Pilot therapeutic education program in multiple system atrophy: Safety, quality of life and satisfaction from a national registry based longitudinal study

BACKGROUND

Therapeutic education programs are effective in several chronic conditions. However, evidence is lacking in multiple system atrophy (MSA). We aimed to assess efficacy and safety of a comprehensive therapeutic education program in people with MSA (PwMSA) and their caregivers.

METHODS

In this prospective longitudinal study we included 16 PwMSA and their main caregivers in 4 groups of 4 dyads each. The program consisted of eight 60-min interdisciplinary sessions: introduction, orthostatic hypotension, speech therapy, gait and respiratory physiotherapy, psychological support, urinary dysfunction, occupational therapy/social work. UMSARS, NMSS, PDQ39, EQ5 and Zarit scales were administered at baseline and 6 months later. After each session participants filled-out a modified EduPark satisfaction questionnaire and a Likert scale. Educational material was generated for each session after suggestions by participants.

RESULTS

At baseline PwMSA and caregivers were comparable in age and sex, with significant correlation between UMSARS-IV (disability) and PDQ39 (quality of life). Adherence to sessions was of 94,92 %. Total modified EduPark scores and Likert scales did not differ in PwMSA vs. caregivers, mild-moderate vs. severe-advanced cases or between genders. The significant difference in satisfaction across sessions (p = 0.03) was driven by higher scores in speech, respiratory and occupational therapy sessions. Longitudinally there was no significant worsening in any scale, nor a significant increase post-vs. pre-program in the number of consultations.

CONCLUSIONS

The healthcare education program in MSA was feasible, satisfactory, and safe for patients and caregivers. The educational material of the program is being forwarded to incident MSA cases attending our clinic.

Informal sale of antibiotics in Guatemalan convenience stores before and after implementation of federal antibiotic dispensing legislation

BACKGROUND

Convenience stores in Guatemala provide essential consumer goods in communities, but many dispense antibiotics illegally. Federal legislation, passed in August of 2019, requires prescriptions for antibiotic purchase at pharmacies but it is unclear if this legislation is enforced or if it has any impact on unlawful sales of antibiotics.

METHODS

To determine if antibiotic availability changed in convenience stores, we carried out a repeated measures study collecting antibiotic availability data before and after implementation of the dispensing regulation.

RESULTS

There was no statistical difference in the proportion of convenience stores that sold antibiotics before and after antibiotic regulations [66.6% (295/443) and 66.7% (323/484), respectively, P>0.96], nor in the number of stores selling amoxicillin [55.5% (246/443) and 52.3% (253/484), respectively, P>0.96], but fewer stores (20%) sold tetracycline capsules after regulation was passed (P<0.05). For stores visited both before and after passage of legislation (n=157), 15% stopped selling antibiotics while 25% started selling antibiotics. Antibiotics from convenience stores were reportedly sold for use in people and animals.

CONCLUSIONS

Antibiotics remain widely available in convenience stores consistent with no significant change in the informal sector after implementation of prescription requirements for pharmacies. Importantly, effects from regulatory change could have been masked by potential changes in antibiotic use during the Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) pandemic.

Plateau iris syndrome: Epidemiology, diagnosis, and treatment: A narrative review

Plateau iris syndrome (PIS) was first coined in 1958 to describe the iris configuration of a patient, 2 years later; the concept of plateau iris was published. In 1992, the anatomic aspects of plateau iris were studied using ultrasound biomicroscopy (UBM) determining it as a form of primary angle-closure glaucoma caused by a large or anteriorly positioned ciliary body that leads to mechanical obstruction of the trabecular meshwork, this condition is most often found in young patients. We aim to review the current literature and knowledge on the diagnosis and treatment options of PIS; the search was conducted in PubMed, LILACS, and BIREME internet search sites using keywords and snowball search strategy of articles published until 2022, focusing on PIS history, epidemiology, clinical diagnosis, UBM feature, and treatment.

Influence of the background in Compton camera images for proton therapy treatment monitoring

Objective. Background events are one of the most relevant contributions to image degradation in Compton camera imaging for hadron therapy treatment monitoring. A study of the background and its contribution to image degradation is important to define future strategies to reduce the background in the system.Approach. In this simulation study, the percentage of different kinds of events and their contribution to the reconstructed image in a two-layer Compton camera have been evaluated. To this end, GATE v8.2 simulations of a proton beam impinging on a PMMA phantom have been carried out, for different proton beam energies and at different beam intensities.Main results. For a simulated Compton camera made of Lanthanum (III) Bromide monolithic crystals, coincidences caused by neutrons arriving from the phantom are the most common type of background produced by secondary radiations in the Compton camera, causing between 13% and 33% of the detected coincidences, depending on the beam energy. Results also show that random coincidences are a significant cause of image degradation at high beam intensities, and their influence in the reconstructed images is studied for values of the time coincidence windows from 500 ps to 100 ns.Significance. Results indicate the timing capabilities required to retrieve the fall-off position with good precision. Still, the noise observed in the image when no randoms are considered make us consider further background rejection methods.

Midbrain and pons MRI shape analysis and its clinical and CSF correlates in degenerative parkinsonisms: a pilot study

OBJECTIVES

To conduct brainstem MRI shape analysis across neurodegenerative parkinsonisms and control subjects (CS), along with its association with clinical and cerebrospinal fluid (CSF) correlates.

METHODOLOGY

We collected demographic and clinical variables, performed planimetric and shape MRI analyses, and determined CSF neurofilament-light chain (NfL) levels in 84 participants: 11 CS, 12 with Parkinson's disease (PD), 26 with multiple system atrophy (MSA), 21 with progressive supranuclear palsy (PSP), and 14 with corticobasal degeneration (CBD).

