Phi Test Research Articles

A correlation between knowledge and attitudes of third trimester of pregnant women with implementation of pregnant gymnastics at Lepo-Lepo health centre, Wundudopi, Baruga, Kendari in 2018

Gymnastics or exercise during pregnancy has a positive effect on the reduction of pain experienced by third trimester pregnant women. Preliminary study conducted at the lepolepo health center in Wundudopi, Baruga, Kendari, and the number of pregnant women for the period of January to June 2018 was 85 pregnant women, consisting of the first, second and third trimesters. Interviews were also conducted to 11 pregnant women in the third trimester, that often experience in the form of back pain, tingling, aches and fatigue, the pregnant woman also did not take any action to overcome it because according to pregnant women the problems experienced are common in pregnant women especially trimester three. The purpose of this study was to determine the relationship between knowledge and attitudes of third trimester pregnant women with the implementation of pregnancy gymnastics. This study applied quantitative using a cross sectional approach, with a population of 85 pregnant women and a sample was 46 third trimester pregnant women. Analysis method used Chi Square Test and Phi Test. The results of the study for knowledge variable showed that there was a correlation between knowledge of third trimester pregnant women with the implementation of pregnant gymnastics with a value of X2count=6.758>X2table=3.841 so that Ho was rejected or Ha was accepted. For attitudes variable from the results of the SPSS test analysis, the chi square statistical test results showed that X2count=5.073>X2table=3.841 so that Ho was rejected or Ha was accepted which means that there was a correlation between the attitude of the third trimester pregnant women and the implementation of pregnant gymnastics. Finally, it is recommended for researchers to continue the research toward other variables related to pregnancy exercise, for relevant agencies to develop services for pregnant women.

Clinical utility and cost modelling of the phi test to triage referrals into image-based diagnostic services for suspected prostate cancer: the PRIM (Phi to RefIne Mri) study

BackgroundThe clinical pathway to detect and diagnose prostate cancer has been revolutionised by the use of multiparametric MRI (mpMRI pre-biopsy). mpMRI however remains a resource-intensive test and is highly operator dependent with variable effectiveness with regard to its negative predictive value. Here we tested the use of the phi assay in standard clinical practice to pre-select men at the highest risk of harbouring significant cancer and hence refine the use of mpMRI and biopsies.MethodsA prospective five-centre study recruited men being investigated through an mpMRI-based prostate cancer diagnostic pathway. Test statistics for PSA, PSA density (PSAd) and phi were assessed for detecting significant cancers using 2 definitions: ≥ Grade Group (GG2) and ≥ Cambridge Prognostic Groups (CPG) 3. Cost modelling and decision curve analysis (DCA) was simultaneously performed.ResultsA total of 545 men were recruited and studied with a median age, PSA and phi of 66 years, 8.0 ng/ml and 44 respectively. Overall, ≥ GG2 and ≥ CPG3 cancer detection rates were 64% (349/545), 47% (256/545) and 32% (174/545) respectively. There was no difference across centres for patient demographics or cancer detection rates. The overall area under the curve (AUC) for predicting ≥ GG2 cancers was 0.70 for PSA and 0.82 for phi. AUCs for ≥ CPG3 cancers were 0.81 and 0.87 for PSA and phi respectively. AUC values for phi did not differ between centres suggesting reliability of the test in different diagnostic settings. Pre-referral phi cut-offs between 20 and 30 had NPVs of 0.85–0.90 for ≥ GG2 cancers and 0.94–1.0 for ≥ CPG3 cancers. A strategy of mpMRI in all and biopsy only positive lesions reduced unnecessary biopsies by 35% but missed 9% of ≥ GG2 and 5% of ≥ CPG3 cancers. Using PH ≥ 30 to rule out referrals missed 8% and 5% of ≥ GG2 and ≥ CPG3 cancers (and reduced unnecessary biopsies by 40%). This was achieved however with 25% fewer mpMRI. Pathways incorporating PSAd missed fewer cancers but necessitated more unnecessary biopsies. The phi strategy had the lowest mean costs with DCA demonstrating net clinical benefit over a range of thresholds.Conclusionphi as a triaging test may be an effective way to reduce mpMRI and biopsies without compromising detection of significant prostate cancers.

