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Original article
Human papillomavirus detection in Corrientes, Argentina: High prevalence of type 58 and its phylodynamics
Detección del virus del papiloma humano en Corrientes, Argentina: alta prevalencia de genotipo 58 y su filodinámica
Héctor M. Marína, Carolina Torresb,c, Gerardo D. Delucab, Viviana A. Mbayedb,c,
Corresponding author
vmbayed@ffyb.uba.ar

Corresponding author.
a Instituto de Medicina Regional, Universidad Nacional del Nordeste, Av Las Heras 727, Resistencia 3500, Chaco, Argentina
b Cátedra de Virología, Facultad de Farmacia y Bioquímica, Universidad de Buenos Aires, Junín 956, 4° piso, Ciudad Autónoma de Buenos Aires 1113, Argentina
c CONICET, Av. Rivadavia 1917, Ciudad Autónoma de Buenos Aires 1033, Argentina
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HPV-16 predominates&#44; whereas the prevalence of other HPV types varies according to the geographic region<a class="elsevierStyleCrossRef" href="#bib0295"><span class="elsevierStyleSup">5</span></a>&#46; It has been reported that about 70<span class="elsevierStyleHsp" style=""></span>&#37; of cervical cancers worldwide are due to HPV-16 and -18<a class="elsevierStyleCrossRefs" href="#bib0370"><span class="elsevierStyleSup">20&#44;32</span></a>&#44; which are the goals of commercial vaccines&#46; However&#44; there are still other prevalent high-risk HPV types&#44; such as HPV-31&#44; -33&#44; -45 and -58<a class="elsevierStyleCrossRef" href="#bib0535"><span class="elsevierStyleSup">53</span></a>&#46; In some provinces of Argentina &#40;Chaco&#44; Corrientes&#44; C&#243;rdoba and Misiones&#41;&#44; an important detection of HPV-33 and HPV-58 has been reported<a class="elsevierStyleCrossRefs" href="#bib0280"><span class="elsevierStyleSup">2&#44;17&#44;22&#44;23&#44;51</span></a>&#46;</p><p id="par0015" class="elsevierStylePara elsevierViewall">Although there have been several studies on the genetic diversity and phylogenetics of HPV<a class="elsevierStyleCrossRefs" href="#bib0290"><span class="elsevierStyleSup">4&#44;14&#44;19&#44;21&#44;42</span></a>&#44; most of them focused on the characterization of HPV-16 and HPV-18 variants and their associations with pathogenic potential and immunogenicity<a class="elsevierStyleCrossRefs" href="#bib0360"><span class="elsevierStyleSup">18&#44;19</span></a>&#46;</p><p id="par0020" class="elsevierStylePara elsevierViewall">Within HPV-58&#44; several authors have identified four distinct clusters &#40;A&#44; B&#44; C and D&#41;&#44; being lineage A the most prevalent worldwide<a class="elsevierStyleCrossRefs" href="#bib0340"><span class="elsevierStyleSup">14&#44;19</span></a>&#46; Reports about the important detections of this high-risk type in regions of Argentina such as the Northeast<a class="elsevierStyleCrossRefs" href="#bib0380"><span class="elsevierStyleSup">22&#44;23&#44;25</span></a>&#44; which has the highest mortality rates due to cervical cancer<a class="elsevierStyleCrossRef" href="#bib0275"><span class="elsevierStyleSup">1</span></a>&#44; require a deeper characterization of viruses of HPV-58&#46;</p><p id="par0025" class="elsevierStylePara elsevierViewall">The aim of this work was to study HPV sequences from the Province of Corrientes&#44; Argentina&#44; especially those belonging to HPV-58&#46; We attempted to characterize the viruses from samples taken from different cervical lesions&#44; their nucleotide changes&#44; phylogenetic relationships and the evolutionary dynamics of HPV-58 in the context of the alpha-9 papillomavirus species&#46;</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0030">Materials and methods</span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0035">Patients</span><p id="par0030" class="elsevierStylePara elsevierViewall">Samples belonged to sexually active women who attended the Services of Gynecology and Obstetrics at hospitals &#8220;Angela Iglesia Llano&#8221; and &#8220;Jos&#233; Ram&#243;n Vidal&#8221; in the city of Corrientes&#44; Province of Corrientes&#44; Argentina&#44; during 2005&#8211;2007 &#40;<span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>255&#41;&#44; and who had colposcopic or cytohistologic findings suggestive of HPV infection &#40;according to the Bethesda System 2001&#41;&#46; Epidemiological data were collected through a standardized questionnaire&#46;</p><p id="par0035" class="elsevierStylePara elsevierViewall">All patients included in this study signed a written informed consent and the study was approved by the Ethics Committee of the Instituto de Medicina Regional of the Universidad Nacional del Nordeste&#44; Corrientes&#44; Argentina &#40;Resolution No&#46;&#58; 435&#47;05&#41;&#46;</p></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0040">Sample collection&#44; HPV detection and typing</span><p id="par0040" class="elsevierStylePara elsevierViewall">Ecto- and endocervical samples were obtained and DNA was extracted by the digestion method with cetyltrimethyl ammonium bromide &#40;CTAB&#41; and purification with isoamyl alcohol &#40;24&#58;1&#41;&#46; DNA quality was evaluated by PCR targeted to 268 base pairs &#40;bp&#41; of the human beta-globin gene using primers GH20 &#40;5&#8242;-GAAGAGCCAAGGACAGGTAC-3&#8242;&#41; and PG04 &#40;5&#8242;-CAACTTCATCCACGTTCACC-3&#8242;&#41; under conditions previously described<a class="elsevierStyleCrossRef" href="#bib0445"><span class="elsevierStyleSup">35</span></a>&#46; Negative samples for this test were discarded&#46; Viral DNA was detected by PCR using consensus primers MY09&#47;11<a class="elsevierStyleCrossRef" href="#bib0445"><span class="elsevierStyleSup">35</span></a>&#46; Positive samples were typed by RFLP analysis&#44; as previously described<a class="elsevierStyleCrossRefs" href="#bib0285"><span class="elsevierStyleSup">3&#44;40</span></a>&#46;</p></span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0045">E6&#47;E7 gene amplification and sequencing</span><p id="par0045" class="elsevierStylePara elsevierViewall">Seventeen samples typified as HPV-58 were amplified and sequenced in the E6 &#40;nt&#46; 110&#8211;559&#41; and E7 &#40;nt&#46; 574&#8211;870&#41; genes&#46; They were amplified by PCR using primers E6-P1&#47;E6-P2 and E7-P1&#47;E7-P2 as previously described<a class="elsevierStyleCrossRef" href="#bib0330"><span class="elsevierStyleSup">12</span></a>&#46; Amplicons were purified using the Wizard SV gel and PCR Clean-up System extraction kits &#40;Promega Corporation&#44; USA&#41; and sequenced in both directions &#40;3500xl Genetic Analyzer&#44; Applied Biosystems&#41;&#46;</p></span><span id="sec0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0050">Statistical analysis</span><p id="par0050" class="elsevierStylePara elsevierViewall">Statistical associations were evaluated with the chi-square test using the Epi-Info v3&#46;5&#46;1 program<a class="elsevierStyleCrossRef" href="#bib0310"><span class="elsevierStyleSup">8</span></a>&#46; Logistic regression analyses were used to determine the odd ratios for HPV detection or high-risk HPV detection according to the cytological status of infections&#44; using the Infostat v2004 program<a class="elsevierStyleCrossRef" href="#bib0400"><span class="elsevierStyleSup">26</span></a>&#46; <span class="elsevierStyleItalic">p</span>-values<span class="elsevierStyleHsp" style=""></span>&#8804;<span class="elsevierStyleHsp" style=""></span>0&#46;05 were considered significant&#46;</p></span><span id="sec0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0055">Mutations and phylogenetic analysis of HPV-58</span><p id="par0055" class="elsevierStylePara elsevierViewall">Sequences from this work &#40;<span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>17&#41; were aligned with ClustalX v2&#46;1 and edited with Bioedit v7&#46;0&#46; Mutations in the E6 and E7 genes were determined by comparison with the prototype genome of HPV-58 &#40;GenBank accession number&#58; <a id="intr0010" class="elsevierStyleInterRef" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=search&db=nucleotide&doptcmdl=genbank&term=NC_001443">NC&#95;001443</a>&#41;&#46;</p><p