Keeping Citizens Informed and Engaged During the COVID-19 Pandemic Using #YoMeInformoPMA: A Case from Latin America.

Social media platforms contribute to the dissemination of information and encourage communication between health agencies and the public, especially during health crises. Public health agencies must engage in carefully crafted educational, communicative, and interactive practices to be effective in their messaging to build relationships with the public. Using quantitative content, social network, and thematic analysis, this study examined 2,500 tweets from April to August 2020 that included the hashtag #YoMeInformoPMA. Panama's Public Health Ministry created the #YoMeInformoPMA hashtag to keep citizens informed and engaged during the COVID-19 pandemic. Research on social media use and implementation in Latin America during the COVID-19 pandemic, to inform and engage the public, is limited. Therefore, the aim of this investigation was to analyze strategies, themes, multimedia formats, key actors, and overall communications patterns of a Latin American health community hashtag. Our results determined that actors using the hashtag #YoMeInformoPMA mainly used an interactive strategy, a message that aims to promote casual conversations, advice, and problem-solving. Findings highlighted evidence of a communication strategy by specific actors in this network, supporting recent studies that indicate engagement between the public and health agencies can take place on social media. Practical implications and recommendations for communication preparation via social media for future health crises are discussed.

Deep learning representations to support COVID-19 diagnosis on CT slices / Representaciones basadas en aprendizaje profundo como apoyo del diagnóstico de la COVID-19 en cortes de tomografía computarizada

Introduction: The coronavirus disease 2019 (COVID-19) has become a significant public health problem worldwide. In this context, CT-scan automatic analysis has emerged as a COVID-19 complementary diagnosis tool allowing for radiological finding characterization, patient categorization, and disease follow-up. However, this analysis depends on the radiologist's expertise, which may result in subjective evaluations. Objective: To explore deep learning representations, trained from thoracic CT-slices, to automatically distinguish COVID-19 disease from control samples. Materials and methods: Two datasets were used: SARS-CoV-2 CT Scan (Set-1) and FOSCAL clinic's dataset (Set-2). The deep representations took advantage of supervised learning models previously trained on the natural image domain, which were adjusted following a transfer learning scheme. The deep classification was carried out: (a) via an end-to-end deep learning approach and (b) via random forest and support vector machine classifiers by feeding the deep representation embedding vectors into these classifiers. Results: The end-to-end classification achieved an average accuracy of 92.33% (89.70% precision) for Set-1 and 96.99% (96.62% precision) for Set-2. The deep feature embedding with a support vector machine achieved an average accuracy of 91.40% (95.77% precision) and 96.00% (94.74% precision) for Set-1 and Set-2, respectively. Conclusion: Deep representations have achieved outstanding performance in the identification of COVID-19 cases on CT scans demonstrating good characterization of the COVID-19 radiological patterns. These representations could potentially support the COVID-19 diagnosis in clinical settings.

Introducción. La enfermedad por coronavirus (COVID-19) es actualmente el principal problema de salud pública en el mundo. En este contexto, el análisis automático de tomografías computarizadas (TC) surge como una herramienta diagnóstica complementaria que permite caracterizar hallazgos radiológicos, y categorizar y hacer el seguimiento de pacientes con COVID-19. Sin embargo, este análisis depende de la experiencia de los radiólogos, por lo que las valoraciones pueden ser subjetivas. Objetivo. Explorar representaciones de aprendizaje profundo entrenadas con cortes de TC torácica para diferenciar automáticamente entre los casos de COVID-19 y personas no infectadas. Materiales y métodos. Se usaron dos conjuntos de datos de TC: de SARS-CoV-2 CT (conjunto 1) y de la clínica FOSCAL (conjunto 2). Los modelos de aprendizaje supervisados y previamente entrenados en imágenes naturales, se ajustaron usando aprendizaje por transferencia. La clasificación se llevó a cabo mediante aprendizaje de extremo a extremo y clasificadores tales como los árboles de decisiones y las máquinas de soporte vectorial, alimentados por la representación profunda previamente aprendida. Resultados. El enfoque de extremo a extremo alcanzó una exactitud promedio de 92,33 % (89,70 % de precisión) para el conjunto 1 y de 96,99 % (96,62 % de precisión) para el conjunto-2. La máquina de soporte vectorial alcanzó una exactitud promedio de 91,40 % (precisión del 95,77 %) para el conjunto-1 y del 96,00 % (precisión del 94,74 %) para el conjunto 2. Conclusión. Las representaciones profundas lograron resultados sobresalientes al caracterizar patrones radiológicos usados en la detección de casos de COVID-19 a partir de estudios de TC y demostraron ser una potencial herramienta de apoyo del diagnóstico.

