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The present study aims to analyze the interaction between Rhodotorula toruloides and magnetic nanoparticles and evaluate their effect on carotenoid production. The manganese ferrite nanoparticles were synthesized without chitosan (MnFe2O4) and chitosan coating (MnFe2O4-CS) by the co-precipitation method assisted by hydrothermal treatment. XRD (X-ray diffraction), Magnetometry, Dynamic Light Scattering (DLS) and FTIR (Fourier-Transform Infrared Spectroscopy), are used to characterize the magnetic nanoparticles. The crystallite size of MnFe2O4 was 16 nm for MnFe2O4 and 20 nm for MnFe2O4-CS. The magnetic saturation of MnFe2O4-CS was lower (39.6 ± 0.6 emu/g) than the same MnFe2O4 nanoparticles (42.7 ± 0.3 emu/g), which was attributed to the chitosan fraction presence. The MnFe2O4-CS FTIR spectra revealed the presence of the characteristic chitosan bands. DLS demonstrated that the average hydrodynamic diameters were 344 nm for MnFe2O4 and 167 nm for MnFe2O4-CS. A kinetic study of cell immobilization performed with their precipitation with a magnet demonstrated that interaction between magnetic nanoparticles and R. toruloides was characterized by an equilibrium time of 2 h. The adsorption isotherm models (Langmuir and Freundlich) were fitted to the experimental values. The trypan blue assay was used for cell viability assessment. The carotenoid production increased to 256.2 ± 6.1 µg/g dry mass at 2.0 mg/mL MnFe2O4-CS. The use of MnFe2O4-CS to stimulate carotenoid yeast production and the magnetic separation of biomass are promising nanobiotechnological alternatives. Magnetic cell immobilization is a perspective technique for obtaining cell metabolites.

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Importance: No prior systematic review and meta-analysis has specifically verified the association of Mediterranean diet (MedDiet)-based interventions with biomarkers of cardiometabolic health in children and adolescents. Objective: To review and analyze the randomized clinical trials (RCTs) that assessed the effects of MedDiet-based interventions on biomarkers of cardiometabolic health among children and adolescents. Data Sources: Four electronic databases were searched (PubMed, Cochrane Library, Web of Science, and Scopus) from database inception to April 25, 2024. Study Selection: Only RCTs investigating the effect of interventions promoting the MedDiet on cardiometabolic biomarkers (ie, systolic blood pressure [SBP], diastolic blood pressure [DBP], triglycerides [TGs], total cholesterol [TC], high-density lipoprotein cholesterol [HDL-C], low-density lipoprotein cholesterol [LDL-C], glucose, insulin, and homeostatic model assessment for insulin resistance [HOMA-IR]) among children and adolescents (aged ≤18 years) were included. Data Extraction and Synthesis: A systematic review and meta-analysis was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement. Data were extracted from the studies by 2 independent reviewers. Results across studies were summarized using random-effects meta-analysis. Main Outcome and Measures: The effect size of each trial was computed by unstandardized mean differences (MDs) of changes in biomarker levels (ie, SBP, DBP, TGs, TC, HDL-C, LDL-C, glucose, insulin, HOMA-IR) between the intervention and the control groups. The quality of the evidence was assessed using the Grading of Recommendations, Assessment, Development, and Evaluations approach. Results: Nine RCTs were included (mean study duration, 17 weeks; range, 8-40 weeks). These studies involved 577 participants (mean age, 11 years [range, 3-18 years]; 344 girls [59.6%]). Compared with the control group, the MedDiet-based interventions showed a significant association with reductions in SBP (mean difference, -4.75 mm Hg; 95% CI, -8.97 to -0.52 mm Hg), TGs (mean difference, -16.42 mg/dL; 95% CI, -27.57 to -5.27 mg/dL), TC (mean difference, -9.06 mg/dL; 95% CI, -15.65 to -2.48 mg/dL), and LDL-C (mean difference, -10.48 mg/dL; 95% CI, -17.77 to -3.19 mg/dL) and increases in HDL-C (mean difference, 2.24 mg/dL; 95% CI, 0.34-4.14 mg/dL). No significant associations were observed with the other biomarkers studied (ie, DBP, glucose, insulin, and HOMA-IR). Conclusions and Relevance: These findings suggest that MedDiet-based interventions may be useful tools to optimize cardiometabolic health among children and adolescents.

