Triage and Risk Concept: Application Proposal for Pre-Hospital Emergencies in a Psychiatric Ambulance in the City of Buenos Aires

The heterogeneity of clinical presentations in psychiatric emergencies creates difficulties in the response by interdisciplinary Mental Health teams. This is aggravated and difficult when the care is carried out on public roads or the patient’s home, that is, it is a pre-hospital context. Our Psychiatric Emergency Hospital, located in the City of Buenos Aires, provides pre-hospital care with a psychiatric ambulance, which is then referred to general hospitals or other health system providers. Not all effectors in the network have the same resources and, at the time of the emergency, the reasons for consultation such as the patient’s clinic are heterogeneous and require the greatest effectiveness in the intervention that is taken. The triage system is a resource that allows the systematization of approaches against the multiplicity of reasons for consultation and presentation of mental pathologies in the emergency room, in addition to providing greater effectiveness in interventions, homogeneity for the health system and consensus among the health effectors. Framed in the Mental Health Law, and especially in the concept of risk, a triage proposal was designed for pre-hospital interventions by the psychiatric ambulance dependent on Hospital Alvear and under current legal regulations with the aim of homogenizing care and referrals with the highest rate of effectiveness to provide quality interdisciplinary medicine.

Macrobioerosion and Microbioerosion in Marine Molluscan Shells from Holocene and Modern Beaches (39°-40°S, South of Buenos Aires Province, Argentina)

The marine sediments of the area of Verde Peninsula - Jabali Island （39°28＇S/62°19%V-40°28＇ S/62°11＇W） Holocene in age （3-2 ky）, and modern beaches contain a significant amount of bioeroded mollusc shells. Fifteen sites were analyzed, in which 20.11% of the mollusc shells （2168 valves） presented bioerosion traces, in 54 species （30 bivalves and 24 gastropods）. Fourteen ichnogenera were reported： Entobia, Maeandropolydora, Iramena, Caulostrepsis, Pennatichnus, Pinaceocladichnus, Trypanites, and Gastrochaenolites （Domichnia）, Gnathichnus and Radulichnus （Pascichnia）, Finichnus and Centrichnus （Fixichnia）, Oichnus （Praedicnia） （macrobioerosion）, y Semidendrina （microbioerosion）, the latter is first reported in mollusc shells in Argentina. Eleven ichnospecies were identified Finichnus peristroma, Maeandropolydora sulcans, Gnathichnus pentax, Pinaceocladichnus onubensis, Caulostrepsis taeniola, Centrichnus eccentricus, Radulichnus inopinatus, Oichnus simplex, Oichnus paraboloides, Oichnus gradatus, and Gastrochaenolites torpedo （lithic remains）. The dominant ichnogenera in the Holocene deposits are Iramena, Entobia and Oichnus. The same ichnogenera are constant with different abundance in the modern beaches, and increasing representation of Pinaceocladichnus and Pennatichnus. The dominant ichnofacies in the Holocene deposits is Trypanites, revealing a benthonic marine community composed of cheilostome bryzoans, clionaid sponges, predator gastropods, regular echinoids, polychaete annelids, bivalves, thallophytas and fungi. Generally, the area was described as a sublittoral, low-energy, stable environment with high rate of oxygenation, and sandy bottoms, with rocky bottoms at Villalonga locality.

Factors associated with H pylori epidemiology in symptomatic children in Buenos Aires,Argentina

AIM: To determine prevalence of H pylori infection in symptomatic children in Buenos Aires, Argentina, and to investigate factors associated with H pylori positivity. METHODS: A total of 395 children with upper gastrointestinal symptoms referred to the Gastroente-rology Unit of the Children Hospital “Sor Maria Ludovica” were evaluated for the presence of H pylori by the 13C-Urea Breath Test (13C-UBT). A questionnaire was applied to the recruited population.RESULTS: Prevalence of H pylori infection was 40.0%in this population (mean age 9.97 ± 3.1 years). The factors associated with H pylori positivity were number of siblings (P < 0.001), presence of pet cats (P = 0.03) and birds (P = 0.04) in the household, and antecedents of gastritis among family members (P = 0.01). After multivariate analysis, number of siblings [Odds ratio (OR) = 1.39; 95% CI, 1.20-1.61] and contact with pet cats (OR = 1.76; 95% CI, 1.00-3.09) remained as variables associated with H pylori infection. CONCLUSION: The prevalence of H pylori infection in children with upper gastrointestinal symptoms in Argentina was similar to that reported in developed countries. Children from families with a higher crowding index and presence of pet cats have a higher risk of being colonized with H pylori.

