Clinical predictors of coronary artery bypass graft surgery in patients hospitalized for Non-ST acute coronary syndrome - Buenos Aires I and ReSCAR22 registries.

Objectives: To identify predictors of coronary artery bypass graft surgery (CABG) requirement as a revascularization method in in real-world non-ST-segment elevation acute coronary syndrome (NSTE-ACS) patients. Materials and methods: . An individual pre-specified analysis of patients with NSTE-ACS was performed from two prospective Argentine registries between 2017 and 2022. We analyzed the difference in baseline characteristics between patients who required CABG and those who did not require this intervention. Then, a logistic regression analysis was performed to determine independent predictors in patients who received CABG as a method of revascularization. Results: A total of 1848 patients with a median age of 54.8 (interquartile range [IQR]: 53.7-56) years and an ejection fraction of 42.1% (IQR: 41.2-43.1) were included. A total of 233 patients required CABG (12.6%). Baseline characteristics between the two groups were similar, except in patients requiring CABG, who were younger (51.5 vs. 55.7 years; p=0.010), more frequently diabetic (38.2% vs. 25.7%; p=0.001) and male (90.1% vs. 73.7%; p=0.001). In addition, they had, to a lesser extent, previous cardiac surgery (2.1% vs. 11.2%; p=0.011). After multivariable analysis, the following were independently associated with CABG: age (Odds Ratio [OR]: 0.99, 95% confidence interval [CI]: 0.98-0.99; p=0.008), male sex (OR: 3.08, 95% CI: 1.87-5.1; p=0.001), history of previous CABG (OR: 0.14, 95% CI: 0.05-0.30; p=0.001) and diabetes (OR: 1.84, 95% CI: 1.31- 2.57; p=0.001). Conclusions: In this analysis of two NSTEACS registries, younger age, male sex, a diagnosis of diabetes and the absence of previous surgery were independent predictors of the requirement for inpatient CABG.

Observation of naturally canalized phonon polaritons in LiV2O5 thin layers.

Polariton canalization is characterized by intrinsic collimation of energy flow along a single crystalline axis. This optical phenomenon has been experimentally demonstrated at the nanoscale by stacking and twisting van der Waals (vdW) layers of α-MoO3, by combining α-MoO3 and graphene, or by fabricating an h-BN metasurface. However, these material platforms have significant drawbacks, such as complex fabrication and high optical losses in the case of metasurfaces. Ideally, it would be possible to canalize polaritons "naturally" in a single pristine layer. Here, we theoretically predict and experimentally demonstrate naturally canalized phonon polaritons (PhPs) in a single thin layer of the vdW crystal LiV2O5. In addition to canalization, PhPs in LiV2O5 exhibit strong field confinement ( λ p ~ λ 0 27 ), slow group velocity (0.0015c), and ultra-low losses (lifetimes of 2 ps). Our findings are promising for the implementation of low-loss optical nanodevices where strongly directional light propagation is needed, such as waveguides or optical routers.

Bilateral Paracentral Corneal Melting and Left-Eye Perforation under Tobemstomig Novel Treatment.

Introduction: We present a rare occurrence of bilateral corneal melting and a left-eye corneal perforation in an oncologic patient undergoing a new biological therapy. Case Presentation: A 63-year-old male with a two-day history of a painful left red eye and bilateral visual impairment was enrolled in a multicenter phase-II study comparing tobemstomig/RO7247669, a PD1-LAG3 bispecific antibody, with nivolumab. Clinical examination revealed a bilateral central corneal thinning, and corneal OCT imaging indicated a significant stromal thinning of 124 µm in the right eye and a central corneal perforation of 286 µm in the left eye. Subsequently, the patient underwent surgical intervention involving an autologous partial scleral patch with a Gundersen conjunctival flap in the left eye, alongside a comprehensive topical and systemic treatment regimen. Due to this immune-related adverse event, the patient was excluded from the clinical trial subsequently later revealing he had been on the bispecific treatment. Conclusion: While immune checkpoint inhibitors hold promise in oncology, they can lead to ocular surface issues, including dry-eye keratitis and, in severe cases, anterior segment thinning culminating in corneal perforation. Timely withdrawal of immunotherapy, coupled with multi-level treatment involving anti-inflammatory and corneal healing approaches, is crucial. In cases of corneal perforation, surgical intervention such as cyanoacrylate application or tectonic surgery becomes imperative.

