Abstract This study examines the in vitro growth and ex vitro establishment of Brassavola tuberculata in relation to the micropropagation system and sucrose concentration employed in the in vitro culture. A completely randomized experimental design was utilized, employing a 2 x 5 factorial arrangement. The experimental period began with seedlings cultivated in vitro for 180 days, which were subsequently transferred to Murashige and Skoog culture media containing sucrose concentrations of 0, 15, 30, 45, or 60 g L-1. The cultures were subjected to two micropropagation systems: conventional and gas exchange. After 90 days of in vitro cultivation, the plants were evaluated, transplanted into a substrate, and placed in a screened nursery for ex vitro cultivation. After 300 days of ex vitro cultivation, the survival and initial characteristics of the plants were assessed. The micropropagation system allowing gas exchange and sucrose concentrations up to 30 g L-1 enhanced the shoot and root growth of in vitro propagated plants. No noticeable anatomical differences were observed after 90 days of in vitro culture among the different sucrose concentrations and micropropagation systems used. In the ex vitro establishment, irrespective of sucrose concentration, the micropropagation system facilitating gas exchange positively influenced all evaluated characteristics.

Resumo Objetivou-se com este trabalho avaliar o crescimento in vitro e estabelecimento ex vitro de Brassavola tuberculata em função do sistema de micropropagação e da concentração de sacarose utilizados no cultivo in vitro. Foi utilizado o delineamento inteiramente casualizado e os tratamentos arranjados em esquema fatorial 2 x 5. Para o início do período experimental, foram utilizadas plântulas cultivadas in vitro por 180 dias, sendo transferidas para meios de cultivo Murashige e Skoog contendo 0, 15, 30, 45 ou 60 g L-1 de sacarose, e as culturas submetidas a dois sistemas de micropropagação: convencional ou com troca gasosa. Após 90 dias de cultivo in vitro, as plantas foram avaliadas e na sequência plantadas em substrato e acondicionadas em viveiro telado para o cultivo ex vitro. Após 300 dias de cultivo ex vitro, as plantas foram avaliadas quanto à sobrevivência e às mesmas características iniciais. A utilização do sistema de micropropagação que permite trocas gasosas, em conjunto com concentrações de sacarose de até 30 g L-1, proporcionou aumento no crescimento de parte aérea e do sistema radicular das plantas propagadas in vitro. As diferentes concentrações de sacarose e os sistemas de micropropagação utilizados não apresentaram diferenças anatômicas perceptíveis aos 90 dias de cultivo in vitro. Já no estabelecimento ex vitro, independente da utilização de sacarose, o sistema de micropropagação que permite trocas gasosas influenciou positivamente todas as características avaliadas.

Abstract Objectives: To describe a collaborative program between pharmacists from an Emergency Department and a long-term Health Care Center, and to evaluate its impact on the frequency of visits to the emergency department. Material and methods: Retrospective observational study in which the interventions performed by a multidisciplinary collaboration team in patients discharged from an Emergency Service to a long-term Health Care Center for 9 months were described. To evaluate the health-care impact of this intervention, the number of re-visits to the emergency department at 30 days of patient's dischrge to long-term Health Care Center was compared with the same period of the previous year. Results: 627 patients discharged from the Emergency Department to the long-term Health Care Center, being treatment modifications reported in 233 patients (mean age: 87.1 (SD: 7.7) years). The main reason for attending the emergency room was respiratory infection (74; 31.8%), followed by urinary infection (33; 14.2%). Interventions were performed in 48 (20.6%) of the patients upon admission by pharmacists of the the long-term Health Care Center, being the adjustment of antibiotic therapy the most frequent intervention (13; 27.1%). There was a non-significant trend towards a reduction in the number of re-visits to the Emergency Department during the intervention period (6.6% vs. 4.9%; p=0.258). Conclusions: Communication between the pharmacists responsible for the Emergency Service and long-term Health Care Centers allows a comprehensive action on the patient's pharmacotherapy, with a potential impact on the healthcare system.

