Selective Action Prediction in Infancy Depending on Linguistic Cues: An EEG and Eyetracker Study.

Humans' capacity to predict actions and to socially categorize individuals is at the basis of social cognition. Such capacities emerge in early infancy. By 6 months of age, infants predict others' reaching actions considering others' epistemic state. At a similar age, infants are biased to attend to and interact with more familiar individuals, considering adult-like social categories such as the language people speak. We report that these two core processes are interrelated early on in infancy. In a belief-based action prediction task, 6-month-old infants (males and females) presented with a native speaker generated online predictions about the agent's actions, as revealed by the activation of participants' sensorimotor areas before the agent's movement. However, infants who were presented with a foreign speaker did not recruit their motor system before the agent's action. The eyetracker analysis provided further evidence that linguistic group familiarity influences how infants predict others' actions, as only infants presented with a native speaker modified their attention to the stimuli as a function of the agent's forthcoming behavior. The current findings suggest that infants' emerging capacity to predict others' actions is modulated by social cues, such as others' linguistic group. A facilitation to predict and encode the actions of native speakers relative to foreign speakers may explain, in part, why infants preferentially attend to, imitate, and learn from the actions of native speakers.

Lean techniques to improve the flow of critically ill patients in a health region with its epicenter in the intensive care unit of a reference hospital. / Técnicas «Lean¼ para la mejora del flujo de los pacientes críticos de una región sanitaria con epicentro en el servicio de medicina intensiva de un hospital de referencia.

OBJECTIVE: To analyze whether the application of Lean techniques to improve the flow of critically ill patients in a health region with its epicenter in the intensive care unit (ICU) of a reference hospital. DESIGN: Observational study with pre and post intervention analysis. SETTING: ICU of a reference hospital. PATIENTS: We design projects and a value stream map of flow and compared pre and post intervention. INTERVENTIONS: We recorded demographic data, patient transfers by EMS for lack of beds and delay times in the discharge from ICU to ward. Multidisciplinary meetings and perform daily visual panel, with high priority ICU discharge. We promote temporary relocation of critically ill patients in other special areas of the hospital. We performed a professional satisfaction questionnaire with pre and post implementation of process. We make a statistical analysis of pre and post-intervention comparisons. RESULTS: We planned for 2013 and progressively implemented in 2014. Analysis of patients entering the critical process flow 1) evaluate patients who must transfer for lack of beds, focusing on a diagnosis: pre 10/22 vs. 3/21 post (P=.045); 2) analysis of time delay in the discharge from the ICU to ward: 360.8±163.9minutes in the first period vs. 276.7±149.5 in the second (P=.036); and 3) personal professional satisfaction questionnaire, with 6.6±1.5 points pre vs. 7.5±1.1 in post (P=.001). Analysis of indicators such as the ICU acquired infections, length of ICU stay, the rate of re-admissions and mortality, with no significant differences between the two periods. CONCLUSIONS: The application of Lean techniques in the critically ill process had a positive impact on improving patient flow within the health region, noting a decrease of transfers outside the region due to lack of beds, reduced delayed discharge from ICU to conventional ward and increased satisfaction of ICU professionals.

Paediatric adverse drug reactions reported to the Spanish Pharmacovigilance System from 2004 to 2009.

