Clinical Prognosis of Right-Sided Infective Endocarditis not Associated with Cardiac Devices or Intravenous Drug use : a Cohort Study and Meta-Analysis

Right-sided infective endocarditis (RSIE), classically associated with intravenous drug use or intracardiac devices, is considered a good-prognosis infective endocarditis (IE) form. However, predisposing factors and prognosis for "NODID" RSIE (NOt associated with cardiac Devices or Intravenous Drug use) remain unclear. The aim of this study was to evaluate predisposing factors and prognosis of NODID RSIE compared to other RSIE forms. A retrospective cohort study (January 2008-January 2019) was conducted in a reference center on 300 patients diagnosed with IE. Endocarditis-related events were defined as related to IE in mortality or open-heart surgery during follow-up. A review and meta-analysis of associated literature (January 2008-January 2019) were also performed. Fifty-seven patients presented RSIE (19%), 22 of which were NODID RSIE (39%). Use of intravascular catheters (23% vs 3%; p = 0.027) and congenital heart diseases (18% vs 0%; p = 0.019) were associated with NODID RSIE. This group had a higher in-hospital mortality (23% vs 3%; p = 0.027) and endocarditis-related event rates (41% vs 6%; p = 0.001) than non-NODID RSIE. Furthermore, NODID RSIE was independently associated with in-hospital endocarditis-related events (OR = 19.29; 95%CI:2.23-167.16; p = 0.007). Our meta-analysis evaluated four studies and identified 96 cases (30%) of NODID RSIE from 320 total RSIE cases. NODID RSIE patients demonstrated higher in-hospital mortality (RR = 2.81; 95%CI:1.61-4.90; p < 0.001; I = 0.0%) and necessity of open-heart surgery (RR = 13.89; 95%CI:4.14-46.60; p < 0.001; I = 0.0%) than non-NODID RSIE cases. Our study suggests that NODID RSIE has the highest endocarditis-related event rate and in-hospital mortality among RSIE cases and therefore should not be considered a good-prognosis IE

Regional development gaps in Argentina: A multidimensional approach to identify the location of policy priorities

Spatial inequalities within Latin American countries have historically attracted the interest ofacademics, policy-makers, and international agencies. This article aims to provide amultidimensional diagnosis of provincial development gaps in Argentina, in order to identifythe location of policy priorities. Therefore, we built a large database, which covers sevendevelopment dimensions, and applied multivariate analysis techniques to overcome someanalytical limitations of previous studies. Results show the stability of provincial developmentgaps between 2003 and 2013 and some heterogeneity within geographic regions. Instead,cluster analysis offers a better classification of Argentine provinces according to theirdevelopment gaps, which can help the government to prioritize the places wheredevelopment policies are strategic.Fil: Niembro, Andrés Alberto. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Patagonia Norte; Argentina. Universidad Nacional de Río Negro; ArgentinaFil: Sarmiento, Jesica Isabel. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Patagonia Norte; Argentina. Universidad Nacional de Río Negro; Argentin

Innovation and productivity in services and manufacturing : The role of ICT investment

Several studies have highlighted ICT as a driver of firm productivity in developed countries. However, the evidence about the impacts of ICT on services and manufacturing and particularly for developing countries is scarce. This paper focuses on understanding the determinants of investments in ICT at firm level and how this adoption ultimately affects innovation and productivity of Uruguayan services firms vis a vis manufacturing. Results show that ICT investments are more subject to economies of scale than other types of investments, are important for obtaining product or process innovations in services and its absence conspires against non-technological (organisational or marketing) innovations. Both ICT and other innovation investments are positively associated with productivity in services but only ICT affect productivity in manufacturing. Interestingly, the absence of investment in ICT is associated with lower levels of productivity

Production of microcystins in calcareous Mediterranean streams: The Alhárabe, Segura river Basin in S.E. Spain

13 páginas, 4 tablas, 8 figuras.The development of epilithic cyanobacteria communities in a Mediterranean calcareous stream in the province of Murcia (SE Spain) was studied during the course of one year in an attempt to clarify the environmental variables that influence the production of microcystins. The predominant cyanobacteria were species of Rivularia, which formed conspicuous colonies throughout the year. Seasonally, other species were abundant: Schizothrix fasciculata, Tolypothrix distorta and Phormidium splendidum. All the species collected produced microcystins to a varying degree (up to five varieties), while the benthic community as a whole produced concentrations as high as 20.45 mgm−2. At the same time, the presence of microcystins dissolved in water was confirmed. Among environmental variables, air temperature and silicate content were positively and strongly correlated with total microcystins, while nitrite, nitrate, orthophosphate, calcium and flow were negatively correlated with them. Dissolved microcystins were negatively correlated with microcystin LR, P.A.R. and total phosphorus and positively with rainfall. The production of microcystin YR seems to be regulated by different factors from those regulating the other main varieties (microcystin LR and microcystin RR). The data obtained indicate that all the tested benthic cyanobacteria produced microcystins in this shallow calcareous stream, which may contribute to their predominance in the prevailing conditions. The accumulation of microcystins in mucilaginous colonies of other groups of algae poses new questions concerning the possible ecological function of these compounds and needs further study.This Projectwas funded by Spanish Ministry of Science and Technology (REN2000-1021-C03-02/HID).Peer reviewe

