Expression of CD28, FAS, PD1, and CTLA4 molecules in the blood of women with triple-negative breast cancer.

BACKGROUND: Locally advanced triple-negative breast cancer (TNBC) represents a public health problem in Brazil. Its standard treatment consists of neoadjuvant chemotherapy (NAC). METHODS: This was a longitudinal study with follow-up performed between the years 2015 and 2017. Thirty women with locally advanced TNBC submitted to NAC, and 30 healthy were included. Peripheral blood samples were collected before NAC (Pre-NAC) and after NAC (Post-NAC). RESULTS: Patients with TNBC had elevated levels of CD28+ T, FAS+ T, CTLA4+ T, PD1+ T, CD28+CD4+ T, PD1+CD4+ T and CD8+ T and PD1+ CD8+ T cells compared to controls (p < 0.05). Patients with pathological complete response (pCR) had low FAS+ T cells, FAS+CD4+ T cells, and PD1+CD8+ T cells compared to the non-pCR (p < 0.05). Significant differences were observed in the levels of CD28+ T cells, FAS+ T and PD1+ T, CD4+ T, CD28+CD4+ T, FAS+CD4+ T, PD1+CD4+ T, CD8+ T, and PD1+CD8+ T cells between Pre-NAC and Post-NAC groups (p < 0.05). CONCLUSION: Alterations in the circulating FAS+CD4+ T and PD1+CD8+ T cell levels Pre-NAC are associated with pCR, suggesting potential predictive biomarkers of NAC response in TNBC. The largest changes in the cellular immune response profile Post-NAC showed that chemotherapy treatment can modulate the immune response and that it is associated with prognosis in TNBC.

Do adolescents consider mind-body skills groups an acceptable treatment for depression: results from a pilot study.

BACKGROUND: Mind-Body Skills Groups (MBSGs) have shown promise in reducing adolescent depression symptoms; however, little is known about adolescents' perspectives on this treatment. The objective of this study was to understand the acceptability of a new treatment for depressed adolescents in primary care settings. METHODS: Adolescents participating in a 10-week MBSG treatment were interviewed to understand their perspectives on the acceptability and effectiveness of the treatment. Interviews were collected at post-intervention and at a 3-month follow-up visit. RESULTS: A total of 39 adolescents completed both the post-intervention and 3-month follow-up interview. At post-intervention and follow-up, 84% of adolescents stated the MBSGs helped them. When asked how the MBSGs helped them, 3 areas were identified: learning new MBSG activities and skills, social connection with others within the group, and outcomes related to the group. Many adolescents reported no concerns with the MBSGs (49% at post- intervention; 62% at follow-up). Those with concerns identified certain activities as not being useful, wanting the group to be longer, and the time of group (after school) being inconvenient. Most adolescents reported that their life had changed because of the group (72% at post-intervention; 61% at follow-up), and when asked how, common responses included feeling less isolated and more hopeful. CONCLUSIONS: Adolescents found the MBSGs to be helpful and acceptable as a treatment option for depression in primary care. Given the strong emphasis on treatment preference autonomy and the social activities within the group, MBSGs appear well-suited for this age group. TRIAL REGISTRATION: NCT03363750 ; December 6th, 2017.

Patient Monitoring Alarms in an Intensive Care Unit: Observational Study With Do-It-Yourself Instructions.

