Depression, Anxiety, and Stress Among Emerging Adult Undergraduates: A Longitudinal and Two-Cohort Study.

Mental disorders constitute one of the population's principal health problems, especially among undergraduates. This quantitative study compared levels of depression, anxiety, and stress in a sample of emerging adult university undergraduates from a gender perspective (1) during the initial and intermediate years of emerging adulthood and (2) in two different cohorts. A total of 383 Spanish emerging adult university undergraduates were monitored longitudinally (2015-2018) and two cohorts were compared (2015-2020). Participants completed the validated Spanish version of the Depression Anxiety Stress Scale-21. Mean-level and rank-order stability was found across the two waves of the longitudinal study in relation to levels of depression, anxiety, and stress. Significant differences were found between the two cohorts, indicating higher levels of psychological distress in 2020 than in 2015. Women were found to have higher levels of psychological distress, particularly stress, than men in both waves and cohorts. Results are discussed in relation to the negative effects of the COVID-19 health crisis on the emotional health of emerging adults. The present study highlights the need to establish measures designed to improve the mental health of emerging adults, which was more severely affected by the COVID-19 crisis than by the aftermath of the 2008 financial crisis. It also underscores the need to develop interventions designed to alleviate the greater degree of stress suffered by women.

Características clínicas y laboratoriales de los diez primeros pacientes con diagnóstico de Guillain-Barré en Piura, 2023

El síndrome de Guillain Barré es una enfermedad derivada del compromiso en las neuronas del sistema nervioso periférico por una respuesta descontrolada del sistema inmune que conduce daño axonal y/o desmielinización. El objetivo de este reporte fue describir los 10 primeros casos sospechosos de Síndrome de Guillain Barré en Piura. Se logró identificar la presencia de Campylobacter jejuni en las muestras de heces del 80% de los pacientes reportados. Es muy importante reconocer rápida y oportunamente al paciente con diagnóstico sospechoso de Guillain Barré, y realizar los estudios necesarios en un brote para identificar los agentes desencadenantes del cuadro.

Guillain Barré syndrome is a disease derived from compromise in neurons of the peripheral nervous system by an uncontrolled response from the immune system that leads to axonal damage and/or demyelination. The objective of this report was to describe the first 10 suspected cases of Guillain Barre Syndrome in Piura. It was possible to identify the presence of Campylobacter jejuni in the stool samples of 80% of the reported patients. It is very important to quickly and opportunely recognize the patient with a suspected diagnosis of Guillain Barré, and to carry out the necessary studies in an outbreak to identify the triggering agents of the condition.

Automation of the Micronucleus Assay Using Imaging Flow Cytometry and Artificial Intelligence.

The micronucleus (MN) assay is used worldwide by regulatory bodies to evaluate chemicals for genetic toxicity. The assay can be performed in two ways: by scoring MN in once-divided, cytokinesis-blocked binucleated cells or fully divided mononucleated cells. Historically, light microscopy has been the gold standard method to score the assay, but it is laborious and subjective. Flow cytometry has been used in recent years to score the assay, but is limited by the inability to visually confirm key aspects of cellular imagery. Imaging flow cytometry (IFC) combines high-throughput image capture and automated image analysis, and has been successfully applied to rapidly acquire imagery of and score all key events in the MN assay. Recently, it has been demonstrated that artificial intelligence (AI) methods based on convolutional neural networks can be used to score MN assay data acquired by IFC. This paper describes all steps to use AI software to create a deep learning model to score all key events and to apply this model to automatically score additional data. Results from the AI deep learning model compare well to manual microscopy, therefore enabling fully automated scoring of the MN assay by combining IFC and AI.

IgG antibody response by ELISA using Wuhan and Lambda variant antigens in BBIBP-CORV vaccinated health care workers. / Anticuerpos IgG determinados mediante ELISA desarrollados con antígenos de linajes Wuhan y Lambda en trabajadores de salud vacunados con BBIBP-CORV.

