Genotypic and phenotypic characterization of resistance to fenhexamid, carboxin, and, prochloraz, in Botrytis cinerea isolates collected from cut roses in Colombia.

Gray mold, caused by Botrytis sp., is a significant disease in Colombian rose crops and its control depends primarily on the intensive use of chemically synthesized fungicides. Despite the importance of this pathogen, there is limited information in Colombian floriculture about molecular taxonomy of species, fungicide resistance of populations and their genetic mechanism of resistance. In this study, we analyze 12 isolates of this fungus collected from rose-producing crops in the Department of Cundinamarca and conducted phylogenetic analysis using HSP60, G3PDH, and RPB2 gene sequences. Additionally, we realize phenotypic and genotypic characterization of resistance to the fungicides fenhexamid, carboxin, and prochloraz, evaluating the in vitro EC50 and presence of mutations of target genes of each isolate. All isolates were characterized as Botrytis cinerea in the phylogenetic analysis and presents different levels of resistance to each fungicide. These levels are related to mutations in target genes, with predominancy of L195F and L400F in the ERG27 gene to fenhexamid resistance, H272R/Y in the SDHB gene for carboxin resistance, and Y136F in the CYP51 gene for prochloraz resistance. Finally, these mutations were not related to morphological changes. Collectively, this knowledge, presented for the first time to the Colombian floriculture, contribute to a better understanding of the genetic diversity and population of B. cinerea from rose-producing crops in the department of Cundinamarca, and serve as a valuable tool for making informed decisions regarding disease management, future research, and improving crop management and sustainability in the Colombian floriculture industry.

Morphological and transcriptional analysis of Colletotrichum lindemuthianum race 7 during early stages of infection in common bean.

The infection process of the hemibiotrophic fungus Colletotrichum lindemuthianum has been independently studied at the microscopic and genomic levels. However, the relationship between the morphological changes and the pathogenicity mechanisms of the fungus at the early stages of the infection remains uncharacterized. Therefore, this study attempts to bridge this gap by integrating microscopic and transcriptional approaches to understand the infection process of C. lindemuthianum. Fungal structures were followed by fluorescence microscopy for 120 hours. Simultaneously, the transcriptomic profile was made using RNAseq. Morphological characterization shows that appressoria, infective vesicles, and secondary hypha formation occur before 72 hours. Additionally, we assembled 38,206 transcripts with lengths between 201 and 3,548 bp. The secretome annotation revealed the expression of 1,204 CAZymes, of which 17 exhibited secretion domains and were identified as chitinases and ß-1,3-glucanases, 27 were effector candidates, and 30 were transport proteins mostly associated with ABC-type. Finally, we confirmed the presence and expression of CAC1 role during the appressoria formation of Clr7. This result represents the first report of adenylate cyclase expression evaluated under three different approaches. In conclusion, C. lindemuthianum colonizes the host through different infection structures complemented with the expression of multiple enzymes, where CAC1 favors disease development.

Photoprotective effect of topical treatment with Lopezia racemosa extract against deleterious UVB irradiation effects in the skin of hairless mice.

Lopezia racemosa is known as a "mosquito flower or perlilla." It is commonly found in corn crops. In traditional Mexican medicine, this plant is used to treat stomach cancer and urinary tract infections. Likewise, compounds and extracts isolated from plants have shown cytotoxic and anti-inflammatory effects. The objective of this study was to evaluate the photochemoprotective effect of topical treatment with the methanolic extract of L. racemosa (MELR) as a photochemoprotective agent against the harmful effects of UV irradiation (UVR) on a bacterial model and hairless mice. The MELR components were separated and analyzed via HPLC-UV-ESI-MS. Antioxidant activity was evaluated by the ability of MERL to scavenge DPPH and ABTS free radicals and by its FRAP capacity. The toxicity of MELR was evaluated in keratinocyte cultures. The photoprotective capacity of MELR was assessed through challenge experiments using models with bacteria and hairless CD1 et/et mice; cytokines related to the damage caused by UVR were also measured. In the methanolic extract of L. racemosa, five metabolites were detected and identified: two isomers of quercetin 6-C glycoside, orientin, quercetin 3-(6″-acetylglycoside) and quercetin 3-(6″-galloylglycoside) 7-(2,3-dihydroxytetrahydro-2H-pyran-4-yl acetate). MELR exhibited DPPH and ABTS radical scavenging properties, in addition to Fe ion reducing activity. MELR showed a photoprotective effect against UVB radiation-induced death in Escherichia coli bacteria. At the histological level, topical treatment of CD-1 et/et mice with MERL reduced the damage caused by UVR. Quantification of interleukins in the blood of mice revealed that the expression of IL-12 was greater in the control group treated with ultraviolet radiation than in the group protected with MELR. The methanolic extract of L. racemosa has photochemoprotective properties.

