The VEGFA rs3025039 Variant Is a Risk Factor for Breast Cancer in Mexican Women.

Breast cancer (BC) is the leading cause of death from tumors in women worldwide, influenced by various factors, including genetics. The T allele of the single nucleotide variant (SNV) rs3025039 at position +936 of the VEGFA gene has been reported to affect the mRNA regulatory mechanisms, potentially altering VEGFA expression and increasing BC risk. This study aimed to investigate the association between rs3025039 and BC in Mexican women residing in Jalisco, Mexico. The study included 231 women with a confirmed diagnosis of BC and 201 healthy subjects as a reference group (RG). PCR-RFLP was employed for the genotyping of rs3025039, with the visualization of amplified products using polyacrylamide gel electrophoresis. Significant differences were observed in rs3025039 alleles and genotypes between BC cases and the RG (p = 0.0038). The frequency of the T allele and the CT genotype was higher in the BC group compared to the RG, with a significant difference (p = 0.0006). In conclusion, this research suggests that the SNV rs3025039 is associated with a higher risk of BC in Mexican women. These findings enhance our understanding of the genetic underpinnings of BC in this population, offering potential insights for future studies and interventions.

Closing the gap: prognostic and predictive biomarker validation for personalized care in a Latin American hormone-dependent breast cancer cohort.

BACKGROUND: Several guidelines recommend the use of different classifiers to determine the risk of recurrence (ROR) and treatment decisions in patients with HR+HER2- breast cancer. However, data are still lacking for their usefulness in Latin American (LA) patients. Our aim was to evaluate the comparative prognostic and predictive performance of different ROR classifiers in a real-world LA cohort. METHODS: The Molecular Profile of Breast Cancer Study (MPBCS) is an LA case-cohort study with 5-year follow-up. Stages I and II, clinically node-negative HR+HER2- patients (n = 340) who received adjuvant hormone therapy and/or chemotherapy, were analyzed. Time-dependent receiver-operator characteristic-area under the curve, univariate and multivariate Cox proportional hazards regression (CPHR) models were used to compare the prognostic performance of several risk biomarkers. Multivariate CPHR with interaction models tested the predictive ability of selected risk classifiers. RESULTS: Within this cohort, transcriptomic-based classifiers such as the recurrence score (RS), EndoPredict (EP risk and EPClin), and PAM50-risk of recurrence scores (ROR-S and ROR-PC) presented better prognostic performances for node-negative patients (univariate C-index 0.61-0.68, adjusted C-index 0.77-0.80, adjusted hazard ratios [HR] between high and low risk: 4.06-9.97) than the traditional classifiers Ki67 and Nottingham Prognostic Index (univariate C-index 0.53-0.59, adjusted C-index 0.72-0.75, and adjusted HR 1.85-2.54). RS (and to some extent, EndoPredict) also showed predictive capacity for chemotherapy benefit in node-negative patients (interaction P = .0200 and .0510, respectively). CONCLUSION: In summary, we could prove the clinical validity of most transcriptomic-based risk classifiers and their superiority over clinical and immunohistochemical-based methods in the heterogenous, real-world node-negative HR+HER2- MPBCS cohort.

A comparative analysis of classical and machine learning methods for forecasting TB/HIV co-infection.

TB/HIV coinfection poses a complex public health challenge. Accurate forecasting of future trends is essential for efficient resource allocation and intervention strategy development. This study compares classical statistical and machine learning models to predict TB/HIV coinfection cases stratified by gender and the general populations. We analyzed time series data using exponential smoothing and ARIMA to establish the baseline trend and seasonality. Subsequently, machine learning models (SVR, XGBoost, LSTM, CNN, GRU, CNN-GRU, and CNN-LSTM) were employed to capture the complex dynamics and inherent non-linearities of TB/HIV coinfection data. Performance metrics (MSE, MAE, sMAPE) and the Diebold-Mariano test were used to evaluate the model performance. Results revealed that Deep Learning models, particularly Bidirectional LSTM and CNN-LSTM, significantly outperformed classical methods. This demonstrates the effectiveness of Deep Learning for modeling TB/HIV coinfection time series and generating more accurate forecasts.

IL10 promoter variants are associated with gene expression but they are not markers of susceptibility to acute coronary syndrome.

