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BACKGROUND: The evolving oncology treatment paradigm has created an unmet need for administration options that improve patient experiences and healthcare efficiencies. PATIENTS AND METHODS: CheckMate 67T (NCT04810078) was a phase 3, open-label, multicenter, noninferiority trial in which patients with advanced/metastatic clear cell renal cell carcinoma were randomized to subcutaneous nivolumab (1200 mg every 4 weeks; coformulated with recombinant human hyaluronidase PH20 20,000 units) or intravenous nivolumab (3 mg/kg every 2 weeks). Primary objective was to assess the noninferiority of subcutaneous versus intravenous nivolumab by coprimary endpoints determined from a population pharmacokinetics analysis (time-averaged serum concentration over the first 28 days [Cavgd28], and minimum steady-state serum concentration [Cminss]; noninferiority threshold: lower boundary of 90% confidence interval (CI) of the geometric mean ratios [GMR] ≥0.8). Objective response rate (ORR) was a key secondary endpoint powered for noninferiority (noninferiority threshold: lower boundary of 95% CI of relative risk of ORR [subcutaneous versus intravenous nivolumab] ≥0.60). RESULTS: Overall, 495 patients were randomized. Relative exposure in the subcutaneous versus intravenous arm reported by the GMR of Cavgd28 and Cminss was 2.098 (90% CI, 2.001-2.200) and 1.774 (90% CI, 1.633-1.927), respectively. After 8 months minimum follow-up, ORR was 24.2% with subcutaneous nivolumab (95% CI, 19.0-30.0) versus 18.2% with intravenous nivolumab (95% CI, 13.6-23.6; relative risk: 1.33 [95% CI, 0.94-1.87]). Coprimary endpoints and ORR met noninferiority thresholds. Additional efficacy and safety measures were similar. CONCLUSION: Subcutaneous nivolumab was noninferior to intravenous nivolumab based on pharmacokinetics and ORR. No new safety signals were observed.

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Background: Mass drug administration (MDA) with niclosamide (NSM) can be used to control taeniasis, the cause of neurocysticercosis. NSM is 84.3% effective against taeniasis and is considered safe as it is not absorbed from the intestinal tract. However, information on its safety and effectiveness during MDA is limited. We evaluated the effectiveness of NSM and reported adverse events (AEs) during a cysticercosis elimination program in Tumbes, Peru. Methods: Three rounds of NSM at 4-month intervals were offered to 77,397 eligible residents. We revisited all participants in their homes 72 h after each round to collect information regarding AEs. We also collected post-treatment stool samples to diagnose taeniasis after the first round, followed by a second sample at 30 days from those infected to evaluate NSM's effectiveness. Findings: During implementation, 68,751 individuals were administered at least one dose of NSM (mean age 29 years, SD 20; 52% male), and 65,551 (95.3%) were visited post-treatment. 988 (1.5%) reported experiencing at least one AE. Almost all AEs (99.2%) were of mild intensity, with no severe AEs recorded. Of 211 participants diagnosed with taeniasis, 188 provided a follow-up stool sample 30-days after treatment and 141 were cured (treatment effectiveness 75.0%). Older age and higher coproantigen levels were significantly associated with treatment failure. Interpretation: MDA with NSM is safe in Taenia solium endemic settings. However, the effectiveness following one dose is lower than expected, which suggests additional treatment may be necessary to enhance the infection control efforts. Funding: The Bill and Melinda Gates Foundation.