BACKGROUND: As one of the most essential technical components of the intensive care unit (ICU), continuous monitoring of patients' vital parameters has significantly improved patient safety by alerting staff through an alarm when a parameter deviates from the normal range. However, the vast number of alarms regularly overwhelms staff and may induce alarm fatigue, a condition recently exacerbated by COVID-19 and potentially endangering patients. OBJECTIVE: This study focused on providing a complete and repeatable analysis of the alarm data of an ICU's patient monitoring system. We aimed to develop do-it-yourself (DIY) instructions for technically versed ICU staff to analyze their monitoring data themselves, which is an essential element for developing efficient and effective alarm optimization strategies. METHODS: This observational study was conducted using alarm log data extracted from the patient monitoring system of a 21-bed surgical ICU in 2019. DIY instructions were iteratively developed in informal interdisciplinary team meetings. The data analysis was grounded in a framework consisting of 5 dimensions, each with specific metrics: alarm load (eg, alarms per bed per day, alarm flood conditions, alarm per device and per criticality), avoidable alarms, (eg, the number of technical alarms), responsiveness and alarm handling (eg alarm duration), sensing (eg, usage of the alarm pause function), and exposure (eg, alarms per room type). Results were visualized using the R package ggplot2 to provide detailed insights into the ICU's alarm situation. RESULTS: We developed 6 DIY instructions that should be followed iteratively step by step. Alarm load metrics should be (re)defined before alarm log data are collected and analyzed. Intuitive visualizations of the alarm metrics should be created next and presented to staff in order to help identify patterns in the alarm data for designing and implementing effective alarm management interventions. We provide the script we used for the data preparation and an R-Markdown file to create comprehensive alarm reports. The alarm load in the respective ICU was quantified by 152.5 (SD 42.2) alarms per bed per day on average and alarm flood conditions with, on average, 69.55 (SD 31.12) per day that both occurred mostly in the morning shifts. Most alarms were issued by the ventilator, invasive blood pressure device, and electrocardiogram (ie, high and low blood pressure, high respiratory rate, low heart rate). The exposure to alarms per bed per day was higher in single rooms (26%, mean 172.9/137.2 alarms per day per bed). CONCLUSIONS: Analyzing ICU alarm log data provides valuable insights into the current alarm situation. Our results call for alarm management interventions that effectively reduce the number of alarms in order to ensure patient safety and ICU staff's work satisfaction. We hope our DIY instructions encourage others to follow suit in analyzing and publishing their ICU alarm data.

Cell cycle arrest and cell death correlate with the extent of ischaemia and reperfusion injury in patients following kidney transplantation - results of an observational pilot study.

A prolonged cold ischaemia time (CIT) is suspected to be associated with an increased ischaemia and reperfusion injury (IRI) resulting in an increased damage to the graft. In total, 91 patients were evaluated for a delayed graft function within 7 days after kidney transplantation (48 deceased, 43 living donors). Blood and urine samples were collected before, immediately after the operation, and 1, 3, 5, 7 and 10 days later. Plasma and/or urine levels of total keratin 18 (total K18), caspase-cleaved keratin 18 (cc K18), the soluble receptor for advanced glycation end products (sRAGE), tissue inhibitor of metalloproteinase-2 (TIMP-2) and insulin-like growth factor-binding protein-7 (IGFBP7) were measured. As a result of prolonged CIT and increased IRI, deceased donor transplantations were shown to suffer from a more distinct cell cycle arrest and necrotic cell death. Plasmatic total K18 and urinary TIMP-2 and IGFBP7 were therefore demonstrated to be of value for the detection of a delayed graft function (DGF), as they improved the diagnostic performance of a routinely used clinical scoring system. Plasmatic total K18 and urinary TIMP-2 and IGFBP7 measurements are potentially suitable for early identification of patients at high risk for a DGF following kidney transplantation from deceased or living donors.

The role of unfractionated heparin for the antiaggregatory effect of aspirin in patients undergoing carotid endarterectomy: Results of an observational clinical study.

The aims of the present study were to examine the influence of a low-dose unfractionated heparin regime on platelet aggregation and to additionally assess the prevalence of primary aspirin resistance in patients undergoing carotid endarterectomy. Therefore, 50 patients undergoing carotid endarterectomy were enrolled. A bolus of 3000 IU unfractionated heparin was administered 2 min before carotid cross-clamping additionally to standard antiaggregatory therapy. Haemostaseological point of care testing was performed twice, prior to surgery and 10 min after unfractionated heparin administration by the use of aggregometric and viscoelastic point of care testing. Following unfractionated heparin administration, the activated partial thromboplastin time increased significantly and clotting time in viscoelastic INTEM test was shown to be significantly prolonged. In contrast, the antiaggregatory effect of aspirin was not diminished in aggregometric ASPI test. A low-dose unfractionated heparin regime during carotid endarterectomy was therefore considered to be safe, without diminishing the antiplatelet effect of aspirin. Moreover, aggregometric point of care testing was identified to be a suitable tool for the identification of patients with primary aspirin resistance ( n = 3).

