Correction to: Low-cost HPV testing and the prevalence of cervical infection in asymptomatic populations in Guatemala.

Following publication of the original article [1], an error was reported in the tagging of Joël Fokom Domgue in the author group. The tagging in this correction article has been fixed.

Low-cost HPV testing and the prevalence of cervical infection in asymptomatic populations in Guatemala.

BACKGROUND: A low cost and accurate method for detecting high-risk (HR) human papillomavirus (HPV) is important to permit HPV testing for cervical cancer prevention. We used a commercially available HPV method (H13, Hybribio) which was documented to function accurately in a reduced volume of cervical specimen to determine the most prevalent HPV types and the distribution of HPV infections in over 1795 cancer-free women in Guatemala undergoing primary screening for cervical cancer by cytology. METHODS: HR-HPV detection was attempted in cervical samples from 1795 cancer-free women receiving Pap smears using the Hybribio™ real-time PCR assay of 13 HR types. The test includes a globin gene internal control. HPV positive samples were sequenced to determine viral type. Age-specific prevalence of HPV was also assessed in the study population. RESULTS: A total of 13% (226/1717) of women tested HPV+, with 78 samples (4.3%) failing to amplify the internal control. The highest prevalence was found in younger women (< 30 years, 22%) and older ones (≥60 years, 15%). The six most common HR-HPV types among the 148 HPV+ typed were HPV16 (22%), HPV18 (11%), HPV39 (11%), HPV58 (10%), HPV52 (8%), and HPV45 (8%). CONCLUSIONS: In this sample of cancer free women in Guatemala, HPV16 was the most prevalent HR type in Guatemala and the age-specific prevalence curve peaked in younger ages. Women in the 30-59-year age groups had a prevalence of HR-HPV of 8%, however, larger studies to better describe the epidemiology of HPV in Guatemala are needed.

[Translated article] Digital health for promoting adherence to antiretroviral treatment in patients with HIV/AIDS: A meta-review.

INTRODUCTION: Digital health or "e-health" is a set of applications based on information and communication technologies (ICTs) that can be used to promote self-care and medication adherence in patients with chronic diseases. The aim of this study was to carry out a review of systematic reviews (meta-review) on efficacy studies of e-health interventions to promote adherence to antiretroviral therapy (ART) in people living with HIV/AIDS. METHODOLOGY: A review of systematic reviews ("meta-review") was performed using the Medline-PubMed database on efficacy studies of e-health components to promote adherence to ART, in patients with HIV/AIDS, proposing a structured search strategy (PICO question). A selection process for systematic reviews was conducted based on inclusion and exclusion criteria. Subsequently, the corresponding data were extracted, and the analysis was accomplished in descriptive tables. RESULTS: A total of 29 systematic reviews were identified, from which 11 were selected. These reviews comprised 55 RCTs with different e-health interventions and enrolled a total of 15,311 HIV/AIDS patients. Studies included a total of 66 comparisons (experimental group vs. control group) in indirect adherence measurements based on different measurement techniques (36 statistically significant); 21 comparisons of viral load (VL) measurements (10 statistically significant); and 8 comparisons of CD4+ cell count measurements (3 statistically significant). m-Health was the most studied component followed by the telephone call and e-learning. CONCLUSION: Evidence was found that supports that some e-health interventions are effective in promoting adherence to ART and improving health outcomes in patients with HIV/AIDS, although it is identified that more studies are needed for more robust evidence.

Digital health to promote adherence to antiretroviral treatment in patients with HIV/AIDS: Meta review. / Salud digital para promover la adherencia al tratamiento antirretroviral en pacientes con VIH/sida: metarevisión.

