Curbing the major and growing threats from invasive alien species is urgent and achievable.

Although invasive alien species have long been recognized as a major threat to nature and people, until now there has been no comprehensive global review of the status, trends, drivers, impacts, management and governance challenges of biological invasions. The Intergovernmental Science-Policy Platform on Biodiversity and Ecosystem Services (IPBES) Thematic Assessment Report on Invasive Alien Species and Their Control (hereafter 'IPBES invasive alien species assessment') drew on more than 13,000 scientific publications and reports in 15 languages as well as Indigenous and local knowledge on all taxa, ecosystems and regions across the globe. Therefore, it provides unequivocal evidence of the major and growing threat of invasive alien species alongside ambitious but realistic approaches to manage biological invasions. The extent of the threat and impacts has been recognized by the 143 member states of IPBES who approved the summary for policymakers of this assessment. Here, the authors of the IPBES assessment outline the main findings of the IPBES invasive alien species assessment and highlight the urgency to act now.

Biological invasions are a population-level rather than a species-level phenomenon.

Biological invasions pose a rapidly expanding threat to the persistence, functioning and service provisioning of ecosystems globally, and to socio-economic interests. The stages of successful invasions are driven by the same mechanism that underlies adaptive changes across species in general-via natural selection on intraspecific variation in traits that influence survival and reproductive performance (i.e., fitness). Surprisingly, however, the rapid progress in the field of invasion science has resulted in a predominance of species-level approaches (such as deny lists), often irrespective of natural selection theory, local adaptation and other population-level processes that govern successful invasions. To address these issues, we analyse non-native species dynamics at the population level by employing a database of European freshwater macroinvertebrate time series, to investigate spreading speed, abundance dynamics and impact assessments among populations. Our findings reveal substantial variability in spreading speed and abundance trends within and between macroinvertebrate species across biogeographic regions, indicating that levels of invasiveness and impact differ markedly. Discrepancies and inconsistencies among species-level risk screenings and real population-level data were also identified, highlighting the inherent challenges in accurately assessing population-level effects through species-level assessments. In recognition of the importance of population-level assessments, we urge a shift in invasive species management frameworks, which should account for the dynamics of different populations and their environmental context. Adopting an adaptive, region-specific and population-focused approach is imperative, considering the diverse ecological contexts and varying degrees of susceptibility. Such an approach could improve and refine risk assessments while promoting mechanistic understandings of risks and impacts, thereby enabling the development of more effective conservation and management strategies.

Taming the terminological tempest in invasion science.

Standardised terminology in science is important for clarity of interpretation and communication. In invasion science - a dynamic and rapidly evolving discipline - the proliferation of technical terminology has lacked a standardised framework for its development. The result is a convoluted and inconsistent usage of terminology, with various discrepancies in descriptions of damage and interventions. A standardised framework is therefore needed for a clear, universally applicable, and consistent terminology to promote more effective communication across researchers, stakeholders, and policymakers. Inconsistencies in terminology stem from the exponential increase in scientific publications on the patterns and processes of biological invasions authored by experts from various disciplines and countries since the 1990s, as well as publications by legislators and policymakers focusing on practical applications, regulations, and management of resources. Aligning and standardising terminology across stakeholders remains a challenge in invasion science. Here, we review and evaluate the multiple terms used in invasion science (e.g. 'non-native', 'alien', 'invasive' or 'invader', 'exotic', 'non-indigenous', 'naturalised', 'pest') to propose a more simplified and standardised terminology. The streamlined framework we propose and translate into 28 other languages is based on the terms (i) 'non-native', denoting species transported beyond their natural biogeographic range, (ii) 'established non-native', i.e. those non-native species that have established self-sustaining populations in their new location(s) in the wild, and (iii) 'invasive non-native' - populations of established non-native species that have recently spread or are spreading rapidly in their invaded range actively or passively with or without human mediation. We also highlight the importance of conceptualising 'spread' for classifying invasiveness and 'impact' for management. Finally, we propose a protocol for classifying populations based on (i) dispersal mechanism, (ii) species origin, (iii) population status, and (iv) impact. Collectively and without introducing new terminology, the framework that we present aims to facilitate effective communication and collaboration in invasion science and management of non-native species.

