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The objective of the study was to analyze the somatotype, anthropometric characteristics, body composition, and the global flexibility battery test. A total of 48 athletes of both sexes from Women's Artistic Gymnastics, Men's Artistic Gymnastics, and Hoop Sport (mean ± standard deviation, age 12.50 ± 2.67 years, body mass 43.16 ± 11.00 kg, height 150.15 ± 11.91 cm). Anthropometric data were obtained using the ISAK protocol. The somatotype was analyzed using the Heath-Carter method. The results indicate significant differences in fat, bone, and residual mass, as well as in the proportions of endomorphy, mesomorphy, and ectomorphy (p <0.05). The somatocard revealed that most athletes were classified as endomorphic mesomorph or ectomorphic mesomorph, with variations between groups. Positive and negative correlations were identified between the anthropometric variables, somatotype, body composition, and global flexibility. All positions of the global flexibility battery test showed negative correlations with residual mass, indicating that the greater the range of flexibility, the lower the residual mass., Competing Interests: There are not conflicts of interest to declare., (Copyright: © 2024 González Macías, Flores. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

Objectives.: Motivation for the study. During the COVID-19 pandemic, the mortality rate from this disease was higher in adults and the elderly. Therefore, it is important to identify the factors that were associated with mortality from COVID-19 in adults, by age group. Main findings. Chronic neurological disease, kidney disease, liver disease, and cancer increased the risk of dying from COVID-19 in the three age groups we analyzed, which were made up of hospitalized patients from Lima and Callao. The risk of mortality associated with comorbidities was higher in patients aged 18 to 29. Implications. This study helps to identify the groups of patients with the highest risk of death from COVID-19, according to age group and type of comorbidity. . To evaluate comorbidities associated with mortality in adult patients hospitalized due to COVID-19 in hospitals in Lima and Callao., Materials and Methods.: In this retrospective cohort study, we analyzed data from adult patients hospitalized due to COVID-19 reported to the National Epidemiological Surveillance System of the Peruvian Ministry of Health from March to October 2020. We estimated relative risks with 95% confidence intervals using Poisson regression models with robust variance to assess comorbidities associated with mortality by age group: young adults (18-29 years), adults (30-59 years) and older adults (≥60 years)., Results.: We included 2366 young adults, 23,781 adults and 25,356 older adults. Older adults had the highest mortality (63.7%) compared to adults (27.1%) and young adults (8.5%). Regardless of age group, the presence of neurological disease, renal disease, liver disease, and cancer was associated with an increased risk of mortality. Additionally, cardiovascular disease was also a risk factor in young adults; obesity, diabetes, cardiovascular disease, chronic lung disease, and immunodeficiency in adults; and obesity and chronic lung disease in the elderly., Conclusions.: Regardless of age groups, individuals with chronic neurologic disease, renal disease, liver disease, and cancer were at high risk of death from COVID-19.

Intravascular lipomas (IVL) located in the superior vena cava (SVS) are rare benign primary venous tumors with less than 15 cases reported in the literature. We report a case of a 64-year-old woman with IVL of the SVC extending to the right brachiocephalic vein. She was treated successfully using a hybrid procedure which involved endovascular control of the right subclavian vein and surgical approach via median sternotomy followed by mass resection and use of pericardial patch for vein defect closure.

Introduction: Peru has suffered an increase of Guillain Barre Syndrome incidence since 2015, being the biggest outbreak during 2019. We aimed to describe the clinical features, outcomes, and factors associated with mortality among cases reported in the 2019 outbreak., Methods: Cross-sectional analysis of data from the National Surveillance of Guillain Barre Syndrome of the National Center for Control Disease and Prevention of Peru. We included all cases that met the Brighton criteria, level 1 to level 3. We used multivariable logistic regression to determinate factors associated with mortality., Results: Overall, 772 cases were analyzed (58.7% male; mean age, 41.7 ± 20.3). 86.0% of cases aged over 30 years. 71.4% had a respiratory or gastrointestinal infection in the last 4 weeks. Case fatality rate was 4.3% and 32.2% of survivors reported sequelae. Axonal subtypes were identified in 75.6% of cases with an available nerve conduction study (38.7%). Age and impaired function of cranial nerves were independently associated with mortality., Conclusions: The 2019 outbreak of Guillain Barre syndrome in Peru was an unprecedented event that affected several regions of the country. Axonal damage was more frequent than demyelinating involvement, which is compatible with findings pointing to Campylobacter jejuni as the triggering agent. The case fatality rate was similar to that reported previously in Peru and other countries, but the high frequency of sequelae is striking., (© 2022. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany.)

Aloe vera products, both in food and cosmetics, are becoming increasingly popular due to their claimed beneficial effects, which are mainly attributed to the active compound acemannan. Usually, these end products are based on powdered starting materials. High temperatures during the drying process to obtain the starting materials have several advantages, like shortening the drying time, eliminating toxic aloin and reducing bacterial contamination. Nevertheless, there are two major drawbacks: first, at temperatures of 80 °C or higher, structural changes in acemannan, especially its deacetylation (>46%), are triggered, which does not happen at lower temperatures (14% at 60 °C); secondly, a toxic principle is formed at higher temperatures, resulting in a higher cytotoxicity. Thus, two temperature-dependent but opposing effects cause with a median cytotoxic concentration of CC50 = 0.4× a peak of cytotoxicity at 80 °C; at 60 °C this cytotoxic substance is not formed and at 100 °C aloin is more readily eliminated, resulting in a CC50 = 1.1× and CC50 = 1.4×, respectively. The cytotoxic substance generated by dry heat at 80 °C is not a modified polysaccharide because its polysaccharide-enriched alcohol-insoluble fraction is with CC50 = 0.9× less cytotoxic. Moreover, this substance is polar enough to be washed away with ethanol. Additionally, when Aloe gel is heated at 80 °C under humid conditions (pasteurization), the cytotoxicity does not increase (CC50 = 1.6×). Finally, to produce powdered starting materials from Aloe gel, it is recommended to use temperatures of around 60 °C in order to preserve the acemannan structure (and thus biological activity) and the low cytotoxicity.

