Prevalencia y determinantes de la infección por virus de papiloma humano en mujeres jóvenes de Guanacaste y Puntarenas, Costa Rica, 2004-2005.

OBJETIVO: Estimar la prevalencia e identificar determinantes de la infección por el virus del papiloma humano (VPH) en mujeres jóvenes (18-25 años). Material y métodos. Se analizaron datos de 5 871 mujeres sexualmente activas a quienes se les realizó una entrevista y toma de muestras cervicouterinas para detección de VPH y citología durante la visita de reclutamiento del Ensayo de Vacunación contra VPH16/18 en Costa Rica. Se calculó la prevalencia total para cualquier tipo de VPH y tipos oncogénicos, no oncogénicos y específicos, con intervalos de confianza al 95% (IC95%). Se utilizó regresión logística múltiple paso-a-paso para identificar determinantes asociados con la infección. RESULTADOS: La prevalencia total de VPH fue 50.0% (IC95% 48.8,51.3) y por tipos oncogénicos fue 33.8% (IC95% 32.6,35.0). El VPH-16 fue el tipo más prevalente (8.3%, IC95% 7.6,9.0). Los determinantes asociados con un alto riesgo de infección prevalente por VPH oncogénicos fueron no estar casada/unión libre, >1 compañero sexual, infección concomitante por Chlamydia trachomatis, y entre aquéllas con un único compañero sexual en su vida, un compañero con antecedente de múltiples compañeras sexuales. Conclusión. Se confirma la asociación de las infecciones por VPH oncogénicos con el comportamiento sexual de la mujer y se destacan los comportamientos del compañero sexual.

Limited Humoral and Specific T-Cell Responses After SARS-CoV-2 Vaccination in PWH With Poor Immune Reconstitution.

BACKGROUND: We analyzed humoral and cellular immune responses induced by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) messenger RNA (mRNA) vaccines in people with human immunodeficiency virus (HIV; PWH) who had CD4+ T-cell counts <200/µL (HIV<200 group). METHODS: This prospective cohort study included 58 PWH in the HIV<200 group, 36 with CD4+ T-cell counts >500/µL (HIV>500 group), and 33 HIV-1-negative controls (control group). Antibodies against the SARS-CoV-2 spike protein (anti-S immunoglobulin [Ig] G) and the receptor-binding domain (anti-RBD IgG) were quantified before and 4 weeks after the first and the second doses of BNT162b2 or mRNA-1273 (at week 8). Viral neutralization activity and T-cell responses were also determined. RESULTS: At week 8, anti-S/anti-RBD IgG responses increased in all groups (P < .001). Median (interquartile range) anti-S and anti-RBD IgG levels at week 8 were 153.6 (26.4-654.9) and 171.9 (61.8-425.8) binding antibody units (BAU)/mL, respectively, in the HIV<200 group, compared with 245.6 (145-824) and 555.8 (166.4-1751) BAU/mL in the HIV>500 group and 274.7 (193.7-680.4) and 281.6 (181-831.8) BAU/mL in controls (P < .05). Neutralizing capacity and specific T-cell immune responses were absent or reduced in 33% of those in the HIV<200 group, compared with 3.7% in the HIV>500 group (P < .01). CONCLUSIONS: One-third of PWH with CD4+ T-cell counts <200/µL show low anti-S/anti-RBD IgG levels, reduced in vitro neutralization activity against SARS-CoV-2, and no vaccine-induced T cells after receiving coronavirus disease 2019 mRNA vaccines.

Fatty Acid Desaturases in the Chloroplast and Endoplasmic Reticulum Promote Susceptibility to the Green Peach Aphid Myzus persicae in Arabidopsis thaliana.

