Corte De Research Articles

The contrasting phenotypes of neutrophils during asymptomatic versus symptomatic Leishmania braziliensis infection.

The mechanisms that mediate immune protection in individuals with subclinical (SC) or asymptomatic infection with L. braziliensis are largely unknown. Neutrophils (PMNs) have been implicated in progressive symptomatic cutaneous leishmaniasis (CL), but their potential participation in maintenance of subclinical infection is unexplored. The aim of this study was to compare the phenotypic and functional profiles of PMNs in individuals with SC infection versus patients with symptomatic CL due to L. braziliensis. Subjects were recruited in the endemic region of Corte de Pedra, Bahia, Brazil. Surface markers to define activation status were characterized by flow cytometry. Functional responses of PMNs including phagocytic capacity, production of oxidative species, and oxidative killing of intracellular parasites were studied in vitro. PMNs from individuals with SC infection displayed a more activated phenotype and greater ability to control the infection than PMNs from patients with CL. In contrast, PMNs from patients with CL exhibited higher expression of HLA-DR and higher production of oxidative species than PMNs from subjects with SC infection. PMNs from individuals with SC infection can control the infection more efficiently than PMNs from patients with CL, despite the lower production of oxidants. Our observations suggest that L. braziliensis may evade microbicidal mechanisms of PMNs from patients with CL, contributing to parasite dissemination and the establishment of disease.

Selective whole-genome amplification reveals population genetics of Leishmania braziliensis directly from patient skin biopsies.

In Brazil, Leishmania braziliensis is the main causative agent of the neglected tropical disease, cutaneous leishmaniasis (CL). CL presents on a spectrum of disease severity with a high rate of treatment failure. Yet the parasite factors that contribute to disease presentation and treatment outcome are not well understood, in part because successfully isolating and culturing parasites from patient lesions remains a major technical challenge. Here we describe the development of selective whole genome amplification (SWGA) for Leishmania and show that this method enables culture-independent analysis of parasite genomes obtained directly from primary patient skin samples, allowing us to circumvent artifacts associated with adaptation to culture. We show that SWGA can be applied to multiple Leishmania species residing in different host species, suggesting that this method is broadly useful in both experimental infection models and clinical studies. SWGA carried out directly on skin biopsies collected from patients in Corte de Pedra, Bahia, Brazil, showed extensive genomic diversity. Finally, as a proof-of-concept, we demonstrated that SWGA data can be integrated with published whole genome data from cultured parasite isolates to identify variants unique to specific geographic regions in Brazil where treatment failure rates are known to be high. SWGA provides a relatively simple method to generate Leishmania genomes directly from patient samples, unlocking the potential to link parasite genetics with host clinical phenotypes.

Leishmania braziliensis causing human disease in Northeast Brazil presents loci with genotypes in long-term equilibrium.

Leishmaniases are neglected tropical diseases that inflict great burden to poor areas of the globe. Intense research has aimed to identify parasite genetic signatures predictive of infection outcomes. Consistency of diagnostic tools based on these markers would greatly benefit from accurate understanding of Leishmania spp. population genetics. We explored two chromosomal loci to characterize a population of L. braziliensis causing human disease in Northeast Brazil. Two temporally distinct samples of L. braziliensis were obtained from patients attending the leishmaniasis clinic at the village of Corte de Pedra: (2008-2011) primary sample, N = 120; (1999-2001) validation sample, N = 35. Parasites were genotyped by Sanger's sequencing of two 600 base pairs loci starting at nucleotide positions 3,074 and 425,451 of chromosomes 24 and 28, respectively. Genotypes based on haplotypes of biallelic positions in each locus were tested for several population genetic parameters as well as for geographic clustering within the region. Ample geographic overlap of genotypes at the two loci was observed as indicated by non-significant Cusick and Edward's comparisons. No linkage disequilibrium was detected among combinations of haplotypes for both parasite samples. Homozygous and heterozygous genotypes displayed Hardy-Weinberg equilibrium (HWE) at both loci in the two samples when straight observed and expected counts were compared by Chi-square (p>0.5). However, Bayesian statistics using one million Monte-Carlo randomizations disclosed a less robust HWE for chromosome 24 genotypes, particularly in the primary sample (p = 0.04). Fixation indices (Fst) were consistently lower than 0.05 among individuals of the two samples at both tested loci, and no intra-populational structuralization could be detected using STRUCTURE software. These findings suggest that L. braziliensis can maintain stable populations in foci of human leishmaniasis and are capable of robust genetic recombination possibly due to events of sexual reproduction during the parasite's lifecycle.

