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Giant left atrium is extremely rare in the paediatric population, especially in asymptomatic cases. We report a 5-year-old child with a giant left atrium due to “non-rheumatic” mitral valve regurgitation that presented as a stroke secondary to atrial tachycardia. This case is noteworthy for the unusual “silent” manifestation of a giant left atrium.
Few studies have examined the psychometric properties of the Connor-Davidson Resilience Scale (CD-RISC) in a large adolescent community sample, finding a significant disparity. This study explores the psychometric properties of the CD-RISC among Spanish adolescents by means of exploratory factor analysis (EFA), Rasch analysis, and measurement invariance (MI) across sex, as well as internal consistency and criterion validity. The sample was comprised of 463 adolescents (231 girls), aged 12 to 18 years, who completed the CD-RISC and other measures on emotional status and quality of life. The EFA suggested that the CD-RISC structure presented a unidimensional model. Consequently, shorter unidimensional CD-RISC models observed in the literature were explored. Thus, the Campbell-Sills and Stein CD–RISC–10 showed the soundest psychometric properties, providing an adequate item fit and supporting MI and non-differential item functioning across sex. Item difficulty levels were biased toward low levels of resilience. Some items showed malfunctioning in lower response categories. With regard to reliability, categorical omega was. 82. Strong associations with health-related quality of life, major depressive disorder symptoms, and emotional symptoms were observed. A weak association was found between resilience and the male sex. Campbell-Sills and Stein’s CD–RISC–10 model emerges as the best to assess resilience among Spanish adolescents, as already reported in adults. Thus, independently of the developmental stage, the core of resilience may reside in the aspects of hardiness and persistence.
To describe IMP-type carbapenemase-producing Pseudomonas aeruginosa outbreaks at Galdakao University Hospital between March 2021 to December 2021.
Design:
Outbreak report.
Setting:
Galdakao University Hospital is a tertiary-care hospital in the Basque Country (northern Spain).
Patients:
All patients with a positive IMP-type carbapenemase producing Pseudomonas aeruginosa (IMP-PA) culture were included in this study, both colonization and infection cases.
Methods:
An outbreak investigation was conducted, in which molecular epidemiology analysis [pulsed-field gel electrophoresis and whole-genome sequencing (WGS)] and environmental screenings were performed.
Results:
Between March and December 2021, 21 cases of IMP-PA were detected in Galdakao University Hospital: 18 infection cases and 3 colonization cases. In total, 4 different pulsotypes were detected belonging to 4 clones according to WGS: ST175 (n = 14), ST633 (n = 3), ST179 (n = 3), and ST348 (n = 1). IMP-13 was detected in most isolates belonging to the ST175 clone and in all ST179 and ST348 clones, whereas IMP-29 was detected in isolates belonging to the ST633 clone. Clinical isolates belonging to the ST175 clone were isolated mainly from patients admitted to the respiratory ward, and isolates belonging to the ST633 clone from patients admitted to the ICU. Two environmental isolates belonging to the ST175 clone were detected in the respiratory ward.
Conclusions:
Molecular and genomic epidemiology revealed that there had been 2 independent IMP-PA outbreaks, one of long duration in the respiratory ward and the other more limited in the ICU.
Sustainable energy economics in Latin America has become relevant due to the region’s dependence on the oil market and the disruption caused by the COVID-19 pandemic. A systematic review of the ten major economies in the region based on gross domestic product is conducted. We primarily analyze production performance of hydro, wind, and solar energies, in terms of total gigawatt hours produced, current participation levels in energy matrices, and total installed capacity. Current and future trends and legal frameworks for each technology and country are discussed. Our analyses indicate that Latin America and the Caribbean can potentially increase the usage of renewable energy sources given a plethora of natural resources, favorable geographical and climatic conditions, and existing large-scale hydro installations to counteract the inconsistency of wind and solar projects. Therefore, governments in the region must overhaul sustainable policies to increase awareness and reduce energy dependence on foreign powers.
El Seminario de Historia Urbana del Departamento de Investigaciones Históricas del INAH reune a un número variable de investigadores, de especialidades diversas, y a un grupo de estudiantes que reciben formación de investigación en historia urbana. La dirección del Seminario está a cargo de Alejandra Moreno Toscano, investigadora de El Colegio de México. El Seminario sobre Problemas Metodológicos en Historia Urbana de Agosto de 1974 tuvo como propósito principal, confrontar diversas investigaciones en curso, subrayando sus dificultades metodológicas.
Large, conglomerate caves in north-eastern Iberia have been significant places since the Neolithic through to historical times; however, their significance during the Palaeolithic has barely been explored. This project is the first systematic study of the use of these iconic geological landmarks among Pleistocene hunter-gatherers.