PD53-12 THE PROSTATE HEALTH INDEX IMPROVES PREDICTIVE VALUE IN PATIENTS WITH PI-RADS 3 LESIONS

INTRODUCTION AND OBJECTIVE: Major technical improvements in multiparametric MRI (mpMRI) of prostate with the standard approach to interpretation using the PI-RADS v2 offers reliable visualization of potentially clinically significant prostate cancer (csPca) and thus has shown advantages as a means by which to better select patients for biopsy and facilitate direct targeting of lesions during biopsy.However, currently available data show that the actual prevalence of csPCa after targeted biopsy in PI-RADS 3 lesions vary from 16% to 21%. We hypothesize that biomarkers such as PHI may better stratify a higher risk subgroup that harbor csPCa in patients with PI-RADS 3 lesions. METHODS: Patients with at least one PI-RADS = 3 lesion on mpMRI were enrolled for cognitive MRI-TRUS fusion-targeted prostate biopsy. All these patients had either PSA greater than 4 ng/ml and/or suspicious digital rectal examination (DRE) and/or previous negative systematic transrectal ultrasound (TRUS) prostate biopsy. All patients had received PHI test before the prostate biopsy. AUC under the ROC curves were estimated for the various PSA derivatives, along with the specificity at a pre-specified sensitivity of 90%. RESULTS: As PI-RADS 3 lesions have relatively low rates of csPCa and may present a new “grey zone” cognitive MRI-TRUS fusion-targeted prostate biopsy. Adding PHI to mpMRI improved predictive performance for overall PCa (AUC 0.818, CI 0.702-0.934) and csPCa detection (AUC 0.881, CI 0.787-0.975). The PHI alone was a significant predictor for any cancer (OR 5.95, 95% CI 1.35–42.36, p = 0.026) and significant cancers (OR 12.41, 95% CI 3.06–28.4, p < 0.001) after adjusting for age, prostate volume, previous negative biopsy and abnormal DRE in logistic regression. We found the optimal cutoff to be ≥ 39.7 which would allow 39.3 % of patients to avoid biopsy. At this level, no csPCa was missed and both sensitivity and NPV were 100%. CONCLUSIONS: In patients with PI-RADS 3 index lesions, which is a gray zone for PI-RADS v2, PHI exhibits outstanding performance in predicting csPCa. Using a PHI cutoff of ≥ 39.7, up to 39 % of prostate biopsy could be avoided in patients with PI-RADS 3 lesions and no csPCa will be missed.Source of Funding: nil

Relationship among perceived stress, oral health status, stomatitis, and xerostomia in the community during the COVID-19 pandemic: A cross-sectional survey

Aim: The aim of the study was to analyze the relationship between self-reported stress, oral health status, xerostomia, and stomatitis in the community during the COVID-19 pandemic.Materials and Methods: This is a cross-sectional study of 380 community respondents from the city of Bandung, Indonesia, consisting of 82 men and 298 women. Data obtained from online questionnaires using consecutive sampling method showed that the respondents agreed to participate in the study by filling in the informed consent. Furthermore, demographic data including age, education level, occupation, and total income were recorded. The variables measured by a questionnaire are self-reported stress, oral health status, xerostomia inventory, and stomatitis. Data distribution was performed by a descriptive statistic, χ2 test, Phi, and Spearman rank test for correlation analysis.Results: There was a significant correlation between perceived stress scale with oral health status (r’s = 0.135; P = 0.003), with stomatitis (r’s = 0.176; P = 0.015), and with xerostomia (r’s = 0.296; P = 0.022). In addition, age, education level, and total income also showed a significant correlation with stress level.Conclusion: From the findings of this study, it can be concluded that oral health status, xerostomia, and stomatitis were associated with levels of stress. Higher stress indicates poor oral health status, as well as severe xerostomia and stomatitis.

