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Objective: Severe weather events exacerbate existing health disparities due to poorly managed non-communicable diseases (NCDs). Our objective is to understand the experiences of staff, providers, and administrators (employees) of Federally Qualified Health Centers (FQHCs) in Puerto Rico and the US Virgin Islands (USVI) in providing care to patients living with NCDs in the setting of recent climate-related extreme events., Methods: We used a convergent mixed-methods study design. A quantitative survey was distributed to employees at 2 FQHCs in Puerto Rico and the USVI, assessing experience with disasters, knowledge of disaster preparedness, the relevance of NCDs, and perceived gaps. Qualitative in-depth interviews explored their experience providing care for NCDs during recent disasters. Quantitative and qualitative data were merged using a narrative approach., Results: Through the integration of quantitative and qualitative data, we recognize: (1) significant gaps in confidence and preparedness of employees with a need for more training; (2) challenges faced by persons with multiple NCDs, especially cardiovascular and mental health disorders; and (3) most clinicians do not discuss disaster preparedness with patients but recognize their important role in community resilience., Conclusion: With these results, we recommend strengthening the capacity of FQHCs to address the needs of their patients with NCDs in disasters.

Background: Keratomycosis is a form of infectious keratitis, an infection of the cornea, which is caused by fungi. This disease is a leading cause of ocular morbidity globally with at least 60 % of the affected individuals becoming monocularly blind., Objective: This bibliometric analysis aimed to comprehensively assess the existing body of literature, providing insights of the evolution of keratomycosis research by identifying key themes and research gaps., Methods: This work used the modeling method Latent Dirichlet Allocation (LDA) to identify and interpret scientific information on topics concerning existing categories in a set of documents. The HJ-Biplot method was also used to determine the relationship between the analyzed topics, taking into consideration the years under study., Results: This bibliometric analysis was performed on a total of 2,599 scientific articles published between 1992 and 2022. The five leading countries with more scientific production and citations on keratomycosis were The United States of America, followed by India, China, United Kingdom and Australia. The top five topics studied were Case Reports and Corneal Infections, which exhibited a decreasing trend; followed by Penetrating Keratoplasty and Corneal Surgery, Ocular Effects of Antifungal Drugs, Gene Expression and Inflammatory Response in the Cornea and Patient Data which have been increasing throughout the years. However Filamentous Fungi and Specific Pathogens, and Antifungal Therapies research has been decreasing in trend., Conclusion: Additional investigation into innovative antifungal drug therapies is crucial for proactively tackling the potential future resistance to antifungal agents in scientific writing., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 Elsevier Inc. All rights reserved.)

Background: Previous studies have shown that women farmers are particularly vulnerable to mental health disorders such as depression and anxiety., Aims: This study aimed to investigate the prevalence of anxiety and depression in women farmers from Ecuador Coastal and Highlands regions., Method: General Anxiety Disorder‑7 (GAD‑7) and Patient Health Questionnaire‑9 (PHQ‑9) were applied. In addition, self-reported number of children, days off, hours of work, pesticide use, sleep habits and years of work in agriculture, were also collected. This cross-sectional study occurred during 2023 with 443 women, for Coastal (197) and Highlands (246), respectively. Multivariable binary logistic regression models were performed to obtained adjusted odds ratios (aOR) and their 95% confidence intervals (95% CI)., Results: 34.5% of Coastal women had depression, while 27.2% of Highlands women had depression. 20.3% of coastal women farmers had anxiety, while in the Highlands 24.8% had anxiety. Coastal mestizo and montubio women exhibited lower probability of depression, but this was not significant in the Highlands. Coastal women farmers that did not have children showed lower odds of depression (aOR 0.05, 95% CI [0.01, 0.34]). A lower likelihood of depression was observed in coastal women that worked more than 8 hours (aOR 0.22, 95% CI [0.07, 0.72]). Women from the Highlands that had shortened sleep duration exhibited lower odds of depression and anxiety., Conclusions: A higher proportion of depressed women farmers was observed in the Coast region and slightly higher numbers of anxiety cases in the Highlands. The number of children may cause workload and is correlated with depression in Coastal women.

Purpose: To describe the epidemiology, incidence, mortality and survival of ocular cancer in Cali between 1962 and 2019., Methods: Ecological population-based study analyzing data of incidence, mortality, and 5-years survival of malignant ocular tumors from the Populational Cancer Registry of Cali between 1962 and 2019., Results: Between 1962 and 2019, 586 ocular tumors were found, 50.5% occurred in females, the mean age at diagnosis was 45 years (standard deviation = 25), 70.3% of ocular malignancies occurred in >14 years. The average annual incidence rate was 7.8 per million for male and 6.9 per million for females. Retinoblastoma (21%), squamous cell carcinoma (20%), melanoma (16%) and lymphoma (8%) were the most common neoplasm. In those <15 years, the most frequent malignant tumors were retinoblastomas (85.7%), followed by non-specified malignant neoplasm (NOS, 7.9%), and rhabdomyosarcoma (3.6%). In those >14 years, there were NOS (30%), followed by squamous cell carcinomas (28%), melanomas (23%), and lymphomas (9.7%). Conjunctiva (38.2%), retina (21%) and orbit (10%) constituted the majority of anatomical sites of ocular tumors. The survival rate was about 83.2% and mortality did not show a decreasing trend over time ( p  > .05)., Conclusions: The incidence of ocular cancer in Cali has a slightly increasing trend, with stable behavior in the last decades. Squamous cell carcinoma, retinoblastoma, melanoma and lymphoma are the most frequent ocular cancers, with being retinoblastoma more frequent than melanoma. In general, ocular cancer had good survival rates in Cali.

