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Cardioneuroablation has emerged as a potential alternative to cardiac pacing in selected cases with vasovagal reflex syncope, extrinsic vagally induced sinus bradycardia-arrest or atrioventricular block. The technique was first introduced decades ago, and its use has risen over the past decade. However, as with any intervention, proper patient selection and technique are a prerequisite for a safe and effective use of cardioneuroablation therapy. This document aims to review and interpret available scientific evidence and provide a summary position on the topic.
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Terapéutica , Síncope Vasovagal , Bloqueo Atrioventricular , Sistema Nervioso Autónomo , Síncope , Bradicardia , Selección de PacienteRESUMEN
Cubanthonomus Anderson, new genus (Coleoptera: Curculionidae: Curculioninae: Anthonomini) is here described to accommodate the Cuban species Cleogonus grossulus Suffrian, which was previously placed as incertae sedis within Cleogonini. The genus is characterized by head constricted behind the eyes, globose form, compact antennal funicle of seven antennomeres, base of pronotum strongly produced posteriorly at middle, elytra with rows of punctures (striae effaced), tarsal claws with small basal tooth, profemora with two teeth, meso- and metafemora with single small tooth. Specimens have been collected in tropical semideciduous forest but no host associations are known.
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Escarabajos , Gorgojos , Animales , Cuba , BosquesRESUMEN
The Pacific Coast tick (Dermacentor occidentalis Marx, 1892) is a frequently encountered and commonly reported human-biting tick species that has been recorded from most of California and parts of southwestern Oregon, southcentral Washington, and northwestern Mexico. Although previous investigators have surveyed populations of D. occidentalis for the presence of Rickettsia species across several regions of California, populations of this tick have not been surveyed heretofore for rickettsiae from Baja California, Oregon, or Washington. We evaluated 1,367 host-seeking, D. occidentalis adults collected from 2015 to 2022 by flagging vegetation at multiple sites in Baja California, Mexico, and Oregon and Washington, United States, using genus- and species-specific assays for spotted fever group rickettsiae. DNA of Rickettsia 364D, R. bellii, and R. tillamookensis was not detected in specimens from these regions. DNA of R. rhipicephali was detected in D. occidentalis specimens obtained from Ensenada Municipality in Baja California and southwestern Oregon, but not from Washington. All ompA sequences of R. rhipichephali that were amplified from individual ticks in southwestern Oregon were represented by a single genotype. DNA of the Ixodes pacificus rickettsial endosymbiont was amplified from specimens collected in southwestern Oregon and Klickitat County, Washington; to the best of our knowledge, this Rickettsia species has never been identified in D. occidentalis. Collectively, these data are consistent with a relatively recent introduction of Pacific Coast ticks in the northernmost extension of its recognized range.
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Dermacentor , Rickettsia , Animales , Rickettsia/aislamiento & purificación , Rickettsia/genética , Dermacentor/microbiología , Washingtón , Oregon , Femenino , México , MasculinoRESUMEN
Blast furnace dust waste (BFDW) proved efficient as a photocatalyst for the decolorization of methylene blue (MB) dye in water. Structural analysis unequivocally identified α-Fe2O3 as the predominant phase, constituting approximately 92%, with a porous surface showcasing unique 10-30 nm agglomerated nanoparticles. Chemical and thermal analyses indicated surface-bound water and carbonate molecules, with the main phase's thermal stability up to 900 °C. Electrical conductivity analysis revealed charge transfer resistance values of 616.4 Ω and electrode resistance of 47.8 Ω. The Mott-Schottky analysis identified α-Fe2O3 as an n-type semiconductor with a flat band potential of 0.181 V vs. Ag/AgCl and a donor density of 1.45 × 1015 cm-3. The 2.2 eV optical bandgap and luminescence stem from α-Fe2O3 and weak ferromagnetism arises from structural defects and surface effects. With a 74% photocatalytic efficiency, stable through three photodegradation cycles, BFDW outperforms comparable waste materials in MB degradation mediated by visible light. The elemental trapping experiment exposed hydroxyl radicals (OHâ¢) and superoxide anions (O2-â¢) as the primary species in the photodegradation process. Consequently, iron oxide-based BFDW emerges as an environmentally friendly alternative for wastewater treatment, underscoring the pivotal role of its unique physical properties in the photocatalytic process.
