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The increasing use of light-based treatments requires a better understanding of the light tissue interaction for pigmented skin. To enhance comprehension in this area, this study proposes the use of pigmented-mimicking skin phantoms to assess the optical properties based on their tone, represented by the Individual Typology Angle (ITA) color scale. In this study, an epoxy resin matrix alongside compact facial powder and titanium dioxide was used to mimic the absorption, scattering, and shade properties of human skins. Eight phantoms covering the skin tones, light (ITA = 45.2°), tan (ITA = 23.3°), brown (ITA = 6.9°, -5.7°, and -16.9°), and dark (ITA = -34.6°, -41.6°, and -48.6°), were crafted. The absorption and reduced scattering coefficients were obtained using integrating spheres and calibrated spectrometers in the 500-900 nm range, and tones were measured using a commercial colorimeter. The experimental fitting proposed in this study could estimate the optical properties as a function of the skin tones through ITA values, by using an exponential function with a second-order polynomial exponent. This investigation aligns with prior studies involving human skin samples, and these findings hold promise for future clinical and diagnostic applications, particularly in the realm of light-based treatments to individual dermatological corrections in pigmented skin.

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Abstract Objective: Periventricular-intraventricular hemorrhage is the most common type of intracranial bleeding in newborns, especially in the first 3 days after birth. Severe periventricular-intraventricular hemorrhage is considered a progression from mild periventricular-intraventricular hemorrhage and is often closely associated with severe neurological sequelae. However, no specific indicators are available to predict the progression from mild to severe periventricular-intraventricular in early admission. This study aims to establish an early diagnostic prediction model for severe PIVH. Method: This study was a retrospective cohort study with data collected from the MIMIC-III (v1.4) database. Laboratory and clinical data collected within the first 24 h of NICU admission have been used as variables for both univariate and multivariate logistic regression analyses to construct a nomogram-based early prediction model for severe periventricular-intraventricular hemorrhage and subsequently validated. Results: A predictive model was established and represented by a nomogram, it comprised three variables: output, lowest platelet count and use of vasoactive drugs within 24 h of NICU admission. The model's predictive performance showed by the calculated area under the curve was 0.792, indicating good discriminatory power. The calibration plot demonstrated good calibration between observed and predicted outcomes, and the Hosmer-Lemeshow test showed high consistency (p = 0.990). Internal validation showed the calculated area under a curve of 0.788. Conclusions: This severe PIVH predictive model, established by three easily obtainable indicators within the NICU, demonstrated good predictive ability. It offered a more user-friendly and convenient option for neonatologists.

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OBJECTIVE: Periventricular-intraventricular hemorrhage is the most common type of intracranial bleeding in newborns, especially in the first 3 days after birth. Severe periventricular-intraventricular hemorrhage is considered a progression from mild periventricular-intraventricular hemorrhage and is often closely associated with severe neurological sequelae. However, no specific indicators are available to predict the progression from mild to severe periventricular-intraventricular in early admission. This study aims to establish an early diagnostic prediction model for severe PIVH. METHOD: This study was a retrospective cohort study with data collected from the MIMIC-III (v1.4) database. Laboratory and clinical data collected within the first 24 h of NICU admission have been used as variables for both univariate and multivariate logistic regression analyses to construct a nomogram-based early prediction model for severe periventricular-intraventricular hemorrhage and subsequently validated. RESULTS: A predictive model was established and represented by a nomogram, it comprised three variables: output, lowest platelet count and use of vasoactive drugs within 24 h of NICU admission. The model's predictive performance showed by the calculated area under the curve was 0.792, indicating good discriminatory power. The calibration plot demonstrated good calibration between observed and predicted outcomes, and the Hosmer-Lemeshow test showed high consistency (p = 0.990). Internal validation showed the calculated area under a curve of 0.788. CONCLUSIONS: This severe PIVH predictive model, established by three easily obtainable indicators within the NICU, demonstrated good predictive ability. It offered a more user-friendly and convenient option for neonatologists.

