Knowledge about Cervical Cancer Prevention and Screening in Women with Cervical Cancer Attending Gynecological Services in Southern Mozambique.

BACKGROUND: Mozambique has high rates of cervical cancer and cancer-related deaths among women. A high rate of refusal and low acceptance of treatment is observed among cervical cancer patients. The extent of their knowledge of the disease is unknown. OBJECTIVES: To assess knowledge about this disease (prevention, risk factors, and the possibilities of early diagnosis) in women with cervical cancer attended in gynecological services in Gaza province, Mozambique. MATERIALS AND METHODS: This cross-sectional study took place in the city of Xai-Xai at the Provincial Hospital of Xai-Xai (HPXX) in the southern province of Gaza (Mozambique). Non-probability convenience sampling was used. Eligible patients (women) aged 35-50 years, diagnosed with cervical cancer and followed at the HPXX in the second quarter of 2021 (n = 60), took part in the survey during their scheduled consultations. Descriptive statistics were calculated using SPSS statistical software (version 16). RESULTS: The study included 60 women, 39 (65%) HIV positive. More than half (55.0%) believed that having a single sexual partner was an effective form of prevention; 50.0% reported that excessive alcohol consumption and having many sexual partners could cause the disease, and 46.7% affirmed that having many children increased the risk. Thirty-eight (63.3%) women reported that early diagnosis of cervical cancer was important for receiving prompt treatment, and 54 (90.0%) said regular visits to the gynecologist were important for an early diagnosis. Thirty-five (58.3%) mentioned acetic acid screening as a diagnostic test. CONCLUSIONS: There are significant gaps in awareness of cervical cancer among high-risk groups.

The retinal basis of vision in chicken.

The Avian retina is far less known than that of mammals such as mouse and macaque, and detailed study is overdue. The chicken (Gallus gallus) has potential as a model, in part because research can build on developmental studies of the eye and nervous system. One can expect differences between bird and mammal retinas simply because whereas most mammals have three types of visual photoreceptor birds normally have six. Spectral pathways and colour vision are of particular interest, because filtering by oil droplets narrows cone spectral sensitivities and birds are probably tetrachromatic. The number of receptor inputs is reflected in the retinal circuitry. The chicken probably has four types of horizontal cell, there are at least 11 types of bipolar cell, often with bi- or tri-stratified axon terminals, and there is a high density of ganglion cells, which make complex connections in the inner plexiform layer. In addition, there is likely to be retinal specialisation, for example chicken photoreceptors and ganglion cells have separate peaks of cell density in the central and dorsal retina, which probably serve different types of behaviour.

Cuttlefish see shape from shading, fine-tuning coloration in response to pictorial depth cues and directional illumination.

Humans use shading as a cue to three-dimensional form by combining low-level information about light intensity with high-level knowledge about objects and the environment. Here, we examine how cuttlefish Sepia officinalis respond to light and shadow to shade the white square (WS) feature in their body pattern. Cuttlefish display the WS in the presence of pebble-like objects, and they can shade it to render the appearance of surface curvature to a human observer, which might benefit camouflage. Here we test how they colour the WS on visual backgrounds containing two-dimensional circular stimuli, some of which were shaded to suggest surface curvature, whereas others were uniformly coloured or divided into dark and light semicircles. WS shading, measured by lateral asymmetry, was greatest when the animal rested on a background of shaded circles and three-dimensional hemispheres, and less on plain white circles or black/white semicircles. In addition, shading was enhanced when light fell from the lighter side of the shaded stimulus, as expected for real convex surfaces. Thus, the cuttlefish acts as if it perceives surface curvature from shading, and takes account of the direction of illumination. However, the direction of WS shading is insensitive to the directions of background shading and illumination; instead the cuttlefish tend to turn to face the light source.

Modelling colour constancy in fish: implications for vision and signalling in water.

