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Color is an important parameter in food because it can be associated with quality. Since ancient times, natural dyes have been used in foods to make them attractive, but due to their poor stability to environmental factors and production processes, technologies emerged over time that led to getting artificial pigments with high stability, low production costs, and high dyeing capacity. However, some adverse indications of health damage have been reported, and that is why there is a growing interest in using natural colorants in food again. The red color is one of the most striking and important tones in the food sector since it is attractive, and it can produce expected taste sensations. One of the natural pigments that provide this red hue are anthocyanins, compounds that are widely distributed in plant sources, unlike artificial colors, have been associated with multiple health benefits. However, the application of anthocyanins represents a challenge due to their low stability against factors such as pH, oxygen, light, and temperature, so they are being stabilized through chemistry or physics way. This work aims to highlight the importance of anthocyanins and illustrate a summary of stabilization and conservation strategies used in patents applied in the food industry, as a methodological background to increase the use of natural pigments in diets.

RESUMEN Introducción y objetivos: La calcificación coronaria es uno de los principales factores que inciden negativamente en la seguridad y la eficacia del intervencionismo coronario percutáneo. Existen varias técnicas de modificación del calcio, pero falta evidencia de estudios aleatorizados sobre la terapia de elección en este escenario. Métodos: El ROLLERCOASTR es un estudio prospectivo, multicéntrico y aleatorizado, diseñado para comparar la seguridad y la eficacia de 3 técnicas de modificación de la placa en el contexto de calcificación coronaria moderada o grave: aterectomía rotacional (AR), aterectomía coronaria con láser láser excimer (ACLE) y litotricia intracoronaria (LIC). El objetivo primario es la expansión del stent evaluada mediante tomografía de coherencia óptica. Su análisis se hará por intención de tratar, con un α de 0,05 entre el grupo de referencia (AR) y cada uno de los otros grupos (ACLE y LIC). Se realizará también un análisis del objetivo primario por protocolo para mantener la coherencia. Si se confirma la hipótesis de no inferioridad, se realizará un análisis bilateral de superioridad. El comité de eventos clínicos y el laboratorio central independiente no conocerán la rama de tratamiento. Asumiendo un error α de 0,05, un error β de 0,2 (80% de potencia), un margen de irrelevancia (ε) del 7% y un 10% de pérdidas por dificultad de medición o imposibilidad de completar la intervención, se estima un tamaño de muestra de 56 casos en cada grupo. Los objetivos secundarios son el éxito del dispositivo, el éxito del procedimiento, la tasa de cruce entre técnicas y la presentación de eventos cardiovasculares adversos importantes al año de seguimiento. Conclusiones: El estudio ROLLERCOASTR evaluará y comparará la seguridad y la eficacia, en pacientes con estenosis coronaria calcificada, de 3 técnicas de modificación de placa: AR, ACLE y LIC. Este ensayo se ha registrado en Clinicaltrials.gov: NCT04181268.

ABSTRACT Introduction and objectives: Coronary calcification is one of the leading factors that affect negatively the safety and effectiveness of percutaneous coronary intervention. Several calcium modification techniques exist. However, there is a lack of randomized evidence on the therapy of choice in this scenario. Methods: The ROLLERCOASTR is a prospective, multicenter, randomized clinical trial designed to compare the safety and efficacy profile of 3 plaque modification techniques in the moderate-to-severe coronary calcification setting: rotational atherectomy (RA), excimer laser coronary angioplasty (ELCA), and intravascular lithotripsy (IVL). The study primary endpoint is stent expansion evaluated by optical coherence tomography. An intention-to-treat analysis will be conducted with an alpha coefficient of 0.05 between the reference group (RA) and the remaining 2 groups (ELCA and IVL). An analysis of the study primary endpoint per protocol will be conducted for consistency purposes. If the non-inferiority hypothesis is confirmed, a superiority 2-sided analysis will be conducted. Both the clinical events committee and the independent core laboratory will be blinded to the treatment arm. Assuming an α error of 0.05, an β error of 0.2 (80% power), a margin of irrelevance (ε) of 7, and losses of 10% due to measurement difficulty or impossibility to complete the intervention, we estimate a sample size of 56 cases per group. The study secondary endpoints are device success, procedural success, crossover rate among the different techniques used, and the occurrence of major adverse cardiovascular events at 1-year follow-up. Conclusions: The ROLLERCOASTR trial will evaluate and compare the safety and effectiveness of 3 plaque modification techniques: RA, ELCA, and IVL in patients with calcified coronary stenosis. This trial was registered at clinicaltrials.gov with identifier NCT04181268.

The physicochemical and biochemical changes during the fermentation of four clones and two native varieties of Theobroma cacao L. were studied. Fermentation was performed in traditional wood cubes. During fermentation, the cotyledon pH decreased, and the temperature increased to more than 10 °C above the ambient temperature (47 °C). The fermentation index (FI) increased in the clones C1, C4, C8, C9, and Guayaquil (G) to close to one at 120 h of fermentation. For the FI of the cocoa Criollo (Cr), a value of 2.5 was proposed according to the spectrophotometric scan performance. The total polyphenol content increased in all the samples from 21 (C8) to 70 (Cr) % in a comparison of the TPC at T0 and T120, respectively. The total flavonoid content increased from 16 (C8) to 51% in Guayaquil (G) during the fermentation period. In the case of the methylxanthines, such as theobromine and caffeine, both quantities decreased. The theobromine content decreased in all the samples from 6 (G) to 31% (C8). The caffeine content decreased in all the samples from 3% in Cr to 25% in C1 and G after fermentation. The antioxidant capability did not change after 120 h of fermentation, and the amount of methylxanthines did not affect the antioxidant potential of the fermented cocoa. The FTIR scan of the fat-free cocoa showed significant differences between the unfermented and fermented beans, and several peaks assigned to carbohydrates and proteins decreased.