Analysis of the Environmental Management System based on ISO 14001 on the American continent.

The American continent is in broad economic and industrial development. Consequently, a more detailed discussion of the impacts generated by such development is needed. Moreover, there is an increase in the number of ISO 14001 certificates issued to this continent. Given the above, no studies were found that bridge the gap to identify the influence of different factors on ISO 14001 in the Americas. Thus, this article has as its main aim to check which economic, environmental and cultural factors have influence on ISO 14001 Certification in the American Continent. The data were collected in the ISO Survey, World Bank, United Nations Development Programme and International Energy Agency. Among the countries of that continent, thirteen were analyzed and only two did not show the economic factors as the influence factor in the multiple regression models fitted with Brazil and the United State. In these models, all presented environmental factors as influencing factors. Only in Brazil the index HDI presented as cultural factor in multiple regression model fitted. The economic factors: Gross Domestic Product and exports of goods and services and environmental: Carbon Dioxide (CO2) and fossil fuel consumption were the most influential in ISO 14001 certification. Venezuela, Uruguay, Colombia and the United States were countries that had factors dependent on each other, featuring the environmental marketing. Briefly, this study brings up several implications: to the academy, with the proposal of new concepts and guidance on the factors that assist in ISO 14001 certification in the American Continent. Additionally, taking into account the industry, the factors serve as efficiency parameters for the implementation of ISO 14001 standard, and for the Government to improve through factors that do not fit in multiple regression models.

[Caustics injuries in the upper gastrointestinal tract: clinical and endoscopic features]. / Lesiones por cáusticos del tracto digestivo superior: características clínicas y endoscópicas.

OBJECTIVE: To describe the clinical and endoscopic features of caustics injuries in the upper gastrointestinal tract in patients of the National Hospital Daniel Alcides Carrión. MATERIALS AND METHODS: A descriptive study was conducted; the study populations were patients diagnosed with caustic ingestion who were admitted into the Gastroenterology service of the HNDAC to perform an upper endoscopy during the period of January 2009 to December 2012. We documented the type of caustic substance ingested, cause of intake, amount ingested, intake mode, signs or symptoms present, endoscopic findings as classified by Zargar, presence of complications and treatment performed. Analysis was performed comparing them based on the ingested caustic type: acid or alkali. RESULTS: We obtained 91 patients; the average age was 30.6±16.3 years. Caustic substances ingested were: bleach (sodium hypochlorite) in 71 (78%) patients, muriatic acid (hydrochloric acid) in 18 (20%) patients, caustic soda in 2 (2%) patients. The average intake was 136ml (30-500 ml). The most frequent signs and symptoms were vomiting, abdominal pain, nausea and sore throat. The 46% of patients had injuries. 100% of patients who ingested acid and 33% who ingested alkali had lesions. Five (5%) patients had oropharyngeal lesions, 24 (26%) in the esophagus, 36 (40%) in the stomach and 12 (13%) in the duodenum. Grade I lesions were found in 10 (11%) patients, 16 (18%) patients with grade II lesions and 15 (16%) of patients with grade III, 12 patients who toke acid had lesions of grade III. Esophageal stricture was found in 2 (2%) patients, gastric stenosis in 7 (8%) patients and esophageal and gastric stenosis in 3 (3%) patients. Two patients required pneumatic dilation and 10 surgical treatments. CONCLUSION: Most injuries were found in the stomach. Acidic injuries occur more frequently and with greater severity than alkaline. Acidic substances produce esophageal or gastric stenosis more frequently than alkaline.

Thresholds of copper phytotoxicity in field-collected agricultural soils exposed to copper mining activities in Chile.

