Community-Based Knowledge Translation Strategies for Maternal, Neonatal, and Perinatal Outcomes: A Systematic Review of Quantitative and Qualitative Data.

Objective: To identify and assess the effect of community-based Knowledge Translation Strategies (KTS) on maternal, neonatal, and perinatal outcomes. Methods: We conducted systematic searches in Medline, Embase, CENTRAL, CINAHL, PsycInfo, LILACS, Wholis, Web of Science, ERIC, Jstor, and Epistemonikos. We assessed the certainty of the evidence of the studies using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) framework. Results: We identified seven quantitative and seven qualitative studies. Quantitative findings suggest that there is a possible effect on reducing maternal mortality (RR 0.65; 95% CI, 0.48-0.87; moderate evidence certainty); neonatal mortality (RR 0.79; 95% CI 0.70-0.90; moderate evidence certainty); and perinatal mortality (RR 0.84; 95% CI 0.77-0.91; moderate evidence certainty) in women exposed to KTS compared to those who received conventional interventions or no intervention at all. Analysis of qualitative studies identified elements that allowed to generate benefit effects in improving maternal, neonatal, and perinatal outcomes. Conclusion: The KTS in maternal, neonatal, and perinatal outcomes might encourage the autonomy of communities despite that the certainty of evidence was moderate.

A Paleogenomic Reconstruction of the Deep Population History of the Andes.

There are many unanswered questions about the population history of the Central and South Central Andes, particularly regarding the impact of large-scale societies, such as the Moche, Wari, Tiwanaku, and Inca. We assembled genome-wide data on 89 individuals dating from ∼9,000-500 years ago (BP), with a particular focus on the period of the rise and fall of state societies. Today's genetic structure began to develop by 5,800 BP, followed by bi-directional gene flow between the North and South Highlands, and between the Highlands and Coast. We detect minimal admixture among neighboring groups between ∼2,000-500 BP, although we do detect cosmopolitanism (people of diverse ancestries living side-by-side) in the heartlands of the Tiwanaku and Inca polities. We also highlight cases of long-range mobility connecting the Andes to Argentina and the Northwest Andes to the Amazon Basin. VIDEO ABSTRACT.

Quasi-two-layer morphodynamic model for bedload-dominated problems: bed slope-induced morphological diffusion.

We derive a two-layer depth-averaged model of sediment transport and morphological evolution for application to bedload-dominated problems. The near-bed transport region is represented by the lower (bedload) layer which has an arbitrarily constant, vanishing thickness (of approx. 10 times the sediment particle diameter), and whose average sediment concentration is free to vary. Sediment is allowed to enter the upper layer, and hence the total load may also be simulated, provided that concentrations of suspended sediment remain low. The model conforms with established theories of bedload, and is validated satisfactorily against empirical expressions for sediment transport rates and the morphodynamic experiment of a migrating mining pit by Lee et al. (1993 J. Hydraul. Eng.119, 64-80 (doi:10.1061/(ASCE)0733-9429(1993)119:1(64))). Investigation into the effect of a local bed gradient on bedload leads to derivation of an analytical, physically meaningful expression for morphological diffusion induced by a non-zero local bed slope. Incorporation of the proposed morphological diffusion into a conventional morphodynamic model (defined as a coupling between the shallow water equations, Exner equation and an empirical formula for bedload) improves model predictions when applied to the evolution of a mining pit, without the need either to resort to special numerical treatment of the equations or to use additional tuning parameters.

Linking social, ecological, and physical science to advance natural and nature-based protection for coastal communities.

Interest in the role that ecosystems play in reducing the impacts of coastal hazards has grown dramatically. Yet the magnitude and nature of their effects are highly context dependent, making it difficult to know under what conditions coastal habitats, such as saltmarshes, reefs, and forests, are likely to be effective for saving lives and protecting property. We operationalize the concept of natural and nature-based solutions for coastal protection by adopting an ecosystem services framework that propagates the outcome of a management action through ecosystems to societal benefits. We review the literature on the basis of the steps in this framework, considering not only the supply of coastal protection provided by ecosystems but also the demand for protective services from beneficiaries. We recommend further attention to (1) biophysical processes beyond wave attenuation, (2) the combined effects of multiple habitat types (e.g., reefs, vegetation), (3) marginal values and expected damage functions, and, in particular, (4) community dependence on ecosystems for coastal protection and co-benefits. We apply our approach to two case studies to illustrate how estimates of multiple benefits and losses can inform restoration and development decisions. Finally, we discuss frontiers for linking social, ecological, and physical science to advance natural and nature-based solutions to coastal protection.

[WHO grade II gliomas: review of the current management]. / Gliomas hemisféricos OMS grado II: revisión del manejo actual.