INTRODUCTION: Digital health or "e-Health" is a set of applications based on Information and Communication Technologies that can be used to promote self-care and medication adherence in patients with chronic diseases. The aim of this study was to carry out a review of systematic reviews (meta-review) on efficacy studies of e-Health interventions to promote adherence to antiretroviral therapy in people living with HIV/AIDS. METHOD: A review of systematic reviews ("meta-review") was performed using the Medline-PubMed database on efficacy studies of e-Health components to promote adherence to antirretroviral therapy, in patients with HIV/AIDS, proposing a structured search strategy (PICO question). A selection process for systematic reviews was conducted based on inclusion and exclusion criteria. Subsequently, the corresponding data were extracted, and the analysis was accomplished in descriptive tables. RESULTS: A total of 29 systematic reviews were identified, from which 11 were selected. These reviews comprised 55 randomized controlled therapies with different e-Health interventions and enrolled a total of 15,311 HIV/AIDS patients. Studies included a total of 66 comparisons (experimental group vs. control group) in indirect adherence measurements based on different measurement techniques (36 statistically significant); 21 comparisons of viral load measurements (10 statistically significant); and 8 comparisons of CD4+ cell count measurements (3 statistically significant). m-Health was the most studied component followed by the telephone call and e-Learning. CONCLUSIONS: Evidence was found that supports that some e-Health interventions are effective in promoting adherence to antirretroviral therapy and improving health outcomes in patients with HIV/AIDS, although it is identified that more studies are needed for more robust evidence.

Relations of oxidative stress in freshwater phytoplankton with heavy metals and polycyclic aromatic hydrocarbons.

The phytoplankton is the basis of food webs and also, may bioconcentrate different toxic substances. This phenomenon is well documented, but there are few studies on the toxic effects on the phytoplankton community. In the current study the relation of oxidative stress (TBARS, ROOH, RC=O) and antioxidant defenses (activities of SOD, CAT, GPx and GST) of two phytoplankton communities with BCF of heavy metals (Cu, Fe, Mn, Pb, Zn) and of PAHs (naphthalene, pyrene, indenol, benzo[a]pyrene, benzo[a]anthracene, benzo[b]fluoranthene) was tested. Three sampling surveys were conducted bimonthly on the surface and bottom at different sampling points in the lakes Menor and Mayor of the 2nd section of Chapultepec Park. Also negative and positive controls obtained in the laboratory were included. Toxicity relationships were analyzed using the integrated biomarker response (IBR). Both green algae and cyanobacteria dominated. The contents of ROOH and protein oxidation assessed as RC=O were higher in the Lago Menor, a water body that contains ancient sediments. Through the IBR it was demonstrated that these damages were influenced by Pb, indenol and benzo[b]fluoranthene. In contrast, TBARS content was higher in Lago Mayor, which has sediment in formation. Through IBR it was estimated that Cu, Fe, Mn, Pb, indenol and benzo[b]fluoranthene were related to this damage. However, oxidative stress was accompanied by an induction of CAT and SOD, in contrast, GPx and GST had low or null activity. The field data were similar to the positive controls. We demonstrated for the first time that, although the phytoplankton suffers oxidative stress elicited by metals and PAHs, this community is able to counter this damage through antioxidant defenses. The effects of organic or inorganic toxics in phytoplankton depend on their bioavailability that is modulated by the sediment and also by its physicochemical properties and the characteristics of the abiotic medium.

Evaluation of the Influence of Road Geometry on Overtaking Cyclists on Two-Lane Rural Roads.

Road cycling, both individually and in groups, is common in Spain, where most two-lane rural roads have no cycle lanes. Due to this, and the difference in speed between drivers and cyclists, the overtaking manoeuvre is one of the most dangerous interactions. This study analyses how road geometry influences the overtaking manoeuvre performance. Field data of 1355 overtaking manoeuvres were collected using instrumented bicycles, riding along different rural road segments, and considering individual, medium and large groups of cyclists. The safety variables that characterise the overtaking manoeuvre are overtaking vehicle speed and lateral clearance. These variables have been correlated to geometric characteristics of the road, such as the type of centre line, the horizontal alignment, the speed limit, and the road cross section. Regression models have been fitted considering each cyclist group size and configuration. For individuals and medium groups, wider roads generate higher lateral clearances and lower overtaking speeds, while for large groups only the solid centre line was significant, generating lower clearances and higher speeds. Results suggest that other factors need to be considered, especially for large groups. Results offer a deeper understanding of the phenomenon by providing key points for improving road geometry design, such as widening the shoulders.

