WHO method for estimating congenital syphilis to inform surveillance and service provision, Paraguay.

Problem: In Paraguay, incomplete surveillance data resulted in the burden of congenital syphilis being underestimated, which, in turn, led to missed opportunities for infant diagnosis and treatment. Approach: The prevalence of congenital syphilis, as defined by the World Health Organization (WHO), was estimated for Paraguay using the WHO congenital syphilis estimation tool. This tool was also used to monitor progress towards the elimination of mother-to-child transmission of syphilis. Local setting: The burden of syphilis in Paraguay has historically been high: its prevalence in pregnant women was estimated to be 3% in 2018. Relevant changes: The incidence rate of congenital syphilis estimated using the WHO tool was around nine times the reported prevalence. Subsequently, Paraguay: (i) provided training to improve diagnosis and case reporting; (ii) strengthened information systems for case monitoring and reporting; and (iii) procured additional rapid dual HIV-syphilis and rapid plasma reagin tests to increase syphilis testing capacity. In addition, the Ministry of Health prepared a new national plan for eliminating mother-to-child transmission of syphilis, with clear monitoring milestones. Lessons learnt: Health-care providers' reporting and surveillance procedures for congenital syphilis may not adequately reflect national and international case definitions. Use of the WHO congenital syphilis estimation tool in Paraguay drew attention to congenital syphilis as a national public health problem and highlighted the importance of comprehensive national surveillance systems and accurate data. Ongoing use of the WHO tool can track progress towards the elimination of mother-to-child transmission of syphilis by helping improve syphilis service coverage and national surveillance.

Road traffic injuries and substance use among emergency department patients in the Dominican Republic and Peru.

OBJECTIVE: To report demographic and substance use characteristics and risk of road traffic injury (RTI) from alcohol use, cannabis use, and combined use in a sample of emergency department patients from two countries in Latin America and the Caribbean. METHODS: A cross-sectional study in which patients 18 years and older admitted within six hours of suffering an RTI to one emergency department in Santa Domingo, Dominican Republic (n = 501) and in Lima, Peru (n = 431) were interviewed. Case-crossover analysis, based on self-reported use prior to the RTI, was used to analyze risk from alcohol, cannabis, and co-use. RESULTS: Overall, 15.3% reported alcohol use prior to the event and 2.5% cannabis use. Drivers using alcohol only were over twice as likely to have an RTI (OR = 2.46, p < 0.001), and nearly eight times more likely if using both alcohol and cannabis (OR = 6.89, p < 0.01), but risk was not elevated for cannabis alone. Significant differences were not found for passengers or pedestrians. CONCLUSIONS: Risk of RTI for drivers in these two samples is significantly elevated from alcohol use, and more so for co-use with cannabis. Differences between the two countries underscore the need for similar data from the region to determine risk of RTI from substance use, including risk for passengers and pedestrians. Data suggest that alcohol contributes significantly to the burden of RTI, which calls for more stringent enforcement of alcohol control policy related to drink driving in the region.

Shifting patterns of disparities in unintentional injury mortality rates in the United States, 1999-2016

[ABSTRACT]. Objectives. To analyze changes in racial/ethnic disparities for unintentional injury mortality from 1999-2016. Methods. Mortality data are from the National Center for Health Statistics (NCHS) for all unintentional injuries, analyzed separately by injury cause (motor vehicle accidents [MVA], poisonings, other unintentional) for white, black, and Hispanic populations within four age groups: 15-19, 20-34, 35-54, 55-74 for males and for females. Results. Rates across race/ethnic groups varied by gender, age and cause of injury. Unintentional injury mortality showed a recent increase for both males and females, which was more marked among males and for poisoning in all race/ethnic groups of both genders. Whites showed highest rates of poisoning mortality and the steepest increase for both genders, except for black males aged 55-74. MVA mortality also showed an increase for all race/ethnic groups, with a sharper rise among blacks, while Hispanics had lower rates than either whites or blacks. Rates for other unintentional injury mortality were similar across groups except for white women over 55, for whom rates were elevated. Conclusions. Data suggest while mortality from unintentional injury related to MVA and poisoning is on the rise for both genders and in most age groups, blacks compared to whites and Hispanics may be suffering a disproportionate burden of mortality related to MVAs and to poisonings among those over 55, which may be related to substance use.

[RESUMEN]. Objetivos. Analizar cambios en las disparidades por raza y grupo étnico en materia de mortalidad por traumatismos no intencionales de 1999 al 2016. Métodos. Los datos de mortalidad de todos los traumatismos no intencionales provienen del Centro Nacional de Estadísticas Sanitarias y se han analizado por separado por causa de traumatismo (colisiones automovilísticas, intoxicaciones y otras causas no intencionales) y por población blanca, negra e hispana, tanto en hombres como en mujeres, en cuatro grupos etarios: de 15 a 19, de 20 a 34, de 35 a 54 y de 55 a 74. Resultados. Las tasas en todos los grupos raciales y étnicos variaron según el sexo, la edad y la causa del traumatismo. La mortalidad por traumatismo no intencional mostró un aumento reciente tanto en hombres como en mujeres, que fue más marcado en el caso de los hombres, y por intoxicación en todos los grupos raciales y étnicos de ambos sexos. La población blanca mostró las tasas más elevadas de mortalidad por intoxicación y el incremento más acentuado en ambos sexos, con excepción de los hombres negros entre 55 y 74 años de edad. La mortalidad por colisión automovilística también registró un aumento en todos los grupos raciales y étnicos, con un incremento mayor en la población negra, mientras que la población hispana mostró tasas inferiores que la blanca o la negra. Las tasas de mortalidad por otros traumatismos no intencionales fueron similares en todos grupos salvo en el caso de las mujeres blancas de más de 55 años, cuyas tasas mostraron un incremento. Conclusiones. Los datos indican que, si bien la mortalidad por traumatismo no intencional relacionada con colisiones automovilísticas e intoxicación está en alza en ambos sexos y en la mayoría de los grupos etarios, la población negra en comparación con la blanca y la hispana puede estar presentando una carga desproporcionada de mortalidad relacionada con colisiones automovilísticas e intoxicación en personas mayores de 55, que podrían estar relacionado con el consumo de sustancias psicoactivas.

[RESUMO]. Objetivos. Analisar as mudanças nas disparidades étnico-raciais da mortalidade por lesões acidentais no período 1999-2016. Métodos. Os dados de mortalidade foram obtidos do Centro Nacional de Estatísticas de Saúde (NCHS) dos Estados Unidos para todos os tipos de lesões acidentais e analisados em separado por causa de lesão (acidentes de trânsito de veículos a motor, envenenamento/intoxicação e outros tipos de acidentes) em grupos populacionais de brancos, negros e hispânicos de ambos os sexos divididos em quatro faixas etárias: 15–19, 20–34, 35–54 e 55–74 anos. Resultados. As taxas de mortalidade nos grupos étnico-raciais variaram segundo sexo, idade e causa de lesão. Houve um aumento recente na mortalidade por lesões acidentais nos sexos masculino e feminino, sendo mais acentuado no sexo masculino e por envenenamento/intoxicação em todos os grupos étnicosraciais de ambos os sexos. A população branca apresentou as maiores taxas de mortalidade por envenenamento/intoxicação e o aumento mais acentuado na mortalidade em ambos os sexos, exceto por homens negros de 55–74 anos. Ocorreu também um aumento da mortalidade por acidentes de trânsito de veículos a motor em todos os grupos étnico-raciais, sendo mais acentuado em negros, e a mortalidade na população hispânica foi menor que em brancos ou negros. As taxas de mortalidade por outros tipos de acidentes foram semelhantes em todos os grupos, exceto em mulheres brancas acima de 55 anos que apresentaram taxas elevadas. Conclusões. Os dados analisados indicam que, apesar de a mortalidade por lesões acidentais por acidentes de trânsito de veículos a motor e envenenamento/intoxicação estar aumentando em ambos os sexos e na maioria das faixas etárias, em comparação a brancos e hispânicos, os negros possivelmente sofrem um ônus desproporcional de mortalidade por acidentes de trânsito e envenenamento/intoxicação no grupo acima de 55 anos que pode estar associada ao uso de substâncias químicas.

