Working with Families of Young Children who are Deaf or Hard of Hearing Through Tele-Intervention

Tele-intervention services have been utilized for many years to serve families of young children, in addition to or in lieu of traditional in-person intervention services. Recently, the COVID-19 pandemic cultivated urgent dependence on access to effective services via a distance connection. As such, the need for information, guidance, and resources related to tele-intervention as a primary service model has increased. This article serves as the introduction to a monographic series aiming to describe practices, circumstances, and perceptions surrounding tele-intervention services for families of children aged birth to five who are deaf or hard of hearing. Topics include: (a) a brief history of tele-intervention as a service delivery model, (b) an overview of tele-intervention for families of children who are deaf or hard of hearing, including the impact of COVID-19 on emergency virtual services, (c) a description of the components of a tele-intervention session with families of infants and toddlers, and (d) a discussion of the challenges implementing services via tele-intervention. Figures containing information related to state funding and ideal session components for tele-intervention services are provided

Genetic Connectivity of a Coral Reef Ecosystem Predator: The Population Genetic Structure and Evolutionary History of the Caribbean Reef Shark (Carcharhinus perezi)

Aim The Caribbean reef shark (Carcharhinus perezi) is one of few extant reef sharks inhabiting the Atlantic Ocean. Its variability in movements across habitat types suggests the possibility of a complex genetic population structure. Here, we use mitochondrial and nuclear DNA to investigate the genetic connectivity of the Caribbean reef shark across contemporary and evolutionary time-scales and relate our findings to the ecology of this understudied species. Location Tropical western Atlantic and Caribbean. Methods Samples were obtained from 216 individuals from six western Atlantic and Caribbean locations. Individuals were genotyped at seven nuclear microsatellite DNA loci and sequenced at two mitochondrial (control region [CR]; NADH dehydrogenase subunit 4 [ND4]) and one nuclear locus (lactate dehydrogenase [LDH]). Analyses to resolve the population genetic structure and evolutionary history of this species were adopted. Results Sequencing of the CR (1,068 bp, n = 216), ND4 (741 bp, n = 213) and LDH (258 bp, n = 165) loci, resolved 11, 8 and 13 unique haplotypes (or alleles), respectively. Overall, Caribbean reef sharks showed low levels of genetic diversity and most marker sets identified strong genetic differences (FSTand ΦST) between sharks sampled in Brazil versus all other locations (msat FST \u3e 0.017; CR-ND4 ΦST \u3e 0.013). Mitochondrial DNA showed evidence of increased genetic partitioning among western North Atlantic sampling sites, although widespread haplotype sharing (~85%–92%) and a shallow population history were found. Main Conclusions Findings of genetic differentiation are concordant with previous movement studies showing residency and/or site-fidelity to specific locations by individuals. However, similar to other reef shark studies, we found that the level of genetic connectivity among populations was context dependent—i.e., sharks occupying isolated habitats showed greater genetic differentiation compared with those sharks occupying semi-isolated or continuous reef habitats. Furthermore, low genetic diversity and a shallow mitochondrial population history were found, suggesting historical demographic fluctuations, including population collapse and more recent expansions

