Nonuniversality of front fluctuations for compact colonies of nonmotile bacteria

The front of a compact bacterial colony growing on a Petri dish is a paradigmatic instance of non-equilibrium fluctuations in the celebrated Eden, or Kardar-Parisi-Zhang (KPZ), universality class. While in many experiments the scaling exponents crucially differ from the expected KPZ values, the source of this disagreement has remained poorly understood. We have performed growth experiments with B. subtilis 168 and E. coli ATCC 25922 under conditions leading to compact colonies in the classically alleged Eden regime, where individual motility is suppressed. Non-KPZ scaling is indeed observed for all accessible times, KPZ asymptotics being ruled out for our experiments due to the monotonic increase of front branching with time. Simulations of an effective model suggest the occurrence of transient nonuniversal scaling due to diffusive morphological instabilities, agreeing with expectations from detailed models of the relevant biological reaction-diffusion processes.This work has been supported by Ministerio de Economía y Competitividad, Agencia Estatal de Investigación, and Fondo Europeo de Desarrollo Regional (Spain and European Union) through Grants No. FIS2015- 66020-C2-1-P, FIS2015-69167-C2-1-P, FIS2015-73337-JIN, and BIO2016-79618-R, and by Comunidad Autónoma de Madrid (Spain) Grant No. NANOAVANSENS S2013/MIT302

Certainty of the Global Burden of Disease 2019 Modelled Prevalence Estimates for Musculoskeletal Conditions: A Meta-Epidemiological Study

Objectives: To describe and assess the risk of bias of the primary input studies that underpinned the Global Burden of Disease Study (GBD) 2019 modelled prevalence estimates of low back pain (LBP), neck pain (NP), and knee osteoarthritis (OA), from Australia, Brazil, Canada, Spain, and Switzerland. To evaluate the certainty of the GBD modelled prevalence evidence.Methods: Primary studies were identified using the GBD Data Input Sources Tool and their risk of bias was assessed using a validated tool. We rated the certainty of modelled prevalence estimates based on the GRADE Guidelines 30―the GRADE approach for modelled evidence.Results: Seventy-two primary studies (LBP: 67, NP: 2, knee OA: 3) underpinned the GBD estimates. Most studies had limited representativeness of their study populations, used suboptimal case definitions and applied assessment instruments with unknown psychometric properties. The certainty of modelled prevalence estimates was low, mainly due to risk of bias and indirectness.Conclusion: Beyond the risk of bias of primary input studies for LBP, NP, and knee OA in GBD 2019, the certainty of country-specific modelled prevalence estimates still have room for improvement

Prevalencia de la vía aérea difícil, en paciente con sobrepeso en cirugía general en el Hospital Escuela Antonio Lenin Fonseca, agosto–enero del año 2022

El objetivo de esta investigación fue comprobar la prevalencia de la vía aérea difícil en pacientes con sobre peso en pacientes sometidos a cirugía general en el Hospital Escuela Antonio Lenin Fonseca en periodo de agosto – enero del año 2022.Se realizó un estudio de tipo descriptivo cuantitativo en los pacientes con sobre peso, La muestra estuvo constituida por 60 pacientes en total, 4 pacientes son vía área difícil y 56 pacientes no presentaron vía aérea difícil. Teniendo en cuenta la edad de la población que predomino entre 22 a 73 años, con un peso de 52 a 100 kilogramos y un índice de masa corporal de 25 a 29.9 sobre peso y de 30 a 34.9 obesidad grado I.Se evaluaron todos los predictores de vía aérea difícil como: Circunferencia de cuello, Mallampati, Distancia Tiromentoniana, Distancia Esternomentoniana, Distancia Interincisivos, Cormack y Lehane, Test de la Mordida y Perfil Facial. Estas valoraciones se realizaron en la visita preanestesica prequirurgica, siendo el único que no se realizó en la valoración preanestesica Cormack y Lehane este se realizó dentro de quirófano para visualizar el grado de dificultad de vía aérea difícil.En nuestro estudio de prevalencia de vía aérea difícil, en pacientes con sobre peso sometidos a cirugía general, 4 paciente presentaron vía aérea difícil tanto en obesidad grado I y sobre peso, sin embargo 56 pacientes no presentaron vía aérea difíci

