Abordaje terapéutico de las complicaciones tempranas en pacientes gran quemados en Sala de Cuidados Inensivos Pediátrico del Hospital Dr. Fernando Vélez Paiz, Enero 2020 a Diciembre 2021

Las quemaduras en la población infantil constituyen un serio problema por el alto riesgo de mortalidad que representan con relación al adulto, por tanto, se realizó el siguiente estudio con el objetivo de describir el abordaje terapéutico de las complicaciones tempranas de los pacientes gran quemado en sala de cuidados intensivos pediátricos. Siendo un estudio descriptivo, retrospectivo de corte transversal, con universo de 30 pacientes ingresados de enero 2020 a diciembre 2021. Presentando los siguientes resultados: Por su sexo se presentó en igual proporción, en su mayoría menores de 5 años el rango promedio de 2-5 años en un 53%, de procedencia urbana en el 57%. El agente causal es térmico en un 90%, con un 97% severos, su condición clínica al momento del ingreso fue estable en 70% de los casos, en las complicaciones se observó predominio de complicaciones metabólicas seguidas de complicaciones locales, hematoinfectologicas y hemodinámicas; respecto al manejo se observó que 97.6% de las complicaciones recibieron manejo desde manejo dinámico de líquidos, correcciones electrolíticas, uso de vasopresores, ventilación mecánica, terapia antimicrobiana según sensibilidad de los aislamientos, lavados quirúrgicos, uso de hemo componentes y hemoderivados de acuerdo a cada complicación presentadas. Por tanto, se considera la necesidad de una guía de manejo de las complicaciones dado a la alta proporción de las mismas en este tipo de pacient

Conocimientos, actitudes y prácticas sobre Métodos Anticonceptivos en Adolescentes de 4º y 5º Año del Instituto Nacional Acoyapa San Sebastián del Municipio de Acoyapa, Departamento de Chontales en el período del 1º de Mayo al 31 de Agosto del 2015

La sexualidad ha sido un tema de gran curiosidad en todas las épocas y en el momento actual constituye uno de los temas más comentados en el mundo; pero en la adolescencia que es un período de incertidumbre, el entendimiento de lo futuro es aún incipiente, lo que impide la posibilidad de anticipar consecuencias. El desarrollo emocional es todavía incompleto, y existe un escaso desarrollo de las habilidades de comunicación interpersonal, lo que dificulta, en cierta forma, el negociar con la pareja situaciones vinculadas con las relaciones sexuales y el uso de métodos anticonceptivos. El tipo de estudio es descriptivo, de corte transversal, el cual se llevó a cabo en dolescentes de 4° y 5° año del Instituto Nacional Acoyapa San Sebastián, fundado en 1887, ubicada en la zona D del Municipio ya mencionado, El universo estuvo constituido por 194 jóvenes, la muestra fue de tipo no probabilístico, por conveniencia, establecidos de acuerdo a los criterios de inclusión y exclusión. La fuente de información fue secundaria, de datos indirectos, extraída de las encuestas. Resultados: Encontramos los factores socio-demográficos de 159 estudiantes que formaron parte del estudio, la edad de 15-17 años corresponde el 81.13% (129), entre 18-19 años el 18.87% (30), referente al sexo el 39.62%(63) son del sexo masculino y en un 60.38% (96) al sexo femenino, en relación al nivel conocimiento el 22.64%(36) fue mala, regular, 39.62%(65) y bueno 39.62% (65), La actitud tomada por los adolescentes hacia los métodos anticonceptivos fue desfavorable con 9.43% (15) y el 90.57% (144) presentan actitud favorable, los adolescentes que iniciaron la vida sexual activa representado por 41.51% (66) y los que no con 58.49% (93) y los que usaron en la primera relación sexual algún método fue del 50

Scavenging in the Anthropocene: Human impact drives vertebrate scavenger species richness at a global scale

