Survival Status of Patients with Cervical Cancer Registered in Nantong / 肿瘤防治研究

Objective To analyze the survival status of inpatients with cervical cancer registered in Nantong admitted in Nantong Cancer Hospital from 2002 to 2017. Methods Inpatients with cervical cancer in Nantong Cancer Hospital were followed up from 2017 until December 31, 2020 using active and passive methods to determine their survival outcome. The rate of follow-up loss was statistically analyzed by Chi-square test, the observed survival rate for each year was calculated using the life table, the survival curve was drawn with R language, and the survival rates of patients in different age groups and from different regions were compared with log-rank test (Mantel-Cox). Results A total of 5645 cervical cancer cases were registered. Among them, the survival outcome was recorded for 5512 cases. The success rate of follow-up was 97.64%, and the loss of follow-up rate was 2.36%. The average age of onset was 56.67±12.78 years. The median survival time was 6.54 years, and the 1-, 3-, 5-, and 10-year observed survival rates were 91.50%, 76.95%, 60.99%, and 28.51%, respectively. Among the age groups, significant differences in survival rate were observed between the 15- and 60-year-old groups (χ2=7.469, P=0.006) and between the 15- and 80-year-old groups (χ2=36.317, P < 0.001). No significant difference in survival rate was found between patients from Haimen and Qidong (χ2=2.779, P=0.095) and between patients from Qidong and Tongzhou (χ2=0.515, P=0.473). Significant difference in survival rate was observed among other regions (P < 0.05). Conclusion In this study group, the survival rates of hospital-based patients with cervical cancer significantly differ among the age groups and regions of origin and significantly decreased with age. The high follow-up rate fully reflects the comprehensive effect of the treatment in Nantong Cancer Hospital for registered patients with cervical cancer in Nantong.

Distribuição de óbitos devido ao câncer do colo do útero nos municípios de extrema pobreza, Brasil, 2000 a 2018 / Distribution of deaths due to cervical cancer in extreme poverty municipalities, Brazil, from 2000 to 2018

Resumo Introdução: O câncer do colo uterino (CCU) permanece uma importante causa de morte nas regiões mais pobres do mundo. Objetivo: Analisar tendências da distribuição relativa de óbitos por CCU ocorridos nos municípios de extrema pobreza (EP) do Brasil, de 2000 a 2018. Método: A distribuição relativa de óbitos por CCU nos municípios de EP foi avaliada em relação ao total de óbitos observados em cada Unidade Federativa (UF). Uma modelagem autorregressiva foi usada para avaliar as tendências temporais da distribuição relativa de óbitos de 2000 a 2018. Resultados: De 2000 a 2018, houve 94.065 óbitos por CCU no Brasil, e 10,7% deles ocorreram nos municípios de EP. Seis estados (Amazonas, Roraima, Pará, Amapá, Tocantins e Mato Grosso do Sul) tiveram 100% dos seus municípios de EP reportando a ocorrência desses óbitos. As tendências na distribuição de óbitos nos municípios de EP em relação ao total de óbitos de cada UF seguiram em elevação em onze estados brasileiros. Conclusões: O CCU é doença prioritária das políticas públicas do Brasil, e as tendências desses óbitos observadas nos municípios mais pobres apontam que mais atenção deve ser dada a estas unidades de análise, a fim de melhorar a saúde das pessoas mais pobres.

Abstract Background: Cervical cancer (CC) remains a major cause of death in the poorest regions of the world. Objective: To analyze trends in relative distribution of CC deaths occurred in extreme poverty municipalities, Brazil, from 2000 to 2018. Method: The relative distribution of CC deaths occurred in extreme poverty municipalities was evaluated in relation to total number of CC deaths observed in each Federative Unit (FU). An autoregressive modeling was used to assess the temporal trends in the death distribution, 2000-2018. Results: From 2000 to 2018, there were 94,065 CC deaths, and 10.7% of them were recorded in extreme poverty municipalities. There were six states (Amazonas, Roraima, Pará, Amapá, Tocantins, and Mato Grosso do Sul) with 100.0% of extreme poverty municipalities reporting the occurrence of these deaths. The trends of death distribution in extreme poverty municipalities in relation to the total of deaths in each FU followed in increasing trends in eleven Brazilian FU. Conclusions: CC is a disease prioritized by public policies in Brazil, and the trends of these deaths observed in the poorest municipalities point out that more attention should be given to these units of analysis, in order to improve the health of the poorest people.

