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Background: There is growing evidence of fungal infections associated with COVID-19. The development of cryptococcosis in these patients has been infrequently reported. However, it can be life-threatening. Objective: To identify cases of COVID-19 patients who developed cryptococcosis and to compare baseline characteristics and management between those who survived and those who died. Methods: We conducted a scoping review using PubMed, Scopus, Web of Science, and Embase to identify studies that reported patients with COVID-19 and cryptococcosis. No language restriction was applied. Single case reports, case series, and original articles were included. It is important to note that 'n' refers to the total number of individuals with the specified variable. Results: A total of 58 studies were included. Among these studies, 51 included individual patient data, detailing information on a total of 65 patients, whereas eight studies reported the proportion of cryptococcosis in COVID-19 patients. One study provided both individual and aggregate case information. From individual patient data, the majority were male (73.9%; n = 48) with a median age of 60 years (range: 53-70). Severe COVID-19 and multiple comorbidities, led by arterial hypertension and diabetes mellitus, were frequently reported, but few had classic immunosuppression factors. On the other hand, HIV status, either negative or positive, was reported in just over half of the patients (61.5%; n = 40). Most were admitted to the intensive care unit (ICU) (58.5%; n = 31), received mechanical ventilation (MV) (50.0%; n = 26), and developed disseminated cryptococcosis (55.4%; n = 36). Secondary infection, mainly bacterial, was reported in 19 patients (29.2%). Mortality was 47.7% (n = 31). Of the studies that reported the proportion of cryptococcosis in COVID-19 cases, the majority were descriptive studies published as conference abstracts. Conclusion: Cryptococcosis in COVID-19 patients has been reported more frequently. However, it is still not as common as other fungal infections associated with COVID-19. Few patients have some classic immunosuppression factors. The factors associated with mortality were male sex, age, ICU admission, MV, secondary infections, and lymphopenia.

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BACKGROUND: Anaemia is a public health problem in Peru. In the Loreto region of the Amazon, ≥50% of children may be anaemic, although insufficient information exists for rural villages. METHODS: To generate more data about childhood anaemia in the Peruvian Amazon, haemoglobin was measured as part of a trachoma survey in 21 randomly selected villages. All children 1-9 y of age from 30 randomly selected households per village were recruited. Anaemia was classified according to the World Health Organization guidelines and a socio-economic status (SES) index was created for each household using principal component analysis. Spatial autocorrelation was determined using Moran's I and Ripley's K function. RESULTS: Of 678 children with complete haemoglobin data, 25.4% (95% confidence interval [CI] 21.2 to 30.1) had mild-or-worse anaemia and 22.1% (95% CI 15.6 to 30.3) had moderate-or-worse anaemia. Mild-or-worse anaemia was more common among children whose primary source of drinking water was surface water (prevalence ratio [PR] 1.26 [95% CI 1.14 to 1.40], p<0.001) and who were in the lowest SES tercile (PR 1.16 [95% CI 1.02 to 1.32], p=0.021). Moderate-or-worse anaemia was more common among boys (PR 1.32 [95% CI 1.09 to 1.60], p=0.005). No evidence of geospatial clustering was found. CONCLUSIONS: Remote villages of the Amazon would benefit from interventions for childhood anaemia and the poorest households would have the most to gain. Integrating anaemia screening into neglected tropical diseases surveys is an opportunity to use public health resources more efficiently.

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The purpose of this study is to analyze the nonlinear behavior of a steel warehouse structured by moment-resistant frames, which utilizes an overhead crane on its interior brackets and as an external load of the weight of the lining panels. The analysis methods used are (i) pushover analysis, which consists of applying an incremental force in the transverse and longitudinal direction to obtain the capacity curve of the structure; (ii) time-history analysis, in which different records of destructive earthquakes that occurred in Chile are used in order to analyze the response of the structure to these loads. The results indicate that the transverse direction is more ductile than the Y direction of the structure within the pushover and time-history methods but not using the N2 method. It is also found that most of the columns are within the life safety and collapse prevention criteria. It is concluded that most of the analyses agree with each other and with what is expected, except for the N2 method, which contradicts the results of the time-history analysis, so the N2 method would not be suitable for this type of structure. In addition, it has been determined that the overhead crane loads do not substantially affect the seismic performance of the warehouse.

