Cardiovascular Ultrasound Predictors for Brain Alterations in Fetuses With Heart Disease: An Exploratory Review of the Literature.

OBJECTIVE: To identify cardiovascular ultrasound predictors for brain anomalies in fetuses with heart disease. METHODS: A literature search was performed in the following databases: MEDLINE through OVID, EMBASE, Cochrane Registry Center for Controlled Trials (CENTRAL), and LILACS, from their inception until May 2023. Clinical studies, cross-sectional studies, case-control studies, cohorts, and systematic reviews were included. Data extraction was performed, and the risk of bias was assessed using the QUADAS-2 tool. RESULTS: Among 2705 studies evaluated, after filtering information, 10 articles were selected that met the inclusion criteria. These studies noted the following outcomes: a decrease in fetal head circumference, changes in brain maturation measured in days, decreased depth of brain fissures, and a decrease in total brain volume. The studies show a statistically significant correlation with the presence of the following cardiovascular predictors: low or mixed oxygen content in the ascending aorta (p < 0.001), retrograde flow in the aortic arch (p < 0.001), lower z values of the MCA-PI (p < 0.05), higher UA-PI z values (p < 0.01), and lower CPR (p < 0.05). In addition, lower values of left ventricular flow (p < 0.01), ductus arteriosus (p < 0.0001), and combined cardiac output index (p < 0.01) were reported. CONCLUSIONS: This review describes the most relevant evidence correlating the effects of hemodynamic changes that lead to states of chronic hypoxia related to the aforementioned changes in the central nervous system.

Wastewater monitoring of SARS-CoV-2 gene for COVID-19 epidemiological surveillance in Tucumán, Argentina.

Wastewater-based epidemiology provides temporal and spatial information about the health status of a population. The objective of this study was to analyze and report the epidemiological dynamics of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in the province of Tucumán, Argentina during the second and third waves of coronavirus disease 2019 (COVID-19) between April 2021 and March 2022. The study aimed to quantify SARS-CoV-2 RNA in wastewater, correlating it with clinically reported COVID-19 cases. Wastewater samples (n = 72) were collected from 16 sampling points located in three cities of Tucumán (San Miguel de Tucumán, Yerba Buena y Banda del Río Salí). Detection of viral nucleocapsid markers (N1 gene) was carried out using one-step reverse transcription-quantitative polymerase chain reaction (RT-qPCR). Viral loads were determined for each positive sample using a standard curve. A positive correlation (p < 0.05) was observed between viral load (copies/mL) and the clinically confirmed COVID-19 cases reported at specific sampling points in San Miguel de Tucumán (SP4, SP7, and SP8) in both months, May and June. Indeed, the high viral load concurred with the peaks of COVID-19 cases. This method allowed us to follow the behavior of SARS-CoV-2 infection during epidemic outbreaks. Thus, wastewater monitoring is a valuable epidemiological indicator that enables the anticipation of increases in COVID-19 cases and tracking the progress of the pandemic. SARS-CoV-2 genome-based surveillance should be implemented as a routine practice to prepare for any future surge in infections.

Cambios percibidos en hábitos de alimentación, composición corporal, condición física y psicológica de deportistas universitarios durante la cuarentena por Covid-19 / Perceived changes in eating habits, body composition, physical and psychological condition of university athletes during the Covid-19 quarantine

RESUMEN Objetivo: Describir los cambios percibidos en hábitos de alimentación, composición corporal, condición física y psicológica de deportistas universitarios durante la cuarentena por Covid-19 en 2020. Materiales y métodos: Estudio transversal, de fuente de información secundaria; 403 deportistas universitarios diligenciaron una encuesta en línea en el segundo semestre de 2020. Se utilizó la estadística descriptiva para analizar los datos, para determinar asociación entre las variables de interés: tipo de deporte, sexo y Covid-19 se utilizó la prueba de significancia estadística Chi X2 de Pearson <0,05. Resultados: Del total de deportistas, el 53,3 eran hombres. La mayoría practicaba deportes individuales (55,3 %). Alrededor del 89 % de atletas no presentó Covid-19. El 59,8 % sintió que el peso empeoró, siendo mayor en los deportes individuales (p= 0,005). Una proporción mayor de mujeres recibió asesoría por parte de un entrenador y de redes sociales (62,7 %) y 7 de cada 10 hombres complementaba su entrenamiento con información proveniente de redes sociales (p=0,001). Las características psicológicas fueron las que mostraron mayores diferencias significativas según sexo y el tipo de deporte. Conclusión: La cuarentena por Covid-19 está asociada con cambios desfavorables en los deportistas universitarios; específicamente, se percibieron cambios en los hábitos de alimentación con un aumento en la cantidad de alimentos de baja calidad nutricional y alta densidad calórica, cambios negativos en el peso y peor condición física. Los deportes individuales se vieron más afectados frente a los deportes de conjunto; en lo psicológico se resalta la mala adaptación a la cuarentena con sentimientos de soledad, ansiedad y mal estado de ánimo, donde las mujeres fueron las más afectadas.

