Leveraging technology to improve access to medical education in anatomy and physiology in resource-limited settings: A mixed methods study.

This study assesses the acceptability, appropriateness, feasibility, and efficacy of a novel asynchronous video-based intervention for teaching respiratory physiology and anatomy to medical students in resource-limited settings. A series of short video lectures on pleural anatomy, pulmonary physiology, and pathophysiology was created using Lightboard and screen capture technology. These were uploaded to YouTube and Google Drive and made available to 1st-3rd year medical students at two Latin American universities for 1 week. Employing a parallel-convergent mixed methods design, we conducted surveys, focus groups, interviews, and pre/post testing for qualitative and quantitative data. Thematic Analysis was used to analyze qualitative data and McNemar's test for quantitative analysis. Seventy-six students participated. The videos' short format, interactivity, and Lightboard style were highly valued for their flexibility, time efficiency, and educational impact. Students recognized their clinical relevance and trusted their content, suggesting potential applicability in similar settings. Despite infrastructure and connectivity challenges, the use of flexible streaming and downloadable options facilitated learning. Survey results indicated high levels of feasibility (99%), appropriateness (95%), and acceptability (95%), with significant knowledge gains observed (37% correct pre-test answers vs. 56% post-test, p < 0.0001). Our findings demonstrate high acceptability, appropriateness, feasibility, and efficacy of a targeted asynchronous education centered on short-format videos in resource-limited settings, enabling robust learning despite local barriers. Flexible access is key for overcoming localized barriers. Taking an adaptive, learner-centered approach to content creation and delivery to address constraints was pivotal to success. Our modular videos could serve as versatile models for flexible education in resource-constrained settings.

Acute Administration of Calafate (Berberis microphylla) Extract Induces the Expression of Thermogenic Markers and Modulates Gut Microbiota in Mice Fed a High-Fat Chow Diet.

INTRODUCTION: Obesity, characterized by excess adipose tissue, is a major public health problem worldwide. Brown adipose tissue (BAT) and beige adipose tissue participate in thermogenesis through uncoupling protein 1 (UCP1). Polyphenols including those from Calafate (a native polyphenol-rich Patagonian berry), are considered as potential anti-obesity compounds due to their pro-thermogenic characteristics. However, polyphenols are mainly metabolized by the gut microbiota (GM) that may influence their bioactivity and bioavailability. The aim of this study was to determine the impact of dietary administration with a Calafate polyphenol-rich extract on thermogenic activity of BAT and beige adipose tissue and GM composition. METHODS: Eight-week-old C57BL6 mice (n = 30) were divided into 4 groups to receive for 24 weeks a control diet (C), a high-fat diet alone (HF), or high-fat diet supplemented with Calafate extract (HFC) or the same high-fat diet supplemented with Calafate extract but treated with antibiotics (HFCAB) from week 19-20. Administration with Calafate extract (50 mg/kg per day) was carried out for 3 weeks from week 21-23 in the HFC and HFCAB groups. After euthanasia, gene expression of thermogenic markers was analyzed in BAT and inguinal white adipose tissue (iWAT). Transmission electron microscopy was performed to assess mitochondrial morphology and cristae density in BAT. GM diversity and composition were characterized by deep sequencing with the MiSeq Illumina platform. RESULTS: Calafate extract administration had no effect on weight gain in mice fed a high-fat diet. However, it prevented alterations in mitochondrial cristae induced by HFD and increased Dio2 expression in BAT and iWAT. The intervention also influenced the GM composition, preventing changes in specific bacterial taxa induced by the high-fat diet. However, the antibiotic treatment prevented in part these effects, suggesting the implications of GM. CONCLUSION: These results suggest that the acute administration of a Calafate extract modulates the expression of thermogenic markers, prevents alterations in mitochondrial cristae and intestinal microbiota in preclinical models. The study highlights the complex interaction between polyphenols, thermogenesis, and the GM, providing valuable insights into their potential roles in the treatment of obesity-related metabolic diseases.

Proof of concept of the Universal Baby video innovation for early child development in Lima, Peru.

