Hepatic arterial buffer response in monochorionic twins with selective fetal growth restriction.

OBJECTIVES: Monochorionic twins (MC) have higher risk of perinatal morbi-mortality compared to singletons and dichorionic twins (DC). Selective fetal growth restriction (sFGR) increases the chances of adverse outcome. Hepatic arterial buffer response (HABR) is an important mechanism for maintaining liver perfusion. We hypothesised that HABR is active in monochorionic diamniotic twins (MCDA) with sFGR where restricted fetus may have liver hypoperfusion. The objective of this study is to test whether the HAV-ratio is diminished in pregnancies affected by selective fetal growth restriction pointing to activation of HABR in the growth-restricted fetus. METHODS: sFGR was defined according to a consensus definition. Hepatic artery (HA) peak systolic velocity (PSV) was measured and its correlation with fetal Dopplers and pregnancy characteristics were determined. A ratio using HA-PSV (HAV-ratio) was calculated and its association with sFGR was established. Further analysis of HA-PSV was performed comparing z-scores between normal and growth restricted fetuses. RESULTS: We included 202 MCDA pregnancies, 160 (79 %) normal and 42 (21 %) with sFGR. HAV-ratio was significant different between groups. The mean HAV-ratio was 1.01 (±0.20) for normal twins and 0.77 (±0.25) for sFGR. Furthermore, HA-PSV z-scores was significant increased in in growth-restricted fetus (0.94±1.45), while in normal fetuses was -0.16 (±0.97). CONCLUSIONS: Our findings demonstrate that, in pregnancies with sFGR, HAV-ratio is significantly lower than in normal MCDA pregnancies. The lower HAV-ratio is due to an increase in HA PSV in the growth restricted fetus. This observation indicates an activation of HABR in the small fetus.

Cross-Sectional Study of the Anthropometric Profile and Nutrient Status of Elite Female Ice Hockey Players: Differences by Play Position.

Both the characteristics of ice hockey and the environmental conditions in which it is played affect the maintenance of the player's nutritional status and, therefore, their state of health and performance. The primary aim of this work was to examine the anthropometric profile, estimated energy expenditure, and macronutrient and micronutrient dietary intake of elite female ice hockey players by play position. As a secondary aim, their dietary intakes were compared with the recommendations. Hypotheses suggest variations in body composition based on ice hockey players' positions, with the expectation that these athletes may not align with energy and nutrient recommendations. Fifteen elite female ice hockey players were anthropometrically measured, basal metabolic rate and total energy expenditure were estimated, a 3-day, 24 h recall questionnaire was registered, and the results were compared with the recommended dietary intake for the Spanish population. Each player's position on the field requires an individualized physical and nutritional approach. There are no significant imbalances (p > 0.05) between energy and nutrient intake in relation to the Recommended Daily Intake (RDI); however, increasing the consumption of vegetables and seafood while reducing meat and fat intake would assist these athletes in maintaining a healthier energy balance, optimizing body composition, and aligning with nutritional parameters that are better suited to enhance physical performance.

Hepatic arterial buffer response: activation in donor fetuses and the effect of laser ablation of intertwin anastomosis.

OBJECTIVES: Hepatic arterial buffer response (HABR) is an important defence mechanism for maintaining liver blood flow. It is suspected that HABR is active in monochorionic diamniotic twins (MCDA) with twin-to-twin transfusion syndrome (TTTS) where donor compensates a setting of volume depletion and the recipient an overload. The present study investigates whether in TTTS, HABR is active in donor and/or recipient individually and try to determine if the activation of HABR is a direct response to TTTS. METHODS: Hepatic artery (HA) peak systolic velocity (PSV) was measured in normal MCDA fetuses and TTTS. Correlation with relevant fetal Dopplers and characteristics were determined. Z-scores for HA-PSV (HAV-Z) were calculated and its association with TTTS in donors and recipients were determined as well as changes in HAV-Z after laser treatment. RESULTS: In this study 118 MCDA were included, 61.9 % normal and 38.1 % TTTS. Of the TTTS 22 required laser treatment. A total of 382 scans were performed in normal group and 155 in TTTS. Our data demonstrates that in donors HAV-Z was 2.4 Z-scores higher compared to normal fetuses (ß=2.429 95 % CI 1.887, 2.971; p<0.001) and after laser treatment HAV-Z reduced (ß=-1.829 95 % CI -2.593, -1.064; p<0.001). There was no significant difference between recipients and normal (ß=-0.092 95 % CI -0.633, 0.449; p=0.738). CONCLUSIONS: HABR is active in TTTS, promoting an increased hepatic blood flow in donors. The activation is direct response to TTTS as shown by the reduction in HAV-Z after laser. This finding provides important insights into the pathophysiology of TTTS.

