The Portable Dynamic Fundus Instrument: Uses in telemedicine and research

For years ophthalmic photographs have been used to track the progression of many ocular diseases such as macular degeneration and glaucoma as well as the ocular manifestations of diabetes, hypertension, and hypoxia. In 1987 a project was initiated at the Johnson Space Center (JSC) to develop a means of monitoring retinal vascular caliber and intracranial pressure during space flight. To conduct telemedicine during space flight operations, retinal images would require real-time transmissions from space. Film-based images would not be useful during in-flight operations. Video technology is beneficial in flight because the images may be acquired, recorded, and transmitted to the ground for rapid computer digital image processing and analysis. The computer analysis techniques developed for this project detected vessel caliber changes as small as 3 percent. In the field of telemedicine, the Portable Dynamic Fundus Instrument demonstrates the concept and utility of a small, self-contained video funduscope. It was used to record retinal images during the Gulf War and to transmit retinal images from the Space Shuttle Columbia during STS-50. There are plans to utilize this device to provide a mobile ophthalmic screening service in rural Texas. In the fall of 1993 a medical team in Boulder, Colorado, will transmit real-time images of the retina during remote consultation and diagnosis. The research applications of this device include the capability of operating in remote locations or small, confined test areas. There has been interest shown utilizing retinal imaging during high-G centrifuge tests, high-altitude chamber tests, and aircraft flight tests. A new design plan has been developed to incorporate the video instrumentation into face-mounted goggle. This design would eliminate head restraint devices, thus allowing full maneuverability to the subjects. Further development of software programs will broaden the application of the Portable Dynamic Fundus Instrument in telemedicine and medical research

Brewer - OMI ozone comparisons in EUBREWNET

Póster elaborado para el Quadrennial Ozone Symposium celebrado en Edinburgh los días 4–9 de septiembre de 201

Aerosol optical depth in the ultraviolet range: a new product in EUBREWNET

Póster elaborado para el Quadrennial Ozone Symposium celebrado en Edinburgh los días 4–9 de septiembre de 2016The AERONET sun photometers at the Izaña station have been calibrated within the AERONET Europe TNA, supported by the European Community-Research Infrastructure Action under the FP7 ACTRIS grant agreement no. 262254

Discarded livers tested by normothermic machine perfusion in the VITTAL trial:Secondary end points and 5-year outcomes

Normothermic machine perfusion (NMP) enables pretransplant assessment of high-risk donor livers. The VITTAL trial demonstrated that 71% of the currently discarded organs could be transplanted with 100% 90-day patient and graft survivals. Here, we report secondary end points and 5-year outcomes of this prospective, open-label, phase 2 adaptive single-arm study. The patient and graft survivals at 60 months were 82% and 72%, respectively. Four patients lost their graft due to nonanastomotic biliary strictures, one caused by hepatic artery thrombosis in a liver donated following brain death, and 3 in elderly livers donated after circulatory death (DCD), which all clinically manifested within 6 months after transplantation. There were no late graft losses for other reasons. All the 4 patients who died during the study follow-up had functioning grafts. Nonanastomotic biliary strictures developed in donated after circulatory death livers that failed to produce bile with pH &gt;7.65 and bicarbonate levels &gt;25 mmol/L. Histological assessment in these livers revealed high bile duct injury scores characterized by arterial medial necrosis. The quality of life at 6 months significantly improved in all but 4 patients suffering from nonanastomotic biliary strictures. This first report of long-term outcomes of high-risk livers assessed by normothermic machine perfusion demonstrated excellent 5-year survival without adverse effects in all organs functioning beyond 1 year (ClinicalTrials.gov number NCT02740608).</p

Guidelines on the management of valvular heart disease: The Task Force on the Management of Valvular Heart Disease of the European Society of Cardiology.

