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A randomized, double-blind and controlled study was conducted to assess the effectiveness of the intake of 250 mL of lactose-free skimmed milk enriched with ashwagandha (Withania somnifera) alone or combined with tryptophan vs. non-enriched milk (control) on the subjective quality of sleep in healthy adults with sleep problems. The duration of supplementation was 90 days. Fifty-two eligible subjects were assigned to the study arms of ashwagandha 250 mg, ashwagandha 250 mg plus tryptophan 175 mg, ashwagandha 600 mg, and control with 13 subjects in each group. It was hypothesized that ashwagandha plus tryptophan could be superior to ashwagandha alone for improving sleep-related variables. Changes in the visual analogue scale (VAS) for sleep quality were significantly higher in the three experimental groups as compared with controls (p = 0.014). Improvements in the subscales of the Pittsburg Sleep Quality Index (PSQI) were found in all groups, but between-group differences were not significant. In the index of insomnia severity, decreases were higher in the three experimental groups as compared with controls especially in the group of ashwagandha 600 mg. Daytime somnolence was also reduced in the three experimental groups. Changes in anxiety levels and Morningness–Eveningness Questionnaire were not observed. The study products did not elicit changes in body composition and were well tolerated and safe. The data did not support the hypothesis, as the combination of ashwagandha and tryptophan did not show greater benefits in improving sleep quality than ashwagandha alone. However, the results from the three experimental groups containing ashwagandha were more favorable compared to the placebo group.

A single-center, randomized, double-blind, and placebo-controlled clinical trial assessed the efficacy in improving body composition and in weight management of a dietary supplement consisting of 400 mg of a standardized extract of the persimmon fruit (Diospyros kaki L.f.) in adult subjects with a BMI between 25 and 34.99 kg/m2 administered for 120 consecutive days. In total, 36 participants were assigned to the placebo group and 35 to the experimental group (registered at ClinicalTrials.gov (NCT05750342)). Primary analysis focused on overweight subjects (placebo, n = 26; experimental, n = 23). In this group, fat mass expressed in kg and percentage evaluated by both dual-energy X-ray absorptiometry (DEXA) and bioelectrical impedance analysis (BIA) decreased significantly (between-group differences p < 0.001) in those receiving the persimmon extract as compared with the placebo. No significant reduction in lean mass was observed, suggesting that the muscle mass was maintained during fat loss. The use of the investigational product improved classic anthropometric parameters to a statistically significantly greater extent than the placebo, including body weight, BMI, and waist and abdominal circumference (p < 0.001), in the overweight group. In the overall population, similar improvements were observed, with significant between-group differences (p < 0.001) in fat mass reduction and improvements in body composition. Changes in the biochemical lipidic, glycemic, and anti-inflammatory profile were not found, except for between-group significant differences (p < 0.001) in decreases in tumor necrosis factor-alpha (TNFα) and increases in total antioxidant capacity (TAC) in favor of the experimental condition. There was a significant increase in fecal fat excretion in the experimental group at the end of the study in subjects with low fecal fat (9%) at baseline. Consumption of the investigational product vs. placebo improved the quality of life, with significantly greater scores in the total score and the mental health component of the SF-12 questionnaire. The persimmon extract was safe and well tolerated.

We are a group of 11 women in Albuquerque, New Mexico. Nine of us are immigrants from Mexico. One of us is from an immigrant household. One of us is neither. We have been working collaboratively on a research study called Tertulias (Spanish for “ a social gathering ”), which is an innovative women’s peer support group approach we created to reduce social isolation, depression, and stress among women immigrants from Mexico, and to increase their resilience and sense of empowerment. In the process of implementing the Tertulias study, we are revealing the profound power of peer support, friendship, and small, quotidian kindnesses. But we are also exposing the immensity and scope of trauma, fear, loneliness, depression, and self-blame that exist in the Mexican immigrant community because of domestic violence. Our experience with domestic violence and with the consciousness-raising and support we found in Tertulias has made us want to be involved in a positive manner to do something about this issue in our community. We want our experience to mean something—to be used to make a difference. We are opening our hearts and sharing our stories and ideas. We wanted to be included as co-authors of this article because we want our stories to be received and heard by other women. We want to plant seeds to help other women find their inner strength to be able to escape from their chains. We have to return for others. It is a commitment—to understand how we were able to do it and share that with others. Through our experience participating in Tertulias , we learned that we could overcome what felt overwhelming and impenetrable. We could leave the violence and rediscover and recreate ourselves and our lives.

