Species trait diversity sustains multiple dietary nutrients supplied by freshwater fisheries.

Species, through their traits, influence how ecosystems simultaneously sustain multiple functions. However, it is unclear how trait diversity sustains the multiple contributions biodiversity makes to people. Freshwater fisheries nourish hundreds of millions of people globally, but overharvesting and river fragmentation are increasingly affecting catches. We analyse how loss of nutritional trait diversity in consumed fish portfolios affects the simultaneous provisioning of six essential dietary nutrients using household data from the Amazon and Tonlé Sap, two of Earth's most productive and diverse freshwater fisheries. We find that fish portfolios with high trait diversity meet higher thresholds of required daily intakes for a greater variety of nutrients with less fish biomass. This beneficial biodiversity effect is driven by low redundancy in species nutrient content profiles. Our findings imply that sustaining the dietary contributions fish make to people given declining biodiversity could require more biomass and ultimately exacerbate fishing pressure in already-stressed ecosystems.

Latin American Consensus for Pediatric Cardiopulmonary Resuscitation 2017: Latin American Pediatric Critical Care Society Pediatric Cardiopulmonary Resuscitation Committee.

OBJECTIVES: To develop a Latin American Consensus about Pediatric Cardiopulmonary Resuscitation. To clarify, reinforce, and adapt some specific recommendations for pediatric patients and to stimulate the implementation of these recommendations in clinical practice. DESIGN: Expert consensus recommendations with Delphi methodology. SETTING: Latin American countries. SUBJECTS: Experts in pediatric cardiopulmonary resuscitation from 19 Latin American countries. INTERVENTIONS: Delphi methodology for expert consensus. MEASUREMENTS AND MAIN RESULTS: The goal was to reach consensus with all the participating experts for every recommendation. An agreement of at least 80% of the participating experts had to exist in order to deliver a recommendation. Two Delphi voting rounds were sent out electronically. The experts were asked to score between 1 and 9 their level of agreement for each recommendation. The score was then classified into three groups: strong agreement (score 7-9), moderate agreement (score 4-6), and disagreement (score 1-3). Nineteen experts from 19 countries participated in both voting rounds and in the whole process of drafting the recommendations. Sixteen recommendations about organization of cardiopulmonary resuscitation, prevention, basic resuscitation, advanced resuscitation, and postresuscitation measures were approved. Ten of them had a consensus of 100%. Four of them were agreed by all the participants except one (94.7% consensus). One recommendation was agreed by all except two experts (89.4%), and finally, one was agreed by all except three experts (84.2%). All the recommendations reached a level of agreement. CONCLUSIONS: This consensus adapts 16 international recommendations to Latin America in order to improve the practice of cardiopulmonary resuscitation in children. Studies should be conducted to analyze the effectiveness of the implementation of these recommendations.

Paediatric cardiopulmonary resuscitation training program in Latin-America: the RIBEPCI experience.

BACKGROUND: To describe the design and to present the results of a paediatric and neonatal cardiopulmonary resuscitation (CPR) training program adapted to Latin-America. METHODS: A paediatric CPR coordinated training project was set up in several Latin-American countries with the instructional and scientific support of the Spanish Group for Paediatric and Neonatal CPR. The program was divided into four phases: CPR training and preparation of instructors; training for instructors; supervised teaching; and independent teaching. Instructors from each country participated in the development of the next group in the following country. Paediatric Basic Life Support (BLS), Paediatric Intermediate (ILS) and Paediatric Advanced (ALS) courses were organized in each country adapted to local characteristics. RESULTS: Five Paediatric Resuscitation groups were created sequentially in Honduras (2), Guatemala, Dominican Republican and Mexico. During 5 years, 6 instructors courses (94 students), 64 Paediatric BLS Courses (1409 students), 29 Paediatrics ILS courses (626 students) and 89 Paediatric ALS courses (1804 students) were given. At the end of the program all five groups are autonomous and organize their own instructor courses. CONCLUSIONS: Training of autonomous Paediatric CPR groups with the collaboration and scientific assessment of an expert group is a good model program to develop Paediatric CPR training in low- and middle income countries. Participation of groups of different countries in the educational activities is an important method to establish a cooperation network.

Comparing in situ removal strategies for improving styrene bioproduction.

