Resistencia De Salmonella Spp A Antibióticos Y Fluctuación Fisicoquímica Del Agua A Nivel Espacial En La Cuenca Media Del Río Usumacinta, México

La presencia de antibióticos en cuerpos de agua es un indicador de su mal uso. Se realizaron muestreos en seis sitios con marcada influencia antropogénica en la cuenca media del río Usumacinta, México, durante la estación de seca, con la finalidad de estudiar la variación espacial fisicoquímica del agua y la resistencia antimicrobiana de Salmonella spp. La identificación bacteriana se realizó con pruebas bioquímicas convencionales. La resistencia bacteriana fue evaluada mediante la sensibilidad antibiótica a la amikacina (AK 30 μg), levofloxacina (LEV 5 μg), ceftriaxona (CRO μg 30), cloranfenicol (CLO 30 μg), trímetropina-sulfametoxazol (TRI-SXT 25 μg), ampicilina (AM 10 μg), (cefalotina CF 30 μg), gentamicina (GE 10 μg), (netilmicina NET 30 μg), nitrofurantoína (NF 300 μg), cefepime (FEP 30 μg) y cefotaxima (CTX 30 μg); con la técnica de difusión estandarizada de Kirby Bauer. Los resultados detectaron 16 cepas correspondientes a Salmonella spp. Así mismo, los diámetros de los halos de inhibición del crecimiento bacteriano fueron significativos, por efecto del tipo de antibiótico empleado para las pruebas. Así como, por efecto del sitio de muestreo (p < 0.05). El 100% de las cepas de Salmonella spp fueron sensibles a los antibióticos AK, LEV, CRO, GE, NET, FEP y la CTX; mientras el 93.7% fueron resistentes a la AM. Finalmente, la resistencia de Salmonella spp, a antibióticos puede verse afectada por el grado de perturbación antropogénica del sitio muestreado y según el tipo de antibiótico presente en el agua. The presence of antibiotics in water bodies is an indicator of their misuse. Samples were conducted at six sites with marked anthropogenic influence in the middle basin of the Usumacinta River, Mexico, during the dry season. In order to study the physicochemical spatial variation of water and the antimicrobial resistance of Salmonella spp., bacterial identification was performed with conventional biochemical tests. Bacterial resistance was evaluated by the antibiotic sensitivity of amikacin (AK 30 μg), levofloxacin (LEV 5 μg), ceftriaxone (CRO μg 30), chloramphenicol (CLO 30 μg), trimetropin-sulfamethoxazole (TRI-SXT 25 μg), ampicillin (AM 10 μg), cephalothin (CF 30 μg), gentamicin (GE 10 μg), netilmicin (NET 30 μg), nitrofurantoin (NF 300 μg), cefepime (FEP 30 μg) and cefotaxime (CTX 30 μg); with the standardized diffusion technique of Kirby Bauer. The results showed the diameters of the bacterial growth inhibition halos were significant, due to the type of antibiotic used for the tests. In addition, the effect of the sampling site was significant (p <0.05). 100% of Salmonella spp strains were sensitive to antibiotics AK, LEV, CRO, GE, NET, FEP and CTX; while 93.7 %were resistant to AM. Finally, the resistance of Salmonella spp to antibiotics can be affected by the degree of anthropogenic disturbance of the sampled site, and according to the type of antibiotic present in the water

Linking High Risk Postpartum Women with a Technology Enabled Health Coaching Program to Reduce Diabetes Risk and Improve Wellbeing: Program Description, Case Studies, and Recommendations for Community Health Coaching Programs

