Tailoring of Mesoporous Silica-Based Materials for Enhanced Water Pollutants Removal.

The adsorptive performance of mesoporous silica-based materials towards inorganic (metal ions) and organic (dyes) water pollutants was investigated. Mesoporous silica materials with different particle size, surface area and pore volume were prepared and tailored with different functional groups. These materials were then characterised by solid-state techniques, namely vibrational spectroscopy, elemental analysis, scanning electron microscopy and nitrogen adsorption-desorption isotherms, allowing the successful preparation and structural modifications of the materials to be confirmed. The influence of the physicochemical properties of the adsorbents towards the removal of metal ions (Ni2+, Cu2+ and Fe3+) and organic dyes (methylene blue and methyl green) from aqueous solutions was also investigated. The results reveal that the exceptionally high surface area and suitable ζ-potential of the nanosized mesoporous silica nanoparticles (MSNPs) seem to favour the adsorptive capacity of the material for both types of water pollutants. Kinetic studies were performed for the adsorption of organic dyes by MSNPs and large-pore mesoporous silica (LPMS), suggesting that the process follows a pseudo-second-order model. The recyclability along consecutive adsorption cycles and the stability of the adsorbents after use were also investigated, showing that the material can be reused. Current results show the potentialities of novel silica-based material as a suitable adsorbent to remove pollutants from aquatic matrices with an applicability to reduce water pollution.

Reversed priapism, thrombosis of the dorsal penile vein: A case report.

Priapism is an unintentional prolonged penile erection, lasting equal to or greater than 4 hours, in the absence of sexual stimulation or after having finished it. It is a rare pathology that can represent a urological emergency. The present report describes the case of a 25-year-old patient who presented priapism after suffering a one-meter fall on the genital area. Patient is a 25-year-old male with macroscopic hematuria without clots, testicular pain 4/10 on the numerical pain scale, stabbing type, without irradiation, secondary to a fall that occurred 3 months earlier, which resulted in a blow to the genital area. He presented an evolution of 20 days with detumescence and erectile dysfunction. Penile Doppler was performed and inverted priapism, arteriolacunar fistula at the base of the left corpus cavernosum, plus severe erectile dysfunction, were diagnosed. After a cavernography and an arteriography, a thrombolysis was performed. The patient continued with anticoagulant treatment with clopidogrel and enoxaparin and did not present complications after thrombolysis. A detailed clinical history, physical examination and a Doppler ultrasound study can provide a clear and timely diagnosis for the patient. Cavernography and arteriography have shown satisfactory results. In the present case, thrombolysis treatment with alteplase provided favorable results.

"We All Have a Job to Do in This World, It's up to Us": Farmworker and Farmer Mental Health in a Rural US-Mexico Border Region.

Improving mental health outcomes for agricultural populations is dependent on understanding the unique farming related stressors in context of the local culture and community. This study was designed to assess the prevalence of stressors and mental health risks among farmers and farmworkers in a rural, medically underserved US-Mexico border region. Of 135 study respondents, 55.6% (n = 18) farmers had clinical depression symptomatology based on the Center for Epidemiologic Studies depression screening scale (CES-D) and 40.2% (n = 117) farmworkers had stress levels that pose significant mental health risks based on the Migrant Farmworker Stress Inventory. Farmworker females were 2.3 times more likely to have a score of clinical concern. Results provide an understanding of the distinct sources of stress for both farmers and farmworkers and the mental health challenges across the industry. With an understanding that suicide is the third leading cause of injury death in Imperial County and depression associated with an increased risk of suicidality, the agricultural workforce in Imperial County is particularly vulnerable. Local farm organizations, employers, and community organizations can help increase mental health access, acceptability, and availability to achieve greater safety and health in the region's largest workforce.

An Overview of PRR- and NLR-Mediated Immunities: Conserved Signaling Components across the Plant Kingdom That Communicate Both Pathways.

