Calculating minimum safety distance against wildfires at the wildland-urban interface in Chile and Spain.

Wildfires in the urban-forest interface constitute a civil protection emergency, causing considerable personal injury and damage to properties. The potential impacts of wildfires on buildings can be minimized by reducing the surrounding fuel and the use of structural materials with low flammability. However, the costs associated with implementing these actions and the responsibility for maintenance usually present conflicts with the property owners. This study aimed to identify minimum safety distances in wildland-urban interfaces within priority areas. The priority areas were identified based on the integration of fire risk and fuel hazard. Radiant heat is a variable in the behavior of fire that directly influences the definition of safety distances. In this research the radiant heat transfer was calculated based on the potential fire behavior for each study area. A comparative study of the horizontal heat transfer method and the radiant heat flux model was carried out. The horizontal heat transfer method indicated the highest vegetation-free distances, ranging from 23 m to 32 m. Some safety distances were validated using experimental fires and wildfires. The findings from the experimental fires and wildfires emphasize the need for a progressive fuel load reduction to mitigate radiant heat transfer. This may include both the removal of surface fuel and removal of trees to mitigate against crown fires. Our findings provide relevant information for decision-making on the effectiveness and efficiency of safety distances at the wildland-urban interface.

Hydrocephalus in Mexican children with Coccidioidal Meningitis: Clinical, serological, and neuroimaging findings.

BACKGROUND: Coccidioidal meningitis (CM) is a fungal infectious disease that rarely affects children. Even in endemic areas, coccidiomycosis rarely affects the pediatric population. However, 40% of affected children develop hydrocephalus. Here, we describe the clinical, serological, and neuroimaging findings in a series of Mexican children admitted to our neurosurgical service with hydrocephalus and subsequently diagnosed with CM. METHODS: We report a prospective series of pediatric patients with hydrocephalus secondary to CM in an endemic area at the north of Mexico. Our report includes children with CM who were hospitalized from 2015 to 2019 in a regional hospital in Torreón, Coahuila. Clinical evolution was monitored for 1 year after hospital discharge. RESULTS: Our series include five children with CM (2-17-years-old, three female), who were hospitalized for hydrocephalus and developed intracranial hypertension. The most frequent neuroimaging findings were leptomeningeal enhancement (5/5) and basal arachnoiditis (4/5), followed by asymmetric hydrocephalus (3/5), abnormalities in fourth ventricle morphology (3/5), and cerebral vasculitis (2/5). CM was diagnosed by positive serology or pathology studies. All children were initially managed with fluconazole and a shunt was placed for management of hydrocephalus. Four patients recovered without permanent neurological deficits and one subject developed persistent vegetative state. One year after hospital discharge, none of the subjects died. CONCLUSION: This series contributes to the limited number of pediatric CM cases reported in the literature, and describes neuroimaging findings in the pediatric population. The cases here presented show that the identification of Coccidioides as causal agent in pediatric meningitis is crucial for targeted treatment and can affect dramatically neurological prognosis. Furthermore, our report stresses that even in endemic areas pediatric coccidiomycosis represents a diagnostic challenge, which is further exacerbated by the limited availability of resources in these regions. Therefore, a positive immunoglobulin G by enzyme immunoassay is enough for diagnosis of CM in endemic areas without access to CF.

Impact of the Coronavirus Disease 2019 Pandemic on Working and Training Conditions of Neurosurgery Residents in Latin America and Spain.