Background: Coarctation of the aorta (CoA) can either present alone as an isolated condition or in association with other aortic arch or cardiac anomalies. One percent of patients with CoA have concomitant an aberrant right subclavian artery (ARSA). Purpose: We report the case of a 35-year-old woman with uncontrolled hypertension who was found to have CoA and ARSA. Results: The patient was treated successfully using a hybrid procedure comprising ARSA ligation and subclavian to carotid transposition, followed by thoracic endovascular aortic repair. Conclusions: Patients with CoA should be carefully studied, considering the possible coexistence of other congenital aortic arch defects, such as ARSA. Hybrid repair is a safe and effective approach for this condition.

COVID-19 pandemic is ongoing for more than a year and has changed priorities and boosted some WBE studies. The aim of this work is to contributed to our knowledge sharing the methodology developed for SARS-CoV-2 detection in wastewater of Madrid region of over six million and a half inhabitants, where the sewer system is a combined system. At first, a pilot test in a small metropolitan area was carried out in order to define the criteria for the selection of the sampling points to be applied to the entire region. Methodologys for laboratory analysis and statistical analysis and interpretation of data are also presented. This work relies highly on fieldwork, so sewer network safe accessibility is paramount. A total of 289 sampling points were weekly characterised. Each sampling point represents a sewershed, some of them in a cascade distribution. Samples are tested for SARS-CoV-2 concentration (gc/L, genome copies per litre) and physicochemical parameters are also analysed to validate or discard what at first could be an unusual virus presence. Field results are correlated with health indicators such as incidence rates and hospitalisation data. This information is daily shared with regional health authorities, disaggregated by municipalities, or aggregated for the entire Madrid region. Results have proved to anticipate health indicators. The tool is used as an early warning indicator for COVID-19 pandemic. Further work is planned to apply the current scheme for a permanent epidemiological surveillance system of 87 sampling points to pinpoint infection hotspots and activate the linked sewersheds in the event of an outbreak., (Copyright © 2021. Published by Elsevier Inc.)

Historically, the taxonomic identification of the two snook species, Centropomus viridis and C. nigrescens, has been challenging due to their morphological similarity and the inconsistency of the characters used for diagnosis. Therefore, this study aimed to evaluate the usefulness of the morphologic, meristic, and morphometric characters currently being used to identify C. viridis and C. nigrescens, based on molecular data. The results showed that the gas-bladder shape (i.e., C. viridis with diverticula and C. nigrescens without diverticula) was the only morphological character univocally related to genetic identification. Likewise, geometric morphometrics separated two groups; each corresponds to only one of two genetically (and gas bladder shape) identified species. Of all the meristic characters examined, only the second dorsal fin ray count (nine for C. viridis and ten for C. nigrescens) was related to the gas bladder shape and genetic identity; therefore, it is the only external character with a diagnostic utility to separate each species.

We present an experimental and theoretical physical random bit (PRB) generator using the mesoscopic chaos from a photonic-crystal optomechanical microcavity with a size of ∼10µm and very low operating intracavity energy of ∼60 Femto-Joule that was fabricated with CMOS compatible processes. Moreover, two kinds of PRB generation were proposed with rates over gigabits per second (Gbps). The randomness of the large PRB strings was further verified using the NIST Special Publication 800-22. In addition, the Diehard statistical test was also used to confirm the quality of the obtained PRBs. The results of this study can offer a new generation of dedicated PRB solutions that can be integrated on Si substrates, which can speed up systems and eliminate reliance on external mechanisms for randomness collection.

Modern navigation systems integrate the global positioning system (GPS) with an inertial navigation system (INS), which complement each other for correct attitude and velocity determination. The core of the INS integrates accelerometers and gyroscopes used to measure forces and angular rate in the vehicular inertial reference frame. With the help of gyroscopes and by integrating the acceleration to compute velocity and distance, precision and compact accelerometers with sufficient accuracy can provide small-error location determination. Solid-state implementations, through coherent readout, can provide a platform for high performance acceleration detection. In contrast to prior accelerometers using piezoelectric or capacitive readout techniques, optical readout provides narrow-linewidth high-sensitivity laser detection along with low-noise resonant optomechanical transduction near the thermodynamical limits. Here an optomechanical inertial sensor with an 8.2 μg Hz -1/2 velocity random walk (VRW) at an acquisition rate of 100 Hz and 50.9 μg bias instability is demonstrated, suitable for applications, such as, inertial navigation, inclination sensing, platform stabilization, and/or wearable device motion detection. Driven into optomechanical sustained-oscillation, the slot photonic crystal cavity provides radio-frequency readout of the optically-driven transduction with an enhanced 625 μg Hz -1 sensitivity. Measuring the optomechanically-stiffened oscillation shift, instead of the optical transmission shift, provides a 220× VRW enhancement over pre-oscillation mode detection., Competing Interests: Conflict of Interest The authors declare no conflict of interest.

