Estado de salud y frecuencia de factores predisponentes para covid-19 grave, población universitaria / Health status and frequency of predisposing factors for severe COVID-19, university population

INTRODUCCIÓN: La COVID-19 ha provocado diversas consecuencias en el mundo, actualmente se siguen estudiando sus factores predisponentes y consecuencias. El objetivo del presente estudio fue determinar el estado de salud y la frecuencia de los factores de riesgo para COVID-19 grave en estudiantes, docentes y administrativos universitarios. MATERIALES Y MÉTODOS: Estudio descriptivo de corte transversal, se aplicó un cuestionario virtual. Se recopiló información epidemiológica personal y del entorno cercano, grupo sanguíneo, hacinamiento en administrativos, peso y talla. RESULTADOS: Se obtuvo la información de 209 docentes, 103 administrativos y 1556 estudiantes. En docentes el 49.52% tiene alguna enfermedad crónica, el 29% tuvo COVID-19. En administrativos, el 56.31% tiene alguna enfermedad crónica, el 29% tuvo COVID-19. En estudiantes el 30% tiene enfermedad crónica, el 24.42% tuvo COVID-19. La mayoría de los docentes tiene sobrepeso, principalmente el sexo masculino desde los 51 años. El 50% del personal administrativo presenta sobrepeso, en igual proporción en ambos sexos y a partir de 41 años. En estudiantes la mayoría tiene un estado nutricional normal, el 27,9% presenta sobrepeso, siendo mayor en el sexo femenino y en el grupo de 20 a 25 años de edad. CONCLUSIONES: Son factores frecuentes en docentes y administrativos la edad, enfermedad crónica, grupo sanguíneo diferente de 0Rh positivo y sobrepeso.

INTRODUCTION: COVID-19 has caused various consequences in the world, its predisposing factors and consequences are currently being studied. The objective of this study was to determine the state of health and the frequency of risk factors for severe COVID-19 in university students, teachers, and administrators. MATERIALS AND METHODS: Descriptive cross-sectional study, a virtual questionnaire was applied. Personal epidemiological information and information about the immediate environment, blood group, overcrowding in administrative offices, weight and height were collected. RESULTS: Information was obtained from 209 teachers, 103 administrators and 1556 students. In teachers, 49.52% have some chronic disease, 29% had COVID-19. In administrative, 56.31% have some chronic disease, 29% had COVID-19. In students, 30% have a chronic disease, 24.42% had COVID-19. Most of the teachers are overweight, mainly the male sex from the age of 51. 50% of the administrative staff is overweight, in equal proportion in both sexes and from 41 years of age. In students, the majority have a normal nutritional status, 27.9% are overweight, being higher in the female sex and in the group of 20 to 25 years of age. CONCLUSIONS: Frequent factors in teachers and administrators are age, chronic illness, blood group other than 0Rh positive, and overweight

Aprendizaje automático aplicado a la predicción de diabetes mellitus, utilizando información socioeconómica y ambiental de usuarios del sistema de salud

Objetivo: Se propuso aplicar modelos basados en técnicas de aprendizaje automático como apoyo para el diagnóstico temprano de la diabetes mellitus, utilizando variables de datos ambientales, sociales, económicos y sanitarios, sin la dependencia de la toma de muestras clínicas. Metodología: Se utilizaron datos de 10 889 usuarios afiliados al régimen subsidiado de salud de la zona suroccidental en Colombia, diagnosticados con hipertensión y agrupados en usuarios sin (74,3 %) y con (25,7 %) diabetes mellitus. Se entrenaron modelos supervisados utilizando k vecinos más cercanos, árboles de decisión y bosques aleatorios, así como modelos basados en ensambles, aplicados a la base de datos antes y después de balancear el número de casos en cada grupo de diagnóstico. Se evalúo el rendimiento de los algoritmos mediante la división de la base de datos en datos de entreno y de prueba (70/30, respectivamente), y se utilizaron métricas de exactitud, sensibilidad, especificidad y área bajo la curva. Resultados: Los valores de sensibilidad aumentaron considerablemente al utilizar datos balanceados, pasando de valores máximos del 17,1 % (datos sin balancear) a valores de hasta 57,4 % (datos balanceados). El valor más alto de área bajo la curva (0,61) fue obtenido con los modelos de ensambles, al aplicar un balance en el número de datos por cada grupo y al codificar las variables categóricas. Las variables de mayor peso estuvieron asociadas con aspectos hereditarios (24,65 %) y con el grupo étnico (5.59 %), además de la dificultad visual, el bajo consumo de agua, una dieta baja en frutas y verduras, y el consumo de sal y azúcar. Conclusiones: Aunque los modelos predictivos, utilizando información socioeconómica y ambiental de las personas, surgen como una herramienta para el diagnóstico temprano de la diabetes mellitus, estos aún deben ser mejorados en su capacidad predictiva.

Objective: The objective was to apply models based on machine learning techniques to support the early diagnosis of diabetes mellitus, using environmental, social, economic and health data variables, without dependence on clinical sample collection. Methodology: Data from 10,889 users affiliated with the subsidized health system in the southwestern area of Colombia, diagnosed with hypertension and grouped into users without (74.3%) and with (25.7%) diabetes mellitus, were used. Supervised models were trained using k-nearest neighbors, decision trees, and random forests, as well as ensemble-based models, applied to the database before and after balancing the number of cases in each diagnostic group. The performance of the algorithms was evaluated by dividing the database into training and test data (70/30, respectively), and metrics of accuracy, sensitivity, specificity, and area under the curve were used. Results: Sensitivity values increased significantly when using balanced data, going from maximum values of 17.1% (unbalanced data) to values as high as 57.4% (balanced data). The highest value of area under the curve (0.61) was obtained with the ensemble models, by applying a balance in the amount of data for each group and by coding the categorical variables. The variables with the greatest weight were associated with hereditary aspects (24.65%) and with the ethnic group (5.59%), in addition to visual difficulty, low water consumption, a diet low in fruits and vegetables, and the consumption of salt and sugar. Conclusions: Although predictive models, using people's socioeconomic and environmental information, emerge as a tool for the early diagnosis of diabetes mellitus, their predictive capacity still needs to be improved.