Cell-surface-localized pattern recognition receptors (PRRs) and intracellular nucleotide-binding domain and leucine-rich repeat receptors (NLRs) are plant immune proteins that trigger an orchestrated downstream signaling in response to molecules of microbial origin or host plant origin. Historically, PRRs have been associated with pattern-triggered immunity (PTI), whereas NLRs have been involved with effector-triggered immunity (ETI). However, recent studies reveal that such binary distinction is far from being applicable to the real world. Although the perception of plant pathogens and the final mounting response are achieved by different means, central hubs involved in signaling are shared between PTI and ETI, blurring the zig-zag model of plant immunity. In this review, we not only summarize our current understanding of PRR- and NLR-mediated immunities in plants, but also highlight those signaling components that are evolutionarily conserved across the plant kingdom. Altogether, we attempt to offer an overview of how plants mediate and integrate the induction of the defense responses that comprise PTI and ETI, emphasizing the need for more evolutionary molecular plant-microbe interactions (EvoMPMI) studies that will pave the way to a better understanding of the emergence of the core molecular machinery involved in the so-called evolutionary arms race between plants and microbes.

"We left the crop there lying in the field": Agricultural worker experiences with the COVID-19 pandemic in a rural US-Mexico border region.

California agricultural workers are predominately Latino/a, are medically underserved, and reside in larger households, placing them at elevated COVID-19 risk at work and at home. While some research has examined COVID-19 among agricultural workers in the interior of the United States, little research exists on experiences of COVID-19 along the US-Mexico border. Grounded in resilience thinking, this study aims to understand how agricultural workers navigated their heightened risk to COVID-19 at work and at home, and made use of available resources in the context of a bi-national community. Our study utilized qualitative interviews with 12 agricultural workers to understanding the COVID-19 experiences of resident and daily migrant agricultural workers in Imperial County, California, located along the US-Mexico border. Findings suggest that agricultural workers faced significant impacts and risks at work (work stoppages, stress about bringing COVID-19 home to family) and at home (contracting COVID-19, loss of friends and family, and mental health challenges). Agricultural workers and their employers often implemented COVID-19 precautions such as social distancing measures, personal protective equipment, hand washing and hand sanitizers, and isolation. Many agricultural workers did access testing resources on either side of the US-Mexico border and worked with US-based Spanish-speaking community-based organizations to register for vaccine appointments. To better support agricultural workers and their employers in the future, we recommend the following: 1. Prioritize agricultural workplace conditions to increase agricultural worker physical and mental health, 2. Extend public health services into agricultural work sites of transit and the workplace, and 3. Lastly, trusted Spanish-speaking community-based organizations can play a critical role in public health outreach.

Lindqvist@Nanoporous MOF-Based Catalyst for Effective Desulfurization of Fuels.

An effective and sustainable oxidative desulfurization process for treating a multicomponent model fuel was successfully developed using as a heterogeneous catalyst a composite material containing as an active center the europium Lindqvist [Eu(W5O18)2]9- (abbreviated as EuW10) encapsulated into the nanoporous ZIF-8 (zeolitic imidazolate framework) support. The EuW10@ZIF-8 composite was obtained through an impregnation procedure, and its successful preparation was confirmed by various characterization techniques (FT-IR, XRD, SEM/EDS, ICP-OES). The catalytic activity of the composite and the isolated EuW10 was evaluated in the desulfurization of a multicomponent model fuel containing dibenzothiophene derivatives (DBT, 4-MDBT and 4,6-DMDBT) with a total sulfur concentration of 1500 ppm. Oxidative desulfurization was performed using an ionic liquid as extraction solvent and aqueous hydrogen peroxide as oxidant. The catalytic results showed a remarkable desulfurization performance, with 99.5 and 94.7% sulfur removal in the first 180 min, for the homogeneous active center EuW10 and the heterogeneous EuW10@ZIF-8 catalysts, respectively. Furthermore, the stability of the nanocomposite catalyst was investigated by reusing and recycling processes. A superior retention of catalyst activity in consecutive desulfurization cycles was observed in the recycling studies when compared with the reusing experiments. Nevertheless, the nanostructure of ZIF-8 incorporating the active POM (polyoxometalate) was shown to be highly suitable for guaranteeing the absence of POM leaching, although structural modification was found for ZIF-8 after catalytic use that did not influenced catalytic performance.