Lymphocyte Subsets in Defense Against New Pathogens in Patients with Cancer.

INTRODUCTION: Immunity in cancer patients is modified both by the cancer itself and by oncospecific treatments. Whether a patient's adaptive immunity is impaired depends on their levels of naive lymphocytes and other cell populations. During the COVID-19 pandemic, cancer patients are at greater risk of progressing to severe forms of the disease and have higher mortality rates than individuals without cancer, particularly while they are receiving cancer-specific therapies. An individual's protection against infection, their response to vaccines, and even the tests that determine the humoral immune response to SARS-CoV-2, depend on lymphocyte populations, meriting their study. OBJECTIVE: Estimate blood concentrations of lymphocytes involved in the immune response to new pathogens in cancer patients. METHODS: We carried out an analytical study of 218 cancer patients; 124 women and 94 men, 26-93 years of age, who were treated at the National Oncology and Radiobiology Institute in Havana, Cuba, March-June, 2020. Patients were divided into five groups: (1) those with controlled disease who were not undergoing cancer-specific treatment; (2) those undergoing debulking surgery; (3) patients undergoing chemotherapy; (4) patients undergoing radiation therapy and (5) patients currently battling infection. We evaluated the following peripheral blood lymphocyte subpopulations via flow cytometry: B lymphocytes (total, naive, transitional, memory, plasmablasts and plasma cells); T lymphocytes (total, helper, cytotoxic and their respective naive, activated, central memory and effector memory subsets); and total, secretory and cytotoxic natural killer cells and T natural killer cells. We also estimated neutrophil/lymphocyte ratios. Lymphocyte concentrations were associated with controlled disease and standard cancer therapy. For variables that did not fall within a normal distribution, ranges were set by medians and 2.5-97.5 percentiles. The two-tailed Mann-Whitney U test was used to measure the effect of sex and to compare lymphocyte populations. We calculated odds ratios to estimate lymphopenia risk. RESULTS: All cancer patients had lower values of naive helper and cytotoxic T lymphocyte populations, naive B lymphocytes, and natural killer cells than normal reference medians. Naive helper T cells were the most affected subpopulation. Memory B cells, plasmablasts, plasma cells, activated T helper cells, and cytotoxic central memory T cells were increased. Patients undergoing treatment had lower levels of naive lymphocytes than untreated patients, particularly during radiation therapy. The risk of B lymphopenia was higher in patients in treatment. The odds ratio for B lymphopenia was 8.0 in patients who underwent surgery, 12.9 in those undergoing chemotherapy, and 13.9 in patients in radiotherapy. CONCLUSIONS: Cancer and conventional cancer therapies significantly affect peripheral blood B lymphocyte levels, particularly transitional T helper lymphocytes, reducing the immune system's ability to trigger primary immune responses against new antigens.

Driver Behavior When Overtaking Cyclists Riding in Different Group Configurations on Two-Lane Rural Roads.

The presence of cyclists on Spanish rural roads is ever increasing and currently frequent, and thus becoming a serious safety concern. In rural environments, the risk of a crash is higher than in rural areas. The main cause is the higher speed of motor vehicles during overtaking manoeuvres. This manoeuvre is especially challenging when cyclists ride in groups as they may change size, length, shape, and speed along their route. These variables and those related to road cross-section can influence driver behaviour when overtaking a group of cyclists. To study this, instrumented bicycles were used to ride along five road segments with different geometric and traffic characteristics. Cyclists rode individually and in groups. Overtaking was evaluated by analysing the lateral distance, the speed, and other characteristics of the manoeuvre. Wider roads presented higher lateral clearances and overtaking speeds. Narrower roads had a high opposing lane invasion but a high level of compliance with the minimum lateral clearance. A higher clearance and lower speed of overtaking vehicles was registered when cyclists rode in line. Compliance with the 1.5 m clearance depended on the group configuration, being higher when cyclists rode in line. However, overtaking cyclists riding two abreast presented more accelerative manoeuvres, especially on narrow roads.

