A Chiral B-N Adduct as a New Frontier in Ferroelectrics and Piezoelectric Energy Harvesting.

Within the burgeoning field of electronic materials, B-N Lewis acid-base pairs, distinguished by their partial charge distribution across boron and nitrogen centers, represent an underexplored class with significant potential. These materials exhibit inherent dipoles and are excellent candidates for ferroelectricity. However, the challenge lies in achieving the optimal combination of hard-soft acid-base pairs to yield B-N adducts with stable dipoles. Herein, we present an enantiomeric pair of B-N adducts [R/SC6H5CH(CH3)NH2BF3] (R/SMBA-BF3) crystallizing in the polar monoclinic P21 space group. The ferroelectric measurements on RMBA-BF3 gave a rectangular P-E hysteresis loop with a remnant polarization of 7.65 µC cm-2, a value that aligns with the polarization derived from the extensive density-functional theory computations. The PFM studies on the drop-casted film of RMBA-BF3 further corroborate the existence of ferroelectric domains, displaying characteristic amplitude-bias butterfly and phase-bias hysteresis loops. The piezoelectric nature of the RMBA-BF3 was confirmed by its direct piezoelectric coefficient (d33) value of 3.5 pC N-1 for its pellet. The piezoelectric energy harvesting applications on the sandwich devices fabricated from the as-made crystals of RMBA-BF3 gave an open circuit voltage (VPP) of 6.2 V. This work thus underscores the untapped potential of B-N adducts in the field of piezoelectric energy harvesting.

A spatial framework for improved sanitation to support coral reef conservation.

Coral reefs are one of the most valuable yet threatened ecosystems in the world. Improving human wastewater treatment could reduce land-based impacts on coral reefs. However, information on the quantity and spatial distribution of human wastewater pollution is lacking. Here, we develop a spatial model linking residential human wastewater pollution (nitrogen and phosphorus/year) and conservation sectors [coral reefs] to better understand the relative differences in the distribution and efficacy of different sanitation services and their potential implications for conservation monitoring and management. We apply our model to Fiji, where ongoing initiatives and investments in wastewater treatment for human health could be leveraged to cost-effectively improve coral reef condition. We estimate that wastewater treatment plants account for nearly 80% of human wastewater nutrients released into surface waters. Wasterwater nutrient pollution is widespread, affecting 95% of reefs, but is concentrated across a few watersheds. Our spatially explicit approach can be used to better understand potential benefits and trade-offs between sanitation service improvements and coral reef health, helping to bridge the sanitation and conservation sectors as well as inform and prioritize on the ground action.

Ruptura de hematoma hepático secundario a terapia neural / Rupture of hepatic hematoma secondary to neural therapy

Objetivo: determinar si la terapia neural es una opción de tratamiento que pueda ser utilizada sin la aparición de efectos adversos. Presentación del caso: se presenta y analiza el caso de una paciente que ingresó a urgencias por dolor abdominal generalizado diagnosticándose hematoma hepático y realizándosele una revisión de la literatura científica. Resultados: se procedió a efectuar laparotomía con cirugía de control de daños, obteniendo resultados satisfactorios con egreso hospitalario sin complicaciones agregadas. Conclusiones: la terapia neural es un tratamiento del cual no se tiene suficiente evidencia científica que avale su seguridad en los pacientes

Objective: to determine whether neural therapy is a treatment option which can be used without the occurrence of adverse effects. Case report: we present and analyze the case of a female patient who was admitted to the emergency room for generalized abdominal pain. A hepatic hematoma was diagnosed, and a review of the scientific literature was conducted. Results: a laparotomy with damage control surgery was performed, obtaining satisfactory outcomes, with hospital discharge without any added complications. Conclusions: neural therapy is a treatment for which there is not enough scientific evidence to support its safety in patients

Descripción de 4 casos: tumor desmoide de la mama, diagnóstico y manejo de un tumor infrecuente / Description of four cases: desmoid tumor of the breast, diagnosis and management of a rare tumor

Introducción: el tumor desmoide (TD) de la mama es una lesión poco frecuente constituida por proliferación de células fibroblásticas. Puede localizarse a nivel intra o extraabdominal y la localización mamaria es excepcional. Aunque es una lesión benigna tiene un comportamiento localmente agresivo sin metástasis ganglionar o a distancia. Su etiología es desconocida y entre el 10 y 20% de los casos están relacionados con la poliposis adenomatosa familiar. Se presenta como un nódulo sólido de nueva aparición e indoloro. El tratamiento clásicamente ha sido la resección quirúrgica, con elevadas tasas de recurrencia a pesar de márgenes libres. Otras terapias están siendo estudiadas. Nuestro objetivo es revisar el manejo del TD de la mama a través del análisis de la casuística en nuestro centro en los últimos 10 años y la revisión de las evidencias disponibles. Métodos: análisis descriptivo retrospectivo. Los casos se identificaron empleando el sistema de explotación de la información del hospital. Se realizó una revisión narrativa de la literatura. Resultados: nuestra serie consta de 4 casos, mujeres de entre 36 y 66 años. Tres de ellas consultaron por nódulo palpable. La BAG presentó hallazgos compatibles con un TD. Los casos fueron presentados en un comité multidisciplinar y se propuso una resección quirúrgica amplia. La AP confirmó el diagnóstico y en uno de los casos informó de márgenes afectos. Durante el seguimiento se evidenció recidiva en dicho caso. Conclusiones: los TD son tumores infrecuentes, de repercusión clínica y respuesta al tratamiento variable. Este debe incluir la opción expectante y, en cualquier caso, individualizarse y consensuarse dentro de una perspectiva multidisciplinar. (AU)

