Integrating perspectives in developing mycorrhizal trait databases: a call for inclusive and collaborative continental efforts.

Global assessments of mycorrhizal symbiosis present large sampling gaps in rich biodiversity regions. Filling these gaps is necessary to build large-scale, unbiased mycorrhizal databases to obtain reliable analyses and prevent misleading generalizations. Underrepresented regions in mycorrhizal research are mainly in Africa, Asia, and South America. Despite the high biodiversity and endemism in these regions, many groups of organisms remain understudied, especially mycorrhizal fungi. In this Viewpoint, we emphasize the importance of inclusive and collaborative continental efforts in integrating perspectives for comprehensive trait database development and propose a conceptual framework that can help build large mycorrhizal databases in underrepresented regions. Based on the four Vs of big data (volume, variety, veracity, and velocity), we identify the main challenges of constructing a large mycorrhizal dataset and propose solutions for each challenge. We share our collaborative methodology, which involves employing open calls and working groups to engage all mycorrhizal researchers in the region to build a South American Mycorrhizal Database. By fostering interdisciplinary collaborations and embracing a continental-scale approach, we can create robust mycorrhizal trait databases that provide valuable insights into the evolution, ecology, and functioning of mycorrhizal associations, reducing the geographical biases that are so common in large-scale ecological studies.

Predicting students' academic progress and related attributes in first-year medical students: an analysis with artificial neural networks and Naïve Bayes.

BACKGROUND: Dropout and poor academic performance are persistent problems in medical schools in emerging economies. Identifying at-risk students early and knowing the factors that contribute to their success would be useful for designing educational interventions. Educational Data Mining (EDM) methods can identify students at risk of poor academic progress and dropping out. The main goal of this study was to use machine learning models, Artificial Neural Networks (ANN) and Naïve Bayes (NB), to identify first year medical students that succeed academically, using sociodemographic data and academic history. METHODS: Data from seven cohorts (2011 to 2017) of admitted medical students to the National Autonomous University of Mexico (UNAM) Faculty of Medicine in Mexico City were analysed. Data from 7,976 students (2011 to 2017 cohorts) of the program were included. Information from admission diagnostic exam results, academic history, sociodemographic characteristics and family environment was used. The main dataset included 48 variables. The study followed the general knowledge discovery process: pre-processing, data analysis, and validation. Artificial Neural Networks (ANN) and Naïve Bayes (NB) models were used for data mining analysis. RESULTS: ANNs models had slightly better performance in accuracy, sensitivity, and specificity. Both models had better sensitivity when classifying regular students and better specificity when classifying irregular students. Of the 25 variables with highest predictive value in the Naïve Bayes model, percentage of correct answers in the diagnostic exam was the best variable. CONCLUSIONS: Both ANN and Naïve Bayes methods can be useful for predicting medical students' academic achievement in an undergraduate program, based on information of their prior knowledge and socio-demographic factors. Although ANN offered slightly superior results, Naïve Bayes made it possible to obtain an in-depth analysis of how the different variables influenced the model. The use of educational data mining techniques and machine learning classification techniques have potential in medical education.

Mechanistic Insights about Sorafenib-, Valproic Acid- and Metformin-Induced Cell Death in Hepatocellular Carcinoma.

Hepatocellular carcinoma (HCC) is among the main causes of death by cancer worldwide, representing about 80-90% of all liver cancers. Treatments available for advanced HCC include atezolizumab, bevacizumab, sorafenib, among others. Atezolizumab and bevacizumab are immunological options recently incorporated into first-line treatments, along with sorafenib, for which great treatment achievements have been reached. However, sorafenib resistance is developed in most patients, and therapeutical combinations targeting cancer hallmark mechanisms and intracellular signaling have been proposed. In this review, we compiled evidence of the mechanisms of cell death caused by sorafenib administered alone or in combination with valproic acid and metformin and discussed them from a molecular perspective.

Facilitators and barriers of the implementation of point-of-care devices for cardiometabolic diseases: a scoping review.

