Can the ROX index predict high-flow nasal cannula failure in children under 2 with lower respiratory tract infection?

OBJECTIVE: This study evaluates the ROX index's accuracy in predicting the success or failure of high-flow nasal cannula (HFNC) therapy in children under 2 years with acute respiratory failure (ARF) from lower respiratory tract infections. METHODS: From January 2018 to 2021 we conducted this multicenter retrospective cohort study, which included patients aged 2-24 months. We aimed to assess HFNC therapy outcomes as either success or failure. The analysis covered patient demographics, diagnoses, vital signs, and ROX index values at intervals from 0 to 48 h after initiating HFNC. We used bivariate analysis, repeated measures ANOVA, multivariate logistic regression, and the area under the receiver operating characteristic (AUC-ROC) curve for statistical analysis. RESULTS: The study involved 529 patients from six centers, with 198 females (37%) and a median age of 9 months (IQR: 3-15 months). HFNC therapy failed in 38% of cases. We observed significant variability in failure rates across different centers and physicians (p < .001). The ROX index was significantly associated with HFNC outcomes at all time points, showing an increasing trend in success cases over time (p < .001), but not in HFNC failure cases. Its predictive ability is limited, with AUC-ROC values ranging from 0.56 at the start to 0.67 at 48 h. CONCLUSION: While the ROX index is associated with HFNC outcomes in children under 2 years, its predictive ability is modest, impacted by significant variability among patients, physicians, and centers. These findings emphasize the need for more reliable predictive tools for HFNC therapy in this patient population.

Machine learning-based automated planning for hippocampal avoidance prophylactic cranial irradiation.

PURPOSE: Design and evaluate a knowledge-based model using commercially available artificial intelligence tools for automated treatment planning to efficiently generate clinically acceptable hippocampal avoidance prophylactic cranial irradiation (HA-PCI) plans in patients with small-cell lung cancer. MATERIALS AND METHODS: Data from 44 patients with different grades of head flexion (range 45°) were used as the training datasets. A Rapid Plan knowledge-based planning (KB) routine was applied for a prescription of 25 Gy in 10 fractions using two volumetric modulated arc therapy (VMAT) arcs. The 9 plans used to validate the initial model were added to generate a second version of the RP model (Hippo-MARv2). Automated plans (AP) were compared with manual plans (MP) according to the dose-volume objectives of the PREMER trial. Optimization time and model quality were assessed using 10 patients who were not included in the first 44 datasets. RESULTS: A 55% reduction in average optimization time was observed for AP compared to MP. (15 vs 33 min; p = 0.001).Statistically significant differences in favor of AP were found for D98% (22.6 vs 20.9 Gy), Homogeneity Index (17.6 vs 23.0) and Hippocampus D mean (11.0 vs 11.7 Gy). The AP met the proposed objectives without significant deviations, while in the case of the MP, significant deviations from the proposed target values were found in 2 cases. CONCLUSION: The KB model allows automated planning for HA-PCI. Automation of radiotherapy planning improves efficiency, safety, and quality and could facilitate access to new techniques.

Construction of miRNA-mRNA networks for the identification of lung cancer biomarkers in liquid biopsies.

Lung cancer (LC) is the most common cause of cancer death worldwide mostly due to the low survival rate: 75% of cases are identified in advanced stages. In this study, the list of useful biomarkers to make an early diagnosis using liquid biopsies was expanded. A total of 30 samples of LC were analyzed to define potential miRNA biomarkers in liquid biopsies for LC. The biomarkers have been identified in interaction networks miRNA-mRNA. The potential biomarkers have been then validated in large cohorts. A total of 15 candidate miRNAs, that regulate the repression of 30 mRNAs, have been identified as a specific functional interaction network for squamous carcinoma, while the specific functional interaction network of adenocarcinoma consists of four candidate miRNAs that seem to handle the repression of five mRNA. Inspection of expression levels in larger cohorts validates the usefulness of the 11 candidates as biomarkers in liquid biopsies. The 11 candidate miRNAs found could be utilized to form diagnostic predictive biomarkers for LC in liquid biopsies.

Survival Outcomes of Patients With Mediastinal Germ Cell Tumors: Experience of a Cancer Center in South America.