Objetivo: Propôs-se aplicar modelos baseados em técnicas de aprendizagem automática como apoio para o diagnóstico precoce da diabetes mellitus, utilizando variáveis de dados ambientais, sociais, econômicos e sanitários, sem a dependência da coleta de amostras clínicas. Metodologia: Usaram-se dados de 10.889 usuários filiados ao regime subsidiado de saúde da zona sudoeste da Colômbia, diagnosticados com hipertensão e agrupados em usuários sem (74,3%) e com (25,7%) diabetes mellitus. Foram treinados modelos supervisionados utilizando k vizinhos mais próximos, árvores de decisão e florestas aleatórias, assim como modelos baseados em montagens, aplicados à base de dados antes de depois de equilibrar o número de casos em cada grupo de diagnóstico. Avaliou-se o desempenho dos algoritmos por meio da divisão da base de dados de treino e teste (70/30, respectivamente), e utilizaram-se métricas de exatidão, sensibilidade, especificidade e área sob a curva. Resultados: Os valores de sensibilidade aumentaram de maneira significativa ao utilizar dados equilibrados, passando de valores máximos de 17,1% (dados sem equilibrar) a valores de até 57,4% (dados equilibrados). O valor mais elevado de área sob a curva (0,61) foi obtido com os modelos de montagens, ao aplicar um balanço no número de dados por cada grupo e codificar as variáveis categóricas. As variáveis de maior peso estiveram associadas com fatores hereditários (24,65%) e com o grupo étnico (5,59%), além da dificuldade visual, o baixo consumo de água, um regime baixo em frutas e vegetais e o consumo de sal e açúcar. Conclusões: Embora os modelos preditivos, utilizando informação socioeconômica e ambiental das pessoas, surgem como uma ferramenta para o diagnóstico precoce da diabetes mellitus, ainda devem ser melhorados em sua capacidade preditiva.

Epidemiología de los factores ambientales relacionados con la vía β-catenina y su impacto en el desarrollo y progresión del cáncer colorrectal / Epidemiology of environmental factors related to beta-catenin pathway and its impact on the development and progression of colorectal cancer

Resumen El cáncer colorrectal (CCR) es una enfermedad compleja determinada por factores de riesgo genéticos, ambientales y de estilo de vida. Los factores genéticos (hereditarios) tienen gran influencia en su desarrollo, sin embargo, la mayoría de los casos de CCR son esporádicos y se desarrollan gradualmente a lo largo de varios años. Los principales factores ambientales de riesgo están asociados a la vía de señalización de β-catenina, entre ellos obesidad, falta de actividad física, consumo de carnes rojas y procesadas, alcoholismo y tabaquismo. La vía está relacionada con la regulación de la homeostasis celular, autorrenovación celular durante la embriogénesis y edad adulta. La principal recomendación para evitar el desarrollo del CCR es reducir los factores de riesgo, aumentar el consumo de frutas, verduras y granos, hacer ejercicio de manera rutinaria y limitar el consumo tanto de alcohol como de tabaco. Dado que los antecedentes familiares y la presencia de un síndrome hereditario aumentan el riesgo, se sugiere hacer exámenes periódicos para detectar CCR y emplear predictores del desarrollo como los marcadores bioquímicos y moleculares, los cuales se presentan en este trabajo.

Abstract Colorectal cancer (CRC) is a complex disease, determined by genetic, environmental and lifestyle-associated risk factors. Genetic (inherited) factors have great influence on its development; however, most cases of CRC are sporadic and gradually develop over several years. The main environmental risk factors are associated with β-catenin signaling pathway, including obesity, lack of physical activity, consumption of red and processed meats, alcoholism, and smoking. The pathway is related to cell homeostasis regulation and cell self-renewal during embryogenesis and adulthood. The main recommendation for preventing the development of CRC is to reduce the risk factors, increase the consumption of fruits, vegetables and grains, exercise regularly and limit the consumption of both alcohol and tobacco. However, family history and the presence of a hereditary syndrome increase the risk, which is why carrying out periodic examinations to detect CRC is suggested, using development predictors such as biochemical and molecular markers, which are discussed in this work.

Self-regulation in youth with bipolar disorder

Objectives: To examine the composition of self-regulation in pediatric bipolar disorder (PBD) through the relationship between executive functions, emotion processing, and family environmental factors. Methods: 58 participants (36 with PBD and 22 controls), ages 12-17, were assessed using the Barratt Impulsiveness Scale (BIS), Conners' Continuous Performance Test (CPT-II), Wisconsin Cards Sorting Test (WCST), Computerized Neurocognitive Battery Emotion Recognition Test-Facial Emotion Recognition Test (PENNCNB ER-40), and Expressed Emotion Adjective Checklist Questionnaire (EEAC). Results: Adolescents with PBD displayed significant deficits in all three spheres when compared to the control group. Emotion processing correlated negatively with inhibition and attention, and correlated positively with mental flexibility/working memory. Family environmental factors correlated negatively with mental flexibility/working memory and emotion processing, and positively with attention and inhibition. These correlations indicate that better inhibitory control, attention, and mental flexibility/working memory are associated with greater emotion processing and a fitter family environment. Conclusion: This study is the first to investigate all of the components of self-regulation deficits simultaneously in patients with PBD. Results suggest that self-regulation is essential for a comprehensive perspective of PBD and should be assessed in an integrative and multifaceted way. Understanding that self-regulation is impacted by the abovementioned factors should influence treatment and improve the functional impairments of daily life observed in this population.

Initial analysis of the environmental factors on the prognosis of patients with chronic obstructive pulmonary disease / 公共卫生与预防医学

Objective To analyze the effect of different environments risks on the prognosis of patients with chronic obstructive pulmonary disease (COPD). Methods A total of 231 patients diagnosed with COPD who visited Mianyang Hospital of Traditional Chinese Medicine from April 2018 to January 2021 were selected as the study subjects and divided into two groups according to whether the residence was changed after discharge, that is, Mianyang Environmental Living Suzhou Environmental Living Group. The follow-up time was 2019 December to September 2021. The contents include relative humidity, temperature, PM2.5, PM10, air quality index, exposure to household smoking environment, and open windows for ventilation. The regional environment was mainly measured three times, namely October to February (expressed as cold period), June to August (expressed as warm period), March to May and September to October (expressed as suitable period). The family environment was followed up every 2 months by means of questionnaires and interviews, and detailed records were recorded. After the follow-up, the COPD Assessment Test (CAT) and Modified Dyspnea Rating Score (mMRC) were analyzed. Concentration-response curves were used to analyze the influence of living environment exposure on the prognosis of COPD patients. The generalized additive model with semi-Poisson distribution as the connection function was used to study the influence of univariate and multifactor environmental factors on COPD. Results The air quality index of Mianyang was higher than that of Suzhou during the cold period, while that of Mianyang was lower than that of Suzhou during the suitable period. Meanwhile, the average relative humidity of Suzhou was higher than that of Mianyang during the warm period. The comparison of CAT and mMRC scores of COPD patients in the two regions in different quarters showed that the CAT and mMRC scores of COPD patients in Mianyang City were lower than those in Suzhou City during the cold period, and the difference between groups was statistically significant (P2.5 (warm period), PM10 (warm period) and NO2 (suitable period) increased by 10μg/m3, 8μg/m3, 12μg/m3 and CO (suitable period) increased by 0.3mg/m3 respectively caused COPD function The scores of indicators CAT and mMRC increased. After adjusting for other pollutants, PM2.5, CO were still related to the prognosis of COPD. Concentration-response curve results showed that the risk of increasing CAT score decreased with increasing daily windowing time; conversely, the risk of increasing CAT score was increasing with increasing environmental exposure to smoking. Conclusion Pollutant exposure and living environment factors have a significant impact on the prognosis of COPD, and improving the environment is of great significance for the recovery of COPD pulmonary function.