Fertilización asistida con óvulos propios en mujeres mayores de 40 años: indicaciones y resultados

Las mujeres posponen su maternidad por el deseo de superación personal y profesional. Se conoce que la cantidad y calidad de los óvulos por ciclo dependen de la edad de la paciente. Las tasas de éxito en tratamientos de reproducción asistida disminuyen con la edad, especialmente después de los 40 años. Se observan tasas más altas de nacidos vivos en mujeres más jóvenes y las tasas disminuyen significativamente en mujeres mayores debido a la disminución de la fertilidad y el aumento de abortos espontáneos. Por ello, la edad es crucial al evaluar la posibilidad de un embarazo exitoso mediante tratamientos de reproducción asistida (TRA). Las indicaciones para realizar fertilización in vitro (FIV) con óvulos propios en mujeres mayores de 40 años incluyen iniciar lo más pronto procedimientos de alta complejidad, buena evaluación de la reserva ovárica con análisis de la hormona antimülleriana y conteo de folículos antrales para realizar asesoramiento genético, proponer FIV-inyección intracitoplasmática de espermatozoides (ICSI) antes de los 44 años, generar expectativas realistas y realizar consentimiento informado, con estadisticas propias. En la REDLARA, de todos los procedimientos de FIV-ICSI, el 34% de las pacientes tienen más de 40 años; se prefiere transferir blastocistos con prueba genética preimplantacional de aneuploidías (PGT-A) para seleccionar embriones euploides. Las tasas de éxito son bajas, inclusive cuando son tasas de embarazo por transferencia de un embrión en el grupo de mujeres ≥ 40 años (18,2% sin PGT, 42,7% con PGT en el IMRCRP). Se recomienda acumular óvulos o embriones realizando múltiples estimulaciones ováricas. Se debe optar por transferir un solo embrión para evitar complicaciones obstétricas con embarazos múltiples en pacientes ≥ 40 años, por el alto riesgo debido a la edad.

Women postpone motherhood because of their desire for personal and professional improvement. It is known that the quantity and quality of oocytes per cycle depends on the patient's age. Success rates in assisted reproduction treatments decrease with age, especially after 40 years of age. Higher live birth rates are observed in younger women, and rates decrease significantly in older women due to decreased fertility and increased miscarriages. Therefore, age is crucial when assessing the possibility of a successful pregnancy through assisted reproductive treatments (ART). The indications to perform in vitro fertilization (IVF) with own ovules in women older than 40 years include starting as soon as possible highly complex procedures, good evaluation of ovarian reserve with antimüllerian hormone analysis (AMH) and antral follicle count (AFC) for genetic counseling, proposing IVF-intracytoplasmatic sperm injection (ICSI) before the age of 44 years, generating realistic expectations and informed consent, with own statistics. At REDLARA, of all IVF-ICSI procedures, 34% of patients are over 40 years old; preference is given to transfer blastocysts with preimplantation genetic testing for aneuploidy (PGT-A) to select euploid embryos. Success rates are low, even when they are pregnancy rates per embryo transfer in the group of women ≥ 40 years (18.2% without PGT, 42.7% with PGT in IMRCRP). It is recommended to bank ovules or embryos by performing multiple ovarian stimulations. A single embryo transfer should be chosen to avoid obstetric complications with multiple pregnancies in patients ≤ 40 years, because of the high risk due to age.

Increased Cesarean Section Rates during the COVID-19 Pandemic: Looking for Reasons through the Robson Ten Group Classification System / Aumento das taxas de cesárea durante a pandemia de COVID-19: procurando explicações por meio da Classificação de Robson

Abstract Objective To compare cesarean section (CS) rates according to the Robson Ten Group Classification System (RTGCS) and its indications in pregnant women admitted for childbirth during the first wave of the coronavirus disease 2019 (COVID-19) pandemic with those of the previous year. Materials and Methods We conducted a cross-sectional study to compare women admitted for childbirth from April to October 2019 (before the pandemic) and from March to September 2020 (during the pandemic). The CSs and their indications were classified on admission according to the RTGCS, and we also collected data on the route of delivery (vaginal or CS). Both periods were compared using the Chi-squared (χ2) test or the Fisher exact test. Results In total, 2,493 women were included, 1,291 in the prepandemic and 1,202 in the pandemic period. There was a a significant increase in the CS rate (from 39.66% to 44.01%; p = 0.028), mostly due to maternal request (from 9.58% to 25.38%; p < 0.01). Overall, groups 5 and 2 contributed the most to the CS rates. The rates decreased among group 1 and increased among group 2 during the pandemic, with no changes in group 10. Conclusion There was an apparent change in the RTGSC comparing both periods, with a significant increase in CS rates, mainly by maternal request, most likely because of changes during the pandemic and uncertainties and fear concerning COVID-19.