OBJECTIVE: Community-based video interventions offer an effective and potentially scalable early interaction coaching tool for caregivers living in low resource settings. We tested the Universal Baby (UB) video innovation; an early interaction coaching tool using video sourced and produced locally with early child development (ECD) expert supervision. METHODS: This proof-of-concept study enrolled 40 caregivers of children ages 10-18 months assigned to intervention and control groups by health establishments in Carabayllo, Lima, Peru. Mother/child dyads received 12 weekly group health education sessions with social support. Of those, 16 caregivers also received 6 UB videos featuring brain science education and local clips of responsive, reciprocal interaction, also known as "serve and return" interaction. Survey data assessed feasibility and acceptability of the intervention. We assessed improved quality of mother/child interaction using the Parenting Interactions with Children: Checklist of Observations Linked to Outcomes (PICCOLO). RESULTS: We found the program feasible. We successfully trained the local team to produce UB videos using locally-sourced footage and delivered the videos as part of a community-based intervention. We also found it to be acceptable in that participants enthusiastically received the UB videos, reporting they enjoyed being videotaped, and learned how to recognize and appropriately respond to their child's nuanced sounds and gestures. The median change in total PICCOLO scores favored the intervention group compared to the control group. CONCLUSIONS: UB offers great potential as a sustainable, potentially scalable, and culturally appropriate tool to promote equity for child development among young children living in low resource homes globally.

Control of spontaneous charging of sliding water drops by plasma-surface treatment.

Slide electrification is the spontaneous separation of electric charges at the rear of water drops sliding over solid surfaces. This study delves into how surfaces treated with a low-pressure plasma impact water slide electrification. Ar, O2, and N2 plasma treatment reduced the drop charge and contact angles on glass, quartz, and SU-8 coated with 1H,1H,2H,2H-perfluoroctyltrichlorosilane (PFOTS), and polystyrene. Conversely, 64% higher drop charge was achieved using electrode-facing treatment in plasma chamber. Based on the zeta potential, Kelvin potential, and XPS measurements, the plasma effects were attributed to alterations of the topmost layer's chemistry, such as oxidation and etching, and superficially charge deposition. The surface top layer charges were less negative after electrode-facing and more negative after bulk plasma treatment. As a result, the zeta potential was less negative after electrode-facing and more negative after bulk plasma treatment. Although the fluorinated layer was applied after plasma activation, we observed a discernible impact of plasma-glass treatment on drop charging. Plasma surface modification offers a means to adjust drop charges: electrode-facing treatment of the fluorinated layer leads to an enhanced drop charge, while plasma treatment on the substrate prior to fluorination diminishes drop charges, all without affecting contact angles or surface roughness.

Regnase-1 D141N mutation induces CD4+ T cell-mediated lung granuloma formation via upregulation of Pim2.

Regnase-1 is an RNase that plays a critical role in negatively regulating immune responses by destabilizing inflammatory mRNAs. Dysfunction of Regnase-1 can be a major cause of various inflammatory diseases with tissue injury and immune cell infiltration into organs. This study focuses on the role of RNase activity of Regnase-1 in developing inflammatory diseases. We have constructed mice with a single point mutation at the catalytic center of Regnase-1 RNase domain, which lacks endonuclease activity. D141N mutant mice demonstrated systemic inflammation, immune cell infiltration into various organs and progressive development of lung granuloma. CD4+ T cells, mainly affected by this mutation, upregulated mTORC1 pathway and facilitated the autoimmune trait in D141N mutation. Moreover, serine/threonine kinase Pim2 contributed to lung inflammation in this mutation. Inhibition of Pim2 kinase activity ameliorated granulomatous inflammation, immune cell infiltration and proliferation in the lungs. Additionally, Pim2 inhibition reduced the expression of adhesion molecules on CD4+ T cells, suggesting a role for Pim2 in facilitating leukocyte adhesion and migration to inflamed tissues. Our findings provide new insights into the role of Regnase-1 RNase activity in controlling immune function and underscore the therapeutic relevance of targeting Pim2 to modulate abnormal immune responses.

Screening of variables affecting the selective leaching of valuable metals from waste motherboards' PCBs.

