Estudiar y trabajar como factores de riesgo en estudiantes de enfermería, Universidad Nacional Formosa, 2022 / Study and work as risk factors in nursing students, National University of Formosa,2022

Objetivo: Correlacionar la variable principal sostén del hogar con las variables género, edad, horas de trabajo, horas de sueño y factores de riesgo cardiovascular (índice de masa corporal, hipertensión arterial, dislipemia y diabetes mellitus), en estudiantes de 3º, 4 y 5º año de la Licenciatura en Enfermería, Universidad Nacional de Formosa. Metodología: estudio descriptivo, correlacional, transversal realizado en 214 estudiantes, durante el año 2022, utilizándose un cuestionario on-line autoadministrado, estructurado y medición de peso y talla. Resultados: el 76% fueron mujeres; 64%, principal fueron principal sostén del hogar, 57% refirió dormir menos de 6 horas al día, 15 % trabaja más de 41 horas semanales; 67% tuvo respuestas no saludables a la variable estrés, para la variable actividad física este valor ascendió a 71% y el 53,8% presentó exceso de peso. Se encontró asociación significativa entre ser el principal sostén del hogar con exceso de peso, trabajar 41 horas o más semanalmente, dormir menos de 6 horas al día y con la presencia de 3 o más factores de riesgo cardiovascular. Conclusiones: Las condiciones de vida que afrontan los estudiantes que de manera simultánea estudian, trabajan y son principal sostén del hogar pueden generar estrés, el cual es un factor de riesgo para las enfermedades cardiovasculares[AU]

Objetive: to correlate the main variable of primary income earner or primary breadwinner with gender, age, working hours, sleep hours, and cardiovascular disease risk factors (body mass index, hypertension, dyslipidemia, and diabetes mellitus) in 3rd, 4th, and 5th-year nursing students at the Nursing Program at the National University of Formosa. Methodology: The study was a descriptive, correlational, cross-sectional, conducted with 214 students during 2022 using a self-administered structured online questionnaire and measurement of weight and height. Results: 76% were women, 64% were the main breadwinner, 57% reported sleeping less than 6 hours a day, 15% working more than 41 hours per week; 67% had unhealthy responses to the stress variable, this value rose to 71% for the physical activity variable, and 53.8% were overweight. A significant association was found between the main variable of primary breadwinner and being overweight, working 41 or more hours weekly, and the presence of 3 or more cardiovascular risk factors. Conclusions: The living conditions faced by students who simultaneously study and work, and being the main breadwinner in the household can generate stress, which is a risk factor for cardiovascular diseases[AU]

Objetivo:: correlacionar a variável principal de sustento econômico do lar com as variáveis gênero, idade, horas de trabalho, horas de sono e fatores de risco cardiovascular (índice de massa corporal,hipertensão arterial, dislipidemia e diabetes mellitus) em estudantes do 3º, 4º e 5º ano do curso de graduação em Enfermagem, Universidade Nacional de Formosa. Metodologia: O estudo foi descritivo, correlacional e transversal, realizado em 214 estudantes durante o ano de 2022. Foi utilizado um questionário online autoadministrado e estruturado, e a medição de peso e altura dos estudantes foi realizada. Resultados: 76% dos estudantes eram mulheres; 64% eram o principal sustento econômico do lar; 57% relataram dormir menos de 6 horas por dia, 15% responderam que trabalham mais de 41 horas por semana; em relação aos fatores de risco cardiovascular, 67% tiveram respostas não saudáveis para a variável estresse, para a variável atividade física esse valor aumentou para 71% e 53,8% apresentaram excesso de peso. Foi encontrada uma associação significativa entre a variável principal de sustento econômico do lar com as variáveis excesso de peso, trabalhar 41 horas ou mais por semana, dormir menos de 6 horas al día e a presença de 3 ou mais fatores de risco cardiovascular. Conclusões: As condições de vida enfrentadas pelos estudantes que simultaneamente estudam, trabalham e são o principal sustento do lar podem gerar estresse, que é um fator de risco para doenças cardiovasculares[AU]

Evaluación funcional de niños, niñas y adolescentes con diagnóstico de trastorno del espectro autista en Argentina: estudio multicéntrico TEA-CIFunciona / Functional assessment of children and adolescents with autism spectrum disorder in Argentina: ICF-ASD multicenter study

