Síndrome de Williams-Campbell: reporte de caso / Williams-Campbell Syndrome: Case Report

El síndrome de Williams-Campbell (SWC) es una entidad clínica caracterizada por la deficiencia de cartílago en la pared bronquial de los bronquios subsegmentarios. Es una condición congénita que por lo general se diagnostica en la niñez, pero hay reportes de caso en la población adulta y se cree que esto se debe a un menor déficit de cartílago. Los síntomas principales de esta condición son la presencia de tos, disnea e infecciones respiratorias a repetición. Radiológicamente, se evidencia la presencia de bronquiectasias de pared delgada. El diagnóstico se basa en descartar otras causas más comunes de bronquiectasias, así como en la identificación de las características radiológicas y la presencia del componente congénito. Presentamos el caso de un joven con síntomas respiratorios desde la infancia, con necesidad de múltiples hospitalizaciones por procesos infecciosos de origen pulmonar a repetición, con lo cual se llega al diagnóstico de un síndrome de Williams-Campbell.

Williams-Campbell syndrome (WCS) is a clinical entity characterized by cartilage deficiency in the bronchial wall of the subsegmental bronchi. It is a congenital condition that is usually diagnosed in childhood, but there are case reports in the adult population, and it is believed that this is due to a minor cartilage deficiency. The main symptoms of this condition are the presence of cough, dyspnea and repeated respiratory infections. Radiologically, the presence of thin-walled bronchiectasis is evident. The diagnosis is based on ruling out other more common causes of bronchiectasis, as well as identifying the radiological characteristics and the presence of the congenital component. We present the case of a young man with respiratory symptoms since childhood requiring multiple hospitalizations due to repeated infectious processes of pulmonary origin, in which the diagnosis of Williams-Campbell syndrome was reached.

Comparative Outcomes of Day-Case Percutaneous Nephrolithotomy vs Conventional Inpatient Surgery: A Systematic Review and Meta-Analysis.

OBJECTIVE: To conduct a systematic review and meta-analysis to evaluate the effectiveness and safety of PCNL performed as a day-case surgery in comparison to inpatient PCNL. METHODS: Databases were searched up to January 27, 2024, for randomized and non-randomized studies comparing outcomes between day case PCNL and inpatient PCNL. Pooled data were analyzed using a Random-Effects (RE) model when Higgins I2% heterogeneity values were >50%; otherwise, a Fixed-Effects model was employed. The results were reported as odds ratios (OR), mean difference (MD) or standardized MD (SMD) with 95% confidence intervals (CI). Statistical significance was set at p < 0.05. RESULTS: One randomized controlled trial (RCT) and fourteen observational studies totaling 1574 patients were included. Pooled results revealed that patients in the day-case PCNL group experienced reduced blood loss (SMD -0.71 95% CI: [-1.31, -0.12] p 0.02) and transfusion rates (OR 0.10 95% CI: [0.03, 0.39], p 0.0008), lower overall and minor complications (OR 0.56, 95% CI: [0.42, 0.76], p 0.0002, and OR 0.52, 95% CI: [0.37, 0-73], p 0.0002, respectively), shorter operative time (MD -11.46, 95% CI: [-17.41, -5-50], p < 0.00001), and reduced total costs (MD -1597.18, 95% CI [-2436.42, -757.93], p 0.0002). Major complications, stone-free rate (SFR), emergency department (ED) visits, and readmission rates were similar between the groups. CONCLUSION: Day-case PCNL is a feasible and safe alternative to inpatient PCNL surgery in carefully selected patients, without increasing the risk of complications or readmission rates, and is likely to reduce total costs.

