Validation of the severe respiratory insufficiency questionnaire for Chile.

BACKGROUND: Long-term home non-invasive ventilation (LTH-NIV) has an impact on the health-related quality of life of patients with chronic hypercapnic respiratory failure (CRF) of different causes. There are generic and specific questionnaires for respiratory diseases. In 2003 a specific questionnaire was developed for patients with CRF in LTH-NIV, called the Severe Respiratory Insufficiency (SRI) questionnaire, which has been shown to be reproducible and reliable and has been validated in several languages. The aim of the study was to translate and culturally adapt the SRI questionnaire for adult Chilean patients under LTH-NIV, and to assess its psychometric properties. METHODS: The Chilean version of the SRI was obtained using the translation-back translation method, which was then applied by cross-sectional study to a non-probabilistic convenience sample of stable patients from five regions of Chile. The validated Chilean version of the SRI questionnaire and SF-36 (gold standard) questionnaire were applied, demographic and ventilatory data were collected. Reliability was analysed using Cronbach's alpha and intraclass correlation (test-retest). Construct validity was tested using exploratory factor analysis (principal component extraction and equimax orthogonal rotation) and hypothesis testing (Mann-Whitney test). Convergent criterion validity was tested using Spearman's rho. RESULTS: The sample comprised 248 patients, 132 women (53.2%), median age (IQR) was 62 years (51-75), 146 patients (58.9%) were 60 years or older, 40% had a low education level. The mean ± SD completion time of the questionnaire was 18.8 ± 9.1 min, and 100% of the items were answered. The questionnaire was self-applied by 46.8% of the sample. The validated Chilean version of the SRI questionnaire showed very good overall reliability (0.95) and by scales (> 0.7). It showed a good correlation with the SF-36, with equivalent scales, a rotated matrix with 8 factors and hypotheses that explain the underlying constructs. CONCLUSIONS: The validated Chilean version of the SRI questionnaire has good psychometric properties. It is feasible, valid, and reliable for application to evaluate patients with CRF in LTH-NIV. It was found to be sensitive to assess the characteristics of the local population.

Theoretical considerations on maximum running speeds for large and small animals.

Mechanical equations for fast running speeds are presented and analyzed. One of the equations and its associated model predict that animals tend to experience larger mechanical stresses in their limbs (muscles, tendons and bones) as a result of larger stride lengths, suggesting a structural restriction entailing the existence of an absolute maximum possible stride length. The consequence for big animals is that an increasingly larger body mass implies decreasing maximal speeds, given that the stride frequency generally decreases for increasingly larger animals. Another restriction, acting on small animals, is discussed only in preliminary terms, but it seems safe to assume from previous studies that for a given range of body masses of small animals, those which are bigger are faster. The difference between speed scaling trends for large and small animals implies the existence of a range of intermediate body masses corresponding to the fastest animals.

The mechanical cost of transport of fast running animals.

Regarding running animals, algebraic expressions for the horizontal (ωx) and vertical (ωy) components of the mechanical cost of transport are deduced for a ground force pattern based on the Spring-mass model. Defining µËœ as the maximum ground forces ratio µËœ=max(Fx)/max(Fy), the analysis shows that the mechanical cost of transport ωx+ωy for fast running animals is approximately proportional to µËœ, and to the relative contact length, and positively correlated to the limb take-off angle and the collision angle. The vertical cost ωy is shown to approximate to zero for fast running animals. Sustained top running speeds are predicted to require the largest possible values of µËœ and therefore relatively large horizontal propulsive forces, as well as a minimum possible ground contact time. The equations also show that animals running relatively slow would tend to prefer certain interval of values for parameter µËœ, which would minimize both their mechanical cost of transport and their metabolic cost of transport. Very large animals are suspected to be less capable of developing large values of µËœ, which possibly renders them incapable of developing great speeds.

Exoskeletons: Contribution to Occupational Health and Safety.