The presence of valuable and hazardous metals in waste printed circuit boards, especially, motherboards, makes their recovery necessary as implies great economic and environmental advantages and develops urban mining processes. Hence, this research is focused on the selective leaching of Cu, Pb, and Sn as base metals using nitric acid and hydrochloric acid and Au, Ag, and Pd as precious metals using thiourea and sodium thiosulfate from waste motherboards' PCBs in a sequential eco-friendly two-stage process. Previously, thiourea and sodium thiosulfate were used as leaching agents to investigate their applicability for the leaching of metals from PCBs in a single-stage process. Screening experimental design was applied to screen the variables affecting the leaching process in order to evaluate their impact on the recovery of metals and select the significant factors. The results demonstrated that base and precious metals can be leached appropriately in two consecutive stages compared to a single-stage process. Nitric acid was found to be a much more efficient agent to leach Cu and Pb in comparison with hydrochloric acid which was more suitable for the leaching of Sn. In the case of precious metals, higher amounts of Au were leached using thiourea, whereas sodium thiosulfate was able to leach more Pd. Roughly similar results were obtained for the leaching of Ag using these leaching agents. Nitric acid concentration, average particle size, temperature, and leaching time were found to be significant to maximize the leaching of Cu and Pb and minimize that for Au, Ag, and Pd in the first stage. Initial pH was the only variable influencing the second stage, in particular, Au leaching by thiourea.

A Boron Scan of Ethyl Acetoacetate Leads to Versatile Building Blocks.

Discovered in the 19th century, ethyl acetoacetate has been central to the development of organic chemistry, including its pedagogy and applications. In this study, we present borylated derivatives of this venerable molecule. A boron handle has been installed at either α ${{\rm \alpha }}$ - or ß ${\beta }$ -position of acetoacetate by homologation of acyl-MIDA (N-methyliminodiacetic acid) boronates with diazoacetates. Either alkyl or boryl groups were found to migrate with regiochemistry being a function of the steric bulk of the diazo species. Boryl ß ${{\rm \beta }}$ -ketoesters can be further modified into borylated pyrazolones and oximes, thereby expanding the synthetic toolkit and offering opportunities for additional modifications.

The Role of Attractive Non-Covalent Interactions in Peptide Macrocyclization.

The efficiency of macrocyclization reactions relies on the appropriate conformational preorganization of a linear precursor, ensuring that reactive ends are in spatial proximity prior to ring closure. Traditional peptide cyclization approaches that reduce the extent of terminal ion pairing often disfavor cyclization-conducive conformations and can lead to undesired cyclodimerization or oligomerization side reactions, particularly when they are performed without high dilution. To address this challenge, synthetic strategies that leverage attractive noncovalent interactions, such as zwitterionic attraction between chain termini during macrocyclization, offer a potential solution by reducing the entropic penalty associated with linear peptides adopting precyclization conformations. In this study, we investigate the role of (N-isocyanoimino)triphenylphosphorane (Pinc) in facilitating the cyclization of linear peptides into conformationally rigid macrocycles. The observed moderate diastereoselectivity is consistent with the preferential Si-facial addition of Pinc, where the isocyanide adds to the E-iminium ion on the same face as the l-proline amide group. The resulting peptide chain reveals that the activated phosphonium ylide of Pinc brings the reactive ends close together, promoting cyclization by enclosing the carboxylate within the interior of the pentapeptide and preventing the formation of byproducts. For shorter peptides with modified peptide backbones, the cyclization mechanism and outcome are redirected, as nucleophilic motifs such as thiazole and imidazole can covalently trap nitrilium intermediates. The isolation of the intermediate in the unproductive macrocyclization pathway, along with nuclear magnetic resonance and density functional theory studies, provides insights into heterocycle-dependent selectivity. The Pinc-driven macrocyclization process has generated diverse collections of cyclic molecules, and our models offer a comprehensive understanding of observed trends, facilitating the development of other heterocycle-forming macrocyclization reactions.

S/N/O-Enriched Carbons from Polyacrylonitrile-Based Block Copolymers for Selective Separation of Gas Streams.