Modelling duration of car-bicycles overtaking manoeuvres on two-lane rural roads using naturalistic data.

Nowadays, Spanish two-lane rural roads frequently accommodate sport cyclists. They usually ride on the shoulder or on the right edge of the lane, sharing the infrastructure with motorised vehicles. Due to the speed difference between road users, the most frequent and dangerous interaction is in overtaking manoeuvres. One key factor from a safety and traffic operation point of view is the overtaking duration. The main aim of this paper is to analyse how factors related to the road, the cyclists, and the overtaking manoeuvre influence the duration of overtaking to cyclists on two-lane rural roads. Naturalistic field data were obtained using instrumented bicycles. Seven groups of cyclists, formed by different numbers of cyclists riding in-line and two-abreast, rode along five rural roads with different geometric and traffic characteristics. A total of 1592 flying manoeuvres, in which drivers did not reduce their speed, and 192 accelerative manoeuvres were analysed. The overtaking duration, considering each overtaking strategy, was modelled using Bayesian statistics. Results showed that flying manoeuvres were more prevalent than accelerative. They were performed with higher speeds and lower lateral clearances and, therefore, presented lower overtaking durations. For both overtaking strategies, duration increased on wider roads and with a larger size of the group. The presence of an oncoming vehicle decreased the overtaking duration. However, other factors presented opposite effects on the duration depending on the overtaking strategy. The developed predictive models allow obtaining overtaking durations varying road and cyclist grouping characteristics. Results can be used by road administration to manage and propose some specific countermeasures to integrate the cyclists in a safe and efficient way on two-lane rural roads.

Using the LN34 Pan-Lyssavirus Real-Time RT-PCR Assay for Rabies Diagnosis and Rapid Genetic Typing from Formalin-Fixed Human Brain Tissue.

Human rabies post mortem diagnostic samples are often preserved in formalin. While immunohistochemistry (IHC) has been routinely used for rabies antigen detection in formalin-fixed tissue, the formalin fixation process causes nucleic acid fragmentation that may affect PCR amplification. This study reports the diagnosis of rabies in an individual from the Dominican Republic using both IHC and the LN34 pan-lyssavirus real-time RT-PCR assay on formalin-fixed brain tissue. The LN34 assay generates a 165 bp amplicon and demonstrated higher sensitivity than traditional PCR. Multiple efforts to amplify nucleic acid fragments larger than 300 bp using conventional PCR were unsuccessful, probably due to RNA fragmentation. Sequences generated from the LN34 amplicon linked the case to the rabies virus (RABV) strain circulating in the Ouest Department of Haiti to the border region between Haiti and the Dominican Republic. Direct sequencing of the LN34 amplicon allowed rapid and low-cost rabies genetic typing.

Influence of cytokine and intercellular adhesion molecule-1 gene polymorphisms on acute rejection in pediatric renal transplantation.

Immune response regulation by cytokines is a key to understanding AGR. The influence of the functional polymorphisms in genes coding for TNF-alpha (-308G > A), IL-10 (-819C > T, and -1082A > G), IFN-gamma [(CA)n], TGF-beta1 (+869T > C), and iCAM-1 (R241G and E469K), in addition to HLA and gender matching on the presentation of AGR in 51 pediatric renal recipients during a 36-month post-transplantation follow-up were analyzed. Also, donors and a control group were genotyped. All groups were within Hardy-Weinberg equilibrium for all polymorphisms except IL-10-819C > T and TNF-alpha (p < 0.005 and p < 0.01, respectively) in recipients. Transplants with gender mismatch showed a higher risk for AGR than those between individuals with gender match (OR, 4.227; p = 0.010). Recipients with a high-production compared with low-production TNF-alpha allele experienced earlier AGR (p = 0.030), and those with high-production alleles of both TNF-alpha and IFN-gamma showed a further increased risk (OR = 11.129, p = 0.024). These findings support the notion that a single genotype cannot by itself explain an event as complex as AGR. The sum or combination of different specific alleles of these genes could better account for the immune response to an allograft.

