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Candida albicans is an opportunist pathogen responsible for a large spectrum of infections, from superficial mycosis to systemic diseases known as candidiasis. During infection in vivo, Candida albicans must adapt to host microenvironments and this adaptive response is crucial for the survival of this organism, as it facilitates the effective assimilation of alternative carbon sources others than glucose. We performed a global proteomic analysis on the global changes in protein abundance in response to changes in micronutrient levels, and, in parallel, explored changes in the intracellular redox and metabolic status of the cells. We show here that each of the carbon sources considered — glucose, acetate and lactate — induces a unique pattern of response in C. albicans cells, and that some conditions trigger an original and specific adaptive response involving the adaptation of metabolic pathways, but also a complete remodeling of thiol-dependent antioxidant defenses. Protein S-thiolation and the overproduction of reduced glutathione are two components of the response to high glucose concentration. In the presence of acetate, glutathione-dependent oxidative stress occurs, reduced thiol groups bind to proteins, and glutathione is exported out of the cells, these changes probably being triggered by an increase in glutathione-S-transferases. Overall, our results suggest that the role of cellular redox status regulation and defenses against oxidative stress, including the thiol- and glutathione-dependent response, in the adaptive response of C. albicans to alternative carbon sources should be reconsidered.

Aims The aim of this study was to examine perioperative blood transfusion practice, and associations with clinical outcomes, in a national cohort of hip fracture patients. Methods A retrospective cohort study was undertaken using linked data from the Scottish Hip Fracture Audit and the Scottish National Blood Transfusion Service between May 2016 and December 2020. All patients aged ≥ 50 years admitted to a Scottish hospital with a hip fracture were included. Assessment of the factors independently associated with red blood cell transfusion (RBCT) during admission was performed, alongside determination of the association between RBCT and hip fracture outcomes. Results A total of 23,266 individual patient records from 18 hospitals were included. The overall rate of blood transfusion during admission was 28.7% (n = 6,685). There was inter-hospital variation in transfusion rate, ranging from 16.6% to 37.4%. Independent perioperative factors significantly associated with RBCT included older age (90 to 94 years, odds ratio (OR) 3.04 (95% confidence interval (CI) 2.28 to 4.04); p < 0.001), intramedullary fixation (OR 7.15 (95% CI 6.50 to 7.86); p < 0.001), and sliding hip screw constructs (OR 2.34 (95% CI 2.19 to 2.50); p < 0.001). Blood transfusion during admission was significantly associated with higher rates of 30-day mortality (OR 1.35 (95% CI 1.19 to 1.53); p < 0.001) and 60-day mortality (OR 1.54 (95% CI 1.43 to 1.67); p < 0.001), as well as delays to postoperative mobilization, higher likelihood of not returning to their home, and longer length of stay. Conclusion Blood transfusion after hip fracture was common, although practice varied nationally. RBCT is associated with adverse outcomes, which is most likely a reflection of perioperative anaemia, rather than any causal effect. Use of RBCT does not appear to reverse this effect, highlighting the importance of perioperative blood loss reduction. Cite this article: Bone Joint J 2022;104-B(11):1266–1272.

