Reduction-Responsive Cationic Vesicles from Bolaamphiphiles with Ionizable Amino Acid or Dipeptide Polar Heads.

This paper presents a study of the aggregation of cationic bolaamphiphilic molecules into vesicles. These molecules are based on a cystamine core with protonated terminal dipeptide groups. The study found that vesicles can be formed at pH 4 for all of the dipeptide-terminated bolaamphiphiles containing different combinations of l-valine, l-phenylalanine, and l-tryptophan. The concentration for aggregation onset was determined by using pyrene as a fluorescent probe or light dispersion for compounds with tryptophan. Dynamic light scattering (DLS) studies and transmission electron microscopy (TEM) reveal that the vesicles have diameters ranging from 140 to 500 nm and show the capability of loading hydrophobic cargos, such as Nile red, and their liberation in reductive environments. Furthermore, the bolaamphiphiles are only fully protonated and prone to vesicle formation at acidic pH, making them a promising alternative for gastrointestinal delivery.

Clinical Outcomes of Transcatheter Arterial Embolization for Secondary Stiff Shoulder.

PURPOSE: To assess the clinical outcomes of transcatheter arterial embolization (TAE) for secondary stiff shoulder (SSS). MATERIALS AND METHODS: This is a retrospective analysis of prospectively collected data performed between January 2017 and December 2019. This study comprised 25 patients (20 women and 5 men; median age, 49 years; range 27-59) with SSS resistant to conservative management during at least 3 months. The median time of stiffness was 12 months. The etiology of SSS was postoperative in 14 patients (56%) and posttraumatic in the remaining 11 patients (44%). Periods of immobilization in all patients were associated. TAE was performed, and technical aspects, adverse events, changes for pain, and physical examination before and 6 months after TAE were assessed. RESULTS: Abnormal vessels were observed in 20 of 25 (80%) of the procedures. Transitory cutaneous erythema was noted in 4 patients treated after TAE. Significant differences were observed in the median pain visual analog scale reduction between before and 6 months after TAE (8 vs 2, P < .001). Shoulder mobility significantly improved in both flexion and abduction degrees between before and at 6 months after TAE in (70° vs 150°; P < .001). No symptoms of recurrence appeared. CONCLUSIONS: TAE can result in pain reduction and mobility improvement in patients with SSS refractory to conservative therapy.

Economic evaluation of workplace health promotion interventions focused on Lifestyle: Systematic review and meta-analysis.

AIM: To identify and evaluate randomized clinical trials focusing on economic evaluation of workplace health promotion (WHP) interventions based on healthy lifestyles, physical activity and nutrition. DESIGN: A systematic review and meta-analysis was carried out between March and May 2019, following the PRISMA statement. DATA SOURCES: The literature search was conducted on Cochrane Library, Scopus, WOS and Medline databases. REVIEW METHODS: The quality appraisal included the overall risk of bias (Cochrane Collaboration tool), the quality of the evidence (GRADEpro) and the quality of the health economic analysis (QHES instrument). RESULTS: Of the 15 studies selected, 3 were interventions based on nutrition, 11 were focused on lifestyle and only one on physical activity. Given the heterogeneity of included studies, it was decided to do a subgroup analysis. For the weight loss (n = 5 studies), a general increase of 0.56 Kg (95% CI = 0.76, 0.84) I2  = 99.41%, and for the Quality-adjusted Life Years achieved (n = 5 studies) a very small increase of 0.003 (95% CI = 0.002, 0.004) I2  = 99.25%, were observed. CONCLUSIONS: The implementation of lifestyle interventions in the workplace has proven to be cost-effective for both employers and society. IMPACT: What problem did the study address? There are few studies aimed at evaluating the efficiency of WHP interventions. However, those that identify and assessing interventions related to lifestyle are particularly scarce, despite the evidence showing that these researchers improve the quality of care of occupational health. What were the main findings? This systematic review demonstrates the effectiveness of the WHP interventions, and in some cases, the efficiency of these interventions for both employers and society. Additional research in this area is necessary as well as the assessment of the cost-effectiveness of such interventions. Where and on whom will the research have an impact? To know the cost-benefit of different WHP interventions allows more efficient management of resources, which helps to make political and business decisions, becoming healthier and safer workplaces.

