Antiretroviral treatment initiation does not differentially alter neurocognitive functioning over time in youth with behaviorally acquired HIV.

Although youth living with behaviorally acquired HIV (YLWH) are at risk for cognitive impairments, the relationship of impairments to HIV and potential to improve with antiretroviral therapy (ART) are unclear. This prospective observational study was designed to examine the impact of initiation and timing of ART on neurocognitive functioning in YLWH in the Adolescent Medicine Trials Network for HIV/AIDS Interventions. Treatment naïve YLWH age 18-24 completed baseline and four additional assessments of attention/working memory, complex executive, and motor functioning over 3 years. Group 1 co-enrolled in an early ART initiation study and initiated ART at enrollment CD4 >350 (n = 56); group 2 had CD4 >350 and were not initiating ART (n = 66); group 3 initiated ART with CD4 <350 (n = 59) per standard of care treatment guidelines at the time. Treatment was de-intensified to boosted protease inhibitor monotherapy at 48 weeks for those in group 1 with suppressed viral load. Covariates included demographic, behavioral, and medical history variables. Analyses used hierarchical linear modeling. All groups showed improved performance with peak at 96 weeks in all three functional domains. Trajectories of change were not significantly associated with treatment, timing of treatment initiation, or ART de-intensification. Demographic variables and comorbidities were associated with baseline functioning but did not directly interact with change over time. In conclusion, YLWH showed improvement in neurocognitive functioning over time that may be related to practice effects and nonspecific impact of study participation. Neither improvement nor decline in functioning was associated with timing of ART initiation or therapy de-intensification.

Materials with fungi-bioinspired surface for efficient binding and fungi-sensitive release of antifungal agents.

Materials with fungi-bioinspired surface have been designed to host ergosterol-binding polyene antibiotics and to release them via a competitive mechanism only when fungi are present in the medium. Silicone rubber (SR) surfaces were endowed with selective loading and fungi-triggered release of polyene antifungal agents by means of a two-step functionalization that involved the grafting of glycidyl methacrylate (GMA) via a γ-ray preirradiation method (9-21.3% wt grafting) and the subsequent immobilization of ergosterol (3.9-116.8 mg/g) to the epoxy groups of polyGMA. The functionalized materials were characterized using FTIR and Raman spectroscopy, thermogravimetric analysis (TGA), and fluorescence, scanning electron microscopy (SEM), and atomic force microscopy (AFM) image analyses. Specific interactions between natamycin or nystatin and ergosterol endowed SR with ability to take up these polyene drugs, while immobilization of ergosterol did not modify the loading of antifungal drugs that did not interact in vivo with ergosterol (e.g., miconazole). In a buffer medium, polyene-loaded ergosterol-immobilized slabs efficiently retained the drug (<10% released at day 14), while in the presence of ergosterol-containing liposomes that mimic fungi membranes the release rate was 10-to-15-fold enhanced due to a competitive displacement of the drug from the ergosterol-immobilized slab to the ergosterol-containing liposomes. Release in the presence of cholesterol liposomes was slower due to a weaker interaction with polyene agents. The fungi-responsive release was demonstrated for both polyene drugs tested and for slabs prepared with a wide range of amounts of immobilized GMA and ergosterol, demonstrating the robustness of the approach. Nystatin-loaded functionalized slabs were challenged with Candida albicans and showed improved capability to inhibit biofilm formation compared to nystatin-soaked pristine SR, confirming the performance of the bioinspired materials.

Nutritional Status of Breastfeeding Mothers and Impact of Diet and Dietary Supplementation: A Narrative Review.

