Acute Myocardial Injury Assessed by High-Sensitivity Cardiac Troponin I Levels in Adult Patients with Early Sepsis at a Tertiary Referral Center in Mexico: An Exploratory Study.

The objective of the study was to describe the frequency of acute myocardial injury (AMI) assessed by high-sensitivity cardiac troponin I (hs-cTnI) levels and to determine the possible initial risk factors (related to the characteristics of the patient, the disease, and the initial management) in a population of adult patients with early sepsis (within the first 72 h of diagnosis) in a single tertiary hospital center in western Mexico. For the inferential statistics, the proportions of the categorical dichotomous variables were compared using the chi-square test. In all analyses, p values less than 0.05 with a 95% confidence interval were considered significant. We included a total of 64 patients diagnosed with early sepsis, of whom 46 presented elevated hs-cTnI and were classified as having AMI. In our study, the frequency of AMI in patients with early sepsis was 71.87%, and no significant differences were found in all of the characteristics of patients with early sepsis with and without AMI, nor was any significant association found with any of the variables analyzed. In the population of western Mexico, the frequency of AMI in patients with early sepsis, assessed by hs-cTnI levels, is high and similar to that reported in other populations worldwide.

Underlying and proximate drivers of biodiversity changes in Mesoamerican biosphere reserves.

Protected areas are of paramount relevance to conserving wildlife and ecosystem contributions to people. Yet, their conservation success is increasingly threatened by human activities including habitat loss, climate change, pollution, and species overexploitation. Thus, understanding the underlying and proximate drivers of anthropogenic threats is urgently needed to improve protected areas' effectiveness, especially in the biodiversity-rich tropics. We addressed this issue by analyzing expert-provided data on long-term biodiversity change (last three decades) over 14 biosphere reserves from the Mesoamerican Biodiversity Hotspot. Using multivariate analyses and structural equation modeling, we tested the influence of major socioeconomic drivers (demographic, economic, and political factors), spatial indicators of human activities (agriculture expansion and road extension), and forest landscape modifications (forest loss and isolation) as drivers of biodiversity change. We uncovered a significant proliferation of disturbance-tolerant guilds and the loss or decline of disturbance-sensitive guilds within reserves causing a "winner and loser" species replacement over time. Guild change was directly related to forest spatial changes promoted by the expansion of agriculture and roads within reserves. High human population density and low nonfarming occupation were identified as the main underlying drivers of biodiversity change. Our findings suggest that to mitigate anthropogenic threats to biodiversity within biosphere reserves, fostering human population well-being via sustainable, nonfarming livelihood opportunities around reserves is imperative.

Comparison of Central Aortic Pressure between Women with Preeclampsia and Normotensive Postpartum Women from an Urban Region of Western Mexico.

Background and Objectives: Central aortic pressure (CAP) can be measured through noninvasive methods, and CAP wave analysis can provide information about arterial stiffness. The objective of this study was to compare CAP in women with preeclampsia and normotensive postpartum women from an urban region in western Mexico. Materials and Methods: We recruited 78 women in immediate puerperium, including 39 with preeclampsia and 39 with normotension, who received delivery care in our hospital between September 2017 and January 2018. Pulse wave analysis was used to assess central hemodynamics as well as arterial stiffness with an oscillometric device. For this purpose, the measurement of the wave of the left radial artery was obtained with a wrist applanation tonometer and the ascending aortic pressure wave was generated using the accompanying software (V 1.1, Omron, Japan). Additionally, the systolic CAP, diastolic pressure, pulse pressure, heart rate, and rise rate adjusted for a heart rate of 75 bpm were determined. The radial pulse wave was calibrated using the diastolic and mean arterial pressures obtained from the left brachial artery. For all the statistical analyses, we considered p < 0.05 to be significant. Results: The results were as follows: a systolic CAP of 125.40 (SD 15.46) vs. 112.10 (SD 10.12) with p < 0.0001 for women with and without preeclampsia, respectively. Systolic CAP was significantly elevated in women with preeclampsia and could indicate an elevated risk of cardiovascular disease. Conclusion: CAP is an important parameter that can be measured in this group of patients and is significantly elevated in women with postpartum preeclampsia, even when the brachial blood pressure is normal.