Resumo Objetivo Comparar as taxas de cesárea segundo a Classificação de Robson, assim como suas indicações, em mulheres admitidas para parto durante a primeira onda de doença do coronavírus 2019 (coronavirus disease 2019, COVID-19, em inglês), com as do ano anterior. Materiais e Métodos Conduzimos um estudo transversal que comparou as mulheres admitidas para parto entre abril e outubro de 2019 (pré-pandemia) e entre março e setembro de 2020 (durante a pandemia). As cesarianas e as suas indicações foram classificadas conforme o sistema proposto por Robson, e obteve-se a via de parto (vaginal ou cesárea). Ambos os períodos foram comparados usando-se os testes do Qui quadrado ou o exato de Fisher. Resultados Ao todo, 2.943 mulheres foram incluídas, das quais 1.291 antes da pandemia e 1.202 durante a pandemia. A taxa de cesárea aumentou significativamente (de 39.66% para 44,01%; p = 0,028), principalmente devido a desejo materno (de 9,58% para 25,38%; p < 0,01). Os grupos 5 e 2 foram os que mais contribuíram para as taxas de cesárea. Durante a pandemia, o grupo 1 reduziu sua frequência, enquanto o grupo 2 a aumentou. Conclusão Houve uma aparente mudança nas características da população conforme a classificação de Robson. Observou-se significativo aumento nas taxas de cesárea, principalmente por desejo materno, o que reflete possíveis incertezas e medos relacionados à COVID-19.

MOHS SURGERY: NARRATIVE REVIEW

Technique widely used in dermatology for the treatment of skin cancer. The historical perspective highlights the evolution of Mohs surgery since its development by Dr. Frederic Mohs in the 1930s, emphasizing its focus on basal cell carcinoma and subsequent renements in instrumentation, anesthesia, and tissue processing methods. Mohs surgery, which involves stepwise removal of cancerous tissue layers with immediate microscopic examination to ensure complete tumor removal while preserving healthy tissue. The advantages of Mohs surgery include high cure rates, tissue preservation, real-time margin assessment, and precise mapping. However, the procedure is time-consuming, requires specialized training, and may have higher costs compared to alternative treatments. Perioperative management considerations, including preoperative assessment, anesthesia techniques, surgical procedure, wound care, and follow-up, are discussed to ensure optimal outcomes and patient satisfaction. Understanding the historical context, surgical technique, advantages, and disadvantages of Mohs surgery is crucial for healthcare professionals involved in the management of skin cancer patients.

Effect of the timing of insertion of postpartum intrauterine contraceptive device (PPIUCD) copper T380A on expulsion rates

Background & objectives: Postpartum intrauterine contraceptive device (PPIUCD) is well accepted and recommended for contraception. However, anxiety at the time of delivery may restrict the acceptance of a PPIUCD for its immediate insertion. So far there is limited evidence to conclude anything concrete on the association between the expulsion rates and the timing of insertion following a vaginal delivery. Thus, this study was undertaken to compare the expulsion rates in immediate and early insertions and their safety and complications. Methods: This prospective comparative study was carried out over 17 months on women delivering vaginally in a tertiary care teaching hospital in South India. A copper device (CuT380A) was inserted using Kelly’s placental forceps either within 10 min of placental delivery (immediate group, n=160) or between 10 min upto 48 h postpartum (early group, n=160). Ultrasound was done before discharge from the hospital. The expulsion rates and any other complications at six-week and three-month follow up were studied. Chi-square test was used to compare the difference in expulsion rates. Results: The expulsion rate was five per cent in the immediate compared to 3.7 per cent in the early group (no significant difference). In ten cases, the device was found to be in the lower uterus upon ultrasound before discharge. These were repositioned. There was no case with perforation, irregular bleeding or infection up to the three-month follow up. Higher age, higher parity, lack of satisfaction and motivation to continue were predictors of expulsion. Interpretation & conclusions: In the present study PPIUCD was found to be safe with overall expulsion in 4.3 per cent. It was marginally, though not significantly, higher in the immediate group.

De que morrem as crianças de 5 a 14 anos no estado do Rio de Janeiro? Análise do período 2000-2019 / What do children aged 5 to 14 years die from in the state of Rio de Janeiro, Brazil? Trend analysis of the period 2000-2019

Resumo Objetivou-se investigar a magnitude e a tendência da mortalidade de crianças de 5 a 14 anos por causas, no estado do Rio de Janeiro, de 2000 a 2019. Estudo ecológico de tendência temporal utilizando dados do Sistema de Informações sobre Mortalidade (SIM). Calcularam-se taxas de mortalidade por 100 mil crianças, por capítulos, grupos e categorias (CID-10). Estimou-se a série temporal por regressão joinpoint. As taxas de mortalidade de 10 a 14 anos foram superiores às da faixa de 5 a 9 anos. As cinco principais causas foram as mesmas de 5 a 14 anos, com diferente ordem de importância. As duas principais foram causas externas e neoplasias (31% e 15% para 5 a 9 anos; 45% e 11% para 10 a 14 anos). De 5 a 9 anos, a tendência da mortalidade teve declínio anual (8%) entre 2011 e 2015. De 10 a 14 anos, o declínio anual foi 1,3%, de 2000 a 2019. A mortalidade por causas externas decresceu em ambas as faixas, menos para a categoria "Agressão por arma de fogo" (meninos,10-14 anos) e "Afogamento" (meninos, 5-9 anos). A mortalidade por neoplasias ficou estável para todos. Doenças infecciosas e respiratórias decresceram de forma diferenciada entre os grupos. A maioria das causas de morte é evitável ou tratável, apontando necessidade de investimentos em saúde e intersetoriais.

