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La pandemia por COVID-19 ha supuesto el confinamiento de aproximadamente un tercio de la población mundial, provocando un cambio drástico en las actividades de la vida diaria con enorme impacto sanitario, económico y social.

La tomografía de coherencia óptica (OCT) se ha convertido en una herramienta imprescindible en las consultas de oftalmología pediátrica. Sin embargo, las OCT disponibles en la actualidad no incluyen ninguna base de datos normativa para población pediátrica, lo que puede conllevar errores importantes de interpretación.

Les personnes atteintes de paralysie cérébrale présentent des troubles permanents du mouvement et de la posture qui sont la conséquence de lésions cérébrales survenues sur le cerveau en développement du fœtus ou du nourrisson. Les troubles moteurs sont souvent accompagnés d’autres déficits qui jouent également un rôle dans la diminution de l’autonomie des personnes touchées. La rééducation motrice représente un élément central de la prise en charge des personnes concernées, qui leur permet de tirer le meilleur parti de leurs ressources physiques en favorisant ainsi leur autonomie et leur participation sociale, tout au long de leur vie. Cependant, les associations de familles font remonter leur perception de difficultés dans l’accès à une rééducation motrice de qualité. Il n’existe pas à ce jour en France de référentiel de rééducation motrice pour la paralysie cérébrale permettant de recommander ou au contraire de déconseiller les interventions rééducatives. De plus, il n’existe pas de données françaises sur les préférences des personnes concernées. La construction de référentiels de bonne pratique se doit d’intégrer entre autres, une revue des pratiques basées sur les preuves mais aussi sur les préférences des personnes atteintes. Devant les remontées des familles et associations, l’absence de référentiel de rééducation motrice et de données françaises concernant les préférences des personnes concernées, la Fondation paralysie cérébrale a proposé de contribuer à fournir des données objectives afin d’apporter les valeurs des personnes concernées à une future réflexion de recommandation de bonne pratique de rééducation motrice : un outil essentiel d’harmonisation des pratiques de santé et d’amélioration de la vie des personnes concernées. En conséquence, la fondation en partenariat avec les associations de familles, les sociétés savantes, a lancé une enquête nationale dont l’objectif était d’évaluer les soins reçus, besoins perçus et priorités d’amélioration attendues en rééducation motrice rapportés par les personnes concernées et leur famille. Cet article décrit les fondements rationnels et la gouvernance associant les personnes atteintes de paralysie cérébrale, leurs familles et les professionnels mise en place pour élaborer, mener et publier cette enquête.

Background: There is a national shortage of organs available for transplantation, and utilization rates for thoracic organs are less than 40%. In addition, the optimal method of assessing cardiovascular status during donor management is uncertain. FloTrac is a noninvasive hemodynamic technique that measures cardiac output and fluid responsiveness. Our objective was to measure the impact of using this technique to guide management on fluid balance, vasopressor usage, thyroid hormone usage, and pulmonary function. We hypothesized that FloTrac guidance will increase thoracic organs transplanted per donor (OTPD).Methods: Data were prospectively collected on a convenience sample of 38 donors after neurologic determination of death. Organs transplanted, net fluid balance, dosage of vasopressors, dosage of thyroid hormone, and Pao2:Fio2were compared between treatment and control groups.Results: The treatment group had greater thoracic OTPD (1.3 [1.0] vs 0.4 [0.6], P= .004) and overall OTPD (4.3 [1.5] vs 2.7 [1.5], P= .002). Donors in the treatment group maintained a neutral fluid balance, had more thyroid hormone used, and had an improvement in oxygenation.Conclusion: The implementation of this technology to aid providers may help ameliorate the shortage of thoracic and overall organs available for transplantation.