Hunger in French Guiana, an endemic plague worsened by the health crisis / La faim en Guyane française : un fléau endémique amplifié par la crise sanitaire

In 2020, food shortages occurred at the beginning of the confinement period that was supposed to curb the COVID-19 pandemic. In French Guiana, where a major part of the population lives under the poverty line, health workers voiced major concerns. Alongside massive food aid distributions, a first transversal study was carried out in August 2020 targeting poor neighborhoods in Cayenne. The results were particularly worrying. More than 80% of households had been suffering from hunger during that month, with a median decrease of 46% in revenue. Two other investigations followed in February and then in August of 2021. With the relaxing of the health measures, the situation improved in the Cayenne region, but two out of three were still affected, showing signs of quantitative deficiencies and insufficient food diversity. The situation seemed particularly grave for children. In light of this situation, we propose to create an observatory of food insecurity in Guiana, while maintaining this topic as a health priority. In addition, the fight against food insecurity cannot be limited to multi-sectorial material and strategic aide. It must be thought about in a more global manner, including health and social questions, territorial management policies, access to land and water, access to rights and social inclusion. Targeted actions helping the most exposed and vulnerable people is also an important stake, independent of the administrative situation and residency rights of the concerned people.

En 2020, des pénuries alimentaires sont survenues dès l'entrée en vigueur du confinement destiné à contrôler la pandémie de COVID-19. En Guyane Française, où une forte proportion de la population vivait déjà sous le seuil de pauvreté, des alertes préoccupantes ont émané d'acteurs de santé. En parallèle du déploiement d'une aide alimentaire massive, une première enquête transversale a été menée en août 2020, ciblant les quartiers précaires des environs de Cayenne. Les résultats étaient particulièrement inquiétants : plus de 80 % des ménages avaient souffert de la faim dans le mois, avec une baisse médiane de revenus de 46 %. Deux autres enquêtes ont suivi, en février, puis en août 2021. Avec l'allègement des mesures sanitaires, la situation s'était sensiblement améliorée dans la région de Cayenne, mais deux ménages sur trois restaient impactés, avec des carences quantitatives et une diversité alimentaire insuffisante. La situation semblait particulièrement critique parmi les enfants. Au vu de cette situation, nous proposons de créer un observatoire de l'insécurité alimentaire en Guyane, tout en maintenant ce sujet en tête des priorités sanitaires. En outre, la lutte contre l'insécurité alimentaire ne peut se limiter à l'aide matérielle : la stratégie, multisectorielle, doit être pensée en globalité, intégrant les problématiques sanitaires et sociales, les enjeux de l'aménagement du territoire, de l'accès à la terre et à l'eau, de l'accès aux droits et à l'insertion sociale. Un ciblage juste des actions vers les publics les plus exposés et vulnérables est également un enjeu important, indépendamment de la situation administrative et du droit au séjour des personnes concernées.

[Experience in COVID-19 in hospitalized patients in pediatric critical units during pandemic period]. / Experiencia en COVID-19 en pacientes hospitalizados en unidades de paciente crítico pediátrico durante el periodo pandémico.

OBJECTIVES: To characterize the COVID-19 disease profile in Chilean children hospitalized in pediatric intensive care units (PICU) and to evaluate risk factors associated with severe COVID-19. PATIENTS AND METHOD: A multicenter prospective cohort study with patients 0-18 years of age with confirmed SARS-CoV-2 hospitalized in PICU. Clinical, laboratory, imaging, and therapeutic variables were recorded. We compared "mild/moderate COVID-19" with ''severe COVID-19" using median with interquartile range (IQR), Mann-Whitney U test, two-tailed Fisher's test, and forward binary multivariate analysis to adjust variables for "severe COVID-19". A p < 0.05 was considered significant. RESULTS: From 16 PICUs, 219 patients were recruited, 55.3% were male, with a median age of 86 months (IQR: 13.5-156). The most frequent comorbidities were obesity and respiratory diseases. Overall mortality was 3.6%. "Severe COVID-19" (26.5%) showed more leukopenia, lymphopenia, increased inflammatory parameters, and altered organ function (p < 0.05). It also developed more sepsis/shock, ARDS, and organ dysfunction, requiring more hemodynamic, anti-inflammatory, anticoagulation, and antibiotic therapy, with a longer stay in the PICU/hospital (p < 0.05), and 13.8% of mortality. Risk factors associated with "severe COVID-19" were shock on admission to the PICU [aOR 28.44 (95%CI 10.45-77.4)], obesity [aOR 3.55 (95%CI 1.3-9.6)], consolidation [aOR 3.1 (95%CI 1.1 -8.7)], atelectasis [aOR: 8.7 (95%CI 1.17-64.3)], stress dose of corticosteroids [aOR 7.7 (95%CI 1.9-30.6)], early antibiotic therapy [aOR: 12.02 (95%CI 1.11-130.02)], acquired/congenital immunodeficiency [aOR: 19.2 (95%CI: 1.19-321)], and oncological pathology [aOR 10.7 (95%CI 2.14-47.8)]. CONCLUSION: In this Chilean pediatric cohort, most patients with COVID-19 admitted to de PICU were male, of school age, with associated comorbidity. Risk factors for developing severe COVID-19 were the presence of comorbidities such as acquired/congenital immunodeficiency, oncological pathology, and obesity, in addition to shock on admission and consolidations on X-rays.

Development of a lumbar puncture virtual simulator for medical students training: A preliminary evaluation.