Translation barriers in conducting qualitative research with Spanish speakers.

Cross-cultural qualitative research is rare and challenging because of difficulties of collecting reliable and valid information when conducting research in a language other than the researcher's primary language. Although standards of rigor exist for the data collection, analysis, interpretation, and reporting of qualitative data, no such standards exist for translation of translinguistic qualitative research. Therefore, a new methodology modeled after Brislin's translation principles was utilized with 60 Latino participants experiencing side effects as a result of prostate cancer treatment. Interviews were conducted in Spanish, transcribed verbatim, and then translated by research staff. By adapting Brislin's process, a new methodology was developed that more accurately conveys the true meaning of the participant's experience, is more appropriate and meaningful, and opens doors to researchers interested in conducting research in a language other than their own, while at the same time ensuring the reliability and validity of study data.

Renegotiating masculine identity after prostate cancer treatment.

Because little is known about how low-income Latino and African American men attribute meaning and adapt to prostate cancer treatment-related symptoms relative to masculine identity, in this study we sought to develop a descriptive model of this process. Using qualitative methods, 60 Latino and 35 African American/Black men were interviewed by language- and ethnicity-matched male interviewers using a semistructured guide. Interviews were audiotaped and transcribed verbatim. Spanish transcripts were rigorously translated to produce English transcripts. Analysis using grounded theory techniques found that men constructed masculine identities that were influenced by early experience, challenged by several factors including prostate cancer treatment, and underwent a renegotiation process that resulted in the maintenance of their identity as men. Development and testing of interventions that support this process will facilitate the adaptation process for men in a culturally relevant manner.

Obesity and adipocytokines in breast cancer and benign breast disease / Obesidad y adipocitocinas en cáncer de mama y enfermedad mamaria benigna

Background: There is a relationship between obesity and the development of breast cancer; adipocytokines are among the mechanisms related. Objective: To describe the impact of obesity in leptin, adiponectin, resistin and tumor necrosis factor-alpha (TNF-alpha) serum levels in women with breast cancer (BC) and benign breast disease (BBD). Methods: A cross-sectional study was carried out with a sample of 54 individuals divided into two groups: BC (n = 27) and BBD (n = 27). Serum levels of leptin, adiponectin, resistin and TNF-alpha were determined. Body mass index (BMI) was calculated. Statistical analysis included mean, standard deviation, median and interquartile range; the differences between groups were determined by Student´s t test, Mann-Whitney U and Kruskall Wallis test to identify differences between the groups. Results: We didn't find any significant differences related to anthropometric characteristics between BC and BBD groups, or to leptin, adiponectin, resistin and TNF-alpha serum levels (p = NS). We found higher leptin serum levels in obese women with BBD compared with non-obese women with BC (med 22.26 versus 4.34 ng/mL; p = 0.028). Adiponectin serum levels in non-obese women from the BC group were higher than serum levels found in non-obese women with BBD (med 7.10 versus 2.22 ng/mL; p = 0.038) Conclusion: We found higher leptin serum levels and lower adiponectin serum levels in BBD women than BC women in this population with high frequency of obesity.

