Screening for Substance Use Disorders during Pregnancy: A Decision at the Intersection of Racial and Reproductive Justice.

OBJECTIVE: Improve racial equity with routine universal drug screening / Study Design: Commentary on the medicolegal and social history of the United States and the field of obstetrics and gynecology regarding drug screening policy / Results: Critical aspects to inform an equitable drug screening policy include (1) racial bias and stigma related to substance use, (2) the legislative history surrounding substance use during pregnancy, (3) the relationship between substance use and mass incarceration which disproportionately affects persons of color, (4) propensity toward punitive measures for Black mothers with substance use, including termination of parental rights, (5) the role of the medical field in fostering mistrust among our patients / Conclusion: new practices in screening for substance use during pregnancy are needed. KEY POINTS: · Increasing demand for racial justice warrants reframing the issue of urine drug screening.. · The current legal constructs continue to disproportionately impact women of color.. · Routine verbal screening can replace urine drug screening and diminish implicit biases..

Paradoxical choice and the reinforcing value of information.

Signals that reduce uncertainty can be valuable because well-informed decision-makers can better align their preferences to opportunities. However, some birds and mammals display an appetite for informative signals that cannot be used to increase returns. We explore the role that reward-predictive stimuli have in fostering such preferences, aiming at distinguishing between two putative underlying mechanisms. The 'information hypothesis' proposes that reducing uncertainty is reinforcing per se, somewhat consistently with the concept of curiosity: a motivation to know in the absence of tractable extrinsic benefits. In contrast, the 'conditioned reinforcement hypothesis', an associative account, proposes asymmetries in secondarily acquired reinforcement: post-choice stimuli announcing forthcoming rewards (S+) reinforce responses more than stimuli signalling no rewards (S-) inhibit responses. In three treatments, rats faced two equally profitable options delivering food probabilistically after a fixed delay. In the informative option (Info), food or no food was signalled immediately after choice, whereas in the non-informative option (NoInfo) outcomes were uncertain until the delay lapsed. Subjects preferred Info when (1) both outcomes were explicitly signalled by salient auditory cues, (2) only forthcoming food delivery was explicitly signalled, and (3) only the absence of forthcoming reward was explicitly signalled. Acquisition was slower in (3), when food was not explicitly signalled, showing that signals for positive outcomes have a greater influence on the development of preference than signals for negative ones. Our results are consistent with an elaborated conditioned reinforcement account, and with the conjecture that both uncertainty reduction and conditioned reinforcement jointly act to generate preference.

Corrección de fractura oblicua corta de calcáneo en una hembra juvenil de Puma concolor, utilizando una aguja de Steitnmann y placa de compresión / Correction of short oblique calcaneal fracture in a juvenile female Puma concolor, using a Steitnmann needle and compression plate / Correção de fratura oblicua corta do calcâneo em uma fêmea filhote de Puma concolor, utilizando uma agulha de Steitnmann e placa de compressão

Resumen El tráfico de vida silvestre es uno de los negocios ilícitos más lucrativos y es uno de los principales problemas que enfrenta la fauna silvestre del Ecuador. Una cachorra hembra de puma, víctima de comercio ilegal fue retenida por la Fundación Big Mammals Conservation en la provincia de Loja, en el sur de Ecuador y fue trasladada al centro de Rescate Ilitío, bajo cuidado de la Fundación Cóndor Andino. Posteriormente fue movilizada al Hospital Veterinario de fauna silvestre Planeta Vida para su examinación y tratamiento. El espécimen presentó fractura del hueso calcáneo, dermatitis de contacto en la región del cuello y mala condición corporal (2/5). Se realizó la corrección de la fractura, rehabilitación y plan alimenticio, con lo que se logró reestablecer su bienestar animal.

Abstract Wildlife trafficking is one of the most lucrative illicit businesses and is one of the main problems facing wildlife in Ecuador. A female puma cub, a victim of illegal trade, was held by the Big Mammals Conservation Foundation in the province of Loja, in southern Ecuador, and was transferred to the Ilitío Rescue Center, under the care of the Fundación Cóndor Andino. She was subsequently moved to the Planeta Vida Wildlife for examination and treatment. The specimen presented fracture of the calcaneal bone, contact dermatitis in the neck region and poor body condition (2/5). The correction of the fracture, rehabilitation and feeding plan were carried out, with which it was perfected to reestablish its animal welfare.

Resumo O tráfico de vida silvestre é um dos negócios ilícitos mais lucrativos e é um dos principais problemas enfrentados pela vida silvestre no Equador. Um filhote de puma fêmea, vítima do comércio ilegal, foi detida pela Fundação de Conservação de Grandes Mamíferos na província de Loja, no sul do Equador, e foi transferida para o Centro de Resgate Ilitío, sob os cuidados da Fundação Cóndor Andino. Ela foi posteriormente transferida para o Hospital Veterinário Planeta Vida Wildlife para exame e tratamento. O espécime apresentava fratura do osso do calcâneo, dermatite de contato na região do pescoço e má condição corporal (2/5). Foi realizado a correção da fratura, reabilitação e plano de alimentação, com o qual foi possível restabelecer o bem-estar dos animais.

[Cutaneous anthrax, the last outbreak diagnosed in Chile]. / Ántrax cutáneo, último brote diagnosticado en Chile.

