Retinoscopía estática: variabilidad interobservadores entre docentes y estudiantes de optometría en una institución universitaria de Bogotá D.C.

Introducción: el gold estándar para el error refractivo es la retinoscopía. Los docentes de optometría al evaluar estudiantes, aceptan una diferencia de ±0,50D en la refracción pero no se ha evaluado estadísticamente si es adecuado para ametropías bajas y altas. El objetivo fue cuantificar el grado de concordancia interobservadores en retinoscopía estática entre docentes y estudiantes, para ametropías altas y bajas. Metodología: estudio de concordancia entre 4 observadores en 40 ojos, 20 con ametropías altas y 20 con bajas; muestreo no probabilístico por conveniencia. Análisis estadístico con coeficiente de correlación intraclase, confiabilidad 95%, poder 90%, y con método gráfico de límites de acuerdo al 95%. Resultados: concordancia para el equivalente esférico entre docentes 0,96 y entre estudiantes 0,56. En estudiantes concordancia de 0,89 para defectos refractivos bajos y docentes 0,96 para defectos altos. Concordancia entre cuatro examinadores 0,78, defectos bajos 0,86 y para altos 0,67. Margen de error entre docentes ±0,87D y estudiantes ±3,15D. En defectos bajos ±0,61D para docentes y ±0,80D para estudiantes y en defectos altos ±1,10D y ±4,22D respectivamente. Discusión: hubo mayor confiabilidad en retinoscopía entre profesionales experimentados. Se comparó la concordancia entre docentes y estudiantes, por eso puede haberse encontrado menor concordancia que la descrita por otros estudios que compararon entre profesionales a pesar haber sido elegidos por sus buenas calificaciones. Se deben formular estrategias de enseñanza que permitan reducir los márgenes de error obtenidos y mejorar la concordancia entre docentes y estudiantes.

Evaluación a largo plazo en mujeres tratadas con laser para depilación facial en uniláser medica

El vello facial no deseado es un problema común en las mujeres, los tratamientos láser han mostrado efectividad para su manejo. Objetivo: Evaluar los resultados de la depilación láser en cara de las pacientes tratadas a largo plazo (20 sesiones o más ) luego de un seguimiento de 6 meses durante los años 1997 y 2012. Metodología: 55 mujeres que con tipo de piel II a V recibieron 20 o más sesiones de láser con seguimiento mayor a 6 meses posterior al la última sesión. Resultados: la edad promedio fue (32 ± 9,3 años), el 18,2 % presentaban SOP o Hiperandrogenismo el número de sesiones en cara fue de (30,84 ± 12,132), un promedio de disparos de (6,330 ± 7,804), los Kilojulios acumulados tuvieron un promedio de (126,5 ± 161,4) la fluencia promedio fue (18,5 ± 3,2 Julios/cm2), el láser de Alexandrita fue utilizado en el 98% de las pacientes. Se encontró cambios significativos entre el conteo inicial y el final de vello facial (484,9 ± 568.9 (med=300) vs. 103,33± 138,63 (med=60), p<0.001, Test de Wilcoxon). El 32.7% mostraron reducción > 90% (5,5% reducción del 100%). Conclusión : El tratamiento con de depilación con láser mostro una reducción significativa del vello facial, en mujeres mayores de 14 años con un tratamiento a largo plazo (20 sesiones o más), con una tasa de reducción mayor del 90% en 32.7% de las pacientes y un promedio de reducción del grupo de 79,36 ±15,51 %, similar a lo reportado en los diferentes estudios (77%).