ABSTRACT Objetive: Describe the perceived changes in eating habits, body composition, physical and psychological condition of university athletes during the quarantine by Covid-19, in the year 2020. Materials and methods: Cross-sectional study, from a secondary data source, 403 universitary athletes answered an online survey on 2020's second semester. Descriptive statistics was used to analyze data, Pearson's Chi X2 <0,05 test was used to determine association between variables of interest: Sport type, sex and Covid-19. Results: The majority practiced individual sports (55.3 %). About 89 % of athletes did not present Covid-19 59.8 % felt that body weight worsened, being higher in individual sports (p= 0.005). Most of the athletes trained for at least one hour a day (81.1 %), a higher proportion of women received advice from a coach and from social networks (62.7 %), while 7 out of 10 men only complemented their training with information from social networks (p=0.001), the type of sport also presented an association in this variable (p=0.024) The psychological characteristics were those that showed the greatest significant differences according to gender and type of sport. Conclusion: The Covid-19 quarantine is associated with unfavorable changes in university athletes, specifically changes in eating habits were perceived with an increase in the amount of foods of low nutritional quality, negative changes in weight, worse physical condition, where the individual sports were more affected compared to group sports, feelings of loneliness, anxiety and bad mood, where women were the most affected.

Precision Culture Scaling to Establish High-Throughput Vasculogenesis Models.

Hydrogel-based 3D cell cultures can recapitulate (patho)physiological phenomena ex vivo. However, due to their complex multifactorial regulation, adapting these tissue and disease models for high-throughput screening workflows remains challenging. In this study, a new precision culture scaling (PCS-X) methodology combines statistical techniques (design of experiment and multiple linear regression) with automated, parallelized experiments and analyses to customize hydrogel-based vasculogenesis cultures using human umbilical vein endothelial cells and retinal microvascular endothelial cells. Variations of cell density, growth factor supplementation, and media composition are systematically explored to induce vasculogenesis in endothelial mono- and cocultures with mesenchymal stromal cells or retinal microvascular pericytes in 384-well plate formats. The developed cultures are shown to respond to vasculogenesis inhibitors in a compound- and dose-dependent manner, demonstrating the scope and power of PCS-X in creating parallelized tissue and disease models for drug discovery and individualized therapies.

Caracterización fisicoquímica, nutricional y sensorial de dos complementos alimenticios biofortificados / Physicochemical, nutritional, and sensory characterization of two biofortified food supplements

Introducción: Las ciencias de la nutrición y los alimentos innovan en la industria elaborando productos con compuestos nutricionales que contribuyan a la resolución de problemáticas en salud pública. Pero, además de las características nutricionales, son importantes las características sensoriales, siendo un factor determinante en la aceptación de estos productos. Objetivo: Evaluar características fisicoquímicas, nutricionales y sensoriales de dos complementos alimenticios, tipo sopa y bebida achocolatada, desarrollados con biofortificación. Materiales y métodos: Se consideraron 3 fases, fase 1, preparación de dos tipos complementos alimenticios (4 formulaciones), usando la liofilización para la deshidratación de algunas materias primas, complementada con otras técnicas de procesamiento y cocción. Fase 2, evaluación sensorial por panel de expertos a través de prueba descriptiva cuantitativa y hedónica, y fase 3, caracterización bromatológica. El análisis de la información se realizó con el software Jamovi 2.3.21. mediante análisis descriptivo e inferencial. Resultados: El análisis sensorial evidenció que los alimentos que contiene corazón de res en un 5% fueron los más aceptados por los panelistas en todos los atributos sensoriales en ambos complementos. La caracterización bromatológica mostró que el complemento tipo bebida achocolatada con corazón es excelente fuente de proteína, zinc y calcio y buena fuente de hierro y vitamina E, mientras que, el complemento tipo sopa con corazón es excelente fuente de proteína, zinc, hierro, tiamina, omega 3, vitamina E y buena fuente de calcio de acuerdo con la normatividad colombiana de rotulado y etiquetado nutricional. Conclusiones: Ambos complementos con corazón mostraron una aceptación sensorial satisfactoria, presentaron una importante concentración de nutrientes, que, por su fuente natural y animal, son considerados de alta biodisponibilidad(AU)

