Learning resilience: Household and institutional responses to multiple livelihood threats in the context of Hurricanes Iota and Eta in northern Nicaragua

Despite converging agendas identifying the importance of farm and livelihood diversification as a key strategy to help reduce disaster risk, conserve biodiversity, reduce climate emissions, improve food security, and build resilience in agriculture and food systems (Kremen and Merenlender 2018; Hufnagel et al., 2020), contentious debates continue about how to accelerate broader food system transformations, who should lead them, and where they are going (e.g., the 2021 UN Food Summit). The influential 2016 report of the International Panel of Experts on Sustainable Food Systems, which analyzed obstacles and opportunities for moving from either traditional subsistence agriculture or industrialized monoculture towards diversified agroecological farming (IPES-Food 2016), helped shift the policy agenda toward an alternative approach to food systems transformation (Gliessman & Ferguson, 2020). However, several assumptions about farmers’ initial starting conditions oversimplified how smallholder farmers begin potential transitions. In practice, many smallholders are neither purely subsistence producers nor entirely specialized commodity farmers; instead they combine subsistence and commercial agriculture to try to make a living, feed themselves, shape their cultures, and achieve their self-defined goals (Burnett & Murphy, 2014). Despite recent studies addressing several of these issues (Kerr et al., 2019), research gaps remain, including the absence of broad-based empirical evidence on which diversification strategies are most likely to contribute to farmers’ dietary diversity, food sovereignty, food security, women’s empowerment, and resilience, and under what circumstances; how smallholders learn about these practices and why they adopt or avoid them; and how cooperatives or other institutions promote (or may retard) them. We seek to fill these gaps using a mixed-methods, place-based study

Synthesis and Characterization of Magnesium Hydroxide Nanoparticles via Hydrothermal Method

The interest in the nanostructured magnesium hydroxide (Mg(OH)2) is rapidly growing due to the fact that its physical and chemical properties makes it appropriate for multiple applications. So far, it has been used in medicine, industry, or more recently, in the conservation of cultural heritage. The current research is based on the synthesis and the characterization of functional and nanocrystalline Mg(OH)2 with different particle sizes, morphologies and high purity. The synthesis was carried out via the hydrothermal method using hydrazine hydrate as a precipitator. Moreover, due to it is essential to study the behaviour of this type of nanoparticles under factors as the time of exposition, the relative humidity and CO2 concentration, they were exposed to controlled atmosphere at high relative humidity (75%RH). The carbonation process was also studied, identifying the different magnesium carbonate polymorphs.The physical and chemical property of synthesizedMg(OH)2 nanoparticles have been characterized by X Ray diffraction (XRD), Scanning electron microscopy (SEM), Transmission electron microscopy (TEM), High resolution Transmission electron Microscopy (HR-TEM), thermogravimetry (TG) and differential scanning calorimetry (DSC). The results showed the successful use of this synthesis route to obtain Mg(OH)2 nanostructured with important properties for the preservation of the stone heritage and promising CO2 adsorption properties

