Comprehensive inventory of páramo birds and their habitat affinities in a conservation hotspot, the Macizo del Cajas Biosphere Reserve, southern Ecuador

The páramo ecosystem is a significant centre of Andean bird diversity with high concentrations of threatened species. The Macizo del Cajas Biosphere Reserve's páramos are a district of the biogeographic páramo province of northern Andes and are therefore considered a conservation hotspot with representative bird diversity. To enhance regional conservation efforts, comprehensive inventories of bird species that occupy this páramo are required. We present an updated bird inventory for the páramos of Macizo del Cajas and included validated records from eBird and GBIF databases along with records from continuous monitoring across this páramo landscape for five years. We also provide notes on habitat affinity and important new, rare, restricted range, and threatened birds. We report 112 bird species within the reserve, including five endemics, and three globally and 12 nationally threatened species. Finally, we discuss the use of habitat affinities as indicators of biodiversity patterns in páramo to improve conservation tools for key habitats.

El ecosistema de páramo es un centro importante de diversidad de aves andinas con altas concentraciones de especies amenazadas. Los páramos de la Reserva de la Biosfera Macizo del Cajas son un distrito biogeográfico de la provincia del páramo de los Andes del norte y por tanto, son un punto crítico de conservación con una diversidad de aves representativa. Inventarios exhaustivos de la avifauna que ocupa este páramo son requeridos para asegurar esfuerzos de conservación regional. El presente estudio brinda un inventario actualizado de aves de los páramos del Macizo del Cajas. Se incluyen registros verificados desde eBird y GBIF, así como registros de cinco años continuos de monitoreo a través del paisaje de páramo. Además, se incluyen notas acerca de la afinidad de hábitat y registros importantes, nuevos, raros y de aves amenazadas. En total, se reportan 112 especies de aves dentro de la reserva, incluyen cinco endémicas, tres globalmente amenazadas y 12 a escala nacional. Finalmente, se discute el uso de la afinidad de hábitat como indicador de los patrones de biodiversidad en el páramo para mejorar herramientas de conservación para hábitats clave.

Adaptación transcultural al español rioplatense de la escala "Telemedicine Satisfaction and Usefulness Questionnaire" y evaluación del nivel de satisfacción global de la Tele-Rehabilitación en un Servicio de Kinesiología y Terapia Ocupacional / A Cross-cultural Adaptation of the "Telemedicine Satisfaction and Usefulness Questionnaire" Scale to Rioplatense Spanish and an Evaluation of the Global Satisfaction Level of Tele-Rehabilitation in a Kinesiology and Occupational Therapy Service

Introducción: el servicio de Kinesiología del Hospital Italiano de Buenos Aires adoptó la virtualidad para la atención de pacientes durante la pandemia de COVID-19. Se decidió realizar una adaptación transcultural del cuestionario de 17 ítems validado al español de España Telemedicine Satisfaction and Usefulness Questionnaire (TSUQ) para conocer la satisfacción de los pacientes. Métodos: dos investigadores nativos realizaron una adaptación del cuestionario TSUQ al español rioplatense. Participaron pacientes atendidos entre mayo de 2021 y marzo de 2022 que habían realizado al menos cuatro sesiones de Tele-Rehabilitación (TR). Fue evaluada la correlación de la puntuación del instrumento resultante con la de un ítem agregado a modo de criterio externo concurrente. La validación del constructo fue llevada a cabo mediante sendos análisis factoriales exploratorios y confirmatorios. Resultados: obtuvimos 293 cuestionarios (media de edad 57 años, 64% sexo femenino). Luego de los resultados del AFE (Análisis factorial Exploratorio) (n = 101), consensuamos eliminar 5 ítems. El cuestionario resultante (12 ítems) fue luego validado en una nueva muestra (n = 192) a través de un AFC (Análisis factorial Confirmatorio). La fiabilidad compuesta, la varianza media extractada y la validez convergente fueron adecuadas, mientras que la validez discriminante fue escasa. Documentamos una moderada correlación (Spearman de 0,35, p < 0,0001) entre el puntaje total del cuestionario y el de la pregunta agregada como criterio externo concurrente de validación y una excelente correlación entre versiones. Conclusión: la versión abreviada del cuestionario TSUQ en español tiene propiedades psicométricas adecuadas, lo que lo vuelve un instrumento valioso para evaluar la satisfacción de los pacientes que realizan Tele-Rehabilitación. (AU)

Introduction: the Kinesiology service of the Hospital Italiano de Buenos Aires adopted virtuality for patient care during the COVID-19 pandemic. It was decided to make a cross-cultural adaptation of the 17-item Telemedicine Satisfaction and Usefulness Questionnaire (TSUQ) validated for Peninsular Spanish to assess patient satisfaction. Methods: two native researchers adapted the TSUQ questionnaire to Riplatense Spanish. The participants were patients seen between May 2021 and March 2022 who had undergone at least four sessions of TR. We evaluated the correlation between the resulting instrument score and that of an item added as a concurrent external criterion. Construct validation was done with exploratory and confirmatory factor analysis. Results: we obtained 293 questionnaires (mean age 57 years, 64% female). After the AFE results (n=101), we agreed on eliminating five items. The final questionnaire (12 items) was tested in a new sample (n=192) with a CEA. Composite reliability, mean-variance extracted, and convergent validity were adequate, whereas the discriminant accuracy was low. We documented a moderate correlation (Spearman of 0.35, p < 0.0001) between the total questionnaire score and the aggregate question score as a concurrent external validation criterion and an excellent correlation between versions. Conclusion: the abbreviated version of the TSUQ questionnaire in Spanish has suitable psychometric properties, which makes it a valuable instrument for evaluating patient satisfaction in persons undergoing Tele-Rehabilitation. (AU)

Manejo médico-dental de una paciente de la tercera edad con apnea obstructiva del sueño y roncopatía. Reporte de caso