Road traffic injuries and substance use among emergency department patients in the Dominican Republic and Peru

[ABSTRACT]. Objective. To report demographic and substance use characteristics and risk of road traffic injury (RTI) from alcohol use, cannabis use, and combined use in a sample of emergency department patients from two countries in Latin America and the Caribbean. Methods. A cross-sectional study in which patients 18 years and older admitted within six hours of suffering an RTI to one emergency department in Santa Domingo, Dominican Republic (n = 501) and in Lima, Peru (n = 431) were interviewed. Case-crossover analysis, based on self-reported use prior to the RTI, was used to analyze risk from alcohol, cannabis, and co-use. Results. Overall, 15.3% reported alcohol use prior to the event and 2.5% cannabis use. Drivers using alcohol only were over twice as likely to have an RTI (OR = 2.46, p < 0.001), and nearly eight times more likely if using both alcohol and cannabis (OR = 6.89, p < 0.01), but risk was not elevated for cannabis alone. Significant differences were not found for passengers or pedestrians. Conclusions. Risk of RTI for drivers in these two samples is significantly elevated from alcohol use, and more so for co-use with cannabis. Differences between the two countries underscore the need for similar data from the region to determine risk of RTI from substance use, including risk for passengers and pedestrians. Data suggest that alcohol contributes significantly to the burden of RTI, which calls for more stringent enforcement of alcohol control policy related to drink driving in the region.

[RESUMEN]. Objetivo. Presentar las características demográficas y de consumo de sustancias psicoactivas y el riesgo de traumatismos causados por el tránsito debidos al consumo de alcohol, cannabis y su consumo combinado en una muestra de pacientes del departamento de urgencias de dos países de América Latina y el Caribe. Métodos. Se realizó un estudio transversal en que se entrevistaron pacientes de 18 años o más ingresados en las siguientes seis horas de haber recibido traumatismos causados por el tránsito en un departamento de urgencias en Lima (Perú) (n = 431) y en Santo Domingo (República Dominicana) (n = 501). Se empleó el análisis de cruce de casos, basado en el consumo autoinformado con anterioridad a los traumatismos causados por el tránsito, para evaluar el riesgo por consumo de alcohol, cannabis y consumo combinado. Resultados. En términos generales, 15,3% notificó consumo de alcohol con anterioridad al evento y 2,5%, consumo de cannabis. Los conductores que consumieron alcohol únicamente tuvieron más del doble de probabilidades de sufrir traumatismos causados por el tránsito (OR = 2,46, p < 0,001) y casi ocho veces más probabilidades si consumieron tanto alcohol como cannabis (OR = 6,89, p < 0,01), si bien el riesgo no fue tan elevado para el consumo único de cannabis. No se encontraron diferencias significativas en pasajeros o peatones. Conclusiones. El riesgo de sufrir traumatismos causados por el tránsito para los conductores en estas dos muestras es significativamente más elevado por el consumo de alcohol y más aún por el consumo combinado con cannabis. Las diferencias entre ambos países ponen de manifiesto la necesidad de obtener datos similares sobre la región para determinar el riesgo de sufrir traumatismos causados por el tránsito debidos al consumo de sustancias psicoactivas, así como el riesgo para pasajeros y peatones. Los datos indican que el alcohol agrava significativamente la carga de los traumatismos causados por el tránsito, lo que exige un cumplimiento más estricto de las políticas de control del alcohol relacionadas con la conducción bajo los efectos del alcohol en la región.

[RESUMO]. Objetivo. Descrever as características demográficas e uso de substâncias químicas e o risco de lesões por acidentes de trânsito associados ao consumo de álcool, uso de cannabis (maconha) e uso combinado de álcool e cannabis em uma amostra de pacientes que deram entrada no setor de emergência em dois países da América Latina e no Caribe. Métodos. Estudo transversal em que foram entrevistados pacientes maiores de 18 anos que deram entrada no setor de emergência no espaço de seis horas após sofrerem lesões por acidentes de trânsito em Santo Domingo, na República Dominicana (n = 501), e em Lima, Peru (n = 431). Foi realizada uma análise cruzada de casos com dados obtidos do autorrelato do uso de substâncias químicas anterior ao acidente de trânsito para avaliar o risco associado ao consumo de álcool, uso de cannabis e uso combinado. Resultados. Dos pacientes entrevistados, 15,3% relataram consumo de álcool e 2,5% referiram uso de cannabis antes do acidente. Os condutores que fizeram uso de álcool tiveram uma chance duas vezes maior de ter lesões por acidente de trânsito (OR = 2,46, p < 0,001) e uma chance de cerca de oito vezes maior com o uso combinado de álcool e cannabis (OR = 6,89, p < 0,01). Porém, o risco não foi elevado com o uso somente de cannabis. Não foram observadas diferenças significativas no risco para passageiros ou pedestres. Conclusões. Verificou-se que o risco de lesões por acidentes de trânsito para os condutores nas duas amostras estudadas foi significativamente elevado com o consumo de álcool e foi ainda maior com o uso combinado de álcool e cannabis. As diferenças entre os dois países reforçam a necessidade de dados semelhantes da Região para determinar o risco de lesões por acidentes de trânsito com o uso de substâncias químicas, inclusive para determinar o risco para passageiros e pedestres. Os dados indicam que o álcool contribui significativamente à carga de lesões por acidentes de trânsito requerendo o cumprimento mais rigoroso da política de controle do consumo de álcool associado à condução de veículos na Região.

Shifting patterns of disparities in unintentional injury mortality rates in the United States, 1999-2016 / Tendencias cambiantes en las disparidades en las tasas de mortalidad por traumatismo no intencional en Estados Unidos entre 1999 y 2016 / Mudança nos padrões de disparidade nas taxas de mortalidade por lesões acidentais nos Estados Unidos, 1999-2016

ABSTRACT Objectives. To analyze changes in racial/ethnic disparities for unintentional injury mortality from 1999-2016. Methods. Mortality data are from the National Center for Health Statistics (NCHS) for all unintentional injuries, analyzed separately by injury cause (motor vehicle accidents [MVA], poisonings, other unintentional) for white,black, and Hispanic populations within four age groups: 15-19, 20-34, 35-54, 55-74 for males and for females. Results. Rates across race/ethnic groups varied by gender, age and cause of injury. Unintentional injury mortality showed a recent increase for both males and females, which was more marked among males and for poisoning in all race/ethnic groups of both genders. Whites showed highest rates of poisoning mortality and the steepest increase for both genders, except for black males aged 55-74. MVA mortality also showed an increase for all race/ethnic groups, with a sharper rise among blacks, while Hispanics had lower rates than either whites or blacks. Rates for other unintentional injury mortality were similar across groups except for white women over 55, for whom rates were elevated. Conclusions. Data suggest while mortality from unintentional injury related to MVA and poisoning is on the rise for both genders and in most age groups, blacks compared to whites and Hispanics may be suffering a disproportionate burden of mortality related to MVAs and to poisonings among those over 55, which may be related to substance use.

