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In Colombia, Public-Private Partnerships have emerged as a tool for increasing the development of infrastructure projects for highways. These projects have focused on economic highways and have set aside the social ones. This article proposes a conceptual framework based on shadow toll schemes, cash flows, and the three bands proposed by the World Bank, which are used in this article as mechanisms for funding rural highway projects. Strategic financial indicators were considered in designing the proposal. Thus, it is appropriate to encourage both private investment and financial mechanisms to promote projects which will have a social impact. In addition, this article introduces new policies to be implemented by the Colombian government with the aim of encouraging private investors to invest in social highways. As a result, it is expected that this work will contribute to enhancing the financing process in Colombia. It is concluded that to increase the development of rural highways, the creation of a debt fund with an investment focus on social projects is mandatory. Future research opportunities on this topic are identified. [ABSTRACT FROM AUTHOR]

The goal of this study was to establish a reproducible protocol to measure active extension strength in the index finger. The secondary objectives consisted in correlating the independent or associated index extension strength to the other fingers force of contraction of the extensor indicis propius with hand dominance. The population studied consisted of 24 healthy volunteers, including 19 women and 20 right-handed individuals. The independent and dependent index extension strength in each hand was measured three times with a dynamometer by three examiners at Day 0 and again at Day 7. Intra and inter-examiner reproducibility were, respectively, >0.90 and >0.75 in all cases. The independent extension strength was lower than the dependent one. There was no difference between the independent index extension strength on the dominant and non-dominant sides. The same was true for the dependent strength. Our results show that our protocol is reproducible in measuring independent and dependent index extension strength. Dominance did not come into account.Level of evidence: II [ABSTRACT FROM AUTHOR]

The growing need for promoting the development of social infrastructure in order to close the gap in potable water supply requires an active participation of the private sector. Indeed, public policies are required to detect the critical aspects and challenges toward a reliable water supply for larger populations. This paper emphasizes the analysis and assessment of the current conditions of potable water supply sector in Colombia. In this context, we do consider potable water supply as an important component of social infrastructure taking into account the existing regulations for utility companies in Colombia and the current legislation (Bill 1508/2012), which promotes private sector participation in developing infrastructure. As a result of this analysis, new policies could be implemented by local authorities to foster new private investments in social infrastructure projects. In addition, new funding mechanisms could be explored to diversify the supply of financial resources, including those from capital markets and multilateral agencies. It is expected that this paper will contribute to define policies and best practices to increase the participation of the private sector in potable water supply taking into account the legal and regulatory environment in Colombia, which it is very similar to other developing countries. [ABSTRACT FROM AUTHOR]

The article provides information on the surgical treatment of collateral nerves. Topics include the dissection of the nerves, the tensile strength of the nerve, and the use of a pycnometer. The article also discusses the need for nerve studies, the use of Young's Modulus, and the linear regression of the nerve.

Hip fracture is a public health problem recognized worldwide and a potentially catastrophic threat for older persons, even carrying a demonstrated excess of mortality. Handgrip strength (HGS) has been identified as a predictor of different outcomes (mainly mortality and disability) in several groups with hip fracture., Purpose: The aim of this study was to determine the association between low HGS and 1-year mortality in a cohort of older patients over 60 years old with fragility hip fractures who underwent surgery in the Colombian Andes Mountains., Methods: A total of 126 patients (median age 81 years, women 77%) with a fragility hip fracture during 2019-2020 were admitted to a tertiary care hospital. HGS was measured using dynamometry upon admission, and data about sociodemographic, clinical and functional, laboratory, and surgical intervention variables were collected. They were followed up until discharge. Those who survived were contacted by telephone at one, three, and 12 months. Bivariate, multivariate, and Kaplan-Meier analyses with survival curves were performed., Results: The prevalence of low HGS in the cohort was 71.4%, and these patients were older, had poorer functional and cognitive status, higher comorbidity, higher surgical risk, time from admission to surgery > 72 h, lower hemoglobin and albumin values, and greater intra-hospital mortality at one and three months (all p < 0.01). Mortality at one year in in patients with low HGS was 42.2% and 8.3% in those with normal HGS, with a statistically significant difference (p = 0.000). In the multivariate analysis, low HGS and dependent gait measured by Functional Ambulation Classification (FAC) were the factors affecting postoperative 1-year mortality in older adults with hip fractures., Conclusion: In this study of older people with fragility hip fractures, low HGS and dependent gait were independent predictive markers of 1-year mortality., (© 2024. The Author(s).)

