Intolerance of uncertainty and emotion regulation: A meta-analytic and systematic review.

Intolerance of uncertainty, a transdiagnostic factor manifested across emotional disorders, has been associated with difficulties in regulating emotions. This meta-analysis addresses the lack of synthesis of this relationship. PsycInfo, PubMed, Scopus, and ProQuest were systematically searched for relevant articles published up to and during November 2022. We combined 161 effect sizes from 91 studies (N = 30,239), separating the analysis into maladaptive and adaptive emotion regulation strategies and their association with intolerance of uncertainty. We found a moderate positive relationship between maladaptive, and a moderate inverse relationship between adaptive emotion regulation and intolerance of uncertainty. Analysing the magnitude of relationships revealed that cognitive avoidance and mindfulness were the maladaptive and adaptive strategies respectively which had the largest effect sizes and thus strongest relationships with intolerance of uncertainty. Combining all strategies, cognitive avoidance remained the largest effect size, while expressive suppression had the smallest effect size and was non-significant in its relationship. Further analyses testing study sample, design, and age as moderators found no significant moderator for the relationships between intolerance of uncertainty and emotion regulation strategies. These findings have implications for future intolerance of uncertainty interventions, with emotion regulation as a potential target of change.

Efectividad de un programa educativo sobre salud bucodental dirigido a familiares de niños en grado preescolar / Effectiveness of an educational program on oral health aimed at relatives of preschool children

RESUMEN Introducción: Las enfermedades bucales tienen su inicio en edades tempranas el accionar educativo de la familia es determinante, por ello resulta necesario contribuir a elevar su nivel de información en torno a la salud bucodental. Objetivo: Evaluar la efectividad de un programa educativo sobre salud bucodental dirigido a familiares de niños en grado preescolar. Métodos: Se realizó un estudio pre-experimental y prospectivo en la Escuela Primaria «Fe del Valle Ramos¼, de Sagua la Grande, en el período de marzo del 2017 a junio del 2018. La población estuvo constituida por 39 familias y la muestra por 36, seleccionadas por un muestreo no probabilístico intencional por criterios de inclusión y exclusión. Se utilizaron métodos teóricos, empíricos y estadísticos. Los empíricos utilizados fueron: cuestionario a las familias, criterio de especialistas y la observación participante. Se analizó como variables el nivel de información sobre salud bucodental y la efectividad del programa educativo. Resultados: La evaluación del nivel de información sobre salud bucodental dirigido a familiares de niños en grado preescolar fue de mal en 24 familias, para un 66,7 %. El programa educativo diseñado contiene 6 temas, distribuidos en 13 actividades; fue valorado por los especialistas de pertinente y factible para ser aplicado posteriormente. Conclusiones: El diseño de un programa educativo sobre salud bucodental dirigido a familiares de niños en grado preescolar contribuyó a elevar el nivel de información de los mismos lo que avala su efectividad y repercutirá positivamente para evitar enfermedades bucales.

ABSTRACT Introduction: oral diseases have their onset at an early age, the educational action of the family is decisive, that is why it is necessary to contribute to raising their level of information on oral health. Objective: to evaluate the effectiveness of an educational program on oral health aimed at relatives of preschool children. Methods: a prospective and pre-experimental was carried out at "Fe del Valle Ramos" school, in Sagua la Grande, from March 2017 to June 2018. The population consisted of 39 families and the sample was made up of 36, who were selected by an intentional non-probabilistic sampling based on inclusion and exclusion criteria. Theoretical, empirical and statistical methods were used. Family questionnaire, specialist criteria and participant observation were the empirical ones used. The level of information on oral health and the effectiveness of the educational program were analyzed as variables. Results: the evaluation of the level of information on oral health aimed at relatives of children in preschool grade was bad in 24 families (66.7%). The designed educational program contains 6 themes, distributed in 13 activities; it was assessed by the specialists as pertinent and feasible to be applied later. Conclusions: the design of an educational program on oral health aimed at relatives of preschool children contributed to raising their level of information, which supports its effectiveness and will have a positive impact on preventing oral diseases.

Evaluación del desempeño de una celda de combustible microbiana con electrodo de grafito modificado para el tratamiento de agua residual del procesamiento del café / Evaluation of the performance of a microbial fuel cell with modified graphite electrode for the treatment of wastewater from coffee processing / Avaliação do desempenho de uma célula combustível microbial com eletrodo de grafite modificado para o tratamento de águas residuais do processamento de café

