Abstract Post-heart transplant patient care is a challenging task for multidisciplinary teams. Thus, patient rehabilitation is of paramount importance. Phase I of cardiac rehabilitation helps prevent the pulmonary and functional sequelae found in patients whilst in ICU and during hospitalisation. Functional progression based on the global muscle strength, mobility, and exercise tolerance seem to be a good alternative for this population. The role of physiotherapy in critical care is crucial for the proper treatment of these patients.

Resumen Introducción: Los equinoideos (erizos de mar) brindan refugio a una variedad de ectosimbiontes facultativos u obligatorios. Objetivo: Evaluar la hipótesis de que los decápodos y los peces prefieren asociarse con individuos y especies de equinoideos con espinas más largas. Métodos: Estudiamos visualmente la frecuencia de crustáceos decápodos y peces asociados con equinoideos en aguas poco profundas (< 4 m) y aguas más profundas (5-20 m) en Los Cabos, Baja California Sur, México, del 1-6 de enero 2019. Resultados: Examinamos 1 058 equinoideos de seis especies. Cinco especies de decápodos se asociaron con tres especies de equinoideos. Al comparar con otras especies de equinoideos, en aguas poco profundas, los decápodos se asociaron 5.1 veces más frecuentemente con la especie de equinoideo de espinas más largas, Diadema mexicanum (7.0 veces más decápodos por individuo en D. mexicanum); en aguas más profundas, la frecuencia fue similar para todas las especies de equinoideos. Catorce especies de peces se asociaron con 4 especies de equinoideos. En aguas poco profundas, los peces se asociaron 2.6 veces más con D. mexicanum (4.5 veces más peces por individuo). No hubo preferencia por una especie de equinoideo en aguas más profundas. Individuos de D. mexicanum con espinas largas tuvieron más asociación con decápodos y peces. Las asociaciones se dieron con mayor frecuencia en aguas poco profundas. Múltiples individuos y especies de decápodos y peces a menudo se asociaron con un solo D. mexicanum. Un decápodo que presumiblemente es Tuleariocaris holthuisi mostró una posible asociación obligatoria con uno de los equinoideos (D. mexicanum); las otras especies de decápodos y todas las especies de peces presentaron asociaciones facultativas. Conclusión: Nuestros resultados apoyan la hipótesis de que los decápodos y los peces se asociaron con mayor frecuencia con los equinoideos con las espinas más largas, presumiblemente para reducir el riesgo de depredación.

Abstract Introduction: Echinoids (sea urchins) provide shelter for a variety of facultative or obligatory ectosymbionts. Objective: To evaluate the hypothesis that decapods and fishes prefer to associate with echinoid individuals and species that have longer spines. Methods: We visually studied the frequency of decapod crustaceans and fishes associated with echinoids in shallow water (< 4 m) and deeper water (5-20 m) at Los Cabos, Baja California Sur, Mexico, during 1-6 January 2019. Results: We inspected 1 058 echinoids of six species. Five decapod species associated with three species of echinoids. When compared with other echinoid species, in shallow water, decapods associated 5.1 times more often with the longest-spined echinoid Diadema mexicanum (7.0 times more decapods per individual D. mexicanum); in deeper water, association frequency was similar for all echinoid species. Fourteen fish species associated with four echinoid species. In shallow water, fishes associated 2.6 times more with D. mexicanum (4.5 times more fishes per individual). There was no preferred echinoid species in deeper water. Longer-spined D. mexicanum had more decapods and fishes. Associations were more frequent in shallow water. Multiple individuals and species of decapods and fish often associated together with a single D. mexicanum. The decapod that presumably is Tuleariocaris holthuisi showed a possible obligatory association with one of the equinoids (D. mexicanum); the other decapods and all fish species are facultative associates. Conclusion: Our results support the hypothesis that decapods and fishes associate most frequently with echinoids with the longest spines, presumably to reduce the risk of predation.