OBJECTIVES: . To evaluate the IgG antibody response by ELISA using Wuhan and Lambda antigens in health care workers with and without history of SARS-CoV-2 infection prior to immunization with the first and second doses of Sinopharm vaccine (BBIBP-CorV). MATERIALS AND METHODS: . An analytical study was carried out in health care workers over 18 years of age. Fifty-one participants with history and 100 participants without history of SARS-CoV-2 infection, who received two doses of Sinopharm vaccine, were included. IgG antibodies were assessed 21 days after the first dose, 21 days after the second dose and 3 months after the second dose by in-house ELISA using the complete antigen of the Wuhan variant (B.1.1) and lambda variant (C-37) of SARS-CoV-2 virus. RESULTS: . Both groups showed a large increase in the percentage of people with antibodies after the second dose, however, this percentage decreased 3 months after the second dose. The difference between the antibody index measured by ELISA with Wuhan variant antigen versus the ELISA with lambda variant was significant (p<0.001). CONCLUSIONS: . There is a significant increase in the presence of IgG type antibodies after 15 days of the second dose of BBIBP-CorV vaccination in participants without previous infection and a decrease after 3 months of the second dose in the ratio of IgG antibody reactivity indexes in ELISAs with the variant antigen as with ELISAs with the lambda variant.

OBJETIVOS.: Evaluar la respuesta de anticuerpos IgG determinada mediante ELISA utilizando antígenos de los linajes Wuhan y Lambda en trabajadores de la salud con y sin antecedente de infección por SARS-CoV-2 previa a la inmunización con la primera y segunda dosis de la vacuna Sinopharm (BBIBP-CorV). MATERIALES Y MÉTODOS.: Se realizó un estudio analítico en trabajadores de salud mayores de 18 años. Se incluyeron 51 participantes con antecedente y 100 participantes sin antecedente de infección por SARS-CoV-2, quienes recibieron dos dosis de la vacuna Sinopharm. Los anticuerpos IgG se evaluaron 21 días después de la primera dosis, 21 días después de la segunda dosis y 3 meses después de la segunda dosis mediante una prueba de ELISA in house desarrollado utilizando el antígeno completo del linaje Wuhan (B) y del linaje Lambda(C.37) del virus de SARS-CoV-2. RESULTADOS.: En ambos grupos se observó un incremento del porcentaje de personas con anticuerpos luego de la segunda dosis, sin embargo, este porcentaje disminuyó luego de 3 meses de la segunda dosis. Se halló una diferencia significativa entre el índice de anticuerpos medido por ELISA con el antígeno del linaje Wuhan versus el ELISA con el linaje Lambda (p<0,001). CONCLUSIONES.: Existe un aumento significativo de la presencia de anticuerpos tipo IgG luego de 15 días de la segunda dosis de la vacunación con BBIP-CORV en los participantes sin infección previa y una disminución, luego de 3 meses de la segunda dosis, de la razón de índices de reactividad de anticuerpos IgG en los ELISA desarrollados con el antígeno de la variante como en los ELISA desarrollados con la variante Lambda.

Anticuerpos IgG determinados mediante ELISA desarrollados con antígenos de linajes Wuhan y Lambda en trabajadores de salud vacunados con BBIBP-CORV / IgG antibody response by ELISA using Wuhan and Lambda variant antigens in BBIBP-CORV vaccinated health care workers

RESUMEN Objetivos. Evaluar la respuesta de anticuerpos IgG determinada mediante ELISA utilizando antígenos de los linajes Wuhan y Lambda en trabajadores de la salud con y sin antecedente de infección por SARS-CoV-2 previa a la inmunización con la primera y segunda dosis de la vacuna Sinopharm (BBIBP-CorV). Materiales y métodos. Se realizó un estudio analítico en trabajadores de salud mayores de 18 años. Se incluyeron 51 participantes con antecedente y 100 participantes sin antecedente de infección por SARS-CoV-2, quienes recibieron dos dosis de la vacuna Sinopharm. Los anticuerpos IgG se evaluaron 21 días después de la primera dosis, 21 días después de la segunda dosis y 3 meses después de la segunda dosis mediante una prueba de ELISA in house desarrollado utilizando el antígeno completo del linaje Wuhan (B) y del linaje Lambda(C.37) del virus de SARS-CoV-2. Resultados. En ambos grupos se observó un incremento del porcentaje de personas con anticuerpos luego de la segunda dosis, sin embargo, este porcentaje disminuyó luego de 3 meses de la segunda dosis. Se halló una diferencia significativa entre el índice de anticuerpos medido por ELISA con el antígeno del linaje Wuhan versus el ELISA con el linaje Lambda (p<0,001). Conclusiones. Existe un aumento significativo de la presencia de anticuerpos tipo IgG luego de 15 días de la segunda dosis de la vacunación con BBIP-CORV en los participantes sin infección previa y una disminución, luego de 3 meses de la segunda dosis, de la razón de índices de reactividad de anticuerpos IgG en los ELISA desarrollados con el antígeno de la variante como en los ELISA desarrollados con la variante Lambda.

