The role of neophobia in a pioneer olfactory enrichment for amazons, macaws, and toucans / El papel de la neofobia en un enriquecimiento olfativo pionero para guacamayos, loros y tucanes

Abstract Introduction: Despite sensory enrichment being critical for ensuring the well-being of captive wild animals, smells are not being included in enrichment protocols for birds. For this group, neophobia can be a problem when it comes to implementing new enrichment devices. Objective: To explore how participation in an olfactory enrichment and latency times varies between bird taxonomic groups (Amazona spp. / Ara spp. / Ramphastos spp.). Methods: We exposed 257 birds to a scent enrichment, and we recorded which individuals engaged with it and the time they took to interact with it. Results: We discovered that participation by toucans in the enrichment was higher compared to amazons and macaws. Furthermore, latency time to interact with the enrichment was higher in amazons that in the other species. Our findings could suggest that toucans are neophilic species which could benefit from higher exploration rates. Amazons on the contrary seem to be particularly neophobic, possibly because of their less opportunistic feeding habits compared to toucans and their higher vulnerability to predation compared to macaws. Conclusion: These results point out that toucans would be more inclined to engage in environmental enrichments, while a more natural design using smells inside familiar objects could be a more successful enrichment for psittacids.

Resumen Introducción: A pesar de que el enriquecimiento sensorial es fundamental para garantizar el bienestar de los animales silvestres en cautiverio, los olores no son incluidos de forma rutinaria en los protocolos de enriquecimiento para aves. Además, en el caso de estos animales, la neofobia puede ser un problema a la hora de implementar nuevos dispositivos de enriquecimiento. Objetivo: Explorar cómo varía la participación y la latencia en la interacción con un enriquecimiento olfativo entre grupos taxonómicos de aves (Amazona spp. / Ara spp. / Ramphastos spp.). Métodos: Expusimos a 257 aves a un enriquecimiento olfativo y registramos qué individuos participaron y el tiempo que tardaron en interactuar con él. Resultados: La participación en el enriquecimiento fue mayor en los tucanes en comparación con las amazonas y los guacamayos. Además, el tiempo de latencia para interactuar con el enriquecimiento fue mayor en las amazonas que en las otras especies. Nuestros hallazgos sugieren que los tucanes son especies neofílicas que podrían beneficiarse de tasas de exploración más altas. Por otro lado, las amazonas parecen ser particularmente neofóbicas, posiblemente debido a sus hábitos alimenticios menos oportunistas en comparación con los tucanes y a su mayor vulnerabilidad a la depredación en comparación con los guacamayos. Conclusión: Estos resultados señalan que los tucanes serían más proclives a participar en enriquecimientos ambientales, mientras que un diseño que utilice olores dentro de objetos más naturales o familiares podría ser más exitoso para las psitácidas.

The burden of major complications on failure to rescue after surgery for acute type A aortic dissection: Analysis of more than 19,000 patients.

BACKGROUND: The relationship between the number and type of postoperative complications and mortality in the setting for surgery for acute type A aortic dissection (ATAAD) remains underexplored despite its critical role in the failure-to-rescue (FTR) metric. METHODS: This retrospective study used data from the Society of Thoracic Surgeons Adult Cardiac Surgical Database on ATAAD surgeries performed between January 2018 and December 2022. Patients were categorized based on their number of major complications. The primary outcome was FTR. We used multilevel regression and classification and regression tree models. RESULTS: We included 19,243 patients (33% females), with a median age of 61 years. Regarding complications, 47.7% of patients had 0, 20.2% had 1, 12.7% had 2, and 19.4% experienced 3 or more. The most frequently reported complications were prolonged mechanical ventilation (30.3%), unplanned reoperation (19.5%), and renal failure (17.2%). Cardiac arrest occurred in 7.1% of cases. FTR increased from 13% in patients with 1 complication to >30% in those with 4 or more complications. Cardiac arrest (adjusted odds ratio [aOR], 10.9) and renal failure (aOR, 5.3) had the highest odds for mortality, followed by limb ischemia (aOR, 2.7), stroke (aOR, 2.6), and gastrointestinal complications (aOR, 2.4). Hospitals in the top performance quartile consistently showed lower FTR rates across all levels of complication. CONCLUSIONS: The study validates a dose-response association between postoperative complications and mortality in patients undergoing surgery for ATAAD. Top-performing hospitals consistently show lower FTR rates independent of the number of complications. Future research should focus on the timing of complications and interventions to reduce the burden of complications.

Understanding evolutionary rescue and parallelism in response to environmental stress.

