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PURPOSE: We aimed to (1) determine the extent of coverage of colorectal cancer patients in Arkansas All-Payer Claims Database (APCD), (2) assess coverage difference between persistent poverty and other areas, and (3) identify patient, tumor, and area factors associated with inclusion in APCD. METHODS: Data were from 2018 to 2020 Arkansas APCD linked with 2019 Arkansas Central Cancer Registry (ACCR). We constructed four cohorts to assess APCD's coverage of CRC patients: (Cohort 1) ≥ 1 day of medical coverage in APCD in 2019; (Cohort 2) APCD coverage in the diagnosis month; continuous APCD coverage in the 30; Year around diagnosis (six months before to five months after diagnosis month) (Cohort 3); or until death within six months (Cohort 4). We compared proportions in the cohorts by area persistent poverty designation. Logistic regressions identified factors associated with inclusion in APCD cohorts. PATIENT SELECTION: CRC patients diagnosed in 2019 from ACCR, excluding in situ disease. RESULTS: Of the 1,510 CRC patients diagnosed in 2019, 83% had ≥ 1 day of medical coverage in 2019 APCD (Cohort1), 81% had coverage in the diagnosis month (Cohort 2), and 63% had continuous coverage in the year around diagnosis (Cohort 3). Additionally, 11% died within six months but had continuous coverage until death (Cohort 4, 74%). No coverage difference was found between persist poverty and other areas. Age and primary payer type at diagnosis were the main predictors of inclusion in APCD. CONCLUSION: Arkansas APCD had high coverage of Arkansas CRC patients. No selection bias by area of persistent poverty designation was present.
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The purpose of this study was to describe a statewide COVID-19 transmission involving places of worship (POWs) during the early phase of the pandemic. During the period of May 2020-December 2020, this analysis evaluated COVID-19 cases in Arkansas reported in REDCap for overall cases associated with POWs, cluster detection, and network analysis of one POW utilizing Microbetrace. A total of 9904 COVID-19 cases reported attending an in-person POW service during the early phase of the pandemic with 353 probable POW-associated clusters identified. Network analysis for 'POW A' showed at least 60 COVID-19 cases were traced to at least 4 different settings. The pandemic gave an opportunity to observe and stress the importance of public health and POWs working closely together with a shared goal of facilitating worship in a manner that optimizes congregational and community safety during a public health emergency.
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COVID-19 , Humanos , Arkansas/epidemiologia , COVID-19/epidemiologia , Surtos de Doenças , Pandemias , Saúde Pública , Controle de Doenças TransmissíveisRESUMO
UNLABELLED: Abstract Objective: No information is available on the effect of cigarette smoke on bronchoconstrictor-induced air trapping in asthma. The aim of this study was to evaluate the additional influence of smoking on methacholine- and adenosine 5'-monophosphate (AMP)-induced air trapping in subjects with asthma. METHODS: Airway responsiveness to methacholine and AMP, bronchial (J'awNO) and alveolar (CANO) nitric oxide (NO) and exhaled breath condensate pH were measured in 68 adults (23 current smokers with asthma, 23 non-smokers with asthma and 22 current or former smokers with chronic obstructive pulmonary disease; COPD). The degree of air trapping induced by each bronchoconstrictor agent was expressed by the percent fall in forced vital capacity (FVC) at a 20% fall in forced expiratory volume in 1 s relative to FVC after saline inhalation (ΔFVC%). RESULTS: The ΔFVC% for AMP was higher in both smokers with asthma and patients with COPD than in non-smokers with asthma (p<0.001). By contrast, ΔFVC% for methacholine was similar in the three groups of subjects (p=0.69). In smokers with asthma, but not in the other two groups, there was a correlation between the residual volume/total lung capacity at baseline and the ΔFVC% induced by each bronchoconstrictor agent. Mean values for J'awNO were higher in non-smokers with asthma than in the other two groups (p<0.05). CONCLUSIONS: The results of this study suggest that factors underlying bronchoconstriction induced by indirect agonists are different in smokers and non-smokers with asthma. These observations might be clinically relevant, because triggers that frequently induce bronchial obstruction in the real world act by an indirect mechanism.
