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Biomarkers (coming from host or parasite) to monitor Chagas disease (CD) progression as well as the therapeutic response in chronic CD are critically needed, since seronegativization, which may be considered the best indicator of therapeutic cure, takes several years to be observed in adults. Several molecules have been suggested as biomarkers for CD, however, they have to be validated. Taking advantage of mouse models of Trypanosoma cruzi infection, we investigated changes in the degradation profile of fibronectin in plasma. The degradation profile of fibronectin was different in the acute phase compared to the chronic phase of the infection. Fibronectin fragments of approximately 150, 100, 40 and 30 kDa were identified. Furthermore, those degradation profiles correlated with acute parasitaemia as well as with cardiac parasite burden and tissue damage during the infection. The usefulness of fibronectin degradation as a biomarker for therapeutic response following drug treatment and immunotherapeutic vaccination also was evaluated and a decreased fibronectin degradation profile was observed upon benznidazole or a vaccine candidate treatment.
Se presentan los resultados del recorrido de superficie realizado en la comunidad de Santo Domingo Tonaltepec en la Mixteca Alta de Oaxaca, en el que se identificaron y registraron 43 nuevos sitios arqueológicos datados a las fases Ramos (alrededor de los 300 aC hasta los 250 dC), Las Flores (aproximadamente 250-900 dC) y Natividad (aproximadamente 900-1521 dC). Estos nuevos sitios se contextualizan en el ámbito regional al relacionarlos con los sitios urbanos identificados para cada una de estas fases en los valles adyacentes de Coixtlahuaca, Nochixtlán, Tamazulapan y Teposcolula. Basados en estos datos, consideramos que Tonaltepec se encontró relativamente aislado y fuera del control de los sitios urbanos tempranos durante Ramos; que se transformó en un asentamiento fronterizo entre las entidades políticas durante la fase Las Flores; y que aprovechó los beneficios de localizarse sobre la ruta de comunicación entre importantes reinos mixtecos durante Natividad. La localización de Tonaltepec, relativamente lejos de los principales valles, pero a la vez entre ellos, le otorgó ventajas que supo aprovechar a través de la historia de desarrollo político de la región.
To quantify the energy, nutrients-to-limit and total gram amount consumed and identify their top food sources consumed by Latin Americans.
Data from the Latin American Study of Nutrition and Health (ELANS).
ELANS is a cross-sectional study representative of eight Latin American countries: Argentina, Brazil, Chile, Colombia, Costa Rica, Ecuador, Peru and Venezuela.
Two 24-h dietary recalls on non-consecutive days were used to estimate usual dietary intake of 9218 participants with ages between 15–65 years. ‘What We Eat in America’ food classification system developed by United States Department of Agriculture was adapted and used to classify all food items consumed by the ELANS population. Food sources of energy, added sugars, SFA, Na and total gram amount consumed were identified and ranked based on percentage of contribution to intake of total amount.
Three-highest ranked food categories of total energy consumed were: rice (10·3%), yeast breads (6·9%), and turnovers and other grain-based items (6·8 %). Highest ranked food sources of total gram amount consumed were fruit drinks (9·6%), other 100% juice (9·3%) and rice (8·3%). Three highest ranked sources for added sugars were other 100% juice (24·1 %), fruit drinks (16·5%), and sugar and honey (12·4%). SFA ranked foods were turnovers and other grain-based (12·6 %), cheese (11·9%), and pizza (10·3%). Three top sources of Na were rice (13·9%), soups (9·1 %) and rice mixed dishes (7·3 %).
Identification of top sources of energy and nutrients-to-limit among Latin Americans is critical for designing strategies to help them meet nutrient recommendations within energy needs.
Elasmobranchs in the Gulf of California have been found with malformations, probably originated during embryonic development or caused by environmental anomalies and pollution associated with intense mining activity in the region. Clasper malformations are reported for the first time in two specimens of Pseudobatos buthi, a species recently described from the Gulf of California. The function of the claspers was not affected by the size difference, because specimens presented the distinctive characteristics of an adult individual. The reproductive system did not show any malformation, with symmetrical testes. Histological analysis of the testes revealed a normal spermatogenic development. To elucidate the causes and to detect a possible effect of the morphological malformations due to high levels of heavy metals, trace concentration values (cadmium, copper, iron, manganese, silver, lead and zinc) were determined in muscle and liver. Cadmium and lead concentrations in the muscle of the two specimens were below the permissible limit for human consumption (<0.05 mg kg−1); however, iron and zinc presented high values (0.455, 4.024 mg kg−1 in muscle and 21.931, 3.694 mg kg−1 in liver respectively). Mining activity and heavy metal pollution in the sampling area may have caused the malformations, which might be attributed to the high values of iron and zinc discovered in the muscle and liver.
