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The Turkestan cockroach, Periplaneta lateralis (Walker), is an invasive urban pest prevalent in dry areas of the southwestern United States. Treatment with liquid spray formulations containing insecticides is the most conventional method to decrease Turkestan cockroach population abundance around buildings. Intensive application of insecticide treatments near natural environments has prompted concerns regarding the impacts on non-target aquatic and terrestrial ecosystems. Technologies embedding insecticides in a paint matrix have successfully been used for the long-term reduction in disease-vector populations in tropical areas. Here, we evaluated the potential effectiveness of three pyrethroid-based paints against Turkestan cockroach nymphs on common surfaces inhabited by this species. Turkestan cockroaches continuously exposed for 1 h to 1-month aged alphacypermethrin and deltamethrin paints applied to concrete, metal, or PVC caused moderate to high mortality. Evaluations using choice boxes indicated that deltamethrin and transfluthrin paints had combined lethal and repellent effects on cockroaches. Alphacypermethrin also caused repellency and killed cockroaches rapidly. We discuss the implications of these findings on cockroach control practices.

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Continuamos con la serie de casos clínicos en Cardiología Pediátrica revisando los motivos de consulta frecuentes en las consultas de Pediatría de Atención Primaria, presentados de forma breve y práctica y tratando de mostrar la utilidad del electrocardiograma, método diagnóstico del que disponemos en Atención Primaria. En esta ocasión se presenta el caso de un adolescente de 15 años que acude a consulta de Cardiología para valoración por detección de un soplo cardiaco. Se discuten los hallazgos electrocardiográficos, ecográficos y la orientación en el manejo de este paciente (AU)

We continue with the series of clinical cases in Pediatric Cardiology reviewing the frequent reasons for consultation in Primary Care Pediatrics, presented in a brief and practical way and trying to show the usefulness of the electrocardiogram, a diagnostic method available in Primary Care. In this issue we present the case of a 15-year-old adolescent who attended a cardiology consultation for evaluation of a heart murmur. We discuss the electrocardiographic and echographic findings and the orientation in the management of this patient. (AU)

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Hybrid positron emission tomography (PET)/magnetic resonance imaging (MRI) is highly suited for abdominal pathologies. A precise co-registration of anatomic and metabolic data is possible thanks to the simultaneous acquisition, leading to accurate imaging. The literature shows that PET/MRI is at least as good as PET/CT and even superior for some indications, such as primary hepatic tumors, distant metastasis evaluation, and inflammatory bowel disease. PET/MRI allows whole-body staging in a single session, improving health care efficiency and patient comfort.

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Histamine is a biogenic amine that regulates multiple physiological functions in diverse organisms, specifically playing a central role in the mammalian immune response. The common bed bug, Cimex lectularius L. (Hemiptera: Cimicidae), excretes histamine in large amounts in its feces as a component of its aggregation pheromone, which contaminates homes. The potential health risks associated with the presence of indoor histamine are unclear, but to predict future exposure risks, it is critical that we understand if other arthropods excrete histamine in any discernible phylogenetic pattern. In the present study, we evaluated histamine excretion by various arthropods; specifically those commonly found in large numbers indoors, other hematophagous species, and other species in the order Hemiptera. To evaluate arthropods for histamine excretion, rearing containers for each arthropod were swabbed and/or the harborage substrates were collected. Samples were then analyzed for the presence of histamine using gas chromatography-mass spectrometry. For those arthropods where histamine was present above the method detection limit, total histamine excretion was quantified over a period of 2 wk. Our results indicate that histamine excretion is limited to hematophagous hemipterans (bed bugs, bat bugs, tropical bed bugs, and kissing bugs), suggesting that indoor histamine contamination in the United States can be primarily linked to bed bugs.