Prevalencia vía aérea difícil, paciente con sobrepeso en cirugía general, Hospital Escuela Antonio Lenin Fonseca, agosto–enero del año 2022

En el campo de la Anestesiología es prioritaria la seguridad del paciente, para minimizar en lo posible los riesgos y anticiparse a los problemas que pudieran surgir. El manejo de la vía aérea es uno de los pilares fundamentales en Anestesiología también en medicina de urgencia y cuidados críticos. El manejo de la vía aérea es la “A” del “ABC “en los protocolos de Reanimación y Trauma. Como objetivo principal fue comprobar la prevalencia de la vía aérea difícil en pacientes con sobre peso en pacientes sometidos a cirugía general en el Hospital Escuela Antonio Lenin Fonseca en periodo de agosto –enero del año 2022. Se realizó un estudio de tipo descriptivo cuantitativo, el estudio se realizó en el Hospital Escuela Antonio Lenin Fonseca con una muestra de 60 pacientes, de los cuales 4 pacientes presentaron vía aérea difícil y 56 pacientes no presentaron vía aérea difícil, 1 pacientes con sobre peso 2 pacientes con obesidad grado II, y un paciente con grado II. Todos los pacientes con vía aérea difícil encontrados tenían sobre peso u obesidad I, En Mallampati mayor predominio clase II, En el cormack y lehane predomino el grado I y grado II, El peso máximo fue de 100 kilogramos, una media de 83 y un mínimo de 5

Nonuniversality of front fluctuations for compact colonies of nonmotile bacteria

The front of a compact bacterial colony growing on a Petri dish is a paradigmatic instance of non-equilibrium f luctuations in the celebrated Eden, or Kardar-Parisi-Zhang (KPZ), universality class. While in many experiments the scaling exponents crucially differ from the expected KPZ values, the source of this disagreement has remained poorly understood. We have performed growth experiments with B. subtilis 168 and E. coli ATCC 25922 under conditions leading to compact colonies in the classically alleged Eden regime, where individual motility is suppressed. Non-KPZ scaling is indeed observed for all accessible times, KPZ asymptotics being ruled out for our experiments due to the monotonic increase of front branching with time. Simulations of an effective model suggest the occurrence of transient nonuniversal scaling due to diffusive morphological instabilities, agreeing with expectations from detailed models of the relevant biological reaction-diffusion processe

Effectiveness of an intervention for improving drug prescription in primary care patients with multimorbidity and polypharmacy:Study protocol of a cluster randomized clinical trial (Multi-PAP project)

