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Objectives: This study aimed to assess the real use of cefazolin for methicillin-susceptible Staphylococcus aureus (MSSA) infective endocarditis (IE) in the Spanish National Endocarditis Database (GAMES) and to compare it with antistaphylococcal penicillin (ASP). Methods: Prospective cohort study with retrospective analysis of a cohort of MSSA IE treated with cloxacillin and/or cefazolin. Outcomes assessed were relapse; intra-hospital, overall, and endocarditis-related mortality; and adverse events. Risk of renal toxicity with each treatment was evaluated separately. Results: We included 631 IE episodes caused by MSSA treated with cloxacillin and/or cefazolin. Antibiotic treatment was cloxacillin, cefazolin, or both in 537 (85%), 57 (9%), and 37 (6%) episodes, respectively. Patients treated with cefazolin had significantly higher rates of comorbidities (median Charlson Index 7, P

We report the discovery of Cerberus, an extremely red object detected with the MIRI Deep Imaging Survey (MIDIS) observations in the F1000W filter of the Hubble Ultra Deep Field. The object is detected at signal-to-noise ratio (S/N) ∼ 6, with F1000W ∼ 27 mag, and undetected in the NIRCam data gathered by the JWST Advanced Deep Extragalactic Survey (JADES), fainter than the 30.0–30.5 mag 5 σ detection limits in individual bands, as well as in the MIDIS F560W ultradeep data (∼29 mag, 5 σ ). Analyzing the spectral energy distribution built with low-S/N (

JWST spectroscopy has revolutionized our understanding of galaxies in the early Universe. Covering wavelengths up to 5.3 μ m, NIRSpec can detect rest-frame optical H α emission lines out to z = 7 and [O iii ] to z = 9.5. Observing these lines in more distant galaxies requires longer wavelength spectroscopy with MIRI. Here we present MIRI Medium Resolution Spectrograph integral field unit observations of the lensed galaxy merger MACS0647–JD at z = 10.165. With exposure times of 4.2 hr in each of two bands (SHORT and LONG), we detect H α at 9 σ , [O iii ] λ 5008 at 11 σ , and [O iii ] λ 4960 at 3 σ . Combined with previously reported NIRSpec spectroscopy that yielded seven emission lines including the auroral line [O iii ] λ 4363, we present the first direct metallicity measurement of a z > 10 galaxy: $12+\mathrm{log}({\rm{O}}/{\rm{H}})=7.79\pm 0.09$ , or ${0.13}_{-0.03}^{+0.02}\,{Z}_{\odot }$ . This is similar to galaxies at z ∼ 4–9 with direct metallicity measurements, though higher than expected given the high specific star formation rate log(sSFR/yr ^−1 ) = −7.4 ± 0.3. We further constrain the ionization parameter $\mathrm{log}(U)$ = −1.9 ± 0.1, ionizing photon production efficiency log( ξ _ion ) = 25.3 ± 0.1, and SFR = 5.0 ± 0.6 M _⊙ yr ^−1 within the past 10 Myr. These observations demonstrate the combined power of JWST NIRSpec and MIRI for studying galaxies in the first 500 million years.

We present JWST/NIRSpec high-resolution G395H/F290LP spectroscopy of MACS0647−JD, a gravitationally lensed galaxy merger at z = 10.167. The new spectroscopy, which is acquired for the two lensed images (JD1 and JD2), detects and resolves emission lines in the rest-frame ultraviolet and blue optical, including the resolved [O ii ] λ λ 3726, 3729 doublet, [Ne iii ] λ 3870, He i λ 3890, H δ , H γ , and [O iii ] λ 4363. This is the first observation of the resolved [O ii ] λ λ 3726, 3729 doublet for a galaxy at z > 8. We measure a line flux ratio [O ii ] λ 3729/ λ 3726 = 0.9 ± 0.3, which corresponds to an estimated electron density of $\mathrm{log}({n}_{e}/{\mathrm{cm}}^{-3})=2.9\pm 0.5$ . This is significantly higher than the electron densities of local galaxies reported in the literature. We compile measurements from the literature and further analyze the redshift evolution of n _e . We find that the redshift evolution follows the power-law form of n _e = A × (1 + z ) ^p with $A={54}_{-23}^{+31}$ cm ^−3 and $p={1.2}_{-0.4}^{+0.4}$ . This power-law form may be explained by a combination of metallicity and morphological evolution of galaxies, which become, on average, more metal poor and more compact with increasing redshift.

