Linear Vibronic Coupling Approach for Surface-Enhanced Raman Scattering: Quantifying the Charge-Transfer Enhancement Mechanism.

The outstanding amplification observed in surface-enhanced Raman scattering (SERS) is due to several enhancement mechanisms, and standing out among them are the plasmonic (PL) and charge-transfer (CT) mechanisms. The theoretical estimation of the enhancement factors of the CT mechanism is challenging because the excited-state coupling between bright plasmons and dark CT states must be properly introduced into the model to obtain reliable intensities. In this work, we aim at simulating electrochemical SERS spectra, considering models of pyridine on silver clusters subjected to an external electric field E⃗ that represents the effect of an electrode potential Vel. The method adopts quantum dynamical propagations of nuclear wavepackets on the coupled PL and CT states described with linear vibronic coupling models parametrized for each E⃗ through a fragment-based maximum-overlap diabatization. By presenting results at different values of E⃗, we show that indeed there is a relation between the population transferred to the CT states and the total scattered intensity. The tuning and detuning processes of the CT states with the bright PLs as a function of the electric field are in good agreement with those observed in experiments. Finally, our estimations for the CT enhancement factors predict values in the order of 105 to 106, meaning that when the CT and PL states are both in resonance with the excitation wavelength, the CT and PL enhancements are comparable, and vibrational bands whose intensity is amplified by different mechanisms can be observed together, in agreement with what was measured by typical experiments on silver electrodes.

Assessing the negative impact of chlorantraniliprole, isoxaflutole, and simazine pesticides on phospholipid membrane models and tilapia gill tissues.

The indiscriminate and, very often, incorrect use of pesticides in Brazil, as well as in other countries, results in severe levels of environmental pollution and intoxication of human life. Herein, we studied plasma membrane models (monolayer and bilayer) of the phospholipid Dioleoyl-sn-glycerol-3-phosphocholine (DOPC) using Langmuir films, and large (LUVs) and giant (GUVs) unilamellar vesicles, to determine the effect of the pesticides chlorantraniliprole (CLTP), isoxaflutole (ISF), and simazine (SMZ), used in sugarcane. CLTP affects the lipid organization of the bioinspired models of DOPC π-A isotherms, while ISF and SMZ pesticides significantly affect the LUVs and GUVs. Furthermore, the in vivo study of the gill tissue in fish in the presence of pesticides (2.0 × 10-10 mol/L for CLTP, 8.3 × 10-9 mol/L for ISF, and SMZ at 9.9 × 10-9 mol/L) was performed using optical and fluorescence images. This investigation was motivated by the gill lipid membranes, which are vital for regulating transporter activity through transmembrane proteins, crucial for maintaining ionic balance in fish gills. In this way, the presence of phospholipids in gills offers a model for understanding their effects on fish health. Histological results show that exposure to CLTP, ISF, and SMZ may interfere with vital gill functions, leading to respiratory disorders and osmoregulation dysfunction. The results indicate that exposure to pesticides caused severe morphological alterations in fish, which could be correlated with their impact on the bioinspired membrane models. Moreover, the effect does not depend on the exposure period (24h and 96h), showing that animals exposed to pesticides for a short period suffer irreparable damage to gill tissue. In summary, we can conclude that the harm caused by pesticides, both in membrane models and in fish gills, occurs due to contamination of the aquatic system with pesticides. Therefore, water quality is vital for the preservation of ecosystems.

Internet-based cognitive behavioral therapy intervention for youth with type 1 diabetes and depressive symptoms: a pilot and feasibility study.

