Recent Advances in the Preparation and Application of Biochar Derived from Lignocellulosic Biomass: A Mini Review.

With the rapid growth in the global population and the accelerating pace of urbanization, researching and developing novel strategies for biomass utilization is significant due to its potential for use in renewable energy, climate change mitigation, waste management, and sustainable agriculture. In this environmental context, this review discusses the recent advances in biomass conversion technologies for biochar production, including the first carbonization process and the subsequent activation methods of the biochar derived from lignocellulosic biomass (LBC). Parallel to this, this review deals with other essential parameters in biochar production, such as feedstock types, reaction environments, and operating conditions in the pyrolysis process, to determine the production and composition of LBC. Moreover, the wide-ranging applications of LBC in areas such as adsorption, catalysts, and energy storage are discussed, offering sustainable and environmentally friendly alternatives while reducing reliance on traditional energy sources and mineral resources, thereby providing practical solutions to environmental and energy challenges. Overall, this review not only provides a comprehensive comparative analysis of different LBC preparation methods, but also facilitates a deeper understanding of the advantages and limitations of these methodologies when it comes to developing high-value materials for sustainable applications.

Efectos de la pandemia por COVID-19 en la atención de pacientes con diabetes mellitus, Partido de General Pueyrredon, Argentina / Efectos de la pandemia por COVID-19 en la atención de pacientes con diabetes mellitus, Partido de General Pueyrredon, Argentina

INTRODUCCIÓN: La pandemia por COVID-19 condujo a la adopción de medidas de confinamiento con impacto en el control de la diabetes mellitus (DM). El objetivo fue evaluar el efecto de la pandemia en la atención de personas con DM del subsector público y privado de salud del Partido de General Pueyrredon (PGP). MÉTODOS: Se utilizó un diseño cuasiexperimental que comparó dos períodos: pandemia (3 de marzo de 2020 al 2 de marzo de 2021) y prepandemia (3 de marzo de 2019 al 2 de marzo de 2020). Se incluyó a personas de 18 años y más del PGP con diagnóstico de DM; se conformaron dos grupos según cobertura de salud. Los criterios de valoración principal fueron la hemoglobina glicosilada (HbA1c) y el control metabólico; los secundarios: glucemia basal, índice de masa corporal (IMC), triglicéridos, colesterol, consultas médicas, internación, fondo de ojo e índice albúmina/creatinina. Las diferencias con valor p<0,05 se consideraron estadísticamente significativas. Se ajustaron modelos multivariados. RESULTADOS: Se incluyeron 327 participantes (51,7% del subsector público). La mediana de HbA1c aumentó de 8,1% (rango intercuartílico [RIC] 2,7) a 8,8% (RIC 2,8). La pandemia, la atención en el subsector público y el tratamiento incompleto de la DM fueron predictores independientes del aumento de HbA1c; en tanto que el tratamiento con insulina lo fue del deterioro del control glucémico. DISCUSIÓN: La pandemia impactó negativamente en la atención de la DM, evidenciando desigualdades en los subsectores del sistema de salud.

Fabrication, performance, and potential environmental impacts of polysaccharide-based food packaging materials incorporated with phytochemicals: A review.

Although food packaging preserves food's quality, it unfortunately contributes to global climate change since the considerable carbon emissions associated with its entire life cycle. Polysaccharide-based packaging materials (PPMs) are promising options to preserve foods, potentially helping the food industry reduce its carbon footprint. PPMs incorporated with phytochemicals hold promise to address this critical issue, keep food fresh and prolong the shelf life. However, phytochemicals' health benefits are impacted by their distinct chemical structures thus the phytochemicals-incorporated PPMs generally exhibit differential performances. PPMs must be thoughtfully formulated to possess adequate physicochemical properties to meet commercial standards. Given this, this review first-time provides a comprehensive review of recent advances in the fabrication of phytochemicals incorporated PPMs. The application performances of phytochemicals-incorporated PPMs for preserving foods, as well as the intelligent monitoring of food quality, are thoroughly introduced. The possible associated environmental impacts and scalability challenges for the commercial application of these PPMs are also methodically assessed. This review seeks to provide comprehensive insights into exploring new avenues to achieve a greener and safer food industry via innovative food packaging materials. This is paramount to preserve not only food shelf life but also the environment, facilitating the eco-friendly development of the food industry.

Novel Biomass-Based Polymeric Dyes: Preparation and Performance Assessment in the Dyeing of Biomass-Derived Aldehyde-Tanned Leather.