Nutrition Status of Female Winter Sports Athletes.

Eating disorders, especially restrictive eating, are common among female athletes. There are two main types of winter sports: those that are practiced outdoors on snow (-25 to +5 °C and 2500 m), such as alpine skiing and snowboarding, and those that are practiced indoors on ice (5-10 °C at low altitude), such as figure skating and ice hockey. The aim of this research was to identify the nutritional status and potential risk of female athletes practicing winter sports, considering the altitude of training. The sample was composed of 58 women (aged 19.81 years (SD: 12.61)) who were competitors in some winter sports. Anthropometrics and nutritional variables were taken. Statistically significant differences were found between HA and LA groups for all the characteristics except thigh skinfold, and neither group had an energy intake (EI) that matched their total energy expenditure (TEE). Both groups met at least two-thirds of the RDI for all minerals and vitamins except iodine, fluorine, vitamin D, vitamin E, and retinol. This study suggests that female winter sports athletes have insufficient energy, vitamin, and mineral intake, which can be worsened with altitude.

Balance between maternal antiviral response and placental transfer of protection in gestational SARS-CoV-2 infection.

The intricate interplay between maternal immune response to SARS-CoV-2 and the transfer of protective factors to the fetus remains unclear. By analyzing mother-neonate dyads from second and third trimester SARS-CoV-2 infections, our study shows that neutralizing antibodies (NAbs) are infrequently detected in cord blood. We uncovered that this is due to impaired IgG-NAb placental transfer in symptomatic infection and to the predominance of maternal SARS-CoV-2 NAbs of the IgA and IgM isotypes, which are prevented from crossing the placenta. Crucially, the balance between maternal antiviral response and transplacental transfer of IgG-NAbs appears to hinge on IL-6 and IL-10 produced in response to SARS-CoV-2 infection. In addition, asymptomatic maternal infection was associated with expansion of anti-SARS-CoV-2 IgM and NK cell frequency. Our findings identify a protective role for IgA/IgM-NAbs in gestational SARS-CoV-2 infection and open the possibility that the maternal immune response to SARS-CoV-2 infection might benefit the neonate in 2 ways, first by skewing maternal immune response toward immediate viral clearance, and second by endowing the neonate with protective mechanisms to curtail horizontal viral transmission in the critical postnatal period, via the priming of IgA/IgM-NAbs to be transferred by the breast milk and via NK cell expansion in the neonate.

Dietary exposure to endocrine disruptors in gut microbiota: A systematic review.

Endocrine disrupting chemicals (EDCs) can interfere with hormonal actions and have been associated with a higher incidence of metabolic disorders. They affect numerous physiological, biochemical, and endocrinal activities, including reproduction, metabolism, immunity, and behavior. The purpose of this review was to elucidate the association of EDCs in food with the gut microbiota and with metabolic disorders. EDC exposure induces changes that can lead to microbial dysbiosis. Products and by-products released by the microbial metabolism of EDCs can be taken up by the host. Changes in the composition of the microbiota and production of microbial metabolites may have a major impact on the host metabolism.

Estimation of the Quality of the Diet of Mexican University Students Using DQI-I.