Parents who spent more hours in intensive care units with their low birthweight newborn infant did not achieve autonomous care faster.

AIM: We examined the correlation between how long it took the parents of very low birthweight infants, born weighing up to 1500 g, to provide different kinds of autonomous care in a neonatal intensive care unit (NICU). METHODS: This prospective observational was conducted in the NICU of a Spanish hospital from 10 January 2020 to 3 May 2022. The unit had 11 beds single-family rooms and provided eight beds in an open bay room. The study examined breastfeeding, patient safety, participation in rounds, pain prevention and cleanliness. RESULTS: We studied 96 patients and their parents and there was no correlation between any type of care and the time it took parents to provide it autonomously. Parents in the single-family room cohort spent a median of 9.5 h per day between them in the NICU, while the parents in the open bay room spent 7.0 h with their infants (p = 0.03). However, parents in the single-family room group were able to recognise pain faster (p = 0.02). CONCLUSION: Parents in single-family rooms spent more time in the NICU and recognised pain faster but did not achieve autonomous care faster than parents in the open bay group.

Evaluation of the Effects of Atorvastatin and N-Acetyl Cysteine on Platelet Counts in Patients with Primary Immune Thrombocytopenia: An Exploratory Clinical Trial.

Objective: We aimed to evaluate the efficacy of the combination of atorvastatin and N-acetyl cysteine in increasing platelet counts in patients with immune thrombocytopenia who were resistant to steroid therapy or had a relapse after treatment. Material and Methods: The patients included in this study received oral treatment of atorvastatin at a dose of 40 mg daily and N-acetyl cysteine at a dose of 400 mg every 8 h. The desired treatment duration was 12 months, but we included patients who completed at least 1 month of treatment in the analysis. The platelet counts were measured prior to the administration of the study treatment and in the first, third, sixth, and twelfth months of treatment (if available). A p value < 0.05 was considered statistically significant. Results: We included 15 patients who met our inclusion criteria. For the total treatment duration, the global response was 60% (nine patients); eight patients (53.3%) had a complete response and one patient (6.7%) had a partial response. Six patients (40%) were considered as having undergone treatment failure. Of the responder group, five patients maintained a complete response after treatment (55.5%), three patients maintained a partial response (33.3%), and one patient (11.1%) lost their response to the treatment. All of the patients in the responder group had significant increases in their platelet counts after treatment (p < 0.05). Conclusion: This study provides evidence of a possible treatment option for patients with primary immune thrombocytopenia. However, further studies are needed.

Clinical and Biochemical Profile Associated with Renal Recovery after Acute Kidney Injury in A Mexican Population: Retrospective Cohort Study.

Background and Objectives: Our primary objective was to study the clinical and biochemical characteristics associated with acute kidney injury (AKI) remission in a group of Mexican patients. Materials and methods: We retrospectively enrolled 75 patients who were diagnosed with AKI and separated the sample into two groups: nonremitting patients (n = 27, 36%) vs. remitting patients (n = 48, 64%). Results: We found significant relationships between nonremitting AKI and previous diagnosis of chronic kidney disease (p = 0.009), higher serum creatinine (Cr) at admission (p < 0.0001), lower estimated glomerular filtration rate (eGFR) (p < 0.0001), maximum serum creatinine during hospitalization (p < 0.0001), higher fractional excretion of sodium (FENa) (p < 0.0003) and 24-h urine protein (p = 0.005), higher serum potassium on admission (p = 0.025), abnormal levels of procalcitonin (p = 0.006), and increased risk of death (p = 0.015). Conclusion: Chronic kidney disease (CKD), lower eGFR, higher levels of serum creatinine during hospitalization, higher FENa and 24-h urine protein, abnormal levels of procalcitonin, and higher serum potassium on admission were associated with nonremitting AKI. These findings may facilitate the rapid identification of patients at risk for nonremitting AKI based on clinical and biochemical characteristics. Furthermore, these findings may inform the design of timely strategies for the vigilance, prevention, and treatment of AKI.