RESUMEN Objetivos. Analizar cambios en las disparidades por raza y grupo étnico en materia de mortalidad por traumatismos no intencionales de 1999 al 2016. Métodos. Los datos de mortalidad de todos los traumatismos no intencionales provienen del Centro Nacional de Estadísticas Sanitarias y se han analizado por separado por causa de traumatismo (colisiones automovilísticas, intoxicaciones y otras causas no intencionales) y por población blanca, negra e hispana, tanto en hombres como en mujeres, en cuatro grupos etarios: de 15 a 19, de 20 a 34, de 35 a 54 y de 55 a 74. Resultados. Las tasas en todos los grupos raciales y étnicos variaron según el sexo, la edad y la causa del traumatismo. La mortalidad por traumatismo no intencional mostró un aumento reciente tanto en hombres como en mujeres, que fue más marcado en el caso de los hombres, y por intoxicación en todos los grupos raciales y étnicos de ambos sexos. La población blanca mostró las tasas más elevadas de mortalidad por intoxicación y el incremento más acentuado en ambos sexos, con excepción de los hombres negros entre 55 y 74 años de edad. La mortalidad por colisión automovilística también registró un aumento en todos los grupos raciales y étnicos, con un incremento mayor en la población negra, mientras que la población hispana mostró tasas inferiores que la blanca o la negra. Las tasas de mortalidad por otros traumatismos no intencionales fueron similares en todos grupos salvo en el caso de las mujeres blancas de más de 55 años, cuyas tasas mostraron un incremento. Conclusiones. Los datos indican que, si bien la mortalidad por traumatismo no intencional relacionada con colisiones automovilísticas e intoxicación está en alza en ambos sexos y en la mayoría de los grupos etarios, la población negra en comparación con la blanca y la hispana puede estar presentando una carga desproporcionada de mortalidad relacionada con colisiones automovilísticas e intoxicación en personas mayores de 55, que podrían estar relacionado con el consumo de sustancias psicoactivas.

RESUMO Objetivos. Analisar as mudanças nas disparidades étnico-raciais da mortalidade por lesões acidentais no período 1999-2016. Métodos. Os dados de mortalidade foram obtidos do Centro Nacional de Estatísticas de Saúde (NCHS) dos Estados Unidos para todos os tipos de lesões acidentais e analisados em separado por causa de lesão (acidentes de trânsito de veículos a motor, envenenamento/intoxicação e outros tipos de acidentes) em grupos populacionais de brancos, negros e hispânicos de ambos os sexos divididos em quatro faixas etárias: 15-19, 20-34, 35-54 e 55-74 anos. Resultados. As taxas de mortalidade nos grupos étnico-raciais variaram segundo sexo, idade e causa de lesão. Houve um aumento recente na mortalidade por lesões acidentais nos sexos masculino e feminino, sendo mais acentuado no sexo masculino e por envenenamento/intoxicação em todos os grupos étnicos-raciais de ambos os sexos. A população branca apresentou as maiores taxas de mortalidade por envenenamento/intoxicação e o aumento mais acentuado na mortalidade em ambos os sexos, exceto por homens negros de 55-74 anos. Ocorreu também um aumento da mortalidade por acidentes de trânsito de veículos a motor em todos os grupos étnico-raciais, sendo mais acentuado em negros, e a mortalidade na população hispânica foi menor que em brancos ou negros. As taxas de mortalidade por outros tipos de acidentes foram semelhantes em todos os grupos, exceto em mulheres brancas acima de 55 anos que apresentaram taxas elevadas. Conclusões. Os dados analisados indicam que, apesar de a mortalidade por lesões acidentais por acidentes de trânsito de veículos a motor e envenenamento/intoxicação estar aumentando em ambos os sexos e na maioria das faixas etárias, em comparação a brancos e hispânicos, os negros possivelmente sofrem um ônus desproporcional de mortalidade por acidentes de trânsito e envenenamento/intoxicação no grupo acima de 55 anos que pode estar associada ao uso de substâncias químicas.

Road traffic injuries and substance use among emergency department patients in the Dominican Republic and Peru / Traumatismos causados por el tránsito y consumo de sustancias psicoactivas en pacientes del departamento de urgencias en Perú y República Dominicana / Lesões por acidentes de trânsito e uso de substâncias químicas em pacientes que deram entrada no setor de emergência na República Dominicana e Peru

ABSTRACT Objective. To report demographic and substance use characteristics and risk of road traffic injury (RTI) from alcohol use, cannabis use, and combined use in a sample of emergency department patients from two countries in Latin America and the Caribbean. Methods. A cross-sectional study in which patients 18 years and older admitted within six hours of suffering an RTI to one emergency department in Santa Domingo, Dominican Republic (n = 501) and in Lima, Peru (n = 431) were interviewed. Case-crossover analysis, based on self-reported use prior to the RTI, was used to analyze risk from alcohol, cannabis, and co-use. Results. Overall, 15.3% reported alcohol use prior to the event and 2.5% cannabis use. Drivers using alcohol only were over twice as likely to have an RTI (OR = 2.46, p < 0.001), and nearly eight times more likely if using both alcohol and cannabis (OR = 6.89, p < 0.01), but risk was not elevated for cannabis alone. Significant differences were not found for passengers or pedestrians. Conclusions. Risk of RTI for drivers in these two samples is significantly elevated from alcohol use, and more so for co-use with cannabis. Differences between the two countries underscore the need for similar data from the region to determine risk of RTI from substance use, including risk for passengers and pedestrians. Data suggest that alcohol contributes significantly to the burden of RTI, which calls for more stringent enforcement of alcohol control policy related to drink driving in the region.

RESUMEN Objetivo. Presentar las características demográficas y de consumo de sustancias psicoactivas y el riesgo de traumatismos causados por el tránsito debidos al consumo de alcohol, cannabis y su consumo combinado en una muestra de pacientes del departamento de urgencias de dos países de América Latina y el Caribe. Métodos. Se realizó un estudio transversal en que se entrevistaron pacientes de 18 años o más ingresados en las siguientes seis horas de haber recibido traumatismos causados por el tránsito en un departamento de urgencias en Lima (Perú) (n = 431) y en Santo Domingo (República Dominicana) (n = 501). Se empleó el análisis de cruce de casos, basado en el consumo autoinformado con anterioridad a los traumatismos causados por el tránsito, para evaluar el riesgo por consumo de alcohol, cannabis y consumo combinado. Resultados. En términos generales, 15,3% notificó consumo de alcohol con anterioridad al evento y 2,5%, consumo de cannabis. Los conductores que consumieron alcohol únicamente tuvieron más del doble de probabilidades de sufrir traumatismos causados por el tránsito (OR = 2,46, p < 0,001) y casi ocho veces más probabilidades si consumieron tanto alcohol como cannabis (OR = 6,89, p < 0,01), si bien el riesgo no fue tan elevado para el consumo único de cannabis. No se encontraron diferencias significativas en pasajeros o peatones. Conclusiones. El riesgo de sufrir traumatismos causados por el tránsito para los conductores en estas dos muestras es significativamente más elevado por el consumo de alcohol y más aún por el consumo combinado con cannabis. Las diferencias entre ambos países ponen de manifiesto la necesidad de obtener datos similares sobre la región para determinar el riesgo de sufrir traumatismos causados por el tránsito debidos al consumo de sustancias psicoactivas, así como el riesgo para pasajeros y peatones. Los datos indican que el alcohol agrava significativamente la carga de los traumatismos causados por el tránsito, lo que exige un cumplimiento más estricto de las políticas de control del alcohol relacionadas con la conducción bajo los efectos del alcohol en la región.