ABSTRACT Non-indigenous communities are particularly insightful in terms of understanding the process of healing plant acquisition and loss. This study explores the traditional medicinal plant knowledge and use of a long-isolated, African-descended community in the Atlantic rainforests of northeastern Brazil. We investigated the primary plant species used and their therapeutic applications. We hypothesized that women and the oldest members of the community would be the most knowledgeable about medicinal plants. We carried out semi-structured interviews and walk-in-the-woods plant collecting techniques with 74 informants. We identified 133 ethnospecies of plants used to treat a wide variety of illnesses. The most commonly used plant parts were leaves; the most common form of preparation was as infusion. As anticipated, medicinal plant knowledge generally increased with age. However, there was no significant gender difference in plant knowledge. We attribute this to the increasingly similar livelihood roles and geographical spaces occupied by men and women in the community. There was, however, a trend for women to be more knowledgeable about the healing properties of herbaceous and cultivated plants. Increasing contact with the outside world has resulted in a confluence of traditional, often African-derived healing therapies, with the novel healing plant knowledge and allopathic medicine of outsiders.

Resumen: El uso de la pausa al final de la inspiración (PFI) en ventilación mecánica data de hace más de 50 años y con mayor impulso en la década de los 70, se le atribuye una mejoría en la presión parcial de oxígeno arterial (PaO2) al incrementar la presión media de la vía aérea (Pma), mayor aclaramiento de la presión parcial de dióxido de carbono arterial (PaCO2) y permite la monitorización de la presión meseta (Pmeseta) en la mecánica ventilatoria; sin embargo, los estudios clínicos sobre su uso son escasos y controversiales. En este artículo se abordan los mecanismos fisiológicos, fisiopatológicos y la evidencia sobre el uso de la PFI en ventilación mecánica (VM).

Abstract: The use of the end inspiratory pause (EIP) in mechanical ventilation has been going on for more than 50 years and with greater momentum in the 1970s, an improvement in the partial pressure of arterial oxygen (PaO2) is attributed to the increase mean airway pressure, greater clearance of partial pressure of arterial carbon dioxide and allows monitoring of plateau pressure in ventilatory mechanics; However, the Clinical studies on its use are few and controversial. This article addresses the physiological and pathophysiological mechanisms and the evidence on the use of EIP in mechanical ventilation.

Resumo: A utilização da pausa ao final da inspiração (PFI) na ventilação mecânica remonta a mais de 50 anos e com maior impulso na década de 70, atribui-se uma melhora na pressão parcial de oxigênio arterial (PaO2) pelo aumento da pressão média das vias aéreas (Pma), uma maior depuração da pressão parcial de dióxido de carbono arterial (PaCO2) e permite a monitorização da pressão de platô (Pplateau) na mecânica ventilatória, porém estudos Os dados clínicos sobre seu uso são escassos e controversos. Este artigo aborda os mecanismos fisiológicos e fisiopatológicos e as evidências sobre o uso do PFI na ventilação mecânica (VM).

Abstract The United States-Mexico-Canada Agreement (USMCA) was the product of a renegotiation of the former North American Free Trade Agreement (NAFTA) that was intended by the Trump administration to “put America first.” This article analyzes the most important new provisions in the USMCA that that administration believed would inhibit foreign investment in Mexico and reverse the offshoring of U.S. jobs. Some of the new provisions represent improvements over NAFTA, especially the limitations on investor-state dispute settlement and strengthened protections for labor rights. However, the new requirements for automobile production are likely to backfire by making North American automotive production more expensive and less competitive. On the whole, the formation of the USMCA probably enhanced, rather than lessened, the confidence of foreign investors in the Mexican economy. However, the agreement is unlikely to bring about large gains in U.S. manufacturing employment or to boost the long-run growth of the Mexican economy.

