Phlebotomine sand fly survey in the focus of leishmaniasis in Madrid, Spain (2012-2014): seasonal dynamics, Leishmania infantum infection rates and blood meal preferences

BACKGROUND: An unusual increase of human leishmaniasis cases due to Leishmania infantum is occurring in an urban area of southwestern Madrid, Spain, since 2010. Entomological surveys have shown that Phlebotomus perniciosus is the only potential vector. Direct xenodiagnosis in hares (Lepus granatensis) and rabbits (Oryctolagus cuniculus) collected in the focus area proved that they can transmit parasites to colonized P. perniciosus. Isolates were characterized as L. infantum. The aim of the present work was to conduct a comprehensive study of sand flies in the outbreak area, with special emphasis on P. perniciosus. METHODS: Entomological surveys were done from June to October 2012-2014 in 4 stations located close to the affected area. Twenty sticky traps (ST) and two CDC light traps (LT) were monthly placed during two consecutive days in every station. LT were replaced every morning. Sand fly infection rates were determined by dissecting females collected with LT. Molecular procedures applied to study blood meal preferences and to detect L. infantum were performed for a better understanding of the epidemiology of the outbreak. RESULTS: A total of 45,127 specimens belonging to 4 sand fly species were collected: P. perniciosus (75.34%), Sergentomyia minuta (24.65%), Phlebotomus sergenti (0.005%) and Phlebotomus papatasi (0.005%). No Phlebotomus ariasi were captured. From 3203 P. perniciosus female dissected, 117 were infected with flagellates (3.7%). Furthermore, 13.31% and 7.78% of blood-fed and unfed female sand flies, respectively, were found infected with L. infantum by PCR. The highest rates of infected P. perniciosus were detected at the end of the transmission periods. Regarding to blood meal preferences, hares and rabbits were preferred, although human, cat and dog blood were also found. CONCLUSIONS: This entomological study highlights the exceptional nature of the Leishmania outbreak occurring in southwestern Madrid, Spain. It is confirmed that P. perniciosus is the only vector in the affected area, with high densities and infection rates. Rabbits and hares were the main blood meal sources of this species. These results reinforce the need for an extensive and permanent surveillance in this region, and others of similar characteristics, in order to control the vector and regulate the populations of wild reservoirs.This study was partially sponsored and funded by: Dirección General de Salud Pública, Consejería de Sanidad, Comunidad de Madrid; Colegio de Veterinarios de Madrid; Colegio de Biólogos de Madrid and EU grant FP7-261504 EDENext (http://www.edenext.eu).S

Characterisation of Human Embryonic Stem Cells Conditioning Media by 1H-Nuclear Magnetic Resonance Spectroscopy

BACKGROUND: Cell culture media conditioned by human foreskin fibroblasts (HFFs) provide a complex supplement of protein and metabolic factors that support in vitro proliferation of human embryonic stem cells (hESCs). However, the conditioning process is variable with different media batches often exhibiting differing capacities to maintain hESCs in culture. While recent studies have examined the protein complement of conditioned culture media, detailed information regarding the metabolic component of this media is lacking. METHODOLOGY/PRINCIPAL FINDINGS: Using a (1)H-Nuclear Magnetic Resonance ((1)H-NMR) metabonomics approach, 32 metabolites and small compounds were identified and quantified in media conditioned by passage 11 HFFs (CMp11). A number of metabolites were secreted by HFFs with significantly higher concentration of lactate, alanine, and formate detected in CMp11 compared to non-conditioned media. In contrast, levels of tryptophan, folate and niacinamide were depleted in CMp11 indicating the utilisation of these metabolites by HFFs. Multivariate statistical analysis of the (1)H-NMR data revealed marked age-related differences in the metabolic profile of CMp11 collected from HFFs every 24 h over 72 h. Additionally, the metabolic profile of CMp11 was altered following freezing at -20°C for 2 weeks. CM derived from passage 18 HFFs (CMp18) was found to be ineffective at supporting hESCs in an undifferentiated state beyond 5 days culture. Multivariate statistical comparison of CMp11 and CMp18 metabolic profiles enabled rapid and clear discrimination between the two media with CMp18 containing lower concentrations of lactate and alanine as well as higher concentrations of glucose and glutamine. CONCLUSIONS/SIGNIFICANCE: (1)H-NMR-based metabonomics offers a rapid and accurate method of characterising hESC conditioning media and is a valuable tool for monitoring, controlling and optimising hESC culture media preparation