Research progress on the role of environmentally induced DNA methylation in congenital cleft lip and/or palate / 口腔疾病防治

@#Congenital cleft lip and/or palate (CL/P) is a common malformation of maxillofacial development. At present, it is believed that the etiology of congenital cleft lip and palate mainly results from genetic factors and environmental factors. Epigenetic changes induced by environmental factors may be the key factor in the occurrence of fetal congenital malformations. As one of the important epigenetic modifications, DNA methylation has been widely and deeply studied in many fields, but as a link between the individual and the environment, its application in CL/P is limited. Existing studies have shown that DNA methylation is closely related to the occurrence of cleft lip and palate. Stimulation of folate deficiency, smoking, pollutant exposure and other environmental factors can induce changes in the state of DNA methylation, thus affecting gene expression in the development of lip and palate and leading to the occurrence of deformities.

Diversidad de aves en un gradiente altitudinal en la Reserva de la Biosfera Sierra de Manantlán, México / Diversity of birds along an elevation gradient in the Sierra de Manantlán Biosphere Reserve, Mexico

Resumen Introducción: México concentra alrededor del 11 % de las especies de aves del mundo, de las cuales el 20 % son endémicas del país, concentrándose el mayor número en la región occidental. Objetivo: Analizar la composición, diversidad y distribución de la avifauna a lo largo de un gradiente altitudinal en el occidente de México. Métodos: La investigación se realizó en la Reserva de la Biosfera Sierra de Manantlán. Registramos especies de aves vistas o escuchadas en 28 puntos de conteo fijos a lo largo de un gradiente de elevación de 1 000 m. La comparación de la riqueza y la completitud del muestreo se determinaron con curvas de interpolación y extrapolación. Las franjas se compararon con un Procedimiento no Paramétrico de Permutación Multirespuesta. Se usaron correlaciones y ordenaciones indirectas para analizar cambios en la riqueza y abundancia. Resultados: Registramos 129 especies (estimado: 96 % de completitud): 19 endémicas de México, 13 en alguna categoría de riesgo y 21 consideradas indicadoras. La elevación determinó la distribución y abundancia de las especies, y las franjas altitudinales más bajas, tuvieron los valores más altos de riqueza y abundancia. Conclusión: La mayor riqueza y abundancia de especies se registró a menor altitud, con un cambio significativo en la composición y tipo de especies indicadoras por franja.

Abstract Introduction: Mexico concentrates around 11 % of the world's bird species, of which 20 % are endemic to the country, with the highest number concentrated in the Western region. Objective: To analyze composition, diversity and avifaunal distribution along an elevation gradient in Western Mexico. Methods: The research was done in the Sierra de Manantlán Biosphere Reserve. We recorded seen or heard bird species in 28 fixed count points along a 1 000 m elevation gradient. Comparative richness and sampling completeness were determined with interpolation and extrapolation curves. Belts were compared with Non-Parametric Multi-Response Permutation. Correlations and indirect ordinations were used to analyze changes in richness and abundance. Results: We recorded 129 species (estimate: 96 % completeness): 19 endemics to Mexico, 13 in some risk category, and 21 considered indicators. Elevation determined the distribution and abundance of species, and the lower elevational bands, had the highest richness and abundance values. Conclusion: The highest species richness and abundance were recorded at lower elevations, with a significant change in composition and type of indicator species by belt. The numbers of endemic and at-risk species remained constant with elevation.

Factores ambientales que inhiben la práctica de la actividad física. Percepción del entorno / Environmental factors inhibiting the practice of physical activity. Perception of the environment

Investigaciones acerca de obesidad, sedentarismo,sobrepeso y de la insurgencia de enfermedades crónicas ycardiovasculares se centraban primordialmente en factoresbiológicos y conductuales. Más recientemente, autores se estánponiendo de acuerdo en que el entorno social y físico puedetener también un papel relevante. Algunos aspectos del entornopueden promover o desfavorecer la actividad física. En estarevisión, se da una visión general de lo que se sabe actualmentesobre la relación entre el entorno físico y la actividad física en lapoblación y como la desigualdad de oportunidades para realizarejercicios físicos en el área que rodea a la vivienda familiar seconvierte en un factor que influye en la realización de actividadfísica y la salud. Se detalla así mismo, la relación entre factoresambientales y la actividad física que pueden variar según elámbito de la actividad, llegando a tener un impacto desigualen los diferentes espacios. Un espacio puede ser saludable obeneficioso para la sociedad al andar para trasladarse de un sitio aotro, pero perjudicial a la hora de realizar alguna actividad físicaen las calles. Para organizaciones como la OMS, la percepciónde la población relacionada con su entorno y estilos de vida,es un elemento que contribuye no solo a generar acciones quemejoren la calidad de vida sino a fomentar entornos saludablesque permitan la incorporación de las niñas, las mujeres, laspersonas mayores, los grupos desfavorecidos y las personas condiscapacidad o enfermedades crónicas, a programas y lugaresseguros, asequibles y apropiados(AU)

Research on obesity, sedentary lifestyles, overweightand the emergence of chronic and cardiovascular diseases hasfocused primarily on biological and behavioral factors. Morerecently, authors are agreeing that the social and physicalenvironment may also play a role. Some aspects of theenvironment may promote or discourage physical activity.In this review, an overview is given of what is currentlyknown about the relationship between the physical environmentand physical activity in the population and how unequalopportunities for physical exercise in the area surrounding thefamily home becomes a factor influencing physical activity andhealth. It also details the relationship between environmentalfactors and physical activity that may vary according to the area of activity, having an unequal impact in different spaces.A space can be healthy or beneficial for society when walkingto move from one place to another, but detrimental whenperforming physical activity in the streets. For organizationssuch as WHO, the perception of the population related to theirenvironment and lifestyles is an element that contributes notonly to generate actions that improve the quality of life but alsoto promote healthy environments that allow the incorporationof girls, women, the elderly, disadvantaged groups and peoplewith disabilities or chronic diseases, to safe, affordable andappropriate programs and places(AU)

