Diseño de un programa de seguimiento de poblaciones de cánidos silvestres en ambientes esteparios de la Patagonia, Argentina

Wildlife management decisions should be based on solid baseline information, with monitoring populations as a necessary activity whenever the management objective is maintaining abundance at a previously stated level. Developing a monitoring program requires careful experimental and statistical considerations in order to get confidence about its capability in detecting predefined trends. Our objective was to develop a monitoring program for two canid species (the Grey Fox Pseudalopex griseus and the Culpeo Fox P. culpaeus), based on visitation indices to bait stations. Using MONITOR software we estimated the sampling effort necessary to detect a 50% decrease in their populations during the next 5 years (annual rate of –12,94%) and during the next 10 years (annual rate of –6,70%), with a minimum power of 80%. We assume that the environmental cost of making a Type II error (failing to detect a real population trend) is greater than that of making a Type I error (sounding a false alarm) and used three alpha levels 0.05, 0.10 and 0.15. We also tested an increasing sampling effort (number of bait stations lines), and activating them during one, two and up to three times in a single year. We fed the MONITOR program with the mean visitation index to the 20 transects activated on several occasions during the previous year in the study area. In order to detect a 50% decrease over the next 5 years, any monitoring program should be based on at least two annual replicates of the bait stations. A monitoring program accessible to the protected area manpower and financial resources and considering the conservation status of the target species would be one developed to detect a 50% decrease over the next 10 years, activating 16 lines once a year, during two or three consecutive nights and an alpha of 0.10. We also discuss alternatives to use only the first nigh of visit in order to assimilate bait stations to scent stations and make these results comparable with other studiesin Patagonia, Argentina. Monitoring programs like the one presented here would be valuable to help managers when deciding about harvest quotas for the fur trade, or anticipating conflicts and solutions with sheep rangers by detecting increasing trends in Culpeo populations. La gestión de la fauna silvestre debe basarse en sólida información de base. Ello incluye el seguimiento de poblaciones para ayudar a mantenerlas en tamaños próximos a aquellos previamente fijados. El desarrollo de programas de seguimiento requiere de una considerable planificación y evaluación estadística antes de su implementación. El objetivo de nuestro trabajo fue desarrollar un programa de seguimiento para dos especies de cánidos silvestres en Patagonia: el zorro colorado (Pseudalopex culpaeus) y el zorro gris (P. griseus). Tratamos de averiguar, utilizando el programa MONITOR, cual debería ser el esfuerzo de muestreo anual para detectar una disminución del 50% de la población actual en los próximos 5 años (esto es una tasa anual de –12,94%), o en los próximos 10 años (una tasa anual de –6.70%), satisfaciendo una potencia mínima del 80%. El trabajo de campo se realizó en el área protegida “Monumento Natural Bosques Petrificados”, Provincia de Santa Cruz, Argentina. Como estimador de la abundancia de los zorros se utilizaron las visitas a líneas de estaciones de cebado. El costo ambiental de cometer un error de Tipo II es mayor que el de cometer uno de Tipo I, por lo que utilizamosalternativamente tres niveles de α: 0.05, 0.10 y 0.15. Probamos también un esfuerzo de muestreo (número de líneas de estaciones de cebado) creciente, activándolas una, dos y hasta tres veces por año. Como valores iniciales para alimentar el programa MONITOR utilizamos la media y desviación estándar del índice de visita a cada una de las 20 líneas que se instalaron en el área de estudio. Para detectar una disminución del 50% en cinco años cualquier programa de seguimiento poblacional deberá basarse al menos en dos repeticiones anuales de las estaciones de cebado. Un programa de seguimiento accesible a las disponibilidades del área protegida sería aquel diseñado para detectar una disminución del 50% en diez años (-6.7% anual), con un α de 0.10 y un esfuerzo de 16 líneas, activadas una vez por año y revisadas durante dos o tres noches consecutivas. Se proponen alternativas para utilizar solo la primer noche de muestreo, de forma que los resultados sean luego comparables con los de experiencias de estaciones de olor en otras regiones de la Patagonia. La puesta en marcha de programas como el aquí presentado servirán para la toma de decisiones a organizaciones encargadas de la gestión de la fauna silvestre, autorizando o prohibiendo extracciones destinadas al mercado peletero. Servirían también para conocer a tiempo incrementos poblacionales, permitiendo así tomar medidas preventivas tendentes a disminuir conflictos con la actividad ganadera.&nbsp