id="par0060" class="elsevierStylePara elsevierViewall">To classify sequences into HPV-58 lineages&#44; a Bayesian phylogenetic analysis was performed using E6 and E7 concatenated sequences&#46; Analysis was performed using an appropriate substitution model estimated with the jModeltest v2&#46;1 software&#44; the uncorrelated lognormal &#40;UCLN&#41; molecular clock model and a Bayesian Skyline Plot model implemented in BEAST v1&#46;8&#46; The Maximum Clade Credibility Tree &#40;MCCT&#41; was obtained using TreeAnnotator v1&#46;8 from the BEAST package&#46;</p></span><span id="sec0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0060">Phylodynamic analyses</span><p id="par0065" class="elsevierStylePara elsevierViewall">The phylodynamic patterns of the HPV type 58 and the alpha-9 species group of the genus <span class="elsevierStyleItalic">Alphapapillomavirus</span> &#40;HPV types 16&#44; 31&#44; 33&#44; 35&#44; 52&#44; 58 and 67&#41; were studied using a Bayesian coalescent analysis&#46; Estimations included the demographic reconstruction and the time to the most recent common ancestors &#40;tMRCAs&#41; for the different groups&#46;</p><p id="par0070" class="elsevierStylePara elsevierViewall">Datasets included sequences from all groups of each type &#40;dataset HPV-58&#58; 154 sequences&#59; dataset HPV-Alpha-9&#58; 221 sequences&#41; &#40;available upon request&#41;&#46; Analyses were performed on the E6 and E7 genes&#44; using an appropriate substitution model and calibration for each gene&#46; Analyses were carried out using the UCLN molecular clock model and the Skygrid model implemented in BEAST v1&#46;8&#46; A substitution rate of 1&#46;0<span class="elsevierStyleHsp" style=""></span>&#215;<span class="elsevierStyleHsp" style=""></span>10<span class="elsevierStyleSup">&#8722;7</span><span class="elsevierStyleHsp" style=""></span>substitutions per site per year &#40;s&#47;s&#47;y&#41;<a class="elsevierStyleCrossRef" href="#bib0415"><span class="elsevierStyleSup">29</span></a> or previously proposed substitution rates for the E6 and E7 genes &#40;2&#46;39<span class="elsevierStyleHsp" style=""></span>&#215;<span class="elsevierStyleHsp" style=""></span>10<span class="elsevierStyleSup">&#8722;8</span> and 1&#46;44<span class="elsevierStyleHsp" style=""></span>&#215;<span class="elsevierStyleHsp" style=""></span>10<span class="elsevierStyleSup">&#8722;8</span><span class="elsevierStyleHsp" style=""></span>&#40;s&#47;s&#47;y&#41;&#44; respectively&#41; were used for calibration<a class="elsevierStyleCrossRef" href="#bib0475"><span class="elsevierStyleSup">41</span></a>&#46; The uncertainty in parameter estimates was evaluated in the 95<span class="elsevierStyleHsp" style=""></span>&#37; highest posterior density &#40;HPD95<span class="elsevierStyleHsp" style=""></span>&#37;&#41; interval&#46;</p></span><span id="sec0045" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0065">GenBank accession numbers</span><p id="par0075" class="elsevierStylePara elsevierViewall">Sequences reported in this work have been deposited in GenBank under accession numbers KP161621 and KP161654&#46;</p></span></span><span id="sec0050" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0070">Results</span><span id="sec0055" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0075">HPV detection and typing</span><p id="par0080" class="elsevierStylePara elsevierViewall">A total of 255 samples belonging to women with a median age of 29 years &#40;range<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>15&#8211;62&#41; and mode of 25 years &#40;confidence interval 95<span class="elsevierStyleHsp" style=""></span>&#37;<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>16&#8211;34&#41; were collected for this study&#46; These samples were classified as having reactive cellular changes caused by inflammation &#40;RCC&#59; <span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>63&#44; 24&#46;7<span class="elsevierStyleHsp" style=""></span>&#37;&#41;&#44; atypical squamous cells of undetermined significance &#40;ASCUS&#59; <span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>11&#44; 4&#46;3<span class="elsevierStyleHsp" style=""></span>&#37;&#41;&#44; low-grade squamous intraepithelial lesions &#40;LSIL&#59; <span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>152&#44; 59&#46;6<span class="elsevierStyleHsp" style=""></span>&#37;&#41;&#44; high-grade squamous intraepithelial lesions &#40;HSIL&#59; <span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>18&#44; 7&#46;1<span class="elsevierStyleHsp" style=""></span>&#37;&#41; and cervical cancer &#40;<span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>11&#44; 4&#46;3<span class="elsevierStyleHsp" style=""></span>&#37;&#41;&#46;</p><p id="par0085" class="elsevierStylePara elsevierViewall">HPV DNA was detected in 56&#46;1<span class="elsevierStyleHsp" style=""></span>&#37; of the cervical lesions &#40;143&#47;255&#41;&#46; An increased severity of the cytological status was associated with a greater rate of HPV detection and especially&#44; with a greater rate of high-risk HPV types detection &#40;<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#46;01&#41; &#40;<a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a>&#41;&#46;</p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia><p id="par0090" class="elsevierStylePara elsevierViewall">Twenty-two different HPV types were detected&#46; The decreasing order of the main types detected&#44; including their presence in multiple infections&#44; were HPV-16&#44; -58&#44; -53&#44; -31&#44; -6 and -18 &#40;<a class="elsevierStyleCrossRef" href="#tbl0010">Table 2</a>&#41;&#46; Multiple infections were detected in 8 samples &#40;3&#46;1<span class="elsevierStyleHsp" style=""></span>&#37;&#41;&#46; The frequency of the current vaccine viral types &#40;-16&#44; -18&#44; -6&#44; -11&#41; was 44&#46;8<span class="elsevierStyleHsp" style=""></span>&#37;&#44; while the high-risk and probable high-risk HPV types not included in the vaccine reached 33&#46;6<span class="elsevierStyleHsp" style=""></span>&#37;&#46;</p><elsevierMultimedia ident="tbl0010"></elsevierMultimedia><p id="par0095" class="elsevierStylePara elsevierViewall">The most prevalent types -16 and -58 represented 21&#46;4 and 14&#46;3<span class="elsevierStyleHsp" style=""></span>&#37; of the LSIL cases in which HPV was detected&#44; respectively&#46; HPV-58 predominated among the HSIL cases with HPV detection&#44; reaching 37&#46;5<span class="elsevierStyleHsp" style=""></span>&#37;&#44; followed by HPV-16 in the 33&#46;3<span class="elsevierStyleHsp" style=""></span>&#37;&#46; In contrast&#44; HPV-58 was not detected among cervical cancers&#44; while HPV-16 was present in 80<span class="elsevierStyleHsp" style=""></span>&#37; of them&#46;</p><p id="par0100" class="elsevierStylePara elsevierViewall">HPV DNA was not found in 43&#46;9<span class="elsevierStyleHsp" style=""></span>&#37; of samples&#44; possibly owing to low viral load or sample degradation&#44; while indeterminate cases &#40;<span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>3&#41; presented an electrophoretic RFLP pattern that did not match any of the patterns currently taken as reference&#44; according to Bernard <span class="elsevierStyleItalic">et al</span><a class="elsevierStyleCrossRef" href="#bib0285"><span class="elsevierStyleSup">3</span></a>&#46;</p></span><span id="sec0060" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0080">Analysis of mutations in HPV-58</span><p id="par0105" class="elsevierStylePara elsevierViewall">A deeper molecular characterization of the HPV-58&#44; the second most prevalent type in this study&#44; was performed to analyze changes with respect to the prototype virus and to look for mutations previously associated with cervical lesions&#46; Seventeen samples from women &#40;22&#8211;33 years&#41; with viruses typed as HPV-58 were sequenced along the E6 and E7 genes&#46;</p><p id="par0110" class="elsevierStylePara elsevierViewall">The results showed