Ornamental Phoenix palm trees as habitat for fauna in the Mediterranean Region - results from a full year monitoring.

In the European Mediterranean Region, palm trees are a common element in cities and semi-urban landscapes and have become important habitat structures for local fauna. This study aimed to monitor the invertebrate and vertebrate fauna occurring on and associated with ornamental palms of the genus Phoenix, over the course of one year. Five study sites were used in southern Spain, with varying levels of management. Several complementary methods were applied monthly in order to assess the vertebrates and invertebrates associated with the full seasonal cycle of palms, including flowering and fruiting. The study resulted in the identification of 216 invertebrate families from seven different classes and 89 vertebrate species, consisting of 62 bird, 20 mammal (including bats), six reptile and one amphibian species associated with Phoenix palms. It thus highlights that Phoenix palms provide a habitat for many species and individuals over the course of one year.

Evaluation of models to estimate the bioaccumulation of organic chemicals in earthworms.

Modelling approaches to estimate the bioaccumulation of organic chemicals by earthworms are important for improving the realism in risk assessment of chemicals. However, the applicability of existing models is uncertain, partly due to the lack of independent datasets to test them. This study therefore conducted a comprehensive literature review on existing empirical and kinetic models that estimate the bioaccumulation of organic chemicals in earthworms and gathered two independent datasets from published literature to evaluate the predictive performance of these models. The Belfroid et al. (1995a) model is the best-performing empirical model, with 91.2% of earthworm body residue simulations within an order of magnitude of observation. However, this model is limited to the more hydrophobic pesticides and to the earthworm species Eisenia fetida or Eisenia andrei. The kinetic model proposed by Jager et al. (2003b) which out-performs that of Armitage and Gobas (2007), predicted uptake of PCB 153 in the earthworm E. andrei to within a factor of 10. However, the applicability of Jager et al.'s model to other organic compounds and other earthworm species is unknown due to the limited evaluation dataset. The model needs to be parameterised for different chemical, soil, and species types prior to use, which restricts its applicability to risk assessment on a broad scale. Both the empirical and kinetic models leave room for improvement in their ability to reliably predict bioaccumulation in earthworms. Whether they are fit for purpose in environmental risk assessment needs careful consideration on a case by case basis.

Earthworm lipid content and size help account for differences in pesticide bioconcentration between species.

The uptake and elimination kinetics of pesticides from soil to earthworms are important in characterising the risk of pesticides to soil organisms and the risk from secondary poisoning. However, the understanding of the relative importance of chemical, soil, and species differences in determining pesticide bioconcentration into earthworms is limited. Furthermore, there is insufficient independent data in the literature to fully evaluate existing predictive bioconcentration models. We conducted kinetic uptake and elimination experiments for three contrasting earthworm species (Lumbricus terrestris, Aporrectodea caliginosa, Eisenia fetida) in five soils using a mixture of five pesticides (log Kow 1.69 - 6.63). Bioconcentration increased with pesticide hydrophobicity and decreased with soil organic matter. Bioconcentration factors were comparable between earthworm species for hydrophilic pesticides due to the similar water content of earthworm species. Inter-species variations in bioconcentration of hydrophobic pesticides were primarily accounted for by earthworm lipid content and specific surface area (SSA). Existing bioconcentration models either failed to perform well across earthworm species and for more hydrophilic compounds (log Kow < 2) or were not parameterised for a wide range of compounds and earthworm species. Refined models should incorporate earthworm properties (lipid content and SSA) to account for inter-species differences in pesticide uptake from soil.

Infección congénita por citomegalovirus en neonatos muy bajo peso / Congenital cytomegalovirus infection in very low birth weight neonates

