Characterization of the startup transient electrokinetic flow in rectangular channels of arbitrary dimensions, zeta potential distribution, and time-varying pressure gradient.

The solution to the startup transient EOF in an arbitrary rectangular microchannel is derived analytically and validated experimentally. This full 2D transient solution describes the evolution of the flow through five distinct periods until reaching a final steady state. The derived analytical velocity solution is validated experimentally for different channel sizes and aspect ratios under time-varying pressure gradients. The experiments used a time resolved micro particle image velocimetry technique to calculate the startup transient velocity profiles. The measurements captured the effect of time-varying pressure gradient fields derived in the analytical solutions. This is tested by using small reservoirs at both ends of the channel which allowed a time-varying pressure gradient to develop with a time scale on the order of the transient EOF. Results showed that under these common conditions, the effect of the pressure build up in the reservoirs on the temporal development of the transient startup EOF in the channels cannot be neglected. The measurements also captured the analytical predictions for channel walls made of different materials (i.e., zeta potentials). This was tested in channels that had three PDMS and one quartz wall, resulting in a flow with an asymmetric velocity profile due to variations in the zeta potential between the walls.

Directional flow sensing by passively stable larvae.

Mollusk larvae have a stable, velum-up orientation that may influence how they sense and react to hydrodynamic signals applied in different directions. Directional sensing abilities and responses could affect how a larva interacts with anisotropic fluid motions, including those in feeding currents and in boundary layers encountered during settlement. Oyster larvae (Crassostrea virginica) were exposed to simple shear in a Couette device and to solid-body rotation in a single rotating cylinder. Both devices were operated in two different orientations, one with the axis of rotation parallel to the gravity vector, and one with the axis perpendicular. Larvae and flow were observed simultaneously with near-infrared particle-image velocimetry, and behavior was quantified as a response to strain rate, vorticity and centripetal acceleration. Only flows rotating about a horizontal axis elicited the diving response observed previously for oyster larvae in turbulence. The results provide strong evidence that the turbulence-sensing mechanism relies on gravity-detecting organs (statocysts) rather than mechanosensors (cilia). Flow sensing with statocysts sets oyster larvae apart from zooplankters such as copepods and protists that use external mechanosensors in sensing spatial velocity gradients generated by prey or predators. Sensing flow-induced changes in orientation, rather than flow deformation, would enable more efficient control of vertical movements. Statocysts provide larvae with a mechanism of maintaining their upward swimming when rotated by vortices and initiating dives toward the seabed in response to the strong turbulence associated with adult habitats.

Hydrodynamic sensing and behavior by oyster larvae in turbulence and waves.

Hydrodynamic signals from turbulence and waves may provide marine invertebrate larvae with behavioral cues that affect the pathways and energetic costs of larval delivery to adult habitats. Oysters (Crassostrea virginica) live in sheltered estuaries with strong turbulence and small waves, but their larvae can be transported into coastal waters with large waves. These contrasting environments have different ranges of hydrodynamic signals, because turbulence generally produces higher spatial velocity gradients, whereas waves can produce higher temporal velocity gradients. To understand how physical processes affect oyster larval behavior, transport and energetics, we exposed larvae to different combinations of turbulence and waves in flow tanks with (1) wavy turbulence, (2) a seiche and (3) rectilinear accelerations. We quantified behavioral responses of individual larvae to local instantaneous flows using two-phase, infrared particle-image velocimetry. Both high dissipation rates and high wave-generated accelerations induced most larvae to swim faster upward. High dissipation rates also induced some rapid, active dives, whereas high accelerations induced only weak active dives. In both turbulence and waves, faster swimming and active diving were achieved through an increase in propulsive force and power output that would carry a high energetic cost. Swimming costs could be offset if larvae reaching surface waters had a higher probability of being transported shoreward by Stokes drift, whereas diving costs could be offset by enhanced settlement or predator avoidance. These complex behaviors suggest that larvae integrate multiple hydrodynamic signals to manage dispersal tradeoffs, spending more energy to raise the probability of successful transport to suitable locations.

Directional flow sensing by passively stable larvae.

