Comparison of MAF-32 and a One-Pot Synthesized Superparamagnetic Iron Oxide/MAF-32 Composite for the Adsorption of Diclofenac.

The global presence of pharmaceutical pollutants in water sources represents a burgeoning public health concern. Recent studies underscore the urgency of addressing this class of emerging contaminants. In this context, our work focuses on synthesizing a composite material, FexOy/MAF-32, through a streamlined one-pot reaction process, as an adsorbent for diclofenac, an emerging environmental contaminant frequently found in freshwater environments and linked to potential toxicity towards several organisms such as fish and mussels. A thorough characterization was performed to elucidate the structural composition of the composite. The material presents magnetic properties attributed to its superparamagnetic behavior, which facilitates the recovery efficiency of the composite post-diclofenac adsorption. Our study further involves a comparative analysis between the FexOy/MAF-32 and a non-magnetic counterpart, comprised solely of 2-ethylimidazolate zinc polymer. This comparison aims to discern the relative advantages and disadvantages of incorporating magnetic iron oxide nanoparticles in the contaminant removal process facilitated by a coordination polymer. Our findings reveal that even a minimal incorporation of iron oxide nanoparticles substantially enhanced the composite's overall performance in pollutant adsorption.

Influence of standard culture conditions and effect of oleoresin from the microalga Haematococcus pluvialis on splenic cells from healthy Balb/c mice - a pilot study.

In this work, we used splenocytes from healthy mice to study the effects of the two most commonly used cell culture media (A, B) with different compositions of redox reagents. The incubation of cells for 24 h resulted in a significant decrease in viability and metabolic activity of splenocytes, and the negative effects of incubation in medium B were more pronounced. In standard conditions, oxidative stress in cells was manifested by reduced mitochondrial potential, and this effect correlated with the transition of 58.3% of cells to the early stage of apoptosis under reducing conditions of medium A and up to 66.1% of cells under super-reducing conditions in medium B, suggesting altered cell physiology. High levels of ROS/RNS activated transcription factor Nrf2, superoxide dismutase 1, and catalase. The higher mRNA levels of these genes were under the conditions of medium B, whose super-reducing environment in combination with the environment of conventional incubators proved to be less suitable for the cells compared to medium A. Treatment of the cells with a lower concentration (10 µg/ml) of oleoresin obtained from the microalga H. pluvialis partially eliminated the negative effects of cultivation. Higher concentration of oleoresin (40 µg/ml) was slightly cytotoxic, due to the significant antioxidant effect of astaxanthin, the main bioactive component of the extract, which eliminated most of the ROS/RNS acting as signalling molecules. This study shows that the standard culture conditions do not reflect the physiological in vivo cell conditions; therefore, they are not generally suitable for incubation of all cell types.

Estigma en mujeres de peso alto a través de un análisis fenomenológico interpretativo

Tener peso alto es una característica que ha sido devaluada y denigrada socialmente, convirtiendo a las personas de cuerpos grandes en víctimas de estereotipos, prejuicios y discriminación, lo que se ha denominado estigmatización por el peso, fenómeno que ocurre especialmente en mujeres. El objetivo de este estudio fue describir las experiencias de estigma de peso de mujeres con obesidad que viven en el sur de Chile. Participaron seis mujeres entre 20 y 57 años a través de entrevistas semi-estructuradas realizadas de manera remota. Mediante Análisis Fenomenológico Interpretativo se identificaron cuatro supratemas y diversos subtemas, los supratemas son: 1. La obesidad como parte de la persona. 2. Las experiencias de sentirse discriminada. 3. Todo gira en función del peso. 4. Lo que la sociedad piensa de la obesidad, los que en su conjunto permiten caracterizar la experiencia de vivir con obesidad y sufrir el estigma asociado al peso en distintos ámbitos de sus vidas, incluso en contextos sanitarios. Las consecuencias de esta experiencia son diversas y negativas, destacando el impacto que tiene en su autoestima y las constantes emociones negativas que derivan de las situaciones de discriminación. Estos resultados ponen de manifiesto la importancia de avanzar hacia la diversidad y aceptación corporal, lo que supone un desafío a la sociedad en general y en particular a los proveedores de salud, ya que se requiere de intervenciones libres de prejuicios y orientadas a la salud y el bienestar de las personas.

Carrying a high weight is a characteristic that has been devalued and socially denigrated, turning people with large bodies into victims of stereotypes, prejudice, or discrimination, which has been called weight stigmatisation, a phenomenon that occurs especially in women. The aim of this study was to describe the weight stigma experiences of women with obesity who live in southern Chile. Six women between 20 and 57 years of age participated in semi-structured interviews conducted remotely. Through Interpretative Phenomenological Analysis four supra-themes and several sub-themes were identified, the supra-themes are: 1. Obesity as part of the person. 2. Experiences of feeling discriminated. 3. Everything is about weight. 4. what society thinks of obesity, which together allow characterising the experience of living with obesity and suffering the weight stigma in different areas of their lives, including in health contexts. The consequences of this experience are diverse and negative, highlighting the impact it has on their self-esteem and the constant negative emotions that derive from discrimination situations. These results highlight the importance of moving toward body diversity and acceptance, which is a challenge for society in general and health care providers in particular, as it requires interventions free from prejudice and orientated to the health and well-being of individuals.

