The effect of a live music therapy intervention on critically ill paediatric patients in the intensive care unit: A quasi-experimental pretest-posttest study.

BACKGROUND: Music therapy as a nonpharmacological means of managing patient pain, anxiety, and discomfort is a recognised technique, although it is not widely used in the paediatric intensive care unit (PICU). AIM: The aim of this study was to assess the clinical effect of a live music therapy intervention on vital signs and levels of discomfort and pain for paediatric patients in the PICU. METHODS: This was a quasi-experimental pretest-posttest study. The music therapy intervention was carried out by two music therapists who were specifically trained, each possessing a master's degree in the field of hospital music therapy. Ten minutes before the start of the music therapy session, the investigators recorded the vital signs of the patients and assessed their levels of discomfort and pain. The procedure was repeated at the start of the intervention; at 2, 5, and 10 min during the intervention; and at 10 min following the conclusion of the intervention. RESULTS: Two hundred fifty-nine patients were included; 55.2% were male, with a median age of 1 year (0-21). A total of 96 (37.1%) patients suffered a chronic illness. The main reason for PICU admission was respiratory illness, at 50.2% (n = 130). Significantly lower values were observed for heart rate (p = 0.002), breathing rate (p < 0.001), and degree of discomfort (p < 0.001) during the music therapy session. CONCLUSIONS: Live music therapy results in reduced heart rates, breathing rates, and paediatric patient discomfort levels. Although music therapy is not widely used in the PICU, our results suggest that using interventions such as that used in this study could help reduce patient discomfort.

Correction: Collective motion of chiral Brownian particles controlled by a circularly-polarized laser beam.

Correction for 'Collective motion of chiral Brownian particles controlled by a circularly-polarized laser beam' by Raúl Josué Hernández et al., Soft Matter, 2020, 16, 7704-7714, DOI: .

Collective motion of chiral Brownian particles controlled by a circularly-polarized laser beam.

We demonstrate the emergence of circular collective motion in a system of spherical light-propelled Brownian particles. Light-propulsion occurs as consequence of the coupling between the chirality of polymeric particles - left (L)- or right (R)-type - and the circularly-polarized light that irradiates them. Irradiation with light that has the same helicity as the particle material leads to a circular cooperative vortical motion between the chiral Brownian particles. In contrast, opposite circular-polarization does not induce such coupling among the particles but only affects their Brownian motion. The mean angular momentum of each particle has a value and sign that distinguishes between chiral activity dynamics and typical Brownian motion. These outcomes have relevant implications for chiral separation technologies and provide new strategies for optical torque tunability in mesoscopic optical array systems, micro- and nanofabrication of light-activated engines with selective control and collective motion.

TRPV4: A Physio and Pathophysiologically Significant Ion Channel.

Transient Receptor Potential (TRP) channels are a family of ion channels whose members are distributed among all kinds of animals, from invertebrates to vertebrates. The importance of these molecules is exemplified by the variety of physiological roles they play. Perhaps, the most extensively studied member of this family is the TRPV1 ion channel; nonetheless, the activity of TRPV4 has been associated to several physio and pathophysiological processes, and its dysfunction can lead to severe consequences. Several lines of evidence derived from animal models and even clinical trials in humans highlight TRPV4 as a therapeutic target and as a protein that will receive even more attention in the near future, as will be reviewed here.

Abdominal Aortic Aneurysm Associated with Polycystic Kidney Disease: Endovascular Aortic Repair and Renal Embolization.

A 79-year old patient with an asymptomatic 63-mm infrarenal abdominal aortic aneurysm, confirmed on computed tomography, was admitted in our unit. The patient had undergone kidney transplantation years before, due to renal failure secondary to polycystic kidney disease. Renal function at admission was normal. The aneurysm had a very short neck, and a standard endovascular aortic repair procedure was not feasible. Therefore, the 2 renal arteries were embolized with coils and endovascular repair of the aneurysm, covering the ostia of the renal arteries, was achieved placing the endoprosthesis up to the level of the superior mesenteric artery. The course of the patient was uneventful and was discharged without complications. Endovascular repair in patients without infrarenal aortic necks and nonfunctional kidneys secondary to polycystic kidney disease can be achieved with safety embolizing and covering the ostia of the renal arteries.

