Loss of Cognitive Function in Mexican children due to lead exposure and the associated economic costs.

BACKGROUND: Lead exposure reduces the cognitive development and future economic prospects of children. While previous studies in high-income settings have explored productivity losses associated with lead exposure, limited research has focused on low and middle-income countries like Mexico. OBJECTIVES: This study aims to provide a comprehensive assessment of the economic implications of lead exposure on Mexican children using, for the first time, nationally representative Blood lead levels (BLLs) measurements in children aged 1-4, specifically focusing on the costs of forgone lifetime income due to cognitive losses. METHODS: BLLs of children aged 1-4 were extracted from the 2018-2019 National Health and Nutrition Survey (ENSANUT). Estimations of cognitive losses were derived from a log-linear relationship between BLLs and IQ loss. Lost lifetime economic productivity per child was calculated, assuming a 2% reduction in lifetime potential productivity for each IQ point lost due to lead exposure, based on previous literature (Attina and Trasande, 2013; Larsen and Sanchez-Triana, 2023). Productivity data were obtained from representative sources for Mexico. RESULTS: The estimated economic loss amounted to US $33.02 billion, equivalent to 2.76% of Mexico's Gross Domestic Product (GDP) in 2019 (calculated for a 1-year cohort). On a national scale, the long-term loss of cognition for children 1-4 years old is 4.14 IQ points per child due to lead exposure, with significant variability across States (range: 3.26 to 5.26). Lead-poisoned children (≥5 µg/dL) suffered an average loss of 6.42 IQ points (range: 0 to 6.97). In terms of economic impact, some States like Chiapas experienced losses of 7.08% of its GDP, while others had losses as low as 0.67%. Intriguingly, states with lower Human Development Indexes (HDIs) exhibited relatively higher economic losses despite lower average blood lead levels. DISCUSSION: The heterogeneous impact of lead exposure across Mexican states underscores the necessity for tailored regional policies. These findings emphasize the urgency for targeted interventions and informed policy measures to mitigate the socioeconomic consequences of lead exposure on Mexican children.

Outcomes of an extracorporeal cardiopulmonary resuscitation (ECPR) program for in- and out-of-hospital cardiac arrest in a tertiary hospital in Spain.

OBJECTIVE: To analyze if the implementation of a multidisciplinary extracorporeal cardiopulmonary resuscitation (ECPR) program in a tertiary hospital in Spain is feasible and could yield survival outcomes similar to international published experiences. DESIGN: Retrospective observational cohort study. SETTING: One tertiary referral university hospital in Spain. PATIENTS: All adult patients receiving ECPR between January 2019 and April 2023. INTERVENTIONS: Prospective collection of variables and follow-up for up to 180 days. MAIN VARIABLES OF INTEREST: To assess outcomes, survival with good neurological outcome defined as a Cerebral Performance Categories scale 1-2 at 180 days was used. Secondary variables were collected including demographics and comorbidities, cardiac arrest and cannulation characteristics, ROSC, ECMO-related complications, survival to ECMO decannulation, survival at Intensive Care Unit (ICU) discharge, survival at 180 days, neurological outcome, cause of death and eligibility for organ donation. RESULTS: Fifty-four patients received ECPR, 29 for OHCA and 25 for IHCA. Initial shockable rhythm was identified in 27 (50%) patients. The most common cause for cardiac arrest was acute coronary syndrome [29 (53.7%)] followed by pulmonary embolism [7 (13%)] and accidental hypothermia [5 (9.3%)]. Sixteen (29.6%) patients were alive at 180 days, 15 with good neurological outcome. Ten deceased patients (30.3%) became organ donors after neuroprognostication. CONCLUSIONS: The implementation of a multidisciplinary ECPR program in an experienced Extracorporeal Membrane Oxygenation center in Spain is feasible and can lead to good survival outcomes and valid organ donors.

In vitro anthelmintic activity and colocalization analysis of hydroxycinnamic acids obtained from Chamaecrista nictitans against two Haemonchus contortus isolates.