Validación del instrumento para medir los factores ambientales asociados a neumonía en niños menores de 5 años / Validation of the instrument to measure environmental factors associated with pneumonia in children under 5 years of age

La neumonía es una infección respiratoria que afecta a los pulmones y puede llevar a la muerte. Los niños menores de 5 años pueden adquirir la enfermedad a través de bacterias, virus y hongos, lo cual puede generarse por ciertos factores ambientales no propicios. Objetivos: Validar el instrumento para medir los factores ambientales asociados a neumonía en niños menores de 5 años que acuden a consulta externa del hospital Martin Icaza del Cantón Babahoyo, julio - diciembre 2020; determinar la confiabilidad del instrumento para medir los factores ambientales asociados a neumonía en niños menores de 5 años. Materiales y métodos: Se utiliza un diseño no experimental, con enfoque mixto, método deductivo, de tipo transversal, de campo, prospectivo. Se aplicó un plan piloto con el fin de identificar la validez, coherencia y pertinencia del instrumento, y a su vez determinar la confiabilidad del mismo con base al criterio de expertos. El componente cuantitativo constó de un plan piloto a 16 padres, donde 8 niños padecían neumonía, mientras los 8 restantes no; en tanto que la entrevista se realizó a dos representantes de niños con neumonía. Resultados: La validación de los instrumentos vino dada por tres profesionales que fueron seleccionados por su experiencia y prestigio, estos calificaron la validez, pertinencia y coherencia donde se obtuvo la ponderación de muy confiable. Los resultados mostraron que la enfermedad se transmite por contacto con personas que padecen estas enfermedades (62.5%), los principales síntomas son la tos, fiebre y dolor de garganta (50.0%), las personas viven con 4 o 5 personas en la misma casa (56.3%) y poseen animales (75.0%). Se identificó efectos emocionales negativos, tales como desesperación, ansiedad, tristeza, depresión e impotencia. Conclusión: El instrumento analizado es válido, coherente y pertinente, siendo muy confiable para su aplicación(AU)

Pneumonia is a respiratory infection that affects the lungs and can lead to death. Children under 5 years of age can acquire the disease through bacteria, viruses and fungi, which can be generated by certain unfavorable environmental factors. Objectives: To validate the instrument to measure the environmental factors associated with pneumonia in children under 5 years of age who attend the outpatient clinic of the Martin Icaza hospital in Babahoyo Canton, July - December 2020; determine the reliability of the instrument to measure the environmental factors associated with pneumonia in children under 5 years of age. Materials and methods: A non-experimental design is used, with a mixed approach, deductive method, cross-sectional, field, prospective. A pilot plan was applied in order to identify the validity, coherence and relevance of the instrument, and in turn determine its reliability based on expert criteria. The quantitative component consisted of a pilot plan for 16 parents, where 8 children suffered from pneumonia, while the remaining 8 did not; while the interview was conducted with two representatives of children with pneumonia. Results: The validation of the instruments was given by three professionals who were selected for their experience and prestige, they qualified the validity, relevance and coherence where the weighting of very reliable was obtained. The results showed that the disease is transmitted by contact with people suffering from these diseases (62.5%), the main symptoms are cough, fever and sore throat (50.0%), people live with 4 or 5 people in the same house (56.3%) and own animals (75.0%). Negative emotional effects were identified, such as despair, anxiety, sadness, depression and helplessness. Conclusion: The analyzed instrument is valid, coherent and pertinent, being very reliable for its application(AU)

Relative condition factor and predictive model for the presence of the invasive snail Achatina (Lissachatina) fulica in Sergipe, Northeast Brazil / Fator de condição relativo e modelo preditivo para a presença do caracol invasor Achatina (Lissachatina) fulica em Sergipe, Nordeste do Brasil

Abstract: Achatina fulica is among the world's 100 most impactive invasive species, and is now found in almost all Brazilian states, including Sergipe. This exotic snail is known to have negative impacts, not only on the environment, due primarily to the rapid growth of its populations, but also on public health, given that it is an intermediate host of nematodes that cause zoonotic diseases. However, relatively little is known of the development of this snail, including its relative condition factor. We investigated the occurrence of A. fulica in 24 municipalities distributed in the eight subregions of the state of Sergipe in the dry and rainy season. Furthermore, we present here a predictive model for the occurrence of A. fulica based on the variation in climate and soil chemistry. This snail was more frequent on soils with a pH of 6.5-7.5. A negative correlation was found between the growth of A. fulica and the soil pH, then, the more acidic the soil, the more allometric the growth of A. fulica. The relative condition factor indicated differences in the development pattern of A. fulica among the eight subregions. The influence of rain in increasing the frequency of A. fulica showed a significant correlation. As well, higher temperatures influenced the resting behavior of A. fulica. The mathematical model used to identify the potential presence of A. fulica presented a high degree of agreement. This is the first ecological study of A. fulica to verify the association between the body mass-length relationship and the relative condition factor, and the results indicate that the development of this exotic land snail in Sergipe is influenced by climatic factors and principally, the soil pH. The predictive mathematical model provides valuable insights into the biotic and abiotic factors associated with the presence of A. fulica, and the influence of climatic variables and the chemical parameters of the soil on the occurrence of this species. These findings provide important guidelines for the development of measures for the control of A. fulica populations, which will contribute to both public and environment health.

Resumo: Achatina fulica está entre as 100 das piores espécies invasoras em todo o mundo, e no Brasil está presente em quase todos os estados, incluindo Sergipe. Este caracol exótico é conhecido por ter impactos negativos, não só no meio ambiente, devido principalmente ao rápido crescimento de suas populações, mas também na saúde pública, uma vez que é um hospedeiro intermediário de nematodeos causadores de doenças zoonóticas. No entanto, pouco se sabe a respeito do desenvolvimento dessa espécie, incluindo o fator de condição relativo. Investigamos a ocorrência de A. fulica em 24 municípios distribuídos nos oito territórios do estado de Sergipe no período seco e chuvoso. Além disso, apresentamos aqui um modelo preditivo para a ocorrência de A. fulica baseado na variação do clima e da química do solo. Esse caracol é mais frequente no solo com pH de 6,5 à 7,5, sendo esse padrão ideal para o crescimento isométrico. O crescimento alométrico de A. fulica apresentou correlação negativa com o pH do solo, quanto mais ácido for o solo, maior será o crescimento de A. fulica. O fator de condição de A. fulica, apresentou diferença no desenvolvimento nos oito Territórios. A influência da chuva na frequência de A. fulica apresentou correlação significativa. Além disso, temperaturas mais elevadas influenciaram no comportamento de repouso de A. fulica. O modelo matemático para identificar a possível presença de A. fulica apresentou uma concordância forte. Este é o primeiro estudo ecológico de A. fulica a verificar a associação entre a relação massa-comprimento e o fator de condição relativo, sendo possível evidenciar que essa espécie exótica em Sergipe sofre alterações no desenvolvimento, por fatores climáticos e principalmente pelo pH do solo. O modelo matemático preditivo fornece informações valiosas sobre os fatores bióticos e abióticos associados à presença de A. fulica e a influência de variáveis climáticas e dos parâmetros químicos do solo na ocorrência desta espécie. Esses achados fornecem importantes diretrizes para o desenvolvimento de medidas de controle de populações de A. fulica, que poderão contribuir para a saúde pública e ambiental.

