Improved accuracy and robustness of electron density profiles from JET's X-mode frequency-modulated continuous-wave reflectometers.

JET's frequency-modulated continuous wave (FMCW) reflectometers have been operating well with the current design since 2005, and density profiles have been automatically calculated intershot since then. However, the calculated profiles had long suffered from several shortcomings: poor agreement with other diagnostics, sometimes inappropriately moving radially by several centimeters, elevated levels of radial jitter, and persistent wriggles (strong unphysical oscillations). In this research, several techniques are applied to the reflectometry data analysis, and the shortcomings are significantly improved. Starting with improving the equilibrium reconstruction that estimates the background magnetic field, adding a ripple correction in the reconstructed magnetic field profile, and adding new inner-wall reflection positions estimated through ray-tracing, these changes not only improve the agreement of reconstructed profiles to other diagnostics but also solve density profile wriggles that were present during band transitions. Other smaller but also persistent wriggles were also suppressed by applying a localized correction to the measured beat frequency where persistent oscillations are present. Finally, the burst analysis method, as introduced by Varela et al. [Nucl. Fusion 46 S693 (2006)], has been implemented to extract the beat frequency from stacked spectrograms. Due to the strong suppression of spurious reflections, the radial jitter that sometimes would span several centimeters has been strongly reduced. The stacking of spectrograms has also been shown to be very useful for stacking recurring events, like small gas puff modulations, and extracting transport coefficients that would otherwise be below the noise level.

PROMPT to improve speech motor abilities in children with cerebral palsy: a wait-list control group trial protocol.

BACKGROUND: Children with cerebral palsy (CP) often have communication impairments, including speech altered intelligibility. Multiple levels of disrupted speech have been reported in CP, which negatively impact on participation and quality of life, with increase of care needs. Augmentative Alternative Communication (AAC) is an option, with debated benefits and limitations, in particular for its functional use. This is supported by a substantial lack of defined evidences in favor of direct speech articulation intervention in CP. Motor learning-based interventions are effective in CP and are the basis of speech motor interventions such as PROMPT (Prompts for Restructuring Oral Muscular Phonetic Targets). The PROMPT speech motor treatment provides tactile-kinesthetic inputs to facilitate articulatory movements by dynamic modelling, resulting in more efficient motor patterns that can be integrated into speech and communication. In CP, exploratory evidences support the feasibility and preliminarily advantages on intelligibility of motor speech treatments, such as PROMPT, with increased speech motor control, also documented by kinematic analyses. METHODS: A randomized waitlist-control trial will be conducted in children aged between 3- and 10-years having CP and dysarthria (estimated sample size = 60 children). Children will be allocated in the immediate intervention or in the waitlist control group. The intervention consists of an intensive 3 weeks period of twice-a-day administration of PROMPT. Standard care will be administered in the control (waitlist) group. After repeated baseline assessments (T0), the PROMPT treated group will undergo the experimental 3-week intervention period, with T1 assessment at the end. A further T2 assessment will be provided at medium term (3 months after the end of the intervention) for evaluating the stability of intervention. Primary and secondary speech clinical and kinematics outcome measures will be collected at T0, T1 and T2. DISCUSSION: This paper describes the study protocol consisting of a RCT with two main objectives: (1) to evaluate the or short-term benefits of an intensive speech motor intervention on speech and intelligibility in children with CP and the stability of the intervention at medium term; (2) to describe the kinematic correlates of speech motor control modifications. TRIAL REGISTRATION: Trial registration date 06/12/2019; ClinicalTrials.gov Identifier: NCT04189159 .

LUNCH-Lung Ultrasound for early detection of silent and apparent aspiratioN in infants and young CHildren with cerebral palsy and other developmental disabilities: study protocol of a randomized controlled trial.

