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Substantial progress has been made in the standardization of nomenclature for paediatric and congenital cardiac care. In 1936, Maude Abbott published her Atlas of Congenital Cardiac Disease, which was the first formal attempt to classify congenital heart disease. The International Paediatric and Congenital Cardiac Code (IPCCC) is now utilized worldwide and has most recently become the paediatric and congenital cardiac component of the Eleventh Revision of the International Classification of Diseases (ICD-11). The most recent publication of the IPCCC was in 2017. This manuscript provides an updated 2021 version of the IPCCC.
The International Society for Nomenclature of Paediatric and Congenital Heart Disease (ISNPCHD), in collaboration with the World Health Organization (WHO), developed the paediatric and congenital cardiac nomenclature that is now within the eleventh version of the International Classification of Diseases (ICD-11). This unification of IPCCC and ICD-11 is the IPCCC ICD-11 Nomenclature and is the first time that the clinical nomenclature for paediatric and congenital cardiac care and the administrative nomenclature for paediatric and congenital cardiac care are harmonized. The resultant congenital cardiac component of ICD-11 was increased from 29 congenital cardiac codes in ICD-9 and 73 congenital cardiac codes in ICD-10 to 318 codes submitted by ISNPCHD through 2018 for incorporation into ICD-11. After these 318 terms were incorporated into ICD-11 in 2018, the WHO ICD-11 team added an additional 49 terms, some of which are acceptable legacy terms from ICD-10, while others provide greater granularity than the ISNPCHD thought was originally acceptable. Thus, the total number of paediatric and congenital cardiac terms in ICD-11 is 367. In this manuscript, we describe and review the terminology, hierarchy, and definitions of the IPCCC ICD-11 Nomenclature. This article, therefore, presents a global system of nomenclature for paediatric and congenital cardiac care that unifies clinical and administrative nomenclature.
The members of ISNPCHD realize that the nomenclature published in this manuscript will continue to evolve. The version of the IPCCC that was published in 2017 has evolved and changed, and it is now replaced by this 2021 version. In the future, ISNPCHD will again publish updated versions of IPCCC, as IPCCC continues to evolve.
The California kingsnake (Lampropeltis californiae), native to North America, is a significant threat to the conservation of endemic species in the Spanish Macaronesian island of Gran Canaria. However, its role disseminating potential invasive parasites, such as zoonotic pentastomids, has not been proven. Among its parasitic fauna, only protistans have been documented, in contrast to other Lampropeltis spp., which are known to carry pentastomids. Thus, a parasitological study is urgently required. Between 2016 and 2018, a total of 108 snakes were necropsied and stool samples examined. A single snake was infested with Ophionyssus natricis, and another individual with Serpentirhabdias sp. Only this latter snake presented gross lesions, characterized by granulomatous pneumonia. No Pentastomida were found. By contrast, almost the entire population (98.5%) was infested with larval helminths (three different nematode and two cestode species), characterized by granulomatous gastrointestinal serositis. This suggests the snake poses a ‘dead end’ host for local parasites. Based on these findings, snakes in Gran Canaria carry potential zoonotic mites, which along with Serpentirhabdias sp. could represent a threat to endemic lizards. The presence of metazoan parasites and their lesions are reported for the first time in the California kingsnake.
Investigations of the Proyecto Arqueológico Tlajinga Teotihuacan (PATT) in 2019 focused on the southern neighborhood center of this cluster of non-elite residences in the southern periphery of the ancient Mexican metropolis. Our objective was to better understand the social infrastructure of public space within the district and how it tied its inhabitants together. Our methods included excavations at two large architectural complexes, geophysical prospection of these and adjacent structures and plazas, and chemical residue analysis of floors and sediments. They revealed architecturally elaborate complexes decorated with mural painting that appear to have been the loci of civic-ceremonial activities. Materials from the excavated portions of the complexes are inconsistent with residential uses, although it is possible that local elites lived elsewhere in the complexes or in others located nearby. The investigations therefore demonstrate that the semipublic spaces of neighborhood centers were distributed as distantly as this periphery of Teotihuacan and could be as elaborate as those in the urban epicenter, underscoring the city's more muted social inequality.
Data on short-term peripheral intravenous catheter–related bloodstream infections per 1,000 peripheral venous catheter days (PIVCR BSIs per 1,000 PVC days) rates from Latin America are not available, so they have not been thoroughly studied.
