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Sebastià Sabater,1 Ignacio Andres,1 Veronica Lopez-Honrubia,1 Roberto Berenguer,1 Marimar Sevillano,1 Esther Jimenez-Jimenez,2 Angeles Rovirosa,3 Meritxell Arenas,4 1Department of Radiation Oncology, Complejo Hospitalario Universitario de Albacete, Albacete, 2Department of Radiation Oncology, Hospital Son Espases, Palma de Mallorca, 3Department of Radiation Oncology, Hospital Clinic, Barcelona, 4Department of Radiation Oncology, Hospital Universitari Sant Joan, Reus, Spain Abstract: Endometrial cancer (EC) is one of the most common gynecological cancers among women in the developed countries. Vaginal cuff is the main location of relapses after a curative surgical procedure and postoperative radiation therapy have proven to diminish it. Nevertheless, these results have not translated into better survival results. The preeminent place of vaginal cuff brachytherapy (VCB) in the postoperative treatment of high- to intermediate-risk EC was given by the PORTEC-2 trial, which demonstrated a similar reduction in relapses with VCB than with external beam radiotherapy (EBRT), but VCB induced less late toxicity. As a result of this trial, the use of VCB has increased in clinical practice at the expense of EBRT. A majority of the clinical reviews of VCB usually address the risk categories and patient selection but pay little attention to technical aspects of the VCB procedure. Our review aimed to address both aspects. First of all, we described the risk groups, which guide patient selection for VCB in clinical practice. Then, we depicted several technical aspects that might influence dose deposition and toxicity. Bladder distension and rectal distension as well as applicator position or patient position are some of those variables that we reviewed. Keywords: endometrial cancer, vaginal cuff brachytherapy, rectum, bladder, technique

INTRODUCCIÓN: El entorno escolar juega un rol importante para prevenir la malnutrición en la infancia. El objetivo fue evaluar la disponibilidad de agua potable en la cocina, la oferta durante el almuerzo y la jornada escolar y la presencia de kioscos en escuelas públicas de la provincia de Buenos Aires según prestación alimentaria y necesidades básicas insatisfechas (NBI). MÉTODOS: Se realizó un análisis post hoc de la Encuesta del Servicio Alimentario Escolar 2016-2019 de una muestra de 3342 escuelas iniciales, primarias y secundarias. Se evaluó el suministro de agua en la cocina, las fuentes de agua potable para los alumnos, la bebida en el almuerzo y la disponibilidad de kiosco. Las variables se analizaron por nivel educativo y se estratificaron según la prestación alimentaria. Se realizó un análisis estadístico descriptivo. RESULTADOS: Alrededor del 1% (n=30) de las escuelas no contaban con agua potable en la cocina, y no se observaron diferencias porcentuales por prestación ni tertil de NBI. El 10% de las escuelas no ofrecía bebida en el almuerzo, y 7 de cada 10 no disponía de fuente de agua potable accesible; 4 de cada 10 primarias y secundarias presentaron kiosco. Al evaluar según NBI, la proporción de escuelas con kiosco decrecía a medida que aumentaba el tertil. DISCUSIÓN: Es fundamental generar políticas de regulación del entorno escolar con un enfoque integral y sistémico para prevenir la malnutrición en la población infantil más vulnerable.

Background: Since 2016, the School Food Program in the Buenos Aires Province, Argentina, implemented a nutritional regulatory framework (NRF) and varying administration systems (AS). Here, we examined the association between the interventions (only NRF and NRF + AS) and breakfast nutritional and food indicators between 2016 and 2019. Methods: Data collected from the Survey of the School Food Program, 2016-2019, were analyzed. The dependent variables were the energy, macro-and micronutrients, milk/yogurt, and fruit quantities in school breakfasts. The independent variables were the school's status: (a) control group, (b) Intervention 1 (only NRF), and (c) Intervention 2 (NRF + AS). We preformed crude and adjusted linear regressions with robust variances. Results: We evaluated 4,060 schools (control group: 24%; Intervention 1: 39%; Intervention 2: 37%). Only vitamin A levels increased after Intervention 1, and almost all indicators (80%) showed better values when applying Intervention 2. School Health Policy Implications: Nutritional and food indicator improvements were associated with the implementation of the NRF and AS, emphasizing the significance of design and management of school food public policies, along with the amount of investment/territorial coverage. Conclusions: Our findings highlight the importance of school food and nutrition policies with a potential impact on improving the nutritional status of children.

