Microbial-Based Biofungicides Mitigate the Damage Caused by Fusarium oxysporum f. sp. cubense Race 1 and Improve the Physiological Performance in Banana.

Fusarium wilt of banana (FWB) is the most limiting disease in this crop. The phytosanitary emergency caused by FWB since 2019 in Colombia has required the development of ecofriendly control methods. The aim of this study was to test the effectiveness of microbial-based biofungicides against FWB caused by Fusarium oxysporum f. sp. cubense race 1 (Foc R1) and correlate such effect with plant physiological parameters. Five Trichoderma (T1 to T4 and T9) and four Bacillus (T5 to T8)-based biofungicides were evaluated in pot experiments. In vitro, dual confrontation tests were also carried out to test whether the in vitro effects on Foc growth were consistent with the in vivo effects. While Trichoderma-based T3, T4, and T9, and Bacillus-based T8, significantly reduced the growth of Foc R1 in vitro, Trichoderma-based T1, T3, T4, and T9 temporarily reduced the Foc population in the soil. However, the incidence progress of FWB was significantly reduced by Bacterial-based T7 (74% efficacy) and Trichoderma-based T2 (50% efficacy). The molecular analysis showed that T7 prevented the inner tissue colonization by Foc R1 in 80% of inoculated plants. The T2, T4, T7, and T9 treatments mitigated the negative effects caused by Foc R1 on plant physiology and growth. Our data allowed us to identify three promising treatments to control FWB, reducing the progress of the disease, delaying the colonization of inner tissue, and mitigating physiological damages. Further studies should be addressed to determine the modes of action of the biocontrol agents against Foc and validate the utilization in the field.

Hydrogel capsules as new delivery system for Trichoderma koningiopsis Th003 to control Rhizoctonia solani in rice (Oryza sativa).

The incorporation of biological control agents (BCAs) such as Trichoderma spp. in agricultural systems favors the transition towards sustainable practices of plant nutrition and diseases control. Novel bioproducts for crop management are called to guarantee sustainable antagonism activity of BCAs and increase the acceptance of the farmers. The encapsulation in polymeric matrices play a prominent role for providing an effective carrier/protector and long-lasting bioproduct. This research aimed to study the influence of biopolymer in hydrogel capsules on survival and shelf-life of T. koningiopsis. Thus, two hydrogel capsules prototypes based on alginate (P1) and amidated pectin (P2), containing conidia of T. koningiopsis Th003 were formulated. Capsules were prepared by the ionic gelation method and calcium gluconate as crosslinker. Conidia releasing under different pH values of the medium, survival of conidia in drying capsules, storage stability, and biocontrol activity against rice sheath blight (Rhizoctonia solani) were studied. P2 prototype provided up to 98% survival to Th003 in fluid bed drying, faster conidia releasing at pH 5.8, storage stability greater than 6 months at 18 °C, and up to 67% of disease reduction. However, both biopolymers facilitate the antagonistic activity against R. solani, and therefore can be incorporated in novel hydrogel capsules-based biopreparations. This work incites to develop novel biopesticides-based formulations with potential to improve the delivery process in the target site and the protection of the active ingredient from the environmental factors.

Relaciones institucionales en la implementación de estrategias de promoción, protección y apoyo de la lactancia materna: una revisión integrativa / Institutional relationships in the implementation of breastfeeding promotion, protection and support strategies: an integrative review

Fundamentos: la importancia que tiene la lactancia materna en la salud y calidad de vida de los individuos hace necesario que las políticas establecidas para su promoción sean operadas mediante la participación y articulación de instituciones y a través de redes interinstitucionales. Métodos: para la compilación de la información se hizo una revisión integrativa de literatura, cuyo propósito fue ampliar la comprensión de un tema a partir de la recopilación, sistematización y análisis de producciones científicas. Resultados: se seleccionaron 14 artículos publicados entre 2013 y 2020 y, en su mayoría, escritos en inglés, provenientes de países como Estados Unidos, Alemania, Reino Unido y Samoa. Los temas más recurrentes fueron el análisis de políticas públicas, la coordinación de programas y la percepción del funcionamiento de las estrategias de promoción, protección y apoyo a la lactancia materna. En conclusión: las relaciones intra e interinstitucionales son claves a la hora de implementar políticas de promoción de la lactancia materna. Sin embargo, para su puesta en marcha, se requiere financiación y articulación en los niveles operativos de sistemas de salud. En definitiva, las labores de articulación, seguimiento y evaluación requieren relaciones fortalecidas que fomenten, protejan, promuevan y apoyen la práctica de la lactancia materna. (AU)