The TileCal Optical Multiplexer Board 9U

TileCal is the hadronic calorimeter of the ATLAS experiment at LHC/CERN. The system contains roughly 10,000 channels of read-out electronics, whose signals are gathered and digitized in the front-end electronics and then transmitted to the counting room through two redundant optical links. Then, the data is received in the back-end system by the Optical Multiplexer Board (OMB) 9U which performs a CRC check to the redundant data to avoid Single Event Upsets errors. A real-time decision is taken on the event-to-event basis to transmit single data to the ReadEOut Drivers (RODs) for processing. Due to the low dose level expected during the first years of operations in ATLAS it was decided not to use a redundant system and currently the front-end electronics is directly connected to the RODs. However, the increasing luminosity of the LHC will force to use the redundant read-out and the OMB system will be installed. Moreover, the OMB can be used as a ROD injector to emulate the front-end electronics for ROD software tests during detector maintenance periods taking advantage of its location in the data acquisition chain. First we will give a detailed description of the main components of the board and the different operation modes. Then, the production and qualification tests will be explained including a detailed description of the test-bench, software and validation protocols

Is the physician's behavior in dyslipidemia diagnosis in accordance with guidelines? Cross-sectional ESCARVAL study.

Clinical inertia has been defined as mistakes by the physician in starting or intensifying treatment when indicated. Inertia, therefore, can affect other stages in the healthcare process, like diagnosis. The diagnosis of dyslipidemia requires ≥2 high lipid values, but inappropriate behavior in the diagnosis of dyslipidemia has only previously been analyzed using just total cholesterol (TC).To determine clinical inertia in the dyslipidemia diagnosis using both TC and high-density lipoprotein cholesterol (HDL-c) and its associated factors.Cross-sectional.All health center visits in the second half of 2010 in the Valencian Community (Spain).11,386 nondyslipidemic individuals aged ≥20 years with ≥2 lipid determinations.Gender, atrial fibrillation, hypertension, diabetes, cardiovascular disease, age, and ESCARVAL training course. Lipid groups: normal (TC<5.17 mmol/L and normal HDL-c [≥1.03 mmol/L in men and ≥1.29 mmol/L in women], TC inertia (TC≥5.17 mmol/L and normal HDL-c), HDL-c inertia (TC<5.17 mmol/L and low HDL-c), and combined inertia (TC≥5.17 mmol/L and low HDL-c).TC inertia: 38.0% (95% CI: 37.2-38.9%); HDL-c inertia: 17.7% (95% CI: 17.0-18.4%); and combined inertia: 9.6% (95% CI: 9.1-10.2%). The profile associated with TC inertia was: female, no cardiovascular risk factors, no cardiovascular disease, middle or advanced age; for HDL-c inertia: female, cardiovascular risk factors and cardiovascular disease; and for combined inertia: female, hypertension and middle age.Cross-sectional study, under-reporting, no analysis of some cardiovascular risk factors or other lipid parameters.A more proactive attitude should be adopted, focusing on the full diagnosis of dyslipidemia in clinical practice. Special emphasis should be placed on patients with low HDL-c levels and an increased cardiovascular risk

Descriptive analysis of inertia groups for dyslipidemia at primary health care centers in a Spanish region.

<p>Abbreviations: n(%), absolute frequency(relative frequency); TC, total cholesterol; HDL-c, high density lipoprotein cholesterol.</p

Analysis of factors associated with inertia groups for dyslipidemia at primary health care centers in a Spanish region.

<p>Abbreviations: TC, total cholesterol; HDL-c, high density lipoprotein cholesterol; Adj. OR, Adjusted Odds Ratio; CI, Confidence Interval.</p><p>Goodness-of-fit of the inertia models: TC: <i>X²</i> = 552.7, p<0.001; HDL-c: <i>X</i>² = 182.9, p<0.001; Combined: <i>X</i>² = 205.7, p<0.001.</p><p>OR adjusted for gender, atrial fibrillation, hypertension, diabetes mellitus, cardiovascular disease, age groups and the on-line course.</p><p>^*: Reference.</p

Main characteristics of the studies that evaluate clinical inertia in the diagnosis of dyslipidemia.

<p>Abbreviations: TC, total cholesterol; DM, diabetes mellitus; CVD, cardiovascular disease. *: This value was obtained through a weighted average. ^†: The sample size is not given in the original article. We therefore obtained it from linear programming mathematical calculations based on the Simplex method.</p

Nondyslipidemic patients at primary healthcare centers in a Spanish region.

<p>CI, confidence interval; TC, total cholesterol; HDL-c; high-density lipoprotein cholesterol.</p