High-performance chrome-free leather production is currently one of the most concerning needs to warrant the sustainable development of the leather industry due to the serious chrome pollution. Driven by these research challenges, this work explores using biobased polymeric dyes (BPDs) based on dialdehyde starch and reactive small-molecule dye (reactive red 180, RD-180) as novel dyeing agents for leather tanned using a chrome-free, biomass-derived aldehyde tanning agent (BAT). FTIR, 1H NMR, XPS, and UV-visible spectrometry analyses indicated that a Schiff base structure was generated between the aldehyde group of dialdehyde starch (DST) and the amino group of RD-180, resulting in the successful load of RD-180 on DST to produce BPD. The BPD could first penetrate the BAT-tanned leather efficiently and then be deposited on the leather matrix, thus exhibiting a high uptake ratio. Compared with the crust leathers prepared using a conventional anionic dye (CAD), dyeing, and RD-180 dyeing, the BPD-dyed crust leather not only had better coloring uniformity and fastness but it also showed a higher tensile strength, elongation at break, and fullness. These data suggest that BPD has the potential to be used as a novel sustainable polymeric dye for the high-performance dyeing of organically tanned chrome-free leather, which is paramount to ensuring and promoting the sustainable development of the leather industry.

Hydrothermal conversion of biomass to fuels, chemicals and materials: A review holistically connecting product properties and marketable applications.

Biomass is a renewable and carbon-neutral resource with good features for producing biofuels, biochemicals, and biomaterials. Among the different technologies developed to date to convert biomass into such commodities, hydrothermal conversion (HC) is a very appealing and sustainable option, affording marketable gaseous (primarily containing H2, CO, CH4, and CO2), liquid (biofuels, aqueous phase carbohydrates, and inorganics), and solid products (energy-dense biofuels (up to 30 MJ/kg) with excellent functionality and strength). Given these prospects, this publication first-time puts together essential information on the HC of lignocellulosic and algal biomasses covering all the steps involved. Particularly, this work reports and comments on the most important properties (e.g., physiochemical and fuel properties) of all these products from a holistic and practical perspective. It also gathers vital information addressing selecting and using different downstream/upgrading processes to convert HC reaction products into marketable biofuels (HHV up to 46 MJ/kg), biochemicals (yield >90 %), and biomaterials (great functionality and surface area up to 3600 m2/g). As a result of this practical vision, this work not only comments on and summarizes the most important properties of these products but also analyzes and discusses present and future applications, establishing an invaluable link between product properties and market needs to push HC technologies transition from the laboratory to the industry. Such a practical and pioneering approach paves the way for the future development, commercialization and industrialization of HC technologies to develop holistic and zero-waste biorefinery processes.

A novel synergistic covalence and complexation bridging strategy based on multi-functional biomass-derived aldehydes and Al(III) for engineering high-quality eco-leather.

To get rid of the chrome pollution faced by the leather industry, we explored a novel engineering high-quality eco-leather technology based on the synergistic interactions between biomass-based aldehydes and Al(III). Firstly, dialdehyde xanthan gum (DXG) was prepared to covalently crosslink with the collagen fibers (CFs) via Schiff-base linkages under alkaline conditions, endowing the leather with a shrinkage temperature (Ts) of 80 °C and opening channels for the subsequent penetration of Al species (AL). Secondly, and for this latter purpose, the DXG-tanned leather was acidified to release part of the DXG from the leather according to the dynamic nature of the Schiff-base. Containing suitable oxygen-containing groups (OGs) with excellent complexation capabilities, the released DXG served as masking agents for AL, facilitating the penetration of AL into the inner CFs network for further complexation crosslinking. Consequently, a denser crosslinking network was constructed in the leather, and the crust leather exhibited higher Ts (82.2 °C), improved mechanical (tensile strength: 13.4 N/mm2, tear strength: 53.3 N/mm) and organoleptic properties than those of the DXG crust or AL crust leathers. This demonstrates that this synergistic covalence and complexation bridging strategy is a sustainable option to substitute highly restricted chrome tanning agent for eco-leather production.

Design of highly active Ni catalysts supported on carbon nanofibers for the hydrolytic hydrogenation of cellobiose.

The direct transformation of cellulose into sugar alcohols (one-pot conversion) over supported nickel catalysts represents an attractive chemical route for biomass valorization, allowing the use of subcritical water in the hydrolysis step. The effectiveness of this process is substantially conditioned by the hydrogenation ability of the catalyst, determined by design parameters such as the active phase loading and particle size. Herein, mechanistic insights into catalyst design to produce superior activity were outlined using the hydrolytic hydrogenation of cellobiose as a model reaction. Variations in the impregnation technique (precipitation in basic media, incipient wetness impregnation, and the use of colloidal-deposition approaches) endowed carbon-nanofiber-supported catalysts within a wide range of Ni crystal sizes (5.8-20.4 nm) and loadings (5-14 wt%). The link between the properties of these catalysts and their reactivity has been established using characterization techniques such as X-ray diffraction, transmission electron microscopy, X-ray photoelectron spectroscopy, and inductively coupled plasma-optical emission spectroscopy (ICP-OES). A fair compromise was found between the Ni surface area (3.89 m2/g) and its resistance against oxidation for intermediate crystallite sizes (∼11.3 nm) loaded at 10.7 wt%, affording the hydrogenation of 81.2% cellobiose to sorbitol after 3 h reaction at 190°C and 4.0 MPa H2 (measured at room temperature). The facile oxidation of smaller Ni particle sizes impeded the use of highly dispersed catalysts to reduce the metal content requirements.

