[Retinal alterations detected by non-mydriatic retinal camera screening and referral to ophthalmology in a population with high cardiovascular risk]. / Alteraciones retinianas detectadas por screening con cámara retinal no midriática y derivación a oftalmología en una población de alto riesgo cardiovascular.

OBJECTIVE: To describe the main retinal alterations detected by non-mydriatic retinal camera screening and to evaluate factors related to referral to ophthalmology in a population at high cardiovascular risk in Palmira, Colombia. MATERIALS AND METHODS: Cross-sectional observational study, which included 11,983 photographic imaging records of patients with hypertension and diabetes mellitus from Gesencro's S.A.S. comprehensive chronic disease care program between 2018 and 2020. Risk factors associated to referral to ophthalmology were evaluated with logistic regression, and crude and adjusted ORs (odds ratios) were obtained. RESULTS: A total of 11,880 records were analyzed; 67.7±12years old, and 69.5% were women. Among the retinal alterations were patients with diabetic retinopathy classified as more than mild in 10% and gradeI hypertensive retinopathy in 54.9% right eye, 51.9% left eye. Macular edema was also identified. Only 2069 patients (17.4%) required referral to ophthalmology, and for imaging control 82.6%. In the multivariate analysis, the risk factors associated with the probability of being referred were male gender, age 60years and older, glycosylated hemoglobin out-of-target, advanced chronic kidney disease and the microalbumin-to-creatinine ratio moderate to severely elevated. CONCLUSION: This study makes it possible to determine the importance of screening with a non-mydriatic retinal camera in patients at high cardiovascular risk to detect retinal abnormalities and assess risk factors associated with referral to ophthalmology. Early documentation of ocular compromise in these patients could prevent and avoid visual impairment and blindness.

Identifying and preventing burnout in young oncologists, an overwhelming challenge in the COVID-19 era: a study of the Spanish Society of Medical Oncology (SEOM).

BACKGROUND: Young oncologists are at particular risk of professional burnout, and this could have a significant impact on their health and care of their patients. The coronavirus disease 2019 (COVID-19) pandemic has forced rapid changes in professionals' jobs and training, with the consequent physical and psychological effects. We aimed to characterize burnout levels and determinants in young oncologists, and the effects of the pandemic on their training and health. METHODS: Two online surveys were conducted among oncology residents and young oncology specialists in Spain. The first addressed professional burnout and its determinants before the COVID-19 pandemic, while the second analyzed the impact of the pandemic on health care organization, training, and physical and psychological health in the same population. RESULTS: In total, 243 respondents completed the first survey, and 263 the second; 25.1% reported significant levels of professional burnout. Burnout was more common among medical oncology residents (28.2%), mainly in their second year of training. It was significantly associated with a poor work-life balance, inadequate vacation time, and the burnout score. Nearly three-quarters of respondents (72%) were reassigned to COVID-19 care and 84.3% of residents missed part of their training rotations. Overall, 17.2% of this population reported that they had contracted COVID-19, 37.3% had scores indicating anxiety, and 30.4% moderate to severe depression. Almost a quarter of young oncologists (23.3%) had doubts about their medical vocation. CONCLUSIONS: Burnout affects a considerable number of young oncologists. The COVID-19 pandemic has had a profound impact on causes of burnout, making it even more necessary to periodically monitor it to define appropriate detection and prevention strategies.

Discriminant ability of phenolic compounds and short chain organic acids profiles in the determination of quality parameters of Brandy de Jerez.

Brandy de Jerez is the most produced spirit in Spain. The rules of its Regulatory Council require the spirit to age in American oak casks that have previously contained any kind of sherry wine. This use, called seasoning, releases wine compounds into the spirit. Because of the differences among sherries, the organoleptic features of a brandy will be significantly different from any other depending on the seasoning. In addition, its specific features make it different from any other spirit. The chromatographic profiles of Brandy de Jerez are reported to be different depending on the seasonings through their ageing process. Different types of Brandy de Jerez have been characterised, regarding their seasoning, using chromatographic techniques. Applying statistical analysis, correlations between the chromatographic profiles and the seasonings have risen up. In addition, the profiles have demonstrated to possess a high degree of correlation with the ageing time of the samples.

