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Tick-borne diseases (TBDs) can sometimes cause severe symptoms and lead to hospitalisation, but they often go unnoticed in the Emergency Department (ED). The aim of this study was twofold: (i) to describe the profile of patients hospitalised by TBDs; and (ii) to evaluate the data collected in the medical records from the ED in order to analyse their potential clinical consequences. A total of 84 cases that included all TBD diagnoses registered in the ED records were identified and analysed. These corresponded to all the hospitalisations by TBDs in the last 10 years (2009–2019) in two tertiary hospitals in Granada, Spain. Statistical analyses were made using RStudio. Coinciding with the absence of patient's report of exposure to ticks, 64.3% of TBDs were not suspected in the ED. Intensive care unit admission was required in 8.3% of cases, and the mortality rate was 2.4%. Non-suspected cases showed longer hospital stay (P < 0.001), treatment duration (P = 0.02) and delay in the initiation of antibiotic treatment (P < 0.001). Our findings indicate that symptoms associated with TBDs are highly non-specific. In the absence of explicit information related to potential tick exposure, TBDs are not initially suspected. As a consequence, elective treatment administration is delayed and hospitalisation time is prolonged. In conclusion, our results highlight the importance of addressing potential exposure to ticks during the ED contact with patients presenting with febrile syndrome.
We have monitored tributyltin (TBT) pollution in Galicia (NW Spain) for more than a decade by means of assessing gastropod imposex in populations of Nucella lapillus (N ≥ 34) and Tritia reticulata (N ≥ 18) at regular intervals. Several thousand specimens were processed to obtain their shell height (SH), penis length (PL) and vas deferens sequence (VDS); imposex indices (including the VDS index, VDSI) were subsequently calculated. The regional mean SH of both females and males has not changed significantly in either species throughout the study. This also applies to the mean male PL in N. lapillus, but male T. reticulata penises surprisingly enlarged. On the contrary, the regional mean female PL (MFPL) and all imposex indices significantly decreased in both snails. Results confirm previous conclusions based on the chemical analyses of tissues and partial imposex observations. In addition, the close correlations between MFPL and VDSI show some potential applications to TBT biomonitoring.
To determine the association between excess body fat, assessed by skinfold thickness, and the incidence of type 2 diabetes mellitus (T2DM) and hypertension (HT).
Data from the ongoing PERU MIGRANT Study were analysed. The outcomes were T2DM and HT, and the exposure was skinfold thickness measured in bicipital, tricipital, subscapular and suprailiac areas. The Durnin–Womersley formula and SIRI equation were used for body fat percentage estimation. Risk ratios and population attributable fractions (PAF) were calculated using Poisson regression.
Rural (Ayacucho) and urban shantytown district (San Juan de Miraflores, Lima) in Peru.
Adults (n 988) aged ≥30 years (rural, rural-to-urban migrants, urban) completed the baseline study. A total of 785 and 690 were included in T2DM and HT incidence analysis, respectively.
At baseline, age mean was 48·0 (sd 12·0) years and 47 % were males. For T2DM, in 7·6 (sd 1·3) years, sixty-one new cases were identified, overall incidence of 1·0 (95 % CI 0·8, 1·3) per 100 person-years. Bicipital and subscapular skinfolds were associated with 2·8-fold and 6·4-fold risk of developing T2DM. On the other hand, in 6·5 (sd 2·5) years, overall incidence of HT was 2·6 (95 % CI 2·2, 3·1) per 100 person-years. Subscapular and overall fat obesity were associated with 2·4- and 2·9-fold risk for developing HT. The PAF for subscapular skinfold was 73·6 and 39·2 % for T2DM and HT, respectively.
We found a strong association between subscapular skinfold thickness and developing T2DM and HT. Skinfold assessment can be a laboratory-free strategy to identify high-risk HT and T2DM cases.
The disease caused by the influenza virus is a global public health problem due to its high rates of morbidity and mortality. Thus, analysis of the information generated by epidemiological surveillance systems has vital importance for health decision making. A retrospective analysis was performed using data generated by the four molecular diagnostic laboratories of the Mexican Social Security Institute between 2010 and 2016. Demographics, influenza positivity, seasonality, treatment choices and vaccination status analyses were performed for the vaccine according to its composition for each season. In all cases, both the different influenza subtypes and different age groups were considered separately. The circulation of A/H1N1pdm09 (48.7%), influenza A/H3N2 (21.1%), influenza B (12.6%), influenza A not subtyped (11%) and influenza A/H1N1 (6.6%) exhibited well-defined annual seasonality between November and March, and there were significant increases in the number of cases every 2 years. An inadequate use of oseltamivir was determined in 38% of cases, and the vaccination status in general varied between 12.1 and 18.5% depending on the season. Our results provide current information about influenza in Mexico and demonstrate the need to update both operational case definitions and medical practice guidelines to reduce the inappropriate use of antibiotics and antivirals.
