Unlocking the potential of Eichhornia crassipes for wastewater treatment: phytoremediation of aquatic pollutants, a strategy for advancing Sustainable Development Goal-06 clean water.

The 2030 Agenda, established in 2015, contains seventeen Sustainable Development Goals (SDGs) aimed at addressing global challenges. SDG-06, focused on clean water, drives the increase in basic sanitation coverage, the management of wastewater discharges, and water quality. Wastewater treatment could contribute to achieving 11 of the 17 SDGs. For this purpose, phytoremediation is a low-cost and adaptable alternative to the reduction and control of aquatic pollutants. The objective of this study is to highlight the role of macrophytes in the removal and degradation of these compounds, focusing on Eichhornia crassipes (Mart.) Solms, commonly known as water hyacinth. The reported values indicate that this plant has a removal capacity of over 70% for metals such as copper, aluminum, lead, mercury, cadmium, and metalloids such as arsenic. Additionally, it significantly improves water quality parameters such as turbidity, suspended solids, pH, dissolved oxygen, and color. It also reduces the presence of phosphates, and nitrogen compounds to values below 50%. It also plays a significant role in the removal of organic contaminants such as pesticides, pharmaceuticals, and dyes. This study describes several valuable by-products from the biomass of the water hyacinth, including animal and fish feed, energy generation (such as briquettes), ethanol, biogas, and composting. According to the analysis carried out, E. crassipes has a great capacity for phytoremediation, which makes it a viable solution for wastewater management, with great potential for water ecosystem restoration.

Computational Insights into the Interplay of Mechanical Forces in Angiogenesis.

This study employs a meshless computational model to investigate the impacts of compression and traction on angiogenesis, exploring their effects on vascular endothelial growth factor (VEGF) diffusion and subsequent capillary network formation. Three distinct initial domain geometries were defined to simulate variations in endothelial cell sprouting and VEGF release. Compression and traction were applied, and the ensuing effects on VEGF diffusion coefficients were analysed. Compression promoted angiogenesis, increasing capillary network density. The reduction in the VEGF diffusion coefficient under compression altered VEGF concentration, impacting endothelial cell migration patterns. The findings were consistent across diverse simulation scenarios, demonstrating the robust influence of compression on angiogenesis. This computational study enhances our understanding of the intricate interplay between mechanical forces and angiogenesis. Compression emerges as an effective mediator of angiogenesis, influencing VEGF diffusion and vascular pattern. These insights may contribute to innovative therapeutic strategies for angiogenesis-related disorders, fostering tissue regeneration and addressing diseases where angiogenesis is crucial.

Health Disparities in Patients With Musculoskeletal Injuries: Food Insecurity Is a Common and Clinically Challenging Problem.

BACKGROUND: Health disparities have important effects on orthopaedic patient populations. Socioeconomic factors and poor nutrition have been shown to be associated with an increased risk of complications such as infection in patients undergoing orthopaedic surgery. Currently, there are limited published data on how food insecurity is associated with medical and surgical complications. QUESTIONS/PURPOSES: We sought to (1) determine the percentage of patients who experience food insecurity in an orthopaedic trauma clinic at a large Level 1 trauma center, (2) identify demographic and clinical factors associated with food insecurity, and (3) identify whether there are differences in the risk of complications and reoperations between patients who experience food insecurity and patients who are food-secure. METHODS: This was a cross-sectional study using food insecurity screening surveys, which were obtained at an orthopaedic trauma clinic at our Level 1 trauma center. All patients 18 years and older who were seen for an initial evaluation or follow-up for fracture care between November 2022 and February 2023 were considered for inclusion in this study. For inclusion in this study, the patient had to have surgical treatment of their fracture and have completed at least one food insecurity screening survey. Ninety-eight percent (121 of 123) of patients completed the screening survey during the study period. Data for 21 patients were excluded because of nonoperative treatment of their fracture, nonfracture-related care, impending metastatic fracture care, and patients who had treatment at an outside facility and were transferring their care. This led to a study group of 100 patients with orthopaedic trauma. The mean age was 51 years, and 51% (51 of 100) were men. The mean length of follow-up available for patients in the study was 13 months from the initial clinic visit. Patient demographics, hospital admission data, and outcome data were collected from the electronic medical records. Patients were divided into two cohorts: food-secure versus food-insecure. Patients were propensity score matched for adjusted analysis. RESULTS: A total of 37% of the patients in this study (37 of 100) screened positive for food insecurity during the study period. Patients with food insecurity were more likely to have a higher BMI than patients with food security (32 kg/m2 compared with 28 kg/m2; p = 0.009), and they were more likely not to have healthcare insurance or to have Medicaid (62% [23 of 37] compared with 30% [19 of 63]; p = 0.003). After propensity matching for age, gender, ethnicity, current substance use, Charleston comorbidity index, employment status, open fracture, and length of stay, food insecurity was associated with a higher percentage of superficial infections (13% [4 of 31] compared with 0% [0 of 31]; p = 0.047). There were no differences between the groups in the risk of reoperation, deep infection, and nonunion. CONCLUSION: Food insecurity is common among patients who have experienced orthopaedic trauma, and patients who have it may be at increased risk of superficial infections after surgery. Future research in this area should focus on defining these health disparities further and interventions that could address them. LEVEL OF EVIDENCE: Level III, therapeutic study.

