Central Caribbean Research Articles

Hypnosis for depression: Systematic review of randomized clinical trials with meta-analysis

IntroductionMajor Depressive Disorder (MDD) is one of the most debilitating diseases worldwide and has seen a significant increase in diagnoses during the pandemic, demanding more and better therapeutic tools to manage the post-pandemic scenario. ObjectiveThe aim of this systematic review is to provide a comprehensive analysis of the last 20 years of clinical research on Hypnotherapy (HT) to determine whether this intervention has evidence to support its recommendation for the treatment of MDD. MethodsThis review included only randomized clinical trials (RCTs) involving adult populations diagnosed with MDD, regardless of the severity level (mild, moderate, or severe) according to any validated diagnostic criteria, compared to a control group (active treatment or none), with any follow-up duration and free access to the manuscript. The bibliographic survey was conducted across seven distinct databases: MEDLINE (PubMed), Embase, CENTRAL, PsycINFO, Scopus, ScieELO, and Latin American and Caribbean Health Sciences Literature (LILACS). The risk of bias was assessed by two independent investigators using Cochrane's revised tool (RoB 2), and the final judgment was made by consensus. To better analyze the included studies, the certainty of the evidence was evaluated through the Grading of Recommendations Assessment, Development and Evaluation (GRADE). ResultsThere is not enough evidence to indicate that hypnosis-based interventions may reduce the severity of depression, which precludes the clinical recommendation of this intervention for patients in the real world, pending the production of better evidence of effectiveness and safety, although no evidence of significant adverse effects was found.

Shell-bearing Bivalvia and Gastropoda from a rocky shore in the Central Caribbean of Colombia

This study documents the natural accumulation of mollusk shells on an elevated rocky shore carved into the calcareous rocks of the La Popa formation at Punta Roca (Atlántico), covering an estimated area of 0.35 km2. Hydrodynamic transport and differential exposure to environmental conditions are the primary factors contributing to shell deposition. A total of 58 mollusk species were identified, including 30 bivalves and 28 gastropods. The Veneridae was the most prominent, with the highest number of species (7) and shells comprising 64.22 % of the total. Key species contributing to the accumulation include the bivalves Anomalocardia cf. flexuosa, Polymesoda cf. arctata, Leukoma pectorina, Tivela mactroides, Crassostrea rhizophorae, and the gastropod Vitta virginea. These species are primarily characteristic of estuarine environments, with the exception of T. mactroides. Notably, the first recorded occurrence of the non-native gastropod Naria turdus (Cypraeidae) on the Colombian Caribbean coast was documented. The accumulations exhibit varying degrees of abrasion, fragmentation, encrustation, and bioerosion, with some shells appearing almost intact, indicating differences in origin and transport mechanisms. The extraction of shells for ornamental purposes poses a significant challenge to this natural accumulation.

Human impact on the scenic quality of coastal dunes: A study of the central Caribbean coast of Colombia

This paper provides a scenic assessment of 19 dune sites using the Dune Scenery Evaluation System (DSES). The DSES assesses values from a checklist of 18 physical and 8 human parameters and allows the calculation of a scenic evaluation index (D Value), which classifies D sites into five classes: Class I, usually natural areas of top scenic characteristics, to Class V, poor scenic dune areas with a greater impact of human interventions. Our findings reveal a predominance of coastal dune systems falling into middle to lower scenic quality classes (III, IV, and V), indicating considerable degradation due to intense human activities. Notably, these activities have adversely impacted the structural integrity and scenic value of these dunes, leading to a loss of biodiversity and increased vulnerability to natural hazards. This paper highlights the critical need for integrated coastal management strategies that balance conservation with sustainable development. Furthermore, our study proposes the enhancement of existing regulatory frameworks, community engagement in conservation efforts, and the implementation of ecological restoration projects aimed at reversing the degradation and restoring the ecological and scenic value of these vital landscapes. The findings underline the potential of using scenic quality as an ecological indicator to guide conservation and management practices, ensuring the preservation of coastal dunes, which are essential for ecological sustainability and local economic benefits. This multidisciplinary approach not only enriches our understanding of the complex interactions within dune ecosystems but also sets a precedent for future research and policymaking in coastal zone management.