Seguridad de los antipsicoticos en embarazo en pacientes con psicosis. Revisión sistemática

Enfermedades mentales de tipo psicótico en gestantes se han asociado con mayor número de resultados negativos. Los síntomas psicóticos durante el embarazo se presentan aproximadamente 7.1 por 100.000 casos. Dentro de las consecuencias se incluye mayor riesgo de parto pretérmino, bajo peso al nacer, alteraciones placentarias, malformaciones congénitas de predominio cardiovascular y mayor tasa de muertes perinatales. Como abordaje terapéutico son frecuentes los antipsicóticos de primera generación, aceptados como seguros pero en menor grado se han considerados los antipsicóticos de segunda generación pues ha sido escasamente evaluada su seguridad durante la gestación. Aún existe controversia sobre los potenciales efectos secundarios de algunos antipsicóticos dado los resultados contradictorios. Métodos: Revisión sistemática de la literatura de artículos que proporcionaron mejor evidencia para determinar cuáles antipsicóticos de elección durante la gestación en pacientes con esquizofrenia de acuerdo a su perfil de seguridad. Se evaluó calidad metodológica reconociendo particularidades y resultados de los estudios incluidos. Resultados: De 39 estudios seleccionados, cinco fueron incluidos en esta revisión, clasificándose como nivel de evidencia IIa y evaluados según su calidad metodológica con escala NOS. Se evaluó paso placentario de antipsicóticos, malformaciones fetales, complicaciones obstétricas como parto pretérmino, bajo y alto peso fetal, complicaciones respiratorias, diabetes gestacional, aborto espontáneo, entre otros. Discusión: Se debe sopesar el riesgo-beneficio, la significancia estadística, la significancia clínica y las particularidades de las pacientes a tratar. Conclusión: Los estudios analizados evaluaron diferentes medicamentos antipsicóticos, dificultando consolidación de información en especial en conclusiones solidas ante algunas premisas como fármacos de elección.

Hipotensión arterial y variabilidad de la frecuencia cardiaca en pacientes embarazadas llevadas a cesarea bajo anestesia raquídea

INTRODUCCION La hipotensión arterial por anestesia raquídea en embarazadas llevadas a cesárea es frecuente y deletérea para la madre y el feto, sin que a la fecha exista una herramienta clínicamente útil para predecirla. La variabilidad de la frecuencia cardiaca es una medida que estima la actividad del sistema nervioso autónomo y algunos estudio iniciales indican una posible utilidad como herramienta predictiva de hipotensión arterial en esta población. METODOLOGIA Se realizó un estudio observacional descriptivo para examinar el comportamiento de la variabilidad de la frecuencia cardiaca, medida como razón de Baja frecuencia/Alta frecuencia, con un punto de corte de 2.5 tomada con un reloj POLAR RS800CX, en una población de pacientes con embarazo a término llevadas a cesárea, en un hospital de tercer nivel en Bogotá- Colombia entre Febrero y Abril del 2015. RESULTADOS El estudio incluyó 82 pacientes. Se determinó que la razón Baja frecuencia/Alta frecuencia mayor a 2,5 era poco frecuente en nuestra población (15.85%), y su asociación no fue significativa. DISCUSION El presente estudio demostró que la asociación entre la presencia de hipotensión y un índice Baja frecuencia/Alta frecuencia con punto de corte de 2.5 no es significativo para nuestra población de mujeres con embarazo a término llevadas a cesárea con anestesia espinal. Según los resultados se sugieres un punto de corte de 1.6 como punto de partida para la realización de nuevos estudios que permitan validar este valor.

Mapping fibre orientation in complex-shaped biological systems with micrometre resolution by scanning X-ray microdiffraction

A fully automated procedure to extract and to image local fibre orientation in biological tissues from scanning X-ray diffraction is presented. The preferred chitin fibre orientation in the flow sensing system of crickets is determined with high spatial resolution by applying synchrotron radiation based X-ray microbeam diffraction in conjunction with advanced sample sectioning using a UV micro-laser. The data analysis is based on an automated detection of azimuthal diffraction maxima after 2D convolution filtering (smoothing) of the 2D diffraction patterns. Under the assumption of crystallographic fibre symmetry around the morphological fibre axis, the evaluation method allows mapping the three-dimensional orientation of the fibre axes in space. The resulting two-dimensional maps of the local fibre orientations - together with the complex shape of the flow sensing system - may be useful for a better understanding of the mechanical optimization of such tissues.

