Conversion of High Tibial Osteotomy to Unicompartmental Knee Arthroplasty: Surgical Pearls to Ensure a Successful Outcome.

Historically, high tibial osteotomy (HTO) was considered a contraindication for medial unicompartmental knee arthroplasty (UKA). While some recent reports demonstrate good outcomes after UKA for failed HTO, revision to unicompartmental knee arthroplasty (UKA) after failed HTO remains controversial. UKA after HTO is a demanding procedure primarily related to preoperative valgus alignment, residual medial knee laxity, and abnormal proximal tibia geometry. The aim of this technical note is to present surgical pearls and strategies to ensure a successful outcome of UKA after failed HTO.

Sex Specific Considerations in Anterior Cruciate Ligament (ACL) Injuries in the Female Athlete: State of the Art.

The increased participation of females in sports has been accompanied by an increase in the rate of anterior cruciate ligament (ACL) injuries. The literature has identified risk factors for non-contact ACL injuries in female athletes including anatomic, hormonal, biomechanical, neuromuscular, and environmental factors. This review will provide an overview of sex-specific considerations when managing female athletes with ACL injuries. A discussion of sex-specific surgical and rehabilitative treatment strategies with the goal of optimizing return to sport after ACL reconstruction will be emphasized.

High prevalence of asymptomatic and subpatent Plasmodium falciparum infections but no histidine-rich protein 2 gene deletion in Bouaké, Côte d'Ivoire.

This study aimed to estimate the prevalence of asymptomatic and subpatent P. falciparum infections in the city of Bouaké, Central Côte d'Ivoire, to compare the performance of three tests, and to investigate potential P. falciparum histidine-rich protein 2 (pfhrp2) gene deletions. A cross-sectional survey was conducted in nine neighborhoods in Bouaké in 2016. Matched light microscopy (LM), rapid diagnostic test (RDT), and quantitative PCR (qPCR) data were used to determine the prevalence of P. falciparum infection and compare the performance of the three diagnostic tests. Pfhrp2/3 deletions were genotyped by digital PCR. Among 2313 individuals, 97.2% were asymptomatic and 2.8% were symptomatic. P. falciparum prevalence among symptomatic individuals was 25.8%, 30.3%, and 40.9% by LM, RDT, and varATS qPCR, respectively, and among asymptomatic individuals, it was 10.3%, 12.5%, and 34.9%. Asymptomatic infections comprised 96.4% of all malaria infections, with 58.2% detectable only by varATS qPCR. Although the prevalence of asymptomatic P. falciparum infections was higher in school-age children (5-14 years: 42.0%) compared to < 5 years (17.3%) and ≥ 15 years (35.9%), subpatent infections were more likely in ≥ 15 years (70.4%) than in < 5 years (39.7%) and school-age children (41.2%). LM and RDTs were reliable only at parasite densities > 10,000 parasites/µL. Individuals who were positive according to all three tests had significantly greater parasite density (856.8 parasites/µL; 95% CI 707.3-1,038) than did those who were positive by varATS qPCR only (13.7 parasites/µL; 95% CI 11.4-16.3) (p < 0.0001). No pfhrp2 deletions were observed. The high prevalence of asymptomatic and subpatent infections highlights the need for targeted strategies to reduce malaria in urban Côte d'Ivoire.

Anxiety, Depression, and Quality of Sleep Vary in Their Correlation to Postoperative Outcomes of Rotator Cuff Repair: A Prospective Study.

Background/Objectives: Recent studies imply that psychological factors and sleep quality play a role in the outcomes of surgical procedures, including in orthopedic surgery. The aim of the present study is to evaluate possible correlations between preoperative depression, anxiety, and quality of sleep and functional 6-month postoperative scores in patients having undergone rotator cuff repair (RCR). Methods: All patients included in the study performed the Hospital Anxiety and Depression Scale (HADS) and Pittsburgh Sleep Quality Index (PSQI) questionnaires preoperatively and 36-item Short-Form Health Survey (SF-36), Oxford Shoulder Score (OSS), Shoulder Pain and Disability Index (SPADI), and PSQI questionnaires at the six-month postoperative follow-up. A total of 47 patients were included in the analysis. Results: Statistically significant differences between preoperative anxious and not-anxious groups were found in the postoperative SF-36 Physical Component Summary (PCS) and Mental Component Summary (MCS) scores and PSQI score. The correlation of the preoperative depression score to postoperative outcome measures revealed a strong positive correlation between the preoperative HADS-D score and the 6-month PCS, MCS, and OSS scores. The correlation of preoperative sleep quality to postoperative outcome measures revealed a strong positive correlation between the preoperative PSQI score and 6-month MCS score. Conclusions: Anxious patients had worse postoperative RCR outcomes. Depression may be influenced by factors related to RC pathology; however, there were no statistically significant correlations. Sleep quality generally improves postoperatively, and no significant association was found between bad preoperative sleepers and worse outcomes.