COMPARATIVE STUDY AMONG HISTOLOGIC GRADUATION SYSTEMS OF ORAL EPITHELIAL DYSPLASIAS

Objective The objective of this study was to evaluate the histologic grading systems for oral epithelial dysplasia (ODE). Study Design One hundred slides of ODE containing cases selected from 2 distinct oral pathology services were examined by 4 evaluators, who classified each case according to the architectural and cytologic criteria and were diagnosed according to the World Health Organization (WHO) system and binary. In addition to these 2 systems, a third form of analysis was considered, taking into account the presence or absence of ODE. Results The results were statistically analyzed in a descriptive way and by the correlation methods (Kendall tau-B and Phi test) and concordance (kappa). The WHO graduation system presented lower agreement among the evaluators; the best agreement among the evaluators occurred when considering the presence or absence of dysplasia; and in addition, it has been observed that less experienced oral pathologists tend to have more severe diagnoses than those with a longer career. Conclusions The lack of interobserver agreement was evident, highlighting the need for further studies, due to the great importance and relevance of OEDs.

SelectMDx versus Prostate Health Index in the identification of high-grade prostate cancer.

30 Background: A major clinical challenge is to identify patients at increased risk of high-grade prostate cancer (PCa) (Gleason scores ≥ 7) before biopsy. Thus, we evaluated the clinical utility of SelectMDx and Prostate Health Index (phi) tests for diagnosis of high-grade PCa as compared with transperineal mapping biopsy (TMB) results, where an average of 80 prostate needle biopsies are taken every 5 mm for a diagnostic accuracy of 98%. Methods: 70 patients were selected who had TMB. They were evaluated with both SelectMDx and phi tests from before or after TMB; all had serum and post-digital rectal examination urine samples collected prior to treatment, stored in our biorepository. phi was evaluated using proPSA, free PSA and total PSA in serum. SelectMDx test measured mRNA levels of the HOXC6 and DLX1 in post-DRE urine. Published data shows that phi &lt;27 and SelectMDx score = 0% correlate with patients free of HG PCa. Test results were compared against TMB histopathology data. Multivariate logistic regression (MLS) analyses and receiver operating characteristic (ROC) curves were used to determine diagnostic accuracy. DeLong test was used to determine statistical significance of ROC curves. All analyses were done for diagnosis of any PCa and high-grade PCa. Results: TMB histopathology showed 17/70 patients with no PCa and 22/53 with high-grade PCa. The sensitivity, specificity, positive (PPV) and negative (NPV) predictive values of each test are shown in the table below. Pairwise ROC comparison showed no statistically significant difference in the area under the curve of diagnosing PCa (0.75 vs 0.65) and high-grade PCa (0.71 vs 0.81) by phi and SelectMDx tests respectively. MLS analyses showed phi was significantly better than SelectMDx for diagnosing PCa (β = 0.054; p=0.005) and SelectMDx was significantly better than phi for diagnosing high-grade PCa (β = 8.45; p=0.0002). Conclusions: With high sensitivity and NPV, SelectMDx test is more useful than phi for screening patients at risk of high-grade PCa prior to biopsy. [Table: see text]

Occupational Irritan Contact Dermatitis Among Shipyard Workers in Samarinda, Indonesia

Occupational irritant contact dermatitis (OICD) is still a occupational health problem. Shipyard workers are susceptible to OICD. A cross sectional study was conducted on 32 samples of shipyard workers in Samarinda to analyze the prevalence of OICD and related factors. The dependent variable is OICD, while independent variable consists of age, length of service, length of contact, history of skin diseases, personal hygene and personal protective equipment. Data collection through interview and direct observation, data analysis using Phi test and multiple logistic regression. All respondents had OICD and significantly correlated with working period (p = 0.001), history of skin disease (p = 0.004), personal hygene (p = 0.003) and use of PPE (p = 0.05). History of skin disease (B = 1.116) and use of PPE (B = 1.053) are most dominant variables. Personal hygiene improvements, tightening monitoring of use of PPE and improving occupational health efforts have been suggested.