Complicaciones vasculares en pacientes diabéticos con hemoglobina glicosilada alterada internados en el Centro Médico Nacional - Hospital Nacional periodo 2022 - 2023 / Vascular complications in diabetic patients with altered glycated hemoglobin admitted to Centro Médico Nacional - Hospital Nacional period 2022 ­ 2023

Introducción: la diabetes mellitus es una enfermedad crónica que, al no ser controlada, puede desencadenar en complicaciones macro y microvasculares. Uno de los indicadores de un adecuado control glucémico es la hemoglobina glicosilada. Objetivos: determinar la frecuencia de complicaciones macro y microvasculares en pacientes diabéticos tipo 2 con hemoglobina glicosilada alterada internados en el Hospital Nacional de Itauguá periodo 2022 - 2023 Metodología: estudio observacional, descriptivo de corte transversal que incluyó a 170 pacientes adultos internados en el servicio de clínica médica del Hospital Nacional (Itauguá, Paraguay) durante los años 2022 y 2023. Resultados: la edad media fue de 58 ± 12 años, con predominio del sexo femenino (51 %). La complicación más frecuentemente diagnosticada fue la enfermedad del pie relacionada a la diabetes con 83 pacientes (49 %), seguido por retinopatía diabética 23 (14 %). El valor promedio de hemoglobina glicosilada fue de 10 ± 2 %. Solamente 6 (4 %) del total de pacientes presentó un valor de HbA1C≥ 7,1 %. La comorbilidad asociada más frecuente fue la hipertensión arterial 87 (51 %). El 91 % de los pacientes conocía ser portador de la enfermedad, el 80 % recibía algún tipo de tratamiento. Conclusiones: el pie diabético fue la complicación vascular diagnosticada con mayor ,frecuencia, especialmente en pacientes con HbA1C≥ 7,1 %.

Introduction: diabetes mellitus is a chronic disease that, if not controlled, can lead to macro- and microvascular complications. One of the indicators of adequate glycemic control is glycosylated hemoglobin. Objectives: to determine the frequency of macro and microvascular complications in type 2 diabetic patients with altered glycosylated hemoglobin admitted to the Hospital Nacional from 2022 to 2023 Methodology: this was an observational, descriptive, cross-sectional study that included 170 adult patients admitted to the Internal Medicine service of the Hospital Nacional (Itauguá, Paraguay) during the years 2022 and 2023. Results: the mean age was 58 ± 12 years, with a predominance of the female sex (51 %). The most frequently diagnosed complication was foot disease related to diabetes with 83 patients (49 %), followed by diabetic retinopathy 23 (14 %). The average value of glycosylated hemoglobin was 10 ± 2 %. Only 6 (4 %) of the total patients had an HbA1C value ≤7 %. The most frequent associated comorbidity was arterial hypertension 87 (51 %). 91 % of the patients knew they were carriers of the disease, 80 % received some type of treatment. Conclusions: diabetic foot was the most frequently diagnosed vascular complication, especially in patients with HbA1C ≥7.1 %.

Infecciones más frecuentes en pacientes con Lupus Eritematoso Sistémico internados en el Servicio de Clínica Médica del Hospital Nacional / Most frequent infections in patients with Systemic Lupus Erythematosus admitted to the Medical Clinic Service of the Hospital Nacional

Introducción: el lupus eritematoso sistémico (LES) se conoce como una enfermedad autoinmune multisistémica, cuya causa es desconocida, se caracteriza por la presencia de complejos inmunes y autoanticuerpos. En series internacionales se describe una presentación de procesos infecciosos en estos pacientes hasta en un 75 % de los casos, las infecciones ocurren tanto al inicio de la enfermedad como en etapas tardías, y son causa directa de muerte en 30 % a 60 % de los casos y motivo de hospitalización hasta de 30 %. Objetivos: determinar los procesos infecciosos más frecuentes en pacientes con lupus eritematoso sistémico internados en el Servicio de Clínica Médica del Hospital Nacional en el periodo 2022-2023. Metodología: diseño observacional, descriptivo de corte transversal de pacientes con diagnóstico de lupus eritematoso sistémico según criterios de European League Against Rheumatism (EULAR)-2019 que se encuentran internados en el servicio de Clínica Médica del Hospital Nacional (Itaugua-Paraguay) en el periodo de 2022-2023. Resultados: la edad media de los pacientes fue de 34 años, con predominio del sexo femenino en el 88.18 %. Las infecciones del aparato respiratorio fue la más frecuentemente diagnosticada en 50 (45.45 %) pacientes, seguido por la infección de vías urinarias 47 (42.38 %) pacientes, el condicionante de riesgo predominante fue el uso de corticoides en un total 105 (96.40 %) pacientes, se estableció en un total de 97 (88.18 %) pacientes con antibioticoterapia, dentro del aspecto demográfico de la zona urbana 56 (50.90 %) pacientes y rural 54(49.1 %). Conclusión: la infección del aparato respiratorio fue la infección más frecuente, el condicionante de riesgo predominante es el uso de corticoides y recibieron antibioticoterapia la cual en monoterapia fue la más utilizada