Cellular infiltrate in cutaneous leishmaniasis lesions and therapeutic outcome

BackgroundThe treatment of cutaneous leishmaniasis is a challenge. A better understanding of the in situ mechanisms involved in the evolution and cure of the disease is essential for the development of new therapies. ObjectiveCorrelate histopathological and immunological characteristics of cutaneous leishmaniasis lesions with clinical outcome after different treatment regimens. MethodsThe authors analyzed cellular infiltration and immunohistochemistry staining for CD4, CD8 and IL-17 in biopsy samples from 33 patients with cutaneous leishmaniasis before treatment. All patients were recruited in a randomized clinical trial at Corte de Pedra (Bahia-Brazil) and assigned to receive Glucantime®, Glucantime® + Oral Tamoxifen or Glucantime® + Topical Tamoxifen. Patients were followed for 2 to 6 months to define disease outcome. ResultsA similar expression of CD4, CD8 and IL-17 was observed in lesion samples regardless of clinical outcome. In general, a higher amount of CD8 cells were observed compared with CD4 cells. An important observation was that all patients whose cellular infiltrate did not contain plasma cells were cured after treatment. Study limitationsIsolated quantification of TCD8 and IL-17 using immunohistochemistry is insufficient to analyze the role of these molecules in the immunopathogenesis of cutaneous leishmaniasis. In addition, the expansion of the immunohistochemistry panel would allow a more complete analysis of the immune response in situ. ConclusionsThe absence of plasma cells in cutaneous leishmaniasis lesions was related to a favorable therapeutic outcome.

A Black Jurist in a Slave Society: Antonio Pereira Rebouças and the Trials of Brazilian Citizenship

A Black Jurist in a Slave Society: Antonio Pereira Rebouças and the Trials of Brazilian Citizenship

Mexican apex judiciary and its multiple interpretations: Challenges for the constitutional right to health

Abstract The judicialization of social rights is a reality in Latin America; however, little has been said about this phenomenon in Mexico or about the role of the Mexican Supreme Court (Suprema Corte de Justicia de la Nación, SCJN) in advancing an effective guarantee of the right to health. In several countries, courts have adopted either an active role in defining health policy and protecting the right to health or a passive one. Studying the ways in which health-related cases are resolved in Mexico enables us to evaluate the role of the SCJN when ruling for or against this right. This article aims to determine whether the SCJN, through the analysis of its rulings, is or could be a catalyst for change in the healthcare system. This article reports on the results of a systematic content analysis of twenty-two SCJN rulings, examining the claimants, their claims as understood by the SCJN, and the elements considered by the justices in their decision-making process. The analysis of the way in which the SCJN ruled in these cases demonstrates that the SCJN must be uniform and consistent in applying constitutional and conventional principles to improve predictability of its decisions and to be innovative in responding to the new requirements posed by economic, social, and cultural rights. The SCJN should increase its possibilities of promoting structural reforms where laws or policies are inconsistent with constitutional or conventional standards by maintaining a middle ground with respect of the executive and legislative branches.

Ultrastructure of the Antennae and Sensilla of Nyssomyia intermedia (Diptera: Psychodidae), Vector of American Cutaneous Leishmaniasis.

The antennal sensilla and the antenna of females Nyssomyia intermedia, one of the main vectors of American cutaneous leishmaniasis, were studied by scanning electron microscopy. The main goal was to characterize the quantity, typology, and topography of the sensilla with particular attention to the olfactory types. The insects were captured in the city of Corte de Pedra, State of Bahia, Brazil, by CDC-type light traps and raised in a laboratory as a new colony. Fourteen well-differentiated sensilla were identified, among six cuticular types: trichoidea, campaniformia, squamiformia, basiconica, chaetica, and coeloconica. Of these, six sensilla were classified as olfactory sensilla due to their specific morphological features. Smaller noninnervated pilosities of microtrichiae type were also evidenced by covering all antennal segments. The antennal segments differ in shapes and sizes, and the amount and distribution of types and subtypes of sensilla. This study may foment future taxonomic and phylogenetic analysis for a better evolutionary understanding of the sand flies. Besides, it may assist the targeting of future electrophysiological studies by Single Sensillum Recording, and aim to develop alternative measures of monitoring and control of this vector.