This study assessed the in vitro anthelmintic activity of ethyl acetate extract (Cn-EtOAc) and its bioactive fractions (CnR3 and CnR5) obtained from Chamaecrista nictitans aerial parts against two Haemonchus contortus (Hc) isolates, one resistant (strain HcIVM-R) and another susceptible (strain HcIVM-S) to ivermectin. Ferulic acid and p-coumaric acid were identified in the bioactive fractions; therefore, their commercial standards were also assessed. A colocalization analysis between the ferulic acid commercial standard and eggs of the HcIVM-R strain was performed using confocal laser scanning microscopy and the ImageJ program. The ovicidal effects of the Cn-EtOAc extract, bioactive fractions and commercial compounds were tested through the egg hatching inhibition (EHI) assay on H. contortus isolates HcIVM-R and HcIVM-S. The Cn-EtOAc caused 88 % and 92 % EHI at 5000 µg/mL on HcIVM-R and HcIVM-S, respectively. Fractions CnR3 and CnR5 displayed the highest ovicidal activity against HcIVM-S, with effective concentrations (EC90) of 2134 and 601 µg/mL, respectively. Meanwhile, the commercial standards ferulic acid and p-coumaric acid also resulted in higher effectiveness on the same strain, with EC90 of 57.5 and 51.1 µg/mL. A colocalization analysis of ferulic acid and eggs of HcIVM-R revealed that this compound is localized to the cuticle surface of the embryo inside the egg parasite. The results demonstrated that both ferulic and p-coumaric acids interrupt the egg-hatching processes of the two Hc isolates. Both phenolic acids isolated from C. nictitans and commercial standards exhibited the best anthelmintic effect on HcIVM-S. These findings indicate that the phenolic acids were less effective in egg hatch inhibiting on the HcIVM-R strain compared to the HcIVM-S strain.

The building of an institutional liver transplant registry: opportunities and challenges.

To improve current data systems for institutional decision-making, the Adult Liver Transplant Registry was established at the Hospital Italiano de Buenos Aires, Argentina. This article describes its design and implementation and reports on the outcomes for patients transplanted since its January 2020 launch. A multidisciplinary team designed the registry by identifying key variables from a literature review while considering balance between data depth and feasibility. Rigorous quality control measures were enforced, including monthly audits and staff training. Benchmark indicators for post-transplant outcomes were established. As of November 2023, the registry included 136 transplants. Its implementation and maintenance were straightforward, with no significant difficulties encountered. Cirrhosis was the predominant indication (77%) for transplant. Only one living donor transplantation was performed. Post-transplant results generally aligned with benchmarks, but rates of biliary complications slightly exceeded the recommended thresholds. The one-year post-transplant survival rate was 87%. The successful registry implementation provides a robust framework for research, treatment management, and patient care enhancement within a liver transplant unit.

Electron Nuclear Dynamics of H+ + C2H2 at ELab = 30, 200, and 450 eV.