The optimal management of diffuse WHO grade II gliomas (GGII) is still controversial. Some authors propose a long-term radiological follow-up of the tumor, others perform a biopsy and treat only if clinical or radiological signs of progression, finally, others propose an active treatment from diagnosis. There is mounting evidence that suggest that expectant management is no longer optimal, supporting active treatment from diagnosis. In the present work, an extensive review of the recent literature was performed, in order to clarify some of these controversies. Neuroimaging techniques, such as magnetic resonance imaging (MRI), multivoxel spectroscopy or methionine positron emission tomography (PET), give valuable information about the tumor, but lack of sufficient reliability to make a definitive diagnosis of GGII. Stereotactic biopsy leads to misdiagnosis in up to 71% of cases, which has been associated with sampling errors and inter-observer variability due to the small sample obtained. Therefore, it is now considered that a definitive diagnosis of GGII requires a detailed histological analysis of the sample after maximum tumor removal. Despite the lack of class I evidence, there is growing evidence from cohort studies, favoring extensive surgical resection to improve survival and time to tumor degeneration. Surgery is also effective to treat epilepsy, as an improvement in up to 76% of drug-resistant epilepsies has been documented. Consequently, surgery is now considered as a crucial step for diagnosis and treatment of these tumors. Early radiotherapy after surgery lengthens the period without progression but does not affect overall survival, and is related to cognitive disorders that affect quality of life. Hence, this treatment could be deferred until tumor progression.

Gliomas hemisféricos OMS grado II: revisión del manejo actual / No disponible

El manejo de los gliomas difusos OMS grado II (GGII) es a día de hoy controvertido. Algunos autores proponen una actitud expectante, con seguimiento radiológico a largo plazo, otros proponen realizar una biopsia y plantear un tratamiento solo si hay signos clínicos o radiológicos de progresión, y por último otros proponen un tratamiento activo desde el diagnóstico. En los últimos años han aparecido varios estudios que pueden ayudar a aclarar estas controversias. En este trabajo se revisa la literatura reciente con a intención de aclarar algunos puntos controvertidos en el manejo de los GGII. Las secuencias convencionales de resonancia magnética (RM) y otras técnicas de neuroimagen más recientes, como la espectroscopia multivoxel o la tomografía por emisión de positrones (PET) con metionina, carecen de la fiabilidad suficiente para realizar un diagnóstico definitivo de GGII. La biopsia estereotáxica es poco invasiva, pero conduce a errores diagnósticos en GGII hasta en el 71% de los casos, lo que se ha asociado a errores en el muestreo y a la variabilidad interobservador por la escasa muestra obtenida. Por todo ello, se considera actualmente que el diagnóstico definitivo de GGII solo se consigue mediante el análisis histológico de la muestra obtenida tras la extirpación máxima del tumor. Respecto al impacto pronóstico de la cirugía, no existe evidencia clase I, pero hay fuertes indicios provenientes de estudios de cohorte con gran número de pacientes y seguimiento a largo plazo de que la extirpación extensa tiene un impacto positivo en la supervivencia y en el tiempo hasta la malignización del tumor. El tratamiento quirúrgico es también efectivo para (..) (AU)

Pharmaco-toxicological study of Kageneckia oblonga, Rosaceae.

The probable antipyretic, antiinflammatory, analgesic and antioxidant properties of Kageneckia oblonga, Rosaceae, were investigated and the major compounds of its active extracts were isolated. The study comprised the acute toxicity of the extracts of global methanol, hexane, dichloromethane and methanol. The cytotoxicity of global methanol extract was studied in three tumoral cell lines. All the extracts exhibited the pharmacological activities under study. Methanol and dichloromethane were the most toxic extracts. From the global methanol extract, isolations were performed of prunasin, 23,24- dihydro-cucurbitacin F, and a new cucurbitacin, 3beta-(beta-D-glucosyloxy)-16alpha,23alpha-epoxycucurbita-5,24-diene-11-one. The cytotoxicity of both cucurbitacins on human neutrophils at the assayed concentrations was not statistically significant. In-vitro assays showed that both cucurbitacins can be partly responsible for the analgesic, antipyretic, and anti-inflammatory activities. Evaluation was done of the cytotoxicity of global methanol extract, 23, 24-dihydrocucurbitacin F, aqueous extracts and prunasin against P-388 murine leukaemia, A-549 human lung carcinoma and HT-29 colon carcinoma. Since global methanol extract presented a strong cytotoxicity against P-388 murine leukaemia, A-549 human lung carcinoma, and HT-29 cell lines, it is highly probable that this extract contain one or more cytotoxic compounds that could be investigated for their potential use as an agent against cancer.

Cirugía del bazo: estudio retrospectivo de 5 aÑos Hospital Luis Vernaza, Guayaquil / Surgery of the spleen: retrospective study of 5 years in Hospital Luis Vernaza, Guayaquil

Se revisaron 69 casos de intervenciones quirúrgicas del Bazo atendidos en los Servicios de Emergencia y Cirugía General del Hospital Luis Vernaza durante los a;os 1981-85, donde se intenta evaluar los criterios de admisión, manejo, tratamiento así como la morbi-mortalidad. El mayor porcentaje correspondió al sexo masculino, el grupo etáreo más afecto fue el de 21-30 años con 28,9%, la causa más incidente fue la traumática con 47,8% seguida de la causa médica con 40,5%. La sintomatología reportada fue dolor, distensión abdominal, anemia. Para el diagnóstico se utilizó datos de laboratorio, radiológicos pero dobre todo la valoración clínico-quirúrgica. Los casos de emergencia fueron 52% y los selectivos en 47,5% el promedio de estancia hospitalaria fue de 26,3 días, la morbilidad de 28,9% y la mortalidad de 8,6% principalmente por traumatismo