A "What Matters Most" approach to investigating intersectional stigma toward HIV and cancer in Hanoi, Vietnam.

BACKGROUND: Vietnam is experiencing a growing burden of cancer, including among people living with HIV. Stigma acts as a sociocultural barrier to the prevention and treatment of both conditions. This study investigates how cultural notions of "respected personhood" (or "what matters most") influence manifestations of HIV-related stigma and cancer stigma in Hanoi, Vietnam. METHODS: Thirty in-depth interviews were conducted with people living with HIV in Hanoi, Vietnam. Transcripts were thematically coded via a directed content analysis using the What Matters Most conceptual framework. Coding was done individually and discussed in pairs, and any discrepancies were reconciled in full-team meetings. RESULTS: Analyses elucidated that having chu tín-a value reflecting social involvement, conscientiousness, and trustworthiness-and being successful (eg, in career, academics, or one's personal life) are characteristics of respected people in this local cultural context. Living with HIV and having cancer were seen as stigmatized and interfering with these values and capabilities. Intersectional stigma toward having both conditions was seen to interplay with these values in some ways that had distinctions compared with stigma toward either condition alone. Participants also articulated how cultural values like chu tín are broadly protective against stigmatization and how getting treatment and maintaining employment can help individuals resist stigmatization's most acute impacts. CONCLUSIONS: HIV-related and cancer stigma each interfere with important cultural values and capabilities in Vietnam. Understanding these cultural manifestations of these stigmas separately and intersectionally can allow for greater ability to measure and respond to these stigmas through culturally tailored intervention.

Factors Influencing Tobacco Smoking and Cessation Among People Living with HIV: A Systematic Review and Meta-analysis.

Tobacco smoking is highly prevalent among people living with HIV (PLWH), yet there is a lack of data on smoking behaviours and effective treatments in this population. Understanding factors influencing tobacco smoking and cessation is crucial to guide the design of effective interventions. This systematic review and meta-analysis of studies conducted in both high-income (HICs) and low- and middle-income countries (LMICs) synthesised existing evidence on associated factors of smoking and cessation behaviour among PLWH. Male gender, substance use, and loneliness were positively associated with current smoking and negatively associated with smoking abstinence. The association of depression with current smoking and lower abstinence rates were observed only in HICs. The review did not identify randomised controlled trials conducted in LMICs. Findings indicate the need to integrate smoking cessation interventions with mental health and substance use services, provide greater social support, and address other comorbid conditions as part of a comprehensive approach to treating tobacco use in this population. Consistent support from health providers trained to provide advice and treatment options is also an important component of treatment for PLWH engaged in care, especially in LMICs.

Depression and associated factors among HIV-positive smokers receiving care at HIV outpatient clinics in Vietnam: a cross-sectional analysis.

OBJECTIVES: To assess the prevalence of depressive symptoms and associated factors among people living with HIV (PLWH) who were current cigarette smokers and receiving treatment at HIV outpatient clinics (OPCs) in Vietnam. DESIGN: A cross-sectional survey of smokers living with HIV. SETTING: The study was carried out in 13 HIV OPCs located in Ha Noi, Vietnam. PARTICIPANTS: The study included 527 PLWH aged 18 and above who were smokers and were receiving treatment at HIV OPCs. OUTCOME MEASURES: The study used the Centre for Epidemiology Scale for Depression to assess depressive symptoms. The associations between depressive symptoms, tobacco dependence and other characteristics were explored using bivariate and Poisson regression analyses. RESULTS: The prevalence of depressive symptoms among smokers living with HIV was 38.3%. HIV-positive smokers who were female (prevalence ratio, PR 1.51, 95% CI 1.02 to 2.22), unmarried (PR 2.06, 95% CI 1.54 to 2.76), had a higher level of tobacco dependence (PR 1.06, 95% CI 1.01 to 1.11) and reported their health as fair or poor (PR 1.66, 95% CI 1.22 to 2.26) were more likely to have depression symptoms compared with HIV-positive smokers who were male, married, had a lower level of tobacco dependence and self-reported their health as good, very good or excellent. CONCLUSION: The prevalence of depressive symptoms among smokers receiving HIV care at HIV OPCs was high. Both depression and tobacco use screening and treatment should be included as part of ongoing care treatment plans at HIV OPCs.

State of the Science of Scale-Up of Cancer Prevention and Early Detection Interventions in Low- and Middle-Income Countries: A Scoping Review.