PURPOSE: This study was conducted to evaluate relevant new information about ADRs reported in the Spanish paediatric population over a 6-year period. METHODS: Adverse drug reactions (ADRs) for individuals aged 0-17 years reported to the Spanish Pharmacovigilance System from 2004 to 2009 were analysed with respect to time, age and sex, category of ADR [System Organ Class (SOC)], seriousness, suspected medicines [level 2 of the Anatomical Therapeutic Chemical (ATC) Classification System] and type of reporter. RESULTS: In total, 4,279 ADR reports corresponding to 8,196 ADRs were analysed, approximately two ADRs per report. The rate of paediatric ADR reports in 2009 was 165 per million, of which nearly half (46 %) were for children (age group 2-11 years). Similar total numbers of ADRs were reported for boys and girls. The most frequent ADRs reported were from the following SOCs: general disorders and administration site conditions (34 %); skin and subcutaneous tissue disorders (15 %); nervous system disorders (14 %). Reports encompassed medicines from various ATC groups: vaccines and anti-infectives for systemic use (67 %); nervous system (9 %); respiratory system (9 %). On average, 37 % of ADRs were classified as serious. There were 33 fatal ADRs, and 35 % of the paediatric population associated with the ADR notifications required hospitalization or extended hospital stay. CONCLUSIONS: In Spain, ADR reporting rate in the paediatric population has increased since 2004. The proportion of suspected ADR reports related to vaccines was predominant, which highlights the important role played by nurses. ADR notification of congenital malformations in newborn infants highlights the need for joint action between the Spanish System of Pharmacovigilance of Medicines for Human Use (SEFV-H) and paediatricians, obstetricians and gynaecologists. The publication of safety reports by regulatory agencies is determinant for the increased number of ADR notifications.

Language background shapes third-party communication expectations in 14-month-old infants.

Infants expect native and non-native speech to communicate, i.e. to transfer information between third-parties. Here, we explored if infants understand that communication depends on the use of shared conventional systems (e.g. speaking the same language), and if linguistic input (monolingual vs. bilingual) influences infants' expectations about who can communicate with whom. Fourteen-month-old monolingual and bilingual infants were presented with two actresses who spoke distinct languages (Experiment 1) or the same foreign language (Experiment 2). At test, one of the actresses uttered a foreign-language sentence (communicator) to inform the other actress (recipient) about her preference for one of two objects she could not reach. Infants expected effective communication between the two actresses when they belonged to the same linguistic group. When they demonstrated to speak distinct languages, however, only bilinguals expected that the communicator's message would be effectively transmitted to the recipient -they found more surprising the condition in which the recipient gave to the communicator the non-preferred object (vs. the preferred). The results suggest that infants expect speech to convey information between third-parties only when individuals share the same conventional system. In addition, the results suggest that, unlike monolinguals, bilinguals expect speakers of their native-language to have access to multiple conventional systems.

Metformin-associated hyperlactacidaemia acidosis: Diagnosis rate in standard clinical practice and its relationship with renal failure. / Acidosis con hiperlactacidemia por metformina: frecuencia de su diagnóstico en la práctica clínica habitual y relación con la insuficiencia renal.

BACKGROUND AND OBJECTIVES: Observational study on the difference between the number of cases of acidosis with hyperlactacidaemia suspected of being caused by metformin diagnosed in standard clinical practice and the incidence of this condition according to the datasheet. The study also explored the relationship between renal function and metformin-associated hyperlactacidaemia acidosis. PATIENTS: We identified cases of acidosis between 2013 and 2014 by analysing the minimum basic data set and laboratory requests. We selected patients who presented venous lactate levels >2.7 mmol/L at the time they were treated and for whom the use of outpatient metformin was confirmed. The causal relationship with metformin was independently evaluated by several researchers. The incident cases were calculated based on the number of patients who had been dispensed a drug containing metformin during the same period in the study area. RESULTS: We identified 476 cases of acidosis. Metformin was suspected of causing the condition of acidosis with hyperlactacidaemia in 20 of these cases, which represents an incidence rate of 6.57/10,000 patients. Eighty-five percent of the cases presented acute renal failure. CONCLUSIONS: The apparent incidence of acidosis with hyperlactacidaemia in patients treated with metformin is greater than that established in the datasheet (<1/10,000). The onset of metformin-associated hyperlactacidaemia acidosis is related to acute renal impairment.

The cosmic ray shadow of the Moon observed with the ANTARES neutrino telescope.