Ciencias de la Biología y Agronomía

Este volumen I contiene 17 capítulos arbitrados que se ocupan de estos asuntos en Tópicos Selectos de Ciencias de la Biología y Agronomía, elegidos de entre las contribuciones, reunimos algunos investigadores y estudiantes. Se presenta un Estudio Comparativo de los Recursos Hidrológico-Forestales de la Microcuenca de la Laguna de Epatlan, Pue. (1993 a 2014); la Situación Actual de la Mancha de Asfalto en Maíz (Zea mays L.) en los Municipios de Jiquipilas y Ocozocoautla, Chiapas, México; las poblaciones sobresalientes de maíz de la raza Zapalote Chico, en la Región Istmeña de Oaxaca; Se indica el índice de área foliar de cultivo de Chile Poblano mediante dos métodos en condiciones protegidas; Esquivel, Urzúa y Ramírez exploran el efecto de la biofertilización con Azospirillum en el crecimiento y producción de Jitomate; esbozan su artículo sobre la determinación del nivel de Heterosis en híbridos de Maíz para la Comarca Lagunera; una investigación sobre la estabilización de semilla de Solanum lycopersicum durante el almacenamiento y estimulación de la germinación; acotan sobre el CTAB como una nueva opción para la detección de Huanglongbing en cítricos, plantean su evaluación sobre el aluminio y cómo afecta la vida de florero de Heliconia psittacorum; indican sobre el impacto del H-564C, como un híbrido de maíz con alta calidad de proteina para el trópico húmedo de México; presetan su investigación sobre la producción de Piña Cayena Lisa y MD2 (Ananas comosus L.) en condiciones de Loma Bonita, en Oaxaca; acotan sobre el efecto de coberteras como control biológico por conservación contra áfidos en Nogal Pecanero; esbozan sobre la caracterización de cuatro genotipos de Frijol Negro en Martínez de la Torre, Veracruz, México; presentan una caracterización hidroecológica de la microcuenca de Arroyo Prieto, Yuriría, Gto., y alternativas para su restauración ambiental; presentan su investigación sobre el efecto del hongo Beauveria bassiana sobre solubilización de fosfatos y la disponibilidad de fósforo en el suelo; plantean su investigación sobre la Germinación y regeneración in vitro de Epidendrum falcatum LINDL; esbozan su artículo sobre genotipos de frijol negro y su tolerancia a sequía terminal en Veracruz, México

Canagliflozin and renal outcomes in type 2 diabetes and nephropathy

BACKGROUND Type 2 diabetes mellitus is the leading cause of kidney failure worldwide, but few effective long-term treatments are available. In cardiovascular trials of inhibitors of sodium–glucose cotransporter 2 (SGLT2), exploratory results have suggested that such drugs may improve renal outcomes in patients with type 2 diabetes. METHODS In this double-blind, randomized trial, we assigned patients with type 2 diabetes and albuminuric chronic kidney disease to receive canagliflozin, an oral SGLT2 inhibitor, at a dose of 100 mg daily or placebo. All the patients had an estimated glomerular filtration rate (GFR) of 30 to <90 ml per minute per 1.73 m2 of body-surface area and albuminuria (ratio of albumin [mg] to creatinine [g], >300 to 5000) and were treated with renin–angiotensin system blockade. The primary outcome was a composite of end-stage kidney disease (dialysis, transplantation, or a sustained estimated GFR of <15 ml per minute per 1.73 m2), a doubling of the serum creatinine level, or death from renal or cardiovascular causes. Prespecified secondary outcomes were tested hierarchically. RESULTS The trial was stopped early after a planned interim analysis on the recommendation of the data and safety monitoring committee. At that time, 4401 patients had undergone randomization, with a median follow-up of 2.62 years. The relative risk of the primary outcome was 30% lower in the canagliflozin group than in the placebo group, with event rates of 43.2 and 61.2 per 1000 patient-years, respectively (hazard ratio, 0.70; 95% confidence interval [CI], 0.59 to 0.82; P=0.00001). The relative risk of the renal-specific composite of end-stage kidney disease, a doubling of the creatinine level, or death from renal causes was lower by 34% (hazard ratio, 0.66; 95% CI, 0.53 to 0.81; P<0.001), and the relative risk of end-stage kidney disease was lower by 32% (hazard ratio, 0.68; 95% CI, 0.54 to 0.86; P=0.002). The canagliflozin group also had a lower risk of cardiovascular death, myocardial infarction, or stroke (hazard ratio, 0.80; 95% CI, 0.67 to 0.95; P=0.01) and hospitalization for heart failure (hazard ratio, 0.61; 95% CI, 0.47 to 0.80; P<0.001). There were no significant differences in rates of amputation or fracture. CONCLUSIONS In patients with type 2 diabetes and kidney disease, the risk of kidney failure and cardiovascular events was lower in the canagliflozin group than in the placebo group at a median follow-up of 2.62 years

Impact of COVID-19 on cardiovascular testing in the United States versus the rest of the world