PURPOSE: Cancer deaths in low- and middle-income countries (LMICs) will nearly double by 2040. Available evidence-based interventions (EBIs) for cancer prevention and early detection can reduce cancer-related mortality, yet there is a lack of evidence on effectively scaling these EBIs in LMIC settings. METHODS: We conducted a scoping review to identify published literature from six databases between 2012 and 2022 that described efforts for scaling cancer prevention and early detection EBIs in LMICs. Included studies met one of two definitions of scale-up: (1) deliberate efforts to increase the impact of effective intervention to benefit more people or (2) an intervention shown to be efficacious on a small scale expanded under real-world conditions to reach a greater proportion of eligible population. Study characteristics, including EBIs, implementation strategies, and outcomes used, were summarized using frameworks from the field of implementation science. RESULTS: This search yielded 3,076 abstracts, with 24 studies eligible for inclusion. Included studies focused on a number of cancer sites including cervical (67%), breast (13%), breast and cervical (13%), liver (4%), and colon (4%). Commonly reported scale-up strategies included developing stakeholder inter-relationships, training and education, and changing infrastructure. Barriers to scale-up were reported at individual, health facility, and community levels. Few studies reported applying conceptual frameworks to guide strategy selection and evaluation. CONCLUSION: Although there were relatively few published reports, this scoping review offers insight into the approaches used by LMICs to scale up cancer EBIs, including common strategies and barriers. More importantly, it illustrates the urgent need to fill gaps in research to guide best practices for bringing the implementation of cancer EBIs to scale in LMICs.

Invasive Phenoprofiling of Acute-Myocardial-Infarction-Related Cardiogenic Shock.

BACKGROUND: Studies had previously identified three cardiogenic shock (CS) phenotypes (cardiac-only, cardiorenal, and cardiometabolic). Therefore, we aimed to understand better the hemodynamic profiles of these phenotypes in acute myocardial infarction-CS (AMI-CS) using pulmonary artery catheter (PAC) data to better understand the AMI-CS heterogeneity. METHODS: We analyzed the PAC data of 309 patients with AMI-CS. The patients were classified by SCAI shock stage, congestion profile, and phenotype. In addition, 24 h hemodynamic PAC data were obtained. RESULTS: We identified three AMI-CS phenotypes: cardiac-only (43.7%), cardiorenal (32.0%), and cardiometabolic (24.3%). The cardiometabolic phenotype had the highest mortality rate (70.7%), followed by the cardiorenal (52.5%) and cardiac-only (33.3%) phenotypes, with significant differences (p < 0.001). Right atrial pressure (p = 0.001) and pulmonary capillary wedge pressure (p = 0.01) were higher in the cardiometabolic and cardiorenal phenotypes. Cardiac output, index, power, power index, and cardiac power index normalized by right atrial pressure and left-ventricular stroke work index were lower in the cardiorenal and cardiometabolic than in the cardiac-only phenotypes. We found a hazard ratio (HR) of 2.1 for the cardiorenal and 3.3 for cardiometabolic versus the cardiac-only phenotypes (p < 0.001). Also, multi-organ failure, acute kidney injury, and ventricular tachycardia/fibrillation had a significant HR. Multivariate analysis revealed that CS phenotypes retained significance (p < 0.001) when adjusted for the Society for Cardiovascular Angiography & Interventions score (p = 0.011) and ∆congestion (p = 0.028). These scores independently predicted mortality. CONCLUSIONS: Accurate patient prognosis and treatment strategies are crucial, and phenotyping in AMI-CS can aid in this effort. PAC profiling can provide valuable prognostic information and help design new trials involving AMI-CS.

Adapting a tobacco cessation treatment intervention and implementation strategies to enhance implementation effectiveness and clinical outcomes in the context of HIV care in Vietnam: a case study.

BACKGROUND: Smoking rates remain high in Vietnam, particularly among people living with HIV/AIDS (PLWH), but tobacco cessation services are not available in outpatient HIV clinics (OPCs). The research team is conducting a type II hybrid randomized controlled trial (RCT) comparing the cost-effectiveness of three tobacco cessation interventions among PLWH receiving care in HIV clinics in Vietnam. The study is simultaneously evaluating the implementation processes and outcomes of strategies aimed at increasing the implementation of tobacco dependence treatment (TDT) in the context of HIV care. This paper describes the systematic, theory-driven process of adapting intervention components and implementation strategies with demonstrated effectiveness in high-income countries, and more recently in Vietnam, to a new population (i.e., PLWH) and new clinical setting, prior to launching the trial. METHODS: Data collection and analyses were guided by two implementation science frameworks and the socio-ecological model. Qualitative interviews were conducted with 13 health care providers and 24 patients in three OPCs. Workflow analyses were conducted in each OPC. Qualitative data were analyzed using rapid qualitative analysis procedures. Based on findings, components of the intervention and implementation strategies were adapted, followed by a 3-month pilot study in one OPC with 16 patients randomized to one of two intervention arms. RESULTS: The primary adaptations included modifying the TDT intervention counseling content to address barriers to quitting among PLWH and Vietnamese sociocultural norms that support smoking cessation. Implementation strategies (i.e., training and system changes) were adapted to respond to provider- and clinic-level determinants of implementation effectiveness (e.g., knowledge gaps, OPC resource constraints, staffing structure, compatibility). CONCLUSIONS: Adaptations were facilitated through a mixed method, stakeholder (patient and health care provider, district health leader)-engaged evaluation of context-specific influences on intervention and implementation effectiveness. This data-driven approach to refining and adapting components aimed to optimize intervention effectiveness and implementation in the context of HIV care. Balancing pragmatism with rigor through the use of rapid analysis procedures and multiple methods increased the feasibility of the adaptation process. TRIAL REGISTRATION: ClinicalTrials.gov NCT05162911 . Registered on December 16, 2021.

