MEDICAL-SURGICAL MANAGEMENT OF INTESTINAL INFECTION BY PROSTHENORCHIS ELEGANS IN NONHUMAN PRIMATES FROM COSTA RICA.

Parasitism is one of the most important diseases in nonhuman primates (NHP). Parasitism by Prosthenorchis elegans can be a threat to health and conservation of NHP in Costa Rica. Surgical management of intestinal acanthocephalan infection in two squirrel monkeys (Saimiri oerstedii) and one white-faced monkey (Cebus imitator) is described as an alternative to the lack of pharmacologic control options when there is a high burden of parasites present. A complete physical evaluation, including medical ultrasound techniques, allow for diagnosis of the parasite and its lesions. When animals present with a high burden of parasites, surgical management has shown to promote good health outcomes and increase the probability of survival.

Integrating new variables into a framework to support cacao denomination of origin: a case study in Southwest Colombia.

BACKGROUND: Cocoa quality plays a pivotal role in establishing denominations of origin, with genotypes, geography, climate and soil conditions being key variables. However, these factors have not been comprehensively explored in defining cacao denominations of origin. The present study addresses this gap by laying the foundation for cacao denomination of origin, focusing on the Buenaventura region on Colombia's Pacific coast. Our goal is to provide a holistic understanding of the elements underpinning cacao denomination of origin, emphasizing Buenaventura's unique cocoa quality and geographical significance. RESULTS: Through the Buenaventura case, we propose a robust framework applicable to other cacao-producing regions, elevating the recognition and value of cacao denomination of origin. Our framework encompasses geography, agronomy, genetics, microbial diversity, pests and diseases and cocoa quality. In a pioneering move, we propose a cacao denomination of origin in Colombia, specifically examining Bajo Calima, Sabaletas and Cisneros within Buenaventura region. Buenaventura stands out for its cocoa quality, characterized by fruity flavors attributed to the rich biodiversity of the lowland rainforest. CONCLUSION: Our analysis indicates specific geographical indicators for each of the study zones, with Buenaventura identified as a region with natural characteristics to produce fine flavour cocoa products. Each zone exhibited a high differentiation and diversity of cacao cultivars. Buenaventura has the potential to be designated as a future denomination of origin for cacao from the Pacific region of Colombia, characterized by its unique fruity-aroma chocolates. Our framework is adaptable to other cacao-producing regions, facilitating the establishment of denominations of origin within the cocoa industry and agriculture. © 2023 The Authors. Journal of The Science of Food and Agriculture published by John Wiley & Sons Ltd on behalf of Society of Chemical Industry.

Ensuring access to essential health products: Lessons from Colombia's leishmaniasis control and elimination initiative.

BACKGROUND: This paper identifies opportunities and challenges for leishmaniasis control and elimination in Colombia, emphasizing the role of pooled procurement of essential medicines and supplies. Colombia is among the countries most affected by leishmaniasis globally, and also faces the dual challenge of procuring critically needed medicines in the context of limited national resources. It recently renewed its commitment to the control and elimination of leishmaniasis under its 2022-2031 Public Health Plan (PDSP) through a comprehensive public health approach. METHODOLOGY/PRINCIPAL FINDINGS: The methodology comprises a comprehensive literature review and key informant interviews with leishmaniasis experts from the Colombian national control program and PAHO/WHO, focusing on cutaneous, mucocutaneous, and visceral leishmaniasis. Leishmaniasis is endemic throughout Colombia, with over 11 million people at risk, many of whom live in poverty-stricken, remote and isolated rural areas with limited access to health services. Leishmaniasis care, including medicines, is provided free of charge, but many barriers were nonetheless identified at environmental, population, and health system levels, including the supply of quality-assured medicines. Opportunities to alleviate these barriers were identified, including the support of the PAHO Strategic Fund. Within the context of the sustainable development goals and international leishmaniasis control and elimination targets, Colombian officials have established their own priorities, the highest of which is the reduction of deaths from visceral leishmaniasis. CONCLUSIONS/SIGNIFICANCE: The elimination of leishmaniasis as a public health problem presents significant challenges, given its biological complexity and diversity, physical and clinical manifestations, social and economic impacts, frequently burdensome treatment regimens, and insufficient supply of necessary medicines. However, rigorous prevention and control efforts through strong political commitment and a highly motivated workforce can dramatically reduce its burden. Colombia's new PDSP, which highlights leishmaniasis control, is an opportunity for a revitalized health system response through committed leadership, intersectoral actions, and partnerships with international organizations that share a common vision.

