Background Vector-borne diseases(VBDs)are important contributors to the global burden of infectious diseases due to their epidemic potential,which can result in signifcant population and economic impacts.Oropouche fev...Background Vector-borne diseases(VBDs)are important contributors to the global burden of infectious diseases due to their epidemic potential,which can result in signifcant population and economic impacts.Oropouche fever,caused by Oropouche virus(OROV),is an understudied zoonotic VBD febrile illness reported in Central and South America.The epidemic potential and areas of likely OROV spread remain unexplored,limiting capacities to improve epidemiological surveillance.Methods To better understand the capacity for spread of OROV,we developed spatial epidemiology models using human outbreaks as OROV transmission-locality data,coupled with high-resolution satellite-derived vegetation phe‑nology.Data were integrated using hypervolume modeling to infer likely areas of OROV transmission and emergence across the Americas.Results Models based on one-support vector machine hypervolumes consistently predicted risk areas for OROV transmission across the tropics of Latin America despite the inclusion of diferent parameters such as diferent study areas and environmental predictors.Models estimate that up to 5 million people are at risk of exposure to OROV.Nevertheless,the limited epidemiological data available generates uncertainty in projections.For example,some out‑breaks have occurred under climatic conditions outside those where most transmission events occur.The distribu‑tion models also revealed that landscape variation,expressed as vegetation loss,is linked to OROV outbreaks.Conclusions Hotspots of OROV transmission risk were detected along the tropics of South America.Vegetation loss might be a driver of Oropouche fever emergence.Modeling based on hypervolumes in spatial epidemiology might be considered an exploratory tool for analyzing data-limited emerging infectious diseases for which little understand‑ing exists on their sylvatic cycles.OROV transmission risk maps can be used to improve surveillance,investigate OROV ecology and epidemiology,and inform early detection.展开更多
A large fire of 233 ha in Huascarán National Park in Peru provided an opportunity to compare plant and bird responses in burned and nearby unburned zones of the puna. Heights and live diameters of flagship Puya r...A large fire of 233 ha in Huascarán National Park in Peru provided an opportunity to compare plant and bird responses in burned and nearby unburned zones of the puna. Heights and live diameters of flagship Puya raimondii rosettes(assigned to four broad developmental phases), plant communities(66 species in 24 families and nine growth forms) and bird communities(77 species in six trophic guilds) were monitored after the fire. Although no mortality was observed, Puya raimondii plants were affected by the fire, losing approximately 60% of their photosynthetic area across all developmental phases, but recovered quickly during the first two years after fire. The comparison of Puya rosette recovery after fire was complicated by the changes in live rosette diameter for unburned plants, which showed plasticity of photosynthetic area linked to seasonal and annual fluctuations in precipitation in this relatively dry environment(decreased by 26% for mature adult plants over the study period). Fire caused an immediate change in the density, biomass and composition of vegetation. Although the species present remained similar, their abundances changed significantly immediately after the fire, with notable reductions in dominant tussock grasses. This provided opportunities for other plants, resulting in higher postfire diversity of plant species, genera, families and growth forms. In turn, the changes in vegetation after fire affected the composition of birds according to their trophic guild. Granivores largely disappeared,generalists were mostly unaffected, and other guilds showed a more complex response. As the vegetation recovered, most displaced birds returned within approximately one year.展开更多
We present a study of star-forming galaxies (SFGs) with pseudobulges (bulges with Sérsic index n<2) in a loca close major-merger galaxy pair sample (H-KPAIR).With data from new aperture photometries in the opt...We present a study of star-forming galaxies (SFGs) with pseudobulges (bulges with Sérsic index n<2) in a loca close major-merger galaxy pair sample (H-KPAIR).With data from new aperture photometries in the optical and near-infrared bands (aperture size of 7 kpc) and from the literature,we find that the mean Age of central stellar populations in Spirals with pseudobulges is consistent with that of disky galaxies and is nearly constant against the bulge-to-total ratio (B/T).Paired Spirals have a slightly lower fraction of pure disk galaxies (B/T≤0.1) than their counterparts in the control sample.Compared to SFGs with classical bulges,those with pseudobulges have a higher (>2σ) mean of specific star formation rate (sSFR) enhancement (sSFR_(enh)=0.33±0.07 versus sSFR_(enh)=0.12±0.06) and broader scatter (by~1 dex).The eight SFGs that have the highest sSFR_(enh)in the sample all have pseudobulges.A majority (69%) of paired SFGs with strong enhancement (having sSFR more than5 times the median of the control galaxies) have pseudobulges.The Spitzer data show that the pseudobulges in these galaxies are tightly linked to nuclear/circum-nuclear starbursts.Pseudobulge SFGs in S+S and in S+E pairs have significantly (>3σ) different sSFR enhancement,with the means of sSFR_(enh)=0.45±0.08 and-0.04±0.11respectively.We find a decrease in the sSFR enhancements with the density of the environment for SFGs with pseudobulges.Since a high fraction (5/11) of pseudobulge SFGs in S+E pairs are in rich groups/clusters (loca density N_(1Mpc)≥7),the dense environment might be the cause for their low s SFR_(enh).展开更多
Background: Deep brain stimulation (DBS) is an established treatment for patients with advanced Parkinson’s disease (PD). Reports show continued patient satisfaction after surgery despite not maintaining clinical imp...Background: Deep brain stimulation (DBS) is an established treatment for patients with advanced Parkinson’s disease (PD). Reports show continued patient satisfaction after surgery despite not maintaining clinical improvement as measured by evolution scales. Objectives: The present study sought to explore expectations and level of satisfaction in patients after DBS surgery with a semi-structured questionnaire and subsequent correlation with functional scales, Quality of Life (QoL), and motor and non-motor symptoms. Methods: We performed descriptive statistics to represent demographic data, Wilcoxon rank tests to determine significant differences, and Spearman correlation between the applied scales. Results: We evaluated 20 patients with a history of DBS surgery. 45% were female, with a mean age of 55.7 ± 14.15 years, a mean disease duration of 13.42 ± 8.3 years, and a mean time after surgery of 3.18 ± 1.86 years. Patients reported surgery meeting expectations in 85.5% and continued satisfaction in 92%. These two variables showed a significant correlation. Conclusions: This sample of patients remained satisfied after DBS surgery, although we found no differences in motor and non-motor clinimetric scales. Further studies are needed to confirm the importance of assessing quality of life in patients with DBS.展开更多
