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Background: Chagas disease (CD), caused by the parasite Trypanosoma cruzi, is the most important endemic anthropozoonosis in Argentina. Since 2010, the World Health Organization has highlighted the urgent need to validate diagnostic systems that allow rapid detection of T. cruzi, infection in primary healthcare centers. Serological rapid diagnostic tests (RDTs) for T. cruzi, infection could be used to improve case management, as RDTs do not require specialized laboratories or highly trained staff to use them. We aimed to generate unbiased performance data of RDTs in Argentina, to evaluate their usefulness for improving T. cruzi, diagnosis rates. Methods and principal findings: This is a retrospective, laboratory-based, diagnostic evaluation study to estimate the clinical sensitivity/specificity of four commercially available RDTs for T. cruzi, using the Chagas disease diagnostic algorithm currently used in Argentina as the reference standard. In total, 400 serum samples were tested, 200 from individuals with chronic T. cruzi infection and 200 from individuals not infected with T. cruzi. All results were registered as the agreement of at least two operators who were blinded to the reference standard results. The sensitivity estimates ranged from 92.5–100% (95% confidence interval (CI) lower bound 87.9–98.2%); for specificity, the range was 76–96% (95% CI lower bound 69.5–92.3%). Most RDTs evaluated showed performances comparable with the reference standard method, showing almost perfect concordance (Kappa 0.76–0.92). Conclusions: Our study demonstrates that, under controlled laboratory conditions, commercially available RDTs for CD have a performance comparable to the Argentinian diagnostic algorithm, which is based on laboratory-based serological tests. For the next stage of our work, the RDTs will be evaluated in real-world settings. Author summary: Trypanosoma cruzi is the causative agent of Chagas disease, the most significant transmissible disease between animals and humans in Argentina. It is estimated that two-thirds of individuals with the disease currently reside in urban areas, and globally, only 10% of those affected are aware of their condition. The diagnosis of chronic infection requires conducting at least two different laboratory tests mainly available at reference laboratories, which poses logistical and economic challenges for both the patients and the health systems, and it often results in limited access to high-quality diagnosis. Primary healthcare has the potential to address around 90% of the population's healthcare needs over their lifetime. Although there are rapid diagnostic tests for T. cruzi infection, that could be potentially incorporated at lower levels of the healthcare system in Argentina, there is a lack of independent evaluation of the available tests. In fact, since 2010 the World Health Organization emphasized the need of evaluating diagnostic tests that enable the rapid detection of T. cruzi infection in primary care centers. In this study, we assessed under controlled laboratory conditions the ability of the rapid diagnostic tests for confirming or ruling out the chronic infection in patients in Argentina. [ABSTRACT FROM AUTHOR]

Bolivia has the highest incidence of Chagas disease (CD) worldwide. Caused by the parasite Trypanasoma cruzi, CD is generally a chronic condition. Diagnosis is logistically and financially challenging, requiring at least two different laboratory-based serological tests. Many CD cases are missed; in Bolivia it is estimated just 6% of individuals chronically infected with T. cruzi get diagnosed. Achieving control on the way to elimination of CD requires a radical simplification of the current CD testing pathways, to overcome the barriers to accessing CD treatment. We aimed to generate unbiased performance data of lateral flow assays (LFAs) for T. cruzi infection in Bolivia, to evaluate their usefulness for improving T. cruzi diagnosis rates in a precise and efficient manner. This retrospective, laboratory-based, diagnostic evaluation study sought to estimate the sensitivity/specificity of 10 commercially available LFAs for T. cruzi, using the current CD diagnostic algorithm employed in Bolivia as the reference test method. All tests were blinded at the study site and performed by three operators. In total, 470 serum samples were tested, including 221 and 249 characterized as CD-positive/-negative, respectively. The LFAs were scored according to their relative importance using a decision-tree-based algorithm, with the mean decrease in Gini index as the scoring metric. The estimates of sensitivities ranged from 62.2–97.7% (95% confidence interval (CI) lower bound 55.0–94.7%); for specificities the range was 78.6–100% (95% CI lower bound 72.0–97.5%); 5/10 and 6/10 tests had sensitivity >90% and specificity >95%, respectively. Four LFAs showed high values of both sensitivity (93–95%) and specificity (97–99%). The agreement between 6 LFAs and the reference tests was almost perfect (Kappa 0.83–0.94). Most LFAs evaluated thus showed performances comparable with current laboratory-based diagnostic methods. Author summary: Chagas disease (CD) is caused by the parasite Trypanasoma cruzi. CD is generally a chronic condition. Individuals living in vulnerable situations and marginalized populations are often more susceptible to CD infection and morbidity, determined by, among other factors, a lack of access to timely diagnosis and care. However, diagnosing CD is difficult and expensive, requiring at least two different laboratory-based tests in highly specialized facilities, and many cases of CD go undiagnosed. In Bolivia, which has the highest incidence of CD worldwide, it is estimated that just 6% of chronically infected individuals get diagnosed. Lateral flow assays (LFAs) are tests that could be used to improve case management, especially in hard-to-reach populations, as they do not need specialized laboratories or highly trained people to use them. We carried out a study to evaluate LFAs that can be used for the rapid detection of CD infection, to evaluate their usefulness for diagnosis. Most of the tests we evaluated under controlled laboratory conditions were comparable to those of current laboratory-based diagnostic methods. [ABSTRACT FROM AUTHOR]