The economic hardship of dairy producers has worsened in the last decade because of increasing costs of production. A field survey with 51 dairy farmers was conducted to explore strategies to mitigate economic hardship. Factor and cluster analyses were conducted to characterize the farmers and their farms. Differences among groups regarding changes adopted to increase incomes, to reduce costs, and to pay bills were tested using Fisher’s exact test. Four factors explained 76.2% of the cumulative variance and four groups were identified: “stagnant farms” were in group 1, with the lowest daily income over concentrate feed cost (DIOCFC) and the least number of changes, “effectively management farms” were in group 2, with the highest DIOCFC and the highest number of income-increasing changes, the “cost reducing farms” were in group 3, with the smallest in size with a focus on cutting cost, and the “mixed strategy farms” were in group 4, with the largest herd size. Most prevalent income-increasing strategies included attempts to improve cow nutritional balance and milk composition, whereas the most prevalent cost-reducing strategies included reductions in input purchases of inputs (concentrates and fertilizers) and selected household expenses. Selling cows was a common strategy to generate cash in acute hardship situations. In conclusion, responses to economic hardship varied substantially among groups of farms, cost-reducing strategies were linked to lower cow productivity and lower technological levels, but income-increasing strategies were linked to higher cow productivity and higher DIOCFC. Our findings may contribute to the design of extension initiatives to promote useful strategies to help mitigate economic hardship on dairy farms.
To examine whether the educational level moderates the relationship between baseline depressive symptoms and cognitive functioning at 5- and 10-year follow-ups in older adults, considering the association between cognitive functioning and difficulty with activities of daily living (ADL).
Using a prospective design, a path analysis was performed.
In-home, face-to-face interviews and self-administered questionnaires, within the National Social Life, Health, and Aging Project.
In total, 1,461 participants (mean age = 66.62) were followed up from Wave 1 (baseline) to Wave 2 (at 5 years) and Wave 3 (at 10 years).
Depressive symptoms were assessed at baseline. Cognitive functioning and difficulty with ADL were assessed at baseline and at 5 and 10 years.
Educational level moderates the relationship between depressive symptoms and cognitive functioning at 5 years (β = 0.07, SE = 0.03, p = 0.04, Cohen’s f2 = 0.02), being depressive symptoms related to poor cognitive functioning only at low educational levels. Cognitive functioning predicts difficulty with ADL at 5 and 10 years (β = −0.08, SE = 0.03, p = 0.008, Cohen’s f2 = 0.01; β = −0.09, SE = 0.03, p = 0.006, Cohen’s f2 = 0.02). The proposed model yielded excellent fit (CFI = 1.00, RMSEA = 0.0001, 90% CI 0.0001–0.03, SRMR = 0.004, and χ2(8) = 7.16, p = 0.52).
Cognitive reserve may act as a protective factor against the effect of depressive symptoms on cognition in older adults, which, in turn, is relevant to their functional independence.
Sperm morphometric and morphologic data have been shown to represent useful tools for monitoring fertility, improving assisted reproduction techniques and conservation of genetic material as well as detecting inbreeding of endangered primates. We provide here for the first time sperm morphologic and morphometric data from Cercopithecus neglectus, Cercopithecus cephus, Papio papio and critically endangered Cercopithecus roloway, as well as comparative data from other Cercopithecinae species, i.e. Allochrocebus lhoesti, Mandrillus sphinx and Papio anubis. Following collection from the epididymis, spermatozoa were measured for each species for the following parameters: head length, head width, head perimeter, head area, midpiece length and total flagellum length, and the head volume, ellipticity, elongation, roughness and regularity were then calculated. Our data are consistent with both the general morphology and the morphometric proportions of Cercopithecinae sperm. Some specificities were observed, with C. cephus displaying a narrow head (width = 2.76 ± 0.26 µM) and C. roloway displaying a short midpiece (6.65 ± 0.61 µM). This data set represents an important contribution, especially for Cercopithecus roloway, one of the most endangered monkeys in the world, and further data on additional specimens coupled to data on mating systems and reproductive ecology should allow a better understanding of the mechanisms underlying these morphological differences across primate species.
