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La presente investigación se desarrolló con el objetivo de determinar la relación que existe entre el estrés laboral y la satisfacción marital, se utilizaron los instrumentos de la OIT para evaluar el nivel de estrés laboral y la Escala de Satisfacción Marital. Se trabajó con una muestra de 92 docentes de tres instituciones educativas de la ciudad de Arequipa. Los resultados muestran que hay una relación estadísticamente significativa entre el estrés laboral y la satisfacción marital en docentes de instituciones educativas de la ciudad de Arequipa; evidenciado con el valor del coeficiente de correlación lineal de Pearson r = -.41 lo que indica que existe una correlación negativa y significativa entre las variables de estrés laboral y satisfacción marital, es así que mientras menor sea el estrés laboral, mayor será la satisfacción marital de los docentes.

En un ecosistema degradado, que actualmente es objeto de restauración, analizar de manera detallada la estructura de la vegetación y describir su relación con especies de aves es muy relevante para su manejo. El análisis de la arquitectura de las plantas es un método visual para describir la estructura de la vegetación como resultado de su estrategia de crecimiento. Por medio de este método se analizó la oferta de hábitat de las aves insectívoras Myrmeciza longipes (hormiguero ventriblanco), Thamnophilus doliatus (batará rayado) y Synallaxis albescens (pijuí pechiblanco) como parte de un estudio poblacional y de calidad de hábitat en un remanente de bosque seco tropical de 11 079 hectáreas, en Huila, Colombia. Por medio de conteos y también con la información secundaria recopilada, se estableció cómo estas especies usan los diferentes estratos de la vegetación. Teniendo en cuenta que árboles con más perchas incrementan el forrajeo de aves insectívoras, que más perchas significan mayor refugio para las aves, y también que mayor cruce de perchas posibilitan la aparición de horquetas para el anclaje de nidos de estas especies, en 186 parcelas se determinó que la zona está dominada por siete modelos arquitectónicos, divididos en tres grupos según su oferta potencial de recursos del hábitat para las tres especies: 1) modelos arquitectónicos Roux, Petit y Prevost con una calidad alta; 2) modelos arquitectónicos Koriba y Nozerán con una calidad intermedia; y 3) modelos arquitectónicos McClure y Holttum con una calidad muy baja.

Chitosan (CS) is a promising biopolymer and has been tested as a complement to the action and compensation of toxicity presented by anti-tuberculosis drugs. The present work studied the adjuvant effect of CS with the drug ethambutol (EMB) as a compound (CS-EMB), to explore its antimicrobial and cytotoxic activity, using transmission electron microscopy (TEM), to examine ultracellular changes that represent possible antimycobacterial action of CS on Mycobacterium tuberculosis (Mtb). Antimycobacterial activities were tested against reference strains Mtb ATCC® H37Rv and multidrug resistant (MDR). In vitro cytotoxicity tests were performed on Raw 264.7. For the studied compounds, morphological, ultrastructural, and physical–chemical analyses were performed. Drug-polymer interactions that occur through the H bridges were confirmed by physical–chemical analyses. The CS-EMB compound is stable at pHs of 6.5–7.5, allowing its release at physiological pH. The antibacterial activity (minimum inhibitory concentration) of the CS-EMB compound was 50% greater than that of the EMB in the H37Rv and MDR strains and the ultrastructural changes in the bacilli observed by TEM proved that the CS-EMB compound has a bactericidal action, allowing it to break down the Mtb cell wall. The cytotoxicity of CS-EMB was higher than that of isolated EMB, IC50 279, and 176 μg/mL, respectively. It is concluded that CS-EMB forms a promising composite against strains Mtb H37Rv and multidrug resistant (MDR-TB). Key points • Our study will be the first to observe ultrastructurally the effects of the CS-EMB compound on Mtb cells. • CS-EMB antimicrobial activity in a multidrug-resistant clinical strain. • The CS-EMB compound has promising potential for the development of a new drug to fight tuberculosis.

Inflammatory bowel disease (IBD) can involve multiple organ systems, and pancreatic manifestations of IBD are not uncommon. The incidence of several pancreatic diseases is more frequent in patients with Crohn's disease and ulcerative colitis than in the general population. Pancreatic manifestations in IBD include a heterogeneous group of disorders and abnormalities ranging from mild, self-limited disorders to severe diseases. Asymptomatic elevation of amylase and/or lipase is common. The risk of acute pancreatitis in patients with IBD is increased due to the higher incidence of cholelithiasis and drug-induced pancreatitis in this population. Patients with IBD commonly have altered pancreatic histology and chronic pancreatic exocrine dysfunction. Diagnosing acute pancreatitis in patients with IBD is challenging. In this review, we discuss the manifestations and possible causes of pancreatic abnormalities in patients with IBD.

