A Nonstandard Proof of the Banach-Steinhaus Theorem

pp. 185-188The Banach-Steinhaus theorem, also known as Uniform Boundedness Principle, has a standard proof a little bit too long. In this article we will give a real short proof using the nonstandard analysis technique

Lagrangian Descriptors: A Method for Revealing Phase Space Structures of General Time Dependent Dynamical Systems

In this paper we develop new techniques for revealing geometrical structures in phase space that are valid for aperiodically time dependent dynamical systems, which we refer to as Lagrangian descriptors. These quantities are based on the integration, for a finite time, along trajectories of an intrinsic bounded, positive geometrical and/or physical property of the trajectory itself. We discuss a general methodology for constructing Lagrangian descriptors, and we discuss a "heuristic argument" that explains why this method is successful for revealing geometrical structures in the phase space of a dynamical system. We support this argument by explicit calculations on a benchmark problem having a hyperbolic fixed point with stable and unstable manifolds that are known analytically. Several other benchmark examples are considered that allow us the assess the performance of Lagrangian descriptors in revealing invariant tori and regions of shear. Throughout the paper "side-by-side" comparisons of the performance of Lagrangian descriptors with both finite time Lyapunov exponents (FTLEs) and finite time averages of certain components of the vector field ("time averages") are carried out and discussed. In all cases Lagrangian descriptors are shown to be both more accurate and computationally efficient than these methods. We also perform computations for an explicitly three dimensional, aperiodically time-dependent vector field and an aperiodically time dependent vector field defined as a data set. Comparisons with FTLEs and time averages for these examples are also carried out, with similar conclusions as for the benchmark examples.Comment: 52 pages, 25 figure

Initial stage of cross-cultural adaptation to Portuguese of Brazil of the HIV Knowledge Questionnaire (HIV-K-Q)

Modelo do estudo: Transversal. Objetivo do estudo: Adaptar o HIV Knowledge Questionnaire (HIVK-Q) do inglês para o português do Brasil. Metodologia: A Adaptação Transcultural seguiu os passos metodológicos definidos por Reichenheim e constou das seguintes etapas: equivalência conceitual e de itens, equivalência semântica e equivalência operacional. A validade aparente e a validade de conteúdo foram avaliadas por seis juízes. A validade de conteúdo foi calculada pelo Coeficiente de Validade de Conteúdo de cada item (CVCc) e para o questionário como um todo (CVCt). Foi realizada uma aplicação dialogada por meio de grupos focais com 15 universitários e 15 usuários de centros comunitários. Resultados: Dos 45 itens do instrumento original, quatro apresentaram baixa validade de conteúdo (CVCc<0,80), sendo que dois itens (25 e 31) foram retirados. O CVCt foi 0,82 para clareza da linguagem, 0,93 para pertinência prática e 0,90 para relevância teórica. Para os critérios de amplitude e equilíbrio foram iguais a 0,90. Os itens que apresentaram problemas de compreensão foram devidamente retificados de acordo com as sugestões dos juízes e dos grupos focais. Conclusão: A versão proposta apresenta itens satisfatórios e apropriados para utilizações em avaliações psicométricas futuras, as quais permitirão demonstrar dados sobre a aplicabilidade do questionário para avaliar o conhecimento sobre o HIV/AidsStudy design: cross-sectional. Objective: to adapt the HIV Knowledge Questionnaire (HIV-KQ) from English to Portuguese of Brazil. Methodology: the Cross-Cultural Adaptation followed the methodological steps defined by Reichenheim and consisted of the following steps: conceptual and items equivalence, semantic equivalence and operational equivalence. The apparent validity and content validity was assessed by six judges. The content validity was calculated by Content Validity coefficient for each item (CVCc) and for all questionnaire (CVCt). The dialogued application was carried out by focus groups with 15 college students and 15 users of community centers. Results: Of the 45 items of the original instrument, four present lower content validity (CVCc <0.80), being that two items (25 and 31) were removed. The CVCt was 0.82 to clarity of language, 0.93 to practice relevance and 0.90 theoretical relevance. For amplitude and balance criteria were equal to 0.90. Items that showed understanding problems were corrected according to suggestions of judges and focal groups. Conclusion: The proposed version presents satisfactory items and suitable for use in psychometric assessments in the future, which will demonstrate data about the applicability of the questionnaire to evaluate the knowledge about HIV/AID

Cognitive Reserve Characteristics and Occupational Performance Implications in People with Mild Cognitive Impairment