Introducción: La infección congénita por el citomegalovirus en neonatos menores de 1500 gramos puede ser causa de morbilidad, mortalidad y discapacidad. Objetivo: Describir el comportamiento de la infección congénita por citomegalovirus en un servicio de neonatología. Métodos: Se realizó un estudio descriptivo y transversal con 61 neonatos. Se les realizó detección de citomegalovirus en la primera semana de vida en suero y orina, mediante reacción en cadena de la polimerasa, para determinar infección congénita. Se evaluaron variables perinatales en todos los neonatos, así como elementos clínicos y resultados de exámenes complementarios en los infectados. Resultados: La incidencia de infección congénita fue de un 10 por ciento (6/61). El 5 por ciento de los estudios fueron positivos (6/122). Ninguna muestra de orina resultó positiva (0/61) y en el 10 por ciento de las muestras de suero (6/61) se detectó el genoma del virus. Se encontró asociación entre valoración nutricional al nacer e infección por citomegalovirus (p< 0,05). El 83 por ciento de los neonatos infectados presentaron algún signo clínico y el síndrome de dificultad respiratoria fue el más frecuente (67 por ciento). En todos los neonatos con infección congénita el ultrasonido cerebral fue normal y en el 33 por ciento se detectó retinopatía de la prematuridad en el fondo de ojo. Conclusiones: La incidencia de infección congénita por citomegalovirus es alta en este grupo de riesgo. Los signos clínicos encontrados y los resultados del fondo de ojo en neonatos con infección congénita se relacionaron con la prematuridad y la valoración nutricional de hipotrófico se asoció con esta infección(AU)

Introduction: Congenital cytomegalovirus infection in neonates weighing less than 1500 grams can be a cause of morbidity, mortality, and disability. Objective: To describe the behavior of congenital cytomegalovirus infection in a neonatal service. Methods: A descriptive and cross-sectional study was conducted with 61 neonates. Cytomegalovirus was detected in the first week of life in serum and urine, by polymerase chain reaction, to determine congenital infection. Perinatal variables were evaluated in all neonates, as well as clinical elements and results of complementary examinations in infected infants. Results: The incidence of congenital infection was 10 percent (6/61). 5 percent of the studies were positive (6/122). No urine samples were positive (0/61) and the virus genome was detected in 10 percent of serum samples (6/61). An association was found between nutritional assessment at birth and cytomegalovirus infection (p < 0.05). A total of 83 percent of infected neonates had some clinical sign, with respiratory distress syndrome being the most common (67 percent). In all neonates with congenital infection, brain ultrasound was normal, and retinopathy of prematurity was detected in 33 percent of patients with fundus retinopathy. Conclusions: The incidence of congenital cytomegalovirus infection is high in this risk group. The clinical signs found and the results of the fundus in neonates with congenital infection were related to prematurity and the nutritional assessment of hypotrophic was associated with this infection(AU)

Applying a tiered environmental risk assessment framework to estimate the risk of pesticides to soil organisms in Latin America.

This work investigates the application of a tiered risk assessment scheme for soil organisms based on the risk quotient (RQ) and the toxicity exposure ratio (TER). Forty-five pesticides registered in Latin America were chosen and the ecotoxicological endpoints for earthworms, Collembola, and microorganisms were collated. Tier I assessment was made on conservative assumptions in which no refinements were applied. There, 14 pesticides (31%) exceed the RQ regulatory trigger indicating unacceptable risk, whereas 27 (60%) indicate unacceptable risk on the TER approach. In a Tier II evaluation when refinement options such as foliar interception, field half-life, and the dissipation following the peak estimated environmental concentration are considered, eight (18%) pesticides indicate unacceptable risk based on the RQ, and 15 (33%) indicate unacceptable risk based on the TER. A nonmetric multidimensional scaling evaluation was performed to understand the relevant characteristics involved in how each pesticide poses a risk to soil organisms. Based on the outcome of this analysis, we observed that, for a given pesticide, the combination of high persistence, low or no crop interception, and high toxicity are likely to require higher tier risk assessment. Refinement options can consider either or both the exposure and/or the effect side of the framework. Exposure refinements are potentially simpler and can be conducted with data already available to risk assessors, whereas effect refinements involving further testing with the organisms potentially at risk are still under discussion for intermediate and higher tiers. A sensitive, simple, and logical environmental risk assessment framework can be used to adequately identify risks based on the relevant protection goals that, in turn, will help to protect the desired soil multifunctionality of the ecosystem. We encourage academia and industry to further investigate these topics to provide the most scientifically robust and evidence-based information to decision makers. Integr Environ Assess Manag 2023;19:446-460. © 2022 SETAC.

