Prevalence of depressive disorder in the adult population of Latin America: a systematic review and meta-analysis

Background

Depressive disorder is one of the leading causes of disability worldwide; however its prevalence and association with inequality and crime is poorly characterised in Latin America. This study aimed to: i. systematically review population-based studies of prevalence of ICD/DSM depressive disorder in Latin America, ii. report pooled regional, country, and sex-specific prevalence estimates, and iii. test its association with four country-level development indicators: human development (HDI), income (Gini) and gender inequality (GII), and intentional homicide rate (IHR).

Methods

We conducted a systematic review and meta-analysis of population-based studies reporting primary data on the prevalence of ICD/DSM depressive disorder in Latin America from 1990 to 2023, irrespective of language. We searched PubMed, PsycINFO, Cochrane Library, SciELO (regional database), LILAC (regional database), and available grey literature. Study quality was assessed using JBI's critical appraisal tools. We generated pooled estimates using random-effects meta-analysis; heterogeneity was assessed using the I2 statistic. Meta-regression analyses were used to test associations of depression prevalence with indicators of inequality and human development. The study was registered with PROSPERO (CRD42019143054).

Findings

Using data from 40 studies in Latin America, lifetime, 12-month, and current prevalence of ICD/DSM depressive disorder were calculated at 12.58% (95% CI 11.00%-14.16%); 5.30% (4.55-6.06%), and 3.12% (2.22-4.03), respectively. Heterogeneity was high across lifetime, 12-month, and current prevalence, sex, and countries. 12-month and current prevalence was associated with higher Gini and GII, 12-month prevalence with lower HDI, and current prevalence with higher IHR.

Interpretation

We found a high prevalence of ICD/DSM depressive disorders in Latin America, and a statistically significant association with inequality and development indicators. The high heterogeneity found across prevalence periods and the major gaps in country representation underscore the need to escalate efforts to improve mental health access and research capabilities in Latin America. Systematic, comparable prevalence estimates would inform more effective decision-making in the region.

Funding

Pfizer Independent Medical Education Grant.

Tunable birefringence and elliptical polarization eigenmodes in a biplate of two quarter-wave plates

Birefringence of elliptical polarization eigenmodes can be conceptualized as a composite system comprising two distinct media: one with linear polarization eigenmodes and the other with circular polarization eigenmodes. However, the practical realization of such a system often involves the combination of two birefringent quarter-wave plates (QWPs). In this study, our objective is to characterize the variable retardation and variable elliptical polarization eigenmodes exhibited by a biplate consisting of two quarter-wave plates. Additionally, we aim to analyze the geometric properties of the transformation of one state of polarization on the Poincaré sphere, employing the emerging state's curve. This curve corresponds to the intersection between the Poincaré sphere and a cone. The outcomes of our study are presented as a function of the angle between the fast axes of the two QWPs. The findings have the potential to contribute to the configuration of q-plates and facilitate the development of quantum communication protocols.

Stigmatic aspherical refracting surfaces from Cartesian ovoids

A theory for Descartes ovoids has been developed in terms of four form parameters, (GOTS). This theory allows the design of optical imaging systems that, in addition to a rigorous stigmatism, exhibit the property of aplanatism, necessary for the proper imaging of extended objects. As a decisive step for the production of these systems, in this work, we propose a formulation of Descartes ovoids in the form of standard aspherical surfaces (ISO 10110-12: 2019), by means of explicit formulas for the corresponding aspheric coefficients. Thus, with these results, the designs developed with Descartes ovoids are finally translated into the language of aspherical surfaces for their production, inheriting the aspherical surfaces of all optical properties of Cartesian surfaces. Consequently, these results make this optical design methodology viable for the development of technological solutions using the current optical fabrication capabilities of the industry.

Definition of a second-order degree of polarization in terms of the complex degree of coherence

The classical theory of random electric fields and polarization formalism has been formulated considering the Stokes parameters' auto-correlations. However, in this work, the need to consider the Stokes parameters' cross-correlations to obtain a complete description of the polarization dynamics of a light source is explained. We propose a general expression for the Stokes parameters' degree of correlation using both auto-correlations and cross-correlations, which we derive from the application of Kent's distribution in the statistical study of Stokes parameter dynamics on Poincaré's sphere. Additionally, from the proposed degree of correlation, we obtain a new expression for the degree of polarization (DOP) in terms of the complex degree of coherence, which is a generalization of the well-known Wolf's DOP. The new DOP is tested using a depolarization experiment in which partially coherent light sources propagate through a liquid crystal variable retarder. The experimental results show that our generalization for the DOP improves the theoretical description of a new depolarization phenomenon that Wolf's DOP cannot describe.

Integrating EM and Patch-seq data: Synaptic connectivity and target specificity of predicted Sst transcriptomic types

Neural circuit function is shaped both by the cell types that comprise the circuit and the connections between those cell types ¹ . Neural cell types have previously been defined by morphology ^{2, 3} , electrophysiology ^{4, 5} , transcriptomic expression ^6-8 , connectivity ^9-13 , or even a combination of such modalities ^14-16 . More recently, the Patch-seq technique has enabled the characterization of morphology (M), electrophysiology (E), and transcriptomic (T) properties from individual cells ^17-20 . Using this technique, these properties were integrated to define 28, inhibitory multimodal, MET-types in mouse primary visual cortex ²¹ . It is unknown how these MET-types connect within the broader cortical circuitry however. Here we show that we can predict the MET-type identity of inhibitory cells within a large-scale electron microscopy (EM) dataset and these MET-types have distinct ultrastructural features and synapse connectivity patterns. We found that EM Martinotti cells, a well defined morphological cell type ^{22, 23} known to be Somatostatin positive (Sst+) ^{24, 25} , were successfully predicted to belong to Sst+ MET-types. Each identified MET-type had distinct axon myelination patterns and synapsed onto specific excitatory targets. Our results demonstrate that morphological features can be used to link cell type identities across imaging modalities, which enables further comparison of connectivity in relation to transcriptomic or electrophysiological properties. Furthermore, our results show that MET-types have distinct connectivity patterns, supporting the use of MET-types and connectivity to meaningfully define cell types.

Hyperspectral camera as a compact payload architecture for remote sensing applications

Monitoring and observation over the surface of the Earth have been a matter of global interest. In this path, recent efforts aim to develop a spatial mission to perform remote sensing applications. Mainly, CubeSat nanosatellites have emerged as a standard for developing low-weight and small-sized instruments. In terms of payloads, state-of-the-art optical systems for CubeSats are expensive and designed to work in general use cases. To overcome these limitations, this paper presents a 1.4 U compact optical system to acquire spectral images from a CubeSat standard satellite at the height of 550 km. To validate the proposed architecture, optical simulations using ray tracing simulation software are presented. Because the performance of computer vision tasks is highly related to data quality, we compared the optical system in terms of the classification performance on a real remote sensing application. The performances of the optical characterization and land cover classification show that the proposed optical system achieves a compact instrument, operating at a spectral range from 450 nm to 900 nm discretized on 35 spectral bands. The optical system has an overall f-number of 3.41 with a ground sampling distance of 52.8 m and a swath of 40 km. Additionally, the design parameters for each optical element are publicly available for validation, repeatability, and reproducibility of the results.