Introducción: Los Desórdenes del Sueño (DDS) son condiciones médicas peligrosas y la Apnea Obstructiva del Sueño (AOS) y la Roncopatía están dentro de las categorías de las Respiratorias. Son aproximadamente 90 y están agrupadas en 6 tipos. Un tercio de la población puede sufrir alguno, pocos son diagnosticados o tratados y el promedio que dormimos es 6 horas de 8 requeridas. Su impacto en la salud y el bienestar general es considerable y conocido. Reporte de caso: Paciente femenina de 68 años que asiste para atención medica por ronquidos que perturbaban el sueño de sus familiares y mal sueño, con ronquidos estridentes al dormir que despertaba a sus familiares. Antecedentes médicos de importancia: hipertensión arterial (HTA) tratada desde hace 20 años. Se observó un riesgo cardiovascular moderado de 44%. Los diagnósticos de DDS del tipo Respiratorio fueron: 1. AOS, en grado leve. 2. Roncopatía. Conclusión: Los DDS son enfermedades peligrosas, incapacitantes y comunes y las respiratorias y las de movimiento, pueden y deben ser detectadas por los Médicos y los Odontólogos durante un examen de rutina. (provisto por Infomedic International)

Sleep Disorders (SD) are dangerous medical conditions and Obstructive Sleep Apnea (OSA) and Snoring are amongst the Respiratory. There are approximately 90 different and are grouped in 6 types. One third of the population may be suffering of one, few are diagnosed or treated and the average time we sleep is 6 hours of 8 we need. Its impact on the general wellbeing and health is considerable and known. Temporomandibular Disorders (TMD) that according to the NIH, are dysfunctions of the temporomandibular joints and muscles and OSA are sisters. On October 23, 2017, the American Dental Association issued a mandate to its members that evaluation for OSA and similar disorders should be a part of the routine dental evaluation.  Regarding the relationship TMD and SD, we have more information: 1. In 2 (Respiratory and Movement) of the 6 groups of SD, there is a relationship with Dentistry.  2. Sleep depends on the health of the masticatory system (MS).  3. Some of the treatment modalities and manifestations are in the mouth. The intention of this case report is to present the standard of care and successful management of these DDS with the modality of Sleep Medicine and Dentistry. (provided by Infomedic International)

From genes to ecosystems: a synthesis of amphibian biodiversity research in Brazil / De genes a ecossistemas: uma síntese da pesquisa em biodiversidade de anfíbios no Brasil

Abstract Here, we summarize examples of significant advances in amphibian research supported by the São Paulo Research Foundation (FAPESP), focusing on recent discoveries in the fields of community ecology, habitat change, infection diseases, and multipurpose DNA sequencing. We demonstrated that FAPESP has been fundamental not only by directly funding research projects and scholarships, but also through its science training policy, fostering international collaborations with world-class research institutions, improving and consolidating new lines of research that often depended on a synergetic combination of different knowledge and complex tools. We emphasized that future studies will continue to focus on basic questions, such as description of new species, as well as taxonomic and systematic corrections. Furthermore, we also expect that there will be a strong integration among different disciplines using novel bioinformatics tools and modeling approaches, such as machine learning. These new approaches will be critical to further develop our understanding of foundational questions of amphibian life-history trait variation, disease transmission, community assembly, biogeography, and population forecasts under different global change scenarios such as agricultural expansion, agrochemical use, habitat loss, and climate change.

Resumo No presente estudo apresentamos exemplos de avanços significativos nas pesquisas com anfíbios financiadas pela Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP), focando em descobertas recentes nos campos de ecologia de comunidades, modificação do habitat, doenças infecciosas e o sequenciamento de DNA com múltiplos propósitos. Demonstramos que a FAPESP tem sido fundamental não somente pelo financiamento direto de projetos de pesquisa e bolsas de estudo, mas também através de sua política de formação científica, fomentando colaborações internacionais com instituições de pesquisa de excelência mundial, melhorando e consolidando novas linhas de pesquisa que frequentemente dependem da combinação sinérgica entre diferentes linhas de conhecimento e ferramentas complexas. Enfatizamos que futuros estudos continuem com foco em questões básicas, como a descrição de novas espécies, bem como correções taxonômicas e sistemáticas. Além disso, esperamos uma forte integração entre diferentes disciplinas usando novas ferramentas de bioinformática e abordagens de modelagem, como o aprendizado de máquina. Essas novas abordagens serão críticas para desenvolver ainda mais nossa compreensão a respeito de questões fundamentais sobre as características da história de vida dos anfíbios, transmissão de doenças, estrutura de comunidades, biogeografia e previsões populacionais em diferentes cenários de mudanças globais, como a expansão da agricultura, uso de agrotóxicos, perda de habitat e mudanças climáticas.

Associação entre Terapia com Estatinas e Menor Incidência de Hiperglicemia em Pacientes Internados com Síndromes Coronarianas Agudas / Association between Statin Therapy and Lower Incidence of Hyperglycemia in Patients Hospitalized with Acute Coronary Syndromes

Resumo Fundamento O maior risco de se desenvolver diabetes com o uso de estatinas é um desafio para a segurança do uso dessa classe de medicamentos em longo prazo. No entanto, poucos estudos analisaram essa questão durante síndromes coronarianas agudas (SCA). Objetivos Investigar a associação entre início precoce da terapia com estatina e níveis de glicemia em pacientes admitidos com SCA. Métodos Este foi um estudo retrospectivo de pacientes hospitalizados por SCA. Pacientes que nunca haviam usado estatinas foram incluídos e divididos segundo uso ou não de estatina nas primeiras 24 horas de internação. O desfecho primário foi a incidência de hiperglicemia na internação (definida como pico de glicemia > 200mg/dL). Modelos de regressão logística e modelos lineares multivariados foram usados para ajuste quanto a fatores de confusão e um modelo de pareamento por escore de propensão foi desenvolvido para comparações entre os dois grupos de interesses. Um valor de p menor que 0,05 foi considerado estatisticamente significativo. Resultados Um total de 2357 pacientes foram incluídos, 1704 deles alocados no grupo que receberam estatinas e 653 no grupo que não receberam estatinas nas primeiras 24 horas de internação. Após os ajustes, uso de estatina nas primeiras 24 horas foi associado com uma menor incidência de hiperglicemia durante a internação (OR ajustado = 0,61, IC95% 0,46-0,80; p < 0,001) e menor necessidade de uso de insulina (OR ajustado = 0,56, IC 95% 0,41-0,76; p < 0,001). Essas associações mantiveram-se similares nos modelos de pareamento por escore de propensão, bem como após análises de sensibilidade, como exclusão de pacientes que desenvolveram choque cardiogênico, infecção grave ou pacientes que foram a óbito durante a internação hospitalar. Conclusões Entre os pacientes internados com SCA que não receberam estatinas previamente, a terapia precoce com estatina associou-se independentemente com menor incidência de hiperglicemia durante a internação. (Arq Bras Cardiol. 2021; 116(2):285-294)