RESULTS

MSA featured the most extensive and significant brainstem shape narrowing (that is, atrophy), mostly in the pons. CBD presented local atrophy in several small areas in the pons and midbrain compared to PD and CS. PSP presented local atrophy in small areas in the posterior and upper midbrain as well as the rostral pons compared to MSA. Our findings of planimetric MRI measurements and CSF NfL levels replicated those from previous literature. Brainstem shape atrophy correlated with worse motor state in all parkinsonisms and with higher NfL levels in MSA, PSP, and PD.

CONCLUSION

Atypical parkinsonisms present different brainstem shape patterns which correlate with clinical severity and neuronal degeneration. In MSA, shape analysis could be further explored as a potential diagnostic biomarker. By contrast, shape analysis appears to have a rather limited discriminant value in PSP.

KEY POINTS

• Atypical parkinsonisms present different brainstem shape patterns. • Shape patterns correlate with clinical severity and neuronal degeneration. • In MSA, shape analysis could be further explored as a potential diagnostic biomarker.

Tectomer-Mediated Optical Nanosensors for Tyramine Determination

The development of optical sensors for in situ testing has become of great interest in the rapid diagnostics industry. We report here the development of simple, low-cost optical nanosensors for the semi-quantitative detection or naked-eye detection of tyramine (a biogenic amine whose production is commonly associated with food spoilage) when coupled to Au(III)/tectomer films deposited on polylactic acid (PLA) supports. Tectomers are two-dimensional oligoglycine self-assemblies, whose terminal amino groups enable both the immobilization of Au(III) and its adhesion to PLA. Upon exposure to tyramine, a non-enzymatic redox reaction takes place in which Au(III) in the tectomer matrix is reduced by tyramine to gold nanoparticles, whose reddish-purple color depends on the tyramine concentration and can be identified by measuring the RGB coordinates (Red-Green-Blue coordinates) using a smartphone color recognition app. Moreover, a more accurate quantification of tyramine in the range from 0.048 to 10 μM could be performed by measuring the reflectance of the sensing layers and the absorbance of the characteristic 550 nm plasmon band of the gold nanoparticles. The relative standard deviation (RSD) of the method was 4.2% (n = 5) with a limit of detection (LOD) of 0.014 μM. A remarkable selectivity was achieved for tyramine detection in the presence of other biogenic amines, especially histamine. This methodology, based on the optical properties of Au(III)/tectomer hybrid coatings, is promising for its application in food quality control and smart food packaging.

[Predictions of a SEIR model for COVID-19 cases in Cali-Colombia]

OBJECTIVE

To predict the number of cases of COVID-19 in the city of Cali-Colombia through the development of a SEIR model.

METHODS

A SEIR compartmental deterministic model was used considering the states: susceptible (S), exposed (E), infected (I) and recovered (R). The model parameters were selected according to the literature review, in the case of the case fatality rate data from the Municipal Secretary of Health were used. Several scenarios were considered taking into account variations in the basic number of reproduction (R0), and the prediction until april 9 was compared with the observed data.

RESULTS

Through the SEIR model it was found that with the highest basic number of reproduction [2,6] and using the case fatality rate for the city of 2,0%, the maximum number of cases would be reached on June 1 with 195 666 (prevalence). However, when comparing the observed with the expected cases, at the beginning the observed occurrence was above the projected, but then the trend changes decreasing the slope.

CONCLUSIONS

SEIR epidemiological models are widely used methods for projecting cases in infectious diseases, however it must be taken into account that they are deterministic models that can use assumed parameters and could generate imprecise results.

[SARS-coV-2 spatio - temporal analysis in Cali, Colombia]

OBJECTIVE

To describe the spatio-temporal distribution of the COVID-19 in the city of Cali during the first month of the epidemic.

METHODS

An exploratory analysis of spatial data was carried out, consisting of a kernel density analysis and the presence of spatial patterns was verified by the K-Ripley function.

RESULTS

The spatial distribution of the cases tends to initially concentrate in the north and south of the city, with a changing dynamic towards the east and west.

CONCLUSIONS

The identified spatial pattern may be influenced by the isolation measures taken at the local and national level, but the effect of the low access of the general population to diagnostic tests, delays and restraints to know the results cannot be ruled out and even possible biases due to difficulties in the technique of taking the sample or its conservation.

Two-Dimensional Triblock Peptide Assemblies for the Stabilization of Pickering Emulsions with pH Responsiveness

A variety of two-dimensional (2D) nanomaterials, including graphene oxide and clays, are known to stabilize Pickering emulsions to fabricate structures for functions in sensors, catalysts, and encapsulation. We introduce here a novel Pickering emulsion using self-assembled amphiphilic triblock oligoglycine as the emulsifier. Peptide amphiphiles are more responsive to environmental changes (e.g., pH, temperature, and ionic strength) than inorganic 2D materials, which have a chemically rigid, in-plane structure. Noncovalent forces between the peptide molecules change with the environment, thereby imparting responsiveness. We provide new evidence that the biantennary oligoglycine, Gly₄-NH-C₁₀H₂₀-NH-Gly₄, self-assembles into 2D platelet structures, denoted as tectomers, in solution at a neutral buffered pH using small-angle X-ray scattering and molecular dynamics simulations. The molecules are stacked in the platelets with a linear conformation, rather than in a U-shape. We discovered that the lamellar oligoglycine platelets adsorbed at an oil/water interface and stabilized oil-in-water emulsions. This is the first report of 2D oligoglycine platelets being used as a Pickering stabilizer. The emulsions showed a strong pH response in an acidic environment. Thus, upon reducing the pH, the protonation of the terminal amino groups of the oligoglycine induced disassembly of the lamellar structure due to repulsive electrostatic forces, leading to emulsion destabilization. To demonstrate the application of the material, we show that a model active ingredient, β-carotene, in the oil is released upon decreasing the pH. Interestingly, in pH 9 buffer, the morphology of the oil droplets evolved over time, as the oligoglycine stabilizer created progressively a thicker interfacial layer. This demonstration opens a new route to use self-assembled synthetic peptide amphiphiles to stabilize Pickering emulsions, which can be significant for biomedical and pharmaceutical applications.