Applying Deep Learning Cancer Subtyping Algorithms Trained on Physical Slides to Multiphoton Imaging of Unembedded Samples

Introduction/Objective

Deep learning algorithms on digital images of physical tissue slides have shown potential improvements in accuracy and precision of diagnostic interpretation of neoplastic histology. Clustering-constrained- attention multiple-instance learning (CLAM) is one such method that identifies diagnostic sub-regions to accurately classify whole slides. Often, algorithm performance degrades when deployed on datasets that differ from the original set and it is subject to physical slide preparation variability. New multiphoton imaging modalities have potential workflow and quality advantages over physical slides, producing images analogous to whole slide imaging (WSI) without cutting artifacts, but performance of existing algorithms trained on digitized physical slides and applied to multiphoton images remains completely unknown. Given this, we aimed to test the performance of CLAM algorithms for subtyping renal cell carcinoma (RCC) and lung cancer (LC) applied to pseudo-colored multiphoton WSI.

Methods/Case Report

Clinical RCC and LC surgical resection samples were processed and imaged by Clearing Histology with MulitPhoton microscopy (CHiMP, Applikate Technologies, Fairfield, CT), producing digital images of un- cut, un-embeded tissue to generate H&E-like optical slices. Multiphoton images were downscaled to 0.5 um/px to match algorithm target resolution. CLAM models for subtyping RCC (chromophobe, clear cell, papillary) and LC (squamous & adenocarcinoma) previously trained using TCGA and CPTAC whole slide images of physical slides were applied directly to CHiMP multiphoton images without adjustment. Reference cancer subtype classifications were provided from physical and digital slides.

Results (if a Case Study enter NA)

For the subtypes included during training, multiphoton WSIs of RCC and LC were accurately subtyped by the CLAM models without stain normalization nor network fine tuning producing high prediction levels. Subtypes not included during the training (namely oncocytoma for RCC) resulted in low scoring model predictions (below 0.85), indicating specificity of identification. Multiple slide levels improved interpretation of several difficult cases for CLAM predictions.

Conclusion

This preliminary data suggests that CLAM models trained on standard H&E WSIs for RCC and LC subtyping are applicable to pseudo-H&E multiphoton WSIs without domain adaptations. This implies that diagnostic histologic features have been learned by these CLAM models and are efficiently recognized in digital histology images produced via CHiMP.

The Validity and Reliability of the PHQ-9 and PHQ-2 on Screening for Major Depression in Spanish Speaking Immigrants in Chile: A Cross-Sectional Study

BACKGROUND

The study aimed to explore the psychometric properties of two versions of the Patient Health Questionnaires (PHQ-9 and PHQ-2) on screening for Major Depressive Disorder (MDD) among Spanish-speaking Latin American adult immigrants in Santiago, and to explore factors associated with a higher risk of occurrence of MDD among them.

METHODS

A representative sample of 897 Spanish-speaking immigrants completed the PHQ-9. The Composite International Diagnostic Interview (CIDI) was employed to evaluate MDD. Internal consistency and structural validity were evaluated using Cronbach's α coefficient and confirmatory factor analysis (CFA). Convergent validity with the 7-item General Anxiety Disorder Scale (GAD-7) was assessed using Spearman's correlations. Sensitivity, specificity, positive predictive values, and area under the receiver operating characteristic (ROC) curve were calculated for different cut-off points. Logistic regression analysis was used to identify factors associated with the risk of MDD.

RESULTS

Cronbach's α coefficient of the PHQ-9 was 0.90; item-total correlation coefficients ranged from 0.61 to 0.76 and correlation with the GAD-7 was moderate (r = 0.625; p < 0.001). CFA on three alternative models suggests a plausible fit in the overall sample and among two of the subsamples: Peruvians and Venezuelans. Taking the results of CIDI as the gold standard for MDD, the area under the ROC curve was 0.91 (95% confidence interval (CI): 0.83~1.0). When the cut-off score was equal to 5, values of sensitivity, specificity, and Youden's index were 0.85, 0.90, and 0.75, respectively. Multivariate logistic regression analyses showed that the influence of having three or more children (OR = 3.91, 95% CI: 1.20~12.81; p < 0.05), residency in Chile of up to three years (OR = 1.79, 95% CI: 1.07~3.00; p < 0.05), active debt (OR = 2.74, 95% CI: 1.60~4.70; p < 0.001), a one (OR = 2.01, 95% CI: 1.03~3.94; p < 0.05) and two or more events of adversity during childhood (OR = 5.25, 95% CI: 1.93~14.3; p < 0.01) on the occurrence of MDD was statistically significant. Reliability (α = 0.62), convergent (r = 0.534; p < 0.01) and criterion (AUC = 0.85, 95% CI: 0.67~1.00) validity coefficients of the PHQ-2 were weaker than for the PHQ-9.

CONCLUSIONS

The PHQ-2 and the PHQ-9 are reliable and valid instruments for use as screeners for MDD among Spanish-speaking populations of Latin America.

Achromatic stigmatism: achromatic Cartesian ovoid

Monochromatic and chromatic aberrations are imaging defects mainly studied from a geometrical optics point of view. These defects are treated through optimization and minimization methods to achieve acceptable performance in optical imaging systems, where the correct choice of glass materials is one of the main challenges. The selection of glass materials is a complex issue that requires a large amount of computing power within sophisticated computational algorithms and enough professional experience in the area. However, in this work, we propose a new methodology to treat the chromatic and geometrical aberrations simultaneously by taking advantage of the relationship between form parameters of Cartesian surfaces and wavelength in the material. From this relationship, we obtain an achromatism principle that establishes the conditions for refracting systems to present a strictly achromatic stigmatism.

Perceived stress and physiological consistency during mental stress exercises and controlled breathing

Introduction

The measurement of the physiological coherence, the order and the quality of the connection of complex systems such as the cardiac and the respiratory system, varies in situations of stress and relaxation.

Objectives

We aim to assess changes in physiological coherence and perception of stress during mental stress and directed breathing exercises.

Methods

Repeated-measures study in healthy adults without prior training in breathing techniques, aged between 18 and 65 years of both sexes who were evaluated in three situations: baseline, mental stress (Stroop test and successive subtractions), and directed breathing, during which were captured heart rate and respiratory signals to estimate physiological coherence and the participants rated the perceived stress at each moment.

Results

34 participants were analyzed, 59% women, with a median age of 36 years (Rq = 13). During mental stress tasks, the median for physiological coherence was similar to baseline coherence but increased significantly with five minutes of directed breathing exercises (38% vs. 63% p <0.0001). The highest perception of stress was during successive subtractions (Me 7, Rq = 4) and the lowest during directed breathing exercises (Me 2 Rq = 3.0). The correlation was sought between physiological coherence and perception of stress during each of the four moments of the study. Basal (Rho Spearman -0.05, p 0.54); Stroop (Rho -0.17, p 0.03); successive subtractions (Rho 0.50, p 0.77); and directed breathing (Rho -0.28, p 0.09).