Resumen Objetivos: Describir un programa de colaboración entre farmacéuticos de un Servicio de Urgencias y un Centro Sociosanitario, así como evaluar su impacto sobre la frecuencia de reconsulta al Servicio de Urgencias. Material y métodos: Estudio observacional retrospectivo en el cual se describieron las intervenciones realizadas por un programa de colaboración multidisciplinar en pacientes dados de alta desde un Servicio de Urgencias a un Centro Sociosanitario durante 9 meses. Para evaluar el impacto asistencial del programa, se comparó el número de reconsultas al Servicio de Urgencias a los 30 días de los pacientes derivados al Centro Sociosanitario con el mismo periodo del año previo a la intervención. Resultados: De los 627 pacientes dados de alta desde el Servicio de Urgencias hasta al centro de sociosanitario, se comunicaron modificaciones de tratamiento en 233 pacientes (edad media: 87,1 (SD:7,7) años). El principal motivo de asistencia a Urgencias fue infección respiratoria/broncoaspiaración (74; 31,8%), seguida de infección urinaria (33; 14,2%). Se realizaron intervenciones en 48 (20,6%) de los pacientes al ingreso por parte de los farmacéuticos del centro sociosanitario, siendo mayoritario el ajuste de antibioterapia (13; 27,1%). Se observó una tendencia no significativa a la reducción en el número de reconsultas al Servicio de Urgencias (6,6% vs. 4,9%; p=0,258). Conclusiones: La comunicación entre los farmacéuticos responsables del Servicio de Urgencias y de los Centros Sociosanitarios permite optimizar de forma precoz el tratamiento farmacoterapéutico de los pacientes, con un potencial impacto sobre las reconsultas a los Servicios de Urgencias.

ABSTRACT This study explored the nature of health risks in the population of three municipalities within the Metropolitan Area of the Valley of Mexico (MAVM) by means of an empirical analysis of health effects associated with air pollution and temperature variation. Based on the environmental justice theory, we asked whether, in unequal socioeconomic municipalities of the MAVM, the association between PM10 concentrations and mortality depends on socioeconomic disparities. We differ from previous studies that have established a relationship between PM10 and mortality based on a state-space model instead of the Poisson regression model. The state-space model allows estimating the size of the unobserved at-risk population, its hazard rate, the life expectancy of individuals in that population, and the effect of changes in environmental conditions on that life expectancy. Our results show a lower hazard rate in a wealthy municipality, as compared to a higher hazard rate in a poor one. The lower hazard rate of the wealthy municipality extends life expectancy and enhances the likelihood of inhabitants staying long-lasting within the population at risk, thus increasing the size of that population, as compared to the population at risk in the poor municipality, whose members show a lower life expectancy. Thus, the smaller the at-risk population, the sicker its average member and the smaller the impact on long-term mortality. Our study examines how regional health disparities could provide information for public health policy initiatives which might improve living conditions among different communities.

RESUMEN En este artículo evaluamos empíricamente el efecto de la contaminación del aire y la variación de la temperatura sobre los riesgos de salud de la población en tres municipios de la Zona Metropolitana del Valle de México (ZMVM). Con base en la teoría de la justicia ambiental nos preguntamos si en estos municipios de la ZMVM la asociación entre la concentración de PM10 y la mortalidad depende de las disparidades socioeconómicas de la población. En esta investigación diferimos de lo que habitualmente se ha hecho en otros estudios que establecen la relación entre la concentración de PM10 y la mortalidad al usar un modelo de espacio de estados, en lugar del modelo de regresión de Poisson. El modelo de espacio de estados permite estimar el tamaño de la población en riesgo no observada, su tasa de riesgo, la esperanza de vida de los individuos de esa población y el efecto de los cambios en las condiciones ambientales sobre la esperanza de vida. Nuestros resultados muestran una tasa de riesgo más baja en el municipio de mayor nivel socioeconómico comparada con la tasa más alta del municipio con menor nivel socioeconómico. La menor tasa de riesgo del municipio con mayor nivel socioeconómico incrementa la esperanza de vida y la probabilidad de que sus habitantes permanezcan más tiempo en la población en riesgo, aumentando de esta forma el tamaño de dicha población, en comparación con el municipio de menor nivel socioeconómico, cuyos habitantes muestran menor esperanza de vida. Entonces, entre más pequeña sea la población en riesgo, más enfermos estarán sus habitantes y, por tanto, menor será el impacto sobre la mortalidad en el largo plazo. Nuestro estudio examina cómo se comportan las disparidades de salud a nivel regional y podría proporcionar información para proponer iniciativas de políticas de salud pública, con el fin de mejorar las condiciones de vida entre las diferentes comunidades.