Abstract This study investigated the magnitude and trends of cause-specific mortality among children 5 to 14 years of age in the state of Rio de Janeiro (RJ) from 2000 to 2019. We performed an ecological study, using data from the Mortality Information System (MIS). We calculated mortality rates per 100,000 children by chapters, groups, and categories of causes of death (ICD-10). Trends were estimated by joinpoint regression. Mortality rates among children aged 10 to 14 years were higher than those among children 5 to 9. The five leading causes of death were the same in both age groups, but they ranked differently. The two leading ones were external causes and neoplasms (31% and 15% among children aged 5 to 9 years; 45% and 11% among children aged 10 to 14 years). Among children 5 to 9 years, the mortality trend showed an annual decline (8%) from 2011 to 2015. Among children aged 10 to 14 years, the annual decline was 1.3% from 2000 to 2019. Mortality due to external causes decreased in both age groups, except for the category "Assault by unspecified firearm" (boys, 10 to 14 years) and "Unspecified drowning and submersion" (boys, 5 to 9 years). Mortality caused by neoplasms remained steady in both age groups. Infectious and respiratory diseases decreased differently between the two groups. Most causes of death are preventable or treatable, indicating the need for health and intersectoral investments.

Comparative study of the surgical treatment for supraduodenal distal cholangiocarcinoma and Bismuth-Corlette type I hilar cholangiocarcinoma / 中华普通外科杂志

Objective:To analyze the surgical efficacy and prognosis of supraduodenal distal cholangiocarcinoma (SDC) and Bismuth-Corlette type I hilar cholangiocarcinoma (BIC), and to explore the clinical characteristics of cholangiocarcinoma at different sites.Methods:The clinical data of 33 patients with SDC and 25 patients with BIC undergoing surgical treatment at the First Affiliated Hospital of Anhui Medical University from Jan 2009 to Dec 2016 were analyzed retrospectively.Results:In the BIC group, four patients (16.0%) had combined caudate lobectomy, while in SDC group no caudate lobectomy was needed ( P=0.030). The incidence of pancreatic fistulae in SDC group and BIC group was 18.2% (6/33) and 0 (0/25), respectively ( P=0.032). The cumulative survival rates 1, 3, and 5 years after operation were 94.0%, 54.5%, and 30.3% in SDC group and 88.0%, 28.0%, and 16.0% in BIC group, respectively ( P=0.045). Univariate analysis showed that location of cholangiocarcinoma, residual status and AJCC stage were correlated with postoperative prognosis of cholangiocarcinoma patients. Multivariate analysis showed that BIC, non-R 0 resection and AJCC stage Ⅲ/Ⅳ were independent risk factors for overall survival after surgery. Conclusion:The overall survival rate of SDC patients after radical surgical resection was significantly higher than that of the BIC group.

Clinical efficacy of caspofungin combined with voriconazole in the treatment of older adult patients with pulmonary fungal infection / 中国基层医药

Objective:To investigate the clinical efficacy of caspofungin combined with voriconazole in the treatment of older adult patients with pulmonary fungal infection and its effects on pulmonary function and inflammatory factors.Methods:A total of 100 patients with pulmonary fungal infection admitted to Hangzhou Ninth People's Hospital from January 2016 to December 2020 were included in this study. They were randomly assigned to undergo treatment with either voriconazole (control group, n = 50) or caspofungin combined with voriconazole (observation group, n = 50) for 14 consecutive days. Clinical efficacy and changes in pulmonary function and inflammatory factors after treatment relative to before treatment were determined in each group. Results:Total response rate in the observation group was significantly higher than that in the control group [90.00% (45/50) vs. 74.00% (37/50), χ2 = 4.33, P < 0.05). After treatment, forced vital capacity, forced expiratory volume in 1 second, and maximum expiratory flow rate in the observation group were (2.31 ± 0.77) L, (79.30 ± 6.72)%, (86.14 ± 7.27)%, respectively, which were significantly higher than (1.78 ± 0.74) L, (73.22 ± 6.56)%, (78.16 ± 7.09)% in the control group ( t = 3.50, 4.57, 5.55, all P < 0.05). Tumor necrosis factor α, interleukin-6, and procalcitonin levels in the observation group were (8.32 ± 1.41) ng/L, (35.19 ± 3.40) μg/L, (1.94 ± 0.78) ng/L, respectively, which were significantly lower than (10.15 ± 1.58) ng/L, (46.09 ± 3.64) μg/L, (2.43 ± 0.84) ng/L in the control group ( t = 6.11, 15.43, 3.02, all P < 0.05). The incidence of adverse reactions in the observation group was 4.0% (2/50), which was significantly lower than 18.0% (9/50) in the control group ( χ2 = 5.00, P < 0.05). Conclusion:Caspofungin combined with voriconazole for the treatment of pulmonary fungal infection in older adult patients can effectively improve pulmonary function, inhibit the inflammatory response, and have no obvious adverse reactions with accurate clinical efficacy.

