Facilitating Factors and Barriers to the Implementation of the Icelandic Prevention Model of Adolescent Substance Use in Chile: A Focus Group Study.

The use of alcohol and other drugs is a major public health problem in adolescence. The implementation of evidence-based prevention strategies is still scarce in the global south. This study aimed to evaluate facilitators and barriers to the implementation of the Icelandic prevention model of adolescent substance use (IPM) in Chile. We conducted a qualitative study of stakeholders during the implementation process of the IPM in six municipalities of the Metropolitan Region of Santiago, Chile. We convened six focus groups with parents and professionals from schools and municipal prevention teams (38 participants). Recordings were transcribed and submitted to a six-step thematic analysis. The following facilitators emerged: Participants valued the contribution of the IPM to articulate existing programs and teams, its community focus, and the local data obtained through the survey. There were also several barriers: Those included resistance to adopting a foreign model, the tension between generating local strategies and looking for measures to ensure the fidelity of the implementation, socioeconomic differences between and within municipalities, low-risk perception and supervision of parents in Chile, and a culture that generally does not discourage adolescent substance use. Implementation of the IPM was largely accepted by the stakeholders who agreed with the community approach of the model. The main barriers to consider were related to cultural and socioeconomic factors that need to be addressed in further research and may limit the effects of the model in Chile.

Two new species of the genus Hoplopeza Bezzi (Diptera, Hybotidae, Ocydromiinae) from the high Andean forests of Colombia.

Two new Andean species of Hoplopeza Bezzi are described and illustrated: Hoplopeza colombiana sp. nov. and Hoplopeza rafaeli sp. nov. These species are the first record from the Andean ecosystem of Colombia. In addition, the genus is diagnosed, the first description of the female terminalia, as well as a key and distribution map of the Andean species of the genus are presented.

Evaluating natural and anthropogenic inputs on the distribution of potentially toxic elements in urban soil of Valdivia, Chile.

The increasing population in urban areas in the last decades requires an effort to understand the geochemistry of contaminant elements in urban soil. Topsoil plays a crucial role in the exposure of Potentially Toxic Elements (PTEs) to humans through ingestion, dermal contact, and inhalation. In Chile, the last census revealed that 88.6% of people live in cities or towns and only 11.4% in rural areas. This study presents the first systematic geochemical survey of urban soil in the city of Valdivia, in the South of Chile. Topsoil samples (0-10 cm depth) were collected in less disturbed locations within the city at 130 sampling sites using a grid of 0.25 km2 squares covering a total area of approximately 30 km2. The concentrations of Al, Fe, Na, Ca, Mg, K, Ti, Be, V, Cr, Mn, Co, Ni, Cu, Zn, As, Mo, Sn, Cd, Se, Pb and Hg were measured. The results showed that high concentrations of Cu, V, Zn and Pb are located mainly in the city's northern area and exceed international soil quality legislation for agricultural use. Data processing comprised plotting of individual spatial distribution maps and the use of a combination of multivariate statistical methods. Hierarchical cluster analysis and principal component analysis identified three element associations. The two element groups V-Al-Ti-Fe-Cr-Co-Mn-Be-Ni and Ca-Na-K-As-Mg are interpreted as a dominant lithological origin related to the most pristine soil conditions in less populated areas. By contrast, the Sn-Pb-Zn-Mo-(Cu-Hg) association presents a significant correlation with urbanization indicators, including vehicular traffic and industrial activities developed since the end of the nineteenth century in Valdivia.

Effectiveness of a Therapeutic Exercise Program to Improve the Symptoms of Peripheral Neuropathy during Chemotherapy: Systematic Review of Randomized Clinical Trials.

BACKGROUND: Therapeutic exercise has an important role to manage chemotherapy-induced peripheral neuropathy symptoms. However, there is little evidence of its effectiveness. OBJECTIVE: To synthesize the evidence regarding therapeutic exercise during chemotherapy to improve peripheral neuropathy symptoms. DATABASES: PubMed, CINAHL, Cochrane Library, PEDro, ScienceDirect, Scopus, Web of Science and BIREME. METHODOLOGY: Randomized clinical trials were included. GRADE was used to synthesize evidence and an inverse variance model for meta-analysis. RESULTS: Up to May 2022, 2172 references were analyzed and 14 studies that evaluated 1094 participants were included. The exercises were highly effective in improving pain threshold and moderately effective in improving peripheral neuropathy symptoms at the 8-week follow-up and the 4-24 weeks. Furthermore, the evidence was low in improving thermal threshold, tactile and vibratory sensitivity. CONCLUSION: Therapeutic exercise generates a significant reduction in peripheral neuropathy symptoms in patients in short- and long-term follow-up with a moderate level of evidence quality.