Liver graft procurement in neurologically deceased donor:Hospital Italiano of Buenos Aires approach

To the Editor:Liver procurement(LP)from a neurologically deceased donor(NDD)is one of the most important spotlights in liver transplanta-tion(LT)[1,2].The commonly used approaches include the“rapid”en-bloc dissection,the in vivo normothermic dissection,or a com-bination of both,according to the preferences and/or the experi-ence of the LP/LT team.A correct LP is essential to achieve optimal results.On the counterpart,defective execution of any of its steps can leave the liver graft unusable and/or cause severe complica-tions in the recipient[3].

Disease Prevalence and Symptoms Caused by <i>Alternaria tenuissima</i>and <i>Pestalotiopsis guepinii</i>on Blueberry in Entre Ríos and Buenos Aires, Argentina

About 60% of blueberry (Vaccinium corymbosum) plantations in Argentina are located in the provinces of Entre Ríos and Buenos Aires. Alternaria tenuissima and Pestalotiopsis guepinii have been reported as pathogens of blueberry, causing leaf spots and branch cankers. The aims of this research were to estimate the prevalence of these microorganisms on leaves and fruits taken from crops located in Entre Ríos and Buenos Aires, as well as to differentiate leaf symptoms after target inoculations with each pathogen individually and in mixtures. Both fungi were present in blueberry fields from 2010 to 2013. A. tenuissima was the most prevalent pathogen, as most of the symptoms detected in the fields had been caused by this species. As a result of inoculations on cv. O’Neal, injured tissues showed symptoms before undamaged ones. Leaf symptoms caused by A. tenuissima differed from those caused by P. guepinii because of their predominant reddish color and the absence of drop-off of the central part of the lesions. When inoculated in a mixture, incubation period on leaves was intermediate between the registered for individual inoculations. The leaves showed reddishbrown spots typical of A. tenuissima and dark brown spots typical of P. guepinii, both with red margins. Blight, defoliation and canker symptoms caused in each case were undistinguishable.

Health Effects of Climate and Air Pollution in Buenos Aires: A First Time Series Analysis

Background: The impact of urban air pollution and temperature changes over health is a growing concern for epidemiologists all over the world and particularly for developing countries where fewer studies have been performed. Aim: The main goal of this paper is to analyze the short term effects of changes in temperature and atmospheric carbon monoxide on daily mortality in Buenos Aires, Argentina. Methods: We conducted a time series study focused on three age groups, gender, and cardiovascular and respiratory mortality, with lags up to four days and temporal variables as modifiers. Results: Temperature correlates positively with total mortality for summer months, with a RR = 1.0184 (95%, CI 1.0139, 1.0229) on the same day for each 1℃ increase. In winter this relationship reverses, as 1?C temperature increase exhibit a protective effect with a RR = 0.9894 (95%, CI 0.9864, 0.9924) at the 3 day lag. Carbon monoxide correlates always positively with mortality, with a RR = 1.0369 (95%, CI 1.0206, 1.0534) for each 1 ppm increase, on the previous day. Conclusions: Climate and pollution parameters measured in Buenos Aires City exhibit a correlation with health outcomes. The impacts of temperature and carbon monoxide vary with age and gender, being elderly the most susceptible subgroup. One day after an increase in CO of 1 ppm, about 4% extra deaths can be expected. The correlation found between increases in CO and mortality for greater lags may be ascribed to the role of CO as a chemical marker of urban air pollution, indicating the co-presence of other pollutants.