Previous studies have shown that the transition from the University environment to remote learning impacted student mental health. Our study aimed to investigate the effects of university environment on anxiety and depressive symptoms in health sciences students. Students at the Technical University of Manabí, Ecuador, with 6-10 in-person semesters, who shifted to remote learning and then returned to face-to-face learning were selected. Students responded to the General Anxiety Disorder-7 (GAD-7) and Patient Health Questionnaire-9 (PHQ-9). In addition, questions regarding social interaction, physical exercise, mood and sleep habits were also asked. This longitudinal study tracked 323 students during the return to in-person classes and term end. The results showed similar rates of anxiety (GAD-7, p = 0.011- p = 0.002) and depression (PHQ-9 p = 0.001- p = 0.032) among students at week 1 and week 15. Previous diagnosis of depression (OR, 0.171; CI 0.050-0.579, p < 0.005) was shown to correlate with depression levels in week 1, with no changes seen at follow-up. Anxiety levels were shown to be associated with a previous diagnosis of the disorder at week 1, but not at follow-up (OR 0.233; CI 0.085-0.643, p < 0.005). The return to in-person learning among university students maintained levels of anxiety and depressive symptoms, underscoring ongoing vulnerabilities to mental health disorders in this group.

Glioblastoma is a common and aggressive malignant central nervous system tumor in adults. This study aims to evaluate and analyze the scientific results, collaboration countries, main research topics, and topics over time reported about glioblastoma. A bibliometric analysis of glioblastoma publications was performed mainly using R and Multbiplot software for author, journal, and resume. Associated statistic methods Latent Dirichlet Allocation (LDA) and HJ-Biplot. Inclusion criteria were research articles from the PubMed database published in English between 1973 and December 2022. A total of 64,823 documents with an annual growth rate of 8.27% indicates a consistent increase in research output over time. The results for the number of citations and significant publications showed Cancer Res, J Neuro-Oncol, and Neuro-Oncology are the most influential journals in the field of glioblastoma. The countries that concentrated research were the tumor United States, China, Germany, and Italy. Finally, there has been a marked growth in studies on prognosis and patient survival, therapies, and treatments for glioblastoma. These findings reinforce the need for increased global resources to address glioblastoma, particularly in underdeveloped countries. Glioblastoma research's exponential growth reflects sustained interest in early diagnosis and patient survival., (© 2024. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

Prior work has suggested that discrimination and immigration-related stress may impede mental health care seeking and utilization among Latinx populations. These effects may be more nuanced as both discrimination and immigration-related stress may increase symptomology, particularly post-traumatic stress disorder (PTSD) and depression. Both symptoms may, in turn, prompt attempts to seek care. The current study examined the direct effects of discrimination and immigration-related stress on care access, as well as potentially indirect effects with PTSD and depression symptoms as mediators. Interviews and online surveys were completed with 234 Latinx residents of the Midwest, assessing everyday discrimination, discrimination in healthcare, PTSD symptoms, depression symptoms, current mental health utilization, and previous unsuccessful attempts to seek care. Direct effects of discrimination and immigration-related stress were largely unrelated to care access variables. Discrimination in healthcare settings predicted both unsuccessful attempts to seek care and current use, but this effect was positive. The indirect effect was largely supported, but only for PTSD symptoms and not depression. Results indicate that further investigation is necessary to understand the direct effects of discrimination on care access. Further, discrimination and immigration-related stress may indirectly prompt attempts to seek mental health care.

In response to COVID-19 pandemic, we have launched a vaccine development program against SARS-CoV-2. Here we report the safety, tolerability, and immunogenicity of a recombinant protein RBD fusion heterodimeric vaccine against SARS-CoV-2 (PHH-1V) evaluated in a phase 1-2a dose-escalation, randomized clinical trial conducted in Catalonia, Spain. 30 young healthy adults were enrolled and received two intramuscular doses, 21 days apart of PHH-1V vaccine formulations [10 µg (n = 5), 20 µg (n = 10), 40 µg (n = 10)] or control [BNT162b2 (n = 5)]. Each PHH-1V group had one safety sentinel and the remaining participants were randomly assigned. The primary endpoint was solicited events within 7 days and unsolicited events within 28 days after each vaccination. Secondary endpoints were humoral and cellular immunogenicity against the variants of concern (VOCs) alpha, beta, delta and gamma. All formulations were safe and well tolerated, with tenderness and pain at the site of injection being the most frequently reported solicited events. Throughout the study, all participants reported having at least one mild to moderate unsolicited event. Two unrelated severe adverse events (AE) were reported and fully resolved. No AE of special interest was reported. Fourteen days after the second vaccine dose, all participants had a >4-fold change in total binding antibodies from baseline. PHH-1V induced robust humoral responses with neutralizing activities against all VOCs assessed (geometric mean fold rise at 35 days p < 0.0001). The specific T-cell response assessed by ELISpot was moderate. This initial evaluation has contributed significantly to the further development of PHH-1V, which is now included in the European vaccine portfolio.ClinicalTrials.gov Identifier NCT05007509EudraCT No. 2021-001411-82., (© 2023. Springer Nature Limited.)