Summary: Background: Tracking infectious diseases at the community level is challenging due to asymptomatic infections and the logistical complexities of mass surveillance. Wastewater surveillance has emerged as a valuable tool for monitoring infectious disease agents including SARS-CoV-2 and Mpox virus. However, detecting the Mpox virus in wastewater is particularly challenging due to its relatively low prevalence in the community. In this study, we aim to characterize three molecular assays for detecting and tracking the Mpox virus in wastewater from El Paso, Texas, during February and March 2023. Methods: In this study, a combined approach utilizing three real-time PCR assays targeting the C22L, F3L, and F8L genes and sequencing was employed to detect and track the Mpox virus in wastewater samples. The samples were collected from four sewersheds in the City of El Paso, Texas, during February and March 2023. Wastewater data was compared with reported clinical case data in the city. Findings: Mpox virus DNA was detected in wastewater from all the four sewersheds, whereas only one Mpox case was reported during the sampling period. Positive signals were still observed in multiple sewersheds after the Mpox case was identified. Higher viral concentrations were found in the pellet than in the supernatant of wastewater. Notably, an increasing trend in viral concentration was observed approximately 1–2 weeks before the reporting of the Mpox case. Further sequencing and epidemiological analysis provided supporting evidence for unreported Mpox infections in the city. Interpretation: Our analysis suggests that the Mpox cases in the community is underestimated. The findings emphasize the value of wastewater surveillance as a public health tool for monitoring infectious diseases even in low-prevalence areas, and the need for heightened vigilance to mitigate the spread of Mpox disease for safeguarding global health. Funding: Center of Infectious Diseases at UTHealth, the University of Texas System, and the Texas Epidemic Public Health Institute. The content of this paper is solely the responsibility of the authors and does not necessarily represent the official views of these funding organizations.

Background: Polycaprolactone (PCL) is a highly recognized synthetic polymer for its biocompatibility, ease of fabrication and mechanical strength in bone tissue engineering. Its applications have extended broadly, including regeneration of oral and maxillofacial lost tissues. Its usefulness has brought attention of researchers to regenerate periodontal lost tissues, including alveolar bone, periodontal ligament and cementum. The aim of this systematic review was to obtain an updated analysis of the contribution of PCL-based scaffolds in the alveolar bone regeneration process. Methods: This review adheres to the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines for systematic reviews. A computerized search of the PubMed, EBSCO, Scielo and Web of Science databases was performed, restricting literature search to published studies in English or Spanish between January 2002 and March 2023. Database search returned 248 studies which were screened based on title, author names and publication dates. Results: Data from 17 studies were reviewed and tabulated. All studies combined PCL with other biomaterials (such as Alginate, hydroxyapatite, bioactive glass, poly (lactic-co-glycolic acid)), growth factors (BMP-2, rhCEMP1), and/or mesenchymal stromal cells (adipose-derived, bone marrow, periodontal ligament or gingiva mesenchymal stromal cells). PCL scaffolds showed higher cell viability and osteoinductive potential when combined with bioactive agents. Complementary, its degradation rates were affected by the addition or exposure to specific substances, such as: Dopamine, Cerium Oxide, PLGA and hydrogen peroxide. Conclusions: PCL is an effective biomaterial for alveolar bone regeneration in periodontally affected teeth. It could be part of a new generation of biomaterials with improved regenerative potential.

These extensive kelps forest are among the most productive and diverse habitats on the planet, playing an important ecological role in marine ecosystems. These habitats have been affected by anthropogenic factors worldwide and directly by environmental variations resulting from climate change. The Magellan ecoregion has the southernmost kelp forests in the world, dominated by the species Macrocystis pyrifera. This species presents high ecophysiological plasticity being able to inhabit heterogeneous environments, characteristic of the fjord and channel systems of the region, and has high ecological, sociocultural, and economic importance for local coastal communities. To understand the ecophysiological acclimation strategies of M. pyrifera, samples from different blades were collected at different depths at four locations in the Magellan Ecoregion: Possession Bay, Skyring Sound, Otway Sound, and Puerto del Hambre seasonally. Abiotic measurements (salinity, temperature, and PAR light) were carried out for each location sampled. Measurements of photosynthetic parameters, Fv/Fm, rETRmax, Ek and α; pigment analysis of Chl a, Chl c, and fucoxanthin; and fecundity analysis of the sporophylls of each population studied were carried out on the M. pyrifera sporophytes. Significant differences were observed between seasons, locality, and depth of blades. Each population generally showed different photoacclimation processes, depending on the local conditions such as salinity values and probably tidal cycles. This is reflected in the photosynthetic, pigment, and fecundity values obtained during this study. The higher Fv/Fm values in all populations during the winter and autumn seasons and the differences in Chl c and fucoxanthin concentration during the winter period in Otway Sound and Puerto del Hambre population suggest the marked seasonal acclimation of M. pyrifera. In addition, the coastal environmental heterogeneity observed in the Magellan ecoregion related to salinity gradients (Skyring Sound) or wide tidal amplitudes (Possession Bay) influences the acclimation strategy of each population of M. pyrifera. Therefore, the characteristics of each population should be considered in order to promote its sustainability in times of social and climate change.

RESUMEN La calcificación coronaria es probablemente el mayor determinante de un mal resultado de la angioplastia y se asocia a mayores tasas de eventos adversos. En la actualidad existen distintas técnicas de modificación de la placa basadas en balones o en dispositivos específicos. El conocimiento de sus características y su uso adecuado son aspectos clave para el tratamiento óptimo de las lesiones calcificadas. Este artículo de posicionamiento, promovido desde la Asociación de Cardiología Intervencionista de la Sociedad Española de Cardiología (ACI-SEC), describe las técnicas de modificación de la placa existentes en la actualidad y propone un algoritmo para el tratamiento de la lesión calcificada.

ABSTRACT Coronary artery calcification is probably the main determinant of the poor outcome of percutaneous coronary interventions and is associated with higher rates of adverse events. There are currently different balloon or specific device-based plaque modification techniques available. Knowing their characteristics and proper use is key for the optimal treatment of calcified lesions. This position paper—promoted by the Interventional Cardiology Association of the Spanish Society of Cardiology (ACI-SEC)—describes existing plaque modification techniques currently available and proposes an algorithm for the management of calcified lesions.