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Amazonia is an invaluable global asset for all its ecological and cultural significance. Indigenous peoples and their lands are pivotal in safeguarding this unique biodiversity and mitigating global climate change. Understanding the causal structure behind variation in the degree of environmental conservation across different indigenous lands-each with varying institutional, legal, and socioenvironmental conditions-is an essential source of information in the struggle for long-term sustainable management of Amazonian ecosystems. Here, we use data from the Instituto Socioambiental for 361 indigenous lands in the Brazilian Amazon coded for environmental integrity, territorial integrity, legal stability, indigenous governance, and threats due to infrastructure projects. Using Bayesian networks to learn the causal structure amongst these variables reveals two causal pathways leading to environmental integrity. One causal pathway starts with territorial integrity and is mediated by infrastructure projects, while the other is directly from legal stability. Hence, safeguarding indigenous lands from exploitation is best accomplished via legal land rights and stricter enforcement instead of placing the onus on indigenous governance, which is also a direct outcome of legal stability.
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Conservación de los Recursos Naturales , Ecosistema , Teorema de Bayes , Biodiversidad , BrasilRESUMEN
Plant macrofossils from packrat (Neotoma spp.) middens provide direct evidence of past vegetation changes in arid regions of North America. Here we describe the newest version (version 5.0) of the U.S. Geological Survey (USGS) North American Packrat Midden Database. The database contains published and contributed data from 3,331 midden samples collected in southwest Canada, the western United States, and northern Mexico, with samples ranging in age from 48 ka to the present. The database includes original midden-sample macrofossil counts and relative-abundance data along with a standardized relative-abundance scheme that makes it easier to compare macrofossil data across midden-sample sites. In addition to the midden-sample data, this version of the midden database includes calibrated radiocarbon (14C) ages for the midden samples and plant functional type (PFT) assignments for the midden taxa. We also provide World Wildlife Fund ecoregion assignments and climate and bioclimate data for each midden-sample site location. The data are provided in tabular (.xlsx), comma-separated values (.csv), and relational database (.mdb) files.
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Clima , Fósiles , Plantas , México , América del Norte , SigmodontinaeRESUMEN
We conducted a comprehensive analysis of the surface microtexture of kefir biofilms grown on Theobroma grandiflorum Shum (cupuaçu) juice using atomic force microscopy. Our goal was to investigate the unique monofractal and multifractal spatial patterns of these biofilms to complement the existing limited literature. The biofilms were prepared dispersing four different concentrations of kefir grains in cupuaçu juice. Our morphological analysis showed that the surface of the obtained biofilms is essentially formed by the presence of cupuaçu fibers and microorganisms like lactobacilli and yeast. The topographic height-based parameter analysis reveals that there is a dependence between surface roughness and the concentration of kefir grains used. The strongly anisotropic well-centralized topographical height distribution of the biofilms also exhibited a quasi-symmetrical and platykurtic pattern. The biofilms exhibit comparable levels of spatial complexity, surface percolation and surface homogeneity, which can be attributed to their similar topographic uniformity. This aspect was further supported by the presence of similar multifractality in the biofilms, suggesting that despite their varying topographic roughness, their vertical growth dynamics follow a similar pattern. Our findings demonstrate that the surface roughness of kefir biofilms cultivated on cupuaçu juice is influenced by the concentration of kefir grains in the precursor solution. However, this dependence follows a consistent pattern across different concentrations. Graphical Abstract.
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Kéfir , Biopelículas , Lactobacillus , Saccharomyces cerevisiaeRESUMEN
Isolated indigenous societies who actively avoid sustained peaceful contact with the outside world are critically endangered. Last year, "Tanaru", the lone surviving man of his tribe for at least 35 years, died in Southwest Amazonia, marking the latest cultural extinction event in a long history of massacres, enslavement, and epidemics. Yet in the upper reaches of the Amazon Basin, dozens of resilient isolated tribes still manage to survive. Remote sensing is a reliable method of monitoring the population dynamics of uncontacted populations by quantifying the area cleared for gardens and villages, along with the fire detections associated with the burning of those clearings. Remote sensing also provides a method to document the number of residential structures and village fissioning. Only with these longitudinal assessments can we better evaluate the current no-contact policies by the United Nations and governments, along with the prospects for the long-term survival of isolated tribes. While the world's largest isolated indigenous metapopulation, Pano speakers in Acre, Brazil, appears to be thriving, other smaller isolated populations disconnected from metapopulations continue to be extremely vulnerable to external threats. Our applied anthropological conservation approach is to provide analyses of publicly available remote sensing datasets to help inform policies that enhance the survival and well-being of isolated cultural groups.