Evolutionary rescue, the process by which populations facing environmental stress avoid extinction through genetic adaptation, is a critical area of study in evolutionary biology. The order in which mutations arise and get established will be relevant to the population's rescue. This study investigates the degree of parallel evolution at the genotypic level between independent populations facing environmental stress and subject to different demographic regimes. Under density regulation, 2 regimes exist: In the first, the population can restore positive growth rates by adjusting its population size or through adaptive mutations, whereas in the second regime, the population is doomed to extinction unless a rescue mutation occurs. Analytical approximations for the likelihood of evolutionary rescue are obtained and contrasted with simulation results. We show that the initial level of maladaptation and the demographic regime significantly affect the level of parallelism. There is an evident transition between these 2 regimes. Whereas in the first regime, parallelism decreases with the level of maladaptation, it displays the opposite behavior in the rescue/extinction regime. These findings have important implications for understanding population persistence and the degree of parallelism in evolutionary responses as they integrate demographic effects and evolutionary processes.

Rescue from complications after pancreaticoduodenectomies at a low-volume Caribbean center: Value of tailored peri-pancreatectomy protocols.

BACKGROUND: Pancreaticoduodenectomy (PD) is a technically complex operation, with a relatively high risk for complications. The ability to rescue patients from post-PD complications is as a recognized quality measure. Tailored protocols were instituted at our low volume facility in the year 2013. AIM: To document the rate of rescue from post-PD complications with tailored protocols in place as a measure of quality. METHODS: A retrospective audit was performed to collect data from patients who experienced major post-PD complications at a low volume pancreatic surgery unit in Trinidad and Tobago between January 1, 2013 and June 30, 2023. Standardized definitions from the International Study Group of Pancreatic Surgery were used to define post-PD complications, and the modified Clavien-Dindo classification was used to classify post-PD complications. RESULTS: Over the study period, 113 patients at a mean age of 57.5 years (standard deviation [SD] ± 9.23; range: 30-90; median: 56) underwent PDs at this facility. Major complications were recorded in 33 (29.2%) patients at a mean age of 53.8 years (SD: ± 7.9). Twenty-nine (87.9%) patients who experienced major morbidity were salvaged after aggressive treatment of their complication. Four (3.5%) died from bleeding pseudoaneurysm (1), septic shock secondary to a bile leak (1), anastomotic leak (1), and myocardial infarction (1). There was a significantly greater salvage rate in patients with American Society of Anesthesiologists scores ≤ 2 (93.3% vs 25%; P = 0.0024). CONCLUSION: This paper adds to the growing body of evidence that volume alone should not be used as a marker of quality for patients requiring PD. Despite low volumes at our facility, we demonstrated that 87.9% of patients were rescued from major complications. We attributed this to several factors including development of rescue protocols, the competence of the pancreatic surgery teams and continuous, and adaptive learning by the entire institution, culminating in the development of tailored peri-pancreatectomy protocols.

Qualidade de vida profissional em bombeiros: um protocolo de revisão de escopo / Quality of professional life in firefighters: a scope review protocol

OBJETIVO: Mapear tendências de utilização do Professional quality of life (PROQOL) em bombeiros. MÉTODO: Será aplicada a metodologia do Joanna Briggs Institute (JBI) para revisões de escopo. Seguirá diretrizes do Pre-ferred Reporting Items for Systematic reviews and Meta-Analyses ex-tension for Scoping Reviews(PRISMA-ScR). Realizou-se pesquisa nas plataformas do Open Science Framework (OSF), International Prospective Register of Systematic Reviews (PROSPERO), Cochrane Library, Epistemonikos, e no repositório online de acesso aberto (FIGSHARE), para identificar artigos idênticos, como não foi encontrado considera-se este trabalho original. Serão incluídas nesta revisão as bases: Excerpta Medica dataBASE (EMBASE), SCOPUS, Medical Literature Analysis and Retrieval Systemon Line (PubMed - MEDLINE), Science Direct, PsycInfo da American Psychological Association (APA), Google Scholar, Cumulative Indexto Nursing and Allied Health Literature (CINAHL), bem como, Teses, Dissertações, artigos de sites governamentais e de bombeiros. Dois revisores selecionarão os artigos de maneira independente, não havendo consenso um terceiro revisor decidirá pela inclusão ou exclusão do estudo. O levantamento foi registrado na plataforma OSF website, e será um dos estudos mais abrangentes sobre a utilização dessa escala em Bombeiros.

OBJECTIVE: To map trends in the use of Professional Quality of Life (PROQOL) in firefighters. METHOD: The methodology of Joanna Briggs Institute (JBI) will be applied for scope reviews. It will follow guidelines from Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-SCR). Research was carried out on the Open Science Framework (OSF), International PROSPECTIVE Register of Systematic Reviews (PROSPERO), Cochrane Library, Epistemonikos, and on the open access online repository (FIGSHARE), to identify identical articles, as this original work was not found. The basis which will be included in this review: Excerpta Medica dataBASE (EMBASE), SCOPUS, Medical Literature Analysis and Retrieval System on Line (PubMed - MEDLINE), Science Direct, PsycInfo da American Psychological Association (APA), Google Scholar, Cumulative Index to Nursing and Allied Health Literature (CINAHL), as well as, Theses, Dissertations, Articles of Government and Fire Sites. Two reviewers will select the articles independently, and without consensus a third reviewer will decide whether to include or exclude the study. The survey was registered on the OSF website platform, and it will be one of the most comprehensive studies on the use of this scale on Firefighters.

