Medical students' knowledge about human papillomavirus (HPV), HPV vaccine and head and neck cancer.

The Human Papillomavirus (HPV) is a sexually transmitted infection that significantly affects the population worldwide. HPV preventive methods include vaccination, prophylactics, and education. Different types of cancers associated with HPV usually take years or decades to develop after infections, such as Head and Neck Cancer(HNC). Therefore, HPV prevention can be considered cancer prevention. A sample of medical students in Puerto Rico was evaluated to assess their knowledge about HPV, HPV vaccine, and HNC through two previously validated online questionnaires composed of 38 dichotomized questions, we measured HPV, HPV vaccination(HPVK), and HNC knowledge (HNCK). Out of 104 students surveyed, the mean HPVK score obtained was 20.07/26, SD = 3.86, while the mean score for HNCK was 6.37/12, SD = 1.78. Bidirectional stepwise regression showed study year and HPV Vaccine name had been the most influential variables on HPVK and HNCK. MS1 participants scored lower than MS2-MS4 participants, with no significant difference between MS2-MS4 scores. The results reveal knowledge gaps in HPV/HPV Vaccine and HNC among surveyed medical students. Our findings also suggest an association between knowledge of personal vaccination status, self-perceived risk, and how uncertainty in these factors may affect the medical students' understanding of HPV, HPV vaccination, and associated cancers.

First description of the mitochondrial genomes of the Central American brocket deer Mazama temama (Kerr, 1792) and the Yucatán Peninsula brocket deer Odocoileus pandora Merriam, 1901.

BACKGROUND: The Central American (Mazama temama) and the Yucatán Peninsula brocket deer (Odocoileus pandora) are deer species with cryptic habits, and little is known about their biology. Odocoileus pandora is listed as Vulnerable on the 2015 IUCN Red List of Threatened Species, while M. temama is considered Data Deficient; however, it currently faces a decreasing population trend. METHODS AND RESULTS: We assembled the complete mitochondrial genome for two M. temama specimens and one complete and one partial for O. pandora from Illumina 150 bp paired-end reads. The mitogenomes of M. temama and O. pandora have a length of 16,479-16,480 and 16,419 bp, respectively, AT-biased; they consist of 13 protein-coding genes, two ribosomal RNA genes, 22 transfer RNA genes, and one non-coding control region, most of them follow a transcription direction in the heavy strand of the molecule. The mitochondrial genome of O. pandora shows some particularities compared to other deer species, like a shorter control region of 987-990 bp and a cytochrome b gene with a length of 1,143 bp. Our phylogenetic analyses confirm the close affinity of M. temama to South American M. americana and the nested position of the genus Odocoileus, including O. pandora, into the genus Mazama. CONCLUSIONS: Here, we described for the first time the complete mitochondrial genome for these two species. While our study provides additional information about the taxonomic status of the northern neotropical brocket deer, further research is needed to solve the complicated taxonomy of neotropical deer.

Adjuvant dabrafenib and trametinib for patients with resected BRAF -mutated melanoma: DESCRIBE-AD real-world retrospective observational study.

BRAF and MEK inhibitor, dabrafenib plus trametinib, adjuvant therapy is effective for high-risk resected melanoma patients with BRAF - V600 mutations. However, real-world evidence is limited. We aimed to determine the feasibility of this therapy in routine clinical practice. DESCRIBE-AD, a retrospective observational study, collected real-world data from 25 hospitals in Spain. Histologically confirmed and resected BRAF -mutated melanoma patients aged ≥18 years who were previously treated with dabrafenib plus trametinib adjuvant therapy, were included. The primary objectives were treatment discontinuation rate and time to discontinuation. The secondary objectives included safety and efficacy. From October 2020 to March 2021, 65 patients were included. Dabrafenib and trametinib discontinuation rate due to treatment-related adverse events (TRAEs) of any grade was 9%. Other reasons for discontinuation included patients' decisions (6%), physician decisions (6%), unrelated adverse events (3%), disease progression (5%), and others (5%). The median time to treatment discontinuation was 9 months [95% confidence interval (CI), 5-11]. G3-4 TRAEs occurred in 21.5% of patients, the most common being pyrexia (3%), asthenia (3%), and diarrhoea (3%). Unscheduled hospitalisations and clinical tests occurred in 6 and 22% of patients, respectively. After 20-month median follow-up (95% CI, 18-22), 9% of patients had exitus due to disease progression, with a 12-month relapse-free survival and overall survival rates of 95.3% and 100%, respectively. Dabrafenib and trametinib adjuvant therapy proved effective for melanoma patients in a real-world setting, with a manageable toxicity profile. Toxicity frequencies were low leading to low incidence of unscheduled medical visits, tests, and treatment discontinuations.