Mixed emulsion of liquid crystal microresonators: towards white laser systems.

Microdroplet systems have attracted great interest because of their wide range of applications, easiness in processing and handling, feasibility in developing miniaturized devices with high performances and large flexibility. In this study, a stable emulsion based on different dye-doped chiral liquid crystal droplets has been engineered in order to achieve simultaneous omnidirectional lasing at different wavelengths. To obtain the mixed emulsion of dye doped Bragg onion-type microresonators the twofold action, as a surfactant and a droplet stabilizer, of the polyvinyl alcohol dissolved in water has been exploited. Multiple wavelengths lasing in all directions around the mixed emulsion is demonstrated. By water evaporation, a plastic sheet including different types of chiral droplets is also obtained, retaining all the emission characteristic of the precursor emulsion. A relevant feature is the large flexibility of the preparation method that enables an easy and full control of the lasing spectrum addressing white laser systems. However, the simplicity of the procedure based on a single-step process as well as the high stability of the mixed emulsion is a relevant result, envisaging strong potentiality for developing easy and friendly technologies useful in the field of identification, sensing, imaging, coating and lab-on-a-chip architectures.

Ureteroarterial Fistulas: Diagnosis, Management, and Clinical Evolution.

BACKGROUND: Ureteroarterial fistulas (UAFs) have a low incidence but are a potentially fatal cause of hematuria. Initially treated by open surgery, endovascular techniques have decreased potential complications. MATERIAL AND METHODS: We present a short series of UAFs (n = 5) treated in our institution in the last 10 years: 1 case showed up after aorta-iliac bypass surgery, 1 case after endovascular aortic repair and embolization of right hypogastric artery, and 3 cases after oncological surgeries. We review the published literature via PubMed. RESULTS: The different approaches (2 open and 3 endovascular procedures) were based on the clinical situation of the patients and on technical limitations. Three patients died after the procedure (2 after open surgery and 1 after endovascular treatment). In our institution, endovascular treatment showed good results in terms of early complications and associated mortality compared with open surgery. CONCLUSIONS: UAF is a rare but a potentially fatal complication in patients with predisposing factors. No long-term follow-up has been published to assess the possible complications arising from the technique, such as prosthetic infection. No antibiotic treatment protocols have been established, so long-term follow-up is necessary to determine late complications.

Chiral particles in the dual-beam optical trap.

We investigate the dynamics of chiral microparticles in a dual-beam optical trap. The chiral particles have the structure of spherical chiral microresonators, with a reflectance deriving from the supramolecular helicoidal arrangement. Due to the strong asymmetric response of the particles to light with a specific helicity and wavelength, their trapping position and rotational frequency can be controlled by proper combination of the polarization state of the two light beams. Here symmetric and asymmetric polarization configurations of dual- interfering beam traps have been investigated. Based on the polarization controlled asymmetric transmission of the chiral particles, a tunable wash-board potential is created enabling the control of the trapping position along the beams axis. Asymmetric configurations display polarization controlled rotation of the trapped particles. Optical binding of rotating particles exhibits a complex dynamics.

Investigating the causality of changes in the landscape pattern of Lake Urmia basin, Iran using remote sensing and time series analysis.

Lake Urmia is the second largest hypersaline lake in the world in terms of surface area. In recent decades, the drop in water level of the lake has been one of the most important environmental issues in Iran. At present, the entire basin is threatened due to abrupt decline of the lake's water level and the consequent increase in salinity. Despite the numerous studies, there is still an ambiguity about the main cause of this environmental crisis. This paper is an attempt to detect the changes in the landscape structure of the main elements of the whole basin using remote sensing techniques and analyze the results against climate data with time series analysis for the purpose of achieving a more clarified illustration of processes and trends. Trend analysis of the different affecting factors indicates that the main cause of the drastic dry out of the lake is the huge expansion of irrigated agriculture in the basin between 1999 and 2014. The climatological parameters including precipitation and temperature cannot be the main reasons for reduced water level in the lake. The results show how the increase in irrigated agricultural area without considering the water resources limits can lead to a regional disaster. The approach used in this study can be a useful tool to monitor and assess the causality of environmental disaster.