It has been argued that the identification of the phytotoxic metal thresholds in soil should be based on field-collected soil rather than on artificially-contaminated soils. However, the use of field-collected soils presents several difficulties for interpretation because of mixed contamination and unavoidable covariance of metal contamination with other soil properties that affect plant growth. The objective of this study was to estimate thresholds of copper phytotoxicity in topsoils of 27 agricultural areas historically contaminated by mining activities in Chile. We performed emergence and early growth (21 days) tests (OECD 208 and ISO 11269-2) with perennial ryegrass (Lolium perenne L.). The total Cu content in soils was the best predictor of plant growth and shoot Cu concentrations, while soluble Cu and pCu(2+) did not well correlate with these biological responses. The effects of Pb, Zn, and As on plant responses were not significant, suggesting that Cu is a metal of prime concern for plant growth in soils exposed to copper mining activities in Chile. The effects of soil nutrient availability and shoot nutrient concentrations on ryegrass response were not significant. It was possible to determine EC10, EC25 and EC50 of total Cu in the soil of 327 mg kg(-1), 735 mg kg(-1) and 1144 mg kg(-1), respectively, using the shoot length as a response variable. However, the derived 95% confidence intervals for EC10, EC25 and EC50 values of total soil Cu were wide, and thus not allowing a robust assessment of metal toxicity for agricultural crops, based on total soil Cu concentrations. Thus, plant tests might need to be performed for metal toxicity assessment. This study suggests shoot length of ryegrass as a robust response variable for metal toxicity assessment in contaminated soils with different nutrient availability.

Methylglyoxal as a new biomarker in patients with septic shock: an observational clinical study.

INTRODUCTION: The role of reactive carbonyl species, such as methylglyoxal (MG), has been overlooked within the context of the sepsis syndrome. The aims of this study were to assess the impact of MG formation in different inflammatory settings and to evaluate its use for early diagnosis as well as prognosis of the sepsis syndrome. METHODS: In total, 120 patients in three groups were enrolled in this observational clinical pilot study. The three groups included patients with septic shock (n = 60), postoperative controls (n = 30), and healthy volunteers (n = 30). Plasma samples from patients with septic shock were collected at sepsis onset and after 24 hours and 4, 7, 14, and 28 days. Plasma samples from postoperative controls were collected prior to surgery, immediately following the end of the surgical procedure as well as 24 hours later and from healthy volunteers once. Plasma levels of MG were determined by high-performance liquid chromatography. Additionally, plasma levels of procalcitonin, C-reactive protein, soluble CD14 subtype, and interleukin-6 were determined. RESULTS: Patients with septic shock showed significantly higher plasma levels of MG at all measured times, compared with postoperative controls. MG was found to identify patients with septic shock more effectively-area under the curve (AUC): 0.993-than procalcitonin (AUC: 0.844), C-reactive protein (AUC: 0.791), soluble CD14 subtype (AUC: 0.832), and interleukin-6 (AUC: 0.898) as assessed by receiver operating characteristic (ROC) analysis. Moreover, plasma levels of MG in non-survivors were significantly higher than in survivors (sepsis onset: *P = 0.018 for 90-day survival; **P = 0.008 for 28-day survival). Plasma levels of MG proved to be an early predictor for survival in patients with septic shock (sepsis onset: ROC-AUC 0.710 for 28-day survival; ROC-AUC 0.686 for 90-day survival). CONCLUSIONS: MG was identified as a marker for monitoring the onset, development, and remission of sepsis and was found to be more useful than routine diagnostic markers. Further studies are required to determine the extent of MG modification in sepsis and whether targeting this pathway could be therapeutically beneficial to the patient. TRIAL REGISTRATION: German Clinical Trials Register DRKS00000505. Registered 8 November 2010.

[Diagnostic of ascites due to portal hypertension: accuracy of the serum-ascites albumin gradient and protein analises in ascitic fluid]. / Eficacia de la gradiente de albúmina sangre-ascític y los análisis de proteínas en líquido ascítico en el diagnóstico de ascitis hipertensiva portal.

