•Women physicians and surgical trainees are at higher risk of mental health problems.•Aggressions were more reported by surgical trainees and women physicians.•Between 10% and 23% of physicians ...reported clinical symptoms of depression or anxiety.•Perceived distress was higher in women from surgical and nonsurgical specialties.•The experience of adversities and mental health problems should be more visualized.
Physicians in training face a variety of stressors throughout their professional development and according to their gender. Among them, surgical trainees appear to be especially at risk for mental health problems.
The aim of the present study was to compare demographic features, professional activities and adversities, depression, anxiety, and distress among men and women trainees of surgical and nonsurgical medical specialties.
A cross-sectional, retrospective, comparative study was conducted on a total of 12,424 trainees (68.7% nonsurgical and 31.3% surgical) from Mexico through an online survey. Demographic features, variables related to professional activities and adversities, depression, anxiety, and distress were evaluated through self-administered measures. Comparative analyses using the Cochran-Mantel-Haenszel test for categorical variables and multivariate analysis of variance including medical residency program and gender as fixed factors to test their interaction effect for continuous variables were used.
An important interaction between medical specialty and gender was found. Women trainees from surgical specialties report more frequent psychological and physical aggressions. Women from both specialties had higher distress, significant anxiety, and depression than men. Men from surgical specialties worked more hours per day.
Gender differences are evident in trainees for medical specialties, with a larger impact in surgical fields. Mistreatment of students is a pervasive behavior that affects society as a whole, and actions to improve learning and working environments in all medical specialties, but mostly in surgical fields, are urgently needed.
Five experimental diets containing different lipid sources, fish oil (D1), soybean lecithin (D2), corn oil (D3), canola oil (D4) and olive oil (D5), were evaluated in Atractosteus tropicus larvae for ...the relative gene expression of the enzymes fatty acid synthase (fas), acetyl‐CoA carboxylase 1 (acc1) and carnitine palmitoyltransferase 1C (cpt1c), in addition to their effects on larval growth, survival and cannibalism during a 30‐day feeding trial. Higher growth and survival were obtained in treatments D1 and D2, and lower performance in diets D3, D4 and D5. The highest levels of expression of fas and acc1 occurred in larvae fed with D1, which contained high amounts of n‐3 long‐chain polyunsaturated fatty acids (LC‐PUFA), mainly DHA and EPA FA are regulators of lipogenesis. The higher cpt1c expression in plant‐based diets is attributed to the fact that these diets are rich in α‐linolenic acid (ALA) and low DHA, EPA and ARA levels that favour ß‐oxidation. In conclusion, the diets with fish oil (D1) and soybean lecithin (D2) were the best treatments for larval growth, survival and cannibalism and thus appear to meet both lipid and energy requirements of A. tropicus larvae, meanwhile the use of vegetable oils influences the expression of intermediary lipogenic genes.
El artículo presenta el estado del arte y metodología del proyecto de investigación doctoral “Marco de referencia para el modelamiento y simulación de la ciberdefensa marítima – MARCIM”. El estado ...del arte definió los antecedentes del problema de investigación, estado de la actividad científica, tendencias y retos de las temáticas del MARCIM: ciberdefensa, modelamiento y simulación en ciberseguridad y ciberdefensa; y ciberseguridad y ciberdefensa marítima. La metodología se planteó con un enfoque en modelamiento de sistemas complejos, por fases y actores de aplicación. El artículo concluye principalmente que la ciberdefensa marítima a nivel estratégico se comporta como un sistema complejo, con dinámicas, procesos y elementos que no se pueden identificar claramente, que requieren del modelamiento y simulación, con un enfoque metaheurístico, para estudiar el conjunto de acciones e interacciones entre sus entidades.