PURPOSE: Mediastinal germ cell tumors (GCT) are rare neoplasms associated with poor survival prognosis. Due to their low incidence, limited information is available about this disease in South America. The objective of this study is to report the clinical characteristics and outcomes of patients with mediastinal GCT in a cancer center in Colombia. MATERIALS AND METHODS: We conducted a retrospective analysis of patients with mediastinal GCT treated at the National Cancer Institute at Bogota (Colombia) between 2008 and 2020. Survival curves were presented using the Kaplan-Meier method. Chi-square and Cox proportional hazard model tests were used for data analysis. RESULTS: Sixty-one patients were included in the study. Of them, 60 were male and 51 (83.6%) of whom had non-seminomatous germ cell tumors (NSGCT). Twenty-nine patients (47.5%) presented with superior vena cava syndrome, and 18 (29.5%) patients had extrapulmonary metastatic involvement. The three-year overall survival (OS) of NSGCT patients was 26%. The 3-year OS of NSGCT patients who underwent surgical resection of residual mediastinal mass after chemotherapy was 59%. Non-surgical management after first-line chemotherapy was associated with a worse survival prognosis in NSGCT patients (p = 0.002). Ten patients with mediastinal seminomatous germ cell tumors (SCGT) achieved a 3-year OS of 100%. CONCLUSION: Mediastinal NSGCT had poor outcomes. Surgery of the residual mass after first-line chemotherapy seems to improve the outcome of NSGCT patients. Advanced disease at presentation may reflect inadequate access to reference cancer centers in Colombia and potentially explain poor survival outcomes in this cohort. On the other hand, mediastinal SCGT is a biologically different disease; most patients will achieve disease remission and long-term survival with first-line chemotherapy.

Determinantes de la hospitalización en pacientes con diagnóstico de bronquiolitis en Barranquilla, Colombia / Determinants of hospitalization in patients diagnosed with bronchiolitis in Barranquilla, Colombia

RESUMEN Objetivo Describir la frecuencia de los factores de riesgo que inciden en la hospitalización de pacientes con diagnóstico de bronquiolitis atendidos en una empresa social del estado (ESE) ubicada en la ciudad de Barranquilla, Colombia. Materiales y Métodos Estudio descriptivo de corte transversal retrospectivo. La fuente de información fueron las historias clínicas de ingresos al servicio de urgencias de los niños que fueron valorados por el servicio de pediatría entre los años 2016 y 2018. En total se evaluaron 865 historias, de las cuales se descartaron 103 por no cumplir con los criterios de inclusión descritos para el estudio. Resultados Los factores de riesgo modificables fueron los que más se presentaron en el grupo estudiado. El que pudo tener mayor importancia fue la aparición de la enfermedad. La lactancia materna exclusiva inadecuada fue de gran relevancia para la aparición, así como la gravedad de la enfermedad. Discusión Las enfermedades crónicas no modificables tienen relevancia por su relación con la aparición y la gravedad de enfermedades como la bronquiolitis. Factores variables como el bajo peso al nacer, la prematurez y la enfermedad cardiaca fueron considerados como los de mayor valor e importancia frente a la enfermedad en la población estudiada. Conclusiones La mayoría de los factores de riesgo que inciden en los pacientes se podrían evitar o aminorar con educación y con estrategias de mejora en la comunidad.

ABSTRACT Objective To describe the frequency of risk factors that have an impact on hospitali-zation of patients diagnosed with bronchiolitis and served in a state hospital located in Barranquilla, Colombia. Materials and Methods A retrospective, cross-sectional, descriptive study was perfor-med. The source of information was the medical records of children who were admitted to emergency service and valued by the pediatrics service between 2016 and 2018. 865 medical records were studied. 103 of them were discarded, because they did not meet the inclusion criteria described by the study. Results The modifiable risk factors were the ones that presented the most in the group studied. The onset of the disease could be the most important. Inadequate exclusive breastfeeding was of great importance for the onset, as well as the severity of the disease. Discussion Chronic non-modifiable diseases are relevant because of their relationship to the onset and severity of diseases such as bronchiolitis. Low birth weight, prematurity, and heart disease have the highest valuation and were considered the most important factors in relation to the disease in the studied population. Conclusions Most risk factors presented by patients could be avoided or reduced with education and strategies of improvement to the community, being able to decrease the appearance of the disease.