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Up to now, rubber materials have been used in a wide range of applications, from automotive parts to special-design engineering pieces, as well as in the pharmaceutical, food, electronics, and military industries, among others. Since the discovery of the vulcanization of natural rubber (NR) in 1838, the continuous demand for this material has intensified the quest for a synthetic substitute with similar properties. In this regard, synthetic polyisoprene rubber (IR) emerged as an attractive alternative. However, despite the efforts made, some properties of natural rubber have been difficult to match (i.e., superior mechanical properties) due not only to its high content of cis-1,4-polyisoprene but also because its structure is considered a naturally occurring nanocomposite. In this sense, cutting-edge research has proposed the synthesis of nanocomposites with synthetic rubber, obtaining the same properties as natural rubber. This review focuses on the synthesis, structure, and properties of natural and synthetic rubber, with a special interest in the synthesis of IR nanocomposites, giving the reader a comprehensive reference on how to achieve a mimic of NR.

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BACKGROUND: Stroke mimics are non-vascular conditions that present with acute focal neurological deficits, simulating an acute ischemic stroke. Susumber berry (SB) toxicity is a rare cause of stroke mimic with limited case reports available in the literature. OBJECTIVES: We report four new cases of SB toxicity presenting as stroke mimic, and we performed a systematic review. METHODS: MEDLINE/EMBASE/WoS were searched for "susumber berries," "susumber," or "solanum torvum." RESULTS: 531 abstracts were screened after removal of duplicates; 5 articles and 2 conference abstracts were selected describing 13 patients. A total of 17 patients who ingested SB and became ill were identified, including our 4 patients. All but one presented with acute neurologic manifestation; 16 (94%) presented with dysarthria, 16 (94%) with unstable gait, 8 (47%) with nystagmus/gaze deviation, 10 (59%) with blurry vision, and 5 (29%) with autonomic symptoms. Six (35%) required ICU admission, and 3 (18%) were intubated. Fourteen (82%) had a rapid complete recovery, and 3 were hospitalized up to 1 month. CONCLUSIONS: SB toxicity can cause neurological symptoms that mimic an acute stroke typically with a posterior circulation symptom complex. Altered SB toxins (from post-harvest stressors or temperature changes) might stimulate muscarinic/nicotinic cholinergic receptors or inhibit acetylcholinesterase, causing gastrointestinal, neurological, and autonomic symptoms. In cases of multiple patients presenting simultaneously to the ED with stroke-like symptoms or when stroke-like symptoms fail to localize, a toxicological etiology (such as SB toxicity) should be considered.

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The aim of this study is to analyze the factorial structure of the Multidimensional Body-Self Relations Questionnaire-Appearance Scales (MBSRQ-AS) to determine the adjustment of the study structure proposed in the Spanish short version in a young, non-clinical Chilean population and to evaluate the possible influence of sex, age, and BMI on body image measurement. The sample consisted of 614 Chilean youth (259 male and 355 female) between 15 and 28 years old (M = 18.81; SE = 2.46), from the Metropolitan Region, and four regions of the coast and south-central zone of the country. The average Body Mass Index (BMI) was 22.5 kg/m2 (SD = 3.16). The model fit was evaluated by confirmatory factor analysis (WLSMV) using the following: a model with a single general factor, a model with the five factors of the original version, a five-factor ESEM model, and a MIMIC model analyzed including sex, age, and BMI. The results show that the MIMIC sex, age, and BMI model presents an acceptable fit, observing that four factors, Appearance Orientation (AO), Body Areas Satisfaction (BAS), Overweight Preoccupation (OP), and Self-Classification Weight (SCW), are affected significantly for the sex variable, one for age, Appearance Evaluation (AE), and four for BMI (AE, BAS, OP, and SCW). In conclusion, MBSRQ-AS replicates the five-dimensional structure in a non-clinical sample of young Chileans; however, their scores are not invariant as they depend on sex, age, and BMI.

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The present study objectified to evaluate the trophic relationships and the possible aggressive mimicry involving Carnegiella strigata, Carnegiella marthae and Gnathocharax steindachneri, in lowland forest streams. Samplings occurred in November 2002, March and August 2003 in Amanã Sustainable Development Reserve (ASDR). The total of 943 fish was caught, being 79.43% of C. marthae, 3.18% of C. strigata and 17.39% of G. steindachneri. Stomach contents, degree of stomach repletion, relative volume and frequency of occurrence of food items were evaluated. Thirteen food items were identified, and the presence of terrestrial and aquatic insects indicates the high dependence of these species and the flooded forest. Low feeding overlap was observed between Carnegiella strigata and C. marthae compared to Gnathocharax steindachneri. However, the overlap between the two Carnegiella species was relatively high, which could explain the low frequency of syntopic occurrence among these species, suggesting a possible case of competitive exclusion.(AU)