Interleukin-10 (IL-10) is an immunomodulatory cytokine that plays a pivotal role in the pathogenesis of acute coronary syndromes (ACS). Here, we evaluated the role of IL10 promoter variants as markers for ACS susceptibility in Western Mexican patients as well as its association with IL10 mRNA and IL-10 plasma levels. Three promoter variants (- 1082 A > G, - 819 T > C and - 592 A > C) were analyzed in 300 ACS patients and 300 control group (CG) individuals. IL10 relative gene expression was evaluated in peripheral blood mononuclear cells (PBMC) and IL-10 levels were quantified in plasma. The allelic, genotypic and haplotypic frequencies did not show significant differences between groups. ACS patients had sevenfold higher mRNA IL10 level compared to CG (p = 0.0013). Homozygous C/C carriers in both - 819 T > C and - 592 A > C variants had 0.4-fold higher IL10 mRNA expression than heterozygous and polymorphic allele homozygous genotypes (p = 0.0357) in ACS group. There were significant differences in plasma IL-10 levels in CG and ACS group (1.001 vs 1.777 pg/mL, p = 0.0051). The variants were not markers of susceptibility to ACS in Western Mexican individuals. ACS patients showed higher IL10 expression than CG individuals which could be mediated by - 819 T > C and - 592 A > C variants and pharmacotherapy.

Social protection in areas vulnerable to tuberculosis: a mixed methods study in São Luís, Maranhão.

OBJECTIVES: to analyze the risk areas for tuberculosis and the influences of social protection on the development of treatment for the disease in the municipality of São Luís, Maranhão. METHODS: this is explanatory sequential mixed method research. In the quantitative phase, the data were obtained from the Notifiable Diseases Information System from 2010 to 2019, with georeferencing being carried out to identify areas vulnerable to tuberculosis. In the qualitative phase, semi-structured interviews were carried out with individuals who received social benefits. RESULTS: 7,381 cases were geocoded, and, from the purely spatial scanning analysis, it was possible to identify 13 spatial clusters of risk. As for the interviews, there was a positive relationship between patient improvement and receiving benefits. CONCLUSIONS: geographic space and social determinants are relevant for reorienting monitoring actions for the conditions that generate the health-disease process.

Operational indicators for pulmonary tuberculosis diagnosis in people living with HIV before and after Xpert MTB/RIF implementation in the state of São Paulo, Brazil.

Tuberculosis (TB) in people living with HIV (PLHIV) is usually paucibacillary and the smear microscopy has limitations and may lead to high proportions of non-confirmed pulmonary tuberculosis (NC-PTB). Despite culture being the reference method, it usually takes 6 to 8 weeks to produce the results. This study aimed to analyze the effect of a rapid molecular test (Xpert) in the confirmatory rate of PTB among PLHIV, from 2010 to 2020, in São Paulo state, Brazil. This is an ecological study with time series analysis of the trend and the NC-PTB rates before and after Xpert implementation in 21 municipalities. The use of Xpert started and gradually increased after 2014, while the rate of NC-PTB in PLHIV decreased over this time, being more significant between late 2015 and mid-2017. The city of Ribeirão Preto stands out for having the highest percentage (75.0%) of Xpert testing among PLHIV and for showing two reductions in the NC-PTB rate. The cities with low Xpert coverage had a slower and smaller decrease in the NC-PTB rate. Despite being available since 2014, a significant proportion of PLHIV suspected of PTB in the state of São Paulo did not have an Xpert ordered by the doctors. The implementation of Xpert reduced the NC-PTB rates with growing effect as the coverage increased in the municipality.

The impact of Benevolent Childhood Experiences on adult Flourishing: the mediating role of Light Triad traits.

The literature has well documented the relationship between Adverse Childhood Experiences, personality traits, and well-being. However, less is known about how Benevolent Childhood Experiences (BCEs) relate to "light" personality traits and Flourishing. The study analyzed the effects of BCEs on Flourishing, considering the mediator role of Light Triad traits (Kantianism, Humanism, and Faith in Humanity). The study used a quantitative methodology with a non-experimental, cross-sectional design; 410 Honduran adults responded to the survey, including questions regarding Light Triad personality traits, Flourishing, and BCEs. On average, respondents reported 7.34 BCEs. The number of reported BCEs did not vary significantly between men and women. However, specific BCEs were categorically associated with subjects' sex. A higher proportion of men reported having at least one teacher who cared about the respondent, having opportunities to have a good time, and liking/feeling comfortable with oneself. Flourishing was significantly higher for participants who reported the presence of BCEs. The largest effect size was achieved for the difference in Flourishing scores between those who reported liking school as a child and those who disliked it. The number of Benevolent Childhood Experiences had a significant total and direct effect on Flourishing scores. Significant indirect effects were also identified. Faith in Humanity and Humanism, not Kantianism, mediated the relationship between BCEs and Flourishing. BCEs significantly explained all Light Triad traits. In conclusion, BCEs have significant direct and indirect effects on adult Flourishing; Faith in Humanity and Humanism mediate this relationship.

