Trends in research on cacti: the food of the future.

Cacti are a distinguished group of plants that stand out for their great nutritional values, diverse uses, and unique morphology, allowing them to grow and thrive under different conditions such as dry, xeric, and even low-temperature environments. The world is going through significant climate changes that are affecting the agriculture system. Therefore, sustainable and multifunctional crops, as many species of the Cactaceae family are, might be a good alternative in the near future. In this work, the uses of cacti in human food were analyzed through a scientific prospection from the point of view of their temporal and spatial distribution and potential uses. Brazil is the country with more publications related to the scope of this work, followed by Mexico. The presence of cacti in these countries can influence their interest in these species, which might reflect the results encountered in this study. The uses and ethnobotanical applications of cacti vary in different countries worldwide. Cactus is consumed fresh (in salads), in preparations (jams and sweets), and juices, being also present in traditional dishes in countries like Mexico. This study emphasizes cacti's importance in people's diets and ongoing world changes. Their ability to thrive even in hot environments with low water resources will lead to a greater focus on these species in the upcoming years. Furthermore, these plants have great flavor and contain several beneficial chemical compounds with desirable nutritional and health properties. Therefore, knowledge dissemination combined with technological innovations will allow greater use of these multifunctional species for human consumption. © 2024 Society of Chemical Industry.

Indications of the Neurotomy of Genicular Nerves by Radiofrequency for the Treatment of Knee Osteoarthritis: A Literature Review.

Osteoarthritis (OA) is one of the most frequent and incapacitating pathologies today, especially of the knee. Among the possible approaches for knee OA, the neurotomy of the genicular nerves by radiofrequency (RF) has been gaining prominence. However, as this is a relatively new procedure, indications for its implementation are still unclear. The objective of the present review is to identify the main indications of the use of RF for the treatment of knee OA in the medical literature. A review of the literature was performed in January 2018 through a search in the PubMed, ClinicalKey and Google Scholar databases. After reviewing the main articles on the subject, it was concluded that the main indications of the use of RF for the treatment of knee OA were: OA Kellgren-Lawrence grades 3 and 4, with moderate to severe pain and failure of conservative treatment, mainly in elderly people; persistence of pain even after total knee arthroplasty (TKA); patients with an indication for TKA who refuse to undergo surgical treatment.

Venous thromboembolism, can we do better? Profile of venous thromboembolism risk and prophylaxis in a University Hospital in the State of São Paulo.

BACKGROUND: Venous thromboembolism (VTE) is a silent and potentially lethal disease that affects a considerable proportion of hospitalized patients. It has high morbidity and mortality and is responsible for a heavy financial burden on healthcare systems. However, VTE can be prevented using prophylaxis measures that have been established in the literature. Nonetheless, in the real world, mean rates of appropriately administered VTE prophylaxis are lower than 50%. OBJECTIVES: To define the epidemiological profile of patients with VTE in a University Hospital and the rate of appropriately administered VTE prophylaxis at that service and to identify measures to improve the rate. METHODS: A cross-sectional, observational study was conducted with data collected from the medical records of patients who met the inclusion criteria. The rates of correct VTE prophylaxis prescribed to clinical and surgical patients were compared, assessed according to guidelines published by the Brazilian Society of Angiology and Vascular Surgery (SBACV), based on VTE risk classification. RESULTS: The overall rate of correctly-prescribed VTE prophylaxis was 42.1%, while 57.9% of patients were not managed correctly in this respect. Clinical patients had a 52.9% rate of appropriate prophylaxis, while the equivalent rate for surgical patients was 37.5%. CONCLUSIONS: Rates of correctly-prescribed VTE prophylaxis are still lower than they should be. Ongoing education, measures to encourage bedside risk stratification, and improvements to the electronic prescription system could increase appropriate VTE prophylaxis rates.