Colour vision and colour signals are important to aquatic animals, but light scattering and absorption by water distorts spectral stimuli. To investigate the performance of colour vision in water, and to suggest how photoreceptor spectral sensitivities and body colours might evolve for visual communication, we model the effects of changes in viewing distance and depth on the appearance of fish colours for three teleosts: a barracuda, Sphyraena helleri, which is dichromatic and two damselfishes, Chromis verater and Chromis hanui, which are trichromatic. We assume that photoreceptors light-adapt to the background, thereby implementing the von Kries transformation, which can largely account for observed colour constancy in humans and other animals, including fish. This transformation does not, however, compensate for light scattering over variable viewing distances, which in less than a metre seriously impairs dichromatic colour vision, and makes judgement of colour saturation unreliable for trichromats. The von Kries transformation does substantially offset colour shifts caused by changing depth, so that from depths of 0 to 30 m modelled colour changes (i.e. failures of colour constancy) are sometimes negligible. However, the magnitudes and directions of remaining changes are complex, depending upon the specific spectral sensitivities of the receptors and the reflectance spectra. This predicts that when judgement of colour is important, the spectra of signalling colours and photoreceptor spectral sensitivities should be evolutionarily linked, with the colours dependent on photoreceptor spectral sensitivities, and vice versa.

The challenge of objective scar colour assessment in a clinical setting: using digital photography.

OBJECTIVE: Scar assessment in the clinical setting is typically impeded by a lack of quantitative data and most systems rely on subjective rating scales which are user dependant and show considerable variability between raters. The growing use of digital photography in medicine suggests a more objective approach to scar evaluation. Our objective was to determine if cameras could be of practical use for measuring colour in a clinical setting. METHOD: The measurement of colour and reflectance spectra in photographs faces two difficulties: firstly the effects of variable illumination spectra, and secondly to recover accurate colour and spectral information from the sparse red, green and blue (RGB) camera signals. As a result the colour rendition is often inaccurate, and spectral information is lost. To deal with variable illumination and other factors that systematically affect all reflectance spectra ColourWorker (a method for image-based colour measurement implemented in software) calibrates the spectral responses of the camera's RGB sensors using a colour standard in the image. To make best use of the calibrated signals, it takes advantage of the fact that although a given RGB signal can be caused by an infinite number of spectra, most natural reflectance spectra vary smoothly and have predictable forms. This means given a set of examples of spectra produced by the materials of interest, it is possible to estimate the specific spectrum that produced a given RGB signal once corrected for the illumination. We describe a method for recovering spectral and chromatic information relating to surface reflectance from ordinary digital images and apply this to analyse photographs of surgical scars, taken as part of a clinical trial, in an attempt to better quantify clinical scar assessment. It should be noted the pre-existing trial protocol did not allow for a comprehensive evaluation of the accuracy of the method which would require the spectrophotometric measurement of skin regions corresponding to those in the photographs. RESULTS: Scar colour was estimated reliably, and with simple image analysis we were able to record the change in colour across the skin. Furthermore, we describe a simple automated assessment procedure that enables scar severity to be quantified and defined using a single scalar value easily. CONCLUSION: Such image-based colour measurement and assessment offers considerable advantages over other current methods, including spectrometers, which measure only a single point, or printed charts.

Healthcare quality indicators of peripheral artery disease based on systematic reviews.

OBJECTIVES: Peripheral artery disease (PAD) is a major health problem whose clinical management includes multiple options regarding risk factor control, diagnosis, and medical and surgical treatment. The aim was to generate indicators based on systematic reviews to evaluate the quality of healthcare provided in PAD. METHODS: Electronic searches were run for systematic reviews in The Cochrane Library (Issue 6, 2011), MEDLINE, EMBASE, and other databases (up to June 2011). Conclusive systematic reviews of high methodological quality were selected to formulate clinical recommendations. Indicators were derived from clinical recommendations with moderate to very high strength of evidence as assessed by the GRADE system. RESULTS: From 1,804 reviews initially identified, 29 conclusive and high-quality systematic reviews were selected and nine clinical recommendations were formulated with a moderate to very high strength of recommendation. Six indicators were finally generated: four on pharmacological interventions, antiplatelet agents, naftidrofuryl, cilostazol, and statins; and two lifestyle interventions, exercise and tobacco cessation. No indicators were derived for diagnostic tests or surgical techniques. Most indicators targeted patients with intermittent claudication. CONCLUSIONS: These quality indicators will help clinicians to assess the appropriateness of healthcare provided in PAD. The development of evidence-based indicators in PAD is limited by the lack of methodological quality of the research in this disease, the inconclusiveness of the evidence on diagnostic and surgical techniques, and the dynamic nature of the vascular diseases field.

