Gender differences in workplace violence against physicians and nurses in Latin America: a survey from the Interamerican Society of Cardiology.

OBJECTIVES: To evaluate gender differences in workplace violence (WPV) against physicians and nurses in Latin America. STUDY DESIGN: Cross-sectional study. METHODS: A cross-sectional electronic survey was conducted between January 11 and February 28, 2022. A prespecified gender analysis was performed. RESULTS: Among the 3056 responses to the electronic survey, 57% were women, 81.6% were physicians, and 18.4% were nurses. At least one act of violence was experienced by 59.2% of respondents, with verbal violence being the most common (97.5%). Women experienced more WPV than men (65.8% vs 50.4%; P < 0.001; odds ratio [OR]: 1.89; 95% confidence interval [CI]: 1.63-2.19). Women were more likely to report at least one episode of WPV per week (19.2% vs 11.9%, P < 0.001), to request for psychological help (14.5% vs 9%, P = 0.001) and to experience more psychosomatic symptoms. In addition, women were more likely to report having considered changing their job after an aggression (57.6% vs 51.3%, P = 0.011) and even leaving their job (33% vs 25.7%, P = 0.001). In a multivariate analysis, being a woman (OR: 1.76), working in emergency departments (OR: 1.99), and with COVID-19 patients (OR: 3.3) were independently associated with more aggressive interactions, while older age (OR: 0.95) and working in a private setting (OR: 0.62) implied lower risk. CONCLUSIONS: Women are more likely to experience WPV and to report more psychosomatic symptoms after the event. Preventive measures are urgently needed, with a special focus on high-risk groups such as women.

Design and fabrication of Mach-Zehnder interferometers in soda-lime glass for temperature sensing applications.

High sensitivity represents one of the main goals that sensing devices need to satisfy for their applications. This work presents to the best of our knowledge the first integrated Mach-Zehnder interferometer (MZI) embedded in soda-lime glass with comparable sensitivity to silicon-on-insulator (SOI) devices. We manufactured the MZIs by the femtosecond direct laser writing (FDLW) technique and characterized them with temperature. Four buried MZIs were manufactured by slightly increasing the optical path due to separation between the arms of the interferometer (Δ s). We achieved a fringe shift of ∼8n m for an increase of 0.18 µm. We have characterized one of these devices with temperature from 30°C to 70°C obtaining a sensitivity of ∼28p m/ ∘ C. We improved the sensitivity of the device to ∼54p m/ ∘ C due to the advantage of the unique three-dimensional (3D) capabilities that FDLW provides, overcoming the characteristically low thermo-optic coefficient of soda-lime glass just by rotating the MZI structure 11°.

Calidad de vida en niños supervivientes de tumor de sistema nervioso central / Quality of life in child survivors of central nervous system tumor

INTRODUCCIÓN: Los cuidados de calidad de los supervivientes incluyen vigilancia de la recurrencia y de segundos tumores, intervención en el control de síntomas y de necesidades psicosociales y coordinación del cuidado. OBJETIVO: Conocer la calidad de vida en los niños sobrevivientes de cáncer que son vistos en la consulta externa del servicio de Oncología Pediátrica. MATERIAL Y MÉTODO: Estudio descriptivo transversal, realizado en la consulta externa del Servicio de Oncología Pediátrica del Centro Médico Nacional 20 de noviembre ISSSTE, con 16 pacientes supervivientes de Tumor de Sistema Nervioso Central aplicando Inventario de calidad de vida. (PedsQL MT) Resultados: La dimensión menos afectada fue la social con una media de 73.44 seguida de la física tuvo una media de 71.87, con emocional media de 67.19 y la escolar fue la que menos afectada estuvo con media de 68.75. CONCLUSIÓN: Es fundamental que el médico detecte problemas tardíos derivados del tratamiento y de la enfermedad, prevenir complicaciones y secuelas graves, otorgar ayuda al niño y a su familia para integrarse a la sociedad necesarias para enfrentar a la sociedad e integrarse a ella sin dificultades, logrando así una mejor calidad de vida.