A 15-year longitudinal study of search-and-rescue dogs identifies the musculoskeletal, integumentary, and gastrointestinal systems as commonly affected.

OBJECTIVE: A longitudinal study followed search-and-rescue (SAR) dogs for 15 years to determine the incidence of health events and whether factors of deployment during 9/11, breed, or sex altered the risk of specific events. ANIMALS: 150 SAR dogs: 95 dogs deployed to the September 11 terrorist attack sites and 55 SAR dogs not deployed. METHODS: Each year, a survey was sent to the handler to collect health information until the dog died or the handler withdrew from the study. The reported health events were then categorized according to the body system affected and etiology. Incidence risk rates, with 95% CIs, were calculated for the most common types of health events. Incidence rate ratios were calculated stratified by deployment status, sex, and breed and significance assessed. RESULTS: 1 or more health event was recorded in 96 of the 150 enrolled dogs. The most affected systems were the musculoskeletal (31%; CI, 24 to 39), integumentary (22%; CI, 15 to 29), and gastrointestinal (20%; CI, 14 to 26). The health events were most commonly reported as inflammatory (45%; CI, 37 to 53) and degenerative (28%; CI, 21 to 35) in nature. There were no significant differences in incidence of health events based on deployment status to the September 11, 2001, terrorist attacks. Additionally, there was no significant effect of breed or sex on incidence of health events. CLINICAL RELEVANCE: To improve the health and longevity of SAR dogs, disease prevention and management programs should focus on reducing the health problems involving the musculoskeletal system as well as the integumentary and gastrointestinal systems.

Identifying the most important, frequent, and physically demanding tasks of Brazilian firefighters.

This study aimed to identify the most important, frequently performed, and physically demanding tasks performed by Brazilian firefighters and to identify tasks that could be used to assess physical fitness. A subjective task analysis was conducted. Five hundred twenty-four firefighters (84% male; 16% females) responded to an online survey and rated 37 tasks across three domains (most important, most frequent, and most physically demanding). A dichotomous decision analysis was used to inform the proposed physical fitness tests. Wildland firefighting tasks presented the highest overall mean rate. Traffic control was considered the most important and frequently performed task. Lifeguard rescue was considered the most physically demanding task. The dichotomous analysis identified 14 essential tasks (seven structural firefighting and seven automobile accidents). The tasks identified may be helpful in developing criterion physical fitness tests and training programs related to firefighters' demands.Practitioner summary: The unpredictability, variability, and dangerousness of firefighting make it challenging to observe the physical demands imposed on firefighters. A subjective task analysis was conducted to identify essential tasks performed by Brazilian firefighters. Wildland firefighting, lifeguard rescue, automobile accidents, and structural firefighting tasks were the most important, frequent, and physically demanding.

The Speaker Method: A Novel Release Method for Offspring Mammals and 5-Year Study on Three Costa Rican Mammals.

Nowadays, wild animals are threatened by humans, with the number of species and individuals decreasing during recent years. Wildlife rescue centers play a vital role in the conservation of wildlife populations. This study aims to describe a new release technique, the Speaker Method, to rescue and facilitate the reunion of different baby mammals that arrived at a wildlife rescue center with their mothers within their natural habitat, avoiding the need for captivity. This method is based on a recorded baby's cry played on a speaker to make a "call effect" in the mother. The efficacy of the Speaker Method for babies' reunion with their mothers was 45.8% in Hoffmann's two-toed sloths (Choloepus hoffmanni) and 91.9% in brown-throated sloths (Bradypus variegatus). Among the mantled howler monkeys (Alouatta palliata), 50% of the babies could be released using this new technique. The findings suggest that the method could be helpful in the early release of young individuals, highlighting higher release outcomes in these three species compared to traditional nursery care provided by human caretakers, who face inherent difficulties in raising young animals without their mothers.

On-Demand ICS + FABA Combinations in 6-11-Year-Old Children.

In recent years, some new concepts have been added to asthma treatment such as "anti-inflammatory reliever" (ß2-agonist use associated to an inhaled corticosteroid (ICS) as a reliever treatment) that combines the benefits of both therapies and provides short- and long-term benefits for treatment in asthma patients. Robust evidence has been presented in patients over 12 years, and the main changes in the international guidelines for asthma treatment were originally made in this age group. However, a few suggestions have been added to treatments in younger patients, in part because of the scarce evidence that exists in this group. We aim to analyze the information regarding the utilization of ICS + fast-acting beta-agonist (FABA) combination in children between 6 and 11 years. Although up until today only three published trials exist (two studies use beclomethasone + albuterol and one study uses budesonide + formoterol), they provide significant information on the benefits of ICS + FABA use in this population.

