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Semiconductor hollow spheres have garnered significant attention in recent years due to their unique structural properties and enhanced surface area, which are advantageous for various applications in catalysis, energy storage, and sensing. The present study explores the surfactant-assisted synthesis of bismuth ferrite (BiFeO3) hollow spheres, emphasizing their enhanced visible-light photocatalytic activity. Utilizing a novel, facile, two-step evaporation-induced self-assembly (EISA) approach, monodisperse BiFeO3 hollow spheres were synthesized with a narrow particle size distribution. The synthesis involved Bi/Fe citrate complexes as precursors and the triblock copolymer Pluronic P123 as a soft template. The BiFeO3 hollow spheres demonstrated outstanding photocatalytic performance in degrading the emerging pollutants Rhodamine B and metronidazole under visible-light irradiation (100% degradation of Rhodamine B in <140 min and of metronidazole in 240 min). The active species in the photocatalytic process were identified through trapping experiments, providing crucial insights into the mechanisms and efficiency of semiconductor hollow spheres. The findings suggest that the unique structural features of BiFeO3 hollow spheres, combined with their excellent optical properties, make them promising candidates for photocatalytic applications.

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INTRODUCTION/OBJECTIVES: The heterodimer exostosin-1/exostosin-2 (EXO-1/2) is a novel antigen observed in membranous nephropathy associated with systemic lupus erythematosus. This study aimed to evaluate the association between EXO-1/2 positivity in kidney biopsy and kidney outcomes. METHODS: The kidney biopsy tissue from 50 class 5 lupus nephritis (LN) and 55 mixed class 3/4 + 5 LN patients was stained for EXO-1/2. Baseline clinical and histological characteristics were compared between EXO-1/2 positive and EXO-1/2 negative patients. Time-to-event analyses were performed to compare rates of response to therapy, kidney flares, and progression to a 40% decline of the glomerular filtration rate (eGFR), doubling of serum creatinine, and kidney failure. RESULTS: Fourteen out of 50 (28%) of class 5 and 5 out of 55 (9%) of mixed class 3/4 + 5 LN stained positive for EXO-1/2. Patients with class 5 LN and EXO-1/2 positive stain were younger, with better kidney function at presentation, and lower scarring in the kidney biopsy analysis. Over a median follow-up of 100 months, patients with positive EXO-1/2 staining had significantly lower rates of progression in the full cohort. When analyzed separately in class 5 and mixed class LN subgroups, there were significantly lower rates of progression to a 40% decline of the eGFR and non-statistically significant trends for doubling of serum creatinine and kidney failure. CONCLUSION: EXO-1/2 is a novel antigen detected in class 5 LN and associated with a good prognosis of kidney function. The incorporation of EXO-1/2 staining in clinical practice can potentially modify the management of LN due to its prognostic implications. Key Points • Exostosin-1/exostosin-2 antigen has been found in cases of membranous nephropathy associated with autoimmune diseases such as systemic lupus erythematosus. • Exostosin-1/exostosin-2 staining in the kidney biopsy of class 5 or mixed class 3/4 + 5 lupus nephritis is associated with a good long-term prognosis of kidney function. • The incorporation of exostosin-1/exostosin-2 staining into clinical practice can potentially modify management due to its prognostic implications.

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In recent years, semiconductor hollow spheres have gained much attention due to their unique combination of morphological, chemical, and physico-chemical properties. In this work, we report for the first time the synthesis of BiFeO3 hollow spheres by a facile hydrothermal treatment method. The mechanism of formation of pure phase BiFeO3 hollow spheres is investigated systematically by variation of synthetic parameters such as temperature and time, ratio and amount of precursors, pressure, and calcination procedures. The samples were characterized by X-ray powder diffraction, scanning electron microscopy, energy dispersive X-ray spectroscopy, and UV-vis diffuse reflectance spectroscopy. We observe that the purity and morphology of the synthesized materials are very sensitive to synthesis parameters. In general, the chemically and morphologically very robust hollow spheres have diameters in the range of 200 nm to 2 µm and a wall thickness of 50-200 nm. The synthesized BiFeO3 hollow spheres were applied as catalysts in the photodegradation of the model pollutant Rhodamine B under visible-light irradiation. Notably, the photocatalyst demonstrated exceptionally high removal efficiencies leading to complete degradation of the dye in less than 150 min at neutral pH. The superior efficiencies of the synthesized material are attributed to the unique features of hollow spheres. The active species in the photocatalytic process have been identified by trapping experiments.

