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The intestinal microbiota and the human body are in a permanent interaction. There is a symbiotic relationship in which the microbiota plays a vitally important role in the performance of numerous functions, including digestion, metabolism, the development of lymphoid tissue, defensive functions, and other processes. It is a true metabolic organ essential for life and has potential involvement in various pathological states, including cancer and pathologies other than those of a digestive nature. A growing topic of great interest for its implications is the relationship between the microbiota and cancer. Dysbiosis plays a role in oncogenesis, tumor progression, and even the response to cancer treatment. The effect of the microbiota on tumor development goes beyond a local effect having a systemic effect. Another aspect of great interest regarding the intestinal microbiota is its relationship with drugs, modifying their activity. There is increasing evidence that the microbiota influences the therapeutic activity and side effects of antineoplastic drugs and also modulates the response of several tumors to antineoplastic therapy through immunological circuits. These data suggest the manipulation of the microbiota as a possible adjuvant to improve oncological treatment. Is it possible to manipulate the microbiota for therapeutic purposes?

Introduction: Due to the pandemic, academic challenges arose, and virtual simulation was used to replace the clinical experiences, offering innovative learning strategies and standardized teaching. Objective: To compare the perception and the level of satisfaction in the acquisition of knowledge, abilities and skills through face-to-face and virtual simulation among medical students. Methods: Analytical cross-sectional study including medical students who received virtual and face-to-face simulation practices. A survey was con-ducted to investigate the sociodemographic and academic characteristics, institutional physical conditions, self-assessment regarding the acquisition of technical and soft skills, and quality and satisfaction with clinical simulation. Results: 105 students with a median age of 22 years were included, who reported greater acquisition of technical skills through face-to-face simulation compared to the virtual modality. In-person simulation resulted in an 85% mastery of some topics compared to virtual simulation (65.7%, p < 0.001). However, for medication presentation and dosage scenarios, 80% reported mastery of the topic through virtual practice compared to 53.3% in the face-to-face modality (p < 0.001). The development of soft skills was similar in both scenarios, such as problem solving (83.8%), effective communication (78.1%), among others. Conclusions: Clinical simulation is crucial to medical training, its face-to- face application is perceived as the most suitable way to use it in the educational environment.

Abstract Background Continuous glucose monitoring can improve glycemic control for hospitalized patients with diabetes, according to current evidence. However, there is a lack of consensus-established recommendations for the management of hospitalized patients with diabetes using flash continuous glucose monitoring system (fCGM) in Latin America. Therefore, this expert consensus exercise aimed to establish guidelines on the implementation of fCGM in the management of hospitalized patients with diabetes in Latin America. Methods The modified Delphi method was applied on a panel of nine specialists, establishing consensus at 80%. A twenty-two-question instrument was developed to establish recommendations on the use of fCGM in hospitalized patients living with diabetes. Results Based on consensus, experts recommend the use of fCGM in hospitalized patients with diabetes starting at admission or whenever hyperglycemia (> 180 mg/dl) is confirmed and continue monitoring throughout the entire hospital stay. The recommended frequency of fCGM scans varies depending on the patient's age and diabetes type: ten scans per day for pediatric patients with type 1 and 2 diabetes, adult patients with type 1 diabetes and pregnant patients, and seven scans for adult patients with type 2 diabetes. Different hospital services can benefit from fCGM, including the emergency room, internal medicine departments, intensive care units, surgery rooms, and surgery wards. Conclusions The use of fCGM is recommended for patients with diabetes starting at the time of admission in hospitals in Latin America, whenever the necessary resources (devices, education, personnel) are available.

Objective: The objective of this study was to analyze the evolution in the diagnosis and management of indeterminate thyroid nodules over three time periods. Methods: In total, 3020 patients with thyroid nodules underwent cytological evaluation during three periods (2006– 2008, 2012–2014, 2017–2019). The distribution of diagnostic cytology, risk of malignancy, diagnostic performance indices of fine needle aspiration (FNA), and cytologic–histologic correlation in indeterminate cytology were analyzed. Results: Only 2.2% of cytology tests were insufficient for a diagnosis. About 86.9% cytology was benign, 1.7% malignant, and 11.4% indeterminate. Indeterminate cytology rates were 15.9% (2006–2008), 10.1% (2012–2014), and 10% (2017–2019). Surgery was performed in 13% of benign cytology, resulting in malignant histology in 2.7%. All malignant and suspicious cytology underwent surgery, with malignancy confirmed in 98% and 77% of cases, respectively. All ‘indeterminate with atypia’ cytology (2006–2008) and Bethesda IV (2012–2014; 2017–2019) underwent surgery, with malignancy confirmed in 19.6%, 43.8%, and 25.7%, respectively. In the ‘indeterminate without atypia’ category (2006–2008) and Bethesda III (2012–2014; 2017–2019), diagnostic surgery was performed in 57.7%, 78.6%, and 59.4%, respectively, with malignancy confirmed in 3.3%, 20.5%, and 31.6%. The FNA sensitivity was 91.6%, with a negative predictive value greater than 96% in all periods. The specificity exceeded 75% in the last two periods. Conclusion: The Bethesda system reduces indeterminate cytology and improves the accuracy of FNA diagnosis. We reported a higher proportion of malignancy than expected in Bethesda III, underscoring the importance of having institution-specific data to guide decision-making. However, there is a need for risk stratification tools that allow for conservative management in low-risk cases.

Background: Psychological distress is a predictor of future health and disease data, with consequent implications for both the patient and the healthcare system. Taking advantage of the unprecedented situation caused by the COVID-19 pandemic we aimed to assess whether the type of medical care received by patients during the initial months of the pandemic influenced their evolution, particularly at the psychological level. Additionally, we investigated whether allostatic load was associated not only with physical but also psychological alterations. Methods: All the patients diagnosed with COVID-19 infection at HM Madrid Hospital during the month of March 2020 were studied, both those hospitalized (110) and those treated on an outpatient basis (46). They were psychologically evaluated using the Profile of Mood States (POMS) test. We calculated the allostatic load using different laboratory parameters. Results: Outpatient patients had significantly higher scores than hospitalized ones in Tension-Anxiety (52 ± 19.3 vs. 38 ± 4.3; p < 0.001). So, 36.9% of the outpatient patients exhibited anxiety. Allostatic load has not been correlated with patients’ psychological alterations. Conclusions: Psychological distress of outpatient patients should be taken into account in their management to improve mental health planning. This knowledge could provide comprehensive care to patients including their mental health, in the face of subsequent epidemics/pandemics.

Background: Despite concerted efforts in South America, these diseases continue to pose a significant burden of morbidity and mortality in endemic regions. This study aimed to analyse hospital data and investigate the hospitalisation rates of dengue fever, leishmaniasis, and malaria in Ecuador between 2015 and 2022. Methods: Open-access databases from the National Institute of Statistics and Censuses of Ecuador between 2015 and 2022 were analysed. Data were filtered using specific terms for each disease (ICD-10), and descriptive statistics of geographical distributions were calculated using Microsoft Excel, Stata 14.2, and Rstudio. Results: Dengue had the highest burden, with 31,616 reported cases, followed by malaria (1,316) and leishmaniasis (283). From 2015 to 2022, the highest hospitalisation rate per 105 inhabitants for dengue was observed in Sucumbios province (697.2), for malaria in Pastaza province (108.4), and for leishmaniasis in Morona Santiago province (18.8). The data’s trend analysis revealed a slight increase in dengue and mild downward trends in hospitalisation for malaria and leishmaniasis. Conclusions: The results suggest that vector-borne disease control has failed in Ecuador. Unfortunately, there was no significant trend towards a decrease in dengue, malaria, and leishmaniasis in Ecuador during the years studied. This study highlights the need to optimise sustainable vector control programs and emphasises continuous monitoring of disease incidence and control measures.