One of the main problems in current flotation plants and new projects is the significant decrease in feed grades and changes in the mineral composition, which has an important effect on the mineral liberation and associations. Additionally, flotation plants usually operate with a feed throughput higher than the original design, which has a significant impact on the feed particle size. All these conditions affect the metallurgical performance, and they must be evaluated and addressed by improving the control strategies for the optimization of banks. For this purpose, the flotation of valuable minerals along the circuits requires better understanding, considering the compromise between performance and selectivity in flotation circuits. This paper presents a characterization of the different minerals recovered along industrial flotation circuits. Plant sampling campaigns, performed in a copper industrial concentrator in Chile, provided the data for the study. Two rougher flotation banks consisting of cells of 130 m3 and 300 m3, were evaluated. All the samples from the industrial surveys were analysed by screening and mineralogy, and the mineral recovery along the circuits was evaluated per particle size class, liberation class, type of associations, and others. Additionally, operating data on froth depth profiles complemented the evaluation of the mineral composition of concentrate streams along the circuit. The results allowed for identifying and quantifying the main factors that affect the copper recovery and concentrate grade along the flotation banks. We found that minerals with liberation lower than 50% have a significant impact on the recovery. On the other hand, the decrease in the Cu grade in concentrates along the flotation circuits is mainly due to the relative increase of middling minerals (less liberated), non-valuable floatable minerals, such as free pyrite, and gangue entrainment. The characterization of the gangue entrainment flowrate along the flotation banks showed a strong relationship with froth depth, which becomes more critical towards the last cells of the banks. [ABSTRACT FROM AUTHOR]

The SARS-CoV2 promotes dysregulation of Renin–Angiotensin–Aldosterone. The result is excessive retention of water, producing a state of noxious hypervolemia. Consequently, in COVID-19 injury lung is pulmonary edema. Our report is a case–control study, retrospective. We included 116 patients with moderate–severe COVID-19 lung injury. A total of 58 patients received standard care (Control group). A total of 58 patients received a standard treatment with a more negative fluid balance (NEGBAL group), consisting of hydric restriction and diuretics. Analyzing the mortality of the population studied, it was observed that the NEGBAL group had lower mortality than the Control group, p = 0.001. Compared with Controls, the NEGBAL group had significantly fewer days of hospital stay (p < 0.001), fewer days of ICU stay (p < 0.001), and fewer days of IMV (p < 0.001). The regressive analysis between PaO2/FiO2BAL and NEGBAL demonstrated correlation (p = 0.04). Compared with Controls, the NEGBAL group showed significant progressive improvement in PaO2/FiO2 (p < 0.001), CT score (p < 0.001). The multivariate model, the vaccination variables, and linear trends resulted in p = 0.671 and quadratic trends p = 0.723, whilst the accumulated fluid balance is p < 0.001. Although the study has limitations, the promising results encourage more research on this different therapeutic approach, since in our research it decreases mortality. [ABSTRACT FROM AUTHOR]