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This work has evaluated the collapse fragility of a typical Chilean building for residential use, structured based on shear-resistant RC walls and inverted beams arranged along its entire perimeter, using the incremental dynamic analysis (IDA) for the evaluation of its structural behavior, using for this the 2018 version of the SeismoStruct software. This method evaluates the global collapse capacity of the building from the graphical representation of its maximum inelastic response, obtained through a non-linear time-history analysis, against the scaled intensity of a set of seismic records obtained in the subduction zone, thus creating the IDA curves of the building. The processing of the seismic records is included within the applied methodology to make them compatible with the elastic spectrum of the Chilean design, achieving an adequate seismic input in the two main structural directions. In addition, an alternative IDA method based on the elongated period is applied to calculate the seismic intensity. The results of the IDA curve obtained with this procedure and the standard IDA analysis are analyzed and compared. The results show that the method relates very well to the structure's demand and capacity and confirms the non-monotonous behavior exposed by other authors. Regarding the alternative IDA procedure, the results indicate that the method is inadequate, failing to improve the results obtained by the standard method.

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OBJECTIVE: To determine the relationship between socioeconomic status (SES) and visual impairment (VI) or blindness in the rural Peruvian Amazon, hypothesizing that higher SES would have a protective effect on the odds of VI or blindness. METHODS: In this cross-sectional study of 16 rural communities in the Peruvian Amazon, consenting adults aged ≥ 50 years were recruited from ~30 randomly selected households per village. Each household was administered a questionnaire and had a SES score constructed using principal components analysis. Blindness and VI were determined using a ministry of health 3-meter visual acuity card. RESULTS: Overall, 207 adults aged ≥ 50 were eligible; 146 (70.5%) completed visual acuity screening and answered the questionnaire. Of those 146 participants who completed presenting visual acuity screening, 57 (39.0%, 95% CI 30.2-47.1) were classified as visually impaired and 6 (4.1%, 95% CI 0.9-7.3) as blind. Belonging to the highest SES tercile had a protective effect on VI or blindness (OR 0.29, 95% CI 0.09 to 0.91, p = 0.034), with a linear trend across decreasing levels of SES (p = 0.019). This observed effect remained significant regardless of how SES groups were assigned. CONCLUSION: Belonging to a higher SES group resulted in a lower odds of VI or blindness compared to those in the lowest SES group. The observation of a dose response provides confidence in the observed association, but causality remains unclear. Blindness prevention programs could maximize impact by designing activities that specifically target people with lower SES.

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BACKGROUND: Clinical practice guidelines (CPGs) are statements that should be rigorously developed to guide clinicians' decision-making. However, given the scarce evidence for certain vulnerable groups like children, CPGs' recommendations formulation could be challenging. METHODS: We conducted a scoping review of CPGs for COVID-19 management in children. Documents were included if they claimed to be a "clinical practice guideline", published between January and October 2021, and described the process followed to issue their recommendations. We assessed the quality using the "Appraisal of Guidelines for Research and Evaluation II" (AGREE-II) and described how the recommendations were reached. RESULTS: We found five CPGs that fulfilled our inclusion criteria. The median score on the overall AGREE-II evaluation was 61% (range: 49%-72%), and the score on the third domain referred to the rigor of methodological development was 52% (range: 25%-88%). Recommendations for remdesivir, tocilizumab, and intravenous immunoglobulin were heterogeneous across CPGs (in favor, against, no recommendation), as well as the methodologies used to present the evidence, perform the benefits/harms balance, and issue the recommendation. CONCLUSIONS: Heterogeneous recommendations and justifications across CPGs were found in the three assessed topics. Future CPGs should describe in detail their evidence-to-decision process to issue reliable and transparent recommendations.