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Incendios , Tecnología de Sensores Remotos , Humanos , Brasil , Crecimiento Demográfico , Conservación de los Recursos NaturalesRESUMEN
BACKGROUND: Geographic patterns of lung cancer mortality rate differ in the region bordering Mexico in contrast to the US. This study compares lung cancer mortality between border and non-border counties by race/ethnicity and gender. METHODS: This study utilized population-level death certificate data from US Centers for Disease Control and Prevention Public Internet Wide-Ranging Online Data for Epidemiologic Research dataset between 1999 and 2020. Established algorithms were implemented to examine lung cancer deaths among US residents. We analyzed the age-adjusted data by year, race/ethnicity, gender, and geographic region. Joinpoint regression was used to determine mortality trends across time. RESULTS: Lung cancer mortality rates were lower in border counties compared to non-border counties across time (p < 0.05). Hispanic lung cancer mortality rates were not different in border counties compared to non-border counties during the same period (p > 0.05). Lung cancer mortality among non-Hispanic White living in border counties was lower than non-Hispanic White residing in non-border counties (p < 0.01), and non-Hispanic Black living in border counties had lower lung cancer mortality than non-Hispanic Black in non-border counties in all but three years (p < 0.05). Both female and male mortality rates were lower in border counties compared to non-border counties (p < 0.05). CONCLUSION: Differences in lung cancer mortality between border counties and non-border counties reflect lower mortality in Hispanics overall and a decline for non-Hispanic White and non-Hispanic Black living in border counties experiencing lower lung cancer mortality rates than non-border counties. Further studies are needed to identify specific causes for lower mortality rates in border counties.
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Toxorhinus amarillo Anderson, new species (Coleoptera: Curculionidae: Dryophthorinae; Rhynchophorini), is here described from Ecuador (Cotopaxi, Biochoa Otonga). The species is compared to the other two species in the genus.
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Gorgojos , Animales , Ecuador , Gorgojos/anatomía & histología , Gorgojos/clasificación , Especificidad de la Especie , Masculino , FemeninoRESUMEN
Cuneane is a strained hydrocarbon that can be accessed via metal-catalyzed isomerization of cubane. The carbon atoms of cuneane define a polyhedron of the C2v point group with six facesâtwo triangular, two quadrilateral, and two pentagonal. The rigidity, strain, and unique exit vectors of the cuneane skeleton make it a potential scaffold of interest for the synthesis of functional small molecules and materials. However, the limited previous synthetic efforts toward cuneanes have focused on monosubstituted or redundantly substituted systems such as permethylated, perfluorinated, and bis(hydroxymethylated) cuneanes. Such compounds, particularly rotationally symmetric redundantly substituted cuneanes, have limited potential as building blocks for the synthesis of complex molecules. Reliable, predictable, and selective syntheses of polysubstituted cuneanes bearing more complex substitution patterns would facilitate the study of this ring system in myriad applications. Herein, we report the regioselective, AgI-catalyzed isomerization of asymmetrically 1,4-disubstituted cubanes to cuneanes. In-depth DFT calculations provide a charge-controlled regioselectivity model, and direct dynamics simulations indicate that the nonclassical carbocation invoked is short-lived and dynamic effects augment the charge model.
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Objectives: Aortic valve repair can be limited by inadequate leaflet tissue for proper coaptation. Various kinds of pericardium have been used for cusp augmentation, but most have failed because of tissue degeneration. A more durable leaflet substitute is needed. Methods: In this report, 8 consecutive cases are presented in which autologous ascending aortic tissue was used to augment inadequate native cusps during aortic valve repair. Biologically, aortic wall is a living autologous tissue that could have exceptional durability as a leaflet substitute. Techniques for insertion are described in detail, along with procedural videos. Results: Early surgical outcomes were excellent, with no operative mortalities or complications, and all valves were competent with low valve gradients. Patient follow-up and echocardiograms to a maximum of 8 months' postrepair remain excellent. Conclusions: Because of superior biologic characteristics, aortic wall has the potential to provide a better leaflet substitute during aortic valve repair and to expand patient categories amenable to autologous reconstruction. More experience and follow-up should be generated.