From the closet to the shore: Fashion waste pollution on Colombian Central Caribbean beaches

This paper examines the environmental effects of fashion waste on the central Caribbean coast of Colombia, highlighting significant ecological issues in coastal areas. A survey of 27 beaches found 503 items of fashion waste, mainly shoes and sandals, with an average density of 0.93 items/m2. The distribution of this type of waste varies notably across different beach types, with exposed, rural, and remote beaches showing higher accumulation, indicating a relationship between beach characteristics and waste concentration. Primary sources of this waste include riverine transport, coastal tourism, and poorly managed sewage systems, impacting urban, rural, and village beaches differently. The study reveals that longshore currents and oceanic movements, significantly influence the transport and fate of this waste, with exposed beaches accumulating more fashion waste than sheltered ones. The presence of driftwood also plays a vital role in trapping fashion waste along coastlines. The findings highlight the need for effective management strategies to mitigate the impact of fashion waste, providing crucial insights for local and national coastal managers and implications for managing fashion waste in the Southern Caribbean and similar regions worldwide.

Extreme waves in the Caribbean Sea: spatial regionalization and long-term analysis

The extreme wave height distribution in the Caribbean Sea is studied using a new method based on the maximum basin-wide aggregate of significant wave height, Hs, values per month. Besides, by means of the Self-Organizing Maps (SOM) technique, we identify coherent geographical regions with similar extreme wave height variability in the Caribbean Sea. Our findings revealed three primary regions: the eastern side with comparatively lower values, the central region with intermediate values, and the western side with the highest extreme wave heights. The study also examines the wind forcing conditions driving the spatial and temporal variability of the extreme waves, highlighting the influence of the low-pressure belt dynamics as well as the role played by the Caribbean Low-Level Jet (CLLJ) index, and the impact of cold fronts and hurricanes on extreme wave heights. Additionally, we explore the relationship between the extreme wave height distribution and climatic indices, such as the Atlantic Multidecadal Oscillation (AMO), the Atlantic Meridional Mode (AMM), the North Atlantic Oscillation (NAO) and the Oceanic Niño (ONI). The results reveal that the spatial distribution of extreme wave heights in the Caribbean Sea is mostly ruled by the influence of the CLLJ, with correlations close to 80%. In addition, significant correlations were observed between the extreme wave heights and the ENSO in the central Caribbean, as well as positive correlations between the extreme wave heights and NAO in the eastern part of the basin, and significant values of correlation with the negative phases of AMO and AMM in the whole basin. We show that, unlike conventional (or broadly used) methods deployed to identify extreme wave height, such as percentile 99th, Hs99, our methodology allows a further assessment of the wind and climate forcing conditions associated with the extreme wave events. Although, we acknowledge that the method here presented has limitations to capture extreme wave height outliers, it has the advantage of being used concomitant with the wind forcing to develop multivariate wave climate analysis at basin scale, and could be extended to a more local scale when studying coastal processes.

Identifying the Drivers of Caribbean Severe Weather Impacts

Severe weather impacts in the central Caribbean are quantified by an objective index of daily maximum wind and rainfall (W•R) in the area 16–19°N, 63–69°W over the period 1970–2021. The index, based on ERA5 hindcast assimilation of satellite and in situ data, peaks from the July to October season as high sea temperatures and weak wind shear promote tropical cyclogenesis. Climate forcing is studied by reducing the W•R index to seasonal values and regressing the time series onto reanalysis fields 10°S–25°N, 180°W–20°E. The outcome reflects Jul–Oct warming in the tropical Atlantic, cooling in the tropical east Pacific (cold tongue), decreased/increased convection over the Pacific/Atlantic, and tropical upper easterly winds. New findings emerge in the Mar–Jun season preceding higher W•R: reduced SW-cloud bands in the northeast Pacific, a convective trough over the equatorial Atlantic, and Caribbean cold-air outbreaks. The multivariate El Niño Southern Oscillation index correlates with Jul–Oct Caribbean W•R at 2-month lead time and shows growing influence. Composite analysis of the top-10 years identifies an anomalous Pacific–Atlantic Walker Circulation favoring higher Caribbean W•R. Salinity is below normal and heat flux is downward across the Atlantic. Anomalous low-level airflow inhibits upwelling in the SW Caribbean, deepening atmospheric moisture. A leading case (TC Fiona 2022) demonstrates the environmental conditions underpinning storm intensification. The key drivers of severe weather impacts yield guidance in strategic planning, risk management and disaster preparedness. New insights are gained from a localized index of severe weather.

