Modelling cost-effectiveness of syphilis detection strategies in prisoners: exploratory exercise in a Chilean male prison.

BACKGROUND: Syphilis, together with other sexually transmitted infections, remains a global public health problem that is far from controlled. People deprived of liberty are a vulnerable population. Control activities in prisons rely mostly on passive case detection, despite the existence of affordable alternatives that would allow switching to active case-finding strategies. Our objective was to develop a mathematical modelling framework for cost-effectiveness evaluation, from a health system perspective, of different approaches using rapid tests for the detection of syphilis in inmates' populations and to explore the results based on a Chilean male prison population. METHODS: A compartmental model was developed to characterize the transmission dynamics of syphilis inside a prison with the ongoing strategy (passive case detection, with VRDL + FTA-ABS), considering the entrance and exit of inmates over a 40 year period. The model allows simulation of the implementation of a reverse algorithm for the current situation (rapid test + VDRL), different screening strategies (entry point, massive periodically; both with rapid test + VDRL) and treatment of detected cases. The parameters for the exploratory exercise were obtained from systematic searches of indexed and grey literature and field work (EQ-5D questionnaire application and key actors interviews). Probabilistic sensitivity analysis was conducted to account for uncertainty in relevant parameters. RESULTS: The proposed framework allows the evaluation of different detection strategies. In this study, all the strategies were cost-effective in the baseline scenario when considering an ICER threshold of 1 Chilean GDP per capita (US$15,000). The strategies most likely to be cost-effective (over 80% probability) were: current situation with reverse algorithm, entry point screening and mass screening every two years; the latter was the most effective, achieving the lowest prevalence (0.7% and 1.7% over the period versus the 3% prevalence in the current situation). CONCLUSIONS: Mathematical modelling that considers the performance of different tests and detection strategies could be a useful tool for decision making. The exploratory results show the efficiency of adopting both the use of the rapid tests and performing active case detection to significantly reduce the burden of syphilis in Chilean prisons in the near future.

Magnetic detection of sentinel nodes in oral squamous cell carcinoma by means of superparamagnetic iron oxide contrast.

The aim was to evaluate sentinel node detection capacity by means of a magnetic probe in 11 patients with oral squamous cell carcinoma at stages T1-T2 received submucosal injections of a superparamagnetic iron oxide contrast agent (SPIO). A magnetic probe was used for sentinel node biopsy. The use of SPIO and magnetic probes in the early stages of oral cancer may offer an alternative to conventional radioisotope techniques and/or elective neck dissection.

Isolation of saprophytic Leptospira spp. from a selected environmental water source of Argentina.

Ten Leptospira spp. strains were isolated from water samples from Nievas stream, Olavarría, Buenos Aires province (Argentina). The isolates showed the typical motility and morphology of the genus Leptospira under dark field microscopy, developing in liquid EMJH medium after eight days of incubation at 13°C and 30°C. All isolates were negative by the Multiple Locus Variable Number Tandem Repeat Analysis (MLVA). Molecular identification by 16S rRNA gene sequencing identified all isolates as nonpathogenic leptospires. Four isolates showed a genetic profile identical to that of the reference strain Leptospira biflexa serovar Patoc, and six isolates revealed sequence similarities within the 97-98% range, closely related to Leptospira yanagawae and Leptospira meyeri, respectively. Strains ScialfaASA42, ScialfaASA45, ScialfaASA44, ScialfaASA47, ScialfaASA49, ScialfaASA50 and ScialfaASA51 possibly represent a novel species of the genus Leptospira.

Obstructive membrane at the base of the left atrial appendage, a multi-imaging approach.

The left atrial appendage (LAA) is a small muscular extension that grows from the anterolateral wall of the left atrium, in the proximity of the left pulmonary veins. The presence of a membrane in the LAA is a rare clinical entity whose origin is not known. Its clinical implication in the genesis of atrial arrhythmias and thromboembolic risk remains unknown. We report a case of an obstructive membrane located at the base of the LAA, found incidentally in a young patient who was initially undergoing a transesophageal echocardiogram prior to an invasive treatment for atrial fibrillation.

Trichinella Infection in Culled Wild Boar (Sus scrofa) from El Palmar National Park, Argentina, and Exposure Risk in Humans and Dogs Consuming Wild Boar Meat.

