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BACKGROUND: The CDC and ACIP recommend COVID-19 vaccination for patients with inborn errors of immunity (IEI). Not much is known about vaccine safety in IEI, and whether vaccination attenuates infection severity in IEI. OBJECTIVE: To estimate COVID-19 vaccination safety and examine effect on outcomes in patients with IEI. METHODS: We built a secure registry database in conjunction with the US Immunodeficiency Network to examine vaccination frequency and indicators of safety and effectiveness in IEI patients. The registry opened on January 1, 2022, and closed on August 19, 2022. RESULTS: Physicians entered data on 1245 patients from 24 countries. The most common diagnoses were antibody deficiencies (63.7%). At least one COVID-19 vaccine was administered to 806 patients (64.7%), and 216 patients received vaccination prior to the development of COVID-19. The most common vaccines administered were mRNA-based (84.0%). Seventeen patients were reported to seek outpatient clinic or emergency room care for a vaccine-related complication, and one patient was hospitalized for symptomatic anemia. Eight hundred twenty-three patients (66.1%) experienced COVID-19 infection. Of these, 156 patients required hospitalization (19.0%), 47 required ICU care (5.7%), and 28 died (3.4%). Rates of hospitalization (9.3% versus 24.4%, p

IntroductionMeaningful engagement of partners in co-creating and refining health-related programs can increase the initial uptake, sustained implementation, broad reach, and effectiveness of these programs. This is especially important for underserved communities where resources are limited and need to be prioritized. Brainwriting premortem is a novel qualitative approach to partner engagement that combines the strengths of individual idea generation with the concept of premortem exercise that addresses failure points prior to the implementation of new programs.MethodsAn adapted form of brainwriting premortem was used to inform iterative refinements to a COVID-19 testing program at a Federally Qualified Health Center (FQHC) in San Diego. Patients and providers from the FQHC participated in interviews at two time points (early- and mid-implementation of the program). Interview data were transcribed, translated, and analyzed using a rapid qualitative approach. Key themes and sub-themes were identified and used to inform refinements to the program.ResultsA total of 11 patients (7 Spanish- and 4 English-speaking) and 8 providers participated in the brainwriting premortem interviews. Key themes related to possible reasons for COVID-19 testing program failure: advertising/sharing information; access to testing; handling of test results; staff and patient safety; patient beliefs and views regarding the SARS-CoV-2 virus; and COVID-19 testing options offered. Proposed solutions were offered for the key failures except for patient beliefs and views regarding the SARS-CoV-2 virus. Additional solutions offered were related to education, physical operations, and recruitment strategies. Real-time changes to the program flow and components were made in response to 7 suggestions from patients and 11 from providers. Changes related to the process of returning results were the most common, and included sending results via email with distinct workflows based on the test result.ConclusionThe implementation of the adapted brainwriting premortem technique allowed us to incorporate the perspective of key partners in the delivery and iterative refinement of the COVID-19 testing program. This was an effective tool in the context of an FQHC and can be a promising and approach to incorporate iterative input from patients and providers to ensure successful program implementation. Future studies, particularly those requiring rapid response to public health emergencies, should consider the use of this technique.

Solar PV irrigation system (SPIS) has proven its potential to impact the agricultural sector. It is known for producing zero GHG emissions, and recent studies have proved its effectiveness compared to fuel-based pumps. However, some factors affecting its operations and economic viability that require further study. This study assessed the viability and sustainability of SPIS for providing rice irrigation in the province of Sorsogon, Philippines. Our objectives were to a) identify the optimal deployment locations, b) determine the most effective energy system configurations for rice irrigation, and c) assess the impact on achieving SDGs. Analysis showed that 17% of the province's total land area is suitable for SPIS deployment. A one-hectare land requires 3.302 kWh of energy per day and a water pump with a peak power of 1.1 kW. The optimal energy configuration provided an annual energy of 8,547 kWh from the Solar PV system and an additional 119 kWh delivered by the diesel generator. This setup demonstrates the lowest net present cost (NPC) of ₱ 1,079,642 and the lowest levelized cost of electricity (LCOE) of ₱ 17.79/kWh. A future SPIS project was assessed to have 27 possible synergies and 3 tradeoffs that impact achieving sustainable development goals (SDGs). The participation of stakeholders, along with local farmers, in discussions about adapting SPIS projects will help ensure the sustainability of the application and the acceptance of the technology. The findings of this study introduced new insights and understanding of the critical aspects of solar PV irrigation system applications.

