A comprehensive database showing quantitative mixing effects related to volume and enthalpy in systems of dibromomethane with alkylalkanoates and with alkanes.

The data presented in this article are part of a very extensive project on studies of solutions of halogenated compounds with alkanes, esters, alcohols, etc. The contribution presented focuses on original data regarding binaries formed by dibromomethane with a set of 21 alkyl esters and with 6 alkanes. The data show a database on changes in volume and on the energy experienced in the mixing processes, with a contribution of more than 900 points (x 1,y E=h E or v E). The provided information is original and was measured in the laboratory at a constant temperature of 298.15 K and atmospheric pressure. Brominated compounds are of interest in various industrial applications, such as pharmaceutical, chemical, agriculture, and others. As these compounds are typically found in solution the information provided has significant value. In addition, scientists use this information for theoretical purposes to develop behavioural theories.

Progesterone promotes Cxcl2-dependent vaginal neutrophil killing by activating cervical resident macrophage-neutrophil crosstalk.

Vaginal infections in women of reproductive age represent a clinical dilemma with significant socio-economic implications. The understanding of mucosal immunity failure during early pathogenic invasions that allow the pathogen to grow and thrive is far from complete. Neutrophils infiltrate most tissues following circadian patterns as part of normal repair, regulation of microbiota, or immune surveillance and become more numerous after infection. Neutrophils are responsible for maintaining vaginal immunity. Specific to the vagina, neutrophils continuously infiltrate at high levels, although during ovulation they retreat to avoid sperm damage and permit reproduction. Here we show that after ovulation, progesterone promotes resident vaginal macrophage-neutrophils crosstalk by up-regulating Yolk sac and early fetal organs (Folr2+ (folate receptor 2)) macrophage Cxcl2 expression, in a Tnfa-monocyte-derived macrophage (Cx3cr1hi MHCIIhi) mediated manner, to activate neutrophils' capacity to eliminate sex-transmitted and opportunistic microorganisms. Indeed, progesterone plays an essential role in conciliating the balance between the commensal microbiota, sperm, and the threat of pathogens: because progesterone not only promotes a flurry of neutrophils but also increases neutrophilic fury to restore immunity after ovulation to thwart pathogenic invasion post-intercourse. Therefore, modest progesterone dysregulations could lead to a suboptimal neutrophilic response, resulting in insufficient mucosal defense and recurrent unresolved infections.

Design, develop, and implement the strategic information system on health, dependence, and healthy aging: an analysis of the Mexican experience.

BACKGROUND: The Decade of Healthy Aging (2021-2030) emerges as a 10 years strategy to improve the lives of older adults, their families, and the communities in which they live. One of the actions defined in this framework is related to improving the measurement, monitoring, and understanding of characteristics, factors, and needs related to aging and health. The aim was to analyze and assess the process of construction and development of the Strategic Information System on Health, Funcional Dependence and Aging (SIESDE, for its acronym in Spanish). SIESDE will provide strategic information in Mexico at the municipal, state, and national levels that support the public policies on healthy aging. METHODS: The system processes and analyzes the data sources of the Health Information Systems and the National System of Statistical and Geographical Information. SIESDE comprises three components: (1) Design, construction, and evaluation of the indicators; (2) storage, management, and visualization, and (3) diffusion and translation of information. RESULTS: A total of 135 indicators were built on seven themes: (1) demographic, socioeconomic, and aging conditions, (2) health, (3) functional dependence, (4) healthy aging, (5) health services, (6) social and physical environments, and (7) complex indicators. CONCLUSIONS: SIESDE is an effective system for providing an overall view of health, aging, and functional dependence.

Cardiac events occurring after allogeneic hematopoietic cell transplantation with post-transplant cyclophosphamide. Study conducted on behalf of the GETH-TC.