Herramientas educativas audiovisuales inclusivas: diseño y aplicación

Fundamento: lograr que las personas con necesidades educativas especiales se formen sobre la base del mérito, las capacidades propias, el esfuerzo, la perseverancia y sobre todo que tomen en cuenta sus potencialidades, es un reto. Objetivo: diseñar videos accesibles para estudiantes, incluyendo aquellos con necesidades educativas especiales, así como evaluar su aplicabilidad. Métodos: se diseñaron videos y su aplicación en base al modelo teórico Technological Pedagogical and Content Knowledge: conocimiento curricular, conocimiento pedagógico y conocimiento tecnológico, con énfasis en la adaptación a necesidades educativas especiales para facilitar el aprendizaje. La evaluación consideró la aplicación del instrumento "Evaluación de herramientas educativas audiovisuales" desde los parámetros: atención, curiosidad, utilidad en repaso, estímulo a aprender, ayuda al entendimiento y el deseo de reutilizarlos. Resultados: se diseñaron tres videos con elementos de accesibilidad para estudiantes, incluyendo estudiantes con necesidades educativas especiales. En la evaluación se consiguió, de forma general, el aumento de la calificación en las pruebas parciales de la asignatura tras el empleo de los videos; la percepción de uso determinó la satisfacción como recurso de aprendizaje. Conclusiones: el diseño de recursos audiovisuales accesibles sin diferencia con estudiantes en condición de discapacidad beneficia a todo el grupo de estudiantes, en el marco de la igualdad.

Background: to achieve that people with special educational needs are trained on the basis of merit, their own abilities, effort, perseverance and above all that they take into account their potential, is a challenge. Objective: design accessible videos for students, including those with special educational needs, as well as evaluate their applicability. Methods: videos and their application were designed based on the Technological Pedagogical and Content Knowledge theoretical model: curricular knowledge, pedagogical knowledge and technological knowledge, with emphasis on adaptation to special educational needs to facilitate learning. The evaluation considered the application of the instrument "Evaluation of audiovisual educational tools" from the parameters: attention, curiosity, usefulness in review, stimulus to learn, help to understand and the desire to reuse them. Results: three videos were designed with accessibility elements for students, including students with special educational needs. In the evaluation, it was achieved, in a general way, the qualification increase in the partial tests of the subject after the use of the videos; the use's perception determined the satisfaction as a learning resource. Conclusions: the design of accessible audiovisual resources without difference with students with disabilities, benefits the entire group of students, within the equality framework.

Research and Publication Trends in Pediatric Surgery in Latin America: A Bibliometric and Visual Analysis from 2012 to 2021.

INTRODUCTION: Pediatric surgery is a developing specialty with increasing volume in Latin America. However, the research and scientific activity trends carried out in this region in recent years are unknown. This study aimed to analyze and visualize Latin American research in pediatric surgery from 2012 to 2021. MATERIAL AND METHODS: Bibliometric cross-sectional study of scientific articles on pediatric surgery published by Latin American authors from 2012 to 2021 in Scopus was performed. Statistical and visual analysis was performed with R programming language and VOS viewer. RESULTS: 449 articles were found. Observational studies (44.7%; n = 201), case reports (20.4%; n = 92) and narrative reviews (11.4%; n = 51) were found to be the most common study designs. The published articles were predominantly monocentric (73.1%; n = 328), only 17% (n = 76) involved authors from 2 or more countries, and mostly there was no collaboration with high-income countries (80.6%; n = 362). The Journal of Pediatric Surgery was the journal with the highest volume of articles published (n = 37). The most used terms were Laparoscopy, Complications, and Liver Transplantation, and the countries with the highest number of articles published were Brazil and Argentina. CONCLUSIONS: This study found a progressive increase in the scientific activity of Latin authors in pediatric surgery from 2012 to 2021. The evidence produced was mainly from observational studies and case reports, predominantly conducted in Brazil. Multinational and international collaboration was low; the most frequent topics of interest were laparoscopy and minimally invasive surgery. LEVELS OF EVIDENCE: IV.

[Relation between weight stigma and emotional eating: an approach from structural equation modeling]. / Relación entre estigma de peso y alimentación emocional: una aproximación desde el modelo de ecuaciones estructurales.

Introduction: Introduction: dietary intake has been shown to be one of the main factors influencing weight gain, and weight stigma contributes to increased emotional eating. However, the factors that mediate this relationship have been less studied. Objective: the aim of this study was to identify the relationship between weight stigma and emotional eating, and whether this relationship is mediated by internalizing weight bias and psychological distress. Methods: a non-probabilistic sample of 332 people from the general population (192 women and 140 men) answered self-report psychological instruments and provided anthropometric measurements. Results: through structural equation analysis (SEM), direct relationships were identified, among which the relationship between weight stigma and emotional eating stands out (ß = 0.422, p < 0.001), in addition to the indirect relationship between these variables mediated by internalized weight bias and psychological distress (ßindirect = 0.016, p = < 0.05). The model had good indicators of goodness of fit and explained 85 % of the variance. Conclusion: the results show the importance of including psychological and behavioral variables in the treatment of emotional eating in people with overweight and obesity, as well as addressing these issues from public policies to reduce the associated stigma that still prevails in society.