Introduction: This mixed methods study describes processes to actively engage underserved, immigrant, and refugee communities in COVID-19 vaccine efforts to co-create culturally relevant resources and dissemination.Methods: A survey on health care characteristics and COVID-19 attitudes was deployed between March-November 2021 followed by listening sessions conducted in December 2021. All participants were recruited through the project's Community Advisory Board. The survey, completed by 77 adults, was available in English, Spanish, Burmese, Kizigua, and Karen. Listening sessions were led by trained, multilingual, and multicultural interviewers.Results: Doctors/healthcare providers were rated as the most trusted messengers of COVID-19 information, however, trusted sources varied across communities. Data from three listening sessions (with a total of 14 participants) expanded survey findings with a focus on trusted sources of COVID-19 communication.Conclusions: This study confirmed the importance of healthcare professionals as trusted messengers for COVID-19 information among underserved communities. Qualitative data highlighted the importance of schools, ethnically-based community organizations, and friends/family with health and English literacy skills for immigrant and refugee communities. Findings suggest opportunities for collaboration with specific trusted sources for future public health dissemination efforts.Trial registration: not applicable.

Abstract Background The concept of quality in health care has evolved, placing greater importance on the patient’s needs, culture, and social context, as well as their participation in clinical decision-making, as highlighted by Mead and Bower’s Person-Centered Care Model. The aim of the present study was to design and validate an instrument to assess the extent to which healthcare services provided by PEMEX (Petróleos Mexicanos) offer person-centered care according to user perceptions. Methods The first phase comprised the development of 57 items based on the analysis of responses from an open-ended questionnaire administered to 30 users of Pemex healthcare services. This questionnaire was designed considering the four factors of the person-centered care model, however, the high correlation between the 4 factors (i.e., r ≥ .80) indicated an overfactoring effect and consequently an increase in the risk of overfitting. Therefore, an exhaustive analysis of the instrument was performed, starting with the review of the individual behavior of each item, and carrying out exploratory and confirmatory factor analysis. Using a sample of 330 individuals, an exploratory factor analysis was perfomed. Afterward, a confirmatory factorial analysis was carried out with 335 participants. Finally, a new confirmatory factorial analysis included 130 participants due to the refinements made in the previous phase. Internal consistency was assessed using Cronbach’s α and McDonald’s ω at every phase. Results The exploratory factor analysis retained 35 items in a single factor that accounted for 49% of the variance with an internal consistency of Cronbach’s α and McDonald’s ω = 0.97. Because the factorial structure by confirmatory factorial analysis was unsatisfactory, the initial model was refined, leading to the retention of 11 items and a final model with adjustment index of χ2 = 127.53, χ2/gl = 2.89, RMSEA = 0.07, IC RMSEA 0.06 to 0.09, TLI = 0.95 and CFI = 0.96, with an internal consistency of Cronbach’s α and McDonald’s ω = 0.93. Due to the refinements, a new confirmatory factorial analysis was conducted with suitable goodness-of-fit criteria in most items (χ2 = 151.44, χ2/gl = 3.43, RMSEA = 0.13, IC RMSEA 0.11 to 0.16, TLI = 0.93 and CFI = 0.94), resulting in a Cronbach’s α and McDonald’s ω = 0.98. Conclusions The instrument exhibits suitable psychometric properties to be employed to measure the degree to which medical care is patient centered. This instrument represents a strategy for promoting an innovative healthcare model.

Abstract Background DNA is an important target for oxidative attack and its modification may increase the risk of mutagenesis. The aim of this study was to evaluate and compare salivary levels of the oxidative stress biomarker 8-hydroxy-2′-deoxyguanosine (8-OHdG) in patients with oral cancer (OC) compared to the control group by a comprehensive search of the available literature. Methods The present systematic review and meta-analysis followed the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines and was registered in Open Science Framework (OSF): https://doi.org/10.17605/OSF.IO/X3YMR. Four electronic databases were used to identify studies for this systematic review: PubMed, Scopus, ScienceDirect, and Web of Science from January 15, 2005, to April 15, 2021. The Joanna Briggs Institute (JBI) tool was used to assess article quality. Results Of the 166 articles identified, 130 articles were excluded on the basis of title and abstract screening (duplicates, reviews, etc.). Thirty-six articles were evaluated at full text and 7 articles met the inclusion criteria. Of these, only 5 studies had compatible data for quantitative analysis. An increase in salivary 8-OHdG levels was found in patients with OC compared to healthy subjects, but without statistical significance. 8-OHdG: SMD = 2,72 (95%CI= -0.25–5.70); *p = 0.07. Conclusions This systematic review and meta-analysis suggests a clear trend of increased 8-OHdG levels in saliva of OC patients compared to the control group. However, further studies are required to clarify and understand the altered levels of this oxidative stress marker.