Resumen La actividad cafetalera en Costa Rica procesa aproximadamente 69.000 toneladas de café mediante la técnica de beneficiado húmedo. Esta actividad conlleva un alto impacto ambiental debido a la generación de8Lde agua residual/kg de café oro producido. El presente trabajo tiene como objetivo utilizar el agua residual del procesamiento de café como sustrato en celdas combustibles microbianas (CCM), con el propósito de generar energía eléctrica a través de su uso y, a la vez, disminuir la carga orgánica del residuo. La CCM empleó un cátodo modificado con ftalocianinas de hierro (FePc), generó una eficiencia coulómbica de 0,7% y una densidad de potencia de 89 UW/ cm2 en un ciclo de operación de cinco días. Además, se determinó que la CCM disminuye la demanda química de oxígeno (DQO) del residuo hasta en 27% bajo las condiciones de operación nativas del sustrato, a temperatura ambiente, sin mediadores químicos para la reacción anódica y con el uso de electrodos de platino para el cátodo. El estudio confirma la oportunidad de emplear el sustrato con una flora microbiana nativa apta para la operación de la tecnología de la CCM, y así perfilar el dispositivo como una opción novedosa para el tratamiento de este residuo en Costa Rica.

Abstract In Costa Rica coffee production is the most traditional agroindustrial activity, each year approximately 69,000 tons of coffee are processed through the technique of wet processing. The process has a high environmental impact since it generates eight liters of wastewater/kg of produced coffee. Consequently, the main goal of this research was to evaluate the electric generation of a Microbial Fuel Cell (MFC) with two chambers, using coffee wastewater as a substrate, which would generate a sustainable solution with an added economic value to this waste in Costa Rica. The MFC with a cathode modified with iron phthalocyanines (FePc) generated a coulombic efficiency of 0.7% and a power density of 89 -uW/cm2 in a 5-day operation cycle. In addition, it was determined that the MFC decreases the COD of the waste by up to 27% under native substrate conditions, without the use of high temperatures, or chemical mediators for the anodic reaction and platinum electrodes for the cathode chamber. The efficiency of the device can be improved with changes at design level that reduce the ohmic internal resistance and improve electrical generation, the study confirms the potential of the substrate with a native microorganism suitable for the use of MFC technology, shaping the device as a novelty option for the treatment of the waste in Costa Rica.

Resumo A indústria do café na Costa Rica processa cerca de 69 000 toneladas de café por meio da técnica de moagem úmida, o que acarreta um alto impacto ambiental devido à geração de 8 L de água residual / kg de café dourado. O objetivo deste trabalho era usar águas residuais do processamento do café como substrato em Células de Combustível Microbianas (CCM) a fim de gerar energia elétrica por meio do seu aproveitamento e ao mesmo tempo reduzir a carga orgânica do resíduo. CCM usando cátodo modificado com ftalocianinas de ferro (FePc) gerou uma eficiência coulômbica de 0,7% e uma densidade de potência de 89 uW/cm2 em um ciclo operacional de cinco dias. Além disso, foi determinado que o CCM reduz a Demanda Química de Oxigénio (DQO) do resíduo em até 27% nas condições nativas de operação do substrato, à temperatura ambiente, sem mediadores químicos para a reação anódica e com a utilização de eletrodos de platina para o cátodo. O estudo confirma a oportunidade de utilizar o substrato com flora microbiana nativa adequada para o funcionamento da tecnologia CCM e, assim, delinear o dispositivo como uma nova opção para o tratamento desses resíduos na Costa Rica.

Sulfated glycosaminoglycan-like polymers are present in an acidophilic biofilm from a sulfidic cave.

Sulfated glycosaminoglycans (sGAG) are negatively charged extracellular polymeric substances that occur in biofilms from various environments. Yet, it remains unclear whether these polymers are acquired from the external environment or produced by microbes in the biofilm. To resolve this, we analyzed the presence of sGAGs in samples of an acidophilic biofilm collected from Sulfur Cave in Puturosu Mountain (Romania), an environment that is largely inaccessible to contamination. A maximum of 55.16 ± 2.06 µg sGAG-like polymers were recovered per mg of EPS. Enzymatic treatment with chondroitinase ABC resulted in a decrease of the mass of these polymers, suggesting the structure of the recovered sGAG is similar to chondroitin. Subsequent FT-IR analysis of these polymers revealed absorbance bands at 1230 cm-1, 1167 cm-1 and 900 cm-1, indicating a possible presence of polysaccharides and sulfate. Analysis of genomic sequences closely related to those predominant in the acidophilic biofilm, contained genes coding for sulfotransferase (an enzyme needed for the production of sGAG), which supports the hypothesis of microbial synthesis of sGAGs within the biofilm.

[Model of care for the treatment of patients with osteoarthritis from the first to the third level]. / Modelo de atención para el tratamiento de pacientes con osteoartritis del primer al tercer nivel.