Dune ecosystems along the central Caribbean coast of Colombia: Evolution, human influences, and conservation challenges

The need for effective coastal dune management holds prominence due to its crucial role in preserving these unique and diverse ecosystems. Dunes have become a focal point in coastal management which reflects their extensive use of coastal areas. This study presents the first assessment of 19 dune systems along an 83 km reach on the Central Caribbean coast of Colombia. These dune systems are classified into four groups: i) Nebkha, ii) Foredunes, iii) Foredune and Blowout, and iv) Foredune, Blowout, and Transgressive dunes; each with unique characteristics and distribution patterns. Vegetation analysis identified 37 species, dominated by herbaceous forms. Four species were found to be new records for the Atlántico Department. Recent analysis of the evolution of these dune systems (1954–2022) revealed both accretion and erosion processes, with a dominant erosion trend in the more recent years. Anthropogenic interventions were minimal in most dune systems, but some exhibited varying levels of human-made structures. Litter was assessed across four grades (A-D), with no dune systems reaching Grade A, and most dunes exhibiting elevated to high-extreme levels of litter (Grades C and D). Coastal dunes are threatened by urbanization, sand mining, litter, invasive species, and beach driving, and lack of clear landward back-dune areas for migration due to sea-level rise and climate change. The results provide valuable information for coastal managers and planners to make informed decisions and conserve these unique ecosystems.

Decoding plastic pollution in the geological record: A baseline study on the Caribbean Coast of Colombia, north South America

This study presents the first report of plastics in the geological record (rocks and formations composed of plastics) along the central Caribbean Coast of Colombia, northern coast of South America. These novel records of pollution include two rock types (plastiglomerates and quartz plastisandstones), two altered plastic types (pyroplastics and plasticrusts), two soil types (plasticlasts and anthrosols), and a series of artifacts (fossils) found near human settlements. All of them were analyzed using Fourier Transform Infrared (FTIR) spectroscopy. Polyester, high-density polyethylene, and copolymers of alkyl acrylates or methacrylates were identified as the principal polymers forming these rocks. This research provides new insights into the petrology of these emerging new forms of pollution, for which humans are primarily responsible for their generation and distribution. Similarly, the results presented emphasize that plastics are generating a deluge of pollutants in terms of variety and volume, overwhelming natural environments globally. Controlling or even eliminating their use has become one of the most significant challenges of the 21st Century.

Assessment of the Magdalena River delta socio-ecological system through the Circles of Coastal Sustainability framework

River-mouth systems and deltas are hotspots where many of the coastal syndromes can be found. Moreover, these systems provide essential ecosystem services (e.g., recreation, food provisioning, protection against natural hazards). The present study focuses on the socio-ecological system at the delta of the Magdalena River in the central Caribbean Region in Colombia. This research seeks to assess the multidimensional sustainability of the Magdalena river-mouth system (MRm-SES) to improve the knowledge basis for its integrated management. To do so, an assessment tool named “Circles of Coastal Sustainability” (CCS) was used to evaluate the system splitting it into four domains (environmental, social, economic and governance) that were divided into 5 categories each. These domains were evaluated through a total of 52 indicators distributed like this: 16 for the Environmental domain, 16 for the Economic domain, 12 for the Social and Cultural domain and, 8 for the Governance domain. The results show that the overall sustainability of the MRm-SES is classified as “Satisfactory.” None of the domains is in “Excellent” or “Bad” conditions. However, the evaluation of the categories shows that four (4) of them have “Poor” conditions (i.e., Social Benefits, Demographics, Economic Security, and Resources Management). Hence, it is recommended to put those categories at the centre of the discussion to define management strategies (e.g., Preserving and restoring habitats; tackling sources of pollution and excessive sediment; local reduction of net Greenhouse Gas and adaptation to climate change; participation of local communities in the management design and implementation), without disregarding the interrelation with the other categories and dimensions. Finally, it is argued that despite all the improvement opportunities, the CCS is a valuable tool to evaluate and communicate with different stakeholders (academic community, managers and decision-makers, local communities, etc.), to improve the sustainability of coastal systems in Colombia and the world.