Fatty acid desaturases (FADs) in plants influence levels of susceptibility to multiple stresses, including insect infestations. In this study, populations of the green peach aphid (Myzus persicae) on Arabidopsis thaliana were reduced by mutations in three desaturases: AtFAB2/SSI2, which encodes a chloroplastic stearoyl-[acyl-carrier-protein] 9-desaturase, and AtFAD7 or AtFAD3, which encode ω-3 FADs in the chloroplast and endoplasmic reticulum (ER), respectively. These data indicate that certain FADs promote susceptibility to aphids and that aphids are impacted by desaturases in both the chloroplast and ER. Aphid resistance in ssi2, fad3, and fad7, singly or in combination, might involve altered signaling between these subcellular compartments. C18:1 levels are depleted in ssi2, whereas C18:2 accumulation is enhanced in fad3 and fad7. In contrast, fad8 has higher than normal C18:2 levels but also high C18:1 and low C18:0 and does not impact aphid numbers. Potentially, aphids may be influenced by the balance of multiple fatty acids (FAs) rather than by a single species, with C18:2 promoting aphid resistance and C18:1 promoting susceptibility. Although the fad7 mutant also accumulates higher-than-normal levels of C16:2, this FA does not contribute to aphid resistance because a triple mutant line that lacks detectable levels of C16:2 (fad2fad6fad7) retains comparable levels of aphid resistance as fad7. In addition, aphid numbers are unaffected by the fad5 mutation that inhibits C16:1 synthesis. Together, these results demonstrate that certain FADs are important susceptibility factors in plant-aphid interactions and that aphid resistance is more strongly associated with differences in C18 abundance than C16 abundance.[Formula: see text] Copyright © 2021 The Author(s). This is an open access article distributed under the CC BY-NC-ND 4.0 International license.

A simple and readily available inflammation-based risk scoring system on admission predicts the need for mechanical ventilation in patients with COVID-19.

OBJECTIVE: To investigate whether a simplified inflammation-based risk scoring system comprising three readily available biomarkers (albumin, C-reactive protein, and leukocytes) may predict major adverse outcomes in patients with COVID-19. METHODS: Upon admission to the emergency room, the inflammation-based risk scoring system was applied and patients were classified as having mild, moderate, or severe inflammation. In-hospital occurrence of thrombosis, need for mechanical ventilation, and death were recorded. RESULTS: One-hundred patients (55 ± 13 years; 71% men) were included and classified as having mild (29%), moderate (12%), or severe (59%) inflammation. The need for mechanical ventilation differed among patients in each group (16%, 50%, and 71%, respectively; P < 0.0001), yielding a 4.1-fold increased risk of requiring mechanical ventilation in patients with moderate inflammation and 5.4 for those with severe inflammation. On the contrary, there were no differences for the occurrence of thrombosis (10%, 8%, and 22%, respectively; P = 0.142) or death (21%, 42%, and 39%, respectively; P = 0.106). In the multivariate analysis, only severe inflammation (hazard ratio [HR] = 4.1), D-dimer > 574 ng/mL (HR = 3.0), and troponin I ≥ 6.7 ng/mL (HR = 2.4) at hospital admission were independent predictors of the need for mechanical ventilation. CONCLUSION: The inflammation-based risk scoring system predicts the need for mechanical ventilation in patients with severe COVID-19.

Effect of production system and inhibitory potential of aroma volatiles on polyphenol oxidase and peroxidase activity in tomatoes.

BACKGROUND: Polyphenol oxidase (PPO) and peroxidase (POD) are key enzymes associated with shelf life and defense responses. Thus, the activity of PPO and POD enzymes is usually assessed to check the quality of food samples and to understand the physiological responses of plants to different stresses. However, the outcomes of PPO and POD activity assessment studies are highly dependent on assay conditions. Hence, in this study, we initially optimized PPO and POD extraction and high-throughput 96-well plates-based enzymatic activity assessment methods to evaluate the inhibitory potential of tomato volatile compounds. Later, we explored the effects of net-house and open-field growing on the PPO and POD activity in tomato fruits of eight cultivars. RESULTS: We found 150 mM of catechol and pH 7.0 were the optimal conditions for the maximum activity for the PPO assay. Conversely, 24 mM guaiacol with 12 mM H2 O2 and pH 6.0 was the best condition for the POD assay. Thermal inactivation studies confirmed that tomato POD is more resistant to heat than PPO. We found that the production systems had a considerable genotype-specific impact on tomato PPO and POD activity. Moreover, amongst the volatiles that were studied, ß-damascenone and d-limonene showed 50% PPO inhibition at 40 and 80 mM, respectively. CONCLUSION: The results of this study can be used to improve the shelf-life of fresh tomato fruit and its products. The findings also underscore the significance of PPO and POD enzymes as physiological trait markers in the tomato crop and fruit quality improvement programs. © 2020 Society of Chemical Industry.

A Comparison of the Effects of FATTY ACID DESATURASE 7 and HYDROPEROXIDE LYASE on Plant-Aphid Interactions.

