[Interlevel incident management: The experience of a primary care district]. / Gestión de incidencias interniveles. La experiencia de un distrito de atención primaria.

AIM: Determine the prevalence and define the profile of interlevel incidences (ININ) between primary care (PC) and hospital (HC). DESIGN: Multicenter cross-sectional descriptive study. SITE: Primary care. PARTICIPANTS: Professionals from a Health District and its reference hospitals. INTERVENTIONS: ININ are errors in communication between PC and HC professionals derived from administrative, pharmaceutical or clinical procedures not resolved during the formal interlevel communication processes, which requires a coordinated and validated response from the health care directions to not overload the family physician. MAIN MEASUREMENTS: ININ by category, hospital services and health centers, total and validated, relative to the total number of referrals, and the reason for the ININ. RESULTS: We detected 2011 ININs (3.36%) among the 59.859 referrals, although only 1684 were validated (83.7%). Most were administrative (59.5%), followed by pharmaceutical (24.2%), clinical (10.2%) and reverse (6.1%). 41.3% of the clinical ININs were grouped around 5 hospital specialties, and 45.9% in 5 health centers. The main reasons for clinical ININ were non-prescription of the recommended pharmacological treatment in outpatient clinics or on hospital discharge (27.3%), request for referral to another hospital specialist (27.9%), or request to referral in person to patients who had already been referred by teleconsultation (17.8%). CONCLUSIONS: 3.36% of interlevel referrals are accompanied by incidents and 83.7% are validated and processed. It is necessary to develop ININ management tools to guarantee safe healthcare and debureaucratize PC.

Scale-free chaos in the confined Vicsek flocking model.

The Vicsek model encompasses the paradigm of active dry matter. Motivated by collective behavior of insects in swarms, we have studied finite-size effects and criticality in the three-dimensional, harmonically confined Vicsek model. We have discovered a phase transition that exists for appropriate noise and small confinement strength. On the critical line of confinement versus noise, swarms are in a state of scale-free chaos characterized by minimal correlation time, correlation length proportional to swarm size and topological data analysis. The critical line separates dispersed single clusters from confined multicluster swarms. Scale-free chaotic swarms occupy a compact region of space and comprise a recognizable "condensed" nucleus and particles leaving and entering it. Susceptibility, correlation length, dynamic correlation function, and largest Lyapunov exponent obey power laws. The critical line and a narrow criticality region close to it move simultaneously to zero confinement strength for infinitely many particles. At the end of the first chaotic window of confinement, there is another phase transition to infinitely dense clusters of finite size that may be termed flocking black holes.

CT differentiation of fat-poor angiomyolipomas from papillary renal cell carcinomas: development of a predictive model.

PURPOSE: To identify specific contrast-enhanced CT (CECT) findings and develop a predictive model with logistic regression to differentiate fat-poor angiomyolipomas (fpAML) from papillary renal cell carcinomas (pRCC). METHODS: This is a single-institution retrospective study that assess CT features of histologically proven 67 pRCC and 13 fpAML. CECT variables were studied by means of univariate logistic regression. Variables included patients' demographics, tumor attenuation (unenhanced and at arterial, venous and excretory post-contrast phases), type of enhancement, morphological features (axial long and short diameters, long-short axis ratio (LSR) and tumor to kidney angle interface) and presence of visible calcifications or vessels. Those variables with a p ≤ 0.05 underwent standard stepwise logistic regression to find predictive combinations of clinical variables. Best models were evaluated by AUROC curves and were subjected to Leave-one-out cross validation to assess their robustness. RESULTS: Odds ratio (OR) between pRCC and fpAML was statistically significant for patient's gender, tumor attenuation in arterial, venous and excretory phases, tumor's long diameter, short diameter, LSR, type of enhancement, presence of intratumoral vessels and tumor-kidney angle interface. The best predictive model resulted in an area under the curve (AUC) of 0.971 and included gender, tumor-kidney angle interface and venous attenuation with the following equation: Log(p/1 - p) = - 2.834 + 4.052 * gender + - 0.066 * AngleInterface + 0.074 * VenousphaseHU. CONCLUSIONS: The combination of patients' gender, tumor to kidney angle interface and venous enhancement helps to distinguish fpAML from pRCC.

