Background The leadless Micra pacemaker has emerged as a safe and minimally invasive alternative for selected patients with arrhythmias. However, as the technology is still relatively new, clinical experience with urgent device retrieval—particularly in critical care settings—remains limited. Case Summary An 85-year-old female with chronic atrial fibrillation and complete heart block underwent Micra pacemaker implantation. Within minutes of tether removal, the device became dislodged and migrated between the tricuspid valve and the right ventricular apex, resulting in nonsustained ventricular tachycardia. Immediate retrieval was performed using a double-snare technique through a single 23-French delivery sheath. The pacemaker was successfully extracted within 40 minutes, with no complications. Discussion This case highlights a rare but critical complication of leadless pacemaker dislodgement, requiring urgent recognition and rapid procedural response. The double-snare technique enabled safe and efficient retrieval through a single access site, minimizing procedural time and trauma—key considerations in high-risk and elderly patients. As leadless pacing becomes more widespread, familiarity with emergency retrieval strategies and procedural adaptability will be essential, particularly in intensive care and interventional cardiology settings.

Closed timelike curves (CTCs) have long presented paradoxes and logical challenges within the context of general relativity. Proposed constructs such as Gödel's rotating universe, the Tipler cylinder, traversable wormholes, and the inner regions of Kerr black holes all theoretically allow CTCs-but only under unphysical assumptions such as infinite mass, negative energy, or cosmological rotation. This paper introduces Infinity Algebra as a symbolic and structural framework that replaces such pathological geometries with a consistent algebraic encoding of time, causality, and recurrence. We demonstrate that CTCs do not emerge under Infinity Algebra, not by constraint, but by coherent symbolic substitution. The analysis shows how CTCs are artifacts of incomplete frameworks and idealized conditions-disproved in physical reality by cosmological observations and thermodynamic consistency. Infinity Algebra thus offers a causally consistent, infinite-dimensional alternative to curved-loop solutions.

In this study, we introduce Riemann-Liouville and Hadamard intuitionistic fuzzy fractional  ⊕⊗ integrals of intuitionistic fuzzy valued functions and obtain some of their basic properties. We also give some examples to illustrate the obtained results.

Inflorescence architecture has evolved through interactions with pollinators, affecting display effectiveness and self-pollination relevance. Spiranthes australis (Orchidaceae), or Ladies Tresses, shows remarkable within-population variation in inflorescence morphology, particularly in the strength and direction of the floral helix. The underlying mechanisms for this variation remain poorly understood. We first investigated the morphological basis of inflorescence variation and then evaluated its effects on display and reproductive success. The frequency of clockwise and counterclockwise floral helices did not deviate from a 1:1 ratio across populations. The combination of rotation directions in paired inflorescences on the same individual did not differ from random expectation, whereas their divergence angles were strongly correlated, suggesting random determination of helix direction and genetic control of divergence angle. Morphological analysis showed that variation in divergence angle among individuals was linked to the degree of rachis torsion. A detection test using human participants showed that inflorescence models with small divergence angles were detected more easily than those with large ones. Detection time varied by presentation direction for extreme (small/large) angles but not for intermediate ones, suggesting better all-around visibility in intermediate angles. Field observations revealed that inflorescences with intermediate divergence angles had lower fruit set than those with small or large angles, despite producing the most flowers. As a result, reproductive success did not differ among divergence angle categories. This trade-off may underlie the evolutionary maintenance of within-population variation in divergence angle.

Estimating the large-scale variability and trends in subsurface ocean temperatures is limited by sparse in situ observations inadequate for resolving mesoscale eddies. Travel times of seismically generated sound waves, sensitive to path-integrated temperature, provide complementary integral constraints. We here use earthquakes along the Japan Trench and receivers at Wake Island to sample the Kuroshio Extension region in the Northwest Pacific. We develop a Gaussian process framework, optimized via maximum likelihood, to estimate temperature anomalies and uncertainties from this seismic data and to combine it with in situ data from Argo profiles and shipboard data. This framework shows seismic measurements are quantitatively consistent with in situ data and substantially reduce uncertainties in large-scale variability and trends. Relative to their prior, error variances of area-mean temperature fluctuations due to mesoscale eddies from 2008 to 2021 are reduced by 30% by the in situ data, 39% by the seismic data, and 50% by the combination. For pathmean estimates, the combined reduction is 83% in error variances, compared to 45% from in situ data alone. The data show a steady subsurface warming of 11.8 ± 5.0 mK yr −1 (2σ uncertainty) from 2008 to 2021 and no substantial trend between 1997 and 2008.

