Unravelling large-scale patterns and drivers of biodiversity in dry rivers.

More than half of the world's rivers dry up periodically, but our understanding of the biological communities in dry riverbeds remains limited. Specifically, the roles of dispersal, environmental filtering and biotic interactions in driving biodiversity in dry rivers are poorly understood. Here, we conduct a large-scale coordinated survey of patterns and drivers of biodiversity in dry riverbeds. We focus on eight major taxa, including microorganisms, invertebrates and plants: Algae, Archaea, Bacteria, Fungi, Protozoa, Arthropods, Nematodes and Streptophyta. We use environmental DNA metabarcoding to assess biodiversity in dry sediments collected over a 1-year period from 84 non-perennial rivers across 19 countries on four continents. Both direct factors, such as nutrient and carbon availability, and indirect factors such as climate influence the local biodiversity of most taxa. Limited resource availability and prolonged dry phases favor oligotrophic microbial taxa. Co-variation among taxa, particularly Bacteria, Fungi, Algae and Protozoa, explain more spatial variation in community composition than dispersal or environmental gradients. This finding suggests that biotic interactions or unmeasured ecological and evolutionary factors may strongly influence communities during dry phases, altering biodiversity responses to global changes.

Foreword to the Special Issue on "Seafarer's Mental Health and Well-Being".

This special collection encompasses 10 articles that delve into the pressing aspects of seafarers' well-being, mental health, and the workplace. The articles are categorized into 2 broad topics.The first topic, comprising 6 articles, scrutinizes the contributory factors to seafarers' psychological well-being on board, covering sleep problems, food provisions, sexual abstinence, work-life balance, and psychosocial and work environment factors associated with seafaring. Four of these papers also focus on job satisfaction, work effectiveness, and retention in relation to seafarers' psychological well-being. The second topic includes 4 articles on seafarers' mental health assessment and promotion. These articles examine measurement tools for mental health, well-being, and resilience, as well as formal training and technology, including mobile apps, in seafarers' health promotion and education. The insights gleaned from this special collection have the potential to significantly influence the practices of researchers, policymakers, and shipping companies. By shedding light on the need to enhance seafarers' employment characteristics and address the health, safety, and well-being aspects of their work and life, this research can guide these stakeholders to better support seafarers in their crucial role as "key workers."

Medication reconciliation in hospitalized hematological patient. / Conciliación de la medicación en el paciente hematológico ingresado.

OBJECTIVE: The main objective was to analyze unjustified discrepancies during the medication reconciliation process in patients admitted to the Hematology Service of our hospital and the pharmaceutical interventions. As a secondary objective, to detect possible points of the procedure to be perfected with a view to protocolizing the medication reconciliation process in hematological patients that adapts to the conditions of our center. METHODS: Cross-sectional observational pilot study carried out in a reference hospital in hematology for a population of 800,000 inhabitants. Adult inpatients admitted to the Hematology Service between August and October 2022 whose medication had been reconciled were included. The main variables were: number and type of unjustified discrepancy, proposed pharmaceutical intervention, and acceptance rate. RESULTS: 36 conciliation processes were analyzed, 34 admissions and 2 intrahospital transfer. 58.3% of the patients presented at least one unjustified discrepancy. 38 unjustified discrepancies were detected, with an acceptance of pharmaceutical interventions of 97.4%. The most common types of discrepancy were medication omission (56.8%) and drug interaction (24.3%). The most frequent pharmaceutical interventions were reintroducing medication (48.6%) and treatment discontinuation (16.2%). Polypharmacy and chemotherapy multiplied by 4 the probability of presenting drug interactions. CONCLUSIONS: The most common unjustified discrepancies in the medication reconciliation process in hospitalized hematology patients are: Medication omission and drug interactions. The reintroduction of medication and suspension of the prescription are the most frequent accepted pharmaceutical interventions. Polypharmacy is related to an increase in unjustified discrepancies. The factors that promote the appearance of interactions are admissions to receive chemotherapy treatment and polypharmacy. The main point of improvement detected is the need to create a circuit that allows conciliation to be carried out on discharge. Medication reconciliation contribute to improving patient safety by reducing medication errors.

Association between Post-Hospitalization Psychological Distress, Exercise Capacity, Physical Function and Health Status in COVID-19 Survivors.