Introduction: systemic lupus erythematosus (SLE) is known as a multisystem autoimmune disease, whose cause is unknown, and is characterized by the presence of immune complexes and autoantibodies. In international series, presentation of infectious processes is described in these patients in up to 75 % of cases. Infections occur both at the beginning of the disease and in late stages, and are a direct cause of death in 30 % to 60 % of patients. Cases and reason for hospitalization up to 30 %. Objectives: determine the most frequent infectious processes in patients with systemic lupus erythematosus admitted to the Medical Clinic Service of the Hospital Nacional in the period 2022-2023. Methodology: observational, descriptive cross-sectional design of patients with a diagnosis of systemic lupus erythematosus according to criteria of European League Against Rheumatism (EULAR)-2019 who are admitted to the Medical Clinic service of the Hospital Nacional (Itauguá-Paraguay) in the period of 2022-2023. Results: the average age of the patients was 34 years, with a predominance of the female sex in 88.18 %. Respiratory system infections were the most frequently diagnosed in 50 (45.45 %) patients, followed by urinary tract infection in 47 (42.38 %) patients. The predominant risk factor was the use of corticosteroids in a total of 105 (96.40 %) patients, it was established in a total of 97 (88.18 %) patients with antibiotic therapy, within the demographic aspect of the urban area 56 (50.90 %) patients and rural 54 (49.1 %). Conclusion: respiratory tract infection was the most frequent infection, the predominant risk factor is the use of corticosteroids and they received antibiotic therapy, which in monotherapy was the most used.

Economic costs of invasive non-native species in urban areas: An underexplored financial drain.

Urbanization is an important driver of global change associated with a set of environmental modifications that affect the introduction and distribution of invasive non-native species (species with populations transported by humans beyond their natural biogeographic range that established and are spreading in their introduced range; hereafter, invasive species). These species are recognized as a cause of large ecological and economic losses. Nevertheless, the economic impacts of these species in urban areas are still poorly understood. Here we present a synthesis of the reported economic costs of invasive species in urban areas using the global InvaCost database, and demonstrate that costs are likely underestimated. Sixty-one invasive species have been reported to cause a cumulative cost of US$ 326.7 billion in urban areas between 1965 and 2021 globally (average annual cost of US$ 5.7 billion). Class Insecta was responsible for >99 % of reported costs (US$ 324.4 billion), followed by Aves (US$ 1.4 billion), and Magnoliopsida (US$ 494 million). The reported costs were highly uneven with the sum of the five costliest species representing 80 % of reported costs. Most reported costs were a result of damage (77.3 %), principally impacting public and social welfare (77.9 %) and authorities-stakeholders (20.7 %), and were almost entirely in terrestrial environments (99.9 %). We found costs reported for 24 countries. Yet, there are 73 additional countries with no reported costs, but with occurrences of invasive species that have reported costs in other countries. Although covering a relatively small area of the Earth's surface, urban areas represent about 15 % of the total reported costs attributed to invasive species. These results highlight the conservative nature of the estimates and impacts, revealing important biases present in the evaluation and publication of reported data on costs. We emphasize the urgent need for more focused assessments of invasive species' economic impacts in urban areas.

Underexplored and growing economic costs of invasive alien trees.

The high ecological impacts of many invasive alien trees have been well documented. However, to date, we lacked synthesis of their economic impacts, hampering management actions. Here, we summarize the cost records of invasive trees to (I) identify invasive trees with cost information and their geographic locations, (II) investigate the types of costs recorded and sectors impacted by invasive trees and (III) analyze the relationships between categories of uses of invasive trees and the invasion costs attributed to these uses. We found reliable cost records only for 72 invasive trees, accumulating a reported total cost of $19.2 billion between 1960 and 2020. Agriculture was the sector with the highest cost records due to invasive trees. Most costs were incurred as resource damages and losses ($3.5 billion). Close attention to the ornamental sector is important for reducing the economic impact of invasive trees, since most invasive trees with cost records were introduced for that use. Despite massive reported costs of invasive trees, there remain large knowledge gaps on most invasive trees, sectors, and geographic scales, indicating that the real cost is severely underestimated. This highlights the need for further concerted and widely-distributed research efforts regarding the economic impact of invasive trees.