Recomendaciones para el diagnóstico, tratamiento y seguimiento del cáncer de mama durante la pandemia de SARS-Cov-2/COVID-19 en Colombia / Recommendations for the diagnosis, treatment and monitoring of breast cancer during the SARS-Cov-2/COVID-19 pandemic in Colombia

Resumen Bajo las nuevas condiciones generadas por la pandemia de COVID-19, los tratamientos para el cáncer de mama requieren algunas reorientaciones y cuidados que se exponen en este artículo. Se consideran aquí las tres fases de gravedad de la pandemia y los respectivos tratamientos que demandan en función de los lineamientos dictados por el Ministerio de Salud y Protección Social de Colombia. Se trata de un conjunto de referencias para orientar las terapias y tratamientos, inspiradas en las políticas de salud regionales, nacionales e institucionales.

Abstract Under the new conditions generated by the COVID-19 pandemic, breast cancer treatments requires some reorientations and cares that are discussed in this article. The three phases of severity of the pandemic and the respective treatments they require -based on the guidelines issued by the Ministry of Health and Social Protection of Colombia- are considered here. It is a set of references to guide therapies and treatments, inspired by regional, national and institutional health policies.

Efecto del cambio de la terapia antirretroviral en la falla virológica en una cohorte de pacientes que conviven con el VIH en Medellín, Antioquia, Colombia / Effect of the change in antirretroviral therapy on virological failure in a cohort of patients living with HIV in Medellín, Antioquia, Colombia

Objetivo: determinar el efecto del cambio en la terapia antirretroviral sobre el control virológico en una cohorte de pacientes VIH positivos de una institución prestadora de servicios de salud en Medellín, Antioquia (Colombia) en el año 2017. Materiales y métodos: estudio observacional analítico transversal, comparativo entre pacientes que cambiaron y no cambiaron el esquema inicial de terapia antirretroviral. Se realizó en una cohorte de 1245 pacientes que conviven con el VIH. Resultados: un total de 322 pacientes fueron evaluados. El principal motivo de cambio fue la presencia de efectos adversos a la terapia antirretroviral, seguido de la falla virológica sin genotipo e intolerancia a la terapia antirretroviral. La falla virológica, RP 1,4 IC95% (1,2-1,6, p0,00), el tener genotipo, RP 1,2 IC95% (1,1-1,3, p 0,00) y el padecer una infección oportunista, RP 1,3 IC95% (1,0-1,6, p 0,03), se asociaron a mayor número de cambios a la TAR. La adherencia a la terapia antirretroviral, RP 0,18 IC95% (0,1-0,3, p 0,00) y la toma de otros medicamentos no relacionados al VIH (RP 0,6, IC95% 0,4-0,8, p 0,005) se asociaron a menor frecuencia de cambio de la terapia antirretroviral. El cambio de la terapia antirretroviral (OR ajustado 3,4, IC 95% (2,0-5,8), continúa siendo el factor pronóstico más importante para falla virológica. Conclusión: el cambio de la terapia antirretroviral, definida en este estudio como la principal variable de exposición, representa el principal factor de riesgo para falla virológica, incluso cuando fue ajustado por otras variables..Au

Objective: to determine the effect of the change in antiretroviral therapy on virological control in a cohort of HIV positive patients corresponding to a healthcare institution in Medellín, Antioquia (Colombia) in 2017. Materials and methods: cross-sectional,comparative analytical observational study. It was performed in a cohort of 1245 patients living with HIV. Results: a total of 322 patients were evaluated. The main reason for change was the presence of adverse effects to antiretroviral therapy, followed by virological failure without genotype and antiretroviral therapy intolerance. Virological failure, PR 1.4 95% CI (1.2-1.6, p 0,00), having genotype, PR 1.2 95% CI (1.1-1.3, p0,00 ) and suffering from an opportunistic infection, PR 1.3 95% CI (1.0-1.6, p 0,03),were associated with a greater number of changes to antiretroviral therapy. Adherence to antiretroviral therapy, PR 0.18 95% CI (0.1-0.3, p 0,00) and taking other non-HIVrelated medications (PR 0.6, 95% CI 0.4-0 , 8, p 0,005) were associated with a lower frequency of change of antiretroviral therapy. The change in antiretroviral therapy (adjusted OR 3.4, 95% CI (2.0-5.8)) remains the most important prognostic factor for virological failure. Conclusion: the change in antirretroviral therapy, defined in this study as the main exposure variable, represents the main risk factor for virological failure, even when was adjusted for other variables..Au