BACKGROUND: Point-of-care testing (POCT) devices may facilitate the delivery of rapid and timely results, providing a clinically important advantage in patient management. The challenges and constraints in the implementation process, considering different levels of actors have not been much explored. This scoping review aimed to assess literature pertaining to implementation facilitators and barriers of POCT devices for the diagnosis or monitoring of cardiometabolic diseases. METHODS: A scoping review of the literature was conducted. The inclusion criteria were studies on the inception, planning, or implementation of interventions with POCT devices for the diagnosis or monitoring of cardiometabolic diseases defined as dyslipidemia, cardiovascular diseases, type 2 diabetes, and chronic kidney disease. We searched MEDLINE, Embase, and Global Health databases using the OVID searching engine until May 2022. The Consolidated Framework of Implementation Research (CFIR) was used to classify implementation barriers and facilitators in five constructs. Also, patient, healthcare professional (HCP), and organization level was used. RESULTS: Twenty studies met the eligibility criteria for data extraction. All studies except two were conducted in high-income countries. Some findings are: 1) Intervention: the most widely recognized facilitator was the quick turnaround time with which results are obtained. 2) Outer setting: at the organizational level, the lack of clear regulatory and accreditation mechanisms has hindered the adoption and sustainability of the use of POCT. 3) Inner setting: for HCP, performing POCT during the consultation was both a facilitator and a barrier in terms of time, personnel, and service delivery. 4) Individuals: the implementation of POCT may generate stress and discomfort in some HCP in terms of training and new responsibilities. 5) Process: for patients, it is highly appreciated that obtaining the sample was simple and more comfortable if venipuncture was not used. CONCLUSION: This scoping review has described the facilitators and barriers of implementing a POCT device for cardiometabolic conditions using the CFIR. The information can be used to design better strategies to implement these devices and benefit more populations that have low access to cardiometabolic tests.

Use of historical mapping to understand sources of soil-lead contamination: Case study of Santa Ana, CA.

This paper investigates the historical sources of soil-lead contamination in Santa Ana, California. Even though dangerous levels of soil-lead have been found in a wide variety of communities across the United States, public health institutions lack clarity on the historical origins of these crises. This study uses geo-spatial data collected through archival research to estimate the impact of two potential sources of lead contamination in the past -- lead-paint and leaded gasoline. It examines, through a combination of statistical and historical methods, the association between lead concentrations in contemporary soil samples and patterns in the evolution of the city's physical features, such as the growth of urbanized areas and the historical flow of traffic. We emphasize the value of historical data collected through archival research for understanding the sources of environmental lead, particularly leaded gasoline, which our study found to be the most likely and most prominent contributor to soil-lead in Santa Ana's environment. This research contributes to environmental-justice advocacy efforts to reframe lead poisoning as a systemic environmental issue and outlines the path forward to community-level remediation strategies.

Isotretinoin and Thalidomide Down-Regulate c-MYC Gene Expression and Modify Proteins Associated with Cancer in Hepatic Cells.

Hepatocellular carcinoma (HCC) is the most common form of liver cancer. The number of cases is increasing and the trend for the next few years is not encouraging. HCC is usually detected in the advanced stages of the disease, and pharmacological therapies are not entirely effective. For this reason, it is necessary to search for new therapeutic options. The objective of this work was to evaluate the effect of the drugs isotretinoin and thalidomide on c-MYC expression and cancer-related proteins in an HCC cellular model. The expression of c-MYC was measured using RT-qPCR and western blot assays. In addition, luciferase activity assays were performed for the c-MYC promoters P1 and P2 using recombinant plasmids. Dose-response-time analyses were performed for isotretinoin or thalidomide in cells transfected with the c-MYC promoters. Finally, a proteome profile analysis of cells exposed to these two drugs was performed and the results were validated by western blot. We demonstrated that in HepG2 cells, isotretinoin and thalidomide reduced c-MYC mRNA expression levels, but this decrease in expression was linked to the regulation of P1 and P1-P2 c-MYC promoter activity in isotretinoin only. Thalidomide did not exert any effect on c-MYC promoters. Also, isotretinoin and thalidomide were capable of inducing and repressing proteins associated with cancer. In conclusion, isotretinoin and thalidomide down-regulate c-MYC mRNA expression and this is partially due to P1 or P2 promoter activity, suggesting that these drugs could be promising options for modulating the expression of oncogenes and tumor suppressor genes in HCC.

