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La ingeniería agrícola es una profesión que tiene por objeto de estudio la adecuación del medio productivo para la producción y la conservación de los productos agrícolas.

There are reports of children COVID-19 or COVID-19 like symptoms with hyperinflammatory multisystem syndrome, ARDS, gastrointestinal and atypical Kawasaki disease presenting to PICU worldwide temporally associated with COVID-19, for which there are important nutrition support considerations. As a result, the European Society of Pediatric and Neonatal Intensive Care – Metabolism, Endocrine and Nutrition group (ESPNIC-MEN) and paediatric nutritionists working in PICUs are being consulted regarding nutrition management of critically ill children with COVID-19 or COVID-19 like symptoms. Therefore, the aim of this short report is to provide a summary of nutrition support recommendations for critically ill children with COVID-19. They are based on the ESPNIC-MEN section recommendations published in January 2020 and surviving sepsis recommendations from February 2020. [ABSTRACT FROM AUTHOR]

Se realizó una investigación para evaluar las pérdidas de grano presentadas en la recolección de arroz con combinada en la región de Ambalema (Tolima). Se utilizaron las variedades CICA 8, CICA 9 e IR-22, y las combinadas John Deere 955R, Case 960 y Case 1200. Se tomaron datos climatológicos (humedad relativa, temperatura, velocidad del viento, etc.), características del cultivo (humedad del grano (bh), densidad, altura de los tallos, etc.), y parámetros de operación de la combinada (velocidad del cilindro, velocidad del molinete, índice del molinete, separación cilindro-cóncavo, etc.) durante todo el tiempo del ensayo. Se evaluaron las pérdidas naturales, las pérdidas en el cabezote, las pérdidas en la trilla y las pérdidas en la separación y limpieza. Las pérdidas promedias presentadas en la combinada fueron: 1.44% en el cabezote, 1.56% en la trilla, 4.12% en la separación y limpieza, yen total el 7.17% en 39 observaciones realizadas. Las variables independientes que más influyeron en las pérdidas fueron la humedad del grano y la humedad relativa.

A research project was carried out in order to study the effect of different variables in the planting of some leguminosae, like soybeans ICA-Pance and L-108 and beans Adzuki. ICA-Gualí and ICA-Pijao.

We present specific heat measurements on a series of BaFe2(As1-xPx)2 single crystals with phosphorous doping ranging from x = 0.3 to x = 0.55. Our results reveal that BaFe2(As1-xPx)2 follows the scaling ΔC/Tc ≈ Tc2remarkably well. The clean-limit nature of this material imposes additional restraints on theories aimed at explaining the scaling. Furthermore, we find that the Ginzburg-Landau parameter decreases significantly with doping whereas the superconducting anisotropy is Γ ≈ 2.6, independent of doping. [ABSTRACT FROM AUTHOR]

We report on the specific-heat determination of the anisotropic phase diagram of single crystals of optimally doped SmFeAsO1-xFx. In zero field, we find a clear cusplike anomaly in C/T with ΔC/Tc=24 mJ/mol K² at Tc=49.5 K. In magnetic fields along the c axis, pronounced superconducting fluctuations induce broadening and suppression of the specific-heat anomaly which can be described using three-dimensional lowest-Landau-level scaling with an upper critical field slope of –3.5 T/K and an anisotropy of Γ =8. The small value of ΔC/Tc yields a Sommerfeld coefficient γ ∼ 8 mJ/mol K², indicating that SmFeAsO1-xFx is characterized by a modest density of states and strong coupling. [ABSTRACT FROM AUTHOR]

