Absolute dimensions of the low-mass eclipsing binary system NSVS 10653195

Low-mass stars in eclipsing binary systems show radii larger and effective temperatures lower than theoretical stellar models predict for isolated stars with the same masses. Eclipsing binaries with low-mass components are hard to find due to their low luminosity. As a consequence, the analysis of the known low-mass eclipsing systems is key to understand this behavior. We developed a physical model of the LMDEB system NSVS 10653195 to accurately measure the masses and radii of the components. We obtained several high-resolution spectra in order to fit a spectroscopic orbit. Standardized absolute photometry was obtained to measure reliable color indices and to measure the mean Teff of the system in out-of-eclipse phases. We observed and analyzed optical VRI and infrared JK band differential light-curves which were fitted using PHOEBE. A Markov-Chain Monte Carlo (MCMC) simulation near the solution found provides robust uncertainties for the fitted parameters. NSVS 10653195 is a detached eclipsing binary composed of two similar stars with masses of M1=0.6402+/-0.0052 Msun and M2=0.6511+/-0.0052 Msun and radii of R1=0.687^{+0.017}_{-0.024} Rsun and R2=0.672^{+0.018}_{-0.022} Rsun. Spectral types were estimated to be K6V and K7V. These stars rotate in a circular orbit with an orbital inclination of i=86.22+/-0.61 degrees and a period of P=0.5607222(2) d. The distance to the system is estimated to be d=135.2^{+7.6}_{-7.9} pc, in excellent agreement with the value from Gaia. If solar metallicity were assumed, the age of the system would be older than log(age)~8 based on the Mbol-log Teff diagram. NSVS 10653195 is composed of two oversized and active K stars. While their radii is above model predictions their Teff are in better agreement with models.Comment: 14 pages, 8 figures, 12 tables. Accepted for publication in A&A. Tables 1, 2, 3 and 7 are only available in electronic form at the CDS (Strasbourg

Complicaciones en accesos vasculares femorales durante el implante de dispositivos de alto perfil (TAVR, EVAR, TEVAR, FEVAR)

Complicaciones en accesos vasculares femorales durante el implante de dispositivos de alto perfil TAVR, EVAR, TEVAR, FEVA

Antimicrobial resistance among migrants in Europe: a systematic review and meta-analysis

BACKGROUND: Rates of antimicrobial resistance (AMR) are rising globally and there is concern that increased migration is contributing to the burden of antibiotic resistance in Europe. However, the effect of migration on the burden of AMR in Europe has not yet been comprehensively examined. Therefore, we did a systematic review and meta-analysis to identify and synthesise data for AMR carriage or infection in migrants to Europe to examine differences in patterns of AMR across migrant groups and in different settings. METHODS: For this systematic review and meta-analysis, we searched MEDLINE, Embase, PubMed, and Scopus with no language restrictions from Jan 1, 2000, to Jan 18, 2017, for primary data from observational studies reporting antibacterial resistance in common bacterial pathogens among migrants to 21 European Union-15 and European Economic Area countries. To be eligible for inclusion, studies had to report data on carriage or infection with laboratory-confirmed antibiotic-resistant organisms in migrant populations. We extracted data from eligible studies and assessed quality using piloted, standardised forms. We did not examine drug resistance in tuberculosis and excluded articles solely reporting on this parameter. We also excluded articles in which migrant status was determined by ethnicity, country of birth of participants' parents, or was not defined, and articles in which data were not disaggregated by migrant status. Outcomes were carriage of or infection with antibiotic-resistant organisms. We used random-effects models to calculate the pooled prevalence of each outcome. The study protocol is registered with PROSPERO, number CRD42016043681. FINDINGS: We identified 2274 articles, of which 23 observational studies reporting on antibiotic resistance in 2319 migrants were included. The pooled prevalence of any AMR carriage or AMR infection in migrants was 25·4% (95% CI 19·1-31·8; I2 =98%), including meticillin-resistant Staphylococcus aureus (7·8%, 4·8-10·7; I2 =92%) and antibiotic-resistant Gram-negative bacteria (27·2%, 17·6-36·8; I2 =94%). The pooled prevalence of any AMR carriage or infection was higher in refugees and asylum seekers (33·0%, 18·3-47·6; I2 =98%) than in other migrant groups (6·6%, 1·8-11·3; I2 =92%). The pooled prevalence of antibiotic-resistant organisms was slightly higher in high-migrant community settings (33·1%, 11·1-55·1; I2 =96%) than in migrants in hospitals (24·3%, 16·1-32·6; I2 =98%). We did not find evidence of high rates of transmission of AMR from migrant to host populations. INTERPRETATION: Migrants are exposed to conditions favouring the emergence of drug resistance during transit and in host countries in Europe. Increased antibiotic resistance among refugees and asylum seekers and in high-migrant community settings (such as refugee camps and detention facilities) highlights the need for improved living conditions, access to health care, and initiatives to facilitate detection of and appropriate high-quality treatment for antibiotic-resistant infections during transit and in host countries. Protocols for the prevention and control of infection and for antibiotic surveillance need to be integrated in all aspects of health care, which should be accessible for all migrant groups, and should target determinants of AMR before, during, and after migration. FUNDING: UK National Institute for Health Research Imperial Biomedical Research Centre, Imperial College Healthcare Charity, the Wellcome Trust, and UK National Institute for Health Research Health Protection Research Unit in Healthcare-associated Infections and Antimictobial Resistance at Imperial College London

