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Southeastern South America is particularly vulnerable to extreme hydrometeorological events (EHEs). This study presents a multi-hazard analysis of long-term and short-term EHEs and their changes across southeastern South America for the 1961–1990 and 1991–2020 periods, using daily to monthly ERA5 data. Long-term EHEs are studied using the standardized precipitation index at 3- and 18-month timescales. Short-term EHEs are characterized by heatwaves, heavy precipitation, and flash droughts. Individual hazard components are derived by multiplying the frequency, duration, and intensity of the identified EHEs. The long-term and short-term EHE multi-hazard indices are formulated by aggregating these individual hazard components. Long-term multi-hazards prevail in the southwest and central west of the study region, including Argentina’s core crop region. A substantial water excess hazard hotspot is found in the southern areas, while the hotspot of seasonal to hydrological drought hazard is in northern and western areas. Short-term multi-hazards are more common in the north and central east, primarily impacting northeastern Argentina, southern Brazil, and southeastern Paraguay. In this hotspot region, heatwave hazard has increased by 30% in the last decades and flash drought and heavy precipitation frequencies are the highest. The current total multi-hazard, combining long-term and short-term multi-hazard indices, is higher and more widespread than between 1960 and 1990. Short-term hazards are more likely to co-occur, while long-term hazards tend to alternate. The study region is one of the most productive agricultural areas worldwide, so high EHE hazards can impact crop yields, threaten food security, and affect human well-being.

This article discusses an updated perspective concerning the issues to consider when implementing an electronic batch recording system, based on recent US Food and Drug Administration policy announcements regarding enforcement [...]

Chimeric antigen receptor T-cell (CAR-T) therapy has transformed the treatment of high-risk B-cell malignancies, but it remains associated with high rates of cytokine release syndrome (CRS) and immune effector cell-associated neurotoxicity syndrome (ICANS). While prolonged toxicities are also observed in a subset of patients, to date the factors associated with the duration of CRS and ICANS are unknown. Here, we provide the first characterization of factors associated with time to CRS/ICANS resolution in patients receiving the FDA-approved CD19 CAR T-cell product axicabtagene ciloleucel (axi-cel).

The article discusses whether Neo-Scholasticism can make a comeback to Catholic theology and philosophy. Topics discussed include the reliance of Neo-Scholastic apologetics on the metaphysics of Saint Thomas Aquinas, the incoherence of modernism faced by Neo-Scholastic apologetics, and the focus on God's existence by them.

Human exposure to elements is a process difficult to control and monitor. Studies on this topic usually rely on single spot urine sample to assess exposure, with the risk of ignoring variability over a longer period. In this work, we measured the urinary excretion of toxic and essential elements during 1 year with the overall goal of exploring the variability caused by seasonality on their concentration. Seven participants were recruited, and first morning urines were collected three times for each season, during November, January, April and July. Participants followed the same balanced diet during the week of collection. We then monitored nineteen essential and toxic elements in urines by inductively coupled plasma mass spectrometry. Unsupervised multivariate statistical analysis separated samples collected during summer from the ones collected during other seasons. Twelve elements had a significant seasonal variation (ANOVA test, p< 0.05) and their levels resulted increased during summer. These elements were both contaminants, such as Ni, Hg, Cd and Tl, and essential elements such as Se and Cu. However, none of these elements was detected at toxic concentration. In this study, we point out for the first time the variability of urine element concentration due to seasonality and we propose that the season of collection should be considered when providing urinary reference values of elements.

Founded by Russian émigrés fleeing from the Bolshevik Revolution, Seminarium Kondakovianumfaced the Communist regime’s strong opposition during its years of publication. This article recounts the stages of this troubled story - from the journal’s foundation with the support of the Ruská Akce(a policy developed in Czechoslovakia in 1920s to welcome middle-class Russian refugees), through its relations with Soviet scholars and institutions affected by Soviet policy in 1920s and 1930s until the late aftermath at the end of World War ii, when the last remnants of the Kondakov Institute confronted the Soviet Army first, and, three years later, the Communist putsch in Czechoslovakia.

