Balancing trade-offs: Enhanced carbon assimilation and productivity with reduced nutritional value in a well-watered C4 pasture under a warmer CO2-enriched atmosphere.

The concentration of atmospheric CO2 and temperature are pivotal components of ecosystem productivity, carbon balance, and food security. In this study, we investigated the impacts of a warmer climate (+2 °C above ambient temperature) and an atmosphere enriched with CO2 (600 ppm) on gas exchange, antioxidant enzymatic system, growth, nutritive value, and digestibility of a well-watered, managed pasture of Megathyrsus maximus, a tropical C4 forage grass, under field conditions. Elevated [CO2] (eC) improved photosynthesis and reduced stomatal conductance, resulting in increased water use efficiency and plant C content. Under eC, stem biomass production increased without a corresponding increase in leaf biomass, leading to a smaller leaf/stem ratio. Additionally, eC had negative impacts on forage nutritive value and digestibility. Elevated temperature (eT) increased photosynthetic gains, as well as stem and leaf biomass production. However, it reduced P and K concentration, forage nutritive value, and digestibility. Under the combined conditions of eC and eT (eCeT), eT completely offset the effects of eC on the leaf/stem ratio. However, eT intensified the effects of eC on photosynthesis, leaf C concentration, biomass accumulation, and nutritive value. This resulted in a forage with 12% more acid detergent fiber content and 28% more lignin. Additionally, there was a decrease of 19% in crude protein leading to a 15% decrease in forage digestibility. These changes could potentially affect animal feeding efficiency and feedback climate change, as ruminants may experience an amplification in methane emissions. Our results highlight the critical significance of conducting multifactorial field studies when evaluating plant responses to climate change variables.

Translation, cross-cultural adaptation, and validation of a Latin American Spanish version of the ID Migraine screening test.

OBJECTIVE: To translate, culturally adapt, and validate a version of the ID Migraine into Latin American Spanish. BACKGROUND: Although still considered a common diagnosis, half of the patients with migraine in Latin America experience diagnostic delay. The ID Migraine is a test developed in 2003 as a valuable tool for the early diagnosis of migraine at the primary care level; however, there is no validated Spanish or culturally adapted version for the Spanish-speaking population. METHODS: This is an analytical, translation, and test-validation study. We performed back translation and cross-cultural adaptation. The Latin American Spanish version ID Migraine MX was applied to headache clinic patients from March 2021 to January 2022 to perform a validation process against the gold standard: blinded expert diagnosis according to the International Classification of Headache Disorders, 3rd edition (ICHD-3), criteria. RESULTS: One hundred seventeen patients from the headache clinic of the National Institute of Neurology and Neurosurgery of Mexico City were screened. We found 62/117 (53%) patients positive for screening with ID Migraine MX, and 47/117 (40%) positive for migraine according to ICHD-3 criteria. A sensitivity (95% CI) of 0.91 (0.80-0.97), specificity of 0.73 (0.61-0.82), positive predictive value of 0.694 (0.57-0.794), and negative predictive value of 0.93 (0.83-0.97) were obtained. The positive likelihood ratio was 3.38 (2.27-4.99), and the negative likelihood ratio was 0.12 (0.04-0.30). After calling the patients 1 month after the first interview, the calculated Kappa test-retest was 0.75 (p = 0.001). CONCLUSION: A translated and cross-culturally adapted version into Spanish of the ID Migraine was obtained, with a diagnostic performance similar to the original instrument. Clinicians may use this test at the first level of care to reduce the rate of misdiagnosis and the time from onset of symptoms to diagnosis and treatment of migraine.

Semiparametric generalized estimating equations for repeated measurements in cross-over designs.

A model for cross-over designs with repeated measures within each period was developed. It was obtained using an extension of generalized estimating equations that includes a parametric component to model treatment effects and a non-parametric component to model time and carry-over effects; the estimation approach for the non-parametric component is based on splines. A simulation study was carried out to explore the model properties. Thus, when there is a carry-over effect or a functional temporal effect, the proposed model presents better results than the standard models. Among the theoretical properties, the solution is found to be analogous to weighted least squares. Therefore, model diagnostics can be made by adapting the results from a multiple regression. The proposed methodology was implemented in the data sets of the cross-over experiments that motivated the approach of this work: systolic blood pressure and insulin in rabbits.

Tratamiento psicológico inclusivo como modalidad terapéutica en el estado cognitivo-emocional-conductual en las personas prejubilables / Inclusive psychological treatment as a therapeutic modality for cognitive, emotional and behavioural state in pre-retired people

Introducción: La prejubilación se define como una etapa de la vida donde convergen factores biológicos, psicológicos, sociales, culturales, espirituales y ambientales que preparan al individuo para un cambio global y profundo. Objetivo: Precisar mediante el tratamiento psicológico inclusivo los cambios ocurridos en el proceso cognoscitivo del pensamiento y las modificaciones obtenidas en la esfera emocional en el grupo intervenido. Métodos: Se realizó un estudio cuasi-experimental en el Policlínico Docente «Marta Abreu», de Santa Clara, Villa Clara, en el período de enero de 2017 a febrero de 2019. Se emplearon procedimientos, métodos y técnicas con la aplicación de esta modalidad terapéutica en un grupo estudio de 200 personas prejubilables, de 55 a 65 años de edad. Se utilizaron métodos teóricos, empíricos y estadísticos-matemáticos. Se aplicaron técnicas psicológicas antes del tratamiento psicológico inclusivo, y después de este, en el grupo estudio y en el grupo control. Resultados: Fueron muy reveladores en el grupo estudio, y se registraron cambios muy significativos en los procesos intelectuales, en el pensamiento lógico verbal, práctico constructivo y rumiativo; además estados emocionales ansioso bajo y depresivo leve, autoestima alta, y notable mejoría en la vulnerabilidad al estrés. En el grupo control no se reflejaron cambios favorables. Conclusiones: El tratamiento psicológico inclusivo resultó efectivo por el logro de cambios positivos en el estado cognitivo-emocional-conductual en personas prejubilables del grupo estudio. La aplicación de las estrategias de desactivación fisiológica, cognitivas, reflexivo vivenciales, informativas, así como las habilidades de conductas de afrontamiento, las acciones de mantenimiento y generalización y las ayudas paliativas y moderadoras de estrés en la atención a personas prejubilables, constituyó un novedoso recurso terapéutico.