Evaluación neurológica durante el primer año en niños muy bajo peso al nacer con infección por citomegalovirus / Neurological evaluation during the first year in very low birth weight children with cytomegalovirus infection

Introducción: La infección congénita por citomegalovirus es causa de pérdida auditiva y alteraciones cognitivas. La infección perinatal por este virus es más frecuente en neonatos< 1500 g y produce menos secuelas neurológicas. Objetivo: Describir la evaluación neurológica en el primer año de vida en niños muy bajo peso al nacer con infección por citomegalovirus. Métodos: Estudio descriptivo y longitudinal en el que se incuyeron 14 neonatos< 1500 g, con diagnóstico de infección congénita o perinatal por citomegalovirus; a los cuales se les realizó evaluación del neurodesarrollo, ultrasonido craneal, potenciales evocados auditivos de tallo cerebral y potenciales visuales a las 40 semanas, a los seis meses y al año de edad gestacional corregida. En la primera evaluación se realizó además, electroencefalograma. Resultados: El 43 por ciento tuvo infección congénita y 57 por ciento infección perinatal. A las 40 semanas se evaluaron completamente 79 % de los casos, a los seis meses 64 por ciento y al año 36 por ciento. No se observaron anormalidades en el ultrasonido craneal, ni en el electroencefalograma. Al año de edad corregida, se detectaron alteraciones ligeras del neurodesarrolo en 33,3 por ciento del total de casos (2/6) y con igual porcentaje en los niños con infección congénita (1/3) y perinatal (1/3). En ningún paciente evaluado se detectó sordera neurosensorial, ni daño del nervio visual. Conclusiones: Las alteraciones del neurodesarrollo encontradas al año de edad corregida pueden estar relacionadas con la prematuridad o la infección por citomegalovirus. El seguimiento a mediano y largo plazo es necesario para detectar otras secuelas neurológicas de debut tardío(AU)

Introduction: Congenital cytomegalovirus infection is a cause of hearing loss and cognitive impairments. Perinatal infection by this virus is more frequent in neonates< 1500 g and produces fewer neurological sequelae. Objective: To describe neurological evaluation in the first year of life in very low birth weight children with cytomegalovirus infection. Methods: A descriptive and longitudinal study involving 14 neonates< 1500 g, with a diagnosis of congenital or perinatal cytomegalovirus infection; to which neurodevelopmental evaluation, cranial ultrasound, auditory brain stem evoked potentials and visual potentials were performed at 40 weeks, six months and one year of corrected gestational age. In the first evaluation, electroencephalogram was also performed. Results: 43 percent had congenital infection and 57 percent perinatal infection. At 40 weeks, 79 percent of cases were fully evaluated, at six months 64 percent and at one year 36 percent. No abnormalities were observed on the cranial ultrasound or electroencephalogram. At one year of corrected age, slight alterations in neurodevelopment were detected in 33.3 percent of all cases (2/6) and with the same percentage in children with congenital (1/3) and perinatal (1/3) infection. In no patient evaluated, sensorineural deafness or visual nerve damage was detected. Conclusions: The neurodevelopmental alterations found at one year of corrected age may be related to prematurity or cytomegalovirus infection. Medium- and long-term follow-up is necessary to detect other late-onset neurological sequelae(AU)

Evaluación de riesgos psicosociales y su influencia en el desarrollo de burnout en el personal de emergencias del Hospital General Docente Calderón / Evaluation of psychosocial risks and their influence on the development of burnout in emergency personnel of the Hospital General Docente Calderón