Este texto busca dilucidar la noción de identidad asociada al urbanismo y la relaciona de forma directa con el concepto de sistema patrimonial, integrando diversos componentes de este último como factores clave para soportar una propuesta metodológica de lectura integral del territo­rio, la cual relaciona el tiempo y el espacio como ejes determinantes. Una nueva visión sobre el concepto de patrimonio, alejada de una concepción monumental, requiere necesariamente nuevas formas de leerlo, observarlo, rastrearlo y documentarlo. Los elementos característicos de la identidad que expone este texto, permiten una búsqueda objetiva de las huellas, hechos, símbolos y manifestaciones que, más allá de las declaratorias institucionales del patrimonio, legitiman una relación cultural de una comunidad con su territorio y se concretan como ma­nifestación, evidencia y consolidación del paso del tiempo en el sistema patrimonial.

Rehabilitation is a discipline increasingly growing around the world due to several reasons, but probably the most important one is aging population and chronicity. A need to harmonize education has been identified, and although several International organizations such as the European Union of Medical Specialists (UEMS) and the International Society of Physical Medicine and Rehabilitation (ISPRM) have defined standards, given the quick growth of new evidence and assessment methods an urge to establish new ones arises. Functional assessment and tools used to do so are key in rehabilitation processes. This comprises self-reported questionnaires, conventional clinical evaluation but more notably high technology assessment methods, such as movement analysis systems, posturography, different types of dynamometers and kinesiologic electromyography among others. More recently, a wide range of wearable systems has been introduced in patient assessment. This is generating many published protocols as well as reliability and validity studies. The objective of this narrative review is to present main assessment technologies relevant to rehabilitation, its situation of this specific area in pre-graduate and post-graduate rehabilitation educational programs, and to elaborate a formative proposal including technological foundations of assessment and also highlighting the importance of solid reliability and validity of assessment methods comprehension. The main objective of this proposal is to provide basic knowledge about rehabilitation and methodologies for outcomes evaluation, including new technologies, to all health professionals, but especially to those who work or will work in the field of Rehabilitation.

There is an urgent need to strengthen the implementation of the 3Rs principle (Replacement, Reduction and Refinement) in the use of experimental animals in toxinological research and in the assessment of the neutralizing efficacy of snake antivenoms. This is a challenging task owing to the inherent complexity of snake venoms. The state of the art on this topic is hereby reviewed, with emphasis on the studies in which a correlation has been observed between in vivo toxicity tests and in vitro surrogate assays, particularly in the study of lethal activity of venoms and its neutralization. Correlations have been described with some venoms-antivenoms when using: (a) enzyme immunoassays, (b) hemagglutination, (c) enzyme assays (proteinase, phospholipase A2), (d) in vitro coagulant effect on plasma, (e) cell culture assays for cytotoxicity, (f) functional assays for assessing neurotoxicity in vitro, (g) use of hens’ eggs, and (h) antivenomics. Additionally, the routine introduction of analgesia in these assays and the design of more ‘humane’ protocols for the lethality test are being pursued. It is expected that the next years will witness a growing awareness of the relevance of the 3Rs principles in antivenom testing, and that new in vitro alternatives and more ‘humane’ experimental designs will emerge in this field.