This study aims to determine whether post-hospitalization psychological distress is associated with exercise capacity, physical function and health status in COVID-19 survivors. In this observational study, hospitalized COVID patients were included and divided into two groups according to the mental component summary subscale of the 12-item Short-Form Health Survey. Patients with a score ≤ 45 were included in the psychological distress group, and patients with a score > 45 were included in the non-psychological distress group. The main variables were exercise capacity, physical function, and health status. Patients were evaluated at discharge, 3 months, and at 6 months follow-up. Finally, a total of 60 patients were included in the study. Significant differences were found in exercise capacity, physical function, and health status (p < 0.05), with worse results in the group with psychological distress at discharge and 3 months follow-up. At 6 months after discharge, COVID patients with psychological distress exhibited worse results in exercise capacity, physical function, and health status, being significant exercise capacity and physical function (p < 0.05). It can be concluded that COVID patients with psychological distress at hospital discharge reported worse exercise capacity, physical function and health status at hospital discharge, 3 months and 6 months follow-up.

Exploring the Impact of Protein Supplement Source on Body Composition in Women Practicing Anaerobic Resistance Exercise: A Pilot Study.

Supplements based on protein hydrolysates have been used as an effective source to access amino acids with greater bioavailability, promoting absorption to improve body composition. Five groups of young women were randomly selected. They followed a personalized eating plan that included different protein supplements (meat, vegan, branched-chain amino acids [BCAAs], whey, and control group), combined with an exercise plan, for eight weeks, aiming to assess their consumption effects combined with resistance exercise on body composition. Bioelectrical impedance before and after the treatment was conducted. The results showed that the supplementation with BCAAs presented a significant decrease (p < 0.05) on the BMI in this group (initial BMI = 19.7 kg/m2; final BMI = 19.4 kg/m2). When comparing the final measures among the groups, the BCAAs and vegan supplements caused a significant decrease in body weight (50.24 kg and 51.34 kg, respectively). The BMI of the group supplemented with meat proteins was statistically higher (22.06 kg/m2) than that the group supplemented with BCAAs (19.4 kg/m2) (p < 0.05). No significant changes were observed in the type of protein consumed to produce muscle mass in the participants after eight weeks of study under a controlled diet and anaerobic resistance exercise. Participants exhibited energy deficiencies, but their macronutrient distribution appeared normal. Following an 8-week intervention, meat and BCAAs reduced weight and BMI, although no statistical differences were observed. It is recommended to extend the treatment for a more comprehensive understanding.

Insights on just culture from seafarers and shipping companies in Indonesia: An exploratory study.

BACKGROUND: Just culture aspires to prompt organizational learning from enhanced feedback by frontline operators. Just culture requires mechanisms to eliminate fear and sanction but not accountability when reporting safety-related issues. Adopted in sectors such as aviation, just culture remains an underdeveloped field in the maritime sector. OBJECTIVE: This study explores how some pre-requisites for a just culture (i.e., ease of reporting, motivation to report, and trust) are perceived and potentially implemented by seafarers' and shipping company safety representatives in Indonesia. METHODS: Semi-structured interviews were used to collect qualitative data in an exploratory study involving eleven active seafarers and four safety managers from shipping companies in Indonesia. RESULTS: The conditions for ease of reporting seem present, at least on paper. Shipping companies receive one to two near-miss reports per month. However, incidents seem to be underreported. It appears that companies are unsuccessful in establishing the motivation and trust necessary to enhance safety event reporting. CONCLUSION: The study suggests that the concept of a just culture is not well understood among certain Indonesian shipping companies. The main barriers to implementing a just culture relate to hierarchical structures in the industry, frequent crew changes, blame culture, and lack of anonymous reporting for safety concerns.

A Systematic Review of Assessment Methods for Seafarers' Mental Health and Well-Being During the COVID-19 Pandemic.

Seafarers spend more time at sea than on land, which makes them a hard-to-reach community. Since their mental health and well-being is usually addressed from a land-based perspective, dedicated and validated methods incorporating maritime specificities are lacking. During the COVID-19 pandemic, research into seafarers' mental health and well-being flourished. However, a systematic review of the literature to assess the type and appropriateness of assessment methods pertaining to the mental health and well-being of seafarers has yet to be undertaken. This study reviews 5 databases (ERIC, Scopus, PubMed, Google Scholar and EBSCO) to assess the methods used to examine seafarers' mental health and well-being during the pandemic. Peer-reviewed literature alongside grey literature that applied quantitative or qualitative instruments to measure seafarers' mental health and/or well-being, published in English between March 2020 and February 2023, was eligible for the review. Studies from all geographic regions and regardless of nationality, rank and ship type of the subjects were explored. Database searches produced 272 records. Five additional records were identified via other methods. We identified 27 studies suitable for review, including 24 published in peer-reviewed scientific journals and 3 reports and surveys produced by the industry or welfare organizations. Assessment methods used to measure seafarers' mental health and well-being vary significantly in the literature. The frequent use of ad hoc questionnaires limits the possibility to replicate and compare the studies due to various inconsistencies. Furthermore, several validation and reliability measures needed more solidity when applied to the seafaring population. Such inadequate measuring and a mix of assessment methods impacted the comparison of results and might inflate the risks of underreporting or overstating mental complaints.