80These guidelines focus on valvular heart disease in adults and adolescents, are oriented towards management, and will not deal with endocarditis and congenital valve diseases in adults and adolescents, since recent guidelines have been produced by the ESC on these topics. Although valvular heart disease is less common in industrialized countries than coronary disease, heart failure, or hypertension, guidelines are needed in this field for several reasons: valvular heart disease is common and often requires intervention; substantial advances have been made in the understanding of its pathophysiology; the patient population has changed with a continuous decline of acute rheumatic fever and an increased incidence of degenerative valvular diseases in industrialized countries. The incidence of endocarditis remains stable and other causes of valve disease are rare. Because of the predominance of degenerative valve disease, the two most frequent valve diseases are now calcific aortic stenosis and mitral regurgitation. Aortic regurgitation and mitral stenosis have become less common. Diagnosis is now dominated by echocardiography, which has become the standard to evaluate valve structure and function. Treatment has not only developed through the continuing progress in prosthetic valve technology, but has also been reoriented by the development of conservative surgical approaches and the introduction of percutaneous interventional techniques.openopenVahanian, A; Baumgartner, ; H, ; Bax, ; J, ; Butchart, ; E, ; Dion, ; R, ; Filippatos, ; G, ; Flachskampf, ; F, ; Hall, ; R, ; Iung, ; B, ; Kasprzak, ; J, ; Nataf, ; P, ; Tornos, ; P, ; Torracca, ; L, ; Wenink, ; A, ; Silvia, ; Priori, G.; Blanc, Jean-Jacques; Andrzej, ; Budaj, ; John, ; Camm, ; Veronica, ; Dean, ; Jaap, ; Deckers, ; Kenneth, ; Dickstein, ; John, ; Lekakis, ; Keith, ; Mcgregor, ; Marco, ; Metra, ; João, ; Morais, ; Ady, ; Osterspey, ; Juan, ; Tamargo, ; Luis, José; Zamorano, ; Annalisa, ; Angelini, ; Manuel, ; Antunes, ; Angel, Miguel; Fernandez, Garcia; Christa, ; Gohlke-Baerwolf, ; Gilbert, ; Habib, ; John, ; Mcmurray, ; Catherine, ; Otto, ; Luc, ; Pierard, ; Josè, ; Pomar, L.; Bernard, ; Prendergast, ; Raphael, ; Rosenhek, ; Sousa, Miguel; Uva, ; Juan, ; Tamargo,Vahanian, A; Baumgartner, ; H, ; Bax, ; J, ; Butchart, ; E, ; Dion, ; R, ; Filippatos, ; G, ; Flachskampf, ; F, ; Hall, ; R, ; Iung, ; B, ; Kasprzak, ; J, ; Nataf, ; P, ; Tornos, ; P, ; Torracca, ; L, ; Wenink, ; A, ; Silvia, ; Priori, G.; Blanc, Jean Jacques; Andrzej, ; Budaj, ; John, ; Camm, ; Veronica, ; Dean, ; Jaap, ; Deckers, ; Kenneth, ; Dickstein, ; John, ; Lekakis, ; Keith, ; Mcgregor, ; Marco, ; Metra, Marco; João, ; Morais, ; Ady, ; Osterspey, ; Juan, ; Tamargo, ; Luis, José; Zamorano, ; Annalisa, ; Angelini, ; Manuel, ; Antunes, ; Angel, Miguel; Fernandez, Garcia; Christa, ; Gohlke, Baerwolf; Gilbert, ; Habib, ; John, ; Mcmurray, ; Catherine, ; Otto, ; Luc, ; Pierard, ; Josè, ; Pomar, L.; Bernard, ; Prendergast, ; Raphael, ; Rosenhek, ; Sousa, Miguel; Uva, ; Juan, ; Tamargo

