Microbiota as key factors in inflammatory bowel disease.

Inflammatory Bowel Disease (IBD) is characterized by prolonged inflammation of the gastrointestinal tract, which is thought to occur due to dysregulation of the immune system allowing the host's cells to attack the GI tract and cause chronic inflammation. IBD can be caused by numerous factors such as genetics, gut microbiota, and environmental influences. In recent years, emphasis on commensal bacteria as a critical player in IBD has been at the forefront of new research. Each individual harbors a unique bacterial community that is influenced by diet, environment, and sanitary conditions. Importantly, it has been shown that there is a complex relationship among the microbiome, activation of the immune system, and autoimmune disorders. Studies have shown that not only does the microbiome possess pathogenic roles in the progression of IBD, but it can also play a protective role in mediating tissue damage. Therefore, to improve current IBD treatments, understanding not only the role of harmful bacteria but also the beneficial bacteria could lead to attractive new drug targets. Due to the considerable diversity of the microbiome, it has been challenging to characterize how particular microorganisms interact with the host and other microbiota. Fortunately, with the emergence of next-generation sequencing and the increased prevalence of germ-free animal models there has been significant advancement in microbiome studies. By utilizing human IBD studies and IBD mouse models focused on intraepithelial lymphocytes and innate lymphoid cells, this review will explore the multifaceted roles the microbiota plays in influencing the immune system in IBD.

A lineage explanation of human normative guidance: the coadaptive model of instrumental rationality and shared intentionality.

This paper aims to contribute to the existing literature on normative cognition by providing a lineage explanation of human social norm psychology. This approach builds upon theories of goal-directed behavioral control in the reinforcement learning and control literature, arguing that this form of control defines an important class of intentional normative mental states that are instrumental in nature. I defend the view that great ape capacities for instrumental reasoning and our capacity (or family of capacities) for shared intentionality coadapted to each other and argue that the evolution of this capacity has allowed the representation of social norms and the emergence of our capacity for normative guidance.

Quick Curing Mechanisms for All-Season Paints and Renders.

Paints and coatings are required to quickly cure under a broad variety of environmental conditions and deliver solid long-term performance. Achieving a balance during all seasons between quick curing of a coating film, i.e., early rain resistance, while maintaining sufficient workability and open time for an optimized aesthetic appearance is a challenge for the architectural coatings industry. This article describes how the colloidal physics differs between the current standard mechanism to achieve early rain resistance by inhibited coagulants in winter paints and a new mechanism that provides all-season paints. A combination of advanced physical characterization methods, such as electrophoretic mobility, dynamic light scattering and confocal laser scanning microscopy, in combination with application tests, is used to provide a comprehensive mechanism of the early rain resistance achieved by such paints. In addition, it is shown that this new system can be transferred to wood coatings and organic renders. The key finding of this article is that all-season paints combining early rain resistance at cold and damp conditions with open time at high temperatures and dry conditions rely on fast paint film formation with high early integrity rather than coagulants triggered by base evaporation.

Enhancing Research Mentors' Cultural Awareness in STEM: A Mentor Training Intervention.

Research mentoring relationships are critical to mentees' persistence in STEM careers. Cultural identity variables (gender, race, ethnicity) influence how mentees experience mentoring relationships, including their developmental needs and expectations of mentors. Research shows that mentees from underrepresented groups in STEM often want to discuss topics related to race and ethnicity and how these factors impact their careers. However, many research mentors are uncertain of their ability to broach cultural diversity issues in mentorship, or in strategies to engage in culturally aware mentoring practices. To address this need, we developed an evidence-based mentor training intervention for Enhanced Cultural Awareness (ECA) in mentorship. We implemented this 2hr module online with research mentors (N=62) largely from well-represented racial/ethnic groups in STEM who were mentoring undergraduate researchers from underrepresented racial/ethnic groups. Mentors reported significant gains in skills, attitudes and behaviors related to cultural awareness in mentoring. The majority of mentors found the training valuable, and 97% of mentors reported intending to make changes in mentoring practices post intervention. Our results indicate that the ECA module is an effective tool to increase mentors' capacity to enact culturally aware mentoring practices. Implications for continued research and mentorship education to enhance mentors' cultural awareness are also discussed.