Understanding the distribution of biodiversity across the Earth is one of the most challenging questions in biology. Much research has been directed at explaining the species latitudinal pattern showing that communities are richer in tropical areas; however, despite decades of research, a general consensus has not yet emerged. In addition, global biodiversity patterns are being rapidly altered by human activities. Here, we aim to describe large‐scale patterns of species richness and diversity in terrestrial vertebrate scavenger (carrion‐consuming) assemblages, which provide key ecosystem functions and services. We used a worldwide dataset comprising 43 sites, where vertebrate scavenger assemblages were identified using 2,485 carcasses monitored between 1991 and 2018. First, we evaluated how scavenger richness (number of species) and diversity (Shannon diversity index) varied among seasons (cold vs. warm, wet vs. dry). Then, we studied the potential effects of human impact and a set of macroecological variables related to climatic conditions on the scavenger assemblages. Vertebrate scavenger richness ranged from species‐poor to species rich assemblages (4–30 species). Both scavenger richness and diversity also showed some seasonal variation. However, in general, climatic variables did not drive latitudinal patterns, as scavenger richness and diversity were not affected by temperature or rainfall. Rainfall seasonality slightly increased the number of species in the community, but its effect was weak. Instead, the human impact index included in our study was the main predictor of scavenger richness. Scavenger assemblages in highly human‐impacted areas sustained the smallest number of scavenger species, suggesting human activity may be overriding other macroecological processes in shaping scavenger communities. Our results highlight the effect of human impact at a global scale. As speciesrich assemblages tend to be more functional, we warn about possible reductions in ecosystem functions and the services provided by scavengers in human‐dominated landscapes in the Anthropocene

Identification of genetic variants associated with Huntington's disease progression: a genome-wide association study

Background Huntington's disease is caused by a CAG repeat expansion in the huntingtin gene, HTT. Age at onset has been used as a quantitative phenotype in genetic analysis looking for Huntington's disease modifiers, but is hard to define and not always available. Therefore, we aimed to generate a novel measure of disease progression and to identify genetic markers associated with this progression measure. Methods We generated a progression score on the basis of principal component analysis of prospectively acquired longitudinal changes in motor, cognitive, and imaging measures in the 218 indivduals in the TRACK-HD cohort of Huntington's disease gene mutation carriers (data collected 2008–11). We generated a parallel progression score using data from 1773 previously genotyped participants from the European Huntington's Disease Network REGISTRY study of Huntington's disease mutation carriers (data collected 2003–13). We did a genome-wide association analyses in terms of progression for 216 TRACK-HD participants and 1773 REGISTRY participants, then a meta-analysis of these results was undertaken. Findings Longitudinal motor, cognitive, and imaging scores were correlated with each other in TRACK-HD participants, justifying use of a single, cross-domain measure of disease progression in both studies. The TRACK-HD and REGISTRY progression measures were correlated with each other (r=0·674), and with age at onset (TRACK-HD, r=0·315; REGISTRY, r=0·234). The meta-analysis of progression in TRACK-HD and REGISTRY gave a genome-wide significant signal (p=1·12 × 10−10) on chromosome 5 spanning three genes: MSH3, DHFR, and MTRNR2L2. The genes in this locus were associated with progression in TRACK-HD (MSH3 p=2·94 × 10−8 DHFR p=8·37 × 10−7 MTRNR2L2 p=2·15 × 10−9) and to a lesser extent in REGISTRY (MSH3 p=9·36 × 10−4 DHFR p=8·45 × 10−4 MTRNR2L2 p=1·20 × 10−3). The lead single nucleotide polymorphism (SNP) in TRACK-HD (rs557874766) was genome-wide significant in the meta-analysis (p=1·58 × 10−8), and encodes an aminoacid change (Pro67Ala) in MSH3. In TRACK-HD, each copy of the minor allele at this SNP was associated with a 0·4 units per year (95% CI 0·16–0·66) reduction in the rate of change of the Unified Huntington's Disease Rating Scale (UHDRS) Total Motor Score, and a reduction of 0·12 units per year (95% CI 0·06–0·18) in the rate of change of UHDRS Total Functional Capacity score. These associations remained significant after adjusting for age of onset. Interpretation The multidomain progression measure in TRACK-HD was associated with a functional variant that was genome-wide significant in our meta-analysis. The association in only 216 participants implies that the progression measure is a sensitive reflection of disease burden, that the effect size at this locus is large, or both. Knockout of Msh3 reduces somatic expansion in Huntington's disease mouse models, suggesting this mechanism as an area for future therapeutic investigation

A multi-country test of brief reappraisal interventions on emotions during the COVID-19 pandemic.