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Monofosfato de Adenosina/administração & dosagem , Asma/fisiopatologia , Broncoconstritores/administração & dosagem , Cloreto de Metacolina/administração & dosagem , Fumar/fisiopatologia , Adulto , Asma/metabolismo , Testes Respiratórios , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Óxido Nítrico/metabolismo , Doença Pulmonar Obstrutiva Crônica/metabolismo , Doença Pulmonar Obstrutiva Crônica/fisiopatologia , Fumaça , Fumar/metabolismo , Nicotiana , Capacidade VitalRESUMO
Antibiotic resistant Salmonella enterica are on the increase, worldwide. Given the scarcity of data, this study aimed to investigate its occurrence, virulence, and antibiotic resistance in Costa Rica's food chain. In total, 65 chicken meat- and 171 chicken caecal samples were collected and examined for Salmonella. High frequencies of Salmonella were found in chicken meat (58.5 %, n/N = 38/65) and poultry farms (38.0 %, n/N = 65/171). The majority of Salmonella from chicken meat (89.5 %, n/N = 34/38) and caecum samples (93.6 %, n/N = 59/63) exhibited multidrug resistance (MDR). Serovar Infantis was the most prevalent (94 %, n/N = 67/71), followed by serovars Anatum and Kentucky (3 %, n/N = 2/71). A pESI-like plasmid (92 %, n/N = 65/71) containing virulence and resistance markers was found in S. Infantis. Given the high prevalence of MDR Salmonella, this study emphasizes the need to enhance surveillance systems for foodborne pathogens and antimicrobial resistance in Costa Rica's food production chain.
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Aves Domésticas , Salmonella enterica , Animais , Estudos Transversais , Antibacterianos/farmacologia , Costa Rica , Galinhas , Farmacorresistência Bacteriana Múltipla , Salmonella , SorogrupoRESUMO
BACKGROUND: Chronic musculoskeletal (MSK) diseases are an important cause of disability in the Mayan community of Chankom in Yucatán, Mexico. OBJECTIVE: To understand a community-based participatory research (CBPR) strategy implemented in Chankom to design a community-based rehabilitation (CBR) program for people living with MSK diseases. METHODS: Qualitative descriptive thematic analysis from an ethnographic work conducted in Chankom, during the implementation of a CBPR strategy from 2014 to 2017. RESULTS: Four main themes describe the main processes that formed our CBPR strategy: 1) forming and maintaining an alliance between academic and community members, 2) prioritizing community needs, 3) integrating local and global knowledge and 4) shared-decision-making. This CBPR strategy allowed the design of a CBR program formed by six main interventions: 1) health services coordination, 2) personal support, 3) community venous blood sampling services, 4) community specialized services, 5) health promotion, and 6) health transportation services. CONCLUSIONS: Co-designing a CBR program for people living with chronic MSK diseases in Chankom was possible through an extensive community engagement work structured around four main processes, including the essential principles of CBPR. The designed CBR program includes culturally sensitive interventions aimed at improving the quality, availability, accessibility, and acceptability of health care services. Moreover, the program mainly addressed the "health" component of the World Health Organization-CBR matrix, suggesting a need for a new CBPR cycle after it is implemented and evaluated in the future.
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Antropologia Cultural , Pesquisa Participativa Baseada na Comunidade , Humanos , Tomada de Decisão Compartilhada , Promoção da Saúde , MéxicoRESUMO
A study of cestode specimens that were collected during survey work on elasmobranchs collected from Taiwan and Northern Territory, Australia, revealed the presence of 1 new combination into the genus Stillabothrium (Rhinebothriidea: Escherbothriidae) and 2 new species of the genus. Phyllobothrium biacetabulatum, collected from Rhinobatos schlegelii, is transferred to Stillabothrium and its description is emended, as is the diagnosis for the genus Stillabothrium and the family Escherbothriidae. Stillabothrium biacetabulatum n. comb. differs from existing species of the genus in that the face of its bothridia is laced with a network of longitudinal and horizontal muscle fibers that do not contribute to the formation of septa. Stillabothrium lunae n. sp. is described from Himantura leoparda and differs from existing species of the genus in that its bothridium possesses an anterior field of 7-8 loculi that are wider than long. Stillabothrium mariae n. sp. is described from Maculabatis astra. This species differs from all species of Stillabothrium except Stillabothrium campbelli in possessing 10-12 horizontally oriented bothridial loculi. Stillabothrium mariae n. sp. differs from S. campbelli in having longer bothridia and from all other species of Stillabothrium in that it lacks, rather than possesses, conspicuous septa and loculi that are longer than wide in the posterior region of its bothridia. Bayesian and parsimony-bootstrap analysis of 28S rDNA revealed S. biacetabulatum n. comb., S. lunae n. sp., and S. mariae n. sp. to be part of Clade 1 of Stillabothrium, with S. biacetabulatum n. comb. being the sister species to S. mariae n. sp. Stillabothrium lunae n. sp. was found to be the sister species to Stillabothrium borneoense.