Are We Underestimating Benthic Cyanotoxins? Extensive Sampling Results from Spain

Microcystins (MCs) are potent hepatotoxins, and their presence in water bodies poses a threat to wildlife and human populations. Most of the available information refers to plankton, and much less is known about microcystins in other habitats. To broaden our understanding of the presence and environmental distribution of this group of toxins, we conducted extensive sampling throughout Spain, under a range of conditions and in distinct aquatic and terrestrial habitats. More than half of the tested strains were toxic; concentrations of the hepatotoxin were low compared with planktic communities, and the number of toxic variants identified in each sample of the Spanish strains ranged from 1–3. The presence of microcystins LF and LY (MC-LF and MC-LY) in the tested samples was significant, and ranged from 21.4% to 100% of the total microcystins per strain. These strains were only detected in cyanobacteria Oscillatoriales and Nostocales. We can report, for the first time, seven new species of microcystin producers in high mountain rivers and chasmoendolithic communities. This is the first report of these species in Geitlerinema and the confirmation of Anatoxin-a in Phormidium uncinatum. Our findings show that microcystins are widespread in all habitat types, including both aerophytic and endolithic peat bogs and that it is necessary to identify all the variants of microcystins in aquatic bodies as the commonest toxins sometimes represent a very low proportion of the total

Implications of cyanophyta toxicity on biological monitoring of calcareous streams in north-east Spain

8 páginas, 3 tablas, 8 figurasThere is increasing evidence that benthic cyanophytes in Mediterranean calcareous streams can influence the macroinvertebrate community, probably directly due to toxicity. A study was therefore planned to establish whether this also influenced the results of indices used for the biological monitoring of stream water quality. Two indices (BMWPc based on macroinvertebrates; IBD based on diatoms) widely used to assess water quality based on the diversity of macroinvertebrate and diatom assemblages were calculated for two unpolluted Mediterranean calcareous streams in north-east Spain. The toxicity levels of the cyanophyte communities were quantified by the Microtox test. There was a clear inverse relationship between the dominance of cyanophytes and the values obtained for the biological indices. It is recommended that cyanophyte biomass should be incorporated in some way in the calibration of index values; the use of phycobiliprotein concentration and/or the chlorophyll a:phycobiliprotein ratio is proposed.This paper summarizes some of the results of the project AMB97-1176-C02 of the CICYT of the Spanish Ministry of Science.Peer reviewe

Global sampling reveals low genetic diversity within Compsopogon (Compsopogonales, Rhodophyta)

Twenty-five specimens of the freshwater red alga Compsopogon were collected from locations in North America, South America, Europe, Asia, Australasia and Oceania, and from an aquarium, with the goal of determining genetic diversity among specimens and ascertaining the number of phylogenetic species. Specimens were morphologically identified as having either the 'caeruleus' morphology, with regular polyhedral cortical cells, or the 'leptoclados' morphology, with irregular cortical cells with rhizoidal outgrowths. The 'leptoclados' morphology has been used by some researchers to distinguish the genus Compsopogonopsis from Compsopogon, or at least to distinguish C. leptoclados from other Compsopogon species. Sequence data for the rbcL gene and cox1 barcoding region were obtained for most specimens. In addition, SSU and partial LSU (barcode) rDNA were explored for a few specimens, but all sequences were identical. For the 25 newly generated and eight previously published rbcL gene data, there were seven unique haplotypes, but the sequence divergence was very low (≤7 bp, ≤ 0.7%). One haplotype was widespread, represented by 21 specimens from diverse locations in all regions sampled. Likewise, the 22 new and one previously published cox1 barcode region sequences yielded seven unique haplotypes with little sequence divergence (≤13 bp, ≤ 2.0%). One haplotype was widespread, being shared among 16 specimens from all regions. The combined molecular and morphological data showed no genetic differentiation between the 'caeruleus' and 'leptoclados' morphologies. The ubiquitous distribution of Compsopogon in tropical/subtropical regions and its low genetic variation are probably facilitated by the alga's ability to tolerate a wide range of stream conditions and its propagation via asexual spores. Given the findings of previous culture-based studies, morphometric research and field observations, coupled with the results of our study, we conclude there is only a single monospecific genus worldwide and that the species is correctly called C. caeruleus, since this is the oldest validly published name; all other previously described species of Compsopogon and Compsopogonopsis are synonyms. © 2013 British Phycological Society