One of the main objectives of the ANTARES telescope is the search for point-like neutrino sources. Both the pointing accuracy and the angular resolution of the detector are important in this context and a reliable way to evaluate this performance is needed. In order to measure the pointing accuracy of the detector, one possibility is to study the shadow of the Moon, i.e. the deficit of the atmospheric muon flux from the direction of the Moon induced by the absorption of cosmic rays. Analysing the data taken between 2007 and 2016, the Moon shadow is observed with 3.5 σ statistical significance. The detector angular resolution for downward-going muons is 0 . 73 ∘ ± 0 . 14 ∘ . The resulting pointing performance is consistent with the expectations. An independent check of the telescope pointing accuracy is realised with the data collected by a shower array detector onboard of a ship temporarily moving around the ANTARES location.

α-Defensins and bacterial/permeability-increasing protein as new markers of childhood obesity.

OBJECTIVES: The aim of this paper is to test whether α-defensins and bacterial/permeability-increasing protein were related to obesity and cardiovascular risk factors in prepubertal children. METHODS: Plasma α-defensins and bacterial/permeability-increasing protein, body mass index (BMI), waist circumference, systolic blood pressure (SBP), carotid intima media thickness (cIMT), HOMA-IR and HMW-adiponectin were assessed. RESULTS: In a cross-sectional study (N = 250), higher α-defensins concentrations were positively associated with BMI, waist, SBP, cIMT, HOMA-IR and negative correlated with HMW-adiponectin (all between r = 0.191 and r = 0.377, p ≤ 0.01 and p ≤ 0.0001). Conversely, plasma bacterial/permeability-increasing protein concentrations presented inversed associated with the same parameters (all between r = -0.124 and r = -0.329; p ≤ 0.05 and p ≤ 0.0001). In a longitudinal study (N = 91), α-defensins at age 7 were associated with BMI (ß = 0.189, p = 0.002; model R2 = 0.847) and waist (ß = 0.241, pthinsp;= 0.001; model R2 = 0.754) at age 10. CONCLUSIONS: α-Defensins and bacterial/permeability-increasing protein may be the markers of childhood obesity. Increased concentrations of α-defensins may predict BMI and abdominal fat deposition in children.

Preoperative detection of gastrointestinal neuroendocrine tumors using endoscopic ultrasonography.

OBJECTIVE: Almost 30% of gastroenteropancreatic neuroendocrine tumors (GEPET) escape preoperative identification using standard imaging techniques. The goal of this retrospective study is to present our cumulative experience in the assessment of GEPET by preoperative endoscopic ultrasonography (EUS), and to compare it with a literature review. PATIENTS AND METHODS: Thirty-seven patients with suspected specific hormonal syndromes were sequentially examined with US, CT, MRI, angiography, OctreoScan, and radial and sectorial EUS. Sixteen were males (43%) and 21 were females (57%), with a mean age of 61 years (interval: 40-84 a). Of all 37 patients, 27 had 19 endocrine tumors in the pancreas and 14 tumors in their gastrointestinal tract. No tumors were demonstrated in 10 patients, hence they were used as a control group. Of all 37 patients, 24 were operated on or had histological samples collected, with the presence of 26 GEPET (10 carcinoids) being confirmed in 22 patients. RESULTS: EUS sensitivity and diagnostic accuracy were 81% and 78%. Specificity was 80%. All these values were similar to the mean values obtained from the literature review. Three pancreatic rumors smaller than or equal to 1 cm (insulinomas) were detected, which had escaped diagnosis with previous US, CT, and MRI studies. An echoendoscopic examination of the pancreas could not be completed in two cases (5%), a pancreas carcinoid and an already gastrectomized double pancreatic gastrinoma. CONCLUSION: EUS is a good preoperative technique for GEPET detection, and may likely be superior to other imaging techniques in the assessment of small tumors. The usefulness of EUS as a primary exploration after US or HCT has been posited for tumor diagnosis and localization before surgery.

Improving the peer-review process and editorial quality: key errors escaping the review and editorial process in top scientific journals.