Introducción: El uso de mHealth puede mejorar la adherencia a el automonitoreo con glucometría capilar (GC) en la transición del ámbito hospitalario al ambulatorio. Objetivo: evaluar la adherencia al automonitoreo con GC de los pacientes con Diabetes Tipo 2 (DM2) vinculados a un programa de educación usuarios de mHealth (ClouDi) comparado con el programa de educación y seguimiento presencial usual. Materiales y métodos: Estudio longitudinal prospectivo. Se analizaron pacientes con DM2 valorados por consulta de educación de diabetes con indicación de tratamiento con insulina al egreso hospitalario. Se analizaron dos grupos: uno con seguimiento presencial y otro vinculado a un programa educativo y uso de ClouDi. Resultados: De los 86 pacientes (44% de sexo femenino, 41 usuarios ClouDi, edad promedio 58.8 ± 11.2 años, con una media de duración de la diabetes de 7.8 ± 7.4 años), 53.6% se encontraban en estrato 2, el 92.9% pertenecían al régimen contributivo, el 42.9% con educación básica primaria y 51.2% empleados. Fue considerada la adherencia a la GC al realizar y registrar 3 o más mediciones por día en los pacientes de ClouDi fue mayor comparado con los pacientes en cuidado usual (64.4% vs 28.2%, p

Forecasting air pollutant levels is essential in regulatory plans focused on controlling and mitigating air pollutants, such as particulate matter. Focusing the forecast on air pollution peaks is challenging and complex since the pollutant time series behavior is not regular and is affected by several environmental and urban factors. In this study, we propose a new hybrid method based on artificial neural networks to forecast daily extreme events of PM2.5 pollution concentration. The hybrid method combines self-organizing maps to identify temporal patterns of excessive daily pollution found at different monitoring stations, with a set of multilayer perceptron to forecast extreme values of PM2.5 for each cluster. The proposed model was applied to analyze five-year pollution data obtained from nine weather stations in the metropolitan area of Santiago, Chile. Simulation results show that the hybrid method improves performance metrics when forecasting daily extreme values of PM2.5.

Background: Patients with B-lymphocyte malignancies (BCMs) receiving B-lymphocyte-targeted therapies have increased risk of severe COVID-19 outcomes and impaired antibody response to SARS-CoV-2 mRNA vaccination in comparison to non-hematologic oncologic patients or general population. Consequently, it is vital to explore vaccine-induced T-lymphocyte responses in patients referred for the understanding of immune protection against SARS-CoV2 infections. The objective of the present study was to analyze the recall immune responses carried out by T lymphocytes after two COVID-19 mRNA vaccine doses. Methods: We enrolled 40 patients with BCMs and 10 healthy controls (HCs) after 4 weeks from the second mRNA vaccine dose. Spike (S)-specific T-lymphocyte responses were assessed in peripheral blood mononuclear lymphocytes (PBMCs) by intracellular IFN-γ staining combined with flow cytometry. Furthermore, the humoral response was assessed with the measurement of anti-spike antibodies. Results: From March to July 2021, 40 patients (median age 68) received mRNA vaccines. The overall antibody response for BCMs was 52.5% versus 100% for the healthy controls (p = 0.008). The antibody response was different across BCMs: 18.75% for non-Hodgkin lymphoma, 54.5% for chronic lymphocytic leukemia, and 92.3% for multiple myeloma. Responses varied by malignancy type and treatment, with anti-CD20 therapies showing the lowest response (6.7%). T-lymphocyte analysis revealed reduced numbers and altered differentiation stages in patients compared to the controls. However, the vaccine-induced T response was generally robust, with variations in specific T subpopulations. Conclusions: mRNA vaccines induced significant humoral and cellular immune responses in B-cell lymphoid malignancy patients, although responses varied by treatment type and malignancy. Further research is needed to optimize vaccination strategies in this population.

Abstract Background The mean weight loss (WL) after successful bariatric surgery is approximately one third of the initial body weight, which is mainly achieved between the first 2 years of follow‐up. However, 15%–35% of patients do not achieve a significant percentage of total WL (%TWL). Information on factors associated with a higher or lower WL after bariatric surgery is limited. This study aimed to assess the change in %TWL and describe the factors associated with greater or lesser WL over time. Methods This prospective longitudinal study included patients treated with laparoscopic Roux‐en‐Y gastric bypass or sleeve gastrectomy. Baseline data were recorded before surgery. Follow‐up was performed at 3 (n = 141), 6 (n = 208), 9 (n = 115), 12 (n = 216), 24 (n = 166), and 36 months (n = 99). Generalized estimating equation analysis was performed to assess the changes in %TWL over time and factors associated with different patterns of WL. Results In total, 231 patients were included (women, 82.2%; basal body mass index (BMI) 41.4 ± 5.1 kg/m2). The tendencies to increase %TWL (32 ± 6.5) were evident in the first year and stabilized thereafter. Sustained nutritionist follow‐up (2.3%, p = 0.004), baseline BMI >40 kg/m2 (0.4%, p 30 min/day after surgery reduced their %TWL by 0.6% (p = 0.002). Conclusions Modifiable factors such as nutritional monitoring and WL before surgery are associated with a significant increase in %TWL over time. Basal BMI was associated with a significant decrease in %TWL.

ABSTRACTTo evaluate the changes in the gut microbiota associated with changes in the biochemical markers of nonalcoholic fatty liver disease (NAFLD) after a lifestyle intervention with the Mediterranean diet. Participants (n = 297) from two centers of PREDIMED-Plus trial (Prevención con Dieta Mediterránea) were divided into three different groups based on the change tertile in the Hepatic Steatosis Index (HSI) or the Fibrosis−4 score (FIB−4) between baseline and one year of intervention. One-year changes in HSI were: tertile 1 (T1) (−24.9 to −7.51), T2 (−7.5 to −1.86), T3 (−1.85 to 13.64). The most significant differences in gut microbiota within the year of intervention were observed in the T1 and T3. According to the FIB−4, participants were categorized in non-suspected fibrosis (NSF) and with indeterminate or suspected fibrosis (SF). NSF participants showed higher abundances of Alcaligenaceae, Bacteroidaceae, Bifidobacteriaceae, Clostridiaceae, Enterobacteriaceae, Peptostreptococcaceae, Verrucomicrobiaceae compared to those with SF. Then, participants were divided depending on the FIB−4 tertile of change: T1 (−89.60 to −5.57), T2 (−5.56 to 11.4), and T3 (11.41 to 206.24). FIB−4 T1 showed a decrease in Akkermansia and an increase in Desulfovibrio. T2 had an increase in Victivallaceae, Clostridiaceae, and Desulfovibrio. T3 showed a decrease in Enterobacteriaceae, and an increase in Sutterella, Faecalibacterium, and Blautia. A relation between biochemical index changes of NAFLD/NASH (HSI and FIB−4) and gut microbiota changes were found. These observations highlight the importance of lifestyle intervention in the modulation of gut microbiota and the management of metabolic syndrome and its hepatic manifestations.

Abstract Objective: To examine the cross-sectional and longitudinal (2-year follow-up) associations between dietary diversity (DD) and depressive symptoms. Design: An energy-adjusted dietary diversity score (DDS) was assessed using a validated FFQ and was categorised into quartiles (Q). The variety in each food group was classified into four categories of diversity (C). Depressive symptoms were assessed with Beck Depression Inventory-II (Beck II) questionnaire and depression cases defined as physician-diagnosed or Beck II >= 18. Linear and logistic regression models were used. Setting: Spanish older adults with metabolic syndrome (MetS). Participants: A total of 6625 adults aged 55–75 years from the PREDIMED-Plus study with overweight or obesity and MetS. Results: Total DDS was inversely and statistically significantly associated with depression in the cross-sectional analysis conducted; OR Q4 v. Q1 = 0·76 (95 % CI (0·64, 0·90)). This was driven by high diversity compared to low diversity (C3 v. C1) of vegetables (OR = 0·75, 95 % CI (0·57, 0·93)), cereals (OR = 0·72 (95 % CI (0·56, 0·94)) and proteins (OR = 0·27, 95 % CI (0·11, 0·62)). In the longitudinal analysis, there was no significant association between the baseline DDS and changes in depressive symptoms after 2 years of follow-up, except for DD in vegetables C4 v. C1 = (β = 0·70, 95 % CI (0·05, 1·35)). Conclusions: According to our results, DD is inversely associated with depressive symptoms, but eating more diverse does not seem to reduce the risk of future depression. Additional longitudinal studies (with longer follow-up) are needed to confirm these findings.