BackgroundIntra-atrial reentrant tachycardia (IART) is a frequent arrhythmia in patients with Fontan circulation. Although its supraventricular origin, such arrhythmia can be poorly tolerated as it leads to haemodynamic impairment. Concomitant assessment of pressure/volume overload of cardiac chambers due to valvular disease or residual shunts is necessary.Case summaryWe report the case of a 33-year-old male with Fontan extracardiac conduit, suffering from IART with initial poor haemodynamic tolerance. He had a medical history of pulmonary atresia with intact ventricular septum and Type 0 bicuspid aortic valve, with a total of four cardiac surgeries. Echocardiography demonstrated a severe impairment of the univentricular ejection fraction and a critical aortic stenosis. Given the limited medical treatment options of the arrhythmia and the risks of another heart surgery, both IART ablation and transcatheter aortic valve replacement (TAVR) were performed during the same procedure. The IART critical isthmus located in the antero-lateral region of the extracardiac conduit was effectively treated with radiofrequency. Rapid pacing during TAVR was provided by a catheter placed in the unique ventricle via a transconduit puncture. The aortic valve was deployed with minimal para-valvular regurgitation and a satisfactory transvalvular gradient. At follow-up, the univentricular ejection fraction normalized and no arrhythmic episode was recorded in absence of anti-arrhythmic drugs.DiscussionThis case highlights the need of a collaborative approach for treating complex cases of adult congenital heart disease, suffering from both electrophysiological and haemodynamic disorders. This combination offered an elegant and safest solution for treating concomitantly a life-threatening arrhythmia and an aortic stenosis.

IntroductionScaling the equipment of young athletes is justified by the constraints-led approach introduced in motor learning. The aim of the present study is to analyze the effect of racket scaling on the serve biomechanics and performance parameters for young tennis players (between 8 and 11 years-old).MethodsNine young intermediate competitive tennis players (age: 9.9 ± 1.0 years) performed maximal effort flat serves with three different rackets (scaled 23 inches, scaled 25 inches and full-size 27 inches) in a randomized order. A radar measured ball speed while shoulder and elbow kinetics and upper and lower limb kinematics were calculated with a 20-camera optical motion capture system. Repeated measures ANOVAs were used to analyze the effect of the three rackets on ball speed, percentage of serve in, serve kinematics and kinetics.ResultsNo significant differences in ball speed, maximal racket head velocity and percentage of serve in were observed between the three rackets. The lowest maximal upper limb kinetics and the highest upper limb maximal angular velocities were obtained with the scaled 23 inches racket.DiscussionUsing scaled rackets has the advantage to decrease shoulder and elbow loadings without reducing serve performance. Consequently, the present results incite tennis coaches and parents to not upgrade too soon the size of the racket in young intermediate tennis players to avoid overuse injury risks in the long term. Our results showed that the full-size 27 inches racket induced higher lower limb kinematics. As a consequence, occasionally serving with a fullsize racket can be a sparingly interesting intervention to help young tennis players to intuitively and immediately increase their leg drive action, allowing a more functional representation of the elite junior serve.

The cerebellar cortex is a well-studied brain structure with diverse roles in motor learning, coordination, cognition and autonomic regulation. However, a complete inventory of cerebellar cell types is currently lacking. Here, using recent advances in high-throughput transcriptional profiling1–3, we molecularly define cell types across individual lobules of the adult mouse cerebellum. Purkinje neurons showed considerable regional specialization, with the greatest diversity occurring in the posterior lobules. For several types of cerebellar interneuron, the molecular variation within each type was more continuous, rather than discrete. In particular, for the unipolar brush cells—an interneuron population previously subdivided into discrete populations—the continuous variation in gene expression was associated with a graded continuum of electrophysiological properties. Notably, we found that molecular layer interneurons were composed of two molecularly and functionally distinct types. Both types show a continuum of morphological variation through the thickness of the molecular layer, but electrophysiological recordings revealed marked differences between the two types in spontaneous firing, excitability and electrical coupling. Together, these findings provide a comprehensive cellular atlas of the cerebellar cortex, and outline a methodological and conceptual framework for the integration of molecular, morphological and physiological ontologies for defining brain cell types., A comprehensive atlas of cell types and regional specializations in the mouse cerebellar cortex.

