Mechanistic Insights into the Synthesis of Nickel-Graphene Nanostructures for Gas Sensors.

Toxic gases are used in different types of industries and thus, present a potential health hazard. Therefore, highly sensitive gas sensing materials are essential for the safety of those operating in their environments. A process involving electrospinning polymer solutions impregnated with transition metal ions are developed to yield nanofibers that are annealed to form graphitic carbon / nickel nanoparticle-based fibers for gas sensing applications. The performance of these gas sensors is strongly related to the ability to control the material parameters of the active material. As the formation of these nanostructures, which nucleate within solid carbon scaffolds, have not been investigated, the growth mechanisms are look to understand in order to exert control over the resulting material. Evaluation of these growth mechanisms are conducted through a combination of thermogravimetric analysis with mass spectrometry (TGA-MS), x-ray diffraction (XRD), scanning electron microscopy (SEM), transmission electron microscopy (TEM), and x-ray photoelectron spectroscopy (XPS) and reveal nucleation of nickel at the onset of the polymer scaffold decomposition with subsequent growth processes, including surface diffusion, aggregation, coalescence and evaporation condensation, that are activated at different temperatures. Gas sensing experiments conducted on analyte gases demonstrate good sensitivity and response times, and significant potential for use in other energy and environmental applications.

Dissolved arsenic and lead concentrations in rooftop harvested rainwater: Community generated dataset.

Here, we detail arsenic (As) and lead (Pb) concentrations in community science generated rooftop harvested rainwater data from Project Harvest (PH), a co-created community science study, and National Atmospheric Deposition Program (NADP) National Trends Network wet-deposition AZ samples as analyzed by Palawat et al. [1]. 577 field samples were collected in PH and 78 field samples were collected by NADP. All samples were analyzed via inductively coupled plasma mass spectrometry (ICP-MS) for dissolved metal(loid)s including As and Pb by the Arizona Laboratory for Emerging Contaminants after 0.45 um filtration and acidification. Method limits of detection (MLOD) were assessed and sample concentrations above MLODs were considered detects. Summary statistics and box and whisker plots were generated to assess variables of interest such as community and sampling window. Finally, As and Pb data is provided for potential reuse; the data can be used to assess contamination of harvested rainwater in AZ and to inform community use of natural resources.

Metabolomic Insights of Biosurfactant Activity from Bacillus niabensis against Planktonic Cells and Biofilm of Pseudomonas stutzeri Involved in Marine Biofouling.

In marine environments, biofilm can cause negative impacts, including the biofouling process. In the search for new non-toxic formulations that inhibit biofilm, biosurfactants (BS) produced by the genus Bacillus have demonstrated considerable potential. To elucidate the changes that BS from B. niabensis promote in growth inhibition and biofilm formation, this research performed a nuclear magnetic resonance (NMR) metabolomic profile analysis to compare the metabolic differences between planktonic cells and biofilms of Pseudomonas stutzeri, a pioneer fouling bacteria. The multivariate analysis showed a clear separation between groups with a higher concentration of metabolites in the biofilm than in planktonic cells of P. stutzeri. When planktonic and biofilm stages were treated with BS, some differences were found among them. In planktonic cells, the addition of BS had a minor effect on growth inhibition, but at a metabolic level, NADP+, trehalose, acetone, glucose, and betaine were up-regulated in response to osmotic stress. When the biofilm was treated with the BS, a clear inhibition was observed and metabolites such as glucose, acetic acid, histidine, lactic acid, phenylalanine, uracil, and NADP+ were also up-regulated, while trehalose and histamine were down-regulated in response to the antibacterial effect of the BS.

Primary HPV-DNA screening in women under 30 years of age: health technology assessment / Tamización primaria con prueba ADN-VPH en mujeres menores de 30 años: evaluación de tecnología sanitaria

