Meta-analysis review of fish trophic levels in marine protected areas based on stable isotope data

Stable isotopes (δ15N) have been used to determine trophic levels in marine food webs. This study assessed if Marine Protected Areas (MPAs) affect the trophic levels of fishes based on stable isotopes in the western Mediterranean. A total of 22 studies including 600 observations were found and the final dataset consisted of 11 fish species and 146 observations comparing trophic levels inside and outside MPAs. The database was analysed by meta-analysis and the covariate selected was the level of protection (inside vs. outside MPAs). The results indicate significant differences between trophic levels inside and outside the MPAs; however, results differ from expectations since the trophic level was lower inside than outside MPAs. Three habitats were analysed (coastal lagoons, demersal, and littoral) and significant statistical differences were found among them: trophic level was higher in demersal habitats than in coastal lagoons and littoral areas. No significant differences were found in species classified by trophic functional groups. Several hypotheses are considered as possible explanations linked to protection level, time since protection, and MPA size. We debate the suitability of using the stable isotope δ15N as a direct indicator of trophic level in evaluating MPA effects on food webs.Versión del editor0,568

Tuberculosis en España en el año 2013. Situación epidemiológica

[ES] En este estudio se presenta la situación de la tuberculosis en España en 2013 a partir de los datos de la Red Nacional de Vigilancia Epidemiológica, así como los resultados de tratamiento de los casos declarados en 2012. La tasa de incidencia de tuberculosis en 2013 fue de 11,88 casos por 100.000 habitantes, un 8% inferior a la del año 2012. Este descenso se debe fundamentalmente a la tendencia descendente y sostenida de las tasas de tuberculosis pulmonar y de adultos, mientras que en las tuberculosis de otras localizaciones y en niños el descenso es menos acusado, con tendencia a la estabilización. El porcentaje de casos nacidos en otros países se mantiene estable (aproximadamente 30% del total). Se dispone de información sobre el estatus VIH del 75% de los casos, de los que 7% fueron VIH positivos. Respecto a los resultados de tratamiento, el 76% de los casos nuevos pulmonares confirmados por cultivo declarados en 2012 tenían un resultado satisfactorio, 7% fallecieron, y del 12% no se disponía de información. [EN] This report presents the epidemiological situation of tuberculosis (TB) in Spain in 2013, from the Epidemiological National Surveillance Network data. The incidence TB rate for 2013 in Spain was 11.88/100,000, an 8% decrease in relation to the previous year. This may be explained by the downward trend for pulmonary disease in adults. The extrapulmonary disease and children rates had slight decrease or stabilization. Foreign-born cases represent 30% of the total TB cases. The HIV status was known for 75% of cases (7% HIV positive). In relation to the outcome of treatment for TB cases reported in 2012, 76% of new culture-confirmed pulmonary cases had a successful outcome, 7% died during the treatment, and the outcome was unknown for 12% of cases.N

Twist, tilt, and orientational order at the nematic to twist-bend nematic phase transition of 1¿, 9¿-bis(4-cyanobiphenyl-4'-yl) nonane: A dielectric, H 2 NMR, and calorimetric study

The nature of the nematic-nematic phase transition in the liquid crystal dimer 1¿, 9¿-bis(4-cyanobiphenyl-4'-yl) nonane (CB9CB) has been investigated using techniques of calorimetry, dynamic dielectric response measurements, and H2 NMR spectroscopy. The experimental results for CB9CB show that, like the shorter homologue CB7CB, the studied material exhibits a normal nematic phase, which on cooling undergoes a transition to the twist-bend nematic phase (NTB), a uniaxial nematic phase, promoted by the average bent molecular shape, in which the director tilts and precesses describing a conical helix. Modulated differential scanning calorimetry has been used to analyze the nature of the NTB-N phase transition, which is found to be weakly first order, but close to tricritical. Additionally broadband dielectric spectroscopy and H2 magnetic resonance studies have revealed information on the structural characteristics of the recently discovered twist-bend nematic phase. Analysis of the dynamic dielectric response in both nematic phases has provided an estimate of the conical angle of the heliconical structure for the NTB phase. Capacitance measurements of the electric-field realignment of the director in initially planar aligned cells have yielded values for the splay and bend elastic constants in the high temperature nematic phase. The bend elastic constant is small and decreases with decreasing temperature as the twist-bend phase is approached. This behavior is expected theoretically and has been observed in materials that form the twist-bend nematic phase. H2 NMR measurements characterize the chiral helical twist identified in the twist-bend nematic phase and also allow the determination of the temperature dependence of the conical angle and the orientational order parameter with respect to the director