Introducción: Los riesgos psicosociales son factores que pueden afectar el bienestar psi-cológico y emocional de una persona en el entorno laboral, como el estrés laboral, la falta de apoyo social y la falta de autonomía en el trabajo. Estos riesgos pueden tener una gran influencia en el desarrollo del síndrome de burnout, una afección psicológica que se carac-teriza por agotamiento emocional, despersonalización y disminución del rendimiento laboral. Objetivo: Identificar los factores psicosociales de riesgo que puedan afectar de manera considerable al desarrollo del síndrome de burnout, planteando medidas preventivas que ayudaran a aplacar los riesgos evidenciados.Material y Métodos: Estudio descriptivo - transversal, con diseño no experimental, se uti-lizó 2 instrumentos: 1) Factores Psicosociales (FPSICO3.0), el cual está compuesto por 44 preguntas con su subdivisión de 89 sub preguntas, mide 9 factores de riesgo psicosocial (intra laborales); 2) Factores de riesgo Psicosociales (MBI-HSS) contiene 22 preguntas, mide 3 factores para burnout: baja realización personal del trabajo, agotamiento emocional y des-personalización. Resultados: Según la correlación de Spearman (Rho) manejado con margen de error del 0.05, los factores de riesgo psicosocial (intra laborales) tiempo de trabajo, demanda psicológica, participación/supervisión; interés por el trabajador y compensación; son directamente propor-cionales al nivel de burnout. Los resultados muestran que el 7% de personal presenta burnout y el 51% indicios del mismo, a mayor edad hay mayor prevalencia de burnout y el puesto de trabajo con mayor vulnerabilidad es el de médico general en funciones hospitalarias. Discusión: Los instrumentos (MBI-HSS y Fpsico 3.0) utilizados en la presenteb investiga-ción, fueron desarrollados para la población hospitalaria dentro de condiciones laborales, mismos que también han sido utilizados por varias investigaciones previas en el Ecuador y en diferentes países, por lo que el análisis de los estudios previos similares reflejan sobre los factores psicosociales que más inciden en el personal sanitario de las áreas de emergencias tanto ecuatorianas como extranjeras y son similares a los resultados del presente estudio, enfatizando además que el factor carga de trabajo en todas las investigación comparativas, a pesar de ser un factor de riesgo alto, no incide en la nuestra, al ser susceptible de buen manejo y adaptación ante la demanda de pacientes.

Introduction: Psychosocial risks can affect the psychological and emotional well-being of a person in the work environment, aspects such as work stress, lack of social support and autonomy at work. These risks may cause the appearance of Burnout syndrome, a psycho-logical condition characterized by emotional exhaustion, depersonalization, and work perfor-mance decrease. Objective:Identify the psychosocial risk factors that can significantly lead to the development of Burnout syndrome; propose preventive measures that will help mitigate the risks evidenced.Materials and Methods:Descriptive - cross-sectional study, with a non-experimental de-sign, 2 instruments were used: 1) Psychosocial Factors (FPSICO3.0), which is made up of 44 questions with their subdivision of 89 sub-questions, measures 9 psychosocial risk factors (in-tra-work); 2) Psychosocial Risk Factors (MBI-HSS) contains 22 questions, measures 3 factors for burnout: low personal performance at work, emotional exhaustion and depersonalization. Outcome: According to Spearman's correlation (Rho) managed with a margin of error of 0.05, psychosocial risk factors (intra-work) work time, psychological demand, participation/supervision; worker interest and compensation; are directly proportional to the level of bur-nout. The results show that 7% of the staff have burnout and 51% have signs of it. The older, the higher the prevalence of burnout; The profession with the greatest vulnerability to Bur-nout syndrome are doctors and nurses working in hospitals.Discussion: The instruments (MBI-HSS and Fpsico 3.0) used in the present research were developed for the hospital employees within working conditions, which have also been used by previous researches in Ecuador as well as in different countries, so the similar previous studies reflect on the psychosocial factors that most affect health workers in both Ecuadorian and foreign emergency areas and are similar to the results of the present study, which empha-sizes the workload factor in all comparative research, despite being a high risk factor, it does not affect ours, as it is susceptible to good management and adaptation to patient demand.

Audiometría de altas frecuencias en adolescentes expuestos a ruidos / High frequency audiometry in adolescents exposed to noises

Introducción: La audiometría de altas frecuencias (9000-20 000 Hz) puede ser de gran utilidad en el diagnóstico precoz de hipoacusia inducida por ruidos en contraste con la audiometría convencional (125-8000 Hz). Objetivo: Evaluar la utilidad de la audiometría de altas frecuencias en el diagnóstico precoz de la hipoacusia inducida por ruidos en adolescentes. Métodos: Estudio descriptivo, observacional y transversal en 85 adolescentes expuestos a ruidos; 45 cursaban el décimo grado en un preuniversitario de la provincia La Habana, en el curso escolar 2013-2014 y 40, el primer año de la carrera de medicina, en una facultad de La Habana en el curso escolar 2015- 2016. A todos se le realizó una encuesta, examen físico de otorrinolaringología, audiometría convencional y audiometría de alta frecuencia. Resultados: La audiometría convencional fue normal en todos los casos. En la audiometría de altas frecuencias en todos los adolescentes estudiados comenzó a disminuir la audición a partir de los 13 000 Hz y se apreció una hipoacusia neurosensorial en aumento hasta 85 decibeles en oído derecho y 78 decibeles en oído izquierdo en 20 000 Hz de frecuencia. Conclusiones: Los adolescentes evaluados tienen hábitos auditivos que pueden perjudicar su audición, todos ya poseen signos de daño que no se manifiestan a través de la audiometría convencional pero sí a través de la audiometría de alta frecuencia en las diferentes exposiciones a ruidos de altos decibeles. Lo anterior demuestra la utilidad de esta audiometría, no solo dentro del campo de la audiología, sino también en la medicina preventiva(AU)