The quality of diet can be measured using diet quality indices, based on knowledge of associations between diet and health. The objective of this work was to evaluate whether the International Diet Quality Index is suitable for use as a diet quality index in populations of Mexican university girls. A cross-sectional nutritional survey was conducted at the University of Chihuahua (Mexico), collecting semi-quantitative nutritional information and socio-economic and lifestyle data from a representative sample of 400 women. Mean (Standard Deviation (SD)) age was 21.43 years (SD: 3.72); 59.1% were normal weight, 26.6% overweight, 15.3% obesity. The Diet Quality Index-International (DQI-I) was developed according to the method of Kim et al. (2003) and focused on major aspects of a high-quality diet (variety, adequacy, moderation and overall balance). The total score of Diet Quality Index-International reached 53.86% (SD: 11.43), indicating that the general diet of Mexican women a poor-quality diet. Adequacy scored highest, followed by moderation and variety. Overall balance scored the lowest. Variety: 26.3 % consumed less than 4 food groups daily, only 12.8% take more than 1 serving from each food group, and 50.6% consumed only one source of protein daily. Regarding adequacy, a large proportion of the population reported an intake of proteins, vitamin C, calcium, iron, and fruit greater than 50% of recommendation; the vegetables, fiber and grain groups were less 50%. Poor scores were obtained for total fat and SFA consumption (moderation). No statistically significant differences are observed for any of the variables under study and score of the Diet Quality Index-International: body mass index, weight, physical activity level, education level of father and mother, location of lunch, breakfast considered important, knowledge of nutrition, which allows us to consider a relatively uniform population in its eating habits. These people are close to a Westernized diet, and an intervention in nutritional education would be advisable to improve the intake of unprocessed foods, consume a greater variety of protein sources and significantly reduce consumption of sugary foods and soft drinks. Due to different methodological and cultural factors, the proposed Diet Quality Index-International dietary assessment method does not seem to be useful in the assessment of diet quality in the Mexican university population, so further research is needed to develop a diet quality index adapted to the Mexican population.

Hepatic arterial buffer response in monochorionic diamniotic pregnancies with twin-to-twin transfusion syndrome.

OBJECTIVES: Hepatic arterial buffer response (HABR) is an important regulatory process for hepatic blood flow. Its activity has been described in some fetal adverse conditions but in twin-to-twin transfusion syndrome (TTTS) it is unknown if such response is present. The aim of this study is to test the hypothesis that HABR operates in monochorionic diamniotic twins (MCDA) with TTTS. METHODS: Hepatic artery pulsatility index (PI) and peak systolic velocity (PSV) were measured prospectively in 64 MCDA pregnancies. 43 without TTTS (group 1) and in 21 pregnancies with TTTS (group 2). We calculated ratios for PI (HAPI-ratio) and PSV (HAV-ratio) between recipient and donor in group 2 or bigger and smaller fetus in group 1 and compared groups. The association of HAV-ratio and HAPI ratio with TTTS, relation with other fetal Dopplers and reliability of measurement by a single operator were investigated. RESULTS: HAV-ratio and HAPI-ratio appears to be independent from fetal Dopplers, estimated weight and gestational age. In group 2, HAV-ratio is lower than group 1 (p<0.001, 95% CI 0.443-0.643). In group 1 the mean HAV-ratio is 1.014 (±0.021) while in group 2 is 0.47 (±0.035). HAPI-ratio is lower in group 2 than in group 1 although this difference was not significant (p=0.066, 95% CI -0.007-0.231). A good reliability of measurements of hepatic artery PSV and PI was demonstrated by intraclass correlation coefficient analysis (ICC 0.971 95% CI 0.963-0.977, p<0.001 and ICC 0.694 95% CI 0.596-0.772, p<0.001, respectively). CONCLUSIONS: Monochorionic pregnancies with TTTS are associated with lower HAV-ratios. This could be explained by an active HABR.

Influence of BPA exposure, measured in saliva, on childhood weight.

