High exposure of global tree diversity to human pressure.

Safeguarding Earth's tree diversity is a conservation priority due to the importance of trees for biodiversity and ecosystem functions and services such as carbon sequestration. Here, we improve the foundation for effective conservation of global tree diversity by analyzing a recently developed database of tree species covering 46,752 species. We quantify range protection and anthropogenic pressures for each species and develop conservation priorities across taxonomic, phylogenetic, and functional diversity dimensions. We also assess the effectiveness of several influential proposed conservation prioritization frameworks to protect the top 17% and top 50% of tree priority areas. We find that an average of 50.2% of a tree species' range occurs in 110-km grid cells without any protected areas (PAs), with 6,377 small-range tree species fully unprotected, and that 83% of tree species experience nonnegligible human pressure across their range on average. Protecting high-priority areas for the top 17% and 50% priority thresholds would increase the average protected proportion of each tree species' range to 65.5% and 82.6%, respectively, leaving many fewer species (2,151 and 2,010) completely unprotected. The priority areas identified for trees match well to the Global 200 Ecoregions framework, revealing that priority areas for trees would in large part also optimize protection for terrestrial biodiversity overall. Based on range estimates for >46,000 tree species, our findings show that a large proportion of tree species receive limited protection by current PAs and are under substantial human pressure. Improved protection of biodiversity overall would also strongly benefit global tree diversity.

Dimensions of invasiveness: Links between local abundance, geographic range size, and habitat breadth in Europe's alien and native floras.

Understanding drivers of success for alien species can inform on potential future invasions. Recent conceptual advances highlight that species may achieve invasiveness via performance along at least three distinct dimensions: 1) local abundance, 2) geographic range size, and 3) habitat breadth in naturalized distributions. Associations among these dimensions and the factors that determine success in each have yet to be assessed at large geographic scales. Here, we combine data from over one million vegetation plots covering the extent of Europe and its habitat diversity with databases on species' distributions, traits, and historical origins to provide a comprehensive assessment of invasiveness dimensions for the European alien seed plant flora. Invasiveness dimensions are linked in alien distributions, leading to a continuum from overall poor invaders to super invaders-abundant, widespread aliens that invade diverse habitats. This pattern echoes relationships among analogous dimensions measured for native European species. Success along invasiveness dimensions was associated with details of alien species' introduction histories: earlier introduction dates were positively associated with all three dimensions, and consistent with theory-based expectations, species originating from other continents, particularly acquisitive growth strategists, were among the most successful invaders in Europe. Despite general correlations among invasiveness dimensions, we identified habitats and traits associated with atypical patterns of success in only one or two dimensions-for example, the role of disturbed habitats in facilitating widespread specialists. We conclude that considering invasiveness within a multidimensional framework can provide insights into invasion processes while also informing general understanding of the dynamics of species distributions.

Seedling growth and survival of five tree species in secondary forests and adjacent pastures in the montane rain forests of Southern Costa Rica.

Successful forest restoration in tropical environments is limited by the paucity of studies on the initial establishment and early survival requirements of seedlings of most native tropical tree species under disturbed conditions. Here, we evaluated the initial growth responses and the regeneration potential of seedlings of five tree species native to Costa Rica (Hasseltia floribunda, Inga densiflora, Persea americana, Tapirira mexicana and Trichilia pittieri). Seedlings were grown in secondary forests and adjacent open pastures under contrasting conditions of light availability. We quantified seedling growth, survival and herbivory from August 2010 to August 2011 on a monthly basis, and measured differences in leaf mass per area (LMA) at the end of the experiment. We found significant variation in growth responses between the understory of secondary forests and pastures. Growth in height was highest in pastures across all species, with I. densiflora, P. americana and T. mexicana showing the most striking differences. In contrast, H. floribunda and T. pittieri did not show differences in diameter growth between environments. Except for T. mexicana, herbivory increased throughout the experiment in all the species. Herbivory increased faster in pastures for H. floribunda and T. pittieri and showed higher rates in the forest understory for I. densiflora and P. americana. Seedling survival showed significant differences for all species across environments. Survival of H. floribunda and I. densiflora was higher in secondary forests, whereas the other species showed higher survival in pastures. Leaf mass per area showed higher values in the pastures across all species, it suggests that individuals exposed to high light conditions had great photosynthetic rate and great leaf construction capacity. Due to their rapid growth and high survival, I. densiflora and T. mexicana showed great potential to restore abandoned pastures and secondary forests. Increasing our knowledge on the response of seedlings under disturbed conditions in tropical ecosystems is critical for improving the restoration of altered environments by matching the ecological amplitude of native species with specific environmental conditions.