Barcelona scale for buccophonatory apraxia: Quantitative assessment tool

INTRODUCTION

Currently there is no tool to quantify buccophonatory apraxia to stratify, compare and monitor patients longitudinally in an objective manner. Our aim in this study is to create a quantitative scale for buccophonatory apraxia and evaluate it in patients with the non-fluent/grammatical variant of primary progressive aphasia (nfvPPA) and other neurodegenerative diseases that occur with speech and/or language problems.

METHODS

The scale was designed based on useful elements in the assessment of buccophonatory apraxia and the total was quantified in seconds. The scale was administered to 64 participants with diagnoses of: nfvPPA, semantic variant of primary progressive aphasia (svPPA), logopenic variant of primary progressive aphasia (lvPPA), Huntington's disease, Parkinson's disease, as well as a group of healthy controls.

RESULTS

Patients showed a significantly higher score compared to controls. The nfvPPA group had the highest mean score on the scale (429 seconds ± 278). The scale was useful to differentiate vnfPPA from svPPA and Parkinson's disease (area under curve [AUC] of 0.956 and 0.989, respectively), but less to differentiate it from Huntington's disease (AUC = 0.67) and lvPPA. There was a statistically significant relationship between total score and disease severity in nfvPPA (P < .029).

CONCLUSIONS

The Barcelona scale for buccophonatory apraxia could be useful to quantitatively evaluate buccophonatory apraxia in different neurodegenerative diseases, and compare patients, especially in nfvPPA.

Joint image reconstruction algorithm in Compton cameras

Objective. To demonstrate the benefits of using an joint image reconstruction algorithm based on the List Mode Maximum Likelihood Expectation Maximization that combines events measured in different channels of information of a Compton camera. Approach. Both simulations and experimental data are employed to show the algorithm performance. Main results. The obtained joint images present improved image quality and yield better estimates of displacements of high-energy gamma-ray emitting sources. The algorithm also provides images that are more stable than any individual channel against the noisy convergence that characterizes Maximum Likelihood based algorithms. Significance. The joint reconstruction algorithm can improve the quality and robustness of Compton camera images. It also has high versatility, as it can be easily adapted to any Compton camera geometry. It is thus expected to represent an important step in the optimization of Compton camera imaging.

First case of within-host co-infection of different SARS-CoV-2 variants in Ecuador

Background

COVID-19 infection caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) can cause mild symptoms to severe illness and death. Co-infections of SARS-CoV-2 with other respiratory viruses have been described. However, two SARS-CoV-2 lineage co-infection have been rarely reported.

Methodology

A genotyping analysis and two different types of whole genome sequencing were performed (Illumina MiniSeq and ONT MinION). When examining the phylogenetic analysis in NextClade and Pangolin webservers, and considering the genotyping findings, conflicting results were obtained.

Results

The raw data of the sequencing was analyzed, and nucleotide variants were identified between different reads of the virus genome. B.1 and P.1 lineages were identified within the same sample.

Conclusions

We concluded that this is a co-infection case with two SARS-CoV-2 lineages, the first one reported in Ecuador.

Direct Outreach in Bars and Clubs to Enroll Cigarette Smokers in Mobile Cessation Services: Exploratory Study

Background

Cigarette smoking and alcohol use are well known to be concomitant behaviors, but there is a lack of studies related to recruitment of smokers for mobile cessation services at places where alcohol is consumed, such as bars and clubs. Adapting recruitment strategies to expand the reach of cessation programs to where tobacco users are located may help decrease the health-equity gap in tobacco control by improving reach and enrollment of underserved smokers residing in low-income and rural areas who are not reached by traditional cessation services.

Objective

The purpose of this exploratory study was to assess the feasibility of direct outreach in bars, clubs, and restaurants to recruit smokers to Quitxt, our mobile smoking cessation service. Quitxt is delivered through SMS text messaging or Facebook Messenger.

Methods

We collaborated with an advertising agency to conduct in-person recruitment of young adult smokers aged 18-29 years, focusing on urban and rural Spanish-speaking Latino participants, as well as English-speaking rural White and African American participants. Street team members were recruited and trained in a 4-hour session, including a brief introduction to the public health impacts of cigarette smoking and the aims of the project. The street teams made direct, face-to-face contact with smokers in and near smoking areas at 25 bars, clubs, and other venues frequented by young smokers in urban San Antonio and nearby rural areas.

Results

The 3923 interactions by the street teams produced 335 (8.5%) program enrollments. Most participants were English speakers with a mean age of 29.2 (SD 10.6) years and smoked a mean of 8.5 (SD 6.2) cigarettes per day. Among users who responded to questions on gender and ethnicity, 66% (70/106) were women and 56% (60/107) were Hispanic/Latino. Among users ready to make a quit attempt, 22% (17/77) reported 1 tobacco-free day and 16% (10/62) reported maintaining cessation to achieve 1 week without smoking. The response rate to later follow-up questions was low.

Conclusions

Direct outreach in bars and clubs is a useful method for connecting young adult cigarette smokers with mobile cessation services. However, further research is needed to learn more about how mobile services can influence long-term smoking cessation among those recruited through direct outreach, as well as to test the use of incentives in obtaining more useful response rates.

Effect of an anti-inflammatory dietary intervention on quality of life among breast cancer survivors

PURPOSE

Behavioral interventions have been used with breast cancer survivors (BCS) in cancer pain management and post-treatment quality of life (QOL) studies. We studied the effects of an anti-inflammatory dietary intervention on QOL in BCS.

METHODS

One hundred fifty-three overweight and obese (body mass index [BMI] ≥ 25 kg/m²), early stage (0-III), English-speaking BCS who had completed all cancer treatment 2 or more months prior to enrollment were recruited into a two-arm randomized controlled trial with a 2 (group) by 3 (time) repeated measures design. Intervention components included six monthly food-preparation workshops and twelve motivational interviewing telephone calls. Endpoints included the Perceived Stress Scale (PSS), the Functional Assessment of Cancer Therapy-General (FACT-G) and Breast Cancer (FACT-B), and the Center for Epidemiologic Studies Depression Scale (CES-D). Repeated measures analysis using PROC MIXED in SAS version 9.4 was used.