Addressing the C/N imbalance in the treatment of irrigated agricultural water by using a hybrid constructed wetland at field-scale.

To mitigate excess of nitrate-N (NO3--N) derived from agricultural activity, constructed wetlands (CWs) are created to simulate natural removal mechanisms. Irrigated agricultural drainage water is commonly characterized by an organic carbon/nitrogen (C/N) imbalance, thus, C limitation constrains heterotrophic denitrification, the main biotic process implicated in NO3--N removal in wetlands. We studied a pilot plant with three series (169 m2) of hybrid CWs over the first two years of functioning to examine: i) the effect of adding different C-rich substrates (natural soil vs. biochar) to gravel on NO3--N removal in a subsurface flow (Phase I), ii) the role of a second phase with a horizontal surface flow (Phase II) as a source of dissolved organic C (DOC), and its effect in a consecutive horizontal subsurface flow (Phase III) on NO3--N removal, and iii) the contribution of each phase to global NO3--N removal. Our results showed that the addition of a C-rich substrate to gravel had a positive effect on NO3--N removal in Phase I, with mean efficiencies of 40% and 17% for soil and biochar addition, respectively, compared to only gravel (0.75%). In Phase II, the algae growth turned into a DOC concentration increase, but it did not enhance NO3--N removal in Phase III. In series with C-rich substrate addition, the largest contribution to NO3--N removal was found in Phase I. However, in series with only gravel, Phase II was the most effective on NO3--N removal. Contribution of Phase III to NO3--N removal was almost negligible.

Utility of the Serum Protein Electrophoresis in the Opportunistic Screening for the Deficiency of Alpha-1 Antitrypsin.

BACKGROUND: A deficiency in alpha-1 antitrypsin (AAT1) is a rare disorder that represents a significant health threat and early diagnostic priority issue. We investigated the usefulness of the serum protein electrophoresis (SPE) as an opportunistic screening tool for AAT1 deficiency. METHODS: For 6 months, all SPE carried out for any reasons were evaluated in our center. In those with less than 3% of alpha-1 globulins, AAT1 concentrations were studied. The SERPINA1 gene was subsequently sequenced in those patients displaying concentrations below 100 mg/dL. RESULTS: Out of the total, 14 patients (0.3%) were identified with low AAT1 concentrations, with 11 of them agreeing to enter the study. Of those, mutations in the SERPINA1 gene were discovered in 10 patients (91%). Heterozygous mutations were detected in seven patients; three had the c.1096G>A mutation (p.Glu366Lys; Pi*Z), two had the c.863A>T mutation (p.Glu288Val; Pi*S), one had the c.221_223delTCT mutation (p.Phe76del; Pi*Malton), and the last one had the c.1066G>A (p.Ala356Thr) mutation, which was not previously described. Finally, one patient had the c.863A>T mutation in homozygosis, whereas two double heterozygous patients c.863A>T/c.1096G>A were detected. CONCLUSIONS: An altered result in the concentration of AAT1 anticipates a mutation in the SERPINA1 gene in a manner close to 91%. The relationship between a decrease in the alpha-1 globulin band of the SPE and an alteration in the AAT1 concentration is direct in basal states of health. The SPE is presented as a highly sensitive test for opportunistic screening of AAT1 deficiency.