BACKGROUND: The coronavirus disease 2019 (COVID-19) pandemic has exerted a significant impact on health care workers. Recent studies have reported the detrimental effects of the pandemic on neurosurgery residents in North America, Asia, and Italy. However, the impact of the pandemic on neurosurgical training in Latin America and Spain has not yet been reported. In the present report, we describe effects of COVID-19 on training and working conditions of neurosurgery residents in these countries. METHODS: An electronic survey with 33 questions was sent to neurosurgery residents between September 7, 2020 and October 7, 2020. Statistical analysis was made in SPSS version 25. RESULTS: A total of 293 neurosurgery residents responded. The median age was 29.47 ± 2.6 years, and 79% (n = 231) were male. Of respondents, 36.5% (n = 107) were residents training from Mexico; 42% surveyed reported COVID symptoms and 2 (0.7%) received intensive care unit care; 61.4% of residents had been tested for COVID and 21.5% had a positive result; 84% of the respondents mentioned persisted with the same workload (≥70 hours per week) during the pandemic. Most residents from Mexico were assigned to management of patients with COVID compared with the rest of the countries (88% vs. 68.3%; P < 0.001), mainly in medical care (65.4% vs. 40.9%; P < 0.001), mechanical ventilators (16.8% vs. 5.9%; P = 0.003), and neurologic surgeries (94% vs. 83%; P = 0.006). CONCLUSIONS: Our results offer a first glimpse of the changes imposed by the COVID-19 pandemic on neurosurgical work and training in Latin America and Spain, where health systems rely strongly on a resident workforce.

Discrimination of residents during neurosurgical training in Mexico: Results of a survey prior to SARS-CoV-2.

BACKGROUND: Recent severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic represents an important negative impact on global training of neurosurgery residents. Even before the pandemic, discrimination is a challenge that neurosurgical residents have consistently faced. In the present study, we evaluated discriminatory conditions experienced by residents during their neurosurgical training in Mexico before the SARS-CoV-2 pandemic. METHODS: An electronic survey of 18 questions was sent among residents registered in the Mexican Society of Neurological Surgery (MSNS), between October 2019 and July 2020. Statistical analysis was made in IBM SPSS Statistics 25. The survey focused on demographic characteristics, discrimination, personal satisfaction, and expectations of residents. RESULTS: A response rate of 50% (132 of 264 residents' members of MSNS) was obtained and considered for analysis. Median age was 30.06 ± 2.48 years, 5.3% (n = 7) were female and 16.7% (n = 22) were foreigners undergoing neurosurgical training in Mexico. Approximately 27% of respondents suffered any form of discrimination, mainly by place of origin (9.1%), by gender (8.3%) or by physical appearance (6.1%). About 42.9% (n = 3) of female residents were discriminated by gender versus 6.4% (n = 8) of male residents (P = 0.001); while foreign residents mentioned having suffered 10 times more an event of discrimination by place of origin compared to native Mexican residents (36.4% vs. 3.6%, P < 0.001). CONCLUSION: This manuscript represents the first approximation to determine the impact of discrimination suffered by residents undergoing neurosurgical training in Mexico before the SARS-CoV-2 pandemic.

High-peak-power pulse generation from a monolithic master oscillator power amplifier at 1.5 µm.

We present an experimental study on the generation of high-peak-power short optical pulses from a fully integrated master-oscillator power-amplifier emitting at 1.5 µm. High-peak-power (2.7 W) optical pulses with short duration (100 ps) have been generated by gain switching the master oscillator under optimized driving conditions. The static and dynamic characteristics of the device have been studied as a function of the driving conditions. The ripples appearing in the power-current characteristics under cw conditions have been attributed to mode hopping between the master oscillator resonant mode and the Fabry-Perot modes of the entire device cavity. Although compound cavity effects have been evidenced to affect the static and dynamic performance of the device, we have demonstrated that trains of single-mode short optical pulses at gigahertz frequencies can be conveniently generated in these devices.