La hipótesis central de esta investigación consiste en determinar que la necesidad de la reformulación de la justicia civil, radica en adecuarse a los estándares que la Corte Interamericana de Derechos Humanos ha establecido sobre el debido proceso. Para el cumplimiento de tal meta argumentaremos que dicho resultado no puede alcanzarse por la vía de la adecuación de la actual legislación a ciertas garantías. En tal sentido, resulta necesario un cambio de paradigma entorno a los principios que informan el proceso civil en Chile. Es por este cambio en las bases sobre los cuales se erige el proceso que resulta indispensable la implementación de un nuevo Código Procesal Civil. Mediante esta obra, el lector podrá apreciar, especialmente en su parte dispositiva, que para adecuarnos a los estándares de debido proceso impuestos por la Corte IDH, será necesario una reformulación en la esencia del proceso, lo cual no puede ser alcanzado mediante parcialidades, sino más bien mediante la promulgación de un Código Procesal Civil

Cyclophilins are chaperone proteins that play important roles in signal transduction. Among them, cyclophilins A, B, C, and D were widely associated with inflammation and cardiovascular diseases. Cyclophilins A and C have been proposed as coronary artery disease biomarkers. However, less is known about their relationship with cardiovascular risk factors. Therefore, this study aimed to determine the association between cyclophilin A, B, C, and D and cardiovascular risk factors in coronary artery disease. Serum levels of cyclophilins were measured in 167 subjects (subdivided according to cardiovascular risk factors presence). This study reveals that cyclophilin A and C are elevated in patients regardless of the risk factors presence. Moreover, cyclophilin B is elevated in male patients with hypertension, type 2 diabetes, or high glucose levels. In addition, cyclophilins A, B, and C were significantly correlated with cardiovascular risk factors, but only cyclophilin B was associated with type 2 diabetes. The multivariate analysis strengthens the predictive value for coronary artery disease presence of cyclophilin A (>8.2 ng/mL) and cyclophilin C (>17.5 pg/mL) along with the cardiovascular risk factors tobacco, hypertension, dyslipidemia, and high glucose and cholesterol levels. Moreover, the risk of coronary artery disease is increased in presence of cyclophilin B levels above 63.26 pg/mL and with hypertension or dyslipidemia in male patients. Consequently, cyclophilins A and C serum levels are reinforced as useful coronary artery disease biomarkers, meanwhile, cyclophilin B is a valuable biomarker in the male population when patients are also suffering from hypertension or dyslipidemia.

RESUMEN Introducción y objetivos: Las lesiones coronarias largas y difusas, cuando se tratan percutáneamente, requieren a menudo superposición de los stents, que se asocia a una mayor tasa de reestenosis. Por otro lado, el adelgazamiento progresivo de las arterias dificulta el tratamiento de las lesiones largas. En este estudio se analizan la seguridad y la eficacia clínica de los stents liberadores de sirolimus largos no cónicos (> 36 mm) para el tratamiento de lesiones largas de novo en un escenario real. Métodos: Estudio prospectivo, no aleatorizado, multicéntrico, con 696 pacientes consecutivos con implantación de stent BioMime largo no cónico para el tratamiento de lesiones coronarias de novo largas y difusas. El criterio de valoración de seguridad fueron los eventos adversos cardiovasculares mayores en el seguimiento, definidos como la combinación de muerte cardiaca, infarto de miocardio, necesidad de nueva revascularización en la misma lesión guiada por la clínica, trombosis del stent o hemorragia mayor a los 12 meses. Resultados: De los 696 pacientes incluidos, el 38,79% eran diabéticos. La edad media fue de 64,6 ± 14 años y el 80% eran varones. La indicación de revascularización fue un síndrome coronario agudo en el 63,1%. Se identificaron 899 lesiones, de las que 742 se trataron con éxito con stents BioMime (37-40-44-48 mm). La incidencia acumulada de eventos adversos cardiovasculares mayores fue del 8,1% a los 12 meses, con un 2,09% de muertes de causa cardiaca, un 1,34% de infartos de miocardio y un 0,5% de trombosis del stent. Conclusiones: El presente estudio confirma la seguridad y el buen perfil clínico a 12 meses del stent BioMime largo no cónico para el tratamiento de lesiones coronarias de novo largas y difusas, por lo que debe considerarse un tratamiento seguro y eficaz para este tipo de lesiones en la práctica clínica habitual.

ABSTRACT Introduction and objectives: Coronary lesions with stent overlapping are associated with higher neointimal proliferation that leads to more restenosis. Furthermore, the tapering of coronary arteries is a major challenge when treating long coronary lesions. This study attempted to assess the safety and clinical level of performance of long nontapered sirolimus-eluting coronary stent systems (> 36 mm) to treat long and diffused de novo coronary lesions in real-world scenarios. Methods: This was a prospective, non-randomized, multicentre study that included 696 consecutive patients treated with the long nontapered BioMime sirolimus-eluting coronary stent system in long and diffused de novo coronary lesions. The safety endpoint was major adverse cardiovascular events defined as a composite of cardiac death, myocardial infarction, clinically driven target lesion revascularization, stent thrombosis, and major bleeding at the 12-month follow-up. Results: Of a total of 696 patients, 38.79% were diabetic. The mean age of all the patients was 64.6 ± 14 years, and 80% were males. The indication for revascularization was acute coronary syndrome in 63.1%. A total of 899 lesions were identified out of which 742 were successfully treated with long BioMime stents (37 mm, 40 mm, 44 mm, and 48 mm). The cumulative incidence of major adverse cardiovascular events was 8.1% at the 12-month follow-up including cardiac death (2.09%), myocardial infarction (1.34%), and total stent thrombosis (0.5%). Conclusions: This study confirms the safety and good performance of long nontapered BioMime coronary stents to treat de novo coronary stenosis. Therefore, it can be considered a safe and effective treatment for long and diffused de novo coronary lesions in the routine clinical practice.

