Discussion on the Pathogenesis of Osteonecrosis of the Femoral Head Under the System of Non-uniform Settlement During Bone Resorption and Multidimensional Composite Bowstring Working in Coordination with the Theory of Liver-Kidney and Muscle-Bone Based on the Concept of Liver and Kidney Sharing the Common Source / 广州中医药大学学报

From the perspective of the physiological basis of liver and kidney sharing the common source in traditional Chinese medicine(TCM),and by integrating the theory of kidney dominating bone,liver dominating tendon,and meridian sinew of TCM as well as the bone resorption and collapse theory,and non-uniform settlement theory and lower-limb musculoskeletal bowstring structure theory of modern orthopedics,the pathogenesis of osteonecrosis of the femoral head(ONFH)under the system of non-uniform settlement during bone resorption and multidimensional composite bowstring working in coordination with the theory of liver-kidney and muscle-bone was explored.The key to the TCM pathogenesis of ONFH lies in the deficiency of the liver and kidney,and then the imbalance of kidney yin-yang leads to the disruption of the dynamic balance of bone formation and bone resorption mediated by osteoblasts-osteoclasts,which manifests as the elevated level of bone metabolism and the enhancement of focal bone resorption in the femoral head,and then leads to the necrosis and collapse of the femoral head.It is considered that the kidney dominates bone,liver dominates tendon,and the tendon and bone together constitute the muscle-bone-joint dynamic and static system of the hip joint.The appearance of collapse destroys the originally balanced muscle-bone-joint system.Moreover,the failure of liver blood in the nourishment of muscles and tendons further exacerbates the imbalance of the soft tissues around the hip joint,accelerates the collapse of the muscle-bone-joint dynamic and static system,speeds up the process of femoral head collapse,and ultimately results in irreversible outcomes.Based on the above pathogenesis,the systematic integrative treatment of ONFH should be based on the TCM holistic concept,focuses on the focal improvement of internal and external blood circulation of the femoral head by various approaches,so as to rebuild the coordination of joint function.Moreover,attention should be paid to the physical constitution of the patients,and therapy of tonifying the kidney and regulating the liver can be used to restore the balance between osteogenesis and osteoblastogenesis,and to reconstruct the muscle-bone-joint system,so as to effectively delay or even prevent the occurrence of ONFH.

The Malignancy Medical Record Quality Analysis by Medical Insurance Settlement List / 中国医院管理

Objective To protect the economic benefits of the hospital by improving the medical record quality,quality control ability,and standardising the filling of the medical insurance settlement list.Methods Re-quality control of previous malignant tumour cases,with the help of the intelligent health insurance case collaboration system,compare the changes in case entry and benchmark costs after the revision of errors,analyse the results caused by different errors,and summarise the correct experience.Results Erroneous disease diagnoses can lead to losses or suspected fraud in health insurance billing,affecting the economic operation of healthcare organisations.Conclusion The improvement of the quality of the medical insurance settlement list not only needs to improve the quality of case writing,coding level,but also needs to read the connotation of the policy through extensive study.

Embriogénesis, desarrollo larval y sobrevivencia post-asentamiento del coral Orbicella annularis (Scleractinia: Merulinidae)

Introducción: Las poblaciones del coral Orbicella annularis han mostrado bajo reclutamiento en el Caribe. Uno de los cuellos de botella demográficos es la alta mortalidad en las primeras etapas de desarrollo. El conocimiento detallado del ciclo y las tasas de supervivencia de estas fases nos permitirá ayudar en la recuperación de la población y la restauración de los arrecifes. Objetivo: Describir la embriogénesis y estadios larvarios obtenidos por fertilización asistida y medir las tasas de asentamiento y supervivencia de las larvas en sustratos artificiales, antes de ser trasplantadas al arrecife. Métodos: Seis días después de la luna llena de septiembre de 2021, se recolectaron bolsas de gametos de ocho colonias de O. annularis en el Parque Nacional Natural Los Corales del Rosario y San Bernardo, Colombia, y se llevaron al laboratorio. Se realizó fecundación cruzada, se siguió el desarrollo embrionario y larvario hasta el asentamiento larval y se registró supervivencia hasta el día 41. Las larvas se mantuvieron en tres tanques con agua de mar filtrada con 126 sustratos marcados, previamente acondicionados con algas coralináceas costrosas. Luego, los sustratos se trasplantaron al arrecife. Resultados: El inicio del desarrollo embrionario ocurrió 1.11 hAF (horas después de la fertilización), cuando las células mostraron signos de la primera división, y duró hasta 104.59 hAF cuando comenzaron a metamorfosearse. El asentamiento de larvas se observó al sexto día AF. Veintiún días después de la fecundación se encontraron zooxantelas. La supervivencia de las larvas después del asentamiento fue de 27.5 %. Conclusión: En este primer esfuerzo de propagación sexual utilizando O. annularis en Colombia, 1.4 % de larvas competentes completaron todo el proceso de desarrollo. Aunque la tasa de supervivencia fue baja, estos resultados se suman a los esfuerzos de restauración de corales en el Caribe en los que se ayuda a las especies a aumentar la supervivencia de los corales en sus primeras etapas de desarrollo.

