CARMENES: data flow

CARMENES, the new Calar Alto spectrograph especially built for radial-velocity surveys of exoearths around M dwarfs, is a very complicated system. For reaching the goal of 1 m/s radial-velocity accuracy, it is appropriate not only to monitor stars with the best observing procedure, but to monitor also the parameters of the CARMENES subsystems and safely store all the engineer and science data. Here we describe the CARMENES data flow from the different subsystems, through the instrument control system and pipeline, to the virtual-observatory data server and astronomers

Consideraciones para una óptima salud en el puesto de trabajo

La ergonomía desempeña un papel creciente en la solución del problema de rehabilitación de personas que en una u otra medida han perdido la capacidad de trabajo; también se estudian las aptitudes y peculiaridades psíquicas y físicas de las personas de edad avanzada y de aquellos individuos considerados como trabajadores especialmente sensibles. Por ello los principios ergonómicos se aplican para optimizar las condiciones de trabajo en relación al bienestar de la persona, su salud y su seguridad, sin olvidar la eficiencia tecnológica y económica. El abordaje de los factores de riesgo que intervienen en la producción de problemas de espalda en los profesionales, incluye al ser humano en sentido integral, desde el punto de vista físico, psicológico y social. En nuestro trabajo nos vamos a centrar en los factores físicos principalmente, destacaremos la adopción de posturas forzadas, movimientos bruscos, así como la inadecuada preparación física y el sedentarismo en una profesión sanitaria, la del técnico en transporte sanitario. Pero no debemos dejar de hacer mención de los otros puntos de vista: el estrés laboral, el apremio de tiempo, que da lugar a que se trabaje con mayor ritmo y no precisamente adoptando posiciones correctas. Aspectos relacionados con la satisfacción laboral también acentúan el estrés y la tensión muscular. La ausencia de una formación preventiva adecuada respecto a técnicas de movilización de enfermos. La falta de personal en los centros de trabajo, que implican una sobrecarga; el deficiente o nulo uso de medios mecánicos adecuadamente diseñados desde el punto de vista ergonómico.Ergonomics plays an increasing role in solving the problem of rehabilitation of people have lost the ability to work, it also examines the skills and mental and physical peculiarities of the elderly and those individuals considered workers are particularly sensitive. Therefore apply ergonomic principles to optimize the conditions of work for the welfare of the person, their health and safety, not forgetting the technological and economic efficiency. The approach of the risk factors involved in the production of back problems in the professionals, including the human being in integral sense from the standpoint of physical, psychological and social. In our work we focus mainly on physical factors, we will highlight the adoption of awkward postures, sudden movements, as well as inadequate physical fitness and physical inactivity in a health profession, the technician in health transport. But we must not fail to mention the other points of view: work stress, time pressure, which leads you to work with greater pace and not just taking proper positions. Aspects related to job satisfaction also accentuate stress and muscle tension. The absence of adequate preventive training on techniques of mobilization of patients. The lack of staff in the workplace, resulting in an overload, the poor or no use of properly designed mechanical means from the ergonomic standpoint.peerReviewe

Ampicillin Plus Ceftriaxone Combined Therapy for Enterococcus faecalis Infective Endocarditis in OPAT

Cardiovascular Infectious Study Group of the Andalusian Society of Infectious Diseases.Ampicillin plus ceftriaxone (AC) is a well-recognized inpatient regimen for Enterococcus faecalis infective endocarditis (IE). In this regimen, ceftriaxone is usually administered 2 g every 2 h (AC12). The administration of AC in outpatient parenteral antibiotic treatment (OPAT) programs is challenging because multiple daily doses are required. AC regimens useful for OPAT programs include once-daily high-dose administration of ceftriaxone (AC24) or AC co-diluted and jointly administered in bolus every 4 h (ACjoined). In this retrospective analysis of prospectively collected cases, we aimed to assess the clinical effectivity and safety of three AC regimens for the treatment of E. faecalis IE. Fifty-nine patients were treated with AC combinations (AC12 n = 32, AC24 n = 17, and ACjoined n = 10). Six relapses occurred in the whole cohort: five (29.4%) treated with AC24 regimen and one (10.0%) with ACjoined. Patients were cured in 30 (93.3%), 16 (94.1%), and eight (80.0%) cases in the AC12, AC24 and ACjoined groups, respectively. Unplanned readmission occurred in eight (25.0%), six (35.3%), and two (20.0%) patients in the AC12, AC24 and ACjoined groups, respectively. The outcome of patients with E. faecalis IE treated with AC in OPAT programs relies on an optimization of the delivery of the combination. AC24 exhibit an unexpected rate of failures, however, ACjoined might be an effective alternative which clinical results should corroborate in further studies.The authors received no financial support for the research, authorship, and/or publication of this article. GVA was supported by the Instituto de Salud Carlos III, cofinanced by the European Development Regional Fund (“A way to achieve Europe”), Subprograma Miguel Servet (grant CP19/00159). HHL was supported by the Instituto de Salud Carlos III, Subprograma Rio Hortega (grant CM19/00152)