Mexico is one of the most biodiverse countries in the world, with an important proportion of endemism mainly because of the convergence of the Nearctic and Neotropical biogeographic regions, which generate great diversity and species turnover at different spatial scales. However, most of our knowledge of the Mexican ant biota is limited to a few well-studied taxa, and we lack a comprehensive synthesis of ant biodiversity information. For instance, most of the knowledge available in the literature on Mexican ant fauna refers only to species lists by states, or is focused on only a few regions of the country, which prevents the study of several basic and applied aspects of ants, from diversity and distribution to conservation. Our aims in this data paper are therefore (1) to compile all the information available regarding ants across the Mexican territory, and (2) to identify major patterns in the gathered data set and geographic gaps in order to direct future sampling efforts. All records were obtained from raw data, including both unpublished and published information. After exhaustive filtering and updating information and synonyms, we compiled a total of 21,731 records for 887 ant species distributed throughout Mexico from 1894 to 2018. These records were concentrated mainly in the states of Chiapas (n = 6,902, 32.76%) and Veracruz de Ignacio de la Llave (n = 4,329, 19.92%), which together comprise half the records. The subfamily with the highest number of records was Myrmicinae (n = 10,458 records, 48.12%), followed by Formicinae (n = 3,284, 15.11%) and Ponerinae (n = 1,914, 8.8%). Most ant records were collected in the Neotropical region of the country (n = 12,646, 58.19%), followed by the Mexican transition zone (n = 5,237, 24.09%) and the Nearctic region (n = 3,848, 17.72%). Native species comprised 95.46% of the records (n = 20,745). To the best of our knowledge, this is the most complete data set available to date in the literature for the country. We hope that this compilation will encourage researchers to explore different aspects of the population and community research of ants at different spatial scales, and to aid in the establishment of conservation policies and actions. There are no copyright restrictions. Please cite this data paper when using its data for publications or teaching events., (© 2019 by the Ecological Society of America.)

Terrestrial fate and transport processes of E. coli can be complicated by human activities like urbanization or livestock grazing. There is a critical need to address contributing sources of bacterial contamination, properly assess the management of critical sources, and ultimately reduce E. coli concentrations in impaired water bodies. In particular, characterization of wildlife animal contributions and other "background" input sources of microbial pollution are highly uncertain and data are scarce. This study attempts to identify critical sources of E. coli and the efficacy of conservation practices for mitigating E. coli concentrations in the Arroyo Colorado watershed, Texas, using a process-based hydrologic and water quality model. We propose to incorporate a bacterial source tracking assessment into the modeling framework to fill the gap in data on wildlife and human contribution. In addition, other sources identified through a GIS survey, national census, and local expert knowledge were incorporated into the model as E. coli sources. Results suggest that simulated distribution of E. coli sources significantly improved after incorporating this enhanced data on E. coli sources into the model (R 2  = 0.90) compared to the SWAT result without BST (R 2  = 0.59). Scenario assessments indicate that wildlife contributions may remain significant despite land use change and urbanization, expected to mostly occur in agricultural and range lands. A combination of nonpoint source management measures, voluntary implementation of advanced treatment by wastewater plants where possible, and installation of aerators in the zone of impairment were demonstrated to be effective measures for restoring the recreation and aquatic life uses of the Arroyo Colorado., (Copyright © 2018 Elsevier B.V. All rights reserved.)

For the sensitive high-resolution force- and field-sensing applications, the large-mass microelectromechanical system (MEMS) and optomechanical cavity have been proposed to realize the sub-aN/Hz 1/2 resolution levels. In view of the optomechanical cavity-based force- and field-sensors, the optomechanical coupling is the key parameter for achieving high sensitivity and resolution. Here we demonstrate a chip-scale optomechanical cavity with large mass which operates at ≈77.7 kHz fundamental mode and intrinsically exhibiting large optomechanical coupling of 44 GHz/nm or more, for both optical resonance modes. The mechanical stiffening range of ≈58 kHz and a more than 100 th -order harmonics are obtained, with which the free-running frequency instability is lower than 10 -6 at 100 ms integration time. Such results can be applied to further improve the sensing performance of the optomechanical inspired chip-scale sensors.

We demonstrate the controllable optomechanical coupling and Drude self-pulsation plasma locking in chip-scale optomechanical cavities. The optomechanical coupling between the optical and mechanical degrees-of-freedom is dependent on the intracavity energy via the coupled fiber position. With the deterministic optomechanical stiffening, the interaction between optomechanical oscillation and self-pulsation can be controlled. Intracavity locking with 1/6 subharmonics is obtained over a wide optical detuning range of 190.01-192.23 THz. These results bring new insights into implementations of nonlinear dynamics at mesoscopic scale, with potential applications from photonic signal processing to nonlinear dynamic networks.

Free superior gluteal artery perforator (SGAP) flaps are a reliable option for breast reconstruction in patients with insufficient abdominal tissue or abdominal scarring. Liposuction in a donor site is a relative contraindication for harvesting a free flap, despite current case reports challenging this tenet. We describe a case of a 36-year-old woman who underwent unilateral breast reconstruction with free SGAP flap. She underwent liposuction of the contralateral buttock for symmetry. Approximately, one year post-operatively, she developed local recurrence of the breast cancer. Previously liposculpted buttock was used as donor site for a second free SGAP flap anastomosed to internal mammary artery., (Copyright © 2012 Wiley-Liss, Inc.)