Introduction: Nutrition and food sciences innovate in the industry by elaborating products with nutritional compounds that contribute to the resolution of public health problems. But, in addition to nutritional characteristics, sensory characteristics are important, being a determining factor in the acceptance of these products. Objective: To evaluate physicochemical, nutritional and sensory characteristics of two food supplements, soup and chocolate drink, developed with biofortification. Materials and methods: Three phases were considered: phase 1, preparation of two types of food supplements (4 formulations), using freeze-drying for dehydration of some raw materials, complemented with other processing and cooking techniques. Phase 2, sensory evaluation by expert panel through quantitative descriptive and hedonic test, and phase 3, bromatological characterization. The analysis of the information was carried out with Jamovi 2.3.21. software through descriptive and inferential analysis. Results: The sensory analysis showed that foods containing 5% beef heart were the most accepted by the panelists in all sensory attributes in both supplements. The bromatological characterization showed that the chocolate drink type supplement with heart is an excellent source of protein, zinc and calcium and a good source of iron and vitamin E, while the soup type supplement with heart is an excellent source of protein, zinc, iron, thiamine, omega 3, vitamin E and a good source of calcium in accordance with Colombian regulations on nutritional labeling and labeling. Conclusions: Both supplements with heart showed a satisfactory sensory acceptance, presented an important concentration of nutrients, which, due to their natural and animal source, are considered of high bioavailability(AU)

Percepciones sobre el manejo nutricional del estreñimiento idiopático en el adulto mayor / Perceptions on the Nutritional Management of Idiopathic Constipation in the Elderly

Introducción: Los adultos mayores son la población más propensa a presentar desórdenes gastrointestinales, específicamente y en mayor proporción el estreñimiento idiopático. La alimentación es un factor clave, pero poco estudiado a la hora de tratar el estreñimiento. Objetivo: Comprender las diferentes percepciones por parte de los profesionales de la salud, los cuidadores y el adulto mayor acerca del manejo del estreñimiento idiopático, desde un enfoque alimentario, teniendo en cuenta las preferencias y gustos en el adulto mayor institucionalizado de Medellín. Métodos: La técnica de generación de la información se realizó a través de grupos focales, efectuando seis grupos: uno conformado por los profesionales del área de la salud, tres por los adultos mayores y dos por los cuidadores. Resultados: Se identificó que una de las recomendaciones que más se repite es el incremento del aporte de fibra y líquidos. En general, los adultos mayores tienen poca adherencia a las estrategias nutricionales para el manejo del estreñimiento, ya que los alimentos que se les ofrecen no se adecuan a sus preferencias. Conclusiones: No existe una percepción unánime en el personal de salud y los cuidadores con respecto a la efectividad del tratamiento nutricional para el manejo del estreñimiento en el adulto mayor; sin embargo, se identificaron testimonios exitosos sobre el uso de algunas frutas, la inclusión de fibra en la dieta y el aumento en el consumo de líquidos(AU)

Introduction: Older adults are the population most likely to present with gastrointestinal disorders specifically and idiopathic constipation to a greater extent. Diet is a key factor, but it has been little studied when it comes to treating constipation. Objective: To understand the different perceptions by health professionals, caregivers and older adults about the management of idiopathic constipation, from a dietary approach, taking into account the preferences and tastes of institutionalized older adults in Medellín. Methods: The information generation technique was carried out through focus groups, establishing six groups: one made up of health professionals, three for older adults and two for caregivers. Results: It was identified that one of the most repeated recommendations is to increase the intake of fiber and fluids. In general, older adults have poor adherence to nutritional strategies for managing constipation, since food offered to them do not suit their preferences. Conclusions: There is no unanimous perception among health personnel and caregivers regarding the effectiveness of nutritional treatment for the management of constipation in older adults; however, successful testimonies were identified regarding the use of some fruits, the inclusion of fiber in the diet and the increase in fluid consumption(AU)

Cumulative Febrile, Respiratory, and Gastrointestinal Illness Among Infants in Rural Guatemala and Association With Neurodevelopmental and Growth Outcomes.