Induced-charge electrophoresis of a tilted metal nanowire near an insulating wall.

Electric fields are commonly used to control the orientation and motion of microscopic metal particles in aqueous suspensions. For example, metallodielectric Janus spheres are propelled by the induced-charge electro-osmotic flow occurring on their metallic side, the most common case in electrokinetics of exploiting symmetry breaking of surface properties for achieving net particle motion. In this work, we demonstrate that a homogeneous metal rod can translate parallel to a dielectric wall as a result of the hydrodynamic wall-particle interaction arising from the induced-charge electro-osmosis on the rod surface. The applied electric field could be either dc or low-frequency ac. The only requirement for a nonvanishing particle velocity is that the axis of the rod be inclined with respect to the wall, i.e., it cannot be neither parallel nor perpendicular. We show numerical results of the rod velocity as a function of rod orientation and distance to the wall. The maximum particle velocity is found for an orientation of between ∼30^{∘} and ∼50^{∘}, depending on the position and aspect ratio of the cylinder. Particle velocities of up to tens of µm/s are predicted for typical conditions in electrokinetic experiments.

On a Closer Look of a Doppler Tolerant Noise Radar Waveform in Surveillance Applications.

The prevalence of Low Probability of Interception (LPI) and Low Probability of Exploitation (LPE) radars in contemporary Electronic Warfare (EW) presents an ongoing challenge to defense mechanisms, compelling constant advances in protective strategies. Noise radars are examples of LPI and LPE systems that gained substantial prominence in the past decade despite exhibiting a common drawback of limited Doppler tolerance. The Advanced Pulse Compression Noise (APCN) waveform is a stochastic radar signal proposed to amalgamate the LPI and LPE attributes of a random waveform with the Doppler tolerance feature inherent to a linear frequency modulation. In the present work, we derive closed-form expressions describing the APCN signal's ambiguity function and spectral containment that allow for a proper analysis of its detection performance and ability to remove range ambiguities as a function of its stochastic parameters. This paper also presents a more detailed address of the LPI/LPE characteristic of APCN signals claimed in previous works. We show that sophisticated Electronic Intelligence (ELINT) systems that employ Time Frequency Analysis (TFA) and image processing methods may intercept APCN and estimate important parameters of APCN waveforms, such as bandwidth, operating frequency, time duration, and pulse repetition interval. We also present a method designed to intercept and exploit the unique characteristics of the APCN waveform. Its performance is evaluated based on the probability of such an ELINT system detecting an APCN radar signal as a function of the Signal-to-Noise Ratio (SNR) in the ELINT system. We evaluated the accuracy and precision of the random variables characterizing the proposed estimators as a function of the SNR. Results indicate a probability of detection close to 1 and show good performance, even for scenarios with a SNR slightly less than -10 dB. The contributions in this work offer enhancements to noise radar capabilities while facilitating improvements in ESM systems.

HIV and AIDS in the state of Paraná, Brazil, 2007-2022: trends and spatiotemporal distribution.

OBJECTIVE: The aim of this study was to analyze the spatiotemporal evolution of the incidence rates of human immunodeficiency virus (HIV) and acquired immune deficiency syndrome (AIDS) in the state of Paraná, Brazil. METHODS: An ecological study with an analytical component of time series analysis was conducted in the state of Paraná from 2007 to 2022. The data source was the Notifiable Diseases Information System. To study the trend, the Prais-Winsten generalized linear regression model was used by decomposing the time series, and for spatial analysis, the Moran's index was applied. RESULTS: The total sample consisted of 50,676 HIV/AIDS records. The incidence rate showed an increasing trend, with an average growth of 2.14% [95% confidence interval - 95%CI 1.16-3.13] per month. From 2007 to 2014 and from 2015 to 2022, the average number of cases in the state was 105.64 and 159.20 per 100,000 inhabitants, respectively, with significant variation among municipalities. Spatial clusters of high risk persisted in the metropolitan region, the capital, and coastal areas, and a new cluster was observed in the northern region of the state. CONCLUSION: The incidence rates of HIV/AIDS showed an upward trend over time. The number of cases varied considerably in some municipalities, especially in the coastal region. Spatial analysis revealed geospatial patterns of high risk in the main metropolitan areas of Paraná: Curitiba (including the coastal area), Londrina, and Maringá, which share characteristics such as a high degree of urbanization and ongoing economic development.

