Associations between early introduction to complementary foods, subsequent cereal-added bottle feeding and daily macronutrient intake among infants.

Introducing complementary foods early during infancy has been associated with an increased risk of overweight later in life, but the pathway is an understudied topic. Hence the study was conducted with low-income and primarily minority mother-infant dyads to: 1) understand how the introduction of complementary foods prior to 4 months was associated with socio-demographic characteristics and food security status; 2) determine the association between early introduction to complementary foods and breastfeeding and adding cereal into the bottle in later infancy (i.e., at 6 and 9 months), and; 3) examine how adding infant cereal into the bottle was related to daily calorie and macronutrient intake in infancy. We conducted interviews with mothers (n = 201) at 4 months of age and 24-h feeding recalls at age 6 and 9 months. Results indicated that 29% of the infants were fed complementary foods before 4 months of age. Introducing complementary foods early was negatively associated with breastfeeding and positively associated with adding cereal into the bottle at 6-months. This practice was more common among those who experienced marginal to very low levels of food security. Comparing by race/ethnicity, Latinx mothers were significantly less likely to introduce solids early. After controlling for sex, infants fed cereal in the bottle were consuming significantly more calories compared to their counterparts. Specifically, adding cereal into the bottle resulted in approximately 10% additional daily calorie intake among infants. Understanding how these feeding practices affect appetite development and weight status during infancy is warranted.

Breastfeeding: How is it related to food insecurity and other factors among low-income mothers?

A cross-sectional study was conducted to (1) examine breastfeeding initiation and continuation rates, and; (2) investigate association between food insecurity and breastfeeding status, among low-income mothers. Mothers of infants two-months or younger were recruited from a local pediatric clinic serving primarily low-income families. Upon giving consent, mothers were interviewed in-person or over the phone in either English or Spanish. Of the total 92 mothers interviewed, 90% initiated breastfeeding, but only 24% were doing exclusive breastfeeding at 2 months of infant's age. After controlling for socio-demographics, it was found that food-insecure mothers were less likely to continue with breastfeeding (ß = -1.51, p = .024). Future research is warranted to understand pathways through which food insecurity affects breastfeeding and how this disparity can be prevented to ensure a safe and secure start for infants worldwide.

Co-circulation and simultaneous co-infection of dengue, chikungunya, and zika viruses in patients with febrile syndrome at the Colombian-Venezuelan border.

BACKGROUND: In Colombia, the dengue virus (DENV) has been endemic for decades, and with the recent entry of the chikungunya virus (CHIKV) (2014) and the Zika virus (ZIKV) (2015), health systems are overloaded because the diagnosis of these three diseases is based on clinical symptoms, and the three diseases share a symptomatology of febrile syndrome. Thus, the objective of this study was to use molecular methods to identify their co-circulation as well as the prevalence of co-infections, in a cohort of patients at the Colombian-Venezuelan border. METHODS: A total of 157 serum samples from patients with febrile syndrome consistent with DENV were collected after informed consent and processed for the identification of DENV (conventional PCR and real-time PCR), CHIKV (conventional PCR), and ZIKV (real-time PCR). DENV-positive samples were serotyped, and some of those positive for DENV and CHIKV were sequenced. RESULTS: Eighty-two patients were positive for one or more viruses: 33 (21.02%) for DENV, 47 (29.94%) for CHIKV, and 29 (18.47%) for ZIKV. The mean age range of the infected population was statistically higher in the patients infected with ZIKV (29.72 years) than in those infected with DENV or CHIKV (21.09 years). Both co-circulation and co-infection of these three viruses was found. The prevalence of DENV/CHIKV, DENV/ZIKV, and CHIKV/ZIKV co-infection was 7.64%, 6.37%, and 5.10%, with attack rates of 14.90, 12.42, and 9.93 cases per 100,000 inhabitants, respectively. Furthermore, three patients were found to be co-infected with all three viruses (prevalence of 1.91%), with an attack rate of 4.96 cases per 100,000 inhabitants. CONCLUSION: Our results demonstrate the simultaneous co-circulation of DENV, CHIKV, ZIKV and their co-infections at the Colombian-Venezuelan border. Moreover, it is necessary to improve the differential diagnosis in patients with acute febrile syndrome and to study the possible consequences of this epidemiological overview of the clinical outcomes of these diseases in endemic regions.