Caracterización de la morbilidad materna en el Servicio de Cuidados Intensivos / Characterization of maternal morbidity in Intensive Care

Introducción.La morbilidad materna es más frecuente cada día y su estudio facilita la oportunidad de identificar los riesgos durante la gestación, el parto y el puerperio.Objetivo.Caracterizar la morbilidad materna en los Servicios de Cuidados Intensivos.Método:Se realizó un estudio observacional, transversal y retrospectivo. El universo incluyó 389 maternas. Se aplicó un cuestionario que tuvo como fuente, la historia individual. Para identificar la relación entre las variables cualitativas, se utilizó la prueba estadística de ji-cuadrado de Pearson (nivel de significación de p<0.05).Resultados:El 32.6 porciento de las pacientes tenían los criterios de morbilidad materna extrema. Durante los ocho años se observó una tendencia al aumento en el número de ingresos, por la morbilidad grave como la extrema. La edad gestacional promedio fue de 32.6±8.7 semanas. La situación obstétrica al ingreso que prevaleció, fue el puerperio 65 porciento, de ellas 112, 44.3 porciento con criterio de morbilidad extrema (p<0.001). Las principales causas de ingreso por los motivos obstétricos fueron la enfermedad hipertensiva en el embarazo, la hemorragia obstétrica y la sepsis puerperal. Los principales criterios para el diagnóstico de morbilidad materna extrema fueron la histerectomía por hemorragia y la infección 22.6 porciento, el choque circulatorio y la necesidad de transfundir más de cinco unidades de glóbulos.Conclusiones:Existe un ascenso del número de ingresos, durante los años de estudio, debido a la morbilidad materna grave, por la hipertensión en el embarazo y la extrema por la hemorragia obstétrica, poshisterectomía(AU)

Introduction:Maternal morbidity is more frequent each day and its study facilitates the opportunity to identify the present risks during pregnancy, delivery and puerperium.Objective:To characterize maternal morbidity in Intensive Care.Methods:An observational, cross sectional and retrospective study was carried out. The universe included 389 maternals. A questionnaire was applied. Its source was the patiets´ clinical records. To identify the relation among the qualitative variables, Pearson X–square statistical test was used (level of meaning p<0.05).Results:The 32.6 per cent had extreme maternal morbidity criteria. During eight years an increasing tendency was observed in the number of admissions because of critical and extreme morbidities. The average gestational age was 32.6±8.7 weeks. The obstetric situation on admission which prevailed was the puerperium 65 per cent, from them 112, 44.3 per cent with extreme morbidity criterion (p<0.001). The main admission obstetric causes were hypertension in pregnancy, obstetric hemorrhage and puerperal sepsis. The main criteria for the diagnosis of extreme maternal morbidity were hysterectomy for hemorrhage and infection 22.6 per cent, circulatory shock and the necessity of transfusion with more than five units of globules.Conclusions:There is an increasing in the number of admissions because of critical maternal morbidity, during the years under study due to hypertension in pregnancy, and the extreme for post hysterectomy obstetric hemorrhage(AU)

Redundant cytokine requirement for intestinal microbiota-induced Th17 cell differentiation in draining lymph nodes.

Differentiation of intestinal T helper 17 (Th17) cells, which contribute to mucosal barrier protection from invasive pathogens, is dependent on colonization with distinct commensal bacteria. Segmented filamentous bacteria (SFB) are sufficient to support Th17 cell differentiation in mouse, but the molecular and cellular requirements for this process remain incompletely characterized. Here, we show that intestine-draining mesenteric lymph nodes (MLNs), not intestine proper, are the dominant site of SFB-induced intestinal Th17 cell differentiation. Subsequent migration of these cells to the intestinal lamina propria is dependent on their upregulation of integrin ß7. Stat3-dependent induction of RORγt, the Th17 cell-specifying transcription factor, largely depends on IL-6, but signaling through the receptors for IL-21 and IL-23 can compensate for absence of IL-6 to promote SFB-directed Th17 cell differentiation. These results indicate that redundant cytokine signals guide commensal microbe-dependent Th17 cell differentiation in the MLNs and accumulation of the cells in the lamina propria.

In Situ Photoacoustic Study of Optical Properties of P-Type (111) Porous Silicon Thin Films.

