Profiles of COVID-19 vaccine hesitancy by race and ethnicity in eastern Pennsylvania.

BACKGROUND: Throughout US history, chronic and infectious diseases have severely impacted minority communities due to a lack of accessibility to quality healthcare and accurate information, as well as underlying racism. These fault lines in the care of minority communities in the US have been further exacerbated by the rise of the COVID-19 pandemic. This study examined the factors associated with COVID-19 vaccine hesitancy by race and ethnicity, particularly among African American and Latinx communities in Eastern Pennsylvania (PA). METHODS: Survey data was collected in July 2021 in Philadelphia, Scranton, Wilkes-Barre, and Hazleton, PA. The 203 participants (38.7% Black, 27.5% Latinx) completed the 28-question survey of COVID-19 vaccination attitudes in either English or Spanish. RESULT: Out of the 203 participants, 181 participants met all the inclusion criteria, including completed surveys; of these participants, over three-fifths (63.5%) were acceptant of the COVID-19 vaccine whereas the remainder (36.5%) were hesitant. Binary logistic regression results showed that age, concern for vaccine efficacy, race, knowledge on the vaccine, and belief that the COVID-19 virus is serious significantly influenced COVID-19 vaccine hesitancy. Minorities were more likely to be hesitant toward vaccination (OR: 2.8, 95% CI: 1.1, 6.8) than non-Hispanic whites. Those who believed the COVID-19 vaccine was ineffective (OR: 8.3, 95% CI: 3.8, 18.2), and that the virus is not serious (OR: 8.3, 95% CI: 1.1, 61.8) showed the greatest odds of hesitancy. CONCLUSIONS: Minority status, age less than 45 years, misinformation about seriousness of COVID-19 illness, and concern about vaccine efficacy were contributing factors of COVID-19 vaccine hesitancy. Therefore, understanding and addressing the barriers to COVID-19 vaccination in minority groups is essential to decreasing transmission and controlling this pandemic, and will provide lessons on how to implement public health measures in future pandemics.

Laparoscopic revisional surgery for an unusual complication of Roux-en-Y gastric bypass.

With the worldwide epidemic of obesity, there has been an increase in the numbers of primary and revisional procedures of bariatric surgery such as the Roux-en-Y gastric bypass (RYGBP). Nevertheless, this type of surgery is not exempt from complications. An excessive length of non-functional Roux limb proximal to the jejunojejunostomy can cause abnormal upper gastrointestinal symptoms after laparoscopic RYGBP. We present the case of a female patient who presented these unspecific abdominal symptoms after laparoscopic RYGBP who underwent laparoscopic resection in order to reduce the length of the dilated blind loop responsible for the symptoms.

Distribución espacial de algunas propiedades físicas del suelo en un transecto de la granja tunguavita, paipa

El uso de técnicas geoestadísticas permite conocer la variabilidad de las propiedades de los suelos y facilita la interpretación, la predicción y la toma de decisiones. Con el fin de establecer el impacto del manejo que se le ha dado a la granja Tunguavita, se realizó un transecto, en el cual, se tomaron 85 puntos de muestreo, que se encontraban en un zona de bosque, dedicada a pastos y a explotación equina. Se determinaron las relaciones de masa-volumen, las humedades en profundidad y las resistencias a la penetración a dos profundidades. La aireación fue la relación de masa- volumen que presentó el mayor coeficiente de variación, lo que implica un manejo diferente a lo largo del transecto evaluado. La densidad real y la porosidad tienen una baja dispersión en el espacio. Las densidades aparente y real, la porosidad, la aireación y la relación de vacíos tuvieron un rango superior a 1000m. Los muestreos para la resistencia a la penetración y las humedades medidas con TDR, se deberían hacer cada 600m. La resistencia a la penetración mostró ser inversamente proporcional al contenido de humedad en el suelo. Las variables medidas se correlacionan en dos grupos: el primero, asocia a las densidades con las humedades medidas a diferentes profundidades y, el segundo grupo, relaciona la resistencia a la penetración a 15cm con la medida a 30cm. La resistencia a la penetración es un buen indicador de la compactación del suelo y del manejo agropecuario que se da en la granja Tunguavita.

