65 research outputs found

    Size dependence of second-order hyperpolarizability of finite periodic chain under Su-Schrieffer-Heeger model

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    The second hyperpolarizability γN(−3ωω,ω,ω)\gamma_N(-3\omega\omega,\omega,\omega) of NN double-bond finite chain of trans-polyactylene is analyzed using the Su-Schrieffer-Heeger model to explain qualitative features of the size-dependence behavior of γN\gamma_N. Our study shows that γN/N\gamma_N/N is {\it nonmonotonic} with NN and that the nonmonotonicity is caused by the dominant contribution of the intraband transition to γN\gamma_N in polyenes. Several important physical effects are discussed to reduce quantitative discrepancies between experimental and our resultsComment: 3 figures, 1 tabl

    Niemann-Pick disease type-B: a unique case report with compound heterozygosity and complicated lipid management

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    BACKGROUND: Niemann-Pick disease (NPD) is a rare autosomal recessive hereditary disease characterized by deficient activity of acid sphingomyelinase. CASE PRESENTATION: We present a case of NPD type B with a unique compound heterozygosity for SMPD1 (NM_000543.4:c.[84delC];[96G¿>¿A]) in which both mutations that induce an early stop codon are located before the second in-frame initiation codon. The clinical presentation of the patient is compatible with NPD type B. She was initially diagnosed of Gaucher Disease, but her altered lipid profile led to a clinical suspicion of NPD. Combined high doses of atorvastatin and ezetimibe were given to treat the severe hypercholesterolemia. CONCLUSIONS: The pharmacological management of the lipid profile in these patients is important. A unique compound mutation in SMPD1 gene is described

    Conociendo a los tutores de Medicina Interna: nuevas necesidades para la formación

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    Introducción y objetivos Los tutores son los responsables de planificar el aprendizaje de los residentes. El objetivo de este trabajo es conocer la situación de los tutores de Medicina Interna en España y detectar áreas de mejora que puedan facilitar su trabajo. Material y métodos Encuestas online a tutores de Medicina Interna de mayo a julio de 2017 con análisis posterior de los datos. Resultados Respondieron 110 tutores, de 13 comunidades autónomas y hospitales de todos los niveles con docencia en Medicina Interna. Sesenta y tres fueron hombres (57, 3%), la media de edad fue de 48 años y tenían una experiencia como tutores de 8, 5 años. En el 88, 2% de los casos se respeta la ratio de cinco residentes por tutor; un 46% piensa que debería disminuirse esta ratio para optimizar su labor. Un tercio había sido elegido por el responsable del servicio y el 30% nunca ha realizado cursos sobre formación. La entrevista tutor-residentes es utilizada por la mayoría de los tutores (96, 4%) como herramienta de comunicación. En relación a las rotaciones, la cuarta parte no son planificadas por los tutores y, solo la mitad, contacta con los centros donde los residentes realizan las rotaciones externas. El 61% cree que no se realiza bien la evaluación de residentes, con muy escasa utilización de las nuevas herramientas de evaluación. Conclusiones Disminuir la ratio tutor/residente y la formación en técnicas de evaluación y desarrollo del aprendizaje podría mejorar la calidad de la tutorización. Introduction and objectives: Mentors are responsible for planning the residents’ learning. The aim of this study was to determine the situation of internal medicine mentors in Spain and detect areas of improvement that can facilitate their work. Material and methods: Online surveys were sent to internal medicine mentors from May to July 2017, the results of which were subsequently analysed. Results: A total of 110 mentors from 13 autonomous communities and from hospitals of all levels with courses in internal medicine responded to the survey. Of these mentors, 63 were men (57.3%), and the mean age was 48 years. The mean experience as mentors was 8.5 years. Some 88.2% of the cases had a ratio of 5 residents to 1 mentor; 46% of the mentors believed this ratio should be decreased to optimize their work. A third of the mentors were chosen by the heads of the department, and 30% had not previously taken courses on training. The mentor-resident interview was used by most mentors (96.4%) as a communication tool. A quarter of the rotations were not planned by the mentors, and only half had contact with the centres where the residents performed the external rotations. Sixty-one percent of the mentors were of the opinion that resident assessments were not conducted properly, with very little use of the new assessment tools. Conclusions: Reducing the mentor-resident ratio and adding training in assessment techniques and learning development could improve the quality of the mentoring

    Factors contributing to attrition behavior in diabetes self-management programs: A mixed method approach

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    <p>Abstract</p> <p>Background</p> <p>Diabetes self-management education is a critical component in diabetes care. Despite worldwide efforts to develop efficacious DSME programs, high attrition rates are often reported in clinical practice. The objective of this study was to examine factors that may contribute to attrition behavior in diabetes self-management programs.</p> <p>Methods</p> <p>We conducted telephone interviews with individuals who had Type 2 diabetes (n = 267) and attended a diabetes education centre. Multivariable logistic regression was performed to identify factors associated with attrition behavior. Forty-four percent of participants (n = 118) withdrew prematurely from the program and were asked an open-ended question regarding their discontinuation of services. We used content analysis to code and generate themes, which were then organized under the Behavioral Model of Health Service Utilization.</p> <p>Results</p> <p>Working full and part-time, being over 65 years of age, having a regular primary care physician or fewer diabetes symptoms were contributing factors to attrition behaviour in our multivariable logistic regression. The most common reasons given by participants for attrition from the program were conflict between their work schedules and the centre's hours of operation, patients' confidence in their own knowledge and ability when managing their diabetes, apathy towards diabetes education, distance to the centre, forgetfulness, regular physician consultation, low perceived seriousness of diabetes, and lack of familiarity with the centre and its services. There was considerable overlap between our quantitative and qualitative results.</p> <p>Conclusion</p> <p>Reducing attrition behaviour requires a range of strategies targeted towards delivering convenient and accessible services, familiarizing individuals with these services, increasing communication between centres and their patients, and creating better partnerships between centres and primary care physicians.</p

    Diversity, Phylogeny and Expression Patterns of Pou and Six Homeodomain Transcription Factors in Hydrozoan Jellyfish Craspedacusta sowerbyi

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    Formation of all metazoan bodies is controlled by a group of selector genes including homeobox genes, highly conserved across the entire animal kingdom. The homeobox genes from Pou and Six classes are key members of the regulation cascades determining development of sensory organs, nervous system, gonads and muscles. Besides using common bilaterian models, more attention has recently been targeted at the identification and characterization of these genes within the basal metazoan phyla. Cnidaria as a diploblastic sister group to bilateria with simple and yet specialized organs are suitable models for studies on the sensory organ origin and the associated role of homeobox genes. In this work, Pou and Six homeobox genes, together with a broad range of other sensory-specific transcription factors, were identified in the transcriptome of hydrozoan jellyfish Craspedacusta sowerbyi. Phylogenetic analyses of Pou and Six proteins revealed cnidarian-specific sequence motifs and contributed to the classification of individual factors. The majority of the Craspedacusta sowerbyi Pou and Six homeobox genes are predominantly expressed in statocysts, manubrium and nerve ring, the tissues with sensory and nervous activities. The described diversity and expression patterns of Pou and Six factors in hydrozoan jellyfish highlight their evolutionarily conserved functions. This study extends the knowledge of the cnidarian genome complexity and shows that the transcriptome of hydrozoan jellyfish is generally rich in homeodomain transcription factors employed in the regulation of sensory and nervous functions
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