Link between DOC in near surface peat and stream water in an upland catchment

Hydrologic transport of dissolved organic carbon (DOC) from peat soils may differ to organo-mineral soils in how they responded to changes in flow, because of differences in soil profile and hydrology. In well-drained organo-mineral soils, low flow is through the lower mineral layer where DOC is absorbed and high flow is through the upper organic layer where DOC is produced. DOC concentrations in streams draining organo-mineral soils typically increase with flow. In saturated peat soils, both high and low flows are through an organic layer where DOC is produced. Therefore, DOC in stream water draining peat may not increase in response to changes in flow as there is no switch in flow path between a mineral and organic layer. To verify this, we conducted a high-resolution monitoring study of soil and stream water at an upland peat catchment in northern England. Our data showed a strong positive correlation between DOC concentrations at − 1 and − 5 cm depth and stream water, and weaker correlations between concentrations at − 20 to − 50 cm depth and stream water. Although near surface organic material appears to be the key source of stream water DOC in both peat and organo-mineral soils, we observed a negative correlation between stream flow and DOC concentrations instead of a positive correlation as DOC released from organic layers during low and high flow was diluted by rainfall. The differences in DOC transport processes between peat and organo-mineral soils have different implications for our understanding of long-term changes in DOC exports. While increased rainfall may cause an increase in DOC flux from peat due to an increase in water volume, it may cause a decrease in concentrations. This response is contrary to expected changes in DOC exports from organo-mineral soils, where increase rainfall is likely to result in an increase in flux and concentration.

The surface geometry of carbon monoxide and oxygen co-adsorbed on Ni{111}

Low energy electron diffraction (LEED) structure determinations have been performed for the p(2 x 2) structures of pure oxygen and oxygen co-adsorbed with CO on Ni{111}. Optimisation of the non-geometric parameters led to very good agreement between experimental and theoretical IV-curves and hence to a high accuracy in the structural parameters. In agreement with earlier work atomic oxygen is found to adsorb on fee sites in both structures. In the co-adsorbed phase CO occupies atop sites. The positions of the substrate atoms are almost identical, within 0.02 Angstrom, in both structures, implying that the interaction with oxygen dominates the arrangement of Ni atoms at the surface.

Night-time tropospheric chemistry of the unsaturated alcohols (Z)-pent-2-en-1-ol and pent-1-en-3-ol: Kinetic studies of reactions of NO3 and N2O5 with stress-induced plant emissions

The night-time tropospheric chemistry of two stress-induced volatile organic compounds (VOCs), (Z)-pent-2-en-1-ol and pent-1-en-3-ol, has been studied at room temperature. Rate coefficients for reactions of the nitrate radical (NO3) with these pentenols were measured using the discharge-flow technique. Because of the relatively low volatility of these compounds, we employed off-axis continuous-wave cavity-enhanced absorption spectroscopy for detection of NO3 in order to be able to work in pseudo first-order conditions with the pentenols in large excess over NO3. The rate coefficients were determined to be (1.53 +/- 0.23) x 10(-13) and (1.39 +/- 0.19) x 10(-14) cm(3) molecule(-1) s(-1) for reactions of NO3 with (Z)-pent-2-en-1-ol and pent-1-en-3-ol. An attempt to study the kinetics of these reactions with a relative-rate technique, using N2O5 as source of NO3 resulted in significantly higher apparent rate coefficients. Performing relative-rate experiments in known excesses of NO2 allowed us to determine the rate coefficients for the N2O5 reactions to be (5.0 +/- 2.8) x 10(-19) cm(3) molecule(-1) s(-1) for (Z)-pent-2-en-1-ol, and (9.1 +/- 5.8) x 10(-19) cm(3) molecule(-1) s(-1) for pent-1-en-3-ol. We show that these relatively slow reactions can indeed interfere with rate determinations in conventional relative-rate experiments.

