Effects of Thermal Gradients in High-Temperature Ultrasonic Non-Destructive Tests.

Ultrasonic inspection techniques and non-destructive tests are widely applied in evaluating products and equipment in the oil, petrochemical, steel, naval, and energy industries. These methods are well established and efficient for inspection procedures at room temperature. However, errors can be observed in the positioning and sizing of the flaws when such techniques are used during inspection procedures under high working temperatures. In such situations, the temperature gradients generate acoustic anisotropy and consequently distortion of the ultrasonic beams. Failure to consider such distortions in ultrasonic signals can result, in extreme situations, in mistaken decision making by inspectors and professionals responsible for guaranteeing product quality or the integrity of the evaluated equipment. In this scenario, this work presents a mathematical tool capable of mitigating positioning errors through the correction of focal laws. For the development of the tool, ray tracing concepts are used, as well as a model of heat propagation in solids and an experimentally defined linear approximation of dependence between sound speed and temperature. Using the focal law correction tool, the relative firing delays of the active elements are calculated considering the temperature gradients along the sonic path, and the results demonstrate a reduction of more than 68% in the error of flaw positioning.

Deferred Action for Childhood Arrivals (DACA) medical students - an examination of their journey and experiences as medical students in limbo.

BACKGROUND: Although the value of DACA medical students has been hypothesized, no data are available on their contribution to US healthcare. While the exact number of DACA recipients in medical school is unknown, DACA medical students are projected to represent an increasing proportion of physicians in the future. The current literature on DACA students has not analyzed the experiences of these students. METHODS: A mixed-methods study on the career intentions and experiences of DACA medical students was performed utilizing survey data and in-depth interviews. The academic performance of a convenience sample of DACA medical students was compared to that of matriculated medical students from corresponding medical schools, national averages, and first-year residents according to specialty. RESULTS: Thirty-three DACA medical students completed the survey and five participated in a qualitative interview. The average undergraduate GPA (SD) of the DACA medical student sample was 3.7 (0.3), the same as the national GPA of 2017-2018 matriculated medical students. The most common intended residency programs were Internal Medicine (27.2%), Emergency Medicine (15.2%), and Family Medicine (9.1%). In interviews, DACA students discussed their motivation for pursuing medicine, barriers and facilitators that they faced in attending medical school, their experiences as medical students, and their future plans. CONCLUSIONS: The intent of this sample to pursue medical specialties in which there is a growing need further exemplifies the unique value of these students. It is vital to protect the status of DACA recipients and realize the contributions that DACA physicians provide to US healthcare.

Correction to: Alterations in bacterial communities, SCFA and biomarkers in an elderly HIV-positive and HIV-negative population in western Mexico.

An amendment to this paper has been published and can be accessed via the original article.

Model Predictive Torque Control for Velocity Tracking of a Four-Wheeled Climbing Robot.

Climbing robots are characterized by a secure surface coupling that is designed to prevent falling. The robot coupling ability is assured by an adhesion method leading to nonlinear dynamic models with time-varying parameters that affect the robot's mobility. Additionally, the wheel friction and the force of gravity force are also relevant issues that can compromise the climbing ability if they are not well modeled. This work presents a model-based torque controller for velocity tracking in a four-wheeled climbing robot specially designed to inspect storage tanks. The model-based controller (MPC) compensates for the effects of nonlinearities due to the forces of gravity, friction, and adhesion through the dynamic and kinematic modeling of the climbing robot. Dynamic modeling is based on the Lagrange-Euler approach, which allows a better understanding of how forces and torques affect the robot's movement. Besides, an analysis of the interaction force between the robot and the contact surface is proposed, since this force affects the motion of the climbing robot according to spatial orientation. Finally, simulations are carried out to examine the robot's dynamics during the climbing movement, and the MPC is validated through the redrobot simulator V-REP and practical experiments. The presented results highlight the compensation of the nonlinear effects due to the robot's climbing motion by the proposed MPC controller.

Spirituality and Religious Practices and Its Association with Geriatric Syndromes in Older Adults Attending to a Geriatric's Clinic in a University Hospital.