Abstract Background Increased risk of new-onset diabetes with statins challenges the long-term safety of this drug class. However, few reports have analyzed this issue during acute coronary syndromes (ACS). Objective To explore the association between early initiation of statin therapy and blood glucose levels in patients admitted with ACS. Methods This was a retrospective analysis of patients hospitalized with ACS. Statin-naïve patients were included and divided according to their use or not of statins within the first 24 hours of hospitalization. The primary endpoint was incidence of in-hospital hyperglycemia (defined as peak blood glucose > 200 mg/dL). Multivariable linear and logistic regression models were used to adjust for confounders, and a propensity-score matching model was developed to further compare both groups of interest. A p-value of less than 0.05 was considered statistically significant. Results A total of 2,357 patients were included, 1,704 of them allocated in the statin group and 653 in the non-statin group. After adjustments, statin use in the first 24 hours was associated with a lower incidence of in-hospital hyperglycemia (adjusted OR=0.61, 95% CI 0.46-0.80; p < 0.001) and lower need for insulin therapy (adjusted OR = 0.56, 95% CI 0.41-0.76; p < 0.001). These associations remained similar in the propensity-score matching models, as well as after several sensitivity analyses, such as after excluding patients who developed cardiogenic shock, severe infection or who died during index-hospitalization. Conclusions Among statin-naïve patients admitted with ACS, early statin therapy was independently associated with lower incidence of in-hospital hyperglycemia. (Arq Bras Cardiol. 2021; 116(2):285-294)

Mucina y Enfermedad Periodontal / Mucin and periodontal disease

La enfermedad periodontal (EP) es una patología que afecta principalmente los tejidos que rodean a la pieza dentaria (PD) y se caracteriza, en la mayoría de los casos, por una exposición bacteriana que favorece una respuesta destructiva e inflamatoria del huésped, que conduce a la pérdida de inserción periodontal de la PD, provocando una marcada reabsorción ósea y la posible pérdida de las PD. El diagnóstico de EP implica evaluaciones clínicas y radiográficas, en la actualidad se están realizando diversas investigaciones para evaluar posibles compuestos en los fluidos orales a través de lo cual puede ser posible evaluar la presencia y gravedad de estas enfermedades, como así también el riesgo en los pacientes. Hay evidencias de la interacción de macromoléculas salivales, como las mucinas, con microorganismos específicos. De esta manera las mucinas, junto con otros productos de la saliva, ayudan a modular tanto el número como el tipo de proliferación de ciertos organismos y provocar la disminución de otros. La revisión de la literatura actual concluye que las mucinas salivales pueden servir como un parámetro bioquímico de la inflamación del periodonto (AU)

Periodontal disease (PD) is a pathology that mainly affects the tissues surrounding the tooth (PD) and is characterized, in most cases, by a bacterial exposure that favors a destructive and inflammatory response of the host, which leads to the loss of periodontal insertion of the PD, causing a marked bone resorption and the possible loss of the PD. The diagnosis of PD involves clinical and radiographic evaluations, at present several investigations are being carried out to evaluate possible compounds in oral fluids through which it may be possible to evaluate the presence and severity of these diseases, as well as the risk in patients. There is evidence of the interaction of salivary macromolecules, such as mucins, with specific microorganisms. In this way, mucins, together with other saliva products, help modulate both the number and type of proliferation of certain organisms and cause the decrease of others. The review of the current literature concludes that salivary mucins can serve as a biochemical parameter of inflammation of the periodontium (AU)

Human impacts and the loss of Neotropical freshwater fish diversity

Neotropical Ichthyology promotes the Special Issue (SI) "Human impacts and the loss of Neotropical freshwater fish diversity" with the purpose of publishing relevant scientific articles on the current biodiversity crisis and the loss of Neotropical freshwater fishes in the Anthropocene. The SI is composed of 22 publications, being two review articles and 20 original articles. A total of 107 researchers contributed to these papers, involving 44 institutions based in Brazil and six other countries. Published articles investigated main anthropic activities and their impacts on fish diversity, with special focus on river regulation, mining, land use changes, aquaculture, and fisheries. Studies provided evidence about the loss of fish diversity in the Neotropics, including fish kill events, demographic changes, contamination, changes in assemblage structure, loss of taxonomic and functional diversity, besides the degradation of ecosystem functions and services, and the lack of effective protection and conservation. Studies were conducted in rivers, streams, lakes, and reservoirs from different Neotropical systems. The studies published in this SI represent a relevant sample of the current worrisome situation of freshwater fishes in the Neotropical region and call for urgent revision in environmental policies, management and conservation initiatives, and socioeconomic priorities.(AU)

A revista Neotropical Ichthyology lança o Volume Especial (SI) "Human impacts and the loss of Neotropical freshwater fish diversity" com o objetivo de publicar artigos científicos relevantes sobre a atual crise da biodiversidade e a perda de diversidade de peixes de água doce Neotropicais no Antropoceno. O SI é composto por 22 publicações, sendo dois artigos de revisão e 20 artigos originais. Um total de 107 pesquisadores contribuíram com esses artigos, envolvendo 44 instituições sediadas no Brasil e em seis outros países. Os artigos publicados investigaram as principais atividades antrópicas e seus impactos sobre a diversidade de peixes, com foco especial na regulação dos rios, mineração, mudanças no uso do solo, aquicultura e pesca. Os estudos forneceram evidências sobre a perda de diversidade de peixes na região Neotropical, incluindo eventos de mortandade, alterações demográficas, contaminação, mudanças na estrutura das assembleias, perda de diversidade taxonômica e funcional, além da degradação de funções e serviços ecossistêmicos, e falta de ações efetivas de proteção e conservação. Os estudos foram conduzidos em rios, riachos, lagos e reservatórios de diferentes sistemas Neotropicais. Os estudos publicados neste SI representam uma amostra relevante da atual situação dos peixes de água doce na região Neotropical, reforçando a necessidade de revisão das políticas ambientais, ações de manejo e conservação, e prioridades socioeconômicas.(AU)