Non-Invasive Electrophysiological Mapping Entropy Predicts Atrial Fibrillation Ablation Efficacy Better Than Clinical Characteristics

[EN] Success rate of atrial fibrillation (AF) ablation remains far from satisfactory. In this study, a 6 months AF freedom predictive model based on Fuzzy Entropy of non-invasive body surface potential maps is compared with clinical predictors. The study included 29 patients referred for pulmonary vein isolated catheter ablation procedure. Non-invasive electrocardiographic mapping with 54 ECG electrodes was recorded for all patients during the ablation procedure. Six months follow up was used to evaluate the efficacy of the ablation procedure. Predictions based on non-invasive electrocardiographic mappings during adenosine infusion (accuracy: 90%, AUC: 0.93) showed a clear improvement over standard-of-care clinical parameter models (accuracy: 62.1%, AUC: 0. 54). Our results indicate that measurements of electrophysiological complexity of AF signals could improve the clinical practice by predicting the efficacy of AF ablation procedures.This work was supported by the Instituto de Salud Carlos III FEDER (DTS16/00160; PI16/01123; PI17/01059; PI17/01106; EIT-Health 19600 AFFINE)De La Nava, AS.; Fabregat, MC.; Rodrigo, M.; Hernández, I.; Liberos, A.; Fernández-Avilés, F.; Guillem Sánchez, MS.... (2019). Non-Invasive Electrophysiological Mapping Entropy Predicts Atrial Fibrillation Ablation Efficacy Better Than Clinical Characteristics. IEEE. 1-4. https://doi.org/10.22489/CinC.2019.299S1

Absence of disparities in anthropometric measures among Chilean indigenous and non-indigenous newborns

<p>Abstract</p> <p>Background</p> <p>Studies throughout North America and Europe have documented adverse perinatal outcomes for racial/ethnic minorities. Nonetheless, the contrast in newborn characteristics between indigenous and non-indigenous populations in Latin America has been poorly characterized. This is due to many challenges, including a lack of vital registration information on ethnicity. The objective of this study was to analyze trends in anthropometric measures at birth in Chilean indigenous (Mapuche) and non-indigenous children over a 5-year period.</p> <p>Methods</p> <p>We examined weight and length at birth using information available through a national data base of all birth records for the years 2000 through 2004 (n = 1,166.513). Newborns were classified ethnically according to the origins of the parents' last names.</p> <p>Result</p> <p>The average birthweight was stable over the 5 year period with variations of less than 20 g in each group, and with mean values trivially higher in indigenous newborns. The proportion weighing less than 2500 g at birth increased modestly from 5.2% to 5.6% in non-indigenous newborns whereas the indigenous births remained constant at 5.2%. In multiple regression analyses, adjusting flexibly for gestational age and maternal characteristics, the occurrence of an indigenous surname added only 14 g to an average infant's birthweight while holding other factors constant. Results for length at birth were similar, and adjusted time trend variation in both outcomes was trivially small after adjustment. Anthropometric indexes at birth in Chile are quite favorable by international standards.</p> <p>Conclusion</p> <p>There is only a trivial degree of ethnic disparity in these values, in contrast to conditions for ethnic minorities in other countries. Moreover, these values remained roughly constant over the 5 years of observation in this study.</p

