Assessment of Two Diabetes Point-of-Care Analyzers Measuring Hemoglobin A1c in the Peruvian Amazon

Aims: Measurement of glycated hemoglobin (HbA1c) is an important indicator of glucose control over time. Point-of-care (POC) devices allow for rapid and convenient measurement of HbA1c, greatly facilitating diabetes care. We assessed two POC analyzers in the Peruvian Amazon where laboratory-based HbA1c testing is not available.

Methods: Venous blood samples were collected from 203 individuals from six different Amazonian communities with a wide range of HbA1c, 4.4-9.0% (25-75 mmol/mol). The results of the Afinion AS100 and the DCA Vantage POC analyzers were compared to a central laboratory using the Premier Hb9210 high-performance liquid chromatography (HPLC) method. Imprecision was assessed by performing 14 successive tests of a single blood sample.

Results: The correlation coefficient r for POC and HPLC results was 0.92 for the Afinion and 0.93 for the DCA Vantage. The Afinion generated higher HbA1c results than the HPLC (mean difference = +0.56% [+6 mmol/mol]; p < 0.001), as did the DCA Vantage (mean difference = +0.32% [4 mmol/mol]). The bias observed between POC and HPLC did not vary by HbA1c level for the DCA Vantage (p = 0.190), but it did for the Afinion (p < 0.001). Imprecision results were: CV = 1.75% for the Afinion, CV = 4.01% for the DCA Vantage. Sensitivity was 100% for both devices, specificity was 48.3% for the Afinion and 85.1% for the DCA Vantage, positive predictive value (PPV) was 14.4% for the Afinion and 34.9% for the DCA Vantage, and negative predictive value (NPV) for both devices was 100%. The area under the receiver operating characteristic (ROC) curve was 0.966 for the Afinion and 0.982 for the DCA Vantage. Agreement between HPLC and POC in classifying diabetes and prediabetes status was slight for the Afinion (Kappa = 0.12) and significantly different (McNemar’s statistic = 89; p < 0.001), and moderate for the DCA Vantage (Kappa = 0.45) and significantly different (McNemar’s statistic = 28; p < 0.001).

Conclusions: Despite significant variation of HbA1c results between the Afinion and DCA Vantage analyzers compared to HPLC, we conclude that both analyzers should be considered in health clinics in the Peruvian Amazon for therapeutic adjustments if healthcare workers are aware of the differences relative to testing in a clinical laboratory. However, imprecision and bias were not low enough to recommend either device for screening purposes, and the local prevalence of anemia and malaria may interfere with diagnostic determinations for a substantial portion of the population.

Reproductive state of hunted female mammals during 2000-2015 in Nueva Esperanza, Peruvian Andes

The annual birthrate of female offspring and the intrinsic rate of natural increase (rmax) of populations are key reproductive parameters in models for assessing hunting sustainability or population viability of species. We calculated wild birthrate (pregnancy rate) for ten mammal species, using 180 months (from 2000 to 2015) of reproductive data from 950 hunted female animals collected with the participation of local hunters in the Peruvian Amazon. The methodology assured that no animals were killed outside the hunter's normal activities. The data included shows the reproductive state (pregnant or non-pregnant) of all collected individuals (n=1090), related to the date of collection. Hunters registered required data from genital organs from 950 (87.2%) hunted females, and 140 (12.8%) collected tracts lacked the collection date due to lost or non-legible individual sample codification.

Late-career international migration and reproductive work. A comparison between Peruvian and Ukrainian women in the Southern Europe

Research on the relationship between reproductive work and women´s life trajectories including the experience of labour migration has mainly focused on the case of relatively young mothers who leave behind, or later re-join, their children. While it is true that most women migrate at a younger age, there are a significant number of cases of men and women who move abroad for labour purposes at a more advanced stage, undertaking a late-career migration. This is still an under-estimated and under-researched sub-field that uncovers a varied range of issues, including the global organization of reproductive work and the employment of migrant women as domestic workers late in their lives. By pooling the findings of two qualitative studies, this article focuses on Peruvian and Ukrainian women who seek employment in Spain and Italy when they are well into their forties, or older. A commonality the two groups of women share is that, independently of their level of education and professional experience, more often than not they end up as domestic and care workers. The article initially discusses the reasons for late-career female migration, taking into consideration the structural and personal determinants that have affected Peruvian and Ukrainian women’s careers in their countries of origin and settlement. After this, the focus is set on the characteristics of domestic employment at later life, on the impact on their current lives, including the transnational family organization, and on future labour and retirement prospects. Apart from an evaluation of objective working and living conditions, we discuss women’s personal impressions of being domestic workers in the context of their occupational experiences and family commitments. In this regard, women report varying levels of personal and professional satisfaction, as well as different patterns of continuity-discontinuity in their work and family lives, and of optimism towards the future. Divergences could be, to some extent, explained by the effect of migrants´ transnational social practices and policies of states.