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BACKGROUND: Cerebral arteriovenous malformations (AVMs) are complex lesions that can cause hemorrhagic stroke and significant neurological disability. Adenosine induces cardiac standstill and hypotension, which are thought to be useful during cerebral AVM embolization. Herein, we conducted a systematic review and meta-analysis of the technique's safety. METHODS: Following PRISMA guidelines, four databases were queried for studies describing the use of adenosine-assisted embolization of cerebral AVMs. Adenosine-related intraoperative complications, permanent neurological outcomes, morbidity, and mortality assessed the technique's safety. Single proportion analysis under a random-effects model was performed. Heterogeneity was assessed using I² statistics, and publication bias was evaluated through funnel plot analysis and Egger's regression test. RESULTS: Ten studies were included, involving 79 patients (55.7% male) with 79 AVMs (54.4% unruptured and 70.9% Spetzler-Martin grade III-V) who underwent 123 embolizations (80.4% and 5.9% under transarterial and transvenous approaches, respectively) with n-butyl cyanoacrylate (80.4%), ethylene vinyl alcohol (14.4%), or both (5.2%). The incidence of transient adenosine-related intraoperative complications was 0% (95% CI 0% to 3%, I2=24%). Besides, the incidence of adenosine-related morbidity, mortality, and permanent outcomes was 0% (95% CI 0% to 3%, I2=0%). During follow-up, good functional outcomes were reported for 64 patients (81%). CONCLUSIONS: Adenosine's effects on blood flow control can facilitate embolization and mitigate the risk of AVM rupture and embolic agent migration. Although current evidence stems from observational studies, the results of this meta-analysis suggest a safe drug profile due to minimal associated morbidity and mortality. Further research from larger randomized and controlled studies is warranted to attain a higher level of evidence. PROSPERO REGISTRY NUMBER: CRD42023494116.

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OBJECTIVE: The aim of this study was to examine the relationship of ultra-processed food (UPF) intake with the incidence of glaucoma in a large sample of Spanish university graduates followed prospectively. METHODS: Prospective cohort study using data from the SUN Project. A final sample of 19,225 participants (60.1% women) was included in this study, with a mean age of 38.2 years (standard deviation (SD) = 12.4). Participants were followed-up for a mean time of 12.9 years (SD = 5.4). Dietary intake was measured using a 136-item semiquantitative food-frequency questionnaire. UPFs were defined based on the NOVA classification system. Glaucoma diagnosis was determined by asking the participants if they had ever been diagnosed with glaucoma by an ophthalmologist. This self-reported diagnosis of glaucoma has been previously validated. RESULTS: After adjusting for several covariates, participants with the highest UPF consumption were at higher risk of glaucoma (hazard ratio (HR) = 1.83; 95% confidence interval (CI) 1.06 to 3.17) when compared to participants in the lowest category of UPF consumption. Regarding subgroup analyses, a significant multiplicative interaction was found for age (p = 0.004) and omega 3:6 ratio (p = 0.040). However, an association between UPF consumption and glaucoma was only found in older participants (aged ≥ 55 years), in men, in the most physically active group, in the group of non- or former smokers, in those with a lower omega 3:6 ratio, and in those with a lower energy intake. Regarding the contribution of each type of UPF group, UPF coming from sweets showed a significant risky effect (HR = 1.51; CI 95% 1.07 to 2.12). CONCLUSIONS: This prospective cohort study shows that participants with a greater UPF consumption have a higher risk of developing glaucoma when compared to participants with a lower consumption. Our findings emphasize the relevance of monitoring and limiting the consumption of UPFs as a means of preventing glaucoma incidence.

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The present work aimed to study, predict and understand benzene migration that occurred during an industrial spill using numerical simulation by computational fluid dynamics. Advection, diffusion and adsorption were the main mechanisms considered that governed the spill incident. The incident occurred due to a fracture under a fuel oil storage tank. The tank was located on a hill 18 m high, and the initial value of benzene concentration (soil saturation) was 60 ppm. When the spill was discovered, samples in the affected zone were taken using an experimental design. Many samples showed a greater concentration of benzene than allowed by Mexican Official Standards (MOSs) (15 ppm). The concentrations found 100 m away from the spill were around 60 to 15 ppm. Due to the spill being under the tank, it was difficult to discover. The numerical simulation provided an estimate that the spill started around 2 years ago. The type of soil in the afflicted zone is rocky, and, consequently, it is difficult to estimate how long it will take to reach the concentration allowed by the MOSs, but the numerical simulation predicts that this concentration will be reached in 14 years. Experimental values of the spill contaminant concentration were statistically similar to the CFD estimated data (p < 0.05).