Pneumocystis jirovecii Colonization in Mexican Patients with Chronic Obstructive Pulmonary Disease.

The prevalence of colonization by Pneumocystis jirovecii (P. jirovecii) has not been studied in Mexico. We aimed to determine the prevalence of colonization by P. jirovecii using molecular detection in a population of Mexican patients with chronic obstructive pulmonary disease (COPD) and describe their clinical and sociodemographic profiles. We enrolled patients discharged from our hospital diagnosed with COPD and without pneumonia (n = 15). The primary outcome of this study was P. jirovecii colonization at the time of discharge, as detected by nested polymerase chain reaction (PCR) of oropharyngeal wash samples. The calculated prevalence of colonization for our study group was 26.66%. There were no statistically significant differences between COPD patients with and without colonization in our groups. Colonization of P. jirovecii in patients with COPD is frequent in the Mexican population; the clinical significance, if any, remains to be determined. Oropharyngeal wash and nested PCR are excellent cost-effective options to simplify sample collection and detection in developing countries and can be used for further studies.

Índice de masa triponderal y marcadores de riesgo metabólico en niños y adolescentes con obesidad / Triponderal mass index and markers of metabolic risk in children and adolescents with obesity

Antecedentes y objetivo El índice de masa triponderal (IMT) estimaría mejor que el índice de masa corporal (IMC) el exceso de adiposidad, manteniendo valores estables durante la infancia. Este trabajo pretende determinar la correlación del IMT con marcadores de riesgo metabólico y establecer valores del IMT que se relacionen con un aumento del riesgo metabólico. Material y métodos Estudio multicéntrico, observacional, transversal y prospectivo en menores de 14 años con obesidad. Variables: edad, sexo, estadio puberal, peso, talla, perímetro abdominal, IMC, IMT, glucosa e insulina basales, índice HOMA, presión arterial, perfil lipoproteico, transaminasas y ácido úrico. El IMC y el IMT se expresaron según los valores del estudio longitudinal de Barcelona. Se realizó análisis estadístico con el programa SPSS*. Resultados Se incluyeron 199 pacientes (50,3% varones), con una edad media de 11,08 (2,48) años e IMT de 19,68 (2,36) kg/m3. Se observó correlación del IMT con el perímetro abdominal (r = 0,571; p = 0), la insulina (r = 0,198; p = 0,005), el índice HOMA (r = 0,189; p = 0,008) y el c-HDL (r = −0,188; p = 0,008). El IMT > 20,15 kg/m3 se asoció a insulina ≥ 15 mUI/ml (p = 0,029) y el IMT > 20,36 kg/m3 a c-HDL < 40 mg/dl (p = 0,023). Conclusiones El IMT se correlacionó con el incremento del perímetro abdominal, la insulina y el índice HOMA, y la disminución del c-HDL. El IMT > 20 kg/m3 puede asociarse a elevación de la insulina y a descenso del c-HDL. Por ello, el IMT parece ser un parámetro útil en la valoración de los pacientes pediátricos con obesidad (AU)Background and objective

Triponderal mass index (TMI) would estimate excess adiposity better than body mass index (BMI), maintaining stable values during childhood. This work aims to determine the correlation between TMI and markers of metabolic risk as well as set values of TMI that are related to an increase of metabolic risk. Material and methods Multicenter, observational, cross-sectional and prospective study in children under 14 years of age with obesity. Variables: age, sex, pubertal stage, weight, height, abdominal circumference, BMI, TMI, basal glucose and insulin, HOMA index, blood pressure, lipoprotein profile, transaminases and uric acid. BMI and TMI were expressed according to the values of the Barcelona longitudinal study. Statistical analysis was performed with the SPSS* program. Results One hundred and ninety-nine patients (50.3% male), age 11.08 (2.48) years, TMI 19.68 (2.36) kg/m3. Correlation between TMI and abdominal circumference (r = 0.571; p = 0), insulin (r = 0.198; p = 0.005), HOMA index (r = 0.189; p = 0.008) and HDL-c (r = −0.188; p = 0.008) was observed. IMT > 20.15 kg/m3 was associated with insulin ≥ 15 mIU/ml (p = 0.029) and IMT > 20.36 kg/m3 with HDL-c < 40 mg/dl (p = 0.023). Conclusions TMI was correlated with increase of abdominal circumference, insulin and HOMA index and decrease of HDL-c. IMT > 20 kg/m3 can be associated with increased insulin and decreased HDL-c. Therefore, the IMT seems to be a useful parameter in the assessment of pediatric patients with obesity (AU)