Physiologically based stress detection systems have proven to be effective in identifying different stress conditions in the body to determine the source of stress and be able to counteract it. However, some stress conditions have not been widely studied, including thermal stress, cognitive stress, and combined (thermal-cognitive) stress conditions, which are frequently encountered in work or school environments. In order to develop systems to detect and differentiate these conditions, it is necessary to identify the physiological indicators that characterize each of them. The present research aims to identify which physiological indicators (heart rate, respiratory rate, galvanic skin response, and local temperature) could differentiate different stress conditions (no-stress, cognitive stress, thermal stress, and combined (thermal-cognitive) stress conditions). Thirty participants were exposed to cognitive, thermal, and combined stress sources while recording their physiological signals. The findings indicate that both mean heart rate and mean galvanic skin response identify moderate thermal and cognitive stress conditions as distinct from a no-stress condition, yet they do not differentiate between the two stress conditions. Additionally, heart rate uniquely identifies the cognitive-thermal stress condition, effectively distinguishing this combined stress condition from the singular stress conditions and the no-stress condition. Mean local temperature specifically signals thermal stress conditions, whereas mean respiratory rate accurately identifies cognitive stress conditions, with both indicators effectively separating these conditions from each other and from the no-stress condition. This is the first basis for differentiating thermal and cognitive stress conditions through physiological indicators., (© 2024 Society for Psychophysiological Research.)

Gene expression assays (GEAs) can guide treatment for early-stage breast cancer. Several large prospective randomized clinical trials, and numerous additional studies, now provide new information for selecting an appropriate GEA. This systematic review builds upon prior reviews, with a focus on five widely commercialized GEAs (Breast Cancer Index®, EndoPredict®, MammaPrint®, Oncotype DX®, and Prosigna®). The comprehensive dataset available provides a contemporary opportunity to assess each GEA's utility as a prognosticator and/or predictor of adjuvant therapy benefit., (© 2024 The Author(s). Journal of Surgical Oncology published by Wiley Periodicals LLC.)

We present the case of a 53-year-old Caucasian man with a history of intravenous drug use who presented with fever and multiple pustules predominantly affecting hairy areas of the body, with no clinical improvement despite previous antibiotic treatment. Culture of the pustules confirmed Candida albicans infection and histological examination of skin biopsies revealed suppurative granulomas compatible with candidomycetic folliculitis. The patient was successfully treated with systemic antifungals and discharged with resolution of symptoms. Candidomycetic folliculitis is a condition typically associated with brown heroin consumption due to the use of acidic solvent that promotes Candida growth. Clinical manifestations include fever followed by skin lesions, with possible systemic involvement if untreated. Extensive folliculitis with associated fever in an IVDU should raise suspicion of this pathology since early diagnosis and appropriate treatment are crucial to prevent complications., Competing Interests: Declaration of competing interest None., (Copyright © 2024 Japanese Society of Chemotherapy, Japanese Association for Infectious Diseases, and Japanese Society for Infection Prevention and Control. Published by Elsevier Ltd. All rights reserved.)

Urbanization and agricultural intensification are considered the main causes of recent insect decline in temperate Europe, while direct climate warming effects are still ambiguous. Nonetheless, higher temperatures advance spring leaf emergence, which in turn may directly or indirectly affect insects. We therefore investigated how Sentinel-2-derived start of season (SOS) and its spatial variability (SV-SOS) are affected by spring temperature and whether these green-up variables can explain insect biomass and richness across a climate and land-use gradient in southern Germany. We found that the effects of both spring green-up variables on insect biomass and richness differed between land-use types, but were strongest in forests. Here, insect richness and biomass were higher with later green-up (SOS) and higher SV-SOS. In turn, higher spring temperatures advanced SOS, while SV-SOS was lower at warmer sites. We conclude that with a warming climate, insect biomass and richness in forests may be affected negatively due to earlier and more uniform green-up. Promising adaptation strategies should therefore focus on spatial variability in green-up in forests, thus plant species and structural diversity., (© 2023. Springer Nature Limited.)