Introducción: Introducción: se ha demostrado que la ingesta alimentaria es uno de los principales factores que influyen en el incremento del peso y que el estigma de peso contribuye a una mayor alimentación emocional. Sin embargo, los factores que median esta relación han sido menos estudiados. Objetivo: el objetivo de este estudio fue identificar la relación que existe entre estigma de peso y alimentación emocional, y si esta relación está mediada por la internalización del sesgo de peso y el malestar psicológico. Métodos: una muestra no probabilística de 332 personas de población general (192 mujeres y 140 hombres) respondió instrumentos psicológicos de autorreporte y proporcionó medidas antropométricas. Resultados: por medio de un análisis de ecuaciones estructurales (SEM), se identificaron relaciones directas, entre las que destaca la relación del estigma de peso y alimentación emocional (ß = 0,422, p < 0,001), además de la relación indirecta entre estas variables mediante la internalización del sesgo de peso y malestar psicológico (ßindirecto = 0,016, p = < 0,05). El modelo tuvo buenos indicadores de bondad de ajuste y explicó un 85 % de la varianza. Conclusión: los resultados muestran la importancia de incluir variables psicológicas y conductuales en el tratamiento de la alimentación emocional en personas con sobrepeso y obesidad, así como de abordar estos temas desde políticas públicas para disminuir el estigma asociado que aún impera en la sociedad.

Liver decompensation is a frequent cause of treatment discontinuation and prognostic factor in intermediate-advanced HCC.

INTRODUCTION AND OBJECTIVES: With the advent of new therapeutic options for patients with hepatocellular carcinoma (HCC) for intermediate or advanced stages of the Barcelona Clinic Liver Cancer (BCLC), regional real-world data regarding prognostic survival factors are of significant importance. PATIENTS AND METHODS: A multicenter prospective cohort study was conducted in Latin America including BCLC B or C patients since 15th May 2018. We report here the second interim analysis focusing on prognostic variables and causes of treatment discontinuation. Cox proportional hazard survival analysis was performed, estimating hazard ratios (HR) and 95% confidence intervals (95% CI). RESULTS: Overall, 390 patients were included, 55.1% and 44.9% were BCLC B and C at the time of study enrollment. Cirrhosis was present in 89.5% of the cohort. Among the BCLC-B group, 42.3% were treated with TACE with a median survival since the first session of 41.9 months. Liver decompensation before TACE was independently associated with increased mortality [HR 3.22 (CI 1.64;6.33); P<.001]. Systemic treatment was initiated in 48.2% of the cohort (n=188), with a median survival of 15.7 months. Of these, 48.9% presented first-line treatment discontinuation (44.4% tumor progression, 29.3% liver decompensation, 18.5% symptomatic deterioration, and 7.8% intolerance), and only 28.7% received second-line systemic treatments. Liver decompensation [HR 2.9 (1.64;5.29); P<.0001], and symptomatic progression [HR 3.9 (1.53;9.78); P=0.004] were independently associated with mortality after first-line systemic treatment discontinuation. CONCLUSIONS: The complexity of these patients, with one-third presenting liver decompensation after systemic therapies, underlines the need for multidisciplinary team management and the central role of hepatologists.

Problemas de salud mental en universitarios durante la pandemia por COVID-19: ¿qué tipo de ayuda buscan? / Mental health problems in university students during the COVID-19 pandemic: What kind of help do they seek?

Introducción: La pandemia por COVID-19 ha tenido un impacto negativo en el bienestar psicológico de la población, siendo los jóvenes un grupo especialmente vulnerable. Objetivo: El presente estudio se propuso examinar los niveles de búsqueda de ayuda (formal e informal) para problemas en salud mental y sus variables asociadas en una muestra de estudiantes universitarios de la Región de La Araucanía, en el contexto de la pandemia por COVID-19. Método: A través de un muestreo no probabilístico por conveniencia, se reclutó a 500 estudiantes de entre 18 y 29 años. Se describió y comparó su nivel de búsqueda de ayuda, así como variables que podrían obstaculizarla o facilitarla, según género. Adicionalmente, se estimaron modelos de regresión lineal múltiple diferenciados por género, con la búsqueda de ayuda informal como variable criterio. Resultados: Se evidenció una renuencia general a buscar ayuda (formal e informal) tanto en hombres como mujeres, una mayor experimentación de malestar psicológico y mayor conocimiento sobre salud mental en mujeres. Finalmente, se observaron diferencias en los predictores de la búsqueda de ayuda informal entre hombres y mujeres, siendo el apoyo social y las emociones negativas en pandemia los únicos comunes entre géneros. Conclusión: Se discuten los bajos niveles de búsqueda de ayuda evidenciados, y las diferencias observadas en variables asociadas, en función de la brecha de género en salud mental.