International Nosocomial Infection Control Consortium (INICC) members conducted a prospective, surveillance study on PIVCR BSIs from January 2010 to March 2018 in 100 intensive care units (ICUs) among 41 hospitals, in 26 cities of 9 countries in Latin America (Argentina, Brazil, Colombia, Costa Rica, Dominican-Republic, Ecuador, Mexico, Panama, and Venezuela). The Centers for Disease Control and Prevention (CDC) National Health Safety Network (NHSN) definitions were applied, and INICC methodology and INICC Surveillance Online System software were used.
In total, 10,120 ICU patients were followed for 40,078 bed days and 38,262 PVC days. In addition, 79 PIVCR BSIs were identified, with a rate of 2.06 per 1,000 PVC days (95% confidence interval [CI], 1.635–2.257). The average length of stay (ALOS) of patients without a PIVCR BSI was 3.95 days, and the ALOS was 5.29 days for patients with a PIVCR BSI. The crude extra ALOS was 1.34 days (RR, 1.33; 95% CI, 1.0975–1.6351; P = .040).
The mortality rate in patients without PIVCR BSI was 3.67%, and this rate was 6.33% in patients with a PIVCR BSI. The crude extra mortality was 1.70 times higher. The microorganism profile showed 48.5% gram-positive bacteria (coagulase-negative Staphylococci 25.7%) and 48.5% gram-negative bacteria: Acinetobacter spp, Escherichia coli, and Klebsiella spp (8.5% each one), Pseudomonas aeruginosa (5.7%), and Candida spp (2.8%). The resistances of Pseudomonas aeruginosa were 0% to amikacin and 50% to meropenem. The resistance of Acinetobacter baumanii to amikacin was 0%, and the resistance of coagulase-negative Staphylococcus to oxacillin was 75%.
Our PIVCR BSI rates were higher than rates from more economically developed countries and were similar to those of countries with limited resources.
Pelagic seabird populations have declined strongly worldwide. In the North Atlantic there was a huge reduction in seabird populations following the European colonization of the Azores, Madeira and Canary archipelagos but information on seabird status and distribution for the subtropical region of Cabo Verde is scarce, unavailable or dispersed in grey literature. We compiled and compared the historical and current distribution of all seabird species breeding in the Cabo Verde archipelago, updated their relative abundance, investigated their inland habitat preferences, and reviewed their threats. Currently, the breeding seabird community in Cabo Verde is composed of Bulwer’s Petrel Bulweria bulwerii, White-faced Storm-petrel Pelagodroma marina aedesorum, Cape Verde Shearwater Calonectris edwardsii, Cape Verde Storm-petrel Hydrobates jabejabe, Cape Verde Petrel Pterodroma feae, Boyd's Shearwater Puffinus lherminieri boydi, Brown Booby Sula leucogaster, and Red-billed Tropicbird Phaethon aethereus. One breeding species is currently extinct, the Magnificent Frigatebird Fregata magnificens. The relative abundance of Cape Verde Shearwater, Boyd’s Shearwater, Cape Verde Petrel, and Cape Verde Storm-petrel was determined from counts of their nocturnal calls in Santo Antão, São Vicente, Santa Luzia, Branco, Raso and São Nicolau. Cape Verde Petrel occurred only on mountainous islands (Santo Antão, São Nicolau, Santiago, and Fogo) from mid-to high elevations. Larger species such as the Cape Verde Shearwater and Boyd’s Shearwater exhibited a wider distribution in the archipelago, occurring close to the coastline but at lower densities on populated islands. Small procellariforms such as the Cape Verde Storm-petrel occurred at high densities only on rat-free islets and in steep areas of main islands where introduced cats and rats are unlikely to occur. The main threats to seabird populations in Cabo Verde range from predation by introduced predators, habitat alteration or destruction, and some residual human persecution.
Muchos animales se encuentran entretejidos en las visiones cósmicas de diferentes culturas del mundo. En este contexto varias especies han sido idealizadas como referentes que sintetizan atributos apreciados por el hombre como poder, valor, nobleza, así como fuerzas de la naturaleza o de lo desconocido. Con frecuencia son animales grandes los que han capturado la atención humana desde sus orígenes, como lo refleja el arte parietal antiguo. Probablemente esto obedece a que se les consideró importantes para la vida cotidiana y también a su supuesta influencia en mitos de mundos paralelos.