Priapismo y leucemia mieloide crónica en adolescente. Debut poco frecuente. Reporte de caso / Priapism and chronic myeloid leukemia in an adolescent. Rare debut presentation. A case report

El priapismo es una erección dolorosa y persistente acompañada o no de estímulo sexual. Una causa poco frecuente de esta anormalidad es la leucemia mieloide crónica. Se han reportado pocos casos de priapismo como manifestación inicial de una leucemia de este tipo en pacientes adolescentes. A continuación, se informa el caso de un paciente de 16 años de edad que presentó priapismo como manifestación inicial de una leucemia mieloide crónica. Durante su evolución, no se realizó aspiración de los cuerpos cavernosos. Se inició tratamiento hematológico específico y, ante la persistencia del priapismo, fue necesario realizar un shunt de cuerpos cavernosos en dos ocasiones, tratamiento a pesar del cual existen altas probabilidades de secuelas.

Priapism is a painful and persistent erection, with or without sexual stimulation. A rare cause of such abnormality is chronic myeloid leukemia. Few cases of priapism as an initial manifestation of this type of leukemia have been reported in adolescent patients. Here we describe the case of a 16-year-old patient who presented with priapism as the initial manifestation of chronic myeloid leukemia. No cavernosal aspiration was performed. A specific hematological treatment was started and, given the persistence of priapism, the patient required 2 corpora cavernosa shunt procedures; despite this treatment, there is a high probability of sequelae.

Physical Violence and Aggression in Parkinson's Disease: A Systematic Review.

BACKGROUND: Physical violence and aggression (PVA), defined as behaviors with the potential to cause bodily injury, are unfortunate risks in the management of all-cause neurodegenerative dementias. While dementia in Parkinson's disease (PD) may not be evident for many years after clinical onset, neuropsychiatric disturbances occur at all stages of the disease. At issue is whether PVA in PD is associated with clinical factors that can be targets for prevention and management in the absence of a prevailing dementia syndrome. OBJECTIVE: This systematic review examined the extent to which PVA in PD without dementia is a clinically significant concern and whether it is associated with factors that could warrant proactive management. METHODS: A systematic search of 9 electronic databases used MeSH headings and equivalent terms for PD, aggression, and violence. Eligible manuscripts were original articles that were published in peer-reviewed journals and reported on adults with PD in the awake state with PVA as possible outcomes. Extracted data included study design, PD ascertainment methods and characteristics, PVA assessment methods, subject demographics, psychiatric and medical comorbidities, and pertinent results. Inciting and confounding factors were extracted from case reports. Quality assessment tools were applied in accordance with the study design (e.g., observational, qualitative, or case report). RESULTS: The search identified 10 manuscripts: 2 observational quantitative studies (total n with PD = 545), 1 qualitative study (n with PD = 20), and 7 case reports (n = 7). The observational studies suggested that PVA is less common than other neuropsychiatric disturbances, but heterogeneous methods and quality concerns prevented further conclusions. In the case reports, all patients were male, and most were early onset. In 6 of the reports, PVA occurred in the context of bilateral subthalamic nucleus deep brain stimulation. CONCLUSIONS: PVA, while relatively rare in PD, can be a significant management issue that is associated with select premorbid characteristics and antiparkinsonian motor treatments. As PVA may be under-reported, further understanding of its frequency, causes, risk factors, and outcomes would benefit from its systematic assessment, ideally using self-report and informant-based questionnaires.