Falta de adherencia al tratamiento farmacológico y factores asociados en pacientes mexicanos con diabetes mellitus tipo 2 / Factors associated with the lack of adherence to treatment among patients with type 2 diabetes mellitus

BACKGROUND: Adherence to pharmacological treatment (APT) is crucial for patients with type 2 diabetes mellitus (T2DM) to achieve metabolic control and decrease complications. AIM: To establish the proportion of APT in patients with T2DM, the influence of the same on blood glucose, and the factors involved in a lack of ATP. MATERIAL AND METHODS: Diabetic patients were interrogated about sociodemographic factors, the evolution of the disease, their fasting blood glucose levels, and the use of other treatments. APT was evaluated with the Morisky-Green questionnaire, patient beliefs about treatments with the Beliefs about Medicines Questionnaire (BMQ), and patient knowledge about T2DM with the standard questionnaire. RESULTS: A representative sample of 400 individuals of both sexes was studied, finding a lack of APT in 74.5% of patients. The latter patients showed a significantly greater level of blood glucose while being more preoccupied and less informed about the disease. A lack of APT was associated with the refusal to undergo the blood glucose test among men (Odds ratio (OR)=3.70; 95% confidence intervals (CI), 1.58-8.66) and with the consumption of medicinal plants among women (OR=2.53; IC 95%, 1.23-5.23). CONCLUSIONS: A lack of APT in patients with T2DM is a serious problem and associated with a lack of knowledge about the disease. It is urgent to strengthen the educational programs in relation to T2DM to promote adherence to treatment.

[Voriconazole monitorization in pediatric patients, difficulties in dose adjustment]. / Importancia de la monitorización de concentraciones plasmáticas de voriconazol y dificultad en ajuste de dosis en un paciente pediátrico.

We present a 10-year-old male patient with a diagnosis of relapsed acute myeloid leukemia (AML), presenting with high-risk febrile neutropenia (HRFN), after a cycle of intensive chemotherapy, evolving with an invasive fungal infection demonstrated by histopathology. Treatment with intravenous voriconazole was started, with erratic plasmatic levels, which require successive dose adjustments which also occurred with oral administration. Finally, he had a favorable response to treatment, despite of the dosing difficulties to reach therapeutic levels. Active search as well as preemptive antifungal therapy, together with plasmatic level monitorization of voriconazole allowed a prompt recovery and improved the patient prognosis.

Decision-making for dental pulp exposure: a survey in graduate programs at Brazilian universities.

Clinical decision-making tends to be based on what clinicians have been taught during undergraduate and graduate programs. The aim of the present study was to assess the clinical approach and to identify the factors that influence the decision-making for dental pulp exposure among graduate students and coordinating professors in endodontics programs offered at Brazilian universities. The study used a mail-out survey developed in the Qualtrics platform, based on seven clinical reports in which dental pulp exposure was evidenced. Descriptive statistics showing vital pulp therapy (VPT) and root canal treatment (RCT) were calculated for each clinical report. Data on the participants' (n = 113) profile and variables related to clinical and radiographic characteristics of the cases were evaluated as to their potential to affect decision-making and analyzed by logistic regression (p < 0.05). VPT was likely to be indicated in cases of patients with immature teeth (OR = 0.017; 95%CI = 0.004 -0.073). RCT indications were related to the presence of symptoms (OR = 5.326; 95%CI = 1.429-19.852) and old age (OR = 21.057; 95%CI=6.809-65.120). In pulp exposure secondary to trauma, time of pulp exposure was significantly associated with RCT indication (OR=3.267; 95%CI=1.332-8.012). The present study demonstrated that patient age, root development, and symptom features were the main factors affecting participants' decision-making.