Between the end of the thirteenth century and the beginning of the fourteenth, Thessaloniki was a flourishing and cosmopolitan city: in this context was realized the Ptolemy Marc. gr. Z. 516 (904), then belonging to cardinal Basilios Bessarion and today preserved in the Marciana Library of Venice. Copied in Greek by a Frank named Andrea Teluntàs, the manuscript contained also a cryptic cycle of illumination that once Italo Furlan defined as an ethic and philosophical Christian Weltanschauung.The paper focuses on the illuminated cycle contained in the Ptolemy Marc. gr. Z. 516 (904), analyzing its artistic and literary sources and providing also a stylistic reading of it.

According to the Russian art historian Nikodim Kondakov, Byzantine illumination was less affected by religious and political interferences than monumental art, and should therefore be considered as the most authentic expression of Byzantine art and the most useful field in enabling scholars to understand the development of Byzantine art through the centuries. Even following this statement, Seminarium Kondakovianum - founded in honor of Kondakov, and printed in Prague between 1927 and 1938 (plus a 1940 issue realized in Belgrade) - published during the 1920s and the 1930s just five articles concerning Byzantine illumination, a scarce number considering the importance Kondakov gave to their study. This paper focuses on them, examining both the different methodological approaches and the interesting choices of the manuscripts presented. Malickij, Kosteckaja and Grabar followed strictly the “iconographic methodology” recommended by Kondakov, and the first two even wrote about a subject already studied by Kondakov in the late nineteenth century, the Moscovite Chludov Psalter. This methodological hegemony was partially interrupted by Kurt Weitzmann, who, in a 1937 article, focused more on the formal aspects than on the iconography of the miniatures depicted in the Tetraevangelion of Skevophylakion.

Twelfth-century Palermo was а city animated bу different languages, cultures and religions, as is well described bу the famous miniature in the the Liber ad honorem Augusti, which depicts the city in mourning after the death of William II. The Hauteville rulers, especially King Roger II, promoted а cultural program reflecting this Mediterranean koiné. The rhetorical choice of using Arabic artists to create the image of а luxurious and cosmopolitan court, while Byzantine art emphasized Roger's role as pius rex christianus, sustained and legitimated his political aspirations and power. Starting with the mosaic panel in the Church of St. Mary of the Admiral, in which the sovereign is shown being crowned by Christ with the Byzantinc loros, and then analysing two manuscripts conserved in the Venice's Biblioteca nazionale marciana - the Homerus Venetus А (Marc. gr. 454) and the Greek-Arabic Gospel (Marc. gr. 539) - this article investigates the political use of art made during the reign of Roger II and the ideological motives that influenced the king's decisions.

Longitudinal NMR relaxation times were used to investigate the thermal transitions occurring in an aqueous triblock copolymer of the poly(oxyethylene)–poly(oxypropylene)–poly(oxyethylene) family. In such a system molecule–micelle and micelle–liquid crystal transitions are observed, depending on temperature and composition. The longitudinal relaxation time, R 1, significantly changes when the aforementioned phase transitions take place. In the case of molecule–micelle equilibrium, changes in R 1 values of the methyl (and methynic) group signal, located in the lipophilic portion of block copolymers, are observed. The effect is ascribed to a significant dehydration of the poly(oxypropylene) chains, as a consequence of micelle formation. Conversely, the thermal transitions from micelles to liquid-crystalline phases are associated with significant changes in the relaxation time of poly(oxyethylene) units. The latter effect is tentatively ascribed to a partial dehydration and/or interdigitation of the poly(oxyethylene) moieties in the block copolymer.