A potential consequence for urban birds' fitness: Exposed anthropogenic nest materials reduce nest survival in the clay-colored thrush.

Urban bird dwellers survive and reproduce in highly urbanized ecosystems. Some individuals adjust to these novel conditions by changing natural nesting materials for artificial materials, thus making nests more conspicuous in the environment. The consequences of using artificial materials for nesting remain poorly understood, especially from a nest-predator perspective. We studied if exposed artificial materials on bird nests affect the daily survival rate in a common dweller species, the clay-colored thrush (Turdus grayi). We used previously collected nests with a different area of exposed artificial materials and placed them with clay eggs on the main campus of the Universidad de Costa Rica. During 12 days of the reproductive season, we monitored the nests using trap cameras located in front of each nest. We found that nest survival decreased as the proportion of exposed artificial materials increased in the nest and, unexpectedly, that the principal predators were conspecifics. Thus, artificial materials used in the outer layer of nests make them more susceptible to predation. The use of artificial materials likely reduce reproductive success and population size in urban clay-colored thrush, but further field experiments measuring the effect of waste in birds' nests on the reproductive success of urban birds are needed.

Global beta-diversity of angiosperm trees is shaped by Quaternary climate change.

As Earth's climate has varied strongly through geological time, studying the impacts of past climate change on biodiversity helps to understand the risks from future climate change. However, it remains unclear how paleoclimate shapes spatial variation in biodiversity. Here, we assessed the influence of Quaternary climate change on spatial dissimilarity in taxonomic, phylogenetic, and functional composition among neighboring 200-kilometer cells (beta-diversity) for angiosperm trees worldwide. We found that larger glacial-interglacial temperature change was strongly associated with lower spatial turnover (species replacements) and higher nestedness (richness changes) components of beta-diversity across all three biodiversity facets. Moreover, phylogenetic and functional turnover was lower and nestedness higher than random expectations based on taxonomic beta-diversity in regions that experienced large temperature change, reflecting phylogenetically and functionally selective processes in species replacement, extinction, and colonization during glacial-interglacial oscillations. Our results suggest that future human-driven climate change could cause local homogenization and reduction in taxonomic, phylogenetic, and functional diversity of angiosperm trees worldwide.

Mechanisms driving plant functional trait variation in a tropical forest.

Plant functional trait variation in tropical forests results from taxonomic differences in phylogeny and associated genetic differences, as well as, phenotypic plastic responses to the environment. Accounting for the underlying mechanisms driving plant functional trait variation is important for understanding the potential rate of change of ecosystems since trait acclimation via phenotypic plasticity is very fast compared to shifts in community composition and genetic adaptation. We here applied a statistical technique to decompose the relative roles of phenotypic plasticity, genetic adaptation, and phylogenetic constraints. We examined typically obtained plant functional traits, such as wood density, plant height, specific leaf area, leaf area, leaf thickness, leaf dry mass content, leaf nitrogen content, and leaf phosphorus content. We assumed that genetic differences in plant functional traits between species and genotypes increase with environmental heterogeneity and geographic distance, whereas trait variation due to plastic acclimation to the local environment is independent of spatial distance between sampling sites. Results suggest that most of the observed trait variation could not be explained by the measured environmental variables, thus indicating a limited potential to predict individual plant traits from commonly assessed parameters. However, we found a difference in the response of plant functional traits, such that leaf traits varied in response to canopy-light regime and nutrient availability, whereas wood traits were related to topoedaphic factors and water availability. Our analysis furthermore revealed differences in the functional response of coexisting neotropical tree species, which suggests that endemic species with conservative ecological strategies might be especially prone to competitive exclusion under projected climate change.