Rationale: The optimal timing for listing of cystic fibrosis patients for lung transplantation is controversial.Objectives: We conducted a retrospective cohort study of 343 patients listed for lung transplantation at four academic medical centers to identify risk factors for death while awaiting transplantation.Methods: Data on possible risk factors were abstracted from medical records.Measurements: Time to death, patient demographic characteristics, and risk factors for death while awaiting transplantation were assessed. Univariate and multivariate survival analyses were performed using Cox regression.Results: By univariate analyses, FEV1 < or = 30% predicted (HR, 3.8; 95% CI, 2.0-7.5), Pa(CO2) > or = 50 mm Hg (HR, 1.85; 95% CI, 1.1-3.0), and shorter height (HR, 1.8; 95% CI, 1.1-3.0) were associated with a higher risk of death. Referral from an accredited cystic fibrosis center was associated with a lower risk (HR, 0.53; 95% CI, 0.30-0.92). The final multivariate model included referral from an accredited cystic fibrosis center (HR, 0.5; 95% CI, 0.3-1.0) and listing year after 1996 (HR, 0.4; 95% CI, 0.2-0.7); both were associated with a lower risk of death. FEV1 < or = 30% predicted (HR, 6.8; 95% CI, 2.4-19.3), Pa(CO2) > or = 50 mm Hg (HR, 6.9; 95% CI, 1.5-32.1), and use of a nutritional intervention (HR, 2.3; 95% CI, 1.3-4.1) were associated with increased risk. Patients with FEV1 > 30% predicted had a higher risk of death only when their Pa(CO2) was > or = 50 mm Hg (HR, 7.0; 95% CI, 1.5-32), while the increased risk of death with FEV1 < or = 30% was not further influenced by the presence of hypercapnia.Conclusions: We identified risk factors for waiting list mortality that could impact on transplant listing and allocation guidelines. [ABSTRACT FROM AUTHOR]

Each discovery of a new high temperature superconductor drives the expectation that advanced engineering of materials defect structures will enable effective vortex pinning and high values of the electrical current density. Here, we demonstrate that single crystals of the iron-based superconductor Ba0.6K0.4Fe2As2 with Tc = 37.5 K can accommodate an unprecedented large concentration of strong-pinning defects in the form of discontinuous nm-sized nanorods with no degradation of the superconducting transition temperature. At a temperature of 5 K, we find a critical current density of 5 MA/cm2 that is magnetic field independent in fields up to 7 T. [ABSTRACT FROM AUTHOR]

We compared estimates of body Fe stores (BIS) calculated from plasma ferritin concentration alone (BISF) or the ratio of transferrin receptor/ferritin (BISR) for infants, school children or pregnant women enrolled in previously completed intervention trials (total N=1346). The 165 subjects (12.3%) with elevated CRP (>10 mg/L) were excluded from analysis. The correlation coefficients between BISF and BISR were >0.93 for all 4 studies both before and after intervention. The Kappa index ranged from 0.5-1.0, indicating moderate to high agreement between BISF and BISR. All the sensitivities of BISF for identifying individuals with low Fe stores (defined as BISR<0 mg/kg BW) were greater than 0.9, except for the youngest age group (4 mo old infants) (sensitivity=0.67) and all specificities were greater than 0.9, except for pregnant women (specificity=0.66). The effect sizes of Fe intervention trials were significantly greater for change in Fe reserves estimated by BISR than by BISF for studies with larger effect sizes (0.92 vs 0.79, 1.42 vs 1.28, P<0.001). However, there were no differences between estimates for studies with smaller effect sizes (0.83 vs 0.78, 0.35 vs 0.37, P>0.2). Plasma ferritin concentration alone provides a good approximation of total body Fe reserves, as estimated by ratio of transferrin receptor/ferritin, based on high correlation, sensitivity and specificity among individuals with non-elevated CRP. [ABSTRACT FROM AUTHOR]