Assessment of toxigenic fungi in poultry feed

Introduction - Feed supplies the necessary nutrients for the growth of healthy animals, which are a part of the human diet. The presence of toxigenic fungi in animal feed such as Aspergillus spp. may contribute to 1) the loss of nutritional value of feedstuff, since fungi will assimilate the most readily available nutrients present in the feed, and 2) the development of mycotoxicoses and chronic conditions, which can raise economic issues due to animal disease and contamination of animal derived products. Aim of the study - The goal of this work was to evaluate the incidence of Aspergilli, particularly from the Circumdati, Flavi and Fumigati sections, through real-time quantitative PCR (qPCR) in 11 feed samples.

Fungi distribution in poultry feed

Feed can easily be contaminated and colonized by fungi that use up the nutrients for their own metabolism and growth, producing secondary metabolites such as mycotoxins that are not eliminated throughout the feed processing. The major problems associated with mycotoxin contaminated animal feed are metabolic disturbances resulting in poor animal productivity. In addition, handling contaminated animal feed can also raise health issues regarding workers exposure to fungi and mycotoxins. The scope of this work was to characterize fungal distribution in 11 poultry feed samples. Twenty grams of feed were suspended in 180 mL of distilled water and homogenized during 20 minutes at 200 rpm. The washed supernatant was plated in malt extract agar (MEA) and dichloran glycerol agar base (DG18) media for morphological identification of the mycobiota present. Using macro- and microscopic analysis of the colonies, fungal contamination was evident in 72.7% of the analyzed poultry feed samples. Fungal load ranged from 0 to 13140 CFU/g, and the most prevalent species/genera were F. graminearum complex (71.1%), Penicillium sp. (11.6%), Cladosporium sp. (8.8%), and Fusarium poae (3.6%). In addition to these species, we also isolated Aspergillus sections Circumdati, Nigri and Aspergilli, and Mucor and Rhizopus genus albeit at a lower abundance. The data obtained showed that, besides high fungal contamination, mycotoxins contamination is probably a reality, particularly in the final product since mycotoxins resist to all the processing operations including thermal treatment. Additionally, data claimed attention for the probable co-exposure to fungi and mycotoxins of the workers in feed industries.

Occupational exposure to Aspergillus spp. in poultry and swine feed production

Workers from feed production often develop allergic respiratory symptoms and fungi are likely to be a significant contributing factor to these symptoms. This study intended to characterize fungal contamination in two feed production units, one for poultry and other for swine consumption. We aimed at identifying which unit presented the highest risk of occupational exposure to Aspergillus spp.

Linear decompositions of cognitive achievement gaps a cautionary note and an illustration using peruvian data

Las brechas de desarrollo entre los niños de diversos fondos socioeconómicos emergen temprano y persisten en un cierto plazo. La formación cognoscitiva de la habilidad es un proceso acumulativo y, así, todas las influencias relevantes que ocurrieron hasta que se mide la habilidad del tiempo pueden desempeñar papel en formar estas brechas. Las descomposiciones lineares basadas en la técnica de la Oaxaca-Blinder son una manera bastante común de estimar la contribución de dos o más categorías de variables a estas diferencias en el logro cognoscitivo. Dos ejemplos prominentes de estas categorías son influencias de la familia y de la escuela. Al respeto, los objetos expuestos de la literatura no tienen ningún consenso en términos de estrategia de la descomposición y la interpretación de sus componentes, tan bien como una tendencia a separar influencias del hogar y de la escuela asignando todas las características observadas de la casa, familia y del niño a la primera categoría. Esto puedo conducir a las implicaciones engañosas de la política y a los diagonales en las contribuciones estimadas de las categorías. Este análisis intenta contribuir a la literatura de dos maneras. Primero, explora formalmente el potencial para los diagonales en los ejercicios de la descomposición procurados hasta ahora. En segundo lugar, ofrece una estrategia alternativa de la descomposición constante con supuestos del comportamiento explícitas con respecto a la determinación de las entradas de la habilidad. Esto previene opciones arbitrarias en términos de técnica de la descomposición, sus componentes e interpretación, y también hace los diagonales menos propensos del análisis. Ilustro de manera empírica los puntos principales del análisis que emplea un dataset que contenga la información longitudinal sobre cuentas de la prueba, familia y características cognoscitivas de la escuela, para descomponer la brecha cognoscitiva de la habilidad observada, en la edad de 8 años entre los niños urbanos y rurales en Perú.

