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BackgroundThere is limited evidence from antimicrobial stewardship programmes in less-resourced settings. This study aimed to improve the quality of antibacterial prescriptions by mitigating overuse and promoting the use of narrow-spectrum agents in intensive care units (ICUs) in a middle-income country.MethodsWe established a quality improvement collaborative (QIC) model involving nine Argentine ICUs over 11 months with a 16-week baseline period (BP) and a 32-week implementation period (IP). Our intervention package included audits and feedback on antibacterial use, facility-specific treatment guidelines, antibacterial timeouts, pharmacy-based interventions and education. The intervention was delivered in two learning sessions with three action periods along with coaching support and basic quality improvement training.ResultsWe included 912 patients, 357 in BP and 555 in IP. The latter had higher APACHE II (17 (95% CI: 12 to 21) vs 15 (95% CI: 11 to 20), p=0.036), SOFA scores (6 (95% CI: 4 to 9) vs 5 (95% CI: 3 to 8), p=0.006), renal failure (41.6% vs 33.1%, p=0.009), sepsis (36.1% vs 31.6%, p<0.001) and septic shock (40.0% vs 33.8%, p<0.001). The days of antibacterial therapy (DOT) were similar between the groups (change in the slope from BP to IP 28.1 (95% CI: −17.4 to 73.5), p=0.2405). There were no differences in the antibacterial defined daily dose (DDD) between the groups (change in the slope from BP to IP 43.9, (95% CI: −12.3 to 100.0), p=0.1413).The rate of antibacterial de-escalation based on microbiological culture was higher during the IP (62.0% vs 45.3%, p<0.001).The infection prevention control (IPC) assessment framework was increased in eight ICUs.ConclusionImplementing an antimicrobial stewardship program in ICUs in a middle-income country via a QIC demonstrated success in improving antibacterial de-escalation based on microbiological culture results, but not on DOT or DDD. In addition, eight out of nine ICUs improved their IPC Assessment Framework Score.

In this paper, we conduct a thorough investigation of the surface and curvature tensions, σ and γ, of three-flavor cold quark matter using the Nambu–Jona–Lasinio (NJL) model with vector interactions. Our approach ensures both local and global electric charge neutrality, as well as chemical equilibrium under weak interactions. By employing the multiple reflection expansion formalism to account for finite size effects, we explore the impact of specific input parameters, particularly the vector coupling constant ratio ηV, the radius R of quark matter droplets, as well as the charge-per-baryon ratio ξ of the finite size configurations. We focus on the role of the contributions of each term of the NJL Lagrangian to the surface and curvature tensions in the mean field approximation. We find that the total surface tension exhibits two different density regimes: it remains roughly constant at around 100MeVfm−2 up to approximately 2–4 times the nuclear saturation density, and beyond this point, it becomes a steeply increasing function of nB. The total surface and curvature tensions are relatively insensitive to variations in R but are affected by changes in ξ and ηV. We observe that the largest contribution to σ and γ comes from the regularized divergent term, making these quantities significantly higher than those obtained within the MIT bag model.

Abstract Gynoid lipodystrophy, also called cellulite, is defined as a metabolic disorder of the subcutaneous tissue that alters body contour. It is rare in men but affects 80%–90% of adult women.The authors describe a technique for the treatment of cellulite with non-traumatic subcisionTM of septa by cannula associated with large-gel-particle hyaluronic acid (HA). It uses a special marking, a safe plan and a specific product. The product being used is Subskin Aeskins, in a subcutaneous plan as no major blood vessels were found.The authors report good aesthetic results with the proposed technique. The patients reported a high degree of satisfaction.The product chosen has high G prime and large particles, which accounts for resistance to deformation and a high lifting power. Moreover, HA is a biocompatible, absorbable product and considered a safe filler. This technique allows the treatment of an area with various surface irregularities.The Square Technique proved to be a minimally invasive technique, with fast results, no major risks and little downtime, bringing satisfaction to patients and improving their self-confidence and quality of life. Our article presents a technique for the treatment of gynoid lipodystrophy, commonly known as cellulite, utilising non-traumatic cannulated treatment of the septa with large-gel-particle hyaluronic acid (HA). The technique, employing a special marking, safe plan, and the use of HA with high G prime and large particles, yielded good aesthetic results and high patient satisfaction. With its resistance to deformation and high lifting power, HA proved to be a biocompatible and safe filler, enabling the treatment of surface irregularities. The Square Technique showcased its efficacy as a minimally invasive approach, delivering fast results, minimal risks, and enhancing patients' self-confidence and quality of life.