Introducción. El trastorno del espectro autista (TEA) se caracteriza por dificultades de comunicación social y comportamientos repetitivos y estereotipados. Además de la categoría diagnóstica, las actividades que los niños, niñas y adolescentes (NNyA) pueden realizar y la participación social son los aspectos principales por considerar desde el marco de la Clasificación Internacional del Funcionamiento, la Discapacidad y la Salud (CIF), propuesta por la Organización Mundial de la Salud, para describir los estados de salud. En una investigación previa, elaboramos la primera versión de una herramienta pediátrica basada en la CIF llamada TEA-CIFunciona para evaluación funcional de NNyA con diagnóstico de TEA, que permitió captar características funcionales adaptadas a nuestro contexto cultural. Se propuso como objetivo posterior aplicar TEA-CIFunciona en formato multicéntrico para evaluar NNyA de diferentes regiones, revisar y actualizar la herramienta, e identificar barreras y facilitadores. Población y métodos. Se administró TEA-CIFunciona versión 1.0 a NNyA con diagnóstico confirmado de TEA (según criterios del DSM-5), menores de 16 años, en seguimiento en cinco centros de atención pediátrica del país. Resultados. Se obtuvo la versión 2.0 de TEA-CIFunciona con 34 categorías (10 funciones corporales, 15 actividades y participación, y 9 factores ambientales). Se elaboró el perfil funcional de la muestra completa (n = 308). Conclusiones. La versión actualizada de TEA-CIFunciona contribuye a estandarizar y a sistematizar la obtención de información necesaria para adecuar el seguimiento de los NNyA con TEA a nivel nacional. Además, permite identificar barreras por superar y facilitadores para generalizar

Introduction. Autism spectrum disorder (ASD) is characterized by difficulties in social communication and repetitive and stereotyped behaviors. In addition to the diagnostic category, the activities performed by children and adolescents and their social involvement are the main aspects to be considered according to the International Classification of Functioning, Disability, and Health (ICF) proposed by the World Health Organization to describe health status. In a previous study, we developed the first version of a pediatric tool based on the ICF called ICF-ASD for the functional assessment of children and adolescents with ASD to capture functional characteristics adapted to our cultural setting. Our subsequent objective was to apply the ICF-ASD in a multicenter format to assess children and adolescents from different regions, review, and update it, and identify barriers and facilitators. Population and methods. The ICF-ASD version 1.0 was administered to children and adolescents younger than 16 years with a confirmed diagnosis of ASD (as per DSM-5 criteria), who were receiving follow-up at 5 children's health centers across Argentina. Results. Version 2.0 of the ICF-ASD was obtained, which included 34 categories (10 under body function, 15 under activities and participation, and 9 under environmental factors). A functional profile was developed for the whole sample (n = 308). Conclusions. The updated version of the ICF-ASD helps to standardize and systematize the collection of necessary data for an adequate follow-up of children and adolescents with ASD at a national level. It also allows to identify barriers to overcome and facilitators to be generalized

Caracterización de pacientes con trombosis portal sobre hígado no cirrótico en un hospital universitario de Medellín, Colombia / Characterization of patients with portal vein thrombosis on non-cirrhotic liver at a university hospital in Medellín, Colombia

Introducción. La trombosis de la vena porta es la oclusión parcial o completa de la luz de la vena porta o sus afluentes por la formación de trombos. Se asocia a desenlaces adversos y a un peor pronóstico. La frecuencia de aparición viene en aumento, a menudo de manera incidental, debido al uso cada vez mayor de imágenes diagnósticas. Metodología. Estudio observacional de una serie de casos de pacientes mayores de 18 años a quienes se les documentó trombosis venosa portal en hígado no cirrótico en el periodo comprendido entre enero de 2012 y diciembre de 2019 en un hospital de cuarto nivel de la ciudad de Medellín, Colombia. Resultados. Se documentaron 94 trombosis portales, la media de edad fue 44 ± 15 años, el 56 % eran mujeres. El promedio de aparición de síntomas fue de 14 días. La presentación de la trombosis fue aguda en un 41 %, crónica en 44 % y de instauración aguda sobre una trombosis crónica en un 15 %. La presentación clínica fue asintomática en el 33 %, el dolor abdominal fue la presentación más común con el 62 %. La trombofilia adquirida de mayor ocurrencia fueron las neoplasias mieloproliferativas crónicas en un 18 %, seguida del síndrome antifosfolípido en un 6 %. El método diagnóstico más usado fue la TAC trifásica en un 58 % seguido de la ultrasonografía en un 35 %. El 66 % de los pacientes fueron anticoagulados, siendo la warfarina el principal anticoagulante usado en un 56 %. El 16 % presento algún tipo de sangrado, aunque ninguno fue sangrado mayor. Conclusiones. La trombosis portal sigue siendo en muchos casos un hallazgo incidental. Se encontró un número inusual de neoplasias mieloproliferativas crónicas. La anticoagulación es segura y eficaz, aunque los anticoagulantes orales directos aún tienen un uso restringido.