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While supramolecular chemistry involving organic and metallo-organic host assemblies is a well-established and important field with applications in gas-storage, drug-delivery and the regio- and stereo-control of organic reactions, the use of main group elements in this setting (beyond the second row of the p-block) has been little explored. In this paper we show how periodic trends in the p-block can provide the means for systematic size and structural control in an important class of supramolecular porphyrin-based capsules. The formation of molecular and extended 2D capsule arrangements between the heavier Group 15 tris(3-pyridyl) linkers Sb(3-py)3 and Bi(3-py)3 and the metallo-porphyrins MTPP (M = Zn, Mg; TPP = tetraphenylporphyrin, 3-py = 3-pyridyl) is the first study involving heavier Group 15 pyridyl linkers. The increase in C-E bond length in the E(3-py)3 linkers moving down Group 15 (from E = P, to Sb, to Bi) can be used to alter the dimensions and structural preference of the capsules, as can oxidation of the Group 15 bridgehead atoms themselves. The subtle changes in the dimensions and Lewis acidity of the encapsulates have a dramatic effect on the rate and selectivity of the catalytic oxidative cleavage of organic diols and catalytic oxidation of α-hydroxyketones. By providing simple tools for modulating the chemical and steric properties of the capsules this work should have direct applications for the tuning of the activity and specificity of a range of catalytic systems based on main-group-based capsules of this type.

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BACKGROUND: The southwestern United States is home to a variety of arthropods including Turkestan cockroaches, Blatta lateralis (Walker); hematophagous kissing bugs, Tritoma rubida (Uhler); and Arizona bark scorpions, Centruroides sculpturatus Ewing. These arthropods cause medical concern when they become established around homes and/or invade indoors. Traditionally, the management of these pests has relied primarily on the use of chemical insecticides; however, they offer poor prospects for control owing to their lack of efficacy as well as the effects of insecticides on humans and the environment. Botanical repellents are an option that has not been fully investigated for the management of these pests. Here, we investigated the behavioral responses of common urban pests of the southwestern USA to recently discovered coconut fatty acids (CFAs), to establish the potential use of these compounds as repellents. RESULTS: Fresh residues of CFA mixture (CFAm) and their constituents caprylic acid, capric acid, capric acid methyl ester, lauric acid, and lauric acid methyl ester, tested at a concentration of 1 mg cm-2 , strongly repelled all arthropods. The repellent activity of CFAm lasted for at least 7 days, and the addition of lavender oil, used as an odor-masking agent, did not decrease this effect. Concentrations of CFAm ten times lower (0.1 mg cm-2 ) still repelled Turkestan cockroaches, and concentrations 100 times lower (0.01 mg cm-2 ) repelled T. rubida and scorpions. CONCLUSIONS: CFAm and some of their constituents are efficacious, economical, and logistically feasible for inclusion in integrated pest management programs for these important urban pests of the southwestern USA. © 2023 Society of Chemical Industry.

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PURPOSE: To externally validate an algorithm for non-invasive differentiation of hepatic mucinous cystic neoplasms (MCN) from benign hepatic cysts (BHC), which differ in management. METHODS: Patients with cystic liver lesions pathologically confirmed as MCN or BHC between January 2005 and March 2022 from multiple institutions were retrospectively included. Five readers (2 radiologists, 3 non-radiologist physicians) independently reviewed contrast-enhanced CT or MRI examinations before tissue sampling and applied the 3-feature classification algorithm described by Hardie et al. to differentiate between MCN and BHC, which had a reported accuracy of 93.5%. The classification was then compared to the pathology results. Interreader agreement between readers across different levels of experience was evaluated with Fleiss' Kappa. RESULTS: The final cohort included 159 patients, median age of 62 years (IQR [52.0, 70.0]), 66.7% female (106). Of all patients, 89.3% (142) had BHC, and the remaining 10.7% (17) had MCN on pathology. Agreement for class designation between the radiologists was almost perfect (Fleiss' Kappa 0.840, p < 0.001). The algorithm had an accuracy of 98.1% (95% CI [94.6%, 99.6%]), a positive predictive value of 100.0% (95% CI [76.8%, 100.0%]), a negative predictive value of 97.9% (95% CI [94.1%, 99.6%]), and an area under the receiver operator characteristic curve (AUC) of 0.911 (95% CI [0.818, 1.000]). CONCLUSION: The evaluated algorithm showed similarly high diagnostic accuracy in our external, multi-institutional validation cohort. This 3-feature algorithm is easily and rapidly applied and its features are reproducible among radiologists, showing promise as a clinical decision support tool.

