Awareness of obstetric warning signs in Ecuador: a cross-sectional study.

OBJECTIVE: In Ecuador, the reported maternal death rate was 45.71 per 100,000 live births in 2013. This may be partly due to a lack of maternal knowledge of obstetric warning signs during pregnancy, delivery and the post-partum period. This study sought to evaluate awareness of obstetric warning signs among pregnant women in relation to individual demographic and area-level socio-economic indicators. STUDY DESIGN: We conducted a cross-sectional analysis of data collected by Ecuador's Ministry of Health at the conclusion of a national maternal health campaign (2014-2015). A nationally representative sample of 3435 pregnant women from the nine administrative zones completed surveys regarding basic demographics and their awareness of obstetric warning signs. METHODS: We defined eight obstetrical warning signs according to the literature and Ecuadorian practice that could occur during pregnancy, delivery and the post-partum period (severe headache, strong abdominal ache, bleeding or presence of malodorous secretion, rupture of the amniotic sac, high fever, abnormal presentation of the baby, decrease in baby's movements and delayed labour). A woman was considered 'aware' if she recognised at least four of the eight warning signs and stated she would seek immediate healthcare at their presentation. For each administrative zone, four socio-economic indicators (poverty, illiteracy, unemployment and subemployment) were obtained from the National Institute of Statistics and Census. Correlates of awareness of the obstetric warning signs were evaluated using hierarchical logistic models clustered by the administrative zone. RESULTS: Nationally, 86.9% of women were 'aware' of obstetric warning signs. After adjustment for age, socio-economic indicators and clustering, indigenous participants were 59% less likely to be aware of obstetric warning signs than mestizos (odds ratio [OR] = 0.41, 95% confidence interval [CI] = 0.28-0.59). For every 1% increase in area poverty, participants had a 5% decreased likelihood of being aware of obstetric warning signs (OR = 0.95, 95% CI = 0.93-0.96), adjusting for age, ethnicity and other socio-economic indicators. The most effective source of campaign information about obstetric warning signs was personal communication with a healthcare professional, as opposed to mass media advertisements (OR = 1.90, 95% CI = 1.34-2.71). CONCLUSIONS: A majority of Ecuadorian pregnant and post-partum women are aware of obstetric warning signs. Indigenous ethnicity and area-level poverty are associated with a lack of awareness. Personal communication with a healthcare professional was the most effective source of information. These findings have implications for improvement of maternal awareness of warning signs.

Expression of hMLH1 and hMSH2 proteins in ameloblastomas and tooth germs.

BACKGROUND: Mismatch repair proteins (MMRPs) are a group of nuclear enzymes that participate in the repair of base mismatches that occur during DNA replication in all proliferating cells. The most studied MMRPs are hMSH2 and hMLH1, which are known to be highly expressed in normal tissues. A loss of MMRPs leads to the accumulation of DNA replication errors in proliferating cells. Ki-67 is a biomarker regarded to be the gold-standard tool for determining cell proliferation by immunohistochemical methods. The aim of this study was to investigate the immunohistochemical expression of hMLH1, hMSH2 and Ki-67 proteins in ameloblastomas and tooth germs, to contribute to the understanding of the development of this odontogenic neoplasm. MATERIAL AND METHODS: Immunohistochemical assays to determine the presence of proteins hMSH2, hMLH1 and Ki-67 were performed in 80 ameloblastomas (40 solid and 40 unicystic) and five tooth germs. RESULTS: Unicystic ameloblastomas showed higher MMRP expression (hMLH1: 62.5 ± 43.4; hMSH2: 83.3 ± 47.8) than did solid ameloblastomas (hMLH1: 59.4 ± 13.5; hMSH2: 75.8 ± 40.2). Additionally, the cell proliferation index assessed by Ki-67 was inversely proportional to the expression of MMRP. Comparison between tooth germs and ameloblastoma revealed significantly higher expression of hMLH1, hMSH2 and Ki-67 in tooth germs (p=0.02). CONCLUSIONS: The differences of MMRP and Ki-67 immunoexpression between ameloblastomas and tooth germ suggest that alterations in the MMRP mechanisms could participate in the biological behavior of ameloblastomas.

Six-Year Follow-up of Slaughterhouse Surveillance (2008-2013): The Catalan Slaughterhouse Support Network (SESC).