BACKGROUND: Infectious disease exposures in early life are increasingly recognized as a risk factor for poor subsequent growth and neurodevelopment. We aimed to evaluate the association between cumulative illness with neurodevelopment and growth outcomes in a birth cohort of Guatemalan infants. METHODS: From June 2017 to July 2018, infants 0-3 months of age living in a resource-limited region of rural southwest Guatemala were enrolled and underwent weekly at-home surveillance for caregiver-reported cough, fever, and vomiting/diarrhea. They also underwent anthropometric assessments and neurodevelopmental testing with the Mullen Scales of Early Learning (MSEL) at enrollment, 6 months, and 1 year. RESULTS: Of 499 enrolled infants, 430 (86.2%) completed all study procedures and were included in the analysis. At 12-15 months of age, 140 (32.6%) infants had stunting (length-for-age Z [LAZ] score < -2 SD) and 72 (16.7%) had microcephaly (occipital-frontal circumference [OFC] < -2 SD). In multivariable analysis, greater cumulative instances of reported cough illness (beta = -0.08/illness-week, P = 0.06) and febrile illness (beta = -0.36/illness-week, P < 0.001) were marginally or significantly associated with lower MSEL Early Learning Composite (ELC) Score at 12-15 months, respectively; there was no association with any illness (cough, fever, and/or vomiting/diarrhea; P = 0.27) or with cumulative instances of diarrheal/vomiting illness alone ( P = 0.66). No association was shown between cumulative instances of illness and stunting or microcephaly at 12-15 months. CONCLUSIONS: These findings highlight the negative cumulative consequences of frequent febrile and respiratory illness on neurodevelopment during infancy. Future studies should explore pathogen-specific illnesses, host response associated with these syndromic illnesses, and their association with neurodevelopment.

Cyclic fatigue resistance of three reciprocating nickel-titanium instruments with heat treatment at intrachannel temperature / Resistencia a la fatiga cíclica de tres instrumentos alternativos de níquel-titanio con tratamiento térmico a temperatura intracanal

Introduction: the in vitro study compared the dynamic cyclic fatigue resistance of 3 reciprocating NiTi files with heat treatment. Methods: we distributed 30 new endodontic files in three groups. The endodontic files selected for this experiment were: AF Blue R3 25/06 (AFB) (Fanta Dental, Shanghai, China), X1 Blue File 25/06 (X1B) (MK Life, Porto Alegre, RS, Brazil), and Reciproc Blue 08/25 (RB) (VDW, Munich, Germany. We measured the time to file fractureand the length of the fractured fragment. ANOVA analysis was used, followed by the Tukey test for multiple comparisons, with a significance level of 5% (P < 0,05). Results: the mean time in seconds until the file fractured was 170.7 ±15,1 for AFB files, 110,4 ±26,8 for X1B, and 163,3 ±22,9 for RB files. This difference was statistically significant when comparing X1B to AFB (p: 0,000) and X1B to RB (p: 0,000). However, there are no statistically significant differences between RB and AFB (p:0,739). Conclussions: this study found that RB and AFB files exhibit similar resistance to cyclic fatigue.

Introducción: el estudio in vitro comparó la resistencia a la fatiga cíclica dinámica de 3 limas NiTi recíprocas con tratamiento térmico. Métodos: distribuimos 30 limas endodónticas nuevas en tres grupos. Las limas endodónticas seleccionadas para este experimento fueron: AF Blue R3 25/06 (AFB) (Fanta Dental, Shanghai, China), X1 Blue File 25/06 (X1B) (MK Life, Porto Alegre, RS, Brasil), y Reciproc Blue 08/25 (RB) (VDW, Munich, Alemania. Se midió el tiempo transcurrido hasta la fractura de la lima y la longitud del fragmento fracturado. Se utilizó el análisis ANOVA, seguido de la prueba de Tukey para comparaciones múltiples, con un nivel de significación del 5% (P < 0.05). Resultados: el tiempo medio en segundos hasta la fractura de la lima fue de 170.7 ±15.1 para las limas AFB, 110.4 ±26.8 para las X1B y 163.3 ±22.9 para las RB. Esta diferencia fue estadísticamente significativa al comparar X1B con AFB (p: 0.000) y X1B con RB (p: 0.000). Sin embargo, no hay diferencias estadísticamente significativas entre RB y AFB (p:0.739). Conclusiones: en este estudio se ha comprobado que las limas RB y AFB presentan una resistencia similar a la fatiga cíclica.

Challenges and lessons learned from the rapid operationalization of a prospective cohort to study the natural history and neurodevelopmental outcomes of postnatal Zika virus infection among infants and children in rural Guatemala.

During the course of the 2015-2017 outbreak of Zika virus (ZIKV) in the Americas, the emerging virus was recognized as a congenital infection that could damage the developing brain. As the Latin American ZIKV outbreak advanced, the scientific and public health community questioned if this newly recognized neurotropic flavivirus could affect the developing brain of infants and young children infected after birth. We report here the study design, methods and the challenges and lessons learned from the rapid operationalization of a prospective natural history cohort study aimed at evaluating the potential neurological and neurodevelopmental effects of postnatal ZIKV infection in infants and young children, which had become epidemic in Central America. This study enrolled a cohort of 500 mothers and their infants, along with nearly 400 children 1.5-3.5 years of age who were born during the initial phase of the ZIKV epidemic in a rural area of Guatemala. Our solutions and lessons learned while tackling real-life challenges may serve as a guide to other researchers carrying out studies of emerging infectious diseases of public health priority in resource-constrained settings.