Singlet Oxygen Generation, Quenching and Reactivity with Metal Thiolates.

Metal thiolate complexes can act as photosensitizers for the generation of singlet oxygen, quenchers of singlet oxygen, and they may undergo chemical reactions with singlet oxygen leading to oxidized thiolate ligands. This review covers all of the chemical reactions of thiolate ligands with singlet oxygen (through early 2021). Since some of these reactions are self-sensitized photooxidations, singlet oxygen generation by metal complexes is also discussed. Mechanistic features such as the effects of protic vs. aprotic conditions are presented and compared with the comparatively well-understood photooxidation of organic sulfides. In general, the total rate of singlet oxygen removal correlates with the nucleophilicity of the thiolate ligand which in turn can be influenced by the metal. Some interesting patterns of reactivity have been noted as a result of this survey: Metal thiolate complexes bearing arylthiolate ligands appear to exclusively produce sulfinate (metal-bound sulfone) products upon reaction with singlet oxygen. In contrast, metal thiolate complexes bearing alkylthiolate ligands may produce sulfinate and/or sulfenate (metal-bound sulfoxide) products. Several mechanistic pathways have been proposed for these reactions, but the exact nature of any intermediates remains unknown at this time.

Tracking late Pleistocene Neandertals on the Iberian coast.

Here, we report the recent discovery of 87 Neandertal footprints on the Southwest of the Iberian Peninsula (Doñana shoreline, Spain) located on an upper Pleistocene aeolian littoral setting (about 106 ± 19 kyr). Morphometric comparisons, high resolution digital photogrammetric 3D models and detailed sedimentary analysis have been provided to characterized the footprints and the palaeoenvironment. The footprints were impressed in the shoreline of a hypersaline swamped area related to benthic microbial mats, close to the coastline. They have a rounded heel, a longitudinal arch, relatively short toes, and adducted hallux, and represent the oldest upper Pleistocene record of Neandertal footprints in the world. Among these 87 footprints, 31 are longitudinally complete and measure from 14 to 29 cm. The calculated statures range from 104 to 188 cm, with half of the data between 130 and 150 cm. The wide range of sizes of the footprints suggests the existence of a social group integrated by individuals of different age classes but dominated, however, by non-adult individuals. The footprints, which are outside the flooded area are oriented perpendicular to the shoreline. These 87 footprints reinforce the ecological scenario of Neandertal groups established in coastal areas.

Least-squares gamma estimation in fringe projection profilometry.

This paper introduces a novel, to the best of our knowledge, method to estimate and compensate the nonlinear gamma factor introduced by the optical system in fringe projection profilometry. We propose to determine this factor indirectly by adjusting the least-squares plane to the estimated phase coming from the reference plane. We only require a minimal set of three fringe sinusoidal images to estimate the gamma factor. This value can be used to rectify computational legacy data and also to generate and project the new set of fringe patterns for which we perform the inverse gamma compensation. Experimental results demonstrate the feasibility of the proposed method to estimate and correct the gamma distortion.

A gene-tree test of the traditional taxonomy of American deer: the importance of voucher specimens, geographic data, and dense sampling.