Evaluación de las Lesiones Orofaciales y Traumatismos Dentales en Deportes de Combate y no Combate

Los deportes de combate conllevan un alto riesgo de padecer traumatismos dentoalveolares. Este estudio se evaluó la incidencia de traumatismos y lesiones orofaciales relacionadas con los deportes de combate, junto con la evaluación de las actitudes y hábitos de los deportistas respecto al uso de protectores bucales. Este estudio se realizó mediante sistema de encuestas digitales distribuidas en diferentes clubes deportivos donde se practican deportes de combate y no combate. Los deportistas de combate tienen más probabilidad sufrir alguna lesión orofacial que los no deportistas de combate. El sexo masculino y la experiencia son factores predisponentes en la aparición de traumatismos y lesiones orofaciales, siendo las laceraciones de tejidos blandos las más frecuentes. Los deportistas de combate llevan más protectores bucales que los deportistas en general, siendo el protector tipo II el más usado. Los deportistas que no llevan protectores no consideran que sea necesario. En caso de sufrir una avulsión dental, la mayoría de los participantes consideran que es posible reimplantar un diente avulsionado.

Combat sports carry a high risk of suffering dentoalveolar trauma. This study evaluated the incidence of dentoalveolar lesions related to combat sports, together with the evaluation of athletes' attitudes and habits regarding the use of mouth guards. This study was carried out using a digital survey system distributed in different sports clubs where combat and non-combat sports are practiced. Combat athletes are more likely to suffer a dentoalveolar lesion than non-combat athletes. Male sex and experience are predisposing factors in the appearance of dentoalveolar lesions, with soft tissue lacerations being the most frequent. Combat athletes wear more mouth guards than athletes in general, with the type II protector being the most used. Athletes who do not wear protectors do not consider it necessary. In case of suffering a dental avulsion, most of the participants consider that it is possible to reimplant an avulsed tooth.

Volume-failure-to-rescue relationship in acute type A aortic dissections: An analysis of The Society of Thoracic Surgeons Database.

OBJECTIVE: To determine the relationship between volume of cases and failure-to-rescue (FTR) rate after surgery for acute type A aortic dissection (ATAAD) across the United States. METHODS: The Society of Thoracic Surgeons adult cardiac surgery database was used to review outcomes of surgery after ATAAD between June 2017 and December 2021. Mixed-effect models and restricted cubic splines were used to determine the risk-adjusted relationships between ATAAD average volume and FTR rate. FTR calculation was based on deaths associated with the following complications: venous thromboembolism/deep venous thrombosis, stroke, renal failure, mechanical ventilation >48 hours, sepsis, gastrointestinal complications, cardiopulmonary resuscitation, and unplanned reoperation. RESULTS: In total, 18,192 patients underwent surgery for ATAAD in 832 centers. The included hospitals' median volume was 2.2 cases/year (interquartile range [IQR], 0.9-5.8). Quartiles' distribution was 615 centers in the first (1.3 cases/year, IQR, 0.4-2.9); 123 centers in the second (8 cases/year, IQR, 6.7-10.2); 66 centers in the third (15.6 cases/year, IQR, 14.2-18); and 28 centers in the fourth quartile (29.3 cases/year, IQR, 28.8-46.0). Fourth-quartile hospitals performed more extensive procedures. Overall complication, mortality, and FTR rates were 52.6%, 14.2%, and 21.7%, respectively. Risk-adjusted analysis demonstrated increased odds of FTR when the average volume was fewer than 10 cases per year. CONCLUSIONS: Although high-volume centers performed more complex procedures than low-volume centers, their operative mortality was lower, perhaps reflecting their ability to rescue patients and mitigate complications. An average of fewer than 10 cases per year at an institution is associated with increased odds of failure to rescue patients after ATAAD repair.

Sofosbuvir plus glecaprevir/pibrentasvir as salvage therapy after liver transplantation in NS5A inhibitor-experienced patients. A case series.

BACKGROUND: Treatment of chronic hepatitis C virus (HCV) infection with direct-acting antivirals achieves a sustained virologic response rate higher than 95%. However, virologic failure remains a clinical challenge, and data on retreatment are limited, especially in special populations such as liver transplant (LT) recipients. OBJECTIVES: This study evaluated the sofosbuvir plus glecaprevir-pibrentasvir (GLE/PIB) regimen in LT recipients who had failed to a nonstructural protein 5A (NS5A) inhibitor-based regimen. MATERIAL AND METHODS: Retrospective study of 111 liver transplant recipients between January 2018 and December 2020; 18 patients presented with HCV recurrent infection after LT, out of whom three had a history of at least one NS5A inhibitor-based regimen. Salvage therapy with sofosbuvir plus GLE/PIB was started for 12 weeks; baseline characteristics and outcomes were recorded. RESULTS: All three patients (100%) achieved an undetectable HCV viral load 12 weeks after treatment completion. No serious adverse events were observed. CONCLUSION: In our series, sofosbuvir plus GLE/PIB for 12 weeks is an effective and safe salvage therapy after LT in patients previously treated with NS5A inhibitors.

