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1.
Sci Rep ; 14(1): 13656, 2024 06 13.
Artículo en Inglés | MEDLINE | ID: mdl-38871774

RESUMEN

Increasing forest structural complexity is becoming a common goal in forestry worldwide. However, the lack of empirical quantification clouds its implementation. Here we quantified the long-term effects (> 30 y) of partial harvest on stand structural complexity and net primary productivity using the east-west precipitation gradient (318-2508 mm, mean annual precipitation-MAP) of western Patagonian as a study system. In this gradient, pairs of 1-ha plots on 20 sites (20 plots harvested and 20 plots unharvested) were installed. In each plot terrestrial laser scanning was used to quantify the stand structural complexity index (SSCI), and Sentinel satellite images to obtain the Enhanced Vegetation Index (EVI: proxy of net primary productivity). Generalized linear mixed-effect models were used to relate SSCI to MAP and EVI to SSCI, with harvesting as indicator variable, and site as random variable (two plots nested to same precipitation). Results showed that harvested plots on mesic-to-humid sites (but not on dry sites) had higher SSCI and EVI values compared to unharvested plots, likely due to a greater vertical canopy packing. These results show the influence of precipitation on SSCI, which resulted in a more diversified stand structure and higher EVI. Such insights support site-specific management aimed to increase forest structural complexity.


Asunto(s)
Bosques , Lluvia , Agricultura Forestal/métodos , Árboles
2.
Gac Sanit ; 38 Suppl 1: 102393, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-38714433

RESUMEN

OBJECTIVE: Providing a general overview of the European Union's health workforce mobility under the challenges facing health systems regarding the supply of health workers. METHOD: We use a descriptive method, based on the analysis of secondary data, qualitative and quantitative, concerning the European Semester from the European Union, complemented with statistical data from both the Union and some international organisations. RESULTS: The mobility of health professionals in the Union, associated to strong reliance on recruiting abroad and shortages due to emigration, was identified as a challenge in the European Semester process in a significant number of times during 2017-2023. The pandemic aggravated pre-existing shortages and the need to strike a balance between maintaining the resolution capacity of health systems while abiding by the free movement of health professionals. The information shows that Romania, Slovakia, Spain, Lithuania, Latvia, Portugal, Bulgaria, Greece, Croatia, Hungary, Italy, and Slovenia could be flagged with an "issuer profile". Luxembourg, Ireland, Malta, and Sweden could be flagged with a "recipient profile". We benefited from improvements in the information system concerning the Union's health workforce. Further advances regarding the harmonisation of health professions' definition are needed, especially for nurses. CONCLUSIONS: The European Union faces internal migrations of health professionals. Mobility is used as a solution to shortages. The pandemic aggravated pre-existing shortages bringing to the forefront the need to strike a balance between health objectives and internal market objectives. Member States are immersed in health reforms, some financed with European Funds. Promoting health workforce planning and forecasting would emerge as a necessary action, including improving harmonised information. Drawing in a systematic way on the available information from the European Semester reports may provide some clues to give answers to policymaking concerning health professionals' mobility.


Asunto(s)
Unión Europea , Fuerza Laboral en Salud , Humanos , COVID-19/epidemiología , Personal de Salud , Emigración e Inmigración/tendencias , Pandemias
3.
Arch Gerontol Geriatr ; 121: 105365, 2024 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-38364710