OBJECTIVE: To evaluate the diagnostic accuracy of the Serum-Ascites Albumin Gradient (GASA), Protein Concentration in the Ascitic Fluid (PTLA), Albumin Concentration in the ascitic fluid (CAA) and the Protein Ascites/Serum Ratio (IPAS) for the diagnosis of ascites due to portal hypertension. MATERIALS AND METHODS: it was an observational and retrospective study of validation of diagnostic tests. The study population was patients from a National Public Health Hospital Daniel Alcides Carrion of Callao, Peru, during the period January to December of 2012, patients over 15 years old with a diagnosis of ascites which samples were taken for study by paracentesis with an standard technique, it was analyzed total protein and albumin, as well as study of total protein and albumin in blood. We obtained the diagnostic accuracy, sensitivity, specificity, PPV and NPV of the Serum-Ascites Albumin Gradient (GASA), Protein Concentration in the Ascitic Fluid (PTLA), Albumin Concentration in the ascitic fluid (CAA) and the Protein Ascites/Serum Ratio (IPAS) for the diagnosis of ascites due to portal hypertension. To determine ascites by HTP as diagnostic tests we took into account: GASA >= 1.1, PTLA <2.5, CAA <1.1 or IPAS< 0.5. RESULTS: There were 126 patients diagnosed with ascites, 10 patients was excluded for having incomplete data. Of the 116 patients, the average age was 53.03 +/- 15.73 years old, male 65 (56%) and female 51 (44%). 61 (52%) had ascites due to portal hypertension from liver cirrhosis, and 55 (48%) of ascites due to NO HTP. The sensitivity and specificity for GASA was 93% and 47% respectively, for PTLA was 80% and 89% respectively, for CAA was 85% and 87% respectively and for the IPAS was 83% and 80% respectively. The área under the ROC curve for GASA was 0.70, ATPL was 0.84, IPAS was 0.81 and CAA was 0.86, we found statistically significant differences between GASA compared to the other three parameters (p<0.01 ). CONCLUSION: The diagnostic accuracy of CAA, ATPL and IPAS is higher than the GASA to discriminate between ascites due to HTP or NO HTP, so that they could be used in clinical practice alone or together to achieve a diagnostic approach more successful.

[Rectal mucosal prolapse syndrome: study of cases. Hospital Daniel A Carrion, Lima, Peru, 2010-2013]. / Síndrome de prolapso de mucosa rectal: estudio de casos. Hospital Daniel A Carrión,Lima, Perú. 2010-2013.

OBJECTIVE: to describe the clinical, endoscopic, and histological characteristics of rectal mucosal prolapse syndrome, formerly known as Solitary rectal ulcer, in patients from a general hospital. MATERIAL AND METHODS: All patient diagnosed as rectal mucosal prolapse syndrome during 2010-2013 was selected; the medical history war reviewed and the histological slides were reevaluated by two pathologists. RESULTS: 17 cases of rectal mucosal prolapse syndrome were selected, the majority were males under 50 years, the most common clinical findings were rectal bleeding (82%) and constipation (65%), the endocopic findings were heterogeneous,: erythema (41%), ulcers (35%) and elevated lesions (29%). All cases presented fibromuscularhyperplasia in lamina propia and crypt distortion in the microscopic evaluation. CONCLUSION: In our study of rectal mucosal prolapse syndrome. The most common clinical findings were rectal bleeding and constipation. Erythematous mucosa was the most common endoscopic finding.

Prediction of pollutant emission characteristics in ISO50001 energy management in the Americas: Uni and multivariate machine learning approach.

The American continent is experiencing significant economic and industrial development driven by sustainability principles. In this context, discussions on improving energy consumption have become increasingly frequent and dynamic across various sectors of civil society, including the implementation of energy efficiency measures as advocated by the ISO50001 energy management standard. However, there is a pressing need to investigate which socioeconomic aspects are responsible for the issuance of this certification in the Americas and how these factors relate to characteristic industrial emissions, especially particulate matter. This study aims to evaluate the socioeconomic factors influencing ISO50001 standard issuance and how these adjusted factors correlate with particulate matter of 2.5 µm and 10 µm dimensions. To achieve this, machine learning techniques were employed, considering the complex nature and risk of data overfitting. Model fitting was performed through multiple lasso regression, and the relationship between the adjusted factors was examined through cross-correlation analysis. The analyses indicate a strong correlation of adjusted macroeconomic indicators, especially with PM2.5, suggesting an association with cardiorespiratory problems and methane-related origins. This work is of great relevance to academia as it proposes new concepts regarding the interaction between energy efficiency standards and particulate matter. For the industrial sector, the adjusted factors provide guidance for standard implementation while also helping to mitigate health issues. Additionally, for the government, these results can assist in formulating policies to address specific health problems related to this area.