Abstract Objective: To assess the association between the consumption of ultra-processed foods (UPF) and diet quality among preschool children and women of reproductive age from Argentina. Design: Cross-sectional and nationally representative survey. The food items were classified according to the NOVA system. Consumption of fruits, vegetables, legumes, nuts, seeds and wholegrains was estimated, and the energy and nutrients related to non-communicable disease (NCD) intake. Linear regression was used to assess the associations. Setting: Argentina. Participants: Children aged 2–5 years (n 7022), female adolescent aged 10–19 years (n 2165) and women aged 20–49 years (n 4414). Results: UPF represented more than a quarter of total energy intake, 27 % in children, 31 % in female adolescents and 26 % in women. Across all age groups, the major contributors to UPF consumption were cookies and pastries (about 6·0–7·0 %), soft drinks (about 2·7–3·7 %), candies (about 1·8–4·6 %), and juices (about 1·3–1·7 %). The consumption of fresh vegetables, fresh fruits and legumes was negatively associated with UPF consumption. A significant positive association was found between the dietary share of UPF and the dietary content of NCD-promoting nutrients such as free sugars and total saturated and trans-fats. In contrast, a significant negative association was found with the content of NCD-protective such as fibre and protein. Conclusions: UPF were associated with lower consumption of healthy foods and higher intake of nutrients related to NCD in children and women of reproductive age in Argentina. It is necessary to design food policies that simultaneously reduce the consumption of UPF while promoting the intake of fresh and whole foods to improve the dietary quality.

Abstract Vascular endothelial function is challenged during cerebral ischemia and reperfusion. The endothelial responses are involved in inflammatory leukocyte attraction, adhesion and infiltration, blood–brain barrier leakage, and angiogenesis. This study investigated gene expression changes in brain endothelial cells after acute ischemic stroke using transcriptomics and translatomics. We isolated brain endothelial mRNA by: (i) translating ribosome affinity purification, enabling immunoprecipitation of brain endothelial ribosome-attached mRNA for translatome sequencing and (ii) isolating CD31+ endothelial cells by fluorescence-activating cell sorting for classical transcriptomic analysis. Both techniques revealed similar pathways regulated by ischemia but they showed specific differences in some transcripts derived from non-endothelial cells. We defined a gene set characterizing the endothelial response to acute stroke (24h) by selecting the differentially expressed genes common to both techniques, thus corresponding with the translatome and minimizing non-endothelial mRNA contamination. Enriched pathways were related to inflammation and immunoregulation, angiogenesis, extracellular matrix, oxidative stress, and lipid trafficking and storage. We validated, by flow cytometry and immunofluorescence, the protein expression of several genes encoding cell surface proteins. The inflammatory response was associated with the endothelial upregulation of genes related to lipid storage functions and we identified lipid droplet biogenesis in the endothelial cells after ischemia. The study reports a robust translatomic signature of brain endothelial cells after acute stroke and identifies enrichment in novel pathways involved in membrane signaling and lipid storage. Altogether these results highlight the endothelial contribution to the inflammatory response, and identify novel molecules that could be targets to improve vascular function after ischemic stroke.

La calidad de la alimentación en edades tempranas es un derecho básico, del que dependen la supervivencia, el crecimiento saludable, la prevención de enfermedades crónicas y malnutrición en todas sus formas. El objetivo de este trabajo fue describir los consumos alimentarios de menores de 13 años de áreas urbanas de la Argentina en 2018-19, según el nivel de ingresos de los hogares. Estudio transversal con datos de la 2° Encuesta Nacional de Nutrición y Salud 2018-19, que toma una muestra probabilística polietápica de localidades urbanas de 5.000 habitantes y más de Argentina. Se analizó el consumo de alimentos de niños y niñas (5763 0 a 23 meses y 5829 de 2 a 12 años) obtenido por R24h. Se clasificaron alimentos y bebidas según las Guías Alimentarias para la Población Argentina, se analizó el porcentaje que consumió cada categoría y la cantidad promedio consumida, por grupo de edad y se estratificó según nivel de ingresos. Se realizó análisis estadístico descriptivo y regresión lineal. Se observó bajo consumo de alimentos recomendados (frutas, legumbres, verduras, frutas secas y semillas) y alto consumo de aquellos que las guías alimentarias recomiendan evitar (bebidas endulzadas, golosinas, galletitas, amasados de pastelería y cereales desayuno). En determinados grupos de alimentos se evidencian diferencias entre los niños que viven en hogares de diferente nivel de ingresos (ej frutas y azúcar), mientras que en otros grupos no existen diferencias (ej, bebidas endulzadas y galletitas). El consumo se aleja de las recomendaciones con notorias desigualdades según el nivel de ingreso. Para mejorar la calidad de la alimentación de la población infantil son necesarios cambios en los entornos y en el sistema alimentario dado que afecta directamente la seguridad alimentaria nutricional, la malnutrición, el estado de salud y el bienestar de la población.