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BACKGROUND: Juvenile idiopathic arthritis (JIA) is the most common chronic rheumatological disease in children. It is a multisystemic, dynamic pathophysiology of unknown cause and genetically heterogeneous. OBJECTIVE: To compare the quality of life and illness' activity in patients with juvenile idiopathic arthritis, from urban, suburban and rural areas. MATERIAL AND METHODS: Comparative, observational, and cross-sectional study in pediatric patients treated in a second-level medical care hospital, during the period from August to October 2015. The following questionnaires were applied: The Childhood Health Assessment Questionnaire for Quality of Life and The Disease Activity Score-28, in addition to the facial pain and verbal numerical scales for disease activity, both for patients and parents. The Kruskal-Wallis test was used for data analysis. RESULTS: 42 patients of three geostatistical areas were included: urban, suburban and rural; the middle age was 12.7 years, with predominance of the feminine sex (3:1). The polyarticulate type is more prevalent in the rural area. The pain is similar in the three regions. The population of the areas did not find significant difference for activity of the illness and quality of life between geostatistical areas (p ≤ 0.05). CONCLUSIONS: The patients with juvenile idiopathic arthritis are usually older of eight years. The quality of life is better in the patients of the urban area, compared to those of other areas.

INTRODUCCIÓN: la artritis idiopática juvenil (AIJ) es la enfermedad reumatológica crónica más frecuente en niños. Es una fisiopatología multisistémica, dinámica, de causa desconocida y genéticamente heterogénea. OBJETIVO: comparar la calidad de vida y la actividad de la enfermedad en pacientes con artritis idiopática juvenil, originarios de áreas urbanas, suburbanas y rurales. MATERIAL Y MÉTODOS: estudio comparativo, observacional y transversal, en pacientes pediátricos atendidos en un hospital de segundo nivel de atención médica, durante el periodo de agosto a octubre de 2015. Se aplicaron los cuestionarios: Childhood Health Assessment Questionnaire para calidad de vida y Disease Activity Score-28, además de las escalas facial del dolor y verbal numérica para actividad de la enfermedad, tanto a los pacientes como a los padres. Se utilizó la prueba de Kruskal-Wallis para el análisis de los datos. RESULTADOS: se incluyeron 42 pacientes de tres áreas geoestadísticas: urbana, suburbana y rural; la edad media fue de 12.7 años, con predominio del sexo femenino (3:1). El tipo de clasificación poliarticular es el más prevalente en el área rural. El dolor es similar en las tres regiones. No se encontró diferencia significativa para actividad de la enfermedad y calidad de vida entre la población de las áreas geoestadísticas (p ≤ 0.05). CONCLUSIONES: los pacientes con artritis idiopática juvenil suelen ser mayores de ocho años. La calidad de vida es mejor en los pacientes del área urbana, en comparación con los de las otras áreas.