Rutas tróficas en macrozooplancton del Lago de Tota - Boyacá, Colombia

1 recurso en línea (56 páginas) : ilustraciones, figuras, tablas.In aquatic ecosystems inputs of matter and energy present in greater or lesser extent depending on the basin, given the origin and quality of these resources, you can alter the balance in metabolism or interactions in the food web. Using stable isotopes of carbon and nitrogen, the link between potential sources of funds and use established by macrozooplankton species in Lake Big and Lake Fellow the Lake Tota sectors. Trophic possible ways the role of each species in the proposed network, as well. In general, most of this study, most species have a bond with the autotrophic pathway, being the phytoplankton the food resource base for the food web, commonly found impoverished carbon signals. Particularly, the analysis showed a variation in the source or resource for two species (Daphnia laevis and Bosmina (Bosmina) cf. longirostris), with an enrichment in its signal to 19.92 ‰ -20.34 ‰ δ13C, which can be given by plasticity in their food supply, and even if Boeckella gracilis having a signal indicating a specialization in its appeal with carbon impoverished -30 to -26 ‰ values δ13C while nitrogen values are enriched with an average value 20.21 ‰ in δ15N. To set the trophic fractionation means establishing three groups, the first (herbivores) consisting of (D. laevis, B. (Bosmina) and Ceriodaphnia pulchella cf. longirostris), the second (omnivore) which is (Daphnia pulex, Macrocyclops sp. and Cyclopoida), and a third group (secondary consumer) where is the only calanoido B. gracilis. In comparing the temporal variation is observed that there is a significant change in signals δ13C and δ15N of some species in relation to the influence of sources and allochthonous or autochthonous origin, spatial variation was not significant. It is concluded that the macrozooplanton Lake Tota, has a strong link with the autotrophic pathway and pelagic trophic levels have 3 sections, plus the primary producers and the food web in general tends to have an amplitude of trophic niche.En los ecosistemas acuáticos se presentan aportes de materia y energía, en mayor o menor proporción dependiendo de su cuenca, dado el origen y calidad de estos recursos, se puede alterar el balance en el metabolismo o las interacciones en la red trófica. Utilizando los isotopos estables de Carbono y Nitrógeno, se estableció el vínculo entre fuentes potenciales de recursos y el uso por las especies del macrozooplancton en los sectores Lago grande y Lago chico del lago de Tota (Boyacá). Así, se propusieron las posibles vías tróficas y el rol de cada especie en la red. En general, en la mayor parte de este estudio, las especies tuvieron un vínculo marcado con la vía autotrófica, siendo el fitoplancton el recurso alimenticio base para la red trófica, encontrando comúnmente señales empobrecidas de carbono. Particularmente, el análisis mostró una variación en la fuente o recurso para dos especies (Daphnia laevis y Bosmina (Bosmina) cf. longirostris), con un enriquecimiento en su señal de 19.92‰ δ13C a -20.34‰ δ13C, lo que se puede dar por una plasticidad en su fuente alimenticia, e incluso el caso de Boeckella gracilis que tiene una señal que indica una especialización en su recurso con valores empobrecidos de carbono -30 a -26‰ δ13C mientras que los valores de nitrógeno son enriquecidos con un valor promedio de 20.21‰ en δ15N. Para establecer el fraccionamiento trófico medio se formaron tres grupos, el primero (herbívoros) conformado por (D. laevis, B. (Bosmina) cf. longirostris y Ceriodaphnia pulchella), el segundo (omnívoro) en el que se encuentra (Daphnia pulex, Macrocyclops sp. y Cyclopoida), y un tercer grupo (Consumidor secundario) donde esta B. gracilis el único calanoido. En la comparación de la variación temporal, se observa que hay un cambio significativo en las señales de δ13C y δ15N de algunas especies en relación a la influencia de las fuentes y su origen alóctono o autóctono, la variación espacial no fue significativa. Se concluye que el macrozooplanton del lago de Tota, tiene un fuerte vínculo con la vía autotrófica y que los niveles tróficos pelágicos tienen 3 eslabones, más los productores primarios, y la red trófica en general tiende a tener una amplitud del nicho trófico. En los ecosistemas acuáticos se presentan aportes de materia y energía, en mayor o menor proporción dependiendo de su cuenca, dado el origen y calidad de estos recursos, se puede alterar el balance en el metabolismo o las interacciones en la red trófica. Utilizando los isotopos estables de Carbono y Nitrógeno, se estableció el vínculo entre fuentes potenciales de recursos y el uso por las especies del macrozooplancton en los sectores Lago grande y Lago chico del lago de Tota (Boyacá). Así, se propusieron las posibles vías tróficas y el rol de cada especie en la red. En general, en la mayor parte de este estudio, las especies tuvieron un vínculo marcado con la vía autotrófica, siendo el fitoplancton el recurso alimenticio base para la red trófica, encontrando comúnmente señales empobrecidas de carbono. Particularmente, el análisis mostró una variación en la fuente o recurso para dos especies (Daphnia laevis y Bosmina (Bosmina) cf. longirostris), con un enriquecimiento en su señal de 19.92‰ δ13C a -20.34‰ δ13C, lo que se puede dar por una plasticidad en su fuente alimenticia, e incluso el caso de Boeckella gracilis que tiene una señal que indica una especialización en su recurso con valores empobrecidos de carbono -30 a -26‰ δ13C mientras que los valores de nitrógeno son enriquecidos con un valor promedio de 20.21‰ en δ15N. Para establecer el fraccionamiento trófico medio se formaron tres grupos, el primero (herbívoros) conformado por (D. laevis, B. (Bosmina) cf. longirostris y Ceriodaphnia pulchella), el segundo (omnívoro) en el que se encuentra (Daphnia pulex, Macrocyclops sp. y Cyclopoida), y un tercer grupo (Consumidor secundario) donde esta B. gracilis el único calanoido. En la comparación de la variación temporal, se observa que hay un cambio significativo en las señales de δ13C y δ15N de algunas especies en relación a la influencia de las fuentes y su origen alóctono o autóctono, la variación espacial no fue significativa. Se concluye que el macrozooplanton del lago de Tota, tiene un fuerte vínculo con la vía autotrófica y que los niveles tróficos pelágicos tienen 3 eslabones, más los productores primarios, y la red trófica en general tiende a tener una amplitud del nicho trófico.Bibliografía: páginas 46-56.MaestríaMagíster en Ciencias Biológica