Implementation of Virtual Sensors for Monitoring Temperature in Greenhouses Using CFD and Control.

Virtual sensing is crucial in order to provide feasible and economical alternatives when physical measuring instruments are not available. Developing model-based virtual sensors to calculate real-time information at each targeted location is a complex endeavor in terms of sensing technology. This paper proposes a new approach for model-based virtual sensor development using computational fluid dynamics (CFD) and control. Its main objective is to develop a three-dimensional (3D) real-time simulator using virtual sensors to monitor the temperature in a greenhouse. To conduct this study, a small-scale greenhouse was designed, modeled, and fabricated. The controller was based on the convection heat transfer equation under specific assumptions and conditions. To determine the temperature distribution in the greenhouse, a CFD analysis was conducted. Only one well-calibrated and controlled physical sensor (temperature reference) was enough for the CFD analysis. After processing the result that was obtained from the real sensor output, each virtual sensor had learned the associative transfer function that estimated the output from given input data, resulting in a 3D real-time simulator. This study has demonstrated, for the first time, that CFD analysis and a control strategy can be combined to obtain system models for monitoring the temperature in greenhouses. These findings suggest that, generally, virtual sensing can be applied in large greenhouses for monitoring the temperature using a 3D real-time simulator.

Phylogenetic and evolutionary analysis of dengue virus serotypes circulating at the Colombian-Venezuelan border during 2015-2016 and 2018-2019.

Dengue is an endemic disease in Colombia. Norte de Santander is a region on the border of Colombia and Venezuela and has reported the co-circulation and simultaneous co-infection of different serotypes of the dengue virus (DENV). This study aimed to conduct a phylogenetic analysis on the origin and genetic diversity of DENV strains circulating in this bordering region. Serum samples were collected from patients who were clinically diagnosed with febrile syndrome associated with dengue during two periods. These samples were tested for DENV and serotyping was performed using reverse transcriptase-polymerase chain reaction. Subsequently, positive samples were amplified and the envelope protein gene of DENV was sequenced. Phylogenetic and phylogeographic analyses were performed using the sequences obtained. Basic local alignment search tool analysis confirmed that six and eight sequences belonged to DENV-1 and DENV-2, respectively. The phylogenetic analysis of DENV-1 showed that the sequences belonged to genotype V and clade I; they formed two groups: in the first group, two sequences showed a close phylogenetic relationship with strains from Ecuador and Panama, whereas the other four sequences were grouped with strains from Venezuela and Colombia. In the case of DENV-2, the analysis revealed that the sequences belonged to the Asian-American genotype and clade III. Furthermore, they formed two groups; in the first group, three sequences were grouped with strains from Colombia and Venezuela, whereas the other five were grouped with strains from Venezuela, Colombia and Honduras. This phylogenetic analysis suggests that the geographical proximity between Colombia and Venezuela is favourable for the export and import of different strains among serotypes or clades of the same DENV serotype, which could favour the spread of new outbreaks caused by new strains or genetic variants of this arbovirus. Therefore, this information highlights the importance of monitoring the transmission of DENV at border regions.

sICAM-1 intrathecal synthesis and release during the acute phase in children suffering from Coxsackie A9 and S. pneumoniae meningoencephalitis.

The intercellular adhesion molecule is a transmembrane glycoprotein belonging to the immunoglobulin superfamily. Serum and cerebrospinal fluid (CSF) soluble intercellular adhesion molecule 1 (sICAM-1) from normal control children as well as from children with Guillain-Barré syndrome (GBS), with Coxsackie A9 virus meningoencephalitis and with Streptococcus pneumoniae meningoencephalitis were studied. sICAM-1 was quantified using an immunoenzimatic assay and albumin using the immunodiffusion technique in both biological fluids. Increased sICAM-1 values in CSF in patients with GBS correspond to an increase of the albumin CSF/serum quotient. In contrast, in inflammatory diseases like S. pneumoniae and Coxsackie A9 virus meningoencephalitis an increased brain-derived fraction was observed. In particular cases these values are 60-65% and 70-75% respectively. The results indicate an additional synthesis of sICAM-1 in subarachnoidal space during central nervous system (CNS) inflammatory process. An important role of sICAM-1 in the transmigration of different cell types into CSF during CNS inflammation in children with S. pneumoniae and Coxsackie A9 meningoencephalitis may be suggested.

