Evaluating the Impact of the Diabetes Mellitus Strategy for the National Health System: An Interrupted Time Series Analysis

Background: Diabetes mellitus is a significant public health problem. Macrovascular complications (stroke, acute myocardial infarction (AMI) and lower limb amputations (LLAs) represent the leading cause of morbi-mortality in DM. This work aims to evaluate the impact of the approval of the Diabetes Mellitus Strategy of the National Health System (SDM-NHS) on hospitalizations for those macrovascular complications related to DM. Methods: Interrupted time series applying segmented regression models (Negative Binomial) adjusted for seasonality to data from hospital discharge records with a primary or secondary diagnosis of DM (code 250 ICD9MC). Results: Between 2001 and 2015, there have been 7,302,750 hospital discharges with a primary or secondary diagnosis of DM. After the approval of the SDM-NHS, all the indicators showed a downward trend, modifying the previous trend in the indicators of AMI and LLA. The indicators of stroke and AMI also showed an immediate reduction in their rates. Conclusions: After the approval of the SDM-NHS, an improvement has been observed in all the indicators of macrovascular complications of DM evaluated, although it is difficult to establish a causal relationship between the strategy and the effects observed. Interrupted time series is applicable for evaluating the impact of interventions in public health when experimental designs are not possible.This research was partially funded by the Nazarbayev University #080420FD1916.S

Cooperative Learning: a solution for unstructured groups

El aprendizaje cooperativo es un método de aprendizaje en pequeños grupos, donde la responsabilidad del proceso educativo recae en los propios alumnos/as. En este caso, el profesor/a ayudar a los miembros del equipo a comprender la importancia de trabajar juntos y encontrar la mejor manera de interactuar para asegurar que el proceso de aprendizaje produzca adecuados resultados para cada miembro.Este agrupamiento ayuda a los estudiantes a expresar sus opiniones y a desarrollar las habilidades necesarias. Los estudiantes pueden trabajar en los mismos grupos, o la composición del equipo puede variar dependiendo de la actividad.Cooperative learning is a method of learning in small groups, where the responsibility for the educational process lies with the learners themselves. In this case, the teacher helps the team members to understand the importance of working together and to find the best way of interacting to ensure that the learning process produces appropriate outcomes for each member. Students may work in the same groups, or the composition of the team may vary depending on the activities

Centres of Infant and Primary Education in situation of socioeconomic disadvantage

Los centros en situación de desventaja socioeconómica son aquellos que requieren una continua compensación educativa, pues se caracterizan por poseer grupos significativos de alumnos y alumnas en situación de desventaja respecto a su acceso, permanencia y promoción en el sistema educativo. Sobre todo, cuentan un número importante de alumnado perteneciente a minorías étnicas o culturales en situaciones sociales de desventaja. Se considera de interés, mostrar a la comunidad educativa cómo son estos centros educativos: sus características y contexto.Schools in a situation of socioeconomic disadvantage are those that require continuous educational compensation, since they are characterized by having significant groups of students in a situation of disadvantage with respect to their access, permanence, and promotion in the educational system. Above all, there are a significant number of students belonging to ethnic or cultural minorities in socially disadvantaged situations. It is considered of interest to show the educational community what these schools are like: their characteristics and context

Carbon Materials as Additives to WO3 for an Enhanced Conversion of Simulated Solar Light

We have explored the impact of the incorporation of nanoporous carbons as additives to tungsten oxide on the photocatalytic degradation of two recalcitrant pollutants: rhodamine B and phenol, under simulated solar light. For this purpose, WO3/carbon mixtures were prepared using three carbon materials with different properties (in terms of porosity, structural order and surface chemistry). Despite the low carbon content used (2 wt. %), a significant increase in the photocatalytic performance of the semiconductor was observed for all the catalysts. Moreover, the influence of the carbon additive on the performance of the photocatalysts was found to be very different for the two pollutants. Carbon additives of hydrophobic nature increased the photodegradation yield of phenol compared to bare WO3, likely due to the higher affinity and stronger interactions of phenol molecules towards basic nanoporous carbons. Oppositely, the use of acidic carbon additives led to higher rhodamine B conversions due to increased acidity of the WO3/carbon mixtures and the stronger affinity of the pollutant for acidic catalyst’s surfaces. As a result, the photooxidation of rhodamine B is favored by means of a coupled (photosensitized and photocatalytic) degradation mechanism. All these results highlight the importance of favoring the interactions of the pollutant with the catalyst’s surface through a detailed design of the features of the photocatalyst

A systematic review of the use of health services by immigrants and native populations

