Dietary oleacein, a secoiridoid from extra virgin olive oil, prevents collagen-induced arthritis in mice.

Olacein (OLA), one of the main secoiridoids derived from extra virgin olive oil (EVOO), has been shown to modulate oxidative and inflammatory responses in various pathological conditions; however, its potential benefit in joint disorders such as rheumatoid arthritis (RA) is unknown. Therefore, this study was designed to evaluate the preventive role of the effects of an OLA-supplemented diet in the murine model of collagen-induced arthritis (CIA), delving into the possible mechanisms and signaling pathways involved. Animals were fed an OLA-enriched preventive diet for 6 weeks prior to CIA induction and until the end of the experimental time course. On day 43 after the first immunization, mice were sacrificed: blood was collected, and paws were histologically and biochemically processed. Dietary OLA prevented collagen-induced rheumatic bone, joint and cartilage conditions. Circulating matrix metalloproteinase (MMP)-3 and proinflammatory cytokine (IL-6, IL-1ß, TNF-α, IL-17) levels were significantly decreased in the joint, as well as MMP-9 and cathepsin-K (CatK) expression in secoiridoid-fed animals. In addition, dietary OLA was able to decrease COX-2, mPGES-1 and iNOS protein expressions and, also, PGE2 levels. The mechanisms possibly involved in these protective effects could be related to the activation of the Nrf-2/HO-1 axis and the inhibition of proinflammatory signaling pathways, including JAK-STAT, MAPKs and NF-κB, involved in the production of inflammatory and oxidative mediators. These results support the interest of OLA, as a nutraceutical intervention, in the management of RA.

Nature in the Office: A Systematic Review of Nature Elements and Their Effects on Worker Stress Response.

Work-related stress is a significant problem in many work environments and can have negative consequences for both employees and organisations. This review aimed to identify which elements of biophilic design in the workplace affect workers' stress response. To enable this, a literature search was conducted using PsycINFO, Scopus, and Medline. The search was limited to articles published from 2012 to June 2023. This review only integrated quantitative data, incorporating twelve records for qualitative synthesis. The selected studies suggest that strategies such as access to outdoor environments or the creation of outdoor areas are effective in reducing stress in the workplace. If these are not feasible, the examined research advocates the use of virtual means to recreate such relaxation or break spaces. Furthermore, aspects of interest for future research were identified, such as multisensory stimulation, including the sense of smell, the exploration of views with natural elements, the creation of shelters, or the study of biomorphic forms.

Effects of Dietary Oleacein Treatment on Endothelial Dysfunction and Lupus Nephritis in Balb/C Pristane-Induced Mice.

Systemic lupus erythematosus (SLE) is a chronic immune-inflammatory disease characterized by multiorgan affectation and lowered self-tolerance. Additionally, epigenetic changes have been described as playing a pivotal role in SLE. This work aims to assess the effects of oleacein (OLA), one of the main extra virgin olive oil secoiridoids, when used to supplement the diet of a murine pristane-induced SLE model. In the study, 12-week-old female BALB/c mice were injected with pristane and fed with an OLA-enriched diet (0.01 % (w/w)) for 24 weeks. The presence of immune complexes was evaluated by immunohistochemistry and immunofluorescence. Endothelial dysfunction was studied in thoracic aortas. Signaling pathways and oxidative-inflammatory-related mediators were evaluated by Western blotting. Moreover, we studied epigenetic changes such as DNA methyltransferase (DNMT-1) and micro(mi)RNAs expression in renal tissue. Nutritional treatment with OLA reduced the deposition of immune complexes, ameliorating kidney damage. These protective effects could be related to the modulation of mitogen-activated protein kinases, the Janus kinase/signal transducer and transcription activator of transcription, nuclear factor kappa, nuclear-factor-erythroid-2-related factor 2, inflammasome signaling pathways, and the regulation of miRNAs (miRNA-126, miRNA-146a, miRNA-24-3p, and miRNA-123) and DNMT-1 expression. Moreover, the OLA-enriched diet normalized endothelial nitric oxide synthase and nicotinamide adenine dinucleotide phosphate (NADPH) oxidase-1 overexpression. These preliminary results suggest that an OLA-supplemented diet could constitute a new alternative nutraceutical therapy in the management of SLE, supporting this compound as a novel epigenetic modulator of the immunoinflammatory response.

