Landing manoeuvres predict roost-site preferences in bats.

Roosts are vital for the survival of many species, and how individuals choose one site over another is affected by various factors. In bats, for example, species may use stiff roosts such as caves or compliant ones such as leaves; each type requires not only specific morphological adaptations but also different landing manoeuvres. Selecting a suitable roost within those broad categories may increase landing performance, reducing accidents and decreasing exposure time to predators. We addressed whether bats select specific roost sites based on the availability of a suitable landing surface, which could increase landing performance. Our study focused on Spix's disc-winged bats (Thyroptera tricolor), a species known to roost within developing tubular leaves. As previous studies show that this species relies on the leaves' apex for safe landing and rapid post-landing settlement, we predicted that bats would prefer to roost in tubular structures with a longer apex and that landing would be consistently more effective on those leaves. Field observations showed that T. tricolor predominantly used two species for roosting, Heliconia imbricata and Calathea lutea, but they preferred roosting in the former. The main difference between these two plant species was the length of the leaf's apex (longer in H. imbricata). Experiments in a flight cage also showed that bats used more consistent approach and landing tactics when accessing leaves with a longer apex. Our results suggest that landing mechanics may strongly influence resource selection, especially when complex manoeuvres are needed to acquire those resources.

Specialized landing maneuvers in Spix's disk-winged bats (Thyroptera tricolor) reveal linkage between roosting ecology and landing biomechanics.

Disk-winged bats (Thyroptera spp.) are the only mammals that use suction to cling to smooth surfaces, having evolved suction cups at the bases of the thumbs and feet that facilitate attachment to specialized roosts: the protective funnels of ephemeral furled leaves. We predicted that this combination of specialized morphology and roosting ecology is coupled with concomitantly specialized landing maneuvers. We tested this by investigating landings in Thyroptera tricolor using high-speed videography and a force-measuring landing pad disguised within a furled leaf analogue. We found that their landing maneuvers are distinct among all bats observed to date. Landings comprised three phases: (1) approach, (2) ballistic descent and (3) adhesion. During approach, bats adjusted trajectory until centered in front of and above the landing site, typically the leaf's protruding apex. Bats initiated ballistic descent by arresting the wingbeat cycle and tucking their wings to descend toward the leaf, simultaneously extending the thumb disks cranially. Adhesion commenced when the thumb disks contacted the landing site. Significant body reorientation occurred only during adhesion, and only after contact, when the thumb disks acted as fulcra about which the bats pitched 75.02±26.17 deg (mean±s.d.) to swing the foot disks into contact. Landings imposed 6.98±1.89 bodyweights of peak impact force. These landing mechanics are likely to be influenced by the orientation, spatial constraints and compliance of furled leaf roosts. Roosting ecology influences critical aspects of bat biology, and taken as a case study, this work suggests that roosting habits and landing mechanics could be functionally linked across bats.

A chemotherapy only therapeutic approach to pediatric Hodgkin lymphoma: AHOPCA LH 1999.

BACKGROUND: AHOPCA is a collaborative group that designs uniform treatment regimens (protocols) for children diagnosed with cancer in Central America. Based on a preliminary report from one of the AHOPCA centers, AHOPCA adopted a treatment regimen to maintain a good event-free survival (EFS) as well as eliminate radiation therapy from the treatment of children with Hodgkin lymphoma. PROCEDURE: Newly diagnosed patients with histologically proven Hodgkin lymphoma were staged according to the Ann Arbor classification and divided into favorable (stage I, stage IIA, and IIIA) and unfavorable (stage IIB, IIIB, and IV) groups. Subjects classified as group 1 (favorable) were treated with six 28-day cycles of chemotherapy (COPP/COPP ± ABV). Subjects classified as group 2 (unfavorable) were treated with eight 28-day cycles of COPP/ABV chemotherapy. RESULTS: Of 269 patients registered, 216 were eligible for evaluation. The mean age at diagnosis was 7.5 years with a male to female ratio of 3.7-1. The predominant histology was nodular sclerosis (44%) but with a relatively high proportion of mixed cellularity (35.2%) The EFS at 5 and 10 years was 71% and 68%, respectively. There was a 14% rate of abandonment of therapy. CONCLUSION: This treatment regimen for children with Hodgkin lymphoma, when applied as a multi-institutional regimen, had poorer outcome than our previously reported preliminary data and was inferior to the EFS reported in high-income countries. The major contributor adversely affecting EFS in this report is abandonment of therapy. Given these results, AHOPCA initiated a concerted effort to decrease abandonment of therapy.