Landscape-scale forest cover drives the predictability of forest regeneration across the Neotropics.

Abandonment of agricultural lands promotes the global expansion of secondary forests, which are critical for preserving biodiversity and ecosystem functions and services. Such roles largely depend, however, on two essential successional attributes, trajectory and recovery rate, which are expected to depend on landscape-scale forest cover in nonlinear ways. Using a multi-scale approach and a large vegetation dataset (843 plots, 3511 tree species) from 22 secondary forest chronosequences distributed across the Neotropics, we show that successional trajectories of woody plant species richness, stem density and basal area are less predictable in landscapes (4 km radius) with intermediate (40-60%) forest cover than in landscapes with high (greater than 60%) forest cover. This supports theory suggesting that high spatial and environmental heterogeneity in intermediately deforested landscapes can increase the variation of key ecological factors for forest recovery (e.g. seed dispersal and seedling recruitment), increasing the uncertainty of successional trajectories. Regarding the recovery rate, only species richness is positively related to forest cover in relatively small (1 km radius) landscapes. These findings highlight the importance of using a spatially explicit landscape approach in restoration initiatives and suggest that these initiatives can be more effective in more forested landscapes, especially if implemented across spatial extents of 1-4 km radius.

[Triponderal mass index and markers of metabolic risk in children and adolescents with obesity]. / Índice de masa triponderal y marcadores de riesgo metabólico en niños y adolescentes con obesidad.

BACKGROUND AND OBJECTIVE: Triponderal mass index (TMI) would estimate excess adiposity better than body mass index (BMI), maintaining stable values during childhood. This work aims to determine the correlation between TMI and markers of metabolic risk as well as set values of TMI that are related to an increase of metabolic risk. MATERIAL AND METHODS: Multicenter, observational, cross-sectional and prospective study in children under 14 years of age with obesity. VARIABLES: age, sex, pubertal stage, weight, height, abdominal circumference, BMI, TMI, basal glucose and insulin, HOMA index, blood pressure, lipoprotein profile, transaminases and uric acid. BMI and TMI were expressed according to the values of the Barcelona longitudinal study. Statistical analysis was performed with the SPSS* program. RESULTS: One hundred and ninety-nine patients (50.3% male), age 11.08 (2.48) years, TMI 19.68 (2.36)kg/m3. Correlation between TMI and abdominal circumference (r=0.571; p=0), insulin (r=0.198; p=0.005), HOMA index (r=0.189; p=0.008) and HDL-c (r=-0.188; p=0.008) was observed. IMT>20.15kg/m3 was associated with insulin≥15mIU/ml (p=0.029) and IMT>20.36kg/m3 with HDL-c<40mg/dl (p=0.023). CONCLUSIONS: TMI was correlated with increase of abdominal circumference, insulin and HOMA index and decrease of HDL-c. IMT>20kg/m3 can be associated with increased insulin and decreased HDL-c. Therefore, the IMT seems to be a useful parameter in the assessment of pediatric patients with obesity.

Soil resistance and recovery during neotropical forest succession.

