Health care safety incidents in paediatric emergency care.

OBJECTIVE: To characterize safety incidents in paediatric emergency departments (PEDs): frequency, sources, root causes, and consequences. MATERIALS AND METHODS: We conducted a cross-sectional, observational and descriptive study in the PED of the Clinical University Hospital XX (blinded for review). Patients were recruited through opportunity sampling and the data were collected during care delivery and one week later through a telephone survey. The methodology was based on the ERIDA study on patient safety incidents related to emergency care, which in turn was based on the ENEAS and EVADUR studies. RESULTS: The study included a total of 204 cases. At least one incident was detected in 25 cases, with two incidents detected in 3 cases, for a total incidence of 12.3%. Twelve incidents were detected during care delivery and the rest during the telephone call. Ten percent did not reach the patient, 7.1% reached the patient but caused no harm, and 82.1% reached the patient and caused harm. Thirteen incidents (46.4%) did not have an impact on care delivery, 8 (28.6%) required a new visit or referral, 6 (21.4%) required additional observation and 1 (3.6%) medical or surgical treatment. The most frequent root causes were health care delivery and medication. Incidents related to procedures and medication were most frequent. Of all incidents, 78.6% were considered preventable, with 50% identified as clear failures in health care delivery. CONCLUSIONS: Safety incidents affected 12.3% of children managed in the PED of the HCUVA, of which 78.6% were preventable.

Sit-to-Stand Power Is a Stronger Predictor of Gait Speed than Knee Extension Strength.

With a growing aging population, the routine assessment of physical function may become a critical component of clinical practice. The purpose of this cross-sectional study is to compare two common assessments of muscular function: (1) isometric knee extension strength (KES) and (2) sit-to-stand (STS) muscle power tests, in predicting objective physical function (i.e., gait speed) in aging adults. 84 adults (56% female, mean (SD) age = 66.6 (9.4) years) had their relative KES, STS power, usual gait speed (UGS), and fast gait speed (FGS) assessed. Multiple linear regression examined the associations between KES, STS power, and gait outcomes. When entered in separate models, KES and STS power were both independently associated with UGS and FGS (Std. ß = 0.35-0.44 and 0.42-0.55 for KES and STS power, respectively). When entered in the same model, STS power was associated with UGS and FGS (Std. ß = 0.37 [95%CI: 0.15, 0.58] and 0.51 [95%CI: 0.31, 0.70], respectively), while KES was only associated with FGS (Std. ß = 0.25 [95%CI: 0.02, 0.48]). STS power seems to be a valid indicator of function in aging adults. Its feasibility as a screening tool for "low" function in the primary care setting should be explored.

Newcastle disease virus vector-based SARS-CoV-2 vaccine candidate AVX/COVID-12 activates T cells and is recognized by antibodies from COVID-19 patients and vaccinated individuals.

Introduction: Several effective vaccines for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) have been developed and implemented in the population. However, the current production capacity falls short of meeting global demand. Therefore, it is crucial to further develop novel vaccine platforms that can bridge the distribution gap. AVX/COVID-12 is a vector-based vaccine that utilizes the Newcastle Disease virus (NDV) to present the SARS-CoV-2 spike protein to the immune system. Methods: This study aims to analyze the antigenicity of the vaccine candidate by examining antibody binding and T-cell activation in individuals infected with SARS-CoV-2 or variants of concern (VOCs), as well as in healthy volunteers who received coronavirus disease 2019 (COVID-19) vaccinations. Results: Our findings indicate that the vaccine effectively binds antibodies and activates T-cells in individuals who received 2 or 3 doses of BNT162b2 or AZ/ChAdOx-1-S vaccines. Furthermore, the stimulation of T-cells from patients and vaccine recipients with AVX/COVID-12 resulted in their proliferation and secretion of interferon-gamma (IFN-γ) in both CD4+ and CD8+ T-cells. Discussion: The AVX/COVID-12 vectored vaccine candidate demonstrates the ability to stimulate robust cellular responses and is recognized by antibodies primed by the spike protein present in SARS-CoV-2 viruses that infected patients, as well as in the mRNA BNT162b2 and AZ/ChAdOx-1-S vaccines. These results support the inclusion of the AVX/COVID-12 vaccine as a booster in vaccination programs aimed at addressing COVID-19 caused by SARS-CoV-2 and its VOCs.