A series of polyacrylonitrile (PAN)-based block copolymers with poly(methyl methacrylate) (PMMA) as sacrificial bock were synthesized by atom transfer radical polymerization and used as precursors for the synthesis of porous carbons. The carbons enriched with O- and S-containing groups, introduced by controlled oxidation and sulfuration, respectively, were characterized by Raman spectroscopy, scanning electron microscopy, and X-ray photoelectron spectrometry, and their surface textural properties were measured by a volumetric analyzer. We observed that the presence of sulfur tends to modify the structure of the carbons, from microporous to mesoporous, while the use of copolymers with a range of molar composition PAN/PMMA between 10/90 and 47/53 allows the obtainment of carbons with different degrees of porosity. The amount of sacrificial block only affects the morphology of carbons stabilized in oxygen, inducing their nanostructuration, but has no effect on their chemical composition. We also demonstrated their suitability for separating a typical N2/CO2 post-combustion stream.

The potential role of apigenin in the enhancement of the antioxidant adaptation to exercise by bioactive dietary compounds

Oxidative stress (OS) occurs when the antioxidant defense system is overwhelmed by the predominance of reactive oxygen species (ROS) and pro-oxidant factors. Several diseases such as hypertension, insulin resistance, type 2 diabetes mellitus and neurodegenerative diseases are characterized by chronic OS. Physical exercise constitutes an affordable tool to prevent or ameliorate these conditions. However, during physical activity, acute ROS are produced inducing an activation in peroxisome proliferator activated receptor-Gamma Coactivator-1alpha (PGC-1α), and nuclear factor erythroid-2 related factor 2 (Nrf2), PGC-1α/Nrf2 pathway. This signaling pathway facilitates interaction with antioxidant response elements (ARE), thereby initiating an upregulation in the expression of antioxidant enzymes including superoxide dismutase (SOD), catalase (CAT), glutathione peroxidase (GPX) and mitochondrial biogenesis. In both cases, whether involving healthy animals or individuals engaged in physical exercise, supplementation with antioxidant scavengers leads to a reduction in the expression and activity of PGC-1α, SOD, CAT, and GPX across various tissues, which is not observed with indirect antioxidants. The preventive role of physical exercise against chronic OS is avoided when executed in conjunction with supplementation of scavenger antioxidants. However, similar to exercise, the indirect antioxidant apigenin can activate the PGC1-α/Nrf2 signaling pathway. Here, we summarize evidence supporting apigenin as a non-nutritional supplement that could enhance the adaptive effects of exercise, improving the endogenous antioxidant defense. Therefore, apigenin could be an interesting supplement to enhance the endogenous antioxidant adaptation induced by exercise in healthy subjects, but also to improve the effectiveness of exercise to prevent oxidative stress-associated diseases.

El estrés oxidativo (OS) ocurre cuando el sistema de defensa antioxidante es sobrepasado por el predominio de especies reactivas de oxígeno (ROS) y factores prooxidantes. Varias enfermedades como la hipertensión, la resistencia a la insulina, la diabetes mellitus tipo 2 y enfermedades neurodegenerativas se caracterizan por un OS crónico. El ejercicio físico constituye una herramienta asequible para prevenir o mejorar estas enfermedades. Sin embargo, durante la actividad física, se producen ROS agudas que inducen una activación en la vía PGC-1α/Nrf2. Esta vía de señalización facilita la interacción con los elementos de respuesta antioxidante (ARE), iniciando así una regulación que permite la expresión de enzimas antioxidantes, incluidas SOD, CAT, GPX y biogénesis mitocondrial. En ambos casos, ya sea que se trate de animales sanos o de individuos que practican ejercicio físico, la suplementación con antioxidantes "scavengers" conduce a una reducción en la expresión y actividad de PGC-1α, SOD, CAT y GPX en varios tejidos, lo que no se observa con antioxidantes "indirectos". El papel preventivo del ejercicio físico contra el OS crónico se atenúa cuando se realiza en conjunto con la suplementación de antioxidantes "scavengers". Sin embargo, de manera similar al ejercicio, la apigenina es un antioxidante "indirecto" que puede activar la vía de señalización PGC1-α/Nrf2. Aquí, resumimos la evidencia que respalda a apigenina como un suplemento no-nutricional que podría mejorar los efectos adaptativos del ejercicio, mejorando la defensa antioxidante endógena de sujetos sanos que no tienen suficiente tiempo para hacer ejercicio.