RESUMEN

OBJECTIVES: To describe the extent, characteristics, and knowledge gaps regarding explicit decision criteria for deprescribing drugs with anticholinergic or sedative properties (Ach/Sed) in older adults. DESIGN: Scoping review. SETTING AND PARTICIPANTS: Original studies, clinical trial protocols, grey literature, and Summaries of Product Characteristics. METHODS: Searches targeting explicit decision criteria for deprescribing Ach/Sed were performed across MEDLINE, EMBASE, CINAHL, and Web of Science, including trial registries (clinicaltrials.gov, ICTRP, EU-CTR, ANZCTR) for pertinent articles, study protocols. Additionally, to encompass non-traditional or 'grey literature' sources, Google searches and relevant agency websites were explored, alongside the summary of product characteristics for Ach/Sed. RESULTS: The initial literature search identified 8,192 unique data sources. After review, 188 original articles or books, 79 internet sources, and 127 SmPCs were included. Examining these sources for explicit criteria for 154 Ach/Sed, overall, 1,271 explicit criteria guidance for identifying clinical scenarios warranting deprescription of Ach/Sed across 145/154 Ach/Sed were identified. These criteria were identified mainly from qualitative research and Summaries of Product Characteristics. Additionally, 455 criteria-based recommendations suggesting approaches for tapering implementation across 76/154 Ach/Sed were identified, mostly from sources classified as expert opinions. Significant heterogeneity was found across the approaches for tapering Ach/Sed. CONCLUSIONS: This scoping review provides a comprehensive overview of the literature providing guidance for clinical scenarios where Ach/Sed should be deprescribed and highlights the existing knowledge gaps regarding comprehensive guidance on tapering these drugs which warranties future research and development.


Asunto(s)
Antagonistas Colinérgicos , Hipnóticos y Sedantes , Humanos , Anciano , Hipnóticos y Sedantes/uso terapéutico , Investigación Cualitativa , Antagonistas Colinérgicos/uso terapéutico
4.
rev.cuid. (Bucaramanga. 2010) ; 14(3): 1-14, 20230901.
Artículo en Inglés | LILACS, BDENF, COLNAL | ID: biblio-1510105

RESUMEN

Introduction: Serum vitamin D levels depend on sunlight, diet, and other factors. Objective: We aimed to determine serum vitamin D levels and evaluate their relationship with anthropometric indicators and lifestyle habits in apparently healthy volunteers. Materials and Methods: In this cross-sectional study (n=75), socio-demographic, anthropometric, and lifestyle habit-related data were collected. Serum vitamin D levels were determined with high performance liquid chromatography, food intake was measured by semiquantitative frequency and nutritional status was assessed by anthropometry. Chi-square test and also principal component analysis were used to analyze the relationship between some variables and vitamin D status. Spearman's test was used to determine correlations between quantitative variables. Results: 73% were women and 61% belonged to medium socio-economic level. Median vitamin D intake was 137 (83.1­227.3) IU/day. Based on body mass index (BMI), 44% individuals had overweight/obesity. The 68% exhibited deficient/insufficient vitamin D levels (Hypovitaminosis D). BMI classification and waist circumference (CW) were not related with vitamin D status; however, activities with higher sun exposure were highly related (p = 0.013). Sun exposure time explained variation in component 2 (16.60%), where most of the individuals with normal level were grouped. Sun exposure time was positively correlated with vitamin D status (r = 0.263; p = 0.023). Discussion: Excess weight and abdominal obesity are not always associated with hypovitaminosis D. Conclusions: The majority of individuals showed hypovitaminosis D but their status was not related with anthropometric indicators. A Sun exposure time was the only factor positively correlated with vitamin D status.


Introducción: Los niveles séricos de vitamina D dependen de la luz solar, la dieta y otros factores. Objetivo: Nuestro objetivo fue determinar los niveles séricos de vitamina D y evaluar su relación con indicadores antropométricos y estilos de vida en voluntarios aparentemente sanos. Materiales y métodos: En este estudio trasversal (n=75) se recogieron datos sociodemográficos, antropométricos y aquellos relacionados con hábitos y estilos de vida. La vitamina D se determinó por cromatografía liquida de alta eficiencia; la ingesta de alimentos, mediante frecuencia semicuantitativa, y el estado nutricional por antropometría. Para analizar la relación entre algunas variables y el estado de la vitamina D se usó la prueba de Chi cuadrado y también el análisis de componentes principales. Se empleó la prueba de Spearman para determinar la correlación entre variables cuantitativas. Resultados: El 73% eran mujeres y el 61% pertenecían a un estrato socioeconómico medio. La mediana de la ingesta de vitamina D fue de 137 (83,1­227,3) UI/día. Según el índice de masa corporal (IMC), el 44% de los individuos tenían sobrepeso/obesidad. El 68% mostro deficiencia/insuficiencia de vitamina D (hipovitaminosis D). La clasificación del IMC y la circunferencia abdominal no se relacionaron con el estado de la vitamina D; sin embargo, las actividades con una mayor exposición solar estuvieron altamente relacionadas (p=0,013). El tiempo de exposición solar explico la variación en el componente 2 (16,60%) donde se agruparon la mayoría de los individuos con niveles normales. El tiempo de exposición solar tuvo una correlación positiva con el estado de la vitamina D (r = 0,263; p = 0,023). Discusión: El exceso de peso y la obesidad abdominal no siempre se relacionan con la hipovitaminosis D. Conclusiones: La mayoría de los individuos presentaron hipovitaminosis D, pero su estado no se relacionó con los indicadores antropométricos. El tiempo de exposición al sol fue el único factor que se correlaciono positivamente con el estado de la vitamina D.