Higher Virulence of Diplodia seriata Isolates on Vines of cv. Cabernet Sauvignon Associated with 10-Year-Old Wood Compared to Young Tissue.

Botryosphaeria dieback (BD) occurs in young and old plants. In the field, the prevalence and severity of the disease increase proportionally with the age of vineyards. Among the pathogens that cause BD, Diplodia seriata is the most prevalent species in Chile and other countries with a Mediterranean climate. To date, no information is available on the susceptibility of adult wood to infection by this pathogen since most of the pathogenicity tests have been carried out on 1- or 2-year-old shoots or detached canes. Therefore, a pathogenicity test was carried out on plants under field conditions, with inoculations in 1-year-old shoots and 2- and 10-year-old wood in grapevine cv. Cabernet Sauvignon. A pathogenicity test was carried out with two isolates of D. seriata. The results for the plants show that D. seriata was significantly more aggressive on the 10-year-old than on the one- or two-year-old tissue, where the lesions were 4.3 and 2.3 cm on average, respectively. These results were compared with the lesions obtained from two-year-old canes after the isolates were activated in grape berries. Also, the Chilean isolates of D. seriata were compared phylogenetically with those from other countries, and no major differences were found between them. Our results are consistent with the damage observed in the field, contributing to the knowledge of the epidemiology of this disease in Mediterranean climates. In the future, the effect observed in cv. Cabernet Sauvignon with D. seriata on virulence at different tissue ages should be tested for other BD-causing agents and wine varieties.

[Bisap-O: obesity included in score BISAP to improve prediction of severity in acute pancreatitis]. / BISAP-O: obesidad incluida en el score BISAP para mejorar la prediccion de severidad en pancreatitis aguda.

INTRODUCTION: Most patients with acute pancreatitis exhibits a self-limiting clinical course and relatively free of major complications. Several scores have been created with the intention of achieving adequate and early predict the severity of pancreatitis in order to reduce this mortality. BISAP score was validated in 2008 as a predictor of mortality for acute pancreatitis, obesity is an independent risk factor that increases the risk of severity in patients with acute pancreatitis.The aim of this study is to determine whether obesity BISAP added a score improves prediction of severity in patients with acute pancreatitis. MATERIAL AND METHODS: This study was conducted in Daniel Alcides Carrión Hospital, Lima, Peru. The patient data were collected in the Emergency Service, it was a cross-sectional retrospective study, between January 2009 and June 2010. RESULTS: We evaluated a total of 99 patients with acute pancreatitis. Etiology of the 99 were biliary pancreatitis. Only 2 ended in death (2%). Most cases occurred in female patients 77/22 (77.8%). Sixteen of the 99 patients (16%) were considered severe acute pancreatitis. 90% (89/99) had a BISAP <3, 10% a BISAP ≥ 3, fifteen of the 99 patients had a BISAP-O> 3, of them 12 were actually considered a severe pancreatitis. Of 16 patients with severe pancreatitis, 14 patients had a BMI>25. (P = 0.03, OR = 4.39). BISAP-O has a sensitivity, specificity, PPV and NPV of 75%, 96.4%, 80% and 95.2% respectively, with an accuracy of 92.3%. The area under the curve for BISAP-O was 0.94 (95% CI 0.89 to 0.99). There was no difference when compared with the other studied scores (p = 0.45). CONCLUSIONS: BISAP The score is a simple method that can be used to predict the severity of acute pancreatitis. Obesity associated BISAP (BISAP-O) provides higher sensitivity and diagnostic accuracy to score BISAP and can serve as a parameter to help predict severity in patients with acute pancreatitis. It was not possible to assess the BISAP-O score as a predictor of mortality for patients with acute pancreatitis, due to the low mortality rate in the present study. Further studies are required to validate the score BISAP associated with obesity in predicting severity.

