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Large satellite discrepancies and model biases in representing precipitation over the Southern Ocean (SO) are related directly to the region's limited surface observations of precipitation. To help address this knowledge gap, the study investigated the precipitation characteristics and rain rate retrievals over the remote SO using ship‐borne data of the Ocean Rainfall And Ice‐phase precipitation measurement Network disdrometer (OceanRAIN) and dual‐polarimetric C‐band radar (OceanPOL) aboard the Research Vessel (RV) Investigator in the Austral warm seasons of 2016–2018. Seven distinct synoptic types over the SO were analyzed based on their radar polarimetric signatures, surface precipitation phase, and rain microphysical properties. OceanRAIN observations revealed that the SO precipitation was dominated by drizzle and light rain, with small‐sized raindrops (diameter <1 mm) constituting up to 47% of total accumulation. Precipitation occurred most frequently over the warm sector of extratropical cyclones, while concentrations of large‐sized raindrops (diameter >3 mm) were prominent over synoptic types with colder and more convectively unstable environments. OceanPOL observations complement and extend the surface precipitation properties sampled by OceanRAIN, providing unique information to help characterize the variety of potential precipitation types and associated mechanisms under different synoptic conditions. Raindrop size distributions (DSD) measured with OceanRAIN over the SO were better characterized by analytical DSD forms with two‐shape parameters than single‐shape parameters currently implemented in satellite retrieval algorithms. This study also revised a rainfall retrieval algorithm for C‐band radars to reflect the large amount of small drops and provide improved radar rainfall estimates over the SO. Plain Language Summary: Precipitation is a major component of the hydrologic cycle in high‐latitude regions including the remote Southern Ocean (SO). However, large differences continue to exist among current precipitation products in the region, owing in part to the absence of high‐quality surface observational records suitable for evaluation across a range of temporal and spatial scales. This work uses two instruments aboard the RV Investigator over the Australian sector of the SO in the Austral warm seasons of 2016–2018: the OceanRAIN disdrometer and OceanPOL radar. We found variability in radar features and surface precipitation properties among seven distinct synoptic conditions over the SO. This work also discussed two important findings related to remote sensing retrievals of SO rain. First, we demonstrated why the rainfall retrieval assumptions in satellite algorithms may need to be refined to account for the unique rainfall properties in the SO. Second, we formulated a new set of equations suitable for shipborne C‐band radars in improving rain rate estimates over the region. This work leads toward more accurate, high‐resolution estimates of precipitation over the measurement‐sparse SO to better understand a range of climatological and meteorological processes in the region. Key Points: Different synoptic types across the Southern Ocean exhibit distinctive polarimetric signatures and surface precipitation propertiesSmall raindrops of less than one millimeter contribute up to 47% of total accumulation during the Austral warm seasons over the regionA new formulation for radar rainfall estimates that reflects the large numbers of small drops over the Southern Ocean is proposed [ABSTRACT FROM AUTHOR]