Meat inspection has the ultimate objective of declaring the meat and offal obtained from carcasses of slaughtered animals fit or unfit for human consumption. This safeguards the health of consumers by ensuring that the food coming from these establishments poses no risk to public health. Concomitantly, it contributes to animal disease surveillance. The Catalan Public Health Protection Agency (Generalitat de Catalunya) identified the need to provide its meat inspectors with a support structure to improve diagnostic capacity: the Slaughterhouse Support Network (SESC). The main goal of the SESC was to offer continuing education to meat inspectors to improve the diagnostic capacity for lesions observed in slaughterhouses. With this aim, a web-based application was designed that allowed meat inspectors to submit their inquiries, images of the lesions, and samples for laboratory analysis. This commentary reviews the cases from the first 6 years of SESC operation (2008-2013). The program not only provides continuing education to inspectors but also contributes to the collection of useful information on animal health and welfare. Therefore, SESC complements animal disease surveillance programs, such as those for tuberculosis, bovine cysticercosis, and porcine trichinellosis, and is a powerful tool for early detection of emerging animal diseases and zoonoses.

Quasi-distributed and wavelength selective addressing of optical micro-resonators based on long period fiber gratings.

A novel all-in-fiber method for coupling light to high-Q silica whispering gallery mode (WGM) optical micro-resonators is presented, which is based on a pair of long period fiber gratings (LPGs) written in the same silica fiber, along with a thick fiber taper (15-18 µm in waist) in between the LPGs. The proposed coupling structure is robust and can be replicated many times along the same fiber simply cascading LPGs with different bands. Typical Q-factors of the order of 10(8) and total coupling efficiency up to 60% were measured collecting the resonances of microspheres or microbubbles at the fiber end. This approach uniquely allows quasi-distributed and wavelength selective addressing of different micro-resonators along the same fiber.

Long period grating-based fiber coupler to whispering gallery mode resonators.

We present a new method for coupling light to high-Q silica whispering gallery mode resonators (WGMs) that is based on long period fiber gratings (LPGs) written in silica fibers. An LPG allows selective excitation of high-order azimuthally symmetric cladding modes in a fiber. Coupling of these cladding modes to WGMs in silica resonators is possible when partial tapering of the fiber is also implemented in order to reduce the optical field size and increase its external evanescent portion. Importantly, the taper size is about one order of magnitude larger than that of a standard fiber taper coupler. The suggested approach is therefore much more robust and useful especially for practical applications. We demonstrate coupling to high-Q silica microspheres and microbubbles detecting the transmission dip at the fiber output when crossing a resonance. An additional feature of this approach is that by cascading LPGs with different periods, a wavelength selective addressing of different resonators along the same fiber is also possible.

Optical frequency conversion in silica-whispering-gallery-mode microspherical resonators.

High quality factor whispering-gallery-mode microresonators are ideally suited for nonlinear optical interactions. We analyze, experimentally and theoretically, a variety of χ((3)) nonlinear interactions in silica microspheres, consisting of third harmonic generation and Raman assisted third order sum-frequency generation in the visible. A tunable, room temperature, cw multicolor emission in silica microspherical whispering-gallery-mode microresonators has been achieved by controlling the cavity mode dispersion and exciting nonequatorial modes for efficient frequency conversion.

The use of null models and partial least squares approach path modelling (PLS-PM) for investigating risk factors influencing post-weaning mortality in indoor pig farms.

Although post-weaning mortality (PWM) in pig farming is mainly due to the effect of pathogens, farm type or swine management are also directly or indirectly involved. In this work, we used null models and the partial least squares approach (PLS) to structural equation modelling, also known as PLS path modelling (PLS-PM), to explore whether farm type, swine management and pathogens, including porcine circovirus type 2, swine influenza virus, porcine reproductive and respiratory syndrome virus and Aujeszky's disease virus, directly or indirectly influenced PWM in 42 Spanish indoor pig farms. The null model analysis revealed that contact with multiple combinations of viruses could occur by chance. On the other hand, PLS-PM showed that farm characteristics do not influence virus infections, and thus neither farm type nor associated management practices shaped PWM due to pathogens. Accordingly, preventive programmes aimed at controlling PWM in intensive farming should prioritize the control of major pig pathogens.

Fiber ring laser for intracavity sensing using a whispering-gallery-mode resonator.