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BACKGROUND: The COVID-19 pandemic introduced unprecedented challenges to medical education systems and medical students worldwide, making it necessary to adapt teaching to a remote methodology during the academic year 2020-2021. The aim of this study was to characterize the association between medical professionalism and dropout intention during the pandemic in Peruvian medical schools. METHODS: A cross-sectional online-survey-based study was performed in four Peruvian medical schools (two public) during the academic year 2020-2021. Medical students, attending classes from home, answered three scales measuring clinical empathy, teamwork, and lifelong learning abilities (three elements of medical professionalism) and four scales measuring loneliness, anxiety, depression, and subjective wellbeing. In addition, 15 demographic, epidemiological, and academic variables (including dropout intention) were collected. Variables were assessed using multiple logistic regression analysis. RESULTS: The study sample was composed of 1107 students (390 male). Eight variables were included in an explanatory model (Nagelkerke-R2 = 0.35). Anxiety, depression, intention to work in the private sector, and teamwork abilities showed positive associations with dropout intention while learning abilities, subjective wellbeing, studying in a public medical school, and acquiring a better perception of medicine during the pandemic showed a negative association with dropout intention. No association was observed for empathy. CONCLUSIONS: Each element measured showed a different role, providing new clues on the influence that medical professionalism had on dropout intention during the pandemic. This information can be useful for medical educators to have a better understanding of the influence that professionalism plays in dropout intention.

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Gastric adenocarcinoma (GAC) is the fourth-leading global cause of cancer mortality and leading infection-associated cancer. High incidence regions include Latin America and Eastern Asia. Immigrants from high incidence regions maintain their GAC risk. GAC is a major U.S. cancer disparity, incidence rates are 2-10 time higher in non-white populations. Emerging guidelines recommend 3-year surveillance endoscopy for patients with high-risk gastric premalignant conditions (GPMCs). Clinical trials of GPMC chemoprevention agents are lacking. We conducted an NCI Division of Cancer Prevention-funded, phase II placebo-controlled chemoprevention trial in patients with GPMCs (atrophic gastritis, intestinal metaplasia) with a highly bioavailable preparation of curcuminoids (Meriva®). The trial sites in Puerto Rico and rural Honduras had important characteristics: (1) representative Caribbean and Mesoamerican populations, linked to large U.S. immigrant populations; (2) high prevalence of H. pylori infection and GPMCs; (3) absence of turmeric and curcuminoids in the local diets; (4) proven bidirectional collaboration with U.S. academic institutions. H. pylori-negative GPMC patients were randomized to study drug (500 mg po bid) or placebo for 180 days (NCT02782949), with primary outcomes based upon histologic parameters. Principal study challenges included: (1) international regulatory environment; (2) research infrastructure strengthening, particularly in Central America; (3) participant recruitment in Honduras wherein only 10-15% are H. pylori negative; (4) the Covid-19 pandemic; and (5) natural disasters (3 hurricanes). There were no losses to follow-up related to the pandemic or natural disasters. In conclusion, the south-south partnership provides a model for chemoprevention and translational studies in Latino populations with prevalent cancers such as GAC.

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Neurocysticercosis is a parasitic disease of major public health importance. Definitive diagnosis requires neuroimaging, which is typically unavailable in rural impoverished regions of endemicity. Screening immunoassays can support diagnosis in this setting by identifying individuals most likely to have severe forms of disease for referral to imaging. Urine sampling is convenient, painless, and generally well accepted. We developed a rapid point-of-care (POC) assay to detect urinary antigens and assessed concordance with a standard antigen ELISA (Ag-ELISA), both using monoclonal antibodies TsW8/TsW5. From 28,145 stored community samples with Ag-ELISA results, we selected 843 for comparison, 281 each from nonreactive (ratio <1), reactive-below-cutoff (ratio 1:3), and positive (ratio ≥3) samples. Overall agreement was 73.6%, with strong agreement observed in the nonreactive (280/281, 99.6%) and positive (255/281, 90.8%) groups. This affordable noninvasive POC test can be applied to identify individuals in the community most at risk of developing severe disease.

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To determine if fluoride's established negative impact on adult kidney health begins during gestation, an intergenerational model of Wistar rats was exposed to two doses of fluoride (2.5 or 5.0 mg/kg/day via gavage) 20 days before mating and during gestation (20 days). The results revealed that fluoride was distributed to the amniotic fluid and fetus, resulting in lower weight, more pronounced fetal restriction, and decreased creatinine, osmolarity, and amniotic fluid volume. At the kidney level, less development in the nephrogenic and cortical zones was observed in the fluoride treatment groups, with an imbalance in the number of glomeruli and "S" shaped bodies, an increase in the immunoexpression of the marker of proliferation Ki-67 in the nephrogenic zone, an increase in the expression of Wnt4 and more maturation of the renal tubules, indicating that fluoride exposure during pregnancy alters kidney development and promotes early maturation of tubular segments.