The spr2 mutation in tomato (Solanum lycopersicum), which disrupts function of FATTY ACID DESATURASE 7 (FAD7), confers resistance to the potato aphid (Macrosiphum euphorbiae) and modifies the plant’s C6 volatile profiles. To investigate whether C6 volatiles play a role in resistance, HYDROPEROXIDE LYASE (HPL), which encodes a critical enzyme in C6 volatile synthesis, was silenced in wild-type tomato plants and spr2 mutants. Silencing HPL in wild-type tomato increased potato aphid host preference and reproduction on 5-week old plants but had no influence on 3-week old plants. The spr2 mutation, in contrast, conferred strong aphid resistance at both 3 and 5 weeks, and silencing HPL in spr2 did not compromise this aphid resistance. Moreover, a mutation in the FAD7 gene in Arabidopsis thaliana also conferred resistance to the green peach aphid (Myzus persicae) in a genetic background that carries a null mutation in HPL. These results indicate that HPL contributes to certain forms of aphid resistance in tomato, but that the effects of FAD7 on aphids in tomato and Arabidopsis are distinct from and independent of HPL.

Cervical cancer incidence after screening with HPV, cytology, and visual methods: 18-Year follow-up of the Guanacaste cohort.

Testing negative for human papillomavirus (HPV) predicts long-term reassurance against invasive cervical cancer (ICC). To provide realistic estimates of effectiveness for new screening programs, we studied ICC risk after a 7-year repeated multimethod screening effort. In 1993-1994, 10,049 women aged 18-97 years were enrolled into a population-based cohort study of cervical HPV in Guanacaste, Costa Rica. Women were screened at different intervals according to enrollment results. Each visit (mean 3.2, 90% attendance) included split-sample conventional, automated, and liquid-based cytology, visual inspection, cervicography, and PCR-based HPV testing. Abnormal screening led to colposcopy and excisional treatment as appropriate during the study. Referral to colposcopy for HPV in the absence of other findings was introduced only at the last visit. Population-based Costa Rica Cancer Registry linkage identified cohort women diagnosed with ICC in the 18 years following cohort enrollment. The ICC cumulative risk was 0.4% (n = 38); 18 were diagnosed with ICC after study participation. Of these, 9 were missed at the screening step (negative screening or below the referral threshold, refused screening or colposcopy), 5 attended colposcopy but were not diagnosed as CIN2+, and 4 were treated for CIN2/3 but progressed to ICC nonetheless. Decreasing age-standardized ICC rates for the 1993-2011 period were observed in Guanacaste; cohort women showed additional 31% ICC incidence reduction with apparent downstaging of cancers that occurred. ICC risk following negative HPV testing in the optimal age range 30-50 years was extremely low. Real-life screening effectiveness following introduction is lower than the potential near-complete efficacy predicted by HPV natural history.

Age of Onset, Current Use of Alcohol, Tobacco or Marijuana and Current Polysubstance Use Among Male and Female Mexican Students.

AIMS: This study aimed to examine alcohol, tobacco or marijuana use onset and associations between age of onset and current use, and between age of onset and current polysubstance use among a sample of Mexican young people aged 17-20 years. METHODS: Alcohol, tobacco, marijuana and other substance use were identified in a 2012 cross-sectional survey of male and female students entering first year university in Mexico City. Chi-square tests and logistic regression models examined associations between gender, age of onset, order of onset, family substance use and current polysubstance use among 22,224 students. RESULTS: The largest proportions of males and females initiated alcohol at age 15, tobacco at ages 15-16 and marijuana at ages 16-17. Earlier alcohol and tobacco initiation was associated with past 30-day use of the same substance. Gender differences in alcohol and tobacco use were small but males were significantly more likely than females to use marijuana and be polysubstance users. Family substance use was associated with earlier onset. There was a significant association between the earliest age of any of the three substances and current polysubstance use. CONCLUSIONS: A number of contextual and cultural factors in Mexico may be contributing to early onset, continued use and polysubstance use and deserve attention in research and by prevention programs.

Association of Anxiety-Related Polymorphisms with Sports Performance in Chilean Long Distance Triathletes: A Pilot Study.