Introduction: The desmoid tumor (DT) of the breast is a rare lesion consisting of proliferation of fibroblastic cells. It can be located intra- or extra-abdominally and the mammary location is exceptional. Although it is a benign lesion, it has a locally aggressive behavior without lymph node or distant metastasis. Its etiology is unknown and 10–20% of cases are related to familial adenomatous polyposis. It presents as a new, painless solid nodule. The treatment has traditionally been surgical resection, with high rates of recurrence despite free margins. Other therapies are being studied. Our objective is to review the management of DT of the breast through the analysis of the casuistry in our center in the last 10 years and the review of the available evidence. Methods: Retrospective descriptive analysis. The cases were identified using the hospital information exploitation system. A narrative review of the literature was performed. Results: Our series consists of 4 cases, women between 36 and 66 years old. Three of them consulted for a palpable nodule. The CNB presented findings compatible with DT. The cases were presented to a multidisciplinary committee and a wide surgical resection was proposed. The AP confirmed the diagnosis and in one of the cases reported affected margins. During follow-up, recurrence was observed in this case. Conclusions: DTs are infrequent tumors, with clinical repercussions and variable response to treatment. This must include the expectant option and, in any case, be individualized and agreed upon within a multidisciplinary perspective. (AU)

Análisis del manejo de lesiones B3 de la mama en nuestro centro: comparativa con consensos y oportunidades de mejora / Analysis of the management of B3 breast lesions in our center: Comparison with consenses and opportunities for improvement

Introducción: las lesiones B3 comprenden un grupo heterogéneo de lesiones proliferativas epiteliales de mama que suponen un riesgo variable de aparición subsiguiente de carcinoma. Nuestro objetivo es analizar el manejo de las lesiones B3 en nuestro centro entre 2017 y 2021 y compararlo con las recomendaciones de los consensos internacionales. Material y métodos: análisis descriptivo retrospectivo. Se incluyeron en el estudio todos los pacientes con diagnóstico histológico (por BAG o BAV) de lesión de mama B3, intervenidos o no, en el periodo indicado. Resultados: se identificaron 79 casos. Se realizó BAG en el 83,54% de los casos y BAV en el 16,45%. El 80,3% de las BAG realizadas fueron diagnósticas de LP, en 6 casos HDA y en 5 casos TF. Se realizó BAV en 11 casos. Se indicó intervención quirúrgica en el 97,46% de los casos. El análisis anatomopatológico de la pieza quirúrgica mostró en el 63,63% de los casos LP sin atipia. Cinco casos (6,49%) fueron diagnosticados de CLIS, 5 casos de CDIS, 4 casos de TF benigno y 4 casos de HDA. Dos casos fueron diagnosticados de CR y de HD usual. Discusión: el manejo de las lesiones B3 llevado a cabo en nuestro centro está marcado por el sobretratamiento respecto a las recomendaciones de los consensos. Una adaptación más estricta a las recomendaciones vigentes, la discusión de los casos en el CMD, que incluya la correlación radio-patológica y la evaluación de la lesión residual, y el uso más frecuente de BAV podría disminuir esta tendencia. (AU)

Introduction: B3 lesions comprise a heterogeneous group of proliferative epithelial lesions of the breast that pose a variable risk of subsequent development of carcinoma. Our objective is to analyze the management of B3 lesions in our center between 2017 and 2021 and compare it with the recommendations of the international consensus. Material and methods: Retrospective descriptive analysis. All patients with a histological diagnóstico (by BAG or AVB) of a B3 breast lesion, operated on or not, in the indicated period, were included in the study. Results: 79 cases were identified. BAG was performed in 83.54% of the cases and BAV in 16.45%. 80.3% of the BAG performed were diagnostic of LP, HDA in 6 cases and TF in 5 cases. BAV was performed in 11 cases. Surgical intervention was indicated in 97.46% of the cases. The anatomopathological analysis of the surgical specimen showed LP without atypia in 63.63% of the cases. Five cases (6.49%) were diagnosed with LCIS, five cases with DCIS, four cases with benign TF, and four cases with HDA. Two cases were diagnosed with CR and usual HD. Discussion: The management of B3 lesions carried out in our center is marked by overtreatment with respect to the consensus recommendations. A stricter adaptation to the current recommendations, the discussion of the cases in the CMD, which includes the radiopathological correlation and the evaluation of the residual lesion, and the more frequent use of AVB could reduce this tendency. (AU)