Mollusc larvae have a stable, velum-up orientation that may influence how they sense and react to hydrodynamic signals applied in different directions. Directional sensing abilities and responses could affect how a larva interacts with anisotropic fluid motions, including those in feeding currents and in boundary layers encountered during settlement. Oyster larvae (Crassostrea virginica) were exposed to simple shear in a Couette device and to solid-body rotation in a single rotating cylinder. Both devices were operated in two different orientations, one with the axis of rotation parallel to the gravity vector, and one with the axis perpendicular. Larvae and flow were observed simultaneously with near-infrared particle-image velocimetry, and behaviors were quantified as a response to strain rate, vorticity, and centripetal acceleration. Only flows rotating about a horizontal axis elicited the diving response observed previously for oyster larvae in turbulence. The results provide strong evidence that the turbulence-sensing mechanism relies on gravity-detecting organs (statocysts) rather than mechanosensors (cilia). Flow sensing with statocysts sets oyster larvae apart from zooplankters such as copepods and protists that use external mechanosensors in sensing spatial velocity gradients generated by prey or predators. Sensing flow-induced changes in orientation, rather than flow deformation, would enable more efficient control of vertical movements. Statocysts provide larvae with a mechanism of maintaining their upward swimming when rotated by vortices and initiating dives toward the seabed in response to the strong turbulence associated with adult habitats.

Impact of quality management systems in the performance of educational centers: educational policies and management processes.

In this paper, the findings of an I + D + i research are presented. In this study, an analysis was conducted to assess 14 educational centers where in one of two distinct quality systems had been implemented: the EFQM (European Foundation Quality Management) and el Proyecto de Calidad Integrado (PCI)-the Integrated Quality Project-promoted by the Horrêum Foundation (Álvarez and Santos, 2003; Villa and Marauri, 2004). The EFQM was first used by businesses before being recently transferred to the academics. It comprised nine factors that were translated in an educational context: leadership, policy and strategy, people, alliances and resources, processes, impact on people, impact on clients, impact on society, and key impacts of an organization. The first five factors examine the way activities are carried out and improved, and the final four focus on the impact, i.e., the effect of the organization's activities. Improvement is achieved through learning and innovation. The PCI (Muñoz and Sarasúa, 2005) has its educational origins in the Effective School Improvement model. Seven factors are analyzed (Sarasola et al., 2003; Villa et al., 2004): institutional approach, organizational structures, relationships and living together, counseling and tutoring, curriculum, family and the community (Martínez and Galíndez, 2003), and management and services. The study looks at the impact that the two aforementioned quality systems (EFQM and PCI) have had on educational centers. The term "impact" is understood as the changes experienced both inside and outside an educational center. It must be sustainable overtime, considering the changes and effects achieved, as evidence of improvement. The quantitative analysis focuses on two dimensions. The first addresses three key factors of educational policy: educational planning, communication, and support and rewards for teachers. The second comprises three factors linked to management processes in educational institutions: organizational climate, teaching and learning processes, and relationships with the community.

[Advertising and feeding: influence of graphical advertisements on dietary habits during childhood and adolescence]. / Publicidad y alimentación: influencia de los anuncios gráficos en las pautas alimentarias de infancia y adolescencia.

BACKGROUND AND OBJECTIVES: An optimal nutritional diet, especially during the infancy and adolescence, is an important social objective, to create habits and behaviours that will maintain during the adult life of the present children. The objective of this study is to collect and evaluate the publicity of nutritional products and how this is directed to children, before the approval of the codex of regulation of the publicity of nutritional products as directed to minors, prevention of obesity and health (codex PAOS) and after the start of the codex. SETTING, MATERIALS AND METHODS: To watch and collect data from commercials of nutritional products, such as transmitted by television during the infant programs. RESULTS: The obtained results show a great discrepancy between the diet constituted by the commercials for nutritional products and a diet, normally recommended for children. Besides this, nos changes in the commercials were noticed after the start of the codex. CONCLUSION: The commercials for nutritional products with a very high caloric value are transmitted to children during the infant programs are not appropriate for an optimal diet. The start of the Codex PAOS did not have much effect in the amount and quality of the commercials of nutritional products, such as directed to the infant public.