BACKGROUND: Lumbar puncture is an essential medical procedure whose objective is to obtain cerebrospinal fluid. Lumbar puncture is considered a complex procedure, mainly for novice residents who suffer from stress and low confidence, which may result in harm to the patient. METHODS: The LPVirSim, has been developed in four stages: i) requirements analysis through user-centred design; ii) prototyping of the virtual environment and the haptic component; iii) preliminary tests with Ph.D. students and physicians using two haptic devices (Omega.7 and Sigma.7); iv) a user study where physicians evaluated the usability and user experience. RESULTS: The LPVirSim integrates non-technical skills and the possibility of representing different patients for training. Usability increased from 61.76 to 68.75 in the preliminary tests to 71.43 in the user study. CONCLUSIONS: All the results showed good usability and demonstrated that the simulator arouses interest and realistically represents a Lumbar puncture, through the force and visual feedback.

Extra-legal abortion and post-abortion care knowledge, attitudes, and practices among obstetrician-gynecologist clinicians and medical residents in San José, Costa Rica: a qualitative study.

BACKGROUND: Induced abortion in Costa Rica is illegal in all cases except to save the life of the pregnant person. Despite severe restrictions to legal abortion, individuals in Costa Rica still induce abortions outside of the formal healthcare system. These individuals and those with spontaneous abortions, also known as miscarriages, occasionally need medical care for complications. In Costa Rica, an estimated 41% of unintended pregnancies end in abortion, yet there is very little published literature exploring the perspectives of healthcare providers on abortion in Costa Rica. METHODS: We interviewed ten obstetrician-gynecologist clinicians and five obstetrician-gynecologist medical residents in San José, Costa Rica about their beliefs and practices related to extra-legal abortion and post-abortion care (PAC) using a Spanish language in-depth semi-structured interview guide. After transcription and translation into English, analysis team pairs used a combination of deductive and inductive coding to identify themes and sub-themes within the data. RESULTS: Obstetrician-gynecologist clinicians and medical residents were aware of the presence of extra-legal abortion, and particularly, medication abortion, in their communities, but less familiar with dosing for induction. They expressed the desire to provide non-judgmental care and support their patients through extra-legal abortion and PAC journeys. Study participants were most familiar with providing care to individuals with spontaneous abortions. When discussing PAC, they often spoke about a policy of reporting individuals who seek PAC following an extra-legal abortion, without commenting on whether or not they followed the guidance. CONCLUSIONS: This study contributes to a gap in research about the knowledge, attitudes, and practices of Costa Rican obstetrician-gynecologist clinicians and medical residents around extra-legal abortion and PAC. The results reveal an opportunity to train these healthcare providers as harm reduction experts, who are able to accurately counsel individuals who are seeking abortion services outside of the healthcare system, and to provide training to improve care for individuals needing PAC.

Studying the microbiome of suppressive soils against vascular wilt, caused by Fusarium oxysporum in cape gooseberry (Physalis peruviana).

Cape gooseberry (Physalis peruviana) is Colombia's second most exported fruit, with a market worth 37.8 million USD in 2021. Fusarium oxysporum f sp. physalis (Foph) is arguably the most devastating pathogen causing losses of up to 80%. Managing this disease is challenging due to pathogen resistance or the reduced efficacy of commercial fungicides and the production of resistant structures allowing pathogen survival in the soil for up to 30 years. Thus, new methods of control are necessary. Two cape gooseberry farms (organic vs. conventional) were detected free from Foph in Nariño. We hypothesize that the soil microbiome might have a suppressive effect against vascular wilt, caused by Foph. To test this, farm soils were propagated by adding 10% farm soil and 90% peat soil. Then, peat soil (control) and propagated soils were inoculated with Foph. A decrease of 65%-68% in disease incidence and a 70% in disease severity reduction was observed in seedlings grown in propagated soils compared to peat soil. We then used next-generation sequencing to study the soil microbiome to understand the possible mechanisms for disease suppression of propagated soils. We conclude that despite the high diversity of soil microbiomes, the relative abundance of some taxa might be a more important indicator of disease suppression than the presence of specific taxa.

Hunger in French Guiana's Vulnerable Urban Neighborhoods: A Neglected Consequence of COVID-19.

BACKGROUND: In French Guiana, restrictions to control the spread of SARS-CoV-2 were put in place between March 2020 and March 2022. In vulnerable urban neighborhoods, during this period, requests for food assistance increased and fear of hunger overtook fear of being affected by COVID-19. OBJECTIVE: The objective of this survey was to describe food security during the COVID-19 pandemic in French Guiana and to study the relationship between the socioeconomic conditions of the study households and household hunger. METHODS: A multicenter survey was therefore conducted in mobile clinics and fixed structures providing care to at-risk urban populations. In a face-to-face interview, a community health worker asked participants questions about the sociodemographic and economic profile of the household, and about household food security (food consumption score, coping strategies in the face of food shortages, and household hunger index). Two hundred seventy-seven households were recruited in February 2021. RESULTS: According to the household hunger scale, 42.6% of households experienced moderate hunger and 23.8% of households experienced severe hunger in the month preceding the survey. Lack of residence permit, lack of social support, water insecurity, small housing, and lack of access to an urban garden were determinants related to the risk of household hunger. CONCLUSIONS: Food insecurity has affected a large majority of the households in this survey, and the immediate consequences for children's health were already apparent. These results draw attention to a neglected health problem in a socioeconomically vulnerable population during the COVID-19 pandemic.

Flow Diverter Treatment for Non-Ruptured Carotid Aneurysms: Efficacy and Safety.

