Evaluation of the Antioxidant and Antimicrobial Potential of SiO2 Modified with Cinnamon Essential Oil (Cinnamomum Verum) for Its Use as a Nanofiller in Active Packaging PLA Films.

One of the main causes of food spoilage is the lipid oxidation of its components, which generates the loss of nutrients and color, together with the invasion of pathogenic microorganisms. In order to minimize these effects, active packaging has played an important role in preservation in recent years. Therefore, in the present study, an active packaging film was developed using polylactic acid (PLA) and silicon dioxide (SiO2) nanoparticles (NPs) (0.1% w/w) chemically modified with cinnamon essential oil (CEO). For the modification of the NPs, two methods (M1 and M2) were tested, and their effects on the chemical, mechanical, and physical properties of the polymer matrix were evaluated. The results showed that CEO conferred to SiO2 NPs had a high percentage of 2,2-diphenyl-l-picrylhydrazyl (DPPH) free radical inhibition (>70%), cell viability (>80%), and strong inhibition to E. coli, at 45 and 11 µg/mL for M1 and M2, respectively, and thermal stability. Films were prepared with these NPs, and characterizations and evaluations on apple storage were performed for 21 days. The results show that the films with pristine SiO2 improved tensile strength (28.06 MPa), as well as Young's modulus (0.368 MPa) since PLA films only presented values of 27.06 MPa and 0.324 MPa, respectively; however, films with modified NPs decreased tensile strength values (26.22 and 25.13 MPa), but increased elongation at break (from 5.05% to 10.32-8.32%). The water solubility decreased from 15% to 6-8% for the films with NPs, as well as the contact angle, from 90.21° to 73° for the M2 film. The water vapor permeability increased for the M2 film, presenting a value of 9.50 × 10-8 g Pa-1 h-1 m-2. FTIR analysis indicated that the addition of NPs with and without CEO did not modify the molecular structure of pure PLA; however, DSC analysis indicated that the crystallinity of the films was improved. The packaging prepared with M1 (without Tween 80) showed good results at the end of storage: lower values in color difference (5.59), organic acid degradation (0.042), weight loss (24.24%), and pH (4.02), making CEO-SiO2 a good component to produce active packaging.

Chemically Modified Nanoparticles for Enhanced Antioxidant and Antimicrobial Properties with Cinnamon Essential Oil.

We explored the potential of different nanoparticles (TiO2, CaCO3, and Al2O3), considering their pure form and modified with cinnamon essential oil (CEO). These materials were characterized using various techniques, including FTIR spectroscopy, XRD analysis, TGA, and SEM. The interaction between CEO and nanoparticles changed depending on the nanoparticle type. Al2O3 nanoparticles exhibited the strongest interaction with CEO, increasing their antioxidant capacity by around 40% and their transfer of antimicrobial properties, particularly against Gram-negative bacteria. In contrast, TiO2 and CaCO3 nanoparticles showed limited interaction with CEO, resulting in lower antioxidant capacity and antimicrobial activity. Incorporating pure and CEO-modified nanoparticles into polylactic acid (PLA) films improved their mechanical and thermal properties, which are suitable for applications requiring greater strength. This research highlights the potential of metal oxide nanoparticles to enhance the antimicrobial and antioxidant capabilities of polymers. In addition, incorporating cinnamon essential oil can increase the antioxidant and antimicrobial effectiveness of the metal oxide nanoparticles and improve the mechanical and thermal properties of PLA films. Thus, these PLA films exhibit favorable characteristics for active packaging applications.

Effect of a Community Health Worker Intervention on Acute Care Use, Advance Care Planning, and Patient-Reported Outcomes Among Adults With Advanced Stages of Cancer: A Randomized Clinical Trial.