As an important conventional monomer compound, the biological production of styrene carries significant promise with respect to creating novel sustainable materials. Since end-product toxicity presently limits styrene production by previously engineered Escherichia coli, in situ product removal by both solvent extraction and gas stripping were explored as process-based strategies for circumventing its inhibitory effects. In solvent extraction, the addition of bis(2-ethylhexyl)phthalate offered the greatest productivity enhancement, allowing net volumetric production of 836 ± 64 mg/L to be reached, representing a 320 % improvement over single-phase cultures. Gas stripping rates, meanwhile, were controlled by rates of bioreactor agitation and, to a greater extent, aeration. A periodic gas stripping protocol ultimately enabled up to 561 ± 15 mg/L styrene to be attained. Lastly, by relieving the effects of styrene toxicity, new insight was gained regarding subsequent factors limiting its biosynthesis in E. coli and strategies for future strain improvement are discussed.

Placing engineering in the earthquake response and the survival chain.

Earthquakes injure millions and simultaneously disrupt the infrastructure to protect them. This perspective argues that the current post-disaster investigation paradigm is insufficient to protect communities' health effectively. We propose the Earthquake Survival Chain as a framework to change the current engineering focus on infrastructure to health. This framework highlights four converging research opportunities to advance understanding of earthquake injuries, search and rescue, patient mobilizations, and medical treatment. We offer an interdisciplinary research agenda in engineering and health sciences, including artificial intelligence and virtual reality, to protect health and life from earthquakes.

Mortality in Patients with 22q11.2 Rearrangements.

The 22q11.2 region is highly susceptible to genomic rearrangements leading to multiple genomic disorders, including 22q11.2 microdeletion syndrome (22q11.2 DS) (MIM# 188400), 22q11.2 microduplication syndrome (MIM# 608363), supernumerary der(22)t(11;22) syndrome (also known as Emanuel Syndrome; MIM# 609029), and Cat Eye Syndrome (MIM# 115470). In this study, we present data on causes of mortality, average age of death, and the existing associated risk factors in patients with 22q11.2 rearrangements. Our cohort included 223 patients (120 males and 103 females) with confirmed diagnoses of 22q11.2 rearrangements diagnosed through molecular techniques (FISH, MLPA, and CMA). Relatives from patients who have been molecularly confirmed with 22q11.2 rearrangements have also been added to the study, regardless of the presence or absence of symptoms. Of these 223 individuals, 21 (9.4%) died. Deceased patients' rearrangements include 19 microdeletions, 1 microduplication, and 1 patient with a marker chromosome. The median age of death was 3 months and 18 days (ranging from 3 days to 34 years). There were 17 patients who died at pediatric age (80.95%), 3 died at adult age (14.28%), and for 1 of whom, the age of death is unknown (4.76%). Eighteen patients were White Mediterranean (European non-Finnish) (85.71%) whereas three were Amerindian (South American) (14.28%). Mortality from cardiac causes accounted for 71.42%. The second most frequent cause of death was sepsis in two patients (9.52%). One patient died from respiratory failure (4.76%) and one from renal failure (4.76%). Information regarding the cause of death was not available in two patients (9.52%). Most patients who died were diagnosed within the first week of life, the majority on the first day. This study adds additional information on mortality in one of the largest cohorts of patients with 22q11.2 rearrangements in more than 30 years of follow-up.

Correction: Addante-Moya et al. Assessment of the Optimum Linker Tethering Site of Alternariol Haptens for Antibody Generation and Immunoassay Development. Toxins 2021, 13, 883.

In the original publication [...].

Nonketotic hyperglycinemia presenting as pulmonary hypertensive vascular disease and fatal pulmonary edema in response to pulmonary vasodilator therapy.

The association of pulmonary hypertensive vascular disease with nonketotic hyperglycinemia is rare. We describe 5 infants diagnosed with nonketotic hyperglycinemia, in whom pulmonary hypertensive vascular disease was the main presenting feature, and who developed severe pulmonary edema in response to pulmonary vasodilators.

Corrosion at the stem-sleeve interface of a modular titanium alloy femoral component as a reason for impaired disengagement.