Work-Life Stress during the Coronavirus Pandemic among Latina Farmworkers in a Rural California Region.

OBJECTIVES: To examine the type and severity of stressors experienced among Latina farmworkers during the COVID-19 pandemic. METHODS: A survey containing the Migrant Farmworker Stress Inventory was administered to 77 female-identifying Latina farmworkers working in a US-Mexico border region. A sub-sample of five participants participated in key-informant interviews. Data collection occurred in Summer 2021. RESULTS: Nearly 40% of Latina farmworkers reported high stress levels indicative of clinical mental health risks. Health and safety concerns and experienced stressors identified included visible substance abuse and poor bathroom conditions at the field site, language barriers, and balancing work and home life demands. CONCLUSIONS: Latina farmworkers have unique health and safety needs, and COVID-19 has contributed to the experienced stressors. Understanding the familial and working environment sources of stress specific to female agriculture workers is imperative to implementing culturally and gender-responsive strategies to better support the health and safety of farming populations in future pandemics.

Importancia de la monitorización de concentraciones plasmáticas de voriconazol y dificultad en ajuste de dosis en un paciente pediátrico / Voriconazole monitorization in pediatric patients, difficulties in dose adjustment

Resumen Presentamos el caso de un escolar de 10 años, con el diagnóstico de una recaída de una leucemia mieloide aguda que cursó con un episodio de una neutropenia febril de alto riesgo, posterior a un ciclo intensivo de quimioterapia, evolucionando con una infección fúngica invasora demostrada por histopatología. Se inició tratamiento con voriconazol intravenoso, evolucionando con concentraciones plasmáticas erráticas que requirieron sucesivos ajustes de dosis, lo que también ocurrió con la administración oral del medicamento. Finalmente, tuvo una respuesta favorable al tratamiento, a pesar de la dificultad de la dosificación para alcanzar niveles terapéuticos. La búsqueda activa y la terapia antifúngica anticipada, así como la monitorización seriada de concentraciones terapéuticas de voriconazol, permitieron un tratamiento antifúngico óptimo y oportuno, mejorando el pronóstico del paciente.

Abstract We present a 10-year-old male patient with a diagnosis of relapsed acute myeloid leukemia (AML), presenting with high-risk febrile neutropenia (HRFN), after a cycle of intensive chemotherapy, evolving with an invasive fungal infection demonstrated by histopathology. Treatment with intravenous voriconazole was started, with erratic plasmatic levels, which require successive dose adjustments which also occurred with oral administration. Finally, he had a favorable response to treatment, despite of the dosing difficulties to reach therapeutic levels. Active search as well as preemptive antifungal therapy, together with plasmatic level monitorization of voriconazole allowed a prompt recovery and improved the patient prognosis.

Occupational Stressors and Access to COVID-19 Resources among Commuting and Residential Hispanic/Latino Farmworkers in a US-Mexico Border Region.

Hispanic/Latino and migrant workers experience high degrees of occupational stress, constitute most of California's agricultural workforce, and were among the most impacted populations by the COVID-19 pandemic. However, relatively little is known about the occupational stress experienced by farmworkers who commute daily between the US and Mexico. Occupational stress is considered an imbalance between the demands at work and the capabilities to respond in the context of the workforce. The goal of this study is to determine the type and severity of stressors in daytime and resident farmworkers and how COVID-19 vaccination status contributes to these stressors. Interviews containing the Migrant Farmworker Stress Inventory (MSWSI) were administered to a sample of 199 Hispanic/Latino farmworkers in Imperial County, a multi-billion-dollar agriculture sector in the US. Principal factor analysis differentiated latent factors in the MFSWI. Simple linear regression models and correlations identified associations between MFWSI scores and sample characteristics. The MFWSI reduced to five stressor domains: Health and Well-Being Vulnerabilities, Inadequate Standards of Living/Unknown Conditions of Living, Working Conditions, Working Environment, and Language Barriers. Approximately 40 percent of the respondents reported significant stress levels, with foreign-born (p = 0.014) and older respondents (p = 0.0415) being more likely to experience elevated stress regardless of their nighttime residence. We found that Spanish-language COVID-19 outreach might have been particularly effective for workers who reported high stress from English-language communication (p = 0.001). Moreover, our findings point to the importance of worker and human rights to mitigate the high-stress foreign-born workers who live in Mexico and the US experience.