Epidemiology of Ehrlichia canis in healthy dogs from the Southeastern region of the state of Rio de Janeiro, Brazil

This cross-sectional, observational, and descriptive study aims to investigate the epidemiology of Ehrlichia canis in healthy owned dogs from the Southeastern region of Rio de Janeiro, Brazil. Blood samples were collected from 390 households dogs. During the visits, an epidemiological questionnaire was filled out concerning the dogs’ characteristics as well as the environments in which they lived. The variables were analyzed using a bivariate test, while the correlation analysis between the variables was performed via a phi test. The variables that had p-values lower than 0.2 in the bivariate analysis and had a low or moderate correlation were selected for the multivariate analysis. The model that had the lowest Akaike information criterion (AIC) value was retained. Among the 390 blood samples tested, 24.8% were considered positive for E. canis. The parsimonious logistic regression model presented an AIC value of 408.75 and showed three variables that favored the presence of E. canis DNA in the tested dogs: the animal’s access to urban streets and neighborhoods (odds ratio [OR] = 1.91; p-value = 0.02; confidence interval [CI]: 1.14 − 3.18), tick infestation (OR = 2.01; p-value = 0.006; CI: 1.22 − 3.32), and poor hygienic conditions (OR = 2.19; p-value = 0.002; CI: 1.31 − 3.67). The model was considered well-calibrated based on the Hosmer–Lemeshow test (p = 0.39). According to the present study, dogs that have access to the street and neighborhood, are infested with ticks, and live under poor hygienic conditions are more likely to be infected with E. canis in the state of Rio de Janeiro, Brazil.

Cost analysis of prostate cancer detection including the prostate health index (phi).

To assess the economic impact of introducing the prostate health index (phi) for prostate cancer (PCa) detection. A total of 177 patients who presented in an academic institution with a tPSA between 2 and 10ng/ml and underwent prostate biopsies within the 3months were enrolled. With phi and tPSA thresholds of 43 and 4ng/ml, respectively, probability for each branch of a decision tree model for PCa diagnosis and corresponding mean cost were estimated with "Monte Carlo" simulations. A sensitivity analysis was performed. With a similar sensitivity, phi strategy increased positive predictive value by 13.9 points and negative predictive value by 31.6 points in comparison to tPSA strategy. Mean costs per patient with tPSA and phi strategies were €514 and €528, respectively, for a phi test price at 50€. One-way sensitivity analysis showed that phi strategy was less expensive (508€/patient) than tPSA strategy with a phi test price below 30€. In multi-criteria sensitivity analysis, PPV and the rates of positive phi and tPSA were the parameters with the largest impact on the final cost as opposed to the cost of the biopsy or imaging which have less influence. With an expected rate of positive phi test < 60%, tPSA strategy was more expensive than phi strategy. The introduction of phi index in PCa detection would result in a significant clinical benefit compared to tPSA strategy. In our economic model, the phi strategy was equivalent or slightly more expensive than the current tPSA strategy.

Comparative Analysis of Apical Root Crack Propagation after Root Canal Preparation at Different Instrumentation Lengths Using ProTaper Universal, ProTaper Next and ProTaper Gold Rotary Files: An In vitro Study.

Aim:To compare the incidence of apical root crack formation after root canal preparation at different instrumentation lengths using ProTaper Universal (PTU), ProTaper Next (PTN) and ProTaper Gold (PTG) file systems.Subjects and Methods:Eighty-four mandibular first premolars with single and straight root canal were mounted in resin block after simulating periodontal ligaments. 1–2 mm of root apex was exposed followed by sectioning of 1 mm of root tip for better stereomicroscopic visualization. While the Control group was left unprepared, experimental groups were instrumented up to root canal length (RCL) and (RCL-1 mm) respectively using PTU, PTN and PTG. After staining the root apex with 1% methylene blue dye, stereomicroscopic images were obtained for evaluating apical root cracks. The data were analyzed using Chi-square, phi and Cramer test. The significance level was set at P < 0.05.Results:Significantly less dentinal defects were seen between PTG and PTU while there was no significant difference between PTU-PTN and PTN-PTG. Furthermore, samples instrumented up to RCL-1 mm showed lesser cracks as compared with samples instrumented up to RCL.Conclusion:PTG produced least number of cracks followed by PTN and PTU. Furthermore, instrumenting short of RCL reduced the crack formation risk.