Background. Low-income minority women with prior gestational diabetes mellitus (pGDM) or high BMIs have increased risk for chronic illnesses postpartum. Although the Diabetes Prevention Program (DPP) provides an evidence-based model for reducing diabetes risk, few community-based interventions have adapted this program for pGDM women. Methods. STAR MAMA is an ongoing randomized control trial (RCT) evaluating a hybrid HIT/Health Coaching DPP-based 20-week postpartum program for diabetes prevention compared with education from written materials at baseline. Eligibility includes women 18–39 years old, ≥32 weeks pregnant, and GDM or BMI > 25. Clinic- and community-based recruitment in San Francisco and Sonoma Counties targets 180 women. Sociodemographic and health coaching data from a preliminary sample are presented. Results. Most of the 86 women included to date (88%) have GDM, 80% were identified as Hispanic/Latina, 78% have migrant status, and most are Spanish-speaking. Women receiving the intervention indicate high engagement, with 86% answering 1+ calls. Health coaching callbacks last an average of 9 minutes with range of topics discussed. Case studies presented convey a range of emotional, instrumental, and health literacy-related supports offered by health coaches. Discussion. The DPP-adapted HIT/health coaching model highlights the possibility and challenge of delivering DPP content to postpartum women in community settings. This trial is registered with ClinicalTrials.gov NCT02240420

Особливості реалізації графічного конвеєру при візуалізації тривимірних моделей приміщень університету

В більшості систем комп‘ютерної графіки застосовується графічний конвеєр – логічна група послідовно виконуваних обчислень (етапів), які в результаті дають синтезовану сцену на екрані комп‘ютера. Серед основних – етапи геометричних перетворень та візуалізації. Результат виконання кожного з цих етапів впливає на кінцевий вигляд синтезованої сцени, тому їх коректне завершення є необхідною умовою отримання якісного зображення

31 visiones actuales de la transparencia

Treinta y una aportaciones de autores nacionales y extranjeros sobre la transparencia de las instituciones públicas y de los sujetos obligados por la Ley 19/2013 de 9 de diciembre y el derecho de acceso a la información pública

Quasi-experimental trial of diabetes Self-Management Automated and Real-Time Telephonic Support (SMARTSteps) in a Medicaid managed care plan: study protocol

<p>Abstract</p> <p>Background</p> <p>Health information technology can enhance self-management and quality of life for patients with chronic disease and overcome healthcare barriers for patients with limited English proficiency. After a randomized controlled trial of a multilingual automated telephone self-management support program (ATSM) improved patient-centered dimensions of diabetes care in safety net clinics, we collaborated with a nonprofit Medicaid managed care plan to translate research into practice, offering ATSM as a covered benefit and augmenting ATSM to promote medication activation. This paper describes the protocol of the Self-Management Automated and Real-Time Telephonic Support Project (SMARTSteps).</p> <p>Methods/Design</p> <p>This controlled quasi-experimental trial used a wait-list variant of a stepped wedge design to enroll 362 adult health plan members with diabetes who speak English, Cantonese, or Spanish and receive care at 4 publicly-funded clinics. Through language-stratified randomization, participants were assigned to four intervention statuses: SMARTSteps-ONLY, SMARTSteps-PLUS, or wait-list for either intervention. In addition to usual primary care, intervention participants received 27 weekly calls in their preferred language with rotating queries and response-triggered education about self-care, medication adherence, safety concerns, psychological issues, and preventive services. Health coaches from the health plan called patients with out-of-range responses for collaborative goal setting and action planning. SMARTSteps-PLUS also included health coach calls to promote medication activation, adherence and intensification, if triggered by ATSM-reported non-adherence, refill non-adherence from pharmacy claims, or suboptimal cardiometabolic indicators. Wait-list patients crossed-over to SMARTSteps-ONLY or -PLUS at 6 months. For participants who agreed to structured telephone interviews at baseline and 6 months (n = 252), primary outcomes will be changes in quality of life and functional status with secondary outcomes of 6-month changes in self-management behaviors/efficacy and patient-centered processes of care. We will also evaluate 6-month changes in cardiometabolic (HbA1c, blood pressure, and LDL) and utilization indicators for all participants.</p> <p>Discussion</p> <p>Outcomes will provide evidence regarding real-world implementation of ATSM within a Medicaid managed care plan serving safety net settings. The evaluation trial will provide insight into translating and scaling up health information technology interventions for linguistically and culturally diverse vulnerable populations with chronic disease.</p> <p>Trial Registration</p> <p>ClinicalTrials.gov: <a href="http://www.clinicaltrials.gov/ct2/show/NCT00683020">NCT00683020</a></p