Orange processing generates peel by-products rich in phenolic compounds, particularly flavanones like hesperidin and narirutin, offering potential health benefits. Utilizing these by-products is of significant interest in supporting Spain’s circular bioeconomy. Therefore, the aim of this study was to investigate the fermentation of orange peels by different lactic acid bacteria (LAB) strains and its impact on phenolic composition and antioxidant activity. Three different LAB strains, two Lactiplantibacillus plantarum, and one Levilactobacillus brevis were utilized. The phenolic compounds were measured by HPLC-ESI-TOF-MS, and antioxidant activity was assessed using DPPH and ABTS methods. The growth of the LAB strains varied, showing initial increases followed by gradual declines, with strain-specific patterns observed. Medium acidification occurred during fermentation. A phenolic analysis revealed an 11% increase in phenolic acids in peels fermented by La. plantarum CECT 9567-C4 after 24 h, attributed to glycosylation by LAB enzymes. The flavonoid content exhibited diverse trends, with Le. brevis showing an 8% increase. The antioxidant assays demonstrated strain- and time-dependent variations. Positive correlations were found between antioxidant activity and total phenolic compounds. The results underscore the importance of bacterial selection and fermentation time for tailored phenolic composition and antioxidant activity in orange peel extracts. LAB fermentation, particularly with La. plantarum CECT 9567 and Le. brevis, holds promise for enhancing the recovery of phenolic compounds and augmenting antioxidant activity in orange peels, suggesting potential applications in food and beverage processing.

Contexto: en pacientes con COVID-19, la diabetes mellitus y la hiperglucemia son condiciones prevalentes. La literatura es escasa en cuanto a la asociación de estas dos variables con desenlaces desfavorables en pacientes hospitalizados por COVID-19. Objetivo: evaluar la asociación entre hiperglucemia y la aparición de desenlaces adversos en pacientes con COVID-19. Metodología: estudio de cohorte retrospectiva en el que se evaluó la asociación entre presentar hiperglucemia con la aparición de síndrome de dificultad respiratoria aguda (SDRA), lesión renal aguda (LRA) y muerte intrahospitalaria en pacientes hospitalizados por COVID-19. Resultados: se incluyeron 408 pacientes (edad media 60.48, 58.8 % hombres, 34.1 % con diabetes, 40.4 % con hiperglucemia intrahospitalaria). La hiperglucemia se asoció de forma independiente a un mayor riesgo de SDRA (OR: 1.84, IC 95 %: 1.15 – 2.94; p=0.001), LRA (OR: 2.73; IC: 1.24–5.96; p=0.012) y muerte intrahospitalaria (OR: 2.61; IC: 1.20–5.68; p=0.015) después de controlar por variables de confusión. El antecedente de diabetes no se asoció de forma independiente con un mayor riesgo en ninguno de los tres desenlaces adversos. Conclusiones: la hiperglucemia se asocia de forma independiente con peores desenlaces en pacientes hospitalizados por COVID-19 a diferencia de la diabetes mellitus.

IntroductionElevated pulse pressure (ePP) is an independent marker of cardiovascular risk (CVR) in people older than 60, and a functional marker of subclinical target organ damage (sTOD) which can predict cardiovascular events in patients with hypertension (HTN), regardless of sTOD.ObjectiveTo evaluate the prevalence of ePP in adult population seen in primary care and its association with other vascular risk factors, sTOD and with cardiovascular disease (CVD).Materials and methodsObservational multicentre study conducted in Spain (8,066 patients, 54.5% women) from the prospective cohort study IBERICAN recruited in Primary Care. Pulse pressure (PP) was defined as the difference between the systolic blood pressure (SBP) and the diastolic blood pressure (DBP) ≥60 mmHg. Adjusted (for age and sex) ePP prevalence were determined. Bivariate and multivariate analyses of the possible variables associated with ePP were carried out.ResultsThe mean of PP was 52.35 mmHg, and was significantly higher (p

Verticillium wilt of olive (VWO) is one of the most widespread and devastating olive diseases in the world. Harnessing host resistance to the causative agent is considered one of the most important measures within an integrated control strategy of the disease. Aiming to understand the mechanisms underlying olive resistance to VWO, the metabolic profiles of olive leaves, stems and roots from 10 different cultivars with varying levels of susceptibility to this disease were investigated by liquid chromatography coupled to mass spectrometry (LC-MS). The distribution of 56 metabolites among the three olive tissues was quantitatively assessed and the possible relationship between the tissues’ metabolic profiles and resistance to VWO was evaluated by applying unsupervised and supervised multivariate analysis. Principal component analysis (PCA) was used to explore the data, and separate clustering of highly resistant and extremely susceptible cultivars was observed. Moreover, partial least squares discriminant analysis (PLS-DA) models were built to differentiate samples of highly resistant, intermediate susceptible/resistant, and extremely susceptible cultivars. Root models showed the lowest classification capability, but metabolites from leaf and stem were able to satisfactorily discriminate samples according to the level of susceptibility. Some typical compositional patterns of highly resistant and extremely susceptible cultivars were described, and some potential resistance/susceptibility metabolic markers were pointed out.

This paper addresses the challenges associated with steel pipes used for transporting liquid fluids within buried sections of mining facilities, specifically in areas with heavy mining vehicles. While existing design standards, such as AW-WA M11, and manufacturer recommendations largely consider loads from vehicles like the AASHTO HS20 or Cooper E-80, both weighing below 35 tons, these guidelines inadequately represent the actual loads experienced on certain mining roads, notably those accommodating heavy vehicles, like haul roads. The research presented here focuses on the interaction between soil and buried steel pipes under the substantial loads exerted by mining vehicles with a maximum gross load of up to 612 tons, inclusive of hauled material weight. Utilizing a parametric study with the finite element method, the paper identifies critical variables influencing efforts and deflections calculations in these facilities. The analysis of 108 models, varying parameters related to trench pipe installation conditions, offers insights that empower designers to refine soil trench parameters in mining facilities, mitigating pipe failures and optimizing installation costs. Ultimately, the key influential variables affecting pipe deflection and stress are identified as the trench backfill height and the elasticity modulus of the trench lateral fill.

Urocortin-2 (Ucn-2) has demonstrated cardioprotective actions against myocardial ischemia-reperfusion (I/R) injuries. Herein, we explored the protective role of Ucn-2 through microRNAs (miRNAs) post-transcriptional regulation of apoptotic and pro-fibrotic genes. We determined that the intravenous administration of Ucn-2 before heart reperfusion in a Wistar rat model of I/R recovered cardiac contractility and decreased fibrosis, lactate dehydrogenase release, and apoptosis. The infusion of Ucn-2 also inhibited the upregulation of 6 miRNAs in revascularized heart. The in silico analysis indicated that miR-29a and miR-451_1∗ are predicted to target many apoptotic and fibrotic genes. Accordingly, the transfection of neonatal rat ventricular myocytes with mimics overexpressing miR-29a, but not miR-451_1∗, prevented I/R-induced expression of pro- and anti-apoptotic genes such as Apaf-1, Hmox-1, and Cycs, as well as pro-fibrotic genes Col-I and Col-III. We also confirmed that Hmox-1, target of miR-29a, is highly expressed at the mRNA and protein levels in adult rat heart under I/R, whereas, Ucn-2 abolished I/R-induced mRNA and protein upregulation of HMOX-1. Interestingly, a significant upregulation of Hmox-1 was observed in the ventricle of ischemic patients with heart failure, correlating negatively with the left ventricle ejection fraction. Altogether, these data indicate that Ucn-2, through miR-29a regulation, provides long-lasting cardioprotection, involving the post-transcriptional regulation of apoptotic and fibrotic genes.