Recent advances on the structure and the function relationships of the TRPV4 ion channel.

The members of the superfamily of Transient Receptor Potential (TRP) ion channels are physiologically important molecules that have been studied for many years and are still being intensively researched. Among the vanilloid TRP subfamily, the TRPV4 ion channel is an interesting protein due to its involvement in several essential physiological processes and in the development of various diseases. As in other proteins, changes in its function that lead to the development of pathological states, have been closely associated with modification of its regulation by different molecules, but also by the appearance of mutations which affect the structure and gating of the channel. In the last few years, some structures for the TRPV4 channel have been solved. Due to the importance of this protein in physiology, here we discuss the recent progress in determining the structure of the TRPV4 channel, which has been achieved in three species of animals (Xenopus tropicalis, Mus musculus, and Homo sapiens), highlighting conserved features as well as key differences among them and emphasizing the binding sites for some ligands that play crucial roles in its regulation.

Identification and properties of TRPV4 mutant channels present in polycystic kidney disease patients.

Polycystic kidney disease (PKD), a disease characterized by enlargement of the kidney through cystic growth is the fourth leading cause of end-stage kidney disease world-wide. TRPV4, a calcium-permeable TRP, channel participates in kidney cell physiology and since TRPV4 forms complexes with another channel whose malfunction is associated to PKD, TRPP2 (or PKD2), we sought to determine whether patients with PKD, exhibit previously unknown mutations in TRPV4. Here, we report the presence of mutations in the TRPV4 gene in patients diagnosed with PKD and determine that they produce gain-of-function (GOF). Mutations in the sequence of the TRPV4 gene have been associated to a broad spectrum of neuropathies and skeletal dysplasias but not PKD, and their biophysical effects on channel function have not been elucidated. We identified and examined the functional behavior of a novel E6K mutant and of the previously known S94L and A217S mutant TRVP4 channels. The A217S mutation has been associated to mixed neuropathy and/or skeletal dysplasia phenotypes, however, the PKD carriers of these variants had not been diagnosed with these reported clinical manifestations. The presence of certain mutations in TRPV4 may influence the progression and severity of PKD through GOF mechanisms. PKD patients carrying TRVP4 mutations are putatively more likely to require dialysis or renal transplant as compared to those without these mutations.

Antitumor activity of Mn(III) complexes in combination with phototherapy and antioxidant therapy.

Manganese (Mn) is an essential trace element and trivalent Mn complexes have been used as oxidation catalysts and enzyme mimetics. We studied the cytotoxicity of Mn(III) derivatives of citrate, pyrophosphate and salicylene diamine (respectively, MnCit, MnPPi and EUK8) toward HeLa cells stressed by ultraviolet irradiation and the effect of the co-administration of ascorbate and para-amino salicylate (PAS) on cell viability. Metal complexes enhanced the lethality of irradiated cells, and this effect was even more pronounced when ascorbate was co-administered with Mn(III) species. The active role of Mn(III) compounds in the antitumor activity was demonstrated by the treatment of the cells with the chelator PAS, which restored the viability of both non-irradiated and UV-irradiated cells. The association of the Mn(III) metallodrugs with radiation and an antioxidant proved to be a very effective approach to chemotherapy.

Tunable locking of calcite narrow frequency filters through modulation switching.

Generating pairs of Raman beams for gravimetry with fiber phase modulators is quite convenient but generates additional frequencies that must be filtered. The frequency filtering could be achieved by using a long (dispersive) birefringent calcite crystal followed by a polarizer that blocks the transmission of certain laser frequencies, as has been shown before. Here, we present a method to tune such a filter to the desired frequency position. The correction signal for the feedback is obtained by comparing (subtracting) the transmission through the filter when sending light that has been phase modulated or not, taking advantage of the fiber modulator that is already installed in the system. The method allows for continuously alternating between using the modulator for monitoring the filter position and other uses, an important characteristic for the operation of a complete gravimetric sequence.

Prognostic Scores and Survival Rates by Etiology of Hepatocellular Carcinoma: A Review.