Mejorar el desempeño de estudiantes académicos y socioculturalmente desfavorecidos utilizando una estrategia de aprendizaje basada en un tutorial e-MEIK (modelo de evaluación integrado en el programa de Kinesiología), desde la inducción hasta la investigación, en un programa de pregrado (fisioterapia) en la Universidad Bernardo O’Higgins, una universidad socialmente inclusiva ubicada en Santiago de Chile. La estrategia de aprendizaje se enfoca en diferentes objetivos de investigación a desarrollar e implementar por parte de los estudiantes debido a los malos resultados académicos de los estudiantes de primer año. Este modelo, con 267 estudiantes participantes, utilizó la Investigación Basada en Problemas (PBI) donde cada grupo integró las materias que estudió con su realidad profesional en un ensayo final y un video. Resultados: Al comparar las tasas de aprobación de los estudiantes en cada año académico (2010-2012), hubo una mejora significativa (p < .001), que demostró que los estudiantes, con deficiencias educativas a nivel de ingreso a la universidad, pueden mejorar sus estrategias de aprendizaje y rendimiento académico. La estrategia de aprendizaje fomentó la motivación, logró metas específicas e impactó el desempeño de los estudiantes, así como el desarrollo de sus propias habilidades. También fue posible mejorar sus habilidades lectoras, manejo del tiempo, potencial creativo y espontaneidad para superar obstáculos.

The pathophysiology of Takotsubo Syndrome has not yet been precisely defined. Different hypotheses have been proposed, including cardiotoxicity due to catecholaminergic hormone release, metabolic disorders, coronary microvascular dysfunction and epicardial coronary artery spasm. Invasive coronary physiology is considered the cornerstone to understand physiological assessment of coronary blood flow in this setting. We have reviewed most important studies in coronary invasive physiology in this field to update the state of the art in TakoTsubo Syndrome.

RESUMEN Introducción y objetivos: Los resultados del Magmaris en el síndrome coronario agudo son controvertidos y se necesitan más estudios para evaluar su seguridad a largo plazo. El objetivo del trabajo fue analizar mediante un estudio observacional la seguridad clínica más allá de 12 meses de los Magmaris implantados en un único centro hospitalario en pacientes con síndrome coronario agudo. Métodos: Se registraron de manera consecutiva 36 pacientes con Magmaris implantados entre noviembre de 2016 y noviembre de 2018 con diagnóstico de síndrome coronario agudo. Para el objetivo primario se consideró el combinado orientado al dispositivo de infarto de miocardio del vaso diana, fracaso de la lesión diana y muerte de causa cardiovascular. Como objetivo secundario se incluyó la trombosis del dispositivo. Resultados: En cuanto al combinado orientado al dispositivo no se observó infarto de miocardio del vaso diana (0%), en 2 casos (5,6%) se observó fracaso de la lesión diana y se constató 1 caso de muerte cardiaca (2,8%) a los 36 meses del implante del Magmaris, sin poder conocer la causa por no disponer de autopsia. Con respecto a los objetivos secundarios, no hubo casos de trombosis del Magmaris durante el seguimiento. Conclusiones: Nuestros resultados, con un seguimiento a largo plazo, apoyan...

ABSTRACT Introduction and objectives: The results of Magmaris implantation in the acute coronary syndrome setting is uncertain and more studies will be needed to assess the long-term safety profile of these devices. The objective of this work was to conduct an observational study to analyze the clinical safety profile of Magmaris implanted in a single hospital center in the acute coronary syndrome setting beyond 12 months. Methods: Registry of 36 patients with Magmaris devices implanted between November 2016 through November 2018 with a diagnosis of acute coronary syndrome included consecutively. The primary endpoint was considered the device-oriented composite endpoint of target vessel myocardial infarction, target lesion failure, and cardiac death. Secondary endpoints included Magmaris related thrombosis. Results: Regarding the device-oriented combination, no target vessel myocardial infarction was observed, 0 cases (0%), while target lesion failure was seen in 2 cases (5.6%). There were no cases of Magmaris thrombosis at the follow-up and only 1 case of cardiac death (2.8%) was found 36 months after Magmaris implantation. The cause of death could not be determined since no autopsy was performed. Conclusions: Our results with long-term follow-up confirm that Magmaris has a favorable clinical profile in the acute coronary syndrome complex setting.

ABSTRACT Introduction and objectives: After the positive pre-clinical and clinical results with Angiolite, a cobalt-chromium sirolimus-eluting stent, we decided to analyze its performance in a non-selected, real-world population: the RANGO registry. Methods: We conducted an observational, prospective, multicenter registry of patients with different clinical indications. All consecutive patients treated with percutaneous coronary intervention with, at least, 1 Angiolite stent and who gave their informed consent were included. The registry primary endpoint was the occurrence of target lesion failure (TLF) at 6, 12, and 24 months defined as cardiovascular death, myocardial infarction (MI) related to target vessel, and clinically driven target lesion revascularization. The secondary endpoints were the individual components of the primary endpoint, major adverse cardiovascular events (MACE: all-cause mortality, any MI, or any revascularization), and stent thrombosis. We describe the 2-year clinical results of the RANGO study in the entire population, in those who only received Angiolite stents, and in 2 predefined subgroups: diabetics and patients with small-vessels (≤ 2.5mm). Results: 646 patients (426 of them only received Angiolite stents) with a high-risk profile were recruited: prevalence of previous MI (18.4%), previous coronary revascularization (23.4%), clinical presentation as ST-segment elevation MI (23.1%), and multivessel disease (47.8%). At the 2-year follow-up, the rates of TLF, MACE, and stent thrombosis were 3.4%, 9.6%, and 0.9%, respectively. Similar results were observed among patients treated with Angiolite stents only: TLF, 3.1%; MACE, 8.0%; thrombosis, 0.7%. The rates were not significantly different for the diabetic (TLF, 3.0%; MACE, 14.1%; thrombosis, 1.0%), and small-vessel subgroups (TLF, 4.3%; MACE, 12.1%; thrombosis, 0%). Conclusions: In conclusion, the results of this observational registry on the use of Angiolite in a real-world population, including a high-risk population, corroborate the excellent results observed in previous studies, up to a 2-year follow-up. An extended 5-year follow-up is planned to discard the occurrence of late events.

