Functional responses to multiple sequential abiotic stress (waterlogging-drought) in three woody taxa with different root systems and stress tolerance.

There is generally a trade-off in the resistance to drought and to waterlogging. However, several species are sequentially subjected to both stressors in many environments. We evaluated the ecophysiological strategies to cope with multiple sequential stress of waterlogging and drought (W + D) of three taxa differing in stress resistance and root morphology: the phreatophic Eucalyptus camaldulensis (Ec) and two shallow-rooted willow clones: Salix matsudana x Salix alba (SmxSa) and Salix nigra (Sn4). Individuals of the three taxa were grown in pots and assigned to either of four treatments: Control (well-watered plants), well-watered followed by drought (C + D); waterlogged for 15 days followed by drought (W15d + D) and waterlogged for 30 days followed by drought (W30d + D). Biomass allocation, growth (diameter, height, length of leaves, and roots), specific leaf area, stomatal conductance, water potential, hydraulic conductivity of roots and branches, leaf C13 and root cortical aerenchyma formation were determined at different stages of the experiment. Ec growth was not affected by W + D, developing tolerance strategies at leaf and whole plant levels. Differential effects of W + D were observed in both Salix clones depending on the time of waterlogging. In Sn4 and SmxSa, the root biomass was affected in W15d + D treatment, but a root tolerance response (aerenchyma and adventitious root formation) was observed in W30d + D. In the three taxa, and contrary to expectations, the previous exposure to a waterlogging period did not increase the susceptibility of the plants to a subsequent drought event. On the contrary, we found tolerance, which depended on the time of waterlogging exposure.

Addressing high cervical cancer rates in the Rio Grande Valley along the Texas-Mexico border: a community-based initiative focused on education, patient navigation, and medical provider training/telementoring.

AIMS: Cervical cancer incidence and mortality rates are approximately 55% higher in the Rio Grande Valley (RGV) along the Texas-Mexico border compared with the average rates in the US. Our aim was to improve cervical cancer prevention efforts in the RGV through a comprehensive multilevel intervention initiative focused on community education, patient navigation, and training of local providers. METHODS: We initiated a program in the RGV which consisted of (1) community education, (2) patient navigation, and (3) a training/mentoring program for local medical providers including hands-on training courses coupled with telementoring using Project ECHO® (Extension for Community Health Outcomes). We assessed the number of women undergoing cervical cancer screening, diagnosis, and treatment at three participating clinics caring for underserved women in the region. RESULTS: From November 2014 to October 2018, 14,846 women underwent cervical cancer screening. A total of 2030 (13.7%) women underwent colposcopy for abnormal results (179% increase over baseline) and 453 women underwent loop electrosurgical excision procedures (LEEPs) for treatment of cervical dysplasia. Invasive cancer was diagnosed in 39 women who were navigated to a gynecologic oncologist for treatment. Seven local medical providers were trained to perform colposcopy and/or LEEP. Project ECHO telementoring videoconferences were held every 2 weeks for a total 101 sessions with an average of 22 participants per session and a total of 180 patient cases presented and discussed. CONCLUSIONS: Our program led to a large number of women undergoing diagnosis and treatment of cervical dysplasia in the RGV. If sustained, we anticipate these efforts will decrease cervical cancer rates in the region. The program is currently being expanded to additional underserved areas of Texas and globally to low- and middle-income countries.

Detección precoz de la ambliopía en Atención Primaria / Early detection of amblyopia in Primary Care