Final warming of the Southern Hemisphere polar vortex in high- and low-top CMIP5 models

The final warming date of the polar vortex is a key component of Southern Hemisphere stratospheric and tropospheric variability in spring and summer. We examine the effect of external forcings on Southern Hemisphere final warming date, and the sensitivity of any projected changes to model representation of the stratosphere. Final warming date is calculated using a temperature-based diagnostic for ensembles of high- and low-top CMIP5 models, under the CMIP5 historical, RCP4.5, and RCP8.5 forcing scenarios. The final warming date in the models is generally too late in comparison with those from reanalyses: around two weeks too late in the low-top ensemble, and around one week too late in the high-top ensemble. Ensemble Empirical Mode Decomposition (EEMD) is used to analyse past and future change in final warming date. Both the low- and high-top ensemble show characteristic behaviour expected in response to changes in greenhouse gas and stratospheric ozone concentrations. In both ensembles, under both scenarios, an increase in final warming date is seen between 1850 and 2100, with the latest dates occurring in the early twenty-first century, associated with the minimum in stratospheric ozone concentrations in this period. However, this response is more pronounced in the high-top ensemble. The high-top models show a delay in final warming date in RCP8.5 that is not produced by the low-top models, which are shown to be less responsive to greenhouse gas forcing. This suggests that it may be necessary to use stratosphere resolving models to accurately predict Southern Hemisphere surface climate change.

The surprising role of orography in the initiation of an isolated thunderstorm in southern England

Many factors, both mesoscale and larger scale, often come together in order for a particular convective initiation to take place. The authors describe a modeling study of a case from the Convective Storms Initiation Project (CSIP) in which a single thunderstorm formed behind a front in the southern United Kingdom. The key features of the case were a tongue of low-level high θw air associated with a forward-sloping split front (overrunning lower θw air above), a convergence line, and a “lid” of high static stability air, which the shower was initially constrained below but later broke through. In this paper, the authors analyze the initiation of the storm, which can be traced back to a region of high ground (Dartmoor) at around 0700 UTC, in more detail using model sensitivity studies with the Met Office Unified Model (MetUM). It is established that the convergence line was initially caused by roughness effects but had a significant thermal component later. Dartmoor had a key role in the development of the thunderstorm. A period of asymmetric flow over the high ground, with stronger low-level descent in the lee, led to a hole in a layer of low-level clouds downstream. The surface solar heating through this hole, in combination with the tongue of low-level high θw air associated with the front, caused the shower to initiate with sufficient lifting to enable it later to break through the lid.

Interface dynamics in planar neural field models

Neural field models describe the coarse-grained activity of populations of interacting neurons. Because of the laminar structure of real cortical tissue they are often studied in two spatial dimensions, where they are well known to generate rich patterns of spatiotemporal activity. Such patterns have been interpreted in a variety of contexts ranging from the understanding of visual hallucinations to the generation of electroencephalographic signals. Typical patterns include localized solutions in the form of traveling spots, as well as intricate labyrinthine structures. These patterns are naturally defined by the interface between low and high states of neural activity. Here we derive the equations of motion for such interfaces and show, for a Heaviside firing rate, that the normal velocity of an interface is given in terms of a non-local Biot-Savart type interaction over the boundaries of the high activity regions. This exact, but dimensionally reduced, system of equations is solved numerically and shown to be in excellent agreement with the full nonlinear integral equation defining the neural field. We develop a linear stability analysis for the interface dynamics that allows us to understand the mechanisms of pattern formation that arise from instabilities of spots, rings, stripes and fronts. We further show how to analyze neural field models with linear adaptation currents, and determine the conditions for the dynamic instability of spots that can give rise to breathers and traveling waves.

Dynamical complexity in a mean-field model of human EEG

A recently proposed mean-field theory of mammalian cortex rhythmogenesis describes the salient features of electrical activity in the cerebral macrocolumn, with the use of inhibitory and excitatory neuronal populations (Liley et al 2002). This model is capable of producing a range of important human EEG (electroencephalogram) features such as the alpha rhythm, the 40 Hz activity thought to be associated with conscious awareness (Bojak & Liley 2007) and the changes in EEG spectral power associated with general anesthetic effect (Bojak & Liley 2005). From the point of view of nonlinear dynamics, the model entails a vast parameter space within which multistability, pseudoperiodic regimes, various routes to chaos, fat fractals and rich bifurcation scenarios occur for physiologically relevant parameter values (van Veen & Liley 2006). The origin and the character of this complex behaviour, and its relevance for EEG activity will be illustrated. The existence of short-lived unstable brain states will also be discussed in terms of the available theoretical and experimental results. A perspective on future analysis will conclude the presentation.