Termite sensitivity to temperature affects global wood decay rates.

Deadwood is a large global carbon store with its store size partially determined by biotic decay. Microbial wood decay rates are known to respond to changing temperature and precipitation. Termites are also important decomposers in the tropics but are less well studied. An understanding of their climate sensitivities is needed to estimate climate change effects on wood carbon pools. Using data from 133 sites spanning six continents, we found that termite wood discovery and consumption were highly sensitive to temperature (with decay increasing >6.8 times per 10°C increase in temperature)-even more so than microbes. Termite decay effects were greatest in tropical seasonal forests, tropical savannas, and subtropical deserts. With tropicalization (i.e., warming shifts to tropical climates), termite wood decay will likely increase as termites access more of Earth's surface.

[Argentine cross-cultural adaptation of the amyotrophic lateral sclerosis: functional rating scale-revised]. / Escala revisada de valoración funcional de esclerosis lateral amiotrófica: adaptación transcultural.

INTRODUCTION: Amyotrophic Lateral Sclerosis Functional Rating Scale-Revised is a basic tool for the evaluation of people with this disease. In our country, versions are used without the necessary methodological process to adapt them culturally and to be able to certify the plausibility of the data collected. It was our goal to generate an appropriate version adapted to Argentine Spanish. METHODS: Cross-cultural adaptation of the scale was carried out, producing its Argentine version. Said production was carried out according to internationally accepted methodological procedures: sequential process of translation / synthesis / back-translation and consolidation of the version obtained by a multidisciplinary committee that solved of disagreements under Delphi methodology. The version obtained was tested on ALS people to determine of the existing syntactic - pragmatic level of difficulty, after which the final version was constituted. Difficulty level analysis was performed according to indicators: mode, median, qualitative variation index, variation ratio, accumulated frequency of positive evaluations, identification / modification of observed items (determining criterion: concordance criterion = 80%). RESULTS: After 3 rounds of consultation, the version agreed upon by the committee was obtained, obtaining agreement levels of 83.33%-100%. Its testing involved 21 functional alphabets, natives/residents, 67% men, mean age 51 years old, mean evolution 1.4 years. The general indicators supported the understanding of the version and the absence of conflicting items. DISCUSSION: The version obtained demonstrated its conceptual content validity regarding the English version, presenting not semantic nor pragmatic conflicts affecting their use in an Argentine population of ALS patients.

Introducción: La Escala Revisada de Valoración Funcional de la Esclerosis Lateral Amiotrófica es una herramienta básica para la evaluación de personas con esta enfermedad. En nuestro país se utilizan versiones sin el proceso metodológico necesario para adaptarlas culturalmente y poder certificar lo verosímil de los datos recogidos. Fue nuestro objetivo generar una apropiada versión adaptada al español argentino. Métodos: Se realizó la adaptación transcultural de la escala produciendo su versión argentina, conforme procedimientos y medidas de verificación de calidad metodológica internacionalmente aceptadas: proceso secuencial de traducción/síntesis/retrotraducción; resolución de discrepancias y consolidación de la versión obtenida por comité multidisciplinario bajo metodología Delphi; puesta a prueba de dicha versión en una población de personas con esclerosis lateral amiotrófica analizando el nivel de dificultad sintáctico-pragmático; constitución de la versión final. El análisis del nivel de dificultad se constituyó en base a los siguientes indicadores: moda, mediana, índice variación cualitativa, razón de variación, frecuencia acumulada de apreciaciones positivas, identificación / modificación de ítems observados, tomando como base un criterio de concordancia = 80%. Resultados: Tras 3 rondas de consulta se obtuvo la versión consensuada por el comité, obteniéndose niveles de concordancia del 83,33%-100%. Su puesta a prueba involucró a 21 alfabetos funcionales, nativos/residentes, 67% hombres, media edad 51 años, media evolución 1,4 años. Ausencia de dificultad a nivel comprensión y la ausencia de ítems conflictivos. Discusión: La versión obtenida demostró su validez de contenido conceptual respecto de la original, sin presentar conflictos semánticos o pragmáticos que afecten su uso en nuestra población.