Recent voyages of the Australian R/V Investigator across the remote Southern Ocean have provided unprecedented observations of precipitation made with both an Ocean Rainfall and Ice-Phase Precipitation Measurement Network (OceanRAIN) maritime disdrometer and a dual-polarization C-band weather radar (OceanPOL). This present study employs these observations to evaluate the Global Precipitation Measurement (GPM) Integrated Multi-satellitE Retrievals for GPM (IMERG) and the fifth major global reanalysis produced by ECMWF (ERA5) precipitation products. Working at a resolution of 60 min and 0.25° (∼25 km), light rain and drizzle are most frequently observed across the region. The IMERG product overestimated precipitation intensity when evaluated against the OceanRAIN but captured the frequency of occurrence well. Looking at the synoptic/process scale, IMERG was found to be the least accurate (overestimated intensity) under warm-frontal and high-latitude cyclone conditions, where multilayer clouds were commonly present. Under postfrontal conditions, IMERG underestimated the precipitation frequency. In comparison, ERA5's skill was more consistent across various synoptic conditions, except for high pressure conditions where the precipitation frequency (intensity) was highly overestimated (underestimated). Using the OceanPOL radar, an area-to-area analysis (fractional skill score) finds that ERA5 has greater skill than IMERG. There is little agreement in the phase classification between the OceanRAIN disdrometer, IMERG, and ERA5. The comparisons are complicated by the various assumptions for phase classification in the different datasets. Significance Statement: Our best quantitative estimates of precipitation over the remote, pristine Southern Ocean (SO) continue to suffer from a high degree of uncertainty, with large differences present among satellite-based and reanalysis products. New instrumentation on the R/V Investigator, specifically a dual-polarization C-band weather radar (OceanPOL) and a maritime disdrometer (OceanRAIN), provide unprecedented high-quality observations of precipitation across the SO that will aid in improving precipitation estimates in this region. We use these observations to evaluate the IMERG and ERA5 precipitation products. We find that, in general, IMERG overestimated precipitation intensity, but captured the frequency of occurrence well. In comparison, ERA5 was found to overestimate the frequency of precipitation. Using the OceanPOL radar, an area-to-area analysis finds that ERA5 has greater skill than IMERG. [ABSTRACT FROM AUTHOR]

Se pretende conocer los efectos de la terapia ortopedica maxilar temprana en niiios menores de un alio, con sindrome de Down, empleando una placa de acetato blando con estimulador palatino tipo Castillo-Morales, que bused mejorar la posiciOn lingual por medio de un estimulo exteroceptivo. Se tomaron modelos de estudio, medidas antropometricas y registro filmico a 34 nitios, evaluando cambios craneales, faciales y de arcos dentales durante seis meses. Los niiios que recibieron la terapia evidenciaron mejoria en la posicion lingual, algunos incluso obtuvieron selle labial; ademits presentaron mayores dimensiones faciales en las medidas antropometricas: altura facial, diametro bicigomcitico, diametro bigonial e indice facial. Las mediciones de modelos no mostraron diferencias estadisticamente significativas entre el grupo con tratamiento y el grupo sin tratamiento. Los pacientes mOs pequeiios se adaptaron mejor a la placa, lo cual indica que la terapia puede ser favorable si se inicia a edades tempranas. Se observaron cambios cuantitativos (evaluacion antropometrica y de modelos) y cualitativos (video y opinion de los padres) con la terapia ortopedica maxilar temprana que favOrece el mejoramiento en la funciOn y desarrollo craneofacial de los nitios con sindrome de Down

The persistent Southern Ocean (SO) shortwave radiation biases in climate models and reanalyses have been associated with the poor representation of clouds, precipitation, aerosols, the atmospheric boundary layer, and their intrinsic interactions. Capitalizing on shipborne observations collected during the Clouds Aerosols Precipitation Radiation and atmospheric Composition Over the Southern Ocean 2016 and 2018 field campaigns, this research investigates and characterizes cloud and precipitation processes from synoptic to micro scales. Distinct cloud and precipitation regimes are found to correspond to the seven thermodynamic clusters established using a K‐means clustering technique, while less distinctions are evident using the cyclone and (cold) front compositing methods. Cloud radar and disdrometer data reveal that light precipitation is common over the SO with higher intensities associated with cyclonic and warm frontal regions. Multiple lines of evidence suggest the presence of diverse microphysical features in several cloud regimes, including the likely dominance of ice aggregation in deep precipitating clouds. Signatures of mixed phase, and in some cases, riming were detected in shallow convective clouds away from the frontal conditions. Two of the K‐means clusters with contrasting cloud and precipitation properties are observed over the high‐latitude SO and coastal Antarctica, suggesting distinct physical processes therein. Through a single case study, in‐situ and remote‐sensing data collected by an overflight of the Southern Ocean Clouds Radiation Aerosol Transport Experimental Study were also evaluated and complement the ship‐based analysis. Plain Language Summary: The current generation of climate models and reanalyses products have difficulties in properly representing the radiative balance over the Southern Ocean (SO), which can be traced to the poor understanding of clouds and precipitation processes in this region. The remote location of the SO is a key factor for the lack of field observations that allow the scientific community to address the above‐mentioned problem. However, recent coordinated field campaigns have collected an unprecedented amount of data, offering new opportunities to explore this understudied region. This research paper aims to study clouds and precipitation processes over the SO using shipborne data collected from two field campaigns in 2016 and 2018. Using different synoptic classification techniques, we identify unique macro and micro cloud and precipitation behaviors that correspond to the various weather patterns across a wide range of latitudes. In addition, we use aircraft observations collected from an overflight to evaluate and complement our analysis of the shipborne data. The study offers a framework that may help better understand the nature of the model biases over the SO. Key Points: Distinct cloud and precipitation regimes correspond to the Southern Ocean synoptics, defined using a sounding K‐means clustering techniqueEvidence suggests diverse microphysical features, like mixed phase in shallow convection and ice aggregation in deep precipitating cloudsTwo unique synoptic patterns have unique cloud and precipitation properties over the high‐latitudes, where climate models have large biases [ABSTRACT FROM AUTHOR]

