RESUMO
The COVID-19 pandemic drastically affected higher education and higher education students around the world, but few studies of college students' experiences during the COVID-19 pandemic have been conducted in Latin America. This study describes the COVID-19-related experiences and perspectives of Peruvian college students. We surveyed 3,427 full-time college students (average age: 23 years) attending a multi-campus Peruvian university in fall 2020. Participants were recruited through the digital platform of the learning management system at their university, email, and social media. We asked participants how they were managing risks related to COVID-19; the continuity of social, educational, and work activities; and the psychological and economic impacts of the pandemic on their lives. Since March 2020, 73.0% of participants reported COVID-19-related symptoms, but only 33.9% were tested for COVID-19. During the national quarantine imposed by the Peruvian government (March 15-June 30, 2020), 64.3% of participants remained in their house. Furthermore, while 44.0% of participants were working in February 2020 (95% CI: [41.7%, 46.4%]), only 23.6% (95% CI: [21.7%, 25.7%]) were working immediately after the pandemic began (i.e., at the end of April 2020). Participants were more stressed about the health and educational implications of COVID-19 for Peruvian society and their families than about themselves. The public health, economic, and educational implications of COVID-19 on college students are continuing to unfold. This study informed Peruvian higher education institutions' continued response to the COVID-19 pandemic, the progressive return to postpandemic activities, as well as other future pandemics and other crises.
Assuntos
COVID-19 , SARS-CoV-2 , Estudantes , Humanos , COVID-19/epidemiologia , COVID-19/psicologia , Peru/epidemiologia , Estudantes/psicologia , Estudantes/estatística & dados numéricos , Universidades , Feminino , Masculino , Adulto Jovem , Inquéritos e Questionários , Adulto , Pandemias , Adolescente , Quarentena/psicologiaRESUMO
OBJECTIVE: Women with HIV (WWH) have heightened heart failure risk. Plasma OPN (osteopontin) is a powerful predictor of heart failure outcomes in the general population. Limited data exist on relationships between plasma OPN and surrogates of HIV-associated heart failure risk. DESIGN: Prospective, cross-sectional. METHODS: We analyzed relationships between plasma OPN and cardiac structure/function (assessed using cardiovascular magnetic resonance imaging) and immune activation (biomarkers and flow cytometry) among 20 WWH and 14 women without HIV (WWOH). RESULTS: Plasma OPN did not differ between groups. Among WWH, plasma OPN related directly to the markers of cardiac fibrosis, growth differentiation factor-15 (ρâ=â0.51, Pâ=â0.02) and soluble interleukin 1 receptor-like 1 (ρâ=â0.45, Pâ=â0.0459). Among WWH (but not among WWOH or the whole group), plasma OPN related directly to both myocardial fibrosis (ρâ=â0.49, Pâ=â0.03) and myocardial steatosis (ρâ=â0.46, Pâ=â0.0487). Among the whole group and WWH (and not among WWOH), plasma OPN related directly to the surface expression of C-X3-C motif chemokine receptor 1 (CX3CR1) on nonclassical (CD14-CD16+) monocytes (whole group: ρâ=â0.36, Pâ=â0.04; WWH: ρâ=â0.46, Pâ=â0.04). Further, among WWH and WWOH (and not among the whole group), plasma OPN related directly to the surface expression of CC motif chemokine receptor 2 (CCR2) on inflammatory (CD14+CD16+) monocytes (WWH: ρâ=â0.54, Pâ=â0.01; WWOH: ρâ=â0.60, Pâ=â0.03), and in WWH, this held even after controlling for HIV-specific parameters. CONCLUSION: Among WWH, plasma OPN, a powerful predictor of heart failure outcomes, related to myocardial fibrosis and steatosis and the expression of CCR2 and CX3CR1 on select monocyte subpopulations. OPN may play a role in heart failure pathogenesis among WWH. CLINICALTRIALSGOV REGISTRATION: NCT02874703.