Considering the importance of the diseases affecting the productive performance of animals in the dairy industry worldwide, it is necessary to implement tools that help to control and limit the occurrence of such diseases. As the increased somatic cell counts (SCC) are a direct expression of the inflammatory process, they are candidates to become the usual parameter for assessing udder health regarding milk quality and for monitoring mastitis incidences. Toll-Like Receptors are membrane proteins that play a key role in immunity, recognizing pathogens and, subsequently, activating immune responses. The present study was conducted to identify single nucleotide polymorphisms in the TLR4 gene of buffaloes and to analyze its associations with somatic cell counts. DNA samples of 120 Murrah buffaloes were used. The whole coding region of the TLR4 gene was amplified by polymerase chain reaction reactions and sequenced for polymorphism scanning. A total of 13 polymorphisms were identified for the sequenced regions of the TLR4, most of which are in the coding region. The association with the somatic cell score was highly significant (p < 0.001) for all identified polymorphisms of TLR4 gene (g.54621T>A, g.54429G>T, g.54407T>A, g.46616C>A, g.46613T>G, g.46612A>G, g.46611C>A, g.46609T>G, g.46541C>G, g.46526C>A, g.46516T>C, g.46376C>T, g.46372T>C). Therefore, it is suggested that the markers of the TLR4 gene can be used as molecular markers for mastitis resistance in buffaloes, due to their association with somatic cell counts.

Traditional selection programs for dairy cattle, based on quantitative principles, have worked well and allowed strong selection processes in the world over many decades. The objectives of this work were to estimate linkage disequilibrium (LD) levels at varying SNPs densities, to evaluate the effective population size of Holstein cattle, to characterize runs of homozygosity (ROH) distribution through Holstein cattle from Nariño and, to estimate and compare inbreeding coefficient (F) based on genomic markers information, runs of homozygosity (FROH), genomic relationship matrix (FGRM), and excess of homozygous (FSNP). After quality control, the dataset used was composed of 606 Holstein animals and 22200 SNP markers. PLINK program was used to identify LD, Ne, ROH segment and FROH and FSNP, FGRM was calculated with BLUPF90 family of programs. The average of r2 in all chromosomes was 0.011, the highest r2 was found in BTA3 (0.0323), and the lowest in BTA12 (0.0039). 533 ROH segments were identified in 319 animals; findings obtained in this study suggest that on average 0,28% of Holstein genome is autozygous. Total length of ROH was composed mostly of small segments (ROH1-4Mb and ROH4-8Mb). These segments accounted for approximately 96%, while larger ROH (ROH>8Mb) were 3.37% of all ROH detected. Inbreeding averages FROH, FSNP and FGRM methodologies were 0.28%, 3.11% and 3.36% respectively. The Pearson’s correlation among these different F values was: 0.49 (FROH-FSNP), 0.25 (FROH-FGRM), 0.22 (FSNP-FGRM). The distribution of ROH shared regions identified on 19 autosome chromosomes, cover a relevant number of genes inside these ROH. Our result evidenced lowest LD extension levels compared with other Holstein populations; inbreeding results suggest that FGRM and FSNP may be useful estimators of individual autozygosity in Holstein from Colombia. Genes related with production and reproduction were found, but the most important are the two that may be related to adaptation to Colombian high tropics. This work is a pioneer and be the starting point for programs of genetic improvement and genomic population studies in the country and mainly in high tropic areas where the dairy breeds have an important production.