Aim: To analyze the presence of fetal myocardial dysfunction in intrahepatic cholestasis of pregnancy (ICP) at diagnosis. Methods: This prospective cohort study included 49 pregnant participants with ICP at diagnosis and 49 nonaffected controls from a single public hospital. ICP was diagnosed based on clinical symptoms after excluding other causes of pruritus and presence of autoimmune diseases. Total bile acids were not obtained in this cohort. ICP pregnancies were assessed with a functional echocardiography at diagnosis including PR‐interval, isovolumetric contraction time (ICT), ejection time (ET), and isovolumetric relaxation time (IRT) for electrical, systolic, and diastolic function, respectively. Controls were assessed at recruitment. Perinatal outcomes were obtained from delivery books. The main outcome was the presence of PR‐interval prolongation or first‐degree fetal heart block, and echographic signs of diastolic and systolic dysfunction. Results: Compared to controls, ICP were above upper limit in conjugated bilirubin (2.0% vs. 20.4%; p = 0.008), aspartate aminotransferase (2.0% vs. 24.5%; p = 0.002), and alanine aminotransferase (4.1% vs. 28.6%; p = 0.002). ICP was associated with a higher PR‐interval (130 ± 12 ms vs. 121 ± 6 ms; p < 0.0001) with five first‐degree fetal heart blocks. IRT was significantly higher in ICP (42 ± 6 ms vs. 37 ± 5 ms; p = 0.0001), with no differences in ICT and ET. PR‐interval trend was only positively correlated with IRT in ICP pregnancies (p = 0.04 and p = 0.34, in ICP and controls, respectively). Conclusions: Our study demonstrates that fetuses affected by maternal ICP are associated with electrical and diastolic myocardial dysfunction. More studies focused on antenatal and postnatal functional echocardiography are necessary to validate our results and consider these markers in the clinical management of ICP pregnancies. [ABSTRACT FROM AUTHOR]

Epstein Barr virus (EBV) gains access to the host through tonsillar crypts. Our aim was to characterize microenvironment composition around EBV+ cells in tonsils from pediatric carriers, to disclose its role on viral pathogenesis. LMP1 expression, assessed by immunohistochemistry (IHC), was used to discriminate EBV + and - zones in 41 tonsil biopsies. Three regions were defined: Subepithelial (SE), interfollicular (IF) and germinal center (GC). CD8, GrB, CD68, IL10, Foxp3, PD1, CD56 and CD4 markers were evaluated by IHC; positive cells/100 total cells were counted. CD8+, GrB+, CD68+ and IL10+ cells were prevalent in EBV+ zones at the SE region (p < 0.0001, p = 0.03, p = 0.002 and p = 0.002 respectively, Wilcoxon test). CD4+ and CD68+ cell count were higher in EBV + GC (p = 0.01 and p = 0.0002 respectively, Wilcoxon test). Increment of CD8, GrB and CD68 at the SE region could indicate a specific response that may be due to local homing at viral entry, which could be counterbalanced by IL10, an immunosuppressive cytokine. Additionally, it could be hypothesized that CD4 augment at the GC may be involved in the EBV-induced B-cell growth control at this region, in which macrophages could also participate. [ABSTRACT FROM AUTHOR]

Despite the growing incidence of child exploitation offences, there is little knowledge of the neuropsychological function of older child exploitation material offenders (CEMOs). Given that studies have reported that sex offenders demonstrate deficits attributed to frontal and temporal lobe function, the aim of this pilot study was to investigate the frontotemporal function of older first-time child exploitation material offenders (FTCEMOs). The neuropsychological performance of 11 older FTCEMOs was compared with 34 older historical sex offenders (HSOs) and 32 older nonsex offender (NSO) controls. Forty-five percent of FTCEMOs admitted to a pedophilic interest, which was significantly lower than those reported by HSOs. FTCEMOs provided significantly higher intellectual function scores than HSOs. Results revealed no evidence of mild or major neurocognitive disorder in FTCEMOs. Although the groups were not significantly different, compared with normative data, FTCEMOs reported a high incidence of impairment on a measure of decision making and on a measure of facial emotional recognition. [ABSTRACT FROM AUTHOR]

Background/aims: The issue of whether sex offenders have cognitive deficits remains controversial. The objective of this study was to compare the neuropsychological function of older adult first time sex-offenders (FTSO), who had not previously been charged with a sexual offence prior to the age of 50, to historical long-term sex offenders (HSO) and non-sex offenders (NSO). The hypotheses were (a) that FTSO would demonstrate greater deficits in executive function, decision-making, and memory compared to non-sex offenders; and (b) the HSOs would present similar neuropsychological deficits to non-sex offenders.Method: A battery of neuropsychological measures was administered to 100 participants comprising 32 FTSOs, 36 HSOs, and 32 NSOs.Results: Both FTSOs and HSOs showed significant impairment on tests of executive function (including verbal fluency, trail-making, and the Hayling test of response inhibition) as well as on tests of verbal and verbal memory compared to NSOs; however, there was no difference between the two sex offender groups.Conclusions: Older adult sex offenders, overall, demonstrated poorer neuropsychological performance than older adult non-sex offenders did, although there was no difference between older first-time and historical offenders. Cognitive deficits may increase the risk of sexual offending due to impaired capacity in self-regulation, planning, judgment, and inhibition. A proportion of older adult sex offenders may be harboring acquired frontal lobe pathology. [ABSTRACT FROM AUTHOR]

