Viral Zoonoses That Fly with Bats: A Review

Emerging infectious diseases are a growing threat to human health and a great challenge for global medical attention systems. Governmental agencies in tropical regions with abundant zoonotic pathogens should implement an active vigilance/monitoring model in bat reservoir populations because of their species richness, abundance and dispersal capabilities. Chiropterans represent approximately 20% of all mammal species, the second largest order in terms of number of species after rodents. Importantly, bats constitute natural reservoirs for potential infection of humans of several infectious disease agents such as Coronavirus, Filovirus, Lyssavirus, Paramyxovirus, and Flavivirus. Local disease outbreaks caused by new pathogens can expand globally as a result of human intrusion on wildlife ecosystems and subsequent dispersion of pathogens facilitated by international travel—for example, what happened in 2003 during the severe acute respiratory syndrome pandemic (SARS). At this time, it is not possible to predict which pathogen will cross the species barrier in the future. Nonetheless, a better understanding of a holistic transmission process could help the design of strategies to prevent and control of future pandemics. In this work, we present a summary of the potential societal (economic and epidemiological) effect of disease outbreaks of virus families associated with bats, and the preventive and control measures that could be anticipated

Viral Zoonoses That Fly with Bats: A Review

Emerging infectious diseases are a growing threat to human health and a great challenge for global medical attention systems. Governmental agencies in tropical regions with abundant zoonotic pathogens should implement an active vigilance/monitoring model in bat reservoir populations because of their species richness, abundance and dispersal capabilities. Chiropterans represent approximately 20% of all mammal species, the second largest order in terms of number of species after rodents. Importantly, bats constitute natural reservoirs for potential infection of humans of several infectious disease agents such as Coronavirus, Filovirus, Lyssavirus, Paramyxovirus, and Flavivirus. Local disease outbreaks caused by new pathogens can expand globally as a result of human intrusion on wildlife ecosystems and subsequent dispersion of pathogens facilitated by international travel—for example, what happened in 2003 during the severe acute respiratory syndrome pandemic (SARS). At this time, it is not possible to predict which pathogen will cross the species barrier in the future. Nonetheless, a better understanding of a holistic transmission process could help the design of strategies to prevent and control of future pandemics. In this work, we present a summary of the potential societal (economic and epidemiological) effect of disease outbreaks of virus families associated with bats, and the preventive and control measures that could be anticipated

E.coli 0157: H7 enterohemorrágico: un agente etiológico de diarrea y zoonosis en Colombia subestimado. Parte I

En los últimos años, la enfermedad diarreica aguda (EDA) se ha convertido en un serio problema de salud pública; la EDA tiene las características de una verdadera pandemia si tenemos en cuenta que ha afectado a múltiples países en Europa y América. A nivel mundial, la EDA es una de las causas más importantes de morbi-mortalidad sobre todo en lactantes, niños y ancianos. Se ha estimado que en Asia, Africa y Latinoamérica, en razón a los factores socioeconómicos y nutricionales, la probabilidad de que un niño muera por enfermedad diarreica antes de los 7 años pueda llegar al 50%. En los países desarrollados la mortalidad es mucho menor, pero todavía significativa. (Máttar 1998). Según la organización mundial de la salud (OMS), la EDA, afecta a 750 millones de niños anualmente, y en este período se calcula que unos 4.6 millones mueren debido a la deshidratación que producen estos procesos infecciosos. Datos del Instituto Nacional de Salud (INS) y del Ministerio de Salud de Colombia, muestran que en 1993 se presentaron 470.772 casos de EDA en una población de 4.224.121 niños menores de 5 años para los 33 departamentos del país, siendo así una de las patológias más comunes en la población infantil y en especial en los menores de 5 años (Máttar 1996). EDA es una de las principales causantes de muerte infantil en Colombia (Máttar 1996); es una entidad multifactorial en la que principalmente, el criterio diagnóstico ha sido clínico a través del tiempo, y donde, el diagnóstico etiológico preciso no es usualmente el empleado