Nota editorial

In its first issue, RDP Revista Digital de Posgrado, in its Articles section, offers two contributions to the Engineering field: “State of the art about of the impact of landslide on bridges” and “Numerical computation of the flexibility matrix of variable cross section beams, with finite elements”; as well as one text in the field of Law: “The environmental damage: legal entify for the repair obligation”. The Essay section proposes another contribution to Law: “Beyond the jurisdictional work of Suprema Corte de Justicia de la Nación”, and another in the field of Humanities: “Living and thinking about the construction of anarchist society from the Mesoamerican reality, yesterday and today”. The section of Bibliographical Reviews contains two recommendations, one in Architecture, and the other in History: Visiones del neoclásico en la Arquitectura, and La cultura mexicana en el siglo XX.

La reelección en México, experiencia 2018

A partir de la reforma constitucional de 2014, la figura jurídica de la reelección fue nuevamente incorporada al sistema electoral mexicano, y en el pasado proceso electoral 2017-2018 resultaron reelectos un importante número de legisladores locales e integrantes de los ayuntamientos. En el artículo se estudian las generalidades de la figura de la reelección, los casos más importantes que tuvieron lugar en el ámbito de la justicia electoral ante el Tribunal Electoral del Poder Judicial de la Federación, y algunas acciones de inconstitucionalidad ante la Suprema Corte de Justicia de la Nación. Finalmente, se formulan una serie de tablas en las que se deduce el impacto numérico que tuvo la reelección en el sistema político mexicano, así como su efectividad y arraigo en la ciudadanía, al elegir de manera consecutiva a los legisladores y ediles que se postularon.

El puente de Alfonso XIII de Sevilla: análisis patrimonial

El puente de Alfonso XIII de Sevilla fue construido en el extremo norte del canal del mismo nombre o Corta de Tablada, inicio de un ambicioso programa de ampliación del puerto de Sevilla. Fue inaugurado en 1926, poco antes de la Exposición Iberoamericana que se desarrolló en el sector sur de la ciudad, hacia donde se ampliaba dicha zona portuaria. El puente, móvil, fue utilizado eficazmente hasta el siguiente evento universal en 1992 cuando, viejo y obsoleto, fue sustituido por otro nuevo contiguo. Poco tiempo después fue desmontado y la estructura metálica yace lastimosamente en tierra, en la margen del río aguas abajo, trasladada poco más de un kilómetro de distancia de su ubicación original.
 
 Este estudio tiene como objeto la exposición del análisis patrimonial del puente, apoyado en una documentación gráfica específica, ha servido para reflexionar y concluir sobre su posible reutilización y condiciones de reimplantación en el paisaje.

Nacer en palacio. El ritual del nacimiento en la corte de los Austrias by María Cruz de Carlos Varona