[Estimation of the population attributable fraction due to obesity in hospital admissions for flu valued according to Body Mass Index (BMI) and CUN-BAE]. / Estimación de la fracción atribuible poblacional debida a la obesidad en los ingresos hospitalarios por gripe valorada según el índice de masa corporal (IMC) y el CUN-BAE.

INTRODUCTION: The obesity pandemic together with the influenza pandemic could lead to a significant burden of disease. The body mass index (BMI) does not discriminate obesity appropriately. The CUN-BAE has recently been used as an estimate of body fatness for Caucasians, including BMI, gender, and age. The aim of this study is to assess the population attributable fraction of hospital admissions due to influenza, due to the body fatness measured with the BMI, and the CUN-BAE. METHODS: A multicentre study was conducted using matched case-controls. Cases were hospital admissions with the influenza confirmed by the RT-PCR method between 2009 and 2011. The risk of hospital admission and the population attribuible fraction were calculated using the BMI or the CUN-BAE for each adiposity category in a conditional logical regression analysis adjusted for confounding variables. The analyzes were estimated in the total sample, in unvaccinated people, and those less than 65 years-old. RESULTS: A total of 472 hospitalised cases and 493 controls were included in the study. Compared to normal weight, the aOR of influenza hospital admissions increases with each level of BMI (aOR=1.26; 2.06 and 11.64) and CUN-BAE (aOR=2.78; 4.29; 5.43 and 15.18). The population attributable fraction of influenza admissions using CUN-BAE is 3 times higher than that estimated with BMI (0,72 vs. 0,27), with the differences found being similar the non-vaccinated and under 65 year-olds. CONCLUSION: The BMI could be underestimating the burden of disease attributable to obesity in individuals hospitalised with influenza. There needs to be an appropriate assessment of the impact of obesity and vaccine recommendation criteria.

Occupancy of platelet receptors for platelet-activating factor in patients with septicemia.

The possible involvement of platelet-activating factor (PAF) in the pathogenesis of endotoxemia, was investigated by using a binding assay to patients' platelets, complemented with the extraction and chemical characterization of PAF obtained from patients' platelets. Platelets from 12 human volunteers had 281 +/- 63 freely accessible high affinity binding sites (PAF-receptors) per platelet; whereas this number was of 49 +/- 37 PAF-receptors per platelet, n = 14 samples, P less than 0.01, in a group of 13 patients with positive blood culture. A group of patients with respiratory or cardiovascular disturbances and negative blood culture had 253 +/- 74, accessible receptors per platelet (n = 19 samples from 16 patients, P less than 0.01 as compared to septic patients, which was not significantly different when compared to control individuals). Patients with sepsis possessed significant amounts of PAF associated to their platelets, whereas this mediator could not be isolated from platelets of patients with respiratory or cardiovascular disturbances and negative blood culture, nor from platelets of control individuals. PAF was also assayed in whole blood samples and found at high concentrations in sepsis patients. These data indicate that occupancy of PAF receptors in combination with high amounts of platelet-associated PAF, is a common finding in patients with sepsis.

[Hospital mortality in the Internal Medicine Services of a first level center]. / Mortalidad hospitalaria en el Servicio de Medicina Interna de un hospital de primer nivel.

BACKGROUND AND OBJECTIVE: Hospital mortality is a indicator of quality of care, and their study may improve assistance of hospitalized patients. Our objective was to know the most frequent death causes of hospitalized patients, to identify clinical and analytical variables associated with each cause, and to determine gender differences. MATERIAL AND METHODS: A systematic and retrospective revision of 113 medical reports of death patients was carried out; it corresponded 26% of all deaths occurred between March 2002 to November 2004. At each case, epidemiological variables, previous clinical reports, biochemical and haematological parameters, death cause and in-hospital complications were registered. RESULTS: Mean age was 79 +/- 10 years and 58.4% of cases were males. Thirty eight percent had previous admission, and 45% had functional class III-IV. Men died with less age that women (76.6 +/- 10.3 versus 82.3 +/- 8.0 p < 0.002) and they had more frequent antecedents of chronic bronchopulmonary disease (43% versus 19%, p <0.04); however, women had worse ventilatory situation at admission. The main death causes were cardiopulmonary (56% whole, 34% because of respiratory insufficience, 14% because of pneumonia, and 8% because of acute lung oedema), followed by neurological causes (25% whole, 23% because of stroke) and 19% because another reason (neoplasia, multiorganic failure, hepatic insufficience and renal failure). Patients died from cardiopulmonary cause had a more frequent previous hospitalization (p < 0.04). Patients died from neurological cause had higher systolic and diastolic blood pressure at admission (p < 0.0001), higher rate of hypertension (p < 0.0001) and more frequent nosocomial fever (p = 0.0001). CONCLUSIONS: In our Service, male patients died with less age that women, the main death causes were cardiorespiratory diseases and subsequently neurologic diseases. Hypertension at admission was most frequent in patients died from neurologic cause.