[Determinants of hospitalization in patients diagnosed with bronchiolitis in Barranquilla, Colombia]. / Determinantes de la hospitalización en pacientes con diagnóstico de bronquiolitis en Barranquilla, Colombia.

OBJECTIVE: To describe the frequency of risk factors that have an impact on hospitali-zation of patients diagnosed with bronchiolitis and served in a state hospital located in Barranquilla, Colombia. MATERIALS AND METHODS: A retrospective, cross-sectional, descriptive study was perfor-med. The source of information was the medical records of children who were admitted to emergency service and valued by the pediatrics service between 2016 and 2018. 865 medical records were studied. 103 of them were discarded, because they did not meet the inclusion criteria described by the study. RESULTS: The modifiable risk factors were the ones that presented the most in the group studied. The onset of the disease could be the most important. Inadequate exclusive breastfeeding was of great importance for the onset, as well as the severity of the disease. DISCUSSION: Chronic non-modifiable diseases are relevant because of their relationship to the onset and severity of diseases such as bronchiolitis. Low birth weight, prematurity, and heart disease have the highest valuation and were considered the most important factors in relation to the disease in the studied population. CONCLUSIONS: Most risk factors presented by patients could be avoided or reduced with education and strategies of improvement to the community, being able to decrease the appearance of the disease.

OBJETIVO: Describir la frecuencia de los factores de riesgo que inciden en la hospitalización de pacientes con diagnóstico de bronquiolitis atendidos en una empresa social del estado (ESE) ubicada en la ciudad de Barranquilla, Colombia. MATERIALES Y MÉTODOS: Estudio descriptivo de corte transversal retrospectivo. La fuente de información fueron las historias clínicas de ingresos al servicio de urgencias de los niños que fueron valorados por el servicio de pediatría entre los años 2016 y 2018. En total se evaluaron 865 historias, de las cuales se descartaron 103 por no cumplir con los criterios de inclusión descritos para el estudio. RESULTADOS: Los factores de riesgo modificables fueron los que más se presentaron en el grupo estudiado. El que pudo tener mayor importancia fue la aparición de la enfermedad. La lactancia materna exclusiva inadecuada fue de gran relevancia para la aparición, así como la gravedad de la enfermedad. DISCUSIÓN: Las enfermedades crónicas no modificables tienen relevancia por su relación con la aparición y la gravedad de enfermedades como la bronquiolitis. Factores variables como el bajo peso al nacer, la prematurez y la enfermedad cardiaca fueron considerados como los de mayor valor e importancia frente a la enfermedad en la población estudiada. CONCLUSIONES: La mayoría de los factores de riesgo que inciden en los pacientes se podrían evitar o aminorar con educación y con estrategias de mejora en la comunidad.

Characterization of gallium resistance induced in a Pseudomonas aeruginosa cystic fibrosis isolate.

The repurposing of gallium nitrate as an antibacterial, a drug used previously for the treatment of hypercalcemia, is a plausible alternative to combat infections by Pseudomonas aeruginosa, since it has antipseudomonal properties in vitro and in vivo in animal models and in human lung infections. Furthermore, gallium nitrate tolerance in clinical isolates is very rare. Nevertheless, studies on the reference strains PA14 and PAO1 show that resistance against gallium nitrate is achieved by decreasing gallium intracellular levels by increasing the production of pyocyanin. In this work, we induced resistance in a cystic fibrosis P. aeruginosa isolate and explored its resistance mechanisms. This isolated strain, INP-58M, was not a pyocyanin producer, and its pyoverdine levels remained unchanged upon gallium addition. However, it showed higher activities of NADPH-producing enzymes and the antioxidant enzyme SOD when gallium was added, which suggests a better antioxidant response. Remarkably, gallium intracellular levels in the resistant isolate were higher than those of the parental strain at 20 h but lower after 24 h of culture, suggesting that this strain is capable of gallium efflux.