Academic leaders all over the world are encouraging the use of active methodologies in teaching, especially in higher education. The reason for this is that social changes are happening at an ever-increasing rate, and they require students and teachers to develop digital skills. This is especially significant for health sciences degrees, in which future graduates must have effective problem-solving skills. To respond to this challenge, the use of a project-based learning (PBL) methodology, together with various monitoring techniques based on the use of Educational Data Mining (EDM) and mixed methods, will provide teachers with information about the effectiveness of the methodology and guide the implementation of personalized educational responses. This study provides a protocol for the application of the PBL methodology in e-Learning and blended-Learning (b-Learning) teaching modalities for health sciences students studying occupational therapy in higher education. In addition, statistical techniques for the analysis of covariance and unsupervised learning allow differences to be detected between the two teaching modalities, thus specifying their effectiveness in terms of a range of variables related to behavioral patterns, performance, and satisfaction. Data visualization also helps in understanding the qualitative aspects of the learning process. These data will help teachers to produce more effective proposals for the implementation of the PBL methodology based on the based on the context of the teaching-learning process. Therefore, this protocol offers many resources and materials to help teachers implement the PBL methodology in e-Learning and b-Learning teaching methods.

International audience; OBJECTIVES: The overall death toll from COVID-19 in Africa is reported to be low but there is little individual-level evidence on the severity of the disease. This study examined the clinical spectrum and outcome of patients monitored in COVID-19 care centres (CCCs) in two West-African countries. METHODS: Burkina Faso and Guinea set up referral CCCs to hospitalise all symptomatic SARS-CoV-2 carriers, regardless of the severity of their symptoms. Data collected from hospitalised patients by November 2020 are presented. RESULT: A total of 1,805 patients (64% men, median age 41 years) were admitted with COVID-19. Symptoms lasted for a median of 7 days (IQR 4-11). During hospitalisation, 443 (25%) had a SpO2 < 94% at least once, 237 (13%) received oxygen and 266 (15%) took corticosteroids. Mortality was 5% overall, and 1%, 5% and 14% in patients aged

A large number of small forests typically harbor higher biodiversity than a small number of large forests totaling the same area, suggesting that small patches are disproportionately valuable for biodiversity conservation. However, policies often favor protection of large forest patches. Here we demonstrate a global trend of higher deforestation in small than large forest patches: the likelihood that a randomly selected forest plot disappeared between 1992 and 2020 increased with decreasing size of the forest patch containing that plot. Our results imply a disproportionate impact of forest loss on biodiversity relative to the total forest area removed. Achieving recent commitments of the post-2020 Global Biodiversity Framework will require revision of current policies and increased societal awareness of the importance of small habitat patches for biodiversity protection.

Aims: The inability to prescribe blood transfusions is a potential barrier to timely hospice enrollment for patients with blood cancers. The benefits and harms of transfusions near the end of life (EOL), however, are poorly characterized and patients’ preferences are unknown. We sought to characterize the recollections of bereaved caregivers about the relationships between transfusions and hospice enrollment decisions. Methods: We recruited 18 bereaved caregivers of 15 decedents who died within 6-18 months of the interview. Interviews focused on caregivers’ recollections of transfusion and hospice enrollment decisions. Transcripts were analyzed for themes. Results: We identified 2 themes. First, caregivers described that transfusions were necessary and the decisions to receive transfusions or not were deferred to the clinicians. Second, only 1 caregiver recalled transfusions as relevant to hospice decisions. In that instance there was a delay. Caregivers identified difficulties recognizing death was imminent, hope for miracles, and the necessity of accepting life was ending as more relevant barriers. Conclusions: The results indicate clinicians’ beliefs in transfusion at EOL may be a more relevant barrier to hospice enrollment than patients’ preferences. Strategies to evaluate accurately and discuss the actual benefits and harms of transfusions at the EOL are necessary to advise patients and integrate their preferences into decisions.

Le service est un coup fondamental pour gagner un match à haut niveau. Dans une optique de formation du joueur à long terme, il est nécessaire de connaître les étapes d’apprentissage de ce coup sur le plan biomécanique. Toutefois, les données scientifiques concernant la biomécanique du service se sont focalisées sur les catégories U12, U14, U16, U18 et +18. L’objectif de cette étude est de proposer une analyse cinématique préliminaire du service chez des enfants de 10 ans et moins (U10) pour fournir des points de repère aux entraîneurs concernant l’enseignement du service chez les plus jeunes joueurs.