Introduction In the USA, transgender women are among the most vulnerable to HIV. In particular, transgender women of colour face high rates of infection and low uptake of important HIV prevention tools, including pre-exposure prophylaxis (PrEP). This paper describes the design, sampling methods, data collection and analyses of the TURNNT (‘Trying to Understand Relationships, Networks and Neighbourhoods among Transgender women of colour’) study. In collaboration with communities of transgender women of colour, TURNNT aims to explore the complex social and environmental (ie, neighbourhood) structures that affect HIV prevention and other aspects of health in order to identify avenues for intervention.Methods and analyses TURNNT is a prospective cohort study, which will recruit 300 transgender women of colour (150 Black/African American, 100 Latina and 50 Asian/Pacific Islander participants) in New York City. There will be three waves of data collection separated by 6 months. At each wave, participants will provide information on their relationships, social and sexual networks, and neighbourhoods. Global position system technology will be used to generate individual daily path areas in order to estimate neighbourhood-level exposures. Multivariate analyses will be conducted to assess cross-sectional and longitudinal, independent and synergistic associations of personal relationships (notably individual social capital), social and sexual networks, and neighbourhood factors (notably neighbourhood-level social cohesion) with PrEP uptake and discontinuation.Ethics and dissemination The TURNNT protocol was approved by the Columbia University Institutional Review Board (reference no. AAAS8164). This study will provide novel insights into the relationship, network and neighbourhood factors that influence HIV prevention behaviours among transgender women of colour and facilitate exploration of this population’s health and well-being more broadly. Through community-based dissemination events and consultation with policy makers, this foundational work will be used to guide the development and implementation of future interventions with and for transgender women of colour.

Introducción: Se ha documentado que implementar programas de actividades recreativas durante las sesiones de diálisis es una buena alternativa para mejorar no solo la percepción hacia el tratamiento, sino también otras alteraciones presentes en las personas con enfermedad renal crónica en tratamiento con hemodiálisis. Objetivos: Analizar la satisfacción de los pacientes con el Proyecto Déficit de Actividades Recreativas, así como cuantificar el coste económico del mismo. Material y método: Estudio descriptivo transversal realizado en 2019. Se recogieron datos clínicos. Se valoró la satisfacción con el proyecto de actividades propuesto. Se recogieron datos de autopercepción sobre el estado de salud y el tratamiento. Se cuantificó el coste económico del proyecto. Resultados: Evaluados 37 pacientes. La puntuación mediana de satisfacción para las actividades fue: Programa Pallapupas 8/10 [P256; P7510], Celebraciones mensuales 10/10 [P258; P7510], Ejercicio físico intradiálisis 7/10 [P255; P7510], Conciertos en directo 7/10 [P255,5; P759,5]. En la autopercepción, un 37,84% (n=14) percibía negativamente el tratamiento y un 29,73% (n=11) no estar satisfecho con la inversión de tiempo. El 91,89% (n=34) desea continuar participando en las actividades organizadas. El coste total teórico de las 4 actividades evaluadas es de 33.715,22 euros al año. Conclusiones: Se ha hallado una alta satisfacción de los pacientes con el Proyecto déficit de actividades recreativas en hemodiálisis, pudiendo ser el coste anual de dicho proyecto asumible.

Context: The Sechium edule fruit is grown and consumed because of their nutritional values in different countries of Latin America. Costa Rica is one of the most important producers and exporters. It is consumed as an antioxidant because its flavonoid content suggests such activity; however, the selection of varieties to crop does not involve the phytochemical profile of them. Aims: To characterize the phytochemical and antioxidant profile of the S. edule varieties grown in Costa Rica. Methods: The in vitro radical scavenging activity of different S. edule extracts were measured using DPPH and ORAC assays, as well as their inhibition of lipid peroxidation in rat liver and their redox potential by cyclic voltammetry. Flavonoids glycosides were isolated by HPLC and their structures were determined by NMR. Results: The S. edule varieties grown in Costa Rica showed a good radical scavenging activity and inhibition of lipid peroxidation; there were significant differences between varieties. In addition, the redox potential determined by electrochemical methods suggested the presence of flavonoids, which was confirmed by the isolation of apigenin 7-O-rutinoside and luteolin 7-O-rutinoside. Conclusions: The antioxidant potential of varieties of S. edule grown in Costa Rica was confirmed, identifying the 845 variety as the best antioxidant profile.

Gastric cancer is one of the most common cancers worldwide, with a bad prognosis associated with late-stage diagnosis, significantly decreasing the overall survival. This highlights the importance of early detection to improve the clinical course of these patients. Although screening programs, based on endoscopic or radiologic approaches, have been useful in countries with high incidence, they are not cost-effective in low-incidence populations as a massive screening strategy. Additionally, current biomarkers used in daily routine are not specific and sensitive enough, and most of them are obtained invasively. Thus, it is imperative to discover new noninvasive biomarkers able to diagnose early-stage gastric cancer. In this context, liquid biopsy is a promising strategy. In this review, we briefly discuss some of the potential biomarkers for gastric cancer screening and diagnosis identified in blood, saliva, urine, stool, and gastric juice.

