A soft systems approach of asthma management in children based on therapeutic education and e-learning.

One of the most common respiratory chronic diseases is asthma, with 5-16 % of world prevalence. In chronic disease, prevention, diagnosis, management, and palliation are the strategies for a care model; the patient-self management is fundamental with the so-called therapeutic education (TE) to train the patient in the necessary skills. The challenge of TE grows when the patient is a child or a person with special needs, even more in public health care in low- and middle-income countries. This is a problematic human situation, that needs soft system thinking. In this research, the analytic hierarchy process was used to determine the perceived importance of the factors that affect children's asthma health care in a public health institution in Mexico. The soft systems methodology (SSM) was applied to learn about the disease self-management, in order to obtain activities models and an action plan. According to AHP, human resources and education were percived as the most important among the factors that affect children health care within the institution. The perceived importance of two main subfactors (human resources training and TE) was around 34 %, which emphasizes the need to generate strategies for the improvement of the education of patients and health care providers. In MSS, the rich vision, the CATWOE, the root definition, and an activities model were proposed, including the application of an instructional design methodology (ADDIE) for the development of learning objects of asthma for children. Desirable and feasible actions and recommendations include the update of the national clinical practice guides, the use of control measures such as the Asthma Control Test, and a daily asthma diary to register the daily status of the breathing capacity, the drug administration, and the potential trigger events. The proposed model can be used as part of a systemic patient-and-family centered approach for chronic care model (CCM), particularly in diseases unsuitable for prevention interventions.

Los retos en la evaluación radiológica de las metástasis cerebrales, más allá de la progresión / Challenges in radiological evaluation of brain metastases, beyond progression

La resonancia magnética es la piedra angular en la evaluación de las metástasis cerebrales. Los retos clínicos residen en discriminar las metástasis de imitadores como infecciones o tumores primarios y en evaluar la respuesta al tratamiento. Este, en ocasiones, condiciona un crecimiento, que debe encuadrarse como una pseudoprogresión o una radionecrosis, ambos fenómenos inflamatorios atribuibles al mismo, o bien considerarse como una recurrencia. Para responder a estas necesidades, las técnicas de imagen son objeto de constantes investigaciones. No obstante, un crecimiento exponencial tras la radioterapia debe interpretarse con cautela, incluso ante resultados sospechosos de progresión por técnicas avanzadas, ya que puede tratarse de una radionecrosis. El objetivo de este trabajo es familiarizar al lector con los fenómenos inflamatorios de las metástasis cerebrales tratadas con radioterapia y describir dos signos radiológicos relacionados: la «nube inflamatoria» y el «realce en anillo incompleto», con el fin de adoptar un manejo conservador en estos casos.(AU)

MRI is the cornerstone in the evaluation of brain metastases. The clinical challenges lie in discriminating metastases from mimickers such as infections or primary tumors and in evaluating the response to treatment. The latter sometimes leads to growth, which must be framed as pseudo-progression or radionecrosis, both inflammatory phenomena attributable to treatment, or be considered as recurrence. To meet these needs, imaging techniques are the subject of constant research. However, an exponential growth after radiotherapy must be interpreted with caution, even in the presence of results suspicious of tumor progression by advanced techniques, because it may be due to inflammatory changes. The aim of this paper is to familiarize the reader with inflammatory phenomena of brain metastases treated with radiotherapy and to describe two related radiological signs: «the inflammatory cloud» and «incomplete ring enhancement», in order to adopt a conservative management with close follow-up.(AU)

Challenges in radiological evaluation of brain metastases, beyond progression.

MRI is the cornerstone in the evaluation of brain metastases. The clinical challenges lie in discriminating metastases from mimickers such as infections or primary tumors and in evaluating the response to treatment. The latter sometimes leads to growth, which must be framed as pseudo-progression or radionecrosis, both inflammatory phenomena attributable to treatment, or be considered as recurrence. To meet these needs, imaging techniques are the subject of constant research. However, an exponential growth after radiotherapy must be interpreted with caution, even in the presence of results suspicious of tumor progression by advanced techniques, because it may be due to inflammatory changes. The aim of this paper is to familiarize the reader with inflammatory phenomena of brain metastases treated with radiotherapy and to describe two related radiological signs: "the inflammatory cloud" and "incomplete ring enhancement", in order to adopt a conservative management with close follow-up.