We present deep James Webb Space Telescope (JWST)/Mid-Infrared Instrument (MIRI) F560W observations of a flux-limited, Atacama Large Millimeter/submillimeter Array (ALMA)-selected sample of 28 galaxies at z = 0.5–3.7 in the Hubble Ultra Deep Field (HUDF). The data from the MIRI Deep Imaging Survey (MIDIS) reveal the stellar structure of the HUDF galaxies at rest-frame wavelengths of λ > 1 μ m for the first time. We revise the stellar mass estimates using new JWST photometry and find good agreement with pre-JWST analyses; the few discrepancies can be explained by blending issues in the earlier lower-resolution Spitzer data. At z ∼ 2.5, the resolved rest-frame near-infrared (1.6 μ m) structure of the galaxies is significantly more smooth and centrally concentrated than seen by the Hubble Space Telescope at rest-frame 450 nm (F160W), with effective radii of R _e (F560W) = 1–5 kpc and Sérsic indices mostly close to an exponential (disk-like) profile ( n ≈ 1), up to n ≈ 5 (excluding active galactic nuclei). We find an average size ratio of R _e (F560W)/ R _e (F160W) ≈ 0.7 that decreases with stellar mass. The stellar structure of the ALMA-selected galaxies is indistinguishable from a HUDF reference sample of all galaxies with a MIRI flux density greater than 1 μ Jy. We supplement our analysis with custom-made, position-dependent, empirical point-spread function models for the F560W observations. The results imply that a smoother stellar structure is in place in massive gas-rich, star-forming galaxies at “Cosmic Noon,” despite a more clumpy rest-frame optical appearance, placing additional constraints on galaxy formation simulations. As a next step, matched-resolution, resolved ALMA observations will be crucial to further link the mass- and light-weighted galaxy structures to the dusty interstellar medium.

We study the stellar population properties of 182 spectroscopically confirmed (MUSE/VLT) Ly α emitters (LAEs) and 450 photometrically selected Lyman-break galaxies (LBGs) at z = 2.8–6.7 in the Hubble Extreme Deep Field. Leveraging the combined power of Hubble Space Telescope and JWST NIRCam and MIRI observations, we analyze their rest-frame UV-through-near-IR spectral energy distributions, with MIRI playing a crucial role in robustly assessing the LAEs’ stellar masses and ages. Our LAEs are low-mass objects $({{\rm{log}}}_{10}({M}_{\star }/{M}_{\odot })\simeq 7.5)$ with little or no dust extinction ( E ( B − V ) ≃ 0.1) and a blue UV continuum slope ( β ≃ −2.2). While 75% of our LAEs are young (

We present the ultraviolet luminosity function and an estimate of the cosmic star formation rate density at 8 < z < 13 derived from deep NIRCam observations taken in parallel with the MIRI Deep Survey of the Hubble Ultra Deep Field (HUDF), NIRCam covering the parallel field 2. Our deep (40 hr) NIRCam observations reach an F277W magnitude of 30.8 (5 σ ), more than 2 mag deeper than JWST public data sets already analyzed to find high-redshift galaxies. We select a sample of 44 z > 8 galaxy candidates based on their dropout nature in the F115W and/or F150W filters, a high probability for their photometric redshifts, estimated with three different codes, being at z > 8, good fits based on χ ^2 calculations, and predominant solutions compared to z < 8 alternatives. We find mild evolution in the luminosity function from z ∼ 13 to z ∼ 8, i.e., only a small increase in the average number density of ∼0.2 dex, while the faint-end slope and absolute magnitude of the knee remain approximately constant, with values α = − 2.2 ± 0.1, and M ^* = − 20.8 ± 0.2 mag. Comparing our results with the predictions of state-of-the-art galaxy evolution models, we find two main results: (1) a slower increase with time in the cosmic star formation rate density compared to a steeper rise predicted by models; (2) nearly a factor of 10 higher star formation activity concentrated in scales around 2 kpc in galaxies with stellar masses ∼10 ^8 M _⊙ during the first 350 Myr of the universe, z ∼ 12, with models matching better the luminosity density observational estimations ∼150 Myr later, by z ∼ 9.

