Adult Organophosphate and Carbamate Insecticide Exposure and Sperm Concentration: A Systematic Review and Meta-Analysis of the Epidemiological Evidence.

BACKGROUND: Evidence of the negative impacts of contemporary use insecticides on sperm concentration has increased over the last few decades; however, meta-analyses on this topic are rare. OBJECTIVES: This investigation assessed the qualitative and quantitative strength of epidemiological evidence regarding adult exposure to two classes of contemporary use insecticides-organophosphates (OPs) and N-methyl carbamates (NMCs)-and sperm concentration using robust and reproducible systematic review and meta-analysis methods. METHODS: Three scientific databases (PubMed, Scopus, and Web of Science), two U.S. government databases (NIOSHTIC-2 and Science.gov), and five nongovernmental organization websites were searched for relevant primary epidemiological studies published in any language through 11 August 2022. Risk of bias and strength of evidence were evaluated according to Navigation Guide systematic review methodology. Bias-adjusted standardized mean difference effect sizes were calculated and pooled using a three-level, multivariate random-effect meta-analysis model with cluster-robust variance estimation. RESULTS: Across 20 studies, 21 study populations, 42 effect sizes, and 1,774 adult men, the pooled bias-adjusted standardized mean difference in sperm concentration between adult men more- and less-exposed to OP and NMC insecticides was -0.30 (95% CI: -0.49, -0.10; PSatt<0.01). Sensitivity and subgroup analyses explored statistical heterogeneity and validated the model robustness. Although the pooled effect estimate was modified by risk of bias, insecticide class, exposure setting, and recruitment setting, it remained negative in direction across all meta-analyses. The body of evidence was rated to be of moderate quality, with sufficient evidence of an association between higher adult OP and NMC insecticide exposure and lower sperm concentration. DISCUSSION: This comprehensive investigation found sufficient evidence of an association between higher OP and NMC insecticide exposure and lower sperm concentration in adults. Although additional cohort studies can be beneficial to fill data gaps, the strength of evidence warrants reducing exposure to OP and NMC insecticides now to prevent continued male reproductive harm. https://doi.org/10.1289/EHP12678.

Modified NEOMOD score as a neonatal mortality prediction tool in a medium-income country: A validation diagnostic test study.

Background and Aims: Multiple organ dysfunction (MOD) is a potentially reversible physiological disorder that involves two or more systems. Modified NEOMOD (Neonatal Multiple Organ Dysfunction score) scale could be a useful instrument to measure MOD and predict mortality. Our aim was to validate modified NEOMOD in patients from a neonatal intensive care unit (NICU) of a middle-income country. Methods: Diagnostic test study. Preterm newborns admitted NICU were included. Daily values were collected from birthday to Day 14. MOD was defined as at least one point in two or more systems. The lowest score is 0 and the maximum is 16. The outcome variable was mortality. Secondary outcomes were bronchopulmonary dysplasia, retinopathy of prematurity (ROP), late-onset neonatal sepsis (LONS), intraventricular hemorrhage (IVH) and length of hospital stay. Area under the curve (AUC) and Hosmer-Lemeshow test were calculated to evaluate scale discrimination and calibration. Logistic regression was used to estimate the association between daily modified NEOMOD score and death. Results: We included 273 patients who met the inclusion criteria. MOD incidence was 74.4%. The median gestational age in patients with MOD was 30 (interquartile range [IQR]: 27-33) and in patients without MOD it was 32 (IQR: 31-33) (p < 0.001). There were 40 deaths (14.6%), 38 (18.7%) from the MOD group and 2 (2.9%) from non-MOD group. On accumulated Day 7, AUC was 0.89 (95% confidence interval [CI]: 0.83-0.95). Modified NEOMOD had good calibration (X 2 = 2.94, p = 0.982). DBP (12.8% vs. 2.9%, p = 0.001), ROP (3.9% vs. 0%, p = 0.090), IVH (33% vs. 12.9%, p < 0.001), and LONS (36.5% vs. 8.6%, p < 0.001) frequency was higher in the MOD group than non-MOD group. Length of hospital stay also was higher in MOD group (median 21 days [IQR 7-44] vs. median 5 days [IQR 4-9], p = 0.004). Conclusion: Modified NEOMOD scale presents good discrimination and calibration for death in preterm children. This scale could help in clinical decision-making in real-time.

Sol-Gel Entrapped Lewis Acids as Catalysts for Biodiesel Production.

