Training load and heart rate variability in acute exposure to hypobaric hypoxia: A case study

Objetivo: Analizar el control de la carga de entrenamientoen la estrategia de aclimatación empleada por dos atletas amateur (mujer y hombre) antes de una ascensión exitosa a 5460 metros. Metodología: Durante 195 días consecutivos se realizaron mediciones basales de variabilidad de la frecuencia cardiaca (VFC). Se obtuvieron cuatro muestras de sangre durante la semana previa al evento principal (Pre), inmediatamente antes de la ascensión (Pre A), después (Post A) y una semana de recuperación (Post C). Resultados:Los registros diarios de VFC matutinos parecen ser una forma útil para monitorizar el estado de equilibrio simpático-parasimpático en montañistas antes de abordar las sesiones de entrenamiento. Se observó que ambos sujetos aumentaron sus niveles de leucocitos y neutrófilos exhibiendo variaciones sobre 60% entre las condiciones pre A y post B. Eritrocitos, hematocrito y hemoglobina presentaron tras la exposición aguda a 5460 m disminuciones, lo que coincide conlas diferencias porcentuales en plaquetas entre ambos sujetos (-3% y -51%). Conclusiones: Los registros diarios de VFC matutinos y de 5 minutos de duración parecen ser una forma útil para monitorizar el estado de equilibrio simpático-parasimpático. Se observaron cambios significativos en algunas células de la serie blanca.Aim: To analyzethe control of training load for an acclimatization strategy employed by two amateur athletes (female and male) prior to a successful ascent to 5460 meters. Methodology:Baseline heart rate variability (HRV) measurements were taken for 195 consecutive days. Four blood samples were taken the week before the main event (Pre), pre-ascent (Pre A), post-ascent (Post A), and one-week post-ascent (Post C). Results:Daily morning HRV recordings were useful for monitoring the state of sympathetic-parasympathetic balance in mountaineers prior to tackling training sessions. Both subjects had increased leukocytes and neutrophil levels, exhibiting variations over 60% between pre-A and post-B conditions. Erythrocytes, hematocrit, and haemoglobin decreased after acute exposure to 5460 m, coinciding with changes in platelet levels between both subjects (-3% and -51%). Conclusions:Daily morning and 5-min HRV recordings are a useful way for monitoring the state of sympathetic-parasympathetic balance. Significant changes were observed in some white blood cells

Carga de entrenamiento y variabilidad de la frecuencia cardiaca en una exposición aguda a la hipoxia hipobárica: Estudio de caso

Objetivo: Analizar el control de la carga de entrenamiento en la estrategia de aclimatación empleada por dos atletas amateur (mujer y hombre) antes de una ascensión exitosa a 5460 metros. Metodología: Durante 195 días consecutivos se realizaron mediciones basales de variabilidad de la frecuencia cardiaca (VFC). Se obtuvieron cuatro muestras de sangre durante la semana previa al evento principal (Pre), inmediatamente antes de la ascensión (Pre A), después (Post A) y una semana de recuperación (Post C). Resultados: Los registros diarios de VFC matutinos parecen ser una forma útil para monitorizar el estado de equilibrio simpático-parasimpático en montañistas antes de abordar las sesiones de entrenamiento. Se observó que ambos sujetos aumentaron sus niveles de leucocitos y neutrófilos exhibiendo variaciones sobre 60% entre las condiciones pre A y post B. Eritrocitos, hematocrito y hemoglobina presentaron tras la exposición aguda a 5460 m disminuciones, lo que coincide con las diferencias porcentuales en plaquetas entre ambos sujetos (-3% y -51%). Conclusiones: Los registros diarios de VFC matutinos y de 5 minutos de duración parecen ser una forma útil para monitorizar el estado de equilibrio simpático-parasimpático. Se observaron cambios significativos en algunas células de la serie blanca

Borderline Personality Disorder With Cocaine Dependence: Impulsivity, Emotional Dysregulation and Amygdala Functional Connectivity

Background: Borderline personality disorder is present in 19% of cocaine dependence cases; however, this dual pathology is poorly understood. We wished to characterize the dual pathology and find its functional connectivity correlates to better understand it.Methods: We recruited 69 participants divided into 4 groups: dual pathology (n = 20), cocaine dependence without borderline personality disorder (n = 19), borderline personality without cocaine dependence (n = 10) and healthy controls (n = 20). We used self-reported instruments to measure impulsivity and emotional dysregulation. We acquired resting state fMRI and performed seed-based analyses of the functional connectivity of bilateral amygdala.Results: Borderline personality disorder and cocaine dependence as factors had opposing effects in impulsivity and emotional dysregulation, as well as on functional connectivity between left amygdala and medial prefrontal cortex. On the other hand, in the functional connectivity between right amygdala and left insula, the effect of having both disorders was instead additive, reducing functional connectivity strength. The significant functional connectivity clusters were correlated with impulsivity and emotional dysregulation.Conclusions: In this study, we found that clinical scores of dual pathology patients were closer to those of borderline personality disorder without cocaine dependence than to those of cocaine dependence without borderline personality disorder, while amygdala-medial prefrontal cortex functional connectivity patterns in dual pathology patients were closer to healthy controls than expected

Mecanismos de participación ciudadana en los Planes de Abandono de lotes de hidrocarburos en Perú – El caso del ex Lote 1-AB