Influence of the alkaline earth cations on the topology of MII/CuII mixed-metal-organic frameworks (M = Ca, Sr and Ba)

The use of the mononuclear copper(ii) complex, [Cu II(Me 2pma) 2] 2- (Me 2pma = N-2,6-dimethylphenyloxamate), as a bis(bidentate) metalloligand toward solvated alkaline earth metal cations affords a new series of oxamato-bridged heterobimetallic two-dimensional compounds with mixed square-octagonal [Ca II 2Cu II 3] or square [M II 2Cu II 3] (M = Sr and Ba) layered structures of (4·82) and (44·62) net topologies, respectively. © 2012 The Royal Society of Chemistry.This work was supported by the MICINN (Spain) (Projects CTQ2010-15364, MAT2010-19681, DPI2010-21103-C04-03, CSD2007-00010 and CSD2006-00015), the Generalitat Valenciana (Spain) (Project PROMETEO/2009/108), the ACIISI-Gobierno Autónomo de Canarias (Spain) (Project PIL-2070901 and structuring project NANOMAC), theMFR and the CNRS (France).We also acknowledge the Long Term Project HS3902 of the ESRF, Grenoble, France, for the beamtime assigned. J. F.-S. thanks the Generalitat Valenciana for a doctoral grant. E. P. and J. P. thank the ‘‘Juan de la Cierva’’ (MICINN) and the structuring project NANOMAC, respectively, for postdoctoral contracts.Peer Reviewe

Oligo-m-phenyleneoxalamide Copper(II) Mesocates as Electro-Switchable Ferromagnetic Metal–Organic Wires

Double-stranded copper(II) string complexes of varying nuclearity, from di- to tetranuclear species, have been prepared by the CuII-mediated self-assembly of a novel family of linear homo- and heteropolytopic ligands that contain two outer oxamato and either zero (1 b), one (2 b), or two (3 b) inner oxamidato donor groups separated by rigid 2-methyl-1,3-phenylene spacers. The X-ray crystal structures of these CuIIn complexes (n=2 (1 d), 3 (2 d), and 4 (3 d)) show a linear array of metal atoms with an overall twisted coordination geometry for both the outer CuN2O2 and inner CuN4 chromophores. Two such nonplanar all-syn bridging ligands 1 b–3 b in an anti arrangement clamp around the metal centers with alternating M and P helical chiralities to afford an overall double meso-helicate-type architecture for 1 d–3 d. Variable-temperature (2.0–300 K) magnetic susceptibility and variable-field (0–5.0 T) magnetization measurements for 1 d–3 d show the occurrence of S=nSCu (n=2–4) high-spin ground states that arise from the moderate ferromagnetic coupling between the unpaired electrons of the linearly disposed CuII ions (SCu=1/2) through the two anti m-phenylenediamidate-type bridges (J values in the range of +15.0 to 16.8 cm−1). Density functional theory (DFT) calculations for 1 d–3 d evidence a sign alternation of the spin density in the meta-substituted phenylene spacers in agreement with a spin polarization exchange mechanism along the linear metal array with overall intermetallic distances between terminal metal centers in the range of 0.7–2.2 nm. Cyclic voltammetry (CV) and rotating-disk electrode (RDE) electrochemical measurements for 1 d–3 d show several reversible or quasireversible one- or two-electron steps that involve the consecutive metal-centered oxidation of the inner and outer CuII ions (SCu=1/2) to diamagnetic CuIII ones (SCu=0) at relatively low formal potentials (E values in the range of +0.14 to 0.25 V and of +0.43 to 0.67 V vs. SCE, respectively). Further developments may be envisaged for this family of oligo-m-phenyleneoxalamide copper(II) double mesocates as electroswitchable ferromagnetic ‘metal–organic wires’ (MOWs) on the basis of their unique ferromagnetic and multicenter redox behaviors.This work was supported by the MICINN (Spain) (projects CTQ2007- 61690, MAT2007-60660, CSD2007-00010, and CSD2006-00015), the Generalitat Valenciana (Spain) (Project PROMETEO/2009/108), the Gobierno Autónomo de Canarias (Spain) (Project PI2002/175), the MESR and the CNRS (France). E.P. acknowledges the MICINN for a postdoctoral (“Juan de la Cierva”) grant.Peer Reviewe

Diabetes health information technology innovation to improve quality of life for health plan members in urban safety net.