Springtime Southwest Cloud Bands in the Central Caribbean

Abstract Southwest cloud bands during spring (April and May) bring rains to central Caribbean islands at the end of the dry season. A cluster analysis of daily 500-hPa geopotential height fields for 1980–2021 identifies a low-west–high-east dipole pattern related to Pacific–North America response to El Niño–Southern Oscillation (ENSO) and springtime wet spells over the Dominican Republic and Puerto Rico. The regional dipole and local rain time series are ranked to identify the top 10 cases for analysis of meteorological conditions. Hovmöller plots of midlevel meridional wind and specific humidity during April 1983 and May 1986 wet spells reveal a standing Rossby wave train pattern that converges moisture onto the leading edge of a subtropical trough. Composite vertical sections during Caribbean Sea wet spells reveal lower easterly–upper westerly wind anomalies over South America associated with the equatorial Madden–Julian oscillation. Thunderstorm clusters within the southwesterly airflow induce multiday wet spells and flash floods. A second statistical method demonstrated how ENSO underpins Caribbean spring climate anomalies via tropical ocean–atmosphere Rossby wave coupling. Historical trends and long-range projections indicate that springtime tropical–midlatitude interactions may diminish due to an accelerating Hadley cell and retreating jet stream, leading to a delayed onset of the wet season across the Antilles Islands.

Are sediment textural parameters an "influencer" of microplastics presence in beach environments?

Diverse litter studies on Colombia's Central Caribbean Coast have presented the Microplastic issues regarding typology, magnitudes, and distribution. No studies have examined MPs' presence and abundances in relation to sediment grain size and the sediments statistical parameters (mean, median, sorting, skewness, kurtosis). This work attempts to fill this information gap in a study of 15 sampling sites along Colombia's Central Caribbean Coast. Sediment samples were collected and analysed to determine sediment granulometric properties, in association with the presence, magnitudes, shapes, and impact of MPs, and their possible relationships. Within the study area, grain size distribution was similar between surveyed sites, with a dominance of three textural groups: sands, slightly gravelly sands, and slightly gravelly muddy sands. In terms of size-sorting categories, the percentages were moderately well sorted (60%), moderately sorted (20%), well sorted (13%), and very well sorted (7%). Microplastic abundances (densities) ranged from 160 to 1120 MPs/kg, similar to other global beaches. Microplastic fibers were the dominant typology at 86.8% of the combined beaches total. Multiple linear regression analysis suggested that approximately 30% of the MPs' presence could be related to changes in the five sediment statistics used in this work, being the most important statistical parameter sorting with 11% (r2=0.27 - F-Statistic=0.67). To manage the MP issue, reducing the current elevated plastic inputs into the environment is necessary/mandatory. Approaches to reach this goal must be focused on the entire plastic life cycle (extraction, design, production, use, disposal, recovery, recycling).

The damselfly genus Megaloprepus (Odonata: Pseudostigmatidae): Revalidation and delimitation of species-level taxa including the description of one new species.

As the longest-winged odonate species of the extant world, Megaloprepus caerulatus (Drury, 1782) has received attention by many entomologists. While the behavior and ecology of this species has been subject of intense studies, biogeography and species status throughout its distributional range in old-growth Neotropical forests are less well known. For tropical forests, this information is a sine qua non when estimating the impact of degradation and climate change. Recent population genetic analyses, quantitative morphometric, and traditional taxonomic studies rediscovered a complex composed of cryptic species within the genus Megaloprepus Rambur, 1842up until now still regarded as a monotypic genus. Here we introduce one new species Megaloprepus diaboli sp. nov. from the southern Pacific coast of Costa Rica and from the central Caribbean coast of Honduras and Guatemala. The holotype is from the Corcovado National Park, Costa Rica (N82855.62 W833513.92), and was deposited at the National Museum of Costa Rica. Aside from M. caerulatus, two formerly described and later refused species within the genus were reevaluated and consequently raised to species status: Megaloprepus latipennis Selys, 1860 is found in the northeastern regions of Mesoamerica and Megaloprepus brevistigma Selys, 1860 in South America east of the Andes. Morphological descriptions of selected specimens (holotype of M. diaboli, lectotype of M. latipennis, and the mature males of M. brevistigma and M. caerulatus) are provided. Diagnostic features of the four species are illustrated, discussed, and summarized in a key to adult males.

