Repercusión de un sistema centralizado de ingresos sobre la eficacia y eficiencia de una unidad geriátrica de recuperación funcional

ObjectiveTo evaluate the influence of a change in the management of admissions on the activity and care outcomes of a Geriatric Functional Recovery Unit (GFRU).Material and methodsA retrospective observational study was conducted. Since 2000, the Hospital Central Cruz Roja GFRU has been collecting data grouped into periods of 4 years, except for the centralised admissions (September 2016-December 2018). The data collected on admission included the Red Cross Functional and Mental scales, the Barthel index, the main diagnosis of the functional decline (grouped into stroke, orthopaedic problem, and multifactorial immobility episodes), and comorbidity evaluated by the Charlson index. The following outcome variables were analysed: the overall and relative functional gain at discharge; length of hospital stay; the functional efficiency, discharges to nursing homes, and transfers to acute care units. An analysis was made of the relationship between the admissions from the centralised unit and the previous period (directly admission managed by GFRU), using multivariate analysis (linear regression for continuous outcome variables and logistic regression for the dichotomous ones), adjusted for admission variables.ResultsPatients admitted from the centralised unit showed a greater overall and relative functional gain (difference between both means: 3.49 points, 95% CI; 1.65-5.33, and 12.41%, 95% CI; 0.74-24.08, respectively), longer stay (12.92 days, 95% CI; 11.54-14.30) and lower efficiency (−0.36, 95% CI; −0.16 to −0.57), higher risk of institutionalisation (OR 1.61, 95% CI; 1.19-2.16), and transfers to acute care units (OR 3.16, 95% CI; 2.24-4.47).ConclusionsA centralised admissions system had an influence on the improvement of functional parameters in the patients, but with a longer length of hospital stay, and lower efficiency. Increases in institutionalisation at discharge and transfers to acute care units were also observed.     

Association between rs10118757(A/G) in methylthioadenosine phosphorylase gene and coronary artery disease in Chinese Hans

Studies focusing on the association of gene methylthioadenosine phosphorylase (MTAP) with the risk of coronary artery disease (CAD) and myocardial infarction (MI) are limited.     

A randomized trial of cognitive rehabilitation in cancer survivors

Aims

The second most frequently reported post-treatment symptom in cancer survivors are concerns about impaired cognition. Despite numerous studies demonstrating significant impairments in a portion of survivors, information on effective treatments remains an emerging area of research. This study examined the effectiveness of a group-based cognitive rehabilitation intervention in cancer survivors.

Main methods

This study was a randomized, controlled study of a 7-week cognitive rehabilitation intervention delivered in group format. Participants were evaluated with subjective symptom questionnaires and objective neurocognitive tests prior to and following treatment.

Key findings

Twenty-eight participants (mean age 58 years) with a median of 3 years (± 6 years) post-primary/adjuvant treatment and various cancer sites (breast, bladder, prostate, colon, uterine) completed the study. Compared to baseline, the treatment group demonstrated improvements in symptoms of perceived cognitive impairments (p < .01), cognitive abilities (p < .01) and overall quality of life with regard to cognitive symptoms (p < .01) as measured by the FACT-Cog. The treatment group also improved on objective measures of attention (p < .05) and a trend toward improvement on verbal memory. Significant improvement was not observed on all cognitive tests.

Significance

A group based cognitive rehabilitation intervention in cancer survivors was effective for improving attention abilities and overall quality of life related to cognition. Results suggest that group based cognitive rehabilitation may be an effective intervention for treating cognitive dysfunction in cancer patients and should be further studied in a larger trial with an active control condition.     

Infection Status of Hydatid Cysts in Humans and Sheep in Uzbekistan

Uzbekistan is endemic of cystic echinococcosis (CE). In order to estimate endemicity of CE, we collected data from emergency surgery due to CE in 2002-2010 and also investigated the prevalence of hydatid cysts in the liver and lungs of sheep at an abattoir in Uzbekistan from July 2009 to June 2010. In 14 emergency hospitals, 8,014 patients received surgical removal or drainage of CE during 2002-2010, and 2,966 patients were found in 2010. A total of 22,959 sheep were grossly examined of their liver and lungs, and 479 (2.1%) and 340 (1.5%) of them were positive for the cyst in the liver and lungs, respectively. Echinococcus granulosus is actively transmitted both to humans and sheep, and CE is a zoonotic disease of public health priority in Uzbekistan.     

