Long-term outcomes for pediatric heart transplant recipients transitioning to adult care teams.

BACKGROUND: There are limited data evaluating the success of a structured transition plan specifically for pediatric heart transplant (HT) recipients following their transfer of care to an adult specialist. We sought to identify risk factors for poor adherence, graft failure, and mortality following the transfer of care to adult HT care teams. METHODS: We retrospectively reviewed all patients who underwent transition from the pediatric to adult HT program at our center between January 2011 and June 2021. Demographic characteristics, comorbid conditions, and psychosocial history were collected at the time of HT, the time of transition, and the most recent follow-up. Adverse events including mortality, graft rejection, infection, and renal function were also captured before and after the transition. RESULTS: Seventy-two patients were identified (54.1% male, 54.2% Caucasian). Mean age at the time of transition was 23 years after a median of 11.6 years in the pediatric program. The use of calcineurin inhibitors was associated with reduced mortality (HR .04, 95% CI .0-.6, p = .015), while prior psychiatric hospitalization (HR 45.3, 95% CI, 6.144-333.9, p = .0001) was associated with increased mortality following transition. Medication nonadherence and young age at the time of transition were markers for high-risk individuals prior to the transition of care. CONCLUSIONS: Transition of HT recipients from a pediatric program to an adult program occurs during a vulnerable time of emerging adulthood, and we have identified risk factors for mortality following transition. Development of a formalized transition plan with a large multidisciplinary team with focused attention on high-risk patients, including those with psychiatric comorbidities, may favorably influence outcomes.

Electric Field Gradient in Chiral and Tetrahedral Molecules within High-Order LRESC Formalism.

In this work, we present the electric field gradient (EFG) given by the linear response elimination of the small component (LRESC) scheme up to the 1/c4 order (c is the speed of light in vacuum) in CHFClX (X = Br, I, At) chiral molecules, together with CHF2Br and CH2FX (X = Br, I, At) tetrahedral systems. The former could be good candidates for further parity violation studies, especially when heavy atoms are surrounding. In this context, the LRESC scheme demonstrates effective applicability to large tetrahedral and chiral molecules that incorporate heavy elements, with relativistic effects playing a crucial role. The LRESC results of EFG exhibit an excellent agreement with those calculated at the four-component level, giving differences of only hundredths order in a.u. (atomic units) for the bromine nucleus and less than 0.1 a.u. for the iodine nucleus. Regarding the other nuclei, for the chiral molecules, there is a heavy atom effect on the light atom (HALA) for chlorine and fluorine atoms as the substituent halogen atom becomes heavier. Furthermore, the electronic part of the EFG for the central carbon and the fluorine nuclei presents an important dependence with the environment in the molecules under study. With accurate calculations of the EFG and tabulated nuclear quadrupole moment, the nuclear quadrupole coupling constant is obtained within the LRESC scheme, including for the first time correlation effects on the spin-dependent corrections with this methodology, providing results close to the experimental ones for Cl, Br, and I atoms. At the Hartree-Fock level, the differences are around 6% for Br and I nuclei, and at the density functional theory level with the LDA and PBE0 functionals, the differences are no more than 2%.

Coordination of Mercury(II) in Water Promoted over Hydrolysis in Solvated Clusters [Hg(H2O)1-6](aq)2+: Insights from Relativistic Effects and Free Energy Analysis.

Understanding the nature of the interaction between mercury(II) ions, Hg2+, and water molecules is crucial to describe the stability and chemical behavior of structures formed during solvation, as well as the conditions that favor the Hg2+ coordination or inducing water hydrolysis. In our study, we explored exhaustively the potential energy surface of Hg2+ with up to six water molecules. We analyzed electronic and Gibbs free energies, binding, and nuclear magnetic resonance parameters. We used the zeroth-order regular approximation Hamiltonian, including scalar and spin-orbit relativistic corrections for free energy calculations and geometry optimizations to explore the interplay between electron correlation and relativistic effects. We analyzed intermolecular interactions with energy decomposition analysis, quantum theory of atoms in molecules, and natural bond orbital. Additionally, we used the four-component Dirac Hamiltonian to compute solvent effect on the magnetic shielding and J-coupling constants. Our results revealed that the water hydrolysis by Hg2+ requires a minimum of three water molecules. We found that the interaction between Hg2+ and water molecules is an orbital interaction due to relativistic effects and the most stable structures are opened-shape clusters, reducing the number of oxygen-mercury contacts and maximizing the formation of hydrogen bonds among water molecules. In these types of clusters, Hg2+ promotes the water hydrolysis over coordination with oxygen atoms. However, when we considered the change associated with the transfer of a cluster from the ideal gas to a solvated system, our solvation free energy analysis revealed that closed-shape clusters are more favorable, maximizing the number of oxygen-mercury contacts and reducing the formation of hydrogen bonds among water molecules. This finding suggests that, under room conditions, the coordination of Hg2+ is more favorable than hydrolysis. Our results have significant implications for understanding Hg2+ behavior in water, helping to develop targeted strategies for mercury remediation and management, and contributing to advancements in the broader field of environmental chemistry.