The Antarctic Paleogene marine fossil record has been the key to reconstructing the evolution of the Weddellian Sea and final dismemberment of Southern Gondwana.In this context,Eocene marine vertebrates from Seymour(M...The Antarctic Paleogene marine fossil record has been the key to reconstructing the evolution of the Weddellian Sea and final dismemberment of Southern Gondwana.In this context,Eocene marine vertebrates from Seymour(Marambio)Island have provided valuable information.We present the first Eocene record of marine reptiles from the southern Atlantic Coast of South America.This corresponds to several postcranial turtle remains represented by a proximal end of the right humerus,three caudal and one thoracic vertebrae,a fragment of the left pubis,and ten ossicles of the dorsal carapace,coming from the Leticia Formation(late-mid Eocene)at Cabo Tiburones,Tierra del Fuego,Argentina.These materials show severalfeatures such as the size and general morphology of the humerus and vertebrae,and the presence of relatively small,irregular,smooth,and unkeeled ossicles,which allow us to assign them to Dermochelyidae indet.Dermochelyids are a cosmopolitan group ofcryptodiran turtles,registered from the late Cretaceous up to the recent,with some physiological-biological peculiarities(e.g.,endothermy and an exclusive jellyfish-based diet)and characterized by the presence of an osseous carapace formed by ossicles.The new finding from the Leticia Formation is an addition to the scarce and extremely fragmentary record of Eocene dermochelyids from the southern seas like those from the La Meseta and Submeseta formations(Antarctica)and the Waihao and Burnside formations(New Zealand).This new information allows us to discuss the presence of these turtles in such high latitudes in the past and its implication in the evolution of the Weddellian fauna.展开更多
Traditional Chinese medicine(TCM) arrived from China to Latin America and the Caribbean in the 1840s due to the massive migration of Chinese people to the region. In a few years, the press noticed the presence of Chin...Traditional Chinese medicine(TCM) arrived from China to Latin America and the Caribbean in the 1840s due to the massive migration of Chinese people to the region. In a few years, the press noticed the presence of Chinese herbalists practicing in different cities and countries regardless of the demographic weight of the Chinese community. The fascination with Chinese doctors implicated not only the press but also the literature, a phenomenon particularly observed in Cuba. In the first decades of the 20th century, the reactivation of Chinese immigration to the region fostered an anti-Chinese climate that materialized in more significant migratory restrictions and control of their businesses, such as what happened with Chinese herbalists. These herbalists who practiced inside and outside the Chinese community started to object to criticism and persecution by the conservative press and professional doctors. Despite this, Chinese doctors will continue to maintain their support of a significant number of ill persons. This work seeks to illuminate the historical relevance of TCM in Latin America and the Caribbean, focusing on the cases of Peru, Chile, and Cuba. This last country was far from China culturally and geographically, but as in many other small towns in the region, Chinese medicine presented an alternative to the treatment of illnesses.展开更多
Excess sodium intake is associated with high blood pressure and cardiovascular diseases. This study examined food services in Costa Rica as a major source of sodium. The research included six cafeterias, six fast food...Excess sodium intake is associated with high blood pressure and cardiovascular diseases. This study examined food services in Costa Rica as a major source of sodium. The research included six cafeterias, six fast food establishments, 13 restaurants, and 15 diners using non-probabilistic convenience sampling. Interviews were conducted with workers to assess knowledge, attitudes, and practices regarding salt reduction. The findings were analyzed to determine effective intervention strategies. Participants showed regular knowledge about salt/sodium. While they recognized the link with high blood pressure, understanding of other health problems was limited. Positive attitudes were observed toward healthy cooking and reducing sodium in pre-prepared food, especially in restaurants. Over 70% expressed a desire to reduce salt in food services, with more than 80% indicating a need for staff training, particularly in cafeterias lacking knowledge of low-salt preparations. High-sodium ingredients were prevalent, with saltshakers and sauces readily available. However, some individuals were reluctant to reduce salt/sodium intake, citing concerns about taste, food variety, and customer complaints. Obstacles to reducing salt/sodium levels included limited accessibility and the cost of low-sodium ingredients. The data collection tools and methodologies used in this study can serve as a foundation for future investigations and strategies to reduce salt consumption in food services. The study recommends government support for transforming the gastronomic sector and implementing regulations and knowledge enhancement. Collaboration with the productive sector is crucial for creating healthy environments. This research presents valuable evidence regarding the utilization of salt and sodium in the gastronomic sector, thereby assisting in the decision-making process for public health initiatives and the prevention of non-communicable chronic diseases. It highlights the significance of tackling sodium reduction in food services to encourage the adoption of healthy culinary practices and enhance the overall health of the population.展开更多
High blood pressure and other non-communicable diseases associated with excessive salt/sodium consumption represent a major challenge to the health of the world’s population. Consumption is a human behavior that is u...High blood pressure and other non-communicable diseases associated with excessive salt/sodium consumption represent a major challenge to the health of the world’s population. Consumption is a human behavior that is usually influenced by significant factors, internal and external to people. The design of a national social marketing intervention is described. The whole process was developed by a national interdisciplinary team over the course of a decade (2011-2022). Its purpose is to promote changes in this behavior, through gradual reduction of salt/sodium consumption in the target populations of Costa Rica, for the prevention and control of associated diseases. The process includes four phases: research, situation analysis, creation of a proposal for the social marketing strategy, and implementation and evaluation. Last phase was not developed by the research team. The main inputs used to design this intervention were the data generated in three qualitative researchers carried out by the national work team and the social marketing regional plan for salt consumption reduction in Latin America. By analyzing these research data, marketing mix components were determined for designing the intervention. The marketing strategy is promotional and is based on encouraging a natural diet with less sodium using natural seasonings and adding less discretional salt and industrialized products high in sodium, in the preparation of food and dishes. The primary key audience is the mother of the school-aged child, and the secondary is the adult caregivers of this child. It is expected that in the short term, health promoters from different government and non-state sectors will contribute to the implementation of the national social marketing plan, to achieve, in the medium or long term, a consumption that approaches five grams of salt per person per day. This plan is a country initiative to position the value of a natural diet with less sodium and to contribute to the prevention and treatment of HT and NCD associated diseases.展开更多