[Incidence and associated factors in ulcer bleeding recurrence post inyectotherapy with adrenaline]. / Incidencia y factores asociados en la recurrencia de sangrado ulceroso post inyectoterapia con adrenalina.

AIM: To determine the incidence and associated factors with upper gastrointestinal bleeding after injection therapy with adrenaline in a general hospital. STUDY DESIGN: longitudinal and analytic. Clinical records of patients with upper gastrointestinal bleeding who received injection therapy with adrenalin during 2005 and 2011 in Daniel Alcides Carrion Hospital, Peru were reviewed. Rebleeding and pre-endoscopic and endoscopic associated factors were sought. A bivariate (Chi Square, Fisher Exact test and RR) and multivariate analysis were performed. RESULTS: A total of 111 patients were included. Rebleeding rate was 20.7%. Multivariate analysis showed active bleeding (p=0.002) and anticoagulant drugs (p=0.035) were associated with rebleeding. CONCLUSION: Rebleeding rate was 20.7% and active bleeding as well as anticoagulant drugs use were associated factors.

Treatment completion among justice-involved youth engaged in behavioral health treatment studies in the United States: A systematic review and meta-analysis.

Justice-involved youth (JIY) have high rates of behavioral health disorders, but few can access, much less complete, treatment in the community. Behavioral health treatment completion among JIY is poorly understood, even within treatment studies. Measurement, reporting, and rates of treatment completion vary across studies. This systematic review and meta-analysis synthesizes the literature on rates of treatment completion among JIY enrolled in research studies and identifies potential moderators. After systematically searching 6 electronic databases, data from 13 studies of 20 individual treatment groups were abstracted and coded. A meta-analysis examined individual prevalence estimates of treatment completion in research studies as well as moderator analyses. Prevalence effect sizes revealed high rates of treatment completion (pr = 82.6). However, analysis suggests a high likelihood that publication bias affected the results. Treatment groups that utilized family- or group-based treatment (pr = 87.8) were associated with higher rates of treatment completion compared to treatment groups utilizing individual treatment (pr = 61.1). Findings suggest that it is possible to achieve high rates of treatment completion for JIY, particularly within the context of family- and group-based interventions. However, these findings are limited by concerns about reporting of treatment completion and publication bias.

Implementation of a Brief Dialectical Behavioral Therapy Skills Group in High Schools for At-Risk Youth: Protocol for a Mixed Methods Study.

BACKGROUND: Adolescence is a developmental period marked by engagement in risk-taking behaviors, especially among impulsive or emotionally dysregulated youth. Thus, interventions that teach skills to reduce the risk of negative outcomes associated with emotional dysregulation are required. Social and emotional learning (SEL) programs have been developed to address both adolescent emotional dysregulation and risk-taking behaviors; however, current programs have mostly been implemented among younger youth and are used as a tier 1 universal intervention rather than a targeted tier 2 intervention for youth identified with emotional regulation difficulties. OBJECTIVE: This study aimed to address the need for SEL programming that can be delivered in schools, particularly for older youth who have difficulties with emotional or behavioral dysregulation, to reduce the risk of health-risk behaviors among this population. METHODS: Here, we outline the implementation of an SEL intervention titled Going 4 Goals, a 9-session adaptation of the Dialectical Behavioral Therapy for Adolescents (DBT-A) program delivered to at-risk high school students in a school setting. The primary objectives of the study are to test whether participating in the skills group intervention produces significant increases in the core DBT-A skills of mindfulness, emotional regulation, distress tolerance, and interpersonal effectiveness, while also producing significant decreases in substance use and risky behaviors. These primary outcomes are based on changes in participant scores between baseline and after the intervention and follow-ups at 1, 3, and 6 months compared with a control group of youth participating in the school's health curriculum at the same time points. Qualitative interviews will also be conducted with intervention participants and school staff to examine acceptability and facilitators of and barriers to the intervention. RESULTS: A total of 171 participants across 13 groups had been enrolled in the intervention, with data collection ending December 2021. Data analysis will begin in the spring of 2022, with expected results to be published in the spring of 2023. CONCLUSIONS: This paper describes the protocol of the 9-session school-based adaptation of the DBT-A intervention and discusses the strengths and limitations of the study and future directions. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): DERR1-10.2196/32490.