The use ofgeostatistical techniques allows to find the variability of soil properties and also facilitates interpretation, prediction and decision making. Therefore, in order to establish the impact of management that has been given to the farm Tunguavita, a transect was conducted in which 85 sample points were taken, located found in a wooded area, an area devoted to pasture, and an area of equine exploitation. Volume mass ratios, humidities in depth and resistance to penetration at two depths was determined. Aeration was the mass-volume ratio that had the highest variation coefficient, which implies the different management practices along the evaluated transect. The particle density and porosity have a low dispersion in space. Bulk and particle densities, porosity, aeration and voids ratio presented a range higher than 1000m. Therefore, sampling for penetration resistance and moisture with TDR measurements should be done each 600m. Resistance to penetration showed to be inversely proportional to the moisture content in the soil. The measured variables are correlated in two groups, the first one associated densities with the humidities, measured at different depths, and the second group related to penetration resistance at 15cm with measurement at 30cm. The penetration resistance is a good indicator of soil compaction and the agricultural management that occurs in the Tunguavita farm.

Evaluation of Three Devices for the Isolation of the Stromal Vascular Fraction from Adipose Tissue and for ASC Culture: A Comparative Study.

Adipose-derived stem/stromal cells (ASCs) reside in the stromal vascular fraction (SVF) of adipose tissue (AT) and can be easily isolated. However, extraction of the SVF from lipoaspirate is a critical step in generating ASC, and semiautomated devices have been developed to enhance the efficacy and reproducibility of the outcomes and to decrease manipulation and contamination. In this study, we compared the reference method used in our lab for SVF isolation from lipoaspirate, with three medical devices: GID SVF-1™, Puregraft™, and Stem.pras®. Cell yield and their viability were evaluated as well as their phenotype with flow cytometry. Further on, we determined their proliferative potential using population doublings (PD), PD time (PDT), and clonogenicity assay (CFU-F). Finally, we checked their genetic stability using RT-qPCR for TERT mRNA assay and karyotyping as well as their multilineage potential including adipogenic, chondrogenic, and osteogenic differentiation. Our results demonstrate that all the devices allow the production of SVF cells with consistent yield and viability, in less time than the reference method. Expanded cells from the four methods showed no significant differences in terms of phenotype, proliferation capabilities, differentiation abilities, and genetic stability.

Understanding Treatment Gaps for Mental Health, Alcohol, and Drug Use in South Dakota: A Qualitative Study of Rural Perspectives.

PURPOSE: More than 25% of US adults experience mental health or substance use conditions annually, yet less than half receive treatment. This study explored how rural participants with behavioral health conditions pursue and receive care, and it examined how these factors differed across American Indian (AI) and geographic subpopulations. METHODS: We undertook a qualitative follow-up study from a statewide survey of unmet mental health and substance use needs in South Dakota. We conducted semistructured phone interviews with a purposive sample of key informants with varying perceptions of need for mental health and substance use treatment. RESULTS: We interviewed 33 participants with mental health (n = 18), substance use (n = 9), and co-occurring disorders (n = 6). Twenty participants (61.0%) lived in rural communities that did not overlap with AI tribal land. Twelve participants (34.3%) were AI, 8 of whom lived on a reservation (24.2%). The discrepancy between actual and perceived treatment need was related to how participants defined mental health, alcohol, and drug use "problems." Mental health disorders and excessive alcohol consumption were seen as a normal part of life in rural and reservation communities; seeking mental health care or maintaining sobriety was viewed as the result of an individual's willpower and frequently related to a substantial life event (eg, childbirth). Participants recommended treatment gaps be addressed through multicomponent community-level interventions. DISCUSSION: This study describes how rural populations view mental health, alcohol, and drug use. Enhancing access to care, addressing discordant perceptions, and improving community-based interventions may increase treatment uptake.

Factors Related to Early Clinical Effects of Quetiapine Extended-Release: A Multinational, Prospective, Observational Study.