The synthesis of nanoparticles by biological methods using microorganisms, enzymes, or plant extracts has been suggested as a possible ecofriendly alternative to chemical and physical methods that involve the use of h...The synthesis of nanoparticles by biological methods using microorganisms, enzymes, or plant extracts has been suggested as a possible ecofriendly alternative to chemical and physical methods that involve the use of harmful reducing agents. Green synthesis of silver nanoparticles (AgNPs) was achieved using Eugenia uniflora ripe fruit extract, which was characterized by phytochemical screening revealing the presence of polyphenols (quinones, flavonoids, and tannins), reducing compounds, and terpenes. These excellent antioxidants reduced silver nitrate to give the AgNPs, which were characterized by transmission electron microscopy (TEM), dynamic light scattering (DLS), and ζ potential analysis. The diameter of the AgNPs ranged from 10.56 ± 1.2 nm to 107.56 ± 5.7 nm. The antibacterial activity of the AgNPs was evaluated using a modification of the Kirby-Bauer technique with Escherichia coli, Pseudomonas aeruginosa, and Staphylococcus aureus. The inhibition halos were 11.12 ± 0.02 mm, 13.96 ± 0.07 mm, and 11.29 ± 0.76 mm, respectively. The synthesis using E. uniflora is an ecofriendly and low cost method of obtaining silver nanoparticles that could be used in health sciences because of their activity against bacteria with antibiotic resistance.展开更多
During the review and identification of specimens of the genus Damasippus Stål, 1875 deposited in the National Museum of Costa Rica, some specimens were found that corresponded to four non-described species: D. s...During the review and identification of specimens of the genus Damasippus Stål, 1875 deposited in the National Museum of Costa Rica, some specimens were found that corresponded to four non-described species: D. sepia n.sp., D. viridicorpus n.sp, D. duoviridis n.sp and D. viridilabrum n. sp. Due to the above, a review of the literature describing the species of this group was carried out, with which an illustrated dichotomous key was developed to identify the 16 species, in addition to a partial phylogenetic analysis to corroborate that they do not correspond to the species D. fuscipes, due to its morphological similarity.展开更多
Brucellosis is an infectious disease of worldwide distribution, which has a great economic impact due to the productive and reproductive losses that it causes, in addition to the serious public health problem. The aim...Brucellosis is an infectious disease of worldwide distribution, which has a great economic impact due to the productive and reproductive losses that it causes, in addition to the serious public health problem. The aim of this study is to estimate the economic losses, through financial analysis, caused by bovine brucellosis in the province of Carchi, over a one-year period. A random sampling was used to determine the prevalence in the study area, where 2976 animals were considered, and the Rose Bengal (RB) test was used as a screening test and the Fluorescence Polarized Assay (FPA) as a confirmatory test, obtaining a prevalence of 8.2% (244/2976). In addition, parameters associated to the losses caused by brucellosis in cattle were determined by literature review. To estimate costs, field information was collected through a survey of a total of 100 randomly selected farmers. The loss estimated due to calves lost as a result of abortions and neonatal death was USD. 79170.00. The loss due to death of 4 cows as a result of metritis was estimated at USD. 5000.00. The cost of examination and treatment of aborted cows was USD. 20100.00. The losses due to reduction in milk production from aborted and non-aborted seropositive cows were estimated at USD. 158114.21. The financial losses due to brucellosis in province of Carchi were estimated at USD. 262384.21.展开更多
Artificial intelligence(AI)technologies and sensors have recently received significant interest in intellectual agriculture.Accelerating the application of AI technologies and agriculture sensors in intellectual agric...Artificial intelligence(AI)technologies and sensors have recently received significant interest in intellectual agriculture.Accelerating the application of AI technologies and agriculture sensors in intellectual agriculture is urgently required for the growth of modern agriculture and will help promote smart agriculture.Automatic irrigation scheduling systems were highly required in the agricultural field due to their capability to manage and save water deficit irrigation techniques.Automatic learning systems devise an alternative to conventional irrigation management through the automatic elaboration of predictions related to the learning of an agronomist.With this motivation,this study develops a modified black widow optimization with a deep belief network-based smart irrigation system(MBWODBN-SIS)for intelligent agriculture.The MBWODBN-SIS algorithm primarily enables the Internet of Things(IoT)based sensors to collect data forwarded to the cloud server for examination purposes.Besides,the MBWODBN-SIS technique applies the deep belief network(DBN)model for different types of irrigation classification:average,high needed,highly not needed,and not needed.The MBWO algorithm is used for the hyperparameter tuning process.A wideranging experiment was conducted,and the comparison study stated the enhanced outcomes of the MBWODBN-SIS approach to other DL models with maximum accuracy of 95.73%.展开更多
Cannabidiol (CBD), one of the most studied phytocannabinoids, is non-psychotropic and can induce protective effects on the central nervous system against acute and chronic brain injury. Interestingly, CBD inhibits pro...Cannabidiol (CBD), one of the most studied phytocannabinoids, is non-psychotropic and can induce protective effects on the central nervous system against acute and chronic brain injury. Interestingly, CBD inhibits processes relating to amyloid beta (Aβ)-induced neurotoxicity in mouse models of Alzheimer’s disease, though the detailed molecular mechanism underlying the CBD neurotoxicity modulation is not fully understood. In this study, using atomic force microscopy, we find that CBD promotes the aggregation of Aβ peptides, enhancing the formation of Aβ oligomers, also known as Aβ-derived diffusible ligands (ADDLs). The CBD-mediated sequestration of Aβ monomers in soluble ADDLs could reduce neurotoxicity. This study highlights a possible role of CBD in modulating the formation of ADDL aggregates and provides insight into potentially neuroprotective properties of CBD in Alzheimer’s disease.展开更多
Artemisinins tested against W-2 strains of malaria falciparum are investigated with molecular electrostatic potential (MEP), in an attempt to identify key features of the compounds that are necessary for their activit...Artemisinins tested against W-2 strains of malaria falciparum are investigated with molecular electrostatic potential (MEP), in an attempt to identify key features of the compounds that are necessary for their activities, as well as to investigate likely interactions with the receptor in a biological process and to use that information to propose new molecules. In order to discover the best geometry involving the ligand-receptor complexes (heme) studied and help in the proposition of the new derivatives, molecular simulations of interactions between the most negative charged region around the peroxide and heme locates (the ones around the Fe2+ ion) were carried out. In addition, PCA (principal components analysis), HCA (hierarchical cluster analysis), SDA (stepwise discriminant analysis), and KNN (K-nearest neighbor) multivariate models were employed to investigate which descriptors are responsible for the classification between the higher and lower antimalarial activity of the compounds, and also this information was used to propose new potentially active molecules. The information accumulated in studies of MEP, molecular docking, and multivariate analysis supported the proposal of new structures with potential antimalarial activities. The multivariate models constructed were applied to the new structures and indicated numbers 19 and 20 as the most prominent for syntheses and biological assays.展开更多