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Amazonia has as least two major centers of ancient human social complexity, but the full geographic extents of these centers remain uncertain. Across the southern rim of Amazonia, over 1,000 earthwork sites comprised of fortified settlements, mound villages, and ditched enclosures with geometric designs known as geoglyphs have been discovered. Qualitatively distinct and densely located along the lower stretches of major river systems and the Atlantic coast are Amazonian Dark Earth sites (ADEs) with deep anthropogenic soils enriched by long-term human habitation. Models predicting the geographic extents of earthworks and ADEs can assist in their discovery and preservation and help answer questions about the full degree of indigenous landscape modifications across Amazonia. We classify earthworks versus ADEs versus other non-earthwork/non-ADE archaeological sites with multi-class machine learning algorithms using soils, climate, and distances to rivers of different types and sizes as geospatial predictors. Model testing is done with spatial cross-validation, and the best model at the optimal spatial scale of 1 km has an Area Under the Curve of 0.91. Our predictive model has led to the discovery of 13 new geoglyphs, and it pinpoints specific areas with high probabilities of undiscovered archaeological sites that are currently hidden by rainforests. The limited, albeit impressive, predicted extents of earthworks and ADEs means that other non-ADE/non-earthwork sites are expected to predominate most of Western and Northern Amazonia.
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Bosque Lluvioso , Suelo , Humanos , Brasil , Ríos , ArqueologíaRESUMEN
Herein, we carefully investigated the Fe3+ doping effects on the structure and electron distribution of Cr2O3 nanoparticles using X-ray diffraction analysis (XRD), maximum entropy method (MEM), and density functional theory (DFT) calculations. We showed that increasing the Fe doping induces an enlargement in the axial ratio of c/a, which is associated with an anisotropic expansion of the unit cell. We found that as Fe3+ replaces Cr in the Cr2O3 lattice, it caused a higher interaction between the metal 3d states and the oxygen 2p states, which led to a slight increase in the Cr/Fe-O1 bond length followed by an opposite effect for the Cr/Fe-O2 bonds. Our results also suggest that the excitations characterize a well-localized bandgap region from occupied Cr d to unoccupied Fe d states. The Cr2O3 and Fe-doped Cr2O3 nanoparticles behave as Mott-Hubbard insulators due to their band gap being in the d-d gap, and Cr 3d orbitals dominate the conduction band. These findings suggest that the magnitude and the character of the electronic density near the O atom bonds in Cr2O3 nanoparticles are modulated by the Cr-Cr distances until its stabilization at the induced quasi-equilibrium of the Cr2O3 lattice when the Fe3+ doping values reaches the saturation level range.
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BACKGROUND: The COVID-19 pandemic raised awareness of the need to better understand where and how patient-level costs are incurred in health care organizations, as health managers and other decision-makers need to plan and quickly adapt to the increasing demand for health care services to meet patients' care needs. Time-driven activity-based costing offers a better understanding of the drivers of cost throughout the care pathway, providing information that can guide decisions on process improvement and resource optimization. This study aims to estimate COVID-19 patient-level hospital costs and to evaluate cost variability considering the in-hospital care pathways of COVID-19 management and the patient clinical classification. METHODS: This is a prospective cohort study that applied time-driven activity-based costing (TDABC) in a Brazilian reference center for COVID-19. Patients hospitalized during the first wave of the disease were selected for their data to be analyzed to estimate in-hospital costs. The cost information was calculated at the patient level and stratified by hospital care pathway and Ordinal Scale for Clinical Improvement (OSCI) category. Multivariable analyses were applied to identify predictors of cost variability in the care pathways that were evaluated. RESULTS: A total of 208 patients were included in the study. Patients followed five different care pathways, of which Emergency + Ward was the most followed (n = 118, 57%). Pathways which included the intensive care unit presented a statistically significant influence on costs per patient (p < 0.001) when compared to Emergency + Ward. The median cost per patient was I$2879 (IQR 1215; 8140) and mean cost per patient was I$6818 (SD 9043). The most expensive care pathway was the ICU only, registering a median cost per patient of I$13,519 (IQR 5637; 23,373) and mean cost per patient of I$17,709 (SD 16,020). All care pathways that included the ICU unit registered a higher cost per patient. CONCLUSIONS: This is one of the first microcosting study for COVID-19 that applied the TDABC methodology and demonstrated how patient-level costs vary as a function of the care pathways followed by patients. These findings can be used to develop value reimbursement strategies that will inform sustainable health policies in middle-income countries such as Brazil.