INTRODUCTION: Osteoarthritis in Mexico is one of the ten most frequent causes of disability. Early diagnosis and detection of risk factors are determinant for treatment. The institutional organization establishes therapeutic guidelines according to each level of care, but effective management is not achieved. MATERIAL AND METHODS: A prospective, pilot, interventional, clinical study was conducted, which included patients diagnosed with different degrees of knee osteoarthritis in the first, second and third level of care, with an integrative model that includes a group of professionals for the intervention of nutritional, physiotherapeutic, social and psychological evaluation from the first level. RESULTS: The intervention of a multidisciplinary care group allows a correct evaluation and assignment of the level of care, optimizing human and material resources. The participation of different disciplines in nutrition, psychology, social work, physiotherapy and rehabilitation modifies the global lifestyle by involving the patients themselves in their treatment. The intervention group had improvements in the visual analog pain scale, mobility arcs, low body mass index and improvement in the psychological aspect. CONCLUSIONS: The proposed model of care demonstrates that implementation in the institution and in each clinical care unit should be considered to improve outcomes.

INTRODUCCIÓN: La osteoartritis en México es una de las 10 causas más frecuentes de discapacidad. El diagnóstico temprano y la detección de factores de riesgo son determinantes para el tratamiento. La organización institucional establece las pautas terapéuticas de acuerdo con cada nivel de atención, pero no se logra un manejo efectivo. MATERIAL Y MÉTODOS: Se realizó un estudio prospectivo, piloto, de intervención, clínico conformado por pacientes diagnosticados con diferentes grados de osteoartritis de rodilla en el primer, segundo y tercer nivel de atención, con un modelo integrador que incluyó un grupo de profesionales para la intervención de la evaluación nutricional, fisioterapéutica, social y sicológica desde el primer nivel. RESULTADOS: La intervención de un grupo de atención multidisciplinaria permite una correcta evaluación y asignación del nivel de atención optimizando los recursos humanos y materiales. La participación de diferentes disciplinas en nutrición, sicología, trabajo social, fisioterapia y rehabilitación modifica el estilo de vida global al involucrar a los propios pacientes en su tratamiento. El grupo de intervención tuvo mejoras en la escala de dolor análogo visual, arcos de movilidad, bajo índice de masa corporal y mejoría en el aspecto sicológico. CONCLUSIONES: El modelo de atención propuesto demuestra que la implementación en la institución y en cada unidad clínica de atención debe considerarse para mejorar los resultados.

Hematoma hepático subcapsular como complicación del síndrome de HELLP: reporte de caso / Subcapsular hepatic hematoma as a complication of the HELLP syndrome: Case report

Presentamos el caso de una paciente con diagnóstico de hematoma subcapsular hepático como complicación del síndrome de HELLP. Debido al bajo volumen de casos publicados, la conducta terapéutica en esta entidad no ha sido definida con claridad. En el caso presentado, la ejecución pronta de un estudio de imagen fue clave para el establecimiento del diagnóstico. En caso de tratarse de un hematoma sin compromiso hemodinámico, el tratamiento conservador puede ser exitoso, como se demostró en nuestro caso

A case is presented on a patient diagnosed with a hepatic subcapsular haematoma as a complication of the HELLP syndrome. Due to the low volume of published cases, the therapeutic behaviour of this condition has not been clearly defined. In the case presented, the early execution of an imaging study was a key factor in establishing the diagnosis. In the case of a haematoma without haemodynamic compromise, conservative treatment can be successful, as demonstrated in our case

Tratamiento quirúrgico de condroides en las bolsas guturales de un equino mediante abordaje Whitehouse modificado. Reporte de caso / Standing surgical treatment of chondroids in guttural pouches of a horse through a modified Whitehouse approach. Case report

RESUMEN Una yegua de raza caballo criollo colombiano (CCC) de 34 meses de edad fue remitida al Centro de Veterinaria y Zootecnia de la Universidad CES, en la ciudad de Medellín (Colombia), para la extracción quirúrgica de condroides en ambas bolsas guturales. La paciente se intervino en estación utilizando neuroleptoanalgesia y a continuación, se empleó la técnica Whitehouse modificado en cada bolsa gutural para extraer la totalidad de los condroides. Posteriormente, se realizó tratamiento antibiótico y antinflamatorio pre y post quirúrgico con trimetoprim-sulfadiazina y flunixin meglumine vía sistémica; además, penicilina G sódica local. Luego de la intervención la paciente fue dada de alta sin complicaciones y finalmente se evidenció la resolución completa de la condición respiratoria. El reporte de este caso permitirá conocer con detalle la técnica Whitehouse modificado, así como sus retos quirúrgicos y consideraciones, ya que a la fecha en Colombia no hay otros reportes al respecto en un CCC.

