Mobile Data Gathering and Preliminary Analysis for the Functional Reach Test.

The functional reach test (FRT) is a clinical tool used to evaluate dynamic balance and fall risk in older adults and those with certain neurological diseases. It provides crucial information for developing rehabilitation programs to improve balance and reduce fall risk. This paper aims to describe a new tool to gather and analyze the data from inertial sensors to allow automation and increased reliability in the future by removing practitioner bias and facilitating the FRT procedure. A new tool for gathering and analyzing data from inertial sensors has been developed to remove practitioner bias and streamline the FRT procedure. The study involved 54 senior citizens using smartphones with sensors to execute FRT. The methods included using a mobile app to gather data, using sensor-fusion algorithms like the Madgwick algorithm to estimate orientation, and attempting to estimate location by twice integrating accelerometer data. However, accurate position estimation was difficult, highlighting the need for more research and development. The study highlights the benefits and drawbacks of automated balance assessment testing with mobile device sensors, highlighting the potential of technology to enhance conventional health evaluations.

Sensor-based systems for the measurement of Functional Reach Test results: a systematic review.

The measurement of Functional Reach Test (FRT) is a widely used assessment tool in various fields, including physical therapy, rehabilitation, and geriatrics. This test evaluates a person's balance, mobility, and functional ability to reach forward while maintaining stability. Recently, there has been a growing interest in utilizing sensor-based systems to objectively and accurately measure FRT results. This systematic review was performed in various scientific databases or publishers, including PubMed Central, IEEE Explore, Elsevier, Springer, the Multidisciplinary Digital Publishing Institute (MDPI), and the Association for Computing Machinery (ACM), and considered studies published between January 2017 and October 2022, related to methods for the automation of the measurement of the Functional Reach Test variables and results with sensors. Camera-based devices and motion-based sensors are used for Functional Reach Tests, with statistical models extracting meaningful information. Sensor-based systems offer several advantages over traditional manual measurement techniques, as they can provide objective and precise measurements of the reach distance, quantify postural sway, and capture additional parameters related to the movement.

Enzymes Involved in Antioxidant and Detoxification Processes Present Changes in the Expression Levels of Their Coding Genes under the Stress Caused by the Presence of Antimony in Tomato.

Currently, there is an increasing presence of heavy metals and metalloids in soils and water due to anthropogenic activities. However, the biggest problem caused by this increase is the difficulty in recycling these elements and their high permanence in soils. There are plants with great capacity to assimilate these elements or make them less accessible to other organisms. We analyzed the behavior of Solanum lycopersicum L., a crop with great agronomic interest, under the stress caused by antimony (Sb). We evaluated the antioxidant response throughout different exposure times to the metalloid. Our results showed that the enzymes involved in the AsA-GSH cycle show changes in their expression level under the stress caused by Sb but could not find a relationship between the NITROSOGLUTATHIONE REDUCTASE (GSNOR) expression data and nitric oxide (NO) content in tomato roots exposed to Sb. We hypothesize that a better understanding of how these enzymes work could be key to develop more tolerant varieties to this kind of abiotic stress and could explain a greater or lesser phytoremediation capacity. Moreover, we deepened our knowledge about Glutathione S-transferase (GST) and Glutathione Reductase (GR) due to their involvement in the elimination of the xenobiotic component.

Ocular hypertension after EyeCee One preload lens implantation: a retrospective cohort study.

Objective: In 2022, several cases of ocular hypertension (OHT) related to EyeCee One preloaded IOLs were reported. The aim of this study was to determine the presurgical and surgical variables associated with this response. Methods and analysis: An analysis was conducted on patients who underwent isolated cataract surgery between September 2022 and December 2022 at the Hospital Universitario del Henares. The influence of potential factors was studied using the Kruskal-Wallis test and multiple regression analysis. Results: A total of 353 cataract surgeries were included in the study. No significant differences between the different IOLs were found related to a change in the IOP on the first postoperative day (p = 0.395), but the change in the IOP after 1 month was higher in the EyeCee One group (p = 0.016). Approximately 6.1% of the patients who received EyeCee One had an IOP increase greater than 10 mmHg, compared to only 0.8% of the patients who received other IOLs. The odds ratio (OR) of experiencing an IOP increase greater than 10 mmHg in the EyeCee One group at the 1-month visit was 7.99 (1.52-41.99). The multiple regression analysis showed that receiving the EyeCee One lens was associated with a 2-mmHg increase in IOP. A previous history of glaucoma or OHT was not associated with greater IOP. Two patients in the EyeCee One group developed severe visual loss. Conclusion: Patients who received the EyeCee One IOL experienced significant increases in IOP at the 1-month visit. A small number of patients might suffer visual loss secondary to the rise in IOP.