N-11-azaartemisinins potentially active against Plasmodium falciparum are designed by combining molecular electrostatic potential (MEP), ligand-receptor interaction, and models built with supervised machine learning m...N-11-azaartemisinins potentially active against Plasmodium falciparum are designed by combining molecular electrostatic potential (MEP), ligand-receptor interaction, and models built with supervised machine learning methods (PCA, HCA, KNN, SIMCA, and SDA). The optimization of molecular structures was performed using the B3LYP/6-31G* approach. MEP maps and ligand-receptor interactions were used to investigate key structural features required for biological activities and likely interactions between N-11-azaartemisinins and heme, respectively. The supervised machine learning methods allowed the separation of the investigated compounds into two classes: cha and cla, with the properties ε<sub>LUMO+1</sub> (one level above lowest unoccupied molecular orbital energy), d(C<sub>6</sub>-C<sub>5</sub>) (distance between C<sub>6</sub> and C<sub>5</sub> atoms in ligands), and TSA (total surface area) responsible for the classification. The insights extracted from the investigation developed and the chemical intuition enabled the design of sixteen new N-11-azaartemisinins (prediction set), moreover, models built with supervised machine learning methods were applied to this prediction set. The result of this application showed twelve new promising N-11-azaartemisinins for synthesis and biological evaluation.展开更多
The study of the mineral and organic content of the Allende meteorite is important for our understanding of the molecular evolution of the universe as well as the ancient Earth. Previous studies have characterized the...The study of the mineral and organic content of the Allende meteorite is important for our understanding of the molecular evolution of the universe as well as the ancient Earth. Previous studies have characterized the magnetic minerals present in ordinary and carbonaceous chondrites, providing information on the evolution of magnetic fields. The interaction of organic compounds with magnetic minerals is a possible source of chemical diversity, which is crucial for molecular evolution. Carbon compounds in meteorites are of great scientific interest for a variety of reasons, such as their relevance to the origins of chirality in living organisms. This study presents the characterization of organic and mineral compounds in the Allende meteorite. The structural and physicochemical characterization of the Allende meteorite was accomplished through light microscopy, powder X-ray diffraction with complementary Rietveld refinement, Raman and infrared spectroscopy, mass spectrometry, scanning electron microscopy, and atomic force microscopy using magnetic signal methods to determine the complex structure and the interaction of organic compounds with magnetic Ni-Fe minerals. The presence of Liesegang-like patterns of chondrules in fragments of the Allende structure may also be relevant to understanding how the meteorite was formed. Other observations include the presence of magnetic materials and nanorod-like solids with relatively similar sizes as well as the heterogeneous distribution of carbon in chondrules. Signals observed in the Raman and infrared spectra resemble organic compounds such as carbon nanotubes and peptide-like molecules that have been previously reported in other meteorites, making the Mexican Allende meteorite a feasible sample for the study of the early Earth and exoplanetary bodies.展开更多
The global incidence and prevalence of diabetes mellitus(DM)have reached epidemic proportions.Estimates indicate that more than 360 million people will be affected by DM by 2030.All of these individuals will be at ris...The global incidence and prevalence of diabetes mellitus(DM)have reached epidemic proportions.Estimates indicate that more than 360 million people will be affected by DM by 2030.All of these individuals will be at risk of developing diabetic retinopathy(DR).It is extremely important to categorize,classify and stage the severity of DR in order to establish adequate therapy.With proper management more than 90%of cases of visual loss can be prevented.The purpose of the current paper is to review the classification of DR with a special emphasis on the International Clinical Disease Severity Scale for DR.This new classification is simple to use,easy to remember and based on scientific evidence.It does not require specialized examinations such as optical coherence tomography or fluorescein angiography.It is based on clinical examination and applying the Early Treatment of Diabetic Retinopathy Study 4:2:1 rule.展开更多
Rice(Oryza sativa L.)is an important staple food crop worldwide due to its adaptability to different environmental conditions.Because of its great economic and social importance,there is a constant requirement for new...Rice(Oryza sativa L.)is an important staple food crop worldwide due to its adaptability to different environmental conditions.Because of its great economic and social importance,there is a constant requirement for new varieties with improved agronomic characteristics,such as tolerance to different biotic(such as bacterium,fungus,insect and virus)and abiotic stresses(such as salinity,drought and temperature),higher yield and better organoleptic and nutritional value.Among the new genome editing technologies,the clustered regularly interspaced short palindromic repeats(CRISPR)/CRISPR-associated protein(Cas)(CRISPR/Cas)system allows precise and specific edition in a targeted genome region.It is one of the most frequently used techniques for the study of the function of new genes and for the development of mutant lines with enhanced tolerance to biotic and abiotic stresses,herbicide resistance or improved yield.The wide varieties of applications for this technology include simple non-homologous end joining,homologous recombination,gene replacement,and base editing.In this review,we analyzed how some of these applications have been used in rice cultivars to obtain rice varieties better adapted to current environmental conditions and market requirements.展开更多