Unsuccessful tuberculosis treatment outcomes across Brazil's geographical landscape before and during the COVID-19 pandemic: are we truly advancing toward the sustainable development/end TB goal?

BACKGROUND: Tuberculosis is one of the most significant infectious diseases for global public health. The reallocation of healthcare resources and the restrictions imposed by the COVID-19 pandemic have hindered access to TB diagnosis and treatment. Increases in unfavorable outcomes of the disease have been observed in Brazil. The objective of this study was to analyze the spatial distribution of unfavorable TB treatment outcomes in Brazil before and during the pandemic. METHODS: An ecological study with spatial analysis was conducted with all 5569 municipalities in Brazil. All reported cases of tuberculosis between January 2010 and December 2021, as well as reported cases of COVID-19 from February 2020 to December 2021, were included. The outcomes studied encompass loss to follow-up, drug-resistant tuberculosis, and death. The Getis Ord GI* technique was employed to assess spatial association, and the Kernel density estimator was used to identify areas with concentrated increases or decreases in outcomes. Bivariate Local Moran's I was used to examine the spatial association between outcomes and COVID-19 incidence. The study was approved by the Research Ethics Committee of Ribeirão Preto Nursing School, University of São Paulo. RESULTS: There were 134,394 cases of loss to follow-up, 10,270 cases of drug resistance, and 37,863 deaths. Clusters of high and low values were identified for all three outcomes, indicating significant changes in the spatial distribution patterns. Increases in concentrations were observed for lost to follow-up cases in the Southeast, while reductions occurred in the Northeast, South, and Midwest. Drug-resistant tuberculosis experienced an increase in the Southern and Southeastern regions and a decrease in the Northeast and South. TB-related deaths showed notable concentrations in the Midwest, Northeast, South, and Southeast. There was an increase in high occurrence clusters for deaths after 2020 and 2021 in the Northeast. CONCLUSIONS: The pandemic has brought additional challenges, emphasizing the importance of enhancing efforts and disease control strategies, prioritizing early identification, treatment adherence, and follow-up. This commitment is vital for achieving the goal of tuberculosis elimination.

Predictive models for health outcomes due to SARS-CoV-2, including the effect of vaccination: a systematic review.

BACKGROUND: The interaction between modelers and policymakers is becoming more common due to the increase in computing speed seen in recent decades. The recent pandemic caused by the SARS-CoV-2 virus was no exception. Thus, this study aims to identify and assess epidemiological mathematical models of SARS-CoV-2 applied to real-world data, including immunization for coronavirus 2019 (COVID-19). METHODOLOGY: PubMed, JSTOR, medRxiv, LILACS, EconLit, and other databases were searched for studies employing epidemiological mathematical models of SARS-CoV-2 applied to real-world data. We summarized the information qualitatively, and each article included was assessed for bias risk using the Joanna Briggs Institute (JBI) and PROBAST checklist tool. The PROSPERO registration number is CRD42022344542. FINDINGS: In total, 5646 articles were retrieved, of which 411 were included. Most of the information was published in 2021. The countries with the highest number of studies were the United States, Canada, China, and the United Kingdom; no studies were found in low-income countries. The SEIR model (susceptible, exposed, infectious, and recovered) was the most frequently used approach, followed by agent-based modeling. Moreover, the most commonly used software were R, Matlab, and Python, with the most recurring health outcomes being death and recovery. According to the JBI assessment, 61.4% of articles were considered to have a low risk of bias. INTERPRETATION: The utilization of mathematical models increased following the onset of the SARS-CoV-2 pandemic. Stakeholders have begun to incorporate these analytical tools more extensively into public policy, enabling the construction of various scenarios for public health. This contribution adds value to informed decision-making. Therefore, understanding their advancements, strengths, and limitations is essential.

Social media addiction relationship with academic engagement in university students: The mediator role of self-esteem, depression, and anxiety.