BACKGROUND: The Hartmann's operation, although less frequently performed today, is still used when initial colonic anastomosis is too risky in the short term. However, the subsequent procedure to restore gastrointestinal continuity is associated with significant morbidity and mortality. PATIENTS AND METHODS: The review of an institutional review board (IRB)-approved prospectively maintained database provided data on the Hartmann's reversal procedure performed by either laparoscopic or open technique at our institution. The data collected included: demographic data, operative approach, conversion for laparoscopic cases and perioperative morbidity and mortality. RESULTS: Over a 14-year period from January 1997 to August 2011, 74 Hartmann's reversal procedures were performed (laparoscopic surgery-49, open surgery-25). The average age was 55 years for the laparoscopic and 57 years for the open surgery group, respectively. Male patients represent 61% of both groups. There was no significant difference in operative time between the two groups (149 min vs 151 min; P = 0.95), and there was a tendency to lower morbidity (3/49-7.3% vs 4/25-16%; P = 0.24) in the laparoscopic surgery group. In the laparoscopic group, eight patients (16.3%) were converted to open surgery, mostly due to severe adhesions. The length of hospital stay was significantly shorter for the laparoscopic group (5 days vs 7 days; P = 0.44). CONCLUSIONS: The Hartmann's reversal procedure can be safely performed in the majority of the cases using a laparoscopic approach with a low morbidity rate and achieving a shorter hospital stay. [ABSTRACT FROM AUTHOR]

Background Availability of child pornography on the Internet has created new opportunities for offending. It has been noted that many people charged with offences relating to this had not previously been identified as sexual offenders against children. Aim Our aim was to compare the characteristics of people charged with child pornography offences as a result of police monitoring of the Internet with those detected by other means. We hypothesised that those apprehended via the Internet would e b more likely to be older and less likely to have severe psychiatric disorder or to have been previously charged with a sexual offence involving contact with a child than those identified by other means. Methods Data were extracted from the findings of clinical examinations by the authors either in the course of preparing reports for court, or in the course of providing treatment. Results There were 52 men detected by police Internet surveillance and 53 men detected by other means, the latter including 16 men who had not been charged with an offence at the time of referral. Those detected via the Internet were more likely to be in possession of very large quantities of child pornography. Those detected by other means were more likely to have major psychiatric and substance abuse disorders and to report childhood sexual abuse. A subgroup analysis of the 89 people who were facing charges at the time of the assessment found that the only significant differences were in the amount of material and the history of sexual abuse. Conclusions The men recruited to this study, conducted over a period of nearly 10 years, reflect the changing nature of the technology used to commit this type of offence in that time. The characteristics of the subjects did not confirm the stereotype of an Internet child pornography offender who was high functioning and otherwise well adjusted and carried a low risk of other types of offences. [ABSTRACT FROM AUTHOR]

Objective: The purpose of this study was to describe the demographic and clinical variables of the conditionally released forensic patient population in New South Wales. Method: Data were gathered from 74 conditionally released forensic patients. Results: Of this population, 37% had committed homicides and 50% had committed serious violent offences (attempted murder, grievous bodily harm or robbery). Approximately two-thirds had their first admission to a psychiatric hospital before the age of 30. The majority (83%) of patients were diagnosed with schizophrenia and 55% had a history of substance use disorders; 24% were deemed to have been intoxicated at the time of the offence. Conclusions: Conditionally released forensic patients in NSW show similar characteristics to those in other jurisdictions. Areas identified for further evaulation are comorbid substance use and rehabilitation, longer term outcomes and the under representation of indigenous persons. [ABSTRACT FROM AUTHOR]