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Cat fleas, small blood-feeding ectoparasites that feed on humans and animals, cause discomfort through their bites, and can transmit numerous diseases to animals and humans. Traditionally, fleas have been reared for research on live animals, but this process requires animal handling permits, inflicts discomfort on animals, and requires money and time to maintain the host animals. Although artificial membrane-based feeding systems have been implemented, these methods are not sustainable in the long term because they result in lower blood consumption and egg production than those with rearing on live hosts. To maximize these parameters, we tested blood from four hosts to determine the most suitable blood, on the basis of blood consumption and egg production. We also tested the effects of adding the phagostimulant adenosine-5´-triphosphate to the blood to maximize blood consumption. In 48 hours, fleas fed dog blood consumed the most blood, averaging 9.5 µL per flea, whereas fleas fed on cow, cat, or human blood consumed 8.3 µL, 5.7 µL, or 5.2 µL, respectively. Addition of 0.01 M and 0.1 M adenosine-5´-triphosphate to dog and cow blood did not enhance blood consumption. In a 1-week feeding period, the total egg production was also greatest in fleas fed dog blood, with females producing 129.5 eggs, whereas females on cat, human, and cow blood produced 97.2, 83.0, and 70.7 eggs, respectively. The observed results in dog blood indicate an improvement over previously reported results in cat fleas fed with an artificial feeding system. Improving the sustainability of rearing cat flea colonies without feeding on live animals will enable more humane and convenient production of this pest for scientific research.

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The substitution of heavier, more metallic atoms into classical organic ligand frameworks provides an important strategy for tuning ligand properties, such as ligand bite and donor character, and is the basis for the emerging area of main-group supramolecular chemistry. In this paper, we explore two new ligands [E(2-Me-8-qy)3] [E = Sb (1), Bi (2); qy = quinolyl], allowing a fundamental comparison of their coordination behavior with classical tris(2-pyridyl) ligands of the type [E'(2-py)3] (E = a range of bridgehead atoms and groups, py = pyridyl). A range of new coordination modes to Cu+, Ag+, and Au+ is seen for 1 and 2, in the absence of steric constraints at the bridgehead and with their more remote N-donor atoms. A particular feature is the adaptive nature of these new ligands, with the ability to adjust coordination mode in response to the hard-soft character of coordinated metal ions, influenced also by the character of the bridgehead atom (Sb or Bi). These features can be seen in a comparison between [Cu2{Sb(2-Me-8-qy)3}2](PF6)2 (1·CuPF6) and [Cu{Bi(2-Me-8-qy)3}](PF6) (2·CuPF6), the first containing a dimeric cation in which 1 adopts an unprecedented intramolecular N,N,Sb-coordination mode while in the second, 2 adopts an unusual N,N,(π-)C coordination mode. In contrast, the previously reported analogous ligands [E(6-Me-2-py)3] (E = Sb, Bi; 2-py = 2-pyridyl) show a tris-chelating mode in their complexes with CuPF6, which is typical for the extensive tris(2-pyridyl) family with a range of metals. The greater polarity of the Bi-C bond in 2 results in ligand transfer reactions with Au(I). Although this reactivity is not in itself unusual, the characterization of several products by single-crystal X-ray diffraction provides snapshots of the ligand transfer reaction involved, with one of the products (the bimetallic complex [(BiCl){ClAu2(2-Me-8-qy)3}] (8)) containing a Au2Bi core in which the shortest Au → Bi donor-acceptor bond to date is observed.

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We present the case of a 64-year-old male with a history of chronic liver disease due to hepatitis C virus, with a sustained viral response after oral antiviral treatment and without follow-up for 5 years. He was admitted after a one-month history of constitutional symptoms, low-grade fever, abdominal pain and a palpable epigastric tumor. Analysis showed marked elevation of acute phase reactants (48,000 leukocytes and C-reactive protein of 19mg/dl) and dissociated cholestasis. Two lesions were identified by abdominal CT.

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Tricuspid valvulopathy has gained a lot of attention in recent years, especially due to the advances in percutaneous management. CHD can present with primary or secondary malfunction of the tricuspid valve, often not addressed due to high surgical risk after several interventions. We present two cases of adults with complex congenital heart malformations and borderline clinical situations who successfully underwent percutaneous tricuspid replacement.