A genome-proteome-based approach for xylan degradation by Cohnella sp. AR92.

Several members of Cohnella genus have been reported as xylanolytic bacteria with significant capacity as carbohydrate-active enzyme producers (CAZymes), whose mechanisms involving xylan degradation are a key goal for suitable applications in bio-based industries. Using Cohnella sp. AR92 bacterium, we ensembled a genomic-proteomic approach to assess plant biomass conversion targeting its xylanolytic set of enzymes. Also, the genomic traits of the strain AR92 were compared to other Cohnella spp., showing a significant variability in terms of genome sizes and content of genes that code CAZymes. The AR92 strain genome harbours 209 CAZymes encoding sequences active on different polysaccharides, particularly directed towards xylans. Concurrent proteomic data recovered from cultures containing three kinds of lignocellulosic-derived substrates showed a broad set of xylan-degrading enzymes. The most abundant CAZymes expressed in the different conditions assayed were endo-ß-1,4-xylanases belonging to the GH11 and GH10 families, enzymes that were previously proved to be useful in the biotransformation of lignocellulosic biomass derived from sugarcane as well as onto xylan-enriched substrates. Therefore, considering the large reserve of CAZymes of Cohnella sp. AR92, a xylan processing model for AR92 strain is proposed.

Albergues temporales como apoyo a la accesibilidad al tercer nivel de atención para poblaciones rurales dispersas: experiencias de pacientes y acompañantes / Temporary shelters to support accessibility to tertiary health care services for rural dispersed populations: patients and companions experiences

Introducción: los servicios de salud en zonas rurales dispersas se han focalizado en la atención primaria. Para lograr integralidad es necesario brindar accesibilidad a los servicios de tercer nivel, lo que representa un reto para los sistemas de salud por los costos y la disponibilidad de profesionales. Varios países desplazan especialistas y equipos a las zonas rurales; en Colombia son los pacientes quienes se trasladan a los centros especializados y las aseguradoras en salud administran dineros provenientes del estado para cubrir los costos. Para ello se requiere el apoyo de albergues temporales que brinden alojamiento y alimentación a pacientes y familiares de bajos recursos. Métodos: estudio cualitativo de caso con enfoque fenomenológico para conocer la experiencia de los usuarios de dos albergues que atienden pacientes y acompañantes provenientes de una zona distante 700 km de Bogotá. Resultados: los servicios de los albergues son bien percibidos por los usuarios, aunque sedestacan aspectos locativos por mejorar. El servicio se focaliza en hospedaje, transporte y alimentación quedando un vacío en otras necesidades como ocupación del tiempo libre, apoyo emocional y social. La demora en la atención en salud es la principal causa de inconformidad pues afecta la cotidianidad de las familias por el desplazamiento y la incomunicación. Conclusiones: la atención especializada trasladando pacientes de las zonas dispersas a los centros urbanos representa una experiencia innovadora que debe ser evaluada desde el punto de vista económico y emocional para analizar su relación costo beneficio y su sostenibilidad.

Introduction: health services in disperse rural areas have focused on primary care. In order to achieve comprehensive services, access to tertiary health care services needs to be provided. This represents a challenge for health systems in terms of costs and availability of healthcare professionals. In several countries, specialists and equipment are moved to rural areas; while in Colombia it is the patient who travels to the specialized centers. Health insurers administer money from the state to cover the expenses. This requires temporary shelters providing accommodation and food to low-income patients and their families. Methods: a phenomenological qualitative case study approach to learn about users experiences in two lodges serving patients and their companions who come from an area 700 km away from Bogota. Results: shelters ́ services are well qualified by users, although facilities need to be improved in some aspects. Services are centered on accommodation, transportation and food leaving a gap in other needs such as free time and leisure activities and emotional and social support. Delay in health care provision is the main cause of dissatisfaction for it affects family everyday life due to displacement and lack of communication. Conclusions: specialized assistance by transferring patients from dispersed areas to urban centers represents an innovative experience which should be evaluated from the economic and emotional perspective to enable a cost-benefit and sustainability analysis.

Caregiver rating of early childhood development: Reliability and validity of the ASQ-3 in rural Guatemala.