The LRESC-Loc Model to Analyze Magnetic Shieldings with Localized Molecular Orbitals.

The leading electronic mechanisms of relativistic effects in the NMR magnetic shieldings of heavy-atom (HA) containing molecules are well described by the linear response with elimination of small components model (LRESC). We show here first results from a new version of the LRESC model written in terms of localized molecular orbitals (LMOs) which is coined as LRESC-Loc. Those LMOs resemble "chemist's orbitals", representing lone-pairs, atomic cores, and bonds. The whole set of relativistic effects are expressed in terms of non-ligand-dependent and ligand-dependent contributions. We show the electronic origin of trends and behavior of different mechanisms in molecular systems which contain heavy elements that belong to any of the IB to VIIA groups of the periodic table. The SO mechanism has a well-defined dependence with the LPs (LPσ and LPπ) when the HAs have them, but the non-SO mechanisms mostly depend on other LMOs. In addition we propose here that the SO mechanism can be used to characterize interactions involving LPs and the non-SO mechanisms to characterize covalent and close-shell interactions. All our main results are in accord with previous findings, though we are now able to analyze them in a different manner.

High order relativistic corrections on the electric field gradient within the LRESC formalism.

In this work, we present relativistic corrections to the electric field gradient (EFG) given by the Linear Response Elimination of the Small Component (LRESC) scheme at 1/c2 order and including for the first time spin-dependent (SD) corrections at 1/c4 order. We show that these new terms improve the performance of LRESC as results with this methodology are very close to those calculated at the four-component Dirac-Hartree-Fock (4c-DHF) level. We assess the new corrections in BrY and AtY di-halogen (Y = F, Cl, Br, I, and At) and XZY bi-linear molecules (Z = Zn, Cd, and Hg; X, Y = F, Cl, Br, I, and At). At the 4c-DHF level, we analyze the contributions coming from the large and small components of the relativistic 4c wave function to the electronic part of EFG and compare them with the LRESC corrections to find their electronic origin. For the HgX2 (X = Cl, Br, and I) subset, when the SD correcting terms are included, LRESC calculations match very well with 4c-DHF ones and those from the literature, with differences less than 1% for molecules containing up to three heavy atoms. We show that LRESC gives accurate values of EFG, allowing the analysis of the electronic origin of relativistic effects in terms of well-known nonrelativistic operators.

Glycerol Boosted Rh-Catalyzed Hydroaminomethylation Reaction: A Mechanistic Insight.

We report a Rh-catalyzed hydroaminomethylation reaction of terminal alkenes in glycerol that proceeds efficiently under mild conditions to produce the corresponding amines in relatively high selectivity towards linear amines, moderate to excellent yields by using a low catalyst loading (1 mol % [Rh], 2 mol % phosphine) and relative low pressure (H2 /CO, 1:1, total pressure 10 bar). This work sheds light on the importance of glycerol in enabling enamine reduction via hydrogen transfer. Moreover, evidence for the crucial role of Rh as chemoselective catalyst in the condensation step has been obtained for the first time in the frame of the hydroaminomethylation reaction by precluding deleterious aldol condensation reactions. The hydroaminomethylation proceeds under a molecular regime; the outcome of catalytically active species into metal-based nanoparticles renders the catalytic system inactive.

Performance of the LRESC Model on top of DFT Functionals for Relativistic NMR Shielding Calculations.