Our objective was to determine which subgroups of exclusively breastfed infants may be at risk of iron deficiency prior to 6 mo. We compared the prevalence of low plasma ferritin concentration (< 12 ug/L) and iron deficiency anemia (IDA, ferritin < 12 ug/L and Hb < 105 g/L) at 6 mo among 404 infants in 6 different studies in Ghana, Honduras, Mexico and Sweden who had a birth weight > 2500 g and were exclusively or predominantly breastfed or had not received any iron-fortified formulas or milks. Infants with elevated C-reactive protein concentration (8%) were excluded. The percentage with low ferritin was 6% in Sweden, 17% in Mexico, 13-25% in Honduras and 12-37% in Ghana. The percentage with IDA was 1% in Sweden, 4% in Mexico, 5-11% in Honduras and 8-15% in Ghana. With data pooled from all studies, the key predictors of low ferritin (20% overall) were immediate umbilical cord clamping (AOR 4.5 [1.9, 11.0]), male sex (AOR 4.0 [2.2, 7.3]) and birth weight < 3 kg (AOR 2.3 [1.3, 4.0]). The predictors of IDA (8% overall) were male sex (AOR 7.2 [2.4, 21.6]), birth weight < 3 kg (AOR 3.0 [1.4, 6.6]), weight gain since birth above the median (AOR 3.1 [1.2, 7.9]) and immediate cord clamping (AOR 3.7 [0.8, 16.5]). These variables could be used to identify which exclusively breastfed infants are at risk of IDA before 6 mo. [ABSTRACT FROM AUTHOR]

BAL GM has higher sensitivity than traditional culture methods. However, smaller studies have documented higher false positivity in the early post-transplant period. This study aimed to evaluate the rate of IA in patients who had a negative fungal culture and positive BAL GM in the first 30 days post lung transplant. We retrospectively identified LTRs from January 2010 to January 2017, who had a negative Aspergillus culture and positive BAL GM with an index cutoff value of ≥1.0 in the first 30 days post-transplant. Development of IA within 30 days after the initial positivity was evaluated. ISHLT definitions were used to define IA and colonization. We reviewed 791 LTRs; 119 patients had negative fungal culture and a positive BAL GM in the first 30 days post-transplant. 59% (70/119) were male, mean age 53 years old, 15% (18/119) had cystic fibrosis. 3% (4/119) of the patients had IA at the time of initial positive BAL GM. Of the other 115 patients, 112 were noted to be positive only once, 3 were positive two or more times. 63% (73/115) received preemptive antifungal therapy. None of them developed IA. 37% (42/115) did not receive preemptive antifungal therapy, and only 7% (3/42) developed IA. In the absence of antifungal therapy, 7% (3/42) of LTRs subsequently developed IA following positive BAL GM >1.0 in the first 30 days post-transplant. Further characterization of patients with positive BAL GM during the first month may be helpful in devising the pre-emptive antifungal therapy in the early period after lung transplantation. [ABSTRACT FROM AUTHOR]

HS is a rare but potentially fatal complication of Lung Transplantation (LT), association with DU has been hypothesized. Optimal screening methods to prevent/diagnose HS early are uncertain. Both pulmonary DU PCR and daily Serum Ammonium Screening (SAS) have been suggested. We investigated HS and the association with DU PCR and SAS. We included all LT recipients from 07/2019-02/2020 and 10/2021-03/2022 with available donor bronchial wash samples from the LT Biobank. Briefly, DNA was extracted using Qiagen DNA kit and Mollicute PCR performed using an AMPIPROBE® Ureaplasma spp. / M. genitalium / M. hominis Assay Kit. Generation of a cycle number (Ct) value of 30 was considered positive as recommended by manufacturer. Recipients were prospectively followed for HS symptoms for 30 d post-LT. Daily ammonia serum levels were measured for the first 14 days (d) as per center-specific practice, and thereafter if clinically indicated. HS was defined by new neurological symptoms and the presence of elevated serum ammonium (>70 umol/l). We compared patients who developed HS with to those who did not. Of 139 LT recipients, 4 (2.8%) developed HS during the study period. Recipient and donor characteristics of LT recipients with and without HS are shown in Table A. All HS cases were diagnosed within the first 14 days, while daily SAS was in place, median time to HS was 7.5 days (IQR 4,11). DU PCR was found to be positive in 4.3% (6/139) at transplant. Only 1/4 cases of HS was associated with a positive DU PCR. HS was treated with Moxifloxacin/Doxycycline combination (4/4) for a median duration of 14d (IQR 12,14), 2/4 received renal replacement therapy. No patient died within 180 days post HS diagnosis. HS was a rare complication in our LT cohort. The low prevalence of DU detection in our cohort questions the utility of donor screening. Daily SAS of the recipient might add to early HS diagnosis. [ABSTRACT FROM AUTHOR]

