Efectos de la pandemia de COVID-19 sobre la salud mental de niños y adolescentes: revisión sistemática y meta-análisis / Effects of the covid-19 pandemic on the mental health of children and adolescents: systematic review and meta-analysis

Introducción: La enfermedad por COVID-19 ha afectado a millones de personas en todo el mundo y ha planteado un desafío sin precedentes a los sistemas de salud, provocando medidas como el distanciamiento social y el confinamiento domiciliario, que han afectado a la vida diaria y las relaciones sociales de la población. El objetivo principal de este artículo fue examinar las consecuencias de estas circunstancias en la salud mental infanto-juvenil. Método: Se realizó una revisión sistemática de la literatura científica disponible en PubMed, PsycINFO, Embase y ScinceDirect, de acuerdo con las recomendaciones de la Declaración PRISMA. La selección de los estudios se realizó en base a los siguientes criterios: estudios de investigación originales, con un diseño metodológico prospectivo, publicados a partir del año 2020 y que en sus resultados evaluaran mediante escalas niveles de depresión, estrés, ansiedad y/o problemas conductuales de la población infanto-juvenil durante la pandemia por SARS-CoV-2. Resultados: De los 334 estudios identificados, 14 cumplían los criterios establecidos para ser incluidos en esta revisión. Se agruparon los resultados en sintomatología internalizante y externalizante. En relación a la sintomatología internalizante, la diferencia de medias pre-post, analizada mediante la d de Cohen, fue de 0.172 (0.036; 0.308) siendo significativa (p = 0.0131). Por el contrario, no se objetivaron diferencias significativas en la sintomatología externalizante (p = 0.7314).Conclusiones: Durante la pandemia se observó un aumento de la sintomatología internalizante, pero no de la externalizante, en niños y adolescentes. Al mismo tiempo, se observaron variaciones que sugieren que el efecto podría estar modulado por factores individuales y contextuales.(AU)

Introduction: COVID-19 disease has affected millions of people worldwide and has posed an unprecedented challenge to health systems, leading to measures such as social distancing and home confinement that have affected the daily life and social relationships of the population. This article reviews the consequences of these circumstances on child and adolescent mental health. Methods: A systematic review of the scientific literature available in PubMed, PsycINFO, Embase and ScinceDirect was carried out, in accordance with the recommendations of the PRISMA Declaration. The selection of studies followed the following criteria: original research studies with a prospective methodological design published from the year 2020 and whose results evaluated levels of depression, stress, anxiety and/or behavioral problems in the child and adolescent population during the SARS-CoV-2 pandemic using clinical scales. Results: Of the 334 studies identified, 14 met the criteria established to be included in this review. Results were grouped into internalizing and externalizing symptomatology. In relation to internalizing symptomatology the mean difference pre-post analyzed using Cohen’s d was 0.172 (0.036; 0.308), which was significant (p = 0.0131). No significant differences were observed in externalizing symptomatology (p = 0.7314). Conclusions: During the pandemic an increase in internalizing symptoms was observed, but not in externalizing symptoms, in children and adolescents. Also were observed variations suggesting that the effect could be modulated by individual and contextual factors.(AU)

Cider apple pomace as a source of nutrients: Evaluation of the polyphenolic profile, antioxidant and fiber properties after drying process at different temperatures.

Apple pomace, the by-product of the cider industry, contains a high content of antioxidant compounds and dietary fiber. Drying would allow its preservation for a later use. The aim of this study was to evaluate the effect of the drying temperature on the drying kinetics, antioxidant properties and the fiber characteristics. For this, drying experiments were performed at different temperatures (40-120 °C). The increase in temperature enhanced the drying rate, as was shown by the effective diffusivity and mass transfer coefficient identified by modelling. The influence of temperature was quantified through the activation energy (38.21 kJ/mol). Regarding the retention of antioxidant properties, the best results were found at 80-100 °C while 40-60 °C was the best temperature range for the fiber characteristics. Therefore, 80 °C could be an adequate temperature for drying of cider apple pomace, as it represents a good balance between kinetics, and antioxidant and fiber properties.