PURPOSE: Internal carotid artery (ICA) aneurysm treatment with a flow diverter (FD) has shown an adequate efficacy and safety profile, presenting high complete occlusion or near occlusion rates with low complications during follow-up. The purpose of this study was to evaluate the efficacy and safety of FD treatment in non-ruptured internal carotid aneurysms. MATERIALS AND METHODS: This is a retrospective, single-center, observational study evaluating patients diagnosed with unruptured ICA aneurysms treated with an FD between January 1, 2014, and January 1, 2020. We analyzed an anonymized database. The primary effectiveness endpoint was complete occlusion (O'Kelly-Marotta D, OKM-D) of the target aneurysm through 1-year follow-up. The safety endpoint was the evaluation of modified Rankin Scale (mRS) 90 days after treatment, considering a favorable outcome an mRS 0-2. RESULTS: A total of 106 patients were treated with an FD, 91.5% were women; the mean follow- up was 427.2±144.8 days. Technical success was achieved in 105 cases (99.1%). All patients included had 1-year follow-up digital subtraction angiography control; 78 patients (73.6%) completed the primary efficacy endpoint by achieving total occlusion (OKM-D). Giant aneurysms had a higher risk of not achieving complete occlusion (risk ratio, 3.07; 95% confidence interval, 1.70 - 5.54]). The safety endpoint of mRS 0-2 at 90 days was accomplished in 103 patients (97.2%). CONCLUSION: Treatment of unruptured ICA aneurysms with an FD showed high 1-year total occlusion results, with very low morbidity and mortality complications.

CADMA-Chem: A Computational Protocol Based on Chemical Properties Aimed to Design Multifunctional Antioxidants.

A computational protocol aimed to design new antioxidants with versatile behavior is presented. It is called Computer-Assisted Design of Multifunctional Antioxidants and is based on chemical properties (CADMA-Chem). The desired multi-functionality consists of in different methods of antioxidant protection combined with neuroprotection, although the protocol can also be used to pursue other health benefits. The dM38 melatonin derivative is used as a study case to illustrate the protocol in detail. This was found to be a highly promising candidate for the treatment of neurodegeneration, in particular Parkinson's and Alzheimer's diseases. This also has the desired properties of an oral-drug, which is significantly better than Trolox for scavenging free radicals, and has chelates redox metals, prevents the ●OH production, via Fenton-like reactions, repairs oxidative damage in biomolecules (lipids, proteins, and DNA), and acts as a polygenic neuroprotector by inhibiting catechol-O-methyl transferase (COMT), acetylcholinesterase (AChE) and monoamine oxidase B (MAOB). To the best of our best knowledge, CADMA-Chem is currently the only protocol that simultaneously involves the analyses of drug-like behavior, toxicity, manufacturability, versatile antioxidant protection, and receptor-ligand binding affinities. It is expected to provide a starting point that helps to accelerate the discovery of oral drugs with the potential to prevent, or slow down, multifactorial human health disorders.

Chemical profile, antimicrobial activity, and leaf anatomy of Adenophyllum porophyllum var. cancellatum.

Adenophyllum porophyllum var. cancellatum, known as "árnica del monte" in Mexico, is an aromatic annual plant belonging to the Asteraceae family that grows from southern Arizona to central Mexico. The aerial parts of the plant are used in traditional medicine to treat skin diseases such as irritations, infections, and wounds. In this study, the essential oil of this plant was characterized, and its antimicrobial activity was evaluated. This species has large glands in its leaves; therefore, for quality control purposes, an anatomical study of the leaves was performed. The essential oil was isolated from the aerial parts of the plant through hydro-distillation and analyzed using a gas chromatography/mass spectrometry (GC/MS) system. Its anti-yeast activity was evaluated against three Candida species and ten bacterial strains using the disk diffusion technique. The minimum inhibitory concentration (MIC), minimum fungicidal concentration (MFC), and minimum bactericidal concentration (MBC) were determined using broth microdilution. Anatomical study was performed on the middle part of the leaf. A yield of 0.5% of the essential oil was obtained from the herb, and Eighteen compounds in the essential oil were identified, within them trans pinocamphone (29.5%), limonene (24.7%), pinocarvone (21.8%), and cis pinocamphone (8.0%) were the main components. The inhibition zones were between 10 mm and 20 mm, and the MIC and MFC against the three Candida species ranged from 60 to 500 µg/ml. The leaf anatomy showed anisocytic stomata, simple and glandular trichomes of different types, and large and elliptical-shaped lysigenous glands, which can be used for taxonomic identification. The A. porophyllum var. cancellatum essential oil can serve as an alternative source of natural antimicrobial agents as an affordable approach to control infectious diseases. This is the first study that reports the chemical composition and antimicrobial activity of the essential oil, as well as the leaf anatomy of this species.

Sexual vulnerability of migrant women in the multicultural context of French Guiana: A societal issue.

