High prevalence of chronic malnutrition in indigenous children under 5 years of age in Chimborazo-Ecuador: multicausal analysis of its determinants.

BACKGROUND: Despite the multiple initiatives implemented to reduce stunting in Ecuador, it continues to be a public health problem with a significant prevalence. One of the most affected groups is the rural indigenous population. This study aimed to analyze the prevalence of chronic malnutrition in indigenous children under 5 years of age and its association with health determinants, focusing on one of the territories with the highest prevalence of stunting. METHODS: A cross-sectional study in 1,204 Kichwa indigenous children under the age of five, residing in rural areas of the counties with the highest presence of indigenous in the province of Chimborazo-Ecuador. A questionnaire on health determinants was applied and anthropometric measurements were taken on the child and the mother. Stunting was determined by the height-for-age z-score of less than 2 standard deviations, according to the World Health Organization´s parameters. Data were analyzed using bivariate and multivariate Poisson regression. RESULTS: 51.6% (n = 646) of the children are stunted. Height-for-age z-scores were significantly better for girls, children under 12 months, families without overcrowding, and families with higher family income. The variables that were significantly and independently associated with stunting were: overcrowding (PR 1.20, 95% CI 1-1.44), the mother required that the father give her money to buy medicine (PR 1.33, 95% CI 1.04-1.71), the father did not give her money to support herself in the last 12 months (1.58, 95% CI 1.15-2.17), mother's height less than 150 cm (PR 1.42, 95% CI 1.19-1.69) and the child was very small at birth (PR 1.75, 95% CI 1.22-2.5). CONCLUSION: One out of every two rural indigenous children included in this study is stunted. The high prevalence of stunting in the indigenous and rural population is multicausal, and requires an intersectoral and multidisciplinary approach. This study identified three fundamental elements on which public policy could focus: (a) reduce overcrowding conditions, improving economic income in the rural sector (for example, through the strengthening of agriculture), (b) provide prenatal care and comprehensive postnatal care, and (c) promote strategies aimed at strengthening the empowerment of women.

Digital health literacy and subjective wellbeing in the context of COVID-19: A cross-sectional study among university students in Ecuador.

Background: The COVID-19 pandemic has generated an avalanche of information, which, if not properly addressed, generates uncertainty and limits healthy decision-making. On the other hand, the pandemic has exacerbated mental health problems among young people and adolescents, causing a worsening of their wellbeing. Previous studies have found that digital health literacy has a positive impact on people's attitudes toward the disease. This study aimed to analyze the association between digital health literacy on COVID-19 with subjective wellbeing in university students. Methods: A cross-sectional study was developed in 917 students from Ecuador. Subjective wellbeing was measured with the World Health Organization WellBeing Scale. Digital health literacy was assessed using the Spanish-translated version of the Digital Health Literacy Instrument adapted to the context of the COVID-19 pandemic. Bivariate and multivariate linear regressions were performed. Results: Digital health literacy and subjective wellbeing proofed to be significantly higher among males and among students with higher social status. The association between digital health literacy and subjective wellbeing was significant; for each increase of one point in the digital health literacy scale, an average increase of 9.64 points could be observed on the subjective wellbeing scale (IC 95% 5.61 - 13.67, p-value <0.001). This correlation persisted after adjust by demographic and socioeconomic variables. Conclusion: Improving digital health literacy in health would improve the subjective wellbeing of university students. It is suggested strengthen the digital health literacy through public and university policies that promote access, search skills and discernment of digital information. Socioeconomic and gender inequalities related to digital health literacy need to be further investigated.

Perceived Discrimination and Psychological Distress: A Survey of Filipinx Americans in Massachusetts during the COVID-19 Pandemic.