Introducción: la detección precoz de alteraciones visuales en la infancia tiene importancia ya que pueden causar problemas en el desarrollo visual, el rendimiento escolar o, incluso, suponer un riesgo vital como el retinoblastoma. El objetivo de este estudio es realizar una revisión bibliográfica sobre las actividades diagnósticas que puede realizar el pediatra de Atención Primaria (PAP) para mejorar el cribaje de la ambliopía, e identificar la edad más adecuada para este cribado. Material y métodos: se ha realizado una búsqueda bibliográfica de textos científicos en inglés y español publicados en los últimos 20 años en bases de datos como PubMed y Google Académico. Algunas de las palabras clave fueron: “amblyopia”, “vision screening”, “pediatric”, “retinoscopy” y “photoscreener”. Resultados: se encontraron 376 resultados, seleccionándose 29 artículos y dos libros que incluían métodos diagnósticos de ambliopía realizados por el PAP (Bruckner, Hirschberg, Cover test, estereopsis y agudeza visual) y otros más avanzados (retinoscopia, autorrefractómetros, fotorrefractómetros y potenciales evocados). Los programas de cribado y derivación al oftalmólogo realizados por el PAP están basados en métodos tradicionales, siendo en general poco objetivos y heterogéneos. Conclusiones: los resultados encontrados no definen la edad óptima para el cribado, ni la prueba o combinación de pruebas más adecuadas para evitar derivaciones innecesarias o que una alteración pase inadvertida. Sin embargo, este cribado puede realizarse sencilla y rápidamente a partir de los 6 meses de vida mediante métodos avanzados como fotorrefractometría. Aumentar los recursos disponibles del PAP y conocer su aplicabilidad real y sus beneficios clínicos puede precisar posteriores investigaciones (AU)

Introduction: early detection of visual alterations in childhood has special relevance since it can cause problems in visual development, school performance, or even pose a vital risk such as retinoblastoma. The aim of this study was to conduct a traditional review about the diagnostic procedures that can be performed by the Primary Care Pediatrician (PCP) to improve the screening of amblyopia and to identify the most appropriate age for this screening.Material and methods: a bibliographic search of scientific texts in English and Spanish published in the last 20 years in databases such as PubMed and Google Scholar has been carried out. Some of the key words were: “amblyopia”, “vision screening”, “pediatric”, “retinoscopy” and “photoscreener”.Results: 376 results were found. 29 articles and 2 books were selected covering diagnostic methods of amblyopia performed by the PCP (Bruckner, Hirschberg, Cover test, stereopsis and visual acuity assessment) and others more advanced (retinoscopy, autorefractometry, photorefractometry and evoked potentials). The screening and ophthalmologist referral programs performed by the PCP are based on traditional methods and are generally not very objective and heterogeneous.Conclusions: the evidence does not allow to define the optimal age to amblyopia screening or which test or combination of tests could be the most appropriate to avoid unnecessary referrals or unnoticed alterations. However, this screening can be performed easily and quickly from the age of 6 months using diagnostic methods such as photorefractometry. Increasing the available resources in PCP clinic and knowing its applicability and clinical benefits may require further research. (AU)

Evaluating the implementation of a multi-level mHealth study to improve hydroxyurea utilization in sickle cell disease.

Background: Sickle Cell Disease (SCD) is a progressive genetic disease that causes organ damage and reduces longevity. Hydroxyurea is an underutilized evidence-based medication that reduces complications and improves survival in SCD. In a multi-site clinical trial, part of the NIH-funded Sickle Cell Disease Implementation Consortium (SCDIC), we evaluate the implementation of a multi-level and multi-component mobile health (mHealth) patient and provider intervention to target the determinants and context of low hydroxyurea use. Given the complexity of the intervention and contextual variability in its implementation, we combined different behavioral and implementation theories, models, and frameworks to facilitate the evaluation of the intervention implementation. In this report, we describe engagement with stakeholders, planning of the implementation process, and final analytical plan to evaluate the implementation outcomes. Methods: During 19 meetings, a 16-member multidisciplinary SCDIC implementation team created, conceived, and implemented a project that utilized Intervention Mapping to guide designing an intervention and its evaluation plan. The process included five steps: (1) needs assessment of low hydroxyurea utilization, (2) conceptual framework development, (3) intervention design process, (4) selection of models and frameworks, and (5) designing evaluation of the intervention implementation. Results: Behavioral theories guided the needs assessment and the design of the multi-level mHealth intervention. In designing the evaluation approach, we combined two implementation frameworks to best account for the contextual complexity at the organizational, provider, and patient levels: (1) the Consolidated Framework for Implementation Research (CFIR) that details barriers and facilitators to implementing the mHealth intervention at multiple levels (users, organization, intervention characteristics, broader community), and (2) the Technology Acceptance Model (TAM), a conceptual model specific for explaining the intent to use new information technology (including mHealth). The Reach Effectiveness Adoption Implementation and Maintenance (RE-AIM) framework was used to measure the outcomes. Discussion: Our research project can serve as a case study of a potential approach to combining different models/frameworks to help organize and plan the evaluation of interventions to increase medication adherence. The description of our process may serve as a blueprint for future studies developing and testing new strategies to foster evidence-based treatments for individuals living with SCD.