Introduction: pre-retirement is defined as a stage of life where biological, psychological, social, cultural, spiritual and environmental factors converge to prepare the individual for a global and profound change. Objective: to determine, through the inclusive psychological treatment, the changes occurred in the cognitive process of thinking and the modifications obtained in the emotional sphere in the intervened group. Methods: a quasi-experimental study was carried out at "Marta Abreu" Teaching Polyclinic in Santa Clara, Villa Clara from January 2017 to February 2019. Procedures, methods and techniques were used with the application of this therapeutic modality in a study group of 200 pre-retired people aged 55 to 65 years old. Theoretical, empirical, statistical and mathematical methods were used. Psychological techniques were applied before and after the inclusive psychological treatment in the study and control groups. Results: they very revealing in the study group, and very significant changes were registered in intellectual processes as well as in verbal-logical, practical-constructive and ruminative thinking; also low anxious and mild depressive emotional states, high self-esteem, and notable improvement in vulnerability to stress. No favorable changes were reflected in the control group. Conclusions: the inclusive psychological treatment was effective in achieving positive changes in the cognitive, emotional and behavioural state in pre-retired people from the study group. The application of physiological deactivation, cognitive, experiential, reflective, and informative strategies, as well as coping behavioural skills, maintenance and generalization actions and palliative and moderating stress aids in the care of pre-retired people constituted a novel therapeutic resource.

Adjustments in photosynthetic pigments, PS II photochemistry and photoprotection in a tropical C4 forage plant exposed to warming and elevated [CO2].

Global climate change will impact crops and grasslands, affecting growth and yield. However, is not clear how the combination of warming and increased atmospheric carbon dioxide concentrations ([CO2]) will affect the photosystem II (PSII) photochemistry and the photosynthetic tissue photoinhibition and photoprotection on tropical forages. Here, we evaluated the effects of elevated [CO2] (∼600 µmol mol-1) and warming (+2 °C increase temperature) on the photochemistry of photosystem II and the photoprotection strategies of a tropical C4 forage Panicum maximum Jacq. grown in a Trop-T-FACE facility under well-watered conditions without nutrient limitation. Analysis of the maximum photochemical efficiency of PSII (Fv/Fm), the effective PSII quantum yield Y(II), the quantum yield of regulated energy dissipation Y(NPQ), the quantum yield of non-regulated energy dissipation Y(NO), and the malondialdehyde (MDA) contents in leaves revealed that the photosynthetic apparatus of plants did not suffer photoinhibitory damage, and plants did not increase lipid peroxidation in response to warming and [CO2] enrichment. Plants under warming treatment showed a 12% higher chlorophyll contents and a 58% decrease in α-tocopherol contents. In contrast, carotenoid composition (zeaxanthin and ß-carotene) and ascorbate levels were not altered by elevated [CO2] and warming. The elevated temperature increased both net photosynthesis rate and aboveground biomass but elevated [CO2] increased only net photosynthesis. Adjustments in chlorophyll, de-epoxidation state of the xanthophylls cycle, and tocopherol contents suggest leaves of P. maximum can acclimate to 2 °C warmer temperature and elevated [CO2] when plants are grown with enough water and nutrients during tropical autumn-winter season.

Warming offsets the benefits of elevated CO2 in water relations while amplifies elevated CO2-induced reduction in forage nutritional value in the C4 grass Megathyrsus maximus.

Tropical grasslands are very important to global carbon and water cycles. C4 plants have increased heat tolerance and a CO2 concentrating mechanism that often reduces responses to elevated concentrations of CO2 ([CO2]). Despite the importance of tropical grasslands, there is a scarcity of studies that elucidate how managed tropical grasslands will be affected by elevated [CO2] and warming. In our study, we used a combination of a temperature-free air-controlled enhancement (T-FACE) and a free-air carbon dioxide enrichment (FACE) systems to increase canopy temperature and [CO2] under field conditions, respectively. We warmed a field-grown pasture dominated by the C4 tropical forage grass Megathyrsus maximus by 2°C above ambient under two levels of [CO2] (ambient (aC) and elevated (eC - 600 ppm) to investigate how these two factors isolated or combined regulate water relations through stomatal regulation, and how this combination affects PSII functioning, biochemistry, forage nutritive value, and digestibility. We demonstrated that the effects of warming negated the effects of eC in plant transpiration, water potential, proline content, and soil moisture conservation, resulting in warming canceling the eCO2-induced improvement in these parameters. Furthermore, there were additive effects between eC and warming for chlorophyll fluorescence parameters and aboveground nutritive value. Warming sharply intensified the eCO2-induced decrease in crude protein content and increases in forage fibrous fraction and lignin, resulting in a smaller forage digestibility under a warmer CO2-enriched atmosphere. Our results highlight the importance of multifactorial studies when investigating global change impacts on managed ecosystems and the potential consequences for the global carbon cycle like amplification in methane emissions by ruminants and feeding a positive climate feedback system.

Práctica de Enfermería para control emocional en personas con antecedentes de infarto agudo de miocardio / Nursing practice for emotional control in people with a history of acute myocardial infarction

RESUMEN El ejercicio de la Enfermería tiene un alto componente de responsabilidad y comportamiento ético para el control emocional de las personas con antecedentes de infarto agudo de miocardio. Este sustento le da significado a la práctica de la Enfermería para ser aplicada de forma sistemática y organizada. Se realizó una investigación descriptiva con el objetivo de proponer acciones, desde la Enfermería, que contribuyan al mejoramiento del control emocional en las personas con antecedentes de infarto agudo de miocardio pertenecientes al Policlínico Docente Universitario «Martha Abreu de Estévez¼, de Santa Clara, Villa Clara, en el período de enero de 2017 a febrero de 2019. En las personas estudiadas se constató un predominio de: autoestima baja, alta vulnerabilidad al estrés y la ansiedad. Por otro lado, se evidenciaron dificultades en el conocimiento de sus estados emocionales, incapacidad para clarificar y reparar sus emociones, así como una satisfacción vital no satisfactoria.

ABSTRACT Nursing practice has a high component of responsibility and ethical behavior for the emotional control of people with a history of acute myocardial infarction. This support gives meaning to the practice of Nursing to be applied in a systematic and organized way. A descriptive research was carried out with the objective of proposing actions, from the point of view of Nursing, that contribute to the improvement of emotional control in people with a history of acute myocardial infarction belonging to "Martha Abreu de Estévez" University Teaching Polyclinic, in Santa Clara, Villa Clara, from January 2017 to February 2019. A predominance of low self-esteem, high vulnerability to stress and anxiety was found in the people studied. On the other hand, difficulties in understanding their emotional states, inability to clarify and repair their emotions, as well as unsatisfactory life satisfaction were evidenced.