Abiotic, Hybrid, and Biological Electrocatalytic Materials Applied in Microfluidic Fuel Cells: A Comprehensive Review.

This article provides an overview of the work reported in the past decade in the field of microfluidic fuel cells. To develop appropriate research, the most commonly used electrocatalytic materials were considered and a new classification was proposed based on their nature: abiotic, hybrid, or biological. This classification allowed the authors to discern the information collected. In this sense, the types of electrocatalysts used for the oxidation of the most common fuels in different environments, such as glucose, ethanol, methanol, glycerol, and lactate, were presented. There are several phenomena presented in this article. This information gives an overview of where research is heading in the field of materials for electrocatalysis, regardless of the fuel used in the microfluidic fuel cell: the synthesis of abiotic and biological materials to obtain hybrid materials that allow the use of the best properties of each material.

Visual contrast and color in rapid learning of novel patterns by chicks.

Biological communication signals often combine bright and dark colors, such as yellow and black, but it is unclear why such patterns are effective. The literature on aposematism suggests that high contrast patterns may be easily learnt or innately avoided, whereas studies of sexual signaling refer to their attractiveness or to their cost. Here, in experiments with poultry chicks trained to find food in patterned containers, we confirm that elevated contrast dramatically increases the rate of initial attack on novel stimuli, but this response is labile. The chicks pecked once at a novel unrewarded stimulus and then ignored it for at least 24 h. Such single trial learning has not previously been reported for birds without a positively aversive unconditioned stimulus such as quinine. We then tested and rejected two hypotheses about the function of high contrast patterns: first that the preferential responses are due to novelty, and second that elevated contrast enhances learning about a novel color. More generally, the observations are consistent with the idea that elevated contrast attracts attention, thereby enhancing both initial responses - whether positive or negative - and the rate of learning.

Orbital ophthalmomiasis due to Dermatobia hominis in an immunosuppressed patient from the ecuadorian andean area.

An 83-year-old Ecuadorian male, indigent with a history of malnutrition and chronic alcoholism, presented with a clinical feature characterized by progressive growth of larvae at the left eye level (LE), associated with areas of ocular tissue putrefaction. Upon admission, his vision in the right eye (RE) was of hand movement and no light perception in LE, the anterior segment of the RE showed a brunescent cataract, with no other alteration, while the LE presented edema, bipalpebral erythema and an abundant number of mobile larvae distributed throughout the orbit, associated with areas of necrosis, putrefaction and distortion of the anatomy of the ocular tissues. Orbital tomography showed a significant compromise of the orbit, indicating surgical management by left orbital exenteration with taxonomic identification of the larvae as Dermatobia hominis associated with it, antibiotic treatment was implemented and a frontal fasciocutaneous flap was performed by the plastic surgery department.

Sedentary behavior, brain-derived neurotrophic factor and brain structure in midlife: A longitudinal brain MRI sub-study of the coronary artery risk development in young adults study.

Background: Brain-derived neurotrophic factor levels are higher in those who are physically active and lower in people with cognitive dysfunction. This study investigated whether brain-derived neurotrophic factor mediated or modified the association of sedentary time to MRI-estimated brain volumes in midlife. Methods: Baseline (n = 612) and five-year follow-up (n = 418) data were drawn from the multicenter Coronary Artery Risk Development in Young Adults Brain MRI sub-study, including Black and White participants (aged 50.3 years, 51.6% females, 38.6% Black). Sedentary time (hours per day) was categorized into quartiles with low ≤ 4.3 (reference) and high > 8.4. Outcomes of the study were total brain, white matter, gray matter, hippocampal volumes, and white matter fractional anisotropy at baseline and 5-year percent change from baseline. The study used general linear regression models to examine the mediation and moderation effects of brain-derived neurotrophic factor (natural log transformed) on the associations of sedentary time to brain outcomes. The authors adjusted the regression model for age, sex, race, intracranial volume, education, and vascular factors. Results: Cross-sectionally, baseline participants with the highest sedentary time had a lower total brain (-12.2 cc; 95%CI: -20.7, -3.7), gray matter (-7.8 cc; 95%CI: -14.3, -1.3), and hippocampal volume (-0.2 cc; 95%CI: -0.3, 0.0) compared with populations with the lowest sedentary time. The brain-derived neurotrophic factor levels did not mediate the associations between brain measures and sedentary time. Brain-derived neurotrophic factor was found to moderate associations of sedentary time to total brain and white matter volume such that the brain volume difference between high and low sedentary time decreased as brain-derived neurotrophic factor levels increased. Longitudinally, higher baseline brain-derived neurotrophic factor level was associated with less brain volume decline. The longitudinal associations did not differ by sedentary time, and brain-derived neurotrophic factor did not mediate or moderate the association of sedentary time to brain measure changes. Conclusions: Higher brain-derived neurotrophic factor levels may buffer the negative effects of sedentary time on the brain.