Multivariate word properties in fluency tasks reveal markers of Alzheimer's dementia.

INTRODUCTION: Verbal fluency tasks are common in Alzheimer's disease (AD) assessments. Yet, standard valid response counts fail to reveal disease-specific semantic memory patterns. Here, we leveraged automated word-property analysis to capture neurocognitive markers of AD vis-à-vis behavioral variant frontotemporal dementia (bvFTD). METHODS: Patients and healthy controls completed two fluency tasks. We counted valid responses and computed each word's frequency, granularity, neighborhood, length, familiarity, and imageability. These features were used for group-level discrimination, patient-level identification, and correlations with executive and neural (magnetic resonanance imaging [MRI], functional MRI [fMRI], electroencephalography [EEG]) patterns. RESULTS: Valid responses revealed deficits in both disorders. Conversely, frequency, granularity, and neighborhood yielded robust group- and subject-level discrimination only in AD, also predicting executive outcomes. Disease-specific cortical thickness patterns were predicted by frequency in both disorders. Default-mode and salience network hypoconnectivity, and EEG beta hypoconnectivity, were predicted by frequency and granularity only in AD. DISCUSSION: Word-property analysis of fluency can boost AD characterization and diagnosis. HIGHLIGHTS: We report novel word-property analyses of verbal fluency in AD and bvFTD. Standard valid response counts captured deficits and brain patterns in both groups. Specific word properties (e.g., frequency, granularity) were altered only in AD. Such properties predicted cognitive and neural (MRI, fMRI, EEG) patterns in AD. Word-property analysis of fluency can boost AD characterization and diagnosis.

Surgical induced necrotizing scleritis following intraocular lens replacement.

PURPOSE: To report a surgical-induced necrotizing scleritis, as well as its medical and surgical management. METHODS: Case-report. RESULTS: An 88 year-old patient with a three-day severe single-left-eye ocular pain. One-time surgery involving PPV with removal of dislocated intraocular lens and secondary implantation of iris-claw Artisan® lens was performed 6 months earlier. Visual acuity of 20/100. Slit-lamp examination revealed a 5 × 2 mm non-suppurative superior scleral defect. Empirical topical antibiotic treatment with dexamethasone, as well as oral doxycycline was started. Infectious and autoimmune diseases were ruled out. Non-infectious scleritis treatment was conducted with intravenous Methylprednisolone 3 day pulses, followed by weekly tapered Prednisone and intramuscular Methotrexate. However, 1 month after the diagnosis, the defect was worsened; hence, a heterologous scleral patch graft was performed and, days after the intervention, Adalimumab was initiated. To date, 6 months later, remains with proper scleral patch, a diary low-dose Prednisone, and spacing Adalimumab treatment. CONCLUSION: Surgery-induced necrotizing scleritis is a severe condition that compromise the ocular and visual integrity. Proper diagnosis, as well as early treatment is required to achieve remission, prevent relapses, and avoid structural complications. In refractory cases, anti-TNF-α immunotherapy associated with surgical tectonic graft interventions can achieve promising results.

The Effect of Selective Laser Melting Fabrication Parameters on the Tensile Strength of an Aged New Maraging Steel Alloy with 8% Cr, Reduced Ni Content (7%), and No Co or Mo.

The aim of this paper was to optimise the manufacturing parameters of a new maraging steel alloy with 8% Cr, reduced Ni content (7%), and no Co or Mo. This alloy was developed by ArcelorMittal and its trade name is LeanSi. The alloy was produced using the selective laser melting (SLM) process. In the as-built state, the microstructure of the alloy was fully martensitic. The optimisation of the manufacturing parameters was determined via a multivariate factorial design of experiments including 12 experiments and three factors. The factors (i.e., the fabrication parameters) analysed were laser power, scanning speed, and hatch distance. The objective was to eliminate porosity and maximise density. It was concluded that, to achieve this, the laser power should be set at 250 W, the scanning speed at 1000 mm/s, and the hatch distance at 80 microns. The porosity obtained under these manufacturing parameters was 0.06 ± 0.03% with a confidence level of 95%. If these manufacturing parameters were modified, the material exhibited a defective interlayer bond with the formation of "balling" and high porosity. The tensile specimens tested in the as-built state showed plastic deformation. However, all the aged specimens showed brittle fracture behaviour, evidenced by the presence of very small micro-cavities (where the fracture energy consumed was very small) and small cleavage planes. The specimens produced with the manufacturing parameters at their optimum levels and aged at 480 °C for 2 h achieved tensile strength values that averaged 1430 MPa. The porosity of these specimens was reduced by more than 85%. Reverse austenite was detected at ageing temperatures of 540 °C upwards.