substitutions in two nucleotide positions in the 450<span class="elsevierStyleHsp" style=""></span>bp of the E6 gene &#40;0&#46;4<span class="elsevierStyleHsp" style=""></span>&#37;&#41; and 11 in the 297<span class="elsevierStyleHsp" style=""></span>bp of the E7 gene &#40;3&#46;7<span class="elsevierStyleHsp" style=""></span>&#37;&#41;&#46; The genomes grouped into nine different variants named COR1 to COR9&#44; according to the substitution patterns&#44; compared with the prototype virus &#40;<a class="elsevierStyleCrossRef" href="#tbl0015">Table 3</a>&#41;&#46; Amino acid changes were observed only in the deduced E7 protein sequence&#46;</p><elsevierMultimedia ident="tbl0015"></elsevierMultimedia><p id="par0115" class="elsevierStylePara elsevierViewall">The most frequent mutations were C307T &#40;E6 gene&#44; in 90<span class="elsevierStyleHsp" style=""></span>&#37; of the samples&#41; and G694A &#40;G41R&#41;&#44; T744G&#44; and A761G &#40;G63D&#41;&#44; found in 100<span class="elsevierStyleHsp" style=""></span>&#37; of the E7 sequences&#46; Other seven mutations &#40;A542C in the E6 gene and G634C&#44; G686A&#44; G691A&#44; C767A&#44; G859A&#44; A866C in the E7 gene&#41; were also found&#59; however&#44; their oncogenic potential has not been described or evaluated yet&#46;</p></span><span id="sec0065" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0085">Phylogenetic and phylodynamic analyses</span><p id="par0120" class="elsevierStylePara elsevierViewall">The phylogenetic analysis showed that samples from Corrientes city belonged to lineage A&#44; sublineage 2 &#40;A2&#41;&#44; according to the proposed intratypic taxonomy of HPV-58<a class="elsevierStyleCrossRefs" href="#bib0340"><span class="elsevierStyleSup">14&#44;19</span></a>&#46; Moreover&#44; sequences from Corrientes were intermingled with sequences from all around the world&#58; China&#44; Japan&#44; Taiwan&#44; the USA&#44; Scotland and Costa Rica &#40;<a class="elsevierStyleCrossRef" href="#fig0005">Fig&#46; 1</a>&#41;&#46;</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><p id="par0125" class="elsevierStylePara elsevierViewall">Two substitution rates were used for calibrating the analyses of evolutionary dynamics of the alpha-9 species group and the HPV-58&#46; These alternative hypotheses estimated that the tMRCA for the alpha-9 group originated 20&#46;5 million years &#40;My&#41; ago &#40;HPD95<span class="elsevierStyleHsp" style=""></span>&#37;<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>16&#46;3&#8211;25&#46;8<span class="elsevierStyleHsp" style=""></span>My&#41; or 3&#46;7<span class="elsevierStyleHsp" style=""></span>My &#40;HPD95<span class="elsevierStyleHsp" style=""></span>&#37;<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>3&#46;0&#8211;4&#46;7<span class="elsevierStyleHsp" style=""></span>My&#41; for the slowest and the fastest substitution rates&#44; respectively&#44; whereas&#44; the split up of HPV-58 and its closest cluster&#44; type HPV-33&#44; was dated 8&#46;5<span class="elsevierStyleHsp" style=""></span>My ago &#40;HPD95<span class="elsevierStyleHsp" style=""></span>&#37;<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>5&#46;4&#8211;11&#46;5<span class="elsevierStyleHsp" style=""></span>My&#41; or 1&#46;5<span class="elsevierStyleHsp" style=""></span>My ago &#40;HPD95<span class="elsevierStyleHsp" style=""></span>&#37;<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>1&#46;0&#8211;2&#46;1<span class="elsevierStyleHsp" style=""></span>My&#41;&#46; Moreover&#44; type 16 resulted as the most ancient type &#40;&#8764;0&#46;8 or 0&#46;15<span class="elsevierStyleHsp" style=""></span>My&#41;&#44; followed by types 58&#44; 33 and 52 &#40;&#8764;0&#46;6 or &#8764;0&#46;11<span class="elsevierStyleHsp" style=""></span>My&#41; &#40;<a class="elsevierStyleCrossRef" href="#fig0010">Fig&#46; 2</a>a&#41;&#46;</p><elsevierMultimedia ident="fig0010"></elsevierMultimedia><p id="par0130" class="elsevierStylePara elsevierViewall">A deeper analysis on type HPV-58 indicated that its diversification might have started &#8764;0&#46;54 or 0&#46;11<span class="elsevierStyleHsp" style=""></span>My years ago&#44; while the tMRCA for lineage A was estimated &#8764;300&#44;000 or &#8764;65&#44;800 years ago &#40;<a class="elsevierStyleCrossRef" href="#fig0010">Fig&#46; 2</a>b&#41;&#46; Finally&#44; diversification of main groups within the lineage A &#40;sublineages A1&#8211;A3&#41; might have started &#8764;70&#44;000&#8211;200&#44;000 or &#8764;23&#44;900&#8211;41&#44;000 years ago &#40;<a class="elsevierStyleCrossRef" href="#fig0010">Fig&#46; 2</a>b&#41;&#46;</p></span></span><span id="sec0070" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0090">Discussion</span><p id="par0135" class="elsevierStylePara elsevierViewall">HPV is an important cofactor for cervical neoplasia&#44; and in Argentina it is the most frequent neoplasia &#40;20&#46;9&#47;100&#44;000 women&#41; after mammary cancer &#40;71&#46;2&#47;100&#44;000 women&#41;<a class="elsevierStyleCrossRef" href="#bib0435"><span class="elsevierStyleSup">33</span></a>&#46; Provinces in the North and Northeastern regions of the country exhibit the highest rates for cervical cancer mortality<a class="elsevierStyleCrossRef" href="#bib0275"><span class="elsevierStyleSup">1</span></a>&#44; e&#46;g&#46; the Province of Corrientes shows a mortality rate due to cervical cancer of 14&#47;100&#44;000 women&#44; which is three-fold higher than the rate for Buenos Aires&#44; the Capital city of the country&#44; and even exceeds the value of the mortality rate due to mammary cancer estimated by screening studies in Corrientes<a class="elsevierStyleCrossRefs" href="#bib0275"><span class="elsevierStyleSup">1&#44;36</span></a>&#46;</p><p id="par0140" class="elsevierStylePara elsevierViewall">The population under study gathered women with a low socioeconomic status&#44; who are particularly vulnerable to this disease due to reduced access to prevention and control programs&#46;</p><p id="par0145" class="elsevierStylePara elsevierViewall">Despite the studies performed in this region&#44; the number of reported cases is still scarce to evaluate the role of high-risk types<a class="elsevierStyleCrossRefs" href="#bib0280"><span class="elsevierStyleSup">2&#44;22&#8211;24&#44;47&#44;48</span></a>&#46; However&#44; it should be noted that we found a high diversity of oncogenic types&#44; with an increased proportion of high-risk and probable high-risk types not included in the current vaccines&#46; This is of concern since there are reports suggesting a limited cross-protection of the vaccines against non vaccine types<a class="elsevierStyleCrossRefs" href="#bib0485"><span class="elsevierStyleSup">43&#44;50&#44;53</span></a>&#46; Therefore&#44; it is necessary to strengthen the monitoring of regional circulation of these types in cases of intraepithelial lesions&#44; contributing to impact assessment of current vaccines against HPV<a class="elsevierStyleCrossRef" href="#bib0540"><span class="elsevierStyleSup">54</span></a>&#46;</p><p id="par0150" class="elsevierStylePara elsevierViewall">The description of the molecular epidemiology of HPV before the vaccine introduction in 2011 will lead to a better description of the dynamics of the circulation of different genotypes and their variants and also to a better understanding of the relationship between HPV types and cancer in our country&#44; which is useful information for the evaluation of new vaccine formulations&#46; Further studies in post-vaccinal stages will allow to evaluate the dynamics of high-risk HPV types and cross protection among different types<a class="elsevierStyleCrossRefs" href="#bib0320"><span class="elsevierStyleSup">10&#44;54</span></a>&#46; It is worth noting that HPV-58 is included in the nonavalent vaccine V503 formulation&#44; which is still under evaluation<a class="elsevierStyleCrossRef" href="#bib0350"><span class="elsevierStyleSup">16</span></a>&#46;</p><p id="par0155" class="elsevierStylePara elsevierViewall">The most frequently found type in Corrientes