Introducción: existe relación entre la obesidad y el desarrollo de cáncer de mama (CaM); entre los mecanismos implicados están las adipocitocinas. Objetivo: establecer el efecto de la obesidad sobre los valores séricos de leptina, adiponectina, resistina y el factor de necrosis tumoral-alfa (TNF-alfa) en mujeres con CaM y enfermedad mamaria benigna (EMB). Métodos: estudio transversal analítico. Se determinaron los niveles séricos de leptina, adiponectina, resistina y TNF-alfa, así como el índice de masa corporal (IMC) de 27 mujeres con CaM incidente y 27 con EMB. Se utilizaron promedios, desviaciones estándar, medianas (Me) y rangos intercuartílicos, así como las pruebas t de Student, U de Mann-Whitney y Kruskall-Wallis para identificar diferencias entre los grupos. Resultados: no se encontraron diferencias antropométricas, ni en niveles séricos de TNF-alfa, leptina y resistina entre los grupos (p = NS). Los niveles de leptina de las mujeres con EMB y obesidad fueron significativamente superiores que en las mujeres con CaM no obesas (Me 22.26 frente a 4.34 ng/mL; p = 0.028). Los niveles de adiponectina en mujeres con CaM con IMC sin obesidad fueron mayores que los encontrados en pacientes con EMB con IMC y sin obesidad (Me 7.10 frente a 2.22 ng/mL; p = 0.038). Conclusión: en esta población con elevada frecuencia de obesidad, se encontraron niveles mayores de leptina en mujeres con EMB con respecto a las mujeres con CaM; asimismo, se encontró un patrón inverso en adiponectina.

[Impact of pasteurization/freeze-drying on available immunoglobulin content of the mature human milk. Use in human milk banking of hospitals]. / Impacto de la pasteurización/liofilización en el contenido disponible de inmunoglobulinas en leche humana madura. Estudio de aplicación en bancos de leche humana en hospitales.

INTRODUCTION: This study analyzes the effect on the content of immunoglobulins and C3 complement of freeze drying after pasteurization by three different methods in mature human milk (MHM). OBJECTIVE: Freeze drying is proposed as a complementary method for the maintenance of MHM therapeutic properties with greater validity. METHODS: This was a descriptive study in which MHM samples were obtained. Next, aliquots of the samples obtained were pasteurized by three methods: 62.5 centigrades degrees/30 minutes, 72 centigrades degrees/15 minutes, 85 centigrades degrees/5 minutes, followed by a rapid cooling at 5 ºC. Then, 30 ml volumes of pasteurized sample were freeze-dried over a period of 36 hours. Total protein determination was performed by the Lowry method. The concentrations of immunoglobulins A, G and M, and complement C3, were determined by conventional nephelometric technique following the manufacturer's instructions. Statistical significance was defined as p < 0.05. RESULTS: The method of pasteurization of MHM with increased protein and immunoglobulin retention was at 62.5 centigrades degrees, however, pasteurization at 72 centigrades degrees before freeze-drying showed better retention of immunoglobulins. CONCLUSIONS: Our results suggest that the freeze-drying of pasteurized MHM is a suitable method for the conservation in human milk banks. Both the nutritional composition and the extension of its validity and the application of the two processes together provide the advantage of maintaining the therapeutic properties of human milk to improve the health of the newborn in a vulnerable, impaired or immunosuppressed state.

INTRODUCCIÓN: este estudio analiza el efecto sobre el contenido de inmunoglobulinas y complemento C3 de la liofilización posterior a la pasteurización por tres métodos diferentes en leche humana madura (LHM). OBJETIVO: la liofilización es propuesta como método complementario para el mantenimiento de las propiedades terapéuticas de la LHM con mayor vigencia. MÉTODOS: estudio descriptivo en el que se obtuvieron muestras de LHM. Alícuotas de las muestras obtenidas se pasteurizaron por tres métodos: 62,5 grados centígrados/30 minutos, 72 grados centígrados/15 minutos 85 grados centígrados/5 minutos, seguido de un enfriamiento rápido a 5 grados centígrados. Después, volúmenes de 30 ml de muestra pasteurizada fueron liofilizados durante un periodo de 36 horas. La determinación de proteínas totales fue realizada por el método Lowry. Las concentraciones de inmunoglobulinas A, G y M y el complemento C3 fueron determinadas por nefelometría convencional, siguiendo las instrucciones del fabricante. La significancia estadística se definió como p < 0,05. RESULTADOS: el método de pasteurización de LHM con mayor retención de proteína e inmunoglobulinas fue a la temperatura de 62,5 grados centígrados, sin embargo, la pasteurización a 72 grados centígrados antes de la liofilización mostró mayor retención de inmunoglobulinas. CONCLUSIONES: nuestros resultados sugieren que la liofilización de LHM pasteurizada es un método eficiente para la conservación en bancos de leche humana. Tanto la composición nutricional como la extensión de su vida útil y la aplicación de los dos procesos juntos proporcionan la ventaja de mantener las propiedades terapéuticas de la leche humana para mejorar la salud del recién nacido en estado vulnerable, desmedro o inmunosuprimido.

