Mortality in Children Treated With Maintenance Peritoneal Dialysis: Findings From the International Pediatric Peritoneal Dialysis Network Registry.

RATIONALE & OBJECTIVE: Research on pediatric kidney replacement therapy (KRT) has primarily focused on Europe and North America. In this study, we describe the mortality risk of children treated with maintenance peritoneal dialysis (MPD) in different parts of the world and characterize the associated demographic and macroeconomic factors. STUDY DESIGN: Prospective cohort study. SETTING & PARTICIPANTS: Patients younger than 19 years at inclusion into the International Pediatric Peritoneal Dialysis Network registry, who initiated MPD between 1996 and 2017. EXPOSURE: Region as primary exposure (Asia, Western Europe, Eastern Europe, Latin America, North America, and Oceania). Other demographic, clinical, and macroeconomic (4 income groups based on gross national income) factors also were studied. OUTCOME: All-cause MPD mortality. ANALYTICAL APPROACH: Patients were observed for 3 years, and the mortality rates in different regions and income groups were calculated. Cause-specific hazards models with random effects were fit to calculate the proportional change in variance for factors that could explain variation in mortality rates. RESULTS: A total of 2,956 patients with a median age of 7.8 years at the start of KRT were included. After 3 years, the overall probability of death was 5%, ranging from 2% in North America to 9% in Eastern Europe. Mortality rates were higher in low-income countries than in high-income countries. Income category explained 50.1% of the variance in mortality risk between regions. Other explanatory factors included peritoneal dialysis modality at start (22.5%) and body mass index (11.1%). LIMITATIONS: The interpretation of interregional survival differences as found in this study may be hampered by selection bias. CONCLUSIONS: This study shows that the overall 3-year patient survival on pediatric MPD is high, and that country income is associated with patient survival.

A rational approach for the improvement of biomass production and lipid profile in cacao cell suspensions.

Cocoa butter (CB) is produced in the seeds of Theobroma cacao representing 50% of its dry weight. The lipid composition plays an important role in the physicochemical, rheological, and sensory properties of the CB, making this fat a valuable resource for the production of chocolates, cosmetics, and pharmaceuticals. In this paper, are described experimental strategies used for a rational improvement of biomass production and fatty acids in cacao cell suspension cultures. First, the lipid profile in four cacao varieties is characterized, and then, one variety is selected to induce cell suspensions using a direct method without previous establishment of a callus phase. To improve growth and total fat production in cell suspension cultures, modified DKW media and newly designed media culture, based on the mineral concentrations of cacao seeds (cacao biomass production, "CBP"), are analyzed and compared. In addition, the effect of acetate in the lipid profile of cell suspensions is evaluated. Ultrastructural histological analysis of lipid vesicles in cacao seeds and cell suspensions is also performed. The results will show that it is feasible to establish cacao suspensions without the calli step and increase the biomass production by selecting a suitable cacao variety and tissue and also applying a new culture media formulation. In addition, it is possible to synthesize fatty acids in cell cultures and modify the lipid profile adding a precursor of the novo biosynthesis of fatty acids such as the acetate. Transmission electronic microscopy examinations and differential interference contrast microscopy analysis will demonstrate that lipid vesicles are the main reserve substance in both cacao seeds and cell suspensions.

Efficient gene targeting in a Candida guilliermondii non-homologous end-joining pathway-deficient strain.

The yeast, Candida guilliermondii, has been widely studied due to its biotechnological interest as well as its biological control potential. It integrates foreign DNA predominantly via ectopic events, likely through the well-known non-homologous end-joining (NHEJ) pathway involving the Ku70p/Ku80p heterodimer, Lig4p, Nej1p and Lif1p. This phenomenon remains highly deleterious for targeted gene knock-out strategies that require the homologous recombination process. Here, we have constructed a ku70 mutant strain derived from the ATCC 6260 reference strain of C. guilliermondii. Following a series of disruption attempts of various genes (FCY1, ADE2 and TRP5), using several previously described dominant selectable markers (URA5, SAT-1 and HPH#), we demonstrated that the efficiencies of homologous gene targeting in such a NHEJ-deficient strain was very high compared to the wild type strain. The C. guilliermondii ku70 deficient mutant thus represents a powerful recipient strain to knock-out genes efficiently in this yeast.