AIM: To review the initial presentation and demonstrate the importance of Takotsubo cardiomyopathy. METHODS: A PubMed search using the terms "Takotsubo cardiomyopathy (TC)" and "apical ballooning syndro...AIM: To review the initial presentation and demonstrate the importance of Takotsubo cardiomyopathy. METHODS: A PubMed search using the terms "Takotsubo cardiomyopathy (TC)" and "apical ballooning syndrome" yield 211 publications. Only those that were relevant were fully reviewed. The gender, age, precipitating stressor, main complaint at presentation, electrocardiogram (ECG) at admission and serum cardiac markers of patients diagnosed with TC, were extracted as available. The data were organized in tables and graphics, and the incidence of the disorder was calculated and analyzed. RESULTS: A total of 250 clinical cases were examined. The predominant gender that was affected was female, with a prevalence of 87.5%. The mean age of presentation was 64±14 years. The cases were divided by age into 10-year intervals. The age interval of 60-69 years showed the highest frequency of TC, accounting for 79 cases. The most common precipitating stressor was physical (50% of cases). Chest pain wasthe primary complaint at presentation (58.8% of cases) followed by dyspnea (30% of cases). The ST segment changes category was the most common (60%), followed by T wave changes (39.6%). Of the 60% of cases with ST segment changes, 12% had concomitant T wave changes. This means that for 27.6% of the cases, the primary abnormality in the ECG was T wave changes; 87.6% of cases with TC had a change in the ST segment, in the T wave or in both. The percentage of ECGs presenting with changes in the anterior wall was 54.4% (35.6% of ST segment elevation +1.6% of ST segment depression +17.2% of T wave inversion). The percentage of patients presenting with changes in the lateral segment of the heart was 46.8%, while the percentage of patients with changes in the inferior heart was 21.6% and the percentage of patients with changes in the apical region was only 16%. The prevalence of elevated creatinine kinase and/or troponin on initial presentation was 89.3%. CONCLUSION: It is essential that every physician consider Takotsubo cardiomyopathy as a possible differential diagnosis when a patient is classified with acute coronary syndrome. To do so, it is necessary to know the clinical presentation of this syndrome in its early stages.展开更多
文摘Background Vector-borne diseases(VBDs)are important contributors to the global burden of infectious diseases due to their epidemic potential,which can result in signifcant population and economic impacts.Oropouche fever,caused by Oropouche virus(OROV),is an understudied zoonotic VBD febrile illness reported in Central and South America.The epidemic potential and areas of likely OROV spread remain unexplored,limiting capacities to improve epidemiological surveillance.Methods To better understand the capacity for spread of OROV,we developed spatial epidemiology models using human outbreaks as OROV transmission-locality data,coupled with high-resolution satellite-derived vegetation phe‑nology.Data were integrated using hypervolume modeling to infer likely areas of OROV transmission and emergence across the Americas.Results Models based on one-support vector machine hypervolumes consistently predicted risk areas for OROV transmission across the tropics of Latin America despite the inclusion of diferent parameters such as diferent study areas and environmental predictors.Models estimate that up to 5 million people are at risk of exposure to OROV.Nevertheless,the limited epidemiological data available generates uncertainty in projections.For example,some out‑breaks have occurred under climatic conditions outside those where most transmission events occur.The distribu‑tion models also revealed that landscape variation,expressed as vegetation loss,is linked to OROV outbreaks.Conclusions Hotspots of OROV transmission risk were detected along the tropics of South America.Vegetation loss might be a driver of Oropouche fever emergence.Modeling based on hypervolumes in spatial epidemiology might be considered an exploratory tool for analyzing data-limited emerging infectious diseases for which little understand‑ing exists on their sylvatic cycles.OROV transmission risk maps can be used to improve surveillance,investigate OROV ecology and epidemiology,and inform early detection.
基金supported by the Universidad Nacional Mayor de San Marcos: Resolución Rectoral (RR) N° 00883-R-06, project code 061001191RR N° 00914-R-07, project code 071001281and RR N°03556-R-19, project code D19120061。
文摘A large fire of 233 ha in Huascarán National Park in Peru provided an opportunity to compare plant and bird responses in burned and nearby unburned zones of the puna. Heights and live diameters of flagship Puya raimondii rosettes(assigned to four broad developmental phases), plant communities(66 species in 24 families and nine growth forms) and bird communities(77 species in six trophic guilds) were monitored after the fire. Although no mortality was observed, Puya raimondii plants were affected by the fire, losing approximately 60% of their photosynthetic area across all developmental phases, but recovered quickly during the first two years after fire. The comparison of Puya rosette recovery after fire was complicated by the changes in live rosette diameter for unburned plants, which showed plasticity of photosynthetic area linked to seasonal and annual fluctuations in precipitation in this relatively dry environment(decreased by 26% for mature adult plants over the study period). Fire caused an immediate change in the density, biomass and composition of vegetation. Although the species present remained similar, their abundances changed significantly immediately after the fire, with notable reductions in dominant tussock grasses. This provided opportunities for other plants, resulting in higher postfire diversity of plant species, genera, families and growth forms. In turn, the changes in vegetation after fire affected the composition of birds according to their trophic guild. Granivores largely disappeared,generalists were mostly unaffected, and other guilds showed a more complex response. As the vegetation recovered, most displaced birds returned within approximately one year.
基金supported by the National Natural Science Foundation of China(NSFC)No.11873055 and No.11933003sponsored(in part)by the Chinese Academy of Sciences(CAS)through a grant to the CAS South America Center for Astronomy(CASSACA)+4 种基金support from project PID2020-114414GB-100,financed by MCIN/AEI/10.13039/501100011033the Junta de Andaluciaía(Spain)grant FQM108support by the National Key R&D Program of China No.2017YFA0402600the National Natural Science Foundation of China(NSFC)grant Nos.11890692,12133008,and 12221003China Manned Space Project No.CMS-CSST2021-A04。
文摘We present a study of star-forming galaxies (SFGs) with pseudobulges (bulges with Sérsic index n<2) in a loca close major-merger galaxy pair sample (H-KPAIR).With data from new aperture photometries in the optical and near-infrared bands (aperture size of 7 kpc) and from the literature,we find that the mean Age of central stellar populations in Spirals with pseudobulges is consistent with that of disky galaxies and is nearly constant against the bulge-to-total ratio (B/T).Paired Spirals have a slightly lower fraction of pure disk galaxies (B/T≤0.1) than their counterparts in the control sample.Compared to SFGs with classical bulges,those with pseudobulges have a higher (>2σ) mean of specific star formation rate (sSFR) enhancement (sSFR_(enh)=0.33±0.07 versus sSFR_(enh)=0.12±0.06) and broader scatter (by~1 dex).The eight SFGs that have the highest sSFR_(enh)in the sample all have pseudobulges.A majority (69%) of paired SFGs with strong enhancement (having sSFR more than5 times the median of the control galaxies) have pseudobulges.The Spitzer data show that the pseudobulges in these galaxies are tightly linked to nuclear/circum-nuclear starbursts.Pseudobulge SFGs in S+S and in S+E pairs have significantly (>3σ) different sSFR enhancement,with the means of sSFR_(enh)=0.45±0.08 and-0.04±0.11respectively.We find a decrease in the sSFR enhancements with the density of the environment for SFGs with pseudobulges.Since a high fraction (5/11) of pseudobulge SFGs in S+E pairs are in rich groups/clusters (loca density N_(1Mpc)≥7),the dense environment might be the cause for their low s SFR_(enh).