What are the living conditions and health status of those who don't report their migration status? a population-based study in Chile

BACKGROUND: Undocumented immigrants are likely to be missing from population databases, making it impossible to identify an accurate sampling frame in migration research. No population-based data has been collected in Chile regarding the living conditions and health status of undocumented immigrants. However, the CASEN survey (Caracterizacion Socio- Economica Nacional) asked about migration status in Chile for the first time in 2006 and provides an opportunity to set the base for future analysis of available migration data. We explored the living conditions and health of self-reported immigrants and respondents who preferred not to report their migration status in this survey. METHODS: Cross-sectional secondary analysis of CASEN survey in Chile in 2006. Outcomes: any disability, illness/accident, hospitalization/surgery, cancer/chronic condition (all binary variables); and the number of medical/emergency attentions received (count variables). Covariates: Demographics (age, sex, marital status, urban/rural, ethnicity), socioeconomic status (education level, employment status and household income), and material standard of living (overcrowding, sanitation, housing quality). Weighted regression models were estimated for each health outcome, crude and adjusted by sets of covariates, in STATA 10.0. RESULTS: About 1% of the total sample reported being immigrants and 0.7% preferred not to report their migration status (Migration Status - Missing Values; MS-MV). The MS-MV lived in more deprived conditions and reported a higher rate of health problems than immigrants. Some gender differences were observed by health status among immigrants and the MS-MV but they were not statistically significant. Regressions indicated that age, sex, SES and material factors consistently affected MS-MVs’ chance of presenting poor health and these patterns were different to those found among immigrants. Great heterogeneity in both the MS-MV and the immigrants, as indicated by wide confidence intervals, prevented the identification of other significantly associated covariates. CONCLUSION: This is the first study to look at the living conditions and health of those that preferred not to respond their migration status in Chile. Respondents that do not report their migration status are vulnerable to poor health and may represent undocumented immigrants. Surveys that fail to identify these people are likely to misrepresent the experiences of immigrants and further quantitative and qualitative research is urgently required

The influence of chronological age on cognitive biases and impulsivity levels in male patients with gambling disorder

Altres ajuts: Delegación del Gobierno para el Plan Nacional sobre Drogas: 2017I067 i 2019I47Due to the contribution of age to the etiology of gambling disorder (GD), there is a need to assess the moderator effect of the aging process with other features that are highly related with the clinical profile. The objective of this study is to examine the role of the chronological age into the relationships between cognitive biases, impulsivity levels and gambling preference with the GD profile during adulthood. Sample included n = 209 patients aged 18-77 years-old recruited from a Pathological Gambling Outpatients Unit. Orthogonal contrasts explored polynomial patterns in data, and path analysis implemented through structural equation modeling assessed the underlying mechanisms between the study variables. Compared to middle-age patients, younger and older age groups reported more impairing irrational beliefs (P = 0.005 for interpretative control and P = 0.043 for interpretative bias). A linear trend showed that as people get older sensation seeking (P = 0.006) and inability to stop gambling (P = 0.018) increase. Path analysis showed a direct effect between the cognitive bias and measures of gambling severity (standardized effects [SE] between 0.12 and 0.17) and a direct effect between impulsivity levels and cumulated debts due to gambling (SE = 0.22). Screening tools and intervention plans should consider the aging process. Specific programs should be developed for younger and older age groups, since these are highly vulnerable to the consequences of gambling activities and impairment levels of impulsivity and cognitive biases