Future warming will change the chemical composition and leaf blade structure of tropical C3 and C4 forage species depending on soil moisture levels.

Temperature and soil moisture strongly affect the nutritional value and digestibility of forage plants through changes in leaf chemical composition or the proportion of leaf blade tissues. In this study, we aimed to evaluate leaf blade anatomical modifications of two tropical forage species, Stylosanthes capitata (C3) and Megathyrsus maximus (C4) under warmed conditions (+2 °C) at well-watered and rainfed conditions and investigate the interactions between leaf anatomical alterations, leaf chemical composition, and leaf digestibility. Experiments were conducted under field conditions using a Temperature-free air-controlled enhancement (T-FACE) system. We observed that plants under elevated temperature produced leaves with smaller stomata and thinner mesophyll tissue and reduced total leaf thickness, potentially impacting gas exchange. On the other hand, reduced soil moisture increased stomatal density and thickness of the adaxial epidermis. In both species, leaf fibrous fractions concentration increased under warmed and non-irrigated conditions, while crude protein concentration and digestibility decreased. However, leaf digestibility was associated with leaf chemical composition rather than the proportion of different leaf blade tissues. We concluded that although both species developed leaf anatomical modifications to acclimate under future warming conditions, leaf nutritional value and digestibility will be reduced, potentially impacting future livestock production and methane emissions by ruminants.

Programa educativo sobre la actividad física: repercusión en el estado neurocognitivo de las personas prejubilables / Educational program on physical activity: impact on the neurocognitive state of early retirement

RESUMEN Fundamento: las sociedades civilizadas se han propuesto estrategias para fortalecer la calidad de vida, el validismo e independencia de los adultos mayores prejubilables o con vínculo laboral activo extendido. Objetivo: determinar modificaciones en el afrontamiento a los acontecimientos vitales y en el estado neurocognitivo en personas en etapa de prejubilación al aplicar un programa educativo basado en la actividad física. Métodos: se realizó un estudio de intervención con diseño cuasiexperimental en el Policlínico Universitario "Marta Abreu", de Santa Clara, Villa Clara, Cuba, entre abril 2017-mayo 2019. Se aplicaron métodos teóricos, empíricos, estadísticos-matemáticos y una batería de exploración neuropsicológica basada en los postulados de Luria, que permitió el diagnóstico de las alteraciones del pensamiento. Luego se procedió a la aplicación del programa educativo basado en la actividad física en el grupo estudio; y finalmente se compararon los resultados en un antes y un después en el grupo estudio, y entre este y el grupo testigo. Resultados: se observó mayor cuantificación de los procesos intelectuales eficientes, mejoría en el pensamiento lógico-verbal, práctico-constructivo y rumiativo en el grupo estudio; mientras en el grupo testigo no se reflejaron estos cambios. Conclusiones: se determinaron modificaciones positivas en el grupo estudio, evidenciadas en progresos neurocognitivos en las personas prejubilables, lo cual demostró la efectividad del programa educativo basado en la actividad física, una vez aplicado.

ABSTRACT Background: civilized societies have proposed strategies to strengthen the quality of life, validity and independence of early retirement or with extended active employment relationship. Objective: to determine modifications in the coping with life events and in the neurocognitive state in people in pre-retirement stage when applying an educational program based on physical activity. Methods: an intervention study with a quasi-experimental design was carried out at the "Marta Abreu" University Polyclinic, Santa Clara, Villa Clara, Cuba, from April 2017 to May 2019. Theoretical, empirical, statistical-mathematical methods and a battery of neuropsychological examination based on Luria's postulates, which allowed the diagnosis of thought disorders. Then the educational program based on physical activity was applied in the study group; and finally the results were compared in a before and after in the study group, and between this and the control group. Results: greater quantification of efficient intellectual processes, improvement in logical-verbal, practical-constructive and ruminative thinking was observed in the study group; while in the control group these changes were not reflected. Conclusions: positive modifications were determined in the study group, evidenced in neurocognitive progress in early retirement, which demonstrated the effectiveness of the educational program based on physical activity, once applied.

Comparación de la eficacia de la transfusión de paquetes globulares de ≤ 15 vs ≥ 16 a 40 días de extracción sobre los efectos hemodinámicos y gasométricos de pacientes con traumatismo craneoencefálico severo en la Unidad de Cuidados Intensivos / Comparison of the efficacy of the transfusion of globular packages of ≤ 15 vs ≥ 16 to 40 days of extraction on the hemodynamic and gasometric effects of patients with severe traumatic brain in the Intensive Care Unit / Comparação da eficácia da transfusão de hemácias de ≤ 15 vs ≥ 16 a 40 dias de extração sobre os efeitos hemodinâmicos e gasométricos de pacientes com traumatismo cranioencefálico grave na Unidade de Terapia Intensiva

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Abstract: Introduction: since the beginning of blood banks, refinements in laboratory processes have allowed longer red blood cell storage times. While advantageous to the logistics of stock management, the clinical impact of RBC storage duration prior to transfusion remains uncertain and a topic of growing interest. Although the structural, biochemical, and impermeable changes that red blood cells undergo during storage are well described, the evidence that this storage injury translates into adverse clinical outcomes for patients receiving blood with longer storage times remains controversial. Objective: to compare the efficacy of the transfusion of globular packages of ≤ 15 days of extraction vs. globular packages ≥ 16-40 days of extraction in the hemodynamic and gasometric repercussion of patients with severe traumatic brain injury (TBI), hospitalized in the Intensive Care Unit of HE CMNO. Material and methods: a controlled, single-center, randomized, single-blind, prospective and comparative clinical trial was conducted, where patients between 18 and 80 years of age with severe postoperative cranioencephalic trauma who required blood transfusions were invited to participate. Participants were included in two random groups, group F and group E. Group F was administered packed cells ≤ 15 days of extraction. Group E will be administered globular packages ≥ 16-40 days of extraction. During the study, various hemodynamic and biochemical variables were measured before, during, and after blood transfusion, and a comparison of the results obtained between groups F and E was subsequently made. Results: in the present study, a total of 26 patients with severe TBI were included and who were transfused with red blood cell packs, of the total number of patients, 13 were transfused with a «standard¼ red blood cell pack and another 13 patients with a «fresh¼ red blood cell pack. The average days of transfusion after extraction were 18 and 14 days for the «standard¼ and «fresh¼ packs, respectively (p ≤ 0.001). Twenty-one infectious events were reported, 11 in the group of patients who were transfused with the standard pack and 10 in the fresh pack group. Mortality at 28 days was estimated in 31% of the patients transfused with the standard pack and in 23% of the patients with the fresh pack (RR, for 28-day mortality of 0.90 [95% CI 0.56-144]). The median duration time in the intensive care unit was 8 days for both groups (0.32 SD), and of the days associated with the ventilator, 15 days were observed for the group of patients with the standard package and 7 for the group with fresh package (0.60 SD), without discovering statistically significant differences in these variables. However, in this analysis statistically significant differences were found for the gasometric parameters of central venous oxygen saturation, cardiac output (Fick) and lactate before and after transfusion in favor of the group of patients transfused with fresh pack (p ≤ 0.05). Conclusion: the results of this study infer that there is no association between the storage time of transfused red blood cells and the presence of adverse clinical outcomes with longer storage times. In both groups, transfusions were equally safe and effective. The researchers refer to the sample size as a limitation for this study.