Manejo de un tumor benigno del pezón infrecuente en un hospital terciario. El adenoma de pezón / Management of a rare nipple benign tumor in a tertiary hospital. the nipple adenoma

El adenoma de pezón es un tumor benigno que se origina en los conductos galactóforos del pezón. El objetivo de nuestro estudio es describir y comparar con la literatura la casuística del adenoma de pezón en nuestro centro, desde enero de 2009 hasta diciembre de 2019. Nuestra serie de casos la forman 5 pacientes. Todos son mujeres, de edades comprendidas entre los 40 y los 82 años. Dos pacientes consultaron por telorragia y las restantes fueron derivadas de atención primaria por lesiones en el pezón de nueva aparición. Las pruebas de imagen no presentaron hallazgos específicos. El resultado de la biopsia preoperatoria fue diagnóstico de adenoma de pezón en todos los casos. En todos los casos se realizó exéresis simple de la lesión. Ningún paciente presentó recidiva ni aparición de carcinoma con una media de seguimiento de 31 meses. Una paciente falleció por otros motivos. Como conclusión se destaca la importancia de la biopsia y el estudio inmunfenotípico para realizar el diagnóstico diferencial con otras afecciones como la enfermedad de Paget o el carcinoma de pezón. El manejo quirúrgico no muestra cambios respecto a la literatura, prefiriendo opciones más conservadoras como la escisión local con resultados excelentes a largo plazo. (AU)

Nipple adenoma is a benign tumor that originates in the milk ducts of the nipple. The objective of our study is to describe and compare the casuistry of nipple adenoma in our center between January 2009 and December 2019 with the literature. Our case series consists of 5 patients. They are all women, aged between 40 and 82 years. Two patients consulted for telorrhagia and the rest were referred from primary care for new-onset nipple lesions. Imaging tests did not present specific findings. The result of the preoperative biopsy was diagnostic of nipple adenoma in all cases. In all cases, simple exeresis of the lesion was performed. No patient presented recurrence or appearance of carcinoma with a mean follow-up of 31 months. One patient died for other reasons. In conclusion, the importance of the biopsy and the immunophenotypic study to perform the differential diagnóstico with other pathologies such as Paget's disease or nipple carcinoma should be highlighted. Surgical management shows no changes compared to the literature, preferring more conservative options such as local excision with excellent long-term results. (AU)

Union formation, within-couple dynamics, and child well-being: A global macrolevel perspective.

Studies on global changes in families have greatly increased over the past decade, adopting both a country-specific and, more recently, a cross-national comparative perspective. While most studies are focused on the drivers of global changes in families, little comparative research has explored the implications of family processes for the health and well-being of children. This study aims to fill this gap and launch a new research agenda exploring the intergenerational implications of union-formation and within-couple dynamics for children's health and well-being across low- and middle-income countries (LMICs), both globally, regionally, and by the stage of fertility transition. We do so by adopting a macro-level perspective and a multi-axis conceptualization of children's outcomes - health at birth, health in later life, and schooling - and leveraging Demographic and Health Survey and World Bank data across 75 LMICs. Our results show that in societies where partnerships are characterized by more equal status between spouses - i.e., where the age range between spouses and differences in years of schooling between partners are narrower - children fare better on several outcomes. These associations are particularly strong in mid- and high-fertility settings. Despite a series of regularities, our results also highlight a set of findings whereby, at a macro-level, the prevalence of marriage and divorce/separation are not invariably associated with children's outcomes, especially in LMICs where fertility is comparatively lower. We document little cross-regional heterogeneity, primarily highlighting the centrality of demographic factors such as age vis-à-vis, for instance, region-specific characteristics that are more tied to the social fabric of specific societies.

Modulating cyclic nucleotides pathways by bioactive compounds in combatting anxiety and depression disorders.

Anxiety and depression disorders are highly prevalent neurological disorders (NDs) that impact up to one in three individuals during their lifetime. Addressing these disorders requires reducing their frequency and impact, understanding molecular causes, implementing prevention strategies, and improving treatments. Cyclic nucleotide monophosphates (cNMPs) like cyclic adenosine monophosphate (cAMP), cyclic guanosine monophosphate (cGMP), cyclic uridine monophosphate (cUMP), and cyclic cytidine monophosphate (cCMP) regulate the transcription of genes involved in neurotransmitters and neurological functions. Evidence suggests that cNMP pathways, including cAMP/cGMP, cAMP response element binding protein (CREB), and Protein kinase A (PKA), play a role in the physiopathology of anxiety and depression disorders. Plant and mushroom-based compounds have been used in traditional and modern medicine due to their beneficial properties. Bioactive compound metabolism can activate key pathways and yield pharmacological outcomes. This review focuses on the molecular mechanisms of bioactive compounds from plants and mushrooms in modulating cNMP pathways. Understanding these processes will support current treatments and aid in the development of novel approaches to reduce the prevalence of anxiety and depression disorders, contributing to improved outcomes and the prevention of associated complications.