was HPV-16&#44; as also observed all around the world in populations both with normal cytology and cervical abnormalities<a class="elsevierStyleCrossRefs" href="#bib0295"><span class="elsevierStyleSup">5&#44;9&#44;34&#44;46</span></a>&#46; However&#44; the secondary types vary depending on the geographic region under study&#46; In this work&#44; the most important secondary type was HPV-58&#44; as also observed in other studies in the cities of Corrientes and Resistencia<a class="elsevierStyleCrossRefs" href="#bib0380"><span class="elsevierStyleSup">22&#44;23</span></a>&#46; This result differs from the reference meta-analysis conducted by Bruni <span class="elsevierStyleItalic">et al&#46;</span><a class="elsevierStyleCrossRef" href="#bib0295"><span class="elsevierStyleSup">5</span></a> on samples with normal cytology&#44; which showed that HPV-18 was the most important secondary type both globally and in Latin America and the Caribbean&#46; In different regions of the world&#44; and even in other regions of Argentina<a class="elsevierStyleCrossRefs" href="#bib0450"><span class="elsevierStyleSup">36&#44;39&#44;45</span></a>&#44; HPV-58 was found to have low frequency &#40;&#60;2<span class="elsevierStyleHsp" style=""></span>&#37;&#41; when samples with different grade of lesions were considered<a class="elsevierStyleCrossRefs" href="#bib0315"><span class="elsevierStyleSup">9&#44;34&#44;46</span></a>&#46; However&#44; HPV-58 displays a high prevalence in specific regions of the world&#44; especially in Northeast Asia &#40;4&#8211;15<span class="elsevierStyleHsp" style=""></span>&#37;&#41;&#44; Mexico &#40;24&#8211;28<span class="elsevierStyleHsp" style=""></span>&#37;&#41;&#44; Costa Rica &#40;12<span class="elsevierStyleHsp" style=""></span>&#37;&#41; and Brazil &#40;12&#8211;14<span class="elsevierStyleHsp" style=""></span>&#37;&#41;<a class="elsevierStyleCrossRefs" href="#bib0305"><span class="elsevierStyleSup">7&#44;11&#44;28&#44;30&#44;38&#44;52</span></a>&#46;</p><p id="par0160" class="elsevierStylePara elsevierViewall">Four different lineages &#40;A&#8211;D&#41; have been identified within HPV-58<a class="elsevierStyleCrossRefs" href="#bib0340"><span class="elsevierStyleSup">14&#44;19</span></a>&#46; All the viruses reported in this work belonged to lineage A&#44; sublineage A2&#44; which is the most prevalent in the Americas<a class="elsevierStyleCrossRef" href="#bib0340"><span class="elsevierStyleSup">14</span></a>&#59; none of them belonged to lineage D&#44; which was previously reported in some samples from Argentina<a class="elsevierStyleCrossRef" href="#bib0340"><span class="elsevierStyleSup">14</span></a>&#46;</p><p id="par0165" class="elsevierStylePara elsevierViewall">HPV-58 is considered a high-risk viral type&#46; However&#44; its disease impact shows geographic variation&#44; since cervical cancer and HSIL are more prevalent in Asian women with HPV-58 than in women from other regions<a class="elsevierStyleCrossRef" href="#bib0500"><span class="elsevierStyleSup">46</span></a>&#46;</p><p id="par0170" class="elsevierStylePara elsevierViewall">The association between pathogenicity and geographic location could be a consequence of specific genetic backgrounds of the host populations but it could also be related to a differential geographic distribution of distinct HPV variants&#46; For other types it has been proposed that different variant lineages might display different pathogenic potentials<a class="elsevierStyleCrossRefs" href="#bib0425"><span class="elsevierStyleSup">31&#44;44</span></a>&#46; In line with this fact&#44; subgroups within lineage A of HPV-58&#44; which display a differential distribution worldwide&#44; could be related to different clinical progression&#46;</p><p id="par0175" class="elsevierStylePara elsevierViewall">Chan <span class="elsevierStyleItalic">et al&#46;</span><a class="elsevierStyleCrossRef" href="#bib0340"><span class="elsevierStyleSup">14</span></a> proposed to further investigate the possible association of oncogenicity with sublineage A1 of HPV-58 in Asia&#46; Indeed&#44; some mutations in the E7 gene showed a trend of association with the severity of the neoplasia<a class="elsevierStyleCrossRef" href="#bib0330"><span class="elsevierStyleSup">12</span></a>&#46; In our work&#44; we found no association between high pathogenicity and HPV-58 infections&#44; neither with the mutations reported as involved in this phenotype&#59; however&#44; it should be noted that only sublineage A2 was detected and that the samples belonged to women under 35 years old&#44; and therefore not included in the age range &#40;35&#8211;64 years old&#41; strongly associated with progression to cervical cancer<a class="elsevierStyleCrossRef" href="#bib0430"><span class="elsevierStyleSup">32</span></a>&#46;</p><p id="par0180" class="elsevierStylePara elsevierViewall">The analysis of genome sequences showed that E7 mutations &#40;the only ones rendering amino acid changes&#41; were more frequent than E6 mutations&#46; Neither mutations previously associated with the severity of neoplasia<a class="elsevierStyleCrossRefs" href="#bib0330"><span class="elsevierStyleSup">12&#44;15&#44;27</span></a>&#44; nor cervical cancer associated to HPV-58 were found&#46; However&#44; other mutations not reported previously &#40;such as C767A &#91;T65K&#93; and G859A &#91;A96T&#93;&#41; were found among the samples and deserve further attention given that they localize in a highly reactive epitope among patients with cervical cancer<a class="elsevierStyleCrossRef" href="#bib0335"><span class="elsevierStyleSup">13</span></a>&#46; Additional studies in the E6 protein assessing the presence of mutations in the protein binding motifs PDZ might help to study their impact on the low oncogenicity of HPV-58 in this population<a class="elsevierStyleCrossRef" href="#bib0515"><span class="elsevierStyleSup">49</span></a>&#46;</p><p id="par0185" class="elsevierStylePara elsevierViewall">The evolutionary dynamics of the alpha-9 species group and particularly&#44; of type HPV-58 was analyzed&#46; The alpha-9 species separated into two highly supported groups&#44; one formed by types 16&#44; 31&#44; 35 and&#44; the other&#44; by types 33&#44; 52&#44; 58&#44; 67&#46;</p><p id="par0190" class="elsevierStylePara elsevierViewall">Different substitutions rates &#8211; needed for phylodynamic analysis calibration &#8211; have been proposed for papillomaviruses&#44; such as 1&#46;0<span class="elsevierStyleHsp" style=""></span>&#215;<span class="elsevierStyleHsp" style=""></span>10<span class="elsevierStyleSup">&#8722;7</span><span class="elsevierStyleHsp" style=""></span>s&#47;s&#47;y &#40;originally proposed for the L1 gene of mucosal HPV&#41;<a class="elsevierStyleCrossRef" href="#bib0415"><span class="elsevierStyleSup">29</span></a>&#44; 2&#46;4<span class="elsevierStyleHsp" style=""></span>&#215;<span class="elsevierStyleHsp" style=""></span>10<span class="elsevierStyleSup">&#8722;8</span> and 1&#46;4<span class="elsevierStyleHsp" style=""></span>&#215;<span class="elsevierStyleHsp" style=""></span>10<span class="elsevierStyleSup">&#8722;8</span><span class="elsevierStyleHsp" style=""></span>s&#47;s&#47;y &#40;from the <span class="elsevierStyleItalic">Feline papillomavirus</span> &#40;FPV&#41; for E6 and E7 genes&#44; respectively&#41;<a class="elsevierStyleCrossRef" href="#bib0475"><span class="elsevierStyleSup">41</span></a>&#46; The use of these rates resulted in different diversification times of the viral types that belong to the alpha-9 species group&#44; including HPV-58&#46; For instance&#44; at type level&#44; the tMRCA of HPV-16&#44; -33&#44; -52 and -58 showed ancestral times within the last million years &#40;&#8764;0&#46;6 to &#8764;0&#46;8<span class="elsevierStyleHsp" style=""></span>My&#41; using the substitution rates proposed by Rector <span class="elsevierStyleItalic">et al&#46;</span> or about 0&#46;10&#8211;0&#46;15<span class="elsevierStyleHsp" style=""></span>My using those proposed by Halpern&#46; Particularly&#44; lineage A within HPV-58 would have diversified &#8764;65&#44;800 or &#8764;300&#44;000 years ago &#40;depending on the calibration used&#41;&#44; and the common ancestor of sublineages A1&#8211;A3 could have been dated &#8764;40&#44;000 or &#8764;200&#44;000 years ago&#44; suggesting that their dispersion &#8211; even using the fastest substitution rate &#8211; accompanied or preceded human migration across the globe<a class="elsevierStyleCrossRef" href="#bib0300"><span class="elsevierStyleSup">6</span></a>&#46;</p><p id="par0195" class="elsevierStylePara elsevierViewall">This hypothesis could explain the worldwide distribution of sublineage A2&#44; whereas other factors might be involved in the emergence and dispersion of the others groups&#44; as previously proposed<a class="elsevierStyleCrossRef" href="#bib0360"><span class="elsevierStyleSup">18</span></a>&#46; Is it worth noting that none of the substitutions rates used to calibrate are proposed for the E6 or E7 genes in HPV&#44; thus these estimations should be taken with caution&#46;</p><p id="par0200" class="elsevierStylePara elsevierViewall">Summarizing&#44; this study describes the molecular epidemiology of HPV in a region of Argentina with a high rate for cervical cancer mortality&#46; The secondary type was HPV-58 &#40;after HPV-16&#41;&#44; sublineage A2&#46; Although we found no association between this type and high pathogenicity&#44; there are still some concerns about the extent of cross protection of the vaccines against the types not included in their design&#46; In addition&#44; we described genomic variants of HPV-58 and characterized the ancient origin of this type and its diversification&#44; in the context of the alpha-9 papillomavirus species phylodynamics&#46;</p></span><span id="sec0075" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0095">Ethical disclosures</span><span id="sec0080" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0100">Protection of human and animal subjects</span><p id="par0205" class="elsevierStylePara elsevierViewall">The authors declare that no experiments were performed on humans or animals for this investigation&#46;</p></span><span id="sec0085" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0105">Confidentiality of data</span><p id="par0210" class="elsevierStylePara elsevierViewall">The authors declare that no patient data appear in this article&#46;</p></span><span id="sec0090" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0110">Right to privacy and informed consent</span><p id="par0215" class="elsevierStylePara elsevierViewall">The authors must have obtained the informed consent of the patients and&#47;or subjects mentioned in the article&#46; The author for correspondence must be in possession of this document&#46;</p></span></span><span id="sec0095" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0115">Conflict of interest</span><p id="par0220" class="elsevierStylePara elsevierViewall">The authors declare that they have no conflicts of interest&#46;</p></span></span>"
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        4 => array:2 [
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          "titulo" => "Introduction"
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        5 => array:3 [
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          "titulo" => "Materials and methods"
          "secciones" => array:7 [
            0 => array:2 [
              "identificador" => "sec0015"
              "titulo" => "Patients"
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            1 => array:2 [
              "identificador" => "sec0020"
              "titulo" => "Sample collection&#44; HPV detection and typing"
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            2 => array:2 [
              "identificador" => "sec0025"
              "titulo" => "E6&#47;E7 gene amplification and sequencing"
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            3 => array:2 [
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              "titulo" => "Statistical analysis"
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              "titulo" => "Mutations and phylogenetic analysis of HPV-58"
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        6 => array:3 [
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          "titulo" => "Results"
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              "identificador" => "sec0055"
              "titulo" => "HPV detection and typing"
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            1 => array:2 [
              "identificador" => "sec0060"
              "titulo" => "Analysis of mutations in HPV-58"
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            2 => array:2 [
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              "titulo" => "Phylogenetic and phylodynamic analyses"
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              "titulo" => "Protection of human and animal subjects"
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              "titulo" => "Right to privacy and informed consent"
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          "titulo" => "Conflict of interest"
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          "titulo" => "References"
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    "fechaRecibido" => "2015-05-21"
    "fechaAceptado" => "2015-09-09"
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            1 => "Argentina"
            2 => "E6"
            3 => "E7"
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        "resumen" => "<span id="abst0005" class="elsevierStyleSection elsevierViewall"><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall"><span class="elsevierStyleItalic">Human papillomavirus</span> &#40;HPV&#41; has the highest mortality rate due to cervical cancer in Northeastern Argentina&#46; The aim of this work was to detect and characterize HPV in samples from the Province of Corrientes&#44; Argentina&#46; HPV detection and typing was performed using PCR-RFLP on samples with different cervical lesions &#40;<span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>255&#41;&#46; Seventeen viruses typified as HPV-58 were sequenced &#40;E6 and E7 genes&#41; and mutations were analyzed&#46; HPV DNA was detected in 56&#46;1<span class="elsevierStyleHsp" style=""></span>&#37; of the cervical lesions &#40;143&#47;255&#41;&#46; Twenty-two different HPV types were detected&#46; The type most frequently found among the total number of samples and HPV-positive samples was HPV-16 &#40;14&#46;5<span class="elsevierStyleHsp" style=""></span>&#37; and 25&#46;9<span class="elsevierStyleHsp" style=""></span>&#37;&#44; respectively&#41;&#44; followed by HPV-58 &#40;8&#46;2<span class="elsevierStyleHsp" style=""></span>&#37;&#47;14&#46;7<span class="elsevierStyleHsp" style=""></span>&#37;&#44; respectively&#41;&#44; which is also considered a high-risk viral type&#46; Increased severity of the cytological status was associated with greater rates of HPV detection and&#44; especially&#44; with the detection of greater rates of high-risk types&#46; In addition&#44; the evolutionary dynamics of the alpha-9 species group and HPV-58 was studied&#46; All HPV-58 viruses reported in this work belonged to lineage A&#44; sublineage A2&#46; The phylodynamic analysis indicated that diversification of main groups within lineage A might have accompanied or preceded human migrations across the globe&#46; Given that the most prevalent viruses found belonged to high-risk HPV types&#44; some concerns might arise about the extent of cross protection of the vaccines against the types not included in their design&#46;</p></span>"
      ]
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        "titulo" => "Resumen"