[Emotion recognition rehabilitation combined with cognitive stimulation for people with Alzheimer's disease. Efficacy for cognition and functional aspects]. / Rehabilitacion del reconocimiento de emociones combinada con estimulacion cognitiva para personas con enfermedad de Alzheimer. Eficacia sobre aspectos cognitivos y funcionales.

INTRODUCTION: The ability to recognize facial emotional expression is essential for social interactions and adapting to the environment. Emotion recognition is impaired in people with Alzheimer's disease (AD), thus rehabilitation of these skills has the potential to elicit significant benefits. AIM: To assess the efficacy of a combined treatment of rehabilitation of emotion recognition (RER) and cognitive stimulation (CS) for people with AD, due to its potential implications for more effective psychosocial interventions. SUBJECTS AND METHODS: 36 patients were assigned to one of three experimental conditions: an experimental group (EG) that received 20 sessions of RER and 20 sessions of CS; a control group (CG) that received 40 sessions of CS, and a treatment as usual group (TAU). RESULTS: 32 patients completed the treatment (77.53 ± 5.43 years). Significant differences were found in MMSE30 (F = 5.10; p = 0.013), MMSE35 (F = 4.16; p = 0.026), affect recognition (Z = -2.81; p = 0.005) and basic activities of daily living (Z = -2.27; p = 0.018) favouring the efficacy of the combined treatment. The TAU group showed a decline in depression (Z = -1.99; p = 0.048), apathy (Z = -2.30; p = 0.022) and anosognosia (Z = -2.19; p = 0.028). CONCLUSIONS: The combined treatment of RER + CS was more effective than TAU and CS alone for the treatment of patients with AD. This is the first study about the rehabilitation of affect recognition in AD.

TITLE: Rehabilitacion del reconocimiento de emociones combinada con estimulacion cognitiva para personas con enfermedad de Alzheimer. Eficacia sobre aspectos cognitivos y funcionales.Introduccion. Se han encontrado deficits en el reconocimiento de emociones en personas con enfermedad de Alzheimer (EA), pero no se ha informado de ningun tratamiento rehabilitador de esta capacidad en esta poblacion. Objetivo. Evaluar la eficacia de un tratamiento combinado de rehabilitacion del reconocimiento de emociones (RRE) y estimulacion cognitiva (EsC) sobre las funciones cognitivas, el estado de animo, la anosognosia, la capacidad funcional y el reconocimiento de emociones de personas con EA. Sujetos y metodos. En un diseño cuasi experimental, 36 pacientes con EA fueron asignados a tres condiciones: un grupo experimental, que recibio 20 sesiones de RRE y 20 sesiones de EsC; un grupo control, que recibio 40 sesiones de EsC, y un grupo que recibio tratamiento usual (GTU). Resultados. Completaron el estudio 32 pacientes, con una edad media de 77,53 ± 5,43 años. Se observo mejoria en el Minimental State Examination en su version de 30 items (F = 5,10; p = 0,013) y en la de 35 (F = 4,16; p = 0,026), reconocimiento de afectos (Z = ­2,81; p = 0,005) y actividades basicas de la vida diaria (Z = ­2,27; p = 0,018) a favor del grupo experimental. El grupo que recibio tratamiento usual empeoro en depresion (Z = ­1,99; p = 0,048), apatia (Z = ­2,30; p = 0,022) y anosognosia (Z = ­2,19; p = 0,028). Conclusiones. El tratamiento combinado de RRE y EsC fue mas eficaz que la EsC y que el tratamiento usual. Es la primera vez que se informa de un tratamiento rehabilitador del reconocimiento de emociones en personas con EA.

Ultrasound-assisted extraction of hemicelluloses from grape pomace using response surface methodology.

