Orthopedic Provider Gender Preference Among Patients in an Orthopedic Surgery Residency Program of a Hispanic American Community.

Background: There are limited data regarding the gender preferences of Hispanic Americans when selecting their orthopedic surgeon. This study aimed to evaluate the gender preferences of Hispanic Americans when choosing a physician as their orthopedic provider. Materials and Methods: A cross-sectional survey was administered to all consecutive Hispanic American patients treated at the outpatient orthopedic clinics of a tertiary medical center in Puerto Rico between October 4, 2019 and March 4, 2020. Sociodemographic status and opinion of gender preference in orthopedic surgery were assessed and analyzed between female and male respondents. Results: A total of 628 surveys were completed. There were 343 (54.6%) females and 285 (45.4%) males with an average age of 51.0 ± 13.0 years. A significantly higher portion of female respondents was widowed (p = 0.01), had a higher educational level (p = 0.02), were unemployed (p = 0.01), and had a lower individual annual income salary (p = 0.04); when compared with males. Most of the respondents had no gender preference (91.1% = 572/628) for an orthopedic provider. Among those with a gender preference, 5.1% (32/628) preferred a male surgeon, and 3.8% (24/628) preferred a female surgeon. No significant difference was found between male and female respondents in the opinion of an orthopedic provider. Conclusions: This study illustrates that Hispanic Americans have no gender preference when choosing an orthopedic provider. Therefore, patient preference should not be considered a factor contributing to women's under-representation in our orthopedic surgery training program. Our findings may also assist future studies in search of other indications attributed to the under-representation of females in this field.

Metrics based on information entropy applied to evaluate complexity of landscape patterns.

Landscape is an ecological category represented by a complex system formed by interactions between society and nature. Spatial patterns of different land uses present in a landscape reveal past and present processes responsible for its dynamics and organisation. Measuring the complexity of these patterns (in the sense of their spatial heterogeneity) allows us to evaluate the integrity and resilience of these complex environmental systems. Here, we show how landscape metrics based on information entropy can be applied to evaluate the complexity (in the sense of spatial heterogeneity) of patches patterns, as well as their transition zones, present in a Cerrado conservation area and its surroundings, located in south-eastern Brazil. The analysis in this study aimed to elucidate how changes in land use and the consequent fragmentation affect the complexity of the landscape. The scripts CompPlex HeROI and CompPlex Janus were created to allow calculation of information entropy (He), variability (He/Hmax), and López-Ruiz, Mancini, and Calbet (LMC) and Shiner, Davison, and Landsberg (SDL) measures. CompPlex HeROI enabled the calculation of these measures for different regions of interest (ROIs) selected in a satellite image of the study area, followed by comparison of the complexity of their patterns, in addition to enabling the generation of complexity signatures for each ROI. CompPlex Janus made it possible to spatialise the results for these four measures in landscape complexity maps. As expected, both for the complexity patterns evaluated by CompPlex HeROI and the complexity maps generated by CompPlex Janus, the areas with vegetation located in a region of intermediate spatial heterogeneity had lower values for the He and He/Hmax measures and higher values for the LMC and SDL measurements. So, these landscape metrics were able to capture the behaviour of the patterns of different types of land use present in the study area, bringing together uses linked to vegetation with increased canopy coverage and differentiating them from urban areas and transition areas that mix different uses. Thus, the algorithms implemented in these scripts were demonstrated to be robust and capable of measuring the variability in information levels from the landscape, not only in terms of spatial datasets but also spectrally. The automation of measurement calculations, owing to informational entropy provided by these scripts, allows a quick assessment of the complexity of patterns present in a landscape, and thus, generates indicators of landscape integrity and resilience.

Multiple antibiotic resistances and virulence markers of uropathogenic Escherichia coli from Mexico.

Virulence and antibiotic resistance properties related to different Escherichia coli phylogenetic groups have not been studied in detail in Mexico. We aimed to identify patterns of virulence genes and multidrug resistance in phylogenetic groups of uropathogenic strains (UPEC). Strains of E. coli were isolated from outpatients with urinary tract infections (UTIs), who went to unit of the public health sector in the State of Mexico. E. coli virulence markers and phylogenetic groups were identified by PCR. Susceptibility to 12 antimicrobials was determined by Kirby-Bauer. E. coli was identified in 60.4% (n = 194) of the patients with UTIs. Phylogroups B2 51% (n = 99), A 13.4% (n = 26) and B1 10.3% (n = 20) were the most frequent. Resistance to three or up to eleven antibiotics was detected in most phylogroups (n = 188). The genes fimH (n = 146), feoB (n = 179), iutA (n = 178), sitA (n = 121), fyuA (n = 99), and traT (n = 142) were mainly detected in strains of phylogroups B2, A, B1, C, and D. Seventy-two patterns of virulence markers were distributed across eight E. coli phylogenetic groups. A high frequency of virulence markers and the multiple antibiotic resistance phenotypes was observed in the phylogroups. The genes of extended-spectrum ß-lactamases (ESBLs) found with higher frequency among UPEC strains were blaTEM, blaSHV y blaCTX-M group 1, CIT (plasmid-mediated AmpC ß-lactamase), and blaOXA-like. In conclusion, our findings show the importance of surveillance, permanent monitoring, and particularly controlled prescription of antibiotics by physicians in the social security health system to reduce the spread of highly virulent UPEC strains that are resistant to multiple antimicrobial agents.