BACKGROUND: Children with neurological impairment may have dysphagia and/or gastro-esophageal reflux disease (GERD), which predispose to complications affecting the airways, increasing risk for aspiration-induced acute and chronic lung disease, or secondarily malnutrition, further neurodevelopmental disturbances, stressful interactions with their caregivers and chronic pain. Only multidisciplinary clinical feeding evaluation and empirical trials are applied to provide support to the management of feeding difficulties related to dysphagia or GERD, but no standardized feeding or behavioral measure exists at any age to assess aspiration risk and support the indication to perform a videofluoroscopic swallowing study (VFSS) or a fibre-optic endoscopic examination of swallowing (FEES), in particular in newborns and infants with neurological impairments. Lung ultrasound (LUS) has been proposed as a non-invasive, radiation-free tool for the diagnosis of pulmonary conditions in infants, with high sensitivity and specificity. METHODS: A RCT will be conducted in infants aged between 0 and 6 years having, or being at risk for, cerebral palsy, or other neurodevelopmental disease that determines abnormal muscular tone or motor developmental delay assessed by a quantitative scale for infants or if there is the suspicion of GERD or dysphagia based on clinical symptoms. Infants will be allocated in one of 2 groups: 1) LUS-monitored management (LUS-m); 2) Standard care management (SC-m) and after baseline assessment (T0), both groups will undergo an experimental 6-months follow-up. In the first 3 months, infants will be evaluated a minimum of 1 time per month, in-hospital, for a total of 3 LUS-monitored meal evaluations. Primary and secondary endpoint measures will be collected at 3 and 6 months. DISCUSSION: This paper describes the study protocol consisting of a RCT with two main objectives: (1) to evaluate the benefits of the use of LUS for monitoring silent and apparent aspiration in the management of dysphagia and its impact on pulmonary illness and growth and (2) to investigate the impact of the LUS management on blood sample and bone metabolism, pain and interaction with caregivers. TRIAL REGISTRATION: Trial registration date 02/05/2020; ClinicalTrials.gov Identifier: NCT04253951 .

Biocompatible Probes Based on Rare-Earth Doped Strontium Aluminates with Long-Lasting Phosphorescent Properties for In Vitro Optical IMAGING.

In recent decades, the demand for biomedical imaging tools has grown very rapidly as a key feature for biomedical research and diagnostic applications. Particularly, fluorescence imaging has gained increased attention as a non-invasive, inexpensive technique that allows real-time imaging. However, tissue auto-fluorescence under external illumination, together with a weak tissue penetration of low wavelength excitation light, largely restricts the application of the technique. Accordingly, new types of fluorescent labels are currently being investigated and, in this search, phosphorescent nanoparticles promise great potential, as they combine the interesting size-dependent properties of nanoscale materials with a long-lasting phosphorescence-type emission that allows optical imaging well after excitation (so avoiding autofluorescence). In this work, core-shell structures consisting of SrAlO:Eu,Dy luminescent cores encapsulated within a biocompatible silica shell were prepared, showing a green persistent phosphorescence with an afterglow time of more than 1000 s. A high-energy ball milling procedure was used to reduce the size of the starting phosphors to a size suitable for cellular uptake, while the silica coating was produced by a reverse micelle methodology that eventually allows the excitation and emission light to pass efficiently through the shell. Confocal fluorescence microscopy using HeLa cancer cells confirmed the potential of the all-ceramic composites produced as feasible labels for in vitro optical imaging.

Hybrid Hierarchical Heterostructures of Nanoceramic Phosphors as Imaging Agents for Multiplexing and Living Cancer Cells Translocation.

Existing fluorescent labels used in life sciences are based on organic compounds with limited lifetime or on quantum dots which are either expensive or toxic and have low kinetic stability in biological environments. To address these challenges, luminescent nanomaterials have been conceived as hierarchical, core-shell structures with spherical morphology and highly controlled dimensions. These tailor-made nanophosphors incorporate Ln:YVO4 nanoparticles (Ln = Eu(III) and Er(III)) as 50 nm cores and display intense and narrow emission maxima centered at ∼565 nm. These cores can be encapsulated in silica shells with highly controlled dimensions as well as functionalized with chitosan or PEG5000 to reduce nonspecific interactions with biomolecules in living cells. Confocal fluorescence microscopy in living prostate cancer cells confirmed the potential of these platforms to overcome the disadvantages of commercial fluorophores and their feasibility as labels for multiplexing, biosensing, and imaging in life science assays.