Prevalence Estimation, Antimicrobial Susceptibility, and Serotyping of Salmonella enterica Recovered from New World Non-Human Primates (Platyrrhini), Feed, and Environmental Surfaces from Wildlife Centers in Costa Rica.

Concern about zoonoses and wildlife has increased. Few studies described the role of wild mammals and environments in the epidemiology of Salmonella. Antimicrobial resistance is a growing problem associated with Salmonella that threatens global health, food security, the economy, and development in the 21st century. The aim of this study is to estimate the prevalence and identify antibiotic susceptibility profiles and serotypes of non-typhoidal Salmonella enterica recovered from non-human primate feces, feed offered, and surfaces in wildlife centers in Costa Rica. A total of 180 fecal samples, 133 environmental, and 43 feed samples from 10 wildlife centers were evaluated. We recovered Salmonella from 13.9% of feces samples, 11.3% of environmental, and 2.3% of feed samples. Non-susceptibility profiles included six isolates from feces (14.6%): four non-susceptible isolates (9.8%) to ciprofloxacin, one (2.4%) to nitrofurantoin, and one to both ciprofloxacin and nitrofurantoin (2.4%). Regarding the environmental samples, one profile was non-susceptible to ciprofloxacin (2.4%) and two to nitrofurantoin (4.8%). The serotypes identified included Typhimurium/I4,[5],12:i:-, S. Braenderup/Ohio, S. Newport, S. Anatum/Saintpaul, and S. Westhampton. The epidemiological surveillance of Salmonella and antimicrobial resistance can serve in the creation of strategies for the prevention of the disease and its dissemination throughout the One Health approach.

Perceived importance and interest in research by Chilean primary care providers.

BACKGROUND: Primary care providers (PCPs) are relevant stakeholders for primary care research (PCR). OBJECTIVE: We report the perceived importance and interest in PCR of a national sample of Chilean PCPs. METHODS: We conducted a cross-sectional study targeting Chilean PCPs. An electronic survey assessing perceived relevance of PCR, research training and experience, training interests, and demographics was disseminated through emails and WhatsApp messages. Descriptive statistics were used to summarize data. Logistic regression models were used to estimate adjusted probabilities and 95% confidence intervals for high interest in PCR, high interest in using research methods, and high interest in receiving research training, and predictors of these outcomes. RESULTS: A total of 387 providers completed the online survey. Only 26.4% of PCPs had research experience as a principal or co-investigator. However, most clinicians perceived PCR as very important (92.5%) and were interested in using research methods (90.7%) and receiving training (94.3%). There were no statistically significant differences in these perceptions between provider's discipline, role, sex, age, and geographical location after adjusting for covariates. CONCLUSIONS: Despite few Chilean PCPs have research training, a large majority perceive it as important, are interested in using it in their practice and would like to receive training.

New Brassinosteroid Analogs with 23,24-Dinorcholan Side Chain, and Benzoate Function at C-22: Synthesis, Assessment of Bioactivity on Plant Growth, and Molecular Docking Study.

The synthesis and biological evaluation of brassinosteroids (BRs) analogs with chemical modification in the side alkyl chain is a matter of current interest. Recently, a series of BR analogs with phenyl or benzoate groups in the alkyl chain have been reported. The effect of substitution in the aromatic ring on the biological activities of these new analogs has been evaluated, and the results suggest that the bioactivity is enhanced by substitution with an F atom. In this context, we have synthesized, characterized, and evaluated a series of new analogs of 23,24-bisnorcholenic type in which the benzoate group at the C-22 position is substituted with an F atom at "ortho or para" positions. Plant growth-promoting activities were evaluated by using the rice lamina inclination test and bean second internode biotest. The results obtained with both bioassays indicate that the compound with an F atom in the para position on the aromatic ring is the most active BR analog and in some cases is even more active than brassinolide. The docking study confirmed that compounds with an F atom adopt an orientation similar to that predicted for brassinolide, and the F atom in the "para" position generates an extra hydrogen bond in the predicted binding position.

[Evaluation of a clinical orientation Call Center during the first months of the COVID-19 pandemic]. / Evaluación de un call center de orientación clínica durante los primeros meses de pandemia COVID-19: capacidad de resolución de los llamados.