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Metabolic diseases are a worldwide health problem. Insulin resistance (IR) is their distinctive hallmark. For their study, animal models that provide reliable information are necessary, permitting the analysis of the cluster of abnormalities that conform to it, its progression, and time-dependent molecular modifications. We aimed to develop an IR model by exogenous insulin administration. The effective dose of insulin glargine to generate hyperinsulinemia but without hypoglycemia was established. Then, two groups (control and insulin) of male Wistar rats of 100 g weight were formed. The selected dose (4 U/kg) was administered for 15, 30, 45, and 60 days. Zoometry, a glucose tolerance test, insulin response, IR, and the serum lipid profile were assessed. We evaluated insulin signaling, glycogenesis and lipogenesis, redox balance, and inflammation in the liver. Results showed an impairment of glucose tolerance, dyslipidemia, hyperinsulinemia, and peripheral and time-dependent selective IR. At the hepatic level, insulin signaling was impaired, resulting in reduced hepatic glycogen levels and triglyceride accumulation, an increase in the ROS level with MAPK-ERK1/2 response, and mild pro-oxidative microenvironmental sustained by MT, GSH, and GR activity. Hepatic IR coincides with additions in MAPK-p38, NF-κB, and zoometric changes. In conclusion, daily insulin glargine administration generated a progressive IR model. At the hepatic level, the IR was combined with oxidative conditions but without inflammation.

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Introduction: The anti-CD20 antibody rituximab (RTX) has substantially improved outcomes of patients with B-cell lymphomas, although more efficient therapies are needed for refractory or relapsing lymphomas. An approach to increase the clinical effectiveness of anti-tumor therapy is the use of antibody-cytokine fusion proteins (immunocytokines (ICKs)) to deliver at the tumor site the antibody effector functions and cytokines that trigger anti-tumor activities. In particular, IL-2-based ICKs have shown significant results in preclinical studies but not in clinical trials due to the toxicity profile associated to high doses IL-2 and the undesired expansion of Tregs. Methods: To improve the efficacy of RTX therapy, we fused a murine (mIgG2a) or a human (hIgG1) version of RTX to a mutated IL-2 (no-alpha mutein), which has a disrupted affinity for the high affinity IL-2 receptor (IL-2R) to prevent the stimulation of Tregs and reduce the binding to endothelial cells expressing CD25, the α chain of high affinity IL-2R. Characterization of anti-CD20-IL2no-alpha ICKs was performed by SDS-PAGE, Western-blotting and SEC-HPLC and also by several functional in vitro techniques like T-cell proliferation assays, apoptosis, CDC and ADCC assays. The in vivo activity was assessed by using murine tumor cells expressing huCD20 in C57/Bl6 mice. Results: Both ICKs exhibited similar in vitro specific activity of their IL2no-alpha mutein moieties and kept CD20-binding capacity. Anti-CD20-IL2no-alpha (hIgG1) retained antibody effector functions as complement-dependent cytotoxicity and enhanced direct apoptosis, NK cell activation and antibody-dependent cellular cytotoxicity relative to RTX. In addition, both ICKs demonstrated a higher antitumor efficacy than parental molecules or their combination in an EL4-huCD20 tumor model in immunocompetent mice. Anti-CD20-IL2no-alpha (hIgG1) strongly expanded NK and CD8+ T cells but not Tregs in tumor-bearing mice. Discussion: These findings suggest that anti-CD20-IL2no-alpha could represent an alternative treatment for B cell lymphoma patients, mainly those refractory to RTX therapy.