Using Computer Vision to Annotate Video-Recoded Direct Observation of Physical Behavior.

Direct observation is a ground-truth measure for physical behavior, but the high cost limits widespread use. The purpose of this study was to develop and test machine learning methods to recognize aspects of physical behavior and location from videos of human movement: Adults (N = 26, aged 18-59 y) were recorded in their natural environment for two, 2- to 3-h sessions. Trained research assistants annotated videos using commercially available software including the following taxonomies: (1) sedentary versus non-sedentary (two classes); (2) activity type (four classes: sedentary, walking, running, and mixed movement); and (3) activity intensity (four classes: sedentary, light, moderate, and vigorous). Four machine learning approaches were trained and evaluated for each taxonomy. Models were trained on 80% of the videos, validated on 10%, and final accuracy is reported on the remaining 10% of the videos not used in training. Overall accuracy was as follows: 87.4% for Taxonomy 1, 63.1% for Taxonomy 2, and 68.6% for Taxonomy 3. This study shows it is possible to use computer vision to annotate aspects of physical behavior, speeding up the time and reducing labor required for direct observation. Future research should test these machine learning models on larger, independent datasets and take advantage of analysis of video fragments, rather than individual still images.

Mechanism of multicyclic ß-carotene impregnation into corn starch aerogels via supercritical CO2 with mathematical modeling.

ß-carotene, a natural dye renowned for its antioxidant and provitamin A activities, is hindered from direct use in food and drug products due to its susceptibility to oxidation, easy isomerization under light, heat, or acidic conditions, as well as its low water solubility and oral bioavailability. In this study, we addressed these challenges by loading ß-carotene into corn starch aerogels via supercritical carbon dioxide (sc-CO2) and assessed its loading contributions through adsorption during contact time and precipitation during depressurization. The loading process was studied under two cycles at pressure of 30 MPa, temperature of 40 °C, depressurization rate of 0.4 MPa/min, and co-solvent (ethanol) mass percentage of 1.2 %. Experiments found adsorption minimally contributed to impregnation, while precipitation became the primary loading mechanism. The subsequent work focused on a mathematical model describing ß-carotene loading into corn starch aerogels via precipitation, using the law of conservation of mass and classical nucleation theory. The model shows that using pure CO2 results in a loading efficiency of 0.10 mg ß-carotene/g aerogel, while with CO2 and 1.2 % ethanol as the co-solvent, the loading efficiency increases threefold to 0.30 mg ß-carotene/g aerogel.

An eco-friendly extraction method to obtain pectin from passion fruit rinds (Passiflora edulis sp.) using subcritical water and pressurized natural deep eutectic solvents.

This work evaluated the efficiency of Subcritical Water Extraction (SWE) and Pressurized Natural Deep Eutectic Solvents (P-NaDESs) under different temperatures (100, 120, 140 and 160 °C) in obtaining pectin from Passion Fruit Rinds (PFR) and its residual biomass (PFR - UAPLE), and compare the results with those of Conventional Extraction (CE). The highest pectin yields, 19.1 and 27.6 %, were achieved using P-NaDES (Citric Acid:Glucose:Water) at 120 °C for PFR and its PFR-UAPLE, respectively. Regarding the Degree of Esterification (DE), pectin obtained with SWE and CE had DE below 50 %, while with P-NaDES (Citric Acid: Glucose:Water), DE was above 50 %. Higher Molecular Weights (MW) (98 and 81 kDa) were obtained with SWE and P-NaDES from PFR compared to PFR-UAPLE and CE. Galacturonic acid was the most abundant (74 to 78 %) monosaccharide obtained by SWE. In terms of morphology, water extraction provided pectin with more uniform textures, whereas extraction with acidified mixtures led to more heterogeneous surfaces. Overall, comparing SWE and P-NaDES, the obtained pectins differed in terms of monomeric composition, MW and DE. These results indicate that pectins obtained by both methods can have different applications depending on their structural characteristics.