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COVID-19 , Vías Clínicas , Humanos , Brasil , Estudios Prospectivos , Pandemias , Factores de Tiempo , Costos de Hospital , Hospitales , Hospitalización , Costos de la Atención en SaludRESUMEN
OBJECTIVE: This study evaluates the relationship between atherosclerotic plaque characteristics (APCs) and angiographic stenosis severity in patients with and without diabetes. Whether APCs differ based on lesion severity and diabetes status is unknown. RESEARCH DESIGN AND METHODS: We retrospectively evaluated 303 subjects from the Computed TomogRaphic Evaluation of Atherosclerotic Determinants of Myocardial IsChEmia (CREDENCE) trial referred for invasive coronary angiography with coronary computed tomographic angiography (CCTA) and classified lesions as obstructive (≥50% stenosed) or nonobstructive using blinded core laboratory analysis of quantitative coronary angiography. CCTA quantified APCs, including plaque volume (PV), calcified plaque (CP), noncalcified plaque (NCP), low-density NCP (LD-NCP), lesion length, positive remodeling (PR), high-risk plaque (HRP), and percentage of atheroma volume (PAV; PV normalized for vessel volume). The relationship between APCs, stenosis severity, and diabetes status was assessed. RESULTS: Among the 303 patients, 95 (31.4%) had diabetes. There were 117 lesions in the cohort with diabetes, 58.1% of which were obstructive. Patients with diabetes had greater plaque burden (P = 0.004). Patients with diabetes and nonobstructive disease had greater PV (P = 0.02), PAV (P = 0.02), NCP (P = 0.03), PAV NCP (P = 0.02), diseased vessels (P = 0.03), and maximum stenosis (P = 0.02) than patients without diabetes with nonobstructive disease. APCs were similar between patients with diabetes with nonobstructive disease and patients without diabetes with obstructive disease. Diabetes status did not affect HRP or PR. Patients with diabetes had similar APCs in obstructive and nonobstructive lesions. CONCLUSIONS: Patients with diabetes and nonobstructive stenosis had an association to similar APCs as patients without diabetes who had obstructive stenosis. Among patients with nonobstructive disease, patients with diabetes had more total PV and NCP.
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Aterosclerosis , Enfermedad de la Arteria Coronaria , Estenosis Coronaria , Diabetes Mellitus , Placa Aterosclerótica , Humanos , Constricción Patológica/complicaciones , Estudios Retrospectivos , Enfermedad de la Arteria Coronaria/complicaciones , Placa Aterosclerótica/diagnóstico por imagen , Angiografía Coronaria/métodos , Aterosclerosis/complicaciones , Angiografía por Tomografía Computarizada/métodos , Diabetes Mellitus/epidemiología , Inteligencia Artificial , Estenosis Coronaria/complicaciones , Valor Predictivo de las PruebasRESUMEN
Iron niobates, pure and substituted with copper (Fe1-xCuxNbO4 with x = 0-0.15), were prepared by the solid-state method and characterized by X-ray diffraction, Raman spectroscopy, and magnetic measurements. The results of the structural characterizations revealed the high solubility of Cu ions in the structure and better structural stability compared to the pure sample. The analysis of the magnetic properties showed that the antiferromagnetic-ferromagnetic transition was caused by the insertion of Cu2+ ions into the FeNbO4 structure. The pure FeNbO4 structure presented an antiferromagnetic ordering state, with a Néel temperature of approximately 36.81K. The increase in substitution promoted a change in the magnetic ordering, with the state passing to a weak ferromagnetic order with a transition temperature (Tc) higher than the ambient temperature. The origin of the ferromagnetic ordering could be attributed to the increase in super-exchange interactions between Fe/Cu ions in the Cu2+-O-Fe3+ chains and the formation of bound magnetic polarons in the oxygen vacancies.