Abstract P3-12-23: Characterization of triple-negative breast cancer in two Central American countries

Abstract Background. Triple-negative (TNBC) is the most aggressive subtype of breast cancer and represents 12% of all cases in the US. In the Mexican population, the prevalence of TNBC is 23%. The prognosis is poor for most of these women, with a higher risk of locoregional recurrence, lower disease-free survival, and lower cancer-specific survival. The sociodemographic characteristics of Central American women, such as indigenous, afro descendants, and Hispanic descent, have been associated with factors such as high nuclear grade, high proliferation index, aggressive clinical presentation with advanced stages, high recurrence rates, and an increased risk of cancer fatality rate. Yet, no epidemiological characterization of women treated for TNBC in specialized hospitals in Central American countries exists to this date. Therefore, we describe the characteristics of women diagnosed with TNBC in three specialized hospitals in Guatemala and Honduras. Methods. We identify 1,501 women with breast cancer who attended three specialized hospitals, two in Guatemala and one in Honduras, from 2015 to 2021. Self-reported sociodemographic and clinical characteristics were determined, as well as pathologic data from medical records. Results. Of the 1,501 women, 272 (18.12%) were diagnosed with triple-negative phenotype. The median age was 49.5 years, with 25% under 40.5 years of age, 95.2% reported mestizo race, 51.5% were pre-menopausal, 49.6% had a high histologic grade (grade 3), and 98.8 had locally advanced disease (Table 1). Conclusions: The characteristics described in our sample were similar to those in other Hispanic populations. The prevalence of TNBC in our sample was lower than in Mexico but higher than that of the US. Our sample was made of primarily young women with locally advanced disease and pathologic factors associated with aggressive cancer behavior, such as high grade, lymphovascular invasion, and high Ki67 index. This first report is the product of a multidisciplinary team with interest in breast cancer subtypes. Our objectives include expanding the collaboration of clinical researchers to all the Central American and Caribbean countries and contributing to the understanding of molecular behavior of TNBC and support advances in treatment. Table 1.Characterization of women diagnosed with TNBC in three hospitals in Central AmericanCHARACTERISTIC% (95% CI)n = 272RaceMestizo95.2 (91.9 - 97.2)Indigenous4.8 (2.8 - 8.1)AgeMean (SD)49.5 years (11.7)IQR40.5 - 57Tobacco useYes3.7 (2.0 – 6.7)Number of pregnanciesMean (SD)1.5 (0.5)IQR1 – 2MenopauseYes48.5 (42.6 – 54.5)Use of contraceptivesYes14.0 (10.3 – 18.7)MulticentricYes19.2 (14.9 – 24.5)HypertensionYes8.4 (5.7 – 12.4)DiabetesYes8.8 (6.0 – 12.9)IMCLess than 3042.3 (36.5 – 48.3)Family history of cancerYes12.9 (9.4 – 17.5)Histologic grade15.5 (3.3 – 9.0)244.8 (39.0 – 50.8)349.6 (43.7 – 55.6)Lymphovascular invasionYes44.5 (38.6 – 50.5)Clinical stageI1.1 (0.3 – 3.4)II40.4 (34.7 – 46.4)III54.4 (48.4 – 60.8)IV4.0 (2.2 – 7.2)KI 67Mean (SD)46.9 (24.1)IQR30 - 70TherapyNeoadjuvant chemotherapy29.2 (21.3 – 38.7)RPC32.1 (23.9 – 41.6)Surgery97.4 (94.5 – 98.7)Adjuvant chemotherapy55.0 (49.0 – 60.8)Radiotherapy94.4 (90.8 – 96.6)MetastasisYes4.0 (2.2 – 7.2)BRCAMutated0.4 (0.0 – 2.6)WT2.2 (1.0 – 4.8) Citation Format: Agatha Reyes-Morales, Juan Francisco Alvarado-Muñoz, Suyapa Bejarano, Hugo Castro, Victor Puac-Polanco, Marco Chivalan, Silvana Torselli. Characterization of triple-negative breast cancer in two Central American countries [abstract]. In: Proceedings of the 2021 San Antonio Breast Cancer Symposium; 2021 Dec 7-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2022;82(4 Suppl):Abstract nr P3-12-23.