Background: Two work-horse approaches to postmastectomy breast reconstruction are the deep inferior epigastric perforator flap and the superior gluteal artery perforator (SGAP) flap [and its variation, the lateral septocutaneous superior gluteal artery perforator flap]. Our purpose was fourfold: 1) to analyze our experience with the SGAP flaps for simultaneous bilateral breast reconstruction; 2) to analyze our experience with lateral septocutaneous superior gluteal artery perforator flaps for that procedure; 3) to compare our results with those in the literature; and 4) to highlight the importance of preoperative three-dimensional computed tomographic angiography., Methods: A retrospective chart review was completed for 23 patients who underwent breast reconstruction between December 2005 and January 2010 via an SGAP flap (46 flaps). We reviewed flap weight, ischemia time, length of stay, overall flap survival, fat necrosis development, and emergency re-exploration., Results: Mean weights were 571.2 ± 222.0 g (range 186-1,117 g) and 568.0 ± 237.5 g (range 209-1,115 g) for the left and right buttock flap, respectively. Mean ischemia time was 129.1 ± 15.7 and 177.7 ± 24.7 minutes for the first and second flap, respectively. Mean hospital stay was 5.3 ± 2.5 days. All flaps survived. Fat necrosis developed in five flaps (10.8%), and emergency re-exploration was required in three patients (three flaps)., Conclusions: When harvesting abdominal tissue is a poor option, the SGAP flap is an efficacious procedure for patients desiring autologous breast reconstruction, and bilateral procedures can be performed simultaneously., (Copyright © 2012 Wiley Periodicals, Inc.)

Halogenated 1,3,5-triazapentadienyl ligands [N{(C(3)F(7))C(C(6)F(5))N}(2)](-), [N{(CF(3))C(C(6)F(5))N}(2)](-) and [N{(C(3)F(7))C(2,6-Cl(2)C(6)H(3))N}(2)](-), alone or in combination with other N-donors like CH(3)CN, CH(3)(CH(2))(2)CN, and N(C(2)H(5))(3), have been used in the stabilization of thermally stable, two-, three- or four-coordinate silver(i) adducts. X-Ray crystallographic analyses of {[N{(C(3)F(7))C(C(6)F(5))N}(2)]Ag}(n), {[N{(C(3)F(7))C(C(6)F(5))N}(2)]Ag(NCCH(3))}(n), {[N{(C(3)F(7))C(2,6-Cl(2)C(6)H(3))N}(2)]Ag(NCCH(3))}(n), {[N{(CF(3))C(C(6)F(5))N}(2)]Ag(NCCH(3))(2)}(n) and {[N{(C(3)F(7))C(C(6)F(5))N}(2)]Ag(NCC(3)H(7))}(n) revealed the presence of bridging 1,3,5-triazapentadienyl ligands bonded to silver through terminal nitrogen atoms. These adducts are polymeric in the solid state. [N{(C(3)F(7))C(2,6-Cl(2)C(6)H(3))N}(2)]AgN(C(2)H(5))(3) is monomeric and features a 1,3,5-triazapentadienyl ligand bonded to Ag(I) in a κ(1)-fashion via only one of the terminal nitrogen atoms. The solid state structure of [N{(C(3)F(7))C(C(6)F(5))N}(2)]H has also been reported and it forms polymeric chains via inter-molecular N-H···N hydrogen-bonding.

Background: Determining the type and source of cells involved in regenerative processes has been one of the most important goals of researchers in the field of regeneration biology. We have previously used several cellular markers to characterize the cells involved in the regeneration of the intestine in the sea cucumber Holothuria glaberrima., Results: We have now obtained a monoclonal antibody that labels the mesothelium; the outer layer of the gut wall composed of peritoneocytes and myocytes. Using this antibody we studied the role of this tissue layer in the early stages of intestinal regeneration. We have now shown that the mesothelial cells of the mesentery, specifically the muscle component, undergo dedifferentiation from very early on in the regeneration process. Cell proliferation, on the other hand, increases much later, and mainly takes place in the mesothelium or coelomic epithelium of the regenerating intestinal rudiment. Moreover, we have found that the formation of the intestinal rudiment involves a novel regenerative mechanism where epithelial cells ingress into the connective tissue and acquire mesenchymal phenotypes., Conclusions: Our results strongly suggest that the dedifferentiating mesothelium provides the initial source of cells for the formation of the intestinal rudiment. At later stages, cell proliferation supplies additional cells necessary for the increase in size of the regenerate. Our data also shows that the mechanism of epithelial to mesenchymal transition provides many of the connective tissue cells found in the regenerating intestine. These results present some new and important information as to the cellular basis of organ regeneration and in particular to the process of regeneration of visceral organs.

Background: Three-dimensional computed tomographic angiography (3D CTA) can be used preoperatively to evaluate the course and caliber of perforating blood vessels for abdominal free-flap breast reconstruction. For postmastectomy breast reconstruction, many women inquire whether the abdominal tissue volume will match that of the breast to be removed. Therefore, our goal was to estimate preoperative volume and weight of the proposed flap and compare them with the actual volume and weight to determine if diagnostic imaging can accurately identify the amount of tissue that could potentially to be harvested., Methods: Preoperative 3D CTA was performed in 15 patients, who underwent breast reconstruction using the deep inferior epigastric artery perforator flap. Before each angiogram, stereotactic fiducials were placed on the planned flap outline. The radiologist reviewed each preoperative angiogram to estimate the volume, and thus, weight of the flap. These estimated weights were compared with the actual intraoperative weights., Results: The average estimated weight was 99.7% of the actual weight. The interquartile range (25th to 75th percentile), which represents the "middle half" of the patients, was 91-109%, indicating that half of the patients had an estimated weight within 9% of the actual weight; however, there was a large range (70-133%)., Conclusion: 3D CTA with stereotactic fiducials allows surgeons to adequately estimate abdominal flap volume before surgery, potentially giving guidance in the amount of tissue that can be harvested from a patient's lower abdomen., (Copyright © 2011 Wiley-Liss, Inc.)