Developmental coordination disorder in preschool children in Taiyuan / 中国基层医药

Objective:To investigate the current situation of developmental coordination disorder in preschool children in Taiyuan, providing evidence for developing health strategies for preschool children in this city.Methods:We selected 11 126 preschool children aged 3-5 years from 24 kindergartens in Taiyuan using the cluster random sampling method during November-December 2018. Each preschool child was tested with the developmental coordination disorder questionnaire for young children.Results:The incidence of developmental coordination disorder was 3.4%, and the incidence of suspected developmental coordination disorder was 5.4%, and the incidences of which were higher in boys than in girls ( χ2 = 9.46, P < 0.01). The incidence of developmental coordination disorder decreased with aging ( r = -0.06, P < 0.01). The incidence of developmental coordination disorder was negatively correlated with parents' education level and maternal passive smoking during pregnancy ( r = -0.11, P < 0.01; r = -0.12, P < 0.01; r = -0.03, P < 0.01). Lower parents' education level and maternal passive smoking during pregnancy led to a higher incidence of developmental coordination disorder in children. Conclusion:Preschool children from Taiyuan had a lower incidence of developmental coordination disorder than those from economically developed south areas. The higher the gross domestic product in the areas where the kindergartens locate, the lower the incidence of developmental coordination disorder ( r = 0.03, P < 0.01). Environmental factors have a certain impact on developmental coordination disorders in preschool children. Parents, kindergarten teachers, and child health workers should take active intervention measures against the adverse factors in the early development environment of children.

Environmental influences on the ichthyoplankton in hypersaline estuaries located in a Semiarid Northeastern Brazilian coast

Hypersaline estuaries are commonly found in the Semiarid Northeast Brazilian coast. However, the utilization of these estuaries by early life stages of fishes is less well documented. This study aimed to evaluate the effects of environmental factors on the ichthyoplankton, and to describe their spatial and temporal variation in two estuaries (Tubarão and Casqueira). The sampling were diurnally in four excursions carried out during two dry-season months (November and December 2017) and two rainy-season months (May and July 2018). A total of 423 larvae representing 30 species (14 families) and 2,762 eggs (five families) were collected. Although the community structures were similar in both estuaries, there was strong seasonal variation, with higher abundances observed during the dry season. Low rainfall was the primary environmental driver affecting ichthyoplankton in both estuaries. Other environmental factors, such as depth, water temperature, and channel width, were also predictor variables for the distribution of eggs and larvae. The ichthyoplankton was dominated by marine estuarine-dependent species in both estuaries, accounting for 76% of individuals. The presence of the early life stages of typically marine species suggests that hypersaline environments provide important nursery areas and play an essential role for some coastal fish species.(AU)

Os estuários hipersalinos são comumente encontrados na região semiárida da costa nordestina brasileira. No entanto, a utilização desses estuários pelos primeiros estágios de vida dos peixes é pouco documentada. O objetivo deste estudo foi avaliar os efeitos de fatores ambientais sobre o ictioplâncton e descrever sua variação espacial e temporal em dois estuários (Tubarão e Casqueira). As amostragens foram diurnas em quatro excursões realizadas em dois meses da estação seca (novembro e dezembro de 2017) e dois meses da estação chuvosa (maio e julho de 2018). Um total de 423 larvas representando 30 espécies (14 famílias) e 2.762 ovos (cinco famílias) foram coletadas. Embora as estruturas das comunidades fossem semelhantes em ambos os estuários, houve fortes diferenças de variação sazonal, com maiores abundâncias observadas durante a estação seca. A baixa precipitação foi o principal fator ambiental que afetou o ictioplâncton em ambos os estuários. Outros fatores, como profundidade, temperatura da água e largura do canal, também foram preditoras para a distribuição de ovos e larvas. O ictioplâncton foi dominado por espécies marinhas dependentes em ambos os estuários, representando 76% dos indivíduos. A presença de estágios iniciais de espécies tipicamente marinhas sugere que ambientes hipersalinos fornecem áreas de berçário importantes e desempenham um papel essencial para algumas espécies de peixes costeiros.(AU)

Instrumento para identificar barreras ambientales percibidas por personas mayores en el contexto cubano / An Instrument for Identifying Environmental Barriers Perceived by Elderly People in the Cuban Context

Introducción: El envejecimiento de la población cubana trae aparejado un aumento de la discapacidad. En este sentido la Clasificación Internacional del Funcionamiento, de la Discapacidad y la Salud recomienda el diseño de instrumentos de medición que identifiquen los factores ambientales que afectan la funcionalidad. Objetivo: Describir las propiedades psicométricas de un instrumento de medición diseñado para identificar barreras ambientales percibidas por las personas mayores en el contexto cubano en cuanto a la validez de apariencia, de contenido y constructo. Métodos: Se realizó un estudio de desarrollo tecnológico. Se consultó a un grupo de expertos para la validación de apariencia y contenido, y se calculó el coeficiente de validez de contenido insesgado y corregido. Para la validez de constructo se calculó el análisis factorial de los componentes principales. Resultados: El coeficiente de validez de contenido insesgado y el corregido mostraron cifras superiores a 0,80, considerado como bueno. El análisis factorial arrojó siete factores que explican las dimensiones exploradas en la definición que se pretende medir. Conclusiones: El instrumento diseñado mostró un alto acuerdo entre los expertos en cuanto a la validez de apariencia y contenido. Los indicadores evidenciaron que el instrumento tiene una estructura multidimensional que se corresponde con el constructo que se pretende medir(AU)

