Preserving the spots: Jaguar (Panthera onca) distribution and priority conservation areas in Colombia.

The jaguar (Panthera onca) is a charismatic species considered Vulnerable in Colombia but yet largely unknown in the country. The species is mostly threatened by the continuous decline in its habitats, mostly derived from deforestation and habitat loss, additional to hunting and conflicts with humans. Thus, the future of jaguars in Colombia depends on protecting and recovering existing habitats. The aims of this study were to 1) evaluate jaguar distribution and identify the remnant patches of habitat in Colombia, 2) define an ecological connectivity network within the country, and 3) propose a priority areas portfolio for the conservation and recovery of jaguars. We used a presence background model for estimating species potential distribution and subsequently identified remaining habitat patches across the country based on land cover and species-specific ecological attributes. We then created an ecological connectivity network based on circuit theory and following a multi-criteria approach identified jaguar priority areas for conservation (JPCA) and recovery (JPRA). Jaguar potential distribution comprises 1103122.43 km2, from which 56.71% maintain suitable patches of potential habitat. We identified 960 corridors between remnant patches of natural or semi-natural vegetation. Based on the criteria, JPCAs with greater importance were identified in each of the five Colombian regions. JPRAs were located mainly towards the Andean and Caribbean regions. These JPCAs and JPRAs could serve as a guide for designing and implementing management strategies for the long-term conservation and recovery of the species in Colombia.

Spotting what's important: Priority areas, connectivity, and conservation of the Northern Tiger Cat (Leopardus tigrinus) in Colombia.

Leopardus tigrinus is among the least known carnivore species in the Neotropics, including considerable taxonomic uncertainty. Here we model the distribution, connectivity and overlap with existing conservation areas for the species in Colombia. Using a Species Distribution Modeling approach, we estimated current potential range of the species in Colombia and identified potential habitat blocks remaining in the country. In addition, we designed a connectivity network across the available cores, using a circuit theory approach, to evaluate habitat linkage. Finally, we defined a prioritization scheme for the remaining habitat cores and assessed the level of coverage of protected areas for the country. L. tigrinus is potentially present across the three Andean branches of Colombia, with still considerable continuous habitat cores, mostly located on the eastern and central Andean ranges. Most habitat cores are theoretically connected, but nearly 15% are isolated. Priority areas were located across the eastern and central ranges, but with very significant and promising cores in the northern eastern and western ranges. Current level of protection indicates nearly 30% of the range is "protected", but only about 25% is under national strict protected areas. Evolution of this coverage showed some periods of significant increase but interestingly the number of cores grew at a faster rate than overall proportion protected, likely indicating numerous discontinuous fragments, and not contiguous functional landscapes. This represents the most updated assessment of the distribution and conservation status for the species in Colombia, and indicates the numerous conservation opportunities, especially in most populated areas of the country. We found unique business environmental passive's opportunities, including compensation and development potential, which are becoming more available in the country.

Effects of the COVID-19 pandemic on the Colombian labour market: Disentangling the effect of sector-specific mobility restrictions.

We assess the effect of the COVID-19 pandemic and particularly the sector-specific mobility restrictions on the Colombian labour market. We exploit the sectoral and temporal variation of the restriction policies to identify their effect. Mobility restrictions significantly reduced employment, accounting for approximately a quarter of the total job loss between February and April of 2020. The remaining three quarters of the job losses could be attributed to the disease's regional patterns and other epidemiological and economic factors affecting the whole country. Therefore, we should expect important employment losses even in the absence of such restrictions. We also assess the effect of restrictions on the intensive margin, finding negative, although smaller effects on the number of hours worked and wages. Most of the employment effect is driven by salaried workers, while self-employment was more responsive to the disease spread. Finally, we find that women are disproportionally affected: mobility restrictions account for a third of the recent increase of the gender gap in salaried employment.

Effets de la pandémie de COVID­19 sur le marché du travail colombien : analyse des répercussions liées aux restrictions de mobilité par secteur. Dans cet article, nous évaluons les répercussions de la pandémie de COVID­19, et notamment des restrictions en matière de mobilité propres à chaque secteur, sur le marché du travail colombien. Nous nous appuyons sur les variations temporelles et sectorielles des politiques de restriction pour déterminer leurs effets. Les restrictions de mobilité ont sensiblement détérioré l'emploi en détruisant environ un quart du nombre total d'emplois supprimés entre février et avril 2020, les trois­quarts restants pouvant être imputés aux caractéristiques régionales de la pandémie ainsi qu'à d'autres facteurs épidémiologiques et économiques touchant l'ensemble du pays. Nous pourrions donc nous attendre à d'importantes destructions d'emplois, même en l'absence de telles restrictions. Nous évaluons également les effets des restrictions à la marge intensive, et nous constatons des effets négatifs mais plus faibles sur le nombre d'heures travaillées ainsi que sur les salaires. Les effets de ces restrictions sur l'emploi sont motivés en grande partie par les travailleurs salariés, les travailleurs indépendants se montrant plus réactifs face à la propagation de la maladie. Enfin, nous constatons que les femmes sont touchées de façon disproportionnée, les restrictions de mobilité comptant pour un tiers de l'accentuation récente de l'écart hommes­femmes en matière d'emploi salarié.