Introduction: The COVID-19 pandemic has impacted the psychological well-being of the population, with young people being a particularly vulnerable group. Aim: The present study examines help-seeking intention for mental health problems and associated variables among male and female university students in La Araucanía Region during the COVI-19 pandemic. Method: A sample of 500 students aged 18 to 29 was recruited through non-probabilistic convenience sampling. Help-seeking levels and facilitating or hindering variables were compared by gender. Multiple linear regression models were estimated separately by gender to predict the criterion variable of informal help-seeking. Results: The results indicate that both men and women are reluctant to seek help (formal and informal). Women reported higher levels of psychological distress and greater knowledge about mental health than men. Differences in predictors of informal help-seeking between men and women are evidenced, with social support and negative emotions in pandemic being the only common predictors between genders. Conclusion: The low levels of help-seeking evidenced, and the differences observed in associated variables based on the gender gap in mental health, are discussed.

Role of Protein Kinase A Activation in the Immune System with an Emphasis on Lipopolysaccharide-Responsive and Beige-like Anchor Protein in B Cells.

Cyclic AMP-dependent protein kinase A (PKA) is a ubiquitous enzymatic complex that is involved in a broad spectrum of intracellular receptor signaling. The activity of PKA depends on A-kinase anchoring proteins (AKAPs) that attach to PKAs close to their substrates to control signaling. Although the relevance of PKA-AKAP signaling in the immune system is evident in T cells, its relevance in B and other immune cells remains relatively unclear. In the last decade, lipopolysaccharide-responsive and beige-like anchor protein (LRBA) has emerged as an AKAP that is ubiquitously expressed in B and T cells, specifically after activation. A deficiency of LRBA leads to immune dysregulation and immunodeficiency. The cellular mechanisms regulated by LRBA have not yet been investigated. Therefore, this review summarizes the functions of PKA in immunity and provides the most recent information regarding LRBA deficiency to deepen our understanding of immune regulation and immunological diseases.

Hepatitis B: Anticuerpos contra antígeno de superficie en residentes de pediatría, Hospital Central de Maracay

Introducción: Los profesionales del área de la salud tienen un riesgo incrementado de contraer la infección por el virus de hepatitis B (VHB). Objetivo: Evaluar anticuerpos contra el antígeno de superficie de la hepatitis B, en los residentes de pediatría del Hospital Central de Maracay en el período junio-agosto de 2021. Materiales y métodos: Estudio clínico epidemiológico, no experimental y de corte transversal, en el que se tomó muestra sanguínea a 54 médicos residentes para la determinación de anticuerpos contra el antígeno de superficie del VHB (Anti-HBs). Resultados: El promedio de edad fue 27,48 años con una desviación estándar de 1,6. El 83,33 % pertenecían al sexo femenino, 51,85.% cursaban el 1er año del posgrado, 33,33 % con esquema de vacunación documentado, de estos, 66,67.% completaron el esquema y 77,78 % cumplidos en la adultez. Con respecto al tiempo de la última dosis, el 66,67 % hasta 10 años. Se detectaron niveles de Anti-HBs mayores de 10 mUl/mL en el 94,44 %, con mayor prevalencia de niveles protectores a favor del sexo femenino. Se evidenció una correlación lineal positiva entre los niveles de Anti-HBs y el tiempo desde la última dosis de la vacuna contra la hepatitis B. Conclusiones: Aunque existe una debilidad en los médicos residentes en cuanto a la tenencia y cumplimiento del esquema de inmunización, la mayoría de ellos mostraron niveles protectores de anti-HBs. A mayor tiempo transcurrido desde la última dosis de la vacuna hay un descenso en los niveles de anti-HBs lo que justifica dosis de refuerzo a los 10 años.

Introduction: Health professionals have an increased risk of contracting hepatitis B virus infection (HBV). Objective: To evaluate antibodies against hepatitis B surface antigen in residents of pediatrics of the Central Hospital of Maracay in the period June-August. 2021. Materials and methods: Clinical epidemiological, nonexperimental and cross-sectional study, in which blood samples were taken from fifty-four medical residents for the determination of antibodies against the HBV surface antigen. Results: The average age was 27.48 years with a standard deviation of 1.6. 83.33 % were female, 51.85 % were in the first year of postgraduate studies, 33.33 % had a documented vaccination schedule, of these, 66.67 % completed the schedule and 77.78 % completed it in adulthood. Regarding the time of the last dose, for 66.67 % of the study population, it was up to 10 years ago. Anti-HBs levels greater than 10mUl/ml were detected in 94.44 %, with a higher prevalence of protective levels in favor of the female sex. A positive linear correlation between the levels of Anti-HBs and the time since the last dose of the hepatitis B vaccine was evidenced. Conclusions: Although there is a weakness in the resident doctors in terms of possession and compliance with the immunization schedule, the most of them showed protective levels of anti-HBs. The longer the time elapsed since the last dose of the vaccine, there is a decrease in anti-HBs levels, which justifies a booster dose at 10 years.