Middle Meningeal Artery Embolization versus Surgery in Patients with Chronic Subdural Hematoma-No More Fence Sitting?

BACKGROUND: Endovascular treatment of patients with chronic subdural hematoma using middle meningeal artery (MMA) embolization could become an alternative to surgical hematoma evacuation. The aim of the study was to compare methods and identify parameters to help determine the correct treatment modality. METHODS: We retrospectively reviewed 142 cases conducted internally; 78 were treated surgically and 64 were treated using MMA embolization. We analyzed the treatment failure rate and complications, and using a binary logistic regression model, we identified treatment failure risk factors. RESULTS: We found a comparable treatment failure rate of 23.1% for the surgery group and 21.9% for the MMA embolization group. However, in the MMA embolization group, 11 cases showed treatment failure due to early neurological worsening with a need for concomitant surgery. We also found a recurrence of hematoma in 15.4% of cases in the surgery group and 6.3% of cases in the MMA embolization group. CONCLUSION: Both modalities have their advantages; however, correct identification is crucial for treatment success. According to our findings, hematomas with a maximal width of <18 mm, a midline shift of <5 mm, and no acute or subacute (hyperdense) hematoma could be treated with MMA embolization. Hematomas with a maximal width of >18 mm, a midline shift of >5 mm, and no membranous segmentation could have better outcomes after surgical treatment.

Subjective behavioral measures in myopic and pre-myopic children before and after the COVID lockdown.

Background: There are environmental factors that may contribute to the onset of myopia. This study aims to evaluate the children's lifestyle changes before and after the COVID-19 lockdown and how they can influence their vision. Methods: The same questionnaire was administered to children aged between 5 and 7 in Spain every year in September before (2017-2019) and after the COVID-19 lockdown (2020-2021). All the children also passed a vision exam consisting of the measurement of visual acuity (VA) and determination of objective and subjective refraction. Children were classified as myopes, pre-myopes, or hyperopes. The cut-off points to define the refractive error were established according to the value of the spherical equivalent (SE): hyperopia (SE > +0,75D), myopia (SE ≤ -0,5D), or pre-myopia (-0.5D < SE ≥ +0.75D). Data analysis is performed with the SPSS 27.0 software (SPSS Inc., Chicago, Illinois). Results: In the pre-COVID period, the pre-myopes were the ones who spent the longest time outdoors, and after the COVID lockdown, there were no differences between groups. There neither were any differences in the time spent doing near-work activities between the groups in both periods (p > 0.05). Regarding the spherical equivalent, in the pre-COVID period, the mean value was 0.75 ± 2.09D and after the COVID lockdown, it was 0.47 ± 1.88D (p < 0.001). Conclusion: Pre-myopes spent more time outdoors than myopes in the pre-COVID period, while myopes spent more time using digital devices. All these differences do not exist after the COVID lockdown, with a general increase in the time spent outdoors and a decrease in the use of digital devices. Further studies are needed to know if these lifestyle changes remain and how they influence the onset of myopia.

Equity throughout the life course and the evolving role of the Pan American Health Organization

[ABSTRACT]. The objective of this article is to summarize the evolution of the regional commitments of the Pan Ameri- can Health Organization (PAHO) on health promotion and strategies to improve the health and well-being of women, children, adolescents, and older persons. PAHO regional strategies approved by Member States in the last 20 years are used as the main source of information. The article presents the challenges of making health promotion a public health strategy widely applied in the Region of the Americas and the efforts to renew Member States’ collective actions. The article also describes current PAHO efforts to include the positive aspects of health (i.e., well-being, optimal development, and functional ability) and the life course approach as opportunities to advance equity. The article reflects on immunization as a public good and the urgency to address the current challenges as a core element of the regional efforts to transform health systems after more than two years of the COVID-19 pandemic.