Six Collective Challenges for Sustainability of Almería Greenhouse Horticulture.

Globally, current food consumption and trade are placing unprecedented demand on agricultural systems and increasing pressure on natural resources, requiring tradeoffs between food security and environmental impacts especially given the tension between market-driven agriculture and agro-ecological goals. In order to illustrate the wicked social, economic and environmental challenges and processes to find transformative solutions, we focus on the largest concentration of greenhouses in the world located in the semi-arid coastal plain of South-east Spain. Almería family farming, predominantly cooperative, greenhouse intensive production, commenced after the 1960s and has resulted in very significant social and economic benefits for the region, while also having important negative environmental and biodiversity impacts, as well as creating new social challenges. The system currently finds itself in a crisis of diminishing economic benefits and increasing environmental and social dilemmas. Here, we present the outcomes of multi-actor, transdisciplinary research to review and provide collective insights for solutions-oriented research on the sustainability of Almeria's agricultural sector. The multi-actor, transdisciplinary process implemented collectively, and supported by scientific literature, identified six fundamental challenges to transitioning to an agricultural model that aims to ameliorate risks and avoid a systemic collapse, whilst balancing a concern for profitability with sustainability: (1) Governance based on a culture of shared responsibility for sustainability, (2) Sustainable and efficient use of water, (3) Biodiversity conservation, (4) Implementing a circular economy plan, (5) Technology and knowledge transfer, and (6) Image and identity. We conclude that the multi-actor transdisciplinary approach successfully facilitated the creation of a culture of shared responsibility among public, private, academic, and civil society actors. Notwithstanding plural values, challenges and solutions identified by consensus point to a nascent acknowledgement of the strategic necessity to locate agricultural economic activity within social and environmental spheres.This paper demonstrates the need to establish transdisciplinary multi-actor work-schemes to continue collaboration and research for the transition to an agro-ecological model as a means to remain competitive and to create value.

A Simple Bone Cyst in Cervical Vertebrae of an Adolescent Patient.

INTRODUCTION: Spinal simple bone cysts, also known as solitary cysts, are extremely unusual benign primary bone tumors with few cases reported in the literature. CASE PRESENTATION: Incidental Magnetic Resonance Imaging (MRI) finding of a C2 Simple bone cyst in a 13-year-old female patient is reported. Complementary studies suggested the benign nature of the lesion. Patient underwent cervical curettage followed by tumor excision. A lateral submandibular approach to the upper cervical spine was used and careful bone resection was possible with a radiofrequency assisted burr and no instrumentation or fixation was required. The stability of the defect was ensured by filling it with bone allograft and by prescribing a postsurgical plastic cervical collar to maintain neck immobilization. Histological examination supported the diagnosis of simple bone cyst. At 6-12-month follow-up the patient presented no recurrence or symptomatology. CONCLUSIONS: Solitary bone cysts are infrequent entities in the cervical vertebrae and preservation of spine stability without instrumentation to avoid neurological complications is often challenging. In this case, the proximity of the cyst to the right vertebral artery and the risk of injury were high; however the surgical approach used was successful and no recurrence or instability was evidenced on postoperative MRI.

Characterization of a triple-recombinant, reassortant rotavirus strain from the Dominican Republic.