Iniciativas para la adopción y uso de recursos educativos abiertos en Instituciones de Educación Superior / Initiatives for Accepting and Using Open Educational Resources in Higher Educations Institutions

Las iniciativas de adopción y uso de recursos educativos abiertos en Instituciones de Educación Superior se proyectan hacia la creación de entornos adecuados para el acceso a la información y el desarrollo sostenible de recursos de aprendizaje de calidad. Al mismo tiempo que incluye modelos de colaboración basados en las necesidades de docentes y estudiantes. El objetivo de este artículo es identificar iniciativas que contribuyan a la adopción y uso de recursos educativos abiertos en las Instituciones de Educación Superior de Cuba. El trabajo se basa en una investigación documental, que tiene en cuenta la adopción y uso de estos recursos en Educación Superior a nivel internacional. Como conclusión, se hace un análisis de los retos que deben enfrentar las universidades para favorecer el uso de recursos educativos abiertos por los docentes en el contexto universitario de Cuba(AU)

The initiatives for accepting and using open educational resources in higher education institutions are planned based on the creation of adequate settings for accessing information and the sustainable development of quality learning resources. At the same time, it includes collaboration models based on the necessities of teachers and students. The objective of this article is to identify initiatives that contribute to accepting and using open educational resources in higher education institutions in Cuba. The work is basically a documentary research, which takes into account the acceptance and use of these resources in higher education internationally. In conclusion, an analysis is carried out of the challenges that universities must face in order to promote the use of open educational resources opened by teachers in the Cuban university context(AU)

Evaluación de los niveles de actividad física en universitarios mediante método directo / Physical activity level assessment in university students by direct method

RESUMEN Objetivo Identificar a través de un método de medición directo de la actividad física, las categorías en las que se ubican un grupo de estudiantes universitarios; así como relacionar estas categorías con variables de tipo sociodemográfico y antropométrico. Métodos Estudio de corte transversal y fase comparativa en 601 estudiantes universitarios a los que se les indagó sobre las variables sociodemográficas: género, edad, estado civil y estrato socioeconómico y autopercepción de salud. Se determinó el Índice de Masa Corporal y los niveles de actividad física mediante el Test de Clasificación de Sedentarismo de Pérez-Rojas-García sobre el comportamiento de la frecuencia cardíaca. Resultados Se observó diferencias significativas (p=0,000) en la frecuencia cardíaca entre activos e inactivos, en los inactivos fue de 143,4 p/m en comparación con 115,1 p/m en los activos. Con respecto a los resultados de la regresión logística, los estudiantes de género femenino presentan mayor riesgo de ser inactivos físicamente con la prueba objetiva [OR 2,6 (1,9-3,6)]; asimismo, se observa que las personas con sobrepeso y obesidad tienen mayor probabilidad de ser inactivos [OR 1,9 (1,4-2,9)]. Conclusión Se evidencia una elevada frecuencia de inactividad física en la población universitaria, asociada significativamente a la obesidad y al género femenino, datos que se convierten en una línea de base fundamental para la elaboración de programas de entrenamiento y actividad física específicos para población universitaria.(AU)

ABSTRACT Objectives To identify the categories in which a group of university students are classified by directly measuring physical activity, and to relate these categories with socio-demographic and anthropometric variables. Materials and Methods Cross-sectional and comparative phase study in 601 university students who were interviewed to inquire about socio-demographic variables such as sex, age, marital status, socioeconomic status and self- perceived health. Body Mass Index (BMI) and physical activity levels were determined by applying the Perez-Rojas-García Sedentarism Classification Test on heart rate behavior. Results Significant heart rate differences (p=0.000) between the active and the inactive group of university students were observed. The inactive group had a heart rate of 143.4 bpm compared to 115.1 bpm in the active group. Regarding the results of the logistic regression, female students had a greater risk of being physically inactive in the objective test [OR 2.6 (1.9 to 3.6)], while overweight and obese people are more likely to be inactive [OR 1.9 (1.4-2.9)]. Conclusion The assessment shows that a high prevalence of physical inactivity in university students is significantly associated with obesity and the female sex. This Information is fundamental for designing specific training programs and physical activities for university students.(AU)

[Physical activity level assessment in university students by direct method]. / Evaluación de los niveles de actividad física en universitarios mediante método directo.