Conclusions

A correlation was found between physiological coherence and perception of stress during the Stroop test; however, no association was found.

Disclosure

No significant relationships.

An International Adult Guideline for Making Clozapine Titration Safer by Using Six Ancestry-Based Personalized Dosing Titrations, CRP, and Clozapine Levels

This international guideline proposes improving clozapine package inserts worldwide by using ancestry-based dosing and titration. Adverse drug reaction (ADR) databases suggest that clozapine is the third most toxic drug in the United States (US), and it produces four times higher worldwide pneumonia mortality than that by agranulocytosis or myocarditis. For trough steady-state clozapine serum concentrations, the therapeutic reference range is narrow, from 350 to 600 ng/mL with the potential for toxicity and ADRs as concentrations increase. Clozapine is mainly metabolized by CYP1A2 (female non-smokers, the lowest dose; male smokers, the highest dose). Poor metabolizer status through phenotypic conversion is associated with co-prescription of inhibitors (including oral contraceptives and valproate), obesity, or inflammation with C-reactive protein (CRP) elevations. The Asian population (Pakistan to Japan) or the Americas' original inhabitants have lower CYP1A2 activity and require lower clozapine doses to reach concentrations of 350 ng/mL. In the US, daily doses of 300-600 mg/day are recommended. Slow personalized titration may prevent early ADRs (including syncope, myocarditis, and pneumonia). This guideline defines six personalized titration schedules for inpatients: 1) ancestry from Asia or the original people from the Americas with lower metabolism (obesity or valproate) needing minimum therapeutic dosages of 75-150 mg/day, 2) ancestry from Asia or the original people from the Americas with average metabolism needing 175-300 mg/day, 3) European/Western Asian ancestry with lower metabolism (obesity or valproate) needing 100-200 mg/day, 4) European/Western Asian ancestry with average metabolism needing 250-400 mg/day, 5) in the US with ancestries other than from Asia or the original people from the Americas with lower clozapine metabolism (obesity or valproate) needing 150-300 mg/day, and 6) in the US with ancestries other than from Asia or the original people from the Americas with average clozapine metabolism needing 300-600 mg/day. Baseline and weekly CRP monitoring for at least four weeks is required to identify any inflammation, including inflammation secondary to clozapine rapid titration.

Weighted neurofeedback facilitates greater self-regulation of functional connectivity between the primary motor area and cerebellum

Objective.Brain-computer interface (BCI) is a tool that can be used to train brain self-regulation and influence specific activity patterns, including functional connectivity, through neurofeedback. The functional connectivity of the primary motor area (M1) and cerebellum play a critical role in motor recovery after a brain injury, such as stroke. The objective of this study was to determine the feasibility of achieving control of the functional connectivity between M1 and the cerebellum in healthy subjects. Additionally, we aimed to compare the brain self-regulation of two different feedback modalities and their effects on motor performance.Approach.Nine subjects were trained with a real-time functional magnetic resonance imaging BCI system. Two groups were conformed: equal feedback group (EFG), which received neurofeedback that weighted the contribution of both regions of interest (ROIs) equally, and weighted feedback group (WFG) that weighted each ROI differentially (30% cerebellum; 70% M1). The magnitude of the brain activity induced by self-regulation was evaluated with the blood-oxygen-level-dependent (BOLD) percent change (BPC). Functional connectivity was assessed using temporal correlations between the BOLD signal of both ROIs. A finger-tapping task was included to evaluate the effect of brain self-regulation on motor performance.Main results.A comparison between the feedback modalities showed that WFG achieved significantly higher BPC in M1 than EFG. The functional connectivity between ROIs during up-regulation in WFG was significantly higher than EFG. In general, both groups showed better tapping speed in the third session compared to the first. For WFG, there were significant correlations between functional connectivity and tapping speed.Significance.The results show that it is possible to train healthy individuals to control M1-cerebellum functional connectivity with rtfMRI-BCI. Besides, it is also possible to use a weighted feedback approach to facilitate a higher activity of one region over another.

Asociación Mexicana de Hepatología A.C. Clinical guideline on hepatitis B

Hepatitis B virus (HBV) infection continues to be a worldwide public health problem. In Mexico, at least three million adults are estimated to have acquired hepatitis B (total hepatitis B core antibody [anti-HBc]-positive), and of those, 300,000 active carriers (hepatitis B surface antigen [HBsAg]-positive) could require treatment. Because HBV is preventable through vaccination, its universal application should be emphasized. HBV infection is a major risk factor for developing hepatocellular carcinoma. Semi-annual liver ultrasound and serum alpha-fetoprotein testing favor early detection of that cancer and should be carried out in all patients with chronic HBV infection, regardless of the presence of advanced fibrosis or cirrhosis. Currently, nucleoside/nucleotide analogues that have a high barrier to resistance are the first-line therapies.

Impact of COVID-19 Pandemic on Cardiovascular Testing in Asia

Background

The coronavirus disease-2019 (COVID-19) pandemic significantly affected management of cardiovascular disease around the world. The effect of the pandemic on volume of cardiovascular diagnostic procedures is not known.

Objectives

This study sought to evaluate the effects of the early phase of the COVID-19 pandemic on cardiovascular diagnostic procedures and safety practices in Asia.

Methods

The International Atomic Energy Agency conducted a worldwide survey to assess changes in cardiovascular procedure volume and safety practices caused by COVID-19. Testing volumes were reported for March 2020 and April 2020 and were compared to those from March 2019. Data from 180 centers across 33 Asian countries were grouped into 4 subregions for comparison.

Results

Procedure volumes decreased by 47% from March 2019 to March 2020, showing recovery from March 2020 to April 2020 in Eastern Asia, particularly in China. The majority of centers cancelled outpatient activities and increased time per study. Practice changes included implementing physical distancing and restricting visitors. Although COVID testing was not commonly performed, it was conducted in one-third of facilities in Eastern Asia. The most severe reductions in procedure volumes were observed in lower-income countries, where volumes decreased 81% from March 2019 to April 2020.

Conclusions

The COVID-19 pandemic in Asia caused significant reductions in cardiovascular diagnostic procedures, particularly in low-income countries. Further studies on effects of COVID-19 on cardiovascular outcomes and changes in care delivery are warranted.

Asociación Mexicana de Hepatología A.C. Clinical guideline on hepatitis B

Hepatitis B virus (HBV) infection continues to be a worldwide public health problem. In Mexico, at least three million adults are estimated to have acquired hepatitis B (total hepatitis B core antibody [anti-HBc]-positive), and of those, 300,000 active carriers (hepatitis B surface antigen [HBsAg]-positive) could require treatment. Because HBV is preventable through vaccination, its universal application should be emphasized. HBV infection is a major risk factor for developing hepatocellular carcinoma. Semi-annual liver ultrasound and serum alpha-fetoprotein testing favor early detection of that cancer and should be carried out in all patients with chronic HBV infection, regardless of the presence of advanced fibrosis or cirrhosis. Currently, nucleoside/nucleotide analogues that have a high barrier to resistance are the first-line therapies.