Background The neuropeptide Y (NPY) is one of the most abundant neurotransmitters in the nervous system. NPY acts as a potent stimulator of angiogenesis, inflammation, and adipogenesis, through the NPY 2 receptor (NPY2R). Changes in the NPY signaling pathway have been linked to Acute Coronary Syndrome (ACS). Objectives The purpose of this study is to determine the association between variants in the NPY and NPY2R genes, as well as the severity of acute coronary syndrome (ACS). Methods Approximately 221 ACS patients and 278 healthy controls were selected for this study. Four variants in NPY and two variants in NPY2R genes were genotyped using Taqman allelic discrimination and sequencing. The Chi-square and Fisher's exact tests were used to verify the genotype frequencies. The logistic regression analyses were used for the evaluation of the studied variables. Haplotype analysis was used to evaluate the linkage disequilibrium (LD) between the variants (pC variant was found with the ACS group when compared to the healthy group. In the analysis between variants and risk factors in the ACS group, NPY c.84G>A was associated with hypertension. The analysis between TIMI risk showed a significance for NPY c.20T>C between the low and intermediate/high TIMI risk groups. In the haplotype analysis, strong linkage disequilibrium (LD) was found between the variants NPY c.150G>A and NPY c.-485T>C. Conclusion The NPY c.20T>C variant appears to contribute to the development of ACS. The NPY2R c.-1116A>G variant may contribute to the early development of ACS and the NPY c.84G>A variant appears to contribute to the development of hypertension. In addition, the NPY c.20T>C is associated with a protective effect in ACS severity.

Soil moisture is essential for agricultural production. Knowledge on its spatial-temporal variability is indispensable to support agriculture, and it is strongly influenced by cultural practices, soil cover conditions and irrigation methods. Thus, this study aimed to evaluate the temporal stability and spatial distribution of soil moisture as a function of the use of banana leaves as soil cover in a plot under conventional sprinkler irrigation and cultivated with banana in the Brazilian semiarid region. The study area was divided in two sectors, with and without covering using banana leaves. Soil moisture was monitored before and after irrigation, at 16 times, using FALKER HidroFarm sensors installed on a transect with 11 units spaced by 8 m, in each sector. The data were analyzed using descriptive statistics, temporal stability and Spearman correlation test. The morphology of the banana leaves and the irrigation system used contributed to lower soil moisture in the covered sector at all monitoring times. Variations in the physical-hydraulic properties of the soil promoted variations in soil moisture with the position of the sensors in the ground. The temporal stability technique allowed the identification of points that represent the mean behavior of soil moisture throughout the area. The use of banana leaf residues caused less soil wetting using sprinkler irrigation, indicating the need to pre-grind the material or use localized irrigation systems, practices that are not very accessible to small farmers.

Many vertebrate species undergo population fluctuations that may be random or regularly cyclic in nature. Vertebrate population cycles in northern latitudes are driven by both endogenous and exogenous factors. Suggested causes of mysterious disappearances documented for populations of the Neotropical, herd-forming, white-lipped peccary (Tayassu pecari, henceforth “WLP”) include large-scale movements, overhunting, extreme floods, or disease outbreaks. By analyzing 43 disappearance events across the Neotropics and 88 years of commercial and subsistence harvest data for the Amazon, we show that WLP disappearances are widespread and occur regularly and at large spatiotemporal scales throughout the species’ range. We present evidence that the disappearances represent 7–12-year troughs in 20–30-year WLP population cycles occurring synchronously at regional and perhaps continent-wide spatial scales as large as 10,000–5 million km2. This may represent the first documented case of natural population cyclicity in a Neotropical mammal. Because WLP populations often increase dramatically prior to a disappearance, we posit that their population cycles result from over-compensatory, density-dependent mortality. Our data also suggest that the increase phase of a WLP cycle is partly dependent on recolonization from proximal, unfragmented and undisturbed forests. This highlights the importance of very large, continuous natural areas that enable source-sink population dynamics and ensure re-colonization and local population persistence in time and space.

Chitosan (CS) is a promising biopolymer and has been tested as a complement to the action and compensation of toxicity presented by anti-tuberculosis drugs. The present work studied the adjuvant effect of CS with the drug ethambutol (EMB) as a compound (CS-EMB), to explore its antimicrobial and cytotoxic activity, using transmission electron microscopy (TEM), to examine ultracellular changes that represent possible antimycobacterial action of CS on Mycobacterium tuberculosis (Mtb). Antimycobacterial activities were tested against reference strains Mtb ATCC® H37Rv and multidrug resistant (MDR). In vitro cytotoxicity tests were performed on Raw 264.7. For the studied compounds, morphological, ultrastructural, and physical-chemical analyses were performed. Drug-polymer interactions that occur through the H bridges were confirmed by physical-chemical analyses. The CS-EMB compound is stable at pHs of 6.5-7.5, allowing its release at physiological pH. The antibacterial activity (minimum inhibitory concentration) of the CS-EMB compound was 50% greater than that of the EMB in the H37Rv and MDR strains and the ultrastructural changes in the bacilli observed by TEM proved that the CS-EMB compound has a bactericidal action, allowing it to break down the Mtb cell wall. The cytotoxicity of CS-EMB was higher than that of isolated EMB, IC50 279, and 176 μg/mL, respectively. It is concluded that CS-EMB forms a promising composite against strains Mtb H37Rv and multidrug resistant (MDR-TB).Key points• Our study will be the first to observe ultrastructurally the effects of the CS-EMB compound on Mtb cells.• CS-EMB antimicrobial activity in a multidrug-resistant clinical strain.• The CS-EMB compound has promising potential for the development of a new drug to fight tuberculosis.