The aim of this study is to analyze the unemployment in the Social Services, trying to understand the causes that motivate it. The non-insertion of the social worker in the labor market is a worrying social problem. Therefore, in an attempt to understand and explore this social problem we used a qualitative methodology doing some interviews to graduates in social service by the Faculty of Social Sciences of the Catholic University, Regional Centre of Braga. It was concluded that the surrounding social model is one of the biggest causes of the crisis that we are witnessing with effects in multiple spheres of society. The current social model has created a paradoxical society filled by many trained professionals but who do not have the opportunity to put their skills into practice because they are in a saturated labor market that does not take advantage of the skilled workforce that they have and that each disrespect either by the lack of offers or by the weak conditions that it offers. [ABSTRACT FROM AUTHOR]

Monogamous primates are widely reported as living in small groups of an adult pair and one to three juveniles who are assumed to disperse soon after sexual maturity. Given the scarcity of long-term demographic data on monogamous primates, the ultimate causes of dispersal, as well as the age at which dispersal occurs, have not been systematically examined. This study investigated age of juvenile dispersal in ten groups of Aotus azarai in Formosa, Argentina. Survival analysis techniques for censored data were applied to 42 months of observations to construct age-specific probabilities of remaining in the natal group. Our results show that approximately 50% of the young dispersed around 24 months of age while the other half remained in the natal territory with the natal group for more than 36 months. Dispersal in Aotus has previously been characterized as applying uniformly to all offspring within a set age range. Our results suggest a more complex social structure existing alongside a monogamous mating structure and raise the possibility of selective bequeathal of the territory to the offspring. The ultimate causes of delayed dispersal may be analyzed from the perspectives of offspring and parents. Offspring that do not leave the natal group after maturity may delay their reproductive lives but gain the advantage of prolonged access to, or inheritance of, the territorial resource. Parents that tolerate their offspring in the group beyond their age of maturity may increase the possibility that their territories will be inherited by their own offspring. Patterns of dispersal in this monogamous species may therefore reflect the reproductive value of a capital resource: a territory.

In Colombia, Public-Private Partnerships have emerged as a tool for increasing the development of infrastructure projects for highways. These projects have focused on economic highways and have set aside the social ones. This article proposes a conceptual framework based on shadow toll schemes, cash flows, and the three bands proposed by the World Bank, which are used in this article as mechanisms for funding rural highway projects. Strategic financial indicators were considered in designing the proposal. Thus, it is appropriate to encourage both private investment and financial mechanisms to promote projects which will have a social impact. In addition, this article introduces new policies to be implemented by the Colombian government with the aim of encouraging private investors to invest in social highways. As a result, it is expected that this work will contribute to enhancing the financing process in Colombia. It is concluded that to increase the development of rural highways, the creation of a debt fund with an investment focus on social projects is mandatory. Future research opportunities on this topic are identified. [ABSTRACT FROM AUTHOR]