Human waste used as nesting material affects nest cooling in the clay-colored thrush.

The internal temperature of nests largely depends on the materials used in their construction because the characteristics of each material affect the isolation of nest walls. In urban environments, the availability of natural materials for nest building decreases, while the availability of artificial materials increases. Therefore, many urban bird species use more artificial materials for nest building inside cities, which may affect the thermal properties of the nest. We conducted an experiment to measure the effect of artificial materials included as part of the nest structure, on nest thermoregulation. We used as a model, nests of the clay-colored thrush (Turdus grayi), an urban bird species that have been reported using artificial nest materials. In our experiment, we measured how variation in artificial materials mass affects the nest cooling rate in a climate-controlled room. We found that artificial materials increased the cooling rate of clay-colored thrush nests, compared with nests with only natural materials. This result is especially relevant because showed a negative direct effect of the use of artificial material for nest building in birds. Considering that the availability of artificial material is increasing in urban areas, while natural material is decreasing, it is expected that the negative effect of using artificital material for nest construction would increase in the clay-colored thrush and other city bird species.

The predictive power of pollination syndromes: Passerine pollination in heterantherous Meriania macrophylla (Benth.) Triana (Melastomataceae).

The cloud forest species Meriania macrophylla (Benth.) Triana has pseudocampanulate flowers with bulbous stamen appendages, typical for the passerine pollination syndrome found in the Melastomataceae tribe Merianieae. The species is further characterized by strong stamen dimorphism (heteranthery), a condition otherwise associated with pollen-rewarding bee-pollinated species (both in Melastomataceae and beyond). In passerine-pollinated Merianieae, however, flowers usually only show weak stamen dimorphism. Here, we conducted field and laboratory investigations to determine the pollinators of M. macrophylla and assess the potential role of strong heteranthery in this species. Our field observations in Costa Rica confirmed syndrome predictions and indeed proved pollination by passerine birds in M. macrophylla. The large bulbous set of stamens functions as a food-body reward to the pollinating birds, and as trigger for pollen release (bellows mechanism) as typical for the passerine syndrome in Merianieae. In contrast to other passerine-pollinated Merianieae, the second set of stamens has seemingly lost its rewarding and pollination function, however. Our results demonstrate the utility of the pollination syndrome concept even in light of potentially misleading traits such as strong heteranthery.

La especie de bosque nuboso Meriania macrophylla (Benth.) Triana presenta flores pseudocampanuladas con estambres con un apéndice bulboso, una morfología típica de las flores polinizadas por aves paserinas en Merianieae. Además, la especie se caracteriza por tener dos verticilos diferentes de estambres (heteroanteria), una condición que generalmente se asocia a especies polinizadas por abejas con polen como recompensa. En las especies de Merianieae polinizadas por aves la heteroantería es leve, si presente. Para este estudio determinamos los polinizadores de M. macrophylla y evaluamos posibles explicaciones de la presencia de estambres heteroantéricos Nuestras observaciones de campo en Costa Rica confimaron nuestras predicciones de que la polinización de esta especie se da por aves. Los conectivos engrosados funcionan como recompensa para las aves, que al removerlos de la flor activan el mecanismo de expulsión de polen. En contraste, el segundo verticilo de estambres aparentemente perdió tanto la función de recompensa como su función reproductiva. Nuestros resultados demuestran la utilidad de los síndromes de polinización incluso en presencia de caracteres confusos como la presencia de heteroanteria muy marcada.

Mental health problems among healthcare workers involved with the COVID-19 outbreak.