Background: French Guiana is a multicultural French territory in Amazonia with an old migration history and a high prevalence of HIV infection. The objective of this study was to evaluate situations of sexual vulnerability and their associated factors among migrant women in French Guiana. Methods: A cross-sectional epidemiological study was carried out in 2021 in the French Red Cross Prevention and Health Centers of the two main cities of French Guiana (Cayenne and Saint Laurent du Maroni). Analysis was performed with multivariate stepwise logistic regression using Stata 15.0 software. Findings: A total of 382 migrant women were included, with a median age of 31 years, mainly born in Haiti (80%), Suriname (9%), or Dominican Republic (6%), undocumented (71%), and with financial difficulties (77%). Among the 20% having casual partners, 57% reported unprotected sexual intercourse, more often the Haitian and Surinamese women. A history of rape was reported by 20% of women, most often in the country of origin (71%). Lifetime rape was associated with being threatened [aOR = 3.69 (1.96-6.96)] or being physically abused [aOR = 12.95 (6.51-25.75)] in the multivariate analysis. Among the women surveyed, 30% reported having ever exchanged sex for money, food, or shelter in their lifetime. Transactional sex is more common among Dominican women [aOR = 5.59 (1.84-16.95)] and women living in French Guiana for more than 2 years [aOR = 2.32 (1.38-3.92)]. Transactional sex is also associated with alcohol misuse [aOR = 2.57 (1.46-4.53)], history of threats [aOR = 2.03 (1.14-3.63)], history of rape [aOR = 1.92 (1.03-3.60)], and depressive disorders [aOR = 2.08 (1.21-3.60)]. Interpretation: Migrant women in French Guiana are in a situation of sexual vulnerability. An intervention focused on sexual education and the promotion of prevention tools among Haitian women is advisable. Better prevention and support for transactional sex are needed to prevent violence and its mental health and alcohol misuse consequences for all women, especially Dominican women.

[Comparison of a community-based nutritional intervention and a conventional nutritional intervention in Mayan communities in Mexico]. / Comparación de una intervención nutricional basada en la comunidad y una intervención nutricional convencional en localidades mayas de México.

Poor nutritional conditions persist in many Mayan communities in Yucatán, Mexico, even though various programs have been implemented. The study aimed to compare the effects of a community-based nutritional intervention with an intercultural focus versus a conventional nutritional intervention on body mass index (BMI) and diet in women in Mayan communities in Yucatán. The sample included adult women with BMI ≥ 25kg/m2 from neighboring rural Mayan villages. Both interventions lasted three months with 11 sessions and followed the prevailing guidelines. The community-based intervention used an intercultural tool called Good Mayan Food [Plato del Bien Comer Maya], besides strategies designed according to information obtained from a prior qualitative study phase using interviews. The group that received the community-based intervention (n = 7), compared to the conventional intervention group (n = 9), showed larger decreases in BMI (-0.58 ± 0.70 kg/m2 and +0.27 ± 0.64kg/m2; p = 0.042), waist circumference (-2.15 ± 2.60 cm and -0.50 ± 0.75 cm; p = 0.042), and consumption of fats (-53.23 ± 21.92 grams and -7.34 ± 25.77 grams; p = 0.004), as well as higher increases in weekly consumption of some local foods such as nance fruit (p = 0.012), tamarind (p = 0.001), and chili peppers (p = 0.004). The community-based intervention was the only one to show a significant decrease in daily calorie intake (baseline: 2,067 ± 91 kcal/day, at three months: 1,474 ± 31 kcal/day; p = 0.018), and both groups showed decreases in the consumption of ultra-processed foods, but without significant differences between the two groups. The community-based intervention group showed better results than the conventional intervention group.

Las malas condiciones nutricionales en muchas localidades mayas de Yucatán, México, persisten, a pesar de que se han implementado diversos programas. El objetivo fue comparar los efectos de una intervención nutricional basada en la comunidad con enfoque intercultural (INBC) y una intervención nutricional convencional (INC), sobre el índice de masa corporal (IMC) y la dieta en mujeres de localidades mayas de Yucatán. Fueron incluidas mujeres adultas con IMC ≥ 25kg/m2 de dos pequeñas localidades rurales mayas vecinas. Ambas intervenciones fueron de tres meses y con 11 sesiones, siguiendo la normatividad vigente; en la INBC fue utilizada la herramienta intercultural, denominada Plato del Bien Comer Maya, además se incluyeron en la INBC estrategias diseñadas con base en información obtenida en una fase previa de estudio cualitativo con entrevistas. El grupo con la INBC (n = 7), en comparación con el grupo con la INC (n = 9), tuvo una mayor disminución de IMC (-0,58 ± 0,70 kg/m2 y +0,27 ± 0,64 kg/m2; p = 0,042), de la circunferencia de cintura (-2,15 ± 2,60 cm y -0,50 ± 0,75 cm; p = 0,042) y del consumo de grasas (-53,23 ± 21,92 gramos y -7,34 ± 25,77 gramos; p = 0,004), así como mayor incremento en las frecuencias semanales de consumo de algunos alimentos locales como nance (p = 0,012), tamarindo (p = 0,001) y chile (p = 0,004), la INBC fue la única que presentó una disminución significativa en el consumo diario de calorías (basal: 2.067 ± 91 kcal/día, a los tres meses: 1.474 ± 31 kcal/día; p = 0,018), hubo en ambos grupos disminuciones en el consumo de alimentos ultraprocesados, pero sin diferencias comparando los grupos; el grupo con la INBC obtuvo mejores resultados que el grupo con la INC.

