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The dynamics of the isomerization reaction LiNC...LiCN is considered at a quantum level. This study is performed with the aid of dynamically localized wave packets, which provide a wealth of information about the relevant parts of the molecular phase space. Three cases are considered, corresponding to energies close to the threshold for isomerization. The initial position of the packet is always localized in the LiNC well (which is the most stable), and different energies and distributions among the vibrational modes of the molecule are used. The packet will then explore phase space and, as a result of these dynamics, different time scales (including those from intramolecular energy transfer processes) exist, which appear in the low resolution features of the corresponding spectra. The characteristics of these spectra are discussed and analyzed using a variety of techniques, making extensive use of the ideas of nonlinear dynamics, and the conditions for the applicability of statistical theories to evaluate reaction rates in this case are considered. [ABSTRACT FROM AUTHOR]

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Introduction. Demodicosis is a term that groups cutaneous conditions caused by mites from the Demodex genus, like D. folliculorum and D. brevis. It has a variable prevalence and it depends on the population studied, there are no reports of it in Mexico. This study is designed to determine the prevalence, main signs and symptoms associated to periocular Demodex infestation of patients from a third level hospital. Material and Methods. This is a descriptive and transversal study that included 100 patients attending a high specialty ophthalmologic unit at the Hospital Civil de Guadalajara Fray Antonio Alcalde from September to November 2015. We did a descriptive sociodemographic analysis and a demodicosis periocular prevalence calculus. Results. The total sample included 92 patients with mite presence, but infection could be proved in only 44% of them with an index greater or equal to 50%. Males were the most affected. The presence of cylinders and intense periocular pruritus were the most frequently associated signs and symptoms. Discussion. The role of the pathogen Demodex has not been completely determined. It is believed that it may play a role in the pathogenesis when it starts replication. After it enters the dermis it is considered responsible or contributing factor for the development of blepharitis or blepharoconjunctivitis. Its prevalence is variable and depends on the population studied; this is unknown in our environment. Norn and cols. performed studied a group of 400 patients and the prevalence was of 48%. Galvis and cols. described a prevalence of 42.1% in a 128 patient study. Both describe similar results as those described in our study (44%). [ABSTRACT FROM AUTHOR]

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Introduction: Dental bleaching is the first choice to improve smile esthetics, but, in some cases, it needs to be associated with resin composite restoration to obtain a satisfactory result. Unfortunately, the bonding of resin-based materials can be impaired due to residual oxygen molecules, which can decrease the durability of the restoration., Objectives: To evaluate the effect of the antioxidant application on the bond strength of bleached enamel after 24 hr and 3 years of water storage., Methods: In total, 84 bovine teeth were used in this study. Of these, 77 were bleached with 35% hydrogen peroxide in a single session for three cycles of 15 min. Then, the specimens were divided into groups ( n  = 7 each): control (without bleaching), without antioxidant (WA) use; application of 10% sodium ascorbate (SA) gel, grape seed (GS) extract, and aloe vera (AV). The restorative procedure was performed immediately after bleaching, 7 and 14 days after bleaching. Specimens were sectioned and evaluated using microtensile bond strength ( μ TBS). Half of the resin-enamel sticks were tested after 24 hr, and the remaining half after 3 years of water storage. µ TBS data were analyzed using a three-way analysis of variance, Tukey's test, and Dunnett's test., Results: The lowest µ TBS values were observed when the restoration was performed immediately after bleaching in the AV, GS, and WA groups when compared with the SA group ( p < 0.005). However, no significant differences were observed among all groups after 3 years of water storage ( p < 0.001)., Conclusions: SA at 10% was the most effective antioxidant agent for improving the immediate bond strength. However, independent of the antioxidant agent used, the bond strength values were maintained or recovered after 3 years of water storage. SA at 10% could be used to avoid delayed bonding procedures after in-office whitening without compromising bond strength over time. Clinical Significance . The use of antioxidants after dental bleaching can be effective in improving the bonding durability of the adhesive restorations., Competing Interests: The authors declare that they have no conflicts of interest., (Copyright © 2023 Alexandra Mena-Serrano et al.)