Mycobacterium abscessus (MABS) is a non-tuberculous mycobacteria (NTM) known to cause life threatening disease involving the lung, skin and soft tissue, and disseminated disease in lung transplantation recipients (LTRs). Therefore, many centres consider the presence of MABS as a relative contraindication to lung transplantation (LT). The goal of this study was to assess the epidemiology and outcomes of MABS infection before and after LT in a pan-Canadian cohort. We conducted a multicenter retrospective cohort study including all 4 LT centers in Canada. All LTRs transplanted between January 2006 and December 2016 with at least one respiratory sample positive for MABS complex prior to or post transplantation were included. Pulmonary disease was defined using the American Thoracic Society criteria for NTM lung infection. Follow up duration was 5 years after transplantation. Among a cohort of 2230 LTRs across Canada, 15 patients (0.67%) had MABS infection prior to LT. Median age was 32 (range 17-58), 7/15 (47%) were female and the most common underlying disease was cystic fibrosis 11/15 (73%). Among patients with MABS infection pre-transplant, 80% (12/15) received treatment prior to transplant. Following LT, 53% (8/15) developed recurrent MABS infection (6 disease and 2 colonization). Five-year mortality among patients with pre-transplant MABS infection was 27% (4/15). Among patients with pre-transplant MABS infection, mortality was higher in those who had recurrence of MABS infection after transplant (50% vs 0%, 0.077), though this did not reach statistical significance. Microbiologic eradication prior to transplant occurred in 8/15 (72.7%) and was associated with decreased mortality (0% vs 57.1%, 0.026) and decreased risk of recurrence (12.5% vs 100%, 0.001). In addition to the 8 patients with recurrent disease, 12 patients developed de novo MABS infection after transplant of which 66.7% (8/12) had disease. Among the 14 patients with post-transplant disease, 5 year mortality was 50% (7/14), the majority of which was due to MABS infection (5/7, 71.4%). MABS is an uncommon cause of infection among LTRs. Recurrence rate among those with pre-transplant infection is high and this may be associated with decreased survival. Survival among those with pre-transplant MABS infection was similar to contemporary cohorts of LTRs. [ABSTRACT FROM AUTHOR]

Esophageal dysmotility is very common in patients with end-stage lung disease and post lung transplant and is thought to predispose to allograft injury through higher risk of aspiration. We routinely test lung transplant recipients for esophageal dysmotility with High Resolution Manometry (HRM) at 3 months post-transplant. We hypothesize that lung transplant recipients (LTRs) with significant esophageal dysmotility are more likely to develop lung injury leading to CLAD and death. Among 1753 LTRs transplanted at our center between July 2000 and June 2018, we retrospectively analyzed 426 patients who had HRM with a 24 hour-pH impedance study available post-transplantation. Esophageal hypomotility was defined as >= 30% of failed and/or simultaneous esophageal contractions, while esophageal hypermotility was defined as evidence of higher amplitude on HRM. Cox proportional hazards models adjusted for age, sex, native lung disease, CMV matching, and transplant type (single vs double) were used to determine the association between esophageal dysmotility and death/retransplant or CLAD. Esophageal hypomotility and hypermotility was found in 120 (28%) and 22 (5%) patients, respectively. Mild, moderate, and severe hypomotility was found in 58 (48%), 14 (12%), and 48 (40%) patients, respectively. In multivariate analyses, esophageal hypermotility or hypomotility was not associated with CLAD (HR 0.59 [95% CI 0.21-1.60]; HR 0.79 [95% CI 0.52-1.19]). or death (HR 0.53 [95% CI 0.16-1.68]; HR 0.62 [95% CI 0.37-1.03]). The risk of CLAD or death did not vary by severity of hypomotility. In a large single-center lung transplant cohort study, we have determined that esophageal dysmotility is not associated with CLAD or death. Concurrent GI co-morbidities, such as reflux and gastroparesis, may play a role in modifying this risk. Additionally, center-specific approaches to patient selection and/or treatment may be related to outcomes and will be further assessed in future studies. [ABSTRACT FROM AUTHOR]