Hepatocellular carcinoma (HCC) is a common cancer and ranks sixth among all malignancies worldwide. Risk factors for HCC can be classified as infectious or behavioral. Viral hepatitis and alcohol abuse are currently the most common risk factors for HCC; however, nonalcoholic liver disease is expected to become the most common cause of HCC in upcoming years. HCC survival rates vary according to the causative risk factors. As in any malignancy, staging is crucial in making therapeutic decisions. The selection of a specific score should be individualized according to patient characteristics. In this review, we summarize the current data on epidemiology, risk factors, prognostic scores, and survival in HCC.

Syntheses of mycobactin analogs as potent and selective inhibitors of Mycobacterium tuberculosis.

Three analogs of mycobactin T, the siderophore secreted by Mycobacterium tuberculosis (Mtb) were synthesized and screened for their antibiotic activity against Mtb H(37)Rv and a broad panel of Gram-positive and Gram-negative bacteria. The synthetic mycobactins were potent (MIC(90) 0.02-0.88 µM in 7H12 media) and selective Mtb inhibitors, with no inhibitory activity observed against any other of the microorganisms tested. The maleimide-containing analog 40 represents a versatile platform for the development of mycobactin-drug conjugates, as well as other applications.

[Prevalence of peripheral neuropathy among primary care type 2 diabetic patients]. / Prevalencia de neuropatía periférica en diabéticos tipo 2 en el primer nivel de atención.

BACKGROUND: Neuropathy is a common complication of diabetic patients. AIM: To determine the prevalence of diabetic peripheral neuropathy in Type 2 diabetic patients attended at a family medicine unit. MATERIAL AND METHODS: Cross-sectional assessment of 348 type 2 diabetic patients aged 34-89 years (60% females) with a disease duration of 5 to 15 years. Peripheral neurological status was evaluated using The Michigan Neuropathy Screening Instrument, a tool that includes a self-assessment of symptoms and a physical examination. RESULTS: Diabetic neuropathy was found in 240 patients (69%). The prevalence in males and females was 72 and 67% respectively. The prevalence in patients with a disease duration of 5, 10 and 15 years, was 59, 69 and 77%, respectively. Fifty percent of patients with neuropathy complained of dry skin, 2% had ulcers, 43% had an abnormal perception of vibration and 29% had an abnormal monofilament test. CONCLUSIONS: The overall prevalence of peripheral neuropathy in this group of patients was 69% and was directly associated with the duration of the disease.

Embryonic and larval development of Eugerres mexicanus (Perciformes: Gerreidae) in Tenosique, Tabasco, Mexico.

Most studies on Eugerres mexicanus mainly consider biogeographic and systematic aspects and rarely address reproductive characteristics, which are useful for fishery population management plans. This study aimed at evaluating the ontogeny of E. mexicanus, based on 30 embryos and 30 larvae sampled by induced spawning of breeders, taken in February 2009 from the Usumacinta River in Tenosique, Tabasco, Mexico. All descriptions of the embryonic development were based on morphometric and meristic data and followed standard methods. Eggs, recovered at the gastrula stage, had an average diameter of 1.17mm (SD=0.08). The bud stage appeared during the first three hours of development, in which the posterior side was adhered to the vitellus; Kupffer's vesicle was visible. Yolk-sac larvae hatched 18 hours after fertilization, exhibiting a light brown color and an average total length of 2.94mm (SD=0.70); the preflexion stage was reached eight days after hatching, with a total average length of 4.67mm (SD=0.50) and a total notochord length of 4.45mm (SD=0.50). The flexion stage was reached on the 16th day, with an average total length of 6.66mm (SD=1.53), while postflexion was reached on the 24th day, with 10.33mm (SD=1.45). The pre-juvenile stage was reached on the 33rd day, with a total length of 14.30mm (SD=0.93), showing IX spines and 10 rays and III spines and eight rays in the dorsal and anal fins, respectively. The juvenile stage was reached by the 45th day, with an average length of 28.16mm (SD=1.93) and average weight of 4.75g (SD=1.49). Prejuveniles showed an initial pigmentation with dark colored dots in the superior and inferior jaw and dispersed on the head, while juveniles presented the same pigmentation pattern, decreasing towards the margin of the caudal peduncle. In conclusion, the embryonic developmental stages of E. mexicanus were typical for the Gerreidae group. However, their morphometric characters were slightly different since the diameter and size of the drop of oil were bigger than those reported for marine species. In addition, regarding pigmentation, the yolk-sac larvae of E. mexicanus were olive and yellow on the margin of the notochord, which differs from those reported for other species. This is the first recorded report on the reproductive biology and early life development of this species.

