First contribution to the genus Gymnopilus (Agaricales, Strophariaceae) in Paraguay

Gymnopilus is characterized by its ferruginous-yellow basidiomata and lamellae, ferruginous spore print, ellipsoidal basidiospores with warty and rough ornamentation, and lacking a germinative pore. Here, novel data on the Gymnopilus species of Paraguay is presented, macro and microscopic morphological characteristics, distribution, and ecology are described, and a taxonomic discussion is provided. Gymnopilus imperialis is recorded in the Alto Paraná Department, G. lepidotus in the Central Department, G. luteofolius in the Cordillera Department, G. peliolepis in the Paraguarí Department, and G. purpureosquamulosus in the Central Department and Boquerón, all as new records for Paraguay. Photographs of the fresh basidiomata and some microscopic structures such as basidia and basidiospores are attached.Fil: Campi Gaona, Michelle Geraldine. Universidad Nacional de Asunción; ParaguayFil: Maubet, Yanine. Universidad Nacional de Asunción; ParaguayFil: Grassi, Emanuel Marcelo. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - San Luis. Instituto Multidisciplinario de Investigaciones Biológicas de San Luis. Universidad Nacional de San Luis. Facultad de Ciencias Físico Matemáticas y Naturales. Instituto Multidisciplinario de Investigaciones Biológicas de San Luis; ArgentinaFil: Niveiro, Nicolás. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Nordeste. Instituto de Botánica del Nordeste. Universidad Nacional del Nordeste. Facultad de Ciencias Agrarias. Instituto de Botánica del Nordeste; ArgentinaFil: Guzmán Dávalos, Laura. Universidad de Guadalajara; Méxic

The Differential Diagnosis of Discrepant Thyroid Function Tests: Insistent Pitfalls and Updated Flow-Chart Based on a Long-Standing Experience.

Background: Discrepant thyroid function tests (TFTs) are typical of inappropriate secretion of TSH (IST), a rare entity encompassing TSH-secreting adenomas (TSHoma) and Resistance to Thyroid Hormone (RTHβ) due to THRB mutations. The differential diagnosis remains a clinical challenge in most of the cases. The objective of this study was to share our experience with patients presenting with discrepant TFTs outlining the main pitfalls in the differential diagnosis. Methods: medical records of 100 subjects with discrepant TFTs referred to Thyroid Endocrine Centers at the University of Milan were analyzed, retrospectively. Patients were studied by dynamic testing (TRH test, T3-suppression test, or a short course of long-acting somatostatin analog, when appropriate), THRB sequencing, and pituitary imaging. Results: 88 patients were correctly diagnosed as RTHβ with (n = 59; 16 men, 43 women) or without THRB variants (n = 6; 2 men, 4 female) or TSHoma (n = 23; 9 men, 14 women). We identified 14 representative subjects with an atypical presentation or who were misdiagnosed. Seven patients, with spurious hyperthyroxinemia due to assays interference were erroneously classified as RTHβ (n = 4) or TSHoma (n = 3). Three patients with genuine TSHomas were classified as laboratory artifact (n = 2) or RTHβ (n = 1). Two TSHomas presented atypically due to coexistent primary thyroid diseases. In one RTHβ a drug-induced thyroid dysfunction was primarily assumed. These patients experienced a mean diagnostic delay of 26 ± 14 months. Analysis of the investigations which can differentiate between TSHoma and RTHβ showed highest accuracy for the T3-suppression test (100% specificity with a cut-off of TSH <0.11 μUI/ml). Pituitary MRI was negative in 6/26 TSHomas, while 11/45 RTHβ patients had small pituitary lesions, leading to unnecessary surgery in one case. Conclusions: Diagnostic delay and inappropriate treatments still occur in too many cases with discrepant TFTs suggestive of central hyperthyroidism. The insistent pitfalls lead to a significant waste of resources. We propose a revised flow-chart for the differential diagnosis

Autonomous and Human-Driven Vehicles Interacting in a Roundabout: A Quantitative and Qualitative Evaluation

Optimizing traffic dynamics in an evolving transportation landscape is crucial, particularly in scenarios where autonomous vehicles (AVs) with varying levels of autonomy coexist with human-driven cars. While optimizing Reinforcement Learning (RL) policies for such scenarios is becoming more and more common, little has been said about realistic evaluations of such trained policies. This paper presents an evaluation of the effects of AVs penetration among human drivers in a roundabout scenario, considering both quantitative and qualitative aspects. In particular, we learn a policy to minimize traffic jams (i.e., minimize the time to cross the scenario) and to minimize pollution in a roundabout in Milan, Italy. Through empirical analysis, we demonstrate that the presence of AVs} can reduce time and pollution levels. Furthermore, we qualitatively evaluate the learned policy using a cutting-edge cockpit to assess its performance in near-real-world conditions. To gauge the practicality and acceptability of the policy, we conduct evaluations with human participants using the simulator, focusing on a range of metrics like traffic smoothness and safety perception. In general, our findings show that human-driven vehicles benefit from optimizing AVs dynamics. Also, participants in the study highlight that the scenario with 80% AVs is perceived as safer than the scenario with 20%. The same result is obtained for traffic smoothness perception

Is There a Crucial Link Between Vitamin D Status and Inflammatory Response in Patients With COVID-19?