Desarrollo sostenible y el desafío del control fiscal ambiental: Sustainable development and the challenge of environmental fiscal control

Despite the fact that there is a large number of regulations in Colombia that have the ultimate goal of protecting the most precious legal asset, the healthy environment; It will be highlighted by what is observed in this investigation, with data extracted from reports from both the Comptroller General of the Republic (CGR 2018-2020) and the General Auditor of the Republic (SIA MISONAL 2018- 2020), that the environmental fiscal control It has not been audited and is executing efficiently and with the same percentages, with respect to the different types of natural resources. That is, of water, air, biodiversity, or the soil. Therefore, the country's environmental problems increase with it.Posterior a la entrada en vigencia de la Constitución Política de Colombia de 1991, nace como pilar fundamental en lo que respecta a la protección del medio ambiente, una preocupación del legislador por establecer una eficiente vigilancia de la gestión fiscal del Estado, coadyuvada por algunos organismos que tienen como función principal, la de realizar un seguimiento permanente al recurso Público, sin oponibilidad de reserva legal para el acceso de la información, cimentado en la eficiencia, economía, equidad, desarrollo sostenible y el verificado cumplimiento del principio de valoración de costos ambientales. Pese a que existe en Colombia, una gran cantidad de normas que tienen como fin último, el de proteger el bien jurídico más preciado, el medio ambiente, se destacará mediante lo observado en la presente investigación, con datos extraídos de los sistemas de rendición de cuenta de la Auditoría General de la República - AGR (SIA MISIONAL 2018-2021) , de informes tanto de la Contraloría General de la República (CGR 2018-2020) como de las Contralorías Territoriales , que el control fiscal ambiental no ha sido aplicado eficientemente, respecto de los distintos tipos de recursos naturales. Esto es, agua, aire, biodiversidad, o el suelo. Por lo tanto, se incrementa con ello, la problemática ambiental del país

Mapping mental health care services for children and youth population in Colombia’s Pacific:potential for boundary spanning between community and formal services

Background: Conflict and violence can impact on the mental health of children and young people, who are in a crucial stage of their personal growth. Not much is known about the provision of mental health care to young people in conflict-affected areas. Community-based care can be essential, as state-led services are often scarce in conflict contexts, like Colombia’s Pacific region where this research was conducted. According to the WHO, such care is ideally provided in the form of a network of interconnected services, offered by different actors beyond the formal health sector. This article describes the relationship between the formal and community mental health systems in Colombia’s Pacific region, and identifies ways of improving their interaction.Methods: Qualitative data were collected through 98 semi-structured interviews with community organisations, schools, international organisations and state institutions. These interviews aimed to identify the strategies used to promote young people’s mental health and the interactions between the different providers. Boundary spanning theory was used to analyse how different actors and forms of mental health care provision could coordinate better.Results: Community organisations and schools use a wide array of strategies to attend to the mental health of children and young people, often of a collective and psychosocial nature. State institutions offer more clinically focused strategies, which are however limited in terms of accessibility and continuity. International organisations aim to strengthen state capacity, but often struggle due to high staff turnover. Although mental health care pathways exist, their effectiveness is limited due to ineffective coordination between actors.Conclusions: To make sure that the variety of strategies to improve young people’s mental health effectively reach their beneficiaries, better coordination is needed between the different actors. Mental health care pathways should therefore integrate community organisations, while community connectors can help to manage the coordination between different actors and forms of clinical and psychosocial support