BACKGROUND: During sanitary emergencies such as the recent pandemic, health services can collapse. In these cases, remote orientation services such as call centers may help to debottleneck these services. AIM: To assess the demand and problem resolution of a clinical guidance telephone service during the COVID-19 pandemic. MATERIAL AND METHODS: The call registry between May and August 2020 of an orientation call center for COVID-19 was analyzed. The number of calls, sociodemographic features of callers, type of enquiry and given indications were described. RESULTS: We analyzed 1,278 telephone calls, corresponding to 655 people. Sixty nine percent of queries were resolved during the call and in 31% of calls, users were referred to face-to-face evaluation. Two percent of these referrals were to an emergency service. CONCLUSIONS: The call center had a high level of resolution, favoring remote consultation and reducing face-to-face care, improving users'accessibility.

Long-term Mammography Utilization after an Initial Randomized Intervention Period by all Underserved Chilean Women in the Clinics.

Chile has one of the highest rates of breast cancer in Latin America. Mammography rates among women, especially those of low socioeconomic status (SES), are thought to contribute to high breast cancer morbidity and mortality. A successful randomized controlled trial among women aged 50 to 70 in a low-SES primary care clinic in Chile led to a significant increase in mammography screening rates in a two-year intervention trial. This study assesses the sustainability of the intervention after ten years and identifies factors that might have been associated with a long-term effect using the RE-AIM (Reach, Effectiveness, Adoption, Implementation, Maintenance) framework. The mammography rates among women aged 50 to 70 in the low-SES intervention clinic were compared to two populations of women aged 50 to 70 from middle-SES clinics and to national data. Qualitative data were used to answer questions of adoption, implementation, and maintenance, while quantitative data assessed the reach and effectiveness. After ten years, low-SES women at the intervention clinic maintained significantly higher mammography screening rates vs. middle-SES women at the comparison clinics (36.2% vs. 30.1% and 19.4% p < 0.0001). Women of a low SES at the intervention clinic also had significantly higher screening rates compared to women of a low SES at a national level (44.2% vs. 34.2% p < 0.0001). RE-AIM factors contributed to understanding the long-term difference in rates. Mailed contact, outreach interventions, and the integration of health promoters as part of the Community Advisory Board were important factors associated with the effects observed. This study provides information on factors that could contribute to reducing the social gap on breast cancer screening.

Evaluación de un call center de orientación clínica durante los primeros meses de pandemia COVID-19: capacidad de resolución de los llamados / Evaluation of a clinical orientation Call Center during the first months of the COVID-19 pandemic

BACKGROUND: During sanitary emergencies such as the recent pandemic, health services can collapse. In these cases, remote orientation services such as call centers may help to debottleneck these services. AIM: To assess the demand and problem resolution of a clinical guidance telephone service during the COVID-19 pandemic. Material and Methods: The call registry between May and August 2020 of an orientation call center for COVID-19 was analyzed. The number of calls, sociodemographic features of callers, type of enquiry and given indications were described. RESULTS: We analyzed 1,278 telephone calls, corresponding to 655 people. Sixty nine percent of queries were resolved during the call and in 31% of calls, users were referred to face-to-face evaluation. Two percent of these referrals were to an emergency service. Conclusions: The call center had a high level of resolution, favoring remote consultation and reducing face-to-face care, improving users'accessibility.

Mixed-Methods Evaluation of the Initial Implementation of Advanced Home Visits in Chile.

Home visiting programs are evidence-based interventions that have a myriad outcomes for mothers and newborns. Chile offers these services as part of the Chile Crece Contigo, a nationwide program. However, implementing home visiting programs in community settings is difficult. In this study, we report clinic, provider, and participant engagement with the implementation of advanced home visits (ViDAs) in Chilean primary care clinics. ViDAs include a high number of visits, external supervision, and the use of technology. In this study, qualitative and quantitative data were collected to assess the initial implementation of the home visiting strategy. Qualitative data consisted of individual interviews and focus groups with directors of city health departments, clinic managers, and providers conducting home visits. Quantitative data included clinic, provider, and participant recruitment. City health departments were approached to authorize the participation of primary care clinics in the ViDAs program. Then, clinic directors were invited to approve the implementation of the home visiting program at their health centers. In total, 16 clinics, 42 practitioners, and 185 participants were recruited. A large amount of resources was needed to recruit clinics, providers, and participants. The intervention had low acceptability, low adoption, and a high implementation cost. Initial program implementation experienced several challenges. Identified facilitators and barriers both highlighted the need for community engagement at all levels for the successful implementation of an innovation in Chilean primary care clinics. In addition, this article provides recommendations for practitioners and researchers regarding the conduct of research in community-based settings.