ANTECEDENTES: El tratamiento del virus de la hepatitis C (VHC) crónica con antivirales de acción directa logra tasas de respuesta virológica sostenida superiores a 95 %. Sin embargo, el manejo del fracaso virológico sigue siendo un desafío clínico y la evidencia sobre el retratamiento es limitada, especialmente en poblaciones como los receptores de trasplante hepático (TH). OBJETIVO: Este estudio evaluó el régimen de sofosbuvir más glecaprevir/pibrentasvir (GLE/PIB) en receptores de TH en quienes falló el régimen basado en inhibidores de la proteína no estructural 5A (NS5A). MATERIAL Y MÉTODOS: Estudio retrospectivo de 111 pacientes trasplantados entre enero de 2018 y diciembre de 2020; 18 pacientes presentaron infección recurrente por VHC posterior al TH, tres de ellos tuvieron antecedentes de al menos un régimen basado en inhibidores de NS5A. Se inició terapia de rescate con sofosbuvir más GLE/PIB durante 12 semanas posterior al TH; se registraron las características basales de los pacientes y sus desenlaces. RESULTADOS: En los tres pacientes se logró obtener una carga viral indetectable de VHC a las 12 semanas de finalizar el tratamiento. No se observaron eventos adversos graves. CONCLUSIÓN: En nuestra serie, sofosbuvir más GLE/PIB durante 12 semanas demostró ser una terapia de rescate efectiva y segura posterior al TH en pacientes previamente tratados con inhibidores de NS5A.

Sofosbuvir más glecaprevir/pibrentasvir como terapia de rescate postrasplante hepático en pacientes con exposición previa a inhibidores de NS5A. Serie de casos / Sofosbuvir plus glecaprevir/pibrentasvir as salvage therapy after liver transplantation in NS5A inhibitor-experienced patients. A case series

Resumen Antecedentes: El tratamiento de la infección crónica por el virus de la hepatitis C (VHC) con antivirales de acción directa logra tasas de respuesta virológica sostenida superiores a 95 %. Sin embargo, el manejo del fracaso virológico sigue siendo un desafío clínico y la evidencia sobre el retratamiento es limitada, especialmente en poblaciones como los receptores de trasplante hepático (TH). Objetivo: Este estudio evaluó el régimen de sofosbuvir más glecaprevir/pibrentasvir (GLE/PIB) en receptores de TH en quienes falló el régimen basado en inhibidores de la proteína no estructural 5A (NS5A). Material y métodos: Estudio retrospectivo de 111 pacientes trasplantados entre enero de 2018 y diciembre de 2020; 18 pacientes presentaron infección recurrente por VHC posterior al TH, tres de ellos tuvieron antecedentes de al menos un régimen basado en inhibidores de NS5A. Se inició terapia de rescate con sofosbuvir más GLE/PIB durante 12 semanas posterior al TH; se registraron las características basales de los pacientes y sus desenlaces. Resultados: En los tres pacientes se logró obtener una carga viral indetectable de VHC a las 12 semanas de finalizar el tratamiento. No se observaron eventos adversos graves. Conclusión: En nuestra serie, sofosbuvir más GLE/PIB durante 12 semanas demostró ser una terapia de rescate efectiva y segura posterior al TH en pacientes previamente tratados con inhibidores de NS5A.

Abstract Background: Treatment of chronic hepatitis C virus (HCV) infection with direct-acting antivirals achieves a sustained virologic response rates higher than 95%. However, virologic failure remains a clinical challenge, and data on retreatment are limited, especially in special populations such as liver transplant (LT) recipients. Objective: This study evaluated the sofosbuvir plus glecaprevir-pibrentasvir (GLE/PIB) regimen in LT recipients who had failed to a nonstructural protein 5A (NS5A) inhibitor-based regimen. Material and methods: Retrospective study of 111 liver transplant recipients between January 2018 and December 2020; 18 patients presented with HCV recurrent infection after LT, out of whom three had a history of at least one NS5A inhibitor-based regimen. Salvage therapy with sofosbuvir plus GLE/PIB was started for 12 weeks; baseline characteristics and outcomes were recorded. Results: All three patients (100%) achieved an undetectable HCV viral load 12 weeks after treatment completion. No serious adverse events were observed. Conclusion: In our series, sofosbuvir plus GLE/PIB for 12 weeks is an effective and safe salvage therapy after LT in patients previously treated with NS5A inhibitors.

Effectiveness of R1-nj Anthocyanin Marker in the Identification of In Vivo Induced Maize Haploid Embryos.