High prevalence and autochtonous transmission of human pegivirus (HPgV-1) in blood donors in the extreme southern of Brazil.

Recent studies have suggested that human pegivirus 1 (HPgV-1) may have some pathogenic potential. In the southernmost region of Brazil, studies on HPgV-1 are scarce, and circulating genotypes have not yet been identified. The current study aimed to evaluate the prevalence of HPgV-1 among blood donors from the southernmost region of Brazil and identify the genotypes involved with associated factors. A cross-sectional study was conducted with 281 blood donors, who had their plasma subjected to RNA extraction, complementary DNA synthesis, HPgV-1 detection by nested polymerase chain reaction, and subsequent genotyping. The observed prevalence of HPgV-1-RNA was 21.7%. The only variable that was significantly associated with virus infection was the relationship status of the donor. Single or no fixed partner blood donors were twice as likely to have HPgV-1 (95% CI, 1.12 to 4.56; P = 0.02). Genotype 2-subtypes 2b (69%) and 2a (29%)-was the most prevalent. In the absence of risk factors for parenteral transmission, it is likely that sexual transmission was the route of infection in the individuals studied. Further work will be needed to determine whether this virus is inert in the population, or if there are potential deleterious effects in infected individuals.

Body frame size, body image, self-esteem, and health-related quality of life in schoolchildren.

OBJECTIVE: The aim of this study was to explore the relationship between body frame size (BFS) and body image, self-esteem, and health-related quality of life (HRQL) in Mexican schoolchildren. METHODS: This cross-sectional study included children aged 6 to 11 years. Body image, self-esteem, and HRQL were evaluated through interviews. Two frame-size measures, biacromial and bitrochanteric diameters, were collected and summed for categorizing BFS as small, medium, or large. Height and weight were also measured. Spearman's correlations were determined and adjusted by sex, age, and body mass index (BMI). Multiple logistic regression analyses were performed with the psychological measure as the binary dependent variable, the categories of BFS as the independent variable, and sex, age, and BMI as control variables. RESULTS: The correlation between BFS and body image was 0.15 (P < .01) and after BMI adjustment was 0.07 (P > .05). BFS did not correlate with self-esteem nor HRQL (P > .05). Of the children, 79% were dissatisfied with their body image, 20% had a low self-esteem, and 31.8% had a poorly perceived HRQL; there were no differences by BFS. The multivariate analysis showed that a large BFS was not associated with body image dissatisfaction (OR 1.2, 95% CI 0.6-2.3), low self-esteem (OR 1.3, 95% CI 0.7-2.6), or poor HRQL (OR 1.3, 95% CI 0.8-2.2). CONCLUSIONS: BFS was not correlated with body image, self-esteem, or HRQL. A high self-esteem and a good level of HRQL prevailed, but a high proportion of children were dissatisfied with their body image. School interventions should promote an appropriate body image and a healthy lifestyle.

Melodic intonation therapy in post-stroke nonfluent aphasia: a randomized pilot trial.

OBJECTIVE:: To collect data to estimate the sample size of a definitive randomized controlled trial to evaluate the effects of Melodic Intonation Therapy in post-stroke nonfluent aphasia. DESIGN:: A randomized, crossover, interventional pilot trial. SETTING:: Departments of Neurology and Rehabilitation from a university general hospital. PARTICIPANTS:: Stroke survivors with post-stroke nonfluent aphasia. INTERVENTIONS:: Patients randomized to group 1 had treatment with Melodic Intonation Therapy first (12 sessions over six weeks) followed by no treatment; the patients in group 2 started active treatment between three and six months after their inclusion in the study, serving as waiting list controls for the first phase. MAIN MEASURES:: The Communicative Activity Log (CAL) questionnaire and the Boston Diagnostic Aphasia Examination (BDAE) were evaluated at baseline, and at six and 12 weeks. RESULTS:: Twenty patients were included. Four of the patients allocated to group 2 crossed over to group 1, receiving the treatment at first. Intention-to-treat analysis: after adjustment for baseline scores, the mean difference in the CAL evaluation from baseline in the treated group was 8.5 points (95% confidence interval (CI), 0.11-17.0; P = .043), with no significant change in any of the BDAE sections. Per-protocol analysis showed similar results with a clear treatment effect ( P = .043) on the CAL. CONCLUSION:: Melodic Intonation Therapy might have a positive effect on the communication skills of stroke survivors with nonfluent aphasia as measured by the CAL questionnaire. A full-scale trial with at least 27 patients per group is necessary to confirm these results.

