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BACKGROUND: Emotional and stress-related disorders show high incidence, prevalence, morbidity, and comorbidity rates in Mexico. In recent decades, research findings indicate that cognitive behavioral interventions, from a disorder-specific perspective, are the effective front-line treatment for anxiety and depression care. However, these treatments are not often used. Reasons include limited access and low availability to effective interventions and comorbidity between mental disorders. Emotional deregulation of negative affectivity has been found to be a mediating factor in addressing emotional disorders from a transdiagnostic perspective, aimed at two or more specific disorders. In addition, technological advancement has created alternatives for psychological assistance, highlighting the possibilities offered by technologies since Internet-supported intervention programs have been empirically tested for effectiveness, efficiency and efficacy and can be key to ensuring access to those who are inaccessible. The aim of the study is to evaluate the efficacy, moderators of clinical change and acceptability of a transdiagnostic guided Internet-delivered intervention versus a transdiagnostic self-guided Internet-delivered intervention for emotional, trauma and stress-related disorders, and waiting list in community sample. METHODS: A three-armed, parallel group, superiority randomized controlled clinical trial with repeated measurements at four times: pretest, posttest, follow-up at 3, 6 and 12 months. Outcomes assessor, participant, care provider and investigator will be blinded. Participants aged 18 to 70 years will be randomly allocated 1:1:1 to one of three study arms: a) Transdiagnostic guided internet-delivered intervention with synchronous assistance, b) Transdiagnostic self-guided internet-delivered intervention, c) Waiting list group. Based on sample size estimation, a minimum of 207 participants (69 in each intervention group) will be included. DISCUSSION: The study could contribute to improving the efficacy of transdiagnostic internet-delivered interventions to promote the dissemination of evidence-based treatments and eventually, to decrease the high prevalence of emotional and trauma-related disorders in the Mexican population. TRIAL REGISTRATION: ClinicalTrial.gov: NCT05225701 . Registered February 4, 2022.
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Terapia Cognitivo-Comportamental , Terapia Assistida por Computador , Transtornos de Ansiedade/diagnóstico , Transtornos de Ansiedade/terapia , Terapia Cognitivo-Comportamental/métodos , Humanos , Internet , México , Ensaios Clínicos Controlados Aleatórios como Assunto , Terapia Assistida por Computador/métodos , Resultado do TratamentoRESUMO
The objective of this study was to evaluate the reliability and validity of the Geriatric Depression Scale in its 15-item version (GDS-15) in Mexican older adults. Participants included 1178 older adults between the ages of 60 and 94 (M = 69.16, SD = 7.69); 53.9% were women and 55.8% were married or with a partner. They completed the GDS-15, a subjective well-being scale, and a quality-of-life questionnaire. A Kuder-Richardson coefficient of .80 was obtained, which indicates an acceptable internal consistency of the GDS-15, as well as evidence of divergent validity with significant correlations of -.783 with subjective well-being and -.569 with quality of life, in addition to concurrent validity when discriminating between participants with low scores from those with high scores of depressive symptoms. The need for a simple screening tool such as the GDS-15 that helps in the identification of depressive symptoms in Mexican older adults is underlined.
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Depressão/diagnóstico , Escalas de Graduação Psiquiátrica , Fatores Etários , Idoso , Idoso de 80 Anos ou mais , Depressão/etiologia , Feminino , Humanos , Masculino , México , Pessoa de Meia-Idade , Escalas de Graduação Psiquiátrica/normas , Reprodutibilidade dos Testes , Inquéritos e QuestionáriosRESUMO
BACKGROUND: Obesity is a very heterogeneous disorder at both the clinical and molecular levels and with high heritability. Several monogenic forms and genes with strong effects have been identified for non-syndromic severe obesity. Novel therapeutic interventions are in development for some genetic forms, emphasizing the importance of determining genetic contributions. OBJECTIVE: We aimed to define the contribution of rare single-nucleotide genetic variants (RSVs) in candidate genes to non-syndromic severe early-onset obesity (EOO; body mass index (BMI) >+3 standard deviation score, <3 years). METHODS: Using a pooled DNA-sequencing approach, we screened for RSVs in 15 obesity candidate genes in a series of 463 EOO patients and 480 controls. We also analysed exome data from 293 EOO patients from the "Viva la Familia" (VLF) study as a replication dataset. RESULTS: Likely or known pathogenic RSVs were identified in 23 patients (5.0%), with 7 of the 15 genes (BDNF, FTO, MC3R, MC4R, NEGR1, PPARG and SIM1) harbouring RSVs only in cases (3.67%) and none in controls. All were heterozygous changes, either de novo (one in BDNF) or inherited from obese parents (seven maternal, three paternal), and no individual carried more than one variant. Results were replicated in the VLF study, where 4.10% of probands carried RSVs in the overrepresented genes. RSVs in five genes were either absent (LEP) or more common in controls than in cases (ADRB3, LEPR, PCSK1 and PCSK2) in both obese datasets. CONCLUSIONS: Heterozygous RSVs in several candidate genes of the melanocortin pathway are found in ~5.0% patients with EOO. These results support the clinical utility of genetic testing to identify patients who might benefit from targeted therapeutic intervention.