Different factors affecting athletic performance are well established: intensity and type of training, anthropometric characteristics as well as an important psychological component. However, the contribution of the genetic background has been less investigated. The aim of the present study was to investigate the influence of polymorphisms within genes associated with stress and anxiety (5HTT, CRH2R, ACE, NK1R, 5HT1AR and CRF-BP) on the physical capability and sports performance in triathletes. One hundred and ninety two (192) unrelated Chilean triathletes who participated in the 2014 70.3 Pucón city triathlon were divided into opposite subgroups of sports performance according to their time results. We identified significant associations for five polymorphisms (5HTT 5-HTTLPR, ACE I/D, NK1R rs6715729, 5HT1AR -1019C>G and CRF-BP CRF-BPs11) with athletic performance. Our results indicate that these polymorphisms are associated with differential sports performance in Chilean triathletes, establishing an initial background for better understanding the relationship between physical performance, genetics and anxiety disorders.

The ethylene response factor Pti5 contributes to potato aphid resistance in tomato independent of ethylene signalling.

Ethylene response factors (ERFs) comprise a large family of transcription factors that regulate numerous biological processes including growth, development, and response to environmental stresses. Here, we report that Pti5, an ERF in tomato [Solanum lycopersicum (Linnaeus)] was transcriptionally upregulated in response to the potato aphid Macrosiphum euphorbiae (Thomas), and contributed to plant defences that limited the population growth of this phloem-feeding insect. Virus-induced gene silencing of Pti5 enhanced aphid population growth on tomato, both on an aphid-susceptible cultivar and on a near-isogenic genotype that carried the Mi-1.2 resistance (R) gene. These results indicate that Pti5 contributes to basal resistance in susceptible plants and also can synergize with other R gene-mediated defences to limit aphid survival and reproduction. Although Pti5 contains the ERF motif, induction of this gene by aphids was independent of ethylene, since the ACC deaminase (ACD) transgene, which inhibits ethylene synthesis, did not diminish the responsiveness of Pti5 to aphid infestation. Furthermore, experiments with inhibitors of ethylene synthesis revealed that Pti5 and ethylene have distinctly different roles in plant responses to aphids. Whereas Pti5 contributed to antibiotic plant defences that limited aphid survival and reproduction on both resistant (Mi-1.2+) and susceptible (Mi-1.2-) genotypes, ethylene signalling promoted aphid infestation on susceptible plants but contributed to antixenotic defences that deterred the early stages of aphid host selection on resistant plants. These findings suggest that the antixenotic defences that inhibit aphid settling and the antibiotic defences that depress fecundity and promote mortality are regulated through different signalling pathways.

Drinking patterns and victimization among male and female students in Mexico.

AIMS: The purpose of this study is to estimate the prevalence of alcohol use and alcohol-related consequences, identify drinking profiles using latent profile analysis (LPA), and investigate associations between profiles and violent victimization among young people in Mexico. METHODS: LPA identified profiles of drinking behavior in a survey of entering first year university students. Multinomial and logistic regression examined associations between drinking patterns, socio-demographic variables and violent victimization. RESULTS: The LPA identified five profiles of behaviors and consequences among the 22,224 current, former and never drinkers: Non/Infrequent-No Consequences, Occasional-Few Consequences, Regular-Some Consequences, Heavy-Many Consequences and Excessive-Many Consequences drinkers. The Occasional-Few Consequences profile comprised the largest, and the Excessive-Many Consequences profile the smallest, group of drinkers. Multinomial regression showed males and older students more likely to be Heavy or Excessive-Many Consequences drinkers. Living alone was associated with higher odds, and higher maternal education with lower odds, of being a Non/Infrequent-No Consequences drinker. Heavier drinking profiles were more likely to experience violent victimization adverse consequences. Logistic regression showed male and female Heavy and Excessive-Many Consequences drinkers had the highest odds, and Non/Infrequent drinkers the lowest odds, of experiencing any victimization. CONCLUSION: Findings suggest changes in male and female drinking behavior and a continuation of the established pattern of infrequent but high consumption among Mexican youths. Both male and female Heavy and Excessive-Many Consequences drinkers were at elevated risk for experiencing victimization. Identifying cultural gender norms about drinking including drinker expectations and drinking context that contribute to these patterns can inform prevention efforts.

Natural mentors and youth drinking: a qualitative study of Mexican youths.