Doubled haploid (DH) technology has become integral to maize breeding programs to expedite inbred line development and increase the efficiency of breeding operations. Unlike many other plant species that use in vitro methods, DH production in maize uses a relatively simple and efficient in vivo haploid induction method. However, it takes two complete crop cycles for DH line generation, one for haploid induction and the other one for chromosome doubling and seed production. Rescuing in vivo induced haploid embryos has the potential to reduce the time for DH line development and improve the efficiency of DH line production. However, the identification of a few haploid embryos (~10%) resulting from an induction cross from the rest of the diploid embryos is a challenge. In this study, we demonstrated that an anthocyanin marker, namely R1-nj, which is integrated into most haploid inducers, can aid in distinguishing haploid and diploid embryos. Further, we tested conditions that enhance R1-nj anthocyanin marker expression in embryos and found that light and sucrose enhance anthocyanin expression, while phosphorous deprivation in the media had no affect. Validating the use of the R1-nj marker for haploid and diploid embryo identification using a gold standard classification based on visual differences among haploids and diploids for characteristics such as seedling vigor, erectness of leaves, tassel fertility, etc., indicated that the R1-nj marker could lead to significantly high false positives, necessitating the use of additional markers for increased accuracy and reliability of haploid embryo identification.

Origem e destinação da fauna silvestre: levantamento de dados no estado de Sergipe / Origin and destination of wildlife: survey data in the state of Sergipe

A biodiversidade da Região Nordeste Brasileira encontra-se ameaçada pela ação humana devido a atividades como o desmatamento e a retirada de espécies silvestres do seu ambiente de origem. Assim, objetiva-se, com esta pesquisa, realizar um levantamento descritivo acerca das ações de recebimento e destinação dos animais silvestres realizadas pelo Instituto Brasileiro do Meio Ambiente e dos Recursos Naturais Renováveis (IBAMA) no estado de Sergipe. Para isso, foram utilizados os dados provenientes dos registros de captura realizados pelo IBAMA/SE entre os anos de 2016 e 2020. Os animais que compunham esse banco de dados foram classificados conforme sua classe taxonômica, sendo: aves, répteis ou mamíferos. A origem dos animais que chegaram ao IBAMA foi subdividida da seguinte forma: oriundos de apreensão, de resgate ou de entrega voluntária. Já a destinação desses animais foi classificada como: óbito, soltura, cativeiro ou outros (quando não se enquadravam nas classes anteriores). Foi elaborado um banco de dados utilizando o software Excel®, e os dados foram analisados de maneira descritiva. Dos 5.247 indivíduos apreendidos ao longo do período estudado, a maior parte pertencia à classe das aves (81,9%), seguida pela dos répteis (16,4%) e dos mamíferos (1,7%). A apreensão foi a origem mais comum dos animais recebidos pelo IBAMA/SE em todos os anos avaliados; em segundo e terceiro lugar estão a entrega voluntária e o resgate, respectivamente. Para todas as classes taxonômicas, a principal destinação dos animais foi a soltura, enquanto o envio para cativeiros foi a alternativa menos frequente em todos os anos.

The biodiversity of the Brazilian Northeast region is threatened by human action due to activities such as deforestation and the removal of wild species from their original environment. Thus, this research aims to carry out a descriptive survey about the actions of reception and destination of wild animals performed by the Environment and Renewable Natural Resources Brazilian Institute Environment and Renewable Natural Resources (IBAMA) in the State of Sergipe. For this, data from capture records carried out by IBAMA/SE between 2016 and 2020 were used. The animals that made up this database were classified according to their taxonomic class, being, Birds, Reptiles, or Mammals. The origin of animals that arrived at IBAMA was subdivided as follows: from seizure, rescue, or voluntary delivery. The destination of these animals was classified as: death, release, captivity, or others (when they did not fit into the previous classes). A database was created using Excel® software, and the data were analyzed descriptively. Of the 5247 individuals apprehended over the period studied, most belonged to the bird class (81.9%), followed by reptiles (16.4%) and mammals (1.7%). Seizure was the most common origin of animals received by IBAMA/SE in all evaluated years, in second and third place are voluntary delivery and rescue, respectively. For all taxonomic classes, the main destination of the animals was release, while sending to captivity was the least frequent alternative in all years.

Third-line and rescue therapy for refractory Helicobacter pylori infection: A systematic review.