C≡N and N≡O Bond Cleavages of Acetonitrile and Nitrosyl Ligands at a Dimolybdenum Center to Render Ethylidyne and Acetamidinate Ligands.

Extended reduction of [Mo2Cp2(µ-Cl)(µ-PtBu2)(NO)2] (1) with Na(Hg) in acetonitrile (MeCN) at room temperature resulted in an unprecedented full cleavage of the C≡N bond of a coordinated MeCN molecule to yield the vinylidene derivative Na[Mo2Cp2(µ-PtBu2)(µ-CCH2)(NO)2], which upon protonation with (NH4)PF6 gave the ethylidyne complex [Mo2Cp2(µ-PtBu2)(µ-CMe)(NO)2] [Mo1-Mo2 = 2.9218(2) Å] in a selective and reversible way. Controlled reduction of 1 at 273 K yielded instead, after protonation, the 30-electron acetamidinate complex [Mo2Cp2(µ-PtBu2)(µ-κN:κN'-HNCMeNH)(µ-NO)]PF6 [Mo1-Mo2 = 2.603(2) Å], in a process thought to stem from the paramagnetic MeCN-bridged intermediate [Mo2Cp2(µ-PtBu2)(µ-NCMe)(NO)2], followed by a complex sequence of elementary steps including cleavage of the N≡O bond of a nitrosyl ligand.

Priapism and chronic myeloid leukemia in an adolescent. Rare debut presentation. A case report. / Priapismo y leucemia mieloide crónica en adolescente. Debut poco frecuente. Reporte de caso.

Priapism is a painful and persistent erection, with or without sexual stimulation. A rare cause of such abnormality is chronic myeloid leukemia. Few cases of priapism as an initial manifestation of this type of leukemia have been reported in adolescent patients. Here we describe the case of a 16-year-old patient who presented with priapism as the initial manifestation of chronic myeloid leukemia. No cavernosal aspiration was performed. A specific hematological treatment was started and, given the persistence of priapism, the patient required 2 corpora cavernosa shunt procedures; despite this treatment, there is a high probability of sequelae.

El priapismo es una erección dolorosa y persistente acompañada o no de estímulo sexual. Una causa poco frecuente de esta anormalidad es la leucemia mieloide crónica. Se han reportado pocos casos de priapismo como manifestación inicial de una leucemia de este tipo en pacientes adolescentes. A continuación, se informa el caso de un paciente de 16 años de edad que presentó priapismo como manifestación inicial de una leucemia mieloide crónica. Durante su evolución, no se realizó aspiración de los cuerpos cavernosos. Se inició tratamiento hematológico específico y, ante la persistencia del priapismo, fue necesario realizar un shunt de cuerpos cavernosos en dos ocasiones, tratamiento a pesar del cual existen altas probabilidades de secuelas.

Cáncer de mama con metástasis cutánea: caso clínico y cuestionamiento ético / Breast cancer with skin metastasis: clinical case and ethical questioning

El cáncer de mama es el tipo de cáncer más frecuente y la quinta causa de muerte por cáncer en mujeres a nivel mundial. Este tipo de cáncer constituye un importante problema de salud, tanto por su incidencia y mortalidad como por sus repercusiones físicas, psicológicas y económicas. Los programas de cribado y diagnóstico precoz, así como la mejora de los tratamientos, favorecen de manera significativa el pronóstico y la supervivencia a la enfermedad. Pero cuando se detecta de manera tardía, ya sea por fallo del sistema o por dejadez de la persona, surge el problema moral, la dicotomía entre tratar de curar a pesar de los efectos secundarios negativos de los tratamientos o aplicar medidas paliativas procurando mejorar la calidad de vida. A continuación, presentamos un caso clínico de una mujer de 78 años con cáncer de mama con diseminación cutánea y ulceración. Se revisa el tema: incidencia, evolución, mortalidad, linfedema, calidad de vida, decisiones anticipadas y atención paliativa.(AU)