Body frame size in school children is related to the amount of adipose tissue in different depots but not to adipose distribution.

OBJECTIVES: The main aim of this study was to test the hypothesis that body frame size is related to the amount of fat in different adipose tissue depots and to fat distribution in schoolchildren. METHODS: Children aged between 5 and 10 years were included in this cross-sectional study (n = 565). Body frame size, adiposity markers (anthropometric, skinfolds thickness, and ultrasound measures), and fat distribution indices were analyzed. Correlation coefficients adjusted by reliability were estimated and analyzed by sex; the significance of the difference between two correlation coefficients was assessed using the Fisher z-transformation. RESULTS: The sample included primarily urban children; 58.6% were normal weight, 16.1% overweight, 19.6% obese, and the rest were underweight. Markers of subcutaneous adiposity, fat mass and fat-free mass, and preperitoneal adiposity showed higher and significant correlations with the sum of the biacromial + bitrochanteric diameter than with the elbow diameter, regardless of sex. The fat distribution conicity index presented significant but weak correlations; and visceral adipose tissue, hepatic steatosis, and the waist-for-hip ratio were not significantly correlated with body frame size measures. CONCLUSIONS: Body frame size in school children was related to the amount of adipose tissue in different depots, but not adipose distribution. More studies are needed to confirm this relationship and its importance to predict changes in visceral fat deposition during growth.

Prevalence of human pegivirus (HPgV) infection in patients carrying HIV-1C or non-C in southern Brazil.

Previous studies have demonstrated that coinfection with HPgV is a protective factor for human immunodeficiency virus (HIV)-infected patients, leading to slower disease progression, and longer survival after established disease. The present study sought to estimate the prevalence of HPgV infection and associated risk factors in patients harboring C or non-C HIV-1 subtypes followed-up at HU-FURG, southern Brazil. Samples from 347 HIV-1-infected subjects were subjected to plasma RNA extraction, cDNA synthesis, HPgV RNA detection, and HIV-1 genotyping. The overall prevalence of HPgV RNA was 34%. Individuals aged 18-30 years had higher chances of infection compared with those 50 years or older (95%CI 1.18-52.36, P = 0.03). The number of sexual partner between one and three was a risk factor for HPgV infection (95%CI 1.54-10.23; P < 0.01), as well as the time since diagnosis of HIV-1 ≥ 11 years (95%CI 1.01-2.89; P = 0.04). Patients infected with HIV non-C subtypes had six times more chance of being HPgV-infected when compared to subtype C-infected subjects (95%CI 2.28-14.78; P < 0.01). This was the first study conducted in southern Brazil to find the circulation of HPgV. HIV/HPgV coinfection was associated with a longer survival among HIV+ patients. Of novelty, individuals infected by HIV non-C subtypes were more susceptible to HPgV infection. However, additional studies are needed to correlate the HIV-1 subtypes with HPgV infection and to clarify cellular and molecular pathways through which such associations are ruled. J. Med. Virol 88:2106-2114, 2016. © 2016 Wiley Periodicals, Inc.

Fluorescence Microscopy as a Diagnostic Tool for Dermatophytosis.

Dermatophytosis is a superficial fungal infection of keratinized tissues. Dermatophytes can cause discomfort but are not usually life threatening. However, the infection can spread and may lead to systemic fungal infections in immunocompromised patients. Currently available diagnostic methods include potassium hydroxide (KOH) testing and periodic acid-Schiff (PAS) staining. However, most diagnostic techniques cannot be performed rapidly; days to weeks may be required for conclusive results. Certain dermatophytes autofluoresce and can be observed under fluorescence microscopy. The authors examined a series of 24 cases of hematoxylin and eosin-stained dermatophytoses using fluorescence microscopy and compared the results with those obtained using PAS staining. The diagnostic performance of fluorescence microscopy was better than that of PAS staining. Fluorescence microscopy allowed the detection of all the cases that were detected using PAS staining. In addition, fluorescence microscopy facilitated the detection of weak fluorescence in 2 cases with ambiguous PAS results. These results support the integration into clinical practice of fluorescence microscopy as a simple and rapid diagnostic tool for evaluating cases of suspected dermatophytosis.