INTRODUCTION: Quality care survivors include surveillance of recurrence and second tumors, intervention in the control of symptoms, psychosocial needs and coordination of care. OBJECTIVE: To determine the quality of life in childhood cancer survivors who are seen in outpatient pediatric oncology service. MATERIALS AND METHODS: A cross sectional study was performed in the outpatient clinic of pediatric oncology of National Medical Center "20 de Noviembre" ISSSTE, with 16 surviving patients of central nervous system tumor applying quality of life inventory. (PedsQL TM) RESULTS: The least affected was the social dimension with an average of 73.44 followed by physics which had an average of 71.87, emotional with a mean of 67.19 and school was the least affected with an average of 68.75. CONCLUSIONS: It is essential that the physician detected late problems from treatment and disease, prevent complications and serious sequelae, grant helps the child and family to join the society and integrate it seamlessly, making a better quality of life.

An experimental evaluation of a concept to improve conventional aortic prostheses.

Conventionally used textile prosthesis for traditional open surgical repair (OSR) of aortic aneurysms have a lower compliance than the native aortic tissue. Graft placements lead to an acute drop in compliance which effects cardiovascular risk and the development of graft related complications. A custom-made spring casing was applied to a Dacron graft segment under physiological pressure conditions within a five-element biventricular mock circulation loop, to investigate experimentally a concept to improve the compliance of a conventional aortic prosthesis by changing the transverse graft cross-section. Two different prosthesis locations, proximal and distal of compliant silicone tubing were used to study uniaxial graft compression with an elastic device. To characterise the devices' performance by means of pulse pressure (PP), diastolic pressure (Pdia) and pulse wave velocity(PWV), fluid pressures and flow were recorded. In a proximal graft setting (ascending aorta repair) elastic uniaxial compression with a custom-made spring casing (2 cm width) could significantly reduce PP by 10-14% (p < .001) and slowed PWV from 6.7 to 5.2 m/s (22%, p = .002). Applied to a graft in a distal position, the spring casing demonstrated less impact on PP (2-10%), but significantly reduced PWV in this mock aorta segment from 13.7 to 5.5 m/s (60%, p = .004). In conclusion, a newly conceptualised spring casing applied to the external wall of synthetic aortic grafts can reduce PP and slow PWV. By restoring elastic aortic recoil in stiff textile aortic prostheses, the presented concept is a potential solution to improve long-term aortic prosthesis related complications.

Identifying drivers of forest resilience in long-term records from the Neotropics.

Here, we use 30 long-term, high-resolution palaeoecological records from Mexico, Central and South America to address two hypotheses regarding possible drivers of resilience in tropical forests as measured in terms of recovery rates from previous disturbances. First, we hypothesize that faster recovery rates are associated with regions of higher biodiversity, as suggested by the insurance hypothesis. And second, that resilience is due to intrinsic abiotic factors that are location specific, thus regions presently displaying resilience in terms of persistence to current climatic disturbances should also show higher recovery rates in the past. To test these hypotheses, we applied a threshold approach to identify past disturbances to forests within each sequence. We then compared the recovery rates to these events with pollen richness before the event. We also compared recovery rates of each site with a measure of present resilience in the region as demonstrated by measuring global vegetation persistence to climatic perturbations using satellite imagery. Preliminary results indeed show a positive relationship between pre-disturbance taxonomic richness and faster recovery rates. However, there is less evidence to support the concept that resilience is intrinsic to a region; patterns of resilience apparent in ecosystems presently are not necessarily conservative through time.

Melancholic versus Nonmelancholic Major Depression Compared.