As más condições nutricionais em muitas localidades maias de Yucatán (México) persistem apesar da implementação de diversos programas. O objetivo era comparar os impactos de uma intervenção nutricional baseada na comunidade com enfoque intercultural (INBC) e uma intervenção nutricional convencional (INC), sobre o índice de massa corporal (IMC) e a dieta de mulheres de localidades maias de Yucatán. Foram incluídas mulheres adultas com IMC ≥ 25kg/m2 de duas pequenas localidades rurais maias vizinhas. Ambas as intervenções duraram três meses e contaram com 11 sessões, conforme as normas vigentes; na INBC, foi utilizada a ferramenta intercultural denominada Prato de Comer Bem Maia [Plato del Bien Comer Maya], além de estratégias adicionais idealizadas com base em dados obtidos em uma fase prévia de estudo qualitativo com entrevistas. Em comparação com o grupo com a INC (n = 9), o grupo com a INBC (n = 7) teve maior diminuição de IMC (-0,58 ± 0,70 kg/m2 e +0,27 ± 0,64 kg/m2; p = 0,042), da circunferência abdominal (-2,15 ± 2,60 cm y -0,50 ± 0,75 cm; p = 0,042) e do consumo de gorduras (-53,23 ± 21,92 gramas y -7,34 ± 25,77 gramas; p = 0,004), bem como um aumento maior das frequências semanais de consumo de alguns alimentos locais como o murici (p = 0,012), o tamarindo (p = 0,001) e pimenta (p = 0,004). A INBC foi a única a apresentar uma diminuição significativa do consumo diário de calorias (inicial: 2.067 ± 91 kcal/dia, após três meses: 1.474 ± 31 kcal/dia; p = 0.018). Houve em ambos os grupos redução equivalente do consumo de alimentos ultraprocessados; o grupo com a INBC obteve melhores resultados que o grupo com a INC.

Towards a Non-Contact Method for Identifying Stress Using Remote Photoplethysmography in Academic Environments.

Stress has become a common condition and is one of the chief causes of university course disenrollment. Most of the studies and tests on academic stress have been conducted in research labs or controlled environments, but these tests can not be extended to a real academic environment due to their complexity. Academic stress presents different associated symptoms, anxiety being one of the most common. This study focuses on anxiety derived from academic activities. This study aims to validate the following hypothesis: by using a non-contact method based on the use of remote photoplethysmography (rPPG), it is possible to identify academic stress levels with an accuracy greater than or equal to that of previous works which used contact methods. rPPG signals from 56 first-year engineering undergraduate students were recorded during an experimental task. The results show that the rPPG signals combined with students' demographic data and psychological scales (the State-Trait Anxiety Inventory) improve the accuracy of different classification methods. Moreover, the results demonstrate that the proposed method provides 96% accuracy by using K-nearest neighbors, J48, and random forest classifiers. The performance metrics show better or equal accuracy compared to other contact methods. In general, this study demonstrates that it is possible to implement a low-cost method for identifying academic stress levels in educational environments.

Prevalencia y factores asociados con los resultados espirométricos en trabajadores expuestos a sustancias químicas

Objetivo: Analizar la prevalencia y los factores asociados con los patrones espirométricos de trabajadores expuestos a sustancias químicas. Materiales y métodos: Estudio descriptivo correlacional, diseño no experimental, con abordaje cuantitativo, realizado en una muestra censal de 515 trabajadores expuestos a sustancias químicas laborales. La recolección de la información se realizó mediante pruebas espirométricas con equipos Spirolab III, previamente calibrado y siguiendo el protocolo convencional. El análisis estadístico se realizó con SPSS.25 utilizando medidas de tendencia central, de dispersión e índice de correlación de Pearson para muestras paramétricas. Se respetaron los principios éticos para la investigación en humanos. Resultados: La prevalencia de alteraciones crónicas compatible con patrón obstructivo fue de 7,60 % y restrictivo de 1,00 %. Los factores con asociación positiva fueron la edad, el sexo, la exposición a sustancias químicas y el hábito de fumar. Conclusiones: Se encontró menor prevalencia que la descrita en otros estudios, además se identificó asociación con factores sociodemográficos, hábitos y laborales.

Objective: To analyze the prevalence and the factors associated with the spirometric patterns of workers exposed to chemical substances. Materials and methods: Descriptive correlational study, non-experimental design, with a quantitative approach, carried out in a census sample of 515 workers exposed to occupational chemicals. The collection of the sample was carried out using spirometric tests with Spirolab III equipment, previously calibrated and following the conventional protocol. Statistical analysis was performed with SPSS.25 using measures of central tendency, dispersion and Pearson's correlation index, for parametric samples. The ethical principles for research in humans were respected. Results: The prevalence of chronic alterations compatible with an obstructive pattern was 7.60 % and restrictive 1.00 %. Factors with a positive association were age, sex, exposure to chemicals, and smoking. Conclusions: A lower prevalence was found than that described in other studies, and an association with sociodemographic, habit and work factors was also identified.

Validation of the COVID-19 Fear Scale modified for application during the perinatal period.