Assessment on determinants of contraceptive morbidity in Northeast India

IntroductionWith the increase in widening role of women, need for family planning and contraceptive use is ever increasing. Healthy reproductive and sexual health for many women is still a dream in Northeast India. Bulk of women are unaware about morbidity associated with the contraceptive use as the service providers usually do not provide information on side-effects to the user thus women suffer silently, which ultimately may lead to severe health consequences. ObjectivesPresent study aims to understand the pattern of contraceptive use and morbidity associated with it. MethodsPresent study uses District Level Household and Facility Survey 2012-2013 (DLHS-4) data of seven North-eastern states of India. Only the currently married women (CMW) who are usual resident and not pregnant are retained. Hence a sample of 30,670 CMW are kept for assessing contraceptive use, subsequently 7,825 CMW are filtered for understanding contraceptive morbidity. Statistical technique like Cramer’s V and Phi test, and logistic regression are used for the analysis. ResultsResult shows that the percentage of using modern contraceptive method was highest in Sikkim and lowest in Meghalaya. Key findings of the present study are that women with higher parity, having information about side effects and belonging to non-tribal community are more likely to report having contraceptive morbidity, whereas it is opposite for the users of modern spacing methods ConclusionHigher parity women in particular should be provided information about proper use and side-effects of modern contraceptives, so that they can make an informed choice of contraception and lead a healthy life.

Clinical utility of the Prostate Health Index (phi) for biopsy decision management in a large group urology practice setting

BackgroundDeciding when to biopsy a man with non-suspicious DRE findings and tPSA in the 4–10 ng/ml range can be challenging, because two-thirds of such biopsies are typically found to be benign. The Prostate Health Index (phi) exhibits significantly improved diagnostic accuracy for prostate cancer detection when compared to tPSA and %fPSA, however only one published study to date has investigated its impact on biopsy decisions in clinical practice.MethodsAn IRB approved observational study was conducted at four large urology group practices using a physician reported two-part questionnaire. Physician recommendations were recorded before and after receiving the phi test result. A historical control group was queried from each site's electronic medical records for eligible men who were seen by the same participating urologists prior to the implementation of the phi test in their practice. 506 men receiving a phi test were prospectively enrolled and 683 men were identified for the historical control group (without phi). Biopsy and pathological findings were also recorded for both groups.ResultsMen receiving a phi test showed a significant reduction in biopsy procedures performed when compared to the historical control group (36.4% vs. 60.3%, respectively, P < 0.0001). Based on questionnaire responses, the phi score impacted the physician’s patient management plan in 73% of cases, including biopsy deferrals when the phi score was low, and decisions to perform biopsies when the phi score indicated an intermediate or high probability of prostate cancer (phi ≥36).Conclusionsphi testing significantly impacted the physician’s biopsy decision for men with tPSA in the 4–10 ng/ml range and non-suspicious DRE findings. Appropriate utilization of phi resulted in a significant reduction in biopsy procedures performed compared to historical patients seen by the same participating urologists who would have met enrollment eligibility but did not receive a phi test.

The Veracity of Troponin Test Requests for Patients Presenting to the Emergency Department with Chest Pain; a Clinical Audit.

Introduction:Troponin test is one of the methods for diagnosing acute coronary syndrome, but the overuse and misuse of this test has increased the costs imposed on the health system and the patients. Objective:The present study was conducted to investigate the veracity of troponin test requests for patients presenting to an emergency department with chest pain and examine the effectiveness of training emergency medicine assistants in reducing unnecessary and inappropriate requests in emergency departments. Methods:This clinical audit was conducted in the emergency department of Imam Hossein Hospital, Tehran, Iran, in 2014. Sampling was carried out using the census method and all the cases presenting to the emergency department for whom a troponin test was requested by the emergency medical assistants were included in the research. First, the veracity of the current troponin test requests was assessed; then, training was given to the personnel, and the veracity of the troponin test requests was once again verified after the training was completed. The rate of veracious troponin requests for the patients was measured based on two factors, including the interval between the patients’ admission and the troponin test request, and the interval between the onset of pain and the troponin test request. The veracity of the troponin test request was compared before and after training using the Phi test and Cramer’s V test in IBM SPSS-21. Results:This study examined a total of 500 patients (250 before training and 250 after), who had a mean age of 57.65±18.15 years, including 51.6% men. Significant differences were observed between the mean time of the patients’ admission and the overall and post-training troponin test results (P=0.000), and also between the mean time of the onset of pain and the overall and post-training troponin test results (P=0.000). The number of positive troponin test results did not differ significantly between the patients in either of the two stages (P=0.39). Conclusion:Unnecessary troponin test requests reduced significantly after this clinical audit in the examined emergency department.