Catabolic Response Profiles, Catabolic Uniformity and Richness as Microbiological Indicators in a Soil of Pergamino, Buenos Aires Province, with and without Previous Application of Glyphosate

Incubation assay in trays was performed with two soils with different application histories of glyphosate: no application, and previous application. The soils used were Typic Argiudolls of Pergamino, province of Buenos Aires, and the treatments were: control (no application), and 20, 200 and 2000 mg of active ingredient per kg of soil. Sampling was performed at the beginning (T0) and 45 days after (T45). Catabolic response profiles (CRP), catabolic richness and catabolic uniformity were determined according to the methodology based on measuring the differences in respiration induced by substrate in a short time (4 hours). The substrates used in this study were 20, namely, two amines, 5 aminoacids, two carbohydrates, and 11 carboxylic acids. The objective of this work was to compare soils with different histories of application of glyphosate, measuring its effect on catabolic response profiles, catabolic uniformity and catabolic richness. In this study, no differences were observed between catabolic richness among the different sampling times and doses of glyphosate applied. Glyphosate application affected the structure of the soil microbial communities. At the end of the test, soils with all doses of previous herbicide application showed greater catabolic uniformity than soils without previous application.

Construction of a Computational Scheme for the Fuzzy HIV/AIDS Epidemic Model with a Nonlinear Saturated Incidence Rate

This work aimed to construct an epidemic model with fuzzy parameters.Since the classical epidemic model doesnot elaborate on the successful interaction of susceptible and infective people,the constructed fuzzy epidemicmodel discusses the more detailed versions of the interactions between infective and susceptible people.Thenext-generation matrix approach is employed to find the reproduction number of a deterministic model.Thesensitivity analysis and local stability analysis of the systemare also provided.For solving the fuzzy epidemic model,a numerical scheme is constructed which consists of three time levels.The numerical scheme has an advantage overthe existing forward Euler scheme for determining the conditions of getting the positive solution.The establishedscheme also has an advantage over existing non-standard finite difference methods in terms of order of accuracy.The stability of the scheme for the considered fuzzy model is also provided.From the plotted results,it can beobserved that susceptible people decay by rising interaction parameters.

活动期糖尿病夏科神经性骨关节病诊疗指南——《国际糖尿病足工作组:糖尿病相关的足病预防与管理指南(2023)》的一部分

国际糖尿病足工作组(IWGDF)自1999年以来发布了糖尿病足病预防和治疗的循证指南。这是IWGDF发布的第一部关于糖尿病患者活动期夏科神经性骨关节病诊断和治疗的指南。我们遵循GRADE方法,以人群-评估-比较-结局(PACO)和人群-干预-比较-结局(PICO)的格式设计临床问题,系统检索医学文献,并提出有依据的推荐。这些推荐是基于我们系统综述的证据,如无证据则参考专家意见,并考虑到与干预相关的受益和危害、患者偏好、可行性和适用性以及成本的权衡。我们在本章节介绍了2023年糖尿病患者活动期夏科神经性骨关节病的诊断和治疗指南,并提出了未来的关键研究方向。

Hepatic perivascular epithelioid cell tumors:Benign,malignant,and uncertain malignant potential

In 2013,the World Health Organization defined perivascular epithelioid cell tumor(PEComa)as“a mesenchymal tumor which shows a local association with vessel walls and usually expresses melanocyte and smooth muscle markers.”This generic definition seems to better fit the PEComa family,which includes angiomyolipoma,clear cell sugar tumor of the lung,lymphangioleiomyomatosis,and a group of histologically and immunophenotypically similar tumors that include primary extrapulmonary sugar tumor and clear cell myomelanocytic tumor.Clear cell tumors with this immunophenotypic pattern have also had their malignant variants described.When localizing to the liver,preoperative radiological diagnosis has proven to be very difficult,and most patients have been diagnosed with hepatocellular carcinoma,focal nodular hyperplasia,hemangioma,or hepatic adenoma based on imaging findings.Examples of a malignant variant of the liver have been described.Finally,reports of malignant variants of these lesions have increased in recent years.Therefore,we support the use of the Folpe criteria,which in 2005 established the criteria for categorizing a PEComa as benign,malignant,or of uncertain malignant potential.Although they are not considered ideal,they currently seem to be the best approach and could be used for the categorization of liver tumors.

Omics-based biomarkers as useful tools in metabolic dysfunctionassociated steatotic liver disease clinical practice:How far are we?