This research analyzed how addiction to social media relates to academic engagement in university students, considering the mediating role of self-esteem, symptoms of depression, and anxiety. A quantitative methodology was used with a non-experimental-relational design. A set of questionnaires was applied to a non-probabilistic sample of 412 students enrolled at the National Autonomous University of Honduras. On average, participants use 4.83 different social media platforms at least once a week. Instagram and TikTok users report significantly higher levels of social media addiction, symptoms of depression, and anxiety compared to non-users. Directly, social media addiction does not significantly influence academic engagement scores. However, there are significant indirect inverse effects on academic engagement. Symptoms of depression and self-esteem mediate these effects. Social media addiction increases symptoms of depression, which in turn decreases academic engagement scores. Social media addiction decreases self-esteem, which serves as a variable that significantly increases academic engagement. Overall, findings suggest that social media addiction has a total inverse effect on academic engagement; symptoms of depression and self-esteem mediate this relationship. The implications of these findings are discussed.

Social protection in areas vulnerable to tuberculosis: a mixed methods study in São Luís, Maranhão / Protección social en zonas vulnerables a la tuberculosis: un estudio mixto en São Luís, Maranhão / Proteção social em áreas vulneráveis à tuberculose: um estudo misto em São Luís, Maranhão

ABSTRACT Objectives: to analyze the risk areas for tuberculosis and the influences of social protection on the development of treatment for the disease in the municipality of São Luís, Maranhão. Methods: this is explanatory sequential mixed method research. In the quantitative phase, the data were obtained from the Notifiable Diseases Information System from 2010 to 2019, with georeferencing being carried out to identify areas vulnerable to tuberculosis. In the qualitative phase, semi-structured interviews were carried out with individuals who received social benefits. Results: 7,381 cases were geocoded, and, from the purely spatial scanning analysis, it was possible to identify 13 spatial clusters of risk. As for the interviews, there was a positive relationship between patient improvement and receiving benefits. Conclusions: geographic space and social determinants are relevant for reorienting monitoring actions for the conditions that generate the health-disease process.

RESUMEN Objetivos: analizar las áreas de riesgo para la tuberculosis y las influencias de la protección social en el desarrollo del tratamiento de la enfermedad en el municipio de São Luís, Maranhão. Métodos: se trata de una investigación explicativa de método mixto secuencial. En la fase cuantitativa, los datos se obtuvieron del Sistema de Información de Enfermedades de Declaración Obligatoria del 2010 al 2019, realizándose georreferenciación para identificar áreas vulnerables a la tuberculosis. En la fase cualitativa se realizaron entrevistas semiestructuradas a personas que recibían beneficios sociales. Resultados: se geocodificaron 7.381 casos y, a partir del análisis de escaneo puramente espacial, fue posible identificar 13 grupos espaciales de riesgo. En cuanto a las entrevistas, hubo una relación positiva entre la mejora del paciente y la recepción de beneficios. Conclusiones: el espacio geográfico y los determinantes sociales son relevantes para reorientar las acciones de seguimiento de las condiciones que generan el proceso salud-enfermedad.

RESUMO Objetivos: analisar as áreas de risco para a tuberculose e as influências da proteção social no desenvolvimento do tratamento para a doença no município de São Luís, Maranhão. Métodos: trata-se de pesquisa de método misto sequencial explanatório. Na fase quantitativa, os dados foram obtidos do Sistema de Informação de Agravos de Notificação de 2010 a 2019, sendo realizado georreferenciamento para identificação das áreas vulneráveis à tuberculose. Na fase qualitativa, realizaram-se entrevistas semiestruturadas com indivíduos que recebiam benefício social. Resultados: foram geocodificados 7.381 casos, e, a partir da análise de varredura puramente espacial, foi possível identificar 13 aglomerados espaciais de risco. Quanto às entrevistas, verificou-se uma relação positiva entre a melhora dos pacientes e o recebimento de benefícios. Conclusões: o espaço geográfico e os determinantes sociais são relevantes para reorientação das ações de monitoramento das condições geradoras do processo saúde-doença.