Introduction: Endocrine disruptors such as bisphenol A (BPA), BPA glycidyl methacrylate, and other BPA acrylate-based derivatives have been related to type 2 diabetes, the metabolic syndrome, and obesity, among other metabolic disorders. The objective of this study is to examine the influence of BPA exposure by saliva analysis and daily physical activity on the risk of overweight/obesity in schoolchildren from southern Spain. Methods: The study included 300 children (53.5% girls) aged 7-10 years. Participants completed a questionnaire with four sections: participant data, including demographic information and life and family habits; semi-quantitative food frequency questionnaire; anthropometric variables; and physical activity variables. All participants underwent dental examination, when the presence of sealants/composites in each tooth and other dental alterations was recorded, and samples of whole saliva were collected for UHPLC-MS/MS analyses. Results: Risk of overweight/obesity was significantly influenced by body fat composition (OR = 10.77), not walking to and from school (OR = 1.38), lesser energy expenditure in sedentary activities (OR = 12.71), greater energy expenditure in sports (OR =1.62), and exposure to BPA from dental sealants/composites (OR = 1.38; p = 0.058). Discussion: Further research is warranted on this issue in children, who may be especially vulnerable to the negative health effects of endocrine disruption.

Adaptive Filtering for the Maternal Respiration Signal Attenuation in the Uterine Electromyogram.

The electrohysterogram (EHG) is the uterine muscle electromyogram recorded at the abdominal surface of pregnant or non-pregnant woman. The maternal respiration electromyographic signal (MR-EMG) is one of the most relevant interferences present in an EHG. Alvarez (Alv) waves are components of the EHG that have been indicated as having the potential for preterm and term birth prediction. The MR-EMG component in the EHG represents an issue, regarding Alv wave application for pregnancy monitoring, for instance, in preterm birth prediction, a subject of great research interest. Therefore, the Alv waves denoising method should be designed to include the interference MR-EMG attenuation, without compromising the original waves. Adaptive filter properties make them suitable for this task. However, selecting the optimal adaptive filter and its parameters is an important task for the success of the filtering operation. In this work, an algorithm is presented for the automatic adaptive filter and parameter selection using synthetic data. The filter selection pool comprised sixteen candidates, from which, the Wiener, recursive least squares (RLS), householder recursive least squares (HRLS), and QR-decomposition recursive least squares (QRD-RLS) were the best performers. The optimized parameters were L = 2 (filter length) for all of them and λ = 1 (forgetting factor) for the last three. The developed optimization algorithm may be of interest to other applications. The optimized filters were applied to real data. The result was the attenuation of the MR-EMG in Alv waves power. For the Wiener filter, power reductions for quartile 1, median, and quartile 3 were found to be -16.74%, -20.32%, and -15.78%, respectively (p-value = 1.31 × 10-12).

Adherence to a Mediterranean Diet Pattern, Physical Activity, and Physical Self-Concept in Spanish Older Adults.

BACKGROUND: The aging world population is accelerating rapidly. Physical self-concept (PSC) is one of the psychosocial factors with the greatest influence on an individual's well-being and health. The traditional Mediterranean dietary pattern (MDP) is considered one of the healthiest dietary models, as it is nutritionally complete and easy to follow. OBJECTIVE: To assess the adherence to MDP and its association with the practice of physical activity (PA) and PSC levels in the older adult Spanish population. METHODS: A cross-sectional study was conducted on a representative sample of Spanish older adults (n = 342; older than 55 years old). Their PSC was assessed using a previously validated PSC questionnaire. Adherence to an MDP was assessed using a validated Mediterranean Diet Adherence Screener questionnaire. Their PA was measured using the Spanish version of the Rapid Assessment of Physical Activity Questionnaire. Data on age, sex, hypertension, cholesterol or diabetes suffered in the last 12 months, as well as weight, height, and BMI, were collected. RESULTS: At the lowest levels of PSC, the percentage of individuals who were non-active and non-adhering to the MDP was lower compared to the highest levels (75.0% vs. 19.6; p = 0.001; Cramer's V = 0.414, and 83.3% vs. 57.9%; p = 0.001; Cramer's V = 0.221, respectively). This sample showed an abandonment of the most classic habits of the MDP, such as the consumption of olive oil, vegetables, fruits, nuts and fish. CONCLUSIONS: Non-adherence to the MDP and low levels of PA are associated with low levels of PSC in older adults.