Artificial structures as biological “influencers”: Hydrozoa and Anthozoa diversity in a Colombian Caribbean Marina

The Puerto Velero Marina, located on the central Caribbean coast of Colombia, is an example of an artificial structure that serves as a substrate for a vulnerable community such as cnidarians (Hydrozoa and Anthozoa). This study provides the first assessment of corals and other cnidarians inhabiting artificial marine habitats in a marginal environment of the Caribbean of Colombia. The Puerto Velero Marina was built into a 7 km2 sand spit generated by sedimentation at the mouth of the Magdalena River. In this study were recorded 14 cnidarian species, among which were found 48 small colonies of scleractinian corals such as Porites, Siderastrea, Phyllangia, and Astrangia. This initial biodiversity assessment of the artificial structure provides a baseline that highlights the importance of further monitoring programs to identify non-native species that could reach this kind of hard structures.

Wave energy flux in the Caribbean Sea: Trends and variability

Wave Energy Flux (WEF) in the Colombian Caribbean Sea is assessed using a 60 years wave reanalysis from 1958 to 2017. Significant wave height (Hs) and mean wave energy period (Tm_1,0) are validated against in situ buoy data from the National Oceanic and Atmospheric Administration and from the Dirección General Marítima in the Central Caribbean Sea and in front of the Colombian shelf. WEF is calculated at virtual buoys allocated in the central Caribbean, at the continental shelf and around insular territories revealing a long-term decrease in magnitude with an annual rate between 0.01 and 0.2% with different regional behavior. In addition, WEF variations at interannual scale are found to be associated with ENSO phases. Wave energy power decreased from 1989 to 2017 in all analyzed locations.

Assisted gene flow using cryopreserved sperm in critically endangered coral

Assisted gene flow (AGF) is a conservation intervention to accelerate species adaptation to climate change by importing genetic diversity into at-risk populations. Corals exemplify both the need for AGF and its technical challenges; corals have declined in abundance, suffered pervasive reproductive failures, and struggled to adapt to climate change, yet mature corals cannot be easily moved for breeding, and coral gametes lose viability within hours. Here, we report the successful demonstration of AGF in corals using cryopreserved sperm that was frozen for 2 to 10 y. We fertilized Acropora palmata eggs from the western Caribbean (Curaçao) with cryopreserved sperm from genetically distinct populations in the eastern and central Caribbean (Florida and Puerto Rico, respectively). We then confirmed interpopulation parentage in the Curaçao-Florida offspring using 19,696 single-nucleotide polymorphism markers. Thus, we provide evidence of reproductive compatibility of a Caribbean coral across a recognized barrier to gene flow. The 6-mo survival of AGF offspring was 42%, the highest ever achieved in this species, yielding the largest wildlife population ever raised from cryopreserved material. By breeding a critically endangered coral across its range without moving adults, we show that AGF using cryopreservation is a viable conservation tool to increase genetic diversity in threatened marine populations.

A preliminary assessment of shark captures by a small‐scale fishery in the central Caribbean coast of Panama

The authors declare not conflict of interest. The datasets generated and analyzed during the current study are not publicly available because further analysis is still in process but are available from the corresponding author on reasonable request.

Microplastics pollution on Colombian Central Caribbean beaches

The growing literature on microplastics (MPs) in coastal and marine environs reflects the seriousness of this pollutant category. Diverse litter studies on Colombia's Central Caribbean Coast have not presented detailed study of MPs' typology, magnitude or distribution. This baseline study presents for first time the MPs problem on 23 beaches in 75 km coastal reach between Punta Roca and Galerazamba, on the central Colombian Caribbean Coast. The Microplastics Pollution Index (MPPI) and Coefficient of Microplastic Impact (CMPI) were developed and applied along with the Environmental Status Index (ESI) and their integration through sector analysis, and mapping using Agglomerative Hierarchical Clustering and Multidimensional Scaling, and Principal Components Analysis. Microplastics abundances (densities) ranged from 2457 to 557 MPs/kg, similar to other global beaches and bays. The MPs Index for the 23 beaches classified 8 beaches as “Moderate,” 10 beaches as “High” and 5 as “Very High.” Microplastic fibers were the dominant typology at 83% of the combined beaches total (ranging from Moderate to Very High for individual beaches).