[RESUMEN]. El objetivo de este artículo es resumir la evolución de los compromisos regionales de la Organización Pan- americana de la Salud (OPS) en materia de promoción de la salud y estrategias para mejorar la salud y el bienestar de mujeres, niños y niñas, adolescentes y personas mayores. Se han empleado como principal fuente de información las estrategias regionales de la OPS aprobadas por los Estados Miembros en los últi- mos 20 años. En el artículo se presentan los desafíos de convertir la promoción de la salud en una estrategia de salud pública de amplia ejecución en la Región de las Américas y los esfuerzos para renovar las medidas colectivas de los Estados Miembros. Asimismo, se describe la labor actual de la OPS para incluir los aspectos positivos de la salud (como el bienestar, el desarrollo óptimo y la capacidad funcional) y el enfoque del curso de vida como oportunidades para fomentar la equidad. Finalmente, se reflexiona sobre la inmunización como bien público y la urgencia de abordar los desafíos actuales como elemento central de los esfuerzos regio- nales para transformar los sistemas de salud tras más de dos años de pandemia de COVID-19.

[RESUMO]. O objetivo deste artigo é resumir a evolução dos compromissos regionais da Organização Pan-Americana da Saúde (OPAS) relativos à promoção da saúde e estratégias para melhorar a saúde e o bem-estar de mulheres, crianças, adolescentes e pessoas idosas. As estratégias regionais da OPAS aprovadas pelos Estados Membros nos últimos 20 anos são a principal fonte de informação. O artigo apresenta os desafios enfrentados para fazer da promoção da saúde uma estratégia de saúde pública amplamente aplicada na Região das Américas e os esforços para renovar as ações coletivas dos Estados Membros. O artigo também descreve os atuais esforços da OPAS para incluir os aspectos positivos da saúde (isto é, bem-estar, desenvolvimento ideal e habilidade funcional) e a abordagem de curso da vida como oportunidades para promover a equidade. O artigo faz reflexões sobre a imunização como um bem público e a urgência de abordar os desafios atuais como um elemento central dos esforços regionais para transformar os sistemas de saúde após mais de dois anos da pandemia de COVID-19.

Equity throughout the life course and the evolving role of the Pan American Health Organization / Equidad a lo largo del curso de vida y la evolución del papel de la Organización Panamericana de la Salud / Equidade ao longo da vida e a evolução do papel da Organização Pan-Americana da Saúde

ABSTRACT The objective of this article is to summarize the evolution of the regional commitments of the Pan American Health Organization (PAHO) on health promotion and strategies to improve the health and well-being of women, children, adolescents, and older persons. PAHO regional strategies approved by Member States in the last 20 years are used as the main source of information. The article presents the challenges of making health promotion a public health strategy widely applied in the Region of the Americas and the efforts to renew Member States' collective actions. The article also describes current PAHO efforts to include the positive aspects of health (i.e., well-being, optimal development, and functional ability) and the life course approach as opportunities to advance equity. The article reflects on immunization as a public good and the urgency to address the current challenges as a core element of the regional efforts to transform health systems after more than two years of the COVID-19 pandemic.

RESUMEN El objetivo de este artículo es resumir la evolución de los compromisos regionales de la Organización Panamericana de la Salud (OPS) en materia de promoción de la salud y estrategias para mejorar la salud y el bienestar de mujeres, niños y niñas, adolescentes y personas mayores. Se han empleado como principal fuente de información las estrategias regionales de la OPS aprobadas por los Estados Miembros en los últimos 20 años. En el artículo se presentan los desafíos de convertir la promoción de la salud en una estrategia de salud pública de amplia ejecución en la Región de las Américas y los esfuerzos para renovar las medidas colectivas de los Estados Miembros. Asimismo, se describe la labor actual de la OPS para incluir los aspectos positivos de la salud (como el bienestar, el desarrollo óptimo y la capacidad funcional) y el enfoque del curso de vida como oportunidades para fomentar la equidad. Finalmente, se reflexiona sobre la inmunización como bien público y la urgencia de abordar los desafíos actuales como elemento central de los esfuerzos regionales para transformar los sistemas de salud tras más de dos años de pandemia de COVID-19.

RESUMO O objetivo deste artigo é resumir a evolução dos compromissos regionais da Organização Pan-Americana da Saúde (OPAS) relativos à promoção da saúde e estratégias para melhorar a saúde e o bem-estar de mulheres, crianças, adolescentes e pessoas idosas. As estratégias regionais da OPAS aprovadas pelos Estados Membros nos últimos 20 anos são a principal fonte de informação. O artigo apresenta os desafios enfrentados para fazer da promoção da saúde uma estratégia de saúde pública amplamente aplicada na Região das Américas e os esforços para renovar as ações coletivas dos Estados Membros. O artigo também descreve os atuais esforços da OPAS para incluir os aspectos positivos da saúde (isto é, bem-estar, desenvolvimento ideal e habilidade funcional) e a abordagem de curso da vida como oportunidades para promover a equidade. O artigo faz reflexões sobre a imunização como um bem público e a urgência de abordar os desafios atuais como um elemento central dos esforços regionais para transformar os sistemas de saúde após mais de dois anos da pandemia de COVID-19.