Plasma SHBG Levels as an Early Predictor of Response to Bariatric Surgery.

BACKGROUND: Obesity is a growing global health problem, and currently, bariatric surgery (BS) is the best solution in terms of sustained total weight loss (TWL). However, a significant number of patients present weight regain (WR) in time. There is a lack of biomarkers predicting the response to BS and WR during the follow-up. Plasma SHBG levels, which are low in obesity, increase 1 month after BS but there is no data of plasma SHBG levels at long term. We performed the present study aimed at exploring the SHBG role in predicting TWL and WR after BS. METHODS: Prospective study including 62 patients with obesity undergoing BS. Anthropometric and biochemical variables, including SHBG were analyzed at baseline, 1, 6, 12, and 24 months; TWL ≥ 25% was considered as good BS response. RESULTS: Weight loss nadir was achieved at 12 months post-BS where maximum SHBG increase was reached. Greater than or equal to 25% TWL patients presented significantly higher SHBG increases at the first and sixth months of follow-up with respect to baseline (100% and 150% respectively, p = 0.025), than < 25% TWL patients (40% and 50% respectively, p = 0.03). Also, these presented 6.6% WR after 24 months. The first month SHBG increase predicted BS response at 24 months (OR = 2.71; 95%CI = [1.11-6.60]; p = 0.028) and TWL in the 12th month (r = 0.330, p = 0.012) and the WR in the 24th (r = - 0.301, p = 0.028). CONCLUSIONS: Our results showed for the first time that increase in plasma SHBG levels within the first month after BS is a good predictor of TWL and WR response after 2 years.

Lactoferrin gene polymorphisms associated with clinical mastitis in Honduran Holstein inheritance cows.

BACKGROUND: Lactoferrin (LTF) is an iron-binding glycoprotein found in milk and other exocrine secretion with antibacterial activity proposed as an alternative to mastitis treatment or prevention. LTF has been proposed as a candidate gene for mastitis resistance selection. The aim of this paper was to assess LTF promotor to explore variations with potential association to mastitis resistance in dairy cows from Honduras. METHODS: A resequencing of promotor and Exon I of LTF gene in extreme mastitis susceptibility cows (126 Holstein and Holstein crossbred) was performed. RESULTS: Eight polymorphisms were found in promotor region, four of them were novel variations. Two were important by frequency among extreme groups, but a polymorphism in - 421 A/T position was significantly (P = 0.0188) associated to mastitis susceptibility. CONCLUSION: Results support the key role of regulatory region of LTF gene. Some candidate genes are proposed in association with mastitis traits and implications are discussed.

Tasas de egreso hospitalario por torsión ovárica en el período 2018-2021 en Chile según grupo etario: un estudio descriptivo / Ovarian torsion hospital discharge rates in the period 2018-2021 in Chile according to age group: a descriptive study

Introducción: La torsión ovárica (TO) es la rotación completa o parcial del ovario por sobre su propio pedículo vascular. El objetivo es comparar descriptivamente las tasas de egreso hospitalario (TEH) por TO en el período 2018-2021 en Chile. Materiales y métodos: Estudio descriptivo, transversal. Los datos de egresos hospitalarios por TO en Chile entre 20182021 (n=1.599) según grupo etario y días de estadía hospitalaria se obtuvieron del Departamento de Estadísticas e Información de Salud. Se calculó la TEH. No se requirió comité de ética. Resultados: Se determinó una TEH por TO de 4,33/100.000 habitantes entre los años 2018 y 2021, siendo el año 2021 la mayor con 5,92. Los grupos etarios de 10-14 y 15-19 años registraron las mayores TEH de 8,5 y 7,55, respectivamente. El promedio de días de estadía hospitalaria por TO entre los años 2018-2021 fue de 2,15 días, siendo el año 2018 el mayor con 2,3 días. Pacientes de 80 años y más presentaron la mayor duración de estancia hospitalaria con 3,37 días. Discusión: La TEH por TO en Chile aumentó durante los últimos años. En 2020-2021 las mayores TEH por TO se encontraron entre los 10-19 años, probablemente por aumentos en la prevalencia de síndrome de ovario poliquístico en Chile. Los grupos de mayor edad registraron la mayor duración de estancia hospitalaria, pudiendo deberse a una mayor susceptibilidad a complicaciones postquirúrgicas. Considerando la escasa fuente de información al respecto, nuestro estudio permite dar a conocer un perfil epidemiológico nacional actualizado.