BACKGROUND: Although performance-based assessment of early childhood development is preferred, there are a number of limitations to this methodology in low resource settings (LRSs). Hence, clinicians and researchers often rely on caregiver report screening tools. The Ages and Stages Questionnaire 3 (ASQ) is one of the most widely used caregiver report measures globally. Adequate psychometric properties have been demonstrated in high income settings, especially when used in older children, high- risk children, or those with severe neurodevelopmental delays. However, its utility is more variable within very young children and for use in LRSs. METHODS: The reliability and validity of the ASQ was determined for children ages 0-5 years living in rural Guatemala. Internal consistency and test-retest reliability were assessed, as well as concurrent and predictive validity. Sensitivity, specificity, positive and negative predictive values related to performance-based developmental assessment (Mullen Scales of Early Learning; MSEL) and growth status (i.e. stunting) were also calculated. RESULTS: Internal consistency reliability for the ASQ was adequate, except when results were limited by small sample size. Test-retest reliability ranged from low to moderate (r = 0.08-0.43; p < 0.05-0.01). However, there was significant variability in mean scores over time across ASQ domain scores. In terms of validity, the ASQ did not discriminate adequately between children who performed within or below age-expectations on performance-based developmental testing or those with and without stunting. CONCLUSIONS: The ASQ did not demonstrate adequate psychometric properties in rural Guatemala, consistent with concerns documented in other LRSs. These results indicate that existing caregiver report screening measures of early childhood development should be utilized with caution in LRSs, and alternative methods for assessment or in the development and utilization of caregiver report measures should be considered.

Parent Report of Health Related Quality of Life in Young Children in Rural Guatemala: Implementation, Reliability, and Validity of the PedsQL in Stunting and Wasting.

In this study, we review the implementation, reliability, and validity of the Pediatric Quality of Life Inventory (PedsQL), a measure of health-related quality of life, in young children in rural Guatemala. Mothers of 842 children (age range = 1-60 months) completed the PedsQL Generic Core Scales 4.0 serially for 1 year. Low (Pearson's r = 0.28, P < .0001) to moderate (Pearson's r = 0.65, P < .0001) consistency in responding over time was shown. The PedsQL did not discriminate reliably between healthy children and those with stunting or wasting. PedsQL scores were not lower during the time of an acute illness. While we found low to moderate evidence for the reliability of the PedsQL in healthy children, it did not discriminate between healthy children and those with stunting, wasting or other acute illness.

Surface roughness of titanium disks influences the adhesion, proliferation and differentiation of osteogenic properties derived from human.

PURPOSE: The aim of this study was to investigate the response of osteogenic cell lineage and gingival fibroblastic cells to different surface treatments of grade IV commercially pure Titanium (cpTi) disks. MATERIAL AND METHODS: Grade IV cpTi disks with different surfaces were produced: machined (M), sandblasting (B), sandblasting and acid subtraction (NP), and hydrophilic treatment (ACQ). Surface microtopography characteristics and chemical composition were investigated by scanning electron microscopy (SEM) and energy dispersive x-ray spectrometry (EDS). Adhesion and proliferation of SC-EHAD (human surgically-created early healing alveolar defects) and HGF-1 (human gingival fibroblasts) on Ti disks were investigated at 24 and 48 h, and osteogenic differentiation and mineralization were evaluated by assessing alkaline phosphatase (ALP) activity and alizarin red staining, respectively. RESULTS: No significant differences were found among the various surface treatments for all surface roughness parameters, except for skewness of the assessed profile (Rsk) favoring M (p = 0.035 ANOVA). M disks showed a slightly higher (p > 0.05; Kruskal-Wallis/Dunn) adhesion of HGF-1 (89.43 ± 9.13%) than SC-EHAD cells (57.11 ± 17.72%). ACQ showed a significantly higher percentage of SC-EHAD (100%) than HGF-1 (69.67 ± 13.97%) cells adhered at 24 h. SC-EHAD cells expressed increased ALP activity in osteogenic medium at M (213%) and NP (235.04%) surfaces, but higher mineralization activity on ACQ (54.94 ± 4.80%) at 14 days. CONCLUSION: These findings suggest that surface treatment influences the chemical composition and the adhesion and differentiation of osteogenic cells in vitro. CLINICAL RELEVANCE: Hydrophilic surface treatment of grade IV cpTi disks influences osteogenic cell adhesion and differentiation, which might enhance osseointegration.

Predicting Successful Laparoendoscopic Transhiatal Esophagectomy (THE) by Mediastinal Height Measurement.