Inclusion of non-inferiority analysis in superiority-based clinical trials with single-arm, two-stage Simon's design

Non-inferiority (NI) analysis is not usually considered in the early phases of clinical development. In some negative phase II trials, a post-hoc NI analysis justified additional phase III trials that were successful. However, the risk of false positive achievements was not controlled in these early phase analyses. We propose to preplan NI analyses in superiority-based Simon's two-stage designs to control type I and II error rates. Simulations have been proposed to assess the control of type I and II errors rates with this method. A total of 12,768 two-stage Simon's design trials were constructed based on different assumptions of rejection response probability, desired response probability, type I and II errors, and NI margins. P-value and type II error were calculated with stochastic ordering using Uniformly Minimum Variance Unbiased Estimator. Type I and II errors were simulated using the Monte Carlo method. The agreement between calculated and simulated values was analyzed with Bland-Altman plots. We observed the same level of agreement between calculated and simulated type I and II errors from both two-stage Simon's superiority designs and designs in which NI analysis was allowed. Different examples has been proposed to explain the utility of this method. Inclusion of NI analysis in superiority-based single-arm clinical trials may be useful for weighing additional factors such as safety, pharmacokinetics, pharmacodynamic, and biomarker data while assessing early efficacy. Implementation of this strategy can be achieved through simple adaptations to existing designs for one-arm phase II clinical trials

Co-ocurrencia de Chattonella marina y Gymnodinium catenatum en laBahía de LaPaz, Golfo de California (primavera2009)

During the period of 24 March to 14 May 2009, water and net samples were obtained for phytoplankton analyses; one aliquot was fixed in Lugol´s solution for species quantification and identification. Net samples were used for the identification of live phytoplankton species. Additionally, temperature in situ, chlorophyll a and inorganic nutrients were measured weekly in three stations. Two species were identified: Chattonella marina (Subrahmanyan) Y. Hara et Chihara and Gymnodinium catenatum Graham. Chattonella marina was the most abundant species with a density at subsurface level of 14 × 103 to 36 × 103 cell L-1 . Gymnodinium catenatum had densities were of 1 × 103 to 19 × 103 cell L-1 . Water column temperature was quasi homogeneous from surface to 20 m in depth, with an interval of 19.5 to 22.0 °C and 20.0 to 21.5 °C from March to April respectively. In the middle of May stratification of the water column initiated with a slight temperature difference of 5.0 °C recorded from surface to 20 m in depth. Nitrates varied from 0.5 to 11.0 µM and orthophosphates from 0.4 to 2.6 µM. Chlorophyll a showed a value at surface level of 7.5 mg m-3 and 3.5 mg m-3 at 20 m in March; in May chlorophyll a values ranged between 2.0 to 7.0 mg m-3 . We conclude that the presence of these two species during this study period was associated to the relaxation of the mixing processes in the zoneDurante el período del 24 de marzo al 14 de mayo de 2009 en la Bahía de La Paz, se obtuvieron muestras de agua y de red para análisis de fitoplancton. Una alícuota se fijó con una solución de Lugol para la identificación y cuantificación, la de red se utilizó para la identificación in vivo. Semanalmente se midió la temperatura in situ, se determinaron nutrientes inorgánicos y clorofila a en tres estaciones. Se identificaron dos especies: Chattonella marina (Subrahmanyan) Y. Hara et Chihara y Gymnodinium catenatum Graham. Chattonella marina fue la especie más abundante con densidades de 14 × 103 a 36 × 103 cél. L-1 a nivel sub-superficial. Gymnodinium catenatum se registró con densidades de 1 × 103 a 19 × 103 cél. L-1 . La temperatura del agua fue homogénea desde la superficie hasta los 20 m de profundidad, con un intervalo de 19.5 a 22.0 °C y de 20.0 a 21.5 °C a finales de marzo y abril respectivamente. En la primera mitad de mayo se inició la estratificación, con una diferencia térmica de 5.0 °C entre la superficie y los 20 m. Los nitratos variaron de 0.5 a 11.0 µM y los ortofosfatos de 0.4 a 2.6 µM. La clorofila a en marzo presentó un valor en superficie de 7.5 mg m-3 y a 20 m de 3.5 mg m-3 , en mayo varió de 2.0 a 7.0 mg m-3 . Se concluye que la aparición de las dos especies observadas en este estudio se asocia a la disminución de los procesos de mezcla en esta bahía