Introduction: Ovarian Torsion (OT) is complete or partial rotation of the ovary above its vascular pedicle. The objective is to descriptively compare the Hospital Discharge Rates (HDR) for OT in the period 2018-2021 in Chile. Material and methods: Descriptive, cross-sectional study. The data of hospital discharge for OT in Chile between 20182021 (n=1,599) according to age group and days of hospital stay were obtained from the Department of Health Information Statistics. HDR was calculated. No ethics committee was required. Results: An HDR for OT of 4.33/100.000 population was determined between the years 2018 and 2021, with 2021 being the highest with 5.92. The age groups of 10-14 and 15-19 years old registered the highest HDR of 8.5 and 7.55, respectively. The average number of days of hospital stay for OT between the years 2018-2021 was 2.15 days, with 2018 being the longest year with 2.3 days. Patients 80 years and older had the longest hospital length of stay with 3.37 days. Discussion: The HDR for OT in Chile has increased in recent years. In 2020-2021 the highest HDR for OT were found between 10-19 years old, probably due to increases in the prevalence of polycystic ovary syndrome in Chile. The oldest age groups recorded the longest average hospital length of stay, which may be due to increased susceptibility to postoperative complications. Considering the limited source of information in this regard, our study allows us to present an updated national epidemiological profile.

Multidisciplinary Management of Intrusive Luxation: Four-year Clinical Follow-up.

This article aims to describe the multidisciplinary clinical management of an intrusive luxation case. The clinical case reports the management of crown fracture and intrusive luxation of permanent maxillary incisors. The clinical results and subjective outcomes four years after the trauma and after two years of post-treatment follow-up are presented. An 11-year-old female patient sought dental care at the local University after experiencing dental trauma. Crown fracture of tooth 8 and the intrusion and crown fracture of teeth 9 and 10 were clinically diagnosed. The multidisciplinary treatment performed involved: periodontal surgical procedures; orthodontic traction; endodontic treatment; dental bleaching; and esthetic resin composite restorations. After two years of follow-up, the clinical parameters of the restorations were satisfactory, as well as the periodontal and periapical status. Oral health-related quality of life was assessed before and after treatment using the OHIP-Aes instrument, with a significant improvement in quality of life after treatment. The multidisciplinary approach was an effective treatment for this case of intrusive luxation. The dentofacial function and esthetics were recovered and the patient's quality of life was improved.

Estrés oxidativo, respuesta inmune, plasticidad sináptica y cognición en modelos transgénicos de la enfermedad de Alzheimer / Oxidative stress, the immune response, synaptic plasticity, and cognition in transgenic models of Alzheimer disease

Introducción: En el mundo, alrededor de 50 millones de personas padecen demencia; la forma más común es la enfermedad de Alzheimer (EA), que representa el 60-70% de los casos. Dada su alta incidencia, se hace imperativo diseñar estudios que permitan ampliar el conocimiento sobre su aparición y desarrollo, para proponer diagnósticos tempranos y/o posibles tratamientos. Una de las estrategias metodológicas que se han desarrollado son los modelos transgénicos murinos para el estudio de los factores involucrados en su etiología, y entre ellos, el estrés oxidativo y la respuesta inmune.DesarrolloSe realizó una búsqueda de artículos originales y revisiones en PubMed, Scopus y Google Scholar (2013-2019). En esta revisión abordamos dos factores que han sido estudiados de forma independiente: el estrés oxidativo y la respuesta inmune en modelos transgénicos para la EA, y se discute la relación que existe entre ellos y que impacta en la pérdida de la plasticidad sináptica y estructural, produciendo como efecto final el deterioro cognitivo.ConclusiónEsta revisión describe posibles mecanismos en donde participan el estrés oxidativo y la respuesta inmune sobre los efectos moleculares, celulares y conductuales en la EA, observando una estrecha relación entre estos elementos que conducen hacia el deterioro cognitivo. (AU)