This review aims to characterize the current landscape of exoskeletons designed to promote medical care and occupational safety in industrial settings. Extensive exploration of scientific databases spanning industries, health, and medicine informs the classification of exoskeletons according to their distinctive attributes and specific footholds on the human physique. Within the scope of this review, a comprehensive analysis is presented, contextualizing the integration of exoskeletons based on different work activities. The reviewers extracted the most relevant articles published between 2008 and 2023 from IEEE, Proquest, PubMed, Science Direct, Scopus, Web of Science, and other databases. In this review, the PRISMA-ScR checklist was used, and a Cohen's kappa coefficient of 0.642 was applied, implying moderate agreement among the reviewers; 75 primary studies were extracted from a total of 344. The future of exoskeletons in contributing to occupational health and safety will depend on continued collaboration between researchers, designers, healthcare professionals, and industries. With the continued development of technologies and an increasing understanding of how these devices interact with the human body, exoskeletons will likely remain valuable for improving working conditions and safety in various work environments.

Stochastic tsunami modeling induced by kinematic complex sources.

In this study, local tsunami hazard due to seismic sources is evaluated in a stochastic framework. Several assumptions such as static passive generation, constant rake angle and source centroid (among others) are relaxed. Spatial uncertainties are modeled in a large set of scenarios. The proposed methodology is easy to implement and can be combined with other types of sources or hazards. Application in the Kuril-Kamchatkah trench shows a straightforward use of our methodology, producing simple hazard maps, which can be replicated in any region of the world.

Did a 3800-year-old Mw ~9.5 earthquake trigger major social disruption in the Atacama Desert?

Early inhabitants along the hyperarid coastal Atacama Desert in northern Chile developed resilience strategies over 12,000 years, allowing these communities to effectively adapt to this extreme environment, including the impact of giant earthquakes and tsunamis. Here, we provide geoarchaeological evidence revealing a major tsunamigenic earthquake that severely affected prehistoric hunter-gatherer-fisher communities ~3800 years ago, causing an exceptional social disruption reflected in contemporary changes in archaeological sites and triggering resilient strategies along these coasts. Together with tsunami modeling results, we suggest that this event resulted from a ~1000-km-long megathrust rupture along the subduction contact of the Nazca and South American plates, highlighting the possibility of Mw ~9.5 tsunamigenic earthquakes in northern Chile, one of the major seismic gaps of the planet. This emphasizes the necessity to account for long temporal scales to better understand the variability, social effects, and human responses favoring resilience to socionatural disasters.

Using Blue Intensity from drought-sensitive Pinus sylvestris in Fennoscandia to improve reconstruction of past hydroclimate variability.

High-resolution hydroclimate proxy records are essential for distinguishing natural hydroclimate variability from possible anthropogenically-forced changes, since instrumental precipitation observations are too short to represent the whole spectrum of natural variability. In Northern Europe, progress in this field has been hampered by a relative lack of long and truly moisture-sensitive proxy records. In this study, we provide the first assessment of the dendroclimatic potential of Blue Intensity (BI) and partial ring-width measurements (latewood and earlywood width series) from a network of cold and drought-prone Pinus sylvestris L. sites in Sweden. Our results show that all tree-ring parameters and sites share a clear and strong sensitivity to warm-season precipitation. The ΔBI parameter, in particular, shows considerable potential for hydroclimate reconstructions, here permitting a cross-validated precipitation reconstruction capable of explaining 56% (1901-2010 period) of regional-scale warm-season high-frequency precipitation variance. Using ΔBI as an alternative to ring-width improves the predictive skill with nearly a 20 percentage points increase in explained variance, reduces signal instability over time as well as allows a broader seasonal window (May-July) to be reconstructed. Additionally, we found that earlywood BI also reflect a positive late winter through early summer temperature signal. These findings emphasize that tree-rings, and in particular wood density parameters such as from BI, are capable of providing fundamental information to advance our understanding of hydroclimate variability in regions with a cool and rather humid climate regime that traditionally has been overlooked in studies of past droughts. Increasing the spatio-temporal coverage of hydroclimate records in northern Europe, and taking full advantage of the opportunities offered by the wood densitometric properties should be considered a research priority.

Low pathogenic avian influenza (H7N6) virus causing an outbreak in commercial Turkey farms in Chile.

In late 2016, an H7N6 low pathogenic avian influenza virus outbreak occurred in domestic turkeys in Central Chile. We characterized the genetic and antigenic properties of the outbreak virus and its experimental transmission in chickens. Our studies demonstrate that the outbreak virus is a reassortment of genes identified from Chilean wild bird viruses between 2013 and 2017 and displays molecular adaptations to poultry and antiviral resistance to adamantanes. Further, these wild bird viruses are also able to transmit in experimentally infected chickens highlighting the need for continued surveillance and improvement of biosecurity in poultry farms.