The envelope glycoprotein (Env) of retroviruses, such as the Feline leukemia virus (FeLV), is the main target of neutralizing humoral response, and therefore, a promising vaccine candidate, despite its reported poor immunogenicity. The incorporation of mutations that stabilize analogous proteins from other viruses in their prefusion conformation (e.g., HIV Env, SARS-CoV-2 S, or RSV F glycoproteins) has improved their capability to induce neutralizing protective immune responses. Therefore, we have stabilized the FeLV Env protein following a strategy based on the incorporation of a disulfide bond and an Ile/Pro mutation (SOSIP) previously used to generate soluble HIV Env trimers. We have characterized this SOSIP-FeLV Env in its soluble form and as a transmembrane protein present at high density on the surface of FeLV Gag-based VLPs. Furthermore, we have tested its immunogenicity in DNA-immunization assays in C57BL/6 mice. Low anti-FeLV Env responses were detected in SOSIP-FeLV soluble protein-immunized animals; however, unexpectedly no responses were detected in the animals immunized with SOSIP-FeLV Gag-based VLPs. In contrast, high humoral response against FeLV Gag was observed in the animals immunized with control Gag VLPs lacking SOSIP-FeLV Env, while this response was significantly impaired when the VLPs incorporated SOSIP-FeLV Env. Our data suggest that FeLV Env can be stabilized as a soluble protein and can be expressed in high-density VLPs. However, when formulated as a DNA vaccine, SOSIP-FeLV Env remains poorly immunogenic, a limitation that must be overcome to develop an effective FeLV vaccine.

Objective When considering proposals to improve diets, it is important to understand how factors like price and income can affect saturated fat (SF) intake and demand. In this study, we examine and estimate the influence of price and income on intake across 160 countries, by age and sex, and derive sensitivity measures (price elasticities) that vary by age, sex and world region.Design We econometrically estimate intake responsiveness to income and prices across countries, accounting for differences by world region, age and sex. Intake data by age, sex and country were obtained from the 2018 Global Dietary Database. These data were then linked to global price data for select food groups from the World Bank International Comparison Programme and income data from the World Development Indicators Databank (World Bank).Results Intake differences due to price were highly significant, with a 1% increase in price associated with a lower SF intake (% energy/d) of about 4.3 percentage points. We also find significant differences across regions. In high-income countries, median (age 40) intake reductions were 1.4, 0.8 and 0.2 percentage points, given a 1% increase in the price of meat, dairy, and oils and fats, respectively. Price elasticities varied with age but not sex. Intake differences due to income were insignificant when regional binary variables were included in the analysis.Conclusion The results of this study show heterogeneous associations among prices and intake within and across countries. Policymakers should consider these heterogeneous effects as they address global nutrition and health challenges.

Most COVID-19 vaccines are based on the SARS-CoV-2 Spike glycoprotein (S) or their subunits. However, S shows some structural instability that limits its immunogenicity and production, hampering the development of recombinant S-based vaccines. The introduction of the K986P and V987P (S-2P) mutations increases the production and immunogenicity of the recombinant S trimer, suggesting that these two parameters are related. Nevertheless, S-2P still shows some molecular instability and it is produced with low yield. Here we described a novel set of mutations identified by molecular modeling and located in the S2 region of the S-2P that increase its production up to five-fold. Besides their immunogenicity, the efficacy of two representative S-2P-based mutants, S-29 and S-21, protecting from a heterologous SARS-CoV-2 Beta variant challenge was assayed in K18-hACE2 mice (an animal model of severe SARS-CoV-2 disease) and golden Syrian hamsters (GSH) (a moderate disease model). S-21 induced higher level of WH1 and Delta variants neutralizing antibodies than S-2P in K18-hACE2 mice three days after challenge. Viral load in nasal turbinate and oropharyngeal samples were reduced in S-21 and S-29 vaccinated mice. Despite that, only the S-29 protein protected 100% of K18-hACE2 mice from severe disease. When GSH were analyzed, all immunized animals were protected from disease development irrespectively of the immunogen they received. Therefore, the higher yield of S-29, as well as its improved immunogenicity and efficacy protecting from the highly pathogenic SARS-CoV-2 Beta variant, pinpoint the S-29 mutant as an alternative to the S-2P protein for future SARS-CoV-2 vaccine development.