Introduction: Worldwide, approximately 50 million people have dementia, with Alzheimer disease (AD) being the most common type, accounting for 60%-70% of cases. Given its high incidence, it is imperative to design studies to expand our knowledge about its onset and development, and to develop early diagnosis strategies and/or possible treatments. One methodological strategy is the use of transgenic mouse models for the study of the factors involved in AD aetiology, which include oxidative stress and the immune response.DevelopmentWe searched the PubMed, Scopus, and Google Scholar databases for original articles and reviews published between 2013 and 2019. In this review, we address two factors that have been studied independently, oxidative stress and the immune response, in transgenic models of AD, and discuss the relationship between these factors and their impact on the loss of synaptic and structural plasticity, resulting in cognitive impairment.ConclusionThis review describes possible mechanisms by which oxidative stress and the immune response participate in the molecular, cellular, and behavioural effects of AD, observing a close relationship between these factors, which lead to cognitive impairment. (AU)

Oxidative stress, the immune response, synaptic plasticity, and cognition in transgenic models of Alzheimer disease.

INTRODUCTION: Worldwide, approximately 50 million people have dementia, with Alzheimer disease (AD) being the most common type, accounting for 60%-70% of cases. Given its high incidence, it is imperative to design studies to expand our knowledge about its onset and development, and to develop early diagnosis strategies and/or possible treatments. One methodological strategy is the use of transgenic mouse models for the study of the factors involved in AD aetiology, which include oxidative stress and the immune response. DEVELOPMENT: We searched the PubMed, Scopus, and Google Scholar databases for original articles and reviews published between 2013 and 2019. In this review, we address 2 factors that have been studied independently, oxidative stress and the immune response, in transgenic models of AD, and discuss the relationship between these factors and their impact on the loss of synaptic and structural plasticity, resulting in cognitive impairment. CONCLUSION: This review describes possible mechanisms by which oxidative stress and the immune response participate in the molecular, cellular, and behavioural effects of AD, observing a close relationship between these factors, which lead to cognitive impairment.

Oxidative stress, the immune response, synaptic plasticity, and cognition in transgenic models of Alzheimer disease. / Estrés oxidativo, respuesta inmune, plasticidad sináptica y cognición en modelos transgénicos de la enfermedad de Alzheimer.

INTRODUCTION: Worldwide, approximately 50 million people have dementia, with Alzheimer disease (AD) being the most common type, accounting for 60%-70% of cases. Given its high incidence, it is imperative to design studies to expand our knowledge about its onset and development, and to develop early diagnosis strategies and/or possible treatments. One methodological strategy is the use of transgenic mouse models for the study of the factors involved in AD aetiology, which include oxidative stress and the immune response. DEVELOPMENT: We searched the PubMed, Scopus, and Google Scholar databases for original articles and reviews published between 2013 and 2019. In this review, we address two factors that have been studied independently, oxidative stress and the immune response, in transgenic models of AD, and discuss the relationship between these factors and their impact on the loss of synaptic and structural plasticity, resulting in cognitive impairment. CONCLUSION: This review describes possible mechanisms by which oxidative stress and the immune response participate in the molecular, cellular, and behavioural effects of AD, observing a close relationship between these factors, which lead to cognitive impairment.

Ozone pollution, oxidative stress, synaptic plasticity, and neurodegeneration.