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Variação Genética/genética , Obesidade Infantil/genética , Adolescente , Adulto , Criança , Pré-Escolar , Estudos de Coortes , Feminino , Heterozigoto , Humanos , Masculino , Mutação/genética , Adulto JovemRESUMO
A high performance compact silicon photonics polarization splitter is proposed and demonstrated. The splitter is based on an asymmetric directional coupler. High extinction ratios at the through and drop ports of the polarization splitter are achieved by using an on-chip TE-pass polarizer and a TM-pass polarizer, respectively. The splitter, implemented on a silicon-on-insulator platform with a 220 nm-thick silicon device layer, has a measured insertion loss lower than 1 dB (for both TE and TM modes) and extinction ratio greater than 25 dB (for TM mode) and greater than 36 dB (for TE mode), in the wavelength range from 1.5 µm to 1.6 µm. The footprint of the device is 12 µm × 15 µm.
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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.
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BACKGROUND: The hallmark of the neurobehavioural phenotype of Williams-Beuren syndrome (WBS) is increased sociability and relatively preserved language skills, often described as opposite to autism spectrum disorders (ASD). However, the prevalence of ASD in WBS is 6-10 times higher than in the general population. We have investigated the genetic factors that could contribute to the ASD phenotype in individuals with WBS. METHODS: We studied four males and four females with WBS and a confirmed diagnosis of ASD by the Autism Diagnostic Interview-Revised. We performed a detailed molecular characterisation of the deletion and searched for genomic variants using exome sequencing. RESULTS: A de novo deletion of 1.55 Mb (6 cases) or 1.83 Mb (2 cases) at 7q11.23 was detected, being in 7/8 patients of paternal origin. No common breakpoint, deletion mechanism or size was found. Two cases were hemizygous for the rare T allele at rs12539160 in MLXIPL, previously associated with ASD. Inherited rare variants in ASD-related or functionally constrained genes and a de novo nonsense mutation in the UBR5 gene were identified in six cases, with higher burden in females compared with males (p=0.016). CONCLUSIONS: The increased susceptibility to ASD in patients with WBS might be due to additive effects of the common WBS deletion, inherited and de novo rare sequence variants in ASD-related genes elsewhere in the genome, with higher burden of deleterious mutations required for females, and possible hypomorphic variants in the hemizygous allele or cis-acting mechanisms on imprinting.