Antecedentes: el etiquetado nutricional permite a los consumidores tomar mejores decisiones sobre alimentación, lo que contribuye a combatir las enfermedades crónicas no transmisibles. Objetivo: determinar cómo influye la interpretación del etiquetado nutricional, presente en los alimentos industrializados en Colombia, en la decisión de compra de estudiantes de pregrado del área de la salud de la Universidad CES. Materiales y métodos: se realizó un estudio observacional descriptivo en 76 estudiantes de quinto semestre de programas de pregrado del área de la salud. Resultados: la frecuencia en el uso del etiquetado nutricional se asoció con el sexo (p = 0,036), el tipo de programa (p < 0,001) y el conocimiento de la función del etiquetado nutricional (p = 0,000). La buena interpretación del etiquetado nutricional no condicionó la frecuencia en su uso (p = 0,095); además, el nivel de interpretación del etiquetado nutricional no se asoció con el sexo ni con el tipo de programa de pregrado. Finalmente, se encontró que la decisión de compra estaba influenciada por la costumbre (p = 0,018) y la publicidad (p = 0,008) y no por la interpretación del etiquetado nutricional. Conclusiones: aunque el uso del etiquetado nutricional es más frecuente entre las mujeres, los estudiantes de Nutrición y Dietética y entre quienes conocen la función del etiquetado nutricional, la decisión de compra no está influenciada por su interpretación.

Anemia causes hypo-oxygenation in the brain, which could lead to cognitive disorders. We examined dietary iron intake as well as anemia markers (i.e., hemoglobin, hematocrit, mean corpuscular volume) and diabetes coexistence in relation to neuropsychological function and quality of life. In this study, 6117 community-dwelling adults aged 55–75 years (men) and 60–75 years (women) with overweight/obesity and metabolic syndrome were involved. We performed the Mini-Mental State Examination (MMSE), the Trail Making Test parts A and B (TMT-A/B), Semantic Verbal Fluency of animals (VFT-a), Phonological Verbal Fluency of letter P (VFT-p), Digit Span Test (DST), the Clock Drawing Test (CDT), and the Short Form-36 Health Survey (SF36-HRQL test). Dietary iron intake did not influence neuropsychological function or quality of life. However, anemia and lower levels of anemia markers were associated with worse scores in all neurophysiological and SF36-HRQL tests overall, but were especially clear in the MMSE, TMT-B (cognitive flexibility), and the physical component of the SF36-HRQL test. The relationships between anemia and diminished performance in the TMT-A/B and VFT tasks were notably pronounced and statistically significant solely among participants with diabetes. In brief, anemia and reduced levels of anemia markers were linked to inferior cognitive function, worse scores in different domains of executive function, as well as a poorer physical, but not mental, component of quality of life. It was also suggested that the coexistence of diabetes in anemic patients may exacerbate this negative impact on cognition. Nevertheless, dietary iron intake showed no correlation with any of the outcomes. To make conclusive recommendations for clinical practice, our findings need to be thoroughly tested through methodologically rigorous studies that minimize the risk of reverse causality.

Introducción: La conciencia de hipoglucemia puede afectar el éxito del tratamiento. Una medición objetiva de la misma requiere instrumentos como el HypoA-Q, que, a diferencia de otros, mide conciencia de episodios nocturnos, sin embargo, no se dispone de una versión en español. Objetivo: Traducir y adaptar culturalmente la escala HypoA-Q para la medición de conciencia de hipoglucemia en pacientes colombianos con Diabetes Mellitus. Metodología: Estudio de Adaptación transcultural del instrumento HypoA-Q. Se obtuvo autorización de la autora para su traducción y adaptación a la población colombiana. Se siguió la metodología de la European Organisation for Research and Treatment for Cancer (EORTC): se realizaron dos traducciones directas por hablantes nativos del español, una versión reconciliada, dos traducciones inversas por dos hablantes nativos del inglés y una prueba piloto en 15 pacientes con diagnóstico de diabetes. Resultados: Aunque las traducciones directas al español fueron similares, se hicieron ajustes para obtener una versión reconciliada con palabras más fáciles de comprender y se hizo el cambio de unidades de mmol/L a mg/dl. Las traducciones inversas fueron similares al original en Ingles. La prueba piloto, realizada en 15 pacientes no requirió ajustar ninguno de los ítems, pues la frecuencia de ítems con dificultades de comprensión, confusión o palabras ofensivas fue menor al 15%. Conclusiones: Se dispone de la versión en español para Colombia de la escala HypoA-Q. Se debe realizar un estudio de evaluación de sus propiedades psicométricas antes de ser usada en investigaciones o en la práctica clínica.

Contexto: la cirugía bariátrica permite una pérdida de peso sostenible, sin embargo, entre el 15?% y el 35?% de estos pacientes presentan reganancia de peso asociada a desenlaces clínicos adversos. Objetivo: describir los factores asociados a la reganancia de peso en una cohorte de pacientes manejados en una clínica de obesidad. Metodología: se realizó un estudio de casos y controles anidado en una cohorte. Se definió “caso” como el paciente que presentó ganancia ? 10?% de peso respecto al mínimo posoperatorio en al menos un control entre el segundo y el décimo año de seguimiento, y “control” como todo aquel paciente que no cumplió dicho criterio. Se evaluaron variables clínicas, antropométricas, quirúrgicas y hábitos de vida, y se evaluó la asociación entre cada una de las variables consideradas como factor de riesgo mediante un análisis univariado y multivariado. Resultados: se incluyó a 154 pacientes: 31 casos y 123 controles casos. En el análisis multivariado, los factores que se asociaron a la reganancia de peso fueron IMC prequirúrgico > 40 kg/m2 (OR 3,02; IC95?% 1,08-8,46, p = 0,035), actividad física moderada a intensa (OR 6,07; IC95?% 1,23-29,8; p = 0,026) y trastorno de ansiedad (OR 5,50; 1,71-17,6; p = 0,004). Factores como pérdida de peso prequirúrgica (OR 0,84, IC95?% 0,74-0,98; p = 0,021) y dieta < 1200 calorías (OR 0,36; IC95?% 0,13-1,00; p = 0,050) disminuyeron el riesgo de reganancia. Conclusiones: el 25?% de los pacientes presentan reganancia de peso, de dos a diez años después de la cirugía bariátrica. Factores pre y posquirúrgicos se asociaron a la reganancia de peso, sugiriendo la importancia del seguimiento multidisciplinario a largo plazo en pacientes tratados con cirugía.

IntroductionThe COVID-19 pandemic has had an impact both in general and mental healthcare, challenged the health systems worldwide, and affected their capacity to deliver essential health services. We aimed to describe perceived changes in ease of access to general and mental healthcare among patients with a diagnosis of depression and/or unhealthy alcohol use in Colombia.MethodsThis study is embedded in the DIADA project, a multicenter implementation research study aimed at evaluating the integration of mental healthcare in primary care in Colombia. Between November 2020 and August 2021, we conducted a COVID-19 pandemic impact assessment in a cohort of participants with newly diagnosed depression and/or unhealthy alcohol use part of DIADA project. We assessed the ease of access and factors related to perceived ease of access to general or mental healthcare, during the COVID-19 pandemic.Results836 participants completed the COVID-19 pandemic impact assessment. About 30% of participants considered their mental health to be worse during the pandemic and 84.3% perceived access to general healthcare to be worse during the pandemic. Most of participants (85.8%) were unable to assess access to mental health services, but a significant proportion considered it to be worse. Experiencing worse ease of access to general healthcare was more frequent among women, patients with diagnosis of depression, and patients with comorbidities. Experiencing worse ease of access to mental healthcare was more frequent among patients aged between 30 and 49.9 years, from socioeconomic status between 4 and 6, affiliated to the contributive social security regime, attending urban study sites, and those who perceived their mental health was worse during the pandemic.DiscussionDespite the overall perception of worse mental health during the pandemic, the use of mental healthcare was low compared to general healthcare. Ease of access was perceived to be worse compared to pre-pandemic. Ease of access and access were affected by geographical study site, socioeconomic status, age and gender. Our findings highlight the need for improved communication between patients and institutions, tailored strategies to adapt the healthcare provision to patients' characteristics, and continued efforts to strengthen the role of mental healthcare provision in primary care.