Introdução: Os níveis séricos de vitamina D dependem da luz solar, da dieta e de outros fatores. Objetivo: Nosso objetivo foi determinar os níveis séricos de vitamina D e avaliar sua relação com indicadores antropométricos e hábitos de vida em voluntários aparentemente saudáveis. Materiais e métodos: Neste estudo transversal (n=75), foram coletados dados sociodemográficos, antropométricos e relacionados a hábitos de vida. Os níveis séricos de vitamina D foram determinados por cromatografia liquida de alto desempenho, a ingestão de alimentos foi medida por frequência semiquantitativa e o estado nutricional foi avaliado por antropometria. O teste do qui-quadrado e a análise de componentes principais foram utilizados para analisar a relação entre algumas variáveis e o estado da vitamina D. O teste de Spearman foi usado para determinar as correlações entre as variáveis quantitativas. Resultados: 73% eram mulheres e 61% pertenciam a um nível socioeconômico médio. A ingestão media de vitamina D foi de 137 (83,1-227,3) UI/dia. Com base no índice de massa corporal (IMC), 44% dos indivíduos tinham sobrepeso/obesidade. Os 68% apresentaram níveis deficientes/insuficientes de vitamina D (hipovitaminose D). A classificação do IMC e a circunferência da cintura (CW) não foram relacionadas ao status da vitamina D; entretanto, as atividades com maior exposição ao sol foram altamente relacionadas (p = 0,013). O tempo de exposição ao sol explicou a variação no componente 2 (16,60%), onde a maioria dos indivíduos com nível normal foi agrupada. O tempo de exposição ao sol foi positivamente correlacionado com o status de vitamina D (r = 0,263; p = 0,023). Discussão: O excesso de peso e a obesidade abdominal nem sempre estão associados com a hipovitaminose D. Conclusões: A maioria dos indivíduos apresentou hipovitaminose D, mas seu status não foi relacionado com indicadores antropométricos. O tempo de exposição ao sol foi o único fator positivamente correlacionado com o status da vitamina D.


Asunto(s)
Luz Solar , Vitamina D , Antropometría , Voluntarios Sanos , Estilo de Vida
5.
Dev Comp Immunol ; 140: 104597, 2023 03.
Artículo en Inglés | MEDLINE | ID: mdl-36450302

RESUMEN

Salmonella Typhimurium is a food-borne pathogen that causes salmonellosis. When in contact with the host, neutrophils are rapidly recruited to act as first line of defense. To better understand the pathogenesis of this infection, we used an in vitro model of neutrophil infection to perform dual RNA-sequencing (both host and pathogen). In addition, and given that many pathogens interfere with kinase-mediated phosphorylation in host signaling, we performed a phosphoproteomic analysis. The immune response was overall diminished in infected neutrophils, mainly JAK/STAT and toll-like receptor signaling pathways. We found decreased expression of proinflammatory cytokine receptor genes and predicted downregulation of the mitogen-activated protein (MAPK) signaling pathway. Also, Salmonella infection inhibited interferons I and II signaling pathways by upregulation of SOCS3 and subsequent downregulation of STAT1 and STAT2. Additionally, phosphorylation of PSMC2 and PSMC4, proteasome regulatory proteins, was decreased in infected neutrophils. Cell viability and survival was increased by p53 signaling, cell cycle arrest and NFkB-proteasome pathways activation. Combined analysis of RNA-seq and phosphoproteomics also revealed inhibited vesicle transport mechanisms mediated by dynein/dynactin and exocyst complexes, involved in ER-to-Golgi transport and centripetal movement of lysosomes and endosomes. Among the overexpressed virulence genes from Salmonella we found potential effectors responsible of these dysregulations, such as spiC, sopD2, sifA or pipB2, all of them involved in intracellular replication. Our results suggest that Salmonella induces (through overexpression of virulence factors) transcriptional and phosphorylation changes that increases neutrophil survival and shuts down immune response to minimize host response, and impairing intracellular vesicle transport likely to keep nutrients for replication and Salmonella-containing vacuole formation and maintenance.