Wild Fruits of Crataegus monogyna Jacq. and Sorbus aria (L.) Crantz: From Traditional Foods to Innovative Sources of Pigments and Antioxidant Ingredients for Food Products.

Hawthorn (Crataegus monogyna Jacq.) and whitebeam (Sorbus aria (L.) Crantz) are wild species traditionally used as ethnic foods in the Mediterranean area. Their red berries, and mainly the peels, may be used as ingredients due to their color (replacing other synthetic colorants) or functional properties. Some previous studies analyze all edible fruits, but there is very little literature on the composition and properties of the pulpless epidermis of the fruits of C. monogyna and no literature concerning the fruits of S. aria. Total phenolic compounds (TPC) and families of hydroxybenzoic acids, hydroxycinnamic acids, flavonols, and total monomeric anthocyanins were determined in the epidermis of C. monogyna and S. aria fruits. The in vitro antioxidant capacity was also determined using QUENCHER (Quick-Easy-New-CHEap-Reproducible) methodology. Anthocyanins profiles were analyzed in hydroalcoholic extracts through HPLC/MS. C. monogyna fruits presented higher content of TPC than S. aria, with hydroxybenzoic acids (2870.6 mg GAE/100g dw) as the major family, followed by flavonols (771.4 mg QE/100 g dw) and hydroxycinnamic acids (610.3 FAE/100 g dw). Anthocyanins were found in 251.7 mg cyanidin-3-glucoside/100 g dw, characterized by the content of cyanidin-O-hexoxide and peonidin-O-hexoxide. The levels of these compounds correlated with higher values of a* parameter (higher intensity of reddish color). These fruits also showed higher antioxidant capacity by Q-Folin-Ciocalteu and Q-FRAP. S. aria peels had fewer phenolic compounds, particularly anthocyanins (33.7 mg cyanidin-3-glucoside/100 g dw), containing different cyanidin derivatives. From these results, new insights about the composition of the epidermis of these wild fruits are provided, and their potential as ingredients for the food industry is corroborated.

Effect of postextubation noninvasive ventilation with active humidification vs high-flow nasal cannula on reintubation in patients at very high risk for extubation failure: a randomized trial.

PURPOSE: High-flow nasal cannula (HFNC) oxygen therapy was noninferior to noninvasive ventilation (NIV) for preventing reintubation in a heterogeneous population at high-risk for extubation failure. However, outcomes might differ in certain subgroups of patients. Thus, we aimed to determine whether NIV with active humidification is superior to HFNC in preventing reintubation in patients with ≥ 4 risk factors (very high risk for extubation failure). METHODS: Randomized controlled trial in two intensive care units in Spain (June 2020‒June 2021). Patients ready for planned extubation with ≥ 4 of the following risk factors for reintubation were included: age > 65 years, Acute Physiology and Chronic Health Evaluation II score > 12 on extubation day, body mass index > 30, inadequate secretions management, difficult or prolonged weaning, ≥ 2 comorbidities, acute heart failure indicating mechanical ventilation, moderate-to-severe chronic obstructive pulmonary disease, airway patency problems, prolonged mechanical ventilation, or hypercapnia on finishing the spontaneous breathing trial. Patients were randomized to undergo NIV with active humidification or HFNC for 48 h after extubation. The primary outcome was reintubation rate within 7 days after extubation. Secondary outcomes included postextubation respiratory failure, respiratory infection, sepsis, multiorgan failure, length of stay, mortality, adverse events, and time to reintubation. RESULTS: Of 182 patients (mean age, 60 [standard deviation (SD), 15] years; 117 [64%] men), 92 received NIV and 90 HFNC. Reintubation was required in 21 (23.3%) patients receiving NIV vs 35 (38.8%) of those receiving HFNC (difference -15.5%; 95% confidence interval (CI) -28.3 to -1%). Hospital length of stay was lower in those patients treated with NIV (20 [12‒36.7] days vs 26.5 [15‒45] days, difference 6.5 [95%CI 0.5-21.1]). No additional differences in the other secondary outcomes were observed. CONCLUSIONS: Among adult critically ill patients at very high-risk for extubation failure, NIV with active humidification was superior to HFNC for preventing reintubation.

