Infección por hongos Chytridiales en una población de Oocystis Borgei (Oocystaceae, Chlorophyceae)

A study of chytrid infection on a phytoplankton population of the cloroccocal species Oocystis borgei (Chlorophyceae, Oocystaceae) living in an eutrophic reservoir (El Vellón, Madrid) during the stagnation period has been undertaken. The infection process was expanded in swiftly high pH and temperature conditions. Parasity fungal community peaked as host population stopped growing, fungal resting stages beginning to develop at the same time. At the end of the infection, Oocystis population was disappeared. Oocystis's water column distribution was not affected by parasitic process.Se ha estudiado el impacto de una infección por hongos Chytridiales (Phycomycetes) sobre una población del alga Oocystis borgei (Chlorophyceae, Oocystaceae) localizada en un embalse eutrófico (El Vellón, Madrid) durante el periodo de estratificación. El proceso de infección se desarrolla en condiciones ligeramente elevadas de pH y temperatura. La comunidad de hongos parásitos presenta su máximo cuando la población del alga hospedante deja de crecer y comienza su descenso, momento en el que con frecuencia se observa la aparición de esporas de resistencia de los hongos. Al final de la infección, la población de Oocystis desaparece. La distribución espacial del alga en la columna vertical no se ve afectada por el efecto del parasitismo

Efecto de una infección de hongos "Chytridiales" ("Phycomycetes") sobre una población natural del alga "Fotterella tetrachlorelloides" Buck "Tetrachlorelloides" Buck ("Chlorophyceae", "Oocystaceae")

Se ha estudiado el impacto de una infección de hongos Chytridiales (Phycomycetes) sobre una población natural del alga cenobial Fotterella tetrachlorelloides (Chlorophyceae, Oocystaceae) localizada en un embalse eutrófíco (El Vellón, Madrid) durante el período de estratificación. Con el desarrollo de la infección se observa un descenso drástico de la población de Fotterella y una disminución del número de células por cenobio. Los hongos parásitos alcanzan su máximo cuando la población del hospedante deja de crecer y comienza su descenso, momento en el que empiezan a aparecer las esporas de resistencia de los hongos. La distribución espacial del alga en la columna vertical se ve modificada por el efecto del parasitismo, localizándose la mayor parte de los cenobios infectados a un metro de profundidad (81 % de la iluminación superficial).A study of chytrid infection on a wild phytoplankton population of the colonial species Fotterella tetrachlorelloides (Chlorophyceae, Oocystaceae) living in an eutrophic reservoir (El Vellón, Madrid) during the stagnation period has been undertaken. A dramatic decay of the Fotterella population was seen in connection with fungal development on it, as well as a diminishing number of algal cells per colony. Parasitic fungi peaked as host population stopped growing, fungal resting stages beginning to develop at the same time. Fotterella's water column distribution was partly an effect of the parasitic process, most of the infected colonies laying at the 1 m depth layer (81 % of surface irradiance)

Correction to : Complex multiple risk intervention to promote healthy behaviours in people between 45 to 75 years attended in primary health care (EIRA study): study protocol for a hybrid trial

UDTRIA

Complex multiple risk intervention to promote healthy behaviours in people between 45 to 75 years attended in primary health care (EIRA study) : study protocol for a hybrid trial

Health promotion is a key process of current health systems. Primary Health Care (PHC) is the ideal setting for health promotion but multifaceted barriers make its integration difficult in the usual care. The majority of the adult population engages two or more risk behaviours, that is why a multiple intervention might be more effective and efficient. The primary objectives are to evaluate the effectiveness, the cost-effectiveness and an implementation strategy of a complex multiple risk intervention to promote healthy behaviours in people between 45 to 75 years attended in PHC. This study is a cluster randomised controlled hybrid type 2 trial with two parallel groups comparing a complex multiple risk behaviour intervention with usual care. It will be carried out in 26 PHC centres in Spain. The study focuses on people between 45 and 75 years who carry out two or more of the following unhealthy behaviours: tobacco use, low adherence to the Mediterranean dietary pattern or insufficient physical activity level. The intervention is based on the Transtheoretical Model and it will be made by physicians and nurses in the routine care of PHC practices according to the conceptual framework of the "5A's". It will have a maximum duration of 12 months and it will be carried out to three different levels (individual, group and community). Incremental cost per quality-adjusted life year gained measured by the tariffs of the EuroQol-5D questionnaire will be estimated. The implementation strategy is based on the "Consolidated Framework for Implementation Research", a set of discrete implementation strategies and an evaluation framework. EIRA study will determine the effectiveness and cost-effectiveness of a complex multiple risk intervention and will provide a better understanding of implementation processes of health promotion interventions in PHC setting. It may contribute to increase knowledge about the individual and structural barriers that affect implementation of these interventions and to quantify the contextual factors that moderate the effectiveness of implementation. , .Retrospectively registered on May 2, 2017