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Fluoruros , Riñón , Ratas Wistar , Animales , Femenino , Embarazo , Riñón/efectos de los fármacos , Riñón/metabolismo , Fluoruros/toxicidad , Proteína Wnt4/genética , Proteína Wnt4/metabolismo , Líquido Amniótico/metabolismo , Ratas , Antígeno Ki-67/metabolismo , Masculino , Feto/efectos de los fármacos , Exposición Materna/efectos adversos

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Lowe Syndrome (LS) is a rare X-linked disorder characterized by renal dysfunction, cataracts, and several central nervous system (CNS) anomalies. The mechanisms underlying the neurological dysfunction in LS remain unclear, albeit they share some phenotypic characteristics similar to the deficiency or dysfunction of the Reelin signaling, a relevant pathway with roles in CNS development and neuronal functions. In this study, we investigated the role of OCRL1, an inositol polyphosphate 5-phosphatase encoded by the OCRL gene, mutated in LS, focusing on its impact on endosomal trafficking and receptor recycling in human neuronal cells. Specifically, we tested the effects of OCRL1 deficiency in the trafficking and signaling of ApoER2/LRP8, a receptor for the ligand Reelin. We found that loss of OCRL1 impairs ApoER2 intracellular trafficking, leading to reduced receptor expression and decreased levels at the plasma membrane. Additionally, human neurons deficient in OCRL1 showed impairments in ApoER2/Reelin-induced responses. Our findings highlight the critical role of OCRL1 in regulating ApoER2 endosomal recycling and its impact on the ApoER2/Reelin signaling pathway, providing insights into potential mechanisms underlying the neurological manifestations of LS.

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Moléculas de Adhesión Celular Neuronal , Endosomas , Proteínas de la Matriz Extracelular , Proteínas Relacionadas con Receptor de LDL , Proteínas del Tejido Nervioso , Neuronas , Monoéster Fosfórico Hidrolasas , Transporte de Proteínas , Proteína Reelina , Serina Endopeptidasas , Humanos , Monoéster Fosfórico Hidrolasas/metabolismo , Monoéster Fosfórico Hidrolasas/genética , Monoéster Fosfórico Hidrolasas/deficiencia , Proteínas del Tejido Nervioso/metabolismo , Proteínas del Tejido Nervioso/genética , Proteínas del Tejido Nervioso/deficiencia , Serina Endopeptidasas/metabolismo , Serina Endopeptidasas/genética , Serina Endopeptidasas/deficiencia , Moléculas de Adhesión Celular Neuronal/metabolismo , Moléculas de Adhesión Celular Neuronal/genética , Moléculas de Adhesión Celular Neuronal/deficiencia , Proteínas de la Matriz Extracelular/metabolismo , Proteínas de la Matriz Extracelular/genética , Proteínas de la Matriz Extracelular/deficiencia , Endosomas/metabolismo , Neuronas/metabolismo , Proteínas Relacionadas con Receptor de LDL/metabolismo , Proteínas Relacionadas con Receptor de LDL/genética , Transducción de Señal , Síndrome Oculocerebrorrenal/genética , Síndrome Oculocerebrorrenal/metabolismo