In this work, gallium phosphide thin films were deposited on glass substrates by radio frequency (RF) magnetron sputtering technique under different depositions conditions. The X-ray diffraction analysis showed a diversity of states: from amorphous in the films deposited at 175 °C to a nearly stoichiometric and polycrystalline films, exhibiting cubic phase with preferred orientation along (220), in the films deposited at temperatures higher than 250 °C. Scanning electron microscopy images revealed that all films were uniform with a smooth surface, while the energy-dispersive spectroscopy (EDS) analysis showed that there was a visible dependence on the Ga/P ratio in the deposition conditions and confirmed that a residual Ga metallic phase was presented in the surface of all the films. The Raman analysis showed the structural evolution of the GaP films was strongly dependent on the deposition conditions. The conductivity of the films was slightly dependent on the argon pressure and the rf power, but strongly dependent on the deposition temperature, mainly above 200 °C. The optical transmission and absorption analyses of the GaP films revealed an indirect band gap of ∼1.70 eV in the films deposited at temperatures less than 200 °C, which transited to a band gap of 2.26 eV as the deposition temperature was close to 300 °C. [ABSTRACT FROM AUTHOR]

AbstractBackgroundSince the introduction of percutaneous closure in the United States, rates of secundum atrial septal defect and patent foramen ovale closures have increased substantially. Whether or not closure rates are uniform or vary due to differences in regional practice patterns is unknown. We sought to investigate this by comparing regional rates of closure across Florida.MethodsWe identified all atrial septal defect closures from 2001 to 2006 in the Florida State Inpatient Database. Using small area analysis, zip codes were assigned to Hospital Referral Regions based on where patients were most likely to go for closure. We obtained population-normalised rates of overall, percutaneous, and surgical closure.ResultsOf 1830 atrial septal defect and patent foramen ovale closures from 2001 to 2006, 751 were surgical and 1004 were percutaneous. The statewide closure rate was 1.91 per 100,000 people per year; regional rates varied 3.8-fold from 0.78 to 2.94 per 100,000 people per year. Percutaneous rates varied sevenfold from 0.25 to 1.75 per 100,000 people per year, while surgical rates varied 2.71-fold from 0.53 to 1.44 per 100,000 people per year.ConclusionsDespite a consistent prevalence of atrial septal defects, and patent foramens ovale, rates of repair vary across regions, suggesting that closure is driven by provider practice patterns rather than patient pathology. Efforts should be directed towards increasing consensus regarding the appropriate, evidence-based indications for closure so as to avoid the costs and potential negative sequelae of over- or undertreatment.

In the last few years coalition formation algorithms have been proposed as a possible way of modeling autonomous agent cooperation in multi‐agent systems. This work is based on a previously proposed coalition formation model founded on game theory for a class of task‐oriented problems that guarantees an optimum task allocation and a stable profit division. In this paper we study two properties of the model that are very important for application in real‐life scenarios: robustness and tolerance to an agent's misbehavior. First, we study the robustness of this model as regards the effect the agent's failure has on the resultant profits of the coalition formation. Secondly, we also study the coalition formation model in the presence of misbehaving agents. Agents have some kind of execution autonomy, and they can deceive or mislead each other when they reveal their information, if they believe this will give them more profits. Copyright © 2005 John Wiley & Sons, Ltd.

This was an open-label multicenter study to compare the cycle control and effect on well-being of two oral contraceptives containing gestodene and one containing desogestrel. A total of 2419 healthy women ≤ 41 years of age were randomized to receive oral contraceptives containing monophasic gestodene (Minulet®; n = 806, mean age 24.5 years), triphasic gestodene (Tri-Minulet®; n = 808, mean age 24.6 years) or monophasic desogestrel (Mercilon®; n = 805, mean age 24.6 years). Subjects were to participate in the study for up to 13 treatment cycles. A modified Moos Menstrual Distress Questionnaire was used to evaluate menstrual symptoms and to assess overall well-being.A total of 698 women were withdrawn from the study, 154 due to adverse events. Cycle control with gestodene was superior to that with desogestrel at almost all time points, particularly for breakthrough bleeding and/or spotting, which occurred significantly less frequently with gestodene than with desogestrel at cycles 1-1 and 9-11 (p < 0.05). Generally, the proportion of subjects with breakthrough bleeding and/or spotting was almost twice as great with desogestrel as with gestodene. The duration of bleeding was not consistently different between the gestodene and desogestrel groups; however, the intensity of bleeding was greater with gestodene at all time points (p < 0.05). The latent period before withdrawal bleeding was significantly longer for monophasic gestodene at cycles 1-5 and 8-10 (p < 0.05). Treatment significantly improved overall well-being at cycles 6 and 9 with triphasic gestodene and at cycle 13 with desogestrel; however, no statistically significant differences among treatment groups in overall well-being scores or individual factors of well-being could be identified. All three treatments were well tolerated. The most common drug-related adverse events were headache (14.2%), breast pain (6.2%), nausea (4.1%), metrorrhagia (5.9%) and abdominal pain (3.5%). The incidence of adverse events in all treatment groups was similar, with the exception of metrorrhagia, which occurred in more patients in the desogestrel group than in the gestodene treatment groups (p < 0.05).