Highlights From the Annual Meeting of the American Epilepsy Society 2022

With more than 6000 attendees between in-person and virtual offerings, the American Epilepsy Society Meeting 2022 in Nashville, felt as busy as in prepandemic times. An ever-growing number of physicians, scientists, and allied health professionals gathered to learn a variety of topics about epilepsy. The program was carefully tailored to meet the needs of professionals with different interests and career stages. This article summarizes the different symposia presented at the meeting. Basic science lectures addressed the primary elements of seizure generation and pathophysiology of epilepsy in different disease states. Scientists congregated to learn about anti-seizure medications, mechanisms of action, and new tools to treat epilepsy including surgery and neurostimulation. Some symposia were also dedicated to discuss epilepsy comorbidities and practical issues regarding epilepsy care. An increasing number of patient advocates discussing their stories were intertwined within scientific activities. Many smaller group sessions targeted more specific topics to encourage member participation, including Special Interest Groups, Investigator, and Skills Workshops. Special lectures included the renown Hoyer and Lombroso, an ILAE/IBE joint session, a spotlight on the impact of Dobbs v. Jackson on reproductive health in epilepsy, and a joint session with the NAEC on coding and reimbursement policies. The hot topics symposium was focused on traumatic brain injury and post-traumatic epilepsy. A balanced collaboration with the industry allowed presentations of the latest pharmaceutical and engineering advances in satellite symposia

Surgical site infection after gastrointestinal surgery in high-income, middle-income, and low-income countries: a prospective, international, multicentre cohort study

Background: Surgical site infection (SSI) is one of the most common infections associated with health care, but its importance as a global health priority is not fully understood. We quantified the burden of SSI after gastrointestinal surgery in countries in all parts of the world. Methods: This international, prospective, multicentre cohort study included consecutive patients undergoing elective or emergency gastrointestinal resection within 2-week time periods at any health-care facility in any country. Countries with participating centres were stratified into high-income, middle-income, and low-income groups according to the UN's Human Development Index (HDI). Data variables from the GlobalSurg 1 study and other studies that have been found to affect the likelihood of SSI were entered into risk adjustment models. The primary outcome measure was the 30-day SSI incidence (defined by US Centers for Disease Control and Prevention criteria for superficial and deep incisional SSI). Relationships with explanatory variables were examined using Bayesian multilevel logistic regression models. This trial is registered with ClinicalTrials.gov, number NCT02662231. Findings: Between Jan 4, 2016, and July 31, 2016, 13 265 records were submitted for analysis. 12 539 patients from 343 hospitals in 66 countries were included. 7339 (58·5%) patient were from high-HDI countries (193 hospitals in 30 countries), 3918 (31·2%) patients were from middle-HDI countries (82 hospitals in 18 countries), and 1282 (10·2%) patients were from low-HDI countries (68 hospitals in 18 countries). In total, 1538 (12·3%) patients had SSI within 30 days of surgery. The incidence of SSI varied between countries with high (691 [9·4%] of 7339 patients), middle (549 [14·0%] of 3918 patients), and low (298 [23·2%] of 1282) HDI (p < 0·001). The highest SSI incidence in each HDI group was after dirty surgery (102 [17·8%] of 574 patients in high-HDI countries; 74 [31·4%] of 236 patients in middle-HDI countries; 72 [39·8%] of 181 patients in low-HDI countries). Following risk factor adjustment, patients in low-HDI countries were at greatest risk of SSI (adjusted odds ratio 1·60, 95% credible interval 1·05–2·37; p=0·030). 132 (21·6%) of 610 patients with an SSI and a microbiology culture result had an infection that was resistant to the prophylactic antibiotic used. Resistant infections were detected in 49 (16·6%) of 295 patients in high-HDI countries, in 37 (19·8%) of 187 patients in middle-HDI countries, and in 46 (35·9%) of 128 patients in low-HDI countries (p < 0·001). Interpretation: Countries with a low HDI carry a disproportionately greater burden of SSI than countries with a middle or high HDI and might have higher rates of antibiotic resistance. In view of WHO recommendations on SSI prevention that highlight the absence of high-quality interventional research, urgent, pragmatic, randomised trials based in LMICs are needed to assess measures aiming to reduce this preventable complication