Adequate nutrition during breastfeeding is crucial for ensuring the good health of mothers and babies. Despite the high energy and nutrient demands of breastfeeding, lactating women are often vulnerable from a nutritional perspective. The nutritional focus during breastfeeding tends to be on the newborn, often neglecting the mother's diet. Therefore, in the present narrative review, nutrient intakes were compared with the dietary reference values (DRVs) proposed by the European Food Safety Authority (EFSA) as well as by the World Health Organization/Food and Agriculture Organization (WHO/FAO). In the diets of lactating mothers, dietary inadequacies were observed in the intake of some vitamins, such as folic acid, vitamin B12, vitamin A, and vitamin D, and in the intake of certain minerals like calcium, iron, and iodine; polyunsaturated omega-3 fatty acid deficiencies, primarily in eicosapentaenoic acid and docosahexaenoic acid, were also observed. On the other hand, the debate on the necessity of supplementation during lactation continues; the need for nutritional supplementation during lactation depends on many factors, such us mothers' eating habits. There seems to be a positive association between nutritional supplementation of the lactating mother and the concentration of certain nutrients in human milk. The present narrative review provides an update on the nutritional status (fatty acids and micronutrients) of breastfeeding mothers and the impact of diet and dietary supplementation on human milk composition.

Omega-3 and Omega-6 Polyunsaturated Fatty Acid Intakes, Determinants and Dietary Sources in the Spanish Population: Findings from the ANIBES Study.

The multiple roles of polyunsaturated fatty acids (PUFA) in growth and general health are well documented. However, available intake data for the Spanish population are limited and lack gender and age considerations. Therefore, our goal was to assess dietary intake adequacy of omega-3 and omega-6 PUFA, their determinants and their major food sources among the Spanish population. Due to their influence on various beneficial functions attributed to omega-3 PUFA, combined intake adequacy with folic acid (FA), vitamin B12 and choline was also assessed. Intake data were obtained from the ANIBES cross-sectional study on a representative sample of the Spanish population (9-75 years; n = 2009), where dietary intake was analysed with a three-day dietary record. Median intake of total omega-3 PUFA stood at 0.81 g/day (0.56-1.19 g/day), with α-linolenic acid (ALA) at 0.61 g/day (0.45-0.85 g/day), eicosapentaenoic acid (EPA) at 0.03 g/day (0.01-0.12 g/day) and docosahexaenoic acid (DHA) at 0.06 g/day (0.0-0.20 g/day). Accordingly, 65% of the Spanish population showed insufficient intakes for total omega-3 PUFA; 87% for ALA, and 83% for combined EPA and DHA. Inadequate intakes were significantly higher in children, adolescents, and younger women of childbearing age (18-30 years). In contrast, inadequacy due to excessive intakes was almost negligible. Regarding omega-6 PUFA, total intake was 10.1 g/day (7.0-14.0 g/day), 10.0 g/day (6.9-13.9 g/day) for linoleic acid (LA) and 0.08 g/day (0.05-0.13 g/day) for arachidonic acid (AA). Non-compliance due to either insufficient or excessive intakes of LA stood at around 5% of the sample, with the elderly showing significantly higher degrees of inadequacy due to insufficient intakes (10%; p ≤ 0.05). Median omega-6 to omega-3 ratio was 12:1, and significantly higher in men compared to women (p ≤ 0.05); in children, adolescents and adults compared to the elderly (p ≤ 0.05); and in younger women of childbearing age compared to the older group (31-45 years) (p ≤ 0.001). Oils and fats and meat and meat products were the main dietary sources for the essential fatty acids LA and ALA, respectively. Meat and meat products were as well the main providers of AA, while fish and shellfish were almost exclusively the only sources of EPA and DHA. However, main food sources identified showed important differences across age groups. Finally, the total combined degree of inadequacy observed for omega-3 PUFA, FA, vitamin B12 and choline reached 21.3% of the ANIBES population. The observed degree of inadequacy of omega-3 PUFA intakes among the Spanish population makes it urgent to increase its consumption and to consider the need for supplementation. This should also be the main strategy for the optimization of the omega-6/omega-3 ratio, as the adequacy observed for omega-6 intakes is relatively acceptable. Additional improvement of the dietary intake of FA, vitamin B12 and choline could contribute to the beneficial effects of omega-3 PUFA.

Risk Factors for Perinatal Transmission of Hepatitis C Virus.

