Tuberculosis case notifications and outcomes in Peruvian prisons prior to and during the COVID-19 pandemic: a national-level interrupted time series analysis.

Background: The COVID-19 pandemic has significantly disrupted tuberculosis (TB) programs, making it urgent to focus TB elimination efforts on key populations. People experiencing incarceration are at high risk for TB, however, how COVID-19-related disruptions have impacted incarcerated populations with TB is unknown. Methods: Using Peruvian National TB Program data from Jan 2018 to Dec 2021, an interrupted time series of drug-susceptible (DS) TB case notifications pre- and during COVID-19 was conducted (cut-off date: COVID-19 emergency declaration in Peru, 16 March 2020). The effect of TB care occurring pre-vs. during COVID-19 on TB treatment success in the incarcerated and non-incarcerated populations was explored using logistic regression. Findings: DS-TB cases notified in prisons from Jan 2018 to Dec 2021 (n = 10,134) represented 10% of all cases notified in the country (n = 101,507). In the first week of COVID-19, DS-TB case notifications dropped by 61.2% (95% CI: 59.9-62.7%) in the non-incarcerated population and 17.7% (95% CI: 17.5-17.9%) among the incarcerated population. TB treatment success was significantly lower in people receiving TB care entirely during the COVID-19 pandemic vs. before COVID-19 in the non-incarcerated population (OR: 0.81, 95% CI: 0.78-0.85), but not statistically significantly lower in the incarcerated population (OR: 0.88, 95% CI: 0.76-1.01). Incarceration status was not found to modify the effect of COVID-19 period on TB treatment outcomes (OR: 1.07, 95% CI: 0.92-1.25), although treatment success was higher in the incarcerated population (OR [incarcerated vs. not incarcerated, pre-COVID]: 1.52, 95% CI: 1.39-1.67). Interpretation: Both incarcerated and non-incarcerated populations experienced a large drop in DS-TB case notifications (although higher in the non-incarcerated population). Lower TB treatment success among those receiving care during COVID-19 indicates significant TB service disruptions in the overall population. The finding that incarceration at time of diagnosis was associated with treatment success is plausible in Peru given increased screening and stricter treatment monitoring in prisons. Funding: Canadian Institutes of Health Research (Funding Reference Number: 179418) .

Alkaloid production and response to natural adverse conditions in Peganum harmala: in silico transcriptome analyses.

Peganum harmala is a valuable wild plant that grows and survives under adverse conditions and produces pharmaceutical alkaloid metabolites. Using different assemblers to develop a transcriptome improves the quality of assembled transcriptome. In this study, a concrete and accurate method for detecting stress-responsive transcripts by comparing stress-related gene ontology (GO) terms and public domains was designed. An integrated transcriptome for P. harmala including 42 656 coding sequences was created by merging de novo assembled transcriptomes. Around 35 000 transcripts were annotated with more than 90% resemblance to three closely related species of Citrus, which confirmed the robustness of the assembled transcriptome; 4853 stress-responsive transcripts were identified. CYP82 involved in alkaloid biosynthesis showed a higher number of transcripts in P. harmala than in other plants, indicating its diverse alkaloid biosynthesis attributes. Transcription factors (TFs) and regulatory elements with 3887 transcripts comprised 9% of the transcriptome. Among the TFs of the integrated transcriptome, cystein2/histidine2 (C2H2) and WD40 repeat families were the most abundant. The Kyoto Encyclopedia of Genes and Genomes (KEGG) MAPK (mitogen-activated protein kinase) signaling map and the plant hormone signal transduction map showed the highest assigned genes to these pathways, suggesting their potential stress resistance. The P. harmala whole-transcriptome survey provides important resources and paves the way for functional and comparative genomic studies on this plant to discover stress-tolerance-related markers and response mechanisms in stress physiology, phytochemistry, ecology, biodiversity, and evolution. P. harmala can be a potential model for studying adverse environmental cues and metabolite biosynthesis and a major source for the production of various alkaloids.