OBJECTIVE: The mental health problems and perceived needs of healthcare workers involved with coronavirus disease (COVID-19) may vary due to individual and contextual characteristics. The objective of this study was to evaluate healthcare workers' mental health problems during the common COVID-19 exposure scenario in Mexico, comparing those on the frontline with other healthcare workers according to gender and profession, determining the main risk factors for the most frequent mental health problems. METHODS: A cross-sectional online study was conducted with a non-probabilistic sample of 5,938 Mexican healthcare workers who completed brief screening measures of mental health problems and ad hoc questions about sociodemographic professional characteristics, conditions related to increased risk of COVID-19 infection, life stressors during the COVID-19 emergency, and perceived need to cope with COVID-19. RESULTS: The identified mental health problems were insomnia, depression, and posttraumatic stress disorder (PTSD), all of which were more frequent in frontline healthcare workers (52.1, 37.7, and 37.5%, respectively) and women (47.1, 33.0 %, and 16.3%, respectively). A lack of rest time was the main risk factor for insomnia (OR = 3.1, 95%CI 2.6-3.7, p ≤ 0.0001). Mourning the death of friends or loved ones due to COVID-19 was the main risk factor for depression (OR = 2.2, 95%CI 1.8-2.7, p ≤ 0.0001), and personal COVID-19 status was the main risk factor for PTSD (OR = 2.2, 95%CI 1.7-2.9, p ≤ 0.0001). CONCLUSION: The most frequent mental health problems during the common exposure scenario for COVID-19 in Mexico included the short-term psychological consequences of intense adversity. A comprehensive strategy for preventing mental health problems should focus on individuals with cumulative vulnerability and specific risk factors.

Climatic and edaphic controls over tropical forest diversity and vegetation carbon storage.

Tropical rainforests harbor exceptionally high biodiversity and store large amounts of carbon in vegetation biomass. However, regional variation in plant species richness and vegetation carbon stock can be substantial, and may be related to the heterogeneity of topoedaphic properties. Therefore, aboveground vegetation carbon storage typically differs between geographic forest regions in association with the locally dominant plant functional group. A better understanding of the underlying factors controlling tropical forest diversity and vegetation carbon storage could be critical for predicting tropical carbon sink strength in response to projected climate change. Based on regionally replicated 1-ha forest inventory plots established in a region of high geomorphological heterogeneity we investigated how climatic and edaphic factors affect tropical forest diversity and vegetation carbon storage. Plant species richness (of all living stems >10 cm in diameter) ranged from 69 to 127 ha-1 and vegetation carbon storage ranged from 114 to 200 t ha-1. While plant species richness was controlled by climate and soil water availability, vegetation carbon storage was strongly related to wood density and soil phosphorus availability. Results suggest that local heterogeneity in resource availability and plant functional composition should be considered to improve projections of tropical forest ecosystem functioning under future scenarios.

Psychopathic Disorder Subtypes Based on Temperament and Character Differences.

The concept of psychopathy has shifted from people who commit crimes to those with a particular personality and deviant behaviors. Although antisocial personality disorder is associated with psychopathy, it also seems common in individuals with narcissistic personality traits. Psychopathy may be the expression of earlier, persistent patterns of individual characteristics as personality. The psychobiological model of personality can be useful for determining whether the expression of psychopathy differs in accordance with personality dimensions and specific personality disorders. The aim was to compare temperament and character dimensions between individuals with psychopathy with comorbid predominant antisocial or narcissistic personality traits and control subjects and to determine which dimensions distinguish these groups. Control subjects (n = 80) and individuals with psychopathy (n = 80) were assessed using the Psychopathy Checklist-Reviewed, the Structured Clinical Interview for DSM-IV Axis II disorders and the Temperament and Character Inventory-Revised. Reward dependence and Self-Directedness distinguish psychopathic individuals with predominant narcissistic personality traits whereas Novelty Seeking and Self-Transcendence characterize those with antisocial personality traits. Individuals with antisocial or narcissistic psychopathy could be identified by their temperament and character traits. The expression of psychopathy differed in accordance with biologically based, environmentally shaped personality traits.

Demographic and clinical features related to perceived discrimination in schizophrenia.