Eosinophils: Old Players in a New Game.

Eosinophils are terminal polymorphonuclear cells with a high number of cytoplasmic granules that originate in bone marrow. Some are exosomes, which contain multiple molecules, such as specific eosinophilic proteins, cytokines, chemokines, enzymes, and lipid mediators that contribute to the effector role of these cells. Moreover, exosomes present a large number of receptors that allow them to interact with multiple cell types. Eosinophils play an important role in defense against infestations and are a key element in asthma and allergic diseases. Eosinophils are recruited to the inflamed area in response to stimuli, modulating the immune response through the release to the extracellular medium of their granule-derived content. Various mechanisms of degranulation have been identified. Polymorphonuclear leukocytes contain multivesicular bodies that generate exosomes that are secreted into the extracellular environment. Eosinophilic exosomes participate in multiple processes and mechanisms. Eosinophils participate actively in asthma and are hallmarks of the disease. The cells migrate to the inflammatory focus and contribute to epithelial damage and airway remodeling. Given their relevance in this pathology, new therapeutic tools have been developed that target mainly eosinophils and their receptors. In this manuscript, we provide a global, updated vision of the biology of eosinophils and the role of eosinophils in respiratory diseases, particularly asthma. We also summarize asthma treatments linked to eosinophils and new therapeutic strategies based on biological products in which eosinophils and their receptors are the main targets.

Sex difference in counts of α4 and α7 nicotinic acetylcholine receptors in the nasal polyps of adults with or without exposure to tobacco smoke.

OBJECTIVE: To assess counts of α4 and α7 nicotinic acetylcholine receptors in nasal polyps of adults with or without long-term exposure to cigarette tobacco smoke. METHODS: Twenty-two patients with and 22 patients without exposure to cigarette tobacco smoke participated in the study. After endoscopic polypectomy, the fragments of the nasal polyps were analysed by immunohistochemistry. RESULTS: Compared to patients with no exposure, patients with exposure showed higher counts of α4 and α7 nicotinic acetylcholine receptors (t-test, p 0.05). CONCLUSION: Exposure to cigarette tobacco smoke may induce increased counts of α4 and α7 nicotinic acetylcholine receptors in nasal polyps of adults, with lower counts in males than females without exposure to tobacco smoke.

Study of a laboratory-scaled new method for the accelerated continuous ageing of wine spirits by applying ultrasound energy.

During the ageing of brandies, many physicochemical processes take place involving the distilled spirit and the wood of the casks. Because of these reactions, the polyphenolic content of brandies and their content of organic acids increase with the ageing. These reactions are slow, and the ageing of high-quality brandies takes several years. In this paper, the development of a system that uses the circulation of the wine distillate through encapsulated American oak chips and the application of ultrasound energy with the aim of producing aged wine spirits has been carried out, and the influences of the operation variables over the characteristics of the produced drink have been measured. With that proposal, the influence of different powers of ultrasound, and also the influence of the movement of the liquor through oak chips, was determined first. This way, the results show that higher powers of ultrasound, of nearly 40W/L, in addition with the movement of the spirit, improve the extraction of phenolic compounds in a 33.94%, after seven days of ageing. Then, applying Youden and Steiner's experimental design, eight experiments of ageing were performed, and the samples obtained by this new method were analysed to obtain information related to their physicochemical and oenological characterisation in order to determine the experimental conditions that produce the best ageing results. This way, the best spirit produced by this new method of ageing is obtained with a high alcoholic strength of the distilled wine and a high quantity of oak chips, and with room temperature and high flow rate. In addition, the presence of oxygen in the sample and the absence of light increase the quality of the produced spirit. Finally, the application of ultrasound energy in large pulses is related with the improvement of two important ageing markers: the intensity of the colour and the TPI. As a last experiment, we applied this ageing method to five varietal spirits. The sensorial analysis of aged samples showed the aged spirits had better ratings than the initial distilled wine.