Introduction. Portal vein thrombosis is the partial or complete occlusion of the lumen of the portal vein or its tributaries by thrombus formation. It is associated with adverse outcomes and a poorer prognosis. Its frequency is increasing, often incidentally, due to the growing use of diagnostic imaging. Methodology. This is an observational study of a case series of patients over 18 years old who were documented with portal vein thrombosis in a non-cirrhotic liver between January 2012 and December 2019 in a fourth-level hospital in the city of Medellín, Colombia. Results. Ninety-four cases of portal vein thrombosis were documented. The mean age was 44 ± 15 years, and 56 % were women. The average onset of symptoms was 14 days. Thrombosis presentation was acute in 41 %, chronic in 44 %, and acute on chronic in 15 %. Clinically, 33 % were asymptomatic, and abdominal pain was the most common presentation at 62 %. The most common acquired thrombophilia was chronic myeloproliferative neoplasms at 18 %, followed by antiphospholipid syndrome at 6 %. The most used diagnostic method was triphasic CT at 58 %, followed by ultrasonography at 35 %. Sixty-six percent of the patients received anticoagulation, with warfarin being the main anticoagulant used at 56 %. Sixteen percent experienced some type of bleeding, although none were major. Conclusions. Portal vein thrombosis remains, in many cases, an incidental finding. An unusual number of chronic myeloproliferative neoplasms were found. Anticoagulation is safe and effective, although the use of direct oral anticoagulants remains restricted.

Effect of NiAl alloy microparticles deposited in flexible SERS substrates on the limit of detection of rhodamine B molecules.

Flexible-SERS (FSERS) substrates were fabricated by depositing Ni64Al36(NiAl)-alloy-microparticles and/or spherical Ag-NPs (sizes of 10-40 nm) on recycled plastics, which had an aluminum layer on their surface. First, FSERS substrates made of Al + Ag-NPs and an area of 1 cm2 were used to detect rhodamine B (RhB) molecules. The limit-of-detection (LOD) for RhB was 8.35 × 10-22 moles (∼503 molecules), and the enhancement factor (EF) was 3.11 × 1015. After adding NiAl-microparticles to the substrate, the LOD decreased to 8.35 × 10-24 moles (∼5 molecules) and the EF was increased to 2.05 × 1017. Such EF values were calculated with respect to substrates made only with Al + NiAl-alloy (without Ag-NPs), which did not show any Raman signal. Other FSERS substrates were made with graphene-layer + Ag-NPs or graphene-layer + NiAl-alloy + Ag-Nps, and the best LOD and EF values were 8.35 × 10-22 moles and 6.89 × 1015, respectively. Overall, combining the Ag-NPs and NiAl-alloy microparticles allowed for the zeptomole detection of RhB. This was possible due to the formation of Ag aggregates around the alloy microparticles, which enhanced the number of hotspots. If no alloy is present in the FSERS substrates, the detection of RhB is lowered. Overall, we presented a low-cost FSERS substrate that does not require expensive Au films or Au-NPs (as previously reported) to detect RhB at the zeptomole level.

Synchronous cemento-ossifying fibromas: a systematic review.

BACKGROUND: This systematic review aimed to incorporate published data regarding synchronous cemento-ossifying fibromas (COF), with an analysis of their demographic and clinicopathological characteristics. MATERIAL AND METHODS: Case reports and case series of synchronous COF were searched in PubMed, Web of Science, Scopus, EMBASE, and LILACS according to the PRISMA (2020) statement. Also, a manual search was carried out and the grey literature was assessed. A descriptive statistical analysis was performed. RESULTS: Nineteen studies comprising 20 cases of synchronous COF were included. The mean age at diagnosis was 35 years (±13.8), with a predominance of female patients (n=12/60%). In 13 cases (65%) the mandible and the maxilla were affected simultaneously. In two cases (10%) first-degree relatives (parents or siblings) had been previously diagnosed with COF. The diagnostic hypotheses were reported in 8 cases (40%), with florid cemento-osseous dysplasia, ameloblastic fibroodontoma, calcifying cystic odontogenic tumor, osteoma and cementoblastoma being cited in the differential diagnosis. Among the cases with details about management (n=17), eleven were treated by surgical enucleation and/or excision (64.7%). Follow-up was provided for 10 cases (50%), with a mean period of 44.7±62.19 months. Recurrence occurred in three of informed cases. CONCLUSIONS: Synchronous manifestation of COF is rare. Female patients around the 3rd decade of life are more commonly affected. Bilateral involvement of the mandible and maxilla is the most common clinical presentation.