We present a complete simplest-level electron nuclear dynamics (SLEND) investigation of H+ + C2H2 at collision energies ELab = 30, 200, and 450 eV. This reaction is relevant in astrophysics and provides a computationally feasible prototype for proton cancer therapy reactions. SLEND is a time-dependent, variational, direct, and nonadiabatic method that adopts a classical-mechanics description for the nuclei and a Thouless single-determinantal wave function for the electrons. We perform this study with our code PACE, which incorporates the One Electron Direct/Electron Repulsion Direct (OED/ERD) atomic integrals package developed by the Bartlett group. Current SLEND simulations with the 6-31G** basis set involves 2,646 trajectory calculations from 9 nonredundant, symmetry-inequivalent projectile-target orientations. For H+ + C2H2 at ELab = 30 eV, SLEND/6-31G** simulations predict one simple scattering process, and three reactive ones: C2H2 hydrogen substitution, C2H2 fragmentation into two CH moieties, and C2H2 fragmentation into CHC and H moieties, respectively. We reveal and analyze the mechanisms of these processes through computer animations; this valuable chemical information is inaccessible by experiments. The SLEND/6-31G** scattering angle functions exhibit primary and secondary rainbow scattering features that vary with the projectile-target orientations and collision energies. SLEND/6-31G** predicts 1-electron-transfer (1-ET) integral cross sections at ELab = 30, 200, and 450 eV in good agreement with their experimental counterparts. SLEND/6-31-G** predicts 1-ET differential cross sections (DCSs) at ELab = 30 eV that agree well with their experimental counterparts over all the measured scattering angles. In addition, SLEND/6-31G** predicts 0-ET DCSs at ELab = 30 eV that agree well with their experimental counterparts at low scattering angles, but less satisfactorily at higher ones. Remarkably, both the 0- and 1-ET DCSs from SLEND/6-31G** exhibit distinct primary rainbow scattering signatures in excellent agreement with their experimentally inferred counterparts. Furthermore, both SLEND/6-31G** and the experiment indicate that the primary rainbow scattering angles from the 0- and 1-ET DCSs are identical (an unusual fact in proton-molecule collisions). Through these rainbow scattering predictions, SLEND has also validated a procedure to extract primary rainbow angles from structureless DCSs. We analyze the obtained theoretical results in comparison with available experimental data and discuss forthcoming developments in the SLEND method.

Anthelmintic efficacy of an organic fraction from Guazuma ulmifolia leaves and evaluation of reactive oxidative stress on Haemonchus contortus.

This study describes the anthelmintic efficacy of an organic fraction (EtOAc-F) from Guazuma ulmifolia leaves and the evaluation of its reactive oxidative stress on Haemonchus contortus. The first step was to assess the anthelmintic effect of EtOAc-F at 0.0, 3.5, 7.0 and 14 mg kg of body weight (BW) in gerbil's (Meriones unguiculatus) artificially infected with H. contortus infective larvae (L3). The second step was to evaluate the preliminary toxicity after oral administration of the EtOAc-F in gerbils. Finally, the third step was to determine the relative expression of biomarkers such as glutathione (GPx), catalase (CAT), and superoxide dismutase (SOD) against H. contortus L3 post-exposition to EtOAc-F. Additionally, the less-polar compounds of EtOAc-F were identified by gas mass spectrophotometry (GC-MS). The highest anthelmintic efficacy (97.34%) of the organic fraction was found in the gerbils treated with the 14 mg/kg of BW. Histopathological analysis did not reveal changes in tissues. The relative expression reflects overexpression of GPx (p<0.05, fold change: 14.35) and over expression of SOD (p≤0.05, fold change: 0.18) in H. contortus L3 exposed to 97.44 mg/mL of EtOAc-F compared with negative control. The GC-MS analysis revealed the presence of 4-hydroxybenzaldehyde (1), leucoanthocyanidin derivative (2), coniferyl alcohol (3), ferulic acid methyl ester acetate (4), 2,3,4-trimethoxycinnamic acid (5) and epiyangambin (6) as major compounds. According to these results, the EtOAc-F from G. ulmifolia leaves exhibit anthelmintic effect and increased the stress biomarkers on H. contortus.

Management practices in facilities providing HIV services to key populations in Kenya and Malawi: A descriptive analysis of management in community-based organizations.

HIV services for key populations (KP) at higher risk of HIV infection are often delivered by community-based organizations. To achieve HIV epidemic control, countries need to scale up HIV services for KP. Little is known about the management practices of community-based organizations delivering health services. We explored the management practices and facility characteristics of community-based health facilities providing HIV services to key populations as part of the LINKAGES program in Kenya and Malawi. We collected information on management practices from 45 facilities called drop-in centers (DICs) during US Government FY 2019, adapting the World Management Survey to the HIV community-based health service delivery context. We constructed management domain scores for each facility. We then analyzed the statistical correlations between management domains (performance monitoring, people management, financial management, and community engagement) and facility characteristics (e.g., number of staff, organization maturity, service scale) using ordinary least square models. The lowest mean management domain scores were found for people management in Kenya (38.3) and financial management in Malawi (25.7). The highest mean scores in both countries were for performance monitoring (80.9 in Kenya and 82.2 in Malawi). Within each management domain, there was significant variation across DICs, with the widest ranges in scores (0 to 100) observed for financial management and community involvement. The DIC characteristics we considered explained only a small proportion of the variation in management domain scores across DICs. Community-based health facilities providing HIV services to KP can achieve high levels of management in a context where they receive adequate levels of above-facility support and oversight-even if they deliver complex services, rely heavily on temporary workers and community volunteers, and face significant financial constraints. The variation in scores suggests that some facilities may require more above-facility support and oversight than others.