OBJECTIVE: To estimate the rate of perinatal transmission of hepatitis C virus (HCV) infection, to identify risk factors for perinatal transmission of HCV infection, and to determine the viremic threshold for perinatal transmission. METHODS: This was a prospective, multicenter, observational study of pregnant individuals at less than 24 weeks of gestation screened for HCV infection from 2012 to 2018 in the Eunice Kennedy Shriver National Institute of Child Health and Human Development Maternal-Fetal Medicine Units Network. Individuals found to be HCV antibody-positive were followed throughout pregnancy. Children were followed for evidence of perinatal transmission at 2-6 months (HCV RNA testing) and at 18-24 months (HCV RNA and antibody testing) of life. The primary outcome was perinatal transmission, defined as positive test results at either follow-up time point. RESULTS: A total of 109,379 individuals were screened for HCV infection. Of the 1,224 participants who screened positive, 772 (63.1%) enrolled and 432 of those 772 (56.0%) had data available to assess primary outcome. The overall rate of perinatal transmission was 6.0% (26/432, 95% CI 4.0-8.7%). All children with HCV infection were born to individuals with demonstrable viremia. In viremic participants (n=314), the perinatal transmission rate was 8.0% (95% CI 5.2-11.5%). Risk factors for perinatal transmission included HCV RNA greater than 106 international units/mL (adjusted odds ratio [aOR] 8.22, 95% CI 3.16-21.4) and vaginal bleeding reported at any time before delivery (aOR 3.26, 95% CI 1.32-8.03). A viremic threshold for perinatal transmission could not be established. CONCLUSION: Perinatal transmission of HCV infection was limited to viremic individuals. High viral loads and antepartum bleeding were associated with perinatal transmission.

End-group rearrangements in poly(propylene sulfide) matrix-assisted laser desorption/ionization time-of-flight analysis. Experimental evidence and possible mechanisms.

RATIONALE: Polysulfides [poly(1,2-alkylene sulfides)] are oxidation-responsive polymers that are finding application in drug release and biomaterials. The precise knowledge of their macromolecular characteristics is of the essence in view of their application to biological systems. METHODS: Matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI-TOF MS) with and without silver trifluoroacetate was used to characterize a series of polymers with increasing molecular weight in the range 1000-4000 g/mol and with low polydispersity (<1.12). RESULTS: Well-resolved peaks and accurate mass-measured values were obtained using a 2-(4-hydroxyphenylazo)benzoic acid (HABA) matrix, but significant fragmentations took place in the absence of silver as a cationizing reagent. Elimination reactions appeared to occur at terminal groups and limited depolymerization could be recorded. Interestingly, the most common fragmentation pathway seemed to be based on an as-yet-unreported process of hydrogen transfer requiring the presence both of ester groups and of thioethers. CONCLUSIONS: The use of an appropriate cationizing reagent (silver trifluoroacetate) appeared to suppress end-group eliminations; we hypothesize that this action is based on the involvement of the terminal groups in silver chelation.

A Descriptive Analysis of Macronutrient, Fatty Acid Profile, and Some Immunomodulatory Nutrients in Standard and Disease-Specific Enteral Formulae in Europe.