Mammaplasty is a widely performed surgical procedure worldwide, utilized for breast reconstruction, in the context of breast cancer treatment, and aesthetic purposes. To enhance post-operative outcomes and reduce risks (hematoma with required evacuation, capsular contracture, implant-associated infection and others), the controlled release of medicaments can be achieved using drug delivery systems based on cyclodextrins (CDs). In this study, our objective was to functionalize commercially available silicone breast implants with smooth and textured surfaces through in-situ polymerization of two CDs: β-CD/citric acid and 2-hydroxypropyl-β-CD/citric acid. This functionalization serves as a local drug delivery system for the controlled release of therapeutic molecules that potentially can be a preventive treatment for post-operative complications in mammaplasty interventions. Initially, we evaluated the pre-treatment of sample surfaces with O 2 plasma, followed by chitosan grafting. Subsequently, in-situ polymerization using both types of CDs was performed on implants. The results demonstrated that the proposed pre-treatment significantly increased the polymerization yield. The functionalized samples were characterized using microscopic and physicochemical techniques. To evaluate the efficacy of the proposed system for controlled drug delivery in augmentation mammaplasty, three different molecules were utilized: pirfenidone (PFD) for capsular contracture prevention, Rose Bengal (RB) as anticancer agent, and KR-12 peptide (KR-12) to prevent bacterial infection. The release kinetics of PFD, RB, and KR-12 were analyzed using the Korsmeyer-Peppas and monolithic solution mathematical models to identify the respective delivery mechanisms. The antibacterial effect of KR-12 was assessed against Staphylococcus epidermidis and Pseudomonas aeruginosa , revealing that the antibacterial rate of functionalized samples loaded with KR-12 was dependent on the diffusion coefficients. Finally, due to the immunomodulatory properties of KR-12 peptide on epithelial cells, this type of cells was employed to investigate the cytotoxicity of the functionalized samples. These assays confirmed the superior properties of functionalized samples compared to unprotected implants., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2023 Escobar, Carrera, Naveas, Pulido, Manso, Guarnieri, Lancellotti, Cotta, Corrales-Ureña, Rischka and Hernandez-Montelongo.)

In the early 2000s, a method for cross-linking cyclodextrins (CDs) with citric acid (CTR) was developed. This method was nontoxic, environmentally friendly, and inexpensive compared to the others previously proposed in the literature. Since then, the CD/CTR biopolymers have been widely used as a coating on implants and other materials for biomedical applications. The present review aims to cover the chemical properties of CDs, the synthesis routes of CD/CTR, and their applications as drug-delivery systems when coated on different substrates. Likewise, the molecules released and other pharmaceutical aspects involved are addressed. Moreover, the different methods of pretreatment applied on the substrates before the in situ polymerization of CD/CTR are also reviewed as a key element in the final functionality. This process is not trivial because it depends on the surface chemistry, geometry, and physical properties of the material to be coated. The biocompatibility of the polymer was also highlighted. Finally, the mechanisms of release generated in the CD/CTR coatings were analyzed, including the mathematical model of Korsmeyer-Peppas, which has been dominantly used to explain the release kinetics of drug-delivery systems based on these biopolymers. The flexibility of CD/CTR to host a wide variety of drugs, of the in situ polymerization to integrate with diverse implantable materials, and the controllable release kinetics provide a set of advantages, thereby ensuring a wide range of future uses.

Objective: To identify the relationship between prophylactic indomethacin (PI) administration and incidence of intraventricular hemorrhage., Study Design: A retrospective analysis of extremely premature infants <27 weeks gestational age born between January 2014 and September 2020., Results: A total of 421 infants were included from three of Nationwide Children's Hospital delivery centers. Of those 255 (61%) received PI. After adjustment by inverse proportionality treatment weighting (IPTW), no differences were found in incidence of intraventricular hemorrhage (IVH) at the time of the first ultrasound, 31% vs. 33% in PI and control groups respectively (p = 0.68). The rate of rise of serum creatinine from baseline to day of life four was significantly higher in the PI group (0.14 mg/dl PI and 0.03 mg/dl control, p < 0.001)., Conclusion: PI was not associated with any benefit in prevention of IVH, but is associated with adverse effects including acute rise in creatinine., (© 2022. The Author(s), under exclusive licence to Springer Nature America, Inc.)

Capillary malformations (CMs) are the most common vascular anomalies, composed of enlarged capillaries and venules with thickened perivascular cell coverage in skin and mucous membranes. These congenital anomalies represent an error in vascular development during embryogenesis. Most of the CMs occur without any syndromic findings; the association between CMs systemic anomalies in some patients, however, makes the recognition of additional syndrome features critical. Some genetic disorders discussed, which feature CMs, include Sturge-Weber syndrome, diffuse CMs with overgrowth, Klippel-Trenaunay syndrome, CLOVES syndrome, among others. This article can aid clinicians in better identifying CMs and associated syndromes and provide consistent terminology to facilitate interdisciplinary management., (Copyright © 2022 Elsevier Inc. All rights reserved.)

After the discovery of prion phenomenon, the physiological role of the cellular prion protein (PrP C ) remained elusive. In the past decades, molecular and cellular analysis has shed some light regarding interactions and functions of PrP C in health and disease. PrP C , which is located mainly at the plasma membrane of neuronal cells attached by a glycosylphosphatidylinositol (GPI) anchor, can act as a receptor or transducer from external signaling. Although the precise role of PrP C remains elusive, a variety of functions have been proposed for this protein, namely, neuronal excitability and viability. Although many issues must be solved to clearly define the role of PrP C , its connection to the central nervous system (CNS) and to several misfolding-associated diseases makes PrP C an interesting pharmacological target. In a physiological context, several reports have proposed that PrP C modulates synaptic transmission, interacting with various proteins, namely, ion pumps, channels, and metabotropic receptors. PrP C has also been implicated in the pathophysiological cell signaling induced by β-amyloid peptide that leads to synaptic dysfunction in the context of Alzheimer's disease (AD), as a mediator of Aβ-induced cell toxicity. Additionally, it has been implicated in other proteinopathies as well. In this review, we aimed to analyze the role of PrP C as a transducer of physiological and pathological signaling., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2021 Panes, Saavedra, Pineda, Escobar, Cuevas, Moraga-Cid, Fuentealba, Rivas, Rezaei and Muñoz-Montesino.)

