Plasmapheresis vs. immunoglobulin in autoimmune neurologic diseases: a meta-analysis

Objectives: to evaluate the efficacy and safety of human immunoglobulin versus plasmapheresis in the management of autoimmune neurologic diseases. Likewise, length of hospital stay and duration of ventilator support were compared. Methods: Randomized controlled trials and analytical observational studies of more than 10 cases, were reviewed. Cochrane Neuromuscular Disease Group trials, MEDLINE, EMBASE, HINARI Ovid, the Database of abstracts of reviews of effectiveness and the Economic evaluation Database were searched as data source. Reference lists were examined for further relevant articles. A random-effect model was used to derive a pooled risk ratio. Results: 725 articles were found and 27 met the criteria for a population studied of 4717 cases: 14 articles were about Guillain Barré syndrome, 10 of Myasthenia Gravis, one of Sydenham Chorea, one of Chronic inflammatory demyelinating polyneuropathy, and one of PANDAS. No evidence was found in favor of any of the two treatments as regards effectiveness (OR 0.94, IC 0.63 – 1.41, p= 0.77) or ventilator support time; IGIV had a significant better safety profile than plasmapheresis (OR 0.70, IC 0.51 – 0.96, p= 0.03) and patients needed less time of hospital stay (p=0.03). Conclusions: There is no evidence for superiority in the effectiveness of immunoglobulin or plasmapheresis in the management of autoimmune neurologic diseases. Nevertheless, patients treated with immunoglobulin have statistically significant less adverse effects, a shorter hospital stay and a tendency of less ventilator support time. These premises could lead to fewer costs for health services but an economic study should be done.

Conceptual Rapprochement and the Analysis of the Historical, Normative and Jurisprudential Treatment of the Rural Workers, as Regards the Need for Special Protection

This article aims to present an approach to the issue of farm or rural zone workers, including a labour law study of agrarian legal decisions, so as to demonstrate their importance in respect to social, economic and cultural rights in Colombia. The study will serve to illustrate through the history, the applicable law and the jurisprudence, the different ways in which farmers have been treated from the time of the origin until the arrival of modern systems of industrialization. It calls into question the effectiveness of existing laws and the role of the courts, in spite of globalization, to maintain the minimum rights and guarantees of farm workers who are considered to be a vulnerable population. In conclusion, this study seeks to illustrate the current role of the Labor law and the National Health Service in the area of demonstrating of the existence or absence of mechanisms to protect workers in rural areas and the need to create some mechanisms that involve social justice given its prime importance in the Constitution of 1991.

Preliminary factorial structure of the O’Kelly Women’s Belief Scales in Mexican population

A Back-translated Mexican version of the Austra- lian o’Kelly Women’s Belief scales was given to a sample of 363 women born and living in Mexico. A factor analysis with a varimax rotation with cu- toff eigenvalues of 3 showed that 36 out of the 92 items originally developed in the Australian study accounted for 40.138% of the variance, and could be ultimately grouped into two factors: one “ra- tionality” factor, with a total of 14 items, and one “Irrationality” factor with a total of 22 items, and with a very low Pearson’s rs (.119) between them. these results support the equivalency of the Mexi- can version to the original instrument used to iden- tify the presence of the reBt’s absolutistic, rigid beliefs about traditional feminine roles in women.

SIDUR: development of an information system, using controlled vocabulary designed to the characterization and sample of population with and without disability, attended by Rehabilitation programs, University of Rosario

Introduction: the statistical record used in the Field Academic Programs (PAC for it’s initials in Spanish) of Rehabilitation denotes generalities in the data conceptualization, which complicates the reliable guidance in making decisions and provides a low support for research in rehabilitation and disability. In response, the Research Group in Rehabilitation and Social Integration of Persons with Disabilities has worked on the creation of a registry to characterize the population seen by Rehabilitation PAC. This registry includes the use of the International Classification of Functioning, Disability and Health (ICF) of the WHO. Methodology: the proposed methodology includes two phases: the first one is a descriptive study and the second one involves performing methodology Methontology, which integrates the identification and development of ontology knowledge. This article contextualizes the progress made in the second phase. Results: the development of the registry in 2008, as an information system, included documentary review and the analysis of possible use scenarios to help guide the design and development of the SIDUR system. The system uses the ICF given that it is a terminology standardization that allows the reduction of ambiguity and that makes easier the transformation of health facts into data translatable to information systems. The record raises three categories and a total of 129 variables Conclusions: SIDUR facilitates accessibility to accurate and updated information, useful for decision making and research.