A retrospective analysis of the change in anti-malarial treatment policy: Peru

<p>Abstract</p> <p>Background</p> <p>National malaria control programmes must deal with the complex process of changing national malaria treatment guidelines, often without guidance on the process of change. Selecting a replacement drug is only one issue in this process. There is a paucity of literature describing successful malaria treatment policy changes to help guide control programs through this process.</p> <p>Objectives</p> <p>To understand the wider context in which national malaria treatment guidelines were formulated in a specific country (Peru).</p> <p>Methods</p> <p>Using qualitative methods (individual and focus group interviews, stakeholder analysis and a review of documents), a retrospective analysis of the process of change in Peru's anti-malarial treatment policy from the early 1990's to 2003 was completed.</p> <p>Results</p> <p>The decision to change Peru's policies resulted from increasing levels of anti-malarial drug resistance, as well as complaints from providers that the drugs were no longer working. The context of the change occurred in a time in which Peru was changing national governments, which created extreme challenges in moving the change process forward. Peru utilized a number of key strategies successfully to ensure that policy change would occur. This included a) having the process directed by a group who shared a common interest in malaria and who had long-established social and professional networks among themselves, b) engaging in collaborative teamwork among nationals and between nationals and international collaborators, c) respect for and inclusion of district-level staff in all phases of the process, d) reliance on high levels of technical and scientific knowledge, e) use of standardized protocols to collect data, and f) transparency.</p> <p>Conclusion</p> <p>Although not perfectly or fully implemented by 2003, the change in malaria treatment policy in Peru occurred very quickly, as compared to other countries. They identified a problem, collected the data necessary to justify the change, utilized political will to their favor, approved the policy, and moved to improve malaria control in their country. As such, they offer an excellent example for other countries as they contemplate or embark on policy changes.</p

Technology-assisted stroke rehabilitation in Mexico: a pilot randomized trial comparing traditional therapy to circuit training in a Robot/technology-assisted therapy gym

Background Stroke rehabilitation in low- and middle-income countries, such as Mexico, is often hampered by lack of clinical resources and funding. To provide a cost-effective solution for comprehensive post-stroke rehabilitation that can alleviate the need for one-on-one physical or occupational therapy, in lower and upper extremities, we proposed and implemented a technology-assisted rehabilitation gymnasium in Chihuahua, Mexico. The Gymnasium for Robotic Rehabilitation (Robot Gym) consisted of low- and high-tech systems for upper and lower limb rehabilitation. Our hypothesis is that the Robot Gym can provide a cost- and labor-efficient alternative for post-stroke rehabilitation, while being more or as effective as traditional physical and occupational therapy approaches. Methods A typical group of stroke patients was randomly allocated to an intervention (n = 10) or a control group (n = 10). The intervention group received rehabilitation using the devices in the Robot Gym, whereas the control group (n = 10) received time-matched standard care. All of the study subjects were subjected to 24 two-hour therapy sessions over a period of 6 to 8 weeks. Several clinical assessments tests for upper and lower extremities were used to evaluate motor function pre- and post-intervention. A cost analysis was done to compare the cost effectiveness for both therapies. Results No significant differences were observed when comparing the results of the pre-intervention Mini-mental, Brunnstrom Test, and Geriatric Depression Scale Test, showing that both groups were functionally similar prior to the intervention. Although, both training groups were functionally equivalent, they had a significant age difference. The results of all of the upper extremity tests showed an improvement in function in both groups with no statistically significant differences between the groups. The Fugl-Meyer and the 10 Meters Walk lower extremity tests showed greater improvement in the intervention group compared to the control group. On the Time Up and Go Test, no statistically significant differences were observed pre- and post-intervention when comparing the control and the intervention groups. For the 6 Minute Walk Test, both groups presented a statistically significant difference pre- and post-intervention, showing progress in their performance. The robot gym therapy was more cost-effective than the traditional one-to-one therapy used during this study in that it enabled therapist to train up to 1.5 to 6 times more patients for the approximately same cost in the long term. Conclusions The results of this study showed that the patients that received therapy using the Robot Gym had enhanced functionality in the upper extremity tests similar to patients in the control group. In the lower extremity tests, the intervention patients showed more improvement than those subjected to traditional therapy. These results support that the Robot Gym can be as effective as traditional therapy for stroke patients, presenting a more cost- and labor-efficient option for countries with scarce clinical resources and funding. Trial registration ISRCTN98578807