Dancing vortices in a driven nematic liquid crystal cell: Theory and experiment.

The interaction of light beams with helical defects in optical materials generates optical vortices. Understanding and manipulating the dynamics of helical defects allows for the creation of versatile sources of optical vortex beams. Using a magnetic ring on a nematic liquid crystal cell, we trapped helical defects identified as matter vortices. We observe oscillatory rotating and beating matter vortices by applying a low-frequency voltage. Experimentally, we determine the region of parameters where these vortices are observed. The amplitude of oscillatory rotating vortices decays with the inverse of the voltage frequency. We propose an adequate amplitude equation, which allows us to describe the vortex dynamics; theoretical findings have a qualitative agreement with the experimental observations.

Guía para la práctica de acogimiento familiar, relato de una experiencia / Guidelines for being a foster care home, report of an experience

Recibir a un niño o a una niña en cuidado transitorio supone la fortaleza para enfrentar situaciones complejas, ofrecer cuidados y contención, y ser consciente del carácter temporario de ese hecho. El pediatra juega un papel determinante no solo en el cuidado de la salud de niños, niñas y adolescentes con derechos vulnerados, sino también como actor clave en la detección temprana de los casos, a partir de una mirada atenta y comprometida con la situación de cada niño. Se presenta un caso de 5 hermanos con derechos vulnerados, en el que intervino el Sistema de Promoción y Protección Integral de Derechos de los Niños a través de un programa de familias de abrigo, con el objetivo de clarificar la situación legal actual y concientizar sobre dicha alternativa.

Receiving a child in foster home care needs the strength to face complex situations, gives care and support, and be aware of the temporary nature of that position. The pediatrician plays a decisive role not only in the health care of children and adolescents with lost rights, but also in the early detection of cases, based on an attentive and committed attitudes facing each child circumstances. We present the experience of 5 siblings with lost rights in which the Promotion and Integral Protection of Children's Rights System intervened through a program of foster families, with the aim of clarifying the current legal situation and raising awareness about this alternative.

Guidelines for being a foster care home, report of an experience. / Guía para la práctica de acogimiento familiar, relato de una experiencia.

Receiving a child in foster home care needs the strength to face complex situations, gives care and support, and be aware of the temporary nature of that position. The pediatrician plays a decisive role not only in the health care of children and adolescents with lost rights, but also in the early detection of cases, based on an attentive and committed attitudes facing each child circumstances. We present the experience of 5 siblings with lost rights in which the Promotion and Integral Protection of Children's Rights System intervened through a program of foster families, with the aim of clarifying the current legal situation and raising awareness about this alternative.

Recibir a un niño o a una niña en cuidado transitorio supone la fortaleza para enfrentar situaciones complejas, ofrecer cuidados y contención, y ser consciente del carácter temporario de ese hecho. El pediatra juega un papel determinante no solo en el cuidado de la salud de niños, niñas y adolescentes con derechos vulnerados, sino también como actor clave en la detección temprana de los casos, a partir de una mirada atenta y comprometida con la situación de cada niño. Se presenta un caso de 5 hermanos con derechos vulnerados, en el que intervino el Sistema de Promoción y Protección Integral de Derechos de los Niños a través de un programa de familias de abrigo, con el objetivo de clarificar la situación legal actual y concientizar sobre dicha alternativa.

Multicenter study on multidisciplinary committees in advanced prostate cancer.

INTRODUCTION AND OBJECTIVE: Although Multidisciplinary Teams (MDTs) are recommended in the management of Advanced Prostate Cancer (APC), their functioning in real practice has been poorly evaluated. We carried out a multicenter study with the objective of evaluating the functioning of uro-oncology MDTs in 6 hospitals. MATERIALS AND METHODS: A descriptive cross-sectional study was performed. The level of Compliance with the Fundamental Quality Requirements (CFQR) of the MDTs was evaluated by means of a questionnaire filled out by the coordinators of the MDTs in each hospital. The information on the perspective of the members of the MDTs was evaluated through an anonymous survey. RESULTS: A high level of CFQR in MDTs was evidenced (75%), showing deficiencies in terms of protocol update, agendas, audits, and scientific production. The survey was answered by 62.32% of the 69 physicians surveyed (urologists, oncologists, radiation therapists, radiologists, and pathologists). The 88.4% consider the duration of the meetings appropriate. There are disparate opinions concerning the protection of the MDT meeting time as well as protocol update. Of the patients with APC presented at the MDTs meeting, 62,8% require intervention from two specialties. Only 50% of respondents believe that all CRPC cases are discussed and that there is a prior agenda. The decisions made by the MDTs are reflected in the clinical history in 65.1% and are binding only in 60.5% of the cases. Half of the respondents have not been trained in MDTs. Most participants (90.7%) agree on the fact that MDTs. convey benefits. CONCLUSIONS: The evaluations of the MDTs identify rectifiable deficiencies by modifying hospital inertia and care planning.