En varias culturas alrededor del mundo se ha asignado a los osos un sitio prominente. Se conocen rituales y cultos relacionados con la presencia del oso en distintos grupos humanos en Asia, en pueblos originarios de Norteamérica y culturas de los Andes. Estas manifestaciones ocurren, por lo general, en sociedades que se encuentran asentadas en territorios dentro las principales áreas de distintas especies de osos. Sin embargo, en partes marginales de territorios ocupados por osos, las referencias culturales a ellos son escasas. Por ejemplo, no se había reportado la representación de estos mamíferos en las culturas que se desarrollaron en Mesoamérica.
Trabajos arqueológicos recientes en el sitio de Tancama (Querétaro, México), ocupado por un grupo de afinidad Huasteca cuya mayor actividad se dio en el período clásico (entre 500 y 700 d.C.; fechas de C14), han revelado una escultura de barro asociada con restos de uno de los edificios principales, que representa un oso de cuerpo entero (se determinó como un oso negro, Ursus americanus, dado que es la única especie presente en el área). Además de la escultura, se encontraron vasijas y fragmentos cerámicos, excavados en otros edificios, que muestran rasgos diagnósticos de la cabeza de un oso.
El presente estudio analiza este primer y singular hallazgo para Mesoamérica, enfatizando su relevancia para la región. Se analizan las relaciones entre la efigie principal de oso como parte de un edificio y las numerosas vasijas con representaciones ursiformes, para explorar el posible significado cultural local de esta especie animal.
The second and final year of the Erasmus Plus programme ‘Innovative Education and Training in high power laser plasmas’, otherwise known as PowerLaPs, is described. The PowerLaPs programme employs an innovative paradigm in that it is a multi-centre programme, where teaching takes place in five separate institutes with a range of different aims and styles of delivery. The ‘in-class’ time is limited to 4 weeks a year, and the programme spans 2 years. PowerLaPs aims to train students from across Europe in theoretical, applied and laboratory skills relevant to the pursuit of research in laser plasma interaction physics and inertial confinement fusion. Lectures are intermingled with laboratory sessions and continuous assessment activities. The programme, which is led by workers from the Hellenic Mediterranean University and supported by co-workers from the Queen’s University Belfast, the University of Bordeaux, the Czech Technical University in Prague, Ecole Polytechnique, the University of Ioannina, the University of Salamanca and the University of York, has just finished its second and final year. Six Learning Teaching Training activities have been held at the Queen’s University Belfast, the University of Bordeaux, the Czech Technical University, the University of Salamanca and the Institute of Plasma Physics and Lasers of the Hellenic Mediterranean University. The last of these institutes hosted two 2-week-long Intensive Programmes, while the activities at the other four universities were each 5 days in length. In addition, a ‘Multiplier Event’ was held at the University of Ioannina, which will be briefly described. In this second year, the work has concentrated on training in both experimental diagnostics and simulation techniques appropriate to the study of plasma physics, high power laser matter interactions and high energy density physics. The nature of the programme will be described in detail, and some metrics relating to the activities carried out will be presented. In particular, this paper will focus on the overall assessment of the programme.
Our objective was to determine the frequency of zika (ZIKV), chikungunya (CHIKV) and dengue (DENV) virus coinfection and describe the mortality cases that occurred during the epidemiologic surveillance of the ZIKV epidemic in Colombia. We analysed all cases of suspected ZIKV infection that were reported to the National Institute of Health (October 2015–December 2016). DENV, CHIKV and ZIKV RNA were detected in serum or tissue samples using polymerase chain reaction assay. Medical records of the fatal cases were reviewed. We identified that 23 871 samples were processed. The frequency of viral agents was 439 (1.84%) for DENV, 257 (1.07%) for CHIKV and 10118 (42.38%) for ZIKV. Thirty-four (0.14%) cases of coinfection were identified. The CHIKV–ZIKV coinfection was present in 28 cases (82.3%), DENV–CHIKV in three (8.8%) and DENV–ZIKV in three (8.8%). Seven (20.6%) coinfection cases were fatal (two DENV–CHIKV cases and five CHIKV–ZIKV cases). Two cases were foetal deaths and the others were related to neurological syndrome and sepsis. In conclusion, the frequency of arbovirus coinfection during epidemic of ZIKV was low, and CHIKV–ZIKV coinfection was the most common. Mortality was high among coinfection patients. The role of each virus in the mortality cases of coinfection warrants further studies.