Depression is more common in youth with type 1 diabetes (T1D) compared to youth without diabetes. This study aims to assess the efficacy of Competent Adulthood Transition with Cognitive Humanistic and Interpersonal Teaching (CATCH-IT), an internet-based cognitive behavioral therapy (CBT) intervention, in adolescents with T1D and depressive symptoms. Adolescents (13 to 17 years old) with T1D and mild (score 5-9) or moderate (score 10-14) depressive symptoms on Patient Health Questionnaire-Adolescent (PHQ-A) screening assessment were recruited to participate and received online access to the CATCH-IT modules for 6 months (requested to complete in 12 weeks). Statistical analyses included paired t-test for changes in Center for Epidemiologic Studies Depression Scale (CES-D), PHQ-A, Problem Areas in Diabetes-Teen version (PAID-T), and hemoglobin A1c (HbA1c). Nineteen patients were consented, 15 met inclusion criteria and received the intervention. In the seven participants that completed the modules, there was a trend towards improvements in PHQ-A, CES-D and HbA1c. Participants provided robust qualitative feedback on the modules and areas for improvement in subsequent iterations, such as inclusion of diabetes-related content. Given the prevalence of depression in diabetes, feasible, low resource interventions are needed. Internet programs such as CATCH-IT can serve as an effective first line intervention in this high-risk population. A modified version of CATCH-IT tailored for adolescents with T1D may be beneficial in this patient population.

Bioseguridad en ambientes quirúrgicos durante la COVID-19 / Biosafety in Surgical Environments during the COVID-19 Pandemic

Introducción: La COVID-19 significó un gran reto para los servicios de cirugía a nivel mundial, lo que trajo como consecuencia modificaciones, incluso la suspensión de la actividad quirúrgica en algunos casos con el objetivo de garantizar seguridad tanto para el paciente como para el personal de salud. Objetivo: Describir acciones que contribuyan a garantizar condiciones de bioseguridad en ambientes quirúrgicos durante la pandemia de COVID-19. Métodos: Se realizó una revisión bibliográfica para la cual se usaron 37 referencias bibliográficas en inglés y español. Se consultaron fuentes científicas como PubMed/Medline, SciELO, Scopus, ScienceDirect y fuentes oficiales como la Organización Mundial de la Salud. Desarrollo: Ante la reanudación de la cirugía electiva se crearon protocolos de actuación. Deben clasificarse los pacientes en 3 grupos según la posibilidad de padecer COVID-19: individuos sanos, portadores asintomáticos y pacientes con síntomas. Además, debe darse prioridad a los pacientes cuyos procedimientos fueron cancelados. Se preconiza crear circuitos independientes y separados para evitar el contacto de casos sospechosos o confirmados de COVID-19 con el resto de pacientes. Para garantizar mayor seguridad debe entrenarse al personal médico en la forma correcta de utilizar los medios de protección personal. La inducción anestésica de estos pacientes debe garantizar su seguridad y prevenir el contagio. Una vez concluida la cirugía, se llevará a cabo la recuperación inicial del paciente dentro del propio quirófano y este será higienizado estrictamente. Conclusiones: Los profesionales sanitarios deben estar adecuadamente entrenados y conocer las medidas de bioseguridad y protocolos sanitarios tanto del hospital como del país en que se encuentren(AU)

Introduction: COVID-19 posed a great challenge to surgical services worldwide, resulting in modifications, including the suspension of surgical activity in some cases with the aim of ensuring safety for both the patient and the health personnel. Objective: To describe actions that contribute to guarantee biosafety conditions in surgical environments during the COVID-19 pandemic. Methods: A bibliographic review was carried out using 37 bibliographic references in English and Spanish. Scientific sources, such as PubMed/Medline, SciELO, Scopus and ScienceDirect, were consulted; as well as official sources, such as the World Health Organization. Development: When elective surgery was resumed, action protocols were created. Patients should be classified into 3 groups, according to the possibility of having COVID-19: healthy individuals, asymptomatic carriers, and patients with symptoms. In addition, priority should be given to patients whose procedures have been cancelled. Independent and isolated wards are recommended to be created in order to avoid contact between suspected or confirmed COVID-19 cases and the rest of the patients. To ensure greater safety, the medical personnel should be trained in the correct use of personal protective equipment. The anesthetic induction of these patients should ensure their safety and prevent contagion. Once the surgery is over, the initial recovery of the patient will be carried out inside the operating room itself, which shall be strictly sanitized. Conclusions: Healthcare professionals must be adequately trained and be aware of the biosecurity measures and healthcare protocols of both the hospital and the country where they are located(AU)

Atomic force microscopy for the evaluation of corneal surface roughness after femtosecond laser flap creation and excimer ablation.