Cystic fibrosis (CF) can lead to end stage lung disease for which lung transplantation can be a life-saving therapy. CF has systemic manifestations that can lead to other end organ damage. In addition, immune suppression following single organ transplantation has adverse effects including end stage renal disease. Multi-organ transplant in CF has had a significant impact on long-term survival of CF patients. In this study, we aim to assess the impact of multi-organ transplant on the survival of CF patients. This is a retrospective review of all CF patients who have been multi-organ recipients after their initial lung transplant (March 1988 to July 2020). Lung re- transplant only were excluded. From 435 lung transplant recipients we identified 19 patients with CF who had received multi-organ transplant either simultaneously with the lung transplant or consecutively over time. 7 recipients received simultaneously 15 organs that included: 1 heart and lung, 5 lung and liver and 1 lung, liver, pancreas. The median survival for this group was: 8.9 years. 12 recipients received consecutively 30 organs that included: 6 lung followed by kidney transplant; 1 lung followed by liver transplant; 1 lung followed by combined kidney+liver; 1 lung followed by combined kidney + pancreas; 1 lung followed by liver and then kidney transplant; 1 lung transplant followed by a second lung transplant and later on kidney transplant and finally 1 lung followed by another lung transplant and later on combined kidney+ pancreas.The median survival of these multiorgan recipients is 14 years. The current median survival for CF patients in our program excluding re-transplants is 8.2 years. Lung transplant for CF offers survival benefit and improved quality of life, such that a subgroup of these patients qualify for a second and even a third organ transplant to further prolong life. [ABSTRACT FROM AUTHOR]

There is a paucity of studies assessing the incidental finding of histoplasmosis in the explanted tissue from lung transplant recipients (LTRs). Thus, there are currently no recommendations for the management of Histoplasmosis in the explanted organ of LTRs. This study aims to describe our experience in the management of histopathologic evidence of Histoplasmosis, encountered unexpectedly in the explanted tissue of LTRs at the time of transplantation. We retrospectively identified LTRs at the Toronto program from 2010-2017, with histopathologic evidence of Histoplasma in the lung explanted tissue. Of 810 LTRs, 6 recipients had Histoplasmosis in the explanted organ (incidence 0.75%, clinical characteristics shown in Table 1. None of the 6 patients had a previously known diagnosis of Histoplasmosis. All of them lived in Ontario, Canada, and only one had traveled abroad in the past five years (to Florida, USA). All 6 patients had lung parenchyma and lymph node involvement in the histopathology findings, with necrotizing granulomas and fungal spores compatible with Histoplasmosis. All patients received antifungal pre-emptive therapy after transplant: 4 (67%) Itraconazole and 2 (33%) voriconazole for a mean duration of 4.8 months (IQR, 2.82-8.1 months). No patients in this group developed posttransplant Histoplasmosis (median follow up of 3.0 years [IQR 2.0-4.1 years]). The unexpected finding of histoplasmosis in the explanted tissue of LTRs was infrequent (0.75%) in this non-endemic area. None of the patients, all of whom received antifungal therapy, developed active Histoplasmosis post-transplant. [ABSTRACT FROM AUTHOR]