Everyday activities are replete with contextual cues for infants to exploit in the service of learning words. Nelson's (1985) script theory guided the hypothesis that infants participate in a set of predictable activities over the course of a day that provide them with opportunities to hear unique language functions and forms. Mothers and their firstborn 13-month-old infants (N = 40) were video-recorded during everyday activities at home. Transcriptions and coding of mothers' speech to infants-time-locked to activities of feeding, grooming, booksharing, object play, and transition-revealed that the amount, diversity, pragmatic functions, and semantic content of maternal language systematically differed by activity. The activities of everyday life shape language inputs to infants in ways that highlight word meaning., (© 2018 Society for Research in Child Development.)

Promoting parent involvement in adolescent residential substance use treatment is an evidence-based principle, yet engaging parents is challenging. Parent SMART (Substance Misuse among Adolescents in Residential Treatment) is a technology-assisted intervention that was designed to engage parents of adolescents in residential SU treatment during the post-discharge transition period. A prior pilot randomized controlled trial ( n =61 parent-adolescent dyads) established Parent SMART's feasibility, acceptability, and preliminary effectiveness in reducing adolescent substance use and substance-related problems across both a short- (i.e., acute stay) and long- (i.e., residential) term care facility. The current secondary analysis extends this prior work by examining whether Parent SMART was associated with improvements in putative mediators of change: parental monitoring and parent-adolescent communication. Multi-modal assessment consisting of participant-report questionnaires and a behavioral interaction task evaluated parenting processes over the 24 weeks following discharge. Generalized linear mixed models showed no significant time by condition interactions on the participant-report questionnaires, but found significant interactions on all five scales of the behavioral interaction task. Supplemental analyses by residential facility detected additional interaction effects favoring Parent SMART on the participant-report questionnaires. Plotting of the interaction effects indicated that Parent SMART was associated with improvements in parenting processes, whereas TAU was associated with relatively stable or worsening parenting scores. Parent SMART demonstrated preliminary effectiveness in improving key parenting processes among adolescents discharged from residential substance use treatment. Parent SMART warrants further testing in a fully-powered trial that evaluates parental monitoring and parent-adolescent communication as mediators of change.

As we all know, COVID-19 has impacted the entire world. Quarantine disrupts people's lives, with high levels of stress and negative psychological impacts. Studies carried out mostly in the Far East, Europe, or the United States have started to provide evidence on survivors, frontline healthcare workers, and parents. The present study is the first survey to be carried out in Latin America (in Santiago, the capital of Chile). It aims to (a) explore the perceived psychological impact and future concerns; (b) evaluate vulnerability factors; (c) describe the perceived psychological impacts on participants whose psychological help and actual online psychotherapy was interrupted; and (d) explore the future need for psychological help. Procedure: An online survey was carried out (the first 2 weeks of lockdown in Santiago), which included sociodemographic data, perceived psychological impact, future concerns, and questions about psychological support. Participants: A total of 3,919 subjects answered, mostly women (80%). Results: The main perceived psychological impacts were concern (67%) and anxiety (60%). Future concerns were : general health (55.3%), employment (53.1%), and finances (49.8%). Younger participants had a greater perceived psychological impact ( p 's < 0.01) and concerns about employment, finances, mental health, stigma, and general health ( p 's < 0.001). Women reported more perceived psychological impact than men ( p 's < 0.05). Men reported mainly boredom (χ 2 = 11.82, gl = 1, p < 0.001). Dependent employees experienced more boredom, anxiety, distress, sleep problems, an inability to relax, and a lack of concentration than the self-employed (p's < 0.05). While the latter reported future concerns about employment and finances ( p 's < 0.001), dependent employees reported them on their general and mental health ( p 's < 0.001). Regarding psychological support, 22% of participants were receiving it before lockdown. They showed more perceived psychological impact than those who were not ( p 's < 0.01), and 7% of them had online psychotherapy, reporting excellent (32.1%) or odd but working (65.2%) results. Finally, of the total sample, almost half of the participants (43.8%) felt they would need emotional support after this pandemic, and these are the ones that also showed higher perceived psychological impact ( p 's < 0.001). This study confirms the presence of perceived negative emotional impact and concerns about the future. Also, there are vulnerable groups, such as women, younger people, the self-employed, and people with psychological processes that were interrupted., (Copyright © 2020 Dagnino, Anguita, Escobar and Cifuentes.)

Previous research suggests that learning to categorize faces along a novel dimension changes the perceptual representation of such dimension, increasing its discriminability, its invariance, and the information used to identify faces varying along the dimension. A common interpretation of these results is that categorization training promotes the creation of novel dimensions, rather than simply the enhancement of already existing representations. Here, we trained a group of participants to categorize faces that varied along two morphing dimensions, one of them relevant to the categorization task and the other irrelevant to the task. An untrained group did not receive such categorization training. In three experiments, we used face adaptation aftereffects to explore how categorization training changes the encoding of face identities at the extremes of the category-relevant dimension and whether such training produces encoding of the category-relevant dimension as a preferred direction in face space. The pattern of results suggests that categorization training enhances the already existing norm-based coding of face identity, rather than creating novel category-relevant representations. We formalized this conclusion in a model that explains the most important results in our experiments and serves as a working hypothesis for future work in this area.