Background: Changes in migration patterns that have occurred in recent decades, both quantitative, with an increase in the number of immigrants, and qualitative, due to different causes of migration (work, family reunification, asylum seekers and refugees) require constant u pdating of the analysis of how immigrants access health services. Understanding of the existence of changes in use patterns is necessary to adapt health services to the new socio-demographic reality. The aim of this study is to describe the scientific evidence that assess the differences in the use of health services between immigrant and native populations. Methods: A systematic review of the electronic database MEDLINE (PubMed) was conducted with a search of studies published between June 2013 and February 2016 that addressed the use of health services and compared immigrants with native populations. MeSH terms and key words comprised Health Services Needs and Demands/Accessibility/Disparities/Emigrants and Immigrants/Native/Ethnic Groups. The electronic search was supplemented by a manual search of grey literature. The following information was extracted from each publication: context of the study (place and year), characteristics of the included population (definition of immigrants and their sub-groups), methodological domains (design of the study, source of information, statistical analysis, variables of health care use assessed, measures of need, socio-economic indicators) and main results. Results: Thirty-six publications were included, 28 from Europe and 8 from other countries. Twenty-four papers analysed the use of primary care, 17 the use of specialist services (including hospitalizations or emergency care), 18 considered several levels of care and 11 assessed mental health services. The characteristics of immigrants included country of origin, legal status, reasons for migration, length of stay, different generations and socio-demographic variables and need. In general, use of health services by the immigrants was less than or equal to the native population, although some differences between immigrants were also identified. Conclusions: This review has identified that immigrants show a general tendency towards a lower use of health services than native populations and that there are significant differences within immigrant sub-groups in terms of their patterns of utilization. Further studies should include information categorizing and evaluating the diversity within the immigrant population.The study was funded by the Institute of Health Carlos III and REDISSEC Thematic NetworkS

Multiple evoked and induced alpha modulations in a visual attention task: Latency

Alpha event-related desynchronization (ERD) has been widely applied to understand the psychophysiological role of this band in cognition. In particular, a considerable number of publications have described spectral alterations in several pathologies using this time-frequency approach. However, ERD is not capable of specifically showing nonphase (induced) activity related to the presentation of stimuli. Recent studies have described an evoked and induced activity in the early phases (first 200 ms) of stimulus processing. However, scarce studies have analyzed induced and evoked modulations in longer latencies (>200 ms) and their potential roles in cognitive processing. The main goal of the present study was to analyze diverse evoked and induced modulations in response to visual stimuli. Thus, 58- channel electroencephalogram (EEG) was recorded in 21 healthy subjects during the performance of a visual attention task, and analyses were performed for both target and standard stimuli. The initial result showed that phase-locked and nonphase locked activities coexist in the early processing of target and standard stimuli as has been reported by previous studies. However, more modulations were evident in longer latencies in both evoked and induced activities. Correlation analyses suggest that similar maps were present for evoked and induced activities at different timepoints. In the discussion section, diverse proposals will be stated to define the potential roles of these modulations in the information processing for this cognitive task. As a general conclusion, induced activity enables the observation of cognitive mechanisms that are not visible by ERD or ERP modulations

Species richness and diversity of benthic diatom communities in tropical mountain streams of Mexico

We examined community structure of benthic diatoms and their substratum preferences (epilithic vs. macroalgae) by season in 4 tropical mountain streams in central Mexico. Of the 74 species compiled, Cymbella silesiaca, Rhoicosphenia abbreviate, and Reimeria sinuata were the most abundant and frequent. About 14% of species were exclusively epilithic, 13% were associated with macroalgae, and 73% had no clear preference. Environmental factors most closely related to spatial and temporal distribution of epilithic diatoms were changes in stream discharge and water temperature. For diatoms associated with macroalgae, the most important factors were changes in current velocity and the coverage and richness of macroalgae. The similarities in species richness and diversity in the 4 study sites suggest that the diatom community develops under conditions of moderate disturbance. The few differences found in species richness between epilithic and macroalgae-associated diatoms suggest that these diatoms do not have substratum preferences. The abundance of macroalgae-associated diatoms in all sites suggests a positive effect (facilitation) of macroalgae on diatoms