This multicenter study investigates the incidence and predictors of cardiac events (CE) following allo-HCT with PTCY in 453 AML patients. CE occurred in 57 (12.3%) patients within a median of 52 days (IQR: 13-289), with day 100 and 5-year cumulative incidences of 7.7% and 13.5%. Early (first 100 days) and late CE occurred at rates of 7.7% and 4.8%. The most prevalent CE were heart failure (n = 18, 31.6%), pericardial complications (n = 16, 28.1%), and arrhythmia (n = 14, 24.6%). The proportions of patients older than 55 years (64.9% vs. 46.1%, P = 0.010), with hypertension (36.8% vs. 18.4%, P = 0.001) and dyslipidemia (28.1% vs. 11.1%, P = 0.001) were higher in patients with CE. Patients undergoing haplo-HCT trend to have more CE (68.4% vs. 56.8%, P = 0.083). The multivariate regression analysis revealed that only hypertension (HR 1.88, P = 0.036) and dyslipidemia (HR 2.20, P = 0.018) were predictors for CE, with no differences according to donor type (haplo-HCT vs. others: HR 1.33, P = 0.323). Among the 57 patients with CE, the mortality rate was 12.2%. Notably, the diagnosis of CE negatively impacted NRM (HR 2.57, P = 0.011) and OS (HR 1.80, P = 0.009), underscoring necessity of aggressively treating cardiovascular risk factors, and implementing post-transplant cardiac monitoring protocols to prevent these complications.

Determining the Best Noninvasive Test for Peripheral Arterial Disease Diagnosis to Predict Diabetic Foot Ulcer Healing in Patients Following Endovascular Revascularization.

BACKGROUND/OBJECTIVES: To analyze the best noninvasive tests prognosis marker in patients with diabetic foot ulcer (DFU) who underwent endovascular revascularization based on clinical outcomes, such as healing rate, time to heal, and free amputation survival after at least a six-month follow-up. METHODS: A multicentric prospective observational study was performed with 28 participants with ischemic or neuroischemic DFU who came to the participant centers and underwent endovascular revascularization between January 2022 and March 2023. Toe systolic pressure (TP), ankle systolic pressure (AP), the ankle brachial pressure index (ABPI), the toe brachial pressure index (TBPI), transcutaneous pressure of oxygen (TcPO2), and skin perfusion pressure (SPP) were evaluated using PeriFlux 6000 System, Perimed, Sweden, before (Visit 0) and four weeks after revascularization (Visit 1). The primary clinical outcome was an evaluation of the clinical evolution of noninvasive tests comparing Visit 0 and Visit 1, estimating the sensitivity for predicting wound healing of noninvasive tests at six months following initial recruitment. RESULTS: After six months, 71.43% (n = 20) of DFU healed, four patients (14.3%) received major amputations, and one (3.5%) died. The two tests that best predicted wound healing after revascularization according to the ROC curve were TcPO2 and TP with sensitivities of 0.89 and 0.70 for the cut-off points of 24 mmHg and 46 mmHg, respectively. CONCLUSIONS: TcPO2 and TP were the two tests that best predicted wound healing in patients who underwent endovascular revascularization. Clinicians should consider the importance of the evaluation of microcirculation in the healing prognosis of patients with diabetic foot ulcers.

Cardiac Events after Allo-HCT in Patients with Acute Myeloid Leukemia. Study Conducted con Behalf of the GETH-TC.

This multicenter study sponsored by GETH-TC aimed to investigate the incidence and predictors of early (within the first 100 days) and late cardiac events (CE) (ECE and LCE) following allo-HCT in AML patients treated with anthracyclines, focusing on exploring the impact of PTCY on cardiac complications and the impact of CE on overall survival (OS) and non-relapse mortality (NRM). 1020 AML patients were included. PTCY was given to 450 (44.1%) adults. Overall, 94 (9.2) patients experienced CE and being arrythmias, pericardial complications, and heart failure the most prevalent ones. ECE occurred in 49 (4.8%) patients in a median of 13 days after allo-HCT, while LCE were diagnosed in 45 (4.4%) patients in a median of 3.6 years after transplant. Using PTCY increased the risk for ECE in multivariate analysis (HR 2.86, P=0.007), but did not not significantly affect the risk for LCE (HR 1.06, P=0.892). The impact of variables on outcomes revealed was investigated using multivariate regression analyses and revealed that the diagnosis of CE significantly decreased the likelihood of OS (HR 1.66, P=0.005) and increased the likelihood of NRM (HR 2.88, P<0.001). Furthermore, despite using PTCY increased the risk for ECE, its administration was found to be beneficial for OS (HR 0.71, P=0.026). The study suggests that while the incidence of CE was relatively low, it significantly impacted mortality. Standard doses of PTCY increased ECE risk but were associated with improved OS. Therefore, implementing protocols to prevent cardiac complications is recommended, considering the widespread adoption of PTCY in allo-HCT.