文摘Background: Deep brain stimulation (DBS) is an established treatment for patients with advanced Parkinson’s disease (PD). Reports show continued patient satisfaction after surgery despite not maintaining clinical improvement as measured by evolution scales. Objectives: The present study sought to explore expectations and level of satisfaction in patients after DBS surgery with a semi-structured questionnaire and subsequent correlation with functional scales, Quality of Life (QoL), and motor and non-motor symptoms. Methods: We performed descriptive statistics to represent demographic data, Wilcoxon rank tests to determine significant differences, and Spearman correlation between the applied scales. Results: We evaluated 20 patients with a history of DBS surgery. 45% were female, with a mean age of 55.7 ± 14.15 years, a mean disease duration of 13.42 ± 8.3 years, and a mean time after surgery of 3.18 ± 1.86 years. Patients reported surgery meeting expectations in 85.5% and continued satisfaction in 92%. These two variables showed a significant correlation. Conclusions: This sample of patients remained satisfied after DBS surgery, although we found no differences in motor and non-motor clinimetric scales. Further studies are needed to confirm the importance of assessing quality of life in patients with DBS.
基金funded by the Agencia Nacional de Promoción Científica y Tecnológica-Proyectos de Investigación Científica y Tecnológica-PICT 2017-0607(to M.Reguero)and PICT 2019-00327(to M.Buono).
文摘The Antarctic Paleogene marine fossil record has been the key to reconstructing the evolution of the Weddellian Sea and final dismemberment of Southern Gondwana.In this context,Eocene marine vertebrates from Seymour(Marambio)Island have provided valuable information.We present the first Eocene record of marine reptiles from the southern Atlantic Coast of South America.This corresponds to several postcranial turtle remains represented by a proximal end of the right humerus,three caudal and one thoracic vertebrae,a fragment of the left pubis,and ten ossicles of the dorsal carapace,coming from the Leticia Formation(late-mid Eocene)at Cabo Tiburones,Tierra del Fuego,Argentina.These materials show severalfeatures such as the size and general morphology of the humerus and vertebrae,and the presence of relatively small,irregular,smooth,and unkeeled ossicles,which allow us to assign them to Dermochelyidae indet.Dermochelyids are a cosmopolitan group ofcryptodiran turtles,registered from the late Cretaceous up to the recent,with some physiological-biological peculiarities(e.g.,endothermy and an exclusive jellyfish-based diet)and characterized by the presence of an osseous carapace formed by ossicles.The new finding from the Leticia Formation is an addition to the scarce and extremely fragmentary record of Eocene dermochelyids from the southern seas like those from the La Meseta and Submeseta formations(Antarctica)and the Waihao and Burnside formations(New Zealand).This new information allows us to discuss the presence of these turtles in such high latitudes in the past and its implication in the evolution of the Weddellian fauna.
基金funded by ANID—Millennium Science Initiative Program (No. NCS2022_053)。
文摘Traditional Chinese medicine(TCM) arrived from China to Latin America and the Caribbean in the 1840s due to the massive migration of Chinese people to the region. In a few years, the press noticed the presence of Chinese herbalists practicing in different cities and countries regardless of the demographic weight of the Chinese community. The fascination with Chinese doctors implicated not only the press but also the literature, a phenomenon particularly observed in Cuba. In the first decades of the 20th century, the reactivation of Chinese immigration to the region fostered an anti-Chinese climate that materialized in more significant migratory restrictions and control of their businesses, such as what happened with Chinese herbalists. These herbalists who practiced inside and outside the Chinese community started to object to criticism and persecution by the conservative press and professional doctors. Despite this, Chinese doctors will continue to maintain their support of a significant number of ill persons. This work seeks to illuminate the historical relevance of TCM in Latin America and the Caribbean, focusing on the cases of Peru, Chile, and Cuba. This last country was far from China culturally and geographically, but as in many other small towns in the region, Chinese medicine presented an alternative to the treatment of illnesses.
文摘Excess sodium intake is associated with high blood pressure and cardiovascular diseases. This study examined food services in Costa Rica as a major source of sodium. The research included six cafeterias, six fast food establishments, 13 restaurants, and 15 diners using non-probabilistic convenience sampling. Interviews were conducted with workers to assess knowledge, attitudes, and practices regarding salt reduction. The findings were analyzed to determine effective intervention strategies. Participants showed regular knowledge about salt/sodium. While they recognized the link with high blood pressure, understanding of other health problems was limited. Positive attitudes were observed toward healthy cooking and reducing sodium in pre-prepared food, especially in restaurants. Over 70% expressed a desire to reduce salt in food services, with more than 80% indicating a need for staff training, particularly in cafeterias lacking knowledge of low-salt preparations. High-sodium ingredients were prevalent, with saltshakers and sauces readily available. However, some individuals were reluctant to reduce salt/sodium intake, citing concerns about taste, food variety, and customer complaints. Obstacles to reducing salt/sodium levels included limited accessibility and the cost of low-sodium ingredients. The data collection tools and methodologies used in this study can serve as a foundation for future investigations and strategies to reduce salt consumption in food services. The study recommends government support for transforming the gastronomic sector and implementing regulations and knowledge enhancement. Collaboration with the productive sector is crucial for creating healthy environments. This research presents valuable evidence regarding the utilization of salt and sodium in the gastronomic sector, thereby assisting in the decision-making process for public health initiatives and the prevention of non-communicable chronic diseases. It highlights the significance of tackling sodium reduction in food services to encourage the adoption of healthy culinary practices and enhance the overall health of the population.
文摘High blood pressure and other non-communicable diseases associated with excessive salt/sodium consumption represent a major challenge to the health of the world’s population. Consumption is a human behavior that is usually influenced by significant factors, internal and external to people. The design of a national social marketing intervention is described. The whole process was developed by a national interdisciplinary team over the course of a decade (2011-2022). Its purpose is to promote changes in this behavior, through gradual reduction of salt/sodium consumption in the target populations of Costa Rica, for the prevention and control of associated diseases. The process includes four phases: research, situation analysis, creation of a proposal for the social marketing strategy, and implementation and evaluation. Last phase was not developed by the research team. The main inputs used to design this intervention were the data generated in three qualitative researchers carried out by the national work team and the social marketing regional plan for salt consumption reduction in Latin America. By analyzing these research data, marketing mix components were determined for designing the intervention. The marketing strategy is promotional and is based on encouraging a natural diet with less sodium using natural seasonings and adding less discretional salt and industrialized products high in sodium, in the preparation of food and dishes. The primary key audience is the mother of the school-aged child, and the secondary is the adult caregivers of this child. It is expected that in the short term, health promoters from different government and non-state sectors will contribute to the implementation of the national social marketing plan, to achieve, in the medium or long term, a consumption that approaches five grams of salt per person per day. This plan is a country initiative to position the value of a natural diet with less sodium and to contribute to the prevention and treatment of HT and NCD associated diseases.