Alteraciones hemodinámicas en el paciente crítico portador de catéter venoso central al administrar drogas vasoactivas / Hemodynamic alterations in the critical patient with central venous catheter when administering vasoactive drugs

Los CVC (Catéteres Venosos Centrales) son de uso frecuente en las unidades de cuidados intensivos y reanimación para el manejo del paciente en una situación crítica. Estos catéteres aportan información valiosa para el diagnóstico, valoración del paciente y el tratamiento del mismo en situaciones graves de inestabilidad hemodinámica, principalmente. Es de vital importancia, el consenso hospitalario del uso de estos catéteres, ya que proporcionan una herramienta muy útil y con cada vez menos riesgos potenciales asociados a su uso.Los CVC tienen como objetivo, las mediciones hemodinámicas, aportes parenterales al paciente, cubrir necesidades de urgencia, extracciones sanguíneas, administración de fármacos vasoactivos, etc. Por sus características, son los más aptos para los pacientes de UCIs y REAs.Existen numerosos estudios que indican que en un catéter venoso central de tres/cinco luces, las extracciones de muestras para analítica, se deben llevar a cabo extrayendo una mínima cantidad de sangre de la luz proximal, sin lavado previo ni posterior1, con el fin de evitar la manipulación excesiva del catéter, y las anemias iatrogénicas debidas a la cantidad de sangre que se desecha. Sin embargo, no existe consenso, ni estudios de relevancia e investigación que indiquen cuál es la distribución adecuada de las perfusiones en un catéter venoso central de varias luces, cuando se administran drogas vasoactivas, tipo noradrenalina, dopamina, dobutamina, etc., ni tampoco cual es la repercusión hemodinámica si se realiza la extracción por otra rama del catéter venoso central. Los estándares de práctica de la terapia de infusión proporcionan recomendaciones basadas en la evidencia que publica la Infusión Nurses Society2 cada 5 años. Sí hay, por el contrario, estudios que demuestran cuál es la forma más adecuada del cambio de perfusiones cuando se terminan, con el fin de evitar las alteraciones hemodinámicas del paciente. (AU)

CVCs (Central Venous Catheters) are frequently used in intensive care and resuscitation units for the management of patients in a critical situation. These catheters provide valuable information for the diagnosis, assessment of the patient and the treatment of the same in serious situations of hemodynamic instability, mainly. It is of vital importance, the hospital consensus of the use of these catheters, since they provide a very useful tool and with fewer and fewer potential risks associated with their use.The CVCs have as their objective, hemodynamic measurements, parenteral contributions to the patient, cover emergency needs, blood extractions, administration of vasoactive drugs, etc. Due to their characteristics, they are the most suitable for patients with ICUs and OERs.There are numerous studies that indicate that in a three/five-light central venous catheter, the extractions of samples for analysis should be carried out by extracting a minimum amount of blood from the proximal lumen, without prior or subsequent washing1, in order to avoid excessive manipulation of the catheter, and iatrogenic anemias due to the amount of blood that is discarded. However, there is no consensus, nor studies of relevance and research that indicate what is the appropriate distribution of infusions in a central venous catheter of several lights, when vasoactive drugs, noradrenaline type, dopamine, dobutamine, etc. are administered, nor what is the hemodynamic repercussion if the extraction is performed by another branch of the central venous catheter. The infusion therapy standards of practice provide evidence-based recommendations published by the Nurses Society2 Infusion every 5 years. On the contrary, there are studies that demonstrate the most appropriate form of change in infusions when they are finished, in order to avoid hemodynamic alterations in the patient. (AU)

Dwarf Kiwi (Actinidia arguta Miq.), a Source of Antioxidants for a Healthy and Sustainable Diet.