Contexto: el consenso sobre el manejo del ejercicio para los pacientes con diabetes tipo 1 (DM1) no incluye recomendaciones para pacientes usuarios de sistemas híbridos de asa cerrada (SHAC). Objetivo: describir en pacientes con DM1, usuarios de SHAC con uso de objetivo temporal, el comportamiento de la glucosa intersticial durante ejercicio aeróbico (EA) y de resistencia (ER). Metodología: estudio piloto descriptivo en el cual se incluyeron pacientes mayores de 18 años tratados con SHAC. Se registraron datos demográficos basales y se programaron sesiones de actividad física de EA de intensidad moderada y ER de acuerdo con las recomendaciones del consenso. En ambas sesiones se indicó uso del objetivo temporal 60 minutos antes y medir la glucosa capilar durante la actividad física (basal, 15, 30, 45 y 60 minutos). Al finalizar las sesiones de ejercicio se descargaron los datos del dispositivo. Resultados: se incluyeron 10 pacientes (80?% mujeres, edad promedio 41,1 ± 11,8 años) con TIR entre 70-180 mg/dl > 90?%. Durante el EA, el promedio de glucosa basal, 15, 13, 45 y 60 minutos fue de 147,1 ± 24,1 mg/dl, 131,4 ± 15,5 mg/dl, 131,4 ± 15,5 mg/dl, 107,9 ± 17 mg/dl y 101,3 ± 19,5 mg/dl, p < 0,05, respectivamente. Durante el ER no se observaron cambios significativos con respecto a la glucosa basal y 36 horas posterior a la actividad física se presentaron 2,75 eventos de hipoglucemia nivel 1, sin hipoglucemia severa. Conclusiones: el EA disminuye los niveles de glucosa de forma temprana y significativa, mientras que en el ER los niveles de glucosa permanecen estables. Los datos reportados en este estudio sugieren que el uso de SCHA es seguro si se siguen las pautas del consenso y se programa el objetivo temporal.

Avocado peel and seed are the main by-products of avocado processing and are considered as promising sources of phenolic compounds with biological activities. Thus, this research focuses on the establishment, for the first time, of ultrasound-assisted extraction of flavan-3-ols with high antioxidant activity from avocado peel and seed using a sonotrode. Indeed, 2 Box–Behnken designs were performed for 15 experiments, with each design having three independent factors (ratio ethanol/water (v/v), time (min) and amplitude (%)). In both models, the responses included total procyanidins (flavan-3-ols) measured via HPLC-FLD and antioxidant activity measured via DPPH, ABTS and FRAP. The results showed that applying the sonotrode extraction method could increase flavan-3-ols recovery by 54% and antioxidant activity by 62–76% compared to ultrasound bath technology. Therefore, this technology was demonstrated to be a non-thermal, low time-consuming and scalable method that allowed the recovery of flavan-3-ols from avocado by-products that could be used as functional ingredients.

Urban and peri-urban agriculture is one of the strategies that emerged on the path towards agri-food sustainability in cities. This paper aims at improving the knowledge of the soil properties in a peri-urban area and their agricultural potential to support ecosystems with biodiversity worth conserving. The study area was located in the mid-plain of the Segura River (SE Spain). Arable soil layer samples were collected at 68 points to assess the distribution of organic carbon and to study other indicators of soil quality. A Wilcoxon and Kruskal–Wallis test was conducted to compare between the types of soils present in the area (calcaric Fluvisols and calcaric Regosols) and soil uses (industrial, cultivated and abandoned). Statistical analysis indicates that there are significant differences (at the 0.05 significance level) between Fluvisols and Regosols (p value = 3.65 × 10−5). Regarding use, the abandoned Fluvisols presented an average value of 9.33 g kg−1 of OC while the Fluvisols that are currently cultivated have a higher average content of OC (11.35 g kg−1). For soils under industrial use, the average OC content is 5.13 g kg−1. Spatial distribution of organic carbon in these soils depends on the type of soil and the human influence on them, including the use.

El llamado «milagro de las lágrimas o del sudor», ocurrido en Granada en 1670 en torno a la Virgen del Rosario, representa un punto de inflexión en el contexto de la época. Además de los testigos habituales que podía requerir este tipo de procesos, fieles o devotos, nos proporciona una interesante nómina de artistas y artífices activos en esas fechas en la ciudad, entre ellos el pintor Pedro Atanasio de Bocanegra, que fueron llamados a declarar en calidad de expertos en materia artística en el proceso de clarificación del mismo.

Avocado seeds, a common waste in the avocado processing industry, have been found to have several bioactivities, such as anticancer, antimicrobial, hypocholesterolemic, antioxidant, and antidiabetic activities, among others. Nowadays, this wastage is causing an environmental problem, so the use of new technologies to take advantage of it is a novel field of research. In this study, the submerged fermentation by lactic acid bacteria was used as a novel tool for improving the bioactive compound extraction from avocado seeds. Avocado seeds were fermented by different strains, their polar compounds were identified and quantified by HPLC-ESI-TOF-MS, the antioxidant activity was measured by DPPH and FRAP assays, and the antidiabetic activity was analyzed by the alpha-amylase assay. A total of 32 polar compounds were identified, with 13 of them being described in avocado seeds for the first time. Avocado seeds fermented by Pentosaceus acidilactici showed the highest sum of polar compounds (6279.63 ± 67.74 µg/g d.w.), and by extension, of hydroxytyrosol glucoside (2989.76 ± 3.64 µg/g d.w.). Lactiplantibacillus plantarum CECT 9567 showed the highest antioxidant activity measured by both DPPH and FRAP assays (6294.67 ± 19.44 and 6846.91 ± 2.13 µg TE/g d.w., respectively). Furthermore, Lactiplantibacillus plantarum CECT 748T had the highest antidiabetic activity (52.15% ± 0.67% inhibition of alpha-amylase activity), attributable to the polyphenols. According to the results, submerged fermentation by lactic acid bacteria led to an interesting increase of the polar compounds’ extractability of avocado seeds, consequently improving the bioactivities of the extracts, which could then be used for food nutraceutical or cosmetic purposes.

Vaccinium myrtillus L. (bilberry) leaves are an important by-product of berry production that may be used as a source of phenolic compounds which have a positive effect on human health. Therefore, an ultrasound-assisted extraction via sonotrode has been used for the first time to recover bioactive compounds from bilberry leaves. The extraction has been optimized using a Box–Behnken design. The influence of ethanol:water ratio (v/v), time of extraction (min) and amplitude (%) were evaluated considering total phenolic content (TPC) and antioxidant capacity (DPPH and FRAP assays) as dependent variables in a response surface methodology (RSM). Optimum values for the independent factors were 30:70 ethanol/water (v/v), 5 min of extraction and 55% amplitude. The empirical values of the independent variables using the optimized conditions were 217.03 ± 4.92 mg GAE/g d.w. (TPC), 271.13 ± 5.84 mg TE/g d.w. (DPPH) and 312.21 ± 9.30 mg TE/g d.w. (FRAP). The validity of the experimental design was confirmed using ANOVA and the optimal extract was characterized using HPLC-MS. A total of 53 compounds were tentatively identified, of which 22 were found in bilberry leaves for the first time. Among them, chlorogenic acid was the most abundant molecule, representing 53% of the total phenolic compounds identified. Additionally, the antimicrobial and anticancer activities of the optimum extract were tested. Gram-positive bacteria demonstrated high sensitivity to bilberry leaves extract in vitro, with MBC values of 6.25 mg/mL for Listeria monocytogenes, Listeria innocua and Enterococcus faecalis, and 0.8 mg/mL for Staphylococcus aureus and Bacillus cereus. Furthermore, bilberry leaves extract exerted in vitro antiproliferative activity against HT-29, T-84 and SW-837 colon tumor cells with IC50 values of 213.2 ± 2.5, 1140.3 ± 5.2 and 936.5 ± 4.6 μg/mL, respectively. Thus, this rapid ultrasound-assisted extraction method has demonstrated to be an efficient technique to obtain bilberry leaves extract with in vitro antioxidant, antimicrobial and anticancer capacities that may be useful for the food industry as natural preservative or even for the production of functional foods or nutraceuticals.