Perioperative Myocardial Infarction Following Dabigatran Reversal With Idarucizumab in a Patient Undergoing Orthotopic Liver Transplantation.

Insufficient information is available regarding the administration of anticoagulants, specifically direct oral anticoagulants, in individuals with cirrhosis awaiting liver transplantation. In this report, we present a case of a 66-year-old male with atrial fibrillation treated with dabigatran who received idarucizumab prior to orthotopic liver transplantation. Hemostatic status was monitored throughout the procedure with both conventional hemostatic tests and point-of-care viscoelastic hemostatic assays. The patient suffered an intraoperative myocardial infarction, which could be related to the use of idarucizumab.

Terahertz Twistoptics-Engineering Canalized Phonon Polaritons.

The terahertz (THz) frequency range is key to studying collective excitations in many crystals and organic molecules. However, due to the large wavelength of THz radiation, the local probing of these excitations in smaller crystalline structures or few-molecule arrangements requires sophisticated methods to confine THz light down to the nanometer length scale, as well as to manipulate such a confined radiation. For this purpose, in recent years, taking advantage of hyperbolic phonon polaritons (HPhPs) in highly anisotropic van der Waals (vdW) materials has emerged as a promising approach, offering a multitude of manipulation options, such as control over the wavefront shape and propagation direction. Here, we demonstrate the THz application of twist-angle-induced HPhP manipulation, designing the propagation of confined THz radiation between 8.39 and 8.98 THz in the vdW material α-molybdenum trioxide (α-MoO3), hence extending twistoptics to this intriguing frequency range. Our images, recorded by near-field optical microscopy, show the frequency- and twist-angle-dependent changes between hyperbolic and elliptic polariton propagation, revealing a polaritonic transition at THz frequencies. As a result, we are able to allocate canalization (highly collimated propagation) of confined THz radiation by carefully adjusting these two parameters, i.e. frequency and twist angle. Specifically, we report polariton canalization in α-MoO3 at 8.67 THz for a twist angle of 50°. Our results demonstrate the precise control and manipulation of confined collective excitations at THz frequencies, particularly offering possibilities for nanophotonic applications.

Treatment of a case of septic tibial nonunion by the Capanna technique.

This report presents the case of a 25-year-old male with an infected tibial diaphyseal nonunion caused by a bone transport procedure carried out to treat an open fracture the patient had sustained 10 years before referral to our hospital. After an initial radical debridement, a bone defect was created, which was subsequently obliterated by placement of an antibiotic-impregnated cement spacer and Stimulan beads and covered by an anterolateral thigh flap. As the patient refused to wear an external fixator and his osseous biology was not amenable to a Masquelet procedure, a decision was made to apply the Capanna technique as soon as the infection healed. The second debridement resulted in a 12-cm-long bone defect that was filled with a tibial allograft and a vascularized fibular graft. At six months, the patient had regained full knee function and was able to bear his full weight, without pain or the need of support equipment. At one year, the bone had healed completely, the infection had subsided and the patient was able to resume his everyday activities. Although the Capanna technique was initially developed to reinforce reconstructions at risk of fracture or nonunion as a result of chemotherapy, its use in post-traumatic cases has been shown to be successful in a selected group of patents. Our study demonstrated that increasing the stability of a reconstruction with an allograft can accelerate the time to heal, and that using a vascularized fibular graft can enhance incorporation of the whole construct. It can be concluded that the Capanna technique is a valid treatment option for managing infected segmental bone defects in selected patients.

Treatment adherence in patients without ST-elevation acute coronary syndrome.