Prostate cancer brachytherapy: SFRO guidelines 2021.

Prostate brachytherapy techniques are described, concerning both permanent seed implant and high dose rate brachytherapy. The following guidelines are presented: brachytherapy indications, implant procedure for permanent low dose rate implants and high dose rate with source projector, as well as dose and dose-constraints objectives, immediate postoperative management, post-treatment evaluation, and long-term follow-up.

Best practice in brachytherapy.

The 2020 recommendations for good brachytherapy procedures ("Recorad") are updated based on the 2016 article. This new brachytherapy article took into account recent data published in the literature as well as international recommendations. The different brachytherapy steps are successively described from the treatment preparation (brachytherapy technique prescription; procedure and material, dedicated images for planification, dose distribution analysis and validation) to the end of the procedure as well as post-treatment surveillance.

The Mediterranean diet and health: a comprehensive overview.

The Mediterranean diet (MedDiet), one of the most studied and well-known dietary patterns worldwide, has been associated with a wide range of benefits for health. In the present narrative review, we aimed to provide a comprehensive overview of the current knowledge on the relation of the MedDiet to important health outcomes, considering both observational and intervention studies with both risk factors and clinical diseases as outcomes. In addition, we considered the clinical and public health impacts of the MedDiet on both human and planetary health. Earlier research confirmed by recent studies has provided strong evidence for the benefits of the MedDiet on cardiovascular health, including reduction in the incidence of cardiovascular outcomes as well as risk factors including obesity, hypertension, metabolic syndrome, and dyslipidaemia. There is also evidence that MedDiet is associated with lower rates of incident diabetes, and better glycaemic control in diabetic patients compared to control diets. In prospective studies, adherence to the MedDiet reduced mortality, especially cardiovascular mortality, hence increased longevity. In addition, it has been associated with less age-related cognitive dysfunction and lower incidence of neurodegenerative disorders, particularly Alzheimer's disease. Furthermore, the relatively low environmental impacts (water, nitrogen and carbon footprint) of the MedDiet is an additional positive aspect of the Mediterranean dietary model. It is likely that the combination of a healthy diet with social behaviours and the way of life of Mediterranean regions makes the MedDiet a sustainable lifestyle model that could likely be followed in other regions with country-specific and culturally appropriate variations.

Oral Health and Undernutrition in the Frail Elderly Persons.

