the economic well-being of fruit growers can promote the conservation of natural resources. Finally, a principal component factor analysis (PCFA) was conducted to construct the General Sustainability Index (GSI). A network graph for each municipality revealed that the indicators of the production systems are in an unfavorable environment in almost all aspects related to sustainability. The GSI values reveal unstable agroecological conditions that are causing environmental deterioration, with critical levels in the municipalities of Arboleda, Sandoná, and Providencia. Social investment and public policies must be implemented to improve the economic conditions of the producers, accompanied by legislation on the proper management of natural resources.