The feasibility of using dwarf kiwi fruits (Actinia arguta Miq.) as a healthy and sustainable food, compared to other types of commercial kiwi fruits, was evaluated in the present study. The overall antioxidant capacity of these fruits was assessed by either extraction-dependent methods (ABTS, ORAC) or the direct method called Quick, Easy, New, CHEap, Reproducible (QUENCHER) (DPPH, FRAP, Folin-Ciocalteu), applied for the first time to analyze kiwi fruits. With this methodology, all the molecules with antioxidant capacity are measured together in a single step, even those with high molecular weight or poor solubility in aqueous extraction systems, such as antioxidant dietary fiber. The effect of kiwi extracts on physiological and induced intracellular reactive oxygen species (ROS) production on IEC-6 cells was also analyzed, as well as total phenolic content (TPC) by Fast Blue BB, flavonols, hydroxycinnamic acids, and hydroxybenzoic acids. A. arguta fruits showed the highest values in all the antioxidant assays, being remarkably higher than the other kiwi species for Q-FRAP and Q-DPPH. Dwarf kiwi showed the highest potential in reducing physiological ROS and the highest values of TPC (54.57 mgGAE/g), being hydroxybenzoic acids the main phenolic family found (2.40 mgGAE/g). Therefore, dwarf kiwi fruits are a natural source of antioxidants compared to conventional kiwi fruits, being a sustainable and healthy alternative to diversify fruits in the diet.

Benefit with preventive noninvasive ventilation in subgroups of patients at high-risk for reintubation: a post hoc analysis.

BACKGROUND: High-flow nasal cannula (HFNC) was shown to be non-inferior to noninvasive ventilation (NIV) for preventing reintubation in a general population of high-risk patients. However, some subgroups of high-risk patients might benefit more from NIV. We aimed to determine whether the presence of many risk factors or overweight (body mass index (BMI) ≥ 25 kg/m2) patients could have different response to any preventive therapy, NIV or HFNC in terms of reduced reintubation rate. METHODS: Not pre-specified post hoc analysis of a multicentre, randomized, controlled, non-inferiority trial comparing NFNC and NIV to prevent reintubation in patients at risk for reintubation. The original study included patients with at least 1 risk factor for reintubation. RESULTS: Among 604 included in the original study, 148 had a BMI ≥ 25 kg/m2. When adjusting for potential covariates, patients with ≥ 4 risk factors (208 patients) presented a higher risk for reintubation (OR 3.4 [95%CI 2.16-5.35]). Patients with ≥ 4 risk factors presented lower reintubation rates when treated with preventive NIV (23.9% vs 45.7%; P = 0.001). The multivariate analysis of overweight patients, adjusted for covariates, did not present a higher risk for reintubation (OR 1.37 [95%CI 0.82-2.29]). However, those overweight patients presented an increased risk for reintubation when treated with preventive HFNC (OR 2.47 [95%CI 1.18-5.15]). CONCLUSIONS: Patients with ≥ 4 risk factors for reintubation may benefit more from preventive NIV. Based on this result, HFNC may not be the optimal preventive therapy in overweight patients. Specific trials are needed to confirm these results.

Biologically Relevant Micellar Nanocarrier Systems for Drug Encapsulation and Functionalization of Metallic Nanoparticles.