Addressing mental health problems among persons without stable housing in the context of the COVID-19 pandemic: study protocol for a randomised trial. RESPOND - France.

BACKGROUND: The COVID-19 pandemic has had an impact on population-wide mental health and well-being. Although people experiencing socioeconomic disadvantage may be especially vulnerable, they experience barriers in accessing mental health care. To overcome these barriers, the World Health Organization (WHO) designed two scalable psychosocial interventions, namely the web-based Doing What Matters in Times of Stress (DWM) and the face-to-face Problem Management Plus (PM+), to help people manage stressful situations. Our study aims to test the effectiveness of a stepped-care program using DWM and PM + among individuals experiencing unstable housing in France - a majority of whom are migrant or have sought asylum. METHODS: This is a randomised controlled trial to evaluate the effectiveness and cost effectiveness of a stepped-care program using DWM and PM + among persons with psychological distress and experiencing unstable housing, in comparison to enhanced care as usual (eCAU). Participants (N = 210) will be randomised to two parallel groups: eCAU or eCAU plus the stepped-care program. The main study outcomes are symptoms of depression and anxiety measured using the Patient Health Questionnaire Anxiety and Depression Scale (PHQ-ADS). DISCUSSION: This randomised controlled trial will contribute to a better understanding of effective community-based scalable strategies that can help address the mental health needs of persons experiencing socioeconomic disadvantage, whose needs are high yet who frequently have limited access to mental health care services. TRIAL REGISTRATION: this randomised trial has been registered at ClinicalTrials.gov under the number NCT05033210.

Deep eutectic solvents as an alternative for extraction of flavonoids from soybean (Glycine max (L) Merrill) and okara: An experimental and computational approach based on COSMO-SAC model.

In this study, different Deep Eutectic Solvents based on choline chloride ([Ch]Cl) with carboxylic acids, sugars, and glycerol, were investigated as alternative solvents for the extraction of flavonoids from soybean and okara. Initially, the COSMO-SAC was investigated as a tool in solvent screening for the extraction of flavonoids. Experimental validation was performed using total flavonoid analysis with the solvents that showed greater interaction with the solutes. The extracts obtained from soybean and okara using the DES [Ch]Cl:acetic acid added with 30 % water showed the highest total flavonoid content, 1.05 mg eq. of catechin/g dry soybean and 0.94 mg eq. of catechin /g dry okara, respectively. For phenolic compound extraction, [Ch]Cl: acetic acid DES extracted approximately 1.16 mg GAE/g of soybean and 0.69 mg GAE/g of okara. For antioxidant activity, soybean and okara extracts obtained with [Ch]Cl: acetic acid showed FRAP results of 0.40 mg Trolox/mL of extract and 0.45 mg Trolox/mL of extract, respectively. In addition, the isoflavones daidzein, genistein, glycitein, daidzin, genistin, and glycitin were identified and quantified in the soybean and okara extracts obtained with DES [Ch]Cl: acetic acid with 30% water, totaling 1068.05 and 424.32 µg total isoflavones/g dry sample. Therefore, The COSMO-SAC model was a useful tool in solvent screening, saving time and costs. Also, DES can be an alternative solvent for extracting flavonoids to replace conventional organic solvents, respecting current environmental and human health concerns.

Bloom syndrome patients and mice display accelerated epigenetic aging.

Bloom syndrome (BSyn) is an autosomal recessive disorder caused by variants in the BLM gene, which is involved in genome stability. Patients with BSyn present with poor growth, sun sensitivity, mild immunodeficiency, diabetes, and increased risk of cancer, most commonly leukemias. Interestingly, patients with BSyn do not have other signs of premature aging such as early, progressive hair loss and cataracts. We set out to determine epigenetic age in BSyn, which can be a better predictor of health and disease over chronological age. Our results show for the first time that patients with BSyn have evidence of accelerated epigenetic aging across several measures in blood lymphocytes, as compared to carriers. Additionally, homozygous Blm mice exhibit accelerated methylation age in multiple tissues, including brain, blood, kidney, heart, and skin, according to the brain methylation clock. Overall, we find that Bloom syndrome is associated with accelerated epigenetic aging effects in multiple tissues and more generally a strong effect on CpG methylation levels.