Large-scale two-dimensional turbulence in the atmosphere

Global FGGE data are used to investigate several aspects of large-scale turbulence in the atmosphere. The approach follows that for two-dimensional, nondivergent turbulent flows which are homogeneous and isotropic on the sphere. Spectra of kinetic energy, enstrophy and available potential energy are obtained for both the stationary and transient parts of the flow. Nonlinear interaction terms and fluxes of energy and enstrophy through wavenumber space are calculated and compared with the theory. A possible method of parameterizing the interactions with unresolved scales is considered. Two rather different flow regimes are found in wavenumber space. The high-wavenumber regime is dominated by the transient components of the flow and exhibits, at least approximately, several of the conditions characterizing homogeneous and isotropic turbulence. This region of wavenumber space also displays some of the features of an enstrophy-cascading inertial subrange. The low-wavenumber region, on the other hand, is dominated by the stationary component of the flow, exhibits marked anisotropy and, in contrast to the high-wavenumber regime, displays a marked change between January and July.

Intra-crystalline protein diagenesis (IcPD) in Patella vulgata. Part II: Breakdown and temperature sensitivity

Artificial diagenesis of the intra-crystalline proteins isolated from Patella vulgata was induced by isothermal heating at 140 °C, 110 °C and 80 °C. Protein breakdown was quantified for multiple amino acids, measuring the extent of peptide bond hydrolysis, amino acid racemisation and decomposition. The patterns of diagenesis are complex; therefore the kinetic parameters of the main reactions were estimated by two different methods: 1) a well-established approach based on fitting mathematical expressions to the experimental data, e.g. first-order rate equations for hydrolysis and power-transformed first-order rate equations for racemisation; and 2) an alternative model-free approach, which was developed by estimating a “scaling” factor for the independent variable (time) which produces the best alignment of the experimental data. This method allows the calculation of the relative reaction rates for the different temperatures of isothermal heating. High-temperature data were compared with the extent of degradation detected in sub-fossil Patella specimens of known age, and we evaluated the ability of kinetic experiments to mimic diagenesis at burial temperature. The results highlighted a difference between patterns of degradation at low and high temperature and therefore we recommend caution for the extrapolation of protein breakdown rates to low burial temperatures for geochronological purposes when relying solely on kinetic data.

Televised Whorf: cognitive restructuring in advanced foreign language learners as a function of audio-visual media exposure

The encoding of goal-oriented motion events varies across different languages. Speakers of languages without grammatical aspect (e.g., Swedish) tend to mention motion endpoints when describing events, e.g., “two nuns walk to a house,”, and attach importance to event endpoints when matching scenes from memory. Speakers of aspect languages (e.g., English), on the other hand, are more prone to direct attention to the ongoingness of motion events, which is reflected both in their event descriptions, e.g., “two nuns are walking.”, and in their non-verbal similarity judgements. This study examines to what extent native speakers of Swedish (n = 82) with English as a foreign language (FL) restructure their categorisation of goal-oriented motion as a function of their English proficiency and experience with the English language (e.g., exposure, learning). Seventeen monolingual native English speakers from the United Kingdom (UK) were engaged for comparison purposes. Data on motion event cognition were collected through a memory-based triads matching task, in which a target scene with an intermediate degree of endpoint orientation was matched with two alternative scenes with low and high degrees of endpoint orientation, respectively. Results showed that the preference among the Swedish speakers of L2 English to base their similarity judgements on ongoingness rather than event endpoints was correlated with their use of English in their everyday lives, such that those who often watched television in English approximated the ongoingness preference of the English native speakers. These findings suggest that event cognition patterns may be restructured through the exposure to FL audio-visual media. The results thus add to the emerging picture that learning a new language entails learning new ways of observing and reasoning about reality.