Role of MicroRNA-204 in Regulating the Hallmarks of Breast Cancer: An Update.

microRNA-204-5p (miR-204) is a small noncoding RNA with diverse regulatory roles in breast cancer (BC) development and progression. miR-204 is implicated in the instauration of fundamental traits acquired during the multistep development of BC, known as the hallmarks of cancer. It may act as a potent tumor suppressor by inhibiting key cellular processes like angiogenesis, vasculogenic mimicry, invasion, migration, and metastasis. It achieves this by targeting multiple master genes involved in these processes, including HIF-1α, ß-catenin, VEGFA, TGFBR2, FAK, FOXA1, among others. Additionally, miR-204 modulates signaling pathways like PI3K/AKT and interacts with HOTAIR and DSCAM-AS1 lncRNAs, further influencing tumor progression. Beyond its direct effects on tumor cells, miR-204 shapes the tumor microenvironment by regulating immune cell infiltration, suppressing pro-tumorigenic cytokine production, and potentially influencing immunotherapy response. Moreover, miR-204 plays a crucial role in metabolic reprogramming by directly suppressing metabolic genes within tumor cells, indirectly affecting metabolism through exosome signaling, and remodeling metabolic flux within the tumor microenvironment. This review aims to present an update on the current knowledge regarding the role of miR-204 in the hallmarks of BC. In conclusion, miR-204 is a potential therapeutic target and prognostic marker in BC, emphasizing the need for further research to fully elucidate its complex roles in orchestrating aggressive BC behavior.

Extended septal myectomy versus alcohol septal ablation: clinical results at a national referral centre.

OBJECTIVES: Extended septal myectomy and alcohol septal ablation are 2 invasive treatments for hypertrophic obstructive cardiomyopathy. Our goal was to compare which of these techniques achieved a higher reduction in gradients, improvement in New York Heart Association (NYHA) functional class and reduction in medical treatment. METHODS: It is a single-centre observational and retrospective analysis. We used multivariable regression analyses to assess the association of ablation/myectomy with different outcomes. The odds ratio or coefficient along with the 95% confidence interval was estimated according to the group and adjusted for the corresponding preprocedural variables and EuroSCORE II. RESULTS: A total of 78 patients underwent septal myectomy, and 25 patients underwent alcohol septal ablation. Basal and Valsalva gradients after myectomy were reduced to a higher degree in comparison to ablation: 21.0 mmHg [P < 0.001, 95% confidence interval -30.7; -11.3], and 34.3 mmHg (P < 0.001, -49.1; -19.5) respectively. Those patients who received a myectomy had a lower probability of having moderate mitral regurgitation (odds ratio = 0.18, P = 0.054). Patients after septal myectomy were more likely to be NYHA functional class I (80.4%), whereas patients after ablation were more likely to be NYHA functional class III (48%). Both groups continued with beta-blocker therapy, but disopyramide could be discontinued after the myectomy in more cases (20%-36% vs 59%-1.3%; P < 0.001), and there was a tendency to discontinue calcium channel blockers (48%-16% vs 15.4-3.8%; P = 0.054). CONCLUSIONS: After adjustment using preprocedural gradients and EuroSCORE II, myectomy achieves greater reduction in left ventricular outflow tract gradients compared to septal ablation.

Desigualdades sociales urbano-rurales en la mortalidad por siniestros viales en Colombia, 1998-2019

Introducción: Anualmente se pierden 1,35 millones de vidas por causa de siniestros viales; su ocurrencia se ha relacionado, además de factores comportamentales, con desigualdades sociales. Objetivo: Analizar las desigualdades sociales urbano-rurales en la mortalidad por siniestros viales en Colombia para el periodo 1998-2019. Materiales y métodos: Estudio ecológico a partir del análisis de las tasas de mortalidad ajustadas de los grupos poblacionales urbanos y rurales estratificados por sexo. Se hicieron análisis con regresión de Joinpoint y se calcularon medidas de desigualdad simple absoluta y relativa. Resultados: Se registraron 139 323 muertes por siniestros viales, en Colombia la tasa de mortalidad por esta causa se ha venido reduciendo. En contraste con las áreas rurales, en las áreas urbanas esta reducción es más significativa. Existen desigualdades en la mortalidad entre las áreas urbanas y rurales que han venido estrechándose. No obstante, en el caso de hombres y mujeres ha venido incrementándose. Discusión: La reducción de la tasa de mortalidad por siniestros viales sugiere que las intervenciones en seguridad vial han sido efectivas. La mayor mortalidad en hombres puede explicarse a partir de factores comportamentales. Las desigualdades urbano-rurales pueden estar relacionadas con las dinámicas de desarrollo. Conclusiones: Se registra una reducción en la tasa de mortalidad por siniestros viales, la cual es más significativa en áreas urbanas. Existen desigualdades urbano-rurales en la mortalidad por esta causa. Las políticas de seguridad vial deben partir de un enfoque integrador vinculado con otras agendas políticas.