A blended neurostimulation protocol to delineate cortico-muscular and spino-muscular dynamics following neuroplastic adaptation.

In this paper we propose a novel neurostimulation protocol that provides an intervention-based assessment to distinguish the contributions of different motor control networks in the cortico-spinal system. Specifically, we use a combination of non-invasive brain stimulation and neuromuscular stimulation to probe neuromuscular system behavior with targeted impulse-response system identification. In this protocol, we use an in-house developed human-machine interface (HMI) for an isotonic wrist movement task, where the user controls a cursor on-screen. During the task, we generate unique motor evoked potentials based on triggered cortical or spinal level perturbations. Externally applied brain-level perturbations are triggered through TMS to cause wrist flexion/extension during the volitional task. The resultant contraction output and related reflex responses are measured by the HMI. These movements also include neuromodulation in the excitability of the brain-muscle pathway via transcranial direct current stimulation. Colloquially, spinal-level perturbations are triggered through skin-surface neuromuscular stimulation of the wrist muscles. The resultant brain-muscle and spinal-muscle pathways perturbed by the TMS and NMES, respectively, demonstrate temporal and spatial differences as manifested through the human-machine interface. This then provides a template to measure the specific neural outcomes of the movement tasks, and in decoding differences in the contribution of cortical- (long-latency) and spinal-level (short-latency) motor control. This protocol is part of the development of a diagnostic tool that can be used to better understand how interaction between cortical and spinal motor centers changes with learning, or injury such as that experienced following stroke.

Updated taxonomy of digital mental health interventions: a conceptual framework.

Most individuals at risk for or already experiencing mental disorders have no access to mental health care. Digital mental health interventions (DMHIs) can be effective in preventing and treating mental disorders. A taxonomy of digital interventions was previously proposed to organize the different types of digital tools being developed to expand mental health service delivery. This article updates that framework and presents illustrations for four types of digital interventions specific to mental health and revises their definitions. The illustrations primarily focus on studies that include populations underrepresented in the literature to highlight the potential of DMHIs to reduce health disparities. Provider administered DMHIs (Type 1) and provider administered DMHIs with blended digital adjuncts (Type 2) are offered within a healthcare system. Self-help human supported/guided DMHIs with therapeutic or technical guidance (Type 3) are offered outside a healthcare system. And self-help fully automated DMHIs (Type 4) are interventions similar to self-help books, do not involve human support and are also offered outside a healthcare system. Type 1, 2, and 3 interventions are consumable, they require human time to administer and are limited by the number of hours a health care provider or guide (to promote adherence) is available. Type 4 interventions are non-consumable because these can be used an unlimited number of times anytime anywhere in the world without human interaction. Identifying DMHIs as belonging to one of these categories can promote the development of each category, guide future reviews and help disseminate those DMHIs to as many people as possible.

Capsicum chinense var. BRS Moema: chemical characterization by HPLC-ESI-MS/MS and antiproliferative screening.

Capsiate and phenolics present in the free, esterified, glycosylated, and insoluble-bound forms of BRS Moema peppers were characterized and quantified using UHPLC-ESI-MS/MS. Additionally, the in vitro antiproliferative activity of BRS Moema extract was evaluated. The peppers showed considerable quantities of capsiate and phenolic compounds. Esterified phenolics were the main fraction, followed by the insoluble-bound fraction, indicating that relying solely on the extraction of soluble phenolics may underestimate the total phenolic content. Among the fourteen phenolics identified in extract fractions, gallic acid was the major constituent. Phenolic fractions displayed high antioxidant capacity by TEAC and ORAC assays. Nevertheless, the correlation between phenolic compounds and antioxidant activity suggested that other bioactive or phenolic compounds may contribute to the overall phenolic compounds and antioxidant capacity of the obtained fractions. Concerning the antiproliferative activity, the extract did not exhibit any effect on cell proliferation within the evaluated concentration range. These findings indicated that BRS Moema peppers can serve as a rich source of phenolic compounds. Therefore, fully utilizing them could bring advantages to the food and pharmaceutical industries, as well as to consumers and producers.

Supercritical CO2 as a Valuable Tool for Aroma Technology.