Perfil antropométrico, somatotipo y estado nutricional del taekwondoín mexicano / Anthropometric profile, somatotype and nutritional status of Mexican taekwondoin

RESUMEN: El perfil antropométrico y el somatotipo son herramientas imprescindibles para monitorizar el rendimiento morfológico del atleta de alto rendimiento. El objetivo del presente estudio es la descripción del perfil antropométrico y el somatotipo dominante de atletas mexicanos de taekwondo (TKD) de alto rendimiento. El perfil antropométrico y el somatotipo fueron determinados en 16 atletas de TKD mexicanos [8 hombres, edad media 21,5 años (19,8-23,0, IC 95%); 8 mujeres, edad media 21,9 años (19,2-24,4, IC 95%)]. Una prueba T-Student para muestras independiente fue usada para comparar las medias entre ambos sexos (Hombres vs Mujeres). La estatura (P = 0,001), los pliegues del muslo anterior (p = 0,006) y pantorrilla (p = 0,049), la circunferencia del brazo flexionado (p = 0,047), los diámetros del húmero (p = 0,011) y fémur (p = 0,012), el área total y área muscular del brazo (p = 0,001) fueron significativamente diferentes entre hombres y mujeres. Un somatotipo ecto-mesomórfico predomino tanto en hombres (2,1-3,2-4,2) como en el grupal (2,4-3,1-3,8), pero ectomorfo-mesomórfico (2,8-3,2-3,4) para las mujeres. El somatotipo del atleta de TKD mexicano predominó por una mayor linearidad relativa seguido de una magnitud musculoesquelética y una menor adiposidad relativa. Los hallazgos de este estudio aportan evidencias morfológicas para monitorizar el rendimiento físico y nutricional del atleta de TKD.

SUMMARY: Body composition, somatotype and nutritional status are essential tools for monitoring the perfor- mance of high-performance athlete. The objective of the present study was to verify the body composition, the dominant somatotype and nutritional status of high-performance taekwondo athletes of the Mexican TKD team. The anthropometric profile, somatotype and nutritional status were determined in sixteen Mexican TKD athletes [8 men, mean age 21.5 yrs. (19.8-23.0 95% CI); 8 women, mean age 21.9 yrs. (19.2-24.4 95% CI)]. An independent-samples t-test was used to compare the means between both genders (Men vs. Women). The height (p = 0.001), the anterior thigh (p = 0.006) and calf (p = 0.049) folds, the flexed arm circumference (p = 0.047), the humerus (p = 0.011) and femur (p = 0.012) diameters, the fat free mass (p = 0.020) and arm total area (p = 0.049) and arm muscle area (p = 0.001) were significantly different between men and women. The percentage of body fat and arm fat area were not significant between both genders. A normal caloric reserve, but a slightly high percentage of body fat was observed for both genders. In addition, normal and high protein reserves were identified for men and women, respectively. An ecto-mesomorphic somatotype was highlighted in both men (2.1-3.2-4.2) and in the group (2.4-3.1-3.8), but ectomorphic- mesomorphic (2.8-3.2-3.4) to women. The somatotype of the Mexican TKD athlete predominated by a greater relative linearity followed by a musculoskeletal magnitude and a lower relative adiposity. The findings of this study provide morphological evidence to monitor the physical and nutritional performance of the high-performance TKD athlete.

Ley 21331: nuevos desafíos de la Ley del reconocimiento y protección de los derechos de las personas en la atención de salud mental / Law 21331: new challenges of the law of recognition and protection of people's rights in mental health care

