Primary health care (PHC) has increased in global relevance as it has been demonstrated to be a useful strategy to promote community access to health services. Multilateral organizations and national ...governments have reached a consensus regarding the basic principles of PHC, but the application of these varies from country to country due to the particularities of local health systems.This article aims to review and summarize PHC strategies and the configuration of health networks in Latin American and Caribbean countries.The review was carried out using keywords in at least 9 databases. Papers in languages other than English, Portuguese, and Spanish were excluded, while non-refereed articles and regional gray literature were incorporated. As a result, 1,146 papers were identified. After three instances of analysis, 142 articles were selected for this investigation. Data were analyzed according to an analysis by theme.The evidence collected on health reforms in the region reflects the need to intensify care strategies supported by PHC and care networks. These must be resilient to changes in the population's needs and must be able to adapt to contexts of epidemiological accumulation.
Complex traits are those whose inheritance does not follow simple and predictable patterns. They are not governed by a single locus, instead, they are determined by several loci and are influenced by ...the environment. Most of the traits with agronomic interest and economic importance such as resistance to biotic and abiotic stress, and yield, among others, are quantitative traits and their study is based on dissecting the underlying genetic architecture, the number of loci responsible for the variance of a quantitative trait, the relevant contribution made by each locus and their interaction with the environment. This review provides the most relevant conceptual bases for the study of the genetic architecture of complex quantitative traits in plants. The methodologies that allow identifying the loci and candidate genes that govern this type of traits are described, such as QTL mapping by linkage and association mapping. In addition, the incorporation of these loci in phenotype prediction strategies such as marker-assisted selection and genomic selection, exhibits the benefits and limitations of these approaches. Finally, the challenges and perspectives facing the study of the genetic architecture of complex traits in plants are discussed.
Complex traits are those whose inheritance does not follow simple and predictable patterns. They are not governed by a single locus, instead, they are determined by several loci and are influenced by ...the environment. Most of the traits with agronomic interest and economic importance such as resistance to biotic and abiotic stress, and yield, among others, are quantitative traits and their study is based on dissecting the underlying genetic architecture, the number of loci responsible for the variance of a quantitative trait, the relevant contribution made by each locus and their interaction with the environment. This review provides the most relevant conceptual bases for the study of the genetic architecture of complex quantitative traits in plants. The methodologies that allow identifying the loci and candidate genes that govern this type of traits are described, such as QTL mapping by linkage and association mapping. In addition, the incorporation of these loci in phenotype prediction strategies such as marker-assisted selection and genomic selection, exhibits the benefits and limitations of these approaches. Finally, the challenges and perspectives facing the study of the genetic architecture of complex traits in plants are discussed.
It remains unclear whether rectal colonization with multidrug-resistant organisms (MDROs) is prevalent and predisposes to infections by the same pathogens in patients with cirrhosis.
Two series of ...critically ill patients were evaluated. In the Barcelona cohort, 486 consecutive patients were prospectively evaluated, 129 with and 357 without cirrhosis (2015-2016). Rectal swabs were performed at admission and weekly thereafter (until intensive care unit ICU discharge) to detect MDRO colonization. Risk factors for colonization and infection by MDROs were evaluated. A retrospective cohort from Frankfurt (421 patients with cirrhosis; 2010-2018) was investigated to evaluate MDRO rectal colonization in another epidemiological scenario.
In the Barcelona cohort, 159 patients were colonized by MDROs (32.7%), 102 (64.2%) at admission and 57 (35.8%) during follow-up. Patients with cirrhosis showed higher rates of rectal colonization at admission than those without cirrhosis (28.7% vs. 18.2%, p = 0.01) but similar colonization rates during ICU stay. Extended-spectrum beta-lactamase-Enterobacterales were the most frequent MDROs isolated in both groups. Colonization by MDROs independently increased the risk of infection by MDROs at admission and during follow-up. Risk of new infection by the colonizing strain was also significantly increased in patients with (hazard ratio HR 7.41) and without (HR 5.65) cirrhosis. Rectal colonization by MDROs was also highly prevalent in Frankfurt (n = 198; 47%; 131 at admission 66.2% and 67 33.8% during follow-up), with vancomycin-resistant enterococci being the most frequent colonizing organism. Rectal colonization by MDROs was also associated with an increased risk of infection by MDROs in this cohort. Infections occurring in MDR carriers were mainly caused by the colonizing strain.
Rectal colonization by MDROs is extremely frequent in critically ill patients with cirrhosis. Colonization increases the risk of infection by the colonizing resistant strain.
Rectal colonization by multidrug-resistant organisms (MDROs) is a prevalent problem in patients with cirrhosis requiring critical care. The pattern of colonizing bacteria is heterogeneous with relevant differences between centers. Colonization by MDROs is associated with increased risk of infection by the colonizing bacteria in the short term. This finding suggests that colonization data could be used to guide empirical antibiotic therapy and de-escalation policies in patients with cirrhosis.
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•Rectal colonization by multidrug-resistant organisms (MDROs) is a prevalent problem in critically ill patients with cirrhosis.•The pattern of colonizing bacteria is heterogeneous with relevant differences between centers.•Extended-spectrum beta-lactamase-Enterobacterales predominated in Barcelona and vancomycin-resistant enterococci in Frankfurt.•Colonization by MDROs is associated with increased risk of infection by the colonizing bacteria in the short-term.
Malaria is a major tropical disease where important needs are to mitigate symptoms and to prevent the establishment of infection. Cyclopeptides containing N-methyl amino acids with in vitro activity ...against erythrocytic forms as well as liver stage are presented. The synthesis, parasitological characterization, physicochemical properties, in vivo evaluation, and mice pharmacokinetics are described.