A mathematical prediction of pineapple sorption isotherms was developed using Ross, Norrish and Henderson equations. The prediction considered to have the pineapple average composition oflhe main solutes: sucrose, glucose, fructose, citric acid, malic acid, NaCI, KC1 and cellulose as non-solute. Water activity of individual sugars and organic acids was obtained by Norrish's equation and for the two salts by Raoult's Law. Solute solubility at different temperatures was taken into account. Predicted isotherms were compared with the experimental isotherms obtained in laboratory at 30, 35, 40 and 45° C and with the isotherms reported in literature at 30 and 45° C. The generalized correlation coefficients ( r2 ) between predicted and experimental isotherms were in the range of 0.8 - 0.98.

The present study was designed to investigate the mechanism of the antiplatelet action of the anaesthetic propofol in vitro.Human whole blood was incubated with different concentrations of propofol and its solvent Intralipid®. We determined, platelet aggregometry in whole blood, platelet‐enriched plasma (PRP), PRP plus red blood cells (RBC), and PRP plus leucocytes (LC); platelet production of thromboxane B2(TxB2), ATP release by platelet dense granules, adenosine uptake by RBC, intraplatelet levels of cyclic adenosine monophosphate (cyclic AMP) and cyclic guanosine monophosphate (cyclic GMP), and LC production of nitric oxide (NO).Propofol‐induced inhibition of platelet aggregation was greater in whole blood (IC5080–136 μM) than in PRP (IC50>600 μM), except when aggregation was induced by arachidonic acid, in which case the antiaggregatory effect of the anaesthetic was similar in both media (IC5072–85 μM). Inhibition of platelet aggregation correlated significantly with inhibition of TxB2synthesis (r2=0.83). Propofol also inhibited granular ATP release; this effect was greatest in whole blood.The presence of RBC or LC increased the antiaggregatory effect of propofol, mainly when collagen was used as aggregating agent. Intralipid inhibited the uptake of adenosine by RBC, however this effect probably does not contribute significantly to its antiaggregatory effect.The anaesthetic potentiated the NO‐cyclic GMP pathway, mainly by increasing the synthesis of NO by LC. Intralipid had no effect on the NO‐cyclic GMP pathway in the LC‐platelet interaction.Propofol inhibited platelet aggregation in human whole blood, possibly through the sum of the effects of Intralipid on the platelet‐RBC interaction and the increased synthesis of NO by LC in the platelet‐LC interaction.

Summary:  The authors undertook a follow-up study of 286 patients who underwent surgical treatment for intracranial meningioma between 1973 and 1994, in order to analyse clinical, radiological, topographic, histopathological and therapeutic factors significantly influencing tumour recurrence.  All patients were followed by using either computed tomography (CT) or magnetic resonance from 3 months to 17 years since first surgery (mean follow-up: 4.1 years). Forty-four (15.4%) recurrences were detected during this time period. Overall recurrence rates were 14%, 37% and 61% at 5, 10 and 15 years, respectively.  Factors significantly associated with tumour relapse in bivariate analysis were: tumour location at petroclival and parasagittal (middle third) regions, incomplete surgical resection (assessed by Simpson's classification), atypical and malignant histological types (WHO classification), presence of nucleolar prominence, presence of more than 2 mitosis per 10 high-power fields, and heterogeneous tumour contrast enhancement on the CT scan.  The multivariate analysis using the Cox's proportional hazards model identified the following risk factors for recurrence: incomplete surgical resection (Relative risk: 2.2; 95% Confidence interval: 1.33–3.64), non conventional histological type (RR: 2.13; 95%CI: 1–4.53), heterogeneous contrast enhancement on the CT scan (RR: 2.25; 95%CI: 1.1–4.72) and presence of more than 2 mitosis per 10 high-power fields (RR: 2.28; 95%CI: 0.99–5.27). Patients without any of these features showed low recurrence rates (4% and 18% at 5 and 10 years), and thus, they need less clinical and radiological controls through the follow-up than patients with some of these risk factors.

