The Major Hypotheses of Alzheimer's Disease: Related Nanotechnology-Based Approaches for Its Diagnosis and Treatment.

Alzheimer's disease (AD) is a well-known chronic neurodegenerative disorder that leads to the progressive death of brain cells, resulting in memory loss and the loss of other critical body functions. In March 2019, one of the major pharmaceutical companies and its partners announced that currently, there is no drug to cure AD, and all clinical trials of the new ones have been cancelled, leaving many people without hope. However, despite the clear message and startling reality, the research continued. Finally, in the last two years, the Food and Drug Administration (FDA) approved the first-ever medications to treat Alzheimer's, aducanumab and lecanemab. Despite researchers' support of this decision, there are serious concerns about their effectiveness and safety. The validation of aducanumab by the Centers for Medicare and Medicaid Services is still pending, and lecanemab was authorized without considering data from the phase III trials. Furthermore, numerous reports suggest that patients have died when undergoing extended treatment. While there is evidence that aducanumab and lecanemab may provide some relief to those suffering from AD, their impact remains a topic of ongoing research and debate within the medical community. The fact is that even though there are considerable efforts regarding pharmacological treatment, no definitive cure for AD has been found yet. Nevertheless, it is strongly believed that modern nanotechnology holds promising solutions and effective clinical strategies for the development of diagnostic tools and treatments for AD. This review summarizes the major hallmarks of AD, its etiological mechanisms, and challenges. It explores existing diagnostic and therapeutic methods and the potential of nanotechnology-based approaches for recognizing and monitoring patients at risk of irreversible neuronal degeneration. Overall, it provides a broad overview for those interested in the evolving areas of clinical neuroscience, AD, and related nanotechnology. With further research and development, nanotechnology-based approaches may offer new solutions and hope for millions of people affected by this devastating disease.

Características clínicas y hallazgos endoscópicos en niños con hipertensión portal atendidos en un hospital pediátrico / Clinical characteristics and endoscopic findings in children with portal hypertension seen in a pediatric hospital

Antecedentes: El término hipertensión portal (HP) se define como el aumento patológico en el gradiente de presión porto-sistémico en cualquier segmento del sistema venoso portal. Objetivo: Determinar las características clínicas y hallazgos endoscópicos de pacientes con HP atendidos en el Hospital María, Especialidades Pediátricas (HMEP). Métodos: Se realizó un estudio observacional, descriptivo y retrospectivo. El universo fueron todos los pacientes de 18 años o menos con diagnóstico de HP que asistieron al servicio de gastroenterología pediátrica del HMEP entre 2015-2022. Fue tomado todo el universo para aná- lisis. Se realizó análisis de datos descriptivo univariado utilizando el programa STATA 15.1. Resultados: Se analizó un total de 38 pacientes, 55.3% (21/38) de edad preescolar. El 57.9% (22/38) fue masculino y el nivel de escolaridad más frecuente fue primaria incompleta en 55.3%. La procedencia en 79% (30/38) de la zona centro y oriente del país. El Sangrado Digestivo Alto (SDA) se en- contró en 42% de los pacientes (16/38) y la etiología pre-hepática fue la más frecuente en 65.8 % (25). Discusión: se encontró que el inicio de la enfermedad fue en pre-escolares con predominio del sexo masculino; las causas pre-hepáticas fueron la etiología más frecuente de SDA coincidiendo con lo publicado por otros autores. El SDA fue el síntoma inicial predominante, evidenciado en hallazgos endoscópicos como várices esofágicas y gástricas. Conclusión: La HP es poco frecuente en edad pediátrica tiene consecuencias severas en la calidad de vida y sobrevida del paciente...(AU)

Rapid Selective Detection and Quantification of ß-Blockers Used in Doping Based on Molecularly Imprinted Nanoparticles (NanoMIPs).