Breast cancer is the most common type of cancer and the fifth leading cause of cancer death in women worldwide. This type of cancer constitutes a major health problem, both due to its high incidence and mortality and its physical, psychological and economic. Screening programs and early diagnosis, as well as improved treatments, significantly improve the prognosis and survival of disease. But when it is detected late, either due to system failure or neglect of the person, the moral problem arises, the dichotomy between trying to cure despite negative side effects of treatments or applying palliative measures trying to improve the quality of life, life despite anticipating that it will be short. Below we present a clinical case of a 78-year-old woman with skin dissemination and ulceration breast cancer. The subject is reviewed: incidence, evolution, mortality, lymphedema, quality of life, early decisions and palliative care.(AU)

A Comprehensive Look at In Vitro Angiogenesis Image Analysis Software.

One of the complex challenges faced presently by tissue engineering (TE) is the development of vascularized constructs that accurately mimic the extracellular matrix (ECM) of native tissue in which they are inserted to promote vessel growth and, consequently, wound healing and tissue regeneration. TE technique is characterized by several stages, starting from the choice of cell culture and the more appropriate scaffold material that can adequately support and supply them with the necessary biological cues for microvessel development. The next step is to analyze the attained microvasculature, which is reliant on the available labeling and microscopy techniques to visualize the network, as well as metrics employed to characterize it. These are usually attained with the use of software, which has been cited in several works, although no clear standard procedure has been observed to promote the reproduction of the cell response analysis. The present review analyzes not only the various steps previously described in terms of the current standards for evaluation, but also surveys some of the available metrics and software used to quantify networks, along with the detection of analysis limitations and future improvements that could lead to considerable progress for angiogenesis evaluation and application in TE research.

Passalidae (Coleoptera, Scarabaeoidea) from the Caribbean coast of Colombia: synopsis, key, and new species description.

Bess beetles (Passalidae) are a subsocial family of Coleoptera with approximately 1000 known species of saproxylophagous diet and pantropical distribution, with few extratropical species. Because of their high levels of endemism (especially in mountains), feeding habits, and complex subsociability; Passalidae is considered an excellent biological subject for taxonomic, biogeographical, and evolutionary studies. Colombia is the richest country with more than 118 recorded species of Passalidae, most of the species being related to humid and mountain areas. Colombia's Caribbean region constitutes the northern portion of the country, extending for more than 130,000 km2 and includes four of the eight biogeographical provinces of Colombia. Since the 2000s this region has been the subject of systematic surveys for Passalidae; as a result, 18 passalid species have been recorded to date. After new explorations and review of entomological collections, the knowledge of the passalid fauna for the region is updated, recording 28 species (8 new records, 2 new species) for which are provided species diagnoses, photographs, and a taxonomic key. The dry plain, characteristic of the lowlands, is dominated by widely distributed species such as Passaluspunctiger and Passalusinterstitialis, while the mountainous systems provide species of more restricted distributions, some of them endemic to the Colombian Caribbean.

Estenose de bioprótese valvar aórtica de rápida evolução para disfunção biventricular grave: um desafio diagnóstico e terapêutico / Bioprosthetic aortic valve stenosis that rapidly progresses to severe biventricular dysfunction: a diagnostic and therapeutic challenge