Synthesis of the perfluorinated 1,3,5-triazapentadiene [N{(CF(3))C(C(6)F(5))N}(2)]H and the use of its conjugate base as a supporting ligand for the isolation of silver(i) and copper(i) complexes are reported. Some of the related chemistry involving [N{(C(3)F(7))C(C(6)F(5))N}(2)](-) (that has bulkier -C(3)F(7) groups on the 1,3,5-triazapentadienyl ligand backbone) is also presented. X-ray crystallographic data show a wide variety of structures ranging from intermolecular, hydrogen-bonded chain structure for [N{(CF(3))C(C(6)F(5))N}(2)]H with a twisted W-shaped N(3)C(2) core, monomeric [N{(CF(3))C(C(6)F(5))N}(2)]Ag(CN(t)Bu)(2) and [N{(C(3)F(7))C(C(6)F(5))N}(2)]Ag(CN(t)Bu)(2) where the κ(1)-bonded triazapentadienyl ligand bonding to the metal fragment via the central nitrogen atom, monomeric [N{(CF(3))C(C(6)F(5))N}(2)]Ag(PPh(3))(2) and [N{(C(3)F(7))C(C(6)F(5))N}(2)]Ag(PPh(3))(2) that feature κ(1)-bonded triazapentadienyl ligand bonding to the metal fragment via one of the terminal nitrogen atoms, to that of the monomeric [N{(CF(3))C(C(6)F(5))N}(2)]Cu(CN(t)Bu)(2) containing a κ(2)-bonded triazapentadienyl ligand and a U-shaped NCNCN ligand backbone. The isocyanide adducts show relatively high ν(CN) values in the IR spectra., (This journal is © The Royal Society of Chemistry 2011)

The ligand class 2,2'-pyridylpyrrolide is surveyed, both for its structural features and its electronic structure, when attached to monovalent K, Cu, Ag, Au, and Rh. The influence of pyrrolide ring substituents is studied, as well as the question of push/pull interaction between the pyridyl and pyrrolide halves. The π donor ability of the pyrrolide is found to be less than that of an analogous phenyl. However, in contrast to the phenyl analog, the HOMO is pyrrolide π in character for pyridylpyrrolide complexes of copper and rhodium, while it is conventionally metal localized for planar, d(8) rhodium pyridylphenyl. Monovalent three-coordinate copper complexes show great deviations from Y-shaped toward T-shaped structures, including cases where the pyridyl ligand bonds only weakly.

Background: Interferon-γ-release assays (IGRAs) have been developed for the diagnosis of tuberculosis infection, but few data are available for children. There currently is no reference standard for the diagnosis of tuberculosis infection., Objective: To compare the performance of 1 IGRA, the T-SPOT.TB assay with the tuberculin skin test (TST) in children with different epidemiologic risk factors for tuberculosis., Methods: We conducted a prospective study of 210 patients referred to 3 pediatric tuberculosis clinics, including those with no risk factors for tuberculosis (low risk, n = 27), risk factors but no identifiable source case (intermediate risk, n = 78), contact with a known source case (high risk, n = 74), and active disease (n = 31). Children were tested with TST and T-SPOT.TB. Concordance analyses were performed, and assay outcomes were modeled by multivariate logistic regression., Results: For 13 children with culture-confirmed tuberculosis disease, sensitivity of TST and T-SPOT.TB was 77% and 92%, respectively, and concordance was 69%. For high-risk children, concordance was 94% for BCG-unimmunized children and 88% for BCG-immunized children. For intermediate-risk children, concordance was 74% for BCG-unimmunized children and 33% for BCG-immunized children. For low-risk children, concordance was 74% for BCG-unimmunized children and 20% for BCG-immunized children. Multivariate analysis revealed that contact with a source case was associated with T-SPOT.TB result, but age and BCG immunization were not., Conclusions: T-SPOT.TB is comparable to the TST in the diagnosis of tuberculosis disease and identification of high-risk children with tuberculosis infection and is more specific than the TST in children who have received the BCG vaccine.

Background: Many studies demonstrate direct patient benefits from use of preoperative computed tomography angiograms (CTA) for abdominal tissue-based breast reconstruction. We present a novel classification schema to translate imaging results into further clinical relevance., Methods: Each hemiabdomen CTA was classified into a schema that addressed findings of expected anatomy, anatomy that necessitates a change in operative technique and anatomy that suggests less morbid procedures may be considered., Results: Eighty-six patients (172 hemiabdomens) were available for study. Of the reconstructions performed in this time period, 40 (47%) were bilateral and 46 (53%) unilateral. Based on perforator size and location, relative perimuscular anatomy, and continuity of vessels, five categories were defined: type I "Traditional" anatomy (n = 150, 87%), type II "Highly Favorable" anatomy (n = 11, 6.4%), type III "Altered-Superiorly Translocated" anatomy (n = 9, 5.2%), type IV "Superficial Dominant" anatomy (n = 26, 15%), and type V "Hostile" anatomy (n = 4, 2.3%). The additive total is greater than 100%, because vessels may fall into more than one category., Discussion: In providing the microsurgeon with a preoperative vascular map that has the potential to influence the preoperative, operative, and postoperative course, abdominal CTAs should be considered a worthy adjunct to the diagnostic armamentarium of the reconstructive surgeon. These classifications and their clinical impacts become even more important in centers performing increasing numbers of bilateral reconstructions. We believe that our simple schema can facilitate effective use of this powerful tool, aiding in overall care of the breast reconstruction patient., (Copyright © 2010 Wiley-Liss, Inc.)