Foods for special medical purposes (FSMPs) are commercially available formulations used as a source of nutrition when administered orally or by tube feeding. This study examines, for the first time, the nutritional composition of enteral formulae (EFs) according to European nutritional guidelines. We developed a descriptive study on 118 EFs from 2020 to 2021. Formulae were classified as standard (SFs) and disease-specific (DSF). According to the protein-energy content, SFs were classified into G1, normoprotein-normocaloric; G2, normoprotein-hypercaloric; G3, hyperproteic-normocaloric; and G4, hyperproteic-hypercaloric. Disease-related formulae for metabolic stress, renal, cancer, pulmonary, diabetes, malabsorption, and surgery were studied. Macronutrient distribution, fatty acid profile (monounsaturated [MUFA], polyunsaturated [PUFA], saturated [SFA]), derived fat quality indexes, and immuno-modulatory nutrients (omega-3, eicosapentaenoic acid [EPA], docosahexaenoic acid [DHA], arginine and nucleotides) per 1,500 kcal infused were calculated. In total, 53% were SFs, mainly normoproteic (G1, G2) with higher carbohydrate contents in normocaloric vs. hypercaloric SFs. The most balanced fatty acid profiles (MUFA: 17.7%; PUFA: 6.8%; SFA: 9.5%) belonged to G1. The PUFA/MUFA ratio: ≥0.5 was in 85.7% with a higher proportion of EPA+DHA (46%) vs. omega-3 (15.8%) in SFs. In DSFs (46.9%), higher carbohydrate content (>50%) was in malabsorption and surgery, whereas high-fat content (>50%) was in pulmonary and renal formulae. DSFs had higher SFA vs. MUFA content, except for diabetes. EPA and DHA were added in 45.5% (cancer, malabsorption, and surgery). Only 12.7% of DSFs had arginine and nucleotides. A higher proportion of SFs was found, in line with current European guidelines. Results highlighted a wide intra-group variability of nutrients among the formula selected. These findings are useful to evaluate the nutritional composition of EFs from a preventive and/or therapeutic perspective in clinical settings.

Iron Supplementation at the Crossroads of Nutrition and Gut Microbiota: The State of the Art.

Gut microbiota has received significant attention owing to its decisive role in human health and disease. Diet exerts a significant influence on the variety and number of bacteria residing in the intestinal epithelium. On the other hand, as iron is a key micronutrient for blood formation and oxygen supply, its deficiency is highly prevalent worldwide. In fact, it is the most common cause of anemia and thus, iron supplementation is widespread. However, there is concern due to some potential risks linked to iron supplementation. Therefore, we have reviewed the available evidence of the effects that iron supplementation exerts on the gut microbiota as well as its potential benefits and risks. The compiled information suggests that iron supplementation is potentially harmful for gut microbiota. Therefore, it should be performed with caution, and by principle, recommended only to individuals with proven iron deficiency or iron-deficiency anemia to avoid potential adverse effects. In any case, large and long-term population studies are urgently needed to confirm or refute these results, mainly focused on vulnerable populations.

Perception and knowledge of low- and no-calorie sweeteners in multidisciplinary stakeholders from Spain.

Low- and no-calorie sweeteners (LNCS) as a category are one of the most thoroughly evaluated additives, and thus their safety has been largely recognised. However, their potential risks and benefits generate great controversy and discussion within countries' food policies and public debate. The goal of this study was to evaluate the degree of knowledge and the perception of key Spanish stakeholders about the role of LNCS in diet, their safety, regulatory issues and their impact on health and wellness, as well as to complete a SWOT analysis of the Strengths, Weaknesses, Opportunities and Threats regarding this topic from their perspective. Participants (n = 45 stakeholders) completed an anonymous survey about their knowledge and perception of LNCS, their role in the diet, safety and legislation, as well as health issues and completed a SWOT analysis. Most of them agreed with aspects related to safety guarantees and authorisation procedure of LNCS; however, certain disparity in their opinion in relation to several of the topics was observed, especially regarding the possible role of LNCS in diet quality and health. Effective communication strategies to inform professionals and the general population, as well as new research that deepens our knowledge of the role of LNCS in weight management and other health outcomes seem to be urgently needed.

Hearing Function and Nutritional Status in Aviation Pilots from Spain Exposed to High Acoustic Damage.