        "resumen" => "<span id="abst0010" class="elsevierStyleSection elsevierViewall"><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">El virus del papiloma humano &#40;<span class="elsevierStyleItalic">Human papillomavirus</span> &#91;HPV&#93;&#41; tiene la mayor tasa de mortalidad por c&#225;ncer de cuello uterino en el noreste de Argentina&#46; El objetivo de este trabajo fue detectar y caracterizar el HPV en muestras de la provincia de Corrientes&#44; Argentina&#46; La detecci&#243;n y la tipificaci&#243;n se realiz&#243; mediante PCR-RFLP en muestras con diferentes lesiones cervicales &#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>255&#41;&#46; Se secuenciaron 17 virus tipificados como HPV-58 &#40;genes E6 y E7&#41; y se analizaron sus mutaciones&#46; Adem&#225;s&#44; se estudi&#243; la din&#225;mica evolutiva de los virus del grupo alfa-9 y&#44; en particular&#44; del HPV-58&#46; Se detect&#243; ADN viral en el 56&#44;1<span class="elsevierStyleHsp" style=""></span>&#37; de las lesiones cervicales &#40;143&#47;255&#41; y se detectaron 22 tipos del HPV&#46; El tipo encontrado con mayor frecuencia entre el total de muestras y entre las HPV-positivas fue el HPV-16 &#40;14&#44;5<span class="elsevierStyleHsp" style=""></span>&#37;&#47;25&#44;9<span class="elsevierStyleHsp" style=""></span>&#37;&#44; respectivamente&#41;&#44; seguido por el HPV-58 &#40;8&#44;2<span class="elsevierStyleHsp" style=""></span>&#37;&#47;14&#44;7<span class="elsevierStyleHsp" style=""></span>&#37;&#44; respectivamente&#41;&#44; tambi&#233;n considerado como de alto riesgo&#46; El aumento de la gravedad de las lesiones se asoci&#243; a mayores tasas de detecci&#243;n del HPV y&#44; en especial&#44; con mayores tasas de detecci&#243;n de tipos de alto riesgo&#46; Todos los HPV-58 encontrados pertenecieron al linaje A&#44; sublinaje A2&#46; El an&#225;lisis filodin&#225;mico indic&#243; que la diversificaci&#243;n de los grupos principales dentro del linaje A podr&#237;a haber acompa&#241;ado o precedido las migraciones humanas en todo el mundo&#46; Dado que los virus m&#225;s prevalentes pertenecieron a los tipos del HPV de alto riesgo&#44; podr&#237;an surgir interrogantes sobre el alcance de la protecci&#243;n cruzada de las vacunas contra los tipos no incluidos en su dise&#241;o&#46;</p></span>"
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          "en" => "<p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Bayesian phylogenetic tree of the E6 and E7 sequences of HPV-58&#46; Posterior probability values higher than 0&#46;5 are shown at nodes for relevant groups&#46; Isolates reported in this work are shown in bold&#46; Type HPV-33 was used as outgroup&#46; The country of origin is indicated when available &#40;abbreviated in uppercase&#41;&#46; BF&#44; Burkina Faso&#59; CHI&#44; China&#59; CR&#44; Costa Rica&#59; ITA&#44; Italy&#59; RW&#44; Rwanda&#59; TW&#44; Taiwan&#59; ZAM&#44; Zambia&#46;</p>"
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          "en" => "<p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">Maximum Clade Credibility Tree for the Alpha-9 species group &#40;a&#41; and for HPV type 58 &#40;b&#41; obtained with a substitution rate of 1<span class="elsevierStyleHsp" style=""></span>&#215;<span class="elsevierStyleHsp" style=""></span>10<span class="elsevierStyleSup">&#8722;7</span><span class="elsevierStyleHsp" style=""></span>s&#47;s&#47;y&#46; The time to the most recent common ancestor &#40;median and HPD95<span class="elsevierStyleHsp" style=""></span>&#37;&#41; and posterior probability values for relevant groups are shown at nodes&#46;</p>"
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                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Cytology<a class="elsevierStyleCrossRef" href="#tblfn0005"><span class="elsevierStyleSup">a</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black"><span class="elsevierStyleItalic">n</span> &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">HPV positive &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Odd ratio &#40;IC95<span class="elsevierStyleHsp" style=""></span>&#37;&#41;<a class="elsevierStyleCrossRef" href="#tblfn0010"><span class="elsevierStyleSup">b</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black"><span class="elsevierStyleItalic">p</span>-Value&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">High-risk HPV positive &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Odd ratio &#40;IC95<span class="elsevierStyleHsp" style=""></span>&#37;&#41;<a class="elsevierStyleCrossRef" href="#tblfn0015"><span class="elsevierStyleSup">c</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black"><span class="elsevierStyleItalic">p</span>-Value&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">RCC&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">63 &#40;24&#46;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">12 &#40;19&#46;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">5 &#40;7&#46;9&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">ASCUS&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">11 &#40;4&#46;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">7 &#40;63&#46;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">7&#46;4 &#40;1&#46;9&#8211;29&#46;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;004&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">2 &#40;18&#46;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">2&#46;6 &#40;0&#46;4&#8211;15&#46;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;298&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">L-SIL&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">152 &#40;59&#46;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">98 &#40;64&#46;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">7&#46;7 &#40;3&#46;8&#8211;15&#46;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#60;0&#46;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">60 &#40;39&#46;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">7&#46;6 &#40;2&#46;9&#8211;20&#46;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#60;0&#46;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">H-SIL&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">18 &#40;7&#46;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">16 &#40;88&#46;9&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">34&#46;0 &#40;6&#46;9&#8211;168&#46;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#60;0&#46;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">15 &#40;83&#46;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">58&#46;0 &#40;12&#46;4&#8211;270&#46;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#60;0&#46;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">CC&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">11 &#40;4&#46;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">10 &#40;90&#46;9&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">42&#46;5 &#40;5&#46;0&#8211;364&#46;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#60;0&#46;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">10 &#40;90&#46;9&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">116&#46;0 &#40;12&#46;2&#8211;1100&#46;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#60;0&#46;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="8" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Total&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">255&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">143 &#40;56&#46;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">92 &#40;36&#46;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
              ]
              "imagenFichero" => array:1 [
                0 => "xTab986748.png"
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          "notaPie" => array:3 [
            0 => array:3 [
              "identificador" => "tblfn0005"
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              "nota" => "<p class="elsevierStyleNotepara" id="npar0005">RCC&#44; reactive cellular changes&#59; L-SIL&#44; low-grade squamous intraepithelial lesion&#59; H-SIL&#44; high-grade squamous intraepithelial lesion&#59; CC&#44; cervical cancer&#46;</p>"
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            1 => array:3 [
              "identificador" => "tblfn0010"