Recomendaciones para la práctica clínica: hipoglucemia en personas con diabetes mellitus / Recommendations for clinical practice: hypoglycemia in people with diabetes mellitus

En la hipoglucemia secundaria, el tratamiento de la diabetes mellitus (DM) se define ante un valor de glucemia por debajo de 70 mg/dl, pudiendo manifestarse por síntomas autonómicos y neuroglucopénicos, con consecuencias a corto y largo plazo, como el deterioro de las funciones cognitivas y el aumento del riesgo cardiovascular, entre otras. La hipoglucemia en personas con DM1 es más frecuente que en aquellas con DM2. Los factores que incrementan su riesgo son: el retraso en la ingesta de comida, el alcohol, el ejercicio intenso, el ayuno y la neuropatía autonómica. Por otro lado, las hipoglucemias inadvertidas se asocian con un mayor riesgo de hipoglucemia grave. Los niños y adultos mayores son un grupo vulnerable a estos eventos que, en muchos casos, presentan síntomas difíciles de distinguir. A su vez, la hipoglucemia durante el embarazo se asocia con mayor riesgo de complicaciones. Otro grupo importante para detectar estos episodios son los pacientes hospitalizados a fin de disminuir la morbimortalidad asociada a los mismos. La calidad de vida está claramente afectada en los pacientes que sufren episodios de hipoglucemia, por lo cual resulta esencial instaurar estrategias de prevención como la educación, el monitoreo glucémico, realizar modificaciones en la dieta y el ejercicio, y ajustar la medicación. El tratamiento, en caso de no presentar pérdida de conciencia, será por vía oral, de lo contrario, se recurrirá a glucosa endovenosa o glucagón intramuscular.

Hypoglycemia due to treatment of diabetes mellitus (DM) is defined by a blood glucose value below 70 mg/dl, which can manifest itself by autonomic and neuroglycopenic symptoms, with short- and long-term consequences, such as impaired cognitive functions and increased cardiovascular risk, among others. Hypoglycemia in people with DM1 is more frequent than in those with DM2. Factors that increase its risk are: delayed food intake, alcohol, intense exercise, fasting and autonomic neuropathy. On the other hand, inadvertent hypoglycemia is associated with an increased risk of severe hypoglycemia. Children and older adults are a vulnerable group to these events that, in many cases, present symptoms that are difficult to distinguish. Hypoglycemia during pregnancy is associated with an increased risk of complications. Another important group to detect these episodes are hospitalized patients in order to reduce the morbimortality associated with them. Quality of life is clearly affected in patients who suffer episodes of hypoglycemia, so it is essential to implement prevention strategies such as education, glycemic monitoring, dietary and exercise modifications, and medication adjustment. Treatment, if there is no loss of consciousness, will be oral, otherwise, intravenous glucose or intramuscular glucagon will be used.

Green and sustainable 'Al-Zr-oligosaccharides' tanning agents from the simultaneous depolymerization and oxidation of waste paper.

Developing chrome-free and sustainable tanning agents is extremely important to the sustainability of the leather industry. Herein, we have synthesized an Al-Zr-oligosaccharides tanning agent via a simultaneous degradation and oxidation of cellulose in waste paper. The influence of the temperature and the concentrations of AlCl3 and H2O2 during the synthesis were thoroughly investigated on the properties of the tanning agent and the leather produced. The synthesis temperature and the concentration of AlCl3 were the factors primarily affecting the effective depolymerization of cellulose. They controlled the conversion of waste paper into oligosaccharides with an appropriate molecular weight to efficiently penetrate the leather matrix. In parallel, the H2O2 concentration substantially influenced the tanning performance of the Al-Zr-oligosaccharides, diminishing the chromaticity of the tanning liquid via oxidation and promoting the conversion of C2/C3/C6-OH moieties into -CHO/-COOH. These functional groups increased the surface charge of the oligosaccharides allowing more effective coordination with Al/Zr, which facilitated the penetration of Al/Zr species into the leather matrix. Once inside the leather matrix, Al and Zr were released and reacted with the collagen fibers in leather, which resulted in effective leather tanning. The process optimization revealed that up to 57% of waste paper could be converted into a low-chromaticity (4350 AU) liquid hydrolysate with the synthesis conducted at 177 °C in a system comprising 47 mM AlCl3 and 5 vol% H2O2. The application of this liquid for tanning provided leather with a shrinkage temperature (86.5 °C) sufficiently high for commercial applications. These excellent results, combined with the intrinsic green nature of our approach, exemplify a step forward to simultaneously reduce pollution and hazards in leather industries giving a second life to waste paper.