The role of canopy gaps in the regeneration of coastal dune forest

In regenerating coastal dune forest, the canopy consists almost exclusively of a single species, Acacia karroo. When these trees die, they create large canopy gaps. If this promotes the persistence of pioneer species to the detriment of other forest species, then the end goal of a restored coastal dune forest may be unobtainable. We wished to ascertain whether tree species composition and richness differed significantly between canopy gaps and intact canopy, and across a gradient of gap sizes. In three known‐age regenerating coastal dune forest sites, we measured 146 gaps, the species responsible for gap creation, the species most likely to reach the canopy and the composition of adults, seedlings and saplings. We paired each gap with an adjacent plot of the same area that was entirely under intact canopy and sampled in the same way. Most species (15 of 23) had higher abundance in canopy gaps. The probability of self‐replacement was low for A. karroo even in the largest gaps. Despite this predominance of shade‐intolerant species, regenerating dune forest appears to be in the first phase of succession with ‘forest pioneers’ replacing the dominant canopy species. The nature of these species should lead to successful regeneration of dune forest.     

Identity and phylogenetic placement of Spirogyra species (Zygnematophyceae,Charophyta) from California streams and elsewhere1

Diversity of the filamentous green algae in the genus Spirogyra (Zygnematophyceae) was investigated from more than 1,200 stream samples from California. We identified 12 species of Spirogyra not previously known for California (CA), including two species new to science, Spirogyra californica sp. nov. and Spirogyra juliana sp. nov. Environmental preferences of the Californian species are discussed in the light of their restricted distribution to stream habitats with contrasting nutrient levels. We also investigated the systematic relationships of Spirogyra species from several continents using the chloroplast‐encoded genes ribulose‐1,5‐bisphosphate carboxylase/hydrogenase large subunit (rbcL) and the beta subunit of the ATP synthase (atpB). Californian species were positioned in most major clades of Spirogyra. The phylogeny of Spirogyra and its taxonomic implications are discussed, such as the benefits of combining structural and molecular data for more accurate and consistent species identification. Considerable infraspecific genetic variation of globally distributed Spirogyra species was observed across continental scales. This finding suggests that structurally similar species from distant regions may be genetically dissimilar and that Spirogyra may contain a large number of cryptic species. Correlating the morphological and genetic variation within the genus will be a major challenge for future researchers.     

Vom Ruhr Zoo zur ZOOM Erlebniswelt III: Der Bauabschnitt Asien

In the Zoom Erlebniswelt Gelsenkirchen the third and last biogeographical area dedicated to the Asian fauna was opened in March 2010 covering a total area of five hectares. In May 2013 a new enclosure for tigers was added. The emphasis of the Asia area lies on a 4700 m² tropical hall with mammals and birds, and Asian gastronomic facilities as well. Included is a mixed species exhibit for orangutans (Pongo abelii), northern plains grey langurs (Semnopithecus entellus) and Asian small clawed otters (Aonyx cinerea). Along a 1.3 km outside path enclosures for some species of colder climates were built, too. The transformation of the former Ruhr Zoo Gelsenkirchen to the modern ZOOM Erlebniswelt herewith is brought to a close.     

铜尾矿复垦地土壤动物群落的恢复

土壤动物在退化生态系统的恢复与重建中发挥着重要作用.为了解铜尾矿复垦地区土壤动物群落特征的变化规律,采用样带法和陷阱法对安徽铜陵市林冲铜尾矿复垦地及其外围林灌地土壤动物群落进行调查.样带法共获得土壤动物3 154只,隶属5门10纲,共计27个类群,优势类群为线虫纲、弹尾目和蜱螨目,常见类群为猛水蚤目和鞘翅目幼虫;陷阱法共获得土壤动物2 160只,主要有弹尾目、膜翅目、双尾目、蜘蛛目、倍足纲和寡毛纲等12类群.自铜尾矿复垦地中心到外围林灌地,土壤动物密度和丰度呈递增趋势;与外围林灌地相比,铜尾矿复垦地土壤动物群落多样性DG指数较低而Shannon-Wiener指数较高;与外围林灌地距离越大,与外围林灌地群落相似性系数越小;表聚性越明显.地表土壤动物从外围林灌地迁入铜尾矿复垦地的多度和丰富度随间隔距离的增加而不断减少,随调查时间的延长而增加,随外围林灌类型的变化而变化.上述结果表明,铜尾矿复垦地及其外围林灌地土壤动物群落之间具有明显的时空差异性和渐变性,这为外围林灌地土壤动物迁入铜尾矿复垦地定居提供了证据.