Serum concentrations of DDE, PCBs, and other persistent organic pollutants and mammographic breast density in Triana, Alabama, a highly exposed population.

INTRODUCTION: Although some persistent organic pollutants (POPs) are considered human carcinogens, results from studies evaluating exposures and breast cancer risk have been inconsistent, potentially related to varying ages at exposure. Additionally, few studies evaluated the association between POPs exposure and mammographic breast density (MBD), an intermediate biomarker of breast cancer risk. We carried out a cross-sectional study to investigate associations between serum POPs concentrations and MBD measured in 1998 in female residents of Triana, Alabama, in a predominately African American population with high POPs exposures, particularly to p,p'-DDT (1,1,1-trichloro-2,2-bis(p-chlorophenyl)ethane). METHODS: We measured lipid-adjusted serum concentrations (ng/g lipid) of p,p'-DDT and its main metabolite p,p'-DDE (1,1-dichloro-2,2-bis(p-chlorophenyl)ethylene), polychlorinated biphenyls (PCBs), ß-hexachlorocyclohexane (ß-HCCH), heptachlor epoxide, oxychlordane, trans-nonachlor, mirex, and aldrin for each woman in our study (n = 210). We also measured two MBD metrics, percent MBD (%MBD) and area of MBD (aMBD). Using adjusted Spearman correlation coefficients (rs) we evaluated correlations between %MBD and aMBD with individual POPs in the overall population and by age group (19-40, 41-54, and 55-91 years) and also estimated adjusted mean measures of MBD with 95% confidence intervals across tertiles of analytes using generalized linear models (GLM). We calculated p-values for multiplicative interaction by age group using GLM. Additional analyses excluded women with current hormone replacement therapy (HRT) use and evaluated early-life exposure (prior to age 18) during the heaviest contamination period in Triana (1947-90). RESULTS: Among all women, we found no correlation between p,p'-DDE and %MBD, but after age stratification and exclusion of HRT users, there was a suggestion of a difference by age group, with younger women having a weak positive correlation (rs = 0.12, p = 0.37) and older women having a weak negative correlation (rs = -0.12, p = 0.43); pinteraction = 0.06. In contrast, PCBs were weakly positively correlated with %MBD among all women, with the correlation magnitudes increasing after excluding current HRT users (rs-total PCBs = 0.17, p = 0.03). After age stratification and exclusion of HRT users, correlations for PCBs were higher among younger and middle-age women, with only a handful of these correlations being statistically significant. For ß-HCCH, the strongest finding was a negative correlation among older women (rs = -0.26, p = 0.07). Correlations were positive predominantly in the younger age group for heptachlor epoxide (rs = 0.27, p = 0.04), oxychlordane (rs = 0.35, p = 0.006), and trans-nonachlor (rs = 0.37, p = 0.003), and largely null for the middle and older age groups; pinteraction range: 0.03-0.05. Similar patterns were found in GLM analyses using tertiles of exposure and aMBD as the metric for MBD. Women exposed during the heaviest chemical contamination period in Triana prior to age 18 had positive correlations between %MBD and PCBs, heptachlor epoxide, mirex, oxychlordane, and trans-nonachlor. CONCLUSIONS: In this population, despite high exposures to p,p'-DDT and thus high serum concentrations of its main metabolite, p,p'-DDE, we did not find strong evidence of a positive association with MBD. In fact, there was some evidence of a negative association among older women for p,p'-DDE; a similar pattern was found for ß-HCCH. However, younger women with higher serum levels of PCBs, heptachlor epoxide, oxychlordane, and trans-nonachlor, who were likely exposed in early life, had higher MBD. These findings should be replicated in larger studies.

Chachafruto starch: Physicochemical characterization, film-forming properties, and 3D printability.