Introduction: Populations of the coral Orbicella annularis have shown low recruitment in the Caribbean. One of the demographic bottlenecks is the high mortality in the early stages of development. Detailed knowledge of the cycle and survival rates of these phases will allow us to assist in population recovery and reef restoration. Objective: To describe the embryogenesis and larval stages obtained by assisted fertilization and measure the settlement and survival rates of larvae on artificial substrates, before being outplanted to the reef. Methods: Six days after the full moon in September 2021, gamete bundles were collected from eight O. annularis colonies in Los Corales del Rosario and San Bernardo National Natural Park, Colombia and brought to the laboratory. Cross fertilization was carried out and embryonic and larval development were followed until larval settlement and survival was recorded until day 41. The larvae were kept in three tanks with filtered sea water with 126 tagged substrates, previously conditioned with crustose coralline algae. The substrates were then outplanted to the reef. Results: The onset of embryonic development occurred 1.11 hAF (hours after fertilization), when cells showed signs of the first cleavage, and lasted until 104.59 hAF when they began to metamorphose. Larvae settlement was observed on the sixth day AF. Twenty-one days after fertilization, zooxanthellae were found. Post-settlement larval survival was 27.5 %. Conclusions: In this first sexual propagation effort using O. annularis in Colombia, 1.4 % of competent larvae completed the entire development process. Although low survival rate, these results add to coral restoration efforts in the Caribbean in which species are assisted to increase the survival of corals in their early stages of development.

Research on the problems and countermeasures of direct settlement for chronic and special critical dis-eases in cross provincial outpatient service——taking suzhou S hospital as an example / 现代医院

Objective To explore the current implementation status and existing problems of direct settlement for chronic and special critical diseases in cross provincial outpatient service policies,propose improvement strategies and suggestions,pro-vide reference for further improving direct settlement for chronic and special critical diseases in cross provincial outpatient service policies,enhance patient satisfaction and convenience in seeking medical treatment,and jointly maintain the safety of medical in-surance funds.Methods Extract settlement data from chronic and special critical diseases in cross provincial outpatient service and medical insurance service platform data from S Hospital,collect and sort out the difficulties encountered in daily settlement,and analyze the problems and reasons in the implementation of settlement policies.Results Direct settlement for chronic and special critical diseases in cross provincial outpatient service has brought convenience to patients,with an increasing number of settlement personnel.However,there are still problems such as cumbersome settlement processes,low settlement personnel,ina-bility to settle certain diseases,unclear settlement policies for patients,limited number of medical institutions opened,and inac-curate settlement data.Conclusion Medical insurance departments and institutions at all levels need to work together to develop a unified list of outpatient treatment for chronic and special critical diseases,expand the scope of pilot diseases and medical insti-tutions,optimize settlement processes,strengthen information construction,strengthen policy promotion and personnel training,establish a regulatory mechanism of outpatient treatment for chronic and special critical diseases in remote locations.

Preliminary study on inter-provincial direct settlement of outpatient expenses for patients with chronic diseases and special diseases in a cancer hospital / 中华医院管理杂志

Objective:To analyze the operation data of inter-provincial direct settlement of patients with chronic diseases and special diseases in outpatient service, explore the effect of policy implementation and put forward corresponding suggestions.Methods:The descriptive analysis method was used to analyze the real-time settlement data of outpatients with chronic disease and special disease of a grade A tertiary cancer hospital in Beijing in 2022, including changing trend in medical visits, age distribution of the medical population, disease distribution of the medical population, medical departments, cost structure, and payment of medical insurance benefits.Results:In 2022, the hospital admitted a total of 12 812 outpatient patients with chronic and special diseases from 28 provinces and Xinjiang Production and Construction Corps, with an increase from 53 in January to 1 957 in December. The age of the patients was 11 to 88 years old, most of whom were 51 to 70 years old. The main disease was lung cancer, and the main visiting departments were internal medicine(chemotherapy) and radiotherapy(radiotherapy). The cost of diagnosis and treatment was relatively high, and the average proportion of medical insurance fund payment was 79.94%.Conclusions:The inter-provincial direct settlement policy for outpatients with chronic diseases and special diseases could further release the demand for medical treatment, greatly reduce the economic burden of cancer patients, and help to solve the problem of " difficult and expensive medical treatment" for patients with cancer and other major diseases.

Analysis of influencing factors of medical insurance fund settlement in neonatology under DIP payment method / 中国卫生政策研究

Objective:To analyze the DIP medical insurance settlement situation of neonatology and its influencing factors,to optimize the medical insurance settlement rules of neonatology,and to promote the fine management of payment method reform.Methods:City Y,the pilot city of national DIP payment method,was selected as the case area,and the data of the whole sample of patients in neonatology department of City Y were analyzed by descriptive analysis,four-quadrant bubble chart,and multivariate linear regression methods,combined with qualitative data analysis and interview study.Results:There were 1 372 neonates in City Y in 2022,with a health insurance billing rate of 84.82%and 81.10%in tertiary care facilities.There were 718 unenrolled cases.Tertiary care institutions,not enrolled,low-birth-weight babies,higher days of hospitalization,lower days of birth,and lower settlement scores were the influencing factors for the low rate of health insurance settlement in neonatology(P<0.05).Conclusion:Neonatology medical insurance settlement rate was significantly lower than that of the city,and tertiary care institutions had higher deficits,which may lead to the risk of shirking critically ill neonatal patients.There were problems of insufficient grouping refinement and score distortion in neonatology.Recommendation:We should improve the management and adjustment mechanism of core elements,optimize the DIP grouping of neonatology,comprehensively consider the resource consumption characteristics of neonates,rationally and dynamically adjust the price of neonatal medical services,and scientifically set the neonatology markup coefficients,so as to achieve synergistic improvement in the development of neonatology and health insurance,and to push forward the connotative and refined development of the reform of the payment method of health insurance.