Introduction: High frequency audiometry (9000-20 000 Hz) can be really useful in the early diagnosis of deafness induced by noises, in contrast with conventional tonal audiometry (125-8000 Hz). Objective: Assess the usefulness of high frequency audiometry in the early diagnosis of deafness induced by noises in adolescents. Methods: Descriptive, observational and cross-sectional study in 85 adolescents exposed to noises; 45 of them were studying the 10th grade in a high school of Havana province, and 40 of them were in the first year of Medicine in a faculty of Havana province during school year 2015-2016. All of them took a survey, a physical examination of otolaryngology, liminar total audiometry and high frequency audiometry. Results: Tonal audiometry was normal in all the cases. In high frequency audiometry of all the studied adolescents started to decrease audition from 13000 HZ and it was noticed an increasing neurosensorial deafness up to 85 decibels in the right ear and 78 decibels in the left ear in 20 000 Hz of frequency. Conclusions: The adolescents assessed have auditive habits that can jeopardize their audition; all of them already have signs of damage that are not noticed in the tonal audiometry but in the high frequency audiometry in the different exposures to noises of high decibels. This proves the usefulness of this kind of audiometry not only in the field of audiology, but also in preventive medicine(AU)

Nanoproteomics enables proteoform-resolved analysis of low-abundance proteins in human serum.

Top-down mass spectrometry (MS)-based proteomics provides a comprehensive analysis of proteoforms to achieve a proteome-wide understanding of protein functions. However, the MS detection of low-abundance proteins from blood remains an unsolved challenge due to the extraordinary dynamic range of the blood proteome. Here, we develop an integrated nanoproteomics method coupling peptide-functionalized superparamagnetic nanoparticles (NPs) with top-down MS for the enrichment and comprehensive analysis of cardiac troponin I (cTnI), a gold-standard cardiac biomarker, directly from serum. These NPs enable the sensitive enrichment of cTnI (<1 ng/mL) with high specificity and reproducibility, while simultaneously depleting highly abundant proteins such as human serum albumin (>1010 more abundant than cTnI). We demonstrate that top-down nanoproteomics can provide high-resolution proteoform-resolved molecular fingerprints of diverse cTnI proteoforms to establish proteoform-pathophysiology relationships. This scalable and reproducible antibody-free strategy can generally enable the proteoform-resolved analysis of low-abundance proteins directly from serum to reveal previously unachievable molecular details.

Atención al neonato expuesto o infectado con el virus varicela-zoster

La gestante con varicela en el primer trimestre puede trasmitir la infección a la descendencia, en cuyo caso hay riesgo de aborto o de muerte fetal o de secuelas permanentes en el producto de la gestación. El objetivo de esta comunicación es actualizar a los perinatólogos, neonatólogos y epidemiológicos en la atención al neonato expuesto o infectado por el virus de la varicela zoster en el contexto nacional. La infección por el virus en el periodo neonatal puede ser grave y fatal en prematuros extremos, en pretérminos hijos de madres sin exposición previa al virus y en recién nacidos cuyas madres hayan iniciado el exantema cinco días antes del parto o hasta dos días posteriores a este. La varicela es prevenible por vacuna y en los países desarrollados, existe una gammaglobulina específica contra el virus de la varicela zoster para ser aplicada en expuestos a este virus con alto riesgo de presentar formas graves de la enfermedad. En el contexto nacional, la infección por el virus de la varicela, es frecuente y la inmunización activa y pasiva no está disponible, por lo que es necesario estar actualizado en la atención de los grupos vulnerables de padecer esta infección.