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BACKGROUND Subacute thyroiditis, myocarditis, and hepatitis are inflammatory disorders that may develop after viral infections, including SARS-CoV-2. These entities may appear after resolution of the respiratory syndrome. CASE REPORT A previously healthy 64-year-old male patient came to the hospital reporting severe chest pain. He had a history of a COVID-19 pneumonia with PCR confirmation 4 weeks before. On admission to the Coronary Care Unit (CCU), the patient had a negative PCR for SARS-CoV-2; the following tests were performed: total T3 643.4 ng/dl (reference 35-193 ng/dl), total thyroxine 12.0 µg/dl (reference 4.8-11.7 µg/dl), free T4 1.85 ng/dl (reference 0.7-1.48 ng/dl), TSH 0.01 µIU/ml (reference 0.35-4.94 µIU/ml); total bilirubin 0.76 mg/dl (reference 0.0-1.5 mg/dl), alkaline phosphatase 185 U/L (reference 40-150 U/L), alanine aminotransferase 194.6 U/L (reference 6-66 U/L), aspartate aminotransferase 93.4 U/L (reference 9-55 U/L); on admission to the CCU high-sensitivity troponin I 548.3 pg/ml (reference 0.0-34.2 pg/ml), after 24 h in the CCU 801 pg/ml, and after 11 days (as an outpatient) 4.5 pg/ml. A thyroid gammagram revealed absent uptake of the radionuclide. Normal cardiac gammagraphy and cardiac enzymes ruled out myocardial ischemia and infarction. The following diagnoses were made: myocarditis, subacute thyroiditis, and reactive hepatitis due to SARS-CoV-2 infection. CONCLUSIONS COVID-19 has been demonstrated to be a multisystemic inflammatory disorder. The serious illness that developed in our patient after relief of his pulmonary disease underlines this nature. We suggest close follow-up of patients even after apparent clinical resolution, and performing thyroid, myocardial, and liver tests if clinically indicated.

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Female androgenetic alopecia (FAGA) is a common cause of hair loss in women. Typically, it is characterized by a reduction of hair density on biparietal and vertex regions of the scalp with preservation of the anterior hair implantation line. However, it can also appear with recession of the anterior hairline known as FAGA with male pattern (FAGA-M). In these cases, it is important to consider a state of hyperandrogenism and look for other signs such as hirsutism, acne, and menstrual irregularities. A sudden onset in a postmenopausal woman must make us suspicious of an androgen-secreting tumor. We present two cases of FAGA-M secondary to an ovarian tumor that was successfully resolved after surgical treatment.

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BACKGROUND Riedel's thyroiditis is a rare form of immunoglobulin G (IgG) 4-related invasive fibrosis of the thyroid gland; given its scarce incidence, standardized therapeutic guidelines are unavailable. Although complications are unusual, obstructive symptoms produced by the stony-hard goiter may put patients' lives at risk. The diagnosis must be biopsy-proven, and treatment consists of thyroid hormone replacement and anti-inflammatory drugs, although sometimes thyroidectomy may be required. CASE REPORT A 69-year-old woman presented with a 7-month history of progressive hypothyroidism and obstructive dysphagia. On physical examination, she had a large, stony-hard goiter. A Doppler ultrasound study revealed a massive, avascular enlargement of the thyroid gland. A computed tomography scan failed to demonstrate any extrathyroidal extension of the abnormal tissue. A Tru-Cut biopsy of the thyroid was performed. Extensive replacement of thyroid follicles by prominent bands of fibrous tissue was observed, with follicular obliteration and mild focal occlusive phlebitis. A lymphoplasmacytic infiltrate was clearly identified; no oxyphilic nor giant cells were found. On immunohistochemistry, the immunoglobulin G (IgG) 4/IgG ratio in the plasma cell infiltrate was 40%; increased serum IgG4 levels were also found, supporting the diagnosis of Riedel's thyroiditis. The patient was successfully treated with levothyroxine replacement and tamoxifen with prompt resolution of obstructive symptoms. CONCLUSIONS Fibrous thyroiditis should be considered in the differential diagnosis of primary hypothyroidism in a patient with a stony-hard goiter. Although steroids are often used as a therapeutic strategy for this disease, our patient had an excellent therapeutic response to tamoxifen, avoiding adverse effects associated with steroid therapy, the higher cost of monoclonal antibody therapy, and surgery-associated risks.