Este estudo teve como objetivo analisar as relações tróficas e a possível existência de uma relação de mimetismo agressivo envolvendo Carnegiella strigata, Carnegiella marthae e Gnathocharax steindachneri, em igarapés de terra firme. As coletas ocorreram em novembro de 2002, março e agosto de 2003 e foram realizadas na Reserva de Desenvolvimento Sustentável de Amanã (RDSA). Foram capturados 943 peixes, onde C. marthae representou 79,43%, C. strigata 3,18% e G. steindachneri 17,39%. Foram analisados os conteúdos estomacais e verificados grau de repleção, volume relativo e frequência de ocorrência dos alimentos. Foram identificados 13 itens alimentares, onde insetos terrestres e aquáticos denotaram alto grau de dependência destas espécies em relação à floresta alagada. Ocorreu baixa sobreposição alimentar das espécies Carnegiella strigata e C. marthae em relação a Gnathocharax steindachneri. Entretanto, a sobreposição entre as duas espécies de Carnegiella foi relativamente alta, o que poderia explicar a baixa frequência de ocorrência sintópica entre essas espécies, sugerindo um possível caso de exclusão competitiva.(AU)

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The present study objectified to evaluate the trophic relationships and the possible aggressive mimicry involving Carnegiella strigata, Carnegiella marthae and Gnathocharax steindachneri, in lowland forest streams. Samplings occurred in November 2002, March and August 2003 in Amanã Sustainable Development Reserve (ASDR). The total of 943 fish was caught, being 79.43% of C. marthae, 3.18% of C. strigata and 17.39% of G. steindachneri. Stomach contents, degree of stomach repletion, relative volume and frequency of occurrence of food items were evaluated. Thirteen food items were identified, and the presence of terrestrial and aquatic insects indicates the high dependence of these species and the flooded forest. Low feeding overlap was observed between Carnegiella strigata and C. marthae compared to Gnathocharax steindachneri. However, the overlap between the two Carnegiella species was relatively high, which could explain the low frequency of syntopic occurrence among these species, suggesting a possible case of competitive exclusion.

Este estudo teve como objetivo analisar as relações tróficas e a possível existência de uma relação de mimetismo agressivo envolvendo Carnegiella strigata, Carnegiella marthae e Gnathocharax steindachneri, em igarapés de terra firme. As coletas ocorreram em novembro de 2002, março e agosto de 2003 e foram realizadas na Reserva de Desenvolvimento Sustentável de Amanã (RDSA). Foram capturados 943 peixes, onde C. marthae representou 79,43%, C. strigata 3,18% e G. steindachneri 17,39%. Foram analisados os conteúdos estomacais e verificados grau de repleção, volume relativo e frequência de ocorrência dos alimentos. Foram identificados 13 itens alimentares, onde insetos terrestres e aquáticos denotaram alto grau de dependência destas espécies em relação à floresta alagada. Ocorreu baixa sobreposição alimentar das espécies Carnegiella strigata e C. marthae em relação a Gnathocharax steindachneri. Entretanto, a sobreposição entre as duas espécies de Carnegiella foi relativamente alta, o que poderia explicar a baixa frequência de ocorrência sintópica entre essas espécies, sugerindo um possível caso de exclusão competitiva.

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The present study objectified to evaluate the trophic relationships and the possible aggressive mimicry involving Carnegiella strigata, Carnegiella marthae and Gnathocharax steindachneri, in lowland forest streams. Samplings occurred in November 2002, March and August 2003 in Amanã Sustainable Development Reserve (ASDR). The total of 943 fish was caught, being 79.43% of C. marthae, 3.18% of C. strigata and 17.39% of G. steindachneri. Stomach contents, degree of stomach repletion, relative volume and frequency of occurrence of food items were evaluated. Thirteen food items were identified, and the presence of terrestrial and aquatic insects indicates the high dependence of these species and the flooded forest. Low feeding overlap was observed between Carnegiella strigata and C. marthae compared to Gnathocharax steindachneri. However, the overlap between the two Carnegiella species was relatively high, which could explain the low frequency of syntopic occurrence among these species, suggesting a possible case of competitive exclusion.

