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Background Hemolytic uremic syndrome secondary to Shiga-toxin-producing Escherichia coli infection (STEC-HUS) generally shows a favorable outcome. Few cases develop extra-renal complications, since neurological involvement is an important cause of morbidity and mortality. The role of complement in STEC-HUS has been recently highlighted, and the use of eculizumab in severe cases has been communicated. HUS results from environmental and genetic factors, but the simultaneous occurrence of STEC and complement mutations remains undetermined. Methods A pediatric case with severe STEC-HUS carrying CFH mutations, with favorable response to eculizumab is analyzed. Results STEC-HUS was diagnosed in a 4-year-old girl with classic HUS, including low C3. Peritoneal dialysis was started due to hypertension, oligoanuria, and pleural effusion. She evolved with generalized tonic-clonic seizures and required mechanical ventilation. MRI reported multiple supra- and infratentorial ischemic lesions with laminar/striatal cortical necrosis and leukoencephalopathy. After two eculizumab doses, a significative stabilization in diuresis, blood pressure, creatinine, and C3 was achieved. At the third week, episodes of massive digestive bleeding and a life-threatening condition required a colectomy thus preserving the ileocecal valve. Due to atypical evolution, a genetic study was considered, identifying two heterozygous variants (CFH S1191L/V1197A). Conclusion STEC-HUS in patients with a genetic predisposition has been previously reported, but the low frequency of occurrence makes it a rare disease. As in the present case, patients with atypical course might benefit from genetic analysis to evaluate early eculizumab initiation and to better understand its phenotype. Graphical abstract A higher resolution version of the Graphical abstract is available as Supplementary information, Author(s): Carla Galvez [sup.1] , Paola Krall [sup.1] [sup.2] , Alejandro Rojas [sup.2] , Jun Oh [sup.3] , Francisco Cano [sup.1] Author Affiliations: (1) grid.443909.3, 0000 0004 0385 4466, Department [...]

BackgroundTreatment with tyrosine kinase inhibitors (TKIs) for patients with chronic myeloid leukemia (CML) is effective but needs to continue for several years, possibly indefinitely. Although generally safe, TKI may have hitherto poorly recognized effects in the quality of life (QoL) of such patients.MethodsWe prospectively measured the symptom burden of patients with chronic phase CML enrolled on frontline TKI trials with dasatinib, nilotinib, or ponatinib. A total of 219 patients were enrolled and filled out the MD Anderson Symptom Inventory (MDASI)-CML questionnaire before the start of therapy and during follow-up at defined time points of 3, 6, 9, 12, 18, and 24 months.ResultsThe median age was 50 years. Longitudinal analysis showed relatively stable symptom severity scores over time. Fatigue was the most common symptom in all three cohorts, both prior to the start of therapy and during therapy, including after achievement of deep molecular remission. Work was the most affected component of daily living. Overall patients tolerated therapy well with improvement of their symptoms from baseline, with few dose reductions related to toxicity or symptomatology. Although 31% of the patients who completed MDASI-CML achieved complete molecular remission by 24 months of treatment, nearly 90% experienced persistent mild symptoms.ConclusionSide effects related to TKIs may impact the quality of life in patients with CML-CP. Further studies should investigate factors (comorbidities, concomitant medications, dose and schedule, etc) associated with these symptoms and interventions that may improve the patients' QoL, including treatment discontinuation when safely feasible.