BackgroundMultisystem inflammatory syndrome in children (MIS-C), a hyperinflammatory condition associated with SARS-CoV-2 infection, has emerged as a serious illness in children worldwide. Immunoglobulin or glucocorticoids, or both, are currently recommended treatments.MethodsThe Best Available Treatment Study evaluated immunomodulatory treatments for MIS-C in an international observational cohort. Analysis of the first 614 patients was previously reported. In this propensity-weighted cohort study, clinical and outcome data from children with suspected or proven MIS-C were collected onto a web-based Research Electronic Data Capture database. After excluding neonates and incomplete or duplicate records, inverse probability weighting was used to compare primary treatments with intravenous immunoglobulin, intravenous immunoglobulin plus glucocorticoids, or glucocorticoids alone, using intravenous immunoglobulin as the reference treatment. Primary outcomes were a composite of inotropic or ventilator support from the second day after treatment initiation, or death, and time to improvement on an ordinal clinical severity scale. Secondary outcomes included treatment escalation, clinical deterioration, fever, and coronary artery aneurysm occurrence and resolution. This study is registered with the ISRCTN registry, ISRCTN69546370.FindingsWe enrolled 2101 children (aged 0 months to 19 years) with clinically diagnosed MIS-C from 39 countries between June 14, 2020, and April 25, 2022, and, following exclusions, 2009 patients were included for analysis (median age 8·0 years [IQR 4·2-11·4], 1191 [59·3%] male and 818 [40·7%] female, and 825 [41·1%] White). 680 (33·8%) patients received primary treatment with intravenous immunoglobulin, 698 (34·7%) with intravenous immunoglobulin plus glucocorticoids, 487 (24·2%) with glucocorticoids alone; 59 (2·9%) patients received other combinations, including biologicals, and 85 (4·2%) patients received no immunomodulators. There were no significant differences between treatments for primary outcomes for the 1586 patients with complete baseline and outcome data that were considered for primary analysis. Adjusted odds ratios for ventilation, inotropic support, or death were 1·09 (95% CI 0·75-1·58; corrected p value=1·00) for intravenous immunoglobulin plus glucocorticoids and 0·93 (0·58-1·47; corrected p value=1·00) for glucocorticoids alone, versus intravenous immunoglobulin alone. Adjusted average hazard ratios for time to improvement were 1·04 (95% CI 0·91-1·20; corrected p value=1·00) for intravenous immunoglobulin plus glucocorticoids, and 0·84 (0·70-1·00; corrected p value=0·22) for glucocorticoids alone, versus intravenous immunoglobulin alone. Treatment escalation was less frequent for intravenous immunoglobulin plus glucocorticoids (OR 0·15 [95% CI 0·11-0·20]; p

En México, la llegada de la covid-19 afectó la participación laboral de la mayoría de la población. A propósito de ese fenómeno, con este artículo se busca medir los niveles de desajuste educativo –por sobreducación y subeducación– antes y después del cierre de actividades decretado ante la pandemia. Se revisan los cambios en el ajuste educativo entre el primer trimestre de 2020 y el tercero del mismo año, sumando además el primer trimestre de 2021. La atención se centra en si se modificaron los perfiles sociodemográficos y si esto implicó cambios en las condiciones de los desajustados, o si bien estos fueron producto de la crisis. Para el análisis se utilizan la Encuesta Nacional de Ocupación y Empleo y modelos multinomiales sobre la probabilidad de insertarse en algún tipo de inadecuación educativa con una base agrupada para cinco ediciones de la encuesta a fin de establecer los cambios en el tiempo. Los resultados muestran que se registra un aumento de alrededor de 0,5 % de sobreducación en la población ocupada total, si se consideran las características sociodemográficas y de inserción laboral. Del mismo modo, se reflejan diferencias entre los empleos informales y los formales en términos de cómo ocurren estos cambios, pues los primeros se inician con incrementos, mientras en los segundos esto se da en el mediano plazo.