BACKGROUND AND OBJECTIVES: The first weeks of treatment with antipsychotics are important for the development of their long-term efficacy. The objective of this study was to identify factors related to early clinical effects and quality of life (QoL) improvements with quetiapine extended-release (XR). METHODS: Six hundred and sixty-five patients starting with quetiapine XR were followed up for 8 weeks (schizophrenia = 153, major depression = 200, bipolar depression = 252, other psychiatric conditions = 60). Clinical effects were assessed by the Clinical Global Impression of Change scale (CGI-C), QoL by the visual analog scale (VAS) of the EQ-5D (QoL-VAS), and adherence by the Moriksy scale. Adverse events were explored: movement disorders by the UKU and Simpson-Angus scales, weight gain by calibrated balances, and diurnal somnolence by the Epworth Somnolence Scale (ESS). RESULTS: The mean dose of quetiapine XR during follow-up was 195.6 ± 154.8 mg/day. CGI and QoL-VAS scores improved significantly at week 8 by 2.7 ± 0.1 points and 25.1 ± 0.9 points. Adverse events were observed in 34 and 26 % of patients at weeks 4 and 8, respectively. A significant reduction in ESS score was also observed at week 8. Factors independently associated with change in QoL-VAS ≥20 points (n = 292, 43 %) were female gender, more severe disease at baseline, higher antipsychotic dose during follow-up, and improvements in somnolence. Factors independently associated with clinically significant improvement (CGI-C ≥5, n = 610, 93 %) were greater change in QoL-VAS, less frequent movement disorders at baseline, and lack of adverse events during follow-up, especially somnolence. CONCLUSIONS: Results from this real-setting, large observational study in Central America suggest that disease severity at baseline, gender, antipsychotic dose, and occurrence of adverse reactions has a significant impact on the early clinical effects of quetiapine XR. Clinicaltrials.gov registration number NCT02409823.

Control of cellular proliferation by modulation of oxidative phosphorylation in human and rodent fast-growing tumor cells.

The relationship between cell proliferation and the rates of glycolysis and oxidative phosphorylation in HeLa (human) and AS-30D (rodent) tumor cells was evaluated. In glutamine plus glucose medium, both tumor lines grew optimally. Mitochondria were the predominant source of ATP in both cell types (66-75%), despite an active glycolysis. In glucose-free medium with glutamine, proliferation of both lines diminished by 30% but oxidative phosphorylation and the cytosolic ATP level increased by 50%. In glutamine-free medium with glucose, proliferation, oxidative phosphorylation and ATP concentration diminished drastically, although the cells were viable. Oligomycin, in medium with glutamine plus glucose, abolished growth of both tumor lines, indicating an essential role of mitochondrial ATP for tumor progression. The presumed mitochondrial inhibitors rhodamines 123 and 6G, and casiopeina II-gly, inhibited tumor cell proliferation and oxidative phosphorylation, but also glycolysis. In contrast, gossypol, iodoacetate and arsenite strongly blocked glycolysis; however, they did not affect tumor proliferation or mitochondrial metabolism. Growth of both tumor lines was highly sensitive to rhodamines and casiopeina II-gly, with IC(50) values for HeLa cells lower than 0.5 microM, whereas viability and proliferation of human lymphocytes were not affected by these drugs (IC(50) > 30 microM). Moreover, rhodamine 6G and casiopeina II-gly, at micromolar doses, prolonged the survival of animals bearing i.p. implanted AS-30D hepatoma. It is concluded that fast-growing tumor cells have a predominantly oxidative type of metabolism, which might be a potential therapeutic target.

Determining and understanding the control of glycolysis in fast-growth tumor cells. Flux control by an over-expressed but strongly product-inhibited hexokinase.