Bundled Payments for Care Improvement-Advanced Program (BPCI-A) is designed to pay a single payment covering services provided during an episode of care. Sepsis is associated with increased readmissions, mortality, and health care costs. The purpose of the study was to evaluate the BPCI program patients with sepsis who were readmitted within 90 days versus not readmitted. This was a retrospective cohort study including 271 (110 readmitted) patients enrolled in the BPCI program with Diagnostic-Related Grouping codes of septicemia or severe sepsis. Skin/soft tissue infection was the most common infection. There was a significant difference between the groups for resource needs at discharge including wound care (25.45% versus 11.18%; P = 0.002) and physical therapy (74.55% versus 57.14%; P = 0.004). Mortality was higher among readmissions, 43.64% versus 26.71% no readmission ( P = 0.004). Identifying risk factors for readmission, providing appropriate resources, and follow-up may contribute to improved patient outcomes for patients with sepsis enrolled in the BPCI program., (Copyright © 2022 the American College of Medical Quality.)

Marine alkaloids comprise a class of compounds with several nitrogenated structures that can be explored as potential natural bioactive compounds. The scientific interest in these compounds has been increasing in the last decades, and many studies have been published elucidating their chemical structure and biological effects in vitro. Following this trend, the number of in vivo studies reporting the health-related properties of marine alkaloids has been increasing and providing more information about the effects in complex organisms. Experiments with animals, especially mice and zebrafish, are revealing the potential health benefits against cancer development, cardiovascular diseases, seizures, Alzheimer's disease, mental health disorders, inflammatory diseases, osteoporosis, cystic fibrosis, oxidative stress, human parasites, and microbial infections in vivo. Although major efforts are still necessary to increase the knowledge, especially about the translation value of the information obtained from in vivo experiments to clinical trials, marine alkaloids are promising candidates for further experiments in drug development.

Rapid population growth and increasing food demand have impacts on the environment due to the generation of residues, which could be managed using sustainable solutions such as the circular economy strategy (waste generated during food processing must be kept within the food chain). Reusing discarded fish remains is part of this management strategy, since they contain high-value ingredients and bioactive compounds that can be used for the development of nutraceuticals and functional foods. Fish side streams such as the head, liver, or skin or the cephalothorax, carapace, and tail from shellfish are important sources of oils rich in omega-3. In order to resolve the disadvantages associated with conventional methods, novel extraction techniques are being optimized to improve the quality and the oxidative stability of these high-value oils. Positive effects on cardiovascular and vision health, diabetes, cancer, anti-inflammatory and neuroprotective properties, and immune system improvement are among their recognized properties. Their incorporation into different model systems could contribute to the development of functional foods, with market benefits for consumers. These products improve the nutritional needs of specific population groups in a scenario where noncommunicable diseases and pandemic crises are responsible for several deaths worldwide.

Primary microcephaly is caused by mutations in genes encoding centrosomal proteins including WDR62 and KIF2A. However, mechanisms underlying human microcephaly remain elusive. By creating mutant mice and human cerebral organoids, here we found that WDR62 deletion resulted in a reduction in the size of mouse brains and organoids due to the disruption of neural progenitor cells (NPCs), including outer radial glia (oRG). WDR62 ablation led to retarded cilium disassembly, long cilium, and delayed cell cycle progression leading to decreased proliferation and premature differentiation of NPCs. Mechanistically, WDR62 interacts with and promotes CEP170's localization to the basal body of primary cilium, where CEP170 recruits microtubule-depolymerizing factor KIF2A to disassemble cilium. WDR62 depletion reduced KIF2A's basal body localization, and enhanced KIF2A expression partially rescued deficits in cilium length and NPC proliferation. Thus, modeling microcephaly with cerebral organoids and mice reveals a WDR62-CEP170-KIF2A pathway promoting cilium disassembly, disruption of which contributes to microcephaly.