Antifungal Mechanism of Ruta graveolens Essential Oil: A Colombian Traditional Alternative against Anthracnose Caused by Colletotrichum gloeosporioides.

Here, we report for the first time on the mechanisms of action of the essential oil of Ruta graveolens (REO) against the plant pathogen Colletotrichum gloeosporioides. In particular, the presence of REO drastically affected the morphology of hyphae by inducing changes in the cytoplasmic membrane, such as depolarization and changes in the fatty acid profile where straight-chain fatty acids (SCFAs) increased by up to 92.1%. In addition, REO induced changes in fungal metabolism and triggered apoptosis-like responses to cell death, such as DNA fragmentation and the accumulation of reactive oxygen species (ROS). The production of essential enzymes involved in fungal metabolism, such as acid phosphatase, ß-galactosidase, ß-glucosidase, and N-acetyl-ß-glucosaminidase, was significantly reduced in the presence of REO. In addition, C. gloeosporioides activated naphthol-As-BI phosphohydrolase as a mechanism of response to REO stress. The data obtained here have shown that the essential oil of Ruta graveolens has a strong antifungal effect on C. gloeosporioides. Therefore, it has the potential to be used as a surface disinfectant and as a viable replacement for fungicides commonly used to treat anthracnose in the postharvest testing phase.

Full range leadership style and its effect on effectiveness, employee satisfaction, and extra effort: an empirical study.

The purpose of this study is to determine if there is a positive relationship between full-range leadership and employees' effort, efficiency, and satisfaction. A questionnaire was administered to 577 executives from Colombian companies, and the data was analyzed using a partial least squares structural equation modeling (PLS-SEM) approach. The results show that both transformational and transactional leadership have a direct and significant impact on extra effort, effectiveness, and satisfaction, with transformational leadership having the greatest impact on these factors. Conversely, passive-avoidant leadership has negative effects on these three constructs. This study validates the effectiveness of the MLQ 5X in a South American country, a geographical region where such studies are in their early stages. Finally, the whole range of leadership styles-transformational, transactional, and passive-avoidant-is looked at. These styles are seen as second-order constructs that challenge latent multidimensional models as they emerge.

ß-D-Glucose-Reduced Silver Nanoparticles Remodel the Tumor Microenvironment in a Murine Model of Triple-Negative Breast Cancer.

Breast cancer is the most diagnosed type of cancer worldwide and the second cause of death in women. Triple-negative breast cancer (TNBC) is the most aggressive, and due to the lack of specific targets, it is considered the most challenging subtype to treat and the subtype with the worst prognosis. The present study aims to determine the antitumor effect of beta-D-glucose-reduced silver nanoparticles (AgNPs-G) in a murine model of TNBC, as well as to study its effect on the tumor microenvironment. In an airbag model with 4T1 tumor cell implantation, the administration of AgNPs-G or doxorubicin showed antitumoral activity. Using immunohistochemistry it was demonstrated that treatment with AgNPs-G decreased the expression of PCNA, IDO, and GAL-3 and increased the expression of Caspase-3. In the tumor microenvironment, the treatment increased the percentage of memory T cells and innate effector cells and decreased CD4+ cells and regulatory T cells. There was also an increase in the levels of TNF-α, IFN-γ, and IL-6, while TNF-α was increased in serum. In conclusion, we suggest that AgNPs-G treatment has an antitumor effect that is demonstrated by its ability to remodel the tumor microenvironment in mice with TNBC.

Towards better mortality prediction in cancer patients in the ICU: a comparative analysis of prognostic scales: systematic literature review.

OBJECTIVE: To evaluate the predictive ability of mortality prediction scales in cancer patients admitted to intensive care units (ICUs). DESIGN: A systematic review of the literature was conducted using a search algorithm in October 2022. The following databases were searched: PubMed, Scopus, Virtual Health Library (BVS), and Medrxiv. The risk of bias was assessed using the QUADAS-2 scale. SETTING: ICUs admitting cancer patients. PARTICIPANTS: Studies that included adult patients with an active cancer diagnosis who were admitted to the ICU. INTERVENTIONS: Integrative study without interventions. MAIN VARIABLES OF INTEREST: Mortality prediction, standardized mortality, discrimination, and calibration. RESULTS: Seven mortality risk prediction models were analyzed in cancer patients in the ICU. Most models (APACHE II, APACHE IV, SOFA, SAPS-II, SAPS-III, and MPM II) underestimated mortality, while the ICMM overestimated it. The APACHE II had the SMR (Standardized Mortality Ratio) value closest to 1, suggesting a better prognostic ability compared to the other models. CONCLUSIONS: Predicting mortality in ICU cancer patients remains an intricate challenge due to the lack of a definitive superior model and the inherent limitations of available prediction tools. For evidence-based informed clinical decision-making, it is crucial to consider the healthcare team's familiarity with each tool and its inherent limitations. Developing novel instruments or conducting large-scale validation studies is essential to enhance prediction accuracy and optimize patient care in this population.