Introduction: surgery in morbidly obese patients as a treatment for gynecologic cancer is a challenge for surgeons and anesthesiologists, since it is associated with the processes of increasing intraoperative and postoperative complications. Objective: to describe the main results gained with the use of laparoscopic surgery in patients with morbid obesity and endometrial adenocarcinoma treated at the Instituto Nacional de Oncología y Radiobiología (INOR) of Havana, Cuba, from January 2019 to March 2020. Method: a descriptive, observational, cross-sectional study was carried out in 22 patients, with body mass index more than 40 kg/m2 and diagnosis of endometrial adenocarcinoma, who underwent laparoscopic surgery. The primary data was obtained from the medical records, which were used to create a database in a Microsoft Excel spreadsheet to synthesize all the information. Results: the predominant age group was between 61 and 70 years old. Endometrial adenocarcinoma was the most frequent cancer (77.27%). The degree of differentiation was well differentiated, infiltrating less than 50 % of the myometrium. The predominant surgical staging was IA (72.72%). Transoperative bleeding was 78.9 ± 5.7 ml (range between 10 and 200 ml), mean operative time was 82 min (range 75-132 min), and hospital stay was less than 24 hours (90.90%). Surgical conversion was performed in 4.54% of cases. Conclusions: morbidly obese patients may benefit from the laparoscopic approach for the treatment and laparoscopic surgical staging of endometrial carcinoma, which decreases morbidity and hospital stay.

This is the case of a 53-year-old man with aortic stenosis, ascending aortic aneurysm, and type B aortic dissection treated with Bentall procedure where a 40 mm uncovered self-expanding stent-graft (AMDS, JOTEC GmbH, Germany) was anastomosed to the aortic graft distal border with the intent to collapse the entry (figure 1A). The patient’s written informed consent was obtained to run the tests and publish the case. Figure 1. The follow-up radiographic monitoring revealed significant stent-graft kinking while the dissection entry remained opened (figure 1B,F). Given the high risk involved in the reintervention, endovascular treatment was decided. Under intravascular echocardiography guidance a hydrophilic guidewire was used to cross the stent-graft lumen. Afterwards, the guidewire was exchanged for a different one with stronger support to proceed with dilatations using semi-compliant balloons with significant recoil being reported after balloon deflation (figure 2A,C). Figure 2. To achieve greater radial strength, we decided to implant a double-layer stent. An uncovered stent to expand the stent-graft was implanted followed by 1 covered expandable polytetrafluoroethylene (e-PTFE) stent to seal the dissection entry. An 18 Fr DrySeal sheath (Gore Inc, United States) was used to implant 2 60 mm 10-zig CP stents (NuMED Inc, United States), 1 covered and the other one not....

Varón de 53 años con estenosis aórtica, aneurisma de aorta ascendente y disección de aorta de tipo B, intervenido con cirugía de Bentall en la que se anastomosó al extremo distal del injerto aórtico una endoprótesis autoexpandible no recubierta (AMDS, JOTEC GmbH, Alemania) de 40 mm con intención de colapsar la puerta de entrada (figura 1A). Se obtuvo el consentimiento informado por escrito del paciente para realizar las pruebas y para la publicación del caso. Figura 1. En el control radiológico posterior se observó una marcada torsión de la endoprótesis, permaneciendo la puerta de la disección abierta. (figura 1B-F). Dado el alto riesgo de la reintervención, se decidió tratamiento endovascular. Con una guía hidrófila y control con ecocardiografía intravascular, se consiguió cruzar a la luz de la endoprótesis; la guía se intercambió por otra de más soporte para proceder a dilataciones con balones semidistensibles, observándose importante recoil tras el desinflado (figura 2A-C). Figura 2. Para conseguir una mayor fuerza radial se decidió implantar 2 capas de stent, primero uno no recubierto con el cual expandir la endoprótesis y seguidamente otro recubierto de politetrafluoroetileno expandible (e-PTFE) para sellar la puerta de entrada de la disección. Con una vaina DrySeal (Gore Inc., Estados Unidos) de 18 Fr...