Research on Influencing Factors of Percutaneous Coronary Stent Implantation by Group Settlement Based on CHS-DRG / 中国医院管理

Objective To analyze the data of percutaneous coronary stent implantation related groups in certain hospi-tal of Beijing,so as to provide data support for promoting CHS-DRG payment reform and provide guidance and reference for its refined management.Methods The case data of local medical insurance patients in Beijing who received percutaneous coronary stent implantation from January 2020 to December 2021 in certain hospital were statistically analyzed,collect the medical insurance settlement information of the selected patients,and analyze the factors that affect their entry into FM19 group settlement.Results There are differences in the factors affecting FM19 inclusion in different reform stages,overtransfer personnel is a new independent factor that interferes with the group settlement in the actual operation stage.Some special operation codes may interfere with cases entering FM19 group due to pri-ority effect among disease groups.Conclusion The grouping settlement conditions of CHS-DRG are more complex,patients with different expense types need to be specifically analyzed according to the current grouping scheme and reimbursement policy.At present,there are relatively few disease groups settled by package for urban residents,and they continue to be affected by the rule of grouping priority.However,it is necessary to fully implement and strengthen the cost control of disease groups for urban employees,and rationally optimize the diagnosis and treat-ment plan to finely control medical costs.

Recruitment of crustose coralline algae on tiles material for monitoring coral larvae settlement's consolidators at Nature Reserve Pulau Sempu, East Java, Indonesia / Recrutamento de algas coralinas crustosas em azulejos para monitorar consolidadores de assentamentos de larvas de coral na Reserva Natural Pulau Sempu, Java Oriental, Indonésia

Crustose coralline algae (Corallinophycideae) are red algae that produced calcium carbonate and are well recognized as foundation species in the epipelagic zone of the marine ecosystem. These algae induced settlement juvenile of coral by released chemical cues from bacterial communities on the surface of their colonies. Their extracellular calcium carbonate also can stabilize reef structure that influencing many invertebrate attaches and growth in the seabed. Crustose coralline algae (CCA) have obtained attention because of their distribution and health compromise to increasing seawater temperature, ocean acidification, and pollutant. As a cryptic species in the ecosystem, the presence of CCA recruit sometimes doesn’t have attention, especially on their capability to occupy the empty space. This study aimed to document coverage and number of CCA recruit in two different recruitment tile’s material. The highest CCA percentage of the cover was showed inside surface than others surface in all stations. Light intensity and low sedimentation were suggested as a key factor of success of high coverage. Overall, station higher CCA recruits have shown from Tiga Warna. Low sedimentation and protection from aerial exposure became the main reason for it. No significant difference number of CCA recruits between marble and sandstone in this study. Successful CCA recruitment in this study can give a wide picture that natural recruitment of coral and other reef biodiversity in Southern Malang might be will succeed because of the abundance of coralline algae that support their life history stage.

As algas coralinas crustosas (Corallinophycideae) são algas vermelhas que produzem carbonato de cálcio e são bem reconhecidas como espécies de base na zona epipelágica do ecossistema marinho. Essas algas induziram o assentamento juvenil de coral por meio de estímulos químicos liberados por comunidades bacterianas na superfície de suas colônias. Seu carbonato de cálcio extracelular também pode estabilizar a estrutura do recife que influencia muitos invertebrados anexados e crescimento no fundo do mar. As algas coralinas crustosas (CCA) têm obtido atenção devido à sua distribuição e comprometimento da saúde com o aumento da temperatura da água do mar, acidificação dos oceanos e poluentes. Como uma espécie enigmática no ecossistema, a presença de recrutamento CCA às vezes não recebe atenção, especialmente em sua capacidade de ocupar o espaço vazio. Este estudo teve como objetivo documentar a cobertura e o número de recrutamento de CCA em dois materiais de recrutamento diferentes. A maior porcentagem de CCA da cobertura foi mostrada na superfície interna do que nas outras superfícies em todas as estações. A intensidade da luz e a baixa sedimentação foram sugeridas como um fator-chave para o sucesso da alta cobertura. De modo geral, recrutas de CCA mais graduados mostraram-se em Tiga Warna. A baixa sedimentação e a proteção contra a exposição aérea se tornaram a principal razão para isso. Não houve diferença significativa no número de recrutas CCA entre mármore e arenito neste estudo. O recrutamento bem-sucedido de CCA neste estudo pode dar uma imagem ampla de que o recrutamento natural de corais e outros recifes da biodiversidade no sul de Malang será bem-sucedido por causa da abundância de algas coralinas que sustentam seu estágio de história de vida.