Tailoring the visible light photoactivity of un-doped defective TiO2 anatase nanoparticles through a simple two-step solvothermal process.

Anatase TiO2 has become a material of great interest for photocatalytic production of hydrogen, environmental purification and solar energy conversion. Among the key parameters boosting the photocatalytic efficiency of the anatase nanoparticles, an increased light absorption to expand its optical response to the visible region, together with an improved charge separation of the photo-generated electrons and holes, can be enumerated. In this work, yellow-coloured, single-phase anatase nanoparticles have been obtained using a simple two-step solvothermal routine which requires no external addition of dopants, nor the use of a harassing/aggressive synthesis atmosphere. The obtained powders display a lowered bandgap (<3.0 eV) and significantly reduce the recombination processes, eventually leading to an improved photocatalytic performance under visible light, as exemplified by an enhanced degradation of phenol. This exceptional response is linked to the presence of intrinsic defects in the yellowish particles and, hence, the specific conditions of the proposed methodology become crucial to produce a propitious TiO2-defective nanomaterial capable of photo-degrade the phenol molecule, in contrast with the lack of photocatalytic activity currently exhibited by commercial photocatalysts under visible light.

Terapia de ondas de choque en patología músculo-esquelética / Pathology shock wave therapy muscle-skeletal

Extracorporeal shock waves are unique sound waves that generate a rapid increase in pressure in the tissues in which they are applied. They were first used on the management of urolithiasis and later spread to other pathologies such as musculoskeletal. A series of studies have been carried out to support the usefulness of shock waves in patients with plantar fasciitis, Achilles tendinopathy, epicondylitis, rotator cuff injury with or without calcification, patellar tendinopathy and peritrochanteric pathology that has lasted more than three months and have not responded to the initial handling. There is no consensus regarding the specific protocols to be used. In these conditions, shock waves are only a part of a comprehensive treatment, and should always be associated with other conventional therapies. (AU)

Lesiones músculo-esqueléticas de hombro en usuarios de silla de ruedas / Musculo-skeletal injuries of shoulder in wheelchair users

Manual wheelchair is one the most used mobility device in people that is unable to walk. It enhances functional independence in non ambulant people, but it costs a great energy expenditure and is a source of painful musculoskeletal injuries. The most frequently affected joint in manual wheelchair users is the shoulder (rotator cuff tendinopathy and subacromial impingement). In this review, we aim to describe the risk factors and biomechanical issues that make wheelchair users more prone to develop shoulder pain. Further, we discuss potencial approaches for the prevention and early treatment of these injuries. (AU)

Metas sociales, clima motivacional, disciplina y actitud del alumno según el docente / Social Goals, Motivational climate, discipline and attitudes of the student according to teacher

El objetivo ha sido analizar la relación existente entre el género y la experiencia laboral del profesorado con las metas sociales, el clima motivacional, las estrategias de disciplina y las actitudes hacia la Educación Física. La muestra estaba constituida por 970 chicos y 1032 chicas con edades comprendidas entre los 12-19 años. Se aplicó una batería de test compuesta por el EMSEF (Moreno, González-Cutre, y Sicilia, 2007), el LAPOPECQ (Cervelló, Jiménez, Moya, y Moreno, 2010), la SDSS (Gutiérrez, López, y Ruiz, 2009) y el CAEFP (Gutiérrez y Ruíz, 2009). Se analizaron Modelos Lineales de Regresión Múltiple. En los resultados, solo el tiempo de servicio del docente mantiene significatividad con el clima rendimiento y las razones intrínsecas de disciplina. En cambio, la edad del alumnado es significativa con las metas sociales, y el género con el clima rendimiento, ambas metas, las razones introyectadas y la indiferencia del profesor (AU)

The aim was to analyze the relationship between gender and work experience of teachers with social goals, motivational climate, discipline strategies and attitudes toward physical education. The sample consisted of 970 boys and 1032 girls aged 12-19. A battery of tests consisting of the EMSEF (Moreno, González-Cutre, and Sicilia, 2007), the LAPOPECQ (Cervelló, Jiménez, Moya, and Moreno, 2010), the SDSS (Gutiérrez, López, and Ruiz, 2009) was applied and CAEFP (Gutiérrez and Ruiz, 2009). Linear Regression Models were analyzed. In the results, only the service time faculty holds significance with performance climate and intrinsic reasons of discipline. In contrast, the age of students is significant to social goals, and gender with performance climate, both goals, introjected reasons and indifference of the teacher (AU)

Adsorption properties of trifluoroacetic acid on anatase (101) and (001) surfaces: a density functional theory study.