Background: Intraoperative ultrasound (IOUS) guided conservative surgery has been shown to reduce rates of positive margins in breast cancer. The aim of the study is to evaluate the feasibility of using IOUS to assess superficial/anterior margins in nipple and skin sparing mastectomy (NSM/SSM) and its impact on reducing rates of positive margins., Methods: This prospective study includes all breast cancer patients who had an indication for NSM/SSM at our Institution. Superficial margin width was measured by IOUS before surgery and the area marked on the skin. Same measurement was performed afterwards in the mastectomy specimen. Any superficial margin < 5 mm was re-excised intraoperatively following the mark on the skin., Results: Fifty-nine patients were included, 47 patients (79.7%) underwent NSM, and 12 patients (20.3%) a SSM. Of the 59 patients, 23 (38.98%) had margins ≥5 mm and 36 patients (61.02%) had margins of ≤5 mm. Of the 36 patients with superficial margins ≤5 mm, 20 had margins <2 mm, and 6 of them had intraoperative involved superficial margins in final pathology. However, after IOUS-guided re-excision, final pathology showed no involved margins. A 2 mm margin was set as the cut-off point for performing an intraoperative re-excision. IOUS guided re-excisions for intraoperative margins ≤2 mm significantly reduced the risk of close/positive margins in final pathology, p < 0.0001., Conclusion: The results showed that IOUS margin evaluation significantly reduced the rate of superficial positive margins in NSM/SSM. It is feasible and effective and may avoid challenging reoperations and/or additional radiation therapy for positive margins., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (© 2023 Published by Elsevier Ltd.)

Arthropods respond to vegetation in multiple ways since plants provide habitat and food resources and indicate local abiotic conditions. However, the relative importance of these factors for arthropod assemblages is less well understood. We aimed to disentangle the effects of plant species composition and environmental drivers on arthropod taxonomic composition and to assess which aspects of vegetation contribute to the relationships between plant and arthropod assemblages. In a multi-scale field study in Southern Germany, we sampled vascular plants and terrestrial arthropods in typical habitats of temperate landscapes. We compared independent and shared effects of vegetation and abiotic predictors on arthropod composition distinguishing between four large orders (Lepidoptera, Coleoptera, Hymenoptera, Diptera), and five functional groups (herbivores, pollinators, predators, parasitoids, detritivores). Across all investigated groups, plant species composition explained the major fraction of variation in arthropod composition, while land-cover composition was another important predictor. Moreover, the local habitat conditions depicted by the indicator values of the plant communities were more important for arthropod composition than trophic relationships between certain plant and arthropod species. Among trophic groups, predators showed the strongest response to plant species composition, while responses of herbivores and pollinators were stronger than those of parasitoids and detritivores. Our results highlight the relevance of plant community composition for terrestrial arthropod assemblages across multiple taxa and trophic levels and emphasize the value of plants as a proxy for characterizing habitat conditions that are hardly accessible to direct environmental measurements., (© 2023. The Author(s).)