Replacing fossil fuels with biodiesel enables the emission of greenhouse gases to be decreased and reduces dependence on fossil fuels in countries with poor natural resources. Biodiesel can be produced by an esterification reaction between free fatty acids (FFAs) and methanol or by transesterification of triglycerides from oils. Both reactions require homogeneous or heterogeneous catalysis. Production of biodiesel catalyzed by heterogeneous catalysts seems to be the preferred route, enabling easy product separation. As we have previously shown, the Lewis acids AlCl3 and BF3 can serve as highly efficient catalysts under ultrasonic activation. The present study focused on the development of oleic acid (OA) esterification with methanol by the same catalysts immobilized in silica matrices using the sol-gel synthesis route. During the course of immobilization, AlCl3 converts to AlCl3 × 6H2O (aluminite) and BF3 is hydrolyzed with the production of B2O3. The immobilized catalysts can be reused or involved in a continuous process. The possibility of biodiesel production using immobilized catalysts under ultrasonic activation is shown for the conversion of FFAs into biodiesel in batch and continuous mode.

Not All Dry Eye in Contact Lens Wear Is Contact Lens-Induced.

OBJECTIVES: To compare subjective and clinical outcomes in three study groups: (1) asymptomatic contact lens (CL) wearers (ASYM); (2) symptomatic CL wearers who become asymptomatic on lens removal; and (3) symptomatic CL wearers who do not resolve on lens removal. METHODS: Ninety-two subjects completed the Berkeley Dry Eye Flow Chart with and without lenses, ocular surface examinations, and a battery of questionnaires. RESULTS: Thirty-seven subjects (40%) were ASYM, 30 (33%) had contact lens-induced dry eye (CLIDE), and 25 (27%) had underlying physiological DE. Visual Analog Scale ratings, OSDI score, and SPEED score were significantly better for the ASYM group (P<0.001) but did not distinguish CLIDE from DE. The DE group was significantly worse than CLIDE and ASYM, which were similar, in precorneal noninvasive tear breakup time (8.2 sec DE vs. 12.3 sec CLIDE and 14.3 sec ASYM; P=0.002), anterior displacement of the Line of Marx (P=0.017), and superior conjunctival staining (P=0.001). CONCLUSIONS: Many CL wearers presenting with dryness symptoms have an underlying DE condition and will not respond to treatments aimed at changing lenses or solutions. Contradictory results from research studies of DE in CL wearers could be due in part to a failure to distinguish subjects with symptoms due specifically to CL wear from those whose symptoms have underlying causes unrelated to CL wear.

Effect of inoculum on the anaerobic digestion of food waste accounting for the concentration of trace elements.

The production of renewable energy in the form of methane from the anaerobic digestion (AD) of food waste (FW) varies depending on factors such as the quantity and quality of the inoculum. This research evaluated the influence of trace elements (Ca, K, Fe, Zn, Al, Mg, Co, Ni, and Mo) present in inoculum from different sources (wastewater treatment plants (WWTPs): 2 agro-industrial WWTPs and 1 municipal WWTP) on the AD of FW. This study found that the source of the inoculum determines the content of macronutrients and trace elements, which can alter the requirements of the AD process and therefore affect methane production. The inoculum obtained from municipal WWTPs contain potentially inhibitory concentrations of Zn and Al that negatively affect methane production (<70 mL CH4·gVS-1), the hydrolysis constant (<0.19 d-1), and the lag-phase (>7 days). It was also found that high concentrations of trace elements such as Ni (35.2 mg kg-1) and Mo (15.4 mg kg-1) in the inoculum increase methane production (140.7 mL CH4·gVS-1) and hydrolysis constant (>0.18d-1) in addition to presenting short lag-phase (<1 day) in the AD of food waste.

Urban malaria transmission in a non-endemic area in the Andean region of Colombia.