Modularity in sleeved femoral components allows the exchange of the stem without disruption of the fixation between the sleeve and the surrounding bone at revision surgery. Failure to disengage the stem from the sleeve would represent an unnecessary compromise from the intended usefulness of the modular design. We report the results of an examination of 22 modular titanium alloy femoral components retrieved after 0.0 to 8.8 years in vivo. In 7 implants, the stem-sleeve interface could not be disengaged without cutting through the components or using mechanical force. Moderate to severe corrosion was detected in all 7 of these cases. Corrosive surface changes were observed in an additional 6 interfaces. There was no correlation with the length of time that the devices had been implanted. When only the stem is to be revised, orthopedic surgeons should be aware of difficulties in disengagement and anticipate alternative surgical procedures.

Model-based analysis of multi-UAV path planning for surveying postdisaster building damage.

Emergency responders require accurate and comprehensive data to make informed decisions. Moreover, the data should be acquired and analyzed swiftly to ensure an efficient response. One of the tasks at hand post-disaster is damage assessment within the impacted areas. In particular, building damage should be assessed to account for possible casualties, and displaced populations, to estimate long-term shelter capacities, and to assess the damage to services that depend on essential infrastructure (e.g. hospitals, schools, etc.). Remote sensing techniques, including satellite imagery, can be used to gathering such information so that the overall damage can be assessed. However, specific points of interest among the damaged buildings need higher resolution images and detailed information to assess the damage situation. These areas can be further assessed through unmanned aerial vehicles and 3D model reconstruction. This paper presents a multi-UAV coverage path planning method for the 3D reconstruction of postdisaster damaged buildings. The methodology has been implemented in NetLogo3D, a multi-agent model environment, and tested in a virtual built environment in Unity3D. The proposed method generates camera location points surrounding targeted damaged buildings. These camera location points are filtered to avoid collision and then sorted using the K-means or the Fuzzy C-means methods. After clustering camera location points and allocating these to each UAV unit, a route optimization process is conducted as a multiple traveling salesman problem. Final corrections are made to paths to avoid obstacles and give a resulting path for each UAV that balances the flight distance and time. The paper presents the details of the model and methodologies, and an examination of the texture resolution obtained from the proposed method and the conventional overhead flight with the nadir-looking method used in 3D mappings. The algorithm outperforms the conventional method in terms of the quality of the generated 3D model.

Substitution of inland fisheries with aquaculture and chicken undermines human nutrition in the Peruvian Amazon.

With declining capture fisheries production, maintaining nutrient supplies largely hinges on substituting wild fish with economically comparable farmed animals. Although such transitions are increasingly commonplace across global inland and coastal communities, their nutritional consequences are unknown. Here, using human demographic and health information, and fish nutrient composition data from the Peruvian Amazon, we show that substituting wild inland fisheries with chicken and aquaculture has the potential to exacerbate iron deficiencies and limit essential fatty acid supplies in a region already experiencing high prevalence of anaemia and malnutrition. Substituting wild fish with chicken, however, can increase zinc and protein supplies. Chicken and aquaculture production also increase greenhouse gas emissions, agricultural land use and eutrophication. Thus, policies that enable access to wild fisheries and their sustainable management while improving the quality, diversity and environmental impacts of farmed species will be instrumental in ensuring healthy and sustainable food systems.

Assessment of the Optimum Linker Tethering Site of Alternariol Haptens for Antibody Generation and Immunoassay Development.

Immunochemical methods for mycotoxin analysis require antigens with well-defined structures and antibodies with outstanding binding properties. Immunoreagents for the mycotoxins alternariol and/or alternariol monomethyl ether have typically been obtained with chemically uncharacterized haptens, and antigen conjugates have most likely been prepared with mixtures of functionalized molecules. For the first time, total synthesis was performed, in the present study, to obtain two haptens with opposite linker attachment locations. The functionalized synthetic haptens were purified and deeply characterized by different spectrometric methods, allowing the preparation of bioconjugates with unequivocal structures. Direct and indirect competitive enzyme-linked immunosorbent assays, using homologous and heterologous conjugates, were employed to extensively evaluate the generated immunoreagents. Antibodies with high affinity were raised from conjugates of both haptens, and a structure-activity relationship between the synthetic haptens and the specificity of the generated antibodies could be established. These results pave the way for the development of novel highly sensitive immunoassays selective of one or two of these Alternaria mycotoxins.