Validación de un cuestionario en español sobre la usabilidad de la telemedicina / Validation of a Spanish questionnaire on telemedicine usability

Resumen La telemedicina es la prestación de servicios de la salud mediante la utilización de tecnologías de la información y la comunicación. Su implementación se realiza a través de sistemas cuya usabilidad es variable. En 2016, Parmant y col., desarrollaron y validaron un cuestionario en inglés que mide su usabilidad y permite evaluar los factores que influyen en la misma. En 2019, tradujimos, adaptamos transculturalmente y publicamos este cuestionario en español. Con el objetivo de transformar el mismo en una herramienta confiable y accesible, cuya utilidad es indiscutible en el contexto actual, llevamos a cabo un trabajo de investigación que permitió su validación y simplificación.

Abstract Telemedicine is the provision of services by health professionals through the use of information and communication technologies. Its implementation is usually carried out through systems of variable usability. In 2016, Parmanto et al, developed and validated a questionnaire in English that measures its usability and allows to evaluate all factors that influence it. In 2019, we translated, adapted cross-culturally, and published this questionnaire in Spanish. With the aim of transforming it into a reliable and accessible tool, the utility of which is indisputable in the current context, we carried out a research work that allowed its validation and simplification.

Las hormonas femeninas en fisiología renal: Sensibilidad a la sal y regulación de la proliferación epitelial / Female hormones in renal physiology. Salt sensitivity and regulation of epithelial proliferation

Un tercio de la población mundial tiene niveles anormalmente altos de presión arterial, hipertensión, responsable de casi el 50% de las muertes por accidente cerebrovascular y enfermedad coronaria. La sensibilidad a la sal es un factor de riesgo para la morbilidad y mortalidad cardiovascular y también para otras enfermedades. En estudios previos describimos un modelo de hipertensión sal sensible (HSS) en ratas Wistar ovariectomizadas (oVx) adultas. Las ratas oVx son normotensas con ingesta normal de sal (NS, 0.24% de NaCl), pero desarrollan un perfil de HSS con una ingesta elevada de sal (HS, 1% de NaCl). En los estudios en riñón encontramos que el circuito receptor D1 de dopamina, citocromo P450 4A y Na+, K+-ATPasa está alterado por la ausencia de hormonas ováricas, lo que se asocia a menor excreción de sodio e hipertensión arterial. La ingesta HS en ratas oVx también promueve cambios en la expresión de proteínas relacionadas con el transporte de sodio en células mononucleares de sangre periférica, principalmente linfocitos periféricos. Por lo tanto, el transporte de sodio se modifica en varios niveles de la fisiología normal. En estudios recientes observamos que el estradiol aumenta la proliferación y diferenciación de células epiteliales en cultivos de corteza renal humana. Sensibilidad a la sal, inmunidad adaptativa, presión arterial y proliferación de células epiteliales en riñón son fenómenos de gran importancia biológica regulados por estradiol.

Female sex hormones participate in the regulation of blood pressure and renal epithelial proliferation, effects not related to their reproductive function. About one-third of the world's population has abnormally high levels of blood pressure, hypertension, which is responsible for almost 50% of deaths from stroke and coronary heart disease. Salt sensitivity is a risk factor for cardiovascular morbidity and mortality and other diseases as well. We reported a model of salt sensitive hypertension in adult ovariectomized (oVx) Wistar rats. oVx rats are normotensive under normal salt intake (NS, 0.24% NaCl), but upon a high salt intake (HS, 1% NaCl) oVx rats developed a blood pressure profile of salt-sensitive hypertension. Our studies on kidney molecules related to sodium balance found that the circuit dopamine D1-like receptor, cytochrome P450 4A and Na+, K+-ATPase is altered by the absence of ovary hormones which is accompanied by a reduced ability to excrete sodium. In oVx rats HS intake also promotes changes in the expression of proteins related to sodium transport in peripheral blood mononuclear cells, mainly peripheral lymphocytes. Therefore, sodium transport is modified at several levels of normal physiology. Lately, we described that estradiol increases the rate of renal epithelial cell proliferation in primary cultures developed from human renal cortex. Thus, salt sensitivity, adaptive immunity, blood pressure and renal cell proliferation are complex biological responses regulated by female sex hormones.

Schneider's first-rank symptoms as predictors of remission in antipsychotic-naive first-episode psychosis

Objective: German psychiatrist Kurt Schneider proposed the concept of first-rank symptoms (FRS) of schizophrenia in 1959. However, their relevance for diagnosis and prediction of treatment response are still unclear. Most studies have investigated FRS in chronic or medicated patients. The present study sought to evaluate whether FRS predict remission, response, or improvement in functionality in antipsychotic-naive first-episode psychosis. Methods: Follow-up study of 100 patients at first episode of psychosis (FEP), with no previous treatment, assessed at baseline and after 2 months of treatment. The participants were evaluated with the standardized Positive and Negative Syndrome Scale (PANSS) and Global Assessment of Functioning (GAF) and for presence of FRS. Results: Logistic regression analysis showed that, in this sample, up to three individual FRS predicted remission: voices arguing, voices commenting on one's actions, and thought broadcasting. Conclusion: Specific FRS may predict remission after treatment in FEP patients. This finding could give new importance to Kurt Schneider's classic work by contributing to future updates of diagnostic protocols and improving estimation of prognosis.