Proceso de enfermería para la cesación del hábito tabáquico en paciente con EPOC: Reporte de caso / Nursing Process for Smoking Cessation in COPD Patients: Case Report / Processo de enfermagem para cessação do tabagismo em pacientes com DPOC: Relato de caso

Introducción. La enfermedad pulmonar obstructiva crónica es un problema de salud pública a nivel mundial y el cese del consumo de tabaco es la medida más efectiva para disminuir la incidencia y su progresión. Esta medida es especialmente eficaz en personas envejecidas, en quienes las consecuencias son más agudas a causa de los cambios biopsicosociales, cambios que aumentan la probabilidad de infecciones, dependencia funcional y fragilidad. El objetivo de este reporte es describir los cambios en el hábito tabáquico de una persona mayor con enfermedad pulmonar obstructiva crónica, tras ser incluida en un plan de cuidado organizado y según las etapas del proceso de Enfermería dirigido al cese del hábito tabáquico. Metodología. Reporte de caso de Enfermería bajo el Modelo de Promoción de la Salud de Nola Pender y el proceso de Enfermería, articulado con la taxonomía diagnóstica North American Nursing Diagnosis Association International, la Clasificación de Resultados de Enfermería (Nursing Outcomes Classification) y la Clasificación de Intervenciones de Enfermería (Nursing Interventions Classification). Resultados. Tras el proceso de Enfermería se evidencia la cesación del hábito tabáquico en la persona mayor y se destaca en el proceso la participación del núcleo familiar y el reconocimiento de los riesgos en salud asociados. Conclusiones. Se reconoce el rol de Enfermería como preponderante en la prevención y el abandono del hábito tabáquico que, orientado por un proceso de cuidado organizado, con respaldo disciplinar y científico, ayuda a mejorar el estado de salud y manejo de los factores de riesgo.

Introduction. Quitting tobacco consumption is the most effective measure for reducing the incidence and progression of chronic obstructive pulmonary disease, which is a global public health issue. This measure is especially effective in seniors, in whom the consequences are more acute due to biopsychosocial changes, changes that increase the probability of infection, functional dependence and fragility. The objective of this report is to describe the changes in the tobacco habits of a senior with chronic obstructive pulmonary disease after being included in an organized health care plan according to the Nursing process' stages for quitting tobacco habits. Methodology. A nursing case report under Nola Pender's Health Promotion Model and the Nursing process, articulated with the diagnostic taxonomy North American Nursing Diagnosis Association International, Nursing Outcomes Classification and Nursing Interventions Classification. Results. It was evident the senior quit their tobacco habits after the Nursing process was carried out, and participation from family members and recognition of the associated health risks stood out in the process. Conclusions. The role of Nursing is pivotal in preventing and quitting tobacco habits, which, guided by an organized health care process with disciplinary and scientific support, helps improve health conditions and manage risk factors.

Introdução. A doença pulmonar obstrutiva crônica é um problema de saúde pública global e a cessação do consumo de tabaco é a medida mais eficaz para reduzir sua incidência e progressão. Essa medida é especialmente eficaz em idosos, nos quais as consequências são mais agudas devido a alterações biopsicossociais, alterações que aumentam a probabilidade de infecções, dependência funcional e fragilidade. O objetivo deste relato é descrever as mudanças no hábito de fumar de um idoso com doença pulmonar obstrutiva crônica, após a inclusão em um plano de cuidados organizado e de acordo com as etapas do processo de Enfermagem visando a cessação do tabagismo. Metodologia. Relato de caso de Enfermagem sob o Modelo de Promoção da Saúde de Nola Pender e o processo de Enfermagem, articulado com a taxonomia diagnóstica North American Nursing Diagnosis Association International, a Classificação de Resultados de Enfermagem Nursing Outcomes Classification e a Classificação de Intervenções de Enfermagem Nursing Interventions Classification. Resultados. Após o processo de Enfermagem, evidencia-se a cessação do tabagismo no idoso e destaca-se a participação do núcleo familiar e o reconhecimento dos riscos à saúde associados no processo. Conclusões. O papel da Enfermagem é reconhecido como preponderante na prevenção e cessação do tabagismo, o que, pautado por um processo assistencial organizado, com respaldo disciplinar e científico, auxilia na melhoria do estado de saúde e no manejo dos fatores de risco.

[Weight stigma, Mediterranean diet and obesity]. / Estigma de peso, dieta mediterránea y obesidad.

Introduction: Introduction: obesity is a disease that affects a high percentage of the world's population. Although its origin is multicausal and multifactorial, less attention has been paid to psychological and behavioral variables. Aim: to determine whether psychological variables (weight stigma, stress and depressive symptomatology) and behavioral variable (Mediterranean diet index) predict obesity according to body mass index (BMI), controlling for the effect of physiological variables (HDL cholesterol, triglycerides, glucose and blood pressure) and sociodemographic variables (sex, income, educational level). Methods: non-experimental, cross-sectional, correlational design. By means of a non-probabilistic convenience sampling, 344 persons were selected from the general Chilean population from the Araucanía region (Mage = 55.7 years; SD = 5.1 years; 55.8 % women). A blood sample, anthropometric measurement of weight and height, and self-report measures of psychological and behavioral variables were obtained. Results: a 5-block hierarchical multiple regression analysis was performed. Sociodemographic covariates did not significantly predict BMI, however physiological covariates, the behavioral variable and weight stigma, were significantly associated with BMI, with weight stigma being the predictor that explained the most variance. Conclusions: the findings allow us to verify the role of psychological and behavioral variables in the multifactorial etiology of obesity. The findings are discussed in the light of the biopsychosocial approach, and a multidisciplinary approach to obesity is suggested.