Abstract Volumetric modulated arc radiotherapy treatments (VMAT) can achieve highly conformed dose distributions however, due to the complexity of the technique, there may have differences between the planned and administered dose distributions, generated by the precision in the dose calculation of the treatment planning system (TPS) or by the errors associated with it. One way to quantify the difference between both dose distributions is by using the gamma index; however, there is no accord regarding the parameters that should be used in its analysis. On the other hand, this gamma index may depend on the pathology and the area to be treated. For this reason, the present work aims to evaluate different parameters of the analysis of the gamma index for breast cancer treatments; these are local and global normalization, the analysis criteria (1%/1 mm, 2%/2 mm, 3%/2 mm, 2%/3 mm, 3%/3 mm and 5%/3 mm), and the low dose threshold (LDT) of 5% and 10%. For this, 30 treatment plans performed with VMAT technique in a 6 MV Infinity linear accelerator (Elekta, Stockholm, Sweden) were analyzed, calculated with the TPS Monaco V.5.11.03 (Elekta, Stockholm, Sweden) and measured with the Octavius 4D system (PTW, Freiburg, Germany). The results of the analysis of the global gamma index were of a gamma passing rate (%GP) greater than 95% for analysis criteria of 3%/3 mm and 5%/3 mm; however, for these same parameters in the local gamma index analysis, the results are 85.8% and 91.1% respectively. In addition, from the LDT evaluation, it is observed that there is a mean increase of %GP for the local gamma index analysis and a mean decrease of %GP for the global gamma index analysis, for the LDT from 5% to 10%. On the other hand, the standard deviation is lower in the global gamma index; analysis than in the local one, and it decreases when the analysis criteria are less strict. It is concluded that there is not a great difference in choosing the LDT of 5% or 10%. When the gamma analysis criteria are less strict, the %GP increases both for the analysis of the local and global gamma index, taking this into account, each parameter should be used carefully according to the treatment plan to be analyzed, taking into account the advantages and disadvantages of each parameter.

Resumen: Introducción: El ligamento cruzado anterior es una estructura anatómica que tiende a dar problemas a los especialistas al formular un diagnóstico certero. Existen herramientas de medición que apoyan el diagnóstico como el KT1000; sin embargo, aún presenta algunas limitaciones, pues sólo logra medir un solo eje de movimiento, mientras que la maniobra de pivot-shift logra capturar más información sobre el estado del ligamento, ya que permite evaluar los tres ejes de movimiento de la articulación. La maniobra de pivot-shift carece de una ejecución estándar, por ello puede producir discordancia entre evaluadores; así se crea la necesidad de una herramienta capaz de estandarizar la maniobra al tiempo que arroje una medición interpretable. Material y métodos: La aplicación «pivot-shift meter» es un software para móviles capaz de capturar información de los movimientos realizados al ejecutar una maniobra de pivote. Se utilizó el índice de correlación intraclase para medir la correlación intra- e interobservador de la información capturada por la aplicación. Los datos fueron obtenidos de 66 participantes aleatorios, mediante el giroscopio integrado del teléfono móvil. Resultados: Con los 66 ensayos realizados se observó que los evaluadores tienden a alcanzar una alta reproducibilidad al ejecutar las maniobras dentro del periodo de tiempo establecido por la aplicación, que alcanzó un índice de correlación intraclase por encima de 90%. Conclusión: La correlación intra- e interobservador es lo suficientemente alta como para poder realizar un análisis cuantitativo de la maniobra de pivot-shift a través de un teléfono móvil.

Abstract: Introduction: The anterior cruciate ligament is an anatomical structure that tends to cause problems for specialists when formulating an accurate diagnosis. There are measurement tools that support the diagnosis such as the KT1000; however, it still has some limitations, since it only manages to measure a single axis of movement, while the «pivot-shift» maneuver manages to capture more information about the state of the ligament, as it allows to evaluate the three axes of movement of the joint. The «pivot-shift» maneuver lacks a standard execution, therefore it can produce disagreement between evaluators; this creates the need for a tool capable of standardizing the maneuver, while providing an interpretable measurement. Material and methods: Pivot-shift meter application, a mobile software capable of capturing information on the movements made when executing a pivot maneuver. Intraclass correlation coefficient to measure the intra- and inter-observer correlation of the information captured by the application. The data was obtained from 66 random participants, using the mobile phone’s built-in gyroscopes. Results: With the 66 tests carried out, it was observed that the evaluators tend to achieve high reproducibility when executing the maneuvers within the time period established by the application, which reached an intraclass correlation coefficient above 90%. Conclusion: The intra- and inter-observer correlation is high enough to be able to perform a quantitative analysis of the pivot-shift maneuver, through a mobile phone.