Polyploidy as a Factor in the Evolution of the Bouteloua curtipendula Complex (Poaceae: Chloridoideae)

In this paper we assess the impact of polyploidy and hybridization in the Bouteloua curtipendula species complex (BCC). The BCC is a monophyletic group of perennial grasses in the Chloridoideae subfamily. We tested for evolutionary signatures of hybridization and polyploidy in the BCC by obtaining 77 chromosome counts from anther mother cells (2n = 20 to >100) and comparing the phylogenetic pattern of diploids and polyploids in nuclear and chloroplast trees. We sequenced ITS and trnT-L-F regions for 96 and 70 individuals, respectively, resulting in 150 nuclear ribosomal ITS sequences, including 54 cloned sequences. We found no evidence for recombination between ITS sequences with a PHI test. Maximum parsimony and Bayesian analyses were used to estimate the ITS phylogeny. Diploid samples were found in all clades, while most of the polyploid samples were concentrated in a single clade. Cloned diploids contained one to three copies of ITS with >99% sequence similarity. The tetraploids B. purpurea and some B. curtipendula samples had a low amount of variation among ITS copies, while the cloned polyploids possessed several highly divergent ITS copies. Pollen size correlates with ploidy-level in the BCC, but is not a clear indicator of genome size. We found evidence that the BCC lineage has a complicated evolutionary history that has included autopolyploidy and allopolyploidy.

Abstract 4645: A serum multiomics signature for enhancing prostate cancer diagnosis and prognosis

Abstract Introduction and Objective: Diagnosis of prostate cancer (CaP) has relied on prostate specific antigen (PSA) level and digital rectal examination (DRE) followed by prostate biopsies. These modalities have the potential to yield false-positive and false-negative results for CaP. These challenges prompted efforts to develop more specific body fluid based assays including PCA3, TMPRSS2:ERG, K4csore and PHI tests. Further, emerging data on significant racial differences of common CaP driver genes, e.g., PTEN and ERG in CaP can lead to significant limitations in biomarker performance. Thus, the goal of our study was to discover CaP serum markers with equal performance among African American (AA) and Caucasian American (CA) men. We employed proteomics, signal- and structural lipidomics and metabolomics platforms to discover serum biomarkers and evaluate their utility for diagnosis and prognosis of CaP in AA and CA men. Methods: Sera from 700 individuals were analyzed, which included AA and CA CaP patients stratified for ERG oncoprotein expression by immunohistochemistry (N=495). Sera from age-matched healthy control men were also included (N=205) in this study. Quantitative global profiles of lipidome, proteome and metabolome were analyzed by high resolution MS-based technologies. Random forest and Interrogative Biology® analytical platforms were used to identify analytes differentiating healthy from CaP cases including clinical-pathologic data. Results: The unbiased global profiling and integration of the data and clinical-pathologic features have led to the identification of molecular fingerprints differentiating cancer patients from healthy controls. Specifically, three analytes in serum metabolome showed robust separation between both AA and CA CaP and control groups. Elevated levels of nicotinamide and eicosenoic acid and decreased levels of a decanoylcarnitate alone have indicated strong separation between cases and controls. Further inclusion of additional 9 analytes provided an optimal multi-omics panel for distinguishing the combined cohort of AA and CA cases vs. healthy controls. Conclusions: The findings presented here support that an integrated multiomics approach has the potential to define serum marker panels for diagnosis of CaP in the context of racial diversity and molecular annotation (e.g., ERG) of CaP. These promising data are undergoing validation in additional patient cohorts. Citation Format: Michael A. Kiebish, Jennifer Cullen, Albert Dobi, Amina Ali, Leonardo O. Rodrigues, Yezhou Sun, Aniruddha Pawar, Aditee Dalvi, Denise Young, Vivek K. Vishnudas, Jason Sedarsky, Gyorgy Petrovics, Emily Chen, Viatcheslav Akmaev, Inger L. Rosner, David McLeod, Isabell A. Sesterhenn, Rangaprasad Sarangarajan, Alagarsamy Srinivasan, Elder Grainger, Niven R. Narain, Shiv Srivastava. A serum multiomics signature for enhancing prostate cancer diagnosis and prognosis [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2017; 2017 Apr 1-5; Washington, DC. Philadelphia (PA): AACR; Cancer Res 2017;77(13 Suppl):Abstract nr 4645. doi:10.1158/1538-7445.AM2017-4645