Influencing factors of the repeat reactive (RR) rates of minipools implicated in minipool(MP) nucleic acid testing(NAT) in Xiamen / 中国输血杂志

【Objective】 To analyze the influencing factors of the repeat reactive (RR) rates of minipools implicated in minipool (MP) nucleic acid testing(NAT) in Xiamen Blood Center, in order to provide reference for NAT. 【Methods】 Samples of blood donors from January 1, 2019 to October 31, 2022 were collected in Xiamen Blood Center and tested by MP-NAT(pools of six). Statistical analysis and comparison of MP-NAT RR rates was performed among different years, testers, reagent batches, instrument combinations, CT values of MP-NAT reactive pools and sample backgrounds. 【Results】 A total of 234 715 blood samples were tested by MP-NAT, and 428 pools were reactive, in which 248 pools were individual-donor NAT reactive, with a MP-NAT RR rate of 57.9%. The difference of MP-NAT RR rates were not statistically significant among different years, testers, reagent batches, instrument combinations, and sample backgrounds (P> 0.05). The difference of MP-NAT RR rates among different CT values of MP-NAT reactive pools was statistically significant (χ2=69.587, P<0.05). Significantly abnormal RR rate accurred in two months in 2022, and returned to normal after timely handling. 【Conclusion】 The MP-NAT RR rates is one of the important indicators to monitor the quality of NAT. Once there is a significant change in the MP-NAT RR rates, comprehensive analysis and timely handling should be carried out to ensure the quality of blood detection.

Healthcare providers' satisfaction with participation in private health insurance scheme in a city in the southern Nigeria

Health insurance coverage in Nigeria is still very low as over 70% of health care expenditure is financed by out-of-pocket payment. Health care providers are critical participants in the private health insurance scheme, therefore, their perception and satisfaction with the scheme is fundamental in ensuring sustainability. This study assessed health providers' satisfaction with private health insurance scheme in Port Harcourt Rivers State.Method: A descriptive cross-sectional study which engaged a two-stage sampling method to recruit 60 participating health facilities and 180 responding health personnel by simple random sampling at each stage. A structured, pretested interviewer-administered questionnaire was used to collect data on the levels of satisfaction with the four major domains of satisfaction viz; billing rate, payment models, HMO administrative processes and claims management. Data was analysedusing of SPSS, version 26. Characteristics of the responding facilities were tabulated and compared. Level of satisfaction was deduced by Likert Scale according to the domains of satisfaction. Regression analysis with p-value was set at less than or equal to 0.05 was used to determine the predictors of satisfaction with participation in health insurance. The level of satisfaction with negotiated billing rates, payment models, HMO administrative processes and claims management were analyseddescriptively, and results were presented as means, standard deviation, frequencies and percentages, in tables, pie and bar charts

The burden of healthcare-associated infection in Moroccan hospitals: systematic review and meta-analysis

Healthcare-associated infections (HAI), also referred to as nosocomial infections, is defined as an infection acquired in a hospital setting. This infection is considered a HAI if it was not present or incubating at the time of admission. This includes infections acquired in the hospital but appearing after discharge, and also occupational infections among staff of the facility. HAI are a major patient safety measure to be considered in hospitals.

Aplicación móvil para el análisis estadístico en Android / Mobile application for statistics analysis on Android

El uso de dispositivos móviles en la vida moderna es imprescindible debido a las ventajas que brindan al ofrecer nuevas posibilidades e implementar de manera virtual servicios ya establecidos. La mayor existencia de móviles que computadoras en los estudiantes de Cuba nos motivó a la realización de esta aplicación. El objetivo de este artículo es describir la aplicación nombrada Cálculos estadísticos y tasas en salud (Calc. Tasas versión 1.7) construida para realizar cálculos en un curso de Bioestadística, cubriendo gran parte del contenido de esta asignatura en la enseñanza de pregrado de las universidades médicas, así como otros contenidos de interés en esta materia. También incorpora una base de datos con información demográfica y sanitaria de Cuba y sus provincias en el período 2013-2020. Como resultado se logró independencia tecnológica al dejar de usar programas foráneos y se logró una mayor portabilidad pues funciona tanto en móviles como en computadoras utilizando un emulador de Android(AU)