Objectives: This study sought to quantify and compare the decline in volumes of cardiovascular procedures between the United States and non-US institutions during the early phase of the coronavirus disease-2019 (COVID-19) pandemic. Background: The COVID-19 pandemic has disrupted the care of many non-COVID-19 illnesses. Reductions in diagnostic cardiovascular testing around the world have led to concerns over the implications of reduced testing for cardiovascular disease (CVD) morbidity and mortality. Methods: Data were submitted to the INCAPS-COVID (International Atomic Energy Agency Non-Invasive Cardiology Protocols Study of COVID-19), a multinational registry comprising 909 institutions in 108 countries (including 155 facilities in 40 U.S. states), assessing the impact of the COVID-19 pandemic on volumes of diagnostic cardiovascular procedures. Data were obtained for April 2020 and compared with volumes of baseline procedures from March 2019. We compared laboratory characteristics, practices, and procedure volumes between U.S. and non-U.S. facilities and between U.S. geographic regions and identified factors associated with volume reduction in the United States. Results: Reductions in the volumes of procedures in the United States were similar to those in non-U.S. facilities (68% vs. 63%, respectively; p = 0.237), although U.S. facilities reported greater reductions in invasive coronary angiography (69% vs. 53%, respectively; p < 0.001). Significantly more U.S. facilities reported increased use of telehealth and patient screening measures than non-U.S. facilities, such as temperature checks, symptom screenings, and COVID-19 testing. Reductions in volumes of procedures differed between U.S. regions, with larger declines observed in the Northeast (76%) and Midwest (74%) than in the South (62%) and West (44%). Prevalence of COVID-19, staff redeployments, outpatient centers, and urban centers were associated with greater reductions in volume in U.S. facilities in a multivariable analysis. Conclusions: We observed marked reductions in U.S. cardiovascular testing in the early phase of the pandemic and significant variability between U.S. regions. The association between reductions of volumes and COVID-19 prevalence in the United States highlighted the need for proactive efforts to maintain access to cardiovascular testing in areas most affected by outbreaks of COVID-19 infection

Mortality from gastrointestinal congenital anomalies at 264 hospitals in 74 low-income, middle-income, and high-income countries: a multicentre, international, prospective cohort study

Summary Background Congenital anomalies are the fifth leading cause of mortality in children younger than 5 years globally. Many gastrointestinal congenital anomalies are fatal without timely access to neonatal surgical care, but few studies have been done on these conditions in low-income and middle-income countries (LMICs). We compared outcomes of the seven most common gastrointestinal congenital anomalies in low-income, middle-income, and high-income countries globally, and identified factors associated with mortality. Methods We did a multicentre, international prospective cohort study of patients younger than 16 years, presenting to hospital for the first time with oesophageal atresia, congenital diaphragmatic hernia, intestinal atresia, gastroschisis, exomphalos, anorectal malformation, and Hirschsprung’s disease. Recruitment was of consecutive patients for a minimum of 1 month between October, 2018, and April, 2019. We collected data on patient demographics, clinical status, interventions, and outcomes using the REDCap platform. Patients were followed up for 30 days after primary intervention, or 30 days after admission if they did not receive an intervention. The primary outcome was all-cause, in-hospital mortality for all conditions combined and each condition individually, stratified by country income status. We did a complete case analysis. Findings We included 3849 patients with 3975 study conditions (560 with oesophageal atresia, 448 with congenital diaphragmatic hernia, 681 with intestinal atresia, 453 with gastroschisis, 325 with exomphalos, 991 with anorectal malformation, and 517 with Hirschsprung’s disease) from 264 hospitals (89 in high-income countries, 166 in middleincome countries, and nine in low-income countries) in 74 countries. Of the 3849 patients, 2231 (58·0%) were male. Median gestational age at birth was 38 weeks (IQR 36–39) and median bodyweight at presentation was 2·8 kg (2·3–3·3). Mortality among all patients was 37 (39·8%) of 93 in low-income countries, 583 (20·4%) of 2860 in middle-income countries, and 50 (5·6%) of 896 in high-income countries (p<0·0001 between all country income groups). Gastroschisis had the greatest difference in mortality between country income strata (nine [90·0%] of ten in lowincome countries, 97 [31·9%] of 304 in middle-income countries, and two [1·4%] of 139 in high-income countries; p≤0·0001 between all country income groups). Factors significantly associated with higher mortality for all patients combined included country income status (low-income vs high-income countries, risk ratio 2·78 [95% CI 1·88–4·11], p<0·0001; middle-income vs high-income countries, 2·11 [1·59–2·79], p<0·0001), sepsis at presentation (1·20 [1·04–1·40], p=0·016), higher American Society of Anesthesiologists (ASA) score at primary intervention (ASA 4–5 vs ASA 1–2, 1·82 [1·40–2·35], p<0·0001; ASA 3 vs ASA 1–2, 1·58, [1·30–1·92], p<0·0001]), surgical safety checklist not used (1·39 [1·02–1·90], p=0·035), and ventilation or parenteral nutrition unavailable when needed (ventilation 1·96, [1·41–2·71], p=0·0001; parenteral nutrition 1·35, [1·05–1·74], p=0·018). Administration of parenteral nutrition (0·61, [0·47–0·79], p=0·0002) and use of a peripherally inserted central catheter (0·65 [0·50–0·86], p=0·0024) or percutaneous central line (0·69 [0·48–1·00], p=0·049) were associated with lower mortality. Interpretation Unacceptable differences in mortality exist for gastrointestinal congenital anomalies between lowincome, middle-income, and high-income countries. Improving access to quality neonatal surgical care in LMICs will be vital to achieve Sustainable Development Goal 3.2 of ending preventable deaths in neonates and children younger than 5 years by 2030