Abstract This study explores the impact of the COVID-19 pandemic on Memorial University of Newfoundland (MUN) undergraduate and graduate students. Using the National College Health Assessment (third revision) (NCHA-III) survey, the relationship between COVID-related stressors and mental health was assessed after controlling for demographic, economic, and academic variables, and reported mental illness. A hierarchical regression revealed that psychological distress was higher for students who were undergraduate, female, of lower family income, with a pre-existing anxiety or depressive disorder. Psychological distress was also predicted by direct COVID stressors (e.g., fear of infection), as well as indirect stressors, including worries about employment and tuition, professor/instructor support, campus efforts to ensure safety, and discrimination/hostility due to race/ethnicity. Chi Square tests subsequently revealed that graduate students were more likely to be concerned about the threat COVID-19 posed to loved ones, separation from family/friends, and pandemic duration, while undergraduates were more likely concerned about returning to school, tuition, employment, and the legitimacy of their degree. Undergraduates were also more likely to have witnessed discrimination/hostility, and less likely to report professor/instructor support. Finally, independent t tests revealed that undergraduate students were significantly lower in overall social support, as well as for particular subdomains including ‘guidance’, ‘social integration’, and ‘reassurance of worth’. Interpretation of the findings and implications are considered.

Agri-environmental schemes (AES) implemented by farmer collectives for meadow bird protection in The Netherlands create complex landscape mosaics due to the variability of options and combinations farmers use. We propose a method to simplify this complexity, using the number of meadow birds potentially benefiting as the measure of success, and evaluate how AES combinations affect management success as a function of monetary investments. Between 2016 and 2022, we conducted field surveys to measure the density and distribution of Black-tailed Godwits across three land-use types: AES, site-protected areas, and intensive agriculture. AES fields were categorized into nest protection, inundation, delayed mowing, and herb-rich grasslands. We analysed the relationship between these managements, the area they cover, and godwit numbers, while also examining land area and subsidies. Intensive agriculture covered 74.3 % of the area but hosted only 23.2 % of the godwit population at low densities (0.063 godwits/ha). In contrast, protected areas (6.2 % of the area) and AES fields (19.5 %) supported 24.7 % and 52.1 % of the population at higher densities (0.48 and 0.46 godwits/ha, respectively). Among AES types, delayed mowing and herb-rich grasslands showed the highest godwit densities (0.66 and 1.25 godwits/ha, respectively) covering smaller areas (6 % and 1.1 %). These AES types pay the highest subsidies, while nest protection, covering 10.5 % of the area with lower godwit densities, pays the lowest. Although AES fields hosted about half of the godwit population, area-wise the focus remained on nest protection, and with intensive agriculture dominated the landscape. This may limit effectiveness at a population level, calling for re-evaluating conservation priorities and funding.

BackgroundCOVID-19 vaccine uptake has been uneven, particularly across racial/ethnic and age groups. This study seeks to understand factors associated with COVID-19 vaccine uptake in a large cross-sectional sample of predominantly Latinos/Latinas individuals living near the US/Mexico border.MethodsData are extracted from a 176-item survey conducted as part of a parent study focused on the co-creation of a COVID-19 testing program for underserved communities developed through a partnership between an academic institution and a Federally Qualified Health Center. The following participant variables were examined: health history, COVID-19 symptoms, COVID-19 testing and vaccine experiences, and perceptions of sources of health information. Participant characteristics were compared using chi-square tests. Multivariate logistic regressions were used for the final statistical model.ResultsFrom 1 May 2021 to 30 April 2022, 4,964 adults, 66% of whom were identified as women, completed the survey. Approximately 80% of participants reported having received at least one COVID-19 vaccine. Female sex, older age, Hispanic/Latino(a) ethnicity, previous influenza vaccination, advanced education, and perceived elevated risk of COVID-19 were significantly (p < 0.05) associated with having received a COVID-19 vaccine. Regarding sources of health information, individuals who indicated they trust their doctor, healthcare provider, or the US government "a great deal" were more likely to have received a COVID-19 vaccine compared to individuals who indicated that they trusted these sources "not at all." In contrast, those who reported having "a great deal" of trust in their faith leader or their social media contacts were significantly less likely to have received a COVID-19 vaccine than those who reported that they trusted these sources "not at all."ConclusionSex, education, past influenza vaccination, perceived risk of COVID-19 infection, and trust in specific sources of information were correlated with the uptake of COVID-19 vaccination. Additional research is needed to better understand why this confluence of factors, particularly the unique findings about trusted sources of information, are associated with vaccine uptake. Understanding these associations, specifically within underserved, Latino/Hispanic communities, is an important first step to inform efforts aimed at increasing and sustaining COVID-19 vaccine uptake and adoption of other public health interventions.