Human performance enhancing drugs (PEDs), frequently used in sport competitions, are strictly prohibited by the World Anti-Doping Agency (WADA). Biological samples collected from athletes and regular patients are continuously tested regarding the identification and/or quantification of the banned substances. Current work is focused on the application of a new analytical method, molecularly imprinted nanoparticles (nanoMIPs), to detect and determine concentrations of certain prohibited drugs, such as ß-blockers, in water and human urine samples. These medications are used in the treatment of cardiovascular conditions, negative effects of adrenaline (helping to relief stress), and hypertension (slowing down the pulse and softening the arteries). They can also significantly increase muscle relaxation and improve heart efficiency. The new method of the detection and quantification of ß-blockers is based on synthesis, characterization, and implementation of nanoMIPs (so-called plastic antibodies). It offers numerous advantages over the traditional methods, including high binding capacity, affinity, and selectivity for target molecules. Additionally, the whole process is less complicated, cheaper, and better controlled. The size and shape of the nanoMIPs is evaluated by dynamic light scattering (DLS) and transmission electron microscope (TEM). The affinity and selectivity of the nanoparticles are investigated by competitive pseudo enzyme-linked immunosorbent assay (pseudo-ELISA) similar to common immunoassays employing natural antibodies. To provide reliable results towards either doping detection or therapeutic monitoring using the minimal invasive method, the qualitative and quantitative analysis of these drugs is performed in water and human urine samples. It is demonstrated that the assay can detect ß-blockers in water within the linear range 1 nmol·L-1-1 mmol·L-1 for atenolol with the detection limit 50.6 ng mL-1, and the linear range 1 mmol·L-1-10 mmol·L-1 for labetalol with the detection limit of 90.5 ng·mL-1. In human urine samples, the linear range is recorded in the concentration range 0.1 mmol·L-1-10 nmol·L-1 for atenolol and 1 mmol·L-1-10 nmol·L-1 for labetalol with a detection limit of 61.0 ng·mL-1 for atenolol and 99.4 ng·mL-1 for labetalol.

Instrumentos para evaluar bienestar en adolescentes en Chile: una revisión exploratoria / Instruments to evaluate well-being in Chilean adolescent population: a scoping review

En la actualidad, el bienestar es un área de estudio fundamental para la psicología debido a su estrecha relación con la salud física y mental, especialmente en grupos adolescentes, que son considerados prioritarios en el cuidado de la salud. Sin embargo, aún no existe consenso en cuanto a cómo definir y medir el bienestar, lo que ha generado una gran variedad de instrumentos con diferentes bases teóricas. En Chile se han validado instrumentos para evaluar el bienestar, pero no se ha realizado una sistematización que permita identificar y describir los instrumentos en función de sus perspectivas teóricas y propiedades psicométricas, particularmente en población adolescente. Por este motivo se realizó un Scoping Review de los instrumentos utilizados para medir bienestar en este colectivo. Para ello se llevó a cabo una búsqueda sistemática de acuerdo con la declaración PRISMA. Los resultados arrojaron un total de 25 instrumentos validados en esta población que presentaron adecuadas propiedades psicométricas desde diversos constructos teóricos. Se concluye que existen diversos instrumentos validados en Chile para evaluar la multidimensionalidad que implica el concepto de bienestar en población adolescente.

Currently, well-being is a crucial study area for psychology due to its close relationship with physical and mental health, especially among adolescents, who are considered a priority in health care. However, there is still no consensus on how to define and measure wellbeing, which has resulted in the generation of various measurement instruments with different theoretical bases. In Chile, instruments have been validated to assess well-being. However, there has been no systematisation to identify and describe the instruments in terms of their theoretical perspectives and psychometric properties, particularly in the adolescent population. For this reason, a Scoping Review of the instruments used to measure well-being in adolescents was carried out using a systematic search according to the PRISMA statement. The results yielded 25 instruments validated in this population that presented adequate psychometric properties from different theoretical constructs. In conclusion, several validated instruments in Chile assess the multidimensionality implied by the concept of well-being in the adolescent population.

EmERGE mHealth Platform: Implementation and Technical Evaluation of a Digital Supported Pathway of Care for Medically Stable HIV.