Evaluación urodinámica y comparativa de la calidad de vida en pacientes con trastorno de vaciamiento vesical sometidos a terapia InterStim, Medtronic®

ResumenAntecedentesDesde 1980 la terapia de neuroestimulación sacra ha demostrado ser una terapia válida y alternativa en el manejo de los trastornos miccionales por patología del tracto urinario bajo, siendo sus principales indicaciones la retención urinaria idiopática, la incontinencia de urgencia y la incontinencia fecal. En nuestro país sigue siendo una terapia novedosa y no se cuenta aún con estudios que evalúen esta eficacia en términos de calidad de vida o con parámetros cuantitativos.Objetivo del estudioEstablecer la eficacia de la terapia de neuroestimulación sacra tipo InterStim, Medtronic®, en el manejo de los pacientes con trastornos de vaciamiento vesical, efectuando un análisis urodinámico y de la calidad de vida comparativo previo y posterior al tratamiento, determinando los volúmenes miccionales, los períodos de incontinencia, la satisfacción del paciente y la calidad de vida.Material y métodosDesde enero de 2010 hasta junio de 2013, en el Hospital Central Militar se realizó evaluación urodinámica y comparativa de la calidad de vida mediante el empleo del instrumento SF-36 v2 (versión mexicana) e ICIQSF, en los pacientes que presentaron trastorno de vaciamiento vesical de etiología no obstructiva y que fueron refractarios a tratamiento médico.ResultadosSe incluyeron 10 pacientes en el estudio, bajo los siguientes diagnósticos: disinergia detrusor-esfínter, vejiga hiperactiva y retención urinaria no obstructiva, ubicados por género (2 masculinos y 8 femeninos). En la totalidad de los pacientes se presentó mejoría del 50% o superior durante la fase de prueba de la terapia de neuroestimulación, y se colocó fase definitiva con los siguientes resultados: se obtuvieron resultados equivalentes al 50-65% de mejoría en los parámetros cualitativos de función física, función social y rol emocional, así como en las variables cuantitativas de volumen de vaciamiento, eficacia de vaciamiento y disminución de los períodos de incontinencia.DiscusiónComo se ha establecido a nivel de la literatura mundial, nuestros resultados fueron similares en el efecto benéfico y la eficacia en la calidad de vida e incontinencia urinaria, respectivamente, y se reportan porcentajes de éxito mayores al 50% en el cese total de los episodios de incontinencia.ConclusionesLa neuromodulación mediante la estimulación del nervio sacro es una forma exitosa de tratamiento en los trastornos de vaciamiento vesical de etiología no obstructiva y refractaria al tratamiento médico, es segura, mínimamente invasiva y de fácil aplicación, y mejora la calidad de vida de los pacientes. Sin embargo, es necesario realizar estudios aleatorizados y que consideren parámetros objetivos (urodinámicos), así como las complicaciones posibles a mediano y largo plazo en este tipo de terapia.AbstractBackgroundSince 1980, sacral neuromodulation therapy has been shown to be a valid alternative therapy in the management of urinary disorders due to lower urinary tract pathology, and its primary indications are: idiopathic urinary retention, urge incontinence, and fecal incontinence. It is still considered a novel therapy in Mexico and there are no studies using quantitative parameters that evaluate its efficacy in terms of quality of life.AimsTo establish the efficacy of the Medtronic InterStim® sacral neuromodulation therapy in the management of patients with bladder voiding disorders through urodynamic and quality of life analyses before and after treatment. Urine volume, periods of incontinence, patient satisfaction, and quality of life were determined.MethodsA comparative urodynamic and quality of life evaluation was carried out using the SF-36 v2 (Mexican version) and the ICIQSF instruments on patients presenting with nonobstructive bladder voiding disorders that were refractory to medical treatment.ResultsTen patients with the following diagnoses were included in the study: detrusor sphincter dyssynergia, overactive bladder, and nonobstructive urinary retention. Two of the patients were men and 8 were women. There was a 50% or greater improvement in all 10 patients during the test phase of the neuromodulation therapy and the definitive placement phase produced the following results: a 50-65% improvement in the qualitative parameters of physical function, social function, and emotional role, as well as in the quantitative variables of voiding volume, voiding efficacy, and reduced periods of incontinence.DiscussionOur results were similar to those established in the international literature in relation to the beneficial effect on quality of life and efficacy in urinary incontinence management; the literature reports success percentages in the complete cessation of incontinence episodes at above 50%.ConclusionsNeuromodulation through sacral nerve stimulation is a successful form of treatment of nonobstructive and medical treatment-refractory bladder voiding disorders. It is safe, minimally invasive, and easy to apply and it improves patient quality of life. Nevertheless, further randomized studies on this type of therapy need to be conducted that take into account objective parameters (urodynamics) and possible medium and long-term complications