ABSTRACT A 34 months old Colombian creole mare was referred to veterinary clinic of CES University, in Medellin (Colombia), for the surgical extraction of chondroids in both guttural pouch. The patient was intervened by standing surgery using neuroleptanalgesia. The modified Whitehouse technique was subsequently performed on each guttural pouch to extract all the chondroids. Antibiotic and anti-inflammatory treatment, pre and postsurgical, was systemically administered using trimethoprim/sulfadiazine and flunixin meglumine, as well as local sodium penicillin G. After the intervention, the patient was discharged without complications and its respiratory condition came to complete solution. This case report will allow knowing in detail the modified Whitehouse surgical technique along with its surgical challenges and considerations. In Colombia, to date, there are no reports of its use in CCH.

Sub-cycle dynamics in relativistic nanoplasma acceleration.

The interaction of light with nanometer-sized solids provides the means of focusing optical radiation to sub-wavelength spatial scales with associated electric field enhancements offering new opportunities for multifaceted applications. We utilize collective effects in nanoplasmas with sub-two-cycle light pulses of extreme intensity to extend the waveform-dependent electron acceleration regime into the relativistic realm, by using 106 times higher intensity than previous works to date. Through irradiation of nanometric tungsten needles, we obtain multi-MeV energy electron bunches, whose energy and direction can be steered by the combined effect of the induced near-field and the laser field. We identified a two-step mechanism for the electron acceleration: (i) ejection within a sub-half-optical-cycle into the near-field from the target at >TVm-1 acceleration fields, and (ii) subsequent acceleration in vacuum by the intense laser field. Our observations raise the prospect of isolating and controlling relativistic attosecond electron bunches, and pave the way for next generation electron and photon sources.

Associations between neural injury markers of intrauterine growth-restricted infants and neurodevelopment at 2 years of age.

Objectives: The aim of this study was to evaluate the relationships between brain injury biomarkers in intrauterine growth-restricted (IUGR) infants (S100B and neuron-specific enolase (NSE)) and neurodevelopment at 2 years of age. Methods: This prospective case-control study was a cooperative effort among Spanish Maternal and Child Health Network (Retic SAMID) hospitals. At inclusion, biometry for estimated fetal weight and feto-placental Doppler variables were measured for each infant. Maternal venous blood and fetal umbilical arterial blood samples were collected at the time of delivery and neural injury markers S100B and NSE concentrations were measured. Neurodevelopment was evaluated at 2 years of age using the Bayley Scales of Infant and Toddler Development, third edition (Bayley-III). Results: Fifty six pregnancies were included. Thirty-one infants were classified as IUGR and 25 as non-IUGR. Neurodevelopmental evaluation at 2 years of age indicated that there were no between-group differences for any of the tests. For all patients in both groups, we found statistically significant inverse relationships between the concentrations of NSE in the cord blood and the results of the cognitive test (r = -271, p = .042), fine motor subtest (r = -280, p = .036), and social-emotional test (r = -349, p = .015). We also found statistically significant differences between the concentrations of S100B in the cord blood and the results of the cognitive test (r = -306, p = .022) and expressive communication subtest (r = -304, p = .023). For the IUGR group, we found a significant inverse relationship between the concentrations of S100B in the maternal serum and the results of adaptive behavior test (p < .05). In the non-IUGR group, we found statistically significant inverse relationships between the concentration of NSE in the cord blood and the results of the fine motor subtest (r = -446, p = .025) and social-emotional test (r = -489, p = .021). The difference between the concentration of S100B in the cord blood and the language composite score was also statistically significant (p = .038). Conclusions: At 2 years of age, the concentrations of NSE and S100B were higher in the non-IUGR and IUGR groups with the worst scores for some areas of neurodevelopmental evaluation. The value of these biomarkers for prognostic neurodevelopmental use requires further investigation for both non-IUGR and IUGR infants.

[Conservative management of traumatic priapism in paediatric patients]. / Manejo conservador del priapismo traumático en la edad pediátrica.

INTRODUCTION: High-flow priapism is infrequent in pediatric patients. It is mostly secondary to perineal trauma resulting in laceration of a penile artery and the formation of an arterio-cavernous fistula. It does not constitute a medical emergency in itself, and allows conservative management awaiting spontaneous resolution. CLINICAL CASE: A six-year-old boy with painless persistent erection preceded by perineal trauma. Ultrasound imaging confirmed the clinical suspicion of high flow priapism secondary to arterio-cavernous fistula. After adopting a conservative approach, the patient presented progressive detumescence, as well as ultrasound resolution one month after the episode. COMMENTS: In high-flow priapism, venous drainage of the penis is preserved. The classical approach in adults is based on therapeutic angiography, which presents greater technical complexity and the risk of iatrogenic hypoxia in pediatric patients.