The synthesis and characterization of a Cu(I) complex with a cis-bidentate monoanionic nitrogenous ligand, 2-pyridylpyrrolide, L, is reported. This shows binding of one base B = MeCN or CO per copper in a species LCu(B), but this readily releases the volatile ligand under vacuum with aggregation of transient LCu to a mixture of two enantiomers of a chiral trimer: a zwitterion containing inequivalent Cu(I) centers, possible via a new bonding mode of pyridylpyrrolide, and one with nitrogen lone pairs donating to two different metals. Density functional theory calculations show the energetics of both ligand binding and aggregation (including dimer and monomer alternatives), as well as the ability of this ligand to rotate away from planarity to accommodate a bridging structural role. The trimer serves as a synthon for the simple fragment LCu.

Background: Superior gluteal artery perforator (SGAP) flaps are a useful adjunct for autologous microvascular breast reconstruction. However, limitations of short pedicle length, complex anatomy, and donor site deformity make it an unpopular choice. Our goals were to define the anatomic characteristics of SGAPs in cadavers, and report preliminary clinical and radiographic results of using the lateral septocutaneous perforating branches of the superior gluteal artery (LSGAP) as the basis for a modified gluteal flap., Methods: We performed 12 cadaveric dissections and retrospectively reviewed 12 consecutive breast reconstruction patients with gluteal flaps (19 flaps: 9 LSGAP, 10 traditional SGAP) over a 12-month period. The LSGAP flap was converted to traditional SGAP in 53% of flaps because of dominance of a traditional intramuscular perforator. Preoperative 3D computed tomography angiography (CTA) and cadaveric dissections were used to define anatomy. Anatomic, demographic, radiographic, perioperative, and outcomes data were analyzed. Mean follow-up was 4 +/- 3.4 months (range 4 weeks to 10 months)., Results: Compared with the pedicle in the SGAP flap, the mean pedicle length in the LSGAP flap was 1.54 times longer by CTA, 2.05 times longer by cadaver dissection, and 2.36 times longer by intraoperative bilateral measurement. These differences were statistically significant (P < 0.001). Clinically, 100% of the flaps survived., Conclusions: LSGAP flap reconstruction is advantageous, when feasible, because of the septocutaneous pedicle dissection and gain in pedicle length that make microsurgical anastomoses easier without compromising gluteus function., ((c) 2010 Wiley-Liss, Inc.)

The oncologic management of breast cancer has evolved over the past several decades from radical mastectomy to modern-day preservation of chest and breast structures. The increased rate of mastectomies over recent years made breast reconstruction an integral part of the breast cancer management. Plastic surgery now offers patients a wide variety of reconstruction options from primary closure of the skin flaps to performance of microvascular and autologous tissue transplantation. Well-coordinated partnerships between surgical oncologists, plastic surgeons, and patients address concerns of tumor control, cosmesis, and patients' wishes. The gamut of breast reconstruction options is reviewed, particularly noting state-of-the-art techniques, as well as the advantages and disadvantages of various timing modalities.

Lobular breast carcinoma represents 2-20% of infiltrative carcinomas of the breast. The incidence of extrahepatic gastrointestinal (GI) tract metastases observed in necropsy studies varies from 6% to 18% and the most commonly affected organ is the stomach, followed by colon and rectum [1-4]. Reported herein is the case of a 67-year-old woman who was primarily diagnosed and surgically treated for a lobular carcinoma of the breast 15 years ago and is now referred with back pain and right hydronephrosis caused by a metastasis in rectum. Frequently, the absence of specific symptoms of digestive metastases of breast cancer leads to a misdiagnosis of this pathology [5-7]. The treatment will be based on a detailed clinical history and histopathological findings. Metastases from breast cancer in GI tract tumours must be excluded in a patient with previous history of breast carcinoma, as in the case reported herein.

The copper(i) ethylene complex [N{(C(3)F(7))C(Dipp)N}(2)]Cu(C(2)H(4)) (Dipp = 2,6-diisopropylphenyl) has been synthesized by treating [N{(C(3)F(7))C(Dipp)N}(2)]Cu(NCCH(3)) with ethylene at room temperature. [N{(C(3)F(7))C(Dipp)N}(2)]Cu(C(2)H(4)) is an air stable, yellow solid. X-Ray crystallographic data of [N{(C(3)F(7))C(Dipp)N}(2)]Cu(C(2)H(4)) show that the 1,3,5-triazapentadienyl ligand coordinates to copper in kappa(2)-fashion. The copper atom adopts a trigonal-planar geometry. [N{(C(3)F(7))C(Dipp)N}(2)]Cu(C(2)H(4)) and [N{(C(3)F(7))C(Dipp)N}(2)]Cu(NCCH(3)) effectively catalyze carbene and nitrene transfer to a variety of substrates in high efficiencies.