La industria porcina en Colombia ha crecido en los últimos años. Aunque parte de esta actividad se realiza en instalaciones tecnificadas, en varias regiones del país aún existen pequeños sistemas de producción artesanales, cuyas condiciones de manejo de los animales varían desde tenerlos confinados hasta completamente libres, con diferentes implicaciones sanitarias. Este estudio buscó identificar las formas no tecnificadas más comunes para la cría de cerdos en varias regiones de Colombia y explorar sus implicaciones. Se recolectaron datos de las sabanas inundables de la Orinoquía colombiana, la zona en erradicación de la peste porcina clásica y el departamento del Guaviare. La información fue recopilada mediante entrevistas semiestructuradas a funcionarios públicos y pobladores locales involucrados en la cría de cerdos. El trabajo se realizó en agosto de 2017 y entre junio y octubre de 2019. En total, se recorrieron 8.486,4 km en 151 municipios del país, y se realizaron 262 entrevistas semiestructuradas. Se identificaron cuatro tipos de manejo para la cría de cerdos: en cochera, en encierro, cría libre y asilvestrada (sin manejo). Cada tipo de manejo refleja diferentes necesidades de cuidado, inversión económica, riesgo de escape o frecuencia de liberación de los cerdos, lo que facilita el asilvestramiento. Además, se obtuvo información sobre las condiciones sanitarias, la alimentación, la reproducción, la presencia institucional en cada municipio y la dificultad de los pequeños productores para el sacrificio y la comercialización.

The swine industry in Colombia has grown in recent years. A percentage of this industry occurs under technified conditions. However, in several regions of the country, there are small artisanal pig production systems where management exhibits a gradient in animal husbandry from confinement to complete freedom with different health implications. The aim of this study was to identify the most common non- technified forms of pig farming in several regions of Colombia and to explore their implications. Data collection was carried out in the flooded savannas of the Colombian Orinoquia region and through the Classical Swine Fever (CSF) eradication zone, as well as in the Guaviare department. The information was gathered from semi-structured interviews with public officials and local settlers involved in pig farming. The work was carried out in August 2017 and from June to October 2019. In total, the work included a distance of 8,486.4 km along 151 municipalities of the country, and 262 semi-structured interviews were conducted. The following four types of pig farming management were identified: confined, outdoor enclosure, free breeding, and feral or unmanaged breeding. Each management type reflects differences in the need for care, economic investment, escape risk, or pig release frequency, facilitating feral behavior. Furthermore, information on health aspects, food, reproduction, and institutional presence in each municipality as well as on current problems faced by producers for slaughtering and commercialization of pigs was obtained. Resumen La industria porcina en Colombia ha crecido en los últimos años. Aunque parte de esta actividad se realiza en instalaciones tecnificadas, en varias regiones del país aún existen pequeños sistemas de producción artesanales, cuyas condiciones de manejo de los animales varían desde tenerlos confinados hasta completamente libres, con diferentes implicaciones sanitarias. Este estudio buscó identificar las formas no tecnificadas más comunes para la cría de cerdos en varias regiones de Colombia y explorar sus implicaciones. Se recolectaron datos de las sabanas inundables de la Orinoquía colombiana, la zona en erradicación de la peste porcina clásica y el departamento del Guaviare. La información fue recopilada mediante entrevistas semiestructuradas a funcionarios públicos y pobladores locales involucrados en la cría de cerdos. El trabajo se realizó en agosto de 2017 y entre junio y octubre de 2019. En total, se recorrieron 8.486,4 km en 151 municipios del país, y se realizaron 262 entrevistas semiestructuradas. Se identificaron cuatro tipos de manejo para la cría de cerdos: en cochera, en encierro, cría libre y asilvestrada (sin manejo). Cada tipo de manejo refleja diferentes necesidades de cuidado, inversión económica, riesgo de escape o frecuencia de liberación de los cerdos, lo que facilita el asilvestramiento. Además, se obtuvo información sobre las condiciones sanitarias, la alimentación, la reproducción, la presencia institucional en cada municipio y la dificultad de los pequeños productores para el sacrificio y la comercialización.

Polycythaemia vera is a common haematological proliferative disorder. It is characterised by uncontrolled red cell production with ensuing peri-operative vaso-occlusive and haemorrhagic complications. Spinal haematoma after neuraxial anaesthesia is rare; most cases are associated with technical difficulties or bleeding disorders. Current consensus opinion suggests that neuraxial anaesthesia in patients with polycythaemia vera is safe due to a lower risk of thrombotic events and hypoxaemia compared with general anaesthesia. We report a case of a spinal subarachnoid haematoma after uneventful neuraxial anaesthesia in a patient with optimised polycythaemia vera. Despite an emergent laminectomy, the patient developed permanent motor deficits. This report highlights that although neuraxial anaesthesia is recommended by many authors, patients with polycythaemia vera can paradoxically have an increased haemorrhagic risk from platelet dysfunction and acquired von Willebrand disease. Clinicians proceeding with surgery under neuraxial anaesthesia should appreciate these risks even in patients with normal or apparently elevated thrombotic states. This case also demonstrates that traditional coagulation tests may need to be complemented by pre-operative platelet function tests and screening for von Willebrand disease. Finally, the importance of the patient participation in the choice of the anaesthesia technique cannot be understated, with specific attention paid to this frequently unrecognised risk.