The COVID-19 pandemic has increased negative emotions and decreased positive emotions globally. Left unchecked, these emotional changes might have a wide array of adverse impacts. To reduce negative emotions and increase positive emotions, we tested the effectiveness of reappraisal, an emotion-regulation strategy that modifies how one thinks about a situation. Participants from 87 countries and regions (n = 21,644) were randomly assigned to one of two brief reappraisal interventions (reconstrual or repurposing) or one of two control conditions (active or passive). Results revealed that both reappraisal interventions (vesus both control conditions) consistently reduced negative emotions and increased positive emotions across different measures. Reconstrual and repurposing interventions had similar effects. Importantly, planned exploratory analyses indicated that reappraisal interventions did not reduce intentions to practice preventive health behaviours. The findings demonstrate the viability of creating scalable, low-cost interventions for use around the world

Scavenging in the Anthropocene: Human impact drives vertebrate scavenger species richness at a global scale

Understanding the distribution of biodiversity across the Earth is one of the most challenging questions in biology. Much research has been directed at explaining the species latitudinal pattern showing that communities are richer in tropical areas; however, despite decades of research, a general consensus has not yet emerged. In addition, global biodiversity patterns are being rapidly altered by human activities. Here, we aim to describe large‐scale patterns of species richness and diversity in terrestrial vertebrate scavenger (carrion‐consuming) assemblages, which provide key ecosystem functions and services. We used a worldwide dataset comprising 43 sites, where vertebrate scavenger assemblages were identified using 2,485 carcasses monitored between 1991 and 2018. First, we evaluated how scavenger richness (number of species) and diversity (Shannon diversity index) varied among seasons (cold vs. warm, wet vs. dry). Then, we studied the potential effects of human impact and a set of macroecological variables related to climatic conditions on the scavenger assemblages. Vertebrate scavenger richness ranged from species‐poor to species rich assemblages (4–30 species). Both scavenger richness and diversity also showed some seasonal variation. However, in general, climatic variables did not drive latitudinal patterns, as scavenger richness and diversity were not affected by temperature or rainfall. Rainfall seasonality slightly increased the number of species in the community, but its effect was weak. Instead, the human impact index included in our study was the main predictor of scavenger richness. Scavenger assemblages in highly human‐impacted areas sustained the smallest number of scavenger species, suggesting human activity may be overriding other macroecological processes in shaping scavenger communities. Our results highlight the effect of human impact at a global scale. As speciesrich assemblages tend to be more functional, we warn about possible reductions in ecosystem functions and the services provided by scavengers in human‐dominated landscapes in the Anthropocene

Functional traits driving species role in the structure of terrestrial vertebrate scavenger networks

Species assemblages often have a non-random nested organization, which in vertebrate scavenger (carrion-consuming) assemblages is thought to be driven by facilitation in competitive environments. However, not all scavenger species play the same role in maintaining assemblage structure, as some species are obligate scavengers (i.e., vultures) and others are facultative, scavenging opportunistically. We used a database with 177 vertebrate scavenger species from 53 assemblages in 22 countries across five continents to identify which functional traits of scavenger species are key to maintaining the scavenging network structure. We used network analyses to relate ten traits hypothesized to affect assemblage structure with the ‘role’ of each species in the scavenging assemblage in which it appeared. We characterized the role of a species in terms of both the proportion of monitored carcasses on which that species scavenged, or scavenging breadth (i.e., the species ‘normalized degree’), and the role of that species in the nested structure of the assemblage (i.e., the species ‘paired nested degree’), thus identifying possible facilitative interactions among species. We found that species with high olfactory acuity, social foragers, and obligate scavengers had the widest scavenging breadth. We also found that social foragers had a large paired nested degree in scavenger assemblages, probably because their presence is easier to detect by other species to signal carcass occurrence. Our study highlights differences in the functional roles of scavenger species and can be used to identify key species for targeted conservation to maintain the ecological function of scavenger assemblages

Scavenging in the Anthropocene: Human impact drives vertebrate scavenger species richness at a global scale