Parental influences on youth drinking are well documented but not the influence of extended family members. This article explores extended family influences on alcohol use among Mexican youths and whether extended family members can be considered natural mentors. We conducted a qualitative study using ethnographic open ended interviews with 117 first year university students in Mexico City. The ethnographic interviews revealed six drinking groups: excessive, heavy, regular, occasional, abstainers and non drinkers. Youths reported close relationships with extended family members who provided counsel and acted as representatives of familial norms and values. The alcohol beliefs and behaviors of these family members, including their alcohol misuse, had a positive influence on youths' alcohol attitudes. The naturally occurring mentoring relationships of Mexican extended family members can positively influence moderate youth drinking. Natural mentoring relationships should be encouraged and facilitated in prevention efforts for Mexican youths, Mexican-American youths and potentially other Hispanic/Latino youths.

A concise, health service coverage index for monitoring progress towards universal health coverage.

BACKGROUND: There is a growing international commitment to universal health coverage (UHC), but limited means to determine progress towards that goal. We developed a practical index for capturing health service coverage - a critical dimension of UHC -- that was more inclusive than previous methods. METHODS: Our data included publicly-available, indicators reflecting health service delivery, infrastructure, human resources, and health expenditures for 103 countries. We selected a set of internally-consistent indicators and performed principal component analysis. Multiple imputation was used to address missing values. We extracted and rotated four components related to health service coverage and developed a composite index for each country for 2009. RESULTS: Explaining cumulatively almost 80% of the total variance, the four extracted components were characterized as: 1) provision of services, 2) infrastructure and human resources, 3) immunization (provision of services), and 4) financial resources. The health service coverage index developed from these components demonstrated strong correlation with health outcome measures such as infant mortality and life expectancy, supporting its validity. Index values also appeared generally consistent with published reports and the regional distribution of health coverage. CONCLUSIONS: Our approach moved beyond common indicators of service coverage focused on infectious diseases and maternal and child health, to include information on necessary health inputs. The resulting, balanced, composite index of health service coverage demonstrated promise as a metric, likely to discriminate coverage levels between countries and regions. An important number of service provision indicators were correlated, therefore a reduced set of services performed well as a proxy for the full set of available indicators. This parsimonious index is a start toward simplifying the task of policy-makers monitoring progress on a key domain of universal health coverage.

Changes in alcohol use among first year university students in Mexico.

BACKGROUND: Alcohol use and misuse is widespread among university students in many countries. Specific cultural factors may impact alcohol use after entering university. OBJECTIVE: This paper considers changes in alcohol use among first year university students in Mexico. METHODS: A qualitative study using ethnographic interviews with 57 female and 60 male student drinkers in Mexico City from March to June 2011. Each interview was evaluated by a set of thematic codes developed inductively from the interviews. Findings from excessive, heavy, regular, occasional drinkers, abstainers, and non-drinkers were analyzed to explore whether or not linkages existed between and/or among particular themes. RESULTS: Students reported factors associated with changes in role and status, friendships, and increased autonomy as reasons for increasing or decreasing their alcohol use after entering university. CONCLUSIONS/IMPORTANCE: Understanding the influence of Mexican cultural norms on alcohol use among Mexican and Mexican Americans can be helpful in informing studies and preventive efforts among both Mexican and Mexican American young people.

Where will the money come from? Alternative mechanisms to HIV donor funding.

BACKGROUND: Donor funding for HIV programs has flattened out in recent years, which limits the ability of HIV programs worldwide to achieve universal access and sustain current progress. This study examines alternative mechanisms for resource mobilization. METHODS: Potential non-donor funding sources for national HIV responses in low- and middle-income countries were explored through literature review and Global Fund documentation, including data from 17 countries. We identified the source, financing agent, magnitude of resources, frequency of availability, as well as enabling and risk factors. RESULTS: Four non-donor funding sources for HIV programs were identified: earmarked levy for HIV from country budgets; risk-pooling schemes such as health insurance; debt conversion, in which the creditor country reduces the debt of the debtor country and allocates at least a part of that reduction to health; and concessionary loans from international development banks, which unlike grants, must be repaid. The first two are recurring sources of funding, while the latter two are usually one-time sources, and, if very large, might negatively affect the debtor country's economy. Insurance schemes in five African countries covered less than 6.1% of the HIV expenditure, while social health insurance in four Latin American countries covered 8-11% of the HIV expenditure; in Colombia and Chile, it covered 69% and 60%, respectively. Most low-income countries will find concessionary loans hard to repay, as their HIV programs cost 0.5-4% of GDP. Even in a middle-income country like India, a US$255 million concessionary loan to be repaid over 25 years provided only 7.8% of a 5-year HIV budget. Earmarked levies provided only 15% of the annual HIV funding needs in Zimbabwe and Kenya. Debt conversion provided the same share in Indonesia, but in Pakistan it was much higher - the equivalent of 45% of the annual cost of the national HIV program. CONCLUSIONS: Domestic sources of funding are important alternatives to consider and might be able to replace donor HIV funding in specific country contexts, coupled with effective prioritization and efficiency measures. Successful resource mobilization design and implementation require close collaboration with other sectors, particularly with the Ministry of Finance, to make sure that the new financing mechanism is fully synchronized with economic growth and that HIV investments yield returns in the form of higher social benefits.