Efectividad del Decálogo de prevención cardiovascular en diabéticos / Effectiveness of a Decalogue for cardiovascular prevention in diabetics

INTRODUCCIÓN: Evaluar la efectividad en conocimiento, percepción de control y mejora del riesgo cardiovascular (RCV) mediante la entrega de un Decálogo visual. MATERIAL Y MÉTODOS: Ensayo clínico de intervención educativa, no farmacológico, con grupo control paralelo, aleatorizado, evaluado a ciegas, en pacientes diabéticos tipo 2, realizado en Atención Primaria de Salud. Ambos grupos recibieron una intervención educativa sobre RCV y su grado de control, y el de intervención además un Decálogo visual con los factores de RCV modificables que reflejaba visualmente su grado de control. Incluimos 50 pacientes en cada grupo para detectar una mejora del conocimiento multifactorial del RCV del 50%. Todos los pacientes recibieron un recuerdo telefónico a los 2 meses, evaluando enmascaradamente el conocimiento y la percepción de control del RCV, y al cabo de 6 meses se evaluó de nuevo presencialmente el conocimiento y el control real del RCV. RESULTADOS: Seleccionamos 51 hombres y 49 mujeres, de 62,9 años de edad media, 9,2 años de evolución y escaso nivel educativo (32% sin estudios y 52% estudios primarios). Basalmente, el conocimiento, la percepción y el control del RCV fueron del 55,0, 80,4 y 65,9%, respectivamente. A los 2 meses, el conocimiento aumentó en el grupo del Decálogo un 16,5% más que en el grupo de educación convencional (73,6% vs. 63,2%; p < 0,05); la percepción sobreestimada de control mejoró un 34,5% en el total de la muestra (p < 0,001) sin diferencias entre grupos, aunque mejoró más la concordancia en el grupo del Decálogo. A los 6 meses aumentó el conocimiento globalmente en un 25,6% (p < 0,001), desapareciendo las diferencias iniciales entre grupos. El control final del RCV aumentó globalmente y en el grupo del Decálogo en un 6,4% (p < 0,005) y un 9,4% (p < 0,001), respectivamente. El riesgo SCORE disminuyó significativamente de forma global y en ambos grupos, sin diferencias entre ambos. CONCLUSIONES: La intervención educativa mejora globalmente el conocimiento, la percepción y el control del RCV. El Decálogo de RCV incrementa rápidamente el conocimiento y disminuye la falsa percepción subjetiva de control del RCV, aunque el beneficio se equipara a los 6 meses si las intervenciones educativas persisten

INTRODUCTION: To assess the effects of a visual Decalogue aid on the degree of knowledge, control perception and improvement in cardiovascular risk factors (CVRF). MATERIAL AND METHODS: A Primary care randomised non-pharmacological trial of an educational intervention with a parallel control group, and blind evaluation in type 2 diabetic patients. Both groups received an educational intervention on the management of CVRF. The intervention group also received a visual Decalogue aid that showed the level of control patients have over the modifiable CVRF. A total of 50 patients were included in each group in order to identify an improvement of 50% in the multifactorial knowledge of CVRF. All patients received a reminder telephone call at 2 months, with masked evaluation of knowledge and CVRF control perception. In a 6 months visit the level of knowledge and real control of CVRF were re-evaluated. RESULTS: The study included 51 males and 49 females, with mean age of 62.9 years, a mean disease duration of 9.2 years, and low educational level. The level of knowledge, control perception, and real control at baseline was 55%, 80.4%, and 65.9%, respectively. After 2 months the level of knowledge in the Decalogue group increased by 16.5% more than in the conventional education group (73.6% vs. 63.2%; P < .05) and the overestimated control perception improved by 34.5% (P < .001) with no differences between groups, although concordance was better in the Decalogue group. At 6 months there was an overall increase 25.6% (P < .001) in the level of knowledge, with the previous difference between groups levelling off. The final CVRF control improved overall and in the Decalogue group by 6.4% (P < .005) and 9.4% (P < .001), respectively. The SCORE risk significantly decreased overall with no differences between groups. CONCLUSIONS: The educational intervention improves the overall level of knowledge, perception and control of CVRF. The CVRF Decalogue quickly increases the level of knowledge, and decreases the false subjective risk control perception. The benefit, however, becomes equal at 6 months with ongoing education interventions

[Effectiveness of a Decalogue for cardiovascular prevention in diabetics]. / Efectividad del Decálogo de prevención cardiovascular en diabéticos.