The incorporation of triturated tire particles as an aggregate in the concrete mixture is one of the ways to take advantage of this Waste Rubber (WR) in order to improve concrete properties, such as mechanical behavior. In this research we evaluated mechanical behavior of concrete specimens prepared with different amounts WR, which partially substituted the fine aggregate, under an indirect tensile test. In contrast with other’s researcher’s findings, our results show that the specimens with 5% WR present the highest value of indirect tensile strength (TP) of 4.36 MPa. Polynomial relationships between TP and compression strength (f´c), where Tp ranges from 0.1f´c to 0.2f´c. Specimens with the 0, 5 and 10% WR content show two types of failure: normal tension and tiple-cleft failure, described in the norm ASTM 1144-89. Nevertheless, specimens with 15 and 20% WR show a new failure not described in the norm, which is thought to be occurring due to the high amount of WR used.
Physical conditions and chemical abundances of two H II regions and a planetary nebula in the dIrr galaxy Leo A are presented. These determinations were performed using the direct method (Te measured) and the ONS method. We also constructed photoionization models for the three nebulae to determine the abundances and to analyse the ionizing stars. The O abundance was determined to be 12+log(O/H) = 7.4±0.2 in all cases.
Anastrepha ludens (Loew) (Diptera: Tephritidae) is an important pest of mango and citrus in Mexico. Here, we report the effect of the entomopathogenic fungus Metarhizium anisopliae (Metsch.) Sorokin strain MAAP1 on mortality and food consumption in A. ludens adults. Experiments were carried out under laboratory conditions at 26 ± 2 °C, 60 ± 5% RH and 12:12 photoperiod. To assess pathogenicity and sublethal effects, we sprayed flies with 1 × 109 conidia/ml and 1 × 106 conidia/ml solutions, respectively. Food consumption was measured by providing known amounts of food through capillary tubes to caged flies. We found that M. anisopliae was highly virulent to A. ludens, causing 92.3 ± 0.62% mortality at day 13 post-exposure. Interestingly, food consumption reduced by 17% in flies exposed to the fungus. These results support the implementation of M. anisopliae within current strategies used for the integrated pest management of A. ludens.
CHD is becoming an increasing priority worldwide, as it is one of the main causes of death in low- and middle-income countries lately. This study aims to evaluate the association between beverage consumption patterns and the risk of CHD among Mexican adult population. We performed a cross-sectional analysis using data from 6640 adults participating in the Health Workers’ Cohort Study. Factor analysis was performed to identify beverage patterns using sex-specific Framingham prediction algorithms to estimate CHD risk. The prevalence of moderate to high CHD risk was 17·8 %. We identified four major beverage consumption patterns, which were categorised as alcohol, coffee/tea, soft drinks and low-fat milk. We observed a lower risk of CHD (OR=0·61; 95 % CI 0·46, 0·80; and OR=0·58; 95 % CI 0·43, 0·79, respectively) among participants in the upper quintile of alcohol or low-fat milk consumption compared with those in the bottom quintile. In contrast, a higher consumption of soft drinks was positively associated with CHD risk (OR=1·64; 95 % CI 1·21, 2·20) when compared with other extreme quintiles. Finally, coffee/tea consumption was not significantly associated with CHD risk. Our findings suggest that a beverage pattern characterised by a higher intake of sugar-sweetened beverages may be associated with an increased risk of CHD among the Mexican adult population, whereas patterns of moderate alcohol intake and low-fat milk may be associated with a reduced risk.
In this paper we review the design and development of a 100 J, 10 Hz nanosecond pulsed laser, codenamed DiPOLE100X, being built at the Central Laser Facility (CLF). This 1 kW average power diode-pumped solid-state laser (DPSSL) is based on a master oscillator power amplifier (MOPA) design, which includes two cryogenic gas cooled amplifier stages based on DiPOLE multi-slab ceramic Yb:YAG amplifier technology developed at the CLF. The laser will produce pulses between 2 and 15 ns in duration with precise, arbitrarily selectable shapes, at pulse repetition rates up to 10 Hz, allowing real-time shape optimization for compression experiments. Once completed, the laser will be delivered to the European X-ray Free Electron Laser (XFEL) facility in Germany as a UK-funded contribution in kind, where it will be used to study extreme states of matter at the High Energy Density (HED) instrument.