Introducción: Introducción: la obesidad es una enfermedad que afecta a un alto porcentaje de la población mundial. Pese a que su origen es multicausal y multifactorial, menos atención se ha puesto en las variables psicológicas y conductuales. Objetivo: determinar si las variables psicológicas (estigma de peso, estrés y sintomatología depresiva) y la variable conductual (índice de dieta mediterránea) predicen la obesidad según el índice de masa corporal (IMC), controlando el efecto de variables fisiológicas (colesterol HDL, triglicéridos, glucosa y presión arterial) y sociodemográficas (sexo, ingresos, nivel de estudios). Método: diseño no experimental, transversal, correlacional. Por medio de un muestreo no probabilístico por conveniencia, se seleccionó a 344 personas de población general chilena de la región de la Araucanía (Medad = 55,7 años; DE = 5,1 años; 55,8 % de mujeres). Se obtuvo una muestra de sangre, medición antropométrica de peso y talla, y medidas de autorreporte de variables psicológicas y conductuales. Resultados: se realizó un análisis de regresión múltiple jerárquica de 5 bloques. Las covariables sociodemográficas no predijeron significativamente el IMC; sin embargo, las fisiológicas, la variable conductual y el estigma de peso, se asociaron significativamente con el IMC, siendo el estigma de peso el predictor que explicó mayor varianza. Conclusiones: los hallazgos permiten comprobar el rol de las variables psicológicas y conductuales en la etiología multifactorial de la obesidad. Se discute los hallazgos a la luz del enfoque biopsicosocial, y se sugiere un abordaje multidisciplinario de la obesidad.

Factores de riesgo cardiometabólico y funcionamiento cognitivo: el rol de la reserva cognitiva / Association between cardiometabolic risk and cognitive impairment

Background: Several risk factors are associated with cognitive impairment in older people, but little attention has been paid to cardiometabolic variables, as well as how cognitive reserve can mediate this association. Aim: To determine the association of cardiometabolic risk factors with cognitive functioning and whether the cognitive reserve mediates this association. Material and Methods: A cross-sectional study with 300 participants with a median age of 56 years (53% male) was conducted. Participants had a cognitive functioning assessment. Fasting glucose, HDL-cholesterol, and blood pressure were measured. Results: A Structural Equation Modeling, revealed a direct effect of cardiometabolic latent risk factors on both a cognitive functioning (β = -.204; p = .056), and cognitive reserve factors (β = -.236, p = .04). Cognitive reserve was directly associated with cognitive functioning (β = .327, p = .01), but did not mediate the association between the cardiometabolic risk factors and cognitive functioning (β = .077, p = .07). The overall goodness of fitness was excellent χ2 (50) = 58.357, p = .195, comparative fit index = .980, Tucker-Lewis Index = .974, root mean square error of approximation = .023 and Standardized Root Mean Square Residual = .041. Conclusions: A direct effect of cardiometabolic risk factors on cognitive functioning was observed.

Failure in all steps of hepatocellular carcinoma surveillance process is frequent in daily practice.

INTRODUCTION AND OBJECTIVES: Failures at any step in the hepatocellular carcinoma (HCC) surveillance process can result in HCC diagnostic delays and associated worse prognosis. We aimed to estimate the prevalence of surveillance failure and its associated risk factors in patients with HCC in Argentina, considering three steps: 1) recognition of at-risk patients, 2) implementation of HCC surveillance, 3) success of HCC surveillance. METHODS: We performed a multi-center cross-sectional study of patients at-risk for HCC in Argentina seen between10.01.2018 and 10.30.2019. Multivariable logistic regression analysis was used to identify correlates of surveillance failure. RESULTS: Of 301 included patients, the majority were male (74.8%) with a mean age of 64 years old. At the time of HCC diagnosis, 75 (25%) patients were unaware of their diagnosis of chronic liver disease, and only 130 (43%) patients were under HCC surveillance. Receipt of HCC surveillance was significantly associated with follow-up by a hepatologist. Of 119 patients with complete surveillance, surveillance failure occurred in 30 (25%) patients. Surveillance failure was significantly associated with alpha fetoprotein ≥20 ng/mL (OR 4.0, CI 95% 1.43-11.55). CONCLUSIONS: HCC surveillance failure was frequent in all the evaluated steps. These data should help guide strategies to improve the implementation and results of HCC surveillance in our country.