Resumo: Introdução: desde o surgimento dos bancos de sangue, o refinamento dos processos laboratoriais permitiu tempos de estocagem cada vez mais longos para as hemácias. Embora vantajoso para a logística do gerenciamento de estoque, o impacto clínico da duração do armazenamento de glóbulos vermelhos antes da transfusão permanece incerto e um tópico de interesse crescente. Embora as alterações estruturais, bioquímicas e imunológicas pelas quais as hemácias sofrem durante o armazenamento sejam bem descritas, as evidências de que essa lesão de armazenamento resulta em resultados clínicos adversos para pacientes que recebem sangue armazenado por mais tempo permanecem controversas. Objetivo: comparar a eficácia da transfusão de concentrado de hemácias ≤ 15 dias de extração vs concentrado de hemácias ≥ 16-40 dias de extração nas repercussão hemodinâmica e gasométrica dos pacientes com traumatismo cranioencefálico (TCE) grave, internados em Unidade de Terapia Intensiva do HE CMN Occidente. Material e métodos: realizou-se um ensaio clínico, controlado, unicêntrico, randomizado, simples-cego, prospectivo e comparativo, onde foram convidados a participar pacientes com idade entre 18 e 80 anos com traumatismo cranioencefálico grave submetidos a hemicraniectomia descompressiva com necessidade de transfusão sanguínea. Os participantes foram incluídos aleatoriamente em 2 grupos, grupo F e grupo E. Grupo F recebeu concentrado de hemácias ≤ 15 dias após a extração. O grupo E receberá concentrado de hemácias ≥ 16-40 dias após a extração. Durante o estudo, várias variáveis hemodinâmicas e bioquímicas foram medidas antes, durante e após a transfusão de sangue, e posteriormente foi feita uma comparação dos resultados obtidos entre os grupos F e E. Resultados: no presente estudo incluíram-se um total de 26 pacientes com TCE grave e que foram transfundidos com concentrado de hemácias, do total de pacientes 13 foram transfundidos com um concentrado de hemácias «padrão¼ e outros 13 pacientes com um concentrado de hemácias «fresco¼. A média de dias de transfusão após a extração foi de 18 e 14 dias para as pacotes «padrão¼ e «fresco¼, respectivamente (p ≤ 0.001). Relatou-se 21 eventos infecciosos, 11 no grupo de pacientes que receberam transfusão com concentrado padrão e 10 no grupo com concentrado fresco. A mortalidade em 28 dias foi estimada em 31% dos pacientes transfundidos com concentrado padrão e em 23% dos pacientes com concentrado fresco (RR, para mortalidade em 28 dias de 0.90 (IC 95% 0.56-144). A duração mediana na unidade de terapia intensiva foi de 8 dias para ambos os grupos (0.32 DP), sendo que 2 dias associados ao ventilador, foram observados 15 dias para o grupo de pacientes com concentrado padrão e 7 para o grupo de concentrado fresco (0.60 DE), sem descobrir diferenças estatisticamente significativas nas referidas variáveis.No entanto, nesta análise foram encontradas diferenças estatisticamente significativas para os parâmetros gasométricos de saturação venosa central de oxigênio, débito cardíaco (Fick) e lactato antes e após a transfusão em favor do grupo de pacientes transfundidos com concentrado fresco (p ≤ 0.05). Conclusão: os resultados deste estudo inferem que não há associação entre o tempo de estocagem das hemácias transfundidas e a presença de desfechos clínicos adversos com tempos de estocagem mais longos. Em ambos os grupos, as transfusões foram igualmente seguras e eficazes. Os pesquisadores referem-se ao tamanho da amostra como limitante para este estudo.

Challenges of Biomass Utilization for Bioenergy in a Climate Change Scenario.

The climate changes expected for the next decades will expose plants to increasing occurrences of combined abiotic stresses, including drought, higher temperatures, and elevated CO2 atmospheric concentrations. These abiotic stresses have significant consequences on photosynthesis and other plants' physiological processes and can lead to tolerance mechanisms that impact metabolism dynamics and limit plant productivity. Furthermore, due to the high carbohydrate content on the cell wall, plants represent a an essential source of lignocellulosic biomass for biofuels production. Thus, it is necessary to estimate their potential as feedstock for renewable energy production in future climate conditions since the synthesis of cell wall components seems to be affected by abiotic stresses. This review provides a brief overview of plant responses and the tolerance mechanisms applied in climate change scenarios that could impact its use as lignocellulosic biomass for bioenergy purposes. Important steps of biofuel production, which might influence the effects of climate change, besides biomass pretreatments and enzymatic biochemical conversions, are also discussed. We believe that this study may improve our understanding of the plant biological adaptations to combined abiotic stress and assist in the decision-making for selecting key agronomic crops that can be efficiently adapted to climate changes and applied in bioenergy production.