The use of mobile devices in modern life is essential due to the advantages they provide, offering new possibilities and implementing virtual services. The existence of greater number of mobiles phones than computers in Cuban students motivated the realization of this application. The objective of the article is to describe the application Statistical calculations and rates in health (Calc. Rates version 1.7) built to perform calculations in a Biostatistics course, covering a large part of the content of this subject in the undergraduate teaching of medical universities, as well as other content related with this topic. It also incorporates a database with demographic and health information on Cuba and its provinces in the period 2013-2020. As a result, technological independence was achieved by stopping using foreign programs and a greater portability, since it works on both mobile phones and computers through an Android emulator(AU)

Principales problemáticas de las publicaciones científicas: un análisis en perspectiva latinoamericana / Central problems in scientific research publications: analysis through a latin american perspective

Resumen Se identifican y analizan las principales problemáticas de las publicaciones científicas, estudiando los diferentes componentes del ecosistema en el que se producen, con énfasis en la realidad latinoamericana. A través del relevamiento y análisis bibliográfico, se identifican como problemáticas la forma de acceso, los criterios de calidad y evaluación utilizados, la visibilidad, la barrera de la lengua y la brecha de género. Al mismo tiempo que se conceptualizan, se establecen vínculos entre dichos componentes lo que agrega complejidad al fenómeno y permite visualizar los modelos de comunicación científica vigentes. Dicha identificación pretende abrir espacios para la proposición de propuestas a futuro, que aporten en el sentido de brindar mayor acceso y reducir las inequidades observadas. Al mismo tiempo, la exposición del tema permite a los investigadores contar con mayores elementos a la hora de pensar y hacer visibles sus publicaciones. Desde la perspectiva latinoamericana se observaron ciertas particularidades en relación al crecimiento del movimiento de acceso abierto, sostenido muchas veces por instituciones y editoriales que pugnan por mejorar las formas de circulación, distribución, visibilidad y acceso, aunque cuenten con recursos limitados. Finalmente, se insiste en la necesidad de defender y potenciar el modelo de información científica basado en acceso abierto, como uno de los objetivos a promover para hacer frente a la privatización y comercialización del conocimiento producido por las comunidades científicas.

Abstract Identification and analysis of the main problems of scientific researches by studying the different components of the ecosystems they are produced, emphasising in Latin America's reality. Through surveying and bibliographical analysis, problems such as access ways, quality and evaluation criteria, visibility, language barriers and gender gap are identified. As they are defined, these concepts are also threaded, adding complexity to the matter and allowing to visualize scientific media current's state. Its purpose is to open the field for future proposals regarding greater access and narrowing the inequality gap. Besides, the topic's exposure provides researchers with a wider group of elements when thinking about their work and how to publish it. From a latin american perspective, there is observance of certain aspects linked to the growth of the open access movement, which is mainly sustained by insitutions and publishers that try to improve ways of distribution, circulation, visibilty and access, despite limited resources. Finally, the importance of defending and boosting the scientific information access model based on open access is strongly outlined, as one of the main policies that will allow to keep corporate interests apart from the knowledge scientific communities produce.

Response of three wheat varieties to nitrogen levels, seeding rates and their combination; 2: Spike characters

To achieve larger production per unit area, sciences and farmers face a great defiance in improving cropping practices and elicitation new top yielding wheat varieties and also to establish the effects of these factors on the spike characters. Two years experiment were conducted to evaluate the effect of three nitrogen fertilizer levels (recommend rate 80 kg N/fed and 25% lower and higher than the recommended, i.e. 60 and 100 kg N/ fed, three seeding rates (40, 60 and 80 kg grains/fed) and there varieties (Giza-171, Gemmiza-12 and Shandawil-1), on spike characters of wheat at the Agricultural and experimental Research Station, Faculty of Agriculture, Cairo University, Giza, Egypt during 2018/2019 and 2019/2020 seasons. The experimental design was a split- split plot in randomized complete block arrangement with three replications. Nitrogen levels were allocated to the main plots, while the sub plots were assigned for seeding rates. Wheat varieties were distributed at random in the sub-sub plots. Each sub-sub plots area 4 m (2 x 2m). Generally, results indicated that significant effect on spike length and number of grains/ spike in both seasons and on weight of grains/ spike and 1000-grain weight in one season, where the tallest and heaviest spike as well as the heaviest 1000-grain weight were produced at the 100 kg N/fed in both seasons but the highest number of grains/spike was obtained at 80 kg N/fed in one season. It could be concluded that application nitrogen at the rate of 100 kg/fed proceed the favorable effect on spike characters under the environmental conditions of the experimental site and the similar conditions. Seeding rates caused a significant effect on all studied traits in one season, so the highest values were at 80 kg grains/fed, but this effect on 1000-grain weight was true in both seasons, where the highest value was at 60 kg grains/fed. Moreover, varieties were significantly differed in all spike character in both seasons except number and weight of grains/spike in one season where Giza-12 variety surpassed others. Al studied interactions had significant effect on all studied traits either in one or two season. Planting Giza-171 with 80 kg grains/fed and application of 100 kg N/fed was the pest treatment.