RESULTS

On repeated measures analysis (intent to treat), there were no differences between groups on any of the QOL outcomes except the PSS total scores. These were significantly different in the intervention group (IG; n = 76) compared to control group (CG; n = 77), showing a main effect of assignment but no effect of time and no interaction effects.

CONCLUSION

There was an impact on QOL as measured by the PSS between groups. The intervention reduced perceived stress at 6-month follow-up, but the effects dissipated by 12 months. Sources and stress and stress reduction should be a focus of future studies. Future research should also identify appropriate QOL measures that are sensitive to changes brought about by behavioral interventions.

Mortalidad por COVID-19 durante el plan de vacunación contra el virus SARS-CoV2 en Cali, Colombia

El comportamiento de la pandemia de COVID-19 durante los tres picos registrados en Cali ha sido heterogéneo y la severidad de los contagios y decesos ha variado durante el tiempo. Cali con 2.2 millones de habitantes es la tercera ciudad mas poblada de Colombia, registra a la fecha (21-11-21) 285 mil casos confirmados y 7,474 muertes por la infección. El plan de vacunación contra el SARS-CoV2 iniciado en febrero de 2021, ha inmunizado en Cali 1.54 millones de personas. Al igual que en el resto del país, el desarrollo del plan de vacunación en Cali coincidió con el tercer pico de la pandemia, el más prolongado y de mayor mortalidad; así, como con múltiples movilizaciones sociales de cientos de manifestantes agolpados en las calles entre mayo y junio del 2021, en protesta a una reforma tributaria impopular promulgada por el gobierno nacional. En Cali el plan de vacunación también se afectó por falta de acceso a servicios de salud y puntos de vacunación por bloqueos registrados en diferentes territorios de la ciudad. Al final del tercer pico, el país afrontó dificultades para continuar con el plan de vacunación por barreras al acceso de biológicos en el mercado internacional.

Abstract PO-082: Improving adherence to hormone therapy among breast cancer patients through a mobile app and patient navigation: Preliminary results

Background: The successful use of hormone therapy (HT) has contributed to improved 5-year cause-specific breast cancer survival rates, and evidence shows that long-term use produces a larger reduction in recurrence and mortality, with nearly 50% reduction in breast cancer mortality during the second decade after diagnosis. Despite the proven benefits, hormone therapy adherence is suboptimal (less than 80% of daily doses taken), and about 33% of women who are prescribed HT do not take their medication as prescribed and are at increased risk of disease recurrence and increased mortality. Smartphone ownership has increased substantially over the past decade, providing an extraordinary opportunity for innovation in the delivery of tailored interventions to improve patients' adherence to hormonal therapy. Purpose: We present preliminary results of a pilot study that involves a theory-based, culturally tailored, interactive mobile app + patient navigation to improve adherence to HT among breast cancer patients attending the breast clinic at the Mays Cancer Center (MCC). Methods: This is a 2-group parallel, randomized control trial that is currently recruiting 120 breast cancer patients and randomly assigning them to the intervention (60) or the control (60) group. The intervention group receives two components: 1) the HT Helper phone app; and 2) assistance from a patient navigator who will provide educational, psychosocial support and reinforcement, address common barriers, and facilitate the interaction with the medical team as needed. The control group receives the usual care and information provided by the MCC's breast clinic to patients undergoing HT. The app and navigation support are based in Social Cognitive Theory and principles of motivational interviewing. Results: Due to the COVID-19 pandemic, we were forced to suspend the start of the intervention until May 2021. We have recruited 27 patients and will present a general description of participants and preliminary results of the 3-month follow-up. This theory-based intervention will empower patients' self-monitoring and management. It will facilitate patient education, identification/reporting of side effects, delivery of self-care advice, and simplify communication between the patient and the oncology team. Conclusions: The anticipated outcome is a scalable, evidence-based, and easily disseminated intervention with potentially broad use to patients using HT and other oral anticancer agents. The ultimate goal of this innovative multi-communication intervention is to improve overall survival and life expectancy, enhance quality of life, reduce recurrence, and decrease healthcare costs.

Citation Format: Patricia Chalela, Edgar Muñoz, Vivian Cortez, Armida Flores, Pramod Sukumaran, Cliff Despres, Devasena Inupakutika, David Akopian, Amelie G. Ramirez. Improving adherence to hormone therapy among breast cancer patients through a mobile app and patient navigation: Preliminary results [abstract]. In: Proceedings of the AACR Virtual Conference: 14th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2021 Oct 6-8. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2022;31(1 Suppl):Abstract nr PO-082.

Pickering emulsions stabilized by carboxylated nanodiamonds over a broad pH range

HYPOTHESIS

Surfactants in emulsions sometimes do not provide adequate stability against coalescence, whereas Pickering emulsions often offer greater stability. In a search for stabilizers offering biocompatibility, we hypothesized that carboxylated nanodiamonds (ND) would impart stability to Pickering emulsions.

EXPERIMENTS

We successfully prepared Pickering emulsions of sunflower oil in water via two different methods: membrane emulsification and probe sonication. The first method was only possible when the pH of the aqueous ND suspension was ≤ 4.

FINDINGS

Pendant-drop tensiometry confirmed that carboxylated ND is adsorbed at the oil/water interface, with a greater decrease in interfacial tension found with increasing ND concentrations in the aqueous phase. The carboxylated ND become more hydrophilic with increasing pH, according to three-phase contact angle analysis, because of deprotonation of the carboxylic acid groups. Membrane emulsification yielded larger (about 30 µm) oil droplets, probe sonication produced smaller (sub-μm) oil droplets. The Pickering emulsions show high stability against mechanical vibration and long-term storage for one year. They remain stable against coalescence across a wide range of pH values. Sonicated emulsions show stability against creaming. In this first-ever systematic study of carboxylated ND-stabilized Pickering emulsions, we demonstrate a promising application in the delivery of β-carotene, as a model active ingredient.