The linear response within the elimination of the small component model (LRESC) is an insightful and computationally efficient method for including relativistic effects on molecular properties like the nuclear magnetic shielding constants, spin-rotation constant, g-tensor, and electric field gradient of heavy atom containing molecules with atoms belonging up to the sixth row of the periodic table. One of its main advantages is its capacity to analyze the electronic origin of the different relativistic correcting terms. Until now, it was always applied on top of Hartree-Fock ground-state wave functions (LRESC/HF) to calculate and analyze NMR shieldings. In this work, we show the performance of the LRESC formalism on top of some density functional theory (DFT) functionals to compute tin shielding constants in SnX4 (X = H, F, Cl, Br, I) molecular systems. We analyze the performance of each LRESC/DFT scheme on reproducing the electronic mechanisms of the shieldings, taking as a benchmark the results of relativistic calculations at the RPA level of approach (4c/RPA). As in previous works, we divide the LRESC relativistic correcting terms into two groups: core-dependent and ligand-dependent contributions. It is shown here that core-dependent corrections are well-reproduced for the selected DFT functionals, but some differences arise in the ligand-dependent ones. We focus on the performance of different functionals, including the same electron correlation part but containing different amounts of HF exchange. The best results are obtained for the BHandHLYP functional (50% of HF exchange) and the worst for BLYP (0%). When the percentage of HF exchange increases, ligand-dependent contributions are better described, and the final LRESC/DFT results are closer to those obtained with LRESC/HF and 4c/RPA methods. The spin-orbit correction to the shielding constant is one of the main ligand-dependent contributions (there are two more) with total value depending on the amount of HF exchange included in the functional. When the amount of HF exchange decreases, the spin-orbit contribution becomes larger, overestimating the shielding constant even when nonrelativisitc DFT values are much smaller than the nonrelativistic HF ones, as it happens for the heaviest molecular system studied here (SnI4).

Therapeutic Inhibition of VEGF Signaling and Associated Nephrotoxicities.

Inhibition of vascular endothelial growth factor A (VEGFA)/vascular endothelial growth factor receptor 2 (VEGFR2) signaling is a common therapeutic strategy in oncology, with new drugs continuously in development. In this review, we consider the experimental and clinical evidence behind the diverse nephrotoxicities associated with the inhibition of this pathway. We also review the renal effects of VEGF inhibition's mediation of key downstream signaling pathways, specifically MAPK/ERK1/2, endothelial nitric oxide synthase, and mammalian target of rapamycin (mTOR). Direct VEGFA inhibition via antibody binding or VEGF trap (a soluble decoy receptor) is associated with renal-specific thrombotic microangiopathy (TMA). Reports also indicate that tyrosine kinase inhibition of the VEGF receptors is preferentially associated with glomerulopathies such as minimal change disease and FSGS. Inhibition of the downstream pathway RAF/MAPK/ERK has largely been associated with tubulointerstitial injury. Inhibition of mTOR is most commonly associated with albuminuria and podocyte injury, but has also been linked to renal-specific TMA. In all, we review the experimentally validated mechanisms by which VEGFA-VEGFR2 inhibitors contribute to nephrotoxicity, as well as the wide range of clinical manifestations that have been reported with their use. We also highlight potential avenues for future research to elucidate mechanisms for minimizing nephrotoxicity while maintaining therapeutic efficacy.

Microsolvation of methylmercury: structures, energies, bonding and NMR constants ((199)Hg, (13)C and (17)O).