This review addresses the possibilities of using supercritical carbon dioxide (SC-CO2) in the flavor industry in extraction and fractionation processes and its use as a reaction medium to generate aroma esters. The advantages and disadvantages are presented, comparing SC-CO2 processing with traditional methods. The most distinguishable features of SC-CO2 include mild reaction conditions, time savings, fewer toxicity concerns, higher sustainability, and the possibility of modulating solvent selectivity according to the process conditions (such as pressure and temperature). Thus, this review indicates the potential of using SC-CO2 to obtain a high selectivity of compounds that can be applied in aroma technology and related fields.

Views and experiences of migrants and stakeholders involved in social and health care for migrants in Italy during the COVID-19 pandemic: a qualitative study.

BACKGROUND: The COVID-19 pandemic has had major and potentially long-lasting effects on mental health and wellbeing across populations worldwide. However, these impacts were not felt equally, leading to an exacerbation of health inequalities, especially affecting vulnerable populations such as migrants, refugees and asylum seekers. Aiming to inform the adaptation and implementation of psychological intervention programmes, the present study investigated priority mental health needs in this population group. METHODS: Participants were adult asylum seekers, refugees and migrants (ARMs) and stakeholders with experience in the field of migration living in Verona, Italy, and fluent in Italian and English. A two-stage process was carried out to examine their needs using qualitative methods including free listing interviews and focus group discussions, according to Module One of the DIME (Design, Implementation, Monitoring, and Evaluation) manual. Data were analyzed using an inductive thematic analyses approach. RESULTS: A total of 19 participants (12 stakeholders, 7 ARMs) completed the free listing interviews and 20 participants (12 stakeholders and 8 ARMs) attended focus group discussions. Salient problems and functions that emerged during free listing interviews were discussed during the focus group discussions. During the COVID-19 pandemic, ARMs struggled with many everyday living difficulties in their resettlement country due to social and economic issues, revealing a strong influence of contextual factors in determining mental health. Both ARMs and stakeholders highlighted a mismatch between needs, expectations and interventions as factors that may hamper proper implementation of health and social programmes. CONCLUSIONS: The present findings could help in the adaptation and implementation of psychological interventions targeting the needs of asylum seekers, refugees and migrants aiming to find a match between needs, expectations, and the corresponding interventions. TRIAL REGISTRATION: Registration number 2021-UNVRCLE-0106707, February 11 2021.

Effect of supercritical CO2 fractionation of Tahiti lemon (Citrus latifolia Tanaka) essential oil on its antifungal activity against predominant molds from pan bread.

This study aimed to verify the in vitro antifungal activity of Tahiti lemon essential oil (LEO) and its fractions, obtained by supercritical CO2 fractionation, against Penicillium sumatrense and Aspergillus niger isolated from pan bread. For this, LEO was solubilized (20 MPa and 40 °C) and fractionated (10 MPa and 40 °C) in supercritical CO2, resulting in soluble (SF) and precipitated (PF) fractions. LEO, SF and PF volatile compounds were identified by gas chromatography coupled to mass spectrometry (GC-MS) and semiquantified by gas chromatography with a flame ionization detector (GC-FID). To evaluate the in vitro antifungal activity of the essential oils (LEO, SF and PF), the minimal inhibitory and fungicidal concentrations (MIC and MFC, respectively) were determined using the 96-well plate methodology. For this, pan breads ware prepared with no preservatives and stored for seven days at 25 °C, and their pH, water activity and moisture contents were determined. Then, two predominant species (Penicillium sumatrense and Aspergillus niger) were isolated from pan breads, characterized according to their morphological and molecular characteristics, and were used in the antifungal activity studies. LEO and its fractions presented monoterpenes, sesquiterpenes and their oxygenated derivatives in their composition. Specifically, limonene was the major component identified in the essential oils. SF showed greater antifungal potential than PF and LEO, showing that supercritical CO2 fractionation could improve the antifungal efficiency of LEO. The results suggest that LEO and its fractions may contribute to the inhibition of Aspergillus niger and Penicillium sumatrense growth in pan breads.

Standardization proposal to quality control of propolis extracts commercialized in Brazil : A fingerprinting methodology using a UHPLC-PDA-MS/MS approach.