PURPOSE: The COVID-19 Fear Scale (FCV-19S) allows screening in general population; however, there is no specific instrument in our population for screening in the perinatal period that considers fear related with COVID-19 and offspring well-being. We aimed to validate the FCV-19S modified for application during the perinatal period. MATERIALS AND METHODS: Analytical, cross-sectional design. After signing consent, women 18-45 years were included. Internal consistency was calculated with Cronbach's alpha, external validity using the Hospital Anxiety and Depression Scale (HADS), factorial analysis and intraclass correlation coefficient for re-test. RESULTS: The sample included 178 women, mean age 31.04 ± 5.9. We obtained internal consistency with Cronbach's alpha = 0.873 (95%CI, 0.842-0.899). Spearman's Rho coefficient was 0.207 (p= .013). All the elements were statistically significant for the polychoric correlation (p<.001). Reliability test-retest with intraclass correlation was 0.873. CONCLUSIONS: The version of FCV-19S modified with eight items is a valid measurement instrument for application during the perinatal period, showing adequate internal consistency and external validity with HADS as measure of concurrence to identify anxiety related with COVID-19 during the perinatal period.

Stem-cell transplantation for children with primary immune deficiencies: A retrospective study of 19 patients from one centre in Mexico.

INTRODUCTION: For many patients with primary immune deficiency (PID), stem-cell transplantation (SCT) may be life-saving. OBJECTIVE: To review our experience of 11 years transplanting children with PID in Mexico. METHODS: Chart review of patients who underwent SCT from 2008 to 2018, to describe their diagnoses, time to transplant, conditioning regime, survival rate and outcomes. All patients received post-transplant cyclophosphamide as graft-versus-host-disease (GVHD) prophylaxis. RESULTS: 19 patients with combined, phagocytic or syndromic PID from 5 states. Twelve of them were male (58%) and 14 survive (79%). Mean age at HSCT was 41.9 months; mean time from diagnosis was 31.2 months. Seven grafts were umbilical cord and 12 haploidentical. The conditioning regime was myeloablative, with five primary graft failures. Two patients had partial and 10 full chimerism. Five patients died within 2 months after transplant. Immune reconstitution was complete in 11 of 19 patients. We found a prevalence of 21% GVHD. DISCUSSION: We describe 19 patients from Mexico with 8 PID diagnoses who underwent allogenic HSCT over a period of 11 years. Survival rate and other outcomes compare well with industrialized countries. We recommend the use of post-transplant cyclophosphamide to prevent GVHD in scenarios of resource scarcity and a lack of HLA-identical donors.

Cuidados paliativos y su influencia en la calidad de vida de pacientes con insuficiencia cardíaca / Palliative care and its influence on the quality of life of patients with heart failure

La insuficiencia cardíaca congestiva es parte importante de la morbimortalidad mundial. Estos pacientes pierden calidad de vida de manera considerable, particularmente por su trayecto impredecible. Los cuidados paliativos representan una oportunidad para mejorar el control sintomático y prevenir reingresos hospitalarios, especialmente en las fases avanzadas de la enfermedad (New York Heart Association III-IV). El objetivo de esta revisión es determinar la influencia de los cuidados paliativos en la calidad de vida de los pacientes con insuficiencia cardíaca en enfermedad avanzada, puesto que se ha demostrado que sufren múltiples hospitalizaciones: 84% tendrá ≥1 en sus últimos 12 meses de vida, y el reingreso hospitalario a los 30 días posteriores al alta circunda 20-50 %. En general, reciben menos cuidados paliativos que los pacientes oncológicos, y al recibirlos lo hacen presentando una menor funcionalidad (p<0,001). Al implementar los cuidados paliativos aumenta la calidad de vida (p=0,03) y mejoran la depresión (p=0,02), la ansiedad (p=0,048) y la frecuencia de reingresos hospitalarios en comparación con el manejo usual, 33,63 % vs. 61 %, y visitas a emergencias, 35,0 % vs. 60,0 %. Múltiples evidencias señalan que la mortalidad no es influenciada (p>0,19, p>0,22). Según la bibliografía, se concluye que los cuidados paliativos deben ser implementados desde el diagnóstico de esta patología, puesto que ofrecen una mayor calidad de vida, especialmente en enfermedad avanzada

Congestive heart failure is an important part of global morbidity and mortality. These patients lose quality of life considerably, particularly due to their unpredictable path. Palliative care represents an opportunity to improve symptom control and prevent hospital readmissions, especially in the advanced stages of the disease (New York Heart Association III-IV). The objective of this review is to determine the influence of palliative care on the quality of life of patients with heart failure in advanced disease, since it has been shown that they suffer multiple hospitalizations: 84% will have ≥1 in their last 12 months of life, and hospital readmission 30 days after discharge is around 20-50%. In general, they receive less palliative care than cancer patients, and when they receive it they do so with less functionality (p<0.001). When implementing palliative care, quality of life increases (p=0.03) and depression (p=0.02), anxiety (p=0.048) and the frequency of hospital readmissions improve compared to usual management, 33 .63%vs. 61%, and ER visits, 35.0% vs. 60.0%. Multiple pieces of evidence indicate that mortality is not influenced (p>0.19, p>0.22). According to the bibliography, it is concluded that palliative care should be implemented from the diagnosis of this pathology, since it offers a better quality of life, especially in advanced disease

Comparación de una intervención nutricional basada en la comunidad y una intervención nutricional convencional en localidades mayas de México / Comparison of a community-based nutritional intervention and a conventional nutritional intervention in Mayan communities in Mexico / Comparação entre uma intervenção nutricional baseada na comunidade e uma intervenção nutricional convencional em localidades maias de México