Deletion Analysis of 15 exons located outside and inside a “Hot Spot” in the Duchenne Muscular Dystrophy gene in Duchenne’s Muscular dystrophy patients

Introduction. Duchenne and Becker Muscular Dystrophies (DMD/DMB) are X-linked recessive diseases characterized by progressive muscle weakness and wasting, loss of motor skills and death after the second decade of life. Deletions are the most prevalent mutations that affect the dystrophin gene, which spans 79 exons.Objective: Identify deletions on the dystrophin gene in 58 patients affected with DMD.Methods: Through multiplex PCR identify deletions on the dystrophin gene in 58 patients with DMD and observe the frequency of this mutation in our population.Results: We found deletions in 1.72% of patients (1 of 58 persons). Deletions were not the principal cause of disease in our population. It is possible that duplications and point mutations caused this illness in our patients.Conclusions: The frequency of deletions in the 15 exons analyzed from the dystrophin gene was low. The predominant types of mutation in our patients` samples were not deletions as has been observed in the literature worldwide, therefore, it is important to determine other types of mutations as are duplications and point mutations.

Overcoming Gender Disadvantages. Social Policy Analysis of urban middle-class women in Colombia

The World Bank Report 2012 starts with this statement: “Gender equality matters in itself andit matters for development because, in today’s globalized worlds, countries that use the skillsand talents of their women would have an advantage over those which do not use it.” With theframe that suggest that gender equality matters, this paper describes some policy alternativesoriented to overcome gender disadvantages in the formal labor market incorporation of theurban middle class women in Colombia. On balance, the final recommendation suggest that itis desirable to adopt policy alternatives as Community Centers, which are programs orientedto a social redistribution of the domestic work as a way to encourage women participationin the formal labor market with the social support of the members of their own community.The problem that the social policy needs to address is the segregation of women in the formallabor market in Colombia. Although the evidence shows that the women overcome theeducational gap by showing better performance in education that their male peers, womenare still segregated of the labor market. The persistence of high rates of unemployment on thefemale population, the prevalence of the informal labor market as a women labor market, andthe presence of the payment difference between men and women with similar professionaltrainings are circumstances that sustain the segregation statement. These circumstances areinefficient for the society because an economic analysis shows that the cost of maintain the statuquo is externalized in the social security system that includes health, pension and maternityleave regimens. Therefore, the women segregation involves a market failure.This paper evaluates five policy alternatives each directed to the progress of a different causaldimension of the problem: (i) Quotas in the private market, (ii) Flexible working hours,(iii) replace the maternity leave with a family leave, (iv) Increase the Community Centers forredistributing the care work, and (v) Equal payment enforcement. The first alternative looksto increase women’s participation in the formal labor market. The second, third, and fourthalternatives constitute a package addressed at redistributing care work by reducing women’sresponsibility for reproductive work in the household with the help of husbands and the localgovernment. The fifth alternative intervenes to resolve the equal payment problem.After a four criteria evaluation that measure effectiveness, robustness and improbability inimplementation, efficiency and political acceptability or social opposition, the strongest alternativeis the fostering of Community Centers that promote a redistribution of care work. Thispolicy performs well in the assessment process because it combines gender focus with importantindirect effects: child support and human capabilities. The policy also shows a bottomup implementation process that overcomes the main adoption difficulties in the gender focusprograms and is supported by strong evidence of success in the Colombian context; this evidenceis produced by both transnational actors as a World Bank and also in local accountabilityreporters executed by local institutions like Colombian Institute of Family Welfare (ICBF).