Hybrid photocathode based on a Ni molecular catalyst and Sb2Se3 for solar H2 production.

We report a H2 evolving hybrid photocathode based on Sb2Se3 and a precious metal free molecular catalyst. Through the use of a high surface area TiO2 scaffold, we successfully increased the Ni molecular catalyst loading from 7.08 ± 0.43 to 45.76 ± 0.81 nmol cm-2, achieving photocurrents of 1.3 mA cm-2 at 0 V vs. RHE, which is 81-fold higher than the device without the TiO2 mesoporous layer.

Predictors of unfavourable tuberculosis treatment outcome in Bilene District, Gaza Province, Mozambique: A retrospective analysis, 2016 - 2019.

BACKGROUND: Tuberculosis (TB) is a serious public health problem and remains one of the leading causes of death from an infectious agent globally. Mozambique is one of 30 countries considered to have a high TB burden. OBJECTIVES: To describe the clinical characteristics of TB in children and adults in Bilene District in Gaza Province, Mozambique, over 43 months and to assess determinants of unfavourable treatment outcomes. METHODS: This retrospective cohort study took place from 1 January 2016 to 31 July 2019 in Bilene District, Gaza. We included patients in the TB register at the Centro de Saúde de Macia TB unit with available data on final treatment outcome. Predictors of unfavourable outcomes were determined using multivariable logistic regression models. RESULTS: A total of 3 012 TB-infected patients were registered in the TB unit of the Macia health facility during the study period: 358 (11.9%) were children (<14 years), 1 522 (50.5%) were male, and 2 581 (85.7%) were new TB cases. No bacteriological test was performed at diagnosis in 1 250 patients (41.5%). Treatment was successful in 2 863 patients (95.1%), with better outcomes in children than in adults (98.0% v. 94.6%; p=0.005). Although mortality (n=97; 3.2%) was low in both groups, the proportion who died was lower in children compared with adults (1.4% v. 3.5%; p=0.035). Multivariable logistic regression analysis showed that unfavourable outcomes were more likely in men compared with women (adjusted odds ratio (aOR) 1.48; 95% confidence interval (CI) 1.04 - 2.12; p=0.029), in patients with recurrent TB infection compared with newly infected patients (aOR 1.63; 95% CI 1.05 - 2.50; p=0.027), and in patients co-infected with TB and HIV compared with HIV-negative TB-infected patients (aOR 2.17; 95% CI 1.43 - 3.29; p<0.001). The factor conferring the most risk for an unfavourable outcome was positive microbiological sputum results (aOR 5.27; 95% CI 3.25 - 8.54; p<0.001). CONCLUSIONS: Factors independently associated with an unfavourable TB treatment outcome were male sex, recurrent TB infection, having positive microbiology, and co-infection with HIV. It remains crucial to improve data quality and adherence to TB screening and diagnostic algorithms.

Poly-L-lysine-modified with ferrocene to obtain a redox polymer for mediated glucose biosensor application.