Association of Clinical Hypoperfusion Variables With Lactate Clearance and Hospital Mortality.

BACKGROUND: Lactate has shown utility in assessing the prognosis of patients admitted to the hospital with confirmed or suspected shock. Some findings of the physical examination may replace it as screening tool. We have determined the correlation and association between clinical perfusion parameters and lactate at the time of admission; the correlation between the change in clinical parameters and lactate clearance after 6 and 24 h of resuscitation; and the association between clinical parameters, lactate, and mortality. METHODS: Prospective cohort study of adult patients hospitalized in the emergency room with infection, polytrauma, or other causes of hypotension. We measured serum lactate, capillary refill time, shock index, and pulse pressure at 0, 6, and 24 h after admission. A Spearman's correlation was performed between clinical variables and lactate levels, as well as between changes in clinical parameters and lactate clearance. The operative characteristics of these variables were determined by area under the receiver operating characteristic curve analysis and the association between lactate, clinical variables, and mortality through logistic regression. RESULTS: A total of 1,320 patients met the inclusion criteria, 66.7% (n = 880) confirmed infection, 19% (n = 251) polytrauma, and 14.3% (n = 189) another etiology. No significant correlation was found between any clinical variable and lactate values (r < 0.28). None of the variable had an adequate discriminatory capacity to detect hyperlactatemia (AUC < 0.62). In the multivariate model, lactate value at admission was the only variable independently associated with mortality (OR 1.2; 95% CI = 1.1-1.1). CONCLUSIONS: Among patients with hypoperfusion risk or shock, no correlation was found between clinical variables and lactate. Of the set of parameters collected, lactate at admission was the only independent marker of mortality.

Asociación de variables clínicas de hipoperfusión con el lactato y la mortalidad / Association of clinical variables of hypoperfusion with lactate and mortality

Resumen Introducción: entre los pacientes con infección la hiperlactatemia identifica una población de mayor gravedad. Este estudio pretende determinar en pacientes de urgencias la correlación y asociación entre los parámetros clínicos de perfusión y los valores de lactato en el momento de admisión; así como el cambio en los parámetros clínicos con la depuración del lactato. Además, determinar la asociación entre estas variables y la mortalidad intrahospitalaria. Métodos: cohorte prospectiva de pacientes que ingresaron con sospecha de infección a un hospital de tercer nivel. Se midió el lactato en la admisión a las 6 y 24 horas, concomitantemente con las variables llenado capilar, índice de choque y presión de pulso, entre otras. Se realizó correlación de Spearman entre las variables clínicas, los niveles de lactato y su depuración; así como curvas ROC para determinar la capacidad discriminativa de las variables clínicas para detectar hiperlactatemia. Se realizó un modelo de regresión logística multivariable para mortalidad. Resultados: se evaluaron 2257 pacientes, 651 correspondían a infección confirmada. No se encontró ninguna correlación de utilidad entre las variables clínicas y el lactato (r<0.25); y tampoco se detectó adecuada capacidad discriminativa para la detección de hiperlactatemia con ninguna variable clínica (AUC<0.61). En el modelo de regresión logística multivariada el valor del lactato al ingreso fue la única variable que se asoció de manera independiente con mortalidad (OR=1.4, IC95%=1.3-1.6). Conclusiones: entre los pacientes que ingresan a urgencias con infección no se encontró correlación entre las variables clínicas y el lactato; sin embargo, el lactato al ingreso es un marcador pronóstico independiente de mortalidad. (Acta Med Colomb 2017: 42: 97-105).

Abstract Introduction: among patients with infection, hyperlactatemia identifies a population of greater severity. This study aims to determine the correlation and association between clinical perfusion parameters and lactate values in emergency patients at the time of admission, as well as the change in clinical parameters with lactate clearance. In addition, to determine the association between these variables and in-hospital mortality. Methods: Prospective cohort of patients admitted with suspected infection to a third level hospital. Lactate was measured at admission, at 6 and 24 hours, concomitantly with the variables capillary filling, shock index and pulse pressure, among others. Among the clinical variables, Spearman correlation, lactate levels and their clearance, as well as ROC curves to determine the discriminative ability of clinical variables to detect hyperlactatemia were performed. A multivariate logistic regression model for mortality was carried out. Results: 2257 patients were evaluated. 651 were confirmed with infections. No utility correlation was found between clinical variables and lactate (r <0.25), and no discriminative capacity was detected for the detection of hyperlactatemia with any clinical variable (AUC <0.61). In the multivariate logistic regression model the lactate value at admission was the only variable that was independently associated with mortality (OR = 1.4, 95% CI = 1.3-1.6). Conclusions: no correlation was found between clinical variables and lactate among patients admitted to the emergency department with infection; however lactate at admission is an independent prognostic marker of mortality. (Acta Med Colomb 2017: 42: 97-105).