Resumen El Tratado México-Estados Unidos-Canadá (T-MEC) fue producto de una renegociación del anterior Tratado de Libre Comercio de América del Norte (TLCAN), en la que pretendía participar la administración de Trump para “poner a Estados Unidos primero” (“put America first”). Este artículo analiza las nuevas medidas más importantes del T-MEC que aquella administración supuso que inhibirían la inversión extranjera en México y regresarían a Estados Unidos los empleos que habían salido de ese país. Algunas de las nuevas medidas representan mejoras respecto al TLCAN, especialmente las limitaciones sobre el arbitraje de diferencias Estado-inversor (investor-state dispute settlement, ISDS) y el reforzamiento de la protección a los derechos laborales. Sin embargo, los nuevos requerimientos para la producción de automóviles parecen querer sabotear la producción de automotores en Norteamérica, al hacerla más cara y menos competitiva. En general, la creación del T-MEC, más que debilitar, probablemente mejora la confianza de los inversionistas en la economía mexicana. Este acuerdo no parece traer grandes ganancias al empleo en el sector manufacturero en Estados Unidos, y no hay nada que indique una disminución de la estrategia de crecimiento de México basada en su dependencia de las exportaciones.

Abstract Most of the contemporary debate about the origin and early diversification of sigmodontine rodents, the most diverse living subfamily of cricetids, is based on the analysis of molecular evidence. In order to promote interest and highlight the importance of fossil evidence, we conducted a critical review of the paleontological record for this group of rodents. Thus, the Mio-Pliocene genera that have been associated directly or indirectly with the origin of the Sigmodontinae are reviewed. Although Honeymys (Oklahoma and Nebraska, USA, Clarendonian, late Miocene) has been tentatively associated with the origin of the Sigmodontinae, the oldest reliable records for the subfamily in North America are around 5 Ma, if Prosigmodon is considered a sigmodontine (a hypothesis not free of controversy). For South America, poorly-known and fragmentary evidence suggests a first occurrence of sigmodontines towards the late Huayquerian (latest Miocene), although the oldest assemblage with some diversity is from the Montehermosan (early Pliocene). For both North and South America, the most relevant findings, their refined chronological locations, as well as a detail of the main taxonomic problems associated with each one, are discussed. All this information is integrated, in a final section, with that derived from molecular phylogenies. As a guide for future phylogenetic studies based on molecular evidence, several fossils are suggested for calibrations.

ABSTRACT Dear Editor, we thank Corral (2020) for his anticipated interest in our paper on the timing of the porphyry-related high-sulfidation epithermal mineralization at Cerro Quema in the Azuero peninsula of southwestern Panama. Our study, based on three Re-Os ages for molybdenite intimately associated with Cu-bearing sulfide minerals from the hypogene roots of the La Pava center (Figure 1), shows that the main event of high-sulfidation Cu mineralization took place during the earliest Maastrichtian at ~71 Ma. The reported ages, together with the geologic relationships described in our paper (Perelló et al., 2020), plus a series of regional geologic, structural, petrochemical, and geotectonic considerations, not only precisely date the porphyry-related nature of the Cerro Quema high-sulfidation mineralization, but are also significant in that they confirm the rapid evolution of the earliest stages of the Central American Arc - from subduction initiation at 75-73 Ma to arc stability and maturation at 71 Ma (e.g., Buchs et al., 2011a and references therein) - and place the mineralization in a regional geodynamic setting. Irrespective of the regional geologic arguments reiterated by Corral (2020) in support of his previous genetic interpretation (e.g.,Corral et al., 2016) and to invalidate our conclusions, Corral's real concern is the reliability of our molybdenite ages, which are much older than his preferred age of mineralization for Cerro Quema. We believe that many of the points raised by Corral (2020), including the regional and local geologic backgrounds of the deposit and the dated samples, were properly addressed in Perelló et al. (2020), and that it would be redundant to repeat them here. Additional petrochemical evidence in support can be found in Whattam and Stern (2015, 2020) and Whatam (2018).