These studies were performed to determine if estrogen and/or androgens are involved in the regulation of relaxin secretion in the pregnant rat. Animals were hysterectomized at Day 15 of pregnancy and either untreated or given a) a subcutaneous Silastic capsule containing crystalline testosterone, b) a subcutaneous Silastic capsule containing crystalline dihydrotestosterone, or c) daily subcutaneous injections of 100 micrograms estradiol. A group of sham-operated animals served as controls. Serum samples taken at Days 14, 16, and 18 of pregnancy were assayed for relaxin and progesterone.Treatment with either estradiol or testosterone attenuated the decline in serum relaxin and progesterone concentrations observed following hysterectomy, whereas dihydrotestosterone (a nonaromatizable androgen) had no effect upon either relaxin or progesterone levels. These results suggest that estradiol and testosterone, previously implicated in the control of luteal progesterone production, also stimulate luteal relaxin secretion. The mechanism by which testosterone stimulates relaxin secretion is probably via its aromatization to estradiol within the corpus luteum.

The use of a full-order Kalman filter for the alignment process of an inertial navigation system (INS) imposes an unacceptable burden on computers. In this paper we intend to design and analyze a low-order Kalman filter for the initial alignment of a ring laser gyro strapdown inertial system that results in a substantially lighter computer burden with a little significant reduction in system accuracy.

Objective.To study prospectively whether serum and urinary nitrate levels are related to lupus activity.Methods.Fifty patients with systemic lupus erythematosus (SLE) were studied prospectively for 2 yr. Every 4 months, the SLE Disease Activity Index (SLEDAI) was administered to the patients, and blood and 24 h urine samples were obtained; 88 healthy controls were also studied. Nitrate levels were measured by the Greiss method. Statistical analyses were performed using standard parametric and non-parametric tests, and analysis of serial measurements.Results.Twelve patients suffered infections, 12 active nephritis and 17 episodes of non-renal activity. By analysis of serial measurements, serum and urinary nitrate levels did not correlate with SLEDAI. C-Reactive protein (CRP) levels, presence of infection and creatinine clearance weakly influenced nitrate levels.Conclusions.In SLE, serum and urinary nitrate levels do not parallel lupus activity. Other variables, related or not to SLE, seem to affect these levels.Keywords:Nitric oxide, Nitrates, Systemic lupus erythematosus

A previously uncharacterized Saccharomyces cerevisiae gene, FAL1, was found by sequence comparison as a homolog of the eukaryotic translation initiation factor 4A (eIF4A). Fal1p has 55% identity and 73% similarity on the amino acid level to yeast eIF4A, the prototype of ATP-dependent RNA helicases of the DEAD-box protein family. Although clearly grouped in the eIF4A subfamily, the essential Fal1p displays a different subcellular function and localization. An HA epitope-tagged Fal1p is localized predominantly in the nucleolus. Polysome analyses in a temperature-sensitive fal1-1 mutant and a Fal1p-depleted strain reveal a decrease in the number of 40S ribosomal subunits. Furthermore, these strains are hypersensitive to the aminoglycoside antibiotics paromomycin and neomycin. Pulse-chase labeling of pre-rRNA and steady-state-level analysis of pre-rRNAs and mature rRNAs by Northern hybridization and primer extension in the Fal1p-depleted strain show that Fal1p is required for pre-rRNA processing at sites A0, A1, and A2. Consequently, depletion of Fal1p leads to decreased 18S rRNA levels and to an overall deficit in 40S ribosomal subunits. Together, these results implicate Fal1p in the 18S rRNA maturation pathway rather than in translation initiation.