INTRODUCCION: El priapismo de alto flujo es una entidad infrecuente en la edad pediátrica. Es, en su mayoría, secundario a traumatismo perineal que provoca la laceración de una arteria peneana y formación de una fístula arterio-cavernosa. No constituye una emergencia médica, permitiendo un manejo conservador a la espera de su resolución espontánea. CASO CLINICO: Niño de seis años con erección persistente e indolora tras traumatismo perineal. El diagnóstico ecográfico confirma la sospecha de priapismo de alto flujo secundario a fístula arteria-cavernosa. Tras manejo conservador, presenta detumescencia progresiva y resolución ecográfica al mes del episodio. COMENTARIOS: En el priapismo de alto flujo el drenaje venoso del pene se encuentra conservado. El manejo clásico en adultos se fundamenta en la angiografía terapéutica, de mayor complejidad técnica y riesgo de hipoxia iatrogénica en el paciente pediátrico.

Next Generation Driver for Attosecond and Laser-plasma Physics.

The observation and manipulation of electron dynamics in matter call for attosecond light pulses, routinely available from high-order harmonic generation driven by few-femtosecond lasers. However, the energy limitation of these lasers supports only weak sources and correspondingly linear attosecond studies. Here we report on an optical parametric synthesizer designed for nonlinear attosecond optics and relativistic laser-plasma physics. This synthesizer uniquely combines ultra-relativistic focused intensities of about 1020 W/cm2 with a pulse duration of sub-two carrier-wave cycles. The coherent combination of two sequentially amplified and complementary spectral ranges yields sub-5-fs pulses with multi-TW peak power. The application of this source allows the generation of a broad spectral continuum at 100-eV photon energy in gases as well as high-order harmonics in relativistic plasmas. Unprecedented spatio-temporal confinement of light now permits the investigation of electric-field-driven electron phenomena in the relativistic regime and ultimately the rise of next-generation intense isolated attosecond sources.

La fatiga como estado motivacional subjetivo / A fadiga como um estado motivacional subjetivo / Fatigue as a subjective motivational state

Actualmente no existe consenso sobre los factores que determinan la aparición de la fatiga. Hay factores que se derivan exclusivamente del esfuerzo físico, otros que dependen del esfuerzo mental que este lleva aparejado, y otros de los resultados de la tarea que se está realizando. Como consecuencia, se han desarrollado diferentes modelos explicativos que pretenden aunar las diferentes razones de su aparición. No obstante, la tendencia actual es entender la fatiga como un estado motivacional complejo cuyo origen tiene lugar en numerosos procesos fisiológicos y psicológicos que sirven para regular el esfuerzo y proteger al organismo de daños graves. Los objetivos de la presente revisión narrativa son analizar los diferentes enfoques existentes para el estudio y la explicación de la fatiga, establecer el vínculo con el concepto de carga de entrenamiento y justificar la importancia de evaluar las repercusiones de la carga mental para conseguir una adecuada planificación y control del proceso de entrenamiento (AU)

There is currently no consensus on the factors that determine the onset of fatigue. There are some factors that are derived exclusively from the physical effort, others that depend on the mental effort due to physical effort, and some others on the feedback provided by the task being performed. As a result, we have developed different explanatory models that seek to combine the different reasons for its occurrence. Nevertheless, the current trend is to understand fatigue as a complex motivational state whose origin occurs in many physiological and psychological processes that serve to regulate the effort and protect the body from serious damage. The aims of this narrative review are to analyze the different existing approaches to the study and explanation of fatigue, establish the link with the concept of training load and justify the importance of evaluating the impact of mental load to achieve a proper planning and a training process control (AU)

Atualmente não existe consenso sobre os fatores que determinam o aparecimento da fadiga. Existem fatores que são derivados exclusivamente do esforço físico, outros que dependem do esforço mental que ela traz, e outros resultados da tarefa executada. Como consequência, tem-se desenvolvido diferentes modelos explicativos que procuram combinar as diferentes razões para a sua ocorrência. No entanto, a tendência atual é entender a fadiga como um estado motivacional complexo, cuja origem ocorre em muitos processos fisiológicos e psicológicos que servem para regular o esforço e proteger o corpo de danos graves. Os objetivos da presente revisão narrativa são analisar as diferentes abordagens existentes para o estudo e explicação da fadiga, estabelecer a ligação com o conceito de carga de treinamento e justificar a importância de se avaliar o impacto da carga mental para alcançar um planejamento adequado e controle de processo de treinamento (AU)

FBXO31 protects against genomic instability by capping FOXM1 levels at the G2/M transition.