P–403 Sodium tungstate increases embryo adhesion through a direct effect on endometrial cells

Study question

Does sodium tungstate treatment induce a change in endometrial cells’ capacity to implant trophoblasts?

Summary answer

Administration of sodium tungstate to endometrial cells increases trophoblast adhesion.

What is known already

Sodium tungstate (ST) has shown its capacity to modulate the activity of cytokines, such as leptin, an activator of an obligatory signalling cascade in the embryo-implantation process. STAT3, a signal transducer molecule critical for the embryo implantation process, is also known to be activated by ST. Still, ST’s effect on implantation using biological systems has never been studied. Embryo implantation process and endometrium roles are complicated to study in vivo due to a lack of animal models and appropriate techniques. In vitro techniques using immortalised cell lines allows a first approach to study early implantation stages, such as embryo adhesion.

Study design, size, duration

An in vitro study was carried out using a human endometrial carcinoma cell line (HEC–1-A) treated with sodium tungstate for 24 and 48h, and choriocarcinoma cell spheroids (JAr). Different times of treatment and concentrations were studied. Each experiment was performed in triplicate.

Participants/materials, setting, methods

Confluent endometrial HEC–1-A cultures were treated with ST at concentrations (0–150mM) and withaferin A (1mM), negative control for embryo adhesion. After the treatment period, HEC–1-A cultures were washed with ST-free culture medium to eliminate ST. Immediately, 15 JAr trophoblast spheroids were added to cultures and coincubated with gentle agitation for 30, 60 and 90 minutes. An inverted light microscope was used to count adhered and floating spheroids, and determine the trophoblast adherence ratio.

Main results and the role of chance

HEC–1-A cells treated with ST showed normal morphology and growth at all doses except 150mM. At the highest dose tested, the cells’ culture was still viable (negative blue trypan staining) and maintained morphology, but the adhesion to the plate surface was affected. Doses from 0.15 to 15mM were used to perform adhesion assays.

HEC–1-A cells treated with ST for 24h showed an increased capacity to adhere JAr trophoblast spheroids. Adhesion rates reached significant differences at doses of 1.5 and 15mM after 60 and 90 minutes of coincubation. After 90 minutes, untreated cells reached 32.8% adhesion rate, while 1.5 and 15mM ST-treated cells reached 54.6% and 53.4% respectively (p &lt; 0.05 ST vs untreated). Thus, the increment of trophoblast adhesion rate induced by ST reached 66%. Lower adhesion rates were observed after 60 minutes of coincubation but were also significant with a relative increase of 49.1% at 1.5mM and 50.5% at 1.5mM when compared with untreated cells (p &lt; 0.05)

Longer treatments (48h) showed similar trends to 24h-treatments, but with a lower extent of ST effect on HEC–1-A receptivity. Maximum adhesion rates were also observed at 90 minutes of coincubation and 1.5 and 15mM doses. The Mean adhesion rate increase was &gt;40% with both doses. Limitations, reasons for caution: The current study is the first approach to evaluate sodium tungstate effect on endometrium using an in vitro model. Future research using in vivo models should be performed to assess sodium tungstate effect on endometrium receptivity and its potential as a fertility treatment.

Wider implications of the findings: We conclude that the direct effect of sodium tungstate on endometrial cells increases embryo adhesion rate. These results open a new research line to a potential treatment in human reproduction management with sodium tungstate to solve the unmet need of inducing embryo implantation.

Trial registration number

Not applicable

Rigorously aplanatic Descartes ovoids

It is known that, besides being stigmatic, spherical refracting surfaces are aplanatic at their Young points since they satisfy the Abbe sine condition rigorously. The Abbe sine condition is commonly applied to different optical systems using numerical methods or optimization processes, obtaining a design of approximately aplanatic systems. Here, we found several families of Cartesian surfaces, whose sets of each of these families constitute exactly aplanatic systems free of spherical aberration and coma. So, studying the different types of systems, it is found that rigorous aplanatism occurs for objects and images on curved surfaces.

Characterization method of the effective phase retardation in linear birefringent thin sheets

Characterization of the birefringence of materials offers the opportunity to develop applications and elements to manipulate the polarization of light. We propose a new method for characterizing the effective phase retardation based on the linear birefringent law. The proposed method is flexible and easy to implement; it also determines the retardation introduced by a linear birefringent as from an input polarization state and a specific output state generated by the rotated material. The method is evaluated experimentally by characterizing the birefringence of cellophane samples.

Effects of sub-optimal illumination in plants. Comprehensive chlorophyll fluorescence analysis

The fluorescence signals emitted by chlorophyll molecules of plants is a promising non-destructive indicator of plant physiology due to its close link to photosynthesis. In this work, a deep photophysical study of chlorophyll fluorescence was provided, to assess the sub-optimal illumination effects on three plant species: L. sativa, A. hybridus and S. dendroideum. In all the cases, low light (LL) treatment induced an increase in pigment content. Fluorescence ratios - corrected by light reabsorption processes - remained constant, which suggested that photosystems stoichiometry was conserved. For all species and treatments, quantum yields of photophysical decay remained around 0.2, which meant that the maximum possible photosynthesis efficiency was about 0.8. L. sativa (C3) acclimated to low light illumination, displayed a strong increase in the LHC size and a net decrease in the photosynthetic efficiency. A. hybridus (C4) was not appreciably stressed by the low light availability whereas S. dendroideum (CAM), decreased its antenna and augmented the quantum yield of primary photochemistry. A novel approach to describe NPQ relaxation kinetics was also presented here and used to calculate typical deactivation times and amplitudes for NPQ components. LL acclimated L. sativa presented a much larger deactivation time for its state-transition-related quenching than the other species. Comprehensive fluorescence analysis allowed a deep study of the changes in the light-dependent reactions of photosynthesis upon low light illumination treatment.

Semi-Automated and Direct Localization and Labeling of EEG Electrodes Using MR Structural Images for Simultaneous fMRI-EEG

Electroencephalography (EEG) source reconstruction estimates spatial information from the brain’s electrical activity acquired using EEG. This method requires accurate identification of the EEG electrodes in a three-dimensional (3D) space and involves spatial localization and labeling of EEG electrodes. Here, we propose a new approach to tackle this two-step problem based on the simultaneous acquisition of EEG and magnetic resonance imaging (MRI). For the step of spatial localization of electrodes, we extract the electrode coordinates from the curvature of the protrusions formed in the high-resolution T1-weighted brain scans. In the next step, we assign labels to each electrode based on the distinguishing feature of the electrode’s distance profile in relation to other electrodes. We then compare the subject’s electrode data with template-based models of prelabeled distance profiles of correctly labeled subjects. Based on this approach, we could localize EEG electrodes in 26 head models with over 90% accuracy in the 3D localization of electrodes. Next, we performed electrode labeling of the subjects’ data with progressive improvements in accuracy: with ∼58% accuracy based on a single EEG-template, with ∼71% accuracy based on 3 EEG-templates, and with ∼76% accuracy using 5 EEG-templates. The proposed semi-automated method provides a simple alternative for the rapid localization and labeling of electrodes without the requirement of any additional equipment than what is already used in an EEG-fMRI setup.