BACKGROUND: The concept of melancholia has been associated with psychiatric nosology for centuries. Nevertheless, its definition, relationship to the contemporary concept of Major Depressive Disorder, and clinical implications remain uncertain. METHODS: In a total sample of 3211 closely evaluated patient-subjects diagnosed with DSM-5 Major Depressive or Bipolar Disorder and meeting DSM-5 criteria for major depression with melancholic features or not at a European mood disorder center, we matched 1833 for depression severity (baseline HDRS21 score ≥18) and compared rates and ratings of characteristics of interest between the subgroups, using bivariate and multivariate methods. RESULTS: Observed prevalence of melancholic features was 35.2% in the 1833 subjects matched for severity, and 21.0% among all 3211 subjects. Diagnosis was highly dependent on depression-severity measured three ways. Very few clinical characteristics differed between melancholic and nonmelancholic subjects matched for illness-severity; more suicidal ideation with melancholic features was a notable exception. CONCLUSIONS: Study findings leave the distinction of melancholic features from depression-severity unclear and the potential clinical value of diagnosing melancholic features uncertain.

Rheological effects of high substitution levels of fats by inulin in whole cassava dough: chemical and physical characterization of produced biscuits.

Inulin has been used as a fat substitute in baked goods due to its gelling properties and functionality. However, it usually has been done in low substitution levels. The aim of this study was to evaluate the effect in rheological parameters in cassava dough caused by high substitution levels of fats by inulin. Physical and chemical characterization of biscuits were done for evaluation of dough's potential usage in bakery products. Substitution of mozzarella cheese by inulin showed that up to 12.5 g inulin per 100 g cassava flour led to a lower storage modulus, suggesting bakery potential for bread like products. Higher substitutions (25 g, 37.5 g, and 50 g per 100 g cassava flour) led to a higher storage modulus and suggest a potential for cookies and similar products. Hardness results obtained support rheological ones, suggesting higher substitution levels are suitable for cookies and similar products. This is inferred by observing an increase in hardness ranging from 5.80 N up to 17.47 N. Cassava dough with fat substituted by inulin in high levels, has potential in the development of different baked goods.

Evolutionary Spiking Neural Networks for Solving Supervised Classification Problems.

This paper presents a grammatical evolution (GE)-based methodology to automatically design third generation artificial neural networks (ANNs), also known as spiking neural networks (SNNs), for solving supervised classification problems. The proposal performs the SNN design by exploring the search space of three-layered feedforward topologies with configured synaptic connections (weights and delays) so that no explicit training is carried out. Besides, the designed SNNs have partial connections between input and hidden layers which may contribute to avoid redundancies and reduce the dimensionality of input feature vectors. The proposal was tested on several well-known benchmark datasets from the UCI repository and statistically compared against a similar design methodology for second generation ANNs and an adapted version of that methodology for SNNs; also, the results of the two methodologies and the proposed one were improved by changing the fitness function in the design process. The proposed methodology shows competitive and consistent results, and the statistical tests support the conclusion that the designs produced by the proposal perform better than those produced by other methodologies.

ECT beyond unipolar major depression: systematic review and meta-analysis of electroconvulsive therapy in bipolar depression.

OBJECTIVE: In this systematic review and meta-analysis, the response, remission, and speed of response in adults with major depressive disorder (MDD) and bipolar disorder in depressive episode (BDD) receiving an acute course of electroconvulsive therapy (ECT) were quantitatively analyzed. METHODS: Using the Preferred Reporting Items for Systematic Reviews and Meta-analysis guidelines, 1660 citations were identified through five electronic databases. Nineteen articles met final inclusion criteria for meta-analysis. RESULTS: The pooled response and remission rates with ECT in MDD were 74.2% (n = 1246/1680) and 52.3% (n = 850/1626), respectively. In BDD, they were 77.1% (n = 437/567) and 52.3% (n = 275/377), respectively. Although response rates to ECT were statistically higher in BDD (OR = 0.73, 95% CI: 0.56-0.95, P = 0.02), remission rates were similar (OR = 0.91, 95% CI: 0.65-1.26, P = 0.56). Individuals with BDD vs. MDD required fewer number of ECT sessions to achieve response (SMD = -0.23, 95% CI: -0.44 to -0.023, P = 0.03). There were no significant moderator effects identified. CONCLUSION: Response rates and speed of response are higher in individuals with BDD; however, remission rates are equivalent. These findings support increased utilization of ECT in individuals with treatment-refractory BDD.

