Metabolic control in a nationally representative diabetic elderly sample in Costa Rica: patients at community health centers vs. patients at other health care settings

<p>Abstract</p> <p>Background</p> <p>Costa Rica, like other developing countries, is experiencing an increasing burden of chronic conditions such as diabetes mellitus (DM), especially among its elderly population. This article has two goals: (1) to assess the level of metabolic control among the diabetic population age ≥ 60 years old in Costa Rica, and (2) to test whether diabetic elderly patients of community health centers differ from patients in other health care settings in terms of the level of metabolic control.</p> <p>Methods</p> <p>Data come from the project CRELES, a nationally representative study of people aged 60 and over in Costa Rica. This article analyzes a subsample of 542 participants in CRELES with self-reported diagnosis of diabetes mellitus. Odds ratios of poor levels of metabolic control at different health care settings are computed using logistic regressions.</p> <p>Results</p> <p>Lack of metabolic control among elderly diabetic population in Costa Rica is described as follows: 37% have glycated hemoglobin ≥ 7%; 78% have systolic blood pressure ≥ 130 mmHg; 66% have diastolic blood pressure ≥ 80 mmHg; 48% have triglycerides ≥ 150 mg/dl; 78% have LDL ≥ 100 mg/dl; 70% have HDL ≤ 40 mg/dl. Elevated levels of triglycerides and LDL were higher in patients of community health centers than in patients of other clinical settings. There were no statistical differences in the other metabolic control indicators across health care settings.</p> <p>Conclusion</p> <p>Levels of metabolic control among elderly population with DM in Costa Rica are not that different from those observed in industrialized countries. Elevated levels of triglycerides and LDL at community health centers may indicate problems of dyslipidemia treatment among diabetic patients; these problems are not observed in other health care settings. The Costa Rican health care system should address this problem, given that community health centers constitute a means of democratizing access to primary health care to underserved and poor areas.</p

Genetic diversity analysis of common beans based on molecular markers

A core collection of the common bean (Phaseolus vulgaris L.), representing genetic diversity in the entire Mexican holding, is kept at the INIFAP (Instituto Nacional de Investigaciones Forestales, Agricolas y Pecuarias, Mexico) Germplasm Bank. After evaluation, the genetic structure of this collection (200 accessions) was compared with that of landraces from the states of Oaxaca, Chiapas and Veracruz (10 genotypes from each), as well as a further 10 cultivars, by means of four amplified fragment length polymorphisms (AFLP) +3/+3 primer combinations and seven simple sequence repeats (SSR) loci, in order to define genetic diversity, variability and mutual relationships. Data underwent cluster (UPGMA) and molecular variance (AMOVA) analyses. AFLP analysis produced 530 bands (88.5% polymorphic) while SSR primers amplified 174 alleles, all polymorphic (8.2 alleles per locus). AFLP indicated that the highest genetic diversity was to be found in ten commercial-seed classes from two major groups of accessions from Central Mexico and Chiapas, which seems to be an important center of diversity in the south. A third group included genotypes from Nueva Granada, Mesoamerica, Jalisco and Durango races. Here, SSR analysis indicated a reduced number of shared haplotypes among accessions, whereas the highest genetic components of AMOVA variation were found within accessions. Genetic diversity observed in the common-bean core collection represents an important sample of the total Phaseolus genetic variability at the main Germplasm Bank of INIFAP. Molecular marker strategies could contribute to a better understanding of the genetic structure of the core collection as well as to its improvement and validation

VLA cm-wave survey of young stellar objects in the Oph A cluster: constraining extreme UV- and X-ray-driven disk photo-evaporation -- A pathfinder for Square Kilometre Array studies

