Search

The present study hopes to clarify the participation of women's work in secondary sector activities, which include those in manufacturing, mining and quarrying, energy subsector and construction; transcending in turn to the measurement of the economic impact or effect in the rest of the sectors in Panama. The methodology involves the use of data from the VI National Economic Census in its volume III called "Miscellaneous economic activities"; as well as the information of the Supply and Use Tables, both presented by the National Institute of Statistics and Census; and the application of impact analysis as part of the methodology of the Input-Output Tables. The results confirm the gender gap considering participation in the labor market; However, women's work is more productive than men's when measuring the impact, considering purchases and investment in each subsector or economic activity in the secondary sector, for the years analyzed in 2007, 2010 and 2015.

El presente artículo tiene como objetivo el evidenciar la generación de CO2 de los sectores que producen los alimentos, considerando la intensidad energética requerida. La metodología utilizada para lograr este objetivo son las tablas Input-Output 2007, 2010 y 2015, las cuales están agrupadas en 43 sectores de la economía, basadas en los cuadros de oferta y utilización del Sistema de Cuentas Nacionales, además de utilizar la base de datos del Banco Mundial elaborada por el Centro de Análisis de Información de Dióxido de Carbono, División de Ciencias Ambientales del Laboratorio Nacional de Oak Ridge y la base de datos de emisiones para la investigación atmosférica global (a partir de aquí EDGAR), producida por el Centro Común para Investigaciones de la Comisión Europea (JRC), para estimar tales emisiones en cada sector. Los resultados concluyen que las emisiones de CO2 vertidas por los subsectores primarios panameños representan apenas el 2.9% para el 2007, 2% para el 2010 y 1.9% para el 2015, producto de la limitada utilización de energéticos derivados del petróleo, cuya tendencia explica también la desarticulación de estos sectores en la economía panameña.

Recognition of the causes of early mortality (≤30 days) after transvenous lead removal (TLR) is an essential step for the development of quality improvement programs.This study sought to determine the causes of early mortality after TLR and to further understand the circumstances surrounding death after TLR.A retrospective analysis was performed of all patients undergoing TLR from January 1, 2001, to January 1, 2021, at the Mayo Clinic (Rochester, Minnesota; Phoenix, Arizona; and Jacksonville, Florida). Causes of death were identified through a detailed chart review of the electronic health record from within the Mayo Clinic system and outside records when available. The causes of death were further characterized based on whether it was related to the TLR procedure.A total of 2,319 patients were included in the study. The overall 30-day all-cause mortality rate was 3% (n = 69). Among all 30-day deaths, infection was the most common primary cause of death (42%). This was followed by decompensated heart failure (17%), procedure-related death (10%), sudden cardiac arrest (7%), and respiratory failure (6%). The 30-day mortality rate directly due to complications associated with the TLR procedure was 0.3%. One-third of deaths (33%) occurred after discharge from the index hospitalization; among these, 43% were readmitted before their death, 35% died at home or at a nursing facility, and 22% were discharged on comfort care and died in hospice. The main reasons for readmission before death were sepsis and decompensated heart failure.The majority (90%) of 30-day mortality after TLR was not due to complications associated with TLR procedures. The primary causes were infection and decompensated heart failure. This highlights the importance of increased emphasis on postprocedure management of infection and heart failure to reduce postoperative mortality, including after hospital discharge.

Background: Atypical Atrial Flutter (AAFL) prevalence is increasing due to the escalating Atrial Fibrillation (AF) ablations and cardiac surgeries. We wanted to explore the outcome of the AAFL ablation, considering the recent changes in mapping and ablation. Methods: This study was approved by the Institutional Review Board (IRB) of Mayo Clinic hospital. We retrospectively studied 419 patients who had undergone AAFL ablation at Mayo Clinic from January 2017 to June 2022. Thirteen patients declined research authorization, and 19 patients were lost to follow-up during the 90-day blanking period, resulting in a sample size of 387. The median follow-up time for patients was 25.7 months (95% CI 23.7, 32.3). Results: Recurrent symptoms with documentation of atrial arrhythmia Occurred in 226/387 (58.4%) patients, of which 151/226 (66.8%) occurred within the first year. The median time to recurrence was 8.5 months (max 57.8 months). Eleven patients died during the study period, 9 of whom experienced recurrence prior to death. Overall, the median recurrence-free survival (RFS) time was 16.6 months (95% CI 13.2, 20.0) with a 1-year RFS rate of 57.2% (95% CI 52.2, 62.7%). Acute termination occurred 324/387 (83.7%) during the ablation. The 1-year RFS rate was 58.9% (95% CI 53.5%, 64.9%) for patients with acute termination and 49.0% (95% CI 37.9%, 63.4%) for those without acute termination. The rate was not significantly different based on acute termination status (p = 0.11). Conclusions: The one-year RFS rate of 57.2% following AAFL ablation, even though 83.7% achieved acute termination during the procedure, signifies the extent of the underlying substrate abnormalities.