Mesoamerica is the world's third largest biodiversity hotspot and has c. 4,000 wildlife species protected under CITES. Despite the high biodiversity in the region, there is limited global attention, data and funding for conservation. The continued exploitation of wildlife species for the trade requires a more proactive approach to address emerging trends, and low-cost and effective solutions to prevent species decline. Over a 5-month period in 2017, we used expert-driven horizon scanning, facilitated online, to identify emerging trends of the illegal wildlife trade in Mesoamerica. We found that the main emerging trends included digital and technological advancements, greater regional access to the global community, developments in trafficking techniques and growing demand for certain species. Our findings demonstrate that horizon scanning can be used as a tool for identifying emerging trends of illegal wildlife trade in data-poor contexts. We recommend that horizon scanning is used regularly for systematic monitoring of trends and to prioritize resources for immediate and emerging trends in illegal wildlife trade.
The aim of the study was to determine the main factors (sociodemographic, anthropometric, lifestyle and health status) associated with high Na excretion in a representative population of Chile.
Design
Na excretion (g/d), a valid marker of Na intake, was determined by urine analysis and Tanaka’s formulas. Blood pressure was measured by trained staff and derived from the mean of three readings recorded after 15 min rest. The associations of Na excretion with blood pressure and the primary correlates of high Na excretion were determined using logistic regression.
Setting
Chileans aged ≥15 years.
Participants
Participants (n 2913) from the Chilean National Health Survey 2009–2010.
Results
Individuals aged 25 years or over, those who were obese and those who had hypertension, diabetes or metabolic syndrome were more likely to have higher Na excretion. The odds for hypertension increased by 10·2 % per 0·4 g/d increment in Na excretion (OR=1·10; 95 % CI 1·06, 1·14; P < 0·0001). These findings were independent of major confounding factors.
Conclusions
Age, sex, adiposity, sitting behaviours and existing co-morbidities such as diabetes were associated with higher Na excretion levels in the Chilean population. These findings could help policy makers to implement public health strategies tailored towards individuals who are more likely to consume high levels of dietary salt.
New data and a review of historiographic information from Neolithic sites of the Malaga and Algarve coasts (southern Iberian Peninsula) and from the Maghreb (North Africa) reveal the existence of a Neolithic settlement at least from 7.5 cal ka BP. The agricultural and pastoralist food producing economy of that population rapidly replaced the coastal economies of the Mesolithic populations. The timing of this population and economic turnover coincided with major changes in the continental and marine ecosystems, including upwelling intensity, sea-level changes and increased aridity in the Sahara and along the Iberian coast. These changes likely impacted the subsistence strategies of the Mesolithic populations along the Iberian seascapes and resulted in abandonments manifested as sedimentary hiatuses in some areas during the Mesolithic–Neolithic transition. The rapid expansion and area of dispersal of the early Neolithic traits suggest the use of marine technology. Different evidences for a Maghrebian origin for the first colonists have been summarized. The recognition of an early North-African Neolithic influence in Southern Iberia and the Maghreb is vital for understanding the appearance and development of the Neolithic in Western Europe. Our review suggests links between climate change, resource allocation, and population turnover.
Radiocarbon dating of closely associated marine mollusk shells and terrestrial material (mammal bones or charred wood) collected from archaeological contexts in northern Atlantic Iberian coastal areas is used to quantify the marine 14C reservoir effect (ΔR) for the coastal waters off the Cantabrian coast of northern Iberia. For the first time, ΔR values were reliably determined for these coastal waters and, also for the first time, a ΔR was calculated for the Late Pleistocene in Atlantic Iberia. Pairs of coeval samples of different carbon reservoirs selected from Upper Paleolithic (Late Pleistocene) and Mesolithic (Early Holocene) contexts yielded ΔR weighted mean values of –117±70 14C yr and –105±21 14C yr, respectively. These values show oceanographic conditions characterized by a reduced offset between atmospheric and surface water 14C contents, suggesting a nonexistent or very weak upwelling and some stratification of the water column. Similar oceanographic conditions have been recorded in other areas of Atlantic Iberia during the Holocene, such as off Andalusian and northwestern Galician coasts. Results not only provide useful information on environmental conditions but also a framework to obtain more precise and reliable absolute chronologies for the Late Pleistocene and Early Holocene in northern Iberia.