Introduction: Cardiovascular events are the main complication in the perioperative period. Statins are the drug of choice in primary and secondary cardiovascular disease to their lipid-lowering effect level for prevention. Objective: To determine the effect of the preoperative administration of atorvastatin in patients with coronary risk factors under major noncardiac surgery. Methods: A descriptive, prospective, randomized logitudinal in patients older than 60 years who underwent surgery at the University Hospital "General study was conducted. Calixto García "from 2011 to 2014. In all more than three coronary risk factors were identified and two groups were formed. One received a month before surgery atorvastatin 80 mg daily and another not. The variables evaluated were: TAM, FC, ST segment, QT variation and cardiovascular complications at different times. Results: Most patients were female between 65 and 74 years. The most common risk factors were hypertension, hypercholesterolemia and smoking. The TAM, FC and ST segment did not change significantly in either group. The group that received statins had a higher incidence of QT prolongation and postoperative complications of cardiovascular more significantly. Conclusions: The implementation of statin therapy in the preoperative period had a positive effect and significantly reduced morbidity and mortality intraoperatively and immediate postoperative period in these patients.

Floating oscillating water column (OWC) type wave energy converters (WECs), compared to fixed OWC WECs that are installed near the coastline, can be more effective as they are subject to offshore waves before the occurrence of wave dissipation at a nearshore location. The performance of floating OWC WECs has been widely studied using both numerical and experimental methods. However, due to the complexity of fluid–structure interaction of floating OWC WECs, most of the available studies focus on 2D problems with WEC models of limited degrees-of-freedom (DOF) of motion, while 3D mooring effects and multiple-DOF OWC WECs have not been extensively investigated yet under 2D and 3D wave conditions. Therefore, in order to gain a deeper insight into these problems, the present study focuses on wave flume experiments to investigate the motion and mooring performance of a scaled floating OWC WEC model under 2D wave conditions. As a preparatory phase for the present MaRINET2 EsflOWC (efficiency and survivability of floating OWC) project completed at the end of 2017, experiments were also carried out in advance in the large wave flume of Ghent University. The following data were obtained during these experimental campaigns: multiple-DOF OWC WEC motions, mooring line tensions, free surface elevations throughout the wave flume, close to and inside the OWC WEC, change in the air pressure inside the OWC WEC chamber and velocity of the airflow through the vent on top of the model. The tested wave conditions mostly include nonlinear intermediate regular waves. The data obtained at the wave flume of Ghent University, together with the data from the EsflOWC tests at the wave flume of LABIMA, University of Florence, provide a database for numerical validation of research on floating OWC WECs and floating OWC WEC farms or arrays used by researchers worldwide.

The melting temperature (Tm) of a protein is the temperature at which half of the protein population is in a folded state. Therefore, Tm is a measure of the thermostability of a protein. Increasing the Tm of a protein is a critical goal in biotechnology and biomedicine. However, predicting the change in melting temperature (dTm) due to mutations at a single residue is difficult because it depends on an intricate balance of forces. Existing methods for predicting dTm have had similar levels of success using generally complex models. We find that training a machine learning model with a simple set of easy to calculate physicochemical descriptors describing the local environment of the mutation performed as well as more complicated machine learning models and is 2-6 orders of magnitude faster. Importantly, unlike in most previous publications, we perform a blind prospective test on our simple model by designing 96 variants of a protein not in the training set. Results from retrospective and prospective predictions reveal the limited applicability domain of each model. This study highlights the current deficiencies in the available dTm dataset and is a call to the community to systematically design a larger and more diverse experimental dataset of mutants to prospectively predict dTm with greater certainty.

Introducción: Presentamos nuestra experiencia inicial con la cirugía de reparación aórtica aislada o remodelado de la raíz aórtica (operación de Yacoub) en pacientes con dilatación de raíz. Realizamos un seguimiento a medio y corto plazo. Métodos: En el periodo 2009-2011 se ha intervenido a 25 pacientes. En 9 de los casos se realizó la técnica de Yacoub, ya que presentaban además dilatación del anillo y de la raíz: ectasia anuloaórtica en 8 casos, síndrome de Beals un caso. Se implantó el anillo Coroneo® en 6 de estos y sutura subaórtica de Schäfers en 3. En los 16 restantes, la patología fue únicamente valvular (4 casos bicúspide). Se realizaron ecocardiograma intraoperatorio y controles posteriores a los 6 meses, año y 2 años de la cirugía. Resultados: La mortalidad hospitalaria fue de un 4% (1/25). La edad media de 44 años. El tiempo medio de isquemia en la reparación aórtica aislada fue de 54 min y en la cirugía de remodelado de 139 min. Tres pacientes fueron reintervenidos por insuficiencia significativa. El ecocardiograma de control muestra en 21 casos una reparación satisfactoria con insuficiencia mínima residual y moderada en un caso. Conclusiones: Nuestra técnica de elección para la cirugía reparadora de la válvula aórtica es la plicatura central, siendo una técnica intuitiva y reproducible. En la insuficiencia aórtica asociada a aneurisma de raíz aórtica la técnica de elección es el remodelado de Yacoub con anillo Coroneo® dando soporte anular y siendo una técnica duradera.