Trichinellosis is a foodborne disease caused by ingestion of raw or undercooked meat containing Trichinella spp. larvae. Consumption of wild boar (Sus scrofa) meat represents an important source of human trichinellosis worldwide. In El Palmar National Park (EPNP), Argentina, invasive alien wild boars are controlled and meat from culled animals is released for public consumption following on-site artificial digestion (AD) testing. Meat trimmings and offal from the control program are often used as food for dogs (Canis familiaris). We evaluated infection and exposure to Trichinella spp. in wild boars from EPNP, as well as exposure to Trichinella spp. and associated risk factors in dogs and human consumers of wild boar meat. Trichinella spp. larvae were detected in muscle samples from 5/49 wild boars by AD (10.2%; 95% confidence interval [CI], 3.8%-23%), with a mean burden of 0.24 larvae per gram (lpg; range, 0.06-0.95 lpg). Anti-Trichinella antibodies were not detected in wild boar serum samples (n=42). In dogs, 12/34 were seropositive to Trichinella spp. (35.29%; 95%, CI, 20.3%-53.5%). Immunoglobulin (Ig) G antibodies were not detected in human serum samples (n=63). Our results reveal the presence, albeit at low prevalence, of Trichinella spp. in wild boars and exposure in dogs fed game offal. These findings suggest that the low prevalence and parasitic load in wild boars, together with the best practices applied by EPNP culling program personnel, contribute to keeping the risk of infection in people low. The dog results highlight that the parasite is circulating in the area, and therefore the risk of infection is not negligible. We recommend the implementation of an animal surveillance strategy in order to monitor the evolution of this zoonosis in the study area.

Bifurcation analysis of a tuberculosis progression model for drug target identification.

Tuberculosis (TB) is a major cause of morbidity and mortality worldwide. The emergence and rapid spread of drug-resistant M. tuberculosis strains urge us to develop novel treatments. Experimental trials are constrained by laboratory capacity, insufficient funds, low number of laboratory animals and obsolete technology. Systems-level approaches to quantitatively study TB can overcome these limitations. Previously, we proposed a mathematical model describing the key regulatory mechanisms underlying the pathological progression of TB. Here, we systematically explore the effect of parameter variations on disease outcome. We find five bifurcation parameters that steer the clinical outcome of TB: number of bacteria phagocytosed per macrophage, macrophages death, macrophage killing by bacteria, macrophage recruitment, and phagocytosis of bacteria. The corresponding bifurcation diagrams show all-or-nothing dose-response curves with parameter regions mapping onto bacterial clearance, persistent infection, or history-dependent clearance or infection. Importantly, the pathogenic stage strongly affects the sensitivity of the host to these parameter variations. We identify parameter values corresponding to a latent-infection model of TB, where disease progression occurs significantly slower than in progressive TB. Two-dimensional bifurcation analyses uncovered synergistic parameter pairs that could act as efficient compound therapeutic approaches. Through bifurcation analysis, we reveal how modulation of specific regulatory mechanisms could steer the clinical outcome of TB.

Effects of COVID-19 on male sex function and its potential sexual transmission.

INTRODUCTION: Severe Acute Respiratory Syndrome Coronavirus 2, (SARS-CoV-2) was first identified by the Chinese Centers for Disease Control and Prevention on January 8, 2020 and was declared as a global pandemic on March 11, 2020 by WHO. SARS-CoV-2 uses the Angiotensin-converting enzyme 2 (ACE2) receptor as an entry route, associated with the transmembrane serine protease protein (TMPRSS2), which makes the testis and particularly spermatogenesis potentially vulnerable, since this tissue has high expression of ACE2. MATERIAL AND METHODS: We performed a systematic literature review by electronic bibliographic databases in Pubmed, Scopus and ScienceDirect up to August 2020 about the effect of SARS-CoV-2 on male sexual function and its transmission, to assess possible repercussions on sex organs and the existence of a sexual transmission path. RESULTS: Although SARS-CoV-2 presence has not been found in testicle samples, it has been demonstrated that it causes histological changes compatible with orchitis, and sex hormone disturbances. TMPRSS2 is up-regulated in prostate cancer where it supports tumor progression, thus these patients may have a higher risk of SARS-CoV-2 infection. TMPRSS2 inhibitors may be useful for the treatment or prevention of COVID-19. No viral material has been found in blood or semen, however it has been proven to be present in stool and saliva. CONCLUSION: The male reproductive system would be highly vulnerable and susceptible to infection by SARS-CoV-2 given the expression of the ACE2 receptor in somatic and germ cells. The seminal fluid would remain free of viral presence in patients with COVID-19. Regardless, non-genital sex could be an important source of viral transmission. In assisted reproduction techniques all necessary tests must be carried out to ensure the donor is free of the virus at the time of collection and handling of the seminal sample.