This work aimed to characterize the physicochemical, film-forming properties, and 3D printability of a nonconventional starch from chachafruto. The chachafruto native starch (CHS) presented an excellent extraction yield (10 % db) and purity (99 % db), along with an oval and round morphology, a smooth surface with few defects, and a mean diameter of 15.4 µm. The typical B-type diffraction pattern was observed in the CHS with a crystallinity of 17.4 %. The starch presented a paste temperature of 66.1 °C, an enthalpy of 11.5 J g-1, and a final viscosity of 596 Brabender Units. The thermal analysis demonstrated good thermal stability. The evaluated film presented a reduction in crystallinity (8.18 %) to the CHS, which generated a good elasticity in the material. Likewise, it presented a continuous structure without cracks, providing good barrier properties (2.3 × 10-9 g∙m-1∙s-1∙Pa-1) and high transparency. Meanwhile, 3D prints prepared with CHS showed good textural properties and high consistency. The morphological analysis showed that the prints generated organized cell structures. However, high concentrations of CHS were not efficient in obtaining 3D prints. The results of this work demonstrate the tremendous industrial potential of chachafruto as an unconventional source of starch and some alternative uses for adding value to the crop.

Percepción de los usuarios frente a la calidad del servicio de salud en consulta externa en una Institución Prestadora de Servicios de Salud / Perception of users to the quality of the health service in external consultation in a Health Services Provider Institution / Percepção dos usuários diante da qualidade do serviço de saúde em consulta ambulatorial em uma Instituição Prestadora de Serviços de Saúde

Introducción. La comprensión de la calidad de los servicios de salud depende de diversos factores relacionados con la percepción del paciente sobre la atención, los elementos del entorno, factores técnicos, el trato, entre otros, requiere un análisis desde la perspectiva del paciente. Objetivo. Determinar la percepción de los usuarios de la calidad en la prestación del servicio de salud en consulta externa en una Institución Prestadora de Salud durante el segundo semestre del 2017 en Boyacá-Colombia. Método. Estudio descriptivo, enfoque cuantitativo y diseño transversal, los datos se recolectaron con la encuesta SERVQUAL a 143 usuarios. Resultados. El promedio general de las cinco dimensiones de expectativas fue de 4.4714, es decir, el 89.428% del rango del porcentaje de satisfacción, lo que significa que los usuarios tienen un rango satisfactorio según sus expectativas. El resultado general de las cinco dimensiones de percepciones fue de 4.1309, equivalente a 82.618% del rango del porcentaje de satisfacción, reportando que los usuarios tienen un rango satisfactorio según sus percepciones. Conclusiones. Es recomendable que, desde la gerencia administrativa de la Institución Prestadora de Salud, se generen estrategias organizacionales que permitan promover cambios en cuanto a la infraestructura, equipos, personal, material de comunicación e información, limpieza y comodidad

Introduction. Understanding the quality of health services depends on various factors related to the patient's perception of care, the elements of the environment, technical factors, and treatment, among others, requires an analysis from the patient's perspective. Objective. To determine the user perception of the quality in the provision of the health service in the outpatient department at a Heal-thcare Provider Institution during the second semester of 2017 in Boyacá-Colombia. Method. Descriptive study, quantitative approach and cross-sectional design, the data was collected with the SERVQUAL survey administered to 143 users. Results. The overall average of the five expectation dimensions was 4.4714, which corresponds to 89.428% of the satisfaction percentage range, which means that users have a satisfactory range ac-cording to their expectations. The overall result of the five perception dimensions was 4.1309, which is equivalent to 82.618% of the satisfaction percentage range, reporting that users have a satisfactory range according to their perceptions. Conclusions. It is recommended that from the administrative management of the Healthcare Provider Institution, organizational strategies may be generated in order to promote changes in infrastructure, equipment, personnel, communication and information material, cleanliness and comfort