F-box proteins in conjunction with Skp1, Cul1 and Rbx1 generate SCF complexes that are responsible for the ubiquitination of proteins, leading to their activation or degradation. Here we show that the F-box protein FBXO31 is required for normal mitotic progression and genome stability due to its role in regulating FOXM1 levels during the G2/M transition. FBXO31-depleted cells undergo a transient delay in mitosis due to an activated spindle checkpoint concomitant with an increase in lagging chromosomes and anaphase bridges. FBXO31 regulates mitosis in part by controlling the levels of FOXM1, a transcription factor and master regulator of mitosis. FBXO31 specifically interacts with FOXM1 during the G2/M transition, resulting in FOXM1 ubiquitination and degradation. FBXO31 depletion results in increased expression of FOXM1 transcriptional targets and mimics the FOXM1 overexpression. In contrast, co-depletion of FBXO31 and FOXM1 restores the genomic instability phenotype but not the delay in mitosis, indicating that FBXO31 probably has additional mitotic substrates. Thus, FBXO31 is the first described negative regulator of FOXM1 during the G2/M transition.

Online optimal experimental re-design in robotic parallel fed-batch cultivation facilities.

We present an integrated framework for the online optimal experimental re-design applied to parallel nonlinear dynamic processes that aims to precisely estimate the parameter set of macro kinetic growth models with minimal experimental effort. This provides a systematic solution for rapid validation of a specific model to new strains, mutants, or products. In biosciences, this is especially important as model identification is a long and laborious process which is continuing to limit the use of mathematical modeling in this field. The strength of this approach is demonstrated by fitting a macro-kinetic differential equation model for Escherichia coli fed-batch processes after 6 h of cultivation. The system includes two fully-automated liquid handling robots; one containing eight mini-bioreactors and another used for automated at-line analyses, which allows for the immediate use of the available data in the modeling environment. As a result, the experiment can be continually re-designed while the cultivations are running using the information generated by periodical parameter estimations. The advantages of an online re-computation of the optimal experiment are proven by a 50-fold lower average coefficient of variation on the parameter estimates compared to the sequential method (4.83% instead of 235.86%). The success obtained in such a complex system is a further step towards a more efficient computer aided bioprocess development. Biotechnol. Bioeng. 2017;114: 610-619. © 2016 Wiley Periodicals, Inc.

Collective Deceleration of Laser-Driven Electron Bunches.

Few-fs electron bunches from laser wakefield acceleration (LWFA) can efficiently drive plasma wakefields (PWFs), as shown by their propagation through underdense plasma in two experiments. A strong and density-insensitive deceleration of the bunches has been observed in 2 mm of 10^{18} cm^{-3} density plasma with 5.1 GV/m average gradient, which is attributed to a self-driven PWF. This observation implies that the physics of PWFs, usually relying on large-scale rf accelerators as drivers, can be studied by tabletop LWFA electron sources.

The International Spinal Cord Injury Pain Extended Data Set (Version 1.0).

OBJECTIVES: The objective of this study was to develop the International Spinal Cord Injury Pain Extended Data Set (ISCIPEDS) with the purpose of guiding the assessment and treatment of pain after spinal cord injury (SCI). SETTING: International. METHODS: The ISCIPEDS was reviewed by members of the International SCI Data Sets Committee, the International Spinal Cord Society Executive and Scientific Committees, American Spinal Injury Association and American Pain Society Boards, and the Neuropathic Pain Special Interest Group of the International Association for the Study of Pain, individual reviewers and societies. RESULTS: The working group recommended four assessment domains for the ISCIPEDS: (i) Pain symptoms including variables related to pain type, temporal course, severity, unpleasantness, tolerability of pain and questionnaires assessing pain type and symptom severity; (ii) Sensory signs to detect and quantify sensory abnormalities commonly associated with neuropathic pain, including dynamic mechanical and thermal allodynia, and hyperalgesia; (iii) Treatments (ongoing and past 12 months); and (iv) Psychosocial factors and comorbid conditions. CONCLUSION: The ISCIPEDS was designed to be used together with the International SCI Pain Basic Data Set and provide a brief yet thorough assessment of domains related to chronic pain in individuals with SCI. The data set includes pain-relevant self-reported assessments, questionnaires and sensory examinations. The recommendations were based on (i) their relevance to individuals with SCI and chronic pain, (ii) the existence of published findings supporting the utility of the selected measures for use in individuals with SCI, and to the greatest extent possible (iii) their availability in the public domain free of charge.

Workload and cortisol levels in helicopter combat pilots during simulated flights / Carga mental y niveles de cortisol en pilotos de helicóptero de combate en vuelos simulados / Carga de trabalho e níveis de cortisol em pilotos de helicópteros de combate durante voos simulados