Hepatotoxicity induced by acute and chronic paracetamol overdose in adults. Where do we stand?

Paracetamol (Acetaminophen) poisoning data can reveal the potential deficiencies of paracetamol poisoning management guidelines. We conducted a retrospective cohort study of patients >18years who were attended in the emergency department (ED) of a Spanish tertiary hospital, from 2005 to 2010 for suspected paracetamol overdose and who had measurable paracetamol concentrations. 208 patients suspected of paracetamol poisoning were identified. The annual incidence in the ED increased from 2.0 (95%-CI: 0.2-7.2) cases per 10,000 patients in 2005 to 3.4 (95%-CI: 1.1-8.8) in 2010. Only 7 of 98 patients (7.14%) with acute poisoning at toxic doses showed hepatotoxicity signs, 4 (57.1%) of whom presented acute liver failure (ALF) criteria, while 8 of 10 patients (80%) with chronic paracetamol poisoning at toxic doses presented hepatotoxicity and 3 (37.5%) with ALF criteria. The time required to find medical care was 9.0h for acute poisoning and 49.6h for chronic poisoning (p<0.001). We conclude that the incidence of suspected cases of paracetamol poisoning at our hospital is increasing. The majority of toxicity cases, including ALF, associated with the ingestion of paracetamol were due to chronic poisoning. This finding constitutes an important warning regarding paracetamol chronic poisoning, and clinicians should have a higher index of clinical suspicion for this entity.

Occipital cortex activation by long-term repetitive tactile stimulation is necessary for object recognition in blinds: a case report.

Tactile vision has been approached from a variety of angles using different techniques. So far, a certain kind of object (and text) recognition has been shown, though seeing as such has not been achieved yet, and it remains unclear. Trough repetitive passive tactile stimulation perceptual processing is transferred from temporo-parietal to occipital areas, which affects object recognition. We report the results of passive tactile stimulation, as well as rTMS, applied to a 50 year old left handed blind male with over 97% loss of vision, who suffers from Peter's anomaly and microphthalmia. After 15 weeks of passive tactile stimulation, the subject showed increased activity in occipital areas associated with the development of visual-like perception which remained unchanged after three months without passive tactile stimulation. Inhibitory rTMS over the visual cortex led to noticeable reduction of spatial recognition performance and visual sensations in this subject. Stable changes in occipital cortical activity can be associated with subjective sensations of seeing. Once occipital activation has been achieved, it is necessary for spatial object recognition. Both facts highlight the implication of occipital areas in tactile vision and the cortical plasticity of passive tactile long-term stimulation in people with blindness.

Less underestimaton of excess weight by the categorical than the visual method. Its determinants and feeding practices in Mexican mothers of children aged 2 to 12 years.

Introduction: Introduction: perceived body weight refers to the subjectively assessed weight, which may not correspond to the objectively measured weight. Statistics show that 14 % to 83 % of parents misperceive their children's weight status, with a propensity for underestimation. Objective: we compared the accuracy of the visual versus the categorical method. We also identified factors and feeding practices associated with excess weight underestimation. Material and methods: we carried out a cross-sectional study in five states of Mexico with 1,845 mother-child dyads of children aged 2-12 years. The mothers were interviewed about weight perception with two methods, visual and categorical. The Child Feeding Questionnaire identified maternal feeding practices. Actual weight and height were categorized according to WHO criteria. Analysis consisted of Cohen's kappa estimation, multivariate logistic regression, and Mann-Whitney tests. Results: more mothers correctly identified the weight of their children with the categorical than with the visual method (68 % vs 42 %, p < 0.0001). The excess weight underestimation was lower (49 % vs 82 %, p < 0.0001) and the degree of agreement was higher with the categorical method (kappa, 0.39 and 0.08). The better results remained regardless of age. Age 2-5 years increased the odds of overweight/obesity underestimation. Feeding practices differed by weight perception category, child's age, and method of assessment. Conclusions: the categorical method was more accurate. Recognition of correct weight perception is one of the first actions required for controlling childhood overweight/obesity.

