Reproductive Strategy of the Giant Electric Ray in the Southern Gulf of California

The objective of the present study was to describe and characterize macroscopic and microscopic aspects of the reproductive biology of the Giant Electric Ray Narcine entemedor, a viviparous elasmobranch targeted by commercial fishers in Mexico. A total of 305 individual rays were captured (260 females, 45 males); all males were sexually mature. The median size at maturity for females was estimated to be 58.5 cm TL, the median size at pregnancy was 63.7 cm TL, and the median size at maternity was 66.2 cm TL. The range of ovarian follicles recorded per female was 1–69; the maximum ovarian fecundity of fully grown vitellogenic oocytes was 17, and uterine fecundity ranged from 1 to 24 embryos per female. The lengths of the oblong ovarian follicles varied significantly among months, and the largest ovarian follicles were found in July, August, and September. Median embryo size was largest in August, and the size at birth was between 12.4 and 14.5 cm TL. Histological evidence of secretions from the glandular tissue of the uterine villi indicate that this species probably has limited histotrophy as a reproductive mode. Vitellogenesis in the ovary occurred synchronously with gestation in the uterus. The Giant Electric Ray has a continuous annual reproductive cycle; a period of ovulation occurs between May and September and two peaks of parturition, one in January and one in August, occur, suggesting that embryonic diapause occurs in some individuals. These results provide useful information for the management of this important commercial species in Bahía de La Paz, Mexico, and will allow possible modification of the current Mexican regulations to enable better protection of this species

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

Percepción de la calidad del servicio en un centro de atención primaria de salud chileno

The objectives of this research were to quantify the perception of three segments of users who received medical attention in a family health center and to analyze the existence of underlying quality dimensions. The justification is the need to improve service attention and decision making process. The methodology used a randomized survey applied to users who received medical attention in a primary health care center in the commune of Coihueco, Chile. In addition, the univariate analysis was used to quantify perceptions and the factor analysis technique to identify underlying dimensions. The results indicated that the overall quality level of the medical services received by users was 4,05 on an evaluation scale of one to five points and, five underlying quality dimensions were identified among the three user segments. By way of conclusions, it was determined that people equal to or older than 45 years had a higher level of satisfaction with respect to people under 19 and people between 20 and 44 years. In addition, it was possible to distinguish five underlying dimensions among the three segments of users: Respect for the patient, Accessibility of the service, Pleasant environment, Service availability and Tolerance towards the patientLos objetivos de esta investigación fueron cuantificar la percepción de tres segmentos de usuarios que recibieron atención médica en un centro de salud familiar y, analizar la existencia de dimensiones de calidad subyacentes. La justificación es la necesidad de mejorar la atención del servicio y proceso de toma de decisiones. La metodología utilizó una encuesta aleatoria aplicada a usuarios que recibieron atención médica en un centro de salud de atención primaria de la comuna de Coihueco, Chile, además, se utilizó el análisis univariado para cuantificar percepciones y la técnica de análisis de factores para identificar dimensiones subyacentes. Los resultados indicaron que el nivel de calidad global de los servicios médicos recibidos por los usuarios fue de 4,05 en una escala de evaluación de uno a cinco puntos y, se identificaron cinco dimensiones de calidad subyacentes entre los tres segmentos de usuarios., se determinó que las personas iguales o mayores de 45 años presentaron un nivel de satisfacción mayor respecto de las personas menores de 19 años y personas entre 20 y 44 años. Además, se lograron distinguir cinco dimensiones subyacentes entre los tres segmentos de usuarios: Respeto hacia el paciente, accesibilidad del servicio, entorno agradable, accesibilidad del servicio, disponibilidad del servicio y tolerancia hacia el pacient