BACKGROUND: Approximately 25% of patients with colorectal cancer (CRC) will be diagnosed with CRC liver metastases (CRCLM) during the course of their disease. No data regarding CRCLM presentation, management and survival outcomes has been published from either the private or public health care sectors in South Africa. This study aimed to address this deficit, reporting on a private sector cohortMETHODS: A retrospective review of a private health care funder's database from 1 January 2008 to 31 December 2015 was performed. ICD-10 diagnosis codes were used to identify CRC and CRCLM. Procedure codes assigned to hospital admissions were used to identify the type of surgical treatment. Chemotherapy was identified by the WHO Anatomical Therapeutic Chemical classification system of medicines. Treatment patterns were assessed and five-year overall survival (OS) was calculated. Survival was estimated using the Kaplan-Meier method, and Cox proportional-hazards regression was used for between group survival comparisonsRESULTS: Six hundred and one (601) of 3 412 patients presenting with CRC (17.6%) were diagnosed with CRCLM at presentation or during the follow-up period. Sixty patients with CRCLM (10.0%) underwent resection of the primary CRC and liver resection for metastases, 281 (46.8%) underwent CRC resection only, 180 (30%) received chemotherapy only, and 47 (7.8%) received no treatment. Five-year OS for these groups were 57.3%, 15.6%, 9.8% and 0% respectivelyCONCLUSION: Five-year OS of the various CRCLM treatment pathways in a South African private sector population compares to results published in international series. However, a smaller proportion of patients with CRCLM underwent liver resection, compared to international studies

SUMMARY Surgical tracheostomy has well established indications in patients with prolonged intubation. In this article, we present the cases of surgical tracheostomies performed at the Military Hospital of Madrid in the first phase of the COVID 19 pandemic, with 21 cases between the months of april and june 2020. We present our methodology with the material and resources that we use and have adapted to the needs of a reduced space, when performing procedures in the intensive care unit, the presence of few personnel and the added difficulty of using protective equipment.

RESUMEN La traqueostomía quirúrgica tiene indicaciones muy establecidas en pacientes con intubación prolongada. En este artículo se presentan los casos de traqueostomías quirúrgicas realizadas en el Hospital Militar de Madrid en la primera fase de la pandemia por COVID-19, con 21 casos entre los meses de abril y junio de 2020. Se presenta la metodología con el material y los recursos que se han utilizado y adaptado a las necesidades de un espacio reducido, cuando se realizan los procedimientos en la unidad de cuidados intensivos, la presencia de poco personal y la dificultad añadida del equipo protector.

BACKGROUND: In South Africa, there are no national guidelines for the conduct or quality assessment of colonoscopy, the gold standard for investigation and diagnosis of bowel pathologyOBJECTIVES: To describe the clinical profile of patients and evaluate the practice of colonoscopy using procedural quality indicators at the Wits Donald Gordon Medical Centre (WDGMC) outpatient endoscopy unit (OEUMETHODS: We conducted a prospective, clinical practice audit of colonoscopies performed on adults (>18 years of age). A total of 1 643 patients were included in the study and variables that were collected enabled the assessment of adequacy of bowel preparation, length of withdrawal time and calculation of caecal intubation rate (CIR), polyp detection rate (PDR) and adenoma detection rate (ADR). We stratified PDR and ADR by sex, age, population group, withdrawal time and bowel preparation. CIR, PDR and ADR estimates were compared between patient groups by the x² test; Fisher's exact test was used for 2 x 2 tables. A p-value <0.05 was used. Benchmark recommendations by the American Society for Gastrointestinal Endoscopy (ASGE)/American College of Gastroenterology (ACG) Task Force on Colorectal Cancer (CRC) were used in this audit to assess individual endoscopist performance and that of the endoscopy unit as a wholeRESULTS: The mean age of patients was 55.7 (standard deviation (SD) 14.4; range 18 - 91) years, ~60% were female, and the majority (75.5%) were white. Of the outpatients, 77.6% had adequate bowel preparation (ASGE/ACG benchmark >85%). The CIR was 97.0% overall, and screening colonoscopy was 96.3% (ASGE/ACG benchmark >90% overall and >95% for screening colonoscopies). The median withdrawal time for negative-result screening colonoscopies was 5.7 minutes (interquartile range (IQR) 4.2 - 9.3; range 1.1 - 20.6) (ASGE/ACG benchmark > 6minutes), and PDR and ADR were 27.6% and 15.6%, respectively (ASGE/ACG benchmark ADR >25%). We demonstrated a 23.7% increase in PDR and 14.1% increase in ADR between scopes that had mean withdrawal times of >6 minutes and <6 minutes, respectively. Although the number of black Africans in the study was relatively small, our results showed that they have similar ADRs and PDRs to the white population group, contradicting popular beliefCONCLUSIONS: The WDGMC OEU performed reasonably well against the international guidelines, despite some inadequacy in bowel preparation and lower than recommended median withdrawal times on negative-result colonoscopy. Annual auditing of clinical practice and availability of these data in the public domain will become standard of care, making this audit a baseline for longitudinal observation, assessing the impact of interventions, and contributing to the development of local guidelines

