Characterization and effectiveness of a Fracture Liaison Services program in Colombia.

PURPOSE: Fracture Liaison Services programs reduce mortality and the risk of refracture and increase treatment and adherence rates. Greater coverage is an important priority for the future. The aim was to determine the characteristics of patients over 50 years old who suffered fractures and the effectiveness of a Fracture Liaison Services program in a health care institution in Colombia. METHODS: This was a retrospective follow-up study of a cohort of patients with vertebral and nonvertebral fractures managed in a Fracture Liaison Services program. Sociodemographic, clinical and pharmacological variables were identified. Key performance indicators were used to evaluate the effectiveness of the program. Descriptive and bivariate analysis was performed. RESULTS: A total of 438 patients were analyzed. The average age was 77.5 years, and 78.5% were women. Hip and vertebral fractures were the most common (25.3% and 24.9%, respectively). Vertebral fractures prevailed in men (33.0% vs 22.7%; p = 0.041) and those of the radius/ulna in women (20.3% vs 10.6%; p = 0.031). A total of 29.7% had experienced a previous fracture, and 16.7% had received antiosteoporosis drugs. A total of 63.5% of the cases were managed surgically. At discharge, 58.8% received prescriptions for calcium/vitamin D, and 50.7% with prescriptions of antiosteoporotic therapy, especially teriparatide (21.2%) and denosumab (16.4%), without significant differences by sex. However, in women with hip fractures, anti-osteoporotic management prevailed (83.7% vs 64.0; p = 0.032). The effectiveness of the overall program per year was 74.6%. On follow-up, only 9.1% of patients had experienced a new fall, and of those 3.7% presented a new fracture. A total of 4.3% died during follow-up. CONCLUSIONS: Good adherence to the recommendations of the country's clinical practice guidelines was found, and overall, the effectiveness of the program was very satisfactory, with a low incidence of new fractures during follow-up. Fracture Liaison Services programs reduce mortality and the risk of refracture. A retrospective follow-up study of a cohort of patients with vertebral and nonvertebral fractures managed in a Fracture Liaison Services, showed that the effectiveness was 73.6%. On follow-up, 9.1% of patients had experienced a new fall, and of those 3.7% presented a new fracture.

wMel Wolbachia alters female post-mating behaviors and physiology in the dengue vector mosquito Aedes aegypti.

Globally invasive Aedes aegypti disseminate numerous arboviruses that impact human health. One promising method to control Ae. aegypti populations is transinfection with Wolbachia pipientis, which naturally infects ~40-52% of insects but not Ae. aegypti. Transinfection of Ae. aegypti with the wMel Wolbachia strain induces cytoplasmic incompatibility (CI), allows infected individuals to invade native populations, and inhibits transmission of medically relevant arboviruses by females. Female insects undergo post-mating physiological and behavioral changes-referred to as the female post-mating response (PMR)-required for optimal fertility. PMRs are typically elicited by male seminal fluid proteins (SFPs) transferred with sperm during mating but can be modified by other factors, including microbiome composition. Wolbachia has modest effects on Ae. aegypti fertility, but its influence on other PMRs is unknown. Here, we show that Wolbachia influences female fecundity, fertility, and re-mating incidence and significantly extends the longevity of virgin females. Using proteomic methods to examine the seminal proteome of infected males, we found that Wolbachia moderately affects SFP composition. However, we identified 125 paternally transferred Wolbachia proteins, but the CI factor proteins (Cifs) were not among them. Our findings indicate that Wolbachia infection of Ae. aegypti alters female PMRs, potentially influencing control programs that utilize Wolbachia-infected individuals.

Adaptation of a mindfulness-based intervention for trauma-exposed, unhoused women with substance use disorder.

OBJECTIVE: Women experiencing homelessness (WEH) report exceedingly high rates of trauma exposure, posttraumatic stress disorder (PTSD), and substance use disorder (SUD). Mindfulness-based interventions including Mindfulness-based Stress Reduction (MBSR) may help lower traumatic stress-related symptoms and reduce SUD, but have been underexplored in community-based settings serving WEH with symptoms of PTSD and SUD. METHOD: We used a mixed-method, community-engaged approach that implemented a Community Advisory Board and the ADAPT-ITT (assessment, decision, adaptation, production, topical experts, integration, training, testing) framework, including intervention demonstrations, to adapt and refine MBSR for WEH experiencing symptoms of PTSD/SUD. Trauma-exposed WEH (N = 28) living at a drug treatment site provided perspectives and feedback on an MBSR demonstration via quantitative questionnaires and four focus groups. RESULTS: Quantitative measures indicated high perceived acceptability and feasibility: Nearly all WEH reported MBSR activities (including yoga, meditation, body scans, class discussion, and home practice) would be at least "somewhat helpful"; between 71.43% to 89.29% reported each activity would be "a great deal helpful." Most reported the focus group sessions were useful for providing feedback relevant for improving program design and administration. Qualitative findings revealed four themes aligning with quantitative findings that provided useful suggestions to guide MBSR implementation with trauma-exposed WEH: (a) perception of feasibility and effectiveness of MBSR, (b) strategies for successful recruitment, (c) strategies for successful retention, and (d) characteristics of the MBSR trainer. CONCLUSIONS: Focus group recommendations could bolster intervention compliance, engagement, and completion for MBSR and community-based programs for WEH more generally. Results provide suggestions for implementing a trauma-sensitive approach when administering MBSR to trauma-exposed WEH. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

A multi-method exploration of mindfulness as a coping tool: Perspectives from trauma-exposed, unhoused women residing at a drug treatment facility.