ABSTRACT Objectives . To evaluate the IgG antibody response by ELISA using Wuhan and Lambda antigens in health care workers with and without history of SARS-CoV-2 infection prior to immunization with the first and second doses of Sinopharm vaccine (BBIBP-CorV). Materials and methods . An analytical study was carried out in health care workers over 18 years of age. Fifty-one participants with history and 100 participants without history of SARS-CoV-2 infection, who received two doses of Sinopharm vaccine, were included. IgG antibodies were assessed 21 days after the first dose, 21 days after the second dose and 3 months after the second dose by in-house ELISA using the complete antigen of the Wuhan variant (B.1.1) and lambda variant (C-37) of SARS-CoV-2 virus. Results . Both groups showed a large increase in the percentage of people with antibodies after the second dose, however, this percentage decreased 3 months after the second dose. The difference between the antibody index measured by ELISA with Wuhan variant antigen versus the ELISA with lambda variant was significant (p<0.001). Conclusions . There is a significant increase in the presence of IgG type antibodies after 15 days of the second dose of BBIBP-CorV vaccination in participants without previous infection and a decrease after 3 months of the second dose in the ratio of IgG antibody reactivity indexes in ELISAs with the variant antigen as with ELISAs with the lambda variant.

Confirmed Severe Acute Respiratory Syndrome Coronavirus 2 Reinfections After a Second Wave With Predominance of Lambda in Lima and Callao, Peru.

Background: Coronavirus disease 2019 (COVID-19) infection is a major public health problem in the world and reinfections are becoming more frequent. Our main objective was to describe the epidemiological, clinical, and genomic characteristics of the confirmed cases of reinfection by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in the capital of Lima and Callao, Peru. Methods: We searched in the Peruvian laboratory information system from April 2020 up to May 2021, looking for cases having 2 positive molecular tests for SARS-CoV-2 with more than 90 days between them. We performed genomic sequencing to the available pairs of samples and described the clinical characteristics, epidemiological impact, and genomic analysis of the confirmed reinfections. Results: There were 1 694 164 people with a positive diagnostic test for SARS-CoV-2 in Lima/Callao during the study period. Of these, 1695 had 2 positive molecular tests with more than 90 days between them. Two hundred eleven had both samples available for genomic analysis according to our selection criteria, and these were retrieved and submitted to sequencing. Thirty cases were confirmed to be SARS-CoV-2 reinfections with 2 different lineages in the 2 episodes. The variant Lambda (C.37) was the most common during the second infection and accounted for 19 (63.3%) of the 30 cases. Conclusions: We report 30 cases of confirmed SARS-CoV-2 reinfections. The Lambda variant was the most common cause of the second infections, in concordance with its predominant circulation during Peru's second wave. This report describes the largest series of confirmed reinfections by SARS-CoV-2 in Latin America.We describe the epidemiological, clinical, and genomic characteristics of the confirmed cases of reinfection by severe acute respiratory syndrome coronavirus 2 in Lima and Callao, durante la segunda ola en Peru. The Lambda variant (C.37) was the most common cause of the second infections.

Impact of Hydro-Alcoholic Solvents on the Oil and Phenolics Extraction from Walnut (Juglans regia L.) Press-Cake and the Self-Emulsification of Extracts.