Background: the importance of breastfeeding in the health and quality of life of individuals makes it necessary for the policies established for its promotion to be implemented through the participation and coordination of institutions and through inter-institutional networks. Methods: for the compilation of the information, an integrative literature review was carried out, the purpose of which was to broaden the understanding of a topic through the collection, systematization and analysis of scientific productions. Results: 14 articles published between 2013 and 2020 and mostly written in English were selected from countries such as the United States, Germany, United Kingdom and Samoa. The most recurrent themes were the analysis of public policies, program coordination and perceptions of the functioning of breastfeeding promotion, protection and support strategies. Conclusions: Intra- and inter-institutional relationships are key to the implementation of breastfeeding promotion policies. However, their implementation requires funding and coordination at the operational levels of health systems. In short the articulation, monitoring and evaluation require strengthened relationships that encourage, protect, promote and support the practice of breastfeeding. (AU)

Risk factors for reamputation in patients with diabetic foot: A case-control study.

BACKGROUND: Reamputation as a complication of diabetic foot ulcers presents a high economic burden and represents a therapeutic failure. It is paramount to identify as early as possible patients in whom a minor amputation may not be the best option. The purpose of this investigation was to do a case-controlled study to determine risk factors associated with re-amputation in patients with DFU (diabetic foot ulcers) at two University Hospitals. METHODS: Multicentric, observational, retrospective, case-control study from clinical records of 2 university hospitals. Our study included 420 patients, with 171 cases (re-amputations), and 249 controls. We performed a multivariate logistic regression analysis and time-to-event survival analysis to identify re-amputation risk factors. RESULTS: Statistically significant risk factors were artery history of tobacco use (p = 0.001); male sex (p = 0.048); arterial occlusion in Doppler ultrasound (p = 0.001); percentage of stenosis in arterial ultrasound >50 % (p = 0.053); requirement of vascular intervention (p = 0.01); and microvascular involvement in photoplethysmography (p = 0.033). The most parsimonious regression model suggests that history of tobacco use, male sex, arterial occlusion in ultrasound, and percentage of stenosis in arterial ultrasound >50 % remained statistically significant. The survival analysis identified earlier amputations in patients with larger occlusion in arterial ultrasound, high leukocyte count, and elevated ESR. CONCLUSION: Direct and surrogate outcomes in patients with diabetic foot ulcers identify vascular involvement as an important risk factor for reamputation. LEVEL OF EVIDENCE: III.

Conocimientos, actitudes y prácticas sobre lactancia materna en minorías étnicas colombianas / Breastfeeding knowledge, attitudes and practices among Colombian ethnicminorities

Introducción: la lactancia materna tiene beneficios tanto para la madre como para el bebé. Así, las actitudes,conocimientos, influencias de familiares, personas cercanasy personal de salud influyen positivamente al momento deamamantar.Objetivo: describir los conocimientos, actitudes, prácticas y factores relacionados con la decisión de practicar la lactancia materna, específicamente en el caso de madres lactantes afrodescendientes e indígenas que asisten al programa decrecimiento y desarrollo en Jamundí, Colombia. Métodos y materiales: estudio cualitativo descriptivo con perspectiva etnográfica realizado en el municipio de Jamundí,Valle con la participación de 27 madres entre los 18 y 49 años que se identifican a sí mismas como parte de etnias indígenas o afrodescendientes. El instrumento principal para la recolección de información fue la entrevista semi estructurada. Resultados: Buena parte de las madres entrevistadas tienen una actitud positiva frente a la lactancia. Además, mostraron conocimientos básicos a pesar de no haber sido capacitadas en ocasiones anteriores. Conclusión: las prácticas de lactancia materna son influenciadas por factores familiares y sociales.(AU)