RESUMO Objetivo. Descrever as características demográficas e uso de substâncias químicas e o risco de lesões por acidentes de trânsito associados ao consumo de álcool, uso de cannabis (maconha) e uso combinado de álcool e cannabis em uma amostra de pacientes que deram entrada no setor de emergência em dois países da América Latina e no Caribe. Métodos. Estudo transversal em que foram entrevistados pacientes maiores de 18 anos que deram entrada no setor de emergência no espaço de seis horas após sofrerem lesões por acidentes de trânsito em Santo Domingo, na República Dominicana (n = 501), e em Lima, Peru (n = 431). Foi realizada uma análise cruzada de casos com dados obtidos do autorrelato do uso de substâncias químicas anterior ao acidente de trânsito para avaliar o risco associado ao consumo de álcool, uso de cannabis e uso combinado. Resultados. Dos pacientes entrevistados, 15,3% relataram consumo de álcool e 2,5% referiram uso de cannabis antes do acidente. Os condutores que fizeram uso de álcool tiveram uma chance duas vezes maior de ter lesões por acidente de trânsito (OR = 2,46, p < 0,001) e uma chance de cerca de oito vezes maior com o uso combinado de álcool e cannabis (OR = 6,89, p < 0,01). Porém, o risco não foi elevado com o uso somente de cannabis. Não foram observadas diferenças significativas no risco para passageiros ou pedestres. Conclusões. Verificou-se que o risco de lesões por acidentes de trânsito para os condutores nas duas amostras estudadas foi significativamente elevado com o consumo de álcool e foi ainda maior com o uso combinado de álcool e cannabis. As diferenças entre os dois países reforçam a necessidade de dados semelhantes da Região para determinar o risco de lesões por acidentes de trânsito com o uso de substâncias químicas, inclusive para determinar o risco para passageiros e pedestres. Os dados indicam que o álcool contribui significativamente à carga de lesões por acidentes de trânsito requerendo o cumprimento mais rigoroso da política de controle do consumo de álcool associado à condução de veículos na Região.

Characteristics of root-cultivable endophytic fungi from Rhododendron ovatum Planch.

Ericoid mycorrhiza can improve the competitiveness of their host plants at the ecosystem level. The ability of ericoid mycorrhizal fungi to thrive under harsh environmental conditions suggests that they are capable of decomposing plant organic matter. This study aims to characterize 2 strains of root-cultivable endophytic fungi, RooDK1 and RooDK6, from Rhododendron ovatum Planch using colony and hyphal morphology, molecular analysis, observations of mycorrhiza, and investigations of adaptation to different sources of organic matter. Nitrogen utilization was also investigated by assessing protease production and growth on different nitrogen sources. Morphological studies indicated that both species are ericoid mycorrhizal fungi; our molecular studies confirmed RooDK1 as Oidiodendron maius and classified RooDK6 as Pezicula ericae. We observed that only RooDK1 can assist in host plant survival by degrading organic matter. This species also secretes protease and has the highest nitrate reductase activity of these 2 endophytes. Thus, RooDK1 has a greater ability to help the host plants thrive in a harsh habitat.

Multi-level analysis of alcohol-related injury, societal drinking pattern and alcohol control policy: emergency department data from 28 countries.

BACKGROUND AND AIMS: Societal-level volume and pattern of drinking and alcohol control policy have received little attention in the alcohol and injury literature. The aim of this study was to estimate the association between alcohol-related injury, individual-level drinking variables, country-level detrimental drinking pattern and alcohol policy. DESIGN: Probability samples of emergency department (ED) patients from the International Collaborative Alcohol and Injury Study (ICAIS), which includes four collaborative ED studies on alcohol and injury, all using a similar methodology, were analyzed with multi-level modeling of individual-level drinking variables and aggregate-level variables (country drinking pattern and alcohol policy) on alcohol-related injury in 33 ED studies. SETTING: Sixty-two emergency departments in 28 countries covering five regions. PARTICIPANTS: A total of 14 390 injured patients arriving to the ED within 6 hours following injury. MEASURES: Alcohol-related injuries (self-reported drinking prior to the event and causal attribution of injury to drinking) were analyzed in relation to individual-level volume and pattern of drinking, study-level alcohol volume, country detrimental drinking pattern (DDP) and an alcohol policy measure, the International Alcohol Policy and Injury Index (IAPII). The IAPII includes four regulatory domains: availability, vehicular, advertising and drinking context. FINDINGS: Controlling for demographic characteristics, individual-level drinking and study-level volume, the IAPII was associated significantly with the proportion of both self-reported drinking [confidence interval (CI) = 0.97-0.99; P < 0.001] and causal attribution (CI = 0.97-0.99; P < 0.01) and DDP had little effect on these associations. All four domains were significantly predictive of self-reported drinking [availability (CI = 0.93-0.98, P < 0.01); vehicular (CI = 0.91-0.97, P < 0.001); advertising CI = 0.82-0.94, P < 0.01); and context (CI = 0.93-0.99, P < 0.01], while only the vehicular domain was significantly predictive of causal attribution (CI = 0.92-0.99; P < 0.05). CONCLUSIONS: The more restrictive the alcohol policy in a country, the lower the rate of alcohol-related injury, with country-level drinking pattern having little effect on this relationship.

Development of the International Alcohol Policy and Injury Index

[ABSTRACT]. Objective. To develop a new index to measure the effectiveness of alcohol control policies on selected indicators of alcohol-related injuries. Methods. We used the World Health Organization Global Information System on Alcohol and Health (GISAH) for cross-sectional data from 156 countries for this analysis. Five policy domains were selected: physical availability, drinking context, pricing, advertising, and vehicular. Injury mortality and alcohol-attributable fractions (AAFs) for vehicular deaths were also used for the same countries. We created a new composite indicator, the International Alcohol Policy Injury Index (IAPII), in order to assess the association between policy and deaths due to alcohol-related injury. Results. After we controlled for per-capita alcohol consumption, we found that injury deaths and AAF deaths were inversely associated with four of the five policy domains. The domains were weighted according to effectiveness and used to construct the IAPII, which produced acceptable sensitivity and specificity. Regression results, controlling for consumption, demonstrated that the IAPII was significantly associated with AAF vehicular injury death for males, AAF vehicular injury death for females, and overall injury death at p < 0.01. Conclusions. Our findings support the IAPII as a reliable indicator of the relationship between alcohol policies and injury deaths: the stronger the policy, the less the likelihood of both overall and vehicular injury death. Future work should test the effectiveness of the IAPII in reducing alcohol-related injury morbidity, which accounts for a larger share of the global burden of disease than alcohol-related injury mortality does.

[RESUMEN]. Objetivo. Elaborar un nuevo índice para medir la eficacia de las políticas de control del consumo de alcohol sobre la base de indicadores seleccionados de traumatismos relacionados con el alcohol. Métodos. En este análisis, utilizamos el Sistema Mundial de Información sobre el Alcohol y la Salud de la Organización Mundial de la Salud (GISAH) a fin de obtener datos transversales de 156 países. Se seleccionaron cinco ámbitos normativos: disponibilidad de bebidas alcohólicas, contexto del consumo de alcohol, precios, publicidad y conducción de vehículos. También se usaron datos de mortalidad por traumatismos y de “fracciones atribuibles al alcohol” de las defunciones causadas por el tránsito de los mismos países. Creamos un nuevo indicador compuesto, el índice internacional de políticas en materia de alcohol y traumatismos (IIPAL), a fin de evaluar la asociación entre la política y las muertes por traumatismos relacionados con el consumo de alcohol. Resultados. Después de controlar la variable de consumo de alcohol per cápita, observamos que las muertes por traumatismos y las “fracciones atribuibles al alcohol” de las muertes se asociaban inversamente con cuatro de los cinco ámbitos normativos. Los ámbitos se ponderaron según la eficacia y se usaron para construir el nuevo índice, con una sensibilidad y especificidad aceptables. Los resultados de la regresión, con control del consumo de alcohol, mostraron que el índice se asociaba significativamente con la “fracción atribuible al alcohol” de muertes de hombres por traumatismos provocados por el tránsito, la “fracción atribuible al alcohol” de muertes de mujeres por traumatismos provocados por el tránsito y las muertes de personas de ambos sexos por traumatismos (p < 0,01). Conclusiones. Nuestros resultados indican que el IIPAL es un indicador fiable de la relación entre las políticas en materia de alcohol y las muertes por traumatismos: cuanto más restrictiva la política, menor probabilidad de muertes por traumatismos en general y de muertes por traumatismos debidas al tránsito. Los futuros trabajos deberían verificar la eficacia de este índice para reducir la morbilidad por traumatismos relacionados con el alcohol, que constituyen una proporción mayor de la carga de enfermedad mundial que la mortalidad por traumatismos relacionados con el alcohol.