Experience of a virtual course of pneumonology for Medical students at the University of Buenos Aires during the COVID-19 pandemic / Experiencia de un curso virtual de la materia neumonología para alumnos de la carrera de Medicina de la Universidad de Buenos Aires durante la pandemia COVID-19

ABSTRACT Experience of a virtual course of pneumonology for Medical students at the University of Buenos Aires during the COVID-19 pandemic The COVID-19 pandemic not only affects people´s health: schools and universities around the world had to forcibly adapt to a distance education modality. Knowing that the epidemiological situation could continue for several months, the teachers of our Unit, in charge of teaching Pneumonology, had to anticipate and devise a contingency plan to ensure training continuity during 2020-21. The virtual courses took place in four weeks. The classes were given in mp4 format and virtual workshops. Once a week a virtual meeting was held to answer questions related to the content. The students had to be divided into groups to solve practical assignments and a final work with their defense at the end of the course. In addition, they conducted a survey to evaluate the course. The final exam was presential for the 2020 course and virtual for the 2021. All the students who took the exam approved. The experience was enriching, different and challenging. It allowed us to reflect and ask ourselves that the traditional way of teaching can and should be complemented with the resources that technology brings us. Although the total reopening of the University may seem uncertain, this is the opportunity to better plan the way out of the crisis and promote internal reflection on the renewal of the teaching and learning model.

RESUMEN La pandemia por COVID-19 no solo afecta la salud de las personas: escuelas y universidades de todo el mundo debieron adaptarse de forma forzosa a la modalidad de educación a distancia. Sabiendo que la situación epidemiológica de la pandemia podía continuar por varios meses, los docentes de nuestra Unidad, encargada de dictar la asignatura Neumonología, debimos anticiparnos e idear un plan de contingencia para asegurar la continuidad formativa durante el período 2020-21. Los cursos virtuales se llevaron a cabo en cuatro semanas. Se dictaron clases en formato mp4 y talleres virtuales. Una vez por semana se realizaba una reunión virtual para responder preguntas relacionadas con el contenido. Los alumnos debieron dividirse en grupos para resolver trabajos prácticos y un trabajo final con su defensa al completar el curso. Además, realizaron una encuesta para evaluar el curso. El examen final oral fue presencial para el curso 2020 y virtual para el de 2021, y aprobaron todos los alumnos que se presentaron. La experiencia fue enriquecedora, diferente y desafiante. Nos permitió reflexionar y plantearnos que la forma de enseñanza tradicional puede y debe complementarse con los recursos que la tecnología nos acerca. Aunque el momento de la reapertura total de la Universidad pueda parecer incierto, esta es la oportunidad para planificar mejor la salida de la crisis y promover la reflexión interna sobre la renovación del modelo de enseñanza y aprendizaje.

Experiencia de un curso virtual de la materia neumonología para alumnos de la carrera de Medicina de la Universidad de Buenos Aires durante la pandemia COVID-19 / Experience of a Virtual Course of Pneumonology For Medical Students At The University of Buenos Aires During The COVID-19 Pandemic

La pandemia por COVID-19 no solo afecta la salud de las personas: escuelas y universidades de todo el mundo debieron adaptarse de forma forzosa a la modalidad de educación a distancia. Sabiendo que la situación epidemiológica de la pandemia podía continuar por varios meses, los docentes de nuestra Unidad, encargada de dictar la asignatura Neumonología, debimos anticiparnos e idear un plan de contingencia para asegurar la continuidad formativa durante el período 2020-21. Los cursos virtuales se llevaron a cabo en cuatro semanas. Se dictaron clases en formato mp4 y talleres virtuales. Una vez por semana se realizaba una reunión virtual para responder preguntas relacionadas con el contenido. Los alumnos debieron dividirse en grupos para resolver trabajos prácticos y un trabajo final con su defensa al completar el curso. Además, realizaron una encuesta para evaluar el curso. El examen final oral fue presencial para el curso 2020 y virtual para el de 2021, y aprobaron todos los alumnos que se presentaron. La experiencia fue enriquecedora, diferente y desafiante. Nos permitió reflexionar y plantearnos que la forma de enseñanza tradicional puede y debe complementarse con los recursos que la tecnología nos acerca. Aunque el momento de la reapertura total de la Universidad pueda parecer incierto, esta es la oportunidad para planificar mejor la salida de la crisis y promover la reflexión interna sobre la renovación del modelo de enseñanza y aprendizaje.