Introduction: Breastfeeding has benefits for both motherand baby. The attitudes, knowledge, influences of relatives,close people and health personnel can positively influence themoment of breastfeeding, as well as the influence of closepeople, health personnel and family members.Objective:Describe the knowledge, attitudes and practices, as well as the factors related to the decision to breastfeed in the case of Afrodescendant and indigenous breastfeeding mothers who attend the growth and developmentprogram in Jamundí, Colombia.Methods and materials: Descriptive qualitative study withan ethnographic perspective carried out in the municipality ofJamundí with the participation of 27 mothers between the agesof 18 and 49 who consider themselves to be part of indigenousor Afrodescendant ethnic groups. The main instrument forgenerating information was the semistructured interview.Results: Many of the mothers interviewed have a positiveattitude towards breastfeeding. In addition, they showed basic knowledge despite not having been trained on previousoccasions. Conclusion: The practices are influenced by family andsocial factors.(AU)

Factores asociados con amputación de miembros inferiores de pacientes con pie diabético en una cohorte / Factors associated with lower limb amputation of patients with diabetic foot in a cohort

Introducción: El desarrollo de ulceraciones en el Pie Diabético (PD) puede derivar en amputación de miembros inferiores e incluso impactar la morbi mortalidad de los pacientes diabéticos. Por lo anterior, este estudio pretende evaluar las características de los pacientes con PD hospitalizados y manejados en un hospital regional. Materiales y métodos: 121 pacientes son incluidos en el estudio de cohorte retrospectiva entre amputados y no amputados, tomados de la base de datos del hospital entre enero de 2013 y enero de 2018. Los datos demográficos, así como factores relacionados fueron analizados con regresión logística bi y multivariada en relación con la amputación de miembro inferior como variable de desenlace, calculando razón de probabilidades (OR) con intervalos de confianza del 95%. Dicha información fue analizada con el programa estadístico STATA. Resultados: 81 pacientes requirieron amputación de miembros inferiores. En la regresión logística bivariada hay 3 factores relacionados con amputación [nivel de Wagner (p < 0.05 CI 95%), la presencia de leucocitosis (p <0.05 CI 95%) y el compromiso vascular en Doppler arterial (p < 0.05 CI 95%)], sin embargo, la regresión multivariada sólo relaciona el compromiso vascular del Doppler arterial como estadísticamente significativo con amputación de miembros inferiores (p < 0.05 CI 95%). Conclusión: Se muestran 3 factores estadísticamente significativos con la amputación de miembros inferiores en PD (Wagner, leucocitosis y compromiso vascular), reflejando la importancia de un diagnóstico temprano y un manejo adecuado como parte clave en el manejo de esta patología.

Introduction: The development of ulcerations in the Diabetic Foot (DP) can lead to lower limb amputation and even impact the morbidity and mortality of diabetic patients. Therefore, this study aims to evaluate the characteristics of patients with PD hospitalized and managed in a regional hospital. Materials and methods: 121 patients are included in the retrospective cohort study between amputees and non-amputees, taken from the hospital database between January 2013 and January 2018. Demographic data, as well as related factors, were analyzed with logistic regression. bi and multivariate in relation to lower limb amputation as an outcome variable, calculating odds ratio (OR) with 95% confidence intervals. This information was analyzed with the STATA statistical program. Results: 81 patients required lower limb amputation. In the bivariate logistic regression there are 3 factors related to amputation [Wagner level (p < 0.05 95% CI), the presence of leukocytosis (p < 0.05 95% CI) and vascular compromise on arterial Doppler (p < 0.05 95% CI). )], however, multivariate regression only relates vascular compromise on arterial Doppler as statistically significant to lower limb amputation (p < 0.05 95% CI). Conclusion: 3 statistically significant factors are shown with lower limb amputation in PD (Wagner, leukocytosis and vascular compromise), reflecting the importance of early diagnosis and adequate management as a key part in the management of this pathology.