[Factors associated with the lack of adherence to treatment among patients with type 2 diabetes mellitus]. / Falta de adherencia al tratamiento farmacológico y factores asociados en pacientes mexicanos con diabetes mellitus tipo 2.

BACKGROUND: Adherence to pharmacological treatment (APT) is crucial for patients with type 2 diabetes mellitus (T2DM) to achieve metabolic control and decrease complications. AIM: To establish the proportion of APT in patients with T2DM, the influence of the same on blood glucose, and the factors involved in a lack of ATP. MATERIAL AND METHODS: Diabetic patients were interrogated about sociodemographic factors, the evolution of the disease, their fasting blood glucose levels, and the use of other treatments. APT was evaluated with the Morisky-Green questionnaire, patient beliefs about treatments with the Beliefs about Medicines Questionnaire (BMQ), and patient knowledge about T2DM with the standard questionnaire. RESULTS: A representative sample of 400 individuals of both sexes was studied, finding a lack of APT in 74.5% of patients. The latter patients showed a significantly greater level of blood glucose while being more preoccupied and less informed about the disease. A lack of APT was associated with the refusal to undergo the blood glucose test among men (Odds ratio (OR)=3.70; 95% confidence intervals (CI), 1.58-8.66) and with the consumption of medicinal plants among women (OR=2.53; IC 95%, 1.23-5.23). CONCLUSIONS: A lack of APT in patients with T2DM is a serious problem and associated with a lack of knowledge about the disease. It is urgent to strengthen the educational programs in relation to T2DM to promote adherence to treatment.

Decision-making for dental pulp exposure: a survey in graduate programs at Brazilian universities

Abstract Clinical decision-making tends to be based on what clinicians have been taught during undergraduate and graduate programs. The aim of the present study was to assess the clinical approach and to identify the factors that influence the decision-making for dental pulp exposure among graduate students and coordinating professors in endodontics programs offered at Brazilian universities. The study used a mail-out survey developed in the Qualtrics platform, based on seven clinical reports in which dental pulp exposure was evidenced. Descriptive statistics showing vital pulp therapy (VPT) and root canal treatment (RCT) were calculated for each clinical report. Data on the participants' (n = 113) profile and variables related to clinical and radiographic characteristics of the cases were evaluated as to their potential to affect decision-making and analyzed by logistic regression (p < 0.05). VPT was likely to be indicated in cases of patients with immature teeth (OR = 0.017; 95%CI = 0.004 -0.073). RCT indications were related to the presence of symptoms (OR = 5.326; 95%CI = 1.429-19.852) and old age (OR = 21.057; 95%CI=6.809-65.120). In pulp exposure secondary to trauma, time of pulp exposure was significantly associated with RCT indication (OR=3.267; 95%CI=1.332-8.012). The present study demonstrated that patient age, root development, and symptom features were the main factors affecting participants' decision-making.

