Background Congenital anomalies are the fifth leading cause of mortality in children younger than 5 years globally. Many gastrointestinal congenital anomalies are fatal without timely access to neonatal surgical care, but few studies have been done on these conditions in low-income and middle-income countries (LMICs). We compared outcomes of the seven most common gastrointestinal congenital anomalies in low-income, middle-income, and high-income countries globally, and identified factors associated with mortality. MethodsWe did a multicentre, international prospective cohort study of patients younger than 16 years, presenting to hospital for the first time with oesophageal atresia, congenital diaphragmatic hernia, intestinal atresia, gastroschisis, exomphalos, anorectal malformation, and Hirschsprung's disease. Recruitment was of consecutive patients for a minimum of 1 month between October, 2018, and April, 2019. We collected data on patient demographics, clinical status, interventions, and outcomes using the REDCap platform. Patients were followed up for 30 days after primary intervention, or 30 days after admission if they did not receive an intervention. The primary outcome was all-cause, in-hospital mortality for all conditions combined and each condition individually, stratified by country income status. We did a complete case analysis. FindingsWe included 3849 patients with 3975 study conditions (560 with oesophageal atresia, 448 with congenital diaphragmatic hernia, 681 with intestinal atresia, 453 with gastroschisis, 325 with exomphalos, 991 with anorectal malformation, and 517 with Hirschsprung's disease) from 264 hospitals (89 in high-income countries, 166 in middleincome countries, and nine in low-income countries) in 74 countries. Of the 3849 patients, 2231 (58•0%) were male. Median gestational age at birth was 38 weeks (IQR 36-39) and median bodyweight at presentation was 2•8 kg (2•3-3•3). Mortality among all patients was 37 (39•8%) of 93 in low-income countries, 583 (20•4%) of 2860 in middle-income countries, and 50 (5•6%) of 896 in high-income countries (p<0•0001 between all country income groups). Gastroschisis had the greatest difference in mortality between country income strata (nine [90•0%] of ten in lowincome countries, 97 [31•9%] of 304 in middle-income countries, and two [1•4%] of 139 in high-income countries; p≤0•0001 between all country income groups). Factors significantly associated with higher mortality for all patients combined included country income status (low-income vs high-income countries, risk ratio 2•78 [95% CI 1•88-4•11], p<0•0001; middle-income vs high-income countries, 2•11 [1•59-2•79], p<0•0001), sepsis at presentation (1•20 [1•04-1•40], p=0•016), higher American Society of Anesthesiologists (ASA) score at primary intervention (ASA 4-5 vs ASA 1-2, 1•82 [1•40-2•35], p<0•0001; ASA 3 vs ASA 1-2, 1•58, [1•30-1•92], p<0•0001]), surgical safety checklist not used (1•39 [1•02-1•90], p=0•035), and ventilation or parenteral nutrition unavailable when needed (ventilation 1•96, [1•4...
Emotional processing (EP) is a complex cognitive function necessary to successfully adjust to social environments where we need to interpret and respond to cues that convey threat or reward signals. Ex-combatants have consistently shown atypical EP as well as poor social interactions. Available reintegration programs aim to facilitate the re-adaptation of ex-combatants to their communities. However, they do not incorporate actions to improve EP and to enhance cognitive-emotional regulation. The present study was aimed at evaluating the usefulness of an intervention focused on Social Cognitive Training (SCT), which was designed to equip ex-combatants enrolled in the Social Reintegration Route with EP and social cognition skills. A group of 31 ex-combatants (mean age of 37.2, 29 men) from Colombian illegal armed groups were recruited into this study. Of these, 16 were invited to take part in a SCT and the other continued with the conventional reintegration intervention. Both groups underwent 12 training sessions in a period 12–14 weeks. They were assessed with a comprehensive protocol which included Psychosocial, Behavioral, and Emotion Processing instruments. The scores on these instruments prior to and after the intervention were compared within and between groups. Both groups were matched at baseline. Ex-combatants receiving the SCT experienced significant improvements in EP and a reduction in aggressive attitudes, effects not observed in those continuing the conventional reintegration intervention. This is the first study that achieves such outcomes in such a population using SCT intervention. We discuss the implications of such results toward better social reintegration strategies.
Attention is biased towards threat-related stimuli. In three experiments, we investigated the mechanisms, processes, and time course of this processing bias. An emotional flanker task simultaneously presented affective or neutral pictures from the international affective picture system database either as central response-relevant stimuli or surrounding response-uninformative flankers. Participants' response times to central stimuli was measured. The attentional bias was observed when stimuli were presented either for 1500 ms (Experiment 1) or 500 ms (Experiment 2). The threat-related attentional bias held regardless of the stimuli competing for attention even when presentation time was further reduced to 200 ms (Experiment 3). The results indicate that automatic and controlled mechanisms may interact to modulate the orientation of attention to threat. The data presented here shed new light on the mechanisms, processes, and time course of this long investigated by still largely unknown processing bias.