OBJECTIVES: To identify the categories in which a group of university students are classified by directly measuring physical activity, and to relate these categories with socio-demographic and anthropometric variables. MATERIALS AND METHODS: Cross-sectional and comparative phase study in 601 university students who were interviewed to inquire about socio-demographic variables such as sex, age, marital status, socioeconomic status and self- perceived health. Body Mass Index (BMI) and physical activity levels were determined by applying the Perez-Rojas-García Sedentarism Classification Test on heart rate behavior. RESULTS: Significant heart rate differences (p=0.000) between the active and the inactive group of university students were observed. The inactive group had a heart rate of 143.4 bpm compared to 115.1 bpm in the active group. Regarding the results of the logistic regression, female students had a greater risk of being physically inactive in the objective test [OR 2.6 (1.9 to 3.6)], while overweight and obese people are more likely to be inactive [OR 1.9 (1.4-2.9)]. CONCLUSION: The assessment shows that a high prevalence of physical inactivity in university students is significantly associated with obesity and the female sex. This Information is fundamental for designing specific training programs and physical activities for university students.

OBJETIVO: Identificar a través de un método de medición directo de la actividad física, las categorías en las que se ubican un grupo de estudiantes universitarios; así como relacionar estas categorías con variables de tipo sociodemográfico y antropométrico. MÉTODOS: Estudio de corte transversal y fase comparativa en 601 estudiantes universitarios a los que se les indagó sobre las variables sociodemográficas: género, edad, estado civil y estrato socioeconómico y autopercepción de salud. Se determinó el Índice de Masa Corporal y los niveles de actividad física mediante el Test de Clasificación de Sedentarismo de Pérez-Rojas-García sobre el comportamiento de la frecuencia cardíaca. RESULTADOS: Se observó diferencias significativas (p=0,000) en la frecuencia cardíaca entre activos e inactivos, en los inactivos fue de 143,4 p/m en comparación con 115,1 p/m en los activos. Con respecto a los resultados de la regresión logística, los estudiantes de género femenino presentan mayor riesgo de ser inactivos físicamente con la prueba objetiva [OR 2,6 (1,9-3,6)]; asimismo, se observa que las personas con sobrepeso y obesidad tienen mayor probabilidad de ser inactivos [OR 1,9 (1,4-2,9)]. CONCLUSIÓN: Se evidencia una elevada frecuencia de inactividad física en la población universitaria, asociada significativamente a la obesidad y al género femenino, datos que se convierten en una línea de base fundamental para la elaboración de programas de entrenamiento y actividad física específicos para población universitaria.

Considerations on Visible Light Communication security by applying the Risk Matrix methodology for risk assessment.

Visible Light Communications (VLC) is a cutting edge technology for data communication that is being considered to be implemented in a wide range of applications such as Inter-vehicle communication or Local Area Network (LAN) communication. As a novel technology, some aspects of the implementation of VLC have not been deeply considered or tested. Among these aspects, security and its implementation may become an obstacle for VLCs broad usage. In this article, we have used the well-known Risk Matrix methodology to determine the relative risk that several common attacks have in a VLC network. Four examples: a War Driving, a Queensland alike Denial of Service, a Preshared Key Cracking, and an Evil Twin attack, illustrate the utilization of the methodology over a VLC implementation. The used attacks also covered the different areas delimited by the attack taxonomy used in this work. By defining and determining which attacks present a greater risk, the results of this work provide a lead into which areas should be invested to increase the safety of VLC networks.

Study and Validation of Eavesdropping Scenarios over a Visible Light Communication Channel.

The security and privacy provided by Visible Light Communication (VLC) technologies is an area that has been slightly addressed due to the misconception that, since light does not go through solid objects like walls, VLC-based communications cannot be eavesdropped on by outside observers. As an upcoming technology, VLC is expected to be used in multiple environments were, due to radio frequency RF overuse or limitations, RF solutions cannot or should not be employed. In this work, we study the eavesdropping characteristics of a VLC-based communication. To evaluate these concerns, a two-step process was followed. First, several simulations of a standardly used scenario were run. Later on, experimental tests were performed. Following those tests, the results of the simulations and the experimental tests were analyzed. The results of these simulations and tests seemed to indicate that VLC channels can be eavesdropped on without considerable difficulties. Furthermore, the results showed that sniffing attacks could be performed from areas outside the expected coverage of the VLC infrastructure. Finally, the use of the simulation such as the one implemented in this work to recognize places from which sniffing is possible helps determine the risk for eavesdropping that our VLC-based network has.