BACKGROUND: Despite progress during the last decades, patients with coronary artery disease (CAD) remain with a high residual risk due to multiple reasons. Optimal medical treatment (OMT) provides a decrease of recurrent ischemic events after acute coronary syndrome (ACS). Therefore, treatment adherence results crucial to reduce further outcomes after the index event. No recent data are available in Argentinian population; the main objective of our study was to evaluate the adherence at 6 and 15 months in post non-ST elevation acute coronary syndrome (NST-ACS) consecutive patients. Secondary objective was to evaluate the relationship of adherence with 15-month events. METHODS: A prespecified sub-analysis in the prospective registry Buenos Aires I was performed. The adherence was evaluated using the modified Morisky-Green Scale. RESULTS: A number of 872 patients had information about adherence profile. Of them 76.4% were classified as adherents at month 6 and 83.6% at 15 (P=0.06). We did not find any difference in baseline characteristic between the adherent and non-adherent patients at 6 months. The adjusted analysis showed that non-adherent patients had a rate of ischemic events at 15th month of 20% (27/135) vs. 11.5% (52/452) in adherent patients (P=0.001). The bleeding events defined were of 3.6% in the non-adherent group vs. 5% in the adherent group without a statistical difference (P=0.238). CONCLUSIONS: Adherence to treatment is still a major issue as almost 25% of patients should be considered as non-adherent to OMT. No clinical predictor of this phenomenon was identified but our criteria were not exhaustive. Good adherence to treatment was highly associated to a reduction of ischemic events, whereas no impact on bleeding events was found. These data support a better network and collaboration with shared decision between healthcare professionals with patients and family members to improve acceptance and adherence to optimal medical strategies.

Comparación de la violencia y agresiones sufridas por el personal de salud durante la pandemia de COVID-19 en Argentina y el resto de Latinoamérica / Comparison of violence and aggressions suffered by health personnel during the COVID-19 pandemic in Argentina and the rest of Latin America

RESUMEN Objetivos. Explorar la frecuencia e impacto de la violencia contra los trabajadores de salud de Argentina y compararlo con el resto de sus pares de Latinoamérica en el contexto de la pandemia por COVID-19. Materiales y métodos. Estudio de corte transversal a través de una encuesta electrónica al personal médico y no médico de Latinoamérica que desempeño tareas asistenciales desde marzo de 2020. Se utilizó una regresión de Poisson para estimar las Razones de Prevalencia crudas (RP) y ajustadas (RPa) con sus respectivos intervalos de confianza al 95%. Resultados. Un total de 3544 participantes de 19 países respondieron la encuesta; 1992 (56,0%) residían en Argentina. Entre los mismos, el 62,9% padeció al menos un hecho de violencia: 97,7% refirió violencia verbal y 11,8% violencia física. El 41,5% de los agredidos padecieron situaciones de violencia al menos una vez por semana. El personal de salud de Argentina vivenció más frecuentemente violencia que los de otros países (62,9% vs. 54,6%, p<0,001), siendo estos eventos más habituales y estresantes (p<0,05). Además, refirieron más frecuentemente haber considerado cambiar sus tareas asistenciales y/o deseos de abandonar su profesión (p<0,001). En la regresión de Poisson, los participantes de Argentina tuvieron una prevalencia de violencia mayor que los trabajadores de salud de la región (14,6%; p<0,001). Conclusiones. Existió una elevada prevalencia de violencia contra el personal de salud de Argentina durante la pandemia por COVID-19. Estos hechos tuvieron un alto impacto negativo entre quienes los padecieron. Nuestros datos sugieren que, esto podría haber sido más frecuente en Argentina respecto de otras regiones del continente.

ABSTRACT Objectives. To explore the frequency and impact of violence against healthcare workers in Argentina and to compare it with the rest of their Latin American peers during the COVID-19 pandemic. Materials and methods. A cross-sectional study was conducted by applying an electronic survey on Latin American medical and non-medical personnel who carried out health care tasks since March 2020. We used Poisson regression to estimate crude (PR) and adjusted (aPR) Prevalence Ratios with their respective 95% confidence intervals. Results. A total of 3544 participants from 19 countries answered the survey; 1992 (56.0%) resided in Argentina. Of these, 62.9% experienced at least one act of violence; 97.7% reported verbal violence and 11.8% physical violence. Of those who were assaulted, 41.5% experienced violence at least once a week. Health personnel from Argentina experienced violence more frequently than those from other countries (62.9% vs. 54.6%, p<0.001), and these events were more frequent and stressful (p<0.05). In addition, Argentinean health personnel reported having considered changing their healthcare tasks and/or desired to leave their profession more frequently (p<0.001). In the Poisson regression, we found that participants from Argentina had a higher prevalence of violence than health workers from the region (14.6%; p<0.001). Conclusions. There was a high prevalence of violence against health personnel in Argentina during the COVID-19 pandemic. These events had a strong negative impact on those who suffered them. Our data suggest that violence against health personnel may have been more frequent in Argentina than in other regions of the continent.