The recovery of soil conditions is crucial for successful ecosystem restoration and, hence, for achieving the goals of the UN Decade on Ecosystem Restoration. Here, we assess how soils resist forest conversion and agricultural land use, and how soils recover during subsequent tropical forest succession on abandoned agricultural fields. Our overarching question is how soil resistance and recovery depend on local conditions such as climate, soil type and land-use history. For 300 plots in 21 sites across the Neotropics, we used a chronosequence approach in which we sampled soils from two depths in old-growth forests, agricultural fields (i.e. crop fields and pastures), and secondary forests that differ in age (1-95 years) since abandonment. We measured six soil properties using a standardized sampling design and laboratory analyses. Soil resistance strongly depended on local conditions. Croplands and sites on high-activity clay (i.e. high fertility) show strong increases in bulk density and decreases in pH, carbon (C) and nitrogen (N) during deforestation and subsequent agricultural use. Resistance is lower in such sites probably because of a sharp decline in fine root biomass in croplands in the upper soil layers, and a decline in litter input from formerly productive old-growth forest (on high-activity clays). Soil recovery also strongly depended on local conditions. During forest succession, high-activity clays and croplands decreased most strongly in bulk density and increased in C and N, possibly because of strongly compacted soils with low C and N after cropland abandonment, and because of rapid vegetation recovery in high-activity clays leading to greater fine root growth and litter input. Furthermore, sites at low precipitation decreased in pH, whereas sites at high precipitation increased in N and decreased in C : N ratio. Extractable phosphorus (P) did not recover during succession, suggesting increased P limitation as forests age. These results indicate that no single solution exists for effective soil restoration and that local site conditions should determine the restoration strategies. This article is part of the theme issue 'Understanding forest landscape restoration: reinforcing scientific foundations for the UN Decade on Ecosystem Restoration'.

Prevalence of Dysexecutive Symptoms in High School Students during the COVID-19 Pandemic.

This is an observational cross-sectional study designed to ascertain the prevalence and severity of dysexecutive symptoms in high school students during the COVID-19 pandemic. The validated Spanish version of the Dysexecutive Questionnaire (DEX) was used. A total of 2396 participants aged 14-22 years were included. Our sample yielded a mean DEX scale score of 28.14 ± 17.42. By the DEX classification, 889 (37.1%) students achieved optimal scores, 384 (16%) reported mild dysexecutive symptoms, 316 (13.2%) reported moderate dysexecutive symptoms, and 807 (33.7%) reported strong dysexecutive symptoms. We found a significant difference between those with and those without employed mothers, with the former scoring higher (p = 0.004), the same as those with both parents employed (p = 0.004). Adolescents face emotional susceptibility and changes in their family, social, and educational environment related to isolation, resulting in altered emotional responses and social interaction.

El debate de los principios y reglas en la normatividad contable internacional / The debate on principles and rules in international accounting standards / A discussão de princípios e regras nas normas internacionais de contabilidade

RESUMEN El análisis conceptual de los estándares de información financiera internacional trae implícita una discusión jurídica, que se puede remontar al debate entre el pensamiento iuspositivista - iusnaturalista del derecho, debate que puede dar pautas para dilucidar si los estándares del International Accounting Standards Board (lASB) están basados en principios o reglas, así como también, aportar en la conceptualización del marco teórico de las políticas contables. La discusión sobre las bases de la normatividad contable generalmente carece de una visión transdisciplinar acadêmica y práctica. Se utilizó una metodología conceptual e interpretativa para comprender; desde la teorïa del derecho y desde la perspectiva del análisis económico del derecho, el dilema sobre principios o reglas, esto contribuye a la reflexión sobre la elección de las políticas contables adecuadas para la representación financiera y contable de las organizaciones.

AВSTRАСT The conceptual analysis of international financial reporting standards implies a legal discussion, which can be traced back to the debate between the iuspositivist - iusnaturalist thinking of law, a debate that can provide guidelines to elucidate whether the standards of the International Accounting Standards Board (IASB) are based on principles or rules, as well as to contribute to the conceptualization of the theoretical framework of accounting policies. The discussion on the basis of accounting standards generally lacks a transdisciplinary academic and practical vision. A conceptual and interpretative methodology was used to understand, from the theory of law and from the perspective of the economic analysis of law, the dilemma of principles or rules, which contributes to the reflection on the choice of appropriate accounting policies for the financial and accounting representation of organizations.