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BACKGROUND: Illnesses transmitted by Aedes aegypti (Linnaeus, 1762) such as dengue, chikungunya and Zika comprise a considerable global burden; mosquito control is the primary public health tool to reduce disease transmission. Current interventions are inadequate and insecticide resistance threatens the effectiveness of these options. Dried attractive bait stations (DABS) are a novel mechanism to deliver insecticide to Ae. aegypti. The DABS are a high-contrast 28 inch2 surface coated with dried sugar-boric acid solution. Aedes aegypti are attracted to DABS by visual cues only, and the dried sugar solution elicits an ingestion response from Ae. aegypti landing on the surface. The study presents the development of the DABS and tests of their impact on Ae. aegypti mortality in the laboratory and a series of semi-field trials. METHODS: We conducted multiple series of laboratory and semi-field trials to assess the survivability of Ae. aegypti mosquitoes exposed to the DABS. In the laboratory experiments, we assessed the lethality, the killing mechanism, and the shelf life of the device through controlled experiments. In the semi-field trials, we released laboratory-reared female Ae. aegypti into experimental houses typical of peri-urban tropical communities in South America in three trial series with six replicates each. Laboratory experiments were conducted in Quito, Ecuador, and semi-field experiments were conducted in Machala, Ecuador, an area with abundant wild populations of Ae. aegypti and endemic arboviral transmission. RESULTS: In the laboratory, complete lethality was observed after 48 hours regardless of physiological status of the mosquito. The killing mechanism was determined to be through ingestion, as the boric acid disrupted the gut of the mosquito. In experimental houses, total mosquito mortality was greater in the treatment house for all series of experiments (P < 0.0001). CONCLUSIONS: The DABS devices were effective at killing female Ae. aegypti under a variety of laboratory and semi-field conditions. DABS are a promising intervention for interdomiciliary control of Ae. aegypti and arboviral disease prevention.

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Insecticide resistance (IR) can undermine efforts to control vectors of public health importance. Aedes aegypti is the main vector of resurging diseases in the Americas such as yellow fever and dengue, and recently emerging chikungunya and Zika fever, which have caused unprecedented epidemics in the region. Vector control remains the primary intervention to prevent outbreaks of Aedes-transmitted diseases. In many high-risk regions, like southern Ecuador, we have limited information on IR. In this study, Ae. aegypti IR was measured across four cities in southern Ecuador using phenotypic assays and genetic screening for alleles associated with pyrethroid IR. Bottle bioassays showed significant inter-seasonal variation in resistance to deltamethrin, a pyrethroid commonly used by the Ministry of Health, and alpha-cypermethrin, as well as between-city differences in deltamethrin resistance. There was also a significant difference in phenotypic response to the organophosphate, Malathion, between two cities during the second sampling season. Frequencies of the resistant V1016I genotype ranged from 0.13 to 0.68. Frequencies of the resistant F1534C genotype ranged from 0.63 to 1.0, with sampled populations in Machala and Huaquillas at fixation for the resistant genotype in all sampled seasons. In Machala and Portovelo, there were statistically significant inter-seasonal variation in genotype frequencies for V1016I. Resistance levels were highest in Machala, a city with hyperendemic dengue transmission and historically intense insecticide use. Despite evidence that resistance alleles conferred phenotypic resistance to pyrethroids, there was not a precise correspondence between these indicators. For the F1534C gene, 17.6% of homozygous mutant mosquitoes and 70.8% of heterozygotes were susceptible, while for the V1016I gene, 45.6% homozygous mutants and 55.6% of heterozygotes were susceptible. This study shows spatiotemporal variability in IR in Ae. aegypti populations in southern coastal Ecuador, and provides an initial examination of IR in this region, helping to guide vector control efforts for Ae. aegypti.

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OBJECTIVE: The aim of the study was to determine if evidence-based physiotherapy (EBP) was being applied in the public physiotherapy and physical rehabilitation departments in Ecuador, Zone 3. METHODS: A cross-sectional study was developed applying the "Evidence-Based Practice: Beliefs, Attitudes, Knowledge, and Behaviors of Physical Therapists" questionnaire, designed by Jette et al. and validated in Spanish by Guerra et al. to 67 physiotherapists working in the public service in the provinces of Chimborazo, Cotopaxi, Pastaza, and Tungurahua. RESULTS: Of the physiotherapists, 65.67% fully agree in being necessary to implement EBP in their clinical setting; however, 44.78% identified EBP as highly time demanding. Insufficient time (95.52%), lack of information resources (53.73%), and absence of support among co-workers (50.75%) were reported as the main barriers that prevent physiotherapists from practicing EBP. CONCLUSIONS: Physiotherapists showed a positive attitude and interest towards EBP, although there is unawareness on how to accomplish EBP on daily basis in addition to little specific training during preprofessional studies in relation to scientific research.

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