The objective was to evaluate the performance of four hydro-alcoholic solvents to simultaneously extract oil and more polar molecules as phenolics, among others, to produce complex extracts that eventually could self-emulsify after solvent removal. Walnut press-cake was selected as the sourcing material. Extractions were performed as a semi-continuous operation up to a solvent-to-solid ratio of 28, with a fractional collection of the effluent. Among the solvents, labelled by their alcohol content EtOH 58, EtOH 86, iPro 60 and iPro 90 for ethanol (EtOH) and isopropanol (iPro), iPro 90 allowed to reach an oil extraction efficiency of 97% while the recovery for the other solvents was in the range of 30-40%. For both alcohols, the increase of the solvent hydration negatively influenced the oil extraction but positively increased the recovery of phenolics that reached 17.6 mg GAE/gcake when EtOH 58 was used. Several fractions contained enough surface-active material and oil to self-assemble as emulsions. IPro 90 and EtOH 86 showed better performances in the sense that most extracts were able to emulsify, though extraction kinetics pointed out differences. The most hydrated solvents behaved equally, with extraction yields in the same range and a similar but limited emulsifying capacity of only few fractions.

A faster and less costly alternative for RNA extraction of SARS-CoV-2 using proteinase k treatment followed by thermal shock.

One of the biggest challenges during the pandemic has been obtaining and maintaining critical material to conduct the increasing demand for molecular tests. Sometimes, the lack of suppliers and the global shortage of these reagents, a consequence of the high demand, make it difficult to detect and diagnose patients with suspected SARS-CoV-2 infection, negatively impacting the control of virus spread. Many alternatives have enabled the continuous processing of samples and have presented a decrease in time and cost. These measures thus allow broad testing of the population and should be ideal for controlling the disease. In this sense, we compared the SARS-CoV-2 molecular detection effectiveness by Real time RT-PCR using two different protocols for RNA extraction. The experiments were conducted in the National Institute of Health (INS) from Peru. We compared Ct values average (experimental triplicate) results from two different targets, a viral and internal control. All samples were extracted in parallel using a commercial kit and our alternative protocol-samples submitted to proteinase K treatment (3 µg/µL, 56°C for 10 minutes) followed by thermal shock (98°C for 5 minutes followed by 4°C for 2 minutes); the agreement between results was 100% in the samples tested. In addition, we compared the COVID-19 positivity between six epidemiological weeks: the initial two in that the Real time RT-PCR reactions were conducted using RNA extracted by commercial kit, followed by two other using RNA obtained by our kit-free method, and the last two using kit once again; they did not differ significantly. We concluded that our in-house method is an easy, fast, and cost-effective alternative method for extracting RNA and conducing molecular diagnosis of COVID-19.

Improvement of the oxidative stability of camelina oil by enrichment with phospholipid-quercetin formulations.

Camelina oil (Coil) contains 50-60% of polyunsaturated fatty acids which are susceptible to oxidation. In this work, addition of phospholipids (0-20 mg/g) was assessed to improve the solubility of quercetin in Coil and enhance its oxidative stability. Results showed that the solubility of quercetin in Coil increased up to 7.7-fold by phospholipid addition. The solubility of quercetin in Coil was correlated to the phospholipid concentration and reached a maximum value of 1 298 µg/g. The addition of phospholipid-quercetin formulations increased the Coil stability, measured at 60 °C, from 24 h up to 115 h. Coil saturated with only quercetin (168 µg/g) did not significantly increase Coil stability, whereas phospholipids alone extended the oxidation lag time up to 40 h. This work successfully developed a solvent-free method for improving the solubility of quercetin in Coil and enhance its oxidative stability.

Frecuencia de anticuerpos contra Hantavirus en agricultores de arroz de una región tropical en el noreste del Perú / Hantavirus antibody frequency in rice farmers from a tropical region in northeast Peru

RESUMEN Introducción. Existe limitada evidencia acerca de la exposición al hantavirus en el Perú. Los casos sintomáticos y estudios de seroprevalencia en febriles y población asintomática provienen de la región Loreto; sin embargo, existen grupos ocupacionales expuestos a los reservorios en regiones sin circulación conocida del virus. Objetivo. Determinar la frecuencia de anticuerpos contra el hantavirus en arroceros de un valle ubicado en una zona subtropical del Perú. Métodos. Estudio transversal en una muestra aleatoria de 250 agricultores de arroz obtenida en 2010 en el valle Alto Mayo (región San Martín), que incluyó la obtención de una muestra de sangre en cuyo suero se determinó la presencia de anticuerpos inmunoglobulinas G (IgG) mediante ELISA indirecto, y anticuerpos inmunoglobulinas M (IgM) mediante ELISA de captura. Resultados. Identificamos un caso con anticuerpos IgM (0,40%, IC95%: 0,01 a 2,21), pero no encontramos agricultores con anticuerpos IgG. El caso tenía contacto frecuente con ratas y roedores en la vivienda y campo de cultivo. Conclusión. Mostramos la primera evidencia serológica de infección por hantavirus en la región San Martín.