文摘The synthesis of nanoparticles by biological methods using microorganisms, enzymes, or plant extracts has been suggested as a possible ecofriendly alternative to chemical and physical methods that involve the use of harmful reducing agents. Green synthesis of silver nanoparticles (AgNPs) was achieved using Eugenia uniflora ripe fruit extract, which was characterized by phytochemical screening revealing the presence of polyphenols (quinones, flavonoids, and tannins), reducing compounds, and terpenes. These excellent antioxidants reduced silver nitrate to give the AgNPs, which were characterized by transmission electron microscopy (TEM), dynamic light scattering (DLS), and ζ potential analysis. The diameter of the AgNPs ranged from 10.56 ± 1.2 nm to 107.56 ± 5.7 nm. The antibacterial activity of the AgNPs was evaluated using a modification of the Kirby-Bauer technique with Escherichia coli, Pseudomonas aeruginosa, and Staphylococcus aureus. The inhibition halos were 11.12 ± 0.02 mm, 13.96 ± 0.07 mm, and 11.29 ± 0.76 mm, respectively. The synthesis using E. uniflora is an ecofriendly and low cost method of obtaining silver nanoparticles that could be used in health sciences because of their activity against bacteria with antibiotic resistance.
文摘During the review and identification of specimens of the genus Damasippus Stål, 1875 deposited in the National Museum of Costa Rica, some specimens were found that corresponded to four non-described species: D. sepia n.sp., D. viridicorpus n.sp, D. duoviridis n.sp and D. viridilabrum n. sp. Due to the above, a review of the literature describing the species of this group was carried out, with which an illustrated dichotomous key was developed to identify the 16 species, in addition to a partial phylogenetic analysis to corroborate that they do not correspond to the species D. fuscipes, due to its morphological similarity.
文摘Brucellosis is an infectious disease of worldwide distribution, which has a great economic impact due to the productive and reproductive losses that it causes, in addition to the serious public health problem. The aim of this study is to estimate the economic losses, through financial analysis, caused by bovine brucellosis in the province of Carchi, over a one-year period. A random sampling was used to determine the prevalence in the study area, where 2976 animals were considered, and the Rose Bengal (RB) test was used as a screening test and the Fluorescence Polarized Assay (FPA) as a confirmatory test, obtaining a prevalence of 8.2% (244/2976). In addition, parameters associated to the losses caused by brucellosis in cattle were determined by literature review. To estimate costs, field information was collected through a survey of a total of 100 randomly selected farmers. The loss estimated due to calves lost as a result of abortions and neonatal death was USD. 79170.00. The loss due to death of 4 cows as a result of metritis was estimated at USD. 5000.00. The cost of examination and treatment of aborted cows was USD. 20100.00. The losses due to reduction in milk production from aborted and non-aborted seropositive cows were estimated at USD. 158114.21. The financial losses due to brucellosis in province of Carchi were estimated at USD. 262384.21.
基金The APC was funded by Universidad Tecnológica Indoamérica with funding code INV-0012-002.
文摘Artificial intelligence(AI)technologies and sensors have recently received significant interest in intellectual agriculture.Accelerating the application of AI technologies and agriculture sensors in intellectual agriculture is urgently required for the growth of modern agriculture and will help promote smart agriculture.Automatic irrigation scheduling systems were highly required in the agricultural field due to their capability to manage and save water deficit irrigation techniques.Automatic learning systems devise an alternative to conventional irrigation management through the automatic elaboration of predictions related to the learning of an agronomist.With this motivation,this study develops a modified black widow optimization with a deep belief network-based smart irrigation system(MBWODBN-SIS)for intelligent agriculture.The MBWODBN-SIS algorithm primarily enables the Internet of Things(IoT)based sensors to collect data forwarded to the cloud server for examination purposes.Besides,the MBWODBN-SIS technique applies the deep belief network(DBN)model for different types of irrigation classification:average,high needed,highly not needed,and not needed.The MBWO algorithm is used for the hyperparameter tuning process.A wideranging experiment was conducted,and the comparison study stated the enhanced outcomes of the MBWODBN-SIS approach to other DL models with maximum accuracy of 95.73%.
文摘Cannabidiol (CBD), one of the most studied phytocannabinoids, is non-psychotropic and can induce protective effects on the central nervous system against acute and chronic brain injury. Interestingly, CBD inhibits processes relating to amyloid beta (Aβ)-induced neurotoxicity in mouse models of Alzheimer’s disease, though the detailed molecular mechanism underlying the CBD neurotoxicity modulation is not fully understood. In this study, using atomic force microscopy, we find that CBD promotes the aggregation of Aβ peptides, enhancing the formation of Aβ oligomers, also known as Aβ-derived diffusible ligands (ADDLs). The CBD-mediated sequestration of Aβ monomers in soluble ADDLs could reduce neurotoxicity. This study highlights a possible role of CBD in modulating the formation of ADDL aggregates and provides insight into potentially neuroprotective properties of CBD in Alzheimer’s disease.
文摘Artemisinins tested against W-2 strains of malaria falciparum are investigated with molecular electrostatic potential (MEP), in an attempt to identify key features of the compounds that are necessary for their activities, as well as to investigate likely interactions with the receptor in a biological process and to use that information to propose new molecules. In order to discover the best geometry involving the ligand-receptor complexes (heme) studied and help in the proposition of the new derivatives, molecular simulations of interactions between the most negative charged region around the peroxide and heme locates (the ones around the Fe2+ ion) were carried out. In addition, PCA (principal components analysis), HCA (hierarchical cluster analysis), SDA (stepwise discriminant analysis), and KNN (K-nearest neighbor) multivariate models were employed to investigate which descriptors are responsible for the classification between the higher and lower antimalarial activity of the compounds, and also this information was used to propose new potentially active molecules. The information accumulated in studies of MEP, molecular docking, and multivariate analysis supported the proposal of new structures with potential antimalarial activities. The multivariate models constructed were applied to the new structures and indicated numbers 19 and 20 as the most prominent for syntheses and biological assays.