Objective. Examine and compare the cortisol levels before and after a simulated flight related to workload in experienced helicopter combat pilots, searching for physiological levels of anxiety. Method. 15 volunteer Spanish Army helicopter combat pilots (36.83 ± 8.04 years) were studied before and after a simulated flight (eight new tasks). Salivary cortisol was measured by DRG salivary cortisol ELISA, and we studied workload using the NASA-TLX. Results. The differences in the mean values of cortisol level before (5.33 ± 1.55) and after the task at the flight simulator (4.47 ± 0.73) are statistically significant (t14 = 3.301; p = .005) with a high effect size (d = 0.75). Similar significant differences were also found (t14 = 3.301; p = .005) between the workload before (19.76 ± 10.54), and after the task (24.82 ± 10.42; medium effect size d = −0.48). No significant relationships were found between the cortisol levels and the workload. Conclusions. Cortisol levels in saliva and workload are the usual in stress situations, and change inversely: workload increases at the end of the task, whereas the cortisol levels decrease after the simulated flight. The somatic anxiety decreases as the task is done. In contrast, when the pilots are faced with new and demanding tasks, even if they fly this type of helicopter in different conditions, the workload increases toward the end of the task. From an applied point of view, these findings should impact the tactical, physical and mental training of such pilots (AU)

Objetivo. Examinar y comparar los niveles de cortisol antes y después de un vuelo simulado en relación con la carga de trabajo de pilotos de helicópteros con experiencia de combate, en busca de niveles fisiológicos de la ansiedad. Método. Se estudió a 15 pilotos de helicópteros voluntarios del Ejército Español (36.83 ± 8.04 años) antes y después de un vuelo simulado compuesto por 8 tareas nuevas. El cortisol salival se midió por DRG Cortisol ELISA y la carga de trabajo con el NASA-TLX. Resultados. Las diferencias entre los valores medios de nivel de cortisol antes (5.33 ± 1.55) y después de la tarea en el simulador de vuelo (4.47 ± 0.73) son estadísticamente significativas (t14 = 3.301; p = 0.005; elevado tamaño de efecto, d = 0.75), así como (t14 = 3.301; p = 0.005) entre la carga de trabajo antes (19.76 ± 10.54) y después de la tarea (24.82 ± 10.42; tamaño de efecto medio, d = −0.48). No hubo relaciones significativas entre los niveles de cortisol y la carga de trabajo. Conclusiones. Los niveles de cortisol en saliva y la carga de trabajo son habituales en situaciones de estrés, y cambian inversamente: la carga de trabajo aumenta al final de la tarea, mientras que los niveles de cortisol —y de ansiedad somática— disminuyen después del vuelo simulado. En cambio, frente a tareas nuevas y exigentes, la carga de trabajo aumenta al final. Estos hallazgos deberían afectar la planificación del entrenamiento táctico, físico y mental de estos pilotos (AU)

Objetivo. Examinar e comparar os níveis de cortisol antes e depois de voo simulado em relação a carga de trabalho de experientes pilotos de helicóptero de combate, procurando por níveis fisiológicos de ansiedade. Métodos. 15 voluntários pilotos de helicópteros de combate do exército espanhol (36.83 ± 8.04 años) foram estudados antes e depois de um voo simulado (8 novas tarefas). Cortisol salivar foi mensurado por DRG Cortisol salivar ELISA, e foi estudado a carga de trabalho usando o NASA-TLX. Resultados. As diferenças nos valores médios dos níveis de cortisol antes (5.33 ± 1.55) e depois da tarefa no simulador de voo (4.47 ± 0.73) foram estatisticamente significantes (t14 = 3.301; p = .005) com o tamanho do efeito (d = 0.75). Diferenças significantes similares também foram encontradas (t14 = 3.301; p = .005) entre a carga de trabalho antes (19.76 ± 10.54), e depois da tarefa (24.82 ± 10.42); tamanho do efeito médio (d = −0.48). Nenhuma relação significativa foi encontrada entre os níveis de cortisol e a carga de trabalho. Conclusão. Níveis de cortisol na saliva e carga de trabalho são comuns em situações de estresse, e mudam inversamente: a carga de trabalho aumenta ao final da tarefa, enquanto o nível de cortisol diminui depois do voo simulado. A ansiedade somática diminui quando a tarefa acaba. Em contraste, quando os pilotos enfrentam uma nova e exigente tarefa, mesmo que eles voem no mesmo tipo de helicóptero em diferentes situações, a carga de trabalho aumenta em direção ao final da tarefa. Para um ponto de vista aplicável, os achados devem impactar o treinamento tático, físico e mental destes pilotos (AU)

Epstein-Barr virus-specific CD8(+) T lymphocytes from diffuse large B cell lymphoma patients are functionally impaired.