More than meets no eyes: taxonomic status of a Liotyphlops (Serpentes: Anomalepididae) blindsnake from the atlantic rainforest

Liotyphlops Peters, 1881 is an anomalepidid blindsnake genus that encompasses 12 species, widely distributed in Central and South America. In this study, we evaluate the taxonomic status of Liotyphlops sousai Santos & Reis, 2018, a species described based on a single specimen from the Atlantic Rainforest of southern Brazil, and after analyzing evidences based upon molecular systematics, external morphology and osteology, we propose its synonymy with Liotyphlops beui (Amaral, 1924), a common and widely distributed Anomalepidid species. We also provide comments and recommendations on the taxonomy of Liotyphlops, assessing the risks associated with describing a new species based on small type series.

Predicting factors for progression of the myopia in the MiSight assessment study Spain (MASS)

Purpose: To investigate which baseline factors are predictive for success in controlling myopia progression in a group of children wearing MiSight Contact Lens (CLs).Methods: Myopic patients (n=41) fitted with MiSight CLs and followed up two years were included in this study. Bivariate analysis, a logistic regression analysis (LG) and a decision tree (DT) approach were used to screen for the factors influencing the success of the treatment. To assess the response, axial length (AL) changes were considered as main variable. Patients were classified based on a specific range of change of axial length at the end of each year of treatment as “responders” (R) (AL change <0.11mm/per year) and “non-responders” (NR) (AL change ≥0.11mm/per year).Results: Of a total of forty-one Caucasian patients treated with MiSight CLs, 21 and 16 were considered responders in the first and the second year of follow-up, respectively. LG analysis showed that the only factor associated with smaller axial length growth was more time spent outdoors (p=0.0079) in the first year of treatment. The decision tree analysis showed that in the responding group spending more than 3 and 4h outdoors per week was associated with the best response in the first year and in the second year of treatment respectively.Conclusions: The LR and the DT approach of this pilot study identifies time spent outdoors as a main factor in controlling axial eye growth in children treated with MiSight CLs. (AU)

Prevalencia por áreas sanitarias de enfermedad renal crónica en la población diabética de Extremadura durante los años 2012, 2013 y 2014. Un estudio observacional / Prevalence by health areas of chronic kidney disease in diabetic population of Extremadura during the years 2012, 2013 and 2014. An observational study

Antecedentes y objetivo: La diabetes mellitus es la principal causa de enfermedad renal crónica (ERC) en nuestro país. El objetivo fue estimar la prevalencia global y por áreas sanitarias de ERC en la población diabética de Extremadura. Pacientes y métodos: Estudio observacional, longitudinal, retrospectivo en la población diabética atendida en el Sistema Extremeño de Salud durante el periodo 2012-2014. Se incluyeron 90.709 pacientes ≥ 18 años. El cálculo del filtrado glomerular estimado (FGe) se realizó mediante la ecuación CKD-EPI (derivada de la ecuación desarrollada por la Chronic Kidney Disease Epidemiology Collaboration) y se calculó el cociente albúmina/creatinina en orina (CAC). Se consideró paciente con ERC a todo aquel que en su última analítica tenía un FGe<60 mL/min/1,73 m2 y/o un CAC ≥ 30 mg/g, confirmados en una determinación previa separada al menos por tres meses. Resultados: La prevalencia global de ERC fue del 15,6% (17,5% en mujeres y 13,7% en varones) y fue mayor en la provincia de Cáceres (17%) que en la de Badajoz (14,8%, p<0,001), encontrándose la menor prevalencia en el área sanitaria de Navalmoral de la Mata (13%) y la mayor en la de Plasencia (17,8%, p < 0,001). La prevalencia de ERC definida sin necesidad de confirmación de la sostenibilidad del daño renal o del FGe disminuido fue del 26,1% (29,3% en mujeres y 22,9% en varones), lo que supone una sobreestimación de la prevalencia del 67%. Conclusiones: La prevalencia de ERC en población diabética extremeña es menor a la referida habitualmente y difiere significativamente entre sus áreas sanitarias. (AU)