Neurodegenerative VPS41 variants inhibit HOPS function and mTORC1-dependent TFEB/TFE3 regulation.

Vacuolar protein sorting 41 (VPS41) is as part of the Homotypic fusion and Protein Sorting (HOPS) complex required for lysosomal fusion events and, independent of HOPS, for regulated secretion. Here, we report three patients with compound heterozygous mutations in VPS41 (VPS41S285P and VPS41R662* ; VPS41c.1423-2A>G and VPS41R662* ) displaying neurodegeneration with ataxia and dystonia. Cellular consequences were investigated in patient fibroblasts and VPS41-depleted HeLa cells. All mutants prevented formation of a functional HOPS complex, causing delayed lysosomal delivery of endocytic and autophagic cargo. By contrast, VPS41S285P enabled regulated secretion. Strikingly, loss of VPS41 function caused a cytosolic redistribution of mTORC1, continuous nuclear localization of Transcription Factor E3 (TFE3), enhanced levels of LC3II, and a reduced autophagic response to nutrient starvation. Phosphorylation of mTORC1 substrates S6K1 and 4EBP1 was not affected. In a C. elegans model of Parkinson's disease, co-expression of VPS41S285P /VPS41R662* abolished the neuroprotective function of VPS41 against α-synuclein aggregates. We conclude that the VPS41 variants specifically abrogate HOPS function, which interferes with the TFEB/TFE3 axis of mTORC1 signaling, and cause a neurodegenerative disease.

Urinary Extracellular Vesicles as a Source of NGAL for Diabetic Kidney Disease Evaluation in Children and Adolescents With Type 1 Diabetes Mellitus.

Background: Tubular damage has a role in Diabetic Kidney Disease (DKD). We evaluated the early tubulointerstitial damage biomarkers in type-1 Diabetes Mellitus (T1DM) pediatric participants and studied the correlation with classical DKD parameters. Methods: Thirty-four T1DM and fifteen healthy participants were enrolled. Clinical and biochemical parameters [Glomerular filtration Rate (GFR), microalbuminuria (MAU), albumin/creatinine ratio (ACR), and glycated hemoglobin A1c (HbA1c)] were evaluated. Neutrophil gelatinase-associated lipocalin (NGAL), Hypoxia-inducible Factor-1α (HIF-1α), and Nuclear Factor of Activated T-cells-5 (NFAT5) levels were studied in the supernatant (S) and the exosome-like extracellular vesicles (E) fraction from urine samples. Results: In the T1DM, 12% had MAU >20 mg/L, 6% ACR >30 mg/g, and 88% had eGFR >140 ml/min/1.72 m2. NGAL in the S (NGAL-S) or E (NGAL-E) fraction was not detectable in the control. The NGAL-E was more frequent (p = 0.040) and higher (p = 0.002) than NGAL-S in T1DM. The T1DM participants with positive NGAL had higher age (p = 0.03), T1DM evolution (p = 0.03), and serum creatinine (p = 0.003) than negative NGAL. The NGAL-E correlated positively with tanner stage (p = 0.0036), the median levels of HbA1c before enrollment (p = 0.045) and was independent of ACR, MAU, and HbA1c at the enrollment. NFAT5 and HIF-1α levels were not detectable in T1DM or control. Conclusion: Urinary exosome-like extracellular vesicles could be a new source of early detection of tubular injury biomarkers of DKD in T1DM patients.

Four new Neotropical species of Eudicrana Loew (Diptera, Mycetophilidae, Sciophilinae) from the Colombian high Andean ecosystems, with comments on the genus.

Four new species of the sciophiline genus Eudicrana Loew are described for the Eastern and Central Andes of Colombia-Eudicrana silvaandina sp. nov., E. chingaza sp. nov., E. maculata sp. nov. and E. merizaldei. These are the first species of Eudicrana described from the extreme northern range of the Andes. The altitudinal distribution of these species in the paramos and high Andean forest ecosystems is restricted to 1750-3660 m a.s.l. and some other information on the environment is briefly discussed. A key for the Colombian species of Eudicrana is provided and a discussion is elaborated on the position of these species within the genus.