The onset of the COVID-19 pandemic has led to an upsurge of discrimination against Asian American populations, and Filipinx Americans (FA) have reported high cases of perceived discrimination. Prior studies have shown a relationship between experiences of discrimination and poor mental health. The purpose of this study was to examine the association of perceived discrimination and psychological distress among FA living in Massachusetts from a survey collected during the COVID-19 pandemic (N = 133). Multiple regression analysis revealed that experiences of perceived discrimination were associated with psychological distress. Older participants were less likely to report psychological distress. Compared to men, womxn were more likely to report psychological distress. Our findings highlight the potential mental health consequences of perceived discrimination experienced by FA, which may have been exacerbated during the COVID-19 pandemic.

Capital social y malnutrición en población indígena menor de 5 años de cinco cantones de la provincia de Chimborazo / Social capital and malnutrition in the indigenous population under 5 years of age in five cantons of the province of Chimborazo

Introducción: El capital social (CS) incluye varios componentes de la organización social, que podrían mejorar la situación de salud. Existe poca información sobre su asociación con la Desnutrición Crónica (DC). Metodología: El presente estudio transversal analítico fue realizado en los cantones de Riobamba, Alausí, Guamote, Guano y Colta en el periodo 2018-2019. Con una muestra probabilística mediante encuestas a madres/cuidadores se determinó el CS, determinantes de la salud, y mediciones antropométricas. El análisis de datos se realizó mediante regresión bivariada y multivariada, con cálculo de Odds e intervalos de confianza al 95 %, se consideró significativo un valor de p menor a 0.05, se utilizó el software SPSS versión 25.0. Resultados: Se estudiaron 1228 niños, el 50.5% (n = 620) hombres y 49.5% (n= 680) mujeres. Con DC el 52.6% (n = 326) de los hombres y el 46.7% (n = 284) de las mujeres. Los hijos cuyos padres no han escuchado hablar sobre desnutrición infantil presentaron un OR 1.46 (IC95%=1.13-1.9) para el desarrollo de DC. Esta asociación se mantuvo significativa después del ajuste por sexo, edad del niño/a, número de hijos e ingresos económicos. Conclusiones: La asociación entre el CS y la DC en la población indígena menor de 5 años de la provincia de Chimborazo se observó en la falta de información sobre nutrición infantil.

Introduction: Social capital (SC) includes several components of social organization, which could improve the health situation. There is little information on its association with chronic malnutrition. Methods: Cross-sectional and analytical study in 1228 indigenous children under 5 years of age from the Riobamba, Alausí, Guamote, Guano and Colta cantons, in the province of Chimborazo. Surveys were conducted with mothers / caregivers on SC, to assess the dimensions: trust and solidarity, collective action and cooperation, information, communication and social cohesion. Anthropometric measurements were made to the children to determine chronic malnutrition. Data analysis was performed using bivariate and multivariate regression, with calculation of Odds Ratio and 95% confidence intervals, a value of p less than 0.05 was considered significant. SPSS software version 25.0 was used. Results: 50.5% (n = 620) of the children studied were men and 49.5% (n = 680) were women. 52.6% (n = 326) of men and 46.7% (n = 284) of women presented chronic malnutrition. Children whose parents have not heard about child malnutrition were 1.46 (95% CI = 1.13-1.9) times more likely to have chronic malnutrition compared to those who did. This association remained significant after adjusting for sex, age of the child, number of children, and income. Conclusions: The association between CS and chronic malnutrition in the indigenous population under 5 years of age in the province of Chimborazo was observed in the lack of information on child nutrition

Evaluación de umbrales mínimos de celularidad en unidades de sangre de cordon umbilical en el Instituto Nacional Materno Perinatal del Perú / Evaluation of minimum thresholds of cellularity in units of umbilical cord blood at Instituto Nacional Materno Perinatal in Peru

RESUMEN Con el objetivo de evaluar criterios mínimos de celularidad de las unidades de sangre de cordón umbilical (USCU) según los estándares NETCORD en el Instituto Nacional Materno Perinatal de Lima, Perú, se realizó un estudio transversal que incluyó 100 USCU; se determinó el volumen, el recuento de células nucleadas totales (CNT) por hematología y el número de células CD34+ totales, así como también la viabilidad celular, por citometría de flujo. Se encontró que el 56% de las USCU no cumplen los umbrales mínimos de celularidad para ser criopreservadas en un banco de sangre de cordón umbilical. Se encontró, además, que las USCU de recién nacidos de mayor peso y de sexo femenino presentan mayor volumen y recuentos de células. En conclusión, es necesario considerar estas variables para optimizar la colecta de las USCU y obtener mayores recuentos de células que permita almacenar unidades de alta calidad en un futuro banco de sangre de cordón umbilical en Perú.