Background: Hypovitaminosis D has been suggested to play a possible role in coronavirus disease 2019 (COVID-19) infection. Methods: The aim of this study is to analyze the relationship between vitamin D status and a biochemical panel of inflammatory markers in a cohort of patients with COVID-19. A secondary endpoint was to evaluate the correlation between 25OHD levels and the severity of the disease. Ninety-three consecutive patients with COVID-19-related pneumonia were evaluated from March to May 2020 in two hospital units in Pisa, in whom biochemical inflammatory markers, 25OHD levels, P/F ratio at nadir during hospitalization, and complete clinical data were available. Results: Sixty-five percent of patients presented hypovitaminosis D (25OHD ≤ 20 ng/ml) and showed significantly higher IL-6 [20.8 (10.9–45.6) vs. 12.9 (8.7–21.1) pg/ml, p = 0.02], CRP [10.7 (4.2–19.2) vs. 5.9 (1.6–8.1) mg/dl, p = 0.003], TNF-a [8.9 (6.0–14.8) vs. 4.4 (1.5–10.6) pg/ml, p = 0.01], D-dimer [0.53 (0.25–0.72) vs. 0.22 (0.17–0.35) mg/l, p = 0.002], and IL-10 [3.7 (1.8–6.9) vs. 2.3 (0.5–5.8) pg/ml, p = 0.03]. A significant inverse correlation was found between 25OHD and all these markers, even adjusted for age and sex. Hypovitaminosis D was prevalent in patients with severe ARDS, compared with the other groups (75% vs. 68% vs. 55%, p &lt; 0.001), and 25OHD levels were lower in nonsurvivor patients. Conclusions: The relationship between 25OHD levels and inflammatory markers suggests that vitamin D status needs to be taken into account in the management of these patients. If vitamin D is a marker of poor prognosis or a possible risk factor with beneficial effects from supplementation, this still needs to be elucidated

Hepatitis B Surface Antigen Seropositive Men in Serodiscordant Couples: Effects on the Assisted Reproductive Outcomes

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Lazos sociales y pandemia: Una experiencia de investigación en el barrio La Esperanza (Benavidez, partido de Tigre)

El artículo describe una experiencia de investigación colaborativa entre el Observatorio de Crímenes de Estado (FSOC-UBA) y los Hogares de Cristo, con asiento en el barrio La Esperanza-Benavidez-Tigre y presenta una primera aproximación muy exploratoria al análisis del trabajo de campo realizado. Los ejes de indagación que ordenaron la tarea fueron por un lado, comprender cómo había impactado la pandemia del COVID-19 en los barrios populares; por otro, indagar en las estrategias de contención y cuidado implementados por el gobierno nacional y los gobiernos locales ( pertinencia y efectividad en su implementación).Finalmente, dar cuenta del rol de las redes y/o organizaciones de los barrios en la construcción de estrategias autónomas (complementarias o supletorias de las desplegadas por las distintas instancias estatales) como un revelador de las modalidades de configuración de los lazos sociales y clivaje a partir del cual repensar redes de solidaridad y organización territorial. La hipótesis puesta en juego establecía que las organizaciones sociales y barriales habían adquirido protagonismo en la contención de las demandas emergentes en los territorios ante las medidas de aislamiento primero, y distanciamiento después, estipuladas desde los diversos niveles de gobierno. El trabajo de campo se llevó adelante mediante un instrumento de recolección de datos semi estructurado, que se complementó con la realización de encuentros, entrevistas y talleres con referentes del barrio y de la institución con la que trabajamos.The axes of inquiry that ordered the task were, on the one hand, to understand how the COVID-19 pandemic had impacted on the popular neighborhoods; on the other, to investigate the containment and care strategies implemented by the national government and local governments ( relevance and effectiveness in itsimplementation). Finally, to account for the role of neighborhood networks and/or organizations in the construction of autonomous strategies (complementary or supplementary to those deployed by the different state bodies) as a revealer of the modalities of shaping social ties and cleavage from which to rethink networks of solidarity and territorial organization. The research hypothesis established that social and neighborhood organizations had acquired a leading role in containing the emerging demands in the territories in the face of isolation measures first, and distancing later, stipulated by the various levels of government. The field work was carried out through a semi-structured data collection instrument, which was complemented by meetings, interviews and workshops with representatives of the neighborhood and the institution with which we work.Fil: Camelli, María Eva. Universidad de Buenos Aires. Facultad de Ciencias Sociales; Argentina. Universidad Nacional de General Sarmiento. Instituto del Conurbano; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; ArgentinaFil: Olmos, María Belén. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina. Universidad de Buenos Aires. Facultad de Ciencias Sociales; Argentina. Universidad de Buenos Aires. Facultad de Ciencias Sociales. Instituto de Investigaciones "Gino Germani"; ArgentinaFil: Arcem Andrea. Universidad de Buenos Aires. Facultad de Ciencias Sociales; ArgentinaFil: Campi, Aldana. Universidad de Buenos Aires. Facultad de Ciencias Sociales; ArgentinaFil: Caponi, Laura. Universidad de Buenos Aires. Facultad de Ciencias Sociales; ArgentinaFil: Díaz, Walter. Universidad de Buenos Aires. Facultad de Ciencias Sociales; ArgentinaFil: Gimpelewicz, Violeta Laura. Universidad de Buenos Aires. Facultad de Ciencias Sociales; ArgentinaFil: Massera, Lucia Macarena. Universidad de Buenos Aires. Facultad de Ciencias Sociales; ArgentinaFil: Seinhart, Catalina. Universidad de Buenos Aires. Facultad de Ciencias Sociales; ArgentinaFil: Silveyra, Malena. Universidad de Buenos Aires. Facultad de Ciencias Sociales; Argentina. Universidad Nacional de Tres de Febrero. Centro de Estudios sobre Genocidio; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; ArgentinaFil: Feierstein, Daniel Eduardo. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina. Universidad de Buenos Aires. Facultad de Ciencias Sociales; Argentina. Universidad Nacional de Tres de Febrero. Centro de Estudios sobre Genocidio; Argentin