'Maybe It Is Only in Prison That I Could Change Like This' The Course of Severe Mental Illnesses During Imprisonment - A Qualitative 3-Year Follow-Up Study From Chile.

BACKGROUND: Severe mental illness (SMI) among imprisoned individuals is a global health concern. Quantitative research indicates on average mental health symptom improvements during imprisonment, however, it cannot reflect multifaceted factors influencing the course of SMI. This study aimed to explore the subjective course of SMI during imprisonment and to identify influencing factors. METHODS: The study has a 3-year-follow-up design of imprisoned individuals in Chile. We conducted semi-structured interviews with 10 men and 9 women at follow-up who had either major depression or psychosis (severe mental illnesses) at baseline. We included individuals who deteriorated, remained stable or improved their mental health according to quantitative assessments. We explored the subjective course of their mental health condition during the follow-up period. Qualitative data was transcribed and coded using NVivo Software for quantitative content analysis. Qualitative data was also manually coded and was subsequently analyzed using the thematic analysis method with an inductive approach. We developed the final themes using the results of this analysis in combination with the inclusion criteria. RESULTS: The mental health of 10 individuals subjectively improved, 6 experienced deteriorations, and 3 did not perceive any change. Good infrastructure, structure/occupation, intrapersonal resources (will to change, spirituality) and supportive relationships were identified as factors improving mental health. Factors deteriorating mental health were identified as bad infrastructure (e.g., no running water and bad housing conditions) and crowding, lack of psychological treatment, exposure to violence, interpersonal stress (conflictive relationships and separation from family), perceived injustice through sentencing, intrapersonal stressors and previous medical conditions. DISCUSSION: SMI in prison can improve in a supportive environment under certain conditions. These conditions include the improvement of infrastructure (housing and healthcare), the opportunity to work or study, protection from violence during imprisonment, and to develop intrapersonal resources and family relationships. To reduce SMI in prisons the improvement of these conditions should become a priority.

Corrigendum: Initiating Change of People With Criminal Justice Involvement Through Participation in a Drama Project: An Exploratory Study.

[This corrects the article DOI: 10.3389/fpsyt.2019.00716.].

Dyspnea in antiphospholipid syndrome: Beyond pulmonary embolism.

Pulmonary embolism due to primary antiphospholipid syndrome is rarely associated with chronic thromboembolic pulmonary hypertension, and therefore according to the latest guidelines on pulmonary hypertension, routine screening is not recommended. We describe a young patient with a late diagnosis of chronic thromboembolic pulmonary hypertension in the context of pulmonary embolism, primary antiphospholipid syndrome and suboptimal anticoagulation. Of note, mild cardiopulmonary symptoms were consistently misattributed to a depressive disorder because physical examination was normal, serial Doppler echocardiography failed to show pulmonary hypertension, and all other diagnostic tests were normal. Once symptoms became severe, positive screening tests led to the correct diagnosis and surgical referral, and bilateral pulmonary endarterectomy was successfully performed. This case demonstrates the need for extra awareness in patients with antiphospholipid syndrome and pulmonary embolism.

Initiating Change of People With Criminal Justice Involvement Through Participation in a Drama Project: An Exploratory Study.

Introduction: Innovative and interdisciplinary approaches are needed to improve mental health and psychosocial outcomes of people with criminal justice involvement and their families. Aim of the study was to assess effects of the participation in a theatre project on the mental health problems of people with criminal justice involvement and relatives. Methods: We conducted structured diagnostic interviews and in-depth qualitative interviews with five participants performing Shakespeare's Richard III in Chile. Three participants had been imprisoned prior to the project, and two were the parents of a person who died in a prison fire. Qualitative interviews followed a topic guide. Data were transcribed, and a six-phase approach for thematic analysis of the data was used. Results: Substance use disorder or major depression was identified in all the participants. Participation in the theatre project was experienced by the respondents as having a positive effect on the mental health conditions. The research registered the positive experiences of role identification, emotional expression, commitment with group processes, improved skills to socially interact, to be heard by the general public and society, and positive perceptions of the audience (including relatives). Discussion: The study raises the possibility that there may be improvements of depression and substance use problems through the participation of people with criminal justice involvement in a drama project. Wider scale research is recommended on the possible effects. The approach may be an alternative to psychotherapy and medication for some individuals.