Since the dawn of the Republic, the question regarding the diagnosis, management and treatment of mental illnesses has been an unresolved issue to this day. Since before the time of the colony, at the time of the conquest, mental illnesses abounded, both in the Mapuche population - autochthonous indigenous - and in the Spanish. The presence in the river basins of heavy metals and minerals toxic for human consumption, as was originally the Mapocho River, whose waters were not drinkable and were only used for crops adopted from the Inca culture, were consumed by the population of the Spanish conquerors, who manifested various types of mental disorders, either due to the consumption of polluted water and the neurological damage that it caused them, the high levels of stress due to the same occupation and the isolation in which they found themselves and the diseases venereal that they carried, which they progressively transmitted to the aboriginal population. (1) On the other hand, the Mapuche population had magical-ritual treatments and methods to treat these and other diseases based on herbalism, phytotherapy and rituals (2) for the evil of melancholy (depression), anxiety disorders, panic attacks and schizophrenia. (3) Centuries later, when medicine and hard science are presented in society giving way to the scientific method, key people make their appearance within mental health studies, who made their way into the national and world panorama, and who, despite the dark past and the tortuous evolution of this branch of medicine, stand out figures who were pioneers and who gave rise to a reality that today continues in constant development and debate. Today mental health is an issue on the table, and Law 21331, promulgated on April 23, 2021 (4) is a response to changes in the perception that society currently has of the concept of disease, which is contrasted to the thinking and management that existed for years, decades and centuries ago around mental health

Desde los albores de la República, la cuestión referente al diagnóstico, manejo y tratamiento de las enfermedades mentales ha sido un tema sin resolver hasta nuestros días. Desde antes del tiempo de la colonia, en la época de la conquista, las enfermedades mentales abundaban, tanto en la población mapuche -indígena autóctona- como en la española. La presencia en las cuencas fluviales de metales pesados y minerales tóxicos para el consumo humano, como fue en su origen el río Mapocho, cuyas aguas no eran bebestibles y solo se utilizaban para los cultivos adoptados de la cultura inca, fueron consumidas por la población de los conquistadores españoles, los cuales manifestaron diversos tipos de trastornos mentales, ya fuese por el consumo de aguas contaminadas y el daño neurológico que les provocaba, los altos niveles de estrés debido a la misma ocupación y al aislamiento en el que se encontraban y las enfermedades venéreas que portaban, las cuales transmitieron progresivamente a la población aborigen. (1) Por otra parte, la población mapuche tenía tratamientos y métodos mágico-rituales para tratar estas y otras enfermedades basados en la herbolaria, la fitoterapia y los rituales (2) para el mal de la melancolía (depresión), trastornos ansiosos, crisis de pánico y la esquizofrenia.(3) Siglos más tarde, cuando la medicina y la ciencia dura se presentan en sociedad dando paso al método científico, hacen su aparición personas clave dentro de los estudios en salud mental, quienes se abrieron camino dentro del panorama nacional y mundial, y que, pese al pasado oscuro y a la evolución tortuosa de esta rama de la medicina, se destacan figuras que fueron pioneras y que dieron pie a una realidad que hoy en día continúa en constante desarrollo y debate. Hoy la salud mental es un tema sobre la mesa, y la Ley 21331, promulgada el 23 de abril del año 2021 (4) es una respuesta a los cambios en la percepción que la sociedad actualmente tiene frente al concepto de enfermedad, que se contrasta al pensamiento y manejo que durante años, décadas y siglos atrás existió en torno a la salud mental

Synthesis and Fungicidal Activity of Hydrated Geranylated Phenols against Botrytis cinerea.

Botrytis cinerea is a ubiquitous fungus that affects hundreds of plants, resulting in economic losses to the horticulture and fruit industry. The search for new antifungal agents is a matter of current interest. Thus, in this work a series of geranylated phenols in which the side alkyl chain has been hydrated have been synthesized, and their activity against B. cinerea has been evaluated. The coupling of phenol and geraniol has been accomplished under microwave irradiation obtaining the highest reaction yields in the shortest reaction times. Hydration of the side chain was carried out in dioxane with p-toluenesulfonic acid polymer-bound as the catalyst. All synthesized compounds were tested against B. cinerea using the growth inhibition assay and EC50 values were determined. The results show that activity depends on the number and nature of functional groups in the phenol ring and hydration degree of the geranyl chain. The most active compound is 1,4-dihydroquinone with one hydroxyl group attached at the end of the alkyl chain. Results from a molecular docking study suggest that hydroxyl groups in the phenol ring and alkyl chain are important in the binding of compounds to the active site, and that the experimental antifungal activity correlates with the number of H-bond that can be formed in the binding site.

A Novel Kinematic Model of the Tibiofemoral Joint Based on a Parallel Mechanism.