Physiopathology of patello-femoral osteoarthritis: current concepts.

Patellofemoral osteoarthritis (PFOA) is the result of degeneration and loss of articular cartilage of the patella and trochlea, and is a common cause of anterior knee pain. PFOA is triggered by insufficient adaptation to overload of the articular cartilage of the PF joint created by abnormal biomechanics. It is important to understand the pathophysiology and natural history to make the diagnosis and to plan treatment. Innate factors including malalignment, patellar instability, kinematic disorders, and acquired factors like trauma, obesity, and endocrine diseases have been found to be causes of PFOA. Genetic predisposition is also described as a contributing cause but without much scientific evidence. The diagnosis will be based on clinical manifestations, such as anterior knee pain aggravated by overloading activities, identification of risk factors, and exclusion of referred pain from other pathologies, followed by a systematic and structured physical examination. Imaging will be useful for assessing the presence of early osteoarthritis in the other compartments, for classification of the PFOA, and to identify features to establish an adequate treatment. This paper discusses varying management options for different causes of patellofemoral disease and explains the complexity of the PF joint and its often poorly understood biomechanics.

I Am Afraid I Will Not Be Able to Walk, That Is What Worries Me-The Experience of Patients with Knee Osteoarthritis before Total Knee Arthroplasty: A Qualitative Study.

Background: Knee osteoarthritis is the most prevalent type of osteoarthritis. Patients frequently encounter pain triggered by movement that evolves into impaired joint function. Needing persistent rest or having night-time pain signifies advanced disease. Qualitative research is considered the most effective method for comprehending patients' needs and contexts. Methods: This study employed a qualitative research design, allowing the researchers to acquire insights into the patients' beliefs and values, and the contextual factors influencing the formation and expression of these beliefs and values. Results: A cohort of nine patients awaiting total knee replacement (TKR) surgery was included and they were interviewed until data saturation was achieved. The results of the phenomenological analysis resulted in the identification of three themes: "The existence of pain impedes the capacity to participate in daily life activities"; "TKR induced fears and uncertainties regarding the progression of the disease"; "Severe nighttime pain compromising sleep quality". Conclusions: This study analyzes the experiences of people awaiting TKR surgery, emphasizing the importance of addressing their unique needs to improve preoperative education and rehabilitation. In this way, patients' recovery during the postoperative phase can be improved.

A digital microscope for the diagnosis of Plasmodium falciparum and Plasmodium vivax, including P. falciparum with hrp2/hrp3 deletion.

Sensitive and accurate malaria diagnosis is required for case management to accelerate control efforts. Diagnosis is particularly challenging where multiple Plasmodium species are endemic, and where P. falciparum hrp2/3 deletions are frequent. The Noul miLab is a fully automated portable digital microscope that prepares a blood film from a droplet of blood, followed by staining and detection of parasites by an algorithm. Infected red blood cells are displayed on the screen of the instrument. Time-to-result is approximately 20 minutes, with less than two minutes hands-on time. We evaluated the miLab among 659 suspected malaria patients in Gondar, Ethiopia, where P. falciparum and P. vivax are endemic, and the frequency of hrp2/3 deletions is high, and 991 patients in Ghana, where P. falciparum transmission is intense. Across both countries combined, the sensitivity of the miLab for P. falciparum was 94.3% at densities >200 parasites/µL by qPCR, and 83% at densities >20 parasites/µL. The miLab was more sensitive than local microscopy, and comparable to RDT. In Ethiopia, the miLab diagnosed 51/52 (98.1%) of P. falciparum infections with hrp2 deletion at densities >20 parasites/µL. Specificity of the miLab was 94.0%. For P. vivax diagnosis in Ethiopia, the sensitivity of the miLab was 97.0% at densities >200 parasites/µL (RDT: 76.8%, microscopy: 67.0%), 93.9% at densities >20 parasites/µL, and specificity was 97.6%. In Ethiopia, where P. falciparum and P. vivax were frequent, the miLab assigned the wrong species to 15/195 mono-infections at densities >20 parasites/µL by qPCR, and identified only 5/18 mixed-species infections correctly. In conclusion, the miLab was more sensitive than microscopy and thus is a valuable addition to the toolkit for malaria diagnosis, particularly for areas with high frequencies of hrp2/3 deletions.