ABSTRACT A cross-sectional study that included 100 units of umbilical cord blood (UCB) was conducted to evaluate the minimum criteria of cellularity in UCB units, according to NetCord standards at Instituto Nacional Materno Perinatal in Lima, Peru. The volume, total count of nucleated cells by hematological tests and total number of CD34+ as well as cell viability by flow cytometry were determined. The study revealed that 56% of UCB units do not fulfill the minimum criteria of cellularity to be cryopreserved in an umbilical cord blood bank. Furthermore, the UCB units of newborns who weighed more and were female had a higher volume and cell count. In conclusion, these variables must undoubtedly be considered to optimize the collection of UCB units and obtain greater cell counts that enable the storage of high-quality units in a future umbilical cord blood bank in Peru.

Treatment With Human Wharton's Jelly-Derived Mesenchymal Stem Cells Attenuates Sepsis-Induced Kidney Injury, Liver Injury, and Endothelial Dysfunction.

UNLABELLED: : The pathophysiology of sepsis involves complex cytokine and inflammatory mediator networks. Downregulation of endothelial nitric oxide synthase contributes to sepsis-induced endothelial dysfunction. Human Wharton's jelly-derived mesenchymal stem cells (WJ-MSCs) are known to reduce expression of proinflammatory cytokines and markers of apoptosis. We hypothesized that treatment with WJ-MSCs would protect renal, hepatic, and endothelial function in a cecal ligation and puncture (CLP) model of sepsis in rats. Rats were randomly divided into three groups: sham-operated rats; rats submitted to CLP and left untreated; and rats submitted to CLP and intraperitoneally injected, 6 hours later, with 1 × 10(6) WJ-MSCs. The glomerular filtration rate (GFR) was measured at 6 and 24 hours after CLP or sham surgery. All other studies were conducted at 24 hours after CLP or sham surgery. By 6 hours, GFR had decreased in the CLP rats. At 24 hours, Klotho renal expression significantly decreased. Treatment with WJ-MSCs improved the GFR; improved tubular function; decreased the CD68-positive cell count; decreased the fractional interstitial area; decreased expression of nuclear factor κB and of cytokines; increased expression of eNOS, vascular endothelial growth factor, and Klotho; attenuated renal apoptosis; ameliorated hepatic function; increased glycogen deposition in the liver; and improved survival. Sepsis-induced acute kidney injury is a state of Klotho deficiency, which WJ-MSCs can attenuate. Klotho protein expression was higher in WJ-MSCs than in human adipose-derived MSCs. Because WJ-MSCs preserve renal and hepatic function, they might play a protective role in sepsis. SIGNIFICANCE: Sepsis is the leading cause of death in intensive care units. Although many different treatments for sepsis have been tested, sepsis-related mortality rates remain high. It was hypothesized in this study that treatment with human Wharton's jelly-derived mesenchymal stem cells (WJ-MSCs) would protect renal, hepatic, and endothelial function in a model of sepsis in rats. Treatment with WJ-MSCs improved the glomerular filtration rate, improved tubular function, decreased expression of nuclear factor κB and of cytokines, increased expression of eNOS and of Klotho, attenuated renal apoptosis, and improved survival. Sepsis-induced acute kidney injury is a state of Klotho deficiency, which WJ-MSCs can attenuate.