Cysticercosis & Heart: A Systematic Review.

Cysticercosis is a parasitic tissue infection caused by larval cysts of the tapeworm Taenia solium. These larval cysts infect brain, muscle, or other tissue, and are a major cause of adult-onset seizures in most low-income countries with tropical climate. Prevalence it's around 50 million people. Although cardiovascular system is not the most affected, this disease can also be associated with multiple and randomly distributed cysts in the subpericardium, subendocardium and myocardium in up to 25% of infected patients. Most cardiac cysticercosis' cases are asymptomatic, but it can manifest with ventricular arrhythmias and conduction disorders. Area Covered: The "Neglected Tropical Diseases and other Infectious Diseases affecting the Heart" (NET-Heart project) is an initiative by the Emerging Leaders group of the Interamerican Society of Cardiology to systematically review all these endemic conditions affecting the heart. A systematic review was conducted following preferred reporting items for systematic review and meta-analysis guidelines and including articles published in MEDLINE, ScienceDirect, PubMed and LILACS databases. A total of 41 papers were included in this review. Expert Opinion: In the areas of greatest prevalence, unhealthiness and poverty favor the development of this disease, which highlights the need to establish global health policies that reduce morbidity and mortality, economic losses of the affected population, and health costs related to hospitalizations for cardiovascular involvement. Authors provide an algorithm to evaluate the possibility of Cysticercosis' cardiovascular complications.

Endocannabinoid signaling in the central nervous system.

It is hard to overestimate the influence of the endocannabinoid signaling (ECS) system on central nervous system (CNS) function. In the 40 years since cannabinoids were found to trigger specific cell signaling cascades, studies of the ECS system continue to cause amazement, surprise, and confusion! CB1 cannabinoid receptors are expressed widely in the CNS and regulate cell-cell communication via effects on the release of both neurotransmitters and gliotransmitters. CB2 cannabinoid receptors are difficult to detect in the CNS but seem to "punch above their weight" as compounds targeting these receptors have significant effects on inflammatory state and behavior. Positive and negative allosteric modulators for both receptors have been identified and examined in preclinical studies. Concentrations of the endocannabinoid ligands, N-arachidonoylethanolamine and 2-arachidonoylglycerol (2-AG), are regulated by a combination of enzymatic synthesis and degradation and inhibitors of these processes are available and making their way into clinical trials. Importantly, ECS regulates many essential brain functions, including regulation of reward, anxiety, inflammation, motor control, and cellular development. While the field is on the cusp of preclinical discoveries providing impactful clinical and therapeutic insights into many CNS disorders, there is still much to be learned about this remarkable and versatile modulatory system.

Comparison of violence and aggressions suffered by health personnel during the COVID-19 pandemic in Argentina and the rest of Latin America. / Comparación de la violencia y agresiones sufridas por el personal de salud durante la pandemia de COVID-19 en Argentina y el resto de Latinoamérica.