Human fertility after a disaster: a systematic literature review.

Fertility is a key demographic parameter influenced by disaster. With the growing risk of disasters, interest in the fertility response to a disaster is increasing among the public, policy makers and researchers alike. However, a systematic literature review on how disaster affects live birth counts does not yet exist. We reviewed 50 studies retrieved from a systematic search based on a pre-registered protocol. We found an overall negative impact of disasters on fertility. If any, increases in fertility were mostly linked with weather-related physical disasters. We also identified 13 distinct mechanisms which researchers have considered as underlying the fertility effects of disaster. By contrast to the common belief that disasters are more likely to increase fertility in contexts with already high fertility, we found little evidence to suggest that the total fertility rate of the studied populations was an important predictor of the direction, timing or size of fertility impacts. While this may be because no relationship exists, it may also be due to biases we observed in the literature towards studying high-income countries or high-cost disasters. We summarize the methodological limitations identified from the reviewed studies into six practical recommendations for future research. Our findings inform both the theories behind the fertility effects of disasters and the methods for studying them.

Fast accumulation of anthropogenic litter on upgraded breakwaters: A persistent and hidden threat to coastal habitats.

Breakwater construction is common on different coasts, and by means of their structural complexity these built infrastructures can trap anthropogenic litter. We investigated the temporal persistence of anthropogenic litter in breakwaters, and how fast litter accumulates on them. We sampled anthropogenic litter in old (>10 years since construction) breakwaters and in a recently upgraded one (5 months) and on rocky shores located in a coastal conurbation, in central Chile (33°S). We found breakwaters had much higher litter densities than rocky habitats, and this pattern was persistent through time (~5 years). Also, a recently upgraded breakwater had similar composition and densities of litter items as older breakwaters. Therefore, litter accumulation on breakwaters is a very fast process related to their topographic structure and to the willingness of people to dispose of anthropogenic litter in the infrastructure. Redesigning the breakwater structure is required to reduce litter accumulation on the coast and their impacts.

Hospital-based COVID-19 registry: Design and implementation. Colombian experience.

Registries are essential to providing valuable clinical and epidemiological decisions. Designing a registry is challenging because it is time-consuming and resource-intensive, particularly in low- and middle-income countries. Here, we described our experience with the rationale, design, and implementation of a hospital-based COVID-19 registry in Cali, Colombia. We designed and implemented a hospital-based registry over a dynamic web-based structure to record all sociodemographic, clinical, and laboratory tests, imaging, treatment, and outcomes of SARS-CoV-2. We included 4458 confirmed COVID-19 cases of 18 years and older from March 2020 to March 2021. The median age was 48 years. The most frequent comorbidities were hypertension, obesity, and diabetes. The ICU admission rate was 19%, and the in-hospital mortality rate was 20%. The implemented strategies provided rapid and reliable information collection for the registry of emerging studies from the different clinical areas. Regular data quality and feedback are essential to ensure the reliability of the information. The integration of automatic data extraction reduces time consumption in information gathering and resources.

A postmortem study of patients vaccinated for SARS-CoV-2 in Colombia.

INTRODUCTION AND OBJECTIVE: A new coronavirus produces a disease designated as coronavirus disease 2019 (COVID-19). Vaccination against COVID-19 has resulted in decreased mortality. Postmortems of vaccinated patients play an important part in the forensic analysis of adverse effects after vaccination, which is essential for determining its efficacy and security. The main objective of this study was to describe the results of autopsies of patients vaccinated for SARS-CoV-2 carried out in two major centers in Colombia. MATERIALS AND METHODS: A descriptive cross-sectional study of 121 autopsies was performed following Colombian regulations in two main hospitals in Bogotá, Colombia, between March 1st and April 31st, 2021. RESULTS: 118 of the 121 patients (97.52%) had been vaccinated with CoronaVac (Sinovac); only 3 had received other vaccines. Sudden cardiac death was the leading cause of death, with pulmonary embolism another critical finding. No relation between the cause of death and vaccination against SARS-CoV-2 was found. CONCLUSIONS: A clinical autopsy is a vital for an accurate post-mortem diagnosis. Any relation between the SARS-CoV-2 vaccine and the cause of death should be carefully studied in order to provide the general public with evidence-based information about the safety of the vaccination.