Dengue and influenza are pathogens of global concern and cause febrile illness similar to COVID-19. We analyzed data from an enhanced surveillance system operating from three emergency departments ...and an urgent care clinic in Puerto Rico to identify clinical features predictive of influenza or dengue compared with COVID-19. Participants with fever or respiratory symptoms and aged ≥18 years enrolled May 2012-January 2021 with dengue, influenza, or SARS-CoV-2 confirmed by reverse transcriptase polymerase chain reaction were included. We calculated adjusted odds ratios (aORs) and 95% CIs using logistic regression to assess clinical characteristics of participants with COVID-19 compared to those with dengue or influenza, adjusting for age, subregion, and days from illness onset to presentation for clinical care. Among 13,431 participants, we identified 2,643 with dengue (N = 303), influenza (N = 2,064), or COVID-19 (N = 276). We found differences in days from onset to presentation among influenza (2 days interquartile range: 1-3), dengue (3 days 2-4), and COVID-19 cases (4 days 2-7; P < 0.001). Cough (aOR: 0.12 95% CI: 0.07-0.19) and shortness of breath (0.18 0.08-0.44) were less common in dengue compared with COVID-19. Facial flushing (20.6 9.8-43.5) and thrombocytopenia (24.4 13.3-45.0) were more common in dengue. Runny nose was more common in influenza compared with COVID-19 (8.3 5.8-12.1). In summary, cough, shortness of breath, facial flushing, and thrombocytopenia helped distinguish between dengue and COVID-19. Although few features distinguished influenza from COVID-19, presentation > 4 days after symptom onset suggests COVID-19. These findings may assist clinicians making time-sensitive decisions regarding triage, isolation, and management while awaiting pathogen-specific testing.
VISIONS: the VISTA Star Formation Atlas Meingast, Stefan; Alves, João; Bouy, Hervé ...
Astronomy and astrophysics (Berlin),
05/2023, Letnik:
673
Journal Article
Recenzirano
Odprti dostop
VISIONS is an ESO public survey of five nearby (
d
< 500 pc) star-forming molecular cloud complexes that are canonically associated with the constellations of Chamaeleon, Corona Australis, Lupus, ...Ophiuchus, and Orion. The survey was carried out with the Visible and Infrared Survey Telescope for Astronomy (VISTA), using the VISTA Infrared Camera (VIRCAM), and collected data in the near-infrared passbands
J
(1.25 μm), H (1.65 μm), and
K
S
(2.15 μm). With a total on-sky exposure time of 49.4h VISIONS covers an area of 650 deg
2
, it is designed to build an infrared legacy archive with a structure and content similar to the Two Micron All Sky Survey (2MASS) for the screened star-forming regions. Taking place between April 2017 and March 2022, the observations yielded approximately 1.15 million images, which comprise 19 TB of raw data. The observations undertaken within the survey are grouped into three different subsurveys. First, the wide subsurvey comprises shallow, large-scale observations and it has revisited the star-forming complexes six times over the course of its execution. Second, the deep subsurvey of dedicated high-sensitivity observations has collected data on areas with the largest amounts of dust extinction. Third, the control subsurvey includes observations of areas of low-to-negligible dust extinction. Using this strategy, the VISIONS observation program offers multi-epoch position measurements, with the ability to access deeply embedded objects, and it provides a baseline for statistical comparisons and sample completeness – all at the same time. In particular, VISIONS is designed to measure the proper motions of point sources, with a precision of 1 mas yr
−1
or better, when complemented with data from the VISTA Hemisphere Survey (VHS). In this way, VISIONS can provide proper motions of complete ensembles of embedded and low-mass objects, including sources inaccessible to the optical ESA
Gaia
mission. VISIONS will enable the community to address a variety of research topics from a more informed perspective, including the 3D distribution and motion of embedded stars and the nearby interstellar medium, the identification and characterization of young stellar objects, the formation and evolution of embedded stellar clusters and their initial mass function, as well as the characteristics of interstellar dust and the reddening law.
Objective To introduce MexOMICS, a Mexican Consortium focused on establishing electronic databases to collect, cross-reference, and share health-related and omics data on the Mexican population. ...Methods Since 2019, the MexOMICS Consortium has established three electronic-based registries: the Mexican Twin Registry (TwinsMX), Mexican Lupus Registry (LupusRGMX), and the Mexican Parkinson's Research Network (MEX-PD), designed and implemented using the Research Electronic Data Capture web-based application. Participants were enrolled through voluntary participation and on-site engagement with medical specialists. We also acquired DNA samples and Magnetic Resonance Imaging scans in subsets of participants. Results The registries have successfully enrolled a large number of participants from a variety of regions within Mexico: TwinsMX ( n = 2,915), LupusRGMX ( n = 1,761) and MEX-PD ( n = 750). In addition to sociodemographic, psychosocial, and clinical data, MexOMICS has collected DNA samples to study the genetic biomarkers across the three registries. Cognitive function has been assessed with the Montreal Cognitive Assessment in a subset of 376 MEX-PD participants. Furthermore, a subset of 267 twins have participated in cognitive evaluations with the Creyos platform and in MRI sessions acquiring structural, functional, and spectroscopy brain imaging; comparable evaluations are planned for LupusRGMX and MEX-PD. Conclusions The MexOMICS registries offer a valuable repository of information concerning the potential interplay of genetic and environmental factors in health conditions among the Mexican population.
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