We apply a novel mistake index to assess trends in the proportion of corrections published between 1993 and 2014 in Nature, Science and PNAS. The index revealed a progressive increase in the proportion of corrections published in these three high-quality journals. The index appears to be independent of the journal impact factor or the number of items published, as suggested by a comparative analyses among 16 top scientific journals of different impact factors and disciplines. A more detailed analysis suggests that the trend in the time-to-correction increased significantly over time and also differed among journals (Nature 233 days; Science 136 days; PNAS 232 days). A detailed review of 1,428 errors showed that 60% of corrections were related to figures, authors, references or results. According to the three categories established, 34.7% of the corrections were considered mild, 47.7% moderate and 17.6% severe, also differing among journals. Errors occurring during the printing process were responsible for 5% of corrections in Nature, 3% in Science and 18% in PNAS. The measurement of the temporal trends in the quality of scientific manuscripts can assist editors and reviewers in identifying the most common mistakes, increasing the rigor of peer-review and improving the quality of published scientific manuscripts.

Markov chains: computing limit existence and approximations with DNA.

We present two algorithms to perform computations over Markov chains. The first one determines whether the sequence of powers of the transition matrix of a Markov chain converges or not to a limit matrix. If it does converge, the second algorithm enables us to estimate this limit. The combination of these algorithms allows the computation of a limit using DNA computing. In this sense, we have encoded the states and the transition probabilities using strands of DNA for generating paths of the Markov chain.

Dietary intake and nutritional risk among free-living elderly people in Palma de Mallorca.

OBJECTIVE: To describe the dietary intake of free-living, non-institutionalised, elderly people of Palma de Mallorca, and to evaluate their nutritional status and risk of undernutrition. DESIGN: Anthropometric and dietary survey (3-day food record), and risk of undernutrition (MNA-SF) were assessed in 230 (89 men and 141 women) free-living elderly people (average age 72.7 +/- 5.9 years) in Palma de Mallorca. RESULTS: Prevalence of undernutrition (1% in men and 5% in women), overweight (56% in men and 39% in women) and obesity (17% in men and 21% in women) were found. Mean daily energy intake (+/- SD) was 5.7 +/- 1.5 MJ in men and 5.3 +/- 1.3 MJ among women. The contribution of macronutrients to the total energy intake was different from the Recommended Intake for the elderly, since it was too derived from proteins, fats, SFA and sugars, but in only small amounts was derived from complex carbohydrates. Animal protein intake was two-thirds the total protein intake. Dietary fibre was low. Cholesterol/SFA ratio showed dietary risk of atherogenic potential. High percentages of elderly persons showed inadequate intake of calcium, magnesium, zinc, folic acid, vitamin D, and vitamin E. CONCLUSIONS: An increase in dietary complex carbohydrate and fibre, a decrease in fats, especially SFA, and a balanced intake of animal/vegetable proteins and fats are recommended. Dietary supplementation, especially with calcium, vitamin C and E, and occasionally vitamin D, may be useful to improve nutritional and health status of free-living elderly people in Palma de Mallorca.

[Post-transfusion hepatitis in Navarra. Evidence of acute hepatitis C virus infection without elevation of aminotransferases]. / Hepatitis postransfusional en Navarra. Evidencia de infección aguda por el virus de la hepatitis C sin elevación de aminotransferasas.

BACKGROUND: To determine the incidence of postransfusion hepatitis (PTH) and hepatitis C virus (HCV) infection in blood recipients in Navarra and to evaluate the impact of excluding anti-HCV positive donors on the incidence of posttransfusion HCV infection. METHODS: 248 transfusion recipients were included, 150 in a first period before anti-HCV(+) donors exclusion, and 98 in a second period after their exclusion. A serum sample from each patient was collected, bimonthly during the first month and monthly for six months, and another serum sample, twelve months after transfusion. ALT and anti-HCV were tested in each sample with ELISA and RIBA 2nd generation. HCV-RNA was determined with a nested polymerase chain reaction assay. RESULTS: PTH incidence in 1989 was of 2.9%. This incidence decreased to 1.1% after anti-HCV ELISA 1st generation positive donors exclusion. At present, this incidence, with anti-HCV ELISA 2nd generation positive donors exclusion, is 0.8%. 80% of PTH were caused by HCV. 50% of HCV acute infection, confirmed by positive PCR, had normal ALT. CONCLUSIONS: In Navarra, HPT incidence is below 1% after anti-HCV(+) donors exclusion. There are subclinics forms of HCV acute postransfusional infection with normal ALT.