Introduction: Annually, 1,35 million lives are lost due to road accidents; their occurrence has been related, in addition to behavioral factors, to social inequalities. Objective: To analyze urban-rural social inequalities in mortality from traffic accidents in Colombia from 1998-2019. Methods and materials: Ecological study based on the analysis of standardized mortality rates adjusted for age and sex of urban and rural population groups stratified by sex. Joinpoint regression analyses were performed, and absolute and relative simple inequality measures were calculated. Results: There were 139.323 deaths from road accidents; in Colombia mortality rates from this cause has been decreasing. In urban areas, the reduction is more significant than in rural areas. Disparities in mortality between urban and rural areas have been narrowing, however, in the case of men and women, they have been increasing. Discussion: Reducing the mortality rate from road accidents suggests that road safety interventions have been effective. Behavioral factors can explain the higher mortality in men. Urban-rural inequalities can be related to development dynamics. Conclusions: There is a significant reduction in the mortality rate due to road accidents in urban areas. There are urban-rural inequalities in mortality from this cause. Road safety policies must be based on an integrative approach linked to other political agendas.

Antibiotics in Chronic Liver Disease and Their Effects on Gut Microbiota.

Impairments in liver function lead to different complications. As chronic liver disease progresses (CLD), hypoalbuminemia and alterations in bile acid compositions lead to changes in gut microbiota and, therefore, in the host-microbiome interaction, leading to a proinflammatory state. Alterations in gut microbiota composition and permeability, known as gut dysbiosis, have important implications in CLD; alterations in the gut-liver axis are a consequence of liver disease, but also a cause of CLD. Furthermore, gut dysbiosis plays an important role in the progression of liver cirrhosis and decompensation, particularly with complications such as hepatic encephalopathy and spontaneous bacterial peritonitis. In relation to this, antibiotics play an important role in treating CLD. While certain antibiotics have specific indications, others have been subjected to continued study to determine whether or not they have a modulatory effect on gut microbiota. In contrast, the rational use of antibiotics is important, not only because of their disrupting effects on gut microbiota, but also in the context of multidrug-resistant organisms. The aim of this review is to illustrate the role of gut microbiota alterations in CLD, the use and impact of antibiotics in liver cirrhosis, and their harmful and beneficial effects.

Biofortification of Broccoli Microgreens (Brassica oleracea var. italica) with Glucosinolates, Zinc, and Iron through the Combined Application of Bio- and Nanofertilizers.

There is a severe need to develop a sustainable, affordable, and nutritious food supply system. Broccoli microgreens have attracted attention due to their rich nutritional content and abundant bioactive compounds, constituting an important opportunity to feed the ever-increasing population and fight global health problems. This study aimed to measure the impact of the combined application of biofertilizers and zinc and iron nanofertilizers on plant growth and the biofortification of glucosinolates (GLSs) and micronutrients in broccoli microgreens. Biofertilizers were based on plant growth-promoting (PGP) bacterial consortia previously isolated and characterized for multiple PGP traits. Nanofertilizers consisted of ZnO (77 nm) and γ-Fe2O3 (68 nm) nanoparticles synthesized with the coprecipitation method and functionalized with a Pseudomonas species preparation. Treatments were evaluated under seedbed conditions. Plant growth parameters of plant height (37.0-59.8%), leaf diameter (57.6-81.1%) and fresh weight (112.1-178.0%), as well as zinc (122.19-363.41%) and iron contents (55.19-161.57%), were mainly increased by nanoparticles subjected to the functionalization process with Pseudomonas species and uncapped NPs applied together with the biofertilizer treatment. Regarding GLSs, eight compounds were detected as being most positively influenced by these treatments. This work demonstrated the synergistic interactions of applying ZnO and γ-Fe2O3 nanofertilizers combined with biofertilizers to enhance plant growth and biofortify micronutrients and glucosinolates in broccoli microgreens.

Coffee Pulp Gasification for Syngas Obtention and Methane Production Simulation Using Ni Catalysts Supported on Al2O3 and ZrO2 in a Packed Bed Reactor.