Body Mass Index at Presentation of Inflammatory Bowel Disease in Children / 대한소아소화기영양학회지

Purpose@#The evidence for an association between inflammatory bowel disease (IBD) and obesity is conflicting. Therefore, we set out to review the body mass index (BMI) at presentation of IBD to understand if the rise of the obesity rate in the general population, lead to an increase of obesity in patients with IBD at the time of diagnosis. @*Methods@#Retrospective review of all patients with IBD seen at Children's Hospital and Medical Center from January 1st 2010 to December 31st 2014. From the initial visit and endoscopy, we obtained: age; sex; BMI; disease phenotype; disease severity. @*Results@#We had a total of 95 patients, 35 patients were excluded due to incomplete data or referral being made after diagnosis was made. 28 were males and 32 were females, Age range was 2–17 years. A 37 had Crohn's disease, 19 ulcerative colitis, and 4 indeterminate colitis.Disease severity in 19 cases was mild, 29 moderate and 12 severe. BMI distribution was as follows—obese (5.0%), overweight (6.7%), normal weight (65.0%), mild malnutrition (8.3%), moderate malnutrition (15.0%), severe malnutrition (1.7%). @*Conclusion@#Our data is consistent with other series. Showing most children had a normal BMI, regardless of disease severity or phenotypes. One confounding factor is the possibility of delay in referral to GI. This could mean some obese children may fall in the normal BMI range at the time of diagnosis due to ongoing weight loss. Future studies should include prospective cohort studies, comparing incidence of IBD in obese and non-obese patients, severity at presentation, duration of symptoms, and clinical outcomes.

Freshwater fish richness baseline from the São Francisco Interbasin Water Transfer Project in the Brazilian Semiarid

Among Neotropical freshwater ecoregions, the Mid-Northeastern Caatinga (MNCE) is a fish knowledge gap. Its temporary drainages are receptors of the São Francisco interbasin water transfer project (SFR-IWT) in the Brazilian semiarid. We provide a comprehensive baseline of fish richness of the five SFR-IWT basins. Species richness, shared, endemic, threatened and non-native species were obtained using sampling, ichthyologic collections, literature and online repositories (306 localities). In total 121, species were recorded, 111 of them native, and 16 (14.41%) listed for all basins. Higher richness of native species (78, 70.27%) was recorded in the São Francisco lower-middle stretch (SFRE), including 23 endemic, 61 (54.95%) in MNCE basins (13 endemic), and 28 (25.23%) shared between both ecoregions. In the MNCE, 50 species were recorded in Jaguaribe (JAG), 39 in Piranhas-Açu, 36 in Paraíba do Norte, and 32 in Apodi-Mossoró (APO). The number of species shared between the SFRE and each receptor basin varied from 24 (23.08%, JAG) to 20 (22.22%, APO). JAG contains 81.97% of the receptor basins' species. Its higher richness and endemism deserve special attention regarding the ongoing hydrological changes. This study will help detect possible modifications in the ichthyofauna of the main MNCE drainages.(AU)

Dentre as ecorregiões dulcícolas neotropicais, a Nordeste Médio-Oriental (MNCE) é uma lacuna de conhecimento sobre peixes. Suas drenagens temporárias são receptoras do projeto de transposição do São Francisco (SFR-IWT) no semiárido brasileiro. Fornecemos uma linha de base abrangente da riqueza de peixes das cinco bacias do SFR-IWT. Riqueza de espécies, espécies compartilhadas, endêmicas, ameaçadas e não-nativas foram obtidas através de amostragem, coleções ictiológicas, literatura e repositórios online (306 localidades). No total, foram registradas 121 espécies, 111 nativas e 16 (14,41%) listadas para todas as bacias. A maior riqueza de espécies nativas (78, 70,27%) foi registrada no trecho sub-médio do São Francisco (SFRE), incluindo 23 endêmicas e 61 (54,95%) nas bacias da MNCE (13 endêmicas), e 28 (25,23 %) compartilhadas entre ambas ecorregiões. Na MNCE, foram registradas 50 espécies na Jaguaribe (JAG), 39 na Piranhas-Açu, 36 na Paraíba do Norte e 32 na Apodi-Mossoró (APO). O número de espécies compartilhadas entre SFRE e cada bacia receptora variou de 24 (23,08%, JAG) a 20 (22,22%, APO). JAG contém 81,97% das espécies das bacias receptoras. Sua maior riqueza e endemismo merecem atenção especial em relação às mudanças hidrológicas em curso. Este estudo ajudará a detectar possíveis modificações na ictiofauna das principais drenagens da MNCE.(AU)

Propiedades psicométricas y características operativas de la versión adaptada al castellano del cuestionario CRAFFT en adolescentes del conurbano bonaerense / Psychometric properties and operating characteristics of the Spanish-adapted version of the CRAFFT questionnaire in adolescents from Greater Buenos Aires

Introducción. El cuestionario Car, Relax, Alone, Forget, Family and Friends, Trouble (CRAFFT) es un instrumento de tamizaje de riesgo de consumo problemático, abuso o dependencia de alcohol y sustancias en adolescentes. Si bien cuenta con una versión validada y adaptada al castellano para su utilización en adolescentes argentinos (CRAFFTa), su uso no puede generalizarse, ya que no ha sido evaluado en diferentes contextos socioculturales. Objetivo. Evaluar la transferibilidad del CRAFFTa como herramienta de pesquisa de consumo problemático, abuso y dependencia de alcohol y otras sustancias en una población adolescente de bajo nivel socioeconómico. Población y métodos. Se encuestó en forma anónima a una muestra de adolescentes de una localidad de bajos recursos del conurbano bonaerense que concurrían a dos escuelas secundarias. Se aplicó el cuestionario CRAFFT adaptado al español y validado para su uso en Argentina, y se empleó el cuestionario Problem Oriented Screening Instrument for Teenagers substance use and abuse subscale (POSITuas) como prueba de referencia. Resultados. Se obtuvieron 146 cuestionarios completos (tasa de respuesta del 89,6 %). La confiabilidad fue 0,681; validez de criterio: 0,697; sensibilidad: 93,4; especificidad: 72,5; precisión: 0,886. Valor predictivo positivo: 0,898; y negativo: 0,966. La fiabilidad compuesta fue 0,872; varianza media extractada: 0,718. La validez convergente fue aceptable en el análisis factorial confirmatorio, y se empleó una estructura unifactorial. Conclusiones. Las características operativas del CRAFFTa son aceptables para su uso en el rastreo de consumo problemático de alcohol y abuso de sustancias en una población adolescente de bajos recursos.