Resumo Fundamento Os limiares de corte para a “relação do ciclo completo de repouso” (RFR) oscilam em diferentes séries, sugerindo que as características da população podem influenciá-los. Da mesma forma, foram documentados preditores de discordância entre a RFR e a reserva de fluxo fracionado (FFR). O Estudo RECOPA, mostrou que a capacidade diagnóstica está reduzida na “zona cinzenta” da RFR, tornando necessária a realização de FFR para descartar ou confirmar isquemia. Objetivos Determinar os preditores de discordância, integrar as informações que eles fornecem em um índice clínico-fisiológico: a “RFR Ajustada”, e comparar sua concordância com o FFR. Métodos Usando dados do Estudo RECOPA, os preditores de discordância em relação à FFR foram determinados na “zona cinzenta” da RFR (0,86 a 0,92) para construir um índice (“RFR Ajustada”) que pesaria a RFR juntamente com os preditores de discordância e avaliar sua concordância com a FFR. Resultados Foram avaliadas 156 lesões em 141 pacientes. Os preditores de discordância foram: doença renal crônica, cardiopatia isquêmica prévia, lesões não envolvendo a artéria descendente anterior esquerda e síndrome coronariana aguda. Embora limitada, a “RFR Ajustada” melhorou a capacidade diagnóstica em comparação com a RFR na “zona cinzenta” (AUC-RFR = 0,651 versus AUC-“RFR Ajustada” = 0,749), mostrando também uma melhora em todos os índices diagnósticos quando foram estabelecidos limiares de corte otimizados (sensibilidade: 59% a 68%; especificidade: 62% a 75%; acurácia diagnóstica: 60% a 71%; razão de verossimilhança positiva: 1,51 a 2,34; razão de verossimilhança negativa: 0,64 a 0,37). Conclusões Ajustar a RFR integrando as informações fornecidas pelos preditores de discordância para obter a “RFR Ajustada” melhorou a capacidade diagnóstica em nossa população. Mais estudos são necessários para avaliar se os índices clínico-fisiológicos melhoram a capacidade diagnóstica da RFR ou de outros índices coronarianos.

Abstract Background There is scarcity of trials about preventative strategies for low anterior resection syndrome (LARS) in rectal cancer patients. The aim of this study is to evaluate the effectiveness of a pre- and post-surgical pelvic floor rehabilitation program on the bowel symptoms, pelvic floor function, and quality of life of rectal cancer patients. Methods A randomized controlled trial with parallel groups (pelvic floor rehabilitation versus control group), with a blinded evaluator. Participants and setting: 56 stage I to III rectal cancer patients aged from 18 to 80 years old undergoing sphincter preservation surgery at Hospital del Salvador and who have a sufficient knowledge of Spanish. Main outcome measures: ICIQ-B questionnaire for intestinal symptoms, high-resolution anorectal manometry (Alacer Multiplex 24-channel manometry equipment) for anorectal function, pelvic floor muscle strength test with Oxford Modified Scale, and a quality of life test with the EORTC QLQ C30 questionnaire. The evaluations will be carried out at five stages: before surgery, before and after the pelvic floor rehabilitation, and during a 3-month and 1-year follow-up. Interventions: one pre-rehabilitation session and 9 to 12 sessions of pelvic floor rehabilitation, including patient education, pelvic floor muscle exercises, pelvic floor electromyography biofeedback, and capacitive and sensory rectal training with a balloon probe. Rehabilitation will begin 3–5 weeks before the ileostomy is removed (four sessions) and around 3 weeks after stoma removal (5–8 sessions). Discussion We expect the program to improve the bowel symptoms, pelvic floor function, and quality of life of rectal cancer patients. Trial registration Australian New Zealand Clinical Trials Register ACTRN12620000040965 . Registered on 21 January 2020.

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Objetivo: Este estudio tiene como objetivo investigar los cambios en los niveles séricos de CypC y su relación con eventos cardiovasculares a los 12 meses de seguimiento en pacientes con EAC. Método: El estudio incluyó un total de 125 sujetos (40 pacientes con EAC aguda, 40 pacientes con EAC crónica y 45 voluntarios de control) y se analizaron los niveles plasmáticos de CypC desde el inicio hasta los 6 y 12 meses para comprender mejor su comportamiento en la aterosclerosis. Resultados: Se demostró que los niveles séricos de CypC aumentaron gradualmente en pacientes con CAD [(30.63 pg/ml ± 3.77 al inicio del estudio, 38.70 pg/ml ± 6.41 a los 6 meses (p = 0.25) y 47.27 pg/ml ± 5.65 a los 12 meses (p = 0,007)]. Además, los niveles séricos de CypC durante el seguimiento fueron un predictor significativo de EAC (estadístico c 0.76 a los 6 meses y 0.89 a los 12 meses; p < 0.001). A pesar de ello, no hubo asociación significativa entre CypC y eventos cardiovasculares, pero los niveles séricos de CypC tendieron a ser más altos en los pacientes que sufrieron eventos cardiovasculares durante el seguimiento (29.02 pg/mL ± 6.39 vs. 79.96 pg/mL ± 22.18; p = 0.029). En este sentido, los niveles plasmáticos de hsCRP > 2.3 mg/L más NT-proBNP> 300 pg/ml juntos fueron predictores significativos de eventos cardiovasculares durante el seguimiento en pacientes con EAC con niveles de CypC > 17.5 pg/ml (p = 0.048). Conclusiones: Tomados en conjunto, nuestros resultados sugieren que los niveles séricos de CypC aumentan durante el seguimiento en pacientes con EAC y podría ser un nuevo biomarcador con un posible valor pronóstico en combinación con hsCRP y NT-proBNP.