Péptido inmunomodulador CIGB-258 para el tratamiento de pacientes graves y críticos con la COVID-19 / An immunomodulatory peptide CIGB-258 for the treatment of critical and severe COVID-19 patients

Introducción: El CIGB-258 es un péptido inmunomodulador con propiedades antiinflamatorias. Objetivos: Establecer la frecuencia de dosis y el tiempo de tratamiento con el péptido CIGB-258, para pacientes críticos con COVID-19. Además, definir los criterios de uso y el esquema terapéutico del péptido, para pacientes graves con COVID-19. Métodos: Se incluyeron 9 pacientes críticos y 3 pacientes graves. Las evaluaciones clínicas, radiológicas y de laboratorio se registraron de acuerdo al protocolo establecido. Se obtuvieron muestras de suero antes y después del tratamiento con la CIGB-258, para la determinación de los biomarcadores de la inflamación. Resultados: Se estableció el protocolo de actuación con el péptido CIGB-258, el cual consiste en la administración intravenosa de 1 mg del péptido cada 12 horas a los pacientes críticos. La dosis debe aumentarse a 2 mg cada 12 horas, para los pacientes que no muestren mejoría clínica y radiológica en 24 horas. Después de la extubación, los pacientes deben recibir 1 mg de CIGB-258 al día, durante otros tres días. Los pacientes graves deben recibir 1 mg de CIGB-258 cada 12 horas, hasta que resuelvan su condición clínica. Conclusiones: CIGB-258 mostró un buen perfil de seguridad. El protocolo de actuación establecido contribuyó a que todos los pacientes críticos se recuperaran de la dificultad respiratoria y fueran extubados. Los pacientes graves mejoraron considerablemente. Los niveles de los biomarcadores asociados con hiperinflamación y las citocinas disminuyeron significativamente durante el tratamiento(AU)

Introduction: CIGB-258 is an immunomodulatory peptide with anti-inflammatory properties. Objectives: To establish the therapeutic schedule with CIGB-258 peptide for COVID-19 critically ill patients. In addition, to define the criteria for use and schedule of this peptide for COVID-19 seriously ill patients. Methods: 9 critically ill patients and 3 seriously ill patients were included in this study. Clinical, radiological and laboratory evaluations were recorded according to the established protocol. Serum samples were obtained before and after treatment with CIGB-258, for the determination of the inflammation biomarkers. Results: The therapeutic protocol was established with the CIGB-258 peptide, which consists of intravenous administration of 1 mg of peptide every 12 hours for critically ill patients. The dose should be increased to 2 mg every 12 hours, for patients who do not show clinical and radiological improvement in 24 hours. After extubation, patients should receive 1 mg of CIGB-258 daily, for another three days. Seriously ill patients should receive 1 mg of CIGB-258 every 12 hours, until their clinical condition resolves. Conclusions: CIGB-258 showed an excellent safety profile. The established therapeutic protocol contributed to all critically ill patients recovering from respiratory distress and being extubated. Seriously ill patients improved considerably. The levels of the biomarkers associated with hyperinflammation and cytokines decreased significantly during treatment(AU)

Surface Damaging of Brass and Steel Pins when Sliding over Nitrided Samples Cut by Finishing and Roughing EDM Conditions.

In the forging industry, surface quality and surface treatments of dies are crucial parameters to extend their life. These components are usually machined by milling or by Electrical Discharge Machining (EDM), and the final surface roughness depends on the machining techniques and operational conditions used in its fabrication. After milling, a nitriding treatment is widely applied to extend its service life. Nevertheless, no scientific report that informs about nitriding after EDM has been found. Accordingly, this work focuses on the wear and friction behavior of pins made of brass and medium carbon steel sliding over AISI H13 discs, made by wire EDM in the conditions of finishing and roughing. The discs are plasma nitride, and their effect on the wear during pin-on-disc tests is evaluated. In this sense, the analysis of the surface damage for the different pins will help us to understand the service life and wear evolution of the forging dies. The results show that plasma nitride reduces the friction and prevents the degradation of the pin, independently of the material of the pin, when sliding over finishing and roughing EDM conditions.

Detección de nudos críticos para la disminución del tiempo de espera en atención de prolapso de órganos pélvicos en hospital público chileno / Detecting critical knots to decrease the waiting time when caring the pelvic organ prolapse in a chilean public hospital

Resumen Introducción: El problema que se presenta en la atención de salud en los hospitales públicos es la alta cantidad de pacientes, generando un sostenido crecimiento en las listas de espera y provocando un aumento del tiempo de espera, generando un impacto negativo en los usuarios. Objetivo: Mejorar el proceso clínico de atención del prolapso de órganos pélvicos de un hospital público chileno. Metodología: Se identifican nudos críticos mediante diagramas de flujo, realizando un diagnóstico del proceso desde el ingreso del paciente hasta su alta del hospital. Resultados: Se identifican cada uno de los puntos críticos y se proponen soluciones para agilizar el proceso y con ello mejorar la atención a las usuarias, lo que en definitiva llevó a una disminución del tiempo de espera y, lo más relevante, a una disminución en la cantidad de personas en la lista de espera.