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BACKGROUND: There is a growing epidemic of chronic non-communicable diseases in low and middle-income countries, often attributed to urbanization, although there are limited data from marginalized rural populations. This study aimed to estimate prevalence of cardiometabolic diseases and associated risk factors in transitional rural communities. METHODS: A cross-sectional study of Montubio adults aged 18-94 years living in agricultural communities in a tropical coastal region of Ecuador. Data were collected by questionnaires and anthropometry, and fasting blood was analyzed for glucose, glycosylated hemoglobin, insulin, and lipid profiles. Population-weighted prevalences of diabetes, hypertension, and metabolic syndrome were estimated. Associations between potential risk factors and outcomes were estimated using multilevel regression techniques adjusted for age and sex. RESULTS: Out of 1,010 adults recruited, 931 were included in the analysis. Weighted prevalences were estimated for diabetes (20.4%, 95% CI 18.3-22.5%), hypertension (35.6%, 95% CI 29.0-42.1%), and metabolic syndrome (54.2%. 95% CI 47.0-61.5%) with higher prevalence observed in women. Hypertension prevalence increased with age while diabetes and metabolic syndrome peaked in the 6th and 7th decades of life, declining thereafter. Adiposity indicators were associated with diabetes, hypertension, and metabolic syndrome. CONCLUSION: We observed an unexpectedly high prevalence of diabetes, hypertension, and metabolic syndrome in these marginalized agricultural communities. Transitional rural communities are increasingly vulnerable to the development of cardiometabolic risk factors and diseases. There is a need for targeted primary health strategies to reduce the burden of premature disability and death in these communities.

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Hipertensión , Síndrome Metabólico , Población Rural , Humanos , Adulto , Persona de Mediana Edad , Femenino , Ecuador/epidemiología , Masculino , Población Rural/estadística & datos numéricos , Anciano , Adolescente , Estudios Transversales , Síndrome Metabólico/epidemiología , Adulto Joven , Anciano de 80 o más Años , Hipertensión/epidemiología , Factores de Riesgo , Prevalencia , Enfermedades Cardiovasculares/epidemiología , Diabetes Mellitus/epidemiología

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Background: Argentina's smoking rates remain high. We aim to estimate Argentina age-specific histories of smoking initiation, cessation, prevalence, and intensity by birth-cohort to inform policy interventions. Methods: Modeling study. Data from three Argentinian nationally representative surveys conducted from 2004 to 2018 (n = 268,193) were used to generate smoking histories. The Cancer Intervention and Surveillance Modeling (CISNET) Network Lung Working Group age, period, and cohort modeling approach was used to calculate smoking initiation and cessation probabilities, ever and current smoking prevalence, and intensity (cigarettes per day, CPD) by age, sex, and birth cohort from 1950 to 2018. Findings: Ever smoking prevalence increases with age up to 25 and decreases with birth cohorts after 1990. Smoking initiation peaks between 15 and 18 years of age. Among females, initiation probabilities increased until the 1955 cohort, reaching a second peak in 1980-85 cohorts and declining thereafter. Males have higher initiation probabilities than females. Among males, initiation has decreased since the 1950 birth cohort, with a slight increase around the 1985 cohort. Current smoking prevalence has been decreasing since the 1960 birth cohort, except for a peak in 1980-85 cohorts. Cessation increases with age. Mean CPD increases with age and peaks around age 40, appearing flat in females since the 1985 cohort. Interpretation: Recent birth cohorts seem to be experiencing lower rates of initiation, stable rates of quitting and lower current and ever smoking prevalence. The stabilization of cessation probabilities and mean CPD indicate the need to strengthen existing tobacco control measures and advance new ones. Funding: NIH/NCI U01CA253858 grant.