Recruitment of crustose coralline algae on tiles material for monitoring coral larvae settlements consolidators at Nature Reserve Pulau Sempu, East Java, Indonesia

Abstract Crustose coralline algae (Corallinophycideae) are red algae that produced calcium carbonate and are well recognized as foundation species in the epipelagic zone of the marine ecosystem. These algae induced settlement juvenile of coral by released chemical cues from bacterial communities on the surface of their colonies. Their extracellular calcium carbonate also can stabilize reef structure that influencing many invertebrate attaches and growth in the seabed. Crustose coralline algae (CCA) have obtained attention because of their distribution and health compromise to increasing seawater temperature, ocean acidification, and pollutant. As a cryptic species in the ecosystem, the presence of CCA recruit sometimes doesnt have attention, especially on their capability to occupy the empty space. This study aimed to document coverage and number of CCA recruit in two different recruitment tiles material. The highest CCA percentage of the cover was showed inside surface than others surface in all stations. Light intensity and low sedimentation were suggested as a key factor of success of high coverage. Overall, station higher CCA recruits have shown from Tiga Warna. Low sedimentation and protection from aerial exposure became the main reason for it. No significant difference number of CCA recruits between marble and sandstone in this study. Successful CCA recruitment in this study can give a wide picture that natural recruitment of coral and other reef biodiversity in Southern Malang might be will succeed because of the abundance of coralline algae that support their life history stage.

Resumo As algas coralinas crustosas (Corallinophycideae) são algas vermelhas que produzem carbonato de cálcio e são bem reconhecidas como espécies de base na zona epipelágica do ecossistema marinho. Essas algas induziram o assentamento juvenil de coral por meio de estímulos químicos liberados por comunidades bacterianas na superfície de suas colônias. Seu carbonato de cálcio extracelular também pode estabilizar a estrutura do recife que influencia muitos invertebrados anexados e crescimento no fundo do mar. As algas coralinas crustosas (CCA) têm obtido atenção devido à sua distribuição e comprometimento da saúde com o aumento da temperatura da água do mar, acidificação dos oceanos e poluentes. Como uma espécie enigmática no ecossistema, a presença de recrutamento CCA às vezes não recebe atenção, especialmente em sua capacidade de ocupar o espaço vazio. Este estudo teve como objetivo documentar a cobertura e o número de recrutamento de CCA em dois materiais de recrutamento diferentes. A maior porcentagem de CCA da cobertura foi mostrada na superfície interna do que nas outras superfícies em todas as estações. A intensidade da luz e a baixa sedimentação foram sugeridas como um fator-chave para o sucesso da alta cobertura. De modo geral, recrutas de CCA mais graduados mostraram-se em Tiga Warna. A baixa sedimentação e a proteção contra a exposição aérea se tornaram a principal razão para isso. Não houve diferença significativa no número de recrutas CCA entre mármore e arenito neste estudo. O recrutamento bem-sucedido de CCA neste estudo pode dar uma imagem ampla de que o recrutamento natural de corais e outros recifes da biodiversidade no sul de Malang será bem-sucedido por causa da abundância de algas coralinas que sustentam seu estágio de história de vida.

Internal ultrastructure of the planktonic larva of the coral Porites panamensis (Anthozoa: Scleractinia) / Ultraestructura interna de la larva planctónica del coral Porites panamensis (Anthozoa: Scleractinia)

Abstract Introduction: The scleractinian coral life cycle includes planktonic larvae that settle on the benthos, allowing the primary polyp to clone and build a sexually reproducing adult colony. The larval physiology and ecology of Eastern Tropical Pacific scleractinians needs the exploration of basic aspects such as the internal morphology of planulae. Objective: To describe histological and cytological characteristics of Porites panamensis larvae. Methods: During August-July 2019, at Islas Marias Biosphere Reserve, Central Mexican Pacific, we made 14 collections of coral larvae and identified the species with cytochrome oxidase subunit 1 gene. We used a scanning electron microscope and other techniques. Results: The ectoderm was composed by heterogeneous, mono-ciliated, columnar epithelial cells. Nematocysts were clustered at the oral pole of the ectoderm, and cells were evident in the aboral pole of the ectoderm gland. The endoderm had secretory cells, lipids and symbionts. Conclusions: The abundance of secretory cells and nematocysts in the aboral pole suggests their importance in substrate exploration and larval settlement. Our results support previous descriptions of larval ultrastructure in other coral species.

Resumen Introducción: El ciclo de vida del coral escleractinio incluye larvas planctónicas que se asientan en el bentos, lo que permite que el pólipo primario se clone y construya una colonia de adultos con reproducción sexual. La fisiología y ecología larvaria de los escleractinios del Pacífico Tropical Oriental necesita la exploración de aspectos básicos como la morfología interna de las plánulas. Objetivo: Describir las características histológicas y citológicas de las larvas de Porites panamensis. Métodos: Durante agosto-julio 2019, en la Reserva de la Biosfera Islas Marías, Pacífico Central Mexicano, realizamos 14 recolectas de larvas de coral e identificamos las especies con el gen citocromo oxidasa subunidad 1. Utilizamos un microscopio electrónico de barrido y otras técnicas. Resultados: El ectodermo está compuesto por células epiteliales columnares heterogéneas, monociliadas. Los nematocistos se agrupan en el polo oral del ectodermo, mientras que en el polo aboral son visibles células glandulares. El endodermo presentó células secretoras, lípidos y simbiontes. Conclusiones: La abundancia de células secretoras y nematocistos en el polo aboral sugiere su importancia en la exploración del sustrato y asentamiento larvario. Nuestros resultados respaldan las descripciones previas de la ultraestructura de las larvas en otras especies de coral.