Traditional societies are characterized by the predominance of religious worldviews, in contrast to modern societies, which open up other avenues of sense, besides religious expression. This study aims to determine the influence of the values of modern societies on religious changes, between 1990 and 2000. We have recourse to data from the European Values Survey for eight Catholic countries. The EVS questionnaire provides a set of guidelines in various areas of life. Several scales have been built with the aim of presenting value orientations. In our analysis we selected two constructs: following Inglehart's thesis, which enables us to explain the change in values, and the Rokeach set of questions to determine the values that individuals considered essential for life. The results allowed us to conclude that we are witnessing a reconfiguration of the mindset that has a decisive influence on younger generations who have assimilated the values of independence and determination and the values of welfare and selfrealization, once the socio-cultural and economic context was favourable. [ABSTRACT FROM AUTHOR]

Cardiac Sarcoidosis (CS) is a chronic granulomatous disease that can recur in transplanted hearts. There are currently no standardized guidelines for management of CS in heart transplant recipients. A 58-year-old male with end-stage NICM (presumed chemotherapy-related cardiotoxicity) presented with shortness of breath, and persistent low flow alarms on his HVAD. His past medical history was significant for leukemia (treated with doxorubicin), non-sustained VT s/p ICD and HVAD as bridge-to-transplant (2016). RHC showed evidence of cardiogenic shock. He was upgraded to UNOS Status 2 and underwent orthotropic heart transplant (OHT) on 7/30/21. He received standard induction (Basiliximab) and maintenance (Tacrolimus, MMF, prednisone) immunosuppression regimen. Unexpectedly, his explanted heart was noted to have non-necrotizing granulomatous myocarditis consistent with CS. He was switched from MMF to Sirolimus at 7 months post-OHT after TTE showed normal biventricular function and surveillance biopsy revealed 0R, AMR0. He was weaned off prednisone at 8 months. Subsequent cardiac biopsy showed recurrence of non-necrotizing granulomas with focal infiltrates (Fig A), suggesting recurrence of CS and mild acute cellular rejection (1R, AMR0). Patient remained asymptomatic with normal biventricular function. He was restarted on high dose prednisone and switched from Sirolimus to MMF. Tacrolimus goal was kept at 8-10. Five months following CS recurrence, cardiac PET showed no evidence of CS on Tacrolimus, MMF and low-dose prednisone. Recurrent CS in a transplanted heart is rare and usually manifests itself once immunosuppression is weaned. While there are no standard guidelines for its management, standard dose MMF plus low-dose prednisone in addition to Tacrolimus was effective in preventing further recurrence in our patient. Routine monitoring for recurrence is important for early detection and prevention of life-threatening complications. [ABSTRACT FROM AUTHOR]

El actual conjunto de Normas que regulan la oferta de servicios de planificación familiar por parte de los organismos oficiales de salud en Colombia, tuvo su origen a mediados de 1984. Pese a que los documentos técnicos que especificaban las normas y procedimientos de dicha actividad fueron preparados en el año mencionado, sólo hasta 1987 la División Materno Infantil del Ministerio de Salud Pública pudo contar con una publicación especialmente preparada para hacer conocer las normas de la mayoría de los organismos oficiales de salud, instituciones de educación superior, escuelas de auxiliares de enfermería y otros en el país.