INTRODUÇÃO: As próteses valvares biológicas apresentam menor durabilidade, especialmente em crianças e jovens, devido à intensa evolução com calcificação¹ ². DESCRIÇÃO DO CASO: I.O.S.V, homem, portador de valva aórtica bivalvular, estenose aórtica subvalvar e coarctação de aorta. Aos 2 anos, realizou istmoplastia e ressecção de membrana subvalvar; aos 17 anos, notados aneurisma da raiz da aorta (49mm) ascendente (55mm) com hipoplasia do arco transverso, indicada Bentall de Bono com bioprótese e implante de tubo em arco distal. Aos 20 anos (abril/2022), assintomático, ecocardiograma (ECO): HVE discreta, função sistólica preservada, folheto anterior da prótese com redução importante de mobilidade, GM 18mmHg. Assintomático em fevereiro/2023, ECO: dilatação biatrial moderada, biventricular discreta e disfunção sistólica (FAC 33%, TAPSE 12mm, FEVE 47%), folheto anterior com redução importante da mobilidade, GM 35mmHg, iniciado terapia para disfunção ventricular. Após 30 dias evoluiu com congestão, dispneia, tosse com hemoptóicos e febre, internado em hospital externo recebeu tratamento para pneumonia (PAC) e IC, sem melhora clínica. Chegou transferido em mau estado geral, febril, dispneico, hipervolêmico. AngioTC de tórax negativa para TEP, com consolidação pulmonar bibasal. ECO transesofágico: dilatação e disfunção biventricular importante (FAC 17%, TAPSE 13mm, FEVE 27%), prótese valvar com folhetos calcificados, não podendo descartar trombo ou endocardite (EI), GM 50 mmHg, AV 0,6cm² e indexada 0,26 cm²/m². Evoluiu com choque circulatório e, mediante suspeita de EI, foi submetido à cirurgia de urgência com novo Bentall de Bono e prótese mecânica. Evoluiu com melhora clínica gradual, ECO: FEVE 37%, prótese normofuncionante. Anatomopatológico da prótese revelou intensa fibrose e calcificação, sem trombo/EI, cultura da peça sem crescimento bacteriano. CONCLUSÃO: Trata-se de um caso complexo, de rápida evolução do grau de estenose, com progressão para disfunção biventricular grave, instabilidade hemodinâmica e necessidade de correção cirúrgica de urgência. O diagnóstico de PAC foi viés, gerando a suspeita de EI como pos.

Behçet Disease and Bipolar Disorder: A Case Report and Review.

Behçet disease (BD) is a rare, multifactorial condition with multiple manifestations affecting various systems. Bipolar disorder has been reported as more frequent in individuals with BD than in the general population. We report a case of BD and bipolar disorder and summarize previous findings in the literature concerning this topic. Our case illustrates the relevance of managing comorbid BD and bipolar disorder. It is crucial to manage both conditions to maximize the patient's quality of life. Clinicians should be aware of the risk of bipolar disorder in patients with BD and vice versa and an integrated model of care could be useful. The exact biological and psychological aspects mediating the association between the 2 diagnoses remain unclear. Further, larger, prospective studies could help better clarify this relationship, leading to new advances in diagnosis and treatment.

Post-Traumatic Stress Disorder and Risk of Degenerative Synucleinopathies: Systematic Review and Meta-Analysis.

OBJECTIVE: A systematic review was conducted to answer whether adult-onset post-traumatic stress disorder (PTSD) is associated with increased risk of Parkinson's disease (PD) and related synucleinopathies. DESIGN: A systematic search of Medline (Ovid), Embase (Elsevier), PsycInfo (Ovid), Cochrane Library (Wiley), and Web of Science (Clarivate) was performed using MeSH headings and equivalent terms for PTSD, PD, DLB, and related disorders. SETTING: No restrictions. PARTICIPANTS: Eligible articles were published in peer-reviewed journals, sampled adult human populations, and treated PTSD and degenerative synucleinopathies as exposures and outcomes, respectively. MEASUREMENTS: Extracted data included diagnostic methods, sample characteristics, matching procedures, covariates, and effect estimates. Bias assessment was performed with the Newcastle-Ottawa scale. Hazard ratios were pooled using the random effects model, and the Hartung-Knapp adjustment was applied due to the small number of studies. RESULTS: A total of six articles comprising seven unique samples (total n = 1,747,378) met eligibility criteria. The risk of PD was reported in three retrospective cohort studies and one case-control study. Risk of DLB was reported in one retrospective cohort, one case-control, and one prospective cohort study. No studies addressed potential relationships with multiple system atrophy or pure autonomic failure. Meta-analysis of hazard ratios from four retrospective cohort studies supported the hypothesis that incident PTSD was associated with PD and DLB risk (pooled HR 1.88, 95% C.I. 1.08-3.24; p = 0.035). CONCLUSIONS: The sparse literature to-date supports further investigations on the association of mid- to late-life PTSD with Parkinson's and related neurodegenerative disorders.