Recomendaciones para la práctica clínica: hipoglucemia en personas con diabetes mellitus / Recommendations for clinical practice: hypoglycemia in people with diabetes mellitus

En la hipoglucemia secundaria, el tratamiento de la diabetes mellitus (DM) se define ante un valor de glucemia por debajo de 70 mg/dl, pudiendo manifestarse por síntomas autonómicos y neuroglucopénicos, con consecuencias a corto y largo plazo, como el deterioro de las funciones cognitivas y el aumento del riesgo cardiovascular, entre otras. La hipoglucemia en personas con DM1 es más frecuente que en aquellas con DM2. Los factores que incrementan su riesgo son: el retraso en la ingesta de comida, el alcohol, el ejercicio intenso, el ayuno y la neuropatía autonómica. Por otro lado, las hipoglucemias inadvertidas se asocian con un mayor riesgo de hipoglucemia grave. Los niños y adultos mayores son un grupo vulnerable a estos eventos que, en muchos casos, presentan síntomas difíciles de distinguir. A su vez, la hipoglucemia durante el embarazo se asocia con mayor riesgo de complicaciones. Otro grupo importante para detectar estos episodios son los pacientes hospitalizados a fin de disminuir la morbimortalidad asociada a los mismos. La calidad de vida está claramente afectada en los pacientes que sufren episodios de hipoglucemia, por lo cual resulta esencial instaurar estrategias de prevención como la educación, el monitoreo glucémico, realizar modificaciones en la dieta y el ejercicio, y ajustar la medicación. El tratamiento, en caso de no presentar pérdida de conciencia, será por vía oral, de lo contrario, se recurrirá a glucosa endovenosa o glucagón intramuscular.

Hypoglycemia due to treatment of diabetes mellitus (DM) is defined by a blood glucose value below 70 mg/dl, which can manifest itself by autonomic and neuroglycopenic symptoms, with short- and long-term consequences, such as impaired cognitive functions and increased cardiovascular risk, among others. Hypoglycemia in people with DM1 is more frequent than in those with DM2. Factors that increase its risk are: delayed food intake, alcohol, intense exercise, fasting and autonomic neuropathy. On the other hand, inadvertent hypoglycemia is associated with an increased risk of severe hypoglycemia. Children and older adults are a vulnerable group to these events that, in many cases, present symptoms that are difficult to distinguish. Hypoglycemia during pregnancy is associated with an increased risk of complications. Another important group to detect these episodes are hospitalized patients in order to reduce the morbimortality associated with them. Quality of life is clearly affected in patients who suffer episodes of hypoglycemia, so it is essential to implement prevention strategies such as education, glycemic monitoring, dietary and exercise modifications, and medication adjustment.

Direct conversion of almond waste into value-added liquids using carbon-neutral catalysts: Hydrothermal hydrogenation of almond hulls over a Ru/CNF catalyst.

The almond industry leaves behind substantial amounts of by-products, with almond hulls being the primary residue generated. Given that one way to improve food security is by decreasing waste to reduce environmental impacts, developing sustainable processes to manage this by-product is necessary. Herein, we report on the hydrothermal hydrogenation of almond hulls over a carbon-neutral Ru supported on carbon nanofibres (Ru/CNF) catalyst, addressing the temperature, H2 pressure, time and catalyst loading. These variables controlled the distribution of the reaction products: gas (0-5%), liquid (49-82%) and solid (13-51%), and ruled the composition of the liquid effluent. This aqueous fraction comprised oligomers (46-81 wt%), saccharides (2-7 wt%), sugar alcohols (2-15 wt%), polyhydric alcohols (1-8 wt%) and carboxylic acids (7-31 wt%). The temperature and reaction time influenced the extension of hydrolysis, depolymerisation, deamination, hydrolysis, hydrogenation and dehydration reactions. Additionally, the initial H2 pressure and catalyst loading kinetically promoted these transformations, whose extensions were ruled by the amount of H2 effectively dissolved in the reaction medium and the prevalence of hydrogenations over dehydration/decarboxylation reactions or vice versa depending on the catalyst loading. Process optimisation revealed that it is feasible to convert up to 67% of almond hulls into merchantable oligomers at 230 °C, 35 bar initial H2, using 1 g catalyst/g biomass (0.4 g Ru/g biomass) for 360 min. Additionally, decreasing the temperature to 187 °C without modifying the other parameters could convert this material into oligomers (31 wt%) and small oxygenates (17 wt% carboxylic acids, 11 wt% sugar alcohols and 6 wt% polyhydric alcohols) concurrently. The theoretical energy assessment revealed that the total and partial combustion of the spent solid material could provide the required energy for the process and allow catalyst recovery and reutilisation. This environmental friendliness and holistic features exemplify a landmark step-change to valorising unavoidable food waste.