Perceived discrimination contributes to the development of internalized stigma among those with schizophrenia. Evidence on demographic and clinical factors related to the perception of discrimination among this population is both contradictory and scarce in low- and middle-income countries. Accordingly, the main purpose of this study is to determine the demographic and clinical factors predicting the perception of discrimination among Mexican patients with schizophrenia. Two hundred and seventeen adults with paranoid schizophrenia completed an interview on their demographic status and clinical characteristics. Symptom severity was assessed using the Positive and Negative Syndrome Scale; and perceived discrimination using 13 items from the King's Internalized Stigma Scale. Bivariate linear associations were determined to identify the variables of interest to be included in a linear regression analysis. Years of education, age of illness onset and length of hospitalization were associated with discrimination. However, only age of illness onset and length of hospitalization emerged as predictors of perceived discrimination in the final regression analysis, with longer length of hospitalization being the independent variable with the greatest contribution. Fortunately, this is a modifiable factor regarding the perception of discrimination and self-stigma. Strategies for achieving this as part of community-based mental health care are also discussed.

Is local trait variation related to total range size of tropical trees?

The reasons why the range size of closely related species often varies significantly have intrigued scientists for many years. Among other hypotheses, species with high trait variation were suggested to occupy more diverse environments, have more continuity in their distributions, and consequently have larger range sizes. Here, using 34 tree species of lowlands tropical rainforest in southern Costa Rica, we explored whether inherent trait variability expressed at the local scale in functional traits is related to the species' total geographical range size. We formed 17 congeneric pairs of one narrow endemic and one widespread species, sampled 335 individuals and measured eight functional traits: leaf area, leaf thickness, leaf dry matter content, specific leaf area, leaf nitrogen content, leaf phosphorus content, leaf nitrogen to phosphorus ratio, and wood specific gravity. We tested whether there are significant differences in the locally expressed variation of individual traits or in multidimensional trait variance between the species in congeneric pairs and whether species' range size could hence be predicted from local trait variability. However, we could not find such differences between widely distributed and narrow range species. We discuss the possible reasons for these findings including the fact that higher trait variability of widespread species may result from successive local adaptations during range expansion and may hence often be an effect rather than the cause of larger ranges.

Differential aromatase (CYP19) expression in human arteries from normal and neoplasic uterus: an immunohistochemical and in situ hybridization study.

Aromatase CYP19 catalyzes the synthesis of estrogen from androgens in a tissue-specific manner. This enzyme is present in several tissues, including gonads, brain and fatty tissue. More recently, its presence has been described in vessels. Here, we describe the expression of aromatase in human uterine artery and compare its expression with that found in arteries of estrogen-dependent uterine leiomyomata from women. To do this, we employed immunohystochemical and in situ hybridization techniques. We used, a polyclonal antibody raised against the carboxyl terminus of aromatase (ARO) and RNAm probes, of the exon 1 of ARO. We found an increased immunoreactivity of ARO in uterine arteries of patients with leiomyoma as compared with control group. Probe showing positive signal in skin fibroblasts (1b), showed positive hybridization signal in normal artery, while probes with positive signal in placenta (1a), ovary (1c) and testis (1d) were over-expressed in arteries of leiomyomas.

Mental health problems among healthcare workers involved with the COVID-19 outbreak

Objective: The mental health problems and perceived needs of healthcare workers involved with coronavirus disease (COVID-19) may vary due to individual and contextual characteristics. The objective of this study was to evaluate healthcare workers' mental health problems during the common COVID-19 exposure scenario in Mexico, comparing those on the frontline with other healthcare workers according to gender and profession, determining the main risk factors for the most frequent mental health problems. Methods: A cross-sectional online study was conducted with a non-probabilistic sample of 5,938 Mexican healthcare workers who completed brief screening measures of mental health problems and ad hoc questions about sociodemographic professional characteristics, conditions related to increased risk of COVID-19 infection, life stressors during the COVID-19 emergency, and perceived need to cope with COVID-19. Results: The identified mental health problems were insomnia, depression, and posttraumatic stress disorder (PTSD), all of which were more frequent in frontline healthcare workers (52.1, 37.7, and 37.5%, respectively) and women (47.1, 33.0 %, and 16.3%, respectively). A lack of rest time was the main risk factor for insomnia (OR = 3.1, 95%CI 2.6-3.7, p ≤ 0.0001). Mourning the death of friends or loved ones due to COVID-19 was the main risk factor for depression (OR = 2.2, 95%CI 1.8-2.7, p ≤ 0.0001), and personal COVID-19 status was the main risk factor for PTSD (OR = 2.2, 95%CI 1.7-2.9, p ≤ 0.0001). Conclusion: The most frequent mental health problems during the common exposure scenario for COVID-19 in Mexico included the short-term psychological consequences of intense adversity. A comprehensive strategy for preventing mental health problems should focus on individuals with cumulative vulnerability and specific risk factors.