Update of Modified Version of the Foot Function Index Tool Spanish Version (FFI-Sp), in Patients with Rheumatoid Arthritis: Cross Sectional Study.

Background and Objectives: The Foot Function Index (FFI) is a widely recognized patient-reported outcome measure (PROM) for assessing foot functionality and its impact on quality of life in individuals with rheumatoid arthritis (RA). This study aimed to observe the behavior of the tool in the Spanish population with RA, optimize the tool, and check its functionality. Materials and Methods: A total of 549 RA patients, with a predominant female participation (75.6%). This study involved a comprehensive statistical analysis, leading to a refined version of the FFI for a Spanish-speaking population. Results: The original 23-item FFI was revised, resulting in a 15-item version by excluding items that caused confusion or were considered redundant. This modified version maintained the original's subscales of pain, disability, and activity limitation, but with an adjusted item distribution. The construct validity was confirmed through exploratory factor analysis, demonstrating excellent fit indices (Kaiser-Meyer-Olkin test = 0.926, Bartlett's test of sphericity = 4123.48, p < 0.001). The revised FFI demonstrated good internal consistency (Cronbach's alpha = 0.96) and test-retest reliability (ICC = 0.89). Conclusions: This study highlights the applicability of the FFI in Spanish-speaking RA populations, offering a valid and reliable tool for clinicians and researchers. The modifications enhance the FFI's relevance for RA patients, facilitating better assessment and management of foot-related functional impairments.

Low-Dose Thymoglobulin versus Basiliximab Induction Therapy in Low-Risk Living Related Kidney Transplant Recipients: Three-Year Follow-Up Study.

BACKGROUND: The optimal dose of rabbit anti-thymocyte globulin (r-ATG) in renal transplantation is still under debate. We previously reported that a low-dose r-ATG induction of 3 mg/kg can be used safely and effectively in low-risk kidney transplants with good results in the first year after transplantation compared to basiliximab induction. AIMS: The purpose of this study is to evaluate the long-term impact of this trial of low-dose r-ATG versus basiliximab on post-transplant outcomes (patient and graft survival, biopsy-proven acute rejection incidence [BPAR], infectious complications, and side effects). METHODS: Observational study (three-year follow-up) of a 12-month single-center, open-label RCT in de novo kidney allograft recipients assigned to receive either thymoglobulin or basiliximab before transplantation. RESULTS: Patients in the basiliximab group (BG) underwent more kidney transplant biopsies than patients in the low-dose r-ATG group (TG) (50 vs. 31.8%, p = 0.07). Although the 12-month cumulative incidence of BPAR was lower in BG, by the end of the three-year follow-up period this incidence was higher (22%) than in the low-dose TG (15%) (p = ns). Steroids were withdrawn more frequently in the TG group and sirolimus was most frequently indicated. Graft function and graft survival were higher in the low-dose TG than in the BG at three-year follow-up but not statistically significant. Patient survival was similar between groups (>90%). CONCLUSIONS: These three-year follow-up data confirm the efficacy and favorable safety aspects of the low-dose r-ATG (3 mg/kg) in low-risk kidney transplantation.

Emergent perceptual biases from state-space geometry in trained spiking recurrent neural networks.

