The creation and design of tourist information centers: a proposal in Barrancas del Cobre (Mexico)

La presente investigación realiza una propuesta de creación y diseño de un centro de información turística de cara a una posible candidatura de Barrancas del Cobre como Geoparque Mundial de la UNESCO. Dentro de los lineamientos de dicho programa se encuentran diversos criterios muy específicos acerca de la operación del área que desea este reconocimiento. En ellos se encuentra que son necesarias prácticas de conservación del patrimonio y un centro de información para los visitantes, debido a que Barrancas del Cobre no cuenta con estas necesidades básicas. De esta manera, se propone un centro de información que permita el registro de visitantes y, por ende, pueda realizarse un estudio de capacidad de carga, además de proponer que dicho registro de visitantes se haga por medio de una aplicación móvil. La metodología usada para la investigación fue de tipo cualitativa y se empleó la técnica de revisión de la literatura y el método analítico y comparativo con casos prácticos, todo contrarrestado y basado en los estándares de la UNESCO.This research elaborates a proposal to consider Barrancas del Cobre as a possible candidate to be named a Unesco Global Geopark. Within the guidelines of this program are several and specific criteria about the operation and management of the area that desire this recognition. In them, it is found that heritage conservation practices and an information center for visitors are necessary, because Barrancas del Cobre does not have these basic needs, an information center is proposed that allows the registration of visitors and, therefore, a study of load capacity can be carried out, also, it is proposed that said registration of visitors be done through a mobile application. The methodology used for the research was qualitative and the literature review technique, analytical and comparative method with practical cases was used as well, all countered and based on UNESCO standards

Fire response of the endangered Pinus culminicola stands after 18 years in Cerro El Potosí, northeast Mexico

Abstract Aim of the study: To analyze the impact of the 1998 wildfire on dwarf pine (Pinus culminicola) population stands 18 years after the fire. Area of study: Cerro el Potosí, Nuevo León (México). Material and methods: We measured regeneration, biovolume of individuals, diversity and species composition in unburned and burned plots randomly selected in the area. Main results: Recovery was very slow, with limited dense natural regeneration and very slow growth. Significant differences between control and burned plots were found with respect to regeneration, species composition, evenness and soil nutrients, suggesting that fire could promote natural regeneration and biodiversity in these communities. Research highlights: Management efforts are necessary to maintain a natural fire regime and ensure grazing exclusion in order to favor the conservation of the community dominated by this rare species P. culminicola. Additional keywords: fire ecology; DCA; Permanova; richness. Abbreviations used: CIC (Cationic Interchange Complex); DCA (Detrended Correspondence Analysis); EC (Exchangeable Cation); OM (Organic Matter). Authors´ contributions: Conceived, designed and performed the experiments: JRA, EE and HGR. Analyzed the data: JRA, JAV, JRE and YM. Contributed reagents/materials/analysis tools: JAV, JRE, YM, IC and JU. Wrote the paper: JRA, JAE and EE. All authors read and approved the final manuscript. Citation: Arévalo, J. R.; Estrada, E.; Encina, J. A.; Villarreal, J. A.; Escobedo, J. R.; Morales, Y.; Cantú, I.; González-Rodríguez, H.; Uvalle, J. (2017). Fire response of the endangered Pinus culminicola stands after 18 years in Cerro El Potosí, northeast Mexico. Forest Systems, Volume 26, Issue 3, e015. https://doi.org/10.5424/fs/2017263-11566 Received: 20 Apr 2017. Accepted: 21 Nov 2017. Copyright © 2017 INIA. This is an open access article distributed under the terms of the Creative Commons Attribution (CC-by) Spain 3.0 License. Funding: Program of cooperation Universidad de La Laguna-Universidad Autónoma de Nuevo León, included in the official frame agreement of these institutions; Facultad de Ciencias Forestales of the Universidad Autónoma de Nuevo León; University of La Laguna (Research Program) covered the travel expenses of JRA. Competing interests: The authors have declared that no competing interests exist. Correspondence should be addressed to José R. Arévalo: [email protected]

Anatomical Variants of Anterior Cerebral Arterial Circle: A Study by Multidetector Computerized 3D Tomographic Angiography