We report for the first time multitrophic interaction among Thamnophis sumichrasti (Squamata, Natricidae), Isthmura gigantea (Caudata, Plethodontidae), and Megacormus gerstchi (Scorpiones, Euscorpiidae), three endemic, rare and endangered species that inhabit cloud forests and pine-oak forests from Sierra Madre Oriental in México, which provides novel data on their natural history and distribution.

Abstract Introduction The frequency of mother-to-child transmission (MTCT) of human immunodeficiency virus (HIV) in Latin America has decreased considerably. However, new infections continue to be recorded, and the pediatric population remains one of the most vulnerable groups in this region. The main objective of the study was to describe the clinical, epidemiological and psychosocial characteristics of new diagnoses of HIV MTCT in 2018 in the PLANTAIDS network (Paediatric Network for Prevention, Early Detection and Treatment of HIV in Children) during the 3 years following diagnosis. Methodology Retrospective, multicenter, descriptive study based on a 3-year follow-up of patients diagnosed with HIV infection due to MTCT in 2018 in 10 hospitals in 8 Latin American countries (Costa Rica, Ecuador, Mexico, Honduras, El Salvador, Panama, Guatemala and Venezuela). The hospitals belonged to the PLANTAIDS network, which is included in CYTED (Ibero-American Programme of Science and Technology for Development). Results The study population comprised 72 pediatric patients (38.9% male). The median age at diagnosis was 2.4 years (IQR: 0.8–5.4). There were 35 cases of opportunistic infections corresponding to 25 patients (34.7%), with tuberculosis being the most common. Adequate childhood vaccination coverage was achieved in 80.5%. There were 3 cases of acute SARS-CoV-2 infection, and these were asymptomatic or mildly symptomatic. According to the Centers for Disease Control and Prevention (CDC) classification, the most frequent clinical-immunological stage at all check-ups was C1. Three patients died from opportunistic infections and/or advanced HIV infection. Conclusions It is important to diagnose HIV infection early in pediatrics, since early initiation of ART is associated with a decrease in mortality. Despite this, HIV infection has a poor prognosis in children, necessitating adequate follow-up to ensure adherence to health care and ART, although it can sometimes prove difficult in children.

Neighbor discovery (ND) is crucial in deploying wireless sensor networks. Despite the considerable research on ND, most studies focus on networks composed of only two nodes. However, for cases in which more than two nodes are involved, the probability of collision increases, potentially preventing a node from discovering all its neighbors. This problem is especially aggravated for ND protocols that exhibit periodic behaviors that can lead to recurring collisions. This behavior is typical of deterministic ND protocols, in which its inherent operation forces regular on/off patterns and cyclical collisions. To address this problem, this paper introduces AMIND, a new middleware capable of disrupting the cyclic behavior of deterministic ND protocols. It achieves this goal by introducing random shifts in their operation, significantly increasing the number of nodes discovered compared to the existing ND protocols. As a result, AMIND allows a node to discover unknown neighbors after each shift. Simulation results show that the proposed middleware enhances node discoveries that previous ND protocols can achieve, even in scenarios with high collision rates.