In the last decades, the use of camera traps for wildlife studies has increased significantly due to advancements in technology leading to cost reduction and improved reliability. They facilitate the study of wild animals in their natural environment in a minimally invasive manner, eliminating the need for researchers to remain in the field for long periods of time and to stay alert for extended hours. While their use is not too complex, data analysis often represents a bottleneck that demands considerable effort. When cameras are used to obtain videos, the first step upon retrieving information from them is to sort the videos, name them in a standardized manner, identify the content of each file, and label them to organize the information for subsequent data analysis. This process is laborious and repetitive, often leading to human errors that later hinder analysis. In this work an easy to use, customizable semi-automated video processing and tagging software is presented alongside camera trap data analysis from sites used by an endangered otter species (Lontra provocax) from Patagonia. With its use, we were able to process over three thousand video files in a short time, finding that in the area under study (Nahuel Huapi National Park) all otter sites were also used by american minks, some were visited frequently by foxes, domestic dogs and cats, while direct interactions between otters and other animals were never observed. In a particular site a detailed analysis provided data showing a nocturnal pattern of use for the site. When compared to manual data processing the semi-automated process improved efficiency, overall user experience, and reduced the cognitive load associated with manual tagging. The aim of this work was to develop a versatile and user-friendly yet powerful solution to the typical tasks associated with the analysis of camera trap videos.

developing an electrocatalyst with remarkable hydrogen evolution reaction (HER) and oxygen evolution reaction (OER) catalytic performance remains a critical challenge for achieving large-scale hydrogen production. As one of the most efficient HER catalysts, noble metal platinum (Pt), with its unique d-orbital electron configuration, plays a crucial role in various catalytic reactions, and its compounds are also widely utilized. Here, we investigate high activity catalysts composed of different ratio Pt and C elements by composition-adjustment strategy, four highly stable and metallic monolayers are confirmed, i.e. PtC, Pt2C, Pt3C, and Pt4C. The Pt2C monolayer with low Pt loading exhibits the highest electron occupation at the Fermi level, H2O adsorption and dissociation of more efficient and easier, providing a platform for investigating the properties of electrocatalysis. The HER activity of the Pt2C monolayer is predicted to be superior to that of commercial Pt through several reaction factors, i.e. Gibbs free energy, active site density, and exchange current density, which can primarily be attributed to its Janus steric configuration and excellent conductivity. Moreover, the OER overpotential of the Pt2C monolayer is low to 0.58 V, which is comparable to that of the prevalent RuO2 and IrO2 catalysts. All of the intriguing properties make the Pt2C monolayer a promising bifunctional catalyst toward HER and OER.

With the growing global energy demand and the pressing need for a clean energy transition, supercapacitors (SCs) have demonstrated significant application potential in electric vehicles, wearable electronics, and renewable energy storage systems owing to their rapid charge-discharge capability, exceptional power density, and prolonged cycle life. The improvement of their overall performance fundamentally depends on the synergistic design of electrode materials and electrolyte systems, as well as the precise regulation of the electrode-electrolyte interface. This review focuses on the key components of supercapacitors, systematically reviewing the design strategies of high-performance electrode materials, outlining recent advances in novel electrolyte systems, and comprehensively discussing the critical roles of interfacial reinforcement and optimization in enhancing device energy density, power performance, and cycling stability. Furthermore, interfacial engineering strategies and innovations in device architecture are proposed to address interfacial degradation in flexible SCs under mechanical stress. Finally, key future research directions are highlighted, including the development of high-voltage and wide-temperature-range electrolyte systems, and the integrated advancement of multiscale in situ characterization techniques and theoretical modeling. This review aims to provide theoretical guidance and innovative strategies for material design, contributing toward the realization of next-generation supercapacitors with enhanced energy density and reliability.

Tiempo sugerido: 60 minutos Nivel: Primero Básico Descripción En esta actividad, los estudiantes explorarán de forma sencilla el concepto de atracción gravitacional entre el Sol, la Tierra y la Luna. Descubrirán cómo esta fuerza invisible mantiene a los cuerpos celestes en movimiento y por qué es tan importante para la vida en nuestro planeta. Luego, aplicarán lo aprendido construyendo un modelo robótico que represente el sistema Sol-Tierra-Luna con materiales accesibles.

Phylogenetic and functional diversities are crucial for understanding community assembly. While the effects of environmental variables on these diversities are well-documented, the causal relationships between phylogenetic and functional diversities and assembly mechanisms remain unclear. To investigate this, we conducted a common garden trial, creating a gradient of initial phylogenetic diversity in experimental annual plant assemblages across eleven combinations of four species each. Each experimental assemblage was also described in functional terms for three key traits (seed mass, specific leaf area, and maximum plant height) and a multi-trait response. We implemented two irrigation treatments: average rainfall and one-third of the average (drought). We measured the proportion of fruiting plants and seed set per fruit in each experimental assemblage. Our findings highlight the significance of assembly level properties effects on reproductive success and life cycle completion. Overall, initial phylogenetic and functional diversities offer complementary insights into species assembly processes, with niche complementarity and competitive asymmetry being critical drivers.