Studies of Endocrine Disruptors: Nonylphenol and Isomers in Biological Models.

Certain emerging pollutants are among the most widely used chemicals globally, causing widespread concern in relation to their use in products devoted to cleaniness and asepsis. Nonylphenol ethoxylate (NPEOn) is one such contaminant, along with its degradation product, nonylphenol, an active ingredient presents in nonionic surfactants used as herbicides, cosmetics, paints, plastics, disinfectants, and detergents. These chemicals and their metabolites are commonly found in environmental matrices. Nonylphenol and NPEOn, used, are particularly concerning, given their role as endocrine disruptors chemical and possible neurotoxic effects recorded in several biological models, primarily aquatic organisms. Limiting and detecting these compounds remain of paramount importance. The objective of the present review was to evaluate the toxic effects of nonylphenol and NPEOn in different biological models. Environ Toxicol Chem 2023;42:1439-1450. © 2023 SETAC.

Integration of longitudinal deep-radiomics and clinical data improves the prediction of durable benefits to anti-PD-1/PD-L1 immunotherapy in advanced NSCLC patients.

BACKGROUND: Identifying predictive non-invasive biomarkers of immunotherapy response is crucial to avoid premature treatment interruptions or ineffective prolongation. Our aim was to develop a non-invasive biomarker for predicting immunotherapy clinical durable benefit, based on the integration of radiomics and clinical data monitored through early anti-PD-1/PD-L1 monoclonal antibodies treatment in patients with advanced non-small cell lung cancer (NSCLC). METHODS: In this study, 264 patients with pathologically confirmed stage IV NSCLC treated with immunotherapy were retrospectively collected from two institutions. The cohort was randomly divided into a training (n = 221) and an independent test set (n = 43), ensuring the balanced availability of baseline and follow-up data for each patient. Clinical data corresponding to the start of treatment was retrieved from electronic patient records, and blood test variables after the first and third cycles of immunotherapy were also collected. Additionally, traditional radiomics and deep-radiomics features were extracted from the primary tumors of the computed tomography (CT) scans before treatment and during patient follow-up. Random Forest was used to implementing baseline and longitudinal models using clinical and radiomics data separately, and then an ensemble model was built integrating both sources of information. RESULTS: The integration of longitudinal clinical and deep-radiomics data significantly improved clinical durable benefit prediction at 6 and 9 months after treatment in the independent test set, achieving an area under the receiver operating characteristic curve of 0.824 (95% CI: [0.658,0.953]) and 0.753 (95% CI: [0.549,0.931]). The Kaplan-Meier survival analysis showed that, for both endpoints, the signatures significantly stratified high- and low-risk patients (p-value< 0.05) and were significantly correlated with progression-free survival (PFS6 model: C-index 0.723, p-value = 0.004; PFS9 model: C-index 0.685, p-value = 0.030) and overall survival (PFS6 models: C-index 0.768, p-value = 0.002; PFS9 model: C-index 0.736, p-value = 0.023). CONCLUSIONS: Integrating multidimensional and longitudinal data improved clinical durable benefit prediction to immunotherapy treatment of advanced non-small cell lung cancer patients. The selection of effective treatment and the appropriate evaluation of clinical benefit are important for better managing cancer patients with prolonged survival and preserving quality of life.

L-Lysine-Coated Magnetic Core-Shell Nanoparticles for the Removal of Acetylsalicylic Acid from Aqueous Solutions.