Indications of the Neurotomy of Genicular Nerves by Radiofrequency for the Treatment of Knee Osteoarthritis: A Literature Review / Indicações da neurotomia dos nervos geniculares por radiofrequência para o tratamento da osteoartrite do joelho: uma revisão de literatura

Abstract Osteoarthritis (OA) is one of the most frequent and incapacitating pathologies today, especially of the knee. Among the possible approaches for knee OA, the neurotomy of the genicular nerves by radiofrequency (RF) has been gaining prominence. However, as this is a relatively new procedure, indications for its implementation are still unclear. The objective of the present reviewis to identify the main indications of the use of RF for the treatment of knee OA in themedical literature. A review of the literature was performed in January 2018 through a search in the PubMed, ClinicalKey and Google Scholar databases. After reviewing themain articles on the subject, it was concluded that the main indications of the use of RF for the treatment of kneeOAwere:OA Kellgren-Lawrence grades 3 and 4, withmoderate to severe pain and failure of conservative treatment, mainly in elderly people; persistence of pain even after total knee arthroplasty (TKA); patients with an indication for TKAwho refuse to undergo surgical treatment.

Resumo A osteoartrite é uma das patologias mais frequentes e incapacitantes na atualidade, principalmente do joelho. Dentre as abordagens possíveis para osteoartrite, a neurotomia dos nervos geniculares por radiofrequência vem se destacando. Todavia, por se tratar de um procedimento relativamente novo, as indicações para realização ainda não estão bem definidas. O principal objetivo desta revisão foi identificar as principais indicações do uso da radiofrequência para o tratamento da osteoartrite do joelho na literatura médica. Foi realizada revisão da literatura em janeiro de 2018, através de pesquisa nas bases de dados PubMed, Clinicalkey e Google Scholar. Após revisão dos principais artigos no assunto, foi concluído que as principais indicações do uso da radiofrequência para o tratamento da osteoartrite do joelho foram: pacientes com osteoartrite grau 3 e 4 da classificação de Kellgren-Lawrence, com dor de moderada a severa e falha do tratamento conservador, principalmente idosos; persistência da dor, mesmo após realizado artroplastia total de joelho; pacientes com indicação de artroplastia total de joelho e que se recusam a submeter-se ao tratamento cirúrgico.

Profilaxia de tromboembolismo venoso, podemos fazer melhor? Perfil de risco e profilaxia de tromboembolismo venoso em Hospital Universitário do interior do Estado de São Paulo / Venous thromboembolism, can we do better? Profile of venous thromboembolism risk and prophylaxis in a University Hospital in the State of São Paulo

O tromboembolismo venoso (TEV) é uma doença silenciosa e potencialmente letal que acomete parcela importante dos pacientes hospitalizados. Com alta morbimortalidade e elevado custo financeiro para o sistema de saúde, o TEV pode ser prevenido com uso da profilaxia, já estabelecida pela literatura. No mundo real, a profilaxia para TEV possui média de adequação inferior a 50%. Objetivos Definir o perfil epidemiológico do doente com TEV em um hospital universitário e a taxa de adequação da profilaxia para TEV no referido serviço, além de determinar meios para melhorá-la. Métodos Estudo transversal observacional realizado pela coleta de dados no prontuário médico dos pacientes que preencheram critérios de inclusão. Comparou-se a taxa de adequação da profilaxia para TEV prescrita para pacientes clínicos e cirúrgicos, segundo diretrizes da Sociedade Brasileira de Angiologia e Cirurgia Vascular (SBACV), de acordo com sua classificação de risco para TEV. Resultados A taxa global de adequação das prescrições de profilaxia para TEV foi de 42,1% versus 57,9% de inadequação. Pacientes clínicos obtiveram taxa de adequação de 52,9%, enquanto pacientes cirúrgicos obtiveram taxa de adequação de 37,5%. Conclusões As taxas de prescrição adequada para profilaxia para TEV ainda se encontram aquém do esperado. Educação continuada, estímulo à aplicação da estratificação de risco à beira do leito e adequações no sistema de prescrição eletrônica podem aumentar as taxas de prescrição adequada para profilaxia de TEV

Venous thromboembolism (VTE) is a silent and potentially lethal disease that affects a considerable proportion of hospitalized patients. It has high morbidity and mortality and is responsible for a heavy financial burden on healthcare systems. However, VTE can be prevented using prophylaxis measures that have been established in the literature. Nonetheless, in the real world, mean rates of appropriately administered VTE prophylaxis are lower than 50%. Objectives To define the epidemiological profile of patients with VTE in a University Hospital and the rate of appropriately administered VTE prophylaxis at that service and to identify measures to improve the rate. Methods A cross-sectional, observational study was conducted with data collected from the medical records of patients who met the inclusion criteria. The rates of correct VTE prophylaxis prescribed to clinical and surgical patients were compared, assessed according to guidelines published by the Brazilian Society of Angiology and Vascular Surgery (SBACV), based on VTE risk classification. Results The overall rate of correctly-prescribed VTE prophylaxis was 42.1%, while 57.9% of patients were not managed correctly in this respect. Clinical patients had a 52.9% rate of appropriate prophylaxis, while the equivalent rate for surgical patients was 37.5%. Conclusions Rates of correctly-prescribed VTE prophylaxis are still lower than they should be. Ongoing education, measures to encourage bedside risk stratification, and improvements to the electronic prescription system could increase appropriate VTE prophylaxis rates