Background: Primary screening with Human Papilloma Virus (HPV) testing was introduced in Colombia in 2014 for individuals between 30 and 65 years of age. When the result is positive, cytology triage is performed for colposcopy referral. The convenience of initiating HPV-DNA testing for screening at 25 years of age is currently a subject of discussion. Therefore, the objective of this health technology assessment (HTA) is to analyze the available evidence regarding safety, efficacy, cost-effectiveness, values and preferences, ethical dilemmas and considerations pertaining to the implementation of the HPV-DNA test as a cervical screening strategy in women under 30 years of age in the Colombian context. Domains to be assessed: Clinical efficacy and safety 1. Cumulative rate of cervical intraepithelial neoplasia (CIN) grade 2 or high-er after 2 screening rounds. 2. Cumulative rates of invasive cancer of the uterine cervix after 2 screening rounds. 3. Safety: referral to colposcopy. Cost-effectiveness Cost-effectiveness for Colombia. Other domains considered Ethical considerations associated with cervical screening in women under 30 years of age. Organizational and individual considerations. Barriers and facilitators pertaining to the implementation of cervical screening in women under 30 years of age in the Colombian context. Methods: Clinical efficacy and safety assessment A systematic literature search of systematic reviews and clinical trials was conducted in MEDLINE, Embase and CENTRAL. The body of evidence was rated using the GRADE approach. An interdisciplinary team was then convened to create a working group to review the retrieved evidence. This led to the discussion and construction of the conclusions following the guidelines of a formal consensus in accordance with the RAND/UCLA methodology. Economic study Systematic literature research of studies that had assessed cost-effectiveness for Colombia. Results: Clinical outcomes An integrative analysis of 5 randomized clinical trials that met the inclusion critera was performed. Compared with cytology, primary HPV-DNA testing in women under 30 years of age could be associated with a lower frequency of CIN+2 lesions during the first screening round (RR: 1.57; CI: 1.20 to 2.04; low evidence certainty), and a lower incidence of CIN+2 (RR: 0.67; CI: 0.48 to 0.92; low evidence certainty). Moreover, it is associated with a lower frequency of invasive carcinoma at the end of follow-up (RR: 0.19; CI: 0.07 to 0.53; high evidence certainty). Economic results From the financial point of view, the use of HPVDNA testing plus cytology-based triage starting at 25 years of age is perhaps the most cost-effective option for Colombia (incremental cost-effectiveness ratio, COP 8,820,980 in 2013). Other implications Two studies suggest that barriers to implementation attributable to intermediation, public unrest and geographic considerations could be overcome with the use of new screening technologies or strategies. It is important to consider administration and service provision alternatives in order to overcome some acceptability and access barriers. Any cervical screening program must take into consideration ethical principles of nonmaleficence, beneficence, autonomy and equity. Future studies should focus on analyzing new screening techniques with emphasis on the population under 30 years of age. Conclusions: The use of HPV-DNA testing as a screening strategy in women under 30 years of age is a potentially efficacious and cost-effective intervention for Colombia. Future studies should focus on analyzing new screening technologies, with emphasis on the population under 30 years of age.

Antecedentes: A partir del 2014 en Colombia se incorporó la Tamización primaria con prueba de Virus del Papiloma Humano (VPH) desde los 30 hasta los 65 años, cuando la prueba es positiva se hace triage con citología para remisión a colposcopia. Actualmente se discute la conveniencia de iniciar la tamización con prueba de ADN de VPH a partir de los 25 años. De esta manera, el objetivo de esta evaluación de tecnologías sanitarias es analizar la evidencia disponible en torno a la seguridad, efectividad, costoefectividad, valores y preferencias, dilemas éticos y aspectos relacionados con la implementación para el contexto colombiano de la prueba ADN-VPH como estrategia de tamización cervical en mujeres menores de 30 años. Dominios a evaluar: Eficacia clínica y seguridad 1. Tasa acumulada de neoplasia intraepitelial cervical (NIC) grado 2 o más avanzado luego de 2 rondas de tamización. 2. Tasas acumuladas de cáncer invasor de cérvix luego de 2 rondas de tamización. 3. Seguridad: remisión a colposcopia. Costo-efectividad Costo efectividad para Colombia. Otros dominios considerados Aspectos éticos asociados a la tamización cervical en mujeres menores de 30 años. Aspectos organizacionales y del individuo. Barreras y facilitadores relacionados con la implementación en el contexto colombiano de la tamización cervical en mujeres menores de 30 años. Métodos: Evaluación de efectividad y seguridad clínicas Se realizó una búsqueda sistemática de la literatura en MEDLINE, Embase y CENTRAL de revisiones sistemáticas y ensayos clínicos. Se calificó el cuerpo de la evidencia con la aproximación GRADE. Posteriormente, se convocó a un grupo interdisciplinario a una mesa de trabajo en donde se presentó la evidencia recuperada, dando paso a la discusión y a la construcción de las conclusiones, siguiendo los lineamientos de un consenso formal acorde a la metodología RAND/UCLA. Estudio económico Se hizo una búsqueda sistemática de la literatura de estudios que hubieran evaluado el costo-efectividad para Colombia. Resultados: De 7.659 referencias recuperadas se incluyeron 8 estudios. Resultados clínicos Se realizó un análisis integrativo de 5 ensayos clínicos aleatorizados que cumplieron con los criterios de inclusión. Cuando se compara frente a la citología, la tamización primaria con ADN-VPH en mujeres menores de 30 años, podría asociarse con una mayor frecuencia de detección de lesiones NIC2+ durante la primera ronda de cribado (RR: 1.57; IC: 1,20 a 2,04; certeza en la evidencia baja), con una menor incidencia de NIC2+ (RR:0,67; IC: 0,48 a 0,92; certeza en la evidencia baja) y se asocia con una menor frecuencia de carcinoma invasor al término del seguimiento (RR: 0,19; IC: 0,07 a 0,53; certeza en la evidencia alta). Resultados económicos Desde el punto de vista económico, la alternativa de ADN-VPH y triage con citología desde los 25 años quizás representa la alternativa más costo-efectiva para Colombia (razón costo-efectividad incremental $8.820.980 COP año 2013). Otras implicaciones Dos estudios sugieren que las barreras de implementación, atribuibles a circunstancias de intermediación, de orden público y de carácter geográfico, podrían ser solventadas por nuevas tecnologías o estrategias de cribado. Es importante considerar alternativas de forma de administración y de prestación de servicios para solventar algunas barreras de aceptabilidad y acceso. Todo programa de tamización cervical debe contemplar los principios éticos de no maleficencia, beneficencia, autonomía y equidad. Futuros estudios deben enfocarse en analizar nuevas tecnologías de cribado con énfasis en población menor de 30 años. Conclusiones: El uso de la prueba ADN-VPH como estrategia de tamización en mujeres menores de 30 años es una intervención probablemente efectiva y costoefectiva para Colombia. Futuros estudios deben enfocarse en analizar nuevas tecnologías de cribado con énfasis en población menor de 30 años.