Hartree-Fock (HF) and second order perturbation theory (MP2) calculations within the scalar and full relativistic frames were carried out in order to determine the equilibrium geometries and interaction energies between cationic methylmercury (CH3Hg(+)) and up to three water molecules. A total of nine structures were obtained. Bonding properties were analyzed using the Quantum Theory of Atoms In Molecules (QTAIM). The analyses of the topology of electron densities reveal that all structures exhibit a partially covalent HgO interaction between methylmercury and one water molecule. Consideration of additional water molecules suggests that they solvate the (CH3HgOH2)(+) unit. Nuclear magnetic shielding constants σ((199)Hg), σ((13)C) and σ((17)O), as well as indirect spin-spin coupling constants J((199)Hg-(13)C), J((199)Hg-(17)O) and J((13)C-(17)O), were calculated for each one of the geometries. Thermodynamic stability and the values of NMR constants correlate with the ability of the system to directly coordinate oxygen atoms of water molecules to the mercury atom in methylmercury and with the formation of hydrogen bonds among solvating water molecules. Relativistic effects account for 11% on σ((13)C) and 14% on σ((17)O), which is due to the presence of Hg (heavy atom on light atom, HALA effect), while the relativistic effects on σ((199)Hg) are close to 50% (heavy atom on heavy atom itself, HAHA effect). J-coupling constants are highly influenced by relativity when mercury is involved as in J((199)Hg-(13)C) and J((199)Hg-(17)O). On the other hand, our results show that the values of NMR constants for carbon and oxygen, atoms which are connected through mercury (C-HgO), are highly correlated and are greatly influenced by the presence of water molecules. Water molecules introduce additional electronic effects to the relativistic effects due to the mercury atom.

Theoretical analysis of NMR shieldings of group-11 metal halides on MX (M = Cu, Ag, Au; X = H, F, Cl, Br, I) molecular systems, and the appearance of quasi instabilities on AuF.

Accurate calculations of nuclear magnetic shieldings of group-11 metal halides, σ(M; MX) (M = Cu, Ag, Au; X = H, F, Cl, Br, I), were performed with relativistic and nonrelativistic theoretical schemes in order to learn more about the importance of the involved electronic mechanisms that underlie such shieldings. We applied state of the art schemes: polarization propagators at a random phase level of approach (PP-RPA); spin-free Hamiltonian (SF); linear response elimination of small component (LRESC) and density functional theory (DFT) with two different functionals: B3LYP and PBE0. The results from DFT calculations are not close to those from the relativistic polarization propagator calculations at the RPA level of approach (RelPP-RPA), in line with previous results. The spin-orbit (SO) contribution to a shielding constant is important only for MF molecules (M = Cu, Ag, Au). Different electronic mechanisms are considered within the LRESC method, bunched into two groups: core- and ligand-dependent. For the analysed shieldings the core-dependent electronic mechanisms are the most important ones; the ligand-dependent being only important for MF molecules. An out of range value for σ(Au) is found in AuF. It was previously reported in the literature, either originated in the large fluorine electronegativity together with large spin-orbit coupling contributions; or, due to Fermi-contact contributions. We argue here that such an unexpected large value is an artifact originated in the appearance of quasi instabilities, and show how to handle this apparent problem.

Instrument transfer function of slope measuring deflectometry systems.

Slope measuring deflectometry (SMD) systems are developing rapidly in testing freeform optics. They measure the surface slope using a camera and an incoherent source. The principle of the test is mainly discussed in geometric optic domain. The system response as a function of spatial frequency or instrument transfer function (ITF) has yet to be studied thoroughly. Through mathematical modeling, simulation, and experiment we show that the ITF of an SMD system is very close to the modulation transfer function of the camera used. Furthermore, the ITF can be enhanced using a deconvolution filter. This study will lead to more accurate measurements in SMD and will show the physical optics nature of these tests.

Relativistic and electron-correlation effects on the nuclear magnetic resonance shieldings of molecules containing tin and lead atoms.