Effects of Anacetrapib in Patients with Atherosclerotic Vascular Disease

BACKGROUND: Patients with atherosclerotic vascular disease remain at high risk for cardiovascular events despite effective statin-based treatment of low-density lipoprotein (LDL) cholesterol levels. The inhibition of cholesteryl ester transfer protein (CETP) by anacetrapib reduces LDL cholesterol levels and increases high-density lipoprotein (HDL) cholesterol levels. However, trials of other CETP inhibitors have shown neutral or adverse effects on cardiovascular outcomes. METHODS: We conducted a randomized, double-blind, placebo-controlled trial involving 30,449 adults with atherosclerotic vascular disease who were receiving intensive atorvastatin therapy and who had a mean LDL cholesterol level of 61 mg per deciliter (1.58 mmol per liter), a mean non-HDL cholesterol level of 92 mg per deciliter (2.38 mmol per liter), and a mean HDL cholesterol level of 40 mg per deciliter (1.03 mmol per liter). The patients were assigned to receive either 100 mg of anacetrapib once daily (15,225 patients) or matching placebo (15,224 patients). The primary outcome was the first major coronary event, a composite of coronary death, myocardial infarction, or coronary revascularization. RESULTS: During the median follow-up period of 4.1 years, the primary outcome occurred in significantly fewer patients in the anacetrapib group than in the placebo group (1640 of 15,225 patients [10.8%] vs. 1803 of 15,224 patients [11.8%]; rate ratio, 0.91; 95% confidence interval, 0.85 to 0.97; P=0.004). The relative difference in risk was similar across multiple prespecified subgroups. At the trial midpoint, the mean level of HDL cholesterol was higher by 43 mg per deciliter (1.12 mmol per liter) in the anacetrapib group than in the placebo group (a relative difference of 104%), and the mean level of non-HDL cholesterol was lower by 17 mg per deciliter (0.44 mmol per liter), a relative difference of -18%. There were no significant between-group differences in the risk of death, cancer, or other serious adverse events. CONCLUSIONS: Among patients with atherosclerotic vascular disease who were receiving intensive statin therapy, the use of anacetrapib resulted in a lower incidence of major coronary events than the use of placebo. (Funded by Merck and others; Current Controlled Trials number, ISRCTN48678192 ; ClinicalTrials.gov number, NCT01252953 ; and EudraCT number, 2010-023467-18 .)

Informe de Avance 2018-2019 sobre el proyecto "Urbanizaciones turísticas" en la provincia de Córdoba en la última década: trama y conflictos sociourbanos en contextos de patrimonialización y turistificación