Introduction: The aging of the Cuban population brings about an increase in disability. In this sense, the International Classification of Functioning, Disability and Health recommends the design of measurement instruments to identify environmental factors affecting functionality. Objective: To describe, in terms of face, content and construct validity, the psychometric properties of a measurement instrument designed to identify environmental barriers perceived by elderly people in the Cuban context. Methods: A technological development study was carried out. A group of experts was consulted for the face and content validation, while the unbiased and corrected content validity coefficient was calculated. For construct validity, principal component factor analysis was calculated. Results: The unbiased and corrected content validity coefficient showed figures above 0.80, considered as good. Factor analysis yielded seven factors that explain the dimensions explored in the definition intended to be measured. Conclusions: The designed instrument showed high agreement among the experts in terms of face and content validity. The indicators showed that the instrument has a multidimensional structure that corresponds to the construct that it is intended to measure(AU)

Growth characterization and predictive behavior of Eurotium species in a feedstuff matrix / Caracterización del crecimiento y comportamiento predictivo de especies de Eurotium en matriz de alimento balanceado

ABSTRACT Animal feeds are characterized by low water activity values. Nevertheless, fungal contamination withEurotiumspecies are quite common, causing nutritional depletion, spoilage and economic losses. The aim of this work was to assessEurotiumamstelodami,E. chevalieri,E. repensandE. rubrumgrowth in a feed matrix at different conditions of water activity (0.71-0.97) and temperature (5, 15, 25, 30 and 37°C). It was found thatEurotiumspecies are able to grow in a wide range of water activity and temperature in a short period of time (7 days) and faster than in synthetic media. Rosso and probabilistic models were applied in order to determine the limiting and optimum growth conditions as well as growth probability at certain combinations of environmental factors. Both models provided an accurate fit to the cardinal parameters and good performance for growth/no growth cases. This is the first report assessing the growth parameters ofEurotiumspecies directly in animal feed. Data obtained in the present study is useful to predict and avoidEurotiumspecies growth in animal feed.

RESUMEN Los alimentos balanceados se caracterizan por tener bajos valores de actividad de agua. Sin embargo, la contaminación por hongos con especies deEurotiumes bastante común y causa agotamiento nutricional, deterioro y pérdidas económicas. El objetivo de este trabajo fue evaluar el crecimiento deEurotiumamstelodami,E. chevalieri,E. repensyE. rubrumen una matriz de alimento balanceado a diferentes condiciones de actividad de agua (0,71-0,97) y temperatura (5, 15, 25, 30 y 37°C). Se determinó que las especies deEurotiumpueden crecer en un amplio rango de actividades de agua y temperatura en un corto período de tiempo (7 días), y a mayor velocidad que en medio sintético. Se utilizaron los modelos de Rosso y probabilísticos para determinar las condiciones de crecimiento limitantes y óptimas, así como la probabilidad de crecimiento en ciertas combinaciones de factores ambientales. Ambos modelos proporcionaron un ajuste preciso a los parámetros cardinales y una buenaperformancepara los casos de crecimiento/sin crecimiento. Este es el primer trabajo que evalúa los parámetros de crecimiento de las especies deEurotiumdirectamente en alimento balanceado. Los datos obtenidos en el presente estudio son útiles para predecir y evitar el crecimiento de especies deEurotiumen este tipo de alimentos.

Epífitas vasculares: el patito feo de los estudios fenológicos / Vascular epiphytes: the ugly duckling of phenological studies

ABSTRACT The phenology of vascular epiphytes, which account for about 10 % of the world's flowering plants and perform important ecological functions, has been just partially explored. Since phenology is a key tool for the management and conservation of species, the objective of this review was to synthesize the information published so far about the phenology of vascular epiphytes, detect gaps of knowledge, and suggest future lines of investigation to understand the underlying mechanisms. We conducted an online search for articles in Google Scholar and in the ISI Web of Science database from 1800 to 2020, with different combinations of keywords. 107 studies addressing the phenology of different holoepiphyte species were found; 88 % of the studies were performed in the Neotropic, especially in tropical and subtropical wet forests. The phenology of only ca. 2 % (418 spp.) of all reported holoepiphyte species has been explored. There is a bias toward the study of the flowering and fruiting phenology in members of the Orchidaceae (192 spp.) and Bromeliaceae (124 spp.) families. In general, the vegetative and reproductive phenology of epiphytes tends to be seasonal; however, there is a huge gap in our understanding of the proximate and ultimate factors involved. Future research should explicitly focus on studying those factors.

RESUMEN Las epífitas vasculares, que representan cerca del 10 % de la flora vascular y cumplen funciones ecológicas importantes, se han explorado poco desde el punto de vista fenológico. Dado que la fenología es una herramienta clave para el manejo y conservación de especies, el objetivo de este trabajo fue sintetizar la información publicada, detectar vacíos de conocimiento y sugerir líneas de investigación que permitan entender los mecanismos que regulan la fenología de este grupo. Se realizó una búsqueda de artículos en Google Académico y en la base de datos ISI Web of Science desde 1800 a 2020, con diferentes combinaciones de palabras clave. Se encontraron 107 estudios que abordan la fenología de especies holoepífitas, el 88 % de estos estudios se realizaron en el Neotrópico, principalmente en bosques lluviosos tropicales y subtropicales. Solamente se ha estudiado la fenología de ca. 2 % (418 spp.) del total de especies de holoepífitas reportadas; los trabajos se han enfocado principalmente en estudiar la floración y fructificación de miembros de Orchidaceae (192 spp.) y Bromeliaceae (124 spp.). La fenología vegetativa y reproductiva de las epífitas tiende a ser estacional. Sin embargo, existe un vacío enorme de los factores próximos y últimos implicados; los futuros estudios pueden enfocarse a elucidar qué factores detonan la fenología de epífitas vasculares.

Associated factors with the development of congenital anomalies in the neonatal population attended in a highly complex hospital in Colombia: case-control studyFactores asociados al desarrollo de anomalías congénitas en la población neonatal atendida en un hospital de alta complejidad en Colombia: estudio de casos y controles / Associated factors with the development of congenital anomalies in the neonatal population attended in a highly complex hospital in Colombia: case-control study