BACKGROUND: Due to increasing resistance rates of Helicobacter pylori (H. pylori) to different antibiotics, failures in eradication therapies are becoming more frequent. Even though eradication criteria and treatment algorithms for first-line and second-line therapy against H. pylori infection are well-established, there is no clear recommendation for third-line and rescue therapy in refractory H. pylori infection. AIM: To perform a systematic review evaluating the efficacy and safety of rescue therapies against refractory H. pylori infection. METHODS: A systematic search of available rescue treatments for refractory H. pylori infection was conducted on the National Library of Medicine's PubMed search platform based on Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Randomized or non-randomized clinical trials and observational studies evaluating the effectiveness of H. pylori infection rescue therapies were included. RESULTS: Twenty-eight studies were included in the analysis of mean eradication rates as rescue therapy, and 21 of these were selected for analysis of mean eradication rate as third-line treatment. For rifabutin-, sitafloxacin-, levofloxacin-, or metronidazole-based triple-therapy as third-line treatment, mean eradication rates of 81.6% and 84.4%, 79.4% and 81.5%, 55.7% and 60.6%, and 62.0% and 63.0% were found in intention-to-treat (ITT) and per-protocol (PP) analysis, respectively. For third-line quadruple therapy, mean eradication rates of 69.2% and 72.1% were found for bismuth quadruple therapy (BQT), 88.9% and 90.9% for bismuth quadruple therapy, three-in-one, Pylera® (BQT-Pylera), and 61.3% and 64.2% for non-BQT) in ITT and PP analysis, respectively. For rifabutin-, sitafloxacin-, levofloxacin-, or metronidazole-based triple therapy as rescue therapy, mean eradication rates of 75.4% and 78.8%, 79.4 and 81.5%, 55.7% and 60.6%, and 62.0% and 63.0% were found in ITT and PP analysis, respectively. For quadruple therapy as rescue treatment, mean eradication rates of 76.7% and 79.2% for BQT, 84.9% and 87.8% for BQT-Pylera, and 61.3% and 64.2% for non-BQT were found in ITT and PP analysis, respectively. For susceptibility-guided therapy, mean eradication rates as third-line and rescue treatment were 75.0% in ITT and 79.2% in PP analysis. CONCLUSION: We recommend sitafloxacin-based triple therapy containing vonoprazan in regions with low macrolide resistance profile. In regions with known resistance to macrolides or unavailability of bismuth, rifabutin-based triple therapy is recommended.

Tratamiento trombolítico de rescate en paciente con fístula arteriovenosa para hemodiálisis trombosada / Rescue thrombolytic treatment in patients with arteriovenous fistula for thrombosed hemodialysis

Introducción: La hemodiálisis continúa siendo la modalidad de terapia de reemplazo renal prevalente en el mundo. La disfunción de la fístula arteriovenosa para hemodiálisis tiene efectos negativos en el paciente y su calidad de vida, por lo que el acceso vascular funcional se necesita para un adecuado tratamiento de hemodiálisis en pacientes con enfermedad renal terminal. El mayor inconveniente del acceso vascular resulta su alta incidencia de oclusión trombótica, causada por la estenosis, la cual se inicia por lesiones hiperplásicas de la capa intimal del vaso. Una de las modalidades de tratamiento a nivel internacional es la trombólisis del acceso vascular trombosado de menos de 24 horas de evolución. Objetivo: Exponer los resultados obtenidos con la aplicación de la trombólisis percutánea del acceso vascular para hemodiálisis trombosado en paciente con enfermedad renal terminal. Presentación del caso: Paciente masculino de 52 años, con diagnóstico de trombosis aguda del acceso vascular para hemodiálisis por enfermedad renal terminal, de 5 días de evolución, con deterioro de su estado de salud por encontrarse subdializado y urémico, con agotamiento del acceso vascular global para hemodiálisis. Se utilizó el tratamiento fibrinolítico directo del acceso vascular percutáneo a 100 mil UI/hora de Heberquinasa® en 10 horas, con recuperación del latido, thrill y repermeabilización de la fístula para hemodiálisis. Conclusiones: El tratamiento fibrinolítico con Heberquinasa® permitió la recuperación del paciente con trombosis aguda del acceso vascular para hemodiálisis. Se evitaron complicaciones asociadas a la subdiálisis y/o colocación de catéter central, y se incorporó al paciente a su programa de hemodiálisis, con garantías para su calidad de vida(AU)

Introduction: Hemodialysis continues to be the prevalent renal replacement therapy modality in the world. Arteriovenous fistula dysfunction for hemodialysis has negative effects on the patients and their quality of life, so functional vascular access is needed for adequate hemodialysis treatment in patients with end-stage renal disease. The greatest drawback of vascular access is its high incidence of thrombotic occlusion, caused by stenosis, which is initiated by hyperplastic lesions of the intimate layer of the vessel. One of the treatment modalities at the international level is the thrombolysis of the thrombosed vascular access of less than 24 hours of evolution. Objective: To present the results obtained with the application of percutaneous thrombolysis of vascular access for thrombosed hemodialysis in patients with end-stage renal disease. Case presentation: Male patient of 52 years, with diagnosis of acute thrombosis of vascular access for hemodialysis due to end-stage renal disease, 5 days of evolution, with deterioration of his health state due to being sub-dialized and uremic, with exhaustion of the global vascular access for hemodialysis. Direct fibrinolytic treatment of percutaneous vascular access at 100 thousand IU/hour of Heberkinase® was used in 10 hours, with recovery of the heartbeat, thrill and repermeabilisation of the fistula for hemodialysis. Conclusions: Fibrinolytic treatment with Heberkinase® allowed the recovery of the patient with acute thrombosis from the vascular access for hemodialysis. Complications associated with sub-dialysis and/or central catheter placement were avoided, and the patient was incorporated into their hemodialysis program, with guarantees for their quality of life(AU)

Experimental Release of Orphaned Wild Felids into a Tropical Rainforest in Southwestern Costa Rica.