Monitoring equity in universal health coverage with essential services for neglected tropical diseases: an analysis of data reported for five diseases in 123 countries over 9 years.

BACKGROUND: A service coverage index has recently been proposed to monitor progress towards universal health coverage (UHC), and baseline results for 2015 are available. However, evidence on equity in that progress is scarce. The service coverage index did not consider services for neglected tropical diseases (NTDs), a group of preventable diseases defined by WHO member states on the basis of the disproportionate burden they place on their poorest, remotest, and otherwise most marginalised communities. Because of the much-needed equity lens that it could provide, NTD service coverage should not be neglected in efforts to monitor UHC progress. METHODS: We developed an index focused on coverage of services for NTDs, comparable in methods to the UHC service coverage index. On the basis of data availability, we focused on preventive chemotherapy, which was recently included in the highest-priority package of essential UHC interventions. We used data reported to WHO since 2008 for the five NTDs amenable to preventive chemotherapy (lymphatic filariasis, onchocerciasis, schistosomiasis, soil-transmitted helminthiases, and trachoma) to develop an NTD service coverage index based on the geometric mean of coverage rates for individual NTD services with regularly reported data. We then compared this NTD service coverage index with the UHC service coverage index. A high UHC index value and a low NTD index value suggest that a country might not be adequately prioritising interventions for the poor. We measured Spearman rank-order correlation (ρ) of the NTD service coverage index with income inequality, as measured by the Gini coefficient (range of 0-1), where values of the Gini coefficient close to 1 indicate higher income inequality, and a negative correlation was evidence of socioeconomic barriers to health service coverage for people who are least well off. FINDINGS: At least 123 countries can monitor NTD service coverage by use of a simple index. The median national NTD index was 32 in 2016, an increase from 3 in 2012, and from 0 in 2008. In 2015, the NTD index was lower than the UHC index in 81 of the 113 countries for which both NTD and UHC indices are available, by up to 80 points. The NTD index was negatively but weakly correlated with income inequality; this correlation was strongest in the African Region (ρ=-0·46 in 2008, ρ=-0·32 in 2015), suggesting that high-income inequality, although associated with low coverage of services targeting the poor, does not preclude the extension of that coverage. INTERPRETATION: The NTD index can be used to measure equity in progress towards UHC. A broader NTD index including services for other NTDs could be developed at regional and country levels. Comparing the NTD and UHC service coverage indices reveals that some countries that are performing well by the measure of the UHC service coverage index still have work to do in prioritising services for their poorest and otherwise most marginalised communities. Our results offer hope that socioeconomic barriers to health service coverage can be overcome. FUNDING: None.

Cichlids of the Banc d'Arguin National Park, Mauritania: insight into the diversity of the genus Coptodon.

To determine the species diversity of cichlids in the Banc d'Arguin National Park (PNBA) and their phylogenetic relationships with other species in West Africa, a morphometric and meristic and molecular phylogenetic study was conducted. Both approaches not only confirm the presence of Sarotherodon melanotheron in PNBA but also demonstrate the presence of a second species from the genus Coptodon. While morphometric characteristics match the description of the Guinean tilapia Coptodon guineensis, phylogenetic reconstructions based on three mitochondrial and one nuclear DNA fragment demonstrate that C. guineensis is paraphyletic over its range. Because different lineages of C. guineensis are allopatric, the distribution of C. guineensis should be restricted to Ghana and Côte d'Ivoire. The many other lineages of this species should be considered as C. sp. aff. guineensis.

Institutionalization and indiscriminate social behavior: Differential-susceptibility versus diathesis-stress models for the 5-HTTLPR and BDNF genotypes.