We report the genome of a novel human triple-recombinant G4P[6-8_R] mono-reassortant strain identified in a stool sample from the Dominican Republic during routine facility-based rotavirus strain surveillance. The strain was designated as RVA/Human-wt/DOM/2013840364/2013/G4P[6-8_R], with a genomic constellation of G4-P[6-8_R]-I1-R1-C1-M1-(A1-A8_R)-N1-(T1-T7_R)-E1-H1. Recombinant gene segments NSP1 and NSP3 were generated as a result of recombination between genogroup 1 rotavirus A1 human strain and a genotype A8 porcine strain and between genogroup 1 rotavirus T1 human strain and a genotype T7 bovine strain, respectively. Analyses of the RNA secondary structures of gene segment VP4, NSP1 and NSP3 showed that all the recombinant regions appear to start in a loop (single-stranded) region and terminate in a stem (double-stranded) structure. Also, the VP7 gene occupied lineage VII within the G4 genotypes consisting of mostly porcine or porcine-like G4 strains, suggesting the occurrence of reassortment. The remaining gene segments clustered phylogenetically with genogroup 1 strains. This exchange of whole or partial genetic materials between rotaviruses by recombination and reassortment contributes directly to their diversification, adaptation and evolution.

Conocimientos sobre hidratación oral por las madres de pacientes de 1 a 5 años de vida con enfermedad diarreica aguda: República Dominicana / Knowledge about oral hydration by mothers of patients 1 to 5 years old with acute diarrhea: Dominican Republic

Determinar el nivel de conocimiento de la madre con respecto a la hidratación oral del paciente durante un episodio diarreico agudo. Material y Métodos: Estudio observacional, descriptivo con recolección prospectiva y de corte transversal, en el cual se recolectaron datos entre la segunda semana de mayo a la segunda semana de junio 2013; con un cuestionario de 12 ítems con preguntas cerradas con el fin de medir el conocimiento de la madre con relación a la hidratación oral durante el episodio de diarrea. Se eligió la muestra de manera no probabilística por conveniencia. Resultados: La mayoría de las madres conocía las implicancias sobre la salud de su hijo de la enfermedad diarreica aguda, y conocía la importancia de mantener una hidratación adecuada durante el mismo. Se evidenció que un porcentaje de la población, desconocía la preparación y viabilidad del Suero de rehidratación oral (SRO), y se evidenció el uso de otro tipo de bebidas no adecuadas durante el episodio de diarrea aguda. (Bebidas hidratantes comerciales y carbonatados) como terapia de hidratación durante la diarrea. Conclusiones: Se identificó que se hace necesario una mayor información y capacitación a las madres acerca de la manera de rehidratar a sus hijos con diarrea aguda...

Determine the level of Knowledge of the mother regarding oral hydration practices of a child during an acute diarrheal episode. Material and Methods: Observational, descriptive with prospective data collection and transversal cut study, in which data was collected from the second week of may until the second week of June 2013; using a 12 item questionnaire, with close questions with the intent to measure the level of Knowledge of the mother regarding oral hydration practices of the child during an acute diarrheal episode. The simple was taken using a non-probabilistic convenience method. Results: The majority of the mothers knew the health implications regarding acute diarrhea, and the importance of adequate oral hydration during the illness. However, these need to be strengthened, because it was witnessed that a percentage of the population didnÆt know the preparation and the viability of the ORS, and were using other non-adequate beverages during the acute diarrheal episode, like a high percentage of commercial hydration beverages and not on a high percentage the use of carbonated beverages (soda) as a hydration therapy during the diarrhea. Conclusions: Advanced maternal age was associated with a higher rate of C-sections and a higher risk of having a child with Down syndrome. There was no evidence that advanced maternal age is associated with increased neonatal morbidity...

Evaluación de la actividad antioxidante de extractos de Palicourea guianensis (Rubiaceae) / Evaluation of antioxidant activity of Palicourea guianensis (Rubiaceae) extracts