ABSTRACT Introduction. There is little evidence of hantavirus exposition in Peru. Cases and seroprevalence studies in febrile and asymptomatic persons are from Loreto region; however, there are occupational groups exposure to reservoirs in areas without know virus circulation. Objectives. To determinate the frequency of antibodies against hantavirus in rice farmers of a valley in a subtropical area of Peru. Methods. Cross-sectional study in a random sample of 250 rice farmers enrolled in 2010 in Alto Mayo Valley (San Martin region) that included blood sample obtention, in whose serum the presence of IgG antibodies was determined by indirect ELISA, and IgM antibodies by capture ELISA. Results. We identified a case with IgM antibodies (0,40%, 95% CI: 0,01 to 2,21), we did not find farmers with IgG antibodies. The case had frequent contact with rats and rodents in the home and crop field. Conclusion. We show the first serological evidence of hantavirus infection in the San Martin region.

Emotional autonomy and adjustment among emerging adults: The moderating role of family relationships.

Emerging adults build their personal maturity within the family context; however, few studies focus on the role of emotional autonomy during this stage. The aim of this study was to analyze the relationship between emotional autonomy and adjustment during emerging adulthood, bearing in mind the possible moderating role of parental support in this relationship. Data were collected from 1,502 Spanish undergraduate students (903 women) aged between 18 and 29. Participants completed measures of emotional autonomy (EAS, Steinberg & Silverberg, 1986), family social support (MSPSS; Zimet, Dahlem, Zimet & Farley, 1988), psychological well-being (PWBS; Ryff, Lee, Essex & Schmutte, 1995) and psychological distress (DASS-21; Lovibond & Lovibond, 1995). The results indicate that emotional autonomy correlates negatively with family support and psychological well-being and positively with psychological distress. However, only when young people perceive a family context with low social support is gaining emotional distance from their parents associated with an increase in their psychological well-being. Our findings highlight the crucial role that the family environment plays in well-being during young adulthood, and reveal that the effect of emotional distancing from parents on adjustment depends on the quality of the family climate. Future research should seek to gain greater insight into emotional autonomy during emerging adulthood, taking into account cross-cultural diversity.

Perceived Parenting Styles and Adjustment during Emerging Adulthood: A Cross-National Perspective.

The aim of the present study is to determine whether the influence of parenting style on children's wellbeing is sustained during emerging adulthood. This is a stage in which young people, despite feeling themselves to be adults, often remain in the family home and continue to be financially dependent on their parents. Moreover, since parents' beliefs, attitudes and behaviors are constructed and interpreted within their cultural milieu, the study also aims to explore the situation in Spain (SP) and Portugal (PT). Those two Southern Europe countries are representative of what is known as the "family welfare regime", in which the family acts as the main provider of care and security not only during childhood, but also during emerging adulthood. Thus, the present study examines, from a cross-cultural perspective, the relationship between perceived parenting styles and psychological adjustment among a sample of 1047 emerging adults from Spain and Portugal. The results reveal that the most beneficial styles during this stage are the authoritative and permissive ones, with the authoritarian style being more closely related to psychological distress. The study highlights intercultural similarities and the positive role played by more symmetrical relationships in the adjustment of emerging adults in both countries.

The Role of Parents in Emerging Adults' Psychological Well-Being: A Person-Oriented Approach.

