Efficacy of educational interventions in adolescent population with feeding and eating disorders: a systematic review.

BACKGROUND: Educational interventions are a key element in the care of young patients with feeding and eating disorders, forming part of the majority of therapeutic approaches. The aim of this review is to evaluate the impact of educational interventions in adolescents with feeding and eating disorders. METHODS: Following the PRISMA recommendations electronic databases were searched up to 29 June 2023. Studies related to educational interventions in young population diagnosed with feeding and eating disorders (anorexia nervosa, avoidant/restrictive food intake disorder, bulimia nervosa, pica and ruminative disorders and binge- eating disorder) in Spanish and English language, without temporal limitation, were located in the databases: PubMed, Scopus, CINAHL, Cochrane Library, PsycINFO, CUIDEN, DIALNET, and ENFISPO. A search in the databases of grey literature was performed in OpenGrey and Teseo. The review protocol was registered in PROSPERO (CRD42020167736). RESULTS: A total of 191 articles were selected from the 9744 citations screened. Ten publications were included. The results indicated variability between educational programs, including individual and group interventions, learning techniques and various research methodologies. Variables such as learning, attitudinal and perceptual changes, anthropometric parameters, symptom improvement, normalization of eating patterns, evaluation of the program and cognitive flexibility were identified. The risk of bias was high due to the low methodological quality of a large number of studies analyzed. CONCLUSION: The results indicate that educational interventions can influence the improvement of knowledge level and have a positive effect on health outcomes. Although education is a common practice in the treatment of these pathologies, high-quality studies were not identified. Thus, this review concludes that additional evidence is needed to evaluate the effectiveness of educational programs, with further research studies, especially randomized controlled trials, to confirm these results. LEVEL OF EVIDENCE: Level I: Systematic review.

Adaptación de la actividad de la Red de Salud Mental de Navarra durante la pandemia de COVID-19 / Adaptation of the activity of the Network of Mental Health of Navarra during the COVID-19 pandemic

La pandemia de COVID-19 ha supuesto un desafío para los sistemas sanitarios, incluida la atención a la salud mental. Ha sido necesaria la adaptación constante de la práctica asistencial habitual según la situación epidemiológica poblacional. Se recoge la actividad asistencial prestadapor la Red de Salud Mental de Navarra durante los años 2019, 2020 y 2021. Se registra una disminución en el número de consultas ambulatorias realizadas durante 2020 y su recuperación en2021, con un incremento de la demanda en la población femenina. Se han producido variacionesen la ocupación y estancias medias de los recursos de hospitalización, así como una reestructuración funcional y estructural. En el ámbito residencial se produjo el fallecimiento del 9,8% delos usuarios debido al COVID-19. Las tasas de suicidio durante 2020 se mantuvieron similaresa 2019, incrementándose un 36% en 2021. La pandemia ha impactado en la continuidad de losplanes de tratamiento, en la evolución clínica, psicopatológica y emocional de las personasatendidas. Las repercusiones negativas pueden extenderse a lo largo de los próximos años. Porello, será fundamental el desarrollo de estrategias sanitarias, sociales y de salud pública dirigidas a la promoción de la salud y la prevención de los problemas de salud mental.(AU)

Design and fabrication of a microfluidic system with embedded circular channels for rotary cell culture.

The development of functional blood vessels is today a fundamental pillar in the evaluation of new therapies and diagnostic agents. This article describes the manufacture and subsequent functionalization, by means of cell culture, of a microfluidic device with a circular section. Its purpose is to simulate a blood vessel in order to test new treatments for pulmonary arterial hypertension. The manufacture was carried out using a process in which a wire with a circular section determines the dimensions of the channel. To fabricate the blood vessel, cells were seeded under rotary cell culture to obtain a homogeneous cell seeding in the inner wall of the devices. This is a simple and reproducible method that allows the generation of blood vessel models in vitro.

TARTESSUS: A Customized Electrospun Drug Delivery System Loaded with Irinotecan for Local and Sustained Chemotherapy Release in Pancreatic Cancer.