Prevalence of post-traumatic stress disorder risk post-COVID-19 in 12 countries in Latin America: a cross-sectional survey.

Introduction: Latin America was the region most affected by COVID-19 in the second quarter of 2020, and consequently, the impact on mental health requires evaluation. The aim of this study was to assess the risk of post-traumatic stress disorder (PTSD) caused by bereavement due to COVID-19 in 12 countries in Latin America. Methods: The current study was an analytical cross-sectional study. Validated tests were applied for PTSD, depression, anxiety, and stress (DASS-21), questions about the respondent's condition or their environment, and demographic questions, as well as the length of the mourning period of suffering. Results: The outcomes demonstrated that the PTSD risk increased for women (p < 0.001), when a friend or acquaintance had COVID-19 (p = 0.002), when a close relative died from COVID-19 (p = 0.010), having severe depression (p <0.001), severe anxiety (p <0.001), severe stress (p <0.001), residing in Chile (p <0.001), Paraguay (p <0.001), Bolivia (p <0.001), Costa Rica (p <0.001) or El Salvador (p = 0.005). On the other hand, there was less risk of PTSD at an older age (p <0.001) or if respondents had a sentimental partner (p = 0.025). In the case of severe PTSD, there was a greater gender risk for women (p <0.001), a close relative dying from COVID-19 (p = 0.017), having severe depression (p <0.001), severe anxiety (p <0.001), severe stress (p <0.001), residing in Chile (p <0.001), Paraguay (p <0.001), Bolivia (p <0.001) and Costa Rica (p = 0.002). It was also observed that there was less risk of severe PTSD at an older age demographic (p <0.001). Discussion: It can be concluded that the percentages of PTSD are high in its clinical presentation as severe, especially among Latin American women.

Factores asociados a inadecuadas prácticas de distanciamiento social durante la pandemia por COVID-19 en Perú / Factors associated to inadequate practices of social distancing during the COVID-19 pandemic in Peru

Objetivo: Determinar los factores asociados a inadecuadas prácticas de distanciamiento social durante la pandemia por COVID-19 en Perú. Material y métodos. Se administró una encuesta en línea dirigida para adultos de diversas regiones del Perú seleccionados mediante un muestreo por bola de nieve, la encuesta incluía una escala para la medición de prácticas de distanciamiento social, el uso de la información, el afrontamiento emocional frente al coronavirus y características sociodemográficas. Se realizó un análisis bivariado y multivariado utilizando razones de prevalencia cruda (RP) y ajustadas (RPa) con intervalos de confianza al 95 % por medio de modelos lineales generalizados. Resultados. Se incluyeron 377 personas de los cuales el 55,4 % fueron hombres y 77,5 % residían fuera de Lima, el 35 % de los encuestados tuvo inadecuadas prácticas de distanciamiento social lo que estuvo asociado con tener primaria o secundaria incompleta (RPa 1,41, IC 95 %: 1,11 a 1,81), inadecuado uso de la información (RPa 2,82, IC 95 %: 1,98 a 4,05) e inadecuado afrontamiento emocional frente al coronavirus (RPa 1,76, IC 95 %: 1,27 a 2,42). Conclusión. Personas con menor grado de instrucción, inadecuado uso de la información y con un negativo afrontamiento emocional frente al coronavirus tienen mayor probabilidad de inadecuadas prácticas de distanciamiento social.