The preparation of new and functional nanostructures has received more attention in the scientific community in the past decade due to their wide application versatility. Among these nanostructures, micelles appear to be one of the most interesting supramolecular organizations for biomedical applications because of their ease of synthesis and reproducibility and their biocompatibility since they present an organization similar to the cell membrane. In this work, we developed micellar nanocarrier systems from surfactant molecules derived from oleic acid and tetraethylene glycol that were able to encapsulate and in vitro release the drug dexamethasone. In addition, the designed micelle precursors were able to functionalize metallic NPs, such as gold NPs and iron oxide NPs, resulting in monodispersed hybrid nanomaterials with high stability in aqueous media. Therefore, a new triazole-derived micelle precursor was developed as a versatile encapsulation system, opening the way for the preparation of new micellar nanocarrier platforms for drug delivery, magnetic resonance imaging, or computed tomography contrast agents for therapeutic and diagnostic applications.

pH-temperature dual-sensitive nucleolipid-containing stealth liposomes anchored with PEGylated AuNPs for triggering delivery of doxorubicin.

Liposomes (Lip) are useful nanocarriers for drug delivery and cancer nanomedicine because of their ability to efficiently encapsulate drugs with different physical and chemical properties. The pH gradient between normal and tumoral tissues, and their rapid metabolism that induces hyperthermia encourage the development of pH- and thermo-sensitive Lip for delivering anticancer drugs. Nucleolipids have been studied as scaffolding material to prepare Lip, mainly for cancer therapy. Herein, we report for the first time the use of 1,2-dipalmitoyl-sn-glycero-3-(cytidine diphosphate) (DG-CDP) to develop pH/thermo-sensitive nucleolipid-containing stealth Lip stabilized by combination with 1,2-dipalmitoyl-sn-glycero-3-phosphocholine (DPPC) and cholesterol, anchored with NH2-PEGylated gold nanoparticles (PEG-AuNPs, 15 nm) for triggering delivery of doxorubicin (Dox). The optimal composition of DPPC, DG-CDP and cholesterol (94:3:3) was established by Langmuir isotherms. Unloaded and Dox-loaded Lip and AuNPs-Lip exhibited nano-scale sizes (415-650 nm), acceptable polydispersity indexes (<0.33), spherical shapes, and negative Z-potential (-23 to -6.6 mV) due to the phosphate groups of DG-CDP, which allowed the anchoring with positively charged AuNPs. High EE% were achieved (>78%) and although efficient control in the Dox release towards different receptor media was observed, the release of Dox from PEG-AuNPs-Lip-Dox was significantly triggered at acidic pH and hyperthermia conditions, demonstrating its responsiveness to both stimuli. Dox-loaded Lip showed high cytotoxic activity against MDA-MB-231 breast cancer cells and SK-OV-3 ovarian cancer cells, suggesting that Dox was released from these nanocarriers over time. Overall, the liposomal formulations showed promising properties as stimuli-responsive nanocarriers for cancer nanomedicine, with prospects for hyperthermia therapy.

Intensive Family Intervention as Support for Professional Treatment: Evolution of Symptoms in a Diagnosed Case of Autism Spectrum Disorder.

This article shows the progress achieved in a child who has received professional treatment combined with a family intervention at home. It discusses a 22-month-old patient identified as showing warning signs of autism spectrum disorder (ASD), a diagnosis that was subsequently confirmed through a standardized ADOS-2 test at 31 months of age. To establish the initial working objectives, a functional diagnosis was carried out at 23 months of age using the Battelle Developmental Inventory; a maturational delay was detected, situating the child at an age equivalent to 16 months. A professional intervention was designed in an early childhood care center, complemented by family intervention, so that the hours in which the child participated in learning experiences were increased. Notable advances were made in the areas of cognitive and motor skills, with more standard scores than when initially evaluated. Progress was also observed (though to a lesser extent) in other developmental areas such as language total, adaptive behavior, and self-help, while slight delays in the areas of socio-emotional development and reasoning and academic skills were found.

Preparation, Characterization and Evaluation of the Anti-Inflammatory Activity of Epichlorohydrin-ß-Cyclodextrin/Curcumin Binary Systems Embedded in a Pluronic®/Hyaluronate Hydrogel.