Asunto(s)
Infecciones por Salmonella , Salmonella typhimurium , Animales , Neutrófilos/metabolismo , Fosforilación , Complejo de la Endopetidasa Proteasomal/metabolismo , Inmunidad , Proteínas Bacterianas/genética , Proteínas Bacterianas/metabolismo
6.
PLoS One ; 17(9): e0273750, 2022.
Artículo en Inglés | MEDLINE | ID: mdl-36099258

RESUMEN

Leopardus tigrinus is among the least known carnivore species in the Neotropics, including considerable taxonomic uncertainty. Here we model the distribution, connectivity and overlap with existing conservation areas for the species in Colombia. Using a Species Distribution Modeling approach, we estimated current potential range of the species in Colombia and identified potential habitat blocks remaining in the country. In addition, we designed a connectivity network across the available cores, using a circuit theory approach, to evaluate habitat linkage. Finally, we defined a prioritization scheme for the remaining habitat cores and assessed the level of coverage of protected areas for the country. L. tigrinus is potentially present across the three Andean branches of Colombia, with still considerable continuous habitat cores, mostly located on the eastern and central Andean ranges. Most habitat cores are theoretically connected, but nearly 15% are isolated. Priority areas were located across the eastern and central ranges, but with very significant and promising cores in the northern eastern and western ranges. Current level of protection indicates nearly 30% of the range is "protected", but only about 25% is under national strict protected areas. Evolution of this coverage showed some periods of significant increase but interestingly the number of cores grew at a faster rate than overall proportion protected, likely indicating numerous discontinuous fragments, and not contiguous functional landscapes. This represents the most updated assessment of the distribution and conservation status for the species in Colombia, and indicates the numerous conservation opportunities, especially in most populated areas of the country. We found unique business environmental passive's opportunities, including compensation and development potential, which are becoming more available in the country.


Asunto(s)
Carnívoros , Tigres , Animales , Colombia , Conservación de los Recursos Naturales , Ecosistema
7.
Pharmaceuticals (Basel) ; 15(6)2022 Jun 14.
Artículo en Inglés | MEDLINE | ID: mdl-35745667

RESUMEN

New RNA-binding small-molecule scaffolds are needed to unleash the pharmacological potential of RNA targets. Here we have applied a pharmacophore-based virtual screening approach, seldom used in the RNA recognition field, to identify novel conformational inhibitors of the hepatitis C virus internal ribosome entry site. The conformational effect of the screening hits was assessed with a fluorescence resonance energy transfer assay, and the affinity, specificity, and binding site of the ligands were determined using a combination of fluorescence intensity and NMR spectroscopy experiments. The results indicate that this strategy can be successfully applied to discover RNA conformational inhibitors bearing substantially less positive charge than the reference ligands. This methodology can potentially be accommodated to other RNA motifs of pharmacological interest, facilitating the discovery of novel RNA-targeted molecules.