From the teachers' point of view one of the key issues concerning the teaching/ learning process is the students' lack of motivation, either because of the inadequacy of the teaching methods, which do not create involving situations, or because the students simply don't want to study and consequently don't want to learn. To study motivation in learning involves a deeper understanding of a complex system of interrelated factors which operate as a whole in the students' motivation. We have based the present study on Boruchovitch and Neves (2006), Siqueira and Wechsler (2006) and Simões and Alarcão (2011), who defend the use of a quantitative scale to measure students' motivation, with the aim of setting up and validating evaluation tools on students' learning motivation. Our practical procedure consisted on the designing of these instruments, following the theoretical models; its application to a determined number of subjects; the application of other psychological tools for the study of convergent validity and for the verification of theoretical hypothesis; a factor analysis for item construction in the factors which will determine the final instruments and, finally, the study of the time stability for the test application and re-testing after a determined time lapse. The final results allow us to verify that it is possible to measure motivation for learning. We consider it is relevant to continue this research so that we may understand the students' real motivations. This analysis will be essential for the setting up of a set of strategies to fight school failure. [ABSTRACT FROM AUTHOR]

The cooperative breeding hypothesis ( CBH) states that cooperative breeding, a social system in which group members help to rear offspring that are not their own, has important socio-cognitive consequences. Thornton & McAuliffe (2015; henceforth T&M) critiqued this idea on both conceptual and empirical grounds, arguing that there is no reason to predict that cooperative breeding should favour the evolution of enhanced social cognition or larger brains, nor any clear evidence that it does. In response to this critique, Burkart & van Schaik ( henceforth B&vS) attempt to clarify the causal logic of the CBH, revisit the data and raise the possibility that the hypothesis may only apply to primates. They concede that cooperative breeding is unlikely to generate selection pressures for enhanced socio-cognitive abilities, but argue instead that the CBH operates purely through cooperative breeding reducing social or energetic constraints. Here, we argue that this revised hypothesis is also untenable because: (1) it cannot explain why resources so released would be allocated to cognitive traits per se rather than any other fitness-related traits, (2) key assumptions are inconsistent with available evidence and (3) ambiguity regarding the predictions leaves it unclear what evidence would be required to falsify it. Ultimately, the absence of any compelling evidence that cooperative breeding is associated with elevated cognitive ability or large brains (indeed data suggest the opposite is true in non-human primates) also casts doubt on the capacity of the CBH to explain variation in cognitive traits. [ABSTRACT FROM AUTHOR]

Background: Do evolutionary specializations lead to evolutionary constraint? This appears plausible, particularly when specialization leads to loss of complex adaptations. In the owl monkey lineage, nocturnality clearly arose from a diurnal ancestor. This behavioural shift was accompanied by morphological changes in the eye and orbit and complete loss of colour vision via missense mutations in the gene encoding the short-wave sensitive visual pigment (SWS opsin). Interestingly, at least one subspecies of owl monkey, Azara's owl monkey (Aotus azarae azarae), has regained activity in daylight. Given that all primate species that are active in daylight, including primarily diurnal species and species that are active during both day and night, have at least dichromatic colour vision, it seems reasonable to propose that dichromacy would be adaptive in A. a. azarae. With a disabled SWS opsin, the main avenue available for Azara's owl monkeys to re-evolve colour vision is via a polymorphism in the intact X-linked opsin locus, which commonly occurs in other New World monkeys. To examine this possibility we assayed variation in the X-linked opsin of A. a. azarae, focusing on the three exons (3, 4 and 5) that control spectral sensitivity. Results: We found low opsin genetic variation on a population level, and no differences at the three main sites that lead to variation in spectral sensitivity in the opsins of other New World monkeys. Two rare alleles with single amino acid variants are segregating in the population, but previous functional studies indicate that these are unlikely to affect spectral sensitivity. Conclusions: Genetic constraint on the re-evolution of colour vision is likely operating in Azara's owl monkey, which may affect the niche that this subspecies is able to occupy. [ABSTRACT FROM AUTHOR]

This Spanish-based study found that some adolescents link attractiveness with violence. Previous research showed that a socialization process within teenagers' contexts promotes this association. The results suggest that this link is one of the possible causes of the high rates of gender violence among youth. Debates regarding this research already have had political repercussions. Although the 2004 Spanish Act Against Gender Violence--the first of its kind in Europe--acknowledged violence with romantic partners or ex-partners, the 2008 Catalan Act on the Right of Women to Eradicate Chauvinist Violence also recognizes gender violence in dating, and considers preventive socialization as a main measure. This study provides key knowledge to support this purpose. [ABSTRACT FROM AUTHOR]