Case-Crossover Analysis of Air Pollution Health Effects: A Systematic Review of Methodology and Application

Case-crossover is one of the most used designs for analyzing the health-related effects of air pollution. Nevertheless, no one has reviewed its application and methodology in this context. Objective: We conducted a systematic review of case-crossover (CCO) designs used to study the relationship between air pollution and morbidity and mortality, from the standpoint of methodology and application.Data sources and extraction: A search was made of the MEDLINE and EMBASE databases.Reports were classified as methodologic or applied. From the latter, the following information was extracted: author, study location, year, type of population (general or patients), dependent variable(s), independent variable(s), type of CCO design, and whether effect modification was analyzed for variables at the individual level. Data synthesis: The review covered 105 reports that fulfilled the inclusion criteria. Of these, 24 addressed methodological aspects, and the remainder involved the design’s application. In the methodological reports, the designs that yielded the best results in simulation were symmetric bidirectional CCO and time-stratified CCO. Furthermore, we observed an increase across time in the use of certain CCO designs, mainly symmetric bidirectional and time-stratified CCO. The dependent variables most frequently analyzed were those relating to hospital morbidity; the pollutants most often studied were those linked to particulate matter. Among the CCO-application reports, 13.6% studied effect modification for variables at the individual level.Conclusions: The use of CCO designs has undergone considerable growth; the most widely used designs were those that yielded better results in simulation studies: symmetric bidirectional and time-stratified CCO. However, the advantages of CCO as a method of analysis of variables at the individual level are put to little use

Ecological analysis of periphytic diatoms in Mediterranean coastal wetlands (Empordà wetlands, NE Spain)

S'han estudiat els efectes dels factors ambientals sobre el perífiton dels sistemes lenític fluctuants del aiguamolls de l'Empordà. L'estudi s'ha realitzat als tres nivells d'integració: nivell d'ecosistema considerant el rol del perífiton envers els altres productors primaris; a nivell de comunitat, estudiant la composició específica de les diatomees i a nivell de població estudiant la plasticitat fenotípica d'una espècie de diatomea (Nitzschia frustulum). A nivell d'ecosistema s'observa que els factors que afavoreixen el predomini dels diferents tipus de productors primaris (perífiton, fitoplàncton i macròfits) són la renovació i el grau d'eutròfia de l'aigua. A nivell de comunitat els factors determinants en la composició i distribució de les espècies de diatomees són els gradients confinament-inundació així com la productivitat del sistema. En funció d'aquest factors s'han establert 5 associacions de diatomees. A nivell de població es demostra que tant la salinitat, com la relació N : P a l'aigua com el moviment de l'aigua afecten la morfologia i ultraestructura de la valva de N. frustulum. De forma interessant s'observa que la salinitat, considerada com a factor individual, afecta N. frustulum a nivell poblacional provocant-li modificacions en la morfologia de la valva, per en canvi, no afecta a nivell de comunitat, ja que totes les espècies de diatomees presents en ambients de salinitat fluctuant són eurihalines.

Reintroduction of the Eurasian otter (Lutra lutra) in Muga and Fluvià basins (north-eastern Spain): viability, development, monitoring and trends of the new population