[RESUMO]. Objetivo. Desenvolver um novo índice para medir a efetividade das políticas de controle do uso de álcool em indicadores selecionados de lesões relacionadas ao uso de álcool. Métodos. O Sistema Global de Informação sobre Álcool e Saúde (GISAH) da Organização Mundial da Saúde (OMS) foi usado para obter dados transversais de 156 países para esta análise. Foram selecionados cinco domínios de políticas: disponibilidade física, contexto relacionado ao uso de álcool, determinação de preços, publicidade e acidentes de trânsito. A mortalidade por lesões e a fração atribuível ao álcool (FAA) para mortes por acidentes de trânsito também foram usadas para os mesmos países. Foi criado um novo indicador composto, o índice de lesões da Política Internacional de Álcool (IAPII), para avaliar a associação entre política e mortes decorrentes de lesões relacionadas ao uso de álcool. Resultados. Após o controle do consumo de álcool per capita, foi verificado que as mortes por lesões e a mortalidade atribuível ao consumo de álcool apresentavam associação inversa com quatro dos cinco domínios de políticas. Os domínios foram ponderados segundo efetividade e usados para construir o IAPII, que demonstrou ter sensibilidade e especificidade aceitáveis. Os resultados da análise de regressão, após controlado o consumo de álcool, revelaram uma associação significativa do IAPII com mortalidade por acidentes de trânsito atribuível ao álcool no sexo masculino, mortalidade por acidentes de trânsito atribuível ao álcool no sexo feminino e morte decorrentes de lesões em geral (p < 0,01). Conclusões. Os achados desta análise respaldam o IAPII como um indicador confiável da relação entre as políticas de álcool e mortes decorrentes de lesões: quanto mais sólida a política, menor a probabilidade de mortes por acidentes de trânsito ou em geral. Outros estudos devem avaliar a efetividade do IAPII em reduzir a morbidade por lesões relacionadas ao uso de álcool, que representa uma parcela maior da carga global da doença que a mortalidade por lesões relacionadas ao álcool.

Risk of violence-related injury from alcohol consumption and its burden to society in Latin America and the Caribbean

[ABSTRACT]. Objective. To determine the relative risk (RR) and societal burden of injury related to alcohol-attributable intentional interpersonal violence (alcohol-attributable fraction or AAF), and the dose–response relationship, in Latin America and the Caribbean (LAC), where both the RR and AAF for violence-related injuries are believed to be particularly high. Methods. A probability sample of 1 024 emergency department patients from 10 LAC countries who reported an intentional interpersonal violence–related injury (IVRI) was analyzed using case-crossover fractional polynomial analysis of the number of drinks consumed prior to the event. Results. A dose–response relationship with a sixfold increase in risk (RR = 5.6) for up to two drinks prior to injury was observed. Risk was higher for 1) females versus males at more than 10 drinks and 2) males and females 30+ years old versus those younger than 30 at all volume levels. Overall, 32.7% of the 1 024 intentional IVRIs were attributable to alcohol. The AAF was three times larger for males (38%) than for females (12.3%). Conclusions. A dose–response relationship between the volume of alcohol consumed prior to the event and the risk of intentional IVRI was found. Risk was not uniform across gender or age. Females were at greater risk of injury compared to males at higher volumes of drinking but had a lower AAF due to their lower prevalence of drinking at higher levels.

[RESUMEN]. Objetivo. Determinar el riesgo relativo (RR) de la carga social de los traumatismos relacionados con actos de violencia interpersonal intencional atribuibles al alcohol (fracción atribuible al alcohol o AAF) y la relación dosis-efecto en América Latina y el Caribe, donde se cree que tanto el RR como la AAF por traumatismos relacionados con la violencia son particularmente altos. Métodos. Se estudió una muestra probabilística de 1 024 pacientes que ingresaron al servicio de urgencias de 10 países de América Latina y el Caribe y que declararon un traumatismo relacionado con un acto de violencia interpersonal (IVRI) intencional, usando para ello un análisis polinomial fraccionario con cruce de casos del número de bebidas consumidas antes del incidente. Resultados. Se observó una relación dosis-efecto con un aumento de seis veces el riesgo (RR = 5,6) con hasta dos bebidas antes del traumatismo. El riesgo fue mayor para: 1) las mujeres respecto de los hombres con más de 10 bebidas y 2) los hombres y mujeres mayores de 30 años de edad frente a los menores de 30 años en todos los niveles de volumen. En términos generales, 32,7% de los 1 024 IVRI intencionales fueron atribuibles al alcohol. La AAF fue tres veces mayor para los hombres (38%) que para las mujeres (12,3%). Conclusiones. Se observó una relación dosis-efecto entre el volumen de alcohol consumido antes del incidente y el riesgo de IVRI intencional. El riesgo no fue uniforme entre los dos sexos ni en todas las edades. Las mujeres tuvieron un riesgo mayor de traumatismo en comparación con los hombres a volúmenes mayores de consumo, pero tuvieron una AAF más baja debido a una prevalencia más baja del consumo de alcohol en mayores cantidades.

[RESUMO]. Objetivo. Determinar o risco relativo (RR) e o ônus à sociedade de lesões intencionais resultantes da violência interpessoal atribuível ao uso de álcool (fração de risco atribuível ao consumo de álcool, FAA) e a relação de dose-resposta na América Latina e no Caribe (ALC). Acredita-se que o RR e a FAA de lesões resultantes da violência sejam particularmente altos na região. Métodos. Foi estudada uma amostra probabilística englobando 1.024 pacientes atendidos no setor de emergência de 10 países da ALC por lesão intencional resultante de violência interpessoal (LIVI). Foi realizado um estudo de caso-cruzado com análise polinomial fracionada do número de doses de bebida alcoólica consumidas antes do evento. Resultados. Verificou-se uma relação de dose-resposta com aumento do risco de seis vezes (RR = 5,6) associado a duas doses ou menos de bebida alcoólica consumidas antes da ocorrência das lesões. O risco foi maior: 1) no sexo feminino em comparação ao masculino com o consumo acima de 10 doses de bebida alcoólica e 2) em indivíduos do sexo masculino e feminino com acima de 30 anos em comparação aos indivíduos com idade abaixo de 30 anos em todos os níveis de consumo. De modo geral, 32,7% das 1.024 LIVI foram atribuíveis ao consumo de álcool. A FAA foi três vezes maior no sexo masculino (38%) que no feminino (12,3%). Conclusões. Observou-se uma relação de dose-resposta entre o nível de consumo de álcool antes do evento e o risco de LIVI. O risco variou por sexo ou idade. Em comparação aos homens, as mulheres apresentaram maior risco de lesão nos níveis mais elevados de consumo de álcool, porém com FAA menor devido à baixa prevalência do consumo de álcool nestes níveis.