Therapeutic effect of two muscle strengthening programs in patients with patellofemoral pain syndrome. A randomized controlled clinical trial / Efecto terapéutico de dos programas de fortalecimiento muscular en pacientes con síndrome de dolor pátelofemoral. Ensayo clínico controlado aleatorizado

Abstract Introduction: Patellofemoral pain syndrome (PFPS) is one of the most common musculoskeletal disorders affecting the knee joint. Conservative treatment reduces pain and improves functional capacity in the short and medium-term. Objective: To determine the therapeutic effect of two muscle strengthening exercise programs in patients with PFPS from Bogotá, Colombia, aged between 15 and 40 years. Materials and methods: Experimental randomized controlled clinical trial conducted in 40 patients with PFPS from Bogotá, Colombia, aged 15-40 years, with a mild to moderate level of physical activity. Participants were randomly distributed into 2 intervention groups: Group A: 8-week-long core, hip and knee muscles strengthening exercises program; Group B: 8-week-long hip and knee muscles strengthening exercises program. The level of pain was measured using the Visual Analog Scale and the Kujala Anterior Knee Pain Scale. Results: The addition of core muscle strengthening exercises to the traditional treatment improved the quality of life of participants in the intervention group A, where a significant reduction of pain, with a statistically significant difference in the total score of the Kujala scale (p=0.025) was observed. Conclusions: Including core muscle strengthening exercises in the conservative management of PFPS increases its effectiveness to reduce pain and improve the quality of life of these patients. ClinicalTrials.gov Identifier: NCT04011436

Resumen Introducción. El síndrome de dolor pátelofemoral (SPF) es una de las alteraciones musculoesqueléticas más frecuentes que afectan la articulación de la rodilla. El tratamiento conservador reduce el dolor y mejora la capacidad funcional en el corto y mediano plazo. Objetivo. Establecer el efecto terapéutico de dos programas de ejercicios de fortalecimiento muscular en pacientes con SPF de Bogotá, Colombia, con edades entre 15 y 40 años. Materiales y métodos. Ensayo clínico controlado aleatorio experimental realizado en 40 pacientes con SPF de Bogotá, Colombia, con edades entre los 15 y 40 años, con nivel de actividad física leve a moderada y que fueron distribuidos de forma aleatoria en 2 grupos de intervención: Grupo A: programa de ejercicios de fortalecimiento de los músculos del core, la cadera y la rodilla con una duración de 8 semanas; Grupo B: programa de ejercicios de fortalecimiento de los músculos de la cadera y la rodilla con la misma duración. El nivel de dolor se midió a través de la Escala Visual Analógica y de la Escala de Kujala para dolor patelofemoral. Resultados. La adición de ejercicios de fortalecimiento de los músculos del core al tratamiento tradicional mejoró la calidad de vida de los participantes en el grupo de intervención A, donde se observó una reducción significativa del dolor con una diferencia estadísticamente significativa en la puntuación total de la escala Kujala (p=0.025). Conclusiones. Incluir ejercicios de fortalecimiento de los músculos del core al manejo conservador del SPF aumenta su efectividad para reducir el dolor y mejorar la calidad de vida de estos pacientes. ClinicalTrials.gov Identifier: NCT04011436

Biplanar Osteosynthesis for Severely Displaced Proximal-Third Clavicle Fracture: A Case Report.

CASE: We present the case of a 41-year-old man with a displaced extra-articular proximal-third clavicle fracture managed with open reduction and double-plate internal fixation. Twelve months after the procedure, the patient had recovered full range of motion and returned to work. CONCLUSIONS: Proximal-third clavicle fractures are infrequent injuries and are usually treated conservatively. They are associated with thoracic injuries or high-energy dorsal or cervical spinal trauma. In the case of displaced fractures and small medial fragments, orthopaedic management may have unsatisfactory results, creating symptomatic nonunions and functional limitation, we propose a biplanar osteosynthesis, which could be an effective treatment.

Desenlaces clínicos y radiológicos de las fracturas de maléolo lateral manejadas de forma percutánea. Serie de casos / Clinical and radiological outcomes of percutaneously managed lateral malleolar ankle fractures. Case series