Abstract Introduction Meaningful engagement of partners in co-creating and refining health-related programs can increase the initial uptake, sustained implementation, broad reach, and effectiveness of these programs. This is especially important for underserved communities where resources are limited and need to be prioritized. Brainwriting premortem is a novel qualitative approach to partner engagement that combines the strengths of individual idea generation with the concept of premortem exercise that addresses failure points prior to the implementation of new programs. Methods An adapted form of brainwriting premortem was used to inform iterative refinements to a COVID-19 testing program at a Federally Qualified Health Center (FQHC) in San Diego. Patients and providers from the FQHC participated in interviews at two time points (early- and mid-implementation of the program). Interview data were transcribed, translated, and analyzed using a rapid qualitative approach. Key themes and sub-themes were identified and used to inform refinements to the program. Results A total of 11 patients (7 Spanish- and 4 English-speaking) and 8 providers participated in the brainwriting premortem interviews. Key themes related to possible reasons for COVID-19 testing program failure: advertising/sharing information; access to testing; handling of test results; staff and patient safety; patient beliefs and views regarding the SARS-CoV-2 virus; and COVID-19 testing options offered. Proposed solutions were offered for the key failures except for patient beliefs and views regarding the SARS-CoV-2 virus. Additional solutions offered were related to education, physical operations, and recruitment strategies. Real-time changes to the program flow and components were made in response to 7 suggestions from patients and 11 from providers. Changes related to the process of returning results were the most common, and included sending results via email with distinct workflows based on the test result. Conclusion The implementation of the adapted brainwriting premortem technique allowed us to incorporate the perspective of key partners in the delivery and iterative refinement of the COVID-19 testing program. This was an effective tool in the context of an FQHC and can be a promising and approach to incorporate iterative input from patients and providers to ensure successful program implementation. Future studies, particularly those requiring rapid response to public health emergencies, should consider the use of this technique.

Oral cancer holds the sixth position in malignancies worldwide; 90% correspond to oral squamous cell carcinoma (OSCC). Diverse reports suggest that NTRK genes and their receptors are key oncogenesis regulators to tumor progression in human cancers. Objective: To analyze the NTRK and Trk expression and their association with clinicopathological features of OSCC in Mexican patients’ samples. Material and Methods: We analyzed 95 OSCC cases of pan-trk immunoexpression through a software-assisted method. Gene expression was analyzed by RT-qPCR employing the ΔΔCT method. Kruskal–Wallis and Spearman’s correlation tests were performed. Results: Our mean age was 62.4 (±16.9) years. A total of 37 cases were tumors in the lateral border of the tongue. Age was significantly associated with the anatomical site. 42% (40 of 95) cases were pan-trk positive. A total of 21 cases showed intense immunoexpression predominantly in poorly differentiated OSCC, with a significant correlation between immunoexpression and age and gender. Gene expression showed that poorly differentiated cases exhibited higher NTRK2 expression, while well-differentiated cases demonstrated NTRK3 significantly higher expression. Conclusions: Our results suggest that NTRK family expression is present in OSCC, with differential expression related to differentiation degree. Additional information about their activation or mutational status could reinforce their potential as a possible primary or adjuvant treatment target.

El año 2024 nos invita a reflexionar sobre el futuro demográfico de nuestra región y del mundo en su conjunto. Se observa una disminución del crecimiento poblacional y de la fecundidad, un incremento de la migración internacional e intrarregional y un cambio en la estructura poblacional que apunta hacia un envejecimiento permanente de la población. A ello se agrega que las condiciones socioeconómicas siguen apremiantes ante los aumentos inflacionarios, la presencia de conflictos internacionales que cuestionan acuerdos multilaterales y gobernanzas mundiales, retrocesos en algunas luchas por derechos reproductivos, así como las inestabilidades políticas de la región y la continuidad de desigualdades. En un contexto de cambios rápidos y desafíos complejos, la demografía se consolida como una disciplina fundamental para comprender y abordar las transformaciones que enfrentamos, así como ofrecer ideas valiosas para la formulación de políticas en materia de población. En este contexto, la Revista Latinoamericana de Población (RELAP) se enorgullece de mantenerse como un espacio de encuentro y debate para la comunidad demográfica latinoamericana y caribeña. Llegamos al volumen 18 con 31 números publicados, 218 rtículos desde 22 países. Este volumen presenta una selección de investigaciones innovadoras que abordan una amplia gama de temas demográficos. Cada artículo contribuye al avance de nuestro conocimiento sobre la dinámica demográfica de nuestra región. El compromiso con la difusión de la investigación demográfica de alta calidad, la promoción del diálogo interdisciplinario y el intercambio de conocimiento sigue siendo más relevante que nunca. Sin duda, las voces que se encuentran en este recorrido nos ayudan a analizar los nuevos retos. Nos gustaría expresar nuestro sincero agradecimiento a quienes han contribuido al éxito de RELAP, incluyendo a nuestro Comité editorial, Consejo editorial, autores(as), dictaminadores(as) y lectores(as). Su dedicación y apoyo son fundamentales para el antenimiento de la calidad y relevancia de RELAP.