Purpose: Transmetatarsal amputation (TMA) with primary closure has long been an option for limb salvage in patients with advanced chronic limb-threatening ischemia (CLTI) with extensive tissue loss of the forefoot. However, TMA healing and closure techniques are challenging, specifically in high-risk patients. Guillotine transmetatarsal amputations (gTMA) with staged closure may provide an alternative treatment in this population. We report long-term outcomes of such technique. Materials and Methods: A single-center retrospective cohort study of CLTI patients undergoing gTMA between 2017 and 2020 was performed. Limb salvage, wound healing, and survival rates were quantified using Kaplan-Meier (KM) analysis. Multivariate regression was used to identify the effect of patient characteristics on the outcomes. Results: Forty-four gTMA procedures were reviewed. Median follow-up was 381 (interquartile range [IQR], 212–539.75) days. After gTMA, 87.8% (n=36) of the patients were able to ambulate after a median interval of 2 (IQR, 1–3) days. Eventual coverage was achieved in a personalized and staged approach by using a combination of skin substitutes (88.6%, n=39) ± split thickness skin grafts (STSG, 61.4%, n=27). KM estimates for limb salvage, wound healing, and survival were 84.1%, 54.5%, and 88.6% at 1 year and 81.8%, 63.8%, and 84.1% at 2 years. Wound healing was significantly associated with STSG application (p=0.002, OR=16.5, 95% CI 2.87–94.81). Conclusion: gTMA resulted in high limb salvage rates during long-term follow-up in CLTI patients. Adjunctive STSG placement may enhance wound healing at the gTMA site, thus leading to expedited wound closure. Surgeons may consider gTMA as an alternative to reduce limb loss in CLTI patients at high risk of major amputation. Clinical Impact: Currently, the clinical presentation of CLTI is becoming more complex to deal with due to the increasing comorbidities as the society becomes older. The data shown in this article means for clinicians that when facing diffused forefoot gangrene and extensive tissue loss, limb preservation could still be considered instead of major amputation. Guillotine transmetatarsal amputations in the setting of an aggressive multidisciplinary group, can be healed by the responsibly utilization of dermal substitutes and skin grafts leading to the preservation of the extremity, allowing mobility, avoiding of sarcopenia, and decreasing frailty. This will equate to maintenance of independent living and preservation of lifespan. [ABSTRACT FROM AUTHOR]

FDE , LP and |$\mathbf {K_{3}}$| are closely related to each other and admit of an intuitive informational interpretation. However, all these logics are co-NP complete, and so idealized models of how an agent can think. We address this issue by shifting to signed formulae, where the signs express imprecise values associated with two bipartitions of the corresponding set of standard values. We present proof systems whose operational rules are all linear and have only two structural branching rules that express a generalized Principle of Bivalence. Each of these systems leads to defining an infinite hierarchy of tractable approximations to the respective logic, in terms of the maximum number of allowed nested applications of the two branching rules. Further, each resulting hierarchy admits of an intuitive 5-valued non-deterministic semantics. [ABSTRACT FROM AUTHOR]

Mexico is a well-known seismically active country, which is primarily affected by several tectonic plate interactions along the southern Pacific coastline and by active structures in the Gulf of California. In this paper, we investigate this seismicity using the classical Gutenberg–Richter (GR) law and a non-extensive statistical approach based on Tsallis entropy. The analysis is performed using data from the corrected Mexican seismic catalog provided by the National Seismic Service, spanning the period from January 2000 to October 2023, and unlike previous work, it includes six different regions along the entire west coastline of Mexico. The Gutenberg–Richter law fitting to the earthquake sub-catalogs for all six regions studied indicates magnitudes of completeness between 3.30 and 3.76, implying that the majority of seismic movements occur for magnitudes less than 4. The cumulative distribution of earthquakes as derived from the Tsallis entropy was fitted to the corrected catalog data to estimate the q-entropic index for all six regions, which for values greater than one is a measure of the non-extensivity (i.e., non-equilibrium) of the system. All regions display values of the entropic index in the range 1.52 ≲ q ≲ 1.61 , slightly lower than previously estimated ( 1.54 ≲ q ≲ 1.70 ) using catalog data from 1988 to 2010. The reason for this difference is related to the use of modern recording devices, which are sensitive to the detection of a larger number of low-magnitude events compared to older instrumentation. [ABSTRACT FROM AUTHOR]