Sustainable production of lignin micro-/nano-particles (LMNPs) from biomass: Influence of the type of biomass on their self-assembly capability and physicochemical properties.

The production of lignin micro-/nano-particles (LMNPs) has gained growing interest due to their eco-friendly feature and biological compatibility with negligible hazardous impacts. Herein, this work carefully addresses the preparation of LMNPs from different types of biomass, including pine wood, birch wood, pubescens, vinasse, corncob and corncob residue. Firstly, ligno-oligomers were produced from each biomass through a H2O-THF co-solvent system. Then, LMNPs were generated from these effluents. Uniform and spherical LMNPs, consisting of benzene ring-stacked cores and hydrophilic shells, were obtained only from the liquids yielded by the treatment of the corncob residue and pine wood. The characterization of the ligno-oligomers and the LMNPs revealed that the molecular weights of the ligno-oligomers did not exert a significant effect on their self-assembly capability. The presence of guaiacyl units connected by ß-O-4 and ß-ß linkages was beneficial for the π-π stacking of the benzene rings into compact cores, while the existence of ß-5 linkages and Cα-oxidized side-chains exerted a negative effect. Stable and spherical LMNPs with an appropriate negative zeta potential and a relatively high thermal stability were obtained from the corncob residue and pine wood, which can serve as functional materials in various application areas.

Analysis and optimisation of a novel 'almond-refinery' concept: Simultaneous production of biofuels and value-added chemicals by hydrothermal treatment of almond hulls.

For the first time, this work investigates the achievability of developing a biorefinery concept around almond hulls by hydrothermal treatment (HTT), thoroughly scrutinising the influence of the temperature (200-300 °C), pressure (100-180 bar), time (20-180 min) and solid loading (5-25 wt%). This process allowed the conversion of almond hulls into four main products: gas (2-13%), bio-oil (2-12%), aqueous (4-69%) and hydro-char (17-89%). The gas consisted of a mix of H2, CO2, CO and CH4 with a LHV fluctuating from 1 to 13 MJ/m3 STP. The bio-oil comprised a mixture of alkanes, aldehydes, ketones, phenols, furans, benzenes and nitrogen compounds with a HHV between 21 and 31 MJ/kg. The solid product resembled an energetic hydro-char material (HHV 21-31 MJ/kg), while the aqueous effluent comprised a mixture of value-added chemicals, including saccharides and small oxygenated compounds. The production of biofuels can be maximised at 256 °C and 100 bar, using a 5 wt% solid loading for 157 min, conditions at which 43% of the original feedstock can be converted into an elevated energy-filled bio-oil (11% yield, 30 MJ/kg), along with a high energetic hydro-char (32% yield, 29 MJ/kg). Regarding value-added chemicals, up to 10% of the almond hulls can be converted into a bio-oil with a high proportion (45%) of phenolic species at 250 °C and 144 bar with a solid loading of 5 wt% for 167 min. In comparison, a sugar-rich (81 C-wt%) solution can be produced in high yield (54%), by treating a 24 wt% suspension at 252 °C and 180 bar for 153 min. Therefore, the versatility, novelty and intrinsic green and holistic nature of this 'almond-refinery' concept exemplify a landmark achievement in future energy and chemicals production from biomass, which might help render the complete bio-refinery for almond hulls more cost-effectively and ecologically feasible.

Impacto de la pandemia COVID-19 en la atención de la diabetes mellitus según cobertura de salud en el Partido de General Pueyrredón, Argentina / Impact of the COVID-19 pandemic on diabetes mellitus care according to health coverage in the General Pueyrredón District, Argentina