Demographic aging has led to an increase in the prevalence of different diseases, including the so-called geriatric syndromes (GS), like depression, disability and frailty phenotype (FP). Spirituality and religious practices (RP) have been associated with positive health outcomes and could be a protective factor against the development of some GS. Study aims was to determine the frequency of spirituality and RP, and their associations between some GS in adults 60 years of age or older, who attended a geriatric clinic in a university hospital in Mexico. Cross-sectional study in adults aged ≥ 60 years, recruited in 2018, was performed. Participants underwent a comprehensive geriatric assessment, with which spirituality and religious practices model and the diagnosis of GS were obtained. Linear regression analyses were determined to establish the association between RP and GS. We included 128 subjects; mean age was 79 years (SD ± 8). Lowers scores for mass and communion assiduity were associated with worst disability and FP scores (b = - 0.35, P = 0.02; b = - 0.37, P = 0.03). The RP model explained 8% (R2 = 0.083) of the total variance of the depressive symptoms score (P = 0.03). This study showed that the prevalence of RP is higher in Mexican older adults. The RP model can explain 8 and 9% of the variation in dependent variables (depressive symptoms and disability). These results suggest the importance of monitoring RP, as they seem to have a positive impact on health status of the elderly.

Biomarkers for malignant pleural mesothelioma: a meta-analysis.

Malignant pleural mesothelioma (MPM) is a rare but aggressive cancer, and early detection is associated with better survival. Mesothelin, fibulin-3 and osteopontin have been suggested as screening biomarkers. The study conducted a meta-analysis of the mean differences of mesothelin, osteopontin and fibulin-3 in blood and pleural samples. PubMed searches were conducted for studies that measured levels of mesothelin, osteopontin and fibulin-3 in participants with MPM compared with malignancy, benign lung disease or healthy participants. Thirty-two studies with mesothelin levels, 12 studies with osteopontin levels and 9 studies with fibulin-3 levels were included in the meta-analysis. Statistically significant mean differences were seen between MPM patients and all other comparison groups for mesothelin blood and pleural levels. Statistically significant differences in blood osteopontin levels were seen between participants with benign lung disease and healthy participants compared with participants with MPM, but not when comparing participants with cancer with MPM participants. There were not enough studies that reported osteopontin levels in pleural fluid to complete a meta-analysis. Statistically significant differences were seen in both blood and pleural levels of fibulin-3 in MPM patients compared with all other groups. On the basis of these results, mesothelin and fibulin-3 levels appear to be significantly lower in all control groups compared with those with MPM, making them good candidates for screening biomarkers. Osteopontin may be a useful biomarker for screening healthy individuals or those with benign lung disease but would not be useful for screening patients with malignancies.

Alterations in bacterial communities, SCFA and biomarkers in an elderly HIV-positive and HIV-negative population in western Mexico.

BACKGROUND: The study of stool microbiota has taken great relevance in the last years, given its role in the maintenance of the intestinal metabolic, physiological, and immunological homeostasis, as well as, its effect over HIV biomarkers levels such as CD4/CD8 ratio, high sensitivity C-Reactive Protein (hs-CRP), related to poor outcomes (rapid progression to AIDS). Several efforts have been made to characterize the gut microbiome. In HIV infection, most of the studies report the presence of a dysbiotic pattern; however, few of them have made an approach in elderly HIV-positive subjects despite the fact that nowadays this subgroup is rising. In this study, we compared the composition of faecal microbiota, Short Chain Fatty Acids (SCFAs), and systemic biomarkers between elderly HIV-positive and HIV-negative subjects. METHODS: A cross-sectional study with 18 HIV-negative controls and 20 HIV-positive patients. The quantification of Bacteroidetes, Firmicutes, Proteobacteria, Actinobacteria, Lactobacillus, Enterobacteriaceae, Bifidobacterium, Escherichia coli, Clostridium leptum, Clostridium coccoides was performed in faecal samples by qPCR. The analysis was performed by calculating the ΔCq of each microorganism using 16S rDNA as a reference gene. Faecal SCFAs were measured by HPLC. The hs-CRP and sCD14 were performed by ELISA. RESULTS: An increase in the Firmicutes/Bacteroidetes ratio, coupled with a significant increase in the proteobacteria phylum was detected in HIV-positive subjects. In contrast, a decrease in the Clostridium leptum group was observed. Nevertheless, these elderly HIV-positive patients showed higher levels of total SCFAs mainly by an augmented propionic acid values, compared to HIV-negative subjects. Whereas high levels of hs-CRP were positively correlated with sCD14 in the HIV-positive group. CONCLUSIONS: Alterations in bacterial communities reveals a dysbiotic state related to an unbalance of faecal SCFAs. Therefore, these intestinal conditions might drive an increase of poor prognostic biomarkers in elderly HIV-positive subjects.