Examining the Impact of COVID-19 on Upper Manhattan Community-Based Organizations: A Qualitative Analysis of Employee Focus Groups.

Community-based organizations (CBOs) play a key role in assisting local communities, especially those in under-resourced areas, through their deep knowledge of the community's needs and available resources. We examined perceptions of COVID-19's impact on health-related services in CBOs located in Upper Manhattan, New York City (serving East Harlem, Central Harlem, Morningside Heights and Hamilton Heights, and Washington Heights and Inwood). Three focus groups were conducted on Zoom in November 2020; focus groups were composed of participants employed at CBOs in this catchment area. Deidentified interview transcripts were evaluated using an iterative process of thematic content analysis. We identified five major themes related to the impact of COVID-19 on community needs: 1) increased mistrust and decreased service utilization, 2) breakdowns in communication, 3) shift in need, 4) increased risk factors for negative health outcomes among staff and community, and 5) decreased funding and an uncertain future. Because of the pandemic, CBOs have pivoted to cater to the immediate and changing needs of the community and, in doing so, revised their menu of services as well as their service delivery model. In trying to maintain connectivity with and the trust of community members, participants had to construct novel strategies and develop new outreach strategies; participants also recognized the role strain of trying to balance community needs with home responsibilities. Given these findings, concern arises around the long-term health and well-being of community members and participants. The government must provide the necessary resources to ensure the viability of CBOs and create a stronger infrastructure for future emergencies.

The psychoactive effects of Bryophyllum pinnatum (Lam.) Oken leaves in young zebrafish.

Bryophyllum pinnatum (Lam.) Oken (BP) is a plant that is used worldwide to treat inflammation, infections, anxiety, restlessness, and sleep disorders. While it is known that BP leaves are rich in flavonoids, the extent of the beneficial and toxic effects of its crude extracts remains unclear. Although some neurobehavioral studies using leaf extracts have been conducted, none has examined the effects of water-extracted leaf samples. The zebrafish is a powerful animal model used to gain insights into the efficacy and toxicity profiles of this plant due to its high fecundity, external development, and ease of performing behavioral assays. In this study, we performed behavioral testing after acute exposure to different concentrations of aqueous extract from leaves of B. pinnatum (LABP) on larval zebrafish, investigating light/dark preference, thigmotaxis, and locomotor activity parameters under both normal and stressed conditions. LABP demonstrated dose-and time-dependent biphasic effects on larval behavior. Acute exposure (25 min) to 500 mg/L LABP resulted in decreased locomotor activity. Exposure to 300 mg/L LABP during the sleep cycle decreased dark avoidance and thigmotaxis while increasing swimming velocity. After sleep deprivation, the group treated with 100 mg/L LABP showed decreased dark avoidance and increased velocity. After a heating stressor, the 30 mg/L and 300 mg/L LABP-treated groups showed decreased dark avoidance. These results suggest both anxiolytic and psychoactive effects of LABP in a dose-dependent manner in a larval zebrafish model. These findings provide a better understanding of the mechanisms underlying relevant behavioral effects, consequently supporting the safe and effective use of LABP for the treatment of mood disorders.

Numerical Study of a Solar Cell to Achieve the Highest InGaN Power Conversion Efficiency for the Whole In-Content Range.

A solar cell structure with a graded bandgap absorber layer based on InGaN has been proposed to overcome early predicted efficiency. Technological issues such as carrier concentration in the p- and n-type are based on the data available in the literature. The influence of carrier concentration-dependent mobility on the absorber layer has been studied, obtaining considerable improvements in efficiency and photocurrent density. Efficiency over the tandem solar cell theoretical limit has been reached. A current density of 52.95 mA/cm2, with an efficiency of over 85%, is determined for a PiN structure with an InGaN step-graded bandgap absorption layer and 65.44% of power conversion efficiency for the same structure considering piezoelectric polarization of fully-strained layers and interfaces with electron and hole surface recombination velocities of 10-3 cm/s.