Risk of violence-related injury from alcohol consumption and its burden to society in Latin America and the Caribbean / Riesgo de traumatismos relacionados con la violencia producto del consumo de alcohol y su carga social en América Latina y el Caribe / Risco de lesões resultantes da violência associada ao uso de álcool e o ônus à sociedade na América Latina e no Caribe

ABSTRACT Objective To determine the relative risk (RR) and societal burden of injury related to alcohol-attributable intentional interpersonal violence (alcohol-attributable fraction or AAF), and the dose-response relationship, in Latin America and the Caribbean (LAC), where both the RR and AAF for violence-related injuries are believed to be particularly high. Methods A probability sample of 1 024 emergency department patients from 10 LAC countries who reported an intentional interpersonal violence-related injury (IVRI) was analyzed using case-crossover fractional polynomial analysis of the number of drinks consumed prior to the event. Results A dose-response relationship with a sixfold increase in risk (RR = 5.6) for up to two drinks prior to injury was observed. Risk was higher for 1) females versus males at more than 10 drinks and 2) males and females 30+ years old versus those younger than 30 at all volume levels. Overall, 32.7% of the 1 024 intentional IVRIs were attributable to alcohol. The AAF was three times larger for males (38%) than for females (12.3%). Conclusions A dose-response relationship between the volume of alcohol consumed prior to the event and the risk of intentional IVRI was found. Risk was not uniform across gender or age. Females were at greater risk of injury compared to males at higher volumes of drinking but had a lower AAF due to their lower prevalence of drinking at higher levels.

RESUMEN Objetivo Determinar el riesgo relativo (RR) de la carga social de los traumatismos relacionados con actos de violencia interpersonal intencional atribuibles al alcohol (fracción atribuible al alcohol o AAF) y la relación dosis-efecto en América Latina y el Caribe, donde se cree que tanto el RR como la AAF por traumatismos relacionados con la violencia son particularmente altos. Métodos Se estudió una muestra probabilística de 1 024 pacientes que ingresaron al servicio de urgencias de 10 países de América Latina y el Caribe y que declararon un traumatismo relacionado con un acto de violencia interpersonal (IVRI) intencional, usando para ello un análisis polinomial fraccionario con cruce de casos del número de bebidas consumidas antes del incidente. Resultados Se observó una relación dosis-efecto con un aumento de seis veces el riesgo (RR = 5,6) con hasta dos bebidas antes del traumatismo. El riesgo fue mayor para: 1) las mujeres respecto de los hombres con más de 10 bebidas y 2) los hombres y mujeres mayores de 30 años de edad frente a los menores de 30 años en todos los niveles de volumen. En términos generales, 32,7% de los 1 024 IVRI intencionales fueron atribuibles al alcohol. La AAF fue tres veces mayor para los hombres (38%) que para las mujeres (12,3%). Conclusiones Se observó una relación dosis-efecto entre el volumen de alcohol consumido antes del incidente y el riesgo de IVRI intencional. El riesgo no fue uniforme entre los dos sexos ni en todas las edades. Las mujeres tuvieron un riesgo mayor de traumatismo en comparación con los hombres a volúmenes mayores de consumo, pero tuvieron una AAF más baja debido a una prevalencia más baja del consumo de alcohol en mayores cantidades.

RESUMO Objetivo Determinar o risco relativo (RR) e o ônus à sociedade de lesões intencionais resultantes da violência interpessoal atribuível ao uso de álcool (fração de risco atribuível ao consumo de álcool, FAA) e a relação de dose-resposta na América Latina e no Caribe (ALC). Acredita-se que o RR e a FAA de lesões resultantes da violência sejam particularmente altos na região. Métodos Foi estudada uma amostra probabilística englobando 1.024 pacientes atendidos no setor de emergência de 10 países da ALC por lesão intencional resultante de violência interpessoal (LIVI). Foi realizado um estudo de caso-cruzado com análise polinomial fracionada do número de doses de bebida alcoólica consumidas antes do evento. Resultados Verificou-se uma relação de dose-resposta com aumento do risco de seis vezes (RR = 5,6) associado a duas doses ou menos de bebida alcoólica consumidas antes da ocorrência das lesões. O risco foi maior: 1) no sexo feminino em comparação ao masculino com o consumo acima de 10 doses de bebida alcoólica e 2) em indivíduos do sexo masculino e feminino com acima de 30 anos em comparação aos indivíduos com idade abaixo de 30 anos em todos os níveis de consumo. De modo geral, 32,7% das 1.024 LIVI foram atribuíveis ao consumo de álcool. A FAA foi três vezes maior no sexo masculino (38%) que no feminino (12,3%). Conclusões Observou-se uma relação de dose-resposta entre o nível de consumo de álcool antes do evento e o risco de LIVI. O risco variou por sexo ou idade. Em comparação aos homens, as mulheres apresentaram maior risco de lesão nos níveis mais elevados de consumo de álcool, porém com FAA menor devido à baixa prevalência do consumo de álcool nestes níveis.

Development of the International Alcohol Policy and Injury Index / Formulación de un índice internacional de políticas en materia de alcohol y traumatismos / Elaboração da Política Internacional de Álcool e do índice de lesões

ABSTRACT Objective To develop a new index to measure the effectiveness of alcohol control policies on selected indicators of alcohol-related injuries. Methods We used the World Health Organization Global Information System on Alcohol and Health (GISAH) for cross-sectional data from 156 countries for this analysis. Five policy domains were selected: physical availability, drinking context, pricing, advertising, and vehicular. Injury mortality and alcohol-attributable fractions (AAFs) for vehicular deaths were also used for the same countries. We created a new composite indicator, the International Alcohol Policy Injury Index (IAPII), in order to assess the association between policy and deaths due to alcohol-related injury. Results After we controlled for per-capita alcohol consumption, we found that injury deaths and AAF deaths were inversely associated with four of the five policy domains. The domains were weighted according to effectiveness and used to construct the IAPII, which produced acceptable sensitivity and specificity. Regression results, controlling for consumption, demonstrated that the IAPII was significantly associated with AAF vehicular injury death for males, AAF vehicular injury death for females, and overall injury death at p < 0.01. Conclusions Our findings support the IAPII as a reliable indicator of the relationship between alcohol policies and injury deaths: the stronger the policy, the less the likelihood of both overall and vehicular injury death. Future work should test the effectiveness of the IAPII in reducing alcohol-related injury morbidity, which accounts for a larger share of the global burden of disease than alcohol-related injury mortality does.

RESUMEN Objetivo Elaborar un nuevo índice para medir la eficacia de las políticas de control del consumo de alcohol sobre la base de indicadores seleccionados de traumatismos relacionados con el alcohol. Métodos En este análisis, utilizamos el Sistema Mundial de Información sobre el Alcohol y la Salud de la Organización Mundial de la Salud (GISAH) a fin de obtener datos transversales de 156 países. Se seleccionaron cinco ámbitos normativos: disponibilidad de bebidas alcohólicas, contexto del consumo de alcohol, precios, publicidad y conducción de vehículos. También se usaron datos de mortalidad por traumatismos y de "fracciones atribuibles al alcohol" de las defunciones causadas por el tránsito de los mismos países. Creamos un nuevo indicador compuesto, el índice internacional de políticas en materia de alcohol y traumatismos (IIPAL), a fin de evaluar la asociación entre la política y las muertes por traumatismos relacionados con el consumo de alcohol. Resultados Después de controlar la variable de consumo de alcohol per cápita, observamos que las muertes por traumatismos y las "fracciones atribuibles al alcohol" de las muertes se asociaban inversamente con cuatro de los cinco ámbitos normativos. Los ámbitos se ponderaron según la eficacia y se usaron para construir el nuevo índice, con una sensibilidad y especificidad aceptables. Los resultados de la regresión, con control del consumo de alcohol, mostraron que el índice se asociaba significativamente con la "fracción atribuible al alcohol" de muertes de hombres por traumatismos provocados por el tránsito, la "fracción atribuible al alcohol" de muertes de mujeres por traumatismos provocados por el tránsito y las muertes de personas de ambos sexos por traumatismos (p < 0,01). Conclusiones Nuestros resultados indican que el IIPAL es un indicador fiable de la relación entre las políticas en materia de alcohol y las muertes por traumatismos: cuanto más restrictiva la política, menor probabilidad de muertes por traumatismos en general y de muertes por traumatismos debidas al tránsito. Los futuros trabajos deberían verificar la eficacia de este índice para reducir la morbilidad por traumatismos relacionados con el alcohol, que constituyen una proporción mayor de la carga de enfermedad mundial que la mortalidad por traumatismos relacionados con el alcohol.