The aim of this study was to estimate the seroprevalence and risk factors associated with Toxoplasma gondii exposure in dogs and cats from Bangkok, Thailand. Blood samples from 318 dogs and 321 cats were tested for T. gondii antibodies by modified agglutination test (cut-off 1:25). Additionally, 18 dogs and 20 cats were longitudinally sampled for T. gondii antibodies during the same study period, between June and July 2019. The overall seroprevalence in dogs and cats was 7.9% (25/318; 95% CI 4.9–10.8%) and 18.7% (95% CI 14.4–23.0%), respectively. For dogs, risk factors identified were being a mixed-breed animal and living totally outdoors, while increasing age was shown to be a risk factor for cats. Seroconversion was not detected and titres from positive animals remained constant over longitudinal study. The present study indicates that there is a prominent presence of T. gondii in urban and peri-urban areas of Bangkok, suggesting that outdoor dogs and cats should be considered as a possible risk factor for humans.
Healthcare workers (HCWs) not fulfilling the coronavirus disease 2019 (COVID-19) case definition underwent severe acute respiratory coronavirus virus 2 (SARS-CoV-2) screening. Risk of exposure, adherence to personal protective equipment (PPE), and symptoms were assessed. In total, 2,000 HCWs were screened: 5.5% were positive for SARS-CoV-2 by polymerase chain reaction (PCR). There were no differences in PPE use between SARS-CoV-2–positive and –negative HCWs (adherence, >90%). Nursing and kitchen staff were independently associated with positive SARS-CoV-2 results.
To estimate dietary fluoride intake (F) over the course of pregnancy and the overall adjusted difference in dietary F intake by pregnancy stages and levels of compliance with dietary recommendations.
Secondary data analysis from a longitudinal pregnancy cohort study in a population exposed to fluoridated salt. Women were followed during the early, middle and late stages of their pregnancy (n 568). The dietary intake of recommended prenatal nutrients according to Mexican dietary guidelines and F intake (mg/d) was estimated with a validated FFQ. Data were summarised with descriptive statistics. Levels of F intake were compared with the USA’s Institute of Medicine adequate intake (AI) of 3 mg/d for pregnancy. Adjusted differences in F intake by pregnancy stages and levels of compliance with recommendations were estimated using random effects models.
Women participating in the Early Life Exposures in Mexico to ENvironmental Toxicants (ELEMENT) project, from 2001 to 2003.
Median dietary F intake throughout pregnancy ranged from 0·64 (interquartile range (IQR) 0·38) in the early to 0·70 (IQR 0·42) in the middle, and 0·72 (IQR 0·44) mg/d in the late stage (0·01 mg F/kg per d). Corresponding adjusted intakes of F were 0·72 (95 % CI 0·70, 0·74), 0·76 (95 % CI 0·74, 0·77) and 0·80 (95 % CI 0·78, 0·82) mg/d. Women who were moderately and highly compliant with Mexican dietary recommendations ingested, on average, 0·04 and 0·14 mg F/d more than non-compliant women (P < 0·005).
Dietary F intake was below current AI, was greater with the progression of pregnancy and in women who were moderately and highly compliant with dietary recommendations.
The aim was to analyse invasive pneumococcal disease (IPD) serotypes in children aged ⩽17 years according to clinical presentation and antimicrobial susceptibility. We conducted a prospective study (January 2012–June 2016). IPD cases were diagnosed by culture and/or real-time polymerase chain reaction (PCR). Demographic, microbiological and clinical data were analysed. Associations were assessed using the odds ratio (OR) and 95% confidence intervals (CI). Of the 253 cases, 34.4% were aged <2 years, 38.7% 2–4 years and 26.9% 5–17 years. Over 64% were 13-valent pneumococcal conjugate vaccine (PCV13) serotypes. 48% of the cases were diagnosed only by real-time PCR. Serotypes 3 and 1 were associated with complicated pneumonia (P < 0.05) and non-PCV13 serotypes with meningitis (OR 7.32, 95% CI 2.33–22.99) and occult bacteraemia (OR 3.6, 95% CI 1.56–8.76). Serotype 19A was more frequent in children aged <2 years and serotypes 3 and 1 in children aged 2–4 years and 5–17 years, respectively. 36.1% of cases were not susceptible to penicillin and 16.4% were also non-susceptible to cefotaxime. Serotypes 14, 24F and 23B were associated with non-susceptibility to penicillin (P < 0.05) and serotypes 11, 14 and 19A to cefotaxime (P < 0.05). Serotype 19A showed resistance to penicillin (P = 0.002). In conclusion, PCV13 serotypes were most frequent in children aged ⩽17 years, mainly serotypes 3, 1 and 19A. Non-PCV13 serotypes were associated with meningitis and occult bacteraemia and PCV13 serotypes with pneumonia. Non-susceptibility to antibiotics of non-PCV13 serotypes should be monitored.