Interventions aiming to eliminate catastrophic costs due to tuberculosis: a protocol for a systematic review and meta-analysis.

Background : People with tuberculosis disease and their household members may suffer direct out-of-pocket expenses and indirect costs of lost income. These tuberculosis-related costs can worsen poverty, make tuberculosis treatment completion unaffordable, impair quality of life and increase the risk of death. Costs due to tuberculosis are usually defined as catastrophic if they exceed 20% of the pre-disease annual household income. The World Health Organisation strategy to "End TB" and the United Nations Sustainable Development Goals include the target that no households should face catastrophic costs due to tuberculosis. However, there is limited evidence and policy concerning how this global priority of eliminating catastrophic costs due to tuberculosis should be achieved. This systematic review and meta-analysis aims to address this knowledge gap. Methods : Publications assessing interventions that aimed to eliminate catastrophic costs will be identified by searching three electronic databases (PubMed, Scopus and Web of Science) together with reference lists from pertinent publications. We will screen eligible studies, extract data, and assess the risk of bias with the quality assessment tool from the National Heart, Lung, and Blood Institute. Discrepancies will be resolved by discussion between the reviewers. If we find sufficient comparable studies quantifying strategies to eliminate catastrophic costs then a meta-analysis will be performed. This systematic review and meta-analysis is registered with the PROSPERO database (CRD42022292410). Conclusion : This systematic review and meta-analysis aims to rigorously assess the evidence for strategies to eliminate catastrophic costs due to tuberculosis.

Assessing Liver Fibrosis Using the FIB4 Index in the Community Setting.

Liver disease is frequently asymptomatic, challenging early identification in the primary care setting. The fibrosis 4 (FIB4) index is a liver fibrosis biomarker that is a potential alternative to liver biopsy for diagnosing and managing liver disease. This study aimed to calculate the FIB4 index for screening individuals at high risk of liver disease at the community level. This was a retrospective real-world study analyzing blood and serum test results from a central laboratory. The primary outcome was the number of individuals within each risk category for hepatic fibrosis: high risk (FIB4 ≥ 3.25) and low risk (FIB4 < 1.3). The analysis included samples from 31,753 patients, of which 18,102 were aged 40 to 75 years. In these patients, the FIB4 index had been explicitly requested in 1852 (10.2%) cases and estimated ad hoc in the rest. Of the 263 (1.5%) cases with FIB4 ≥ 3.25, the FIB4 index was requested in 46 (17.5%), and 52 (19.8%) showed evidence of liver fibrosis in their medical records, while the rest did not report any data regarding liver fibrosis. FIB4 is a simple score that can play a role as a "red flag" for early identification of patients at high risk of advanced liver fibrosis and their referral to specialized care.

Prevalence of high-risk human papilloma virus infection and abnormal cytology of the anal transformation zone in women with cervical dysplasia. Bogotá, Colombia, 2017-2019 / Prevalencia de infección por virus del papiloma humano de alto riesgo y citología anormal en la zona de transformación anal en mujeres con displasia cervical. bogotá, colombia, 2017-2019

RESUMEN Objetivo: Establecer la prevalencia de infección anal por virus de papiloma humano de alto riesgo (VPH- AR) y citología anal anormal en mujeres con displasia cervical confirmada. Materiales y métodos: Estudio de corte transversal que incluyó pacientes entre 30 y 65 años con diagnóstico nuevo de displasia cervical por histopatología, en dos unidades de colposcopia y patología del tracto genital inferior (una de carácter público y otra privada) entre diciembre de 2017 y abril de 2019. Se excluyeron mujeres con infección por virus de inmunodeficiencia humana (VIH), inmuno compromiso (uso de esteroides, trasplante, quimioterapia), en embarazo o con malformaciones anorrectales. Muestreo consecutivo. Se evaluaron variables sociodemográficas, tipo de relaciones sexuales, el grado de displasia cervical, resultado positivo de prueba de reacción en cadena de la polimerasa para VPH de alto riesgo en canal anal y tipo de VPH-AR identificado (16-18 u otro). Se utilizó estadística descriptiva. Resultados: De 188 candidatas a ingresar se incluyeron 100 pacientes en el análisis, se encontró unaprevalencia de 32 % de infección por VPH de alto riesgo y de 2,8 % de citología anal anormal (ASCUS) en el canal anal. El 68,8 % de las infecciones por VPH-AR en el canal anal correspondió a genotipos de VPH-AR diferentes a 16 o 18. Conclusiones: La prevalencia de infección anal por VPH-AR en mujeres con displasia cervical fue del 32 %. Es importante determinar la utilidad del tamizaje del compromiso de la mucosa anal por virus VPH de alto riesgo de cáncer en mujeres con displasia cervical. Se requieren estudios sobre el pronóstico de la infección anal por VPH-AR en las mujeres con displasia cervical.

