This paper presents a novel target positioner system that exhibits high sensitivity and accuracy. Specifically, the system is capable of precisely locating rough target surfaces within a micron-scale ...in the focal plane. The high sensitivity comes from the nonlinear detection scheme which uses the two-photon-absorption process in a Si-photodiode and a CMOS sensor at 1550 nm. The setup employs a confocal configuration that is easy to align and does not require a conjugated focal plane selective aperture (pinhole), thus demonstrating its feasibility and tilt tolerance of the target. Moreover, the system offers high accuracy up to 5 μm, which corresponds to the step size of the focus scanning. The presented positioner system has potential applications in microfabrication with lasers and laser-driven plasma accelerators even at high repetition rates, limited by the detection bandwidth of the photodiode. Additionally, the principle can be extended to cameras if spatial information is needed and the system design can be extended to other spectral ranges with minimal changes.
Despite the existing research, the etiology of rheumatoid arthritis (RA), an autoimmune disease remains poorly understood with early and accurate diagnosis difficult to achieve. MicroRNAs (miRNAs) ...play an important role in biological processes as modulators of transcription and translation. Previous studies have demonstrated a downregulation of several genes in early RA stages and in addition, miRNAs may serve as early biomarkers of subclinical changes in early RA.
When comparing the four groups (ANOVA P < 0.01, fold change > 4), we found 253 differentially expressed miRNAs. Of these, 97 miRNAs were identified as overexpressed in early rheumatoid arthritis. The validation of miRNA microarray expression was performed in a set by RT-qPCR and showed strong agreement with microarray expression data. The putative targets of overexpressed microRNAs in early RA were significantly enriched in apoptosis, tolerance loss and Wnt pathways. Moreover, ROC analysis showed values of AUC 0.76 and P < 0.05 for miR 361-5p, identifying this miRNA as a potential biomarker of disease.
We identified specific microRNAs associated with early rheumatoid arthritis and proposed them as early biomarkers of disease. Our results provide novel insight into immune disease physiopathology and describe unreported microRNAs in RA with potential for clinical use.
•Early RA is difficult to diagnose due to the lack of specific biomarkers.•Patients with early RA show an overexpression of several miRNAs.•The predicted miRNA target genes were related to inflammation and T cell activation.•The mir-361-5p is overexpressed in early RA and has potential as a biomarker.
Cyberbullying is a common relational problem having negative repercussions on the academic performance of adolescents. Numerous questions remain to be answered with regard to the relationship between ...cyberbullying and school refusal behavior. This study examines school refusal profiles (measured by School Refusal Assessment Scale-Revised) and assesses whether these profiles vary with respect to the level of victimization, aggression, aggression-victimization, and observation of cyberbullying (measured with the Screening of Harassment among Peers). The sample consisted of 1,102 Spanish high school students, aged 12-18 (
= 14.30, SD = 1.71). Latent class analysis revealed three school refusal behavior profiles: non-school refusal behavior, school refusal behavior by negative reinforcements (oriented to the avoidance of social evaluation and negative affectivity in school situations), and school refusal behavior by positive reinforcements (oriented to obtaining the attention of others with significant or tangible reinforcements). The ANOVA found statistically significant differences for all cyberbullying behaviors. Students with school refusal by negative reinforcements had significantly higher mean scores as compared to the other profiles in victimization, aggression, aggression-victimization, and observation behaviors, while the levels of cyberbullying were similar between students without school refusal and students with school refusal behavior by positive reinforcements. These findings underscore the need to consider priority interventions to prevent cyberbullying in children who refuse school for the purpose of avoiding situations of anxiety and negative emotions.
We present a systematic study of the morphology and absorption properties of a typical donor–acceptor polymer (PCPDTBT) with semicrystalline behavior in solution and in thin films. In-situ ...spectroelectrochemical data give information about the evolution of the absorption spectra from neutral to charged species. The experimental data are supported by theoretical calculations in the framework of the density functional theory (DFT). Regarding thin film structures, we show that the choice of the solvent has significant influence on the morphology in thin films: whereas CS2 and CHCl3 give rather structureless (amorphous) morphologies, films from 1-CN exhibit a clear crystalline nanofiber morphology. Accompanying UV/vis/NIR spectra of films are highly dependent on the morphology and therefore on the choice of the processing solvent. The absorption of fiber morphologies is strongly red-shifted compared to the structureless films.
An oxamato‐bridged CoIICuII chain compound has been obtained via the self‐assembly of mononuclear bis‐bidentate copper(II) anionic building blocks and cobalt(II) cations. It is the first example of a ...heterobimetallic ferrimagnetic chain that incorporates slow magnetic relaxation behavior (see Figure).
The long-term clinical evolution of prediabetes and post-transplant diabetes mellitus (PTDM) is unknown.
We analysed, in this cohort study, the reversibility, stability and progression of PTDM and ...prediabetes in 672 patients using repeated oral glucose tolerance tests (OGTTs) for ≤5 years.
Most patients were on tacrolimus, steroids and mycophenolate. About half developed either PTDM or prediabetes. The incidence of PTDM was 32% and bimodal: early PTDM (≤3 months) and late PTDM. Early PTDM reverted in 31%; late PTDM developed in patients with post-transplant prediabetes. The use of OGTTs was necessary to detect around half of PTDM. Pretransplant obesity was a major risk factor for early PTDM, for its persistence and for late PTDM {odds ratio OR 1.18 95% confidence interval (CI) 1.09-1.28}. At 3 months, higher HbA1c promoted OR 2.37 (95% CI 1.38-4.06), while insulin sensitivity protected against OR 0.64 (95% CI 0.48-0.86) late PTDM. At 3 months, 28% had prediabetes; of these, 36% remained stable, 43% normalized and 21% developed late PTDM. Pretransplant obesity OR 1.20 (95% CI 1.04-1.39) and higher HbA1c OR 3.80 (95% CI 1.45-9.94) at 3 months promoted while insulin sensitivity protected against OR 0.57 (95% CI 0.34-0.95) evolution from prediabetes to late PTDM. Immunosuppressive levels or acute rejection did not influence PTDM. Most (84%) of the patients with normal tests at 3 months remained stable without evolving into PTDM; 14% developed prediabetes.