Relación entre características sociodemográficas, obstétricas y psicosociales con el desenlace del parto prematuro en un hospital de alta complejidad / Relationship between sociodemographic, obstetric and psychosocial characteristics with the outcome of premature delivery in a highly complex hospital

INTRODUCCIÓN: La prematuridad es un grave problema de salud pública por la morbilidad, la mortalidad y los costos a ella asociados. OBJETIVO: Evaluar la relación entre las características sociodemográficas, obstétricas y psicosociales con el desenlace de parto prematuro frente a partos de término en el Hospital Guillermo Grant Benavente de Concepción, Chile, entre el segundo semestre de 2016 y el primer semestre de 2017. MÉTODO: Estudio cuantitativo, observacional, de tipo caso-control. La muestra la constituyeron 84 mujeres con parto prematuro y 85 con parto de término. Se utilizó un cuestionario de elaboración propia y la escala de Evaluación Psicosocial Abreviada (EPsA). El estudio fue aprobado por el comité ético científico. Se realizó análisis bivariado, con un nivel de significancia a = 0,05. Los datos se analizaron con el software estadístico SPSS v.25.0. RESULTADOS: No hubo diferencias en los antecedentes sociodemográficos (edad, nivel socioeconómico, estado civil y escolaridad) entre ambos grupos. Solo las mujeres con parto prematuro mantenían en mayor porcentaje que las gestantes de término un trabajo remunerado (43,4% vs. 25,9%). El estado nutricional y el antecedente de parto prematuro previo no se asociaron a un nuevo parto antes de las 37 semanas. La interrupción por cesárea fue significativamente más frecuente en las gestaciones de pretérmino que en el grupo control (p = 0,0377). CONCLUSIONES: En la población estudiada, las características sociodemográficas de las gestantes no tuvieron relación con el desenlace prematuro de la gestación. Algunos factores biomédicos se relacionan significativamente con este riesgo. Es necesario evaluar la pertinencia de aplicar escalas psicosociales en esta población y enfocar los esfuerzos para promover el control preconcepcional en mujeres con antecedentes de parto prematuro o comorbilidad.

INTRODUCTION: Prematurity is a serious public health problem due to morbidity, mortality and associated costs. OBJECTIVE: To evaluate the relationship between sociodemographic, obstetric and psychosocial characteristics with the outcome of premature birth versus term births at the Guillermo Grant Benavente Hospital in Concepción, Chile, between the second semester of 2016 and the first semester of 2017. METHOD: Quantitative, observational case-control study. The sample consisted of 85 women with premature delivery and 85 with term delivery. A self-elaborated questionnaire and Abbreviated Psychosocial Assessment scale (EPsA) were used. The study was approved by the scientific ethics committee. Bivariate and multivariate analysis was performed, with a level of significance a = 0.05. The data were analyzed with the statistical software SPSS v.25.0. RESULTS: There were no differences between the sociodemographic antecedents (age, socioeconomic level, marital status and education) between both groups. Only women with preterm birth had a higher percentage of paid work than full-term pregnant women (43.4% vs. 25.9%). Nutritional status and a history of previous preterm birth were not associated with a new delivery before 37 weeks. Interruption by cesarean section was significantly more frequent in preterm pregnancies than in the control group (p = 0.0377). CONCLUSIONS: In the studied population, the sociodemographic characteristics of the pregnant women were not related to the premature outcome of pregnancy. Biomedical factors are significantly related to this risk. It is necessary to evaluate the relevance of applying psychosocial scales in this population and to focus efforts to promote preconception control in women with a history of preterm birth and/or comorbidities.

The construction of high-magnification homemade lenses for a simple microscope: an easy "DIY" tool for biological and interdisciplinary education.

The rise of microscopy in the seventeenth century allowed scientists to discover a new world of microorganisms and achieve great physiological advances. One of the first microscopes of the epoch was Antonie van Leeuwenhoek's microscope, a deceptively simple device that contains a single ball lens housed in a metal plate allowing the observation of samples at up to ×250 magnification. Such magnification was much greater than that achieved by rudimentary compound microscopes of the era, allowing for the discovery of microscopic, single-celled life, an achievement that marked the study of biology up to the nineteenth century. Since Leeuwenhoek's design uses a single ball lens, it is possible to fabricate variations for educational activities in physics and biology university and high school classrooms. A fundamental problem, however, with home-built microscopes is that it is difficult to work with glass. We developed a simple protocol to make ball lenses of glass and gelatin with high magnification that can be done in a university/high school classroom, and we designed an optimized support for focusing and taking photographs with a smartphone. The protocol details a simple, easily accessible, low-cost, and effective tool for the observation of microscopic samples, possible to perform anywhere without the need for a laboratory or complex tools. Our protocol has been implemented in classrooms in Chile to a favorable reception.