Risk profiles and one-year outcomes of patients with newly diagnosed atrial fibrillation in India: Insights from the GARFIELD-AF Registry.

BACKGROUND: The Global Anticoagulant Registry in the FIELD-Atrial Fibrillation (GARFIELD-AF) is an ongoing prospective noninterventional registry, which is providing important information on the baseline characteristics, treatment patterns, and 1-year outcomes in patients with newly diagnosed non-valvular atrial fibrillation (NVAF). This report describes data from Indian patients recruited in this registry. METHODS AND RESULTS: A total of 52,014 patients with newly diagnosed AF were enrolled globally; of these, 1388 patients were recruited from 26 sites within India (2012-2016). In India, the mean age was 65.8 years at diagnosis of NVAF. Hypertension was the most prevalent risk factor for AF, present in 68.5% of patients from India and in 76.3% of patients globally (P < 0.001). Diabetes and coronary artery disease (CAD) were prevalent in 36.2% and 28.1% of patients as compared with global prevalence of 22.2% and 21.6%, respectively (P < 0.001 for both). Antiplatelet therapy was the most common antithrombotic treatment in India. With increasing stroke risk, however, patients were more likely to receive oral anticoagulant therapy [mainly vitamin K antagonist (VKA)], but average international normalized ratio (INR) was lower among Indian patients [median INR value 1.6 (interquartile range {IQR}: 1.3-2.3) versus 2.3 (IQR 1.8-2.8) (P < 0.001)]. Compared with other countries, patients from India had markedly higher rates of all-cause mortality [7.68 per 100 person-years (95% confidence interval 6.32-9.35) vs 4.34 (4.16-4.53), P < 0.0001], while rates of stroke/systemic embolism and major bleeding were lower after 1 year of follow-up. CONCLUSION: Compared to previously published registries from India, the GARFIELD-AF registry describes clinical profiles and outcomes in Indian patients with AF of a different etiology. The registry data show that compared to the rest of the world, Indian AF patients are younger in age and have more diabetes and CAD. Patients with a higher stroke risk are more likely to receive anticoagulation therapy with VKA but are underdosed compared with the global average in the GARFIELD-AF. CLINICAL TRIAL REGISTRATION-URL: http://www.clinicaltrials.gov. Unique identifier: NCT01090362

An Evaluation of the COVID-19 Pandemic and Perceived Social Distancing Policies in Relation to Planning, Selecting, and Preparing Healthy Meals: An Observational Study in 38 Countries Worldwide

Objectives: To examine changes in planning, selecting, and preparing healthy foods in relation to personal factors (time, money, stress) and social distancing policies during the COVID-19 crisis. Methods: Using cross-sectional online surveys collected in 38 countries worldwide in April-June 2020 (N = 37,207, Mage 36.7 SD 14.8, 77% women), we compared changes in food literacy behaviors to changes in personal factors and social distancing policies, using hierarchical multiple regression analyses controlling for sociodemographic variables. Results: Increases in planning (4.7 SD 1.3, 4.9 SD 1.3), selecting (3.6 SD 1.7, 3.7 SD 1.7), and preparing (4.6 SD 1.2, 4.7 SD 1.3) healthy foods were found for women and men, and positively related to perceived time availability and stay-at-home policies. Psychological distress was a barrier for women, and an enabler for men. Financial stress was a barrier and enabler depending on various sociodemographic variables (all p < 0.01). Conclusion: Stay-at-home policies and feelings of having more time during COVID-19 seem to have improved food literacy. Stress and other social distancing policies relate to food literacy in more complex ways, highlighting the necessity of a health equity lens. Copyright 2021 De Backer, Teunissen, Cuykx, Decorte, Pabian, Gerritsen, Matthys, Al Sabbah, Van Royen and the Corona Cooking Survey Study Group.This research was funded by the Research Foundation Flanders (G047518N) and Flanders Innovation and Entrepreneurship (HBC.2018.0397). These funding sources had no role in the design of the study, the analysis and interpretation of the data or the writing of, nor the decision to publish the manuscript.Scopu