Este estudo teve como objetivo analisar as relações tróficas e a possível existência de uma relação de mimetismo agressivo envolvendo Carnegiella strigata, Carnegiella marthae e Gnathocharax steindachneri, em igarapés de terra firme. As coletas ocorreram em novembro de 2002, março e agosto de 2003 e foram realizadas na Reserva de Desenvolvimento Sustentável de Amanã (RDSA). Foram capturados 943 peixes, onde C. marthae representou 79,43%, C. strigata 3,18% e G. steindachneri 17,39%. Foram analisados os conteúdos estomacais e verificados grau de repleção, volume relativo e frequência de ocorrência dos alimentos. Foram identificados 13 itens alimentares, onde insetos terrestres e aquáticos denotaram alto grau de dependência destas espécies em relação à floresta alagada. Ocorreu baixa sobreposição alimentar das espécies Carnegiella strigata e C. marthae em relação a Gnathocharax steindachneri. Entretanto, a sobreposição entre as duas espécies de Carnegiella foi relativamente alta, o que poderia explicar a baixa frequência de ocorrência sintópica entre essas espécies, sugerindo um possível caso de exclusão competitiva.

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Abstract The present study objectified to evaluate the trophic relationships and the possible aggressive mimicry involving Carnegiella strigata, Carnegiella marthae and Gnathocharax steindachneri, in lowland forest streams. Samplings occurred in November 2002, March and August 2003 in Amanã Sustainable Development Reserve (ASDR). The total of 943 fish was caught, being 79.43% of C. marthae, 3.18% of C. strigata and 17.39% of G. steindachneri. Stomach contents, degree of stomach repletion, relative volume and frequency of occurrence of food items were evaluated. Thirteen food items were identified, and the presence of terrestrial and aquatic insects indicates the high dependence of these species and the flooded forest. Low feeding overlap was observed between Carnegiella strigata and C. marthae compared to Gnathocharax steindachneri. However, the overlap between the two Carnegiella species was relatively high, which could explain the low frequency of syntopic occurrence among these species, suggesting a possible case of competitive exclusion.

Resumo Este estudo teve como objetivo analisar as relações tróficas e a possível existência de uma relação de mimetismo agressivo envolvendo Carnegiella strigata, Carnegiella marthae e Gnathocharax steindachneri, em igarapés de terra firme. As coletas ocorreram em novembro de 2002, março e agosto de 2003 e foram realizadas na Reserva de Desenvolvimento Sustentável de Amanã (RDSA). Foram capturados 943 peixes, onde C. marthae representou 79,43%, C. strigata 3,18% e G. steindachneri 17,39%. Foram analisados os conteúdos estomacais e verificados grau de repleção, volume relativo e frequência de ocorrência dos alimentos. Foram identificados 13 itens alimentares, onde insetos terrestres e aquáticos denotaram alto grau de dependência destas espécies em relação à floresta alagada. Ocorreu baixa sobreposição alimentar das espécies Carnegiella strigata e C. marthae em relação a Gnathocharax steindachneri. Entretanto, a sobreposição entre as duas espécies de Carnegiella foi relativamente alta, o que poderia explicar a baixa frequência de ocorrência sintópica entre essas espécies, sugerindo um possível caso de exclusão competitiva.

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ABSTRACT A case is presented of an atypical manifestation of localized scleroderma. The patient is a 30-year-old Caucasian women with localized facial scleroderma "coup de sabre", with clinical stability foryears. She was seen in the Emergency Department due to a sudden lack of sensitivity in her left side, and was treated as a stroke. Complementary tests showed intracranial parenchymal images that were finally attributed to the localized scleroderma. After a comprehensive literature review, this presentation was more frequent than expected. This is why neurological symptoms should be carefully evaluated in these patients. This is the first stroke-mimic case reported.

RESUMEN A continuación, presentamos el caso de una paciente con una manifestación atípica para esclerodermia localizada. Mujer de 30 an˜ os con esclerodermia localizada facial en sabré¼, con estabilidad clínica de las lesiones durante an˜ os. En el 2017 acude al servicio de urgencias por un cuadro de alteración sensitiva en hemicuerpo izquierdo que fue tratada como un ictus. En los estudios complementarios se objetivaron lesiones parenquimatosas finalmente atribuibles a la esclerodermia localizada. Tras revisar la literatura, este tipo de lesiones es más frecuente de lo esperado, por lo que parece obligatorio dedicar más atención a los síntomas neurológicos en los pacientes con esclerodermia localizada. Este es el primer caso de stroke-mimic reportado.