RESUMEN Estimado Editor, agradecemos a Corral (2020) por su interés anticipado en nuestro artículo sobre el momento de la mineralización epitermal de alta sulfuración en relación con el pórfido en el Cerro Quema en la península de Azuero, al suroeste de Panamá. Nuestro estudio, basado en tres edades Re-Os para la molibdenita, íntimamente asociadas con minerales de sulfuro que contienen Cu de las raíces hipógenas del centro de La Pava (Figura 1), muestra que el evento principal de la mineralización de alta sulfuración de Cu tuvo lugar durante la primera Maastrichtiense en ~71 Ma. Las edades reportadas, junto con la relación geológica descrita en nuestro artículo, (Perelló et al., 2020), además de una serie de consideraciones geológicas, estructurales, petroquímicas y geotectónicas regionales, no solo datan con precisión la naturaleza de la alta sulfuración en relación con el pórfido del Cerro Quema, sino que, además, son significativas porque confirman la rápida evolución de las primeras etapas del Arco Centroamericano- desde la iniciación de la subducción a 75-73 Ma hasta la estabilidad del arco y la maduración a 71 Ma (por ejempdo, Buchs et al., 2011a y referencias en él) - y situar la mineralización en un entorno geodinámico regional. Independientemente de los argumentos geológicos regionales reiterados por Corral (2020) en apoyo a su interpretación genética previa (por ejemplo, Corral et al., 2016)y para invalidar nuestras conclusiones, la verdadera preocupación de Corral es la cortfiabilidad de nuestras edades de molibdenita, las cuales son mucho más antiguas que su edad preferida de mineralización para el Cerro Quema. Creemos que muchos de los puntos planteados por Corral (2020), incluidos los antecedentes geológicos locales y regionales del depósitoy las muestrasfechadas, se abordaron adecuadamente en Perelló et al. (2020), por lo que repetirlos aquí sería redundante. Pueden encontrarse pruebas petroquímicas adicionales en Whattamy Stern (2015, 2020) y Whatam (2018).

Abstract The 70.74 to 70.66 Ma age range for three molybdenite samples accompanying pyrite- and enargite-bearing assemblages effectively constrains an earliest Maastrichtian age for the high-sulfidation Au-Cu mineralization at Cerro Quema, Panama. The epithermal system was contemporaneous with emplacement of a composite dacite dome complex in a geotectonic setting transitional from mafic, primitive intraoceanic (Azuero Protoarc) to more evolved island arc magmatism (Azuero Arc), during initial construction of the Central American land bridge at the trailing edge of the Caribbean Large Igneous Province (CLIP). The molybdenite ages confirm the rapid evolution of the earliest stages of the Central American Arc, from subduction initiation at 75-73 Ma to arc maturation at 71 Ma. A porphyry connection is apparent at Cerro Quema and characterized by highly contorted, banded, and planar quartz-veinlet stockworks and sheeted zones in pyrophyllite- and sericite-bearing patchy-textured rock. These are cut by ledges of quartz, alunite, and dickite, which implies overprinting of the advanced argillic lithocap onto the underlying porphyry environment. Hydrothermal telescoping resulted from synmineralization uplift congruent with an actively emerging volcanic arc, which the Re-Os molybdenite dates accurately constrain at 71 Ma, presumably as a far-field effect of collision between the leading edge of the CLIP with parts of North and South America.

Resumen La edad maastrichtiana temprana, entre los 70,74 y 70,66 millones de años, de la mineralización epitermal de Cu-Au de alta sulfuración en Cerro Quema queda definida mediante dataciones Re-Os en molibdenita contenida en vetillas de pirita y enargita. El sistema epitermal evolucionó durante el emplazamiento de un complejo de domos dacíticos en un ambiente geotectónico transicional entre un arco intraoceánico máfico primitivo (Proto Arco Azuero) y un arco de islas más evolucionado (Arco Azuero), durante la construcción inicial de América Central sobre el borde terminal de la provincia magmática caribeña (“Caribbean Large Igneous Province, CLIP”). Las edades en molibdenita confirman la rápida evolución de los estadios tempranos del Arco Centroamericano, desde el inicio de subducción a los 75 - 73 Ma, hasta uno de madurez a los 71 Ma. Se destaca la relación geológica entre el sistema epitermal de Cerro Quema y un ambiente de tipo pórfido en profundidad, caracterizado este último por un conjunto de vetillas de cuarzo de hábito variable, principalmente irregulares, bandeadas y sinuosas (tipo A), distribuidas en forma de enrejados (“stockworks”) y/o como corredores unidireccionales dentro de un pórfido dacítico. Este último desarrolla textura moteada de tipo “patchy”, con ensambles de alteración dominados por pirofilita y sericita. Estas zonas de intenso vetilleo están cortadas por cuerpos (“ledges”) silíceos con abundante alunita y dickita asociados al desarrollo de una litocapa sobreimpuesta al ambiente de pórfido. Se estima que esta sobreimposición hidrotermal habría resultado como parte del surgimiento del arco volcánico contemporáneo con la mineralización de Cerro Quema, alzamiento que queda constreñido de manera precisa por las edades en molibdenita en los 71 Ma. Este alzamiento del arco habría sido, a su vez, gatillado por procesos tectónicos regionales, entre los que se incluye la colisión entre el borde frontal de la CLIP y ciertas regiones continentales de Norte y Sudamérica.