This multi-method study examined perspectives on mindfulness and coping strategies used by trauma-exposed women experiencing homelessness (WEH), residing in a state-funded residential drug treatment site in Southern California (United States). Questionnaires and in-depth focus group interviews were utilised to examine traumatic experiences over the lifespan, probable-posttraumatic stress disorder (PTSD), and coping strategies. Mindfulness was explored as a potential way to improve coping; potential benefits and challenges associated with implementing a mindfulness-based intervention (MBI) with trauma-exposed WEH were also investigated. A Community Advisory Board (CAB) was formed to identify key issues experienced by WEH and to develop a semi structured interview guide (SSIG). Using the SSIG, women participated in one of four focus groups (total N = 28; n = 7 per group). Quantitative data on demographic indicators, probable-PTSD, and trauma exposure were collected. Almost 90% of women met criteria for probable-PTSD; trauma exposure was exceedingly high; most women had experienced multiple traumas throughout their lives. Four main themes emerged from qualitative analyses, which drew from Grounded Theory and used open, selective, and axial coding: (1) ways of coping with trauma; (2) perspectives on mindfulness; (3) prior experiences with mindfulness; and (4) challenges for conducting a mindfulness programme. Overall, WEH used a variety of coping techniques to deal with their trauma, had some familiarity with mindfulness, and were optimistic an MBI would be helpful, despite identifying several challenges to implementation. MBIs may be helpful adjuncts to traditional care for trauma-exposed, WEH, recovering from substance use disorder. Population-specific considerations may improve implementation and participation.

[99m Tc]Tc-HYNIC-EcgDf21: A defensin short analogue with potential application in infection foci imaging.

Opportunistic infections are a problem of great relevance in public health and the precise detection and localization of infection in the early stages of the disease is of great importance for patient management as well as cost containment. Our proposal seeks to contribute to developing a new agent that meets the needs of diagnosis and follow-up of fungal and bacterial infections, focused on the design of a radiotracer with the potential for recognition of hidden infection foci. Defensins are plant antimicrobial peptides that not only show activity against plant pathogens but also against human ones. A short analogue of EcgDf1 defensin, EcgDf21d (NH2 -ERFTGGHCRGFRRRCFCTKHC-COOH), was labelled through the formation of a 99m Tc-HYNIC complex which was assessed for physicochemical and biological behaviour both in vitro and in vivo. The [99m Tc]Tc-HYNIC-EcgDf21 labelling procedure rendered a single product with remarkably high RCP and stability in the labelling milieu. The Log p value indicated that [99m Tc]Tc-HYNIC-EcgDf21 has a hydrophilic behaviour, confirmed by the biodistribution profiles. The optimal uptake value was obtained for Candida albicans infection model reaching a lesion/muscle ratio of 3, this correlates with in vitro binding studies, and the lesion can be definitely observed in the scintigraphic images.

Implementation of the Theoretical Coulometric Titration Curve in the Determination of the Amount of Substance of Potassium Hydrogen Phthalate: the Search for a Better Metrological Approach.

In metrology, the certification of potassium hydrogen phthalate (KHP) as a reference material is made using the potential primary method of coulometric titration. Usually, this titration is performed in three steps at constant current, where two endpoint (EP) times are determined from the nonlinear regression that fits the empirical W-function (eWf) to the experimental data. As an alternative, we propose the implementation of the theoretical coulometric titration curve (TC). The TC allowed us to compute the KHP amount of substance, the influence of CO2 in the system, the acid dissociation constants for carbonic and phthalic acids, assuming that those species are the only acids present during titration, and the EP times. The amount of substance of KHP estimated with the EP time and obtained from the TC was compared with the results of the eWf, and no statistical difference was found, while the amount of substance, when estimated directly as a parameter of the nonlinear regression of the TC, was lower. Therefore, the traditional method finds the total acidity of the dissolution, and our method finds the KHP purity. In addition, the acid dissociation constants for H2CO3 and phthalic acid estimated in this work agreed with the data reported in the literature. Finally, the description of the coulometric system using the theoretical TC has a solid and well-known chemical support that is not present in the eWf; this fact is essential for the uncertainty budget and the scientific support for coulometry as a potential primary method.