Título del artículo:

Double blind, randomized controlled trial, to evaluate the effectiveness of a controlled nitric oxide releasing patch versus meglumine antimoniate in the treatment of cutaneous leishmaniasis [NCT00317629]

Background: Cutaneous Leishmaniasis is a worldwide disease, endemic in 88 countries, that has shown an increasing incidence over the last two decades. So far, pentavalent antimony compounds have been considered the treatment of choice, with a percentage of cure of about 85%. However, the high efficacy of these drugs is counteracted by their many disadvantages and adverse events. Previous studies have shown nitric oxide to be a potential alternative treatment when administered topically with no serious adverse events. However, due to the unstable nitric oxide release, the topical donors needed to be applied frequently, making the adherence to the treatment difficult. The electrospinning technique has allowed the production of a multilayer transdermal patch that produces a continuous and stable nitric oxide release. The main objective of this study is to evaluate this novel nitric oxide topical donor for the treatment of cutaneous leishmaniasis. Methods and design: A double-blind, randomized, double-masked, placebo- controlled clinical trial, including 620 patients from endemic areas for Leishmaniasis in Colombia was designed to investigate whether this patch is as effective as meglumine antimoniate for the treatment of cutaneous leishmaniasis but with less adverse events. Subjects with ulcers characteristic of cutaneous leishmaniasis will be medically evaluated and laboratory tests and parasitological confirmation performed. After checking the inclusion/exclusion criteria, the patients will be randomly assigned to one of two groups. During 20 days Group I will receive simultaneously meglumine antimoniate and placebo of nitric oxide patches while Group 2 will receive placebo of meglumine antimoniate and active nitric oxide patches. During the treatment visits, the medications will be daily administered and the presence of adverse events assessed. During the follow-up, the research group will visit the patients at days 21, 45, 90 and 180. The healing process of the ulcer, the health of the participants, recidivisms and/or reinfection will also be assessed. The evolution of the ulcers will be photographically registered. In case that the effectiveness of the patches is demonstrated, a novel and safe therapeutic alternative for one of the most important public health problems in many countries will be available to patients. © 2006 Silva et al; licensee BioMed Central Ltd.

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Trials

Título del artículo:

Laser in situ keratomileusis to correct post-keratoplasty astigmatism: 1-Step versus 2-step procedure

Purpose: To investigate the correction of post-penetrating keratoplasty (PKP) astigmatism using laser in situ keratomileusis (LASIK). Visual and refractive outcomes were evaluated after LASIK was performed in 1 step (lamellar cut and ablation in 1 procedure) or 2 steps (lamellar cut then ablation in 2 successive procedures). Setting: Department of Cornea and Refractive Surgery, Vissum-Instituto Oftalmológico de Alicante, University of Miguel Hernández, Alicante, Spain. Methods: In this prospective observational study, 22 consecutive eyes were divided into 2 groups depending on the LASIK procedure performed to correct post-PKP astigmatism. Group 1 (1-step LASIK) included 11 eyes and Group 2 (2-step LASIK), 11 eyes. The patients were followed for 6 months. Results: A statistically significant improvement was obtained in Group 2 with a mean vector analysis result of the cylinder of -4.37 diopters (D) ± 1.79 (SD) (P = .018). In Group 1, the mean astigmatism correction was 2.38 ± 1.71 D. The number of reoperations and residual refractive defects were significantly better in Group 2. Conclusion: The 2-step technique improved the accuracy of excimer laser correction of post-PKP astigmatism. © 2004 ASCRS and ESCRS.

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Journal of Cataract and Refractive Surgery

Título del artículo:

Strategies for the electric supply restoration in Colombian transmission substations

The new regulatory frameworks have converted the reliability issue and its increase, in a critical issue. This document presents the evaluation of reliability indexes and the development of restoration strategies for ten transmission substations of the Colombian transmission company (ISA). An example is also presented emphasizing the reduction of ENS (Energy non Supplied). Case Based Reasoning is proposed as the methodology to be used for Fault diagnosis and action proposing. © 2003 IEEE.