Presidential Commission on the Supreme Court of the United States Final Report

On April 9, 2021, President Joseph R. Biden, Jr. issued Executive Order 14023 establishing this Commission, to consist of “individuals having experience with and knowledge of the Federal judiciary and the Supreme Court of the United States.” The Order charged the Commission with producing a report for the President that addresses three sets of questions. First, the Report should include “[a]n account of the contemporary commentary and debate about the role and operation of the Supreme Court in our constitutional system and about the functioning of the constitutional process by which the President nominates and, by and with the advice and consent of the Senate, appoints Justices to the Supreme Court.” Second, the Report should consider the “historical background of other periods in the Nation’s history when the Supreme Court’s role and the nominations and advice-and-consent process were subject to critical assessment and prompted proposals for reform.” Third, the Report should provide an analysis of the principal arguments for and against particular proposals to reform the Supreme Court, “including an appraisal of [their] merits and legality,” and should be informed by “a broad spectrum of ideas.” The Report begins by explaining the genesis of today’s Court reform debate, including by identifying developments that gave rise to President Biden’s decision to issue the April 2021 Executive Order, particularly the debates surrounding the most recent nominations. This Introduction emphasizes that the Court’s composition and jurisprudence long have been subjects of public controversy and debate in the nation’s civic life: The Court serves as a crucial guardian of the rule of law and also plays a central role in major social and political conflicts. Its decisions have profound effects on the life of the nation. Though conflict surrounding the processes by which the President nominates and the Senate confirms Justices is not new, it has become more intensely partisan in recent years. The Introduction also articulates three common and interrelated ideas frequently invoked in reform debates and throughout the Chapters of the Report: the importance of protecting or enhancing the Court’s legitimacy; the role of judicial independence in our system of government; and the value of democracy and its relationship to the Supreme Court’s decisionmaking. These important ideas can mean different things to different people. The Introduction discusses the range of meanings ascribed to these terms, with the aim of clarifying how they are deployed in arguments for and against reform

Antimicrobial resistance among migrants in Europe: a systematic review and meta-analysis

BACKGROUND: Rates of antimicrobial resistance (AMR) are rising globally and there is concern that increased migration is contributing to the burden of antibiotic resistance in Europe. However, the effect of migration on the burden of AMR in Europe has not yet been comprehensively examined. Therefore, we did a systematic review and meta-analysis to identify and synthesise data for AMR carriage or infection in migrants to Europe to examine differences in patterns of AMR across migrant groups and in different settings. METHODS: For this systematic review and meta-analysis, we searched MEDLINE, Embase, PubMed, and Scopus with no language restrictions from Jan 1, 2000, to Jan 18, 2017, for primary data from observational studies reporting antibacterial resistance in common bacterial pathogens among migrants to 21 European Union-15 and European Economic Area countries. To be eligible for inclusion, studies had to report data on carriage or infection with laboratory-confirmed antibiotic-resistant organisms in migrant populations. We extracted data from eligible studies and assessed quality using piloted, standardised forms. We did not examine drug resistance in tuberculosis and excluded articles solely reporting on this parameter. We also excluded articles in which migrant status was determined by ethnicity, country of birth of participants' parents, or was not defined, and articles in which data were not disaggregated by migrant status. Outcomes were carriage of or infection with antibiotic-resistant organisms. We used random-effects models to calculate the pooled prevalence of each outcome. The study protocol is registered with PROSPERO, number CRD42016043681. FINDINGS: We identified 2274 articles, of which 23 observational studies reporting on antibiotic resistance in 2319 migrants were included. The pooled prevalence of any AMR carriage or AMR infection in migrants was 25·4% (95% CI 19·1-31·8; I2 =98%), including meticillin-resistant Staphylococcus aureus (7·8%, 4·8-10·7; I2 =92%) and antibiotic-resistant Gram-negative bacteria (27·2%, 17·6-36·8; I2 =94%). The pooled prevalence of any AMR carriage or infection was higher in refugees and asylum seekers (33·0%, 18·3-47·6; I2 =98%) than in other migrant groups (6·6%, 1·8-11·3; I2 =92%). The pooled prevalence of antibiotic-resistant organisms was slightly higher in high-migrant community settings (33·1%, 11·1-55·1; I2 =96%) than in migrants in hospitals (24·3%, 16·1-32·6; I2 =98%). We did not find evidence of high rates of transmission of AMR from migrant to host populations. INTERPRETATION: Migrants are exposed to conditions favouring the emergence of drug resistance during transit and in host countries in Europe. Increased antibiotic resistance among refugees and asylum seekers and in high-migrant community settings (such as refugee camps and detention facilities) highlights the need for improved living conditions, access to health care, and initiatives to facilitate detection of and appropriate high-quality treatment for antibiotic-resistant infections during transit and in host countries. Protocols for the prevention and control of infection and for antibiotic surveillance need to be integrated in all aspects of health care, which should be accessible for all migrant groups, and should target determinants of AMR before, during, and after migration. FUNDING: UK National Institute for Health Research Imperial Biomedical Research Centre, Imperial College Healthcare Charity, the Wellcome Trust, and UK National Institute for Health Research Health Protection Research Unit in Healthcare-associated Infections and Antimictobial Resistance at Imperial College London