Medición de la vaina del nervio óptico mediante tomografía computarizada como predictor de mortalidad en pacientes con traumatismo craneoencefálico grave al ingreso a la Unidad de Cuidados Intensivos / Optic nerve sheath measurement through computerized scan as death predictor in patients with serious cranioencephalic trauma on entry to the Intensive Care Unit / Medição da bainha do nervo óptico por tomografia computadorizada como preditor de mortalidade em pacientes com trauma cranioencefálico grave internados na Unidade de Terapia Intensiva

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Abstract: Introduction: Traumatic brain injury (TBI) is a medical-surgical condition characterized by brain involvement secondary to a traumatic lesion. Patients with severe TBI are at high risk of mortality and this will depend on different factors such as the presence of intracranial hypertension, age, origin of the injury and score on the Glasgow coma scale. Measurement of the optic nerve sheath diameter (ONSD) appears to be a good indirect indicator of intercranial hypertension and therefore, a good predictor of mortality. Objective: To determine the most appropriate cut-off point, as well as the measurement of the ONSD usefulness as a prognostic indicator of mortality in patients with severe TBI in the Intensive Care Unit (ICU). Material and methods: This is an analytical, descriptive, and retrospective study. The universe of study consists of all the case/files with TBI. For the sample selection, all available records of patients with severe TBI sent to the ICU during the period from March 1 to August 31, 2021, will be included. Within the inclusion criteria patients with a Glasgow scale score of < 8 points on entry and with a computerized scan done. The dependent variables to considerer are the outcome understood as death or survival of the patient, the days hospitalized in the ICU, the presence of complications; among the dependent variables is the diameter of the optic nerve sheath measured by computerized tomography. Intervening variables were also considered such as the presence of comorbidities and overweight/obesity, the age and sex of the patient. The project consisted of four phases: 1) request for authorization and access to files, 2) application of selection criteria, 3) performance of ONSD measurements and 4) creation of the database. Finally, once the database is formed, the statistical analysis will proceed; for the descriptive part, prevalence's, means (standard deviation) and medians (percentiles) will be calculated for the variables by sex and by outcome, subsequently the diagnostic capacity of the ONSD will be analyzed through the area under the ROC curve (receiving operating characteristics) for the outcome. Afterwards the performance of this and other cut-off points are compared using the Youden index. Results: Sixty records of TBI patients admitted to the ICU were studied, 51 were men (85%), 45 patients survived (75%) and 15 patients died (25%). The average age was of 50.5 ± 10.6 years, the average Glasgow score on admission was 6.6 ± 1.6 points, the average BMI was 26.42 ± 4.10 kg/m2, and the average number of days spent in the ICU was 9.03 ± 6.4. The diameter of the optic nerve was not a predictor of mortality, but if the Glasgow coma scale was, with an AUC of 0.775 (95% CI: 0.648-0.901, p = 0.002), the best cut-off point was 7 with a sensitivity of 93% and specificity of 54%. The bivariate linear regression model points to low Glasgow coma score and long hospital stay as predictors of mortality. Conclusions: The results of this study infer that, consistent with current scientific evidence, the sociodemographic characteristics of our population are similar to those reported by other authors, with men over 50 years of age being the most affected by this entity. On the other hand, the measurement of the diameter of the optic nerve sheath has been considered a good prognostic indicator of intracranial hypertension, which in turn is associated with increased mortality. However, in the present study there is no association between the diameter of the optic nerve sheath and the prognosis of mortality.

Resumo: Introdução: O traumatismo cranioencefálico (TCE) é uma condição médico-cirúrgica caracterizada por lesão cerebral secundária a uma lesão traumática. Pacientes com TCE grave apresentam alto risco de mortalidade e isso dependerá de diversos fatores, como presença de hipertensão intracraniana, idade, origem da lesão e pontuação na Escala de Coma de Glasgow. A medida do diâmetro da bainha do nervo óptico (DBNO) parece ser um bom indicador indireto de hipertensão intracraniana e, portanto, um bom preditor de mortalidade. Objetivo: Determinar o ponto de corte mais adequado, bem como a utilidade da medida do DBNO como indicador prognóstico de mortalidade em pacientes com TCE grave na Unidade de Terapia Intensiva. Material e métodos: Trata-se de um estudo analítico, descritivo e retrospectivo. O universo de estudo é composto por todos os prontuários de casos/pacientes com TCE grave. Para a seleção da amostra foram incluídos todos os prontuários disponíveis de pacientes com TCE grave encaminhados à Unidade de Terapia Intensiva no período de 1o de março a 31 de agosto de 2021, dentro dos critérios de inclusão foram considerados pacientes com escala de Glasgow < 8 pontos na admissão e com uma tomografia computadorizada realizada. As variáveis ​​dependentes consideradas são o desfecho entendido como óbito ou sobrevida do paciente, os dias de internação na UTI, a presença de complicações; dentro das variáveis ​​independentes está o diâmetro da bainha do nervo óptico medido por tomografia computadorizada. Também foram consideradas variáveis ​​intervenientes, como presença de comorbidades e sobrepeso/obesidade, idade e sexo do paciente. O projeto consistiu em três fases: a) Pedido de autorização e acesso aos prontuários, b) Aplicação dos critérios de seleção, c) Desenvolvimento da base de dados. Por fim, uma vez formada a base de dados, procedeu-se à análise estatística. Para a parte descritiva, foram calculadas as prevalências, médias (desvio padrão) e medianas (percentis) das variáveis ​​por sexo e por desfecho. Posteriormente, a capacidade diagnóstica do DBNO foi analisada pela área sob a curva ROC (Receiving Operating Characteristics) para o resultado. Posteriormente, o desempenho deste e de outros pontos de corte foi comparado pelo índice de Youden. Resultados: Foram estudados 60 prontuários de pacientes com TCE que deram entrada na UTI, 51 eram homens (85%), 45 pacientes sobreviveram (75%) e 15 pacientes morreram (25%). A média de idade foi de 50.5 ± 10.6 anos, a média de Glasgow na admissão foi de 6.6 ± 1.6 pontos, a média de IMC foi de 26.42 ± 4.10 kg/m2 e a média de dias de internação na UTI foi de 9.03 ± 6.4. O diâmetro do nervo óptico não foi preditor de mortalidade, mas a Escala de Coma de Glasgow sim, com AUC de 0.775 (IC 95%: 0.648-0.901, p = 0.002), o melhor ponto de corte foi 7 com sensibilidade de 93% e especificidade de 54%. O modelo de regressão linear bivariada aponta para baixo escore de coma de Glasgow e longa permanência hospitalar como preditores de mortalidade. Conclusões: Os resultados deste estudo inferem que, de acordo com as evidências científicas atuais, as características sociodemográficas de nossa população são semelhantes às relatadas por outros autores, sendo os homens com aproximadamente 50 anos de idade os mais acometidos por essa entidade. Por outro lado, a medida do diâmetro da bainha do nervo óptico tem sido considerada um bom indicador prognóstico de hipertensão intracraniana, que por sua vez está associada ao aumento da mortalidade. No entanto, no presente estudo não há associação entre o diâmetro da bainha do nervo óptico e o prognóstico de mortalidade.

Enzymatic Pretreatment with Laccases from Lentinus sajor-caju Induces Structural Modification in Lignin and Enhances the Digestibility of Tropical Forage Grass (Panicum maximum) Grown under Future Climate Conditions.