El objetivo de la investigación es determinar qué mecanismos de participación ciudadana resguardarían mejor el derecho de acceso a la información ambiental en los planes de abandono por vencimiento en los contratos de los lotes para la exploración y explotación de hidrocarburos, a la luz del nuevo Reglamento de Participación Ciudadana para la realización de las Actividades de Hidrocarburos y del reciente Acuerdo de Escazú. Se realizó la recopilación y el análisis de información secundaria relacionada con la participación ciudadana y acceso a la información pública en evaluación del impacto ambiental de actividades extractivas, logrando algunas características de los mecanismos de participación ciudadana más idóneos. Se distinguen los mecanismos formales bajo la conducción de la autoridad ambiental competente y los mecanismos no formales impulsados por el operador del lote por iniciativa propia; asimismo, se recomienda revisar regulación con mayor nivel de efectividad frente a grupos vulnerables como pueblos indígenas. El trabajo busca mayor predictibilidad en la participación ciudadana que garantice la sostenibilidad en el ciclo de vida de las inversiones en el país, impactando positivamente en la confianza y legitimidad de la evaluación del impacto ambiental con las poblaciones del área de influencia de actividades de hidrocarburos

Real-World Evidence in Healthcare Decision Making : Global trends and case studies from Latin America

Objectives: Real-world evidence (RWE) is increasingly used to inform health technology assessments (HTAs) for resource allocation, which are valuable tools for emerging economies such as in America. However, the characteristics and uses in South America are unknown. This study aims to identify sources, characteristics and uses of RWE in Argentina, Brazil, Colombia and Chile, and evaluate the context-specific challenges. The implications for future regulation and responsible management of RWE in the region are also considered. Methods: A systematic literature review, database mapping, and targeted grey literature search were conducted to identify the sources and characteristics of RWE. Findings were validated by key opinion leaders attending workshops in four South American countries. Results: A database mapping exercise revealed 407 unique databases. Geographic scope, database type, population and outcomes captured were reported. Characteristics of National Health Information Systems show efforts to collect interoperable data from service providers, insurers and government agencies, but that initiatives are hampered by fragmentation, lack of stewardship and resources. RWE is mainly used in South America for pharmacovigilance and as pure academic research, but less so for HTA decision-making or pricing negotiations and not at all to inform early access schemes. Conclusions: The quality of data collected in real-world in the case-study countries varies and RWE is not consistently used in healthcare decision-making. Authors recommend that future studies monitor the impact of digitalisation, and the potential effects of access to RWE on the quality of patient care

Self-medication practices during the COVID-19 pandemic among the adult population in Peru: A cross-sectional survey

Self-medication impacts both negatively and positively the health of people, which has become evident during the COVID-19 pandemic. The study aimed to assess the prevalence of self-medicated drugs used for respiratory symptoms, as COVID-19 preventive, for its symptoms or once tested positive. To determine the perception of symptom relief and demographic variables that promote self-medication in Peru. We performed a cross-sectional, analytical, multicenter study in 3792 study respondents on the use, the reason for use, and perception of relief after the use of six drugs during the quarantine period. An online questionnaire was developed, pretested and submitted to the general public. Multivariable logistic regression was used to ascertain factors that influence an individual's desire to self-medicate, associations were considered significant at p < 0.05 and using region (coast, mountain and jungle) as cluster group. The majority of respondents self-medicated with acetaminophen for respiratory symptoms and mainly because they had a cold or flu. It was observed that all the surveyed drugs (acetaminophen, ibuprofen, azithromycin, penicillin, antiretrovirals and hydroxychloroquine) were consumed for various symptoms including: fever, fatigue, cough, sneezing, muscle pain, nasal congestion, sore throat, headache and breathing difficulty. Over 90% of respondents perceived relief of at least one symptom. Multivariable logistic regression showed that older people have a higher frequency of antiretroviral self-medication, respondents who currently have a job had a higher frequency of penicillin self-medication, and that respondents from the Andes consumed less acetaminophen, while the ones from the rainforest consumed it more. There were significant percentages of self-medication, including drugs without sufficient scientific evidence. Age, region where one lived and job status were variables associated with self-medication frequency. Continuous awareness and sensitization about the risks of self-medication are warranted.Revisión por pare

International fisheries threaten globally endangered sharks in the Eastern Tropical Pacific Ocean: the case of the Fu Yuan Yu Leng 999 reefer vessel seized within the Galápagos Marine Reserve

Shark fishing, driven by the fin trade, is the primary cause of global shark population declines. Here, we present a case study that exemplifies how industrial fisheries are likely depleting shark populations in the Eastern Tropical Pacific Ocean. In August 2017, the vessel Fu Yuan Yu Leng 999, of Chinese flag, was detained while crossing through the Galápagos Marine Reserve without authorization. This vessel contained 7639 sharks, representing one of the largest seizures recorded to date. Based on a sample of 929 individuals (12%), we found 12 shark species: 9 considered as Vulnerable or higher risk by the IUCN and 8 listed in CITES. Four species showed a higher proportion of immature than mature individuals, whereas size-distribution hints that at least some of the fishing ships associated with the operation may have been using purse-seine gear fishing equipment, which, for some species, goes against international conventions. Our data expose the magnitude of the threat that fishing industries and illegal trade represent to sharks in the Eastern Tropical Pacific Ocean

The state of the Martian climate

60°N was +2.0°C, relative to the 1981–2010 average value (Fig. 5.1). This marks a new high for the record. The average annual surface air temperature (SAT) anomaly for 2016 for land stations north of starting in 1900, and is a significant increase over the previous highest value of +1.2°C, which was observed in 2007, 2011, and 2015. Average global annual temperatures also showed record values in 2015 and 2016. Currently, the Arctic is warming at more than twice the rate of lower latitudes