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              "etiqueta" => "c"
              "nota" => "<p class="elsevierStyleNotepara" id="npar0015">OR for the rates of high-risk HPV types detection for each cytological status with reference to the RCC status&#44; obtained by a logistic regression analysis&#46;</p>"
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        "tipo" => "MULTIMEDIATABLA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
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                0 => """
                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td-with-role" title="table-head ; entry_with_role_rowhead " align="left" valign="top" scope="col">Type&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " colspan="6" align="center" valign="top" scope="col" style="border-bottom: 2px solid black">Number of cases</th></tr><tr title="table-row"><th class="td" title="table-head  " align="" valign="top" scope="col" style="border-bottom: 2px solid black">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">RCC&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">LSIL&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">CC&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Total &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">16&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">21&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">8&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">36 &#40;14&#46;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">58&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">14&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">21 &#40;8&#46;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">53&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">12&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">14 &#40;5&#46;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">7&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">11 &#40;4&#46;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">31&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">9 &#40;3&#46;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">18&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">8 &#40;3&#46;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">11&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">5 &#40;2&#46;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">66&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">4 &#40;1&#46;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">84&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">4 &#40;1&#46;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">33&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">3 &#40;1&#46;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">45&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">2 &#40;0&#46;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">61&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">2 &#40;0&#46;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">26&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">2 &#40;0&#46;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">35&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">2 &#40;0&#46;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">39&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">2 &#40;0&#46;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">52&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">2 &#40;0&#46;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">56&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1 &#40;0&#46;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">62&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1 &#40;0&#46;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">70&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1 &#40;0&#46;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">81&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1 &#40;0&#46;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">100&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1 &#40;0&#46;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">6&#43;33<a class="elsevierStyleCrossRef" href="#tblfn0020"><span class="elsevierStyleSup">a</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1 &#40;0&#46;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">31&#43;45<a class="elsevierStyleCrossRef" href="#tblfn0020"><span class="elsevierStyleSup">a</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1 &#40;0&#46;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">66&#43;45<a class="elsevierStyleCrossRef" href="#tblfn0020"><span class="elsevierStyleSup">a</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1 &#40;0&#46;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">66&#43;31<a class="elsevierStyleCrossRef" href="#tblfn0020"><span class="elsevierStyleSup">a</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1 &#40;0&#46;4&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1 &#40;0&#46;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">16&#43;31<a class="elsevierStyleCrossRef" href="#tblfn0020"><span class="elsevierStyleSup">a</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1 &#40;0&#46;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">18&#43;55<a class="elsevierStyleCrossRef" href="#tblfn0020"><span class="elsevierStyleSup">a</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1 &#40;0&#46;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">11&#43;61<a class="elsevierStyleCrossRef" href="#tblfn0020"><span class="elsevierStyleSup">a</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1 &#40;0&#46;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Indeterminate&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">3 &#40;1&#46;2&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">54&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">112 &#40;43&#46;9&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">11&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">152&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">18&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">11&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">255&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
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                  \t\t\t\t\tvoid\n
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                  \t\t\t\t</th><th class="td" title="table-head  " colspan="2" align="center" valign="top" scope="col" style="border-bottom: 2px solid black">E6</th><th class="td" title="table-head  " colspan="11" align="center" valign="top" scope="col" style="border-bottom: 2px solid black">E7</th><th class="td" title="table-head  " align="left" valign="top" scope="col">AA&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">307&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">542&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">634&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">686&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">691&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">694&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">744&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">756&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">761&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">767&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">801&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">859&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">866&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="" valign="top" scope="col" style="border-bottom: 2px solid black">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="" valign="top" scope="col" style="border-bottom: 2px solid black">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="" valign="top" scope="col" style="border-bottom: 2px solid