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The aim was to develop a predictive model of infection by multidrug-resistant microorganisms (MDRO). A national, retrospective cohort study was carried out including all patients attended for an infectious disease in 54 Spanish Emergency Departments (ED), in whom a microbiological isolation was available from a culture obtained during their attention in the ED. A MDRO infection prediction model was created in a derivation cohort using backward logistic regression. Those variables significant at p < 0.05 assigned an integer score proportional to the regression coefficient. The model was then internally validated by k-fold cross-validation and in the validation cohort. A total of 5460 patients were included; 1345 (24.6%) were considered to have a MDRO infection. Twelve independent risk factors were identified in the derivation cohort and were combined into an overall score, the ATM (assessment of threat for MDRO) score. The model achieved an area under the curve-receiver operating curve of 0.76 (CI 95% 0.74-0.78) in the derivation cohort and 0.72 (CI 95% 0.70-0.75) in the validation cohort (p = 0.0584). Patients were then split into 6 risk categories and had the following rates of risk: 7% (0-2 points), 16% (3-5 points), 24% (6-9 points), 33% (10-14 points), 47% (15-21 points), and 71% (> 21 points). Findings were similar in the validation cohort. Several patient-specific factors were independently associated with MDRO infection risk. When integrated into a clinical prediction rule, higher risk scores and risk classes were related to an increased risk for MDRO infection. This clinical prediction rule could be used by providers to identify patients at high risk and help to guide antibiotic strategy decisions, while accounting for clinical judgment. more...

This volume sheds light on the current state of complex networks and nonlinear dynamics applied to the understanding of economic and social phenomena ranging from geographical economics to macroeconomics and finance, and its purpose is to give readers an overview of several interesting topics for research at an intermediate level. Three different and interdisciplinary, but complementary, aspects of networks are put together in a single piece, namely: (i) complex networks theory, (ii) applied network analysis to social and economic interrelations, and (iii) dynamical evolution of systems and networks. The volume includes contributions from excellent scholars in economics and social sciences as well as leading experts in the fields of complex networks and nonlinear dynamics. more...

Fundamento. El dolor de espalda es un problema de salud extendido y que afecta a gran parte de la población adulta española, suponiendo además una limitación para el desarrollo de actividades de la vida diaria. El objetivo de este trabajo es estimar el grado de asociación entre la actividad física cotidiana y el dolor de espalda crónico en España. Material y métodos. En el presente trabajo se realiza un análisis de los datos de la Encuesta Europea de Salud en España 2009; se presenta un estudio epidemiológico transversal diseñado para valorar la salud de la población española, en el que han participado 22.188 personas (10.876 hombres y 11.312 mujeres mayores de 16 años), representativas del total de dicha población. Las variables objeto de estudio son: los indicadores de dolor de espalda obtenidos del Módulo Europeo de Estado de Salud y del Módulo Europeo de Asistencia Sanitaria y el patrón de actividad física cotidiana obtenido a partir del Módulo Europeo de Determinantes de Salud. Resultados. El volumen total de actividad física cotidiana es similar en personas sanas y en aquellas que presentan dolor de espalda, pero se observa con más frecuencia un patrón de intensidad baja o moderada en las personas con dolor de espalda crónico en los últimos doce meses (p more...

Multinucleate tetraploid cells with unbalanced chromosomal distribution in aneuploid nuclei were obtained in Allium cepa L. root meristems. For this, their natural diploid cells were treated with a multipolarizing agent (1h carbetamide) followed by an inhibitor of cytokinesis (1h caffeine). Data from these multinucleate cells with aneuploid nuclei suggest that only four out of the thirty-two chromosomes of their autotetraploid complement possess DNA sequences making the nucleus competent to respond to inducers of replication and mitosis. Direct observation of cells where a single replicated chromosome had reached mitosis showed that this chromosome was the one bearing the nucleolar organizer. Six specific chromosomes would confer competence to the nucleus to respond to inducers of replication but not to those producing chromosome condensation. Another four different chromosomes would confer the nucleus with the ability to respond to mitotic inducers but not to replication inducers. The rest of the chromosomal complement seemed to lack any of the DNA sequences needed for these two important cycle transitions. In a nutshell, certain DNA sequences distributed in a few chromosomes of the onion complement are an intranuclear requirement to initiate replication and mitosis in these plant cells. more...