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Poly(3-hydroxybutyrate) (PHB)-based films containing Poly(ethylene glycol) (PEG), esterified sodium alginate (ALG-e) and polymeric additives loaded with Ag nanoparticles (AgNPs) were obtained by a conventional casting method. AgNPs were produced in aqueous suspension and added to polymeric gels using a phase exchange technique. Composite formation was confirmed by finding the Ag peak in the XRD pattern of PHB. The morphological analysis showed that the inclusion of PEG polymer caused the occurrence of pores over the film surface, which were overshadowed by the addition of ALG-e polymer. The PHB functional groups were dominating the FTIR spectrum, whose bands associated with the crystalline and amorphous regions increased after the addition of PEG and ALG-e polymers. Thermal analysis of the films revealed a decrease in the degradation temperature of PHB containing PEG/AgNPs and PEG/ALG-e/AgNPs, suggesting a catalytic effect. The PHB/PEG/ALG-e/AgNPs film combined the best properties of water vapor permeability and hydrophilicity of the different polymers used. All samples showed good antimicrobial activity in vitro, with the greater inhibitory halo observed for the PEG/PEG/AgNPs against Gram positive S. aureus microorganisms. Thus, the PHB/PEG/ALG-e/AgNPs composite demonstrated here is a promising candidate for skin wound healing treatment.
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FeSbO4 powder was prepared using the solid-state reaction method in this work. Afterward, the dense and porous ceramics were obtained by sintering the pressed powder calcined at temperatures of 900 and 1000 °C for 4 h. Rietveld profile analysis of the X-ray powder diffraction data showed that FeSbO4 adopts the trirutile-type structure (space group P42/mnm, with a â 4.63 Å and c â 9.23 Å). SEM images showed that the powder calcined at 900 °C after being sintered at 1200 °C resulted in ceramics of higher crystallinity, larger grains, and consequently, low porosity. The dielectric properties were measured in the frequency range of 10−1 Hz−1 MHz as a function of temperature (25−250 °C). The real (σ') and imaginary (σâ³) parts of the complex conductivity increase with rising annealing temperature for both samples. The real conductivity in the AC region for ð = 100 kHz was 1.59×10−6 S·cm−1 and 7.04×10−7 S·cm−1 for the ceramic samples obtained from the powder calcined at 900 (C-900) and 1000 °C (C-1000), respectively. Furthermore, the dielectric constants (k') measured at room temperature and f=100 kHz were 13.77 (C-900) and 6.27 (C-1000), while the activation energies of the grain region were Ea = 0.53 eV and Ea = 0.49 eV, respectively. Similar activation energy (Ea = 0.52 eV and 0.49 eV) was also obtained by the brick-layer model and confirmed by the adjustment of activation energy by DC measurements which indicated an absence of the porosity influence on the parameter. Additionally, loss factor values were obtained to be equal to 3.8 (C-900) and 5.99 (C-1000) for measurements performed at 100 Hz, suggesting a contribution of the conductivity originated from the combination or accommodation of the pores in the grain boundary region. Our results prove that the microstructural factors that play a critical role in the electrical and dielectric properties are the average grain size and the porosity interspersed with the grain boundary region.
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Molecularly imprinted membrane of ß-caryophyllene (MIM-ßCP) was fabricated incorporating ß-caryophyllene molecularly imprinted polymer nanoparticles (ßCP-NP) into polycaprolactone (PCL) fibers via electrospinning. The ßCP-NP were synthesized by precipitation polymerization using the ßCP as a template molecule and acrylic acid as a functional monomer in the proportion of 1:4 mol, respectively. Atomic force microscopy images and X-ray diffraction confirmed the nanoparticles' incorporation into MIM-ßCP. MIM-ßCP functionalization was evaluated by gas chromatography. The binding capacity was 1.80 ± 0.05 µmol/cm2, and the selectivity test was performed with a mixing solution of ßCP and caryophyllene oxide, as an analog compound, that extracted 77% of the ßCP in 5 min. The electrospun MIM-ßCP can be used to detect and extract the ßCP, applications in the molecular sieve, and biosensor production and may also contribute as an initial methodology to enhance versatile applications in the future, such as in the treatment of skin diseases, filters for extraction, and detection of ßCP to prevent counterfeiting of commercial products, and smart clothing with insect-repellent properties.