The reference values for NMR magnetic shieldings, σ(ref), are of the highest importance when theoretical analysis of chemical shifts are envisaged. The fact that the nonrelativistically valid relationship among spin-rotation constants and magnetic shieldings is not any longer valid for heavy atoms requires that the search for σ(ref) for such atoms needs new strategies to follow. We present here results of σ(ref) that were obtained by applying our own simple procedure which mixes accurate experimental chemical shifts (δ) and theoretical magnetic shieldings (σ). We calculated σ(Sn) and σ(Pb) in a family of heavy-halogen-containing molecules. We found out that σ(ref)[Sn;Sn(CH3)4] in gas phase should be close to 3864.11 ± 20.05 ppm (0.5%). For Pb atom, σ(ref)[Pb;Pb(CH3)4] should be close to 14475.1 ± 500.7 ppm. Such theoretical values correspond to calculations with the relativistic polarization propagator method, RelPPA, at the RPA level of approach. They are closer to experimental values as compared to those obtained applying few different functionals such as PBE0, B3LYP, BLYP, BP86, KT2, and KT3 of the density functional theory, DFT. We studied tin and lead shieldings of the XY(4-n)Z(n) (X = Sn, Pb; Y, Z = H, F, Cl, Br, I) and PbH(4-n)I(n) (n = 0, 1, 2, 3, 4) family of compounds with four-component functionals as implemented in the DIRAC code. For these systems results of calculations with RelPPA-RPA are more reliable than DFT ones. We argue about why those DFT functionals must be modified in order to obtain more accurate results of NMR magnetic shieldings within the relativistic regime: first, there is a dependence among both electron-correlation and relativistic effects that should be introduced in some way in the functionals; and second, the DIRAC code uses standard nonrelativistic functionals and the functionals B3LYP and PBE0 were parametrized only with data taken from light elements. It can explain why they are not able to properly introduce relativistic effects on nuclear magnetic shieldings. We finally show that in the analysis of magnetic shieldings for the family of compounds mentioned above, one must consider the newest and so-called heavy-atom effect on vicinal heavy atoms, HAVHA. Such effects are among the most important relativistic effects in these kind of compounds.

Development of a portable deflectometry system for high spatial resolution surface measurements.

The Slope-Measuring Portable Optical Test System (SPOTS) is a new, portable, high-resolution, deflectometry device that achieves mid to high (20 to 1000 cyc/m) spatial frequency optical surface metrology with very little filtering and very little noise. Using a proof of concept system, we achieved 1 nm RMS surface accuracy for mid to high spatial frequencies, and 300 nrad RMS slope precision. SPOTS offers a turnkey solution for measuring errors on a wide variety of optical surfaces including the large mirrors fabricated at The University of Arizona. This paper defines and discusses SPOTS, including the principles of operation, measurement modes, design, performance, error analysis, and experimental results.

Integrating Microbial Fuel Cell and Hydroponic Technologies Using a Ceramic Membrane Separator to Develop an Energy-Water-Food Supply System.

In this study, a microbial fuel cell was integrated into a hydroponic system (MFC-Hyp) using a ceramic membrane as a separator. The MFC-Hyp is a passive system that allows the transport of nutrients from wastewater in the microbial fuel cell (MFC) to water in the hydroponic vessel (Hyp) through a ceramic membrane separator, with no external energy input. The performance of this system was examined using potato-process wastewater as a source of energy and nutrients (K, P, N) and garlic chives (Allium tuberosum) as a hydroponic plant. The results showed that based on dry weight, the leaves of Allium tuberosum grew 142% more in the MFC-Hyp than those of the plant in the Hyp without the MFC, in a 49-day run. The mass fluxes of K, P, and NO3--N from the MFC to the Hyp through the ceramic membrane were 4.18 ± 0.70, 3.78 ± 1.90, and 2.04 ± 0.98 µg s-1m-2, respectively. It was apparent that the diffusion of nutrients from wastewater in the MFC enhanced the plant growth in the Hyp. The MFC-Hyp in the presence of A. tuberosum produced the maximum power density of 130.2 ± 45.4 mW m-2. The findings of this study suggest that the MFC-Hyp system has great potential to be a "carbon-neutral" technology that could be transformed into an important part of a diversified worldwide energy-water-food supply system.

Novel Catalyst Composites of Ni- and Co-Based Nanoparticles Supported on Inorganic Oxides for Fatty Acid Hydrogenations.

In the quest to develop nanometrically defined catalytic systems for applications in the catalytic valorization of agri-food wastes, small Ni-based nanoparticles supported on inorganic solid supports have been prepared by decomposition of organometallic precursors in refluxing ethanol under H2 atmosphere, in the presence of supports exhibiting insulating or semi-conductor properties, such as MgAl2O4 and TiO2, respectively. The efficiency of the as-prepared Ni-based nanocomposites has been evaluated towards the hydrogenation of unsaturated fatty acids under solvent-free conditions, with high selectivity regarding the hydrogenation of C=C bonds. The influence of the support on the catalytic performance of the prepared Ni-based nanocomposites is particularly highlighted.

Relativistic effects on nuclear magnetic shieldings of CH(n)X(4-n) and CHXYZ (X, Y, Z = H, F, Cl, Br, I).