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Transtorno do Espectro Autista/genética , Fatores de Transcrição de Zíper de Leucina e Hélice-Alça-Hélix Básicos/genética , Ubiquitina-Proteína Ligases/genética , Síndrome de Williams/genética , Alelos , Transtorno do Espectro Autista/patologia , Criança , Pré-Escolar , Deleção Cromossômica , Feminino , Predisposição Genética para Doença , Genoma Humano/genética , Hemizigoto , Humanos , Lactente , Masculino , Fenótipo , Sequenciamento do Exoma , Síndrome de Williams/patologiaRESUMO
Obesity is a multifactorial disorder with high heritability (50-75%), which is probably higher in early-onset and severe cases. Although rare monogenic forms and several genes and regions of susceptibility, including copy number variants (CNVs), have been described, the genetic causes underlying the disease still remain largely unknown. We searched for rare CNVs (>100kb in size, altering genes and present in <1/2000 population controls) in 157 Spanish children with non-syndromic early-onset obesity (EOO: body mass index >3 standard deviations above the mean at <3 years of age) using SNP array molecular karyotypes. We then performed case control studies (480 EOO cases/480 non-obese controls) with the validated CNVs and rare sequence variants (RSVs) detected by targeted resequencing of selected CNV genes (n = 14), and also studied the inheritance patterns in available first-degree relatives. A higher burden of gain-type CNVs was detected in EOO cases versus controls (OR = 1.71, p-value = 0.0358). In addition to a gain of the NPY gene in a familial case with EOO and attention deficit hyperactivity disorder, likely pathogenic CNVs included gains of glutamate receptors (GRIK1, GRM7) and the X-linked gastrin-peptide receptor (GRPR), all inherited from obese parents. Putatively functional RSVs absent in controls were also identified in EOO cases at NPY, GRIK1 and GRPR. A patient with a heterozygous deletion disrupting two contiguous and related genes, SLCO4C1 and SLCO6A1, also had a missense RSV at SLCO4C1 on the other allele, suggestive of a recessive model. The genes identified showed a clear enrichment of shared co-expression partners with known genes strongly related to obesity, reinforcing their role in the pathophysiology of the disease. Our data reveal a higher burden of rare CNVs and RSVs in several related genes in patients with EOO compared to controls, and implicate NPY, GRPR, two glutamate receptors and SLCO4C1 in highly penetrant forms of familial obesity.
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Variações do Número de Cópias de DNA , Obesidade/genética , Polimorfismo de Nucleotídeo Único , Estudos de Casos e Controles , Feminino , Loci Gênicos , Humanos , Masculino , Neuropeptídeo Y/genética , Obesidade/diagnóstico , Transportadores de Ânions Orgânicos/genética , Linhagem , Receptores de Ácido Caínico/genética , Receptores de Glutamato Metabotrópico/genéticaRESUMO
BACKGROUND: The soluble receptor for advanced glycation end-products (sRAGE) has been suggested that it acts as a decoy for capturing advanced glycation end-products (AGEs) and inhibits the activation of the oxidative stress and apoptotic pathways. Lung AGEs/sRAGE is increased in idiopathic pulmonary fibrosis (IPF). The objective of the study was to evaluate the AGEs and sRAGE levels in serum as a potential biomarker in IPF. METHODS: Serum samples were collected from adult patients: 62 IPF, 22 chronic hypersensitivity pneumonitis (cHP), 20 fibrotic non-specific interstitial pneumonia (fNSIP); and 12 healthy controls. In addition, 23 IPF patients were re-evaluated after 3-year follow-up period. Epidemiological and clinical features were recorded: age, sex, smoking habits, and lung function. AGEs and sRAGE were evaluated by ELISA, and the results were correlated with pulmonary functional test values. RESULTS: IPF and cHP groups presented a significant increase of AGE/sRAGE serum concentration compared with fNSIP patients. Moreover, an inverse correlation between AGEs and sRAGE levels were found in IPF, and serum sRAGE at diagnosis correlated with FVC and DLCO values. Additionally, changes in serum AGEs and sRAGE correlated with % change of FVC, DLCO and TLC during the follow-up. sRAGE levels below 428.25 pg/ml evolved poor survival rates. CONCLUSIONS: These findings demonstrate that the increase of AGE/sRAGE ratio is higher in IPF, although the levels were close to cHP. AGE/sRAGE increase correlates with respiratory functional progression. Furthermore, the concentration of sRAGE in blood stream at diagnosis and follow-up could be considered as a potential prognostic biomarker.