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The use of antimony and bismuth in supramolecular chemistry has been largely overlooked in comparison to the lighter elements of Group 15, and the coordination chemistry of the tripodal ligands [Sb(3-py)3] and [Bi(3-py)3] (L) containing the heaviest p-block element bridgehead atoms has been unexplored. We show that these ligands form a common hybrid metal-organic framework (MOF) structure with Cu(I) and Ag(I) (M) salts of weakly coordinating anions (PF6-, SbF6-, and OTf-), composed of a cationic substructure of rhombic cage (M)4(L)4 units linked by Sb/Bi-M bonding. The greater Lewis acidity of Bi compared to Sb can, however, allows anion···Bi interactions to overcome Bi-metal bonding in the case of BF4-, leading to collapse of the MOF structure (which is also seen where harder metals like Li+ are employed). This study therefore provides insight into the way in which the electronic effects of the bridgehead atom in these ligand systems can impact their supramolecular chemistry.

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We report the elusive metallic anion [EtAl(3-py)3]- (3-py = 3-pyridyl) (1), the first member of the anionic tris(3-pyridyl) family. Unexpectedly, the lithium complex 1Li shows substantial protic stability against water and alcohols, unlike related tris(2-pyridyl)aluminate analogues. This stability appears to be related to the inability of the [EtAl(3-py)3]- anion to chelate Li+, which precludes a decomposition pathway involving Li/Al cooperativity.

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BACKGROUND: Chagas disease is a leading cause of cardiac failure in Latin America. Due to poor safety profiles and efficacy of currently available therapeutics, prevention is a priority for the millions living at risk for acquiring this clinically important vector-borne disease. Triatomine vectors of the Chagas disease parasite, Trypanosoma cruzi, are found in the southwestern United States, but risk for autochthonous transmission is thought to be low. The role of ectoparasitic mites is under-explored regarding the ecology of triatomines and Chagas disease transmission. METHODS: Triatomine collections were performed using three common entomologic techniques in 2020-2021 from four different locations in southern Arizona and New Mexico. Triatomines were analyzed visually under a 112.5× microscope for the presence of externally attached mites. Following mite removal, triatomines were tested for T. cruzi infection by PCR. RESULTS: Approximately 13% of the collected triatomines had mites securely attached to their head, thorax, abdomen, and legs. More than one mite attached was a common finding among ectoparasitized triatomines. Mite presence, however, did not statistically influence triatomine T. cruzi status. CONCLUSIONS: Our findings add to a growing body of literature demonstrating the sustainability of mite-infested triatomine populations throughout the Western Hemisphere. Future investigations are warranted to better understand the biologic impact of triatomine mites and their potential to serve as a potential biological control tool.

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Background: Cervicocranial arterial dissection (CIAD) is an important cause of stroke. Aim: To describe the clinical and imaging characteristics of patients with CIAD. Material and Methods: An anonymous registry was made including all patients admitted to a private hospital with a diagnosis of CIAD. Patients were subdivided as having an anterior or posterior circulation dissection (ACD or PCD, respectively). Results: Fifty-seven patients aged 40 ± 8 years (60% women) were included in the study, 39 with PCD and 18 with ACD. Cervical pain was the most common symptom. CIAD was diagnosed with no clinical or imaging signs of stroke in 49% of patients. Fifty one percent of patients had focal neurological deficits and 72% had a NIH stroke score below five. No significant differences between patients with ACD or PCD were found. Fifty patients received antiplatelet therapy (simple or dual), seven patients were anticoagulated and 13 were subjected to stenting due to progression of stenosis with hemodynamic involvement or bilateral dissection with scarce collaterals. The lesion was located in V3 segment in 27 patients and cervical segment of the internal carotid in 16 cases. A favorable Modified Rankin Scale (0-2) was achieved in 85.9%, with a trend towards achieving better functional prognosis in PCD. Conclusions: Due to the greater availability of non-invasive imaging methods, 50% of these patients with CIAD did not have a stroke. Thus, an earlier and more timely management is feasible.

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Effective control of domestic and peridomestic cockroaches requires integrated approaches that emphasize concurrent use of chemicals with alternative control tactics. An integrated pest management (IPM) approach is particularly justified in environments where satisfactory cockroach control cannot be achieved due to multiple factors including development of insecticide aversion and resistance in some cockroach species, and poor sanitation or structural issues that foster infestations. While a flurry of research effort has been devoted to study alternative tactics for cockroach control, only a few of them have been evaluated in the context of IPM programs. This review focuses on examining studies on alternative tactics that are proven efficacious, economical, and logistically feasible for their inclusion in IPM programs for important domestic and peridomestic cockroaches in the USA. Management programs that educate the public on cockroach biology, behavior, and the importance of sanitation; use of traps to monitor infestation levels; apply targeted low impact insecticides such as baits, have demonstrated a greater success for effective and sustainable control of cockroaches when compared to an insecticide-only approach. Incorporation of other alternative control methods to IPM programs will require more applied research that validates their use in real-world scenarios and demonstrates their cost-effectiveness.