This paper describes experimental research on a floating moored Oscillating Water Column (OWC)-type Wave-Energy Converter (WEC) carried out in the wave flume of the Coastal Engineering Research Group of Ghent University. This research has been introduced to cover the existing data scarcity and knowledge gaps regarding response of moored floating OWC WECs. The obtained data will be available in the future for the validation of nonlinear numerical models. The experiment focuses on the assessment of the nonlinear motion and mooring-line response of a 1:25 floating moored OWC WEC model to regular waves. The OWC WEC model motion has 6 degrees of freedom and is limited by a symmetrical 4-point mooring system. The model is composed of a chamber with an orifice on top of it to simulate the power-take-off (PTO) system and the associated damping of the motion of the OWC WEC model. In the first place, the motion response in waves of the moored floating OWC WEC model is investigated and the water surface elevation in the OWC WEC chamber is measured. Secondly, two different mooring-line materials (iron chains and nylon ropes) are tested and the corresponding OWC WEC model motions and mooring-line tensions are measured. The performance of these two materials is similar in small-amplitude waves but different in large wave-amplitude conditions. Thirdly, the influence of different PTO conditions is investigated by varying the diameter of the top orifice of the OWC WEC model. The results show that the PTO damping does not affect the OWC WEC motion but has an impact on the water surface elevation inside the OWC chamber. In addition, an unbalanced mooring configuration is discussed. Finally, the obtained data for a moored cubic model in waves are presented, which is a benchmarking case for future validation purposes.

Un vistazo a la campaña de propaganda de los Estados Unidos en Irán a principios de los años Cincuenta, durante el gobierno del Dr. Mossadeq, y en el contexto global de la Guerra Fría. Sus objetivos, medios y logros, a través del análisis de una serie de documentos. Por medio del Departamento de Estado y utilizando los recursos de las Embajadas en los respectivos países, se diseñaron una serie de medidas con el objetivo de “vender” la imagen de los Estados Unidos y de la democracia occidental, para crear en el subconsciente de los habitantes de los países árabes una impresión positiva de Occidente y del american way of life. A su vez, se mostraría la “falacia” de la doctrina comunista y los efectos desastrosos que tendría para las respectivas naciones y sus vecinos el hecho de que la URSS lograse obtener una influencia importante en la zona. En el fondo se trataba del principio básico de la publicidad: conseguir que el público compre tu producto por delante del de la competencia.____________________ABSTRACT:This article treats about the propaganda campaign of the United States in Iran in the early fifties, during the government of Dr. Mossadeq and in the Cold War context: i.e. its objectives, means and achievements, through the analysis of a series of documents. Through the Department of State and using the resources of the Embassies in the respective countries, it has been designed a series of measures to "sell" the image of the United States and Western democracy, in order to create in the subconscious of the inhabitants of the Arab countries a positive impression of the West and the American way of life. Meanwhile, this propaganda showed the "fallacy" of the communist doctrine and the disastrous effects that USSR achieved a major influence in the area would have for the respective nations and their neighbors. Basically it was the basic principle of advertising: to get the public to buy your product before the one of the competitor.

Presentamos la técnica quirúrgica de cierre perventricular de una comunicación interventricular (CIV) a nivel del septo muscular con un dispositivo Amplatzer en un bebé de 2 meses. Tras realizar una esternotomía media convencional, se puncionó la cara anterior del corazón y, bajo control por ecocardiograma transesofágico, se introdujo un cable guía a través de la comunicación interventricular hasta el ventrículo izquierdo. Se avanzó un introductor de 10 F y se implantó bajo control ecocardiográfico un dispositivo oclusivo Amplatzer de 10 mm cerrando la CIV. El postoperatorio fue satisfactorio y no se apreció cortocircuito residual en el ecocardiograma.