INTRODUCTION: Overpopulation and industrial growth result in an increase in air pollution, mainly due to suspended particulate matter and the formation of ozone. Repeated exposure to low doses of ozone, such as on a day with high air pollution levels, results in a state of chronic oxidative stress, causing the loss of dendritic spines, alterations in cerebral plasticity and in learning and memory mechanisms, and neuronal death and a loss of brain repair capacity. This has a direct impact on human health, increasing the incidence of chronic and degenerative diseases. DEVELOPMENT: We performed a search of the PubMed, Scopus, and Google Scholar databases for original articles and reviews published between 2000 and 2018 and addressing the main consequences of ozone exposure on synaptic plasticity, information processing in cognitive processes, and the alterations that may lead to the development of neurodegenerative diseases. CONCLUSIONS: This review describes one of the pathophysiological mechanisms of the effect of repeated exposure to low doses of ozone, which causes loss of synaptic plasticity by producing a state of chronic oxidative stress. This brain function is key to both information processing and the generation of structural changes in neuronal populations. We also address the effect of chronic ozone exposure on brain tissue and the close relationship between ozone pollution and the appearance and progression of neurodegenerative diseases.

Laparoscopic ventral hernia repair: does IPOM plus allow to increase the indications in larger defects?

PURPOSE: The laparoscopic ventral hernia repair (LVHR) may have a limit of effectiveness, especially in defects greater than 80 cm2, with a higher recurrence rate which contraindicates this technique. The purpose of this study is to analyze the indication of LVHR determining and comparing the recurrence rate according to defect size in two series. METHODS: We analyzed all patients who underwent LVHR between 2007 and 2017. Patients were divided according to the ring size: < o ≥ 80 cm2 into group one (G1) and group two (G2) respectively. In both groups, all three techniques were used: intraperitoneal onlay mesh (IPOM), IPOM with closure of the defect (IPOM plus), and IPOM plus + anterior videoscopic component separation (AVCS). RESULTS: A total of 258 patients underwent LVHR. Mean recurrence rate was 13% in G1 and 24% in G2. A statistically significant difference was found when comparing the IPOM technique among both groups, with a higher recurrence rate when ring size was ≥ 80 cm2 (p < 0.5). However, when comparing recurrence rate in IPOM plus and IPOM plus + AVCS between both groups, no significant differences were observed, yielding a p of 0.51 and 0.63, respectively. CONCLUSION: The IPOM technique has shown a limit of effectiveness in large ventral hernia defects. The combination of techniques (ring closure and AVCS) may be useful to expand the indication for this surgery to larger defects and to reduce the recurrence rate. Prospective randomized studies are required to confirm this trend.

Simulating the city traffic complexity induced by traffic light periods.

We revisited the global traffic light optimization problem through a cellular automata model, which allows us to address the relationship between the traffic lights and car routing. We conclude that both aspects are not separable. Our results show that a good routing strategy weakens the importance of the traffic light period for mid-densities, thus limiting the parameter space where such optimization is relevant. This is confirmed by analyzing the travel time normalized by the shortest path between the origin and destination. As an unforeseen result, we report what seems to be a power-law distribution for such quantities, indicating that the travel time distribution slowly decreases for long travel times. The power-law exponent depends on the density, traffic light period, and routing strategy, which in this case is parametrized by the tendency of agents to abandon a route if it becomes stagnant. These results could have relevant consequences on how to improve the overall traffic efficiency in a particular city, thus providing insight into useful measurements, which are often counter-intuitive, which may be valuable to traffic controllers that operate through traffic light periods and phases.

Recruitment of neurons in basolateral amygdala after intense training produces a stronger memory trace.

Typical amnestic treatments are ineffective when administered to subjects trained in aversively-motivated tasks using relatively high foot-shock intensities. This effect has been found when treatments that disrupt neuronal activity are administered to different regions of the brain, including the amygdala. However, the molecular mechanisms induced by this intense training are unknown. We made a detailed mapping of c-Fos-expressing neurons in four regions of the amygdala after moderate and intense one-trial inhibitory avoidance training. Rats were sacrificed 90 min after training or after appropriate control procedures, and their brains were prepared for immunohistochemical c-Fos protein detection in the central, lateral, and in the anterior and posterior parts of the basolateral amygdaloid nucleus. We found a high percentage of neurons expressing c-Fos in the anterior part of the basolateral nucleus after moderate training, and this percentage increased further after intense training. Moderate and intense training did not induce changes in c-Fos expression in the other explored amygdaloid regions. These results show that inhibitory avoidance training produces a localized expression of c-Fos in the basolateral anterior nucleus of the amygdala, which is dependent upon the intensity of training, and indicate that synaptic plastic changes in this region may be required for the formation of memory of moderate and intense aversive learning.