Reviewed by: Nacer en palacio. El ritual del nacimiento en la corte de los Austrias by María Cruz de Carlos Varona Emilie L. Bergmann María Cruz de Carlos Varona. Nacer en palacio. El ritual del nacimiento en la corte de los Austrias. centro de estudios europa hispÁnica, 2018. 296 pp. nacer en palacio is a much-needed contribution to scholarship on early modern Spanish women's lives and a gendered historiography of the Spanish Habsburg court. The confluence of social science, obstetrical practices, and history of art in this generously illustrated study of royal pregnancy and childbirth makes a compelling argument for maternity as a field of research in its own right, with the potential to change academic approaches to the history of the family as well as material culture and court ritual. The authority and physical activity of women as midwives and birth attendants in Spanish accounts and visual depictions of these events challenge the models of feminine silence and passivity in literary and didactic texts, as well as the commonly accepted view of antagonism between midwives and medical men in early modern Europe. The author draws on documents in the royal archives, including letters, official accounts of religious observances during Habsburg pregnancies and births, and inventories of furnishings and religious objects brought to the queen's chambers in anticipation of the delivery. Among the portraits in chapter 1, "En busca de un heredero," are those of young women, some barely past puberty when the paintings were made, under consideration as possible progenitors of male heirs to the Spanish throne. Thus, verbal accounts emphasize their good health and disposition, the predominance of boy children born to their mothers and aunts, and measurements including the young women's height and the width of their hips. Objectifying as this process of selection was, de Carlos Varona's research also gives evidence of the emotional bonds between monarchs and their wives, citing, for example, Felipe III's grief at the death of Margarita de Austria. The approach to royal childbirth as a cultural system is most evident in chapters 2, "El espacio del parto regio," and 4, "El espacio simbólico de la maternidad regia: el oratorio de la reina," addressing the material culture of royal childbearing. These are also the most relevant chapters for scholars of the comedia, as they address the ways in which royal pregnancy and [End Page 247] childbirths were framed as performances, with processions to chapels within the palace and in the surrounding neighborhoods and with religious objects placed in the queen's personal oratory. The liturgical texts and devotional practices, together with paintings, sculpture, and other religious images, symbolized the identification of the dynastic role of the queen's pregnancy and delivery with key moments in the life of Christ's mother. This link is made explicit in the celebration of the Nativity matins for each royal birth and in two paintings by Juan Pantoja de la Cruz: the Annunciation (ca. 1604), in which Margarita de Austria is depicted as the Virgin Mary, and the Birth of the Virgin (1603), in which the queen's mother is depicted as the midwife and Margarita's sisters as attendants. De Carlos Varona's discussion of devotional practices and religious images in the oratory of Isabel de Borbón demonstrates the consistency of rituals surrounding royal pregnancy and childbirth, aspects of which continued into the reign of Isabel II. The detailed color reproductions of portraits of princesses and queens allow readers to examine significant jewels worn by these women in the belief that they could ensure a healthy pregnancy and birth. Particularly significant among such objects are the marten's heads fashioned from gold and decorated with precious stones, described in inventories and visible in portraits of Isabel de Valois and her daughter Catalina Micaela. The marten, believed to conceive through the ear and give birth through the mouth, was associated with fertility and childbirth as well as with the Immaculate Conception. Margarita de Austria's death at age twenty-six after giving birth to eight children in ten years, of whom only half reached adulthood, provides context for the justifiable anxiety underlying the use of...

Review: Españoles en la corte de los Medici: Arquitectura y política en tiempos de Cosimo I, by Carlos Plaza

Carlos Plaza Espanoles en la corte de los Medici: Arquitectura y politica en tiempos de Cosimo I Madrid: Centro de Estudios Europa Hispanica, 2016, 562 pp., 60 color and 165 b/w illus. €33.66, ISBN 9788415245568 Recent research about early modern Spanish Italy has yielded fruitful results for architectural history. For instance, we now know more about a Castilian cardinal's patronage of Donato Bramante in Rome, and we have new evidence of correspondence between viceroys and a Spanish king about building a royal palace in Naples.1 Carlos Plaza's Espanoles en la corte de los Medici also contributes new knowledge about Spanish patrons of architecture in Florence during that city's transformation by Cosimo I de’ Medici (1519–74) and his successors into the site of a ducal court. This is a book with many protagonists, beginning with Cosimo, his first wife, Eleanora of Toledo (1522–62), and his sons Francesco I (1541–87) and Ferdinando I (1549–1609). The cast of characters expands to include three Spaniards whose Florentine palaces form the core of the study: the courtiers Antonio Ramirez de Montalvo (d. 1581) and Fabio Arrazola de Mondragon (1530/35–86), and the merchant and bali , or grand master, of the Order of Santo Stefano, Baltasar Suarez de la Concha (d. 1620). Plaza's ambitious project probes the biographies of these three Spaniards and elucidates the processes by which they built monuments to glorify the Medici dukes and elevate their own status. Plaza also reevaluates existing scholarship on Bartolomeo Ammannati (1511–92), who emerges as another principal figure. In the book's prologue, Howard Burns commends Plaza's attention to little-known Spanish patrons and to the political, cultural, and architectural contexts in which they operated. Indeed, context drives Plaza's introduction, where he provides wide-ranging information about Florence and its relation with Spain from the late Middle Ages through the sixteenth century. During the Renaissance, according to Plaza, Italy and Spain formed “a common territory” for the circulation of ideas, models, and persons that helped shape architectural …

Dynamics of American tegumentary leishmaniasis in a highly endemic region for Leishmania (Viannia) braziliensis infection in northeast Brazil.