Experience of a virtual course of pneumonology for Medical students at the University of Buenos Aires during the COVID-19 pandemic The COVID-19 pandemic not only affects people´s health: schools and universities around the world had to forcibly adapt to a distance education modality. Knowing that the epidemiological situation could continue for several months, the teachers of our Unit, in charge of teaching Pneumonology, had to anticipate and devise a contingency plan to ensure training continuity during 2020-21. The virtual courses took place in four weeks. The classes were given in mp4 format and virtual workshops. Once a week a virtual meeting was held to answer questions related to the content. The students had to be divided into groups to solve practical assignments and a final work with their defense at the end of the course. In addition, they conducted a survey to evaluate the course. The final exam was presential for the 2020 course and virtual for the 2021. All the students who took the exam approved. The experience was enriching, different and challeng ing. It allowed us to reflect and ask ourselves that the traditional way of teaching can and should be complemented with the resources that technology brings us. Although the total reopening of the University may seem uncertain, this is the opportunity to bet ter plan the way out of the crisis and promote internal reflection on the renewal of the teaching and learning model.

Escala revisada de valoración funcional de esclerosis lateral amiotrófica: adaptación transcultural / Argentine cross-cultural adaptation of the amyotrophic lateral sclerosis: functional rating scale-revised

Resumen Introducción: La Escala Revisada de Valoración Funcional de la Esclerosis Lateral Amiotrófica es una herramienta básica para la evaluación de personas con esta enfermedad. En nuestro país se utilizan versiones sin el proceso metodológico necesario para adaptarlas culturalmente y poder certificar lo vero símil de los datos recogidos. Fue nuestro objetivo generar una apropiada versión adaptada al español argentino. Métodos: Se realizó la adaptación transcultural de la escala produciendo su versión argentina, conforme proce dimientos y medidas de verificación de calidad metodológica internacionalmente aceptadas: proceso secuencial de traducción/síntesis/retrotraducción; resolución de discrepancias y consolidación de la versión obtenida por comité multidisciplinario bajo metodología Delphi; puesta a prueba de dicha versión en una población de perso nas con esclerosis lateral amiotrófica analizando el nivel de dificultad sintáctico-pragmático; constitución de la versión final. El análisis del nivel de dificultad se constituyó en base a los siguientes indicadores: moda, mediana, índice variación cualitativa, razón de variación, frecuencia acumulada de apreciaciones positivas, identificación/ modificación de ítems observados, tomando como base un criterio de concordancia ≥ 80%. Resultados: Tras 3 rondas de consulta se obtuvo la versión consensuada por el comité, obteniéndose niveles de concordancia del 83,33%-100%. Su puesta a prueba involucró a 21 alfabetos funcionales, nativos/residentes, 67% hombres, media edad 51 años, media evolución 1,4 años. Ausencia de dificultad a nivel comprensión y la ausencia de ítems conflictivos. Discusión: La versión obtenida demostró su validez de contenido conceptual respecto de la original, sin presentar conflictos semánticos o pragmáticos que afecten su uso en nuestra población.

Abstract Introduction: Amyotrophic Lateral Sclerosis Functional Rating Scale-Revised is a basic tool for the evaluation of people with this disease. In our country, versions are used without the necessary methodological process to adapt them culturally and to be able to certify the plausibility of the data collected. It was our goal to generate an appropriate version adapted to Argentine Spanish. Methods: Cross-cultural adaptation of the scale was ca rried out, producing its Argentine version. Said production was carried out according to internationally accepted methodological procedures: sequential process of translation / synthesis / back-translation and consolidation of the version obtained by a multidisciplinary committee that solved of disagreements under Delphi methodology. The version obtained was tested on ALS people to determine of the existing syntactic - pragmatic level of difficulty, after which the final version was constituted. Difficulty level analysis was performed according to indicators: mode, median, qualitative variation index, variation ratio, accumulated frequency of positive evaluations, identification/ modification of observed items (determining criterion: concordance criterion ≥ 80%). Results: After 3 rounds of consultation, the version agreed upon by the committee was obtained, obtaining agreement levels of 83.33%-100%. Its testing involved 21 functional alphabets, natives/residents, 67% men, mean age 51 years old, mean evolution 1.4 years. The general indicators supported the understanding of the version and the absence of conflicting items. Discussion: The version obtained demonstrated its conceptual content validity regarding the English version, presenting not semantic nor pragmatic conflicts affecting their use in an Argentine population of ALS patients.

Counterurbanization: A neglected pathway of forest transition.