A Preliminary Exploration of the Placental Position Influence on Uterine Electromyography Using Fractional Modelling.

The uterine electromyogram, also called electrohysterogram (EHG), is the electrical signal generated by uterine contractile activity. The EHG has been considered an expanding technique for pregnancy monitoring and preterm risk evaluation. Data were collected on the abdominal surface. It has been speculated the effect of the placenta location on the characteristics of the EHG. In this work, a preliminary exploration method is proposed using the average spectra of Alvarez waves contractions of subjects with anterior and non-anterior placental position as a basis for the triple-dispersion Cole model that provides a best fit for these two cases. This leads to the uterine impedance estimation for these two study cases. Non-linear least square fitting (NLSF) was applied for this modelling process, which produces electric circuit fractional models' representations. A triple-dispersion Cole-impedance model was used to obtain the uterine impedance curve in a frequency band between 0.1 and 1 Hz. A proposal for the interpretation relating the model parameters and the placental influence on the myometrial contractile action is provided. This is the first report regarding in silico estimation of the uterine impedance for cases involving anterior or non-anterior placental positions.

One Year of COVID-19 in Pregnancy: A National Wide Collaborative Study.

INTRODUCTION: Even though the risk of COVID-19 in pregnancy may be increased, large-scale studies are needed to better understand the impact of the infection in this population. The aim of this study is to describe obstetric complications and the rate of vertical transmission in pregnant women with SARS-CoV-2 infection. MATERIAL AND METHODS: Detected cases of SARS-CoV-2 infection in pregnancy were registered in Portuguese hospitals by obstetricians. Epidemiological, pregnancy and childbirth data were collected. RESULTS: There were 630 positive cases in 23 Portuguese maternity hospitals, most at term (87.9%) and asymptomatic (62.9%). The most frequent maternal comorbidity was obesity. The rates of preterm birth and small-to-gestational-age were 12.1% and 9.9%, respectively. In the third trimester, 2.9% of pregnant women required respiratory support. There were eight cases (1.5%) of fetal death, including two cases of vertical transmission. There were five cases of postpartum respiratory degradation, but no maternal deaths were recorded. The caesarean section rate was higher in the first than in the second wave (68.5% vs 31.5%). RT-PCR SARS-CoV-2 positivity among newborns was 1.3%. CONCLUSION: SARS-Cov-2 infection in pregnancy may carry increased risks for both pregnant women and the fetuses. Individualized surveillance and the prophylaxis of this population with vaccination. is recommended in these cases.

Introdução: Apesar do risco da COVID-19 na gravidez poder ser acrescido, são necessários estudos em larga escala para o melhor conhecimento do impacto desta infeção nesta população. O objetivo deste estudo é descrever as complicações obstétricas e a taxa de transmissão vertical em grávidas com infeção a SARS-CoV-2. Material e Métodos: Os casos conhecidos de infeção por SARS-CoV-2 na gravidez foram registados nos hospitais portugueses por obstetras. Foram recolhidos dados epidemiológicos, da gravidez e do parto. Resultados: Registaram-se 630 casos positivos em 23 maternidades portuguesas, a maioria no termo (87,9%) e assintomática (62,9%). A comorbilidade materna mais frequente foi a obesidade. A taxa de parto pré-termo e de leves para a idade gestacional foi de 12,1% e 9,9%, respectivamente. No terceiro trimestre, 2,9% das grávidas necessitaram de suporte respiratório. Verificou-se uma taxa de 1,5% de morte fetal, incluindo dois casos de transmissão vertical. Houve cinco casos de degradação respiratória no pós-parto, mas sem mortes maternas registadas. A taxa de cesarianas foi mais elevada na primeira do que na segunda vaga (68,5% vs 31,5%). A positividade do RT-PCR SARS-CoV-2 entre os recém-nascidos foi de 1,3%. Conclusão: A infeção pelo SARS-Cov-2 na gravidez pode acarretar riscos aumentados para as grávidas e fetos. Recomenda-se uma vigilância individualizada nestes casos e a profilaxia desta população com a vacinação.