A stimulus held in working memory is perceived as contracted toward the average stimulus. This contraction bias has been extensively studied in psychophysics, but little is known about its origin from neural activity. By training recurrent networks of spiking neurons to discriminate temporal intervals, we explored the causes of this bias and how behavior relates to population firing activity. We found that the trained networks exhibited animal-like behavior. Various geometric features of neural trajectories in state space encoded warped representations of the durations of the first interval modulated by sensory history. Formulating a normative model, we showed that these representations conveyed a Bayesian estimate of the interval durations, thus relating activity and behavior. Importantly, our findings demonstrate that Bayesian computations already occur during the sensory phase of the first stimulus and persist throughout its maintenance in working memory, until the time of stimulus comparison.

Targeting plasmid-encoded proteins that contain immunoglobulin-like domains to combat antimicrobial resistance.

Antimicrobial resistance (AMR) poses a significant threat to human health. Although vaccines have been developed to combat AMR, it has proven challenging to associate specific vaccine antigens with AMR. Bacterial plasmids play a crucial role in the transmission of AMR. Our recent research has identified a group of bacterial plasmids (specifically, IncHI plasmids) that encode large molecular mass proteins containing bacterial immunoglobulin-like domains. These proteins are found on the external surface of the bacterial cells, such as in the flagella or conjugative pili. In this study, we show that these proteins are antigenic and can protect mice from infection caused by an AMR Salmonella strain harboring one of these plasmids. Furthermore, we successfully generated nanobodies targeting these proteins, that were shown to interfere with the conjugative transfer of IncHI plasmids. Considering that these proteins are also encoded in other groups of plasmids, such as IncA/C and IncP2, targeting them could be a valuable strategy in combating AMR infections caused by bacteria harboring different groups of AMR plasmids. Since the selected antigens are directly linked to AMR itself, the protective effect extends beyond specific microorganisms to include all those carrying the corresponding resistance plasmids.

The association of the persecutory ideation questionnaire with clinically-relevant and other outcomes: the moderating role of confidence.

One of the most used self-administered instruments to assess persecutory delusions is the Persecutory Ideation Questionnaire (PIQ). Individual differences in PIQ scores are important because they predict the severity of symptoms associated with psychosis-related disorders. The current research demonstrates that PIQ is associated with two new outcomes: Satisfaction with life (Studies 1 and 2) and therapy length needed for hospital discharge (Study 2). Most relevant, we introduce meta-cognitive confidence in one's scale responses as a construct capable of improving the predictive validity of the PIQ. Across two studies, participants from the general population (Study 1) and from a clinical sample (Study 2) completed the PIQ and then reported the confidence in their responses. As expected, the PIQ was associated with satisfaction with life in both cases and duration of therapy required to receive hospital discharge for the clinical sample. Most importantly, confidence further moderated the extent to which the PIQ scores were linked with both outcomes, with greater consistency between the PIQ and the dependent measures obtained for those with higher confidence. Therefore, asking a single item about the confidence associated with responses to the PIQ enhances the association of PIQ scores and relevant consequences across domains.

ProsTAV, a clinically useful test in prostate cancer: an extension study.

PURPOSE: To assess the clinical performance of ProsTAV®, a blood-based test based on telomere associate variables (TAV) measurement, to support biopsy decision-making when diagnosing suspicious prostate cancer (PCa). METHODS: Preliminary data of a prospective observational pragmatic study of patients with prostate-specific antigen (PSA) levels 3-10 ng/ml and suspicious PCa. Results were combined with other clinical data, and all patients underwent prostate biopsies according to each center's routine clinical practice, while magnetic resonance imaging (MRI) before the prostate biopsy was optional. Sensitivity, specificity, positive and negative predicted values, and subjects where biopsies could have been avoided using ProsTAV were determined. RESULTS: The mean age of the participants (n = 251) was 67.4 years, with a mean PSA of 5.90 ng/ml, a mean free PSA of 18.9%, and a PSA density of 0.14 ng/ml. Digital rectal examination was abnormal in 21.1% of the subjects, and according to biopsy, the prevalence of significant PCa was 47.8%. The area under the ROC curve of ProsTAV was 0.7, with a sensitivity of 0.90 (95% CI, 0.85-0.95) and specificity of 0.27 (95% CI, 0.19-0.34). The positive and negative predictive values were 0.53 (95% CI, 0.46-0.60) and 0.74 (95% CI, 0.62-0.87), respectively. ProsTAV could have reduced the biopsies performed by 27% and showed some initial evidence of a putative benefit in the diagnosis pathway combined with MRI. CONCLUSIONS: ProsTAV increases the prediction capacity of significant PCa in patients with PSA between 3 and 10 ng/ml and could be considered a complementary tool to improve the patient diagnosis pathway.