Frugivory and Seed predation of Jacaratia spinosa (Caricaceae) by Sumichrast’s Vesper Rat, Nyctomys sumichrasti (Rodentia: Cricetidae)

Animal-plant interactions are ubiquitous and critical for tropical ecosystem functioning. Neotropical rodents perform key ecosystem functions such as seed dispersal and predation, however few information is available regarding their ecological interactions. Here, we reported the interaction between the Sumichrast’s Vesper Rat, Nyctomys sumichrasti, and the plant Jacaratia spinosa in the Central Caribbean of Costa Rica. Rodents were observed feeding on the flesh and seeds of the plants. Natural history observations such as this are critical to the knowledge on the feeding links of poorly known Neotropical rodents.

Treatments for unruptured intracranial aneurysms

Unruptured intracranial aneurysms are relatively common lesions in the general population, with a prevalence of 3.2%, and are being diagnosed with greater frequency as non-invasive techniques for imaging of intracranial vessels have become increasingly available and used. If not treated, an intracranial aneurysm can be catastrophic. Morbidity and mortality in aneurysmal subarachnoid hemorrhage are substantial: in people with subarachnoid hemorrhage, 12% die immediately, more than 30% die within one month, 25% to 50% die within six months, and 30% of survivors remain dependent. However, most intracranial aneurysms do not bleed, and the best treatment approach is still a matter of debate. To assess the risks and benefits of interventions for people with unruptured intracranial aneurysms. We searched CENTRAL(Cochrane Library 2020, Issue 5),MEDLINE Ovid, Embase Ovid, and Latin American and Caribbean Health Science Information database (LILACS). We alsosearched ClinicalTrials.gov and the WHO International Clinical Trials Registry Platform from inception to 25 May 2020. There were no language restrictions. We contacted experts in the field to identify further studies and unpublished trials. Unconfounded, truly randomized trials comparing conservative treatment versus interventional treatments (microsurgical clipping or endovascular coiling) and microsurgical clipping versus endovascular coiling for individuals with unruptured intracranial aneurysms. Two review authors independently selected trials for inclusion according to the above criteria, assessed trial quality and risk of bias, performed data extraction, and applied the GRADE approach to the evidence. We used an intention-to-treat analysis strategy. We included two trials in the review: one prospective randomized trial involving 80 participants that compared conservative treatment toendovascular coiling, and one randomized controlled trial involving 136 participants that compared microsurgical clipping toendovascular coiling for unruptured intracranial aneurysms. There wasno difference in outcome events between conservative treatment and endovascular coiling groups. New perioperative neurological deficits were more common in participants treated surgically (16/65, 24.6%; 15.8% to 36.3%) versus 7/69 (10.1%; 5.0% to 19.5%); odds ratio (OR) 2.87 (95% confidence interval (CI) 1.02 to 8.93; P = 0.038). Hospitalizationfor more than five days was more common in surgical participants(30/65, 46.2%; 34.6% to 58.1%) versus 6/69 (8.7%; 4.0% to 17.7%); OR 8.85 (95% CI 3.22 to 28.59; P < 0.001). Clinical follow-up to one year showed 1/48 clipped versus 1/58 coiled participants haddied, and 1/48 clipped versus 1/58 coiled participants had become disabled (modified Rankin Scale > 2). All the evidence is of very low quality. There is currently insufficient good-quality evidence to support either conservative treatment or interventional treatments (microsurgical clipping or endovascular coiling) for individuals with unruptured intracranial aneurysms. Further randomized trials are required to establish if surgery is a better option than conservative management, and if so, which surgical approach is preferred for which patients. Future studies should include consideration of important characteristics such as participant age, gender, aneurysm size, aneurysm location (anterior circulation and posterior circulation), grade of ischemia (major stroke), and duration of hospitalizations.