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INTRODUCTION: Pituitary apoplexy (PA) is a rare neuroendocrinological emergency. The SARS-CoV-2 pandemic recommendations led to a shift in the management of patients with pituitary diseases, especially in the decision-making between conservative and surgical treatment of patients with PA. OBJECTIVE: This study aimed to describe the conservative and surgical treatment and the clinical, visual, and endocrinological outcomes in patients with PA at the Pituitary Center of Excellence (PTCEO) during the SARS-CoV-2 pandemic and within three years. METHODS: This is a cohort study. Patients with PA between April 2020 and September 2023 were followed up. Treatment decisions, clinical manifestations, hormonal profile, and tumor size with MRI were described at the onset, at three months, six months, one year, two years, and three years after diagnosis. RESULTS: A total of 27 patients with PA diagnosis were included in the study. Of these, 12 patients were conservatively treated, six (50%) had prolactinomas, five (41.6%) had non-functioning adenomas, and one (8.3%) had pituicytoma. Fifteen patients were surgically intervened during the first hospitalization, nine (60%) had non-functioning adenomas, four (26.6%) had prolactinomas, one (6.6%) had ACTH-producing adenoma, and one (6.6%) had gonadotropinoma. Two patients from the conservatively treated group (one non-functioning adenoma and one pituicytoma) were intervened surgically at years 2 and 3, respectively. During the initial assessment, there were no statistically significant differences between patients in visual acuity (9 [75%] vs 15 [100%]), visual field affection (8 [66.6%] vs 11 [73.3%]), and cranial nerve deficit (3 [25%] vs 6 [40%]). At six months follow-up, no statistically significant differences were found in the visual acuity improvement (8 [88%] vs 11 [100%]), visual field (8 [100%] vs 8 [72%]), and cranial nerve deficit between the two groups (3 [100%] vs 6 [100%]). Meanwhile, the average length of in-hospital stay was 1.5 vs 10 days (p = 0.019). The tumor size and largest diameter were smaller in the surgically treated group (6.2 vs. 0.5 cm3, p = 0.029 and 2.5 vs. 1.1 cm, p = 0.036, respectively). Visual acuity improved in nine (58.3%) patients at year 1: two (40%) conservative vs seven (100%) surgical (p = 0.039); six (85.7%) patients at year 2: two (66.6%) conservative vs. four (100%) surgical; and three (100%) patients on both groups at year 3. Fourteen patients needed hormonal substitution: 87.5% (eight [88.8%] conservative vs six [85.7%] surgical) at year 1, 85.7% (six patients in both groups) at year 2, and 80% (four conservative vs three [100%] surgical) at year 3. The thyrotropic axis was the most affected in both groups during the three years. During the first-year follow-up, six (85%) patients persisted with tumoral regression (2 [66.6%] conservative vs 4 [100%] surgical) and one (14.2%) patient from the medical group progressed. During the second and third years, 10 and three (100%) of the patients, respectively, showed the regression of the tumoral volume in both groups. CONCLUSIONS: The clinical, visual, and neuroendocrinological outcomes were similar in both groups of patients with PA during the SARS-CoV-2 pandemic. In cases where the Pituitary Apoplexy Score (PAS) score does not surpass three points without neurological deterioration, conservative management can be considered an adequate option for treatment.

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Background and Aims: Acute respiratory failure (ARF) is the most frequent cause of cardiorespiratory arrest and subsequent death in children worldwide. There have been limited studies regarding ARF in high altitude settings. The aim of this study was to calculate mortality and describe associated factors for severity and mortality in children with ARF. Methods: The study was conducted within a prospective multicentric cohort that evaluated the natural history of pediatric ARF. For this analysis three primary outcomes were studied: mortality, invasive mechanical ventilation, and pediatric intensive care unit (PICU) length of stay. Eligible patients were children older than 1 month and younger than 18 years of age with respiratory difficulty at the time of admission. Patients who developed ARF were followed at the time of ARF, 48 h later, at the time of discharge, and at 30 and 60 days after discharge. It was conducted in the pediatric emergency, in-hospital, and critical-care services in three hospitals in Bogotá, Colombia, from April 2020 to June 2021. Results: Out of a total of 685 eligible patients, 296 developed ARF for a calculated incidence of ARF of 43.2%. Of the ARF group, 90 patients (30.4%) needed orotracheal intubation, for a mean of 9.57 days of ventilation (interquartile range = 3.00-11.5). Incidence of mortality was 6.1% (n = 18). The associated factors for mortality in ARF were a history of a neurologic comorbidity and a higher fraction of inspired oxygen at ARF diagnosis. For PICU length of stay, the associated factors were age between 2 and 5 years of age, exposure to smokers, and respiratory comorbidity. Finally, for mechanical ventilation, the risk factors were obesity and being unstable at admission. Conclusions: ARF is a common cause of morbidity and mortality in children. Understanding the factors associated with greater mortality and severity of ARF might allow earlier recognition and initiation of prompt treatment strategies.