In this article, we described a new mobile-Health (mHealth) supported clinical pathway of care for people living with medically stable HIV in terms of platform acceptability, usability and technical feasibility. The EmERGE mHealth platform was codesigned with clinicians and the community, developed using Scrum agile methodology, integrated with hospital information systems and validated in a large prospective cohort study of 2251 participants. The evaluation of this new paradigm of care was conducted using a tailored Health Technology Assessment: the Model for Assessment of Telemedicine Applications. Usability and acceptability were assessed through the System Usability Score and a Patient Reported Experience Measure. The EmERGE platform was successfully deployed across diverse care settings in five European countries and used by 2251 patients and more than 20 clinicians for up to 30 months. Results from the formal evaluation demonstrated that the EmERGE platform is feasible and acceptable, with a high level of usability (median System Usability Score (SUS) 85.0%) and very positive patient-reported experiences (94.2% would recommend to a friend). The EmERGE platform is a secure and General Data Protection Regulation (GDPR)-compliant system with a complete set of functionalities that could be easily adapted to other clinical conditions, clinical sites and health systems thanks to its modular technical architecture.

Molecularly Imprinted Nanoparticles (NanoMIPs) Selective for Proteins: Optimization of a Protocol for Solid-Phase Synthesis Using Automatic Chemical Reactor.

Molecularly imprinted polymer nanoparticles (nanoMIPs) are receiving broad interest as robust and highly selective synthetic receptors for a variety of molecules. Due to their stability, inexpensive synthesis and easy implementation, they are considered a promising alternative to antibodies in sensors, diagnostics and separation applications. The most challenging targets for the production of synthetic receptors are proteins due to their fragile nature and the multitude of possible binding sites in their structure. Herein, we describe the modification and optimization of the protocol for synthesis of nanoMIPs with specificity for proteins using the prototype of an automated solid-phase synthesizer. Using an automated system gives an advantage for the simple, fast and fully controlled, reproducible production of nanoMIPs. The molecular imprinting in the reactor is performed using a template covalently immobilized on a solid support, in mild conditions suitable for preserving protein native structure. The validation of the protocol was made by assessing the ability to regenerate a solid-phase, and by measuring affinity and specificity of nanoparticles. As a model protein, we have chosen trypsin since its enzymatic activity can be easily monitored by using a commercial colorimetric assay. Different protocols were tested for their ability to improve the yield of high affinity nanoparticles in the final elution.

Technologies for Monitoring Lifestyle Habits Related to Brain Health: A Systematic Review.

Brain health refers to the preservation of brain integrity and function optimized for an individual's biological age. Several studies have demonstrated that our lifestyles habits impact our brain health and our cognitive and mental wellbeing. Monitoring such lifestyles is thus critical and mobile technologies are essential to enable such a goal. Three databases were selected to carry out the search. Then, a PRISMA and PICOTS based criteria for a more detailed review on the basis of monitoring lifestyle aspects were used to filter the publications. We identified 133 publications after removing duplicates. Fifteen were finally selected from our criteria. Many studies still use questionnaires as the only tool for monitoring and do not apply advanced analytic or AI approaches to fine-tune results. We anticipate a transformative boom in the near future developing and implementing solutions that are able to integrate, in a flexible and adaptable way, data from technologies and devices that users might already use. This will enable continuous monitoring of objective data to guide the personalized definition of lifestyle goals and data-driven coaching to offer the necessary support to ensure adherence and satisfaction.

Molecularly Imprinted Nanoparticles Assay (MINA) in Pseudo ELISA: An Alternative to Detect and Quantify Octopamine in Water and Human Urine Samples.

In 2004, octopamine was added to the list of drugs banned by the world anti-doping agency (WADA) and prohibited in any sport competition. This work aims to develop a new analytical method to detect octopamine in water and human urine samples. We proposed a pseudo-enzyme-linked immunosorbent assay (pseudo-ELISA) by replacing traditional monoclonal antibodies with molecularly imprinted polymer nanoparticles (nanoMIPs). NanoMIPs were synthesised by a solid-phase approach using a persulfate initiated polymerisation in water. Their performance was analysed in pseudo competitive ELISA based on the competition between free octopamine and octopamine-HRP conjugated. The final assay was able to detect octopamine in water within the range 1 nmol·L-1-0.1 mol·L-1 with a detection limit of 0.047 ± 0.00231 µg·mL-1 and in human urine samples within the range 1 nmol·L-1-0.0001 mol·L-1 with a detection limit of 0.059 ± 0.00281 µg·mL-1. In all experiments, nanoMIPs presented high affinity to the target molecules and almost no cross-reactivity with analogues of octopamine such as pseudophedrine or l-Tyrosine. Only slight interference was observed from the human urine matrix. The high affinity and specificity of nanoMIPs and no need to maintain a cold chain logistics makes the nanoMIPs a competitive alternative to antibodies. Furthermore, this work is the first attempt to use nanoMIPs in pseudo-ELISA assays to detect octopamine.