Abstract: For many web sites, money earning is crucial for keeping the content production. Advertising is one of the most common strategies for web content monetization. To determine where is the more appropriate place for ad location is an essential task to get a gentle introduction of the commercial information. There are algorithms based on keywords appearing within text; however we consider that implicit meaning is more adequate for a better harmony between content advertising. In this work, we present a formal method that determines the best place for advertising location. For this, we explore the underlying tree-like structure of a web page, we extract the text from each (X)HTML node and compute the semantic similarity (by employing latent semantic analysis) w.r.t., the advertising source text. We introduce a unique formula for the numerical calculation of the web page node relevance. We think it could be used for measuring the concordance among web page nodes and the commercial information and for the design of dynamic ads insertion methods.

Resumo A bacia do Rio Doce sofreu o maior acidente ambiental com o influxo de rejeitos de Fundão e Santarém, pertencentes à empresa de mineração Samarco, devido ao desastre em Mariana. Um derramamento entre 50 e 60 milhões de m3 de rejeitos foi estimado pela empresa. De acordo com a Samarco, o rejeito despejado era composto principalmente de argila, silte e alguns metais pesados como ferro, cobre e manganês. Com isso, o presente estudo teve como objetivo avaliar os danos genotóxicos em juvenis de Geophagus brasilienses expostos a água do rio Doce antes (DRWAA – água do Rio Doce antes do acidente) e depois (DRWBA- água do Rio Doce depois do acidente) da chegada dos rejeitos do rompimento das barragens de Germano e Santarém em Mariana, MG, Brasil. Para isso, 24 indivíduos da espécie G. brasilienses (obtidos na piscicultura do IFES/ALEGRE) foram submetidos a um bioensaio com três tratamentos e oito réplicas. Os tratamentos eram: 1) Controle (com água do abastecimento urbano, filtrada com filtro analítico de 0,45 µm); 2) DRWBA e 3) DRWAA. Após um período de 96 h, esses peixes foram anestesiados para retirada de sangue para avaliação dos danos genotóxicos (micronúcleo e cometa). Para a realização do bioensaio, um total de 80 L de água do Rio Doce foram coletados antes da chegada dos rejeitos e outros 80 L foram coletados depois da chegada dos rejeitos e ambas foram submetidas a análises de quantificação de metal. Os peixes expostos ao DRWBA e ao DRWAA apresentaram um aumento significativo na quantidade de micronúcleos eritrocitários e no índice de danos do DNA em relação aos peixes controle, no entanto não apresentaram diferenças entre si. Os resultados obtidos demonstram que a DRWBA já era genotóxica para os peixes, principalmente, em função das concentrações de Cu dissolvido na água. A DRWAA apresentou genotixicidade, provavelmente, em função do aumento da fração dissolvida e do efeito sinérgico de diversos metais presentes nos rejeitos do acidente de Mariana.