Reflexiones del desempeño profesional del fisioterapeutaen el campo de la actividad física / Reflections about physiotherapist professional performance in the field of physical activity / Reflexões do desempenho profissional do fisioterapeuta na área da actividade física

En sus inicios, el accionar profesional del fisioterapeuta se centró en el ámbito clínico, pero hoy en día cuenta con muchos más campos de acción, entre ellos el de la actividad física, la cual puede ser vista desde dos dimensiones: una biológica, entendida como toda actividad que demanda un gasto energético involucrando la acción conjunta de múltiples sistemas para garantizar la ejecución de dicha actividad, y otra social, como una actividad humana que imprime unas condiciones de subjetividad mediada por los contextos en donde el individuo y comunidad la desarrollan. Teniendo en cuenta estas dimensiones y los referentes nacionales e internacionales, el objetivo de este documento es presentar una serie de reflexiones de los autores sobre el desempeño profesional del fisioterapeuta en el campo de la actividad física y las enormes posibilidades que de allí se derivan para el ejercicio profesional en dicho campo.

The physiotherapist professional activities, in the beginning were focused only in the clinical field, nowadays it has many different action fields including Physical Activity. Physical activity can be viewed from two dimensions: one biological, which is defined as any activity which requires energy expenditure involving the combined action of multiple systems; on the other side social, understood as a human activity concerning subjectivity conditions influenced by the environment where the individual and the community are developed. Given these dimensions as well as national and international benchmarks this paper's objective is to present a series of reflections that the authors have done regarding the physiotherapist professional performance in the field of physical activity and the large possibilities derived from their practice in this field.

As ações profissionais do fisioterapeuta, desde a iniciação, foram focalizadas na área clínica só; hoje em dia as áreas profissionais têm se desenvolvido muito mais e entre elas está a atividade física. A atividade física pode ser conceituada desde duas dimensões, uma biológica onde é entendida como toda atividade que precisa de um gasto de energia envolvendo a ação conjunta de múltiplos sistemas para garantir a execução das atividades, e uma social, entendida como aquela atividade humana que taz umas condições de subjetividade mediada pelos contextos onde a pessoa e a comunidade se desenvolvem. Levando em consideração estas dimensões e referentes nacionais e internacionais se pretende apresentar uma série de reflexões que os autores têm realizado frente ao desempenho profissional do fisioterapeuta na área da atividade física, e as possibilidades que são derivadas para o exercício profissional desta área.

Feasibility of conditioning with thymoglobulin and reduced intensity TBI to reduce acute GVHD in recipients of allogeneic SCT.

Murine studies using anti-T-cell antibodies for conditioning in allogeneic SCT demonstrate engraftment with low rates of GVHD. On the basis of this preclinical model, we conditioned 30 patients with advanced hematologic malignancies with rabbit antithymocyte globulin (ATG) and TBI, to reduce rates of fatal acute GVHD. Patients were enrolled in two sequential groups: cohort 1 received ATG 10 mg/kg in divided doses (days -4 to -1)+200 cGy TBI (n=16), and cohort 2 received ATG (days -10 to -7)+450 cGy TBI (n=14). Median donor blood chimerism for the combined group was 94, 93 and 93% in the first, second and third months after transplant. Only three developed grade II acute GVHD despite 43% of patients receiving unrelated donor transplants. One-year survival was 71+/-11 and 54+/-14%, respectively, in recipients of related and unrelated donor SCT. Donor lymphocyte infusions were needed in 12 patients for the management of relapse and for mixed donor-recipient chimerism in 4 patients. We conclude that 10 mg/kg ATG and TBI allows engraftment with a low risk of acute GVHD; however, further dose optimization of ATG is required to achieve a balance between GVHD and disease relapse.

[Hypokalemic metabolic alkalosis: apropos of a case of Gitelman's syndrome]. / Alcalosis metabólica hipopotasémica: a propósito de un síndrome de Gitelman.