Noise-induced hearing loss is the most frequent and preventable occupational disease. Aviation pilots are a vulnerable population, as they spend many hours exposed to noise pollution in their working environment. Different studies suggest that certain dietary compounds may play a key role in the etiology and prevention of this pathology. We aimed to study the relationship linking auditory function, dietary intake, and some serum biomarkers in pilots, exposed to noise in the work environment. A total of 235 pilots, who undergo a periodic medical examination at the Centro de Instrucción de Medicina Aeroespacial (Madrid, SPAIN), were evaluated. Auditory function was assessed by tonal audiometry. Energy and nutrient intakes were estimated by 24 h recall (DIALTM program). Serum homocysteine (Hcy) was determined in a Cobas 6000TM multi-analyzer while folate, vitamin B12, and D were analyzed in a Cobas e411TM. The prevalence of hearing loss (HL) was 64.3%. HL was significantly related to age (r = 0.588, p ≤ 0.001) and flight hours (r = 0.283, p ≤ 0.001). A multiple linear regression model was used to assess the relationship among HL, flight hours, serum folate, and Hcy serum levels. HL was significantly (p < 0.050) associated with flight hours (ß = 0.246), serum folate (ß = −0.143), and serum Hcy (ß = 0.227). Nutritional interventions would be of great interest to monitor and slow down the HL progression in populations exposed to noise pollution in their workplace.

Low- and No-Calorie Sweetener (LNCS) Presence and Consumption among the Portuguese Adult Population.

The use of low and no-calorie sweeteners (LNCS) in food and beverages has become increasingly common in the development and reformulation of products to reduce energy derived from added sugars. Our aim was to identify the presence and consumption of LNCS through food and beverages according to consumption patterns in a representative sample (n = 256) of the Portuguese adult population. The study had a descriptive cross-sectional observational design and was based on the application of a Food Frequency Questionnaire. Overall, it was found that 4.1% of the foods and 16.7% of the beverages consumed by the Portuguese adult population contained LNCS. Food groups mostly contributing to LNCS consumption were non-alcoholic beverages such as soft drinks and juices (34.2%); milk and dairy products (16.5%); appetizers such as chips (8.6%); sugars and sweets such as chocolates, candies, or chewing gums (6.1%); meat and derivative products (2.2%); cereals and derivatives (1.2%) and canned fruits (1.2%). Main LNCS consumed were acesulfame-K, sucralose, and aspartame, single or combined, although their prevalence of use differs greatly among foods, beverages, or tabletop sweeteners. In conclusion, LNCS were found across a wide variety of products available in the Portuguese market and their prevalence of inclusion in the diet of the population evidences the need to develop more studies on the evolution of LNCS intake and its impact on the full dietary model and health. Consequently, these food additives should be included in food composition databases and, periodically, updated to reflect the recurrent reformulation strategies adopted by the food industry in its efforts to reduce the energy contribution of added sugars.

Effects of Supplementation with Folic Acid and Its Combinations with Other Nutrients on Cognitive Impairment and Alzheimer's Disease: A Narrative Review.

Cognitive impairment and Alzheimer's Disease, among other cognitive dysfunctions, has been recognized as a major public health problem. Folic acid is a well-known essential nutrient whose deficiency has been linked to neurocognitive dysfunctions, owing to hyperhomocysteinemia, an independent risk factor for cardio- and cerebrovascular diseases, including cognitive impairment, Alzheimer's Disease, and vascular dementia. However, to date, there is certain controversy about the efficacy of vitamin supplementation in patients with these pathologies. Therefore, we have reviewed the available dietary intervention studies based on folic acid, either alone or in combination with different vitamins or nutrients into the progression of Alzheimer's Disease and Cognitive impairment, highlighting the cognition and biochemical markers employed for the evaluation of the disease progression. Undeniably, the compiled information supports the potential benefits of vitamin supplementation in these pathologies, especially relevant to the aging process and quality of life, although more research is urgently needed to confirm these positive findings.

Effectiveness of Community-Based Interventions Programs in Childhood Obesity Prevention in a Spanish Population According to Different Socioeconomic School Settings.