Platelet hyperactivity has been one of the mechanisms implicated in the pathogenesis of diabetic retinopathy. Antiplatelet agents have been shown, in experimental models, to prevent the development of retinal vascular abnormalities when given from the first day after the onset of diabetes. We assessed the effect of aspirin plus dipyridamole (6 + 12 mg/kg daily) on the retinal vascular pattern in experimental streptozotocin-induced diabetes in rats, when the treatment was given at different intervals after the induction of diabetes, over a 3-month study period. Saline-pretreated diabetic rats showed a time-dependent increases in the platelet production of thromboxane B2 (r = 0.981, P < .0001) and a decrease in the aortic production of 6-keto-PGF1 alpha. The percentage of retinal area occupied by horseradish peroxidase-labeled vessels decreased progressively in relation to the length of time of the evolution of diabetes (r = 0.983, P < .00001) and the thromboxane/prostacyclin ratio. Treatment with aspirin plus dipyridamole caused an inhibition of the platelet production of thromboxane B2 and a decrease in the vascular synthesis of prostacyclin. Treatment with antiplatelet agents slowed down the decrease in the percentage of retinal area occupied by horseradish peroxidase-labeled vessels. These data provide further evidence to support the results of previous clinical trials in which antiplatelet agents had a beneficial effect on the evolution of retinal lesions in early diabetic retinopathy.

A new ‘circuit model’ for converting between even and odd modes in asymmetric series impedances in the ground plane of a coplanar waveguide is presented. The model is based on the separation of modes into two input and two output ports. In contrast to previous work, it enables a quantitative analysis of the energy exchange between modes to be obtained.

A new ‘circuit-model’ for slotline-to-coplanar waveguide asymmetrical transitions is presented and applied to the design of slotline resonators. The model, based on the separation of coplanar-waveguide (CPW) modes into two different ports, overcomes limitations of previous models because it explains the transition behaviour even if CPW air-bridges are not used.

Summary: The antiproteinuric effect of the antiplatelet agent dipyridamole has been assessed after inhibiton of thromboxane B2 (TxB2) synthesis in 8 patients with confirmed membranous glomerulonephritis. There were three study periods, each of 30 days, and 45 days apart, namely a washout period, treatment with dipyridamole 300 mg/d, and dipyridamole 225 mg/d plus aspirin 150 mg/d. On Days 1 and 30 of each study period serum and urine creatinine, 24-h excretion of protein, creatinine clearance, platelet aggregometry on whole blood and serum TxB2 were measured. Treatment with dipyridamole alone or with aspirin produced significant inhibition of platelet aggregation and a fall in 24-h protein excretion; the latter amounted to 54% with dipyridamole alone and 56 % with dipyridamole plus aspirin (NS). Dipyridamole plus aspirin caused an 82 % reduction in serum TxB2.

Background and aims: Cerebral palsy (CP) is the most frequent cause of severe physical disability in children. Associate impairments are common in children with CP. The aims were to describe changes in prevalence of children with CP and vision impairment (VI), and to examine the association between VI and neonatal characteristics, associated impairments and CP subtypes.Methods: All children with CP born 1976-1998 recorded in 17 European population based registers belonging to the SCPE network (Surveillance of Cerebral Palsy in Europe) were eligible. Data were coded according to SCPE Reference and Training Manual. Time trends were modelised with Poisson regression and adjusted for centre effect and study variables.Results: Of the 9631 eligible children, 3300 (34%) had a documented VI (AVI) and 966 (10%) a known severe VI (SVI). A significant change in trend of prevalence of CP with AVI or SVI was observed with a moderate increase until end of the 80' and a subsequent slight decrease. Children with CP born at term were less likely to have any VI (odds ratio 0.60 (0.55-0.68)) but no differences were observed for SVI (0.97 (0.81-1.15)). Children with unilateral CP were less likely to show AVI (0.39 (0.35-044)) or SVI (0.17 (0.13-0.21)); those unable to walk even with aids were more likely to show AVI (4.8 (4.4-5.4)) or SVI (16 (14-21)).Conclusions: Among children with CP one third shows any vision impairment and one in ten shows severe vision impairment. Vision impairment is associated with other impairments (intellectual, hearing) and epilepsy.