INTRODUCTION: To assess the effects of a visual Decalogue aid on the degree of knowledge, control perception and improvement in cardiovascular risk factors (CVRF). MATERIAL AND METHODS: A Primary care randomised non-pharmacological trial of an educational intervention with a parallel control group, and blind evaluation in type 2 diabetic patients. Both groups received an educational intervention on the management of CVRF. The intervention group also received a visual Decalogue aid that showed the level of control patients have over the modifiable CVRF. A total of 50 patients were included in each group in order to identify an improvement of 50% in the multifactorial knowledge of CVRF. All patients received a reminder telephone call at 2 months, with masked evaluation of knowledge and CVRF control perception. In a 6 months visit the level of knowledge and real control of CVRF were re-evaluated. RESULTS: The study included 51 males and 49 females, with mean age of 62.9 years, a mean disease duration of 9.2 years, and low educational level. The level of knowledge, control perception, and real control at baseline was 55%, 80.4%, and 65.9%, respectively. After 2 months the level of knowledge in the Decalogue group increased by 16.5% more than in the conventional education group (73.6% vs. 63.2%; P<.05) and the overestimated control perception improved by 34.5% (P<.001) with no differences between groups, although concordance was better in the Decalogue group. At 6 months there was an overall increase 25.6% (P<.001) in the level of knowledge, with the previous difference between groups levelling off. The final CVRF control improved overall and in the Decalogue group by 6.4% (P<.005) and 9.4% (P<.001), respectively. The SCORE risk significantly decreased overall with no differences between groups. CONCLUSIONS: The educational intervention improves the overall level of knowledge, perception and control of CVRF. The CVRF Decalogue quickly increases the level of knowledge, and decreases the false subjective risk control perception. The benefit, however, becomes equal at 6 months with ongoing education interventions.

Intervalos de referencia de la tirotropina durante la gestación en la provincia de Huelva / Thyrotropin reference ranges during pregnancy in the province of Huelva, Spain

Objetivo: El diagnóstico correcto de hipotiroidismo gestacional requiere determinar los intervalos de referencia trimestrales locales de la TSH. En su ausencia las guías recomiendan utilizar como límites superiores 2,5-3,0-3,0μU/ml para el 1.°-2.°-3.° trimestre. Nuestro objetivo es calcular el rango de referencia para nuestra población. Material y métodos: Estudio observacional de base poblacional realizado en gestantes sanas de 11 centros de salud de la provincia de Huelva incluidas consecutivamente durante el año 2016 en el proceso de embarazo. Excluimos las gestantes con antecedentes de enfermedad tiroidea o médica, malos antecedentes obstétricos, embarazo gemelar, autoinmunidad tiroidea y TSH en valores extremos (<0,4μU/ml o>10μU/ml), así como las que durante el estudio iniciaron tratamiento con levotiroxina por disfunción tiroidea. Resultados: Seleccionamos 186 gestantes de 30,7 años (IC 95%: 29,8-31,6) e IMC de 23,6 (IC 95%: 23,2-24,0) que mayoritariamente se hicieron la 1.ª analítica con anterioridad a la 11.ª semana de gestación. Fueron válidas para el análisis 145-105-67 gestantes en el 1.°-2.°-3.° trimestre, respectivamente, tras excluir sucesivamente abortos (18,9%), autoinmunidad (6,5%), hipo/hipertiroidismos (2,2%) y tratamientos con levotiroxina durante el 2.°/3.° trimestre (18,6%). El percentil 97,5 de la TSH para el 1.°-2.°-3.° trimestre, respectivamente, fue de 4,68-4,83-4,57μU/ml. Durante el estudio se detectaron 80 gestantes con disfunción tiroidea (55,2%), recibiendo 33 de ellas tratamiento con levotiroxina (22,7%); con los nuevos criterios la prevalencia de disfunción tiroidea se reduciría al 6,2% y la necesidad de tratamiento al 4,1%. Conclusión: El rango de normalidad de TSH de nuestra población difiere del propuesto en las guías. Un 18,6% de las gestantes fueron tratadas innecesariamente