ABSTRACT Objective: To determine the prevalence of anal infection caused by high risk human papilloma virus (HR-HPV) and of abnormal anal cytology in women with confirmed cervical dysplasia. Materials and methods: Cross sectional study that included patients between 30 and 65 years of age with a new diagnosis of cervical dysplasia by histopathology attended in two lower genital tract colposcopy and pathology units (one public and one private institution), conducted between December 2017 and April 2019. Women with human immunodeficiency virus (HIV) infection, immune compromise (use of steroids, transplant, chemo therapy), pregnancy or anorectal malformations were excluded. Consecutive sampling. Socio demographic variables, intercourse type, degree of cervical dysplasia, positive results of HR HPV Polymerase Chain Reaction test in anal canal and HR - HPV type indentified (16-18 or others) were evaluated. Descriptive statistics were used. Results: Of 188 candidates, 100 were included in the analysis. A 32 % prevalence of high-risk HPV infection and a 2.8 % prevalence of abnormal cytology in the anal canal (ASCUS) were found. Of the HR-HPV infections in the anal canal, 68.8 % corresponded to HR-HPV genotypes different from 16 or 18. Conclusions: Prevalence of HR HPV infection in women with lower genital tract dysplasia was 32%. It is important to determine the usefulness of screening for anal mucosa compromise by HPV virus associated with a high risk of cancer in women with cervical dysplasia. Studies are needed on the prognosis of anal HR-HPV infection in women with cervical dysplasia.

A natural impact-resistant bicontinuous composite nanoparticle coating.

Nature utilizes the available resources to construct lightweight, strong and tough materials under constrained environmental conditions. The impact surface of the fast-striking dactyl club from the mantis shrimp is an example of one such composite material; the shrimp has evolved the capability to localize damage and avoid catastrophic failure from high-speed collisions during its feeding activities. Here we report that the dactyl club of mantis shrimps contains an impact-resistant coating composed of densely packed (about 88 per cent by volume) ~65-nm bicontinuous nanoparticles of hydroxyapatite integrated within an organic matrix. These mesocrystalline hydroxyapatite nanoparticles are assembled from small, highly aligned nanocrystals. Under impacts of high strain rates (around 104 s-1), particles rotate and translate, whereas the nanocrystalline networks fracture at low-angle grain boundaries, form dislocations and undergo amorphization. The interpenetrating organic network provides additional toughening, as well as substantial damping, with a loss coefficient of around 0.02. An unusual combination of stiffness and damping is therefore achieved, outperforming many engineered materials.

Mechanism of water extraction from gypsum rock by desert colonizing microorganisms.

Microorganisms, in the most hyperarid deserts around the world, inhabit the inside of rocks as a survival strategy. Water is essential for life, and the ability of a rock substrate to retain water is essential for its habitability. Here we report the mechanism by which gypsum rocks from the Atacama Desert, Chile, provide water for its colonizing microorganisms. We show that the microorganisms can extract water of crystallization (i.e., structurally ordered) from the rock, inducing a phase transformation from gypsum (CaSO4·2H2O) to anhydrite (CaSO4). To investigate and validate the water extraction and phase transformation mechanisms found in the natural geological environment, we cultivated a cyanobacterium isolate on gypsum rock samples under controlled conditions. We found that the cyanobacteria attached onto high surface energy crystal planes ({011}) of gypsum samples generate a thin biofilm that induced mineral dissolution accompanied by water extraction. This process led to a phase transformation to an anhydrous calcium sulfate, anhydrite, which was formed via reprecipitation and subsequent attachment and alignment of nanocrystals. Results in this work not only shed light on how microorganisms can obtain water under severe xeric conditions but also provide insights into potential life in even more extreme environments, such as Mars, as well as offering strategies for advanced water storage methods.

Quality of life, tuberculosis and treatment outcome; a case-control and nested cohort study.

BACKGROUND: Global tuberculosis policy increasingly emphasises broad tuberculosis impacts and highlights the lack of evidence concerning tuberculosis-related quality of life (QOL). METHODS: Participants were recruited in 32 Peruvian communities between July 13, 2016 and February 24, 2018 and followed-up until November 8, 2019. Inclusion criteria were age ≥15 years for "patients" (n=1545) starting treatment for tuberculosis disease in health centres; "contacts" (n=3180) who shared a patient's household for ≥6 h·week-1; and randomly selected "controls" (n=277). The EUROHIS-QOL questionnaire quantified satisfaction with QOL, health, energy, activities of daily living (ADL), self, relationships, money and living place. FINDINGS: Newly diagnosed tuberculosis was most strongly associated with lower QOL scores (p<0.001). Patients initially had lower QOL than controls for all EUROHIS-QOL questions (p≤0.01), especially concerning health, ADL and self. Lower initial QOL in patients predicted adverse treatment outcomes and scores <13 points had 4.2-fold (95% CI 2.3-7.6) increased risk of death versus those with higher QOL scores (both p<0.001). Patient QOL was re-assessed 6 months later, and for patients with successful treatment QOL became similar to participants who had never had tuberculosis, whereas patients who did not complete treatment continued to have low QOL (p<0.001). Multidrug-resistant tuberculosis was associated with lower QOL before and during treatment (both p<0.001). Contacts had lower QOL if they lived with a patient who had low QOL score (p<0.0001) or were a caregiver for the patient (p<0.001). CONCLUSIONS: Tuberculosis was associated with impaired psychosocioeconomic QOL which recovered with successful treatment. Low QOL scores predicted adverse treatment outcome. This brief EUROHIS-QOL eight-item questionnaire quantified the holistic needs of tuberculosis-affected people, potentially guiding patient-centred care.