[The diagnosis and preoperative location of digestive endocrine tumors by endoscopic ultrasonography]. / Diagnóstico y localización preoperatoria de los tumores endocrinos digestivos mediante ultrasonografía endoscópica.

UNLABELLED: Around 30% of the gastroenteropancreatic endocrine tumors (GPET) cannot be preoperatively identified by the common diagnostic imaging techniques. The aim of this retrospective study was to present our experience in the diagnosis and localization of GPET by endoscopic ultrasonography (EUS) performed prior to surgery and compare this with a review of the literature. PATIENTS AND METHODS: Twenty patients suspected of having specific hormonal syndromes were correlatively explored with US, CT, MR, angiography, octreoscan and radial EUS with Olympus GFUM3/EUM3 and GF-UM20/EUM 20 and 30. Eleven cases were males (55%) and 9 (45%) females with a mean age of 60 years (range: 40-80 years). Of the 20 patients, 14 had endocrine 16 tumors in the pancreas and 6 tumors in the gastrointestinal tract. In 6 patients no tumors were found and were therefore used as a control group. Of the 20 patients, 14 underwent surgery confirming the existence of GPET in 12 cases. RESULTS: The diagnostic sensitivity and precision of the EUS were of 75 and 78%, respectively, with these percentages being higher to those obtained with other imaging techniques. The specificity was 83%. All these values were slightly lower than the mean obtained on review of the literature. Two pancreatic tumors of less than or equal to 1 cm were detected which had not been previously diagnosed with US, CT and MR. In two cases the exact situation was not determined. Echo-endoscopic exploration of the pancrease could not be completely performed in two cases (10%), one pancreatic carcinoma and one double pancreatic gastrinoma which was gastrectomized. Endoscopic ultrasonography is a good preoperative technique for detecting GPET and in the evaluation of small sized tumors it may surpass other imaging techniques. The usefulness of EUS as a second exploration following US has been suggested for the diagnosis and localization prior to surgery.

[Adverse reactions and other drug-related problems in an emergency service department]. / Reacciones adversas y problemas relacionados con medicamentos en un servicio de urgencia.

BACKGROUND: Adverse Drug Reactions (ADR) and Drug-Related Problems (DRP's) are a frequency cause of hospital emergency room visits and require better assessment. METHOD: An analysis was made of 1097 consecutive admission to the emergency room at the Nuestra Senora de los Volcanes, Hospital (currently the General Hospital of Lanzarote) in Arrecife de Lanzarote (Canary Islands) over a three-month period in order to detect any possible DAR or any other drug-related problems. RESULTS: Nineteen (19) of the 1097 admissions were due to Adverse Drug Reactions (ADR) (1.73%; 95% IC:0.96%-2.5%). Some of the most outstanding of the other "Drug-Related Problems" (DRP's) were medication overdose, which was diagnosed in 5 (0.45%) of the patients; the worsening of the symptoms due to ceasing to take the medication was involved in 8 (0.72%), and incorrect treatments which involved medical care at the emergency room totaled 11 (1.0%). The number of drug-related problems (DRP's) in the sample totaled 43 (3.9%). The drug-related problems (DRP's) led to hospitalization in 1.9% of the cases seen in the emergency room and led to hospitalization in 9.6% of all of hospital admission through the emergency room for the period of time under study. The ADR led to 4.1% of the hospital admissions. CONCLUSIONS: Drug-related problems are a frequent, major problem which has not been well-analyzed in the emergency rooms. Additionally, emergency rooms can function as the first point of detection of a ADR among an outpatient population.