Introducción El estándar de manejo para las fracturas del peroné distal es la reducción abierta más fijación interna con placa y tornillos (bloqueados o no), sin embargo, existen complicaciones asociadas a este tipo de intervención. En pacientes ancianos con mala calidad de tejidos blandos o en quienes presentan traumas de alta energía como etiología de las fracturas en el tobillo, la tasa de complicaciones previamente mencionadas aumenta, por lo que el manejo de las fracturas de peroné distal con tornillos percutáneos representa una alternativa con menor riesgo de complicaciones y con desenlaces similares al manejo convencional. Materiales y métodos Se realiza una serie de casos de pacientes con fractura de peroné manejados de forma percutánea. Se obtuvo una muestra de 17 pacientes por un año, a quienes se les realizó seguimiento sobre tasa de consolidación, funcionalidad y complicaciones postoperatorias. Resultados Diez (62,5%) fueron hombres, con una media de edad de 59 años (rango entre 24 y 90). El 100% fueron secundarios a traumas de alta energía, 10 (62,5%) fueron izquierdas, 14 (87,5%) se clasificaron como Weber B y 7 casos (56,25%) se presentaron concomitantemente con fracturas abiertas. Conclusiones Con el fin de evitar complicaciones, se debe considerar este abordaje en pacientes con comorbilidades, de edad avanzada o con tejidos blandos lesionados severamente o de mala calidad

Background The standard management for distal fibula fractures is open reduction plus internal fixation with plate and screws (blocked or not), however, there are complications associated with this type of intervention. In elderly patients with poor soft tissue quality or in those with high-energy trauma as the etiology of ankle fractures, the rate of previously mentioned complications increases, so that the management of distal fibula fractures with percutaneous screws represents a alternative with lower risk of complications and similar outcomes to conventional management. Methods A series of cases of patients with fibula fracture managed percutaneously was carried out. A sample of 17 patients was obtained for one year, who were followed up on consolidation rate, functionality, and postoperative complications. Results 10 (62.5%) were men, with a mean age of 59 years (range between 24 and 90). 100% were secondary to high-energy trauma, 10 (62.5%) were left, 14 (87.5%) were classified as Weber B and 7 cases (56.25%) presented concomitantly with open fractures. Discussion In order to avoid complications, this approach should be considered in patients with comorbidities, the elderly, or those with severely injured or poor-quality soft tissues.

Entre el juego y la agresión: Normas y reglas del evento comunicativo lúdico en un contexto escolar / Between play and aggression: Norms and rules of playful communicative events in a scholastic context / Entre o jogo e a agressão: Normas e regras do evento comunicativo lúdico em um contexto escolar

La investigación tuvo como propósito comprender la agresión comunicativa entre estudiantes de cuarto grado de primaria. Nos enfocamos en el análisis de la agresión como un tipo de evento comunicativo que se desarrolla a través de normas de interacción e interpretación lingüística -verbales y no verbales- aprendidas y desarrolladas en comunidades de habla específicas. A través de un ejercicio extenso de etnografía de aula realizamos un análisis de actos comunicativos entre los escolares, especialmente durante los juegos. Analizamos las normas de interacción e interpretación puestas en escena durante eventos comunicativos escolares y lúdicos, para conocer los procesos de articulación de los enunciados interpretados como agresivos por los niños y las niñas. Los resultados señalan que en la dimensión comunicativa del juego escolar pueden surgir agresiones debido al manejo que los participantes hacen de las reglas y las normas comunicativas desarrolladas en el entorno cultural en el cual crecen e interactúan. El conjunto de competencias comunicativas aprendidas suele ser aprovechado para legitimar actos e interacciones agresivas de manera implícita, e incluirlo como parte de su cotidianidad escolar.

This research aims to understand communicative aggression amongstudents in the fourth grade. It is focused on an analysis of assault as a type of a communicative event that takes place through norms related to interaction and linguistic interpretation (verbal and nonverbal),which are learnt and developed within communities with specific languages.Through developing an extensive ethnography of the classroom, the authors conducted ananalysis of communicative actions, especially during play. The interaction and interpretation normsin place during school and play-based communicative events to identify the articulation processes ofthe statements interpreted as aggressive by the children.The results show that in the communicative dimension of play in school aggressions can occurdue to the use of communicative rules and norms by participants that are developed in the culturalsetting in which they grow and interact. The set of communicative competencies that are learnt areoften used to legitimize aggressive actors or interaction in an implicit manner, and are included aspart of their daily experience of school.