INTRODUCTION: It is well known that the femtosecond laser lamellar cut induces some degree of surface roughness. Nevertheless, as in femtosecond laser-assisted LASIK (FS-LASIK), an excimer LASIK ablation is performed, and the post-ablation stromal bed should show some degree of smoothening. We decided to compare, using atomic force microscopy (AFM), the roughness of the corneal stromal bed, after a femtosecond lasers device flap was created with or without an excimer myopic ablation. METHODS: Using 6 freshly enucleated porcine eyes, we created in every eye a flap using a femtosecond laser. Additionally, in 3 eyes, an excimer laser ablation to correct-3 diopters (D) was made. AFM imaging of the remaining corneal stroma was performed. Ten different square areas of 20 µm x 20 µm at the central area of the stroma of each corneal sample were studied. The roughness parameters used were the root-mean-square deviation from a perfectly flat surface. RESULTS: The RMS deviation was 360 ± 120 nm in femtosecond laser only, and 110 ± 20 nm in those cases where excimer is also involved (p < 0.0001). CONCLUSIONS: Our results show that the roughness of the surface treated with excimer is clearly lower than in the group with no excimer ablation; thus, the application of laser excimer after a flap created by femtosecond laser seems to soften the nano-irregularities created by this technique.

An integrated approach to address diabetes in the context of food insecurity: Delivering health study protocol.

Background: Diabetes self-management education and support (DSMES) interventions among food insecure individuals with type 2 diabetes (T2D) have found modest improvements in nutrition and health outcomes but are limited by barriers to attendance and retention. This study applies a community-based participatory research approach, engaging community members at all levels of intervention planning, development, implementation, and dissemination, to deliver a plain-language DSMES curriculum to food insecure community members with T2D. Methods: This is a single-arm, pre-post design assessing the efficacy of a 12-week home-delivered DSMES curriculum and T2D-appropriate food box intervention to improve the nutrition and health outcomes of food insecure individuals with T2D. The intervention consists of a weekly food box delivery and handout with video links on key DSMES topics, developed and refined using community advisor feedback. Up to 100 English-, Spanish-, or Marshallese-speaking adult participants with T2D (HbA1c ≥ 7%) and food insecurity are being recruited from food pantries in northwest Arkansas. Data is collected at pre-intervention and immediately post-intervention. The primary study outcome is change in HbA1c. Secondary measures include diet quality (Healthy Eating Index-2015, calculated from 3 24-h dietary recall interviews via phone), body mass index, blood pressure, skin carotenoids, food security, T2D self-management behaviors, T2D self-efficacy, and T2D-related distress. Results: Recruitment began in August 2021 and enrollment is anticipated to be complete in March 2023. Conclusion: Findings from this study will provide a rich understanding of diabetes-related health outcomes and dietary patterns of individuals with food insecurity and T2D and inform future food-focused DSMES interventions in this setting.

Life expectancy after surgical aortic valve replacement for low-gradient aortic stenosis with preserved ejection fraction.

INTRODUCTION AND OBJECTIVES: Surgical aortic valve replacement (SAVR) can modify the natural history of severe aortic stenosis (SAS). However, compared with the general population, these patients have a loss of life expectancy. The life expectancy of patients who undergo SAVR due to low-gradient SAS with preserved left ventricular ejection fraction (LVEF) is unknown. METHODS: We included all patients between 50 and 65 years who underwent isolated SAVR in 27 Spanish centers during an 18-year period. We analyzed observed and expected survival at 18 years in patients with low-gradient SAS with preserved LVEF and all other types of SAS. We used propensity score matching to compare the life expectancy of patients with low-gradient SAS with preserved LVEF vs those with high-gradient SAS with preserved LVEF. RESULTS: We analyzed 5084 patients, of whom 413 had low-gradient SAS with preserved LVEF. For these patients, observed survival at 10, 15 and 18 years was 86.6% (95%CI, 85.3-87.8), 75% (95%CI, 72.7-77.2), and 63.5% (95%CI, 58.8-67.8). Expected survival at 10, 15 and 18 years was 90.2%, 82.1%, and 75.7%. In the matched sample, survival of patients with low-gradient SAS with preserved LVEF was similar to that of patients with high-gradient with preserved LVEF, log-rank test, P=.95; HR=1 (95%CI, 0.7-1.4; P=.95). CONCLUSIONS: There is a loss of life expectancy in patients with all types of SAS undergoing SAVR. This loss is higher in patients with left ventricular dysfunction and lower in patients with low-gradient or high-gradient aortic stenosis with preserved LVEF. The benefit of surgery is similar between these last 2 groups.