Sliding Window Mapping for Omnidirectional RGB-D Sensors.

This paper presents an omnidirectional RGB-D (RGB + Distance fusion) sensor prototype using an actuated LIDAR (Light Detection and Ranging) and an RGB camera. Besides the sensor, a novel mapping strategy is developed considering sensor scanning characteristics. The sensor can gather RGB and 3D data from any direction by toppling in 90 degrees a laser scan sensor and rotating it about its central axis. The mapping strategy is based on two environment maps, a local map for instantaneous perception, and a global map for perception memory. The 2D local map represents the surface in front of the robot and may contain RGB data, allowing environment reconstruction and human detection, similar to a sliding window that moves with a robot and stores surface data.

Correlates of depressive symptoms among older adults living with HIV.

OBJECTIVE: To establish the correlates of depressive symptoms among Mexican community-dwelling older people living with HIV (PLWHIV). METHODS: Cross-sectional, 2-center study of 328 participants aged 50 or older being followed in the outpatient HIV clinics of 2 tertiary care hospitals in Mexico. Data were obtained through a comprehensive geriatric assessment. Multivariate logistic regression analyses were performed to identify the correlates of depressive symptoms. RESULTS: Mean age of participants was 58.4 years (SD = 7.2), and 82.9% were men. Depressive symptoms were present in 15.9% of participants. The multivariate logistic regression models showed that frailty and disability for activities of daily living were both independently associated with depressive symptoms. CONCLUSION: Frailty and disability were independent correlates of depressive symptoms in older PLWHIV. Future studies should attempt to explore the role of physical frailty and disability on psychosocial morbidity among older PLWHIV.

[Small infundibulectomy versus ventriculotomy in tetralogy of Fallot]. / Infundibulectomía mínima adversus ventriculotomía clásica en tetralogía de Fallot.

BACKGROUND: the surgical correction of tetralogy of Fallot (TOF) is standardized on the way to close the septal defect, but differs in the way of expanding the right ventricular outflow tract (RVOT). The aim was to compare the early postoperative clinical course of the RVOT obstruction enlargement in classical ventriculotomy technique and the small infundibulectomy (SI). METHODS: We analyzed the database of the pediatric heart surgery service from 2008 to 2011. Patients with non-complex TOF undergoing complete correction by classical ventriculotomy or SI were selected. Anova, χ(2) and Fisher statistical test were applied. RESULTS: the data included 47 patients, 55 % (26) male, mean age 43 months (6-172), classical ventriculotomy was performed in 61.7 % (29). This group had higher peak levels of lactate (9.07 versus 6.8 mmol/L) p = 0049, and greater magnitude in the index bleeding/kg in the first 12 hours (39.1 versus 20.3 mL/kg) p = 0.016. Death occurred in 9 cases (31.03 %) versus one (5.6 %) in the SI group with p = 0.037; complications exclusive as acute renal failure, hemopneumothorax, pneumonia, permanent AV-block and multiple organ failure were observed. CONCLUSIONS: morbidity and mortality was higher in classical ventriculotomy group in comparison with SI. This is possibly associated with higher blood volume.