The identity of longnose skates (Dipturus-Zearaja-like skates) in the southern cone of the Americas has been a topic of extensive debate. This study employs a comprehensive analysis encompassing morphometrics, claspers, and the examination of COI and NADH2 sequence data to conclusively demonstrate the existence of only two longnose skate species in the southwestern Atlantic Ocean, extending south of 35 °S. Notably, Dipturus argentinensis Díaz de Astarloa, Mabragaña, Hanner and Figueroa, 2008 is revealed as a junior synonym of D. trachyderma (Krefft and Stehmann, 1975). Dipturus leptocaudus (Krefft and Stehmann, 1975) remains a northern valid species, but the specimen from the Falkland Islands (Malvinas) is recognized as a misidentification of D. trachyderma. Zearaja flavirostris (Philippi, 1892) and Dipturus lamillai Concha, Caira, Ebert and Pompert, 2019 are confirmed as junior synonyms of Zearaja brevicaudata (Marini, 1933). These findings contradict the previous report of six species within the same region over the last decade and underscore the presence of D. trachyderma and Z. brevicaudata south of 35 °S in the southwestern Atlantic. Additionally, this study notes the occurrence of only one specimen of Z. chilensis (Guichenot, 1848) in the Falkland Islands (Malvinas), suggesting an unusual frequency of this eastern Pacific skate in the southern Southwest Atlantic. Given that clasper morphology serves as the key distinguishing trait between Dipturus and Zearaja species, we provided a detailed analysis of the clasper characteristics of the Atlantic D. trachyderma, unequivocally situating it within Dipturus. The diagnostic characteristics include: (i) the presence of cartilage with the distal portion referred to as the sentinel, a feature absent in Zearaja; (ii) longer ventral terminal cartilage with the distal end referred to as the funnel, compared to Zearaja; and (iii) a non-spatulate distal lobe, a distinctive trait specific to Dipturus.

The present study reports the first reference on length-weight relationships (LWR) and sexual dimorphism for Bassanago albecens, caught as bycatch in the commercial fishery in the Argentine continental shelf. A total of 91 conger eels were examined. Female specimens (ranged from 371 to 661 mm total length—TL) have body length larger than males (from 396 to 537 mm TL), but the length-weight relationships allometry coefficient was 3.76 for both sexes. Three out of seven morphometric measurements differed between sexes, in particular head size characteristics. These biometric data and their relationships are relevant to the management and conservation of fish diversity and fisheries.

The identity of longnose skates (Dipturus-Zearaja-like skates) in the southern cone of the Americas has been a topic of extensive debate. This study employs a comprehensive analysis encompassing morphometrics, claspers, and the examination of COI and NADH2 sequence data to conclusively demonstrate the existence of only two longnose skate species in the southwestern Atlantic Ocean, extending south of 35 °S. Notably, Dipturus argentinensis Díaz de Astarloa, Mabragaña, Hanner and Figueroa, 2008 is revealed as a junior synonym of D. trachyderma (Krefft and Stehmann, 1975). Dipturus leptocaudus (Krefft and Stehmann, 1975) remains a northern valid species, but the specimen from the Falkland Islands (Malvinas) is recognized as a misidentification of D. trachyderma. Zearaja flavirostris (Philippi, 1892) and Dipturus lamillai Concha, Caira, Ebert and Pompert, 2019 are confirmed as junior synonyms of Zearaja brevicaudata (Marini, 1933). These findings contradict the previous report of six species within the same region over the last decade and underscore the presence of D. trachyderma and Z. brevicaudata south of 35 °S in the southwestern Atlantic. Additionally, this study notes the occurrence of only one specimen of Z. chilensis (Guichenot, 1848) in the Falkland Islands (Malvinas), suggesting an unusual frequency of this eastern Pacific skate in the southern Southwest Atlantic. Given that clasper morphology serves as the key distinguishing trait between Dipturus and Zearaja species, we provided a detailed analysis of the clasper characteristics of the Atlantic D. trachyderma, unequivocally situating it within Dipturus. The diagnostic characteristics include: (i) the presence of cartilage with the distal portion referred to as the sentinel, a feature absent in Zearaja; (ii) longer ventral terminal cartilage with the distal end referred to as the funnel, compared to Zearaja; and (iii) a non-spatulate distal lobe, a distinctive trait specific to Dipturus.

The identity of longnose skates (Dipturus-Zearaja-like skates) in the southern cone of the Americas has been a topic of extensive debate. This study employs a comprehensive analysis encompassing morphometrics, claspers, and the examination of COI and NADH2 sequence data to conclusively demonstrate the existence of only two longnose skate species in the southwestern Atlantic Ocean, extending south of 35 ◦S. Notably, Dipturus argentinensis Díaz de Astarloa, Mabragaña, Hanner and Figueroa, 2008 is revealed as a junior synonym of D. trachyderma (Krefft and Stehmann, 1975). Dipturus leptocaudus (Krefft and Stehmann, 1975) remains a northern valid species, but the specimen from the Falkland Islands (Malvinas) is recognized as a misidentification of D. trachyderma. Zearaja flavirostris (Philippi, 1892) and Dipturus lamillai Concha, Caira, Ebert and Pompert, 2019 are confirmed as junior synonyms of Zearaja brevicaudata (Marini, 1933). These findings contradict the previous report of six species within the same region over the last decade and underscore the presence of D. trachyderma and Z. brevicaudata south of 35 ◦S in the southwestern Atlantic. Additionally, this study notes the occurrence of only one specimen of Z. chilensis (Guichenot, 1848) in the Falkland Islands (Malvinas), suggesting an unusual frequency of this eastern Pacific skate in the southern Southwest Atlantic. Given that clasper morphology serves as the key distinguishing trait between Dipturus and Zearaja species, we provided a detailed analysis of the clasper characteristics of the Atlantic D. trachyderma, unequivocally situating it within Dipturus. The diagnostic characteristics include: (i) the presence of cartilage with the distal portion referred to as the sentinel, a feature absent in Zearaja; (ii) longer ventral terminal cartilage with the distal end referred to as the funnel, compared to Zearaja; and (iii) a non-spatulate distal lobe, a distinctive trait specific to Dipturus.