Epitope approach in molecular imprinting of antibodies.

Herein an approach to prepare molecularly imprinted polymer nanoparticles (nanoMIPs) with specific binding affinity for antibodies is reported. The process relied on the covalent immobilization of the template (whole immunoglobulin G (IgG), Fc domain of human IgG and peptide epitope) onto the surface of a solid support, polymerization and affinity separation of nanoMIPs. The binding between nanoMIPs and their corresponding templates was analyzed and evaluated as being in sub-nanomolar and nano-molar range. The nanoMIPs prepared for Fc domain and epitope demonstrated a specific recognition of both human and goat IgGs, therefore they could be considered as a synthetic analogue of protein A and benefit from its intrinsic stability, short time and low cost of preparation.

Protocol for fast postoperative improvement (FPOI) in gastrointestinal surgery.

INTRODUCTION: Peroperative treatment has required multimodal protocols that stimulate patient evolution and shorten hospital stay. OBJECTIVE: Identify the type of pathology, intervention performed and evaluate the effectiveness of the Rapid Postoperative Improvement Protocol (RAMPO) in patients undergoing elective gastrointestinal surgery. METHOD: A total of 122 patients were evaluated, a group of 61 patients received the RAMPO protocol and the other group of equal number of patients were treated with traditional protocols (Controls). RESULTS: Both groups were admitted for colorectal cancer, colostomy due to benign pathology and gastric cancer. The interventions performed were: colorectal resections (35.25%), intestinal transit restitution (29.51%) and gastrectomy (15.57%). In the RAMPO group, postoperative glycemia values (116.49 vs. 167.08 mg/dl) reflected better metabolic control with shorter hospital stay (5.49 vs. 14.11 days), obtaining a higher degree of satisfaction (91.80 vs. 19.67%) when compared to the control group (p < 0.005). CONCLUSION: The RAMPO protocol presented relevant aspects to the traditional management of patients undergoing elective surgeries of the gastrointestinal tract, being safe, acceptable in our environment, with faster hospital discharge, significantly improving the evolution of patients, a lower percentage of complications and a high degree of satisfaction without increasing morbidity and mortality.

INTRODUCCIÓN: El tratamiento peroperatorio ha requerido protocolos multimodales que estimulen la evolución del paciente y acorten la estancia hospitalaria. OBJETIVO: Identificar el tipo de patología y la intervención realizada, y evaluar la efectividad del protocolo de rápida mejoría posoperatoria (RAMPO) en pacientes sometidos a cirugía electiva gastrointestinal. MÉTODO: Se evaluaron 122 pacientes; a un grupo de 61 se les aplicó el protocolo RAMPO y en el otro grupo de igual número de pacientes se siguieron protocolos tradicionales (controles). RESULTADOS: Ambos grupos ingresaron por cáncer colorrectal, colostomía por patología benigna y cáncer gástrico. Las intervenciones realizadas fueron resecciones colorrectales (35.25%), restitución del tránsito intestinal (29.51%) y gastrectomía (15.57%). En el grupo RAMPO, los valores de glucemia posoperatoria (116.49 vs. 167.08 mg/dl) reflejaron un mejor control metabólico con menor estancia hospitalaria (5.49 vs. 14.11 días), con un mayor grado de satisfacción (91.80% vs. 19.67%) al compararse con el grupo control (p < 0.005). CONCLUSIÓN: El protocolo RAMPO presentó aspectos relevantes al manejo tradicional de los pacientes sometidos a cirugías electivas del tracto gastrointestinal, siendo seguro, aceptable en nuestro medio y con egreso hospitalario más rápido, mejorando de manera significativa la evolución de los enfermos, con menos complicaciones y un alto grado de satisfacción, sin aumentar la morbimortalidad.