INTRODUCTION: Although many studies associate a poor state of oral health with the risk of undernutrition in both the autonomous and dependent elderly, very few of them consider the frail elderly person. However, the identification of the frail elderly is one of major issues of modern geriatrics. It is at this stage that preventive strategies are the most effective against the risks of dependency. The main objective of our study is to explore the nature of the association between oral health and undernutrition in the frail elderly patient, and to identify the associated factors. MATERIALS AND METHODS: We have used the data of an observational transversal monocentric study, conducted among a population of patients hospitalized for frailty assessment at the Geriatric Frailty Clinic (G.F.C.) for Assessment of Frailty and Prevention of Disability. The enrolment site is the Cité de la Santé, at Toulouse University Hospital. Data were collected from January 25, 2016 February 2, 2018. The data collected sociodemographic characteristics, oral health (Oral Health Assessment Tool), nutritional status (Mini Nutritional Assessment), Body Mass Index, and weight loss according to Fried), frailty (Fried criteria), functional status (Mini Mental State Examination, Activity of Daily Living, Instrumental Activity of Daily Living, Geriatric Depression Scale-15), and behavior (tobacco and alcohol). RESULTS: We included 1,155 subjects with an average age of 81.9 years, including 65% women. Bivariate analysis indicated a statistically significant association (p<0.05) between a pathological state of oral health and undernutrition, particularly with regard to decay of natural teeth, pathologies of the tongue, gums and tissues, dry mouth, lack of oral cleanliness and presence of dental pain. Multivariate analysis adjusted for socio-demographic, behavioral and functional data confirmed some of these associations, notably between the item gum/mucous membrane and the decrease of the score (p<0.01); this same item and weight loss according to Fried (p<0.01), and the item tongue and weight loss (p<0.05). A statistically significant association appeared between the state of oral health and frailty (item tongue (p<0.01)). DISCUSSION: Our study shows a statistically significant association between a pathological state of oral health and nutrition disorders in the frail elderly person. This result confirms the hypothesis postulating that a poor state of oral health would be associated with nutritional disorders among the frail elderly. Our analysis also shows a statistically significant association between a deteriorated state of oral health and frailty. Tongue diseases here increase the risk of frailty for the patient. Our results are, however, limited and do not allow for an analysis of causal effect. It would be useful to complete our study by more refined analyses of risk factors, conducted on a larger sample, and with a follow-up patients over time. CONCLUSION: We show here the importance of targeting the frail population in order to screen for oral disease and refer patients for dental care. Ensuring oral health care of frail patients seems indispensable if they are to maintain not only a healthy nutritional state, but also a satisfactory general state of health, thus allowing for successful aging.

Two-dimensional optical chimera states in an array of coupled waveguide resonators.

Two-dimensional arrays of coupled waveguides or coupled microcavities allow us to confine and manipulate light. Based on a paradigmatic envelope equation, we show that these devices, subject to a coherent optical injection, support coexistence between a coherent and incoherent emission. In this regime, we show that two-dimensional chimera states can be generated. Depending on initial conditions, the system exhibits a family of two-dimensional chimera states and interaction between them. We characterize these two-dimensional structures by computing their Lyapunov spectrum and Yorke-Kaplan dimension. Finally, we show that two-dimensional chimera states are of spatiotemporal chaotic nature.

Front depinning by deterministic and stochastic fluctuations: A comparison.

Driven dissipative many-body systems are described by differential equations for macroscopic variables which include fluctuations that account for ignored microscopic variables. Here, we investigate the effect of deterministic fluctuations, drawn from a system in a state of phase turbulence, on front dynamics. We show that despite these fluctuations a front may remain pinned, in contrast to fronts in systems with Gaussian white noise fluctuations, and explore the pinning-depinning transition. In the deterministic case, this transition is found to be robust but its location in parameter space is complex, generating a fractal-like structure. We describe this transition by deriving an equation for the front position, which takes the form of an overdamped system with a ratchet potential and chaotic forcing; this equation can, in turn, be transformed into a linear parametrically driven oscillator with a chaotically oscillating frequency. The resulting description provides an unambiguous characterization of the pinning-depinning transition in parameter space. A similar calculation for noise-driven front propagation shows that the pinning-depinning transition is washed out.

Chain dynamics of human dermis by Thermostimulated currents: A tool for new markers of aging.

BACKGROUND/PURPOSE: The purpose of this clinical study was to identify dielectric markers to complete a previous thermal and vibrational study on the molecular and organizational changes in human dermis during intrinsic and extrinsic aging. METHODS: Sun-exposed and non-exposed skin biopsies were collected from 28 women devised in two groups (20-30 and ≥60 years old). The dielectric relaxation modes associated with localized and delocalized dynamics in the fresh and dehydrated state were determined by the Thermostimulated currents technique (TSC). RESULTS: Intrinsic and extrinsic aging induced significant evolution of some of the dielectric parameters of localized and delocalized dynamics of human skin. With photo-aging, freezable water forms a segregated phase in dermis and its dynamics is close to free water, what evidences the major role of extrinsic aging on water organization in human skin. Moreover, TSC indicators highlight the restriction of localized mobility with intrinsic aging due to glycation, and the cumulative effect of chronological aging and photo-exposition on the molecular mobility of the main structural proteins of the dermis at the mesoscopic scale. CONCLUSION: TSC is a well-suited technique to scan the molecular mobility of human skin. It can be uses as a relevant complement of vibrational and thermal characterization to follow human skin modifications with intrinsic and extrinsic aging.