Background and objective: Diabetes mellitus is the leading cause of chronic kidney disease (CKD) in our country. The objective was to estimate the global prevalence and by health areas of CKD in the diabetic population of Extremadura. Patients and methods: Observational, longitudinal retrospective study in the diabetic population attended in the Extremadura Health System in 2012–2014. A total of 90,709 patients ≥ 18 years old were studied. The estimated glomerular filtration rate (eGFR) was calculated using the Chronic Kidney Disease Epidemiology Collaboration equation (CKD-EPI). The presence of CKD was defined as follows: an eGFR<60 mL/min/1.73 m2 in a time period of greater than three months or the presence of renal damage, as evaluated by an urine albumin-creatinine ratio (UACR) ≥ 30 mg/g, with or without reduced eGFR, also in a time period of greater than three months. Results: The overall prevalence of CKD was 15.6% (17.5% in women and 13.7% in men) and it was higher in the province of Cáceres (17%) than in Badajoz (14.8%, p<0.001), with the lowest prevalence in the Navalmoral de la Mata health area (13%) and the highest in Plasencia (17.8%, p<0.001). The prevalence of CKD defined without the need for confirmation of the sustainability of kidney damage or decreased eGFR was 26.1% (29.3% in women and 22.9% in men), which represents an overestimation of the prevalence of 67%. Conclusions: The prevalence of CKD in Extremadura's diabetic population is lower than usually referred to and differs significantly between its health areas. (AU)

Speciation process on brazilian continental islands, with the description of a new insular lancehead of the genus Bothrops (Serpentes, Viperidae)

Brazilian continental islands represent a natural laboratory to study speciation driven by recent phenotypic and genotypic divergence. The Bothrops jararaca species group is distributed in the Brazilian Atlantic Forest and on most of the Brazilian continental islands. The group is currently composed of the mainland common lancehead (B. jararaca) and four insular species (B. alcatraz, B. insularis, B. otavioi, and B. sazimai). Here, we evaluate mitochondrial DNA and morphological diversity of the B. jararaca species group and aim to provide additional evidence to understand insularization processes on the Brazilian coast. Our results, interpreted together with a comprehensive review of geomorphological data, provide a new conceptual framework for understanding the colonization process of the Brazilian continental islands. This framework suggests a history of multiple rounds of periodic isolation and reconnection between insular populations and their mainland relatives throughout the last 420,000 years. Furthermore, although some insular populations may have speciated prior to the last glacial maximum, other species likely diverged within the last 11,000 years. Additionally, the repeated evolution of size and dietary shift in the B. jararaca species group suggests a remarkable case of convergent adaptation. Our study provides evidence that the Bothrops from Ilha da Moela (Brazilian state of São Paulo) represents an undescribed species, presenting a distinct phenotype, and an exclusive history of isolation and adaptation. We describe this unique lancehead as a new species and we suggest it should be listed as critically endangered based on its endemicity to a small island that is severely impacted by constant and longstanding human presence.

SARS-CoV-2 en aguas residuales y superficiales: ¿cómo lidiar con el problema? / Sars-cov-2 in wastewater and surface water: how to deal with the problem?

Introducción: hoy la humanidad sufre uno de los peores episodios debido a la pandemia causada por el SARS-CoV-2. Su alta infectividad, rápida propagación y persistencia en ciertas superficies dificultan el combate de este virus. Su presencia en aguas residuales y posible transmisión fecal-oral podría ser una nueva amenaza para la salud pública. Objetivo: alertar a la comunidad científica internacional y a los gobiernos sobre la presencia de SARS-CoV-2 en las aguas residuales y sobre qué hacer para evitar su propagación por este medio. Métodos: se realizó una revisión de artículos referenciados en SCOPUS y Web of Science desde el año 2019 relacionados con la presencia del virus en aguas residuales y superficiales. Resultados y discusión: es necesario establecer sistemas de monitoreo, utilizar métodos analíticos sensibles y rápidos para la detección del virus en las aguas residuales y superficiales. Asimismo, implantar protocolos de inactivación del virus en las unidades de salud y en las plantas de tratamiento de aguas. Se recomiendan procesos con oxidantes químicos, radiación ultravioleta, fotocatálisis, foto-Fenton, ozono o filtración por membrana. Además, se debe alertar a la población sobre la importancia del lavado y de la desinfección de productos agrícolas, así como del cuidado en su manejo por parte de los trabajadores agrícolas