Sinopsis del género Malesherbia en el Perú / A synopsis of the genus Malesherbia (Passifloraceae) in Peru

Se presentan 15 taxones de Malesherbia que ocurren en el Perú, incluyendo un nuevo registro, Malesherbia auristipulata. Se proporcionan datos actualizados de distribución departamental, rango altitudinal, además de una clave dicotómica para la determinación de las especies.

We present 15 taxa of Malesherbia occurring in Peru, adding a new record, Malesherbia auristipulata. Updated data for departamental distribution, altitudinal range, and a species key are provided.

Molecularly Imprinted Polymers for the Selective Extraction of Bisphenol A and Progesterone from Aqueous Media.

This paper describes the development of a novel sorbent for selective extraction of endocrine disruptors (EDs) from aqueous media. The main goal was to obtain sufficient molecularly imprinted polymers (MIPs) for selective detection, preconcentration, and extraction of EDs such as bisphenol A (BPA) and progesterone (PG). Series of MIPs and their analogues, non-molecularly imprinted polymers (NIPs), were synthesised following a non-covalent imprinting strategy based on radical polymerisation. Sets of synthesis were performed in order to optimise variables of the polymerisation including solvent, cross-linker, and template ratio. The retention capacity of MIPs was determined using HPLC in the range of 33.3% to 96.6% and 32.5% to 96% for BPA and PG, respectively. The adsorption mechanism was studied by isothermal and kinetic assays. The kinetic analysis showed a high retention capacity within 15 min of contact. The polymer yield was obtained in the range of 30% to 100%. Additionally, there was no significant cross-reactivity observed upon testing MIPs with structural analogues and other endocrine disruptors instead of target molecules. The results also revealed the high importance of different concentrations of cross-linker and solvent during the polymerisation. Firstly, the pre-organisation of complementary functional groups, which were present in the polymerisation mixture, and secondly, selective cavity formation for target molecules.

A comparison of the performance of molecularly imprinted polymer nanoparticles for small molecule targets and antibodies in the ELISA format.

Here we show that molecularly imprinted polymer nanoparticles, prepared in aqueous media by solid phase synthesis with immobilised L-thyroxine, glucosamine, fumonisin B2 or biotin as template, can demonstrate comparable or better performance to commercially produced antibodies in enzyme-linked competitive assays. Imprinted nanoparticles-based assays showed detection limits in the pM range and polymer-coated microplates are stable to storage at room temperature for at least 1 month. No response to analyte was detected in control experiments with nanoparticles imprinted with an unrelated template (trypsin) but prepared with the same polymer composition. The ease of preparation, high affinity of solid-phase synthesised imprinted nanoparticles and the lack of requirement for cold chain logistics make them an attractive alternative to traditional antibodies for use in immunoassays.

Fluorescence-based assay as a new screening tool for toxic chemicals.

Our study involves development of fluorescent cell-based diagnostic assay as a new approach in high-throughput screening method. This highly sensitive optical assay operates similarly to e-noses and e-tongues which combine semi-specific sensors and multivariate data analysis for monitoring biochemical processes. The optical assay consists of a mixture of environmental-sensitive fluorescent dyes and human skin cells that generate fluorescence spectra patterns distinctive for particular physico-chemical and physiological conditions. Using chemometric techniques the optical signal is processed providing qualitative information about analytical characteristics of the samples. This integrated approach has been successfully applied (with sensitivity of 93% and specificity of 97%) in assessing whether particular chemical agents are irritating or not for human skin. It has several advantages compared with traditional biochemical or biological assays and can impact the new way of high-throughput screening and understanding cell activity. It also can provide reliable and reproducible method for assessing a risk of exposing people to different harmful substances, identification active compounds in toxicity screening and safety assessment of drugs, cosmetic or their specific ingredients.

Improving brain injury cognitive rehabilitation by personalized telerehabilitation services: Guttmann neuropersonal trainer.