Revision of the Neotropical Neuratelia Rondani (Diptera, Mycetophilidae, Sciophilinae): two new species, a new combination, and a new synonym.

We describe two new Neotropical species of Neuratelia Rondani from the high Central Andes of Colombia, N.altoandina sp. nov. and N.colombiana sp. nov. The holotype of Eudicranaelegans Lane actually is a species of Neuratelia and a new combination is proposed. Our examination of the holotype of Neurateliasapaici Lane from southeastern Brazil shows this species to be a synonym of N.elegans (Lane), which is formally proposed here. Neurateliasapaici is redescribed. The position of these three species within the genus is discussed. A key for the Neotropical species of Neuratelia is provided.

Earlier puberty in boys with type 1 diabetes mellitus compared to a simultaneously recruited group of control adolescents.

BACKGROUND: Recent studies have suggested that there is an earlier age of onset of puberty in healthy boys. However, no study has determined the age of pubertal development in boys with type 1 diabetes (T1D) and compared the results with a simultaneously recruited group of healthy children. OBJECTIVE: The aim of this study was to evaluate the age of pubertal events in boys with TD1 and determine whether the duration of diabetes, metabolic control or insulin dose are associated with the age of puberty in boys with T1D. METHODS: Boys aged 7 to 19 years with T1D (n = 148, age 12.9 ± 3.0 years) and healthy boys recruited from schools (n = 388 controls, age 12.8 ± 2.2 years) were studied. A pediatric endocrinologist evaluated pubertal development. RESULTS: Boys at genital Tanner stage 2 and the final stages of puberty (genital Tanner 4 and 5) were younger than the control group (P = 0.005, P = 0.003, and P = 0.015, respectively). Both groups of boys had a similar age of pubic Tanner stage development. There were no cases of pubertal delay observed in the T1D cohort. There was no association observed between metabolic control with pubertal timing. T1D adolescents had lower height-SDS than the C group at the final stages of puberty. CONCLUSIONS: Boys with T1D who are treated with modern insulin therapy appear to have an earlier age of onset and an earlier age of final pubertal events than a simultaneously studied group of healthy children. These data suggest that pubertal delay is not a frequent problem for male T1D patients.

[Models of care and classification of "Children with special health care needs-CSHCN": Recommendations from the CSHCN Committee, Chilean Paediatric Society]. / Modelo de atención y clasificación de «Niños y adolescentes con necesidades especiales de atención en salud-NANEAS¼: recomendaciones del Comité NANEAS de la Sociedad Chilena de Pediatría.

"Children with special health care needs" (CSHCN) is an emerging and heterogeneous group of paediatric patients, with a wide variety of medical conditions and with different uses of health care services. There is consensus on how to classify and assess these patients according to their needs, but not for their specific diagnosis. Needs are classified into 6 areas: a) specialised medical care; b) use or need of prescription medication; c) special nutrition; d) dependence on technology; e) rehabilitation therapy for functional limitation; and f) special education services. From the evaluation of each area, a classification for CSHCN is proposed according to low, medium, or high complexity health needs, to guide and distribute their care at an appropriate level of the health care system. Low complexity CSHCN should be incorporated into Primary Care services, to improve benefits for patients and families at this level. It is critical to train health care professionals in taking care of CSHCN, promoting a coordinated, dynamic and communicated work between different levels of the health care system. Compliance with these guidelines will achieve a high quality and integrated care for this vulnerable group of children.

Total protein concentration and diagnostic test results for gray wolf (Canis lupus) serum using Nobuto filter paper strips.

Nobuto filter paper strips are widely used for storing blood-serum samples, but the recovery of proteins from these strips following rehydration is unknown. Poor recovery of proteins could reduce the concentration of antibodies and antigens and reduce the sensitivity of diagnostic assays. We compared the protein concentration, and its association with test sensitivity, of eluted Nobuto strip samples with paired sera. We collected and froze serum from five gray wolves (Canis lupus) for 8 mo. When thawed, we used a spectrophotometer (absorbance 280 nm) to determine the serum protein concentration for paired sera and Nobuto eluates for each animal in 2-fold serial dilutions. Total protein concentration was similar for both sample storage methods (Nobuto eluates and control sera), except for the undiluted samples in which Nobuto eluates had higher total protein concentrations. Both sample storage methods appear to produce similar results using the SNAP® 4Dx® Test to detect antibodies against pathogens causing Lyme disease, anaplasmosis, and ehrlichiosis as well as antigen for canine heartworm disease.