Flash vacuum expansion, a low-cost and energy-efficient alternative process to produce high-quality fruit puree: Application to Physalis peruviana.

Goldenberry has great potential for the development of high-quality products due to its attractive sensory attributes, bioactive compounds, and health benefits. However, postharvest losses are high due to the lack of processing technologies that can both be adapted to rural conditions in producing countries to generate high-quality products. Flash vacuum expansion coupled with vacuum pulping is a new process that can meet these requirements. In the process, the steam holding time (30, 40, and 50 s/130 kPa) and flash vacuum expansion (5 ± 1.2 kPa) were studied. The logarithmic reduction of microbial load and some quality indicators were analyzed during the process and during storage to assess the shelf life of fruit purées. The FVE process with 40 s steam blanching led to a microbial reduction of over 6 log colony forming units (CFU)/g, increased yield and ß-carotene content, and preserved most of the AA content (4-12%). Based on the half-lives of the quality indicators, the shelf life of the purées was between 16 d (20 °C) and 90 d (4 °C). The energy consumption was estimated at approximately 0.30 kWh/kg of product. These results demonstrate that the FVE process, although it includes heat treatment, allows a short exposure to heat of the whole fruits to obtain a high-quality puree with an adequate shelf life in a single step, with a relatively low equipment investment and moderate energy consumption.

The Product of the Fission Yeast fhl1 Gene Binds to the HomolE Box and Activates In Vitro Transcription of Ribosomal Protein Genes.

Fission yeast ribosomal protein genes (RPGs) contain a HomolD box as a core promoter element required for transcription. Some of the RPGs also contain a consensus sequence named HomolE, located upstream of the HomolD box. The HomolE box acts as an upstream activating sequence (UAS), and it is able to activate transcription in RPG promoters containing a HomolD box. In this work, we identified a HomolE-binding protein (HEBP) as a polypeptide of 100 kDa, which was able to bind to the HomolE box in a Southwestern blot assay. The features of this polypeptide were similar to the product of the fhl1 gene of fission yeast. The Fhl1 protein is the homolog of the FHL1 protein of budding yeast and possesses fork-head-associated (FHA) and fork-head (FH) domains. The product of the fhl1 gene was expressed and purified from bacteria, and it was demonstrated that is able to bind the HomolE box in an electrophoretic mobility assay (EMSA), as well as being able to activate in vitro transcription from an RPG gene promoter containing HomolE boxes upstream of the HomolD box. These results indicate that the product of the fhl1 gene of fission yeast can bind to the HomolE box, and it activates the transcription of RPGs.

[Position of the international forum of internal medicine on habits, lifestyle changes and a healthy environment for the prevention of cardiovascular diseases]. / Posicionamiento del foro Internacional de Medicina Interna sobre Hábitos, modificaciones del Estilo de Vida y Ambiente Saludable para la Prevención de Enfermedades Cardiovasculares.

Cardiovascular diseases (CVD), mainly ischemic heart disease and stroke, is the main cause of death worldwide and each year more people die from CVD than from any other cause. These data call for a paradigm shift, where health promotion and cardiovascular prevention will acquire a central role in health policies. From this perspective, dedicating time during the consultation to promoting the acquisition of heart-healthy habits would be indicated in all individuals, regardless of cardiovascular risk classification, the role of the internist being fundamental. This position document from the International Forum of Internal Medicine (FIMI) presents the main indications regarding changes in lifestyle and acquisition of healthy habits to prevent CVD. The different sections will address topics including: nutrition, physical activity, sedentary lifestyle, obesity, smoking, alcohol consumption, sleep, stress, environmental problems related to CVD and specific conditions in women. A section is included about starting CVD promotion and prevention measures at an early age, childhood and adolescence, also mentioning epigenetic aspects related to CVD. Social determinants in CVD are also taken into account, since some of these aspects, such as low socioeconomic level, modify cardiovascular risk and should be taken into account.