C3c intrathecal synthesis evaluation in patients with multiple sclerosis.

INTRODUCTION: Multiple sclerosis (MS) is a chronic, inflammatory and progressive disease of the central nervous system in which local inflammatory injuries of the brain white matter appears, being the most outstanding feature the myeline loss (demyelination). OBJECTIVE: To determine if the complement system might be involved in the MS immunopathogeny favouring the mechanism intervening in the myelin destruction. METHOD: Samples of sera and CSF from twelve patients with a diagnosis of MS obtained at the moment of the admission to the hospital at the beginning of the break out, were collected. Levels of C3c and albumin in sera and in CSF were quantified using radial immunodiffusion plates. RESULTS: High values over 80% of intrathecal synthesis were obtained except in one of the patients. CONCLUSION: Intrathecal synthesis of C3c and its liberation to the CSF means that the activation of the complement system in any of the two ways has taken place, and that once performed its biological functions, has suffered a degradation process.

Seasonal distribution and evolving forms of multiple sclerosis patients diagnosed from April 2004 to November 2007.

BACKGROUND: Multiple sclerosis (MS) was first reported in Cuba in 1965. The most frequent appearance is observed in the first six months of the year. OBJECTIVE: To determine the seasonal distribution and evolving forms of MS patients diagnosed with the disease between April 2004 and November 2007. METHOD: Twenty-one patients with suspected MS and 42 outbreaks were studied. Patients were classified according to Lublin and Revingold's criteria for clinical forms and according to McDonald. RESULTS: Most patients were classified in outbreak and remission and only two patients classified as primary-progressive multiple sclerosis. The higher number of outbreaks occurred in the first two quarters of the year. CONCLUSION: It is recommended to study further weather variables that may be related to the emergence of these outbreaks in our environment.

Seasonal distribution and evolving forms of multiple sclerosis patients diagnosed from April 2004 to November 2007 / Distribución estacional y formas evolutivas de esclerosis múltiple en pacientes diagnosticados entre Abril del 2004 y Noviembre del 2007

BACKGROUND: Multiple sclerosis (MS) was first reported in Cuba in 1965. The most frequent appearance is observed in the first six months of the year. OBJECTIVE: To determine the seasonal distribution and evolving forms of MS patients diagnosed with the disease between April 2004 and November 2007. METHOD: Twenty-one patients with suspected MS and 42 outbreaks were studied. Patients were classified according to Lublin and Revingold's criteria for clinical forms and according to McDonald. RESULTS: Most patients were classified in outbreak and remission and only two patients classified as primary-progressive multiple sclerosis. The higher number of outbreaks occurred in the first two quarters of the year. CONCLUSION: It is recommended to study further weather variables that may be related to the emergence of these outbreaks in our environment.

INTRODUCCIÓN: La esclerosis múltiple (EM) fue reportada en Cuba por primera vez en 1965. Se ha venido observando la aparición más frecuente en los primeros seis meses del año. OBJETIVO: Determinar la distribución estacional y formas evolutivas de EM en pacientes con diagnóstico de esta enfermedad entre abril 2004 y noviembre 2007. MÉTODO: Se estudiaron 21 pacientes con sospecha de EM y un total de 42 brotes. Los pacientes fueron clasificados según los criterios de Lublin y Revingold para las formas evolutivas y según los criterios de McDonald. RESULTADOS: Solo dos pacientes clasificaron en la forma evolutiva progresiva primaria; los primeros dos trimestres del año fueron los de mayor número de brotes. CONCLUSIÓN: Se recomienda profundizar en las variables climatológicas que pudieran tener vínculo con la aparición de estos brotes en nuestro medio.