Care Pathway at a Cancer Center for the Administration of Radiometabolic Therapy with 177Lu-PSMA in Patients with Metastatic Castration-resistant Prostate Cancer.

Objectives: To present a clinical care model for the administration of 177Lu-labeled prostate-specific membrane antigen (PSMA) in radiometabolic therapy for metastatic castration-resistant prostate cancer (mCRPC) at the National Cancer Institute (NCI) of Bogotá, Colombia. Methods: A care model was designed for patients with mCRPC based on the VISION study, a prospective, phase III, multicenter, open-label, randomized study in patients with positive 68Ga-PSMA positron emission tomography/computed tomography who had progressed to taxane and androgen therapy, to receive 177Lu-PSMA-617 combined with the best standard of care vs. the best standard of care alone. The care pathway provided to patients was developed by the Nuclear Medicine Group of the NCI and is the result of adjustments and improvements in the care process and the updating of the literature. Results: A systematic and efficient care model was formalized and implemented for the administration of 177Lu-PSMA therapy in patients with mCRPC who had previously been treated with at least one androgen receptor pathway inhibitor and one or two taxane regimens, with evidence of disease progression. Conclusion: An optimized process of care based on the determinants of clinical outcomes was developed for patients who received this type of radiometabolic therapy.

Expression of α-DIOXYGENASE 1 in tomato and Arabidopsis contributes to plant defenses against aphids.

Plant α-dioxygenases (α-DOX) are fatty acid-hydroperoxidases that contribute to the synthesis of oxylipins, a diverse group of compounds primarily generated through oxidation of linoleic (LA) and linolenic acid (LNA). Oxylipins are implicated in plant signaling against biotic and abiotic stresses. We report here that the potato aphid (Macrosiphum euphorbiae) induces Slα-DOX1 but not Slα-DOX2 expression in tomato (Solanum lycopersicum). Slα-DOX1 upregulation by aphids does not require either jasmonic acid (JA) or salicylic acid (SA) accumulation, since tomato mutants deficient in JA (spr2, acx1) or SA accumulation (NahG) still show Slα-DOX1 induction. Virus-induced gene silencing of Slα-DOX1 enhanced aphid population growth in wild-type (WT) plants, revealing that Slα-DOX1 contributes to basal resistance to aphids. Moreover, an even higher percent increase in aphid numbers occurred when Slα-DOX1 was silenced in spr2, a mutant line characterized by elevated LA levels, decreased LNA, and enhanced aphid resistance as compared with WT. These results suggest that aphid reproduction is influenced by oxylipins synthesized from LA by Slα-DOX1. In agreement with our experiments in tomato, two independent α-dox1 T-DNA insertion mutant lines in Arabidopsis thaliana also showed increased susceptibility to the green peach aphid (Myzus persicae), indicating that the role α-DOX is conserved in other plant-aphid interactions.

Loss of function of FATTY ACID DESATURASE7 in tomato enhances basal aphid resistance in a salicylate-dependent manner.