Computational Model for Electrochemical Surface-Enhanced Raman Scattering: Key Role of the Surface Charges and Synergy between Electromagnetic and Charge-Transfer Enhancement Mechanisms.

We present a computational model for electrochemical surface-enhanced Raman scattering (EC-SERS). The surface excess of charge induced by the electrode potential (Vel) was introduced by applying an external electric field to a set of clusters [Agn]q with (n, q) of (19, ±1) or (20, 0) on which a molecule adsorbs. Using DFT/TD-DFT calculations, these metal-molecule complexes were classified by the adsorbate partial charge, and the main Vel-dependent properties were simultaneously studied with the aid of vibronic resonance Raman computations, namely, changes on the vibrational wavenumbers, relative intensities, and enhancement factors (EFs) for all SERS mechanisms: chemical or nonresonant, and resonance Raman with bright states of the adsorbate, charge-transfer (CT) states, and plasmon-like excitations on the metal cluster. We selected two molecules to test our model, pyridine, for which Vel has a remarkable effect, and 9,10-bis((E)-2-(pyridin-4-yl)vinyl)anthracene, which is almost insensitive to the applied bias. The results nicely reproduced most of the experimental observations, while the limitations of our approach were critically evaluated. We detected that accounting explicitly for the surface charges is key for EC-SERS models and that the highest calculated EFs, up to 107 to 108, are obtained by interstate coupling of bright local excitations of the metal cluster and CT states. These results highlight the importance of nonadiabatic effects in SERS and the capabilities of EC-SERS as a technique with potential to study excited-state coupling by tuning the CT and plasmon-like states by manipulating Vel.

Documento de opinión de expertos para la mejora de la cobertura vacunal frente a la gripe estacional / Expert opinion on strategies to improve vaccination coverage against seasonal influenza

La gripe estacional sigue siendo un importante problema de salud pública, y la vacuna antigripal es la medida más efectiva para su prevención. En nuestro país, los datos de coberturas vacunales de las últimas temporadas muestran unas tasas de vacunación muy por debajo de los objetivos marcados por los organismos oficiales. Tras la pandemia de la COVID19, las coberturas vacunales para la gripe han experimentado una notable mejoría. Dado que resulta imperativo alcanzar y mantener unas elevadas tasas de vacunación con el fin de evitar el impacto clínico y económico de la gripe, un grupo multidisciplinar de expertos en el área de las vacunas hemos analizado cómo afectan las bajas coberturas en nuestro país y hemos diseñado una serie de medidas para incrementar la cobertura vacunal de la gripe, especialmente en los colectivos definidos como prioritarios. (AU)

Seasonal flu continues to be a major public health concern, and the influenza vaccine remains the most effective preventive measure. In Spain, vaccination coverage data from previous seasons show vaccination rates well below official targets; however, these figures improved significantly after the COVID-19 pandemic. Given the importance of achieving and maintaining high vaccination rates in order to avoid the clinical and economic impact of influenza, our multidisciplinary group of experts on vaccines analyzed the impact of low vaccination rates in Spain and drafted a series of measures to boost influenza vaccination coverage, particularly among priority groups. (AU)

Psychometry and Cut-off Points of the Jefferson Scale of Empathy in Medical Students in Central America and the Caribbean.