Introduction: The Car, Relax, Alone, Forget, Family and Friends, Trouble (CRAFFT) questionnaire is an instrument used in the screening for problematic alcohol and substance use, abuse or dependence in adolescents. While there is a Spanish-adapted and validated version for Argentine adolescents (CRAFFTa), it cannot be applied indiscriminately because it has not been assessed in different sociocultural settings. Objective: To assess the transferability of the CRAFFTa as a screening tool for problematic alcohol and drug use, abuse or dependence in an adolescent population of low socio-economic level. Population and methods: An anonymous survey was administered to low-income adolescents living in Greater Buenos Aires and attending two secondary schools. The Spanish-adapted version of the CRAFFT questionnaire, validated for its use in Argentina, was administered, while the Problem Oriented Screening Instrument for Teenagers, substance use and abuse subscale (POSITuas) questionnaire was used as a reference test. Results: A total of 146 questionnaires were completed (completion rate: 89.6 %). Reliability was 0.681; criterion validity: 0.697; sensitivity: 93.4; specificity: 72.5; precision: 0.886; positive predictive value: 0.898; negative predictive value: 0.966. Compound reliability was 0.872; average variance extracted: 0.718. Convergent validity was acceptable in the confirmatory factor analysis, and a single-factor structure was used. Conclusions: The operating characteristics of the CRAFFTa questionnaire are acceptable for its use in the screening for problematic alcohol and substance use, abuse or dependence in a low-income adolescent population.

Validación transcultural del Cuestionario de Enseñanza Clínica de Maastricht / Transcultural validation of the Maastricht Clinical Teaching Questionnaire

La evaluación del desempeño del docente clínico permite proporcionar feedback para motivarlo a mejorar sus habilidades docentes. Se realizó la validación transcultural del Cuestionario de Enseñanza Clínica de Maastricht, mediante la guía internacional para la adaptación de los cuestionarios. Se investigó validez de contenido, proceso de respuesta, constructo y confiabilidad. Luego de la adaptación, residentes de dos hospitales universitarios evaluaron a 187 docentes clínicos. La validación del contenido y del proceso de respuesta fue adecuada. En el análisis factorial confirmatorio, todos los índices y criterios se ajustaron bien con el modelo de 5 factores y 14 ítems. El alfa de Cronbach fue de 0,80. El coeficiente G fue > 0,70, con bajos valores de varianza del error absoluto. Fueron necesarias 6 evaluaciones por docente para una evaluación confiable en cada dominio y en el desempeño global. La versión en castellano del Cuestionario es válida y confiable para evaluar a los docentes.

The evaluation of the clinical teacher's performance provides feedback to motivate them to improve their teaching skills. To perform the cross-cultural adaptation of the Maastricht Clinical Teaching Questionnaire, the International Guide for the Adaptation of the Questionnaires was followed. The validity of content, response process, construct and reliability were investigated. After cross-cultural adaption, residents of two University hospitals evaluated 187 clinical teachers. Content and answering process were validated. In the confirmatory factor analysis, all indexes and criteria for a good fit suited the 5 factors and 14 items model. The Cronbach's alpha coefficient was 0.80. The G coefficient was > 0.70, with low variance of the absolute error. Every clinical teacher should receive at least 6 evaluations to achieve a reliable evaluation of every domain and of their global performance. The Spanish version of the questionnaire is a valid, reliable instrument for medical residents to evaluate teachers.

Impacto del mindfulness en el estrés en trabajadores de una universidad de Lima sur / Impact of mindfulness on stress in workers of a university in southern Lima

RESUMEN Objetivo: Evaluar el impacto de un programa de mindfulness en el estrés fisiológico, distrés emocional, estrés percibido y estrés laboral en un grupo de trabajadores. Materiales y métodos: Participaron 28 trabajadores universitarios (empleados y docentes), quienes habían registrado niveles altos de estrés laboral en una evaluación institucional previa. El programa consistió en seis sesiones de entrenamiento en mindfulness una vez por semana y con dos horas por sesión (12 horas en total), con las técnicas de la atención plena en la respiración, en el cuerpo, pensamiento, emociones y descanso. Se utilizaron mediciones de Biofeedback para evaluar cinco indicadores de estrés fisiológico (temperatura, respiración, pulso, volumen sanguíneo en la piel y presión arterial) y tres pruebas para medir estrés: Inventario de Distrés Emocional Percibido (a = .85), Inventario de Estrés Percibido a = .86), Escala de Estrés Laboral (a = .90), como medidas de pretest y postest. Resultados: Volumen sanguíneo en la piel (d = 0.8), pulso sanguíneo (d = 0.8) y frecuencia de la respiración abdominal (d = 0.9), distrés emocional (d = 0.9), el estrés percibido (d = 0.7) y el estrés laboral (d = 0.6). Conclusión: El mindfulness tuvo un impacto significativo en la reducción del estrés en trabajadores universitarios.

ABSTRACT Objetive: To assess the impacto of a mindfulness program on physiological stress. emotional distress, perceived stress, and work stress in a group of workers. Material and methods: 28 universiy workers (employees and teachers) participated, who had registered high levels of work stress in a previous institutional evaluation. The program consisted of six training sessions in mindfulness once a week and with two hours per sessions (12 hours in total) with the techniques of mindfulness in breathing, in the body (body scan), thinking, emotions and break. Biofeedback measurements were used to evaluate five physiological stress indicators and three tests to measures. Results: blood volumen in the skin (d = 0.8), blood pulse (d = 0.8) and frequency of abdominal breathing (d = 0.9), emotional distess (d = 0.9), perceived stress (d = 0.7) and work stress (d = 0.6). Conclusión: mindfulness had a significant impact on stress reduction in university workers.