We report here that disruption of function of the ω-3 FATTY ACID DESATURASE7 (FAD7) enhances plant defenses against aphids. The suppressor of prosystemin-mediated responses2 (spr2) mutation in tomato (Solanum lycopersicum), which eliminates the function of FAD7, reduces the settling behavior, survival, and fecundity of the potato aphid (Macrosiphum euphorbiae). Likewise, the antisense suppression of LeFAD7 expression in wild-type tomato plants reduces aphid infestations. Aphid resistance in the spr2 mutant is associated with enhanced levels of salicylic acid (SA) and mRNA encoding the pathogenesis-related protein P4. Introduction of the Naphthalene/salicylate hydroxylase transgene, which suppresses SA accumulation, restores wild-type levels of aphid susceptibility to spr2. Resistance in spr2 is also lost when we utilize virus-induced gene silencing to suppress the expression of NONEXPRESSOR OF PATHOGENESIS-RELATED PROTEINS1 (NPR1), a positive regulator of many SA-dependent defenses. These results indicate that FAD7 suppresses defenses against aphids that are mediated through SA and NPR1. Although loss of function of FAD7 also inhibits the synthesis of jasmonate (JA), the effects of this desaturase on aphid resistance are not dependent on JA; other mutants impaired in JA synthesis (acx1) or perception (jai1-1) show wild-type levels of aphid susceptibility, and spr2 retains aphid resistance when treated with methyl jasmonate. Thus, FAD7 may influence JA-dependent defenses against chewing insects and SA-dependent defenses against aphids through independent effects on JA synthesis and SA signaling. The Arabidopsis (Arabidopsis thaliana) mutants Atfad7-2 and Atfad7-1fad8 also show enhanced resistance to the green peach aphid (Myzus persicae) compared with wild-type controls, indicating that FAD7 influences plant-aphid interactions in at least two plant families.

Determinants of government HIV/AIDS financing: a 10-year trend analysis from 125 low- and middle-income countries.

BACKGROUND: Trends and predictors of domestic spending from public sources provide national authorities and international donors with a better understanding of the HIV financing architecture, the fulfillment of governments' commitments and potential for long-term sustainability. METHODS: We analyzed government financing of HIV using evidence from country reports on domestic spending. Panel data from 2000 to 2010 included information from 647 country-years amongst 125 countries. A random-effects model was used to analyze ten year trends and identify independent predictors of public HIV spending. RESULTS: Low- and middle-income countries spent US$ 2.1 billion from government sources in 2000, growing to US$ 6.6 billion in 2010, a three-fold increase. Per capita spending in 2010 ranged from 5 cents in low-level HIV epidemics in the Middle East to US$ 32 in upper-middle income countries with generalized HIV epidemics in Southern Africa. The average domestic public spending per capita was US$ 2.55. The analysis found that GDP per capita and HIV prevalence are positively associated with increasing levels of HIV-spending from public sources; a 10 percent increase in HIV prevalence is associated with a 2.5 percent increase in domestic funding for HIV. Additionally, a 10 percent increase in GDP per capita is associated with an 11.49 percent increase in public spending for HIV and these associations were highly significant. CONCLUSION: Domestic resources in low- and middle-income countries showed a threefold increase between 2000 and 2010 and currently support 50 percent of the global response with 41 percent coming from sub-Saharan Africa. Domestic spending in LMICs was associated with increased economic growth and an increased burden of HIV. Sustained increases in funding for HIV from public sources were observed in all regions and emphasize the increasing importance of government financing.

Strengthening primary health care in low- and middle-income countries: furthering structural changes in the post-pandemic era.

Strengthening primary health care (PHC) is the most cost-effective approach in low- and middle-income countries (LMICs) to achieve sustainable universal health coverage (UHC), protect against health shocks, and promote health and wellbeing for all people. It has been 45 years since PHC was put on the global agenda followed by multiple efforts to advocate for more funding and improved performance of PHC. Yet, investment in PHC is still insufficient and overall performance of PHC systems is weak in LMICs, resulting in increased vulnerability and poor health outcomes especially among marginalized populations. As countries recover from the COVID-19 pandemic, which exposed the fragility of PHC platforms, it is imperative to go beyond advocacy for PHC investments and make systemic changes to strengthen PHC as the foundation of resilient and equitable health systems. We propose five gamechangers to facilitate structural changes for strengthening PHC through a focused health systems approach: (i) integration of client-centered health services at PHC level; (ii) digitization of PHC services; (iii) efficiency gains invested in essential health services; (iv) strengthening management practices for PHC at district and facility levels; and (v) advancing community engagement for PHC. To be successful, the implementation of the gamechangers must be contextualized and focus on achieving sustainable health outcomes, and therefore use implementation approaches that link essential health services to health outcomes. Through this way countries will maximize the possibility of achieving UHC and attaining the ambitious health targets of the Sustainable Development Goals (SDGs) by 2030.