Challenges Faced By Customers In Adoption Of New Age Payment And Settlement System: An Empirical Study From The Banks Of Gurugram, Haryana

New Age Payment and Settlement System was introduced in banking industry to improve the service quality of banking industry. But every new technology comes with lots of challenges and banking industry is not an exception to it, so keeping this in view this research has been conducted to study the challenges faced by customers in using New Age Payment and Settlement System. The data has been collected from 312 customers with the help of semi structured questionnaire and it has been concluded that data security & privacy, phishing and lack of knowledge are the major challenges faced by customers.

A STUDY ON PERFORMANCE ANALYSIS OF SELECT LIFE INSURANCE COMPANIES

In this study, the performance of select life insurance companies was analysed by considering a few important parameters like persistency ratio, claim settlement ratio, solvency ratio, current ratio and the total life insurance premium received. The top ?ve private sector life insurance companies were selected based on the new business premium received by them – SBI Life Insurance Company Ltd, HDFC Life Insurance Company Ltd, ICICI Prudential Life Insurance Company Ltd, Max Life Insurance Company Ltd, Bajaj Allianz Life Insurance Company Ltd . The study was conducted for the duration of ?ve years i.e., 2016-17 to 2020-21. The data collected was completely based on secondary sources. Of all the companies chosen for the study, the total premiums received by SBI Life Insurance Company Ltd has shown a signi?cant increase over the years selected for the study and the study also analysed that the persistency ratio for all the ?ve life insurance companies was decreasing over the years though there is an increase in the life insurance premiums received by the companies over the same duration.

Design and application of intelligent bedside mobile payment from the perspective of industry and finance integration / 中华医院管理杂志

Based on the ideas of management systemization, system standardization, process specialisation, post accountability, duty formalization, form informatization, information digitization and digital intelligence, the smart, mobile and paperless bedside billing service was developed which incorporated both functional and financial prospects. The innovation was realized by Internet+ bedside billing and an integrated information platform, so that the inter-hospital billing system could be connected to the medical insurance system, electrical receive system and commercial insurance system. This saved manpower and equipment deployment, and improved service quality. The bedside intelligent mobile billing system of a hospital was launched in January 2021, and the average discharge billing time of inpatients in 2020 and 2021 was 44.36 min and 30.59 min, respectively, and the online billing fee time was significantly shorter than offline billing in 2021, and the differences were all significant( P<0.01).

Determinants of inequality in health care seeking for childhood illnesses:insights from Nairobi informal settlements / 《全球健康杂志（英文）》

Background:An in-depth understanding of patterns of inequities in healthcare seeking among the urban residents is critical in identifying appropriate interventions strategies.The study evaluates determinants of inequality in health care seeking for childhood illnesses among informal settlement residents in Nairobi,Kenya.Methods:Data from the second Nairobi Cross-Sectional Slum Survey(NCSS 2012)was examined.The inequality in seeking health care for childhood diarrhea as the prototype illness was assessed using concentration index(CI).The wealth index based on the household possessions and amenities was used as a measure for socioeconomic status.Results:A total of 2 027 qualified women were included in this study.About 16.6％of children born of younger mothers aged＜20 years had diarrhea and a similar proportion of children(16.3％)was observed among mothers who were unemployed.The CI of-0.026 on health care seeking for diarrhea among children points to significant inequality among the urban poor(95％confidence interval:-0.028 to-0.023).Conclusion:Occupation of parents,age of mothers,ethnicity,marital status and children's age were major deter-minants with regard to disease outcome and to a broader extent inequality in health care seeking for childhood illnesses.Enhanced bottom top community health invigoration strategies in health information awareness and services access would be instrumental.

Condiciones socioambientales y prevalencia de enfermedades de la piel en un asentamiento urbano precario de Asunción (Paraguay) / Socio-Environmental Conditions and Prevalence of Skin Diseases in a Precarious Urban Settlement in Asunción (Paraguay) / Condições socioambientais e prevalência de dermatoses em um assentamento urbano precário em Assunção (Paraguai)

Introducción: se buscó analizar la prevalencia de enfermedades dermatológicas de la población de un asentamiento urbano precario próximo al vertedero municipal de Asunción (Paraguay), atendiendo a la exposición de las condiciones socioambientales. Materiales y métodos: estudio descriptivo y transversal con una muestra no probabilística intencional que incluyó a 77 personas de entre 5 meses y 76 años. Resultados: en el momento del examen físico, el 96.2 % de las personas presentó, al menos, una lesión cutánea, y el 79.2 %, una o más enfermedades infecciosas de piel; sin embargo, el 77.9 % no había recu-rrido a consulta médica. Las más sobresalientes fueron las micosis (35.1 %), las bacterianas (35.1 %) y las ectoparasitosis (27.3 %). Se identificó que la prevalencia de enfermedades bacterianas de piel apunta a una posible mayor exposición a condiciones adversas como: un clima subtropical de altas temperaturas y húmedo, una alta relación de convivientes en el hogar por dormitorio, problemas de provisión de agua y suelos de arena en los hogares, así como un sistema de evacuación de excretas deficiente, la presencia de animales con escasa vigilancia sanitaria, la proximidad a arroyos y cauces al aire libre depositarios de materia cloacal y el impacto recurrente de raudales los días de intensa lluvia. Conclusión: los resul-tados sugieren que la alta prevalencia de enfermedades cutáneas infecciosas podría relacionarse con una mayor exposición a condiciones socioambientales locales adversas, que son factores relevantes por tener en cuenta para mejorar la atención a la salud de las enfermedades dermatológicas de la población urbana que habita en un asentamiento urbano precario