Early and empirical high-dose cryoprecipitate for hemorrhage after traumatic injury: The CRYOSTAT-2 randomized clinical trial

Critical bleeding is associated with a high mortality rate in patients with trauma. Hemorrhage is exacerbated by a complex derangement of coagulation, including an acute fibrinogen deficiency. Management is fibrinogen replacement with cryoprecipitate transfusions or fibrinogen concentrate, usually administered relatively late during hemorrhage. To assess whether survival could be improved by administering an early and empirical high dose of cryoprecipitate to all patients with trauma and bleeding that required activation of a major hemorrhage protocol. CRYOSTAT-2 was an interventional, randomized, open-label, parallel-group controlled, international, multicenter study. Patients were enrolled at 26 UK and US major trauma centers from August 2017 to November 2021. Eligible patients were injured adults requiring activation of the hospital's major hemorrhage protocol with evidence of active hemorrhage, systolic blood pressure less than 90 mm Hg at any time, and receiving at least 1 U of a blood component transfusion. Patients were randomly assigned (in a 1:1 ratio) to receive standard care, which was the local major hemorrhage protocol (reviewed for guideline adherence), or cryoprecipitate, in which 3 pools of cryoprecipitate (6-g fibrinogen equivalent) were to be administered in addition to standard care within 90 minutes of randomization and 3 hours of injury. The primary outcome was all-cause mortality at 28 days in the intention-to-treat population. Among 1604 eligible patients, 799 were randomized to the cryoprecipitate group and 805 to the standard care group. Missing primary outcome data occurred in 73 patients (principally due to withdrawal of consent) and 1531 (95%) were included in the primary analysis population. The median (IQR) age of participants was 39 (26-55) years, 1251 (79%) were men, median (IQR) Injury Severity Score was 29 (18-43), 36% had penetrating injury, and 33% had systolic blood pressure less than 90 mm Hg at hospital arrival. All-cause 28-day mortality in the intention-to-treat population was 26.1% in the standard care group vs 25.3% in the cryoprecipitate group (odds ratio, 0.96 [95% CI, 0.75-1.23]; P = .74). There was no difference in safety outcomes or incidence of thrombotic events in the standard care vs cryoprecipitate group (12.9% vs 12.7%). Among patients with trauma and bleeding who required activation of a major hemorrhage protocol, the addition of early and empirical high-dose cryoprecipitate to standard care did not improve all cause 28-day mortality. ClinicalTrials.gov Identifier: NCT04704869; ISRCTN Identifier: ISRCTN14998314