Abstract The Doce River basin has suffered the largest environmental accident ever occurred in Brazil with the influx of tailings from Fundão and Santarém, belonging to Samarco mining company, due to the disaster in Mariana. A spill between 50 and 60 million m3 of tailings was estimated by the company. According to Samarco, the wastewater was composed mainly of clay, silt and heavy metals like iron, copper and manganese. Thereby, the objective of the present study was evaluated the genotoxic damage in juvenile of Geophagus brasiliensis (Quoy e Gaimard, 1824) exposed to Doce river water before (DRWBA – Doce River water before acident) and after (DRWAA – Doce River water after acident) the influx of tailings from the Germano and Santarém Dam disasters in Mariana, MG, Brazil. For this, 24 individuals of the species G. brasiliensis (obtained on IFES/ALEGRE fish culture) were submitted to a bioassay with three treatments and eight replicates. The treatments were: 1) Control water (water from the urban water supply system, filtered with a 0.45 µm membrane), 2) DRBA and 3) DRAA. After 96 h, these fishes were anesthetized to remove blood for evaluation of genotoxic damage (micronucleus and comet). For the bioassay, a total of 80 L of The Doce River water were collected before the influx of tailings and after the influx and then submitted to metal quantification analysis. Fish exposed to DRWBA and DRWAA treatments showed a significant increase in both the number of erythrocyte micronuclei and the DNA damage index in relation to the control fish; however, they did not present any differences between the two treatments. The results demonstrate that the DRWBA treatment was already genotoxic for the fish, mainly due to dissolved Cu concentrations in the water. The DRWAA treatment probably presented genotoxicity due to the increase in the dissolved fraction and synergistic effects of several metals found in the tailings of the Mariana accident.

Abstract In the state of Michoacán, forest plantations are carried out using mostly species of Pinus, Eucalyptus and Cupressus. However, seedlings survival rate at the following year is on average 37.8 %, and late planting dates are among the causal factors of mortality. The aim of this work was to evaluate the survival rate and development of Pinus pseudostrobus Lindl. seedlings, established in five different planting dates in land lots of the Indigenous Community of Nuevo San Juan Parangaricutiro, Michoacán. The plantation was established in July and August 2013, with a spacing of 2.0 x 2.0 m and five planting dates (July 1st, 15th and 30th, and August 15th and 30th), following a randomized complete-block experimental design, with five repetitions of 25 plants per repetition, 100 plants per treatment. Total height, diameter at the base of the plant and survival rate were evaluated two years after the plantation. Statistical differences in height were found (p<0.0001). The planting dates 1 and 2 (157 and 157.8 cm) presented a higher growth in comparison to late planting dates, as well as diameter at the base of the plant. No significant differences were found considering survival rates. Water availability on planting dates 1 and 2 was higher and influenced a higher growth in diameter and height in Pinus pseudostrobus.

Resumen En el estado de Michoacán se realizan plantaciones forestales empleando principalmente especies de Pinus, Eucalyptus y Cupressus. Sin embargo, la supervivencia de las plántulas al año siguiente es en promedio de 37.8 %, y entre los factores causales de la mortandad están las fechas de plantación tardías. El objetivo fue evaluar la supervivencia y desarrollo de Pinus pseudostrobus Lindl., establecida con cinco fechas de plantación en terrenos de la Comunidad Indígena de Nuevo San Juan Parangaricutiro, Michoacán. La plantación se estableció en julio y agosto de 2013, con espaciamiento de 2.0 x 2.0 m y se evaluaron cinco fechas de plantación, (1, 15, 30 de julio, y 15 y 30 de agosto), bajo un diseño experimental de bloques completos al azar, con cinco repeticiones de 25 plantas por repetición, 100 plantas por tratamiento. Se evaluó la altura total, diámetro de la base de la planta y la supervivencia. A dos años se determinó diferencias estadísticas en altura (p<0.0001); la fecha 1 y 2 (157 y 157.8 cm), presentaron mayor crecimiento respecto a las fechas tardías de plantación al igual que en diámetro de la base de la planta. No se encontraron diferencias significativas en la variable supervivencia. La disponibilidad hídrica en la fecha 1 y 2 fue mayor e influyó en un mayor crecimiento en diámetro y altura en Pinus pseudostrobus.