Primary and post-chemoradiotherapy MRI detection of extramural venous invasion in rectal cancer: the role of diffusion-weighted imaging.

OBJECTIVE: To assess the added value of diffusion-weighted imaging (DWI) to high-resolution T2-weighted sequences (HRT2w) in MRI detection of extramural venous infiltration (EMVI), according to the previous experience of radiologists. METHODS: A cross-sectional study of a retrospective database including 1.5 T MRI records from 100 patients with biopsy-proven rectal cancer (2011-2016; 75 male/25 female, average 63 y/o), which included primary staging (54) and post-chemoradiotherapy follow-up MRIs (46). The reference standard was histology of surgical specimens. All cases were individually blindly reviewed by ten radiologists: three specialists in abdominal radiology, three specialized in different areas and four residents. In each case, the presence of EMVI was assessed twice: first, using just HRT2w; second, with DWI added to HRT2w. The results were pooled by experience, analyzing sensitivity, specificity, accuracy (area under ROC curve), likelihood ratios, predictive values and overstaging/understaging. RESULTS: Addition of DWI improved diagnostic performance by specialists radiologists, particularly post-chemoradiotherapy (accuracy 0.74-0.84; positive likelihood ratio 3.9-9.1; overstaging 16-8%), less so at primary staging (specificity 76-87.2%; overstaging 21-11%). Non-specialist radiologists also improved, but only at primary staging (accuracy 0.59-0.63). Residents showed small changes, except for notably increased sensitivity in both primary staging (35.7-43%) and post-chemoradiotherapy (41.7-58.3%) staging, at the expense of increased overstaging. CONCLUSIONS: The addition of DWI improved the diagnostic performance of EMVI by experienced radiologists, downgrading overstaging, especially in post-chemoradiotherapy follow-up. It resulted in fewer changes for inexperienced radiologists (enhanced primary staging) and residents (increased sensitivity).

[Validation of the Ocular Surface Disease Index Questionnaire for Chilean patients]. / Adaptación cultural y validación del cuestionario Ocular Surface Disease Index en una población chilena.

BACKGROUND: Ocular Surface Disease Index (OSDI) is the most commonly used questionnaire worldwide to detect dry eye disease. Although it is massively used in clinical practice in Chile, its use has not been validated yet in the country. AIM: To develop a cultural adaptation and to validate the OSDI questionnaire for the Chilean population. MATERIAL AND METHODS: For cultural adaptation, a translation, retro-translation and an expert panel review was carried out. The resulting questionnaire was applied to a pilot group of twelve participants and their comments were considered for the final questionnaire version. The final questionnaire was applied to a non-random sample of 200 patients aged 53 ± 17 years (75% women). Internal consistency and construct validity were evaluated by Cronbach's alpha and exploratory factor analysis respectively. RESULTS: According to the OSDI score, 81% of respondents had dry eye (55% severe). Reliability was 0.91 and factor analysis resulted in three factors explaining 75.4% of the total variance. CONCLUSIONS: The OSDI questionnaire version obtained in this study demonstrated excellent internal consistency values and adequate construct validity making it applicable to clinical practice and dry eye research.

Morphological abnormalities in natural populations of the common South American toad Rhinella arenarum inhabiting fluoride-rich environments.

Morphological abnormalities in amphibians may be attributed to contaminants, ultraviolet radiation and trematode parasites, or a synergistic effect between them. In the present study, morphological abnormalities in Rhinella arenarum adults from natural and artificial fluoride-rich environments were identified and evaluated. Three sites were sampled in central Argentina: Los Vallecitos stream (LF-LV), Los Cerros Negros stream (MF-CN), and Decantation ponds (HF-DP), with low (0.33 mg/L), middle (2.03 mg/L) and high (14.0 mg/L) fluoride levels respectively; the latter site is associated with a fluoride mine. Abnormal individuals were photographed and then standard radiographs were taken. Abnormality frequencies and relative percentage of abnormal individuals were calculated for each site. In addition, skeletochronology was used to estimate toad's age. Five abnormality types were identified: syndactyly, ectrodactyly, polydactyly, microphthalmia and ectromelia. Percentages of abnormal individuals per site were: LF-LV = 4%, MF-CN = 21.2% and HF-DP = 6.4%. The MF-CN and HF-DP populations had morphological abnormality frequencies that exceeded the reference value (5%) reported in the literature. The average age did not differ between sites. The results of this study indicate that there is an association between frequency of morphological abnormalities and high fluoride levels.