BackgroundAmerican Tegumentary Leishmaniasis (ATL) caused by Leishmania braziliensis is endemic in Corte de Pedra, Northeast Brazil. Most L. braziliensis infections manifest as localized cutaneous leishmaniasis (CL). Disseminated manifestations include mucosal leishmaniasis (ML), present at a low constant level for several decades, and newly emerging disseminated leishmaniasis (DL). Surprisingly, DL has recently surpassed ML in its spatial distribution. This led us to hypothesize that distinct forms of ATL might spread in different patterns through affected regions.Methodology/Principal findingsWe explored the incidence and geographic dispersion of the three clinical types of ATL over a span of nearly two decades in Corte de Pedra. We obtained the geographic coordinates of the homes of patients with ATL during 1992–1996, 1999–2003 and 2008–2011. The progressive dispersion of ML or DL in each time period was compared to that of CL in 2008–2011 with the Cusick and Edward’s geostatistical test. To evaluate whether ATL occurred as clusters, we compared each new case in 2008–2011 with the frequency of and distance from cases in the previous 3 to 12 months. The study revealed that DL, ML and CL actively spread within that region, but in distinct patterns. Whereas CL and DL propagated in clusters, ML occurred as sporadic cases. DL had a wider distribution than ML until 2003, but by 2011 both forms were distributed equally in Corte de Pedra. The incidence of ML fluctuated over time at a rate that was distinct from those of CL and DL.Conclusions/SignificanceThese findings suggest that CL and DL maintain endemic levels through successive outbreaks of cases. The sporadic pattern of ML cases may reflect the long and variable latency before infected patients develop clinically detectable mucosal involvement. Intimate knowledge of the geographic distribution of leishmaniasis and how it propagates within foci of active transmission may guide approaches to disease control.

Molecular epidemiology and in vitro evidence suggest that Leishmania braziliensis strain helps determine antimony response among American tegumenary leishmaniasis patients

Antimony is the first line drug for treating American tegumentary leishmaniasis (ATL) in Brazil. In this country, Leishmania braziliensis causes at least three distinct forms of disease: localized cutaneous (CL), mucosal (ML) and disseminated leishmaniasis (DL). All forms can be found in Corte de Pedra, Northeast Brazil. ML and DL respond poorly to antimony, in contrast to CL. The L. braziliensis population causing ATL in Corte de Pedra is genetically very diverse, with strains of the parasite associating with the clinical form of leishmaniasis. We tested the hypotheses that antimony refractoriness is associated with L. braziliensis genotypes, and that parasites from ML and DL present greater in vitro resistance to antimony than L. braziliensis from CL. Comparison of geographic coordinates of living sites between antimony responders and non-responders by Cusick and Edward́s test showed that refractoriness and responsiveness to the drug were similarly wide spread in the region (p>0.05). Parasites were then genotyped by sequencing a locus starting at position 425,451 on chromosome 28, which is polymorphic among L. braziliensis of Corte de Pedra. Haplotype CC- in CHR28/425,451 was associated with risk of treatment failure among CL patients (Fisheŕs exact test, p=0.03, odds ratio=4.65). This haplotype could not be found among parasites from ML or DL. Finally, sensitivity to antimony was evaluated exposing L. braziliensis promastigotes to increasing concentrations of meglumine antimoniate in vitro. Parasites from ML and DL were more resistant to antimony at doses of 2mg/100μL and beyond than those isolated from CL (Fisher’s exact test, p=0.02 and p=0.004, respectively). The intrinsically lower susceptibility of L. brazliensis from ML and DL to antimony parallels what is observed for patients’ responsiveness in the field. This finding reinforces that ML and DL patients would benefit from initiating treatment with drugs currently considered as second line, like amphotericin B.

Atypical Manifestations of Cutaneous Leishmaniasis in a Region Endemic for Leishmania braziliensis: Clinical, Immunological and Parasitological Aspects.