This paper presents a complete kinematic model of the tibiofemoral joint (TFJ) based on a RRPP + 4-SPS parallel mechanism, where R, P, and S stand for revolute, prismatic, and spherical joints, respectively. The model accounts for the contact between tibia and femur, and the four major ligaments: anterior cruciate, posterior cruciate, medial collateral, and lateral collateral, with anatomical significance in their length variations. An experimental flexion passive motion task is performed, and the kinematic model is tested to determine its capability to reproduce the workspace of the motion task. In addition, an optimization process is performed to simulate prescribed ligament length variations during the motion task. The proposed kinematic model is capable to reproduce with high accuracy an experimental three-dimensional workspace, and at the same time, to simulate prescribed ligament length variation during the spatial flexion task. Prescribed ligament length variations are achieved through an optimization process of the ligament insertion points. This model can be used to improve the multibody kinematic optimization (MKO) process during gait analysis, and also in the design of rehabilitation devices as well as trajectories to accelerate the recovery of injured ligaments. The model shows potential to predict ligament length variations during different motion tasks, and can serve as a basis to develop complex models for kinetostatic and dynamic analyses without dealing with computationally expensive models.

Análisis de series temporales respecto tasas de mortalidad general e intrahospitalaria en egresos hospitalarios, población pediátrica oncohematológico, Chile 1997-2016 / Analysis of time series related general and in-hospital mortality rates in hospital discharges, pediatric onco hematological population, Chile 1997-2016

INTRODUCTION: Before the start of the GES program in 2002, mortality was 128.2 deaths per million children under 15 years of age (RENCI). This public program managed to ensure the opportunity for diagnosis and treatment in children under 15 years of age and those less than 25 years of age who recur. Objective: To assess how GES has impacted on in-hospital mortality and lethality between1997and 2016. Methods: Retrospective case control study of 28,997 hospital discharges and 12,434 deaths analyzed using Prais-Weinstein time series between the years 1997 to 2016. They prepared contingency tables with data on: hospital discharges, age, sex and forecasts for 2001 and 2016. Fisher's p <0.05 test was used. Results: For the PreGes period an increase of 1.8% in the male crude mortality rate was observed, while for the Post Ges period an increase was observed with a breaking point at the end of 2008, with an increase of 11.04% compared to the PreGes period. An unexpected increase in the female mortality rate was observed. The odd's ratios associated with sex (higher mortality inmen than in women)0.816CI-0.679- 0.982; p <0.05; OR'S age 1,047 (0.981 per year) IC-1.044-1.051; p <0.0001 FORECAST (FONASA-1.942 IC 1.304-2.89 / ISAPRE = 2.186; IC = 1.267-3.773 p <0.005); Hospitalization days = 1.031 confirmed our research hypothesis 1.026-1.035 p <0.0001. Conclusion: This study found that there are statistically significant differences regarding hospital discharges between the public-private system, in relation to mortality andincreasein sustained crudemalemortality between the years1997 to 2016

INTRODUCCIÓN: Antes del inicio del programa GESen2002, la mortalidad era 128,2 muertes por millón de niños menores de 15 años (RENCI). Este programa público logró asegurar la oportunidad de diagnóstico y tratamiento en menores de15 años y aquellos menores de25añosque recidivan. Objetivo: Evaluar cómo el GES ha impactado en la mortalidad y letalidad intrahospitalaria entre1997a2016. Métodos: Estudio retrospectivo de control de casos en 28.997 egresos hospitalarios y 12.434 defunciones analizadas mediante series temporales de Prais-Weinstein entre los años 1997 a 2016. Se prepararon tablas de contingencia con datos sobre: egresos hospitalarios, edad, sexo y previsiones para2001y 2016.Se utilizóla prueba p <0.05de Fisher. Resultados: Se observó para el período PreGES un incremento de 1.8% en la tasa mortalidad cruda masculina, mientras que para el período Post GES se observó un incremento con punto de quiebre a fines del año 2008, con incremento del 11,04% respecto al período PreGES. Se observó incremento no sostenido en la tasa mortalidad femenina. Los odd's ratios asociados al sexo (mayor mortalidad en hombres que en mujeres) 0.816 IC-0.679-0.982; p <0,05; OR'S edad 1,047 (0.981 por año) IC-1.044-1.051; p<0.0001 PREVISIÓN (FONASA-1.942 IC 1.304-2.89 / ISAPRE =2.186; IC= 1,267-3,773 p<0.005); Días de Hospitalización=1,031 confirmó nuestra hipótesis de investigación 1,026-1,035 p<0.0001. Conclusión: Este estudio encontró que hay diferencias estadísticamente significativas respecto egresos hospitalarios entre el sistema público privado, en relación con la mortalidad e incremento en la mortalidad cruda masculina sostenida entre los años 1997 a 2016. acción en la función auditiva mediante audiometría tonal.