Introduction: It is essential that orthopaedic resident physicians be highly proficient in all aspects, considering the balance between supply, demand, need and context. Fundamental to identify the capacity and quality installed for their training in Mexico., Material and Methods: Observational Study, transverse, non-probabilistic sampling-conglomerates, in two phases. The instrument has 8 domains, 57 variables and 4,867 items. 60 graduate professors of 20 states, 50 hospital sites, 22 university programs., Results: 1,038 years of experience (collective intelligence), 17 years of experience/teacher (01 to 50 years). Identified: acute pathology 30 (2 to 90%), chronic pathology 30 (5 to 96%), patients 15 years, 10 (3 to 30%), patients between 15 and 65 years, 47 (2 to 78%), patients 65 years, 20 (2 to 60%), number of beds/seat 20 (2 to 510), number of clinics 3 (1 to 48), number of surgical procedures/headquarters per year at the national level, was 960 (50 to 24,650). The national average per resident doctor is 362 surgeries/year with 1,450 surgical times/year., Conclusions: The needs and resources for the training of physicians specializing in orthopedics/traumatology are highly heterogeneous, so it should be adapted to the epidemiological needs of the region of influence, in an area of epidemiological transition. 62.2% expressed not having or have bad academic and scientific infrastructure at its headquarters, more than 50% without rotation overseas and 90% without regular scientific production.

Objectives: To evaluate a new ultrasound sign, pleural irregularity (PI), for the study of interstitial lung disease (ILD) in patients with systemic sclerosis (SSc) and antisynthetase syndrome (ASS)., Methods: The study included patients from our SSc and ASS cohorts with varying degrees of ILD, enrolled from 2011 to 2014. Chest high-resolution computed tomography (HRCT), pulmonary function tests (FVC and DLCO) and chest sonography were performed in each patient. Ultrasound PI and B-lines were quantified using a 72-sonographic point score and HRCT lung abnormalities were quantified using Warrick and Wells scores and categorised through Goh's algorithm. PI was correlated with HRCT and pulmonary function test parameters and its diagnostic performance to detect and classify the extent of ILD was evaluated and compared with B-lines., Results: Thirty-seven patients were studied, 21 with ASS and 16 with SSc (8 without ILD). PI correlated with the Warrick score both in SSc (r=0.6, p=0.01) and ASS patients (r=0.6, p=0.005), showing a higher performance to detect ILD than using B-lines (p=0.01). In SSc patients PI also correlated with Wells score (r=0.7, p<0.001) and with DLCO (r=-0.5, p=0.05), showing a high diagnostic value for detecting ILD (AUC=0.85, 95% CI 0.64-1) and classifying it into limited or extensive (AUC=0.81, 95% CI 0.57-1). A modification of the Goh algorithm including PI was developed as a screening tool to avoid the use of HRCT in SSc patients without ultrasound evidence of extensive ILD., Conclusions: PI is useful for evaluation of ILD in SSc and ASS patients, and can be incorporated into a diagnostic algorithm in SSc patients to reducing the need for exposure to ionising radiation.

Background: In many centers patients are hospitalised to perform a renal allograft biopsy., Aim: To evaluate the safety and efficacy of outpatient renal allograft biopsies., Methods: Since December 2011 we perform renal allograft biopsies as an outpatient procedure. Exclusion criteria for performing an outpatient biopsy included: 1.) anticoagulant treatment, 2.) thrombocytopenia &lt;50,000/mm3, 3.) body mass index &gt;35kg/m2 and 4.) uncontrolled hypertension. The number and severity of complications were compared with an historical cohort of 124 biopsies done between 2007 and 2011 when all patients were hospitalised for the procedure and with 42 patients biopsied during hospitalisation between 2011 and 2013., Results: Between 2011 and 2013, 210 (95%) out of 230 biopsies indicated in the outclinic were performed as an outpatient procedure (95%). The incidence of major complications (bleeding requiring blood transfusion and/or embolisation) was 0.8% between 2007 and 2011 and 2.4% in biopsies between 2011 and 2013 in hospitalised patients (p=0.475). No major complications were observed in the outpatient biopsy group. Minor complications (hematuria, hematoma or fistula not requiring transfusion or embolisation) were also not different between groups (3.2%, 7.1% and 2.7%; respectively). Sample size adequacy according to the Banff criteria was not different among groups (p=0.052)., Conclusion: Ambulatory renal allograft biopsy is a safe and efficient procedure.