Importance: Deficiencies in advance care planning and symptom management are associated with avoidable acute care use among patients with cancer. Community health worker (CHW)-led approaches may be an approach to reduce acute care use but remain untested in community settings. Objective: To determine whether a CHW-led advance care planning and symptom screening intervention can reduce acute care use more than usual care in a community setting. Design, Setting, and Participants: This randomized clinical trial was conducted among patients with newly diagnosed advanced-stage or recurrent solid and hematologic cancers from August 8, 2017, through November 30, 2021. Data analysis was performed November 30, 2021, through January 1, 2022, by intention to treat. Interventions: Participants were randomized 1:1 to usual care (control group) or usual care with the 6-month CHW-led intervention (intervention group). Main Outcomes and Measures: The primary outcome was acute care use. Secondary outcomes included advance care planning documentation, supportive care use, patient-reported outcomes, survival, and end-of-life care use. Results: Among 128 participants, median (range) age was 67 (19-89) years; 61 (47.7%) were female; and 2 (1.6%) were American Indian or Alaska Native, 11 (8.6%) were Asian, 5 (3.9%) were Black, 23 (18.0%) were Hispanic or Latino, 2 (1.6%) were of mixed race, 2 (1.6%) were Native Hawaiian or other Pacific Islander, 86 (67.2%) were White, and 20 (15.6%) did not report race. Intervention participants had 62% lower risk of acute care use than the control (hazard ratio, 0.38; 95% CI, 0.19-0.76) within 6 months. At 12 months, intervention participants had 17% lower odds of acute care use (odds ratio [OR], 0.83; 95% CI, 0.69-0.98), 8 times the odds of advance care planning documentation (OR, 7.18; 95% CI, 2.85-18.13), 4 times the odds of palliative care (OR, 4.46; 95% CI, 1.88-10.55), nearly double the odds of hospice (OR, 1.83; 95% CI, 1.16-2.88), and nearly double the odds of improved mental and emotional health from enrollment to 6 and 12 months postenrollment (OR, 1.82; 95% CI, 1.03-3.28; and OR, 2.20; 95% CI, 1.04-4.65, respectively) than the control. There were no differences in the death (control, 26 [40.6%] vs intervention, 32 [50.0%]). Fewer intervention participants had acute care use (0 vs 6 [23.1%]) in the month before death than the control. Conclusions and Relevance: In this randomized clinical trial, integration of a CHW-led intervention into cancer care reduced acute care use and is one approach to improve cancer care delivery for patients with advanced stages of disease in community settings. Trial Registration: ClinicalTrials.gov Identifier: NCT03154190.

Health care coach support to assist with advance care planning and symptom management -A randomized controlled trial.

Advance care planning and symptom management (supportive cancer care) improves patient experiences and reduces acute care use (hospitalizations and emergency department visits). Strong evidence supports team-based approaches to deliver supportive cancer care. However no studies, to our knowledge, have evaluated the use of lay or community health workers to deliver supportive cancer care as compared to usual cancer care. The "Health Care Coach Support" intervention was developed to improve cancer care. The intervention assigns a lay or community health worker "health coach" to all patients newly diagnosed with advanced stages of cancer or patients with recurrent or progressive disease. The intervention aims to educate and activate patients in advance care planning discussions and symptom management with their clinicians. Patients are randomized in a 1:1 allocation to either the 12-month health coach intervention combined with usual oncology care or usual oncology care alone. The primary outcome is to evaluate whether the intervention reduces acute care use measured at 6-months follow-up more than usual care. Secondary outcomes include the effect on acute care, palliative care, and hospice at 12-months follow-up and one month prior to death for patients who die. Additional secondary outcomes include changes in patient satisfaction with decision and patient satisfaction with care from baseline (time of enrollment) to 3-, 6-, 9- and 12-months post-enrollment. The Health Coach Support study addresses an important gap in supportive cancer care by testing whether a team-based approach using non-professional personnel can ensure delivery of these services. Findings can assist in our understanding of how to improve care for patients with cancer. ClinicalTrials.gov Registration #NCT03154190.

A metadata approach to evaluate the state of ocean knowledge: Strengths, limitations, and application to Mexico.