INTRODUCCIÓN: Los defectos congénitos son un grupo de alteraciones con gran heterogeneidad clínica y etiológica. Su prevalencia en los países en vías de desarrollo alcanza aproximadamente un 7%. En Colombia, un 17% de los niños menores de 1 año mueren a causa de anomalías congénitas. OBJETIVO: Determinar los factores de riesgo asociados a anomalías congénitas en neonatos del Departamento del Cauca atendidos en un hospital de alta complejidad. MÉTODO: Estudio de casos y controles en el Hospital Universitario San José, de Popayán, Colombia. Se incluyeron 174 recién nacidos, con una distribución 1:1 para 87 casos y 87 controles, entre julio de 2018 y julio de 2019. Las variables de interés fueron registradas en un instrumento semiestructurado diseñado por los investigadores. Los datos obtenidos fueron analizados usando métodos de estadística descriptiva, prueba exacta de Fisher y modelos de regresión logística binomial (odds ratio [OR] con intervalo de confianza del 95% [IC95%]). RESULTADOS: Las anomalías congénitas más frecuentes fueron del sistema cardiovascular (40,23%), renales (24,14%) y del sistema nervioso central (13,79%). Las variables que se asociaron a anomalías congénitas fueron la educación de la madre (OR: 2,40; IC95%: 1,23-4,68), la educación del padre (OR: 2,93; IC95%: 1,44-5,93), el antecedente de cesárea (OR: 3,3; IC95%: 1,76-6,42), la hemorragia en el primer trimestre (OR: 6,15; IC95%: 1,32-28,63) y el antecedente de malformación en un embarazo previo (OR: 4,05; IC95%: 1,08-15,07). CONCLUSIONES: De acuerdo con los resultados del presente estudio, para tratar de reducir la incidencia de las anomalías congénitas se deben intervenir los factores de riesgo modificables, como la educación de los padres, tratar oportunamente las patologías maternas asociadas al sangrado del primer trimestre y realizar consejería genética a los padres con antecedente de anomalías congénitas en embarazos previos. Lo anterior podría lograrse al mejorar la calidad y la adherencia al control prenatal.

INTRODUCTION: Congenital defects are a group of alterations with great clinical and etiological heterogeneity. The prevalence in developing countries is approximately 7%. In Colombia, 17% of children under 1 year of age die from congenital anomalies. OBJECTIVE: To determine the risk factors associated with congenital anomalies in neonates from the Department of Cauca treated in a highly complex hospital. METHOD: Case-control study at the San José de Popayan University Hospital, Colombia. 174 newborns entered the study, with a 1: 1 distribution for 87 cases and 87 controls, between July 2018 and July 2019. The variables of interest were recorded in a semi-structured instrument designed by the researchers. The data obtained were analyzed using descriptive statistical methods, Fishers exact test and binomial logistic regression models (OR with 95% CI). RESULTS: The most frequent congenital anomalies were those of the cardiovascular system (40.23%), renal (24.14%) and central nervous system (13.79%). The variables associated with congenital anomalies were mothers education (OR 2.40; 95% CI: 1.23-4.68), fathers education (OR 2.93 95% CI: 1.44-5.93), history of cesarean section (OR 3.3 CI 95%: 1.76-6.42), first trimester bleeding (OR 6.15 95% CI: 1.32-28.63); history of malformation (OR: 4,05; 95% CI: 1.08-15.07). CONCLUSIONS: Based on the results of the present study and to try to reduce the incidence of congenital anomalies, modifiable risk factors should be intervened, such as parental education, timely treatment of maternal pathologies associated with 1-trimester bleeding and perform genetic counseling to parents with a history of congenital anomalies in previous pregnancies. This could be achieved by improving quality and adherence to prenatal care.

Factores asociados al desarrollo de anomalías congénitas en la población neonatal atendida en un hospital de alta complejidad en Colombia: estudio de casos y controles / Associated factors with the development of congenital anomalies in the neonatal population attended in a highly complex hospital in Colombia: case-control study

INTRODUCCIÓN: Los defectos congénitos son un grupo de alteraciones con gran heterogeneidad clínica y etiológica. Su prevalencia en los países en vías de desarrollo alcanza aproximadamente un 7%. En Colombia, un 17% de los niños menores de 1 año mueren a causa de anomalías congénitas. OBJETIVO: Determinar los factores de riesgo asociados a anomalías congénitas en neonatos del Departamento del Cauca atendidos en un hospital de alta complejidad. MÉTODO: Estudio de casos y controles en el Hospital Universitario San José, de Popayán, Colombia. Se incluyeron 174 recién nacidos, con una distribución 1:1 para 87 casos y 87 controles, entre julio de 2018 y julio de 2019. Las variables de interés fueron registradas en un instrumento semiestructurado diseñado por los investigadores. Los datos obtenidos fueron analizados usando métodos de estadística descriptiva, prueba exacta de Fisher y modelos de regresión logística binomial (odds ratio [OR] con intervalo de confianza del 95% [IC95%]). RESULTADOS: Las anomalías congénitas más frecuentes fueron del sistema cardiovascular (40,23%), renales (24,14%) y del sistema nervioso central (13,79%). Las variables que se asociaron a anomalías congénitas fueron la educación de la madre (OR: 2,40; IC95%: 1,23-4,68), la educación del padre (OR: 2,93; IC95%: 1,44-5,93), el antecedente de cesárea (OR: 3,3; IC95%: 1,76-6,42), la hemorragia en el primer trimestre (OR: 6,15; IC95%: 1,32-28,63) y el antecedente de malformación en un embarazo previo (OR: 4,05; IC95%: 1,08-15,07). CONCLUSIONES: De acuerdo con los resultados del presente estudio, para tratar de reducir la incidencia de las anomalías congénitas se deben intervenir los factores de riesgo modificables, como la educación de los padres, tratar oportunamente las patologías maternas asociadas al sangrado del primer trimestre y realizar consejería genética a los padres con antecedente de anomalías congénitas en embarazos previos. Lo anterior podría lograrse al mejorar la calidad y la adherencia al control prenatal.

INTRODUCTION: Congenital defects are a group of alterations with great clinical and etiological heterogeneity. The prevalence in developing countries is approximately 7%. In Colombia, 17% of children under 1 year of age die from congenital anomalies. OBJECTIVE: To determine the risk factors associated with congenital anomalies in neonates from the Department of Cauca treated in a highly complex hospital. METHOD: Case-control study at the San José de Popayan University Hospital, Colombia. 174 newborns entered the study, with a 1: 1 distribution for 87 cases and 87 controls, between July 2018 and July 2019. The variables of interest were recorded in a semi-structured instrument designed by the researchers. The data obtained were analyzed using descriptive statistical methods, Fishers exact test and binomial logistic regression models (OR with 95% CI). RESULTS: The most frequent congenital anomalies were those of the cardiovascular system (40.23%), renal (24.14%) and central nervous system (13.79%). The variables associated with congenital anomalies were mothers education (OR 2.40; 95% CI: 1.23-4.68), fathers education (OR 2.93 95% CI: 1.44-5.93), history of cesarean section (OR 3.3 CI 95%: 1.76-6.42), first trimester bleeding (OR 6.15 95% CI: 1.32-28.63); history of malformation (OR: 4,05; 95% CI: 1.08-15.07). CONCLUSIONS: Based on the results of the present study and to try to reduce the incidence of congenital anomalies, modifiable risk factors should be intervened, such as parental education, timely treatment of maternal pathologies associated with 1-trimester bleeding and perform genetic counseling to parents with a history of congenital anomalies in previous pregnancies. This could be achieved by improving quality and adherence to prenatal care.