Peripheral and central arterial pressure and its relationship to vascular target organ damage in carotid artery, retina and arterial stiffness. Development and validation of a tool. The Vaso risk study

<p>Abstract</p> <p>Background</p> <p>Ambulatory blood pressure monitoring (ABPM) shows a better correlation to target organ damage and cardiovascular morbidity-mortality than office blood pressure. A loss of arterial elasticity and an increase in carotid artery intima-media thickness (IMT) has been associated with increased cardiovascular morbidity-mortality. Tools have been developed that allow estimation of the retinal arteriovenous index but not all studies coincide and there are contradictory results in relation to the evolution of the arteriosclerotic lesions and the caliber of the retinal vessels. The purpose of this study is to analyze the relationship between peripheral and central arterial pressure (clinic and ambulatory) and vascular structure and function as evaluated by the carotid artery intima-media thickness, retina arteriovenous index, pulse wave velocity (PWV) and ankle-brachial index in patients with and without type 2 diabetes. In turn, software is developed and validated for measuring retinal vessel thickness and automatically estimating the arteriovenous index.</p> <p>Methods/Design</p> <p>A cross-sectional study involving a control group will be made, with a posterior 4-year follow-up period in primary care. The study patients will be type 2 diabetics, with a control group of non-diabetic individuals. Consecutive sampling will be used to include 300 patients between 34-75 years of age and no previous cardiovascular disease, one-half being assigned to each group. Main measurements: age, gender, height, weight and abdominal circumference. Lipids, creatinine, microalbuminuria, blood glucose, HbA1c, blood insulin, high sensitivity C-reactive protein and endothelial dysfunction markers. Clinic and ambulatory blood pressure monitoring. Carotid ultrasound to evaluate IMT, and retinography to evaluate the arteriovenous index. ECG to assess left ventricle hypertrophy, ankle-brachial index, and pulse wave analysis (PWA) and pulse wave velocity (PWV) with the Sphigmocor System.</p> <p>Discussion</p> <p>We hope to obtain information on the correlation of different ABPM-derived parameters and PWA to organ target damage - particularly vascular structure and function evaluated from the IMT and PWV - and endothelial dysfunction in patients with and without type 2 diabetes. We also hope to demonstrate the usefulness of the instrument developed for the automated evaluation of retinal vascularization in the early detection of alterations in vascular structure and function and in the prognosis of middle-term cardiovascular morbidity.</p> <p>Trial Registration</p> <p>Clinical Trials.gov Identifier: <a href="http://www.clinicaltrials.gov/ct2/show/NCT01325064">NCT01325064</a></p

TOI-3235 b: a transiting giant planet around an M4 dwarf star

We present the discovery of TOI-3235 b, a short-period Jupiter orbiting an M-dwarf with a stellar mass close to the critical mass at which stars transition from partially to fully convective. TOI-3235 b was first identified as a candidate from TESS photometry, and confirmed with radial velocities from ESPRESSO, and ground-based photometry from HATSouth, MEarth-South, TRAPPIST-South, LCOGT, and ExTrA. We find that the planet has a mass of $\mathrm{0.665\pm0.025\,M_J}$ and a radius of $\mathrm{1.017\pm0.044\,R_J}$. It orbits close to its host star, with an orbital period of $\mathrm{2.5926\,d}$, but has an equilibrium temperature of $\mathrm{\approx 604 \, K}$, well below the expected threshold for radius inflation of hot Jupiters. The host star has a mass of $\mathrm{0.3939\pm0.0030\,M_\odot}$, a radius of $\mathrm{0.3697\pm0.0018\,R_\odot}$, an effective temperature of $\mathrm{3389 \, K}$, and a J-band magnitude of $\mathrm{11.706\pm0.025}$. Current planet formation models do not predict the existence of gas giants such as TOI-3235 b around such low-mass stars. With a high transmission spectroscopy metric, TOI-3235 b is one of the best-suited giants orbiting M-dwarfs for atmospheric characterization.Comment: 15 pages, 4 figures. Accepted for publication in APJ