8.
J Clin Med ; 11(12)2022 Jun 11.
Artículo en Inglés | MEDLINE | ID: mdl-35743428

RESUMEN

Anticholinergic burden (AB) is related to cognitive impairment (CI) and older complex chronic patients (OCCP) are more susceptible. Our objective was to evaluate the predictive value of ten anticholinergic scales to predict a potential CI due to anticholinergic pharmacotherapy in OCCP. An eight-month longitudinal multicentre study was carried out in a cohort of OCCP, in treatment with at least one anticholinergic drug and whose cognition status had been evaluated by Pfeiffer test twice for a period of 6-15 months. CI was considered when the Pfeiffer test increased 2 or more points. AB was detected using ten scales included on the Anticholinergic Burden Calculator. An ROC curve analysis was performed to assess the discriminative capacity of the scales to predict a potential CI and the cut-off point of AB that obtains better validity indicators. 415 patients were included (60.2% female, median age of 85 years (IQR = 11)). 190 patients (45.8%) manifested CI. Only the DBI (Drug Burden Index) showed statistically significant differences in the median AB between patients without CI and with CI (0.5 (1.00) vs. 0.67 (0.65), p = 0.006). At the ROC curve analysis, statistically significant values were obtained only with the DBI (AUC: 0.578 (0.523-0.633), p = 0.006). The cut-off point with the greatest validity selected for the DBI was an AB of 0.41 (moderate risk) (sensitivity = 81%, specificity = 36%, PPV = 51%). The DBI is the scale with the greatest discriminatory power to detect OCCP at risk of CI and the best cut-off point is a load value of 0.41.

9.
Plants (Basel) ; 11(10)2022 May 15.
Artículo en Inglés | MEDLINE | ID: mdl-35631738

RESUMEN

Cabo Verde's biodiversity is threatened by activities that meet human needs. To counteract this, an integration of scientific and indigenous knowledge is required, but no comprehensive list of the useful local plants is available. Thus, in this work, we assess (1) their diversity and phytogeography; (2) the role of geophysical, historical, and socio-economic factors on species distribution and uses; and (3) potentially relevant species for sustainable development. Data were obtained from flora, scientific publications, historical documents, herbarium specimens and field work. Many species were introduced since the 15th century to support settlement and commercial interests. We identified 518 useful taxa, of which 145 are native, 38 endemic and 44 endangered. The number of useful taxa is correlated with altitude and agricultural area, as well as with rural population indicators, but not with total population or socio-economic indicators such as gross domestic product. Native taxa are mostly used for fuelwood, forage and utilitarian purposes. Agrobiodiversity and traditional practices seem crucial to cope with recurrent droughts and ensure food security. Most of the introduced species do not present conservation problems, contrasting with the overuse of some native taxa. The safeguarding of native populations will ensure the sustainable exploitation of these resources and benefit the local economy.

10.
J Med Syst ; 46(4): 18, 2022 Feb 28.
Artículo en Inglés | MEDLINE | ID: mdl-35226192

RESUMEN

We describe the technological development of a web platform named CHRONIC-PHARMA that integrates three prescription support tools for patients with chronic diseases: Anticholinergic Burden Calculator (ABC), LESS-CHRON criteria and TRIGGER-CHRON. They focus on the optimization and evaluation of pharmacotherapy in patients with chronic diseases, resulting in a useful, single platform that can facilitate the review of pharmacotherapy and improve the safety of chronically ill patients. This is achieved by estimating and reducing the anticholinergic risk (ABC), detecting opportunities for deprescribing drugs and monitoring its success (LESS-CHRON criteria), as well as calculating the risk of adverse drug events (TRIGGER-CHRON). The platform is freely accessible online ( https://chronic-pharma.com/ ) as well as through a mobile application, and therefore easily accessible among the healthcare community.


Asunto(s)
Efectos Colaterales y Reacciones Adversas Relacionados con Medicamentos , Enfermedad Crónica , Humanos
12.
J Patient Saf ; 18(4): e816-e821, 2022 06 01.
Artículo en Inglés | MEDLINE | ID: mdl-34693926