Post-surgical chemotherapy in pancreatic cancer has notorious side effects due to the high dose required. Multiple devices have been designed to tackle this aspect and achieve a delayed drug release. This study aimed to explore the controlled and sustained local delivery of a reduced drug dose from an irinotecan-loaded electrospun nanofiber membrane (named TARTESSUS) that can be placed on the patients' tissue after tumor resection surgery. The drug delivery system formulation was made of polycaprolactone (PCL). The mechanical properties and the release kinetics of the drug were adjusted by the electrospinning parameters and by the polymer ratio between 10 w.t.% and 14 w.t.% of PCL in formic acid:acetic acid:chloroform (47.5:47.5:5). The irinotecan release analysis was performed and three different release periods were obtained, depending on the concentration of the polymer in the dissolution. The TARTESSUS device was tested in 2D and 3D cell cultures and it demonstrated a decrease in cell viability in 2D culture between 72 h and day 7 from the start of treatment. In 3D culture, a decrease in viability was seen between 72 h, day 7 (p < 0.001), day 10 (p < 0.001), 14 (p < 0.001), and day 17 (p = 0.003) as well as a decrease in proliferation between 72 h and day 10 (p = 0.030) and a reduction in spheroid size during days 10 (p = 0.001), 14 (p < 0.001), and 17 (p < 0.001). In conclusion, TARTESSUS showed a successful encapsulation of a chemotherapeutic drug and a sustained and delayed release with an adjustable releasing period to optimize the therapeutic effect in pancreatic cancer treatment.

Rapid SARS-CoV-2 disinfection on distant surfaces with UV-C: The inactivation is affected by the type of material.

SARS-CoV-2 is responsible for the COVID-19 pandemic, which has caused almost 570 million infections and over six million deaths worldwide. To help curb its spread, solutions using ultraviolet light (UV) for quick virus inactivation inside buildings without human intervention could be very useful to reduce chances of contagion. The UV dose must be sufficient to inactivate the virus considering the different materials in the room, but it should not be too high, not to degrade the environment. In the present study, we have analyzed the ability of a 254 nm wavelength UV-C lamp to inactivate dried samples of SARS-CoV-2 exposed at a distance of two meters, simulating a full-scale scenario. Our results showed that virus inactivation was extremely efficient in most tested materials, which included plastic, metal, wood, and textile, with a UV-C exposure of only 42 s (equivalent to 10 mJ/cm2). However, porous materials like medium density fibreboard, were hard to decontaminate, indicating that they should be avoided in hospital rooms and public places.

Versatile membrane-based microfluidic platform for in vitro drug diffusion testing mimicking in vivo environments.

Mimicking the diffusion that drugs suffer through different body tissues before reaching their target is a challenge. In this work, a versatile membrane-based microfluidic platform was developed to allow for the identification of drugs that would keep their cytotoxic properties after diffusing through such a barrier. As an application case, this paper reports on a microfluidic device capable of mimicking the diffusion that free or encapsulated anticancer drugs would suffer in the intestine before reaching the bloodstream. It not only presents the successful fabrication results for the platform but also demonstrates the significant effect that the analyzed drugs have over the viability of osteosarcoma cells. This intestine-like microfluidic platform works as a tool to allow for the identification of drugs whose cytotoxic performance remains effective enough once they enter the bloodstream. Therefore, it allows for the prediction of the best treatment available for each patient in the battle against cancer.

Different Microfluidic Environments for In Vitro Testing of Lipid Nanoparticles against Osteosarcoma.

The use of lipid nanoparticles as biodegradable shells for controlled drug delivery shows promise as a more effective and targeted tumor treatment than traditional treatment methods. Although the combination of target therapy with nanotechnology created new hope for cancer treatment, methodological issues during in vitro validation of nanovehicles slowed their application. In the current work, the effect of methotrexate (MTX) encapsulated in different matrices was evaluated in a dynamic microfluidic platform. Effects on the viability of osteosarcoma cells in the presence of recirculation of cell media, free MTX and two types of blank and drug-containing nanoparticles were successfully assessed in different tumor-mimicking microenvironments. Encapsulated MTX was more effective than the equal dose free drug treatment, as cell death significantly increased under the recirculation of both types of drug-loaded nanoparticles in all concentrations. In fact, MTX-nanoparticles reduced cell population 50 times more than the free drug when 150-µM drug dose was recirculated. Moreover, when compared to the equivalent free drug dose recirculation, cell number was reduced 60 and 100 points more under recirculation of each nanoparticle with a 15-µM drug concentration. Thus, the results obtained with the microfluidic model present MTX-lipid nanoparticles as a promising and more effective therapy for pediatric osteosarcoma treatment than current treatment options.