Armonización iberoamericana de los instrumentos PCAT para la evaluación del primer nivel de atención

Cuarenta años después de Alma Ata, el mundo está reforzando la consciencia sobre la importancia de los atributos y funciones del primer nivel de atención, pero aún queda mucho por hacer para implementarlos, medirlos y aprender de las experiencias exitosas de algunos países. El conjunto de instrumentos Primary Care Assessment Tools (PCAT), desarrollados en los años 90 en Estados Unidos de América por Starfield y Shi (1), se ha mostrado como la herramienta más completa para el análisis de la atención primaria de la salud (APS) y su utilidad fue reconocida en numerosos países y regiones del mundo. El objetivo de esta carta es comunicar preliminarmente el proceso de armonización de las versiones PCAT ya adaptadas en diversos países de Iberoamérica y subrayar la importancia de estas herramientas para evaluar y comparar el primer nivel de atención, particularmente en sistemas de salud fundados en la estrategia de APS.

Análisis de las demoras en salud en personas que enfermaron de gravedad o fallecieron por dengue en cinco ciudades de Colombia / Análise das demoras no atendimento em saúde em pessoas gravemente doentes ou que morreram de dengue em cinco cidades na Colômbia / Analysis of delays in healthcare in people seriously ill or dead from dengue in five cities in Colombia

Objetivo: Identificar demoras en la atención médica de personas que fallecieron o se recuperaron de dengue grave en cinco ciudades de Colombia. Materiales y métodos. Estudio cualitativo sobre personas que fallecieron por dengue (casos) o que se recuperaron (controles). Se entrevistó a los familiares y se analizaron sus itinerarios de búsqueda de atención en salud. Los datos fueron analizados desde el modelo de las "tres demoras", complementado con diagramas espacio-temporales y entrevistas a profesionales de salud. Resultados: A pesar de desconocer signos y síntomas, se buscó atención rápidamente. Para acceder a la primera consulta el recorrido no representó dificultades. Se presentaron fallas en la calidad del diagnóstico y un mayor número de instituciones consultadas en los casos que en los controles. Se evidenció un proceso de retorno a la demora 1 que puede influir negativamente en futuras decisiones en salud. Conclusiones: Complementar el análisis clásico de demoras con el análisis espacio-temporal de los itinerarios permite visibilizar fallas y aciertos en la calidad de la atención y aportar a la toma de decisiones.

Objetivo: Identificar demoras no atendimento em saúde de pessoas que faleceram ou se recuperaram de dengue grave em cinco cidades da Colômbia. Materiais e métodos: Estudo qualitativo com pessoas que faleceram em decorrência da dengue (casos) ou que se recuperaram (controles). Entrevistaram-se familiares e analisaram-se seus itinerários durante o processo de procura de atendimento nos serviços de saúde. Os dados foram analisados baseados no modelo das "três demoras", complementado com diagramas espaço-temporais e entrevistas com profissionais de saúde. Resultados: Ainda que os signos e sintomas fossem desconhecidos, procurou-se atendimento rapidamente. O percurso para o acesso à primeira consulta não apresentou dificuldades. Apresentaram-se erros na qualidade do diagnóstico e identificou-se maior número de instituições consultadas em casos do que em controles. Evidenciou-se um processo de retorno à demora 1, fato que pode influir negativamente em decisões futuras. Conclusões: Complementar a análise clássica de demoras com a análise espaço-temporal de itinerários permite identificar falhas e acertos na qualidade do atendimento para a tomada de decisões.

Objective: Identify delays in receiving healthcare in cases of patients who either recovered from or died due to severe dengue in five Colombian cities. Method: Qualitative study with deceased persons from dengue (cases) or that recuperated (controls). Family members were interviewed and their itineraries were analyzed. The data was analyzed from the "three delay" model, complemented with spatiotemporal diagrams and interviews to health professionals. Results: Despite not knowing signs and symptoms, attention was rapidly sought. There were no difficulties accessing the route to the first consultation There were flaws in the quality of diagnosis and a higher number of institutions were consulted in cases than in controls. It was evidenced a return to delay 1 that could negatively influence future health decisions. Conclusions: Complementing the delay analysis with spatiotemporal analysis of the itineraries permits the visualization of flaws and successes in the quality of care for decision-making.