Lung transplant (LT) programs typically serve patients from a broad geographic area. A regionalized approach to LT care offers advantages, but patients must relocate or travel to access care. We initiated a small pilot project of a virtual care platform, MyCareConnection (MCC) in LT. We hypothesized that patients and providers would be able to use MCC for communication and monitoring with high satisfaction rates. The pilot began in 01/20, however, in response to the COVID-19 pandemic, we rapidly enrolled many listed and early post-op patients. Exclusion criteria included; limited access to technology (a recent model phone, wifi) or if they were unwilling/ unable to participate. MCC provides access to an online library of educational materials, secure asynchronous texting, a secure video platform, the ability to collect outcome data via surveys and biometrics (BP, HR, temp, SpO2, spirometry, step counts). MCC was used to deliver virtual clinic visits. Tailored home-based physiotherapy was also delivered over MCC (reported separately). Satisfaction was measured by surveys sent to patients, caregivers and staff. 165 LT patients are enrolled in MCC (64 pre-LTx, 101 post-LTx), 36% female, mean age 57.7y (range 20-76y). Few patients were ineligible, but the reasons included; personal preference, old OS, no wifi, delisting and death. The primary indications for listing and LT were ILD (45%), COPD (30%) and CF (7%). 70 users (35 clinicians) performed over 998 video calls, and > 3000 sets of biometric data were recorded by patients. Patient and caregiver satisfaction was excellent, with 94% of recipients (n=35) and 100% of caregivers (n=7) reporting that they would recommend MCC to others, and 75% agreeing that it helped them manage their health condition (n=106). Provider satisfaction was high, with over 70% recommending MCC (n=17). Challenges included the rapid shift to virtual care for clinicians used to in-person care. We have provided comprehensive, interdisciplinary virtual care to more than 165 LT patients. Good patient and staff satisfaction and high uptake of the MCC platform demonstrates that virtual care is highly desirable and feasible in this population. In person assessments are still required for assessment of some complex issues. Gaps to be addressed include inequitable access to technology because of financial, geographical and other issues. [ABSTRACT FROM AUTHOR]

Esophageal dysmotility is very common in lung transplant recipients and is thought to predispose to allograft injury through higher risk of aspiration. At our center, we routinely test lung transplant recipients for esophageal dysmotility with High Resolution Manometry (HRM) at 3 months post-transplant. We hypothesize that lung transplant recipients (LTRs) with significant esophageal dysmotility are more likely to develop lung injury leading to CLAD and death. Among 1753 LTRs transplanted at our center between July 2000 and June 2018, we retrospectively analyzed 426 patients who had HRM with a 24 hour-pH impedance study available post-transplantation. Esophageal hypomotility was defined as >=30% of failed and/or simultaneous esophageal contractions, while esophageal hypermotility was defined as evidence of higher amplitude on HRM. Cox proportional hazards models adjusted for age, sex, native lung disease, CMV matching, and transplant type (single vs double) were used to determine the association between esophageal dysmotility and death/retransplant or CLAD. Esophageal hypomotility and hypermotility was found in 120 (28%) and 22 (5%) patients, respectively. Mild, moderate, and severe hypomotility was found in 58 (48%), 14 (12%), and 48 (40%) patients, respectively. In multivariate analyses, esophageal hypermotility or hypomotility was not associated with CLAD (HR 0.59 [95% CI 0.21-1.60]; HR 0.79 [95% CI 0.52-1.19]). or death (HR 0.53 [95% CI 0.16-1.68]; HR 0.62 [95% CI 0.37-1.03]). The risk of CLAD or death did not vary by severity of hypomotility. In a large single-center lung transplant cohort study, we have determined that esophageal dysmotility is not associated with CLAD or death. Concurrent GI co-morbidities, such as reflux and gastroparesis, may play a role in modifying this risk. Additionally, center-specific approaches to patient selection and/or treatment may be related to outcomes and will be further assessed in future studies. [ABSTRACT FROM AUTHOR]