Mass fish die-off during a diatom bloom in the Bahía de La Paz, Gulf of California

An unusual fish die-off occurred during a bloom of diatoms from June 10th July 3rd 2006 in Bahía de La Paz in the Gulf of California. The prevalent organisms were Pseudo-nitzschia spp. (2.4 × 106 cells L1), Thalassiosira eccentrica (2.3 × 106 cells L1) and Chaetoceros spp. (9.65 x 105 cells L1). Three toxic species were identified: P. pseudodelicatissima-complex, P. fraudulenta, and P. pungens. Fucoxanthin was the dominant pigment during the bloom, peaking at 9.3 ?g L1. Sea surface temperature dramatically increased from 19.0 °C to 27.0 °C during the bloom, with inorganic nitrogen (1.0 ± 0.6 ?M) and Si(OH)4 (15.5 ± 8.0 ?M). Low content of domoic acid measured by HPLC-UV from net samples ranged from 24.0 to 52.0 ng per filter and tissue of the chocolate clam Megapitaria squalida (0.55 ?g g1) and the white clam Dosinia ponderosa (0.06 ?g g1). Domoic acid analysis of dead fish tissues was negative. Fish necropsy indicated that death by asphyxia was probably caused by Thalassiosira eccentrica and Chaetoceros spp. Alternate mixing processes and instability of the water column, as well as sudden changes of both temperature and nutrients created conditions for proliferation of the diatoms

Blood culture-negative infective endocarditis: a worse outcome? Results from a large multicentre retrospective Spanish cohort study

[Background] To assess the impact of blood cultures negative infective endocarditis (BCNIE) on in-hospital mortality.[Methods] Prospective multicentre study with retrospective analysis of a Spanish cohort including adult patients with definite IE. Cardiac implantable devices infection were excluded. Comparisons between blood cultures positive and BCNIE groups were performed to analyse in-hospital mortality.[Results] 1001 cases were included of which 83 (8.3%) had BCNIE. Alternative microbiological diagnosis was achieved for 39 (47%) out 83 cases. The most frequent identifications were: Coxiella burnetii (11; 28.2%), Tropheryma whipplei (4; 10.3%), Streptococcus gallolyticus (4;10.3%) and Staphylococcus epidermidis (3; 7.7%). Surgery was performed more frequently in BCNIE group (57.8 vs. 36.9%, p < .001). All-cause in-hospital mortality rate was 26.7% without statistical difference between compared groups. BCNIE was not associated to worse mortality rate in Cox regression model (aHR = 1.37, 95% CI 0.90–2.07, p = .14). Absence of microbiological diagnosis was also not associated to worse in-hospital prognosis (aHR = 1.62, 95% CI 0.99–2.64, p = .06).[Conclusions] In our cohort, BCNIE was not associated to greater in-hospital mortality based in multivariate Cox regression models. The variables most frequently associated with mortality were indicated but not performed surgery (aHR = 2.48, 95% CI 1.73–3.56, p < .001), septic shock (aHR = 2.24, 95% CI 1.68–2.99, p < .001), age over 65 years (aHR = 1.88, 95% CI 1.40-2.52, p < .001) and complicated endocarditis (aHR = 1.79, 95% CI 1.36–2.37, p < .001).Peer reviewe

Informe de investigación COVID19: Voces de docentes y familias

Proyecto Atlántid

Mortality and other adverse outcomes in patients with type 2 diabetes mellitus admitted for COVID-19 in association with glucose-lowering drugs: a nationwide cohort study