Ferrocene-based polymers as redox mediators are considered versatile and important in the study of glucose biosensors. Poly-L-lysine (PLL), as a cationic polymer, possesses good properties including biocompatibility, biodegradation and water solubility. In this work, PLL was modified with ferrocene carboxylate in a very simple way by activating the carboxyl group of Fc, which reacted with the amino groups of the polymer. The resulting product was analysed by FTIR. Performance as a redox mediator (Fc-PLL) with the enzyme glucose oxidase was tested by cyclic voltammetry and showed an increase in the oxidation current in the presence of glucose in PBS pH 7.4. Additionally, performance as a biosensor was evaluated by amperometry and gave a linear range of 0-10 mM, a limit of detection of 23 µM, a sensitivity of 6.55 µA/cm2 mM and high selectivity. To evaluate the charged regions of Fc-PLL/GOx on the electrode surface, analysis by scanning electrochemical microscopy showed remarkable activity. The Fc-PLL redox polymer as a glucose biosensor has been well accepted as this kind of material, and the results showed remarkable activity as an electron transfer mediator between the redox polymer and the GOx enzyme.

To be seen or to hide: visual characteristics of body patterns for camouflage and communication in the Australian giant cuttlefish Sepia apama.

It might seem obvious that a camouflaged animal must generally match its background whereas to be conspicuous an organism must differ from the background. However, the image parameters (or statistics) that evaluate the conspicuousness of patterns and textures are seldom well defined, and animal coloration patterns are rarely compared quantitatively with their respective backgrounds. Here we examine this issue in the Australian giant cuttlefish Sepia apama. We confine our analysis to the best-known and simplest image statistic, the correlation in intensity between neighboring pixels. Sepia apama can rapidly change their body patterns from assumed conspicuous signaling to assumed camouflage, thus providing an excellent and unique opportunity to investigate how such patterns differ in a single visual habitat. We describe the intensity variance and spatial frequency power spectra of these differing body patterns and compare these patterns with the backgrounds against which they are viewed. The measured image statistics of camouflaged animals closely resemble their backgrounds, while signaling animals differ significantly from their backgrounds. Our findings may provide the basis for a set of general rules for crypsis and signals. Furthermore, our methods may be widely applicable to the quantitative study of animal coloration.

Cuttlefish camouflage: context-dependent body pattern use during motion.

It is virtually impossible to camouflage a moving target against a non-uniform background, but strategies have been proposed to reduce detection and targeting of movement. Best known is the idea that high contrast markings produce 'motion dazzle', which impairs judgement of speed and trajectory. The ability of the cuttlefish Sepia officinalis to change its visual appearance allows us to compare the animal's choice of patterns during movement to the predictions of models of motion camouflage. We compare cuttlefish body patterns used during movement with those expressed when static on two background types; one of which promotes low-contrast mottle patterns and the other promotes high-contrast disruptive patterns. We find that the body pattern used during motion is context-specific and that high-contrast body pattern components are significantly reduced during movement. Thus, in our experimental conditions, cuttlefish do not use high contrast motion dazzle. It may be that, in addition to being inherently conspicuous during movement, moving high-contrast patterns will attract attention because moving particles in coastal waters tend to be of small size and of low relative contrast.

The Retinal Basis of Vertebrate Color Vision.

The jawless fish that were ancestral to all living vertebrates had four spectral cone types that were probably served by chromatic-opponent retinal circuits. Subsequent evolution of photoreceptor spectral sensitivities is documented for many vertebrate lineages, giving insight into the ecological adaptation of color vision. Beyond the photoreceptors, retinal color processing is best understood in mammals, especially the blueON system, which opposes short- against long-wavelength receptor responses. For other vertebrates that often have three or four types of cone pigment, new findings from zebrafish are extending older work on teleost fish and reptiles to reveal rich color circuitry. Here, horizontal cells establish diverse and complex spectral responses even in photoreceptor outputs. Cone-selective connections to bipolar cells then set up color-opponent synaptic layers in the inner retina, which lead to a large variety of color-opponent channels for transmission to the brain via retinal ganglion cells.

Life quality evaluation in patients with bladder cancer: A systematic review. / Evaluación de la calidad de vida en pacientes con cáncer de vejiga: una revisión sistemática.