Assuntos
Infecções por HIV , Insuficiência Cardíaca , Humanos , Feminino , Osteopontina/metabolismo , Estudos Transversais , Estudos Prospectivos , Infecções por HIV/complicações , Fibrose , Receptores de Quimiocinas , Monócitos/metabolismoRESUMO
BACKGROUND: Synovial fluid alpha-defensin (AD) may improve diagnostic accuracy of periprosthetic joint infection (PJI) following total knee (TKA) and hip (THA) arthroplasty but is only available as send-out test. This study evaluated laboratory result accuracy between send-out test vs hospital labs and if AD made a difference in treatment plan. METHODS: A retrospective review was performed of 152 consecutive patients with a TKA or THA joint aspiration for painful or clinically concerning joint. Synovial fluid was sent to our institution (hospital-based labs, HBL) and send-out immunoassay laboratory (Synovasure). Patients were scored with specific criteria from validated scoring system for PJI using HBL and Synovasure results. The score with and without AD test was compared to determine if AD impacted patient management. RESULTS: Overall, there was strong agreement between institutions for PJI diagnosis (Cohen's kappa score 0.96). Twenty-nine patients had PJI diagnosis (score ≥6), of which 28 (97%) had positive AD with 1 false-negative result. Sixty-three patients had inconclusive score (between 2 and 5) and 60 patients had negative PJI diagnosis (score ≤1). Of these patients, 5 underwent surgery for infection. Two patients had surgery for positive AD, 2 for positive culture, and 1 because of elevated HBL results. The AD test changed the PJI diagnosis and influenced decision for surgery in only 1.3% (2/152) of patients. CONCLUSION: Minimal differences were found in laboratory values between institutions. The addition of AD may be useful in cases of equivocal laboratory results but does not appear to be necessary for routine diagnosis of PJI after TKA/THA. LEVEL EVIDENCE: Level III.
Assuntos
Artroplastia de Quadril , Artroplastia do Joelho , Infecções Relacionadas à Prótese , alfa-Defensinas , Biomarcadores , Humanos , Infecções Relacionadas à Prótese/cirurgia , Estudos Retrospectivos , Sensibilidade e Especificidade , Líquido SinovialRESUMO
BACKGROUND: Alpha-defensin (AD) is a synovial biomarker included as a minor criterion in the scoring system for diagnosing periprosthetic joint infection (PJI). The purpose of this study is to study the impact of AD on diagnosis and management of PJI. METHODS: Synovial fluid from 522 patients after total knee and hip arthroplasty was retrospective reviewed. Synovial white blood cell count, percentage of neutrophils, and culture from the AD immunoassay laboratory were reviewed with serum erythrocyte sedimentation rate and C-reactive protein values from our institution. A modified version of the 2018 scoring system for diagnosis of PJI was used, only scoring white blood cell count, percentage of neutrophils, erythrocyte sedimentation rate, and C-reactive protein. AD was then analyzed with these scores to determine if AD changed diagnostic findings or clinical management. RESULTS: Eight-two patients were categorized as "infected" (score ≥6), of which 76 patients had positive AD. Of the 6 "infected" patients with negative AD, 2 had positive cultures (Staphylococcus epidermidis). Two-hundred thirteen patients were diagnosed as "possibly infected" (score 2-5). Fourteen of these patients had positive AD, of which 5 had positive cultures assisting with the diagnosis. The AD test changed the diagnosis from "possibly infected" to "infected" in 8 patients (1.5%) but only altered treatment plan in 6 patients (1.1%). A score <2 (not infected) was calculated in 227 patients with no patients having positive AD. CONCLUSION: AD may be beneficial in some cases where laboratory values are otherwise equivocal; however, its routine use for the diagnosis of PJI may not be warranted.