Unmet needs exist in metabolic dysfunction-associated steatotic liver disease(MASLD)risk stratification.Our ability to identify patients with MASLD with advanced fibrosis and at higher risk for adverse outcomes is still limited.Incorporating novel biomarkers could represent a meaningful improvement to current risk predictors.With this aim,omics technologies have revolutionized the process of MASLD biomarker discovery over the past decades.While the research in this field is thriving,much of the publication has been haphazard,often using single-omics data and specimen sets of convenience,with many identified candidate biomarkers but lacking clinical validation and utility.If we incorporate these biomarkers to direct patients’management,it should be considered that the roadmap for translating a newly discovered omics-based signature to an actual,analytically valid test useful in MASLD clinical practice is rigorous and,therefore,not easily accomplished.This article presents an overview of this area’s current state,the conceivable opportunities and challenges of omics-based laboratory diagnostics,and a roadmap for improving MASLD biomarker research.

Consequences of early life stress on the structure and function of the adult mouse retina

Early-life stress(ELS)refers to a period of environmental/social deprivation,physica l,sexual or emotional abuse,neglect,severe and/or chronic trauma in the prenatal/early postnatal stage,which is closely related to many adverse psychiatric disorders later in life,such as depressive disorder,substance abuse,dysthymia,panic,anxiety,and suicidal behavior in adulthood(Waters and Gould,2022).

Homer1a reduces inflammatory response after retinal ischemia/reperfusion injury

Elevated intraocular pressure(IOP)is one of the causes of retinal ischemia/reperfusion injury,which results in NRP3 inflammasome activation and leads to visual damage.Homerla is repo rted to play a protective role in neuroinflammation in the cerebrum.However,the effects of Homerla on NLRP3inflammasomes in retinal ischemia/reperfusion injury caused by elevated IOP remain unknown.In our study,animal models we re constructed using C57BL/6J and Homer1^(flox/-)/Homerla^(+/-)/Nestin-Cre^(+/-)mice with elevated IOP-induced retinal ischemia/repe rfusion injury.For in vitro expe riments,the oxygen-glucose deprivation/repe rfusion injury model was constructed with M uller cells.We found that Homerla ove rexpression amelio rated the decreases in retinal thickness and Muller cell viability after ischemia/reperfusion injury.Furthermore,Homerla knockdown promoted NF-κB P65^(Ser536)activation via caspase-8,NF-κB P65 nuclear translocation,NLRP3 inflammasome formation,and the production and processing of interleukin-1βand inte rleukin-18.The opposite results we re observed with Homerla ove rexpression.Finally,the combined administration of Homerla protein and JSH-23 significantly inhibited the reduction in retinal thickness in Homer1^(flox/-)Homer1a^(+/-)/Nestin-Cre^(+/-)mice and apoptosis in M uller cells after ischemia/reperfusion injury.Taken together,these studies demonstrate that Homer1a exerts protective effects on retinal tissue and M uller cells via the caspase-8/NF-KB P65/NLRP3 pathway after I/R injury.

Effect of Aspergillus niger prolyl endopeptidase in patients with celiac disease on a long-term gluten-free diet

BACKGROUND The gluten-free diet(GFD)has limitations,and there is intense research in the development of adjuvant therapies.AIM To examine the effects of orally administered Aspergillus niger prolyl endopeptidase protease(AN-PEP)on inadvertent gluten exposure and symptom prevention in adult celiac disease(CeD)patients following their usual GFD.METHODS This was an exploratory,double-blind,randomized,placebo-controlled trial that enrolled CeD patients on a long-term GFD.After a 4-wk run-in period,patients were randomized to 4 wk of two AN-PEP capsules(GliadinX;AVI Research,LLC,United States)at each of three meals per day or placebo.Outcome endpoints were:(1)Average weekly stool gluten immunogenic peptides(GIP)between the run-in and end of treatments and between AN-PEP and placebo;(2)celiac symptom index(CSI);(3)CeD-specific serology;and(4)quality of life.Stool samples were collected for GIP testing by ELISA every Tuesday and Friday during run-ins and treatments.RESULTS Forty patients were randomized for the intention-to-treat analysis,and three were excluded from the per-protocol assessment.Overall,628/640(98.1%)stool samples were collected.GIP was undetectable(<0.08μg/g)in 65.6%of samples,and no differences between treatment arms were detected.Only 0.5%of samples had GIP concentrations sufficiently high(>0.32μg/g)to potentially cause mucosal damage.Median GIP concentration in the AN-PEP arm was 44.7%lower than in the run-in period.One-third of patients exhibiting GIP>0.08μg/g during run-in had lower or undetectable GIP after AN-PEP treatment.Compared with the run-in period,the proportion of symptomatic patients(CSI>38)in the AN-PEP arm was significantly lower(P<0.03).AN-PEP did not result in changes in specific serologies.CONCLUSION This exploratory study conducted in a real-life setting revealed high adherence to the GFD.The AN-PEP treatment did not significantly reduce the overall GIP stool concentration.However,given the observation of a significantly lower prevalence of patients with severe symptoms in the AN-PEP arm,further clinical research is warranted.