The taxonomy of American deer has been established almost entirely on the basis of morphological data and without the use of explicit phylogenetic methods; hence, phylogenetic analyses including data for all of the currently recognized species, even if based on a single gene, might improve current understanding of their taxonomy. We tested the monophyly of the morphology-defined genera and species of New World deer (Odocoileini) with phylogenetic analyses of mitochondrial DNA sequences. This is the first such test conducted using extensive geographic and taxonomic sampling. Our results do not support the monophyly of Mazama, Odocoileus, Pudu, M. americana, M. nemorivaga, Od. hemionus, and Od. virginianus. Mazama contains species that belong to other genera. We found a novel sister-taxon relationship between "Mazama" pandora and a clade formed by Od. hemionus columbianus and Od. h. sitkensis, and transfer pandora to Odocoileus. The clade formed by Od. h. columbianus and Od. h. sitkensis may represent a valid species, whereas the remaining subspecies of Od. hemionus appear closer to Od. virginianus. Pudu (Pudu) puda was not found sister to Pudu (Pudella) mephistophiles. If confirmed, this result will prompt the recognition of the monotypic Pudella as a distinct genus. We provide evidence for the existence of an undescribed species now confused with Mazama americana, and identify other instances of cryptic, taxonomically unrecognized species-level diversity among populations here regarded as Mazama temama, "Mazama" nemorivaga, and Hippocamelus antisensis. Noteworthy records that substantially extend the known distributions of M. temama and "M." gouazoubira are provided, and we unveil a surprising ambiguity regarding the distribution of "M." nemorivaga, as it is described in the literature. The study of deer of the tribe Odocoileini has been hampered by the paucity of information regarding voucher specimens and the provenance of sequences deposited in GenBank. We pinpoint priorities for future systematic research on the tribe Odocoileini.

Incidence of chemotherapy-induced nausea and vomiting associated with docetaxel and cyclophosphamide in early breast cancer patients and aprepitant efficacy as salvage therapy. Results from the Spanish Breast Cancer Group/2009-02 study.

BACKGROUND: Docetaxel-cyclophosphamide (TC) has become a common regimen in moderate-high-risk early breast cancer (EBC), but the incidence of chemotherapy-induced nausea and vomiting (CINV) with this regimen is not well established. This trial investigates the effect of guideline-consistent prophylaxis on CINV related to TC regimen and explores the efficacy of aprepitant among resistant patients. PATIENTS AND METHODS: This prospective multicentre study enrolled 212 chemotherapy-naïve EBC patients receiving T-75 mg/m(2) and C-600 mg/m(2). Antiemetic therapy on the first cycle consisted of dexamethasone for 3 d plus 5-hydroxytryptamine (5-HT3) antagonists on day 1, according to Multinational Association of Supportive Care in Cancer guidelines. The primary end-point was complete response (CR) (no emesis and no need of rescue treatment within the initial 120 h). Patients failing CR on cycle 1 entered in a single-arm study exploring the efficacy of aprepitant on the second cycle. Patients' diaries and Functional Living Index-Emesis (FLIE) questionnaires were collected in cycles 1 and 2. RESULTS: Among the 185 evaluable patients on cycle 1, 161 (87%, 95% confidence interval [CI]: 82.2-91.8) achieved a CR. Twenty-three patients received aprepitant on cycle 2, and 12 reached a CR (52.2%, 95% CI: 31.8-72.6). The absence of CR had a very substantial impact on quality of life on cycles 1 (FLIE before and after: 23.8-38.1, p = 0.0124) and 2 (18.3-42.9, p = 0.0059). CONCLUSIONS: Guideline-consistent antiemetic prophylaxis for the TC regimen is associated with a low incidence of CINV. Aprepitant is effective as secondary prevention of CINV and should be considered as rescue therapy in patients treated with moderate emetogenic chemotherapy.

Analysis of the pathologic response to primary chemotherapy in patients with locally advanced breast cancer grouped according to estrogen receptor, progesterone receptor, and HER2 status.

PURPOSE: In clinical practice, it is possible to classify breast tumors according to estrogen receptor (ER), progesterone receptor (PgR), and HER2 overexpression: ER negative, PgR negative, and HER2 overexpressing; ER negative, PgR negative, and HER2 negative; ER positive, PgR positive, and HER2 negative; ER positive, PgR positive, and HER2 overexpressing; and the less frequent remaining 4 combinations. The aim of this study was to determine the percentage of pathologic complete response (pCR) in patients with locally advanced breast cancer (LABC) treated with neoadjuvant or primary chemotherapy with anthracyclines and taxanes grouped according to ER, PgR, and HER2 status. PATIENTS AND METHODS: Patients with LABC treated with primary chemotherapy including anthracyclines and taxanes were grouped according to ER, PgR, and HER2 status; pCR rates were analyzed using the chi(2) test; and correlations with a P value of < or = 0.05 were considered statistically significant. RESULTS: A total of 103 patients were treated. Only 100 patients were included for the analysis of pCR. Eighteen patients exhibited pCR. The pCR rate for each subgroup was as follows: 39.1% (9 of 23) had ER-negative, PgR-negative, and HER2-negative disease (P < 0.01); 35.7% (5 of 14) had ER-negative, PgR-negative, and HER2-overexpressing disease; 33.3% (3 of 9) had ER-positive, PgR-positive, and HER2-overexpressing disease; and 2.8% (1 of 36) had ER-positive, PgR-positive, and HER2-negative disease (P < 0.01). CONCLUSION: In patients with LABC, grouping breast tumors according to ER, PgR, and HER2 status can help predict pCR to primary chemotherapy.