Objectives: Interstitial lung disease is a common finding in patients with the antisynthetase syndrome. High-resolution computed tomography is the reference test for diagnosis and follow-up of this condition, but it involves considerable radiation exposure. Our aim was to describe chest ultrasound features and its correlation with high-resolution computed tomography findings in a series of patients with the antisynthetase syndrome., Methods: The study included patients from our antisynthetase syndrome cohort with varying degrees of interstitial lung disease, consulting in our outpatient clinic over a 1-year period. Chest high-resolution computed tomography and chest sonography were prospectively performed within a 1-week period. High-resolution computed tomography Warrick score was calculated and chest sonography findings (B-lines) at several sonographic points along the anterior and posterior intercostal spaces were semi-quantitatively analyzed. Rho Spearman statistics were applied for possible correlations., Results: Twenty-one consecutive patients were studied. A median of 59 thoracic points was studied per patient (IQR 6); 44.1% (95% CI 29.9-60.7) of them showed at least one B-line. A correlation coefficient of 0.135 (p=0.5) was found between the percentage of ultrasound points with B-lines and the Warrick's score. Only the number of bronchopulmonary segments showing ground glass findings was associated with the percentage of sonographic points with B-lines (Rho=0.5, p=0.02)., Conclusions: A good correlation between the percentage of sonographic points with B-lines and high-resolution computed tomography ground glass opacities was observed in patients with the antisynthetase syndrome.

There have been quite a few attempts in recent years to provide an initial value coherent state representation for the imaginary time propagator exp(-betaH). The most notable is the recent time evolving Gaussian approximation of Frantsuzov and Mandelshtam [J. Chem. Phys. 121, 9247 (2004)] which may be considered as an expansion of the imaginary time propagator in terms of coherent states whose momentum is zero. In this paper, a similar but different expression is developed in which exp(-betaH) is represented in a series whose terms are weighted phase space averages of coherent states. Such a representation allows for the formulation of a new and simplified forward-backward semiclassical initial value representation expression for thermal correlation functions.

A numerical solution for the quantum dynamics of the spin boson problem is obtained using the semiclassical initial value series representation approach to the quantum dynamics. The zeroth order term of the series is computed using the new forward-backward representation for correlation functions presented in the preceding adjacent paper. This leads to a rapid convergence of the Monte Carlo sampling, as compared to previous attempts. The zeroth order results are already quite accurate. The first order term of the series is small, demonstrating the rapid convergence of the semiclassical initial value representation series. This is the first time that the first order term in the semiclassical initial value representation series has been converged for systems with the order of 50 degrees of freedom.

The forward-backward (FB) approximation as applied to semiclassical initial value representations (SCIVR's) has enabled the practical application of the SCIVR methodology to systems with many degrees of freedom. However, to date a systematic representation of the exact quantum dynamics in terms of the FB-SCIVR has proven elusive. In this paper, we provide a new derivation of a forward-backward phase space SCIVR expression (FBPS-SCIVR) derived previously by Thompson and Makri [Phys. Rev. E 59, R4729 (1999)]. This enables us to represent quantum correlation functions exactly in terms of a series whose leading order term is the FBPS-SCIVR expression. Numerical examples for systems with over 50 degrees of freedom are presented for the spin boson problem. Comparison of the FBPS-SCIVR with the numerically exact results of Wang [J. Chem. Phys. 113, 9948 (2000)] obtained using a multiconfigurational time dependent method shows that the leading order FBPS-SCIVR term already provides an excellent approximation.

A case of Ramsay-Hunt syndrome has been studied with pre- and postcontrast MR imaging, using a three-dimensional Fourier transform fast imaging with steady precession sequence with axially oriented sections and coronal reformatted images. A clear demonstration of the abnormal enhancement of the labyrinth and of the intratemporal cranial nerves was obtained. This demonstration assisted us in establishing the diagnosis of Ramsay-Hunt syndrome.

Herein we describe two additional cases of non-acquired arteriovenous renal fistula, one was congenital or cirsoid and the other was idiopathic or aneurysmal. Patient clinical work up prompted us to suspect this condition which was confirmed by renal arteriography. The usefulness of the diagnostic tests are highlighted and the incidence and management of this type of vascular malformation are discussed.