The methanation of CO2 is of great interest in power-to-gas systems and contributes to the mitigation of climate change through carbon dioxide capture and the subsequent production of high-added-value products. This study investigated CO2 methanation with three Ni catalysts supported on Al2O3 and ZrO2, which were simulated using a mathematical model of a packed bed reactor designed based on their chemical kinetics reported in the literature. The simulated reactive system was fed with syngas obtained from residual coffee pulp obtained after a solvent phytochemical extraction process under several gasification conditions. The results reflect a high degree of influence of the catalyst support, preparation method, and syngas composition on CO2 and H2 conversions and CH4 selectivity. For all the syngas compositions, the Ni/ZrO2 catalysts showed the best values for CO2 conversion and H2 conversion for the Ni/Al2O3 catalyst except in gasification at 700 °C and using the Ni/ZrO2p catalyst.

The Role of ncRNAs in the Immune Dysregulation of Preeclampsia.

The main complications causing practically 75% of all maternal deaths are severe bleeding, infections, and high blood pressure during pregnancy (preeclampsia (PE) and eclampsia). The usefulness of ncRNAs as clinical biomarkers has been explored in an extensive range of human diseases including pregnancy-related diseases such as PE. Immunological dysregulation show that the Th1/17:Th2/Treg ratio is "central and causal" to PE. However, there is evidence of the involvement of placenta-expressed miRNAs and lncRNAs in the immunological regulation of crucial processes of placenta development and function during pregnancy. Abnormal expression of these molecules is related to immune physiopathological processes that occur in PE. Therefore, this work aims to describe the importance of miRNAs and lncRNAs in immune dysregulation in PE. Interestingly, multiple ncRNAS are involved in the immune dysregulation of PE participating in type 1 immune response regulation, immune microenvironment regulation in placenta promoting inflammatory factors, trophoblast cell invasion in women with Early-Onset PE (EOPE), placental development, and angiogenesis, promotion of population of M1 and M2, proliferation, invasion, and migration of placental trophoblast cells, and promotion of invasion and autophagy through vias such as PI3K/AKT/mTOR, VEGF/VEGFR1, and TLR9/STAT3.

Development and Evaluation of Zinc and Iron Nanoparticles Functionalized with Plant Growth-Promoting Rhizobacteria (PGPR) and Microalgae for Their Application as Bio-Nanofertilizers.

Micronutrient deficiencies are widespread and growing global concerns. Nanoscale nutrients present higher absorption rates and improved nutrient availability and nutrient use efficiency. Co-application of nanofertilizers (NFs) with biological agents or organic compounds increases NF biocompatibility, stability, and efficacy. This study aimed to develop and evaluate zinc and iron bio-nanofertilizers formulated with plant growth-promoting rhizobacteria (PGPR) and microalgae. Nanoparticles (NPs) were synthesized with the co-precipitation method and functionalized with Pseudomonas species and Spirulina platensis preparation. NPs were characterized and evaluated on seed germination, soil microbial growth, and early plant response under seedbed conditions. NPs corresponded to zinc oxide (ZnO; 77 nm) and maghemite (γ-Fe2O3; 68 nm). Functionalized nanoparticles showed larger sizes, around 145-233 nm. The seedling vigor index of tomato and maize was significantly increased (32.9-46.1%) by bacteria-functionalized ZnO- and γ-Fe2O3-NPs at 75 ppm. NFs at 250 and 75 ppm significantly increased bacterial growth. NFs also improved early plant growth by increasing plant height (14-44%), leaf diameter (22-47%), and fresh weight (46-119%) in broccoli and radish, which were mainly influenced by bacteria capped ZnO- and γ-Fe2O3-NPs at 250 ppm. Beneficial effects on plant growth can be attributed to the synergistic interaction of the biological components and the zinc and iron NPs in the bio-nanofertilizers.