A postmortem study of patients vaccinated for SARS-CoV-2 in Colombia / Autopsias clínicas en pacientes vacunados contra el SARS-CoV-2: estudio post mortem en una población colombiana

Introduction and objective: A new coronavirus produces a disease designated as coronavirus disease 2019 (COVID-19). Vaccination against COVID-19 has resulted in decreased mortality. Postmortems of vaccinated patients play an important part in the forensic analysis of adverse effects after vaccination, which is essential for determining its efficacy and security. The main objective of this study was to describe the results of autopsies of patients vaccinated for SARS-CoV-2 carried out in two major centers in Colombia. Materials and methods: A descriptive cross-sectional study of 121 autopsies was performed following Colombian regulations in two main hospitals in Bogotá, Colombia, between March 1st and April 31st, 2021. Results: 118 of the 121 patients (97.52%) had been vaccinated with CoronaVac (Sinovac); only 3 had received other vaccines. Sudden cardiac death was the leading cause of death, with pulmonary embolism another critical finding. No relation between the cause of death and vaccination against SARS-CoV-2 was found. Conclusions: A clinical autopsy is a vital for an accurate post-mortem diagnosis. Any relation between the SARS-CoV-2 vaccine and the cause of death should be carefully studied in order to provide the general public with evidence-based information about the safety of the vaccination.(AU)

Introducción y objetivo: Un nuevo virus del linaje de los coronavirus produce una enfermedad que se designó como enfermedad por coronavirus 2019 (COVID-19). Actualmente se están aplicando vacunas contra la COVID-19 y han mostrado disminución de la mortalidad en pacientes infectados. El análisis de los efectos adversos tras la vacunación ha sido fundamental para conocer la eficacia y la seguridad tras la administración. El examen forense y patológico de las muertes después de la vacunación representa un componente crítico. El objetivo principal del estudio fue describir una serie de casos de pacientes con inmunización previa contra el SARS-CoV-2 que fallecieron y a los que se les realizó una autopsia clínica en dos centros de referencia en Colombia para estudios post mortem. Materiales y métodos: Se realizó un estudio descriptivo transversal basado en autopsias siguiendo la normatividad colombiana en dos hospitales de alta complejidad de la ciudad de Bogotá, Colombia, durante el período comprendido entre el 1 de marzo de 2021 y el 31 de abril de 2021. Se analizaron un total de 121 autopsias. Resultados: Un total de 118 pacientes (97,52%) fueron vacunados con CoronaVac (Sinovac). La muerte cardíaca súbita fue la principal causa de fallecimiento en la población del estudio, y la embolia pulmonar fue otro hallazgo crítico encontrado en el estudio forense. No se pudo determinar la relación entre las causas de muerte y la vacunación contra el SARS-CoV-2. Conclusiones: La autopsia clínica es una herramienta vital en las instituciones de salud para brindar un diagnóstico post mortem. Consideramos que el estudio de la causalidad de la vacunación contra el SARS-CoV-2 y las muertes es fundamental para futuros estudios, con la intención de proporcionar información basada en evidencia a la población para apoyar el concepto de vacunación segura contra la COVID-19.(AU)

Effects of different management strategies on long-term trends of Australian threatened and near-threatened mammals.

Monitoring is critical to assess management effectiveness, but broadscale systematic assessments of monitoring to evaluate and improve recovery efforts are lacking. We compiled 1808 time series from 71 threatened and near-threatened terrestrial and volant mammal species and subspecies in Australia (48% of all threatened mammal taxa) to compare relative trends of populations subject to different management strategies. We adapted the Living Planet Index to develop the Threatened Species Index for Australian Mammals and track aggregate trends for all sampled threatened mammal populations and for small (<35 g), medium (35-5500 g), and large mammals (>5500 g) from 2000 to 2017. Unmanaged populations (42 taxa) declined by 63% on average; unmanaged small mammals exhibited the greatest declines (96%). Populations of 17 taxa in havens (islands and fenced areas that excluded or eliminated introduced red foxes [Vulpes vulpes] and domestic cats [Felis catus]) increased by 680%. Outside havens, populations undergoing sustained predator baiting initially declined by 75% but subsequently increased to 47% of their abundance in 2000. At sites where predators were not excluded or baited but other actions (e.g., fire management, introduced herbivore control) occurred, populations of small and medium mammals declined faster, but large mammals declined more slowly, than unmanaged populations. Only 13% of taxa had data for both unmanaged and managed populations; index comparisons for this subset showed that taxa with populations increasing inside havens declined outside havens but taxa with populations subject to predator baiting outside havens declined more slowly than populations with no management and then increased, whereas unmanaged populations continued to decline. More comprehensive and improved monitoring (particularly encompassing poorly represented management actions and taxonomic groups like bats and small mammals) is required to understand whether and where management has worked. Improved implementation of management for threats other than predation is critical to recover Australia's threatened mammals.