Skin aging arises from the complex interplay between intrinsic senescence and extrinsic stressors, particularly ultraviolet (UV) radiation, leading to accumulated senescent cells with characteristic cell cycle arrest, senescence-associated secretory phenotype (SASP) secretion, and metabolic dysfunction. This review elucidates how the interconnected SIRT1/NRF2 axis serves as a central regulator of cutaneous aging - where SIRT1 orchestrates mitochondrial homeostasis and inflammation control through deacetylation of p53, FoxOs, and PGC-1α, while NRF2 masterfully coordinates antioxidant responses via KEAP1 dissociation and ARE activation. Crucially, their crosstalk enhances autophagic clearance and redox balance. Traditional Chinese Medicine provides diverse phytochemicals targeting this axis: galangin and oroxylin A activate SIRT1-mediated pathways; corylin and sulforaphane directly modulate NRF2; while cryptotanshinone and zerumbone exhibit dual-pathway regulation with additional AP-1 inhibition. These compounds, derived from phylogenetically distinct plants, demonstrate functional convergence in mitigating oxidative damage, suppressing inflammation, and maintaining extracellular matrix integrity. Particularly noteworthy is their multi-target capacity - exemplified by salvianolic acid B’s simultaneous enhancement of mitochondrial biogenesis and antioxidant defense. While preclinical data consistently show improvement in skin parameters, clinical translation requires standardized formulations and rigorous safety evaluation. Future directions should integrate omics technologies to identify novel targets and optimize synergistic combinations, bridging traditional medicine with contemporary dermatological research to develop effective, sustainable anti-aging interventions.

White-nose syndrome, caused by the psychrophilic fungus Pseudogymnoascus destructans, is a wildlife disease that infects hibernating bats, resulting in the deaths of millions of bats in North America. Previous studies have confirmed that volatile organic compounds (VOCs) effectively inhibit the growth of P. destructans, but the antifungal mechanisms of these compounds have not been comprehensively characterized. This study screened two VOCs, 2,5-Dimethylcyclohexanol (DMCH) and nonanal, identified from bat cave environments for their potent inhibition of P. destructans. Scanning and transmission electron microscopy revealed mycelial deformations and disruptions in cellular structures following treatment with these compounds. Physiological and biochemical analyses showed that the VOCs induced mycelial apoptosis, increased reactive oxygen species (ROS) activity, increased adenosine triphosphate (ATP), superoxide anion, and glutathione (GSH) contents, and decreased catalase (CAT) and superoxide dismutase (SOD) activities. Comprehensive transcriptomic and metabolomic analyses revealed that the VOCs disrupted mycelial cell wall and membrane structures, affected the expression of virulence genes, interfered with basic metabolic processes, led to disorders in energy metabolism, induced oxidative stress with ribosomal overexpression, interfered with the MAPK signaling pathway, and ultimately induced cell apoptosis. This study provides novel insights into the antifungal effects of VOCs targeting P. destructans and offers a scientific basis for combating white-nose syndrome.

Abstract Objektive: This research conducted to determine the effect of positive psychotherapy-based psychoeducation (PPT) based psychoeducation given to individuals with mental illness on forgiveness and psychological well-being. Methods:The study completed in a randomized controlled manner with 120 individuals diagnosed with mental illness (60 experiments and 60 controls) who were treated in the psychiatry clinic of Turgut Özal Medical Center (TÖMC) between October 2021 and February 2023. Eight sessions of PPT based psychoeducation given to the experimental group in the study. No intervention made in the control group. Descriptive Characteristics Form, Heartland Forgiveness and Psychological Well-Being Scale used in the study. Results:In the analysis of the data, number, percentage, mean, standard deviation, chi-square, dependent and independent groups t-test was used. Forgiveness sub-dimension, which is one of the post-test scale sub-dimensions of the experimental group, and the total mean scores of the forgiveness scale found to be statistically significant (p<0.05). It was determined that the post-test forgiveness scale total score average and the forgiveness of others scale sub-dimension total score averages increased in the experimental group compared to the control group. It was determined that the total mean score of the experimental group post-test psychological well-being scale was statistically significant (p<0.05). Conclusion:It was determined that PPT based psychoeducationgiven to individuals with mental illness was effective in increasing the level of forgiveness and psychological well-being. Keywords: Forgiveness, positive psychotherapy, psychiatric nursing, psychoeducation, psychological well-being, mental illness

Caregivers and other adults modify their speech when addressing infants, but there is significant variability across societies regarding the prevalence of this behavior, known as infant-directed speech (IDS). For example, some studies report significantly less IDS in some less-well-studied societies – including families on Tanna, Vanuatu. This is surprising given that IDS is widely assumed to be a prominent feature of human caregiving, based on research with sample populations in urban regions. Given the variability across cultures in the amount of IDS that children hear in the first few years of life, it is possible that IDS is only one of a suite of important caregiving behaviours that are produced during interactions with infants and young children. To have a better understanding of the range of variability in infant-directed speech and communication with young children, we examined 70 semi-structured video recorded observations of caregivers and their 18- to 24-month-old children living on Tanna, Vanuatu, and Vancouver, Canada. The video observations were 10 minutes long and were collected between 2013 and 2018. We had two kinds of observations – one where we provided a set of toys and one without toys. We determined the duration of time caregivers spent engaging in both verbal and non-verbal interactions with their children using five different interaction codes: Infant-directed 1) speech, 2) behavior, 3) communication (simultaneous speech and behavior), 4) Solo (no interaction), and 4) ANI (attentive non-interference, which was when caregivers looked at their infant but did not direct any behaviours). Caregivers in both societies spent a comparable amount of time interacting with their children during the observations. However, the specific modes of interaction varied across cultural contexts. Caregivers in Vancouver were slightly more likely to use IDS across both sessions, whereas those on Tanna used more IDB, particularly in the Toys session, and more IDC, particularly in the No toys session. Solo interactions were ere minimal, andANI was more frequent in Tanna across both sessions, but particularly when infants had toys. This study aims to contribute to a broader understanding of children’s early experiences with caregivers, moving beyond the urban and western societies that have dominated most of the existing research. The findings provide further evidence in support of variability in the social context of young children across diverse social contexts.