Method based on data mining techniques for breast cancer recurrence analysis

Cancer is a constantly evolving disease, which affects a large number of people worldwide. Great efforts have been made at the research level for the development of tools based on data mining techniques that allow to detect or prevent breast cancer. The large volumes of data play a fundamental role according to the literature consulted, a great variety of dataset oriented to the analysis of the disease has been generated, in this research the Breast Cancer dataset was used, the purpose of the proposed research is to submit comparison of the J48 and randomforest, NaiveBayes and NaiveBayes Simple, SMO Poli-kernel and SMO RBF-Kernel classification algorithms, integrated with the Simple K-Means cluster algorithm for the generation of a model that allows the successful classification of patients who are or Non-recurring breast cancer after having previously undergone surgery for the treatment of said disease, finally the methods that obtained the best levels were SMO Poly-Kernel + Simple K-Means 98.5% of Precision, 98.5% recall, 98.5% TPRATE and 0.2% FPRATE. The results obtained suggest the possibility of using intelligent computational tools based on data mining methods for the detection of breast cancer recurrence in patients who had previously undergone surgery

Finanças públicas, direito financeiro e direito tributário em tempos de pandemia: diálogos ibero-americanos

- Divulgação dos SUMÁRIOS das obras recentemente incorporadas ao acervo da Biblioteca Ministro Oscar Saraiva do STJ. Em respeito à Lei de Direitos Autorais, não disponibilizamos a obra na íntegra.- Localização na estante: 347.73:578.834(7/8) F491p- Organizado por: Carlos Palao Taboada, Germán Orón Moratal, João Ricardo Catarino, José Casalta Nabais, Juan Arrieta Martinez de Pisón e Marciano Seabra de Godoi

Zero by 2030 and OneHealth: The multidisciplinary challenges of rabies control and elimination

"Rabies, caused by a negative strand RNA-virus belonging to the genus Lyssavirus (family Rhabdoviridae of the order Mononegavirales), remains of global concern [1]. This vaccine-preventable viral zoonotic disease is present in more than 150 countries and territories [2]. Ac- cording to the World Health Organization (WHO), rabies is estimated to cause ~59,000 human deaths annually, with 95% of cases occurring in Africa and Asia [3,4]. However, rabies still occurs in other regions, such as Latin America and the Caribbean [5–8], Central Asia and the Middle East [9,10]. Whilst a number of animals can host the rabies virus, dogs are the main source of human rabies deaths, contributing up to 99% of all rabies transmissions to humans. Dog-mediated rabies has been eliminated from Western Europe, Canada, the United States of America (USA), Japan and some Latin American countries [11]. Nevertheless, the risk of reintroduction and disease among travellers to risk areas is a matter of concern [12–15]. As occurred with many other communicable and non-communicable diseases, the 2020–2022 COVID-19 pandemic negatively impacted the efforts of control and reemergence of rabies in certain countries [7,16,17]. Post-pandemic challenges to enhance con- trol and prevention are multiple and need urgent actions to achieve the goal in eight years by 2030 [16].

Atrasentan and renal events in patients with type 2 diabetes and chronic kidney disease (SONAR): a double-blind, randomised, placebo-controlled trial