The interaction of trifluoroacetic acid with anatase TiO2(101) and TiO2(001) surfaces has been studied by means of periodic density functional theory based calculations. On the former, the interaction is weak with the adsorbed molecules in a configuration almost indistinguishable from the gas phase structure. On the latter, the interaction is very strong; the molecule adsorbs as trifluoroacetate and releases a proton that binds an oxygen surface atom with a significant distortion of the substrate. The difference in adsorption the mode and strength can be understood from the different structural features of both surfaces and provides arguments to the role of trifluoroacetic as a morphological control agent in the solvothermal synthesis of TiO2 nanoparticles with predominant (001) facets. This, in turn, has a very significant impact on industrial production strategies of value-added TiO2 for photocatalytic applications. Analysis of calculated core level binding energies for F(1s) confirms the experimental assignment to F at the surface as F(-) at Ti surface sites and to F in -CF3 groups of the adsorbed molecule.

Microwave-induced fast crystallization of amorphous hierarchical anatase microspheres.

The fabrication of hierarchical anatase microspheres with potential photocatalytic properties eventually comprises a consolidation step in which a high degree of crystalline order is typically achieved through conventional electric heating treatments. This however entails a substantial reduction in the specific surface area and porosity of the powders, with the consequent deterioration in their photocatalytic response. Here, we have tested the employ of microwave heating as an alternative energy-saving sintering method to promote fast crystallization. The results obtained suggest that under the microwave radiation, the TiO2 hierarchical structures can effectively crystallize in a drastically reduced heating time, allowing the specific surface area and the porosity to be kept in the high values required for an improved photocatalytic performance.

Implementation of a guideline for physical therapy in the postoperative period of upper abdominal surgery reduces the incidence of atelectasis and length of hospital stay.

OBJECTIVE: The aim of this study was to evaluate the effectiveness of implementing a physical therapy guideline for patients undergoing upper abdominal surgery (UAS) in reducing the incidence of atelectasis and length of hospital stay in the postoperative period. MATERIALS AND METHODS: A "before and after" study design with historical control was used. The "before" period included consecutive patients who underwent UAS before guideline implementation (intervention). The "after" period included consecutive patients after guideline implementation. Patients in the pre-intervention period were submitted to a program of physical therapy in which the treatment planning was based on the individual experience of each professional. On the other hand, patients who were included in the post-intervention period underwent a standardized program of physical therapy with a focus on the use of additional strategies (EPAP, incentive spirometry and early mobilization). RESULTS: There was a significant increase in the use of incentive spirometry and positive expiratory airway pressure after guideline implementation. Moreover, it was observed that early ambulation occurred in all patients in the post-intervention period. No patient who adhered totally to the guideline in the post-intervention period developed atelectasis. Individuals in the post-intervention period presented a shorter length of hospital stay (9.2±4.1 days) compared to patients in the pre-intervention period (12.1±8.3 days) (p<0.05). CONCLUSION: The implementation of a physical therapy guideline for patients undergoing UAS resulted in reduced incidence of atelectasis and reduction in length of hospital stay in the postoperative period.

SU-E-T-180: The Radiological Physics Center's Anthropomorphic Quality Assurance Phantom Program.