Introducción: en la corrección quirúrgica de la tetralogía de Fallot existe uniformidad en la forma de cerrar el defecto septal, pero variedad en cómo ampliar el tracto de salida del ventrículo derecho, por lo que se compara la evolución clínica posoperatoria temprana de la ampliación del tracto de salida del ventrículo derecho con ventriculotomía clásica e infundibulectomía minima. Métodos: análisis de la base de datos de un servicio de cardiocirugía pediátrica de 2008 a 2011. Se eligieron pacientes con tetralogía de Fallot no compleja sometidos a corrección completa mediante ventriculotomía clásica o infundibulectomía minima. Para el análisis estadístico se obtuvo Anova, χ2 y prueba exacta de Fisher. Resultados: 55 % fue del sexo masculino, la edad media fue de 43 meses, la ventriculotomía clásica se realizó en 61.7 %, con la que se tuvo mayor nivel máximo de lactato (9.07 adversus 6.8 mmo/L), de magnitud en el índice hemorragia/kg en las primeras 12 horas (39.1 adversus 20.3 mL/kg), de mortalidad (31.03 adversus 5.6 %), de complicaciones exclusivas como insuficiencia renal aguda, hemoneumotórax, neumonía, bloqueo auriculoventricular permanente y falla orgánica múltiple. Conclusiones: la morbimortalidad fue mayor con la ventriculotomía clásica, relacionada posiblemente con el mayor volumen de sangrado.

Predicting Hemodynamic Changes During Intra-Aortic Balloon Pump Support With a Longitudinal Evaluation.

The use of intra-aortic balloon pump (IABP) has decreased in recent years due to negative outcome studies in cardiogenic shock complicating acute myocardial infarction, despite its favorable adverse-event profile. Acute hemodynamic response studies have identified potential super-responders with immediate improvements in cardiac index (CI) in heart failure patients. This single-center retrospective study aimed to predict CI and mean arterial pressure (MAP) changes throughout the entire duration of IABP support. The study analyzed 336 patients who received IABP between 2016 and 2022. Linear mixed-effect regression models were used to predict CI and MAP improvement during IABP support. The results showed that CI and MAP increases during the first days of support, and changes during IABP support varied with time and were associated with baseline parameters. Longitudinal CI change was associated with body surface area, baseline CI, baseline pulmonary artery pulsatility index, baseline need for pressors, and diabetes. Longitudinal MAP change was associated with baseline MAP, baseline heart rate, need for pressors, or inotropes. The study recommends considering these parameters when deciding if IABP is the most appropriate form of support for a specific patient. Further prospective studies are needed to validate the findings.

Salinity induced anatomical and morphological changes in Chloris gayana Kunth roots.

Chloris gayana Kunth is a grass species valuable as forage which was introduced into Argentina to be used as pasture in saline soils of subtropical and warm-temperate zones, given its good adaptability to drought, salinity and mild freezing. However, its tolerance varies according to the cultivar. In tetraploid cultivars, important reductions in yield have been observed. Here, a study of the variations produced on the root and stem system by salinity at different NaCl concentrations (0, 150 and 250 mM) was performed in the Boma cultivar, with the aim of determining the anatomical and morphological alterations produced by the salt excess. Plants cultivated with the highest level of salinity showed, in the whole, significant differences in the measured variables. A diminution in absolute values of the variables and a major reduction in vascular tissue dimensions were observed, which suggests that the lack of tolerance to salt stress could be related to a deficient adaptation to absorb and transport water and nutrients from the roots.

Exceptional Presentation of Heart Thrombi Secondary to Myocardial Infarction Due to COVID-19 Pandemic.

Left ventricular thrombi (LVT) is an uncommon complication that can occur after a myocardial infarction thanks to the discovery of revascularization therapies. Before it, an LVT was described in up to 60% of patients with myocardial infarction. The authors present a case of a 46-year-old female who presented to the emergency department with one week of dyspnea, who had symptoms of chest pain for a week, however, did not show up in the hospital due to the ongoing COVID-19 pandemic. In-patient new-onset heart failure workup during that time was minimized due to the state of emergency COVID-19 pandemic. The patient lost to follow up appointment and then presented again to the hospital with Echocardiogram at that time showing mid to distal septal and apical hypokinesis, EF 30%-35% and a highly mobile circumferential echogenic mass of 2.4x2.4 cm noted in the left ventricle (LV) with differentials of LV thrombus vs cardiac tumor. Hospital complicated by LV thrombus embolization with bilateral lower extremities (LEs) arterial thrombi and limb ischemia. Left cardiac cath with a result of severe triple vessel disease requires either coronary artery bypass grafting (CABG) or complex percutaneous coronary intervention (PCI). A tentative plan was to pursue CABG, however, lower extremities must be healed prior to cardiothoracic surgery.