Introducción: Introducción: la percepción del peso corporal se refiere al peso evaluado subjetivamente, que puede no corresponder al peso medido objetivamente. Las estadísticas muestran que entre el 14 % y el 83 % de los padres tienen una percepción inadecuada del estado del peso de sus hijos, predominando la subestimación. Objetivo: comparar la precisión del método categórico y la del visual e identificar los factores y prácticas de alimentación asociados a la subestimación del exceso de peso. Material y métodos: se realizó un estudio transversal en cinco estados de México con 1,845 díadas madre-hijo de niños de 2-11 años. Las madres fueron entrevistadas sobre su percepción del peso con un método visual y uno categórico. El Cuestionario de Alimentación Infantil identificó las prácticas de alimentación. El peso y la altura se clasificaron con los criterios de la OMS. Se estimó la kappa de Cohen y se utilizaron la regresión logística multivariada y las pruebas de Mann-Whitney. Resultados: más madres identificaron correctamente el peso de sus hijos con el método categórico que con el visual (68 % vs. 42 %, p < 0,0001). La subestimación del exceso de peso fue menor (49 % vs 82 %, p <0,0001) y el grado de concordancia mayor con el método categórico (kappa: 0,39 y 0,08). Los resultados se mantuvieron independientemente de la edad. La edad de 2-5 años aumentó la probabilidad de subestimar el sobrepeso/obesidad. Las prácticas de alimentación difirieron por categoría de percepción del peso, edad del niño y método de evaluación. Conclusiones: el método categórico fue más preciso. El reconocimiento de la correcta percepción del peso constituye una de las primeras acciones para el control del sobrepeso/obesidad infantil.

Heavy metal concentrations in sharks, rays and chimaeras from the western Mediterranean Sea.

The potential bioaccumulation of pollutants, such as heavy metals, may pose a threat to the western Mediterranean chondrichthyans and human consumers. Therefore, the first extensive assessment of cadmium (Cd), lead (Pb), and copper (Cu) concentrations in the muscle tissue of 17 species of sharks, rays, and chimaeras in this region was conducted via Microwave Assisted Extraction (MAE) and Graphite Furnace Atomic Absorption Spectrometry (GFAAS). Significant differences between species were observed, particularly related to the rabbit fish (Chimaera monstrosa) and the velvet belly lantern shark (Etmopterus spinax), which exceeded the European Union (EU) Commission Regulation 2023/915 threshold of Cd. Overall, heavy metal concentrations correlated negatively with size and trophic level but positively with depth. Although the consumption of these species may entail minimal risk to adult humans, caution is advised, especially for children. These findings are important due to the widespread consumption of chondrichthyans in many western Mediterranean regions.

pH-Induced conversion of bolaamphiphilic vesicles to reduction-responsive nanogels for enhanced Nile Red and Rose Bengal delivery.

This study details the preparation and investigation of molecular nanogels formed by the self-assembly of bolaamphiphilic dipeptide derivatives containing a reduction-sensitive disulfide unit. The described bolaamphiphiles, featuring amino acid terminal groups, generate cationic vesicles at pH 4, which evolve into gel-like nanoparticles at pH 7. The critical aggregation concentration has been determined, and the nanogels' size and morphology have been characterized through Dynamic Light Scattering (DLS) and Transmission Electron Microscopy (TEM). Circular Dichroism (CD) spectroscopy reveals substantial molecular reconfigurations accompanying the pH shift. These nanogels enhance the in vitro cellular uptake of the lipophilic dye Nile Red and the ionic photosensitizer Rose Bengal into Human colon adenocarcinoma (HT-29) cells, eliminating the need for organic co-solvents in the former case. Fluorescence measurements with Nile Red as a probe indicate the reduction-sensitive disassembly of the nanogels. In photodynamic therapy (PDT) applications, Rose Bengal-loaded nanogels demonstrate notable improvements, with flow cytometry analysis evidencing increased apoptotic activity in the study with HT-29 cells.

Comparison between suture and fibrin glue on repair by direct coaptation or tubulization of injured mouse sciatic nerve.