Magnetic properties of nanoparticles as a function of their spatial distribution on liposomes and cells.

The aggregation processes of magnetic nanoparticles in biosystems are analysed by comparing the magnetic properties of three systems with different spatial distributions of the nanoparticles. The first one is iron oxide nanoparticles (NPs) of 14 nm synthesized by coprecipitation with two coatings, (3-aminopropyl)trimethoxysilane (APS) and dimercaptosuccinic acid (DMSA). The second one is liposomes with encapsulated nanoparticles, which have different configurations depending on the NP coating (NPs attached to the liposome surface or encapsulated in its aqueous volume). The last system consists of two cell lines (Pan02 and Jurkat) incubated with the NPs. Dynamic magnetic behaviour (AC) was analysed in liquid samples, maintaining their colloidal properties, while quasi-static (DC) magnetic measurements were performed on lyophilised samples. AC measurements provide a direct method for determining the effect of the environment on the magnetization relaxation of nanoparticles. Thus, the imaginary (χ'') component shifts to lower frequencies as the aggregation state increases from free nanoparticles to those attached or embedded into liposomes in cell culture media and more pronounced when internalized by the cells. DC magnetization curves show no degradation of the NPs after interaction with biosystems in the analysed timescale. However, the blocking temperature is shifted to higher temperatures for the nanoparticles in contact with the cells, regardless of the location, the incubation time, the cell line and the nanoparticle coating, supporting AC susceptibility data. These results indicate that the simple fact of being in contact with the cells makes the nanoparticles aggregate in a non-controlled way, which is not the same kind of aggregation caused by the contact with the cell medium nor inside liposomes.

Validation of the American version of the CareGiver Oncology Quality of Life (CarGOQoL) questionnaire.

BACKGROUND: The CareGiver Oncology Quality of Life (CarGOQoL) questionnaire, a 29-item, multidimensional, self-administered questionnaire, was validated using a large French sample. We reported the linguistic validation process and the metric validity of the English version of CarGOQoL in the United- States. METHODS: The translation process consisted of 3 consecutive steps: forward-backward translation, acceptability testing, and cognitive interviews. The psychometric testing was applied to caregivers of consecutive patients with representative cancers who were recruited from the Regional Cancer Center in northwestern Pennsylvania. All individuals completed the CarGOQoL at baseline, day- 30, and day- 90. Internal consistency, reliability, external validity, reproducibility, and sensitivity to change were tested. RESULTS: The translated version was validated on a total of 87 American cancer caregivers. The dimensions of the CarGOQoL generally demonstrated a high internal consistency (Cronbach's alpha > 0.70 for all but four domain scores). External validity testing revealed that the CarGOQoL index score correlated significantly with all SF-36 dimension scores except the physical composite score (Pearson's correlation: 0.28-0.70). Reproducibility was satisfactory at day- 30 (intraclass correlation coefficient: 0.46-0.94) and day- 90 (0.43-0.92). Four specific dimensions of CarGOQoL showed responsiveness: the Psychological well-being, the Relationships with health care system, the Social support and the Finances. CONCLUSIONS: The American version of the CarGOQoL constitutes a useful instrument to measure QoL in caregivers of cancer patients in the United- States.

[Risk factors for binge eating disorders and its association with obesity in adolescents]. / Factores de riesgo para los trastornos por atracón (TA) y su asociación con la obesidad en adolescentes.

Binge eating disorder (BED) is the most frequent alteration in eating behavior and can affect adolescents. The aim was to determine the prevalence of BED, risk factors, and its association with obesity in adolescents in a secondary education institution of Barquisimeto, Venezuela, between September 2013 and February 2014. A sample of 500 adolescents of both sexes (252 male), between 11 and 18 years of age was studied. A questionnaire was applied and anthropometric measurements were performed: weight, height, body mass index, waist circumference, and waist-height index. According to criteria of the Diagnostic and Statistical Manual of Mental Disorders - V, the prevalence of BED was 7.80%. Risk factors were male gender, age > 14 years, body image dissatisfaction, family dysfunction, depressive symptoms and perceived stress. Binge eating disorder was a risk factor for global obesity and central obesity. The prevalence of BED was higher than internationally found for the general population. Important psychosocial risk factors that should be considered in the implementation of prevention and control strategies were identified.