ABSTRACT: Mexico conserves a great diversity of wild relatives of cultivated plants; for example, different Solanaceae, Cucurbitaceae and Caricaceae species families. In the latter, the Carica and Jacaratia genus are the most notable for the similarity of the fruits, but still poorly studied. These populations develop under edapho-climatic and phytosanitary pressure. Due to the interest to take advantage of these materials, the objective was to identify, collect and characterize C. papaya and J. mexicana germplasm. Populations were identified in four Mexican states, sites were characterized and fruits were collected in the populations. Size, weight and number of seeds were registered, and germination. The data was analyzed by descriptive statistics, analysis of variance and comparison of means, germination was percentage. Furthermore, multivariate analysis was performed. Ten populations were located, at altitudes lower than 900 meters above sea level, in subhumid and semi-dry warm climates. Small fruits were distinguished that correspond to populations of wild papaya and large fruits, the latter exceeding by more than 100% in size with respect to small fruits. The “bonetes” differ structurally by the ribs, but their dimension is close to the populations of semi-cultivated papaya. Germination ranged from 28.2% to 68.8% and eight of 10 populations germinated at 12 days. It is concluded that the germplasm of the wild populations showed similarity in the registered means, unlike the germplasm of the semi-cultivated populations, which suggests that they are in the process of domestication. The percentage germination was low and varied in the observation time. The multivariate analysis allowed us to classify three conjugated groups and one independent group.

RESUMEN: México conserva gran diversidad de parientes silvestres de plantas cultivadas; por ejemplo, diferentes especies de solanáceas, cucurbitáceas y caricáceas. En esta última, los géneros Carica y Jacaratia son los más notables por la similitud de los frutos, pero aun pobremente estudiados. Estas poblaciones desarrollan bajo presión edafo-climática y fitosanitaria. Dado el interés de aprovechar estos materiales, el objetivo fue identificar, colectar y caracterizar germoplasma de C. papaya y J. mexicana . Se identificaron poblaciones en cuatro estados de México, los sitios fueron caracterizados y en las poblaciones se colectaron frutos. Se registró tamaño, peso y número de semillas, y germinación. Los datos se analizaron por estadísticas descriptivas, análisis de varianza y comparación de medias, la germinación fue porcentual. Además, se realizó un análisis multivariado. Se localizaron 10 poblaciones, en altitudes menores a 900 m s.n.m., en climas cálido subhúmedo y semiseco. Se distinguieron frutos pequeños que correspondieron a poblaciones de papaya silvestre y frutos grandes, estos últimos superaron en más de 100% en tamaño con respecto a los frutos pequeños. Los bonetes difieren estructuralmente por las costillas, pero su dimensión es cercana a las poblaciones de papaya semicultivada. La germinación rondó del 28.2% al 68.8% y ocho de 10 poblaciones germinó a los 12 días. Se concluye, el germoplasma de las poblaciones silvestres presentó similitud en las medias registradas, a diferencia del germoplasma de las poblaciones semicultivadas, que orienta a prever que se encuentran en proceso de domesticación. La germinación porcentualmente fue baja y varió en el tiempo de observación. El análisis multivariado permitió clasificar tres grupos conjugados y uno independiente.

Resumo O presente estudo avaliou a influência da geometria do corpo de prova cerâmico (disco vs. quadrado) na resistência flexural biaxial (RFB), por meio de ensaio experimental e análise de elementos finitos (AEF). Blocos de vitrocerâmica reforçada por leucita foram utilizados na confecção de corpos de prova no formato de discos (D; n=14) e quadrados (Q; n=13), com mesma área na superfície inferior (superfície sujeita à tração durante o ensaio). Os corpos de prova foram submetidos a ensaio de flexão biaxial pistão sobre três esferas (ISO 6872:2008). Para calcular a RFB do grupo Q, o raio do corpo de prova, indicado pela fórmula da ISO 6872:2008 para discos, foi substituído por metade do lado do quadrado. AEF foi empregada para comparar o padrão de distribuição de tensões e a primeira tensão principal entre D e Q, com áreas iguais e diferentes na superfície inferior (tração). Teste t de Student não mostrou diferença (p=0,85) na RFB entre D (95,0±9,6 MPa) e Q (84,3±10,3 MPa). AEF indicou um padrão similar de distribuição de tensões, com quase nenhuma diferença na primeira tensão principal entre D e Q com mesma área na superfície inferior (tração). Na condição experimental testada, corpos de prova cerâmicos no formato de quadrado podem ser usados em ensaio de flexão biaxial pistão sobre três esferas. Para o cálculo da RFB, o raio do espécime pode ser substituído por metade do lado do quadrado.