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INTRODUCTION: Balo's Concentric Sclerosis (BCS) is a rare demyelinating disease sometimes considered a variant of multiple sclerosis. It is characterized by an acute or subacute neurological symptoms with characteristic MRI "onion-like" white matter lesions. BCS has a wide range of presentations but is mostly self-limiting. Steroids are indicated in patients with aggressive disease. CASE PRESENTATION: We report 2 cases of BCS with monophasic course of stroke-like symptoms and single periventricular concentric lamella with onion-like appearance on MRI without inflammatory reaction in the CSF. They were treated with corticosteroids achieving clinical improvement and without neurological deficit or relapse over the following years. CLINICAL DISCUSSION: A number of cases of BCS are described in the literature that show marked recovery with early diagnosis and treatment with steroids. CONCLUSION: BCS appears to have a good prognosis when treated early in its diagnosis with steroids.

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ABSTRACT Objective To explore an artificial intelligence approach based on gradient-boosted decision trees for prediction of all-cause mortality at an intensive care unit, comparing its performance to a recent logistic regression system in the literature, and a logistic regression model built on the same platform. Methods A gradient-boosted decision trees model and a logistic regression model were trained and tested with the Medical Information Mart for Intensive Care database. The 1-hour resolution physiological measurements of adult patients, collected during 5 hours in the intensive care unit, consisted of eight routine clinical parameters. The study addressed how the models learn to categorize patients to predict intensive care unit mortality or survival within 12 hours. The performance was evaluated with accuracy statistics and the area under the Receiver Operating Characteristic curve. Results The gradient-boosted trees yielded an area under the Receiver Operating Characteristic curve of 0.89, compared to 0.806 for the logistic regression. The accuracy was 0.814 for the gradient-boosted trees, compared to 0.782 for the logistic regression. The diagnostic odds ratio was 17.823 for the gradient-boosted trees, compared to 9.254 for the logistic regression. The Cohen's kappa, F-measure, Matthews correlation coefficient, and markedness were higher for the gradient-boosted trees. Conclusion The discriminatory power of the gradient-boosted trees was excellent. The gradient-boosted trees outperformed the logistic regression regarding intensive care unit mortality prediction. The high diagnostic odds ratio and markedness values for the gradient-boosted trees are important in the context of the studied unbalanced dataset.

RESUMO Objetivo Explorar uma abordagem de inteligência artificial baseada em árvores de decisão impulsionadas por gradiente para previsão de mortalidade por todas as causas em unidade de terapia intensiva, comparando seu desempenho com um sistema de regressão logística recente na literatura e um modelo de regressão logística construído na mesma plataforma. Métodos Foram desenvolvidos um modelo de árvores impulsionadas por gradiente e um modelo de regressão logística, treinados e testados com o banco de dados Medical Information Mart for Intensive Care. As medidas fisiológicas de pacientes adultos com resolução de 1 hora, coletadas durante 5 horas na unidade de terapia intensiva, consistiram em oito parâmetros clínicos de rotina. Estudou-se como os modelos aprendem a categorizar os pacientes para prever a mortalidade ou a sobrevida, em unidades de terapia intensiva, em 12 horas. O desempenho foi avaliado por meio de estatísticas de acurácia e pela área sob a curva Característica de Operação do Receptor. Resultados As árvores impulsionadas por gradiente produziram área sob a curva Característica de Operação do Receptor de 0,89, em comparação com 0,806 para a regressão logística. A acurácia foi de 0,814 para as árvores impulsionadas por gradiente, em comparação com 0,782 para a regressão logística. A razão de chances de diagnóstico foi de 17,823 para as árvores impulsionadas por gradiente, em comparação a 9,254 para a regressão logística. O kappa de Cohen, a medida F, o coeficiente de correlação de Matthews e a marcação foram maiores para as árvores impulsionadas por gradiente. Conclusão O poder discriminatório das árvores impulsionadas por gradiente foi excelente. As árvores impulsionadas por gradiente superaram a regressão logística em relação à previsão de mortalidade em unidade de terapia intensiva. A alta razão de chances de diagnóstico e os valores de marcação para as árvores impulsionadas por gradiente são importantes no contexto do conjunto de dados não balanceados estudado.