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Produtos Finais de Glicação Avançada/sangue , Fibrose Pulmonar Idiopática/sangue , Fibrose Pulmonar Idiopática/diagnóstico , Receptor para Produtos Finais de Glicação Avançada/sangue , Idoso , Alveolite Alérgica Extrínseca/sangue , Alveolite Alérgica Extrínseca/diagnóstico , Biomarcadores/sangue , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos ProspectivosRESUMO
BACKGROUND: C-reactive protein (CRP) and procalcitonin (PCT) have been described as good predictors of anastomotic leak after colorectal surgery, obtaining the highest diagnostic accuracy on the 5th postoperative day. However, if an enhanced recovery after surgery (ERAS) program is performed, early predictors are needed in order to ensure a safe and early discharge. The aim of this study was to investigate the efficacy of CRP, PCT, and white blood cell (WBC) count determined on first postoperative days, in predicting septic complications, especially anastomotic leak, after laparoscopic colorectal surgery performed within an ERAS program. METHODS: We conducted a prospective study including 134 patients who underwent laparoscopic colorectal surgery within an ERAS program between 2015 and 2017. The primary endpoint investigated was anastomotic leak. CRP, PCT, and WBC count were determined in the blood sample extracted on postoperative day 1 (POD 1), POD 2 and POD 3. RESULTS: Anastomotic leak (AL) was detected in 6 patients (4.5%). Serum levels of CRP and PCT, but not WBC, determined on POD 1, POD 2, and POD 3 were significantly higher in patients who had AL in the postoperative course. Using ROC analysis, the best AUC of the CRP and PCT levels was on POD 3 (0.837 and 0.947, respectively). A CRP cutoff level at 163 mg/l yielded 85% sensitivity, 80% specificity, and 99% negative predictive value (NPV). A PCT cutoff level at 2.5 ng/ml achieved 85% sensitivity, 95% specificity, 44% positive predictive value, and 99% NPV. CONCLUSIONS: CRP and PCT are relevant markers for detecting postoperative AL after laparoscopic colorectal surgery. Furthermore, they can ensure an early discharge with a low probability of AL when an ERAS program is performed.
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Fístula Anastomótica/diagnóstico , Proteína C-Reativa/análise , Neoplasias Colorretais/cirurgia , Laparoscopia/efeitos adversos , Pró-Calcitonina/sangue , Idoso , Biomarcadores/sangue , Feminino , Humanos , Contagem de Leucócitos , Masculino , Assistência Perioperatória , Valor Preditivo dos Testes , Estudos Prospectivos , Sensibilidade e EspecificidadeRESUMO
We report the fabrication of a phase photon sieve (PS) on the tip of a standard single mode fiber by focused ion beam (FIB) milling. The fiber tip was dip-coated with a conductive polymer ( PEDOT: PSS) as an alternative, more advantageous method to the metallization prior to FIB milling. The near field scans of the intensity profile along the optical axis under fiber illumination of a laser at λ = 1.55 µm are presented. We have analyzed the focusing properties and demonstrated the validity of our structure for light coupling into silicon photonics waveguides with improved efficiency and alignment tolerance.
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BACKGROUND: Williams-Beuren syndrome (WBS, OMIM-194050) is a neurodevelopmental disorder with multisystemic manifestations caused by a 1.55-1.83 Mb deletion at 7q11.23 including 26-28 genes. Reported endocrine and metabolic abnormalities include transient hypercalcaemia of infancy, subclinical hypothyroidism in â¼ 30% of children and impaired glucose tolerance in â¼ 75% of adult individuals. The purpose of this study was to further study metabolic alterations in patients with WBS, as well as in several mouse models, to establish potential candidate genes. METHODS: We analysed several metabolic parameters in a cohort of 154 individuals with WBS (data available from 69 to 151 cases per parameter), as well as in several mouse models with complete and partial deletions of the orthologous WBS locus, and searched for causative genes and potential modifiers. RESULTS: Triglyceride plasma levels were significantly decreased in individuals with WBS while cholesterol levels were slightly decreased compared with controls. Hyperbilirubinemia, mostly unconjugated, was found in 18.3% of WBS cases and correlated with subclinical hypothyroidism and hypotriglyceridemia, suggesting common pathogenic mechanisms. Haploinsufficiency at MLXIPL and increased penetrance for hypomorphic alleles at the UGT1A1 gene promoter might underlie the lipid and bilirubin alterations. Other disturbances included increased protein and iron levels, as well as the known subclinical hypothyroidism and glucose intolerance. CONCLUSIONS: Our results show that several unreported biochemical alterations, related to haploinsufficiency for specific genes at 7q11.23, are relatively common in WBS. The early diagnosis, follow-up and management of these metabolic disturbances could prevent long-term complications in this disorder.