Abstract Background Ventricular septal defect is a lethal complication after an acute myocardial infarction which have become infrequent with the advent of reperfusion strategies however; they remain ...a major contributor to mortality. Methods We identified patients using the ICD-9CM procedure codes from the Nationwide Inpatient Sample between the years 2001 and 2013. A multivariate hierarchical logistic regression model was used to identify significant predictors of in-hospital mortality. Results We identified 3,373,206 ST-elevation myocardial infarctions, out of which 10,012 (0.3%) were complicated with ventricular septal defect s. Most of the patients (60%) were older than 65, male (55%), and white (63%). Inferior (49.7%) and anterior (41.1%) myocardial infarctions were more commonly implicated with the development of VSDs. The median (IQR) hospitalization length was 7 days (3.0-13.5). Only 7.65% of patients underwent some intervention with 7% surgical and 0.65% minimally invasive. Mechanical support devices were used in 36.5% of patients, with intra-aortic balloon pump (96%) being the most common. In-hospital mortality remained high at 30.5% (downward trending from 41.6% in 2001 to 23.3% in 2013). Age, cardiogenic shock, and in-hospital cardiac arrest were statistically significant predictors of in-hospital mortality. The utilization of corrective procedures significantly declined. The use of mechanical support devices and performing a corrective procedure were associated with higher mortality, length of stay and cost. Conclusion Ventricular septal defects after acute myocardial infarctions remain associated with significantly high mortality rates. Highly specialized regional centers with individual expertise in the management of septal ruptures are required to improve outcomes of these patients.
Abstract
Orange processing and wood production industries generate wastes in the form of orange peel and eucalyptus leaves. These residues can be valorized as feedstocks to produce essential oils. ...Therefore, a simultaneous orange peel and eucalyptus leaves essential oil extraction process integrating solar energy was simulated. Biomass and essential oils were simulated by using equivalence models. The coupling of solar collectors allowed the extraction of eucalyptus essential oil, with a saving of 10 % in the total energy load.
Introduction
Acromegaly is a rare, insidious disease resulting from the overproduction of growth hormone (GH) and insulin-like growth factor 1 (IGF-1), and is associated with a range of ...comorbidities. The extent of associated complications and mortality risk is related to length of exposure to the excess GH and IGF-1, thus early diagnosis and treatment is imperative. Unfortunately, acromegaly is often diagnosed late, when patients already have a wide range of comorbidities. The presence of comorbid conditions contributes significantly to patient morbidity/mortality and impaired quality of life.
Methods
We conducted a retrospective literature review for information relating to the diagnosis of acromegaly, and its associated comorbidities using PubMed. The main aim of this review is to highlight the issues of comorbidities in acromegaly, and to reinforce the importance of early diagnosis and treatment.
Findings and conclusions
Successful management of acromegaly goes beyond treating the disease itself, since many patients are diagnosed late in disease evolution, they present with a range of comorbid conditions, such as cardiovascular disease, diabetes, hypertension, and sleep apnea. It is important that patients are screened carefully at diagnosis (and thereafter), for common associated complications, and that biochemical control does not become the only treatment goal. Mortality and morbidities in acromegaly can be reduced successfully if patients are treated using a multimodal approach with comprehensive comorbidity management.
Mango malformation disease caused by Fusarium spp. is one of the main limiting factors for mango production in Mexico. Fungal isolates obtained from symptomatic tissue from mango trees in Sinaloa, ...Mexico, were subjected to phylogenetic analysis of the TEF-1α gene, and evaluated for mating type, morphological markers and pathogenicity. Fifteen monosporic Fusarium isolates were identified as Fusarium neocosmosporiellum O'Donnell & Geiser. Phylogenetic analysis confirmed that the sequence obtained in this study corresponds to F. neocosmosporiellum. All 15 isolates were found to be pathogenic, but no differences were observed in aggressiveness among the isolates, which may be a result of low genetic variability within the fungal population. According to the morphological and molecular results, this study confirmed that the causal agent of mango malformation disease was F. neocosmosporiellum. This is the first report of mango malformation disease caused by this fungus in Mexico. This study provides a basis for the development and implementation of an integrated management system for this disease, confirms a new location of this fungus, and highlights that this pathogen is a potential threat to mango cultivation in Mexico.