black">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">A&#42;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">C&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">A&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">G&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">G&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">G&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">G&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">T&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">T&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">G&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">C&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">C&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">G&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">A&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#8211;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="middle">&#8211;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="middle">COR1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#8211;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#8211;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#8211;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#8211;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#8211;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleUnderline">A</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">G&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#8211;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleUnderline">A</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#8211;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#8211;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#8211;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#8211;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">G41RG63D&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="middle">2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="middle">0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="middle">COR2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">T&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#8211;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#8211;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#8211;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#8211;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleUnderline">A</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">G&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#8211;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleUnderline">A</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#8211;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#8211;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#8211;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#8211;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">G41RG63D&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="middle">6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="middle">2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="middle">COR3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">T&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#8211;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleUnderline">C</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#8211;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#8211;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleUnderline">A</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">G&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#8211;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleUnderline">A</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#8211;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#8211;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#8211;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#8211;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">D21HG41RG63D&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="middle">1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="middle">0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="middle">COR4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">T&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#8211;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#8211;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#8211;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleUnderline">A</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleUnderline">A</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">G&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#8211;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleUnderline">A</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#8211;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#8211;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#8211;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#8211;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">N40DG41RG63D&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="middle">1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="middle">0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="middle">COR5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">T&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#8211;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#8211;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#8211;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#8211;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleUnderline">A</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">G&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">C&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleUnderline">A</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#8211;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#8211;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#8211;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#8211;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">G41RG63D&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="middle">0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="middle">1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="middle">COR6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">T&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#8211;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#8211;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#8211;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#8211;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleUnderline">A</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">G&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#8211;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleUnderline">A</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleUnderline">A</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#8211;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#8211;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#8211;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">G41RG63DT65K&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="middle">1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="middle">0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="middle">COR7&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">T&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#8211;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#8211;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#8211;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#8211;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleUnderline">A</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">G&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#8211;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleUnderline">A</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#8211;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#8211;&nbsp;\t\t\t\t\t\t\n
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es en pt

¿Es usted profesional sanitario apto para prescribir o dispensar medicamentos?

Are you a health professional able to prescribe or dispense drugs?

Você é um profissional de saúde habilitado a prescrever ou dispensar medicamentos