Population Pharmacokinetics of Intra-articular and Intravenous Administration of Tranexamic Acid in Patients Undergoing Total Knee Replacement.

BACKGROUND: Tranexamic acid (TXA), an antifibrinolytic drug, is usually administered intravenously; however, intra-articular administration has recently been proven to be as effective as intravenous administration. Limited information regarding the pharmacokinetics (PK) of TXA after intra-articular administration has been reported. AIMS: The aim of this study was to develop a population PK model of TXA administered as a single intra-articular dose and as two intravenous doses, and to study the sources of interindividual variability (IIV) in the PK processes of TXA. The developed model was used to simulate PK profiles of TXA at different dosage regimens and in patients with renal impairment. METHODS: Patients who underwent primary unilateral total knee replacement (TKR) received 1 g/10 mL (concentration of 100 mg/mL) of TXA applied directly to the surgical field before wound closure, or 2 g (two doses of 1 g) of intravenous TXA. A population PK model was developed using a nonlinear mixed-effects approach and sources of IIV, such as sex, age, body weight, height, body mass index (BMI), preoperative haemoglobin, preoperative haematocrit, and creatinine clearance. RESULTS: Twenty-four patients were included, 12 in each group. Twenty patients were female, mean age (standard deviation) was 73.7 years (5.6). The disposition of TXA was best described as a two-compartment model with clearance dependent on creatinine clearance. Bootstrap results indicated that the model was stable and robust. The estimated bioavailability for intra-articular administration was 81%. Simulations indicated that 100% of patients would have plasma concentrations associated with partial fibrinolysis at 8 h post-administration with the dosages and routes of administration used in the present study. Intra-articular administration would produce complete inhibition of fibrinolysis in only 12% of patients compared with 72.5% with intravenous administration. No adverse events were reported. CONCLUSIONS: This population PK model demonstrated that a single dose of high-concentration, low-volume intra-articular TXA can achieve antifibrinolytic plasma concentrations of the drug for 8 h, providing both local and systemic effects in patients undergoing TKR. TXA administration to the surgical field could be an alternative to the intravenous; route for patients undergoing TKR; however, clinical studies are needed to assess the toxic local effects of TXA. TRIAL REGISTRATION: Spanish Clinical Studies Registry Number: 2017-004059-22. Date of registration: 12 April 2018.

Extraction and identification of endopeptidases in convection dried papaya and pineapple residues: A methodological approach for application to higher scale.

The use of agro-industrial waste for application in the obtention of products with high added value has become a trend in recent years, especially in tropical countries whose main economic sector is agricultural exports. In the present study, an applicable method to food industry of extracting proteolytic enzymes from dryed papaya and pineapple residues by convection was developed. Different to other scientific reports the heat treatment at 40 °C of waste residues, to reach 20% moisture, allowed an increase in total soluble protein content and did not alter the proteolytic activity of the extracts when phosphate buffer pH 7.0 was used as solvent. In the residues evaluated as candidates for the extraction of endopeptidases, we observed that green dried papaya peel and dried pineapple core, had higher activity values (914.34 ±â€¯25.47 U/mg and 2152.36 ±â€¯75.99 U/mg, respectively). These results, combined with one-dimensional electrophoresis and protein identification methods by MALDI TOF-TOF, showed the presence of signal peptides characteristic of papain, bromelain and other endopeptidases previously reported in extracts of fresh papaya and pineapple residues. These findings show that the drying of the residues by convection does not alter neither the activity nor the structure of the proteolytic enzymes. Finally, it is confirmed that the use of 20% ammonium sulfate as a precipitating agent allows to reach an efficiency of 74% in different work scales the use of purification and identification protocols in a more adaptable way, making them the most promising waste in Colombia, due to its potential for the production of bromelain on a larger scale.