Esta investigación busca esclarecer las condiciones macroeconómicas que produjeron la caída del empleo en Panamá para el 2020, alcanzando una tasa de desempleo histórica del 18.5% como consecuencia de la enfermedad del Covid-19. La metodológico contempla la utilización de la técnica de descomposición estructural como parte de la metodología input-output; con la finalidad de valorar los cambios en la estructura del modelo de demanda de la economía y los respectivos requerimientos de empleos por grupos actividades económicas, en función a las medidas adoptadas para controlar la enfermedad. Los resultados constatan que la estructura económica panameña, tal como está, permite la pérdida de empleo de forma tal, que Panamá pasa del puesto 54 en el 2018 a la posición 9 del ranking recogido en el Atlas mundial de datos en el 2020 y cuya fuente de información parten de las estadísticas recogidas por la Organización Internacional del Trabajo.

Understanding the timing of vitellogenesis is essential for identifying threats to the reproductive success of endangered oviparous vertebrate species, such as sea turtles. We measured concentrations of testosterone (T) and vitellogenin (VTG) in green sea turtles (Chelonia mydas) nesting at Tortuguero, Costa Rica, as biomarkers of ovarian development. Testosterone concentration increased from the first to second month and VTG concentration increased at the third week of sampling. These results show that Tortuguero green sea turtles were still producing both biomarkers early into the nesting season. VTG concentration was negatively correlated with female weight, suggesting that larger females start nesting earlier at Tortuguero and that we may have sampled larger females further into their reproductive cycle.

Atrial fibrillation is a common clinical manifestation in hospitalized patients with coronavirus disease 2019 (COVID‐19). Medications used to treat atrial fibrillation, such as antiarrhythmic drugs and anticoagulants, may have significant drug interactions with emerging COVID‐19 treatments. Common unintended nontherapeutic target effects of COVID‐19 treatment include potassium channel blockade, cytochrome P 450 isoenzyme inhibition or activation, and P‐glycoprotein inhibition. Drug‐drug interactions with antiarrhythmic drugs and anticoagulants in these patients may lead to significant bradycardia, ventricular arrhythmias, or severe bleeding. It is important for clinicians to be aware of these interactions, drug metabolism changes, and clinical consequences when choosing antiarrhythmic drugs and anticoagulants for COVID‐19 patients with atrial fibrillation. The objective of this review is to provide a practical guide for clinicians who are managing COVID‐19 patients with concomitant atrial fibrillation.

El proceso juridico entre las republicas de Peru y Chile ante la Corte Internacional de Justicia para establecer los limites maritimos entre ambos paises, merecio la elaboracion de una estrategia de comunicacion a cargo de la Cancilleria peruana para promover una opinion publica a favor de las acciones de politica exterior del Estado peruano e informar a su ciudadania los alcances del fallo que pusieron fin a esta controversia; todo ello como un ejemplo de que dos paises pueden resolver sus diferencias de manera pacifica. Palabras clave: Relaciones Internacionales, diplomacia publica, estrategia de comunicacion, opinion publica. DOI: https://doi.org/10.24265/iggp.2020.v7n1.04

Mitral Valve Injury with Catheter Ablation Introduction An increasing number of catheter ablations involve the mitral annular region and valve apparatus, increasing the risk of catheter interaction with the mitral valve (MV) complex. We review our experience with catheter ablation-related MV injury resulting in severe mitral regurgitation (MR) to delineate mechanisms of injury and outcomes. Methods We searched the Mayo Clinic MV surgical database over a 19-year period (1993–2012) and the electrophysiologic procedures database over a 23-year period (1990–2013) and identified 9 patients with catheter ablation related MV injury requiring clinical intervention. Results Indications for ablation included atrial fibrillation (AF) [n = 4], ventricular tachycardia (VT) [n = 3], and left-sided accessory pathways [n = 2]. In all 4 AF patients, a circular mapping catheter entrapped in the MV apparatus was responsible for severe MR. In all 3 VT patients, radiofrequency energy delivery led to direct injury to the MV apparatus. In the 2 patients with accessory pathways, both mechanisms were involved (1 per patient). Six patients required surgical intervention (5 MV repair, 1 catheter removal). One patient developed severe functional MR upon successful endovascular catheter disentanglement that improved spontaneously. Two VT patients with persistent severe postablation MR were managed nonsurgically, 1 of whom died 3 months postprocedure. Conclusion Circular mapping catheter entrapment and ablation at the mitral annulus are the most common etiologies of MV injury during catheter ablation. Close surveillance of the MV is needed during such procedures and early surgical repair is important for successful salvage if significant injury occurs.