Summary Background Abnormal coronary pattern may complicate coronary transfer during arterial switch operation. Objective To evaluate the accuracy of echocardiography in assessing the anatomy of coronary arteries in neonates with transposition of the great arteries, and determine impact on outcomes. Methods We conducted a retrospective analysis of data in neonates with transposition of the great arteries. Preoperative echocardiographic coronary artery pattern and surgical intraoperative reports were compared. Mismatch between transthoracic echocardiography and surgical intraoperative reports and the impact on perioperative outcome were assessed. Coronary patterns were classified into four groups: type 1 (normal); type 2 (risk of coronary with intramural course); type 3 (coronary loop); and type 2 + 3. Results Overall, 108 neonates who underwent an arterial switch operation were included: 68 were classified as type 1; seven as type 2; 32 as type 3; and one as type 2 + 3. Overall, 10 adverse events occurred. Five patients died, three from coronary causes. Survival was 96% at 1 month. Transthoracic echocardiography and surgical intraoperative reports differed in 17.6% of cases. Mortality was 15.8% in case of inappropriate diagnosis and 2.2% for appropriate diagnosis (P = 0.01). Mortality in type 2 was 66.7% in case of discordance versus 0% when concordant. Multivariable analysis found that inappropriate preoperative transthoracic echocardiography diagnosis of coronary pattern was the only significant risk factor for mortality (P = 0.04). Conclusions Echocardiography can assess coronary artery anatomy in neonates with transposition of the great arteries. Intramural coronary course is often misdiagnosed. Preoperative misdiagnosis of coronary artery anomaly may impact perioperative mortality. However, this assessment will have to be confirmed by further larger studies.

Background: Patients with COVID-19 can require critical care for prolonged periods. Patients with persistent critical Illness can have complex recovery trajectories, but this has not been studied for patients with COVID-19. We examined the prevalence, risk factors, and long-term outcomes of critically ill patients with COVID-19 and persistent critical illness.Methods: This was a national cohort study of all adults admitted to Scottish critical care units with COVID-19 from March 1, 2020 to September 4, 20. Persistent critical illness was defined as a critical care length of stay (LOS) of ≥10 days. Outcomes included 1-yr mortality and hospital readmission after critical care discharge. Fine and Gray competing risk analysis was used to identify factors associated with persistent critical Illness with death as a competing risk.Results: A total of 2236 patients with COVID-19 were admitted to critical care; 1045 patients were identified as developing persistent critical Illness, comprising 46.7% of the cohort but using 80.6% of bed-days. Patients with persistent critical illness used more organ support, had longer post-critical care LOS, and longer total hospital LOS. Persistent critical illness was not significantly associated with long-term mortality or hospital readmission. Risk factors associated with increased hazard of persistent critical illness included age, illness severity, organ support on admission, and fewer comorbidities.Conclusions: Almost half of all patients with COVID-19 admitted to critical care developed persistent critical illness, with high resource use in critical care and beyond. However, persistent critical illness was not associated with significantly worse long-term outcomes compared with patients who were critically ill for shorter periods.

Research has demonstrated the existence of two 'natural preference' profiles in running. The objective of this study was to determine the influence of the natural preferences of ground (with a "posterior and flexion" movement) and air (with an "anterior and extension" movement) on the ball speed and impact position during the service of 19 professional players. The results allow to propose a new reading grid of the service technique to consider the preferential motricity of each player while respecting the biomechanical principles

El objetivo principal es caracterizar la composición, calidad y sanidad a los renovales de roble, que han sido sujetos a uno o más raleos comerciales, con énfasis en la participación de los árboles futuro y evaluar la relación entre la respuesta al raleo y la oportunidad de intervención de los rodales.