Gastric adenocarcinoma burden and late-stage diagnosis in Latino and non-Latino populations in the United States and Texas, during 2004-2016: A multilevel analysis

Background

Gastric cancer disproportionately affects Latinos, but little is known about regional effects and risk factors. We compared primary incidence, late‐stage diagnosis, and risk factors for gastric adenocarcinoma (GCA) from 2004 to 2016 in Latinos and non‐Latinos in the United States, Texas (TX), and South Texas (STX).

Methods

We collected case data from Surveillance, Epidemiology, and End Results (SEER) and the Texas Cancer Registry. We generated average annual age‐adjusted incidence rates, rate ratios (RRs), and 95% confidence intervals (CIs) using SEER*Stat software and analyzed the cases by anatomic site, demographics, and county‐level risk factors using SAS 9.4. We constructed multilevel logistic regression models for late‐stage GCA, adjusting for patient‐ and county‐level characteristics.

Results

Latinos had higher overall GCA incidence rates in all regions, with the greatest disparities in overlap GCA in STX males (RR 4.39; 95% CI: 2.85, 6.93). There were no differences in cardia GCA rates for non‐Hispanic Whites (NHWs) and Latino women in all regions. Younger patients, patients with overlapping or not otherwise specified (NOS) lesions, and patients diagnosed during 2012–2016 had higher odds of late‐stage GCA. The stratification by location showed no differences in late‐stage disease between NHWs and Latinos. The stratification by anatomic site showed Latinos with cardia GCA were more likely to have late‐stage GCA than NHWs (OR: 1.13, p = 0.008). At the county level, higher odds of late‐stage GCA were associated with medium and high social deprivation levels in TX without STX (OR: 1.25 and 1.20, p = 0.007 and 0.028, respectively), and medium social deprivation index (SDI) in patients with NOS GCA (OR: 1.21, p = 0.01).

Conclusions

STX Latinos experience greater GCA disparities than those in TX and the United States. Younger age and social deprivation increase the risk for late‐stage GCA, while Latinos and women are at higher risk specifically for late‐stage cardia GCA. There is a need for population‐specific, culturally responsive intervention and prevention measures, and additional research to elucidate contributing risk factors.

Latinos had higher gastric adenocarcinoma incidence than non‐Latinos in the U.S., Texas and South Texas from 2004 to 2016. Younger age and social deprivation increased risk of late‐stage diagnosis, while Latino ethnicity and female gender increased risk of late‐stage gastric adenocarcinoma of the cardia specifically.

Scattering of light by ZnO nanorod arrays

The optical properties of ZnO nanorod (NR) arrays were investigated by optical total transmittance (TT) and diffuse reflectance (DR) spectroscopy in the visible region. The NRs were grown electrochemically in a three-electrode cell over a glass/fluorine-doped tin oxide (FTO) substrate. The mean length, radius, and density of NR samples were characterized by scanning electron microscopy. The results were correlated with the observed optical properties. Since light scattering for these NR arrays is highly dependent on their morphology, therefore, a model for light scattering based in the Mie theory for cylinders was implemented to understand the observed spectra. The mean scattering and extinction cross sections were calculated from the morphology of the samples. They were used to fit the DR spectra. From the fittings, the TT spectra of the samples could be calculated. A good agreement with the experimental results was obtained. This indicates that the implemented model represents well the observed scattering phenomena.

Reply to a letter from Robert Colebunders entitled COVID-19: The African Enigma

We thank Dr. Colebunders for his comments regarding our manuscript. Our study was an ecological study prompted by the low frequency of cases and deaths from the SARS-CoV-2 COVID-19 virus in some African countries. We agree with Dr. Colebunders that other factors could explain the observed association between APOC countries and COVID-19 mortality. However, these unmeasured confounders would have to be strongly associated with Covid-19 mortality to explain the observed 28% reduction. In updated information, as of 12-17-20, APOC countries had a 42% lower risk of death than the non-APOC countries, adjusted for confounders. (Not published) Hellwig et al., in addition to reporting similar findings to ours for African and Asian countries, surmised that they may be connected to ivermectin’s ability to inhibit SARS-CoV-2 replication suggesting other pathways must exist to explain the persistence of such an inhibitory effect after serum levels of ivermectin have declined. As mentioned by Mbow et al. “, it is increasingly recognized that the immune system is shaped not only by genetics but also by environmental factors, such as exposure to microorganisms and parasites. This educates the immune system to protect against invading pathogens not only specifically but also nonspecifically through, for example, “trained immunity,” which involves the reprogramming of innate cells that, on secondary encounter with a pathogen, can show a stronger response.” Those infections, such as onchocerciasis, may downregulate immune responses and potentially inactivate the inflammatory signalling pathways that may induce acute respiratory distress syndrome (ARDS), one of the causes of death in COVID-19 infected persons, seems very attractive explanation.  

Data from quality life questionnaries: QLQ-C30 and QLQ-BR23 in a cohort of Women with breast cancer in Cali, Colombia - 2020

In an attempt to evaluate the contribution of symptoms, functionality and health perception on health-related quality of life of 80 women with breast cancer that underwent chemotherapy for disease treatment was studied. In this study cohort, retrospective data was extracted after the application of the questionnaires QLQ-C30 and QLQ-BR23 for quality of life. These patients belong 3 oncology centers in Cali - Colombia 2020. The quality of life was determined by measuring the interaction of 3 components represented by the global health status, the functional status and the symptoms.