BACKGROUND: Rapid urbanisation in difficult socio-economic conditions such as inadequate housing infrastructure, lack of public services, improper sanitation, and poor water drainage systems in vegetation-rich areas lead to ecological conditions that are conducive to the breeding of mosquitoes and transmission of malaria, in semi-urban and urban settings. OBJECTIVES: This study aimed to describe the cases of malaria that were reported in the peri-urban areas of Pereira (Colombia), between 2008 and 2015. METHODS: A retrospective study was conducted using data from the Malaria Surveillance System 2009-2015 and an outbreak study (between December 2008 and March 2009). Frequency distributions and summary measures, as well as univariate analysis were performed for all the variables in consideration. The annual parasite index (API) was calculated. FINDINGS: Data on 214 cases were obtained from the surveillance system. A majority of the cases were reported in men (63.1%), followed by in children < 15 years (23.8%), and were caused predominantly by Plasmodium vivax (86.0%), with most of the infection occurring in the urban areas (52.8%) of Pereira. The API, by sex and age group, was higher among men ≥ 80 years. The outbreak study reported 14 cases of malaria in rural/peri-urban neighborhoods, and it was observed that the anopheline breeding sites were in close proximity to the houses in these areas. This population did not use protective measures against mosquitoes and chemical control was conducted through residual and spatial insecticide spraying. MAIN CONCLUSIONS: This study suggested the presence of autochthonous malaria transmission, in Pereira, between 2008 and 2015, most of which were cases of P. vivax. A greater intensity was observed between 2008 and 2009 when malaria was possibly reintroduced to the region. During the years of the study, a gradual decrease in the number of reported cases of malaria was observed in Pereira, except for the time period between 2008 and 2009 when a spike was noted (estimated using the API); this was most likely caused by an outbreak. Interventions that are more aggressive in nature are required to prevent further malarial transmission and dissemination.

Urban malaria transmission in a non-endemic area in the Andean region of Colombia

BACKGROUND Rapid urbanisation in difficult socio-economic conditions such as inadequate housing infrastructure, lack of public services, improper sanitation, and poor water drainage systems in vegetation-rich areas lead to ecological conditions that are conducive to the breeding of mosquitoes and transmission of malaria, in semi-urban and urban settings. OBJECTIVES This study aimed to describe the cases of malaria that were reported in the peri-urban areas of Pereira (Colombia), between 2008 and 2015. METHODS A retrospective study was conducted using data from the Malaria Surveillance System 2009-2015 and an outbreak study (between December 2008 and March 2009). Frequency distributions and summary measures, as well as univariate analysis were performed for all the variables in consideration. The annual parasite index (API) was calculated. FINDINGS Data on 214 cases were obtained from the surveillance system. A majority of the cases were reported in men (63.1%), followed by in children < 15 years (23.8%), and were caused predominantly by Plasmodium vivax (86.0%), with most of the infection occurring in the urban areas (52.8%) of Pereira. The API, by sex and age group, was higher among men ≥ 80 years. The outbreak study reported 14 cases of malaria in rural/peri-urban neighborhoods, and it was observed that the anopheline breeding sites were in close proximity to the houses in these areas. This population did not use protective measures against mosquitoes and chemical control was conducted through residual and spatial insecticide spraying. MAIN CONCLUSIONS This study suggested the presence of autochthonous malaria transmission, in Pereira, between 2008 and 2015, most of which were cases of P. vivax. A greater intensity was observed between 2008 and 2009 when malaria was possibly reintroduced to the region. During the years of the study, a gradual decrease in the number of reported cases of malaria was observed in Pereira, except for the time period between 2008 and 2009 when a spike was noted (estimated using the API); this was most likely caused by an outbreak. Interventions that are more aggressive in nature are required to prevent further malarial transmission and dissemination.

Protective Efficacy of Plasmodium vivax Radiation-Attenuated Sporozoites in Colombian Volunteers: A Randomized Controlled Trial.

BACKGROUND: Immunizing human volunteers by mosquito bite with radiation-attenuated Plasmodium falciparum sporozoites (RAS) results in high-level protection against infection. Only two volunteers have been similarly immunized with P. vivax (Pv) RAS, and both were protected. A phase 2 controlled clinical trial was conducted to assess the safety and protective efficacy of PvRAS immunization. METHODOLOGY/PRINCIPAL FINDINGS: A randomized, single-blinded trial was conducted. Duffy positive (Fy+; Pv susceptible) individuals were enrolled: 14 received bites from irradiated (150 ± 10 cGy) Pv-infected Anopheles mosquitoes (RAS) and 7 from non-irradiated non-infected mosquitoes (Ctl). An additional group of seven Fy- (Pv refractory) volunteers was immunized with bites from non-irradiated Pv-infected mosquitoes. A total of seven immunizations were carried out at mean intervals of nine weeks. Eight weeks after last immunization, a controlled human malaria infection (CHMI) with non-irradiated Pv-infected mosquitoes was performed. Nineteen volunteers completed seven immunizations (12 RAS, 2 Ctl, and 5 Fy-) and received a CHMI. Five of 12 (42%) RAS volunteers were protected (receiving a median of 434 infective bites) compared with 0/2 Ctl. None of the Fy- volunteers developed infection by the seventh immunization or after CHMI. All non-protected volunteers developed symptoms 8-13 days after CHMI with a mean pre-patent period of 12.8 days. No serious adverse events related to the immunizations were observed. Specific IgG1 anti-PvCS response was associated with protection. CONCLUSION: Immunization with PvRAS was safe, immunogenic, and induced sterile immunity in 42% of the Fy+ volunteers. Moreover, Fy- volunteers were refractory to Pv malaria. TRIAL REGISTRATION: Identifier: NCT01082341.