Nuclear magnetic shieldings of both carbon and hydrogen atoms of haluro methyl molecules are highly influenced by the substitution of one or more hydrogen by halogen heavy atoms. We applied the linear response elimination of small components, LRESC, formalism to calculate such shieldings and learn whether including only few terms is enough for getting quantitative reproduction of the total shieldings or not. First, we discuss the contribution of all leading relativistic corrections to σ(C), in CHX(2)I molecular models with X = H, F, and Cl, and show that spin-orbit (SO) effects are the main ones. After adding the SO effects to the non-relativistic (NR) results, we obtain ~ 97% (93%) of the total LRESC values for σ(C) (σ(H)). The magnitude of SO terms increases when the halogen atom becomes heavier. In this case, such contributions to σ(C) can be extrapolated as a function of Z, the halogen atomic number. Furthermore, when paramagnetic spin-orbit (PSO) contributions are also considered, we obtain results that are within 1% of the total LRESC value. Then we study in detail the main electronic mechanisms involved to contribute C and H shieldings on CH(n)X(4 - n) (n = 1, 3), and CHXYZ (X, Y, Z = F, Cl, Br, I) model compounds. The pattern of σ(C) for all series of compounds follows a normal halogen dependence (NHD), though with different rate of increase. A special family of compounds is that of CHF(2)X for which σ(nr)(C) follows an inverse halogen dependence though the total shielding have a NHD due to the SO contributions. For the series CH(3)X (X = F, Cl, Br and I), we found that σ(SO) ~ Z(X) (2.53). Another important finding of this work is the logarithmic dependence of σ(SO)(C) with the substituent atomic number: ln σ(SO)(C) = A(X) + a(X) Z(Y) for both family of compounds CH(2)XY and CHX(2)Y. We also performed four-component calculations using the spin-free Hamiltonian to obtain SO contributions within a four-component framework.

Nuclear charge-distribution effects on the NMR spectroscopy parameters.

We present here a systematic study about the influence of the size and type of nuclear charge-distribution models (Gaussian and point-like) on the NMR spectroscopic parameters, the nuclear magnetic shielding σ and the indirect nuclear spin J-coupling. We found that relativistic effects largely enhance the nuclear charge-distribution effects (NChDE) on those parameters being them quite sensitive to the nuclear model adopted for calculations. Results for two rare gas atoms (Kr, Rn) and few molecular systems like HX, (X = Br, I, At), CH(4), SnH(4), SnIH(3), SnI(2)H(2), and PbIH(3) are presented. J-couplings are more sensitive than shieldings in both, relativistic and non-relativistic (NR) regimes. The highest effect (close to 11% of variation in relativistic calculations with that two different nuclear models) is observed for J(Pb-I) in PbIH(3). A similar effect is found for J(Pb-H) in the same molecule, close to 9%. The NChDE for σ(Sn) in SnI(4-n)H(n) with n = 1, 2 is as large as few ppm (between 3 and 8.56 ppm). For J(Sn-H) in this set of molecules, it goes from 37 Hz for SnH(4) to 54 Hz for SnI(2)H(2). Furthermore, we found that the vicinal NChDE is very small though not zero. For (1)J(Sn-H) in SnIH(3), the NChDE of iodine is close to 2 Hz (0.1%). We also studied the NChDE on the ground state electronic energies of atoms and molecules. We found that these effects are only important within the relativistic regime but not within the NR one. They are in good agreement with previous works.

Screening Tool for Mental Health Problems During COVID-19 Pandemic: Psychometrics and Associations With Sex, Grieving, Contagion, and Seeking Psychological Care.