Anemia after Roux-en-Y gastric bypass. How feasible to eliminate the risk by proper supplementation?

BACKGROUND: Anemia after Roux-en-Y gastric bypass (RYGB) has been reported in 5 to 64 % of patients. Since absorption of specific elements is reduced, proper supplementation is mandatory. The aim of this study was to investigate the frequency of anemia, its causes, and the related deficiencies during the 1st postoperative year after RYGB. METHODS: A retrospective review of our prospectively collected database was performed. A total of 486 patients who underwent RYGB in a 5-year period and completed at least 1-year follow-up were included. Daily supplements as suggested by the AACE/TOS/ASMBS guidelines were routinely prescribed. Blood count, iron profile, folic acid, and B12 measurements 1 year after surgery were reviewed. RESULTS: One hundred ninety-five males and 291 females were included, with a mean age of 39.9 ± 11.6 years and a mean body mass index (BMI) of 42.4 ± 6.3 kg/m(2). Anemia 1 year after surgery was found in 19 patients (4 %), 6 males and 13 females. In seven women, it was related to iron deficiency. Two additional women had iron deficiency combined with low vitamin B12. Anemia was secondary to inflammation in two and indeterminate in two. In the six males, the cause of anemia was inflammation in three and indeterminate in three. Abnormal bleeding was found in five of these patients. CONCLUSIONS: Frequency of anemia 1 year after RYGB in our population was low (4 %). Anemia non-attributable to malabsorption was frequently present (n = 9/19). Iron deficiency was found exclusively in women. The most common non-malabsorptive types of anemia were inflammation and dysfunctional uterine bleeding.

A qualitative assessment of psycho-educational videos for frontline COVID-19 healthcare workers in Mexico / Evaluación cualitativa de videos psicoeducativos para personal de salud de primera línea ante el COVID-19 en México

Abstract Introduction Frontline COVID-19 healthcare workers (FLHCWs) are at a high-risk of suffering occupational stress- and trauma-related mental health problems, including burnout and compassion fatigue (B&CF). Given the time limitations (due to their heavy workloads) and need to minimize face-to-face interventions (in order to avoid contagions), psychological interventions for FHCWs should be as brief and remote as possible. Objective To evaluate the usability and clarity of evidence-based psycho-educational videos to prevent B&CF, to deal with uncooperative, hostile, and anxious patients and relatives, and to use personal protective equipment (PPE), from the perspective of Mexican FLHCWs. Method Based on a convenience sampling by intensity approach, videos were distributed requesting feedback based on specific questions through WhatsApp to FLHCWs. Field notes were used to triangulate the information. Results Content analysis of feedback from a final sample of 24 participants ‒75% women, 42 ± 8.4 years old‒ yielded three general thematic categories and seven subthemes: 1. content evaluation, which included three subthemes: utility, pertinence, and practicality; 2. dissemination and other needs, with two subcategories: willingness to share and receive more videos (other needs); and 3. format aspects, also comprising two subthemes: attractiveness and duration. All participants found the videos content very beneficial, relevant, and applicable to the workplace and even in their everyday personal and family life, and were willing to share them and to receive more videos on other issues, including strategies to manage problems related to isolation. Discussion and conclusion Escalation of this remote preventive intervention to other COVID-19 centers and future similar epidemics is recommended.