In Nicaragua, there are ideal environmental conditions for leptospirosis. The objective of this investigation was to detect pathogenic and saprophytic leptospires in water and soil samples from leptospirosis-endemic areas in Nicaragua. Seventy-eight water and 42 soil samples were collected from houses and rivers close to confirmed human cases. Leptospira spp was isolated in Ellinghausen-McCullough-Johnson-Harris (EMJH) culture medium with 5-fluororacil and positive samples were analyzed through PCR for the LipL32 gene, specific for pathogenic leptospires (P1 clade). There were 73 positive cultures from 120 samples, however only six of these (5% of all collected samples) were confirmed to be pathogenic, based on the presence of the LipL32 gene (P1 clade). Of these six pathogenic isolates, four were from Leon and two from Chinandega. Four pathogenic isolates were obtained from water and two from soil. This study proved the contamination of water and soil with pathogenic leptospires, which represents a potential risk for public health.

Objective: In Guatemala, cirrhosis is among the 10 leading causes of death, and mortality rates have increased lately. The reasons for this heavy burden of disease are not clear as the prevalence of prominent risk factors, such as hepatitis B virus, hepatitis C virus and heavy alcohol consumption, appears to be low. Aflatoxin B 1 (AFB 1 ) exposure, however, appears to be high, and thus could be associated with the high burden of cirrhosis. Whether AFB 1 increases the risk of cirrhosis in the absence of viral infection, however, is not clear., Design: Cirrhosis cases (n=100) from two major referral hospitals in Guatemala City were compared with controls (n=200) from a cross-sectional study. Logistic regression was used to estimate the ORs and 95% CIs of cirrhosis and quintiles of AFB 1 in crude and adjusted models. A sex-stratified analysis was also conducted., Results: The median AFB 1 level was significantly higher among the cases (11.4 pg/mg) than controls (5.11 pg/mg). In logistic regression analyses, higher levels of AFB 1 was associated with cirrhosis (quintile 5 vs quintile 1, OR: 11.55; 95% CI 4.05 to 32.89). No attenuation was observed with adjustment by sex, ethnicity, hepatitis B virus status, and heavy alcohol consumption. A significantly increasing trend in association was observed in both models (p trend <0.01). Additionally, the cirrhosis-AFB 1 association was more prominent among men., Conclusions: The current study found a significant positive association between AFB 1 exposure and cirrhosis. Mitigation of AFB 1 exposure and a better understanding of additional risk factors may be important to reduce the burden of cirrhosis in Guatemala., Competing Interests: Competing interests: None declared., (Re-use permitted under CC BY. Published by BMJ.)

Background: Monoclonal gammopathy of renal significance (MGRS)-related lesions are infrequent entities. There are no publications on these disorders in Latin America (LA). The aim of this study was to describe epidemiological and clinical characteristics of these patients in LA., Methods: We performed a multicentre retrospective study. Patients with diagnosis of MGRS between 2012 and 2018 were included. Epidemiological and clinical data were collected from clinical records., Results: Twenty-seven patients from Chile, Argentina, Ecuador and Uruguay were included. Half debuted with a nephrotic syndrome, and 32% required dialysis. Proliferative glomerulonephritis with monoclonal immunoglobulin deposits was found in 33%, amyloidosis in 26% and monoclonal immunoglobulin deposition disease also in 26%. The immunoglobulin most frequently found in renal biopsies was IgG kappa. In 67% a paraprotein was found. Twenty patients received an anti-plasma cell regimen, and 3 a rituximab-based regimen (IgM-MGRS). Renal response (RR) was achieved in 56%. Early treatment (≤3 months) was associated with higher RR (75% vs 43%). Three patients relapsed within 21.5 months, and 3 progressed: 1 to multiple myeloma, 1 to systemic amyloidosis and another to systemic light-chain deposition disease. Two patients died, both due to infection during induction treatment., Conclusion: There was a higher than expected frequency of patients requiring dialysis. The most common MGRS-related lesion was PGNMD. Early treatment was associated with better response. As a rare disease, increasing awareness and promoting early diagnosis are necessary in LA to improve outcomes. SUMMARY AT A GLANCE A collection of 27 cases of MGRS from Latin America with information on epidemiology, clinical characteristics, treatment and outcome of patients diagnosed of MGRS-related renal lesions., (© 2019 Asian Pacific Society of Nephrology.)

Two infant milestones, self-propelled locomotion and stranger anxiety, tend to emerge at a similar age in development. An adaptive relation may exist in which the onset of one influences the development of the other in individual children. We examine whether these milestones systematically co-occur and whether one reliably precedes the other. In the current study, 104 parents completed weekly online surveys between 6 and 12 months, noting milestones as they occurred. Onset ages for locomotor behaviors were correlated with onset of stranger anxiety over and above a milestone in a third domain, namely consonant-vowel babbling. These data suggest that infants' earliest locomotor behaviors may play a role in galvanizing the development of stranger anxiety., (Copyright © 2020 Elsevier Inc. All rights reserved.)