Overweight and obesity amongst childhood are currently global health issues. However, this is the best stage of life to prevent diseases and to promote healthy habits. In our study, we evaluate the effectiveness of the THAO Salud Infantil, a community-based intervention program, by means of a cross-sectional study carried out from 2009 to 2019 surveying children aged 3 to 12 years old (n = 27,686). During the study timeframe, overweight and obesity prevalence, according to both the International Obesity Task Force and Orbegozo Foundation criteria, showed a downward trend. Differences in the anthropometric variables were observed from the beginning to the end of the study, mainly in girls. Analysis of the influence of the socioeconomic status revealed that children from families with lower incomes are in greater risk of suffering from overweight and obesity and showed lower effectiveness of the actions proposed by the program. The overall results of the study confirmed the effectiveness of community-based interventions in terms of childhood overweight/obesity prevention.

Randomized controlled trial of feeding a concentrated formula to infants born to women infected by human immunodeficiency virus.

OBJECTIVE: We tested the hypothesis that concentrated formula (CF) begun within the first 2 weeks of life increases growth in infants born to human immunodeficiency virus (HIV)-infected mothers. MATERIALS AND METHODS: HIV-exposed infants from the United States, the Bahamas, and Brazil were randomized in a double-blind, controlled trial to receive either a CF (87 kcal/100 mL [26 kcal/oz]) or a standard formula (SF; 67 kcal/100 mL [20 kcal/oz]) for 8 weeks. This article presents results for infants who were not determined to be HIV infected based on testing at 4 weeks. Primary outcomes were safety, tolerability, and growth in weight and length. RESULTS: Two thousand ninety-seven infants were enrolled, of whom 1998 were uninfected and had study formula dispensed. At weeks 4 and 8, uninfected infants receiving CF showed higher energy intake than those who were receiving SF (P < 0.001). By week 8, uninfected infants assigned to CF weighed more than infants receiving SF. There were no consistent differences in measures of tolerability, and rates of discontinuation or perceived formula intolerance were similar between treatment groups. CONCLUSIONS: A CF is well tolerated and results in increased weight gain compared with SF. Until the HIV status of an infant is reliably determined, early introduction of a CF in HIV-exposed children may have beneficial effects on growth. The role of early nutritional intervention remains to be determined for individuals living in countries with endemic malnutrition for whom formula feeding is a viable option.

Effects of Drugs and Excipients on Hydration Status.

Despite being the most essential nutrient, water is commonly forgotten in the fields of pharmacy and nutrition. Hydration status is determined by water balance (the difference between water input and output). Hypohydration or negative water balance is affected by numerous factors, either internal (i.e., a lack of thirst sensation) or external (e.g., polypharmacy or chronic consumption of certain drugs). However, to date, research on the interaction between hydration status and drugs/excipients has been scarce. Drugs may trigger the appearance of hypohydration by means of the increase of water elimination through either diarrhea, urine or sweat; a decrease in thirst sensation or appetite; or the alteration of central thermoregulation. On the other hand, pharmaceutical excipients induce alterations in hydration status by decreasing the gastrointestinal transit time or increasing the gastrointestinal tract rate or intestinal permeability. In the present review, we evaluate studies that focus on the effects of drugs/excipients on hydration status. These studies support the aim of monitoring the hydration status in patients, mainly in those population segments with a higher risk, to avoid complications and associated pathologies, which are key axes in both pharmaceutical care and the field of nutrition.

Association between Hydration Status and Body Composition in Healthy Adolescents from Spain.

At present, obesity and overweight are major public health concerns. Their classical determinants do not sufficiently explain the current situation and it is urgent to investigate other possible causes. In recent years, it has been suggested that water intake could have important implications for weight management. Thus, the aim of this study was to examine the effect of hydration status on body weight and composition in healthy adolescents from Spain. The study involved 372 subjects, aged 12-18 years. Water intake was assessed through the validated "hydration status questionnaire adolescent young". Anthropometric measurements were performed according to the recommendations of the International Standards for Anthropometric Assessment (ISAK) and body composition was estimated by bioelectrical impedance analysis. Water intake normalized by body weight was positively correlated with body water content (boys (B): r = 0.316, p = 0.000; girls (G): r = 0.245, p = 0.000) and inversely with body mass index (BMI) (B: r = -0.515, p = 0.000; G: r = -0.385, p =0.000) and fat body mass (B: r = -0.306, p = 0.000; G: r = -0.250, p = 0.001). Moreover, according to BMI, overweight/obese individuals consumed less water than normal weight ones. In conclusion, higher water balance and intake seems to be related with a healthier body composition. In conclusion, higher water balance and intake is associated with a healthier body composition.