Aquesta tesi es basa en el programa de reintroducció de la llúdriga eurasiàtica (Lutra lutra) a les conques dels rius Muga i Fluvià (Catalunya) durant la segona meitat dels 1990s. Els objectius de la tesi foren demostrar la viabilitat de la reintroducció, demostrar l'èxit de la mateixa, estudiar aspectes ecològics i etològics de l'espècie, aprofitant l'oportunitat única de gaudir d'una població "de disseny" i determinar les probabilitats de supervivència de la població a llarg termini. La reintroducció de la llúdriga a les conques dels rius Muga i Fluvià va reeixir, doncs l'àrea geogràfica ocupada efectivament es va incrementar fins a un 64% d'estacions positives a l'hivern 2001-02. La troballa de tres exemplars adults nascuts a l'àrea de reintroducció és una altra prova que valida l'èxit del programa. La densitat d'exemplars calculada a través dels censos visuals ha resultat baixa (0.04-0.11 llúdrigues/km), però s'aproxima al que hom pot esperar en els primers estadis d'una població reintroduïda, encara poc nombrosa però distribuïda en una gran àrea. La mortalitat post-alliberament va ser del 22% un any després de l'alliberament, similar o inferior a la d'altres programes de reintroducció de llúdrigues reeixits. La mortalitat va ser deguda principalment a atropellaments (56%). El patró d'activitat de les llúdrigues reintroduïdes va esdevenir principalment nocturn i crepuscular, amb una escassa activitat diürna. Les seves àrees vitals van ser del mateix ordre (34,2 km) que les calculades en d'altres estudis realitzats a Europa. La longitud mitjana de riu recorreguda per una llúdriga durant 24 hores va ser de 4,2 km per les femelles i 7,6 km pels mascles. Durant el període de radioseguiment dues femelles van criar i els seus moviments van poder ser estudiats amb deteniment. La resposta de la nova població de llúdrigues a les fluctuacions estacionals en la disponibilitat d'aigua, habitual a les regions mediterrànies, va consistir en la concentració en una àrea menor durant el període de sequera estival, a causa de l'increment de trams secs, inhabitables per la llúdriga per la manca d'aliment, fet que va provocar expansions i contraccions periòdiques en l'àrea de distribució. La persistència a llarg termini de la població reintroduïda va ser estudiada mitjançant una Anàlisi de Viabilitat Poblacional (PVA). El resultat va ser un baix risc d'extinció de la població en els propers 100 anys i la majoria dels escenaris simulats (65%) van assolir el criteri d'un mínim de 90% de probabilitat de supervivència. Del model poblacional construït es dedueix que un punt clau per assegurar la viabilitat de la població reintroduïda és la reducció de la mortalitat accidental. A l'àrea d'estudi, els atropellaments causen més del 50% de la mortalitat i aquesta pot ser reduïda mitjançant la construcció de passos de fauna, el tancament lateral d'alguns trams de carretera perillosos i el control de la velocitat en algunes vies. El projecte de reintroducció ha posat a punt un protocol per a la captura, maneig i alliberament de llúdrigues salvatges, que pot contenir informació útil per a programes similars. També ha suposat una oportunitat única d'estudiar una població dissenyada artificialment i poder comparar diversos mètodes per estimar la distribució i la densitat de poblacions de llúdrigues. Per últim, la reintroducció portada a terme a les conques dels rius Muga i Fluvià ha aconseguit crear una nova població de llúdrigues, que persisteix en el temps, que es reprodueix regularment i que es dispersa progressivament, fins i tot a noves conques fluvials.

Lesser Scaup Population Dynamics: What Can Be Learned from Available Data?

Populations of Lesser Scaup (Aythya affinis) have declined markedly in North America since the early 1980s. When considering alternatives for achieving population recovery, it would be useful to understand how the rate of population growth is functionally related to the underlying vital rates and which vital rates affect population growth rate the most if changed (which need not be those that influenced historical population declines). To establish a more quantitative basis for learning about life history and population dynamics of Lesser Scaup, we summarized published and unpublished estimates of vital rates recorded between 1934 and 2005, and developed matrix life-cycle models with these data for females breeding in the boreal forest, prairie-parklands, and both regions combined. We then used perturbation analysis to evaluate the effect of changes in a variety of vital-rate statistics on finite population growth rate and abundance. Similar to Greater Scaup (Aythya marila), our modeled population growth rate for Lesser Scaup was most sensitive to unit and proportional change in adult female survival during the breeding and non-breeding seasons, but much less so to changes in fecundity parameters. Interestingly, population growth rate was also highly sensitive to unit and proportional changes in the mean of nesting success, duckling survival, and juvenile survival. Given the small samples of data for key aspects of the Lesser Scaup life cycle, we recommend additional research on vital rates that demonstrate a strong effect on population growth and size (e.g., adult survival probabilities). Our life-cycle models should be tested and regularly updated in the future to simultaneously guide science and management of Lesser Scaup populations in an adaptive context.