Curcumin (Cur) is an anti-inflammatory polyphenol that can be complexed with polymeric cyclodextrin (CD) to improve solubility and bioavailability. The aim of the present work was to prepare a CurCD hydrogel to treat inflammatory skin conditions. Epichlorohydrin-ß-CD (EpißCD) was used as polymeric CD. To characterize the binary system, solid-state and in-solution studies were performed. Afterwards, an experimental design was performed to optimize the hydrogel system. Finally, the CurEpißCD hydrogel system was tested for anti-inflammatory activity using a HaCat psoriasis cell model. Co-grinded Cur/EpißCD binary system showed a strong interaction and Curcumin solubility was much improved. Its combination with Pluronic® F-127/hyaluronate hydrogel demonstrated an improvement in release rate and Curcumin permeation. After testing its anti-inflammatory activity, the system showed a significant reduction in IL-6 levels. Hydrogel-containing CurEpißCD complex is a great alternative to treat topical inflammatory diseases.

Synergistic Effect of Acetazolamide-(2-hydroxy)propyl ß-Cyclodextrin in Timolol Liposomes for Decreasing and Prolonging Intraocular Pressure Levels.

The purpose of this study was to design, for the first time, a co-loaded liposomal formulation (CLL) for treatment of glaucoma including timolol maleate (TM) in the lipid bilayer and acetazolamide (Acz)-(2-hydroxy)propyl ß-cyclodextrin (HPßCD) complexes (AczHP) solubilized in the aqueous core of liposomes. Formulations with TM (TM-L) and AczHP (AczHP-L), separately, were also prepared and characterized. A preliminary study comprising the Acz/HPßCD complexes and their interaction with cholesterol (a component of the lipid bilayer) was realized. Then, a screening study on formulation factors affecting the quality of the product was carried out following the design of the experiment methodology. In addition, in vitro release and permeation studies and in vivo lowering intraocular pressure (IOP) studies were performed. The results of the inclusion complexation behavior, characterization, and binding ability of Acz with HPßCD showed that HPßCD could enhance the water solubility of Acz despite the weak binding ability of the complex. Ch disturbed the stability and solubility parameters of Acz due to the fact of its competence by CD; thus, Chems (steroid derivative) was selected for further liposome formulation studies. The optimization of the lipid bilayer composition (DDAB, 0.0173 mmol and no double loading) and the extrusion as methods to reduce vesicle size were crucial for improving the physico-chemical properties and encapsulation efficiency of both drugs. In vitro release and permeation studies demonstrated that the CLL formulation showed improvement in in vitro drug release and permeation compared to the liposomal formulations with a single drug (TM-L and AczHP-L) and the standard solutions (TM-S and AczHP-S). CLL showed high efficacy in reducing and prolonging IOP, suggesting that the synergistic effect of TM and Acz on aqueous humor retention and the presence of this cyclodextrin and liposomes as permeation enhancers are responsible for the success of this strategy of co-loading for glaucoma therapy.

Avances en las formulaciones de los antisépticos / Advances in antiseptic formulations

Objetivo: Revisar nuevas formulaciones antisépticas que minimicen los inconvenientes de las formulaciones convencionales y mejoren la efectividad los tratamientos actualmente usados. Metodología: Se ha realizado una búsqueda bibliográfica en diferentes bases de datos científicas, como Pubmed o Sciencedirect, entre otras, así como en artículos de revistas científicas, libros, tesis doctorales y páginas webs oficiales siguiendo siempre criterios de inclusión y exclusión previamente establecidos. Una vez seleccionados los artículos de interés mediante palabras clave, se procedió a la organización de los contenidos de la revisión. Resultados: Las formulaciones convencionales usadas en antisepsia presentan algunas limitaciones, como la formación de biopelículas por Staphylococcus aureus resistentes a meticilina (MRSA), la necesidad de conseguir un efecto más prolongado en el tiempo y la potenciación de la actividad microbiana debido a la resistencia a antisépticos, entre otros. Por este motivo, existen diversas líneas de investigación que intentan contrarrestar estas barreras mediante el diseño de nuevas formulaciones, como los sistemas de administración autoemulsionables de fármacos (SEDDS), sistemas formadores de película o usando la nanotecnología en forma de micelas cargadas con antisépticos, nanopartículas de organosílica mesoporosa o como nanopartículas de plata u ZnO que se combinan con polímeros como los hidrogeles o los poliuretanos para conseguir tratamientos más eficaces mejorando sus propiedades tanto antisépticas como mecánicas. Conclusiones: Las diferentes estrategias que se abordan en esta revisión presentan mejores propiedades antisépticas que las terapias convencionales, según se recoge en los artículos revisados. Por este motivo, seguramente formarán parte de la amplia gama de antisépticos en un futuro próximo. (AU)