Experimental Characterization of Close-Emitter Interference in an Optical Camera Communication System.

Due to the massive insertion of embedded cameras in a wide variety of devices and the generalized use of LED lamps, Optical Camera Communication (OCC) has been proposed as a practical solution for future Internet of Things (IoT) and smart cities applications. Influence of mobility, weather conditions, solar radiation interference, and external light sources over Visible Light Communication (VLC) schemes have been addressed in previous works. Some authors have studied the spatial intersymbol interference from close emitters within an OCC system; however, it has not been characterized or measured in function of the different transmitted wavelengths. In this work, this interference has been experimentally characterized and the Normalized Power Signal to Interference Ratio (NPSIR) for easily determining the interference in other implementations, independently of the selected system devices, has been also proposed. A set of experiments in a darkroom, working with RGB multi-LED transmitters and a general purpose camera, were performed in order to obtain the NPSIR values and to validate the deduced equations for 2D pixel representation of real distances. These parameters were used in the simulation of a wireless sensor network scenario in a small office, where the Bit Error Rate (BER) of the communication link was calculated. The experiments show that the interference of other close emitters in terms of the distance and the used wavelength can be easily determined with the NPSIR. Finally, the simulation validates the applicability of the deduced equations for scaling the initial results into real scenarios.

Helicobacter pylori infection and serum leptin, obestatin, and ghrelin levels in Mexican schoolchildren.

BackgroundThere is little information about the possible role of Helicobacter pylori infection on appetite-regulating peptides in children. This study evaluated the association between H. pylori infection and serum levels of ghrelin, leptin, and obestatin in schoolchildren.MethodsOne hundred seventy-eight schoolchildren, students at boarding schools in Mexico City, participated. H. pylori infection status was determined every 6 months for 1 year by a breath test using 13C-urea; schoolchildren with consistently positive or negative results were selected to participate. Age, sex, and body mass index (BMI) were recorded. Serum concentrations of total ghrelin, leptin, and obestatin via specific enzyme-linked immunosorbent assays were determined.ResultsSchoolchildren with H. pylori infection had lower concentration of leptin, -0.54 pg/ml (95% CI: -0.98 to -0.09), compared to the schoolchildren without infection, after adjustment by age, gender, and BMI. And the children with the infection had a median of obestatin lower in 0.99 ng/ml (95% CI: -1.93 to -0.06) compared with the uninfected children after adjustment by BMI.ConclusionAssociation was found between H. pylori infection and decreased serum concentrations of leptin and obestatin. These results suggest that in schoolchildren, H. pylori infection affects the levels of hormones implicated in regulating appetite and energy homeostasis.

High variability in quorum quenching and growth inhibition by furanone C-30 in Pseudomonas aeruginosa clinical isolates from cystic fibrosis patients.

Pseudomonas aeruginosa colonizes the lungs of cystic fibrosis patients causing severe damage. This bacterium is intrinsically resistant to antibiotics and shows resistance against new antimicrobials and its virulence is controlled by the quorum-sensing response. Thus, attenuating its virulence by quorum quenching instead of inhibiting its growth has been proposed to minimize resistance; however, resistance against the canonical quorum quencher furanone C-30 can be achieved by mutations leading to increased efflux. In the present work, the effect of C-30 in the attenuation of the QS-controlled virulence factors elastase and pyocyanin was investigated in 50 isolates from cystic fibrosis patients. The results demonstrate that there is a high variability in the expression of both elastase and pyocyanin and that there are many naturally resistant C-30 strains. We report that the main mechanism of C-30 resistance in these strains was not due to enhanced efflux but a lack of permeability. Moreover, C-30 strongly inhibited the growth of several of the isolates studied, thus imposing high selective pressure for the generation of resistance.

Plasticity Region Genes jhp0940, jhp0945, jhp0947, and jhp0949 of Helicobacter pylori in Isolates from Mexican Children.