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Cestoides , Elasmobrânquios , Rajidae , Animais , Teorema de Bayes , Cestoides/genética , Northern Territory/epidemiologiaRESUMO
Background: Knowledge of the functionality of the graft and patient survival is essential to assess the success of kidney transplantation. Objective: To determine the survival of transplanted patients by type of donor and the functionality of kidney grafts in a cohort in Mexico. Material and methods: Kidney transplant cohort from 2013 to 2017 in Mexico. 790 patients followed up for one year were analyzed to assess the survival of transplanted patients by type of donor and the functionality of kidney grafts. For this, measures of central tendency and dispersion were used, as well as Kaplan-Meier survival tables with SPSS, version 25. Results: Out of the 790 patients, 518 were from living donors (65.56%) with patient survival of 97.88% and graft function of 93.24% at 12 months of follow-up; 272 patients received the graft from a deceased donor with patient survival of 91.18% and renal graft function of 84.19%. Conclusions: There is still a difference of almost 5% in the survival of the recipient patient from a living donor compared to a deceased donor. For the functionality of the kidney graft, this difference is > 7%. Cadaveric donation has increased; however, even at low figures is of approximately 35% in Mexico.
Introducción: el conocimiento de la funcionalidad del injerto y la supervivencia del paciente es fundamental para valorar el éxito del trasplante renal. Objetivo: determinar la supervivencia de los pacientes trasplantados por tipo de donante y la funcionalidad de los injertos renales en una cohorte en México. Material y métodos: cohorte de trasplante renal de 2013 a 2017 en México. Se analizaron 790 pacientes seguidos por un año para valorar la supervivencia de los pacientes trasplantados por tipo de donante y la funcionalidad de los injertos renales. Para ello se usaron medidas de tendencia central y dispersión, así como tablas de supervivencia de Kaplan-Meier con SPSS, versión 25. Resultados: de los 790 pacientes, 518 fueron de donante vivo (65.56%) con supervivencia del paciente de 97.88% y de funcionalidad del injerto de 93.24% a 12 meses de seguimiento; 272 pacientes recibieron el injerto de donante fallecido con supervivencia del paciente de 91.18% y funcionalidad del injerto renal de 84.19%. Conclusiones: aún existe una diferencia de casi 5% en la supervivencia del paciente receptor de un donante vivo en referencia con un donante fallecido. Para la funcionalidad del injerto renal esta diferencia es > 7%. La donación cadavérica ha aumentado; sin embargo, incluso en cifras bajas es de aproximadamente el 35% en México.
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Sobrevivência de Enxerto , Transplante de Rim , Humanos , Rim , Doadores Vivos , México , Estudos RetrospectivosRESUMO
The production of tequila in Mexico generates a large amount of agave bagasse per year. However, this biomass can be considered as a potential source for biofuel production. In this study, it is described how the hydrothermal pretreatment was scaled in a bench scale, considering the severity index as a strategy. The best condition was at 180⯰C in isothermal regime for 20â¯min with 65.87% of cellulose content and high concentration of xylooligosaccharides (15.31â¯g/L). This condition was scaled up (using severity factor: [logR0]â¯=â¯4.11), in order to obtain a rich pretreated solid in cellulose to perform the enzymatic hydrolysis, obtaining saccharification yields of 98.5 and 99.5% at high-solids loading (10 and 15%, respectively). The pre-saccharification and fermentation strategy was used in the bioethanol production at 10 and 15% of total pretreated solids, obtaining 38.39 and 55.02â¯g/L of ethanol concentration, corresponding to 90.84% and 87.56% of ethanol yield, respectively.