It's been proved that cognitive stimulation has direct effects over the improvement of general cognitive functions in people with cognitive impairment. People older than 50 are progressively familiar with computers and mobile devices, opening an opportunity for computer based online cognitive stimulation programmes.
To compare the efficacy of face to face cognitive stimulation (FFCS) with online home delivered cognitive stimulation (OCS) regarding adherence, number of sessions, cognitive function and mood.
Patients and Methods
Participants were enrolled in a public memory clinic; 51 patients with cognitive decline were assigned to two groups: 27 received FFCS in a group format and 24 received OCS with the assistance of a carer. Both face to face and online interventions where designed and supervised by a trained Occupational Therapist. Pre and post assessments were carried out by a Clinical Psychologist with the Mini Mental State Exam (MMSE), the clock test, and the brief Geriatric Depression Scale. No differences were found between groups in age (69.65±9.74 years), cognitive function (MMSE=24.63±3.67), gender (55% women) and education. The treatment consisted of 32 sessions of CS held twice a week during 4 months.
Data was analysed with nonparametric statistics and between group effect sizes were calculated. The FFCS participants completed 29.19 ± 1.73 sessions while the OCS group completed 26.00 ± 10.64 sessions (p < .000). All the participants in the FFCS group (100%) and 14 of the OCS group (58%) finished the treatment (p < .000).
Between group effect size favoured the FFCS intervention for MMSE (dc = 0.36). No between group differences were found for mood (dc = −0.5) or the clock test (dc = 0.13).
FFCS is better accepted by patients than OCS, with higher rates of adherence and less dropouts. FFCS leads to better results in the preservation of cognitive capacity.
Background: Carbapenemase-producing Enterobacteriaceae (CPE) causes infections associated with high mortality rates among hospitalized patients. CPE transmission occurs frequently, and prevention of patient-to-patient transmission is a priority. However, transmission pathways are not yet completely understood. The colonization of the respiratory tract with a CPE may lead to a higher risk of contamination of the patient’s environment increasing the spread of CPE. Objective: We estimated the rate of CPE spread when respiratory tract infection or colonization is present. Methods: We studied CPE dissemination analyzing a cohort of patients admitted between January 2013 and December 2018 at the university hospital complex of A Corua, a tertiary-care hospital. All patients who were hospitalized in the same room as a patient colonized or infected with a CPE (index case) for at least 24 hours were screened for CPE carriage. The microbiological screening was performed with conventional culture or polymerase chain reaction (PCR) to identified possible CPE patient-to-patient transmission. The screening test included several samples: rectal swab, perineal swab, wound or drainage swab, and low respiratory tract sample. Results: Active screening for CPE carriage was performed in 84 contact patients. Men represent 57.1% of the sample, and the mean age was 78.5 years (men, 68.0 years and women, 80.8 years), with significant differences between sexes (12.9; 95% CI, 19.6 to 6.1). The major group of cases (86.9%) were hospitalized in medical wards. Transmission confirmed by PCR occurred in 13 (15.5%) of 84 contact patients, after a mean exposure to the index case of 13.3 days. No significant differences were detected in terms of mean exposure to index cases between those contact patients who result negative and those who result positive. The 35 index cases (41.7%) tested positive for CPE on the respiratory sample, and exposure to them led to 8 positive contact patients (61.5%). Conclusions: CPE transmission in a tertiary-care hospital occurred frequently. The spread rate is even higher when CPE is present at the respiratory level. Understanding the mode of spread is important for designing effective control measures and adding a respiratory sample to CPE screening could be a key consideration.
Patients with schizophrenia spectrum disorders (SSD) tend to lack insight, which is linked to poor outcomes. The effect size of previous treatments on insight changes in SSD has been small. Metacognitive interventions may improve insight in SSD, although this remains unproved.
We carried out a systematic review and meta-analysis of randomized controlled trials (RCTs) to examine the effects of metacognitive interventions designed for SSD, namely Metacognitive Training (MCT) and Metacognitive Reflection and Insight Therapy (MERIT), on changes in cognitive and clinical insight at post-treatment and at follow-up.