Goats in Canary Islands are milked once a day by tradition, but in most countries with high technology on farms, goats are milked twice a day, which is known to improve milk yield. Therefore it is important to know whether the increase of milking frequency can improve the production without impairing milk quality. The objective of this study was to investigate the short term effects of three milking frequencies on milk yield, milk composition, somatic cell count (SCC) and milk protein profile in dairy goats traditionally milked once a day. Twelve Majorera goats in early lactation (48±4 d in milk) were used. During a 5-week period, goats were milked once a day (X1) in weeks 1 and 5, twice a day (X2) in weeks 2 and 4, and three times a day (X3) in week 3. Milk recording and sampling were done on the last day of each experimental week. Milk yield increased by 26% from X1 to X2. No differences were obtained when goats were switched from X2 to X3, and from X3 to X2. The goats recovered the production level when they returned to X1. Different patterns of changes in the milk constituents due to the milking frequency effect were observed. Fat percentage increased when switched from X1 to X2, then decreased from X2 to X3, and from X3 to X2, whereas it did not show significant differences from X2 to X1. Milking frequency did not affect the protein and lactose percentages. SCC values were unaffected when goats were milked X1, X2 and X3, but then they increased slightly when milking frequency was returned to X2 and X1. Finally, quantitative analysis showed an increase in intensities of milk protein bands from X1 to X2, but the intensities of casein bands (αS1-CN, αS2-CN, β-CN, κ-CN) and major whey proteins (α-La, β-Lg) decreased from X2 to X3.
A study of the fluid flow in a mixing device proposed to dissolve alloying elements in iron baths is performed through a mathematical model in order to predict the best operating conditions for a proper melting/dissolution of solid alloying particles. The mathematical model consists in the mass and momentum conservation equations (continuity and Turbulent Navier-Stokes equations), and the standard two k-epsilon turbulence model. The model is numerically solved in transient regime with the Volume of Fluid algorithm (VOF) to calculate the vortex shape. VOF is built-in the CFD (Computational Fluid Dynamics) software ANSYS FLUENT 14. A flow of metal enters tangentially in the mixing chamber of the proposed mixing device (taken from an open patent) to generate a vortex. The shape and height of the vortex reached in this chamber depends on several design variables, but in this work only the presence or absence of a barrier in the device is analyzed. Results are obtained on the vortex sizes and shapes, liquid flow patterns, turbulent structure, residence times of the particles of alloying elements added to the melt and mixing times (Residence time distribution curves) of two devices: one with a barrier and the other without this barrier. It is found that the presence of the barrier in the device increases turbulence, destroys the vortex, decreases the residence time of the particles, and decreases the volume of fluid in the device. Most of the features of the barrier are detrimental for mixing and inhibits melting/dissolution of the alloying elements. Then, it is suggested a device without the presence of barrier for better performance.
This paper presents a general approach to automatically compile e-learning models to planning, allowing us to easily generate plans, in the form of learning designs, by using existing domain-independent planners. The idea is to compile, first, a course defined in a standard e-learning language into a planning domain, and, second, a file containing students learning information into a planning problem. We provide a common compilation and extend it to three particular approaches that cover a full spectrum of planning paradigms, which increases the possibilities of using current planners: (i) hierarchical, (ii) including PDDL (Planning Domain Definition Language) actions with conditional effects and (iii) including PDDL durative actions. The learning designs are automatically generated from the plans and can be uploaded, and subsequently executed, by learning management platforms. We also provide an extensive analysis of the e-learning metadata specification required for planning, and the pros and cons on the knowledge engineering procedures used in each of the three compilations. Finally, we include some qualitative and quantitative experimentation of the compilations in several domain-independent planners to measure its scalability and applicability.
The science of extra-solar planets is one of the most rapidly changing areas of astrophysics and since 1995 the number of planets known has increased by almost two orders of magnitude. A combination of ground-based surveys and dedicated space missions has resulted in 560-plus planets being detected, and over 1200 that await confirmation. NASA's Kepler mission has opened up the possibility of discovering Earth-like planets in the habitable zone around some of the 100,000 stars it is surveying during its 3 to 4-year lifetime. The new ESA's Gaia mission is expected to discover thousands of new planets around stars within 200 parsecs of the Sun. The key challenge now is moving on from discovery, important though that remains, to characterisation: what are these planets actually like, and why are they as they are?
In the past ten years, we have learned how to obtain the first spectra of exoplanets using transit transmission and emission spectroscopy. With the high stability of Spitzer, Hubble, and large ground-based telescopes the spectra of bright close-in massive planets can be obtained and species like water vapour, methane, carbon monoxide and dioxide have been detected. With transit science came the first tangible remote sensing of these planetary bodies and so one can start to extrapolate from what has been learnt from Solar System probes to what one might plan to learn about their faraway siblings. As we learn more about the atmospheres, surfaces and near-surfaces of these remote bodies, we will begin to build up a clearer picture of their construction, history and suitability for life.