Evaluación de la ingesta de calcio en mujeres pre-menopáusicas consumidoras de alimentación basada en plantas correspondiente al área metropolitana de Buenos Aires / Evaluation of calcium intake in pre-menopausal women consuming a plant-based diet in the Buenos Aires metropolitan area

El calcio es uno de los nutrientes esenciales para la salud ósea. Objetivos: evaluar la ingesta de calcio en un grupo de mujeres pre-menopáusicas consumidoras de alimentación basada en plantas (ABP). Materiales y métodos: un grupo de mujeres premenopáusicas entre 30 y 45 años consumidoras de ABP fueron invitadas a participar. Para la evaluación de ingesta se empleó un recordatorio alimentario de 24 horas. Se utilizó la Encuesta Nacional de Nutrición y Salud (ENNyS, 2007) como información relevada disponible de ingesta de calcio en nuestra población. En un subgrupo de participantes se evaluó la densidad mineral ósea (DMO) de columna lumbar (L1-L4) por el método de absorciometría de rayos X (DXA), mientras que la microarquitectura fue estudiada a través del trabecular bone score (TBS). Resultados: se incluyeron 30 mujeres con un tiempo de adherencia promedio (X±DS) a la ABP 5,6±4 años, edad de 35,6±4 años, y un índice de masa corporal (IMC) de 23.,7±3 kg/m2. Una ingesta diaria de calcio promedio (IC al 95%) de 980 mg (639 mg-1320 mg) fue observada en las mujeres vegetarianas, mientras que en las veganas fue de 772 mg (460 mg-1085 mg), lo que resulta superior a la de la población general (406 mg). Una correlación positiva fue observada entre DMO e IMC (r=0,990; p=0,01) pero no entre DMO e ingesta de calcio. Conclusiones: en esta cohorte de mujeres premenopáusicas consumidoras de ABP, las vegetarianas y el 96,5% de las veganas cubrieron el requerimiento promedio estimado. La adecuada planificación de la ABP permite evitar deficiencias nutricionales que afecten la salud ósea. (AU)

Calcium is one of the essential nutrients intervening in bone health. Objective: To assess calcium intake in a group of premenopausal women consumers of a plant-based diet (PBD). Materials and methods: Premenopausal women between 30 and 45 y/o consumers of a PBD were invited to participate. A 24-hour food reminder was provided for the intake evaluation. Argentina's National Nutrition and Health Survey (ENNyS, 2007) was used as available information on calcium intake in our population. In a participants' subset, the bone mineral density (BMD) of the lumbar spine (L1-L4) was evaluated by dual-energy X-ray absorptiometry (DXA), while the trabecular bone score (TBS) was used to study the microarchitecture. Results: The study included 30 women with an average adherence time (X±DS) to PBD of 5.6±4 years, of 35.6±4 years and a body mass index (BMI) of 23.7±3kg/m2. An average daily calcium intake (95% CI) of 980mg (639 mg-1.320mg) was observed in vegetarian women, while in vegan women it was 772 mg (460mg-1.085mg), higher than the general population (406 mg). A positive correlation was observed between BMD and BMI (r=0.990; p=0.01), though not between BMD and calcium intake. Conclusions: In this cohort of premenopausal women consuming a PBD, the vegetarians and 96.5% of vegans met the estimated average requirement. An appropriate planning of the PBD prevents nutritional deficiencies that may affect bone health. (AU)

Diagnostic Accuracy of Epilepsy-dedicated MRI with Post-processing.

PURPOSE: To evaluate the diagnostic accuracy of epilepsy-dedicated 3 Tesla MRI including post-processing by correlating MRI, histopathology, and postsurgical seizure outcomes. METHODS: 3 Tesla-MRI including a magnetization-prepared two rapid acquisition gradient echo (MP2RAGE) sequence for post-processing using the morphometric analysis program MAP was acquired in 116 consecutive patients with drug-resistant focal epilepsy undergoing resection surgery. The MRI, histopathology reports and postsurgical seizure outcomes were recorded from the patient's charts. RESULTS: The MRI and histopathology were concordant in 101 and discordant in 15 patients, 3 no hippocampal sclerosis/gliosis only lesions were missed on MRI and 1 of 28 focal cortical dysplasia (FCD) type II associated with a glial scar was considered a glial scar only on MRI. In another five patients, MRI was suggestive of FCD, the histopathology was uneventful but patients were seizure-free following surgery. The MRI and histopathology were concordant in 20 of 21 glioneuronal tumors, 6 cavernomas, and 7 glial scars. Histopathology was negative in 10 patients with temporal lobe epilepsy, 4 of them had anteroinferior meningoencephaloceles. Engel class IA outcome was reached in 71% of patients. CONCLUSION: The proposed MRI protocol is highly accurate. No hippocampal sclerosis/gliosis only lesions are typically MRI negative. Small MRI positive FCD can be histopathologically missed, most likely due to sampling errors resulting from insufficient harvesting of tissue.