Objective: To review new antiseptic formulations that minimize the drawbacks of conventional formulations and improve the effectiveness of currently used treatments. Methodology: A bibliographic search was carried out in different scientific databases, such as Pubmed or Science-direct, among others, as well as in articles of scientific journals, books, doctoral theses and official web pages, always following previously established inclusion and exclusion criteria. Once the articles of interest had been se-lected using keywords, the contents of the review were organized. Results: The conventional formulations used in antisepsis have some limitations, such as the formation of biofilms by methicillin-resistant Staphylococcus aureus (MRSA), the need to achieve a more prolonged effect over time and the potentiation of microbial activity due to resistance to antiseptics, among others. For this reason, there are sev-eral lines of research that attempt to counteract these barriers by designing new formulations such as self-emulsify-ing drug delivery systems (SEDDS), film-forming systems or using nanotechnology in the form of antiseptic-loaded micelles, mesoporous organosilica nanoparticles or as silver or ZnO nanoparticles that are combined with polymers such as hydrogels or polyurethanes to achieve more effective treatments by improving both their antiseptic and mechanical properties. Conclusions: The different strategies discussed in this review present better antiseptic properties than conven-tional therapies, as reported in the articles reviewed. For this reason, they will surely be part of the wide range of antiseptics in the near future. (AU)

Antibacterial effect of acetic acid during an outbreak of carbapenem-resistant Acinetobacter baumannii in an ICU (II).

INTRODUCTION: Acetic acid (AA) has been commonly used in medicine as an antiseptic agent for the past 6000 years. This study evaluated the antibacterial effect of AA during an outbreak in an intensive care unit (ICU) facility in Baja California Sur, México. METHODOLOGY: Thirty-five environmental samples were collected, subsequently, disinfection with AA (4%) was performed, and two days later the same areas were sampled inside the ICU facility. Carbapenem-resistant A. baumannii (CRAB) was detected with loop-mediated isothermal amplification assay (Garciglia-Mercado et al. companion paper), targeting blaOXA-23-like, blaOXA-24-like, blaOXA-51-like, blaOXA-58-like, blaIMP and blaVIM genes. CRAB isolates before and after disinfection were compared by PFGE. RESULTS: Eighteen (54.5%) and five (14.3%) of thirty-five environmental samples were identified as Acinetobacter baumannii before and after disinfection, respectively, showing a significant decrease of 85.7% (p < 0.05) both by Loop-mediated isothermal amplification (LAMP) and polymerase chain reaction (PCR). Furthermore, the presence of blaOXA-23-like and blaOXA-58-like genes significantly decreased (p < 0.05) both by LAMP and PCR methods. PFGE genotype showed high similarity among CRAB isolates before and after disinfection, suggesting wide clonal dissemination in the ICU facility. CONCLUSIONS: This study demonstrated the novel application of AA with the LAMP assays developed for detecting CRAB. AA promises to be a cheap and efficacious disinfectant alternative to both developed and especially developing countries, preventing the spread of this organism in the environment and to other susceptible patients in health care settings.

Cholesterol Levels Affect the Performance of AuNPs-Decorated Thermo-Sensitive Liposomes as Nanocarriers for Controlled Doxorubicin Delivery.