Inflammatory bowel disease (IBD) can involve multiple organ systems, and pancreatic manifestations of IBD are not uncommon. The incidence of several pancreatic diseases is more frequent in patients with Crohn's disease and ulcerative colitis than in the general population. Pancreatic manifestations in IBD include a heterogeneous group of disorders and abnormalities ranging from mild, self-limited disorders to severe diseases. Asymptomatic elevation of amylase and/or lipase is common. The risk of acute pancreatitis in patients with IBD is increased due to the higher incidence of cholelithiasis and drug-induced pancreatitis in this population. Patients with IBD commonly have altered pancreatic histology and chronic pancreatic exocrine dysfunction. Diagnosing acute pancreatitis in patients with IBD is challenging. In this review, we discuss the manifestations and possible causes of pancreatic abnormalities in patients with IBD.

Resumen Algunas investigaciones de mamíferos silvestres requieren del uso de métodos que faciliten la manipulación de los individuos en condiciones de campo, sin afectar negativamente a los animales o a los investigadores. Dentro de estos métodos, se encuentra la inmovilización química, la cual no ha sido muy documentada en roedores silvestres de la subfamilia Sigmodontinae (Cricetidae). Por ello, en esta investigación se evaluó el uso de éter dietílico inhalado para manipular roedores sigmodontinos en campo, comparando el tiempo de inducción y el tiempo de recuperación de la anestesia entre especies, sexos y tipos de ambientes. Se capturaron y anestesiaron un total de 289 individuos de seis especies en el Parque Nacional Natural Chingaza. El tiempo de inducción de la anestesia fue diferente entre Microryzomys minutus, Neomicroxus bogotensis, Thomasomys laniger y Thomasomys niveipes (F3; 552 = 9,36; p < 0,05); de igual forma, el tiempo de recuperación de la anestesia fue diferente entre dichas especies (H = 9,59; p = 0,022). No se encontraron diferencias en los tiempos de inducción y recuperación de la anestesia entre sexos, ni entre ambientes. La mortalidad total fue de 4,5 %. No se observaron secreciones mucosas, vómito o complicaciones cardíacas o respiratorias en los individuos anestesiados. Los individuos fueron recapturados y no se evidenciaron alteraciones en su comportamiento o aspecto físico que indicaran una afectación por la anestesia o manipulación en capturas previas. La anestesia inhalada con éter dietílico puede ser una opción rápida y segura para inmovilizar y manipular sigmodontinos durante procedimientos cortos en campo dentro de estudios poblacionales o programas de monitoreo en vida silvestre. Abstract Some researches in wild mammals require methods that enable to handle the animals living in wild conditions, without affecting negatively the animals, or the researchers. These methods include the chemical immobilization, which has not been enough documented when handling wild rodents of the Sigmodontinae subfamily (Cricetidae). Therefore, this research evaluated the use of diethyl ether when handling Sigmodontinae rodents out in the countryside. It compared the induction time to the anesthesia recovery time between species, genders, and type of environments. A total of 289 animals were caught and anesthetized from six species in the Chingaza National Natural Park. The anesthesia induction times were different between Microryzomys minutus, Neomicroxus bogotensis, Thomasomys laniger y Thomasomys niveipes (F3; 552 = 9.36; p < 0.05). Likewise, the anesthesia recovery times were different between the same species (H = 9.59; p = 0.022). No difference was found in the induction times and the anesthesia recovery times between genders, neither for the types of environment. Total mortality was 4.5%. None mucosal secretions, vomit, or cardiac/respiratory complications were observed in the anesthetized animals. These subjects were caught again and they did not show any alterations in their behavior or physical aspect indicating affection derived either from the anesthesia or the previous handling under captivation. Anesthesia with diethyl ether can be a quick and safe choice when it comes to immobilize and handle Sigmodontinae rodents during short procedures out in the countryside, when carrying out population studies or wildlife monitoring programs.

Background and aims Steinert’s disease (SD) is the most common muscular dystrophy of the adult. It is a multi-systemic disorder characterized by skeletal muscle weakness and myotonia, respiratory, cardiac and others abnormalities. SD is a challenge for anesthesiologists due to the exquisite sensitivity to the anesthetics, resulting in potential postoperative complications (frequency of 8.2%) and the risk of a myotonic crisis in the perioperative period. This report aims to present a case of ulnar osteosynthesis in a patient with SD and discuss the possible role of regional anesthesia in the outcome of these patients. Methods A 49-year-old man, ASA III, with SD was scheduled for ulnar osteosynthesis. His past medical history was significant for hiatal hernia, obstructive sleep apnea and restrictive pulmonary disease. His only prior anesthetic exposure was laparoscopic cholecystectomy, with severe respiratory depression requiring intensive care unit admission postoperatively. An ultrasound-guided axillary brachial plexus block with 1.5% mepivacaine (150 mg) and 0.375% ropivacaine (37.5 mg) was performed. A forced-air warming blanket ensured normothermia. Results Intraoperatively the patient remained stable and comfortable. No intercurrences were recorded. Postoperative course was uneventful and the patient was discharged after 2 days. Conclusions Meticulous anaesthetic management in SD is crucial, as is the knowledge about its anesthetic implications and perioperative complications. With this in mind, regional anesthesia presented as a desirable alternative to general anesthesia, effective either in analgesia or in ventilatory support avoidance, in the postoperative period. In fact, the choice of the adequate anesthetic technique plays a decisive role in the outcome of the patient.