RESUMO A análise conceitual das normas internacionais de relato financeiro envolve uma discussão jurídica, que pode ser rastreada até o debate entre o pensamento iuspositivista - iusnaturalista da lei, um debate que pode fornecer diretrizes para esclarecer se as normas do International Accounting Standards Board (IASB) são baseadas em princípios ou regras, bem como para contribuir para a conceitualização da estrutura teórica das políticas contábeis. A discussão com base nas normas contábeis geralmente carece de uma visão acadêmica e prática transdisciplinar Uma metodologia conceitual e interpretativa foi utilizada para compreender a partir da teoria do direito e da perspectiva da análise econômica do direito, o dilema dos princípios ou regras, o que contribui para a reflexão sobre a escolha de políticas contábeis apropriadas para a representação financeira e contábil das organizações.

Strong floristic distinctiveness across Neotropical successional forests.

Forests that regrow naturally on abandoned fields are important for restoring biodiversity and ecosystem services, but can they also preserve the distinct regional tree floras? Using the floristic composition of 1215 early successional forests (≤20 years) in 75 human-modified landscapes across the Neotropic realm, we identified 14 distinct floristic groups, with a between-group dissimilarity of 0.97. Floristic groups were associated with location, bioregions, soil pH, temperature seasonality, and water availability. Hence, there is large continental-scale variation in the species composition of early successional forests, which is mainly associated with biogeographic and environmental factors but not with human disturbance indicators. This floristic distinctiveness is partially driven by regionally restricted species belonging to widespread genera. Early secondary forests contribute therefore to restoring and conserving the distinctiveness of bioregions across the Neotropical realm, and forest restoration initiatives should use local species to assure that these distinct floras are maintained.

Sex-Dependent Performance of the Neutrophil-to-Lymphocyte, Monocyte-to-Lymphocyte, Platelet-to-Lymphocyte and Mean Platelet Volume-to-Platelet Ratios in Discriminating COVID-19 Severity.

Background: The neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), lymphocyte-to-monocyte ratio (LMR), and mean platelet volume-to-platelet ratio (MPR) are combined hematology tests that predict COVID-19 severity, although with different cut-off values. Because sex significantly impacts immune responses and the course of COVID-19, the ratios could be biased by sex. Purpose: This study aims to evaluate sex-dependent differences in the contribution of NLR, PLR, MLR, and MPR to COVID-19 severity and mortality upon hospital admission using a sample of pneumonia patients with SARS-CoV-2 infection. Methods: This single-center observational cross-sectional study included 3,280 confirmed COVID-19 cases (CDC 2019-Novel Coronavirus real-time RT-PCR Diagnostic) from Quito (Ecuador). The receiver operating characteristic (ROC) curve analysis was conducted to identify optimal cut-offs of the above parameters when discriminating severe COVID-19 pneumonia and mortality risks after segregation by sex. Severe COVID-19 pneumonia was defined as having PaO2 < 60 mmHg and SpO2 < 94%, whereas non-severe COVID-19 pneumonia was defined as having PaO2 ≥ 60 mmHg and SpO2 ≥ 94%. Results: The mortality rate of COVID-19 among men was double that in women. Severe COVID-19 pneumonia and non-surviving patients had a higher level of NLR, MLR, PLR, and MPR. The medians of NLR, MLR, and MPR in men were significantly higher, but PLR was not different between men and women. In men, these ratios had lower cut-offs than in women (NLR: 2.42 vs. 3.31, MLR: 0.24 vs. 0.35, and PLR: 83.9 vs. 151.9). The sensitivity of NLR, MLR, and PLR to predict pneumonia severity was better in men (69-77%), whereas their specificity was enhanced in women compared to men (70-76% vs. 23-48%). Conclusion: These ratios may represent widely available biomarkers in COVID-19 since they were significant predictors for disease severity and mortality although with different performances in men and women.