Climate change, mismanaged resource extraction, and pollution are reshaping global marine ecosystems with direct consequences on human societies. Sustainable ocean development requires knowledge and data across disciplines, scales and knowledge types. Although several disciplines are generating large amounts of data on marine socio-ecological systems, such information is often underutilized due to fragmentation across institutions or stakeholders, limited standardization across scale, time or disciplines, and the fact that information is often not searchable within existing databases. Compiling metadata, the information which describes existing sets of data, is an effective tool that can address these challenges, particularly when metadata corresponding to multiple datasets can be combined to integrate, organize and classify multidisciplinary data. Here, using Mexico as a case study, we describe the compilation and analysis of a metadatabase of ocean knowledge that aims to improve access to information, facilitate multidisciplinary data sharing and integration, and foster collaboration among stakeholders. We also evaluate the knowledge trends and gaps for informing ocean management. Analysis of the metadatabase highlights that past and current research in Mexico focuses strongly on ecology and fisheries, with biological data more consistent over time and space compared to data on human dimensions. Regional imbalances in available information were also evident, with most available information corresponding to the Gulf of California, Campeche Bank and Caribbean and less available for the central and south Pacific and the western Gulf of Mexico. Despite existing knowledge gaps in Mexico and elsewhere, we argue that systematic efforts such as this can often reveal an abundance of information for decision-makers to develop policies that meet key commitments on ocean sustainability. Surmounting current cross-scale social and ecological challenges for sustainability requires transdisciplinary approaches. Metadatabases are critical tools to make efficient use of existing data, highlight and address strengths and deficiencies, and develop scenarios to inform policies for managing complex marine social-ecological systems.

Lentes intraoculares en pilotos aviadores: revisión del tema / Intraocular lenses in pilots: a review

Resumen Objetivo: Revisar en la literatura las diferentes posturas de las agencias reguladoras de la aviación sobre la implantación de lentes intraoculares multifocales (MIOLs) en pilotos aviadores civiles que han desarrollado catarata, además de evidencia científica que podría generar una revisión de los lineamientos vigentes. Resultados: Se encontraron el 50% (3 de 6) de agencias revisadas con postura en contra de los MIOLs. Además, se revisaron dos estudios a favor de los MIOLs, en el que implantarlos brinda una mayor independencia de lentes respecto a los monofocales para las tareas visuales dentro y fuera de la cabina, así como un rendimiento sin diferencias en simuladores de vuelo versus los pilotos con lentes intraoculares monofocales. Limitaciones: Existen pocos estudios de MIOLs en pilotos aviadores. Originalidad: No se ha reportado ninguna revisión de las agencias reguladoras respecto a la prohibición o permisión de los MIOLs en pilotos aviadores, tocando evidencia que pudiera consolidar una postura unánime respecto a este tema, como en su momento fue la cirugía refractiva con láser excimer que actualmente no está restringida.

Abstract Objective: To review the literature on the different stands of aviation regulatory agencies on the implantation of multifocal intraocular lenses (MIOLs) in civilian aviators who have developed cataract, as well as scientific evidence that could generate a revision of the current guidelines. Results: 50% (3 of 6) of agencies reviewed were found to be against MIOLs. In addition, two studies were reviewed in favour of MIOLs, in which implanting MIOLs provides greater lens independence from monofocals for visual tasks in and out of the cockpit, as well as no difference in performance in flight simulators versus pilots with monofocal intraocular lenses. Limitations: There are few studies of MIOLs in aviator pilots. Originality: No review of regulatory agencies regarding the prohibition or permission of MIOLs in airline pilots has been reported, touching on evidence that could consolidate a unanimous position on this issue, as was once the case with excimer laser refractive surgery, which is currently unrestricted.

Relación entre ingesta de alimentos ultraprocesados y los parámetros antropométricos en escolares / Relationship between consumption of ultra-processed food and anthropometric parameters in school aged children

La obesidad y las enfermedades crónicas no transmisibles ya son epidémicas en toda América Latina, tanto en los adultos como en los niños y adolescentes. Objetivos: Determinar la relación entre la ingesta de alimentos ultra procesados y los parámetros antropométricos en escolares de una institución educativa de El Agustino, Lima. Material y mótodos: Estudio descriptivo, transversal y observacional, con la aplicación de una encuesta sobre frecuencia de consumo de alimentos ultra procesados además de la evaluación de parámetros antropométricos en alumnos de entre 9 y 17 años de una institución educativa en Lima durante el mes de noviembre del 2017. Se consideró alta ingesta (≥ 5 puntos) y baja ingesta (< 5 puntos). Se incluyeron datos sociodemográficos (edad en años y sexo), peso, talla, índice de masa corporal, í­ndice de masa corporal para la edad, talla para la edad y perí­metro abdominal. Resultados: Se encontró una mayor frecuencia en bajo consumo de alimentos ultra procesados (58,18% en primaria y 60,5% en secundaria). En estudiantes de primaria, está relacionada la ingesta de alimentos ultra procesados con el peso (p= 0,009), IMC (p= 0,017), IMC/Edad (p= 0,031) y perímetro abdominal (p= 0,033). En estudiantes de secundaria se encontró relación entre edad e ingesta baja de consumo de alimentos ultra procesados (p=0,008). Conclusiones: En los escolares de primaria se observa una relación entre la ingesta de alimentos ultra procesados con peso, IMC, IMC/ Edad y perímetro abdominal. Mientras que en los escolares de secundaria se presenta en edad. (AU)