An ultrasound-assisted procedure was applied to the extraction of hemicelluloses from grape pomace at a mild temperature (20°C). A Central composite design (CCD) was employed to optimize the ultrasound-assisted extraction (UAE) of hemicelluloses from grape pomace with the aim to maximize their extraction yield, and, also, the obtention of the main polymers forming this fraction: Xyloglucans (XLG), Mannans (MAN) and Xylans (XN). Extraction time (X1), solid:liquid ratio (X2) and KOH concentration (X3) were the variables used to optimize the process. The conditions that maximize (1) the extraction yield of hemicelluloses and the contents of (2) XLG, (3) MAN and (4) XN, were: (1) X1=2.6h; X2=1:48 (w/v); X3=0.4M, (2) X1=2.9h; X2=1:57 (w/v); X3=2.25M, (3) X1=2.7h; X2=1:58(w/v);X3=2.2M, and (4) X1=3h; X2=1:60 (w/v); X3=2.3M, respectively. Under these conditions, the maximum extraction yield of hemicelluloses, XLG, MAN and XN contents were: ∼7.9±0.2%, ∼3.6±0.02%, ∼1.1±0.04% and ∼1.2±0.02%, respectively. Close agreement between experimental and predicted values was found. The results suggest that the ultrasound-assisted extraction could be a good option for the extraction of hemicellulosic polysaccharides from grape pomace at industrial level.

Impact of applied ultrasonic power on the low temperature drying of apple.

Low temperature drying (LTD) allows high-quality dried products to be obtained, preserving the nutritional properties of fresh foods better than conventional drying, but it is a time-consuming operation. Power ultrasound (US) could be used to intensify LTD, but it should be taken into account that process variables, such as the level of applied power, have an influence on the magnitude and extension of the ultrasonic effects. Therefore, the aim of this work was to assess the influence of the level of applied ultrasonic power on the LTD of apple, analyzing the drying kinetics and the quality of the dried product. For that purpose, apple (Malus domestica cv. Granny Smith) cubes (8.8mm side) were dried (2m/s) at two different temperatures (10 and -10°C), without and with (25, 50 and 75 W) US application. In the dried apple, the rehydration kinetics, hardness, total phenolic content, antioxidant capacity and microstructure were analyzed to evaluate the impact of the level of applied ultrasonic power. At both temperatures, 10 and -10°C, the higher the ultrasonic power level, the shorter the drying time; the maximum shortening of the drying time achieved was 80.3% (at -10°C and 75 W). The ultrasonic power level did not significantly (p<0.05) affect the quality parameters analyzed. Therefore, US could be considered a non-thermal method of intensifying the LTD of fruits, like apple, with only a mild impact on the quality of the dried product.

Válvulas de uretra posterior de diagnóstico tardío / Late diagnosis of posterior urethral valves

Problema clínico: Diagnosticamos 8 pacientes de forma tardía de válvulas de uretra posterior (VUP) entre 1 y 14 años. Cinco pacientes consultaron por sintomatología relacionada con disfunción del vaciamiento vesical. Los otros 3 precisaron una uretrocistoscopia por otro motivo (fístula de hipospadias, dificultad de sondaje y RVU de alto grado), y al rehistoriar a los 2 primeros también presentaban sintomatología de disfunción de vaciado. Todos tenían ecografías preoperatorias: 3 fueron normales y 5 patológicas, con alteraciones a nivel renal o vesical. El diagnóstico se sospechó por cistouretrografía miccional seriada (CUMS) y 4 pacientes tenían estudios urodinámicos. El diagnóstico se confirmó por uretrocistoscopia, realizándose electrofulguración de las válvulas. Realizamos uretrocistoscopia de control a las 3-6 semanas sin observan ninguna estenosis. La sintomatología desapareció en el 100% de los pacientes tras 20 meses de seguimiento. El paciente con RVU se curó. Las ecografías no mostraron progresión de la afectación renal y presentaron mejoría de la afectación vesical. Las flujometrías de control mostraron curvas dentro de la normalidad. Discusión: La mayoría de los niños con VUP se diagnostican ecográficamente en el periodo neonatal. Algunos pacientes manifiestan las VUP a edades más tardías con clínica diversa, lo que dificulta su diagnóstico. Debemos sospecharlas en pacientes varones con síntomas de disfunción de vaciado, tanto si tienen ecografías o cistouretrografía miccional seriada normales o patológicas y recomendamos realizar uretrocistoscopia para descartar obstrucción uretral