Effect of convalescent plasma as complementary treatment in patients with moderate COVID-19 infection.

INTRODUCTION: South America is one of the regions most affected by the COVID-19 pandemic. Specific and affordable treatments are needed to treat SARS-CoV-2 infection. Evidence regarding the use of convalescent plasma in COVID-19 patients is still limited. We compared the safety and efficacy of COVID-19-convalescent plasma administration as a complement to standard treatment in the early management of patients with moderate SARS-CoV-2 infection. METHODS: We carried out a random double blinded, placebo-controlled trial that compared standard treatment plus convalescent plasma (CP) or plus non-convalescent plasma in the management of COVID-19 patients. The main outcome was survival and secondary endpoints included: length of hospitalisation (LOH), days from treatment to discharge, time to clinical improvement or death within a 28-day period, and adverse reactions to treatment. RESULTS: Administration of CP with antibodies against SARS-CoV-2 did not affect patient survival, RR = 1.003, 95% CI (0.3938, 2.555). These results led to terminate the RCT prematurely. However, early treatment of COVID-19 patients with CP tended to decrease the LOH while the delay in CP treatment was associated with longer hospitalisation. In addition, delay in CP treatment negatively affected the recovery of the respiratory rate. CONCLUSION: Use of CP for the treatment of COVID-19 patients is safe and its early use can decrease the LOH and improve respiratory function. Early administration of antibody-rich CP could contribute to decrease the negative impact of COVID-19 pandemic in patients with impaired immune response.

Nightingale, el ‘espacio para el cuidado’ y su influencia en la arquitectura de hospitales / Nightingale, o ‘espaço do cuidado’ e sua influência na arquitetura hospitalar / Nightingale, the ‘space for care’ and its influence on hospital architecture

A lo largo de la historia la salud y laenfermedad han sido motivo depreocupación para los hombres. Estasituación provocó que se crearan espacios arquitectónicos que sirvieran parareconquistar la primera y dejar atrás lasegunda. Son muchos los ejemplos deedificios, los hospitales, que se hanconstruido, unos con carácter temporal yotros definitivos. Los primeros vienen de lamano del mundo grecorromano que sentaron as bases para los posteriores. Pero a medidaque lo místico daba paso a la ciencia lasnecesidades cambiaron. Poco a poco, sefueron adaptando los espacios para crear lascondiciones más idóneas que facilitaran lacuración y el cuidado de los enfermos. Unode los ejemplos más interesantes, y que esconsiderado punto de partida, es laintervención que realiza FlorenceNightingale primero en el Hospital de St.Thomas y posteriormente en el HospitalHerbert en la segunda mitad del siglo XIX.En ellos, ciencia, arquitectura y salud se danla mano para caminar juntas y lograr así suobjetivo: curar y cuidar a los enfermos.(AU)

Throughout history, health andillness have been of concern to men. Thissituation led to the creation of architecturalspaces that served to reconquer the first andleave the second behind. There are manyexamples of buildings, hospitals, that havebeen built, some temporarily and otherspermanent. The former come from the handof the Greco-Roman world that laid thefoundations for the later ones. But as themystical gave way to science the needschanged. Little by little, the spaces wereadapted to create the most suitableconditions that would facilitate the healingand care of the sick. One of the mostinteresting examples, and which isconsidered a starting point, is theintervention carried out by FlorenceNightingale first at St. Thomas Hospital andlater at Herbert Hospital in the second half ofthe 19th century. In them, science,architecture and health go hand in hand towalk together and thus achieve their goal: tocure and care for the sick.(AU)