Porous silicon (PSi) on p++-type (111) silicon substrate has been fabricated by electronically etching method in hydrofluoric acid (HF) media from 5 to 110 mA/cm2 of anodizing current density. The problem of determining the optical properties of (111) PSi is board through implementing a photoacoustic (PA) technique coupled to an electrochemical cell for real-time monitoring of the formation of porous silicon thin films. PA amplitude allows the calculation of the real part of the films refractive index and porosity using the reflectance self-modulation due to the interference effect between the PSi film and the substrate that produces a periodic PA amplitude. The optical properties are studied from specular reflectance measurements fitted through genetic algorithms, transfer matrix method (TMM), and the effective medium theory, where the Maxwell Garnett (MG), Bruggeman (BR), and Looyenga (LLL) models were tested to determine the most suitable for pore geometry and compared with the in situ PA method. It was found that (111) PSi exhibit a branched pore geometry producing optical anisotropy and high scattering films.

Design, fabrication, and optical characterization of one-dimensional photonic crystals based on porous silicon assisted by in-situ photoacoustics.

We present a methodology to fabricate one-dimensional porous silicon (PSi) photonic crystals in the visible range by controlled etching and monitored by photoacoustics. Photoacoustic can record in-situ information about changes in the optical path and chemical reaction as well as in temperature, refractive index, and roughness during porous layers formation. Radiometry imaging can determine the carrier distribution of c-Si substrate that is a fundamental parameter to obtain high-quality PSi films. An electrochemical cell was calibrated through a series of single PSi layers that allows knowing the PA amplitude period, porosity, and roughness as a function of the current density. Optical properties of single layers were determined using the reflectance response in the UV-Vis range to solve the inverse problem through genetic algorithms. PhC structures were designed using the transfer matrix method and effective media approximation.Based on the growth kinetics of PSi single layers, those structures were fabricated by electrochemical etching monitored and controlled by in-situ photoacoustics.

Modulation of hepatic ABC transporters by Eruca vesicaria intake: Potential diet-drug interactions.

The aim of this work was to evaluate whether oral administration of Eruca vesicaria, a species of rocket cultivated in Argentina, could modify cyclophosphamide (CP)-induced genotoxicity through modulation of hepatic ABC transporters. Daily oral administration of E. vesicaria fresh leaves juice (1.0, 1.4 and 2.0  g/kg) for 14 days did not alter genotoxicity biomarkers -alkaline comet assay and micronucleus test -in neither male nor female mice. Instead, repeated intake of this cruciferous decreased CP-induced DNA damage dose-dependently and it caused hepatic overexpression of P-glycoprotein (P-gp; 1.4 and 2.0  g/kg) and multidrug resistance protein 2 (MRP2; 2.0  g/kg), but not breast cancer resistance protein (Bcrp). The antigenotoxic effect of E. vesicaria was prevented by 50 mg/kg verapamil (P-gp inhibitor) or 10 mg/kg indomethacin (MRP2 inhibitor). In turn, CP-induced cytotoxicity (10 mM, 24 h) on human hepatoma cells (HepG2/C3A) was significantly reduced by preincubation with E. vesicaria (1.4 mg/ml; 48 h); this effect was absent when CP was coincubated with 35 µM verapamil, 80 µM indomethacin or 10 µM KO-143 (BCRP inhibitor). Altogether, these results allow us to demonstrate that repeated intake of E. vesicaria exhibited antigenotoxicity, at least in part, by induction of hepatic ABC transporters in vivo in mice as well as in vitro in human liver cells. This could account for other diet-drug interactions.

Mentors' Motivation to Address Race/Ethnicity in Research Mentoring Relationships.

The purpose of this study was to investigate the motivation of research mentors to address race/ethnicity in their research mentoring relationships, using self-determination theory as a conceptual framework. Mentors from STEM fields primarily in the biological sciences (N = 115) were asked to report their level of motivation and the reasons behind their motivation to address the role of race and ethnicity in their mentoring relationships. Mentors' responses were coded using a qualitative approach, and results were examined by mentors' degree of motivation, previous experience with mentoring trainees from different racial/ethnic groups, and mentor race/ethnicity. Extrinsic motivation and amotivation were the most frequently assigned codes to mentors' responses. Implications of these findings for mentor practices, higher education initiatives, and for diversifying the STEM workforce are discussed.

In vivo antigenotoxic activity of Diplotaxis tenuifolia against cyclophosphamide-induced DNA damage: Relevance of modulation of hepatic ABC efflux transporters.