The electrocution of large birds such as eagles and vultures when making simultaneous contact between a phase conductor and the top of a pole on medium voltage woodpole distribution lines is addressed. System (phase-to-phase) voltages of 11 kV, 22 kV and 33 kV are covered. This phenomenon has been investigated by measurement of the resistance of poles used in the field, as well as measurement of the impedance of recently deceased birds. This has previously been used to compile a simple electrical model for 22 kV systems. This paper compiles a detailed model that is used to estimate the risk posed to large birds by this mode of electrocution for all three voltage levels. The results show that only a few scenarios exist whereby a bird may be at risk, which ties in with field experience. Details of how the wood and bird resistance was measured are also included, as are details of calculations performed.

BACKGROUND: The Western Cape province has the highest documented lifetime prevalence of common mental disorders in South Africa. To ensure the efficient, equitable and effective distribution of current resources, there is a need to determine the profile of patients requiring psychiatric admission. AIM: To describe patients admitted to the acute adult admissions unit at Lentegeur Hospital. SETTING: Lentegeur Psychiatric Hospital is situated in Mitchells Plain, Cape Town, and serves about 1 million people from nearby urban and rural areas. METHODS: This retrospective study involved an audit of all patients (18-60 years of age) admitted between 01 January 2016 and 30 June 2016. The clinical records of 573 adult patients were examined RESULTS: The median age of the cohort was 29 years. Most patients (63%) were educated to the secondary level. Only 12% of the patients were employed, and 37% received disability grants. More than 90% of the patients presented with psychotic symptoms. Of these, 28% presented with a first-episode of psychosis. Of all patients, 20% were referred with manic symptoms and 7% with depressive symptoms. Many patients (62%) used substances concurrently in the period leading up to admission. Significantly more males (73%) used substances compared to females (38%). Cannabis was the most widely used substance (51%), followed by methamphetamine (36%). Recent violent behaviour contributed to 37% of the current admissions. A total of 70 patients (13%) tested positive for human immunodeficiency virus (HIV), and 49 (9%) tested positive for syphilis. CONCLUSION: Substance use and a history of violence contributed to admissions in this population.

Abstract In this paper, we introduce fuzzy soft attribute correlation coefficient and apply it to find the correlation between vulnerability government response of various countries related to human trafficking based on six regions with the help of data from “The Global Slavery Index 2016”. Comparison of fuzzy soft attribute correlation coefficients is done with the conventional analysis of sociology by calculating Pearson’s zero-order product-moment correlations. Along with these, some fundamental concepts of mathematical statistics are developed with respect to fuzzy soft set.

The iron complex hexacyanoferrate (Fe4[Fe(CN)6]3), known as Prussian Blue (PB), was electrodeposited over a free-standing carbon nanotube (CNT) film assembled at the interface between two immiscible liquids, water and 1,2-dichlorobenzene. Polarization of the interface achieved through a fixed potential or under potential variation enabled iron present inside CNTs to generate a stable CNT/PB composite. We report herein on the observation that the deposition of PB is dependent on both the pH and applied potential. It was found that aqueous phases containing K3[Fe(CN)6] can decompose under an applied potential, while those containing K4[Fe(CN)6] presented more stable behavior making it a suitable precursor for PB synthesis. The electrodeposition and modification of the interface was followed by in situ spectroelectrochemical Raman spectroscopy, which indicated that an increase in signal due to PB formation was acompanied by changes in the CNT bands due to modification of the CNT walls by decoration with PB, forming a composite structure.