Introduction: Today, humanity suffers one of the worst episodes due to a pandemic caused by the SARS-CoV-2. Its high infectivity and rapid spread combined with its persistence on certain surfaces difficult to fight this virus. Its presence in wastewater and possible fecal-oral transmission could be a new public health threat. Objective: To alert the international scientific community and governments about the presence of SARS-CoV-2 in wastewater, and what to do to prevent its spread by this means. Methods: A review of articles referenced in SCOPUS and Web of Science since 2019 related to the presence of the virus in wastewater and surface water was performed. Results and discussion: It is necessary to establish monitoring systems with the use of sensitive and rapid analytical methods for the on-site detection of viruses in wastewaters and surface waters. It should be established virus inactivation protocols at the health units, and water treatment plants, where are recommended processes with chemical oxidants, ultraviolet radiation, photocatalysis, photo-Fenton, ozone, or membrane filtration. It is necessary to alert the population about the importance of washing and disinfecting agricultural products, mainly vegetables and fruits, as well as the care in its handling by agricultural workers

Equipos de trauma: realidad mundial e implementación en un país en desarrollo. Descripción narrativa / Trauma teams: global reality and implementation in a developing country. Narrative description

Introducción. El trauma es una de las entidades con mayor morbimortalidad en el mundo. Los equipos especializados en la atención del paciente traumatizado son llamados «equipos de trauma¼. Dichos equipos surgieron de la necesidad de brindar tratamiento oportuno multidisciplinario a individuos con heridas que condicionan gran severidad en la guerra; sin embargo, con el paso del tiempo se trasladaron al ámbito civil, generando un impacto positivo en términos de tiempos de atención, mortalidad y morbilidad. El objetivo de este estudio fue describir el proceso de desarrollo de los equipos de trauma a nivel mundial y la experiencia en nuestra institución en el suroccidente colombiano. Métodos. Se realizó una búsqueda en la base de datos PUBMED, que incluyó revisiones sistemáticas, metaanálisis, revisiones de Cochrane, ensayos clínicos y series de casos. Resultados. Se incluyeron 41 estudios para esta revisión narrativa, y se observó que el tiempo de permanencia en Emergencias, el tiempo de traslado a cirugía, la mortalidad y las complicaciones asociadas al trauma fueron menores cuando se implementan equipos de trauma. Discusión. El diseño de un sistema de atención y valoración horizontal de un paciente con traumatismos severos produce un impacto positivo en términos de tiempos de atención, mortalidad y morbilidad. Se hace necesario establecer los parámetros operativos necesarios en las instituciones de salud de alta y mediana complejidad en nuestro país para implementar dichos equipos de trabajo

Introduction. Trauma is one of the entities with the highest morbidity and mortality in the world. Teams specialized in trauma patient care are called «trauma teams¼. These teams arose from the need to provide timely multidisciplinary treatment to individuals with severe injuries in war; however, with time they moved to the civilian arena, generating a positive impact in terms of care times, mortality and morbidity. The objective of this study was to describe the process of development of trauma teams worldwide and the experience in our institution in southwestern Colombia. Methods. A search of the PUBMED database was carried out, which included systematic reviews, metaanalyses, Cochrane reviews, clinical trials, and case series.Results. Forty-one studies were included for this narrative review, and it was observed that the length of stay in the ER, the time of transfer to surgery, mortality and complications associated with trauma were lower when trauma teams are implemented. Discussion. The design of a horizontal care and assessment system for a patient with severe trauma produces a positive impact in terms of care times, mortality and morbidity. It is necessary to establish operational parameters in high and medium complexity health institutions in our country to implement such work teams

Reassessment of Tantilla boipiranga (Serpentes: Colubrinae) and a preliminary approach to the phylogenetic affinities within Tantilla