The purpose of this study was to gain an overview of Spanish emerging adults' family relationships and their link with psychological well-being and psychological distress. The sample comprised 1502 undergraduate students (903 women and 599 men) aged between 18 and 29 (M = 20.32 and SD = 2.13), recruited from two universities in Spain. A cluster analysis identified three groups of families based on the centrality of five family variables: parental involvement, parental support for autonomy, parental warmth, behavioral control, and psychological control. The three groups or clusters were labeled high-quality family relationships (HQ), intermediate-quality family relationships (IQ), and low-quality family relationships (LQ). Women were overrepresented in the HQ cluster, whereas men were overrepresented in the IQ cluster. Moreover, emerging adults who perceived better family relationships (high levels of parental involvement, parental support for autonomy and parental warmth, and low levels of behavioral and psychological control) were found to have a higher level of psychological adjustment. Thus, our results indicate that family plays a key role in the psychological well-being of emerging adults. The discussion focuses on the implications of this finding for the parent-child relationship, and explores how it extends our knowledge about family relationships during emerging adulthood.

El propósito de este estudio fue obtener una visión de conjunto de las relaciones familiares de los adultos emergentes españoles y su vínculo con el bienestar psicológico y el distrés psicológico. La muestra estuvo compuesta por 1502 alumnos universitarios (903 mujeres y 599 hombres) de entre 18 y 29 años (M = 20.32 y SD = 2.13), convocados de dos universidades de España. Un análisis de grupos identificó a tres grupos de familias basándose en la centralidad de cinco variables familiares: participación de los padres, fomento de la autonomía por parte de los padres, calidez de los padres, control del comportamiento y control psicológico. Los tres grupos o agrupaciones se clasificaron como relaciones familiares de alta calidad (AC), relaciones familiares de calidad intermedia (CI) y relaciones familiares de baja calidad (BC). Las mujeres estuvieron sobrerrepresentadas en el grupo de AC, mientras que los hombres estuvieron sobrerrepresentados en el grupo de CI. Además, se descubrió que los adultos emergentes que percibieron mejores relaciones familiares (niveles altos de participación de los padres, fomento de la autonomía por parte de los padres y calidez de los padres, y niveles bajos de control conductual y psicológico) tuvieron un nivel más alto de adaptación psicológica. Por lo tanto, nuestros resultados indican que la familia desempeña un papel clave en el bienestar psicológico de los adultos emergentes. El debate se centra en las consecuencias que tiene este resultado para la relación entre padres e hijos, y analiza cómo amplía nuestro conocimiento acerca de las relaciones familiares durante la adultez emergente.

Neutrophils drive accelerated tumor progression in the collagen-dense mammary tumor microenvironment.

BACKGROUND: High mammographic density has been correlated with a 4-fold to 6-fold increased risk of developing breast cancer, and is associated with increased stromal deposition of extracellular matrix proteins, including collagen I. The molecular and cellular mechanisms responsible for high breast tissue density are not completely understood. METHODS: We previously described accelerated tumor formation and metastases in a transgenic mouse model of collagen-dense mammary tumors (type I collagen-α1 (Col1α1)(tm1Jae) and mouse mammary tumor virus - polyoma virus middle T antigen (MMTV-PyVT)) compared to wild-type mice. Using ELISA cytokine arrays and multi-color flow cytometry analysis, we studied cytokine signals and the non-malignant, immune cells in the collagen-dense tumor microenvironment that may promote accelerated tumor progression and metastasis. RESULTS: Collagen-dense tumors did not show any alteration in immune cell populations at late stages. The cytokine signals in the mammary tumor microenvironment were clearly different between wild-type and collagen-dense tumors. Cytokines associated with neutrophil signaling, such as granulocyte monocyte-colony stimulated factor (GM-CSF), were increased in collagen-dense tumors. Depleting neutrophils with anti-Ly6G (1A8) significantly reduced the number of tumors, and blocked metastasis in over 80 % of mice with collagen-dense tumors, but did not impact tumor growth or metastasis in wild-type mice. CONCLUSION: Our study suggests that tumor progression in a collagen-dense microenvironment is mechanistically different, with pro-tumor neutrophils, compared to a non-dense microenvironment.

[Dengue in Peru: a quarter century after its reemergence]. / Dengue en el Perú: a un cuarto de siglo de su reemergencia.