INTRODUCCIÓN las personas con DM conforman un grupo de alto riesgo de enfermedad y muerte por COVID-19. Objetivos valorar el impacto de la pandemia COVID-19 en la atención de las personas con DM, focalizando en el control metabólico, internación y sus percepciones respecto del proceso de atención, en población con y sin cobertura de salud del PGP, Bs As, Argentina. MÉTODOS se apeló a la triangulación metodológica. El enfoque cuantitativo utilizó un diseño cuasi-experimental que comparó dos períodos de 12 meses de duración cada uno, delimitados por el 3 de marzo de 2020; el cualitativo recurrió a entrevistas en profundidad en base a ejes temáticos, se utilizó análisis temático. Se incluyeron personas de 18 años y más del PGP con diagnóstico de DM; se conformaron dos grupos según su situación de cobertura de salud. Los criterios de valoración principal fueron la HbA1c y el control metabólico; las diferencias con valor de p < 0,05 se consideraron estadísticamente significativas. Se ajustaron modelos multivariados. RESULTADOS se incluyeron 327 participantes [158 con cobertura de salud (48,3%), 169 sin cobertura (51,7%)]. La mediana de HbA1c aumentó de 8,1% (RIC 2,7) a 8,8% (RIC 2,8); los participantes sin cobertura de salud partieron de valores más altos en la prepandemia [Me 9.0 % (RIC 2,4) vs. Me 7,2 % (RIC 1,48)]. La pandemia, la falta de cobertura de salud y el tratamiento incompleto de la DM fueron predictores independientes del aumento de la HbA1c; el tratamiento con insulina fue predictor del deterioro del control glucémico. El trabajo doméstico y de enseñanza recayó en las mujeres. Angustia, estrés y tristeza fueron los sentimientos que caracterizaron la salud mental de las personas con DM en pandemia; el proceso de atención fue percibido con miedo e incertidumbre, acentuado en el grupo sin cobertura de salud. DISCUSIÓN la pandemia COVID-19 impactó en múltiples dimensiones de la vida de las personas con DM, resaltando diferenciales de género y clase.

Mesa 2: Insuficiencia cardíaca y diabetes mellitus tipo 2 / Table 2: heart failure and diabetes mellitus type 2

Desde que el estudio Framingham en 1974 reportó un aumento de dos a cinco veces en el riesgo de desarrollar insuficiencia cardíaca (IC) en pacientes con diabetes mellitus (DM), otros estudios observacionales confirmaron esta asociación que ha tomado gran visibilidad en los últimos años a partir de los resultados de los estudios de seguridad cardiovascular de las drogas antidiabéticas. La IC se define como un síndrome clínico que resulta del deterioro funcional o estructural del llenado ventricular o la eyección de sangre. Puede clasificarse según la fracción de eyección, la presencia de síntomas y la limitación de la actividad física. Existen distintos factores asociados a la IC en personas con DM como la edad, la antigüedad de la enfermedad, la utilización de insulina, la enfermedad coronaria, la hipertensión arterial, la enfermedad arterial periférica, el aumento de creatinina, el escaso control glucémico, la albuminuria y la obesidad. A su vez la IC se asocia a insulinorresistencia y a estados disglucémicos que se consideran de riesgo para el desarrollo de DM. En la fisiopatología están implicados el sistema nervioso simpático, el sistema renina angiotensina aldosterona, los péptidos natriuréticos, alteraciones renales, remodelación del ventrículo izquierdo, miocardiopatía diabética, neuropatía autonómica cardíaca y la inflamación. El diagnóstico de IC es clínico; los estudios complementarios orientan en el diagnóstico etiológico y son útiles en el seguimiento. El buen control glucémico es importante pero no suficiente para reducir el desarrollo de IC. Se ha descripto que algunos antidiabéticos podrían incrementar el riesgo de falla cardíaca y, por el contrario, otros tendrían un efecto beneficioso. El tratamiento de la IC no difiere de una persona sin DM. Dado que el pronóstico de la IC en los pacientes con DM es más severo, los esfuerzos deben centrarse en prevenir, diagnosticar y tratar los factores de riesgo cardiovascular para reducir el desarrollo de IC.

Since the Framingham study in 1974 reported a 2 to 5 fold increase in the risk of developing heart failure (HF) in patients with diabetes mellitus (DM), other observational studies confirmed this association that has gained great visibility in recent years from of the results of cardiovascular safety studies of antidiabetic drugs. HF is defined as a clinical syndrome that results from functional or structural deterioration of ventricular filling or blood ejection. It can be classified according to the ejection fraction, the presence of symptoms and the limitation to physical activity. There are different factors associated with HF in people with DM such as age, duration of the disease, insulin use, coronary heart disease, high blood pressure, peripheral arterial disease, increased creatinine, poor glycemic control, albuminuria and obesity. In turn, HF is associated with insulin resistance and dysglycemic states that are considered of risk for the development of DM. Pathophysiology involves the sympathetic nervous system, the renin angiotensin aldosterone system, natriuretic peptides, kidney abnormalities, left ventricular remodeling, diabetic cardiomyopathy, autonomic cardiac neuropathy, and inflammation. The diagnosis of HF is clinical, complementary studies guide the etiological diagnosis and are useful for follow-up. Good glycemic control is important but not sufficient to reduce the development of HF. It has been described that some antidiabetics could increase the risk of heart failure, while others would have a beneficial effect. The treatment of HF does not differ from a person without DM. Since the prognosis of HF in patients with DM is more severe, efforts should be focused on preventing, diagnosing and treating cardiovascular risk factors, to reduce the development of HF

Production and characterization of lignin and cellulose fractions obtained from pretreated vine shoots by microwave assisted alkali treatment.