Reducing the environmental impact of surgery on a global scale: systematic review and co-prioritization with healthcare workers in 132 countries

Abstract Background Healthcare cannot achieve net-zero carbon without addressing operating theatres. The aim of this study was to prioritize feasible interventions to reduce the environmental impact of operating theatres. Methods This study adopted a four-phase Delphi consensus co-prioritization methodology. In phase 1, a systematic review of published interventions and global consultation of perioperative healthcare professionals were used to longlist interventions. In phase 2, iterative thematic analysis consolidated comparable interventions into a shortlist. In phase 3, the shortlist was co-prioritized based on patient and clinician views on acceptability, feasibility, and safety. In phase 4, ranked lists of interventions were presented by their relevance to high-income countries and low–middle-income countries. Results In phase 1, 43 interventions were identified, which had low uptake in practice according to 3042 professionals globally. In phase 2, a shortlist of 15 intervention domains was generated. In phase 3, interventions were deemed acceptable for more than 90 per cent of patients except for reducing general anaesthesia (84 per cent) and re-sterilization of ‘single-use’ consumables (86 per cent). In phase 4, the top three shortlisted interventions for high-income countries were: introducing recycling; reducing use of anaesthetic gases; and appropriate clinical waste processing. In phase 4, the top three shortlisted interventions for low–middle-income countries were: introducing reusable surgical devices; reducing use of consumables; and reducing the use of general anaesthesia. Conclusion This is a step toward environmentally sustainable operating environments with actionable interventions applicable to both high– and low–middle–income countries

Regeneración en zonas potenciales de laurisilva bajo una bóveda nativa vs. bóveda de exóticas, Tenerife (Islas Canarias)

Exotic tree monocultures adversely affect native ecosystems through competition and alteration of nutrient availability and dynamics. However, there is evidence of some tree plantations facilitating a more rapid recovery of the native plant communities by providing shelter-wood for the plants below and attracting seed dispersers. The results either way are specific to the plantation species and to the native forest type. In this study we analysed the differences in regeneration of native woody species in two stands of exotic species, Pinus radiata and Eucaliptus globulus, occupying native laurel forest ground, and also examined the regeneration in adjacent native forest stands to reveal if the effects of the exotic plants are negatively affecting the recovery of the native plant community. The native stands differed from the exotic stands in tree species richness, basal area and density. However, regeneration was very similar between alien and native stands, and advanced regeneration can be inferred from the results. Differences were quantitatively important, but species composition of the regenerating community was similar. Also, these planted areas have recovered their canopy very fast as long as P. radiata and E. globulus have rapid growth in comparison with native laurel forest species. These rapid recover of the canopy has prevented deeper erosion damage and has to some extent facilitated the regeneration of native species. The results indicate that a progressive elimination of the exotic stands would favor the establishment and growth of native species. The role of some exotic tree species in the restoration of laurel forest areas should not be systematically regarded as negative.Los monocultivos de especies exóticas afectan a los ecosistemas nativos a través de la competencia con especies nativas y alteración de la disponibilidad de nutrientes. Sin embargo, existen evidencias de que las plantaciones de exóticas pueden facilitar la recuperación de las comunidades de plantas nativas proveyendo de una protección de estas especies y atrayendo los dispersores de semillas. En cualquier caso los resultados son específicos de cada plantación y de la especie exótica utilizada. En este estudio se analizan las diferencias de regeneración de especies leñosas en dos formaciones de especies exóticas, Pinus radiata and Eucaliptus globulus, en zonas potenciales de laurisilva y también se examina la regeneración en dos bosques adyacentes de laurisilva y así poder comprar el impacto de las plantaciones de exóticas en la regeneración. La formación de laurisilva se diferencia de las de exótica en riqueza, área basal y densidad. Sin embargo, la composición de la regeneración es muy similar entre las formaciones de nativa y exóticas y se puede inferir una regeneración avanzada de estos resultados. Las diferencias son importantes cuantitativamente pero la composición de especies de la comunidad de plantas regenerando es similar. Las plantaciones han recuperado la bóveda muy rápidamente ya que P. radiata and E. globulus son especies de crecimiento rápido. Esta recuperación rápida de la bóveda ha prevenido los daños erosivos y ha facilitado la regeneración de las especies nativas. Los resultados indican que una progresiva eliminación de la formación de exóticas favorecería el establecimiento y crecimiento de las especies nativas. Las especies exóticas pueden jugar un papel importante en la restauración del bosque de laurel y no siempre tienen que asumirse como elementos negativos