OBJECTIVES.: Motivation for the study. The COVID-19 pandemic has caused profound repercussions at different socio-environmental levels. Its impact on violence against healthcare team workers in Argentina has not been well documented. Main findings. The present study evidenced high rates of aggression, particularly verbal aggression. In addition, almost half of the participants reported having suffered these events on a weekly basis. All participants who experienced violence reported having experienced post-event symptoms, and up to one-third reported having considered changing their profession after these acts. Implications. It is imperative to take action to prevent acts of violence against health personnel, or to mitigate its impact on the victims. . To explore the frequency and impact of violence against healthcare workers in Argentina and to compare it with the rest of their Latin American peers during the COVID-19 pandemic. MATERIALS AND METHODS.: A cross-sectional study was conducted by applying an electronic survey on Latin American medical and non-medical personnel who carried out health care tasks since March 2020. We used Poisson regression to estimate crude (PR) and adjusted (aPR) Prevalence Ratios with their respective 95% confidence intervals. RESULTS.: A total of 3544 participants from 19 countries answered the survey; 1992 (56.0%) resided in Argentina. Of these, 62.9% experienced at least one act of violence; 97.7% reported verbal violence and 11.8% physical violence. Of those who were assaulted, 41.5% experienced violence at least once a week. Health personnel from Argentina experienced violence more frequently than those from other countries (62.9% vs. 54.6%, p<0.001), and these events were more frequent and stressful (p<0.05). In addition, Argentinean health personnel reported having considered changing their healthcare tasks and/or desired to leave their profession more frequently (p<0.001). In the Poisson regression, we found that participants from Argentina had a higher prevalence of violence than health workers from the region (14.6%; p<0.001). CONCLUSIONS.: There was a high prevalence of violence against health personnel in Argentina during the COVID-19 pandemic. These events had a strong negative impact on those who suffered them. Our data suggest that violence against health personnel may have been more frequent in Argentina than in other regions of the continent.

OBJETIVOS.: Explorar la frecuencia e impacto de la violencia contra los trabajadores de salud de Argentina y compararlo con el resto de sus pares de Latinoamérica en el contexto de la pandemia por COVID-19. MATERIALES Y MÉTODOS.: Estudio de corte transversal a través de una encuesta electrónica al personal médico y no médico de Latinoamérica que desempeño tareas asistenciales desde marzo de 2020. Se utilizó una regresión de Poisson para estimar las Razones de Prevalencia crudas (RP) y ajustadas (RPa) con sus respectivos intervalos de confianza al 95%. RESULTADOS.: Un total de 3544 participantes de 19 países respondieron la encuesta; 1992 (56,0%) residían en Argentina. Entre los mismos, el 62,9% padeció al menos un hecho de violencia: 97,7% refirió violencia verbal y 11,8% violencia física. El 41,5% de los agredidos padecieron situaciones de violencia al menos una vez por semana. El personal de salud de Argentina vivenció más frecuentemente violencia que los de otros países (62,9% vs. 54,6%, p<0,001), siendo estos eventos más habituales y estresantes (p<0,05). Además, refirieron más frecuentemente haber considerado cambiar sus tareas asistenciales y/o deseos de abandonar su profesión (p<0,001). En la regresión de Poisson, los participantes de Argentina tuvieron una prevalencia de violencia mayor que los trabajadores de salud de la región (14,6%; p<0,001). CONCLUSIONES.: Existió una elevada prevalencia de violencia contra el personal de salud de Argentina durante la pandemia por COVID-19. Estos hechos tuvieron un alto impacto negativo entre quienes los padecieron. Nuestros datos sugieren que, esto podría haber sido más frecuente en Argentina respecto de otras regiones del continente.

Nuevos paradigmas: 12 años de trombólisis sistémica. Unidad ACV, Hospital de Clínicas / New paradigms: 12 years of systemic thrombolysis. Stroke Unit, Clinicas Hospital / Novos paradigmas: 12 anos de trombólise sistêmica. Unidade AVC, Hospital de Clínicas

Introducción: el ACV constituye un problema de salud y la trombólisis sistémica una estrategia de reperfusión con alto nivel de evidencia para su tratamiento. Los reportes nacionales sobre su utilización son escasos. Objetivos: comunicar y analizar los resultados de esta terapia en el Hospital de Clínicas. Establecer predictores de buena evolución, hemorragia intracraneana y mortalidad. Métodos: estudio observacional analítico de los pacientes trombolizados en el Hospital de Clínicas (2010-2021). Resultados: se realizó trombólisis sistémica a 268 pacientes. La mediana del NIHSS al ingreso fue 12 puntos. Un 42% fueron infartos totales de la circulación anterior. La cardioembolia constituyó la etiopatogenia más frecuente. El 59,3% de los pacientes fueron externalizados con independencia funcional y 55,2% con déficit neurológico mínimo. Las tasas de hemorragia intracraneana sintomática y mortalidad fueron 7,1% y 18,7% respectivamente. El 57% de los pacientes se trataron con tiempo puerta aguja ≤60 minutos. El porcentaje de trombólisis en el total de ACV fue 18,9%. La edad, NIHSS al ingreso e internación en unidad de ACV se comportaron como variables importantes para predecir buena evolución, hemorragia intracraneana y muerte. Discusión y conclusiones: se comunicó la mayor casuística nacional sobre el tema. Los parámetros de efectividad y seguridad del tratamiento fueron comparables a los reportados internacionalmente. Se destacaron los buenos tiempos puerta aguja y tasa trombólisis sobre ACV totales como indicadores satisfactorios de calidad asistencial. La internación en unidad de ACV se comportó como un factor predictor de independencia funcional y protector frente a mortalidad hospitalaria.