The pregnant woman with varicella in the first quarter of pregnancy can transmit the infection to the fetus, in which case there is a risk of miscarriage or fetal death or permanent sequelae in the product of the gestation. The aim of this communication is to upgrade perinatologists, neonatologists and epidemiologists in the management of the neonate exposed or infected by the varicella-zoster virus in the national context. The infection by the virus in the neonatal period can be serious and fatal in extremely premature neonates, in preterm children of mothers without previous exposure to the virus and in newborns whose mothers have showned exanthem five days before delivery or up to two days after this. Varicella is preventable by vaccination and in developed countries there is a specific gammaglobulin against the varicella-zoster virus to be applied in patients exposed to this virus with high risk of presenting severe forms of the disease. In the national context, the infection by the varicella virus is frequent and active and passive immunization is not available, so it is necessary to be updated in the handling of vulnerable groups to this infection.

Recomendaciones para la atención de recién nacidos con sospecha o confirmado de infección por SARS- Cov- 2 en Cuba / Recommendations for the care of newborns suspected or confirmed of infection by SARS-CoV-2 in Cuba

Se exponen las recomendaciones sobre la atención de los recién nacidos en Cuba, hijos de madres con diagnóstico de COVID -19. Se expresan las orientaciones generales sobre la organización de los servicios para el cuidado de los pacientes, los principales aspectos relacionados con la atención en el momento del nacimiento, la alimentación, las características clínicas descritas en esta etapa de la vida, los estudios complementarios que se deberán realizar para el diagnóstico, el tratamiento, los criterios de egreso y el seguimiento. Los autores reunieron la poca evidencia científica existente sobre la infección por coronavirus en la etapa neonatal y de acuerdo con el Grupo Nacional de Neonatología del Ministerio de Salud Pública, se proponen estas recomendaciones, adaptadas a las características de la atención neonatal en Cuba, con el objetivo de orientar las conductas a seguir en los recién nacidos con sospecha o diagnóstico confirmado de COVID-19. Estas recomendaciones están basadas en las publicaciones científicas disponible y sujetas a cambios por la revisión periódica de estas publicaciones, ya que se trata de una infección de reciente aparición, sobre la cual aún existe muy poca información para esta etapa temprana de la vida, como puede ser un caso confirmado de solo 36 horas de vida. Se espera que todo el personal involucrado en la atención de recién nacidos con sospecha o confirmados de infección por SARS- Cov- 2 analicen e incorporen estas recomendaciones en el cuidado y vigilancia de sus pacientes(AU)

In this work are presented recommendations on the care of newborns who are children of mothers diagnosed with COVID-19 in Cuba, and are expressed the general guidelines on the organization of the services for patients care, the main aspects related with the care in the birth moment, feeding related aspects, clinical characteristics described in this stage of life, complementary studies that must be conducted for diagnosis, the treatment to be used, and discharge and follow up criteria. The autors collected poor existent scientific evidence on the infection by coronavirus in the neonatal stage, and jointly with the National Group of Neonatology of the Ministry of Public Health are proposing these recommendations which are adapted to the characteristics of the neonatal care in Cuba with the aim of guiding the behaviours to implement in the attention to newborns suspected or with confirmed diagnosis of COVID-19.These recommendations are based in the available scientific publications and they are subject to changes since this is an emerging infection and there is scarse information of its presence in the earliest stages of life like it can be a confirmed case of just 36 hours of life. It is expected that all the personnel involved in the attention of newborns suspected or confirmed with infection by SARS-Cov-2 can analyze and add these recommendations to the care and surveillance of their patients(AU)

A photocleavable surfactant for top-down proteomics.

We report the identification of a photocleavable anionic surfactant, 4-hexylphenylazosulfonate (Azo), which can be rapidly degraded by ultraviolet irradiation, for top-down proteomics. Azo can effectively solubilize proteins with performance comparable to that of sodium dodecyl sulfate (SDS) and is compatible with mass spectrometry. Azo-aided top-down proteomics enables the solubilization of membrane proteins for comprehensive characterization of post-translational modifications. Moreover, Azo is simple to synthesize and can be used as a general SDS replacement in SDS-polyacrylamide gel electrophoresis.

Discriminatory Accuracy of Preeclampsia Risk Factors in Primary Care.