Incidence of Type 1 diabetes in children in Cáceres, Spain, during 1988-1999.

AIM: To determine the incidence of Type 1 diabetes in Cáceres in children less than 14 years of age. We tested for differences in incidence by age, sex and season at diagnosis. METHODS: All Type 1 diabetes cases with onset <14 years of age between 1988 and 1999 were recorded retrospectively. Pediatric Unit registries provided the primary source of ascertainment. The secondary independent data source was based on the registries of local Diabetic Associations, diabetes camp records and guarantee cards of blood-glucose meters. We used the capture-recapture method for ascertainment. RESULTS: During the 12-year period, 137 new cases of Type 1 diabetes were identified. Completeness of ascertainment was 99.2%. Average annual observed incidence was 16.8/100,000/year (95% C.I. 14.1-19.8). Age-standardised incidence (world population): 16.5/100,000/year (95% C.I. 13.9-19.6). Average annual incidence for 0-4, 5-9 and 10-13-year-old groups: 12.7/100,000 (95% C.I. 8.8-17.9), 18.2/100,000 (95% C.I. 13.7-23.8) and 19.1/100,000 (95% C.I. 14.2-25.1). The highest age-specific annual incidence rate was found in the 10-13-year age group. There was a seasonal onset pattern, with the highest incidence in autumn and winter. November was the month with the highest number of cases (22/137). CONCLUSION: Cáceres has a moderately high incidence of Type 1 diabetes in children less than 14 years of age, similar to that found in other more developed and densely populated regions of Spain, and in the range of other countries of northern Europe. These data do not support the hypothesis of a decrease in the incidence of the disease from north to south over Europe.

The translation into Spanish of the OIE Manual of diagnostic tests and vaccines for terrestrial animals (mammals, birds and bees): problems, solutions and conclusions.

In order to carry out the translation into Spanish of the Manual of diagnostic tests and vaccines for terrestrial animals (mammals, birds and bees) ensuring full scientific and linguistic accuracy, its authors relied on coordination between three types of experts: linguistic, translational and veterinary. In this paper the planning, execution and quality control of such work, which was undertaken with the support and guarantee of the World Organisation for Animal Health (OIE), is reported. In the conclusions the authors describe what they view as necessary guidelines for the OIE to apply in the future regarding its linguistic policy. The working methodology reported in connection with the translation of the Terrestrial Manual into Spanish will be useful for the translation of the Terrestrial Manual or other texts into languages other than Spanish, whether or not they are among the official languages of the OIE.

[Medical and surgical management of noniatrogenic traumatic tracheobronchial injuries]. / Manejo médico-quirúrgico de las lesiones traqueobronquiales traumáticas no iatrogénicas.