RESUMO Objetivo Desenvolver um novo índice para medir a efetividade das políticas de controle do uso de álcool em indicadores selecionados de lesões relacionadas ao uso de álcool. Métodos O Sistema Global de Informação sobre Álcool e Saúde (GISAH) da Organização Mundial da Saúde (OMS) foi usado para obter dados transversais de 156 países para esta análise. Foram selecionados cinco domínios de políticas: disponibilidade física, contexto relacionado ao uso de álcool, determinação de preços, publicidade e acidentes de trânsito. A mortalidade por lesões e a fração atribuível ao álcool (FAA) para mortes por acidentes de trânsito também foram usadas para os mesmos países. Foi criado um novo indicador composto, o índice de lesões da Política Internacional de Álcool (IAPII), para avaliar a associação entre política e mortes decorrentes de lesões relacionadas ao uso de álcool. Resultados Após o controle do consumo de álcool per capita, foi verificado que as mortes por lesões e a mortalidade atribuível ao consumo de álcool apresentavam associação inversa com quatro dos cinco domínios de políticas. Os domínios foram ponderados segundo efetividade e usados para construir o IAPII, que demonstrou ter sensibilidade e especificidade aceitáveis. Os resultados da análise de regressão, após controlado o consumo de álcool, revelaram uma associação significativa do IAPII com mortalidade por acidentes de trânsito atribuível ao álcool no sexo masculino, mortalidade por acidentes de trânsito atribuível ao álcool no sexo feminino e morte decorrentes de lesões em geral (p < 0,01). Conclusões Os achados desta análise respaldam o IAPII como um indicador confiável da relação entre as políticas de álcool e mortes decorrentes de lesões: quanto mais sólida a política, menor a probabilidade de mortes por acidentes de trânsito ou em geral. Outros estudos devem avaliar a efetividade do IAPII em reduzir a morbidade por lesões relacionadas ao uso de álcool, que representa uma parcela maior da carga global da doença que a mortalidade por lesões relacionadas ao álcool.

A simple and rapid identification method for newly emerged porcine Deltacoronavirus with loop-mediated isothermal amplification.

BACKGROUND: Porcine Deltacoronavirus (PDCoV) is a newly emerged enteropathogenic coronavirus that causes diarrhea and mortality in neonatal piglets. PDCoV has spread to many countries around the world, leading to significant economic losses in the pork industry. Therefore, a rapid and sensitive method for detection of PDCoV in clinical samples is urgently needed. RESULTS: In this study, we developed a single-tube one-step reverse transcription loop-mediated isothermal amplification (RT-LAMP) assay specific for nucleocapsid gene to diagnose and monitor PDCoV infections. The detection limit of RT-LAMP assay was 1 × 101 copies of PDCoV, which was approximately 100-fold more sensitive than gel-based one-step reverse transcription polymerase chain reaction (RT-PCR). This assay could specifically amplify PDCoV and had no cross amplification with porcine epidemic diarrhea virus (PEDV), transmissible gastroenteritis virus (TGEV), porcine kobuvirus (PKoV), porcine astrovirus (PAstV), porcine reproductive and respiratory syndrome virus (PRRSV), classic swine fever virus (CSFV), and porcine circovirus type 2 (PCV2). By screening a panel of clinical specimens (N = 192), this method presented a similar sensitivity with nested RT-PCR and was 1-2 log more sensitive than conventional RT-PCR in detection of PDCoV. CONCLUSIONS: The RT-LAMP assay established in this study is a potentially valuable tool, especially in low-resource laboratories and filed settings, for a rapid diagnosis, surveillance, and molecular epidemiology investigation of PDCoV infections. To the best of our knowledge, this is the first work for detection of newly emerged PDCoV with LAMP technology.

Alcohol and Road Traffic Injuries in Latin America and the Caribbean: A Case-Crossover Study.

BACKGROUND: This study reports dose-response estimates for the odds ratio (OR) and population attributable risk of acute alcohol use and road traffic injury (RTI). METHODS: Data were analyzed on 1,119 RTI patients arriving at 16 emergency departments (EDs) in Argentina, Brazil, Costa Rica, Dominican Republic, Guatemala, Guyana, Mexico, Nicaragua, Panama, and Trinidad and Tobago. Case-crossover analysis, pair-matching the number of standard drinks consumed within the 6 hours prior to the RTI with 2 control periods (prior d/wk), was performed using fractional polynomial analysis for dose-response. RESULTS: About 1 in 6 RTI patients in EDs were positive for self-reported alcohol 6 hours prior to the injury (country range 8.6 to 24.1%). The likelihood of an RTI with any drinking prior (compared to not drinking) was 5 times higher (country range OR 2.50 to 15.00) and the more a person drinks the higher the risk. Every drink (12.8 g alcohol) increased the risk of an RTI by 13%, even 1 to 2 drinks were associated with a sizable increase in risk of an RTI and a dose-response was found. Differences in ORs for drivers (OR = 3.51; 95% CI = 2.25 to 5.45), passengers (OR = 8.12; 95% CI = 4.22 to 15.61), and pedestrians (OR = 6.30; 95% CI = 3.14 to 12.64) and attributable fractions were noted. Acute use of alcohol was attributable to 14% of all RTIs, varying from 7% for females to 19% for being injured as a passenger. CONCLUSIONS: The finding that the presence of alcohol increases risk among drivers and nondrivers alike may further help to urge interventions targeting passengers and pedestrians. Routine screening and brief interventions in all health services could also have a beneficial impact in decreasing rates of RTIs. Higher priority should be given to alcohol as a risk factor for RTIs, particularly in Latin America and the Caribbean.

Alcohol Use Patterns and DSM-5 Alcohol Use Disorder on Both Sides of the U.S.-Mexico Border.

BACKGROUND: Alcohol consumption patterns on the U.S.-Mexico border and their relationships with DSM-5 alcohol use disorders (AUD) have been understudied. Yet, the effects of drinking by Mexican-origin individuals may differ between cities on versus off the border both in the United States and in Mexico. We characterize prior 12-month drinking patterns and examine their relationships with AUD, in border and off-border cities of Texas and adjacent Mexican states. METHODS: Data come from the U.S.-Mexico Study of Alcohol and Related Conditions involving 2,336 Mexican Americans in Texas and 2,460 Mexicans in bordering states of Nuevo Leon and Tamaulipas in Mexico. Drinking pattern was defined as an interaction between volume and maximum amount, or intensity (never vs. ever 5+/4+ [men/women], 8+, and 12+ drinks in a day). DSM-5 AUD was assessed using an adaptation of the Alcohol Section of the World Health Organization Composite International Diagnostic Interview core. Separately by gender, 5 logistic regressions models controlling for age were estimated predicting symptoms in 2 or more AUD criteria domains from volume, heavy pattern and, successively, effects of country, and (by country) residing on vs. off the border, or in each of 3 cities/country. RESULTS: A segmentation analysis for Texas males based on rate of experiencing AUD generated several distinct volume groups, each partitioned by an empirically selected maximum, and helped identify a drinking-pattern typology. In gender-stratified models of AUD rates using this typology, adjusting for age, significant volume and intensity effects were seen, more strongly in the United States. Border versus interior differences implied more AUD for given patterns at the border in the United States and the reverse in Mexico, with some city differences also evident. CONCLUSIONS: Drinking-pattern analyses confirm that border proximity may affect drinking problems but in opposite directions in the United States and Mexico, possibly related to economic and psychological stresses specific to respective communities.