Resultados negativos asociados a la medicación y reacciones adversas a medicamentos en servicio de urgencias. Estudio exploratorio de vida real / Negative outcomes associated with medication and adverse drug reactions in the emergency department. Real-life exploratory study

Introducción. El objetivo del estudio es determinar la prevalencia de los resultados negativos asociados a la medicación (RNM) y reacciones adversas a medicamentos (RAM) que tienen los pacientes que acuden al servicio de urgencias (SU) de un centro de salud. Método. Estudio observacional exploratorio, de corte transversal, en pacientes con RNM que consultan en un servicio de urgencias. La información, acorde con las variables de interés, se recolectó con un instrumento diseñado y evaluado para ello. Se aplicó un modelo de regresión logística multivariante sobre los RNM encontrados, para determinar las variables más importantes que predisponen a la aparición de RNM. Además, se determinó la evitabilidad de RNM (criterio de Baena et al.), la gravedad de RNM (clasificación de Schneider) y la causalidad de RAM (algoritmo de Naranjo). Resultados. Un total de 158 pacientes fueron incluidos en el estudio. La prevalencia de visitas al SU motivados por RNM fue 35,0 % (55 pacientes) y de RAM fue de 5,1 % (8 pacientes). El 88,0 % de los RNM se consideraron evitables y el 74,0 % fueron de gravedad leve. Por otra parte, el 37,5 % (n=3) de RAM fueron clasificadas como evitables y el 50,0 % como probables. El modelo logístico multivariado indica una posible asociación entre los RNM con bajos niveles de escolaridad, la utilización de plantas medicinales y el número de enfermedades concomitantes. Conclusiones. La visita de 1 de cada 3 pacientes al servicio de urgencias está asociado a un RNM; mientras que 1 de cada 20 lo está a una RAM. Otros estudios son necesarios (AU)

Introduction. The aim of the study is to determine the prevalence of negative outcomes associated with medication (NOMs) and adverse drug reactions (ADRs) occurring in the emergency department (ED) of a health centre.Method. An exploratory observational, cross-sectional study of patients with NOMs consulting in an ED. According to the variables of interest, the information was collected with an instrument designed and evaluated for this pur-pose.A multivariate logistic regression model was applied to the NOMs and found the most important variables predis-posing to the appearance of NOM. In addition, the avoid ability of NOM (Baena et al. criteria), the severity of NOM (Schneider classification) and the causality of ADR (Naranjo algorithm) were shown.Results. A total of 158 patients were included in the study. The prevalence of visits to the ED due to NOM was 35.0 % (55 patients) and ADR was 5.1 % (8 patients). Overall, 88.0 % of the ADRs were considered avoidable and 74.0 % were of mild severity. On the other hand, 37.5 % (n=3) of suspected ADR were classified as avoidable and 50.0 % as probable. The multivariate logistic model indicates a possible association between NOMs with lower levels of schooling, the use of medicinal plants and the number of diseases.Conclusions. The visit of 1 in 3 patients to the emergency department is associated with a NOM, while 1 in 20 is associated with an ADR. Further studies are needed. (AU)

Identification and Characterization of Beneficial Soil Microbial Strains for the Formulation of Biofertilizers Based on Native Plant Growth-Promoting Microorganisms Isolated from Northern Mexico.

Plant growth-promoting microorganisms (PGPM) benefit plant health by enhancing plant nutrient-use efficiency and protecting plants against biotic and abiotic stresses. This study aimed to isolate and characterize autochthonous PGPM from important agri-food crops and nonagricultural plants to formulate biofertilizers. Native microorganisms were isolated and evaluated for PGP traits (K, P, and Zn solubilization, N2-fixation, NH3-, IAA and siderophore production, and antifungal activity against Fusarium oxysporum). Isolates were tested on radish and broccoli seedlings, evaluating 19 individual isolates and 12 microbial consortia. Potential bacteria were identified through DNA sequencing. In total, 798 bacteria and 209 fungi were isolated. Isolates showed higher mineral solubilization activity than other mechanisms; 399 bacteria and 156 fungi presented mineral solubilization. Bacteria were relevant for nitrogen fixation, siderophore, IAA (29-176 mg/L), and ammonia production, while fungi for Fusarium growth inhibition (40-69%). Twenty-four bacteria and eighteen fungi were selected for their PGP traits. Bacteria had significantly (ANOVA, p < 0.05) better effects on plants than fungi; treatments improved plant height (23.06-51.32%), leaf diameter (25.43-82.91%), and fresh weight (54.18-85.45%) in both crops. Most potential species belonged to Pseudomonas, Pantoea, Serratia, and Rahnella genera. This work validated a high-throughput approach to screening hundreds of rhizospheric microorganisms with PGP potential isolated from rhizospheric samples.