Background: Short-term treatment for people with type 2 diabetes using a low dose of the selective endothelin A receptor antagonist atrasentan reduces albuminuria without causing significant sodium retention. We report the long-term effects of treatment with atrasentan on major renal outcomes. Methods: We did this double-blind, randomised, placebo-controlled trial at 689 sites in 41 countries. We enrolled adults aged 18–85 years with type 2 diabetes, estimated glomerular filtration rate (eGFR)25–75 mL/min per 1·73 m 2 of body surface area, and a urine albumin-to-creatinine ratio (UACR)of 300–5000 mg/g who had received maximum labelled or tolerated renin–angiotensin system inhibition for at least 4 weeks. Participants were given atrasentan 0·75 mg orally daily during an enrichment period before random group assignment. Those with a UACR decrease of at least 30% with no substantial fluid retention during the enrichment period (responders)were included in the double-blind treatment period. Responders were randomly assigned to receive either atrasentan 0·75 mg orally daily or placebo. All patients and investigators were masked to treatment assignment. The primary endpoint was a composite of doubling of serum creatinine (sustained for ≥30 days)or end-stage kidney disease (eGFR <15 mL/min per 1·73 m 2 sustained for ≥90 days, chronic dialysis for ≥90 days, kidney transplantation, or death from kidney failure)in the intention-to-treat population of all responders. Safety was assessed in all patients who received at least one dose of their assigned study treatment. The study is registered with ClinicalTrials.gov, number NCT01858532. Findings: Between May 17, 2013, and July 13, 2017, 11 087 patients were screened; 5117 entered the enrichment period, and 4711 completed the enrichment period. Of these, 2648 patients were responders and were randomly assigned to the atrasentan group (n=1325)or placebo group (n=1323). Median follow-up was 2·2 years (IQR 1·4–2·9). 79 (6·0%)of 1325 patients in the atrasentan group and 105 (7·9%)of 1323 in the placebo group had a primary composite renal endpoint event (hazard ratio [HR]0·65 [95% CI 0·49–0·88]; p=0·0047). Fluid retention and anaemia adverse events, which have been previously attributed to endothelin receptor antagonists, were more frequent in the atrasentan group than in the placebo group. Hospital admission for heart failure occurred in 47 (3·5%)of 1325 patients in the atrasentan group and 34 (2·6%)of 1323 patients in the placebo group (HR 1·33 [95% CI 0·85–2·07]; p=0·208). 58 (4·4%)patients in the atrasentan group and 52 (3·9%)in the placebo group died (HR 1·09 [95% CI 0·75–1·59]; p=0·65). Interpretation: Atrasentan reduced the risk of renal events in patients with diabetes and chronic kidney disease who were selected to optimise efficacy and safety. These data support a potential role for selective endothelin receptor antagonists in protecting renal function in patients with type 2 diabetes at high risk of developing end-stage kidney disease. Funding: AbbVie

Zika virus disease, microcephaly and Guillain-Barré syndrome in Colombia: epidemiological situation during 21 months of the Zika virus outbreak, 2015–2017

Abstract Background The Zika virus disease (ZVD) has had a huge impact on public health in Colombia for the numbers of people affected and the presentation of Guillain-Barre syndrome (GBS) and microcephaly cases associated to ZVD. Methods A retrospective descriptive study was carried out, we analyze the epidemiological situation of ZVD and its association with microcephaly and GBS during a 21-month period, from October 2015 to June 2017. The variables studied were: (i) ZVD cases, (ii) ZVD cases in pregnant women, (iii) laboratory-confirmed ZVD in pregnant women, (iv) ZVD cases associated with microcephaly, (v) laboratory-confirmed ZVD associated with microcephaly, and (vi) ZVD associated to GBS cases. Average number of cases, attack rates (AR) and proportions were also calculated. The studied variables were plotted by epidemiological weeks and months. The distribution of ZVD cases in Colombia was mapped across the time using Kernel density estimator and QGIS software; we adopted Kernel Ridge Regression (KRR) and the Gaussian Kernel to estimate the number of Guillain Barre cases given the number of ZVD cases. Results One hundred eight thousand eighty-seven ZVD cases had been reported in Colombia, including 19,963 (18.5%) in pregnant women, 710 (0.66%) associated with microcephaly (AR, 4.87 cases per 10,000 live births) and 453 (0.42%) ZVD associated to GBS cases (AR, 41.9 GBS cases per 10,000 ZVD cases). It appears the cases of GBS increased in parallel with the cases of ZVD, cases of microcephaly appeared 5 months after recognition of the outbreak. The kernel density map shows that throughout the study period, the states most affected by the Zika outbreak in Colombia were mainly San Andrés and Providencia islands, Casanare, Norte de Santander, Arauca and Huila. The KRR shows that there is no proportional relationship between the number of GBS and ZVD cases. During the cross validation, the RMSE achieved for the second order polynomial kernel, the linear kernel, the sigmoid kernel, and the Gaussian kernel are 9.15, 9.2, 10.7, and 7.2 respectively. Conclusions This study updates the epidemiological analysis of the ZVD situation in Colombia describes the geographical distribution of ZVD and shows the functional relationship between ZVD cases and GBS