This work deals with the optimization of the second stage of a biorefinery scheme to separate simultaneously cellulose and lignin from hydrothermally pre-treated vine shoots. For this, the suitability of the microwave-assisted alkaline delignification was assessed and optimized through a Box-Wilson experimental design. The optimum conditions (150 °C, 6 wt% NaOH, 30 min) allowed maximizing the lignin removal (82 wt%) and minimizing the loss of the cellulose (35 wt%) present in the pre-treated vine shoots. A thorough characterization of the two fractions obtained at optimum conditions was performed: the cellulose rich solid was analyzed by XRD and FTIR and the lignin was subjected to HPSEC, Py/GC-MS, 13C- and 1H NMR. This purposed second stage would allow performing an integral biorefinery with low energy requirements and environmentally friendly conditions. This approach aligns with the circular economy and the zero waste production philosophies, promoting the sustainable development.

Mesa 2: Diabetes Mellitus Tipo 1 y actividad física / Table 2: Diabetes Mellitus Type 1 and physical activity

En personas con diabetes tipo 1 (DM1) el ejercicio físico realizado en forma regular brindaría protección cardiovascular y tendría propiedades inmunomoduladoras pero la compleja interacción entre los efectos del ejercicio sobre el metabolismo glucídico y la terapia con insulina exógena supone un verdadero desafío. El ejercicio aeróbico por la contracción muscular disminuye la glucemia, conduce a un estado de hiperinsulinemia relativa y genera hipoglucemia al inicio o después del mismo mientras que el ejercicio anaeróbico se asocia a hiperglucemia por aumento de catecolaminas e incremento de lactato que favorece la neoglucogénesis hepática. El deterioro de la respuesta de hormonas contrarreguladoras existente en la DM1 amplifica la variabilidad glucémica y dificulta el control metabólico. Existen guías y recomendaciones que buscan brindar un marco de seguridad para la prescripción de actividad física considerando la multiplicidad de disciplinas deportivas, la edad del paciente y la evaluación de las complicaciones crónicas de la diabetes antes del inicio de la misma. Entre las estrategias terapéuticas se encuentran la modulación con hidratos de carbono, la adecuación pre y pos ejercicio de la insulinoterapia y el control intensivo de glucemia y cetonas. Los nuevos infusores de insulina y monitoreo glucémico ofrecen la posibilidad del fraccionamiento y/o suspensión de dosis convirtiéndose en el gold standard entre los deportistas de alto rendimiento. A futuro modelos integrados con calculadoras de ejercicio inteligentes, capacidad predictiva y de "aprendizaje individualizado" (páncreas artificial) posibilitarán mantener la euglucemia y optimizar los beneficios del ejercicio como parte del tratamiento

Processing of Citrus Nanostructured Cellulose: A Rigorous Design-of-Experiment Study of the Hydrothermal Microwave-Assisted Selective Scissoring Process.

A detailed design-of-experiment (DoE) study to investigate the cause-effect interactions of three process variables, that is, temperature (120-200 °C), holding time (0-30 min), and concentration (1.4-5.0 wt %), on the processing of citrus cellulosic matter using acid-free microwave-assisted selective scissoring (Hy-MASS) is reported. Analysis of variance (ANOVA) showed that post-microwave processing, the yield of cellulosic matter (25-72 %), decomposition temperature (345-373 °C), and crystallinity index (34-67 %) were strongly affected by temperature. SEM and TEM analyses showed that the isolated cellulosic matter was heterogeneous and consisted of a mixture of micro- and nanofibers more akin to microfibrillated cellulose (MFC) at low processing temperatures and tending towards aggregated cellulose nanofibrils (CNFs) and cellulose nanocrystals (CNCs) at higher processing temperatures. The water holding capacity of the processed cellulosic matter (15-27 gH2O g-1 ) was higher than the original feedstock or previously reported values. The average molecular weight of the cellulosic matter (113.6-1095.9 kg mol-1 ) decreased significantly by a factor of 10 at operating temperatures above 180 °C, invoking significant scissoring of the cellulosic chains. The process energy input and costs varied between 0.142-0.624 kWh and 13-373 € kg-1 , respectively, and strongly depended on the reaction time.