Human settlement into rural areas (counterurbanization) is generating new patterns of reforestation, with distinctive features compared to the previously considered pathways of forest transition through "economic development" and "forest scarcity". Here, we discuss the specific features of this neglected pathway of forest recovery and describe the process with the support of study cases around the world. This pathway includes specific motivations (e.g., natural amenities, outdoor recreation), particular socio-economic processes, conflicts between newcomers and locals, and specific ecological outcomes (e.g., a larger proportion of non-native species in the new forests). Although this pathway locally affects small areas, as a widespread and expanding process around the world, counterurbanization could have a growing global effect, with the potential to modify biodiversity, ecosystem services, and cultural values. These novel characteristics should be further explored to better understand the patterns and processes of forest transitions in a context of a globally connected world.

The contribution of insects to global forest deadwood decomposition.

The amount of carbon stored in deadwood is equivalent to about 8 per cent of the global forest carbon stocks1. The decomposition of deadwood is largely governed by climate2-5 with decomposer groups-such as microorganisms and insects-contributing to variations in the decomposition rates2,6,7. At the global scale, the contribution of insects to the decomposition of deadwood and carbon release remains poorly understood7. Here we present a field experiment of wood decomposition across 55 forest sites and 6 continents. We find that the deadwood decomposition rates increase with temperature, and the strongest temperature effect is found at high precipitation levels. Precipitation affects the decomposition rates negatively at low temperatures and positively at high temperatures. As a net effect-including the direct consumption by insects and indirect effects through interactions with microorganisms-insects accelerate the decomposition in tropical forests (3.9% median mass loss per year). In temperate and boreal forests, we find weak positive and negative effects with a median mass loss of 0.9 per cent and -0.1 per cent per year, respectively. Furthermore, we apply the experimentally derived decomposition function to a global map of deadwood carbon synthesized from empirical and remote-sensing data, obtaining an estimate of 10.9 ± 3.2 petagram of carbon per year released from deadwood globally, with 93 per cent originating from tropical forests. Globally, the net effect of insects may account for 29 per cent of the carbon flux from deadwood, which suggests a functional importance of insects in the decomposition of deadwood and the carbon cycle.

La transición de adolescentes con enfermedades neurológicas y compromiso respiratorio. Perspectiva de un servicio de neumonología de un hospital de adultos / Transition of Adolescents with Neurological Diseases and Respiratory Involvement. Perspective from the Pulmonology Service of an Adult Hospital

Los avances en los tratamientos médicos y las mejoras en la calidad de la atención logran que un número creciente de adolescentes con enfermedades crónicas lleguen a la adultez y requieran la atención de médicos especialistas de adultos1-3. El pasaje de un centro asistencial pediátrico a otro de adultos es un proceso complejo que puede traer aparejado dificultades para todos los actores intervinientes. .

A Global Review of Ligustrum Lucidum (OLEACEAE) Invasion.

Ligustrum lucidum is a highly invasive East Asian tree that successfully colonizes several subtropical and temperate areas around the world. Its invasion capacity results from a widespread human use mostly in urban and periurban settings, very abundant fruit and seed production, small bird-dispersed fruits, high germination rates, resprouting capacity, fast growth rates, low herbivory levels and tolerance to a wide range of light, temperature and soil. All these traits contribute to its ability to rapidly increase in abundance, alter biodiversity, landscape ecology and limit its management. This paper reviews the current knowledge on L. lucidum with particular focus on its uses, distribution, invasiveness, ecological and economic impacts and control measures. Most relevant aspect of the review highlight the negative ecological impacts of L. lucidum, its potential to continue expanding its range of distribution and the need of further studies on the eco-physiology of the species, economic impact and social perception of its invasion and early warning systems.

DEPDC5 mutation and familial focal epilepsy with variable foci: genotype and phenotype of a family.

Familial focal epilepsy with variable foci is a relatively rare autosomal disease with an unclear incidence, which is characterized by focal seizures arising from different cortical regions in different family members. We describe three members of a two-generation Argentine family with familial focal epilepsy with variable foci syndrome and a DEPDC5 gene mutation. The mean onset age was nine years old. The father experienced episodes with occipital semiology and both siblings exhibited frontal lobe seizures. Their neurological examination and neuroimaging studies were normal. All three patients are currently seizure-free, in spite of initially experiencing frequent seizures. Complete exome sequencing revealed a new DEPDC5 gene mutation (NM_001242896: c.4718T>C; p.L1573P). This study of a family with clinical characteristics that met all the criteria for familial focal epilepsy with variable foci demonstrates the usefulness of exome sequencing as a diagnostic tool. [Published with video sequence on www.epilepticdisorders.com].