Background and aims: Neuromotor, intellectual and behavioural developmental disabilities increase with lower gestational age (GA). The aim of this study is quantify the effect of prematurity and other determinants (biomedical, developmental and social) on health-related quality (HRQoL).Methods: Follow-up study with prospective data collection from birth up to age 7 in children born < 32 weeks gestational age (VP) or < 1500 g (VLBW) discharged. Standardized developmental assessment was performed at age 2, 4 and 7. HRQoL was assessed at 7 by proxy with KIDSCREEN-10, that provides a global index score (0-100) and category thresholds by domain. 169 infants were enrolled. Non responders (39%) showed more favourable neonatal characteristics than responders (e.g. respectively, GA 29.9 vs. 29.0).Results: 102 children were included in the analysis (32% with GA< 28 and 46%>29). Low QoL (score< under the first quartile) was associated with neonatal characteristics: BW< 750g [odds ratio (95CI) 3.6 (1.1-11)], GA< 28weeks [2.2 (0.9-5.2)], multiplicity [2.9 (1.2-6.9)]; and with outcomes at 7 years [adjusted for GA and multiplicity, for both p< 0.05 in all the following models ]: intellectual impairment [3.4(1.1-11)], behavioural disability [2.7(1.0-7.8)], communication disability [3.4(1.1- 10)], visual aids [2.9(1.1-8.0)], non-mainstream schooling [4.7(1.6-13)]. Children born small for gestational age, with abnormal neonatal ultrasound findings, or classified as cerebral palsy, did not show an increased risk of low QoL at 7 years.Conclusions: This study suggests that lower gestational age, multiplicity and some developmental disabilities, but not CP, reduce, consistent and independently, parents-reported QoL of school-age children born VP or with VLBW.

A method to test the assumption of nonhomogeneous Poisson point processes is implemented to analyze corrosion pit patterns. The method is calibrated with three artificially generated patterns and manages to accurately assess whether a pattern distribution is random, regular, or clustered. The interevent and the nearest-neighbor statistics are employed to check the method’s performance. Three empirical corrosion patterns are studied. The outcome of this investigation suggests that maximum pit depths are generally encountered where pit clusters are detected. This result is in agreement with previous studies.

Background: The magnitude and consequences of medical errors are controversial issues; nevertheless, there is a consensus on the preventability of medication errors and their frequent occurrence.Aim: To determine the frequency of different types of error in medical prescriptions and to estimate its occurrence as a function of characteristics and circumstances of the prescriptions.Methods: Cross-sectional study of hand-written prescriptions for newborn infants admitted to a third level neonatal unit during a 5 months study period (july–november 2003). Data were extracted from all prescriptions written on 53 randomly sampled days. Outcome variables: different elements were assessed to describe the correction of a prescription (drug name, dose, units, administration route, interval, legibility); a prescription was considered correct when all its elements were present. Determinants: characteristics and circumstances of the prescriptions (type of drug, day of the week, night/day shift, training of the prescriber and clinical profile of the patient). Data analysis: Proportions and logistic regression adjusted odds ratio (95% confidence interval).Results: 4132 hand-written prescriptions were reviewed. 58.6% of the prescriptions fullfilled the correction criteria. 88% of incorrect prescriptions were intercepted. No adverse effect was related to a prescription error. Dose calculation was incorrect in 12.3% of the prescriptions. An incorrect abbreviation of the units was used in 8.4%; 4% did not stated dose interval and 2.8% stated an incorrect interval. At least one of the elements of the prescription was considered illegible or uncertain in 13.7%. The route of administration was not stated in 12.7%, and it was not correct in 0.7%. The drugs with the higher proportion of incorrect prescriptions were caffeine and erythropoietin. Prescriptions were more frequently correct for newborns admitted to intensive vs. intermediate care, 1.5 (1.3–1.7); birth weight over 2500 g, 1.9 (1.5–2.4); on week-ends vs. rest of the week, 1.3 (1.1–1.5); on afternoon/night vs. morning shifts, 1.8 (1.4–2.3); and when written by intraining vs. staff doctors, 1.5 (1.4–1.8).Conclusion: More than half of prescriptions written out by hand in a neonatal unit were not considered correct. A higher workload is not related with a higher number of incorrect prescriptions. Professional experience does not reduce, in general, the number of prescription errors. The occurrence of miscalculation of dose was higher for medication prescribed daily or routinely.