Role of dry watercourses of an arid watershed in carbon and nitrogen processing along an agricultural impact gradient.

In the Mediterranean arid region such as Southeast (SE) Spain, a considerable part of the fluvial network runs permanently dry. Here, many dry watercourses are embedded in catchments where agriculture has brought changes in carbon (C) and nitrogen (N) availability due to native riparian vegetation removal and the establishment of intensive agriculture. Despite their increasing scientific recognition and vulnerability, our knowledge about dry riverbeds biogeochemistry and environmental drivers is still limited, moreover for developing proper management plans at the whole catchment scale. We examined CO2 and N2O emissions in five riverbeds in SE Spain of variable agricultural impact under dry and simulated rewetted conditions. Sediment denitrifying capacity upon rewetting was also assessed. We found that, regardless of agricultural impact, all riverbeds can emit CO2 under dry and wet conditions. Emissions of N2O were only observed in our study when a long-term rewetting driving saturated sediments was conducted. Besides, most biogeochemical capabilities were enhanced in summer, reflecting the sensitiveness of microbial activity to temperature. Biogeochemical processing variation across rivers appeared to be more controlled by availability of sediment organic C, rather than by agriculturally derived nitrate. We found that the studied dry riverbeds, agriculturally affected or not, may be active sources of CO2 and contribute to transitory N2O emissions during rewetting phenomena, potentially through denitrification. We propose that management plans aiming to support ecosystem biogeochemistry through organic C from native vegetation rather than agricultural exudates would help to reduce anthropogenic greenhouse gases emissions and excess of nutrients in the watershed and to control the nitrate inputs to coastal ecosystems.

Prevalent coinfection and associated factors for Hepatitis B, Hepatitis C, and Human Immunodeficiency Virus in patients submitted to renal replacement therapy: A cross-sectional study of 21 dialysis units in the State of Mexico.

BACKGROUND: Chronic kidney disease (CKD) predispose to viral coinfections in patients submitted to renal replacement therapy (RRT); nevertheless, few reports have been performed to elucidate the current epidemiology within this population in Mexico. AIM: To estimate the prevalence of HBV, HCV, and HIV coinfection and to explore factors associated with prevalent coinfection in patients living with renal failure undergoing to RRT. METHODS: A multicenter cross-sectional recruitment across 21 units at the Mexican Institute of Social Security (IMSS) at the State of Mexico was performed during 2019. A standardized clinical questionnaire was performed to elucidate individual and relatives-related conditions. A treatment facility questionnaire was applied to the chief responsible of each unit to explore treatment facility variables. Serological testing, clinical, biochemical, and anthropometrical parameters were extracted from clinical records. RESULT: In 1,304 patients (57.5% male, mean age 45.5 (SD: 15.6) years, and 95.8% in hemodialysis), the prevalence of any viral coinfection was 3.14% (95% CI: 2.32%-4.23%). The highest viral coinfection prevalence were for HCV, HBV, and HIV, in which men and subjects diagnosed after 2010's had the highest rates. We identify that being submitted to peritoneal dialysis, being treated in a surrogated dialysis center and living with a close relative with prior hepatitis coinfection were associated factors for any viral coinfection. CONCLUSION: In patients submitted to RRT, the prevalence of viral coinfection remains high compared with general population. Screening strategies, medical awareness and targeted public healthcare policies should prioritize better care practices within patients submitted to RRT in Mexico.

¿Cómo realizamos el cribado visual en Atención Primaria? / How is vision screening performed in primary care?

Introducción: la ambliopía es la causa más común de pérdida de visión prevenible en los países desarrollados. Dicha prevención depende de una detección y tratamiento precoces mediante un adecuado cribado visual en la infancia. Nuestro objetivo es describir la situación del cribado visual en Atención Primaria en España y su relación con la formación de los profesionales. Material y métodos: estudio observacional descriptivo mediante encuesta telemática a los pediatras de Atención Primaria acerca de sus conocimientos sobre el desarrollo visual y las técnicas de cribado, material y formación al respecto. Análisis estadístico descriptivo y univariado en busca de relación entre la formación recibida y sus conocimientos. Resultados: el 79,3% de los participantes acierta más de la mitad de las preguntas teóricas. El 82,8% tiene optotipos estandarizados y el 30,7%, el test de Lang. El 72,7% conoce la distancia óptima y el 76,6% la altura óptima para explorar la agudeza visual con optotipos. El 50%, 68,3% y 44,5% realiza el reflejo rojo, el test de Hirschberg y el Cover test en las revisiones indicadas, respectivamente. Más del 90% conoce los criterios de derivación al oftalmólogo. El 3,1% ha recibido formación institucional y el 54,8% autónoma. Existen diferencias en la puntuación obtenida entre los profesionales según la formación recibida. Conclusiones: se detectan aspectos a mejorar. Se debe explorar el reflejo rojo en todas las revisiones del lactante y la alineación ocular desde los 6 meses, así como disponer y mejorar la utilización del test de Lang y de optotipos estandarizados. Existe relación entre un mayor nivel de conocimientos teóricos y prácticos y la formación recibida (AU)