Lazos sociales y pandemia: Una experiencia de investigación en el barrio La Esperanza (Benavidez, partido de Tigre)

El artículo describe una experiencia de investigación colaborativa entre el Observatorio de Crímenes de Estado (FSOC-UBA) y los Hogares de Cristo, con asiento en el barrio La Esperanza-Benavidez-Tigre y presenta una primera aproximación muy exploratoria al análisis del trabajo de campo realizado. Los ejes de indagación que ordenaron la tarea fueron por un lado, comprender cómo había impactado la pandemia del COVID-19 en los barrios populares; por otro, indagar en las estrategias de contención y cuidado implementados por el gobierno nacional y los gobiernos locales ( pertinencia y efectividad en su implementación).Finalmente, dar cuenta del rol de las redes y/o organizaciones de los barrios en la construcción de estrategias autónomas (complementarias o supletorias de las desplegadas por las distintas instancias estatales) como un revelador de las modalidades de configuración de los lazos sociales y clivaje a partir del cual repensar redes de solidaridad y organización territorial. La hipótesis puesta en juego establecía que las organizaciones sociales y barriales habían adquirido protagonismo en la contención de las demandas emergentes en los territorios ante las medidas de aislamiento primero, y distanciamiento después, estipuladas desde los diversos niveles de gobierno. El trabajo de campo se llevó adelante mediante un instrumento de recolección de datos semi estructurado, que se complementó con la realización de encuentros, entrevistas y talleres con referentes del barrio y de la institución con la que trabajamos.The axes of inquiry that ordered the task were, on the one hand, to understand how the COVID-19 pandemic had impacted on the popular neighborhoods; on the other, to investigate the containment and care strategies implemented by the national government and local governments ( relevance and effectiveness in itsimplementation). Finally, to account for the role of neighborhood networks and/or organizations in the construction of autonomous strategies (complementary or supplementary to those deployed by the different state bodies) as a revealer of the modalities of shaping social ties and cleavage from which to rethink networks of solidarity and territorial organization. The research hypothesis established that social and neighborhood organizations had acquired a leading role in containing the emerging demands in the territories in the face of isolation measures first, and distancing later, stipulated by the various levels of government. The field work was carried out through a semi-structured data collection instrument, which was complemented by meetings, interviews and workshops with representatives of the neighborhood and the institution with which we work.Fil: Camelli, María Eva. Universidad de Buenos Aires. Facultad de Ciencias Sociales; Argentina. Universidad Nacional de General Sarmiento. Instituto del Conurbano; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; ArgentinaFil: Olmos, María Belén. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina. Universidad de Buenos Aires. Facultad de Ciencias Sociales; Argentina. Universidad de Buenos Aires. Facultad de Ciencias Sociales. Instituto de Investigaciones "Gino Germani"; ArgentinaFil: Arcem Andrea. Universidad de Buenos Aires. Facultad de Ciencias Sociales; ArgentinaFil: Campi, Aldana. Universidad de Buenos Aires. Facultad de Ciencias Sociales; ArgentinaFil: Caponi, Laura. Universidad de Buenos Aires. Facultad de Ciencias Sociales; ArgentinaFil: Díaz, Walter. Universidad de Buenos Aires. Facultad de Ciencias Sociales; ArgentinaFil: Gimpelewicz, Violeta Laura. Universidad de Buenos Aires. Facultad de Ciencias Sociales; ArgentinaFil: Massera, Lucia Macarena. Universidad de Buenos Aires. Facultad de Ciencias Sociales; ArgentinaFil: Seinhart, Catalina. Universidad de Buenos Aires. Facultad de Ciencias Sociales; ArgentinaFil: Silveyra, Malena. Universidad de Buenos Aires. Facultad de Ciencias Sociales; Argentina. Universidad Nacional de Tres de Febrero. Centro de Estudios sobre Genocidio; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; ArgentinaFil: Feierstein, Daniel Eduardo. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina. Universidad de Buenos Aires. Facultad de Ciencias Sociales; Argentina. Universidad Nacional de Tres de Febrero. Centro de Estudios sobre Genocidio; Argentin