Ribosomal incorporation of cyclic β-amino acids into peptides using in vitro translation

We demonstrate in vitro incorporation of cyclic β-amino acids into peptides by the ribosome through genetic code reprogramming. Further, we show that incorporation efficiency can be increased through the addition of elongation factor P.

Aplanatism in stigmatic optical systems

The minimization of spherical and coma aberrations in optical imaging systems is currently accomplished through the use of corrective aspheric optical surfaces. In this work, we develop a new, to the best of our knowledge, theory for the design of rigorously aplanatic optical systems, considering as a starting point the rigorous stigmatism theory of optical systems composed of Cartesian surfaces. The main characteristic of these surfaces is their, a priori, zero spherical aberration. In a general parametric formulation for systems made up of a set of these surfaces, the Abbe sine condition is adapted to simultaneously obtain the stigmatism and aplanatism conditions. Thus, we achieved the design of optical systems that in theory are immune to both coma and spherical aberrations.

Superconical aplanatic ovoid singlet lenses

In this work, we return to Descartes's idea to develop a formalism to construct rigorously stigmatic singlet lenses comprising two Cartesian surfaces. Optical systems are built using a considerable number of spherical surfaces, presenting in most cases spherical aberration. Wasermann and Wolf proposed eliminating spherical aberration and minimizing third-order coma by using two adjacent aspherical surfaces. That is why, using a parametric formulation for Cartesian ovals, we propose the design of singlet lenses where the condition of rigorous stigmatism is guaranteed for each surface, and therefore, strictly speaking, in the pair of stigmatic points, the lens becomes an optical system free of spherical aberration. This formulation is unified to both refractive and reflective optical surfaces. Therefore, within the framework of the theory of rigorously stigmatic optical systems, making use of Cartesian surfaces for the construction of stigmatic ovoid singlet lenses, we achieve the same functionality of optical systems involving a set of spherical lenses. These lenses have the advantage of being formulated according to a generalized shape factor associated with the Coddington shape factor, allowing an easy classification of these stigmatic lenses. The ideal imaging is carried out by applying an exact ray-tracing method through these ovoid singlet lenses.

AB0688 GAIT PATTERN DIFFERENCES BETWEEN PATIENTS WITH RADIOGRAPHIC AND NON-RADIOGRAPHIC AXIAL SPONDYLOARTHRITIS, THE MyoSpA STUDY

Background:

Axial spondyloarthritis (axSpA) is a chronic inflammatory disease classified as radiographic (r-axSpA) or non-radiographic (nr-axSpA). Defining the gait patterns associated with these two groups can improve its detection and promote early intervention. In normal walking, body segments move around the joints as struts of an inverted pendulum. The resultant cyclic rotations contribute to the forward translation of the body, while minimizing muscle work and maintaining stability. Recent literature describes a decline in this pendulum-like mechanism associated with aging and some neurological diseases (Parkinson and multiple sclerosis).

Objectives:

The aim was to compare the 3D gait kinematics of patients with r-axSpA and nr-axSpA.

Methods:

A cross-sectional study was conducted on 54 participants (18-50 years old), 27 patients with axSpA (according to ASAS criteria, with less than 10 years since symptoms onset) and 27 healthy controls, matched by gender, age and level of physical activity. A sub-analysis was performed involving the whole group of patients classified as r-axSpA (n=14) and nr-axSpA (n=6). Subjects movement was reconstructed using a 3D full-body kinematic model (Kinetikos, Coimbra, Portugal) fed by 15 inertial sensors placed in the head, arms, trunk, pelvis, thighs, shanks and feet. 3D gait kinematics was characterised based on variables that analyse the body movement as a whole (e.g. center of mass displacement, speed), conventional spatiotemporal parameters (e.g. stance/swing time, step length) and joints kinematics time-normalized to 101 points, comprising the gait cycle from 0 to 100%. Nonparametric statistical tests were used.

Results:

In the r-axSpA group, 71,4% were male, with a mean age of 34.43±7.84 years and a BASDAI of 2.84±2.39, whereas in the nr-axSpA, 50% were male, with a mean age of 41.83±6.27 years and a BASDAI of 2.99±0.58. A statistically significant difference was observed in the displacement of the center of mass (with respect to the pelvis local coordinate system) along the anteroposterior axis between the two studied groups (H = 4.96, p = 0.03), with a mean rank displacement of 8.6 for r-axSpA and 15.00 for nr-axSpa, corresponding to a reduction in displacement of 38% (mean 0.00986 vs 0.01579m), in the r-axSpa group.

Conclusion:

Our preliminary results in r-axSpA subjects show a reduction of the pendulum mechanism. Although no significant segmental (kinematics) changes were observed, the sum of all studied variables result in a clear different gait pattern between the two groups. The observed decline can be an early sign of the inefficiency of the r-axSpA group to minimise the cost of transport of the center of mass during walking (i.e. increased instability). This study shows the potential of gait analysis to identify subjects who may benefit from early physiotherapy intervention.

Disclosure of Interests:

Nuno Gonçalves: None declared, Lúcia Domingues: None declared, Atlas Mashayekhi Sardoo: None declared, Lucian Radu: None declared, Santiago Rodrigues-Manica Speakers bureau: Jansse, MSD, Novartis, Agna Neto: None declared, Rita Torres: None declared, José Marona: None declared, Jaime Branco Speakers bureau: Vitoria, César Mendes: None declared, Ricardo Matias: None declared, Fernando Pimentel dos Santos Speakers bureau: Novartis, Pfizer, Biogen, Vitoria,

Explicit Cartesian oval as a superconic surface for stigmatic imaging optical systems with real or virtual source or image

Cartesian ovals, also known as rigorously stigmatic surfaces, are the simplest optical systems capable of producing a perfect point image. Exist both implicit and explicit expressions to represent these surfaces, but they treat both refractive and reflective surfaces independently. Because of the complexity of explicit expressions, the ray-tracing techniques for these surfaces are implemented using third-party software. In this paper, we express Cartesian ovals as a degenerated superconic curve and get a new explicit formulation for Cartesian ovals capable of treating image formation using both object and image points, either real or virtual, and in this formulation can deal with both reflective and refractive rigorously stigmatic surfaces. Finally, using the resultant expressions and the vector Snell–Descartes Law, we propose a self-contained analytical ray-tracing technique for all these surfaces.