OBJECTIVE: To compare the efficacy and tolerability of cyclosporine (CSA) with that of symptomatic therapy (ST) alone and sulfasalazine (SSZ) in the treatment of psoriatic arthritis (PsA). METHODS: Twelve rheumatology centers recruited 99 patients with active PsA in a 24 week, prospective, randomized, open, controlled study. The patients were treated with CSA (3 mg/kg/day) or SSZ (2,000 mg/day) plus ST, or ST alone (nonsteroidal antiinflammatory drugs, analgesics, and/or prednisone < or = 5 mg/day). The primary endpoint was the 6 month change in pain. Analyses were on the basis of the intention-to-treat principle. RESULTS: In comparison with both SSZ and ST, there was a statistically significant difference in favor of CSA in terms of the mean changes in the pain score (p < 0.05), which was considered the primary response variable. A significant decrease in favor of CSA versus ST alone was also observed for swollen joint count (p = 0.05), tender joint count (p = 0.01), joint/pain tenderness score (p = 0.002), patient and physician global assessment by at least one point (p = 0.04 and 0.01, respectively), total Arthritis Impact Measurement Scale score (p = 0.002), and spondylitis functional index (p = 0.002). There was a statistically significant difference in the ACR 50% and ACR 70% response rates between the CSA and ST groups (p = 0.02, 0.05). Comparing the SSZ and ST alone groups, only the spondylitis functional index decreased significantly in the SSZ treated patients (p = 0.03). The Psoriasis Area and Severity Index was significantly lower in the CSA than in the ST and SSZ groups (p = 0.0001 and 0.01, respectively). Decrease in erythrocyte sedimentation rate was significant only in the SSZ versus the ST group (p = 0.02), whereas reduction in C-reactive protein was significant in the CSA treated patients compared with the ST group (p = 0.006). The most common adverse event in the CSA group was mild, reversible kidney dysfunction. CONCLUSION: The results of this open trial confirm that CSA is well tolerated by patients with PsA and suggest that it is more efficacious than ST or SSZ.

To evaluate whether left ventricular hypertrophy in hypertensive patients is associated with a greater impairment of sympathovagal balance assessed by means of heart period variability.

Introduction:Multiple chronic conditions (MCC) are highly prevalent in cardiac patients. People with MCC experience depressive symptoms more frequently than the general population. Self-care has been shown to improve outcomes in a variety of chronic illnesses, but little is known about the influence of depression on these behaviours in MCC. Self-care, is defined as the behaviours adopted to maintain illness stability (self-care maintenance), monitor signs and symptoms (self-care monitoring) and respond to signs and symptoms of an illness exacerbation (self-care management). Our aim was to assess the influence of depression on self-care in MCC patients.Methods:A cross-sectional design was used. Patients were enrolled from community and outpatient settings and included if: ?65 years, had heart failure, diabetes or chronic obstructive pulmonary disease and another chronic condition; they were excluded if they had dementia and/or cancer. Patient Health Questionnaire-9 (PHQ-9) was used to measure depression and Self-Care of Chronic Illness Inventory (SC-CII) was used to measure self-care behaviors (maintenance, monitoring, management). The influence of depression was evaluated with MANOVA, discriminant and regression analysis.Results:The sample (N=366) was mostly female (54.1%) mean age 76.4 years (? 7.26), and 34.2% had heart failure. Mean PHQ-9 score was 6.7 (? 4.42) and 65.6% of patients scored above the cut-point for depression. MANOVA revealed a significant effect of depression on all self-care dimensions; ? = .887, F(3, 362) = 15.308, p< .001. Discriminant analysis revealed a canonical variate that differentiated the two groups; canonical R2= .11, ? = .887, ?2(3, N=366) = 43.295, p= < .001. The maintenance dimension loaded more highly (r= .998) onto the function than the other dimensions. In regression analysis, depression predicted self-care (maintenance, F(1,364) = 810.96, p< .001; monitoring, F(1,364) = 138.07, p< .001; management, F(1,364) = 220.03, p.001).Conclusions:The results suggest that depression influences all three self-care dimensions in people with MCC. Self-care maintenance behaviours (e.g. physical activity, healthy diet, medication adherence) may be affected more by depression than the other dimensions.