Introduction: Strokes are a health problem and systemic thrombolysis constitutes a reperfusion strategy backed up by significant evidence on its positive therapeutic impact. National reports on its use are scarce. Objectives: To report and analyze results obtained with this therapeutic approach at the Clinicas Hospital. To establish predictive factors for a good evolution, intracranial hemorrhage and mortality. Method: Observational, analytical study of thrombolysed patients at Clinicas Hospital (2010-2021). Results: Systemic thrombolysis was performed in 268 patients. Average NIHSS score was 12 points when admitted to hospital.42 % of cases were total anterior circulation infarct (TACI). Cardioembolic ischaemmic stroke was the most frequent etiopahogenesis. 59.3% of patients were discharged with functional independence and 55.2% had minimal neurologic deficit. Symptomatic intracranial hemorrhage and mortality rates were 7.1% and 18.7% respectively. 57% of patients were assisted within ≤60 minutes they showed up at the ER. Thrombolysis percentage in total number of strokes was 18.9%. Age, NIHSS score upon arrival to hospital and admission to the stroke unit were significant variables to predict a good evolution, intracranial hemorrhage and death. Discussion and conclusions: The large number of cases in the country was reported. Effectiveness and safety parameters for this treatment were comparable to those reported internationally. The good door-to-needle time and thrombolysis rate versus total number of strokes stood out as satisfactory indicators of healthcare quality. Admission to the stroke unit behaved as a predictive factor of functional independence and it protected patients from hospital mortality.

Introdução: o AVC é um problema de saúde sendo a trombólise sistêmica uma estratégia de reperfusão com alto nível de evidência para seu tratamento. Os dados nacionais sobre seu uso são escassos. Objetivos: comunicar e analisar os resultados desta terapia no Hospital de Clínicas. Estabelecer preditores de boa evolução, hemorragia intracraniana e mortalidade. Métodos: estudo observacional analítico de pacientes trombolisados no Hospital de Clínicas (2010-2021). Resultados: a trombólise sistêmica foi realizada em 268 pacientes. A mediana do índice NIHSS na admissão foi de 12 pontos. 42% eram infartos totais da circulação anterior. A cardioembolia foi a etiopatogenia mais frequente. 59,3% dos pacientes tiveram alta da unidade com independência funcional e 55,2% com déficit neurológico mínimo. As taxas de hemorragia intracraniana sintomática e mortalidade foram de 7,1% e 18,7%, respectivamente. 57% dos pacientes foram tratados com tempo porta-agulha ≤60 minutos. A porcentagem de trombólise no AVC total foi de 18,9%. Idade, NIHSS na admissão e internação na unidade de AVC se comportaram como variáveis importantes para prever boa evolução, hemorragia intracraniana e óbito. Discussão e conclusões: este trabajo inclui a maior casuística nacional sobre o tema. Os parâmetros de eficácia e segurança do tratamento foram comparáveis aos descritos na bibliografia internacional. Foram destacados como indicadores satisfatórios da qualidade do atendimento os bons tempos porta-agulha e taxa de trombólise em relação ao AVC total. A internação em unidade de AVC comportou-se como preditor de independência funcional e protetor contra a mortalidade hospitalar.

Germanium Monosulfide as a Natural Platform for Highly Anisotropic THz Polaritons.