Objetivo: Descrever o uso de analgesia farmacológica durante o trabalho de parto e desfechos obstétricos. Método: estudo descritivo realizado em uma maternidade de referência do Ceará com 85 mulheres submetidas à analgesia durante o trabalho de parto. Os dados foram coletados por meio dos indicadores de boas práticas de parto e nascimento e de um formulário de dados sociodemográficos e obstétricos elaborado pela autora, gerenciados com a ferramenta eletrônica REDCap e analisados a partir dos testes Qui-quadrado. Resultados: O quantitativo de 12,9% das parturientes iniciou a analgesia na fase latente da dilatação, 70,5% na fase ativa da dilatação e 8,2% durante o período expulsivo. A maioria (63,5%), tratava-se de analgesia peridural contínua, seguida de 24,7% de raquianalgesia e 5,9% de analgesia combinada. Das 85 pacientes que constituíram a amostra, 68,2% pariu via vaginal sem instrumentalização, 29,4% evoluíram para cirurgia cesariana e somente 2,4% pariram com auxílio de fórceps. O quantitativo de 68,2% das mulheres que tiveram parto vaginal, apenas 3,4% foram submetidas ao procedimento. Destaca-se que nenhum caso de realização de manobra de Kristeller foi registrado. Conclusão: a analgesia farmacológica não influenciou negativamente nos desfechos maternos avaliados.

Objective: To examine the intervention programs that have been conducted on body image in adolescents. Materials and methods: The PRISMA statement was used in this review. The search for studies was conducted in PubMed, Web of Science, MEDLINE-ProQuest, and EBSCO databases from January 1, 2017, to January 25, 2022. Methodological quality was assessed using the Quality Assessment Tool for Quantitative Studies, developed by the Effective Public Health Practice Project. Results: Eight studies were included, most of which had a strong methodological quality. The results obtained after the implementation of the programs reflected favorable changes in body image and body satisfaction for adolescents between 11 and 18 years old, only for five studies. Additionally, five studies maintained the same changes at follow-up. Conclusions: Findings from this review allow us to conclude that intervention programs are a safe and effective way to influence adolescent body image.

Abstract Background Sacrococcygeal teratomas (SCTs) are the most common congenital neoplasm and often require resection soon after birth. There are rare reports of cardiac arrest during surgery due to manipulation of the tumor triggering secondary necrosis and hyperkalemia. Case presentation This case describes a very preterm infant with a SCT who develops spontaneous preoperative tumor lysis syndrome (TLS). The medical team utilized rasburicase and the patient underwent total gross resection at 40 h of life. Conclusions We emphasize the importance of the early recognition and management of tumor lysis syndrome in SCT with rasburicase, aggressive management of hyperkalemia and consideration of early resection of SCTs even in the case of a very premature infant.

Neutralizing antibodies are important correlates of protection against dengue. Yet, determinants of variation in neutralization across strains within the four dengue virus serotypes (DENV1-4) is imperfectly understood. Studies focus on structural DENV proteins, especially the envelope (E), the primary target of anti-DENV antibodies. Although changes in immune recognition (antigenicity) are often attributed to variation in epitope residues, viral processes influencing conformation and epitope accessibility also affect neutralizability, suggesting possible modulating roles of nonstructural proteins. We estimated effects of residue changes in all 10 DENV proteins on antigenic distances between 348 DENV collected from individuals living in Bangkok, Thailand (1994-2014). Antigenic distances were derived from response of each virus to a panel of twenty non-human primate antisera. Across 100 estimations, excluding 10% of virus pairs each time, 77 of 295 positions with residue variability in E consistently conferred antigenic effects; 52 were within ±3 sites of known binding sites of neutralizing human monoclonal antibodies, exceeding expectations from random assignments of effects to sites (p = 0.037). Effects were also identified for 16 sites on the stem/anchor of E which were only recently shown to become exposed under physiological conditions. For all proteins, except nonstructural protein 2A (NS2A), root-mean-squared-error (RMSE) in predicting distances between pairs held out in each estimation did not outperform sequences of equal length derived from all proteins or E, suggesting that antigenic signals present were likely through linkage with E. Adjusted for E, we identified 62/219 sites embedding the excess signals in NS2A. Concatenating these sites to E additionally explained 3.4% to 4.0% of observed variance in antigenic distances compared to E alone (50.5% to 50.8%); RMSE outperformed concatenating E with sites from any protein of the virus (ΔRMSE, 95%IQR: 0.01, 0.05). Our results support examining antigenic determinants beyond the DENV surface.