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OBJECTIVES: Latinx and Asian people are experiencing an elevated rate of immigration status-related oppression-both systematically and individually-despite actual nationality, and this type of cultural stressor has seen a rampant increase recently in the United States. We aimed to assess the relation and effect of immigration status microaggressions on psychological stress and some mechanisms connected to these experiences. METHOD: Using a sample of Latinx and Asian college students (N = 776), we unpack the relationships between individual cultural stressors, such as immigration status microaggressions, and psychological stress, by exploring their mediating relation with internalized racism (Mediator 1), and fear of foreign objectification (Mediator 2), using Hayes's (2012) PROCESS Model 6-serial mediation. Furthermore, we expanded on this model, highlighting differences between Latinx and Asian participants (moderator) using a moderated mediation. RESULTS: Findings suggest a full serial mediation. Specifically, the psychological stress associated with immigration status microaggressions was mediated by internalized racism and fear of foreign objectification. Results also highlighted that Latinx participants, compared to Asian ones, showed a significant positive association between immigration status microaggressions with internalized racism and fear of foreign objectification. Furthermore, a significant interaction for Latinx who experience more fear of foreign objectification was positively associated with psychological stress. Indirect effects for each group are discussed. CONCLUSION: Our study is one of the first to explore cultural stress in the form of immigration status microaggressions in connection with more general forms of psychological stress and internalizing processes for two groups historically persecuted around immigration in the United States. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

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Despite the high success rates of dental implants, peri-implantitis is currently the most common complication in dental implantology. Peri-implantitis has an inflammatory nature, it is associated with the accumulation of plaque in the peri-implant tissues, and its evolution can be progressive depending on various factors, comorbidities, and poor oral health. Prophylaxis and different treatment methods have been widely discussed in recent decades, and surgical and non-surgical techniques present both advantages and disadvantages. In this work, a literature review of different studies on the application of adjuvant treatments, such as local and systemic antibiotics and antiseptic treatments, was conducted. Positive outcomes have been found in the short (up to one year after treatment) and long term (up to ten years after treatment) with combined therapies. However, there is still a need to explore new therapies based on the use of advanced drug delivery systems for the effective treatment of peri-implantitis in the long term and without relapses. Hence, micro- and nanoparticles, implants, and injectable hydrogels, among others, should be considered in future peri-implantitis treatment with the aim of enhancing overall therapy outcomes.

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The relevance of science diplomacy and open science in today's world is undeniable. Science diplomacy enables countries to jointly address pressing global challenges, such as climate change, pandemics, and food security. Open science, promoting accessible and transparent research, plays a pivotal role in this context. Nevertheless, the degree of openness is subject to specific circumstances, contingent upon varying factors, including local knowledge and resources. Latin America has not only been at the forefront of pioneering open access strategies, making it an interesting case to study, but it has also shown a tangible interest in using science diplomacy. Our research employs a mixed-methods approach, incorporating a quantitative survey involving 50 organizations and initiatives dedicated to promoting open science in Latin America, along with two qualitative focus group studies. Our primary objective is to assess if and how these entities use science diplomacy to achieve their objectives. Non-policy entities were prioritized due to their institutional stability in the region. We highlight successful strategies and delve into the existing barriers hindering the full implementation of open science principles. Our research aims to enhance collaboration between these organizations and policy and decision-makers by providing a set of recommendations in that direction. By shedding light on the current landscape and dynamics of open science in Latin America, we aspire to focus on science diplomacy, facilitate informed decision-making, and formulate policies that further propel the region along the path of openness, collaboration, and innovation in scientific research.

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Cranial nerve palsy is common in pituitary disease and depends on the extension of the lesion into the cavernous sinuses. Bilateral cranial nerve palsy was described in pituitary adenomas with apoplexy and in only one case in hypophysitis. We present a case of a 32-year-old female manifesting with headache, diplopia, bilateral sixth nerve palsy, and hypopituitarism. Magnetic resonance imaging (MRI) revealed symmetric expansion of the pituitary gland, with bilateral cavernous sinus invasion and thickening of the pituitary stalk. Hypophysitis was suspected, and after treatment with IV methylprednisolone boluses, a decrease in the pituitary lesion was observed, with complete remission of sixth nerve palsy in the right eye and partial improvement in the left eye. In this case, we report an infrequent form of presentation of hypophysitis, and highlight that steroids are the first line of treatment.