Chronic exposure to low concentrations of chlorpyrifos affects normal cyclicity and histology of the uterus in female rats.

Chlorpyrifos (CPF), the most used insecticide in Argentina, can act as an endocrine disruptor at low doses. We previously demonstrated that chronic exposure to CPF induces hormonal imbalance in vivo. The aim of this work was to study the effects of low concentrations of CPF (0.01 and 1 mg/kg/day) on the reproductive system of virgin adult rats. In the ovary, we studied the effects of CPF on steroidogenesis by determining steroid hormone content by RIA and CYP11 and CYP19 enzyme expression by qRT-PCR. The estrous cycle was evaluated by microscopic observation of vaginal smear, as well as by changes in uterine histology. In endometrium, we determined the fractal dimension and expression of PCNA, ERα and PR by IHC. Our results showed that chronic exposure to CPF affects ovarian steroid synthesis, causing alterations in the normal cyclicity of animals. In addition, CPF induced proliferative changes in the uterus, suggesting that it could affect reproduction or act as a risk factor in the development of uterine proliferative pathologies.

Hemolysis in Hemodialysis, Secondary to Severe Vena Cava Stenosis.

Complications in hemodialysis patients are increasingly rare thanks to advances in technology, including more compatible membranes, more flexible lines, safety in water treatments, alarms in the circuit, and standardization in dialysate fluids plus exhaustive chemical and microbiological tests. In addition, it is highly unusual having hemolysis on hemodialysis; however, it is a life-threatening complication, so the cause must be identified and early managed. The etiology can be chemical or mechanical; however, so far, there are no reports in the literature of an association with severe stenosis of the vena cava, as it is described in the case reported here, where a patient presented hemolysis in two hemodialysis sessions, without initially being possible to find the cause; the only identifiable factor was that he had a dysfunctional tunneled jugular catheter, with a history of difficult vascular access. The patient underwent interventional radiology, finding 99% stenosis of the vena cava, which prevented the passage of the contrast agent to the atrium. Angioplasty and catheter replacement were performed, with a resolution of the complication; the subsequent dialysis therapies were satisfactory.

Prevalence and Covariates of Food Insecurity Across the First 1000 Days Among Women of Mixed HIV Status in Western Kenya: A Longitudinal Perspective.

BACKGROUND: Food insecurity (FI) is common globally and can have lifelong consequences. However, few studies have longitudinally examined how FI varies across gestation and the postpartum period ("the first 1000 days"); none have explored this in sub-Saharan Africa or in the context of HIV. OBJECTIVE: To assess the prevalence and covariates of FI in the first 1000 days among Kenyan women. METHODS: All pregnant women attending 7 clinics in western Kenya (n = 1247) were screened for HIV and FI (Individual Food Insecurity Access Scale) between September 2014 and June 2015. A subset of women (n = 371) was recruited into an observational cohort study and surveyed 11 times through 2 years postpartum (NCT02974972, NCT02979418). Data on FI, sociodemographics, and health were repeatedly collected. Severe FI was modeled using multilevel, mixed-effects logistic regressions (n = 346). RESULTS: Of the 1247 pregnant women screened, 76.5% were severely food insecure in the prior month. Further, the prevalence of severe FI was higher among women living with HIV than those without (82.6% vs 74.6%, P < .05). In the cohort, the odds of being severely food insecure decreased monotonically after delivery. Each point higher on the Center for Epidemiologic Studies-Depression scale was associated with 1.08 times greater odds of being severely food insecure (95% CI: 1.05-1.10); each point higher on the Duke/UNC Functional Social Support Scale was associated with 0.97 lower odds of severe FI (95% CI: 0.94-0.99). CONCLUSIONS: Severe FI is prevalent during the first 1000 days in western Kenya. Services to mitigate the far-reaching consequences of this modifiable risk should be considered.