HIV and AIDS in the state of Paraná, Brazil, 2007-2022: trends and spatiotemporal distribution / HIV e AIDS no Estado do Paraná, Brasil, 2007-2022: tendência e distribuição espaçotemporal

ABSTRACT Objective: The aim of this study was to analyze the spatiotemporal evolution of the incidence rates of human immunodeficiency virus (HIV) and acquired immune deficiency syndrome (AIDS) in the state of Paraná, Brazil. Methods: An ecological study with an analytical component of time series analysis was conducted in the state of Paraná from 2007 to 2022. The data source was the Notifiable Diseases Information System. To study the trend, the Prais-Winsten generalized linear regression model was used by decomposing the time series, and for spatial analysis, the Moran's index was applied. Results: The total sample consisted of 50,676 HIV/AIDS records. The incidence rate showed an increasing trend, with an average growth of 2.14% [95% confidence interval - 95%CI 1.16-3.13] per month. From 2007 to 2014 and from 2015 to 2022, the average number of cases in the state was 105.64 and 159.20 per 100,000 inhabitants, respectively, with significant variation among municipalities. Spatial clusters of high risk persisted in the metropolitan region, the capital, and coastal areas, and a new cluster was observed in the northern region of the state. Conclusion: The incidence rates of HIV/AIDS showed an upward trend over time. The number of cases varied considerably in some municipalities, especially in the coastal region. Spatial analysis revealed geospatial patterns of high risk in the main metropolitan areas of Paraná: Curitiba (including the coastal area), Londrina, and Maringá, which share characteristics such as a high degree of urbanization and ongoing economic development.

RESUMO Objetivo: Este estudo teve como objetivo analisar a evolução espaçotemporal das taxas de incidência do vírus da imunodeficiência humana (HIV) e da síndrome da imunodeficiência adquirida (AIDS) no estado do Paraná, Brasil. Métodos: Foi realizado um estudo ecológico com componente analítico de séries temporais e análise espacial no estado do Paraná, de 2007 a 2022. A fonte de dados foi o Sistema de Informação de Agravos de Notificação. Para estudar a tendência, foi utilizado o modelo de regressão linear generalizada de Prais-Winsten por meio da decomposição de séries temporais e, para a análise espacial, foi aplicado o Índice de Moran. Resultados: A amostra total foi composta de 50.676 registros de HIV/AIDS. A taxa de incidência apresentou tendência crescente, com crescimento médio de 2,14% (intervalo de confiança de 95% — IC95% 1,16-3,13) ao mês. Nos períodos de 2007 a 2014 e 2015 a 2022, a média de casos no estado foi de 105,64 e 159,20 a cada 100 mil habitantes, respectivamente, com importantes variações entre os municípios. Agrupamentos espaciais de alto risco permaneceram na região metropolitana à capital e litoral e um novo agrupamento foi observado à região norte do estado. Conclusão: As taxas de incidência do HIV/AIDS apresentaram tendência temporal crescente. O número de casos variou substancialmente em alguns municípios, principalmente naqueles localizados na região litorânea. A análise espacial revelou padrões geoespaciais de alto risco nas principais regiões metropolitanas do Paraná: Curitiba (abrange o litoral), Londrina e Maringá, as quais compartilham características como elevado grau de urbanização e constante desenvolvimento econômico.

Spatial and temporal analysis of tuberculosis incidence in Guinea-Bissau, 2018 to 2020.

OBJECTIVE: to analyze the epidemiological profile, spatial and temporal distribution of tuberculosis in Guinea-Bissau from 2018 to 2020. METHODS: an ecological study, carried out in Guinea-Bissau, considering new cases of tuberculosis. Spatial analysis of areas was used to verify tuberculosis distribution in the country, and time series were used to identify incidence evolution over the years of study. RESULTS: a total of 6,840 new cases of tuberculosis were reported. Tuberculosis incidence rate in the country ranged from 36.8 to 267.7 cases/100,000 inhabitants, with emphasis on the regions of Bissau and Biombo (over 90 cases/100,000). By using time series, it was possible to observe an increase in case incidence over the years of study. CONCLUSIONS: the study made it possible to identify the epidemiological profile of tuberculosis in Guinea-Bissau, spatial distribution heterogeneity, in addition to identifying the disease evolution over the years of investigation.

Case Report: Characterization of known (c.607G>C) and novel (c.416C>G) ELANE mutations in two Mexican families with congenital neutropenia.