Background: The COVID-19 pandemic has created a public mental health crisis. Brief, valid electronic tools are required to evaluate mental health status, identify specific risk factors, and offer treatment when needed. Objective: To determine the construct validity, reliability, and measurement invariance of a brief screening tool for mental health symptoms by sex, loss of loved ones, personal COVID-19 status, and psychological care-seeking during the COVID-19 pandemic. Furthermore, the aim involved establishing a predictive pattern between the mental health variables. Method: A total sample of 27,320 Mexican participants, with a mean age of 32 years (SD = 12.24, range = 18-80), 67% women (n = 18,308), 23.10% with a loss of loved ones (n = 6,308), 18.3% with COVID-19 status (n = 5,005), and 18.40% seeking psychological care (n = 5,026), completed a questionnaire through a WebApp, containing socio-demographic data (sex, loss of loved ones, COVID-19 status, and psychological care-seeking) and the dimensions from the Posttraumatic Checklist, Depression-Generalized Anxiety Questionnaires, and Health Anxiety-Somatization scales. We used the confirmatory factor analysis (CFA: through maximum likelihood to continuous variable data, as an estimation method), the invariance measurement, and the structural equational modeling (SEM) to provide evidence of the construct validity of the scale and the valid path between variables. We analyzed the measurement invariance for each dimension by comparison groups to examine the extent to which the items showed comparable psychometric properties. Findings: The tool included eight dimensions: four posttraumatic stress symptoms -intrusion, avoidance, hyperactivation, and numbing, as well as depression, generalized anxiety, health anxiety, and somatization The tool's multidimensionality, was confirmed through the CFA and SEM. The participants' characteristics made it possible to describe the measurement invariance of scales because of the participants' attributes. Additionally, our findings indicated that women reported high generalized anxiety, hyperactivation, and depression. Those who lost loved ones reported elevated levels of intrusion and health anxiety symptoms. Participants who reported having COVID-19 presented with high levels of generalized anxiety symptoms. Those who sought psychological care reported high levels of generalized anxiety, intrusion, hyperactivation, and health anxiety symptoms. Our findings also show that intrusion was predicted by the avoidance dimension, while health anxiety was predicted by the intrusion dimension. Generalized anxiety was predicted by the health anxiety and hyperactivation dimensions, and hyperactivation was predicted by the depression one. Depression and somatization were predicted by the health anxiety dimension. Last, numbing was predicted by the depression and avoidance dimensions. Discussion and Outlook: Our findings indicate that it was possible to validate the factor structure of posttraumatic stress symptoms and their relationship with depression, anxiety, and somatization, describing the specific bias as a function of sociodemographic COVID-19-related variables. We also describe the predictive pattern between the mental health variables. These mental health problems were identified in the community and primary health care scenarios through the CFA and the SEM, considering the PCL, depression, generalized anxiety, health anxiety, and somatization scales adapted during the COVID-19 pandemic. Therefore, future studies should describe the diagnosis of mental health disorders, assessing the cut-off points in the tool to discriminate between the presence and absence of conditions and mental health cut-off points. Community and primary care screening will lead to effective early interventions to reduce the mental health risks associated with the current pandemic. Limitations: Future studies should follow up on the results of this study and assess consistency with diagnoses of mental health disorders and evaluate the effect of remote psychological help. Moreover, in the future, researchers should monitor the process and the time that has elapsed between the occurrence of traumatic events and the development of posttraumatic stress and other mental health risks through brief electronic measurement tools such as those used in this study.

Improvement of zero waste sustainable recovery using microbial energy generation systems: A comprehensive review.

Microbial energy generation systems, i.e., bioelectrochemical systems (BESs) are promising sustainable technologies that have been used in different fields of application such as biofuel production, biosensor, nutrient recovery, wastewater treatment, and heavy metals removal. However, BESs face great challenges such as large-scale application in real time, low power performance, and suitable materials for their configuration. This review paper aimed to discuss the use of BES systems such as conventional microbial fuel cells (MFCs), as well as plant microbial fuel cell (P-MFC), sediment microbial fuel cell (S-MFC), constructed wetland microbial fuel cell (CW-MFC), osmotic microbial fuel cell (OsMFC), photo-bioelectrochemical fuel cell (PBFC), and MFC-Fenton systems in the zero waste sustainable recovery process. Firstly, the configuration and electrode materials used in BESs as the main sources to improve the performance of these technologies are discussed. Additionally, zero waste recovery process from solid and wastewater feedstock, i.e., energy recovery: electricity generation (from 12 to 26,680 mW m-2) and fuel generation, i.e., H2 (170 ± 2.7 L-1 L-1 d-1) and CH4 (107.6 ± 3.2 mL-1 g-1), nutrient recovery of 100% (PO43-P), and 13-99% (NH4+-N), heavy metal removal/recovery: water recovery, nitrate (100%), sulfate (53-99%), and sulfide recovery/removal (99%), antibiotic, dye removal, and other product recovery are critically analyzed in this review paper. Finally, the perspective and challenges, and future outlook are highlighted. There is no doubt that BES technologies are an economical option for the simultaneous zero waste elimination and energy recovery. However, more research is required to carry out the large-scale application of BES, as well as their commercialization.