Objective: The correct diagnosis of hypothyroidism during pregnancy requires knowledge of the local trimester-specific thyrotropin (TSH) reference ranges. When these are not available, the guidelines recommend upper limits of 2.5, 3.0, and 3.0μU/ml for the 1st, 2nd, and 3rd trimesters, respectively. The aim is to establish the reference range for our local population. Material and methods: A population-based observational study was performed on healthy pregnant women from 11 healthcare centres in the province of Huelva. Women were recruited consecutively during 2016 through the pregnancy process. Women were excluded who had a history of thyroid or medical disease, a poor obstetric history, multiple pregnancy, thyroid autoimmunity, and extreme TSH values (<0.4μU/ml or>10μU/ml), as well as women treated with levothyroxine for thyroid dysfunction. Results: The study included a total of 186 pregnant women, with a mean age of 30.7 years (95% CI: 29.8-31.6) and a body mass index (BMI) of 23.6 (95% CI: 23.2-24.0). Most of them had the first laboratory tests performed before week 11 of pregnancy. Valid subjects for analysis were 145, 105, and 67 pregnant women in the 1st, 2nd, and 3rd trimesters, respectively, after excluding those due to abortion (18.9%), autoimmunity (6.5%), hypo/hyperthyroidism (2.2%), and levothyroxine treatment during the 2nd/3rd trimester (18.6%). The 97.5% TSH percentile for the 1st, 2nd, and 3rd trimester was 4.68, 4.83, and 4.57μU/ml, respectively. Thyroid dysfunction was identified in 80 women (55.2%), 33 of whom received treatment with Levothyroxine (22.7%). With the new criteria, thyroid dysfunction prevalence would be reduced to 6.2%, and the need for treatment to 4.1%. Conclusion: The reference range for TSH in our population differs from that proposed by the guidelines. Unnecessary treatment was being given to 18.6% of pregnant women

[Thyrotropin reference ranges during pregnancy in the province of Huelva, Spain]. / Intervalos de referencia de la tirotropina durante la gestación en la provincia de Huelva.

OBJECTIVE: The correct diagnosis of hypothyroidism during pregnancy requires knowledge of the local trimester-specific thyrotropin (TSH) reference ranges. When these are not available, the guidelines recommend upper limits of 2.5, 3.0, and 3.0µU/ml for the 1st, 2nd, and 3rd trimesters, respectively. The aim is to establish the reference range for our local population. MATERIAL AND METHODS: A population-based observational study was performed on healthy pregnant women from 11 healthcare centres in the province of Huelva. Women were recruited consecutively during 2016 through the pregnancy process. Women were excluded who had a history of thyroid or medical disease, a poor obstetric history, multiple pregnancy, thyroid autoimmunity, and extreme TSH values (<0.4µU/ml or>10µU/ml), as well as women treated with levothyroxine for thyroid dysfunction. RESULTS: The study included a total of 186 pregnant women, with a mean age of 30.7 years (95% CI: 29.8-31.6) and a body mass index (BMI) of 23.6 (95% CI: 23.2-24.0). Most of them had the first laboratory tests performed before week 11 of pregnancy. Valid subjects for analysis were 145, 105, and 67 pregnant women in the 1st, 2nd, and 3rd trimesters, respectively, after excluding those due to abortion (18.9%), autoimmunity (6.5%), hypo/hyperthyroidism (2.2%), and levothyroxine treatment during the 2nd/3rd trimester (18.6%). The 97.5% TSH percentile for the 1st, 2nd, and 3rd trimester was 4.68, 4.83, and 4.57µU/ml, respectively. Thyroid dysfunction was identified in 80 women (55.2%), 33 of whom received treatment with Levothyroxine (22.7%). With the new criteria, thyroid dysfunction prevalence would be reduced to 6.2%, and the need for treatment to 4.1%. CONCLUSION: The reference range for TSH in our population differs from that proposed by the guidelines. Unnecessary treatment was being given to 18.6% of pregnant women.

Development of a QuEChERS-based extraction method for the determination of destruxins in potato plants by UHPLC-MS/MS.