BackgroundAtypical cutaneous leishmaniasis (ACL) has become progressively more frequent in Corte de Pedra, Northeast Brazil. Herein we characterize clinical presentation, antimony response, cytokine production and parasite strains prevailing in ACL.Methodology/Principal FindingsBetween 2005 and 2012, 51 ACL (cases) and 51 temporally matched cutaneous leishmaniasis (CL) subjects (controls) were enrolled and followed over time in Corte de Pedra. Clinical and therapeutic data were recorded for all subjects. Cytokine secretion by patients’ peripheral blood mononuclear cells (PBMC) stimulated with soluble parasite antigen in vitro, and genotypes in a 600 base-pair locus in chromosome 28 (CHR28/425451) of the infecting L. (V.) braziliensis were compared between the two groups. ACL presented significantly more lesions in head and neck, and higher rate of antimony failure than CL. Cytosine–Adenine substitutions at CHR28/425451 positions 254 and 321 were highly associated with ACL (p<0.0001). In vitro stimulated ACL PBMCs produced lower levels of IFN-γ (p = 0.0002) and TNF (p <0.0001), and higher levels of IL-10 (p = 0.0006) and IL-17 (p = 0.0008) than CL PBMCs.Conclusions/SignificanceACL found in Northeast Brazil is caused by distinct genotypes of L. (V.) braziliensis and presents a cytokine profile that departs from that in classical CL patients. We think that differences in antigenic contents among parasites may be in part responsible for the variation in cytokine responses and possibly immunopathology between CL and ACL.

From Arrigunaga to Yoknapatawpha: Ramiro Pinilla and William Faulkner

From Arrigunaga to Yoknapatawpha: Ramiro Pinilla and William Faulkner

The gp63 Gene Cluster Is Highly Polymorphic in Natural Leishmania (Viannia) braziliensis Populations, but Functional Sites Are Conserved.

GP63 or leishmanolysin is the major surface protease of Leishmania spp. involved in parasite virulence and host cell interaction. As such, GP63 is a potential target of eventual vaccines against these protozoa. In the current study we evaluate the polymorphism of gp63 in Leishmania (Viannia) braziliensis isolated from two sets of American tegumentary leishmaniasis (ATL) cases from Corte de Pedra, Brazil, including 35 cases diagnosed between 1994 and 2001 and 6 cases diagnosed between 2008 and 2011. Parasites were obtained from lesions by needle aspiration and cultivation. Genomic DNA was extracted, and 405 bp fragments, including sequences encoding the putative macrophage interacting sites, were amplified from gp63 genes of all isolates. DNA amplicons were cloned into plasmid vectors and ten clones per L. (V.) braziliensis isolate were sequenced. Alignment of cloned sequences showed extensive polymorphism among gp63 genes within, and between parasite isolates. Overall, 45 different polymorphic alleles were detected in all samples, which could be segregated into two clusters. Cluster one included 25, and cluster two included 20 such genotypes. The predicted peptides showed overall conservation below 50%. In marked contrast, the conservation at segments with putative functional domains approached 90% (Fisher’s exact test p<0.0001). These findings show that gp63 is very polymorphic even among parasites from a same endemic focus, but the functional domains interacting with the mammalian host environment are conserved.

La reforma político-electoral 2013-2014. Una participación ciudadana a medio camino

Does it work the participation mechanisms implemented in the electoral political reform 2013-2014? What are the substantive dimensions of democracy? In this paper we examine the useful dimensions to understand the theoretical construction of democracy and contrasted with Mexican democracy from the perspective of participation mechanisms, implemented in the 2013-2014 electoral political reform. The two formal citizen participation mechanisms proposed in the Constitución Política de los Estados Unidos Mexicanos are: iniciativa popular and consulta popular. Both inapplicable: the former because it leaves to Congress the decision to its viability, while the latter leaves to the Suprema Corte de Justicia de la Nación, the interpretation of the legal ambiguity in environments with high public distrust, showing contradictions between an ideal democracy and real democracy in Mexico.

La princesa de Éboli: Cautiva del rey. Vida de Ana de Mendoza y de la Cerda (1540–1592) by Helen H. Reed and Trevor J. Dadson