[Use of plasmapheresis in hypertriglyceridemic pancreatitis]. / Uso de plasmaféresis en pancreatitis hipertrigliceridémica.

Hypertriglyceridemia is reported as cause of 1 to 4% of the episodes of acute pancreatitis. We report the case of a 42-year-old woman with a history of obesity, type 2 diabetes mellitus, hypertriglyceridemia and hypercholesterolemia, with triglycerides of 9365 mg/dl, total cholesterol of 1822 mg/dl, one month prior to the consultation. She presented at the emergency unit with a 5 day history of abdominal pain, which progressed in intensity in the last 48 hours. Abdominal computed tomography revealed pancreatic and peripancreatic inflammation. Thirty-six hours after admission, a first session of plasmapheresis was conducted with a plasma triglyceride and cholesterol reduction of 25 and 30%, respectively. A second session was performed the next day, with a further reduction of triglycerides to 996 mg/dl and cholesterol to 238 mg/dl. During hospitalization the patient presented fever and Klebsiella pneumoniae bacteremia with no pancreatic collection or necrosis in tomography and, later on, nosocomial pneumonia, both infections with adequate response to antibiotic therapy. At the time of discharge, triglycerides and cholesterol levels were 652 mg/dl and 167 mg/dl respectively, no abdominal pain was present and the patient resumed oral nutrition. We observed a 90% reduction of triglycerides and 87% of cholesterol after 2 sessions of plasmapheresis, compared to 70% in average of reduction in most of the studies reviewed. We did not find the presence of bacteremia or nosocomial pneumonia as complications in the reported cases.

Uso de plasmaféresis en pancreatitis hipertrigliceridémica / Use of plasmapheresis in hypertriglyceridemic pancreatitis

La hipertrigliceridemia es causa de 1-4% de las pancreatitis agudas. Presentamos el caso de una mujer de 42 años con antecedentes de obesidad, diabetes mellitus tipo 2, hipertrigliceridemia e hipercolesterolemia (9365 mg/dl y 1822 mg/dl, respectivamente, 1 mes previo a la consulta). Concurrió a nuestro hospital por cuadro de dolor abdominal de 5 días de evolución de tipo cólico con progresión continua en las últimas 48 horas. Se realizó tomografía de abdomen que informó imágenes compatibles con pancreatitis. A las 36 horas de su ingreso se inició la primera sesión de plasmaféresis con una reducción de triglicéridos y colesterol del 25 y 30% respectivamente y una segunda sesión al día siguiente con descenso de triglicéridos a 996 mg/dl y colesterol a 238 mg/dl. Durante su internación presentó bacteriemia por Klebsiella pneumoniae, sin colección ni necrosis pancreática detectables por tomografía de abdomen, y luego neumonía intrahospitalaria, ambas infecciones con buena respuesta a antibioticoterapia. Al alta, los triglicéridos habían descendido a 652 mg/dl, el colesterol a 167 mg/dl, el dolor abdominal había cedido y la paciente presentaba buena tolerancia por vía oral. Observamos una reducción del 90% de triglicéridos y 87% de colesterol luego de dos sesiones de plasmaféresis, comparado con 70% de reducción en promedio en la mayoría de los estudios consultados. En los mismos, no hemos encontrado la presencia de bacteriemia ni neumonía hospitalaria como complicaciones.(AU)

Hypertriglyceridemia is reported as cause of 1 to 4% of the episodes of acute pancreatitis. We report the case of a 42-year-old woman with a history of obesity, type 2 diabetes mellitus, hypertriglyceridemia and hypercholesterolemia, with triglycerides of 9365 mg/dl, total cholesterol of 1822 mg/dl, one month prior to the consultation. She presented at the emergency unit with a 5 day history of abdominal pain, which progressed in intensity in the last 48 hours. Abdominal computed tomography revealed pancreatic and peripancreatic inflammation. Thirty-six hours after admission, a first session of plasmapheresis was conducted with a plasma triglyceride and cholesterol reduction of 25 and 30%, respectively. A second session was performed the next day, with a further reduction of triglycerides to 996 mg/dl and cholesterol to 238 mg/dl. During hospitalization the patient presented fever and Klebsiella pneumoniae bacteremia with no pancreatic collection or necrosis in tomography and, later on, nosocomial pneumonia, both infections with adequate response to antibiotic therapy. At the time of discharge, triglycerides and cholesterol levels were 652 mg/dl and 167 mg/dl respectively, no abdominal pain was present and the patient resumed oral nutrition. We observed a 90% reduction of triglycerides and 87% of cholesterol after 2 sessions of plasmapheresis, compared to 70% in average of reduction in most of the studies reviewed. We did not find the presence of bacteremia or nosocomial pneumonia as complications in the reported cases.(AU)