文摘N-11-azaartemisinins potentially active against Plasmodium falciparum are designed by combining molecular electrostatic potential (MEP), ligand-receptor interaction, and models built with supervised machine learning methods (PCA, HCA, KNN, SIMCA, and SDA). The optimization of molecular structures was performed using the B3LYP/6-31G* approach. MEP maps and ligand-receptor interactions were used to investigate key structural features required for biological activities and likely interactions between N-11-azaartemisinins and heme, respectively. The supervised machine learning methods allowed the separation of the investigated compounds into two classes: cha and cla, with the properties ε<sub>LUMO+1</sub> (one level above lowest unoccupied molecular orbital energy), d(C<sub>6</sub>-C<sub>5</sub>) (distance between C<sub>6</sub> and C<sub>5</sub> atoms in ligands), and TSA (total surface area) responsible for the classification. The insights extracted from the investigation developed and the chemical intuition enabled the design of sixteen new N-11-azaartemisinins (prediction set), moreover, models built with supervised machine learning methods were applied to this prediction set. The result of this application showed twelve new promising N-11-azaartemisinins for synthesis and biological evaluation.
文摘The study of the mineral and organic content of the Allende meteorite is important for our understanding of the molecular evolution of the universe as well as the ancient Earth. Previous studies have characterized the magnetic minerals present in ordinary and carbonaceous chondrites, providing information on the evolution of magnetic fields. The interaction of organic compounds with magnetic minerals is a possible source of chemical diversity, which is crucial for molecular evolution. Carbon compounds in meteorites are of great scientific interest for a variety of reasons, such as their relevance to the origins of chirality in living organisms. This study presents the characterization of organic and mineral compounds in the Allende meteorite. The structural and physicochemical characterization of the Allende meteorite was accomplished through light microscopy, powder X-ray diffraction with complementary Rietveld refinement, Raman and infrared spectroscopy, mass spectrometry, scanning electron microscopy, and atomic force microscopy using magnetic signal methods to determine the complex structure and the interaction of organic compounds with magnetic Ni-Fe minerals. The presence of Liesegang-like patterns of chondrules in fragments of the Allende structure may also be relevant to understanding how the meteorite was formed. Other observations include the presence of magnetic materials and nanorod-like solids with relatively similar sizes as well as the heterogeneous distribution of carbon in chondrules. Signals observed in the Raman and infrared spectra resemble organic compounds such as carbon nanotubes and peptide-like molecules that have been previously reported in other meteorites, making the Mexican Allende meteorite a feasible sample for the study of the early Earth and exoplanetary bodies.
文摘The global incidence and prevalence of diabetes mellitus(DM)have reached epidemic proportions.Estimates indicate that more than 360 million people will be affected by DM by 2030.All of these individuals will be at risk of developing diabetic retinopathy(DR).It is extremely important to categorize,classify and stage the severity of DR in order to establish adequate therapy.With proper management more than 90%of cases of visual loss can be prevented.The purpose of the current paper is to review the classification of DR with a special emphasis on the International Clinical Disease Severity Scale for DR.This new classification is simple to use,easy to remember and based on scientific evidence.It does not require specialized examinations such as optical coherence tomography or fluorescein angiography.It is based on clinical examination and applying the Early Treatment of Diabetic Retinopathy Study 4:2:1 rule.
文摘Rice(Oryza sativa L.)is an important staple food crop worldwide due to its adaptability to different environmental conditions.Because of its great economic and social importance,there is a constant requirement for new varieties with improved agronomic characteristics,such as tolerance to different biotic(such as bacterium,fungus,insect and virus)and abiotic stresses(such as salinity,drought and temperature),higher yield and better organoleptic and nutritional value.Among the new genome editing technologies,the clustered regularly interspaced short palindromic repeats(CRISPR)/CRISPR-associated protein(Cas)(CRISPR/Cas)system allows precise and specific edition in a targeted genome region.It is one of the most frequently used techniques for the study of the function of new genes and for the development of mutant lines with enhanced tolerance to biotic and abiotic stresses,herbicide resistance or improved yield.The wide varieties of applications for this technology include simple non-homologous end joining,homologous recombination,gene replacement,and base editing.In this review,we analyzed how some of these applications have been used in rice cultivars to obtain rice varieties better adapted to current environmental conditions and market requirements.
文摘AIM: To review the initial presentation and demonstrate the importance of Takotsubo cardiomyopathy. METHODS: A PubMed search using the terms "Takotsubo cardiomyopathy (TC)" and "apical ballooning syndrome" yield 211 publications. Only those that were relevant were fully reviewed. The gender, age, precipitating stressor, main complaint at presentation, electrocardiogram (ECG) at admission and serum cardiac markers of patients diagnosed with TC, were extracted as available. The data were organized in tables and graphics, and the incidence of the disorder was calculated and analyzed. RESULTS: A total of 250 clinical cases were examined. The predominant gender that was affected was female, with a prevalence of 87.5%. The mean age of presentation was 64±14 years. The cases were divided by age into 10-year intervals. The age interval of 60-69 years showed the highest frequency of TC, accounting for 79 cases. The most common precipitating stressor was physical (50% of cases). Chest pain wasthe primary complaint at presentation (58.8% of cases) followed by dyspnea (30% of cases). The ST segment changes category was the most common (60%), followed by T wave changes (39.6%). Of the 60% of cases with ST segment changes, 12% had concomitant T wave changes. This means that for 27.6% of the cases, the primary abnormality in the ECG was T wave changes; 87.6% of cases with TC had a change in the ST segment, in the T wave or in both. The percentage of ECGs presenting with changes in the anterior wall was 54.4% (35.6% of ST segment elevation +1.6% of ST segment depression +17.2% of T wave inversion). The percentage of patients presenting with changes in the lateral segment of the heart was 46.8%, while the percentage of patients with changes in the inferior heart was 21.6% and the percentage of patients with changes in the apical region was only 16%. The prevalence of elevated creatinine kinase and/or troponin on initial presentation was 89.3%. CONCLUSION: It is essential that every physician consider Takotsubo cardiomyopathy as a possible differential diagnosis when a patient is classified with acute coronary syndrome. To do so, it is necessary to know the clinical presentation of this syndrome in its early stages.