[1]¿p#1 We prove the veracity of the Syracuse conjecture by establishing that from an arbitrary positive integer different from 1 and 4, the Syracuse process will never return (after i≥1 steps) to any positive integer already reached and we conclude using a probabilistic approach.

Background: The rise in cases of anaphylaxis (TA) to ticks ( Ixodes holocyclus) in Australia underscores the need for effective tick bite prevention and management strategies. This study investigates tick bite prevention and management strategies employed by patients who have previously suffered an anaphylaxis from a tick bite and to whom tick bite prevention and management strategies had been explained contemporaneously. Methods: Patients diagnosed with TA by a consultant immunologist between 2005-2022 in New South Wales, Australia, completed a survey in 2021 assessing tick bite recurrence, life stage identification, removal methods, need for medical assistance, prevention strategies, and geographic tick bite locations. Data were displayed using bar graphs, relationships between tick bite occurrence and prevention methods, such as use of permethrin-treated clothing and backyard pest control were analysed with Kaplan-Meier curves and log-rank tests. Results: Despite receiving education at the time of their previous tick anaphylaxis, 59% of patients experienced further tick bites and 50% struggled to identify the tick life stage. Preferred prevention methods included avoidance, untreated clothing, and repellents, with some using backyard insecticides. We observed a trend towards reduced tick bite recurrence among patients who treated their backyards and wore permethrin-treated clothing. 46% of bites occurred in patients’ backyards. Adherence to tick removal advice was highly variable. Only 30% of patients sought medical help when bitten again. Conclusion: The recurrence of tick bite in tick anaphylaxis patients given education at the time of anaphylaxis, indicates a need for better education and adherence to prevention strategies, targeting high-risk groups, to prevent fatalities.

Background: Until a few years ago, lower limb amputees’ ability to run was constrained by the materials used in their prosthetic components, which typically did not facilitate the proper dynamics necessary for movement at slower speeds. However, many lower limb amputees can now engage in running as a sport, thanks to newly developed components for recreational activities. This research examined the mechanical and miscibility properties of prosthetic feet from experimental, mathematical, and numerical perspectives to provide an athletic prosthetic foot that offers enhanced performance, ease of use, and affordability for amputees with lower limb loss, helping them overcome physical limitations and participate in sports. Method: Eight laminates made from polyester reinforced with various fibers (linen, jute, carbon, perlon, and glass fibers) were produced using a vacuum system and subsequently tested using tensile, flexural, hardness, and FTIR assessments. The density and volume fraction were calculated using the rule of mixtures, and the mechanical properties were input into ANSYS software. The most effective laminates for the athlete’s foot were identified by calculating the total deformation and strain energy after applying the boundary constraints. The results indicated that laminates reinforced with linen, carbon, and glass fibers exhibited the best performance in terms of tensile, flexural, and hardness properties. FTIR analysis suggested a strong interaction between these fibers and resin compared to other groups. Conclusion: These findings highlight the intriguing potential of biodegradable feet for orthopedic applications and the promising advancements in biomedical engineering through increased durability and biocompatibility.

Animals must constantly balance the need to find resources with the risk of predation. Not only avoiding direct encounters with predators but also assessing the overall risk of their environment using cues, social information or habitat traits at multiple spatial and temporal scales. Although such multiscale understanding of the landscape of fear has been recognized, few studies have concomitantly measured how habitat traits at different scales affect risk perception (direct or indirect). Here, we conducted a set of field-based giving-up density experiments to study risk perception on white-naped jays living in semi-arid thorn forests in northeastern Brazil. We recorded data from 23 groups of jays, ranging from 2 to 15 individuals per group, exposed to simulated predators in areas with varying habitat complexity at both local and landscape scales. Overall, our findings support the hypotheses of risky times and habitat complexity risk mediation. White-naped jays exhibited reduced food consumption in the presence of a predator and displayed increased vigilance while consuming less food in more complex habitat patches with dense canopy cover in regenerated forest areas. Finaly, we found no evidence supporting the many-eyes hypothesis; larger groups of white-naped jays did not reduce vigilance. Instead, vigilance was influenced by habitat characteristics like canopy cover and the differences between managed and regenerated forests. These findings underscore the dependency of risk perception on habitat complexity across various scales, indicating that simplifying habitats may create a less fearful environment, thereby increasing prey vulnerability by diminishing antipredator behaviours.