New probe for the improvement of the Spatial Resolution in total-body PET (PROScRiPT)

In recent decades, PET scanners have been widely used for diagnosis and treatment monitoring in nuclear medicine. The continuous effort of the scientific community has led to improvements in scanner performance. Total-body PET is one of the latest upgrades in PET scanners. These kinds of scanners are able to scan the whole body of the patient with a single bed position, since the scanner tube is long enough for the patient to fit inside. While these scanners show unprecedented efficiency and extended field-of-view, a drawback is their low spatial resolution compared to dedicated scanners. In order to improve the spatial resolution of specific areas when measuring with a total-body PET scanner, the IRIS group at IFIC-Valencia is developing a probe. The proposed setup of the probe contains a monolithic scintillation crystal and a SiPM. The signal of the probe is read out by a TOFPET2 ASIC from PETsys, which has shown good performance for PET in terms of spatial and time resolutions. Furthermore, the PETsys technology generates a trigger signal that will be used to time synchronise the probe and the scanner. The proof-of-concept of the probe will be tested in a Preclinical Super Argus PET/CT scanner for small animals located at IFIC. Preliminary simulations of the scanner and the probe under ideal conditions show a slight improvement in the position reconstruction compared to the data obtained with the scanner, therefore we expect a considerable improvement when using the probe in a total-body PET scanner. Characterisation tests of the probe have been performed with a 22Na point-like source, obtaining an energy resolution of 9.09% for the 511 keV energy peak and a temporal resolution of 619 ps after time walk correction. The next step of the project is to test the probe measuring in temporal coincidence with the scanner.

COVID-19: The Ivermectin African Enigma

Introduction

The low frequency of cases and deaths from the SARS-CoV-2 COVID-19 virus in some countries of Africa has called our attention about the unusual behavior of this disease. The ivermectin is considered a drug of choice for various parasitic and viral diseases and shown to have in vitro effects against SARS-CoV-2.

Aims

Our study aimed to describe SARS-CoV2 infection and death rates in African countries that participated in an intensive Ivermectin mass campaign carried out to control onchocerciasis and compare them with those of countries that did not participate.

Methods

Data from 19 countries that participated in the World Health Organization (WHO) sponsored African Programme for Onchocerciasis Control (APOC), from 1995 until 2015, were compared with thirty-five (Non-APOC), countries that were not included. Information was obtained from https://www.worldometers.info/coronavirus/ database. Generalized Poisson regression models were used to obtain estimates of the effect of APOC status on cumulative SARS-CoV-2 infection and mortality rates.

Results

After controlling for different factors, including the Human Development Index (HDI), APOC countries (vs. non-APOC), show 28% lower mortality (0.72; 95% CI: 0.67-0.78) and 8% lower rate of infection (0.92; 95% CI: 0.91-0.93) due to COVID-19.

Conclusions

The incidence in mortality rates and number of cases is significantly lower among the APOC countries compared to non-APOC countries. That a mass public health preventive campaign against COVID-19 may have taken place, inadvertently, in some African countries with massive community ivermectin use is an attractive hypothesis. Additional studies are needed to confirm it.

Abstract PO-008: mHealth for smoking cessation: Development of a bilingual messenger chat to engage young adult smokers

Background: Quitxt is an evidence-based mobile text messaging service for smoking cessation promoted in South Texas via social media advertising. A group analysis of 798 Quitxt participants with a mean age of 29.3 found that 21% of the enrollees reported abstinence at 7 months. This confirmed that a text and mobile media service specifically designed for young adults provides a feasible, potentially cost- effective approach to promoting cessation. Quitxt is tailored to reach Latino, non- Latino white and African American young smokers. Objective: We present the design, development process and preliminary results of a theory-based, bilingual, interactive Facebook Messenger Chat to promote smoking cessation among young adults in Texas. Methods: We conducted focus groups (2) and an online survey (200) with young adult smokers aged 18-30 to assess images, video testimonials, and messages for social media and updated webpages linked to in Quitxt text messages. Feedback from focus group and online survey participants informed the development of the Facebook Messenger Chat prototype. The Chat was pretested multiple times to identify and fix technical issues and improve its functionality. Results: Formative research participants positively reviewed the images, messages, and videos within the Quitxt mobile program, with the suggested addition of more information on negative consequences of smoking. Participants listed Facebook as the most popular social media platform, adding credibility to the conversion of the Quitxt text messaging program into a Facebook Messenger Chat version. This platform also enabled additional graphic content to make the messages more appealing to young adults. After beta-testing, we refined the Messenger Chat prototype and resolved technical issues. The Quitxt communication team designed Facebook ads with a “quit smoking for a New Year’s resolution” theme and began enrollment in late December 2019. Based on past social media recruitment, we expected to recruit up to 300 participants during the 2-week campaign, but we exceeded expectations and enrolled 2,347 in the Messenger Chat version of Quitxt. Additional promotional campaigns in 2020 for Valentine’s Day, St. Patrick’s Day, and as a preventive health measure amid the rise of COVID-19 produced a total of 5,344 enrollments. 73.8% were Spanish speakers, 55.2% were aged 18-29; 74% were males, 81.7% self- identified as Hispanic/Latino, most were light/medium smokers (mean 11.8 cig/day), and 51% were ready to quit the next day. About 14% reported cessation at 1 month.

Conclusions: We followed an iterative design process to develop a bilingual, culturally tailored and interactive Facebook Messenger Chat prototype to deliver our Quitxt smoking cessation program. Preliminary results showed that the Facebook Messenger Chat version may be a successful strategy to deliver smoking cessation services to young adult smokers. The anticipated outcome is a scalable, evidence- based, easily disseminated smoking cessation intervention.

Citation Format: Alfred L. McAlister, Edgar Muñoz, Cliff Despres, Pramod Sukumaran, Illeana Tiemann, Bianca Gutierrez, Sahak Kaghyan, Rahul Mundlamuri, David Akopian, Amelie G. Ramirez, Patricia Chalela. mHealth for smoking cessation: Development of a bilingual messenger chat to engage young adult smokers [abstract]. In: Proceedings of the AACR Virtual Conference: Thirteenth AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2020 Oct 2-4. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2020;29(12 Suppl):Abstract nr PO-008.