OBJECTIVE: To identify scale validation studies for life quality evaluation in patients with bladder cancer. METHODS: Bibliographic search was performed on MEDLINE® via ovid, EMBASE, CENTRAL and LILACS. Subsequently, each of the articles was evaluated, identifying eligibility criteria. This information was confirmed and verified by the researchers, and in cases of missing information, the authors were contacted to complete the data. Due to the nature of the study, no statistical analysis was performed. RESULTS: From 1760 articles found, only 5were included in the qualitative analysis. Five validated questionnaires for quality of life in patients with bladder cancer (BCI, EORTC QLQ-NMIBC24, FACT-VCI, BUSS, FACT-BL). The BCI; most frequently used instrument in bladder cancer studies published to date. The FACT-VCI, instrument of application limited to unique therapeutic options within the spectrum of the disease. The EORTC QLQ-NMIBC24, widely acceptable questionnaire in the European community due to its psychometric characteristics. The BUSS evaluates the patient regardless the stage of the disease. The FACT-BL evaluates life quality in patients with non-muscle invasive bladder cancer. CONCLUSION: The use of validated instruments such as: BCI, EORTC QLQ-NMIBC24, FACT-VI, BUSS and FACT-BL which allow evaluating the impact of disease and the established therapies, is recommended.

Decreased mRNA and protein stability of W1282X limits response to modulator therapy.

BACKGROUND: Cell-based studies have shown that W1282X generates a truncated protein that can be functionally augmented by modulators. However, modulator treatment of primary cells from individuals who carry two copies of W1282X generates no functional CFTR. To understand the lack of response to modulators, we investigated the effect of W1282X on CFTR RNA transcript levels. METHODS: qRT-PCR and RNA-seq were performed on primary nasal epithelial (NE) cells of a previously studied individual who is homozygous for W1282X, her carrier parents and control individuals without nonsense variants in CFTR. RESULTS: CFTR RNA bearing W1282X in NE cells shows a steady-state level of 4.2 ±â€¯0.9% of wild-type (WT) CFTR RNA in the mother and 12.4 ±â€¯1.3% in the father. NMDI14, an inhibitor of nonsense-mediated mRNA decay (NMD), restored W1282X mRNA to almost 50% of WT levels in the parental NE cells. RNA-seq of the NE cells homozygous for W1282X showed that CFTR transcript level was reduced to 1.7% of WT (p-value: 4.6e-3). Negligible truncated CFTR protein was generated by Flp-In 293 cells stably expressing the W1282X EMG even though CFTR transcript was well above levels observed in the parents and proband. Finally, we demonstrated that NMD inhibition improved the stability and response to correctors of W1282X-CFTR protein expressed in the Flp-In-293 cells. CONCLUSION: These results show that W1282X can cause substantial degradation of CFTR mRNA that has to be addressed before efforts aimed at augmenting CFTR protein function can be effective.

The effects of longitudinal chromatic aberration and a shift in the peak of the middle-wavelength sensitive cone fundamental on cone contrast.

Longitudinal chromatic aberration is a well-known imperfection of visual optics, but the consequences in natural conditions, and for the evolution of receptor spectral sensitivities are less well understood. This paper examines how chromatic aberration affects image quality in the middle-wavelength sensitive (M-) cones, viewing broad-band spectra, over a range of spatial frequencies and focal planes. We also model the effects on M-cone contrast of moving the M-cone fundamental relative to the long- and middle-wavelength (L- and M-cone) fundamentals, while the eye is accommodated at different focal planes or at a focal plane that maximizes luminance contrast. When the focal plane shifts towards longer (650 nm) or shorter wavelengths (420 nm) the effects on M-cone contrast are large: longitudinal chromatic aberration causes total loss of M-cone contrast above 10-20 c/d. In comparison, the shift of the M-cone fundamental causes smaller effects on M-cone contrast. At 10 c/d a shift in the peak of the M-cone spectrum from 560 to 460 nm decreases M-cone contrast by 30%, while a 10 nm blue-shift causes only a minor loss of contrast. However, a noticeable loss of contrast may be seen if the eye is focused at focal planes other than that which maximizes luminance contrast. The presence of separate long- and middle-wavelength sensitive cones therefore has a small, but not insignificant cost to the retinal image via longitudinal chromatic aberration. This aberration may therefore be a factor limiting evolution of visual pigments and trichromatic color vision.