Nanotechnologies based on magnetic materials have been successfully used as efficient and reusable strategies to remove pharmaceutical residuals from water. This paper focuses on the fabrication, characterization, and application of ferrite-based magnetic nanoparticles functionalized with L-lysine as potential nanoadsorbents to remove acetylsalicylic acid (ASA) from water. The proposed nanomaterials are composed of highly magnetic and chemically stable core-shell nanoparticles covered with an adsorptive layer of L-lysine (CoFe2O4-γ-Fe2O3-Lys). The nanoadsorbents were elaborated using the coprecipitation method in an alkaline medium, leading to nanoparticles with two different mean sizes (13.5 nm and 8.5 nm). The samples were characterized by XRD, TEM, FTIR, XPS, Zetametry, BET, and SQUID magnetometry. The influence of time, pH, and pollutant concentration was evaluated from batch studies using 1.33 g/L of the nanoadsorbents. The Freundlich isotherm best adjusted the adsorption data. The adsorption process exhibited a pseudo-second-order kinetic behavior. The optimal pH for adsorption was around 4-6, with a maximum adsorption capacity of 16.4 mg/g after 150 min of contact time. Regeneration tests also showed that the proposed nanomaterials are reusable. The set of results proved that the nanoadsorbents can be potentially used to remove ASA from water and provide relevant information for their application in large-scale designs.

Differences in the behavior and diet between shoaling and solitary surgeonfish (Acanthurus triostegus).

Variation in behavior within marine and terrestrial species can influence the functioning of the ecosystems they inhabit. However, the contribution of social behavior to ecosystem function remains underexplored. Many coral reef fish species provide potentially insightful models for exploring how social behavior shapes ecological function because they exhibit radical intraspecific variation in sociality within a shared habitat. Here, we provide an empirical exploration on how the ecological function of a shoaling surgeonfish (Acanthurus triostegus) may differ from that of solitary conspecifics on two Pacific coral reefs combining insight from behavioral observations, stable isotope analysis, and macronutrient analysis of gut and fecal matter. We detected important differences in how the social mode of A. triostegus affected its spatial and feeding ecology, as well as that of other reef fish species. Specifically, we found increased distance traveled and area covered by shoaling fish relative to solitary A. triostegus. Additionally, shoaling A. triostegus primarily grazed within territories of other herbivorous fish and had piscivorous and nonpiscivorous heterospecific fish associated with the shoal, while solitary A. triostegus grazed largely grazed outside of any territories and did not have any such interactions with heterospecific fish. Results from stable isotope analysis show a difference in δ15N isotopes between shoaling and solitary fish, which suggests that these different social modes are persistent. Further, we found a strong interaction between social behavior and site and carbohydrate and protein percentages in the macronutrient analysis, indicating that these differences in sociality are associated with measurable differences in both the feeding ecology and nutrient excretion patterns. Our study suggests that the social behavior of individuals may play an important and underappreciated role in mediating their ecological function.

Poststroke psychosis: a case report.

BACKGROUND: Stroke is currently the second leading cause of death in the elderly population. Neuropsychiatric complications following stroke are common, can be overlooked, and are associated with low quality of life, increase in the burden of caregiving and impaired functional status. METHODS: We report a case of poststroke psychosis in a woman without prior psychiatric history. In addition, a brief, nonsystematic review of the pertinent literature was performed. RESULTS: Psychosis can present in almost 5% of stroke survivors. Many patients with poststroke psychosis have no previous psychiatric history and the most common lesion locations include the right frontal, temporal and parietal lobes, the white matter connecting those areas, as well as the right caudate nucleus. Compared to other stroke survivors, patients with poststroke psychosis are more likely to depend on assistance in their everyday lives, can have more difficulty coping with the sequelae of stroke, and have an increased 10-year mortality risk. Guidelines for diagnosing and managing poststroke psychosis are needed. CONCLUSION: Psychosis is a possible complication of stroke and is associated with impairment and increased mortality. Guidelines for diagnosing and managing poststroke psychosis are currently lacking. To assure evidence-based care, further research is needed.

Our Voice in a rural community: empowering Colombian adolescents to advocate for school community well-being through citizen science.