Cross-cultural validation and Spanish translation of the Boston Interview to evaluate severely obese patients seeking metabolic/bariatric surgery.

INTRODUCTION: obesity is a global health problem. Metabolic/Bariatric surgery (MBS) has proven to be one of the most effective methods for treating the most severe forms. However, a thorough evaluation and preparation of people seeking MBS is necessary. In Spain, there are no standardized interviews to carry out the psychosocial assessment of people seeking MBS. The Boston Interview for MBS (BIBS) is a recognized and flexible tool to evaluate the psychosocial factors. OBJECTIVE: to present the process of translation into Spanish and cross-cultural adaptation of the BIBS. MATERIALS AND METHODS: the reverse translation procedure was followed. To validate the translation, a multidisciplinary group of experts was formed. They were asked to rate the clarity of wording and cultural adaptation of the translation items. In addition, the translated interview was used to evaluate 173 patients seeking MBS who rated their satisfaction with the interview experience. RESULTS: the evaluation of the translation by a group of experts was favorable (global mode and median were 3-excellent, IQR of 1). The overall percentage agreement of the adequacy of "cultural adaptation" of the text was 85.8 % (95 % CI, 0.784, 0.932) and of the "clarity of wording" was 84.7 % (95 % CI, 0.7644; 0.9286). Furthermore, it was well accepted by the majority of the patients interviewed (p(50) 10 out of 10). CONCLUSIONS: the Spanish translation of the BIBS is available for the assessment of Spanish-speaking people seeking MBS. It was rated as having good fidelity to the original English version, and was deemed highly satisfactory by patients.

The efficient application of instilling negative pressure wound therapy with a hypochlorous acid-preserved wound cleanser: a case series and practical advice.

BACKGROUND: The use of negative pressure wound therapy with instillation and dwell time (NPWTi-d) has been shown to be effective in removing nonviable tissue, reducing bioburden, and promoting granulation tissue formation in acute and chronic infected wounds. OBJECTIVE: To illustrate the clinical efficacy of the use of pure hypochlorous acid (pHA) antimicrobially preserved wound cleansing solution as the instillation fluid for NPWTi-d (NPWTi-d/pHA) in wound bed preparation in patients with complex wounds. CASE REPORT: The treatment protocol for use of NPWTi-d/pHA in preparing wound beds for final closure is demonstrated in 3 illustrative cases of patients with complex wounds resulting from necrotizing infection and trauma with heavy contamination. All 3 patients developed a healthy-appearing wound bed deemed suitable for primary closure an average of approximately 1 month following initial surgical debridement. CONCLUSION: The cases presented demonstrate the ability of a pHA antimicrobially preserved wound cleansing solution used as the instillation fluid with NPWTi-d to aid in bacterial reduction, mechanical debridement, and promotion of wound healing. Use of NPWTi-d/pHA in these cases of extensive necrotizing infection and posttraumatic injury with heavy contamination allowed for final closure an average of 1 month after initial surgical debridement.

How plant composition in margins influences the assemblage of pests and predators and its effect on biocontrol in melon fields.

Many agricultural landscapes offer few resources for maintaining natural enemy populations and floral plantings have frequently been adopted to enhance biological pest control in crops. However, restored margins may harbour both pests and natural enemies. The aim was to compare the abundance of pests and natural enemies in three types of margins (unmanaged, sown herbaceous floral strips and shrubby hedgerows) as well as in adjacent melon fields. Besides, yield was compared among melon fields as way of testing the effect of the type of margin on biocontrol. The research was carried out during 2 years in twelve melon fields from four different locations in southern Spain. Arthropods were sampled periodically in margins and melon fields by visual inspections and Berlese extraction. Hedgerow and floral strips hosted higher numbers of both pests and predators than unmanaged margins. Besides, hedgerows had a similar or higher number of natural enemies than floral strips but lower number of pests. In just a few occasions, the type of margin had a significant effect on the abundance of pests and natural enemies in melon fields, but rarely there was consistency between the two growing seasons. No differences were found in yield. We hypothesised that the lack of association in the abundances of pests and natural enemies between margins and melon fields could be attributed to the overriding effects of the landscape and/or the internal population dynamics of arthropods in melon fields. Overall, shrubby hedgerows are more recommended than herbaceous floral strips.