Epstein-Barr virus (EBV) is a persistent virus with oncogenic capacity that has been implicated in the development of aggressive B cell lymphomas, primarily in immunosuppressed individuals, although it can be present in immunocompetent individuals. Changes in the function and clonal diversity of T lymphocytes might be implied by viral persistence and lymphoma development. The aim of the present study was to evaluate the frequency, phenotype, function and clonotypical distribution of EBV-specific T cells after peripheral blood stimulation with a virus lysate in newly diagnosed patients with diffuse large B cell lymphoma (DLBCL) aged more than 50 years without prior histories of clinical immunosuppression compared with healthy controls. Our results showed impaired EBV-specific immune responses among DLBCL patients that were associated primarily with decreased numbers of central and effector memory CD8(+) T lymphocytes. In contrast to healthy controls, only a minority of the patients showed CD4(+)/tumour necrosis factor (TNF)-α(+) T cells expressing T cell receptor (TCR)-Vß17 and CD8(+)/TNF-α(+) T cells with TCR-Vß5·2, Vß9 and Vß18 in response to EBV. Notably, the production of TNF-α was undetectable among TCR-Vß5·3(+), Vß11(+), Vß12(+), Vß16(+) and Vß23(+) CD8(+) T cells. In addition, we observed decreased numbers of CD4(+)/TNF-α(+) and CD8(+)/TNF-α(+), CD8(+)/interleukin (IL)-2(+) and CD8(+)/TNF-α(+)/IL-2(+) T lymphocytes in the absence of T cells capable of producing TNF-α, IL-2 and IFN-γ after EBV stimulation simultaneously. Moreover, DLBCL patients displayed higher IL-10 levels both under baseline conditions and after EBV stimulation. These findings were also observed in patients with positive EBV viral loads. Prospective studies including a large number of patients are needed to confirm these findings.

[Infantile hypertrofic pyloric stenosis or gastric adenomyoma? Differential diagnosis of gastric outlet obstruction in children]. / ¿Estenosis hipertrófica de píloro o adenomioma pilórico? Diagnóstico diferencial de obstrucción gástrica en niños.

PURPOSE: Gastrointestinal adenomyoma is a rare benign tumor most frequently located in the stomach. The differential diagnosis is wide because of its large clinical spectrum and unspecific radiological findings. Surgical excision is both diagnostic and therapeutic. CASE REPORT: A 49-days old girl presented with nonbilious vomiting of 48 hours of evolution. Infantile hypertrofic pyloric stenosis was suspected. Ultrasound showed a nonobstructive nodular lesion in the anterior pyloric wall. MRI suggested a myofibroblastic tumor. We proceeded to laparotomy and complete resection of the pyloric tumor. Histologic diagnosis was gastric adenomyoma. CONCLUSIONS: Pyloric adenomyoma causes obstructive symptoms similar to other common entities such as hypertrophic pyloric stenosis or cystic duplication. We have to consider this condition in children with digestive symptoms and radiological images of intussusceptions or duplication. Surgical excision is recommended to reach a definitive diagnosis and to avoid a possible malignant degeneration.

INTRODUCCION: El adenomioma gastrointestinal es una tumoración benigna rara cuya localización más frecuente es gástrica. Su diagnóstico diferencial es amplio debido a su gran espectro clínico y baja especificidad radiológica. La escisión quirúrgica es diagnóstico-terapeútica. CASO CLINICO: Niña de 49 días que presenta vómitos no biliosos de 48 horas de evolución. Ante sospecha de estenosis hipertrófica de píloro se solicita ecografía que muestra lesión nodular no obstructiva en pared anterior del píloro. Se realiza RM sugestiva de tumor miofibroblástico. Se procede a laparotomía y resección completa de tumoración pilórica, informada histológicamente como adenomioma gástrico. COMENTARIOS: El adenomioma pilórico produce clínica obstructiva y se confunde con entidades comunes como la estenosis hipertrófica de píloro o la duplicación quística. En un niño con síntomas digestivos e imagen radiológica de invaginación o duplicación, debemos tener en cuenta esta patología. La resección quirúrgica es de elección para un diagnóstico certero y para evitar una posible degeneración maligna.

The International Spinal Cord Injury Pain Basic Data Set (version 2.0).

OBJECTIVES: To revise the International Spinal Cord Injury Pain Basic Data Set (ISCIPBDS) based on new developments in the field and on suggestions from the spinal cord injury (SCI) and pain clinical and research community. SETTING: International. METHODS: The ISCIPBDS working group evaluated suggestions regarding the utility of the ISCIPBDS and made modifications in response to these and to significant developments in the field. The revised ISCIPBDS (version 2.0) was reviewed by members of the Executive Committee of the International SCI Standards and Data Sets, the International Spinal Cord Society (ISCoS) Executive and Scientific Committees, the American Spinal Injury Association and American Pain Society Boards and the Neuropathic Pain Special Interest Group of the International Association for the Study of Pain, individual reviewers and societies and the ISCoS Council. RESULTS: The ISCIPBDS (version 2.0) is significantly shortened but still contains clinically relevant core questions concerning SCI-related pain. The revisions include an updated SCI pain classification, omission of three questions regarding temporal pain pattern and three pain interference questions. The remaining three pain interference questions concern perceived interference with activities, mood and sleep for overall pain rather than for individual pain problems and are scored on a 0 to 10 scale.