Cervical cancer, human papillomavirus (HPV), and HPV vaccination: exploring gendered perspectives, knowledge, attitudes, and cultural taboos among Mexican American adults.

Background: Gendered perspectives may be particularly important in shaping norms and values around HPV and HPV vaccination, as previous research suggests that sexuality taboos (e.g. promiscuity) may contribute to low perceived risk among adolescent and young adult Hispanic females. However, research to date focuses primarily on Hispanic mothers, adolescent females, and women of HPV vaccine-eligible age. Hispanic father's perspectives are relatively unknown despite father's important role in shaping norms for their female children.Objective: To close this gap, this study examines gendered perspectives in knowledge, beliefs, and attitudes about HPV and HPV vaccination from Hispanic parents (mothers and fathers), women of vaccine-eligible age (18-26 years old), and women eligible for Pap Test screening (>26 years old) living in two counties along the Texas-Mexico border.Design: We conducted eight focus groups. Research staff transcribed audio recordings verbatim and uploaded them into Atlas(ti) 5.0 for analysis. The research team analyzed the data for content, meaning, patterns and themes using the constant comparison approach.Results: Perspectives were highly gendered. Women's (all groups combined) beliefs focused on misconceptions around how the HPV virus is contracted (e.g. toilet surfaces). Women also linked HPV-related sexual risk to adultery and indiscretion of male partners. Fathers (men) were more likely to link risk to female promiscuity. Fathers also worried that HPV vaccination might increase promiscuity. All groups believe that HPV vaccination is a way to protect Hispanic females in the face of beliefs around sexual behavior and risk of contracting HPV.Conclusion: Results suggest gendered differences in risk beliefs concerning HPV among Hispanics living along the Texas-Mexico border. Researchers can use these findings to address barriers to HPV vaccination, as well as to create culturally appropriate prevention messages that may help reduce disparities in HPV among Hispanic women.

Immediate and transgenerational effects of thymol supplementation, inactivated Salmonella and chronic heat stress on representative immune variables of Japanese quail.

Environmental challenges are integrated in the inmunoneuroendocrine interplay, impacting the immune system of the challenged individuals, and potentially implying transgenerational effects on their offspring. This study addressed whether dietary supplementation with thymol can modulate the immune response of adult Japanese quail when simultaneously exposed to an inoculum of inactivated Salmonella Enteritidis and a chronic heat stress (CHS). We also evaluated whether the experienced situations by adults can affect the immune response of their undisturbed offspring. In the parental generation, supplemented quail exposed to CHS had a higher inflammatory response and similar values of the heterophil/lymphocyte (H/L) ratio than those that were not supplemented. In their offspring, those chicks whose parents were exposed to CHS showed higher inflammatory response and lower antibody production. Regarding the H/L ratio, chicks whose parents were supplemented showed lower H/L ratio values. Dietary supplementation with thymol partially and positively modulated the inflammatory response and avoided H/L ratio alteration in the parental generation exposed to high environmental temperatures, suggesting these adults were better at dealing with the challenge. The lower H/L ratio values in the offspring suggests that chicks are more capable to deal with potential stressful situations associated with conventional breeding conditions.

Thymol, alpha tocopherol, and ascorbyl palmitate supplementation as growth enhancers for broiler chickens.