Control analysis of the glycolytic flux was carried out in two fast-growth tumor cell types of human and rodent origin (HeLa and AS-30D, respectively). Determination of the maximal velocity (V(max)) of the 10 glycolytic enzymes from hexokinase to lactate dehydrogenase revealed that hexokinase (153-306 times) and phosphofructokinase-1 (PFK-1) (22-56 times) had higher over-expression in rat AS-30D hepatoma cells than in normal freshly isolated rat hepatocytes. Moreover, the steady-state concentrations of the glycolytic metabolites, particularly those of the products of hexokinase and PFK-1, were increased compared with hepatocytes. In HeLa cells, V(max) values and metabolite concentrations for the 10 glycolytic enzyme were also significantly increased, but to a much lesser extent (6-9 times for both hexokinase and PFK-1). Elasticity-based analysis of the glycolytic flux in AS-30D cells showed that the block of enzymes producing Fru(1,6)P2 (i.e. glucose transporter, hexokinase, hexosephosphate isomerase, PFK-1, and the Glc6P branches) exerted most of the flux control (70-75%), whereas the consuming block (from aldolase to lactate dehydrogenase) exhibited the remaining control. The Glc6P-producing block (glucose transporter and hexokinase) also showed high flux control (70%), which indicated low flux control by PFK-1. Kinetic analysis of PFK-1 showed low sensitivity towards its allosteric inhibitors citrate and ATP, at physiological concentrations of the activator Fru(2,6)P2. On the other hand, hexokinase activity was strongly inhibited by high, but physiological, concentrations of Glc6P. Therefore, the enhanced glycolytic flux in fast-growth tumor cells was still controlled by an over-produced, but Glc6P-inhibited hexokinase.

Tuberculosis, un problema que no debe ignorar el odontólogo: revisión bibliográfica / Tuberculosis, a problem that must not be ignored by the dentist: a review of the literature

La tuberculosis (TBC) es una infección bacteriana crónica de gran importancia para el odontólogo. El elevado crecimiento de la población y la deficiente aplicación de métodos para el control de esta enfermedad nos lleva a que cada día existan más enfermeos de tuberculosis. La tuberculosis es una de las enfermedades más importantes asociada al SIDA, las diferentes alteraciones inmunológicas de este síndrome facilitan las formas de TBC de reactivación y la rápida progresión de infección a enfermedad. Una compleja interacción de factores influencia el desarrollo de la misma. Existe evidencia directa e indirecta del papel del virus de inmunodeficiencia humana (VIH); sin embargo, el concepto de la reactivación antecede a los tratamientos en hospicios, ancianatos, orfanatos, prisiones y reformatorios, los que han permitido que esta enfermedad reaparezca en la historia como la plaga blanca. A continuación se muestra una revisión de la literatura sobre esta enfermedad que cada día aumenta su incidencia y como profesionales de la salud necesitamos conocer de ella

El Papel del Óxido Nítrico como Mediador de Disfunción Endotelial en la Respuesta Inflamatoria / The role of nitric oxide as a mediator of endothelial dysfuction in the inflamatory response

Los estados inflamatorios recurrentes de infección figuran como uno de los mecanismos que desencadenan la presentación de eventos vasculares debidos a disfunción endotelial. Se conoce que en el proceso de disfunción participan un gran número de mediadores: moléculas de adhesión, citoquinas proinflamatorias (FNTalfa, IL1, IL6, IL8), factores de crecimiento, COX1, NOS inducible, eicosanoides y radicales libres, entre otros. El efecto conjunto o individual de estas sustancias determina un cambio en las actividades de síntesis y metabolismo del endotelio, de modo que se favorecen la tendencia al vasoespasmo, la alteración de la permeabilidad para las lipoproteínas, el reclutamiento de células blancas, la disminución en la regeneración endotelial y el disbalance fibrinolítico que promoverá la generación de trombina y el depósito de plaquetas y fibrina con la consiguiente formación de la placa aterosclerótica. Es importante reconocer al NO no sólo como mediador y regulador de la fisiología vascular normal, sino también como una sustancia metabólicamente activa y multifuncional que en el caso de la infección y de la inflamación interfiere en el ciclo biológico de la célula endotelial (por inhibición de la respiración mitocondrial, generación de radicales más tóxicos y daño directo al ADN); esto conduce al mantenimiento del desbalance en la produción endoteliar de los mediadores hemostáticos y hemodinámicos, prevaleciendo aquellos que conducen a enfermedad endotelial. De esta manera se induce la migración de células musculares lisas hacia la íntima, y la diferenciación hacia fibroblastos para aumentar el tamaño de la placa aterosclerótica, respuesta anormal ante el estrés dinámico, con la consecuente formación de trombos y progresión acelerada hacia la disminución del calibre vascular, que conlleva a incrementar la isquemia del tejido distal