Cognitive rehabilitation aims to remediate or alleviate the cognitive deficits appearing after an episode of acquired brain injury (ABI). The purpose of this work is to describe the telerehabilitation platform called Guttmann Neuropersonal Trainer (GNPT) which provides new strategies for cognitive rehabilitation, improving efficiency and access to treatments, and to increase knowledge generation from the process. A cognitive rehabilitation process has been modeled to design and develop the system, which allows neuropsychologists to configure and schedule rehabilitation sessions, consisting of set of personalized computerized cognitive exercises grounded on neuroscience and plasticity principles. It provides remote continuous monitoring of patient's performance, by an asynchronous communication strategy. An automatic knowledge extraction method has been used to implement a decision support system, improving treatment customization. GNPT has been implemented in 27 rehabilitation centers and in 83 patients' homes, facilitating the access to the treatment. In total, 1660 patients have been treated. Usability and cost analysis methodologies have been applied to measure the efficiency in real clinical environments. The usability evaluation reveals a system usability score higher than 70 for all target users. The cost efficiency study results show a relation of 1-20 compared to face-to-face rehabilitation. GNPT enables brain-damaged patients to continue and further extend rehabilitation beyond the hospital, improving the efficiency of the rehabilitation process. It allows customized therapeutic plans, providing information to further development of clinical practice guidelines.

Aportes del Ferrical® a los requerimientos nutricionales diarios de minerales en la población cubana sana / Contribution of Ferrical® to the daily nutritional mineral requirements of the healthy Cuban population

Introducción: el Ferrical®, suplemento nutricional producido en LABIOFAM, Cuba, aporta fundamentalmente como nutriente mineral, hierro hemínico. Este microelemento es considerado uno de los minerales imprescindibles en la dieta diaria. Las necesidades nutricionales del hierro varían con la edad, entre otros factores; llega a ser hasta de 28 mg diarios para las mujeres embarazadas. Objetivo: identificar el aporte de nutrientes minerales del suplemento nutricional Ferrical® a los requerimientos nutricionales diarios por grupos de población, para Cuba. Métodos: se compararon los valores de cada nutriente mineral informados como requerimiento diario para Cuba y los aportes del Ferrical®, a las dosis propuestas por el fabricante. Para el caso del hierro, se comparó el aporte del Ferrical® a la mayor dosis propuesta, contra el nivel máximo de ingestión tolerable. Resultados: la principal contribución del Ferrical® respecto a minerales es de hierro y potasio. El aporte de potasio es del 8,37 por ciento al 23,92 por ciento de las necesidades diarias de la población sana y del hierro entre el 60 por ciento y el 76,36 por ciento, de los requerimientos. A la máxima dosis propuesta, 120 mL/día, el aporte de hierro es de 33,6 mg, un 84 por ciento del nivel máximo tolerable. Conclusiones: el principal aporte del Ferrical® es del nutriente hierro hemínico, el cual suple las necesidades diarias según los distintos grupos de edades y requerimientos nutricionales específicos; además no presenta ningún nutriente que a las dosis propuestas constituya riesgo de evento adverso(AU)

Introduction: Ferrical® is a nutritional supplement produced by LABIOFAM in Cuba. The main constituent is the hemo group iron, one of the main minerals for health. The nutritional requirements for iron change with the age and it can reach 28 mg daily in pregnant women. Objective: to identify the contribution of mineral nutrients by Ferrical® to meet daily nutritional requirements of the various Cuban population groups. Methods: comparison of each mineral nutrient values reported as daily requirement for Cuba and the Ferrical® contributions at the doses suggested by the manufacturer, was compared with the Cuban people daily nutritional needs. In the case of iron, Ferrical® contribution at the highest suggested dose was compared to the maximum level of allowable Results: Ferrical® mainly provided iron and potassium. The potassium contribution reached 8,37 percent to 23.92 percent of the daily requirements of healthy population whereas iron met 60 percent to 76.36 percent of such requirements. At the highest suggested dose of 120mL/day, iron provided 33.6 mg for 84 percent of maximum allowable intake. Conclusions: the hemo Iron is the principal contribution of Ferrical®, which met the daily needs of the different population group in terms of specific nutritional requirements. Additionally, no risk of adverse event was observed in any nutrient at the suggested doses(AU)