Silicosis: A former occupational disease with new occupational exposure scenarios. / Silicosis: una antigua enfermedad profesional con nuevos escenarios de exposición laboral.

BACKGROUND: Recent studies have shown an increase in the prevalence of silicosis due to the use of artificial quartz aggregates (AQA). The aim of this study was to assess the cases of silicosis in our area reported to the Healthcare Information System for Occupational Epidemiological Surveillance of the Autonomous Community of Valencia to detect new agents of exposure to silica and working conditions that promote its onset. MATERIAL AND METHOD: A descriptive study was conducted of cases of silicosis reported to the Healthcare Information System for Occupational Epidemiological Surveillance of the Autonomous Community of Valencia from January 2009 to September 2016. The data sources include epidemiological-occupational surveys and medical reports. RESULTS: Nineteen cases of silicosis were reported, 74% of which were diagnosed using high-resolution computed tomography. Some 68.4% of the cases were related to the handling of AQA, as assemblers/cutters/sanders of countertops. The subgroup's mean age was 46.62±13.33 years, and the mean exposure was 11.00±3.58 years. The rest of the patients worked in companies with no AQA exposure, with a mean age of 62.33±16.22 years and a mean exposure of 27.16±8.44 years (P<.05). Four cases presented complicated forms (3 exposed to AQA). CONCLUSIONS: The work of assembling/cutting/sanding AQA countertops presents a high risk of developing the disease. The mean age at onset and the exposure time for this group is lower, and the percentage of complicated clinical forms is higher. Improvements need to be made in preventive planning for companies with exposure to these new agents.

Chimera states in a Duffing oscillators chain coupled to nearest neighbors.

Coupled nonlinear oscillators can present complex spatiotemporal behaviors. Here, we report the coexistence of coherent and incoherent domains, called chimera states, in an array of identical Duffing oscillators coupled to their nearest neighbors. The chimera states show a significant variation of amplitude in the desynchronized domain. These intriguing states are observed in the bistability region between a homogeneous state and a spatiotemporal chaotic one. These dynamical behaviors are characterized by their Lyapunov spectra and their global phase coherence order parameter. The local coupling between oscillators prevents one domain from invading the other one. Depending on initial conditions, a family of chimera states appear, organized in a snaking-like diagram.

Gestational chronodisruption leads to persistent changes in the rat fetal and adult adrenal clock and function.

KEY POINTS: Light at night is essential to a 24/7 society, but it has negative consequences on health. Basically, light at night induces an alteration of our biological clocks, known as chronodisruption, with effects even when this occurs during pregnancy. Here we explored the developmental impact of gestational chronodisruption (chronic photoperiod shift, CPS) on adult and fetal adrenal biorhythms and function. We found that gestational chronodisruption altered fetal and adult adrenal function, at the molecular, morphological and physiological levels. The differences between control and CPS offspring suggest desynchronization of the adrenal circadian clock and steroidogenic pathway, leading to abnormal stress responses and metabolic adaptation, potentially increasing the risk of developing chronic diseases. ABSTRACT: Light at night is essential to a 24/7 society, but it has negative consequences on health. Basically, light at night induces an alteration of our biological clocks, known as chronodisruption, with effects even when this occurs during pregnancy. Indeed, an abnormal photoperiod during gestation alters fetal development, inducing long-term effects on the offspring. Accordingly, we carried out a longitudinal study in rats, exploring the impact of gestational chronodisruption on the adrenal biorhythms and function of the offspring. Adult rats (90 days old) gestated under chronic photoperiod shift (CPS) decrease the time spent in the open arm zone of an elevated plus maze to 62% and increase the rearing time to 170%. CPS adults maintained individual daily changes in corticosterone, but their acrophases were distributed from 12.00 h to 06.00 h. CPS offspring maintained clock gene expression and oscillation, nevertheless no daily rhythm was observed in genes involved in the regulation and synthesis of steroids. Consistent with adult adrenal gland being programmed during fetal life, blunted daily rhythms of corticosterone, core clock gene machinery, and steroidogenic genes were observed in CPS fetal adrenal glands. Comparisons of the global transcriptome of CPS versus control fetal adrenal gland revealed that 1078 genes were differentially expressed (641 down-regulated and 437 up-regulated). In silico analysis revealed significant changes in Lipid Metabolism, Small Molecule Biochemistry, Cellular Development and the Inflammatory Response pathway (z score: 48-20). Altogether, the present results demonstrate that gestational chronodisruption changed fetal and adult adrenal function. This could translate to long-term abnormal stress responses and metabolic adaptation, increasing the risk of developing chronic diseases.