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Background: Antimicrobial resistance is a serious public health problem that has become a global threat. Special attention should be given to polymyxins (polymyxin B and colistin) which, since their reintroduction into clinical practice, are considered "last resort" drugs. The objective of this study is to perform a bibliometric analysis of scientific research on polymyxin resistance. Methods: Scopus was used to retrieve documents relevant to polymyxin resistance from 2010 to 2019. Data was exported to Microsoft Excel for table presentation. SciVal was used for volume and citation analysis as well as collaboration patterns. Also, we extracted data regarding the top documents, authors, countries, institutions, and the metrics of journals. VantagePoint and VOSviewer were used for geographical distribution of worldwide research and keyword co-occurrence analysis, respectively. Results: A total of 1,409 documents were retrieved. The retrieved documents received 25.0 citations per document. Articles (73.88%) and letters (18.09%) were the most frequent types of documents. During 2010-2019, there was a significant growth in publications (p-value < 0.001). The received citations were 35,209 with a peak in 2016 (11,250 citations). China and the United States led the scientific production with 299 (21.2%) and 238 (16.9%) publications, respectively. Little or no contribution came from central Asia, Sub-Saharan Africa, and Latin America. Chinese institutions have caused the greatest impact, with University of Zhejiang (China) being the most prolific institution on the subject (88 documents). In terms of the most productive journals, Antimicrobial Agents and Chemotherapy ranked first with 196 (13.9%) documents. Most of the documents were published in quartile one journals and only had national collaboration (43.2%). Analysis of keyword co-occurrence revealed that research on polymyxin resistance during the last decade has focused on its relationship with public health, pharmacology, and genetics. Conclusion: The number of documents on polymyxin resistance has increased significantly in the recent years, with a steep growth from 2016 onwards. China and the United States led the scientific production. Most of the documents were published in high-quality journals. Greater joint efforts and more contribution from central Asia, Sub-Saharan Africa, and Latin America are still needed to tackle this global problem.

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BACKGROUND: Previous studies have assessed the prevalence and characteristics of self-medication in COVID-19. However, no systematic review has summarized their findings. OBJECTIVE: We conducted a systematic review to assess the prevalence of self-medication to prevent or manage COVID-19. METHODS: We used different keywords and searched studies published in PubMed, Scopus, Web of Science, Embase, two preprint repositories, Google, and Google Scholar. We included studies that reported original data and assessed self-medication to prevent or manage COVID-19. The risk of bias was assessed using the Newcastle-Ottawa Scale (NOS) modified for cross-sectional studies. RESULTS: We identified eight studies, all studies were cross-sectional, and only one detailed the question used to assess self-medication. The recall period was heterogeneous across studies. Of the eight studies, seven assessed self-medication without focusing on a specific symptom: four performed in the general population (self-medication prevalence ranged between <4% to 88.3%) and three in specific populations (range: 33.9% to 51.3%). In these seven studies, the most used medications varied widely, including antibiotics, chloroquine or hydroxychloroquine, acetaminophen, vitamins or supplements, ivermectin, and ibuprofen. The last study only assessed self-medication for fever due to COVID-19. Most studies had a risk of bias in the "representativeness of the sample" and "assessment of outcome" items of the NOS. CONCLUSIONS: Studies that assessed self-medication for COVID-19 found heterogeneous results regarding self-medication prevalence and medications used. More well-designed and adequately reported studies are warranted to assess this topic.

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Cryptococcosis is a fungal infection that is rarely reported in patients without human immunodeficiency virus (HIV) infection, especially when the central nervous system (CNS) or pulmonary system is not involved. We report a case of isolated colonic cryptococcosis without disseminated disease in a 64-year-old immunocompetent woman without HIV infection who presented with chronic diarrhea and no episodes of fever or weight loss. The diagnosis was based on histopathology examination. Furthermore, we performed a literature review showing that few reports have been published so far and in the case of colonic cryptococcal infection, the prognosis is favorable among HIV-uninfected patients.

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BACKGROUND: Through the culture of thinness, increasingly promoted in our society as a beauty canon, it is not surprising that the number of people affected by eating disorders is increasing. OBJECTIVE: This research aims to study the relationship between non-suicidal self-injuries and nuclear aspects of eating disorders specified along with this article. METHODS: The sample consisted of 60 women diagnosed with anorexia and bulimia. Questionnaires assessing impulsivity, body satisfaction, alexithymia, body attitude and self-esteem were administered. Participants with non-suicidal self-harm were compared with those without it, and participants with anorexia with and without self-harm and participants with bulimia with and without self-harm were compared. RESULTS: Differences were found in body dissatisfaction= 5.71; p ≤0.01), body attitudes= 4.80; p ≤0.02), self-esteem= 14.09; p ≤0.00) and impulsivity (t= 3.39; p ≤0.01) between participants with and without non-suicidal self-harm. CONCLUSIONS: These are key factors for the clinical area in the treatment of eating disorders to prevent the presence of self-harm, as it allows focusing the treatment target on those aspects such as dissatisfaction and impulsivity, which are key in the development of self-harm.