Delphi Project on the trends in Implant Dentistry in the COVID-19 era: Perspectives from Latin America.

AIM: To establish trends in Implant Dentistry in Latin America in the COVID-19 pandemic. MATERIAL AND METHODS: A steering committee and an advisory group of experts in Implant Dentistry were selected among eighteen countries. An open-ended questionnaire by Delphi methodology was validated including 64 questions, divided in 7 topics, concerning the various trends in dental implantology. The survey was conducted in two rounds, which provided the participants in the second round with the results of the first. The questionnaires were completed on August 2020, and the online meeting conference was held on September 2020. The final prediction was developed through consensus by a selected group of experts. RESULTS: A total of 197 experts from Latin America answered the first and second questionnaire. In the first round, the established threshold for consensus (65%) was achieved in 30 questions (46.87%). In the second round, performed on average 45 days later, this level was achieved in 47 questions (73.43%). Consensus was completely reached on the item "Diagnostic" (100%), the field with the lowest consensus was "Demand for treatment with dental implants" (37.5%). CONCLUSIONS: The present study in Latin America has provided relevant and useful information on the predictions in the education and practice of Implant Dentistry in the COVID-19 era. The consensus points toward a great confidence of clinicians in the biosecurity protocols used to minimize the risk of SARS-CoV-2 transmission. It is foreseen as an important change in education, with introduction of virtual reality and other simulation technologies in implant training.

Roles of quorum sensing in biological wastewater treatment: A critical review.

Quorum sensing (QS) and quorum quenching (QQ) are increasingly reported in biological wastewater treatment processes because of their inherent roles in biofilm development, bacterial aggregation, granulation, colonization, and biotransformation of pollutants. As such, the fundamentals and ubiquitous nature of QS bacteria are critical for fully understanding the process of the wastewater treatment system. In this article, the details of QS-based strategies related to community behaviors and phenotypes in wastewater treatment systems were reviewed. The molecular aspects and coexistence of QS and QQ bacteria were also mentioned, which provide evidence that future wastewater treatment will indispensably rely on QS-based strategies. In addition, recent attempts focusing on the use of QQ for biofilm or biofouling control were also summarized. Nevertheless, there are still several challenges and knowledge gaps that warrant future targeted research on the ecological niche, abundance, and community of QS- and QQ-bacteria in environmental settings or engineered systems.

Maltrato durante el embarazo adolescente: Un estudio descriptivo en gestantes que se atienden en un hospital público de Lima / Abuse during adolescent pregnancy: descriptive study in pregnant women treated in a public hospital in Lima

RESUMEN Introducción: La violencia es un problema que puede ser de tipo físico, psicológico o sexual, si esto se da entre las niñas y adolescentes puede generar problemas serios a futuro. Objetivo: Describir las características de las adolescentes embarazadas que sufrieron maltrato. Material y Método: Estudio observacional descriptivo preliminar. La variable principal fue la agresión durante la gestación en las adolescentes, que fue obtenida según su tipo: físico, sexual o psicológico. Esto fue extraído de una base de datos generada en un Hospital Público de Lima Metropolitana. Resultados: Se incluyó 375 pacientes, siendo la edad promedio 17 años. Tan solo un 34% de las adolescentes no han padecido ningún tipo de violencia. El tipo de agresión más frecuente fue la psicológica, en comparación a la agresión física y sexual. La familia nuclear y la pareja fueron los principales agresores psicológicos y físicos hacia las gestantes adolescentes, la agresión sexual se da principalmente por los familiares y conocidos. Discusión: La frecuencia de violencia en las adolescentes gestantes es elevada. De los tres tipos de violencia analizados, el que más prevalece es el psicológico y los principales agresores son hombres pertenecientes a la familia nuclear de la víctima. El embarazo adolescente es un problema cada vez más frecuente en nuestra sociedad, por lo que debe ser estudiado a profundidad e intervenido oportunamente para la búsqueda de una mejora.