The Impact of COVID-19 on Diagnosis of Heart Disease in Latin America an INCAPS COVID Sub-analysis. / O Impacto da COVID-19 no Diagnóstico de Doenças Cardíacas na América Latina Uma Subanálise do INCAPS COVID.

BACKGROUND: The COVID-19 pandemic has disrupted the delivery of care for cardiovascular diseases in Latin America. However, the effect of the pandemic on the cardiac diagnostic procedure volumes has not been quantified. OBJECTIVE: To assess (1) the impact of COVID-19 on cardiac diagnostic volumes in Latin America and (2) determine its relationship with COVID-19 case incidence and social distancing measures. METHODS: The International Atomic Energy Agency conducted a worldwide survey assessing changes in cardiac diagnostic volumes resulting from COVID-19. Cardiac diagnostic volumes were obtained from participating sites for March and April 2020 and compared to March 2019. Social distancing data were collected from Google COVID-19 community mobility reports and COVID-19 incidence per country from the Our World in Data. RESULTS: Surveys were conducted in 194 centers performing cardiac diagnostic procedures, in 19 countries in Latin America. Procedure volumes decreased 36% from March 2019 to March 2020, and 82% from March 2019 to April 2020. The greatest decreases occurred in echocardiogram stress tests (91%), exercise treadmill tests (88%), and computed tomography calcium scores (87%), with slight variations between sub-regions of Latin America. Changes in social distancing patterns (p < 0.001) were more strongly associated with volume reduction than COVID-19 incidence (p = 0.003). CONCLUSIONS: COVID-19 was associated with a significant reduction in cardiac diagnostic procedures in Latin America, which was more related to social distancing than to the COVID-19 incidence. Better balance and timing of social distancing measures and planning to maintain access to medical care is warranted during a pandemic surge, especially in regions with high cardiovascular mortality.

FUNDAMENTO: A pandemia de COVID-19 interferiu na prestação de atendimento a doenças cardiovasculares na América Latina. No entanto, o efeito da pandemia nos volumes de procedimentos cardíacos diagnósticos ainda não foi quantificado. OBJETIVO: Avaliar (1) o impacto de COVID-19 nos volumes de diagnóstico cardíaco na América Latina e (2) determinar sua relação com a incidência de casos de COVID-19 e as medidas de distanciamento social. MÉTODOS: A International Atomic Energy Agency realizou uma pesquisa mundial avaliando mudanças nos volumes diagnósticos cardíacos decorrentes da COVID-19. Foram obtidos os volumes diagnósticos cardíacos dos locais participantes para março e abril de 2020 e comparados com março de 2019. Foram coletados dados de distanciamento social a partir dos Relatórios de mobilidade da comunidade de Google e a incidência de COVID-19 por país a partir de Our World in Data. RESULTADOS: Foram realizadas pesquisas em 194 centros que realizam procedimentos diagnósticos cardíacos, em 19 países da América Latina. Em comparação com o mês de março de 2019, os volumes dos procedimentos diagnósticos cardíacos diminuíram 36% em março de 2020 e 82% em abril de 2020.As maiores reduções ocorreram em relação aos testes de estresse ecocardiográfico (91%), testes ergométricos de esteira (88%) e escore de cálcio por tomografia computadorizada (87%), com pequenas variações entre as sub-regiões da América Latina. As mudanças em padrões de distanciamento social (p < 0,001) estavam mais fortemente associadas com a redução do volume do que a incidência de COVID-19 (p = 0,003). CONCLUSÕES: A COVID-19 foi associada a uma redução significativa de procedimentos diagnósticos cardíacos na América Latina, a qual foi mais relacionada ao distanciamento social do que ao aumento da incidência da COVID-19. São necessários melhor equilíbrio e timing de medidas de distanciamento social e planejamento para manter o acesso ao atendimento médico durante um surto pandêmico, especialmente em regiões com alta mortalidade cardiovascular.