Incidencia de competencias parentales en el desarrollo de habilidades sociales en hijos únicos / Incidence of parental competences in the development of social skills in kids from single children families

Resumen Múltiples investigaciones han demostrado que los estilos de crianza influyen en el desarrollo socioemocional durante la infancia, en la cual se considera a la familia como el primer ente socializador. El objetivo de esta investigación fue analizar la incidencia de las competencias parentales en el desarrollo de las habilidades sociales de hijos únicos, con edades entre tres y cinco años, teniendo en cuenta cuatro áreas: vinculares, formativas, protectoras y reflexivas. Con respecto a las habilidades sociales se analizaron seis actitudes comportamentales: habilidades sociales básicas; hacer amigos; conversacionales; sentimientos y emociones; capacidad de afrontar y resolver problemas, y la forma de relacionarse con los adultos. Es una investigación cuantitativa, realizada con un método correlacional donde la muestra correspondió a 36 niños y 61 padres de familia. Se utilizaron las siguientes pruebas: Escala de parentalidad positiva y Escala de habilidades sociales. Los hallazgos de esta investigación no coinciden con lo que teóricamente se podría esperar; resulta paradójico que los niños que tienen habilidades sociales medias posean padres con competencias parentales óptimas, mientras que niños con habilidades sociales altas, presentan padres de familia cuyas competencias parentales que se ubican en cualquiera de los tres rangos (en riesgo, en monitoreo y óptimas). Otro hallazgo se relaciona con los niños que presentaron habilidades sociales altas en las seis áreas; a su vez, sus padres registraron competencias parentales protectoras en zona de monitoreo, lo que conlleva a pensar, que existen otros factores diferentes de las competencias parentales que pueden incidir en el desarrollo de las habilidades sociales de los menores.

Abstract Multiple researches have shown that parenting styles influence socio-emotional development during childhood, in which the family is considered the first socializing entity. The objective of this research was to analyze the incidence of parental competencies in the development of the social skills of single children aged between three and five years, taking into account four areas: linkage, formative, protective and reflexive. Regarding social skills, six behavioral attitudes were analyzed: basic social skills; making new friends; conversational; feelings and emotions; ability to face and solve problems; and way of relating to adults. It is a quantitative research, correlational method where the sample corresponded to 36 children and 61 parents. Two tests were applied: Positive Parentally Scale and Social Skills Scale. Pearson Chi-square was used to analyze the information, using Statistica software. The Pearson Chi-square test is a non-parametric test, which aims to determine the existence or not of a significant relationship between two variables. The Parental Competence scale is a very simple questionnaire that applies to the parents or caregivers of a child or adolescent, whose objective is to determine the degree of development of parental competencies that adults use to establish a relationship with the child in care, either as a parent or as a caregiver. The scale groups these competences into four areas: Link, training, protection and reflection. This scale defines three zones to determine the level of competence of the parents: the risk zone, where the parents whose scores are below the reference sample are located; subsequently, the monitoring area is located, where the parents who present scores with percentiles between 30 and 40 are located according to the reference sample. Finally, the optimal zone is defined, where the parents with high scores are located. The social skills scale of Lacunza is a questionnaire that must be applied by parents or caregivers to children between 3 and 5 years old, which measure observable behaviors, which account for the child's social performance during the last three months. This questionnaire is based on other instruments that measure social skills, but makes an adaptation according to the developmental stages of development in preschool children, perfecting three questionnaires according to age: for 3 years the scale presents a composite questionnaire for 12 items; At the age of 4 years, the evaluation is carried out through the development of 12 questions, while for the age of 5 the questionnaire is made up of a total of 15 items. The findings of this research do not match what theoretically would be expected. It is paradoxical that children who have medium social skills have parents with optimal parental skills, while children with high social skills, have parents whose parental skills are located in any of the three ranges (at risk, monitoring and optimal). Another finding is related to children who presented high social skills in the six areas, in turn, their parents registered protective parental competencies in the monitoring area, which leads us to think that there are other factors that can affect in the development of the social skills of minors.

La dificultad analítica del rezago temporal en la denuncia y su relevancia en el análisis de los índices de criminalidad en Colombia (2005-2018) / The analytical difficulty of the time lag in reporting and its relevance for the analysis of crime indicators in Colombia (2005-2018) / A dificuldade analítica do lapso de tempo na denúncia e sua na análise dos índices de criminalidade na Colômbia (2005-2018)

Resumen El objetivo De este artículo es visibilizar y cuantificar la dificultad analítica que se presenta al momento de interpretar los índices de criminalidad, debido al rezago temporal del registro en el instante en que se comete el delito y la fecha de ingreso de la denuncia. Ese rezago temporal genera un sesgo benévolo en la medición del crimen y la interpretación criminal para la toma de decisiones, cuando se comparan periodos parciales (años anteriores y vigencia actual). La metodología Utilizada es exploratoria con un enfoque cuantitativo en el tratamiento de los datos registrados desde el año 2005 hasta el 2018, y consolidados en los sistemas Penal Oral Acusatorio (SPOA) de la Fiscalía General de la Nación y de Información Estadístico Delincuencial, Contravencional y Operativo (SIEDCO) de la Policía Nacional de Colombia. Para el análisis se compararon los datos de los delitos de homicidio, hurto, lesiones personales, violencia intrafamiliar y delitos sexuales durante los primeros cuatro y cinco meses de cada periodo anual con los siguientes meses del año. Como Resultado Se evidenció que el rezago temporal promedio en los homicidios fue del 2,85%; en el hurto del 11,8%; en las lesiones personales del 12,7%; en la violencia intrafamiliar del 18,9% y en los delitos sexuales del 30,5%.