OBJECTIVE: To describe the medical and surgical management of noniatrogenic traumatic tracheobronchial injuries. PATIENTS AND METHOD: From January 1993 to July 2004, 15 cases of traumatic tracheobronchial injury were treated in our department. The diagnosis was established by bronchoscopy and a computed tomography chest scan was performed on all patients. Surgical treatment was selected for patients with unstable vital signs, an open tracheal wound, associated esophageal lesions, progression of subcutaneous or mediastinal emphysema, mediastinitis or suspicious mediastinal secretions on imaging tests, or difficulties with mechanical ventilation due to the traumatic tracheobronchial injury. RESULTS: The mean (SD) age of the patients was 35.5 (18.9) years and 12 (80%) were male. Of the 15 cases, 13 (86.7%) had penetrating trauma and 2 (13.3%) blunt trauma. The most common location of the injury was in the bronchi (9 cases; 60%), followed by the cervical trachea (4 cases; 26.6%), followed by both the thoracic trachea and bronchi (2 cases; 13.4%). The most common initial symptom was subcutaneous emphysema, which presented in 11 (73.3%) patients. Chest (12 cases; 86.7%) and orthopedic injuries (9 cases; 60%) were the most common associated injuries. Surgery was the treatment of choice in 11 (73.3%) cases and conservative medical treatment in 4 (26.7%). An irreversible brain injury caused the death of 1 patient receiving conservative treatment. CONCLUSIONS: Tracheobronchial injuries may be treated conservatively if they meet strict selection criteria. Size and location should not be used as selection criteria for surgical treatment.

[Importance of routine mediastinal staging in women with non-small cell lung cancer]. / Importancia de la estadificación mediastínica, sistemática en mujeres con carcinoma broncogénico, no microcítico.

OBJECTIVE: To study the specific importance of mediastinal staging in women with nonsmall cell lung cancer. PATIENTS AND METHODS: Between July 1981 and September 2003 we surgically staged 2172 patients with nonsmall cell lung cancer who met the inclusion criteria for resectability and operability. A subgroup of 108 women was studied. Cervical mediastinoscopy was performed in all cases, with the addition of anterior mediastinotomy in cases with left upper lobe involvement. All patients underwent a preoperative computed tomography chest scan. RESULTS: Cervical mediastinoscopy was performed on all 108 patients, 26 of whom also underwent anterior mediastinotomy. Positive findings were recorded in 44 (40.7%) of the 108 cases: 39 of the 108 mediastinoscopies (36.1%), 9 of the 26 mediastinotomies (34.6%), and in 5 cases (19.2%) both mediastinoscopy and mediastinotomy. Nodal involvement was found in 13% of cases in clinical stage IA and 30.8% of cases in clinical stage IB. The percentage of positive findings was significantly higher for cases with adenocarcinoma or large cell carcinoma (P<.05). We performed 67 thoracotomies: 46 patients underwent lobectomy (42.6% of the 108), 7 bilobectomy (6.5%), 9 pneumonectomy (8.3%), and 5 exploratory thoracotomy (4.6%). The agreement between clinical staging after mediastinoscopy and pathological staging after thoracotomy was 47% (stage IA) and 57% (stage IB). CONCLUSIONS: Routine mediastinoscopy is indicated for all women with nonsmall cell lung cancer, regardless of clinical stage.

[Utility of local anesthesia of the periprostatic plexus in the control of the pain in the ultrasound-guided prostate biopsy]. / Utilidad de la anestesia local del plexo periprostático en el control del dolor en las biopsias prostáticas guiadas con ecografía.

OBJECTIVE: Periprostatic plexus anesthesia (PPA) is not current practice during prostate ultrasound-guided biopsy (PB). Many patients must undergo a second or more PB if a prostate carcinoma is suspected. Due to pain, many patients reject the procedure, or it has to be performed with general anesthesia. Our objective was to evaluate the utility of PPA to eliminate the pain caused by PB, as well as the acceptance of the procedure under these conditions. PATIENTS AND METHODS: Between october 2002 and june 2003 we designed a randomized prospective study with 275 patients that were seen in 2 different hospitals and required PB. In the 1st group we included 101 males who underwent PB without PA. In the other group, 174 male patients submitted PB after PPA were included. 10 cc lidocaine, 2% diluted 50% was injected with a 22g needle. At the end of the procedure, patients were asked to fill in a questionnaire about their satisfaction and degree of pain felt. RESULTS: In the second group of patients we obtained significantly inferior values (p < 0.005, IC 95%) in the quantitative evaluation of pain compared with the first group (1.24 +/- 0.4 vs. 2.5 +/- 1.1). Ask per the possibility of repeating PB if it were necessary, none of the patients in the 2nd group would object, whereas 10% in the 1st group would not have the biopsy repeated or would only accept it if it was done with general anesthesia. No complications due to PPA were found. CONCLUSION: PPA is a safe procedure that significantly reduces pain during PB, improving its acquiescence among patients.