Genome characterization of a multi-drug resistant Escherichia coli strain, L1PEag1, isolated from commercial cape gooseberry fruits (Physalis peruviana L.).

Introduction: Foodborne infections, which are frequently linked to bacterial contamination, are a serious concern to public health on a global scale. Whether agricultural farming practices help spread genes linked to antibiotic resistance in bacteria associated with humans or animals is a controversial question. Methods: This study applied a long-read Oxford Nanopore MinION-based sequencing to obtain the complete genome sequence of a multi-drug resistant Escherichia coli strain (L1PEag1), isolated from commercial cape gooseberry fruits (Physalis peruviana L.) in Ecuador. Using different genome analysis tools, the serotype, Multi Locus Sequence Typing (MLST), virulence genes, and antimicrobial resistance (AMR) genes of the L1PEag1 isolate were determined. Additionally, in vitro assays were performed to demonstrate functional genes. Results: The complete genome sequence of the L1PEag1 isolate was assembled into a circular chromosome of 4825.722 Kbp and one plasmid of 3.561 Kbp. The L1PEag1 isolate belongs to the B2 phylogroup, sequence type ST1170, and O1:H4 serotype based on in silico genome analysis. The genome contains 4,473 genes, 88 tRNA, 8 5S rRNA, 7 16S rRNA, and 7 23S rRNA. The average GC content is 50.58%. The specific annotation consisted of 4,439 and 3,723 genes annotated with KEEG and COG respectively, 3 intact prophage regions, 23 genomic islands (GIs), and 4 insertion sequences (ISs) of the ISAs1 and IS630 families. The L1PEag1 isolate carries 25 virulence genes, and 4 perfect and 51 strict antibiotic resistant gene (ARG) regions based on VirulenceFinder and RGI annotation. Besides, the in vitro antibiotic profile indicated resistance to kanamycin (K30), azithromycin (AZM15), clindamycin (DA2), novobiocin (NV30), amikacin (AMK30), and other antibiotics. The L1PEag1 isolate was predicted as a human pathogen, matching 464 protein families (0.934 likelihood). Conclusion: Our work emphasizes the necessity of monitoring environmental antibiotic resistance, particularly in commercial settings to contribute to develop early mitigation techniques for dealing with resistance diffusion.

Estimation of the Clinical, Economic, and Social Burden of Stage IV Non-Small Cell Lung Cancer in Mexico.

INTRODUCTION: Lung cancer continues to be the leading cause of death among cancer patients worldwide. This study aimed to estimate the clinical, economic, and social burdens of stage IV non-small cell lung cancer (NSCLC) in private and public healthcare centers in Mexico, utilizing real-world evidence. METHODS: The study population included patients >18 years of age diagnosed with stage IV NSCLC who received cancer treatment at the Centro Médico Nacional Siglo XXI (IMSS), the Centro Médico Nacional "20 de Noviembre" (ISSSTE), the Mexican Institute of Respiratory Diseases (INER), and the Medical Center ABC (American British Cowdray) from 1 January 2019 to 31 December 2020. The analysis included evaluation of epidemiological data, treatment regimens, and clinical outcomes, and emphasized pharmacological and non-pharmacological treatments, including detailed follow-up investigations, as part of comprehensive clinical management. Additionally, the study assessed the social burden through variables such as working-age absenteeism and presenteeism and caregiver productivity loss, as well as economic burden, considering both clinical and social components, with costs adjusted to 2022 Mexican pesos (MXN) values. RESULTS: A total of 188 patients with metastatic NSCLC were studied. The main type of NSCLC tumor found in the sample was adenocarcinoma (81%). Treatment regimens included pharmacological treatments (78%), non-pharmacological treatments (25%), and palliative care (24%). Complications were present in 73% of the cohort, while 60% presented adverse events. Clinical management costs of up to MXN1,001,579 per patient in the public sector and MXN2,140,604 in the private sector were reported. It was estimated that working-age patients lose 84-335 days yearly due to absenteeism and presenteeism, while caregivers report a productivity loss equivalent to 13-30 days due to the management of NSCLC patients. These indirect costs of NSCLC contribute to the social burden. A working-age patient with stage IV disease is associated with an average indirect cost of MXN49,731-178,287 in public institutions, while in private institutions, the cost elevates to MXN438,103. CONCLUSIONS: This study highlights the substantial clinical, economic, and social burdens of stage IV NSCLC in Mexico, revealing significant disparities between public and private healthcare sectors. It underscores the urgent need for standardized practices and equitable care across all systems.