ABSTRACT Introduction: Violence is a problem that can be physical, psychological or sexual, if this occurs between girls and adolescents can generate serious problems in the future. Objective: To describe the characteristics of teenagers pregnant who suffered abuse. Material and Method: Preliminary descriptive observational study. The main variable was the aggression during gestation in teenagers, which was obtained according to their type: physical, sexual or psychological. This was extracted from a database generated in a Public Hospital of Metropolitan Lima. Results: A total of 375 patients were included, with the mean age being 17 years. Only 34% of adolescents did not suffer any type of violence. The most frequent type of aggression was the psychological, in comparison to the physical and sexual aggression. The nuclear family and the couple are the main psychological and physical aggressors towards adolescent pregnant women, the sexual aggression is mainly given by relatives and acquaintances. Discussion: The frequency of violence in pregnant adolescents is high. Of the three types of violence analyzed, the most prevalent is the psychological and the main aggressors are men belonging to the victim's nuclear family. Adolescent pregnancy is an increasingly frequent problem in our society, so it must be studied in depth and intervened in a timely manner in order to seek improvement.

Enfoque inmunogenético de los fenotipos clínicos del asma / An immunogenetic approach to the clinical phenotypes of asthma

El asma bronquial es una enfermedad multifactorial compleja, caracterizada por una heterogeneidad genética que define diferentes fenotipos clínicos. Se realizó una revisión bibliográfica, empleando recursos disponibles en la red Infomed, con el objetivo de profundizar en la inmunogenética del asma, haciendo énfasis en los genes, cuyos productos tienen un papel activo en la inflamación de vías aérea y en la patogénesis de la enfermedad. Se reportan más de cien genes mayores y menores de susceptibilidad a esta enfermedad, la mayoría de estos genes codifican para proteínas, que juegan un papel clave dentro del sistema inmune o modulan la respuesta inflamatoria. Estos genes interactúan entre sí y con el ambiente y determinan el grado de complejidad de la respuesta del sistema inmune. La revisión permite un mejor entendimiento del asma, desde un enfoque inmunogenético, y una mejor comprensión de las variedades clínicas, el diagnóstico y propuestas terapéuticas para los pacientes asmáticos, acorde a cada fenotipo clínico(AU)

Bronchial asthma is a complex multifactorial disease characterized by a genetic heterogeneity that defines different clinical phenotypes. A review paper was carried out using the resources available in the Infomed network, with the aim of deepening the knowledge on asthma immunogenetics, emphasizing the genes which products have an active role in airway inflammation and in the pathogenesis of the disease. More than one hundred major or minor genes of susceptibility to this disease are reported. Most of these genes encode proteins that play a key role within the immune system or adjust the inflammatory response. These genes interact with each other and with the environment and determine the degree of complexity of the immune system response. The paper brings a better understanding of asthma, from an immunogenetic approach, and a better understanding of the clinical varieties, diagnosis and therapeutic proposals for asthmatic patients, according to each clinical phenotype(AU)

2A4 binds soluble and insoluble light chain aggregates from AL amyloidosis patients and promotes clearance of amyloid deposits by phagocytosis †.

Amyloid light chain (AL) amyloidosis is characterized by misfolded light chain (LC) (amyloid) deposition in various peripheral organs, leading to progressive dysfunction and death. There are no regulatory agency-approved treatments for AL amyloidosis, and none of the available standard of care approaches directly targets the LC protein that constitutes the amyloid. NEOD001, currently in late-stage clinical trials, is a conformation-specific, anti-LC antibody designed to specifically target misfolded LC aggregates and promote phagocytic clearance of AL amyloid deposits. The present study demonstrated that the monoclonal antibody 2A4, the murine form of NEOD001, binds to patient-derived soluble and insoluble LC aggregates and induces phagocytic clearance of AL amyloid in vitro. 2A4 specifically labeled all 21 fresh-frozen organ samples studied, which were derived from 10 patients representing both κ and λ LC amyloidosis subtypes. 2A4 immunoreactivity largely overlapped with thioflavin T-positive labeling, and 2A4 bound both soluble and insoluble LC aggregates extracted from patient tissue. Finally, 2A4 induced macrophage engagement and phagocytic clearance of AL amyloid deposits in vitro. These findings provide further evidence that 2A4/NEOD001 can effectively clear and remove human AL-amyloid from tissue and further support the rationale for the evaluation of NEOD001 in patients with AL amyloidosis.