Urban grasslands are crucial for biodiversity and ecosystem services in cities, while little is known about their multifunctionality under climate change. Thus, we investigated the effects of simulated climate change, i.e., increased [CO2] and temperature, and reduced precipitation, on individual functions and overall multifunctionality in mesocosm grasslands sown with forbs and grasses in four different proportions aiming at mimicking road verge grassland patches. Climate change scenarios RCP2.6 (control) and RCP8.5 (worst-case) were simulated in walk-in climate chambers of an ecotron facility, and watering was manipulated for normal vs. reduced precipitation. We measured eight indicator variables of ecosystem functions based on below- and aboveground characteristics. The young grassland communities responded to higher [CO2] and warmer conditions with increased vegetation cover, height, flower production, and soil respiration. Lower precipitation affected carbon cycling in the ecosystem by reducing biomass production and soil respiration. In turn, the water regulation capacity of the grasslands depended on precipitation interacting with climate change scenario, given the enhanced water efficiency resulting from increased [CO2] under RCP8.5. Multifunctionality was negatively affected by reduced precipitation, especially under RCP2.6. Trade-offs arose among single functions that performed best in either grass- or forb-dominated grasslands. Grasslands with an even ratio of plant functional types coped better with climate change and thus are good options for increasing the benefits of urban green infrastructure. Overall, the study provides experimental evidence of the effects of climate change on the functionality of urban ecosystems. Designing the composition of urban grasslands based on ecological theory may increase their resilience to global change., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2023 Rojas-Botero et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

Dung beetles are important actors in the self-regulation of ecosystems by driving nutrient cycling, bioturbation, and pest suppression. Urbanization and the sprawl of agricultural areas, however, destroy natural habitats and may threaten dung beetle diversity. In addition, climate change may cause shifts in geographical distribution and community composition. We used a space-for-time approach to test the effects of land use and climate on α-diversity, local community specialization ( H 2 ') on dung resources, and γ-diversity of dung-visiting beetles. For this, we used pitfall traps baited with four different dung types at 115 study sites, distributed over a spatial extent of 300 km × 300 km and 1000 m in elevation. Study sites were established in four local land-use types: forests, grasslands, arable sites, and settlements, embedded in near-natural, agricultural, or urban landscapes. Our results show that abundance and species density of dung-visiting beetles were negatively affected by agricultural land use at both spatial scales, whereas γ-diversity at the local scale was negatively affected by settlements and on a landscape scale equally by agricultural and urban land use. Increasing precipitation diminished dung-visiting beetle abundance, and higher temperatures reduced community specialization on dung types and γ-diversity. These results indicate that intensive land use and high temperatures may cause a loss in dung-visiting beetle diversity and alter community networks. A decrease in dung-visiting beetle diversity may disturb decomposition processes at both local and landscape scales and alter ecosystem functioning, which may lead to drastic ecological and economic damage., Competing Interests: The authors declare that they have no conflicts of interest., (© 2022 The Authors. Ecology and Evolution published by John Wiley & Sons Ltd.)

Higher temperatures can increase metabolic rates and carbon demands of invertebrate herbivores, which may shift leaf-chewing herbivory among plant functional groups differing in C:N (carbon:nitrogen) ratios. Biotic factors influencing herbivore species richness may modulate these temperature effects. Yet, systematic studies comparing leaf-chewing herbivory among plant functional groups in different habitats and landscapes along temperature gradients are lacking. This study was conducted on 80 plots covering large gradients of temperature, plant richness and land use in Bavaria, Germany. We investigated proportional leaf area loss by chewing invertebrates ('herbivory') in three plant functional groups on open herbaceous vegetation. As potential drivers, we considered local mean temperature (range 8.4-18.8 °C), multi-annual mean temperature (range 6.5-10.0 °C), local plant richness (species and family level, ranges 10-51 species, 5-25 families), adjacent habitat type (forest, grassland, arable field, settlement), proportion of grassland and landscape diversity (0.2-3 km scale). We observed differential responses of leaf-chewing herbivory among plant functional groups in response to plant richness (family level only) and habitat type, but not to grassland proportion, landscape diversity and temperature-except for multi-annual mean temperature influencing herbivory on grassland plots. Three-way interactions of plant functional group, temperature and predictors of plant richness or land use did not substantially impact herbivory. We conclude that abiotic and biotic factors can assert different effects on leaf-chewing herbivory among plant functional groups. At present, effects of plant richness and habitat type outweigh effects of temperature and landscape-scale land use on herbivory among legumes, forbs and grasses., (© 2022. The Author(s).)