Influence of Water Intake and Balance on Body Composition in Healthy Young Adults from Spain.

The increasing prevalence of overweight and obesity has become an epidemic public health problem worldwide. In the last years, several investigations have suggested that water intake and retention could have important implications for both weight management and body composition. However, there is a lack of information about this issue globally, and mainly specifically in Spain. Thus, the aim of this study was to analyze the association between hydration status and body composition in a sample of healthy Spanish adults. The study involved 358 subjects, aged 18-39 years. The recently validated "hydration status questionnaire" was used to assess their water intake, elimination, and balance. Anthropometric measurements were performed according to the recommendations of the International Standards for Anthropometric Assessment (ISAK). Body composition variables were acquired by bioelectrical impedance analysis. Differences in anthropometric and body composition variables were assessed through the ANOVA test and considered significant at p < 0.05. Fluid intake was correlated with body water content. Inverse associations between water consumption, normalized by weight, with body weight, body fat mass, and waist circumference were found. Moreover, according to water balance, significant differences in body water content in females were observed. In conclusion, higher fluid intake seems to be related with a healthier body composition. Therefore, the improvement of water intake and water balance could be useful for overweight and obesity prevention, although further studies are needed to confirm the present findings.

Interplay between Nutrition and Hearing Loss: State of Art.

Hearing loss has been recently ranked as the fifth leading cause of years lived with disability, ahead of many other chronic diseases such as diabetes, dementia, or chronic obstructive pulmonary disease. Moreover, according to the World Health Organization, moderate-to-profound hearing loss affects about 466 million people worldwide. Its incidence varies in each population segment, affecting approximately 10% of children and increasing to 30% of the population over 65 years. However, hearing loss receives still very limited research funding and public awareness. This sensory impairment is caused by genetic and environmental factors, and among the latter, the nutritional status has acquired relevance due its association to hearing loss detected in recent epidemiological studies. Several experimental models have proved that the onset and progression of hearing loss are closely linked to the availability of nutrients and their metabolism. Here, we have reviewed studies focused on nutrient effects on auditory function. These studies support the potential of nutritional therapy for the protection against hearing loss progression, which is especially relevant to the aging process and related quality of life.

Waist circumference as a prognostic index of childhood abdominal obesity: findings in the Spanish population / Circunferencia de la cintura como índice pronóstico de obesidad abdominal infantil: hallazgos en la población española

INTRODUCTION: early detection of childhood obesity plays a crucial role in the prevention of diseases during adulthood. At present, the most commonly used screening tool for detecting overweight/obesity in children is the percentile for age of body mass index, although this rate is unable to provide information about fat distribution. An emerging marker of abdominal fat distribution is waist circumference (WC). OBJECTIVE: the aim of this study was to evaluate the differences between the different diagnostic criteria available to define overweight and obesity in order to establish the optimal WC cut-off values for the Spanish children population. METHODS: a cross-sectional study was carried out in 8,241 schoolchildren aged 3 to 12 years from Villanueva de la Cañada (Madrid, Spain). WC (cm), weight (kg) and height (cm) were measured according to the recommendations of the Society for the Advancement of Kineanthropometry (ISAK). The values obtained for the diagnostic criteria (Spanish Orbegozo Foundation (OF), the International Obesity Task Force (IOTF), and the World Health Organization (WHO) were compared using McNemar's test for paired proportions. The kappa coefficient (κ) was used to assess the degree of agreement of the three classifications. We analyzed the validity of body mass index (BMI) and WC using the receiver operating characteristic (ROC) curve analysis. The Youden index was used to determine cut-off values for WC that identify childhood obesity RESULTS: overweight and obesity prevalences were calculated according to the OF, IOTF, and WHO criteria. There was a "substantial" agreement for the overweight and obesity categories between the Spanish criteria and IOTF (κ = 0.636), while agreement was "slight" between the Spanish criteria and those of WHO (κ = 0.198). The estimated cut-off WC criteria ranged from 54.5 to 88.0, varying according to sex and age. CONCLUSION: the proposed WC cut-off values, stated for the first time in a young Spanish population, are a simple and valid alternative as diagnostic criteria of abdominal obesity