Evaluating the Small Population Paradigm for Rare Large-Bodied Woodpeckers, with Implications for the Ivory-billed Woodpecker

Six large-bodied, ≥ 120 g, woodpecker species are listed as near-threatened to critically endangered by the International Union for Conservation of Nature (IUCN). The small population paradigm assumes that these populations are likely to become extinct without an increase in numbers, but the combined influences of initial population size and demographic rates, i.e., annual adult survival and fecundity, may drive population persistence for these species. We applied a stochastic, stage-based single-population model to available demographic rates for Dryocopus and Campephilus woodpeckers. In particular, we determined the change in predicted extinction rate, i.e., proportion of simulated populations that went extinct within 100 yr, to concomitant changes in six input parameters. To our knowledge, this is the first study to evaluate the combined importance of initial population size and demographic rates for the persistence of large-bodied woodpeckers. Under a worse-case scenario, the median time to extinction was 7 yr (range: 1–32). Across the combinations of other input values, increasing initial population size by one female induced, on average, 0.4%–3.2% (range: 0%–28%) reduction in extinction rate. Increasing initial population size from 5–30 resulted in extinction rates < 0.05 under limited conditions: (1) all input values were intermediate, or (2) Allee effect present and annual adult survival ≥ 0.8. Based on our model, these species can persist as rare, as few as five females, and thus difficult-to-detect, populations provided they maintain ≥ 1.1 recruited females annually per adult female and an annual adult survival rate ≥ 0.8. Athough a demographic-based population viability analysis (PVA) is useful to predict how extinction rate changes across scenarios for life-history attributes, the next step for modeling these populations should incorporate more easily acquired data on changes in patch occupancy to make predictions about patch colonization and extinction rates.

A Demographic Model to Evaluate Population Declines in the Endangered Streaked Horned Lark

The Streaked Horned Lark (Eremophila alpestris strigata) is listed as endangered by the State of Washington, USA and by Canada under the Species at Risk Act and is also classified as a federal candidate for listing under the Endangered Species Act in the USA. A substantial portion of Streaked Horned Lark habitat has been lost or degraded, and range contraction has occurred in Oregon, Washington, and British Columbia. We estimate the vital rates (fecundity, adult and juvenile survival) and population growth rate (λ) for Streaked Horned Larks breeding in Washington, USA and conduct a Life-Stage Simulation Analysis (LSA) to evaluate which vital rate has the greatest influence on λ. We simulated changes in the three vital rates to examine how much they would need to be adjusted either independently or in concert to achieve a stable Streaked Horned Lark population (λ = 1). We also evaluated which fecundity component (the number of fledglings per egg laid or renesting interval) had the greatest impact on λ. The estimate of population growth suggests that Streaked Horned Larks in Washington are declining rapidly (λ = 0.62 ± 0.10) and that local breeding sites are not sustainable without immigration. The LSA results indicate that adult survival had the greatest influence on λ, followed by juvenile survival and fecundity. However, increases in vital rates led to λ = 1 only when adult survival was raised from 0.47 to 0.85, juvenile survival from 0.17 to 0.58, and fecundity from 0.91 to 3.09. Increases in breeding success and decreases in the renesting interval influenced λ similarly; however, λ did not reach 1 even when breeding success was raised to 100% or renesting intervals were reduced to 1 day. Only when all three vital rates were increased simultaneously did λ approach 1 without requiring highly unrealistic increases in each vital rate. We conclude that conservation activities need to target all or multiple vital rates to be successful. The baseline data presented here and subsequent efforts to manage Streaked Horned Larks will provide valuable information for management of other declining Horned Lark subspecies and other grassland songbirds across North America.