Since laccase acts specifically in lignin, the major contributor to biomass recalcitrance, this biocatalyst represents an important alternative to the pretreatment of lignocellulosic biomass. Therefore, this study investigates the laccase pretreatment and climate change effects on the hydrolytic performance of Panicum maximum. Through a Trop-T-FACE system, P. maximum grew under current (Control (C)) and future climate conditions: elevated temperature (2 °C more than the ambient canopy temperature) combined with elevated atmospheric CO2 concentration(600 µmol mol-1), name as eT+eC. Pretreatment using a laccase-rich crude extract from Lentinus sajor caju was optimized through statistical strategies, resulting in an increase in the sugar yield of P. maximum biomass (up to 57%) comparing to non-treated biomass and enabling hydrolysis at higher solid loading, achieving up to 26 g L-1. These increments are related to lignin removal (up to 46%) and lignin hydrophilization catalyzed by laccase. Results from SEM, CLSM, FTIR, and GC-MS supported the laccase-catalyzed lignin removal. Moreover, laccase mitigates climate effects, and no significant differences in hydrolytic potential were found between C and eT+eC groups. This study shows that crude laccase pretreatment is a potential and sustainable method for biorefinery solutions and helped establish P. maximum as a promising energy crop.

Programa educativo para el afrontamiento de una vida futura con calidad en personas prejubilables / Educational program to face a future life with quality in early retirement

RESUMEN Fundamento: los programas de preparación para asumir una jubilación saludable son elementos clave en la protección de la calidad de vida de las personas prejubilables. Objetivo: mostrar la eficacia de la aplicación de un programa educativo dirigido a personas en etapa de prejubilación para el afrontamiento de una vida futura con calidad. Métodos: se realizó un estudio polietápico con diseño cuasiexperimental, en el Policlínico Universitario "Marta Abreu", en Santa Clara, Villa Clara, entre enero 2017-febrero 2019. Se utilizaron métodos teóricos: histórico-lógico, análisis-síntesis, inductivo-deductivo y sistémico-estructural; empíricos: análisis documental, cuestionario antes y después de aplicado el programa; y para valorar la propuesta se utilizaron los grupos focal y nominal, y los criterios de especialistas, además se emplearon métodos matemático-estadísticos. Resultados: el diagnóstico realizado demostró la necesidad de la preparación de las personas prejubilables para afrontar con calidad una nueva etapa de sus vidas, por lo que se diseñó un programa educativo el cual fue estructurado en cinco módulos: la jubilación como una etapa trascendental en la vida del adulto, salud física y salud psicológica, bienestar psicosocial e inteligencia emocional, planificación y emprendimiento y la adaptación integral a una nueva fase. Fue valorado por especialistas, quienes lo consideraron muy pertinente y viable. Conclusiones: el programa educativo resultó efectivo para el mejoramiento de la calidad de vida en personas prejubilables del grupo estudio, pues se constataron cambios significativos en sentido de avance al comparar sus conocimientos antes y después de aplicado y en relación con el grupo de control.

ABSTRACT Background: the preparation programs for assuming a healthy retirement are key elements in protecting life quality in early retirement people. Objective: to show the effectiveness of the application of an educational program aimed at people in pre-retirement stage to face a future life with quality. Methods: a multi-stage study with a quasi-experimental design was carried out at the "Marta Abreu" University Polyclinic, in Santa Clara, Villa Clara, from January 2017 to February 2019. Theoretical methods were used: historical-logical, analysis-synthesis, inductive-deductive and systemic-structural; empirical ones: documentary analysis, questionnaire before and after applying the program; and to assess the proposal, the focal and nominal groups were used, as well as the criteria of specialists, in addition, mathematical-statistical methods were used. Results: the diagnosis showed the need to prepare early retirees to face a new stage of their lives with quality, so an educational program was designed which was structured in five modules: retirement as a transcendental stage in the adult life, physical and psychological health, psychosocial well-being and emotional intelligence, planning and entrepreneurship, and comprehensive adaptation to a new phase. It was valued by specialists, who considered it very relevant and feasible. Conclusions: the educational program was effective for improving the quality of life in early retirement in the study group, since meaningful changes in the direction of progress were found when comparing their knowledge before and after it was applied and in relation to the control group.

Anthelmintic effect of four extracts obtained from Caesalpinia coriaria foliage against the eggs and larvae of Haemonchus contortus.

To investigate the in vitro anthelmintic efficacy of dividivi (Caesalpinia coriaria), a traditional medicinal plant used in Central America and the northern part of South America, extracts from the foliage of this plant were subjected to the egg hatching test (EHT) and larval exsheathment inhibition test (LEIT), against Haemonchus contortus. Four different extracts were evaluated: acetone-water (AW), methanol-water (MW), acetone-water-dichloromethane (AWD) and methanol-water-dichloromethane (MWD). The concentrations used for the EHT and LEIT tests ranged from 500 to 4000 µg mL-1 and six repetitions per concentration. The effective concentrations (EC50) were calculated using Probit analysis. The EC50 for EHT were 2947.0, 3347.0, 3959.6 and 4538.7 µg mL-1 for MWD, MW, AW and AWD, respectively. The EC50 for LEIT were 2883.4, 5927.4, 9876.3 and 9955.4 µg mL-1 for AWD, AW, MWD and MW, respectively. The methanol extracts were the most effective in inhibiting the hatching of eggs, while the acetone extracts showed efficacy in inhibiting larval exsheathment. This study explains the importance that C. coriaria has as a medicinal plant in Central and South American countries.

Adaptación al español y validación de la Escala de Continuidad de Vínculos (ECV) con el ser querido fallecido / Adaptação ao espanhol e validação da escala de continuidade de vínculos (ECV) com o amado falecido / Spanish adaptation and validation of the Continuig Bonds Scale (CBS) with the deceased loved one

Este estudio presenta la validación española de la Escala de Continuidad deVínculos (ECV) compuesta por dos dimensiones: Interiorizada (10 ítems) y exteriorizada(6 ítems). Primero se realizó la traducción-retrotraducción. En la puesta a pruebaparticiparon 255 dolientes de Canarias (España) quienes respondieron mediante encuesta(febrero-marzo 2021). Perfil: mujeres, mediana edad, estudios superiores, laboralmenteactivas, tiempo desde la pérdida de 2-5 años y parentesco más común, progenitores. Laconsistencia interna arrojó un α de Cronbach=0,914 y correlaciones ítems-puntuacióntotal aceptables, en rangos 0,478-0,720. En fiabilidad test-retest las puntuaciones deacuerdo fueron excelentes (CCI=0,889; 0,795-0,940). En validación convergente, unacorrelación con la Escala de inclusión del otro en el yo de rs=-0,402 (p<0,001), niveladecuado. Para la validez de constructo concurrente las puntuaciones totales secorrelacionaron con variables sumatorias de duelo prolongado de Prigerson ydiagnósticos enfermeros NANDA-I: rs=0,568, rs=0,391, rs=0,408, y rs=0,446 (p<0,001).El análisis factorial confirmó dos dimensiones y la varianza total explicada fue 57,153%.Por último, la validez de grupos conocidos mostró diferencias según sexo, parentesco ycausa de muerte. La ECV adaptada y validada al contexto español, ECoVin, resulta uninstrumento válido, fiable y fácil de usar para evaluar la continuidad de vínculos con seresqueridos fallecidos.(AU)