Changes in climate and land use are major threats to pollinating insects, an essential functional group. Here, we unravel the largely unknown interactive effects of both threats on seven pollinator taxa using a multiscale space-for-time approach across large climate and land-use gradients in a temperate region. Pollinator community composition, regional gamma diversity, and community dissimilarity (beta diversity) of pollinator taxa were shaped by climate-land-use interactions, while local alpha diversity was solely explained by their additive effects. Pollinator diversity increased with reduced land-use intensity (forest < grassland < arable land < urban) and high flowering-plant diversity at different spatial scales, and higher temperatures homogenized pollinator communities across regions. Our study reveals declines in pollinator diversity with land-use intensity at multiple spatial scales and regional community homogenization in warmer and drier climates. Management options at several scales are highlighted to mitigate impacts of climate change on pollinators and their ecosystem services.

Arthropod predators are important for ecosystem functioning by providing top-down regulation of insect herbivores. As predator communities and activity are influenced by biotic and abiotic factors on different spatial scales, the strength of top-down regulation ('arthropod predation') is also likely to vary. Understanding the combined effects of potential drivers on arthropod predation is urgently needed with regard to anthropogenic climate and land-use change. In a large-scale study, we recorded arthropod predation rates using artificial caterpillars on 113 plots of open herbaceous vegetation embedded in contrasting habitat types (forest, grassland, arable field, settlement) along climate and land-use gradients in Bavaria, Germany. As potential drivers we included habitat characteristics (habitat type, plant species richness, local mean temperature and mean relative humidity during artificial caterpillar exposure), landscape diversity (0.5-3.0-km, six scales), climate (multi-annual mean temperature, 'MAT') and interactive effects of habitat type with other drivers. We observed no substantial differences in arthropod predation rates between the studied habitat types, related to plant species richness and across the Bavarian-wide climatic gradient, but predation was limited when local mean temperatures were low and tended to decrease towards higher relative humidity. Arthropod predation rates increased towards more diverse landscapes at a 2-km scale. Interactive effects of habitat type with local weather conditions, plant species richness, landscape diversity and MAT were not observed. We conclude that landscape diversity favours high arthropod predation rates in open herbaceous vegetation independent of the dominant habitat in the vicinity. This finding may be harnessed to improve top-down control of herbivores, e.g. agricultural pests, but further research is needed for more specific recommendations on landscape management. The absence of MAT effects suggests that high predation rates may occur independent of moderate increases of MAT in the near future., Competing Interests: The authors have declared that no competing interests exist.

European roe deer ( Capreolus capreolus L.) are important given their economic, recreational and ecological value. However, uncontrolled roe deer numbers can result in negative impacts on forest regeneration and agricultural crops, disease transmission and occurrences of deer-vehicle collisions. Information on the abundance and distribution is needed for effective management. We combined distance sampling (DS) of roe deer dung pellet groups with multiple variables to develop a density surface model (DSM) in the federal state of Bavaria in south-eastern Germany. We used the estimates of pellet group density as a proxy for roe deer relative abundance. We extrapolated our best DSM, conducted a quantitative evaluation and contrasted relative abundance along climate and land-use gradients. Relative abundance of roe deer was influenced by a combination of habitat type, climate and wildlife management variables, which differed between seasons and which reflected changes in food and shelter availability. At the landscape scale, the highest abundance was observed in agriculture-dominated areas and the lowest in urban areas. Higher abundance was also observed in areas with intermediate temperatures compared to the warmest areas. Our results provide information on possible future changes in the distribution of relative abundance due to changes in climate and land-use.

Recently reported insect declines have raised both political and social concern. Although the declines have been attributed to land use and climate change, supporting evidence suffers from low taxonomic resolution, short time series, a focus on local scales, and the collinearity of the identified drivers. In this study, we conducted a systematic assessment of insect populations in southern Germany, which showed that differences in insect biomass and richness are highly context dependent. We found the largest difference in biomass between semi-natural and urban environments (-42%), whereas differences in total richness (-29%) and the richness of threatened species (-56%) were largest from semi-natural to agricultural environments. These results point to urbanization and agriculture as major drivers of decline. We also found that richness and biomass increase monotonously with increasing temperature, independent of habitat. The contrasting patterns of insect biomass and richness question the use of these indicators as mutual surrogates. Our study provides support for the implementation of more comprehensive measures aimed at habitat restoration in order to halt insect declines., (© 2021. The Author(s).)