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2003 IEEE Bologna PowerTech - Conference Proceedings

Título del artículo:

Space-variant optical correlator based on the fractional Fourier transform: Implementation by the use of a photorefractive Bi12GeO12 (BGO) holographic filter

A space-variant optical correlator is proposed on the basis of the fractional Fourier transform. The optical device uses as a recording medium for the holographic filter a photorefractive Bi12GeO12 (BGO) crystal. The experimental results confirm the shift-variance properties. Some limitations that arise from the volume diffraction are also considered. © 1996 Optical Society of America.

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Applied Optics

Título del artículo:

Recent progress in invariant pattern recognition

We present some recent results in invariant pattern recognition, including methods that are invariant under two or more distortions of position, orientation and scale. There are now a few methods that yield good results under changes of both rotation and scale. Some new methods are introduced. These include locally adaptive nonlinear matched filters, scale-adapted wavelet transforms and invariant filters for disjoint noise. Methods using neural networks will also be discussed, including an optical method that allows simultaneous classification of multiple targets. ©2005 Copyright SPIE - The International Society for Optical Engineering.

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Proceedings of SPIE - The International Society for Optical Engineering

Título del artículo:

Optical neural networks for classification into arbitrary classes

Some important concepts of neural networks are similarity, generalization, invariance and training. Some neural networks are supposed to be able to classify objects according to hidden similarities. All of those concepts are put into question by the consideration first put forward by Watenabe that from a purely logical point of view, similarity is a purely arbitrary concept. It can be shown that this implies that the notion of invariance is also arbitrary , that so-called hidden similarities and generalization cannot exist without some external criteria. Such criteria are either implicit in the training algorithms or must be imposed explicitly. This imposes severe limitations on what neural networks can accomplish. However there are some positive implications; neural networks can be designed to classify objects into arbitrary classes. Applications to optical neural networks and examples will be presented.

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Proceedings of SPIE - The International Society for Optical Engineering

Título del artículo:

Cyclacillin in the treatment of acute sinus infections and exacerbations of chronic infections

Cyclacillin was used to treat 40 patients with bacterial sinus infections, either acute or exacerbations of chronic infections. The drug was administered orally in a dosage of 500 mg every six hours for ten days, although three patients required extended treatment. More than 70% of the patients had remission of symptoms in six days, and all but the aforementioned three had remission in ten days or less. More than 90% of the patients had a moderate to good response. The only side effects were gastrointestinal disorders, which disappeared with administration of antacids. No side effects were noted in 72.5% of patients. Cyclacillin proved to be an effective and well-tolerated antibiotic for infections of the paranasal cavities.

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Clinical Therapeutics

Título del artículo:

Application of the calculus of variations to the vertical cut off in cohesive frictionless soil

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Geotechnique

Título del artículo:

Metabolic, behavioural, and psychosocial risk factors and cardiovascular disease in women compared with men in 21 high-income, middle-income, and low-income countries: an analysis of the PURE study

Background: There is a paucity of data on the prevalence of risk factors and their associations with incident cardiovascular disease in women compared with men, especially from low-income and middle-income countries. Methods: In the Prospective Urban Rural Epidemiological (PURE) study, we enrolled participants from the general population from 21 high-income, middle-income, and low-income countries and followed them up for approximately 10 years. We recorded information on participants’ metabolic, behavioural, and psychosocial risk factors. For this analysis, we included participants aged 35–70 years at baseline without a history of cardiovascular disease, with at least one follow-up visit. The primary outcome was a composite of major cardiovascular events (cardiovascular disease deaths, myocardial infarction, stroke, and heart failure). We report the prevalence of each risk factor in women and men, their hazard ratios (HRs), and population-attributable fractions (PAFs) associated with major cardiovascular disease. The PURE study is registered with ClinicalTrials.gov, NCT03225586. Findings: In this analysis, we included 155 724 participants enrolled and followed-up between Jan 5, 2005, and Sept 13, 2021, (90 934 [58·4%] women and 64 790 [41·6%] men), with a median follow-up of 10·1 years (IQR 8·5–12·0). At study entry, the mean age of women was 49·8 years (SD 9·7) compared with 50·8 years (9·8) in men. As of data cutoff (Sept 13, 2021), 4280 major cardiovascular disease events had occurred in women (age-standardised incidence rate of 5·0 events [95% CI 4·9–5·2] per 1000 person-years) and 4911 in men (8·2 [8·0–8·4] per 1000 person-years). Compared with men, women presented with a more favourable cardiovascular risk profile, especially at younger ages. The HRs for metabolic risk factors were similar in women and men, except for non-HDL cholesterol, for which high non-HDL cholesterol was associated with an HR for major cardiovascular disease of 1·11 (95% CI 1·01–1·21) in women and 1·28 (1·19–1·39) in men, with a consistent pattern for higher risk among men than among women with other lipid markers. Symptoms of depression had a HR of 1·09 (0·98–1·21) in women and 1·42 (1·25–1·60) in men. By contrast, consumption of a diet with a PURE score of 4 or lower (score ranges from 0 to 8), was more strongly associated with major cardiovascular disease in women (1·17 [1·08–1·26]) than in men (1·07 [0·99–1·15]). The total PAFs associated with behavioural and psychosocial risk factors were greater in men (15·7%) than in women (8·4%) predominantly due to the larger contribution of smoking to PAFs in men (ie, 1·3% [95% CI 0·5–2·1] in women vs 10·7% [8·8–12·6] in men). Interpretation: Lipid markers and depression are more strongly associated with the risk of cardiovascular disease in men than in women, whereas diet is more strongly associated with the risk of cardiovascular disease in women than in men. The similar associations of other risk factors with cardiovascular disease in women and men emphasise the importance of a similar strategy for the prevention of cardiovascular disease in men and women. Funding: Funding sources are listed at the end of the Article.