Monkeypox virus genome sequence from an imported human case in Colombia / Secuencia genómica del virus de la viruela símica de un caso importado en Colombia

Introduction: Monkeypox virus (MPXV) is an enveloped double-stranded DNA virus with a genome of approximately 197.209 bp. The current classification divides MPXV into three clades: Clade I (Central African or Congo Basin clade) and clades IIa and IIb (West African clades). Objective: To report the complete genome and phylogenetic analysis of a human monkeypox case detected in Colombia. Materials and methods: Exudate from vesicular lesions was obtained from a male patient with recent travel history to Spain. A direct genomic approach was implemented in which total DNA from the sample was purified through a column-based method, followed by sequencing on the Nanopore GridION. Reads were aligned against the MPXV reference genome using minimap2 v.2.24 and phylogenetic inference was performed using maximum likelihood estimation. Results: A total of 11.951 reads mapped directly to a reference genome with 96.8% of coverage (190.898 bp). Conclusion: Phylogenetic analysis of the MPXV circulating in Colombia demonstrated its close relationship to clade IIb responsible for the multi-country outbreak in 2022.

Introducción. El virus de la viruela del mono (MPXV) está compuesto por un genoma de ADN bicatenario, aproximadamente, de 197.209 pb. La clasificación actual agrupa el MPXV en tres clados: clado I (de la cuenca del Congo en África central), y clados IIa y IIb (de África occidental). Objetivo. Reportar el genoma completo y el análisis filogenético de un caso humano de viruela símica detectado en Colombia. Materiales y métodos. Se obtuvo exudado de lesiones vesiculares de un paciente varón con el antecedente de un viaje reciente a España. Se implementó un enfoque directo, en el cual se purificó el ADN total de la muestra mediante un método basado en columnas, seguido de la secuenciación directa en la plataforma Nanopore GridION. Las lecturas se alinearon con el genoma de referencia del MPXV, utilizando minimap2, v.2.24, y la inferencia filogenética fue realizada mediante la estimación por máxima verosimilitud. Resultados. Un total de 11.951 lecturas se alinearon directamente con el genoma de referencia con una cobertura del 96,8 % (190.898 pb). Conclusión. El análisis filogenético del MPXV circulante en Colombia demostró su estrecha relación con el clado de África occidental (clado IIb) responsable del brote en múltiples países en el 2022.

Principales secuelas post neumonía por COVID-19 en pacientes egresados de hospitalización / Main sequelae after COVID-19 pneumonia in patients discharged from hospitalization

Objetivo: Analizar las principales secuelas post neumonía por COVID-19 en pacientes egresados de hospitalización. Método: Revisión bibliográfica narrativa no sistemática. Resultados: 15 artículos analizados. Conclusión: La infección por SARS-CoV-2 afecta principalmente a los pulmones, produciendo en los pacientes neumonía y síndrome de dificultad respiratoria aguda. La infección por SARS-Cov-2 deja secuelas principalmente a nivel pulmonar y cardiaco, relacionado a la gravedad del cuadro agudo, muchas de ellas pueden persistir durante mucho tiempo y llevar a un estado de incapacidad para los pacientes en relación con su bienestar previo al contagio.

Objective: To analyze the main post COVID-19 pneumonia sequelae in patients discharged from hospitalization. Method: Non-systematic narrative bibliographic review. Results: 15 articles analyzed. Conclusion: SARS-CoV-2 infection mainly affects the lungs, producing pneumonia and acute respiratory distress syndrome in patients. SARS-Cov-2 infection leaves sequelae mainly at pulmonary and cardiac level, related to the severity of the acute picture, many of them can persist for a long time and lead to a state of disability for patients in relation to their well-being prior to infection.