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Chronic treatment with sildenafil (SILD) is an effective protector on the development of cardiovascular complications of pulmonary hypertension (PH) and diabetes. However, to date, no studies have evaluated the effect of SILD on cardiopulmonary pathophysiology during PH secondary to type 1 diabetes. AIM: The present study aimed to evaluate the beneficial effects of chronic SILD treatment on pulmonary arterial pressure, right ventricular hypertrophy (RVH) and cardiac autonomic dysfunction in rats with PH secondary to diabetes. METODOLOGY: Male Sprague Dawley rats were randomly distributed into the control group (saline), diabetic group (60 mg/kg with streptozotocin), SILD-treated control group (20 mg/kg) and SILD-treated diabetic group. RESULTS: After 8 weeks the type 1 diabetic animals presented PH, endothelial dysfunction of the pulmonary arteries, electrocardiographic alterations, RVH and overexpression of phosphodiesterase type 5 in the heart. In type 1 diabetic animals, SILD treatment prevented the development of PH, endothelial dysfunction and RVH. SILD treatment also prevented alterations in the corrected QT period and heart rate variability and prevented overexpression of phosphodiesterase type 5. CONCLUSION: Our results indicate for the first time that SILD treatment prevents pulmonary arterial endothelial dysfunction, pulmonary hypertension, right ventricular hypertrophy and improves heart rate variability in type 1 diabetic rats.

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INTRODUCTION: SARS-CoV-2 infection can produce endothelial injury and microvascular damage, one cause of the multiorgan failure associated with COVID-19. Cerebrovascular endothelial damage increases the risk of stroke in COVID-19 patients, which makes prompt diagnosis important. Endothelial dysfunction can be evaluated by using transcranial Doppler ultrasound to study cerebral hemodynamic reserve, but there are few of these studies in patients with COVID-19, and the technique is not included in COVID-19 action and follow-up guidelines nationally or internationally. OBJECTIVE: Estimate baseline cerebral hemodynamic patterns, cerebral hemodynamic reserve, and breath-holding index in recovered COVID-19 patients. METHOD: We conducted an exploratory study in 51 people; 27 men and 24 women 20-78 years of age, divided into two groups. One group comprised 25 recovered COVID-19 patients, following clinical and epidemiological discharge, who suffered differing degrees of disease severity, and who had no neurological symptoms or disease at the time they were incorporated into the study. The second group comprised 26 people who had not been diagnosed with COVID-19 and who tested negative by RT-PCR at the time of study enrollment. Recovered patients were further divided into two groups: those who had been asymptomatic or had mild disease, and those who had severe or critical disease. We performed transcranial Doppler ultrasounds to obtain baseline and post-apnea tests of cerebral hemodynamic patterns to evaluate cerebral hemodynamic reserve and breath-holding indices. We characterized the recovered patient group and the control group through simple descriptive statistics (means and standard deviations). RESULTS: There were no measurable differences in baseline cerebral hemodynamics between the groups. However, cerebral hemodynamic reserve and breath-holding index were lower in those who had COVID-19 than among control participants (19.9% vs. 36.8% and 0.7 vs. 1.2 respectively). These variables were similar for patients who had asymptomatic or mild disease (19.9% vs.19.8%) and for those who had severe or critical disease (0.7 vs. 0.7). CONCLUSIONS: Patients recovered from SARS-CoV-2 infection showed decreased cerebral hemodynamic reserve and breath-holding index regardless of the disease's clinical severity or presence of neurological symptoms. These abnormalities may be associated with endothelial damage caused by COVID-19. It would be useful to include transcranial Doppler ultrasound in evaluation and follow-up protocols for patients with COVID-19.

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OBJECTIVE: To evaluate the effectiveness of a nutritional intervention to promote fruit and vegetable (FV) intake. DESIGN: A randomised controlled community trial was conducted to evaluate the effectiveness of a 7-month nutritional intervention and to promote FV intake, separately and together. All participants attended physical exercise sessions. The intervention was based on the transtheoretical model and Paulo Freire's pedagogy. The interventions included group educational sessions, motivational cards and informational materials. The primary outcome was a change in FV intake (g/d), and secondary outcomes included stages of change, self-efficacy, decisional balance and knowledge on FV. All data were collected face-to-face; and FV intake was assessed using a validated brief questionnaire. SETTING: Health promotion services of Brazilian Primary Health Care. PARTICIPANTS: 3414 users of Brazilian Primary Health Care (1931 in the control group and 1483 in the intervention group (IG)). RESULTS: At baseline, the average daily FV intake was 370·4 g/d (95 % CI 364·2, 376·6). The increase in FV intake (23·4 g/d; 95 % CI 6·7, 40·0) and fruit intake (+17·3 g/d; 95 % CI 5·1, 29·4; P = 0·01) was greater in the IG among participants in the lowest baseline intake. Participants in the IG also showed progression in the stages of change (P < 0·001), increased self-efficacy (P < 0·001) and improved knowledge of FV crops (P < 0·001). CONCLUSIONS: The nutritional intervention was effective in increasing FV intake and fruits intake among individuals with a lower intake at baseline and in maintaining FV intake among those who reported consuming FV as recommended (400 g/d).