Substoichiometric inhibition of transthyretin misfolding by immune-targeting sparsely populated misfolding intermediates: a potential diagnostic and therapeutic for TTR amyloidoses.

Wild-type and mutant transthyretin (TTR) can misfold and deposit in the heart, peripheral nerves, and other sites causing amyloid disease. Pharmacological chaperones, Tafamidis(®) and diflunisal, inhibit TTR misfolding by stabilizing native tetrameric TTR; however, their minimal effective concentration is in the micromolar range. By immune-targeting sparsely populated TTR misfolding intermediates (i.e. monomers), we achieved fibril inhibition at substoichiometric concentrations. We developed an antibody (misTTR) that targets TTR residues 89-97, an epitope buried in the tetramer but exposed in the monomer. Nanomolar misTTR inhibits fibrillogenesis of misfolded TTR under micromolar concentrations. Pan-specific TTR antibodies do not possess such fibril inhibiting properties. We show that selective targeting of misfolding intermediates is an alternative to native state stabilization and requires substoichiometric concentrations. MisTTR or its derivative may have both diagnostic and therapeutic potential.

Novel conformation-specific monoclonal antibodies against amyloidogenic forms of transthyretin.

INTRODUCTION: Transthyretin amyloidosis (ATTR amyloidosis) is caused by the misfolding and deposition of the transthyretin (TTR) protein and results in progressive multi-organ dysfunction. TTR epitopes exposed by dissociation and misfolding are targets for immunotherapeutic antibodies. We developed and characterized antibodies that selectively bound to misfolded, non-native conformations of TTR. METHODS: Antibody clones were generated by immunizing mice with an antigenic peptide comprising a cryptotope within the TTR sequence and screened for specific binding to non-native TTR conformations, suppression of in vitro TTR fibrillogenesis, promotion of antibody-dependent phagocytic uptake of mis-folded TTR and specific immunolabeling of ATTR amyloidosis patient-derived tissue. RESULTS: Four identified monoclonal antibodies were characterized. These antibodies selectively bound the target epitope on monomeric and non-native misfolded forms of TTR and strongly suppressed TTR fibril formation in vitro. These antibodies bound fluorescently tagged aggregated TTR, targeting it for phagocytic uptake by macrophage THP-1 cells, and amyloid-positive TTR deposits in heart tissue from patients with ATTR amyloidosis, but did not bind to other types of amyloid deposits or normal tissue. CONCLUSIONS: Conformation-specific anti-TTR antibodies selectively bind amyloidogenic but not native TTR. These novel antibodies may be therapeutically useful in preventing deposition and promoting clearance of TTR amyloid and in diagnosing TTR amyloidosis.

Vigilancia inmunoepidemiológica del sarampión, rubéola parotiditis poliomielitis y tos ferina en la provincia Las Tunas 2010-2013 / Immuno-epidemiological surveillance of Measles Rubella Parotitis Poliomyelitis and Pertussis in the province of Las Tunas 2010-2013