Objective: To determine the factors associated with inadequate social distancing practices during the COVID-19 pandemic in Peru. Material and methods. A targeted online survey was administered to adults from various regions of Peru selected by snowball sampling. The survey included a scale for measuring social distancing practices, use of information, emotional coping with the coronavirus, and sociodemographic characteristics. Bivariate and multivariate analysis was performed using crude (PR) and adjusted (aPR) prevalence ratios with 95% confidence intervals by means of generalized linear models. Results. We included 377 people of whom 55.4 % were men and 77.5 % resided outside Lima, 35 % of the respondents had inadequate social distancing practices which was associated with having incomplete primary or secondary school (RPa 1.41, 95 % CI: 1.11 to 1.81), inadequate use of information (PRa 2.82, 95 % CI: 1.98 to 4.05) and inadequate emotional coping in the face of coronavirus (PRa 1.76, 95 % CI: 1.27 to 2.42). Conclusion. People with lower educational level, inadequate use of information and negative emotional coping with coronavirus are more likely to have inadequate social distancing practices.

Lactancia materna exitosa en puérperas de menos de 48 horas en el Hospital de Apoyo María Auxiliadora / Puerperal successful breastfeeding in less that 48 hours in Hospital de Apoyo Mar¡a Auxiliadora

Objetivo: Determinar la autoeficacia de la puérperas en amamantar a sus hijos menores de 48 horas y construir el perfil sociodemográfico y obstétrico de las madres. Material y Métodos: El estudio es de tipo descriptivo, transversal, realizados con 100 puérperas de Hospital de Apoyo María Auxiliadora en Lima Perú, entre el 9 y el 14 de noviembre de 2010. Los datos sociodemográficos y obstétricos fueron recolectados de la historia clínica de la madre y se aplicó la BSES-SF. Resultados: 72 (72%) mostraron un elevado nivel de auto eficacia para la lactancia materna, 26 (26%) un nivel medio y 2 (2%) un nivel bajo. Hubo asociación estadísticamente significativa entre la edad, estado civil, paridad, control prenatal, y el puntaje de auto eficacia para la lactancia materna (p<0.05). Conclusiones: Los niveles alcanzados en la BSES-SF por la población estudiada fueron altos. Ser de 20 años, soltera, primípara y menor número de control prenatal, aumentan el riesgo para la lactancia no sea exitosa.

Objective: To determine the efficacy of the women with breastfeeding their children under 48 hours and build the demographic profile and obstetric mothers. Material and Methods: This descriptive, transversal study was conducted with 100 women in “Hospital de Apoyo Mar¡a Auxiliadora” public hospital in Lima Peru, from November 90th to 14th, 2010. Demographic and obstetric data were collected from mother’s medical history and then the BSES-SF from was applied. Results: 72 (72%) mothers showed high self-efficacy to breastfeed. We found a statistically significant association between age, marital status, prenatal checkups and breastfeeding self -efficacy scores (p=<0.05). Conclusions: The levels reached in the BSES-SF for the study population were high. Being under 20, unmarried, primiparous and fewer prenatal care, increase the risk for breastfeeding is not successful.

Protocol-based treatment for children with cancer in low income countries in Latin America: a report on the recent meetings of the Monza International School of Pediatric Hematology/Oncology (MISPHO)--part II.