Abstract PR09: HT Helper: mHealth app to promote hormone therapy adherence among breast cancer patients

Background: Adjuvant hormonal therapy (HT) is highly effective and appropriate for nearly all women with hormone receptor-positive tumors, making such treatment the most widely prescribed therapy for patients with this type of breast cancer. Despite its proven benefits in reducing cancer recurrence and improving survival, HT adherence is suboptimal (less than 80%). About 33% of patients do not take their medication as prescribed and are at increased risk of disease recurrence and lower survival. Purpose: We will present the development and betatesting of HT Helper, a theory-based, bilingual, interactive mHealth app in combination with patient navigation to improve adherence to HT among patients attending the breast clinic at the Mays Cancer Center, as part of the initial phase of a two-group randomized clinical trial study. Methods: As part of the formative research phase, we conducted 4 focus groups (n=21) with breast cancer patients receiving HT, and personal interviews (n=8) with oncologists, nurses, and patient navigators to assess barriers and facilitators to HT adherence, main side effects, app content, and features. Qualitative data informed the initial design and development of app mock-ups; these were assessed with two additional focus groups (n=10). Based on this feedback, we developed the phone app prototype and beta-tested it for two weeks with breast cancer patients (n=5) and research team members. (n=10). Results: Inputs from patients and healthcare team members helped to identify specific app content and features. Key suggestions included adding: educational content on HT, adherence, side effects and how to stay healthy to enhance management skills; a tool for side effects reporting and tracking and social networking with other patients; reminders and inspirational messages; testimonials from real patients; easy avenues to communicate with the study team; information on local resources including support groups; and technical support information. In addition to app colors and icon preferences, patients emphasized the need for a user-friendly app that is easy to navigate with simple and clear educational content. In general, beta-testers found the app easy to use, credible and trustworthy, and their reactions were very positive about app appearance, content, purpose, and usability. After minor technical issues were fixed, the study app was refined and finalized, and it is ready for recruitment. Conclusion: We followed an iterative and patient-centered design process to develop a bilingual, culturally tailored, and interactive mHealth app to be used in combination with patient navigation in a randomized control trial. The anticipated outcome of this innovative multi-communication intervention is a scalable, evidence-based, easily disseminated intervention with potentially broad use to patients using oral anticancer agents.

Citation Format: Edgar Muñoz, Cliff Despres, Pramod Sukumaran, Illeana Tiemann, Bianca Gutierrez, Victoria Paz, Devasena Inupakutica, Sahak Kaghyan, David Akopian, Amelie G. Ramirez, Patricia Chalela. HT Helper: mHealth app to promote hormone therapy adherence among breast cancer patients [abstract]. In: Proceedings of the AACR Virtual Conference: Thirteenth AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2020 Oct 2-4. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2020;29(12 Suppl):Abstract nr PR09.

Quality of life outcomes from a randomized controlled trial of patient navigation in Latina breast cancer survivors

INTRODUCTION

Breast cancer survivorship is a life-long process involving challenges to health-care communities and individuals, especially Latinas. Patient Navigation has shown some success in meeting these challenges. The purpose of this study was to compare the effects of an enhanced Patient Navigation program (Intervention; PN+) vs Control (PN) over time on general cancer and breast cancer-specific quality of life (QoL) in Latina breast cancer survivors (BCS).

METHODS

We conducted a 2-year, two-arm randomized controlled trial of the "Staying Healthy" program among Latina BCS. The design compared PN+ vs PN over time. We recruited 60 patients into each study arm and randomized them by sequential numerical assignment. PN+ participants received culturally tailored educational materials and active, personalized Patient Navigation services, including phone calls, transportation, and care coordination. PN participants were navigated only upon request. Primary outcomes included general cancer (Functional Assessments of Cancer Therapy [FACTS]-G) and breast cancer-specific (FACT-B) QoL.

RESULTS

PN+ participants had significantly improved QoL measures compared to PN at 6-month follow-up on all subscales (P-values .007-.04) except physical well-being (PWB; P = .11). Intervention effect size coefficient (standard error) for FACT-G overall was 7.9 (3.1); P = .01. For FACT-B, it was 10.9 (3.9); P = .006. Again, all subscales showed significant effects [range 1.7-3.1 (0.8-1.2); P-values .006-.04], except for PWB [1.5 (1.0); P = .16] and social/family well-being (SWB) [2.1 (1.1); P = .06]. There were no differences between groups at baseline.

DISCUSSION

Multiple cultural, psychosocial, and socioeconomic variables contributing to these intervention effects will be addressed in future studies. As the national BCS population continues to increase, more Patient Navigation-focused partnerships among patients, health-care professionals, research groups, and community organizations are needed to improve BCS experiences. The Staying Healthy program has the potential to serve as a national survivorship care model for improving Latina BCS QoL.

Laser-Deposited Carbon Aerogel Derived from Graphene Oxide Enables NO2-Selective Parts-per-Billion Sensing

Laser-deposited carbon aerogel is a low-density porous network of carbon clusters synthesized using a laser process. A one-step synthesis, involving deposition and annealing, results in the formation of a thin porous conductive film which can be applied as a chemiresistor. This material is sensitive to NO₂ compared to ammonia and other volatile organic compounds and is able to detect ultra-low concentrations down to at least 10 parts-per-billion. The sensing mechanism, based on the solubility of NO₂ in the water layer adsorbed on the aerogel, increases the usability of the sensor in practically relevant ambient environments. A heating step, achieved in tandem with a microheater, allows the recovery to the baseline, making it operable in real world environments. This, in combination with its low cost and scalable production, makes it promising for Internet-of-Things air quality monitoring.

Obstetric anal sphicnter injury in a Spanish hospital

OBJECTIVE

Estimation of the prevalence of obstetric anal sphincter injury (OASIS) in our environment and study of the associated risk factors.

STUDY DESING

A retrospective observational study of cases and controls of assisted deliveries at the Severo Ochoa University Hospital of Leganés during the period from January 1, 2012, to December 31, 2017. A total of 88 OASIS diagnosed in the study period is compared with a randomly selected group of 181 controls of similar characteristics, vaginal births of cephalic of 36 weeks gestation or more, occurring during the same period.