Titi monkeys (Callicebus spp., Cebidae) are monogamous neotropical primates that live in family-like groups typically consisting of an adult monogamous pair and one or two young. Knowledge about the reproductive biology of this genus is scanty. This study investigated the reproductive biology of female dusky titi monkeys (Callicebus moloch ). An initial analysis characterized reproductive parameters of 32 females from a captive colony maintained for 23 years at the California Regional Primate Research Center (CRPRC). The colony records provided data on reproductive parameters such as interbirth intervals, seasonality, age at first pregnancy, and reproductive rate in captivity. Changes in urinary levels of estrone conjugates (E1C) and pregnanediol-3alpha-glucuronide (PdG) were used to characterize major reproductive events. Urine samples from eleven females were collected during 17 months. The endocrine data were used to examine changes associated with cycling, conception, and the post-partum period as well as to determine the duration of the ovarian cycle and gestation length. The analysis of colony records indicated that females whose infant survived through weaning gave birth at intervals remarkably close to one year, while those who lost their offspring showed a significantly shorter interval. As long as they lived within the family group, mature female offspring did not breed. The analysis of the endocrine profiles indicated that after giving birth to a viable offspring, females undergo a relatively prolonged period of anovulation (approx. 6.5 months), followed by 1-3 non-conceptive cycles (approx. 1 month), after which they conceive and gestate (4.3 months). Am. J. Primatol. 47:183–195, 1999. © 1999 Wiley-Liss, Inc. [ABSTRACT FROM AUTHOR]

The need to compare and combine data quantitatively is becoming morefrequent in studies of animal behaviour, ecology and conservation. Using a hypothetical data set, I point out some limitations of combining and comparing data using Null Hypothesis Significance Testing (NHST). First, I discuss three different aspects of data analysis that should regularly be considered: (1) effect size estimation, (2) confidence intervals estimation and, (3) power analysis. I then suggest meta- analysis as a sensible alternative method to account for some limitations of NHST. Meta-analysis is a quantitative technique for the combination and comparison of independent but similar studies. Meta-analysis allows comparison and summary of effect sizes across studies. When testing hypotheses framed in evolutionary theory, where small effects may have profound consequences, a knowledge of the magnitude of the association may be as important as knowing whether the data complywith the arbitrary, sacred and dogmatic significance criterion of p < 0.05. [ABSTRACT FROM AUTHOR]

Autochthonous microorganisms [a consortium of arbuscular-mycorrhizal (AM) fungi and Bacillus thuringiensis ( Bt )] were assayed and compared to Rhizophagus intraradices ( Ri ), Bacillus megaterium ( Bm ) or Pseudomonas putida ( Psp ) and non-inoculation on Trifolium repens in a natural arid soil under drought conditions. The autochthonous bacteria Bt and the allochthonous bacteria Psp increased nutrients and the relative water content and decreased stomatal conductance, electrolyte leakage, proline and APX activity, indicating their abilities to alleviate the drought stress. Mycorrhizal inoculation significantly enhanced plant growth, nutrient uptake and the relative water content, particularly when associated with specific bacteria minimizing drought stress-imposed effects. Specific combinations of autochthonous or allochthonous inoculants also contributed to plant drought tolerance by changing proline and antioxidative activities. However, non-inoculated plants had low relative water and nutrients contents, shoot proline accumulation and glutathione reductase activity, but the highest superoxide dismutase activity, stomatal conductance and electrolyte leakage. Microbial activities irrespective of the microbial origin seem to be coordinately functioning in the plant as an adaptive response to modulated water stress tolerance and minimizing the stress damage. The autochthonous AM fungi with Bt or Psp and those allochthonous Ri with Bm or Psp inoculants increased water stress alleviation. The autochthonous Bt showed the greatest ability to survive under high osmotic stress compared to the allochthonous strains, but when single inoculated or associated with Ri or AM fungi were similarly efficient in terms of physiological and nutritional status and in increasing plant drought tolerance, attenuating and compensating for the detrimental effect of water limitation. [ABSTRACT FROM AUTHOR]