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Resumen Introducción:: El índice leucoglucémico es un factor pronóstico, poco conocido y utilizado, que relaciona la glucemia y los leucocitos registrados al ingreso hospitalario. Su importancia radica en la determinación del riesgo de complicaciones y la mortalidad en pacientes con infarto agudo de miocardio. Objetivo: Establecer al índice leucoglucémico como factor predictor de complicaciones durante la evolución intrahospitalaria en los pacientes con infarto agudo de miocardio. Método: Estudio de tipo epidemiológico, analítico, observacional y de corte transversal, en una cohorte de pacientes que ingresaron con infarto agudo de miocardio durante un período de un año y tres meses. Resultados: Se incluyó en el estudio a 205 pacientes con infarto agudo de miocardio, cuyo promedio de edad fue de 62.99 ± 12.2 años, con predominio en varones con 69.3%. El infarto agudo de miocardio con elevación del segmento ST predominó en frecuencia con 63.9% y mayor tasa de complicaciones (p < 0.001). El promedio del índice leucoglucémico fue de 1,578.41 ± 1,208.1 y el punto de corte establecido fue de 656.8, de acuerdo con la curva ROC, con sensibilidad del 95.8% y especificidad del 73% para la predicción de complicaciones intrahospitalarias, con OR de 7.89. Conclusión: Un índice leucoglucémico > 656.8 representa un riesgo de 7.89 veces de desarrollar complicaciones en la población estudiada.

Abstract Introduction: Leukoglycemic index is a poorly known and used prognostic factor that correlates blood glucose and leukocytes which are taken at hospital admission. Its importance lies in determining complications and mortality risks in patients with acute myocardial infarction. Objective: To establish the leukoglycemic index as a predictor of complications during the in-hospital evolution in patients with acute myocardial infarction. Methods: Epidemiological, observational, cross-sectional, crosssectional study on a cohort of patients admitted with acute myocardial infarction during a period of 1 year 3 months. Results: 205 patients with acute myocardial infarction were included in this study. The mean age was 62.99 ± 12.2 years old, more frequently in males by 69.3%. It was determined that acute myocardial infarction with ST elevation predominated both in frequency with 63.9%, as well as with a higher rate of complications (p < 0.001). The average of leukoglycemic index was 1578.41 ± 1208.1 and the cut-off point was 656.8, according to ROC curve, with sensitivity of 95.8% and specificity of 73% for the prediction of inhospital complications, OR 7.89. Conclusions: A leukoglycemic index greater than 656.8 represents a 7.89-fold risk of developing complications in the study population.

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Abstract Background: Through the culture of thinness, increasingly promoted in our society as a beauty canon, it is not surprising that the number of people affected by eating disorders is increasing. Objective: This research aims to study the relationship between non-suicidal self-injuries and nuclear aspects of eating disorders specified along with this article. Methods: The sample consisted of 60 women diagnosed with anorexia and bulimia. Questionnaires assessing impulsivity, body satisfaction, alexithymia, body attitude and self-esteem were administered. Participants with non-suicidal self-harm were compared with those without it, and participants with anorexia with and without self-harm and participants with bulimia with and without self-harm were compared. Results: Differences were found in body dissatisfaction= 5.71; p ≤0.01), body attitudes= 4.80; p ≤0.02), self-esteem= 14.09; p ≤0.00) and impulsivity (t= 3.39; p ≤0.01) between participants with and without non-suicidal self-harm. Conclusions: These are key factors for the clinical area in the treatment of eating disorders to prevent the presence of self-harm, as it allows focusing the treatment target on those aspects such as dissatisfaction and impulsivity, which are key in the development of self-harm.

Resumen Introducción: A través de la cultura de la delgadez, cada vez más promovida en nuestra sociedad como canon de belleza, no es de extrañar que este aumentado el número de personas afectadas por Trastornos de Conducta alimentaria. Objetivo: Estudiar la relación entre las autolesiones no suicidas y aspectos nucleares del trastorno de conducta alimentaria que se especifican a lo largo de este artículo. Métodos: La muestra ha sido formada por 60 mujeres diagnosticadas de anorexia y bulimia. Se administraron cuestionarios que evaluaban la impulsividad, satisfacción corporal, alexitimia, actitud corporal y autoestima. Se compararon aquellas participantes que presentaban autolesiones no suicidas con las que no lo presentaban, además se compararon participantes con anorexia con y sin autolesiones y participantes con bulimia con y sin autolesiones. Resultados: Se encontraron diferencias en insatisfacción corporal = 5,71; p ≤0.01), en actitudes corporales= 4.80; p ≤0.02), autoestima= 14.09; p ≤0.00) e impulsividad, (t= 3.39; p ≤0.01) entre participantes con y sin autolesiones no suicidas. Conclusiones: Estos son factores clave para la clínica en el tratamiento de los trastornos de conducta alimentaria para prevenir la presencia de autolesiones, ya que permite enfocar el objetivo del tratamiento a aquellos aspectos como la insatisfacción e impulsividad, que son claves en el desarrollo de autolesiones.