Single-port robotic partial nephrectomy: impact on perioperative outcomes and hospital stay

Single-port (SP) robotic surgery is a novel technology and is at the beginning of its adoption curve in urology. The goal of this narrative review is to provide an overview of SP-robotic partial nephrectomy (PN) 4 years after the introduction of the da Vinci SP dedicated platform, focusing on perioperative outcomes, length of stay, and surgical technique. A nonsystematic review of the literature was conducted. The research included the most updated articles that referred to SP robotic PN. Since its commercial release in 2018, several institutions have reproduced robotic PN by using the SP platform, both via a transperitoneal and a retroperitoneal approach. The published SP-robotic PN series are generally based on preliminary experiences by surgeons who had previous experience with conventional multi-arms robotic platforms. The reported outcomes are encouraging. Overall, three studies reported that SP-robotic PN cases had nonsignificantly different operative time, estimated blood loss, overall complications rate, and length of stay compared to the conventional 'multi-arms' robotic PN. However, in all these series, renal masses treated by SP had overall lower complexity. Moreover, two studies underlined decreased postoperative pain as a major pro of adopting the SP system. This should reduce/avoid the need for opioids after surgery. No study compared SP-robotic versus multi-arms robotic PN in cost-effectiveness. Published experience with SP-robotic PN has reported the feasibility and safety of the approach. Preliminary results are encouraging and at least noninferior with respect to those from the multi-arms series. Prospective comparative studies with long-term oncologic and functional results are awaited to draw more definitive conclusions and better establish the more appropriate indications of SP robotics in the field of PN

Therapy with different dose regimens of rituximab in patients with active moderate-to-severe Graves' Orbitopathy

Background: Immunosuppressive therapy of Graves’ orbitopathy (GO) is indicated during the active phase of disease. Intravenous steroids (IVGC) are effective in about 70% of patients, although unresponsiveness or relapse are observed. In previous studies, rituximab (RTX) has been shown to be effective in inactivating moderate-to-severe GO when used early in the disease, but its optimal dosage has never been studied in randomized clinical trials. Aim of this study was to compare the efficacy and safety of different doses of RTX, based on a post-hoc analysis of two open label studies and one prospective trial randomized to IVGC. Methods: of 40 patients (35 women, 5 men), with active moderate-to-severe GO treated with RTX, 14 received a single dose of 100 mg (Group 1), 15 a single dose of 500 mg (Group 2) and 11 two 1000 mg doses, administered one week apart (Group 3). Thyroid function, TSH-receptor antibodies (TRAb) and peripheral CD19+ cells were measured. Primary endpoint was disease inactivation, measured as a decrease of the Clinical Activity Score (CAS) of at least two points. Secondary endpoints were improvement of proptosis, diplopia, quality of life and safety. Results: Baseline CAS decreased significantly in all groups (P<0.0001), independently of GO duration or whether patients had newly occurring or relapsing GO after IVGC. Proptosis did not significantly change. There was an inverse correlation between the Gorman score for diplopia and RTX dose (P<0.01). The appearance score of the GO-QoL improved in Group 1 (P=0.015), and the visual function score, in Group 2 (P=0.04). A reduction of serum TRAb was observed in Group 1 (P=0.002) and Group 2 (P<0.0002), but not in Group 3. CD19+ cell decreased in all groups (P<0.01), independently of the dose. Conclusions: We studied the optimal dosage of RTX in the treatment of active moderate-to-severe GO. In this analysis, we considered the efficacy of RTX in inactivating GO, in changing its natural course, its effect on disease severity and on the patients’ quality of life. Based on our clinical findings, and balancing the cost of therapy, a single 500 mg dose regimen is suggested in the majority of patients