Prevention of Premature Ovulation by Administration of Gonadotropin Releasing Hormone Antagonist the day After Ovulation Triggering in Diminished Ovarian Reserve Patients / Prevenção da ovulação prematura por meio da administração de antagonismo de liberação de gonadotropismo no dia seguinte à ovulação

Abstract Objective The aim of the present retrospective study was to investigate the effectiveness of single-dose gonadotropin releasing hormone (GnRH) antagonist administration, the day after human chorionic gonadotropin (hCG) triggering for final oocyte maturation, on the prevention of premature luteinization in patients with diminished ovarian reserve in in-vitro fertilization (IVF) cycles. The secondary objective of the study was to search the effect of this protocol on pregnancy outcomes. Methods This is a retrospective study including 267 infertile patients who have single antral follicle seen with ultrasonography on the 2nd or 3rd day of the menstrual cycle before starting IVF treatment. We randomized patients into two groups. The case group comprised patients who had single-dose GnRH antagonist injection the day after hCG triggering formed, and the patients who had the standard treatment regime formed the control group. In both groups, the oocytes were collected 36 hours after hCG injection. Results The premature ovulation rate was significantly low in the case group compared with the control group (6.86 versus 20.6% per scheduled cycle) (p=0.022). Also, the oocyte retrieval rate (93.14 versus 67.87% per scheduled cycle) (p=0.013), the oocyte maturity rate (79.42 versus 47.87%) (p=0.041), the fertilization rate (65.68 versus 34.54%) (p=0.018), and the embryo transfer rate per scheduled cycle (44.11 versus 18.78%) (p=0.003) were higher in the GnRH antagonist group than in the control group. Conclusion The administration of GnRH antagonist the day after hCG trigger in IVF treatments of patients with diminished ovarian reserve enabled a significant decrease in the rate of premature ovulation but had no effect on live birth rate.

Resumo Objetivo O objetivo do presente estudo retrospectivo foi investigar a eficácia da administração do antagonista do hormônio liberador da gonadotrofina (GnRH) em dose única no dia seguinte ao desencadeamento da gonadotrofina coriônica humana (hCG) para a maturação final do oócito, na prevenção da luteinização prematura em pacientes com diminuição do ovário reserva em ciclos de fertilização in vitro (FIV). O objetivo secundário do estudo foi pesquisar o efeito deste protocolo nos resultados da gravidez. Métodos Trata-se de um estudo retrospectivo incluindo 267 pacientes inférteis que apresentam um único folículo antral visto por ultrassonografia no 2° ou 3° dia do ciclo menstrual antes de iniciar o tratamento de FIV. Nós randomizamos os pacientes em dois grupos. Os pacientes que receberam injeção de antagonista de GnRH em dose única no dia seguinte ao desencadeamento do hCG formaram o grupo caso, e os pacientes que receberam o regime de tratamento padrão formaram o grupo controle. Em ambos os grupos, os oócitos foram coletados 36 horas após a injeção de hCG. Resultados A taxa de ovulação prematura foi significativamente baixa no grupo caso em comparação com o grupo controle (6,86 versus 20,6% por ciclo programado) (p=0,022). Além disso, a taxa de recuperação de oócitos (93,14 versus 67,87% por ciclo programado) (p=0,013), a taxa de maturidade do oócito (79,42 versus 47,87%) (p=0,041), a taxa de fertilização (65,68 versus 34,54%) (p=0,018) e a taxa de transferência de embriões por ciclo programado (44,11 versus 18,78%) (p=0,003) foram maiores no grupo antagonista de GnRH do que no grupo controle. Conclusão A administração de antagonista de GnRH, no dia seguinte ao desencadeamento de hCG em tratamentos de FIV de pacientes com reserva ovariana diminuída permitiu uma redução significativa na taxa de ovulação precoce,mas não teve efeito na taxa de nascidos vivos.

Atmospheric evaporative demand and water deficit on the ecophysiology of Rubber seedlings

The search for genetic materials resistant to adverse weather conditions has been a major focus in studies on species of economic interest. The objective of the present study was to assess the growth and photosynthesis of rubber seedlings clones under two conditions of atmospheric evaporative demand, characterized by fluctuations in temperature (TEMP) and vapor pressure deficit (VPD), associated to two water regimens. Hevea brasiliensis Muell. Arg (RRIM 600 and FX 3864) clones were assessed in two microclimates, at low (TEMP 21.2 ºC and VPD 0.29 Kpa) and high (TEMP 26.9 ºC and VPD 1.49 Kpa) atmospheric evaporative demand, under two water regimens: water deficit and well-watered. Water deficit 50% water availability was sufficient to reduce the net CO2 assimilation rate, leaf area and total chlorophyll of the clones studied that impacted growth in both microclimates. The effects of water deficit on growth and net carbon assimilation rate were intensified under high atmospheric evaporative demand. However, when comparing the two clones studied, RRIM 600 showed greater growth and photosynthesis without water restriction. The FX 3864 clone, despite the high CO2 assimilation values under high atmospheric demand and without water restriction, showed a reduced growth. The results of this study form an important basis for the selection of genotypes with the potential to develop in adverse climatic conditions. In this sense, the RRIM 600 genotype is recommended as a promising material that would best adapt under adverse climatic conditions.