RESUMEN

OBJECTIVE: The aim of the study was to evaluate the concordance among 10 anticholinergic scales for the measurement of anticholinergic drug exposure in at-risk elderly complex chronic patients in primary care. METHODS: An 8-month cross-sectional, multicenter study was carried out in a cohort of complex chronic patients older than 65 years in treatment with at least 1 drug with anticholinergic activity. Demographic, pharmacological, and clinical data were collected. Anticholinergic burden and risk were detected using the 10 scales included on the anticholinergic burden calculator (http://www.anticholinergicscales.es/). We used κ statistics to evaluated the concordance 2 to 2 (according to risk: high, medium, low or without risk) among the included scales. RESULTS: Four hundred seventy-three patients were recruited (60.3% female, median age of 84 years [interquartile range = 10]). Eighty was the total number of anticholinergic drugs with any scale (1197 prescriptions), with a median of 2 drugs with anticholinergic activity per patient (interquartile range = 2). The κ statistics comparing all the 10 scales ranged from -0.175 (Drug Burden Index versus Chew Scale) to 0.708 (Anticholinergic Activity Scale [AAS] versus Chew Scale). The best concordance was obtained between AAS and Chew Scale (κ = 0.708), followed by Clinician-Rated Anticholinergic Scale and Duran Scale (κ = 0.632) and AAS and Anticholinergic Cognitive Burden Scale (κ = 0.618), being considered substantial strengths of concordance. CONCLUSIONS: The agreement among the 10 scales in elderly patients with complex chronic conditions was highly variable. Great care should be taken when assessing anticholinergic drug exposure using existing scales because of the wide variability among them. The only scales that showed agreement were the AAS-Chew, Clinician-Rated Anticholinergic Scale-Duran, and AAS-Anticholinergic Cognitive Burden Scale pairs. In the rest of the cases, the scales are not interchangeable.


Asunto(s)
Antagonistas Colinérgicos , Anciano , Anciano de 80 o más Años , Antagonistas Colinérgicos/efectos adversos , Estudios de Cohortes , Estudios Transversales , Femenino , Humanos , Masculino , Factores de Riesgo
13.
Eur J Ophthalmol ; 32(3): 1671-1679, 2022 May.
Artículo en Inglés | MEDLINE | ID: mdl-34254547

RESUMEN

INTRODUCTION: The aim of this study was to describe functional and anatomical changes (best-corrected visual acuity [BCVA], central macular thickness [CMT], and central macular volume [CMV]) in patients with macular edema (ME) secondary to retinal vein occlusion (RVO) treated with intravitreal dexamethasone implant (IDI) and identify its clinical predictors in a real-world setting. METHODS: Data from 111 patients who underwent IDI to treat RVO-associated ME were retrospectively reviewed. Demographic, preoperative, and postoperative variables were assessed using a logistic regression analysis to determine predictors of visual and anatomical improvement. RESULTS: Mean BCVA, CMT, and CMV improved from baseline after IDI (p < 0.001). The strongest predictors of different treatment outcomes were: a baseline BCVA ⩽60 ETDRS letters (OR = 50.600; p < 0.001) and first IDI injection (OR = 2.988; p < 0.001) for BCVA gain ⩾15 Early Treatment Diabetic Retinopathy Study (ETDRS) letters; a baseline BCVA ⩽60 ETDRS letters (OR = 7.893; p = 0.002) and non-chronic ME (OR = 3.875; p = 0.019) for BCVA ⩾80 ETDRS letters achievement; a baseline CMT ⩾400 µm (OR = 49.083; p < 0.001) and a baseline CMV ⩾12 mm3 (OR = 4.235; p < 0.001) for CMT reduction ⩾50%; and a baseline CMT ⩾400 µm (OR = 11.471; p < 0.001) and a baseline CMV ⩾12 mm3 (OR = 10.284; p < 0.001) for CMV reduction ⩾15%. CONCLUSION: This study confirmed the effectiveness of IDI to treat ME secondary to RVO and identified new predictive factors for two visual (⩾15 ETDRS letters gain and BCVA ⩾80 ETDRS letters) and two anatomical outcomes (>50% CMT and >15% CMV reduction).


Asunto(s)
Infecciones por Citomegalovirus , Retinopatía Diabética , Edema Macular , Oclusión de la Vena Retiniana , Infecciones por Citomegalovirus/complicaciones , Infecciones por Citomegalovirus/tratamiento farmacológico , Dexametasona , Retinopatía Diabética/tratamiento farmacológico , Implantes de Medicamentos/uso terapéutico , Glucocorticoides , Humanos , Inyecciones Intravítreas , Edema Macular/diagnóstico , Edema Macular/tratamiento farmacológico , Edema Macular/etiología , Pronóstico , Oclusión de la Vena Retiniana/complicaciones , Oclusión de la Vena Retiniana/diagnóstico , Oclusión de la Vena Retiniana/tratamiento farmacológico , Estudios Retrospectivos , Resultado del Tratamiento , Agudeza Visual
14.
Sci Adv ; 7(33)2021 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-34389532