International audience; The aim of this study was to determine whether decreasing serving distance and net height would immediately influence serve biomechanics and performance in young intermediate tennis players. Ten young tennis players (9 to 12 years) performed maximal effort flat serves from three court conditions ("red", "orange" and "green": serving distance at 6.40, 9.00 and 11.89 m from the net and net height at 0.80 m, 0.80 m and 0.91m, respectively). A radar measured ball speed while serve kinetics and kinematics were calculated with a 20-camera optical motion capture system. Repeated measures ANOVAs were used to analyze the effect of the three conditions on ball speed, serve kinematics and kinetics. No significant differences in shoulder and elbow kinetics were observed between the three conditions. Ball speed, maximal flexion angle of the back knee and maximal angular velocities of back knee extension and trunk flexion significantly improved when players served from the red conditions in comparison with green ones. This study shows that reducing serve distance and net height may be an effective coaching strategy to immediately increase ball speed, leg drive and trunk flexion in young tennis players.

ObjectivesTo explore communities’ perceptions about COVID-19 in the context of the ANRS COV33 Coverage-Africa clinical trial evaluating the efficacy of treatments in preventing clinical worsening of COVID-19.DesignDescriptive qualitative study using semistructured in-depth individual interviews conducted by telephone in French and Soussou between May and September 2021. Data were transcribed, translated in French when applicable and analysed with the thematic analysis method.SettingThe eight neighbourhoods most affected by COVID-19 in Conakry’s urban context, capital of Guinea.Participants4 community leaders acting as key informants—providing insights regarding population’s opinions—and six community members, who were exposed to an information session conducted as part of Coverage-Africa.ResultsAccording to participants, community members have heterogeneous viewpoints about COVID-19: it exists and is dangerous; it is benign (‘bad cold’); or it is fictitious (eg, government conspiracy). The fear of stigmatisation and social isolation of those sick or cured of COVID-19 was largely reported by participants, with illustrations of distressing situations for the victims. To avoid stigma, many patients seem to adopt strategies of discretion (eg, lying/hiding about the disease). Although community attitudes were reported to have evolved since the beginning of the epidemic, stigma remained a pervasive concern for many people.ConclusionsCommunity perceptions about COVID-19 in Conakry may be partly explained by the Guinean context of Ebola history and of sociopolitical tensions. Stigmatisation of COVID+ people seems to be aimed at protecting others against contamination. However, social avoidance can greatly affect the morale of stigmatised people, especially in collectivist cultures like Guinea. Further investigating stigma, including its role on seeking COVID-19 screening and treatment services, and its consequences on mental health among affected/exposed people, would contribute to identifying improved prevention and care interventions in preparation for future health threats, and to promoting participation in health research.Trial registration numberNCT04920838(Pre-results stage).