PURPOSE: To describe the phantoms, program logistics and current results for the Radiological Physics Center's (RPC) anthropomorphic QA phantom program for credentialing institutions for participation in NCI-sponsored advanced technology clinical trials. METHODS: The RPC has developed an extensive phantom credentialing program consisting of four different phantoms designs: H&N, pelvis, lung and spine. These QA phantoms are water-filled plastic shells with imageable targets, avoidance structures, and heterogeneities that contain TLD and radiochromic film dosimeters. Institutions wishing to be credentialed request a phantom and are prioritized for delivery. At the institution, the phantom is imaged, a treatment plan is developed, the phantom is positioned on the treatment couch and the treatment is delivered. The phantom is returned and the measured dose distributions are compared to the institution's electronically submitted treatment plan dosimetry data. RESULTS: The RPC currently has an inventory of 31 H&N, 10 pelvis, 9 lung, and 8 spine phantoms that are mailed to institutions nationally and internationally. In 2011, 444 of these phantoms were mailed out for credentialing. Once the phantom is sent, it takes the institution an average of 26 days to return it to the RPC. On average the dosimeters are analyzed within 17 days and the report is sent 21 days after receipt of the phantom data. In 2011 the percent of phantoms meeting the acceptance criteria increased by 12, 13 and 6 percentage points for the H&N, spine and lung phantoms, respectively. It fell by 5 percentage points for the pelvis phantom. CONCLUSIONS: The RPC's QA phantom program has been an effective and responsive QA tool for assessing the use of advanced technologies in NCI sponsored clinical trials. The RPC has been efficient in its mailing of phantoms, and analyzing and reporting results. Work supported by PHS grant CA10953 and CA081647 (NCI, DHHS).

The purge of genetic load through restricted panmixia in a Drosophila experiment.

Using Drosophila melanogaster, we explore the consequences of restricted panmixia (RP) on the genetic load caused by segregating deleterious recessive alleles in a population where females mate a full sib with probability about (1/2) and mate randomly otherwise. We find that this breeding structure purges roughly half the load concealed in heterozygous condition. Furthermore, fitness did not increase after panmixia was restored, implying that, during RP, the excess of expressed load induced by inbreeding had also been efficiently purged. We find evidences for adaptation to laboratory conditions and to specific selective pressures imposed by the RP protocol. We discuss some of the consequences of these results, both for the evolution of population breeding structures and for the design of conservation programmes.

Leishmaniasis as an opportunistic infection in HIV-infected patients: determinants of relapse and mortality in a collaborative study of 228 episodes in a Mediterreanean region.

The clinical presentation of visceral leishmaniasis shares similarities with other geographically specific infectious diseases associated with AIDS in terms of relapsing course and atypical presentation. However, visceral leishmaniasis has not, until now, been included in the AIDS case definition. The aim of this study was to describe the clinical features and determinants for relapse and case-fatality of visceral leishmaniasis in HIV-infected patients from a Spanish Mediterranean area. A chart review was conducted in 16 hospitals in the autonomous communities of Valencia and Murcia (Spain). From 1988 to 2001, a total of 228 episodes of visceral leishmaniasis were diagnosed in 155 HIV-infected patients by the detection of amastigotes in bone marrow aspirates or in other tissue samples. Most patients had advanced HIV disease, with a median CD4(+) lymphocyte cell count of 55 cells x 10(9) l, and 56% of them had a previous AIDS-indicator disease. The median duration of follow-up was 8.4 months. HIV-infected patients with visceral leishmaniasis presented with fever (76%), hepatomegaly (77%), splenomegaly (78%), and varying degrees of cytopenias. Leishmania was detected in atypical sites in 22 (14%) patients. A total of 37 (24%) patients had a relapse of visceral leishmaniasis. Female gender was a risk factor for relapse, whereas administration of secondary prophylaxis for visceral leishmaniasis and a completed therapy for visceral leishmaniasis were protective factors against relapse. A total of 86 (54%) patients died. Independent determinants for survival were CD4(+) lymphocyte cell count, completed therapy for leishmania, and secondary prophylaxis for visceral leishmaniasis. The findings show that, in HIV-infected patients, visceral leishmaniasis occurs in late stages of HIV disease and often has a relapsing course. Secondary prophylaxis reduces the risk of relapse. Visceral leishmaniasis in the HIV-infected population should be included in the CDC clinical category C for the definition of AIDS in the same way that other geographically specific opportunistic infections are included.