Aportes del Ferrical® a los requerimientos nutricionales diarios de minerales en la población cubana sana / Contribution of Ferrical® to the daily nutritional mineral requirements of the healthy Cuban population

Introducción: El Ferrical®, suplemento nutricional producido en LABIOFAM, Cuba, aporta fundamentalmente como nutriente mineral, hierro hemínico. Este microelemento es considerado uno de los minerales imprescindibles en la dieta diaria. Las necesidades nutricionales del hierro varían con la edad, entre otros factores; llega a ser hasta de 28 mg diarios para las mujeres embarazadas. Objetico: identificar el aporte de nutrientes minerales del suplemento nutricional Ferrical® a los requerimientos nutricionales diarios por grupos de población, para Cuba. Métodos: se compararon los valores de cada nutriente mineral informados como requerimiento diario para Cuba y los aportes del Ferrical®, a las dosis propuestas por el fabricante. Para el caso del hierro, se comparó el aporte del Ferrical® a la mayor dosis propuesta, contra el nivel máximo de ingestión tolerable. Resultados: la principal contribución del Ferrical® respecto a minerales es de hierro y potasio. El aporte de potasio es del 8,37 por ciento al 23,92 por ciento de las necesidades diarias de la población sana y del hierro entre el 60 por ciento y el 76,36 por ciento, de los requerimientos. A la máxima dosis propuesta, 120 mL/día, el aporte de hierro es de 33,6 mg, un 84 por ciento del nivel máximo tolerable. Conclusiones: el principal aporte del Ferrical® es del nutriente hierro hemínico, el cual suple las necesidades diarias según los distintos grupos de edades y requerimientos nutricionales específicos; además no presenta ningún nutriente que a las dosis propuestas constituya riesgo de evento adverso(AU)

Introduction: Ferrical® is a nutritional supplement produced by LABIOFAM in Cuba. The main constituent is the hemo group iron, one of the main minerals for health. The nutritional requirements for iron change with the age and it can reach 28 mg daily in pregnant women. Objetive: to identify the contribution of mineral nutrients by Ferrical® to meet daily nutritional requirements of the various Cuban population groups. Methods: comparison of each mineral nutrient values reported as daily requirement for Cuba and the Ferrical®contributions at the doses suggested by the manufacturer, was compared with the Cuban people daily nutritional needs. In the case of iron, Ferrical® contribution at the highest suggested dose was compared to the maximum level of allowable. Results: Ferrical® mainly provided iron and potassium. The potassium contribution reached 8,37 percent to 23.92 percent of the daily requirements of healthy population whereas iron met 60 percent to 76.36 percent of such requirements. At the highest suggested dose of 120mL/day, iron provided 33.6 mg for 84 percent of maximum allowable intake. Conclusions: the hemo Iron is the principal contribution of Ferrical®, which met the daily needs of the different population group in terms of specific nutritional requirements. Additionally, no risk of adverse event was observed in any nutrient at the suggested doses(AU)

Intelligent Therapy Assistant (ITA) for cognitive rehabilitation in patients with acquired brain injury.

BACKGROUND: This paper presents the design, development and first evaluation of an algorithm, named Intelligent Therapy Assistant (ITA), which automatically selects, configures and schedules rehabilitation tasks for patients with cognitive impairments after an episode of Acquired Brain Injury. The ITA is integrated in "Guttmann, Neuro Personal Trainer" (GNPT), a cognitive tele-rehabilitation platform that provides neuropsychological services. METHODS: The ITA selects those tasks that are more suitable for the specific needs of each patient, considering previous experiences, and improving the personalization of the treatment. The system applies data mining techniques to cluster the patients according their cognitive impairment profile. Then, the algorithm rates every rehabilitation task, based on its cognitive structure and the clinical impact of executions done by similar patients. Finally, it configures the most suitable degree of difficulty, depending on the impairment of the patient and his/her evolution during the treatment. RESULTS: The ITA has been evaluated during 18 months by 582 patients. In order to evaluate the effectiveness of the ITA, a comparison between the traditional manual planning procedure and the one presented in this paper has been done, taking into account: a) the selected tasks assigned to rehabilitation sessions; b) the difficulty level configured for the sessions; c) and the improvement of their cognitive capacities after completing treatment. CONCLUSIONS: The obtained results reveal that the rehabilitation treatment proposed by the ITA is as effective as the one performed manually by therapists, arising as a new powerful support tool for therapists. The obtained results make us conclude that the proposal done by the ITA is very close to the one done by therapists, so it is suitable for real treatments.