Objectives: To determine if chewing gum containing casein phosphopeptide stabilised amorphous calcium phosphate (CPP-ACP) promoted an increase in the abundance of Streptococcus sanguinis and other species associated with dental health in supragingival plaque in a clinical study., Materials and Methods: Nineteen participants were recruited for a three-leg cross-over, randomised, controlled clinical trial. Participants chewed a sugar-free gum with or without CPP-ACP six times daily for 20 min over two weeks. The study also involved no gum chewing (no gum) for the same two week period. Participants were randomly assigned to one of the test gums or no gum for each intervention period. Participants abstained from oral hygiene and had washout periods of two weeks between intervention periods. After each intervention period, supragingival plaque was collected and analysed for bacterial composition by sequencing the V4 variable region of the 16S rRNA gene. Data were analysed using a linear mixed model., Results: The CPP-ACP gum intervention produced a significant (p < 0.01) increase in the proportions of S. sanguinis (112%), as well as the commensal species Rothia dentocariosa (127%), Corynebacterium durum (80%) and Streptococcus mitis (55%) when compared with the no gum intervention. All the species that were promoted by the CPP-ACP gum are known to possess one or both of the alkali-producing enzymes arginine deiminase and nitrate reductase., Conclusion: This clinical study demonstrated that chewing a sugar-free gum containing CPP-ACP promoted prebiosis by significantly increasing the proportion of S. sanguinis and other health-associated bacterial species in supragingival plaque., Clinical Significance: Regular chewing of CPP-ACP sugar-free gum increases the proportions of health-associated commensal species in supragingival plaque to promote prebiosis and oral homeostasis., (Copyright © 2019 Elsevier Ltd. All rights reserved.)

Background: Extracranial vascular malformations affect vessel inflammation, clotting, and ischemia. However, the relationship between extracranial vascular malformations and myocardial infarction (MI) or stroke has not been fully elucidated. Limited studies have investigated the association between extracranial vascular malformations and cardiovascular diseases., Methods: A total of 48,701 patients with extracranial vascular malformations and a control cohort of 487,010 age- and sex-matched participants from the Korean National Health Insurance database were included. The incidence and risk of MI, ischemic stroke (IS), and hemorrhagic stroke (HS) between participants with extracranial vascular malformations and the control cohort was compared., Results: After adjusting for other cardiovascular disease risk factors, the adjusted hazard ratios (aHRs) for venous malformations, capillary malformations (CMs), arteriovenous malformations (AVMs), and lymphatic malformations in patients with acute MI were 1.25 (CI, 1.04 to 1.50), 1.41 (CI, 1.24 to 1.61), 1.68 (CI, 1.18 to 2.37), and 1.40 (CI, 1.31 to 1.48), respectively. For IS, the aHRs were 1.55 (CI, 1.35 to 1.77), 1.92 (CI, 1.74 to 2.11), 1.13 (CI, 0.78 to 1.64), and 1.51 (CI, 1.44 to 1.58), respectively. For HS, the aHRs were 1.51 (CI, 1.12 to 2.05), 5.63 (CI, 4.97 to 6.38), 2.93 (CI, 1.82 to 4.72), and 1.34 (CI, 1.20 to 1.50), respectively., Conclusions: Independent of cardiovascular risk factors, extracranial vascular malformations were associated with an increased risk of MI, IS, and HS. For patients with CMs and AVMs, intracerebral hemorrhage risk was particularly high, accounting for 563% and 293%, respectively. Therefore, even in patients with extracranial CMs or AVMs, performing diagnostic evaluations for cerebral AVMs and using measures to prevent intracerebral hemorrhage are crucial., Clinical Question/level of Evidence: Risk, II., (Copyright © 2024 The Authors. Published by Wolters Kluwer Health, Inc. on behalf of the American Society of Plastic Surgeons.)

Many in-lab studies have demonstrated that the distribution of word learning moments affects the strength and quality of word representations. How are words distributed in speech to children in their daily lives, and how is distribution related to other input characteristics? The present study analyzes transcripts of language input to English-learning infants from three longitudinal, naturalistic corpora captured between 6 and 39 months of age. To describe how word frequency varies across time, we calculated dispersion scores for all word types for each child. Dispersion quantifies the deviation of observed frequencies in each recording session from expected (uniform across sessions) word frequency, providing a measure of how evenly word utterances were spread across sessions. Dispersion is strongly correlated with frequency and moderately correlated with concreteness across all corpora, such that high frequency and low concreteness words are more evenly dispersed. Correlations with measures of age of acquisition (AoA) varied across corpora, and dispersion did not reliably predict AoA above and beyond frequency and concreteness. The contradiction between the current results and results from in-lab experiments is discussed. This study provides a foundation to explore how word learning unfolds across time and contexts in the real world., (© 2024 International Congress of Infant Studies.)

Lead ion in drinking water is one of the most dangerous metals. It affects several systems, such as the nervous, gastrointestinal, reproductive, renal, and cardiovascular systems. Adsorption process is used as a technology that can solve this problem through suitable composites. The adsorption of lead (Pb(II)) on graphene oxide (GO) and on two goethite (α-FeOOH)/reduced graphene oxide (rGO) composites (composite 1: 0.10 g GO: 22.22 g α-FeOOH and composite 2: 0.10 g GO: 5.56 g α-FeOOH), in aqueous medium, was studied. The GO was synthesized from a commercial pencil lead. Composites 1 and 2 were prepared from GO and ferrous sulfate. The GO and both composites were characterized by using scanning electron microscopy (SEM), scanning transmission electron microscopy (STEM), Raman spectroscopy, X-ray diffraction (XRD), Fourier-transform infrared spectroscopy (FTIR), and dynamic light scattering (DLS). The adsorption capacity of Pb(II) on the GO and both composites was evaluated through adsorption isotherms. Composite 1 presented a significant agglomeration of α-FeOOH nanorods on the reduced graphene oxide layers. Meanwhile, composite 2 exhibited a more uniform distribution of nanorods. The adsorption of Pb(II) on the three adsorbents fits the Langmuir isotherm, with an adsorption capacity of 277.78 mg/g for composite 2200 mg/g for GO and 138.89 mg/g for composite 1. Composite 2 emerged as a highly efficient alternative to purify water contaminated with Pb(II).