This paper presented a new approach to the calculation of quality-adjusted life years (QALY) based on multi-criteria decision-making (MCDM) methods and using the EQ-5D-5L questionnaire. The health status utility values were calculated through a hybrid methodology. We combined the analytic hierarchy process (AHP), the AHP with a D-number extended fuzzy preference relation (D-AHP), the fuzzy analytic hierarchy process (F-AHP), and the technique for order preference by similarity to the ideal solution (TOPSIS) to obtain individual and aggregated utility values. The preference data were elicited using a sample of individuals from a Colombian university. In all tested methods, the ordinal preferences were consistent, and the weights were compared using the Euclidean distance criterion (EDC). We identified F-AHP-TOPSIS as the optimal method; its benefits were associated with modeling the response options of the EQ-5D in linguistic terms, it gave the best approximation to the initial preferences according to EDC, and it could be used as an alternative to the known prioritization method. This hybrid methodology was particularly useful in certain medical decisions concerned with understanding how a specific person values his or her current health or possible health outcomes from different interventions in small population samples and studies carried out in low- and middle-low-income countries.

Purpose of Review: In this review, we discuss the current implications of the changing genomic epidemiology of the Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2), etiological agent of the Coronavirus Disease 2019 (COVID-19) and its potential relationship with the change of clinical manifestations in patients with confirmed infection., Recent Findings: Over the course of the current pandemic, the virus has been found more diverse in new countries. Simultaneously, also new clinical manifestations are observed, particularly more prominent gastrointestinal and neurological findings., Summary: SARS-CoV-2/COVID-19 is changing not only its epidemiology, but also its genomic diversity and clinical manifestations, both aspects coupled, needs to be considered in the study of this ongoing pandemic., (© Springer Nature Switzerland AG 2020.)

Despite being a minor component of cells, phosphoinositides are essential for eukaryotic membrane biology, serving as markers of organelle identity and involved in several signaling cascades. Their many functions, combined with alternative synthesis pathways, make in vivo study very difficult. In vitro studies are limited by their inability to fully recapitulate the complexities of membranes in living cells. We engineered the biosynthetic pathway for the most abundant phosphoinositides into the bacterium Escherichia coli , which is naturally devoid of this class of phospholipids. These modified E. coli , when grown in the presence of myo -inositol, incorporate phosphatidylinositol (PI), phosphatidylinositol-4-phosphate (PI4P), phosphatidylinositol-4,5-bisphosphate (PIP2), and phosphatidylinositol-3,4,5-trisphosphate (PIP3) into their plasma membrane. We tested models of biophysical mechanisms with these phosphoinositides in a living membrane, using our system to evaluate the role of PIP2 in nonconventional protein export of human basic fibroblast growth factor 2. We found that PI alone is sufficient for the process.

This study describes a new total wrist implant (Prosthelast ® ) designed to reduce the risk of distal migration of the carpal component. The Prosthelast ® implant consists in a one-block radial implant replacing the metaphysis and the articular surface fixed to a radial elastic centromedullar wire and a carpal component in titanium with an articular condylar surface in polyethylene. We operated on five patients (three male patients and two female patients) and followed them up for 12 months on average. Two of the patients presented with rheumatoid arthritis of the wrist, and an ulnar osteotomy (Darrach procedure) was carried out at the same time of the arthroplasty. All clinical variables improved postoperatively (Quick DASH score, pain score, range of motion) except from wrist flexion which was reduced. No patients underwent revision surgery. Two patients presented with a periprosthetic radiolucent loosening around the radial component, but no implant migration was observed. Overall, the preliminary results of our case series show that the new Prosthelast ® implant presents comparable short-term results to those described in the literature. We will follow up the patients to verify that long-term results are as satisfactory as the short-term results.