Vinculación de la docencia y la investigación en la asignatura Inmunología para estudiantes de Tecnología de la Salud / Link of teaching and research in the Immunology subject for students of Health Technology

OBJETIVO: lograr la vinculación de la docencia y la investigación en la asignatura Inmunología para los estudiantes de Tecnología de la Salud. MÉTODOS: se establecieron actividades prácticas de Inmunología en el Laboratorio Central de Líquido Cefalorraquídeo para todos los alumnos de cuarto año de la carrera de esta especialidad y modalidad. La actividad práctica incluyó la realización de diversas técnicas. Además, se orientó a los interesados en hacer un trabajo de investigación con temas de neuroinmunología a partir de pacientes con determinadas enfermedades en los hospitales de procedencia de los estudiantes como examen final de la asignatura. RESULTADOS: el respaldo a esta forma fue unánime con resultados altamente satisfactorios. La evaluación fue la presentación oral y por escrito de los trabajos finales. De los 10 trabajos presentados, 6 obtuvieron la máxima calificación y 4 fueron recomendados para ser presentados en la Jornada Científica Estudiantil de la facultad. CONCLUSIONES: los resultados confirman lo beneficioso que resulta vincular la teoría con la práctica y las actividades de investigación en la docencia de esta especialidad y modalidad.

OBJECTIVE: to attain the link between teaching and research in the Immunology subject for students of Health Technology. METHODS: practical activities of Immunology were established in the Cerebrospinal Fluid Central Lab for all the 4th-year students of the career of this specialty and modality. The practical activity included the use of various techniques. The interested were advised to make a research paper on neuroimmunology topics based on the patients suffering specific diseases at the same hospitals of the students as a final test of the subject. RESULTS: the support to this strategy was unanimous with highly satisfactory results. The evaluation consisted in the oral and writing presentation of the final papers. Of the 10 papers presented, 6 have the highest qualification, and 4 were recommended to be presented in the Student's Scientific Meeting of faculty. CONCLUSIONS: the results confirmed the convenience of linking theory with practice and with the research activities in the teaching of this specialty and modality.

sICAM-1 intrathecal synthesis and release during the acute phase in children suffering from Coxsackie A9 and S. pneumoniae meningoencephalitis / Sintesis intratecal de sICAM-1 y liberación durante la fase aguda en niños con meningoencefalitis por Coxsackie A9 y S pneumoniae

The intercellular adhesion molecule is a transmembrane glycoprotein belonging to the immunoglobulin superfamily. Serum and cerebrospinal fluid (CSF) soluble intercellular adhesion molecule 1 (sICAM-1) from normal control children as well as from children with Guillain-Barré syndrome (GBS), with Coxsackie A9 virus meningoencephalitis and with Streptococcus pneumoniae meningoencephalitis were studied. sICAM-1 was quantified using an immunoenzimatic assay and albumin using the immunodiffusion technique in both biological fluids. Increased sICAM-1 values in CSF in patients with GBS correspond to an increase of the albumin CSF/serum quotient. In contrast, in inflammatory diseases like S. pneumoniae and Coxsackie A9 virus meningoencephalitis an increased brain-derived fraction was observed. In particular cases these values are 60-65 percent and 70-75 percent respectively. The results indicate an additional synthesis of sICAM-1 in subarachnoidal space during central nervous system (CNS) inflammatory process. An important role of sICAM-1 in the transmigration of different cell types into CSF during CNS inflammation in children with S. pneumoniae and Coxsackie A9 meningoencephalitis may be suggested.

La molécula de adhesión intercelular es una glicoproteína que pertenece a la superfamilia de las inmunoglobulinas. Se estudiaron los niveles de molécula de adhesión intercelular tipo 1 soluble (sICAM-1) en suero y líquido cefalorraquídeo (LCR) de niños con meningoencefalitis por Streptococcus pneumoniae y por Coxsackie A9 al igual que en niños con sindrome de Guillain-Barré (SGB). sICAM-1 fue cuantificado por ensayo inmunoenzimático y la albúmina por inmunodifusión en ambos líquidos biológicos. Los valores incrementados de sICAM-1 en LCR en los pacientes con GBS corresponden a valores aumentados de razón LCR/suero de albúmina. En contraste, en las enfermedades inflamatorias como las meningoencefalitis por S. pneumoniae y por Coxsackie A9 se observa un incremento en la fracción derivada del cerebro. En casos particulares los valores se incrementan hasta un 60-65 por ciento y 70-75 por ciento respectivamente. Los resultados indican una síntesis adicional de sICAM-1 en el espacio subaracnoideo durante el proceso inflamatorio del sistema nervioso central (SNC). Esto puede sugerir un importante papel del sICAM-1 en la transmigración de diferentes tipos celulares en el LCR durante la inflamación del SNC en niños con meningoencefalitis por S pneumoniae y coxsackie A9.