Background: Acute respiratory infection (ARI) is an important cause of mortality in children and adults. However, studies assessing risk factors for ARI-related deaths in low- and middle-income settings are limited. We describe ARI-related death and associated factors among children aged < 2 years and adults aged ≥18 years hospitalized with ARI in Guatemala., Methods: We used respiratory illness surveillance data in Guatemala from 2007 to 2013. ARI was defined as evidence of acute infection and ≥ 1 sign/symptom of respiratory disease in hospitalized patients. Clinical, sociodemographic, and follow-up data were gathered. Nasopharyngeal/oropharyngeal swabs were collected from patients with ARI and tested for 6 respiratory viruses; urine was collected only from adults with ARI and tested for pneumococcal antigen. Blood cultures and chest radiographs were performed at the physician's discretion. Radiographs were interpreted per World Health Organization guidelines to classify endpoint pneumonia (i.e. suggestive of bacterial pneumonia). Multivariable logistic regression was used to compare characteristics of patients with fatal cases, including those who died in-hospital or were discharged in a moribund state, with those of patients with non-fatal cases., Results: Among 4109 ARI cases identified in hospitalized children < 2 years old, 174 (4%) were fatal. Median age at admission was 4 and 6 months for children with fatal and non-fatal cases, respectively. Factors associated with fatality included low weight-for-age, low family income, heart disease, and endpoint pneumonia; breastfeeding and respiratory syncytial virus (RSV) detection were negatively associated with fatality. Among 1517 ARI cases identified in hospitalized adults ≥18 years, 181 (12%) episodes were fatal. Median age at admission was 57 years for adults with fatal and non-fatal cases. Low body mass index, male sex, kidney disease, and endpoint pneumonia were significantly more common among patients with fatal versus non-fatal cases., Conclusions: Our findings highlight some of the factors that must be addressed in order to reduce ARI-related mortality, including promotion of good nutrition, breastfeeding, management and prevention of chronic comorbidities, and poverty reduction. Although no specific pathogen increased risk for death, endpoint pneumonia was significantly associated with fatality, suggesting that the pneumococcal conjugate vaccine could contribute to future reductions in ARI-related mortality.

Objective: To know opinions of adolescents from Cholul, Yucatán, about Plato del Bien Comer Maya in order to improve it as health promotion tool., Materials and Methods: Qualitative study, formative research. Three focus groups were carried out, participating 28 adolescents: 12-16 years old. Criteria of inclusion: studying middle school; to have native family from the town. Analysis of the data made manually., Results: Comparatively with the national Plato del Bien Comer, the Plato Maya was better identified because have local food products easier to obtain and cheaper. The principal finding was to understand Fruto is a linguistic variation word which represents in Maya context both fruits and vegetables. This might be an important key to improve health promotion activities with that population., Conclusions: In order to have better results in nutritional interventions, it is necessary to design educational-communicative strategies in accordance with the local culture., Competing Interests: Declaration of conflict of interests. The authors declare that they have no conflict of interests.

Background: Among the most persistent public health problems in the United States is the gap between adolescents who need therapy for a substance use (SU) disorder and those who seek therapy. The role of parental factors (e.g., impressions of the adolescent's symptoms, sociodemographic factors) has been well documented in work examining adolescent help-seeking from professionals and paraprofessionals but has not been evaluated in studies of therapy-seeking for adolescents with SU. This study's primary objective was to identify parental sociodemographic and parent-reported clinical factors associated with therapy-seeking among parents concerned about their adolescent's SU. A secondary objective was to explore reasons why parents reported not seeking therapy and whether these reasons were associated with sociodemographic and clinical variables. Methods: We conducted a survey of 411 parents of adolescents (age 12-19) who reported elevated concern about their adolescent's SU. Parents were asked whether their adolescent had a history of therapy, and those who reported no history were asked an open-ended question about reasons why they had not sought therapy. Responses were rated by 2 independent coders and used to sort parents into 3 groups: "treaters" (those who had sought therapy), "acknowledgers" (those who acknowledged their adolescent had SU problems but did not seek therapy), and "deniers" (those who denied their adolescent had SU problems). Multinomial logistic regression examined the relationship between sociodemographic and clinical factors and group membership. Results: Multivariate analyses revealed that parent-reported SU severity, internalizing distress, and externalizing behavior problems were all associated with therapy-seeking behavior, with internationalizing distress emerging as the strongest predictor. Additionally, non-Hispanic white parents were more likely to seek therapy than minority parents. Conclusions: Parent report of symptoms, especially internalizing distress, and parental race were associated with therapy-seeking behavior, highlighting opportunities for targeted outreach to engage parents in therapy.

Soybean meal (SBM) is the protein source that is used most in feeding piglets, but its high price has prompted a search for alternatives. One option is sesame meal (SM), a by-product of sesame oil. This study evaluated the effects of SM and phytase on the intestinal morphology, total trypsin activity (TTA) and specific trypsin activity (STA), apparent ileal digestibility (AID) of amino acids (AAs), and apparent total tract digestibility (ATTD) of phosphorus (P), calcium (Ca), and energy (E) in weaned piglets. Twenty piglets weaned at 17 days old were placed in metabolic cages in a temperature-controlled room. When the piglets were 21 days old, cannulas were fitted at the terminal ileum. From the fourth day after surgery, piglets received the experimental treatments for nine days, namely an SM or SBM diet, each with or without phytase. The protein source or phytase did not affect villus height, crypt depth, or TTA. However, phytase increased STA. The AID of dry matter (DM), E, crude protein (CP), and AA was similar among treatments, except for arginine, which was more digestible in the SM diets (85.8) than in the SBM ones (81.6). The ATTD of DM and E was higher in the SM than in the SBM diets. Phytase increased the ATTD of Ca (22.7 %) and P (27.9 %). The findings showed that SM can be used as a protein source for piglets and that its consumption increases arginine intake. The addition of phytase to the diet increases the ATTD of P and Ca. [ABSTRACT FROM AUTHOR]