Stimulus-responsive liposomes (L) for triggering drug release to the target site are particularly useful in cancer therapy. This research was focused on the evaluation of the effects of cholesterol levels in the performance of gold nanoparticles (AuNPs)-functionalized L for controlled doxorubicin (D) delivery. Their interfacial and morphological properties, drug release behavior against temperature changes and cytotoxic activity against breast and ovarian cancer cells were studied. Langmuir isotherms were performed to identify the most stable combination of lipid components. Two mole fractions of cholesterol (3.35 mol% and 40 mol%, L1 and L2 series, respectively) were evaluated. Thin-film hydration and transmembrane pH-gradient methods were used for preparing the L and for D loading, respectively. The cationic surface of L allowed the anchoring of negatively charged AuNPs by electrostatic interactions, even inducing a shift in the zeta potential of the L2 series. L exhibited nanometric sizes and spherical shape. The higher the proportion of cholesterol, the higher the drug loading. D was released in a controlled manner by diffusion-controlled mechanisms, and the proportions of cholesterol and temperature of release media influenced its release profiles. D-encapsulated L preserved its antiproliferative activity against cancer cells. The developed liposomal formulations exhibit promising properties for cancer treatment and potential for hyperthermia therapy.

Influence of Perceived Environmental Quality on the Perceived Restorativeness of Public Spaces.

Parks and town squares can play an important role by offering spaces for cognitive restorativeness in urban contexts. Therefore, it is important that these spaces be designed in a way that encourages restorativeness. Indeed, their perceived quality should motivate users to stay and take advantage of them. Yet, it is not clear whether perceptions as to the quality of these spaces is relevant in promoting restorativeness. Thus, the aim of this study is to analyze whether elements of environmental quality perceived by users of public spaces favor restorativeness both in parks and squares. Environmental and social aspects are taken into consideration, since restorative experiences involve cognitive and physiological recovery, as well as a component of interaction with the environment. In this research, 519 users of 32 urban public spaces-town squares and parks-on the island of Tenerife (Spain) participated. Participants evaluated these spaces using four dimensions that focused on spaces' perceived environmental quality: design of spaces, care of spaces, social interaction, and presence of sensorial elements. Additionally, we evaluated the perceived restorativeness of each space. The results showed that the design of spaces, care of the spaces, social interaction, and presence of sensorial elements explain the variance in perceived restorativeness, although with different weights for parks and squares. We found that perceived quality of a space is a key predictor of its restorativeness. This means that maintaining parks and town squares is a relevant task given that they contribute to reducing cognitive overload, increasing sustainability, and facilitating health care in urban settings.

Amniotic membrane extract eye drops for ocular surface diseases: use and clinical outcome in real-world practice.

PURPOSE: To study the indications and clinical outcomes, in a real-word setting, of amniotic membrane extract eye drops (AMEED) use for ocular surface disease (OSD). METHODS: A retrospective study of patients treated with topical AMEED between January 2018 and January 2020 was conducted. Patients were classified in two groups according to specific OSD-dry eye disease (DED) and wound healing delay (WHD) groups. Demographics, comorbidities, treatment duration and clinical outcomes were analysed. RESULTS: A total of 50 eyes of 36 patients with or without previous treatments were included. Patients in the DED group presented more systemic comorbidities (83 vs 22%; p < 0.001) and spent more mean time under AMEED treatment (10 vs 7.2 months average) than the WHD group (p = 0.0104). In four patients, long-term treatment (more than 24 months) was reported. Global similar symptomatic improvement was reported for both groups (DED 88.9% vs WHD 100%; p = 0.486), with the WHD group especially consisting in general relief (78%) and the DED group reporting more pain improvement (44%) (p = 0.011). Regarding patients with autologous serum as a previous treatment, no statistical differences were found in subjective or objective improvement. An overall success was achieved in 94.4% of the cases and no adverse events were found. CONCLUSION: AMEED administration is a promising mean to treat OSD such as dry eye, persistent epithelial defect and corneal ulcers. Although AMEED may be effective in the treatment of severe DED and persistent epithelial defect or corneal ulcers, conclusions are limited owing to the absence of controlled clinical trials.