Construction and validation of the CAPA questionnaire of Nutritional Knowledge among Adolescents diagnosed with Feeading and Eting disorders.

Feeding and eating disorders represent a serious problem especially in young population. Nutritional education is essential in its treatment and prevention.

Construcción y validación delcuestionario C.A.P.A. Conocimientosen Alimentación de PersonasAdolescentes diagnosticadas detrastornos alimentarios / Construction and validation of the C.A.P.A. questionnaire in Nutrition of Adolescents diagnosed with Adolescents diagnosed with eating disorders

Introducción. Los trastornos de la conducta alimentariarepresentan un grave, problema especialmente en poblaciónjoven. La educación nutricional es fundamental en su tratamiento y prevención.Entre las acciones desarrolladas, en España destaca la estrategia NAOS, que enmarca el programa educativo Perseodestinado a escolares. Sin embargo, existen escasos instrumentos que evalúen los conocimientos tras la realización deeste tipo de acciones. El objetivo del estudio ha sido elaborar y validar un cuestionario que permita evaluar los conocimientos tras realizar el programa Perseo en población juvenil diagnosticada de trastornos alimentarios.Metodología. Se implementó la técnica e-Delphi modificada online, en la que participaron 26 expertos de saludmental y nutrición. Evaluándose el grado de consenso enadecuación y relevancia a través de una escala Likert decuatro puntos y un campo para comentarios. Los criteriosbásicos y suplementarios del desarrollo de la técnica se establecieron previamente.Resultados. Tomando como base el programa Perseo yel cuestionario General Nutrition Knowledge Questionnaire(GNKQ) en su versión adaptada a adolescentes portugueses,se desarrolló una versión inicial del cuestionario de 30 ítemsy 4 posibles respuestas. Tras tres fases, 26 ítems alcanzaron elconsenso requerido tanto en adecuación como en relevancia.Finalmente, se obtuvo un nuevo cuestionario compuesto por26 ítems con un alto grado de consenso en opinión de losexpertos.Conclusiones. El cuestionario ha demostrado una sólidavalidez de contenido. Permitiendo evaluar una intervencióneducativa sobre nutrición, basada en el programa Perseo, enpoblación juvenil con trastornos alimentarios. (AU)

Introduction. Feeding and eating disorders represent aserious problem especially in young population. Nutritionaleducation is essential in its treatment and prevention.Among the actions developed in Spain the NAOS strategyhighlights, which frames the Perseo educational program forschoolchildren. However, there are few tools to evaluate theknowledge after these programs are implemented. The aimof the study was to create and to validate a questionnairethat allows the evaluation of the acquired knowledge onyoung population diagnosed of eating disorders after participating on Perseo program.Methodology. The on-line modified e-Delphi techniquewas applied, 26 mental health and nutrition experts tookpart, evaluating the consensus level on adequacy and relevance through a 4-points Likert scale and a field for comments. Basic and supplementary criteria for the developmentof the technique were previously established.Results. On the basis of the Perseo program and theadapted version of GNKQ for Portuguese teenagers, an initial version of the questionnaire was developed with 30 items and 4 possible answers. After three rounds 26 of theitems reached the required consensus both in adequacyand relevance.Eventually a new questionnaire of 26 items was obtainedwith a high degree of general agreement according to theexperts.Conclusions. The questionnaire has demonstrated astrong validity of content that allows to evaluate an educational intervention on nutrition based on the Perseo program, among young population with eating disorders. (AU)

A versatile cancer cell trapping and 1D migration assay in a microfluidic device.