Introduction: This study analyzes the prevalence of dermatological diseases in the population of a precarious urban settlement near the municipal landfill of Asunción (Paraguay), in relation to expo-sure to socio-environmental conditions. Materials and methods: descriptive, cross-sectional study with a non-probabilistic purposive sample that included 77 people aged between 5 months and 76 years. Results: at the time of physical examination, 96.2% of the people presented at least one skin lesion and 79.2% one or more infectious skin diseases, but 77.9% had not consulted a doctor. The most prominent were mycoses (35.1%), bacterial (35.1%) and ectoparasitoses (27.3%). It was identified that the preva-lence of bacterial skin diseases points to possible increased exposure to adverse conditions such as: a subtropical climate with high temperatures and humidity, a high ratio of people living in the household per bedroom, water supply problems and sandy soils in homes, as well as a deficient excreta disposal system, the presence of animals with poor sanitary surveillance, proximity to streams and open-air waterways that deposit sewage and the recurrent impact of floods on days of heavy rainfall. Conclusion:the results suggest that the high prevalence of infectious skin diseases could be related to increased exposure to adverse local socio-environmental conditions, which are relevant factors to be taken into to improve the health care of skin diseases in the urban population living in a slum settlement

Introdução: este estudo analisa a prevalência de doenças dermatológicas na população de um assen-tamento urbano precário próximo ao aterro sanitário municipal de Asunción (Paraguai) em relação à exposição às condições socioambientais. Materiais e métodos: estudo descritivo, transversal, com uma amostra não-probabilística de propósito que incluiu 77 pessoas com idade entre 5 meses e 76 anos. Resultados: no momento do exame físico, 96,2% das pessoas tinham pelo menos uma lesão de pele e 79,2% tinham uma ou mais doenças infecciosas de pele, mas 77,9% não tinham consultado um médico. As mais importantes foram micoses (35,1%), bacterianas (35,1%) e ectoparasitoses (27,3%). A preva-lência de doenças bacterianas da pele foi identificada como apontando para um possível aumento da exposição a condições adversas tais como: um clima subtropical com altas temperaturas e umidade, uma alta proporção de pessoas vivendo na casa por quarto, problemas de abastecimento de água e solos arenosos nas habitações, bem como um sistema de eliminação de excrementos deficiente, a presença de animais com vigilância sanitária deficiente, proximidade a riachos e cursos de água abertos que depositam águas residuais, e o impacto recorrente de enchentes em dias de chuvas fortes. Conclusão:Os resultados sugerem que a alta prevalência de doenças infecciosas de pele pode estar relacionada ao aumento da exposição a condições sócio-ambientais locais adversas, que são fatores relevantes a serem considerados para melhorar os cuidados com doenças de pele na população urbana que vive em uma favela

Acesso à água e esgotos em ocupação urbana na Região Metropolitana de Belo Horizonte: efeitos na saúde, qualidade de vida e relações de gênero / Access to water and sanitation in urban occupation in the Metropolitan Region of Belo Horizonte: effects on health, quality of life and gender relations

Resumo O artigo visa compreender como ocorre o acesso à água e ao esgotamento sanitário na Ocupação Vitória e a percepção dos moradores acerca da associação entre esse acesso e as condições de saúde: aparecimento de doenças, qualidade de vida e as relações de gênero na comunidade. Trata-se de estudo qualitativo, fundamentado na imersão no trabalho de campo, empregando observação participante na Ocupação e em entrevistas com seus moradores. Observou-se a precariedade do acesso à água pela população, que ocorre por meio de ligações irregulares às redes formais, e a predominância de fossas rudimentares. A população relaciona a falta de saneamento com o surgimento de doenças infecciosas e parasitárias e impactos sobre a desigualdade de gênero. O acesso inadequado à água e esgoto impacta a qualidade de vida da comunidade ao comprometer a produção de alimentos agroecológicos e as práticas culturais e identitárias. A informalidade do assentamento se traduz em maior vulnerabilidade social e maior exposição da população a efeitos sobre sua saúde, principalmente de mulheres e crianças.

Abstract The article aims to understand how access to water and sanitation occurs in the Vitória Occupation and the residents' perception of the association between this access and health conditions: the emergence of diseases, quality of life and gender relations in the community. This is a qualitative study, based on immersion in fieldwork, employing participant observation in the Occupation and in interviews with residents of the Occupation. It was observed the precariousness of access to water by the population, which occurs through irregular connections to formal networks, and the predominance of rudimentary septic tanks. The population relates the lack of sanitation with the emergence of infectious and parasitic diseases and impacts on gender inequality. Inadequate access to water and sewage impacts the community's quality of life by compromising the production of agroecological food and cultural and identity practices. The informality of the settlement translates into greater social vulnerability and greater exposure of the population to effects on their health, especially on women and children.