Whispering-gallery-mode (WGM) microresonators are used as optical transducers for sensing applications. The typical detection scheme is based on tracking the WGM resonance shift, by scanning with a tunable laser, when a change of the refractive index in the region probed by the WGM takes place. We propose a sensing approach based instead on monitoring the position of the laser line of a fiber ring laser having a WGM microsphere in its loop. We have demonstrated that the induced shift is the same for the ring laser line and for the microsphere resonance. The proposed method requires simpler, cheaper equipment and may also improve the sensor resolution because the ring laser line is much narrower than the microsphere WGM resonance.

Planar coupling to high-Q lithium niobate disk resonators.

We demonstrate optical coupling to high-Q lithium niobate disks from an integrated lithium niobate waveguide. The waveguides are made by proton exchange in X-cut lithium niobate substrate. The disks with diameter of 4.7 mm and thickness of 1 mm are made from commercial Z-cut lithium niobate wafers by polishing the edges into a spheroidal profile. Both resonance linewidth and cavity ringdown measurements were performed to calculate the Q factor of the resonator, which is in excess of 10(8). Planar coupling represents the most promising technique for practical applications of whispering gallery mode resonators.

High Q silica microbubble resonators fabricated by arc discharge.

Microbubble resonators combine the unique properties of whispering gallery mode resonators with the intrinsic capability of integrated microfluidics. Here an improved fabrication method of microbubble resonators is presented, based on the heating of a slightly pressurized capillary by a rotating arc discharge. Rotation of the electrodes, moved out of a fiber splicer, ensures a homogeneous distribution of the heat all over the capillary surface. The demonstrated microbubble resonators have Q factors up to 6×10(7) at 1550 nm. Microbubbles were filled with water and aqueous solutions of ethanol in order to test the refractive index sensing capabilities of such resonators, which also show a good temporal stability. The limit of detection of our microbubble resonator sensor is 10(-6) RIU.

Perception of haptic motion is enhanced during conditions of increased postural stability.

BACKGROUND: Coupling between postural sway and fingertip displacement has been observed in individuals lightly touching a moving surface. This can be attributed to the central nervous system (CNS) misinterpreting surface motion as self-motion, evoking a compensatory sway response. RESEARCH QUESTION: Does baseline postural state influence the correct perception of haptic object motion? METHODS: Motion perception detection thresholds of index finger displacement at 1 mm s-1 velocity during light touch were determined for three postural conditions: standing with eyes open (EO) and closed (EC), and sitting with eyes closed. For the standing condition with eyes shut, displacement thresholds were measured using three velocities (1, 2 and 4 mm s-1). RESULTS: Postural condition had a large influence on motion perception, with a reduction in displacement threshold from 12 → 6 → 2 mm during the transition from standing EC → standing EO → sitting EC. A systematic decrease in displacement perception threshold was observed with increasing velocity. This tends to suggest that the increase of the touched object velocity may help overcoming the misinterpretation. SIGNIFICANCE: These results suggest that the ability to disambiguate self motion from haptic motion is enhanced during stable postures, and when stimulus velocity is high. Our findings may help to understand the mechanisms underlying the coupling between surface movements and postural sway, reported in the literature.

High-Q polymer-coated microspheres for immunosensing applications.

Homogeneous polymeric thin layers have been used as functionalizing agents on silica microspherical resonators in view of the implementation of an immunosensor. We have characterized the microspheres functionalized with poly-L-lactic acid and Eudragit L100, as an alternative to the commonly used 3-Aminopropyltrimethoxysilane. It is shown that polymeric functionalization does not affect the high quality factor (Q greater than 10(7)) of the silica microspheres, and that the Q factor is about 3 x 10(5) after chemical activation and covalent binding of immunogammaglobulin (IgG). This functionalizing process of the microresonator constitutes a promising step towards the achievement of an ultra sensitive immunosensor.

Effects of simvastatin on systemic inflammatory responses after cardiopulmonary bypass.