Early Phases of Star Formation: Testing Chemical Tools

Star-forming processes strongly influence the ISM chemistry.Nowadays,many high-quality databases are available at millimeter wavelengths.Using them,it is possible to carry out studies that review and deepen previous results.If these studies involve large samples of sources,it is preferred to use direct tools to study the molecular gas.With the aim of testing these tools such as the use of the HCN/HNC ratio as a thermometer,and the use of H^(13)CO^(+),HC_(3)N,N_(2)H^(+) and C_(2)H as "chemical clocks," we present a molecular line study toward 55 sources representing massive young stellar objects at different evolutionary stages:infrared dark clouds(IRDCs),highmass protostellar objects(HMPOs),hot molecular cores(HMCs) and ultracompact H II regions.We found that the use of the HCN/HNC ratio as a universal thermometer in the ISM should be taken with care because the HCN optical depth is a big issue that can affect the method.Hence,this tool should be utilized only after a careful analysis of the HCN spectrum,checking that no line,neither the main nor the hyperfine ones,presents absorption features.We point out that the analysis of the emission of H^(13)CO^(+),HC_(3)N,N_(2)H^(+) and C_(2)H could be useful to trace and distinguish regions among IRDCs,HMPOs and HMCs.The molecular line widths of these four species increase from the IRDC to the HMC stage,which can be a consequence of the gas dynamics related to the starforming processes taking place in the molecular clumps.Our results not only contribute with more statistics,acting as a probe of such chemical tools,useful to obtain information in large samples of sources,but also complement previous works through the analysis of other types of sources.

Sodium Sulfite as a Novel Hypoxia Revulsant Involved in Hypoxic Regulation in Escherichia coli

As a reducing salt,sodium sulfite could deprive oxygen in solution,which could mimic hypoxic stress in Caenorhabditis elegans.In this study,the wildtype Escherichia coli strain MG1655 was used to examine the inhibition of sodium sulfite-induced hypoxia by observing the bacterial growth curves.

Cluster DetectionMethod of Endogenous Security Abnormal Attack Behavior in Air Traffic Control Network

In order to enhance the accuracy of Air Traffic Control(ATC)cybersecurity attack detection,in this paper,a new clustering detection method is designed for air traffic control network security attacks.The feature set for ATC cybersecurity attacks is constructed by setting the feature states,adding recursive features,and determining the feature criticality.The expected information gain and entropy of the feature data are computed to determine the information gain of the feature data and reduce the interference of similar feature data.An autoencoder is introduced into the AI(artificial intelligence)algorithm to encode and decode the characteristics of ATC network security attack behavior to reduce the dimensionality of the ATC network security attack behavior data.Based on the above processing,an unsupervised learning algorithm for clustering detection of ATC network security attacks is designed.First,determine the distance between the clustering clusters of ATC network security attack behavior characteristics,calculate the clustering threshold,and construct the initial clustering center.Then,the new average value of all feature objects in each cluster is recalculated as the new cluster center.Second,it traverses all objects in a cluster of ATC network security attack behavior feature data.Finally,the cluster detection of ATC network security attack behavior is completed by the computation of objective functions.The experiment took three groups of experimental attack behavior data sets as the test object,and took the detection rate,false detection rate and recall rate as the test indicators,and selected three similar methods for comparative test.The experimental results show that the detection rate of this method is about 98%,the false positive rate is below 1%,and the recall rate is above 97%.Research shows that this method can improve the detection performance of security attacks in air traffic control network.