Pregnancy Malaria: Predisposing Factors, Burden and Management in Agrarian Settlements Southeast Nigeria

Aim:To evaluate predisposing factors, burden and management of malaria amongst pregnant women in some agrariansettlements southeast Nigeria.Study Design:Cross-sectional survey conducted in 4 randomly selected agrarian communities was conducted Place and Duration of Study:Isi-Uzo Local Government Area (Eha-Amufu, Ikem, Mbu, Neke and Umualor). The study lasted six months.Methodology: A total of 385 respondents participated. A cross-sectional survey was conducted in 4 randomly selected agrarian communities was conducted. Data were collected using a structured questionnaire.Results: Obstetric and socio-demographic characteristics of the participants showed that majority were age-bracket 25-34 (42.6%), 1sttrimester (56.4%) and multigravidae (52.8%), primary education group (32.2%), secondary education group (55.6%), farmers (73.1%) and Christians (93.5%). All the respondents (100%) agreed to the presence of overgrown bushes in their environs, many farming activities which is the main source of income and staying out late at night for relaxation. A high percentage of the women experienced fever (57.9), headache (61.6), cough & catarrh (54.5) and anorexia (53.8) monthly reflecting high malaria frequency in the locale. 20.3% had experienced stillbirth, 82.6% neonatal death and 65.5% infant mortality once, twice or more. And according to (58.7%) and (38.7%) of respondents, malaria moderately and highly affects their productivity during pregnancy respectively. Respondents that seek health/treatment in hospitals (50.9) differ insignificantly from those that seek health through traditional remedies (49.1). Cost of treatment was reported to be high and moderate by 31.9% and 65.5% respondents respectively. Poor healthcare delivery was implicated as major dissatisfaction with treatment by 76.4% of respondents.Conclusion:Malaria is a major health problem encountered by pregnant women in agrarian locales. Hence, girls should be exposed to malaria awareness programs an earlier stage of life

Ciudad y bienestar: la tensión entre la urbanización y el habitar / City and Welfare: The Tension Between Urbanization & Settlement

Resumen Este texto reflexiona sobre cómo la tensión entre la urbanización y el habitar expone a sus habitantes a un constante estado de estrés y depresión. Los conduce a hábitos nocivos, que derivan en enfermedades crónicas degenerativas. Por lo tanto, la ciudad no es un espacio para el bienestar de los sujetos, porque, los factores que permiten alcanzar el bienestar, que son los lugares, los objetos, los bienes y salud, no son tomados en cuenta. De ahí que el bienestar tiene un fuerte vínculo con el espacio, el tiempo y la sociedad. Así, la urbanización podría producir espacios armónicos, que permitan un desarrollo, físico, mental y económico.

Abstract: This text refl ects on how the tension between urbanization and settlement exposes inhabitants to a constant state of stress and depression. Which points them towards harmful habits, leading to chronic degenerative diseases. Therefore, the city is not a space oriented to the welfare of the subjects. Because, the factors that allow achieving well-being, which are places, objects, goods and health, are not taken into account. Hence, well-being, has a strong link with space, time and society. Where urbanization, would have to produce those harmonic spaces, which allow development, both physical and mental as well as economic.

Caracterização de Escherichia coli diarreiogênica isolada de água subterrânea para consumo humano em um assentamento rural / Characterization of diarrheagenic Escherichia coli isolated from underground water for human consumption in a rural settlement

Escherichia coli diarreiogênica (DEC) é um importante agente de infecções gastrointestinais transmitidas pela água. O trabalho teve como objetivo avaliar a qualidade microbiológica e físicoquímica de 58 amostras de água subterrânea in natura para consumo de um assentamento rural e caracterizar os isolados de E. coli, genotipicamente dentro dos patotipos de DEC, pela técnica da PCR, e fenotipicamente. Todas as amostras apresentaram contaminação por coliformes totais e 36 (62,1%) por E. coli. Em células HEp-2, dos 170 isolados de E. coli, 106 (62,36%) apresentaram AA, 15 (8,82%) AD, 17 (10%) adesão não caracterizado e 32 (18,82%) foram não aderentes. Quanto à formação de biofilme, 126 (74,12%) cepas são formadoras, e 44 (25,88%) não formaram biofilme. Foram identificadas DEC em 6,89% das amostras de água: três (5,17%) ETEC e uma (1,72%) EAEC. EAEC apresentou AA e as três cepas de ETEC apresentaram AD, AA e não definida. Todas as DEC foram formadoras de biofilme. Dois isolados de ETEC apresentaram resistência à ampicilina e tetraciclina, uma ETEC à aminoglicosídeos, e EAEC foi sensível a todos os antibióticos testados. As ETEC foram classificadas no filogrupo B1 e a EAEC no E. Os sorotipos encontrados foram: O24:H21, OR:H21, O17:H46 e O6:H12. Todas as amostras estavam dentro dos parâmetros normais de flúor e 13 (22,4%) apresentaram resultados acima do padrão permitido de turbidez. A presença de E. coli e DEC nas amostras de água indica a necessidade de adoção de medidas que evitem a contaminação da água fornecida à população, evitando, assim, a transmissão de doenças.(AU)