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Agave , Biocombustíveis , Celulose , Etanol , Fermentação , HidróliseAssuntos
Pesquisa Participativa Baseada na Comunidade , Doenças Musculoesqueléticas , Humanos , Doenças Musculoesqueléticas/reabilitação , Doenças Musculoesqueléticas/prevenção & controle , Pessoas com Deficiência/reabilitação , Feminino , Masculino , Desenvolvimento de Programas , Serviços de Saúde Comunitária/organização & administraçãoRESUMO
Introducción: el conocimiento de la funcionalidad del injerto y la supervivencia del paciente es fundamental para valorar el éxito del trasplante renal. Objetivo: determinar la supervivencia de los pacientes trasplantados por tipo de donante y la funcionalidad de los injertos renales en una cohorte en México. Material y métodos: cohorte de trasplante renal de 2013 a 2017 en México. Se analizaron 790 pacientes seguidos por un año para valorar la supervivencia de los pacientes trasplantados por tipo de donante y la funcionalidad de los injertos renales. Para ello se usaron medidas de tendencia central y dispersión, así como tablas de supervivencia de Kaplan-Meier con SPSS, versión 25. Resultados: de los 790 pacientes, 518 fueron de donante vivo (65.56%) con supervivencia del paciente de 97.88% y de funcionalidad del injerto de 93.24% a 12 meses de seguimiento; 272 pacientes recibieron el injerto de donante fallecido con supervivencia del paciente de 91.18% y funcionalidad del injerto renal de 84.19%. Conclusiones: aún existe una diferencia de casi 5% en la supervivencia del paciente receptor de un donante vivo en referencia con un donante fallecido. Para la funcionalidad del injerto renal esta diferencia es > 7%. La donación cadavérica ha aumentado; sin embargo, incluso en cifras bajas es de aproximadamente el 35% en México
Background: Knowledge of the functionality of the graft and patient survival is essential to assess the success of kidney transplantation. Objective: To determine the survival of transplanted patients by type of donor and the functionality of kidney grafts in a cohort in Mexico. Material and methods: Kidney transplant cohort from 2013 to 2017 in Mexico. 790 patients followed up for one year were analyzed to assess the survival of transplanted patients by type of donor and the functionality of kidney grafts. For this, measures of central tendency and dispersion were used, as well as Kaplan-Meier survival tables with SPSS, version 25. Results: Out of the 790 patients, 518 were from living donors (65.56%) with patient survival of 97.88% and graft function of 93.24% at 12 months of follow-up; 272 patients received the graft from a deceased donor with patient survival of 91.18% and renal graft function of 84.19%. Conclusions: There is still a difference of almost 5% in the survival of the recipient patient from a living donor compared to a deceased donor. For the functionality of the kidney graft, this difference is > 7%. Cadaveric donation has increased; however, even at low figures is of approximately 35% in Mexico
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Humanos , Masculino , Feminino , Gravidez , Adulto , Pessoa de Meia-Idade , Sobrevida , Transplante de Rim , Assistência ao Convalescente , Sobrevivência , Sobrevivência de Enxerto , Estudos de Coortes , MéxicoRESUMO
El estado de nutrición y salud en los niños incide directamente en su aprendizaje y rendimiento escolar. Consiste de una intervención educativa en alimentación y nutrición en unidades educativas (UE) periurbanas pobres, orientada a desarrollar y fortalecer capacidades en docentes, alumnos y sus familias, que contribuyan a mejorar la alimentación, la nutrición y la salud. Se seleccionaron cinco UE: Zulia, Mérida y Caracas (n=6333 niños y niñas), que forman parte del programa de responsabilidad social empresarial de una empresa en alianza con Fundación Bengoa. Se intervino en educación nutricional, servicio de alimentación, formación para la participación y vigilancia nutricional. Nutricionistas y/ chef, dictaron 43 talleres de educación en nutrición (1291 docentes, padres, madres y miembros de la comunidad). Talleres de higiene y manipulación de alimentos, gerencia del servicio de alimentación y menú (379 madres colaboradoras y personal UE). Se formaron 594 personas (Identificación de la realidad social, diseño de planes conjuntos, participación y voluntariado y emprendedores). Se conformó el grupo de niños voluntarios Amigos de la Buena Alimentación (ABA). El desayuno saludable (30% kcal/día) incorporó vegetales y frutas. Entre 2008 y 2012 el porcentaje de sobrepeso (IMC) se redujo de 20,1% a 18,7% y el déficit se mantuvo entre 16,2% a 16,9%. Se confirma la importancia de un programa de educación nutricional que incluye desayuno, para mejorar conocimientos, hábitos alimentarios y la permanencia del niño en la escuela. La participación y el compromiso de los involucrados, es indispensable para el éxito de programas comunitarios en consonancia con su realidad cultural y socioeconómica(AU)
Nutrition and health status in children influence directly their learning and schooling. This program consists in the intervention of food and nutrition knowledge in poor suburban schools, oriented to develop and strengthen capacities in teachers, students and their families, as a contribution to upgrade health and nutrition. Five schools were selected in Zulia, Merida and Caracas (6333 boys and girls) that formed part of a program of social responsibility of a private company in alliance with Fundación Bengoa. Intervention included nutrition education, nutrition surveillance, food services and community participation. Nutritionists and a chef gave 43 nutrition education workshops (1291 teachers, parents and members of the community) food handling and food service management as well as menu planning workshops (379 mothers and teachers). In the field of planning and designing joint ventures, entrepreneurs and voluntary work formation, 595 personas were formed. A group of children called Friends of Healthy Eating was formed. The healthy breakfast (30% kcal/day) included vegetables and fruits. Between 2008 and 20012, overweight (high BMI) diminished from 20.1% to 18.7% although under nutrition remained 16.2-16.9%. The importance of a program of nutrition education that includes breakfast for a better understanding and healthy eating habits as well as to guarantee the child´s permanence at school was confirmed. Participation and the commitment of all involved is indispensable for the success of community programs as part of its cultural an socioeconomic reality(AU)