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Colonic cryptococcal infection is unusual in people living with HIV (PLWH) and even more so without concomitant neurological compromise. Published case reports describe diarrhea and other intestinal manifestations that are often confused with systemic tuberculosis infection. We describe an Peruvian woman living with HIV on antiretroviral therapy who presented hypotensive with a 6-month history of fever and epigastric pain, in addition to episodes of sporadic diarrhea. Due to the suspicion of systemic tuberculosis, antituberculosis treatment was started. Days later, without clinical improvement, colonoscopy revealed ulcers in the transverse colon. Histopathological examination of biopsied tissue was compatible with Cryptococcus spp. She received antifungal therapy with amphotericin B and fluconazole. Despite the treatment, the patient died six days later from multiple organ failure.

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The emergence of information and communication technologies (ICT) has generated a number of research questions, related to their use and potential risk, but also potentials for prevention or health promotion. Online social networks have become an important source of information for users as well as a tool for social relations. As traditional social networks, they can act as vehicles to improve the health of adolescents and youth, as well as play a key role in an educational context. The aim of this work is then to explore the theoretical relevance of ICT, particularly on online social networks, on disease prevention and health promotion of communicable diseases. Literature review points out the role of online social networks, particularly in the field of sexual health, body image, especially eating habits and overweight, as well as smoking and alcohol dependence. Data allow us to understand how online social network behavior and interaction is related to their burden and interventions developed in sexual health and addiction show positive results. More efforts in body image are needed in order to use these tools for prevention and promotion of health from early age.

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As the COVID-19 pandemic progresses, awareness of uncommon presentations of the disease increases. Such is the case with pneumothorax and pneumomediastinum. Recent evidence suggested that these can occur in the context of COVID-19 pneumonia, even in the absence of mechanical ventilation-related barotrauma. We present two patients with COVID-19 pneumonia complicated by pneumomediastinum. The first patient was a 55-year-old woman who developed COVID-19 pneumonia. Her clinical course was complicated by pneumothorax and pneumomediastinum, and, unfortunately, she died 2 days following the admission. The second patient was a 31-year-old man who developed a small pneumomediastinum and was managed conservatively. He had a spontaneous resolution of the pneumomediastinum and was discharged 19 days later. None of our patients required invasive or noninvasive positive pressure ventilation. We performed a literature review of COVID-19 pneumonia cases that developed pneumothorax, pneumomediastinum, or both. The analysis showed that the latter had high mortality (60%). Thus, it is necessary to pay attention to these complications as early identification and management can reduce the associated morbidity and mortality.

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In this work, we discuss the challenging time-resolved fluorescence anisotropy of subtilisin Carlsberg (SC), which contains a single Trp residue and is a model fluorescence system. Experimental decay rates and quenching data suggest that the fluorophore should be exposed to water, but the Trp is partially buried in a hydrophobic pocket in the crystallographic structure. In order to study this inconsistency, molecular dynamics simulations were performed to predict the anisotropy decay rates and emission wavelengths of the Trp. We confirmed the inconsistency of the crystallographic structure with the experimentally observed fluorescence data and performed free energy calculations to show that the buried Trp conformation is 2 orders of magnitude (∼3 kcal/mol) more stable than the solvent-exposed one. However, molecular dynamics simulations in which the Trp side chain was restricted to solvent-exposed conformations displayed a maximum Trp emission wavelength shifted toward lower energies and decay rates compatible with the experimentally probed rates. Therefore, if the solvent-exposed conformations are the most important emitters, the experimental anisotropy can be compatibilized with the crystallographic structure. The most likely explanation is that the fluorescence of the most probable conformation in solution, observed in the crystal, is quenched, and this is consistent with the low quantum yield of Trp113 of SC. Additionally, some experiments might have probed denatured or lysed SC structures. SC anisotropy provides an interesting target for the study of fluorescence anisotropy using simulations, which can be used to test and exemplify how modeling can aid the interpretation of experimental data in a system where structure and solution experiments appear to be inconsistent.