Hourly Relationship between Reference Evapotranspiration and Shoot Shrinkage in Walnut Trees and Pomegranate under Deficit Irrigation.

Diameter fluctuations of branches, shoots, or fruits are related to plant transpiration and water potential. In the past, several models have related dendrometric variables and evapotranspiration on a daily scale. However, trunk-branch shrinkage occurs only between dawn and midday, while evapotranspiration occurs most of the day from sunrise to sunset. Previous models have failed to incorporate this key fact. The objective of the present study was to assess the relationship of hourly daily shrinkage (HDS) between dawn and the next 4 h to the hourly reference evapotranspiration (EToh) of the same period in walnut trees and pomegranate plants under different irrigation regimes. Our data show that the relationship between EToh and HDS is much better than several previous models that included maximum daily shrinkage (MDS) and reference evapotranspiration (ETo). The novel slope analysis of the relationship between HDS versus time used here corresponds to the velocity at which the HDS occurs, which depends on the ETo intensity at that moment. This new method of analyzing this type of data calls for a revision of these models and sets a new baseline for future analysis.

Volatile Organic Compounds (VOCs) Produced by Gluconobacter cerinus and Hanseniaspora osmophila Displaying Control Effect against Table Grape-Rot Pathogens.

Table grapes (Vitis vinifera) are affected by botrytis bunch rot and summer bunch rot, the latter a complex disease caused by Botrytis cinerea, Aspergillus spp., Penicillium expansum and Rhizopus stolonifer. To search for biocontrol alternatives, a new bioproduct composed of Gluconobacter cerinus and Hanseniaspora osmophila, a consortium called PUCV-VBL, was developed for the control of fungal rots in table grapes. Since this consortium presents new biocontrol species, the effect of their VOCs (volatile organic compounds) was evaluated under in vitro and in vivo conditions. The VOCs produced by the PUCV-VBL consortium showed the highest mycelial inhibition against Botrytis cinerea (86%). Furthermore, H. osmophila was able to inhibit sporulation of A. tubingensis and P. expansum. VOCs' effect in vivo was evaluated using berries from Red Globe, Thompson Seedless and Crimson Seedless grapes cultivars, demonstrating a mycelial inhibition by VOCs greater than 70% for all evaluated fungal species. The VOC identification of the PUCV-VBL consortium was analyzed by solid-phase microextraction coupled to gas chromatography-mass spectrometry (SPME-GCMS). A total 26 compounds were identified, including 1-butanol 3-methyl, propanoic acid ethyl ester, ethyl acetate, phenylethyl alcohol, isobutyl acetate and hexanoic acid ethyl ester. Our results show that VOCs are an important mode of action of the PUCV-VBL biological consortium.

[Characteristics of gastroduodenal ulcers in patients with negative biopsies for Helicobacter pylori]. / Caracteristicas de las ulceras gastroduodenales en pacientes con biopsia negativa para helicobacter pylori.

OBJECTIVES: To evaluate the clinical, epidemiological and endoscopic characteristics of the Helicobacter pylori (Hp) negative peptic ulcer disease. METHODS: In this cross sectional study we included 651 patients diagnosed of peptic ulcer disease between January 2000 and December 2005. The diagnosis of Hp infection was established by histology. Clinical and epidemiological characteristics of patients with and without Hp infection were compared. RESULTS: Males prevailed (69%). Hp negative ulcers were older (57.73 +/- 19.44 years old vs 50.26 +/- 18, 64 years old, P < 0.001). Clinical characteristics did not differ among both groups. Duodenal ulcer prevailed in Hp positive patients (56.5%) and gastric ulcer in Hp negative patients (53.5%). Multiple ulcers and intestinal metaplasia were more frequently found in Hp negative cases [9.3% vs 4.5% (P = 0.015) and 34.5% vs 22.1% (P = 0.001), respectively]. CONCLUSION. Hp negative peptic ulcer disease is found in older patients, with a higher frequency of gastric ulcers, multiple lesions and intestinal metaplasia.