A pesquisa teve como objetivo compreender a agressão comunicativa entre os alunos da quarta série. Centra-se na análise de agressão como um tipo de evento de comunicação que ocorre através da interação e regras linguísticas de interpretação (verbal e não verbal) aprendido e desenvolvido em comunidades de fala específicos.Através de uma extensa etnografia de sala de aula foi realizada uma análise de atos comunicativos entre escolares, especialmente durante os jogos. Analisamos as regras de interação e interpretação,colocadas em cena durante eventos comunicativos escolares e de lazer para conhecer os processos comunicativos de articulação das declarações interpretadas como agressiva pelas crianças. Os resultados indicam que na dimensão comunicativa dos jogos escolares podem surgir agressões devido ao manejo que os participantes fazem das regras e normas comunicativas desenvolvidas no ambiente cultural em que crescem e interagem. O conjunto de habilidades de comunicação aprendidas são frequentemente explorados para legitimar atos e interações implicitamente agressivas e incluí-los como parte de seu cotidiano escolar.

Validación al español de la escala «The Iowa satisfaction with anesthesia scale (ISAS)¼ para cuidado anestésico monitorizado en cirugía de oftalmología / Validation to Spanish of the Iowa Satisfaction with Anesthesia Scale (ISAS) for monitored anesthesia care in ophthalmic surgery

La herramienta «The IOWA satisfaction with anesthesia scale (ISAS)¼ fue desarrollada rigurosamente y ha demostrado ser válida y confiable para evaluar la satisfacción del paciente con el cuidado anestésico monitorizado (CAM) en múltiples escenarios; un instrumento de estas características es importante, dado el auge que el CAM está teniendo en el medio. Objetivo: Validar al español la escala ISAS y establecer los indicadores de validez y confiabilidad en pacientes tratados mediante cirugías de oftalmología bajo CAM. Métodos: Se hizo traducción y retrotraducción de la escala, validación de apariencia y pruebas piloto para ajustes. Se aplicó el instrumento definitivo a 117 sujetosmayores de 18 años, ASA I-III en 2 instituciones de salud en Villavicencio (departamento del Meta, Colombia) para medir la validez de criterio concurrente entre los pacientes y el anestesiólogo del caso; se estableció la consistencia interna de la escala en su primera aplicación a los sujetos y se aplicó por segunda y tercera vez el instrumento para verificar confiabilidad test-retest. Resultados: Se constató validez de criterio concurrente anestesiólogo-paciente, con Pearson 0,85 IC 95% (0,79-0,89), intraclase 0,82 IC 95% (0,77-0,88), se midió la consistencia interna con un alfa de Cronbach de 0,71, confiabilidad test-retest (40-65 min), Pearson e intraclase 0,95 IC 95% (0,93-0,96) (12-36 h) Pearson 0,65 IC 95% (0,52-0,75), intraclase 0,64 IC 95% (0,53-0,76). Conclusiones: La validación de la escala ISAS al español permite usar un instrumento válido y confiable para medir objetivamente la satisfacción del paciente en cirugía de oftalmología bajo CAM.

The Iowa Satisfaction with Anesthesia Scale (ISAS) was rigorously developed and has been shown to be valid and reliable for evaluating patient satisfaction with monitored anesthesia care (MAC) in several scenarios. Such an instrument is important given the success thatMAC is enjoying in the field. Objective: Validate the ISAS in Spanish and establish indicators of validity and reliability in patients undergoing ophthalmic surgeries with MAC. Methods: A translation and back-translation of the scale, face validity and pilot tests for adjustmentswere completed. The final instrumentwas applied to 117 subjects over18 years of age, ASA I-III, in two healthcare institutions in Villavicencio (Meta Department, Colombia) in order to measure the concurrent criterion validity between the patients and the anesthesiologist of the case. The internal consistency of the scale was established in its first application to the subjects and later applied for the second and third times to verify the test-retest reliability. Results: A Pearson anesthesiologist/patient concurrent criterion validity 0.85 CI 95% (0.79-0.89), intra-class 0.82 CI 95% (0.77-0.88),was confirmed. Internal consistencywas measured with a Cronbach's alpha of 0.71. Test-retest reliability (40-65 min) was measured with Pearson and intra-class 0.95 CI 95% (0.93-0.96) and, (12-36 h) Pearson 0.65 CI 95% (0.52-0.75), intra-class 0.64 CI 95% (0.53-0.76). Conclusions: The validation of the ISAS in Spanish allows for the use of a valid and reliable instrument to objectively measure the satisfaction of the patient in ophthalmic surgery under MAC.