Bayes classifiers for imbalanced traffic accidents datasets.

Traffic accidents data sets are usually imbalanced, where the number of instances classified under the killed or severe injuries class (minority) is much lower than those classified under the slight injuries class (majority). This, however, supposes a challenging problem for classification algorithms and may cause obtaining a model that well cover the slight injuries instances whereas the killed or severe injuries instances are misclassified frequently. Based on traffic accidents data collected on urban and suburban roads in Jordan for three years (2009-2011); three different data balancing techniques were used: under-sampling which removes some instances of the majority class, oversampling which creates new instances of the minority class and a mix technique that combines both. In addition, different Bayes classifiers were compared for the different imbalanced and balanced data sets: Averaged One-Dependence Estimators, Weightily Average One-Dependence Estimators, and Bayesian networks in order to identify factors that affect the severity of an accident. The results indicated that using the balanced data sets, especially those created using oversampling techniques, with Bayesian networks improved classifying a traffic accident according to its severity and reduced the misclassification of killed and severe injuries instances. On the other hand, the following variables were found to contribute to the occurrence of a killed causality or a severe injury in a traffic accident: number of vehicles involved, accident pattern, number of directions, accident type, lighting, surface condition, and speed limit. This work, to the knowledge of the authors, is the first that aims at analyzing historical data records for traffic accidents occurring in Jordan and the first to apply balancing techniques to analyze injury severity of traffic accidents.

Influence of deficiencies in traffic control devices in crashes on two-lane rural roads.

One of the main objectives of all public administrations is reducing traffic crashes. To this end, Road Safety Inspections (RSI) stand out as a key measure. Signaling roads is one of the foremost tasks of RSI. A road that is improperly or poorly signaled can lead to incorrect placement or maneuvers of vehicles and ambiguous situations that can increase the risk of crashes. This paper analyses the relationship between road crashes in two-lane rural highways and certain deficiencies in signaling. The results show that deficiencies such as "incomplete removal of road works markings" or "no guide sign or in incorrect position" are the ones associated with a higher probability of crashes in two-lane rural highways. In view of these results, governmental agencies should verify that the original conditions of a highway are re-established after any construction work is completed. They should also continuously follow up on the signaling of this type of highway in order to maintain optimal conditions.

Development of safety performance functions for Spanish two-lane rural highways on flat terrain.

Over decades safety performance functions (SPF) have been developed as a tool for traffic safety in order to estimate the number of crashes in a specific road section. Despite the steady progression of methodological innovations in the crash analysis field, many fundamental issues have not been completely addressed. For instance: Is it better to use parsimonious or fully specified models? How should the goodness-of-fit of the models be assessed? Is it better to use a general model for the entire sample or specific models based on sample stratifications? This paper investigates the above issues by means of several SPFs developed using negative binomial regression models for two-lane rural highways in Spain. The models were based on crash data gathered over a 5-year period, using a broad number of explanatory variables related to exposure, geometry, design consistency and roadside features. Results show that the principle of parsimony could be too restrictive and that it provided simplistic models. Most previous studies apply conventional measurements (i.e., R(2), BIC, AIC, etc.) to assess the goodness-of-fit of models. Seldom do studies apply cumulative residual (CURE) analysis as a tool for model evaluation. This paper shows that CURE plots are essential tools for calibrating SPF, while also providing information for possible sample stratification. Previous authors suggest that sample segmentation increases the model accuracy. The results presented here confirm that finding, and show that the number of significant variables in the final models increases with sample stratification. This paper point out that fully models based on sample segmentation and on CURE may provide more useful insights about traffic crashes than general parsimonious models when developing SPF.