Pediatric cancer programs in low-income countries (LIC) can improve outcomes. However, treatment must be tailored to the patient's living conditions and the availability of supportive care. In some cases, a more intense regimen will decrease survival since the increase in death from toxicity may exceed any decrease in relapse. Attempts to practice evidence-based pediatric oncology are thwarted by the lack of evidence derived from local experience in LIC to determine optimal therapy. This report summarizes treatment regimens used by pediatric oncologists from 15 countries of the Caribbean, Central and South America who participate in the Monza International School of Pediatric Hematology/Oncology (MISPHO). Patients with hepatoblastoma, Wilms tumor, and histiocytosis treated on unmodified published protocols had outcomes comparable to those in high-income countries (HIC). Those with rhabdomyosarcoma, osteosarcoma, Hodgkin lymphoma, and acute myeloid leukemia treated with unmodified regimens had event-free survival estimates 10%-20% lower than those reported in HIC due to higher rates of toxic death, abandonment of therapy, and relapse. Treatment of retinoblastoma is complicated by advanced stages and extraocular disease at diagnosis; improved outcomes depend on education of pediatricians and the public to recognize early signs of this disease. Use of unmodified protocols for Burkitt lymphoma and acute lymphoblastic leukemia have been associated with unacceptable toxicity in LIC, so MISPHO centers have modified published regimens by giving lower doses of methotrexate and reducing use of anthracyclines. Despite the use of all-trans-retinoic acid during induction for acute promyelocytic leukemia, the incidence of fatal hemorrhage remains unacceptably high.

Miasis entérica por Hermetia illucens (Diptera: Stratiomyidae) en una paciente geriátrica de Costa Rica / Enteric myiasis by Hermetia illucens (Diptera: Stratiomyidae) in a geriatric patient of Costa Rica

Se reporta un caso de miasis entérica por Hermetia illucens (Diptera: Stratiomyidae) en una paciente femenina de 71 años de edad. La paciente presentó antecedentes de cardiopatía isquémica e hipertensión. También sufrió de colelitiasis y diverticulitis con una alta eosinofilia y recientemente se le diagnosticó un proceso carcinomatoso abdominal. Los niveles de eosinófilos estuvieron entre el 9 y el 31 por ciento en diferentes análisis. Considerando la presencia de huevos de Ascaris lumbricoides en una muestra fecal, fue tratada con mebendazole; luego del tratamiento la paciente defecó dos larvas, cuya morfología es compatible con H. illucens. El presente trabajo constituye el primer informe de una miasis entérica por H. illucens en Costa Rica.

We report a case of enteric myiasis by Hermetia illucens (Diptera: Stratiomyidae) in a 71 year old woman. The patient showed history of ischemic hearth disease and hypertension. She also suffered colelitiasis and diverticulitis with high eosinophilia and recently there was diagnosed an abdominal carcinomatosis process. The eosinophil levels were between 9 to 31% in different analysis. Considering the presence of Ascaris lumbricoides eggs in a fecal sample, she was treated with mebendazole. After the treatment, two larvae compatible with H. illucens (Diptera: Stratiomyidae) were defecated. This is the first report of an enteric myiasis by H. illucens in Costa Rica.

Tumores del ovario en niñas prepúberes / Ovarian tumors in prepuberal girls

Se revisaron los expedientes de 62 niñas prepúberes con edades entre uno y 13 años, que fueron intervenidas quirúrgicamente por presentar tumores originados en el ovario: diecisiete de tipo maligno, (nueve disgerminomas, cinco tumores del seno endodérmico, dos linfomas no Hodgkin y un teratoma inmaduro G III), 14 en estadio III y tres en estadio II y 45 de carácter benigno, (35 teratomas maduros GO, ocho quistes foliculares y dos tumores juveniles de células de la granulosa con función estrógena). En 12 de los tumores malignos se hizo resección quirúrgica amplia y se aplicó quimioterapia y radioterapia y en cinco cirugía conservadora y quimioterapia, obteniéndose sobrevidas del 100% en los disgerminomas y linfomas pero mortalidad del 100% en los casos de tumores del seno endodérmico y teratoma maligno. Todos los pacientes con tumores benignos sobreviven con tratamiento quirúrgico conservador: 26 han presentado menarquias normales y cuatro embarazos con productos sanos. Se considera que en los disgerminomas y linfomas no Hodgkin del ovario la cirugía conservadora y la quimioterapia múltiple pueden curar a las pacientes, pero que, en los casos de tumor del seno endodérmico o teratoma maligno el tratamiento quirúrgico debe ser agresivo y deben utilizarse nuevos quimioterápicos en esquemas apropiados. Los teratomas benignos y tumores juveniles de células de la granulosa se pueden abordar con una cirugía conservadora debido a su comportamiento benigno