Ultra high performance liquid chromatography-tandem mass spectrometry (UHPLC-MS/MS) with electrospray ionization has been proposed for the determination of fifteen natural destruxins (A, B, C, D, E, Ed, Ed1, A2, B2, D2, E2, Cl, DesmA, DesmB, and DH-A), secondary metabolites with insecticidal and phytotoxic activities produced by Metarhizium species fungus, which are being studied as biological agents in pest control. Therefore, procedures to control them in the food chain are required, starting with crops. As a consequence, in this study, a simple QuEChERS-based destruxin (dtx) extraction procedure has been developed and validated in four different parts of potato plant (tuber, root, stem and leaves) for the first time. For dtx A, the limits of detection obtained, ranged between 0.5 and 1.3 µg/kg, and for quantification, ranged between 1.7 and 4.2 µg/kg. Precision values were below 8.5%; and in all cases, recoveries were higher than 91%. Finally, the method has been applied in potato samples inoculated by EAMa 01/58-Su strain, where dtxs A and B were detected and quantified. In all cases, dtx B concentration was higher than dtx A.

Theory of force-extension curves for modular proteins and DNA hairpins.

We study a model describing the force-extension curves of modular proteins, nucleic acids, and other biomolecules made out of several single units or modules. At a mesoscopic level of description, the configuration of the system is given by the elongations of each of the units. The system free energy includes a double-well potential for each unit and an elastic nearest-neighbor interaction between them. Minimizing the free energy yields the system equilibrium properties whereas its dynamics is given by (overdamped) Langevin equations for the elongations, in which friction and noise amplitude are related by the fluctuation-dissipation theorem. Our results, both for the equilibrium and the dynamical situations, include analytical and numerical descriptions of the system force-extension curves under force or length control and agree very well with actual experiments in biomolecules. Our conclusions also apply to other physical systems comprising a number of metastable units, such as storage systems or semiconductor superlattices.

Differential growth of wrinkled biofilms.

Biofilms are antibiotic-resistant bacterial aggregates that grow on moist surfaces and can trigger hospital-acquired infections. They provide a classical example in biology where the dynamics of cellular communities may be observed and studied. Gene expression regulates cell division and differentiation, which affect the biofilm architecture. Mechanical and chemical processes shape the resulting structure. We gain insight into the interplay between cellular and mechanical processes during biofilm development on air-agar interfaces by means of a hybrid model. Cellular behavior is governed by stochastic rules informed by a cascade of concentration fields for nutrients, waste, and autoinducers. Cellular differentiation and death alter the structure and the mechanical properties of the biofilm, which is deformed according to Föppl-Von Kármán equations informed by cellular processes and the interaction with the substratum. Stiffness gradients due to growth and swelling produce wrinkle branching. We are able to reproduce wrinkled structures often formed by biofilms on air-agar interfaces, as well as spatial distributions of differentiated cells commonly observed with B. subtilis.

Evaluation of phenylene-bridged periodic mesoporous organosilica as a stationary phase for solid phase extraction.

A periodic mesoporous organosilica, in particular, a phenylene-bridged material (Ph-PMO), was evaluated for the first time as a sorbent for retaining and eluting fenuron, simazine, atrazine, carbaryl and terbutryn in grape must by solid phase extraction (SPE) prior to their determination with capillary electrophoresis coupled with ultraviolet detection (CE-UV). The analytes were used as model compounds to demonstrate the potential of Ph-PMO for increasing the sensitivity of CE. Under optimal conditions, the limits of detection for the analytes ranged from 0.6 to 4 µg/L, and their limits of quantitation from 2 to 10 µg/L. These values were comparable and, in some cases, even better than those obtained with C18 and HLB materials. Ph-PMO was characterized physicochemically by X-ray diffraction analysis, N2 adsorption-desorption measurements and laser diffraction particle sizing. The sorbent afforded the extraction of atrazine, carbaryl and terbutryn from grape must with mean recoveries ranging from 86 to 105%. Therefore, periodic mesoporous organosilicas possess a high potential as SPE materials.

Sawtooth patterns in force-extension curves of biomolecules: an equilibrium-statistical-mechanics theory.

We analyze the force-extension curve for a general class of systems, which are described at the mesoscopic level by a free energy depending on the extension of its components. Similarly to what is done in real experiments, the total length of the system is the controlled parameter. This imposes a global constraint in the minimization procedure leading to the equilibrium values of the extensions. As a consequence, the force-extension curve has multiple branches in a certain range of forces. The stability of these branches is governed by the free energy: there are a series of first-order phase transitions at certain values of the total length, in which the free energy itself is continuous but its first derivative, the force, has a finite jump. This behavior is completely similar to that observed in real experiments with biomolecules like proteins and with other complex systems.