Análisis de los criterios de diferenciación de nevo displástico y melanoma / Analisys of criteria for differentiation of dysplasic nevi and melanova

Debido a la gran controversia que existe con respecto a la existencia del nevo displástico o de Clark, y a la unificación de criterios entre los investigadores y especialistas, se analizaron los criterios que con mayor frecuencia se presentaban en las diferentes publicaciones respecto este tema, considerando criterios de arquitectura como simetría, nidos, maduración, fibrosis, melanina y proliferación; y dentro de la citología, al número de mitosis, heterotipia nuclear, necrosis, inclusiones y relación núcleo / citoplasma.En un universo de 50 casos de nevo displástico y melanoma, bajo un estudio de tipo ciego simple y con un análisis estadístico en base al test de chi cuadrado, con un p<0,05, se concluyó que de los resultados obtenidos, la simetría, nidos, maduración, fibrosis, melanina, mitosis, heterotipia nuclear y relación núcleo / citoplasma, resultaron estadísticamente significativos, por lo que se comprobaría la existencia del nevo displástico y que estos serían parámetros necesarios para su identificación

Importancia de la glicemia post prandial en el control del paciente diabético / Importance of post prandial glucose in the control of diabetic patients

El control metabólico del paciente diabético es indispensable para su manejo y prevención de complicaciones. Para esto se utilizan una serie de parámetros siendo el más reciente la medición de la glicemia post prandial. Con el fin de comprobar su utilidad, se realizó un estudio, comparando este parámetro con los exámenes habituales de control metabólico en los pacientes hospitalizados en el Servicio de Medicina del Hospital Naval Almirante Nef, entre los meses de Febrero y Junio del año 2002.Los resultados obtenidos muestran una alta correlación entre glicemia post prandial y hemoglobina glicosilada, así como con la presencia de complicaciones, la que fue superior a la existente entre glicemia de ayujno y los parámetros antes mencionados. Estos resultados fueron concordantes con la bibliografía existente, por lo que es aconsejable el uso de la glicemia post prandial para el control metabólico, así como el uso de terapias que se enfoquen a la normalización de estas

Prevalencia de factores de riesgo de enfermedades crónicas no transmisibles en estudiantes de medicina de la Universidad de Valparaíso / Prevalence of risk factors in chronic non-transmissible diseases in medical students

Introducción: la génesis de la enfermedades crónicas no transmisibles, se encuentran asociadas a factores de riesgo relacionados con estilos de vida nocivos para la salud. Resulta interesante observar como se comportan estos factores en estudiantes de medicina. Objetivos: cuantificar la prevalencia de factores de riesgo de enfermedades crónicas no transmisibles en estudiantes de medicina. Población y métodos: se realizó un estudio de corte transversal en 242 alumnos que constituyen el universo de estudiantes de 1§ a 5§ año de la carrera de medicina, de la escuela de medicina de la Universidad de Valparaíso. Los factores de riesgo cuantificados fueron: inactividad física, sobrepeso y obesidad, tabaquismo e hipertensión arterial. Resultados: luego de analizar estadísticamente sus valores, se encontró que el factor de riesgo de mayor prevalencia con un 88 por ciento es la inactividad física, cifras similares para hombres y mujeres y no encontrándose diferencias entre los cursos en estudio. El sobrepeso y obesidad, presentó una prevalencia de un 31,8 por ciento, siendo ésta mayor para hombres que para mujeres, pero no se encontraron diferencias entre los cursos. En cuanto al tabaquismo, éste presenta una prevalencia de 23,6 por ciento, siendo mayor para mujeres que para hombres, pero al cuantificar la intensidad del hábito tabáquico, se observó que ésta era mayor en hombres. No se encontraron variaciones del hábito tabáquico entre los diferentes cursos. Por último, la presión arterial alta presentó una prevalencia de 4,6 por ciento, siendo mayor para hombres que para mujeres. Conclusiones: la prevalencia de los factores de riesgo estudiados es alta. Se recomienda efectuar intervenciones preventivas

Adolescence and poverty.

Adolescents living in America suffer the triple burden of a disproportionate representation among the poor, a major conflict of developmental challenges and poverty-related challenges, and, frequently, additional challenges accompanying a minority heritage. At the same time, these individuals and the communities in which they live enjoy many strengths. This chapter reviews these and related issues.