[Social inequalities related to road traffic mortality]. / Desigualdades sociales relacionadas con la mortalidad por accidentes de tráfico.

OBJECTIVE: To synthesize the social inequalities related to mortality from traffic accidents reported in scientific publications. METHOD: A scoping review following the PRISMA-ScR guide was carried out. Using the MesH vocabulary, we systematically searched for articles in English, Portuguese and Spanish published in the EBSCO, Scielo, Scopus, Ovid, and PubMed databases. RESULTS: We identified 47,790 records in the initial search, of which 35 articles met the selection criteria. Nine out ten publications are in high-income countries; there is a greater interest in analyzing mortality in occupants and drivers of vehicles and motorcyclists. Half of the publications use race-ethnicity and geolocation as socioeconomic position variables. The articles included in this review indicate that groups of people with low socioeconomic positions have higher mortality due to traffic accidents. CONCLUSIONS: The highest mortality from traffic accidents occurs in people with low socioeconomic positions which suggests the development of road safety actions from a comprehensive, integrative perspective and linked to other political agendas to reduce their incidence by 2030. Although road traffic fatalities are higher in low and middle-income countries, few publications are available in these countries. It is necessary to strengthen the research capacities in these countries.

Little transparency and equity in scientific awards for early- and mid-career researchers in ecology and evolution.

Scientific awards can shape scientific careers, helping to secure jobs and grants, but can also contribute to the lack of diversity at senior levels and in the elite networks of scientists. To assess the status quo and historical trends, we evaluated 'best researcher' awards and 'best paper' early- and mid-career awards from broad-scope international journals and societies in ecology and evolution. Specifically, we collated information on eligibility rules, assessment criteria and potential gender bias. Our results reveal that, overall, few awards foster equitable access and assessment. Although many awards now explicitly allow extensions of the eligibility period for substantial career interruptions, there is a general lack of transparency in terms of assessment and consideration of other differences in access to opportunities and resources among junior researchers. Strikingly, open science practices were mentioned and valued in only one award. By highlighting instances of desirable award characteristics, we hope this work will nudge award committees to shift from simple but non-equitable award policies and practices towards strategies enhancing inclusivity and diversity. Such a shift would benefit not only those at the early- and mid-career stages but the whole research community. It is also an untapped opportunity to reward open science practices, promoting transparent and robust science.

Desigualdades sociales relacionadas con la mortalidad por accidentes de tráfico / Social inequalities related to road traffic mortality

Objetivo: Sintetizar las desigualdades sociales relacionadas con la mortalidad por accidentes de tráfico reportadas en publicaciones científicas. Método: Se realizó una revisión exploratoria de la literatura siguiendo la guía PRISMA-ScR. Utilizando el vocabulario MesH se hizo una búsqueda sistemática de artículos publicados en inglés, portugués y español en las bases de datos EBSCO, Scielo, Scopus, Ovid y PubMed. Resultados: Se identificaron 47.790 registros en la búsqueda inicial, de los cuales 35 artículos cumplieron los criterios de selección. Nueve de cada diez publicaciones son de países de altos ingresos y existe un mayor interés en el análisis de la mortalidad en ocupantes y conductores de automotores. La mitad de las publicaciones utilizan la raza, la etnia y la geolocalización como variables de posición socioeconómica. Los artículos incluidos en esta revisión indican que las agrupaciones de personas de baja posición socioeconómica presentan una mayor mortalidad por accidentes de tránsito. Conclusiones: La mayor mortalidad por accidentes de tránsito se presenta en personas de baja posición socioeconómica, lo que sugiere el desarrollo de acciones de seguridad vial que estén vinculadas con otras agendas políticas a fin de reducir su incidencia para 2030. A pesar de que la mortalidad por accidentes de tránsito es mayor en los países de medianos y bajos ingresos, son pocas las publicaciones realizadas en ellos, por lo que se requiere fortalecer las capacidades de investigación en tales países.(AU)