This study examined the effects of advanced lung cancer (stage IV non-small cell lung cancer [NSCLC]) on patients in Mexico, focusing on the health, financial, and caregiver burdens. Researchers studied adults over 18 years of age undergoing cancer treatment at four medical centers across Mexico, analyzing treatment costs and time lost due to illness. All costs were updated to 2022 Mexican pesos (MXN) values. Treating one patient for 1 year can cost up to MXN 1 million in public hospitals and more than MXN 2 million in private hospitals. Patients might lose about 84­335 days of work annually, with caregivers losing 13­30 days. These lost workdays significantly impact finances, costing approximately MXN50,000­178,000 per patient per year in public hospitals and MXN438,000 in private hospitals. The study concludes that understanding these costs can help create better treatment plans, improving patient care and reducing financial burdens. By aligning treatment strategies across public and private healthcare settings, patients could benefit from more consistent and effective care, potentially leading to better health outcomes and reducing the overall impact of the disease on their lives and the broader healthcare system.

Are Neighborhood Greenspaces Associated with Leisure-time Physical Activity? Results from ELSA-Brasil Eight-year Follow-up.

We investigated whether neighborhood greenspaces were associated with physical activity in adulthood over 3 cohort visits after considering perceived safety and neighborhood contextual factors. We also evaluated whether the association with greenspace varied by neighborhood socioeconomic status. Participants (N = 4,800) from the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil) residing in two Brazilian state capitals were evaluated in Visits 1 (2008-2010), 2 (2012-2014) and 3 (2017-2019). Greenspaces were categorized by quintiles of positive Normalized Difference Vegetation Index (NDVI) scores. Physical activity frequency was given by the number of visits at which participants reported moderate/vigorous physical activity (none, 1 or 2, and 3 visits). We used multinomial logistic regression. After adjustment for age, sex, education, research center, residence in slums, individuals in the 4th and 5th NDVI quintiles showed 73% higher odds of physical activity over 3 visits than those in the 1st quintile (4th quintile: 95%CI = 1.24-2.43; 5th quintile: 95%CI = 1.24-2.41). The strength of the association was attenuated after adjustment for perceived safety. After adjustment for contextual factors quantity of sidewalks and streetlights, the OR for the 4th and 5th NDVI quintiles decreased to 1.66 (95%CI = 1.18-2.33) and 1.62 (95%CI = 1.16-2.28), respectively. Finally, after including average household income per capita, the OR for physical activity in 3 visits for the 4th and 5th NDVI quintiles decreased to 1.48 (95%CI = 1.04-2.12) and 1.43 (95%CI = 1.00-2.04; p = 0.053), respectively. Greater greenspace contributed to sustained physical activity during the eight years of follow-up, indicating the potential contribution of public greenspaces to reducing health-related inequalities.

Leisure Time Physical Activity and Incidence of Arterial Hypertension in ELSA-Brasil Participants. / Atividade Física no Tempo Livre e Incidência de Hipertensão Arterial em Participantes do ELSA-Brasil.

BACKGROUND: Evidence indicates that physical activity (PA) has a protective effect against chronic diseases, including high arterial hypertension (AH). OBJECTIVE: This study investigated, longitudinally, the association between changes in leisure time physical activity (LTPA) and the incidence of hypertension in ELSA-Brasil participants. METHODS: Data from 8,968 participants were analyzed at two different times (2008-2010 and 2012-2014). The International Physical Activity Questionnaire (IPAQ), long version, was used to assess LTPA. The association between LTPA and AH was tested using Poisson regression with relative risk (RR) estimation, with a significance level of 5% and a 95% confidence interval. RESULTS: When the LTPA level variable was categorized as sufficient and insufficient, no statistically significant associations were found between LTPA and AH incidence as a function of changes in PA during follow-up. However, when the LTPA variable was categorized as inactive, little active, active, and very active, a statistically significant association was observed between LTPA and AH in participants classified as very physically active. The risk of AH was reduced by 35% among men RR 0.65 (95% CI 0.50-0.86) and by 66% among women RR 0.34 (95% CI 0.20-0.58) who maintained high levels of LTPA at both moments of follow-up. CONCLUSION: These results suggest that maintaining high levels of PA over time is associated with a lower risk of developing AH, highlighting the importance of PA in preventing this condition, for both men and women.