Efectos de diferentes estrategias de manejo sobre las tendencias a largo plazo de los mamíferos amenazados y casi amenazados de Australia Resumen El monitoreo es fundamental para evaluar la efectividad del manejo, aunque faltan evaluaciones sistemáticas y a gran escala de este monitoreo para evaluar y mejorar los esfuerzos de recuperación. Compilamos 1,808 series temporales de 71 especies y subespecies de mamíferos terrestres y voladores amenazadas y casi amenazadas en Australia (48% de todos los taxones de mamíferos amenazados) para comparar las tendencias relativas de las poblaciones sujetas a diferentes estrategias de manejo. Adaptamos el Índice Planeta Vivo para desarrollar el Índice de Especies Amenazadas para los Mamíferos Australianos y así rastrear las tendencias agregadas de todas las poblaciones muestreadas de mamíferos amenazados y de los mamíferos pequeños (<35 g), medianos (35-5,500 g) y grandes (>5,500 g) entre 2000 y 2017. Las poblaciones sin manejo (42 taxones) declinaron en un 63% en promedio; los mamíferos pequeños sin manejo exhibieron las declinaciones más marcadas (96%). Las poblaciones de 17 taxones incrementaron 680% en los refugios (islas o áreas encercadas que excluían o eliminaban al zorro rojo [Vulpes vulpes] y al gato doméstico [Felis catus], especies introducidas) Afuera de los refugios, las poblaciones sometidas al cebado constante de los depredadores en un inicio declinaron en un 75% pero después incrementaron al 47% de su abundancia para el 2000. En los sitios en donde los depredadores no fueron excluidos o cebados sino sometidos a otras acciones (manejo del fuego, control de herbívoros introducidos), las poblaciones de los mamíferos pequeños y medianos declinaron más rápido, pero los mamíferos grandes declinaron de manera más lenta que las poblaciones sin manejo. Sólo el 13% de los taxones contaron con datos para sus poblaciones con y sin manejo; las comparaciones entre índices para este subconjunto mostraron que los taxones con poblaciones en incremento dentro de los refugios declinaron afuera de éstos, pero los taxones con poblaciones sujetas al cebado de depredadores afuera de los refugios declinaron más lentamente que las poblaciones sin manejo y después incrementaron, mientras que las poblaciones sin manejo continuaron su declinación. Se requiere un monitoreo más completo y mejorado (particularmente el que engloba las acciones de manejo mal representadas y los grupos taxonómicos como los murciélagos y los mamíferos pequeños) para entender si ha funcionado el manejo y en dónde. La implementación mejorada del manejo para las amenazas distintas a la depredación es fundamental para recuperar a los mamíferos amenazados de Australia.

Retaining natural vegetation to safeguard biodiversity and humanity.

Global efforts to deliver internationally agreed goals to reduce carbon emissions, halt biodiversity loss, and retain essential ecosystem services have been poorly integrated. These goals rely in part on preserving natural (e.g., native, largely unmodified) and seminatural (e.g., low intensity or sustainable human use) forests, woodlands, and grasslands. To show how to unify these goals, we empirically derived spatially explicit, quantitative, area-based targets for the retention of natural and seminatural (e.g., native) terrestrial vegetation worldwide. We used a 250-m-resolution map of natural and seminatural vegetation cover and, from this, selected areas identified under different international agreements as being important for achieving global biodiversity, carbon, soil, and water targets. At least 67 million km2 of Earth's terrestrial vegetation (∼79% of the area of vegetation remaining) required retention to contribute to biodiversity, climate, soil, and freshwater conservation objectives under 4 United Nations' resolutions. This equates to retaining natural and seminatural vegetation across at least 50% of the total terrestrial (excluding Antarctica) surface of Earth. Retention efforts could contribute to multiple goals simultaneously, especially where natural and seminatural vegetation can be managed to achieve cobenefits for biodiversity, carbon storage, and ecosystem service provision. Such management can and should co-occur and be driven by people who live in and rely on places where natural and sustainably managed vegetation remains in situ and must be complemented by restoration and appropriate management of more human-modified environments if global goals are to be realized.

Retención de la vegetación natural para salvaguardar la biodiversidad y la humanidad Resumen Hoy en día hay muy poca integración de los esfuerzos mundiales para alcanzar los objetivos internacionales de reducción de las emisiones de carbono, impedimento de la pérdida de biodiversidad y conservación de los servicios ambientales esenciales. Estos objetivos dependen parcialmente de la conservación de los bosques, selvas y praderas naturales (por ejemplo, nativos y en su mayoría sin alteraciones) y seminaturales (por ejemplo, de uso humano sostenible o de baja intensidad). Obtuvimos de manera empírica objetivos espacialmente explícitos, cuantitativos y basados en áreas para la conservación de la vegetación terrestre natural y seminatural (por ejemplo, nativa) en todo el mundo para mostrar cómo unificar los objetivos internacionales. Usamos un mapa de 250 m de resolución de la cubierta vegetal natural y seminatural y, a partir de él, seleccionamos las áreas identificadas como importantes en diferentes acuerdos internacionales para alcanzar los objetivos globales de biodiversidad, carbono, suelo y agua. Al menos 67 millones de km2 de la vegetación terrestre de la Tierra (∼79% de la superficie de vegetación restante) requieren ser conservados para contribuir a los objetivos de conservación de la biodiversidad, el clima, el suelo y el agua dulce en virtud de cuatro de las resoluciones de las Naciones Unidas. Esto equivale a conservar la vegetación natural y seminatural en al menos el 50% de la superficie terrestre total de la Tierra (sin contar a la Antártida). Los esfuerzos de retención podrían contribuir a alcanzar múltiples objetivos simultáneamente, especialmente en donde la vegetación natural y seminatural puede gestionarse para lograr beneficios colaterales para la biodiversidad, el almacenamiento de carbono y la provisión de servicios ambientales. Esta gestión puede y debe ser impulsada y llevada a cabo por las personas que viven en y dependen de los lugares donde la vegetación natural y gestionada de forma sostenible permanece in situ y debe complementarse con la restauración y la gestión adecuada de entornos modificados por el hombre si se quieren alcanzar los objetivos globales.