Elastic and anelastic relaxation behaviour of perovskite multiferroics II: PbZr0.53Ti0.47O3 (PZT)-PbFe0.5Ta0.5O3 (PFT).

Elastic and anelastic properties of ceramic samples of multiferroic perovskites with nominal compositions across the binary join PbZr0.53Ti0.47O3-PbFe0.5Ta0.5O3 (PZT-PFT) have been assembled to create a binary phase diagram and to address the role of strain relaxation associated with their phase transitions. Structural relationships are similar to those observed previously for PbZr0.53Ti0.47O3-PbFe0.5Nb0.5O3 (PZT-PFN), but the magnitude of the tetragonal shear strain associated with the ferroelectric order parameter appears to be much smaller. This leads to relaxor character for the development of ferroelectric properties in the end member PbFe0.5Ta0.5O3. As for PZT-PFN, there appear to be two discrete instabilities rather than simply a reorientation of the electric dipole in the transition sequence cubic-tetragonal-monoclinic, and the second transition has characteristics typical of an improper ferroelastic. At intermediate compositions, the ferroelastic microstructure has strain heterogeneities on a mesoscopic length scale and, probably, also on a microscopic scale. This results in a wide anelastic freezing interval for strain-related defects rather than the freezing of discrete twin walls that would occur in a conventional ferroelastic material. In PFT, however, the acoustic loss behaviour more nearly resembles that due to freezing of conventional ferroelastic twin walls. Precursor softening of the shear modulus in both PFT and PFN does not fit with a Vogel-Fulcher description, but in PFT there is a temperature interval where the softening conforms to a power law suggestive of the role of fluctuations of the order parameter with dispersion along one branch of the Brillouin zone. Magnetic ordering appears to be coupled only weakly with a volume strain and not with shear strain but, as with multiferroic PZT-PFN perovskites, takes place within crystals which have significant strain heterogeneities on different length scales.

Elastic and magnetoelastic relaxation behaviour of multiferroic (ferromagnetic + ferroelectric + ferroelastic) Pb(Fe0.5Nb0.5)O3 perovskite.

Resonant Ultrasound Spectroscopy has been used to characterize elastic and anelastic anomalies in a polycrystalline sample of multiferroic Pb(Fe(0.5)Nb(0.5))O(3) (PFN). Elastic softening begins at ~550 K, which is close to the Burns temperature marking the development of dynamical polar nanoregions. A small increase in acoustic loss at ~425 K coincides with the value of T(*) reported for polar nanoregions starting to acquire a static or quasi-static component. Softening of the shear modulus by ~30-35% through ~395-320 K, together with a peak in acoustic loss, is due to classical strain/order parameter coupling through the cubic → tetragonal → monoclinic transition sequence of ferroelectric/ferroelastic transitions. A plateau of high acoustic loss below ~320 K is due to the mobility under stress of a ferroelastic microstructure but, instead of the typical effects of freezing of twin wall motion at some low temperature, there is a steady decrease in loss and increase in elastic stiffness below ~85 K. This is attributed to freezing of a succession of strain-coupled defects with a range of relaxation times and is consistent with a report in the literature that PFN develops a tweed microstructure over a wide temperature interval. No overt anomaly was observed near the expected Néel point, ~145 K, consistent with weak/absent spin/lattice coupling but heat capacity measurements showed that the antiferromagnetic transition is actually smeared out or suppressed. Instead, the sample is weakly ferromagnetic up to ~560 K, though it has not been possible to exclude definitively the possibility that this could be due to some magnetic impurity. Overall, evidence from the RUS data is of a permeating influence of static and dynamic strain relaxation effects which are attributed to local strain heterogeneity on a mesoscopic length scale. These, in turn, must have a role in determining the magnetic properties and multiferroic character of PFN.

Phenolic compounds and furanic derivatives in the characterization and quality control of Brandy de Jerez.