[TK2 mutations and late onset myopathy: first description in a Mexican patient]. / Mutacion del gen TK2 y miopatia de inicio tardio: descripcion del primer caso mexicano.

TITLE: Mutacion del gen TK2 y miopatia de inicio tardio: descripcion del primer caso mexicano.

Characteristics of depressive and bipolar disorder patients with mixed features.

OBJECTIVE: To assess differences between subjects with vs. without mixed features in major affective disorders. METHODS: In 3099 out-patient subjects with DSM-5 major depressive disorder (MDD, n = 1921) or bipolar disorders (BD, n = 1178), we compared those with (Mx) vs. without (Non-Mx) mixed features (agitated-irritable depression or dysphoric [hypo]mania) in an index episode. RESULTS: Prevalence of Mx averaged 21.9% [CI: 20.5-23.4] overall, ranking: BD-II > BD-I > MDD, and in BD depression ≥ [hypo]mania > MDD. Mx subjects were significantly more likely than Non-Mx cases to (i) have other mixed episodes, (ii) have higher irritable and agitated ratings, (iii) have more substance abuse, (iv) switch into mixed episodes, (v) have more suicide attempts and higher suicidal ratings, (vi) change diagnosis from depression to BD, (vii) have higher hypomania scores when depressed or depression scores when [hypo]manic, (viii) be unmarried or separated with fewer children and siblings, (ix) be diagnosed more with BD than MDD, (x) be unemployed, (xi) have BD, suicide and divorce among first-degree relatives, (xii) be female, (xiii) be younger at illness-onset. Both BD and MDD Mx subjects also received antidepressants less, but antipsychotics and mood-stabilizers more, alone and in combination with antidepressants. CONCLUSIONS: Mood disorder subjects with agitated-irritable depression or dysphoric [hypo]mania differed from those without such mixed features, including having a less favorable clinical course and repeated mixed episodes. They may represent a distinct and prevalent, syndromal clinical subtype with prognostic and therapeutic significance.

Coupled-channel study of the Rydberg-valence interaction in HBr.

We report an ab initio study of the low-lying valence and Rydberg states of HBr. The calculations are carried out employing the multireference single- and double-excitation configuration interaction method including the spin-orbit interaction. The first excited adiabatic potential of 1Σ+ symmetry presents two minima which correspond to the Rydberg E1Σ+ and valence V1Σ+ observed states. We calculate the vibrational levels of these two states using a coupled-channel treatment based on the two diabatic potentials deduced from the ab initio adiabatic potentials and the Rydberg-valence interaction. The chaotic energy separations between the observed levels are well reproduced in the calculations. We have also obtained for the first time theoretical data for numerous Rydberg states of HBr lying in the (66-79) × 103 cm-1 excitation energy interval. The calculated spectroscopic parameters are found to be in good agreement with experiment and provide a basis for future studies of radiative and non-radiative processes in the HBr molecule.

Estudio epidemiológico observacional prospectivo del manejo del dolor en pacientes oncológicos en tratamiento radioterápico: estudio GORVAMUR / Pain management in cancer patients receiving radiotherapy: GORVAMUR study, a prospective, observational, epidemiological study