Impacto de la primera edición del diplomado Dirección en la Atención Primaria de Salud / Impact of the first diploma's course in primary health care management

Se realizó una investigación descriptiva de corte transversal con el objetivo de describir a los directivos de la Atención Primaria de Salud de la provincia La Habana 2012 e identificar la satisfacción con la capacitación recibida, como parte de una estrategia del Ministerio de Salud Pública. El universo estuvo constituido por el total de directivos que cursaron la primera edición del diplomado que fueron un total de 18 profesionales que se desempañaban en la atención primaria de salud en la provincia de La Habana. Fueron aplicados dos instrumentos uno al inicio y el otro al final del Diplomado, las variables estudiadas fueron: tiempo de experiencia en el cargo, años de experiencia laboral, formación profesional y expectativas con el Diplomado. Los principales resultados obtenidos en el estudio fueron que los estudiantes manifestaron que la incorporación de conocimientos y habilidades de dirección constituyeron una herramienta para el trabajo diario en los diferentes niveles jerárquicos, actualización en los temas de dirección, calidad en el claustro de profesores, calidad docente de los temas impartidos y mejor preparación para el cargo de dirección, se recomendó impartir el diplomado por todo el país

A cross-sectional descriptive research study was conducted to describe the primary health care managers of La Habana province in 2012, and to find out their level of satisfaction with the received training, as part of a strategy of the Ministry of Public Health. The universe of study was the total number of managers who participated in the first diploma's course; they were 18 professionals who worked at the primary health care level in the province. Two instruments were applied, one at the beginning and the other at the end of the diploma's course, being the studied variables length of experience at the post, years of work experience, professional formation and expectations about the course. The main results were the students' opinions about the incorporation of management knowledge and skills- which represented a useful tool for daily work at the various hierarchical levels- the updated managing topics, the quality of the faculty, the teaching quality of the given topics and the improvement of their preparation for a managing post. It was recommended to give this diploma's course throughout the country

Impacto de la primera edición del diplomado Dirección en la Atención Primaria de Salud / Impact of the first diploma's course in primary health care management

Se realizó una investigación descriptiva de corte transversal con el objetivo de describir a los directivos de la Atención Primaria de Salud de la provincia La Habana 2012 e identificar la satisfacción con la capacitación recibida, como parte de una estrategia del Ministerio de Salud Pública. El universo estuvo constituido por el total de directivos que cursaron la primera edición del diplomado que fueron un total de 18 profesionales que se desempañaban en la atención primaria de salud en la provincia de La Habana. Fueron aplicados dos instrumentos uno al inicio y el otro al final del Diplomado, las variables estudiadas fueron: tiempo de experiencia en el cargo, años de experiencia laboral, formación profesional y expectativas con el Diplomado. Los principales resultados obtenidos en el estudio fueron que los estudiantes manifestaron que la incorporación de conocimientos y habilidades de dirección constituyeron una herramienta para el trabajo diario en los diferentes niveles jerárquicos, actualización en los temas de dirección, calidad en el claustro de profesores, calidad docente de los temas impartidos y mejor preparación para el cargo de dirección, se recomendó impartir el diplomado por todo el país(AU)

A cross-sectional descriptive research study was conducted to describe the primary health care managers of La Habana province in 2012, and to find out their level of satisfaction with the received training, as part of a strategy of the Ministry of Public Health. The universe of study was the total number of managers who participated in the first diploma's course; they were 18 professionals who worked at the primary health care level in the province. Two instruments were applied, one at the beginning and the other at the end of the diploma's course, being the studied variables length of experience at the post, years of work experience, professional formation and expectations about the course. The main results were the students' opinions about the incorporation of management knowledge and skills- which represented a useful tool for daily work at the various hierarchical levels- the updated managing topics, the quality of the faculty, the teaching quality of the given topics and the improvement of their preparation for a managing post. It was recommended to give this diploma's course throughout the country(AU)

Esquizencefalia: un trastorno de la migración neuronal / Schizencephaly: a disorder of neuronal migration

La esquizencefalia es el trastorno más frecuente de la migración neuronal y ocurre entre el tercero y quinto meses de la gestación. Se describen en este artículo sus posibles causas genéticas (EMX2), vasculares e infecciosas, así como sus manifestaciones clínicas, radiológicas y electroencefalográficas. El tratamiento es sintomático y multidisciplinario.

Schizencephaly is the most frequent neuronal migration disorder and it develops between the third and fifth gestational months. Genetic (EMX2), vascular and infectious etiologies have been described. Its clinical, radiological and electroencephalographic characteristics are described in this article. Treatment should be symptomatic and multidisciplinary.