La inmunoepidemiología se ha convertido en imprescindible en el sistema de vigilancia moderno de salud, en la evaluación de los programas de vacunación, en la definición de la inmunidad poblacional y en su papel en la prevención de enfermedades. Este estudio describe el comportamiento en la provincia de Las Tunas de la vigilancia inmunoepidemiológica de cinco enfermedades prevenibles: sarampión, rubéola, parotiditis, poliomielitis y tos ferina. La investigación cubrió el periodo desde el año 2010 hasta el 2013. Los resultados muestran la eficacia de las vacunas empleadas, sin ningún caso positivo registrado y avalan a la vigilancia inmunoepidemiológica establecida desde la atención primaria de salud hasta la red de higiene y epidemiología del municipio, la provincia y la nación. Este sistema es necesario para evaluar con antelación posibles riesgos de enfermedades y la decisión oportuna de medidas de intervención (AU)

Immuno-epidemiology has become essential for the modern health surveillance system in the assessment of the vaccination programs, in the definition of the population´s immunity and its role in illness prevention. This study describes de behavior of immuno-epidemiology surveillance of five illnesses in Las Tunas: measles, rubella, parotitis, poliomyelitis and pertussis. The investigation was made from 2012 to 2013. The results show the efficiency of the vaccines used, with no recorded positive cases and support the surveillance carried out from the primary health attention services to the hygiene and epidemiology network of the municipality, province and nation respectively. It is concluded that the system is necessary for assessing possible risks of illness and the convenient decision of intervention measures in advance(AU)

Determinación del angulo crítico de incidencia del movimiento sísmico para el análisis estructural

En este trabajo se presenta una metodología para el análisis de estructuras sujetas a una o dos componentes horizontales del sismo actuando según una dirección arbitraria; en particular se presenta un procedimiento sencillo para determinar el ángulo crítico de incidencia del sismo que da origen a la máxima respuesta estructural y para calcular las solicitaciones resultantes en la estructura. Cada una de las componentes del sismo se describe mediante un espectro de aceleraciones de amplitud distinta. El método requiere del análisis dinámico de sólo dos casos básicos. A diferencia de otros métodos publicados en la literatura especializada, este método es exácto y obvia la necesidad de hacer un análisis dinámico para cada ángulo de incidencia del sismo. La efectividad del método se demuestra numéricamente aplicando el caso de edificios simétricos y asimétricos, tanto para una componente sismica como para las dos componentes actuando simultáneamente (AU)

Enfoque inmunopatogénico de las infecciones respiratorias agudas virales / An immuno-pathogenic approach to viral acute respiratory infections

Las infecciones virales respiratorias constituyen uno de los principales problemas de salud de cualquier país; por lo tanto, es de vital importancia para los médicos, otros profesionales y estudiantes de la medicina, incorporar conocimientos actualizados de los factores inmunológicos involucrados en la patogénesis de estas enfermedades, que les garanticen lograr un diagnóstico preciso y un manejo clínico correcto de estos pacientes. La revisión realizada tuvo como objetivo profundizar en los conocimientos de los procesos inmunes activados por una infección viral, a partir de la literatura científica actualizada. Se emplearon los servicios disponibles desde la red Infomed y se consultaron 30 revisiones bibliográficas sobre el tema, el 76 por ciento de los últimos cinco años. En las infecciones virales respiratorias se activan una serie de mecanismos innatos y específicos de defensas, en correspondencia con la principal función fisiológica del sistema inmune. Algunos virus desarrollan mecanismos de evasión, logrando burlar las defensas del cuerpo (AU)

Viral respiratory infections are one of the main health problems of any country; consequently, it is of paramount importance for physicians, other professionals and medical students to add updated knowledge on immunological factors involved in the pathogenesis of these diseases, which ensure them to make a precise diagnosis and a correct clinical management of these patients. The aim of this bibliographic checking is to deepen on the knowledge about the immune processes activated by a viral infection, starting from an updated scientific literature. The services offered by Infomed network were used and 30 articles about this theme were checked, out of which a 76 percent belong to the last 5 years. In the viral respiratory infections, a series of innate and defense specific mechanisms are activated, according to the main physiological function of the immune system. Some viruses develop viral evasion mechanisms, achieving to escape bodies defenses (AU)