Protein Tyrosine Phosphatases in Neuroblastoma: Emerging Roles as Biomarkers and Therapeutic Targets.

Neuroblastoma is a type of cancer intimately related with early development and differentiation of neuroendocrine cells, and constitutes one of the pediatric cancers with higher incidence and mortality. Protein tyrosine phosphatases (PTPs) are key regulators of cell growth and differentiation by their direct effect on tyrosine dephosphorylation of specific protein substrates, exerting major functions in the modulation of intracellular signaling during neuron development in response to external cues driving cell proliferation, survival, and differentiation. We review here the current knowledge on the role of PTPs in neuroblastoma cell growth, survival, and differentiation. The potential of PTPs as biomarkers and molecular targets for inhibition in neuroblastoma therapies is discussed.

Spreading of Normal Liquid Helium Drops.

We have used video imaging and interferometric techniques to investigate the dynamics of spreading of drops of ^{4}He on a solid surface for temperatures ranging from 5.2 K (near the critical point) to 2.2 K (near T_{λ}). After an initial transient, the drops become pancake-shaped with a radius that grows as R(t)≈t^{α}, with α=0.149±0.002. The drops eventually begin to shrink due to evaporation driven by gravitational and curvature effects, which limits their lifetime to about 1000 s. Although helium completely wets the substrate, and the spreading takes place over a pre-existing adsorbed film, a distinct contact line with a contact angle of order one degree is visible throughout this process.

Implementation of a Mindfulness-Based Crisis Intervention for Frontline Healthcare Workers During the COVID-19 Outbreak in a Public General Hospital in Madrid, Spain.

Introduction: The COVID-19 outbreak is having an impact on the well-being of healthcare workers. Mindfulness-based interventions have shown effectiveness in reducing stress and fostering resilience and recovery in healthcare workers. There are no studies examining the feasibility of brief mindfulness-based interventions during the COVID-19 outbreak. Materials and Methods: This is an exploratory study with a post intervention assessment. We describe an on-site brief mindfulness intervention and evaluate its helpfulness, safety, and feasibility. Results: One thousand out of 7,000 (14%) healthcare workers from La Paz University Hospital in Madrid (Spain) participated in at least one session. One hundred and fifty out of 1,000 (15%) participants filled out a self-report questionnaire evaluating the helpfulness of the intervention for on-site stress reduction. Ninety two subjects (61%) participated in more than one session. Most of the participants were women (80%) with a mean age of 38.6 years. Almost half of the sample were nurses (46%). Sessions were perceived as being helpful with a mean rating of 8.4 on a scale from 0 to 10. Only 3 people (2%) reported a minor adverse effect (increased anxiety or dizziness). Discussion: Our data supports the utility, safety and feasibility of an on-site, brief mindfulness-based intervention designed to reduce stress for frontline health workers during a crisis. There is a need to continue testing this type of interventions, and to integrate emotion regulation strategies as an essential part of health workers' general training. Clinical Trial Registration number: NCT04555005.

Specific therapies proposed for the management of COVID-19. / Terapias específicas propuestas para el manejo de COVID-19.

The appearance of a new coronavirus, which has caused the collapse of health systems around the world, has led to the emergence of numerous investigations looking for the ideal treatment and proper management of this new entity, since its control has become impossible and its cure an international necessity. To date, there are hundreds of articles and clinical trials to review. For this reason, in an attempt to facilitate the reader's knowledge of the new evidence and in summary form, the different therapies studied so far are presented in this article: their antiviral and adverse effects. Without forgetting that there are still doubts to be resolved and this process of new knowledge is just beginning.

La aparición de un nuevo coronavirus, causante del colapso de los sistemas de salud de todo el mundo, ha provocado el surgimiento de cuantiosas investigaciones en busca del tratamiento ideal y un adecuado manejo a esta nueva entidad, ya que su control se ha vuelto imposible y su cura una necesidad internacional. Hasta la fecha existen cientos de artículos y ensayos clínicos por revisar. Por ello, en un intento por facilitar al lector el entendimiento de la nueva evidencia y en forma de resumen, se exponen en el presente artículo las distintas terapias estudiadas hasta el momento: sus efectos antivirales y adversos. Sin olvidar que aún quedan varias incógnitas por resolver y este proceso de nuevo conocimiento apenas comienza.