The most common causes of congenital neutropenia are mutations in the ELANE (Elastase, Neutrophil Expressed) gene (19p13.3), mostly in exon 5 and the distal portion of exon 4, which result in different clinical phenotypes of neutropenia. Here, we report two pathogenic mutations in ELANE, namely, c.607G>C (p.Gly203Arg) and a novel variant c.416C>G (p.Pro139Arg), found in two Mexican families ascertained via patients with congenital neutropenia who responded positively to the granulocyte colony-stimulating factor (G-CSF) treatment. These findings highlight the usefulness of identifying variants in patients with inborn errors of immunity for early clinical management and the need to rule out mosaicism in noncarrier parents with more than one case in the family.

Digital health for treatment adherence in people with tuberculosis: a systematic review / Saúde digital para a adesão ao tratamento da pessoa com tuberculose: uma revisão sistemática / Salud digital para la adherencia al tratamiento en personas con tuberculosis: una revisión sistemática

Justifications and Objectives: the use of digital health, among people diagnosed with tuberculosis, can be an effective strategy, combined with health services, to increase adherence to treatment and impact the disease's epidemiological data in the country. As this topic has been widely discussed and improved in recent years, it is necessary to further investigate the research available on scientific bases. The objective of this study was to describe the use of digital health technologies to assist with adherence to tuberculosis treatment. Methods: this is a systematic literature review with a rapid review approach, following the PRISMA guidelines and the Cochrane guide. Evidence quality was assessed using the Mixed Methods Appraisal Tool. The studies were identified in PubMed, VHL, CINAHL, Cochrane Trial, SciELO, Scopus and Embase. Experimental, quasi-experimental studies and clinical trials were included, without language restrictions, published between 2020 and 2022. Content: nine studies were selected, which demonstrated that the implementation of digital technologies improved adherence rates to medication treatment and cure rates. Applications use strategies such as synchronous and asynchronous video, voice calls and text messages. Among the studies, only two technology/application names were mentioned. Conclusion: digital technologies have had a positive impact on the treatment of people diagnosed with tuberculosis.(AU)

Justificativas e Objetivos: a utilização da saúde digital, junto às pessoas diagnosticadas com a tuberculose, pode ser uma estratégia eficaz, aliada dos serviços de saúde, para aumentar a adesão ao tratamento e impactar os dados epidemiológicos da doença no país. Como esse tema tem sido amplamente discutido e aprimorado nos últimos anos, é necessário investigar mais a fundo as pesquisas disponíveis nas bases científicas. O objetivo deste estudo foi descrever o uso de tecnologias em saúde digital para auxiliar na adesão ao tratamento da tuberculose. Método: trata-se de revisão sistemática da literatura com abordagem de revisão rápida, seguindo as diretrizes do PRISMA e o guia da Cochrane. A qualidade das evidências foi realizada utilizando a ferramenta Mixed Methods Appraisal Tool. Os estudos foram identificados nas bases de dados PubMed, BVS, CINAHL, Cochrane Trial, SciELO, Scopus e Embase. Foram incluídos estudos experimentais, quase-experimentais e ensaios clínicos, sem restrição de idioma, publicados entre 2020 e 2022. Conteúdo: foram selecionados nove estudos, que demonstraram que a implementação de tecnologias digitais melhorou as taxas de adesão ao tratamento medicamentoso e as taxas de cura. Os aplicativos utilizam estratégias como vídeo síncrono e assíncrono, chamadas de voz e mensagens de texto. Entre os estudos, apenas dois nomes de tecnologia/aplicativo foram mencionados. Conclusão: as tecnologias digitais têm impactado de forma positiva no tratamento das pessoas com diagnóstico de tuberculose.(AU)

Justificaciones y objetivos: el uso de la salud digital entre las personas diagnosticadas con tuberculosis puede ser una estrategia eficaz y aliada de los servicios de salud para aumentar la adherencia al tratamiento e impactar los datos epidemiológicos de la enfermedad en el país. 3. Método: se realizó una revisión sistemática de la literatura con un enfoque de revisión rápida, siguiendo las pautas de PRISMA y la guía de Cochrane. La calidad de la evidencia se evaluó utilizando la herramienta Mixed Methods Appraisal Tool. Los estudios se identificaron en las siguientes bases de datos: PubMed, BVS, CINAHL, Cochrane Trial, SciELO, Scopus y Embase. Se incluyeron estudios experimentales, cuasiexperimentales y ensayos clínicos, sin restricciones de idioma, publicados entre 2020 y 2022. Contenido: se seleccionaron nueve estudios que demostraron que la implementación de tecnologías digitales mejoró las tasas de adherencia al tratamiento con medicamentos y las tasas de curación. Las aplicaciones utilizan estrategias como video sincrónico y asincrónico, llamadas de voz y mensajes de texto. Entre los estudios, sólo se mencionaron dos nombres de tecnologías/aplicaciones. Conclusión: las tecnologías digitales han tenido un impacto positivo en el tratamiento de personas diagnosticadas con tuberculosis.(AU)

Treatment of drug-resistant tuberculosis in children and young adolescents in Brazil.