Ultrastructures and Mechanics of Annealed Nephila clavipes Major Ampullate Silk.

The semicrystalline protein structure and impressive mechanical properties of major ampullate (MA) spider silk make it a promising natural alternative to polyacrylonitrile (PAN) fibers for carbon fiber manufacture. However, when annealed using a similar procedure to carbon fiber production, the tensile strength and Young's modulus of MA silk decrease. Despite this, MA silk fibers annealed at 600 °C remain stronger and tougher than similarly annealed PAN but have a lower Young's modulus. Although MA silk and PAN graphitize to similar extents, annealing disrupts the hydrogen bonding that controls crystal alignment within MA silk. Consequently, unaligned graphite crystals form in annealed MA silk, causing it to weaken, while graphite crystals in PAN maintain alignment along the fiber axis, strengthening the fibers. These shortcomings of spider silk when annealed provide insights into the selection and design of future alternative carbon fiber precursors.

Prevalence of high-risk human papilloma virus infection and abnormal cytology of the anal transformation zone in women with cervical dysplasia. Bogotá, Colombia, 2017-2019.

OBJECTIVE: To determine the prevalence of anal infection caused by high risk human papilloma virus (HR-HPV) and of abnormal anal cytology in women with confirmed cervical dysplasia. METHODS: Cross sectional study that included patients between 30 and 65 years of age with a new diagnosis of cervical dysplasia by histopathology attended in two lower genital tract colposcopy and pathology units (one public and one private institution), conducted between December 2017 and April 2019. Women with human immunodeficiency virus (HIV) infection, immune compromise (use of steroids, transplant, chemo therapy), pregnancy or anorectal malformations were excluded. Consecutive sampling. Socio demographic variables, intercourse type, degree of cervical dysplasia, positive results of HR HPV Polymerase Chain Reaction test in anal canal and HR - HPV type indentified (16-18 or others) were evaluated. Descriptive statistics were used. RESULTS: Of 188 candidates, 100 were included in the analysis. A 32 % prevalence of high-risk HPV infection and a 2.8 % prevalence of abnormal cytology in the anal canal (ASCUS) were found. Of the HR-HPV infections in the anal canal, 68.8 % corresponded to HR-HPV genotypes different from 16 or 18. CONCLUSIONS: Prevalence of HR HPV infection in women with lower genital tract dysplasia was 32%. It is important to determine the usefulness of screening for anal mucosa compromise by HPV virus associated with a high risk of cancer in women with cervical dysplasia. Studies are needed on the prognosis of anal HR-HPV infection in women with cervical dysplasia.

TITULO: PREVALENCIA DE INFECCIÓN POR VIRUS DEL PAPILOMA HUMANO DE ALTO RIESGO Y CITOLOGÍA ANORMAL EN LA ZONA DE TRANSFORMACIÓN ANAL EN MUJERES CON DISPLASIA CERVICAL. BOGOTÁ, COLOMBIA, 2017-2019. OBJETIVO: Establecer la prevalencia de infección anal por virus de papiloma humano de alto riesgo (VPH- AR) y citología anal anormal en mujeres con displasia cervical confirmada. METODOS: Estudio de corte transversal que incluyó pacientes entre 30 y 65 años con diagnóstico nuevo de displasia cervical por histopatología, en dos unidades de colposcopia y patología del tracto genital inferior (una de carácter público y otra privada) entre diciembre de 2017 y abril de 2019. Se excluyeron mujeres con infección por virus de inmunodeficiencia humana (VIH), inmuno compromiso (uso de esteroides, trasplante, quimioterapia), en embarazo o con malformaciones anorrectales. Muestreo consecutivo. Se evaluaron variables sociodemográficas, tipo de relaciones sexuales, el grado de displasia cervical, resultado positivo de prueba de reacción en cadena de la polimerasa para VPH de alto riesgo en canal anal y tipo de VPH-AR identificado (16-18 u otro). Se utilizó estadística descriptiva. RESULTADOS: De 188 candidatas a ingresar se incluyeron 100 pacientes en el análisis, se encontró unaprevalencia de 32 % de infección por VPH de alto riesgo y de 2,8 % de citología anal anormal (ASCUS) en el canal anal. El 68,8 % de las infecciones por VPH-AR en el canal anal correspondió a genotipos de VPH-AR diferentes a 16 o 18. CONCLUSIONES: La prevalencia de infección anal por VPH-AR en mujeres con displasia cervical fue del 32 %. Es importante determinar la utilidad del tamizaje del compromiso de la mucosa anal por virus VPH de alto riesgo de cáncer en mujeres con displasia cervical. Se requieren estudios sobre el pronóstico de la infección anal por VPH-AR en las mujeres con displasia cervical.