Objetivos: Estudiar el manejo del dolor irruptivo en pacientes de oncología radioterápica que lo experimentan, y su impacto en el control analgésico del mismo, la tolerabilidad de los tratamientos analgésicos utilizados, así como la satisfacción y el impacto en la calidad de vida del paciente. Material y métodos: Estudio epidemiológico, observacional, prospectivo, multicéntrico, en pacientes con diagnóstico de cáncer y dolor de origen oncológico tratado con una pauta analgésica de 3er escalón, que iniciaron un tratamiento con radioterapia (RT) susceptible de que el oncólogo modificara su control analgésico. Los pacientes se reclutaron de 15 servicios de Oncología Radioterápica procedentes de centros de las regiones de Valencia y Murcia entre mayo de 2013 y diciembre de 2014. Basalmente se recogieron: datos sociodemográficos, caracterización del proceso oncológico y del dolor, tratamiento analgésico y tipo, y dosis/intensidad de la RT empleada. Al mes y a los tres meses se caracterizó el dolor mediante la valoración del cambio en la dimensión del dolor del cuestionario breve de dolor (CBD) y de la cantidad de dolor producido por episodios de dolor irruptivo, el nivel de satisfacción, la calidad de vida (EuroQol-5D) y la tolerabilidad al tratamiento analgésico. Resultados: Los pacientes incluidos en el análisis (n = 49) fueron mayoritariamente hombres (72,3 %) y la edad media (± desviación estándar) 63,7 ± 11,5 años. En el 26,5 % de los pacientes el tumor se encontraba en pulmón y en el 28,6 % en cabeza y cuello. Todos, excepto uno, refirieron dolor en el momento de la visita basal (20,8 % debido al tumor primario, 54,2 % metástasis y en 22,9 % tratamiento con RT). La mediana (Q1-Q3) del número de crisis al día fue 3,0 (2-4,5). El 60,4 % estaban recibiendo tratamiento para el dolor irruptivo, siendo fentanilo el principio activo más frecuentemente utilizado (70,4 %). Las estrategias para manejar el dolor fueron: refuerzo/modificación de analgésicos de larga duración (30,4 %), corta duración (21,7 %), ambos (21,7 %) o disminución/supresión en analgésicos de acción rápida o de larga (26,1 %). Independientemente de la estrategia, se observa una disminución en cuanto al "máximo dolor", y la cantidad total de dolor entre las 3 visitas, y una mejoría en cuanto a la "calidad de vida", "ganancia de salud" y la "satisfacción global del tratamiento". Solo se reportaron dos reacciones adversas. Conclusiones: El dolor irruptivo en los pacientes oncológicos en tratamiento de radioterapia, constituye un síntoma de elevada prevalencia. No hay una estrategia analgésica predominante para el manejo de estos pacientes, pero el fentanilo es el fármaco más frecuentemente utilizado. Los pacientes están satisfechos con el tratamiento y la reducción del dolor irruptivo repercute favorablemente en el estado general y calidad de vida de los pacientes (AU)

Objectives: To assess breakthrough pain management in patients at radiation oncology and its impact on pain control in these patients, as well as the tolerability of the analgesic treatments used and the satisfaction and impact on the quality of life of patients. Material and methods: An epidemiological, observational, prospective, multicentre study carried out in patients diagnosed with cancer and with cancer pain treated with a 3rd step analgesic therapy who had begun radiotherapy treatment (RT) susceptible to modification by an oncologist, for pain control. Patients were recruited from 15 Radiation Oncology Services centres from the regions of Valencia and Murcia between May 2013 and December 2014. Patient data collected included: demographic data, basal cancer process characterization and baseline pain, and information on basal analgesic treatment and RT employed. Pain level was recorded at 1 and 3 months by assessing: the change in the dimension of Brief Pain Inventory (BPI) pain and the amount of pain caused by episodes of breakthrough pain, the level of satisfaction, the quality of life (EQ-5D), and the tolerability to analgesic treatment. Results: Patients included in the analysis (n = 49) were mainly males (72.3 %) and the mean age (± Standard Deviation) was 63.7 ± 11.5 years. In 26.5 % of patients the tumours were located in lungs and 28.6 % in head and neck. All but one of the patients reported pain during the baseline visit (20.8 % due to the primary tumour, 54.2 % to metastases, and 22.9 % to RT treatment). The median (Q1-Q3) number of breakthrough crises/day was 3.0 (2-4.5). Overall, 60.4 % were receiving treatment for breakthrough pain and Fentanyl was the most commonly used drug (70.4 %). Pain management strategies were: reinforcement/modification of long-term analgesics (30.4%), reinforcement/modification of short-term analgesics (21.7%), reinforcement/modification of long-term and short-term analgesics (21.7 %), and decrease/suppression of any fast- or long-term analgesics (26.1 %). Independently from the strategy, a decrease in the maximum pain and the total amount of pain were observed over time, and an improvement during the follow-up visits was observed in the quality of life, health gain, and overall treatment satisfaction. Only two adverse reactions were reported. Conclusions: Breakthrough pain in cancer patients, who underwent radiotherapy treatment, is a symptom of high prevalence. There is no predominant analgesic strategy in the management of these patients, but Fentanyl is the drug most frequently used. Patients are very satisfied with the pharmacologic treatment and the reduction in the breakthrough pain obtained has a favourable effect on the global health status and quality of life of patients (AU)

Novel giardicidal compounds bearing proton pump inhibitor scaffold proceeding through triosephosphate isomerase inactivation.