The effects of cataract surgery on autonomic heart rate control: a prospective cross-sectional and analytical study

OBJECTIVES: We aimed to evaluate the effects of cataract surgery on cardiac autonomic modulation. METHODS: A cross-sectional and analytical study was conducted at the Hospital Maria Braido in the city of São Caetano do Sul, São Paulo, between 2015 and 2016. We investigated 19 patients of both sexes who were all over 50 years old; all patients had a diagnosis of senile or bilateral cataracts and were recommended to undergo implantation of the intraocular lens. Heart rate variability (HRV) was evaluated before, during and after cataract surgery. RESULTS: There were no significant changes in the time and geometric domains of HRV before, during or after surgery. The high-frequency (HF) band in normalized units (nu) on the spectral analysis significantly increased (p=0.02, Cohen's d=0.9, large effect size). However, the low-frequency (LF) band in nu significantly decreased during surgery (p=0.02, Cohen's d=0.9, large effect size). CONCLUSION: Throughout the intraocular lens implantation cataract surgery, there was an increase in parasympathetic modulation and a decrease in the sympathetic component of the heart rate (HR). We propose that this result is attributable to the supine position of the patients during surgery and the trigeminal reflex.

Do biological maturity and performance influence the training load of track and field athletes? / A maturação sexual e o desempenho influenciam a carga de treinamento de atletas de atletismo?

Abstract It is necessary to clarify if BM and track and field performance can modulate the perception about RPE-session. The purpose of the present study was to verify if biological maturity and track and field-specific performance can be associated with training load (RPE-session method). Seventy-five young athletes (13-15 years old) of both genders participated in the present study. The experimental protocol lasted seven consecutive days. Performance tests (75-m running, long jump, 250-m running, shot put and 1000-m running) were made on the first day. After 48 hours, five days of track and field training it was prescribed, each day represents a training of each performance test. All training sessions had the same duration (120 min). The value of the training load was obtained multiplying the RPE value with training session duration (in minutes). For girls, the training load of 250-m training was correlated with biological maturity (r = -0.36, p = 0.02, n = 37) and specific performance (r = 0.33, p = 0.04, n = 37). All other analyzes indicate that biological maturity and track and field-specific performance do not influence the training load based on RPE-session method. Training load based on RPE-session is not influenced by biological maturity and track and field-specific performance, therefore can be used to control the training load of young track and field athletes. To girls it is necessary a care to control the training sessions intensity of 250-m running.

Resumo É necessário esclarecer se a maturação biológica e o desempenho no atletismo podem modular a PSE da sessão. O objetivo do presente estudo foi verificar se a maturidade biológica e o desempenho específico no atletismo podem estar associados à carga de treinamento (método de PSE da sessão). Setenta e cinco jovens atletas (13-15 anos) de ambos os sexos participaram do presente estudo. O protocolo experimental durou sete dias consecutivos. Testes de desempenho (75 m de corrida, salto em distância, 250 m de corrida, arremesso de peso e 1000 m de corrida) foram feitos no primeiro dia. Após 48 horas, cinco dias de treinamento de atletismo foram prescritos, cada dia representa um treinamento de cada teste de desempenho. Todas as sessões de treinamento tiveram a mesma duração (120 min). O valor da carga de treinamento foi obtido multiplicando o valor do PSE com a duração da sessão de treinamento (em minutos). Para as meninas, a carga de treinamento de 250 m foi correlacionada com a maturidade biológica (r = -0,36, p = 0,02, n = 37) e desempenho específico (r = 0,33, p = 0,04, n = 37). Todas as outras análises indicam que a maturidade biológica e o desempenho específico no atletismo não influenciam a carga de treinamento com base no método da PSE da sessão. A carga de treinamento com base na PSE da sessão não é influenciada pela maturidade biológica e desempenho específico no atletismo, portanto, pode ser usada para controlar a carga de treinamento de jovens atletas de atletismo. Para as meninas é necessário cuidado para controlar a intensidade das sessões de treino de 250m de corrida.

PSA kinetics before 40 years of age

ABSTRACT Purpose: The baseline PSA has been proposed as a possible marker for prostate cancer. The PSA determination before 40 years seems interesting because it not suffers yet the drawbacks related to more advanced ages. Considering the scarcity of data on this topic, an analysis of PSA kinetics in this period seems interesting. Materials and Methods: A retrospective assay in a database of a private diagnostic center was performed from 2003 to 2016. All subjects with a PSA before 40 years were included. Results: 92995 patients performed PSA between the ages of 21 - 39. The mean value ranged from 0.66 ng / mL (at age 22) to 0.76 ng / mL (at age 39) and the overall mean was 0.73 ng / mL. As for outliers, 3783 individuals presented a baseline PSA > 1.6 ng / mL (p95). A linear regression model showed that each year there is a PSA increase of 0.0055 ng / mL (β = 0.0055; r2 = 0.0020; p < 0.001). A plateau in PSA between 23 and 32 years was found and there were only minimal variations among the ages regardless of the evaluated percentile. Conclusion: It was demonstrated that PSA kinetics before 40 years is a very slow and progressive phenomenon regardless of the assessed percentile. Considering our results, it could be suggested that any PSA performed in this period could represent the baseline value without significant distortions.

É possível integrar pecuária à conservação da biodiversidade? Estudo de casos de depredação de ovinos por onça-parda (Puma concolor) / Is it possible to integrate livestock into biodiversity conservation? Case study of sheep depredation by puma (Puma concolor)