[Evaluation of minimum thresholds of cellularity in units of umbilical cord blood at Instituto Nacional Materno Perinatal in Peru]. / Evaluación de umbrales mínimos de celularidad en unidades de sangre de cordon umbilical en el Instituto Nacional Materno Perinatal del Perú.

A cross-sectional study that included 100 units of umbilical cord blood (UCB) was conducted to evaluate the minimum criteria of cellularity in UCB units, according to NetCord standards at Instituto Nacional Materno Perinatal in Lima, Peru. The volume, total count of nucleated cells by hematological tests and total number of CD34+ as well as cell viability by flow cytometry were determined. The study revealed that 56% of UCB units do not fulfill the minimum criteria of cellularity to be cryopreserved in an umbilical cord blood bank. Furthermore, the UCB units of newborns who weighed more and were female had a higher volume and cell count. In conclusion, these variables must undoubtedly be considered to optimize the collection of UCB units and obtain greater cell counts that enable the storage of high-quality units in a future umbilical cord blood bank in Peru.

[Reference intervals for peripheral blood lymphocyte subsets in healthy adults in Lima, Peru]. / Intervalos de referencia de subpoblaciones linfocitarias de sangre periférica en adultos sanos de Lima, Perú

In order to establish the reference intervals (RIs) of peripheral blood lymphocyte subsets (PBL) in healthy adults in Lima (Peru), a cross-sectional study was conducted among blood donors taken in between 2011 and 2012. Based on the criteria obtained from the guidelines of the Clinical and Laboratory Standards Institute (CLSI C28-A3), 318 samples were processed, 61.9% (197/318) coming from male donors. For PBL count, a flow cytometer with a simple platform was used. The RIs are established for each PBL in adults based on sex with their respective reference limits and 90% confidence intervals. Differences were found in CD3+ percentage counts (p=0.001) and in CD3-CD56+ absolute (p=0.003) and percentage counts (p?0.001). The RIs found are different to those described in studies conducted in other countries due to the characteristics of the population and the study model.

Intervalos de referencia de subpoblaciones linfocitarias de sangre periférica en adultos sanos de Lima, Perú / Reference intervals for peripheral blood lymphocyte subsets in healthy adults in Lima, Peru

Con el objetivo de establecer los Intervalos de Referencia (InR) de las subpoblaciones linfocitarias (SPL) de sangre periférica en adultos sanos de Lima (Perú), se realizó un estudio transversal en donantes de sangre captados entre el 2011-2012. Siguiendo criterios basados en las directrices del Clinical and Laboratory Standards Institute (CLSI C28-A3), se procesaron 318 muestras, el 61,9% (197/318) de ellas procedentes de donantes de sexo masculino. Para el recuento de las SPL se empleó un citómetro de flujo de plataforma simple. Se establecieron los InR de cada SPL en personas adultas según sexo con sus respectivos límites de referencia y sus intervalos de confianza al 90%. Se encontraron diferencias en los recuentos porcentuales de CD3+ (p<0,01); y en los recuentos absolutos (p<0,01) y porcentuales (p=0,01) de CD3-CD56+. Los InR hallados son diferentes a los descritos en estudios realizados en otros países. Dichas diferencias se deben a las características de la población y al modelo de estudio.

In order to establish the reference intervals (RIs) of peripheral blood lymphocyte subsets (PBL) in healthy adults in Lima (Peru), a cross-sectional study was conducted among blood donors taken in between 2011 and 2012. Based on the criteria obtained from the guidelines of the Clinical and Laboratory Standards Institute (CLSI C28-A3), 318 samples were processed, 61.9% (197/318) coming from male donors. For PBL count, a flow cytometer with a simple platform was used. The RIs are established for each PBL in adults based on sex with their respective reference limits and 90% confidence intervals. Differences were found in CD3+ percentage counts (p=0.001) and in CD3-CD56+ absolute (p=0.003) and percentage counts (p?0.001). The RIs found are different to those described in studies conducted in other countries due to the characteristics of the population and the study model.