The fetal origins of disease: a prospective cohort study on the association of preeclampsia and childhood obesity.

Cardiovascular diseases are the main cause of mortality worldwide, and childhood excess weight/obesity are strong correlators of accumulated risk in later life. A relationship between maternal preeclampsia and offspring's childhood obesity is recognized, but most studies fail to control for strong confounders. Our goal is to analyze the association between preeclampsia and childhood excess weight/obesity, after accounting for important confounders. We recruited 5133 women with singleton pregnancies during admission for delivery. Sixty-seven pregnancies were complicated by preeclampsia. Maternal and children outcomes were assessed at 10 years of age. We analyzed the association between preeclampsia and childhood excess weight/obesity by fitting a linear regression model (using offspring body mass index (BMI) z-score at 10 years of age) and a logistic regression model (using excess weight/obesity status). We then controlled both models for known confounders, namely maternal prepregnancy BMI, parity, and smoking during pregnancy. At 10 years of age, offspring of preeclamptic mothers had a higher BMI z-score and were more likely classified as overweight/obese, but these differences were not statistically significant. After controlling for maternal prepregnancy BMI, parity, and smoking during pregnancy, there was a high magnitude change in the beta coefficient of preeclampsia in the linear (0.175; -0.014) and the logistic regression models (1.48; 1.23) suggesting that the association between preeclampsia and childhood excess weigh/obesity is significantly confounded by these variables. These confounders also showed a significant association with childhood obesity. This finding suggests that in utero exposure to preeclampsia seems to have less impact in childhood obesity than the previously described confounders.

Secretory IgA and T cells targeting SARS-CoV-2 spike protein are transferred to the breastmilk upon mRNA vaccination.

In view of the scarcity of data to guide decision making, we evaluated how BNT162b2 and mRNA-1273 vaccines affect the immune response in lactating women and the protective profile of breastmilk. Compared with controls, lactating women had a higher frequency of circulating RBD memory B cells and higher anti-RBD antibody titers but similar neutralizing capacity. We show that upon vaccination, immune transfer to breastmilk occurs through a combination of anti-spike secretory IgA (SIgA) antibodies and spike-reactive T cells. Although we found that the concentration of anti-spike IgA in breastmilk might not be sufficient to directly neutralize SARS-CoV-2, our data suggest that cumulative transfer of IgA might provide the infant with effective neutralization capacity. Our findings put forward the possibility that breastmilk might convey both immediate (through anti-spike SIgA) and long-lived (via spike-reactive T cells) immune protection to the infant. Further studies are needed to address this possibility and to determine the functional profile of spike T cells.

Alvarez waves in pregnancy: a comprehensive review.

Alvarez waves are local rhythmic contractions of the myometrium with high frequency and low intensity. They can be detected using internal or external tocography and electrohysterography. Some researchers correlate these small contractions with the initiation of labor, since they have been described as a pattern representing the uterine response to prostaglandin production. Other authors either do not validate a causality relation between Alvarez waves and labor or suggest that they have low predictive value for preterm labor. Alvarez waves' research has become a multidisciplinary subject with inputs ranging from medical science, biomedical engineering, and related areas. A comprehensive review is herein conducted to summarize the state of the art regarding Alvarez waves and their role in the initiation of labor, namely in preterm birth. The results show that a large number of studies have analyzed and characterized Alvarez waves without necessarily digging into their relationship with labor. Publications were categorized in three groups: (A) reports about morphology and characterization of Alvarez waves; (B) publications reporting a positive causality relation between Alvarez waves and labor; and (C) publications reporting an absence of causality regarding the previous hypothesis. Studies in group B outnumbered those in group C. A critical analysis is presented.