Cambios en el currículum de la educación física chilena: voces desde el territorio / Changes in the chilean physical education curriculum: voices from the territory / Mudanças no currículo da educação física chilena: vozes do território

El objetivo de la investigación fue analizar el desarrollo del currículum en los últimos años y la didáctica que utilizan profesores de Educación Física en una región del centro sur de Chile. La metodología del estudio es de tipo cualitativa, a través de entrevistas a docentes con al menos cinco años de permanencia en el sistema educacional. Los resultados dan cuenta de que los profesores abordan el proceso de enseñanza-aprendizaje analizando el contexto en que están inmersos. Al momento de planificar sus clases se apoyan en las bases curriculares dispuestas por el Ministerio de Educación y las características de los estudiantes. Se concluye que, respecto a los desafíos actuales, buscan llevar a la práctica un modelo constructivista, procurando que el estudiante sea parte del proceso educativo, tomando en cuenta su integridad y bienestar. Asimismo, se espera que el currículum incorpore las problemáticas actuales que emergen en la sociedad.

The objective was to analyze the curriculum development and the didactics used by Physical Education teachers in recent years in a region of south-central Chile. The methodology of the study is qualitative, in which interviews were conducted with teachers with at least 5 years of permanence in the educational system. The results show that teachers approach the teaching-learning process by analyzing the context in which they are immersed. When planning their classes, they rely on the curricular bases established by the Ministry of Education and the characteristics of the students. Regarding current challenges, they seek to implement a constructivist model, making the student part of the educational process, taking into account their integrity and well-being. It is also hoped that the curriculum can incorporate the current problems emerging in society.

O objetivo foi analisar o desenvolvimento do currículo nos últimos anos e a didática utilizada pelos professores de Educação Física em uma região do centro-sul do Chile. A metodologia do estudo é qualitativa, em que foram realizadas entrevistas com professores com no mínimo 5 anos de permanência no sistema educacional. Os resultados mostram que os professores abordam o processo de ensino-aprendizagem analisando o contexto em que estão inseridos. Ao planejar suas aulas, eles se baseiam nas bases curriculares estabelecidas pelo Ministério da Educação e nas características dos alunos. Conclui-se que, face aos desafios atuais, procuram implementar um modelo construtivista, tornando o aluno parte do processo educativo, tendo em conta a sua integridade e bem-estar. Da mesma forma, espera-se que o currículo incorpore os problemas atuais que surgem na sociedade.

Comparison of caspofungin and amphotericin B for invasive candidiasis.

BACKGROUND: Caspofungin is an echinocandin agent with fungicidal activity against candida species. We performed a double-blind trial to compare caspofungin with amphotericin B deoxycholate for the primary treatment of invasive candidiasis. METHODS: We enrolled patients who had clinical evidence of infection and a positive culture for candida species from blood or another site. Patients were stratified according to the severity of disease, as indicated by the Acute Physiology and Chronic Health Evaluation (APACHE II) score, and the presence or absence of neutropenia and were randomly assigned to receive either caspofungin or amphotericin B. The study was designed to compare the efficacy of caspofungin with that of amphotericin B in patients with invasive candidiasis and in a subgroup with candidemia. RESULTS: Of the 239 patients enrolled, 224 were included in the modified intention-to-treat analysis. Base-line characteristics, including the percentage of patients with neutropenia and the mean APACHE II score, were similar in the two treatment groups. A modified intention-to-treat analysis showed that the efficacy of caspofungin was similar to that of amphotericin B, with successful outcomes in 73.4 percent of the patients treated with caspofungin and in 61.7 percent of those treated with amphotericin B (difference after adjustment for APACHE II score and neutropenic status, 12.7 percentage points; 95.6 percent confidence interval, -0.7 to 26.0). An analysis of patients who met prespecified criteria for evaluation showed that caspofungin was superior, with a favorable response in 80.7 percent of patients, as compared with 64.9 percent of those who received amphotericin B (difference, 15.4 percentage points; 95.6 percent confidence interval, 1.1 to 29.7). Caspofungin was as effective as amphotericin B in patients who had candidemia, with a favorable response in 71.7 percent and 62.8 percent of patients, respectively (difference, 10.0 percentage points; 95.0 percent confidence interval, -4.5 to 24.5). There were significantly fewer drug-related adverse events in the caspofungin group than in the amphotericin B group. CONCLUSIONS: Caspofungin is at least as effective as amphotericin B for the treatment of invasive candidiasis and, more specifically, candidemia.