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The Lancet

Título del artículo:

Epidemiology of trauma in Bucaramanga, Colombia: Analysis of the institutional trauma registry at the Hospital Universitario of Santander

Introduction. Trauma is one of the main causes of mortality worldwide and represents a public health problem. In Latin America, and particularly in Colombia, few trauma registries have been successfully developed. The objective of this study is to describe the epidemiology of trauma at the Hospital Universitario of Santander in the first year of implementation of the institutional trauma registry. Methods. The Department of General Surgery of the Universidad Industrial of Santander, together with the Hospital Universitario of Santander, began the design of the trauma registry in 2020. All patients admitted to the hospital or who died in the emergency department were included. The implementation of the registry began on August 1, 2020, after carrying out a pilot test. Reports were automatically collected and exported to an unidentified electronic database. Results. 3114 patients were evaluated (M: 31 years; men: 78.1%). The median pre-hospital time was three hours and the most frequent means of transport was self-admission (51.16%). The most frequent mechanism of trauma was penetrating trauma (41.81%), with the majority being injuries caused by a sharp weapon (24.92%). Blunt trauma occurred in 41.71% of the patients evaluated and 14.4% of the population was under the influence of psychoactive substances. The general surgery service was the most consulted (26.97%), followed by the plastic surgery service (21.8%). The median hospital stay was two days (Q1:0; Q3:4) and 75 patients (2.41%) died during their hospital stay. Conclusion. The trauma registry of our institution is presented as a favorable platform for the analysis of prehospital and institutional trauma care, and the development of improvement plans in this context. This registry constitutes a solid tool for the execution of new research projects in this area.

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Revista Colombiana de Cirugia

Título del artículo:

Covid-19 en la Región de las Américas

No disponible.

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Salud publica de Mexico

Título del artículo:

Tuberculosis & Heart

Tuberculosis (TB) is a communicable disease caused by the bacilli Mycobacterium tuberculosis. It is the leading cause of mortality from an infectious disease and is among the top 10 leading causes of death worldwide, particularly in low and middle-income countries (LMIC) where it generates a significant burden of disease (World Heart Organization, 2019). Although TB has been considered a global public health emergency for the last 25 years, it remains poorly controlled. For this reason, in September 2018, the United Nations held its first-ever high-level meeting on TB to assess the state of the epidemic and seek to combat it from a global perspective. As a result, the target 3.3 strategy, which will try to end the TB epidemic by 2030, was established. The goal will be a reduction by 90% of TB mortality and 80% of TB incidence rate compared to 2015 (Harding, 2020).