RESUMEN

Fire plays a dominant role in deforestation, particularly in the tropics, but the relative extent of transformations and influence of fire frequency on eventual forest loss remain unclear. Here, we analyze the frequency of fire and its influence on postfire forest trajectories between 2001 and 2018. We account for ~1.1% of Latin American forests burnt in 2002-2003 (8,465,850 ha). Although 40.1% of forests (3,393,250 ha) burned only once, by 2018, ~48% of the evergreen forests converted to other, primarily grass-dominated uses. While greater fire frequency yielded more transformation, our results reveal the staggering impact of even a single fire. Increasing fire frequency imposes greater risks of irreversible forest loss, transforming forests into ecosystems increasingly vulnerable to degradation. Reversing this trend is indispensable to both mitigate and adapt to climate change globally. As climate change transforms fire regimes across the region, key actions are needed to conserve Latin American forests.

15.
Curr Pharm Des ; 27(40): 4186-4194, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-34463225

RESUMEN

BACKGROUND: Elderly patients with multiple chronic conditions are closely linked to polymedication, a condition that is also highly associated with the presence of adverse effects, such as those observed by anticholinergic activity. Anticholinergic burden is defined in a very variable way and is described inconsistently using different scores and providing different interpretations of the risk of suffering from anticholinergic adverse effects. OBJECTIVE: The objective is to analyse the anticholinergic risk exposure in elderly complex chronic patients. METHODS: A observational multicentre study was performed for a cohort of complex chronic patients over 65 years who received treatment with at least one drug with anticholinergic activity. Anticholinergic exposure was assessed using ten scales included in the Anticholinergic Burden Calculator. RESULTS: 473 patients were recruited, being 67.7% with excessive polypharmacy. 80 was the total number of anticholinergic drugs with any scale, with a median of 2 drugs with anticholinergic activity per patient (IQR=2). Three scales evaluated more than 70% of the patients (Chew: 79.1%; Drug Burden Index (DBI): 77.8%; Anticholinergic Cognitive Burden (ACB): 75.9%). The percentage of different drugs with anticholinergic properties evaluated ranged from 13.8% (Anticholinergic Burden Classification (ABC)) to 57.5% (DBI) and anticholinergic drugs prescriptions oscillated from 14% (Anticholinergic Risk Scale (ARS)) to 53.3% (DBI). 71.1% of patients were at risk (moderate and high risk) according to DBI vs. 9.7% by ARS at the opposite side. Important differences of anticholinergic risk in patients with excessive polypharmacy were in ACB, ABC and DBI scales. CONCLUSION: This study has highlighted clear differences between the scales used. DBI seems to be the scale that identifies a higher number of elderly chronic complex patients at risk of developing anticholinergic adverse effects.


Asunto(s)
Antagonistas Colinérgicos , Efectos Colaterales y Reacciones Adversas Relacionados con Medicamentos , Anciano , Antagonistas Colinérgicos/efectos adversos , Estudios de Cohortes , Estudios Transversales , Humanos , Polifarmacia
17.
Front Psychol ; 11: 612465, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-33329286

RESUMEN

In recent decades, the expansion of economic activity has been accompanied by negative environmental impacts. In response, there have been dramatic changes worldwide in terms of an increased demand for environmentally friendly products and services. To achieve these eco-innovations, firms have sought to acquire knowledge and implement operational flexibility by cooperating with different agents such as universities through a value cocreation system that is also expected to enhance firms' performance. Using a sample of 250 companies, the present paper examines the role of cooperation with universities in the development of diverse environmental innovations and building operational flexibility and, through this, improving firm performance. Results show that firms that value cooperation with universities develop a wider range of environmental innovations and increase their sales and benefits.

18.
Artículo en Inglés | MEDLINE | ID: mdl-32290051

RESUMEN

Although eco-innovation in the agri-food sector is receiving increasing amounts of attention, there is a lack of information about the specific conditions that encourage firms to develop eco-innovation strategies internally. Our empirical method relies on the data of Spanish firms operating in the agri-food sector, and uses the Qualitative Comparative Analysis (QCA). Specifically, we identify the recipes of antecedent conditions that effectively foster the internal development of technological eco-innovation, and then we analyze whether differences exist in the internal development of product and process eco-innovations. The results show that different combinations of conditions can yield internally developed eco-innovation, but all of them indicate that cooperation with stakeholders is the key to fostering technological eco-innovation in this industry. This conclusion encourages the creation of policies and incentives to promote cooperation in order to improve the sustainability of the sector.