Introducción: la proliferación de radicales libres en el cuerpo humano induce daños oxidativos a las biomoléculas que provocan daños a nivel celular y generan diversas anomalías en el organismo, como arterosclerosis, envejecimiento y cáncer. Actualmente, la búsqueda por moléculas con características antioxidantes es cada vez mayor, donde las plantas representan una de las principales fuentes de compuestos. Objetivo: determinar la actividad antioxidante y el contenido de fenoles de los extractos de diferentes polaridades de la parte aérea de la especie Palicourea guianensis (Rubiaceae). Métodos: para la evaluación de la actividad biológica, se calcularon los valores de concentración media inhibitoria (IC50) de los extractos más activos mediante los métodos de captura de electrones DPPH (2,2-difenil-1-picrilhidracilo) y ABTS (ácido 2,2'azinobis-(3-etilbenzotiazolina)-6-sulfónico). Adicionalmente, se determinó la concentración de fenoles totales presentes en los extractos a través del método de Folin-Ciocalteu. Resultados: los extractos en acetato de etilo (PgAEF) y en agua (PgAF) presentaron mayor actividad antioxidante con valores de IC50 de 5 207 y 3 912 mg/L respectivamente. Asimismo, se observó una relación directamente proporcional entre la concentración de fenoles totales presentes en los extractos y la actividad antioxidante exhibida. Conclusiones: las especies de la familia Rubiaceae, especialmente P. guianensis, son una fuente promisoria e importante de metabolitos secundarios con capacidad antioxidante, por lo cual se requieren de mayores estudios que permitan identificar dichas sustancias e integrarlas a programas de terapia antioxidante en el área de la salud(AU)

Introduction: the proliferation of free radicals in the human body induces oxidative damage to biomolecules that cause damage at the cellular level and can generate various abnormalities in the body, such as atherosclerosis, aging and cancer. Currently, the search for molecules with antioxidant properties is increasing, where the plants are a major source of compounds. Objective: to determine the antioxidant activity and phenolic content of extracts of different polarities from the aerial part of Palicourea guianensis (Rubiaceae) species. Methods: for evaluation of the biological activity, the values of the mean inhibitory concentration (IC50) of the most active extracts were estimated by the methods of electron capture DPPH (2,2-diphenyl-1-picrylhidracyl) and ABTS (2,2'azinobis-(3-ethylbenzothiazoline)-6-sulfonic acid). Additionally, the total phenol concentration present in the extracts was determined using the Folin-Ciocalteu reagent. Results: the extracts in ethyl acetate (PgAEF) and in water (PgAF) showed higher antioxidant activity with IC50 values of 5 207 and 3 912 mg/L respectively. Furthermore, there was direct relationship between the concentration of total phenols present in the extracts and the antioxidant activity. Conclusions: Rubiaceae family species, especially P. guianensis are a promising and important source of secondary metabolites with antioxidant capacity, so further studies are required to identify these substances and integrate them to the antioxidant therapy programs of the health areas(AU)

Evaluación a largo plazo de la posición adelantada de la lengua, en pacientes con Síndrome de Down, que utilizaron placa reposicionadora lingual. Primera fase / Long term evaluation of the advanced position of the tongue in Down’s Syndrome patients with a lingual repositioning plaque

El propósito del estudio fue evaluar cefalométricamente los cambios esqueléticos y dentales producidos en pacientes tratados tempranamente con tracción cervical mandibular seguidos de ortodoncia. Para esto se observó una muestra de 30 pacientes, 21 de ellos fueron analizados como grupo experimental y 9 pacientes como grupo control. Ambos, presentaban al inicio del estudio, maloclusión clase III esquelética. El grupo experimental tenía radiografía cefálica lateral antes, durante y al final del tratamiento con tracción cervical mandibular y un año después de terminado el tratamiento (edad promedio de 10.2 ± 1.3 años al inicio y 15.3 ± 1.9 años en retención). El grupo control fueron pacientes sin tratar con radiografía cefálica lateral inicial y con edad promedio de 10.4 ± 1.9 años al inicio y 14.4 ± 1.7 años al final. Se observaron cambios a nivel dental y esquelético permitiendo mejorar así las relaciones maxilo-mandibulares. Se encontró que el tratamiento de la maloclusión clase III con prognatismo mandibular con tracción cervical mandibular previo al pico de crecimiento mandibular, es una buena alternativa para mejorar la estética facial y disminuir la maloclusión...

Manejo temprano del subdesarrollo en el maxilar superior / Early treatment of maxillary hipoplasia

El manejo temprano del subdesarrollo del maxilar superior de paciente en dentición mixta ha sido ampliamente discutido en la literatura. Para su tratamiento se han propuesto diferentes alternativas entre las cuales se incluyen la utilización de la máscara facial de Delaire, cuyo objetivo es realizar una tracción por medio de elásticos que van insertados a un aparato de anclaje intra-oral. Se presenta en este artículo el diagnóstico, tratamiento y seguimiento de una paciente de 10 años de edad que fue tratada con la utilización de dicha técnica.