Local structure and charge distribution in the UO(2)-U(4)O(9) system.

Analysis of X-ray absorption fine structure spectra of UO(2+x) for x = 0-0.20 (UO(2)--U(4)O(9)) reveals that the adventitious O atoms are incorporated as oxo groups with U--O distances of 1.74 A, most likely associated with U(VI), that occur in clusters so that the UO(2) fraction of the material largely remains intact. In addition to the formation of some additional longer U--O bonds, the U sublattice consists of an ordered portion that displays the original U--U distance and a spectroscopically silent, glassy part. This is very different from previous models derived from neutron diffraction that maintained long U--O distances and high U--O coordination numbers. UO(2+x) also differs from PuO(2+x) in its substantially shorter An-oxo distances and no sign of stable coordination with H(2)O and its hydrolysis products.

Local and nanoscale structure and speciation in the PuO2+x-y(OH)2y.zH2O system.

Pu L(3) X-ray absorption fine structure spectra from 24 samples of PuO(2+x) (and two related Pu-substituted oxides), prepared by a variety of methods, demonstrate that (1) although the Pu sublattice remains the ordered part of the Pu distribution, the nearest-neighbor O atoms even at x = 0 are found in a multisite distribution with Pu-O distances consistent with the stable incorporation of OH(-) (and possibly H(2)O and H(+)) into the PuO(2) lattice; (2) the excess O from oxidation is found at Pu-O distances <1.9 A, consistent with the multiply bound "oxo"-type ligands found in molecular complexes of Pu(V) and Pu(VI); (3) the Pu associated with these oxo groups is most likely Pu(V), so that the excess O probably occurs as PuO(2)(+) moieties that are aperiodically distributed through the lattice; and (4) the collective interactions between these defect sites most likely cause them to cluster so as give nanoscale heterogeneity in the form of domains that may have unusual reactivity, observed as sequential oxidation by H(2)O at ambient conditions. The most accurate description of PuO(2) is therefore actually PuO(2+x-y)(OH)(2)(y).zH(2)O, with pure, ordered, homogeneous PuO(2) attained only when H(2)O is rigorously excluded and the O activity is relatively low.

Higher order speciation effects on plutonium L(3) X-ray absorption near edge spectra.

Pu L(3) X-ray near edge absorption spectra for Pu(0-VII) are reported for more than 60 chalcogenides, chlorides, hydrates, hydroxides, nitrates, carbonates, oxy-hydroxides, and other compounds both as solids and in solution, and substituted in zirconolite, perovskite, and borosilicate glass. This large database extends the known correlations between the energy and shape of these spectra from the usual association of the XANES with valence and site symmetry to higher order chemical effects. Because of the large number of compounds of these different types, a number of novel and unexpected behaviors are observed, such as effects resulting from the medium and disorder that can be as large as those from valence.

Speciation and unusual reactivity in PuO2+x.

Pu L(3) XAFS measurements show that the excess oxygen in single phase PuO(2+)(x)() occurs as oxo groups with Pu-O distances of 1.83-1.91 A. This distance and the energy of the edge (via comparison with a large number of related compounds) are more consistent with a Pu(IV/V) than a Pu(IV/VI) mixture. Analogous to Pu(IV) colloids, although the Pu-Pu pair distribution remains single site even when it shows substantial disorder, the Pu-O distribution can display a number of additional shells at specific distances up to 3.4 A even in high fired materials when no oxo groups are present, implying intrinsic H(+)/OH(-)(/H(2)O). The number of oxo atoms increases when samples are equilibrated with humid air at ambient temperature, indicating that the Pu reactivity in this solid system differs notably from that of isolated complexes and demonstrating the importance of nanoscale cooperative phenomena and total free energy in determining its chemical properties.