Objetivo: Analizar la influencia de variables geográficas y sociodemográficas en el consumo de productos ultraprocesados de hogares argentinos urbanos. Métodos: Estudio descriptivo, correlacional y transversal, con datos de la Encuesta Nacional de Gastos de los Hogares 2017-18. Mediante análisis bivariado y multivariado se analizó la relación entre el porcentaje de energía de productos ultraprocesados y las variables geográficas y sociodemográficas. Resultados: Los productos ultraprocesados aportan 30,3% de la energía. El mayor aporte se observó en los hogares del Gran Buenos Aires, con mayores ingresos, mayor clima educativo, en aquellos que no reciben asistencia estatal, sin adultos mayores y sin menores de 14 años. Controladas las demás características sociodemográficas, el clima educativo es la variable de mayor capacidad explicativa y los hogares con menores de 14 años muestran mayor porcentaje de energía proveniente de productos ultraprocesados. Conclusión: Las diferencias en el consumo plantean la necesidad de estrategias que consideren estas particularidades para garantizar seguridad alimentaria y calidad nutricional.

Abstract Microglial cells of the aged brain manifest signs of dysfunction that could contribute to the worse neurological outcome of stroke in the elderly. Treatment with colony‐stimulating factor 1 receptor antagonists enables transient microglia depletion that is followed by microglia repopulation after treatment interruption, causing no known harm to mice. We tested whether this strategy restored microglia function and ameliorated stroke outcome in old mice. Cerebral ischemia/reperfusion induced innate immune responses in microglia highlighted by type I interferon and metabolic changes involving lipid droplet biogenesis. Old microglia accumulated lipids under steady state and displayed exacerbated innate immune responses to stroke. Microglia repopulation in old mice reduced lipid‐laden microglia, and the cells exhibited reduced inflammatory responses to ischemia. Moreover, old mice with renewed microglia showed improved motor function 2 weeks after stroke. We conclude that lipid deposits in aged microglia impair the cellular responses to ischemia and worsen functional recovery in old mice.

Endoesophageal brachytherapy (EBT) or endoesophageal interventional radiotherapy (EIRT) is an effective technique that has been used with varying frequency for many years. It is a very good technique in T1-T2 inoperable esophageal cancer and in the palliation of dysphagia. However, only some centers have access to this technique, and consequently, it is underused. Here, we discussed the indications and several technical aspects as well as the literature available. Also, why this technique is underused and how this can be overcome. We consider that EBT is a very effective technique that should be used whenever indicated.

The standard treatment for locally advanced cervical cancer (LACC) is platinum-based chemotherapy in association with external beam radiotherapy (EBRT) and brachytherapy (BT), often also called ‘interventional radiotherapy’ (IRT). Magnetic resonance imaging (MRI) is the most accurate imaging modality for both staging and response evaluation; therefore MRI-guided IRT has become the method of choice for planning a radiation boost after EBRT. The aim of this paper was to describe the MRI radiological workflow currently ongoing at our Institution. In addition, we provided a detailed pictorial essay of our experience, especially for radiologists, to implement MRI-based IRT spread in clinical practice.

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INTRODUCCIÓN: Las Guías Alimentarias para la Población Argentina (GAPA) ofrecen recomendaciones para una alimentación saludable. El objetivo del trabajo fue evaluar el cumplimiento de las recomendaciones de las GAPA entre 1996 y 2018 según nivel de ingreso y por región del país en el período 2017-2018. MÉTODOS: Se efectuó un estudio descriptivo y transversal, con datos de gastos e ingresos de la Encuesta Nacional de Gastos de los Hogares de 1996-97, 2004-05, 2012-13 y 2017-18. Se comparó el consumo aparente promedio diario con las recomendaciones de cada uno de los grupos de alimentos de las guías. Se realizó análisis estadístico descriptivo. RESULTADOS: Se observaron grupos de alimentos con consumo aparente inferior al recomendado, como verduras, frutas, leche, yogur, legumbres, frutas secas y semillas; grupos con consumo entre dos y tres veces superior al valor máximo establecido en las guías, como azúcares y grasas; y grupos con adecuada cantidad pero escasa variedad, como carnes, aceites, cereales, pan y pastas. A lo largo del tiempo se evidenció el progresivo alejamiento de las recomendaciones de frutas, leche, legumbres, frutas secas, semillas y alimentos de consumo opcional, más inadecuado en algunas regiones del país y más evidente en los hogares de menores ingresos. DISCUSIÓN: Se evidencian importantes diferencias cuantitativas y cualitativas entre lo recomendado y la alimentación argentina, con desbalances más acentuados en los grupos de mayor vulnerabilidad.