BACKGROUND: Apnea of prematurity affects a small proportion but large absolute number of late preterm infants, with out-patient management variably utilized despite relative clinical equipoise and potential for improved cost-effectiveness. METHODS: Over a 5-y period, from 2009 to 2013, infants born at ≥34 weeks gestational age at a level IIIB academic center in Boston, Massachusetts, with discharge-delaying apnea, bradycardia, and desaturation (ABD) events were identified. In-patient costs for discharge-delaying ABD events were compared with hypothetical out-patient management. Out-patient costs took into account 4–10 d of in-patient observation for ABD events before caffeine initiation, 3–5 d of additional in-patient observation before discharge, daily caffeine until 43 weeks corrected gestational age, home pulse oximetry monitoring until 44 weeks corrected gestational age, and consideration of variable readmission rates ranging from 0 to 10%. RESULTS: A total of 425 late preterm and term infants were included in our analysis. Utilization of hypothetical out-patient management resulted in cost savings per eligible patient ranging from $2,422 to $62, dependent upon variable periods of in-patient observation. Sensitivity analysis demonstrated few instances of decreased relative cost-effectiveness. CONCLUSIONS: Out-patient management of discharge-delaying ABD events in a late preterm and term population was a cost-effective alternative to prolonged in-patient observation.

La Colección de Mamíferos “Alberto Cadena García” del Instituto de Ciencias Naturales, Universidad Nacional de Colombia (ICN) ha aportado al conocimiento de los mamíferos en Colombia desde 1959. Con aproximadamente 27.600 especímenes para el año 2020, incluye todos los órdenes de mamíferos reportados para el Colombia y registros de todos los departamentos. Esta colección alberga especímenes de cerca del 80 % de las especies de mamíferos de Colombia. Esta colección contiene material tipo de 21 taxones y tiene disponible la información de sus especímenes en línea. Además de sus actividades de docencia, cuenta con otras colecciones que incluyen huellas, tejidos y registros fotográficos, los cuales tienen continuo crecimiento a partir de salidas de campo de docencia, trabajos de grado, tesis, proyectos de investigación y el depósito de material de entidades externas. Los especímenes de la colección han aportado a más de 90 publicaciones científicas en los últimos 10 años, más de 150 tesis y trabajos de grado de estudiantes de la Universidad Nacional de Colombia.

Twelve species of ungulates are present in Colombia, represented by three species of tapirs, two of peccaries and seven species of deer. A synthesis about the evolutionary and recent history for each of the group is presented, highlighting recent paleontological information for northern South America. Genetic and molecular studies indicate that deer present the greatest uncertainty regarding the number of species and their phylogenetic relationships. By species richness, the Caribbean region, with eight species, is the most diverse, followed by the Andean region with seven, the Orinoquia and Amazonia with six species and finally the Pacific region with four ungulate species. All the species present a greater proportion of their distribution outside protected areas, being two species of Andean ungulates, the mountain tapir (Tapirus pinchaque) and the rabbit deer (Pudu mephistophiles) the only ones reaching 20% of their distribution inside protected areas. Seven species are found in one of the threatened categories of IUCN, in which all species of tapirs are included. Finally, information about hippopotamus (Hippopotamus amphibius) and feral pig (Sus scrofa), alien species with wild populations in Colombia, is presented.

Additional file 1. Data: Questions designed to evaluate HIV stigma.

Summary Background Maternal and neonatal mortality is high in Africa, but few large, prospective studies have been done to investigate the risk factors associated with these poor maternal and neonatal outcomes. Methods A 7-day, international, prospective, observational cohort study was done in patients having caesarean delivery in 183 hospitals across 22 countries in Africa. The inclusion criteria were all consecutive patients (aged ≥18 years) admitted to participating centres having elective and non-elective caesarean delivery during the 7-day study cohort period. To ensure a representative sample, each hospital had to provide data for 90% of the eligible patients during the recruitment week. The primary outcome was in-hospital maternal mortality and complications, which were assessed by local investigators. The study was registered on the South African National Health Research Database, number KZ_2015RP7_22, and on ClinicalTrials.gov, number NCT03044899. Findings Between February, 2016, and May, 2016, 3792 patients were recruited from hospitals across Africa. 3685 were included in the postoperative complications analysis (107 missing data) and 3684 were included in the maternal mortality analysis (108 missing data). These hospitals had a combined number of specialist surgeons, obstetricians, and anaesthetists totalling 0·7 per 100 000 population (IQR 0·2–2·0). Maternal mortality was 20 (0·5%) of 3684 patients (95% CI 0·3–0·8). Complications occurred in 633 (17·4%) of 3636 mothers (16·2–18·6), which were predominantly severe intraoperative and postoperative bleeding (136 [3·8%] of 3612 mothers). Maternal mortality was independently associated with a preoperative presentation of placenta praevia, placental abruption, ruptured uterus, antepartum haemorrhage (odds ratio 4·47 [95% CI 1·46–13·65]), and perioperative severe obstetric haemorrhage (5·87 [1·99–17·34]) or anaesthesia complications (11·47 (1·20–109·20]). Neonatal mortality was 153 (4·4%) of 3506 infants (95% CI 3·7–5·0). Interpretation Maternal mortality after caesarean delivery in Africa is 50 times higher than that of high-income countries and is driven by peripartum haemorrhage and anaesthesia complications. Neonatal mortality is double the global average. Early identification and appropriate management of mothers at risk of peripartum haemorrhage might improve maternal and neonatal outcomes in Africa. Funding Medical Research Council of South Africa.