Reed, Helen H. and Trevor J. Dadson. La princesa de Eboli: Cautiva del rey. Vida de Ana de Mendoza y de la Cerda (1540-1592). Madrid: Centro de Estudios Europa Hispanica y Marcial Pons Historia, 2015. 539 pp.Two distinguished scholars of early-modern literary history have come together to examine and contextualize the remarkable life of Ana de Mendoza y de la Cerda (1540-1592), the Princess of Eboli (hereafter Eboli or Dona Ana). Reed and Dadson anchor their study in the primary-source documents they compiled and glossed for an earlier partnership, the Epistolario e historia documental de Ana de Mendoza y de la Cerda, princesa de Eboli (Madrid, Iberoamericana; Frankfurt am Main, Vervuert, 2013). A collaborative spirit towards scholarly labors animates the book. As the authors explain in the preface, Reed had prepared a biography of Eboli in an initial draft in English. Dadson then joined her, translating this text into Spanish, adding material from his own archival work along the way. The authors also take great care to recognize the works on which they build, most notably Gregorio Maranon's classic biography of Antonio Perez and Esther Alegre Carvajal's series of studies on the Princess of Eboli.Reed and Dadson's foremost aim is to peel away the layers of myth and caricature that have accumulated around Eboli. In theater history, a particularly durable fiction took shape when Giuseppe Verdi-following Friedrich Schiller-transformed a complicated noblewoman from the storied Mendoza family into a Romantic character informed by stereotypes of Spain, blending motifs of Moorish allure with the darker visions of Inquisitorial oppression associated with the Black Legend. In his Don Carlos (debut 1867), Eboli is a secondary character who complicates the tragic love story, as she vies with Isabel de Valois for Don Carlos's love. The crowning moment of this mezzo-soprano part is the Veil Song of Act 2 (Au palais des fees; Nel giardin del bello in the Italian version). In Hispanic studies, Eboli has also assumed a somewhat villainous profile as the estranged patron responsible for subjecting Teresa of Avila to Inquisitorial scrutiny.To provide an accurate assessment of the full life in all its complexity, the authors present ten chapters organized with the precise chronology of traditional biography. Thus, they begin with a first chapter on Familia, infancia y educacion de Ana de Mendoza, continuing with nine more chapters focused on the following milestones: betrothal and marriage to the up-and-coming courtier Ruy Gomez de Silva (Chs. 2-3); the court of Isabel of Valois (Ch. 4); the organization of Pastrana as a ducal village (Ch. 5); her widowhood and fateful entanglement with Antonio Perez (Chs. 6-7); and finally, the murder of Juan de Escobedo and the resulting imprisonment (Chs. 8-10).Theater scholars will find Chapter 4 (En la corte de Isabel de Valois) of special interest, with its analysis of documents that record the emergence of a sophisticated palace theater in the milieu of Philip Il's third queen consort. Isabel of Valois sponsored over forty performances by professional actors between 1561 and 1567 in the room of the Alcazar palace known as the salon de comedias o saraos. Eboli, as a close contemporary and companion of the French queen, was a key protagonist among the court damas who acted in invenciones teatrales on such occasions as the feast of the Epiphany in 1564. The alluring portrait of Dona Ana in pastoral costume by Sofonisba Anguissola (ca. 1565) records the extent that popular literature informed the courtly pastimes. But the levity and sophistication here would contrast with the horrific consequences of Don Carlos's mental unraveling. Indeed, the chapter closes with the double tragedies of the royal heir's death while imprisoned by his father and the young queen's death in childbirth. Here, Reed and Dadson draw attention to the letter of condolence Eboli writes to Isabel's mother, France's queen mother Catherine de'Medici. …

Prevalence and causes of hearing impairment in Africa.

To systematically assess the data on the prevalence and causes of hearing impairment in Africa. Systematic review on the prevalence and causes of hearing loss in Africa. We undertook a literature search of seven electronic databases (EMBASE, PubMed, Medline, Global Health, Web of Knowledge, Academic Search Complete and Africa Wide Information) and manually searched bibliographies of included articles. The search was restricted to population-based studies on hearing impairment in Africa. Data were extracted using a standard protocol. We identified 232 articles and included 28 articles in the final analysis. The most common cut-offs used for hearing impairment were 25 and 30 dB HL, but this ranged between 15 and 40 dB HL. For a cut-off of 25 dB, the median was 7.7% for the children- or school-based studies and 17% for population-based studies. For a cut-off of 30 dB HL, the median was 6.6% for the children or school-based studies and 31% for population-based studies. In schools for the deaf, the most common cause of hearing impairment was cryptogenic deafness (50%) followed by infectious causes (43%). In mainstream schools and general population, the most common cause of hearing impairment was middle ear disease (36%), followed by undetermined causes (35%) and cerumen impaction (24%). There are very few population-based studies available to estimate the prevalence of hearing impairment in Africa. Those studies that are available use different cut-offs, making comparison difficult. However, the evidence suggests that the prevalence of hearing impairment is high and that much of it is avoidable or treatable.