Pseudoseptic Arthritis: An Initial Presentation of Underlying Psoriatic Arthritis.

Pseudoseptic arthritis is an acute inflammatory monoarthritis that clinically mimics septic arthritis. We encountered an 86-year-old male with a past medical history of hypertension, type 2 diabetes mellitus, and chronic kidney disease (CKD) stage 3 who presented in the emergency department with acute onset of severe left knee joint pain and was started on antibiotics for suspected septic arthritis. Septic arthritis was ruled out with negative synovial fluid culture. Timely initiation of steroids rapidly improved his condition, and he was discharged in stable condition on the 7th day of admission. Though pseudoseptic arthritis has been reported in a variety of settings including rheumatoid arthritis, ankylosing spondylitis, and medication such as intraarticular hyaluronic acid injection, our case report presents a case of pseudoseptic arthritis as the initial presentation of undiagnosed psoriatic arthritis.

Adult-Onset Still's Disease With Extensive Lymphadenopathy Mimicking Lymphoproliferative Malignancy.

Adult-onset Still's disease (AOSD), a rare systemic inflammatory disorder of unknown etiology, is considered in broad differential in patients with fever of unknown origin or unexplained lymphadenopathy. It is characterized by spiking fever, evanescent salmon-colored maculopapular rash, arthritis or arthralgia, and leukocytosis. Due to broad differentials and lack of any specific diagnostic tests, diagnosis of AOSD poses a great challenge. A concerned physician should have a high index of suspicion while dealing with patients presenting with clinical symptoms of this systemic disorder. We report a case of a 25-year-old African American female with the past medical history of AOSD, who presented with four weeks history of extensive cervical and axillary lymphadenopathy mimicking lymphoproliferative malignancy. Cases have been reported with the development of malignant lymphoma during the course of AOSD. Therefore, careful monitoring of patients with regular follow-up is vital as these patients may develop lymphoproliferative malignancy in the future.

Academic Performance during the COVID-19 Pandemic and Its Relationship with Demographic Factors and Alcohol Consumption in College Students.

The COVID-19 pandemic has caused many changes in the education sector worldwide, and school curricula have had to adapt to a non-face-to-face modality. However, international studies have concluded that this modality has affected the academic performance of students. The present study aimed to compare the academic performance of a sample of college students from before the start of quarantine with their current performance, and to test whether various demographic factors influenced these changes in conjunction with alcohol consumption. With a non-experimental, comparative and longitudinal design, we applied an ad hoc questionnaire, in conjunction with the AUDIT questionnaire, in a sample of college students (n = 341), and we also obtained data of academic average and failed subjects. The demographic factors that influenced academic performance were sex (p < 0.01), age (p < 0.01) and alcohol consumption (p = 0.001). Most students showed an improvement in their academic average during the quarantine period. Women without failed subjects and low-risk alcohol consumption obtained a better average in this period. In conclusion sex, age and alcohol consumption level were factors associated with academic performance during the quarantine period due to the COVID-19 pandemic; and women had a higher academic average than men did.

Physiopathological Bases of the Disease Caused by HACE1 Mutations: Alterations in Autophagy, Mitophagy and Oxidative Stress Response.