Effectiveness of medication self-management, self-monitoring and a lifestyle intervention on hypertension in poorly controlled patients: The MEDICHY randomized trial.

Background: Uncontrolled hypertension is a common problem worldwide, despite the availability of many effective antihypertensive drugs and lifestyle interventions. We assessed the efficacy of a multi-component intervention in individuals with uncontrolled hypertension in a primary care setting. Methods: This study was a randomized, multicenter, parallel, two-arm, single-blind controlled trial performed in primary healthcare centers in Mallorca (Spain). All participants were 35 to 75-years-old and had poorly controlled hypertension. Patients were randomly assigned in a 1:1 ratio to a control group (usual care) or an intervention group (self-monitoring of blood pressure, self-titration of hypertensive medications, dietary interventions, and physical activity interventions). The primary outcome was decrease in the mean SBP at 6 months relative to baseline. Results: A total of 153 participants were randomized to an intervention group (77) or a control group (76). After 6 months, the intervention group had a significantly lower systolic blood pressure (135.1 mmHg [±14.8] vs. 142.7 mmHg [±15.0], adjusted mean difference: 8.7 mmHg [95% CI: 3.4, 13.9], p < 0.001) and a significantly lower diastolic blood pressure (83.5 mmHg [±8.8] vs. 87.00 mmHg [±9.0], adjusted mean difference: 5.4 [95% CI: 2.9, 7.8], p < 0.0001). The intervention group also had significantly more patients who achieved successful blood pressure control (<140/90 mmHg; 54.4% vs. 32.9%, p = 0.011). Discussion: Self-monitoring of blood pressure in combination with self-management of hypertensive medications, diet, and physical activity in a primary care setting leads to significantly lower blood pressure in patients with poorly controlled hypertension.Clinical Trial Registration: ClinicalTrials.gov, identifier ISRCTN14433778.

Chitosan-Coated Silver Nanoparticles Inhibit Adherence and Biofilm Formation of Uropathogenic Escherichia coli.

Urinary tract infections are commonly caused by uropathogenic Escherichia coli (UPEC), which usually presents multiple virulence and resistance mechanisms, making it difficult to treat. It has been demonstrated that silver and polymeric nanoparticles had potential against these pathogens. In this study, we synthesized thiol chitosan-coated silver nanoparticles (SH-Cs-AgNPs) and evaluated their antibacterial, antibiofilm and antiadherence activity against clinical isolates of UPEC. The SH-Cs-AgNPs showed a spherical shape with a size of 17.80 ± 2.67 nm and zeta potential of 18 ± 2 mV. We observed a potent antibacterial and antibiofilm activity as low as 12.5 µg/mL, as well as a reduction in the adherence of UPEC to mammalian cells at concentrations of 1.06 and 0.53 µg/mL. These findings demonstrate that SH-Cs-AgNPs have potential as a new therapeutic compound against infections caused by UPEC.

Using the random forest method to detect a response shift in the quality of life of multiple sclerosis patients: a cohort study.

BACKGROUND: Multiple sclerosis (MS), a common neurodegenerative disease, has well-described associations with quality of life (QoL) impairment. QoL changes found in longitudinal studies are difficult to interpret due to the potential response shift (RS) corresponding to respondents' changing standards, values, and conceptualization of QoL. This study proposes to test the capacity of Random Forest (RF) for detecting RS reprioritization as the relative importance of QoL domains' changes over time. METHODS: This was a longitudinal observational study. The main inclusion criteria were patients 18 years old or more with relapsing-remitting multiple sclerosis. Every 6 months up to month 24, QoL was recorded using generic and MS-specific questionnaires (MusiQoL and SF-36). At 24 months, individuals were divided into two 'disability change' groups: worsened and not-worsened patients. The RF method was performed based on Breiman's description. Analyses were performed to determine which QoL scores of SF-36 predicted the MusiQoL index. The average variable importance (AVI) was estimated. RESULTS: A total of 417 (79.6%) patients were defined as not-worsened and 107 (20.4%) as worsened. A clear RS was identified in worsened patients. While the mental score AVI was almost one third higher than the physical score AVI at 12 months, it was 1.5 times lower at 24 months. CONCLUSION: This work confirms that the RF method offers a useful statistical approach for RS detection. How to integrate the RS in the interpretation of QoL scores remains a challenge for future research. TRIAL REGISTRATION: ClinicalTrials.gov identifier: NCT00702065.