International nosocomial infection control consortium (INICC) report, data summary of 36 countries, for 2004-2009

The results of a surveillance study conducted by the International Nosocomial Infection Control Consortium (INICC) from January 2004 through December 2009 in 422 intensive care units (ICUs) of 36 countries in Latin America, Asia, Africa, and Europe are reported. During the 6-year study period, using Centers for Disease Control and Prevention (CDC) National Healthcare Safety Network (NHSN; formerly the National Nosocomial Infection Surveillance system [NNIS]) definitions for device-associated health care-associated infections, we gathered prospective data from 313,008 patients hospitalized in the consortium's ICUs for an aggregate of 2,194,897 ICU bed-days. Despite the fact that the use of devices in the developing countries' ICUs was remarkably similar to that reported in US ICUs in the CDC's NHSN, rates of device-associated nosocomial infection were significantly higher in the ICUs of the INICC hospitals; the pooled rate of central line-associated bloodstream infection in the INICC ICUs of 6.8 per 1,000 central line-days was more than 3-fold higher than the 2.0 per 1,000 central line-days reported in comparable US ICUs. The overall rate of ventilator-associated pneumonia also was far higher (15.8 vs 3.3 per 1,000 ventilator-days), as was the rate of catheter-associated urinary tract infection (6.3 vs. 3.3 per 1,000 catheter-days). Notably, the frequencies of resistance of Pseudomonas aeruginosa isolates to imipenem (47.2% vs 23.0%), Klebsiella pneumoniae isolates to ceftazidime (76.3% vs 27.1%), Escherichia coli isolates to ceftazidime (66.7% vs 8.1%), Staphylococcus aureus isolates to methicillin (84.4% vs 56.8%), were also higher in the consortium's ICUs, and the crude unadjusted excess mortalities of device-related infections ranged from 7.3% (for catheter-associated urinary tract infection) to 15.2% (for ventilator-associated pneumonia). Copyright © 2012 by the Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved

The DUNE far detector vertical drift technology. Technical design report

DUNE is an international experiment dedicated to addressing some of the questions at the forefront of particle physics and astrophysics, including the mystifying preponderance of matter over antimatter in the early universe. The dual-site experiment will employ an intense neutrino beam focused on a near and a far detector as it aims to determine the neutrino mass hierarchy and to make high-precision measurements of the PMNS matrix parameters, including the CP-violating phase. It will also stand ready to observe supernova neutrino bursts, and seeks to observe nucleon decay as a signature of a grand unified theory underlying the standard model. The DUNE far detector implements liquid argon time-projection chamber (LArTPC) technology, and combines the many tens-of-kiloton fiducial mass necessary for rare event searches with the sub-centimeter spatial resolution required to image those events with high precision. The addition of a photon detection system enhances physics capabilities for all DUNE physics drivers and opens prospects for further physics explorations. Given its size, the far detector will be implemented as a set of modules, with LArTPC designs that differ from one another as newer technologies arise. In the vertical drift LArTPC design, a horizontal cathode bisects the detector, creating two stacked drift volumes in which ionization charges drift towards anodes at either the top or bottom. The anodes are composed of perforated PCB layers with conductive strips, enabling reconstruction in 3D. Light-trap-style photon detection modules are placed both on the cryostat's side walls and on the central cathode where they are optically powered. This Technical Design Report describes in detail the technical implementations of each subsystem of this LArTPC that, together with the other far detector modules and the near detector, will enable DUNE to achieve its physics goals

Reducing the environmental impact of surgery on a global scale: systematic review and co-prioritization with healthcare workers in 132 countries