A 3- to 4-mo-old male ocelot (Leopardus pardalis) and a 6- to 8-mo-old female margay (Leopardus weidii) were brought in from the wild, held in captivity, and rehabilitated for 906 and 709 days, respectively, at the Rescate Wildlife Rescue Center in Costa Rica. During captivity, both cats were kept as isolated as possible from humans and fed appropriate live wild prey. After maturing and demonstrating the ability to capture and feed on live prey, the cats were radio-collared, released at a national wildlife refuge previously assessed for predator and prey occurrence, and monitored. After 54 days, the ocelot was trapped while preying on chickens in a nearby community, and after 20 days, the margay was found dead, likely due to ocelot predation. Avoiding habituation to humans, assuring hunting abilities, and assessing release sites likely is not sufficient to assure successful release of these species, and more experimental releases with innovative and detailed protocols and monitoring are needed.

Air Rescue for Pediatric Trauma in a Metropolitan Region of Brazil: Profiles, Outcomes, and Overtriage Rates.

Besides ensuring a quick response and transport of trauma victims, helicopter support also involves risks to patients and professionals and has higher operational costs. Studying prehospital triage criteria and their relationship with patient overtriage and outcomes is important, particularly in newly established services and in developing countries with limited health budgets. This could help improve the use of the helicopter rescue and provide better management of the costs and risks related to it. The objective of this study was to determine the epidemiologic and severity profiles of pediatric victims of trauma attended by helicopter in a Brazilian Metropolitan Area to evaluate the outcomes and overtriage rates related to pediatric air rescue in the region. We conducted an observational and retrospective study using 49 hospital and prehospital records from victims of trauma aged <18 years old (yo) assisted by helicopter and then transferred to a tertiary University Hospital. Of the 49 patients, 39 (79.6%) individuals were male, and the mean age was 11.3 yo. Vehicular collisions accounted for 15 (30.6%) of the traumas, and traumatic brain injuries occurred in 28 (57.1%) cases. A total of 29 (59.1%) individuals had severe trauma (Injury Severity Score; ISS >15), and 34 (69.4%) required admission to the intensive care unit. Overtriage varied from 18.4 to 40.8% depending on the criteria used for its definition, being more frequent in individuals aged between 1 and 5 yo. Death occurred in 10 (20.4%) patients. On prehospital evaluation, we classified 29/32 (90.6%) patients with severe trauma according to the Pediatric Trauma Score (PTS ≤8) and 18/25 (72%) according to the Revised Trauma Score (RTS ≤11). Of these, 7/29 (24.1%) and 6/18 (33.3%), respectively, presented ISS <15 at in-hospital evaluation. None of the patients with PTS >8 and 3/7 (42.8%) of those with RTS >11 presented ISS >15. In conclusion, air rescue of pediatric trauma victims was used mainly for critically ill individuals, resulting in rates of overtriage compatible with that found in the literature. PTS showed the lowest rates of overtriage within excellent rates of undertriage.

Post-traumatic stress disorder prevalence and sleep quality in fire victims and rescue workers in southern Brazil: a cross-sectional study.

OBJECTIVES: This survey was conducted to evaluate the prevalence of post-traumatic stress disorder (PTSD) and the sleep quality in victims and rescue team of the third deadliest nightclub fire in the world. STUDY DESIGN: A cross-sectional study. METHODS: Participants were victims and rescue workers exposed to a fire at a nightclub, which occurred in January 2013 in Southern Brazil. The Pittsburgh Sleep Quality Index (PSQI), composed of seven subjective sleep variables (including daytime dysfunction), and PTSD Checklist - Civilian version (PCL-C) were applied to all people who sought medical attention at the local reference center in the first year after the event. Comprehensive information was obtained concerning sociodemographic factors, health status, and sleep complaints. RESULTS: A total of 370 individuals, 190 victims and 180 rescue workers, were included. Participants were 70% male, with an average age of 29 years. The prevalence of PTSD was 31.9%, ranging from 24.4% for rescue workers to 38.9% for victims. The prevalence of poor sleep quality was 65.9%, ranging from 56.1% for rescue workers to 75.3% for victims. Most of the participants with PTSD (91.5%) had PSQI scores >5 (poor sleepers), against 54.0% of the non-PTSD individuals. All seven PSQI subscores showed significant differences between PTSD and non-PTSD individuals, especially daytime dysfunction. Sex, shift work, previous psychiatric disease, and sleep quality remained associated with PTSD in adjusted models, with a prevalence ratio (95% CI) of 1.76 (1.28-2.43) in females, 1.73 (1.17-2.55) in shift workers, 1.36 (1.03-1.80) in individuals with psychiatric disease history, and 5.42 (2.55-11.52) in poor sleepers. CONCLUSIONS: The presence of daytime dysfunction increased by at least tenfold the prevalence of PTSD in this sample. Considering that daytime dysfunction was shown to be strongly associated with PTSD, sleep-related issues should be addressed in the assessment of individuals exposed to traumatic events, both victims and rescuers. Factors like shift work and female sex were also associated with PTSD, especially among victims.