Consumer concern on the quality of products and animal welfare has greatly increased during the past decades. Dietary synthetic antibiotic products used as growth promoters have been restricted or banned in many countries. Edible plants, essential oils, or their main components were suggested as natural feed supplements to improve growth, products' quality, and welfare-related parameters. Thymol (THY), a main component of oregano essential oil, has been proved as an effective antimicrobial and antioxidant compound. Tocopherol (TOC) evidenced antioxidant activity with potential as a growth promoter and a synergic antioxidant activity between TOC and ascorbyl palmitate (AP) has also been reported. Herein, we evaluated whether broiler diet supplementation with THY, and THY with a formulation mix containing TOC and AP (1:0.5:0.5, respectively) have potential as growth enhancers under commercial conditions. Potential protective effects against foot pad dermatitis and hock burns were also evaluated. Newly hatched male broiler chicks with similar body weight (BW) were randomly assigned to 1 of 7 groups (4 replicates each) as follows: Basal (no feed supplements added), Promotor (Basal + 6.26 µmol flavomycin/kg feed), BHT (Basal + 1.33 mmol of buthylated hidroxytoluene (BHT)/kg feed), Prom-BHT (Basal + 6.26 µmol flavomycin/kg feed + 1.33 mmol of BHT/kg feed), TOC-AP (Basal + 0.67 mmoles of TOC + 0.67 mmoles of AP/kg feed), THY (Basal + 1.33 mmoles of THY/kg feed), and THY-TOC-AP (Basal + 0.67 mmoles of THY + 0.67 mmoles of a mix 1:1 of TOC-AP). Along 7 wk, BW, feed intake, and feed conversion ratio were evaluated. Skin injuries were assessed at 35 d of age. At the end of the study (42 d), compared to Basal group, similarly enhanced final BW were observed in all groups but TOC-AP. No main differences between groups were detected in feed intake, feed conversion ratio, or skin injuries. Findings suggest that THY itself or in combination with TOC-AP may have value as a natural growth enhancer alternative for broilers.

A systematic review of adaptations of evidence-based public health interventions globally.

BACKGROUND: Adaptations of evidence-based interventions (EBIs) often occur. However, little is known about the reasons for adaptation, the adaptation process, and outcomes of adapted EBIs. To address this gap, we conducted a systematic review to answer the following questions: (1) What are the reasons for and common types of adaptations being made to EBIs in community settings as reported in the published literature? (2) What steps are described in making adaptations to EBIs? and (3) What outcomes are assessed in evaluations of adapted EBIs? METHODS: We conducted a systematic review of English language publications that described adaptations of public health EBIs. We searched Ovid PubMed, PsycINFO, PsycNET, and CINAHL and citations of included studies for adapted public health EBIs. We abstracted characteristics of the original and adapted populations and settings, reasons for adaptation, types of modifications, use of an adaptation framework, adaptation steps, and evaluation outcomes. RESULTS: Forty-two distinct EBIs were found focusing on HIV/AIDS, mental health, substance abuse, and chronic illnesses. More than half (62%) reported on adaptations in the USA. Frequent reasons for adaptation included the need for cultural appropriateness (64.3%), focusing on a new target population (59.5%), and implementing in a new setting (57.1%). Common adaptations were content (100%), context (95.2%), cultural modifications (73.8%), and delivery (61.9%). Most study authors conducted a community assessment, prepared new materials, implemented the adapted intervention, evaluated or planned to evaluate the intervention, determined needed changes, trained staff members, and consulted experts/stakeholders. Most studies that reported an evaluation (k = 36) included behavioral outcomes (71.4%), acceptability (66.7%), fidelity (52.4%), and feasibility (52.4%). Fewer measured adoption (47.6%) and changes in practice (21.4%). CONCLUSIONS: These findings advance our understanding of the patterns and effects of modifications of EBIs that are reported in published studies and suggest areas of further research to understand and guide the adaptation process. Furthermore, findings can inform better reporting of adapted EBIs and inform capacity building efforts to assist health professionals in adapting EBIs.

Prevalence of twin foaling and blood chimaerism in purebred Spanish horses.

Twin foaling is associated with chimaerism in several domestic species and is recognised in horses. In this study, 21,097 purebred Spanish (Pura Raza Español) horse births from the 2015 to 2016 breeding season were investigated for chimaerism. Twin foaled and chimaeric individuals were assessed on the basis of foaling records, short-tandem repeat (STR) parentage test results and a sex-linked STR-based technique. Fourteen twin pregnancies with 23 twin foals born alive were identified (0.066% twin foaling prevalence), including five blood chimaeric cases (21.7%; overall prevalence 0.011%), suggesting that this genetic condition is extremely low in horses. Furthermore, no true chimaeras were detected. This is the first large scale study analysing the occurrence of chimaerism in a horse population and the first assessment of twin foaling in purebred Spanish horses.

Bovine thyroglobulin gene polymorphisms and their association with sexual precocity in Guzerat bulls.