BACKGROUND: Although it is common to use risk factors in the screening for preeclampsia, they do not always accurately identify patients who truly have this condition. AIM OF THE STUDY: To determine the discriminatory accuracy of known preeclampsia risk factors, both individually and in combination. METHODS: We studied patients undergoing prenatal care who were diagnosed with preeclampsia or eclampsia (n = 160 cases) in primary care and those who were not (n = 430 controls). Data on history of preeclampsia, type 2 diabetes, chronic hypertension, multiple gestation, first pregnancy, pregnancy interval ≥10 years, overweight/obesity, mean arterial pressure (MAP) ≥80 mmHg, and age (<20 years and ≥40 years) were obtained using a dichotomous scale. Discriminatory accuracy indicators were true-positive (TP) and false-positive (FP) rates, positive and negative likelihood ratios (LR+ and LR-), diagnostic odds ratio (DOR), and the area under the receiver-operating characteristic (AUROC) curve; stratified by parity. The case-control status was the reference standard. RESULTS: Certain combinations performed better than individual factors, independent of parity status. Among multiparous women, MAP ≥80 mmHg together with previous preeclampsia and overweight/obesity accumulated the greatest number of discriminatory accuracy indicators, with acceptable values: TP, 72.2%; FP, 1.5%; LR+, 48.4; LR-, 0.3; DOR, 171.6; and AUROC, 0.85. CONCLUSIONS: Discriminatory accuracy was low for almost all individual preeclampsia risk factors. However, the accuracy improved after some factors were combined. To the best of our knowledge, this is the first study to examine the discriminatory accuracy of preeclampsia risk factors used for screening high-risk pregnancies in primary care in Mexico.

Comparison of the discriminatory accuracy of four risk criteria for preeclampsia.

OBJECTIVES: Several criteria have been proposed to categorize the risk of preeclampsia, with notable differences between these criteria. We compared the discriminatory accuracy of criteria for categorizing preeclampsia risk established by four institutions, namely, the World Health Organization (WHO), National Institute for Health and Care Excellence (NICE), American College of Obstetricians and Gynecologists (ACOG), and National Center for Technological Excellence in Health (CENETEC), and estimated the concordance between these criteria. STUDY DESIGN: We performed a secondary data analysis of 590 Mexican obstetric patients who received prenatal care in primary care between 2016 and 2017; 160 had a diagnosis of preeclampsia. MAIN OUTCOME MEASURES: We estimated the true (TP) and false positive (FP) fractions, positive (PPV) and negative predictive values (NPV), positive (LR+) and negative (LR-) likelihood ratios, diagnostic odds ratio (DOR), area under the receiver operating characteristic curve (AUROC), and Kappa coefficient with corresponding 95% confidence intervals (CIs). RESULTS: Only the WHO criteria, followed by the NICE criteria, had the greatest number of accuracy indicators with ideal or acceptable results: TP 83.6%, PPV 60.5%, NPV 90.3%, DOR 14.3, and AUROC 0.79 and TP 84.5%, PPV 51.0%, NPV 90.3%, DOR 9.7, and AUROC 0.74, respectively. The Kappa coefficient between WHO and NICE criteria was 0.78 (95% CI 0.71-0.85). CONCLUSIONS: The discriminatory accuracies of the WHO and NICE criteria were superior to those of the ACOG and CENETEC criteria for classifying preeclampsia risk. Their concordance was good; thus, both criteria seem appropriate for screening preeclampsia in primary care.

Quantifying pesticide deposits and spray patterns at micro-scales on apple (Malus domesticus) leaves with a view to arthropod exposure.

BACKGROUND: Pesticides used in commercial crop systems can adversely affect non-target arthropod populations. The spatial distribution of pesticide residues is rarely studied at scales relevant to these populations. Here, we combine two methods for assessing pesticide spray deposits at spatial scales relevant to non-target arthropods found in apple orchards. Pesticide residues were determined on individual apple leaves through conventional residue analysis; water-sensitive paper was used to investigate spatial distributions in deposits at the micro-scale. We also evaluated how accurately a digital image analysis program estimated pesticide residues. RESULTS: We found that mean pesticide spray coverage on water-sensitive paper varied by up to 6.1% (95% CI 9.4%, 2.7%) within an apple orchard, and leaf residues varied by up to 0.95 (95% CI 0.54, 1.36) mg kg-1 within a tree. Leaf residues based on analytical chemistry were six times lower than pesticide deposition estimated through image analysis of water-sensitive paper, although these correlated strongly. This correlation allowed estimation of actual residues by application of a correction factor. CONCLUSION: Our method demonstrates accurate estimation of pesticide deposits at the individual leaf scale through digital analysis of water-sensitive paper and is a low-cost, rapid alternative to conventional residue analysis techniques. © 2018 The Authors. Pest Management Science published by John Wiley & Sons Ltd on behalf of Society of Chemical Industry.