In COVID-19, pulmonary edema has been attributed to "cytokine storm". However, it is known that SARS-CoV2 promotes angiotensin-converting enzyme 2 deficit, increases angiotensin II, and this triggers volume overload. Our report is based on COVID-19 patients with tomographic evidence of pulmonary edema and volume overload to whom established a standard treatment with diuretic (furosemide) guided by objectives: Negative Fluid Balance (NEGBAL approach). Retrospective observational study. We reviewed data from medical records: demographic, clinical, laboratory, blood gas, and chest tomography (CT) before and while undergoing NEGBAL, from 20 critically ill patients. Once the NEGBAL strategy was started, no patient required mechanical ventilation. All cases reverted to respiratory failure with NEGBAL, but subsequently two patients died from sepsis and acute myocardial infarction (AMI). The regressive analysis between PaO2/FiO2BAL and NEGBAL demonstrated correlation (p < 0.032). The results comparing the Pao2Fio2 between admission to NEGBAL to NEGBAL day 4, were statistically significant (p < 0.001). We noted between admission to NEGBAL and day 4 improvement in CT score (p < 0.001), decrease in the superior vena cava diameter (p < 0.001) and the decrease of cardiac axis (p < 0.001). Though our study has several limitations, we believe the promising results encourage further investigation of this different pathophysiological approach. [ABSTRACT FROM AUTHOR]

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The article discusses the variations in transfer pricing throughout Latin America. Brazilian legislation allows revisions of fixed margins. Interest payments in Brazil must be registered and authorized by the central bank. All countries, except Brazil, have adopted transfer pricing methods provided for in the Organization for Economic Cooperation and Development guidelines. This include comparable uncontrolled price, resale price, cost plus, profit split including residual profit split and transactional net margin method.

Aim: To evaluate the immunohistopathological changes in the contralateral testis of rats after an experimental spermatic cord torsion. Methods: Male Sprague–Dawley rats of 45–50 days old were subjected to a 720° unilateral spermatic cord torsion for 10, 30 and 80 days (experimental group, E), respectively or sham operation (control group, C). Histopathology of the contralateral testis as well as germ cell apoptosis were studied using the Terminal Deoxynucleotidyl Transferase Biotin-dUTP Nick End Labeling (TUNEL) technique. The number of testicular lymphocytes, mast cells and macrophages, and the expression of tumor necrosis factor-α (TNF-α) and its receptor (TNFR1) in testicular cells of the contralateral testis were quantified by histochemistry and immunohistochemistry. TNF-α concentration in testicular fluid was determined by ELISA. Results: In the contralateral testis of rats from the E group, the maximal degree of damage of the germinal epithelium was seen 30 days after torsion. At this time we observed in the E group vs. the C group increases: (i) the number of testicular T-lymphocytes; (ii) the number of testicular mast cells and macrophages; (iii) the percentage of macrophages expressing TNF-α; (iv) TNF-α concentration in testicular fluid; (v) the number of apoptotic germ cells; and (vi) the number of TNFR1+ germ cells. Conclusion: Experimental spermatic cord torsion induces, in the contralateral testis, a focal damage of seminiferous tubules characterized by apoptosis and sloughing of germ cells. Results suggest humoral and cellular immune mediated testicular cell damage in which macrophages and mast cells seem to be involved in the induction of germ cell apoptosis through the TNF-α/TNFR1 system and in the modulation of the inflammatory process. [ABSTRACT FROM AUTHOR]

Our aim was to evaluate the analytical and clinical performance of the SARS-CoV-2 molecular detection kits used in Argentina. Nine real-time reverse-transcription polymerase chain reaction (RT-qPCR) and three reverse-transcription loop-mediated isothermal amplification (RT-LAMP) assays were evaluated using the World Health Organization (WHO) recommended test as reference method. A secondary standard calibrated for the E, N and RdRp genes against the Pan American Health Organization—World Health Organization—International Standard was used to calculate the limit of detection (LoD). A panel of artificial clinical samples, 32 positive and 30 negative for SARS-CoV-2, were analyzed to estimate the kappa concordance (κ) and the diagnostic performance. Differences among the LoD values for the target genes amplified by each kit were >1 log copies/reaction. The κ for the RT-qPCR kits was greater than 0.9, whereas that for the RT-LAMP assays ranged from 0.75 to 0.93. The clinical performance of RT-qPCR kits showed 100% specificity and high sensitivity, although with variations according to the gene analyzed. The E and N genes provided greater clinical sensitivity, whereas the RdRp gene increased the clinical specificity. The RT-LAMP assays revealed a variable diagnostic performance. The information provided can be useful to choose the most appropriate diagnostic test and may contribute to the establishment of a consensus in the diagnosis of SARS-CoV-2 in Argentina and the region. [ABSTRACT FROM AUTHOR]