Introduction: amblyopia is the most frequent cause of preventable vision loss in developed countries. Its prevention depends on early detection and treatment through adequate vision screening in childhood. Our objective was to describe the current situation in vision screening at the primary care level in Spain and its association with the training of professionals.Material and methods: observational descriptive study via a remote survey of primary care paediatricians of their knowledge on visual development and vision screening techniques, equipment and training. We conducted a statistical descriptive and univariate analysis to assess the association between the training received and the level of knowledge. Results: of all respondents, 79.3% answered the theoretical questions correction, 82.8% had standardised optotypes and 30.7% used the Lang test. Also, 72.7% knew the adequate distance and 76.6% the optimal height to assess visual acuity with optotypes. Fifty percent used the red reflex test, 68.3% the Hirschberg test and 44.5% the cover test in the appropriate check-ups. As regards training, 3.1% received it from their institutions, and 54.8% independently. Over 90% knew the criteria for referral to the ophthalmologist. We found differences in the scores of the respondents based on the training received.Conclusion: we identified opportunities for improvement: the red reflex test should be performed during all infant check-ups and ocular alignment checked from 6 months, and the Lang test and standardised optotypes should be available and their use improved. Higher levels of theoretical and practical knowledge are positively correlated with the amount of training received by health professionals. (AU)

Healthy workplace onboard: Insights gained from the COVID-19 impact on mental health and wellbeing of seafarers.

BACKGROUND: Seafarers' mental health is seriously affected by COVID-19. The pandemic could act as a catalyst for change with respect to seafarers' mental health protection and promotion. OBJECTIVE: The study explores the main factors contributing to the mental health and wellbeing of seafarers. Moreover, elements to help seafarers lessen the impact of the pandemic on their work and life onboard are analyzed, and their role in developing a positive psychosocial environment and promoting a healthy workplace onboard are discussed. METHODS: The study involved the use of an ad hoc questionnaire and the adoption of both quantitative and qualitative methods. The sample included one hundred and five active seafarers. RESULTS: Ninety-six percent of the sample stated that mental health is a very or extremely important part of their general health. Seafarers perceive that their mental health has been seriously impacted by COVID-19. Major factors contributing to seafarers' mental health and wellbeing reveal three groups of factors: rest and spare time-related factors, communication/relationship with the external world, and interaction and social life on board factors. CONCLUSIONS: Strategies suggested by seafarers for coping with "inevitable" psychological stress produced by COVID-19 and promoting their wellbeing include managerial, emotional, facilities-related (including communication infrastructure), physical, and social elements to promote wellbeing. Economic, intellectual, and spiritual elements also have to be taken into consideration and require further investigation. Building on seafarers' insights and experiences, a healthy environment onboard should cultivate holistically the four main spheres of a healthy workplace (physical work environment, psychosocial work environment, personal health resources, and enterprise community involvement) and the five features of a healthy psychosocial environment (social, emotional, physical, intellectual and spiritual) under all circumstances, whether exceptional or ordinary.

Volviéndonos mejores: necesidad de acción inmediata ante el reto de la obesidad. Una postura de profesionales de la salud / Becoming better: the need for immediate action to address obesity. A position statement from health professionals

resumen está disponible en el texto completo

Abstract: In recent decades, the growing obesity epidemic in Mexico has become one of the most important public health challenges faced by the country. With support from the World Obesity Federation, we formed a working group in 2021 to identify and summarize priority actions that Mexico can take to face this epidemic. More than 1 000 health professionals joined the development and discussion process. Recommendations from previously published, high-level documents and guidelines were taken into account. In commemoration of World Obesity Day 2022, this statement is presented as input for health care professionals to develop actions to address obesity. The statement includes 10 recommendations that include population-level and individual-level actions. It emphasizes the importance of social participation, comprehensive interventions with a person- centered perspective, planetary sustainability, on improving education and communication campaigns, as well as fostering a built environment that promotes active living, and shielding prevention and control efforts from conflicts of interest. The statement calls for obesity to be treated seriously, based on scientific evidence, in a timely and comprehensive manner, employing a life-course and ethical approach that does not perpetuate weight stigma in society.