Terahertz (THz) electromagnetic radiation is key to access collective excitations such as magnons (spins), plasmons (electrons), or phonons (atomic vibrations), thus bridging topics between optics and solid-state physics. Confinement of THz light to the nanometer length scale is desirable for local probing of such excitations in low-dimensional systems, thereby circumventing the large footprint and inherently low spectral power density of far-field THz radiation. For that purpose, phonon polaritons (PhPs) in anisotropic van der Waals (vdW) materials have recently emerged as a promising platform for THz nanooptics. Hence, there is a demand for the exploration of materials that feature not only THz PhPs at different spectral regimes but also host anisotropic (directional) electrical, thermoelectric, and vibronic properties. To that end, we introduce here the semiconducting vdW-material alpha-germanium(II) sulfide (GeS) as an intriguing candidate. By employing THz nanospectroscopy supported by theoretical analysis, we provide a thorough characterization of the different in-plane hyperbolic and elliptical PhP modes in GeS. We find not only PhPs with long lifetimes (τ > 2 ps) and excellent THz light confinement (λ0/λ > 45) but also an intrinsic, phonon-induced anomalous dispersion as well as signatures of naturally occurring, substrate-mediated PhP canalization within a single GeS slab.

Body into Narrative: Behavioral and Neurophysiological Signatures of Action Text Processing After Ecological Motor Training.

Embodied cognition research indicates that sensorimotor training can influence action concept processing. Yet, most studies employ isolated (pseudo)randomized stimuli and require repetitive single-effector responses, thus lacking ecological validity. Moreover, the neural signatures of these effects remain poorly understood. Here, we examined whether immersive bodily training can modulate behavioral and functional connectivity correlates of action-verb processing in naturalistic narratives. The study involved three phases. First, in the Pre-training phase, 32 healthy persons listened to an action text (rich in movement descriptions) and a non-action text (focused on its characters' perceptual and mental processes), completed comprehension questionnaires, and underwent resting-state electroencephalogram (EEG) recordings. Second, in the four-day Training phase, half the participants completed an exergaming intervention (eliciting full-body movements for 60 min a day) while the remaining half played static videogames (requiring no bodily engagement other than button presses). Finally, in the Post-training phase, all participants repeated the Pre-training protocol with different action and non-action texts and a new EEG session. We found that exergaming selectively reduced action-verb outcomes and fronto-posterior functional connectivity in the motor-sensitive âˆ¼ 10-20 Hz range, both patterns being positively correlated. Conversely, static videogame playing yielded no specific effect on any linguistic category and did not modulate functional connectivity. Together, these findings suggest that action-verb processing and key neural correlates can be focally influenced by full-body motor training in a highly ecological setting. Our study illuminates the role of situated experience and sensorimotor circuits in action-concept processing, addressing calls for naturalistic insights on language embodiment.

Broadband and low-loss TM-pass polarizer using tilted subwavelength structures.

Photonic systems built on the Silicon-on-Insulator platform exhibit a strong birefringence, and must thus be operated with a single polarization for most applications. Hence, on-chip polarizers that can effectively suppress an undesired polarization state are key components for these systems. Polarizers that extinguish TE polarized light while letting TM polarized light pass with low losses are particularly challenging to design for the standard 220 nm Silicon-on-Insulator platform, because the modal confinement is stronger for TE polarization than for TM polarzation. Here, we propose and design a broadband, low loss and high extinction ratio TM-pass polarizer by engineering a Bragg grating that reflects the fundamental TE mode into the first order TE mode using a subwavelength metamaterial which at the same time allows the TM mode to pass. Our device achieves an extinction ratio in excess of 20 dB, insertion losses below 0.5 dB and back-reflections of the fundamental TE mode of the order of -20 dB in a bandwidth of 150 nm as demonstrated with full 3D-FDTD simulations.

World Heart Federation Roadmap for Digital Health in Cardiology.

More than 500 million people worldwide live with cardiovascular disease (CVD). Health systems today face fundamental challenges in delivering optimal care due to ageing populations, healthcare workforce constraints, financing, availability and affordability of CVD medicine, and service delivery. Digital health technologies can help address these challenges. They may be a tool to reach Sustainable Development Goal 3.4 and reduce premature mortality from non-communicable diseases (NCDs) by a third by 2030. Yet, a range of fundamental barriers prevents implementation and access to such technologies. Health system governance, health provider, patient and technological factors can prevent or distort their implementation. World Heart Federation (WHF) roadmaps aim to identify essential roadblocks on the pathway to effective prevention, detection, and treatment of CVD. Further, they aim to provide actionable solutions and implementation frameworks for local adaptation. This WHF Roadmap for digital health in cardiology identifies barriers to implementing digital health technologies for CVD and provides recommendations for overcoming them.