Modelling the coupling of the M-clock and C-clock in lymphatic muscle cells.

Chronic dysfunction of the lymphatic vascular system results in fluid accumulation between cells: lymphoedema. The condition is commonly acquired secondary to diseases such as cancer or the associated therapies. The primary driving force for fluid return through the lymphatic vasculature is provided by contractions of the muscularized lymphatic collecting vessels, driven by electrochemical oscillations. However, there is an incomplete understanding of the molecular and bioelectric mechanisms involved in lymphatic muscle cell excitation, hampering the development and use of pharmacological therapies. Modelling in silico has contributed greatly to understanding the contributions of specific ion channels to the cardiac action potential, but modelling of these processes in lymphatic muscle remains limited. Here, we propose a model of oscillations in the membrane voltage (M-clock) and intracellular calcium concentrations (C-clock) of lymphatic muscle cells. We modify a model by Imtiaz and colleagues to enable the M-clock to drive the C-clock oscillations. This approach differs from typical models of calcium oscillators in lymphatic and related cell types, but is required to fit recent experimental data. We include an additional voltage dependence in the gating variable control for the L-type calcium channel, enabling the M-clock to oscillate independently of the C-clock. We use phase-plane analysis to show that these M-clock oscillations are qualitatively similar to those of a generalised FitzHugh-Nagumo model. We also provide phase plane analysis to understand the interaction of the M-clock and C-clock oscillations. The model and methods have the potential to help determine mechanisms and find targets for pharmacological treatment of lymphoedema.

Contribution to the knowledge of Limoniidae (Diptera: Tipuloidea): first records of 244 species from various European countries.

Background: Limoniidae is one of the most species-rich Dipteran families, with 661 reported species in Europe. Despite the fact that the European limoniid crane fly fauna has been studied ever since Carolus Linnaeus, it is still poorly known. New information: In this study, we summarise the taxonomic and faunistic studies of European Limoniidae, which described new species and reported first country records, between 2010 and 2020. We also report occurrence data of 244 Limoniidae species which represent the first country records or conformational records from various European countries, as we report ten species from Albania, one from Austria, thirty-seven from Belarus, five from Belgium, two from Bulgaria, two from Estonia, six from Finland, seven from France, fourteen from Greece, sixteen from Hungary, two from Iceland, six from Italy, ten from Latvia, one from Malta, nine from Montenegro, two from The Netherlands, ten from North Macedonia, forty-two from Norway, one from Poland, five from Portugal, twenty from Romania, thirty-eight from Serbia, six from Slovenia, five from Spain and seven species from Sweden for the first time. From the European territory of Russia, we report twenty-eight species from Central European Russia, seventy-two from East European Russia, fifteen from North European Russia, one from Northwest European Russia and seven from North Caucasus for the first time. Confirmatory records and corrigenda are also included.

Olbiogaster Osten Sacken (Diptera: Anisopodidae) from Mexico, with the description of three new species.

Three new species of the genus Olbiogaster Osten Sacken-Olbiogaster halffteri sp. nov., Olbiogaster nuxco sp. nov. and Olbiogaster puuc sp. nov.-are described and illustrated from Mexico, based on adult males and females collected in the states of Guerrero, Puebla and Yucatan. Comments for the species known from Mexico and key are provided.

Risk factors for community-associated Clostridioides difficile infection in young children.

The majority of paediatric Clostridioides difficile infections (CDI) are community-associated (CA), but few data exist regarding associated risk factors. We conducted a case-control study to evaluate CA-CDI risk factors in young children. Participants were enrolled from eight US sites during October 2014-February 2016. Case-patients were defined as children aged 1-5 years with a positive C. difficile specimen collected as an outpatient or ⩽3 days of hospital admission, who had no healthcare facility admission in the prior 12 weeks and no history of CDI. Each case-patient was matched to one control. Caregivers were interviewed regarding relevant exposures. Multivariable conditional logistic regression was performed. Of 68 pairs, 44.1% were female. More case-patients than controls had a comorbidity (33.3% vs. 12.1%; P = 0.01); recent higher-risk outpatient exposures (34.9% vs. 17.7%; P = 0.03); recent antibiotic use (54.4% vs. 19.4%; P < 0.0001); or recent exposure to a household member with diarrhoea (41.3% vs. 21.5%; P = 0.04). In multivariable analysis, antibiotic exposure in the preceding 12 weeks was significantly associated with CA-CDI (adjusted matched odds ratio, 6.25; 95% CI 2.18-17.96). Improved antibiotic prescribing might reduce CA-CDI in this population. Further evaluation of the potential role of outpatient healthcare and household exposures in C. difficile transmission is needed.

Neotropical Copestylum Macquart (Diptera: Syrphidae) Breeding in Fruits and Flowers, Including 7 New Species.