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BACKGROUND: Chromosomal abnormalities are present in 50 to 60% of miscarriages and in 6 to 19% of stillbirths. Although microarrays are preferred for studying chromosomal abnormalities, many hospitals cannot offer this methodology. OBJECTIVE: To present the results of the cytogenetic analysis of 303 products of conception (POC), which included 184 miscarriages, 49 stillbirths and 17 cases of undefined age. MATERIAL AND METHODS: Karyotyping, fluorescence in situ hybridization, short tandem repeats and microarrays were used, depending on the type of loss and available sample. RESULTS: In 29 POCs we found maternal tissue and were eliminated from the analyses. Informative results were obtained in 250 (91.2 %)/274 cases; the karyotyping success rate was 80.7%; that of single nucleotide polymorphism microarrays, 94.5%; and that of fluorescence in situ hybridization and short tandem repeat, 100%. Cytogenetic abnormalities were observed in 57.6% of miscarriages and in 24.5% of stillbirths; 94% of total anomalies were numerical and 6% were submicroscopic. CONCLUSIONS: Karyotyping with simultaneous short tandem repeat study to rule out contamination of maternal cells is effective for studying miscarriages; in stillbirths, microarrays are recommended.

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ANTECEDENTES: Las alteraciones cromosómicas están presentes en 50 a 60 % de los abortos espontáneos y en 6 a 19 % de los mortinatos. Aunque se prefieren los microarreglos para estudiarlos, numerosos hospitales no pueden ofrecerlos. OBJETIVO: Presentar los resultados del estudio citogenético de 303 productos de la concepción (POC), 184 se obtuvieron de abortos espontáneos, 49 fueron mortinatos y en 17 no se identificó la de edad gestacional. MATERIAL Y MÉTODOS: Se empleó cariotipo, hibridación in situ con fluorescencia, secuencias cortas repetidas en tándem y microarreglos, según el tipo de pérdida y la muestra disponible. RESULTADOS: En 29 POC se encontró tejido materno, por lo que fueron eliminados de los análisis. En 250 (91.2 %)/274 casos se obtuvieron resultados informativos; la tasa de éxito del cariotipo fue de 80.7 %; la de los microarreglos de SNP, de 94.5 %; y la de la hibridación fluorescente in situ y la repetición corta en tándem, de 100 %. Se observaron anomalías citogenéticas en 57.6 % de los abortos espontáneos y en 24.5 % de los mortinatos; 94 % de las anomalías fueron numéricas y 6 %, submicroscópicas. CONCLUSIONES: El cariotipo en conjunto con el estudio de secuencias cortas repetidas en tándem para descartar contaminación de células maternas es efectivo para estudiar abortos espontáneos; los microarreglos se recomiendan en los mortinatos.

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Aborto Espontáneo , Aberraciones Cromosómicas , Hibridación Fluorescente in Situ , Cariotipificación , Humanos , Femenino , Aborto Espontáneo/epidemiología , Aborto Espontáneo/genética , México/epidemiología , Embarazo , Cariotipificación/métodos , Mortinato/genética , Mortinato/epidemiología , Adulto , Análisis Citogenético/métodos , Repeticiones de Microsatélite , Polimorfismo de Nucleótido Simple , Adulto Joven