RESULTS

During the study period, a total of 8160 deliveries were attended in our hospital, of which 6187 were vaginal and we diagnosed a total of 88 OASIS at the time of delivery. The prevalence of OASIS is 1.07 % for total births and 1.42 % for total vaginal deliveries. In the case-control study, the univariate analysis shows statistical significance for nulliparity (OR 3.84; 95 % CI 2.155-6.834; p < 0.001), instrumental delivery (OR 8.73; 95 % CI 4.706-16.2016; p < 0.001), occipital posterior position (OR 7.23; 95 % CI 2.535-20.633; p < 0.001), long duration of the second stage of labor (OR 1.99; IC95 % 1,159-3,438; p 0.01), episiotomy (OR 3.51; 95 % CI 1,956-6,309; p < 0.001) and OBGYN labor assistant (<0.001). When performing the multivariate analysis, forceps delivery (OR19.68), Thierry spatulas delivery (OR 8.15), vacuum delivery (OR 2.74), nulliparity (OR 2.56) and fetal weight in grams (OR 1.12) remain significant in the final model.

CONCLUSION

The main risk factors for the onset of OASIS are instrumental delivery, nulliparity and fetal birth weight.

Toxicity of Carbon Nanomaterials and Their Potential Application as Drug Delivery Systems: In Vitro Studies in Caco-2 and MCF-7 Cell Lines

Carbon nanomaterials have attracted increasing attention in biomedicine recently to be used as drug nanocarriers suitable for medical treatments, due to their large surface area, high cellular internalization and preferential tumor accumulation, that enable these nanomaterials to transport chemotherapeutic agents preferentially to tumor sites, thereby reducing drug toxic side effects. However, there are widespread concerns on the inherent cytotoxicity of carbon nanomaterials, which remains controversial to this day, with studies demonstrating conflicting results. We investigated here in vitro toxicity of various carbon nanomaterials in human epithelial colorectal adenocarcinoma (Caco-2) cells and human breast adenocarcinoma (MCF-7) cells. Carbon nanohorns (CNH), carbon nanotubes (CNT), carbon nanoplatelets (CNP), graphene oxide (GO), reduced graphene oxide (GO) and nanodiamonds (ND) were systematically compared, using Pluronic F-127 dispersant. Cell viability after carbon nanomaterial treatment followed the order CNP < CNH < RGO < CNT < GO < ND, being the effect more pronounced on the more rapidly dividing Caco-2 cells. CNP produced remarkably high reactive oxygen species (ROS) levels. Furthermore, the potential of these materials as nanocarriers in the field of drug delivery of doxorubicin and camptothecin anticancer drugs was also compared. In all cases the carbon nanomaterial/drug complexes resulted in improved anticancer activity compared to that of the free drug, being the efficiency largely dependent of the carbon nanomaterial hydrophobicity and surface chemistry. These fundamental studies are of paramount importance as screening and risk-to-benefit assessment towards the development of smart carbon nanomaterial-based nanocarriers.

Image reconstruction for a multi-layer Compton telescope: an analytical model for three interaction events

Compton Cameras are electronically collimated photon imagers suitable for sub-MeV to few MeV gamma-ray detection. Such features are desirable to enable in vivo range verification in hadron therapy, through the detection of secondary Prompt Gammas. A major concern with this technique is the poor image quality obtained when the incoming gamma-ray energy is unknown. Compton Cameras with more than two detector planes (multi-layer Compton Cameras) have been proposed as a solution, given that these devices incorporate more signal sequences of interactions to the conventional two interaction events. In particular, three interaction events convey more spectral information as they allow inferring directly the incident gamma-ray energy. A three-layer Compton Telescope based on continuous Lanthanum (III) Bromide crystals coupled to Silicon Photomultipliers is being developed at the IRIS group of IFIC-Valencia. In a previous work we proposed a spectral reconstruction algorithm for two interaction events based on an analytical model for the formation of the signal. To fully exploit the capabilities of our prototype, we present here an extension of the model for three interaction events. Analytical expressions of the sensitivity and the System Matrix are derived and validated against Monte Carlo simulations. Implemented in a List Mode Maximum Likelihood Expectation Maximization algorithm, the proposed model allows us to obtain four-dimensional (energy and position) images by using exclusively three interaction events. We are able to recover the correct spectrum and spatial distribution of gamma-ray sources when ideal data are employed. However, the uncertainties associated to experimental measurements result in a degradation when real data from complex structures are employed. Incorrect estimation of the incident gamma-ray interaction positions, and missing deposited energy associated with escaping secondaries, have been identified as the causes of such degradation by means of a detailed Monte Carlo study. As expected, our current experimental resolution and efficiency to three interaction events prevents us from correctly recovering complex structures of radioactive sources. However, given the better spectral information conveyed by three interaction events, we expect an improvement of the image quality of conventional Compton imaging when including such events. In this regard, future development includes the incorporation of the model assessed in this work to the two interaction events model in order to allow using simultaneously two and three interaction events in the image reconstruction.

Análisis espacio-temporal del SARS-coV-2 en Cali, Colombia

Objetivo Describir la distribución espacio-temporal del COVID-19 en la ciudad de Cali durante el primer mes de epidemia.Métodos Se realizó un análisis exploratorio de datos espaciales, compuesto por un análisis de densidad de Kernel y se verificó la presencia de patrones espaciales por medio de la función K de Ripley.Resultados La distribución espacial de los casos tiende a concentrarse inicialmente en el norte y sur de la ciudad, con una dinámica cambiante hacia el oriente y occidente.Conclusiones El patrón espacial identificado puede estar influenciado por las medidas de aislamiento tomadas a nivel local y nivel nacional, además no se puede descartar el efecto del poco acceso que tiene la población general a las pruebas diagnósticas,los retrasos y represamientos para conocer los resultados de las mismas y aun los posibles sesgos por dificultades en la técnica de toma de la muestra o su conservación.