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Hipotireoidismo/metabolismo , Doenças Metabólicas/metabolismo , Síndrome de Williams/metabolismo , Adolescente , Adulto , Animais , Criança , Pré-Escolar , Modelos Animais de Doenças , Feminino , Humanos , Hipotireoidismo/fisiopatologia , Masculino , Doenças Metabólicas/fisiopatologia , Camundongos , Síndrome de Williams/genética , Síndrome de Williams/fisiopatologia , Adulto JovemRESUMO
Non-phthalate plasticizers (NPPs) are a suitable alternative to phthalates, which are harmful compounds for human, animal health, and the environment. In this study, 28 commercial non-phthalate plasticizers (NPPs) from different families, including adipates, citrates, phosphates, sebacates, trimellitates, benzoates and cyclohexanoates, were determined. Two novel methods for determining these alternative compounds in soil were developed using gas chromatography coupled to high-resolution mass spectrometry (GC-HRMS-Q-Orbitrap) and liquid chromatography coupled to high-resolution mass spectrometry (LC-HRMS-Q-Orbitrap). Solid-liquid extraction (SLE) with ethyl acetate or acetonitrile, along with water as extraction solvents, were employed. In most cases, the GC method exhibited recoveries ranging from 84.9 % to 110.8 % at 20, 40 and 200 µg/kg, while the LC method achieved recoveries between 73.1 % and 115.4 % at 10, 20, 40 and 200 µg/kg. Most of the relative standard deviation (RSD) values were below 20 % for both methods. The validated methods were then applied to analyse soil samples collected from four different areas in Almeria. The results indicated that the compounds detected most frequently at high concentrations were 1-hydroxycyclohexyl phenyl ketone (HCPK) using GC, in the range 29.1-67.4 µg/kg and 2,2,4-trimethyl-1,3-pentanediol diisobutyrate (TXIB) using LC, in the range 39.9-51.5 µg/kg. Additionally, suspect and unknown analysis were carried out, and other plasticizers as phthalates, were also detected, in addition to other substances present in the analysed samples. All the soils exhibited the presence of a few plasticizers, either phthalic and/or non-phthalic.
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PURPOSE: Pseudomyxoma peritonei (PMP) is a rare and poorly understood malignant condition characterized by the accumulation of intra-abdominal mucin produced from peritoneal metastases. Currently, cytoreductive surgery remains the mainstay of treatment but disease recurrence and death after relapse frequently occur in patients with PMP. New therapeutic strategies are therefore urgently needed for these patients. EXPERIMENTAL DESIGN: A total of 120 PMP samples from 50 patients were processed to generate a collection of 50 patient-derived organoid (PDO) and xenograft (PDX) models. Whole exome sequencing, immunohistochemistry analyses, and in vitro and in vivo drug efficacy studies were performed. RESULTS: In this study, we have generated a collection of PMP preclinical models and identified druggable targets, including BRAFV600E, KRASG12C, and KRASG12D, that could also be detected in intra-abdominal mucin biopsies of patients with PMP using droplet digital PCR. Preclinical models preserved the histopathological markers from the original patient sample. The BRAFV600E inhibitor encorafenib reduced cell viability of BRAFV600E PMP-PDO models. Proof-of-concept in vivo experiments showed that a systemic treatment with encorafenib significantly reduced tumor growth and prolonged survival in subcutaneous and orthotopic BRAFV600E-PMP-PDX mouse models. CONCLUSIONS: Our study demonstrates for the first time that systemic targeted therapies can effectively control PMP tumors. BRAF signaling pathway inhibition represents a new therapeutic opportunity for patients with BRAFV600E PMP who have a poor prognosis. Importantly, our present data and collection of preclinical models pave the way for evaluating the efficacy of other systemic targeted therapies toward extending the promise of precision oncology to patients with PMP.
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Terapia de Alvo Molecular , Neoplasias Peritoneais , Medicina de Precisão , Pseudomixoma Peritoneal , Ensaios Antitumorais Modelo de Xenoenxerto , Pseudomixoma Peritoneal/patologia , Pseudomixoma Peritoneal/tratamento farmacológico , Pseudomixoma Peritoneal/genética , Humanos , Animais , Camundongos , Medicina de Precisão/métodos , Terapia de Alvo Molecular/métodos , Neoplasias Peritoneais/tratamento farmacológico , Neoplasias Peritoneais/secundário , Neoplasias Peritoneais/genética , Neoplasias Peritoneais/patologia , Proteínas Proto-Oncogênicas B-raf/genética , Proteínas Proto-Oncogênicas B-raf/antagonistas & inibidores , Feminino , Masculino , Proteínas Proto-Oncogênicas p21(ras)/genética , Sequenciamento do Exoma , Mutação , Linhagem Celular Tumoral , Organoides/efeitos dos fármacos , Organoides/patologia , Biomarcadores Tumorais/genética , Biomarcadores Tumorais/metabolismoRESUMO
The objective of this study was to evaluate the reliability and validity of the FES-I scale in community-dwelling older Mexican adults. Participants were 222 older adults, with a mean age of 70 years; 75% were women who completed a sociodemographic data sheet, a Spanish version of the FES-I scale, intended to explore measures of depression, quality of life, and instrumental activities of daily living. Discriminant validity was demonstrated for all items on the FES-I scale and when groups of older adults were compared according to age. Evidence of internal consistency was found in all the items of the FES-I scale (α = .91) and convergent and divergent validity of the FES-I scale with measures of depression and quality of life, except instrumental activities of daily living. The Confirmatory Factor Analysis shows that the FES-I scale partially retains its two-factor measurement properties since five items were removed from the model to fit the data. The FES-I scale is a valid and reliable measure for clinical evaluations of fear of falls in older Mexican adults in the community.