A health problem each time more frequent and dispersed in tropical and subtropical areas of the world, including Peru where it entered in 1990, is dengue. It is produced by the dengue virus with four serotypes and transmitted by Aedes aegypti, a vector that coexists with humans and whose presence is favored by deficient sanitary, social and economic conditions. Manifestations of severe forms of the disease such as shock and bleeding, are related to the frequent co-circulation of the four serotypes and the emergence of new genotypes such as American/Asian serotype 2. The new classification of the disease by WHO as dengue with or without warning signs and severe dengue, is contributing to more timely diagnosis and treatment, enabling reductions in mortality. Of note is the need to highlight the surveillance of acute febrile illness and Aedes indices that contribute to a timely diagnosis and guide vector control measures through sanitary education and environmental management with community and intersectoral participation, in a creative manner according to ecological niches. An alternative for complementary prevention would be vaccination using tetravalent vaccines whose safety and efficacy must be guaranteed before its use in the population under the framework of comprehensive strategies.

Dengue en el Perú: a un cuarto de siglo de su reemergencia / Dengue in Peru: a quarter century after its reemergence

Un problema sanitario cada vez más frecuente y disperso en áreas tropicales y subtropicales del mundo, incluido el Perú donde ingresó en 1990, es el dengue. Es producido por el virus del dengue con cuatro serotipos y transmitido por el Aedes aegypti, vector que convive con los humanos y cuya presencia es favorecida por deficientes condiciones sanitarias, sociales y económicas. Manifestaciones de formas severas de la enfermedad como el choque y sangrado, están relacionadas con la frecuente cocirculación de los cuatro serotipos y la aparición de nuevos genotipos como el americano/asiático del serotipo 2. La nueva clasificación de la enfermedad por la OMS como dengue con o sin signos de alarma y dengue grave, está contribuyendo a un diagnóstico y tratamiento más oportunos, permitiendo reducir la letalidad. Debe destacarse la necesidad de la vigilancia del síndrome febril y los índices aédicos que contribuyan a un diagnóstico oportuno y orienten las medidas de control vectorial mediante educación sanitaria y manejo ambiental con participación comunitaria e intersectorial, de manera creativa según los nichos ecológicos. Una alternativa de prevención complementaria sería la vacunación utilizando vacunas tetravalentes cuya seguridad y eficacia deben estar garantizadas antes de su uso poblacional en el marco de estrategias integrales.

A health problem each time more frequent and dispersed in tropical and subtropical areas of the world, including Peru where it entered in 1990, is dengue. It is produced by the dengue virus with four serotypes and transmitted by Aedes aegypti, a vector that coexists with humans and whose presence is favored by deficient sanitary, social and economic conditions. Manifestations of severe forms of the disease such as shock and bleeding, are related to the frequent co-circulation of the four serotypes and the emergence of new genotypes such as American / Asian serotype 2. The new classification of the disease by WHO as dengue with or without warning signs and severe dengue, is contributing to more timely diagnosis and treatment, enabling reductions in mortality. Of note is the need to highlight the surveillance of acute febrile illness and Aedes indices that contribute to a timely diagnosis and guide vector control measures through sanitary education and environmental management with community and intersectoral participation, in a creative manner according to ecological niches. An alternative for complementary prevention would be vaccination using tetravalent vaccines whose safety and efficacy must be guaranteed before its use in the population under the framework of comprehensive strategies.

Microtubules regulate GEF-H1 in response to extracellular matrix stiffness.

Breast epithelial cells sense the stiffness of the extracellular matrix through Rho-mediated contractility. In turn, matrix stiffness regulates RhoA activity. However, the upstream signaling mechanisms are poorly defined. Here we demonstrate that the Rho exchange factor GEF-H1 mediates RhoA activation in response to extracellular matrix stiffness. We demonstrate the novel finding that microtubule stability is diminished by a stiff three-dimensional (3D) extracellular matrix, which leads to the activation of GEF-H1. Surprisingly, activation of the mitogen-activated protein kinase kinase/extracellular signal-regulated kinase pathway did not contribute to stiffness-induced GEF-H1 activation. Loss of GEF-H1 decreases cell contraction of and invasion through 3D matrices. These data support a model in which matrix stiffness regulates RhoA through microtubule destabilization and the subsequent release and activation of GEF-H1.