Introdução. A compreensão da qualidade dos serviços de saúde depende de vários fatores relacio-nados à percepção do paciente sobre o cuidado, os elementos do ambiente, os fatores técnicos, o tratamento, entre outros, requer uma análise da perspectiva do paciente.Objetivo. Determinar a percepção dos usuários sobre a qualidade na prestação do serviço de saúde em consulta ambulatorial em uma instituição prestadora de serviços de saúde durante o segundo semestre de 2017 em Boyacá-Colômbia.Método. Estudo descritivo, abordagem quantitativa e transversal, os dados foram coletados com a pesquisa SERVQUAL em 143 usuários.Resultados. A média geral das cinco dimensões das expectativas foi de 4,4714, o que corresponde a 89,428% da faixa percentual de satisfação, o que significa que os usuários têm um intervalo satis-fatório de acordo com suas expectativas. O resultado geral das cinco dimensões das percepções foi de 4,1309, o que equivale a 82,618% do percentual de satisfação, relatando que os usuários têm um intervalo satisfatório de acordo com suas percepções.Conclusões. Recomenda-se que, a partir da gestão administrativa da Instituição Prestadora de Saúde, sejam geradas estratégias organizacionais para promover mudanças em infraestrutura, equipamentos, pessoal, material de comunicação e informação, limpeza e conforto.

Capacidad de regeneración natural del bosque de manglar del Estero Tortuga, Osa, Puntarenas, Costa Rica / Natural regeneration capacity of the mangrove forest of Tortuga Estuary, Osa, Puntarenas, Costa Rica

Resumen Este estudio se realizó entre Febrero 2011 y Enero 2012, en el bosque de mangle del Estero Tortuga. Se establecieron un total de seis parcelas, de 9 m2 cada una, con el fin de evaluar el porcentaje de supervivencia y la tasa de crecimiento de las plántulas de Rhizophora racemosa (G. Mey.) y Pelliciera rhizophorae (Triana & Planch.). Al final del estudio todas las parcelas presentaron un 100% de mortalidad, lo que indica que la zona no está reclutando árboles jóvenes y por lo tanto no se está regenerando naturalmente. Los resultados de este estudio sugieren que la baja influencia de la marea, la baja salinidad del manto freático y la alta tasa de deposición de sedimentos, son las causas de la nula supervivencia de las plántulas y del deterioro de los individuos adultos. Se realizó un análisis comparativo de las zonas de manglar declaradas Patrimonio Natural de Estado y el ecosistema de manglar del Estero Tortuga, el cual muestra que existen áreas que no se encuentran protegidas bajo esta categoría. Se recomienda actualizar esta información con el fin de contar con un registro preciso sobre la ubicación de los manglares de la zona. Además, es prioritario que se aborde el manejo de la cuenca Térraba Sierpe, con el fin de disminuir la cantidad de sedimentos que se depositan en los manglares de la zona.

Abstract The study was conducted from February 2011 to January 2012, in the mangrove forest of Tortuga Estuary. A total of six parcels, each measuring 9m2, were established in the area, to evaluate the survival and growth rates of the mangrove seedlings. By the end of the study all parcels presented 100% mortality, indicating that the area is not recruiting young trees and therefore is not regenerating naturally. The results of this study suggest that the low salinity of the water table and the high rate of deposition of sediments, are the causes of the low survival rate of the seedlings and could also be affecting the adult individuals. The adult trees presented deteriorated health signs such as decomposition of their stilt roots and total loss of foliage. The borders of this ecosystem were georeferenced and compared with the official map that declares the Natural Patrimony of the Country, to determine areas that should be protected under this category. In general the mangrove forest of this estuary can be divided in two zones: the first one is characterized by a mature forest of mainly two species: Rhizophora racemosa (G. Mey.) and Pelliciera rhizophorae (Triana & Planch.). The second one is located in the banks of sand of the estuary, where the dominant specie is Laguncularia racemosa (C.F. Gaertn) in young stages. Both of these areas include mangrove ecosystems that are not included in the Natural Patrimony category. Rev. Biol. Trop. 63 (Suppl. 1): 209-218. Epub 2015 April 01.