Understanding the distribution of biodiversity across the Earth is one of the most challenging questions in biology. Much research has been directed at explaining the species latitudinal pattern showing that communities are richer in tropical areas; however, despite decades of research, a general consensus has not yet emerged. In addition, global biodiversity patterns are being rapidly altered by human activities. Here, we aim to describe large-scale patterns of species richness and diversity in terrestrial vertebrate scavenger (carrion-consuming) assemblages, which provide key ecosystem functions and services. We used a worldwide dataset comprising 43 sites, where vertebrate scavenger assemblages were identified using 2,485 carcasses monitored between 1991 and 2018. First, we evaluated how scavenger richness (number of species) and diversity (Shannon diversity index) varied among seasons (cold vs. warm, wet vs. dry). Then, we studied the potential effects of human impact and a set of macroecological variables related to climatic conditions on the scavenger assemblages. Vertebrate scavenger richness ranged from species-poor to species rich assemblages (4–30 species). Both scavenger richness and diversity also showed some seasonal variation. However, in general, climatic variables did not drive latitudinal patterns, as scavenger richness and diversity were not affected by temperature or rainfall. Rainfall seasonality slightly increased the number of species in the community, but its effect was weak. Instead, the human impact index included in our study was the main predictor of scavenger richness. Scavenger assemblages in highly human-impacted areas sustained the smallest number of scavenger species, suggesting human activity may be overriding other macroecological processes in shaping scavenger communities. Our results highlight the effect of human impact at a global scale. As species-rich assemblages tend to be more functional, we warn about possible reductions in ecosystem functions and the services provided by scavengers in human-dominated landscapes in the Anthropocene.SG, JMPG, and ACA were supported by Juan de la Cierva contracts (Ministerio de Economía y Competitividad, MEC; IJCI‐2015‐24947, FJCI‐2015‐25632, and IJCI‐2014‐20744, respectively). ESG was also supported by Generalitat Valenciana (SEJI/2018/024), ACA by the Govern de les Illes Balears (PD/039/2017), and MM by a Ramón y Cajal contract (MEC; RYC‐2015‐19231). EA was supported by La Caixa‐Severo Ochoa International PhD Program 2015. NS was partly supported by the National Science Centre in Poland (2013/08/M/NZ9/00469). SAL thanks PICT (BID) 0725/2014. MK and KJ were supported by the Slovenian Research Agency (P4‐0059). Contributions of KT and JCB were partially supported through funding from U.S. Department of Agriculture, the U.S. Department of Energy under (DE‐EM0004391) to the University of Georgia Research Foundation. EB and EF were supported by the USA National Science Foundation. CK completed study under research permit NCST/5/002/R/448 with support from Hawk Mountain Sanctuary, The Peregrine Fund, and via Pompeo M. Maresi Memorial Fund via Princeton University. JAS and CCW were supported by the USA National Science Foundation #1255913 and the Gordon and Betty Moore Foundation. Several authors were funded by funds from the MEC (CGL2012‐40013‐C02‐01/02, CGL2015‐66966‐C2‐1‐R and CGL2017‐89905‐R) and from the Junta de Andalucía (RNM‐1925).Peer reviewe

Functional traits driving species role in the structure of terrestrial vertebrate scavenger networks

Species assemblages often have a non-random nested organization, which in vertebrate scavenger (carrion-consuming) assemblages is thought to be driven by facilitation in competitive environments. However, not all scavenger species play the same role in maintaining assemblage structure, as some species are obligate scavengers (i.e., vultures) and others are facultative, scavenging opportunistically. We used a database with 177 vertebrate scavenger species from 53 assemblages in 22 countries across five continents to identify which functional traits of scavenger species are key to maintaining the scavenging network structure. We used network analyses to relate ten traits hypothesized to affect assemblage structure with the “role” of each species in the scavenging assemblage in which it appeared. We characterized the role of a species in terms of both the proportion of monitored carcasses on which that species scavenged, or scavenging breadth (i.e., the species “normalized degree”), and the role of that species in the nested structure of the assemblage (i.e., the species “paired nested degree”), therefore identifying possible facilitative interactions among species. We found that species with high olfactory acuity, social foragers, and obligate scavengers had the widest scavenging breadth. We also found that social foragers had a large paired nested degree in scavenger assemblages, probably because their presence is easier to detect by other species to signal carcass occurrence. Our study highlights differences in the functional roles of scavenger species and can be used to identify key species for targeted conservation to maintain the ecological function of scavenger assemblage