Latinx families face unique barriers to accessing traditional youth mental health services and may instead rely on a wide range of supports to meet youth emotional or behavioral concerns. Previous studies have typically focused on patterns of utilization for discrete services, classified by setting, specialization, or level of care (e.g., specialty outpatient, inpatient, informal supports), yet little is known about how youth support services might be accessed in tandem. This analysis used data from the Pathways to Latinx Mental Health study - a national sample of Latinx caregivers (N = 598) from across the United States collected at the start of the coronavirus pandemic (i.e., May-June 2020) - to describe the broad network of available supports that are used by Latinx caregivers. Using exploratory network analysis, we found that the use of youth psychological counseling, telepsychology, and online support groups was highly influential on support service utilization in the broader network. Specifically, Latinx caregivers who used one or more of these services for their child were more likely to report utilizing other related sources of support. We also identified five support clusters within the larger network that were interconnected through specific sources of support (i.e., outpatient counseling, crisis, religious, informal, and non-specialty). Findings offer a foundational look at the complex system of youth supports available to Latinx caregivers, highlighting areas for future study, opportunities to advance the implementation of evidence-based interventions, and channels through which to disseminate information about available services., (© 2023 Family Process Institute.)

Various post-exercise strategies have been proposed to accelerate recovery during periods of training. However, the effects of water immersion (WI) temperature on recovery amid multiple daily exercise bouts are not well investigated., Purpose: To evaluate the effects of cold and warm water immersion temperatures between acute exercise bouts vs. no WI recovery on running performance., Methods: Nine recreationally trained men (age: 24.0 ± 6.0 years old) participated in four experimental sessions using a crossover design. Each experimental session consisted of unilateral eccentric knee flexion exercise and 90 min of treadmill running at 70% of peak oxygen consumption followed by 15 min of WI at 15°C, 28°C or 38°C or passive recovery seated at room temperature (CON). Four hours following WI or CON, subjects completed a 5 km running time trial. Rectal temperature (Trec), heart rate, and excess post-exercise oxygen consumption (EPOC) were measured., Results: Statistical analyses indicated that time trial performance was not affected by post-exercise recovery by WI (P > .05). The magnitude-based inferences indicated that 15°C (+ 3.6 ± 7.8%) likely and 28°C (+ 3.2 ± 7.5%) possibly improved recovery compared with CON, while the effect of 38°C (- 0.1 ± 12.3%) on recovery was unclear. During WI, heart rate and rectal temperature were not different from CON, but EPOC was higher in 15°C and 28°C compared to CON. Trec in 15°C was lower than CON from the 15th min post WI. EPOC was also greater in 15°C post WI compared to CON., Conclusion: WI at 15°C and 28°C following acute exercise likely and possibly, respectively, improved subsequent 5 km running time trial performance. We speculate that the faster recovery in core temperature post-exercise may underlie these improvements in recovery.

Direct-to-consumer (DTC) marketing strategies represent an increasingly popular approach to promote patient awareness of psychological treatments (PTs). The Marketing Mix is a well-established framework used to inform marketing decisions consisting of four "P's": Product (or Service), Promotion, Place, and Price. We conducted the first DTC marketing survey using the Marketing Mix framework to explore how parents concerned about their adolescents' behavioral health receive information about PTs. A sample of 411 parents (51% girls, 82% Non-Hispanic White) of 12- to 19-year-old adolescents completed an online survey asking how they would prefer to receive information about PTs, including five questions spanning the Promotion, Price, and Place dimensions of The Marketing Mix. A subsample of 158 parents also reported on how they had received PT information during their adolescent's most recent therapy experience, allowing us to compare ideal versus actual therapy experiences. We explored the extent to which experiences varied as a function of parent race/ethnicity, income per capita, parent education level, and adolescent treatment history. Bivariate analyses and multivariate logistic regressions were used to examine which of these variables were associated with parents' responses to specific survey items. Analyses revealed that parent preferences varied as a function of income per capita, education level, and history of treatment. In addition, there were significant gaps between parents' ideal and most recent therapy experiences. Implications for the marketing of PTs are discussed.

Objective: To describe how a community-academic partnership between Taller Salud Inc., a community-based organization, and the Puerto Rico Community Cancer Control Outreach Program of the University of Puerto Rico was crucial in the adaptation and implementation of Cultivando La Salud (CLS), an evidencebased educational outreach program designed to increase breast and cervical cancer screening among Hispanic women living in Puerto Rico. This collaboration facilitated the review and adaptation of the CLS intervention to improve cultural appropriateness, relevance, and acceptability for Puerto Rican women., Methods: A total of 25 interviewers and 12 Lay Health Workers (LHWs) were recruited and trained to deliver the program. The interviewers recruited women who were non-adherent to recommended screening guidelines for both breast and cervical cancer. LHWs then provided one-on-one education using the adapted CLS materials., Results: A total of 444 women were recruited and 48% of them were educated through this collaborative effort., Conclusion: Our main accomplishment was establishing the academic-community partnership to implement the CLS program. Nevertheless, in order to promote better collaborations with our community partners, it is important to carefully delineate and establish clear roles and shared responsibilities for each partner for the successful execution of research activities, taking into consideration the community's needs.