Historias de vida de niños (as) con cancer: construcción de significado y sentido / Children with cancer life stories: cultural construction of sense and meaning

Se realizó un estudio cualitativo con base en las historias de vida narradas mediante una actividad lúdico-creativa por 3 niños y 3 niñas con leucemia linfoblásticaaguda, entre los 7 y los 15 años de edad, acogidos por la Fundación Diana Sarmiento de Bogotá, con el fin de conocer el sentido y significado que le dan al cáncer en sus vidas. El análisis de los hallazgos establece que este grupo de niños y niñas muestran gran capacidad para sobreponerse a sus circunstancias, lo cual lleva a buscar respuestas en la teoría sobre la resiliencia que afirma que además de aspectos inherentes a su personalidad como su inteligencia, reflexividad y responsividad, los niñas(as) resilientes cuentan con familias que los reconocen y/o con entidades que los impulsan, como lo hace esta Fundación que busca fortalecerlos a nivel psicoemocional. Como aspectos importantes de su experiencia, en sus autobiografías destacan: la primera hospitalización; las intervenciones dolorosas; el fuerte impacto del cáncer en sus vidas, que cambiaron a partir de la enfermedad, generándoles limitaciones, y el sufrimiento de sus familias. Es recurrente el sentido espiritual que los niños y las niñas le dan a su experiencia la cual integran a su sentido de vida como una prueba de Dios que deben superar. Esto lleva a considerar la importancia de que la enfermería oncológica y otras disciplinas de la salud tengan en consideración la dimensión espiritual dentro delos procesos de cuidado a estos niños(as) e incluyanel fortalecimiento de la resiliencia en ellos(as).

C3c intrathecal synthesis evaluation in patients with multiple sclerosis

INTRODUCTION: Multiple sclerosis (MS) is a chronic, inflammatory and progressive disease of the central nervous system in which local inflammatory injuries of the brain white matter appears, being the most outstanding feature the myeline loss (demyelination). OBJECTIVE: To determine if the complement system might be involved in the MS immunopathogeny favouring the mechanism intervening in the myelin destruction. METHOD: Samples of sera and CSF from twelve patients with a diagnosis of MS obtained at the moment of the admission to the hospital at the beginning of the break out, were collected. Levels of C3c and albumin in sera and in CSF were quantified using radial immunodiffusion plates. RESULTS: High values over 80 percent of intrathecal synthesis were obtained except in one of the patients. CONCLUSION: Intrathecal synthesis of C3c and its liberation to the CSF means that the activation of the complement system in any of the two ways has taken place, and that once performed its biological functions, has suffered a degradation process.

INTRODUCCION: La esclerosis múltiple (EM) es una enfermedad crónica, inflamatoria y progresiva del sistema nervioso central que cursa con la aparición de lesiones inflamatorias focales en la sustancia blanca cerebral, en las que lo más llamativo es la pérdida de mielina (desmielinización). OBJETIVO: Conocer si el sistema de complemento puede estar involucrado en la inmunopatogenia de la EM favoreciendo los mecanismos que median la destrucción de la mielina. MÉTODO: Se colectaron muestras de suero y LCR de doce pacientes con diagnóstico de EM obtenidas en el momento del ingreso al inicio del brote. Se cuantificaron los niveles de C3c y albúmina en suero y en LCR en placas de inmunodifusión radial. RESULTADOS: Se obtuvieron altos valores que superan el 80 por ciento de síntesis intratecal, menos en uno de los pacientes. CONCLUSION: La síntesis intratecal de C3c y su liberación al LCR significa que ha sucedido la activación del sistema de complemento en alguna de las dos vías y que una vez cumplidas sus funciones biológicas, ha sufrido un proceso de degradación y liberación al LCR en forma de C3c.

Consentimiento informado / Informed consent

Se realizó una revisión bibliográfica acerca del consentimiento informado. Se analizaron las características de la atención y cuidados al paciente desde la antigüedad, en las que predominó la llamada beneficencia paternalista, ya que el enfermo no tenía capacidad de decisión y estaba sometido al criterio del médico, quien poseía toda la moral, autoridad y conocimientos suficientes para ordenarle lo que debía hacer con su salud. Esto predominó durante mucho tiempo, hasta el surgimiento del consentimiento informado, donde la autonomía del paciente con relación a las decisiones médicas, adquiere gran importancia