AIM: Cardiopulmonary bypass is associated with a complex systemic inflammatory response and the extent of their increase has been correlated with the development of postoperative complications. Recent studies suggest that treatment with statins is associated with a significant and marked decrease in inflammation-associated variables such as cytokines. Therefore, we investigated the effects of preoperative simvastatin treatment on systemic inflammatory response and perioperative morbidity after cardiopulmonary bypass. METHODS: A prospective, randomized study, was designed. Forty-four subjects undergoing elective coronary artery bypass grafting who fulfilled the inclusion criteria were randomized to treatment with simvastatin (20 mg/day, group A, N. 22) or control (group B, N. 22) before surgery. Plasma levels of interleukins (IL-6, IL-8, TNF-alpha), and systemic inflammatory response score (SIRS) were measured during the surgical intervention and over the following 48 postoperative hours. Cytokine levels were measured by enzyme-linked assays from plasma samples obtained at specific time points pre- and post-operation. RESULTS: In both groups the serum levels of the proinflammatory cytokines (IL-6, IL-8, TNF-alpha), and leukocytes, and the SIRS score increased significantly over the baseline, though no significant differences were observed between the two groups. The preoperative and postoperative course did not differ between both groups. CONCLUSIONS: In patients undergoing coronary artery bypass grafting with cardiopulmonary bypass, the administration of simvastatin doses not produce any changes in the inflammatory response as measured by the levels of IL-6, IL-8, TNF-alpha and SIRS score, nor does it reduce the complications after cardiac surgery.

[Budd-Chiari syndrome associated with systemic aspergillosis. Case report and literature review.]. / Síndrome de Budd-Chiari asociado a aspergilosis sistémica; informe de un caso y revisión de la literatura.

Budd-Chiari syndrome is a very rare disease related to hepatic vein obstruction. Vascular invasion by fungus is seldom seen and reported. After thorough research of the literature only three cases have been reported. We reported a case of a diabetic patient who showed an acute and aggressive disease, characterized by sepsis, acute hepatic failure and death. Postmortem examination showed disseminated aspergillosis, massive hepatic necrosis, hepatic vein thrombosis and venous occlusion by the fungus.

Fretting damage of Ni-rich ultrafine grained NiTi superelastic wires.

The effects of fretting on Ni-rich ultra-fine grained NiTi superelastic wires have been characterized. Fretting tests have been performed using wire on wire in 90° cross-cylinder configuration until 105 cycles in air at 25 °C. Constant displacement amplitude of 50 µm and normal loads of 10, 20 and 50 N were considered. For a normal load of 10 N, the tribosystem performed in Gross Slip Regime and the predominance of wear damage was observed. Mixed Fretting Regime was instead observed for normal loads of 20 N and 50 N. In these cases, the predominant damage mechanism was crack formation with the cracks oriented normal to the displacement direction. Occurrence of martensitic transformation in the contact region was inferred from the particular shape of the fretting loops. Due to their possible impact on biocompatibility, the debris detached from the tribosystem during the different experiments were collected and characterized by TEM. They consisted in agglomerations of nano-crystalline TiO2 (rutile) and NiO oxide particles sized between 10 and 20 nm.

A proposal on porcine circovirus type 2 (PCV2) genotype definition and their relation with postweaning multisystemic wasting syndrome (PMWS) occurrence.

Porcine circovirus type 2 (PCV2) is the essential infectious agent of postweaning multisystemic wasting syndrome (PMWS). Despite first sequencing studies did not find any association between PCV2 sequences and PMWS occurrence, recent works have suggested the opposite. In the present study, 87 open reading frame 2 (ORF2) sequences obtained from pigs with different clinical conditions and coming from farms with different PMWS status were analyzed. Results further confirmed the existence of two genogroups and the definition of two PCV2 genotypes (1 and 2) is proposed. All sequences included in genotype 1 came from pigs from PMWS affected farms, while all sequences obtained from non-PMWS affected farms corresponded to genotype 2. Moreover, infection of single pigs from PMWS affected farms harbouring both genotypes is described. Present results suggest that PCV2 genotype 1 may potentially be more pathogenic than PCV2 genotype 2.

Lack of transmission of porcine circovirus type 2 to weanling pigs by feeding them spray-dried porcine plasma.

An experiment was conducted to determine whether spray-dried porcine plasma containing 2.47 x 10(5) dna copies of porcine circovirus type 2 (pcv-2) could infect weanling pigs when fed to them. Five specific pathogen-free (spf) weanling pigs were fed ad libitum for 45 days a control diet and six pigs were fed a test diet containing 8 kg sdpp per 100 kg feed. The two groups were housed in separate biosecurity level-3 rooms. None of the pigs in either group developed any clinical signs or became pcv-2 viraemic or seroconverted.

Essential oil composition of the different parts of Eryngium corniculatum Lam. (Apiaceae) from Spain.