SUMMARY: One of the most common causes of stroke is rupture of aneurysms whose approach requires knowledge of anatomical variants. The aim of this study was to determine the prevalence of anatomical variants of the anterior cerebral artery (ACA) and the anterior communicating artery (AComA) by 3D computed tomography angiography (3D CTA) in Mexican individuals. A retrospective, observational, cross-sectional descriptive study of 283 patients, independent of sex or age, in which morphometric measurements of cerebral vessels were evaluated using contrasted 3D CTA from a period of two years was performed. We found at least one "atypical" variant in a third of the study population (33.93 %). The most common "atypical" variant was the absence of the AComA (14.1 %). A significant association between the hypoplastic variant of the right A1 segment and hypoplasia of the left A1 and the right A2 was found, while hypoplasia of the left A1 was associated with hypoplasia of the right A2. There is a difference in the prevalence of anatomical variants of the ACA-AComA complex in Mexican population in relation to other populations. The typical variant is the most prevalent form in the study population. However, the presence of atypical variants represents an important number that should be taken into account in clinical and surgical procedures. KEY WORDS: Anterior cerebral artery; Anatomical variant; Anterior communicating artery; Cerebral arterial circle; Subarachnoid hemorrhage; Cerebral endovascular surgery

La creación y diseño de centros de información turística: una propuesta en Barrancas del Cobre (México)

Abstract This research elaborates a proposal to consider Barrancas del Cobre as a possible candidate to be named a Unesco Global Geopark. Within the guidelines of this program are several and specific criteria about the operation and management of the area that desire this recognition. In them, it is found that heritage conservation practices and an information center for visitors are necessary, because Barrancas del Cobre does not have these basic needs, an information center is proposed that allows the registration of visitors and, therefore, a study of load capacity can be carried out, also, it is proposed that said registration of visitors be done through a mobile application. The methodology used for the research was qualitative and the literature review technique, analytical and comparative method with practical cases was used as well, all countered and based on UNESCO standards. Key words: Tourist information centers, sustainability, mobile application, tourist managementLa presente investigación realiza una propuesta de creación y diseño de un centro de información turística de cara a una posible candidatura de Barrancas del Cobre como Geoparque Mundial de la UNESCO. Dentro de los lineamientos de dicho programa se encuentran diversos criterios muy específicos acerca de la operación del área que desea este reconocimiento. En ellos se encuentra que son necesarias prácticas de conservación del patrimonio y un centro de información para los visitantes, debido a que Barrancas del Cobre no cuenta con estas necesidades básicas. De esta manera, se propone un centro de información que permita el registro de visitantes y, por ende, pueda realizarse un estudio de capacidad de carga, además de proponer que dicho registro de visitantes se haga por medio de una aplicación móvil. La metodología usada para la investigación fue de tipo cualitativa y se empleó la técnica de revisión de la literatura y el método analítico y comparativo con casos prácticos, todo contrarrestado y basado en los estándares de la UNESCO. Palabras clave: Gestión de destinos turísticos, centros de información turística, sustentabilidad, uso de tecnología

Gender differences and management of stroke risk of nonvalvular atrial fibrillation in an upper middle-income country: Insights from the CARMEN-AF registry

Background: Atrial Fibrillation (AF) is associated with an increased risk of stroke and systemic embolism. Several studies have suggested that female AF patients could have a greater risk for stroke. There is scarce information about clinical characteristics and use of antithrombotic therapies in Latin American patients with nonvalvular AF. Objective: To describe the gender differences in clinical characteristics, thromboembolic risk, and antithrombotic therapy of patients with nonvalvular AF recruited in Mexico, an upper middle-income country, into the prospective national CARMEN-AF Registry. Methods: A total of 1423 consecutive patients, with at least one thromboembolic risk factor were enrolled in CARMEN-AF Registry during a three-year period (2014–2017). They were categorized according to Gender. Results: Overall, 48.6% were women, mean age 70 ± 12 years. Diabetes, smoking, alcoholism, non-ischemic cardiomyopathy, coronary artery disease, and obstructive sleep apnea were higher in men. Most women were found with paroxysmal AF (40.6%), and most men with permanent AF (44.0%). No gender differences were found in the use of vitamin K antagonists (VKA) (30.5% in women vs. 28.0% in men). No gender differences were found in the use of direct oral anticoagulants (DOAC) (33.8% women vs 35.4% men). Conclusions: CARMEN-AF Registry demonstrates that in Mexico, regardless of gender, a large proportion of patients remain undertreated. No gender differences were found in the use of VKA or DOAC. Keywords: Atrial fibrillation, Gender, Thromboembolic risk, Antithrombotic therapy, Stroke, Mexic