Institutionalization adversely impacts children's emotional functioning, proving related to attachment disorders, perhaps most notably that involving indiscriminate behavior, the subject of this report. In seeking to extend work in this area, this research on gene X environment (GXE) interplay investigated whether the serotonin transporter (5-HTTLPR) and val66met Brain-Derived Neurotrophic Factor (BDNF) polymorphisms moderated the effect of institutional care on indiscriminate behavior in preschoolers. Eighty-five institutionalized and 135 home-reared Portuguese children were assessed using Disturbances of Attachment Interview (DAI). GXE results indicated that s/s homozygotes of the 5-HTTLPR gene displayed significantly higher levels of indiscriminate behavior than all other children if institutionalized, something not true of such children when family reared. These findings proved consistent with the diathesis-stress rather than differential-susceptibility model of person×environment interaction. BDNF proved unrelated to indiscriminate behavior. Results are discussed in relation to previous work on this subject of indiscriminate behavior, institutionalization and GXE interaction.

Prediction of pregnancy viability in bovine in vitro-produced embryos and recipient plasma with Fourier transform infrared spectroscopy.

We analyzed embryo culture medium (CM) and recipient blood plasma using Fourier transform infrared (FTIR) metabolomics to predict pregnancy outcome. Individually cultured, in vitro-produced (IVP) blastocysts were transferred to recipients as fresh and vitrified-warmed. Spent CM and plasma samples were evaluated using FTIR. The discrimination capability of the classifiers was assessed for accuracy, sensitivity (pregnancy), specificity (nonpregnancy), and area under the receiver operator characteristic curve (AUC). Within all IVP fresh embryos (birth rate=52%), high AUC were obtained at birth, especially with expanded blastocysts (CM: 0.80±0.053; plasma: 0.89±0.034). The AUC of vitrified IVP embryos (birth rate = 31%) were 0.607±0.038 (CM, expanded blastocysts) and 0.672±0.023 (plasma, all stages). Recipient plasma generally predicted pregnancy outcome better than did embryo CM. Embryos and recipients with improved pregnancy viability were identified, which could increase the economic benefit to the breeding industry.

Effect of Low-Temperature Storage on Diaeretiella rapae (McIntosh) (Hymenoptera: Braconidae).

We evaluated the effects of constant low-temperature storage on Diaeretiella rapae (McIntosh) (Braconidae, Aphidiinae). Diaeretiella rapae mummies were stored at 5 ± 1°C for 0-36 days. The percentage of D. rapae emergence varied (100-83%) after 0-32 days of storage. After 32 days, emergence reduced to 55%. According to our Probit analysis, 50% mortality (LT50) of the population of D. rapae was reached after 40 days of storage at 5°C. Storage for up to 32 days did not negatively affect emergence and survival. Cold exposure of D. rapae for 36 days did not influence morphological malformations, sex ratio, and emergence of the F1 generation. After 4-36 days of storage, D. rapae showed a gradual decrease in emergence, longevity, reproductive capacity, and F1 sex ratio. Diaeretiella rapae can be stored for up to 24 days at 5°C, at which time the percentage of parasitism and the F1 sex ratio remain above 38% and at 0.50, respectively.

Genetic architecture of skin and eye color in an African-European admixed population.

Variation in human skin and eye color is substantial and especially apparent in admixed populations, yet the underlying genetic architecture is poorly understood because most genome-wide studies are based on individuals of European ancestry. We study pigmentary variation in 699 individuals from Cape Verde, where extensive West African/European admixture has given rise to a broad range in trait values and genomic ancestry proportions. We develop and apply a new approach for measuring eye color, and identify two major loci (HERC2[OCA2] P = 2.3 × 10(-62), SLC24A5 P = 9.6 × 10(-9)) that account for both blue versus brown eye color and varying intensities of brown eye color. We identify four major loci (SLC24A5 P = 5.4 × 10(-27), TYR P = 1.1 × 10(-9), APBA2[OCA2] P = 1.5 × 10(-8), SLC45A2 P = 6 × 10(-9)) for skin color that together account for 35% of the total variance, but the genetic component with the largest effect (~44%) is average genomic ancestry. Our results suggest that adjacent cis-acting regulatory loci for OCA2 explain the relationship between skin and eye color, and point to an underlying genetic architecture in which several genes of moderate effect act together with many genes of small effect to explain ~70% of the estimated heritability.

The admixture structure and genetic variation of the archipelago of Cape Verde and its implications for admixture mapping studies.