Ten species of Copestylum (Diptera: Syrphidae) were reared from fruits and flowers in Costa Rica, Ecuador and Trinidad. Seven were new and in this paper, we describe them, their development sites and the third stage larva and/or the puparium of all ten species. One new synonym is proposed, Copestylum pinkusi (Curran) [= Copestylum cinctiventre (Curran)]. Similarities and differences between these new and other Copestylum species, suggest they separate into two groups, referred to as the Vagum and Cinctiventre species groups. Features characterising these groups for both adult and early stages are assessed. Each species was also distinguished using adult and early stage characters. Within the Vagum group, adults were more disparate morphologically than the larval stage; this was reversed in the Cinctiventre group. Adult colour patterns are probably cryptic in function and for disguise. Vagum species have disruptive marks, while the Cinctiventre species have reflective colours. Biologically, the groups are almost distinguished by larval development sites. Vagum species use predominantly fruits and have a larval stage that is relatively generalised in form and habit. Cinctiventre species are confined to developing in flowers and the larva is more specialised. A key to both adult and early stages of all ten species is provided.

Nematocera flies recorded in Serra do Courel, northwest Spain, May 2012 (Diptera: Anisopodidae, Blepharoceridae, Cylindrotomidae, Limoniidae, Pediciidae, Tipulidae and Trichoceridae) including descriptions of two new species of Limoniidae.

During May 2012 Diptera were sampled in the Serro do Courel area of Lugo Province, Galicia, northwest Spain. The authors of this paper, members of the Malloch Society (see website) are active in attempting to understand the detailed ecology of flies. Much of this work is through targeting larval stages often with an emphasis on saproxylic situations. By rearing adults from larvae direct relationships between them and their detailed habitat requirements are established. The list of nematocerous Diptera that were sampled includes 36 species two of them new to science and records of six others new to the Iberian peninsula are provided. We describe Lipsothrix galiciensis Hancock & Hewitt sp. nov., and Prionolabis pjotri Hancock sp. nov. of the family Limoniidae and provide a key to adults of European Lipsothrix species. Such results from this brief opportunity indicate the potential of the area for further field work in these and other families of Diptera. 

The syrphids of Serra do Courel, Northern Spain and description of a new Cheilosia Meigen species (Diptera: Syrphidae).

The syrphids (Syrphidae) of Serra do Courel, a mountainous locality of just over 20,000ha at the west end of the Cantabrian Mountains, northern Spain are poorly known. The Scottish based, Malloch Society visited the locality in May 2012 and collected a total of 462 specimens of 98 syrphid species and 36 genera. These represent the first syrphid records from Serra do Courel. The area has many meadows and small woodlands or 'soutos' and these habitats combined were the most productive, 69 spp. recorded. Cheilosia lucense Ricarte sp. nov. is described from Courel and compared with other species of the alpina group. Six other syrphid species were new to the Iberian Peninsula, three of which belong to the saproxylic genus, Brachyopa. In common with studies elsewhere in the Cantabrian Mountains, Cheilosia was the most diverse genus and 21 species were recorded. The syrphid fauna of the Cantabrian Mountains includes 203 species of which 24 are here added and a species checklist provided. 

Heavy alcohol use as a risk factor for severe outcomes among adults hospitalized with laboratory-confirmed influenza, 2005-2012.

We examined heavy alcohol use as a risk factor for severe influenza (intensive care admission or death) among hospitalized adults. In <65- and ≥65-year-olds, heavy alcohol use increased disease severity [relative risk (RR) 1.34; 95 % confidence interval (CI): 1.04-1.74, and RR 2.47; 95 % CI: 1.69-3.60, respectively]. Influenza vaccination and early, empiric antiviral treatment should be emphasized in this population.

Screening for the metabolic syndrome in community psychiatric patients prescribed antipsychotics: a quality improvement programme.

OBJECTIVE: The aim was to evaluate a quality improvement programme designed to increase screening for the metabolic syndrome in community psychiatric patients prescribed antipsychotics. METHOD: Baseline audit against evidence-based standards, followed by provision of benchmarked data and a range of change interventions, with re-audit 1 year later. RESULTS: At baseline, 48 assertive outreach teams across the UK submitted data on screening over the previous year for 1966 patients. At re-audit, 35 of the teams submitted data for 1516 patients. Screening for all four aspects of the metabolic syndrome (measuring blood pressure, obesity, blood glucose and plasma lipids) had increased significantly by re-audit. Clinical variables increasing the likelihood of full screening were clozapine treatment and a known diagnosis of diabetes or dyslipidaemia. CONCLUSION: The programme's success may be partly attributed to the use of a widely-accepted audit standard, and bespoke change interventions that directly addressed barriers to screening identified by the participating clinical teams.

Recommendations for the standardization and interpretation of the electrocardiogram: part I: the electrocardiogram and its technology a scientific statement from the American Heart Association Electrocardiography and Arrhythmias Committee, Council on Clinical Cardiology; the American College of Cardiology Foundation; and the Heart Rhythm Society endorsed by the International Society for Computerized Electrocardiology.

This statement examines the relation of the resting ECG to its technology. Its purpose is to foster understanding of how the modern ECG is derived and displayed and to establish standards that will improve the accuracy and usefulness of the ECG in practice. Derivation of representative waveforms and measurements based on global intervals are described. Special emphasis is placed on digital signal acquisition and computer-based signal processing, which provide automated measurements that lead to computer-generated diagnostic statements. Lead placement, recording methods, and waveform presentation are reviewed. Throughout the statement, recommendations for ECG standards are placed in context of the clinical implications of evolving ECG technology.