In South America, wild populations of peccaries coexist with domestic and feral pigs, with poorly understood consequences. We captured 58 collared peccaries ( Pecari tajacu) and 15 feral pigs ( Sus scrofa) in locations of Colombia where coexistence of these species is known. Blood samples were tested for antibodies against four viral agents, classical swine fever virus (CSFV), Aujeszky's disease virus (ADV), porcine circovirus (PCV-2), and vesicular stomatitis virus (New Jersey and Indiana subtypes) and two bacterial agents, Brucella spp. and six serovars of Leptospira interrogans. The prevalence of CSFV was 5% (3/58) in collared peccaries and 7% (1/15) in feral pigs. The prevalence of PCV-2 was 7% (1/15) in collared peccaries and 67% (2/3) in feral pigs. Vesicular stomatitis prevalence was 33% (8/24) in collared peccaries and 67% (4/6) in feral pigs. Leptospira prevalence was 78% (39/50) in collared peccary and 100% (8/8) in feral pigs; bratislava, grippotyphosa, icterohaemorrhagiae, and pomona were the most frequent serovars. Also, the only white-lipped peccary ( Tayassu pecari) sampled was positive for L. interrogans serovar bratislava and for vesicular stomatitis virus, New Jersey strain. No samples were positive for ADV or Brucella. The seroprevalence of antibodies against L. interrogans was similar to that observed in other studies. Icterohaemorrhagiae appears to be a common serovar among in situ and ex situ peccary populations. Positive antibodies against PVC-2 represent a novel report of exposure to this pathogen in Colombian peccaries. Our results indicate the possible transmission of various pathogens, important for pig farms, in the studied pig and peccaries.

Background The African Surgical Outcomes Study (ASOS) showed that surgical patients in Africa have a mortality twice the global average. Existing risk assessment tools are not valid for use in this population because the pattern of risk for poor outcomes differs from high-income countries. The objective of this study was to derive and validate a simple, preoperative risk stratification tool to identify African surgical patients at risk for in-hospital postoperative mortality and severe complications. Methods ASOS was a 7-day prospective cohort study of adult patients undergoing surgery in Africa. The ASOS Surgical Risk Calculator was constructed with a multivariable logistic regression model for the outcome of in-hospital mortality and severe postoperative complications. The following preoperative risk factors were entered into the model; age, sex, smoking status, ASA physical status, preoperative chronic comorbid conditions, indication for surgery, urgency, severity, and type of surgery. Results The model was derived from 8799 patients from 168 African hospitals. The composite outcome of severe postoperative complications and death occurred in 423/8799 (4.8%) patients. The ASOS Surgical Risk Calculator includes the following risk factors: age, ASA physical status, indication for surgery, urgency, severity, and type of surgery. The model showed good discrimination with an area under the receiver operating characteristic curve of 0.805 and good calibration with c-statistic corrected for optimism of 0.784. Conclusions This simple preoperative risk calculator could be used to identify high-risk surgical patients in African hospitals and facilitate increased postoperative surveillance. Clinical trial registration NCT03044899.

Summary Background There is a need to increase access to surgical treatments in African countries, but perioperative complications represent a major global health-care burden. There are few studies describing surgical outcomes in Africa. Methods We did a 7-day, international, prospective, observational cohort study of patients aged 18 years and older undergoing any inpatient surgery in 25 countries in Africa (the African Surgical Outcomes Study). We aimed to recruit as many hospitals as possible using a convenience sampling survey, and required data from at least ten hospitals per country (or half the surgical centres if there were fewer than ten hospitals) and data for at least 90% of eligible patients from each site. Each country selected one recruitment week between February and May, 2016. The primary outcome was in-hospital postoperative complications, assessed according to predefined criteria and graded as mild, moderate, or severe. Data were presented as median (IQR), mean (SD), or n (%), and compared using t tests. This study is registered on the South African National Health Research Database (KZ_2015RP7_22) and ClinicalTrials.gov (NCT03044899). Findings We recruited 11 422 patients (median 29 [IQR 10–70]) from 247 hospitals during the national cohort weeks. Hospitals served a median population of 810 000 people (IQR 200 000–2 000 000), with a combined number of specialist surgeons, obstetricians, and anaesthetists totalling 0·7 (0·2–1·9) per 100 000 population. Hospitals did a median of 212 (IQR 65–578) surgical procedures per 100 000 population each year. Patients were younger (mean age 38·5 years [SD 16·1]), with a lower risk profile (American Society of Anesthesiologists median score 1 [IQR 1–2]) than reported in high-income countries. 1253 (11%) patients were infected with HIV, 6504 procedures (57%) were urgent or emergent, and the most common procedure was caesarean delivery (3792 patients, 33%). Postoperative complications occurred in 1977 (18·2%, 95% CI 17·4–18·9]) of 10 885 patients. 239 (2·1%) of 11 193 patients died, 225 (94·1%) after the day of surgery. Infection was the most common complication (1156 [10·2%] of 10 970 patients), of whom 112 (9·7%) died. Interpretation Despite a low-risk profile and few postoperative complications, patients in Africa were twice as likely to die after surgery when compared with the global average for postoperative deaths. Initiatives to increase access to surgical treatments in Africa therefore should be coupled with improved surveillance for deteriorating physiology in patients who develop postoperative complications, and the resources necessary to achieve this objective. Funding Medical Research Council of South Africa.