Carga mental en personal de enfermería: Una revisión integradora / Mental workload in nursing staff: An integrative review / Carga de trabalho mental no pessoal de enfermagem: uma revisão integrativa

Introducción: Los profesionales de enfermería están expuestos constantemente a situaciones que generan carga como consecuencia del esfuerzo físico, mental, emocional y económico del cuidado. Objetivo: Identificar a través de la literatura científica el concepto de "Carga Mental en enfermeras", los instrumentos de medición y las estrategias para mitigarla o prevenirla. Metodología: Se realizó una revisión integradora de literatura durante los años 2017 a 2019 sobre artículos publicados desde el año 2000. Se utilizaron las palabras clave DeCS en Español, Inglés y Portugués de: Carga de Trabajo-Workload-Carga de Trabalho, Fatiga Mental- Mental Fatigue- Fadiga Mental, Atención a la Salud Mental-Mental Health Assistance- Assistência à Saùde Mental, Enfermeras-Nurses-Enfermeiras. Las bases de datos consultadas fueron: ProQuest, Scielo, ScienceDirect, Ovid Nursing, Wiley Online Library, EBSCO, ClinicalKey, PubMed, SCOPUS. Se analizaron 39 artículos que cumplieron con los criterios de inclusión. Resultados: Las categorías de análisis fueron: Concepto de carga mental, instrumentos de medición de carga mental en enfermeras y estrategias para mitigarla o prevenirla. Conclusiones: La carga mental es un constructo complejo sin consenso en su definición, incluye varias dimensiones, implica realizar mediciones e intervenciones cognitivas de la función mental, estrés, asertividad y percepción. Se valora a través de medidas fisiológicas de rendimiento y subjetivas. Las últimas han sido las más utilizadas aplicando el método NASA TLX. Las estrategias para mitigarla son: Uso de tecnologías, potenciación de capacidades individuales, justicia distributiva y comunicación asertiva.

Introduction: Nursing professionals are constantly exposed to situations that generate burden as a consequence of the physical, mental, emotional and economic effort of care. Objective: To identify through the scientific literature the concept of "Mental Burden in nurses", the measurement instruments and the strategies to mitigate or prevent it. Methodology: An integrative literature review was carried out during the years 2017 to 2019 on articles published since 2000. The DeCS keywords in Spanish, English and Portuguese were used: Workload-Workload-Workload, Mental Fatigue- Mental Fatigue- Fadiga Mental, Attention to Mental Health-Mental Health Assistance- Assistência à Saùde Mental, Nurses-Nurses-Diseases. The databases consulted were: ProQuest, Scielo, ScienceDirect, Ovid Nursing, Wiley Online Library, EBSCO, ClinicalKey, PubMed, SCOPUS. 39 articles that met the inclusion criteria were analyzed. Results: The categories of analysis were: Concept of mental load, instruments for measuring mental load in nurses and strategies to mitigate or prevent it. Conclusions: The mental load is a complex construct without consensus in its definition, it includes several dimensions, it implies carrying out measurements and cognitive interventions of mental function, stress, assertiveness and perception. It is assessed through subjective and physiological performance measures. The last ones have been the most used applying the NASA TLX method. The strategies to mitigate it are: use of technologies, empowerment of individual capacities, distributive justice and assertive communication.

Introdução: Os profissionais de enfermagem estão constantemente expostos a situações que geram carga em consequência do esforço físico, mental, emocional e econômico do cuidado. Objetivo: Identificar, através da literatura científica, o conceito de "Carga Mental no enfermeiro", os instrumentos de medida e as estratégias para mitigá-lo ou preveni-lo. Metodologia: Foi realizada uma revisão integrativa da literatura durante os anos de 2017 a 2019 em artigos publicados desde 2000. As palavras-chave DeCS em espanhol, inglês e português de: Carga de trabalho-Carga de trabalho-Carga de trabalho, Fadiga mental- Fadiga Mental - Fadiga Mental, Assistência à Saúde Mental - Assistência em Saúde Mental - Assistência à Saúde Mental, Enfermeiros-Enfermeiros-Doenças. Os bancos de dados consultados foram: ProQuest, Scielo, ScienceDirect, Ovid Nursing, Wiley Online Library, EBSCO, ClinicalKey, PubMed, SCOPUS. Foram analisados 39 artigos que atenderam aos critérios de inclusão. Resultados: As categorias de análise foram: conceito de carga mental, instrumentos para medir a carga mental em enfermeiros e estratégias para mitigá-la ou preveni-la. Conclusões: A carga mental é um construto complexo, sem consenso em sua definição, inclui várias dimensões, envolve a realização de medidas cognitivas e intervenções da função mental, estresse, assertividade e percepção. É avaliado através de desempenho fisiológico e medidas subjetivas. Estes últimos foram os mais amplamente utilizados aplicando o método TLX da NASA. As estratégias para mitigá-lo são: uso de tecnologias, fortalecimento de capacidades individuais, justiça distributiva e comunicação assertiva.

Triglycerides/Glucose and Triglyceride/High-Density Lipoprotein Cholesterol Indices in Normal and Preeclamptic Pregnancies: A Longitudinal Study.

Metabolic changes have been correlated with adverse pregnancy outcomes. The aim of the present study is to determine the TyG and TG/HDL-c indices in a cohort of healthy pregnant (n = 142), preeclamptic (n = 18), and healthy nonpregnant women (n = 56). Preeclamptic women were selected from the same cohort. Pregnant women were followed during three periods of pregnancy and postpartum. The results showed a significant increase in the values of TyG and TG/HDL-c (p < 0.01) as pregnancy progresses, without significant differences between healthy and preeclamptic women. TyG and TG/HDL-c indices are significantly low in nonpregnant and three months' postpartum women when compared with each gestational period studied. TyG and TG/HDL-c indices are positively correlated with HOMA-IR in the early and middle pregnancy (p < 0.05). Multiple linear regression using the TyG and TG/HDL-c indices as dependent variables showed that TyG index was significantly associated with HOMA-IR, gestational age, HDL-c, TC, LDL, fasting insulin, and mean BP (p < 0.001); meanwhile, TG/HDL-c index was only associated with HOMA-IR (p < 0.0242) and gestational age (p < 0.001). In conclusion, the TyG and TG/HDL-c indices could be useful in monitoring insulin resistance during pregnancy.