FUNDAMENTO: Evidências apontam que a atividade física (AF) apresenta efeito protetor para as doenças crônicas, incluindo a hipertensão arterial (HA). OBJETIVO: Este estudo investigou, de forma longitudinal, a associação entre as mudanças na atividade física no tempo livre (AFTL) e a incidência de HA em participantes do ELSA-Brasil. MÉTODOS: Foram analisados dados de 8.968 participantes em dois momentos distintos (2008-2010 e 2012-2014). Foi utilizado o Questionário Internacional de Atividade Física (IPAQ), versão longa, para avaliação da AFTL. A associação entre AFTL e HA foi testada por regressão de Poisson com estimativa do risco relativo (RR), com nível de significância de 5% e intervalo de confiança de 95%. RESULTADOS: Quando a variável nível de AFTL foi categorizada em suficiente e insuficiente, não foram encontradas associações estatisticamente significantes entre AFTL e a incidência HA em função das mudanças na AF durante o seguimento. No entanto, a variável AFTL quando categorizada em inativo, pouco ativo, ativo e muito ativo, observou-se associação estatisticamente significante entre AFTL e HA em participantes classificados como muito ativos fisicamente. O risco de HA foi reduzido em 35% entre homens RR 0,65 (IC 95% 0,50-0,86) e em 66% entre as mulheres RR 0,34 (IC 95% 0,20-0,58) que mantiveram altos níveis de AFTL em ambos os momentos do seguimento. CONCLUSÃO: Esses resultados sugerem que a manutenção de altos níveis de AF ao longo do tempo está associada a um menor risco de desenvolver HA, destacando a importância da AF na prevenção dessa condição, tanto para homens quanto para mulheres.

Beyond tobacco: genomic disparities in lung cancer between smokers and never-smokers.

BACKGROUND: Tobacco use is one of the main risk factors for Lung Cancer (LC) development. However, about 10-20% of those diagnosed with the disease are never-smokers. For Non-Small Cell Lung Cancer (NSCLC) there are clear differences in both the clinical presentation and the tumor genomic profiles between smokers and never-smokers. For example, the Lung Adenocarcinoma (LUAD) histological subtype in never-smokers is predominately found in young women of European, North American, and Asian descent. While the clinical presentation and tumor genomic profiles of smokers have been widely examined, never-smokers are usually underrepresented, especially those of a Latin American (LA) background. In this work, we characterize, for the first time, the difference in the genomic profiles between smokers and never-smokers LC patients from Chile. METHODS: We conduct a comparison by smoking status in the frequencies of genomic alterations (GAs) including somatic mutations and structural variants (fusions) in a total of 10 clinically relevant genes, including the eight most common actionable genes for LC (EGFR, KRAS, ALK, MET, BRAF, RET, ERBB2, and ROS1) and two established driver genes for malignancies other than LC (PIK3CA and MAP2K1). Study participants were grouped as either smokers (current and former, n = 473) or never-smokers (n = 200) according to self-report tobacco use at enrollment. RESULTS: Our findings indicate a higher overall GA frequency for never-smokers compared to smokers (58 vs. 45.7, p-value < 0.01) with the genes EGFR, KRAS, and PIK3CA displaying the highest prevalence while ERBB2, RET, and ROS1 the lowest. Never-smokers present higher frequencies in seven out of the 10 genes; however, smokers harbor a more complex genomic profile. The clearest differences between groups are seen for EGFR (15.6 vs. 21.5, p-value: < 0.01), PIK3CA (6.8 vs 9.5) and ALK (3.2 vs 7.5) in favor of never-smokers, and KRAS (16.3 vs. 11.5) and MAP2K1 (6.6 vs. 3.5) in favor of smokers. Alterations in these genes are comprised almost exclusively by somatic mutations in EGFR and mainly by fusions in ALK, and only by mutations in PIK3CA, KRAS and MAP2K1. CONCLUSIONS: We found clear differences in the genomic landscape by smoking status in LUAD patients from Chile, with potential implications for clinical management in these limited-resource settings.

Two-Step Conservative Surgery for Complicated Forms of Diabetes-Related Foot Osteomyelitis.