Propuesta sobre provisión de servicios de salud para los trabajadores del sector informal en las ciudades de La Paz y Santa Cruz de la Sierra / sss

El presente trabajo constituye una primera aproximación al estudio de la Demanda y Provisión por Servicios de Salud de los trabajadores del Sector Informal, o trabajadores No-Formales (gremiales), efectuado a solicitud del Consejo Nacional de Salud de los trabajadores, y financiado por la cooperación técnica de la Organización Panamericana de la Salud.

Propuesta sobre provisión de servicios de salud para los trabajadores del sector informal en las ciudades de La Paz y Santa Cruz de la Sierra / sss

El presente trabajo constituye una primera aproximación al estudio de la Demanda y Provisión por Servicios de Salud de los trabajadores del Sector Informal, o trabajadores No-Formales (gremiales), efectuado a solicitud del Consejo Nacional de Salud de los trabajadores, y financiado por la cooperación técnica de la Organización Panamericana de la Salud.

Disponibilidad digestiva in vitro de lipasa y tripsina en suplementos pancreáticos bajo diferentes grados de acidez / In vitro digestive disposability of lipasa in oral prancreatic supplements: a study under differente acidity parameters

Evaluamos el tiempo de desintegración y la actividad digestiva in vitro de ocho suplementos comerciales pancreáticos bajo condiciones de acidez similares a las gastroduodenales. Las muestras se sometieron a un proceso activo de desintegración durante 45 min a pH de 1, 3 o 6, continuándose el proceso a pH en 6, durante 135 min., la actividad de lipasa y tripsina se determinó cada 15 min por titulometría. A pH constante de 6, los productos sin capa entérica y el Creón tuvieron los tiempos de desintegración más cortos; a pH más ácidos, estos tiempos se alargaron, siendo mayores a 90 min en los productos con capa entérica. La actividad de lipasa fue mayor a pH constante de 6 en Creón, Pankreón y Cotazym-C, Onotón y Cotazym-B. Posterior a la exposición a Ph ácido, la biodisponibilidad enzimática disminuyó en todos los productos. El tiempo de desintegración y la activación de las enzimas por ácido deben tomarse en cuenta al prescribir suplementos pancreáticos.

Los resultados de trasplante renal de donante vivo en Puerto Rico / The results of renal transplantation of alive donors in Puerto Rico

El Programa de Trasplante de Puerto Rico comenzó en 1977, primero adscrito al Hospital de la Administración de Veteranos y más recientemente al Hospital Auxilio Mutuo. Este estudio informa nuestros resultados con 168 trasplantes llevados a cabo desde 1977. Tenemos datos completos de 103 trasplantes de donador vivo llevados a cabo en el Programa entre enero de 1977 y junio de 1984. La mayor parte de los pacientes eran varones, entre las edades de 21 a 50 años y de raza blanca. La evaluación de los donadores fue extremadamente estricta con criterios de exclusión muy rígidos. La técnica quirúrgica y el manejo post-trasplante has sido standard con la excepción de que en 1980 se alteró el régimen inmunosupresor para añadir suero antilinfocítico en la terapia de rechazo y a la vez disminuir drásticamente los requisitos de cortico-esteroides. Los resultados de sobrevida de paciente a 3 años plazo para toda la serie es de 92%, pero después de 1980, y quizás como reflejo de los cambios en inmunosupresión, aumentó la sobrevida a 98%. La sobrevida del injerto se ha mantenido estable entre 77 y 82% a 3 años plazo. La mayor parte de las muertes han sido secundarias a sepsis, casi todas relacionadas al manejo del rechazo. Todas las pérdidas de riñón fueron secundarias a rechazo. Informamos una tasa relativamente baja de complicaciones urológicas y técnicas. También informamos una alta prevalencia de hongos cutáneos y, sin embargo, una incidencia casi ausente de hongos sistémicos. Correlacionamos estos resultados con factores relevantes, con atención a detalles técnicos y médicos