Propolis is a rich source of known and largely explored bioactive compounds with many pharmacological properties. It is used in several commercialized products, such as propolis-enriched honey, candies, mouth and throat sprays, soaps, toothpaste, and skin creams. However, the great diversity of propolis products and different types make the standardization of realistic quality control procedures challenging. Moreover, the extraction of propolis bioactive compounds depends on the technique and the solvent used. In Brazil, the Ministry of Agriculture, Livestock, and Supply (MAPA) set standards to establish commercialized propolis extracts' identity and quality. In addition, according to legislation, propolis extracts must present the main classes of phenols at 200 and 400 nm on the UV spectrum. Still, it is not specified which analysis method should be used to guarantee feasible quality control of the commercialized samples. For this, we proposed a new fast UHPLC-PDA-MS/MS method for analysis and quantification of propolis phenolic compounds. Moreover, we hypothesize that there is no efficient monitoring regarding the quality of the propolis extracts sold in Brazilian stores. Therefore, the present study aimed to perform quality control of 17 Brazilian propolis extracts produced in the Southeast region (green or brown - the most representative samples). The dry extract content (% g/mL), oxidation index (seconds), total flavonoids, and phenolics (% m/m) of each sample were compared with legislation. We conclude that using the UHPLC-PDA method and the investigation that allowed the comparison with the current legislation efficiently practical problems in the commercialization of propolis extracts. However, of the 17 analyzed samples, 6 did not meet the desired the recognized standards, denoting a lack of supervision and efficient quality control, which highlights a dangerous situation regarding the commercialization of this critical product used in several industrial fields, mainly in the food and pharmaceutical sector.

Pressurized liquid extraction coupled in-line with SPE and on-line with HPLC (PLE-SPExHPLC) for the recovery and purification of anthocyanins from SC-CO2 semi-defatted Açaí (Euterpe oleracea).

This study aimed to extract anthocyanins from dried and semi-defatted açaí pulp using green technologies based on the coupling of pressurized liquid extraction (PLE) with in-line purification through solid-phase extraction (SPE) and on-line analysis by high-performance liquid chromatography (HPLC). Critical parameters that affect the extraction efficiency and purification were investigated and optimized by response surface methodology (RSM). PLE was performed with acidified water at different pH (2.0, 4.5, and 7.0) and temperatures (40, 80, and 120 °C) at 15 MPa, 2 mL/min, and solvent-to-feed mass ratio equal to 40. SPE was optimized in a column packed with the adsorbent PoraPak™ Rxn. Different ethanol concentrations (50, 75, and 100 %) and temperatures (30, 40, and 50 °C) were evaluated for the anthocyanin's elution. The optimal conditions of the two experimental designs were determined by the RSM, firstly for PLE: 71 °C and pH 2; then using this PLE condition, the optimization of the SPE was obtained: 30 °C and 50 % ethanol. The developed PLE method provided similar anthocyanin yield to other techniques, and the coupling with SPE in-line produced an extract 5-fold more concentrated than PLE alone. Therefore, the system (PLE-SPE × HPLC-PDA) proved to be a powerful tool for monitoring the extraction process in real-time.

Ectasia vascular antral gastrica (GAVE) / Gastric antral vascular ectasia (GAVE)

La ectasia vascular antral gástrica (GAVE) ha sido reconocida como una de las causas importantes de hemorragia gastrointestinal oculta y oscura. El diagnóstico generalmente se realiza en función de los rasgos endoscópicos característicos, incluida la fila longitudinal de rayas planas y rojizas que irradian desde el píloro hacia el antro que se asemejan a las rayas de una sandía (Watermelon). Estas apariencias, pueden ser fácilmente malinterpretadas como una gastritis de moderada a severa. El diagnóstico del síndrome GAVE en pacientes con enfermedad renal o hepática suele ser problemático porque hay causas más frecuentes de hemorragia gastrointestinal en estas enfermedades como, por ejemplo, malformaciones vasculares, enfermedad ulcerosa péptica, várices esofágicas o gástricas y úlceras colónicas y rectales que eclipsan al síndrome GAVE. Creemos que el tratamiento quirúrgico es una modalidad cuando los diferentes métodos, no pudieron tratar de solucionar esta patología del GAVE. Probablemente en nuestro medio necesitamos más sospecha clínica de esta patología, como así mismo mayor experiencia en los tratamientos endoscópicos de tipo terapéuticos. Ante la falla de estos métodos, la cirugía , ya sea laparoscópica o convencional siguen teniendo lugar en la resolución de estos pacientes con patología poco común.