Droughts constitute natural hazards that affect water supply for ecosystems and human livelihoods. In 2013–2016, the Caribbean experienced the worst drought since the 1950s, and climate projections for the southern Caribbean predict less rainfall by the end of the 21st century. We assessed streamflow response to drought for a watershed in the Colombian Caribbean by analyzing the effects of drought length and land cover on streamflow recovery. We generated a calibrated SWAT model and created annual and monthly drought scenarios from rainfall records. We used our model to predict water yield for selected land covers (wet forest, shade coffee, shrub, and dry forest) under drought conditions. Annual scenarios resulted in water yield reductions of ~15 mm month−1 (wet forest, coffee, and shrub) and 5 mm month−1 (dry forest) for the first month after a two-year drought. Maximum water yield reductions for monthly scenarios occurred after a 10-month drought and were ~100 mm month−1 (wet forest, coffee, and shrub) and 20 mm month−1 (dry forest). Streamflow recovered within nine months (annual scenarios), and two to eight months (monthly scenarios) after drought termination. Drought response seems to be conditioned by climatic factors (rainfall seasonality and spatial variability) and catchment properties.
Emotional processing (EP) is crucial for the elaboration and implementation of adaptive social strategies. EP is also necessary for the expression of social cognition and behavior (SCB) patterns. It is well-known that war contexts induce socio-emotional atypical functioning, in particular for those who participate in combats. Thus, ex-combatants represent an ideal non-clinical population to explore EP modulation and to evaluate its relation with SCB. The aim of this study was to explore EP and its relation with SCB dimensions such as empathy, theory of mind and social skills in a sample of 50 subjects, of which 30 were ex-combatants from illegally armed groups in Colombia, and 20 controls without combat experience. We adapted an Emotional Recognition Task for faces and words and synchronized it with electroencephalographic recording. Ex-combatants presented with higher assertion skills and showed more pronounced brain responses to faces than Controls. They did not show the bias toward anger observed in control participants whereby the latter group was more likely to misclassify neutral faces as angry. However, ex-combatants showed an atypical word valence processing. That is, words with different emotions yielded no differences in N170 modulations. SCB variables were successfully predicted by neurocognitive variables. Our results suggest that in ex-combatants the links between EP and SCB functions are reorganized. This may reflect neurocognitive modulations associated to chronic exposure to war experiences.
Resumen: La gestión de las áreas protegidas en el actual contexto de cambio global requiere de aproximaciones que permitan caracterizar y seguir el funcionamiento de los ecosistemas. La teledetección ofrece herramientas para ello, ya que proporciona índices que informan reiteradamente y para grandes porciones de territorio, de los intercambios de materia y energía que tienen lugar entre la biota y la superficie terrestre. Considerando este principio, y la cada vez mayor disponibilidad de información satelital de calidad y facilidad de uso, desarrollamos junto con el Organismo Autónomo de Parques Nacionales de España (OAPN), un sistema de seguimiento que complementa a otras iniciativas desarrolladas por este organismo para informar del estado de conservación de los parques nacionales. El sistema, denominado REMOTE, se basa en el empleo de los índices de vegetación espectrales (IVs) de uso más extendido (EVI -índice de vegetación mejorado-y NDVI -índice de vegetación normalizado-), derivados de la serie temporal de imágenes satelitales del sensor MODIS-Terra. El sistema permite avanzar en la identificación de las condiciones de referencia para la comprensión y predicción de las respuestas de los ecosistemas frente a perturbaciones e intervenciones, y de los cambios direccionales que éstos están experimentando (tendencias). Así mismo ayuda a la detección de anomalías recientes que alertan de cambios bruscos en el funcionamiento de los ecosistemas. REMOTE se caracteriza porque usa como indicadores tres atributos relacionados con las ganancias de carbono anuales (productividad primaria neta) por parte del dosel vegetal, su estacionalidad y fenología. Además, está diseñado y programado con software libre y gratuito, lo que permitirá modificar o implementar mejoras en él fácilmente. Su implementación tiene como objetivo informar a los tomadores de decisiones y gestores de la Red de Parques Nacionales de España de la salud y estado de conservación de los ecosistemas.Palabras clave: anomalías, atributos funcionales, condiciones de referencia, estado de conservación, ganancias de carbono, índices espectrales de vegetación. System for monitoring ecosystem functioning of Network of National Parks of Spain with remote sensingAbstract: Management of protected areas in the current context of global change requires approaches to characterize and to monitor ecosystem functioning. Remote sensing provides adequate tools for that because it provides indices CASO PRÁCTICO
Executive and cognitive processes constitute an important mechanism to respond to different social demands that people experiment in everyday life. Neuropsychological approaches have evaluated these mechanisms in people with brain injury, mental and behavioral disorders, and recently, in nonclinical populations such as war/armed conflict ex-combatants. Particularly, the long history of Colombian armed conflict allows us to characterize how ex-combatants exposed to armed conflict events identify and learn from social cues to select adaptive and efficient responses. The present study characterizes behavioral and neuropsychological performance in 111 subjects, including victims, ex-combatants, and controls, who were chronically exposed to armed conflict in Colombia. We evaluated cognitive processes such as attention, social categorization, inhibitory control, and cognitive flexibility through computerized and neuropsychological instruments. Results revealed that: (a) ex-combatants had lower performance in cognitive scales compared with the other 2 groups; (b) victims described shorter RTs than ex-combatants and nonexposed controls in attentional task; and (c) nonexposed controls were faster to respond to cognitive flexibility tasks respect to the other 2 groups. We interpreted that differences in the response pattern of ex-combatants and victims are associated with their exposure to armed conflict experiences. We also consider that differential performed among the exposed group is associated with their role in the conflict. We expect in the future to enhance the comprehension of these patterns and contribute to design and implement evidence-based psychological therapies that improve their abilities to adapt to the demands of this social context and, consequently, build peace in those communities.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.