Search for small-bowel capsule diagnostic yield optimization conducted through observational analysis. / Búsqueda de optimización de la cápsula endoscópica mediante análisis observacional.

OBJECTIVES: To search for parameters susceptible to optimization when performing capsule endoscopy (CE) in a third level hospital with high volume and experience in this test. PATIENTS AND METHODS: Retrospective observational study, including 1325 CEs performed between 2017 and 2022. Overall diagnostic yield, effective diagnostic yield, by indication, place of request and waiting list, as well as complete examination rate and cleansing degree were analyzed. RESULTS: The overall diagnostic yield was 70.99%, while the effective diagnostic yield was 72.7%. Diagnostic yields varied between 60.2% and 77.9% depending on the indication and between 64.7% and 74.3% depending on the requesting center. The mean waiting list was 101.15 days, with a tendency to worse results when the waiting list was longer. A total of 77.8% of the examinations were complete. Completion rates were lower in patients >70 years of age (p=0.001), as well as in those with gastric transit >60minutes (p=0.000). A total of 77.3% were clean, with debris that did not impede diagnosis being found in 16.9% and debris that did impede diagnosis in 5.8%. There was a relationship, although not significant, between cleansing degree and age. CONCLUSIONS: The diagnostic yields of CE in our center are in line with those previously reported. Differences were found according to the place of request. Waiting list could also influence diagnostic yield. Completion rates are lower in >70 years of age and when gastric transit is >60minutes. Cleansing degree achieved is acceptable.

Proposal for a standardized methodology for performing endobronchial ultrasound-guided mediastinal cryobiopsy: a four-step approach.

Endobronchial ultrasound (EBUS)-guided mediastinal cryobiopsy is a novel technique that increases the accuracy of diagnosing most pathologies that affect the mediastinum. Although EBUS-guided transbronchial needle aspiration (EBUS-TBNA) is the first choice in the diagnosis of mediastinal pathology, mediastinal cryobiopsy offers a larger and higher quality biopsy with minimal artifacts and no crushing when compared to conventional cytological samples obtained through EBUS-TBNA. It is particularly valuable in pathologies where EBUS-TBNA has diagnostic limitations, such as lymphoproliferative diseases, benign granulomatous conditions like sarcoidosis and silicosis, some rare infectious processes, metastases from rare non-pulmonary tumors, and in advanced stages of non-small cell lung cancer (NSCLC) where immunohistochemistry and molecular analysis are essential for personalized treatment. Therefore, mediastinal cryobiopsy seems to play a crucial role in these challenging scenarios. However, there is ongoing debate in the field of interventional pulmonology regarding the best approach for obtaining a mediastinal cryobiopsy. Some interventional pulmonologists use a high-frequency needle knife to create an incision in the tracheobronchial wall adjacent to the mediastinal lesion before inserting the cryoprobe, while others use a needle to create a pathway to the target area. There are also variations in the use of endoscopic or ultrasound imaging for guidance. In this article, we aim to review the current literature on different methods of performing mediastinal cryobiopsy and share our own clinical experience and methodology in a systematic way for its implementation in a safe, fast, and effective way.

Dispersal history of SARS-CoV-2 in Galicia, Spain.