Clinical problema: We diagnosed 8 patients with late-stage posterior urethral valves (PUV) between 1 and 14 years of age. Five patients complained of symptoms related to voiding dysfunction. The other 3 patients required urethrocystoscopy for other reasons (hypospadias fistulae, difficulty with catheterisation and high-grade vesicoureteral reflux [VUR]). A second review of the first 2 patients’ medical history showed voiding dysfunction symptoms. All patients underwent preoperative ultrasonography: 3 patients had normal results and 5 had renal or vesical disorders. The diagnosis was reached through voiding cystourethrogram (VCUG), and 4 patients underwent urodynamic studies. The diagnosis was confirmed by urethrocystoscopy, performing valve electrofulguration. We performed urethrocystoscopy during the check-ups at 3-6 weeks and observed no stenosis. The symptoms disappeared for all patients after 20 months of follow-up. The patient with VUR was cured. The ultrasounds showed no progression of the renal involvement and showed improvement in the vesical involvement. The velocimetries during check-ups presented curves within normal ranges. Discussion: Most children with PUV are diagnosed through ultrasound during the neonatal period. Some patients present PUV at later ages with diverse symptoms, which impedes its diagnosis. We should suspect PUV in male patients with symptoms of voiding dysfunction, either when they have normal or pathological results from ultrasounds or VCUG. We recommend performing urethrocystoscopy to rule out urethral obstruction

Late diagnosis of posterior urethral valves.

CLINICAL PROBLEM: We diagnosed 8 patients with late-stage posterior urethral valves (PUV) between 1 and 14 years of age. Five patients complained of symptoms related to voiding dysfunction. The other 3 patients required urethrocystoscopy for other reasons (hypospadias fistulae, difficulty with catheterisation and high-grade vesicoureteral reflux [VUR]). A second review of the first 2 patients' medical history showed voiding dysfunction symptoms. All patients underwent preoperative ultrasonography: 3 patients had normal results and 5 had renal or vesical disorders. The diagnosis was reached through voiding cystourethrogram (VCUG), and 4 patients underwent urodynamic studies. The diagnosis was confirmed by urethrocystoscopy, performing valve electrofulguration. We performed urethrocystoscopy during the check-ups at 3-6 weeks and observed no stenosis. The symptoms disappeared for all patients after 20 months of follow-up. The patient with VUR was cured. The ultrasounds showed no progression of the renal involvement and showed improvement in the vesical involvement. The velocimetries during check-ups presented curves within normal ranges. DISCUSSION: Most children with PUV are diagnosed through ultrasound during the neonatal period. Some patients present PUV at later ages with diverse symptoms, which impedes its diagnosis. We should suspect PUV in male patients with symptoms of voiding dysfunction, either when they have normal or pathological results from ultrasounds or VCUG. We recommend performing urethrocystoscopy to rule out urethral obstruction.

Effect of power ultrasound application on aqueous extraction of phenolic compounds and antioxidant capacity from grape pomace (Vitis vinifera L.): experimental kinetics and modeling.

The kinetics of both conventional (mechanical stirring, 200rpm) and acoustic (55±5kHz, 435±5W/L) aqueous extraction of total phenolic content and antioxidant capacity from grape pomace by-products (Vitis vinifera L.) have been experimentally evaluated and modeled at different extraction temperatures (20, 35 and 50°C). A gradual and significant increase of total phenolic content and antioxidant capacity of the extracts was observed as the temperature increased, the highest values being obtained in the case of the extraction assisted acoustically. According to the results, the acoustic assistance of the extraction process led to aqueous extracts with phenolic and antioxidant characteristics similar to those obtained with mechanical stirring, working under lower temperature conditions and during less operating time. Specifically, the conventional extraction of total phenolics at 35 and 50°C did not differ significantly from extractions assisted with power ultrasound at 20 and 35°C, respectively; and the acoustic process required approximately 3, 4 and 8 times less time, at 20, 35 and 50°C, than the conventional extraction to obtain extracts with similar characteristics. The extraction curves obtained for total phenolic content and antioxidant capacity, measured by the ABTS and FRAP methods, were properly represented by a modified Weibull model for both conventional and acoustic extractions within the temperature range 20-50°C, presenting an average percentage of explained variance⩾97.9%, and an average mean relative error⩽7.0%. A high correlation (r(2)⩾0.992) was observed between the experimental and simulated values for all the quality attributes in study.