RESUMO Objetivo: Descrever os desfechos de pacientes com síndrome do desconforto respiratório agudo associada à influenza subtipo H1N1 grave tratados com oxigenação por membrana extracorpórea. Métodos: Trata-se de revisão retrospectiva de uma coorte de pacientes oriunda de um único centro, constituída por adultos com síndrome do desconforto respiratório agudo relacionada com influenza subtipo H1N1 e tratados com oxigenação venovenosa por membrana extracorpórea durante a temporada de inverno no hemisfério norte de 2013/2014. Resultados: Dez pacientes receberam oxigenação venovenosa por membrana extracorpórea para tratamento de influenza subtipo H1N1 entre janeiro de 2013 e março de 2014. Sete deles foram transferidos para nosso centro visando à utilização de oxigenação por membrana extracorpórea dentro de um período de 72 horas após o início da ventilação mecânica. A idade mediana foi de 40 anos, sendo 30% dos pacientes do sexo feminino. O valor mediano da proporção entre pressão parcial de oxigênio e fração inspirada de oxigênio foi de 62,5, sendo o escore RESP mediano de 6. Três pacientes receberam inalação de óxido nítrico e quatro utilizaram posição prona como tratamento de resgate antes de ser iniciada a oxigenação por membrana extracorpórea. A duração mediana da ventilação mecânica foi de 22 dias (variação de 14 - 32). O tempo mediano de permanência na unidade de terapia intensiva foi de 27 dias (variação de 14 - 39). O tempo mediano de permanência no hospital foi de 29,1 dias (variação de 16,0 - 46,9). Ocorreram complicações não importantes de sangramento em seis dos dez pacientes. Oito dos dez pacientes sobreviveram até a alta hospitalar. Conclusão: Os sobreviventes eram relativamente jovens e tiveram alta com boas condições funcionais, o que salienta os anos de vida ajustados pela qualidade que foram salvos. Nossa experiência demonstra que mesmo um programa ainda relativamente novo de oxigenação por membrana extracorpórea pode desempenhar um papel importante, e proporcionar resultados excelentes para os pacientes mais graves.

ABSTRACT Objective: This report aimed to describe the outcomes of the patients with severe H1N1 associated acute respiratory distress syndrome who were treated with extracorporeal membrane oxygenation therapy. Methods: This retrospective review analyzed a single-center cohort of adult patients with H1N1-related acute respiratory distress syndrome who were managed with veno-venous extracorporeal membrane oxygenation during the winter of 2013/2014. Results: A total of 10 patients received veno-venous extracorporeal membrane oxygenation for H1N1 influenza between January 2013 and March 2014. Seven patients were transferred to our center for extracorporeal membrane oxygenation consideration (all within 72 hours of initiating mechanical ventilation). The median patient age was forty years, and 30% were female. The median arterial oxygen partial pressure to fraction of inspired oxygen ratio was 62.5, and the median RESP score was 6. Three patients received inhaled nitric oxide, and four patients were proned as rescue therapy before extracorporeal membrane oxygenation was initiated. The median duration of mechanical ventilation was twenty-two days (range, 14 - 32). The median length of stay in the intensive care unit was twenty-seven days (range, 14 - 39). The median hospital length of stay was 29.1 days (range, 16.0 - 46.9). Minor bleeding complications occurred in 6 of 10 patients. Eight of the ten patients survived to hospital discharge. Conclusion: The survivors were relatively young and discharged with good functional status (i.e., enhancing quality-adjusted life-years-saved). Our experience shows that even a relatively new extracorporeal membrane oxygenation program can play an important role in that capacity and provide excellent outcomes for the sickest patients.