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BACKGROUND: Supervisory effectiveness in long-term care facilities has been identified a key factor in staff satisfaction and quality of care. Determining its utility in Spanish speaking countries will assist with understanding different cultural and health service contexts. OBJECTIVES: To develop and psychometrically test the Supervisory Support Scale in Spanish. The Spanish version of the Supportive Supervisory Scale could be useful for cross-cultural comparisons of supervisory support, which is a key factor to improving work relationships in long-term care facilities. METHODS: Validation was carried out with 405 participants in 37 long-term care facilities. One-way analysis of variance was the test of significance performed to examine the differences among the facilities and Pearson product-moment correlations were used to assess construct validation of the scale. The mean and standard deviation were calculated for each supervisory score in each facility. Structural equation modelling was used to confirm the dimensions of the scale. RESULTS: The item-to-item correlations were positive, ranging from 0.44 to 0.78, indicating good reliability of the scale. The coefficient alpha for the total scale was 0.96. The 15-item had mean item scores which ranged from 2.89 to 3.96 (SD = 1.01-1.26). Standardised factor loadings ranged within a narrow range: 0.75-0.86 for the 'respecting uniqueness' latent variable and 0.76-0.88 for the 'being reliable' latent variable. Construct validity was demonstrated as measure was positively associated with job satisfaction (r = 0.412, p < 0.0001) and was negatively correlated with HCAs' stress and burden. CONCLUSION: The two-factor solution identified in the original scale that highlighted two key attributes of the supervisor; being reliable and respecting uniqueness, was also demonstrated in the Spanish Supervisory Support Scale as there was a moderate fit of the model. IMPLICATIONS FOR PRACTICE: The Spanish version of the Supportive Supervisory Scale could be useful for cross-cultural comparisons of supervisory support in nursing facilities which is a key factor to improving staff relationships and care in nursing facilities.

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Objetivo: El objetivo principal fue evaluar y comparar tres programasde entrega de medicamentos requeridos por los pacientes atendidosen las consultas externas de farmacia hospitalaria: mediante centros desalud, empresa de mensajería externa y oficinas de farmacia. El objetivosecundario fue analizar el coste económico desde la perspectiva delsistema público de salud.Método: Se utilizó el análisis modal de fallos y efectos para el objetivoprincipal. El análisis económico se realizó mediante un estudio de minimización de costes.Resultados: Los resultados en índice de probabilidad de riesgo fueron184 puntos para la entrega mediante centros de salud, 170 mediantemensajería y 126 mediante oficina de farmacia. El estudio económicomostró que actualmente el programa con menor coste económico fue ladispensación mediante oficina de farmacia respecto a mensajería y centros de salud (7.986,52 € versus 18.434,52 € y 11.417,08 €).Conclusiones: La entrega mediante oficina de farmacia tiene el menoríndice de probabilidad de riesgo debido en gran parte al papel delfarmacéutico en la custodia y conservación del medicamento. (AU)

Objective: The main purpose of this study was to analyze and comparethree different medication delivery methods used by the outpatient careunit of a hospital pharmacy, namely health center collection, communitypharmacy collection and home delivery. The secondary purpose was tocompare the economic cost of those methods for the Spanish health service.Method: A failure mode and effects analysis was carried out to attain theprimary objective. For the secondary objective, an in-depth analysis wasperformed of the economic costs associated with each program using acost-minimization analysis.Results: The failure mode and effects analysis resulted in scores of184, 170 and 126 points for the health center collection, home deliveryand community pharmacy collection programs, respectively. The economic evaluation, for its part, rendered estimated costs of €18,434.52,€11,417.08 and €7,986.52 for home delivery, health center collectionand community pharmacy collection services, respectively.Conclusions: The results of the study indicated that collection at the community pharmacy was the program associated to the lowest risk, most likely dueto the crucial role of the pharmacist regarding the custody and preservation of medicines. (AU)

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