Puberty is a stage of sexual development determined by the interaction of environmental factors and genetic mechanisms. Among them, thyroid function plays a key role in sexual development and spermatogenic function and is under the control of several genes, including the well-described thyroglobulin gene (TG). Previous reports have shown genetic association between thyroid function and selected single nucleotide polymorphisms (SNPs) in taurine cattle. Therefore, the identification of genetic mechanisms involved in the regulation of this trait can assist with the selection for early pubertal bulls, thus improving genetic progress in livestock breeding. The aim of this study was to validate the association between TG SNPs and age at puberty in zebuine bulls. Three SNPs (rs110406764, rs109662686, rs109057985) were genotyped in 159 Guzerat animals using SEQUENOM technology. Results showed a significant association (p < .05) between the studied SNPs and puberty age, in agreement with our previous reports in a taurine breed. Interestingly, allele frequencies were different from those already reported, being GAT the most favourable allele for age at puberty in Guzerat (94.4 days lower). Overall, our findings corroborate previous reports and reinforce the importance of genetic influence in the regulation of sexual development and puberty through a thyroid pathway in zebuine cattle.

Embolia pulmonar grasa: Presentación de un caso / Pulmonary fat embolism. Case report

La embolia grasa (EG) es una obstrucción de los vasos sanguíneos por glóbulos de grasa. Ha sido descrita en la circulación pulmonar con una gran variedad de asociaciones, pero las más comunes e importantes se dan con fracturas de huesos largos y daño de tejido blando debido a traumatismo grave. Por su parte, el síndrome de embolia grasa (SEG) es una manifestación poco frecuente, aunque grave, del fenómeno de embolia grasa, que se caracteriza clínicamente por la tríada disnea, petequias y confusión mental. La razón de la discrepancia entre la presencia de embolia grasa y el desarrollo del síndrome no es clara. Presentamos el caso de un hombre de 41 años que, inmediatamente después del trauma, presentó en la tomografía computada (TC) inicial defectos de llenado de atenuación grasa dentro de las arterias pulmonares. Estos fueron interpretados como múltiples embolias grasas macroscópicas. Los valores de atenuación de la tomografía computada multidetector (TCMD) de las embolias pulmonares deben examinarse cuidadosamente en el contexto de un traumatismo agudo o después de procedimientos ortopédicos, debido a la complicación rara pero potencialmente fatal del SEG. En los centros de trauma, la TCMD es una herramienta esencial para hacer el diagnóstico de la embolia grasa macroscópica, así como también para descartar otras causas de hipoxia, como la embolia pulmonar trombótica. La reconstrucción de cortes finos debe utilizarse para la evaluación detallada de la vasculatura pulmonar.

Fat embolism (FE) may be defined as the blockage of blood vessels by fat globules. Pulmonary fat embolisms are reported to be associated with a wide variety of conditions, with the most common and important ones being with long bone fractures and soft tissue damage due to severe trauma. Fat embolism syndrome (FES) is a rare but serious manifestation of the fat embolism phenomenon, characterized clinically by a triad of dyspnea, petechiae, and mental confusión. The discrepancy between the presence of a fat embolism and the development of fat embolism syndrome is unclear. The case is presented of a 41 year-old mate who, on the initial trauma CT sean, presented with filling defeets of fat attenuation within the pulmonary arteries. Those were interpreted as múltiple macroscopic fat emboli. The CT attenuation valúes of pulmonary embolism should be carefully examined in the setting of acute trauma or after orthopedic procedures, as the rare but potentially fatal complicaron of FES may result. In trauma centers, multidetectorcomputed tomography is an essential tool to make the diagnosis of macroscopic fat embolism, and to exelude other causes of hypoxia, such as thrombotic pulmonary embolism. These reconstructions should be used for detailed evaluation of the pulmonary vasculature.

A non-randomized controlled stepped wedge trial to evaluate the effectiveness of a multi-level mammography intervention in improving appointment adherence in underserved women.