Abstract The purpose Of this article is to visualize and quantify the analytic difficulty that arises in interpreting crime indicators due to the time lag between the time when the crime took place and the date on which the crime report was filed2. This time lag creates a lenient bias in crime measurement and interpretation for decision-making effects when time periods are compared (previous periods against the current period). The methodology Used is exploratory with a quantitative approach in the treatment of data recorded from 2005 to 2018, and consolidated in the Oral Criminal Prosecution System (SPOA, for the Spanish original) of the National Prosecutor's Office (Fiscalía) and in the Crime, Infraction and Operations Statistical System (SIEDCO, for the Spanish original) of the National Police of Colombia. Data on the crimes of homicide, theft, personal injuries, intra-family violence and sexual crimes during the first four and five months of each annual period were compared to the data from the subsequent months of the year. As a result It was found that the average time lag was 2.85% for homicides; 11.8% for theft; 12.7% for personal injuries; 18.9% for intra-family violence and 30.5% for sexual crimes.

Resumo O objetivo Deste artigo é tornar visível e quantificar a dificuldade analítica que surge na interpretação dos índices de criminalidade, devido à defasagem temporal do registro no momento em que o crime é cometido e na data de apresentação da denúncia3. Esse lapso temporal gera um viés benevolente na medição e interpretação do crime para a tomada de decisões, quando são comparados períodos parciais (anos anteriores e validade atual). A metodologia Utilizada é exploratória com abordagem quantitativa no tratamento dos dados registados de 2005 a 2018, e consolidados no sistema Penal Oral Acusatório (SPOA) da Procuradoria Geral da Nação e no sistema de Informação Estatístico Delinquencial, Contravencional e Operativo (SIEDCO) da Polícia Nacional da Colômbia. Para a análise foram comparados os dados dos crimes de homicídio, furto, lesões pessoais, violência doméstica e crimes sexuais durante os primeiros quatro e cinco meses de cada período anual com os meses seguintes do ano. Como resultado Constatou-se que a média do lapso temporal nos homicídios foi de 2,85%; no furto de 11,8%; nas lesões pessoais de 12,7%; na violência doméstica de 18,9% e nos crimes sexuais foi de 30,5%.

Relationship Between the Dose Administered, Target Tissue Dose, and Toxicity Level After Acute Oral Exposure to Bifenthrin and Tefluthrin in Young Adult Rats.

Most pyrethroid insecticides (PYRs) share a similar primary target site in mammals. However, the potency estimates of the lethal and sublethal effects of these compounds differ up to 103-fold. The aim of this study was to evaluate the relationship between the dose administered, the target tissue dose, and the effect of 2 highly toxic PYRs, tefluthrin (TEF; 0.1-9 mg/kg) and bifenthrin (BIF; 0.5-12 mg/kg), by using the oral route, a corn oil vehicle (1 ml/kg) and subcutaneous temperature (Tsc) monitoring assays in adult rats. The Tsc was determined at 30-min intervals for 5 h (TEF) or 4.5 h (BIF) after dosing. Rats were sacrificed at 6 h after dosing, and BIF and TEF concentrations were determined in blood (Bd), liver (Lv), and cerebellum (Cb) by using a GC-ECD system. The minimal effective dose of BIF (3 mg/kg) affecting Tsc was similar to that found in prior studies using other testing paradigms. Regarding TEF, a very steep relationship between the dose administered and toxicity was observed, with a near-threshold to low-effective range for Tsc at 0.1-6 mg/kg, and a near lethal syndrome at ≥ 7.5 mg/kg. At 6-7.5 mg/kg TEF, the Cb/Bd and Cb/Lv concentration ratios were both > 1. Conversely, for BIF, the Cb concentration was barely over the Bd concentration and the Cb/Lv concentration ratio remained < 1. Our results and previous findings call for more comprehensive consideration to establish the relevance of the distribution into target tissues and the tissue dosimetry for health risks through the exposure to PYRs in humans.