OBJECTIVE: The objective of this study was to determine cut-off points that can be used to differentiate measures of empathy, which would then be classified as high, medium, or low. To do so, we used data from students from 7 medical schools in Colombia, El Salvador, and the Dominican Republic, after determining the psychometric properties of the 3-dimensional model of empathy in the Jefferson Scale of Empathy, S-version (for medical students). MATERIALS AND METHODS: This non-experimental descriptive study had a sample that consisted of 6291 students. The structure and factor invariance were analyzed by country and sex. A hierarchical cluster analysis and a bifactorial analysis of variance were applied. RESULTS: The measure of empathy was reliable on the global scale (α = .82; ω = .88). A confirmatory factor analysis showed that the original model was replicable and adjusted to the data (comparative fit index [CFI] = .90; goodness of fit index = .94), while the multigroup analysis allowed to assume an invariant factor structure by country and gender (ΔCFI < .01). Tables were constructed with cut off points for empathy and its dimensions. DISCUSSION AND CONCLUSION: Our study solves the problem of comparing the scores and the levels of empathy observed in the medical students at different schools of medicine, making said comparisons within and between countries and between genders. The instrument used has adequate psychometric properties and the cut-off values obtained allow the classifying of people with lower or higher levels of empathy.

Myopic LASIK Outcomes: Comparison of Three Different Femtosecond Lasers and a Mechanical Microkeratome Using the Same Excimer Laser.

INTRODUCTION: To compare the influence of one microkeratome and three femtosecond lasers on myopic laser in situ keratomileusis (LASIK) outcomes. METHODS: Retrospective, observational cohort study. We compared 134 eyes treated with the IntraLase 60 kHz, 112 eyes treated with the Femto LDV Z6, 206 eyes treated with the FS200, and 98 eyes treated with the Hansatome zero compression microkeratome. All eyes were operated on using the same surgical protocol with the same excimer laser (Wavelight Allegretto) and were allocated to refraction-matched groups. RESULTS: One day and one week postoperatively, uncorrected distance visual acuity was significantly lower in the FS200 group compared to others (P = 0.0001). This difference disappeared at the 1- and 3-month postoperative visits. Significant differences were found among groups in terms of safety index (P = 0.0001), residual sphere (P = 0.0001), and residual cylinder (P = 0.02) at the 3-month postoperative visit. No significant differences were found in corrected distance visual acuity or efficacy index. CONCLUSION: According to our results, a slight delay in visual restoration after FS200 LASIK surgery might be expected. This delay was statistically significant at 1 day and 1 week postoperatively, but there were no differences from the 1-month visit onwards. Additionally, significant differences were found among devices in terms of safety index and the refractive results, which were found not to be clinically relevant.

Visual and refractive outcomes of monofocal toric intraocular lens implantation in amblyopic eyes.

PURPOSE: To evaluate the visual and refractive outcomes of monofocal toric intraocular lens (IOL) implantation after cataract surgery in amblyopic eyes. METHODS: Our center's database was used to identify patients who had undergone bilateral cataract surgery between 2016 and 2020 with the implantation of a toric IOL in their amblyopic eye. Exclusion criteria were the presence of strabismus, ocular pathologies other than cataract or intra-surgical complications. The outcomes analysed were uncorrected distance visual acuity (UDVA), subjective refraction and corrected distance visual acuity (CDVA) one month after surgery. RESULTS: Ninety patients were included, with a mean age of 68.96 ± 7.81years. CDVA was lower for the amblyopic eye, both before and after surgery. There was a mean improvement in CDVA of 0.23 ± 0.21 LogMAR for the dominant eye and of 0.39 ± 0.33 for the amblyopic eye, p < 0.001 in both cases. Postoperative subjective refractive cylinder was higher in the amblyopic eye (-0.24 ± 0.39 D versus -0.10 ± 0.25 D, p < 0.01), as well as mean cylinder prediction error (-0.30 ± 0.47 D versus 0.02 ± 0.42 D, p < 0.01), compared to the dominant eye. There was a statistically significant correlation between preoperative and postoperative CDVA in amblyopic eyes (Spearmans Rho = 260, p = 0.013). Mean postoperative UCVA was 0.15 ± 0.25 for amblyopic and 0.03 ± 0.12 for dominant eyes. Only one patient required distance spectacle correction due to residual astigmatism. CONCLUSIONS: Cataract surgery with toric IOL implantation in amblyopic eyes leads to an improvement in visual acuity and to spectacle independence in almost all cases, even in the presence of a higher cylinder prediction error.