The aim of this study was to compare the performance of the Bishop score and transvaginal ultrasonography to predict successful labor induction, and to estimate the most useful cut-off points for the two methods.The five components of the Bishop score were assessed by digital examination and cervical length was measured by transvaginal ultrasonography in 177 women with a single pregnancy, 36-42 weeks of gestation, and a live fetus in cephalic presentation before induction of labor.Multiple regression analysis showed that the Bishop score, cervical length, and parity provided independent contribution in the prediction of the likelihood of delivering vaginally within 60 h. The only component of the Bishop score that was independently predictive of the probability of vaginal delivery within 60 h was station. The best cut-off points for predicting successful induction using receiver operating characteristic curves were 24 mm for cervical length and 4 for the Bishop score. Cervical length was a better predictor than the Bishop score (sensitivity and specificity of 66 and 77% versus 77 and 56%, respectively). Kaplan-Meier survival curves showed that cervical length was the best discriminator of successful induction.Measurement of cervical length by transvaginal ultrasonography is a better predictor of success in labor induction with both topical prostaglandin and oxytocin.

Objective To assess the criterion validity, construct validity and test–retest reliability of the MENCAV menopause quality of life scale. Methods Observational, cross-sectional study covering a random sample of 470 women aged 40–60 years. Two questionnaires were administered, namely, the MENCAV, made up of 37 items in 5 dimensions, and the SF-36. A confirmatory factorial analysis was performed, leaving a final scale with 35 items. To evaluate criterion validity, the relationship between the physical and mental health dimensions of both instruments was estimated. Two experts assessed 40 menopausal women and recorded the correlations with the MENCAV. Construct validity was evaluated by comparing the mean scores of menopausal and non-menopausal women for each of the MENCAV dimensions. To assess test–retest reliability, we estimated the correlation between MENCAV scores when the questionnaire was administered on two separate occasions, 2 weeks apart. Results The final questionnaire comprised 35 items divided into 5 dimensions. All dimensions displayed high levels of reliability, with Cronbach's α values ranging from 0.71 to 0.91, and Cronbach's α for the total scale being 0.89. The intraclass correlation was 0.77 (95% CI: 0.61–0.87). Correlations between the questionnaire and the SF-36 were significant; and those with the experts were significant for the physical, mental and sexual dimensions. Conclusions The MENCAV is a valid and reliable questionnaire for assessing quality of life in menopausal women.

Modulation of mitochondrial respiratory chain, dehydrogenase, and nucleotide-metabolizing enzyme activities is fundamental to cellular protection. Here, we demonstrate that the potassium channel opener diazoxide, within its cardioprotective concentration range, modulated the activity of flavin adenine dinucleotide-dependent succinate dehydrogenase with an IC50of 32 μM and reduced the rate of succinate-supported generation of reactive oxygen species (ROS) in heart mitochondria. 5-Hydroxydecanoic fatty acid circumvented diazoxide-inhibited succinate dehydrogenase-driven electron flow, indicating a metabolism-dependent supply of redox equivalents to the respiratory chain. In perfused rat hearts, diazoxide diminished the generation of malondialdehyde, a marker of oxidative stress, which, however, increased on diazoxide washout. This effect of diazoxide mimicked ischemic preconditioning and was associated with reduced oxidative damage on ischemia-reperfusion. Diazoxide reduced cellular and mitochondrial ATPase activities, along with nucleotide degradation, contributing to preservation of myocardial ATP levels during ischemia. Thus, by targeting nucleotide-requiring enzymes, particularly mitochondrial succinate dehydrogenase and cellular ATPases, diazoxide reduces ROS generation and nucleotide degradation, resulting in preservation of myocardial energetics under stress.

Previous studies comparing the Bishop score with transvaginal cervical ultrasonography for predicting the results of inducing labor have yielded inconsistent results. The present study compared the performance of these measures and determined the most useful cutoff points in 177 women with singleton pregnancies who were evaluated at 36 to 42 weeks' gestation. All had a live fetus in cephalic presentation. The components of the Bishop score were assessed by digital examination, and a different obstetrician measured cervical length by ultrasound. Labor was induced if the Bishop score was less than 6 and the membranes were intact, using 1 or, if needed, 2 intracervical doses of prostaglandin E 2 gel. Oxytocin induction was then begun after 24 hours if required. Oxytocin induction was begun without recording cervical characteristics if premature rupture of the membranes or spontaneous membrane rupture after administration of prostaglandin gel occurred. The commonest indications for induction were prolonged pregnancy and premature membrane rupture. The rate of vaginal delivery in this series was 64%, and delivery took place within 60 hours of initiating induction in all but one of 114 pregnancies. On multiple regression analysis, cervical length, Bishop score, and parity were significantly and independently associated with the likelihood of delivering within 60 hours. The likelihood of vaginal delivery increased as cervical length decreased or the Bishop score increased, and was greater in multiparas than in nulliparas. Although cervical length correlated significantly with the Bishop score, cervical length was a better predictor. The only part of the Bishop score that independently predicted vaginal delivery within 60 hours was station. Based on the area under the receiver operating characteristic curve, the best cutoff points for predicting successful induction of labor were a cervical length≥24 mm or a Bishop score of≥4. Estimating cervical length by transvaginal ultrasonography was a better predictor of successful induction of labor than was the Bishop score in this observational study, regardless of whether induction was achieved using topical prostaglandin or oxytocin.