BACKGROUND: Laparoendoscopic transhiatal esophagectomy (THE) provides advantages over traditional THE by not only avoiding laparotomy but by also allowing more precise esophageal mobilization. Occasionally, the length of the gastric conduit is insufficient to allow delivery into the neck after laparoscopic mobilization and requires laparotomy to complete the procedure. We hypothesize that the need for laparotomy will correlate with the measurement of mediastinal height (distance from thoracic vertebrae T1-T12) on chest CT. METHODS: Medical records of all patients who underwent attempted laparoendoscopic-assisted THE at a tertiary referral center between March 1, 2003 and January 31, 2019 were reviewed. Patients' mediastinal height was measured using computed tomography (CT) imaging of the chest by investigators and analyzed for correlation between mediastinal height and successful completion of a totally laparoendoscopic procedure. RESULTS: A total of 21 cases met inclusion criteria: 9 successful laparoendoscopic THE procedures and 12 failed laparoendoscopic THE procedures (those requiring addition of a mini-laparotomy or thoracotomy). The mean mediastinal length for successful laparoendoscopic surgery was 23.5 cm, whereas the mean mediastinal length for failed laparoscopic surgeries was 24.8 cm (P = .03). Patient's overall height was not found to correlate with the need for conversion. CONCLUSIONS: Shorter mediastinal length is associated with successful laparoendoscopic or laparoscopic THE. This information is readily available to clinicians from routine preoperative staging studies (chest CT) and may be used to potentially predict the success rate of a totally laparoendoscopic approach and aid in patient selection. Further prospective evaluation of these findings is warranted.

Medición de inseguridad alimentaria-nutricional, hambre y estrategias de afrontamiento de niños y adolescentes en Medellín-Colombia / Measurement of food-nutrition insecurity, hunger and coping strategies in children and adolescents in Medellin-Colombia

La inseguridad alimentaria (IA) y hambre afectan a 820 millones de personas en el mundo, 187 millones en América Latina y el Caribe, 18,5 millones en Latinoamérica con más severas crisis humanitarias y a más de la mitad de la población en Colombia. En niños y adolescentes la IA ha sido poco estudiada en Colombia, en parte por ausencia de instrumentos válidos y confiables. El objetivo de esta investigación es determinar la validez y confiabilidad de escalas que miden la IA y las estrategias de afrontamiento (EA) ante la falta de alimentos en niños y adolescentes. Estudio transversal (n=4051) realizado en Medellín-Colombia que midió la IA (10 ítemes) y EA (9 ítemes) con instrumentos desarrollados previamente. Se utilizó SPSS v21 para realizar análisis de componentes principales (ACP), validez y confiabilidad. Siete de cada 10 niños se preocupan por la falta de alimentos. El ACP de instrumento IA arrojó dos componentes: 1. cantidad, calidad y preocupación; 2. episodios de hambre, que explican 57 % de varianza. El ACP de las EA explica 43 % de varianza. Los instrumentos de IA y EA poseen una buena confiabilidad (α-Cronbach's de 0,78 y 0,82). El instrumento de IA se validó comparándolo con la talla para la edad, que arrojó una asociación inversa y significativa entre baja talla y la seguridad alimentaria. Esta investigación es la primera en evidenciar que la problemática de IA está presente en los niños y adolescentes de Medellín. Los instrumentos de IA y EA utilizados resultaron ser altamente válidos y confiables(AU)

Food insecurity (FI) and hunger affected 820 million people in the world, 187 million in Latin America and the Caribbean, 18.5 million in Latin America lived the worst severe food crises, and more than half of the Colombian population live with FI. FI in children and adolescents has been little measure, partly due to absence of valid and reliable instruments in Colombia. The aim of this study is to determine the validity and reliability of the FI and coping strategies (CS) tools in children and adolescents. Cross-sectional study (n = 4051) carried out in Medellín-Colombia. A 10-ítemes scale is used to measure FI and 9-ítemes scale capture the CS. SPSS v21 program was used to analyze data. Principal component analysis (PCA), validity and reliability were applied. Seven out of 10 children mentioned they were worry for FI. PCA showed two main components of FI: 1. Related with quantity, quality and worry about food; 2. Hunger episodes, that explain 57% of variance. PCA of the CS scale resulted in one component that explains 43% of variance. FI and CS instruments resulted in good reliability (α-Cronbach 0.78; 0.82). FI instrument was validated by comparing it with height-for-age indicator, which showed an association between stunting (low height-for-age) and food insecurity. This study is the first to show that children and adolescents living in Medellín are facing FI and CS. The FI and CS scales used were found to be highly valid and reliable(AU)

Reliability and Validity of an Adapted and Translated Version of the Mullen Scales of Early Learning (AT-MSEL) in Rural Guatemala.