Identification of extensive drug resistant Pseudomonas aeruginosa strains: New clone ST1725 and high-risk clone ST233.

Several microorganisms produce nosocomial infections (NIs), among which Pseudomonas aeruginosa stands out as an opportunist pathogen with the capacity to develop multiresistance to first-choice antibiotics. From 2007 to 2013, forty-six NIs produced by P. aeruginosa were detected at a pediatric tertiary care hospital in Mexico with a significant mortality rate (17.39%). All isolates (n = 58/46 patients) were characterized by evaluating their response to several antibiotics as panresistant (PDR), extensively resistant (XDR), multiresistant (MDR) or sensitive (S). In addition, all isolates were typified through multilocus sequencing of seven genes: acsA, aroE, guaA, mutL, nuoD, ppsA and trpE. Furthermore, to establish the genetic relationships among these isolates, we carried out a phylogenetic inference analysis using maximum likelihood to construct a phylogenetic network. To assess evolutionary parameters, recombination was evaluated using the PHI test, and the ratio of nonsynonymous to synonymous substitutions was determined. Two of the strains were PDR (ST1725); 42 were XDR; four were MDR; and ten were S. Twenty-one new sequence types were detected. Thirty-three strains exhibited novel sequence type ST1725. The ratio of nonsynonym to synonym substitutions was 1:1 considering all genes. Phylogenetic analysis showed that the genetic relationship of the PDR, XDR and MDR strains was mainly clonal; however, the PHI test and the phylogenetic network suggest that recombination events occurred to produce a non-clonal population. This study aimed not only to determine the genetic diversity of clinical P. aeruginosa but also to provide a warning regarding the identification and spreading of clone ST1725, its ability to cause outbreaks with high mortality rates, and to remain in the hospital environment for over seven years. These characteristics highlight the need to identify clonal outbreaks, especially where high resistance to most antibiotics is observed, and control measures are needed. This study also represents the first report of the PDR ST1725.

Prevention Messages in Parent-Infant Bed-Sharing: Message Source, Credibility, and Effectiveness.

Objective. Despite educational outreach, bed-sharing prevalence is rising. Mothers’ and fathers’ bed-sharing practices, prevention message source, perceived source credibility, and the effectiveness of the prevention message were evaluated. Methods. Data were collected from 678 community parents via an online survey. Results were analyzed using descriptive statistics and phi tests. Results. Bed-sharing reasons focused on comfort and ease. Mothers were more likely to receive prevention messages from individual professionals or organizations, whereas fathers were more likely to hear prevention messages from spouses/coparents and grandfathers. Physicians were the most common source, and physicians and grandmothers were rated as the most credible and effective. Conclusions. Prevention message source varies between mothers and fathers, highlighting the need for continued research with fathers. Grandmothers and physicians are effective and credible sources of prevention messages. Although less frequent, prevention messages from grandmothers were most effective. There was no evidence of effective messages from educational campaigns.