Gastric antral vascular ectasia (Gave) has been recognized as one of the important causes of hidden and dark gastrointestinal hemorrhage. The diagnosis is generally performed based on the characteristic endoscopic features, including the longitudinal row of flat and reddish stripes that radiate from the pylorus to the antrum that resemble the stripes of a watermelon (watermelon). These appearances can be easily misunderstood as moderate to severe gastritis. The diagnosis of the Gave syndrome in patients with renal or hepatic disease is usually problematic because there are more frequent causes of gastrointestinal bleeding in these diseases such as vascular malformations, peptic ulcerative disease, esophageal or gastric veins and colonic and rectal ulcers that eclipsan al Gave syndrome. We believe that surgical treatment is a modality when the different methods could not try to solve this pathology of the Gave. Probably in our environment we need more clinical suspicion of this pathology, as well as more experience in therapeutic endoscopic treatments. Given the failure of these methods, surgery, whether laparoscopic or conventional continue to take place in the resolution of these patients with unusual pathology.

Extraction of potential bioactive compounds from industrial Tahiti lime (Citrus latifólia Tan.) by-product using pressurized liquids and ultrasound-assisted extraction.

This work evaluated two emerging techniques in extracting phenolic compounds from Tahiti lime pomace - pressurized liquid extraction (PLE) and ultrasound-assisted extraction (UAE). PLE was performed at different temperatures (60 - 110 °C) and times (5 - 40 min), and UAE was carried out varying ultrasound power (160 - 792 W), time (2 - 10 min), and solvent to feed mass ratio (20 - 40 kg solvent/kg dried pomace). Both used ethanol and water (3:1, wt.) as the solvent. The effects of these variables were evaluated on global extraction yield, polyphenols, hesperidin, narirutin yields, and antioxidant capacity. PLE was strongly affected by temperature and extraction time, and the highest temperature (110 °C) provided the best results for global yield, total phenolic, and ORAC, except for hesperidin and narirutin, which were not significative affected by temperature. UAE revealed a weak dependency on power, S/F, and time; however, the lowest power level significantly increased the yields compared to no power application. Thus, P = 480 W, t = 6 min, and S/F = 30 was chosen as the best condition in the UAE in terms of overall extraction yield, total phenolics, specific phenolics, antioxidant capacities, and solvent and energy expenditures. UAE mechanisms were investigated by comparing with heated and stirred maceration, and scanning electron microscopy suggested that total phenolic yield was influenced by mechanisms that only ultrasound can provide. Micrographics confirmed the cavitation effect on Tahiti lime pomace particles' surface. To sum up, PLE resulted in the highest yields and antioxidant capacity, followed by UAE.

Smart pooling: AI-powered COVID-19 informative group testing.

Massive molecular testing for COVID-19 has been pointed out as fundamental to moderate the spread of the pandemic. Pooling methods can enhance testing efficiency, but they are viable only at low incidences of the disease. We propose Smart Pooling, a machine learning method that uses clinical and sociodemographic data from patients to increase the efficiency of informed Dorfman testing for COVID-19 by arranging samples into all-negative pools. To do this, we ran an automated method to train numerous machine learning models on a retrospective dataset from more than 8000 patients tested for SARS-CoV-2 from April to July 2020 in Bogotá, Colombia. We estimated the efficiency gains of using the predictor to support Dorfman testing by simulating the outcome of tests. We also computed the attainable efficiency gains of non-adaptive pooling schemes mathematically. Moreover, we measured the false-negative error rates in detecting the ORF1ab and N genes of the virus in RT-qPCR dilutions. Finally, we presented the efficiency gains of using our proposed pooling scheme on proof-of-concept pooled tests. We believe Smart Pooling will be efficient for optimizing massive testing of SARS-CoV-2.