Prevalencia de Helicobacter pylori en pacientes llevados a endoscopia de vías digestivas altas en un hospital de referencia en Cali, Colombia, en 2020 / Prevalence of Helicobacter pylori in patients undergoing upper digestive tract endoscopy at a referral hospital in Cali, Colombia, in 2020

Resumen Introducción: la infección por Helicobacter pylori tiene una alta prevalencia y distribución a nivel mundial. Por su asociación con el desarrollo de adenocarcinoma gástrico, las actualizaciones sobre su prevalencia son de interés para el médico internista o gastroenterólogo, así como para la generación de políticas públicas. Este estudio midió la prevalencia de H. pylori y evaluó su asociación con hallazgos endoscópicos e histopatológicos en adultos con indicación de endoscopia de vías digestivas altas (EVDA). Metodología: estudio de cohorte analítica para describir la prevalencia de H. pylori y evaluar factores de riesgo asociados a esta infección en pacientes adultos sometidos a EVDA ambulatoria por cualquier indicación médica en la unidad de endoscopia de un hospital universitario de cuarto nivel de complejidad entre junio y diciembre de 2020. Se describen hallazgos endoscópicos, histopatológicos y la prevalencia de H. pylori. Para explorar los factores de riesgo se usó la prueba chi cuadrado (χ2) para evaluar diferencias en las proporciones y las pruebas t de Student y U de Mann-Whitney para las variables continuas según su distribución. Resultados: 613 pacientes cumplieron los criterios de selección y fueron incluidos en el análisis. La indicación más frecuente de EVDA fue dispepsia. La prevalencia de H. pylori fue de 38,5% (intervalo de confianza [IC] 95%: 34,7%-42,4%). Conclusión: H. pylori es un tema de gran interés en las patologías gastrointestinales. La búsqueda endoscópica debe ser en el antro y cuerpo. Su presencia fue mayor en pacientes con esófago normal, gastritis nodular folicular, úlcera duodenal e inflamación aguda al estudio histológico. Se requieren más estudios que complementen el comportamiento epidemiológico local.

Abstract Introduction: Helicobacter pylori infection has a high prevalence and distribution worldwide. Due to its association with the development of gastric adenocarcinoma, updates on its prevalence are of interest to the internist or gastroenterologist and policymaking. This study measured the prevalence of H. pylori and evaluated its association with endoscopic and histopathological findings in adults with an indication for upper GI endoscopy (EGD). Materials and methods: This analytical cohort study describes the prevalence of H. pylori and assesses risk factors associated with this infection in adult patients undergoing outpatient EGD for any medical indication in the endoscopy unit of a quaternary care university hospital between June and December 2020. Endoscopic and histopathological findings and the prevalence of H. pylori are described. To explore the risk factors, the chi-square (χ2) test was used to evaluate differences in proportions and the Student's t and Mann-Whitney U tests for continuous variables according to their distribution. Results: 613 patients met the selection criteria and were included in the analysis. The most frequent indication for EGD was dyspepsia. The prevalence of H. pylori was 38.5% (95% confidence interval [CI]: 34.7-42.4%). Conclusion: H. pylori is a topic of great interest in gastrointestinal pathologies. The endoscopic search should take place in the antrum and body. Its presence was most common in patients with a normal esophagus, follicular nodular gastritis, duodenal ulcer, and acute inflammation upon the histological study. More studies are required to complement the local epidemiological behavior.