Opinions, Attitudes, and Prescribing Practices of Oral Contraceptive Pills of General Practitioners and Gynecologists in India

Background:To study the prescription behavior of oral contraceptive pills (OCPs) by physicians, gynecologists, and alternative medicine practitioners (AMPs). Materials and Methods?Close-ended questionnaire-based cross-section study was performed between 1st September 2012 and 28th February 2014 in three groups of responders, i.e., AMP, general medical practitioners (GMPs), and obstetricians and gynecologists (ObGy). A stratified random cluster sample was used. Data of 400 subjects in all three groups were obtained using both univariate and multi-variate sophisticated statistical analyses for analyzing attitude and practices and were recorded on an ordinal scale using appropriate non-parametric test. Results?Of the 1,237 subjects surveyed, 400 completed questionnaires were received from each of the three groups viz; AMPs, GMPs, and ObGy. Remaining 37 incomplete questionnaires were not included in the final analysis. Conclusion?There are equal misconceptions regarding OCPs among users and prescribing physicians. Preference for OCPs in married and unmarried women is also equally low. OCP usage and their prescription practices can be improved by removing potential barriers, developing public–private partnership, and training promoters.

Egg production and life history of Alona guttata Sars, 1862 (Cladocera, Chydoridae): implications for colonization of temporary ponds / Produção de ovos e história de vida de Alona guttata Sars, 1862 (Cladocera, Chydoridae): implicações para a colonização de lagoas temporárias

Cladocerans are a diverse group of species that show rapid responses to changes in environmental conditions. This adaptive capacity has important implications for egg production and life cycle, especially in transitory environments such as temporary waterbodies. The present study investigated the life history and egg production of Alona gutatta Sars, 1862 (Crustacea, Cladocera), an abundant and frequent species from a high-altitude temporary pond (Lagoa Seca, Minas Gerais, Brazil). Newly hatched neonates were monitored in relation to time of maturation, number of eggs produced per female and time of survival. Neonates required a mean of 8 days to mature. A. guttata survived for a mean of 30.9 ± 8.1 days and produced 2 eggs per brood, generating a mean of 10.95 ± 6.41 neonates during the entire life cycle. The rapid development, short time to produce eggs and long life cycle are important adaptations to the adverse environmental conditions of temporary aquatic environments, which can contribute to the rapid colonization of Alona guttata in transitory ecosystems.

Os cladóceros formam um grupo diverso de espécies que apresentam respostas rápidas às mudanças nas condições ambientais. Essa capacidade adaptativa tem implicações importantes para a produção de ovos e para o ciclo de vida, especialmente em ambientes transitórios, como corpos d'água temporários. O presente estudo investigou a história de vida e a produção de ovos da espécie Alona guttata Sars, 1862 (Crustacea, Cladocera) coletada em uma lagoa temporária de altitude (Minas Gerais, Brasil). Organismos recém eclodidos foram observados (em condições de laboratório) em relação ao tempo de maturação, número de ovos produzidos por fêmea e tempo de sobrevivência. Os neonatos levaram em média 8 dias para atingir o primeiro estágio de maturação. As fêmeas produziram 2 ovos por ninhada e geraram uma média de 10,95 ± 6,41 neonatos durante todo o ciclo de vida. A. guttata apresentou uma média de 30,9 ± 8,1 dias de sobrevivência. O rápido desenvolvimento, o pouco tempo para a produção de ovos e o ciclo de vida longo são adaptações importantes às condições ambientais adversas de ambientes aquáticos temporários, que podem contribuir para a rápida colonização de Alona guttata em ecossistemas transitórios.

Suicidology in China： rate changes and theoretical explorations / 四川精神卫生

Over the past few decades， suicide research in China has undergone profound changes， with its findings developing from small to large scales and with research teams transiting from novice to seasoned professional. During the same period， the suicide rate of the China's population on the mainland has experienced rapid switching from high to low， and theories have emerged to explain the changes in suicide and suicide rate. This paper summarized the historical development and current status of suicide research in China in recent decades， and expounded the reasons for the sharp decline of the suicide rate in mainland China from the economic and cultural aspects， and used Strain Theory of Suicide to systematically explain the changes in suicide and the rate.