BACKGROUND: A growing literature base supports the use of tests developed in high-income countries to assess children in low resource settings when carefully translated, adapted, and applied. Evaluation of psychometric properties of adapted and translated measures within populations is necessary. The current project sought to evaluate the reliability and validity of an adapted and translated version of the Mullen Scales of Early Learning (AT-MSEL) in rural Guatelama. METHODS: The reliability and validity of the AT-MSEL in rural Guatemala were analyzed for children ages 0-5 years. RESULTS: Interrater reliability coefficients (ICC = 0.99-1.0) and internal consistency (Cronbach's alpha = 0.91-0.93) were excellent for all subscales. General linear models utilizing paired data showed consistency between standard scores (p < 0.0001). Mean raw scores increased with chronological age, as expected. Across age groups, subscales were significantly, positively correlated with one another (p < 0.05 - < 0.001) with one exception, visual reception and expressive language at the 0-10 month age range (p = 0.43). CONCLUSIONS: The AT- MSEL showed strong psychometric properties in a sample of young children in rural Guatemala. Findings demonstrate that the AT-MSEL can be used validly and reliably within this specific population of children. This work supports the concept that tests developed in high-income countries can be used to assess children in low resource settings when carefully translated, adapted and applied.

Receptive language skills among young children in rural Guatemala: The relationship between the Test de Vocabulario en Imagenes Peabody and a translated and adapted version of the Mullen Scales of Early Learning.

BACKGROUND: Children in low- and lower middle income countries (LMICs) often have poorer language skills compared with children from high-income countries. Limited availability of culturally and linguistically appropriate assessment measures in LMICs, especially for young children, can hinder early identification and prevention efforts. Here, we describe receptive language (RL) skills among young children in rural Guatemala and report on the validity of a translated and culturally adapted developmental measure of RL. METHODS: Children (n = 157; m = 53.6 months, range = 42-68 months) enrolled in a prospective cohort study of postnatally acquired Zika virus infection were administered the Test de Vocabulario en Imagenes Peabody (TVIP) and the RL scale from a translated and adapted version of the Mullen Scales of Early Learning (MSEL). Performance on the TVIP was compared with the Latin American normative sample. Correlational analysis examined the relationship between performance on the TVIP and the MSEL-RL. RESULTS: Mean scores were significantly below the normative sample mean on the TVIP, t(126) = -11.04, p < .001; d = 1.00. Performance on the TVIP among children who passed the practice items (n = 127) was significantly positively associated with performance on the MSEL-RL (r = .50, p < .001), but not significantly associated with age or gender. Older age (p < .0001) and female gender (p = .018) were associated with passing the TVIP practice items. CONCLUSIONS: Delays in RL vocabulary were identified among young children in rural Guatemala on the TVIP. The association between scores on the TVIP and the RL scale of the MSEL provides preliminary support for the construct validity of this translated and adapted version of the MSEL.

Isolation and characterization of progenitor cells from surgically created early healing alveolar defects in humans: A preliminary study.

BACKGROUND: The granulation tissue present in surgically-created early healing sockets has been considered as a possible source of osteoprogenitor cells for periodontal regeneration, as demonstrated in animal studies. However, the in vitro osteogenic properties of tissue removed from human surgically-created early healing alveolar defects (SC-EHAD) remains to be established, being that the aim of this study. METHODS: Surgical defects were created in the edentulous ridge of two systemically healthy adults. The healing tissue present in these defects was removed 21 days later for the establishment of primary culture. The in vitro characteristics of the cultured cells were determined by Armelin method, 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT) assay, immunohistochemistry, alkaline phosphatase (ALP) activity, mineralization assay, and flow cytometry for detection of stem cells/osteoprogenitor cell markers. RESULTS: Cells were able to adhere to the plastic and assumed spindle-shaped morphology at earlier passages, changing to a cuboidal one with increasing passages. Differences in the proliferation rate were observed with increasing passages, suggesting osteogenic differentiation. ALP and mineralization activities were detected in conventional and osteogenic medium. Fresh samples of SC-EHAD tissue exhibited CD34- and CD45- phenotypes. Cells at later passages (14th) exhibited CD34- , CD45- , CD105- , CD166- , and collagen type I+ phenotype. CONCLUSION: Tissue removed from SC-EHAD is a possible source of progenitor cells.

Integral process assessment of sugarcane agricultural crop residues conversion to ethanol.

This work focuses a whole process assessment on post-harvesting sugarcane residues for 2G ethanol production by different saccharification-fermentation conditions at high solids loading, performed after steam explosion, alkaline and acidic pretreatments. Carbohydrate recoveries and enzymatic digestibility results showed that alkali and steam explosion pretreatments were effective for the biomass assayed. Due to a significant improvement (60%) of the glucose released by combining hemicellulases and cellulases only after the NaOH pretreatment, the most favorable process settled comprised an alkali-based pretreatment followed by a pre-saccharification and simultaneous saccharification and fermentation (PSSF). The produced ethanol reached 4.8% (w/w) as a result of an 80% conversion of the glucose from the pretreated biomass. Finally, an ethanol concentration of 3.2% (w/w) was obtained by means of a steam explosion followed by PSSF, representing a suitable start point to further develop a low environmental impact alternative for ethanol production.