Introduction and objectives: Clinical evidence on the bioresorbable magnesium scaffolds (BRS) is still scarce. We aim to assess clinical outcomes after magnesium BRS deployment in a real-world cohort of patients. Methods: We included in a non-randomized, prospective, single-center registry of all patients treated with at least one Magmaris device in our cath lab. Pre and postdilatation with optical coherence tomography guidance, as part of the 4Ps strategy, were performed in all cases. The primary endpoint was target lesion failure (TLF) at 12 months. Results: 42 patients (with 42 lesions) underwent Magmaris percutaneous coronary intervention (PCI) between June 2016 to April 2017. PCI was performed in an acute setting in 54.76% cases; the most treated vessel was the anterior descending artery, with a mean diameter of 3.30±0.25 mm. All lesions underwent predilatation and postdilatation, with a mean postdilatation pressure of 19.2 atm. Procedural success rate was 100%. TLF rate was 4.7% at 12 months. None of our patients died or suffered myocardial infarction. Two patients (4.7%) underwent clinically-driven target lesion revascularization due to in-stent restenosis. No stent thrombosis was detected. Conclusion: 12-months clinical outcomes after Magmaris PCI demonstrate its safety and feasibility when deployed in a 4Ps strategy. Resumo: Introdução e objetivos: A evidência clínica dos suportes vasculares restaurativos biorreabsorbíveis de magnésio é ainda escassa. O objetivo deste estudo consistiu na avaliação dos resultados clínicos após a implantação dos SVR (suportes vasculares restaurativos) de magnésio numa coorte de doentes do mundo real. Métodos: Incluímos num registo não aleatório, prospetivo e unicêntrico todos os doentes tratados com pelo menos um dispositivo Magmaris, no nosso laboratório de hemodinâmica. A pré e a pós-dilatação, sob a orientação de TCO como parte da estratégia dos 4 Ps, foram efetuadas em todos os casos. O objetivo primário foi a falência da lesão alvo (FLA) aos 12 meses. Resultados: Foram submetidos 42 doentes (com 42 lesões) a ICP com Magmaris entre junho de 2016 e abril de 2017. A ICP foi efetuada num contexto agudo em 54,76% dos casos, sendo a artéria descendente anterior alvo do maior número de tratamentos, com um diâmetro médio de vaso de 3,30±0,25 mm. Todas as lesões foram submetidas a pré e pós-dilatação, com uma pressão média de pós-dilatação de 19,2 atm. A taxa de sucesso do procedimento foi de 100%. A taxa da FLA foi de 4,7% aos 12 meses. Nenhum dos doentes faleceu ou sofreu enfarte do miocárdio. Dois doentes (4,7%) foram submetidos a revascularização da lesão alvo devido a restenose intra stent. Não foi detetada trombose de stent. Conclusão: Os resultados clínicos a 12 meses após a ICP com Magmaris demonstraram segurança e viabilidade quando desenvolvidos sob uma estratégia de 4 Ps.

Introduction: one of the main factors for discomfort in users of removable partial prosthesis is the presence of visible retainers in the anterior zone. In Kennedy Class III arches, that is, exclusively dental loading channels (in which the functional forces reach their final receptor: the alveolar bone), anterior zone retainers may be eliminated by selecting an appropriate prosthetic insertion and removal axis, and mainly by carving guiding planes that should provide retention by mechanical rubbing. This is an in vitro experimental study aimed at proving the hypothesis that it is possible to obtain functional retention in a removable partial prosthesis of dental loading channel without using retainers in the anterior zone. Methods: 7 maxillary models with different types of toothless process were used. As a common characteristic, they all were classified as Kennedy Class III with partial denture arches. A Cr-Co metallic base was built for each model according to their clinical situation. Their design allowed them to be exposed to traction in a universal traction machine (Tinius Olsen H5K-S). Results: the proposed hypothesis was confirmed as expected. The traction force needed to displace the metallic bases with retainers in the anterior zone was 16.93 Newton in average. On the other hand, the metallic bases without retainers in the anterior zone showed an average of 12.84 N. The average values obtained for both groups are higher than those reported in the literature (4.903 N). Conclusions: in Class III removable partial dentures it is possible to use metallic bases with no retainers in the anterior zone.

Abstract Background The intracellular ROCK signaling pathway is an important modulator of blood pressure and of cardiovascular and renal remodeling when Rho-kinase activity is increased. Besides, in preclinical models of diabetes, ROCK activation has also a role in abnormal glucose metabolism as well as in subsequent vascular and myocardial dysfunction. In humans, there are a few data assessing ROCK activation in patients with type 2 diabetes mellitus (T2D) and no studies assessing upstream/downstream components of the ROCK pathway. We assessed here levels of ROCK activation and some of the RhoA/ROCK cascade molecules in peripheral blood mononuclear cells (PBMCs) in T2D patients under current treatment. Methods Cross-sectional observational study comparing 28 T2D patients under current antidiabetic treatment with 31 consecutive healthy subjects, matched by age and gender. Circulating levels of malondialdehyde, angiotensin II and inflammatory cytokines IL-6 and IL-8 were determined in all subjects. ROCK activation in PMBCs, upstream and downstream cascade proteins, and levels of the proinflammatory molecules VCAM, ICAM-1 and IL-8 were determined in their PMBCs by Western blot. Results Compared to healthy controls, ROCK activation in T2D patients measured by 2 direct ROCK targets in PBMCs was increased by 420 and 570% (p

Anthocyanins are phenolic compounds responsible for the color of numerous plant sources. In literature, there is little information about the dahlia flower as a potential source of anthocyanins. This study aimed to develop a procedure for anthocyanins extraction from black dahlia petals using fresh and dehydrated material. A three-stages nested design was used to develop the methodology, 3 solid-liquid-ratios and 6 dissolvents nested in 3 methods. The highest yields were obtained with the homogenization assisted maceration technique, citric acid solvent (2, 4, 6%), and a ratio of 1:30 with dry petals. The results of this study show the opportunity to obtain a high anthocyanin content from black dahlia and open the possibility to use it as another important source of this pigment.