Self-Regulation of the Fusiform Face Area in Autism Spectrum: A Feasibility Study With Real-Time fMRI Neurofeedback

One of the most important and early impairments in autism spectrum disorder (ASD) is the abnormal visual processing of human faces. This deficit has been associated with hypoactivation of the fusiform face area (FFA), one of the main hubs of the face-processing network. Neurofeedback based on real-time fMRI (rtfMRI-NF) is a technique that allows the self-regulation of circumscribed brain regions, leading to specific neural modulation and behavioral changes. The aim of the present study was to train participants with ASD to achieve up-regulation of the FFA using rtfMRI-NF, to investigate the neural effects of FFA up-regulation in ASD. For this purpose, three groups of volunteers with normal I.Q. and fluent language were recruited to participate in a rtfMRI-NF protocol of eight training runs in 2 days. Five subjects with ASD participated as part of the experimental group and received contingent feedback to up-regulate bilateral FFA. Two control groups, each one with three participants with typical development (TD), underwent the same protocol: one group with contingent feedback and the other with sham feedback. Whole-brain and functional connectivity analysis using each fusiform gyrus as independent seeds were carried out. The results show that individuals with TD and ASD can achieve FFA up-regulation with contingent feedback. RtfMRI-NF in ASD produced more numerous and stronger short-range connections among brain areas of the ventral visual stream and an absence of the long-range connections to insula and inferior frontal gyrus, as observed in TD subjects. Recruitment of inferior frontal gyrus was observed in both groups during FAA up-regulation. However, insula and caudate nucleus were only recruited in subjects with TD. These results could be explained from a neurodevelopment perspective as a lack of the normal specialization of visual processing areas, and a compensatory mechanism to process visual information of faces. RtfMRI-NF emerges as a potential tool to study visual processing network in ASD, and to explore its clinical potential.

Statistical theory of the polarization on the Poincaré sphere

The random nature of light emitters requires that the theory to study polarization must adopt a statistical approach. Although the Stokes parameters are proposed in this sense, these are implemented as temporal averages, appealing to an ergodic hypothesis, without discussing which probability distributions are treated. Therefore, here the polarization dynamics on the Poincaré sphere of random light sources, whose phases and amplitudes of the electric fields are statistically independent, is described through the von Mises-Fisher distribution. This allows us to relate the degree of polarization and the normalized Stokes parameters with the concentration parameter and the mean direction of the von Mises-Fisher distribution. Also, it is found that their marginal distributions have the same statistical behavior as the Eliyahu-Brosseau distribution.

Graphene and its derivatives: Opportunities and challenges in dentistry

The emerging science of graphene-based engineered nanomaterials as either nanomedicines or dental materials in dentistry is growing. Apart from its exceptional mechanical characteristics, electrical conductivity and thermal stability, graphene and its derivatives can be functionalized with several bioactive molecules, allowing them to be incorporated into and improve different scaffolds used in regenerative dentistry. This review presents state of the art graphene-based engineered nanomaterial applications to cells in the dental field, with a particular focus on the control of stem cells of dental origin. The interactions between graphene-based nanomaterials and cells of the immune system, along with the antibacterial activity of graphene nanomaterials are discussed. In the last section, we offer our perspectives on the various applications of graphene and its derivatives in association with titanium dental implants, membranes for bone regeneration, resins, cements and adhesives, as well as tooth-whitening procedures.

Efficacy of an information system addressed to nursing staff for diminishing contaminated blood cultures: a blind clinical trial

OBJECTIVE

Evaluate the efficacy of an information system addressed to nursing staff to lower the blood culture contamination rate.

METHODS

A blind clinical trial was conducted at Internal Medicine and Emergency Departments during 2011. After following a reeducation program in BC extraction, participants were randomly selected in a 1:1 ratio. Every participant of the experimental group was informed of each worker's individual performance; whereas the control group was only informed of the global results.

RESULTS

A total of 977 blood extractions were performed in 12 months. Blood culture contamination rate was 7.5%. This rate was higher in the Emergency Department than in Internal Medicine (10% vs. 3.8%; p=0.001). Factors associated with the higher risk of contamination were, in the univariate analysis, the extraction through a recently implanted blood route and the time of professional experience, while those associated with a lower risk were the extraction in Internal Medicine and through a butterfly needle. On multivariate analysis, extraction through a recently placed access was an independent risk factor for an increased contamination rate (OR 2.29; 95%CI 1.18-4.44, p=0.014), while individual information about the blood culture results (OR 0.11; 95%CI 0.023-0.57; p=0.008), and more than 9 years of professional experience were asso-ciated with fewer contaminations (OR 0.30; 95%CI 0.12-0.77; p=0.012). In the intervention group the contamination rate diminished by a 26 %.

CONCLUSIONS

Drawing blood cultures through a recently taken peripheral venous access increased their risk of contamination. The intervention informing the nurse staff of the contamination rate is effective to decrease it.

Abstract GS2-04: Efficacy results from CIBOMA/2004-01_GEICAM/2003-11 study: A randomized phase III trial assessing adjuvant capecitabine after standard chemotherapy for patients with early triple negative breast cancer

Background: Triple negative breast cancers (TNBC) have a greater risk of relapse than non-TNBC. New therapeutic approaches are needed for these patients (pts). CIBOMA/2004-01_GEICAM/2003-11 is a multinational, randomized phase III trial exploring adjuvant capecitabine (X) after completion of standard treatment in early TNBC pts.

Materials and Methods: Patients with operable, node-positive (or node-negative with tumor size ≥ 1 cm), centrally confirmed hormone receptor-negative, HER2-negative early BC, who had received 6–8 cycles (cy) of standard anthracycline and/or taxane-containing chemotherapy or 4 cy of doxorubicin-cyclophosphamide (for node-negative disease) in the (neo)adjuvant setting, were eligible. Patients were randomized to either 8 cy of X (1,000 mg/m2 bid, days 1–14, every 3 weeks) or observation. Stratification factors included center, prior taxane-based therapy, number of involved axillary lymph nodes and phenotype (basal vs non-basal, according to cytokeratins 5/6 and/or EGFR positivity). The primary objective was to compare the disease-free survival (DFS) between both treatment arms, and secondary objectives included the comparison in terms of 5-year DFS, overall survival (OS) and safety. Assuming a 30% risk reduction in DFS rate at 5 years (from 64.7% to 73.7%, hazard ratio 0.70) with 80% power and a two-tailed log-rank test at 0.05, 834 evaluable pts were needed. 876 pts had to be finally enrolled considering a drop-out rate of 5%.

Results: Recruitment of 876 pts from 8 countries was completed in September 2011. Median age was 49 years; 68.5% of pts were postmenopausal, 55.5% were lymph node negative, 71.7% had a basal phenotype, 67.5% received chemotherapy based on anthracyclines and taxanes. Median follow-up was 7.3 years (range 0.0 to 11.1). DFS was not significantly prolonged with X vs observation (hazard ratio (HR) 0.82; 95% confidence interval (CI), 0.63 to 1.06; P=0.1353). Five-year DFS was 79.6% (95% CI, 75.8% to 83.4%) with X and 76.8% (95% CI, 72.7% to 80.9%) with observation. OS was not statistically different between treatment arms (HR 0.92; 95% CI, 0.66 to 1.28; P=0.6228). In subgroup analysis for DFS, we found no statistically significant interaction between X treatment and different subgroups, with the exception of basal vs non-basal phenotypes (basal HR 0.97, 95% CI 0.72 to 1.32, P=0.8620; non-basal HR 0.51, 95% CI, 0.31 to 0.86, P=0.0101; interaction P=0.0357). Similar results were found for OS (basal HR 1.20, 95% CI 0.81 to 1.77, P=0.3684; non-basal HR 0.48, 95% CI, 0.26 to 0.91, P=0.0205; interaction P=0.0155). 75.2% of pts completed 8 cy of X, with a median relative dose intensity of 86.3%. Grade (G) 3 or higher adverse events (AEs) were observed in 40.4% of pts in X arm. In 9.6% of pts the AEs were related with X. Hand-foot syndrome was the most common AE in X arm (G3 on 18.8% of pts).