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The NET-Heart Book: Neglected Tropical Diseases and other Infectious Diseases affecting the Heart

Título del artículo:

Rabies & Heart

Rabies is a neglected tropical disease caused by the Rabies Virus, a single-stranded RNA virus belonging to the Lyssavirus genus. Due to its predilection for the nervous system, the main clinical manifestation of rabies infection is severe encephalitis; however, involvement of other organs have been reported (Jackson, 2016; World Health Organization, 2018). Limited reports have demonstrated that the virus may have a tropism for the heart conduction system, leading to a range of cardiovascular manifestations. While it is important to understand the cardiac manifestations of rabies, it is mostly of academic interest, as once clinically apparent disease is established the fatality rate is virtually 100%. This chapter will review the epidemiology, pathophysiology, diagnosis, treatment and reports of cardiac involvement of rabies.

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The NET-Heart Book: Neglected Tropical Diseases and other Infectious Diseases affecting the Heart

Título del artículo:

Risk factors for prevalent childhood diseases in comprehensive care homes

Introduction: The World Health Organization states that prevalent childhood diseases in 2016 caused a mortality of 5 million in children under 5 years old, due to pneumonia and acute diarrheal disease. Objective: Examine modifiable risk factors for prevalent childhood diseases in traditional community welfare homes in Cucuta, Colombia. Methods: An observational, descriptive, cross-sectional study was conducted in 2018 in 23 households of the Colombian Institute of Family Welfare in Cúcuta; the information was collected from the instrument to identify risk factors for prevalent childhood diseases after initial testing. Results: 276 children were attended, 56.8% of them were boys. Modifiable risk factors were identified in homes; in 22,0% of these, children should improve hand washing; with a similar percentage, it was shown that the cleaning of teaching materials, toys, fans and curtains should be insisted upon; in 17.3% regular infrastructure conditions were observed. In addition, 20,0% of the children shared food, there were children with ongoing diseases and absence of care protocols to follow in such cases, among others. Conclusions: The risk factors can be intervened through the strategy of integrated care for prevalent childhood diseases from its clinical, community and local organization components for its prevention, with the interest and understanding of the shared responsibility for the care of this health problem.

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Revista Cubana de Pediatria

Título del artículo:

The Empowerment of Indigenous Women as a Factor in the Socio-Productive Development of a Rural Community

This article discusses the point of view of women\'s empowerment and its impact on public policy. Also mentions the importance of the role of indigenous women in rural and captures the scenario in the municipality of Pueblo Bello, Cesar, where the indigenous community Jewrwa. For the above, research is developed from the application of the emerging paradigm, for which a dialectical synthesis is assumed through the use of qualitative and quantitative methods in a complementary way. It is developed in three phases: the first consists of field visits to interview 5 groups of indigenous women located in the rural area of \"Pueblo Bello\" - Colombia. In addition, 5 indigenous women from the same region, successful in their professional lives, are interviewed. The second phase consists of the search and systematization of documents from multiple sources of information consulted in the year 2020 in search engines such as: Scielo, Dialnet and Google Scholar, and the third phase is a comparative analysis of the sources of information mentioned above. Data analysis was carried out by structuring thematic categories related to the empowerment of rural indigenous women. Empowerment from the intuitive perspective to drive positive changes in the situations they live, and even the political organization to transform those relationships. Hence, in order to promote processes of empowerment, it is necessary to work on the construction of the autonomy of rural indigenous women. Traditionally, indigenous women are in charge of the care work, learned by inheritance and pre-established social constructs, leaving themselves in the last place, at the service of others.

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Proceedings of the LACCEI international Multi-conference for Engineering, Education and Technology

Título del artículo:

Genetic Algorithm for the Optimization of the Unequal-Area Facility Layout Problem

The facility layout problem is one of the most important and complex problems in operations management. When the area requirements of departments are different, the problem is known as the unequal-area facility layout problem (UAFLP) and consists of locating a given number of departments within a facility plan, to minimize the total material handling cost, which is the most addressed criteria for the facility layout problems. In this chapter, a genetic algorithm (GA) is presented for solving the UAFLP for the case of a sportswear company. The genetic algorithm uses a two-part chromosome and the flexible bay structure (FBS) to obtain feasible solution alternatives for the facility layout. A set of data instances and parameters are used to validate and tune the genetic algorithm, respectively. The GA is applied to a garment production company showing that the genetic algorithm generates feasible and efficient layout alternatives for the case study.