A comprehensive characterization of the phytochemicals present in a blackberry fruit extract by HPLC-TOF-MS has been carried out. The main compounds in the extract were ursane-type terpenoids which, along with phenolic compounds, may be responsible for the bioactivity of the extract. In vitro antioxidant capacity was assessed through Folin–Ciocalteu (31.05 ± 4.9 mg GAE/g d.w.), FRAP (637.8 ± 3.2 μmol Fe2+/g d.w.), DPPH (IC50 97.1 ± 2.4 μg d.w./mL) and TEAC (576.6 ± 8.3 μmol TE/g d.w.) assays. Furthermore, the extract exerted remarkable effects on in vitro cellular antioxidant activity in HUVEC cells at a concentration of 5 mg/mL. Antimicrobial activity of the extract was also tested. Most sensible microorganisms were Gram-positive bacteria, such as E. faecalis, B. cereus and Gram-negative E. coli (MBC of 12.5 mg/mL). IC50 values against colon tumoral cells HT-29 (4.9 ± 0.2 mg/mL), T-84 (5.9 ± 0.3 mg/mL) and SW-837 (5.9 ± 0.2 mg/mL) were also obtained. Furthermore, blackberry extract demonstrated anti-inflammatory activity inhibiting the secretion of pro-inflammatory IL-8 cytokines in two cellular models (HT-29 and T-84) in a concentration-dependent manner. These results support that blackberry fruits are an interesting source of bioactive compounds that may be useful in the prevention and treatment of different diseases, mainly related to oxidative stress.

Background: It is imperative to identify drugs that allow treating symptoms of severe COVID-19. Respiratory failure is the main cause of death in severe COVID-19 patients, and the host inflammatory response at the lungs remains poorly understood.Methods: Therefore, we retrieved data from post-mortem lungs from COVID-19 patients and performed in-depth in silico analyses of single-nucleus RNA sequencing data, inflammatory protein interactome network, and shortest pathways to physiological phenotypes to reveal potential therapeutic targets and drugs in advanced-stage COVID-19 clinical trials.Results: Herein, we analyzed transcriptomics data of 719 inflammatory response genes across 19 cell types (116,313 nuclei) from lung autopsies. The functional enrichment analysis of the 233 significantly expressed genes showed that the most relevant biological annotations were inflammatory response, innate immune response, cytokine production, interferon production, macrophage activation, blood coagulation, NLRP3 inflammasome complex, and the TLR, JAK-STAT, NF-κB, TNF, oncostatin M signaling pathways. Subsequently, we identified 34 essential inflammatory proteins with both high-confidence protein interactions and shortest pathways to inflammation, cell death, glycolysis, and angiogenesis.Conclusion: We propose three small molecules (baricitinib, eritoran, and montelukast) that can be considered for treating severe COVID-19 symptoms after being thoroughly evaluated in COVID-19 clinical trials.

En las últimas décadas los avances en el tratamiento de los pacientes con diabetes tipo 1 han permitido optimizar el control metabólico y disminuir cada vez más la frecuencia de eventos de seguridad entre ellos la hipoglucemia. La tecnología juega un papel fundamental en el control glucémico de estos pacientes y cada vez es más utilizada en la población diabética mundial. Sin embargo, los cambios en el estilo de vida continúan teniendo un papel protagónico y entre ellos el ejercicio se considera fundamental para el manejo no solo de la diabetes sino de las comorbilidades asociadas. La presente revisión busca reforzar el conocimiento desde las bases fisiológicas de esta relación dicotómica y fuerte entre ejercicio físico y diabetes tipo 1 y sentar las bases terapéuticas enfocadas en la disminución de eventos de seguridad principalmente la hipoglucemia.

Objective: Poor sleep quality is a common problem in the general population, frequently associated with personal habits and comorbid conditions. University students may be a vulnerable population because of their daily routine, habits and sleep hygiene behavior. There are few related studies on this subject in Colombian undergraduates. The aim of this study is to characterize sleep quality in Colombian university undergraduates and examine possible associated factors. Methods: Crosssectional study was performed with self-administered questionnaires including demographic data, lifestyle habits, sleep hygiene habits and sleep quality measured by the Pittsburgh Sleep Quality Index (PSQI). The study group included 414 students from different schools enrolled at the Pontificia Universidad Javeriana in Bogotá, Colombia. Results: Prevalence of poor sleep quality according to PSQI was 58.9%. Multivariate analysis showed an association of poor sleep quality with smoking (OR = 3.17 [1.51-6.66]) and eating in bed (OR = 2.13 [1.31-3.47]), with probable protective factors in sleeping at the same time (OR = 0.37 [0.25-0.59]) and having breakfast 5 or more days of the week (OR = 0.53 [0.31-0.91]). Discussion: Poor sleep quality is frequent among undergraduates, regardless of their area of study. The identification of possible related factors may help to design targeted preventive measures, as it is promoting healthy lifestyle habits, adequate sleep hygiene practices and avoiding tobacco use.

Contexto: la prevalencia de las personas mayores con diabetes es significativa y la fragilidad, como síndrome geriátrico potencialmente reversible, se ha relacionado con diferentes desenlaces adversos en salud. Objetivo: describir la importancia de la relación de la diabetes, la fragilidad y el impacto que tiene la valoración geriátrica integral, en el manejo de las personas mayores con estas condiciones. Adicionalmente, dar a conocer herramientas para el tamizaje y diagnóstico de la fragilidad en personas mayores con diabetes. Metodología: se realizó una búsqueda no sistemática de la literatura relacionada con las personas mayores con diabetes, fragilidad y la relación entre estas condiciones, teniendo en cuenta guías de manejo de diabetes y el consenso de fragilidad. Resultados: las guías de manejo promueven la valoración multidimensional de la persona mayor con diabetes, buscando garantizar un manejo integral y adherencia al mismo. Dentro de la evaluación de los diferentes dominios, la fragilidad, como síndrome geriátrico, cobra importancia para definir los objetivos y metas terapéuticas, existiendo diferentes herramientas para su evaluación de acuerdo con el nivel asistencial dónde se encuentre. Conclusiones: el diagnóstico de la fragilidad en las personas mayores, con diabetes, permite individualizar el manejo terapéutico. Sugerimos utilizar Frail como cuestionario de tamizaje y los criterios de fenotipo de fragilidad para su diagnóstico definitivo.

Introducción: La glucometría tiene un rol critico en el manejo del paciente tratado con insulina. Factores técnicos y medioambientales afectan significativamente la precisión de los glucómetros. El objetivo es establecer la precisión clínica y numérica de los glucómetros usados en Colombia, comparado con glucemia central. Métodos: Estudio de pruebas diagnósticas. Se evaluaron glucómetros del plan básico de salud (GluNeo,GlucoQuick,Optium Neo,Select Plus y Gluco Quick Diamond Voice). Se incluyeron adultos tratados con bomba de infusión de insulina integrada a sistema de monitoreo continuo. Se clasificaron las muestras en: >100mg dL,>70 y 100 mg/dL,?70 mg/dL. Para glucosa ?100 mg/dL se administró un bolo de insulina utilizando la función de bolus wizard. Se evalúo la precisión numérica utilizando la media absoluta de la diferencia relativa (MARD) y la precisión clínica según la proporción las mediciones en las zonas A+B de la gradilla de Clarke y la gradilla de Parkes (Consensus). Resultados. Se analizaron 830 mediciones. Todos los dispositivos cumplieron requisitos de precisión para glucosa >100mg/dL. Optium Neo y Gluco Quick Diamond Voice, alcanzaron estándares de cumplimiento al combinar todos los niveles de medición de 12,1% y 13,9%, respectivamente. La precisión clínica para estos dos dispositivos fue de 98% y >95% según gradilla Parkes (Consensus) y Clarke, respectivamente. Se evidenció mayor variabilidad de los resultados en el rango ?70mg/dL. Conclusiones. La precisión numérica fue adecuada para los dispositivos evaluados para valores de glucosa capilar >100mg/dL y disminuye con valores