Evaluation of hippuric acid content in goat milk as a marker of feeding regimen.

Organic producers, traders, and consumers must address 2 issues related to milk: authentication of the production system and nutritional differentiation. The presence of hippuric acid (HA) in goat milk samples has been proposed as a possible marker to differentiate the feeding regimen of goats. The objective of this work is to check the hypothesis that HA could be a marker for the type of feeding regimen of goats by studying the influence of production system (conventional or organic) and feeding regimen (with or without grazing fodder). With this purpose, commercial cow and goat milk samples (n=27) and raw goat milk samples (n=185; collected from different breeds, localizations, and dates) were analyzed. Samples were grouped according to breed, feeding regimen, production system, and origin to compare HA content by ANOVA and honestly significant difference Tukey test at a confidence level of ≥95%. Hippuric acid content was obtained by analyzing milk samples with capillary electrophoresis. This method was validated by analyzing part of the samples with HPLC as a reference technique. Sixty-nine raw goat milk samples (of the total 158 samples analyzed in this work) were quantified by capillary electrophoresis. In these samples, the lowest average content for HA was 7±3 mg/L. This value corresponds to a group of conventional raw milk samples from goats fed with compound feed. The highest value of this group was 28±10 mg/L, corresponding to goats fed compound feed plus grass. Conversely, for organic raw goat milk samples, the highest concentration was 67±14 mg/L, which corresponds to goats fed grass. By contrast, the lowest value of this organic group was 26±10 mg/L, which belongs to goats fed organic compounds. Notice that the highest HA average content was found in samples from grazing animals corresponding to the organic group. This result suggests that HA is a good marker to determine the type of goats feeding regimen; a high content of HA represents a diet based mainly or exclusively on eating green grass (grazing), independently of the production system. Hence, this marker would not be useful for the actual organic policies to distinguish organic milk under the current regulations, because organic dairy ruminants can be fed organic compound feed and conserved fodder without grazing at all.

Spin-oscillator model for the unzipping of biomolecules by mechanical force.

A spin-oscillator system models unzipping of biomolecules (such as DNA, RNA, or proteins) subject to an external force. The system comprises a macroscopic degree of freedom, represented by a one-dimensional oscillator, and internal degrees of freedom, represented by Glauber spins with nearest-neighbor interaction and a coupling constant proportional to the oscillator position. At a critical value F(c) of an applied external force F, the oscillator rest position (order parameter) changes abruptly and the system undergoes a first-order phase transition. When the external force is cycled at different rates, the extension given by the oscillator position exhibits a hysteresis cycle at high loading rates, whereas it moves reversibly over the equilibrium force-extension curve at very low loading rates. Under constant force, the logarithm of the residence time at the stable and metastable oscillator rest position is proportional to F-F(c) as in an Arrhenius law.

Ripples in a string coupled to Glauber spins.

Each oscillator in a linear chain (a string) interacts with a local Ising spin in contact with a thermal bath. These spins evolve according to Glauber dynamics. Below a critical temperature, there appears an equilibrium, time-independent, rippled state in the string that is accompanied by a nonzero spin polarization. On the other hand, the system is shown to form "metastable," nonequilibrium long-lived ripples in the string for slow spin relaxation. The system vibrates rapidly about these quasistationary states, which can be described as snapshots of a coarse-grained stroboscopic map. For moderate observation times, ripples are observed irrespective of the final thermodynamically stable state (rippled or not). Interestingly, the system can be considered as a "minimal" model to understand rippling in clamped graphene sheets.

Biofilm growth on rugose surfaces.

A stochastic model is used to assess the effect of external parameters on the development of submerged biofilms on smooth and rough surfaces. The model includes basic cellular mechanisms, such as division and spreading, together with an elementary description of the interaction with the surrounding flow and probabilistic rules for extracellular polymeric substance matrix generation, cell decay, and adhesion. Insight into the interplay of competing mechanisms such as the flow or the nutrient concentration change is gained. Erosion and growth processes combined produce biofilm structures moving downstream. A rich variety of patterns are generated: shrinking biofilms, patches, ripplelike structures traveling downstream, fingers, mounds, streamerlike patterns, flat layers, and porous and dendritic structures. The observed regimes depend on the carbon source and the type of bacteria.