Oscillating decorated interfaces in parametrically driven systems.

Macroscopic systems forced by the temporal modulation of their parameters exhibit complex interfaces between symmetric states. Here we investigate the origin of the transition from a flat to an oscillating decorated interface. Based on a model that describes a magnetic plane under the influence of an oscillating magnetic field and an extended Josephson junction under the influence of an alternating current, we derive a simple model that accounts for the interface dynamics. Analytically this model allows us to reveal that this transition is a parametric resonance between the frequencies of interface modes and the forcing. Numerical simulations of magnetic systems, extended Josephson junctions, and our simplified model show quite good agreement.

Subretinal fibrosis is associated with fundus pulverulentus in pseudoxanthoma elasticum.

BACKGROUND: Pseudoxanthoma elasticum (PXE) is a rare autosomal recessive disorder caused by mutations in the ABCC6 gene, resulting in various retinal lesions, among other systemic manifestations. Visual loss may occur in PXE, most commonly caused by choroidal neovascularization and macular atrophy, but little is known about the consequences of fundus pulverulentus (FP) in PXE. The aim of this study was to evaluate ophthalmic outcomes in patients with FP associated with PXE in a large series of PXE patients. METHODS: In a retrospective observational study, ophthalmic outcomes were compared between two groups of age-matched patients with genetically and pathologically confirmed PXE: one group with FP versus one without FP. All included patients underwent thorough clinical examination. Further investigation (optical coherence tomography (OCT), Cirrhus, Zeiss Germany, and/or fluorescein/indocyanin green angiography) was performed in cases of suspected choroidal neovascularization (CNV). RESULTS: The study included 13 PXE patients with FP (group 1: 8 men and 5 women, aged 45-65 years) and 47 age-matched PXE patients without FP (group 2: 19 men and 28 women). Mean patient follow-up was 63 months (range 0-132 months). Subretinal fibrosis (SRF) was more frequently associated with FP (9/26 eyes, 34.6%), compared to absence of FP (4/94, 4.2%) (p = 0.0001). Independently of SRF, FP can evolve into deep macular atrophy and/or CNV with dramatic consequences for central vision. CONCLUSIONS: Fundus pulverulentus may occur in PXE and is most commonly associated with subretinal fibrosis in the posterior pole and visual loss by macular atrophy even in the absence of CNV.

Chimera-like states in an array of coupled-waveguide resonators.

We consider coupled-waveguide resonators subject to optical injection. The dynamics of this simple device are described by the discrete Lugiato-Lefever equation. We show that chimera-like states can be stabilized, thanks to the discrete nature of the coupled-waveguide resonators. Such chaotic localized structures are unstable in the continuous Lugiato-Lefever model; this is because of dispersive radiation from the tails of localized structures in the form of two counter-propagating fronts between the homogeneous and the complex spatiotemporal state. We characterize the formation of chimera-like states by computing the Lyapunov spectra. We show that localized states have an intermittent spatiotemporal chaotic dynamical nature. These states are generated in a parameter regime characterized by a coexistence between a uniform steady state and a spatiotemporal intermittency state.

Oral Health and the Frail Elderly.