Observations of young stellar objects (YSOs) in centimeter bands can probe the continuum emission from growing dust grains, ionized winds, and magnetospheric activity that are intimately connected to the evolution of protoplanetary disks and the formation of planets. We carried out sensitive continuum observations toward the Ophiuchus A star-forming region, using the Karl G. Jansky Very Large Array (VLA) at 10 GHz over a field-of-view of 6′ and with a spatial resolution of θmaj ×θmin ~ 0.′′4 × 0.′′2. We achieved a 5 μJy beam−1 rms noise level at the center of our mosaic field of view. Among the 18 sources we detected, 16 were YSOs (three Class 0, five Class I, six Class II, and two Class III) and two were extragalactic candidates. We find that thermal dust emission generally contributed less than 30% of the emission at 10 GHz. The radio emission is dominated by other types of emission, such as gyro-synchrotron radiation from active magnetospheres, free–free emission from thermal jets, free–free emission from the outflowing photoevaporated disk material, and synchrotron emission from accelerated cosmic-rays in jet or protostellar surface shocks. These different types of emission could not be clearly disentangled. Our non-detections for Class II/III disks suggest that extreme UV-driven photoevaporation is insufficient to explain disk dispersal, assuming that the contribution of UV photoevaporating stellar winds to radio flux does not evolve over time. The sensitivity of our data cannot exclude photoevaporation due to the role of X-ray photons as an efficient mechanism for disk dispersal. Deeper surveys using the Square Kilometre Array (SKA) will have the capacity to provide significant constraints to disk photoevaporation.ERC STFC Horizon 202

DETORQUEO, QUIRKY, and ZERZAUST Represent Novel Components Involved in Organ Development Mediated by the Receptor-Like Kinase STRUBBELIG in Arabidopsis thaliana

Intercellular signaling plays an important role in controlling cellular behavior in apical meristems and developing organs in plants. One prominent example in Arabidopsis is the regulation of floral organ shape, ovule integument morphogenesis, the cell division plane, and root hair patterning by the leucine-rich repeat receptor-like kinase STRUBBELIG (SUB). Interestingly, kinase activity of SUB is not essential for its in vivo function, indicating that SUB may be an atypical or inactive receptor-like kinase. Since little is known about signaling by atypical receptor-like kinases, we used forward genetics to identify genes that potentially function in SUB-dependent processes and found recessive mutations in three genes that result in a sub-like phenotype. Plants with a defect in DETORQEO (DOQ), QUIRKY (QKY), and ZERZAUST (ZET) show corresponding defects in outer integument development, floral organ shape, and stem twisting. The mutants also show sub-like cellular defects in the floral meristem and in root hair patterning. Thus, SUB, DOQ, QKY, and ZET define the STRUBBELIG-LIKE MUTANT (SLM) class of genes. Molecular cloning of QKY identified a putative transmembrane protein carrying four C2 domains, suggesting that QKY may function in membrane trafficking in a Ca2+-dependent fashion. Morphological analysis of single and all pair-wise double-mutant combinations indicated that SLM genes have overlapping, but also distinct, functions in plant organogenesis. This notion was supported by a systematic comparison of whole-genome transcript profiles during floral development, which molecularly defined common and distinct sets of affected processes in slm mutants. Further analysis indicated that many SLM-responsive genes have functions in cell wall biology, hormone signaling, and various stress responses. Taken together, our data suggest that DOQ, QKY, and ZET contribute to SUB-dependent organogenesis and shed light on the mechanisms, which are dependent on signaling through the atypical receptor-like kinase SUB

Evaluation of appendicitis risk prediction models in adults with suspected appendicitis

Background Appendicitis is the most common general surgical emergency worldwide, but its diagnosis remains challenging. The aim of this study was to determine whether existing risk prediction models can reliably identify patients presenting to hospital in the UK with acute right iliac fossa (RIF) pain who are at low risk of appendicitis. Methods A systematic search was completed to identify all existing appendicitis risk prediction models. Models were validated using UK data from an international prospective cohort study that captured consecutive patients aged 16–45 years presenting to hospital with acute RIF in March to June 2017. The main outcome was best achievable model specificity (proportion of patients who did not have appendicitis correctly classified as low risk) whilst maintaining a failure rate below 5 per cent (proportion of patients identified as low risk who actually had appendicitis). Results Some 5345 patients across 154 UK hospitals were identified, of which two‐thirds (3613 of 5345, 67·6 per cent) were women. Women were more than twice as likely to undergo surgery with removal of a histologically normal appendix (272 of 964, 28·2 per cent) than men (120 of 993, 12·1 per cent) (relative risk 2·33, 95 per cent c.i. 1·92 to 2·84; P < 0·001). Of 15 validated risk prediction models, the Adult Appendicitis Score performed best (cut‐off score 8 or less, specificity 63·1 per cent, failure rate 3·7 per cent). The Appendicitis Inflammatory Response Score performed best for men (cut‐off score 2 or less, specificity 24·7 per cent, failure rate 2·4 per cent). Conclusion Women in the UK had a disproportionate risk of admission without surgical intervention and had high rates of normal appendicectomy. Risk prediction models to support shared decision‐making by identifying adults in the UK at low risk of appendicitis were identified