Several epidemiological studies have demonstrated that a diet with high contents of cruciferous vegetables (which belong to the Brassicaceae family) may reduce the incidence of cancer and neurodegenerative diseases. However, some authors have postulated that they might bring about toxic effects. Therefore, the aim of this study was to assess the effects of chronic administration of Diplotaxis tenuifolia (wild rocket), a species found in Argentina, concerning its putative genotoxicity or antigenotoxicity against the DNA damage inducer cyclophosphamide, and its ability to modulate the hepatic expression of ABC efflux transporters on mice. The alkaline comet assay and the micronucleus test were used as genotoxicity biomarkers, and the ABC transporter expression was analyzed by Western-blotting. D. tenuifolia juice exhibited no genotoxicity in any of the three tested doses (p > 0.05), showing instead a protective effect against genotoxic damage induced by cyclophosphamide (p < 0.001) in a dose-dependent behavior. Furthermore, hepatic expression of ABCB1 remained unchanged in both sexes at every dose, whereas ABCG2 expression increased in females (p < 0.05) and males (p < 0.01) at the highest dose. Regarding ABCC2, sex-related differences were observed (p < 0.05), its expression decreasing in females (p < 0.05) and increasing in males (p < 0.05). The modulation of these transporters may contribute to the antigenotoxic effects of D. tenuifolia since they act as universal detoxifiers, excreting xenobiotics to the cellular exterior. Phytochemicals present in the juice such as glucosinolates, quercetin and kaempherol may be responsible for these beneficial effects.

Children's developing metaethical judgments.

Human adults incline toward moral objectivism but may approach things more relativistically if different cultures are involved. In this study, 4-, 6-, and 9-year-old children (N=136) witnessed two parties who disagreed about moral matters: a normative judge (e.g., judging that it is wrong to do X) and an antinormative judge (e.g., judging that it is okay to do X). We assessed children's metaethical judgment, that is, whether they judged that only one party (objectivism) or both parties (relativism) could be right. We found that 9-year-olds, but not younger children, were more likely to judge that both parties could be right when a normative ingroup judge disagreed with an antinormative extraterrestrial judge (with different preferences and background) than when the antinormative judge was another ingroup individual. This effect was not found in a comparison case where parties disagreed about the possibility of different physical laws. These findings suggest that although young children often exhibit moral objectivism, by early school age they begin to temper their objectivism with culturally relative metaethical judgments.

The Role of Ontogeny in the Evolution of Human Cooperation.

To explain the evolutionary emergence of uniquely human skills and motivations for cooperation, Tomasello et al. (2012, in Current Anthropology 53(6):673-92) proposed the interdependence hypothesis. The key adaptive context in this account was the obligate collaborative foraging of early human adults. Hawkes (2014, in Human Nature 25(1):28-48), following Hrdy (Mothers and Others, Harvard University Press, 2009), provided an alternative account for the emergence of uniquely human cooperative skills in which the key was early human infants' attempts to solicit care and attention from adults in a cooperative breeding context. Here we attempt to reconcile these two accounts. Our composite account accepts Hrdy's and Hawkes's contention that the extremely early emergence of human infants' cooperative skills suggests an important role for cooperative breeding as adaptive context, perhaps in early Homo. But our account also insists that human cooperation goes well beyond these nascent skills to include such things as the communicative and cultural conventions, norms, and institutions created by later Homo and early modern humans to deal with adult problems of social coordination. As part of this account we hypothesize how each of the main stages of human ontogeny (infancy, childhood, adolescence) was transformed during evolution both by infants' cooperative skills "migrating up" in age and by adults' cooperative skills "migrating down" in age.

Análisis crítico de la responsabilidad social en entidades de salud / Critical analysis of social responsibility in health entities

RESUMEN El estudio de la responsabilidad social, más allá de ser llamativo, resulta de por sí responsable e importante si se toma en consideración que cada vez son más las obligaciones que las organizaciones deben asumir con sus empleados, la sociedad y el medio ambiente. En el artículo se realiza un análisis crítico de la práctica de la responsabilidad social en entidades de salud. Se revisó la bibliografía publicada en los últimos cinco años en tres bases de datos regionales, sobre la responsabilidad social en el sector de la salud en Iberoamérica. Se evidenció la evolución del término de responsabilidad social, en concordancia con otros temas de la gestión organizacional con los que se relaciona dicha práctica, con regularidades en el sector de la salud dada la naturaleza de esta actividad, como es la relación con aspectos culturales de la organización, éticos y ambientales, y con potencialidades para su efectivo desarrollo a partir de un adecuado control social. El estudio de la responsabilidad social en entidades de salud permite visualizar los retos que aún quedan pendientes para el desarrollo efectivo de las relaciones entre las organizaciones y la sociedad