Ao longo da história, a saúde e adoença preocupam os homens. Esta situaçãolevou à criação de espaços arquitetônicosque serviram para reconquistar o primeiro edeixar o segundo para trás. Existem muitosexemplos de edifícios, hospitais, que foramconstruídos, alguns temporários e outrospermanentes. Os primeiros vêm das mãos domundo greco-romano que lançou as basespara os posteriores. Mas, à medida que omístico deu lugar à ciência, as necessidadesmudaram. Aos poucos, os espaços foramsendo adaptados para criar as condiçõesmais adequadas que facilitassem a cura e ocuidado dos enfermos. Um dos exemplosmais interessantes, e que é considerado umponto de partida, é a intervenção realizadapor Florence Nightingale primeiro noHospital St. Thomas e depois no HospitalHerbert na segunda metade do século XIX.Neles, ciência, arquitetura e saúdecaminham juntas para caminharem e assimatingirem seu objetivo: curar e cuidar dosenfermos.(AU)

Fuentes documentales para el estudio de la Sanidad en el Imperio Británico a través de la correspondencia de Florence Nightingale en la British Library / Fontes documentais para o estudo da cura no Império Britânico por meio da correspondência de Florence Nightingale na Biblioteca Britânica / Documentary sources for the study of Healing in the British Empire through the correspondence of Florence Nightingale in the British Library

En el presente trabajo analizamos la documentación sobre Florence Nightingale que encontramos en la British Library. Son de gran interés sus cartas con familiares, políticos y altos cargos del Ejército a través de las cuales podemos profundizar en el conocimiento de la Sanidad del Imperio Británico durante el siglo XIX, principios del siglo XX.(AU)

No presente trabalho analisamos adocumentação sobre Florence Nightingaleque encontramos no British Librart. Suascartas a familiares, políticos e altos oficiaisdo Exército, por meio das quais podemosaprofundar nosso conhecimento sobre aSaúde do Império Britânico durante o século19, início do século 20, são de grandeinteresse.(AU)

In the present work we analyze thedocumentation on Florence Nightingale thatwe found in the British Library. Her letterswith family members, politicians and highofficials of the Army through which we candeepen our knowledge of the Health of theBritish Empire during the 19 th century, thebeginning of the 20th century are of greatinterest.(AU)

Multidimensional tropical forest recovery.

Tropical forests disappear rapidly because of deforestation, yet they have the potential to regrow naturally on abandoned lands. We analyze how 12 forest attributes recover during secondary succession and how their recovery is interrelated using 77 sites across the tropics. Tropical forests are highly resilient to low-intensity land use; after 20 years, forest attributes attain 78% (33 to 100%) of their old-growth values. Recovery to 90% of old-growth values is fastest for soil (<1 decade) and plant functioning (<2.5 decades), intermediate for structure and species diversity (2.5 to 6 decades), and slowest for biomass and species composition (>12 decades). Network analysis shows three independent clusters of attribute recovery, related to structure, species diversity, and species composition. Secondary forests should be embraced as a low-cost, natural solution for ecosystem restoration, climate change mitigation, and biodiversity conservation.

Functional recovery of secondary tropical forests.

One-third of all Neotropical forests are secondary forests that regrow naturally after agricultural use through secondary succession. We need to understand better how and why succession varies across environmental gradients and broad geographic scales. Here, we analyze functional recovery using community data on seven plant characteristics (traits) of 1,016 forest plots from 30 chronosequence sites across the Neotropics. By analyzing communities in terms of their traits, we enhance understanding of the mechanisms of succession, assess ecosystem recovery, and use these insights to propose successful forest restoration strategies. Wet and dry forests diverged markedly for several traits that increase growth rate in wet forests but come at the expense of reduced drought tolerance, delay, or avoidance, which is important in seasonally dry forests. Dry and wet forests showed different successional pathways for several traits. In dry forests, species turnover is driven by drought tolerance traits that are important early in succession and in wet forests by shade tolerance traits that are important later in succession. In both forests, deciduous and compound-leaved trees decreased with forest age, probably because microclimatic conditions became less hot and dry. Our results suggest that climatic water availability drives functional recovery by influencing the start and trajectory of succession, resulting in a convergence of community trait values with forest age when vegetation cover builds up. Within plots, the range in functional trait values increased with age. Based on the observed successional trait changes, we indicate the consequences for carbon and nutrient cycling and propose an ecologically sound strategy to improve forest restoration success.