Abstract This study evaluated the influence of the geometry of ceramic specimens (disc vs. square plate) on the biaxial flexural strength (BFS) using an experimental set and finite element analysis (FEA). Leucite glass-ceramic blocks were used in the preparation of disc (D; n=14) and square plate (S; n=13) specimens with the same lower (tensile) surface area. The specimens were subjected to a piston-on-three-ball flexural test (ISO 6872:2008). To calculate the BFS of the S group, the specimen radius, indicated by the ISO 6872:2008 formula for discs, was replaced by half of the side length. FEA compared the pattern of stress distribution and the first principal stress between D and S specimens having the same and different lower (tensile) surface area. Student’s t-test showed no difference (p=0.85) in the BFS between D (95.0±9.6 MPa) and S (84.3±10.3 MPa). FEA indicated a similar pattern of stress distribution, with almost no difference in the first principal stress of discs and square plates with the same lower (tensile) surface area. In the experimental condition investigated, square plate ceramic specimens can be used in piston-on-three-ball tests. For the calculation of the BFS, the specimen radius may be replaced by half side length of the square specimen.

BACKGROUND: Colorectal cancer (CRC) is the fourth most common cancer in South Africa (SA), and the sixth most lethal. Approximately 25% of patients will have synchronous metastatic disease at the time of their primary CRC diagnosis. Although chemotherapy is used in most stages of the disease, surgical resection of the primary tumour and metastases remains the most successful treatment modality to achieve cure or prolong survival. To date, no data on CRC presentation and management have been published in SA. OBJECTIVES: To determine CRC presentation, general management patterns and overall survival in the SA private healthcare sector. METHODS: A retrospective review of a private healthcare funder's database from 1 January 2008 to 31 December 2015. International Statistical Classification of Diseases and Related Health Problems (10th revision) (ICD-10) diagnosis codes were used to identify colorectal cancer and liver and/or pulmonary metastatic disease. Procedure codes assigned to hospital admissions were used to identify type of surgical treatment. Chemotherapy was identified by the World Health Organization Anatomical Therapeutic Chemical Classification System of medicines. Treatment patterns were determined and 5-year survival rates for these were calculated. Survival was estimated using the Kaplan-Meier method, and Cox proportional hazards regression was used for between-group comparisons of survival. Data analysis was carried out using SAS version 9.4 for Windows. RESULTS: A total of 3 412 patients were included in the study, 2 267 with CRC only and 1 145 with liver (LM) or pulmonary metastases (PM). The mean age was 64.1 years (range 21 - 97), and 54.6% were male; these did not differ statistically between the study groups. Twenty percent of patients with LM or PM underwent surgical resection of their metastases. Five-year survival rates following surgical resection of all disease for CRC only, CRCLM, CRCPM and CRCLMPM were 71.7%, 57.3%, 31.5% and 26.0%, respectively. CONCLUSIONS: SA CRC patients treated in the private healthcare sector have similar disease presentation to that in published international series, with similar outcomes following various treatment pathways; however, it seems that fewer resections of metastases are undertaken compared with international trends.

ABSTRACT Castleman’s disease (CD) is an atypical lymphoproliferative disorder of unknown cause, characterized by non-clonal nodal hyperplastic growth. Two forms of clinical presentation are currently recognized, one localized and the other multicentric, and four histopathologic variants. It is characterized by generalized lymphadenopathy, hepatosplenomegaly, fever and night sweats. CD may present severe pancytopenia, multi-organ failure, lymphoma evolution and it can sometimes be associated with paraneoplastic syndromes such as POEMS syndrome. Associations of these two entities have been widely described in the current literature, although its less common association with amyloidosis is described as isolated clinical cases. We report a case with this triple association: EC, POEMS and amyloidosis.

RESUMEN La enfermedad de Castleman (EC) es un trastorno linfoproliferativo atípico de causa desconocida, caracterizado por crecimiento ganglionar hiperplásico no clonal. Actualmente se reconocen dos formas de presentación clínica, una localizada y otra multicéntrica, y cuatro variantes histopatológicas. Clínicamente se caracteriza por linfadenopatías generalizadas, hepatoesplenomegalia, fiebre y sudoración nocturnas. La EC puede presentar pancitopenia grave y fallo multiorgánico, evolucionar a linfoma y, en algunas ocasiones, asociarse a síndromes paraneoplásicos como el síndrome de POEMS. Las asociaciones de estas dos entidades han sido ampliamente descritas en la literatura actual, aunque su asociación con amiloidosis es menos frecuente y descrita como casos clínicos aislados. Presentamos un caso clínico con esta triple asociación: EC, POEMS y amiloidosis.