Las malas condiciones nutricionales en muchas localidades mayas de Yucatán, México, persisten, a pesar de que se han implementado diversos programas. El objetivo fue comparar los efectos de una intervención nutricional basada en la comunidad con enfoque intercultural (INBC) y una intervención nutricional convencional (INC), sobre el índice de masa corporal (IMC) y la dieta en mujeres de localidades mayas de Yucatán. Fueron incluidas mujeres adultas con IMC ≥ 25kg/m2 de dos pequeñas localidades rurales mayas vecinas. Ambas intervenciones fueron de tres meses y con 11 sesiones, siguiendo la normatividad vigente; en la INBC fue utilizada la herramienta intercultural, denominada Plato del Bien Comer Maya, además se incluyeron en la INBC estrategias diseñadas con base en información obtenida en una fase previa de estudio cualitativo con entrevistas. El grupo con la INBC (n = 7), en comparación con el grupo con la INC (n = 9), tuvo una mayor disminución de IMC (-0,58 ± 0,70 kg/m2 y +0,27 ± 0,64 kg/m2; p = 0,042), de la circunferencia de cintura (-2,15 ± 2,60 cm y -0,50 ± 0,75 cm; p = 0,042) y del consumo de grasas (-53,23 ± 21,92 gramos y -7,34 ± 25,77 gramos; p = 0,004), así como mayor incremento en las frecuencias semanales de consumo de algunos alimentos locales como nance (p = 0,012), tamarindo (p = 0,001) y chile (p = 0,004), la INBC fue la única que presentó una disminución significativa en el consumo diario de calorías (basal: 2.067 ± 91 kcal/día, a los tres meses: 1.474 ± 31 kcal/día; p = 0,018), hubo en ambos grupos disminuciones en el consumo de alimentos ultraprocesados, pero sin diferencias comparando los grupos; el grupo con la INBC obtuvo mejores resultados que el grupo con la INC.

Poor nutritional conditions persist in many Mayan communities in Yucatán, Mexico, even though various programs have been implemented. The study aimed to compare the effects of a community-based nutritional intervention with an intercultural focus versus a conventional nutritional intervention on body mass index (BMI) and diet in women in Mayan communities in Yucatán. The sample included adult women with BMI ≥ 25kg/m2 from neighboring rural Mayan villages. Both interventions lasted three months with 11 sessions and followed the prevailing guidelines. The community-based intervention used an intercultural tool called Good Mayan Food [Plato del Bien Comer Maya], besides strategies designed according to information obtained from a prior qualitative study phase using interviews. The group that received the community-based intervention (n = 7), compared to the conventional intervention group (n = 9), showed larger decreases in BMI (-0.58 ± 0.70 kg/m2 and +0.27 ± 0.64kg/m2; p = 0.042), waist circumference (-2.15 ± 2.60 cm and -0.50 ± 0.75 cm; p = 0.042), and consumption of fats (-53.23 ± 21.92 grams and -7.34 ± 25.77 grams; p = 0.004), as well as higher increases in weekly consumption of some local foods such as nance fruit (p = 0.012), tamarind (p = 0.001), and chili peppers (p = 0.004). The community-based intervention was the only one to show a significant decrease in daily calorie intake (baseline: 2,067 ± 91 kcal/day, at three months: 1,474 ± 31 kcal/day; p = 0.018), and both groups showed decreases in the consumption of ultra-processed foods, but without significant differences between the two groups. The community-based intervention group showed better results than the conventional intervention group.

As más condições nutricionais em muitas localidades maias de Yucatán (México) persistem apesar da implementação de diversos programas. O objetivo era comparar os impactos de uma intervenção nutricional baseada na comunidade com enfoque intercultural (INBC) e uma intervenção nutricional convencional (INC), sobre o índice de massa corporal (IMC) e a dieta de mulheres de localidades maias de Yucatán. Foram incluídas mulheres adultas com IMC ≥ 25kg/m2 de duas pequenas localidades rurais maias vizinhas. Ambas as intervenções duraram três meses e contaram com 11 sessões, conforme as normas vigentes; na INBC, foi utilizada a ferramenta intercultural denominada Prato de Comer Bem Maia [Plato del Bien Comer Maya], além de estratégias adicionais idealizadas com base em dados obtidos em uma fase prévia de estudo qualitativo com entrevistas. Em comparação com o grupo com a INC (n = 9), o grupo com a INBC (n = 7) teve maior diminuição de IMC (-0,58 ± 0,70 kg/m2 e +0,27 ± 0,64 kg/m2; p = 0,042), da circunferência abdominal (-2,15 ± 2,60 cm y -0,50 ± 0,75 cm; p = 0,042) e do consumo de gorduras (-53,23 ± 21,92 gramas y -7,34 ± 25,77 gramas; p = 0,004), bem como um aumento maior das frequências semanais de consumo de alguns alimentos locais como o murici (p = 0,012), o tamarindo (p = 0,001) e pimenta (p = 0,004). A INBC foi a única a apresentar uma diminuição significativa do consumo diário de calorias (inicial: 2.067 ± 91 kcal/dia, após três meses: 1.474 ± 31 kcal/dia; p = 0.018). Houve em ambos os grupos redução equivalente do consumo de alimentos ultraprocessados; o grupo com a INBC obteve melhores resultados que o grupo com a INC.