Las enfermedades cardiovasculares (ECV), principalmente la cardiopatía isquémica y el accidente cerebrovascular (ACV), constituyen la principal causa de muerte a nivel mundial y cada año mueren más personas por ECV que por cualquier otra causa. Estos datos requieren la necesidad de un cambio de paradigma, en donde la promoción de la salud y la prevención cardiovascular adquieran un papel central en las políticas sanitarias. Desde esta perspectiva, dedicar tiempo durante la consulta en promocionar la adquisición de hábitos cardiosaludables estaría indicado en todos los individuos, independientemente de la clasificación de riesgo cardiovascular, siendo fundamental el rol del médico internista en su función de médico de cabecera. En este documento de posicionamiento del Foro Internacional de Medicina Interna (FIMI) se presentan algunas pautas para recomendar e indicar modificaciones en el estilo de vida y adquisición de hábitos saludables para prevenir la ECV, que tienen el objetivo de ser una herramienta practica para el médico internista. Las diferentes secciones abordaran temas que incluyen: nutrición, actividad física, sedentarismo, obesidad, hábito tabáquico, consumo de alcohol, sueño, estrés, problemas ambientales relacionados a la ECV y condiciones específicas en la mujer. Se incluyó un apartado acerca de comenzar las medidas de promoción y prevención de ECV en edades tempranas, infancia y adolescencia, mencionando además aspectos epigenéticos relacionados a la ECV. Se tienen en cuenta además los determinantes sociales en ECV, ya que algunos de estos aspectos, como el bajo nivel socioeconómico, modifican el riesgo cardiovascular y debieran ser tenidos en cuenta.

Position of the international forum of internal medicine on habits, lifestyle changes and a healthy environment for the prevention of cardiovascular diseases.

Cardiovascular diseases (CVD), mainly ischemic heart disease and stroke, is the main cause of death worldwide and each year more people die from CVD than from any other cause. These data call for a paradigm shift, where health promotion and cardiovascular prevention will acquire a central role in health policies. From this perspective, dedicating time during the consultation to promoting the acquisition of heart-healthy habits would be indicated in all individuals, regardless of cardiovascular risk classification, the role of the internist being fundamental. This position document from the International Forum of Internal Medicine (FIMI) presents the main indications regarding changes in lifestyle and acquisition of healthy habits to prevent CVD. The different sections will address topics including: nutrition, physical activity, sedentary lifestyle, obesity, smoking, alcohol consumption, sleep, stress, environmental problems related to CVD and specific conditions in women. A section is included about starting CVD promotion and prevention measures at an early age, childhood and adolescence, also mentioning epigenetic aspects related to CVD. Social determinants in CVD are also taken into account, since some of these aspects, such as low socioeconomic level, modify cardiovascular risk and should be taken into account.

Las enfermedades cardiovasculares (ECV), principalmente la cardiopatía isquémica y el accidente cerebrovascular (ACV), constituyen la principal causa de muerte a nivel mundial y cada año mueren más personas por ECV que por cualquier otra causa. Estos datos requieren la necesidad de un cambio de paradigma, en donde la promoción de la salud y la prevención cardiovascular adquieran un papel central en las políticas sanitarias. Desde esta perspectiva, dedicar tiempo durante la consulta en promocionar la adquisición de hábitos cardiosaludables estaría indicado en todos los individuos, independientemente de la clasificación de riesgo cardiovascular, siendo fundamental el rol del médico internista en su función de médico de cabecera. En este documento de posicionamiento del Foro Internacional de Medicina Interna (FIMI) se presentan algunas pautas para recomendar e indicar modificaciones en el estilo de vida y adquisición de hábitos saludables para prevenir la ECV, que tienen el objetivo de ser una herramienta practica para el médico internista. Las diferentes secciones abordaran temas que incluyen: nutrición, actividad física, sedentarismo, obesidad, hábito tabáquico, consumo de alcohol, sueño, estrés, problemas ambientales relacionados a la ECV y condiciones específicas en la mujer. Se incluyó un apartado acerca de comenzar las medidas de promoción y prevención de ECV en edades tempranas, infancia y adolescencia, mencionando además aspectos epigenéticos relacionados a la ECV. Se tienen en cuenta además los determinantes sociales en ECV, ya que algunos de estos aspectos, como el bajo nivel socioeconómico, modifican el riesgo cardiovascular y debieran ser tenidos en cuenta.