Tumores malignos poco frecuentes en el niño: aspectos clínicos y epidemiológicos / Infrequent malignant tumors in the child: clinical an epidemiological aspects

En un periodo de 15 años fueron diagnosticados, en el Hospital Nacional de Niños de Costa Rica, 56 casos de tumores poco frecuentes en 33 niños del sexo masculino y 23 del femenino, con edades entre uno y 13 años; 21 eran carcinomas indiferenciados de la nasofaringe, 9 eran carcinomas del hígado de tipo adulto, 8 carcinomas de tiroides (7 papilares y uno folicular); 4 carcinomas mucinosos de colon, 4 carcinoides del apéndice, 4 carcinomas mucinosos de glándulas salivales, 3 adenocarcinomas de suprarrenal, un adenocarcinoma de células B del páncreas, un carcinoma epidemoide de piel y un melanoma maligno. Cincuenta por ciento ingresaron con metástasis regionales y 18% con distales; 39% fueron tratados quirúrgicamente; 52% recibieron algún tipo de quimioterapia y 43% radioterapia; 45% de los niños fallecieron en un tiempo promedio de 17 meses después del diagnóstico y 55% se encuentran en remisión por periodos de 12 a 120 meses (promedio 60 meses). Se discuten algunos aspectos sobre padecimientos predisponentes, tales como xeroderma pigmentoso, nevus congénito y cirrosis, presentes en 4 pacientes, la acción cancerígena de la radiación previa y el contacto con dioxinas y aflatoxinas en niños provenientes de regiones agrícolas altamente contaminadas

Resultados del tratamiento del linfoma no Hodgkin del niño: protocolo L278 modificado / Results of the treatment of non-Hodgkin's lymphoma in child: modified L278 protocol

Entre enero de 1983 y julio de l984, un grupo de 14 niños con linfoma no Hodgkin (LNH), 12 del sexo masculino y 2 del femenino (6:1) y edades entre los 2 y 10 años, fueron tratados con el protocolo L278 modificado (Hospital Nacional de Niños de Costa Rica). La modificación se realizó agregando una fase de consolidación después de la inducción, con methotrexate (MTX) (1 g/m2, iv) y rescate leucovorínico (20 mg/m2 im/po c/6 horas por 3 dosis) en los casos de LNH de células B o abdominales y citosín arabinósida (Ara C) (1200 mg/m2 iv) y L asparaginosa (10000 U/m2 im c/48 horas por 4 dosis), en los casos de LNH de células T o mediastinales. En la fase de prevención de recaída al SNC, se agregó Ara C intrarraquídea (60 mg, 50 mg y 30 mg a los niños de más de 3, 2 y 1 año respectivamente) cada 2 semanas por 3 dosis. Los demás medicamentos se aplicaron en la misma forma que en el protocolo L278, pero se acortó la fase de mantenimiento en los E III y IV de 18 a 15 meses. Doce casos eran abdominales: 10 en E III, uno en E II y uno en E IV (médula ósea infiltrada). Uno se localizó en mediastino (E III) y uno en ganglios cervicales (E I). En 10 casos la histología fue indiferenciado no Burkitt, en uno Burkitt y en tres no fue clasificable. Diez pacientes se laparotomizaron, en otros tres el diagnóstico se hizo por biopsia y en uno por citología. Los 14 presentaron remisión inicial completa; un niño, en E IV, recayó en SNC y médula ósea y falleció a los cinco meses del diagnóstico; otro, en E III abdominal, falleció a los nueve meses de remisión comprobada por autopsia, debido a miocardiopatía por adriamicina. Doce niños, fuera de tratamiento, se encuentran en remisión completa con una sobrevida de 15 a 30 meses