Brain and Lung Imaging Correlation in Patients with COVID-19: Could the Severity of Lung Disease Reflect the Prevalence of Acute Abnormalities on Neuroimaging? A Global Multicenter Observational Study.

PURPOSE: Our aim was to study the association between abnormal findings on chest and brain imaging in patients with coronavirus disease 2019 (COVID-19) and neurologic symptoms. MATERIALS AND METHODS: In this retrospective, international multicenter study, we reviewed the electronic medical records and imaging of hospitalized patients with COVID-19 from March 3, 2020, to June 25, 2020. Our inclusion criteria were patients diagnosed with Severe Acute Respiratory Syndrome coronavirus 2 (SARS-CoV-2) infection with acute neurologic manifestations and available chest CT and brain imaging. The 5 lobes of the lungs were individually scored on a scale of 0-5 (0 corresponded to no involvement and 5 corresponded to >75% involvement). A CT lung severity score was determined as the sum of lung involvement, ranging from 0 (no involvement) to 25 (maximum involvement). RESULTS: A total of 135 patients met the inclusion criteria with 132 brain CT, 36 brain MR imaging, 7 MRA of the head and neck, and 135 chest CT studies. Compared with 86 (64%) patients without acute abnormal findings on neuroimaging, 49 (36%) patients with these findings had a significantly higher mean CT lung severity score (9.9 versus 5.8, P < .001). These patients were more likely to present with ischemic stroke (40 [82%] versus 11 [13%], P < .0001) and were more likely to have either ground-glass opacities or consolidation (46 [94%] versus 73 [84%], P = .01) in the lungs. A threshold of the CT lung severity score of >8 was found to be 74% sensitive and 65% specific for acute abnormal findings on neuroimaging. The neuroimaging hallmarks of these patients were acute ischemic infarct (28%), intracranial hemorrhage (10%) including microhemorrhages (19%), and leukoencephalopathy with and/or without restricted diffusion (11%). The predominant CT chest findings were peripheral ground-glass opacities with or without consolidation. CONCLUSIONS: The CT lung disease severity score may be predictive of acute abnormalities on neuroimaging in patients with COVID-19 with neurologic manifestations. This can be used as a predictive tool in patient management to improve clinical outcome.

Pilot-scale phycoremediation using Muriellopsis sp. for wastewater reclamation in the Atacama Desert: microalgae biomass production and pigment recovery.

Municipal wastewater phycoremediation represents a promising circular economy-based process for wastewater reclamation used to recover water and produce biomass. This study aimed to evaluate a pilot-scale phycoremediation system, using the most efficient strain of microalgae for wastewater reclamation in the Atacama Desert. Nitrogen and phosphorus removal, as well as biomass growth, were compared in different microalgae treatments, namely Muriellopsis sp., Scenedesmus almeriensis, Chlamydomonas segnis, Chlorella pyrenoidosa and Chlorella vulgaris. The most efficient treatments, Muriellopsis sp. and S. almeriensis, were scaled up to 20-L bubble column reactors to evaluate nutrient removal and biomass biochemical profile for potential biotechnological application. Finally, Muriellopsis sp. was selected for a pilot-scale phycoremediation experiment (800-L raceway), which removed 84% of nitrogen, 93% of phosphorus and other chemical compounds after 4 days of treatment to meet most of the Chilean standards for irrigation water (NCh. 1333. DS. MOP No. 867/78). Faecal coliforms count was reduced by 99.9%. Furthermore, biomass productivity reached 104.25 mg·L-1·day-1 value with 51% protein, and pigment content of 0.6% carotenoid, with 0.3% lutein. These results indicate the potential of wastewater phycoremediation at an industrial scale for the production of irrigation water and carotenoid using Muriellopsis sp.

Nociceptive pain and anxiety in equines: Physiological and behavioral alterations.