Epistemonikos: a comprehensive database of systematic reviews for health decision-making.

BACKGROUND: Systematic reviews allow health decisions to be informed by the best available research evidence. However, their number is proliferating quickly, and many skills are required to identify all the relevant reviews for a specific question. METHODS AND FINDINGS: We screen 10 bibliographic databases on a daily or weekly basis, to identify systematic reviews relevant for health decision-making. Using a machine-based approach developed for this project we select reviews, which are then validated by a network of more than 1000 collaborators. After screening over 1,400,000 records we have identified more than 300,000 systematic reviews, which are now stored in a single place and accessible through an easy-to-use search engine. This makes Epistemonikos the largest database of its kind. CONCLUSIONS: Using a systematic approach, recruiting a broad network of collaborators and implementing automated methods, we developed a one-stop shop for systematic reviews relevant for health decision making.

INTESTINAL AND BLOOD PARASITES IN SCARLET (ARA MACAO) AND GREAT GREEN (ARA AMBIGUA) MACAWS IN WILDLIFE REHABILITATION CENTERS IN COSTA RICA.

Costa Rica undertakes continuous efforts to recover the native population of macaw species through rehabilitation programs for breeding and releasing birds in protected areas. In the summer of 2018, a total of 107 scarlet (Ara macao) and 93 great green (Ara ambigua) macaws were sampled in four wildlife rehabilitation centers in Costa Rica. Fecal samples representing 200 individuals were analyzed for intestinal parasites, and 23 individuals were sampled for hemoparasites. Ascaridia and Capillaria were found in fecal samples. No hemoparasites were found. The distribution of percentage of infection was analyzed by location, species, and housing type. As part of a health screening prior to release, parasitological examination is recommended.

Hematology and Serum Biochemistry Values of Healthy Free-Ranging Panamanian White-Faced Capuchins (Cebus imitator) in Costa Rica.

We describe the hematology and serum biochemistry values for 26 free-ranging Panamanian white-faced capuchins (Cebus imitator) in Costa Rica. Howell-Jolly bodies and microfilariae were observed in some animals. This baseline information is a tool for health assessment and species conservation.

Does Relaxing the Infinite Sites Assumption Give Better Tumor Phylogenies? An ILP-Based Comparative Approach.

Most of the evolutionary history reconstruction approaches are based on the infinite sites assumption, which states that mutations appear once in the evolutionary history. The Perfect Phylogeny model is the result of the infinite sites assumption and has been widely used to infer cancer evolution. Nonetheless, recent results show that recurrent and back mutations are present in the evolutionary history of tumors, hence the Perfect Phylogeny model might be too restrictive. We propose an approach that allows losing previously acquired mutations and multiple acquisitions of a character. Moreover, we provide an ILP formulation for the evolutionary tree reconstruction problem. Our formulation allows us to tackle both the Incomplete Directed Phylogeny problem and the Clonal Reconstruction problem when general evolutionary models are considered. The latter problem is fundamental in cancer genomics, the goal is to study the evolutionary history of a tumor considering as input data the fraction of cells having a certain mutation in a set of cancer samples. For the Clonal Reconstruction problem, an experimental analysis shows the advantage of allowing mutation losses. Namely, by analyzing real and simulated datasets, our ILP approach provides a better interpretation of the evolutionary history than a Perfect Phylogeny. The software is at https://github.com/AlgoLab/gppf.

Using Health Information Exchange: Usability and Usefulness Evaluation.

Health information exchange (HIE) is implemented in Quebec, Canada to improve the exchange and use of clinical information for decision making in the province's health care system. The objective of this mixed-method approach study was to evaluate the usage, usability, and usefulness of an electronic health record (EHR) to access and import clinical information from a centralized HIE. First, a heuristic analysis was performed of three different commercial EHRs, using end users to analyze the integration feature through think aloud protocols. Second, interviews were conducted with advanced users to describe the usefulness. Third, usage data were analyzed to describe the level of use of each data domain, per EHR and user. The results show that usefulness is high for medication data; leading to greater use of this domain, its relation to integration, and meets the needs of general practitioners. Difficulties in the implementation processes reduced the potential of this system.