Purpose Adequate health insurance coverage is necessary for heart transplantation (HT) candidates. Prior studies have suggested inferior outcomes post HT with public health insurance. We sought to evaluate the effects of insurance type on transplantation rates, listing status and mortality prior to HT. Methods Patients ≥ 18 years old with an LVAD implanted and listed with 1A status were identified in the United Network for Organ Sharing (UNOS) registry between Jan 2010 and Dec 2017, with follow-up through March 2018. Patients were grouped based on the type of insurance Private/self-pay (PV), Medicare (MC) and Medicaid (MA) at the time of listing. We conducted multivariable competing risks regression analysis on listing status and mortality on the waiting list, stratified by insurance type at the time of listing. Results We identified 2,604 patients listed in status 1A (PV: 51.4%, MC: 32.1%, MA:16.5%). MA patients were younger (43.5 vs. 56.4 for MC vs. 51.5 for PV, p<0.001), less frequently white (p<0.001). The cumulative incidence of HT did not differ among the three insurance types (PV: 74.8%, MC 76.3%, MA 71.1%, P=0.14). The cumulative mortality on the waiting list prior to HT was not different among groups (PV: 29.3%, MC 26.3%, MA 21.8%, p=0.94). The reasons for removal from the transplant list is showed in Figure 1. Conclusion We did not detect any disparities in listing status and mortality among different insurance types. The proportion of patients removed because of death was higher among private insurance. In Medicaid patients clinical improvement was the most frequent reason for removal. [ABSTRACT FROM AUTHOR]

We examined whether N-terminal pro-brain natriuretic peptide (NT-proBNP) can serve as a noninvasive marker of filling pressures in ambulatory patients with continuous flow left ventricular assist devices. We retrospectively identified patients who had an outpatient right heart catheterization and NT-proBNP performed the same day between 01/01/2012 and 12/18/2018 at our institution. We evaluated the correlations between NT- proBNP and right atrial pressure (RA), pulmonary artery pressure (PA) and pulmonary capillary wedge pressure (PCWP). The best cut off for NT-proBNP to predict patients that were hemodynamically optimized (CVP<15 and PCWP<18) was derived as the value that minimized the square of the difference between sensitivity and specificity A total of 40 patients were included in the study, Patients characteristics are shown in Table 1. The median NT-proBNP was 1114 pg/mL(IQR 553-2056). The correlations between NT-proBNP and RA (r = 0.58;p<0.001; Coefficient of variation (CV) = 37%); PA(r = 0.34;p=0.03; CV = 26%) and PCWP (r = 0.45;p=0.004; CV = 32%) are shown in figure 1 panels A, B and C respectively. NT-proBNP ≥1168 pg/mL had a 60 %sensitivity and 61% specificity in identifying non-optimum hemodynamics.(Figure 1 panel D). NT-proBNP level is elevated in ambulatory patients with continuous flow left ventricular assist devices and has a moderate correlation with filling pressures. The best cutoff value identified to predict need of hemodynamic optimization had low sensitivity and specificity. [ABSTRACT FROM AUTHOR]