Tantilla is one of the most diverse genera among colubrids, with 67 species arranged in six phenotypically recognized species groups. Tantilla boipiranga is the most recently described species within the T. melanocephala group, and it was described based on a small type series, collected in the rupestrian grasslands of south-eastern Brazil. The morphological diversity and the phylogenetic affinity of this species remain poorly known. Here, based on the assessment of recently collected specimens in combination with results of a molecular phylogenetic analysis, we evaluate the morphological variation within T. boipiranga and its phylogenetic position. Our analyses confirm T. boipiranga as genetically distinct from its generic counterparts, and diagnosable based on a combination of colour pattern, meristic counts, and hemipenial morphology. However, contrary to its original description, the hemipenial ornamentation does not differen-tiate T. boipiranga from the highly variable T. melanocephala. In our phylogenetic analysis, T. boipiranga is retrieved as a monophyletic group, nested within the diversity of T. melanocephala and sister to a clade composed by specimens from south-eastern Brazil. Tantilla melanocephala is recovered as a highly diverse lineage, indicating the possible presence of undescribed species. Additionally, our analysis indicates that the T. coronata and T. planiceps species group are mono-phyletic, while the T. taeniata species group is paraphyletic and the only sampled species for the T. calamarina group is nested within the T. melanocephala group. Our results suggest that the phenotypic evolution within the genus is probably more complex than previously recognized, and some colouration patterns used to define the groups can in fact represent phenotypical convergences. Moreover, our phylogenetic analysis suggests a strong signal of geographical structure in the tree topology. Three main geographical lineages were found, a North American, a South American and a Central Ameri-can. The first two lineages were recovered as monophyletic, while the latter is paraphyletic, with Central American species positioned as sister groups of both, the North American and the South American clades. Although a more comprehensive phylogenetic analysis is needed, our study strongly indicates the existence of hidden diversity within the T. melanocephala group and that Tantilla represents an ideal model to evaluate the validity of phenotypical groups in snake systematics and to study the driven mechanisms of morphological evolution.

A new species of Thamnodynastes Wagler, 1830 from western Amazonia, with notes on morphology for members of the Thamnodynastes pallidus group (Serpentes, Dipsadidae, Tachymenini)

The genus Thamnodynastes is the most diverse within the tribe Tachymenini, with an extensive and complex taxonomic history. The brief descriptions and lack of robust diagnostic characters are the main sources for identification errors and for the difficulty to assess the diversity estimates of the genus. The Thamnodynastes pallidus group was briefly designated to encompass the most arboreal species of the genus, with thinner bodies and longer tails: T. pallidus, T. longicaudus, T. sertanejo, and a fourth undescribed species. After its designation, no other paper addressed this group and its morphological variation, especially for the hemipenis, is still undetermined. After the analysis of all species of Thamnodynastes we were able to corroborate the distinctiveness of the T. pallidus group and to accurately diagnose its fourth species from the western portion of the Amazonia lowlands. The new species is distinguishable from all congeners, except T. sertanejo, by the absence of ventral longitudinal stripes, 17/17/11 dorsal scale rows, and dorsal dark brown blotches on the anterior third of the body. The new species is distinguished from T. sertanejo by the higher number of subcaudals, lower number of ventrals, and smaller body and head sizes. We also provide additional diagnostic features for the Thamnodynastes pallidus group, including new data on hemipenial variation. Finally, we briefly discuss the defensive behavior and morphological characters associated with arboreality in members of the T. pallidus species group.

Museums and cradles of diversity are geographically coincident for narrowly distributed neotropical snakes

Factors driving the spatial configuration of centres of endemism have long been a topic of broad interest and debate. Due to different eco-evolutionary processes, these highly biodiverse areas may harbour different amounts of ancient and recently diverged organisms (paleo- and neo-endemism, respectively). Patterns of endemism still need to be measured at distinct phylogenetic levels for most clades and, consequently, little is known about the distribution, the age and the causes of such patterns. Here we tested for the presence of centres with high phylogenetic endemism (PE) in the highly diverse Neotropical snakes, testing the age of these patterns (paleo- or neo-endemism), and the presence of PE centres with distinct phylogenetic composition. We then tested whether PE is predicted by topography, by climate (seasonality, stability, buffering and relictualness), or biome size. We found that most areas of high PE for Neotropical snakes present a combination of both ancient and recently diverged diversity, which is distributed mostly in the Caribbean region, Central America, the Andes, the Atlantic Forest and on scattered highlands in central Brazil. Turnover of lineages is higher across Central America, resulting in more phylogenetically distinct PE centres compared to South America, which presents a more phylogenetically uniform snake fauna. Finally, we found that elevational range (topographic roughness) is the main predictor of PE, especially for paleo-endemism, whereas low paleo-endemism levels coincide with areas of high climatic seasonality. Our study highlights the importance of mountain systems to both ancient and recent narrowly distributed diversity. Mountains are both museums and cradles of snake diversity in the Neotropics, which has important implications for conservation in this region.