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INTRODUCTION: Vaccine mandates are controversial, and people vary widely in their preferences to support or reject vaccine mandates. For some, vaccine mandates represent a commitment to reduce harm and support public health. For others, vaccine mandates are viewed as a threat to individual freedom and a violation of personal choice. This manuscript investigated support for a COVID-19 vaccine mandate among COVID-19-vaccinated individuals and identified differences by demographic characteristics and COVID-19 experience. METHODS: Cross-sectional surveys were given to COVID-19-vaccinated individuals at a vaccination clinic in South Texas in the U.S. with the goal of identifying attitudes, beliefs, and perceptions about COVID-19 vaccination and willingness to support a COVID-19 vaccination mandate. Associations of interest were analyzed using descriptive statistics. KEY RESULTS: Approximately half of the sample was of Hispanic or Latino origin (48 %); most respondents identified as White (59 %), followed by 12 % who identified as Asian. Overall, 59 % of participants supported the possibility for a COVID-19 vaccine mandate. Preliminary data showed significant racial differences in willingness to support a possible COVID-19 vaccine mandate (χ2 (1, n = 893) = 26.7, p < .001, phi = .17); 80 % of Asian people reported support for COVID-19 vaccination mandate compared to 50 % to 57 % for other racial groups. Significant differences also emerged by ethnicity (χ2 (4, n = 1033) = 7.12, p = .008, phi = .08) whereby a higher percentage of Latino participants (66 %) reported willingness to support a COVID-19 vaccine mandate. Similarly, significant differences were found by age (χ2 (4, n = 1045) = 20.92, p < .001, phi = .21), yet no significant differences were found by sex or previous COVID-19 diagnosis. CONCLUSION: Support for a COVID-19 vaccination mandate is controversial even among vaccinated people. Identifying and understanding cultural and contextual factors that underlie differences in attitudes and beliefs about COVID-19 vaccination mandates is essential to advance dialogue and inform educational health campaigns to increase COVID-19 vaccination rates.

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Vacunas contra la COVID-19 , COVID-19 , Vacunación , Adolescente , Adulto , Anciano , Femenino , Humanos , Masculino , Persona de Mediana Edad , Adulto Joven , COVID-19/prevención & control , Vacunas contra la COVID-19/administración & dosificación , Estudios Transversales , Conocimientos, Actitudes y Práctica en Salud , Hispánicos o Latinos/psicología , Hispánicos o Latinos/estadística & datos numéricos , Programas Obligatorios , Aceptación de la Atención de Salud/psicología , SARS-CoV-2/inmunología , Encuestas y Cuestionarios , Texas , Vacunación/psicología , Vacunación/estadística & datos numéricos , Asiático , Blanco

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The presence of arsenic (As) and fluoride (F-) in drinking water is of concern due to the enormous number of individuals exposed to this condition worldwide. Studies in cultured cells and animal models have shown that As- or F-induced hepatotoxicity is primarily associated with redox disturbance and altered mitochondrial homeostasis. To explore the hepatotoxic effects of chronic combined exposure to As and F- in drinking water, pregnant CD-1 mice were exposed to 2 mg/L As (sodium arsenite) and/or 25 mg/L F- (sodium fluoride). The male offspring continued the exposure treatment up to 30 (P30) or 90 (P90) postnatal days. GSH levels, cysteine synthesis enzyme activities, and cysteine transporter levels were investigated in liver homogenates, as well as the expression of biomarkers of ferroptosis and mitochondrial biogenesis-related proteins. Serum transaminase levels and Hematoxylin-Eosin and Masson trichrome-stained liver tissue slices were examined. Combined exposure at P30 significantly reduced GSH levels and the mitochondrial transcription factor A (TFAM) expression while increasing lipid peroxidation, free Fe 2+, p53 expression, and serum ALT activity. At P90, the upregulation of cysteine uptake and synthesis was associated with a recovery of GSH levels. Nevertheless, the downregulation of TFAM continued and was now associated with a downstream inhibition of the expression of MT-CO2 and reduced levels of mtDNA and fibrotic liver damage. Our experimental approach using human-relevant doses gives evidence of the increased risk for early liver damage associated with elevated levels of As and F- in the diet during intrauterine and postnatal period.

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The author describes how she has earnestly struggled to find her fit in providing mental health services to Hispanic/Latino clients and the Latino communities that she belongs to. She wonders, if no one belongs, then who stands up for historically marginalized Latino communities? Personal and systemic biases and arbitrary criteria for being enough to serve Latino patients hurt providers and clients alike. Her work reminds her of the need to charge against stereotyping and racism to meet patients' needs regardless of skin color or linguistic abilities. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Asunto(s)

Hispánicos o Latinos , Humanos , Hispánicos o Latinos/psicología , Servicios de Salud Mental/tendencias , Racismo/psicología , Femenino