Alcohol use among fatally injured victims in São Paulo, Brazil: bridging the gap between research and health services in developing countries.

BACKGROUND AND AIMS: Most studies reporting alcohol use among fatally injured victims are subject to bias, particularly those related to sample selection and to absence of injury context data. We developed a research method to estimate the prevalence of alcohol consumption and test correlates of alcohol use prior to fatal injuries. DESIGN, SETTING AND PARTICIPANTS: Cross-sectional study based on a probability sample of fatally injured adult victims (n = 365) autopsied in São Paulo, Brazil. Victims were sampled within systematically selected 8-hour sampling blocks, generating a representative sample of fatal injuries occurring during all hours of the day for each day of the week between June 2014 and December 2015. MEASUREMENTS: The presence of alcohol and blood alcohol concentration (BAC) were the primary outcomes evaluated according to victims' socio-demographic, injury context data (type, day, time and injury place) and criminal history characteristics. FINDINGS: Alcohol was detected in 30.1% [95% confidence interval (CI) = 25.6-35.1)] of the victims, with a mean blood alcohol level (BAC) level of 0.11% w/v (95% CI = 0.09-0.13) among alcohol-positive cases. Black and mixed race victims presented a higher mean BAC than white victims (P = 0.03). Fewer than one in every six suicides tested positive for alcohol, while almost half of traffic-related casualties were alcohol-positive. Having suffered traffic-related injuries, particularly those involving vehicle crashes, and injuries occurring during weekends and at night were associated significantly with alcohol use before injury (P < 0.05). CONCLUSIONS: Nearly one-third of fatal injuries in São Paulo between June 2014 and December 2015 were alcohol-related, with traffic accidents showing a greater association with alcohol use than other injuries. The sampling methodology tested here, including the possibility of adding injury context data to improve population-based estimates of alcohol use before fatal injury, appears to be a reliable and lower-cost strategy for avoiding biases common in death investigations.

Differences by gender at twelve months in a brief intervention trial among Mexican-origin young adults in the emergency department.

In this study, we investigate the role of gender in prevalence and consequences of binge drinking and brief intervention outcomes among Mexican-origin young adults aged 18-30 years at the U.S.-Mexico border. We conducted a secondary analysis, stratified by gender, from a randomized controlled trial of a brief motivational intervention in a hospital emergency department. Intervention effects for males included reductions in drinking frequency, binge drinking, and alcohol-related consequences. For females the intervention was associated with reduction in drinking frequency and binge drinking but did not have a significant effect on alcohol-related consequences. Results suggest a new direction for tailoring interventions to gender.

A dose-response estimate for acute alcohol use and risk of suicide attempt.

This study reports dose-response estimates for the relative risk and population attributable risk (PAR) between acute alcohol use and serious suicide attempt. Data were analyzed on 272 suicide attempters arriving at 38 emergency departments within 6 hours of the event in 17 countries. Case-crossover analysis, pair-matching the number of standard drinks consumed within the 6 hours prior to the suicide attempt with that consumed during the same 6-hour period of the previous week, was performed using fractional polynomial analysis for dose-response. Every drink increased the risk of a suicide attempt by 30 percent; even one-two drinks was associated with a sizable increase in the risk of a serious suicide attempt, and a dose-response was found for the relationship between drinking 6 hours prior and the risk of a suicide attempt up to 20 drinks. Acute use of alcohol was responsible for 35 percent PAR of all suicide attempts. While very high levels of drinking were associated with larger relative risk s of suicide attempt, the control and reduction of smaller quantities of acute alcohol use also had an impact on population levels of suicide attempt, as showed here for the first time with our PAR estimates. Interventions to stop drinking or at least decrease levels of consumption could reduce the risk of suicide attempt. Screening people more at risk to suffer these acute effects of ethanol and offering interventions that work to these high-risk groups are a matter of urgent new research in the area.

A simple and rapid identification method for newly emerged porcine Deltacoronavirus with loop-mediated isothermal amplification

BACKGROUND: Porcine Deltacoronavirus (PDCoV) is a newly emerged enteropathogenic coronavirus that causes diarrhea and mortality in neonatal piglets. PDCoV has spread to many countries around the world, leading to significant economic losses in the pork industry. Therefore, a rapid and sensitive method for detection of PDCoV in clinical samples is urgently needed. RESULTS: In this study, we developed a single-tube one-step reverse transcription loop-mediated isothermal amplification (RT-LAMP) assay specific for nucleocapsid gene to diagnose and monitor PDCoV infections. The detection limit of RT-LAMP assay was 1 × 101 copies of PDCoV, which was approximately 100-fold more sensitive than gel-based one-step reverse transcription polymerase chain reaction (RT-PCR). This assay could specifically amplify PDCoV and had no cross amplification with porcine epidemic diarrhea virus (PEDV), transmissible gastroenteritis virus (TGEV), porcine kobuvirus (PKoV), porcine astrovirus (PAstV), porcine reproductive and respiratory syndrome virus (PRRSV), classic swine fever virus (CSFV), and porcine circovirus type 2 (PCV2). By screening a panel of clinical specimens (N = 192), this method presented a similar sensitivity with nested RT-PCR and was 1-2 log more sensitive than conventional RT-PCR in detection of PDCoV. CONCLUSIONS: The RT-LAMP assay established in this study is a potentially valuable tool, especially in low-resource laboratories and filed settings, for a rapid diagnosis, surveillance, and molecular epidemiology investigation of PDCoV infections. To the best of our knowledge, this is the first work for detection of newly emerged PDCoV with LAMP technology.

Factors Explaining Variation in Alcohol Use Disorder Prevalence Across Border and Nonborder Communities in Texas.

BACKGROUND: U.S. border populations have been found to be at high risk for alcohol problems. However, results from the U.S.-Mexico Study on Alcohol and Related Conditions (UMSARC) revealed surprisingly large variation in alcohol outcomes even among Texas border sites, with alcohol use disorder (AUD) prevalence ~1.5 to 1.6 times greater in the border city of Laredo compared to both San Antonio and the border site of McAllen/Brownsville. Because a better understanding of this variation is important to identifying environmental influences on AUD, we developed and tested a conceptual model addressing variation in AUD prevalence across Texas UMSARC sites. METHODS: Surveys involved in-person, household interviews with Mexican-origin residents of the Texas border cities Laredo (n = 751) and McAllen/Brownsville (n = 814), with San Antonio as an off-border comparison (n = 771). Interviews assessed past-year DSM-5 AUD; past-year heavy drinking; coping and enhancement motives; and 7 indicators of substance use climate and stress exposure hypothesized to mediate site effects. Analyses, conducted separately by gender, included regressions and structural equation modeling with Mplus. RESULTS: Preliminary analyses revealed that site effects on AUD prevalence were, unexpectedly, exclusive to men, and that Laredan men were similar to McAllen/Brownsville men on demographics, acculturation, and cross-border mobility. However, sites differed dramatically on most of the hypothesized risk factors. Structural equation models confirmed that site effects on AUD were partially mediated via effects of site on indicators of a permissive climate (i.e., permissive drinking norms, high drug availability) and stress exposures (i.e., high exposure to violence/crime, low family support), and via downstream effects on drinking motives and heavy drinking. CONCLUSIONS: Findings of very high rates of past-12-month AUD among Laredan men (35%) suggest the possibility of significant heterogeneity even within demographically similar border areas and underline the need for additional study of the border region. Findings regarding our conceptual model suggest that this model may constitute a useful initial framework for future research on alcohol problems at the border. However, additional research using representative samples is needed to confirm and expand this model to comprehensively address relevant individual and community factors.