Surveillance of Candida spp bloodstream infections: epidemiological trends and risk factors of death in two Mexican tertiary care hospitals.

INTRODUCTION: Larger populations at risk, broader use of antibiotics and longer hospital stays have impacted on the incidence of Candida sp. bloodstream infections (CBSI). OBJECTIVE: To determine clinical and epidemiologic characteristics of patients with CBSI in two tertiary care reference medical institutions in Mexico City. DESIGN: Prospective and observational laboratory-based surveillance study conducted from 07/2008 to 06/2010. METHODS: All patients with CBSI were included. Identification and antifungal susceptibility were performed using CLSI M27-A3 standard procedures. Frequencies, Mann-Whitney U test or T test were used as needed. Risk factors were determined with multivariable analysis and binary logistic regression analysis. RESULTS: CBSI represented 3.8% of nosocomial bloodstream infections. Cumulative incidence was 2.8 per 1000 discharges (incidence rate: 0.38 per 1000 patient-days). C. albicans was the predominant species (46%), followed by C. tropicalis (26%). C. glabrata was isolated from patients with diabetes (50%), and elderly patients. Sixty-four patients (86%) received antifungals. Amphotericin-B deoxycholate (AmBD) was the most commonly used agent (66%). Overall mortality rate reached 46%, and risk factors for death were APACHE II score ≥ 16 (OR = 6.94, CI95% = 2.34-20.58, p<0.0001), and liver disease (OR = 186.11, CI95% = 7.61-4550.20, p = 0.001). Full susceptibility to fluconazole, AmBD and echinocandins among C. albicans, C. tropicalis, and C. parapsilosis was observed. CONCLUSIONS: The cumulative incidence rate in these centers was higher than other reports from tertiary care hospitals from Latin America. Knowledge of local epidemiologic patterns permits the design of more specific strategies for prevention and preemptive therapy of CBSI.

Recommendations for the management of candidemia in adults in Latin America. Latin America Invasive Mycosis Network.

Candidemia is one of the most frequent opportunistic mycoses worldwide. Limited epidemiological studies in Latin America indicate that incidence rates are higher in this region than in the Northern Hemisphere. Diagnosis is often made late in the infection, affecting the initiation of antifungal therapy. A more scientific approach, based on specific parameters, for diagnosis and management of candidemia in Latin America is warranted. 'Recommendations for the diagnosis and management of candidemia' are a series of manuscripts that have been developed by members of the Latin America Invasive Mycosis Network. They aim to provide a set of best-evidence recommendations for the diagnosis and management of candidemia. This publication, 'Recommendations for the management of candidemia in adults in Latin America', was written to provide guidance to healthcare professionals on the management of adults who have, or who are at risk of, candidemia. Computerized searches of existing literature were performed by PubMed. The data were extensively reviewed and analyzed by members of the group. The group also met on two occasions to pose questions, discuss conflicting views, and deliberate on a series of management recommendations. 'Recommendations for the management of candidemia in adults in Latin America' includes prophylaxis, empirical therapy, therapy for proven candidemia, patient work-up following diagnosis of candidemia, duration of candidemia treatment, and central venous catheter management in patients with candidemia. This manuscript is the second of this series that deals with diagnosis and treatment of invasive candidiasis. Other publications in this series include: 'Recommendations for the diagnosis of candidemia in Latin America', 'Recommendations for the management of candidemia in children in Latin America', and 'Recommendations for the management of candidemia in neonates in Latin America'.

[Recommendations for the diagnosis of candidemia in Latin America. Grupo Proyecto Épico]. / Recomendaciones para el diagnóstico de la candidemia en América Latina.