Pain and anxiety are two of the most important concerns in clinical veterinary medicine because they arise as consequences of multiple factors that can severely affect animal welfare. The aim of the present review was to provide a description and interpretation of the physiological and behavioral alterations associated with pain and anxiety in equines. To this end, we conducted an extensive review of diverse sources on the topic. The article begins by describing the neurophysiological pathway of pain, followed by a discussion of the importance of the limbic system in responses to pain and anxiety, since prolonged exposure to situations that cause stress and pain generates such physiological changes as tachycardia, tachypnea, hypertension, hyperthermia, and heart rate variability (HRV), often accompanied by altered emotional states, deficient rest, and even aggressiveness. In the long term, animals may show deficiencies in their ability to deal with changes in the environment due to alterations in the functioning of their immune, nervous, and endocrinologic systems. In conclusion, pain and anxiety directly impact the homeostasis of organisms, so it is necessary to conduct objective evaluations of both sensations using behavioral scales, like the horse grimace scale, complemented by assessments of blood biomarkers to analyze their correlation with physiological parameters: Heart rate, respiratory rate, HRV, theparasympathetic tone activity index, lactate and glucose levels, and temperature. Additional tools - infrared thermography, for example - can also be used in these efforts to improve the quality of life and welfare of horses.

Does following optimized routes for single cars improve car routing?

We study the impact of deserting a pre-established path, determined by a navigation software, on the overall city traffic. To do so, we consider a cellular automaton model for vehicular traffic, where the cars travel between two randomly assigned points in the city following three different navigation strategies based on the minimization of the individual paths or travel times. We found, in general, that, above a critical car density, the transport improves in all strategies if we decrease the time that the vehicles persist in trying to follow a particular strategy when a route is blocked, namely, the mean flux increases, the individual travel times decrease, and the fluctuations of density in the streets decrease; consequently, deserting helps prevent traffic jams.

Recomendaciones y efectos de la fibra dietaria en niños / Recommendations and effects of dietary fiber for children

Conocida es la influencia de la fibra dietaria sobre los efectos mecánicos a nivel gastrointestinal, la composición y modulación de la microbiota intestinal y su función en la actividad metabólica y nutricional en adultos. En niños y adolescentes estos efectos son menos conocidos, generando interesantes áreas de investigación y desarrollo científico que nos puedan entregar mayor conocimiento de sus repercusiones a nivel fisiológicos y fisiopatológicos. Esta revisión tiene como objetivo entregar información actualizada sobre las diferentes clasificaciones de fibra, sus principales funciones digestivas y metabólicas, así como las recomendaciones de ingesta diaria en pediatría.

Among adults, the influence of dietary fiber on mechanical effects at the gastrointestinal level, the composition and modulation of the intestinal microbiota and function in the metabolic and nutritional activity is known. However, in children and adolescents, these effects are less known, generating interesting areas of research and development that could provide additional knowledge at the physiological and pathophysiological level. The aim of this review was to provide updated information about the different classifications of fiber, the principal digestive and metabolic functions, as well as recommendations for daily intake for pediatric populations.

Therapeutic Patient Education with Learning Objects Improves Asthma Control in Mexican Children.

One of the most common chronic diseases that causes missed school days and workdays is pediatric asthma, producing education, health and economic delays in low and middle-income countries. A patient-centered remarkable therapeutic strategy in the prevention and treatment of chronic diseases is the Therapeutic Patient Education (TPE) which denotes an outstanding difference in the outcomes, from the awareness, to the personal treatment adaption to prevent crises. In this paper, an intervention of TPE with learning objects (LOs) of a pediatric asthma course, designed to train the uncontrolled patient and the caregiver as a team on the specific knowledge to self-control the disease, was carried out at a health facility in Mexico. The Asthma Control Test (ACT) was used and the learning performance was evaluated with formative quizzes. A randomized controlled trial was designed, with pairs of children patients and caregivers during 60 days; the control group was trained with the usual approach, receiving general information about the disease. ACT measures showed statistical significance for the TPE group after the use of the LOs, achieving a controlled state, while the control group did not show difference. Also, the intervention group obtained a higher score in learning performance assessment. The users learned how to avoid risks, the personal triggers of the patient, how to correctly use the different treatments and accessories, consequently, they learned how to self-manage the disease. Our study also confirmed that control of asthma is not only a matter of knowledge, but financial issues to afford the treatment.