The study of human-driven processes is useful to gain a better understanding of the long-term evolution of land degradation, soil erosion, and geomorphology as well as resource availability for human settlement. The objective of this paper is to identify the long-term results of human impact on the vulnerable dryland ecosystems in Northwest Argentina, specifically to analyze the consequences of the spread and consolidation of the agricultural way of life on the landscape. To reach this objective, a multiproxy interdisciplinary geoarchaeological study was conducted to link an evolutionary geomorphological model with the soil development and degradation, peopling, and land use change during the Upper Holocene and integrate distinct areas of the Tafí Valley region, which is the most studied area, other neighbouring valleys, and the Puna. The analyses identified positive human-driven impacts that led to a general degradation of the landscape during the agricultural Prehispanic Period, dated between ca. 2000 and 500 BP. This degradation is manifested by accelerated morphogenesis, mainly fine-grained accumulated sediments, thick deposits, and the presence of human debris interbedded with the natural sediments. The success of the productive agricultural systems that expanded during the Formative Period led to a gradual increase in the demographic density, resulting in extensive environmental degradation due to overexploitation of the drylands of Northwest Argentina, in some cases increased by adverse climatic changes.
Background: Distances between delivery centers and cardiac services can make the care of fetuses with cardiac disease(CD) at risk of acute cardiorespiratory instability(ACRI) at birth a challenge. In 2013 we implemented a fetal echocardiography(FE)-based algorithm targeting fetuses considered high-risk for ACRI at <2 hours of birth for Caesarian section(CS) delivery in our pediatric cardiac operating room(PCOR) of our children's hospital. We examine the experience and outcomes of affected newborns. Methods: We reviewed maternal and postnatal medical records of all fetuses with CD at high-risk for ACRI encountered January 2013-March 2022. Secondary analysis was performed including all fetuses with diagnoses of d-transposition of the great arteries/intact ventricular septum(d-TGA/IVS) and hypoplastic left heart syndrome(HLHS) encountered over the study period. Results: Forty fetuses were considered high-risk for ACRI: 15 d-TGA/IVS and 7 HLHS with restrictive atrial septum(RAS), 4 absent pulmonary valve syndrome, 3 obstructed anomalous pulmonary veins, 2 severe Ebstein anomaly, 2 thoracic/intracardiac tumors and 7 others. PCOR delivery occurred for 33 but not for 7 (5 d-TGA/IVS, 2 HLHS with RAS). For high-risk cases, FE had a positive predictive value of 50% for intervention/ECMO/death at <2 hours and 70% at <24 hours. Of "low-risk" cases, 6/46 with d-TGA/IVS and 0/45 with HLHS required intervention at <2 hours. FE predicted intervention/ECMO/death at <2hours with a sensitivity of 67%, specificity 93%, and positive and negative predictive values of 87% and 87%, respectively, for d-TGA/IVS, and 100%, 95%, 71%, and 100% for HLHS, respectively. Conclusions: FE predicts need for urgent intervention in majority with d-TGA/IVS and HLHS, and in half of the entire spectrum of high-risk CD.
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