Ultrasound-assisted extraction of pectins from grape pomace using citric acid: a response surface methodology approach.

An ultrasound-assisted procedure for the extraction of pectins from grape pomace with citric acid as the extracting agent was established. A Box-Behnken design (BBD) was employed to optimize the extraction temperature (X1: 35-75°C), extraction time (X2: 20-60 min) and pH (X3: 1.0-2.0) to obtain a high yield of pectins with high average molecular weight (MW) and degree of esterification (DE) from grape pomace. Analysis of variance showed that the contribution of a quadratic model was significant for the pectin extraction yield and for pectin MW whereas the DE of pectins was more influenced by a linear model. An optimization study using response surface methodology was performed and 3D response surfaces were plotted from the mathematical model. According to the RSM model, the highest pectin yield (∼32.3%) can be achieved when the UAE process is carried out at 75°C for 60 min using a citric acid solution of pH 2.0. These pectic polysaccharides, composed mainly by galacturonic acid units (<97% of total sugars), have an average MW of 163.9 kDa and a DE of 55.2%. Close agreement between experimental and predicted values was found. These results suggest that ultrasound-assisted extraction could be a good option for the extraction of functional pectins with citric acid from grape pomace at industrial level.

Effects of supercritical carbon dioxide (SC-CO(2)) oil extraction on the cell wall composition of almond fruits.

Extraction of oil from almond fruits using supercritical carbon dioxide (SC-CO(2)) was carried out at 50 degrees C and 330 bar on three sets of almonds: raw almond seeds, raw almond kernels, and toasted almond seeds. Three different oil extraction percentages were applied on each set ranging from approximately 15 to 16%, from approximately 27 to 33%, and from approximately 49 to 64%. Although no major changes were detected in the fatty acid composition between fresh and partially defatted samples, carbohydrate analysis of partially defatted materials revealed important changes in cell wall polysaccharides from almond tissues. Thus, at low extraction percentages (up to approximately 33%), pectic polysaccharides and hemicellulosic xyloglucans were the main type of polymers affected, suggesting the modification of the cell wall matrix, although without breakage of the walls. Then, as supercritical fluid extraction (SCFE) continues and higher extraction rates are achieved (up to approximately 64%), a major disruption of the cell wall occurred as indicated by the losses of all major types of cell wall polysaccharides, including cellulose. These results suggest that, under the conditions used for oil extraction using SC-CO(2), fatty acid chains are able to exit the cells through nonbroken walls; the modification of the pectin-hemicellulose network might have increased the porosity of the wall. However, as high pressure is being applied, there is a progressive breakage of the cell walls allowing the free transfer of the fatty acid chains from inside the cells. These findings might contribute to providing the basis for the optimization of SCFE procedures based on plant food sources.

Effects of Drying Pretreatments on the Cell Wall Composition of Grape Tissues.

Pretreatments by consecutive dipping in NaOH, citric acid, and K(2)S(2)O(5) solutions help to increase the drying rate of grapes and to reduce the darkening due to enzymic and nonenzymic browning during storage of raisins. However, such pretreatments have also an important effect on the cell wall composition of grape tissues. In both skin and pulp tissues the yield of cell wall material decreased substantially with processing, by 19.7 and 22.5%, respectively. Sodium hydroxide and citric acid solutions solubilized large amounts of pectic substances and xyloglucans, whereas potassium metabisulfite solution caused minor modifications to the composition of cell wall polysaccharides. Moreover, drying pretreatments promoted important changes in the amounts of Ca and Mg associated with cell wall components, which suggested possible structural rearrangements of polymers within the wall. All of these observations were in good agreement with the main results obtained after the application of a nondegradative technique such as FTIR spectroscopy to the cell wall preparations of fresh and processed tissues.