Anthrax is a zoonosis caused by a spore-forming bacterium, called Bacillus anthracis. Naturally it is of global distribution, with a predilection in agricultural zones with few norms of public veterinary health. Human contagion occurs through the consumption of diseased animal's meat or through a doorway into the skin or through the spores inhalation of products derived from the affected animal (wool, leather, bones). The most frequent infection in humans occurs in the skin, followed by the gastrointestinal tract and lungs. We present the last outbreak of cutaneous anthrax diagnosed in Chile with a description of the first two clinical cases of the outbreak. Control disease is based on prevention, hence the importance of surveillance in detecting cases and outbreaks.

Paradoxical choice in rats: Subjective valuation and mechanism of choice.

Decision-makers benefit from information only when they can use it to guide behavior. However, recent experiments found that pigeons and starlings value information that they cannot use. Here we show that this paradox is also present in rats, and explore the underlying decision process. Subjects chose between two options that delivered food probabilistically after a fixed delay. In one option ("info"), outcomes (food/no-food) were signaled immediately after choice, whereas in the alternative ("non-info") the outcome was uncertain until the delay lapsed. Rats sacrificed up to 20% potential rewards by preferring the info option, but reversed preference when the cost was 60%. This reversal contrasts with the results found with pigeons and starlings and may reflect species' differences worth of further investigation. Results are consistent with predictions of the Sequential Choice Model (SCM), that proposes that choices are driven by the mechanisms that control action in sequential encounters. As expected from the SCM, latencies to respond in single-option trials predicted preferences in choice trials, and latencies in choice trials were the same or shorter than in single-option trials. We argue that the congruence of results in distant vertebrates probably reflects evolved adaptations to shared fundamental challenges in nature, and that the apparently paradoxical overvaluing of information is not sub-optimal as has been claimed, even though its functional significance is not yet understood.

Ántrax cutáneo, último brote diagnosticado en Chile / Cutaneous anthrax, the last outbreak diagnosed in Chile

Resumen El ántrax, es una zoonosis causada por una bacteria generadora de esporas, llamada Bacillus anthracis. En forma natural tiene una distribución global, con una predilección en zonas agrícolas con pocas normativas de sanidad pública veterinaria. El contagio humano ocurre por el consumo de carnes de animales enfermos, por contacto a través de una puerta de entrada en la piel o por la inhalación de esporas de productos derivados del animal afectado (lana, cuero, huesos). La infección en los seres humanos compromete con mayor frecuencia la piel, seguido por el tracto gastrointestinal y los pulmones. El control de la enfermedad se basa en la prevención, de allí la importancia de la vigilancia en la detección de casos y brotes. Presentamos el último brote de ántrax cutáneo diagnosticado en Chile con descripción de dos primeros casos clínicos del brote.

Anthrax is a zoonosis caused by a spore-forming bacterium, called Bacillus anthracis. Naturally it is of global distribution, with a predilection in agricultural zones with few norms of public veterinary health. Human contagion occurs through the consumption of diseased animal's meat or through a doorway into the skin or through the spores inhalation of products derived from the affected animal (wool, leather, bones). The most frequent infection in humans occurs in the skin, followed by the gastrointestinal tract and lungs. We present the last outbreak of cutaneous anthrax diagnosed in Chile with a description of the first two clinical cases of the outbreak. Control disease is based on prevention, hence the importance of surveillance in detecting cases and outbreaks.

A theory of working memory without consciousness or sustained activity.

Working memory and conscious perception are thought to share similar brain mechanisms, yet recent reports of non-conscious working memory challenge this view. Combining visual masking with magnetoencephalography, we investigate the reality of non-conscious working memory and dissect its neural mechanisms. In a spatial delayed-response task, participants reported the location of a subjectively unseen target above chance-level after several seconds. Conscious perception and conscious working memory were characterized by similar signatures: a sustained desynchronization in the alpha/beta band over frontal cortex, and a decodable representation of target location in posterior sensors. During non-conscious working memory, such activity vanished. Our findings contradict models that identify working memory with sustained neural firing, but are compatible with recent proposals of 'activity-silent' working memory. We present a theoretical framework and simulations showing how slowly decaying synaptic changes allow cell assemblies to go dormant during the delay, yet be retrieved above chance-level after several seconds.

Diagnóstico antenatal de malformaciones fetales / Prenatal diagnosis of fetal abnormalities

El pronóstico neonatal puede cambiar radicalmente al contar con un diagnóstico antenatal de malformaciones, como ocurre por ejemplo con la hernia diafragmática, la peritonitis meconial, los defectos de la pared abdominal, los defectos del tubo neural, las hidrocefalias, las válvulas uretrales posteriores, etc. El 25 por ciento de la mortalidad neonatal es por malformaciones, y ésta sube al 40 por ciento considerando sólo la neonatal precoz. Además, cuando el defecto fetal no es tratable, su conocimiento antenatal tiene implicaciones en las conductas obstétricas y en la preparación psicológica de los padres. Los centros del nivel terciario dependen de la derivación oportuna de los Hospitales y Consultorios periféricos, donde se controla a la gran mayoría de las embarazadas, y es por tanto, la US de nivel primario una herramienta fundamental en el buen control obstétrico (medicina prenatal)