We present a case of Gitelman's Syndrome in a 20 year-old woman who came to our service with weakness, asthenia, leg cramps and tetany. Laboratory studies revealed metabolic alkalosis with hypokalemia, hypomagnesemia and low calcium in a 24-hour urine test. The diagnosis of this syndrome is made in some cases during adult life because this syndrome is asymptomatic over several years. Gitelman's Syndrome is autosomal recessive as is Bartter's Syndrome. The gene is located in chromosome 16q, which encodes the cotransporter Na/Cl sensitive to thiazide in the distal convoluted tubule. The defect of cotransporter produces an alteration of sodium reabsorption that causes electrolytic disorders typical of this Syndrome and different from Bartter's Syndrome. The typical electrolytic alterations are hypocalciuria and hypomagnesemia secondary to high urinary magnesium excretion. The prognosis of this syndrome is excellent and treatment consists in correction of serum electrolytes with oral administration of magnesium and potassium. In spite of this treatment, in some cases it is very difficult to reach normal serum levels of magnesium because of the high doses of oral magnesium, which produce common crises of diarrhea that increase magnesium gastrointestinal losses.

Alcalosis metabólica hipopotasémica: a propósito de un síndrome de Gitelman / Metabolic alkalosis: gitelman´s syndrome

El síndrome de Gitelman es una tubulopatía de herencia autosómica recesiva, al igual que el síndrome de Bartter. Si bien en un principio se pensó que podían tratarse de una misma patología, hallazgos clínicos, biológicos y genéticos posteriores han demostrado que nos encontramos ante dos entidades patológicas diferentes. Ambos síndromes cursan con alcalosis metabólica hipopotasémica con normotensión, hiperreninismo e hiperaldosteronismo. Uno de los hallazgos más característicos en el Gitelman es la hipomagnesemia persistente, así como la hipocalciuria, que lo diferencian del síndrome de Bartter. La alteración fundamental se halla en el túbulo distal, concretamente a nivel del cotransportador Na/Cl sensible a las tiazidas, codificado en el cromosoma 16q. El defecto primario consiste en una incapacidad para la reabsorción de sodio que será la responsable de la secuencia de alteraciones electrolíticas que caracterizan al síndrome (AU)

We present a case of Gitelman’s Syndrome in a 20 year-old woman who come to our service with weakness, asthenia, leg cramps and tetany. Laboratory studies revealed metabolic alkalosis with hypokaliemia, hipomagnesemia and low calcium in 24 hours urine test. The diagnosis of this syndrome is made in some cases during adult life because this syndrome is asymptomatic over several years. Gitelman’s Syndrome is autosomal recessive as is Bartter’s Syndrome. The gene is located in chromosome 16q, which codifies the cotransporter Na/Cl sensitive to thiazide in distal convoluted tubule. The defect of cotransporter produces an alteration of sodium reabsorption that causes electrolytic disorders typical of this Syndrome and different from Bartter’s Syndrome. The typical electrolytic alterations are hypocalciuria and hypomagnesemia secondary to high urinary magnesium excretion. The prognosis of this syndrome is excellent and treatment consists in correction of serum electrolytes with oral administration of magnesium and potassium. In spite of this treatment, in some cases it is very difficult to reach normal serum levels of magnesium because of the high doses of oral magnesium, which produce common crises of diarrhea that increase magnesium gastrointestinal losses (AU)

Estimulación de la proliferación de las células de leucemia aguda linfoblástica en cultivo / Stimulation of acute lymphoblastic leukemia cell proliferation in cell cultures

Para conocer los estimulantes mitógenos más adecuados para la iniciación de la actividad mitótica de los blastos se utilizaronultivos de 20 muestras de células de leucemia aguda linfoblástica (LAL). Se analizaron diferentes concentraciones de fitohemaglutinina (PHA), lectina (Phitolacca americana) (FL) y 2-mercaptoetanol (2-ME) mediante la estimulación de cultivos celulares de 20 muestras. La mucoproteina extraída de las plantas (PHA) resultó ser el mejor activador de la mitosis y de la proliferación. A una concentración de 2.5 mg/ml, ocurrió la división celular; en su ausencia, no se observó proliferación celular. Por otra parte, la FL tuvo un efecto menor de la activación de la mitosis en los cultivos; y el 2-ME no presentó efecto alguno sobre la proliferación de estas células. Además, se observó que la acción mitogénica de la PHA implica la activación de la replicación del ADN celular, tal y como lo demostró la incorporación de [3H]-timidina