Paciente masculino con síndrome antifosfolipídico con compromiso cardiopulmonar y renal. Caso clínico / Male patient with antiphospholipid syndrome with cardiopulmonary and renal involvement. Case report

Objetivo: Analizar el caso clínico de un paciente masculino con síndrome antifosfolipídico con compromiso cardiovascular y renal en el Hospital Regional docente Ambato, detallando factores que provocaron en el paciente el desarrollo de complicaciones y las medidas a tomar para establecer un diagnóstico adecuado y el tratamiento integral. Método: Análisis del caso clínico del paciente masculino de 28 años de edad. Resultados y conclusiones: En el caso clínico expuesto; el estado de hipercoagulabilidad del paciente causó patologías tromboembólicas en diferentes niveles de aparatos y sistemas; estos fueron: trombosis pulmonar aguda que se complicó al presentar el paciente una NAC, trombos en la aurícula derecha, hipertensión pulmonar y trombocitopenia. Los criterios clásicos que deben estar presentes en el síndrome antifosfolípido son: presencia de anticuerpos anticardiolipina o anticoagulante lúpico, las complicaciones trombóticas, y si la paciente es de sexo femenino se incluyen un criterio extra que son los abortos espontáneos.

Objective: To analyze the clinical case of a male patient with antiphospholipid syndrome with cardiovascular and renal involvement at the Hospital Regional docente Ambato, detailing factors that caused the development of complications in the patient and the measures to be taken to establish an adequate diagnosis and comprehensive treatment. Methods: Analysis of the clinical case of a 28-year-old male patient. Results and conclusions: In the clinical case presented; the hypercoagulable state of the patient caused thromboembolic pathologies at different levels of apparatus and systems; these were: acute pulmonary thrombosis which was complicated by the patient presenting with CAP, thrombi in the right atrium, pulmonary hypertension and thrombocytopenia. The classic criteria that must be present in antiphospholipid syndrome are: presence of anticardiolipin antibodies or lupus anticoagulant, thrombotic complications, and if the patient is female an extra criterion is included which are spontaneous abortions.

Morbimortalidad en pacientes COVID-19 positivo / Morbimortality in COVID-19 positive patients

Objetivo: Descripción de la actualidad de la morbimortalidad de pacientes COVID-19 positivo en el Hospital General Docente "Ambato", para comprender el comportamiento del virus. Método: Descriptiva observacional y análisis de casos de morbimortalidad de pacientes. Resultados: La mayor prevalencia de casos COVID-19 se encuentra en adultos maduros (40-65 años) con un 48.1% de los casos registrados. Conclusión: La patogenia en pacientes COVID-19; en los registros proporcionados por el Hospital General Docente Ambato, se evidencia que la existencia de alguna comorbilidad de transcurso crónico, sobre todo en patologías cardiovasculares, respiratorias, renales y endocrino-metabólicas; sumándole a esto, en las poblaciones más vulnerables como son de adultos maduros (40 ­ 64 años de edad); de adultos mayores (> de 65 años); explicarían la tasa elevada de mortalidad y las implicaciones de la aparición de casos críticos, debido a la gravedad de las complicaciones evolutivas conduciendo a la vida humana a un desenlace fatal.

Objective: Description of the current morbimortality of COVID-19 positive patients at the Hospital General Docente "Ambato", in order to understand the behavior of the virus. Method: Descriptive observational and case analysis of patient morbimortality. Results: the highest prevalence of COVID-19 cases is found in mature adults (40-65 years) with 48.1% of registered cases. Conclusion: The pathogenesis in COVID-19 patients; in the records provided by the Hospital General Docente Ambato, it is evident that the existence of some comorbidity of chronic course, especially in cardiovascular, respiratory, renal and endocrine-metabolic pathologies; adding to this, in the most vulnerable populations such as mature adults (40 - 64 years of age); older adults (> 65 years of age); would explain the high mortality rate and the implications of the appearance of critical cases, due to the severity of the evolutionary complications leading to a fatal outcome in human life.