Twelve RCTs, including 10 MCT RCTs (n = 717 participants) and two MERIT trials (n = 90), were selected, totalling N = 807 participants. Regarding cognitive insight six RCTs (n = 443) highlighted a medium effect of MCT on self-reflectiveness at post-treatment, d = 0.46, p < 0.01, and at follow-up, d = 0.30, p < 0.01. There was a small effect of MCT on self-certainty at post-treatment, d = −0.23, p = 0.03, but not at follow-up. MCT was superior to controls on an overall Composite Index of cognitive insight at post-treatment, d = 1.11, p < 0.01, and at follow-up, d = 0.86, p = 0.03, although we found evidence of heterogeneity. Of five MCT trials on clinical insight (n = 244 participants), which could not be meta-analysed, four of them favoured MCT compared v. control. The two MERIT trials reported conflicting results.
Metacognitive interventions, particularly Metacognitive Training, appear to improve insight in patients with SSD, especially cognitive insight shortly after treatment. Further long-term RCTs are needed to establish whether these metacognitive interventions-related insight changes are sustained over a longer time period and result in better outcomes.
The objective of the study was to characterize small-scale dairy production systems to identify the technological preferences according to the farmer and farm characteristics and to analyze the importance and role of the information communication technologies (ICTs) in the dissemination of information related to management and livestock activities. To collect the data, a survey was applied to 170 small-scale dairy farmers from central Mexico. To characterize the farms, a factor analysis (FA) and cluster analysis (CA) were performed. To compare and identify differences between groups, a Kruskal–Wallis test was conducted. Four factors that explain 70.93% of the accumulated variance were identified; these factors explain the use of technology, production characteristics, social connections, and use of ICTs. The cluster analysis identified four groups. Group 1 was integrated by farmers with more experience and the largest farms. Group 2 had higher studies and use of ICTs. Group 3 was formed by young farmers but had a low use of technology. Group 4 contained older farmers with a low use of technology. The young farmers with higher studies have begun to incorporate ICTs into their daily activities on the farm, as observed in Group 2. Smartphones were the most used and were considered important by the farmers of the four groups, since they enable interaction with other farmers and the dissemination of topics of interest related with the farm. In conclusion, four group of farmers were differentiated; therefore, different extension approaches should be implemented to take into account the preferences and the technologies considered most important for each group. The ICTs are emerging technologies among small-scale dairy farmers to communicate information related to livestock management, mainly by young farmers with studies of secondary, as observed in Group 2.
The coronavirus disease 2019 (COVID-19) pandemic has induced a reinforcement of infection control measures in the hospital setting. Here, we assess the impact of the COVID-19 pandemic on the incidence of nosocomial Clostridioides difficile infection (CDI).
We retrospectively compared the incidence density (cases per 10,000 patient days) of healthcare-facility–associated (HCFA) CDI in a tertiary-care hospital in Madrid, Spain, during the maximum incidence of COVID-19 (March 11 to May 11, 2020) with the same period of the previous year (control period). We also assessed the aggregate in-hospital antibiotic use (ie, defined daily doses [DDD] per 100 occupied bed days [BD]) and incidence density (ie, movements per 1,000 patient days) of patient mobility during both periods.
In total, 2,337 patients with reverse transcription-polymerase chain reaction–confirmed COVID-19 were admitted to the hospital during the COVID-19 period. Also, 12 HCFA CDI cases were reported at this time (incidence density, 2.68 per 10,000 patient days), whereas 34 HCFA CDI cases were identified during the control period (incidence density, 8.54 per 10,000 patient days) (P = .000257). Antibiotic consumption was slightly higher during the COVID-19 period (89.73 DDD per 100 BD) than during the control period (79.16 DDD per 100 BD). The incidence density of patient movements was 587.61 per 1,000 patient days during the control period and was significantly lower during the COVID-19 period (300.86 per 1,000 patient days) (P < .0001).
The observed reduction of ~70% in the incidence density of HCFA CDI in a context of no reduction in antibiotic use supports the importance of reducing nosocomial transmission by healthcare workers and asymptomatic colonized patients, reinforcing cleaning procedures and reducing patient mobility in the epidemiological control of CDI.
The paper presents the effects of Mexico’s conditioned cash-transfers programme (PROSPERA programme, formerly Oportunidades) on household poverty in the Northeast urban areas. The estimate was calculated using the Foster-Greer-Thorbecke Index. We use three poverty lines (i.e. food, capability, and patrimonial poverty) which costs were established by the National Assessment Council of the Social Development Policy. The results show that, in the three lines, the intensity and inequality of poverty diminished. Regarding incidence, only in extreme poverty was found a significant effect, so, there is no evidence to support that cash transfers help households to escape poverty.