Obesity and non-transmissible chronic diseases are becoming epidemic in Latin America, both in adults and children-adolescents. Objectives: To determine the relationship between consumption of ultra-processed food and anthropometric parameters in school age children of a school in El Agustino, Lima. Methods: A cross-sectional study was carried-out applying a questionnaire about consumption of ultra-processed food and measuring anthropometric parameters in school children between 9-17 years of age during November 2017. High consumption was considered (≥ 5 points) and low consumption (< 5 points). Data on sociodemographic information (age in years and gender); weight; height; body mass index (BMI); body mass index for age; height for age and abdominal perimeter were collected as well. Results: A high frequency of low consumption of ultra-processed food was found (58.18% in elementary school age and 60.5% in secondary school age children). A relationship of consumption of ultra- processed food with weight (p=0.009), BMI (p=0.017), BMI/age (p=0.031) and abdominal perimeter (p=0.033) was found among elementary school age children. Among secondary school age students, a relationship between age and low consumption of ultra-processed food was found (p=0,008). Conclusions: Among elementary age students a relationship of consumption of ultra-processed food and weight, BMI, BMI/age and abdominal perimeter was found, while only a relationship with age was found among secondary age students. (AU)

Nivel de conocimiento/características sociodemagráficas de las estudiantes universitarias que utilizan anticonceptivos orales de emergencias / Level of Knowledge / Demographic Characteristics of College Students that use Emergency Oral Contraception

El gran auge alcanzado por los anticonceptivos orales de emergencia (AOE) en los últimos años se ha convertido en un tema de interés social. Objetivo: Evaluar el nivel de conocimiento y las características sociodemográficas de las estudiantes universitarias que utilizan anticonceptivos orales de emergencia. Pacientes y Métodos: Estudio descriptivo-transversal, realizado en la Universidad Nacional Autónoma de Honduras en el Valle de Sula (UNAH-VS), en el tercer trimestre del año 2014. El muestreo fue por conveniencia, incluyendo a 66 estudiantes que usaban AOE. La información se obtuvo mediante un instrumento de recolección de datos tipo cuestionario. Resultados: Se encontró que el nivel de conocimiento respecto a los AOE era bajo en 32(48.5%) estudiantes. Las características sociodemográficas predominantes en dichas estudian- tes fueron: Edad 17 y 20 años 33(50.0%), procedentes del área urbana 51(77.3%), residentes en San Pedro Sula 42(63.6%), ingreso familiar entre Lps. 8,000-16,000 32(48.5%), 41 (62.1%) pertenecía a las carreras de las ciencias sociales y las ciencias biológicas y de la salud, solteras55 (83.3%), no trabajaban 48 (72.7%), y forman parte de la religión católica 31 (47.0%). Conclusiones: Aproximadamente la mitad de las estudiantes universitarias que utilizan AOE, lo hacen sin tener conocimientos adecuados respecto al tema, poniendo en riesgo su salud...(AU)

Polymorphism in the matrix metalloproteinase-2 gene promoter is associated with cervical neoplasm risk in Mexican women.

Matrix metalloproteinase-2 (MMP-2) is an enzyme with proteolytic activity on matrix proteins, and previous studies have revealed a strong association between the MMP-2 -1306C-->T polymorphism and the risk of several types of cancer. Our study looked at whether this polymorphism contributed to the development of cervical neoplasia by analyzing 54 patients with invasive squamous cell cervical cancer, 100 patients with cervical intraepithelial neoplasia, and 126 control subjects. The MMP-2 CC genotype was more frequent in the cancer patients when compared with the control group (OR 2.57; 95% CI 1.15-5.86). The association of cervical cancer with the CC genotype was more pronounced in women who had first coitus at an early age (OR 3.96; 95% CI 1.46-11.06). The CC genotype was associated with intraepithelial neoplasia only in women with first coitus at 19 years old or younger. The data suggest that the MMP-2 -1306C-->T polymorphism contributes to the development of squamous cell cervical cancer in the population studied, especially in women who had first coitus at an early age.