Testing standard basis sets for direct ionizations: H+ + H at ELab = 0.1-100 keV.

With the simplest-level electron nuclear dynamics (SLEND) method, we test standard Slater-type-orbital/contracted-Gaussian-functions (STO/CGFs) basis sets for the simulation of direct ionizations (DIs), charge transfers (CTs), and target excitations (TEs) in H+ + H at ELab = 0.1-100 keV. SLEND is a time-dependent, variational, on-the-fly, and nonadiabatic method that treats nuclei and electrons with classical dynamics and a Thouless single-determinantal state, respectively. While previous tests for CTs and TEs exist, this is the first SLEND/STO/CGFs test for challenging DIs. Spin-orbitals with negative/positive energies are treated as bound/unbound states for bound-to-bound (CT and TE) and bound-to-unbound (DI) transitions. SLEND/STO/CGFs simulations correctly reproduce all the features of DIs, CTs and TEs over all the considered impact parameters and energies. SLEND/STO/CGFs simulations correctly predict CT integrals cross-sections (ICSs) over all the considered energies and predict satisfactory DI and TE ICSs within some energy ranges. Strategies to improve SLEND/STO/CGFs for DI predictions are discussed.

Empirical evidence for perspectival similarity.

When a circular coin is rotated in depth, is there any sense in which it comes to resemble an ellipse? While this question is at the center of a rich and divided philosophical tradition (with some scholars answering affirmatively and some negatively), Morales et al. (2020, 2021) took an empirical approach, reporting 10 experiments whose results favor such perspectival similarity. Recently, Burge and Burge (2022) offered a vigorous critique of this work, objecting to its approach and conclusions on both philosophical and empirical grounds. Here, we answer these objections on both fronts. We show that Burge and Burge's critique rests on misunderstandings of Morales et al.'s claims; of the relation between the data and conclusions; and of the philosophical context in which the work appears. Specifically, Burge and Burge attribute to us a much stronger (and stranger) view than we hold, involving the introduction of "a new entity" located "in some intermediate position(s) between the distal shape and the retinal image." We do not hold this view. Indeed, once properly understood, most of Burge and Burge's objections favor Morales et al.'s claims rather than oppose them. Finally, we discuss several questions that remain unanswered, and reflect on a productive path forward on these issues of foundational scientific and philosophical interest. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Modelación de factores motivacionales relacionadas con la satisfacción académica: un estudio multinivel / Modeling motivational factors related to academic satisfaction: a multilevel study

Antecedentes: los factores motivacionales constituyen aspectos fundamentales para lograr experiencias de bienestar asociadas al desarrollo de actividades académicas. Sin embargo, los estudios sobre la satisfacción académica se han focalizado en la dimensión individual, excluyendo la influencia del nivel docente. Objetivo: el estudio tiene por objetivo estimar un modelo hipotético multinivel que explica la satisfacción académica desde factores motivacionales de docentes y estudiantes. Método: la muestra se estructura de manera jerárquica, considerando 745 estudiantes universitarios anidados a 32 docentes. Para el análisis de los datos se utiliza estadística descriptiva y análisis de senderos multinivel. Resultados: los resultados muestran que los factores motivacionales de los estudiantes explican mayoritariamente la variación de la satisfacción académica. No obstante, el nivel docente también incide significativamente a partir de la percepción de presión delos estudiantes, proceso que debilita la motivación autónoma para la enseñanza y la autoeficacia docente, afectando la calidad de los procesos de enseñanza-aprendizaje. Conclusión: se concluye que la configuración de la satisfacción académica implica el despliegue de recursos motivacionales tanto de docentes como de estudiantes, los que a partir de su interacción contribuyenal desarrollo de experiencias de bienestar en el aula. Palabras clave: satisfacción académica; motivaciónautónoma; locus percibido de causalidad; análisis multinivel.