Introduction: The loss of alveolar volume is a clinical implication resulting from dental extractions, which bring potentially important compromises in the aesthetic and functional results of implant-supported rehabilitations. Surgical treatment is indicated in cases of patients with the presence of an important anatomical accident as to the quantity and quality of the remaining bone that is involved in thickness. Objective: The aim of this paper is to report a clinical case of rehabilitation with a dental implant using the Split crest technique. Case Report: A 37 year-old female patient presented as main complaint the absence of dental element 35. After anamnesis, clinical examination and tomographic evaluation of the region of interest it was observed the remaining bone tissue with presence of important anatomical accident regarding the buccal volume. After presentation of treatment alternatives, we opted for bone crest expansion using the Split crest technique and immediate implant installation. The Split crest technique in the mandible is a predictable technique for expanding atrophic ridges. The technique proved to be feasible, providing a significant increase in ridge thickness, absence of complications and reduced treatment time for the patient. Final considerations: Allowing implant installation together with ridge expansion is the major advantage of using the technique to correct potentially important clinical implications in the aesthetic and functional outcome of implant-supported rehabilitations. Introducción: La pérdida de volumen alveolar es una implicación clínica decadente de las extracciones dentales, que conlleva un compromiso potencialmente importante en los resultados estéticos y funcionales de las rehabilitaciones implantadas. El tratamiento quirúrgico está indicado en los casos de pacientes con presencia de un accidente anatómico importante en cuanto a la cantidad y calidad del hueso restante que está implicado en el espesor. Objetivo: El objetivo de este estudio es reportar un caso clínico de rehabilitación con un implante dental utilizando la técnica de la cresta Split. Reporte de caso: Paciente femenina, de 37 años, presentó como queja principal la ausencia del elemento dental 35. Después de la anamnesis, el examen clínico y la evaluación tomográfica de la región de interés se observó el tejido óseo remanente con presencia de accidente anatómico importante respecto al volumen bucal. Tras la presentación de las alternativas de tratamiento se optó por la expansión de la cresta ósea mediante la técnica de la cresta dividida y la instalación inmediata del implante. La técnica de la cresta dividida en la mandíbula es una técnica predecible para expandir las crestas atróficas. La técnica demostró ser viable, proporcionando un aumento significativo del grosor de la cresta, ausencia de complicaciones y reducción del tiempo de tratamiento para el paciente. Consideraciones finales: Permitir la instalación de implantes junto con la expansión de la cresta es la mayor ventaja de utilizar la técnica para corregir implicaciones clínicas potencialmente importantes en el resultado estético y funcional de las rehabilitaciones soportadas por implantes. Introdução: A perda de volume alveolar é uma implicação clinica decorrente de extrações dentarias, que trazem comprometimento potencialmente importantes nos resultados estéticos e funcionais das reabilitações implanto suportada. O tratamento cirúrgico está indicado nos casos de pacientes com presença de acidente anatômico importante quanto na quantidade e qualidade do osso remanescente que apresentam envolvimento em espessura. Objetivo: O objetivo deste trabalho é relatar um caso clinico sobre reabilitação com implante dentário através da técnica de Split crest. Relato de caso: Paciente gênero feminino, 37 anos apresentava como queixa principal a ausência do elemento dental 35. Após anamnese, exame clinico e avaliação tomográfica da região de interesse observou –se o tecido ósseo remanescente com presença de acidente anatômico importante quanto ao volume vestibular. Após apresentação de alternativas de tratamento optou-se pela expansão de crista óssea pela técnica de Split crest e instalação imediata do implante. A técnica Split crest em mandíbula é uma técnica previsível para expansão de rebordos atróficos. A técnica mostrou-se viável propiciando um aumento significativo na espessura do rebordo, ausência de complicações e diminuição do tempo do tratamento ao paciente. Considerações finais: A permissão de instalação do implante juntamente com a expansão do rebordo se faz a maior vantagem da utilização da técnica corrigindo implicações clinicas potencialmente importante no resultado estético e funcional de reabilitações implanto suportado.

Background: According to the US Institute of Medicine guideline, preschool-aged children should participate in ≥15 minutes of physical activity (PA) per hour or 3 hours per day over 12 hours. Examinations of PA guideline compliance to date averaged time spent in PA over several days; however, children could exceed the guideline on some days and not on others. Therefore, this cross-sectional study examined PA guideline compliance in preschool children based on number of minutes per hour (average method) and percentage of days the guideline was met (everyday method). Methods: PA was measured by accelerometry during the preschool day for up to 10 days in 177 children (59.3% males, Mage = 4.23). Minutes per hour and percentage of time in light, moderate to vigorous, and total PAs were calculated. Percentage of days in compliance was determined by number of days in compliance (defined as the child active on average ≥15 min/h) divided by total accelerometer days. Results: Children engaged in PA, on average, 17.01 minutes per hour, suggesting that on average, children are meeting the guideline. However, children were only in compliance with the PA guideline 62.41% of assessment days. Conclusions: Findings demonstrate the importance of examining compliance with both the average and everyday methods to more accurately portray level of Institute of Medicine PA guideline compliance.