Early Effects of Mycorrhizal Fungal Inoculum and Fertilizer on Morphological and Physiological Variables of Nursery-Grown Nothofagus alessandrii Plants.

Nothofagus alessandrii (ruil) is an endangered relict species, endemic to the Mediterranean area of Chile, and one of the most threatened trees in the country. Its natural distribution area has been greatly reduced by the effect of human activities; the remaining fragments are mostly intervened and highly deteriorated as a habitat and refuge for the associated biodiversity. In order to produce healthy and resistant nursery plants for recovery and restoration of N. alessandrii forests, this study evaluates the early effects of mycorrhizal fungal inoculum (MFI) combined with fertilization on the cultivation of seedlings. The experiment was established under a completely randomized design with a factorial arrangement of the mycorrhizal factors (M0 = without mycorrhizal, M1 = Thelephora sp. and M2 = Hebeloma sp.) and fertilization (F1 = standard fertilization and F2 = intensive fertilization), with three replicates of each combination, for each type of plant (P1 = plants from one season and P2 = plants from two seasons). Each experimental unit corresponded to a group of 20 plants, with 720 plants in the test. The results indicate that application of fertilizer and MFI significantly affects some growth and photosynthesis parameters of ruil plants in one and two seasons. The morphological parameters obtained in the study show shoot height values ranging between 67 and 91 cm for P1 and between 96 and 111 cm for P2; while, for shoot diameter, values ranged between 7.91 and 8.24 mm for P1 and between 10.91 and 11.49 mm for P2. Although formation of fully developed mycorrhizal roots was not observed during the assay period, we conclude that inoculation of mycorrhizal fungi combined with fertilization could be an efficient strategy to produce a quality plant, in addition to maintaining a high photosynthetic capacity and, therefore, a higher percentage of survival in the field.

The technology - activities of daily living questionnaire: a version with a technology-related subscale.

BACKGROUND: Information and communication technology (ICT) has become an increasingly important part of daily life. The ability to use technology is becoming essential for autonomous functioning in society. Current functional scales for patients with cognitive impairment do not evaluate the use of technology. The objective of this study was to develop and validate a new version of the Activities of Daily Living Questionnaire (ADLQ) that incorporates an ICT subscale. METHOD: A new technology-based subscale was incorporated into the Spanish version of the ADLQ (SV-ADLQ), entitled the Technology version of the ADLQ (T-ADLQ). The T-ADLQ was administered to 63 caregivers of dementia patients, 21 proxies of mild cognitive impairment patients and 44 proxies of normal elderly subjects (mean age of the sample ± SD: 73.5 ± 8.30 years). We analysed the convergent validity, internal consistency, reliability cut-off point, sensitivity and specificity of the T-ADLQ. The results of the T-ADLQ were compared to the SV-ADLQ. RESULTS: The T-ADLQ showed significant correlations with the Mini-Mental State Examination (MMSE), the Frontal Assessment Battery (FAB) as well as other measures of functional impairment and dementia severity (MMSE: r = -0.70; FAB: r = -0.65; Functional Assessment Questionnaire: r = 0.77; Instrumental Activities of Daily Living Scale: r = -0.75; Clinical Dementia Rating Scale: r = 0.72; p < 0.001). The T-ADLQ showed a good reliability with a relatively high Cronbach's α-coefficient (Cronbach's α = 0.861). When considering a functional impairment cut-off point greater than 29.25%, the sensitivity and specificity of the T-ADLQ were 82 and 90%, respectively. The area under the receiver-operating characteristic curve was 0.937 for the T-ADLQ and 0.932 for the original version of the test. CONCLUSIONS: The T-ADLQ revealed adequate indicators of validity and reliability for the functional assessment of activities of daily living in dementia patients. However, the inclusion of technology items in the T-ADLQ did not improve the performance of the scale, which may reflect the lack of widespread use of technology by elderly individuals. Thus, although it appeared reasonable to add technology use questions to the ADLQ, our experience suggested that this has to be done cautiously, since the sensitivity of these additional items could vary in different populations. The T-ADLQ needs to be validated in a different population of dementia subjects.