Background: Motivational factors constitute fundamental aspects of achieving well-being and experiences associated with the development of academic activities. However, studies on academic satisfaction have focused on the individual dimension, excluding the influence of the teaching level. Objective: the study aims to estimate a hypothetical multilevel model that explains academic satisfaction from motivational factors of teachers and students. Method: the sample is structured hierarchically, considering 745 university students nested within 32 teachers. Descriptive statistics and multilevel pathanalysis are used to analyze the data. Results: the resultsshow that students' motivational factors mainly explain the variation in academic satisfaction. However, the teacher level also has a significant effect from the students'perception of pressure. This process weakens autonomous motivation for teaching and teaching self-efficacy, affecting the quality of the teaching-learning processes.Conclusion: it is concluded that the configuration of academic satisfaction involves the deployment of motivational resources of both teachers and students, which, through their interaction, contribute to the development of well-being experiences in the classroom. Keywords: academic satisfaction; autonomous motivation; perceived locus of causality; multilevel analysis.

Synthetic Polyisoprene Rubber as a Mimic of Natural Rubber: Recent Advances on Synthesis, Nanocomposites, and Applications.

Up to now, rubber materials have been used in a wide range of applications, from automotive parts to special-design engineering pieces, as well as in the pharmaceutical, food, electronics, and military industries, among others. Since the discovery of the vulcanization of natural rubber (NR) in 1838, the continuous demand for this material has intensified the quest for a synthetic substitute with similar properties. In this regard, synthetic polyisoprene rubber (IR) emerged as an attractive alternative. However, despite the efforts made, some properties of natural rubber have been difficult to match (i.e., superior mechanical properties) due not only to its high content of cis-1,4-polyisoprene but also because its structure is considered a naturally occurring nanocomposite. In this sense, cutting-edge research has proposed the synthesis of nanocomposites with synthetic rubber, obtaining the same properties as natural rubber. This review focuses on the synthesis, structure, and properties of natural and synthetic rubber, with a special interest in the synthesis of IR nanocomposites, giving the reader a comprehensive reference on how to achieve a mimic of NR.

Thermal niche breadth and their relationship with sturnira bat species diversification.

The interaction between climatic conditions and the ability of organisms to maintain homeostasis regulates the distribution of species on the planet. However, its influence on macroevolutionary dynamics is not well understood. It has been suggested that diversification rates will be different in lineages with narrow thermal niches (specialists) to diversification rates in generalist lineages, but the evidence for this is elusive. Here, we tested this hypothesis by using the most diverse (in species richness and geographic range variation) tropical bat genus within the Phyllostomidae family. We estimated the realized thermal niche breadth of Sturnira species from their geographic range and categorized them as generalists, cold specialists, or warm specialists. We compared dynamic evolutionary models that differ in 1) niche breadth evolution, 2) parental niche breadth inheritance, and 3) whether niche breadth evolution is associated with shifts in diversification rates. Our best-performing model indicates that most Sturnira species arose as specialists in warm climates and that over time, their niche breadth broadens, and just a subset of those species becomes specialists in cold environments. We found that the evolution of realized thermal niche breadth causes fluctuations in per-lineage rates of diversification, where warm specialists boast the highest speciation rates. However, we found no evidence of these changes in niche neither triggering nor being a result of speciation events themselves; this suggests that diversification events in Sturnira could instead depend on allopatric speciation processes such as the development of geographic barriers.

Correction: Iridium-(κ2-NSi) catalyzed dehydrogenation of formic acid: effect of auxiliary ligands on the catalytic performance.