Variedad en la calidad de la dieta en adultos españoles y mexicanos / Diet quality variety in Spanish and Mexican adults

La pérdida de patrones de alimentación tradicionales a favor de otros más occidentales redunda en un descenso de calidad de la dieta alrededor del mundo. Muchos aspectos determinan la calidad dietética, aunque en general pueden resumirse en una dieta moderada, variada, equilibrada y adecuada para cada individuo. Estos aspectos son evaluados por el Diet Quality Index-International (DQI-I). Objetivo: Comparar la calidad de la dieta de población mexicana y española mediante un índice de calidad internacional de la dieta, determinando que factores son en mayor medida responsables de la pérdida de calidad. Material y métodos: Estudio observacional transversal sobre una muestra representativa de sujetos adultos residentes en Querétaro (México) y de sujetos de la misma franja de edad procedentes de la Región de Murcia, en la cuenca mediterránea española. Se recogieron datos sociodemográficos, antropométricos, de frecuencia de consumo de alimentos y de ingesta con 3 recuerdos de 24 horas y se valoró el DQI-I en la población. Resultados: Se encontraron diferencias para el gasto energético y el DQI-I en todos sus aspectos con valores de calidad superiores para la población mexicana. La variedad fue la dimensión más castigada para todos los sujetos, presentando los mexicanos mejores cifras de consumo de vegetales pero peores para las fuentes proteicas. Conclusiones: La muestra mexicana mejoró las cifras de calidad de la española, tal vez por una mayor influencia de conocimientos en nutrición. El 86% de la población podría mejorar sus puntajes de calidad en el DQI-I ajustando sus frecuencias de consumo de alimentos(AU)

The loss of traditional eating patterns in favour of more Western ones results in a decline in dietary quality around the world. Many aspects determine dietary quality, but in general they can be summarised as a moderate, varied, balanced diet suitable for each individual. These aspects are assessed by the Diet Quality Index-International (DQI-I). Objective: To compare the quality of the diet of the Mexican and Spanish populations using an international diet quality index, determining which factors are most responsible for the loss of quality. Material and methods: Cross-sectional observational study on a representative sample of adult subjects living in Querétaro (Mexico) and subjects of the same age group from the Region of Murcia, in the Spanish Mediterranean basin. Sociodemographic, anthropometric, food frequency consumption and intake data were collected with 3 24-hour recall and the DQI-I was assessed in the population. Results: Differences were found for energy expenditure and DQI-I in all aspects with higher quality values for the Mexican population. Variety was the most punished dimension for all subjects, with Mexicans presenting better figures for vegetable intake but worse for protein sources. Conclusions: The Mexican sample improved the quality figures of the Spanish sample, perhaps due to a greater influence of nutritional knowledge. Eighty-six percent of the population could improve their DQI-I quality scores by adjusting their food consumption frequencies(AU)

Sugar consumption in schoolchildren from southern Spain and influence on the prevalence of obesity.

AIM: The main cause of childhood overweight/obesity is an imbalance between energy intake and energy expenditure. The objective was to determine whether the intake by Spanish schoolchildren of sugars from habitually consumed foods and drinks can be related to overweight/obesity. METHODS: Subjects The study included 657 schoolchildren between 7-10 years from educational centers in Southern Spain. These children live under the influence of the Mediterranean diet. Design Participants completed an encoded questionnaire with three sections: a) data on sex, age, educational center, school year, and life/family habits, among others; b) semi-quantitative food frequency questionnaire related to the previous 12 months; and c) information on anthropometrics and physical activities. RESULTS: Obesity was observed in 10.9% of the children. The daily activity questionnaire showed a mean energy expenditure of 8.73 (1.33) MJ/day. The study considered foods that supply carbohydrates in any form (total carbohydrates, starch, total sugars, added sugars, and free sugars). The likelihood of overweight/obesity was significantly greater with a higher intake/day of total sugars, starch, added sugars, and free sugars. The likelihood of normal weight was significantly greater with lower energy expenditure in sedentary activities (OR = 3.03), higher energy expenditure in sports activities (OR = 1.72), and higher total activity/day measured as METs (OR = 8.31). CONCLUSIONS: In this population, overweight/obesity was influenced by the physical activity of the children and by their intake of energy, total sugars, starch, added sugars, and free sugars. Further studies are warranted to verify this observation and explore the implications for public health policies.