Potencial efecto terapéutico de los polifenoles obtenidos de la cáscara de granada en la esteatosis hepática

RESUMEN Antecedentes: La enfermedad por hígado graso no alcohólico (EHGNA) tiene una elevada prevalencia a nivel mundial, y puede ir desde la esteatosis simple hasta hepatocarcinoma. Su origen es multifactorial, siendo la dieta poco saludable un factor clave en su patogenia y progresión. Los polifenoles son antioxidantes que han mostrado beneficios en el tratamiento de la EHGNA. Una fuente emergente de estos compuestos son los residuos agroindustriales, entre ellos, la cáscara de granada. La cáscara de granada tiene un alto contenido de polifenoles, específicamente de elagitaninos. Su extracto fenólico (extracto de cáscara de granada; ECG) ha mostrado efectos promisorios a nivel metabólico. Sin embargo, su uso presenta algunas limitantes que deben ser consideradas antes de recomendar su ingesta mediante alimentos funcionales o nutracéuticos para prevención o tratamiento de EHGNA. Objetivo: Discutir a partir de datos obtenidos en estudios in vitro y modelos animales, el potencial terapéutico de los polifenoles obtenidos de la cáscara de granada para prevención y tratamiento de la EHGNA. Metodología: Se realizó una búsqueda bibliográfica en bases de datos PubMed y Web of Science (2015 a la fecha) de estudios en modelos de esteatosis hepática in vitro y en animales, además de ensayos clínicos relacionados. Conclusión: Existen datos promisorios sobre el uso del ECG en alteraciones metabólicas propias de la EHGNA y esteatosis hepática, principalmente a nivel de perfil lipídico. Se deben discutir las dosis y formas de administración, con el fin de mejorar su estabilidad y biodisponibilidad. Se requieren ensayos clínicos controlados que confirmen los efectos en humanos.

ABSTRACT Background: Nonalcoholic fatty liver disease (NAFLD) has a high prevalence worldwide and can range from simple steatosis to hepatocarcinoma. Its causes are multifactorial, with an unhealthy diet being a key factor in its pathogenesis and progression. Polyphenols are antioxidants that have shown benefits in treating NAFLD. An emerging source of these compounds is agro-industrial by-products, including pomegranate peels. Pomegranate peels are high in polyphenols, specifically ellagitannins. Its polyphenolic extract (PPE) has shown promising metabolic benefits. However, its use has some limitations that must be considered before recommending its intake through functional foods or nutraceuticals to prevent or treat NAFLD. Objective: This article aims to discuss, using results from in vitro studies and animal models, the therapeutic potential of polyphenols obtained from pomegranate peels to prevent and treat NAFLD. Methods: A bibliographic search was carried out in PubMed and Web of Science databases (2015 to date) of in vitro and animal model studies of hepatic steatosis, in addition to related clinical trials. Conclusion: There are promising data on the use of PPE in metabolic disorders typical of NAFLD and hepatic steatosis, mainly improving lipid profile. Doses and vehicles of administration should be discussed to improve stability and bioavailability. Controlled clinical trials are required to confirm the effects in humans.

Nueva normalidad y el falso dilema salud/economía en tiempos de pandemia Covid-19 en Latinoamérica / New normal and the false health/economy dilemma during the Covid-19 pandemic in Latin America / Nova normalidade e o falso dilema saúde/economia em tempos da pandemia de Covid-19 na América Latina

El Covid-19 ha intensificado la crisis sanitaria y económica en América Latina, incidiendo fuertemente en el retorno securitario hacia el Estado-Nación. Esta voluntad gubernamental, regulada por dispositivos de afrontamiento ante la "excepcionalidad pandémica", se ha visto acompañada por la instalación discursiva de una "nueva normalidad". Conscientes de esta problemática, desde los principios teóricos-metodológicos del análisis crítico del discurso, buscamos examinar la construcción de la "nueva normalidad" desde las alocuciones de los presidentes de Brasil, Chile y Ecuador en el actual contexto pandémico. Los principales hallazgos conciben a la nueva normalidad como un dispositivo que no sólo ha logrado traducir viejas prácticas gubernamentales bajo la legitimidad del Estado de excepción, sino también como un proceso continuista de la vulnerabilización y colonización latinoamericana. Finalmente, este dispositivo es problematizado tanto por la instalación del falso dilema entre salud/economía, como desde su capacidad semiótica para alinearse con el orden discursivo hegemónico del neoliberalismo regional.