Background Healthcare cannot achieve net-zero carbon without addressing operating theatres. The aim of this study was to prioritize feasible interventions to reduce the environmental impact of operating theatres. Methods This study adopted a four-phase Delphi consensus co-prioritization methodology. In phase 1, a systematic review of published interventions and global consultation of perioperative healthcare professionals were used to longlist interventions. In phase 2, iterative thematic analysis consolidated comparable interventions into a shortlist. In phase 3, the shortlist was co-prioritized based on patient and clinician views on acceptability, feasibility, and safety. In phase 4, ranked lists of interventions were presented by their relevance to high-income countries and low–middle-income countries. Results In phase 1, 43 interventions were identified, which had low uptake in practice according to 3042 professionals globally. In phase 2, a shortlist of 15 intervention domains was generated. In phase 3, interventions were deemed acceptable for more than 90 per cent of patients except for reducing general anaesthesia (84 per cent) and re-sterilization of ‘single-use’ consumables (86 per cent). In phase 4, the top three shortlisted interventions for high-income countries were: introducing recycling; reducing use of anaesthetic gases; and appropriate clinical waste processing. In phase 4, the top three shortlisted interventions for low–middle-income countries were: introducing reusable surgical devices; reducing use of consumables; and reducing the use of general anaesthesia. Conclusion This is a step toward environmentally sustainable operating environments with actionable interventions applicable to both high– and low–middle–income countries

Rising rural body-mass index is the main driver of the global obesity epidemic in adults

Body-mass index (BMI) has increased steadily in most countries in parallel with a rise in the proportion of the population who live in cities 1,2 . This has led to a widely reported view that urbanization is one of the most important drivers of the global rise in obesity 3�6 . Here we use 2,009 population-based studies, with measurements of height and weight in more than 112 million adults, to report national, regional and global trends in mean BMI segregated by place of residence (a rural or urban area) from 1985 to 2017. We show that, contrary to the dominant paradigm, more than 55 of the global rise in mean BMI from 1985 to 2017�and more than 80 in some low- and middle-income regions�was due to increases in BMI in rural areas. This large contribution stems from the fact that, with the exception of women in sub-Saharan Africa, BMI is increasing at the same rate or faster in rural areas than in cities in low- and middle-income regions. These trends have in turn resulted in a closing�and in some countries reversal�of the gap in BMI between urban and rural areas in low- and middle-income countries, especially for women. In high-income and industrialized countries, we noted a persistently higher rural BMI, especially for women. There is an urgent need for an integrated approach to rural nutrition that enhances financial and physical access to healthy foods, to avoid replacing the rural undernutrition disadvantage in poor countries with a more general malnutrition disadvantage that entails excessive consumption of low-quality calories. © 2019, The Author(s)

Suppression of human T cell proliferation by the caspase inhibitors, z-VAD-FMK and z-IETD-FMK is independent of their caspase inhibition properties

The caspase inhibitors, benzyloxycarbony (Cbz)-l-Val-Ala-Asp (OMe)-fluoromethylketone (z-VAD-FMK) and benzyloxycarbonyl (Cbz)-Ile-Glu (OMe)-Thr-Asp (OMe)-FMK (z-IETD-FMK) at non-toxic doses were found to be immunosuppressive and inhibit human T cell proliferation induced by mitogens and IL-2 in vitro. Both caspase inhibitors were shown to block NF-κB in activated primary T cells, but have little inhibitory effect on the secretion of IL-2 and IFN-γ during T cell activation. However, the expression of IL-2 receptor α-chain (CD25) in activated T cells was inhibited by both z-VAD-FMK and z-IETD-FMK, whereas the expression of the early activated T cell marker, CD69 was unaffected. During primary T cell activation via the antigen receptor, both caspase-8 and caspase-3 were activated and processed to their respective subunits, but neither caspase inhibitors had any effect on the processing of these two caspases. In sharp contrast both caspase inhibitors readily blocked apoptosis and the activation of caspases during FasL-induced apoptosis in activated primary T cells and Jurkat T cells. Collectively, the results demonstrate that both z-VAD-FMK and z-IETD-FMK are immunosuppressive in vitro and inhibit T cell proliferation without blocking the processing of caspase-8 and caspase-3