Diabetes-related foot osteomyelitis (DFO) is a common yet complex condition, often complicated by concurrent soft tissue infections (STIs). This study evaluates the efficacy of a two-step conservative surgical approach, hypothesizing that it offers comparable outcomes to a one-step procedure. Conducted on a cohort of 93 patients with DFO, the study categorized cases into two types: OM1 (osteomyelitis without STI) and OM2 (osteomyelitis with STI). OM2 was further subdivided into OM2a (early diagnosis) and OM2b (late diagnosis), with OM2 patients undergoing initial soft tissue debridement followed by elective bone surgery. The results indicated no significant differences in infection recurrence or amputation rates between the two surgical approaches, with recurrence observed in 20.7% of cases and amputations in 10.8%. The two-step procedure was associated with higher inflammatory responses and greater need for antibiotics and hospital admissions. However, these factors did not translate into increased recurrence or amputation compared to the one-step procedure. The study supports the two-step approach as a safe and effective method for managing complicated DFO cases, providing a viable alternative to immediate amputation or single-stage surgery. Despite some limitations, including regional specificity and potential underdiagnosis in late-diagnosed cases, the findings offer valuable insights for clinical management and suggest further research to refine treatment protocols. The study's strengths include confirmed histopathological diagnoses and consistent follow-up, reinforcing the validity of the two-step surgical approach for complex DFO treatment.

Unusual adult-onset cardiac rhabdomyomas in tuberous sclerosis complex: a case report.

Background: Tuberous sclerosis complex is a genetic neurocutaneous autosomal dominant syndrome, characterized by the development of multiple benign tumors (hamartomas) affecting various systems. Heart-benign tumors that result from the complex are called cardiac rhabdomyomas. Unlike hamartomas that occur in other organs, cardiac rhabdomyomas are most prevalent in infants and very young children with tuberous sclerosis complex. We present a case of a young adult with tuberous sclerosis who had an unusually late diagnosis of cardiac rhabdomyomas. Case report: A 22-year-old male patient of Afro-descendant, diagnosed with tuberous sclerosis complex in childhood, presented with refractory epilepsy and was treated only with lacosamide. The patient came to medical consultation due to a recent history of episodic, persistent chest pain in the sternal region, associated with physical effort. Echocardiography revealed a non-dilated left ventricle, with several rounded masses of high echogenicity without pedicles at the apical level, the largest measuring 14 × 11 mm, consistent with cardiac rhabdomyomas. Conclusion: Cardiac rhabdomyomas rarely develop in adulthood for individuals with tuberous sclerosis. These late-onset cases can exhibit various symptoms, from simple to complex presentations. Regular clinical checkups are essential for adults with tuberous sclerosis complex.

Translating Open-Ended Questions in Cross-Cultural Qualitative Research: A Comprehensive Framework.

INTRODUCTION: Globalization has increased the importance of multicultural research to address health disparities and improve healthcare outcomes for underrepresented communities. The International Nursing Network for HIV Research (The Network) serves as a platform for researchers to collaborate on cross-cultural and cross-national HIV studies. This article discusses the Network's approach to overcoming barriers in multicultural and multinational research in a qualitative context. METHODS: The network created a protocol to guide decision-making throughout the translation process of qualitative data collected from participants in their native languages. The protocol includes aspects of why, when, what, who, how, where, and by what means the translation is completed. RESULTS: The protocol has allowed researchers to enhance the validity, reliability, and cultural sensitivity of translation process, ensuring the clarity and impact of their research findings. DISCUSSION: Rigorous translation practices promote cross-cultural understanding and respect for participants' perspectives, fostering global collaborations and knowledge exchange.

Patients recovering from COVID-19 who presented with anosmia during their acute episode have behavioral, functional, and structural brain alterations.

Patients recovering from COVID-19 commonly exhibit cognitive and brain alterations, yet the specific neuropathological mechanisms and risk factors underlying these alterations remain elusive. Given the significant global incidence of COVID-19, identifying factors that can distinguish individuals at risk of developing brain alterations is crucial for prioritizing follow-up care. Here, we report findings from a sample of patients consisting of 73 adults with a mild to moderate SARS-CoV-2 infection without signs of respiratory failure and 27 with infections attributed to other agents and no history of COVID-19. The participants underwent cognitive screening, a decision-making task, and MRI evaluations. We assessed for the presence of anosmia and the requirement for hospitalization. Groups did not differ in age or cognitive performance. Patients who presented with anosmia exhibited more impulsive alternative changes after a shift in probabilities (r = - 0.26, p = 0.001), while patients who required hospitalization showed more perseverative choices (r = 0.25, p = 0.003). Anosmia correlated with brain measures, including decreased functional activity during the decision-making task, thinning of cortical thickness in parietal regions, and loss of white matter integrity. Hence, anosmia could be a factor to be considered when identifying at-risk populations for follow-up.