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Abstract A larger therapeutic window for stroke treatment requires a significant change in the organization of emergency services, avoiding the increase in number of imaging exams and indirectly the time to treatment. Objective: To highlight the relation between faster clinical evaluation and stroke over-suspicion and consequently excessive imaging acquisition. To identify predictors of ischemic stroke and stroke mimics (SM), aiming for better patient selection for comprehensive neuroimaging and reperfusion therapies. Methods: Retrospective, cohort, observational, single-center study that reviewed all consecutive files of patients presenting with acute neurological symptoms who underwent CT scan or MRI from July 1, 2016 to July 1, 2017. Results: 736 patient files were reviewed. 385 patients (52.3%) presented with confirmed acute ischemic infarct, 93 (12.6%) had another brain lesion mimicking acute ischemia, and 258 (35.1%) had normal imaging. Acute stroke was more frequent in elderly patients with atrial fibrillation, arterial hypertension, or dysarthria or right motor impairment. Stroke mimic was associated with female patients with low vascular risk factors, low NIHSS, and patients with decreased level of consciousness or symptoms suggestive of posterior circulation. Discussion: 47.7% of all patients seen at the stroke unit did not have acute stroke lesions. Clinical assessment data have been used to provide indicators of acute stroke and stroke mimic patients, and symptoms corresponding to acute stroke and stroke mimic seem to be similar in the literature. Conclusion: Considering that the number of patients admitted for stroke treatment will increase even further with a larger therapeutic window for mechanical thrombectomy and for thrombolysis, a diagnostic decision-making algorithm for stroke patients is required in order to reinforce the suspicion of stroke indicating an urgent MRI.

Resumo Uma janela terapêutica maior para o tratamento do AVC exige uma mudança significativa na organização dos serviços de emergência, para evitar o aumento do número de exames de imagem e indiretamente o tempo de tratamento. Objetivo: destacar a relação entre avaliação clínica mais rápida e suspeita de acidente vascular cerebral e, consequentemente, aquisição de imagem excessiva, e identificar preditores de acidente vascular cerebral isquêmico e imitações de acidente vascular cerebral (SM), visando uma melhor seleção de pacientes para terapias abrangentes de neuroimagem e reperfusão. Métodos: estudo observacional de coorte retrospectivo, em centro único, que revisou todos os arquivos consecutivos de pacientes com sintomas neurológicos agudos submetidos à tomografia computadorizada ou ressonância magnética de 1 de julho de 2016 a 1 de julho de 2017. Resultados: Foram revisados 736 prontuários. 385 pacientes (52,3%) apresentaram infarto isquêmico agudo confirmado, 93 (12,6%) apresentaram outra lesão cerebral imitando isquemia aguda e 258 (35,1%) apresentaram imagem normal. O AVC agudo foi mais frequente em pacientes idosos com fibrilação atrial, hipertensão arterial, ou disartria ou comprometimento motor direito. A imitação de acidente vascular cerebral foi associada a pacientes do sexo feminino com baixos fatores de risco vascular, NIHSS baixo e pacientes com diminuição do nível de consciência ou sintomas sugestivos de circulação posterior. Discussão: 47,7% de todos os pacientes atendidos na unidade de AVC não apresentaram lesões agudas de AVC. Conclusão: Considerando que o número de pacientes admitidos para tratamento de AVC aumentará ainda mais com uma janela terapêutica maior para trombectomia e trombólise IV, é necessário um algoritmo de tomada de decisão diagnóstica para pacientes com AVC, a fim de reforçar a suspeita de AVC indicando uma imagem cerebral urgente.

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RESUMEN Introducción: Un imitador de ictus es toda aquella patología no vascular que se presenta como un ictus isquémico agudo. La presentación clínica, factores epidemiológicos, el tiempo de inicio, la distribución vascular y la disponibilidad de pruebas de imagen, son factores que ayudan a diferenciarlos. Caso clínico: Presentamos un caso, de una mujer de la tercera edad que fue llevada a urgencias por hemiparesia izquierda de cinco horas de evolución. La evolución clínica y las pruebas complementarias permitieron excluir el diagnóstico de ictus isquémico agudo. La semiología fue explicada por una parálisis de Todd prolongada que se comportó como imitador de ictus en la fase aguda y las crisis epilépticas se produjeron en el contexto de una trombosis venosa cerebral. Comentarios: Los imitadores de ictus, al contrario del ictus isquémico agudo, ocurren en pacientes más jóvenes, tienen menos factores de riesgo vascular, menor puntuación de NIHSS, menos afasia y disfagia. Las principales causas son crisis epilépticas y síncopes. Deben considerarse también migrañas, neoplasias, alteraciones tóxicas o metabólicas, encefalopatías y trastornos funcionales. Realizar un estudio neurovascular completo y pruebas dirigidas nos permitirán el diagnóstico.