Ticagrelor in patients with diabetes and stable coronary artery disease with a history of previous percutaneous coronary intervention (THEMIS-PCI) : a phase 3, placebo-controlled, randomised trial

Background: Patients with stable coronary artery disease and diabetes with previous percutaneous coronary intervention (PCI), particularly those with previous stenting, are at high risk of ischaemic events. These patients are generally treated with aspirin. In this trial, we aimed to investigate if these patients would benefit from treatment with aspirin plus ticagrelor. Methods: The Effect of Ticagrelor on Health Outcomes in diabEtes Mellitus patients Intervention Study (THEMIS) was a phase 3 randomised, double-blinded, placebo-controlled trial, done in 1315 sites in 42 countries. Patients were eligible if 50 years or older, with type 2 diabetes, receiving anti-hyperglycaemic drugs for at least 6 months, with stable coronary artery disease, and one of three other mutually non-exclusive criteria: a history of previous PCI or of coronary artery bypass grafting, or documentation of angiographic stenosis of 50% or more in at least one coronary artery. Eligible patients were randomly assigned (1:1) to either ticagrelor or placebo, by use of an interactive voice-response or web-response system. The THEMIS-PCI trial comprised a prespecified subgroup of patients with previous PCI. The primary efficacy outcome was a composite of cardiovascular death, myocardial infarction, or stroke (measured in the intention-to-treat population). Findings: Between Feb 17, 2014, and May 24, 2016, 11 154 patients (58% of the overall THEMIS trial) with a history of previous PCI were enrolled in the THEMIS-PCI trial. Median follow-up was 3·3 years (IQR 2·8–3·8). In the previous PCI group, fewer patients receiving ticagrelor had a primary efficacy outcome event than in the placebo group (404 [7·3%] of 5558 vs 480 [8·6%] of 5596; HR 0·85 [95% CI 0·74–0·97], p=0·013). The same effect was not observed in patients without PCI (p=0·76, p interaction=0·16). The proportion of patients with cardiovascular death was similar in both treatment groups (174 [3·1%] with ticagrelor vs 183 (3·3%) with placebo; HR 0·96 [95% CI 0·78–1·18], p=0·68), as well as all-cause death (282 [5·1%] vs 323 [5·8%]; 0·88 [0·75–1·03], p=0·11). TIMI major bleeding occurred in 111 (2·0%) of 5536 patients receiving ticagrelor and 62 (1·1%) of 5564 patients receiving placebo (HR 2·03 [95% CI 1·48–2·76], p<0·0001), and fatal bleeding in 6 (0·1%) of 5536 patients with ticagrelor and 6 (0·1%) of 5564 with placebo (1·13 [0·36–3·50], p=0·83). Intracranial haemorrhage occurred in 33 (0·6%) and 31 (0·6%) patients (1·21 [0·74–1·97], p=0·45). Ticagrelor improved net clinical benefit: 519/5558 (9·3%) versus 617/5596 (11·0%), HR=0·85, 95% CI 0·75–0·95, p=0·005, in contrast to patients without PCI where it did not, p interaction=0·012. Benefit was present irrespective of time from most recent PCI. Interpretation: In patients with diabetes, stable coronary artery disease, and previous PCI, ticagrelor added to aspirin reduced cardiovascular death, myocardial infarction, and stroke, although with increased major bleeding. In that large, easily identified population, ticagrelor provided a favourable net clinical benefit (more than in patients without history of PCI). This effect shows that long-term therapy with ticagrelor in addition to aspirin should be considered in patients with diabetes and a history of PCI who have tolerated antiplatelet therapy, have high ischaemic risk, and low bleeding risk