The formation of zonal flows from inhomogeneous drift-wave (DW) turbulence is often described using statistical theories derived within the quasilinear approximation. However, this approximation neglects wave–wave collisions. Hence, some important effects such as the Batchelor–Kraichnan inverse-energy cascade are not captured within this approach. Here we derive a wave kinetic equation that includes a DW collision operator in the presence of zonal flows. Our derivation makes use of the Weyl calculus, the quasinormal statistical closure and the geometrical-optics approximation. The obtained model conserves both the total enstrophy and energy of the system. The derived DW collision operator breaks down at the Rayleigh–Kuo threshold. This threshold is missed by homogeneous-turbulence theory but expected from a full-wave quasilinear analysis. In the future, this theory might help better understand the interactions between drift waves and zonal flows, including the validity domain of the quasilinear approximation that is commonly used in the literature.
Composites from carbon nanotubes and polymers have been synthesized and studied. The composites were obtained joining carbon nanotubes with polymethyl methacrylate, nylon-6 and polystyrene. The materials were observed through scanning electron microscopy to evaluate the carbon nanotubes dispersion in the polymeric matrices. FTIR and Raman spectroscopies were used to analyze the interactions among functionalized and non-functionalized multiwalled carbon nanotubes and polymers, demonstrating affinity and peculiar spectra behaviors for each composite with different carbon nanotubes loads.
PA6 and PMMA polymers with different MWCNTs addition (5, 7 and 9 wt %) were synthetized through casting solution, resulting in improvement properties in contrast to pristine polymers. SEM images showed the MWCNTs embedded into polymeric matrices. D, G and G´ bands of MWCNTs were confirmed by Raman spectroscopy and functional groups observed in both nanocomposites by FTIR demonstrated a strong interaction. A significant increasing in electrical conductivity and microhardness was observed in all the nanocomposites. Major microhardness values were obtained in MWCNTs/PA6 (50 HV) however the MWCNTs/PMMA nanocomposites showed the highest electrical conductivity value (6.4×10-4 S/cm).
The identification of threats to migratory species of conservation concern and the relevance of protected areas for them is often biased towards breeding areas. The European Roller Coracias garrulus is a long-distance migrant experiencing a pronounced decline throughout its breeding range, which has been attributed to the degradation of open agricultural habitats. However, its conservation status in non-breeding areas in Africa remains unstudied. Land cover change is a major threat affecting migratory birds in their wintering grounds, therefore identifying important areas for their protection at this stage is a priority. Here we used occurrence data during the wintering season and ecological niche models to identify key land cover and areas used by Rollers in Africa. First, we used 33 filtered locations from six satellite-tracked birds breeding in Spain to describe suitable wintering areas for the Spanish population (westernmost part of the Eurasian breeding range). We also used 1,167 occurrence data in southern Africa from open-access databases and bird atlases to characterise the overall wintering range of the species. The Spanish population occupied a relatively small area in the north-western part of southern Africa, and a narrow range of land covers. Open grassland, less steep areas and those with sparse tree cover are correlated with suitability. In all, 18.06% of suitable wintering areas for the Spanish population overlapped with protected areas. The overall population of Rollers occupied a wider area and range of land cover. Tree cover was the most important variable affecting suitability, with areas without tree cover being the least suitable. We found that 9.58% of suitable wintering areas for the overall population overlapped with protected areas. Our results suggest that Rollers from different origins (breeding populations) use separate, but overlapping, wintering areas and may have different habitat requirements, and therefore, population-specific conservation strategies in these areas might be needed to fully protect the species.
Individuals with schizophrenia have deficits in social cognition that are associated with poor functional outcome. Unfortunately, current treatments result in only modest improvement in social cognition. Oxytocin, a neuropeptide with pro-social effects, has significant benefits for social cognition in the general population. However, studies examining the efficacy of oxytocin in schizophrenia have yielded inconsistent results. One reason for inconsistency may be that oxytocin has typically not been combined with psychosocial interventions. It may be necessary for individuals with schizophrenia to receive concurrent psychosocial treatment while taking oxytocin to have the context needed to make gains in social cognitive skills.