Assuntos
Artroplastia de Quadril , Artroplastia do Joelho , Infecções Relacionadas à Prótese , alfa-Defensinas , Artroplastia de Quadril/efeitos adversos , Artroplastia do Joelho/efeitos adversos , Biomarcadores , Proteína C-Reativa/análise , Humanos , Infecções Relacionadas à Prótese/diagnóstico , Infecções Relacionadas à Prótese/cirurgia , Estudos Retrospectivos , Sensibilidade e Especificidade , Líquido Sinovial/químicaRESUMO
BACKGROUND: Spinopelvic pathology has been identified as a potential risk factor for instability after total hip arthroplasty. Spinopelvic radiographic parameters used to diagnose spinopelvic disease may also impact optimal cup placement. The purpose of this study was to assess the arthroplasty surgeon accuracy in making spinopelvic measurements. METHODS: Five fellowship-trained or in-training arthroplasty surgeons reviewed 44 lateral lumbar radiographs in two sessions. All evaluators were instructed how to perform measurements but had little experience in doing so. Traditional measurements included the pelvic tilt (PT), pelvic incidence (PI), and sacral slope (SS), and novel measurements included the acetabular ante-inclination (AI) and pelvic femoral angle. Surgeon measurements were compared with those made by experienced engineers. intraclass coefficients (ICCs) were calculated and interpreted. RESULTS: The interobserver reliability for 4 of 5 of the spinopelvic parameters was good to excellent (ICC >0.75) with the highest reliability seen for PI measurement (ICC = 0.939). Only moderate interobserver reliability was observed for AI measurement (ICC = 0.559). Intraobserver reliability was the highest for the PI and SS, ranging from moderate to good (ICC, 0.718 to 0.896). The lowest intraobserver reliability was seen for the AI (ICC range, 0.026 to 0.545) and pelvic femoral angle (ICC range, 0.035 to 0.828). Surgeon measurements of PT and SS were compared with engineer measurements with extremely poor correlation observed (ICC <0 for all). CONCLUSION: Surgeon intraobserver and interobserver reliability in making novel radiographic measurements was low compared with traditional radiographic measurements. Surgeon reliability in making traditional measurements of the PT and SS was very poor compared with experienced assessors using software-based measurements.
Assuntos
Artroplastia de Quadril , Acetábulo , Humanos , Radiografia , Reprodutibilidade dos Testes , SacroRESUMO
Panel data from married adults (N = 1,853) in the General Social Survey, a probability sample of the adult household population of the United States, were used to evaluate (a) the longitudinal association between extramarital sex and marital dissolution 2 years later, (b) whether probability of marital dissolution differed as a function of the type of relationship people reported having with their extramarital sex partner, and (c) the degree to which these associations were incremental to participants' level of marital satisfaction at baseline. Compared to people who reported not engaging in extramarital sex, those who reported engaging in extramarital sex at baseline were significantly more likely to be separated or divorced 2 years later. Furthermore, the association between having extramarital sex with a close personal friend and marital dissolution was particularly strong. These associations remained statistically significant after adjusting for marital satisfaction. Results suggest that the identity of the extramarital sex partner and the type of relationship a person has with him or her has important implications for probability of marital dissolution above and beyond the contribution of marital satisfaction.
Se utilizaron los datos de panel de adultos casados (N = 1,853) de la Encuesta Social General (General Social Survey), una muestra probabilística de la población de hogares de adultos de los Estados Unidos, para evaluar (a) la asociación longitudinal entre las relaciones sexuales extramatrimoniales y el divorcio dos años después, (b) si la probabilidad de divorcio difirió como una función del tipo de relación que las personas informaron tener con su pareja de relaciones sexuales extramatrimoniales y (c) el grado en el cual estas asociaciones aumentaron según el nivel de satisfacción matrimonial de los participantes al inicio del estudio. En comparación con las personas que informaron no tener relaciones sexuales extramatrimoniales, aquellos que sí informaron tener relaciones extramatrimoniales al comienzo del estudio tuvieron muchas más probabilidades de estar separados o divorciados dos años después. Además, la asociación entre tener relaciones sexuales extramatrimoniales con un amigo íntimo personal y el divorcio fue particularmente fuerte. Estas asociaciones continuaron siendo estadísticamente significativas después de ajustar teniendo en cuenta la satisfacción conyugal. Los resultados sugieren que la identidad de la pareja extramatrimonial y el tipo de relación que una persona tiene con ella repercuten considerablemente en la probabilidad de divorcio más allá del aporte de la satisfacción matrimonial.