Objective: To synthesize the social inequalities related to mortality from traffic accidents reported in scientific publications. Method: A scoping review following the PRISMA-ScR guide was carried out. Using the MesH vocabulary, we systematically searched for articles in English, Portuguese and Spanish published in the EBSCO, Scielo, Scopus, Ovid, and PubMed databases. Results: We identified 47,790 records in the initial search, of which 35 articles met the selection criteria. Nine out ten publications are in high-income countries; there is a greater interest in analyzing mortality in occupants and drivers of vehicles and motorcyclists. Half of the publications use race-ethnicity and geolocation as socioeconomic position variables. The articles included in this review indicate that groups of people with low socioeconomic positions have higher mortality due to traffic accidents. Conclusions: The highest mortality from traffic accidents occurs in people with low socioeconomic positions which suggests the development of road safety actions from a comprehensive, integrative perspective and linked to other political agendas to reduce their incidence by 2030. Although road traffic fatalities are higher in low and middle-income countries, few publications are available in these countries. It is necessary to strengthen the research capacities in these countries.(AU)

Clinical impact of del Nido cardioplegia in adult cardiac surgery: A prospective randomized trial.

OBJECTIVE: The study objective was to assess the benefits of del Nido cardioplegia compared with cold blood cardioplegia solution in terms of myocardial protection during adult cardiac surgery. METHODS: A total of 474 adult patients undergoing coronary artery bypass grafting, heart valve surgery, thoracic aortic surgery, or combined procedures were randomized to the del Nido cardioplegia group (n = 234) or the cold blood cardioplegia solution group (n = 240) after provided informed consent. The primary end points assessed inotropic support requirements, severe cardiovascular events, and troponin trend within the first 48 hours of intensive care unit stay. Reperfusion arrhythmias, aortic crossclamp and cardiopulmonary bypass times, and other clinical perioperative variables were considered as secondary end points. RESULTS: No statistically significant differences were found regarding postoperative inotropic support requirements or the incidence of severe cardiovascular events. The del Nido cardioplegia group showed a higher return to spontaneous sinus rhythm (P< .001), a lower number of defibrillation attempts (P< .001), and an earlier peak troponin value in the postoperative period. Peak blood glucose levels and intravenous insulin requirements were significantly lower in the del Nido cardioplegia group. We found no significant differences regarding aortic crossclamp or cardiopulmonary bypass time. We did observe a lower incidence of postoperative stroke in the del Nido cardioplegia group (2.6% vs 6.7%; P= .035). CONCLUSIONS: del Nido cardioplegia can be used safely and with comparable outcomes compared with traditional cardioplegia solutions. Additional advantages over glycemic control, reperfusion arrhythmias, and its comfortable redosing interval make del Nido an interesting alternative for myocardial protection in adult cardiac surgery. A significant decrease in postoperative stroke will require further research to shed light on the results of this study. VIDEO ABSTRACT.

Fighting Obesity-Related Micronutrient Deficiencies through Biofortification of Agri-Food Crops with Sustainable Fertilization Practices.

Obesity is a critical medical condition worldwide that is increasingly involved with nutritional derangements associated with micronutrient deficiencies, including iron, zinc, calcium, magnesium, selenium, and vitamins A, C, D, and E. Nutritional deficiencies in obesity are mainly caused by poor-quality diets, higher nutrient requirements, alterations in micronutrient metabolism, and invasive obesity treatments. The current conventional agricultural system is designed for intensive food production, focusing on food quantity rather than food quality, consuming excessive agricultural inputs, and producing nutrient-deficient foods, thus generating severe health and environmental problems; agricultural food products may worsen obesity-related malnutrition. Therefore, modern agriculture is adopting new biofortification technologies to combat micronutrient deficiencies and improve agricultural productivity and sustainability. Biofertilization and nanofertilization practices are increasingly used due to their efficiency, safety, and reduced environmental impact. Biofertilizers are preparations of PGP-microorganisms that promote plant growth by influencing plant metabolism and improving the nutrient uptake, and nanofertilizers consist of synthesized nanoparticles with unique physicochemical properties that are capable of increasing plant nutrition and enriching agricultural products. This review presents the current micronutrient deficiencies associated with obesity, the modern unsustainable agri-food system contributing to obesity progression, and the development of bio- and nanofertilizers capable of biofortifying agri-food crops with micronutrients commonly deficient in patients with obesity.