This study was funded by the Fondo de Investigaciones Sanitarias ISCIII (Grant Numbers PI15/00276, PI15/00572, PI15/00996), REDISSEC (Project Numbers RD12/0001/0012, RD16/0001/0005), and the European Regional Development Fund ("A way to build Europe").Background: Multimorbidity is associated with negative effects both on people's health and on healthcare systems. A key problem linked to multimorbidity is polypharmacy, which in turn is associated with increased risk of partly preventable adverse effects, including mortality. The Ariadne principles describe a model of care based on a thorough assessment of diseases, treatments (and potential interactions), clinical status, context and preferences of patients with multimorbidity, with the aim of prioritizing and sharing realistic treatment goals that guide an individualized management. The aim of this study is to evaluate the effectiveness of a complex intervention that implements the Ariadne principles in a population of young-old patients with multimorbidity and polypharmacy. The intervention seeks to improve the appropriateness of prescribing in primary care (PC), as measured by the medication appropriateness index (MAI) score at 6 and 12months, as compared with usual care. Methods/Design: Design:pragmatic cluster randomized clinical trial. Unit of randomization: family physician (FP). Unit of analysis: patient. Scope: PC health centres in three autonomous communities: Aragon, Madrid, and Andalusia (Spain). Population: patients aged 65-74years with multimorbidity (≥3 chronic diseases) and polypharmacy (≥5 drugs prescribed in ≥3months). Sample size: n=400 (200 per study arm). Intervention: complex intervention based on the implementation of the Ariadne principles with two components: (1) FP training and (2) FP-patient interview. Outcomes: MAI score, health services use, quality of life (Euroqol 5D-5L), pharmacotherapy and adherence to treatment (Morisky-Green, Haynes-Sackett), and clinical and socio-demographic variables. Statistical analysis: primary outcome is the difference in MAI score between T0 and T1 and corresponding 95% confidence interval. Adjustment for confounding factors will be performed by multilevel analysis. All analyses will be carried out in accordance with the intention-to-treat principle. Discussion: It is essential to provide evidence concerning interventions on PC patients with polypharmacy and multimorbidity, conducted in the context of routine clinical practice, and involving young-old patients with significant potential for preventing negative health outcomes. Trial registration: Clinicaltrials.gov, NCT02866799Publisher PDFPeer reviewe

a review of methodological design choices

Publisher Copyright: © 2023 Cambridge University Press. All rights reserved.This systematic literature review aimed to provide an overview of the characteristics and methods used in studies applying the Disability-Adjusted Life Years (DALY) concept for infectious diseases within European Union (EU)/European Economic Area (EEA)/European Free Trade Association (EFTA) countries and the United Kingdom. Electronic databases and grey literature were searched for articles reporting the assessment of DALY and its components. We considered studies in which researchers performed DALY calculations using primary epidemiological data input sources. We screened 3,053 studies of which 2,948 were excluded and 105 studies met our inclusion criteria. Of these studies, 22 were multi-country and 83 were single-country studies, of which 46 were from the Netherlands. Food- and water-borne diseases were the most frequently studied infectious diseases. Between 2015 and 2022, the number of burden of infectious disease studies was 1.6 times higher compared to that published between 2000 and 2014. Almost all studies (97%) estimated DALYs based on the incidence- and pathogen-based approach and without social weighting functions; however, there was less methodological consensus with regards to the disability weights and life tables that were applied. The number of burden of infectious disease studies undertaken across Europe has increased over time. Development and use of guidelines will promote performing burden of infectious disease studies and facilitate comparability of the results.publishersversionepub_ahead_of_prin

Burden of disease attributable to risk factors in European countries: a scoping literature review

Objectives: Within the framework of the burden of disease (BoD) approach, disease, and injury burden estimates attributable to risk factors are a useful guide for policy formulation and priority setting in disease prevention. Considering the important differences in methods, and their impact on burden estimates, we conducted a scoping literature review to: (1) map the BoD assessments including risk factors performed across Europe, and (2) identify the methodological choices in comparative risk assessment (CRA) and risk assessment methods. Methods: We searched multiple literature databases, including grey literature websites, and targeted public health agencies' websites. Results: A total of 113 studies were included in the synthesis and further divided into independent BoD assessments (54 studies) and studies linked to the Global Burden of Disease (59 papers). Our results showed that the methods used to perform CRA varied substantially across independent European BoD studies. While there were some methodological choices that were more common than others, we did not observe patterns in terms of country, year, or risk factor. Each methodological choice can affect the comparability of estimates between and within countries and/or risk factors since they might significantly influence the quantification of the attributable burden. From our analysis, we observed that the use of CRA was less common for some types of risk factors and outcomes. These included environmental and occupational risk factors, which are more likely to use bottom-up approaches for health outcomes where disease envelopes may not be available. Conclusions: Our review also highlighted misreporting, the lack of uncertainty analysis, and the under-investigation of causal relationships in BoD studies. Development and use of guidelines for performing and reporting BoD studies will help understand differences, and avoid misinterpretations thus improving comparability among estimates.info:eu-repo/semantics/publishedVersio