Diarrheogenic Escherichia coli (DEC) is an important agent of waterborne gastrointestinal infections. The objective of this work was to evaluate the microbiological and physico-chemical quality of 58 freshwater groundwater samples for the consumption of a rural settlement and to characterize the E. coli isolates, genotyped within the DEC pathophyses, by the PCR technique, and phenotypically. All water samples presented contamination with total coliforms, and 36 (62.1%) with E. coli. In HEp-2 cells, of 170 E. coli isolates, 106 (62.36%) showed AA, 15 (8.82%) AD, 17 (10%) noncharacterized adhesion and 32 (18.82%) were non-adherent. As for biofilm formation, 126 (74.12%) strains are forming, and 44 (25.88%) did not form biofilm. DEC was identified in 6.89% of the water samples with E. coli: three (5.17%) with enterotoxigenic E. coli (ETEC), and one (1.72%) with enteroaggregative E. coli (EAEC). EAEC showed aggregative adherence, whereas various ETEC strains presented diffuse, aggregative, and non-defined adherence. All DEC strains were biofilm forming. Two isolates of ETEC showed resistance to ampicillin and tetracycline, and one isolate showed resistance to aminoglycosides. The EAEC isolate was sensitive to all antibiotics tested. All ETECs were classified into phylogenetic B1 and EAEC in E. The serotypes identified in our study were: O24:H21, ONT:H21, O17:H46, and O6:H12. All water samples were within normal fluorine parameters; however, measured turbidity was above the permitted standard in 13 (22.4%) samples. The presence of E. coli and DEC in water samples indicates the need to take action to prevent contamination of water resources accessed by people to prevent the transmission of diseases.(AU)

Early life history of the Caribbean coral Orbicella faveolata (Scleractinia: Merulinidae) / Historia de vida temprana del coral caribeño Orbicella faveolata (Scleractinia: Merulinidae)

Introduction: Rehabilitation of hermatypic coral species that have declined in the Caribbean in recent decades is a priority. Production of sexual recruits is considered the best restoration method to aid affected populations. Objective: To gain knowledge of early life stages of Orbicella faveolata and to enhance production of new sexual recruits. Methods: Gamete bundles from the coral species O. faveolata were collected over two years (2018 and 2019) from Los Corales del Rosario y de San Bernardo Natural National Park, Cartagena, Colombia. Assisted fertilization, larval rearing, settlement (onto crustose coralline algae, CCA) and post settlement survival in laboratory conditions were monitored. Results: Embryonic and larval development were documented over 55 hours after the first cleavage, when larvae were fully developed and started pre-settlement behavior. Settlement began 7 days after first cleavage and after 37 days polyps had acquired zooxanthellae. Larval settlement was higher on Lythophyllum congestum and Titanoderma prototypum than in response to Porolithon pachydermum, Neogoniolithon sp., Hydrolithon sp., and Lythophyllum sp. Larvae did not settle on dead coral or on the negative control (sterilized seawater). After the first week post settlement survival was 59 % amongst O. faveolata recruits. During the second week, survival dropped to 42 %, and was further reduced to 0 % at the end of the third week. Conclusions: O. faveolata larvae require cues from certain CCA species to settle, they do not settle in absence of CCA. Increased larvae availability is possible through assisted fertilization in the laboratory, however, due to the high mortality in early post-settlement phases, additional research needs to be conducted in order to scale up larvae production and improve understanding of the cues that enhance settlement and the factors which cause post-settlement mortality.

Introducción: La rehabilitación de las especies de corales hermatípicos del Caribe que han disminuido en las últimas décadas es una prioridad. La producción de reclutas sexuales se considera el mejor método de restauración para ayudar a las poblaciones afectadas. Objetivo: Obtener conocimiento de las primeras etapas de la vida de O. faveolata y mejorar la producción de nuevos reclutas sexuales. Métodos: Por dos años (2018 y 2019), seis días después de luna llena en septiembre, se recolectaron paquetes gaméticos en arrecifes del Parque Nacional Natural Los Corales del Rosario y de San Bernardo, Cartagena, Colombia. Se siguió la fertilización asistida, la cría de larvas, el asentamiento y la supervivencia posterior al asentamiento en algas coralinas costrosas (ACC) en condiciones de laboratorio. Resultados: El desarrollo de embriones y larvas se documenta a lo largo de 55 h después del primer clivaje, cuando la larva está desarrollada completamente y comenzó el comportamiento previo al asentamiento. El asentamiento comienza 7 días después del primer clivaje y 37 días después, la mayoría de los pólipos presentan zooxantelas. El asentamiento larval fue más alto en Lythophyllum congestum y Titanoderma prototypum que en respuesta a Porolithon pachydermum, Neogoniolithon sp., Hydrolithon sp., y Lythophyllum sp. No hubo asentamiento sobre coral muerto ni en el control negativo (agua de mar esterilizada). La supervivencia bajó de un 59 % en la primera semana después del asentamiento, a 42 % durante la segunda semana y 0 % para el final de la tercera semana. Conclusiones: Las larvas de O. faveolata requieren señales de ciertas especies de ACC para asentarse, ellas no se asientan en ausencia de ACC. La disponibilidad de larvas es posible mediante la fertilización asistida en laboratorio. Sin embargo, debido a la alta mortalidad en las primeras fases posteriores al asentamiento, queda mucho por hacer para aumentar la producción de larvas y mejorar nuestro conocimiento y comprensión de las señales que mejoran el asentamiento y las que previenen o inhiben la supervivencia del recluta.