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OBJECTIVE: To evaluate the appropriateness of imaging tests associated with radiation in the field of otolaryngology according to the available recommendations, and to estimate the effective radiation dose associated. METHOD: Cross-sectional epidemiological study of the totality of the imaging test requests carried out by two Spanish hospitals (n = 1931). We collected the following information: patient demographic data, type of imaging test, imaging tests referred in the previous 12 months, referrer department and diagnostic suspicion. In accordance with the available guidelines, we considered the requests: (a) Appropriate; (b) Inappropriate; (c) Not adequately justified; (d) Not included in the guidelines. We calculated the prevalence of each category and their variation according to the different variables. Collective and per capita effective dose were calculated for each category. RESULTS: Of the 538 requests, 42% were considered appropriate, 34.4% inappropriate, 11.9% not adequately justified and 11.7% not included in the guidelines. Imaging tests requested by general partitioners (aOR: 0.18; 95% CI: 0.06-0.50) and clinical departments (aOR: 0.27; 95% CI: 0.11-0.60) were less likely to be considered appropriate than those requested by the Otolaryngology department. Patients with a diagnosis suspicion of tumour pathology were more likely to have a requested imaging test classified as appropriate (aOR: 7.12; 95% CI: 3.25-15.61). The cumulative effective dose was 877.8 mSv, of which 40% corresponded to tests classified as inappropriate. CONCLUSIONS: A high percentage of imaging tests are considered as inappropriate in the field of otolaryngology, with a relevant frequency of associated effective radiation dose. Type of department, the diagnostic suspicion and the type of imaging tests were variables associated to the inappropriateness of the test.
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Background: Scientific research has reported various stressors that could be related to the development of burnout in resident physicians. Objective: To identify the perceived stressors associated with burnout in residents of various medical specialties in Mexico's northwest. Material and methods: A cross-sectional, explanatory, observational, and analytical study was carried out. The sampling was non-probabilistic. Resident physicians from two hospitals in southern Sonora participated. The Occupational Burnout Scale (OED) and the Stressors Check List with intensity were used. Results: 189 resident physicians were included. 87% presented high levels of burnout. Specifically, the work overload and job dissatisfaction stressors were the ones with the greatest predictive power of burnout and dissatisfaction with achievement in resident physicians. By dimensions, physical problems were predictors of the pain dimension in the occupational burnout state. Professional exercise and physical problems predicted burnout in occupational burnout state. And physical problems were predictors for the presence of depression. Conclusions: The data obtained confirm the need to attend physical and mental health of resident doctors, and promote optimal work environments that have a positive impact on the well-being of their members.
Introducción: la investigación científica ha reportado diversos estresores que podrían estar relacionados con el desarrollo del burnout en médicos residentes. Objetivo: identificar los estresores percibidos asociados con burnout en residentes de diversas especialidades médicas en el noroeste de México. Material y métodos: se realizó un estudio analítico, observacional, explicativo y transversal. El muestreo fue no probabilístico. Participaron médicos residentes de dos hospitales del sur de Sonora. Se utilizó la Escala de desgaste ocupacional (EDO) y la Lista de chequeo de estresores con intensidad. Resultados: se incluyeron 189 médicos residentes. El 87% presentó altos niveles de burnout. Específicamente los estresores sobrecarga laboral e insatisfacción laboral tuvieron mayor poder predictivo del agotamiento y la insatisfacción de logro en los médicos residentes. Por dimensiones, los problemas físicos fueron predictores de la dimensión de dolor en el estado de desgaste ocupacional. Asimismo, el ejercicio profesional y los problemas físicos predijeron el agotamiento en el estado de desgaste ocupacional. Y los problemas físicos fueron predictores para la presencia de depresión. Conclusiones: los datos obtenidos confirman la necesidad de atender la salud física y mental de los médicos residentes, así como promover ambientes laborales óptimos que tengan un impacto positivo en el bienestar de sus integrantes.