Los procesos de patrimonialización y turistificación constituyen claves fundamentales de la actual dinámica socio-urbana, estructurando una compleja trama de lugares y sentidos para ser/estar entre todos ya sea en la ciudad o en el campo; espacios pretendidamente comunes donde el disfrute aparece como eje fundamental de la interacción, pero en torno a los cuales se presentan espacios, memorias y objetos en disputa. Postulamos como hipótesis un lazo solidario entre las políticas de patrimonialización y las tendencias de turistificación -orientadas a captar la atención del mercado local, regional y mundial-y la instalación de diversos/heterogéneos modelos de urbanización como terreno de inversiones y capitales productivos cuya injerencia en las formas territoriales, organizativas, societales y subjetivas son significativas. Como corolario se relevan procesos de resistencia colectiva que pugnan por el derecho a las disidentes habitancias del territorio. La distinción entre lo urbano y lo rural se está disolviendo en un conjunto de espacios porosos de desarrollo geográfico y cultural desigual: cuestión visible en los procesos de urbanización turística y, en particular, en espacios donde la disputa sobre el patrimonio revela la emergencia de actores heterogéneos. En esta dirección la presente investigación tiene por objeto indagar esas zonas porosas de urbanización turística en tres regiones de Córdoba (Traslasierra; Noroeste y Ansenuza) con el fin de dar cuenta 2 dimensiones: 1) una estructural, vinculada al estudio de las lógicas de reestructuración del capital a través de la generación de formas de plusvalía novedosas (ancladas en producciones espaciales cuyo territorio es la naturaleza y la cultura); 2) una socio-subjetiva, que busca comprender las injerencias de dichas modificaciones territoriales en las estructuras de experiencia de los pobladores. En esta dirección las preguntas de investigación giran en torno a, por un lado ¿Cuál es el impacto de dichas políticas turísticas en la generación de plusvalía y renta del suelo? ¿De qué manera estas lógicas nos ayudan a comprender el actual funcionamiento del capital?, y por el otro ¿Cómo estas formas de readecuación del territorio como nueva condición espacial (las urbanizaciones turísticas) reconfiguran lazos sociales/culturales y formas de definición subjetiva? Para dar cuenta de ello el diseño metodológico articula diferentes etapas de producción de datos cuantitativos y cualitativos.Fil: Espoz Dalmasso, Maria Belen. Universidad Nacional de Córdoba. Facultad de Ciencias de la Comunicación; Argentina.Fil: Espoz Dalmasso, Maria Belen. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro de Investigaciones y Estudios sobre Cultura y Sociedad; Argentina.Fil: Espoz Dalmasso, Maria Belen. Universidad Nacional de Córdoba. Facultad de Ciencias Sociales; Argentina.Fil: Espoz Dalmasso, Maria Belen. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro de Investigaciones y Estudios sobre Cultura y Sociedad; Argentina.Fil: del Campo, María Lis. Universidad Nacional de Córdoba. Facultad de Ciencias Médicas. Escuela de Nutrición; Argentina.Fil: Quevedo, Cecilia Mercedes. Universidad Nacional de Córdoba. Facultad de Ciencias de la Comunicación; Argentina.Fil: Quevedo, Cecilia Mercedes. Consejo Nacional de Investigaciones Científicas y Técnicas. Instituto de Estudios en Comunicación, Expresión y Tecnologías; Argentina.Fil: Quevedo, Cecilia Mercedes. Universidad Nacional de Villa María; Argentina.Fil: Salcedo Okuma, Luis Darío. Universidad Nacional de Córdoba. Facultad de Ciencias de la Comunicación; Argentina.Fil: Seveso Zanin, Emilio José. Universidad Nacional de San Luis. Facultad de Ciencias de la Educación; Argentina.Fil: Torres, Paula. Universidad Nacional de Córdoba. Facultad de Ciencias de la Comunicación; Argentina.Fil: Torres, Paula. Consejo Nacional de Investigaciones Científicas y Técnicas. Instituto de Estudios en Comunicación, Expresión y Tecnologías; Argentina.Fil: González, María Laura. Universidad Nacional de Córdoba. Facultad de Ciencias de la Comunicación; Argentina.Fil: Fernández, Esteban. Universidad Nacional de Córdoba. Facultad de Ciencias de la Comunicación; Argentina.Fil: Fernández, Esteban. Consejo Nacional de Investigaciones Científicas y Técnicas. Instituto de Estudios en Comunicación, Expresión y Tecnologías; Argentina.Fil: Castro, Julián Francisco. Universidad Nacional de Córdoba. Facultad de Ciencias de la Comunicación; Argentina.Fil: Castro, Julián Francisco. Consejo Nacional de Investigaciones Científicas y Técnicas. Instituto de Estudios en Comunicación, Expresión y Tecnologías; Argentina.Fil: Vaccaro, Natalia Desirée. Universidad Nacional de Córdoba. Facultad de Ciencias de la Comunicación; Argentina.Fil: Vaccaro, Natalia Desirée. Consejo Nacional de Investigaciones Científicas y Técnicas. Instituto de Estudios en Comunicación, Expresión y Tecnologías; Argentina.Fil: Vaccaro, Natalia Desirée. Facultad de Ciencias Sociales; Argentina.Fil: Vaccaro, Natalia Desirée. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro de Investigaciones y Estudios sobre Cultura y Sociedad; Argentina.Fil: Gómez, Eugenia. Universidad Nacional de Córdoba. Facultad de Ciencias de la Comunicación; Argentina.Fil: Remondegui, Mara. Universidad Nacional de Córdoba. Facultad de Ciencias de la Comunicación; Argentina.Fil: Cazzolli, Agustín. Universidad Nacional de Córdoba. Facultad de Ciencias de la Comunicación; Argentina.Fil: Giordano, Pedro. Universidad Nacional de Córdoba. Facultad de Ciencias de la Comunicación; Argentina.Fil: Flores, Milagros. Universidad Nacional de Córdoba. Facultad de Ciencias de la Comunicación; Argentina.Fil: Jorquera, Ayelén Micaela. Universidad Nacional de San Luis. Facultad de Ciencias de la Educación; Argentina.Fil: Stang, José Ignacio. Facultad de Ciencias Sociales; Argentina.Fil: Stang, José Ignacio. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro de Investigaciones y Estudios sobre Cultura y Sociedad; Argentina