Occupational exposure to Aflatoxin B1 in a Portuguese poultry slaughterhouse

Aflatoxin B1 (AFB1) is a secondary metabolite produced by the fungi Aspergillus flavus and is the most potent hepatocarcinogen known in mammals and has been classified by the International Agency of Research on Cancer as Group 1 carcinogen. Although dietary exposure to AFB1 has been extensively documented, there are still few studies dedicated to the problem of occupational exposure. Considering recent findings regarding AFB1 occupational exposure in poultry production, it was considered relevant to clarify if there is also exposure in poultry slaughterhouses. Occupational exposure assessment to AFB1 was done with a biomarker of internal dose that measures AFB1 in the serum by enzyme-linked immunosorbent assay. Thirty workers from a slaughterhouse were enrolled in this study. A control group (n = 30) was also considered in order to know AFB1 background levels for Portuguese population. Fourteen workers (47.0%) showed detectable levels of AFB1 with values from 1.06 to 4.03ng ml(-1), with a mean value of 1.73ng ml(-1). No AFB1 was detected in serum of individuals used as controls. Despite uncertainties regarding the exposure route that is contributing more to exposure (inhalation or dermal) is possible to state that exposure to AFB1 is occurring in the slaughterhouse studied. It seems that reducing AFB1 contamination in poultry production can have a positive result in this occupational setting.

Comparison of indoor and outdoor fungi and particles in poultry units

A descriptive study was developed in order to compare indoor and outdoor air contamination caused by fungi and particles in seven poultry units. Twenty eight air samples of 25 litters were collected through the impaction method on malt extract agar. Air sampling and particles concentration measurement were done in the interior and also outside premises of the poultries’ pavilions. Regarding the fungal load in the air, indoor concentration of mold was higher than outside air in six poultry units. Twenty eight species / genera of fungi were identified indoor, being Scopulariopsis brevicaulis (40.5%) the most commonly isolated species and Rhizopus sp. (30.0%) the most commonly isolated genus. Concerning outdoor, eighteen species/genera of fungi were isolated, being Scopulariopsis brevicaulis (62.6%) also the most isolated. All the poultry farms analyzed presented indoor fungi different from the ones identified outdoors. Regarding particles’ contamination, PM2.5, PM5.0 and PM10 had a statistically significant difference (Mann-Whitney U test) between the inside and outside of the pavilions, with the inside more contaminated (p=.006; p=.005; p=.005, respectively). The analyzed poultry units are potential reservoirs of substantial amounts of fungi and particles and could therefore free them in the atmospheric air. The developed study showed that indoor air was more contaminated than outdoors, and this can result in emission of potentially pathogenic fungi and particles via aerosols from poultry units to the environment, which may post a considerable risk to public health and contribute to environmental pollution.

Effect of poultry viscera meal inclusion in broiler diets in different rearing periods on performance, carcass and parts yields

The objective of the present study was to evaluate the effect of the dietary inclusion of poultry viscera meal (VM) on broiler performance and carcass, parts, and abdominal fat yields in broilers by replacing a diet containing VM with a strictly vegetable diet and vice-versa. A number of 720 one-day-old broiler chicks were randomly distributed in 6 groups: G1-basal diet (BD) - corn and soybean based meal, with no VM from 1 to 42 days of age, G2- 8% VM diet from 1 to 42 days, G3- BD from 1 to 21 and 8% VM diet from 22 to 42 days, G4- BD from 1 to 35 and 8% VM diet from 36 to 42 days, G5- 8% VM diet from 1 to 21 days and BD from 22 to 42 days, G6- 8% VM diet from 1 to 35 and BD from 36 to 42 days. Average body weight, weight gain, feed intake, feed conversion ratio (FCR), production efficiency index, and mortality were determined from 1 to 42 days. There was no effect of treatments on performance or mortality, except for FCR, which was significantly better in the group fed VM from 1 to 35 days and withdrawn at the end of rearing (36-42 days). Also, there were no differences in carcass, parts, and abdominal fat yields, showing that VM in broiler diets does not influence yield parameters.