[1]¿p#1 Interference from distractors can be reduced when they appear at locations or with features that occur frequently, suggesting that statistical learning enables the suppression of high-probability distractor locations and features. Recent studies have proposed that reduced interference in spatial statistic regularity arises not only from attentional suppression at high-probability positions but also from attentional capture at low-probability positions. However, it remains unclear whether feature-based statistical learning follows the same pattern—namely, attentional suppression of high-probability distractor features and attentional capture of low-probability distractor features. This study explored this possibility using both behavioral measures and event-related potentials (ERPs) by introducing an equal-probability baseline condition. The results showed that RTs to high-probability distractors were significantly shorter than low-probability distractors (Experiments1). Crucially, in Experiment 2, RTs to low-probability distractors showed no significant difference compared to equal-probability distractors, yet both were significantly longer than those for high-probability distractors. Consistent with these behavioral findings, ERP data from Experiment 2 further revealed reduced N2pc amplitudes for high-probability distractors relative to both low- and equal-probability distractors, with no amplitude difference between the latter two conditions. Furthermore, P3 amplitudes did not vary across conditions, suggesting that low-probability color singletons did not elicit a rarity effect. These findings indicate that the reduced interference associated with high-probability color distractors is primarily due to attentional suppression of the high-probability distractor feature itself, rather than attentional capture by low-probability distractor features. The implications of these findings for statistical learning and feature-based suppression mechanisms were discussed.

Los 100 PerrosEnsayo reflexivo del libre albedríoAutor: Gabriel Herskovits ORCID: 0009-0007-1227-0613 Fecha: 7 de Enero de 2017 Tipo de documento: Ensayo reflexivo Licencia: Creative Commons Atribución 4.0 Internacional (CC BY 4.0) Registro Safe Creative: 2504191513489Resumen Este ensayo plantea una reflexión sobre el libre albedrío, contrastándolo con la conducta instintiva animal. A través del experimento mental de "los 100 perros", se introduce la noción de que el ser humano —a diferencia del animal— puede actuar según su equilibrio mental, superando impulsos naturales o adquiridos. El ensayo propone que la conducta correcta no es necesariamente la más placentera, sino la que más contribuye al equilibrio interior de cada individuo.Los 100 PerrosIntroducciónImaginemos el siguiente experimento: Tiramos un pedazo de carne en el medio de una habitación y dejamos entrar un perro. Lo más probable es que el perro se coma la carne sin pensarlo. Si repetimos el experimento con 100 perros diferentes, lo más probable es que ocurra 100 veces lo mismo.Los animales movidos por su instinto, repiten la conducta!Hagamos un experimento similar, pero con seres humanos: Un plato de sopa sobre una mesa en una habitación. Es probable que tengamos muchos comportamientos diferentes. Uno se lo toma sin pensarlo; Otro lo piensa un momento y luego lo toma; Otro lo ignora; Otro prueba un poco y luego espera;Y así, cada uno tendrá un impulso diferente movido por su carácter innato y sus costumbres adquiridas, y tendrá Libre Albedrío acerca de tomar o no tomar!Este Libre Albedrío, esta decisión, estará influenciada pero intenta ser la correcta. Y en cada caso, la decisión correcta, puede ser diferente ya que en el caso de los perros, independientemente de las características de cada perro, la conducta será la misma.En el caso del ser humano, la decisión correcta varía de persona en persona!Uno puede ser obeso, otro anoréxico, otro está sin comer hace 2 días y otro acaba de almorzar hace 15 minutos. Entonces, cuál es la decisión correcta ante (cada uno de) nuestros actos? El libre albedrío y el equilibrio mental  Lo correcto es la conducta que vaya en favor de nuestra salud mental! (salud = equilibrio)Cada una de nuestras decisiones, cada una de nuestras conductas varía en cada persona y en cada momento. Si esta conducta es placentera, que lo sea. Pero si no lo es, debería primar que sea saludable. Por ejemplo: Tomar un jarabe para la tos, nos cura la tos. El jarabe es amargo, feo, pero estar sin tos es mejor para nuestra mente, que seguir con tos. Y así, cada decisión! Siempre tenemos el Libre Albedrío de decidir hacer o no hacer lo que es bueno para nuestra mente.Tendremos tendencias innatas y adquiridas que nos jueguen en contra pero depende de nosotros sobreponernos a esas tendencias! Ejercicios cotidianos del libre albedrío  Si voy por la calle y escucho una sirena, yo elijo darme vuelta y ver qué es… qué pasa… y luego imaginarme qué va a pasar… pero soy yo el que elige hacerlo… y si esta decisión aporta positivamente a mi equilibrio mental, es la conducta correcta… Pero si aporta negativamente, tengo el poder de sobreponerme (al impulso de darme vuelta) y evitarla… No me doy vuelta y sigo caminando.Siento el impulso de darme vuelta y mirar? Sí Darme vuelta y mirar, aporta positivamente a mi equilibrio? No Tengo el poder de elegir entre darme vuelta o seguir? SíTal vez estoy discutiendo de determinado tema con alguien. Hay que evaluar hasta dónde es positivo para mi equilibrio mental “ganar” o “perder” dicha discusión.Estoy viendo una película. Me dan ganas de ir al baño pero faltan 10 minutos para el final. ¿La pongo en pausa o aguanto hasta el final? Conclusión Lo correcto es lo que aporte a mi estado de salud mental, o por lo menos, no juegue en contra!¿A quién me acerco? ¿De quién me alejo? ¿De qué temas hablo? ¿Qué temas evito? ¿Qué elijo hacer? ¿Qué elijo NO hacer? ¿Llego hasta el final con esto? ¿O lo dejo así?Y así cada minuto… cada segundo de nuestras vidas… está presente el Libre Albedrío… que es nuestra herramienta para tomar la decisión correcta y actuar…Y la conducta correcta es la que nos lleva (y mantiene) a nuestro equilibrio mental… sea o no sea placentera… sea o no sea fácil… sea o no sea la que deseamos!Referencias Maimónides. Mishné Torá – Hiljot Deot.  Maimónides. Mishné Torá – Hiljot Yesodei HaTorá.  Maimónides. Shmona Perakim.  Maimónides. Moré Nebujim.  Maimónides. El Régimen de la Salud.  Maimónides. Perek Jelek.  Torá. Debarim.  Torá. Vaikrá.  Torá. Éxodo.  Talmud Bavli. Shabat.  Kli Iakar. Comentario sobre Vaikrá.Herskovits, G. (2025). Equilibrio Interno y Conducta: Una Lectura Interdisciplinaria desde Maimónides y la Neurofisiología. Figshare. https://doi.org/10.6084/m9.figshare.29322602.v2