Enfermedad Meningocócica. Temporada 2018-2019, 2019-2020

[ES] La enfermedad meningocócica invasiva (EMI) es una enfermedad producida por Neisseria meningitidis. Esta enfermedad es de declaración obligatoria desde 1901 y debe notificarse a la Red Nacional de Vigilancia Epidemiológica (RENAVE). Este estudio muestra los resultados obtenidos durante las temporadas 2018-2019 y 2019-2020. Durante la temporada 2018-2019 la incidencia de la enfermedad meningocócica invasiva continuó la tendencia creciente observada durante las cinco temporadas anteriores. Fundamentalmente, debido al incremento de los serogrupos W e Y. La incidencia de casos notificados durante la temporada 2019/2020 disminuyó un 31,3% respecto a la temporada anterior 2018/2019. Descendió la incidencia en todos los serogrupos y en todos los grupos de edad. Esta disminución podría deberse a la suma de varios factores. En primer lugar, esta temporada coincidió, en parte, con el inicio de la pandemia de COVID-19, y las medidas de contención de la difusión del SARS-CoV-2 afectaron a su transmisión. En segundo lugar, se introdujo en el calendario de vacunación la vacuna conjugada tetravalente (Men ACWY) en adolescentes (12 años) y, por último, otras limitaciones de la vigilancia durante este año pudieron afectar a la disminución. [EN] Invasive meningococcal disease (IMD) is a disease caused by Neisseria meningitidis. IMD has been notifiable since 1901 and must be reported to the National Epidemiological Surveillance Network (RENAVE). This study shows the results obtained during the 2018-2019 and 2019-2020 seasons. During the 2018-2019 season, the incidence of invasive meningococcal disease continued the increasing trend observed during the previous five seasons. Mainly due to the increase of cases of serogroup W and Y. The incidence of cases reported during the 2019/2020 season decreased by 31,3% compared to the previous 2018/2019 season. Incidence decreased in all serogroups and in all age groups. This decrease could be due to the addition of several factors. First, this season coincided, in part, with the onset of the COVID pandemic, and measures to contain the spread of SARS-CoV-2 affected its transmission. Second, the tetravalent conjugate vaccine (Men ACWY) was introduced into the vaccination schedule in adolescents (12 years old) and finally, other limitations of surveillance during this year could affect the decrease.N

Enfermedad Meningocócica. Temporada 2020-2021

[ES] La enfermedad meningocócica invasiva (EMI) es una enfermedad producida por la bacteria Neisseria meningitidis. Esta enfermedad es de declaración obligatoria desde 1.901 y debe notificarse a la Red Nacional de Vigilancia Epidemiológica (RENAVE). Este boletín muestra los resultados obtenidos durante la temporada 2020-2021. La incidencia de casos notificados durante la temporada 2020/2021 disminuyó un 75 % respecto a la temporada anterior 2019/2020. Esta reducción tan significativa se debe a la suma de varios factores; la reducción de la transmisión debido a las medidas de contención de la difusión del SARSCoV-2, el aumento de coberturas de vacunación de la vacuna conjugada tetravalente (Men ACWY) en adolescentes (12 años) y el catch-up realizado en otras edades y, por último, a otras limitaciones de la vigilancia durante esta temporada que pudieron afectar a la disminución. La incidencia descendió en todos los serogrupos y en todos los grupos de edad. [EN] Invasive meningococcal disease (IMD) is a disease caused by Neisseria meningitidis. This disease has been notifiable since 1,901 and must be notified to the National Epidemiological Surveillance Network (RENAVE). This study shows the results obtained during the 2020-2021 season. The incidence of cases reported during the 2020/2021 season decreased by 83.3% compared to the previous 2019/2020 season. This significant reduction is due to the sum of several factors; the reduction of transmission due to measures to contain the spread of SARS-CoV-2, the increase in vaccination coverage of the quadrivalent conjugate vaccine (Men ACWY) in adolescents (12 years) and the catch-up carried out at other ages and, finally, other limitations of surveillance during this season that could affect the decrease. The incidence decreased in all serogroups and in all age groups

Myc overexpression enhances of epicardial contribution to the developing heart and promotes extensive expansion of the cardiomyocyte population

Myc is an essential regulator of cell growth and proliferation. Myc overexpression promotes the homeostatic expansion of cardiomyocyte populations by cell competition, however whether this applies to other cardiac lineages remains unknown. The epicardium contributes signals and cells to the developing and adult injured heart and exploring strategies for modulating its activity is of great interest. Using inducible genetic mosaics, we overexpressed Myc in the epicardium and determined the differential expansion of Myc-overexpressing cells with respect to their wild type counterparts. Myc-overexpressing cells overcolonized all epicardial-derived lineages and showed increased ability to invade the myocardium and populate the vasculature. We also found massive colonization of the myocardium by Wt1Cre-derived Myc-overexpressing cells, with preservation of cardiac development. Detailed analyses showed that this contribution is unlikely to derive from Cre activity in early cardiomyocytes but does not either derive from established epicardial cells, suggesting that early precursors expressing Wt1Cre originate the recombined cardiomyocytes. Myc overexpression does not modify the initial distribution of Wt1Cre-recombined cardiomyocytes, indicating that it does not stimulate the incorporation of early expressing Wt1Cre lineages to the myocardium, but differentially expands this initial population. We propose that strategies using epicardial lineages for heart repair may benefit from promoting cell competitive ability.We thank V. Garcia for mouse work, E. Arza and A.M. Santos for help with microscopy, R. Nieto and J. Ligos for help with cytometry and Paul Riley for critical reading of the manuscript. This work was supported by grants BFU2012-31086 and ISCIII-RD12/0019/0005 (ISCIII) to MT and BFU2014-52299 and ISCIII-RD12/0019-0022 to RM from the Spanish Ministry of Economy and Competition (MINECO) and grants P2010/BMD-2315 from the Madrid Regional Government to MT and P11-CTS-07564 from the Junta de Andalucia to RM. C.V. was supported by a FPI grant from the MINECO. The CNIC is supported by the MINECO and the Pro-CNIC Foundation.S