The dynamics of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) transmission are influenced by a variety of factors, including social restrictions and the emergence of distinct variants. In this study, we delve into the origins and dissemination of the Alpha, Delta, and Omicron-BA.1 variants of concern in Galicia, northwest Spain. For this, we leveraged genomic data collected by the EPICOVIGAL Consortium and from the GISAID database, along with mobility information from other Spanish regions and foreign countries. Our analysis indicates that initial introductions during the Alpha phase were predominantly from other Spanish regions and France. However, as the pandemic progressed, introductions from Portugal and the United States became increasingly significant. The number of detected introductions varied from 96 and 101 for Alpha and Delta to 39 for Omicron-BA.1. Most of these introductions left a low number of descendants (<10), suggesting a limited impact on the evolution of the pandemic in Galicia. Notably, Galicia's major coastal cities emerged as critical hubs for viral transmission, highlighting their role in sustaining and spreading the virus. This research emphasizes the critical role of regional connectivity in the spread of SARS-CoV-2 and offers essential insights for enhancing public health strategies and surveillance measures.

Enhancing HIV positivity yield in southern Mozambique: The effect of a Ministry of Health training module in targeted provider-initiated testing and counselling

In Mozambique, targeted provider-initiated HIV testing and counselling (PITC) is recommended where universal PITC is not feasible, but its effectiveness depends on healthcare providers' training. This study aimed to evaluate the effect of a Ministry of Health training module in targeted PITC on the HIV positivity yield, and identify factors associated with a positive HIV test. We conducted a single-group pre-post study between November 2018 and November 2019 in the triage and emergency departments of four healthcare facilities in Manhiça District, a resource-constrained semi-rural area. It consisted of two two-month phases split by a one-week targeted PITC training module ("observation phases"). The HIV positivity yield of targeted PITC was estimated as the proportion of HIV-positive individuals among those recommended for HIV testing by the provider. Additionally, we extracted aggregated health information system data over the four months preceding and following the observation phases to compare yield in real-world conditions ("routine phases"). Logistic regression analysis from observation phase data was conducted to identify factors associated with a positive HIV test. Among the 7,102 participants in the pre- and post-training observation phases (58.5% and 41.5% respectively), 68% were women, and 96% were recruited at triage. In the routine phases with 33,261 individuals (45.8% pre, 54.2% post), 64% were women, and 84% were seen at triage. While HIV positivity yield between pre- and post-training observation phases was similar (10.9% (269/2470) and 11.1% (207/1865), respectively), we observed an increase in yield in the post-training routine phase for women in triage, rising from 4.8% (74/1553) to 7.3% (61/831) (Yield ratio = 1.54; 95%CI: 1.11-2.14). Age (25-49 years) (OR = 2.43; 95%CI: 1.37-4.33), working in industry/mining (OR = 4.94; 95%CI: 2.17-11.23), unawareness of partner's HIV status (OR = 2.50; 95%CI: 1.91-3.27), and visiting a healer (OR = 1.74; 95%CI: 1.03-2.93) were factors associated with a positive HIV test. Including these factors in the targeted PITC algorithm could have increased new HIV diagnoses by 2.6%. In conclusion, providing refresher training and adapting the current targeted PITC algorithm through further research can help reach undiagnosed PLHIV, treat all, and ultimately eliminate HIV, especially in resource-limited rural areas.

Impact of Living Donor Liver Transplantation on the Improvement of Hepatocellular Carcinoma Treatment.

Hepatocellular carcinoma (HCC) is one of the leading causes of cancer-related deaths, with increasing incidence. There are different treatment options, but only 30%-40% of HCC cases are diagnosed at an early stage for curative treatment. With the implementation of Milan Criteria for liver transplantation (LT) in HCC cases and its use for organ allocation with successful outcomes, LT has become an optimal treatment. Seeking new criteria for LT and developing updated algorithms for HCC treatment has become a hot topic nowadays. With the experience in living donor liver transplantation (LDLT), especially in Asian countries, LDLT was established and adopted with different criteria for HCC treatment, especially including criteria beyond Milan's size and number of tumors. Living donor grafts are uniquely different than deceased donor grafts as they are not considered a public resource. A living donor graft is rather a private gift intended for a specific recipient. Living donor livers are not limited by organ allocation systems, and this significant advantage of LDLT has opened new frontiers in the treatment of HCC. Improvements in LDLT have had remarkable parallel effects in the successful treatment of HCC as supported by a growing body of literature in the past decade.