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Abstract The emergence of information and communication technologies (ICT) has generated a number of research questions, related to their use and potential risk, but also potentials for prevention or health promotion. Online social networks have become an important source of information for users as well as a tool for social relations. As traditional social networks, they can act as vehicles to improve the health of adolescents and youth, as well as play a key role in an educational context. The aim of this work is then to explore the theoretical relevance of ICT, particularly on online social networks, on disease prevention and health promotion of communicable diseases. Literature review points out the role of online social networks, particularly in the field of sexual health, body image, especially eating habits and overweight, as well as smoking and alcohol dependence. Data allow us to understand how online social network behavior and interaction is related to their burden and interventions developed in sexual health and addiction show positive results. More efforts in body image are needed in order to use these tools for prevention and promotion of health from early age.

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The competition between an unprecedented reductive chlorination and the Pummerer reaction was studied and applied to the synthesis of benzofused oxygen heterocycles including 3-aminochromanes and in the intramolecular chlorination of activated aromatic rings. The use of (COCl)2 as a Pummerer activator showed substantial activity, producing α-chlorinated sulfides that can undergo Pummerer-Friedel-Crafts cyclization. If the aromatic ring has electron-donating groups in position three, then the reaction follows a different pathway, yielding the reductive chlorination products, where the chlorine atom comes from a sulfonium salt.

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Abstract The application of gap dynamics theory appears to be a promising option for tropical forest management and conservation. In the present study of a tree species-rich and old-growth Ecuadorian Neotropical forest, we assessed the spatial distribution of gaps and gap size in relation to: i) tree number at the gap edge, ii) number of tree species at the gap edge, iii) number of tree species per stem at the gap edge, iv) species similarity, v) species evenness at the gap edge, vi) size differentiation at the gap edge, vii) gap isolation and viii) species mingling at the gap edge. Our results demonstrated that the spatial distribution of gaps was random. Various gap attributes were strongly associated with gap size. The number of tree species per stem at the gap edge was negatively correlated to the gap size. Gap sizes up to 50 m2were mostly sufficient to generate tree species-rich forest stands. Assuming that our results were representative for an old-growth neotropical rainforest in Ecuador, our study remarks the following management recommendations: 1) Rainforests have a very complex spatial and diversity structure and logging activities should preferably be omitted because of adverse effects. 2) If logging is inevitable, this should mimic a random choice of trees and tree species, to prevent special selection of tree dimension and species; and a random distribution of trees to be logged, to produce gaps smaller than 50 m2and never larger than 400 m2. Additionally, we suggest cutting not more than 5 % of the tree biomass per 10-20 years period, to preclude stronger alterations of ecosystem processes, and the reduction of existing dead wood from the ecosystem. Rev. Biol. Trop. 66(1): 149-163. Epub 2018 March 01.

Resumen Aplicar la teoría de la dinámica de parches parece ser una opción prometedora para el manejo y conservación de los bosques tropicales. En el presente estudio se analizó la distribución espacial y el tamaño de los parches en relación con: i) el número de árboles en el borde del parche, ii) el número de especies arbóreas en el parche iii) número de especies arbóreas por tronco en el borde del parche, iv) similitud de las especies, v) uniformidad de las especies en el borde del parche, vi) separación del tamaño en el borde del parche, vii) aislamiento del parche y viii) borde del parche. Nuestros resultados demostraron que la distribución espacial de los parches fue aleatoria. Varios atributos de la vegetación se asociaron fuertemente con el tamaño del parche. El número de especies de árboles por fuste en el borde del parche se correlacionó negativamente con el tamaño del parche. Asumiendo que, nuestros resultados fueron representativos de un bosque neotropical en el Ecuador, nuestro estudio respalda las siguientes recomendaciones: 1) Este tipo de bosque húmedo tiene una diversidad espacial y estructural muy compleja; por lo tanto, las actividades de explotación forestal deberían omitirse, ya que afectarán negativamente sus estructuras. 2) Si la tala es inevitable, entonces deberían imitarse las estructuras naturales descritas en este estudio. Es decir, i) una selección aleatoria de especies de árboles a cosechar, con el fin de evitar la selección específica por dimensiones del arbolado o por especies, ii) en la distribución aleatoria de árboles debe tomarse en cuenta que los parches sean menores a 50 m2y jamás mayores a 400 m2. Adicionalmente, se recomienda no cortar más del 5 % de la biomasa arbórea en cada período de corta de entre 10 a 20 años, para evitar alteraciones mayores en los procesos del ecosistema y la reducción de madera muerta existente en estos ecosistemas.