Safety net systems need innovative diabetes self-management programs for linguistically diverse patients. A low-income government-sponsored managed care plan implemented a 27-week automated telephone self-management support/health coaching intervention for English-, Spanish-, and Cantonese-speaking members from 4 publicly funded clinics in a practice-based research network. Compared to waitlist, immediate intervention participants had greater 6-month improvements in overall diabetes self-care behaviors (standardized effect size [ES] = 0.29, P &lt; .01) and 12-Item Short Form Health Survey physical scores (ES = 0.25, P = .03); changes in patient-centered processes of care and cardiometabolic outcomes did not differ. Automated telephone self-management is a strategy for improving patient-reported self-management and may also improve some outcomes

Synthesis, structural analysis, and magnetic properties of ethylmalonate-manganese(II) complexes

12 páginas, 10 figuras, 6 tablas.-- et al.Five manganese(II) complexes of formulas [Mn2(Etmal)2(H2O)2(L)]n (1–4) and {[Mn(Etmal)2(H2O)][Mn(H2O)4]}n (5) with H2Etmal = ethylmalonic acid (1–5) and L = 1,2-bis(4-pyridyl)ethane (bpa) (1), 4,4′-azobispyridine (azpy) (2), 4,4′-bipyridyl (4,4′-bpy) (3), and 1,2-bis(4-pyridyl)ethylene (bpe) (4) were synthesized and structurally characterized by single crystal X-ray diffraction. Their thermal behavior and variable-temperature magnetic properties were also investigated. The structure of the compounds 1–4 consists of corrugated layers of aquamanganese(II) units with intralayer carboxylate-ethylmalonate bridges in the anti-syn (equatorial-equatorial) coordination mode which are linked through bis-monodentate bpa (1), azpy (2), 4,4′-bpy (3), and bpe (4) ligands to build up a three-dimensional (3D) framework. The structure of compound 5 is made up by zigzag chains of manganese(II) ions with a regular alternation of [Mn(H2O)4]2+ and chiral (either Δ or λ enantiomeric forms) [Mn(Etmal)2(H2O)]2– units within each chain. In contrast to the bidentate/bis-monodentate coordination mode of the Etmal ligand in 1–4, it adopts the bidentate/monodentate coordination mode in 5 with the bridging carboxylate-ethylmalonate also exhibiting the anti-syn conformation but connecting one equatorial and an axial position from adjacent metal centers. The manganese–manganese separation through the carboxylate-ethylmalonate bridge in 1–5 vary in the range 5.3167(4)–5.5336(7) Å. These values are much shorter than those across the extended bis-monodentate N-donors in 1–4 with longest/shortest values of 11.682(3) (3)/13.9745(9) Å (4). Compounds 1–5 exhibit an overall antiferromagnetic behavior, where the exchange pathway is provided by the carboxylate-ethylmalonate bridge. Monte Carlo simulations based on the classical spin approach (1–5) were used to successfully reproduce the magnetic data of 1–5.Financial support by the Spanish Ministerio de Ciencia e Innovación through projects MAT2007-60660, MAT2010-16981, CTQ2010-15364, DPI2010-21103-C04-03, “Factoría de Crystalización” (Consolider Ingenio2010 CSD2006-0015), Molecular Nanoscience (Consolider Ingenio CSD2007-00010), ACIISI Gobierno de Canarias and Generalitat Valenciana (PROMETEO/2009/108) is gratefully acknowledged. M.D. and J.F.-S. thank the Spanish Ministerio de Ciencia e Innovación (M.D.) and the Generalitat Valenciana (J.F.-S.) for predoctoral fellowships. J.P. also thanks the Proyecto Estructurante NANOMAC (ACIISI-Gobierno de Canarias) for a postdoctoral contract.Peer reviewe