BACKGROUND: Considerable racial and socio-economic disparities exist in breast cancer. In spite of the existence of numerous evidence-based interventions (EBIs) aimed at reducing breast cancer screening barriers among the underserved, there is a lack of uptake or sub-optimal uptake of EBIs in community and clinical settings. This study evaluates a theoretically based, systematically designed implementation strategy to support adoption and implementation of a patient navigation-based intervention, called Peace of Mind Program (PMP), aimed at improving breast cancer screening among underserved women. METHODS/DESIGN: The PMP will be offered to federally qualified health centers and charity clinics in the Greater Houston area using a non-randomized stepped wedge design. Due to practical constraints of implementing and adopting in the real-world, randomization of start times and blinding will not be used. Any potential confounding or bias will be controlled in the analysis. Outcomes such as appointment adherence, patient referral to diagnostics, time to diagnostic referral, patient referral to treatment, time to treatment referral, and budget impact of the intervention will be assessed. Assessment of constructs from the consolidated framework for implementation research (CFIR) will be assessed during implementation and at the end of the study (sustainment) from each participating clinic. Data will be analyzed using descriptive statistics (chi-square tests) and generalized estimating equations (GEE). DISCUSSION: While parallel group randomized controlled trials (RCT) are considered the gold standard for evaluating EBI efficacy, withholding an effective EBI in practice can be both unethical and/or impractical. The stepped wedge design addresses this issue by enabling all clinics to eventually receive the EBI during the study and allowing each clinic to serve as its own control, while maintaining strong internal validity. We expect that the PMP will prove to be a feasible and successful strategy for reducing appointment no-shows in underserved women. CLINICAL TRIALS REGISTRATION NUMBER: NCT02296177.

Study of the influence of genes related to muscle oxidative processes on beef color.

The biochemical bases of meat color are determined by the concentration and redox state of myoglobin, hemoglobin, cytochromes, and other pigments. Post-mortem depletion of cellular oxygen results in oxidative stresses that consume NADH and affects reducing activity, while enzymatic detoxification influences the cellular oxidative processes, both affecting meat color. The aim of this work was to study the influence of several genes related to cellular oxidative processes that could affect CIELAB meat color parameters. The study was performed in steers that received a grass-based diet combined with grain, hays and silages. Results suggest a possible link between colorimetric parameters (a*, b* and chroma) and SNPs in the GSTP1 gene (P<0.05). Although the influence of the enzymes, encoded by GSTP1 gene, on meat color has been proposed previously at biochemical level and protein expression level, further association studies in different populations and functional studies of proteins are needed to confirm the genetic determination of that gene on meat color.

Development and characterization of activated hydrochars from orange peels as potential adsorbents for emerging organic contaminants.

Activated hydrochars obtained from the hydrothermal carbonization of orange peels (Citrus sinensis) followed by various thermochemical processing were assessed as adsorbents for emerging contaminants in water. Thermal activation under flows of CO2 or air as well as chemical activation with phosphoric acid were applied to the hydrochars. Their characteristics were analyzed and related to their ability to uptake three pharmaceuticals (diclofenac sodium, salicylic acid and flurbiprofen) considered as emerging contaminants. The hydrothermal carbonization and subsequent activations promoted substantial chemical transformations which affected the surface properties of the activated hydrochars; they exhibited specific surface areas ranging from 300 to ∼620 m(2)/g. Morphological characterization showed the development of coral-like microspheres dominating the surface of most hydrochars. Their ability to adsorb the three pharmaceuticals selected was found largely dependent on whether the molecules were ionized or in their neutral form and on the porosity developed by the new adsorbents.

Nitrate uptake improvement by modified activated carbons developed from two species of pine cones.

Activated carbons from two species of pine cones (Pinus canariensis and Cupressus sempervirens) were prepared by phosphoric acid activation and tested for the removal of nitrate ions from aqueous solution. To investigate the feasibility of improving their nitrate adsorption capacity, two different post-treatments­a thermal treatment and a treatment with saturated urea solution­were also applied to the prepared activated carbons. Comparison of the treated and untreated activated carbons showed that both post-treatments improved the nitrate adsorption performance more than twice. The maximum adsorption capacity, as evaluated from determination of the adsorption isotherms for the P. canariensis based carbons, and their proper representation by the Langmuir model, demonstrated that the post-treatment with the urea solution led to activated carbons with increased nitrate removal effectiveness, even superior to other reported results. Enhancements in their adsorption capacity could be mainly ascribed to higher contents of nitrogen and basic functional groups, whereas porous structure of the activated carbons did not seem to play a key role in the nitrate uptake.