Stability of a Seabird Population in the Presence of an Introduced Predator

We hypothesized that although large populations may appear able to withstand predation and disturbance, added stochasticity in population growth rate (λ) increases the risk of dramatic population declines. Approximately half of the Aleutian Islands' population of Least Auklets (Aethia pusilla) breed at one large colony at Kiska Island in the presence of introduced Norway rats (Rattus norvegicus) whose population erupts periodically. We evaluated two management plans, do nothing or eradicate rats, for this colony, and performed stochastic elasticity analysis to focus future research and management. Our results indicated that Least Auklets breeding at Kiska Island had the lowest absolute value of growth rate and more variable λ's (neither statistically significant) during 2001-2010, when compared with rat-free colonies at Buldir and Kasatochi islands. We found variability in the annual proportional change in population size among islands with Kiska Island having the fastest rate of decline, 78% over 20 years. Under the assumption that the eradication of rats would result in vital rates similar to those observed at rat-free Buldir and Kasatochi islands, we found the projected population decline decreased from 78% to 24% over 20 years. Overall, eradicating rats at Kiska Island is not likely to increase Least Auklet vital rates, but will decrease the amount of variation in λ, resulting in a significantly slower rate of population decline. We recommend the eradication of rats from Kiska Island to decrease the probability of dramatic population declines and ensure the future persistence of this important colony.

Patterns of pollen and seed dispersal in a small, fragmented population of the wind-pollinated tree Araucaria angustifolia in southern Brazil

Paternity analysis based on eight microsatellite loci was used to investigate pollen and seed dispersal patterns of the dioecious wind- pollinated tree, Araucaria angustifolia. The study sites were a 5.4 ha isolated forest fragment and a small tree group situated 1.7 km away, located in Paran alpha State, Brazil. In the forest fragment, 121 males, 99 females, 66 seedlings and 92 juveniles were mapped and genotyped, together with 210 seeds. In the tree group, nine male and two female adults were mapped and genotyped, together with 20 seeds. Paternity analysis within the forest fragment indicated that at least 4% of the seeds, 3% of the seedlings and 7% of the juveniles were fertilized by pollen from trees in the adjacent group, and 6% of the seeds were fertilized by pollen from trees outside these stands. The average pollination distance within the forest fragment was 83 m; when the tree group was included the pollination distance was 2006m. The average number of effective pollen donors was estimated as 12.6. Mother- trees within the fragment could be assigned to all seedlings and juveniles, suggesting an absence of seed immigration. The distance of seedlings and juveniles from their assigned mother- trees ranged from 0.35 to 291m ( with an average of 83m). Significant spatial genetic structure among adult trees, seedlings, and juveniles was detected up to 50m, indicating seed dispersal over a short distance. The effective pollination neighborhood ranged from 0.4 to 3.3 ha. The results suggest that seed dispersal is restricted but that there is longdistance pollen dispersal between the forest fragment and the tree group; thus, the two stands of trees are not isolated.

Identifying the critical parameters of a cyanobacterial growth and movement model by using generalised sensitivity analysis

Bloom-forming and toxin-producing cyanobacteria remain a persistent nuisance across the world. Modelling of cyanobacteria in freshwaters is an important tool for understanding their population dynamics and predicting the location and timing of the bloom events in lakes and rivers. A new deterministic-mathematical model was developed, which simulates the growth and movement of cyanobacterial blooms in river systems. The model focuses on the mathematical description of the bloom formation, vertical migration and lateral transport of colonies within river environments by taking into account the major factors that affect the cyanobacterial bloom formation in rivers including, light, nutrients and temperature. A technique called generalised sensitivity analysis was applied to the model to identify the critical parameter uncertainties in the model and investigates the interaction between the chosen parameters of the model. The result of the analysis suggested that 8 out of 12 parameters were significant in obtaining the observed cyanobacterial behaviour in a simulation. It was found that there was a high degree of correlation between the half-saturation rate constants used in the model.