ABSTRACT The study of social responsibility, beyond striking, is of itself responsible and important if one takes into account that more and more obligations that organizations must assume with their employees, society and the environment. This article presents a critical analysis of the practice of social responsibility in health institutions. We reviewed the literature published in the last five years in three regional databases on social responsibility in the health sector in Latin America. It was evidenced the evolution of the term of social responsibility, in agreement with other subjects of the organizational management with which this practice is related, with regularities in the health sector given the nature of this activity, like the relation to cultural aspects of the organization, ethical and environmental, and with potential for its effective development from an adequate social control. The study of social responsibility in health institutions allows us to visualize the remaining challenges for the effective development of relations between organizations and society

Morbilidad obstétrica en la Unidad de Cuidados Intensivos del Hospital General Docente Aleida Fernández Chardiet / Obstetric morbidity in the Intensive Care Unit at General Hospital Aleida Fernandez Chardiet

Introducción: La gestación, parto y puerperio son un proceso que no está exento de riesgos y complicaciones que pueden poner en grave peligro la vida de la paciente y requerir ingreso una Unidad de Cuidados Intensivos. Objetivo: Caracterizar la morbilidad obstétrica en la Unidad de Cuidados Intensivos del Hospital General Docente Aleida Fernández Chardiet. Material y Métodos: Se realizó un estudio descriptivo, retrospectivo y transversal en pacientes obstétricas ingresadas en la Unidad de Cuidados Intensivos de este hospital entre 2012 a 2014. Con un total de 117 pacientes ingresadas. Resultados: El mayor número de ingresos correspondió a pacientes puérperas. La edad media fue de 25.9 años; una edad gestacional de 25.45 semanas como valor de media. El 38.6 por ciento presentó hemorragias obstétricas seguido de los trastornos hipertensivos del embarazo con 35.1 por ciento; la sepsis ocupo un tercer lugar con 26.3 por ciento. Las afecciones no obstétricas más frecuentes fueron la crisis aguda de asma bronquial con 40 por ciento seguido por la bronconeumonía con 30 por ciento de pacientes. La cesárea representó 57.6 por ciento de las cirugías y la sepsis 13.7 por ciento en su gran mayoría puérperas. El APACHE II fue más elevado en las pacientes quirúrgicas. Conclusiones: Las hemorragias obstétricas y los trastornos hipertensivos del embarazo fueron las principales causas de morbilidad materna en las puérperas por las que ingresaron las pacientes en la unidad de cuidados intensivos(AU)

Introduction: Pregnancy, berthing and puerperium are processes not free of risks and complications that can put in danger patients life which require their hospitalization in an intensive care unit.Objective: To characterize the obstetric morbidity in the Intensive Care Unit (ICU) at General Hospital Aleida Fernández Chardiet. Material and Methods: A descriptive, retrospective and transversal study was performed in obstetric patients hospitalized at the ICU from 2012 to 2014. With a number of hospitalized patients equal to 117. Results: The highest number of hospitalized patients corresponded to puerperal. The mean age was 25.9 years old and a gestational age of 25.45 weeks as an average value. 38.6 percent presented obstetric hemorrhages followed by a 35.1 percent with hypertensive disorders of pregnancy; sepsis was in third place with a 26.3 percent. The most frequent non obstetric affections were acute bronchial asthma attack, with a 40 percent followed by bronchopneumonia with 30 percent of the patients. Caesarean represented 57.6 percent of surgeries and sepsis; 13.7 percent most of them in puerperal women. APACHE II was higher in surgical patients. Conclusions: The most frequent obstetric affections leading to admission in the intensive care unit were obstetric hemorrhages and hypertensive disorders in puerperal women(AU)

The Infant Behavior Questionnaire-Revised: Factor structure in a culturally and sociodemographically diverse sample in the United States.