Recently admixed populations offer unique opportunities for studying human history and for elucidating the genetic basis of complex traits that differ in prevalence between human populations. Historical records, classical protein markers, and preliminary genetic data indicate that the Cape Verde islands in West Africa are highly admixed and primarily descended from European males and African females. However, little is known about the variation in admixture levels, admixture dynamics and genetic diversity across the islands, or about the potential of Cape Verde for admixture mapping studies. We have performed a detailed analysis of phenotypic and genetic variation in Cape Verde based on objective skin color measurements, socio-economic status (SES) evaluations and data for 50 autosomal, 34 X-chromosome, and 21 non-recombinant Y-chromosome (NRY) markers in 845 individuals from six islands of the archipelago. We find extensive genetic admixture between European and African ancestral populations (mean West African ancestry = 0.57, sd = 0.08), with individual African ancestry proportions varying considerably among the islands. African ancestry proportions calculated with X and Y-chromosome markers confirm that the pattern of admixture has been sex-biased. The high-resolution NRY-STRs reveal additional patterns of variation among the islands that are most consistent with differentiation after admixture. The differences in the autosomal admixture proportions are clearly evident in the skin color distribution across the islands (Pearson r = 0.54, P-value<2e-16). Despite this strong correlation, there are significant interactions between SES and skin color that are independent of the relationship between skin color and genetic ancestry. The observed distributions of admixture, genetic variation and skin color and the relationship of skin color with SES relate to historical and social events taking place during the settlement history of Cape Verde, and have implications for the design of association studies using this population.

Substituição do óleo de peixe por óleo de soja em dietas para beijupirá (Rachycentron canadum) / Replacement of fish oil by soybean oil in diets for cobia (Rachycentron canadum)

A substituição do óleo de peixe em dietas para beijupirá (Rachycentron canadum) foi avaliada usando-se cinco proporções de óleo de peixe e soja. Duzentos juvenis (±12g) foram distribuídos aleatoriamente em 20 tanques e alimentados até a saciedade aparente durante 42 dias. À medida que se aumentou o teor de óleo de peixe nas dietas, houve aumento proporcional no desempenho. Os juvenis alimentados com dietas que continham 75 e 100 por cento de óleo de peixe apresentaram ganhos de peso mais altos que os das dietas com 0 e 25 por cento de óleo de peixe, enquanto os alimentados com a dieta com 50 por cento de óleo de peixe apresentaram crescimento intermediário. Não foram observadas diferenças nas concentrações de proteína e lipídio na carcaça dos peixes, mas os teores de umidade e cinzas diferiram entre os tratamentos. A inclusão de teores relativamente altos de ingredientes de origem vegetal diminuiu o consumo alimentar, o que afetou negativamente o crescimento. Os resultados indicam a possibilidade de substituição de até 50 por cento do óleo de peixe por óleo de soja em dietas para juvenis do beijupirá.

The replacement of fish oil for cobia (Rachycentron canadum) in diets was evaluated using five proportions of fish oil:soybean oil. Two hundred juveniles (±12g) were randomly distributed in twenty 480L tanks and fed to apparent satiety twice daily for 42 days. Diets contained 12 percent lipids with different proportions of fish to soybean oils and were therefore named OP0, OP25, OP50, OP75 and OP100 according to the inclusion content of fish oil (0, 25, 50, 75 and 100 percent, respectively). Increasing dietary fish oil levels resulted in higher survival, growth and feed intake. Fish fed diets OP75 and OP100 presented higher weight gain than those fed diets OP0 and OP25, whereas fish fed diet OP50 had an intermediate weight gain. Overall, performance was enhanced at higher contents of dietary fish oil. No significant differences on protein and lipid content of fish carcass were observed, but moisture and ash content differed significantly between treatments. The inclusion of relatively higher contents of plant ingredients affected feed intake, which resulted in lower growth rates. The present results suggest the possibility of replacing up to 50 percent of fish oil with soybean oil in diets for cobia juveniles.

Cocaine treatment causes early and long-lasting changes in muscarinic and dopaminergic receptors.