Técnicas «Lean» para la mejora del flujo de los pacientes críticos de una región sanitaria con epicentro en el servicio de medicina intensiva de un hospital de referencia / Lean techniques to improve the flow of critically ill patients in a health region with its epicenter in the intensive care unit of a reference hospital

OBJETIVO: Analizar si la aplicación de técnicas «Lean» mejora el flujo de pacientes críticos de una región sanitaria, tomando como epicentro el servicio de medicina intensiva (UCI) del hospital de referencia. DISEÑO: Estudio observacional con análisis pre y postintervención. ÁMBITO: UCI del hospital de referencia. PACIENTES: Diseñamos proyectos y un mapa de flujo y comparamos características pre y postintervención. INTERVENCIONES: Registramos datos demográficos, de traslados de pacientes por el SEM por falta de camas y los tiempos de demora en la hora de alta de la UCI a planta de hospitalización. Realizamos reuniones multidisciplinarias y panel visual diario, con priorización de altas de UCI. Promovimos la reubicación temporal de pacientes críticos en otras áreas especiales del hospital. Cuestionario de satisfacción profesional con valoración pre y postintervención. Análisis estadístico de las comparaciones pre y postintervención. RESULTADOS: Se planificó durante 2013 y se implementó de forma progresiva en 2014. Las medidas principales fueron: 1) análisis de la entrada de pacientes al flujo del proceso de críticos, evaluando los pacientes que deben trasladarse por falta de camas, centrados en un diagnóstico y un área: 10/22 pre vs. 3/21 post (p = 0,045); 2) análisis del tiempo de demora en la hora de alta de UCI a planta de hospitalización: 360,8 ± 163,9 min en el primer periodo vs. 276,7 ± 149,5 en el segundo (p = 0,036); y 3) cuestionario de satisfacción profesional personal, con 6,6 ± 1,5 puntos pre vs. 7,5 ± 1,1 en post (p = 0,001). Análisis de los indicadores de UCI, como son las infecciones adquiridas, los días de estancia, la tasa de reingresos y la mortalidad, sin diferencias significativas entre ambos periodos. CONCLUSIONES: La aplicación de técnicas ‘Lean’ en el proceso de críticos tuvo un impacto positivo en la mejora del flujo de pacientes dentro de la región sanitaria, observando una disminución de los traslados fuera de la región por falta de camas, una reducción en la demora del alta de UCI a hospitalización convencional y un aumento de la satisfacción de los profesionales de la UCI de referencia

OBJECTIVE: To analyze whether the application of Lean techniques to improve the flow of critically ill patients in a health region with its epicenter in the intensive care unit (ICU) of a reference hospital. DESIGN: Observational study with pre and post intervention analysis. SETTING: ICU of a reference hospital. PATIENTS: We design projects and a value stream map of flow and compared pre and post intervention. INTERVENTIONS: We recorded demographic data, patient transfers by EMS for lack of beds and delay times in the discharge from ICU to ward. Multidisciplinary meetings and perform daily visual panel, with high priority ICU discharge. We promote temporary relocation of critically ill patients in other special areas of the hospital. We performed a professional satisfaction questionnaire with pre and post implementation of process. We make a statistical analysis of pre and post-intervention comparisons. Results: We planned for 2013 and progressively implemented in 2014. Analysis of patients entering the critical process flow 1) evaluate patients who must transfer for lack of beds, focusing on a diagnosis: pre 10/22 vs. 3/21 post (P = .045); 2) analysis of time delay in the discharge from the ICU to ward: 360.8 ± 163.9 minutes in the first period vs. 276.7 ± 149.5 in the second (P = .036); and 3) personal professional satisfaction questionnaire, with 6.6 ± 1.5 points pre vs. 7.5 ± 1.1 in post (P = .001). Analysis of indicators such as the ICU acquired infections, length of ICU stay, the rate of re-admissions and mortality, with no significant differences between the two periods. Conclusions: The application of Lean techniques in the critically ill process had a positive impact on improving patient flow within the health region, noting a decrease of transfers outside the region due to lack of beds, reduced delayed discharge from ICU to conventional ward and increased satisfaction of ICU professionals