A diagramatic scale to quantify severity of antracnose in Rubus glaucus Benth / Uma escala diagramática para quantificar a severidade da antracnose em Rubus glaucus Benth

ABSTRACT: Rubus glaucus Benth, commonly referred to as mora de Castilla, is affected by Colletotrichum acutatum, as it induces anthracnose in many of the plant organs. Generally, it affects the fruits during the post-harvest phase and damages them, causing economic losses due to the poor crop quality. At present, no standardized methods are available for this pathosystem that can be used to characterize quantitatively the epidemic and to permit the prediction and comparison of the disease management techniques. In this research, we proposed a logarithmic diagrammatic scale of the severity of anthracnose induced by C. acutatum in the fruits of the thornless variety of R. glaucus Benth. This scale is constructed on the adjustment of the Weber-Fechner law and includes six classes, viz., 0%, 1-6%, 7-25%, 26-50%, 51-75%, 76-100%. The scale was validated using 14 evaluators, which entailed measuring the affected fruits with and without utilizing the scale; this improved the precision, accuracy and reproducibility of the calculations whenever the scale was used. We concluded that the scale proposed can be used to assess the severity of anthracnose induced by the fungus in the R. glaucus Benth fruits.

RESUMO: Mora de Castilla (Rubus glaucus Benth) é afetado por Colletotrichum acutatum, causando antracnose em órgãos diferentes da planta. Nos frutos geralmente é em pós-colheita, causando danos que geram perdas econômicas relacionadas com a qualidade das culturas. Ainda não existem para esse patossistema métodos padronizados para caracterizar quantitativamente a epidemia e que pode prever e comparar os métodos de manejo da doença. Por esta razão, neste trabalho foi criada uma escala logarítmica diagramática da severidade da antracnose causada pelo fungo C. acutatum em frutos de R. glaucus Benth com base na lei de Weber-Fechnere composto por 6 niveis: 0%, 1-6%, 7-25%, 26-50%, 51-75% e 76-100%. A escala foi validada por 14 evaluadores, fazendo medições de frutos afetados com e sem o uso da escala, que mostrou melhor precisão, exatitude e reproducibilidade nas avaliações em que o uso da escala foi feito. Isto permite concluir que a escala proposta pode ser usada na estimação da severidade da antracnose causada em frutos de R. glaucus Benth.

Rollinia mucosa (Jacq) Baillon (Annonaceae) active metabolites as alternative biocontrol agents against the lace bug Corythucha gossypii (Fabricius): an insect pest / Metabolitos activos de la semilla de Rollinia mucosa (Jacq) Baillon (Annonaceae) como agentes alternativos de biocontrol sobre el insecto fitopatógeno Corythucha gossypii (Fabricius) / Metabólitos ativos de Rollinia mucosa (Jacq) Baillon (Annonaceae) como agentes de biocontrole alternativos contra Corythucha gossypii (Fabricius): um inseto-praga

Abstract The lace bug, Corythucha gossypii (Fabricius) is a serious pest affecting over 24 wild and commercially important plant species of the families Annonaceae, Passiflorcae, Caricaceae, Euphorbiaceae, and Solanaceae. Thus far, commercial insecticides, such as 0.1% Dimethoate and 0.1% Imidacloprid have shown effectiveness against this insect, but no botanical pesticides are available to control this bug. In the present study, a Rollinia mucosa (Jacq.) Baillon ethanol extract was evaluated as a biological control agent against the lace bug. Through a toxicity assay involving Artemia salina, the median lethal concentration (LC50) of a raw ethanol extract of R. mucosa seeds was determined, as well as that of its Acetogenin (F1) and Alkaloid (F2) fractions; these LC50 were 0.184, 0.082, and 0.0493 μg/mL, respectively. In addition, with an insecticide assay on lace bug nymphs, a mortality percentage of 86.67% at 5 μg/mL after 72h was observed. These data demonstrate that the R. mucosa seed extract is highly active. Further chemical characterization studies revealed that the main active metabolites contributing to extract activity were acetogenins and alkaloids.

Resumen El hemíptero, Corythucha gossypii (Fabricius) es un insecto que causa daño sustancial en cultivos de más de 24 especies de plantas de las familias Annonaceae, Passifloraceae, Caricaceae, Euphorbiaceae y Solanaceae. En su mayoría estas plantas son de interés económico. Aunque insecticidas comerciales como el Dimetoato (0.1%) y el Imidacloprid (0.1%) permiten un manejo eficiente de este insecto-plaga, no se han reportado alternativas botánicas para estos insecticidas sintéticos. En el presente estudio se evaluó el extracto etanólico de la semilla de Rollinia mucosa (Jacq.) Baillon, como un biocontrolador de C. gossypii. A través de un test de toxicidad con Artemia salina se determinó que la concentración del extracto etanólico letal para el 50% de la población bajo estudio (LC50) fue de 0.184 μg/mL. De igual modo se identificó que las fracciones de acetogeninas (F1) y de alcaloides (F2) de este extracto tienen un LC50 de 0.082 y 0.0493 μg/mL, respectivamente. En el ensayo insecticida con ninfas de C. gossypii se observó una mortalidad del 86.67% después de 72 horas de exposición al extracto etanólico a una concentración de 5 μg/mL. Lo anterior demuestra que el extracto es altamente activo. La caracterización química del extracto evidenció que los principales metabolitos activos que contribuyen a su actividad insecticida son las acetogeninas y los alcaloides.