Suicide is a serious worldwide health problem of critical consequences. Nowadays genetic factors are considered to be an important cause of suicide. The association between Val66Met (rs6265) ...polymorphism of the BDNF gene and suicide behavior has been increasingly studied. The aim of this study was to perform a meta-analysis in order to unravel the possible association between BDNF gene Val66Met polymorphism and suicide behavior. These meta-analysis and systematic review were performed using 23 articles that searched for a genetic association between Val66Met and suicide behavior, including 4532 cases and 5364 control subjects. The association was analyzed following the models: allelic, homozygous, heterozygous, dominant and recessive. Also, analyses by ethnicity (Caucasian and Asian populations) were done following the same four models. When the overall population was evaluated, we found no evidence of association between the polymorphism Val66Met of BDNF (rs6265) and suicide behavior (Met vs. Val: OR: 1.01; 95% CI = 0.92–1.10). However, a significant increased risk was found in the subgroup analysis by ethnicity in Caucasian populations (Met-Met vs. Met-Val + Val-Val: OR: 1.96; 95% CI = 1.58–2.43) and Asian populations (Val-Val vs. Val-Met + Met: OR: 1.36; 95% CI = 1.04–1.78). Our results suggest there is no association between the BDNF gene Val66Met (rs6265) and suicide behavior in the overall population. However, ethnic differences can be observed and the BDNF Val66Met might increase the risk for suicide behavior in Asian and Caucasian populations. Further studies with larger samples are necessary in order to have conclusive outcomes.
For the commercial culture of the three‐spot cichlid (Amphilophus trimaculatus), it is important to have available a set of protein and lipid ingredients suitable for feed manufacturing, which allow ...to optimize the culture at affordable costs. The in vitro digestibility was evaluated with pH‐stat technique, using stomach and intestine multi‐enzymatic extracts from A. trimaculatus juveniles. The digestion of protein ingredients was taken place both in acid and in alkaline conditions, quantifying the total of free amino acids at the end of the hydrolysis, whereas the digestion of lipid ingredients was taken place only in alkaline conditions. The digestive enzymes of this species showed a better affinity to raw materials of animal origin such as beef meal, fish meal and premium chicken meal, which presented better digestibility. The best lipid ingredient that could be used is the fish oil. However, it is possible to use ingredients from the plant sources, such as soy or cereals, and vegetable oils such as olive, corn or soy oil. It is necessary to complement this study in vitro with the digestibility analysis in vivo, in order to determine the inclusion percentages in feeds and costs and therefore to develop an efficient feed formulation for the aquaculture of A. trimaculatus.
Tropical gar (Atractosteus tropicus) is an ancestral subtropical fish species in southeastern Mexico, which has great potential as a model species for physiological, biomedical and genomic studies. ...The quantification of gene expression through RT-qPCR is one of the most commonly used techniques, due to its precision, sensitivity and high performance, particularly in gene expression to compare between cells, tissues and organs; as well as different populations, stages of development, metabolism, among other conditions. This study analyzed the stability and normalization of six commonly used reference genes such as alpha elongation factor (ef1-α), beta-actin (actb), 18S ribosomal RNA (18s rrna), beta-2-microglobulin (b2m), tubulin alpha (α-tub) and glyceraldehyde 3-phosphate dehydrogenase (gapdh) in the different tissues of the intestine, muscle, gill, stomach, brain and liver in adult males of A. tropicus from reared in captivity through three BestKeeper, geNorm and NormFinder algorithms. Based on our results we can conclude that in the three BestKeeper, NormFinder and geNorm algorithms, the most stable genes are ef1, followed by 18s rrna and actb where the gene stability will depend on specific tissue to analyze in tropical gar A. tropicus adults.
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