Covid-19 has intensified the health and economic crisis in Latin America, strongly affecting a safe return to the Nation-State. This governmental will, regulated by coping devices in the face of "pandemic exceptionality", has been accompanied by the discursive set-up of a "new normal". Being aware of this problem and starting from the theoretical-methodological principles of the critical discourse analysis, we seek to examine the construction of this "new normal" in the speeches of the Brazil, Chile, and Ecuador presidents in the current pandemic context. The main findings conceive the new normal not only as a device that has translated old governmental practices under the State of emergency legitimacy, but also as a continuous process of Latin American vulnerability and colonization. Finally, this device is problematized both by the installation of the false dilemma between health and economy, and by its semiotic ability to align itself with the hegemonic discursive order of regional neoliberalism.

A Covid-19 intensificou a crise econômica e de saúde na América Latina, afetando fortemente o retorno da segurança ao Estado- -nação. Essa vontade governamental, regulada por dispositivos de enfrentamento à "excepcionalidade pandêmica", tem sido acompanhada pela instalação discursiva de um "novo normal". Cientes dessa problemática, a partir dos princípios teórico-metodológicos da análise crítica do discurso, buscamos examinar a construção do "novo normal" a partir das falas dos presidentes do Brasil, Chile e Equador no atual contexto pandêmico. Os principais achados concebem o novo normal como um dispositivo que não só conseguiu traduzir velhas práticas governamentais sob a legitimidade do Estado de exceção, mas também como um processo contínuo de vulnerabilidade e colonização latino-americana. Por fim, esse dispositivo é problematizado tanto pela instalação do falso dilema saúde/economia, quanto por sua capacidade semiótica de alinhar-se à ordem discursiva hegemônica do neoliberalismo regional.

Impacto de la covid-19 en la pobreza mundial / Impact of COVID-19 on global poverty

La pandemia covid-19 se ha configurado como el mayor evento de salud pública conocido por las actuales generaciones, y cuyos efectos han trascendido a los sectores social y económico, llevando a 100 (88-115) millones de personas a condiciones de pobreza, y profundizando el impacto en la población ya considerada vulnerable, revirtiendo los avances previos en materia de progreso económico del actual siglo. Gran parte de esas repercusiones se relacionan a la importante transformación en las costumbres e interacciones de la sociedad a consecuencia de esta crisis sanitaria, que a su vez modificaron la dinámica económica en pequeña y gran escala. El impacto de esta enfermedad ha alcanzado el empleo, ingreso y estabilidad de los trabajadores, forjando un deterioro del capital humano y de las capacidades productivas, desfavoreciendo en especial a las mujeres, que serán más pobres que los hombres para 2030. En estas condiciones, el objetivo de reducir la tasa absoluta mundial de pobreza por debajo del 3 % para el año 2030, adoptado por las Naciones en la firma de los Objetivos de Desarrollo Sostenible (PNUD, 2021), se hará inalcanzable si no se adoptan medidas políticas rápidas, significativas y sustanciales(AU)

The covid-19 pandemic has become the largest public health event known to current generations, and whose effects have transcended the social and economic sectors, leading 100 (88-115) million people to conditions of poverty, and deepening the impact on the population already considered vulnerable, reversing previous advances in economic progress of the current century. A large part of these repercussions are related to the important transformation in the customs and interactions of society as a result of this health crisis, which in turn modified the economic dynamics on a small and large scale. The impact of this disease has reached the employment, income and stability of workers, forging a deterioration of human capital and productive capacities, especially disadvantaging women, who will be poorer than men by 2030. Under these conditions, the goal of reducing the global absolute poverty rate below 3% by 2030, adopted by the Nations at the signing of the Sustainable Development Goals (UNDP, 2021), will become unattainable without swift political action, significant and substantial(AU)