PTDM and prediabetes are very common in renal transplantation. Classic metabolic factors like obesity, prediabetes and insulin resistance promote the evolution of PTDM and prediabetes. Patients with normal glucose metabolism rarely develop PTDM. OGTT is necessary to detect PTDM and prediabetes and thus should be included in clinical practice.
Emergency General Surgery (EGS) conditions account for millions of deaths worldwide, yet it is practiced without benchmarking-based quality improvement programs. The aim of this observational, ...prospective, multicenter, nationwide study was to determine the best benchmark cutoff points in EGS, as a reference to guide improvement measures.
Over a 6-month period, 38 centers (5% of all public hospitals) attending EGS patients on a 24-h, 7-days a week basis, enrolled consecutive patients requiring an emergent/urgent surgical procedure. Patients were stratified into cohorts of low (i.e., expected morbidity risk <33%), middle and high risk using the novel m-LUCENTUM calculator.
A total of 7258 patients were included; age (mean ± SD) was 51.1 ± 21.5 years, 43.2% were female. Benchmark cutoffs in the low-risk cohort (5639 patients, 77.7% of total) were: use of laparoscopy ≥40.9%, length of hospital stays ≤3 days, any complication within 30 days ≤ 17.7%, and 30-day mortality ≤1.1%. The variables with the greatest impact were septicemia on length of hospital stay (21 days; adjusted beta coefficient 16.8; 95% CI: 15.3 to 18.3; P < .001), and respiratory failure on mortality (risk-adjusted population attributable fraction 44.6%, 95% CI 29.6 to 59.6, P < .001). Use of laparoscopy (odds ratio 0.764, 95% CI 0.678 to 0.861; P < .001), and intraoperative blood loss (101–500 mL: odds ratio 2.699, 95% CI 2.152 to 3.380; P < .001; and 500–1000 mL: odds ratio 2.875, 95% CI 1.403 to 5.858; P = .013) were associated with increased morbidity.
This study offers, for the first time, clinically-based benchmark values in EGS and identifies measures for improvement.
•The best benchmark cut-offs in Emergency General Surgery are unknown.•The present study established benchmark cut-off values in a low-risk cohort.•Benchmark cut-off was ≥40.9% for use of laparoscopy, and ≤3 days for hospital stays.•Benchmark cut-off was ≤17.7% for 30-day morbidity, and ≤1.1% for 30-day mortality.•These cut-offs values may guide quality improvement in Emergency General Surgery.
The introduction of video-assisted thoracoscopic (VATS) techniques has led to a new approach in thoracic surgery. VATS is performed by inserting a thoracoscope through a small incisions in the chest ...wall, thus maximizing the preservation of muscle and tissue. Because of its low rate of morbidity and mortality, VATS is currently the technique of choice in most thoracic procedures. Lung resection by VATS reduces prolonged air leaks, arrhythmia, pneumonia, postoperative pain and inflammatory markers. This reduction in postoperative complications shortens hospital length of stay, and is particularly beneficial in high-risk patients with low tolerance to thoracotomy. Compared with conventional thoracotomy, the oncological results of VATS surgery are similar or even superior to those of open surgery. This aim of this multidisciplinary position statement produced by the thoracic surgery working group of the Spanish Society of Anesthesiology and Reanimation (SEDAR), the Spanish Society of Thoracic Surgery (SECT), and the Spanish Association of Physiotherapy (AEF) is to standardize and disseminate a series of perioperative anaesthesia management guidelines for patients undergoing VATS lung resection surgery. Each recommendation is based on an in-depth review of the available literature by the authors. In this document, the care of patients undergoing VATS surgery is organized in sections, starting with the surgical approach, and followed by the three pillars of anaesthesia management: preoperative, intraoperative, and postoperative anaesthesia.
The relationship between human papillomavirus (HPV) and oropharyngeal squamous cell carcinoma has been established. However, data from Ecuador is limited. The objective of this study was to ...characterize HPV infection in Ecuadorian patients with tongue cancer. Fifty-three patients with tongue cancer treated at the tertiary referral center Sociedad de Lucha Contra el Cancer (SOLCA), Guayaquil, between 2006 and 2011 were identified. Linear Array® HPV genotyping was used to identify the presence and types of HPV on formalin-fixed paraffin-embedded biopsy samples from these patients with tongue cancer. HPV was identified in 42% (n=22) and high-risk (HR) HPV in 17% (n=9), with 18 different HPV types identified. The most common types were the HR HPV 33 (14%) and low-risk HPV 67 (14%), followed by the HR HPV 58. More than one HPV type was identified in 27.3% of cases. HPV 33 was frequently associated with other HPV types. No statistically significant differences in gender (P=0.58) and age (P=0.12) were observed between HPV-positive and HPV-negative cases. HPV was identified in almost half of the tongue cancer samples, with subtypes 33 and 67 being the most common. This suggested that HPV played an important role in this disease in the population studied. Given these results, current HPV vaccines may not be as effective in reducing tongue cancer rates in this population.
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