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Intelligent Systems Reference Library

Título del artículo:

Dorsal Vascular Complex Nonligation Method and Preservation of Puboprostatic Ligaments and Endopelvic Fascia During Laparoscopic Radical Prostatectomy: Effect on Continence

Objective: To evaluate the impact on continence rate during 1-year follow-up of a preservation technique that included nonligation of the dorsal vascular complex and sparing of the puboprostatic ligaments and the endopelvic fascia during laparoscopic radical prostatectomy. Material and methods: Information from 30 patients who underwent the preservation technique was pro-spectively collected and compared with data from 60 patients who underwent the nonpreservation traditional technique. A single surgeon performed all procedures. Results: Demographic and preoperative characteristics were similar. The mean patient age was 59 years in both groups. All patients were stage cT1c or cT2. Operative time was significantly lower in the preservation technique group (229.6 vs. 262.7 minutes, P < .001). There were no significant differences in intraopera-tive bleeding, discharge hemoglobin level, blood transfusion rate, length of hospitalization, and drop in the hemoglobin level. The probability of continence recovery was significantly higher in the preservation technique group than in the traditional technique group (hazard ratio = 0.50, 95% CI = 0.31-0.81). The continence rate (0 pads/day) for the preservation technique group versus the traditional technique group at 1, 3, 6, and 12 months was, respectively, 53.3% versus 30% (P = .031), 90% versus 45% (P < .001), 90% versus 63.3% (P = .008), and 96.6% versus 78.3% (P = .024). There were no significant differences between the groups regarding potency and oncologic outcomes. Conclusion: Nonligation of the dorsal vascular complex and preservation of the puboprostatic ligaments and the endopelvic fascia improved urinary continence compared with the traditional nonpreservation technique, with no impact in terms of bleeding and oncologic outcomes.

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Turkish Journal of Urology

Título del artículo:

Prolonged Mechanical Ventilation Following Coronary Artery Bypass Graft in Santiago De Cali, Colombia

Purpose: The purpose of this study was to describe factors associated with prolonged ventilatory support in subjects undergoing coronary artery bypass graft. Patients and Methods: This was an analytical retrospective case–control study. Cases were defined as subjects requiring prolonged mechanical ventilation (>48 hours) following isolated coronary artery bypass graft. Subjects older than 18 years who had undergone surgery were included, while subjects with missing clinical record data, subjects in coma or subjects with prior cardiac surgery were excluded. Variables were measured at the three time points surrounding surgery. Results: A total of 204 cases and 408 controls were included. The final logistic model showed an association between prolonged mechanical ventilation and the following presurgical variables: chronic obstructive pulmonary disease (OR 1.85; 95% CI: 1.06–3.23, p = 0.03) and chronic kidney disease (OR 1.90; 95% CI: −3.31; p = 0.02). The associated transurgical variable was the use of intra-aortic balloon pump (OR 3.63; 95% CI: 1.73–7.61, p = 0.00), and associated postsurgical variables were venous oxygen saturation <60% (OR 2.00; 95% CI: 1.18–3.40, p = 0.01), mediastinitis (OR 18.51; 95% CI: 4.06–84.40, p = 0.00), inotrope use (OR 2.82; 95% CI: 1.77–4.48, p = 0.00), pleural effusion requiring drainage (OR 3.57; 95% CI: 2.02–6.32, p = 0.00) and delirium (OR 3.45; 95% CI: 1.91–6.25, p = 0.00). Conclusion: This study identifies factors associated with prolonged mechanical ventilation in subjects subject to coronary artery bypass graft over the presurgical, transurgical and postsurgical periods, identifying a new factor, delirium, for this type of population.

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Vascular Health and Risk Management

Título del artículo:

Inotropic support in cardiogenic shock: who leads the battle, milrinone or dobutamine?

Cardiovascular diseases remain the leading cause of death globally, with acute myocardial infarction being one of the most frequent. One of the complications that can occur after a myocardial infarction is cardiogenic shock. At present, the evidence on the use of inotropic agents for the management of this complication is scarce, and only a few trials have evaluated the efficacy-adverse effects relationship of some agents. Milrinone and Dobutamine are some of the most frequently mentioned drugs that have been studied recently. However, there are still no data that affirm with certainty the supremacy of one over the other. The aim of this review is to synthesize evidence on basic and practical aspects of these agents, allowing us to conclude which might be more useful in current clinical practice, based on the emerging literature.