La educación alimentaria y nutricional como parte de la atención de jóvenes con síndrome de Down en una fundación especializada de la ciudad de Medellín, Colombia / Diet and nutrition education as part of programs for young people with Down's syndrome living in a specialized foundation in the city of Medellin, Colombia

Resumen Antecedentes: la población con síndrome de Down presenta alta prevalencia de sobrepeso por factores genéticos y ambientales, por lo que requiere educación alimentaria y nutricional para promover su salud. Objetivo: diseñar y evaluar estrategias educativas pertinentes para promover el adecuado estado nutricional en población escolar con síndrome de Down. Materiales y métodos: investigación-acción con una muestra de 13 niños y sus cuidadores. Se realizó observación, tamizaje nutricional, grupo focal, entrevistas en profundidad y actividades lúdicas para el diagnóstico educativo; además, se priorizaron problemas y se diseñaron, implementaron y evaluaron estrategias educativas con los cuidadores. Resultados: se encontraron aspectos favorecedores y dificultades en la alimentación, como rechazo por "alimentos saludables", gusto por los denominados "alimentos malos", ansiedad alimentaria y poco conocimiento sobre alimentación. Se realizaron actividades con los cuidadores, centradas en las dificultades; las más aceptadas y efectivas fueron las experienciales y dialógicas; al finalizar, los participantes expresaron aprendizajes significativos que llevaron a cabo en su vida diaria y la de sus familias. Se evidenciaron modificaciones en cuanto a preparaciones más saludables, variedad en la alimentación y cambios hacia hábitos más saludables. Conclusión: los participantes obtuvieron aprendizajes para mejorar la alimentación de los niños y familiares, a partir de sus necesidades y condiciones, con estrategias basadas en metodologías dialogantes.

Abstract Background: Those living with Down's syndrome present high prevalence of overweight due to genetic and environmental factors, which requires nutrition and dietary education to promote adequate health in this population. Objective: Design and evaluate education strategies pertinent to the promotion of an adequate nutritional status in school-aged children with Down's syndrome. Materials and Methods: Action research with a sample of 13 children and their caregivers. Observations, nutritional screening, focus groups, in-depth interviews, and recreational activities were carried out for educational diagnosis. Furthermore, problems were prioritized, and educational strategies were designed, implemented, and evaluated with the caregivers. Results: Favorable and difficult aspects to eating were found, such as rejection of "healthy foods", taste for "bad foods", food anxiety, and little food knowledge. Activities were carried out with caregivers focused on difficulties, of which the most accepted and effective were the experiential and talk based. At the end, the participants expressed significant learning that they implemented in their daily lives and with their families. Modifications such as healthier food preparations, variety in diet, and changes towards healthier habits were evidenced. Conclusions: Participants gained knowledge on improving the diets of their children and families based on their needs and conditions, with strategies based on dialogue, practical and contextualized methodologies, and taking into consideration their viewpoints and concerns.

Ecological Suitability Regionalization of Ziziphus jujuba / 中国实验方剂学杂志

Objective:To analyze the main factors affecting the <italic>Ziziphus jujuba</italic> distribution and expand the understanding of its distribution and the corresponding influencing factors by comparing the distribution sites of <italic>Z. jujuba</italic> predicted by models with those recorded in the literature. Method:More than 200 distribution sites of <italic>Z. jujuba</italic> accompanied by 55 environmental factors were obtained from literature and specimen review. The environmental factors that affect the distribution of <italic>Z. jujuba</italic> were explored by maximum entropy （MaxEnt） model， and the potential distribution areas of <italic>Z. jujuba</italic> in China were analyzed by ArcGIS， followed by the verification of the main environmental factors using receiver-operating characteristic （ROC） curve and Jackknife method. Result:The area under the curve （AUC） values for the test data and training data were both greater than 0.9， which perfectly satisfied the standard， indicating that the research results were accurate and reliable. Conclusion:The annual average temperature， the average temperature in May， the average temperature in the warmest season， vegetation type， soil type， average temperature in June， average temperature in September， and average temperature in August are proved to be the main environmental factors affecting the distribution of <italic>Z. jujuba</italic>， which can be found almost all over China， except for Heilongjiang and Tibet. <italic>Z. jujuba</italic> is most suitable to be planted in southeastern Sichuan， Chongqing， southern Gansu， Ningxia， most areas of central Shaanxi， eastern and southwestern Shanxi， Henan， eastern and northern Hubei， northern and eastern Anhui， Shandong， Hebei， Beijing， Tianjin， western Liaoning， and Zhejiang. As revealed by literature review， the most suitable growing areas of <italic>Z. jujuba</italic> are southeastern Sichuan， central Shaanxi， southwestern Shanxi， western and northern Henan， Shandong， and southwestern and eastern Hebei.

Identification of climatic and environmental factors associated with incidence of cutaneous leishmaniasis in Central Iran using satellite imagery

Objective: To determine the effect of climatic and environmental factors on the incidence of cutaneous leishmaniasis in Qom province in 2018. Methods: In this cross-sectional study, the data on cutaneous leishmaniasis incidence were collected from the Disease Control and Prevention Center in Qom province. Climatic and environmental data including Normalized Difference Vegetation Index (NDVI), Land Surface Temperature (LST), and soil moisture were extracted using satellite images. Data of altitude and sunny hours were provided based on shuttle radar topography mission digital elevation model and hemispherical viewshed algorithm, respectively. The associations of climatic and environmental variables with the incidence of the disease were analyzed by Pearson correlation method. The ArcGIS 10.3 software was used to determine the geographical distribution of these factors. Results: There were positive correlations between cutaneous leishmaniasis incidence and the two climatic factors: LST and sunny hours per day (P=0.041, P=0.016), and it had weak negative correlations with the digital elevation model (P=0.27), soil moisture (P=0.54), and NDVI (P=0.62). The time delay analysis showed that in one-, two-, and three month periods, the correlations increased with a 95％ confidence interval. Accordingly, the correlation with the three-month time delay was positive and relatively strong between the cutaneous leishmaniasis incidence and LST and sunny hours (P=0.027, P=0.02); nevertheless, there were negative correlations between the cutaneous leishmaniasis incidence and the soil moisture (P=0.27) and NDVI (P=0.62). Conclusions: As Qom is located in one of the semi-arid climate zones, topography and solar energy are important factors affecting the incidence of cutaneous leishmaniasis in autumn. Therefore, appropriate disease control programs are recommended.