The recommended factor structure for the Infant Behavior Questionnaire-Revised (IBQ-R), a widely used parent-report measure of infant temperament, has limited empirical support. Moreover, the recommended factors were developed using homogenous samples not representative of current United States (U.S.) sociodemographics. The objective of this study was to examine the factor structure of the IBQ-R in a culturally and sociodemographically diverse U.S. cohort (N=380 mother-infant dyads). Mothers were assessed during pregnancy on a range of cultural and sociodemographic characteristics and completed the IBQ-R when their infants were 6 months of age. The sample was diverse on maternal marital status, educational attainment, household income, race/ethnicity, primary language spoken, and country of birth. Initial confirmatory factor analysis for the recommended three-factor model yielded a poor fit. Modifications employed in other studies failed to improve model fit. An exploratory factor analysis revealed an acceptable model fit for a three-factor solution that showed similarities to as well as differences from the originally proposed factor structure. Additional analyses suggested lack of invariance on several factor and scale scores by maternal country of birth, race/ethnicity, and household income. The findings suggest that the commonly used IBQ-R factor structure may need to be adjusted for diverse samples and deserves further study.

Relación del transporte prehospitalario con las complicaciones y la mortalidad del infarto agudo de miocardio / Relation of pre hospitable transportation with complications and mortality of acute myocardial infarction

Introducción: el infarto agudo de miocardio es la principal afección cardiovascular que causa complicaciones letales si no se instaura el tratamiento de reperfusión oportuno. Es crucial el funcionamiento de un sistema médico de traslado hacia un centro hospitalario que permita aumentar la sobrevivencia y la calidad de vida de los afectados.Objetivo: relacionar el tipo de transporte prehospitalario con el municipio de procedencia, aplicación de trombolisis, complicaciones y mortalidad general en pacientes con infarto agudo de miocardio. Métodos: se realizó un trabajo descriptivo, transversal, analítico, en 100 pacientes ingresados con infarto agudo de miocardio en la unidad de cuidados intensivos del Hospital Docente Aleida Fernández de Güines, desde el primero de diciembre de 2011 hasta el 30 de noviembre de 2012. Las variables estudiadas fueron la edad, el sexo, tipo de traslado hacia el hospital, municipio de procedencia, aplicación de trombolítico, complicaciones y mortalidad general por insuficiencia cardiaca, choque cardiogénico y arritmias cardiacas. Se calcularon las frecuencias absolutas y relativas; se aplicó Ji Cuadrado para determinar la relación entre variables. Resultados: predominó la edad de 60 a 79 años y el sexo masculino. El transporte más utilizado fue el apoyo vital básico, prevalecieron los pacientes procedentes de Güines. Fue más numerosa la no aplicación de trombolítico. Se observó una elevada incidencia de complicaciones y mortalidad, estas predominaron en los traslados en el apoyo vital básico. Existió relación estadística significativa entre el tipo de transporte y el municipio de procedencia. Conclusión: el tipo de traslado prehospitalario incide en las complicaciones y la mortalidad general de pacientes con infarto agudo de miocardio (AU)

Introduction: acute myocardial infarction is the main cardiovascular disorder that causes lethal complications if the treatment of reperfusion is not early established. The functioning of a medical system transferring to another hospital where survival and life quality of affected patients may be possible is crucial. Objective: to relate the type of pre hospitable transportation with the municipality of origin, application of thrombolysis, complications and general mortality in patients with acute myocardial infarction. Methods: an analytic transversal descriptive work was performed in 100 admitted patients with acute myocardial infarction in the Intensive Care Unit of Aleida Fernández teaching hospital from Güines, from December 1st, 2011 to November 30th, 2012. The studied variables were age, sex, type of transfer to the hospital, municipality of origin, application of thrombolysis, complications and general mortality by cardiac failure cardiogenic shock and cardiac arrhythmias. Absolute and relative frequencies were calculated; Ji Square was applied to determine the relation among variables. Results: 60 a 79 year-old patients and the male sex prevailed. The most used transportation was vital basic support, patients from Güines prevailed. The largest was the non-application of thrombolysis. A high incidence of complications and mortality was observed, which prevailed the vital basic support transfer. There was a significant statistic relation between the type of transportation and the municipality of origin. Conclusion: the type of pre hospitable transfer falls into complications and general mortality of patients with acute myocardial infarction(AU)