Supervivencia en una cohorte de pacientes con enfermedad pulmonar obstructiva crónica acorde a la clasificación GOLD 2017 / Survival in a cohort of patients with chronic obstructive pulmonary disease according to GOLD 2017 classification

Hasta el momento, no existe información sobre la evolución de los pacientes con enfermedad pulmonar obstructiva crónica (EPOC) de acuerdo con la nueva clasificación GOLD 2017. El objetivo de este estudio fue determinar, en una cohorte de pacientes con EPOC seguidos por veinte años, la influencia del cambio a la nueva clasificación en resultados de supervivencia por grupos y su asociación con otras variables como comorbilidades. Se evaluaron enfermos con EPOC (definición GOLD 2017) con seguimiento desde enero de 1996 a diciembre de 2016. Se usaron estadísticas convencionales y análisis de supervivencia de Log- Rank (Mantel-Cox). Se analizaron 354 pacientes: edad 66.5 ± 8.4, 66.7% hombres; ex-tabaquistas: 74.2% (56 paquetes-año); índice de Charlson 4.1 ± 1.7. A los 20 años, estaban vivos 219 (62%) y fallecidos 135 (38%), con un seguimiento de 28 meses (12-54.7). En el análisis uni y multivariado, el sexo masculino y la edad se asociaron a mayor mortalidad. Teniendo en cuenta solo la espirometría, a peor grado de obstrucción al flujo aéreo, la supervivencia es menor. Con la clasificación ABCD 2017, la peor supervivencia se encuentra en el grupo D y solo en este grupo es independiente del nivel de deterioro del VEF1 (p = 0.005). La nueva clasificación ABCD es predictora de mortalidad solo si está asociada a la función pulmonar.

Until now, there is no information on the evolution of patients with chronic obstructive pulmonary disease (COPD) according to the new GOLD classification. The objective of this study was to determine, in a cohort of patients with COPD followed by twenty years, the impact of the change to the new classification: survival by groups and their association with other variables such as comorbidities. COPD patients (GOLD 2017 definition) were evaluated with follow-up since January 1996 to December 2016. Conventional statistics and Log-Rank survival analysis (Mantel-Cox) were used. We analyzed 354 patients: age 66.5 ± 8.4, 66.7% men. Former smokers 74.2% (56 pack-year). Charlson index 4.1 ± 1.7. At the end of study 219 (62%) were alive and 135 (38%) died. The follow-up was 28 months (12-54.7). In the univariate and multivariate analysis, male sex and age were associated with higher mortality. Considering only the spirometry, to a worse degree of airflow obstruction, corresponded a lower survival. With the ABCD 2017 classification, the worst survival was observed in group D. Only in this group, survival is independent of the level of deterioration of FEV1 (p = 0.005). The new ABCD classification is a mortality predictor, only if it is associated to pulmonary function.

[Survival in a cohort of patients with chronic obstructive pulmonary disease according to GOLD 2017 classification]. / Supervivencia en una cohorte de pacientes con enfermedad pulmonar obstructiva crónica acorde a la clasificación GOLD 2017.

Until now, there is no information on the evolution of patients with chronic obstructive pulmonary disease (COPD) according to the new GOLD classification. The objective of this study was to determine, in a cohort of patients with COPD followed by twenty years, the impact of the change to the new classification: survival by groups and their association with other variables such as comorbidities. COPD patients (GOLD 2017 definition) were evaluated with follow-up since January 1996 to December 2016. Conventional statistics and Log-Rank survival analysis (Mantel-Cox) were used. We analyzed 354 patients: age 66.5 ± 8.4, 66.7% men. Former smokers 74.2% (56 pack-year). Charlson index 4.1 ± 1.7. At the end of study 219 (62%) were alive and 135 (38%) died. The follow-up was 28 months (12-54.7). In the univariate and multivariate analysis, male sex and age were associated with higher mortality. Considering only the spirometry, to a worse degree of airflow obstruction, corresponded a lower survival. With the ABCD 2017 classification, the worst survival was observed in group D. Only in this group, survival is independent of the level of deterioration of FEV1 (p = 0.005). The new ABCD classification is a mortality predictor, only if it is associated to pulmonary function.