Revista de Vertebrados de la Estación Biológica de Doñana

Página 298 con error de impresiónEstudio cariológico en dos especies de Serránidos del Mediterráneo (Peces: PerciformesRelaciones morfométricas de Atherina boyeri Risso (Pisces: Atherinidae) de la laguna de Zoñar (Córdoba, España)Contribución al conocimiento de la biometríay osteología de Barbus barbus bocagei, Steindachner, 1866 (Pisces: CyprinidaeLa actividad de la salamandra, Salamandra salamandra (L.), en Galicia.Estudios sobre el sapo corredor (Bufo calamita) en el Sur de España.1. BiometríaEstudios sobre el sapo corredor (Bufo calamita) en el Sur de España. II. AlimentaciónBiología de la reproducción de Rana iberica Boulenger 1879 en zonas simpátridas con Rana temporaria Linneo, 1758Nuevos datos sobre la distribución geográfica de Lacerta monticola cantabrica Mertens, 1929. (Sauria, lacertidae).Datos sobre Lacerta monticola Boulenger, 1905 (Saurio: lacertidae)en el oeste del Sistema Central.Nueva especie de Anolis (lacertilia, Iguanidae) para CubaEtograma cuantificado del cortejo en Falco naumannOntogénesis del comportamiento predador en Falco naumanniContaminación xenobiótica del Parque Nacional de Doñana. 1. Residuos de insecticidas organoclorados, bifenilos policlorados y mercurio en anseriformes y gruiformesReproducción del críalo (Clamator glandarius) en Sierra Morena CentraNidificación de Picus viridis en taludes de arcilla en Ramblas de Guadix (Granada)Comportamiento del calamón Porphyrio porphyrio (Linnaeus, 1758) en Doñana, Marismas del GuadalquiviBiología y ecología de la malvasía (Oxyura leucocephala) en Andalucía.On the differential diet of Carnivora in islands:a method for analysing it and a particular case.Notas sobre la distribución pasada y actual del meloncillo Herpestes ichneumon (L.) en la Península IbéricaEstructuración de las interacciones en una camada de lobos (Canís lupus)Nuevos datos sobre la distribución del Cottus gobio L. (pisces, cottidae) en EspañaSobre la alimentación de Callopistes maculatus (Reptilia,teiidaeObservación de Lacerta lepida depredando un nido de Alectoris rufaNueva cita del galápago leproso Mauremys leprosa (Scheigger, 1812) en los pirineosPrimera cita de Psammodromus hispanicus (Fitzinger) para GaliciaSobre la presencia de Gallotia (=Lacerta) atlantica (Peters y Doria, 1882) en Gran CanariaNota sobre las Lacerta monticola Boulenger, 1905 de las zonas del norte de GaliciaPrimeras notas herpetológicas de la provincia de Soria.Datos sobre selección de hábitat y ecología alimenticia del porrón pardo (Aythya nyroca)Probable nueva área de cría del pechiazul (Luscinia svecica cyanecula) en el sistema central. PerisPredación de Falco peregrinus y Falco subbuteo sobre quirópterosResultados de la producción de Oxyura leucocephala en el año 1981 en las lagunas de Zóñar y el rincónAnálisis de la dieta de Tyto alba en un medio árido antropógeno de los alrededores de Almería¿Son Eudocimus ruber y E. albus distintas especies?EL Estornino pinto (Sturnus vulgaris) en Canarias: nueva especie nidifiante en el archipiélagoDatos sobre la alimentación otoñal del cárabo (Strix aluco) en la sierra de CádizObservación primaveral de rapaces y otras aves en el páramo del estado de Mérida (Venezuela).Murciélago hematófago (Desmodus rotundus) parasitando a un chigüire (Hidrochoerus hydrochaeris)Observaciones sobre la reproducción del zacatuche o teporinho Romerolagus diazi (Mammalia: lagomorpha)Estudio electroforético de hemoglobinas y esterasas sanguíneas en Rhinolophus ferrumequinum (Chiroptera: rhinolophidae) y de hemoglobinas en Tadaria taeniotis (chiroptera: molossidae)Peer reviewe