ABSTRACT Introduction: A stroke mimic is any non-vascular pathology that presents as an acute ischemic stroke. The clinical presentation, the epidemiological factors, the time to onset, vascular distribution and the availability of imaging tests are factors that help to differentiate them. Case report: We present a case, of a woman of the third age who was taken to the emergency department due to a five-hour history of left hemiparesis. The clinical evolution and the supplementary tests allowed to exclude the diagnosis of acute ischemic stroke. The semiology was explained by a prolonged Todd's palsy that behaved as a stroke mimic at the acute phase and the seizures occurred in the context of a cerebral venous thrombosis. Comments: Stroke mimics, in contrast to acute ischemic stroke, occur in younger patients, have fewer vascular risk factors, lower NIHSS score, less aphasia and dysphagia. The main causes are seizures and syncope. Migraines, neoplasms, toxic or metabolic alterations, encephalopathies and functional disorders should also be considered. To perform a complete neurovascular study and directed tests will allow us to make the diagnosis.

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Objetivo: evaluar la estructura interna, invarianza de medida, validez de criterio y confiabilidad del CASM-85 en estudiantes de secundaria peruanos. Materiales y Métodos: se evaluaron 2075 estudiantes de ambos sexos, entre 11 y 18 años, provenientes de colegios nacionales y particulares de Arequipa, Chimbote, Lima y Pucallpa. Se realizó un análisis de la correlación ítem-ítem e ítemresto para cada dimensión del CASM-85, un análisis factorial confirmatorio y modelos MIMIC (Multiple Indicator, Multiple Cause) para evaluar la invarianza de medida a través de grupos según sexo, edad, colegio y ciudad. La confiabilidad fue estimada mediante los coeficientes Alpha y Omega. La validez de criterio entre el CASM-85 y el rendimiento académico se revisó a través de la r de Pearson y modelos de regresión. Resultados: se eliminaron ítems heterogéneos y se obtuvo una forma reducida de 45 ítems a compararse con su original de 53 ítems. Para la forma original el CFI y TLI fue < .9 en todas las ciudades, mientras que para la forma reducida fue < . 9 solo en Chimbote. Los SRMR y RMSEA fueron ≤ .10 y ≤ .09 para las formas original y reducida respectivamente. Los modelos MIMIC confirmaron invarianza para todas las variables excepto para la variable ciudad con la forma original (│ΔCFI│ = .09, │ΔTLI│ = .08). La confiabilidad fue moderada tanto para la forma original (Ω ≥ .68; α ≥ .81) como para la reducida (Ω ≥ .77; α ≥ .84). La r de Pearson mostró una relación positiva y de fuerza débil para la forma original (r = .17) y reducida (r = .18). Conclusión: la forma reducida del CASM-85 (45 ítems) ha mostrado mejores propiedades psicométricas que su forma original.

Objective: To assess the internal structure, measurement invariance, criterion validity and reliability of the CASM-85 in Peruvian high school students. Materials and methods: Two thousand seventy-five (2075) students of both sexes, aged 11 to 18 years, from public and private high schools of Arequipa, Chimbote, Lima and Pucallpa were evaluated. An item-item and item-rest correlation analysis for each dimension of the CASM- 85, a confirmatory factorial analysis and MIMIC (Multiple Indicator, Multiple Cause) models were used to evaluate the measurement invariance across the groups according to their sex, age, school and city. Reliability was estimated using alpha and omega coefficients. The criterion validity between the CASM-85 and academic performance was determined using Pearson’s r and regression models. Results: The heterogeneous items were removed, obtaining a 45-item short form compared to the original 53-item form. In the original form, CFI and TLI were < .9 in all the cities, whereas in the short form, CFI and TLI were < .9 only in Chimbote. SRMR and RMSEA were ≤ .10 and ≤ .09 in the original and short forms, respectively. The MIMIC models confirmed the measurement invariance in all variables, with the exception of the original form between cities (│ΔCFI│ = .09, │ΔTLI│= .08). Reliability was moderate for both the original (Ω ≥ .68; α ≥ .81) and short forms (Ω ≥ .77; α ≥ .84). Pearson’s r showed a positive and weak correlation in the original (r = .17, p < .001) and short (r = .18, p < .001) forms. Conclusion: The CASM-85 short form (45 items) has shown better psychometric properties than its original full form.