Conclusions: In our study, the addition of adjuvant X after standard (neo) adjuvant anthracycline and/or taxane-containing chemotherapy was not associated with a statistically significant improvement of DFS or OS compared to observation in pts with early TNBC. However, in a subgroup analysis a significant DFS and OS improvement was observed with X in pts with non-basal phenotype.

Sponsor: CIBOMA.

Citation Format: Martín M, Barrios CH, Torrecillas L, Ruiz-Borrego M, Bines J, Segalla J, Ruiz A, García-Sáenz JA, Torres R, de la Haba J, García E, Gómez HL, Llombart A, Rodríguez de la Borbolla M, Baena JM, Barnadas A, Calvo L, Pérez-Michel L, Ramos M, Castellanos J, Rodríguez-Lescure A, Cárdenas J, Vinholes J, Martínez de Dueñas E, Godes MJ, Seguí MA, Antón A, López-Álvarez P, Moncayo J, Amorim G, Villar E, Reyes S, Sampaio C, Cardemil B, Escudero MJ, Bezares S, Carrasco E, Lluch A. Efficacy results from CIBOMA/2004-01_GEICAM/2003-11 study: A randomized phase III trial assessing adjuvant capecitabine after standard chemotherapy for patients with early triple negative breast cancer [abstract]. In: Proceedings of the 2018 San Antonio Breast Cancer Symposium; 2018 Dec 4-8; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2019;79(4 Suppl):Abstract nr GS2-04.

Genetic parameters for medullated fiber and its relationship with other productive traits in alpacas

The alpaca fiber diameter (FD) varies from 18 to 36 μm, being the finer fiber categories highly appreciated. However, the alpaca fiber presents some limitations in the textile industry due to the high incidence of fiber medullation and diameter variability, both reduces the comfort feeling of the garments. Decreasing or even removing medullation could be a possible selection objective in alpaca breeding programs for increasing economic value of the alpaca fiber. Therefore, the present work aimed to estimate genetic parameters regarding medullation traits, as well as the genetic correlations with other economical important traits, to be able to select the appropriate criteria to reduce or remove medullation on alpaca fiber and help to reduce the prickle factor in the garments. The data was collected from 2000 to 2017 and belonged to the Pacomarca experimental farm. There were 3698 medullation records corresponding to 1869 Huacaya and 414 Suri genetic types. The fiber samples were taken from the mid side, and were analyzed in an OFDA 100® device. The traits analyzed were percentage of medullation (PM), medullated fiber diameter (MFD), FD, standard deviation of FD, greasy fleece weight as fiber traits; density, crimp in Huacaya and lock structure in Suri, head conformation, leg coverage as morphological traits; weaning weight and age at first calving as secondary and functional traits. Genetic parameters were estimated via a multitrait restricted maximum likelihood. The heritabilities for PM and MFD were 0.225 and 0.237 in Huacaya genetic type and 0.664 and 0.237 in Suri genetic type, respectively; heritabilities for other traits were moderate for productive and morphological traits, and low to moderate for secondary and functional traits. The genetic correlations PM-FD and MFD-FD were high and favorable in both genetic types, between 0.531 and 0.975; the genetic correlation PM-MFD was 0.121 in Huacaya and 0.427 in Suri. The rest of genetic correlations with other traits were in general moderate and favorable. The repeatabilities were 0.556 and 0.668 for PM, and 0.322 and 0.293 for MFD in Huacaya and Suri genetic types, respectively. As a conclusion, PM was identified to be a good selection criterion, probably combined in an index with FD to reduce prickling factor.

Effect of mono/dual antiretroviral therapy on suppression of HCV and HIV during treatment of HCV infection in HIV/HCV-coinfected patients

OBJECTIVE

Data of hepatitis C treatment with direct-acting antivirals (DAAs) in HIV infected patients are limited to a few number of antiretroviral therapies (ART). The aim of this study was to assess the effectiveness and safety of non-conventional ART as monotherapy or dual therapy (MDT) when combined with DAA.

METHODS

Retrospective review of HIV/HCV-coinfected patients treated with DAAs during one year in 3 centers. Sustained virologic response 12 weeks after therapy (SVR) and maintenance of HIV viral suppression were compared between patients receiving triple ART (TT) or MDT.

RESULTS

Overall 485 patients were included (359 receiving TT and 126 MDT). HCV SVR was 93.4% (95%CI, 90.8% to 95.3%) in the intention-to-treat analysis without differences between groups: 92.8% on TT vs 95.2% on MDT (p=0.3). HCV virological failure was associated with lower CD4+cell count at baseline (for every 100-cell/μl increment: OR, 0.8; 95%CI, 0.7-0.9; p=0.01) and with liver stiffness (for every 10-unit increment: OR, 1.5; 95%CI 1.2-1.8; p<0.01). HIV-RNA during HCV treatment or 12 weeks after was detectable in 23 patients on TT (6.6%) and 9 (7.2%) patients on MDT (p=0.8). The median (IQR) change in CD4+cell count was not significantly different between the groups: 15 (-55 to 115) in TT vs -12 (-68 to 133) cells/μl in MDT (p=0.8).

CONCLUSION

DAAs obtain high rates of SVR among HIV/HCV-coinfected patients independently of whether TT or non-conventional ART is used. Suppression of HIV was maintained in both groups.

The energetic physiology of juvenile mussels, Mytilus chilensis (Hupe): The prevalent role of salinity under current and predicted pCO2 scenarios

As a result of human activities, climate forecasts predict changes in the oceans pCO₂ and salinity levels with unknown impacts on marine organisms. As a consequence, an increasing number of studies have begun to address the individual influence of pCO₂ and salinity but much remains to be done to understand their combined effects on the physiology and ecology of marine species. Our study addressed this knowledge gap by measuring the influence of current and predicted levels of pCO₂ (380 and 1200 ppm, respectively) and salinity (20, 25 and 30 psμ) on the energetic physiology of juvenile mussels (Mytilus chilensis) from the south-eastern Pacific region. Our results indicate that a reduced salinity caused a significant reduction in clearance rate, absorption efficiency and scope for growth of this species. Meanwhile, an increase in pCO₂ levels caused a reduction in excretion rates and interacted significantly with salinity in the rate of oxygen uptake measured in the mussel. These results suggest that potential changes in salinity might have a direct role on the physiology of M. chilensis. The effect of pCO₂, although less prevalent among the variables measured here, did interact with salinity and is also likely to alter the physiology of this species. Given the ecological and economic importance of M. chilensis, we call for further studies exploring the influence of pCO₂ across a wider range of salinities.