The Cognitive Reserve hypothesis suggests that there are individual differences in the ability to cope with the pathologic changes in Alzheimer’s Disease. The proportion of elderly individuals has increased in recent years; this increase emphasizes the importance of early detection of mild cognitive impairment and the promotion of healthy ageing. The purpose of our study is to characterize cognitive reserve and occupational performance implications in people with mild cognitive impairment. 125 patients with mild cognitive impairment were enrolled. The Montreal Cognitive Assessments (MoCA) was used to evaluate cognitive status and the Cognitive Reserve Index Questionnaire (CRIq) as an indicator of cognitive reserve. Higher level of education was associated with higher MoCA scores (r = 0.290, p = 0.001). Positive significant correlations were observed between MoCA and total CRIq (r = 0.385, p < 0.001) as well as its three sub-domains, education (r = 0.231, p = 0.010), working activity (r = 0.237, p = 0.008) and leisure time (r = 0.319, p < 0.001). This study findings provide the importance of considering socio-behavioral factors in cognitive status. This research helps to describe the importance of engaging occupationally along the whole life-course as a potential protective factor in ageing, and includes a perspective of occupational therapy regarding the hypothesis of cognitive reserve.Depto. de EnfermeríaFac. de Enfermería, Fisioterapia y PodologíaTRUEpu

Factors associated with quality of care in inflammatory bowel diseases : a view from patient's side using the IQCARO quality of care decalogue

Quality of care (QoC) is a highly important topic in inflammatory bowel disease (IBD). We recently elaborated a decalogue of QoC indicators (IQCARO-QoC) developed by IBD patients. The aim of the present study was to assess the factors associated with patients' evaluation of QoC in Spain using the IQCARO-QoC Decalogue recently developed by IBD patients. A survey including patients' socio-demographic and clinical characteristics, and the IQCARO-QoC Decalogue, was completed by IBD patients. We described patients' assessment of QoC across Spanish patients. A univariable and multivariable analysis was performed to explore the associations between patients' characteristics and QoC. Questionnaires from 788 participant patients were analysed. Participants' mean age was 43.4 years, 63% were females and 58% had Crohn's disease. The mean QoC score was 8.1 (± 2.4 SD) points out of a maximum of 10. Items with the lowest score were related to the provision of information and the implication of the medical team throughout the entire patient care. Factors associated with better QoC scores included: being employed better disease control, fewer numbers of unscheduled visits, and being followed by a gastroenterologist specialized in IBD. Spanish patients' reported QoC seems to be globally good although there is room for improvement, especially in providing adequate information to patients. Care provided by specialized IBD gastroenterologists seems to be related with higher QoC scores

An Exploratory Study of Healing Circles as a Strategy to Facilitate Resilience in an Undocumented Community

Within the United States, the COVID-19 pandemic highlighted critical inequalities affecting undocumented communities and resulting in particularly heightened stress for members of these communities. In addition to the stress associated with COVID-19, immigrants in the United States were more than ever subjected to a hostile antiimmigrant climate under Trump’s administration. Given this compounded stress, the impact of the pandemic on mental health is likely to be disproportionately experienced by undocumented immigrants. In response, a group of psychologists partnered with a leading immigrant rights advocacy organization and formed a reciprocal collaboration to support undocumented communities. A major focus of the collaboration is to foster learning, supporting members of the immigrant community to contribute to their own well-being and others in the community. Accordingly, the collaborative developed and delivered a web-based mental health education session to the immigrant community and to practitioners serving this population. The session presented the use of healing circles as a strength-based approach to building resilience and also sought feedback regarding specific features of healing circles that can enhance their effectiveness in managing distress. Survey data and qualitative findings from this study show that those who participated in the web-based program perceived the session as validating and informative. Findings also underscored the need for creating safe spaces for community members to be vulnerable about their lived experiences while promoting ownership of their narratives. We discuss practical implications pertaining to the development and facilitation of social support groups for immigrants led by nonspecialist community members trained for this role. Impact Statement We describe a reciprocal collaboration between psychologists and an immigrant-led advocacy organization for the purposes of supporting undocumented immigrants in tailoring culturally congruent therapeutic approaches for fostering resilience as they face multiple stressors due to interlocking crises, such as the COVID-19 pandemic and antiimmigrant policies. The collaboration led to the development and delivery of a web-based session that provided immigrant community members and practitioners with recommendations for facilitating healing circles as a strength-based and culturally responsive approach to fostering peer-led social support during stressful times. Findings highlight the need for creating such safe spaces for community members to be vulnerable about their lived experiences and feel validated