High-throughput Plasmodium falciparum hrp2 and hrp3 gene deletion typing by digital PCR to monitor malaria rapid diagnostic test efficacy.

Most rapid diagnostic tests for Plasmodium falciparum malaria target the Histidine-Rich Proteins 2 and 3 (HRP2 and HRP3). Deletions of the hrp2 and hrp3 genes result in false-negative tests and are a threat for malaria control. A novel assay for molecular surveillance of hrp2/hrp3 deletions was developed based on droplet digital PCR (ddPCR). The assay quantifies hrp2, hrp3, and a control gene with very high accuracy. The theoretical limit of detection was 0.33 parasites/µl. The deletion was reliably detected in mixed infections with wild-type and hrp2-deleted parasites at a density of >100 parasites/reaction. For a side-by-side comparison with the conventional nested PCR (nPCR) assay, 248 samples were screened in triplicate by ddPCR and nPCR. No deletions were observed by ddPCR, while by nPCR hrp2 deletion was observed in 8% of samples. The ddPCR assay was applied to screen 830 samples from Kenya, Zanzibar/Tanzania, Ghana, Ethiopia, Brazil, and Ecuador. Pronounced differences in the prevalence of deletions were observed among sites, with more hrp3 than hrp2 deletions. In conclusion, the novel ddPCR assay minimizes the risk of false-negative results (i.e., hrp2 deletion observed when the sample is wild type), increases sensitivity, and greatly reduces the number of reactions that need to be run.

Innovative Process Coupling Short Steam Blanching with Vacuum Flash-Expansion Produces in One Single Stage High-Quality Purple Passion Fruit Smoothies.

Short steam blanching coupled with flash-vacuum expansion (FVE) and de-pulping was used to obtain purée from purple passion fruits discarded from the export chain. Different steam blanching holding times (80, 95, 110 s) were tested at pressure of 130 kPa. After FVE and vacuum de-pulping, fibers, anthocyanins, carotenoids, rheological properties, and microbial reduction were evaluated in the purées. Fruit purées are obtained with a much higher content of cell-wall and bioactive compounds compared to the fresh arils since part of the fruit shell is incorporated into the purée (approximately 20%), which greatly increases the yield of production. Purées exhibited increasing shear-thinning flow behavior with blanching holding time, resulting in a smoothie-like beverage. A reduction greater than 5 log10 CFU/mL was obtained for molds, yeasts, aerobic mesophilic, and coliforms for all the treatments. The shelf life of smoothies based on nutritional and sensorial quality was extended up to 90 days at refrigeration temperature.

Performance of highly sensitive and conventional rapid diagnostic tests for clinical and subclinical Plasmodium falciparum infections, and hrp2/3 deletion status in Burundi.

Rapid diagnostic tests (RDTs) are a key tool for the diagnosis of malaria infections among clinical and subclinical individuals. Low-density infections, and deletions of the P. falciparum hrp2/3 genes (encoding the HRP2 and HRP3 proteins detected by many RDTs) present challenges for RDT-based diagnosis. The novel Rapigen Biocredit three-band Plasmodium falciparum HRP2/LDH RDT was evaluated among 444 clinical and 468 subclinical individuals in a high transmission setting in Burundi. Results were compared to the AccessBio CareStart HRP2 RDT, and qPCR with a sensitivity of <0.3 parasites/µL blood. Sensitivity compared to qPCR among clinical patients for the Biocredit RDT was 79.9% (250/313, either of HRP2/LDH positive), compared to 73.2% (229/313) for CareStart (P = 0.048). Specificity of the Biocredit was 82.4% compared to 96.2% for CareStart. Among subclinical infections, sensitivity was 72.3% (162/224) compared to 58.5% (131/224) for CareStart (P = 0.003), and reached 88.3% (53/60) in children <15 years. Specificity was 84.4% for the Biocredit and 93.4% for the CareStart RDT. No (0/362) hrp2 and 2/366 hrp3 deletions were observed. In conclusion, the novel RDT showed improved sensitivity for the diagnosis of P. falciparum.