Communication gaps in knowledge of freshwater fish biodiversity: implications for the management and conservation of Mexican biosphere reserves.

To detect differences in the information available on freshwater fish species found in Mexican biosphere reserves, the number of species considered in three sources of information: management programmes, Global Biodiversity Information Facility (GBIF) and the scientific literature were compared. Additionally, management actions for the reserves were evaluated. More than 55% of freshwater fish species registered for the reserves were found only in one of the three sources of information, while just 12% was shared among all the three. Fifteen threatened species were registered in GBIF and the scientific literature that were not found in management programmes. Although all the management programmes described conservation actions, none of them gave details about how they would be implemented. Lack of communication among the sources studied, unawareness of the existence of threatened species and the absence of detailed management actions hinder the development of adequate conservation strategies.

The association of host age and gender with inflammation around neurocysticercosis cysts.

The results of previous investigations indicate that age and gender may influence the strength of the human host's immune response to infection of the central nervous system with the larvae of Taenia solium. Most of the relevant research on such neurocysticercosis (NCC) has, however, been conducted on hospital-based samples in developing countries, where differential access to healthcare may bias the study results. Using data from 171 NCC patients participating in a treatment trial, the associations of patient age and gender with the presence of inflammation around NCC cysts (i.e. cysts in the transitional phase) have recently been explored, after controlling for measures of economic and geographical access to healthcare. Data on cysts were collected from computed-tomography or magnetic-resonance images taken at four time-points, from baseline to 12-months post-treatment. The odds of having transitional cysts were evaluated by logistic regression whereas Poisson regression was used to explore the numbers of transitional cysts, with generalised estimating equations (GEE) used to account for the multiple observations over time. After controlling for healthcare access, the odds of having transitional cysts were found to be 1.5-fold higher for the female patients than for the male, although this association was not statistically significant (P = 0.136). In the Poisson model, however, the number of transitional cysts was found to be 1.8-fold higher in the female patients than in the male, and this gender effect was not only statistically significant (P = 0.002) but also constant over time. The association of host age with transitional cysts was more complicated, with significant interaction between age and time. It therefore appears that there are significant gender and age differences in the local immune response to NCC, even after adjusting for differences in healthcare access.

Effects of albendazole treatment on neurocysticercosis: a randomised controlled trial.

AIM: The aim of this trial was to evaluate the effects of albendazole (ALB) on cyst disappearance, reduction of the number of cysts and seizure recurrence. METHODS: 178 patients with new onset symptoms due to active or transitional neurocysticercosis were randomly assigned to receive either 800 mg of ALB daily or placebo for 8 days. All patients also received prednisone. Imaging studies were done at baseline and at months 1, 6 and 12 of follow-up. RESULTS: Active cysts were identified in 59 of 88 people randomised to ALB and 57 of the 90 in the placebo arm. By 1 month, 31% were free of active cysts in the treatment group compared with 7% in the placebo group (p = 0.001). In addition, the ALB group had a greater reduction in the number of active cysts compared with the placebo group (p = 0.001). After 1 month following treatment there was no additional gain by treatment group in the disappearance or reduction in the number of active cysts. ALB treatment had little effect on cysts in the transitional or calcification stage. We found no difference between the ALB and placebo groups in symptoms during treatment or in seizure recurrence during the 12 months after treatment. CONCLUSION: Albendazole plus symptomatic treatment leads to the disappearance of active cysts in 31% of patients compared with 7% of those with symptomatic treatment alone. This treatment effect occurs within the first 30 days after treatment. TRIAL REGISTRATION NUMBER: NCT00283699.

Asymptotic construction of pulses in the discrete Hodgkin-Huxley model for myelinated nerves.

A quantitative description of pulses and wave trains in the spatially discrete Hodgkin-Huxley model for myelinated nerves is given. Predictions of the shape and speed of the waves and the thresholds for propagation failure are obtained. Our asymptotic predictions agree quite well with numerical solutions of the model and describe wave patterns generated by repeated firing at a boundary.