Correction for 'Iridium-(κ2-NSi) catalyzed dehydrogenation of formic acid: effect of auxiliary ligands on the catalytic performance' by Alejandra Gomez-España et al., Dalton Trans., 2023, 52, 6722-6729, https://doi.org/10.1039/d3dt00744h.

The Cost of Providing Comprehensive HIV Services to Key Populations: An Analysis of the LINKAGES Program in Kenya and Malawi.

INTRODUCTION: Timely data on HIV service costs are critical for estimating resource needs and allocating funding, but few data exist on the cost of HIV services for key populations (KPs) at higher risk of HIV infection in low- and middle-income countries. We aimed to estimate the total and per contact annual cost of providing comprehensive HIV services to KPs to inform planning and budgeting decisions. METHODS: We collected cost data from the Linkages across the Continuum of HIV Services for Key Populations Affected by HIV (LINKAGES) program in Kenya and Malawi serving female and male sex workers, men who have sex with men, and transgender women. Data were collected prospectively for fiscal year (FY) 2019 and retrospectively for start-up activities conducted in FY2015 and FY2016. Data to estimate economic costs from the provider's perspective were collected from LINKAGES headquarters, country offices, implementing partners (IPs), and drop-in centers (DICs). We used top-down and bottom-up cost estimation approaches. RESULTS: Total economic costs for FY2019 were US$6,175,960 in Kenya and US$4,261,207 in Malawi. The proportion of costs incurred in IPs and DICs was 66% in Kenya and 42% in Malawi. The costliest program areas were clinical services, management, peer outreach, and monitoring and data use. Mean cost per contact was US$127 in Kenya and US$279 in Malawi, with a mean cost per contact in DICs and IPs of US$63 in Kenya and US$104 in Malawi. CONCLUSION: Actions undertaken above the service level in headquarters and country offices along with those conducted below the service level in communities, comprised important proportions of KP HIV service costs. The costs of pre-service population mapping and size estimation activities were not negligible. Costing studies that focus on the service level alone are likely to underestimate the costs of delivering HIV services to KPs.

In vitro ovicidal effect of p-coumaric acid from Acacia bilimekii aerial parts against Haemonchus contortus.

Acacia bilimekii is a plant with a high content of protein, fibre, and condensed tannins, making it an excellent feed for small ruminants with anthelmintic potential. This study aimed to evaluate the ovicidal activity of a hydroalcoholic extract (Ab-HA) and fractions from A. bilimekii aerial parts on Haemonchus contortus. The ovicidal activity of the Ab-HA extract and its fractions obtained by chromatographic fractionation were evaluated through the egg hatching inhibition (EHI) test. The results showed that the Ab-HA extract had 91% EHI at 20,000 µg/mL with a mean effective concentration (EC50) of 9260 µg/mL. After liquid-liquid fractionation of Ab-HA extract, the aqueous fraction (Ab-Aq) did not show ovicidal activity, whereas the organic fraction (Ab-EtOAc) showed a better EHI than the Ab-HA extract (98.9% at 2500 µg/mL). Then, the chemical fractionation of Ab-EtOAc allowed obtaining six bioactive fractions (AbR12-17) with an EHI greater than 90% at 1500 µg/mL. The best treatment was AbR15 (98.7% EHI at 750 µg/mL). Chemical analysis by HPLC-PDA of AbR15 indicated the presence of p-coumaric acid and the flavone luteolin as major compounds. Additionally, the commercial p-coumaric acid standard was evaluated in the EHI assay and showed an EHI of 97% at 62.5 µg/mL. Meanwhile, the confocal laser scanning microscopy analysis demonstrated a colocalization effect between p-coumaric acid and the H. contortus embryonated eggs. These results indicate that due to their major chemical compounds (including p-coumaric acid), the aerial parts of the plant A. bilimekii, could be considered as natural potential tool for controlling haemonchosis in small ruminants.

Iridium-(κ2-NSi) catalyzed dehydrogenation of formic acid: effect of auxiliary ligands on the catalytic performance.