Chronic kidney disease has been known to affect thyroid hormone metabolism. Low serum levels of T3 and T4 are the most remarkable laboratorial findings. A high incidence of goiter and nodules on thyroid ultrasonography has been reported in patients with end-stage renal disease (ESRD). Our objective is to evaluate the prevalence of laboratorial and morphologic alterations in the thyroid gland in a cohort of patients with ESRD on hemodialysis (HD). Sixty-one patients with ESRD on HD were selected and compared with 43 healthy subjects matched by age, gender, and weight. Patients were submitted to thyroid ultrasonography. T3, free T4 (FT4), thyroid-stimulating hormone, antithyroglobulin, and antithyroperoxidase antibodies were measured. The mean age of patients with ESRD was 47.4 ± 12.3 and 61% were women. ESRD was mainly caused by hypertensive nephrosclerosis and diabetic nephropathy. Mean thyroid volume, as determined by ultrasonography, was similar in both groups. Patients with ESRD had more hypoechoic nodules when compared with the control group (24.1% vs. 7.9%, P = 0.056). Mean serum FT4 and T3 levels were significantly lower in patients with ESRD, and subclinical hypothyroidism was more prevalent in patients with ESRD (21.82% vs. 7.14% control group, P = 0.04). Titers of antithyroid antibodies were similar in both groups. ESRD was associated with a higher prevalence of subclinical hypothyroidism and lower levels of T3 and FT4. Almost a quarter of patients showed thyroid nodules >10 mm. Periodic ultrasound evaluation and assessment of thyroid function are recommended in patients with ESRD on HD.

Hydrological studies in experimental and representative basins are of fundamental importance for water resources management. This paper presents some activities of hydrological research in experimental and representative basins of the State of Pernambuco, Brazil. The study areas are located at Tapacurá and Mundaú representative basins and at the Gameleira experimental basin, and in experimental plots in Pajeú basin. In the Tapacurá basin, three studies were performed: (1) different monthly coefficients "k" of the Thornthwaite method were tested to calculate the effective temperature and, consequently, the reference evapotranspiration, giving rise to the method identified as Modified Thornthwaite; (2) the spatial variability of the retention curve and hydraulic conductivity parameters were analysed using the Beerkan method; (3) changes in vegetation cover were evaluated through the NDVI and NDWI indexes using TM–Landsat 5 images. In the Mundaú representative basin, the performance of different evapotranspiration methods was evaluated and compared to the FAO standard method, Penman-Monteith. In the Pajeú basin, the experimental plot is covered by pasture and sensors were installed to monitor the following variables: rainfall, air temperature, the energy balance components (net radiation, latent and sensible heat, and soil heat flux), wind velocity and CO2 flux into atmosphere, soil moisture and runoff.

Background and objective Dental calculus is a mineralized deposit attached to the tooth surface. We have shown that cellular uptake of dental calculus triggers nucleotide-binding oligomerization domain-like receptor family pyrin domain-containing 3 (NLRP3) inflammasome activation, leading to the processing of the interleukin-1β precursor into its mature form in mouse and human phagocytes. The activation of the NLRP3 inflammasome also induced a lytic form of programmed cell death, pyroptosis, in these cells. However, the effects of dental calculus on other cell types in periodontal tissue have not been investigated. The aim of this study was to determine whether dental calculus can induce cell death in oral epithelial cells. Material and methods HSC-2 human oral squamous carcinoma cells, HOMK107 human primary oral epithelial cells and immortalized mouse macrophages were exposed to dental calculus or 1 of its components, hydroxyapatite crystals. For inhibition assays, the cells were exposed to dental calculus in the presence or absence of cytochalasin D (endocytosis inhibitor), z-YVAD-fmk (caspase-1 inhibitor) or glyburide (NLRP3 inflammasome inhibitor). Cytotoxicity was determined by measuring lactate dehydrogenase (LDH) release and staining with propidium iodide. Tumor necrosis factor-α production was quantified by enzyme-linked immunosorbent assay. Oral epithelial barrier function was examined by permeability assay. Results Dental calculus induced cell death in HSC-2 cells, as judged by LDH release and propidium iodide staining. Dental calculus also induced LDH release from HOMK107 cells. Following heat treatment, dental calculus lost its capacity to induce tumor necrosis factor-α in mouse macrophages, but could induce LDH release in HSC-2 cells, indicating a major role of inorganic components in cell death. Hydroxyapatite crystals also induced cell death in both HSC-2 and HOMK107 cells, as judged by LDH release, indicating the capacity of crystal particles to induce cell death. Cell death induced by dental calculus was significantly inhibited by cytochalasin D, z-YVAD-fmk and glyburide, indicating NLRP3 inflammasome involvement. In permeability assays, dental calculus attenuated the barrier function of HSC-2 cell monolayers. Conclusion Dental calculus induces pyroptotic cell death in human oral epithelial cells and the crystalline structure plays a major role in this process. Oral epithelial cell death induced by dental calculus might be important for the etiology of periodontitis.