Orange peel is one of the main by-products from juice processing, and is considered as a promising source of phenolic compounds with anti-carcinogenic, anti-inflammatory, anti-microbial and antioxidant properties. The drying is an essential step to ensure the storage of this by-product at an industrial level, in order to use it as a functional ingredient or as a nutraceutical. Thus, this research focuses on the evaluation of the effect of the convective air-drying process in orange by-products at three different temperatures (40, 60 and 80 °C) and air flows (0, 0.8 and 1.6 m/s) on the phenolic content (measured by HPLC-MS), the antioxidant activity (measured by DPPH, ABTS and FRAP), and the vitamin C content (measured by HPLC-UV/VIS). Moreover, the mathematical modelling of its drying kinetics was carried out to examine the orange by-product behavior. Among the tested mathematical models, the Page model reported the highest fit and the best drying conditions, which showed the lowest reductions were at 60 °C with an air flow of 1.6 m/s and taking 315 min.

Propósito. La ciencia aplicada, una de las aristas definitorias de la tecnología, ha tenido un acercamiento a la medicina desde su aurora; dicho aspecto llega a lo más profundo de la Endocrinología. El presente texto tiene por objetivo denotar conceptos de aproximación, para así describir la implementación práctica del tándem entre tecnología y Endocrinología en los diferentes tiempos que lo han acompañado. Contenidos. Se empieza con algunos elementos históricos puntuales de encuentro entre la tecnología y la Endocrinología. Posteriormente, se introduce un concepto de vibrante vigencia: el tiempo en rango como métrica del control glucémico en la actualidad. Se reconoce el rol protagónico del monitoreo continuo de glucosa en la diabetes, al igual que se exploran sus potenciales usos. En el cuarto capítulo se hace un alto en el camino para comprender la inmediación entre la matemática y la Endocrinología. En los dos últimos capítulos se hace una inmersión al mundo de los ecosistemas digitales, a través del camino de la inteligencia artificial y recursos funcionales como la apps. Conclusiones. El apasionante mundo de la tecnología nos seduce cada vez más en los diferentes ámbitos; su relación con la Endocrinología es y será en el tiempo de una contundencia irrebatible. De esta manera, se ofrece una invitación abierta a vivir los procesos venideros de dicha fusión conceptual.

Solid-state fermentation (SSF) is widely recognised as a technique to increase the bioactive potential and nutritional value of plant materials. However, the effect of this biotreatment differs for individual substrates. This study aimed to evaluate the impact of SSF with filamentous fungi (Rhizopus, Aspergillus, and Neurospora) on a moringa leaf phenolic profile, antioxidant activity, and amino acid composition. A total of 43 phenolic compounds were determined in the dried leaves analysed by HPLC-ESI-TOF-MS. The leaves contained 11.79 mg/g of free phenolics: flavonols (80.6%, mainly quercetin and kaempferol glycosides), hydroxycinnamic acid derivatives (12.3%), vitexin and vicenin (6.9%), and a small amount of lignan (isolariciresinol isomers). The result of the 1-day fermentation was a slight enhancement in the concentration of individual free phenolics (flavones) and the antioxidant activity of the leaves. However, extending the incubation period caused a significant decrease in those parameters and cannot be recommended for obtaining a food fortificant from moringa leaves. In contrast, the 3-day fermentation with N. intermedia led to a 26% average accumulation of individual amino acids. Therefore, the SSF with Neurospora can be a promising method for improving the nutritional composition of moringa leaves and needs further investigation.

Apple pomace is the main by-product from apple processing in the juice industry and is considered a source of polyphenols with several health bioactivities. Thus, this research focuses on the establishment of the ultrasound-assisted extraction of total phenolic compounds, focusing on phloretin and phloridzin, with high antioxidant activity from apple pomace, using a sonotrode. We used a Box–Behnken design of 15 experiments with 3 independent factors (ethanol (%), time (min) and amplitude (%)). The responses evaluated were the sum of phenolic compounds, phloretin and phloridzin measured by HPLC–MS-ESI-TOF, and antioxidant activity measured by DPPH, ABTS and FRAP. The validity of the model was confirmed by ANOVA. Further, it was carried out using a comparison between different apple pomaces with or without seeds extracted by the optimal conditions. Phloretin and phloridzin accounted for 7 to 32% of the total phenolic compounds in the apple pomaces. Among all the apple pomace analyzed, that of the variety Gala had the highest phenolic content and antioxidant activity. The presence of the cyanogenic compound amygdalin was detected in apple pomaces that contained seeds accompanied with a higher content of phloretin and phloridzin but a lower content of flavan-3-ols.

Phenolic compounds present in mango peel byproducts have been reported to have several beneficial health properties. In this study, we carried out an optimization of phenolic compounds using ultrasound-assisted extraction via ultrasonic bath and sonotrode. To optimize the variables of extraction, a Box–Behnken design was used to evaluate the best conditions to obtain high total phenolic compound extraction and high antioxidant activity evaluated by different methods (DPPH, ABTS, and FRAP). The optimal ultrasonic bath conditions were 45% ethanol, 60 min, and 1/450 ratio sample/solvent (w/v) whereas optimal sonotrode conditions were 55% ethanol, 18 min, and 65% amplitude. The extracts obtained at the optimal conditions were characterized by HPLC–ESI-TOF-MS. A total of 35 phenolic compounds were determined and, to our knowledge, several of them were tentatively identified for the first time in mango peel. The samples were composed mainly by phenolic acids derivatives, specifically of galloylglucose and methylgallate, which represented more than 50% of phenolic compounds of mango peel byproducts. In conclusion, sonotrode is a valuable green technology able to produce enriched phenolic compound extracts from mango peel byproducts that could be used for food, nutraceutical, and cosmeceutical applications.

Phenolic profiles, antioxidant, and antimicrobial activities of hydroethanolic olive leaf extracts from six Mediterranean olive cultivars (Croatian: Lastovka, Levantinka, Oblica; Italian: Moraiolo, Frantoio, Nostrana di Brisighella) were investigated. As expected, various distributions of phenolic levels were observed for each cultivar and the total phenolic content showed high variability (ranging from 4 to 22 mg GAE/g of dry extract), with the highest amount of phenolics found in the Oblica sample, which also provided the highest antiradical (ORAC) and reducing activity (FRAP). The screening of individual compounds was performed by HPLC-PDA-ESI-QTOF-MS and the main detected compounds were oleuropein, hydroxytyrosol, oleoside/secologanoside, verbascoside, rutin, luteolin glucoside, hydroxyoleuropein, and ligstroside. While the antioxidant activity of the samples was relatively high, they showed no bactericidal and bacteriostatic activity against E. coli and S. Typhimurium; weak activity against Staphylococcus aureus, Bacillus cereus, and Listeria innocua; and inhibitory effects against Campylobacter jejuni at 0.5 mg dry extract/mL. The obtained results support the fact that olive leaf extracts, and especially those from the Oblica cultivar, could potentially be applied in various industries as natural preservatives and effective and inexpensive sources of valuable antioxidants.