Highly migratory cancer cells often lead to metastasis and recurrence and are responsible for the high mortality rates in many cancers despite aggressive treatment. Recently, the migratory behavior of patient-derived glioblastoma multiforme cells on microtracks has shown potential in predicting the likelihood of recurrence, while at the same time, antimetastasis drugs have been developed which require simple yet relevant high-throughput screening systems. However, robust in vitro platforms which can reliably seed single cells and measure their migration while mimicking the physiological tumor microenvironment have not been demonstrated. In this study, we demonstrate a microfluidic device which hydrodynamically seeds single cancer cells onto stamped or femtosecond laser ablated polystyrene microtracks, promoting 1D migratory behavior due to the cells' tendency to follow topographical cues. Using time-lapse microscopy, we found that single U87 glioblastoma multiforme cells migrated more slowly on laser ablated microtracks compared to stamped microtracks of equal width and spacing (p < 0.05) and exhibited greater directional persistence on both 1D patterns compared to flat polystyrene (p < 0.05). Single-cell morphologies also differed significantly between flat and 1D patterns, with cells on 1D substrates exhibiting higher aspect ratios and less circularity (p < 0.05). This microfluidic platform could lead to automated quantification of single-cell migratory behavior due to the high predictability of hydrodynamic seeding and guided 1D migration, an important step to realizing the potential of microfluidic migration assays for drug screening and individualized medicine.

Improved microfluidic platform for simultaneous multiple drug screening towards personalized treatment.

Development of new targeted therapies is a challenge in the battle against cancer. Although a variety of treatments is currently available, there is no technique for rapidly evaluating the response of cancer patients to the drug. In this work, a microfluidic platform for the real-time simultaneous analysis of the success rate of different nanoparticle based chemotherapeutic drugs is presented. Based on a previous planar chamber and a reported sensitivity enhancing strategy, linear and cross shape microstructures were integrated into the chamber dome of the microfluidic polydimethylsiloxane and glass platform in order to provide a higher fluid mixing and treatment-cell interaction. Several methotrexate (MTX) based treatments (free MTX, MTX loaded Lecithin-PVA nanoparticles, MTX loaded Lecithin-Tween 80 nanoparticles) as well as their respective controls (cell media and both blank nanoparticles) were recirculated through the microchamber over an osteosarcoma cell monolayer. These nanovehicles reduced cell population to less than 20% (LEC-PVA nanoparticles) and 2.3% (LEC-Tween nanoparticles), demonstrating that nanoparticles are a promising target therapy for cancer treatment. Moreover, microstructured platforms demonstrated a higher efficacy in the drug-screening process: due to the liquid folding a higher amount of nanoparticles was internalized by the cells and, therefore, results were observed faster. In fact, the time required to reduce cell viability to the half was nearly a 75% faster. Furthermore, this microfluidic platform offers the capability to test up to five different drugs simultaneously, making it a powerful tool to evaluate the effect of multiple drugs and determine the most effective and personalized treatment.

Beverage spoilage yeast detection methods and control technologies: A review of Brettanomyces.

Spoilage yeasts detection is the key to improve the quality of alcoholic fermentation beverages such as wine and cider. The metabolic activity of the spoilage yeast causes irreparable damage to many liters of final products every year. Therefore, winemakers and cider-house companies suffer a substantial economic impact. Thus, over the years, many detection techniques have been proposed to control the occurrence of spoilage yeast. Out of the many spoilage yeast genera, Brettanomyces is one of the most commonly encountered in the beverage industry. Leveraging its ability to thrive in wine and cider conditions (low pH, high levels of ethanol, and low oxygenation levels), Brettanomyces can proliferate inside beverage production tanks. Moreover, their resultant by products reduce the quality of the beverage. While the beverage industry has made great strides in detecting harmful organisms, gaps remain. Traditional methods such as microscopy, cell plating, gas chromatography-mass spectrometry, etc. are often imprecise, expensive, and/or complicated. New emerging spoilage yeast detection platforms, such as biosensors and microfluidic devices, aim to alleviate these constraints. Novel platforms have already demonstrated great promise to be a real alternative for in situ and fast detection in the beverage industry. Finally, the review discusses the potential of emerging spoilage yeast detection and treatment methods.

Anticholinergic burden and health outcomes among older adults discharged from hospital: results from the CRIME study.