Life expectancy after aortic valve replacement in young patients.

INTRODUCTION AND OBJECTIVES: In young patients with severe aortic stenosis, it is unknown whether their life expectancy restored after aortic valve replacement (AVR) is unknown. METHODS: We analyzed all patients aged between 50 and 65 years who underwent isolated AVR in 27 Spanish centers during an 18-year period. We compared observed and expected survival at 15 years of follow-up. We repeated all analyses for patients without complications in the postoperative period. RESULTS: A total of 5084 patients were analyzed. For the overall sample, observed survival at 10 and 15 years was 85.3% (95%CI, 84.1%-86.4%) and 73.7% (95%CI, 71.6%-75.6%), respectively. Expected survival was 90.1% and 82.1%. Cumulative relative survival for 1, 5, 10 and 15 years of follow-up was 97.4% (95%CI, 96.9%-97.9%), 96.5% (95%CI, 95.7%-97.3%), 94.7% (95%CI, 93.3%-95.9%), and 89.8% (95%CI, 87.3%-92.1%). For patients without complications, cumulative relative survival for 1, 5, 10 and 15 years was 100.3% (95%CI, 99.8%-100.5%), 98.9% (95%CI 97.6% -99.9%), 97.3% (95%CI, 94.9%-99.4%), and 91.9% (95%CI, 86.5%-96.8%). CONCLUSIONS: Life expectancy in young patients who have severe aortic stenosis and undergo AVR is lower than that of the general population. Life expectancy of individuals without complications during the postoperative period is also reduced. Therefore, baseline characteristics are likely the main factors that explain the reduction in life expectancy.

Femtosecond LASIK for the correction of low and high myopic astigmatism.

INTRODUCTION: Higher preoperative myopic astigmatism is associated with a higher probability of retreatment due to patient dissatisfaction as a result of residual cylindrical error. Nonetheless, retreatment is safe and the final clinical results are comparable to those of patients with lower preoperative astigmatism who were satisfied with the primary treatment. Our purpose is to compare the efficacy and safety of femtosecond LASIK (FS-LASIK) for the refractive correction of patients with low (< 1.5 Diopters (D) versus high (≥ 1.5 D) myopic astigmatism. METHODS: Retrospective observational study of 841 eyes of 825 eligible patients treated with FSLASIK for the correction of simple or compound myopic astigmatism. Outcome measures included residual error, best corrected and uncorrected distance visual acuity (BCVA and UCVA), efficacy and safety 3 months after the primary procedure or the retreatment. RESULTS: Of 841 eyes in total, 432 (51.37%) had < 1.5 D (Group 1) and 409 (48.63%) had ≥ 1.5 D (Group 2) preoperative myopic astigmatism. The efficacy index of primary treatment was 0.94 ± 0.18 in Group 1 and 0.89 ± 0.22 in Group 2 (P = 0.001). Of 138 eyes (16.41%) that were retreated due to dis-satisfaction related to residual refractive error, 28 belonged to Group 1 (6.5%) and 110 (26.9%) to Group 2 (P < 0.001). Following retreatment, small but statistically significant differences in the residual mean postoperative cylinder (-0.08 ± 0.24 vs -0.27 ± 0.46 D, P = 0.001) and UCVA (1.11 vs 0.96, P = 0.0001) were detected for Groups 1 and 2, respectively. However, there were no statistically significant differences in the safety and efficacy indices. CONCLUSION: Following FS-LASIK, eyes with myopic astigmatism ≥ 1.5 D have approximately four times more chances of undergoing retreatment due to dis-satisfaction caused by residual refractive error compared to eyes with myopic astigmatism < 1.5 D. However, the clinical results after retreatment are highly satisfactory and comparable in both groups.