Resumo Corythucha gossypii (Fabricius) é uma praga séria que afeta mais de 24 plantas silvestre e de interesse comercial, pertencentes as famílias Annonaceae, Passifloraceae, Caricaceae, Euphorbiaceae e Solanaceae. Até o momento, inseticidas comerciais como Dimetoato (0.1%) e Imidacloprid (0.1%) apresentam um controle eficiente sobre este inseto, entretanto não há reportes de pesticidas de origem vegetal para o seu controle. No presente estudo, o extrato etanólico de Rollinia mucosa (Jacq.) Baillon foi avaliado como um controle biológico contra Corythucha gossypii. Por meio do ensaio de toxicidade com Artemia salina a concentração letal média (LC50) para o extrato etanólico das sementes, suas frações de acetogeninas (F1) e fração de alcaloides (F2) foi de 0.184, 0.082 y 0.0493 μg/mL, respetivamente. Adicionalmente, na avaliação do ensaio inseticida, se obteve uma porcentagem de mortalidade de 86.67% à concentração de 5 μg/mL após de 72 horas de exposição, demonstrando uma alta atividade do extrato de sementes de R. mucosa. Os estudos em relação à caracterização química evidenciaram que os principais metabólitos que aportam à atividade do extrato foram as acetogeninas e alcaloides.

Automatic segmentation of Potyviridae family polyproteins.

We describe an automatic segmentation method for polyproteins of the viruses belonging to the Potyviridae family. It uses machine learning techniques in order to predict the cleavage site which define the segments in which said polyproteins are cut in their process of functional maturation. The segmentation application is publicly available for use on a website and it can be accessed through the web service interface too. The prediction models have an average sensitivity of 0.79 and a Matthews correlation coefficient average of 0.23. This method is capable of predicting correctly (coinciding with previously published segmentation) the segmentation of sequences which come from Potyvirus and Rymovirus, genera. However accurate prediction capabilities are affected when faced with either atypical sequences or viruses belonging to less common genera in the Potyviridae family. Future work will focus on establishing greater flexibility in this sense.

The impact of glucocorticoids and anti-cd20 therapy on cervical human papillomavirus infection risk in women with systemic lupus erythematosus

OBJECTIVE: To identify the prevalence and factors associated with cervical human papillomavirus infection in women with systemic lupus erythematosus METHODS: This cross-sectional study collected traditional and systemic lupus erythematosus-related disease risk factors, including conventional and biologic therapies. A gynecological evaluation and cervical cytology screen were performed. Human papillomavirus detection and genotyping were undertaken by PCR and linear array assay. RESULTS: A total of 148 patients were included, with a mean age and disease duration of 42.5±11.8 years and 9.7±5.3 years, respectively. The prevalence of squamous intraepithelial lesions was 6.8%. The prevalence of human papillomavirus infection was 29%, with human papillomavirus subtype 59 being the most frequent. Patients with human papillomavirus were younger than those without the infection (38.2±11.2 vs. 44.2±11.5 years, respectively; p = 0.05), and patients with the virus had higher daily prednisone doses (12.8±6.8 vs. 9.7±6.7 mg, respectively; p = 0.01) and cumulative glucocorticoid doses (14.2±9.8 vs. 9.7±7.3 g, respectively; p = 0.005) compared with patients without. Patients with human papillomavirus infection more frequently received rituximab than those without (20.9% vs. 8.5%, respectively; p = 0.03). In the multivariate analysis, only the cumulative glucocorticoid dose was associated with human papillomavirus infection. CONCLUSIONS: The cumulative glucocorticoid dose may increase the risk of human papillomavirus infection. Although rituximab administration was more frequent in patients with human papillomavirus infection, no association was found. Screening for human papillomavirus infection is recommended in women with systemic lupus erythematosus. .

The impact of glucocorticoids and anti-cd20 therapy on cervical human papillomavirus infection risk in women with systemic lupus erythematosus.