This article shows the results obtained in the study of the extraction profiles from oak wood to distillate of several compounds, low molecular weight phenolics, and furanic derivatives, and the relationship of their contents with those found in commercial sherry brandies and other aged distillates of different geographical origin, in order to research the utility of these analytical variables for explaining the highly specific character of Brandy de Jerez. Using multivariate statistic techniques, the aging system (static by anadas, or dynamic, well known as Soleras y Criaderas) has been confirmed as having a great influence on the analytical profile of aged distillates (discrimination is up to 100%). Differences between commercial brandies and those aged experimentally of equivalent average age have also been confirmed. The Solera Gran Reserva Brandies de Jerez show a clear differentiation from the rest of the distillates of different origin (discrimination is up to 80%), indicating their highly specific character.

Lack of relay toxicity in ferret hybrids fed carbaryl-treated prairie dogs.

Carbaryl (1-napthol methylcarbamate) is being considered for control of fleas on prairie dogs (Cynomys spp.) used in black-footed ferret (Mustela nigripes) recovery in the western United States. The potential for relay toxicity in ferrets was determined by feeding carbaryl treated prairie dogs to black-footed ferret x Siberian polecat (M. eversmanni) hybrids. Adult prairie dogs were treated topically with 2.5 g of commercial 5% carbaryl dust sold as flea powder. After 14 days prairie dogs were killed and fed to ferrets. Potential for relay toxicity was evaluated by analyzing ferret blood cholinesterase (CHe), prairie dog brain Che, and hepatic carbamate concentration. There was no difference between pre- and post-exposure blood CHe activity, nor did treated prairie dog brain CHe differ significantly from controls. Post-exposure blood CHe did not exhibit reactivation after dilution in aqueous buffer. Hepatic carbaryl concentrations were less than detection limits (50 ppb). Based on these results, we conclude that short-term use of carbaryl for flea control on prairie dogs does not pose a hazard of relay toxicity in black-footed ferrets.

Naturally occurring selenosis in Wyoming.

A review of Wyoming State Veterinary Laboratory records for 1947-1987 revealed no substantiated cases of naturally occurring selenosis. However, older reports attributed thousands of animal deaths to selenium each year in this area. Beginning in August 1988, cases of suspected selenosis and selenium deficiency were solicited from veterinarians and producers by announcements in various statewide livestock publications. As of August 1991, 4 cases (all horses) of naturally occurring selenosis have been confirmed. Clinical signs were most often referable to epithelial damage, e.g., hoof lesions and loss of mane and tail. None involved neurologic signs. Sources of selenium included native range and grass hay.

In vitro ruminal metabolism of larkspur alkaloids.

Larkspur (Delphinium sp) poisoning of range cattle is a serious, recurring problem in the western United States. Numerous stratagems have been recommended to ameliorate larkspur intoxication, but none are completely effective. Previous studies in this laboratory indicated bovine ruminal microflora are capable of chemically modifying Delphinium alkaloids. Research reported herein was undertaken to further evaluate whether differences in ovine and bovine rumen metabolism might explain differences in susceptibility to larkspur intoxication and whether existing metabolic activity can be enhanced by sustained exposure to Delphinium alkaloids. Comparison of ovine and bovine rumen metabolism of Delphinium geyeri alkaloids in vitro failed to demonstrate differences in the rate of alkaloid metabolism. Rumen liquor collected sequentially from a fistulated cow dosed with dried Delphinium geyeri did not vary in ability to metabolize larkspur alkaloids.

Linear age-dependent population growth with seasonal harvesting.

A population growth is modelled by the Von Foerster PDE with accompanying Lotka-Volterra integral equation describing the birth rate; the age specific death and fertility rates are assumed to depend only on age and not time. A harvesting policy where a fraction of the population of age greater than a given age is harvested for a fraction of a given season. This introduces a time dependence, but this difficulty is circumvented by devising approximate time-independent models whose birthrates bracket the true birthrate--the standard renewal equation theory applies to the approximate models so quantitative results can be obtained.