Resumen Introducción Los trabajadores de la salud de primera línea (TSPL) ante el COVID-19 presentan alto riesgo de desgaste profesional y fatiga por compasión (DP&FC). Tomando en cuenta sus limitaciones de tiempo y la necesidad de minimizar las intervenciones cara a cara, las intervenciones psicológicas para los TSPL deben ser tan breves y remotas como sea posible. Objetivo Evaluar la utilidad y claridad de videos psicoeducativos basados en evidencia para prevenir DP&FC, el manejo de pacientes y familiares no cooperativos, hostiles o ansiosos, y el uso de equipo de protección personal desde la perspectiva de los TSPL mexicanos. Método Los videos se distribuyeron a los TSPL por medio de WhatsApp, solicitándoles su opinión con base en preguntas específicas. Se utilizaron notas de campo para triangular esta información. Resultados El análisis de contenido de las retroalimentaciones recibidas por una muestra final de 24 participantes ‒75% mujeres, 42 ± 8.4 años‒ arrojó tres categorías temáticas y nueve subtemas: 1. evaluación de contenido, con tres subtemas: utilidad, pertinencia y practicidad, 2. difusión y otras necesidades, con dos subcategorías: disponibilidad tanto a compartir como a recibir más videos (otras necesidades), y 3. aspectos de forma, también con dos subtemas: atractivo y duración. La totalidad consideró los videos muy benéficos, relevantes y aplicables en el trabajo y su vida diaria personal y familiar; y reportó disposición a compartirlos y a recibir más material de este tipo. Discusión y conclusión Se recomienda el escalamiento de esta medida preventiva y remota a otros centros COVID-19 y en futuras epidemias similares.

Abordaje y manejo del infarto agudo miocardio con elevación del ST en Costa Rica durante la pandemia por COVID-19 Documento de consenso de la Asociación Costarricense de Cardiología / Approach and management of acute ST elevation myocardial infarction in Costa Rica during the COVID-19 pandemic Consensus document of the Costa Rican Association of Cardiology

Resumen El virus SARS-CoV-2 se ha extendido a nivel mundial, rápidamente ha sobrecargado los sistemas de salud. Esta emergencia ha implicado cambios en la atención usual del infarto agudo miocardio con elevación del ST (IAMCEST) puesto que la actividad habitual de las salas de hemodinamia y las vías de traslado de los pacientes se ha visto afectada. La afectación del personal de salud también es una preocupación relevante por lo que presentamos un documento de Consenso de la Asociación Costarricense de Cardiología que pretende generar una guía de trabajo al personal que atiende esta patología y garantizar la atención adecuada del IAMCEST durante la pandemia en Costa Rica.

Abstract The current COVID-19 has spread worldwide, the outbreak is altering the usual activity of the catheterization laboratorios and the usual treatment pathways of patients with chronic diseases or emergencies, such as Acute Coronary Syndrome could be disrupted. The involvement of health personnel is a relevant concern, so we created a consensus document of the Costa Rican Association of Cardiology that aims to generate a decision-making workflow to treat this pathology and guarantee adequate and continuous care for ST elevation myocardial infarction during the COVID-19 outbreak.

Germ cell mutagenicity of gamma-ethyl-gamma-phenyl-butyrolactone (EPBL) detected in the CF1 mouse-dominant lethal study.

Female and male CFI mice weighing 25-30 g were given 0, 50, 100 or 200 mg/kg of gamma-ethyl-gamma-phenyl-butyrolactone (EPBL) for 5 days intraperitoneally. In the male-dominant lethal phase, males treated with EPBL were mated with untreated females following a 7-day mating schedule with three consecutive mating events. In the female-dominant lethal phase, females treated with EPBL were caged with untreated males. The above dosages and schedule treatments were used. The incidence of pregnancy of females mated on days 1-7 and 8-14 after males were given 200 mg/kg of EPBL and of females given 200 mg/kg when mated to untreated males was decreased. Upon examining surgically exposed uteri and ovaries of pregnant females during the first phase, on gestation days 13-15, an increased incidence of pre-implantation losses with 200 mg/kg of EPBL and an increased incidence of post-implantation losses with 100 and 200 mg/kg was observed. In addition, an increased frequency of pre- and post-implantation losses was seen in females treated with 200 mg/kg. These results support the conclusion that EPBL is a germ cell mutagen and its effects are more pronounced during the post-meiotic stage.