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Brazil, one of the leading countries in livestock production, has not yet developed legislation considering animal welfare issues and most of the actions to improve farm animal welfare (FAW) standards are developed by livestock industries and government focusing in meet the demands of exporting countries. Such actions resulted in FAW protocols and manuals for adoption of best management practices. In this context, farmers' decisions are of particular importance as they may comply with current FAW protocols or even decide to provide better FAW standards than required. A present example of farmers' decisions to provide better FAW standards than required by FAW protocols is in the adoption of environmental enrichment in pig farming. This practice is widely available to pig farmers, however, anecdotal evidence shows that the adoption rate is low. This study uses the theory of planned behavior (TPB) as a framework to identify the socio-psychological factors that influence pig farmers' intention to adopt environmental enrichment on their farms. The TPB hypothesizes that intention is determined by three psychological constructs: attitude, subjective norms, and perceived behavioral control. These three constructs are derived from behavioral, normative, and control beliefs, respectively. Self-identity was added as an additional construct to explain intention. A survey with 185 farmers was conducted. We used Partial-Least-Square Structural Equation Modeling (PLS-SEM) to identify the impact of attitude, subjective norms, perceived behavioral control, and self-identity on farmers' intention to adopt environmental enrichment on their farms. We used MIMIC models to identify the most important beliefs underlying farmers' intention to adopt environmental enrichment in their farms. Results show that the intention of farmers to adopt was mainly determined by their positive perceptions about their own capability to adopt environmental enrichment (perceived behavioral control), followed by their perceptions about the social pressure to adopt it (subjective norms), their positive evaluations of adoption (attitude), and self-identity. The most important behavioral beliefs were 'increase productivity', and 'decrease animals stress'. The most important normative beliefs were 'family', 'neighbor farmers', 'pig buyers', and 'experts'. The most important control belief was 'receive bonus when selling pigs'. These results revealed important implications to design public and private interventions aimed to stimulate the adoption of animal friendly practices.

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The term amyotrophic lateral sclerosis mimic syndrome (ALSms) includes pathologies that present signs or symptoms similar to those caused by amyotrophic lateral sclerosis (ALS), which can lead to misdiagnosis. In general, any kind of misdiagnosis can result in negative clinical, psychological and economic consequences as well diagnostic and treatment delay. The objectives were to determine the frequency and to compare the demographic and clinical characteristics of patients with ALS and ALSms in our ALS clinic. We retrospectively studied all patients evaluated from 2007 to 2017 including only patients with a definite final diagnosis. Out of 368 patients with motor neuron disease symptomatology, 43 (11.7%) had an ALSms. The most frequent etiology was compressive myelopathy (32.6%). Multivariate analysis considering positive associations was statistically significant for patients having only upper or lower motor neuron signs in the physical examination, a non-compatible electromyogram (EMG), as well as atypical first symptoms. ALS misdiagnosis is an ongoing and not infrequent problem. From our series of patients, atypical symptoms, absence of EMG pathological findings or isolated upper or lower motor neuron disease should prompt suspicion of a differential diagnosis.

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A new phenoxo-bridged diMnIII complex, Na[Mn2L(OH)2(H2O)2]·5H2O (1), obtained with the ligand L5- = 5­methyl­2­hydroxo­1,3­xylene­α,α­diamine­N,N,N',N'­tetraacetato, has been prepared and characterized. Mass spectrometry, conductivity, UV-visible, EPR and 1H NMR spectroscopic studies showed that the complex exists in solution as a monoanionic diMnIII complex. Complex 1 catalyzes H2O2 disproportionation with second-order rate constant kcat = 305(9) M-1 min-1 and without a time-lag phase. Based on spectroscopic results, the catalase activity of complex 1 in methanol involves a MnIII2/MnII2 redox cycle, which distinguishes this catalyst from other phenoxo-bridged diMn complexes that cycle between MnIIMnIII/MnIIIMnIV species. Addition of base stabilizes the catalyst, restrains demetallation during catalysis and causes moderate enhancement of catalase activity. The terminal carboxylate donors of 1 not only contribute as internal bases to assist deprotonation of H2O2 but also favor the formation of active homovalent diMn species, just as observed for the enzyme.

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