Disfunción sexual en cáncer de mama: Efecto colateral / Sexual dysfunction in breast cancer: A side effect

Introducción: La disfunción sexual femenina (DSF) incluye un grupo de alteraciones en el deseo sexual, excitación, lubricación, satisfacción, orgasmo, y dispareunia, de carácter multifactorial, involucrando tanto procesos orgánicos y psicológicos como socioculturales. Los diversos tratamientos médico-quirúrgicos, tienen impacto en la función sexual. La disfunción sexual femenina afecta la calidad de vida, con una prevalencia de hasta 45-90% en las pacientes con diagnóstico de cáncer de mama. Objetivo: Evaluar la función sexual en mujeres con cáncer de mama, con seguimiento oncológico mayor al año, evaluando el impacto de los diferentes tratamientos médico-quirúrgicos en el índice de función sexual femenina. Material y método: Estudio observacional, descriptivo y transversal, donde se incluyeron 102 pacientes entre agosto 2019 y febrero de 2020 con cáncer de mama en el Hospital Municipal de Oncología María Curie. Como instrumento de medida se utilizó el cuestionario *Índice De Función Sexual Femenina* (FSFI), asociado a una encuesta para la obtención de datos sociodemográficos e información sobre los procedimientos medico-quirúrgicos realizados para el tratamiento del cáncer de mama. Resultados: La media de edad de las pacientes fue 54.86 años (SD 9.19). El 69.6% de ellas habían realizado tratamiento quirúrgico conservador, mientras que el 30.4% estaban mastectomizadas, no evidenciándose diferencias estadísticamente significativas en relación a la disfunción sexual en ambos grupos. Se realizó tratamiento quimioterápico en 69.6% del total de las pacientes y 75.5% hormonoterapia, observándose diferencia en el score FSFI al cotejar el tipo de hormonoterapia recibida. La prevalencia de disfunción sexual en este grupo fue de 82,35%. Los resultados evidenciaron valores bajos en la escala FSFI, siendo la media 19.6, lo que demuestra alteraciones en la función sexual en esta población. Conclusiones: El cáncer de mama posee un impacto multidimensional en la salud sexual de mujeres con cáncer de mama, constituyendo un elemento que influye en la calidad de vida. Los diversos tratamientos médico-quirúrgicos alteran la sexualidad, no pudiendo aún establecerse la relación directa que tienen sobre esta esfera

Introduction: Female sexual dysfunction (FSD) includes a group of alterations in sexual desire, arousal, lubrication, satisfaction, orgasm, and dyspareunia, of multifactorial character, involving organic and psychological as well as sociocultural processes. The various medical-surgical treatments have an impact on sexual function. Female sexual dysfunction affects quality of life, with a prevalence of up to 45-90% in patients diagnosed with breast cancer. Objective: To evaluate sexual function in women with breast cancer, with oncologic followup of more than one year, evaluating the impact of different medical-surgical treatments on the index of female sexual function. Material and method: Observational, descriptive and cross-sectional study, where 102 pa- tients were included between August 2019 and February 2020 with breast cancer at the Maria Curie Municipal Oncology Hospital. As a measurement instrument, the questionnaire *Female Sexual Function Index* (FSFI) was used, associated with a survey to obtain sociodemographic data and information on the medical-surgical procedures performed for the treatment of breast cancer. Results: The mean age of the patients was 54.86 years (SD 9.19). Of these, 69.6% had undergone conservative surgical treatment, while 30.4% were mastectomized, with no statistically significant differences in relation to sexual dysfunction in the two groups. Chemotherapy treatment was performed in 69.6% of the total patients and 75.5% hormone therapy, showing a difference in the FSFI score when comparing the type of hormone therapy received. The prevalence of sexual dysfunction in this group was 82.35%. The re- sults showed low values on the FSFI scale, with a mean of 19.6, which demonstrates alterations in sexual function in this population. Conclusions: Breast cancer has a multidimensional impact on the sexual health of women with breast cancer, constituting an element that influences the quality of life. The various medical-surgical treatments alter sexuality, although the direct relationship they have on this sphere cannot yet be established

Tracking SARS-CoV-2: Novel Trends and Diagnostic Strategies.