Assuntos
Divórcio/psicologia , Relações Extramatrimoniais/psicologia , Parceiros Sexuais/psicologia , Identificação Social , Cônjuges/psicologia , Adulto , Características da Família , Feminino , Humanos , Estudos Longitudinais , Masculino , Pessoa de Meia-Idade , Estudos de Amostragem , Estados UnidosRESUMO
This longitudinal study was conducted to evaluate actor and partner effects of marital discord on changes in symptoms of depression and generalized anxiety disorder (GAD) in a large population sample of Irish adults (N = 1,445 couples), adjusting for the potential confounds of quality of other social relationships and other psychopathology symptoms. The Actor-Partner Interdependence Model was used to examine actor and partner effects of marital discord on changes in symptoms of depression and GAD at a 2-year follow-up. Additional models examined these associations adjusting for family and friend discord and symptoms of the other type of psychopathology (depressive or GAD symptoms). Actor effects of marital discord on depressive and anxiety symptoms were greater for men than for women. There were significant, positive actor effects of marital discord on depressive symptoms for husbands and wives, which remained significant when adjusting for family and friend discord and GAD symptoms. There were significant, positive actor effects of marital discord on GAD symptoms for husbands, which remained significant when adjusting for family and friend discord and depressive symptoms. Results demonstrate that longitudinal associations between marital discord and depressive symptoms (for wives and husbands) and GAD symptoms (for husbands) are incremental to other rival explanations (family and friend discord and the other set of symptoms). Findings provide evidence for a potential causal association leading from marital discord to symptoms of depression and GAD.
Assuntos
Transtornos de Ansiedade/psicologia , Depressão/psicologia , Conflito Familiar/psicologia , Casamento/psicologia , Cônjuges/psicologia , Adulto , Envelhecimento/psicologia , Feminino , Amigos/psicologia , Humanos , Irlanda , Estudos Longitudinais , Masculino , Questionário de Saúde do Paciente , Sensibilidade e EspecificidadeRESUMO
The world's oceans are a global reservoir of persistent organic pollutants to which humans and other animals are exposed. Although it is well known that these pollutants are potentially hazardous to human and environmental health, their impacts remain incompletely understood. We examined how persistent organic pollutants interact with the drug efflux transporter P-glycoprotein (P-gp), an evolutionarily conserved defense protein that is essential for protection against environmental toxicants. We identified specific congeners of organochlorine pesticides, polychlorinated biphenyls, and polybrominated diphenyl ethers that inhibit mouse and human P-gp, and determined their environmental levels in yellowfin tuna from the Gulf of Mexico. In addition, we solved the cocrystal structure of P-gp bound to one of these inhibitory pollutants, PBDE (polybrominated diphenyl ether)-100, providing the first view of pollutant binding to a drug transporter. The results demonstrate the potential for specific binding and inhibition of mammalian P-gp by ubiquitous congeners of persistent organic pollutants present in fish and other foods, and argue for further consideration of transporter inhibition in the assessment of the risk of exposure to these chemicals.
Assuntos
Subfamília B de Transportador de Cassetes de Ligação de ATP/química , Monitoramento Ambiental , Conformação Proteica/efeitos dos fármacos , Poluição Química da Água , Subfamília B de Transportador de Cassetes de Ligação de ATP/metabolismo , Animais , Sítios de Ligação , Cristalografia por Raios X , Éteres Difenil Halogenados/química , Éteres Difenil Halogenados/toxicidade , Humanos , Hidrocarbonetos Clorados/química , Hidrocarbonetos Clorados/toxicidade , México , Camundongos , Oceanos e Mares , Praguicidas/química , Praguicidas/toxicidade , Atum/metabolismoRESUMO
Risk analysis is increasingly promoted as a tool to support science-based decisions regarding food safety. An online survey comprising 45 questions was used to gather information on the implementation of food safety risk analysis within the Latin American and Caribbean regions. Professionals working in food safety in academia, government, and private sectors in Latin American and Caribbean countries were contacted by email and surveyed to assess their individual knowledge of risk analysis and perceptions of its implementation in the region. From a total of 279 participants, 97% reported a familiarity with risk analysis concepts; however, fewer than 25% were able to correctly identify its key principles. The reported implementation of risk analysis among the different professional sectors was relatively low (46%). Participants from industries in countries with a long history of trade with the United States and the European Union, such as Mexico, Brazil, and Chile, reported perceptions of a higher degree of risk analysis implementation (56, 50, and 20%, respectively) than those from the rest of the countries, suggesting that commerce may be a driver for achieving higher food safety standards. Disagreement among respondents on the extent of the use of risk analysis in national food safety regulations was common, illustrating a systematic lack of understanding of the current regulatory status of the country. The results of this survey can be used to target further risk analysis training on selected sectors and countries.