Caracterización de los inmunofenotipos linfocitarios de sangre periférica en pacientes con cáncer / Characterization of peripheral blood lymphocytes immunophenotype in cancer patients

Introducción: La determinación de los inmunofenotipos linfocitarios en sangre periférica forma parte de la evaluación del estado general del sistema inmunitario. Estos exámenes ofrecen informaciones sobre la distribución, concentración y funcionabilidad de las células inmunitarias, lo cual contribuye a establecer pronósticos en el cáncer y predicciones a las respuestas terapéuticas. Objetivo: Evaluar la distribución de las concentraciones linfocitarias circulantes en sangre periférica de pacientes con cáncer. Métodos: Se realizó un estudio analítico en 154 pacientes con cáncer, atendidos en el Instituto de Oncología y Radiobiología de La Habana, durante los años 2017 a 2019. Se empleó la citometría de flujo multiparamétrica para identificar los inmunofenotipos linfocitarios. Este procedimiento se realizó antes de comenzar cualquier tratamiento inmunoterapéutico. Resultados: Los pacientes con cáncer mostraron mayor heterogeneidad en la distribución de las poblaciones linfocitarias respecto a los controles. En los pacientes la mediana de los linfocitos totales y de las subpoblaciones linfocitarias CD3+, CD4+, CD8+ y CD19+ fueron significativamente menores. Los linfocitos T dobles positivos (CD4/CD8) se encontraron elevados significativamente. No se hallaron diferencias entre sexos. La edad se asoció negativamente con las concentraciones de las poblaciones T en tumores sólidos, y con T y B en los linfomas. En el cáncer de próstata se obtuvieron los valores más bajos de poblaciones linfocitarias. Conclusiones: Los pacientes con cáncer tienen menor concentración de linfocitos en sangre periférica que los controles sanos. Las células más afectadas fueron las subpoblaciones T y los linfocitos B. La edad se asoció negativamente con las concentraciones sanguíneas de linfocitos, lo cual pudiera estar en relación con la inmunosenescencia(AU)

Introduction: Determination of lymphocytic immunophenotypes in peripheral blood is part of the evaluation of the general state of the immune system. These tests provide information about the distribution, concentration, and functionality of immune cells, which helps establish prognoses in cancer and predictions of therapeutic responses. Objective: To evaluate the distribution of circulating lymphocyte concentrations in peripheral blood of cancer patients. Methods: An analytical study was carried out with 154 cancer patients treated at the Institute of Oncology and Radiobiology in Havana, from 2017 to 2019. Multiparametric flow cytometry was used to identify lymphocyte immunophenotypes. This procedure was performed before beginning any immunotherapeutic treatment. Results: Cancer patients showed greater heterogeneity in the distribution of lymphocyte populations compared to control patients. The median for total lymphocytes and the lymphocyte subpopulations of CD3+, CD4+, CD8+ and CD19+ were significantly lower in patients. CD4+ CD8+ double-positive T lymphocytes were found to be significantly elevated. No sex differences were found. Age was negatively associated with the concentrations of T-cells populations in solid tumors, and with T- and B-cells populations in lymphomas. In prostate cancer, the lowest values ​​of lymphocyte populations were obtained. Conclusions: Cancer patients have a lower concentration of lymphocytes in peripheral blood than healthy patients in the control group. The most affected ones were the T-cells subpopulations and B lymphocytes. Age was negatively associated with blood levels of lymphocytes, which could be related to immunosenescence(AU)