Mutational profiling can identify laryngeal dysplasia at risk of progression to invasive carcinoma.

Early diagnosis of laryngeal squamous cell carcinoma (LSCC) at the stage of dysplasia could greatly improve the outcome of affected patients. For the first time we compared the mutational landscape of non-progressing dysplasia (NPD; n = 42) with progressing dysplasia (PD; n = 24), along with patient-matched LSCC biopsies; a total of 90 samples. Using targeted next-generation sequencing identified non-synonymous mutations in six genes (PIK3CA, FGFR3, TP53, JAK3, MET, FBXW7), and mutations were validated by Sanger sequencing and/or qPCR. Analysis was extended in silico to 530 head and neck (HNSCC) cases using TCGA data. Mutations in PIK3CA and FGFR3 were detected in PD and LSCC cases, as well as other HNSCC cases, but absent in NPD cases. In contrast, mutations in JAK3, MET and FBXW7 were found in NPD cases but not PD, LSCC or other HNSCC cases. TP53 was the most frequently mutated gene in both PD and NPD cases. With the exception of R248W, mutations were mutually exclusive. Moreover, five of seven PD mutations were located in motif H2 of p53, whereas none of the NPD mutations were. In summary, we propose that the mutational profile of laryngeal dysplasia has utility for the early detection of patients at risk of progression.

Hyperpolarization-Activated Current Induces Period-Doubling Cascades and Chaos in a Cold Thermoreceptor Model.

In this article, we describe and analyze the chaotic behavior of a conductance-based neuronal bursting model. This is a model with a reduced number of variables, yet it retains biophysical plausibility. Inspired by the activity of cold thermoreceptors, the model contains a persistent Sodium current, a Calcium-activated Potassium current and a hyperpolarization-activated current (Ih) that drive a slow subthreshold oscillation. Driven by this oscillation, a fast subsystem (fast Sodium and Potassium currents) fires action potentials in a periodic fashion. Depending on the parameters, this model can generate a variety of firing patterns that includes bursting, regular tonic and polymodal firing. Here we show that the transitions between different firing patterns are often accompanied by a range of chaotic firing, as suggested by an irregular, non-periodic firing pattern. To confirm this, we measure the maximum Lyapunov exponent of the voltage trajectories, and the Lyapunov exponent and Lempel-Ziv's complexity of the ISI time series. The four-variable slow system (without spiking) also generates chaotic behavior, and bifurcation analysis shows that this is often originated by period doubling cascades. Either with or without spikes, chaos is no longer generated when the Ih is removed from the system. As the model is biologically plausible with biophysically meaningful parameters, we propose it as a useful tool to understand chaotic dynamics in neurons.

Tomographic Particle Image Velocimetry using Smartphones and Colored Shadows.

We demonstrate the viability of using four low-cost smartphone cameras to perform Tomographic PIV. We use colored shadows to imprint two or three different time-steps on the same image. The back-lighting is accomplished with three sets of differently-colored pulsed LEDs. Each set of Red, Green & Blue LEDs is shone on a diffuser screen facing each of the cameras. We thereby record the RGB-colored shadows of opaque suspended particles, rather than the conventionally used scattered light. We subsequently separate the RGB color channels, to represent the separate times, with preprocessing to minimize noise and cross-talk. We use commercially available Tomo-PIV software for the calibration, 3-D particle reconstruction and particle-field correlations, to obtain all three velocity components in a volume. Acceleration estimations can be done thanks to the triple pulse illumination. Our test flow is a vortex ring produced by forcing flow through a circular orifice, using a flexible membrane, which is driven by a pressurized air pulse. Our system is compared to a commercial stereoscopic PIV system for error estimations. We believe this proof of concept experiment will make this technique available for education, industry and scientists for a fraction of the hardware cost needed for traditional Tomo-PIV.

Self-determined shapes and velocities of giant near-zero drag gas cavities.