Fake reviews on online platforms: perspectives from the US, UK and EU legislations.

User-generated online reviews have become essential sources of information for potential consumers. Given the increasing importance of online reviews on consumer purchases, some traders try to publish or promote fake reviews on online platforms to improve the reputation of their goods or services, or to damage the reputation of their competitors. This paper aims (1) to analyse whether and how fake reviews violate the main legal and ethical principles of advertising, according to the legislations of the US, UK and EU as well as the International Advertising and Marketing Communications Code; (2) to assess how the EU, the UK and the US are dealing with them, and find out which approaches and actions are working best; and (3) to offer normative recommendations for effective prosecution of fake reviews. The paper uses a combination of theoretical and sociological approaches (section 1), black letter analysis of law (sections 2 and 3) and a comparative approach (sections 2 and 3). Among others, the article observes (1) that fake reviews are a form of illegal advertising and (2) that the European regulatory instruments provide more protection against fake reviews than the US and argues (3) that an effective fight against fake reviews requires strong administrative bodies, endowed with sufficient resources.

Atomic force microscopy comparative analysis of the surface roughness of two posterior chamber phakic intraocular lens models: ICL versus IPCL.

BACKGROUND: To compare the anterior surface roughness of two commercially available posterior chamber phakic intraocular lenses (IOLs) using atomic force microscopy (AFM). METHODS: Four phakic IOLs were used for this prospective, experimental study: two Visian ICL EVO+ V5 lenses and two iPCL 2.0 lenses. All of them were brand new, were not previously implanted in humans, were monofocal and had a dioptric power of - 12 diopters (D). The anterior surface roughness was assessed using a JPK NanoWizard II® atomic force microscope in contact mode immersed in liquid. Olympus OMCL-RC800PSA commercial silicon nitride cantilever tips were used. Anterior surface roughness measurements were made in 7 areas of 10 × 10 µm at 512 × 512 point resolution. The roughness was measured using the root-mean-square (RMS) value within the given regions. RESULTS: The mean of all anterior surface roughness measurements was 6.09 ± 1.33 nm (nm) in the Visian ICL EVO+ V5 and 3.49 ± 0.41 nm in the iPCL 2.0 (p = 0.001). CONCLUSION: In the current study, we found a statistically significant smoother anterior surface in the iPCL 2.0 phakic intraocular lenses compared with the VISIAN ICL EVO+ V5 lenses when studied with atomic force microscopy.

Treatment of Growth Hormone Deficiency via Daily Intravascular Injections in a Child with Bleeding Disorder.

OBJECTIVES: The standard of treatment for pediatric growth hormone deficiency (GHD) is daily subcutaneous recombinant human growth hormone (rhGH) injections. The efficacy of rhGH treatment given as daily intravenous (IV) boluses is not known. Case Presentation. A female with protein C deficiency, a severe bleeding disorder characterized by thrombosis formation, was diagnosed with GHD at age four years. She has been receiving daily protein C infusion through a permanent port since the newborn period. GHD was treated with daily IV rhGH boluses given through the port following protein C infusion. She has reached a growth rate of 12 cm/year and had no side effects. Surprisingly, serum insulin-like growth factor-1 (IGF1) levels did not rise despite an excellent clinical response. CONCLUSIONS: IV administration may be an alternative route for GHD treatment in eligible patients with permanent vascular access. A rise in serum IGF1 levels may not be needed to achieve the growth-promoting effect of rhGH.