BACKGROUND: The genes jhp0940, jhp0945, jhp0947, and jhp0949 belong to the plasticity region of the Helicobacter pylori genome. Due to their prevalence in isolates from patients with gastritis, duodenal ulcer, and gastric cancer, they have been proposed as markers of gastroduodenal diseases. These genes are associated with pro-inflammatory cytokine induction through the NF-κB activation pathway. Nevertheless, the status of these genes is unknown in H. pylori isolates from children. The aim of the present work was to determine the frequency of the jhp0940-jhp0945-jhp0947-jhp0949 genes in H. pylori isolates from children. MATERIALS AND METHODS: We identified the jhp0940, jhp0945, jhp0947, and jhp0949 genes and the relationship of each with the virulence factors cagA, cagPAI, and dupA by PCR in 49 isolates of H. pylori from children. The results were corroborated using dot blots. In addition, we compared the prevalence of these genes with the prevalence in adults. RESULTS: The prevalence of jhp0940 (53.1%), jhp0945 (44.9%), jhp0947 (77.6%), and jhp0949 (83.7%) was determined in the isolates from children, as was the prevalence of the virulence genes cagA (63.3%), cagPAI (71.4%), and dupA (37.5%). No association was found between the four genes of the plasticity region and the virulence genes. The presence of the intact locus integrated by jhp0940-jhp0945-jhp0947-jhp0949 was very common among the isolates from children. CONCLUSION: The genes jhp0940, jhp0947, and jhp0949 were present in more than 50% of the H. pylori isolates, and the joint presence of jhp0940-jhp0945-jhp0947-jhp0949 was very frequent. The frequency of these genes in isolates from children could contribute to the virulence of H. pylori and the evolution of the infection.

Learning and Human Dignity Are Built Through Observation and Participation in Work.

This chapter focuses on how children learn through work in ongoing family and community endeavors in an Indigenous Mexican (Mixe) community, where cultural values emphasize that human dignity is derived from work and from collaboration with the work of other people, animals, and the natural world. The chapter highlights the central role that work plays in children's learning, and how attentive and more casual observation and accomplishment of endeavors are important tools that children employ in learning.

Efectos de un programa de ejercicios sobre perfil psicomotor en escolares / Effects of an exercise program on psychomotor profile in school

El objetivo del trabajo fue identificar los efectos producidos en el perfil psicomotor y factores motrices en niños de 6 a 8 años de edad al implementar un programa de ejercicios físicos dirigi-dos por fisioterapeutas específicamente para siete factores motrices determinados. Mediante un muestreo intencional y no probabilístico se seleccionaron 60 niños y niñas estudiantes de dos instituciones educativas del distrito de Barranquilla (Colombia). Se evaluó el perfil psicomo-tor de los niños con el protocolo de la "Batería Psicomotora - BPM" propuesta por Da Fonseca (siete factores de la batería). El programa de ejercicios se aplicó durante 12 semanas con direc-trices específicas en cuestión de progresividad e intensidad y posterior a esta etapa se realizó la re-evaluación de la población utilizando la BPM. Los datos fueron ingresados y analizados con el programa SPSS 18.0. En los resultados se evidencia que el perfil psicomotor de los niños cambió positivamente de 21.18 a 23.85 puntos, pasando de un rango 'normal' o perfil 'eupráxico' a un rango 'bueno'. Los factores tonicidad, equilibrio, lateralidad, noción del cuerpo, estructuración espaciotemporal y praxia global, tuvieron cambios significativos en sus niveles de ejecución, mientras que la praxia fina no mostró cambios al aplicar el post-test. Con la práctica organizada y secuencial del programa de ejercicios, se lograron cambios significativos y beneficiosos a nivel motriz evidenciados en el nivel de perfil psicomotor general de los estudiantes participantes.