A numeric quantity which characterize the whole structure of a graph is called a topological index. In fact, a topological index is a function f from the set of all finite simple graphs to the set of real numbers. Henceforth if two graphs G 1 and G 2 are isomorphic, then f (G 1) = f (G 2). The index H 2 is one of the six topological indices that we call them novel harmonic indices. Calculating H 2 for CN C k [n], which we will discuss in this paper by obtaining some results in the graph theory, is in fact a counting problem.

Edges provide valuable insight into the effects of landscape structure on forest ecosystems and faunal distribution. This study assessed edge effects on amphibian diversity in the Yoko Forest Reserve, Democratic Republic of the Congo. Over twelve months (from December 2020 to November 2021), amphibians were surveyed during 24 nocturnal field campaigns using visual detection, habitat searches, and acoustic hearing of vocalizations. Twelve sites were sampled, each including five habitats: primary forest, fallow, field, and two edge types (primary forest-fallow and primary forest-field). Amphibian abundance, species richness, diversity, evenness, and relative density were compared between each edge and its adjacent habitats. A total of 5516 individuals (33 species, 17 genera, 10 families) were recorded. Edges had lower abundance, richness and density than the primary forest but higher than adjacent disturbed habitats. The forest-fallow edge maintained similar diversity to the primary forest, while the forest-field edge showed significantly lower diversity. Forest evenness was lower than at both edges. Several species, including Hylarana albolabris, Leptopelis calcaratus, L. christyi, L. millsoni, L. notatus, L. ocellatus and Sclerophrys pusilla showed intermediate abundances at the primary forest-fallow edge. Similarly, Afrixalus osorioi and Ptychadena mascareniensis showed intermediate abundances in the primary forest-field edge. Scelophrys gracilipes and S. pusilla showed a positive preference for the primary forest-field edge. Afrixalus osorioi, A. quadrivittatus, Chiromantis rufescens, Hylambates verrucosus, Hyperolius sp., H. langi, H. ocellatus, Leptopelis calcaratus, Ptychadena christyi, P. mascareniensis, P. perreti, Sclerophrys gutturalis and S. gracilipes showed a positive preference for the primary forest-fallow edge. Among these species, Chiromantis rufescens and P. mascareniensis showed a moderate but significant preference for this edge, enabling them to be considered specialists of this habitat. These results confirm the structuring role of edges in forest amphibian population’s dynamics.