Minimizing the retarding force on a solid moving in liquid is the canonical problem in the quest for energy saving by friction and drag reduction. For an ideal object that cannot sustain any shear stress on its surface, theory predicts that drag force will fall to zero as its speed becomes large. However, experimental verification of this prediction has been challenging. We report the construction of a class of self-determined streamlined structures with this free-slip surface, made up of a teardrop-shaped giant gas cavity that completely encloses a metal sphere. This stable gas cavity is formed around the sphere as it plunges at a sufficiently high speed into the liquid in a deep tank, provided that the sphere is either heated initially to above the Leidenfrost temperature of the liquid or rendered superhydrophobic in water at room temperature. These sphere-in-cavity structures have residual drag coefficients that are typically less than [Formula: see text] those of solid objects of the same dimensions, which indicates that they experienced very small drag forces. The self-determined shapes of the gas cavities are shown to be consistent with the Bernoulli equation of potential flow applied on the cavity surface. The cavity fall velocity is not arbitrary but is uniquely predicted by the sphere density and cavity volume, so larger cavities have higher characteristic velocities.

Case study: what did Rafael Correa say? Comparing political attention across 10 years of the Ecuadorian president's discourses / Estudio de caso: ¿qué dijo Rafael Correa? Comparando la atención política en 10 años de discursos del presidente ecuatoriano / Estudo de caso: o que Rafael Correa disse? Comparando a atenção política em 10 anos dos discursos do presidente equatoriano

Abstract The "citizen revolution" was a political project executed mainly between 2007 and 2016 by the former president of the Republic of Ecuador, Rafael Correa Delgado, under the paradigm of 21st century socialism. The main characteristic of this project was to introduce a new political agenda to the country that was differentiated from past agendas, by focusing on issues such as the recognition of new rights, improvements to education, instituting a new economic model, and strengthening government and sovereignty, among others. Under this context, this work aims to analyze the political attention of the ex-president, explaining why some issues are more important than others, and why they varied over time. Based on a conceptual framework that takes ideas from the agenda-setting theory, the areas on which the political agenda concentrates are measured by the Shannon entropy index, and its various changes are explained as the results of preferences, institutional factors, and external events. The analysis is based on extensive database analyses of 10 years (covering Rafael Correa's presidency) of government speeches, which are coded according to the methodology of the Comparative Agendas Project (CAP). To the best of our knowledge, this paper is the first work to apply the CAP methodology in Ecuador.

Resumen La "revolución ciudadana" fue el proyecto político ejecutado principalmente por el expresidente de la República del Ecuador, Rafael Correa Delgado, bajo el paradigma del socialismo del siglo XXI, entre 2007 y 2016. Este proyecto se caracterizó por establecer una nueva agenda política en el país, diferenciándose de las pasadas, enfocándose en temas como el reconocimiento de nuevos derechos, mejora de la educación, propuesta un nuevo modelo económico y el fortalecimiento del gobierno y la soberanía entre otros. Bajo este contexto, este trabajo tiene como objetivo analizar la atención política de la agenda del expresidente de la república, explicar por qué algunos temas son más importantes que otros y por qué hay variaciones en ellos a lo largo del tiempo. Con base en un marco conceptual que toma ideas de la teoría del establecimiento de la agenda, se mide la concentración de la agenda política a través del índice de entropía de Shannon y se explican los diferentes cambios en ella a raíz de las preferencias, las fricciones institucionales y los eventos externos. El análisis se basa en extensas bases de datos sobre 10 años de discursos del gobierno (presidencia de Rafael Correa), que están codificados de acuerdo con la metodología del Proyecto de Agendas Comparadas (PAC). Por lo que conocemos, este es el primer trabajo que aplica esta metodología en Ecuador.

Resumo A "revolução cidadã" foi o projeto político realizado principalmente pelo ex-presidente da República do Equador, Rafael Correa Delgado, sob o paradigma do socialismo do século XXI entre 2007 e 2016. Esse projeto foi caracterizado por estabelecer uma nova agenda política no país, diferenciando-se do passado, concentrando-se em questões como reconhecimento de novos direitos, melhoria da educação, proposta de um novo modelo econômico e fortalecimento do governo e da soberania, entre outros. Nesse contexto, este trabalho tem como objetivo analisar a atenção política na agenda do ex-presidente da república, explicar por que algumas questões são mais importantes que outras e por que há variações nelas ao longo do tempo. Com base em uma estrutura conceitual que retira ideias da teoria da definição da agenda, a concentração da agenda política é medida através do índice de entropia de Shannon e as diferentes mudanças nele são explicadas como resultado de preferências, atritos institucionais e eventos externos. A análise é baseada em extensas bases de dados de 10 anos de discursos governamentais (presidência de Rafael Correa), codificados de acordo com a metodologia do Projeto de agendas comparativas (PAC). Até onde sabemos, este é o primeiro trabalho que aplica essa metodologia no Equador.