This study investigates how pedagogical, cultural and institutional factors interact with technical knowledge in educational technology integration and how they relate to equitable and effective technology use in low-resource settings. In the context of a one-to-one tablet initiative in rural Kenya, we explore how these factors constrain or support access to technology, instructor capacity, student engagement and student learning, as well as their implications for reducing educational and digital divides. We employ a mixed methods, such as a quasi-experimental (prepost, nonequivalent control group) research design that draws on data from classroom observations, teacher interviews, student surveys and focus groups, and assessments of student academic performance to generate evidence on classroom practices and student learning in schools with access to tablets, while also highlighting core challenges to successful technology integration. Our findings contribute to the identification of prerequisites and supporting factors for successful educational technology integration, as well as policy levers and school-based strategies that are likely to increase equitable access to quality learning experiences in schools in low-resource contexts. Practitioner Notes What is already known about this topic A lack of funding, planning and infrastructure hinder information and communication technology (ICT) integration. Procurement of educational technology and infrastructure improvement efforts has reduced digital divides, but learning divides persist in implementation. Insufficient teacher technology expertise and professional development constrain teacher's effective use of educational technology in classrooms. What this paper adds We employ mixed methods?triangulating the student assessment data with data from student surveys and focus groups, teacher interviews and classroom observations?to identify how pedagogical, cultural and institutional factors interact with technical knowledge in ICT integration in ways that support or constrain student learning in low-resource contexts. We find that more attention is needed for cultural factors that interact with pedagogical and technical skills to ensure that the classroom instructors' attention is equitability distributed in ways that discourage in-class ?tracking? and differential access to quality learning experiences, such as some teachers' disregard of ?slow learners? in the classroom. In low-resource contexts, providing even basic levels of infrastructure (eg, a consistent power source) and access to general technical knowledge requires more creative and concerted efforts from school leadership and instructors, such as the offer of tutorials and reading clubs outside of the class to expand access and improve the use of devices. Implications for practice and/or policy We find that device sharing can have positive effects on peer-to-peer learning, which suggests that policymakers in Kenya should weigh the benefits of achieving one-to-one device access against the potential advantages of alternative investments, such as expanding professional development on the integration and use of currently available devices. Increasing opportunities for peer-to-peer learning and exchange (among teachers and students) and building shared capacities for ICT integration can help reduce technical issues and lost instructional time.

Los bosques naturales cumplen un rol fundamental para el bienestar de la sociedad, sin embargo, las presiones antrópicas sobre estos ecosistemas pueden comprometer su funcionalidad y capacidad para proveer bienes y servicios. Entre estas presiones, la degradación forestal ha sido identificada como una de las acciones antrópicas más significativas, sin embargo, la falta de claridad y consenso del significado de dicho concepto ha sido una limitante para dimensionar este problema en bosques de todo el mundo. Considerando la necesidad de buscar formas efectivas que permitan abordar este fenómeno para los bosques nativos en Chile, se presenta una definición operacional del concepto de degradación forestal basada en elementos de dinámica forestal, resiliencia y el marco normativo vigente. Dicha definición distingue aquellos procesos de degradación asociados a los disturbios antrópicos que afectan distintos atributos de los bosques nativos y de condiciones o estados de degradación que requieren de asistencia humana para recuperar su funcionalidad y productividad.