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Annals of Medicine and Surgery

Título del artículo:

Burnout Syndrome in Emergency Physicians in Venezuela Early in the COVID-19 Pandemic

Background: Burnout syndrome is a clinical entity that can negatively affect healthcare workers, especially frontline medical staff. Objective: Determine the prevalence of burnout in emergency physicians at the start of the COVID-19 pandemic. Methods: The Maslach Burnout Inventory was administered to 150 emergency physicians in 2020 during the first months of the pandemic in a Venezuelan hospital. There are two limitations, the size of sample is small and the study physicians have poor social conditions that do not allow generalizing the results. Results: Over three quarters of the physicians surveyed (76.7%) experienced burnout and 55.3% had health problems due to stress. The higher the number of years working in the hospital and/or the lower the job satisfaction, the higher the burnout rate (p <0.05). Conclusion: A large number of physicians in Venezuela experienced burnout during the first months of the pandemic, but half of them believed they did not need psychological help. Prevalence of burnout was high among physicians with more years of service and among those with lower job satisfaction.

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Current Psychiatry Research and Reviews

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Glyphosate, AMPA and glyphosate-based herbicide exposure leads to GFAP, PCNA and caspase-3 increased immunoreactive area on male offspring rat hypothalamus

Glyphosate, aminomethylphosphonic acid (AMPA), and glyphosate-based herbicides altered the neuroendocrine axis, the content of brain neurotransmitters, and behavior in experimental animal models. Glyphosate alone, AMPA or Roundup® Active were administered to postpartum female rats, from P0 to P10, and their water consumption was measured daily. The immunoreactivity for glial fibrillary acidic protein (GFAP), proliferating cell nuclear antigen (PCNA) and caspase-3 was measured in the anterior, medial preoptic, periventricular, supraoptic and lateroanterior hypothalamic nuclei of P0-P10 male pups after exposure, via lactation, to these xenobiotics. Puppies exposed to glyphosate had a moderate level of GFAP with no overlapping astrocyte processes, but this overlapping was observed after Roundup® Active or AMPA exposure. After being exposed to Roundup® Active or AMPA, PCNA-positive cells with strong immunoreactivity were found in some hypothalamic nuclei. Cells containing caspase-3 were found in all hypothalamic nuclei studied, but the labeling was stronger after Roundup® Active or AMPA exposure. Xenobiotics significantly increased the immunoreactivity area for all of the markers studied in the majority of cases (p<0.05). AMPA or Roundup® Active treated animals had a greater area of PCNA immunoreactivity than control or glyphosate alone treated animals (p<0.05). The effects observed after xenobiotic exposure were not due to increased water intake. The increased immunoreactivity areas observed for the markers studied suggest that xenobiotics induced a neuro-inflammatory response, implying increased cell proliferation, glial activation, and induction of apoptotic pathways. The findings also show that glyphosate metabolites/adjuvants and/or surfactants present in glyphosate commercial formulations had a greater effect than glyphosate alone. In summary, glyphosate, AMPA, and glyphosate-based herbicides altered GFAP, caspase-3, and PCNA expression in the rat hypothalamus, altering the neuroendocrine axis.

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European journal of histochemistry : EJH

Título del artículo:

Frequentist and Bayesian Hypothesis Testing: An Intuitive Guide for Urologists and Clinicians

Given the limitations of frequentist method for null hypothesis significance testing, different authors recommend alternatives such as Bayesian inference. A poor understanding of both statistical frameworks is common among clinicians. The present is a gentle narrative review of the frequentist and Bayesian methods intended for physicians not familiar with mathematics. The frequentist p -value is the probability of finding a value equal to or higher than that observed in a study, assuming that the null hypothesis (H0) is true. The H0 is rejected or not based on a p threshold of 0.05, and this dichotomous approach does not express the probability that the alternative hypothesis (H1) is true. The Bayesian method calculates the probability of H1 and H0 considering prior odds and the Bayes factor (Bf). Prior odds are the researcher\'s belief about the probability of H1, and the Bf quantifies how consistent the data is concerning H1 and H0. The Bayesian prediction is not dichotomous but is expressed in continuous scales of the Bf and of the posterior odds. The JASP software enables the performance of both frequentist and Bayesian analyses in a friendly and intuitive way, and its application is displayed at the end of the paper. In conclusion, the frequentist method expresses how consistent the data is with H0 in terms of p -values, with no consideration of the probability of H1. The Bayesian model is a more comprehensive prediction because it quantifies in continuous scales the evidence for H1 versus H0 in terms of the Bf and the posterior odds.