Global attitudes in the management of acute appendicitis during COVID-19 pandemic: ACIE Appy Study

Background: Surgical strategies are being adapted to face the COVID-19 pandemic. Recommendations on the management of acute appendicitis have been based on expert opinion, but very little evidence is available. This study addressed that dearth with a snapshot of worldwide approaches to appendicitis. Methods: The Association of Italian Surgeons in Europe designed an online survey to assess the current attitude of surgeons globally regarding the management of patients with acute appendicitis during the pandemic. Questions were divided into baseline information, hospital organization and screening, personal protective equipment, management and surgical approach, and patient presentation before versus during the pandemic. Results: Of 744 answers, 709 (from 66 countries) were complete and were included in the analysis. Most hospitals were treating both patients with and those without COVID. There was variation in screening indications and modality used, with chest X-ray plus molecular testing (PCR) being the commonest (19\ub78 per cent). Conservative management of complicated and uncomplicated appendicitis was used by 6\ub76 and 2\ub74 per cent respectively before, but 23\ub77 and 5\ub73 per cent, during the pandemic (both P < 0\ub7001). One-third changed their approach from laparoscopic to open surgery owing to the popular (but evidence-lacking) advice from expert groups during the initial phase of the pandemic. No agreement on how to filter surgical smoke plume during laparoscopy was identified. There was an overall reduction in the number of patients admitted with appendicitis and one-third felt that patients who did present had more severe appendicitis than they usually observe. Conclusion: Conservative management of mild appendicitis has been possible during the pandemic. The fact that some surgeons switched to open appendicectomy may reflect the poor guidelines that emanated in the early phase of SARS-CoV-2

Evaluation of a quality improvement intervention to reduce anastomotic leak following right colectomy (EAGLE): pragmatic, batched stepped-wedge, cluster-randomized trial in 64 countries

Background Anastomotic leak affects 8 per cent of patients after right colectomy with a 10-fold increased risk of postoperative death. The EAGLE study aimed to develop and test whether an international, standardized quality improvement intervention could reduce anastomotic leaks. Methods The internationally intended protocol, iteratively co-developed by a multistage Delphi process, comprised an online educational module introducing risk stratification, an intraoperative checklist, and harmonized surgical techniques. Clusters (hospital teams) were randomized to one of three arms with varied sequences of intervention/data collection by a derived stepped-wedge batch design (at least 18 hospital teams per batch). Patients were blinded to the study allocation. Low- and middle-income country enrolment was encouraged. The primary outcome (assessed by intention to treat) was anastomotic leak rate, and subgroup analyses by module completion (at least 80 per cent of surgeons, high engagement; less than 50 per cent, low engagement) were preplanned. Results A total 355 hospital teams registered, with 332 from 64 countries (39.2 per cent low and middle income) included in the final analysis. The online modules were completed by half of the surgeons (2143 of 4411). The primary analysis included 3039 of the 3268 patients recruited (206 patients had no anastomosis and 23 were lost to follow-up), with anastomotic leaks arising before and after the intervention in 10.1 and 9.6 per cent respectively (adjusted OR 0.87, 95 per cent c.i. 0.59 to 1.30; P = 0.498). The proportion of surgeons completing the educational modules was an influence: the leak rate decreased from 12.2 per cent (61 of 500) before intervention to 5.1 per cent (24 of 473) after intervention in high-engagement centres (adjusted OR 0.36, 0.20 to 0.64; P &lt; 0.001), but this was not observed in low-engagement hospitals (8.3 per cent (59 of 714) and 13.8 per cent (61 of 443) respectively; adjusted OR 2.09, 1.31 to 3.31). Conclusion Completion of globally available digital training by engaged teams can alter anastomotic leak rates. Registration number: NCT04270721 (http://www.clinicaltrials.gov)