The Exoplanet Characterisation Observatory, EChO, will be the first dedicated mission to investigate the physics and chemistry of Exoplanetary Atmospheres. By characterising spectroscopically more bodies in different environments we will take detailed planetology out of the Solar System and into the Galaxy as a whole.
EChO has now been selected by the European Space Agency to be assessed as one of four M3 mission candidates.
It has been traditionally assumed that medial temporal lobe (MTL) is not required for working memory (WM). However, animal lesion and electrophysiological studies and human neuropsychological and neuroimaging studies have provided increasing evidences of a critical involvement of MTL in WM. Based on previous findings, the central aim of this study was to investigate the contribution of the MTL to verbal WM encoding. Here, we used magnetoencephalography (MEG) to compare the patterns of MTL activation of 9 epilepsy patients suffering from left hippocampal sclerosis with those of 10 healthy matched controls while they performed a verbal WM task. MEG recordings allow detailed tracking of the time course of MTL activation. We observed impaired WM performance associated with changes in the dynamics of MTL activity in epilepsy patients. Specifically, whereas patients showed decreased activity in damaged MTL, activity in the contralateral MTL was enhanced, an effect that became significant in the 600- to 700-ms interval after stimulus presentation. These findings strongly support the crucial contribution of MTL to verbal WM encoding and provide compelling evidence for the proposal that MTL contributes to both episodic memory and WM. Whether this pattern is signaling reorganization or a normal use of a damaged structure is discussed. (JINS, 2009, 15, 536–546.)
Psychiatric disorders are among the top causes worldwide of disease burden and disability. A major criterion for validating diagnoses is stability over time.
Aims
To evaluate the long-term stability of the most prevalent psychiatric diagnoses in a variety of clinical settings.
Method
A total of 34 368 patients received psychiatric care in the catchment area of one Spanish hospital (1992–2004). This study is based on 10 025 adult patients who were assessed on at least ten occasions (360 899 psychiatric consultations) in three settings: in-patient unit, 2000–2004(n=546); psychiatric emergency room, 2000–2004(n=1408); and out-patient psychiatric facilities, 1992–2004 (n=10 016). Prospective consistency, retrospective consistency and the proportion of patients who received each diagnosis in at least 75% of the evaluations were calculated for each diagnosis in each setting and across settings.
Results
The temporal consistency of mental disorders was poor, ranging from 29% for specific personality disorders to 70% for schizophrenia, with stability greatest for in-patient diagnoses and least for out-patient diagnoses.
Conclusions
The findings are an indictment of our current psychiatric diagnostic practice.
Nanocapsules of Bi2S3 with diameters between 5 and 10 nm and shells with an amorphous atomic distribution were synthesized at room temperature, with bismuth nitrate and thiourea as precursors. Aging the solution for several days a black powder precipitated made of a mixture of one amorphous phase and crystalline Bi2S3. When two capsules interacted between each other, the capsule regions in contact crystallized into bismuth sulfide, which explains the origin of the crystalline phase observed in the X-ray diffraction pattern. At this temperature, aggregation of the small nanocapsules also gave rise to necklaces of capsules, which eventually gave rise to nanotubes; these necklaces ordered forming bundles parallel to their largest dimension. When the solution was annealed at temperatures lower than 100 °C, aggregation gave rise to capsules as large as 1 μm in diameter, and tubes with similar diameters; in this case aggregation occurred between small and large nanocapsules. Because of the monomers aggregating had an external spherical symmetry and the low annealing temperatures, which were not high enough to produce sintering, all capsules and tubes formed during aggregation had porous walls, making these materials interesting for many applications.
We have prepared organic-inorganic hybrid materials (OIHM), incorporating an organic phase in the inorganic precursor sol, using high power ultrasound for assistance with agitation. A sono-ormosil results after gelation. Colloidal silica particles have been added to these hybrids to enable network porous volume and pore radius to be tailored to specific requirements. Finally, in vitro bioactivity of this material has been promoted by adding calcium to the initial sol. The structure and bioactivity of these materials have been subjected to preliminary study, including their mechanical behaviour. These materials have a very fine structure especially after colloidal silica particles have been included. When immersed in a solution simulating blood plasma, they are bioactive, and the sample with colloid particles presents a better behaviour in vitro
We prove that if A is a prime non-commutative JB*-algebra which is neither quadratic nor commutative, then there exist a prime C*-algebra B and a real number λ with ½ < λ [les ] 1 such that A = B as involutive Banach spaces, and the product of A is related to that of B (denoted by ∘, say) by means of the equality xy = λx ∘ y + (1 − λ)y ∘ x.