The retreating snowfields and glaciers of Glacier National Park, Montana, USA, present alpine plants with changes in habitat and hydrology. The adjacent and relic periglacial patterned ground consists of solifluction terraces of green, vegetation-rich stripes alternating with sparsely vegetated brown stripes. We established georeferenced transects on striped periglacial patterned ground for long-term monitoring and data collection on species distribution and plant functional traits at Siyeh Pass and at Piegan Pass at Glacier National Park. We documented species distribution and calculated the relative percent cover (RPC) of qualitative functional traits and used 16S rRNA from soil samples to characterize microbial distribution on green and brown stripes. Plant species distribution varied significantly and there were key differences in microbial distribution between the green and brown stripes. The rare arctic-alpine plants Draba macounii, Papaver pygmaeum, and Sagina nivalis were restricted to brown stripes, where the RPC of xeromorphic taprooted species was significantly higher at the leading edge of the Siyeh Pass snowfield. Brown stripes had a higher percentage of the thermophilic bacteria Thermacetogenium and Thermoflavimicrobium. Green stripes were co-dominated by the adventitiously-rooted dwarf shrubs Salix arctica and the possibly N-fixing Dryas octopetala. Green stripes were inhabited by Krummholz and seedlings of Abies lasiocarpa and Pinus albicaulus. Prosthecobacter, a hydrophilic bacterial genus, was more abundant on the green stripes, which had 6,524 bacterial sequences in comparison to the 1,183 sequences from the brown stripes. While further research can determine which functional traits are critical for these plants, knowledge of the current distribution of plant species and their functional traits can be used in predictive models of the responses of alpine plants to disappearing snowfields and glaciers. This research is important in conservation of rare arctic-alpine species on periglacial patterned ground.

To assess the outcomes of neonates prenatally diagnosed with ventricular asymmetry and not operated on within the neonatal period and to determine the risk factors for left heart obstruction occurrence at follow-up. All neonates with prenatal asymmetry of the ventricles, diagnosed from August 1993 to July 2015, not operated on within the neonatal period, were retrospectively included in the study. Left heart echocardiographic measurements at birth and at last follow-up were collected and compared. Left heart anomaly included isthmus and/or aortic valve and/or mitral valve obstruction. There were a total of 34 newborns included in the study. The median follow-up was 2 years. There was no death. Eleven patients were operated on at a median age of three months; seven of them had an obstruction of the left heart (five coarctations of the aorta, one sub-aortic and aortic valve stenosis, and one mitral stenosis). Estimated freedom of left heart surgery was 80% at 6 months and 75% at 10 years. The main risk factor for progression to a left heart anomaly was a hypoplasia of the aortic isthmus (p = 0.0003), while the presence of a left superior vena cava was more frequent in these patients although the difference was not significant. Patients with an aortic isthmus z-score below - 2 at the closure of arterial duct are at risk of later coarctation and therefore follow-up should be extended to at least 3 months. Furthermore, the prenatal ventricular asymmetry does not only identify patients at risk of coarctation but also of other left heart anomalies. This last point should be a better approach with future parents to improve prenatal counseling on a more complex postnatal diagnostic than a simple isolated coarctation.

UNSTRUCTURED To combat the COVID-19 pandemic, many European countries have developed a public health strategy involving the use of digital contact tracing (DCT) applications to improve timely tracking and contact tracing of COVID-19 cases. France’s independent COVID-19 Control and Society Connection Council (CCL) was established by law in May 2020 to issue advice and recommendations on the national epidemic digital systems. In this paper, we present the recommendations by the CCL, with the objective to increase the uptake and utility of French DCT applications. As the country's most vulnerable population has been subjected to greater virus exposure, a stronger impact of the lockdown, and less access to preventive and health care services, the CCL is particularly aware of health inequalities. The French DCT app TousAntiCovid had been downloaded by 13.6 million users (ie, 20% of the French population) in March 2021. To promote the use of DCT apps, the CCL has recommended that communication about the app’s individual and collective objectives be increased. The CCL has also recommended the introduction of clear, simple, accessible, incentivizing, noncoercive information within the digital tools. In addition, the CCL has recommended improving public health policies to address the needs of the underprivileged. The CCL calls for promoting population empowerment with the use of digital tools, improving public health culture for decision-makers dealing with health determinants, taking social considerations into account, and incorporating community participation.