A series of thermally stable, easily isolable, monomeric, and isoleptic coinage metal alkyne complexes have been reported. Treatment of [N{(C(3)F(7))C(Dipp)N}(2)]Li (the lithium salt of the 1,3,5-triazapentadiene [N{(C(3)F(7))C(Dipp)N}(2)]H) with AuCl, CF(3)SO(3)Ag or CF(3)SO(3)Cu in the presence of 3-hexyne led to the corresponding coinage metal alkyne complex [N{(C(3)F(7))C(Dipp)N}(2)]M(EtC[triple bond]CEt) in good yield (M = Au, Ag, Cu; Dipp = 2,6-diisopropylphenyl). X-ray crystal structures of the three coinage metal alkynes are remarkably similar, and show the presence of trigonal-planar metal sites with eta(2)-bonded 3-hexyne. The M-C and M-N bond distances vary in the order Cu < Au < Ag. The bending of the C-C[triple bond]C bond angle is largest for the gold, followed by Cu and Ag adducts. The gold adduct also shows the largest decrease in C[triple bond]C stretching frequency in Raman, while the Ag adduct shows the smallest change compared to that of the uncoordinated alkyne. DFT calculations on [N{(CF(3))C(Ph)N}(2)]M(EtC[triple bond]CEt) and the related ClM(EtC[triple bond]CEt) predict that the M-alkyne bond energy varies in the order Ag < Cu < Au. The gold adducts are also predicted to have the longest C[triple bond]C, largest deviation of C-C[triple bond]C bond angle from linearity, and smallest C[triple bond]C stretching frequency, followed by the Cu and Ag adducts. In these triazapentadienyl coinage metal adducts, the sigma-donation from alkyne --> M dominates over the M --> alkyne pi-back-donation.

Although the use of saphenous vein grafts in free-flap salvage and extremity replantation is relatively common, their use in breast reconstruction is rare. These two case reports represent extreme alternatives for breast reconstruction flap salvage. In our normal daily practice, the overwhelming majority of elective breast reconstructions proceed smoothly. However, the occasional patient may require saphenous vein graft flap rescue for completion of the reconstruction., ((c) 2008 Wiley-Liss, Inc.)

Background: Retrospective studies have shown that occult nipple-areolar complex (NAC) involvement in breast cancer is low, occurring in 6-10% of women undergoing skin-sparing mastectomy (SSM). The cosmetic result and high patient satisfaction of nipple-sparing mastectomy (NSM) has prompted further evaluation of the oncologic safety of this procedure., Methods: We conducted a retrospective chart review of 36 self-selected patients who underwent 51 NSM procedures between 2002 and 2007. Criterion for patient selection was no clinical evidence of nipple-areolar tumor involvement. All patients had the base of the NAC evaluated for occult tumor by permanent histologic section assessment. We also evaluated tumor size, location, axillary node status, recurrence rate, and cosmetic result., Results: Malignant NAC involvement was found in 2 of 34 NSM (5.9%) completed for cancer which prompted subsequent removal of the NAC. Of the 51 NSM, 17 were for prophylaxis, 10 for ductal carcinoma in situ (DCIS), and 24 for invasive cancer. The average tumor size was 2.8 cm for invasive cancer and 2.5 cm for DCIS. Nine patients had positive axillary nodes. Overall, 94% of the tumors were located peripherally in the breast. After mean follow-up of 18 months, only two patients (5.9%) had local recurrence., Conclusion: Using careful patient selection and careful pathological evaluation of the subareolar breast tissue at surgery, NSM can be an oncologically safe procedure in patients where this is important to their quality of life. A prospective study based on focused selection criteria and long-term follow-up is currently in progress.

A rare gold(I) ethylene complex and the closely related copper(I) ethylene adduct have been isolated using [N{(C3F7)C(2,6-Cl2C6H3)N}2]- as the supporting ligand. [N{(C3F7)C(2,6-Cl2C6H3)N}2]Au(C2H4) (1) is an air-stable solid. It features a U-shaped triazapentadienyl ligand backbone and a three-coordinate, trigonal-planar gold center. The copper(I) adduct [N{(C3F7)C(2,6-Cl2C6H3)N}2]Cu(C2H4) (2) also has a similar structure. The 13C NMR signal corresponding to the ethylene carbons of 1 appears at about 64 ppm upfield from the free ethylene, while the ethylene carbons of 2 show a relatively smaller (39 ppm) upfield shift. [N{(C3F7)C(2,6-Cl2C6H3)N}2]M(C2H4) (M=Cu, Au) mediate carbene-transfer reactions from ethyl diazoacetate to saturated and unsaturated hydrocarbons.

Autologous breast reconstruction with microsurgical free tissue transfer has become routine, and perforator-based adipocutaneous flaps are recognized as an excellent option for many patients. Current efforts to optimize patient outcomes focus on minimizing operative morbidity both at the donor and recipient sites. The DIEAP flap avoids most of the abdominal wall morbidity associated with the TRAM. At the recipient site, however, partial rib resection, for access to the internal mammary (IM) artery and vein as recipient vessels, has a risk of chest wall pain, deformity, and pneumothorax. Perhaps more importantly, sacrifice of the IM vessels precludes their use for potential future coronary revascularization. To avoid this, the intercostal perforating branches from the internal mammary system may be used as recipient vessels for microanastomosis. This has been well described using suture technique, although the use of a mechanical coupling device for arterial anastomosis to the perforator has not been reported. We report nine cases whereby a mechanical coupling device was used to perform both the arterial and venous anastomoses of DIEAP and SIEA flap pedicles to IM intercostal perforating vessels. Flap ischemia time was shorter in all cases, allowed ease of anastomosis for vessel size mismatch, and is technically easier in deep wounds. This technique is a further refinement to free flap breast reconstruction and is a powerful application of the coupling device., ((c) 2008 Wiley-Liss, Inc.)