Black-handed spider monkeys (Ateles geoffroyi ssp.) are endangered in Mexico. Safe anesthetic protocols are important for in situ and ex situ conservation problems. Such protocols are scarce in the literature; nor have safety and physiologic responses been reported. High doses and volume are a counter side for field immobilizations. We tested an anesthetic protocol with a combination of tiletamine-zolazepam (5 mg/kg) plus xylazine (1 mg/kg) in 14 black-handed spider monkeys under human care from two facilities in Mexico. Physiological parameters such as HR, RR, T, SPO2, systolic arterial pressure (), diastolic arterial pressure (DAP), and median arterial pressure (MAP) were obtained. HR and RR decreased over time, but T increased significantly during the anesthetic time for the whole group; RR and T decreased for juveniles only. Variation between individuals was observed for HR, RR, and DAP. Volume reduction of drugs was achieved compared to previously reported anesthesia protocols. Induction time was fast (6.2 ± 10.4 min) and no tail prehension was seen. Recovery was prolonged (mean and SD). Physiologic parameters remained stable throughout. The protocol proved to be safe for the chemical immobilization of black-handed spider monkeys. [ABSTRACT FROM AUTHOR]

In this work, we consider the design of power-constrained networked control systems (NCSs) and a differential entropy-based fault-detection mechanism. For the NCS design of the control loop, we consider faults in the plant gain and unstable plant pole locations, either due to natural causes or malicious intent. Since the power-constrained approach utilized in the NCS design is a stationary approach, we then discuss the finite-time approximation of the power constraints for the relevant control loop signals. The network under study is formed by two additive white Gaussian noise (AWGN) channels located on the direct and feedback paths of the closed control loop. The finite-time approximation of the controller output signal allows us to estimate its differential entropy, which is used in our proposed fault-detection mechanism. After fault detection, we propose a fault-identification mechanism that is capable of correctly discriminating faults. Finally, we discuss the extension of the contributions developed here to future research directions, such as fault recovery and control resilience. [ABSTRACT FROM AUTHOR]

Evaluate the structural damage and the changes in the photosynthesis and transpiration rates of aquatic lirium leaves caused by ultrasound (US) irradiation in search of environmentally friendly methodologies for the control of this weed. Aquatic lirium plants were extracted from Xochimilco water canals in Mexico City. A part of the group of plants was selected for irradiation, and the rest formed the control group. The irradiation plants group was exposed to US irradiation of 17 kHz frequency and 30 W × 4 output power for 2 h, at noon and 25 °C room temperature. The structural analysis was done with a MOTICAM 1 digital camera, 800 × 600 pixels, incorporated into the MOTIC PSM-1000 optical microscope and edited with Motic Images Plus 2.0 ML software. The total stomata density and the damaged stomata density were determined by dividing the numbers of total and damaged stomata by the visual field area (67,917 mm2), respectively. The leaves' photosynthesis and transpiration rates were measured using an LI-6400XT Portable Photosynthesis System. Significant damage was observed in the stomata and epidermal cells, finding that the average ratio between the damaged and total stomata densities as a function of time (days) showed an exponential increase described by a Box–Lucas equation with a saturation value near unity and a maximum rate of change of the density of damaged stomata on zero-day (immediately after irradiation), decreasing as the days go by. The transpiration rate showed a sudden increase during the first hour after irradiation, reaching a maximum of 36% of its value before irradiation. It then quickly fell during the next 6 days and more slowly until the 21st day, decreasing 79.9% of its value before irradiation. The photosynthetic rate showed similar behavior with a 37.7% maximum increment and a 73.6% minimum decrease of its value before irradiation. The results of structural stomata damage on the ultrasound-irradiated aquatic lirium leaves are consistent with an excessive ultrasound stimulation on stomata's mechanical operation by guard cells that produce the measured significant increase of the photosynthetic and transpiration rates during the first hour after irradiation. The initial high evaporation could alter the water potential gradient, with a possible generation of tensions in the xylem that could cause embolism in their conduits. The loss of xylem conductivity or hydraulic failure would be consistent with the observed significant fall in the photosynthesis and transpiration rates of the aquatic lirium leaves after its sudden rise in the first hour after irradiation. [ABSTRACT FROM AUTHOR]

In this article, the authors describe a cultural transformation to embrace community-engaged scholarship by faculty members in the Faculty of Land and Food Systems at the University of British Columbia-Vancouver. They describe a transition from community-inquiry faculty projects to community-engaged action research projects achieved through organizational restructuring, curricular revision, and new teaching approaches; discuss the concepts that grounded their curricular revision; and report on the outcomes of their Faculty's transition. (Contains 1 table and 1 figure.)