This study presents the Spanish validation of the Continuituing Bonds Scale(CBS) composed of two dimensions: Internalised (10 items) and externalised (6 items).First, translation-retro translation was carried out. A total of 255 mourners from theCanary Islands (Spain) participated in the test and responded through a survey (February-March 2021). Profile: women, middle-aged, higher education, active at work, time sinceloss 2-5 years and most common relationship, parents. Internal consistency yielded aCronbach's α=0.914 and good item-total score correlations, ranging 0.478-0.720. In test-retest reliability, agreement scores were excellent (ICC=0.889; 0.795-0.940). Inconvergent validation, a correlation with the Inclusion of the Other in the Self (IOS) scaleof rs=-0.402 (p<0.001) was adequate. For concurrent construct validity total scorescorrelated with summative variables of Prigerson prolonged grief and NANDA-I nursingdiagnoses: rs=0.568, rs=0.391, rs=0.408, and rs=0.446 (p<0.001). Factor analysisconfirmed two dimensions, and the total variance explained was 57.153%. Finally,known-group validity showed differences according to sex, kinship and cause of death.The CBS adapted and validated to the Spanish context, ECoVin, is a valid, reliable andeasy-to-use instrument to assess the continuity of bonds with deceased loved ones.(AU)

Este estudo apresenta a validação espanhola da Escala de Continuidade deVínculos (ECV) composta por duas dimensões: internalizada (10 itens) e externalizada(6 itens). A tradução-retrotradução foi realizada primeiro. 255 enlutados das IlhasCanárias (Espanha) participaram do teste e responderam por meio de um inquérito(fevereiro-março de 2021). Perfil: mulheres, meia-idade, ensino superior, trabalho ativo,tempo desde a perda de 2-5 anos e relacionamento mais comum, pais. A consistênciainterna rendeu α de Cronbach = 0,914 e correlações item-pontuação total aceitáveis, emintervalos de 0,478-0,720. Na confiabilidade teste-reteste, os escores de concordânciaforam excelentes (ICC = 0,889; 0,795-0,940). Na validação convergente, correlação coma Escala de inclusão do outro no self de rs=-0,402 (p <0,001), nível adequado. Para avalidade de construto concorrente, os escores totais foram correlacionados com asvariáveis de soma do luto prolongado de Prigerson e os diagnósticos de enfermagem daNANDA-I: rs=0,568, rs=0,391, rs=0,408 e rs=0,446 (p <0,001). A análise fatorialconfirmou duas dimensões e a variância total explicada foi de 57,153%. Por fim, avalidade dos grupos conhecidos mostrou diferenças quanto ao sexo, parentesco e causada morte. O ECV adaptado e validado para o contexto espanhol, ECoVin, é uminstrumento válido, confiável e fácil de usar para avaliar a continuidade dos laços comamados falecidos.(AU)

Morpho-physiological performance of Mikania glomerata Spreng. and Mikania laevigata Sch. Bip ex Baker plants under different light conditions / Desempenho morfo-fisiológico de Mikania glomerata Spreng. e Mikania laevigata Sch. Bip ex Baker sob diferentes condições de luminosidade

In tropical and subtropical zones, lianas play important roles in the process of ecological succession. This study aims to evaluate the photosynthetic and morpho-physiological performance between two lianas species from Mikania genus in response to different levels of radiation: full sun (I0), 25% (I25), 50% (I50), and 75% (I75) retention of solar radiation flux. Plants grown under I75 showed a reduced net photosynthetic rate (A). We observed dynamic photoinhibition at I0 during hours of high irradiation and temperature. The highest and lowest leaf chlorophyll content occurred at I75 and I0, respectively, while carotenoids/total chlorophyll and leaf thickness increased under I0. Total dry mass was higher in plants grown at I0 and I25. However, A values and biomass production of Mikania laevigata were higher at I25, while for Mikania glomerata greater biomass accumulation was observed between I0-I50. Therefore, we concluded that M. laevigata and M. glomerata have different morpho-physiological performances under same the radiation conditions.

Em regiões tropical e subtropical, lianas desempenham um papel importante no processo de sucessão ecológica. O objetivo deste estudo foi avaliar as respostas fotossintéticas e morfo-fisiológicas entre duas espécies de Mikania em diferentes níveis de radiação: sol pleno (I0), 25% (I25), 50% (I50) e 75% (I75) de retenção do fluxo da radiação solar. Plantas crescidas sob I75 mostraram reduzida taxa fotossintética (A). Nós observamos fotoinibição dinâmica em plantas crescidas sob I0 durante as horas de alta irradiação e temperatura. O maior e menor conteúdo de clorofila ocorreu em plantas sob I75 e I0, respectivamente; enquanto carotenoides/clorofila total e espessuras da epiderme e mesofilo aumentaram sob I0. A massa seca total foi maior em plantas crescidas sob I0 e I25. No entanto, os valores de A e a produção de biomassa de M. laevigata foram maiores sob I25; enquanto para M. glomerata, maior acúmulo de biomassa foi observado entre I0-I50. Portanto, nós concluímos que M. laevigata e M. glomerata apresentaram diferentes respostas morfo-fisiológicas sob mesma condição de radiação.