Giardiasis is a worldwide parasitic disease that affects mainly children and immunosuppressed people. Side effects and the emergence of resistance over current used drugs make imperative looking for new antiparasitics through discovering of new biological targets and designing of novel drugs. Recently, it has determined that gastric proton-pump inhibitors (PPI) have anti-giardiasic activity. The glycolytic enzyme, triosephosphate isomerase (GlTIM), is one of its potential targets. Therefore, we employed the scaffold of PPI to design new compounds aimed to increase their antigiardial capacity by inactivating GlTIM. Here we demonstrated that two novel PPI-derivatives (BHO2 and BHO3), have better anti-giardiasic activity than omeprazole in concentrations around 120-130 µM, without cytotoxic effect on mammal cell cultures. The derivatives inactivated GlTIM through the chemical modification of Cys222 promoting local structural changes in the enzyme. Furthermore, derivatives forms adducts linked to Cys residues through a C-S bond. We demonstrated that PPI can be used as scaffolds to design better antiparasitic molecules; we also are proposing a molecular mechanism of reaction for these novel derivatives.

Utilization of vinasses as soil amendment: consequences and perspectives.

Vinasses are a residual liquid generated after the production of beverages, such as mezcal and tequila, from agave (Agave L.), sugarcane (Saccharum officinarum L.) or sugar beet (Beta vulgaris L.). These effluents have specific characteristics such as an acidic pH (from 3.9 to 5.1), a high chemical oxygen demand (50,000-95,000 mg L(-1)) and biological oxygen demand content (18,900-78,300 mg L(-1)), a high total solids content (79,000 and 37,500 mg L(-1)), high total volatile solids 79,000 and 82,222 mg L(-1), and K(+) (10-345 g L(-1)) content. Vinasses are most commonly discarded onto soil. Irrigation of soil with vinasses, however, may induce physical, chemical and biochemical changes and affect crop yields. Emission of greenhouse gases (GHG), such as carbon dioxide, nitrous oxide and methane, might increase from soils irrigated with vinasses. An estimation of GHG emission from soil irrigated with vinasses is given and discussed in this review.

Low-repetition rate femtosecond laser writing of optical waveguides in water-white glass slides.

Energy dose ranges for fabrication of subsurface and ablated ridge waveguides were defined using a low repetition rate femtosecond laser. The waveguides were written along the width of water-white glass slides. The buried waveguides written between 0.23 and 0.62 µJ/µm3 energy dose show strong guidance at 633 nm, reaching in the best cases propagation losses of 0.7 dB/cm. Meanwhile, the ridge waveguides were fabricated between 2.04 and 31.9 µJ/µm3, with a best case of 3.1 dB/cm. Outcomes of this study are promising for use in the manufacturing of sensing devices.

Reflections on the role of senescence during development and aging.

New and stimulating results have challenged the concept that cellular senescence might not be synonymous with aging. It is indisputable that during aging, senescent cell accumulation has an impact on organismal health. Nevertheless, senescent cells are now known to display physiological roles during embryonic development, during wound healing repair and as a cellular response to stress. The fact that senescence has been found in cells that did not attain their maximal round of replications, nor have metabolic alterations or DNA damage, also challenges the paradigm that senescence is cellular aging, and it is in favor of the idea that cellular senescence is a phenomenon that has a function by itself. Therefore, in order to understand this phenomenon it is important to analyze the relationship between senescence and other cellular responses that have many features in common, such as apoptosis, cancer and autophagy, particularly highlighting their role during development and adulthood.