Principales características de la prescripción de fármacos en ancianos del Policlínico José Martí Pérez / Main characteristics of drugs prescription in elderly from José Martí Pérez Polyclinic

Se realizó un estudio descriptivo, longitudinal y retrospectivo de 532 pacientes dispensarizados como adultos mayores frágiles, pertenecientes a 24 consultorios médicos de la familia del Policlínico Docente José Martí Pérez del municipio de Santiago de Cuba, desde el 2014 hasta el 2015, con vistas a describir aspectos relacionados con la prescripción de medicamentos en estos ancianos. En la serie existió la polifarmacia con predominio de las féminas y la asociación de más de 2 enfermedades concomitantes favoreció su aparición. Resultó insuficiente la evaluación en consultas de geriatría para garantizar la valoración integral de los afectados. Se emplearon mayor cantidad de fármacos para afecciones del sistema osteomioarticular, seguidos de agentes con actividad cardiovascular, en tanto, prevalecieron la prescripción por más de un facultativo al mismo paciente y el poco uso de estudios tanto renales como hepáticos para evaluar y/o prevenir reacciones adversas a medicamentos, así como sus interacciones perjudiciales(AU)

A descriptive, longitudinal and retrospective study of 532 patients classified as frail elderly, belonging to 24 family doctor's offices of José Martí Pérez Teaching Polyclinic was carried out in Santiago de Cuba, from 2014 to 2015, aimed at describing aspects related to drug prescription in these elderly. In the series, polypharmacy existed with prevalence of women and the association of more than 2 concomitant diseases favoured its emergence. The evaluation in geriatrics services was insufficient to guarantee the comprehensive valuation of the affected patients. A higher quantity of drugs for the osteomioarticular system disorders was used, followed by agents with cardiovascular activity, while, there was a prevalence of the prescription of more than a doctor to the same patient and the little use of either renal or hepatic studies to evaluate and/or prevent adverse reactions to medications, as well as their harmful interactions(AU)

Principales características de la prescripción de fármacos en ancianos del Policlínico "José Martí Pérez" / Main characteristics of drugs prescription in elderly from José Martí Pérez Polyclinic

Se realizó un estudio descriptivo, longitudinal y retrospectivo de 532 pacientes dispensarizados como adultos mayores frágiles, pertenecientes a 24 consultorios médicos de la familia del Policlínico Docente José Martí Pérez del municipio de Santiago de Cuba, desde el 2014 hasta el 2015, con vistas a describir aspectos relacionados con la prescripción de medicamentos en estos ancianos. En la serie existió la polifarmacia con predominio de las féminas y la asociación de más de 2 enfermedades concomitantes favoreció su aparición. Resultó insuficiente la evaluación en consultas de geriatría para garantizar la valoración integral de los afectados. Se emplearon mayor cantidad de fármacos para afecciones del sistema osteomioarticular, seguidos de agentes con actividad cardiovascular, en tanto, prevalecieron la prescripción por más de un facultativo al mismo paciente y el poco uso de estudios tanto renales como hepáticos para evaluar y/o prevenir reacciones adversas a medicamentos, así como sus interacciones perjudiciales

A descriptive, longitudinal and retrospective study of 532 patients classified as frail elderly, belonging to 24 family doctor's offices of José Martí Pérez Teaching Polyclinic was carried out in Santiago de Cuba, from 2014 to 2015, aimed at describing aspects related to drug prescription in these elderly. In the series, polypharmacy existed with prevalence of women and the association of more than 2 concomitant diseases favoured its emergence. The evaluation in geriatrics services was insufficient to guarantee the comprehensive valuation of the affected patients. A higher quantity of drugs for the osteomioarticular system disorders was used, followed by agents with cardiovascular activity, while, there was a prevalence of the prescription of more than a doctor to the same patient and the little use of either renal or hepatic studies to evaluate and/or prevent adverse reactions to medications, as well as their harmful interactions