Eating the Unthinkable: PICA-Induced Plastic Bezoar Causing Peritonitis—A Call for Community-Based Prevention and Early Recognition of Childhood Anxiety.AbstractRapunzel syndrome is a rare condition where a bezoar extends from the stomach into the duodenum or distal small intestine. Bezoars are formed by the progressive accumulation of a nondegradable foreign body in the stomach. This case highlights the habit of ingesting nonnutritive substances in children (PICA) as the underlying reason for bezoar formation.We report a case of a 6-year-old male who presented with intestinal obstruction and, when operated on in an emergency setting, turned out to have a bezoar of plastic and kite wire threads with intestinal perforation. Bezoar was extracted via laparotomy, and resection-anastomosis was done to achieve a successful outcome. Notably, his siblings, rather than his parents, were more aware of his habit of chewing kite-flying threads, making it necessary to involve all family members in the counselling sessions irrespective of age. Thus, the comprehensive management of such complications needs the integration of surgical and psychological approaches to treat and prevent recurrence.IntroductionBezoars are formed by clumping together millions of strands of indigestible materials, such as hair, cotton threads, etc., in the gastrointestinal tract. They are most commonly formed in the stomach due to its large capacity and can extend into the small bowel. There are a few known types of bezoars, such as trichobezoars (hairs), phytobezoars (fruit fibers, cotton threads, shells, seeds), and pharmacobezoars (medicines), which are being reported in children with a history of PICA and mental retardation [1]. Bezoar forms the reason for 2 - 4% of small bowel obstructions and only 1% of acute surgical emergencies in the pediatric population [2]. Bezoar formation by the consumption of kite-flying threads in the developmentally normal child is rarely reported. This case report highlights the possibility of such an extreme life-threatening complication in children with PICA. Also, it emphasizes the importance of having a high index of suspicion for early diagnosis and the need for subtle psychological assessment and counseling of children in the community.Case presentationA 6-year-old boy of normal mental age was brought to the emergency department of a tertiary care hospital in northern India with a complaint of abdominal pain that had persisted for 20 days, primarily located in the epigastric region. Initially, the pain was intermittent, non-radiating, and was relieved by medication, without any specific aggravating factors. The child also experienced a high-grade fever, reaching up to 104 degrees Fahrenheit. Over time, the abdominal pain became more severe and diffuse, accompanied by recurrent bilious vomiting and progressive abdominal distension. The patient underwent fluid resuscitation at a nearby hospital before arriving at the tertiary care facility. Upon physical examination, the child appeared pale, febrile, and dehydrated, with a pulse rate of 140 beats per minute and a blood pressure of 100/70 mmHg. The abdomen was tense and distended, exhibiting generalized tenderness and signs of peritonitis.InvestigationsLaboratory investigations revealed a hemoglobin level of 8 g/dL and leucocytosis of 12,380/mm³, accompanied by a left shift. There were also elevated inflammatory markers and hypoalbuminemia, with a serum total protein level of 2 g/dL. Additionally, the coagulation profile was deranged, indicating sepsis. The remaining blood tests were within normal limits. (Table 1) A contrast-enhanced computed tomography (CECT) scan of the abdomen revealed a severely distended stomach filled with large mottled material in the lumen, accompanied by a retroperitoneal collection of air. (Figures 1a and 1b).TreatmentAfter the preliminary fluid resuscitation, the child was taken for emergency exploratory laparotomy via midline abdominal incision, which showed bilious-purulent contamination with perforation at the proximal jejunum just distal to the duodenojejunal junction with sharp plastic fibers noted coming out of the perforated jejunum. On retrograde palpation, a similar material with a wire-like consistency was noted occupying the complete lumen of the stomach. (Figure 2) Since the bezoar was quite large, the anterior wall gastrotomy was made, and the bezoar was extracted slowly without significant spillage (Figure 3a). Resection of the diseased duodeno-jejunal segment was done with end-to-end anastomosis. Bezoar was the blended cluster of plastic fibers and entrapped food material (Figure 3b). Peritoneal lavage was done and abdominal drains were kept. Post-operatively the child was closely monitored in the pediatric intensive care unit with the necessary ventilator and ionotropic support due to the florid sepsis.Outcome and follow-upAfter the surgery, the child was closely monitored in the pediatric intensive care unit and received necessary ventilator and inotropic support due to significant sepsis. Fortunately, the child’s condition improved rapidly. By the first postoperative day, the child was taken off both ventilatory and inotropic support and gradually began oral feeding starting on the fifth postoperative day. The child, along with accompanying family members including siblings, underwent psychological counselling. During this process, the child’s younger sister revealed that he frequently chews on plastic wires, including kite-flying strings. However, the older family members were unaware of this habit and could not provide any related samples. He was then discharged in stable condition. The child did not come for physical follow-up counseling sessions but on a telephonic conversation. after 1 year, the child appeared to be doing well with no abnormal eating habits.DiscussionRapunzel syndrome is a rare entity where the bezoar formed in the stomach extends distally into the lumen of the duodenum and jejunum like the long-tied hairs of a princess in a fairy tale by the Grimm Brothers [3]. This, rather than being a gastrointestinal disorder, is a psychological disorder. Therefore, this is often encountered in children with depression, anxiety, and obsessive-compulsive disorders like trichotillomania (pulling out of self-hair), trichophagia (eating of hair), and PICA [4]. PICA is defined as the persistent and compulsive eating of non-nutritive substances for at least one month. PICA is most commonly noted in children at 36 months of age with a common co-occurrence in children with autism and intellectual disabilities, but the index case was normal intellectually and developmentally [5]. Trichobezoar is formed only in 1% of children with trichophagia, and only 20-30% of trichotillomaniacs will do trichophagia [6,7]. The