Em diversas partes da América Latina, a perda e diminuição do habitat natural de animais silvestres ocorre em função do aumento das atividades agropecuárias. Nos últimos anos o número de mortes de animais de criação por depredação tem aumentado, bem como a consequente retaliação aos predadores. Como resultado destas ações, ocorre à extinção ou redução das populações destes predadores de topo, provocando perdas ecológicas. Esse estudo teve como objetivo apontar medidas preventivas e mitigatórias da depredação de ovinos por onça-parda (Puma concolor). Através da análise de dois estudos de casos de depredação no Centro-Oeste brasileiro e na região dos Andes Colombianos, levantamos soluções alternativas sustentáveis para que profissionais e criadores possam se prevenir desta ameaça ao rebanho ovino. Um estudo de caso foi realizado em fazenda no município de Alto Paraguai, Mato Grosso. Entre os anos 2005 e 2014 houve visitas na propriedade para diagnóstico de doenças e realizou-se estudo comparativo da quantidade de mortes por doenças com as mortes por depredação. No ano de 2010 ocorreu um ataque depredatório que resultou em morte de seis ovinos. Em 2014, realizou-se um estudo na região central do Departamento del Valle del Cauca, há 2814m de altitude nos Andes colombianos, para diagnosticar a depredação de gado na região e implementar medidas para prevenir sua ocorrência e avaliar sua eficácia. No total, foram implementadas medidas anti-depredação sobre oito propriedades, e entre elas, um curral com cerca elétrica para ovelhas foi implementada em uma fazenda no município de Tuluá. Os resultados mostram que as perdas econômicas por depredação são graves nas duas regiões estudadas e se equiparam a perdas por doenças no estudo de caso em Mato Grosso, Brasil. Portanto recomenda-se a combinação entre o manejo sanitário, métodos de prevenção e, se necessário, mitigação de ataques depredatório. Além disso, legisladores devem se associar a pesquisadores para traçar estratégias efetivas para esse sério problema na América Latina.(AU)

In several parts of Latin America, the expansion of agriculture over the years has caused loss and reduction of wild fauna natural habitat. Recently, deaths of sheep and cattle have increased due to predation by large carnivores and the resulting retaliation by farmers on predators. Consequently, populations of these top predators have been reduced or have got even locally extinct, leading to imbalances on ecosystems, altered because of the carnivore effects on prey dinamics. The objective of this study is to analyse sheep depredation by puma (Puma concolor), in Central Brazil and in the Colombian Andes and point out preventive and mitigating measures that can be implemented in rural areas. From 2005 to 2014, we visited a ranch in Alto Paraguai, Mato Grosso, Brazil for diagnostic purposes and we compared the death of sheep from diseases and depredation attacks. In 2014, we visited a rural area in the central region of Departamento del Valle del Cauca, at 2814m of altitude in the Colombian Andes, to diagnose sheep predation, implement preventive measures, and evaluate their effectiveness. The results reveal that economic losses due to predation are critical on both studied regions and similar to losses by diseases in Mato Grosso state, Brazil. Thus, we recommend the integration of health management, preventive measures as well as mitigation of depredatory attacks at the local scale and we discuss potential sustainable measures that can be locally implemented by farmers. Furthermore, we recommend that public policies should incorporate scientific results on human-wildlife conflicts to be effective, considering both livestock management and biodiversity conservation.(AU)

Perioperative lumbar plexus block and cardiac ischemia in patients with hip fracture: randomized clinical trial / Bloqueio perioperatório do plexo lombar e isquemia cardíaca em pacientes com fratura de quadril: ensaio clínico randomizado

Abstract Background Perioperative myocardial ischemia is common among patients undergoing hip fracture surgery. Our aim is to evaluate the efficacy of perioperative continuous lumbar plexus block in reducing the risk of cardiac ischemic events of elderly patients undergoing surgery for hip fractures, expressed as a reduction of ischemic events per subject. Methods Patients older than 60 years, ASA II-III, with risk factors for or known coronary artery disease were enrolled in this randomized controlled study. Patients were randomized to conventional analgesia using opioid intravenous patient-controlled analgesia or continuous lumbar plexus block analgesia, both started preoperatively and maintained until postoperative day three. Continuous electrocardiogram monitoring with ST segment analysis was recorded. Serial cardiac enzymes and pain scores were registered during the entire period. We measured the incidence of ischemic events per subject registered by a continuous ST-segment Holter monitoring. Results Thirty-one patients (intravenous patient-controlled analgesia 14, lumbar plexus 17) were enrolled. There were no major cardiac events during the observation period. The number of ischemic events recorded by subject during the observation period was 6 in the lumbar plexus group and 3 in the intravenous patient-controlled analgesia group. This difference was not statistically significant (p = 0.618). There were no statistically significant differences in the number of cases with increased perioperative troponin values (3 cases in the lumbar plexus group and 1 case in the intravenous patient-controlled analgesia group) or in terms of pain scores. Conclusions Using continuous perineural analgesia, compared with conventional systemic analgesia, does not modify the incidence of perioperative cardiac ischemic events of elderly patients with hip fracture.

Resumo Justificativa A isquemia miocárdica perioperatória é comum em pacientes submetidos à cirurgia de fratura de quadril. Nosso objetivo foi avaliar a eficácia do bloqueio perioperatório contínuo do plexo lombar na redução do risco de eventos cardíacos isquêmicos em pacientes idosos submetidos à cirurgia para fraturas de quadril, expresso como uma redução de eventos isquêmicos por indivíduo. Métodos Pacientes com mais de 60 anos de idade, ASA II-III com fatores de risco para ou com doença coronariana conhecida foram incluídos neste estudo controlado e randomizado. Os pacientes foram aleatorizados para analgesia convencional usando analgésicos opioides para administração de analgesia intravenosa controlada pelo paciente (Intravenous Patient-Controlled Analgesia - IVPCA) ou analgesia contínua com o bloqueio do Plexo Lombar (PL), ambas iniciadas no pré-operatório e mantidas até o terceiro dia de pós-operatório. Monitoração contínua de ECG com análise do segmento ST foi registrada. Enzimas cardíacas seriadas e escores de dor foram registrados durante todo o período. Medimos a incidência de eventos isquêmicos por indivíduo registrados com monitoração contínua do segmento ST via Holter. Resultados Trinta e um pacientes (IVPCA 14, PL 17) foram incluídos. Não houve eventos cardíacos sérios durante o período de observação. O número de eventos isquêmicos registrados por sujeito durante o período de observação foi de seis no grupo PL e três no grupo IVPCA. Essa diferença não foi estatisticamente significativa (p = 0,618). Não houve diferenças estatisticamente significativas no número de casos com aumento dos valores de troponina no perioperatório (três casos no grupo LP e um caso no grupo IVPCA) ou em termos de escores de dor. Conclusões O uso da analgesia perineural contínua comparado ao da analgesia sistêmica convencional não modifica a incidência de eventos isquêmicos cardíacos no período perioperatório de pacientes idosos com fratura de quadril.