1. The study of changes that persist after drug discontinuation could be fundamental to understand the mechanisms involved in craving and relapse. 2. In this work the changes occurring in muscarinic, D1- and D2-like receptors after 30 min (immediate), 1 day (early), 5 and 30 days (late) withdrawal periods were studied, in the striatum of rats treated once a day for 7 days with cocaine 20 and 30 mg/kg, i.p. 3. Binding assays were performed in 10% homogenates and ligands used were [3H]-N-methylscopolamine, [3H]-SCH 23390, and [3H]-spiroperidol for muscarinic (M1 + M2-like), D1-, and D2-like receptors, respectively. 4. Muscarinic receptors presented a downregulation at all doses and discontinuation times, while the dissociation constant (Kd) for this receptor decreased after 30 min, 5 and 30 days abstinence times. In relation to D1-like receptors we found an antagonistic effect with 100% increase in receptor number 30 min after the last cocaine injection, but after 1-day withdrawal a downregulation was observed with both doses that persisted up to 30 days, only with the higher dose. The dissociation constant value (Kd) for this receptor showed a decrease only with 5 and 30 days withdrawal. An increase occurred with D2-like receptors at all doses and withdrawal periods studied, while Kd increased in 30-min, 5, and 30 days withdrawal. 5. In this work we found that the subchronic cocaine treatment produces early and long-lasting modifications in cholinergic muscarinic as well in dopaminergic receptors that persist up to 30 days of cocaine withdrawal.

étodos de Screening/pectro estendido: prevalência e comparaçäo de m / Extendedspectrum beta-lactamases: prevalence and comparison of sreening for detection

As beta-lactamases de espectro ampliado podem produzir uma oculta, mas clinicamente significante resistência à celafosporinas de amplo espectro e aztreonam. Estas enzimas säo produzidas principalmente por Klebsiella ssp e Escherichia coli. Critérios interpretativos modificados para um grupo chave de antibióticos ou o uso de testes especiais de susceptibilidade antimicrobiana devem ser usados para aumentar a sensibilidade de detecçäo das ESBL. 735 isolados de E. coli e 192 de Klebsiella sp foram estudados para determinar a prevalência de ESBL no Hospital Universitário Regional Norte do Paraná. Os resultados obtidos indicam 2,99 por cento de E. coli e 36,46 por cento de Klebsiella sp produtoras de ESBL. Usando um grupo de 156 amostras de E. coli e 74 de Klebsiella sp, comparou-se 3 métodos de triagem para detecçäo de ESBL: teste de sinergia de duplo disco, disco difusäo (ambos realizados com ceftazidima, cefotaxima e aztreonam) e painel de microdiluiçäo MicroScan realizado com ceftazidima, ceftriaxona e cefotaxima). Os resultados deste estudo sugerem que e métodos de triagem podem ser igualmente utilizados por laboratórios clínicos em isolados de E. coli e Klebsiella sp

Combined effect of two different polymorphic sequences within the beta globin gene cluster on the level of HbF.

Beta thalassemia and Hb Lepore heterozygotes included in this study exhibit fetal hemoglobin levels varying from trace quantities to 14% (1.74 g/dl) of total hemoglobin in the adult. In this work, we have examined the correlation of DNA sequence polymorphisms with the observed HbF level. The analysis of polymorphic markers within the beta globin cluster in 39 individuals heterozygous for beta thalassemia or Hb Lepore confirms the previous findings for homozygous beta thalassemia: the presence of both an (AT)9 T5 sequence configuration at position -540 of the beta globin gene and a (C --> T) variation at -158 of the Ggamma globin gene is associated with elevated expression of HbF. However, at least one defective beta globin gene is required to reveal this association. The best evidence is from the study of individuals heterozygous for Hb Lepore with various levels of HbF. In these individuals it was possible to explore the effect of a single (AT)x Ty motif (the other being absent from the rearranged Lepore chromosome) on HbF expression. The presence of the (AT)9 T5 configuration increases HbF level from a median of 0.515 g/dl observed in (AT)7 T7 subjects, to 1.39 g/dl. We confirm the existence of linkage disequilibrium between the (C --> T) variation at -158 of Ggamma gene and the (TG)13 configuration at the second intervening sequence (IVS-2) of Agamma gene and identify two new polymorphisms in this region: (TG)7 (CG)5 (TG)8 linked to haplotype V and (TG)8 (CG)5 (TG)10 linked to haplotype II. This study suggests that two distinct regions of the beta cluster, whether in cis or in trans to each other, can interact to enhance HbF expression when a beta thalassemic determinant is present in heterozigosity.