La enfermedad de Behçet es una vasculitis de etiología desconocida, frecuente en los países de oriente, caracterizada por úlceras orales, genitales, uveítis y manifestaciones cutáneas. El propósito del presente artículo es reportar el caso de una patología infrecuente en el medio, así como realizar una revisión bibliográfica de la enfermedad. Se trata de un paciente de 14 años con cuadro clínico de evolución larvada, inicialmente presentó artritis la misma que fue recurrente y de difícil manejo pero no erosiva; y posteriormente presentó úlceras orales, lesiones papulo-pustulosas, úlceras genitales y test de patergia positiva. Como describe la literatura, la artritis en este paciente no era erosiva, durante los períodos de inactividad no había limitación de ninguna articulación, y no respondió al metotrexato. Casi siempre la primera manifestación de la Enfermedad de Behçet son las úlceras orales y no la artritis. El tiempo entre la aparición del primer síntoma y el diagnóstico así como en otras cohortes fue de 3 años. Dentro de los diagnósticos diferenciales de un paciente con artritis debe considerar la Enfermedad de Behçet. En Reumatología debe recalcarse la importancia de replantear los diagnósticos; considerando que estas enfermedades cursan con aparición lenta de los síntomas.

Introducción: El recambio plasmático terapéutico es una técnica extracorpórea de depuración sanguínea. El recambio plasmático terapéutico mediante el método de centrifugación (plasmacentrifugación) requiere flujos de 50 ml/min lo que permite realizar el intercambio con accesos vasculares periféricos. El principal objetivo de este estudio fué el de analizar el uso y las complicaciones del acceso vascular periférico en las sesiones de plasmacentrifugación. Material y Método: Estudio observacional descriptivo longitudinal sobre el análisis de complicaciones del acceso vascular periférico de las sesiones de plasmacentrifugación realizadas entre enero de 2017 y marzo de 2018. Resultados: Inclusión de un total de 93 sesiones de plasmacentrifugación, estas sesiones fueron llevadas a cabo en 9 pacientes con una mediana de 7 [P25:6; P75:10,5] sesiones por paciente. El 66,66% (n=6) fueron mujeres. En el 89,24% (n=83) de las sesiones se usó la centrifugación y en el 10,75% (n=10) la fotoaféresis. La etiología de enfermedad para estos pacientes fue: renal en el 55,55% (n=5) de los casos, neurológica en el 33,33% (n=3) de los casos y dermatológica en el 11,11% (n=1). De las 93 sesiones totales hubo problemas relacionados con la canalización de un acceso vascular periférico en el 52,69% de las sesiones (n=49). Conclusiones: Debido a que en más de la mitad de las sesiones se presentaron complicaciones en el abordaje del acceso vascular periférico, se concluye que es necesario el estudio vascular ambulatorio del paciente antes de la primera sesión, pudiendo ser útil el uso de la punción ecoguiada.

Este artículo presenta una reflexión metodológica basada en investigación empírica sobre el tema de la violencia de género desde el enfoque cualitativo. Expone las características y los alcances de dos técnicas de producción y análisis de datos –la entrevista narrativa y el grupo de discusión– a la luz de dos investigaciones recientes sobre violencia de pareja en México. Ambas perspectivas de análisis son procedimientos metodológicos reconstructivos que se rigen por el principio de la apertura, para que los propios individuos estructuren sus experiencias y significados de acuerdo con sus propios criterios de relevancia. El artículo ilustra el modo en que desde la lógica inductiva la investigación cualitativa puede alcanzar resultados generalizables y de ese modo trascender la perspectiva subjetiva y la singularidad del caso único, en la definición de categorías y en la formación de tipos.