Prevalence and characterization of undiagnosed arterial hypertension in the eastern zone of Mexico.

Arterial hypertension is considered a public health problem with severe consequences at an individual and public health levels. However, there is a lack of information regarding its characterization in Mexico. The objective of this study is to estimate the proportion of undiagnosed arterial hypertension (UAH) and the overall prevalence and clinical management of arterial hypertension within the Eastern Zone of Mexico. Additionally, we explore associated factors related with both UAH and uncontrolled arterial hypertension. We obtained information from the May Measure Month (MMM) 2019 study. People were asked for cardiovascular risk factors and blood pressure was measured according to the protocols of the European Society of Hypertension (ESH). Data from 5901 subjects were extracted: 76.04% from the Eastern Zone of the State of Mexico. The overall prevalence of hypertension was 32.4% (95% CI 31.2-33.6). From all subjects living with hypertension, 28.3% had UAH, 22.1% had previous diagnosis but were untreated; 29.3% were treated but had uncontrolled hypertension. Younger men adults living in the State of Michoacán had increased proportion of UAH and untreated hypertension. We observed that male sex, age, obesity, living at Michoacán were risk factors for UAH. Finally, male sex, diabetes, and living at Michoacán were related risk conditions for having uncontrolled arterial hypertension. In summary, there is a high proportion of UAH in Easter Zone of Mexico. Younger adults had higher proportion of UAH and untreated hypertension profiles. Efficient actions are required to make a timely diagnosis in the young adult population to prevent long-term complications.

Effects of Cardiopulmonary Rehabilitation on the Muscle Function of Children with Congenital Heart Disease: A Prospective Cohort Study.

Critical medical and surgical advances have led to a shift in the care and management of children with congenital heart disease (CHD). These patients present with muscle deconditioning, which negatively influences their response to exercise, functional capacities, and quality of life. This study evaluates the influence of a cardiopulmonary rehabilitation program (CPRP) on the function of peripheral musculature of children with CHD. A single-center prospective cohort study was designed. Fifteen CHD subjects, between 12 and 16 years of age, with reduced aerobic capacity on a cardiopulmonary exercise test, were included in a three-month, 24-session CPRP. Measurements of the subjects' handgrip strength, biceps brachii and quadriceps femoris strength, and triceps surae fatigue process were collected at the beginning of the program, after completion, and six months after the end of the intervention. A substantial and statistically significant improvement was observed in the subjects' handgrip strength (kg) (p < 0.001), biceps brachii and quadriceps femoris strength (N) (p < 0.001), as well as triceps surae fatigue process (repetitions) (p = 0.018), with a maintenance of the results six months after the intervention. These results suggest that a CPRP could potentially improve the peripheral muscle function of children with CHD. Additional research is needed to confirm and expand on this hypothesis.

Preferencias y conductas alimentarias en adolescentes de secundaria básica / Food preferences and behaviors in basic junior high school´s adolescents

Introducción: Los hábitos alimentarios se modifican en la adolescencia por diferentes factores que se relacionan estrechamente con los cambios propios de esta etapa. Objetivo: Examinar las preferencias y conducta alimentaria de adolescentes de secundaria básica. Métodos: Estudio transversal en la escuela secundaria básica "José Martí", municipio Cerro, La Habana, entre septiembre-octubre de 2015 en 94 adolescentes. A todos se les aplicó una encuesta sobre la frecuencia de las principales comidas, así como el consumo semanal de alimentos. Se empleó la prueba Ji-cuadrada para establecer las asociaciones entre variables. Resultados: Predominaron las hembras (55,0 por ciento) con una media de edad de 12,7±0,9 años. La mayoría no cumplen con la frecuencia recomendada de las comidas y su dieta está basada en alimentos con alto contenido de grasas y azucares, alta en sodio y baja en vitaminas, fibras y minerales. Las hembras son las que menos desayunan (32,0 por ciento), los varones los que menos almuerzan (11,4 por ciento) y la cena es la comida que más respetan ambos sexos (98,0 y 97,7 por ciento, respectivamente). Los cereales (64,0 por ciento), azúcares (58,0 por ciento) y lácteos (56,0 por ciento) están dentro de los alimentos más consumidos. El huevo, los embutidos y las carnes rojas son más consumido por los varones y las carnes blancas por las hembras. Conclusiones: La conducta alimentaria de los adolescentes es inadecuada en su mayoría con mayor afectación en el sexo femenino en el desayuno y en el masculino en el almuerzo. Tienen baja preferencia por los vegetales y las frutas en contraste con los cereales, azúcares y lácteos, más consumidos(AU)