Perfil emprendedor de estudiantes de la Tecnología en gestión agropecuaria, Universidad de Caldas

Objetivo: establecer el perfil emprendedor de los estudiantes de Tecnología en Gestión Agropecuaria de la Universidad de Caldas, con base en características sociodemográficas y habilidades para el emprendimiento.Metodología: estudio descriptivo transversal, con una fase comparativa. Se trabajó con 78 estudiantes. La sistematización se realizó en el programa SPSS versión 11.5; se hizo análisis univariado y bivariado para establecer posibles relaciones entre variables. Se aplicaron pruebas de Chi cuadrado y phi para determinar la significancia estadística.Resultados: se encontró que destaca la divergencia entre géneros, en cuanto a actitudes para emprendimiento; las mujeres resultan más capaces para un proceso empresarial, teniendo en cuenta habilidades como la capacidad de comunicación, los lazos interpersonales, capacidad de soportar dificultades y fracasos, tolerancia para aceptar otros puntos de vista. Los hombres por su parte, resaltan en actitudes como delegación de funciones, capacidad de liderazgo, definición de estrategias de corto y largo plazo, transformación y mejora de productos y servicios. Ambos géneros pueden desarrollar habilidades para el emprendimiento.Conclusiones: se concluye que los estudiantes disponen de niveles medios y altos en gran parte de las habilidades que requiere un emprendedor exitoso como liderazgo, disciplina, autocontrol, habilidad para relacionarse con otros, responsabilidad, entre otras. Sin embargo, también existen deficiencias en cuanto al desarrollo de actividades con altos niveles de riesgo e incertidumbre.

Recombination Is a Major Driving Force of Genetic Diversity in the Anaplasmataceae Ehrlichia ruminantium.

The disease, Heartwater, caused by the Anaplasmataceae E. ruminantium, represents a major problem for tropical livestock and wild ruminants. Up to now, no effective vaccine has been available due to a limited cross protection of vaccinal strains on field strains and a high genetic diversity of Ehrlichia ruminantium within geographical locations. To address this issue, we inferred the genetic diversity and population structure of 194 E. ruminantium isolates circulating worldwide using Multilocus Sequence Typing based on lipA, lipB, secY, sodB, and sucA genes. Phylogenetic trees and networks were generated using BEAST and SplitsTree, respectively, and recombination between the different genetic groups was tested using the PHI test for recombination. Our study reveals the repeated occurrence of recombination between E. ruminantium strains, suggesting that it may occur frequently in the genome and has likely played an important role in the maintenance of genetic diversity and the evolution of E. ruminantium. Despite the unclear phylogeny and phylogeography, E. ruminantium isolates are clustered into two main groups: Group 1 (West Africa) and a Group 2 (worldwide) which is represented by West, East, and Southern Africa, Indian Ocean, and Caribbean strains. Some sequence types are common between West Africa and Caribbean and between Southern Africa and Indian Ocean strains. These common sequence types highlight two main introduction events due to the movement of cattle: from West Africa to Caribbean and from Southern Africa to the Indian Ocean islands. Due to the long branch lengths between Group 1 and Group 2, and the propensity for recombination between these groups, it seems that the West African clusters of Subgroup 2 arrived there more recently than the original divergence of the two groups, possibly with the original waves of domesticated ruminants that spread across the African continent several thousand years ago.

Structural Equivalence of an Attitude Toward Religion Scale in Mexico, Nicaragua and China

The Attitude toward Catholicism, Judaism, Hinduism, and Islam scales were adapted for this study into a single scale that measures overall attitudes towards religion. The resulting Attitude toward Religion (ATR) Scale was adapted into both Spanish and Chinese and administered in Mexico (n = 265), Nicaragua (n = 296), and China (n = 460) to a total of 1,021 individuals (59% women, 41% men; Mage = 22.4 years, SD = 7.01 years). The scale’s structural equivalence (i.e. Does the instrument measure the same construct in each country?) was assessed using Exploratory Factor Analyses and pairwise comparisons. Strong evidence for structural equivalence was provided by the analyses’ results, as we obtained a one-dimensional solution (labeled Attitude Toward Religion, ATR) in all three countries and Tucker’s Phi test was very close to 1. These findings support the unidimensional solution for attitudes toward religions obtained in previous scales and broaden the scope for these studies in several cultural contexts. Further implications are discussed.