The current study tested this hypothesis in a 24-week (48 session) double-blind, placebo-controlled trial that combined oxytocin and Cognitive-Behavioral Social Skills Training (CBSST), which included elements from Social Cognition and Interaction Training (SCIT). Participants included 62 outpatients diagnosed with schizophrenia (placebo n = 31; oxytocin n = 31) who received 36 IU BID, with supervised administration 45 min prior to sessions on CBSST group therapy days. Participants completed a battery of measures administered at 0, 12, and 24 weeks that assessed social cognition.
CBSST generally failed to enhance social cognition from baseline to end of study, and there was no additive benefit of oxytocin beyond the effects of CBSST alone.
Findings suggest that combined CBSST and oxytocin had minimal benefit for social cognition, adding to the growing literature indicating null effects of oxytocin in multi-dose trials. Methodological and biological factors may contribute to inconsistent results across studies.
The objective was to compare the performance of the updated Charlson comorbidity index (uCCI) and classical CCI (cCCI) in predicting 30-day mortality in patients with Staphylococcus aureus bacteraemia (SAB). All cases of SAB in patients aged ⩾14 years identified at the Microbiology Unit were included prospectively and followed. Comorbidity was evaluated using the cCCI and uCCI. Relevant variables associated with SAB-related mortality, along with cCCI or uCCI scores, were entered into multivariate logistic regression models. Global model fit, model calibration and predictive validity of each model were evaluated and compared. In total, 257 episodes of SAB in 239 patients were included (mean age 74 years; 65% were male). The mean cCCI and uCCI scores were 3.6 (standard deviation, 2.4) and 2.9 (2.3), respectively; 161 (63%) cases had cCCI score ⩾3 and 89 (35%) cases had uCCI score ⩾4. Sixty-five (25%) patients died within 30 days. The cCCI score was not related to mortality in any model, but uCCI score ⩾4 was an independent factor of 30-day mortality (odds ratio, 1.98; 95% confidence interval, 1.05–3.74). The uCCI is a more up-to-date, refined and parsimonious prognostic mortality score than the cCCI; it may thus serve better than the latter in the identification of patients with SAB with worse prognoses.
The control of Anastrepha obliqua includes the sterilization of mass-reared insects grown in isolation in a constantly controlled environment. Through time, laboratory mass-reared colonies may produce flies with lower field performance. To recover the genetic variation and aptitude of mass-reared populations, wild insects are introduced into mass-reared colonies. Our aim in this study was to determine whether the host species from two localities influence the life history traits of A. obliqua. We collected flies as larvae from infested fruits of Spondias purpurea, S. mombin, Mangifera indica cv. ‘piña’, and M. indica cv. ‘coche’ from two localities in Chiapas, Mexico. There were significant differences in the mating competitiveness of males collected from mango cv. ‘coche’ compared with mass-reared males. There were no differences in the mating propensity between flies from the two localities, even in the number of matings, when weight was considered as a covariable. The mass-reared strain showed the earliest age at first oviposition. The locality affected the longevity and oviposition period, and these influenced the birth rate, intrinsic rate of increase, finite rate of population increase, mean generation time, and doubling time. According to the demographic parameters, the population of S. mombin would allow artificial colonization in less time, considering that it has a high reproduction rate starting at an early age. Even in the propensity test, it had the highest number of matings. However, males with greater sexual competitiveness and longevity for colonization corresponded to those collected from S. purpurea.
Unmanned aircraft vehicles (UAVs) have had a rapid escalation in manageability and affordability, which can be exploited in healthcare. We conducted a systematic review examining the use of drones for health-related purposes.
A search was conducted in Medline, Embase, Global Health, Scopus, CINAHL and SciELO. Experimental studies were selected if the population included human subjects, the intervention was the use of UAVs and there was a health-related outcome.
Of 500 results, five met inclusion criteria during an initial search. An updated search yielded four additional studies. Nine studies, all in high-income countries, were included for systematic syntheses: four studies addressed out-of-hospital cardiac arrest emergencies, three assessed drones for identification of people after accidents, one used drones to transport blood samples and one used drones to improve surgical procedures in war zones.
Research on the use of drones in healthcare is limited to simulation scenarios, and this review did not retrieve any studies from low- and middle-income countries.