Background: Limited evidence exists on the role of glucose-lowering drugs in patients with COVID-19. Our main objective was to examine the association between in-hospital death and each routine at-home glucose-lowering drug both individually and in combination with metformin in patients with type 2 diabetes mellitus admitted for COVID-19. We also evaluated their association with the composite outcome of the need for ICU admission, invasive and non-invasive mechanical ventilation, or in-hospital death as well as on the development of in-hospital complications and a long-time hospital stay. Methods: We selected all patients with type 2 diabetes mellitus in the Spanish Society of Internal Medicine's registry of COVID-19 patients (SEMI-COVID-19 Registry). It is an ongoing, observational, multicenter, nationwide cohort of patients admitted for COVID-19 in Spain from March 1, 2020. Each glucose-lowering drug user was matched with a user of other glucose-lowering drugs in a 1:1 manner by propensity scores. In order to assess the adequacy of propensity score matching, we used the standardized mean difference found in patient characteristics after matching. There was considered to be a significant imbalance in the group if a standardized mean difference > 10% was found. To evaluate the association between treatment and study outcomes, both conditional logit and mixed effect logistic regressions were used when the sample size was ≥ 100. Results: A total of 2666 patients were found in the SEMI-COVID-19 Registry, 1297 on glucose-lowering drugs in monotherapy and 465 in combination with metformin. After propensity matching, 249 patients on metformin, 105 on dipeptidyl peptidase-4 inhibitors, 129 on insulin, 127 on metformin/dipeptidyl peptidase-4 inhibitors, 34 on metformin/sodium-glucose cotransporter 2 inhibitor, and 67 on metformin/insulin were selected. No at-home glucose-lowering drugs showed a significant association with in-hospital death; the composite outcome of the need of intensive care unit admission, mechanical ventilation, or in-hospital death; in-hospital complications; or long-time hospital stays. Conclusions: In patients with type 2 diabetes mellitus admitted for COVID-19, at-home glucose-lowering drugs showed no significant association with mortality and adverse outcomes. Given the close relationship between diabetes and COVID-19 and the limited evidence on the role of glucose-lowering drugs, prospective studies are needed

Mortality and other adverse outcomes in patients with type 2 diabetes mellitus admitted for COVID-19 in association with glucose-lowering drugs: a nationwide cohort study

Background: Limited evidence exists on the role of glucose-lowering drugs in patients with COVID-19. Our main objective was to examine the association between in-hospital death and each routine at-home glucose-lowering drug both individually and in combination with metformin in patients with type 2 diabetes mellitus admitted for COVID-19. We also evaluated their association with the composite outcome of the need for ICU admission, invasive and non-invasive mechanical ventilation, or in-hospital death as well as on the development of in-hospital complications and a long-time hospital stay. Methods: We selected all patients with type 2 diabetes mellitus in the Spanish Society of Internal Medicine’s registry of COVID-19 patients (SEMI-COVID-19 Registry). It is an ongoing, observational, multicenter, nationwide cohort of patients admitted for COVID-19 in Spain from March 1, 2020. Each glucose-lowering drug user was matched with a user of other glucose-lowering drugs in a 1:1 manner by propensity scores. In order to assess the adequacy of propensity score matching, we used the standardized mean difference found in patient characteristics after matching. There was considered to be a significant imbalance in the group if a standardized mean difference > 10% was found. To evaluate the association between treatment and study outcomes, both conditional logit and mixed effect logistic regressions were used when the sample size was ≥ 100. Results: A total of 2666 patients were found in the SEMI-COVID-19 Registry, 1297 on glucose-lowering drugs in monotherapy and 465 in combination with metformin. After propensity matching, 249 patients on metformin, 105 on dipeptidyl peptidase-4 inhibitors, 129 on insulin, 127 on metformin/dipeptidyl peptidase-4 inhibitors, 34 on metformin/sodium-glucose cotransporter 2 inhibitor, and 67 on metformin/insulin were selected. No at-home glucose-lowering drugs showed a significant association with in-hospital death; the composite outcome of the need of intensive care unit admission, mechanical ventilation, or in-hospital death; in-hospital complications; or long-time hospital stays. Conclusions: In patients with type 2 diabetes mellitus admitted for COVID-19, at-home glucose-lowering drugs showed no significant association with mortality and adverse outcomes. Given the close relationship between diabetes and COVID-19 and the limited evidence on the role of glucose-lowering drugs, prospective studies are needed