The essential oil from the different parts (inflorescences, stems+leaves and roots) of E. corniculatum Lam. gathered in Guadalajara (Spain) has been extracted by steam distillation and analysed by gas chromatography and gas chromatography coupled to mass spectrometry. Quantitative and qualitative differences have been found between the analysed parts, although all of them contained the same principal compound, 2,4,6-trimethylbenzaldehyde, representing the 50.8%, 50.0%, and 29.8% of the total oil for inflorescences, stems+leaves and roots, respectively. Other representative constituents of the oil were similar in the different fractions: in the inflorescences compounds were found to be alpha-pinene (4.0%), chrysanthenyl acetate (4.0%), 2,4,5-trimethylbenzaldehyde (3.3%), (2Z,6E)-farnesol (2.0%), (E)-nerolidol (2.1%) and (Z)-beta-ocimene (2.1%), while the stems+leaves oil showed 2,4,5-trimethylbenzaldehyde (3.8%), alpha-pinene (3.4%), (E)-nerolidol (2.4%) and (2Z,6E)-farnesol (2.1%), and in the roots oil a phyllocladene isomer (13.0%), (E)-nerolidol (9.4%), beta-eudesmol (4.1%) and (2Z,6E)-farnesol (2.1%) were found. The presence of C-10 compounds as the main fraction for an Eryngium species is worth mentioning. This is the first report on the chemical composition of this Mediterranean endemic species.

Exploratory field study on Mycoplasma hyopneumoniae infection in suckling pigs.

The present study focused on Mycoplasma hyopneumoniae (M. hyopneumoniae) detection by nPCR in nasal swabs of 507 suckling pigs. These animals came from 69 sows (from 1 to 8 parity number) of a farrow-to-finish herd with Enzootic Pneumonia (EP) problems at finishing stages. At 1 and 3 weeks of age (still in the farrowing units), nasal swabs and blood samples were taken from all piglets. Moreover, from these 507 animals, 37 randomly selected pigs were necropsied at 3 weeks of age. From those necropsied pigs, M. hyopneumoniae presence was tested in bronchial and tonsillar swabs. At 1 week post-farrowing, blood samples from sows were collected and used to detect M. hyopneumoniae antibodies. From the 69 analysed sows, 19 (27.5%) were seropositive. Global percentage of pigs with M. hyopneumoniae detection in nasal swabs at 1 and 3 weeks of age was 1.5% (8 out of 507) and 3.8% (19 out of 507), respectively. From these nPCR positive pigs, 89% (24 out of 27) were seronegative and 11% were seropositive. From necropsied animals, the pathogen DNA was detected in two pigs at bronchus level and in another pig at tonsil. In this study, sow parity was not statistically related with sow seropositivity and piglet colonization. These results confirm that M. hyopneumoniae infection may be detected not only in nasal cavities of naturally infected suckling piglets but also at their low respiratory tract airways. Our results suggest that M. hyopneumoniae detection in lower and upper respiratory tract could be an indicator that respiratory problems associated to EP may start relatively early in the production system. In consequence, sow-to-piglet and/or piglet-to piglet transmission in farrowing barns should not be underestimated.

Chronological study of Mycoplasma hyopneumoniae infection, seroconversion and associated lung lesions in vaccinated and non-vaccinated pigs.

A field trial was conducted to study Mycoplasma hyopneumoniae (Mh) infection dynamics by nested polymerase chain reaction (nPCR) and serology in pigs of a farm affected by enzootic pneumonia (EP). Moreover, correlation of Mh detection at different respiratory tract sites with presence of EP gross and microscopic lung lesions was assessed. These parameters were studied and compared between vaccinated (two doses at 1 and 3 weeks of age versus one dose at 6 weeks of age) and non-vaccinated pigs. Animals were monitored from birth to slaughter by nPCR from nasal swabs and by serology. From 3 to 22 weeks of age, an average of three pigs per treatment and per batch were necropsied (n = 302). The remaining pigs were sent to the slaughter (n = 103). Nasal, bronchial and tonsillar swabs were taken from the necropsied/slaughtered pigs; gross and microscopic EP-suggestive lung lesions were also assessed. Single and double vaccination resulted in earlier seroconversion and higher percentage of Mh seropositive pigs compared to control group. At slaughter, double vaccinated pigs showed lower percentage of EP-compatible gross lung lesions and lower Mh prevalence at upper respiratory tract sites (nasal cavity and tonsil) than control pigs.