PURPOSE: The aim of this study was to evaluate and compare the effectiveness of classical suture and sutureless repair with fibrin glue, by using or not a resorbable collagen tube, after sciatic nerve transection. MATERIAL AND METHODS: Twenty-five mice were used in this study, divided in five groups. They were submitted to sciatic nerve transection and immediate repair of the nerve stumps by either direct suture or fibrin glue adhesion or by the tubulization technique in which the nerves stumps were sutured or glued to a collagen tube (experimental groups). A control group was designed as the best regeneration condition, by using a crush lesion (control group). After eight weeks, the regenerated nerves were processed for light and electron microscopy. Motor function analysis was performed using the sciatic functional index. RESULTS: Quantitative analysis of regenerated nerves between experimental groups showed that those repaired by direct contact of the stumps with fibrin glue showed significant increase in the myelin and fiber areas. The tubulization groups, repaired by suture or fibrin glue, provided similar results. G-ratio analysis revealed that the regenerating axons of all experimental groups presented values equivalent to control (crushing group). CONCLUSIONS: These results suggest that the use of fibrin glue in nerve repair by either direct coaptation or tubulization is an alternative to conventional suture repair, particularly in case of small-size-nerve reconstruction.

Implementation of a perioperative care App in elective thoracic surgery.

INTRODUCTION: The design and implementation inconsistency of perioperative care programs limits their universalization, and it is where e-Health can standardize these processes. The objective of the study is to create a Smartphone App with a perioperative care program, implement it in a group of patients scheduled for a thoracic surgical procedure, and evaluates its use. METHODS: A prospective and descriptive study. We created a Smartphone app (Fissios App) which contains 40 perioperative recommendations and 10 chest physical exercises. Patients were recommended to use it before and after surgery; to measure its use, we created and applied a questionnaire. A descriptive analysis of patient variables and questionnaire responses was performed and their association evaluated. RESULTS: One hundred four patients were included, 60.3% were men with a median age of 62 years (51-71), and 26.72% had completed high school. The 89.3% of patients highlighted the ease of downloading and setting up the app. More than 90% of patients positively assessed clarity in explaining chest physical exercises and perioperative recommendations. One hundred four (79.4%) patients highlighted the contribution of the use of the app during the preoperative period to face the postoperative period. CONCLUSIONS: We created a Smartphone app (Fissios App) with a perioperative care program and it was successfully implemented regardless of the age or educational level of patients. The tool clearly explains the information contained and the patients reported that its use before surgery helped them to face the postoperative period, with an appropriate level of physical demand and time of use.

The Effect of the Varietal Type, Ripening Stage, and Growing Conditions on the Content and Profile of Sugars and Capsaicinoids in Capsicum Peppers.

Peppers (Capsicum sp.) are used both as vegetables and/or spice and their fruits are used in a plethora of recipes, contributing to their flavor and aroma. Among flavor-related traits, pungency (capsaicinoids) and lately volatiles have been considered the most important factors. However, the knowledge of sugars is low, probably due to the fact peppers were historically considered tasteless. Here, using HPLC, we studied the content and profile of major sugars and capsaicinoids in a comprehensive collection of varietal types (genotype, G), grown under different growing systems (environment, E) in two years (Y) and considered the two main ripening stages (R). We found a major contribution to the ripening stage and the genotype in total and individual sugars and capsaicinoids. The year was also significant in most cases, as well as the G × E and G × Y interactions, while the growing system was low or nil. Ripening increased considerably in sugars (from 19.6 to 36.1 g kg-1 on average) and capsaicinoids (from 97 to 142 mg kg-1 on average), with remarkable differences among varieties. Moreover, sugars in fully ripe fruits ranged between 7.5 and 38.5 g kg-1 in glucose and between 5.2 and 34.3 g kg-1 in fructose, and several accessions reached total sugars between 40 and 70 g kg-1, similar to tomatoes. The results reveal the importance of the genotype and the ripening for these traits, particularly sugars, which should be considered key for the improvement of taste and flavor in peppers.

Evaluation of Risk and Preventive Factors for Necrotizing Enterocolitis in Premature Newborns. A Systematic Review of the Literature.