Electrocatalytic N-Doped Graphitic Nanofiber - Metal/Metal Oxide Nanoparticle Composites.

Carbon-based nanocomposites have shown promising results in replacing commercial Pt/C as high-performance, low cost, nonprecious metal-based oxygen reduction reaction (ORR) catalysts. Developing unique nanostructures of active components (e.g., metal oxides) and carbon materials is essential for their application in next generation electrode materials for fuel cells and metal-air batteries. Herein, a general approach for the production of 1D porous nitrogen-doped graphitic carbon fibers embedded with active ORR components, (M/MOx , i.e., metal or metal oxide nanoparticles) using a facile two-step electrospinning and annealing process is reported. Metal nanoparticles/nanoclusters nucleate within the polymer nanofibers and subsequently catalyze graphitization of the surrounding polymer matrix and following oxidation, create an interconnected graphite-metal oxide framework with large pore channels, considerable active sites, and high specific surface area. The metal/metal oxide@N-doped graphitic carbon fibers, especially Co3 O4 , exhibit comparable ORR catalytic activity but superior stability and methanol tolerance versus Pt in alkaline solutions, which can be ascribed to the synergistic chemical coupling effects between Co3 O4 and robust 1D porous structures composed of interconnected N-doped graphitic nanocarbon rings. This finding provides a novel insight into the design of functional electrocatalysts using electrospun carbon nanomaterials for their application in energy storage and conversion fields.

Perfil sociodemográfico, condiciones de salud y atención a personas con diabetes / Socio-demographic profile, health conditions and care for people with diabetes / Perfil sócio demográfico, condições de saúde e cuidados para as pessoas com diabetes

Objetivo: Analizar el perfil sociodemográfico, condiciones de salud y atención a personas con diabetes, a partir de la revisión de historias clínicas. Materiales y Métodos: Estudio descriptivo transversal. La población fue de 821 historias clínicas de pacientes con diabetes mellitus. En total la muestra fue de 230 historias clínicas por método aleatorio simple. Se utilizó el instrumento Impacto en la Condición de Salud y Calidad de Vida de las Atenciones de Salud en Pacientes Diabéticos Tipo 2 de Macul, que evalúa el perfil sociodemográfico, las condiciones de salud y el tipo de atención otorgada. Resultados: 39 % de los pacientes presentó el valor de la última hemoglobina glicosilada mayor de 12 %, el 41,3 % no presentó ningún riesgo de pie diabético, 46,9 % tuvo diagnóstico de obesidad y el 23,9 % presentó sobrepeso. El porcentaje de cumplimiento de citas al mes por parte del médico y la enfermera fue del 100 %, a diferencia del control por parte de la nutricionista que debe realizase cada 6 meses, sólo se registró un cumplimiento del 71,7 %. No se encontró relación estadísticamente significativa entre asistencia al programa con adherencia al tratamiento, o con compensación de la enfermedad. Conclusiones: Los pacientes con diabetes a pesar de estar en un programa de atención integral, no tienen un óptimo control glicémico, lo cual sugiere la revisión del cumplimiento del régimen terapéutico por parte de los profesionales de la salud para prevenir complicaciones que se puedan presentar a corto, mediano o largo plazo.

Objective: To analyze the socio-demographic profile, health conditions and attention to people with diabetes from a review of medical records. Materials and Methods: Cross-sectional descriptive study. The population was of 821 medical records of patients with diabetes mellitus. In total the sample was of 230 medical records through a simple aleatory method. The Impact instrument was used in the Health Condition and Life Quality of the Health Care in Diabetic Patients Type 2 from Macul, that evaluates the socio-demographic profile, the health conditions and the type of attention given. Results: 39% of the patients presented the value of the last glycosylated hemoglobin greater than 12%, 41,3% did not present any risks of diabetic foot, 46,9% had an obesity diagnose and 23,9% presented overweight. The doctor and the nurse percentage of compliance of appointments per month was 100%, as opposed to the control by the nutritionist that must be performed every 6 months, only a of 71,1% of compliance was registered. A statistically significant relationship was not found between compliance to the program and treatment adherence, or with compensation for the disease. Conclusions: Patients with diabetes despite of being in a program of comprehensive care, do not have an optimal glycemic control, which suggests a review of the compliance of the therapeutic regime by the health professionals to prevent complications that may occur in a short, medium, or long term.