The synthesis and X-ray structures of gold(I) adducts supported by beta-diketiminates have been reported. {[HC{(H)C(2,4,6-Br(3)C(6)H(2))N}(2)]Au}(2) and {[HC{(H)C(Dipp)N}(2)]Au}(2) [Dipp = 2,6-(i-Pr)(2)C(6)H(3)] are easily isolable solids and feature 12-membered macrocyclic ring structures. beta-Diketiminate ligands adopt a W-shaped conformation. Gold atoms are bonded to the nitrogen atoms in a linear fashion. (1)H NMR signals corresponding to the protons at the beta-diketiminate ligand beta-C position of the gold adducts appear at a notably high downfield region.

Fully fluorinated triazapentadienyl ligand [N{(C3F7)C(C6F5)N}2]- and the related [N{(C3F7)C(2-F,6-(CF3)C6H3)N}2]- have been synthesized in good yield via a convenient route and used in the isolation of three- and four-coordinate copper(I)-carbon monoxide complexes. They show fairly high nu(CO) values (>2100 cm(-1)), indicating the presence of electron-poor Cu sites. The copper(I)-ethylene adduct [N{(C3F7)C(C6F5)N}2]Cu(C2H4), featuring a three-coordinate Cu site, has also been synthesized using [N{(C3F7)C(C6F5)N}2]CuNCCH3 and C2H4.

The biocide activity of Bacillus thuringiensis (B. thuringiensis) IB-16 strain was evaluated against the blood-feeding nematode Haemonchus contortus (H. contortus) in vitro and in vivo assays. Twenty experimental jirds (Meriones unguiculatus) and 32 sheep were infected with H. contortus by oral route. Fourteen days post infection 10 jirds were treated with 0.2 mg per mL of IB-16 soluble toxin by intraperitoneal (i.p.) route and 8 sheep were treated with 0.5 mg of toxin per kg of body weight by intramuscular route 35 days after H. contortus infection. Same number of treated jirds and sheep were used as control. Fecal and blood samples were analyzed from experimental sheep to estimate the number of parasitic eggs, percentage of eosinophils, packed cell volume (PCV), and IgG title. All experimental jirds and 16 sheep (8 treated and 8 controls) were sacrificed at days 5, 7, and 30 after B. thuringiensis treatment. The percentage of nematode reduction was estimated from L(4) and H. contortus adults. The percentage of protection was 80.0 to jirds and 73.8 and 53.3 to sheep, sacrificed at days 7 and 30, respectively. Moreover, nonsignificant difference (P > or = 0.05) was detected from parasitic eggs, eosinophils, and PCV parameters. Significance level of IgG was observed only before H. contortus treatment with B. thuringiensis soluble toxin (P < or = 0.05) but nonsignificant difference was observed after treatment. These results showed that B. thuringiensis activity was similar to those observed by anthelmintic treatment and it could be used as an alternative biological method.

Introduction: The incidence of the infection by the viruses of the human immunodeficiency (HIV), hepatitis B (HBV) and hepatitis C (HCV) has diminished enormously in developed countries during the last 20 years; nevertheless, in our country we do not know such an incidence and, therefore, the safety of our blood supply., Material and Methods: We performed a retrospective analysis at the Centro Nacional de la Transfusión Sanguínea (CNTS) assessing 17,176,298 serologic tests including HIV, HCV and HBV carried on 5,725,432 blood units collected and informed to the CNTS from January 1999 to December 2003 by all the Mexican blood banks. Prevalence, incidence and residual risk of each one of the aforementioned serologic markers were calculated., Results: The five years mean prevalence for HIV, HBV and HCV has remained steady. The residual risk (RR) when hemagglutination test was employed was 1:977 for HCV; 1:1,564 for HBV and 1:1,262 for HIV. Whereas the RR when ELISA was performed decreased to 1:2,781 for HCV; 1:3,185 for HBV and 1:9,969 for HIV. If nucleic acid amplification test were employed, RR would be 1:8,170 for HBV; 1:9,915 for HCV and 1:19,939 for HIV., Conclusions: The theoretical risk for transfusion-transmitted diseases in our country is still worrisome.

Objective: To determine the effects of diphenhydramine 50 mg and fexofenadine 180 mg on cognitive performance using the Test of Variables of Attention (TOVA), and to ascertain whether the TOVA was sufficiently sensitive to differentiate between the effects of these first- and second-generation H1-receptor antagonists on performance., Study Design: The study used a double-blind, placebo-controlled, randomized, crossover design. Forty-two subjects completed four separate TOVA tests: at baseline and after administration of placebo, diphenhydramine 50 mg, and fexofenadine 180 mg. On each occasion, subjects rated subjective feelings of drowsiness on a visual analog scale (VAS) before taking the TOVA., Results: Compared with placebo, diphenhydramine caused an increased response time (P = 0.0230) and more omission errors (P = 0.0398). Diphenhydramine was also associated with increased drowsiness VAS ratings (P = 0.0065) compared with placebo. Diphenhydramine caused significantly more commission errors than fexofenadine (P = 0.0354). Neither placebonor fexofenadine 180 mg caused significant changes in any TOVA or VAS measurements compared with baseline. Fexofenadine was not statistically different from placebo for any evaluation., Conclusions: The TOVA was sufficiently sensitive to differentiate between the central nervous system effects of fexofenadine and diphenhydramine. Fexofenadine 180 mg had no significant effect on the TOVA measures of performance or on self-reported drowsiness compared with placebo. In contrast, diphenhydramine 50 mg caused significant increases in omission errors and response time on the TOVA and increases in self-reported drowsiness compared with placebo [corrected].