INTRODUCTION: The relationships between oral health conditions and frailty have rarely been explored. A systematic review of frailty components and oral health concluded that differences in study population endpoint criteria and study design cannot establish a relationship between frailty and oral health. OBJECTIVE: This study aims to describe the distribution of the OHAT (Oral Health Assessment Tool) score in a population of frail subjects and to assess associated parameters (age, socio-economic status, living conditions, education level, nutritional habits, cognitive functioning, autonomy). DESIGN: Cross-sectional observational study among patients referred to the Geriatric Frailty Clinic. MEASUREMENTS: 1314 patients participated in different standardized tests to evaluate their health status, cognitive and affective functioning, adaptation to usual daily activities, nutritional status, and oral health status. RESULTS: The risk of oral health deterioration was higher with the appearance of frailty: the OHAT increased significantly with the Fried Frailty Score (p<0.001). Physical performance and oral health were correlated (p<0.001). The OHAT score and the MNA (Mini Nutritional Assessment) score were significantly correlated: oral status seemed better for malnourished subjects (p<0.001). Dementia significantly increased the risk of an unhealthy oral status (p<0.001). There was no significant correlation between oral status and depression, just a trend. CONCLUSION: This pilot study establishes a relationship between the OHAT and Fried Frailty Criteria in a population of frail elderly. It must be expanded to follow the distribution of the different items composing the OHAT score (items assessing lips; tongue; gums and tissues; saliva; natural teeth; dentures; oral cleanliness; and dental pain) with different parameters (age, socio-economic status, living conditions, educational level, medical history, drug treatment, nutritional habits, cognitive functioning, disabilities and handicaps).

The PREDIMED trial, Mediterranean diet and health outcomes: How strong is the evidence?

AIMS: To address potential controversies on the health benefits of the Mediterranean diet (MedDiet) after PREDIMED, a randomized trial of MedDiet for primary cardiovascular prevention. We have focused on: a) the PREDIMED study design, b) analysis of PREDIMED data and c) interpretation of its results. DATA SYNTHESIS: Regarding the design of the trial, its early termination and between-group differences in the intensity of the intervention are potential causes of concern. The planned duration was 6 years but the trial was prematurely stopped when an interim analysis at 4.8-year provided sufficient evidence of benefit for the two MedDiets. In the MedDiet groups supplemented with extra-virgin olive oil or mixed-nuts, the primary composite endpoint (myocardial infarction, stroke, or cardiovascular death) was reduced by 30% and 28% respectively, as compared with the control group. Final results did not change after taking into account the different intensity of educational efforts during the trial. Other potential doubts related to data analysis (e.g., intention to treat versus a per-protocol approach, and consequences of dropouts) should not be causes of concern. Finally, we addressed alternative interpretations of the effect on all-cause mortality. The protocol-defined primary endpoint was a composite cardiovascular endpoint, not all-cause mortality. To analyze total mortality, we would have needed a much larger sample size and longer follow-up. Therefore, the PREDIMED results cannot be used to draw firm conclusions on MedDiets and all-cause mortality. CONCLUSIONS: The PREDIMED study was designed to overcome three major problems of previous nutritional research: a) residual confounding, addressed by using a randomized design; b) single-nutrient approaches, by randomizing an overall dietary pattern; and c) the limitations of assessing only intermediate risk markers, by using hard clinical end-points.

Identification of ageing biomarkers in human dermis biopsies by thermal analysis (DSC) combined with Fourier transform infrared spectroscopy (FTIR/ATR).

BACKGROUND/PURPOSE: The purpose of this clinical study was to identify suitable biomarkers for a better understanding of the molecular and organizational changes in human dermis during intrinsic and extrinsic ageing. METHODS: Sun-exposed and non-exposed skin biopsies were collected from twenty-eight women devised in two groups (20-30 and ≥60 years old). The hydric organization and thermal transitions were determined by Differential Scanning Calorimetry (DSC). Fourier Transform Infrared spectroscopy (FTIR) was used to identify the absorption bands of the dermis and to quantify the different absorbance ratio. RESULTS: The amounts of total, freezable and unfreezable water were determined. A significant increasing amount of freezable water is evidenced in sun-exposed area skin of aged group compared with young group (P=.0126). Another significant effect of extrinsic ageing (P=.0489) is the drastic decrease of fibrillary collagen, the main protein component of dermis. The only significant effect of intrinsic ageing (P=.0184) is an increase of the heat-stable fraction of collagens in dermis. CONCLUSION: DSC and FTIR are well-suited techniques to characterize human skin, giving accurate results with a high reproducibility. The combination of these techniques is useful for a better understanding of human skin modifications with intrinsic and extrinsic ageing.