Recessive HACE1 mutations are associated with a severe neurodevelopmental disorder (OMIM: 616756). However, the physiopathologycal bases of the disease are yet to be completely clarified. Whole-exome sequencing identified homozygous HACE1 mutations (c.240C>A, p.Cys80Ter) in a patient with brain atrophy, psychomotor retardation and 3-methylglutaconic aciduria, a biomarker of mitochondrial dysfunction. To elucidate the pathomechanisms underlying HACE1 deficiency, a comprehensive molecular analysis was performed in patient fibroblasts. Western Blot demonstrated the deleterious effect of the mutation, as the complete absence of HACE1 protein was observed. Immunofluorescence studies showed an increased number of LC3 puncta together with the normal initiation of the autophagic cascade, indicating a reduction in the autophagic flux. Oxidative stress response was also impaired in HACE1 fibroblasts, as shown by the reduced NQO1 and Hmox1 mRNA levels observed in H2O2-treated cells. High levels of lipid peroxidation, consistent with accumulated oxidative damage, were also detected. Although the patient phenotype could resemble a mitochondrial defect, the analysis of the mitochondrial function showed no major abnormalities. However, an important increase in mitochondrial oxidative stress markers and a strong reduction in the mitophagic flux were observed, suggesting that the recycling of damaged mitochondria might be targeted in HACE1 cells. In summary, we demonstrate for the first time that the impairment of autophagy, mitophagy and oxidative damage response might be involved in the pathogenesis of HACE1 deficiency.

Psychometric properties of the Stress Coping Scale Brief-COPE 28 in a Peruvian population / Propiedades psicométricas de la Escala de Afrontamiento al Estrés Brief-COPE 28 en una población peruana

Background: The highly stressful events we are currently experiencing require great cognitive and emotional effort and affect the mental health of the population. In this sense, coping with stress provides evidence of how people use their resources to cope with or avoid stressful events, which requires validated and reliable instruments to measure accurately. Objective: To determine the psychometric properties of reliability and validity of the BRIEF COPE 28, Spanish version. Method: The design used was instrumental; 530 people participated, 60% men and 40% women, between 18 and 60 years old, from different regions of Peru, selected by non-probability convenience sampling. Results: It is evident that the alpha coefficient of coping styles ranges from α ordinal = 0.74 to 0.82; while in strategies it was between α ordinal = 0.59 to 0.90. In terms of internal structure, the four-factor model obtained a good fit SB-χ²/gl=1.836; CFI=0.92; TLI=0.90, SRMS=0.09 and RMSEA=0.10. A good fit was found with the ten coping strategies model SB-χ²/gl=1.902; CFI=0.96; TLI=0.95, SRMS=0.056, RMSEA=0.069. Conclusion: COPE 28 has good internal consistency; and the model with the four coping styles is inconclusive, while the model with ten strategies has adequate goodness of fit.

Introducción: Los acontecimientos altamente estresantes que vivimos actualmente demandan gran esfuerzo cognitivo y emocional y afectan la salud mental de la población; en este sentido el afrontamiento al estrés proporciona evidencia de cómo las personas recurren a sus recursos para afrontar o evadir los eventos estresantes, lo cual necesita de instrumentos validados y confiables para medirlo con precisión. Objetivo: Determinar las propiedades psicométricas de confiabilidad y validez del BRIEF COPE 28, versión española. Método: El diseño usado fue instrumental; participaron 530 personas, 60% varones y 40% mujeres, entre 18 y 60 años, de distintas regiones del Perú, seleccionadas con el muestreo no probabilístico por conveniencia. Resultados: Se evidencia que el coeficiente alfa de los estilos de afrontamiento oscila entre α ordinal=0.74 a 0.82; mientras que en las estrategias fue entre α ordinal=0.59 a 0.90. En cuanto a la estructura interna, el modelo de cuatro factores obtuvo buen ajuste de bondad SB-χ²/gl=1.836; CFI=0.92; TLI=0.90, SRMS=0.09 y RMSEA=0.10. Asimismo, se encontró buen ajuste con el modelo de 10 estrategias de afrontamiento SB-χ²/gl=1.902; CFI=0.96; TLI=0.95, SRMS=0.056, RMSEA=0.069. Conclusión: El COPE 28 tiene buena consistencia interna; y que el modelo con los cuatro estilos de afrontamiento no es concluyente; mientras el modelo con 10 estrategias tiene adecuado ajuste de bondad.