Estrategia de Estado para el tratamiento de la atrofia muscular espinal: un desafío del sistema de salud en Argentina / State strategy for the treatment of spinal muscular atrophy: a challenge for the health system in Argentina / Estratégia de Estado para o tratamento da atrofia muscular espinhal: um desafio para o sistema de saúde da Argentina

Objetivo: analizar la implementación y comercialización de medicamentos de alto costo en el sistema de salud argentino, tomando como referencia el tratamiento médico de la enfermedad de atrofia muscular espinal y analizar la normativa aplicable, demonstrando el paralelismo legislativo con la República Federativa del Brasil. Metodología: se realizó una investigación descriptiva analítica identificando los criterios plasmados en las normas ó reglamentos para la implementación de una medicación de alto costo. Resultados: logramos obtener el marco regulatorio de la medicación denominada nusinersen en Argentina y la República Federativa del Brasil. Conclusión: con el avance de la tecnología, sus altos costos impactan directamente en la posibilidad de acceso, ante lo cual creemos que además de las herramientas de negociación interna de cada país, la cooperación internacional resulta una herramienta fundamental para transformar esta realidad en una oportunidad de acceso.

Objective: to analyze the implementation and commercialization of high-cost drugs in the Argentine health system, taking as a reference the medical treatment of spinal muscular atrophy disease and analyze the applicable regulations, demonstrating the legislative parallelism with the Federative Republic of Brazil. Methods: a descriptive analytical investigation was conducted to identify the criteria set out in the rules or regulations for the implementation of a high-cost medication. Results: we obtained the regulatory framework for the medication called nusinersen in Argentina and the Federative Republic of Brazil. Conclusion: with the advancement of technology, its high costs have a direct impact on the possibility of access, before which we believe that in addition to the internal negotiation tools of each country, international cooperation is a fundamental tool to transform this reality into an opportunity access.

Objetivo: analisar a implantação e comercialização de medicamentos de alto custo no sistema de saúde argentino, tomando como referência o tratamento médico da doença atrofia muscular espinhal; e analisar a regulamentação aplicável, demonstrando o paralelismo legislativo com a República Federativa do Brasil. Metodologia: foi realizada uma pesquisa descritiva analítica, identificando os critérios previstos nas normas ou regulamentos para a implantação de um medicamento de alto custo. Resultados: obtivemos o marco regulatório do medicamento denominado nusinersen na Argentina e na República Federativa do Brasil. Conclusão: os altos custos da tecnologia impactam diretamente no seu acesso. Acreditamos que, além dos instrumentos de negociação interna de cada país, a cooperação internacional é uma ferramenta fundamental para transformar essa realidade em oportunidade de acesso.

Characterization of GASA-1, a new vaccine candidate antigen of Babesia bovis.