A single, unifying mechanism explaining the cause of necrotizing enterocolitis has remained elusive. It is unlikely that one precipitating cause will be found. However, it is increasingly evident that common risk factors do exist such as intestinal immaturity, dysbiosis, and feeding (including type of feeding). Modifying these risk factors to facilitate optimal postnatal intestinal development may lessen the vulnerability to intestinal injury in the preterm infant. Understanding the feeding and medical practices employed in the neonatal intensive care unit and their potential effects on postnatal intestinal development will begin to inform bedside strategies to reduce maladaptive intestinal responses in the preterm infant and the risk of this devastating disease.

In most of the northeast region of Brazil rainfall is relatively low, presenting significant inter-annual fluctuations, especially when compared to rainfall in other areas of Brazil. Moreover, evaporative rates (like the ones found in the northeast semi-arid region) are too high, sometimes reaching over 2800 mm annually. Owing to such a climate character, very large areas in northeast Brazil are subjected to recurrent droughts. This paper presents a methodology for the prediction of seasonal rainfall in semi-arid lands of northeast Brazil. A total of 72 raingauge stations of Paraiba State, and 84 in Ceará State were employed, all of them distributed in three and seven homogeneous areas, respectively. A rainy season with different subdivisions was established for each homogeneous area. The zi proportions – the ratio between the cumulative rainfall of the first rainy season period and the rain that falls during the whole rainy season were made to fit the Beta probabilistic model used for calculating the second and eighth deciles and the probability of rainfall above the average rainfall for the second period of the rainy season. The performance of the prognostic model for individual stations of Paraíba State in the period 1996–2000 was evaluated. In the period 1996 to 2000, with rainfall above average, the error was less than 20 %. The methodology adopted proved very accurate for forecasting droughts in northeast Brazil.

In the first section of this paper, the activity of an iron–chromium-based catalyst for the water–gas-shift reaction is studied at laboratory scale. The influence on the activity of the sweet shift catalyst of the main operating parameters-temperature, space velocity, excess steam, pressure, and gas composition-is evaluated. Base case gas composition M1 was set according to that of the IGCC Power Plant of Puertollano, Spain (ELCOGAS): N 2 13.4 vol%, CO 60.7 vol%, H 2 22.3 vol%, and CO 2 3.6 vol%. The effect of gas hourly space velocity GHSV (2000–5000 h −1 ), steam to CO ratio R , (1–3 mol mol −1 ), pressure P (0.1–2 MPa), and temperature (523–653 K) has been determined. In order to study the effect of gas composition on the activity of the WGS catalyst, the following gas mixtures have been evaluated: M2 (CO 60.7 vol%, H 2 22.3 vol%, and CO 2 17 vol%); M3 (CO 60 vol%, N 2 40 vol%); and M4 (CO 60 vol%, and CO 2 40 vol%). The second part of this paper deals with subsequent WGS testing at bench-scale level, based on the results obtained at laboratory scale. Tests were performed using a gas composition according to that of ELCOGAS IGCC plant. The operating temperature was 583 K, pressure was set at 1 MPa, and gas space velocity was 4715 h −1 . The effect of steam to CO ratio was evaluated.

Successful conservation requires an understanding of animal movement patterns and space use. Such data are hard to obtain, however, when difficult terrain, nocturnal habits, or lack of habituation make direct observation impractical. White-footed tamarins (Saguinus leucopus) are small primates endemic to Colombia that are in danger of extinction due to habitat loss, fragmentation, and the illegal pet trade. Here, we report the results of the first study to use radio-tracking to investigate white-footed tamarin ranging behavior. We recorded the movements of three neighboring tamarin groups simultaneously for 3 month using radio-telemetry. Home range sizes (estimated using both minimum convex polygon and fixed kernel contour methods) were substantially larger than reported in previous studies that did not use remote-tracking. Monte Carlo resampling procedures revealed that home range size differed significantly among the three groups but that the mean daily path length did not. As in other tamarin species, the degree of range overlap between neighboring social groups was high, ranging from 27 to 81%. Using a randomization test, we showed that the observed mean distance between groups was significantly lower than expected by chance for two of the three group dyads. This pattern of intergroup “attraction,” in conjunction with substantial range overlap and high population density, implies that the Bellavista Forest, one of the few remaining habitats of Saguinus leucopus, may be saturated, and promoting habitat restoration should be a priority for the conservation of this species.