[Neonatal hearing loss screening: our results three years after starting the program]. / Despistaje de la hipoacusia neonatal: resultados después de 3 años de iniciar nuestro programa.

Since the 90s there increasing interest in early detection of neonatal hearing loss due to the feasibility of universal neonatal screening as well as to the possibility of early intervention. This has led to set up neonatal screening programs based upon otoacoustic emissions and to a great increase in the number of publications in the field. Our hospital started a neonatal hearing loss screening program using otoacoustic emission in March 2000. We used a Capella Cochlear Emissions (MADSEN electronics) equipment. Until May 2003 we have performed the test in 6372 children with a median age of 71 days. In our study, the sensibility of the test was 90.9% and the specificity 99.7%. Our results are similar to those reported in the literature although the age of the children was higher and we have found an incidence of hearing loss lower than other studies.

Cost-effectiveness Analysis with Influence Diagrams.

BACKGROUND: Cost-effectiveness analysis (CEA) is used increasingly in medicine to determine whether the health benefit of an intervention is worth the economic cost. Decision trees, the standard decision modeling technique for non-temporal domains, can only perform CEA for very small problems. OBJECTIVE: To develop a method for CEA in problems involving several dozen variables. METHODS: We explain how to build influence diagrams (IDs) that explicitly represent cost and effectiveness. We propose an algorithm for evaluating cost-effectiveness IDs directly, i.e., without expanding an equivalent decision tree. RESULTS: The evaluation of an ID returns a set of intervals for the willingness to pay - separated by cost-effectiveness thresholds - and, for each interval, the cost, the effectiveness, and the optimal intervention. The algorithm that evaluates the ID directly is in general much more efficient than the brute-force method, which is in turn more efficient than the expansion of an equivalent decision tree. Using OpenMarkov, an open-source software tool that implements this algorithm, we have been able to perform CEAs on several IDs whose equivalent decision trees contain millions of branches. CONCLUSION: IDs can perform CEA on large problems that cannot be analyzed with decision trees.

Investigation on the aerosol performance of dry powder inhalation hypromellose capsules with different lubricant levels.

HPMC capsules are made by a dipping process and a surface lubricant for the mould pins is an essential processing aid for removing dried capsules shells. For the purpose of this study, the level was determined by quantifying methyloleate (MO) a component found in the lubricant but not in the hypromellose capsules. Here we investigated the influence of the lubricant, low (10.81 µg/capsule=60 mg/kg MO), medium (15.97 µg/capsule=90 mg/kg MO) and high (23.23 µg/capsule=127 mg/kg MO) content on powder (binary mixture of salbutamol: lactose, 1:50 w/w) aerosolization properties was investigated. Results indicated significantly lower emitted dose from capsules with 60 mg/kg MO. Furthermore, the 90 and 127 mg/kg MO level of lubricant capsules produced almost double the Fine Particle Dose & Fine Particle Fraction compared with the low level of lubricant. The data indicates that lubricant level within capsules has an influence on deposition profiles and amount of drug remaining in capsule and inhaler device after actuation. It is suggested lubricant levels greater than 60 mg/kg MO per capsule are required to minimise powder retention within capsules and maximise deposition profiles. AFM (atomic force microscopy) data suggest that internal surface roughness may be related with this phenomena.

Mitochondrial DNA characterisation of European isolates: the Maragatos from Spain.

Mitochondrial DNA analysis confirms that Maragatos from Spain are a genetically isolated human group. Genetic distances between Maragatos and the comparison samples are significantly different even with the León sample (P<0.001) which shares the same geographic area as the Maragatos. Although the north-African haplogroup U6 is present in them, their attributed Berber origin is weakened, as this haplogroup is also detected in surrounding populations with which, in addition, Maragatos have the smaller genetic distances. These U6 haplotypes are ascribed to a pre-historic African colonisation that influenced all the Iberian Peninsula. The presence of Neolithic haplogroups in this sample suggests that their isolation culture was not absolute until recent times.