The role of the new oral anticoagulants in the treatment of coronary disease

Los nuevos anticoagulantes orales llegaron para quedarse en la prevención de ataques cerebrovasculares isquémicos en pacientes con fibrilación auricular no valvular. Varios estudios clínicos han establecido su eficacia y seguridad1---3. Sin embargo, el papel que pueden tener en otras patologías, como la enfermedad coronaria, no está bien estudiado y todavía existen varias e importantes preguntas sin responder. Una de estas es su papel en la prevención secundaria de la enfermedad coronaria, dado que a pesar de un tratamiento médico óptimo y la doble terapia antiplaquetaria, el riesgo de reinfarto ha disminuido tan solo un 30%, fenómeno posiblemente explicado por otros factores relacionados, como el metabolismo lipídico, el estado inflamatorio y el estado protrombótico en el que el factor X activado (Xa), tiene un rol fundamental al generar la conversión de protrombina inactiva a trombina, la cual es el agonista más potente para la agregación plaquetaria4,5. El segundo interrogante está relacionado con los pacientes que tienen fibrilación auricular no valvular y enfermedad coronaria que requieren implante de un stent, en quienes los nuevos anticoagulantes orales podrían llegar a ser una alternativa en combinación con antiagregantes plaquetarios. Actualmente, en Colombia se cuenta con dos tipos de nuevos anticoagulantes orales, los inhibidores directos del factor X activado (rivaroxabán y apixabán) y los inhibidores directos de la trombina (dabigatrán), que pueden ser una nueva herramienta terapéutica para responder a estos interrogantes. Los inhibidores del factor Xa suprimen la síntesis de trombina de una manera indirecta al inhibir este factor, mientras que los antitrombínicos directos inhiben la actividad de la trombina

Complicaciones en accesos vasculares femorales durante el implante de dispositivos de alto perfil (TAVR, EVAR, TEVAR, FEVAR)

Complicaciones en accesos vasculares femorales durante el implante de dispositivos de alto perfil TAVR, EVAR, TEVAR, FEVA

Ain't no mountain high enough: plant invasions reaching new elevations

Most studies of invasive species have been in highly modified, lowland environments, with comparatively little attention directed to less disturbed, high-elevation environments. However, increasing evidence indicates that plant invasions do occur in these environments, which often have high conservation value and provide important ecosystem services. Over a thousand non-native species have become established in natural areas at high elevations worldwide, and although many of these are not invasive, some may pose a considerable threat to native mountain ecosystems. Here, we discuss four main drivers that shape plant invasions into high-elevation habitats: (1) the (pre-)adaptation of non-native species to abiotic conditions, (2) natural and anthropogenic disturbances, (3) biotic resistance of the established communities, and (4) propagule pressure. We propose a comprehensive research agenda for tackling the problem of plant invasions into mountain ecosystems, including documentation of mountain invasion patterns at multiple scales, experimental studies, and an assessment of the impacts of non-native species in these systems. The threat posed to high-elevation biodiversity by invasive plant species is likely to increase because of globalization and climate change. However, the higher mountains harbor ecosystems where invasion by non-native species has scarcely begun, and where science and management have the opportunity to respond in time