Bird species present in urban parks are more colorful than urban avoiders:A test in the Argentinian Pampas

Bird plumage color has been assessed as a possible trait driving the presence of bird species in urban areas.Although some species can see the ultraviolet(UV) spectrum,the mentioned studies did not take into account UV reflectance when characterizing bird plumage.This study aimed to use a recent database of the colorfulness in passerines that incorporated the UV spectrum to compare bird colorfulness and other traits between urban parks and rural areas in Central-East Argentina.Birds in urban parks were surveyed in 51 parks in 6 cities during breeding and non-breeding seasons.A list of Passeriformes species from parks was created,and a list of urban avoider species was created from the bibliography.Species traits were body mass,clutch size,migratory status,nesting site,diet and habitat breadth,and plumage colorfulness.A total of 85 species were detected in the regional pool,of which 30 species were detected in urban parks.Bird species present in urban parks were more colorful than bird species only present in rural areas.In addition,bird presence in urban parks was positively related to their regional frequency and diet breadth.Moreover,urban presence was related to nesting on trees and buildings,whereas species not present in urban parks nested on the ground.The results obtained showed that bird color is significantly associated with presence of bird species in urban parks.

Integrated ribosome and proteome analyses reveal insights into sevoflurane-induced long-term social behavior and cognitive dysfunctions through ADNP inhibition in neonatal mice

A growing number of studies have demonstrated that repeated exposure to sevoflurane during development results in persistent social abnormalities and cognitive impairment.Davunetide,an active fragment of the activity-dependent neuroprotective protein(ADNP),has been implicated in social and cognitive protection.However,the potential of davunetide to attenuate social deficits following sevoflurane exposure and the underlying developmental mechanisms remain poorly understood.In this study,ribosome and proteome profiles were analyzed to investigate the molecular basis of sevoflurane-induced social deficits in neonatal mice.The neuropathological basis was also explored using Golgi staining,morphological analysis,western blotting,electrophysiological analysis,and behavioral analysis.Results indicated that ADNP was significantly down-regulated following developmental exposure to sevoflurane.In adulthood,anterior cingulate cortex(ACC)neurons exposed to sevoflurane exhibited a decrease in dendrite number,total dendrite length,and spine density.Furthermore,the expression levels of Homer,PSD95,synaptophysin,and vglut2 were significantly reduced in the sevoflurane group.Patch-clamp recordings indicated reductions in both the frequency and amplitude of miniature excitatory postsynaptic currents(mEPSCs).Notably,davunetide significantly ameliorated the synaptic defects,social behavior deficits,and cognitive impairments induced by sevoflurane.Mechanistic analysis revealed that loss of ADNP led to dysregulation of Ca^(2+)activity via the Wnt/β-catenin signaling,resulting in decreased expression of synaptic proteins.Suppression of Wnt signaling was restored in the davunetide-treated group.Thus,ADNP was identified as a promising therapeutic target for the prevention and treatment of neurodevelopmental toxicity caused by general anesthetics.This study provides important insights into the mechanisms underlying social and cognitive disturbances caused by sevoflurane exposure in neonatal mice and elucidates the regulatory pathways involved.

The Negative Thermal Expansion Property of NdMnO_(3) Based on Pores Effect and Phase Transition

A novel negative thermal expansion(NTE) material NdMnO_(3) was synthesized by solid-state method at 1 523 K. The crystal structure, phase transition, pores effect and negative expansion properties of NdMnO_(3) were investigated by variable temperature X-ray diffraction(XRD), scanning electron microscope(SEM) and variable temperature Raman spectra. The compound exhibits NTE properties in the orderly O' phase crystal structure. When the temperature is from 293 to 759 K, the ceramic NdMnO_(3) shows negative thermal expansion of-4.7×10^(-6)/K. As temperature increases, the ceramic NdMnO_(3) presents NTE property range from 759 to 1 007 K. The average linear expansion coefficient is-18.88×10^(-6)/K. The physical mechanism of NTE is discussed and clarified through experiments.