[Guideline for interpretation and report of the antibody to hepatitis C virus. Grupo de Desarrollo de la Guía ]. / Guía de interpretación y reporte del anticuerpo a hepatitis C.

Patients with hepatitis C virus (HCV) infection are detected by testing for the presence of antibodies to HCV (Anti-HCV). A positive Anti-HCV test represents a true positive result only in a variable proportion of subjects (35 to 95%). The qualitative interpretation as positive or negative Anti-HCV report is associated with a general lack of understanding regarding the interpretation of results, when more specific testing should be performed, and which tests should be considered for this purpose. Therefore, a substantial variation in supplemental testing practices exists among laboratories and physicians. This guideline was developed on the basis of the best available evidence to classify positive antibody in two (low and high) or three levels (very low, low and high) according to the signal to cutoff (S/CO) ratio: the very low level of the Anti-HCV identifies false-positive results and further diagnostic testing is not necessary. The low antibody level is frequently related with false-positive results and testing with Immunoblot is recommended; only Immunoblot-positive subjects require HCV RNA testing because of a low possibility of being viremic. The high Anti-HCV level is an accurate serological marker for predicting viremia and denotes the need of routine HCV RNA testing in order to efficiently confirm hepatitis C. Cost-effectiveness analysis, based on the Anti-HCV level, recommends the use of the two or three-levels to choose the confirmatory test of positive antibody. This approach can be implemented without increasing test costs because the S/CO ratio is automatically generated in most laboratory analyzers and would provide health care professionals with useful information for counseling and evaluating patients, to eliminate unwarranted notifications in cases of false antibody reactivity, and correctly identifying those Anti-HCV-positive patients who are infected and need antiviral treatment. The written report should include the antibody level (S/CO ratio), the type of the immunoassay applied and interpretation guideline. Anti-HCV testing is performed in multiple settings including blood banks or health department facilities; adoption of this Guideline for interpretation and report of the antibody to hepatitis C virus by laboratories and its implementation by clinicians will improve the accuracy for interpreting antibody result to determine the next step on hepatitis C diagnosis.

Use of Radioisotope Ratios of Lead for the Identification of Historical Sources of Soil Lead Contamination in Santa Ana, California.

Lead (Pb) is an environmental neurotoxicant that has been associated with a wide range of adverse health conditions, and which originates from both anthropogenic and natural sources. In California, the city of Santa Ana represents an urban environment where elevated soil lead levels have been recently reported across many disadvantaged communities. In this study, we pursued a community-engaged research approach through which trained "citizen scientists" from the surrounding Santa Ana community volunteered to collect soil samples for heavy metal testing, a subset of which (n = 129) were subjected to Pb isotopic analysis in order to help determine whether contamination could be traced to specific and/or anthropogenic sources. Results showed the average 206Pb/204Pb ratio in shallow soil samples to be lower on average than deep samples, consistent with shallow samples being more likely to have experienced historical anthropogenic contamination. An analysis of soil Pb enrichment factors (EFs) demonstrated a strong positive correlation with lead concentrations, reinforcing the likelihood of elevated lead levels being due to anthropogenic activity, while EF values plotted against 206Pb/204Pb pointed to traffic-related emissions as a likely source. 206Pb/204Pb ratios for samples collected near historical urban areas were lower than the averages for samples collected elsewhere, and plots of 206Pb/204Pb against 206Pb/207 showed historical areas to exhibit very similar patterns to those of shallow samples, again suggesting lead contamination to be anthropogenic in origin, and likely from vehicle emissions. This study lends added weight to the need for health officials and elected representatives to respond to community concerns and the need for soil remediation to equitably protect the public.