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Urologia Colombiana

Título del artículo:

Knowledge, Attitudes and Practices towards Sexual and Reproductive Health and Rights of Girls among Colombian Healthcare Professionals

This research aims to determine knowledge and attitudes towards sexual and reproductive health and rights of adolescent girls among healthcare professionals working at Café Madrid and Colorados health centers, which are highly vulnerable neighborhoods in Bucaramanga, Santander. To this end, in-depth interviews were conducted with a total of eight healthcare professionals from the above health centers using a script based on WHO recommendations on adolescent sexual and reproductive health and rights and recommendations by the DAPRE-Presidential Council for Women’s Equity—CedaVida Foundation. Healthcare professionals were found to have proper technical and legal knowledge, especially regarding comprehensive care packages for survivors, as well as a gender perspective in their professional practice aimed at achieving equity. Knowledge and experience with sexual and reproductive health and rights provide insight into women’s health from unrestrained choice of contraceptive methods to procedures such as abortion within the current legal framework. Their professional work is also affected by potential barriers that may limit their actions when putting their knowledge into practice.

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International Journal of Environmental Research and Public Health

Título del artículo:

Impact of healthcare capacity disparities on the COVID-19 vaccination coverage in the United States: A cross-sectional study

Background: The impact of the COVID-19 vaccination campaign in the US has been hampered by a substantial geographical heterogeneity of the vaccination coverage. Several studies have proposed vaccination hesitancy as a key driver of the vaccination uptake disparities. However, the impact of other important structural determinants such as local disparities in healthcare capacity is virtually unknown. Methods: In this cross-sectional study, we conducted causal inference and geospatial analyses to assess the impact of healthcare capacity on the vaccination coverage disparity in the US. We evaluated the causal relationship between the healthcare system capacity of 2417 US counties and their COVID-19 vaccination rate. We also conducted geospatial analyses using spatial scan statistics to identify areas with low vaccination rates. Findings: We found a causal effect of the constraints in the healthcare capacity of a county and its low-vaccination uptake. Counties with higher constraints in their healthcare capacity were more probable to have COVID-19 vaccination rates ≤50, with 35% higher constraints in low-vaccinated areas (vaccination rates ≤ 50) compared to high-vaccinated areas (vaccination rates > 50). We also found that COVID-19 vaccination in the US exhibits a distinct spatial structure with defined “vaccination coldspots”. Interpretation: We found that the healthcare capacity of a county is an important determinant of low vaccine uptake. Our study highlights that even in high-income nations, internal disparities in healthcare capacity play an important role in the health outcomes of the nation. Therefore, strengthening the funding and infrastructure of the healthcare system, particularly in rural underserved areas, should be intensified to help vulnerable communities. Funding: None.

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Lancet Regional Health - Americas

Título del artículo:

Perceived built environment characteristics associated with walking and cycling across 355 communities in 21 countries

Research examining built environment (BE) characteristics and walking/cycling behaviors has been conducted primarily in high-income countries and conclusions cannot be applied directly to low- and middle-income countries. We evaluated perceived BE characteristics and walking/cycling behaviors across 355 urban communities in 21 low-, middle-, and high- income countries using individual data for 39,908 adults in the Prospective Urban and Rural Epidemiology study. The 1-week long-form International Physical Activity Questionnaire was used to measure walking/cycling behaviors. Perceived BE characteristics were measured using the Neighborhood Environment Walkability Scale. Mixed effects logistic regression models examined associations between BE measures and walking for transport (≥150 min/wk), walking for leisure (≥150 min/wk), and any cycling for transport, controlling for individual, household, and community factors. Land-use mix diversity, land-use mix access, and street connectivity were associated with higher odds of walking for transport. Land-use mix diversity, land-use mix access, safety from traffic and safety from crime were associated with higher odds of walking for leisure. Land-use mix diversity, land-use mix access, and aesthetics were associated with higher odds of cycling. Differences in associations were observed by country-income status. Our findings can help guide policy makers globally to implement BE design to encourage walking and cycling behaviors.

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Cities