PURPOSE: The purpose of this study is to investigate whether there is an association between anticholinergic burden and mortality or rehospitalization in older adults discharged from hospital. METHODS: Prospective multicenter cohort study carried out with patients aged 65 and older discharged from seven acute care hospitals. The primary outcomes of the study were rehospitalization and mortality within 1 year after discharge. The study population was classified in three groups according to the anticholinergic exposure measured by the Anticholinergic Risk Scale (ARS) and Durán's list at the time of hospital discharge: without risk (ARS/Durán = 0), low risk (ARS/Durán = 1), and high risk (ARS/Durán ≥ 2). Predictors of hospitalizations and mortality were examined using regression models adjusting for important covariates. RESULTS: The mean age of the 921 participants was 81.2 years (SD = 7.4 years). Prevalence of exposure to medications with anticholinergic activity ranged from 19.6% with ARS to 32.1% with Durán's list. During the follow-up period, 30.4% of participants were hospitalized and 19.4% died. Multivariate regression analysis showed that low anticholinergic burden quantified according to Durán's list was significantly associated with all-cause mortality (OR 1.69, 95% CI 1.02-2.82). This association was not present after adjustment when using ARS. No statistically significant association was found between anticholinergic burden and hospitalizations. CONCLUSIONS: Taking medications with anticholinergic activity is associated with greater risk of mortality in older adults discharged from acute care hospitals. Strategies to reduce anticholinergic burden in vulnerable elders could be useful to improve health outcomes. Further research is required to assess the association between anticholinergic burden and hospitalizations in older patients.

Characterization of three-dimensional cancer cell migration in mixed collagen-Matrigel scaffolds using microfluidics and image analysis.

Microfluidic devices are becoming mainstream tools to recapitulate in vitro the behavior of cells and tissues. In this study, we use microfluidic devices filled with hydrogels of mixed collagen-Matrigel composition to study the migration of lung cancer cells under different cancer invasion microenvironments. We present the design of the microfluidic device, characterize the hydrogels morphologically and mechanically and use quantitative image analysis to measure the migration of H1299 lung adenocarcinoma cancer cells in different experimental conditions. Our results show the plasticity of lung cancer cell migration, which turns from mesenchymal in collagen only matrices, to lobopodial in collagen-Matrigel matrices that approximate the interface between a disrupted basement membrane and the underlying connective tissue. Our quantification of migration speed confirms a biphasic role of Matrigel. At low concentration, Matrigel facilitates migration, most probably by providing a supportive and growth factor retaining environment. At high concentration, Matrigel slows down migration, possibly due excessive attachment. Finally, we show that antibody-based integrin blockade promotes a change in migration phenotype from mesenchymal or lobopodial to amoeboid and analyze the effect of this change in migration dynamics, in regards to the structure of the matrix. In summary, we describe and characterize a robust microfluidic platform and a set of software tools that can be used to study lung cancer cell migration under different microenvironments and experimental conditions. This platform could be used in future studies, thus benefitting from the advantages introduced by microfluidic devices: precise control of the environment, excellent optical properties, parallelization for high throughput studies and efficient use of therapeutic drugs.

Novel integrated and portable endotoxin detection system based on an electrochemical biosensor.

This paper describes the design, implementation and validation of a sensitive and integral technology solution for endotoxin detection. The unified and portable platform is based on the electrochemical detection of endotoxins using a synthetic peptide immobilized on a thin-film biosensor. The work covers the fabrication of an optimized sensor, the biofunctionalization protocol and the design and implementation of the measuring and signalling elements (a microfluidic chamber and a portable potentiostat-galvanostat), framed ad hoc for this specific application. The use of thin-film technologies to fabricate the biosensing device and the application of simple immobilization and detection methods enable a rapid, easy and sensitive technique for in situ and real time LPS detection.

Label-free interdigitated microelectrode based biosensors for bacterial biofilm growth monitoring using Petri dishes.

Impedance microbiology (IM) is a known technique that has been applied during the last decades to detect the presence of microorganisms in real samples in different fields: food industry, healthcare, environment, etc. Bacterial biofilms however have not been so far studied despite the fact that they are the most common microbiological formation and that they present resistance to antimicrobial agents. In situ early detection of bacterial biofilm is still a challenge nowadays that causes huge impact in many different scenarios. The ability to detect biofilm generation early will allow better and more efficient treatments preventing high costs and important problems. In this work a new performance of this technique with interdigitated microelectrode sensors (IDE) is proposed. A specific culturing setup where the sensors have been integrated in Petri Dishes has been developed. From the results it can be highlighted that low frequencies are more sensitive for detection than higher ones. The results achieved record variations of approximately 40% in the equivalent serial resistance after 10h of culture. Electrical models have been successfully simulated to find the electrical behavior of the development of biofilms. Variations in both the capacitance and resistance were recorded during the growth of the microbes.