How do women living with HIV experience menopause? Menopausal symptoms, anxiety and depression according to reproductive age in a multicenter cohort

CatedresBackground: To estimate the prevalence and severity of menopausal symptoms and anxiety/depression and to assess the differences according to menopausal status among women living with HIV aged 45-60 years from the cohort of Spanish HIV/AIDS Research Network (CoRIS). Methods: Women were interviewed by phone between September 2017 and December 2018 to determine whether they had experienced menopausal symptoms and anxiety/depression. The Menopause Rating Scale was used to evaluate the prevalence and severity of symptoms related to menopause in three subscales: somatic, psychologic and urogenital; and the 4-item Patient Health Questionnaire was used for anxiety/depression. Logistic regression models were used to estimate odds ratios (ORs) of association between menopausal status, and other potential risk factors, the presence and severity of somatic, psychological and urogenital symptoms and of anxiety/depression. Results: Of 251 women included, 137 (54.6%) were post-, 70 (27.9%) peri- and 44 (17.5%) pre-menopausal, respectively. Median age of onset menopause was 48 years (IQR 45-50). The proportions of pre-, peri- and post-menopausal women who had experienced any menopausal symptoms were 45.5%, 60.0% and 66.4%, respectively. Both peri- and post-menopause were associated with a higher likelihood of having somatic symptoms (aOR 3.01; 95% CI 1.38-6.55 and 2.63; 1.44-4.81, respectively), while post-menopause increased the likelihood of having psychological (2.16; 1.13-4.14) and urogenital symptoms (2.54; 1.42-4.85). By other hand, post-menopausal women had a statistically significant five-fold increase in the likelihood of presenting severe urogenital symptoms than pre-menopausal women (4.90; 1.74-13.84). No significant differences by menopausal status were found for anxiety/depression. Joint/muscle problems, exhaustion and sleeping disorders were the most commonly reported symptoms among all women. Differences in the prevalences of vaginal dryness (p = 0.002), joint/muscle complaints (p = 0.032), and sweating/flush (p = 0.032) were found among the three groups. Conclusions: Women living with HIV experienced a wide variety of menopausal symptoms, some of them initiated before women had any menstrual irregularity. We found a higher likelihood of somatic symptoms in peri- and post-menopausal women, while a higher likelihood of psychological and urogenital symptoms was found in post-menopausal women. Most somatic symptoms were of low or moderate severity, probably due to the good clinical and immunological situation of these women