Surface proteins bound to the cell membrane by glycosylphosphatidylinositol (GPI) anchors are considered essential for the survival of pathogenic protozoans. In the case of the tick-transmitted hemoparasite Babesia bovis, the most virulent causative agent of bovine babesiosis, the GPI-anchored proteome was recently unraveled by an in silico approach. In this work, one of the identified proteins, GASA-1 (GPI-Anchored Surface Antigen-1), was thoroughly characterized. GASA-1 is 179 aa long and has the characteristic features of a GPI-anchored protein, including a signal peptide, a hydrophilic core and a hydrophobic tail that harbors a GPI anchor signal. Transcriptomic analysis shows that it is expressed in pathogenic and attenuated B. bovis strains. Notably, the gasa-1 gene has syntenic counterparts in B. bigemina and B. ovata, which also encode GPI-anchored proteins. This is highly unusual since all piroplasmid GPI-anchored proteins described so far have been found to be species-specific. Sequencing of gasa-1 alleles from B. bovis geographical isolates originating from Argentina, USA, Brazil, Mexico and Australia showed over 98 % identity in both nucleotide and amino acid sequences. A recombinant form of GASA-1 (rGASA-1) was generated in E. coli and anti-rGASA-1 antibodies were raised in mice. Fixed and live immunofluorescence assays showed that GASA-1 is expressed in in vitro cultured B. bovis merozoites and surface-exposed. Moreover, incubation of B. bovis in vitro cultures with anti-GASA-1 antibodies partially, but significantly, reduced erythrocyte invasion, indicating that this protein bears neutralization-sensitive antibody epitopes. Splenocytes of rGASA-1-inoculated mice showed a specific proliferative response when exposed to the recombinant protein, indicating that GASA-1 bears T-cell epitopes. Finally, sera from a group of B. bovis-infected cattle reacted with the recombinant protein, demonstrating that GASA-1 is expressed during natural infection of bovines with B. bovis, and suggesting that it is immunodominant. The high degree of conservation among B. bovis isolates and the presence of syntenic genes in other Babesia species suggest a relevant role of GASA-1 and GASA-1-like proteins for parasite survival, especially considering that, due to their surface location, they are exposed to the selection pressure of the host immune system. The highlighted features of GASA-1 make it an interesting candidate for the development of vaccines against bovine babesiosis.

Deficient glucose uptake is linked to impaired Glut1 expression upon CD3/CD28 stimulation in memory T cells from pleural effusions secondary to lung cancer.

Glucose and nutrient uptake is essential in supporting T cell activation and is increased upon CD3/CD28 stimulation. As T cells from pleural effusions secondary to lung cancer show impaired function, we hypothesized that these cells might have altered expression of nutrient transporters. Here, we analysed by flow cytometry the expression of the transferrin receptor CD71, amino acid transporter CD98 and glucose transporter Glut1 and glucose uptake in pleural effusion-derived T cells from lung cancer patients, after stimulation via CD3/CD28 under normoxia or hypoxia (2% O2 ). We compared the response of T cells from pleural effusions secondary to lung cancer with that of T cells from nonmalignant effusions. In memory T cells from both groups, anti-CD3/CD28-stimulation under normoxia upregulated CD98 and CD71 expression (measured as median fluorescence intensity, MFI) in comparison with anti-CD3-stimulation. Costimulation under hypoxia tended to increase CD98 expression compared to CD3-stimulation in memory T cells from both groups. Remarkably, in the cancer group, memory T cells stimulated via CD3/CD28 under hypoxia failed to increase CD71 and Glut1 expression levels compared to the cells receiving anti-CD3 stimulation, a phenomenon that contrasted with the behaviour of memory T cells from nonmalignant effusions. Consequently, glucose uptake by memory T cells from the cancer group was not increased after CD3/CD28 stimulation under hypoxia, implying that their glycolytic metabolism is defective. As this process is required for inducing an antitumoural response, our study suggests that memory T cells are rendered dysfunctional and are unable to eliminate lung tumour cells.

WalkSafe Keeps Walking for 15 Years: A Program Review.

Unintentional injury is the leading cause of death among children aged 5 to 14 years. The WalkSafe program was developed in response to the number of children admitted to Miami-Dade County, Florida, level-1 trauma centers. WalkSafe was piloted in an initially high-risk neighborhood, which now exhibits a low density of pedestrian crashes. Following countywide implementation of WalkSafe, trauma data exhibit a 78% decrease in pediatric injuries. This article provides a 15-year review of WalkSafe and its role in decreasing pediatric pedestrian injuries in Miami-Dade County. Every year, an alarming number of child pedestrians are injured on the nation's roadways. In Miami-Dade County, Florida, the WalkSafe program aims to reduce pediatric injury through targeted education and multitiered collaboration with community partners.