Actualización sobre deficiencias nutricionales en la mujer deportista a partir de la literatura científica / Update on nutritional deficiencies in women athletes from the scientific literature

Los déficits nutricionales en la mujer deportista causan numerosos problemas de salud, así como un empeoramiento en el rendimiento deportivo, como consecuencia de estas deficiencias nutricionales. El conocimiento de estos déficits y su prevención deben ser un aspecto principal para cualquier responsable deportivo. Establecer la importancia del estudio de los déficits de energía, proteínas, minerales (Fe, Ca y Mg) y vitaminas (Vitamina D, ácido fólico y vitamina B12) que pueden desarrollar las mujeres deportistas y su relación con la prevalencia de la tríada femenina y constatar la importancia del conocimiento por parte de los responsables deportivos de los problemas derivados de los déficits nutricionales. Se realizó una búsqueda bibliográfica de artículos, entre 2013-2020, relevantes para el objetivo de estudio. Se usaron bases de datos científicas como PubMed y Pennutrition, siguiendo los criterios de exclusión e inclusión elegidos para este estudio. 51 artículos fueron encontrados. Los resultados mostraron la prevalencia de energía, Fe, vitamina D y Ca, así como un suficiente aporte proteico, faltan estudios para determinar los niveles de vitamina B12 y ácido fólico. Se observó, además la prevalencia de mujeres que cumplen con uno o varios factores de riesgo para el desarrollo de la tríada de la deportistas femenina. Es imprescindible la prevención o, el tratamiento, de los déficits nutricionales en las mujeres deportistas para asegurar un correcto estado de salud y un rendimiento deportivo óptimo(AU)

Nutritional deficiencies in women athletes cause numerous health problems, as well as a worsening of sports performance, as a result of these nutritional deficiencies. Awareness of these deficiencies and their prevention should be a major aspect for any sports manager. The aim of the study was to establish the importance of studying the deficits of energy, protein, minerals (Fe, Ca and Mg) and vitamins (Vitamin D, folic acid and vitamin B12) that can be developed by female athletes and their relationship with the prevalence of the female triad and to establish the importance of knowledge by sports managers of the problems arising from nutritional deficiencies. 51 papers were found. A bibliographic search of relevant articles for the study objective was carried out (2013-2020). Scientific databases such as PubMed and Pennutrition were used, following the exclusion and inclusion criteria chosen for this study. The results showed the prevalence of energy, Fe, vitamin D and Ca, as well as sufficient protein intake and a lack of studies to determine the levels of vitamin B12 and folic acid. In addition, the prevalence of women meeting one or more risk factors for the development of the female sports triad was observed. It is essential the prevention or, treatment, of nutritional deficits in female athletes to ensure proper health status and optimal sports performance(AU)

Uterine contractions clustering based on electrohysterography.

The uterine electromyogram, also named Electrohysterogram (EHG), is a non-invasive technique that has been used for pregnancy and labour monitoring as well as for research work on uterine physiology. This technique is well established in this field. There is however a vast unexplored potential in the EHG that is currently the subject of interdisciplinary research work involving different scientific fields such as medicine, engineering, physics and mathematics. In this paper, an unsupervised clustering method is applied to a previously obtained set of frequency spectral representations of the respective EHG signal contractions that were previously automatically detected and delineated. An innovative approach using the complete spectrum projection is described, rather than a set of relevant points. The feasibility of the method is established despite the concerns of possible computational burden incurred by the processing of the whole spectrum. Given the unsupervised nature of this classification, a validation procedure was performed whereas the obtained clusters were labelled through the correlation with the common knowledge about the most relevant uterine contraction types, as described in the literature. As a result of this study, a spectral description of the Alvarez contractions was obtained where it was possible to breakdown these important events in two different types according to their spectrum. Spectral estimates of Braxton-Hicks contractions were also obtained and associated to one of the clusters. This led to a full spectral characterization of these uterine events.