Extraction of valuable bioactive compounds from olive leaves is a hot topic and the use of sustainable and green technologies is mandatory in terms of circular economy. In this way, the use of fermentation technologies showed very interesting results in terms of phenolic compound recovery. Because of that in this work the use of solid state fermentations, as valuable tool to improve the phenolic extraction has been checked. Aspergillus oryzae (in mycelium and spore form), Aspergillus awamori and Aspergillus niger were used as fermentation microrganisms. Phenolic compounds were determined by HPLC-ESI-TOF-MS and, to our knowledge, new compounds have been tentatively identified in olive leaves. Fermentation using mycelium of Aspergillus awamori, Aspergillus niger and Aspergillus oryzae were effective to increase both hydroxytyrosol and elenolic acid derivatives whereas the use of spores of Aspergillus oryzae caused a loss of hydroxytyrosoyl derivatives, contrary the content of elenolic derivatives are comparable with the other fermentation treatments and higher than control. The proposed fermentation processes using the mycelium of Aspergillus awamori, Aspergillus niger and Aspergillus oryzae lead to an increase the hydroxytyrosyl and elenolic acid derivatives and could be used at industrial scale to obtain enriched extracts.

The leaves of Annona cherimola Mill (cherimoya) are a potential source of phenolic compounds that have been shown to have beneficial properties. Therefore, this study focuses on establishing an ultrasonic-assisted extraction of phenolic compounds in cherimoya leaves using a sonotrode. For that purpose, a Box-Behnken design based on a response surface methodology (RSM) was used to optimize factors, such as amplitude, extraction time and solvent composition to obtain the maximum content of phenolic compounds by HPLC-MS and the maximum in-vitro antioxidant activity by DPPH, ABTS and FRAP assays in ‘Fino de Jete’ cherimoya leaves. The optimal conditions were 70% amplitude, 10 min and 40:60 ethanol/water (EtOH/H2O) (v/v). The results obtained under these optimum conditions by using a sonotrode were compared with those from an ultrasonic bath; briefly, recovery of phenolic compounds by sonotrode was 2.3 times higher than a bath. Therefore, these optimal conditions were applied to different varieties ‘Campas’, ‘Fino de Jete’ and ‘Negrito Joven’ harvested in the Tropical Coast of Granada (Spain). A total of 39 phenolic compounds were determined in these cherimoya leaf extracts, 24 phenolic compounds by HPLC-MS and 15 proanthocianidins by HPLC-FLD. 5-p-coumaroylquinic acid, lathyroside-7-O-α-l-rhamnopyranoside and quercetin hexose acetate were first identified in cherimoya leaves. The most concentrated phenolic compounds were the flavonoids, such as rutin and quercetin hexoside and proanthocyanidins including monomers. Almost no significant differences in the phenolic content in these cultivars were found (11–13 mg/g d.w. for phenolic compounds and 11–20 mg/g d.w. for proanthocyanidins). In addition, sonotrode ultrasonic-assisted extraction has been shown to be an efficient extraction technique in the phenolic recovery from cherimoya leaves that could be implemented on an industrial scale.

Objetivo: Determinar la relación entre el mediador y el nivel de comprensión lectora de textos literarios de estudiantes de educación inicial. Método: En el estudio participaron 5 niños de 5 años de una institución educativa en Colombia. La investigación es de enfoque cuantitativo, diseño pre experimental tipo -preprueba / post prueba con un solo grupo. La intervención se hizo durante 9 sesiones de trabajo, divididas en 3 ciclos, en los que variaba el nivel de complejidad de los textos. Para evaluar la comprensión al inicio y al final de la investigación, se elaboró una prueba que fue validada por un experto, con preguntas que indagan por el nivel de comprensión literal e inferencial, así mismo, se diseñó una propuesta de intervención pedagógica con el fin de estimular la comprensión de textos literarios (cuentos) en niños de 5 años. Resultados: Los resultados muestran avance en la comprensión a nivel literal e inferencial (coherencia local y global) de los niños gracias a las estrategias puestas en práctica por el mediador. Discusión y Conclusiones: El avance en los procesos de comprensión que se evidenciaron en esta investigación se puede relacionar con las actuaciones del mediador que implementó las estrategias de lectura compartida, la pregunta como estrategia pedagógica y la estimulación de la comprensión desde el nivel literal al nivel inferencial. Además, el proceso realizado permite entender la comprensión como un proceso lento y continuo en el tiempo, de manera que es posible continuar con su cualificación a partir de las mediaciones implementadas.

Introduction: The non-interventional International Operations Hypoglycemia Assessment Tool (IO-HAT) study assessed the incidence of hypoglycemia in patients with insulin-treated diabetes across nine countries, including a cohort of patients in Colombia. Materials and methods: Hypoglycemia incidence among patients with insulin-treated diabetes was assessed across 26 sites in Colombia. Hypoglycaemic events (any, nocturnal or severe) were reported in self-assessment questionnaires (SAQ) and patient diaries based on capillary blood glucose measurement or symptoms. Retrospective events (severe events 6 months before baseline and any event 4 weeks before baseline) were recorded in SAQ, Part 1, and prospective events (4 weeks from baseline) were recorded in SAQ, Part 2, and patient diaries. Differences in hypoglycemia incidence reported in the retrospective and prospective periods were assessed using two-sided tests. Results: Of the 664 patients assessed, 213 had type 1 diabetes (T1D) and 451 had type 2 diabetes (T2D). Nearly all patients experienced at least one hypoglycaemic event in the prospective period (97.1% T1D; 93.3% T2D). Rates of hypoglycemia (events per personyear, PPY) were higher prospectively than retrospectively for any hypoglycemia (T1D: 121.6 vs. 83.2, p

Mechanical ventilation systems require a device for measuring the air flow provided to a patient in order to monitor and ensure the correct quantity of air proportionated to the patient, this device is the air flow sensor. At the beginning of the COVID-19 pandemic, flow sensors were not available in Peru because of the international supply shortage. In this context, a novel air flow sensor based on an orifice plate and an intelligent transducer was developed to form an integrated device. The proposed design was focused on simple manufacturing requirements for mass production in a developing country. CAD and CAE techniques were used in the design stage, and a mathematical model of the device was proposed and calibrated experimentally for the measured data transduction. The device was tested in its real working conditions and was therefore implemented in a breathing circuit connected to a low-cost mechanical ventilation system. Results indicate that the designed air flow sensor/transducer is a low-cost complete medical device for mechanical ventilators that is able to provide all the ventilation parameters by an equivalent electrical signal to directly display the following factors: air flow, pressure and volume over time. The evaluation of the designed sensor transducer was performed according to sundry transducer parameters such as geometrical parameters, material parameters and adaptive coefficients in the main transduction algorithm; in effect, the variety of the described results were achieved by the faster response time and robustness proportionated by transducers of nanostructures based on Anodic Aluminum Oxide (AAO), which enhanced the designed sensor/transducer (ST) during operation in intricate geographic places, such as the Andes mountains of Peru.

Olea europaea subsp. cuspidata has a relatively low commercial value due to the low size and pulp to stone ratio of its drupes compared to commercial olive cultivars. Nevertheless, this subspecies could represent a valid source of useful traits for olive breeding. In the current work, the drupe metabolic composition (secoiridoids, flavonoids, simple phenols, triterpenic acids, etc.) of a progeny of 27 cuspidata genotypes coming from free pollination and their female parent was evaluated by applying a powerful LC-MS method. A total of 62 compounds were detected within the profiles; 60 of them were annotated and 27 quantified. From a quantitative point of view, the genotypes from the progeny of cuspidata showed quite different metabolic profiles to olive common cultivars (“Arbequina”, “Frantoio”, “Koroneiki” and “Picual”) used as controls. Cuspidata drupes were richer in terms of several bioactive compounds such as rutin, hydroxytyrosol glucoside, a few interesting secoiridoids and the compounds of m/z 421 and 363. The relationships among several secondary metabolites determined in the progeny inferred from the results of both PCA and cross-correlation analysis were explained according to metabolic biosynthesis pathways in olive drupes. These outcomes underlined the potential of cuspidata genetic resources as a source of potentially interesting variability in olive breeding programs.

A system of mathematical equations was developed for the calculation of the natural frequencies of helical springs, its predictions being compared with finite element simulation with ANSYS®. Authors derive the general equations governing the helical spring vibration relative to the Frenet trihedral representing the normal, binormal and tangent unit vectors to the spring medium line. The dispersion relation ω=f(k) has been obtained to model a wave traveling along the axis of the wire.