Artificial metaplasticity prediction model for cognitive rehabilitation outcome in acquired brain injury patients.

OBJECTIVE: The main purpose of this research is the novel use of artificial metaplasticity on multilayer perceptron (AMMLP) as a data mining tool for prediction the outcome of patients with acquired brain injury (ABI) after cognitive rehabilitation. The final goal aims at increasing knowledge in the field of rehabilitation theory based on cognitive affectation. METHODS AND MATERIALS: The data set used in this study contains records belonging to 123 ABI patients with moderate to severe cognitive affectation (according to Glasgow Coma Scale) that underwent rehabilitation at Institut Guttmann Neurorehabilitation Hospital (IG) using the tele-rehabilitation platform PREVIRNEC(©). The variables included in the analysis comprise the neuropsychological initial evaluation of the patient (cognitive affectation profile), the results of the rehabilitation tasks performed by the patient in PREVIRNEC(©) and the outcome of the patient after a 3-5 months treatment. To achieve the treatment outcome prediction, we apply and compare three different data mining techniques: the AMMLP model, a backpropagation neural network (BPNN) and a C4.5 decision tree. RESULTS: The prediction performance of the models was measured by ten-fold cross validation and several architectures were tested. The results obtained by the AMMLP model are clearly superior, with an average predictive performance of 91.56%. BPNN and C4.5 models have a prediction average accuracy of 80.18% and 89.91% respectively. The best single AMMLP model provided a specificity of 92.38%, a sensitivity of 91.76% and a prediction accuracy of 92.07%. CONCLUSIONS: The proposed prediction model presented in this study allows to increase the knowledge about the contributing factors of an ABI patient recovery and to estimate treatment efficacy in individual patients. The ability to predict treatment outcomes may provide new insights toward improving effectiveness and creating personalized therapeutic interventions based on clinical evidence.

A new multidisciplinary home care telemedicine system to monitor stable chronic human immunodeficiency virus-infected patients: a randomized study.

BACKGROUND: Antiretroviral therapy has changed the natural history of human immunodeficiency virus (HIV) infection in developed countries, where it has become a chronic disease. This clinical scenario requires a new approach to simplify follow-up appointments and facilitate access to healthcare professionals. METHODOLOGY: We developed a new internet-based home care model covering the entire management of chronic HIV-infected patients. This was called Virtual Hospital. We report the results of a prospective randomised study performed over two years, comparing standard care received by HIV-infected patients with Virtual Hospital care. HIV-infected patients with access to a computer and broadband were randomised to be monitored either through Virtual Hospital (Arm I) or through standard care at the day hospital (Arm II). After one year of follow up, patients switched their care to the other arm. Virtual Hospital offered four main services: Virtual Consultations, Telepharmacy, Virtual Library and Virtual Community. A technical and clinical evaluation of Virtual Hospital was carried out. FINDINGS: Of the 83 randomised patients, 42 were monitored during the first year through Virtual Hospital (Arm I) and 41 through standard care (Arm II). Baseline characteristics of patients were similar in the two arms. The level of technical satisfaction with the virtual system was high: 85% of patients considered that Virtual Hospital improved their access to clinical data and they felt comfortable with the videoconference system. Neither clinical parameters [level of CD4+ T lymphocytes, proportion of patients with an undetectable level of viral load (p = 0.21) and compliance levels >90% (p = 0.58)] nor the evaluation of quality of life or psychological questionnaires changed significantly between the two types of care. CONCLUSIONS: Virtual Hospital is a feasible and safe tool for the multidisciplinary home care of chronic HIV patients. Telemedicine should be considered as an appropriate support service for the management of chronic HIV infection. TRIAL REGISTRATION: Clinical-Trials.gov: NCT01117675.