Enhanced shelf-life of the formulated biocontrol agent Bacillus amyloliquefaciens CPA-8 combining diverse packaging strategies and storage conditions

Two effective biocontrol products (named as BA3 and BA4) based on Bacillus amyloliquefaciens CPA-8 have been reported as a potential alternative to chemical applications against brown rot caused by Monilinia spp. on stone fruit. To have practical use, this study aimed to describe the best packaging strategies (bags or flasks, atmosphere, and temperature of storage) to not only guarantee efficacy but also stability and ease of application of the products to be handled through the normal channels of distribution and storage. In terms of the viability neither the BA3 nor the BA4 product has been compromised after twelve months of storage. However, storage at 4 °C affected the stability and visual aspect of both CPA-8 formulations, mainly associated not only to the increase of RH but also a_w. Moreover, it should be pointed out that flasks did not conserve refrigerated BA3 samples in a suitable way, since RH and a_w increased noticeably making their visual properties unsightly after 10 months of cold storage. At that time, the BA4 products were better preserved at 4 °C when packaged in flasks. Finally, this study also demonstrated that the most suitable packaging conditions for long-term storability (stored at 22 °C) did not show any negative effect in the biocontrol efficacy of CPA-8 in nectarines artificially infected with M. fructicola and provide suitable product delivery and field application. In conclusion, these results contribute to the final stage of development of these two CPA-8 products, practically ready for registration, thus contributing to the environmental-friendly management of postharvest diseases in stone fruit.

The My Child Matters Programme: The Effect of the Implementation of a Childhood Cancer Care Network (ReNaCI) in the Treatment Abandonment of Acute Lymphoblastic Leukemia in Paraguay

Background: In Paraguay, a low-middle income country (GDP per capita of USD 4,728.7), pediatric cancer is the second cause of mortality in children and adolescents 5-19 years of age. There are approximately 300 new cases of pediatric cancer per year. The Pediatric Cancer Center (PCC) of the School of Medicine (SoM) receives 120 new cases per year, of which 40% correspond to acute lymphoblastic leukemia (ALL). Treatment abandonment is the interruption of patient contact with the health personnel and the treatment of more than 30 days after treatment initiation. At our cancer center, ALL treatment abandonment has been a serious problem. The rates were as high as 20% in 2006, lowering to 17.5% in 2008. To prevent abandonment at our center, we assessed the risk for abandonment, then, we concentrated in three basic interventions: review of compliance with appointment, training of parents and teachers, and access for care at satellites clinics closer to home. For missed appointment, parents are contacted via telephone, or through home visits; and in occasions assistance of child protection services was solicited. We systematically trained parents in the importance of the adherence to cancer treatment. Since 2009, we implemented a comprehensive system for referrals of new cases and follow-up by establishing the ReNaCI, (Red Nacional de Atencion al Cancer Infantil) network. Essential funds for building and sustaining the network has been provided by My Child Matters program under the auspices of Sanofi Espoir Fundation, Paris, France. Currently, as part of this network, there is 4 regional pediatric clinics for early cancer detection, referral, treatment, social assistance and follow up of pediatrics patients with cancer. Aim: Assess the effect of the network in the percentage of abandonment of treatment in patients with ALL treated at the PCC of the SoM in Asunción. Methods: We conducted a longitudinal descriptive study of children diagnosed with ALL at the PCC of the SoM between January 2009 and December 2017. We analyzed the percentage of abandonment since the implementation of the ReNACI network and compared with historical data. Results: From January 2009 to December 2017, 396 new patients with ALL diagnose at the PCC of the SoM. More than 70% of the families were evaluated as having an elevated social risk for abandonment. Abandonment rate decreased from 17.5% in 2008, in 2010%-1.96%, and since 2011 there were no abandonment. However, we still observed in the study period 12% of missed appointments to continue the treatment protocol. Conclusion: The ReNaCI network allowed a successful implementation of interventions to address abandonment by establishing a systems of satellite clinics for a medical and social support for the child and his family closer to home during the entire treatment period. But, despite the achievements, a continuous monitoring is still required to sustain the success of our intervention. Funding: Sanofi Espoir Foundation

Efficacy of environmental friendly disinfectants against the major postharvest pathogens of stone fruits on plastic and wood surfaces

Disinfection of surface facilities during postharvest handling operation is an important practice to avoid secondary fruit infections at stone fruit packinghouses. The aim of this work was to evaluate the effect of six environmental friendly disinfectants against Monilinia fructicola, Penicillium expansum, Rhizopus spp., and Alternaria spp. on plastic and wood surfaces. Hydrogen peroxide, peracetic acid, sodium hypochlorite, Mico-E-pro®, Proallium FRD-N®, and DMC Clean-CNS® were used as the disinfectants. Untreated and surfaces treated with water were used as controls. Plastic and wood surfaces were sampled with Rodac plates at 2 and 24 h after treatments and the number of colonies were counted. In general, all disinfectants reduce the number of viable conidia from all studied surfaces. Hydrogen peroxide used in a concentration of 150 mg L^-1 was the less effective disinfectant in all studied pathogens. The commercial product Mico-E-pro® composed of oregano, onion, and orange extract at a dose of 10 mg L^-1 was the most effective disinfectant. Rhizopus spp. was the pathogen more resistant to the disinfectants followed by P. expansum, M. fructicola, and Alternaria spp. Water decreased the number of conidia adhered to the surface. In addition, the untreated control showed substantial conidia reduction after 24 h of artificial inoculation.

Concentrations of Mercury and Other Inorganic Ions in Wet Precipitation Collected from a Mountain Mining Zone and an Urban Area in Central Mexico

We measured and compared mercury (Hg) and other ions in rainwater collected in San Joaquin (mining zone) and Juriquilla (urban area), central Mexico, from 2009 to 2012. A total of 274 rainwater samples were collected and analyzed for pH, electrical conductivity, [Formula: see text] Cl^-, [Formula: see text] Na⁺, K⁺, Ca²⁺, Mg²⁺ and Hg. Mercury concentrations in rainwater varied from 24.21 to 248.89 (x-bar = 86.97 ± 10.77) µg L^- 1 in San Joaquin (mining zone) and 11.26 to 176.91 (x-bar = 81.51 ± 10.24) µg L^- 1 in Juriquilla (urban area). Rainwater sample were collected over periods 1-3 days, depending upon precipitation frequency. Significant correlations (p < 0.05) were found between [Formula: see text] Cl^-, [Formula: see text] Na⁺, K⁺, Ca²⁺, Mg²⁺ and Hg at the San Joaquin site. Significant correlations were obtained between [Formula: see text] Na⁺, K⁺, Ca²⁺, Mg²⁺ and Hg at the Juriquilla site. In order to determine if there were significant differences among each measured parameter in rainwater collected in San Joaquin and Juriquilla, Kruskal-Wallis test was applied to data. We emphasized that the distribution and concentrations of Hg and the studied ions in rainwater samples were affected by atmospheric dust and local meteorological conditions of wind-speed and direction.