Familia y Escuela. Perspectivas transformacionales en el acompañamiento afectivo y sexual / Family and School. Transformational perspectives in emotional and sexual accompaniment

Familia y escuela son instituciones primarias de la sociedad que convergen en la construcción de las bases del carácter y las pautas de comportamiento; por ello, se espera que en estas inicien los acompañamientos al desarrollo afectivo-sexual, mediante el reconocimiento del derecho a la libertad y la autonomía de los niños, niñas y adolescentes. Este artículo tuvo como objetivo analizar la transformación de las perspectivas sobre el acompañamiento afectivo-sexual de la familia y la escuela. Se llevó a cabo una revisión documental de textos académicos que tratan a la familia y la escuela como escenarios de formación afectivo-sexual. Se encontró que las perspectivas del acompañamiento afectivo-sexual son muy diversas, en ocasiones se abordan con fines informativos y, otras, como un elemento importante para la formación de seres sociales. Se concluyó que familia y escuela son aptas para ofrecer acompañamiento afectivo-sexual, por lo cual es importante que su labor sea colaborativa y en pro de la libertad y autonomía de los niños, niñas y adolescentes.

Family and school are the primary institutions of society, which converge in the construction of the foundations of character and behavior patterns; For this reason, it is there that support for affective-sexual development is expected to begin, by recognizing the right to freedom and autonomy of children and adolescents. This article aimed to analyze how the perspectives on the affective-sexual accompaniment of the family and the school have been transformed. A documentary review of academic texts that treat the family and the school as scenarios of affective-sexual formation was carried out. It was found that the perspectives of affective-sexual accompaniment are very diverse, sometimes it is addressed for informational purposes and, others, as an important element for the formation of social beings. It was concluded that family and school are suitable to offer affective-sexual accompaniment, for which it is important that their work is collaborative and in favor of the freedom and autonomy of children and adolescents.

Surface temperature of ewes during estrous cycle measured by infrared thermography.

The use of infrared thermography has not been used previously to assist sheep reproduction. The aim of this study was evaluate the viability of infrared thermography to identify body surface temperature patterns during ewes' estrous cycle. The estrous cycles of 20 Santa Ines ewes were synchronized through hormone treatment (progesterone implant). The ewes were submitted to measurements of body temperature (rectal and vaginal) with a digital thermometer and surface temperature of the anus, vulva, muzzle, left ear and left eye by infrared thermography. Temperature and humidity of the environment and wet-bulb globe temperature (WBGT) were measured. After the progesterone implant's removal, the follicular dynamic was evaluated daily during five days with ultrasound. The estrous cycle was separated into six phases to facilitate interpretation of the differences in body temperatures in each period. Phase 1 was the period before estrous synchronization, phase 2 was the beginning of estrous synchronization, phase 3 was the intermediate period and end of synchronization, phase 4 was the period of estrus manifestations, phase 5 was the ovulation period, and phase 6 was the post-ovulatory period. There was a difference among phases for all body regions evaluated (P < 0.05). All temperatures were higher in the ovulation phase. The rectal and vaginal temperatures measured by digital thermometer were lower during the diestrus period and increased during and after ovulation. The surface temperature of the vulva, measured by thermography, was higher from the estrus phase (4) to the ovulation and post-ovulation phases (5 and 6). The surface temperature of the muzzle was higher from the ovulation phase (5) to the post-ovulation phase (6), showing potential to detect ovulation. The thermography was efficient to detect small temperature variations during different phases of the estrous cycle, allowing the identification of different phases of the cycle in Santa Ines ewes.

Estudio de medios de cultivo para la síntesis de licopeno a partir de clavibacter michiganensis sub. michiganensis / Culture media for lycopene synthesis from Clavibacetr michiganensis sub. michiganensis

El licopeno es un carotenoide de elevado poder antioxidante que se obtiene a partir de fuentes naturales especialmente frutas y vegetales; también puede ser producido mediante el cultivo de microoganismos. En el presente artículo se estudia la síntesis de licopeno a partir del cultivo sumergido de Clavibacter michiganeses sub. michiganenses. Se considera el diseño de medios de cultivo y la separación, cuantificación y caracterización del carotenoide. Con el fin de establecer los niveles más apropiados para los factores de estudio (fuente de carbono, fuente de nitrógeno y sales), se programa un diseño de factor único; para el estudio de optimización se emplea un diseño central compuesto (33), cuya variable respuesta es la concentración de producto. El ajuste estadístico de los resultados experimentales muestra valores de fuente de carbono (glucosa: 7.5 g/L), nitrógeno (peptona: 10g/L y extracto de levadura: 10 g/L) y sales (cloruro de sodio: 10 g/L y fosfato dipotásico: 1 g/L), como constituyentes del medio de cultivo para lograr la mayor concentración de pigmento (2.85 mg carotenos/mL).