Asunto(s)
Conducta Cooperativa , Industria de Alimentos , Invenciones , Difusión de Innovaciones , Alimentos , Humanos
19.
Sci Rep ; 10(1): 7190, 2020 04 28.
Artículo en Inglés | MEDLINE | ID: mdl-32346097

RESUMEN

Small synthetic molecules mimicking the three-dimensional structure of α-helices may find applications as inhibitors of therapeutically relevant protein-protein and protein-nucleic acid interactions. However, the design and use of multi-facial helix mimetics remains in its infancy. Here we describe the synthesis and application of novel bilaterally substituted p-terphenyl compounds containing positively-charged aminoalkyl groups in relative 1,4 positions across the aromatic scaffold. These compounds were specifically designed to mimic all faces of the arginine-rich α-helix of the HIV-1 protein Rev, which forms deeply embedded RNA complexes and plays key roles in the virus replication cycle. Two of these molecules recognized the Rev site in the viral RNA and inhibited the formation of the RRE-Rev ribonucleoprotein complex, a currently unexploited target in HIV chemotherapy. Cellular assays revealed that the most active compounds blocked HIV-1 replication with little toxicity, and likely exerted this effect through a multi-target mechanism involving inhibition of viral LTR promoter-dependent transcription and Rev function. Further development of this scaffold may open new avenues for targeting nucleic acids and may complement current HIV therapies, none of which involve inhibitors interfering with the gene regulation processes of the virus.


Asunto(s)
Fármacos Anti-VIH/química , VIH-1/química , Conformación de Ácido Nucleico , ARN Viral/química , Compuestos de Terfenilo/química , Productos del Gen rev del Virus de la Inmunodeficiencia Humana/química , Línea Celular , Humanos , Conformación Proteica en Hélice alfa
20.
Artículo en Español | LILACS | ID: biblio-1145431

RESUMEN

Justificación: Las fallas en la responsabilidad profesional médica representan un problema de interés por el impacto que tienen en la salud de los pacientes y de los médicos. Objetivo: Evaluar cuál es el nivel de conocimientos de los profesionales de la medicina hondureños sobre aspectos relevantes de la responsabilidad profesional o mala praxis médica. Metodología:Se realizó un estudio transversal descriptivo; la recolección de datosse hizo mediante un instrumento tipo encuesta electrónica con formato de Google®, la cual se validó con un grupo de expertos y cubrió, variables sociodemográficas; de los encuestados, así como cinco ámbitos de conocimiento definidos como: el ámbito legal,el conceptual, el de derechos de los pacientes, el de deberes del médico y el de condicionantes para la denuncia. La población encuestada: estudiantes de medicina con seis o más años cursados de la carrera, indistintamente de la universidad donde estudiaron; médicos residentes y profesionales, ya sea médicos generales o especialistas, todos hondureños. El análisis de los datos se realizó utilizando Excel® 2010, y el Programa R, versión 3.6. Para mejor comprensión de los resultados se construyó una escala descriptiva de acuerdo a los porcentajes de acierto obtenidos. De 0-39% "deficiente", de 40-59% "insuficiente", de 60 a 80% "aceptable", 81-90% "adecuado", de 91% en adelante se clasificócomo "conoce el tema". Resultados: El nivel de conocimiento de los médicos, indistintamente de su formación académica, edad, sexoocentro donde labora, se ubicó en un nivel entre insuficiente y aceptable,siendo el ámbito donde se observó el menor puntaje, con 51,2% de aciertos. Conclusiones: Las fallas en la responsabilidad profesional podrían estar estrechamente ligadas al déficit de competencias y habilidades adecuadas de estudiantes y médicos durante el acto médico...(AU)


Asunto(s)
Humanos , Responsabilidad Legal , Ética Médica , Educación Profesional/ética , Mala Praxis
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