Objetivo: Analisar o perfil sócio demográfico, condições de saúde e cuidados para as pessoas com diabetes a partir da revisão de histórias clínicas. Materiais e Métodos: Estudo descritivo transversal. A população foi de 821 historias clínicas de pacientes com diabetes mellitus. Em total a amostra foi de 230 historias clínicas por método aleatório simples. Utilizou-se o instrumento Impacto na Condição de Saúde e Qualidade de Vida das Assistências Médicas em Pacientes Diabéticos Tipo 2 de Macul, que avalia o perfil sócio demográfico, as condições de saúde e o tipo de atendimento recebido. Resultados: 39% dos pacientes apresentaram o valor da última hemoglobina glicada (Hb A1c) maior de 12%, o 41,3% não apresentou nenhum risco de pé diabético, 46,9% tiveram diagnóstico de obesidade e o 23,9% apresentaram excesso de peso. A porcentagem de cumprimento de consultas ao mês por parte do médico e a enfermeira foi do 100%, a diferença do controle por parte da nutricionista que deve realizar-se a cada 6 meses, apenas registrou-se um cumprimento do 71,7%. Não se encontrou relação estatisticamente significativa entre assistência ao programa com aderência ao tratamento, ou com compensação da doença. Conclusões: Os pacientes com diabetes a pesar de estar num programa de atendimento integral, não tem um óptimo controle glicémico, o qual sugere a revisão do cumprimento do regime terapêutico por parte dos professionais da saúde para prevenir complicações que se possam apresentar a curto, médio ou longo prazo.

Estrategias que modulan el síndrome de Burnout en enfermeros (as): una revisión bibliográfica / Strategies that modulate the Burnout syndrome in nurses: a bibliographic review / Estratégias que modulam a síndrome de Burnout em enfermeiros (as): uma revisão de literatura

Introducción: el síndrome de Burnout es la sensación de agotamiento y pérdida de interés por el trabajo que surge en profesionales que mantienen contacto diario con otras personas. Metodología: se realizó una revisión de artículos que reportan estrategias para modular el Burnout en profesionales de enfermería, en las siguientes bases de datos: Scielo, ProQuest, Sciencie Direct, Ovid Nursing, EBSCO, Medline, Pubmed y Wiley Online Library. Los descriptores en español, inglés y portugués utilizados fueron: Burnout, enfermeras, intervenciones. Se encontraron 1.833 artículos, de los cuales 17 cumplieron con los criterios de selección. Resultados: el efecto de las intervenciones pre y post para el Burnout fue medido con el Maslach Burnout Inventory y la Escala de Depresión y Ansiedad Hospitalaria, entre otros. Las intervenciones más reportadas fueron apoyo social, psico-educación, entrenamiento en la solución de problemas y en habilidades de comunicación. 16 artículos reportaron disminución o ausencia del Burnout después de las intervenciones, con cambios en las variables propuestas por Maslach y Jackson o en la sostenibilidad en el tiempo. Conclusión: se reportan estrategias para el Burnout sin distinción de las variables del mismo; sin embargo, se evidencian diferencias en los resultados frente a cambios positivos en cansancio emocional, en comparación con las otras variables.

Introduction: the Burnout syndrome is the feeling of exhaustion and loss of interest in the work that emerges in professionals that maintain daily contact with other people. Methodology: A review of articles that report strategies to modulate the Burnout in nursing professionals was performed in the following databases: Scielo, ProQuest, ScienceDirect, Ovid Nursing, EBSCO, Medline, Pubmed and Wiley Online Library. The descriptors used in Spanish, English and Portuguese were: Burnout, nurses, interventions. 1833 articles were found, in which 17 met the criteria of selection. Results: the effects of pre and post interventions for the Burnout was measured with the Maslach Burnout Inventory and the Hospital Anxiety and Depression Scale, among others. The interventions most reported were social support, psychoeducation, problem solving training and communication skills. 16 articles reported the decrease or absence of Burnout after the interventions, with changes in the variables proposed by Maslach and Jackson or in the sustainability over time. Conclusion: strategies for the Burnout are reported without distinction of the variables; however, differences are evidenced on the results regarding positive changes in emotional tiredness, compared to other variables

Introdução: a síndrome de Burnout é um transtorno adaptativo crônico associado às demandas e exigências laborais, cujo desenvolvimento é insidioso e frequentemente não reconhecido pelo indivíduo, que gera cansaço emocional, sensação de esgotamento e perda de interesse pelo trabalho, principalmente apresentando-se em professionais que mantem contato diário com outras pessoas. Metodologia: realizou-se uma revisão de artigos que reportam estratégias para modular o Burnout em professionais de enfermagem, nas seguintes bases de dados: Scielo, ProQuest, Sciencie Direct, Ovid Nursing, EBSCO, Medline, Pubmed e Wiley Online Library. Os descritores utilizados em espanhol, inglês e português foram: Burnout, enfermeiras, intervenções. Encontraram-se 1.833 artigos, dos quais 17 cumpriram com os critérios de seleção. Resultados: o efeito das intervenções pré e pós para o Burnout foi medido com o Maslach Burnout Inventory e a Escala de Depressão e Ansiedade Hospitalar, entre outros. As intervenções mais reportadas foram apoio social, psico-educação, treinamento na solução de problemas e em habilidades de comunicação. 16 artigos reportaram diminuição ou ausência do Burnout depois das intervenções, com mudanças nas variáveis propostas por Maslach e Jackson ou na sustentabilidade no tempo. Conclusão: se reportam estratégias para o Burnout sim distinção das variáveis do mesmo; porém, se evidenciam diferenças nos resultados frente a mudanças positivas em cansaço emocional, em comparação com as outras variáveis.