Introduction: Eating habits are modified in adolescence by different factors that are closely related to the typical changes of this stage of life. Objective: Examine the food preferences and behavior of basic junior high school´s adolescents. Methods: Cross-sectional study in "José Martí" Basic Junior High School, Cerro municipality, Havana, in the period September-October 2015 in 94 adolescents. All of them underwent a survey on the frequency of main meals, as well as weekly food consumption. The Ji-square test was used to establish associations among variables. Results: Females predominated (55.0 percent) with an average age of 12.7±0.9 years. Most of them do not meet the recommended frequency of meals and their diet is based on foods high in fat and sugar, high in sodium and low in vitamins, fibers and minerals. Females have less breakfasts (32.0 percent), males have less lunch (11.4 percent) and dinner is the food that both sexes most respect (98.0 and 97.7 percent, respectively). Cereals (64.0 percent), sugars (58.0 percent) and dairy (56.0 percent) are within the most consumed foods. Egg, cold meats and red meats are most consumed by males and white meats by females. Conclusions: Adolescents' food behavior is mostly inadequate. in its majority with greater affectation in the feminine sex at breakfast and in the masculine sex at lunch. They have a low preference for vegetables and fruits in contrast to cereals, sugars and dairy products, which are more consumed(AU)

Impact of a prolonged COVID-19 lockdown on patterns of admission, mortality and performance indicators in a cardiovascular intensive care unit.

BACKGROUND: The effects of an early and prolonged lockdown during the coronavirus disease 2019 (COVID-19) pandemic on cardiovascular intensive care units (CICUs) are not well established. OBJECTIVES: This study analyses patterns of admission, mortality and performance indicators in a CICU before and during the Argentine lockdown in the COVID-19 pandemic. METHODS: This is a retrospective observational cross-sectional study of all consecutive patients aged 18 years or more admitted to the cardiac intensive care unit at a high-volume reference hospital in Buenos Aires, Argentina, comparing hospitalization rates, primary causes of admission, inpatient utilization indicators, pharmacy supplies' expenditures and in-hospital mortality between 5 March and 31 July 2020, with two corresponding control periods in 2019 and 2018. RESULTS: We included 722 female patients [mean age of 61.6 (SD 15.5) years; 237 (32.8%)]. Overall hospitalizations dropped 53.2% (95%CI: 45.3, 61.0%), from 295.5 patients/year over the periods 2018/2019 to 137 patients in 2020. Cardiovascular disease-related admissions dropped 59.9%, while admission for non-cardiac causes doubled its prevalence from 9.6% over the periods 2018/2019 to 22.6% in the study period (P < 0.001).In the period 2020, the bed occupancy rate fell from 82.2% to 77.4%, and the bed turnover rate dropped 50% from 7.88 to 3.91 monthly discharges/bed. The average length of stay doubled from 3.26 to 6.75 days, and the turnover interval increased from 3.8 to 8.39 days in 2020.Pharmacy supplies' expenditures per discharge increased 134% along with a rise in antibiotics usage from 6.5 to 11.4 vials/ampoules per discharge (P < 0.02).Overall mortality increased from 7% (n = 41) to 13.9% (n = 19) (P = 0.008) at the expense of non-cardiac-related admissions (3.6-19.4%, P = 0.01). CONCLUSIONS: This study found a significant reduction in overall and cardiovascular disease-related causes of admission to the cardiac intensive care unit, worse performance indicators and increased in-hospital mortality along the first 5 months of the early and long-lasting COVID-19 lockdown in Argentina. These results highlight the need to foster public awareness concerning the risks of avoiding hospital attendance. Moreover, health systems should follow strict screening protocols to prevent potential biases in the admission of patients with critical conditions unrelated to the COVID-19 pandemic.