Comparación de resultados de la Cirugía Torácica Convencional y la Uniportal en el Instituto Nacional de Oncología y Radiobiología / Comparison of results of Conventional and Uniportal Video-Assisted Thoracic Surgery in the National Institute of Oncology and Radiobiology

Introducción: La cirugía torácica videoasistida por un solo puerto (Uniportal VATS) se ha convertido hoy en uno de los abordajes más utilizados para resecciones pulmonares en muchos centros de cirugía torácica del mundo, en Cuba su introducción es bastante reciente y todavía se encuentra en fase inicial. Objetivo: Comparar los resultados obtenidos por cirugía torácica abierta y Uniportal VATS en pacientes intervenidos en el Instituto Nacional de Oncología y Radiobiología de La Habana (INOR) durante enero de 2016 a abril de 2017. Material y Métodos: Estudio observacional descriptivo de corte longitudinal retrospectivo con 60 pacientes atendidos en el INOR durante enero de 2016 a abril de 2017 a los cuales se les realizó cirugía torácica. Resultados: Veinticuatro pacientes fueron operados por Uniportal VATS y 36 a través de la toracotomía, primaron las lesiones del lado derecho, el procedimiento más realizado fue lobectomía. Los estadíos predominantes fueron IA y IB, la mayoría de los procedimientos fue realizada en tres horas o menos, 8 casos se convirtieron, 13 sufrieron complicaciones. La estadía media de los pacientes tratados con Uniportal VATS fue menor que los que recibieron la toracotomía abierta. Conclusiones: El abordaje Uniportal se caracterizó por ser seguro, tener una gran versatilidad, pocas complicaciones y por mejorar la recuperación postquirúrgica del paciente y acelerar su reincorporación a las actividades de la vida cotidiana(AU)

Introduction: Single-port Video Assisted Thoracic Surgery (Uniportal VATS) has currently become one of the most commonly used approaches for lung resections in many Thoracic Surgery Centers around the world. In Cuba, its introduction is quite recent and it is still in its initial phase. Objective: To compare the results obtained by open thoracic surgery and Uniportal VATS in patients who underwent surgery in the National Institute of Oncology and Radiobiology of Havana (INOR) from January 2016 to April 2017. Material and Methods: An observational descriptive longitudinal retrospective study was conducted in 60 patients who underwent Thoracic Surgery in the INOR during 2016 - April 2017. Results: A total of 24 patients were operated through Uniportal VATS and 36 underwent thoracotomy. The lesions predominantly affected the right side and lobectomy was the most performed surgical procedure. Stages IA and IB predominated. Most of the procedures were carried out in 3 hours or less, 8 cases were converted and 13 suffered from complications. The average postoperative length of stay in hospital for patients who underwent Uniportal VATS was reduced compared to those who underwent open thoracotomy. Conclusions: Uniportal VATS is characterized by being a safe procedure with few complications and great versatility. It improves postoperative recovery of patients and accelerates their return to daily life activities(AU)

Corneal stromal roughness after VisuMax and Intralase femtosecond laser photodisruption: An atomic force microscopy study.

PURPOSE: To compare the induced corneal stromal bed roughness measured with atomic force microscopy (AFM) after LASIK flap creation with the IntraLase 60 kHz and the VisuMax femtosecond laser platforms. METHODS: Three freshly enucleated porcine eyes were operated with each femtosecond laser in this experimental study. Standard LASIK treatment parameters were used for the experiment. After LASIK flap creation, the corneal stromal roughness was assessed using a JPK NanoWizard II® AFM in contact mode immersed in liquid. Olympus OMCL-RC800PSA commercial silicon nitride cantilever tips were used. Surface measurements were made in 10 regions of the central cornea of each sample measuring 20 x 20 microns, at 512 x 512 point resolution. Roughness was measured using the root-mean-square (RMS) value within the given regions. RESULTS: Measurements from 30 regions of the 3 eyes (10 measurements per eye) in the Intralase (FS1) group, and 30 regions of the 3 eyes (10 measurements per eye) in the VisuMax (FS2) group were analyzed. There was a statistically significant difference in mean ± standard deviation RMS values between the FS1 and the FS2 groups (360 ± 120 versus 230 ± 100 nm respectively; P< 0.00001). CONCLUSION: This AFM study indicates that the surface of the stromal bed after LASIK flap creation is smoother in the FS2 group than the FS1 group.