The objective was to identify the effects on psychomotor profile and driving factors in children between 6-8 years to implement an exercise program specifically directed by physical therapists in seven specific driving factors. 60 children students were selected at two educational institutions in the district of Barranquilla (Colombia), using an intentional and non-probability sampling. Psychomotor profile of children was evaluated using the protocol "Psychomotor Battery - BPM" proposed by Da Fonseca, in which seven related factors were evaluated. The exercise program was applied for 12 weeks with specific guidelines within escalation and intensity and following this phase, it was performed this reassessment of the population using the BPM. Data were entered and analyzed using SPSS 18.0 software. In the results it is evident that the psychomotor profile of children changed positively 21.18 to 23.85 points, from a 'normal' range or profile 'eupráxico' to a 'good' range. The tone, balance, laterality, body concept, spacetime structure and global praxia factors had significant changes in their levels of performance, while the fine praxia was unchanged when applying the post-test. With organized and sequential practice of the exercise program, they were achieved significant and beneficial changes to motor level evidenced in the level of general psychomotor profile of participants

Evolución de la desnutrición hospitalaria / Progression of the in-hospital malnutrition

INTRODUCCIÓN: la desnutrición hospitalaria se asocia a un incremento de la morbilidad y mortalidad que repercute en una peor calidad asistencial, con aumento de la tasa media de estadía y tasa de rehospitalización. OBJETIVO: evaluar la evolución de la desnutrición hospitalaria pediátrica usando como herramienta metodológica la Encuesta de Desnutrición Hospitalaria Pediátrica y la Encuesta de Riesgo Nutricional Pediátrico, en el Hospital Pediátrico Universitario "Juan Manuel Márquez", durante los años 2008, 2010 y 2012. MÉTODOS: se realizó un estudio descriptivo transversal en 3 oportunidades que involucró a todos los niños (edades entre 0,1 y 19 años), ingresados en el citado hospital. La muestra estuvo constituida por 157 niños en el estudio de 2008, 188 en el de 2010 y 158 en el de 2012. A todos se les practicó una evaluación antropométrica que incluyó la mensuración del peso y la longitud/talla. Al mismo tiempo, se aplicó la Encuesta de Riesgo Nutricional Pediátrico a todos los niños encuestados, para determinar el riesgo de desnutrición al momento del ingreso. RESULTADOS: se observó un incremento de la desnutrición aguda (peso para la longitud/talla inferior al 3er. percentil) de 9,4 % y de la crónica de 6,1 % respectivamente, desde 2008 a 2012. La obesidad como figura de morbilidad nutricional se incrementó en un 3,1 % en igual periodo. Existió una disminución del riesgo grave de desnutrición al ingreso de 6,0 %, con un incremento del leve de 5,3 %. CONCLUSIONES: la desnutrición hospitalaria pediátrica continúa siendo un problema importante de salud, al que los administradores de salud deben prestarle especial atención, al mismo tiempo que incrementar el esfuerzo el Grupo de Apoyo Nutricional en relación con su función educativa, para mejorar las prestaciones de los servicios nutricionales.

INTRODUCTION: in-hospital malnutrition is associated to increased morbidity and mortality that affect medical assistance quality, with higher average rates of hospital stay and readmission. OBJECTIVE: to evaluate the progression of in-hospital pediatric malnutrition by using the methodological tool called Survey of In-hospital Pediatric Malnutrition and the Survey of Pediatric Nutritional Risk at "Juan Manuel Marquez" university pediatric hospital in 2008, 2010 and 2012. METHODS: a cross-sectional descriptive study was conducted three times and involved all the children aged 0.1 to 19 years who were admitted to this hospital. The sample was made up of 157 children in the 2008, 188 in the 2010 and 158 in 2012 studies, respectively. Anthropometric assessments were made including weight and length/size measurement. At the same time, the Survey of Pediatric Nutritional Risk was applied to all the children to determine the risk of malnutrition at the time of admission. RESULTS: there was an increase of acute malnutrition (weight for length/size lower than 3rd percentile) of 9.4 % and of chronic malnutrition of 6.1 %, from 2008 to 2012. Obesity, as marker of nutritional morbidity, increased by 3.1 % in the same period. Severe malnutrition risk on admission was reduced by 6.0 % whereas the mild risk increased by 5.3 %. CONCLUSIONS: in-hospital pediatric malnutrition remains a significant health problem, so the health managers must pay a special attention to it. At the same time the Nutritional Support Group should increase its efforts for education in order to improve the nutritional services.