The iridium(III) complexes [Ir(H)(Cl)(κ2-NSitBu2)(κ2-bipyMe2)] (2) and [Ir(H)(OTf)(κ2-NSitBu2)(κ2-bipyMe2)] (3) (NSitBu2 = {4-methylpyridine-2-yloxy}ditertbutylsilyl) have been synthesized and characterized including X-ray studies of 3. A comparative study of the catalytic activity of complexes 2, 3, [Ir(H)(OTf)(κ2-NSitBu2)(coe)] (4), and [Ir(H)(OTf)(κ2-NSitBu2)(PCy3)] (5) (0.1 mol%) as catalysts precursors for the solventless formic acid dehydrogenation (FADH) in the presence of Et3N (40 mol%) at 353 K has been performed. The highest activity (TOF5 min ≈ 3260 h-1) has been obtained with 3 at 373 K. However, at that temperature the FTIR spectra show traces of CO together with the desired products (H2 and CO2). Thus, the best performance was achieved at 353 K (TOF5 min ≈ 1210 h-1 and no observable CO). Kinetic studies at variable temperature show that the activation energy of the 3-catalyzed FADH process is 16.76 kcal mol-1. Kinetic isotopic effect (5 min) values of 1.6, 4.5, and 4.2 were obtained for the 3-catalyzed dehydrogenation of HCOOD, DCOOH, and DCOOD, respectively, at 353 K. The strong KIE found for DCOOH and DCOOD evidenced that the hydride transfer from the C-H bond of formic acid to the metal is the rate-determining step of the process.

Metabolic Stroke as a Clinical Manifestation of Zhu-Tokita-Takenouchi-Kim Syndrome: A Case Series.

Objective: This study reports 2 unrelated individuals with Zhu-Tokita-Takenouchi-Kim (ZTTK) syndrome who presented with a metabolic stroke, which has not been commonly reported as a clinical manifestation of this syndrome. Methods: Two female children were identified after presenting to our institution with a metabolic stroke and carried a diagnosis of ZTTK syndrome because of their clinical characteristics and previous genetic testing demonstrating pathogenic variants in SON. Results: Both individuals presented with acute-onset left hemiplegia. They underwent workup, and corresponding metabolic stroke was identified on brain MRI. Both individuals recovered with good functional outcome. One individual was treated with l-arginine, ubiquinol, and levocarnitine. The other individual recovered without any intervention. Discussion: ZTTK syndrome is a rare condition caused by pathogenic variants in SON. This syndrome is characterized by global developmental delay, short stature, facial dysmorphisms, seizures, hypotonia, and brain abnormalities. A metabolic stroke has not been reported as a common manifestation. SON has been reported to play a role in mitochondrial function. This can explain why metabolic stroke can be seen in individuals with ZTTK syndrome. It is important to recognize that metabolic stroke can be a clinical manifestation of ZTTK syndrome because it carries clinical and therapeutic implications.

Insights about levels and sources of organic pollution in an urbanized Amazon estuary (Belém, PA, Northern Brazil).

Amazon aquatic systems have been affected by organic pollution from urbanized regions. This study was conducted to determine the levels, sources, and distribution patterns of 16 polycyclic aromatic hydrocarbons (PAHs) and 6 steroid markers in surficial sediments from an important urbanized Amazon estuarine system (Belém, PA, Northern Brazil). Total PAH concentration (∑PAH) ranged from 878.2 to 9905.7 ng g-1, 3295.2 ng g-1 on average, suggesting a highly contaminated environment. PAH molecular ratios and statistical analysis indicated that PAH originated from a mixture of local sources emissions, mainly related to the combustion of fossil fuels and biomass. Coprostanol levels (maximum concentration = 292.52 ng g-1) could be compared to the mid-range reported in the literature. Studied stations, except for one, presented sterol ratio data indicating organic matter related to untreated sewage. Sterols indicative of sewage contamination showed a correlation with pyrogenic PAH amounts which are transported by the same channels where sewage is discharged.