Candidemia is one of the most frequent opportunistic mycoses worldwide. Limited epidemiological studies in Latin America indicate that incidence rates are higher in this region than in the Northern Hemisphere. Diagnosis is often made late in the infection, affecting the initiation of antifungal therapy. A more scientific approach, based on specific parameters, for diagnosis and management of candidemia in Latin America is warranted. 'Recommendations for the diagnosis and management of candidemia' are a series of manuscripts that have been developed by members of the Latin America Invasive Mycosis Network. They aim to provide a set of best-evidence recommendations for the diagnosis and management of candidemia. This publication, 'Recommendations for the diagnosis of candidemia in Latin America', was written to provide guidance to healthcare professionals on the diagnosis of candidemia, as well as on the usefulness and application of susceptibility testing in patients who have a confirmed diagnosis of candidemia. Computerized searches of existing literature were performed by PubMed. The data were extensively reviewed and analyzed by members of the group. The group also met on two occasions to pose questions, discuss conflicting views, and deliberate on a series of management recommendations. 'Recommendations for the diagnosis of candidemia in Latin America' includes diagnostic methods used to detect candidemia, Candida species identification, and susceptibility testing. The availability of methods, their costs and treatment settings are considered. This manuscript is the first of this series that deals with diagnosis and treatment of invasive candidiasis. Other publications in this series include: 'Recommendations for the management of candidemia in adults in Latin America', 'Recommendations for the management of candidemia in children in Latin America', and 'Recommendations for the management of candidemia in neonates in Latin America'.

Recommendations for the management of candidemia in children in Latin America. Latin America Invasive Mycosis Network.

Candidemia is one of the most frequent opportunistic mycoses worldwide. Limited epidemiological studies in Latin America indicate that incidence rates are higher in this region than in the Northern Hemisphere. Diagnosis is often made late in the infection, affecting the initiation of antifungal therapy. A more scientific approach, based on specific parameters, for diagnosis and management of candidemia in Latin America is warranted. 'Recommendations for the diagnosis and management of candidemia' are a series of manuscripts that have been developed by members of the Latin America Invasive Mycosis Network. They aim to provide a set of best-evidence recommendations for the diagnosis and management of candidemia. This publication, 'Recommendations for the management of candidemia in children in Latin America', was written to provide guidance to healthcare professionals on the management of children who have, or who are at risk of, candidemia. Computerized searches of existing literature were performed by PubMed. The data were extensively reviewed and analyzed by members of the group. The group also met on two occasions to pose questions, discuss conflicting views, and deliberate on a series of management recommendations. 'Recommendations for the management of candidemia in children in Latin America' includes prophylaxis, empirical therapy, therapy for proven candidemia, patient work-up following diagnosis of candidemia, duration of candidemia treatment, and central venous catheter management in children with candidemia. This manuscript is the third of this series that deals with diagnosis and treatment of invasive candidiasis. Other publications in this series include: 'Recommendations for the diagnosis of candidemia in Latin America', 'Recommendations for the management of candidemia in adults in Latin America', and 'Recommendations for the management of candidemia in neonates in Latin America'.

[Recommendations for the management of candidemia in adults in Latin America. Grupo Proyecto Épico]. / Recomendaciones para el manejo de la candidemia en adultos en América Latina.

Candidemia is one of the most frequent opportunistic mycoses worldwide. Limited epidemiological studies in Latin America indicate that incidence rates are higher in this region than in the Northern Hemisphere. Diagnosis is often made late in the infection, affecting the initiation of antifungal therapy. A more scientific approach, based on specific parameters, for diagnosis and management of candidemia in Latin America is warranted. 'Recommendations for the diagnosis and management of candidemia' are a series of manuscripts that have been developed by members of the Latin America Invasive Mycosis Network. They aim to provide a set of best-evidence recommendations for the diagnosis and management of candidemia. This publication, 'Recommendations for the management of candidemia in adults in Latin America', was written to provide guidance to healthcare professionals on the management of adults who have, or who are at risk of, candidemia. Computerized searches of existing literature were performed by PubMed. The data were extensively reviewed and analyzed by members of the group. The group also met on two occasions to pose questions, discuss conflicting views, and deliberate on a series of management recommendations. 'Recommendations for the management of candidemia in adults in Latin America' includes prophylaxis, empirical therapy, therapy for proven candidemia, patient work-up following diagnosis of candidemia, duration of candidemia treatment, and central venous catheter management in patients with candidemia. This manuscript is the second of this series that deals with diagnosis and treatment of invasive candidiasis. Other publications in this series include: 'Recommendations for the diagnosis of candidemia in Latin America', 'Recommendations for the management of candidemia in children in Latin America', and 'Recommendations for the management of candidemia in neonates in Latin America'.