Bacterial wilt (BW), caused by Ralstonia solanacearum, is one of the devastating diseases in tomatoes (Solanum lycopersicum L.). The use of resistant cultivars and breeding for genetic resistance is the most effective, economical, and environmentally friendly management strategy for this disease. It is necessary to screen diverse germplasm and cultivated genotypes to identify resistant resources and to develop resistant cultivars in tomatoes to combat the changing pathogen isolates. This study evaluated 40 United States Department of Agriculture (USDA) tomato accessions for their BW resistance to the R. solanacearum isolate P822 under greenhouse conditions. The tomato plants were inoculated and visually assessed to observe their symptoms, and the disease severity was scored on a scale of 0 to 4 (0 = no leaf wilted, 1 = 25% of leaves wilted, 2 = 50% leaves wilted, 3 = 75% of leaves wilted, and 4 = 100% leaves wilted). Five accessions (PI 645370, PI 647306, PI 600993, PI 355110, and PI 270210) were observed as BW resistance, with PI 645370 showing the greatest resistance. The broad-sense heritability for BW resistance was estimated as 59.9% and 42.8% based on a 0–4 scale of disease incidence and the disease severity index, respectively. Two distinct clusters (sub-populations) were detected among 39 of the 40 accessions. The five identified BW-resistant accessions were distributed in both clusters, suggesting a likely difference in the genetic base among the five resistance accessions. The resistant accessions will contribute significantly to the tomato breeding program to develop new cultivars with BW resistance. [ABSTRACT FROM AUTHOR]

EACH YEAR ROUGHLY two billion people are overfed and two billion are underfed by a global food system that is making measurable impacts upon our planet's atmospheric and oceanic chemistry. [...]

Endometriosis is a benign disease defined as the extra-uterine implantation and proliferation of tissue similar to endometrium (glands and stroma), causing a chronic inflammatory response and adhesions that distort anatomy. The extra-gonadal involvement is rare, but reports of intestinal endometriosis have increased substantially, mainly affecting the sigmoid colon and rectum; isolated involvement of the cecum is rare, even more so in a postmenopausal woman without use of hormone replacement therapy. We report the case of a postmenopausal woman with intestinal obstruction surgically suggestive of malignancy; however, pathological examination revealed endometriosis.

This article is focused on a new procedure concerning a more accurate identification of the occurrence time of an impending major earthquake (EQ). Specifically, we first recapitulate that, as was recently shown [P. Varotsos et al., Communications in Nonlinear Science and Numerical Simulation 125 (2023) 107370], natural time analysis of seismicity supplemented with the non-additive Tsallis entropy S q leads to a shortening of the time window of an impending major EQ. This has been shown for the Tohoku mega-EQ of magnitude M9 that occurred in Japan on 11 March 2011, which is the largest event ever recorded in Japan. Here, we also show that such a shortening of the time window of an impending mainshock can be achieved for major, but smaller EQs, of the order of M8 and M7. In particular, the following EQs are treated: the Chiapas M8.2 EQ, which is Mexico's largest EQ for more than a century that took place on 7 September 2017 near the coast of Chiapas state in Mexico, the 19 September 2017 M7.1 EQ that occurred within the Mexican flat slab, and the M7.1 Ridgecrest EQ on 6 July 2019 in California. [ABSTRACT FROM AUTHOR]