incidence of trichobezoars is 0.5% worldwide, while the incidence of plastic bezoars is unknown and seldom reported [8]. (Table 2)A bezoar is formed when the slippery fibrous strands escape gastric peristalsis and accumulate in the gastric mucosal folds. Peristalsis and the gastric secretions force the fibers to interweave and gradually form a large ball of indigestible fibers that cannot pass through the gastric outlet but can easily extend into the small bowel like a tail. Due to this sheltered increase in the size of bezoar, they are often diagnosed late [9].Rapunzel syndrome is usually reported in the 13-20 age group and mostly in females, as shown in Table 2 [9]. The index case is a 6-year-old who presented in a surgical emergency with signs of perforation peritonitis, which is a rare presentation. Early presentations with just the complaints of abnormal ingestion or psychological behavior are rare. The history of unknowingly chewing plastic and kite threads is often discovered retrospectively after surgery, as in our case, where even the parents failed to recognize and address the issue as in the literature (Table 2). Incipiently, patients usually have epigastric pain, early satiety, loss of appetite, and sometimes a palpable abdominal mass with signs and symptoms of malabsorption. The symptoms worsen due to gradual entanglement and an increase in the size of the bezoar. They may present with melena or hematemesis due to pressure erosive gastritis or duodenal ulcers. Few may present with mechanical obstruction and perforation due to the pressure necrosis of the adjacent mucosa, as in the index case, where the stiff, wire-like fibers were noted popping out of the small intestine at the duodenojejunal junction, the fixed part of the gastrointestinal tract [10]. Although the diagnosis is often delayed due to the lack of proper history and complications, intestinal perforation is the most common complication noted among 108 cases of bezoar reported in the literature [11].Bezoars are best managed through complete removal, along with regular psychological counseling sessions to help prevent recurrence. For smaller bezoars, several minimally invasive removal methods can be utilized, including endoscopic retrieval, bezotriptors to break down the tough fibers, enzymatic dissolution, and laparoscopic retrieval [12,13]. Large and complicated bezoars are removed through surgical gastrotomy or enterotomy, depending on their location, with careful attention to avoid intraperitoneal spillage [11]. The recurrence rate of a bezoar may be as much as 13.5% [14]. Even after the pertinent surgical management, the treatment is considered deficient without genuine cognitive behavioral therapy (CBT) and emotional support to prevent the recurrence of PICA and related complications.ConclusionsEarly recognition of PICA is crucial, as it can lead to severe gastrointestinal complications. Bezoar-related perforation necessitates timely surgical intervention for favorable outcomes. The treatment is considered incomplete if it’s not accompanied by family counselling sessions. Family members, especially siblings, may be more aware of abnormal eating behaviors than parents, emphasizing the role of family-wide counseling. Long-term behavioral therapy and multidisciplinary follow-up are essential in preventing the recurrence.Key clinical message○ Early recognition of PICA is crucial, as it can lead to severe gastrointestinal complications.○ Bezoar-related perforation necessitates timely surgical intervention for favorable outcomes.○ Family members, especially siblings, may be more aware of abnormal eating behaviors thanparents, emphasizing the role of family-wide counseling.○ Long-term behavioral therapy and multidisciplinary follow-up are essential in preventingrecurrence.Patient ConsentWritten informed consent was obtained from the patient’s legal guardian to publish this case report.AcknowledgementsThe authors used ChatGPT (OpenAI) to assist in initially drafting the cover letter and title page. The content was subsequently reviewed and edited by the authors to ensure accuracy and originality.ReferencesMirza MB, Talat N, Saleem M: Gastrointestinal trichobezoar: An experience with 17 cases. 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Nephron sparing surgery (NSS) is a standard technique for patients with bilateral Wilms tumor (WT) and unilateral WT with predisposing syndromes. The decision for intra-operative ureteral stent placement depends on the degree of disruption of the collecting system and must be balanced between the risk of post-operative urinary leak and the risk of stent-related urinary tract infection. The purpose of this study is to find predictors of urinary leak that may guide the decision for ureteral stenting. Methods Patients who underwent NSS for pre-operative diagnosis of renal masses at a single tertiary pediatric hospital between January 2010 and December 2023 were retrospectively reviewed. Exclusion criteria were post-operative diagnosis of non-neoplastic conditions and incomplete data. The following pre-operative variables were studied: laterality of the tumor, symptoms at diagnosis, timing of surgery, pre-operative chemotherapy toxicity grade 3 or higher according to the Common Terminology Criteria for Adverse Events (CTCAE; version 5.0). Three intra-operative variables were studied: the need for intra-operative repair of distal calyces, total duration of surgery and duration of vascular clamping. Primary outcome was the occurrence of urinary leak. Secondary outcomes were post-operative renal dysfunction and post-operative length of hospitalization. Results Thirty-seven patients underwent NSS; seven of them were excluded for post-operative diagnosis of non-neoplastic disease or incomplete data. Twenty patients had unilateral disease and ten had bilateral disease or tumor on horseshoe kidney. Eight patients underwent upfront surgery and twenty-two received neoadjuvant chemotherapy. Ureteral stent was placed intra-operatively in three patients (10%). Urinary leakage was observed in four patients (13%) who did not undergo intraoperative stenting; all of them required delayed stent placement. Urinary leak was significantly associated with pre-operative chemotherapy toxicity (4/10 patients versus 0/20 patients, p = 0.0077). Post-operative renal dysfunction was significantly associated with pre-operative chemotherapy toxicity (8/10 patients vs 3/20 patients; p = 0.0010), bilateral disease (7/10 patients vs 4/20 patients; p = 0.0147) and surgery after neoadjuvant chemotherapy (11/22 patients vs 0/8 patients; p = 0.0140). Post-operative hospitalization was significantly longer in patients with pre-operative chemotherapy toxicity (median 10.5 days versus 7 days, p = 0.0255) and in patients who underwent s