VIH y SARS-CoV-2: aspectos a considerar para enfrentar esta nueva pandemia / HIV and SARS-CoV-2: points to consider to face this new pandemic

En diciembre de 2019 una nueva especie de ß-coronavirus causante de neumonía fue identificada en la ciudad China de Wuhan, el cual posteriormente fue denominado SARS-CoV-2. Este virus de ácido ribonucleico presenta ciertas similitudes con otros virus del mismo material genético, dentro de ellos se ha visto que la infección por virus de la inmunodeficiencia humana se asemeja en diversos aspectos a la infección por SARS-CoV-2. En este comentario presentamos algunas de las similitudes virológicas, inmunológicas, clínicas y farmacológicas entre estos dos virus, las cuales podrían permitirnos entender de mejor manera la inmunopatogenia de COVID-19, así como también tomar algunas decisiones en cuanto al manejo antiviral.

In December 2019, a new species of pneumonia-causing betacoronavirus was identified in Wuhan, China, which was later identified as SARS-CoV-2. This RNA virus presents certain similarities with other viruses of the same genetic material. It has been seen that infection by human immunodeficiency virus resembles the infection by SARS-CoV-2 in various aspects. In this comment, we present some of the virological, immunological, clinical, and pharmacological similarities between HIV and SARS-CoV-2, which could allow us to understand the immunopathogenesis of COVID-19 better, as well as make some decisions in regarding antiviral management.

Information and communication technologies in neonatal health

[ABSTRACT]. Objectives. To identify scientific evidence on the use and results of information and communication technologies for the improvement of neonatal health in general or specific health problems or interventions, and to describe the type of intervention and its results. Methods. A systematic review of the available evidence was performed. The search was carried out in peerreviewed journals between January 1, 2008 and April 30, 2018, in English and Spanish. The searched key terms were (health informatics OR telemedicine OR mHealth) AND (newborn OR newborn care OR neonatal care). Results. From a total of 305 articles initially identified, 10 articles fulfilled the inclusion criteria. The main domains of eHealth identified as applied to neonatal health were telemedicine (3 studies), eLearning (1 study) and mHealth (7 studies). Target population were health care providers or parents. The studies aimed at diagnosis, provision of health care and training, promoting adherence to interventions in parents or improving quality of care. Conclusions. The use of eHealth in general and specifically focused on neonatal health shows important possibilities for development and expansion, given the advances and present needs, and should be considered a key tool for the reduction of inequalities.

[RESUMEN]. Objetivos. Identificar la evidencia científica sobre el uso y los resultados de las tecnologías de la información y la comunicación para mejorar la salud neonatal en general o problemas de salud o intervenciones específicos, y describir el tipo de intervención y sus resultados. Métodos. Se realizó una revisión sistemática de la evidencia disponible. La búsqueda se llevó a cabo en revistas revisadas por pares entre el 1 de enero de 2008 y el 30 de abril de 2018, en español e inglés. Los términos clave de la búsqueda fueron (health informatics OR telemedicine OR mHealth) AND (newborn OR newborn care OR neonatal care). Resultados. De un total de 305 artículos identificados inicialmente, 10 artículos cumplieron los criterios de inclusión. Los principales dominios de la eSalud aplicados a la salud neonatal fueron la telemedicina (3 estudios), el aprendizaje electrónico (1 estudio) y la salud móvil (7 estudios). La población destinataria consistió en los proveedores de atención de la salud o los padres. Los estudios tenían por objeto el diagnóstico, la prestación de atención sanitaria y la capacitación, la promoción del cumplimiento de las intervenciones en los padres o la mejora de la calidad de la atención. Conclusiones. El uso de la eSalud en general, y específicamente en la salud neonatal, muestra importantes posibilidades de desarrollo y expansión, dados los avances y las necesidades actuales, y debería considerarse un instrumento clave para la reducción de las desigualdades.

Description of a second known Liotyphlops caissara specimen (Serpentes: Anomalepididae)

We recorded a second specimen of the poorly known insular blind snake Liotyphlops caissara. This new specimen expands the morphological variation of the number of dorsal scales in the genus Liotyphlops to 296 (vs. 304 in L. wilderi) and, considering the fact that the holotype of this species was destroyed, the present specimen represents the only available L. caissara individual in zoological collections. Also, this new record constitutes the first out of type locality and expands the distribution of the species in about 40 km to the northeastern. According to IUCN criteria (B1a, b [iii]), we suggest that L. caissara be included in the "Endangered" category, since it occurs in only two insular locations and exhibits an occurrence extension of <5,000 km² (about 355 km2).