COVID-19 en receptores de trasplante renal: la experiencia inicial en Colombia

Contexto: los pacientes con trasplante de riñón parecen tener un riesgo particularmente alto de enfermedad grave por COVID-19 debido a la inmunosupresión y la presencia de comorbilidades. Objetivo: describir las características clínicas, paraclínicas y desenlaces de los pacientes trasplantados renales que presentan infección por SARS-COV-2 en un hospital de cuarto nivel en Cali, Colombia. Metodología: realizamos un estudio observacional de receptores de trasplante renal con infección por SARS-CoV-2 ingresados ​​en la Fundación Valle del Lili, de junio a diciembre del 2020. Para ser elegibles en el estudio, los pacientes debían presentar síntomas compatibles, RT-PCR positiva y manejo hospitalario. Se excluyó a los pacientes asintomáticos. Resultados: inscribimos a un total de 50 pacientes, donde el 64 % eran hombres y la edad media fue de 53,5 años (rango 46-60). Las comorbilidades fueron: 36 (70 %) con hipertensión, 16 (32 %) con diabetes mellitus y 5 (10 %) con obesidad y los regímenes inmunosupresores más comunes fueron: tacrolimus, micofenolato y prednisona. La mediana de tiempo desde el inicio de los síntomas hasta la RT-PCR positiva fue de siete días. Los síntomas iniciales más comunes fueron fiebre (64 %), fatiga (58%), tos (44%) y disnea (36%). Los niveles basales de proteína C reactiva (PCR) fueron de 6,43 mg/dl (3,25-11,22), la mediana del recuento de linfocitos fue de 785 mm3/uL (550-1230), el dímero D basal fue de 0,767 ug/ml (0,484-1153,5) y el nivel medio de ferritina fue de 1011 ng/ml (670-2145). El 40 % desarrolló lesión renal aguda (20 pacientes), de los cuales 11 pacientes necesitaron terapia de remplazo renal, 6 de los pacientes fallecieron (12 %), 4/6 por insuficiencia multiorgánica relacionada con la sepsis y 2/6 por el síndrome de dificultad respiratoria agudo (SDRA). Conclusiones: las complicaciones mayores como la lesión renal aguda, el síndrome de dificultad respiratoria aguda y la mortalidad relacionada con la infección por COVID-19 observadas en nuestro estudio son significativas, pero menos frecuentes que las reportadas en otros países.

Background: Patients with kidney transplants seem to be at particularly high risk for severe COVID19 disease due to their impaired immune responses and comorbidities. Purpose: This study aims to describe kidney transplant patients' clinical characteristics and outcomes with SARSCOV-2 infection in a fourth-level hospital in Cali, Colombia. Methodology: We performed an observational study of kidney transplant recipients with SARS-CoV2 infection admitted at Fundación Valle del Lili from June to December 2020. To be eligible for this study, patients have symptoms compatible, a positive RT-PCR and inpatient management. Asymptomatic patients were excluded. Results: We enrolled a total of 50 patients. 64% were male, and the median age was 53.5 years (range 46-60). The comorbidities were 36 (70%) hypertension, 16 (32%) diabetes mellitus, 5 (10%) obesity. The most common immunosuppressive regimen was tacrolimus, mycophenolate and prednisone. The median time from symptoms onset to the positive RT-PCR was 7 days. The most common initial symptom was fever (64%), and fatigue (58%), cough (44%) and dyspnea (36%). Baseline levels of CRP was 6.43 mg/dL (3.25-11.22). The median lymphocyte count was 785 mm3/uL (550-1230). Baseline D-Dimer was 0.767 ug/ml (0.484-1153.5), ferritin median level was 1011ng/ml (670-2145). Six of the patients died (12%), 4/6 were by sepsis-related multi-organ failure and 2/6 were by ARDS. Conclusions: Major complications such as acute kidney injury, acute respiratory distress syndrome and mortality related to COVID-19 infection observed in our study are lower than those reported in other countries.

Disentangling direct and indirect effects of landscape structure on urban bird richness and functional diversity.

As fragmented landscapes become increasingly common around the world, managing the spatial arrangement of landscape elements (i.e., landscape configuration) may help to promote the conservation of biodiversity. However, the relative effects of landscape configuration on different dimensions of biodiversity across species assemblages are largely unknown. Thus, a key challenge consists in understanding when it is necessary to focus on landscape configuration, in addition to landscape composition, to achieve multifunctional landscapes. We tested the effects of landscape composition (the percentage of tree cover and built infrastructure) and landscape configuration (degree of fragmentation) on landscape-level species richness and different metrics of functional diversity of urban birds. We collected data on different bird guilds (nectarivores/frugivores, insectivores) from Brisbane, Australia. Using structural equation models, we found that landscape structure (landscape composition and configuration) affected functional diversity via two main pathways: (1) through effects of landscape composition, mediated by landscape configuration (indirect effects), and (2) through direct ("independent") effects of landscape composition and configuration, filtering species with extreme trait values. Our results show that landscape-level species richness declined with the extent of built infrastructure, but patterns of trait diversity did not necessarily correlate with this variable. Landscape configuration had a stronger mediating effect on some metrics of the functional diversity of insectivores than on the functional diversity of frugivores/nectarivores. In addition, fragmentation increased the effects of built infrastructure for some traits (body size and dispersal capacity), but not for others (habitat plasticity and foraging behavior). These results suggest that differential approaches to managing landscape structure are needed depending on whether the focus is on protecting functional diversity or species richness and what the target guild is. Managing landscape fragmentation in areas with high levels of built infrastructure is important if the objective is to protect insectivore species with uncommon traits, even if it is not possible to preserve high levels of species richness. However, if the target is to enhance both functional diversity and species richness of multiple guilds, the focus should be on improving composition through the reduction of negative effects of built infrastructure, rather than promoting specific landscape configurations in growing cities.