Introduction: Drug-resistant tuberculosis (DR-TB) is a global threat and a challenge for public health authorities worldwide. In children, the diagnosis is even more challenging and DR-TB is poorly described in the literature, as are its treatment outcomes. In this study, we aimed to describe the treatment of drug-resistant TB in children and young adolescents in Brazil. Methods: A descriptive epidemiological study of treatment for DR-TB in children under 15 years of age in Brazil between 2013 and 2020. The primary data source was the Information System for Special Tuberculosis Treatments (SITE-TB). Categorical variables were analyzed using relative frequencies (%) and continuous variables by measures of central tendency to characterize the profile of the cases, namely: sociodemographic, clinical characteristics, procedures, tests performed and treatment success. In order to verify the distribution of cases, a spatial analysis was carried out based on the municipality where the cases resided. Results: Between 2013 and 2020, 19,757 tuberculosis (TB) cases occurred in children aged <15 years in Brazil, and 46 cases of treatment for DR-TB were reported during the same period (annual average of 6 cases). Of these, 73.9% were aged 10-14, 65.2% were male, 4.3% were HIV+ and 43.3% were underweight (BMI<18.5) at the start of treatment. 17.4% had previous contact with TB, 69.6% had primary resistance, 47.8% multidrug resistance. The median duration of treatment was 15 months. DOT and standardized treatment regimen were performed in 52.2% of cases. Bacilloscopy was performed for 97.8% (57.8% positive); culture for 89.1% (75.6% positive), rapid molecular test for 73.9% with proven resistance to rifampicin in 55.8%. Susceptibility testing revealed resistance mainly to isoniazid (87.8%) and rifampicin (60.6%). 73.9% of cases were successfully treated and one death was reported. Cases were treated in 26 Brazilian municipalities, with the majority in Rio de Janeiro (15) and São Paulo (4). Conclusion: DR-TB treatment was recorded in <1% of general TB cases in children and young adolescents, suggesting underreporting of drug-resistant cases in the country. Despite the low number of registered cases, the data reflect the situation of DR-TB in this population and describe important aspects of the problem, as the child needs comprehensive, individualized care, with support from different professionals. We recommend a strengthening of the country's referral services for the care of children with DR-TB so that surveillance and health care services can work together to identify and follow up cases.

[On "the remedies and medications which were given to ailing negroes:" health and death spending on slaves by the Office of the Jesuit Province of Paraguay, 1711-1745]. / Sobre "os remédios e medicinas que se haviam dado a negros enfermos": os gastos com a saúde e a morte de escravos do Ofício da Província Jesuítica do Paraguay, 1711-1745.

This text analyzes the way sick slaves were treated at the Office (ofício) of the Jesuit Province of Paraguay and Santa Catalina Farm (estancia) between 1711 and 1745. The sources consulted - Libro de cuentas del Ofício, Memoriales, and Cartas ânuas - reveal that the sickness of the enslaved people generated expenses, not only for medications, clothing, and food, but also for shrouds for their burial. As for the slaves from the Santa Catalina Farm, the sources indicate that depending on the infirmity, they were sometimes sent to Córdoba, where they were treated by laypersons trained in the healing arts, which incurred different expenses, also recorded in the ledgers.

Neste texto, analisamos o tratamento dispensado aos escravos enfermos do Ofício da Província Jesuítica do Paraguay e da Estância de Santa Catalina entre 1711 e 1745. As fontes analisadas ­ Libro de cuentas del Ofício, Memoriales e Cartas ânuas ­ revelam que o adoecimento de escravos do Ofício gerava despesas tanto com a aquisição de medicamentos, roupas e alimentos quanto com mortalhas para seu sepultamento. No caso dos escravos da Estância de Santa Catalina, observou-se que, dependendo da enfermidade, eles eram encaminhados à cidade de Córdoba, onde eram tratados por leigos treinados nas artes de curar, o que implicava despesas de outra natureza também registradas nos relatórios contábeis.