Encapsulation of biostimulant metabolites has gained popularity as it increases their shelf life and improves their absorption, being considered a good alternative for the manufacture of products that stimulate plant growth and fruit production. Cell-free supernatants (CFS) were obtained from nine indole-3-acetic acid (IAA) producing bacterial strains. Stenotrophomonas maltophilia (PT53T) produced the highest concentration of IAA (15.88 μg/mL) after 48 h of incubation. CFS from this strain, as well as an IAA standard were separately encapsulated in chitosan microparticles (CS-MP) using the ionic gelation method. The CS-MP were analyzed by Fourier transform infrared spectroscopy (FTIR), showing absorption bands at 1641, 1547, and 1218 cm−1, associated with the vibrations of the carbonyl C=O, the N-H amine, and the bond between chitosan (CHI) and sodium tripolyphosphate (TPP). The effects of unencapsulated CFS, encapsulated CFS (EN-CFS), and encapsulated IAA standard (EN-IAA) on germination and growth of seven-day-old tomato (Solanum lycopersicum) seedlings were studied. Results showed that both EN-CFS and EN-IAA significantly (p

Introduction: An increased risk of atrial fibrillation (AF) has been demonstrated in high-performance athletes. Soluble vascular adhesion molecule-1 (sVCAM-1), a biomarker involved in inflammation and cardiac remodeling, is associated with the development of AF in the general population. However, the relationship between sVCAM-1 and left atrial (LA) remodeling has been poorly investigated in long-distance runners (LDR).Aim: To determine the association between LA remodeling and sVCAM-1 levels in LDR during the training period before a marathon race.Methods: Thirty-six healthy male LDR (37.0 ± 5.3 years; 174.0 ± 7.0 height; BMI: 23.8 ± 2.8; V°O2-peak: 56.5 ± 7.3 mL·kg−1·min−1) were evaluated in this single-blind and cross-sectional study. The LDR were separated into two groups according to previous training levels: high-training (HT) (n = 18) ≥100 km·week−1 and low-training (LT) (n = 18) ≥70 and

Little is known about the effects of training load on exercise-induced plasma increase of interleukin-6 (IL-6) and soluble IL-6 receptor (sIL-6R) and their relationship with vascular remodeling. We sought to evaluate the role of sIL 6R as a regulator of IL-6-induced vascular remodeling. Forty-four male marathon runners were recruited and allocated into two groups: low-training (LT,

Algae and microalgae are used as a source of different biomolecules, such as lipids and carbohydrates. Among carbohydrates, polysaccharides, such as β-glucans, are important for their application as antioxidants, antisepsis, and immunomodulators. In the present work, the β-glucans production potential of Microchloropsis salina was assessed using two different culture conditions: a high-density batch and a modeled high-density fed-batch. From the biochemical parameters determined from these two cultures conditions, it was possible to establish that the modeled high-density fed-batch culture improves the biomass growth. It was possible to obtain a biomass productivity equal to 8.00 × 10−2 ± 2.00 × 10−3 g/(L × day), while the batch condition reached 5.13 × 10−2 ± 4.00 × 10−4 g/(L × day). The same phenomenon was observed when analyzing the β-glucans accumulation, reaching volumetric productivity equal to 5.96 × 10−3 ± 2.00 × 10−4 g of product/(L × day) against the 4.10 × 10−3 ± 2.00 × 10−4 g of product/(L × day) obtained in batch conditions. These data establish a baseline condition to optimize and significantly increase β-glucan productivity, as well as biomass, adding a new and productive source of this polymer, and integrating its use in potential applications in the human and animal nutraceutical industry.

HOW WOULD I APPROACH IT? The authors present an interesting and challenging case regarding percutaneous treatment, and with a very complex resolution. This is the case of a patient already surgically revascularized with significant ischemia whose revascularization option is through the bypass on which the entire territory of the left circumflex artery depends on. At this point right now of the angioplasty where the stent cannot be crossed despite the use of the buddy-wire technique, and even though the stent was very short and had good navigability, I would try the following staged maneuvers: 1) Try to advance a high-support guidewire a little more distal inside the native vessel taking advantage of the native artery good distal bed so that the guidewire section with the highest support of all is placed on the curve zone. If possible, I would even bend the tip to avoid damaging the artery aware that the push forward maneuvers we’ll be performing can uncontrollably displace the guidewire at any time. 2) Benefit from the balloon already crossed and the lesion already dilated to redilate the lesion with the balloon using the anchorage technique with the balloon to move the guide extension catheter forward, cross the curve, and eventually reach...

¿CÓMO LO HARÍA? Los autores presentan un interesante caso que supone un reto para el tratamiento percutáneo, y de muy compleja resolución, en un paciente ya revascularizado quirúrgicamente, con isquemia importante, cuya opción de revascularización es a través del puente del que depende por completo todo el territorio de la arteria circunfleja. Partiendo del punto en que nos encontramos en la angioplastia en este momento, al no cruzar el stent a pesar de haber intentado la técnica de buddy-wire y de ser un stent con buena navegabilidad y muy corto, intentaría la siguiente maniobra en estos pasos: 1) Tratar de avanzar la guía de alto soporte un poco más distal en el vaso nativo aprovechando el buen lecho distal de la arteria nativa para que la porción de más soporte de la guía quede colocada en la zona de curvas. Incluso, si fuera posible, se podría doblar la punta para evitar lesionar la arteria, sabiendo que en las maniobras de empuje que vamos a realizar la guía puede desplazarse sin que se pueda controlar en todo momento. 2) Aprovechar que ya ha cruzado un balón y se ha conseguido dilatar la lesión para nuevamente dilatar con el balón la lesión y realizar una técnica...