INTRODUCCIÓN: la detección temprana de la obesidad durante la infancia es de vital importancia para la prevención de patologías durante la edad adulta. En la actualidad, la evaluación de la obesidad infantil se realiza principalmente utilizando el índice de masa corporal por edad percentilado, aunque este no aporta información sobre la distribución del tejido adiposo. Un marcador emergente de distribución de la grasa abdominal es la circunferencia de la cintura (CC). OBJETIVO: el objetivo de este trabajo fue evaluar las diferencias entre diferentes criterios diagnósticos para definir el sobrepeso y la obesidad con el fin de establecer el punto de corte óptimo de la CC en los niños españoles. MÉTODO: se llevó a cabo un estudio observacional transversal de 8241 niños/as (3-12 años) en Villanueva de la Cañada (Madrid, España). Se determinaron el peso, la talla y el perímetro de la cintura atendiendo a los criterios de la Sociedad Internacional para el Avance de la Cineantropometría (ISAK). Los valores obtenidos para los criterios diagnósticos (Fundación Orbegozo (OF), el Grupo Internacional de Obesidad (IOTF) y la Organización Mundial de la Salud (OMS)) se compararon utilizando la prueba de McNemar para proporciones emparejadas. El coeficiente kappa (κ) se utilizó para evaluar el grado de acuerdo de las tres clasificaciones. Analizamos la validez del índice de masa corporal (IMC) y el perímetro de la cintura (CC) utilizando el análisis de la curva característica operativa del receptor (ROC). El índice de Youden se utilizó para determinar los valores de corte de la CC que identifican la obesidad infantil. RESULTADOS: se calcularon las prevalencias del sobrepeso y la obesidad de acuerdo con criterios internacionales (IOTF, OMS) y nacionales (FO). Se observó un acuerdo "substancial" para el sobrepeso y la obesidad entre el criterio diagnóstico español y el IOTF (κ = 0,636), mientras que el acuerdo fue "ligero" entre el criterio español y el de la OMS (κ = 0,198). Los puntos de corte de la CC estimados variaron de 54,5 a 88,0 cm, modificándose en función de la edad y el sexo. CONCLUSIONES: los puntos de corte de la CC propuestos, establecidos por primera vez para niños españoles, son una alternativa simple y válida como criterio diagnóstico de obesidad abdominal

Additive manufacturing of scaffolds with dexamethasone controlled release for enhanced bone regeneration.

The adoption of additive manufacturing in tissue engineering and regenerative medicine (TERM) strategies greatly relies on the development of novel 3D printable materials with advanced properties. In this work we have developed a material for bone TERM applications with tunable bioerosion rate and dexamethasone release profile which can be further employed in fused deposition modelling (the most common and accessible 3D printing technology in the market). The developed material consisted of a blend of poly-ϵ-caprolactone (PCL) and poloxamine (Tetronic®) and was processed into a ready-to-use filament form by means of a simplified melt-based methodology, therefore eliminating the utilization of solvents. 3D scaffolds composed of various blend formulations were additively manufactured and analyzed revealing blend ratio-specific degradation rates and dexamethasone release profiles. Furthermore, in vitro culture studies revealed a similar blend ratio-specific trend concerning the osteoinductive activity of the fabricated scaffolds when these were seeded and cultured with human mesenchymal stem cells. The developed material enables to specifically address different regenerative requirements found in various tissue defects. The versatility of such strategy is further increased by the ability of additive manufacturing to accurately fabricate implants matching any given defect geometry.