Abstract Introduction: The high number of patients is a common issue in public hospitals that causes a negative impact on the users due to the increment in the waiting lists and in the waiting time to be treated. Objective: To improve the clinical process for caring pelvic organ prolapse in a chilean public hospital. Methodology: The methodology was focused on identifying critical knots using flowcharts and diagnosing the patient's process from their admission until their discharge from the hospital. Results: Some solutions were proposed for each critical point identified so as to accelerate the process, thus improving users' health caring. As a result, the high number of people in the waiting lists and the waiting time decreased substantially.

Evaluación de funcionamiento cognitivo en adultos: Análisis y contrastación de tres de los instrumentos de mayor divulgación en Chile / Psychometric properties of three instruments to detect dementia

Background Several instruments are available to measure cognitive functioning in older adults. However, there is paucity of information about their factorial structure and psychometric properties. Aim To determine the factorial structure and the internal reliability of the Mini Mental State Examination (MMSE), the Montreal Cognitive Assessment (MoCA) and the Adenbrookke´s Cognitive Examination (ACE-R), and their cognitive impairment detection capabilities. Material and Methods MMSE, MoCA and ACE-R were applied to 203 older adults aged 54 to 88 years (77% women), excluding participants with dementia. Results The factorial structure of the MMSE suggested that items referred to memory process should be eliminated due to their low reliability and factor loading (b = 0.12; p = 0.146). Although the MoCA had a good reliability, object denomination process items also had to be dropped (b = 0.22; p = 0.003). The ACE-R demonstrated a single factorial structure for all cognitive processes and had a good internal consistency. MMSE, MoCA and ACE-R classified as having dementia 5, 27 and 42% of participants, respectively. Conclusions MoCA and the ACE-R scales appear as better instruments to detect dementia in older people.

Disease Progression in Patients With Hepatitis C Virus Infection Treated With Direct-Acting Antiviral Agents.

BACKGROUND & AIMS: Little is known about how a sustained virologic response (SVR) to treatment of hepatitis C virus infection with direct-acting antivirals (DAAs) affects patient mortality and development of new liver-related events. We aimed to evaluate the incidence of disease progression in patients treated with DAAs. METHODS: We performed a prospective multicenter cohort study of 1760 patients who received DAA treatment at 23 hospitals in Latin America, from May 1, 2016, through November 21, 2019. We excluded patients with a history of liver decompensation, hepatocellular carcinoma (HCC), or solid-organ transplantation. Disease progression after initiation of DAA therapy included any of the following new events: liver decompensation, HCC, liver transplantation, or death. Evaluation of variables associated with the primary outcome was conducted using a time-dependent Cox proportional hazards models. RESULTS: During a median follow-up period of 26.2 months (interquartile range, 15.3-37.5 mo), the overall cumulative incidence of disease progression was 4.1% (95% CI, 3.2%-5.1%), and after SVR assessment was 3.6% (95% CI, 2.7%-4.7%). Baseline variables associated with disease progression were advanced liver fibrosis (hazard ratio [HR], 3.4; 95% CI, 1.2-9.6), clinically significant portal hypertension (HR, 2.1; 95% CI, 1.2-3.8), and level of albumin less than 3.5 mg/dL (HR, 4.1; 95% CI, 2.3-7.6), adjusted for SVR achievement as a time covariable. Attaining an SVR reduced the risk of liver decompensation (HR, 0.3; 95% CI, 0.1-0.8; P = .016) and de novo HCC (HR, 0.2; 95% CI, 0.1%-0.8%; P = .02) in the overall cohort. CONCLUSIONS: Treatment of hepatitis C virus infection with DAAs significantly reduces the risk of new liver-related complications and should be offered to all patients, regardless of disease stage. Clinicaltrials.gov: NCT03775798.

Tolerogenic dendritic cell transfer ameliorates systemic lupus erythematosus in mice.

Current treatments for systemic autoimmune diseases partially improve the health of patients displaying low pharmacological efficacy and systemic immunosuppression. Here, the therapeutic potential of transferring tolerogenic dendritic cells (tolDCs) generated with heme-oxygenase inductor cobalt (III) protoporphyrin IX (CoPP), dexamethasone and rosiglitazone for the treatment of systemic autoimmunity was evaluated in two murine models of systemic lupus erythematosus (SLE), MRL-Faslpr and NZM2410 mice. Dendritic cells treated ex vivo with these drugs showed a stable tolerogenic profile after lipopolysaccharide stimulation. Regular doses of tolDCs were administered to anti-nuclear antibody-positive mice throughout 60-70 days, and the clinical score was evaluated. Long-term treatment with these tolDCs was well tolerated and effective to improve the clinical score on MRL-Faslpr lupus-prone mice. Additionally, decreased levels of anti-nuclear antibodies in NZM2410 mice were observed. Although tolDC treatment increased regulatory T cells, no significant reduction of renal damage or glomerulonephritis could be found. In conclusion, these results suggest that the transfer of histone-loaded tolDCs could improve only some SLE symptoms and reduced anti-nuclear antibodies. This is the first study to evaluate antigen-specific tolDC administration to treat SLE. Our report strengthens the clinical relevance of tolDC generation with CoPP, dexamethasone and rosiglitazone and the use of these modified cells as a therapy for systemic autoimmunity.