The COVID-19 pandemic has had an enormous impact on economies and health systems globally, therefore a top priority is the development of increasingly better diagnostic and surveillance alternatives to slow down the spread of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). In order to establish massive testing and contact tracing policies, it is crucial to have a clear view of the diagnostic options available and their principal advantages and drawbacks. Although classical molecular methods such as RT-qPCR are broadly used, diagnostic alternatives based on technologies such as LAMP, antigen, serological testing, or the application of novel technologies such as CRISPR-Cas for diagnostics, are also discussed. The present review also discusses the most important automation strategies employed to increase testing capability. Several serological-based diagnostic kits are presented, as well as novel nanotechnology-based diagnostic methods. In summary, this review provides a clear diagnostic landscape of the most relevant tools to track COVID-19.

Development and application of practical criteria for the recognition of potential Health Restoration Soundscapes (HeReS) in urban greenspaces.

Urban greenspace soundscapes can contribute to the restorative effects that nature provides for the psychological and emotional health of people when certain conditions are met. The main objective of this paper is to propose practical criteria to help planners and managers in the design, development and preservation of urban greenspaces whose soundscapes may contribute to the renewal of health. Systematic literature review informed a conceptual potential Health Restoration Soundscapes (HeReS) model, based on five conditions: (1) Naturalness, (2) Sound Levels, (3) Perceived Sound Sources, (4) Soundscape Assessment, and (5) Sensescape Coherence and proposed Health Restoration Soundscapes Criteria (HeReS-C), for HeReS evaluation in urban green areas. The HeReS-C were applied in 21 sites in Argentina, Sweden, and Chile. General results are provided for all 21 sites, along with three in-depth profiles of HeReS-C applications that provide case studies across a range of resulting HeReS-C scenarios, including sites that meet the HeReS-C criteria, those that do not, and sites that could qualify in the future, if appropriate management measures are taken. HeReS-C showed to be a promising tool for the recognition of potential health-restoring soundscapes in urban greenspaces; informing their design and management to favor the well-being and health of the population.

Anopheline and human drivers of malaria risk in northern coastal, Ecuador: a pilot study.

BACKGROUND: Understanding local anopheline vector species and their bionomic traits, as well as related human factors, can help combat gaps in protection. METHODS: In San José de Chamanga, Esmeraldas, at the Ecuadorian Pacific coast, anopheline mosquitoes were sampled by both human landing collections (HLCs) and indoor-resting aspirations (IAs) and identified using both morphological and molecular methods. Human behaviour observations (HBOs) (including temporal location and bed net use) were documented during HLCs as well as through community surveys to determine exposure to mosquito bites. A cross-sectional evaluation of Plasmodium falciparum and Plasmodium vivax infections was conducted alongside a malaria questionnaire. RESULTS: Among 222 anopheline specimens captured, based on molecular analysis, 218 were Nyssorhynchus albimanus, 3 Anopheles calderoni (n = 3), and one remains unidentified. Anopheline mean human-biting rate (HBR) outdoors was (13.69), and indoors (3.38) (p = 0.006). No anophelines were documented resting on walls during IAs. HBO-adjusted human landing rates suggested that the highest risk of being bitten was outdoors between 18.00 and 20.00 h. Human behaviour-adjusted biting rates suggest that overall, long-lasting insecticidal bed nets (LLINs) only protected against 13.2% of exposure to bites, with 86.8% of exposure during the night spent outside of bed net protection. The malaria survey found 2/398 individuals positive for asymptomatic P. falciparum infections. The questionnaire reported high (73.4%) bed net use, with low knowledge of malaria. CONCLUSION: The exophagic feeding of anopheline vectors in San Jose de Chamanga, when analysed in conjunction with human behaviour, indicates a clear gap in protection even with high LLIN coverage. The lack of indoor-resting anophelines suggests that indoor residual spraying (IRS) may have limited effect. The presence of asymptomatic infections implies the presence of a human reservoir that may maintain transmission.