Necrotizing enterocolitis (NEC) is a serious condition related to prematurity and the initiation of enteral feeding. In this article, we review the evidence published in recent years on necrotizing enterocolitis risk factors (prematurity, feeding with low-weight formula, existence of intestinal dysbiosis) and protective factors (human milk or donated milk supply, supplementation of human milk with oligosaccharides, probiotics administration, and the determination of disease predictive biomarkers). A systematic review was conducted of preventive, risk and predictive factors for necrotizing enterocolitis in neonates prior to 37 weeks' gestational age, based on a literature search for clinical trials, meta-analyses, randomized controlled trials and systematic reviews published between January 2018 and October 2021. For this purpose, the PubMed, MEDLINE, and Cochrane Library databases were consulted. The literature search obtained 113 articles, of which 19 were selected for further analysis after applying the inclusion and exclusion criteria. The conclusions drawn from this analysis were that adequate knowledge of risk factors that can be prevented or modified (such as alteration of the intestinal microbiota, oxidative stress, metabolic dysfunction at birth, or alteration of the immunity modulation) can reduce the incidence of NEC in premature infants. These factors include the supplementation of enteral nutrition with human milk oligosaccharides (with prebiotic and immunomodulatory effects), the combined administration of probiotics (especially the Lactobacillus spp and Bifidobacterium spp combination, which inhibits bacterial adhesion effects, improves the intestinal mucosa barrier function, strengthens the innate and adaptive immune system and increases the secretion of bioactive metabolites), the supplementation of human milk with lactoferrin and the use of donated milk fortified in accordance with the characteristics of the premature newborn. The determination of factors that can predict the existence of NEC, such as fecal calprotectin, increased TLR4 activity, and IL6 receptor, can lead to an early diagnosis of NEC. Although further studies should be conducted to determine the values of predictive biomarkers of NEC, and/or the recommended doses and strains of probiotics, lactoferrin or oligosaccharides, the knowledge acquired in recent years is encouraging.

Identification based on morphological and molecular characters of Phassus huebneri (Geyer) (Lepidoptera: Hepialidae), a ghost moth feeding on blackberry in Michoacán, Mexico: its biology and parasitoids.

Larvae of an unidentified Lepidopteran hepialid were found boring stems and crown roots of blackberry (Rubus sp.) in Michoacán, Mexico. In this study, the morphological and molecular identification of larvae and adults of this insect was performed. Preliminary aspects of biology, including information on parasitoids associated to larval stage, are also recorded. A total of 109 larvae of various instars were collected and three were reared to adult. The two females and one male were identified as Phassus huebneri (Geyer) (Lepidoptera: Hepialidae) following morphological characters. This identification was corroborated by comparing the cytochrome oxidase I (COI) barcode of two field-collected larvae (IIAFL1 and IIAFL2) with sequences of Phassus spp. obtained from GenBank. A Neighbor-Joining similarity analysis yielded a phenogram with two subclades. The first subclade grouped the IIAFL1 and IIAFL2 sequences with two other Mexican sequences categorized as P. huebneri, whereas in the second subclade other species belonging to the genus Phassus from Guatemala and Costa Rica were grouped together. Larval development of nine instars took about 14 months. Larvae reached a maximum length of 10 cm. The pupal stage lasted 39-41 days. Each of the two females laid over 1,000 unfertilized eggs within a period of 48 h. Larvae were parasitized by Dinera grisescens Fallen (Diptera: Tachinidae) and another unidentified Dinera sp. This study provides additional evidences on the distribution pattern of P. huebneri in western Mexico and presents the first record of this species feeding on one of the most economically important crops in Mexico.

Acquisition of Learning and Empathy Towards Patients in Nursing Students Through Online Escape Room: An Exploratory Qualitative Study.

BACKGROUND: Currently, there are still prejudices and negative beliefs towards people with severe mental disorder. The stigma of healthcare professionals can affect both recovery time and patients' own self-stigma. In universities, it is necessary to reduce these prejudices through training on mental health. PURPOSE: The purpose of this research has been to assess the use of educational escape rooms as a learning and awareness strategy on stigmatizing attitudes towards people with serious mental disorders in university students. METHODS: An online escape room has been designed whose narrative shows the daily life of a person with a serious mental illness. An exploratory qualitative study has been carried out to explore the perception of 44 university students from two Andalusian universities about this escape room. RESULTS: The results of the study show that most of the interviewed students consider that the educational escape room has been a fun and motivating learning strategy, which has allowed them to learn cooperatively and empathize with the protagonist with a mental disorder. CONCLUSION: Online escape rooms can be a useful strategy for teaching health sciences students. Considering it a fun activity, students are more participatory and engaged to the curricular content, in our case, stigmatizing attitudes towards people with serious mental disorders.