OBJECTIVE: To identify the prevalence and factors associated with cervical human papillomavirus infection in women with systemic lupus erythematosus METHODS: This cross-sectional study collected traditional and systemic lupus erythematosus-related disease risk factors, including conventional and biologic therapies. A gynecological evaluation and cervical cytology screen were performed. Human papillomavirus detection and genotyping were undertaken by PCR and linear array assay. RESULTS: A total of 148 patients were included, with a mean age and disease duration of 42.5±11.8 years and 9.7±5.3 years, respectively. The prevalence of squamous intraepithelial lesions was 6.8%. The prevalence of human papillomavirus infection was 29%, with human papillomavirus subtype 59 being the most frequent. Patients with human papillomavirus were younger than those without the infection (38.2±11.2 vs. 44.2±11.5 years, respectively; p = 0.05), and patients with the virus had higher daily prednisone doses (12.8±6.8 vs. 9.7±6.7 mg, respectively; p = 0.01) and cumulative glucocorticoid doses (14.2±9.8 vs. 9.7±7.3 g, respectively; p = 0.005) compared with patients without. Patients with human papillomavirus infection more frequently received rituximab than those without (20.9% vs. 8.5%, respectively; p = 0.03). In the multivariate analysis, only the cumulative glucocorticoid dose was associated with human papillomavirus infection. CONCLUSIONS: The cumulative glucocorticoid dose may increase the risk of human papillomavirus infection. Although rituximab administration was more frequent in patients with human papillomavirus infection, no association was found. Screening for human papillomavirus infection is recommended in women with systemic lupus erythematosus.

Susac's syndrome: an update.

Susac's syndrome is an infrequent neurological disorder characterized by the clinical triad of encephalopathy, hearing loss, and branch retinal artery occlusions. Its pathophysiology is not entirely clear, although it is now thought that it is most probably an immune-mediated endotheliopathy that affects the microvasculature of the brain, retina, and inner ear. An early diagnosis is important as treatment can halt disease progression and prevent permanent disability.

[External periareolar incision for subdermal mastectomy in men with gynecomastia]. / Mastectomia subdérmica mediante incisión periareolar externa en hombres con ginecomastia.

BACKGROUND: Gynecomastia describes a benign increase of the mammary gland in men. When medical treatment fails, symptoms and psychological alterations persist. Subdermal mastectomy is the definitive treatment and can be achieved by different incisions, each with potential complications. We undertook this study to present clinical characteristics of 11 patients with gynecomastia and the results obtained with subdermal mastectomy by means of external periareolar incision. METHODS: A descriptive cohort study in male patients with gynecomastia was carried out in a third-level medical care hospital. Patients were treated with subdermal mastectomy by means of external periareolar incision. RESULTS: There were 11 male patients with an average age of 19 years (range: 11-60 years), 3 patients (27.2%) with bilateral gynecomastia and 8 patients (72.7%) with unilateral gynecomastia. Average time of evolution was 22 months (range: 16-48 months), 9 patients (81.8%) reported pain, 11 patients (100%) reported psychological alterations with cutaneous alteration, 11 patients (100%) had normal secondary sexual characteristics, 1 patient (9%) had supernumerary nipple development, and 11 patients (100%) had well-defined lesions. According to Simon's classification: seven patients (63.6%) were classified as grade 1, three patients (27.2%) as grade 2 and one patient (9.09%) as grade 3. Each patient had a subdermal mastectomy with external periareolar incision, 11 patients (100%) had a histopathological report of gynecomastia; 1 patient (9.09%) displayed keloid healing and none displayed complications inherent to the surgical procedure. CONCLUSIONS: Mastectomy by means of external periareolar incision is useful in the treatment of gynecomastia.

[Analysis of death maternal cases during a 10-year period]. / Análisis de casos de muerte materna ocurridos en un periodo de 10 años.

OBJECTIVES: To determine the clinical features, as well as to present an analysis of the cases of maternal death during a period of ten years. PATIENTS AND METHODS: A descriptive, transverse, retrospective and cases series research was carried out. There was a revision of the expedients of maternal death occurred at the Regional General Hospital number 36 in Puebla, from January 1st, 1996 to December 31st, 2005. They were selected the patients who passed away because of obstetric death. The data collection included the following variables: age, body mass index, education, number of gestations, type of labour, prenatal control, basic cause of dead, and the month and the year in which it occurred. The descriptive statistics was used with central tendency and dispersion measurements. RESULTS: 75 maternal deaths were registered; one of them was excluded because it was not an obstetric cause. The maternal death rate was 63.46 per 100,000 born alive. The 17.5% corresponded to indirect obstetric causes and 82.5% to direct obstetric causes; the 73% were preventable, 27% were no preventable. Forty-eight cases corresponded to ages between 21 and 34 years. Forty-six cases corresponded to mothers with 2 to 4 pregnancies. In 43 cases they had a level of education which ranks between elementary and junior high school. In 31 cases they had a body mass index of 21 to 26. The eclampsia was the cause of maternal death in 20 cases and the obstetric haemorrhage in 16 cases. There were appropriate prenatal controls in 38 cases. CONCLUSIONS: The maternal death cases corresponded to an average age women, multigravidas, no obese, and apparently appropriate prenatal control. During this period there was a tendency to the decrease of obstetric haemorrhage and an increase of the preeclampsia-eclampsia as causes of maternal death.