Purpose Evaluate the prevalence, temporal trends and outcomes of patients with left ventricular assist devices and inotropes at the time of listing for heart transplantation. Methods Patients ≥ 18 years old with an LVAD implanted and listed with 1A status were identified in the United Network for Organ Sharing (UNOS) registry between Jan 2010 and Dec 2017, with follow-up through March 2018. Patients were grouped according to the presence or absence of inotropes at the time of listing. The primary outcomes were mortality on the waiting list or transplantation. Since the occurrence of one of the outcomes will prevent the other from manifesting, we accounted for this by use of competing risks regression. Variables that were adjusted for include age, gender, race, BMI, diabetes, prior cardiac surgery, dialysis-dependent, cerebrovascular disease and presence of an implanted defibrillator. Results A total of 2,714 patients were included in the study. The temporal trend of LVAD patients on inotropic therapy at the time of listing and at the time of transplant is shown in figure 1. Patients on inotropes are younger(49.8 (14.0) vs 52.5 (12.4) p<0.001), less likely to be white(56.7% vs 62.2% p=0.01) and have higher wedge pressure (24.1mmHg (8.4)vs 17.7mmHg (9.5) p <0.001) and higher mean pulmonary arterial pressure (33.8mmHg (10.0) vs 27.0mmHg (10.2)p<0.001). Patients on LVAD and inotropes at the time of listing had higher risk of dying in the waiting list sub-hazard ratio (SHR) =1.48 (95% CI=1.14, 1.90), p=0.002 and were less likely to be transplanted SHR= 0.70 (95% CI=0.63, 0.78), p<0.001 after adjusting for described confounders. Conclusion Approximately 1 in 5 patient on LVAD support is on inotropic therapy at the time of listing for heart transplantation. Patients on LVAD and inotropes have worse outcomes in term of survival and chances of being transplanted. The impact of the new allocation system in these patients remains to be seen. [ABSTRACT FROM AUTHOR]

Abstract: American Cutaneous Leishmaniasis (ACL) is caused by protozoan parasites of the Leishmania genus, and transmitted by females of the Phlebotominae family. The role of wild and domestic hosts in the cycle of Leishmania is still unknown. ACL is endemic in the province of Formosa where Nyssomyia neivai was the most abundant species in several captures and 31 cumulative ACL human cases were reported between 2005 and 2011 in the province. The present report describes the detection, by PCR-RFLP and confirmed by sequencing, of subgenus Leishmania (Viannia) DNA in four free-ranging owl monkeys (Aotus azarai azarai) from Formosa Province. The sequence amplified was the mini-exon gene present in tandem repeats in all species of the Leishmania genus from buffy coat samples. The absence of inhibitors in the samples was checked by a β-globin protocol originally designed to amplify the human β-globin gene. However, other free-ranging primates were found with natural infections of L. (V) braziliensis complex and Leishmania (Viannia) subgenus by parasitological means in America. To the best of our knowledge, there are no published reports on detection of subgenus Leishmania (Viannia) DNA by PCR-RFLP in argentinean free-ranging primates. Additional eco-epidemiological and parasitological studies are necessary to confirm owl monkeys, or any other natural infected mammal species detected by PCR, as a reservoir, incidental host or to propose it as an animal model for research on this topic. [Copyright &y& Elsevier]

To determine the accuracy of non-invasive blood mean blood pressure (MAP) assessment in patients with continuous flow left ventricular assist devices. Systematic electronic search was performed on four online databases (PubMed, Scopus, Embase, and Web of Knowledge) for the terms "Blood Pressure" AND ("Heart-Assist Devices" OR "Left ventricular Assist Devices"). Only studies where a non-invasive blood pressure measurement was compared with intra-arterial blood pressure recording were included. A total of 12 studies with 502 participants were included, of those 402 had intra-arterial blood pressure measurement. The median number of participants per study was 30.5 (range: 5-154). The mean age of participants was 53 years old and 77% were male. All were single center prospective studies and intra-arterial blood pressure recordings were performed in the context of routine medical care in the Intensive Care Unit. Characteristics of the included studies are shown in figure 1. Intra-arterial recording was obtained using fluid filled catheter in all studies. Statements regarding the leveling and calibration of transducer 6 (50%) studies. Simultaneous recording occurred in 4 (30%) studies. The correlations between non-invasive and intra-arterial recordings are shown in Figure 2 Standardization of quality of signal acquisition and assessment of pulsatility was variable among studies. Non-invasive MAP has variable accuracy and this may adversely influence patients outcomes. [ABSTRACT FROM AUTHOR]