Recording EEG In Young Children Without Sedation

Background Although it has been considered that sedation in children undergoing EEG tests is effective and safe and complications are infrequent, occasionally adverse sedation-related events are presented. Objective The aim of this work was to determine if it is possible to carry out EEG in children up to 4 years old without sedation and analyze the factors that could influence upon the possibility of performing EEG, in vigil or with sedation. Methods: In the period between November 2001 to November 2004, 489 patients up to 4 years old were studied in order to analyze how several parameters (sex, age, and diagnosis) could influence upon conditions of performing electroencephalogram (with or without sedation). Patients were assembled into several groups : sex, age (I: 0 - 12 months; II: 13 - 24 months; III: 25 - 36 months; and IV: 37 - 48 months), and diagnostic. The affections were : epilepsy, hyperkinesia, cerebral palsy, spasticity, sobbing spasm, encephalopathy, and psychomotor retardation. Results 281 electroencephalographic studies were carried out in vigil and this value represented 57,5% of the total electroencephalograms performed. During the performance of the study the children\'s behavior was independent of sex and initial diagnostic, but it was influenced by age. The higher number (104) of studied carried out in vigil was performed in children from 37 to 48 months, which represented 70,8 % of cases. The lowest percentage was obtained in children with psychomotor retardation Conclusions In most cases, it is possible to carry out electroencephalograms on children without using sedative drugs. To perform this study in vigil is advantageous because the recording of electroencephalographic signs in abnormal conditions of brain functioning and the appearance of contamination in the recording due to sedative drugs, which could confuse the diagnosis are avoidedIntroduction Bien que considéré comme inoffensive, la pratique de l\'EEG sous sédation chez l\'enfant n\'est pas à l\'abri de complications. Objectif Le but de l\'étude est déterminer s\'il était possible de pratiquer l\'EEG chez l\'enfant âgé 4 ans ou moins, sans sédation. Méthodes Entre novembre 2001 et novembre 2004, 489 patients âges de 4 ans ou moins ont été regroupés selon l\'âge (groupe I: 0 - 12 mois ; groupe II : 13 - 24 mois ; groupe III : 25 - 36 mois; et groupe IV: 37 - 48 mois), le sexe, le diagnostic (épilepsie, hyperkinésie, paralysie cérébrale, spasticité, spasme en flexion, encéphalopathie, et retard psychomoteur au cours de la pratique de l\'EEG, avec et sans sédation. Résultats 281 EEG (57,5%) ont été réalisés chez des enfants en état de vigilance normale. Le comportement des enfants étaient indépendents du sexe et du diagnostic mais essentiellement influencé par l\'âge. Les EEG ont pu être réalisés principalement chez les enfants (104) entre 37 et 48 mois (70,8 %). Le pourcentage le plus bas a été observé chez les enfants atteints d\'un retard psychomoteur. Conclusion Il est possible de réaliser des EEG chez l\'enfant sans sédation. De plus, une vigilance normale permet d\'étudier l\'activité électrique du cerveau sans artéfacts liés aux médicaments utilisés. Keywords: Electroencéphalogramme, Enfants, Sédation, Technique, Electroencephalogram, children, sedation, TechnicAfrican Journal of Neurological Sciences Vol. 24 (1) 2005: pp. 55-6