BACKGROUND: Santa Ana is home to an Afro-descendant rural population of the island of Barú in Cartagena, Colombia. While a popular area for tourism, Santa Ana's population is affected by multidimensional poverty, precarious work conditions, homelessness, broken streets and sewer systems, limited quality education, and a lack of recreation and sport spaces. While Santa Ana's Community Action Board aims to unify efforts and resources to solve these problems, the state's capacity to meet the requirements of the Board is limited. METHODS: We evaluated the relationship between healthy lifestyles and characteristics of Santa Ana's school using the Our Voice Citizen Science Research Method. This systemic approach combines information and communication technologies with group facilitation to empower adolescents to: 1) collect and discuss data about factors in their local environments that facilitate or hinder well-being within their school community; 2) identify relevant local stakeholders who could help to address the issues identified; and 3) advocate collectively for local improvements to support increased well-being at a community level. RESULTS: Eleven citizen scientists ages 13 to 17 years from the science club of Institución Educativa Santa Ana were recruited and together conducted 11 walks within the school to collect data about the facilitators and barriers to student well-being. They identified barriers to well-being related to school infrastructure, furniture, bathrooms, and sense of belonging. They then advocated with school stakeholders and reached agreements on concrete actions to address identified barriers, including fostering a culture among students of caring for school property and presenting their findings to the community action board. This methodology allowed the community to realize how students can become agents of change and take collective action when motivated by solution-oriented methodologies such as Our Voice. Project ripple effects, including greater empowerment and participation in collective actions by students, also were observed. CONCLUSIONS: This study underscores the importance of the school's built environment in the well-being of students in rural areas. The Our Voice method provided the opportunity to inform school-based interventions, and promoted ripple effects that expanded productive dialogue to the community level and generated systemic actions involving actors outside of the school community.

Análise dos resultados da cirurgia do cone na correção da Anomalia de Ebstein / Analysis of the results of cone surgery in the correction of Ebstein Anomaly

INTRODUÇÃO E/OU FUNDAMENTOS: A anomalia de Ebstein é caracterizada por uma formação anormal dos folhetos da valva tricúspide, sendo o folheto anterior com origem ao nível anular, largo, enquanto os folhetos septal e posterior estão dispostos ao longo do ápice do ventrículo direito e frequente aderidos ao endocárdio. MÉTODOS: Análise de dados de 10 pacientes, entre sete à quarenta e dois anos de idade, sexo feminino e masculino, diagnosticados com Anomalia de Ebstein, que foram submetidos à Cirurgia do Cone, desde 2017 à 2022. RESULTADOS E CONCLUSÕES: Conforme a Tabela 1 evidencia, em relação à função ventricular analisada pelo Ecocardiograma Transtorácico (ECOTT), 30% dos pacientes não apresentaram alteração pós procedimento e 70% apresentaram piora da função ventricular. A Insuficiência Tricúspide (IT) apresentou melhora importante, 90% dos pacientes apresentavam IT importante pré procedimento, e apenas 20% pós correção cirúrgica. Em relação à Classe Funcional (CF) de acordo com os critérios da New York Heart Association, 30% dos pacientes se encontravam em CF III pré procedimento, sendo que após a Cirurgia do Cone nenhum paciente se encontrava em tal classe funcional. Em relação ao ritmo cardíaco, 30% dos pacientes possuíam arritmias pré procedimento (Wolf Parkinson White, Ritmo Idioventricular Acelerado e Taquicardia por reentrada átrio ventricular), com 100% de retorno ao ritmo sinusal no pós operatório. Pelos resultados analisados, observamos que a função ventricular não impactou a melhoria da qualidade de vida dos pacientes submetidos à Cirurgia do Cone, uma vez que a própria percepção dos pacientes evidenciou uma melhora de CF. Tal fato pode ser justificado por perda de função ventricular à análise do ECOTT levando em consideração a manipulação cirúrgica e a nova anatomia pós procedimento, uma vez que o novo ventrículo funcional possui uma porção atrializada do ventrículo pré procedimento. A melhora importante do grau da IT talvez seja o grande marcador para a melhora clínica do paciente, sendo muito bem caracterizada no pós operatório. A melhora das arritmias também é um ponto fundamental, uma vez que todos os pacientes que possuíam arritmias e foram submetidos à Cirurgia do Cone, apresentaram retorno ao ritmo sinusal, o que por sua vez, também gera impacto em relação à CF. Dessa forma, pode gerar insuficiência cardíaca ainda no período neonatal, ou o paciente ser oligossintomático. A técnica da Cirurgia do Cone é a mais promissora, uma vez que não é necessário realizar troca valvar tricúspide.