Is there malaria transmission in urban settings in Colombia?

BACKGROUND: Colombia contributes a significant proportion of malaria cases in the Americas, which are predominantly rural. However, in the last 8 years ~ 10 % of the endemic municipalities have also reported urban and peri-urban malaria cases, a growing concern for health authorities. This study focused on the characterization of the officially reported urban malaria cases. METHODS: A descriptive retrospective study based on secondary information provided by the Colombian National Surveillance System-SIVIGILA for the 2008-2012 period was conducted. A total of 17 municipalities with consistent and persistent reports of urban and peri-urban malaria were selected for analysis, which included site of origin and of residence, age, gender and ethnicity of patients, health system affiliation, Plasmodium species and the presence of malaria vectors. RESULTS: A total of 18,113 malaria cases were reported from urban and peri-urban areas of 17 endemic municipalities. Almost 70 % of the reports originated in localities in the departments of Chocó and Nariño, located on the Pacific Coast where a predominantly Afro-Colombian population, of individuals of under 30 years of age, was the most affected (80.7 %), mainly with Plasmodium falciparum infections (52.1 %). Median annual parasite index (API) was 6.4 per 1000 inhabitants (3.4 in 2008; 10.8 in 2010 and 6.0 in 2012). Between 2011 and 2012 complicated cases (2.4 %) and malaria in pregnant women (1.4 %) were reported. Study areas reported the presence of at least seven Anopheles species considered malaria vectors. These analyses did not allow ascertaining the presumable origin of the recorded urban cases due to the lack of a consensus on a definition of urban, peri-urban and rural limits and the lack of proper verification of the geographical source of infection. CONCLUSIONS: The study indicates the probable presence of endemic, unstable and low-intensity malaria transmission in Colombian urban and peri-urban areas of a group of municipalities located mainly on the Pacific coast region and a few others in the eastern region. There is a need to unequivocally confirm the urban or peri-urban origin of the malaria cases reported and the transmission conditions, as well as to develop and implement new strategies for urban and peri-urban malaria control and elimination.

Eficacia de la obturación ortógrada de conductos radiculares con MTA vs. MTA más conos de gutapercha / Orthograde root canal obturation efficacy of MTA vs. MTA with gutta percha points

Objetivo: Evaluar la capacidad del sellado del MTA usado como material único de sellado o usándolo como cemento sellador más conos de gutapercha. Materiales y métodos: Se seleccionaron las raíces mesiales de 24 molares inferiores y se instrumentaron hasta una lima maestra apical # 40 con la técnica de Crown Down. El grupo I fue obturado con conos de gutapercha y el MTA fue usado como cemento sellador; el grupo II fue obturado con MTA solamente. Se utilizaron cuatro raíces como control positivo y negativo; las muestras fueron cubiertas con cera pegajosa, dejando libre solo los dos últimos milímetros apicales, se centrifugaron en tinta china durante una hora y se les realizó procedimiento de transparentación, para posteriormente medir la microfiltración con un microscopio estereoscópico. Resultados: Los resultados fueron analizados estadísticamente con el test de KRUSKAL-WALLIS para variables independientes, y no se encontró diferencia estadísticamente significativa entre los dos grupos. Conclusiones: No se encontró diferencia estadísticamente significativa entre los dos grupos. En situaciones clínicas que no permiten la obturación convencional con conos de gutapercha, cualquiera de las dos técnicas de colocación del MTA son factibles.

Objetives: This study evaluated the sealing capability of MTA when it is used as the only root canal filling material and when it is used as sealing cement combined with gutapercha points. Materials and methods: The mesial roots of 24 inferior molars were selected; they were instrumented until an apical master file # 40 with Crown Down technique. Group I were obtured with gutapercha points and MTA as sealing cement; group II were obtured only with MTA. Four roots were used as positive and negative control, samples were covered with sticky wax, leaving free the apical last 2 mm, they were centrifugued with chinese ink for one hour and then they were turned transparent, to measure the microleakage with a stereoscopic microscope. Results: Results were analyzed statistically with the KRUSKAL-WALLIS test for independent variables and statistically no significant difference was found between the two groups. Conclusion: Statistically no significant difference was found between the two groups. In such clinical situations that don't permit conventional obturation with gutapercha points, both MTA techniques are viable.