This study focused on evaluating the effectiveness of various welding processes in reducing volatile gas emissions in work environments, a crucial factor for occupational health and safety. Comparative tests were carried out on three common welding processes: SMAW, GMAW and GTAW, with a focus on the concentration of formaldehyde and other volatile organic compounds (VOCs) in the air. The results revealed high statistical significance between treatments, confirming substantial differences in VOC emissions. The Tukey test identified the GTAW (TIG) process as the most efficient, with a concentration of total volatiles of 0.0557 mg/m?, well below the threshold of 0.2 mg/m?, where it is expected that no irritation or symptoms of discomfort. In contrast, the SMAW and GMAW processes showed concentrations that could lead to irritation or discomfort. Choosing the appropriate welding process is revealed as a critical factor in reducing VOC emissions and protecting workers' health. VOCs, including formaldehyde and carbon monoxide, can have adverse health effects on workers, and compliance with occupational exposure limits is essential. [ABSTRACT FROM AUTHOR]

The objectives were to evaluate the effects of increasing metal micronutrient concentrations and silicon (Si) concentrations on plant growth and susceptibility to Pythium root rot with hydroponically grown lettuce (Lactuca sativa). In the first experiment, lettuce was grown in hydroponic solutions with metal micronutrients iron (Fe), manganese (Mn), copper (Cu), and zinc (Zn) supplied at either 0, 2.5, 5, or 10 mg∙L−1. A standard commercial hydroponic solution was also included as a control, with metal micronutrients supplied at 2 Fe, 1 Mn, 0.5 Cu, and 0.5 Zn mg∙L−1. In the second experiment, hydroponic lettuce was grown with Si at 0, 7, 14, 28, and 56 mg∙L−1. Hydroponic treatment solutions for both experiments were either dosed with Pythium myriotylum (Pythium treatment) at 1.80 × 104 oospores per L or deionized water as a non-Pythium control. Data were collected on leaf SPAD chlorophyll content, shoot height and width, total plant fresh mass, and root disease severity. Increasing the Cu concentration in solution decreased Pythium disease severity but reduced lettuce growth and yield. Increasing the concentration of the other metal micronutrients also tended to reduce lettuce growth but had no significant influence on root disease. Supplementing the hydroponic solution with Si had no effect on Pythium root disease severity and slightly decreased lettuce growth at 56 mg∙L−1 Si. Results of this study suggest that the management of micronutrients and Si nutrition is not an effective strategy and, at best, a risky strategy for controlling Pythium in hydroponic lettuce. Growers would likely benefit from maintaining metal micronutrient and Si concentrations within the ranges of (in mg∙L−1) 0.5 to 5.5 for Fe, 0.1 to 2.0 for Mn, 0.1 to 0.6 for Cu, 0.1 to 0.6 for Zn, and 0 to 28 for Si for many hydroponic crops. Supplementing Si has the potential to negatively influence plant growth and quality for certain plant species, and testing is necessary to evaluate phytotoxicity risks prior to implementing in commercial practice. Overall, successful mitigation of root rot pathogens in commercial hydroponic production requires the combination of proper sanitation, best management and cultural practices, appropriate hydroponic system design, and the implementation of a water treatment system with proper design and a multi-barrier approach. [ABSTRACT FROM AUTHOR]

Los estudios referentes a la gestión de los recursos líticos -especialmente el sílex- por parte de los grupos prehistóricos en las dos vertientes del Pirineo occidental han aumentado de manera considerable en las últimas décadas. En este trabajo, pretendemos realizar una aproximación a la movilidad de los grupos superopaleolíticos, mediante los Sistemas de Información Geográfica (SIG). Estos nos permiten relacionar espacialmente los afloramientos de sílex y los restos líticos encontrados en los yacimientos arqueológicos. Para ello, hemos construido, a través de los Cost Distance Analysis, una serie de mapas que permiten detectar las dinámicas de expansión de cada uno de afloramientos, así como los patrones de aprovisionamiento de cada yacimiento. Adicionalmente, hemos relacionado los valores numéricos obtenidos del análisis espacial con la cantidad de sílex encontrado en cada nivel arqueológico a partir de estadística descriptiva y la aplicación de la lógica difusa. De esta forma hemos podido revisar los conceptos de autoctonía y aloctonía, así como plantear modelos generales de aprovisionamiento y distribución de sílex en la región.