Toxicity of three organophosphate insecticides in anuran embryos at different temperatures / Toxicidad de tres insecticidas organofosforados en embriones de anuros a diferentes temperaturas

RESUMEN Los efectos de diferentes agroquímicos y de la temperatura han sido temas recurrentes en la investigación en anuros; sin embargo, estas variables se han abordado de manera independiente sin considerar que pueden ejercer una presión simultánea sobre las especies. Por esta razón, este trabajo tiene como objetivo determinar la toxicidad (a través de la Concentración Letal Media -CL50) de los insecticidas organofosforados clorpirifos, diazinón y monocrotofos, bajo tres regímenes térmicos (23, 28 y 33 ± 1 °C) sobre embriones de tres especies de anuros. De acuerdo a los valores de CL50, el insecticida clorpirifos fue el más tóxico, seguido del diazinón y del monocrotofos. Por su parte, de manera general se encontró un incremento de la toxicidad de los insecticidas organofosforados a la temperatura más alta de experimentación (33 °C). Además, el efecto de la temperatura se hizo más notorio para los organismos expuestos al clorpirifos, el insecticida más letal. Estos resultados sugieren un efecto negativo para la fauna acuática de anuros debido al actual uso desmesurado de este tipo de agroquímicos y a su interacción con la temperatura ambiental.

ABSTRACT In anurans, the effects of different agrochemicals and temperature have been recurrent topics in research; however, these variables are addressed independently without considering that they can exert a simultaneous pressure on the species. For this reason, this work aims to determine the toxicity (through the Medium Lethal Concentration -LC50) of the organophosphate insecticides: chlorpyrifos, diazinon and monocrotophos, under three thermal regimes (23, 28 and 33 ± 1 °C) on embryos ofthree species of anurans. According to the LC50 values, the chlorpyrifos insecticide was the most toxic, followed by diazinon and monocrotophos. On the other hand, an increase in the toxicity of the organophosphate insecticides studied was generally found at the highest experimental temperature (33 °C). In addition, the effect of temperature became more noticeable for the organisms exposed to chlorpyrifos, the most lethal insecticide. These results suggest a negative effect for the aquatic fauna of anurans due to the current excessive use of this type of agrochemicals and their interaction with environmental temperature.

La musicoterapia como una modalidad terapéutica reguladora de las emociones en las personas prejubilables / Music therapy as a therapeutic modality regulating emotions in early retired people

RESUMEN Introducción: la prejubilación es un proceso de relevancia social por la alta tasa de crecimiento de la población activa envejecida, cuya preocupación más relevante surge por la extensión, quizás sobredimensionada, de la vida laboral. Objetivo: determinar los resultados de la musicoterapia en personas prejubilables. Métodos: se realizó una intervención musicoterapéutica con el objetivo de regular las emociones en personas prejubilables, ante el dilema del cese del vínculo laboral o la continuidad de este; se realizó un estudio cuasi-experimental en el Policlínico Docente «Marta Abreu¼, Villa Clara, en el período de enero 2017 a febrero 2019. Se emplearon procedimientos, métodos y técnicas con aplicación de la musicoterapia en un grupo estudio de 200 personas prejubilables, de 55 a 65 años de edad. Se utilizaron métodos teóricos, empíricos y estadísticos-matemáticos. Se aplicaron técnicas psicológicas antes y después de la musicoterapia en el grupo estudio y en el grupo control. Resultados: se constataron resultados relevantes en el grupo estudio, y se registraron cambios muy significativos: más estados emocionales ansiosos bajo y depresivo leve, autoestima alta, y notable mejoría en la vulnerabilidad al estrés. En el grupo control no se reflejaron cambios favorables. Conclusiones: la musicoterapia resultó efectiva por el logro de cambios positivos en el estado emocional en personas prejubilables del grupo estudio. La identificación prometedora de potencialidades en el lenguaje musical, con la utilización mínima de la palabra en la atención integral a personas en etapa de prejubilación, constituyó una novedad.

ABSTRACT Introduction: early retirement is a process of social relevance due to the high growth rate of the aging workforce, whose most relevant concern arises from the extension, perhaps oversized, of working life. Objective: to determine the results of music therapy in early retired people. Methods: a music therapy intervention was carried out with the aim of regulating emotions in early retired people, faced with the dilemma of the termination of the employment relationship or its continuity; a quasi-experimental study was carried out at "Marta Abreu" Teaching Polyclinic, Villa Clara, from January 2017 to February 2019. Procedures, methods and techniques with application of music therapy were used in a study group of 200 early retired people aged 55 to 65 years. Theoretical, empirical and statistical-mathematical methods were used. Psychological techniques were applied in the study group before and after music therapy and in the control group without intervention. Results: relevant results were found in the study group, and very significant changes were recorded: more low anxiety and mild depressive emotional states, high self-esteem, and notable improvement in vulnerability to stress. No favorable changes were reflected in the control group. Conclusions: music therapy was effective for achieving positive changes in emotional state in early retired people from the study group. The promising identification of potentialities in musical language, with the minimum use of spoken language in comprehensive care for people in early retirement, was a novelty.

Effect of moringa leaf powder and agave inulin on performance, intestinal morphology, and meat yield of broiler chickens.

The addition prebiotics in broiler diets can benefit digestion and nutrient abortion. The objective of the present study was to evaluate the effects of moringa leaf powder and agave inulin on growth performance, intestinal morphology, and slaughter traits of broiler chickens over 40 d of grow-out. A total of 280 broilers (Ross 308) aged 1 d were randomly allocated to 4 treatments, with 7 replicates each and 10 chicks per replicate: T1 = control diet, T2 = control diet with 15 g/kg of moringa leaf powder, T3 = control diet with 15 g/kg of agave inulin, and T4 = control diet with 15 g/kg of moringa leaf powder and 15 g/kg of agave inulin. The results showed that analysis of treatments at time were not different (P > 0.05) for broiler weights, feed and water intake, and weight gain. Treatment was significant (P < 0.05) for feed efficiency at 22 to 40 d; the T4 group presented higher (P < 0.05) values, and the T1 group presented lower (P < 0.05) values. However, the villus lengths of intestinal sections were different (P < 0.05) among treatments. In the duodenum, jejunum, and ileum, villus lengths were highest (P < 0.05) in the T2 group and lowest (P < 0.05) in the T3 and T4 groups. Villus widths in the duodenum and ileum were highest (P < 0.05) in the T2 group, but the T1 group showed highest (P < 0.05) values in the jejunum sections. The T3 and T4 groups showed lowest (P < 0.05) values in villus width in the duodenum, jejunum, and ileum. Thigh yield was highest (P < 0.05) in the T2 group and lowest (P < 0.05) in the T4 group. The T1 group exhibited the highest (P < 0.05) piece yields for leg, wing, and hip-back. The T4 group showed lowest (P < 0.05) leg and wing yields. Moringa leaf powder and agave inulin at a concentration of 15 g/kg in diets did not affect broiler performance, whereas moringa leaf powder improved intestinal morphology and thigh yield, and agave inulin improved leg yield. The results demonstrated benefits of these 2 feed additives to improve intestine health and meat yield in broilers over a 40-day grow-out.