Objective:Insulin like growth factors-1 (IGF-1) is essential for normal in utero and postnatal human growth. It mediates its effects through the IGF-1 receptor (IGF1R), a widely expressed cell surface tyrosine kinase receptor. The aim of the study was to analyze pre- and post-natal growth, clinical features and laboratory findings in a small for gestational age (SGA) girl in whom discordant postnatal growth persisted and her appropriate for gestational age (AGA) brother.Methods:A girl born with a low weight and length [-2.3 and -2.4 standard deviation (SD) score (SDS), respectively] but borderline low head circumference (-1.6 SD) presented with a height of -1.7 SDS, in contrast to a normal height twin brother (0.0 SDS). IGF-1 resistance was suspected because of elevated serum IGF-1 levels.Results:Sequencing revealed the presence of a previously described pathogenic heterozygous mutation (p.Glu1050Lys) in the SGA girl which was not present in the parents nor in the AGA twin brother.Conclusion:The pathogenic IGF1R mutation in this girl led to intrauterine growth retardation followed by partial postnatal catch-up growth. Height in mid-childhood was in the lower half of the reference range, but still 1.7 SD shorter than her twin brother.

Background: Reverse remodeling is a clinically relevant endpoint in heart failure with reduced ejection fraction (HFrEF). Rho-kinase (ROCK) signaling cascade activation correlates with cardiac remodeling and left ventricular (LV) systolic dysfunction in HFrEF patients. Cardiac resynchronization therapy (CRT) is effective in HFrEF, especially when there is a left bundle block, as this treatment may stimulate reverse remodeling, thereby improving quality of life and prolonging survival for patients with this severe condition. Here, we evaluate the hypothesis that ROCK activation is reduced after effective CRT in HFrEF.Methods: ROCK activation in circulating leukocytes was evaluated in 28 HFrHF patients, using Western blot (myosin light chain phosphatase subunit 1 phosphorylation, MYPT1p/t), before and three months after initiation of CRT. LV systolic function and remodeling were assessed by echocardiography.Results: Three months after CRT, LV ejection fraction increased an average of 14.5% (p < 0.001) in 13 patients (responders), while no change was observed in 15 patients (non-responders). End-systolic diameter decreased 16% (p < 0.001) in responders, with no change in non-responders. ROCK activation in PBMCs decreased 66% in responders (p < 0.05) but increased 10% in non-responders (NS). LV end-diastolic diameter was also 5.2 mm larger in non-responders vs. responders (p = 0.058). LV ejection fraction, systolic diameter, and ROCK activation levels were similar in both groups at baseline.Conclusion: In HFrEF patients, 3 months of effective CRT induced reverse myocardial remodeling, and ROCK activation was significantly decreased in circulating leukocytes. Thus, decreased ROCK activation in circulating leukocytes may reflect reverse cardiac remodeling in patients with heart failure.

Background. The resting full‐cycle ratio (RFR) is a novel resting index which in contrast to the gold standard (fractional flow reserve (FFR)) does not require maximum hyperemia induction. The objectives of this study were to evaluate the agreement between RFR and FFR with the currently recommended thresholds and to design a hybrid RFR-FFR ischemia detection strategy, allowing a reduction of coronary vasodilator use. Materials and Methods. Patients subjected to invasive physiological study in 9 Spanish centers were prospectively recruited between April 2019 and March 2020. Sensitivity and specificity studies were made to assess diagnostic accuracy between the recommended levels of RFR ≤0.89 and FFR ≤0.80 (primary objective) and to determine the RFR “grey zone” in order to define a hybrid strategy with FFR affording 95% global agreement compared with FFR alone (secondary objective). Results. A total of 380 lesions were evaluated in 311 patients. Significant correlation was observed (R2 = 0.81; P

Cardiac hypertrophy is the result of responses to various physiological or pathological stimuli. Recently, we showed that polycystin-1 participates in cardiomyocyte hypertrophy elicited by pressure overload and mechanical stress. Interestingly, polycystin-1 knockdown does not affect phenylephrine-induced cardiomyocyte hypertrophy, suggesting that the effects of polycystin-1 are stimulus-dependent. In this study, we aimed to identify the role of polycystin-1 in insulin-like growth factor-1 (IGF-1) signaling in cardiomyocytes. Polycystin-1 knockdown completely blunted IGF-1-induced cardiomyocyte hypertrophy. We then investigated the molecular mechanism underlying this result. We found that polycystin-1 silencing impaired the activation of the IGF-1 receptor, Akt, and ERK1/2 elicited by IGF-1. Remarkably, IGF-1-induced IGF-1 receptor, Akt, and ERK1/2 phosphorylations were restored when protein tyrosine phosphatase 1B was inhibited, suggesting that polycystin-1 knockdown deregulates this phosphatase in cardiomyocytes. Moreover, protein tyrosine phosphatase 1B inhibition also restored IGF-1-dependent cardiomyocyte hypertrophy in polycystin-1-deficient cells. Our findings provide the first evidence that polycystin-1 regulates IGF-1-induced cardiomyocyte hypertrophy through a mechanism involving protein tyrosine phosphatase 1B.

Objetivo. Estimar la confiabilidad de pruebas para medir la flexibilidad de la musculatura flexoextensora de la rodilla, de acuerdo con la temporada, la edad y la posición de juego en jugadores varones del área formativa de un club profesional de fútbol. Material y métodos. La medición de la flexibilidad se realizó mediante la aplicación de las pruebas Modified. Thomas Test (MT Test) para cuádriceps y el Modified Back-Saber Sit-and-Reach Test (MBS Test) para isquiotibiales. La confiabilidad se estimó mediante el α de Cronbach. Resultados. Ambas pruebas presentaron estimaciones altas de confiabilidad entre temporadas, por categorías de jugadores, puesto de juego y en comparación del rendimiento entre miembro inferior derecho e izquierdo. Conclusiones. Ambas pruebas pueden ser aplicadas en deportes colectivos, como acontece en el área formativa de clubes profesionales de fútbol, especialmente, en la prevención de lesiones deportivas, al tener una validez aceptada, presentar una alta confiabilidad de acuerdo con el estudio y además, tener como características: bajo costo, fácil aplicación y medir un volumen importante de personas en breves periodos de tiempo.