Evidence of a bacterial receptor for lysozyme: binding of lysozyme to the anti-σ factor RsiV controls activation of the ecf σ factor σV.

σ factors endow RNA polymerase with promoter specificity in bacteria. Extra-Cytoplasmic Function (ECF) σ factors represent the largest and most diverse family of σ factors. Most ECF σ factors must be activated in response to an external signal. One mechanism of activation is the stepwise proteolytic destruction of an anti-σ factor via Regulated Intramembrane Proteolysis (RIP). In most cases, the site-1 protease required to initiate the RIP process directly senses the signal. Here we report a new mechanism in which the anti-σ factor rather than the site-1 protease is the sensor. We provide evidence suggesting that the anti-σ factor RsiV is the bacterial receptor for the innate immune defense enzyme, lysozyme. The site-1 cleavage site is similar to the recognition site of signal peptidase and cleavage at this site is required for σV activation in Bacillus subtilis. We reconstitute site-1 cleavage in vitro and demonstrate that it requires both signal peptidase and lysozyme. We demonstrate that the anti-σ factor RsiV directly binds to lysozyme and muramidase activity is not required for σV activation. We propose a model in which the binding of lysozyme to RsiV activates RsiV for signal peptidase cleavage at site-1, initiating proteolytic destruction of RsiV and activation of σV. This suggests a novel mechanism in which conformational change in a substrate controls the cleavage susceptibility for signal peptidase. Thus, unlike other ECF σ factors which require regulated intramembrane proteolysis for activation, the sensor for σV activation is not the site-1 protease but the anti-σ factor.

Differences in body composition and resting energy expenditure in childhood in preterm children born with very low birth weight.

BACKGROUND: Rapid early ponderal growth is associated with adverse metabolic risks in young adults born at term. AIM: To determine whether there are differences in body composition, resting energy expenditure (REE) and metabolic variables between preterm children born with very low birth weight (VLBW) either appropriate (AGA) or small (SGA) for gestational age and whether these differences are related to an early period of weight gain. METHODS: 67 VLBW preterm (40 AGA, 27 SGA). Body composition by DEXA, REE by indirect calorimetry and blood sampling at age 6.7 ± 0.5 years. RESULTS: VLBW SGA children were lighter, shorter, had a lower waist and hip circumference, HDL cholesterol and lipid oxidation rates than their AGA counterparts (adjusted for age, sex and BMI). Birth weight correlated negatively with total body and trunk fat mass. In a multivariate linear regression analysis, we found a positive association between weight gain in the first 3 months of life and total and trunk fat at age 6 years and a reciprocal association with REE at age 6 years. In contrast, the weight gain rate at 6-9 months of life was associated with higher REE and lipid oxidation rates at 6 years. A higher weight gain rate at 9-12 months was associated with a higher lean mass at 6 years. CONCLUSION: An early fast-pace weight gain in VLBW infants may have detrimental consequences for metabolic health later on.

Cell-free production of integral membrane aspartic acid proteases reveals zinc-dependent methyltransferase activity of the Pseudomonas aeruginosa prepilin peptidase PilD.

Integral membrane aspartic acid proteases are receiving growing recognition for their fundamental roles in cellular physiology of eukaryotes and prokaryotes, and may be medically important pharmaceutical targets. The Gram-negative Pseudomonas aeruginosa PilD and the archaeal Methanococcus voltae FlaK were synthesized in the presence of unilamellar liposomes in a cell-free translation system. Cosynthesis of PilD with its full-length substrate, PilA, or of FlaK with its full-length substrate, FlaB2, led to complete cleavage of the substrate signal peptides. Scaled-up synthesis of PilD, followed by solubilization in dodecyl-ß-d-maltoside and chromatography, led to a pure enzyme that retained both of its known biochemical activities: cleavage of the PilA signal peptide and S-adenosyl methionine-dependent methylation of the mature pilin. X-ray fluorescence scans show for the first time that PilD is a zinc-binding protein. Zinc is required for the N-terminal methylation of the mature pilin, but not for signal peptide cleavage. Taken together, our work identifies the P. aeruginosa prepilin peptidase PilD as a zinc-dependent N-methyltransferase and provides a new platform for large-scale synthesis of PilD and other integral membrane proteases important for basic microbial physiology and virulence.