Manejo del neonato con coartación de aorta e hipoplasia de arco

ResumenIntroducciónLa coartación aórtica del neonato puede asociar en un porcentaje importante hipoplasia del arco aórtico, llegando en algunas series al 60%.Cuando existe hipoplasia del arco aórtico distal el tratamiento estándar consiste en la resección de la zona de coartación y anastomosis termino-terminal extendida.En casos de hipoplasia severa del arco aórtico distal y arco distal largo, podría no ser suficiente con la resección y anastomosis termino-terminal extendida, por lo que sería razonable realizar alguna técnica adicional para ampliar el arco aórtico distal, evitando así un abordaje anterior, el uso de parada circulatoria con o sin perfusión cerebral selectiva y el aumento de la morbimortalidad perioperatoria.MétodosPresentamos los resultados de 4 neonatos, a los que se les realizó una ampliación del arco aórtico distal, según técnica de Amato (anastomosis latero-lateral entre las arterias carótida y subclavia izquierdas), para posteriormente resecar la zona de coartación y anastomosar la aorta descendente al arco aórtico previamente ampliado.ResultadosEn todos los casos el ecocardiograma postoperatorio mostró arco reconstruido con flujo laminar. No se ha presentado ningún caso de recoartación durante un período de seguimiento medio de 12 meses.ConclusiónConsideramos que la técnica de elección en la coartación con hipoplasia de arco distal es la resección y anastomosis termino-terminal extendida.En casos seleccionados, con arco aórtico distal muy largo y severamente hipoplásico, la técnica de Amato es una alternativa atractiva, con el objeto de evitar un abordaje anterior y el uso de CEC. Además, puede realizarse en un primer tiempo, manteniendo perfusión sistémica ductus-dependiente.AbstractIntroductionNeonatal aortic coarctation can be combined with a significant percentage of aortic arch hypoplasia, reaching 60% in some series.When there is hypoplasia of the distal aortic arch, the standard treatment consists of resection of the coarctation zone and extended end-to-end anastomosis.In cases of severe distal aortic arch hypoplasia and a long distal arch, resection and extended end-to-end anastomosis would not be sufficient, making it reasonable to perform an additional technique to widen the distal aortic arch, thus avoiding an anterior approach and interrupting the blood circulation with or without selective cerebral infusion, with the resulting risk of an increase in perioperative morbidity and mortality.MethodsThe results are presented on 4 neonates on whom a widening of the distal aortic arch was performed using the Amato technique (side-to-side anastomosis between the left carotid and subclavian arteries), in order to subsequently resect the coarctation zone and perform an anastomosis of the descending aorta to the previously widened aortic arch.ResultsThe post-operative echocardiogram showed a reconstructed arch with laminar flow in all cases. There has been no recurrence of coarctation in any of the cases during a mean follow-up of 12 months.ConclusionWe believe that resection with extended end-to-end anastomosis is the technique of choice in coarctation with distal arch hypoplasia.The Amato technique is an attractive alternative in selected cases with a very long and severely hypoplastic distal arch, with the aim of avoiding an anterior approach and the use of extracorporeal circulation. This could also be performed initially, maintaining ductal-dependent systemic perfusion

A bioinspired hybrid silica–protein material with antimicrobial activity by iron uptake

A silica–protein hybrid material has been prepared by simultaneous covalent deposition of apoferritin and lactoferrin on functionalized silica. This material exhibits strong antibacterial activity against E. coli due to its high iron-uptake capacity.This work was supported by MINECO and FEDER (project CTQ2009-09344), Junta de Andalucía (project P07-FQM-02899) and BIOSEARCH SA (contract PostBIO)

Evaluation of Natural Language Processing for the Identification of Crohn Disease-Related Variables in Spanish Electronic Health Records:A Validation Study for the PREMONITION-CD Project

Background: The exploration of clinically relevant information in the free text of electronic health records (EHRs) holds the potential to positively impact clinical practice as well as knowledge regarding Crohn disease (CD), an inflammatory bowel disease that may affect any segment of the gastrointestinal tract. The EHRead technology, a clinical natural language processing (cNLP) system, was designed to detect and extract clinical information from narratives in the clinical notes contained in EHRs. Objective: The aim of this study is to validate the performance of the EHRead technology in identifying information of patients with CD. Methods: We used the EHRead technology to explore and extract CD-related clinical information from EHRs. To validate this tool, we compared the output of the EHRead technology with a manually curated gold standard to assess the quality of our cNLP system in detecting records containing any reference to CD and its related variables. Results: The validation metrics for the main variable (CD) were a precision of 0.88, a recall of 0.98, and an F1 score of 0.93. Regarding the secondary variables, we obtained a precision of 0.91, a recall of 0.71, and an F1 score of 0.80 for CD flare, while for the variable vedolizumab (treatment), a precision, recall, and F1 score of 0.86, 0.94, and 0.90 were obtained, respectively. Conclusions: This evaluation demonstrates the ability of the EHRead technology to identify patients with CD and their related variables from the free text of EHRs. To the best of our knowledge, this study is the first to use a cNLP system for the identification of CD in EHRs written in Spanish. © 2022 JMIR Medical Informatics. All rights reserved