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Esgotamento Profissional , Medicina , Médicos , Esgotamento Profissional/epidemiologia , Esgotamento Profissional/etiologia , Esgotamento Profissional/psicologia , Esgotamento Psicológico , Estudos Transversais , Humanos , Médicos/psicologiaRESUMO
Williams-Beuren syndrome (WBS), a neurodevelopmental genetic disorder whose manifestations include visuospatial impairment, provides a unique model to link genetically determined loss of neural cell populations at different levels of the nervous system with neural circuits and visual behavior. Given that several of the genes deleted in WBS are also involved in eye development and the differentiation of retinal layers, we examined the retinal phenotype in WBS patients and its functional relation to global motion perception. We discovered a low-level visual phenotype characterized by decreased retinal thickness, abnormal optic disk concavity, and impaired visual responses in WBS patients compared with age-matched controls by using electrophysiology, confocal and coherence in vivo imaging with cellular resolution, and psychophysics. These mechanisms of impairment are related to the magnocellular pathway, which is involved in the detection of temporal changes in the visual scene. Low-level magnocellular performance did not predict high-level deficits in the integration of motion and 3D information at higher levels, thereby demonstrating independent mechanisms of dysfunction in WBS that will require remediation strategies different from those used in other visuospatial disorders. These findings challenge neurodevelopmental theories that explain cortical deficits based on low-level magnocellular impairment, such as regarding dyslexia.
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Percepção de Movimento , Disco Óptico/fisiopatologia , Transtornos da Visão/fisiopatologia , Visão Ocular , Córtex Visual/fisiopatologia , Síndrome de Williams/fisiopatologia , Adolescente , Adulto , Criança , Dislexia/genética , Dislexia/patologia , Dislexia/fisiopatologia , Feminino , Deleção de Genes , Humanos , Masculino , Disco Óptico/crescimento & desenvolvimento , Disco Óptico/patologia , Fenótipo , Transtornos da Visão/genética , Transtornos da Visão/patologia , Visão Ocular/genética , Córtex Visual/crescimento & desenvolvimento , Córtex Visual/patologia , Síndrome de Williams/genética , Síndrome de Williams/patologiaRESUMO
An amendment to this paper has been published and can be accessed via a link at the top of the paper.
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This work explores the development of highly sensitive salinity sensors. The demonstrated sensors are based on optical fibres and consist on Fabry-Pérot optical cavities formed by optimized processes that include chemical etching and fusion splicing, on which microfluidic channels are milled by focused ion beam. Two configurations are presented and their performance compared, including a design that makes use of Vernier-effect for the simultaneous measurement of salinity and temperature with high sensitivity. The interrogation of the devices is carried out by spectral measurements using a broadband light source yielding sensitivities to salinity up to 82.61 nm/M, or 6830.0 nm/RIU.
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We report on the fabrication and characterization of a volatile organic compound sensor architecture addressing common drawbacks of photonic integrated sensors such as reusability and specificity. The proposed sensor, built on a silicon-on-insulator platform and based on arrayed waveguide interference, has a chemically selective polydimethylsiloxane polymer cladding, which encapsulates the waveguides and provides an expandable and permeable low refractive index material. This cladding material acts as the chemical transducer element, changing its optical properties when in contact with specific volatile organic compounds, whose presence in the context of environmental and public health protection is important to monitor. The sensor operates at room temperature and its selectivity was confirmed by multiple tests with water, toluene, chlorobenzene, and hexane, through which the sturdiness of the sensor was verified. A maximum spectral shift of about 22.8 nm was measured under testing with chlorobenzene, at a central wavelength of 1566.7 nm. In addition, a sensitivity of 234.8 pm/% was obtained for chlorobenzene mass percent concentrations, with a limit of detection of 0.24%m/m. The thermal sensitivity of the sensor has been found to be 0.9 nm/°C.