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The study aimed to prospectively examine the association between different sedentary behaviors and the risk of depression. We included 12,691 Spanish university graduates (mean age: 36.7 year; SD: 11.5), participants of the Seguimiento Universidad de Navarra cohort (the SUN Project), initially free of depression who were followed-up for a median of 10.9 years. Based on items presented in our baseline questionnaire, time spent in four sedentary behaviors (hours/day) were evaluated: overall sitting time; TV-viewing; computer use; and driving. Participants were classified as incident cases of depression if they reported a physician diagnosis of depression in at least one of the follow-up assessments conducted after the first two years of follow-up. Cox regression models were used to assess the relationship between sedentary behaviors and depression. A total of 560 incident cases of depression were identified during follow-up. We found no significant association between overall sitting time, TV-viewing or driving and risk of depression. On the other hand, computer use was directly associated with the risk of developing depression during the follow-up (p-value for trend = 0.020), with the participants in the highest quartile of computer use (3.64 to 10 hours/week) having a higher risk of developing depression (HR = 1.33; 95%CI: 1.05-1.70) than those in the lowest quartile (0 to 0.25 hours/week) after adjusting for potential confounders. Prolonged use of computer was independently associated with an increased risk of developing depression among young middle-aged adult university graduates from a Spanish cohort.

El objetivo del estudio fue examinar prospectivamente la asociación entre diferentes comportamientos sedentarios y el riesgo de depresión. Incluimos a 12.691 graduados universitarios españoles (media de edad: 36,7 años; SD: 11,5), participantes en la cohorte de Seguimiento Universidad de Navarra (Proyecto SUN), que no sufrieran depresión inicialmente y a quienes se les realizó un seguimiento durante una mediana de 10.9 años. Basados en los ítems presentados en nuestro cuestionario de línea de base, se evaluó el tiempo transcurrido con cuatro comportamientos sedentarios (horas/día): tiempo sentado en general, tiempo viendo TV, usando el ordenador, y conduciendo. Los participantes se clasificaron como casos incidentes de depresión, si informaban de un diagnóstico médico de depresión, emitido por un doctor en al menos una de las evaluaciones de seguimiento llevadas a cabo tras los dos primeros años de seguimiento. Los modelos de regresión Cox se usaron para evaluar la relación entre comportamientos sedentarios y depresión. Se identificaron un total de 560 casos incidentes de depresión durante el seguimiento. No encontramos ninguna asociación significativa entre el tiempo sentado en general, tiempo viendo TV, o conduciendo y el riesgo de depresión. Por otro lado, el uso del ordenador estuvo directamente asociado con el riesgo de desarrollar depresión durante el seguimiento (valor de p para tendencia = 0,020), con los participantes en el cuartil más alto de uso del ordenador (3,64 a 10 horas/semana) teniendo un riesgo más alto de desarrollar depresión (HR = 1,33; IC95%: 1,05-1,70), respecto a quienes estaban en el cuartil más bajo (0 a 0,25 horas/semana) tras realizar un ajuste para potenciales factores de confusión. El uso prolongado del ordenador estuvo independientemente asociado con el mayor riesgo de desarrollar depresión entre adultos jóvenes de mediana edad, graduados universitarios, procedentes de una cohorte española.

O estudo buscou examinar prospectivamente a associação entre diversos comportamentos sedentários e risco de depressão. Incluímos 12.691 indivíduos espanhóis com nível universitário (média de idade: 36,7 anos; DP: 11,5), participantes da coorte Seguimiento Universidad de Navarra (Projeto SUN), inicialmente sem depressão, que foram seguidos por uma mediana de 10,9 anos. Com base nos itens apresentados no questionário da linha de base, foram avaliados os tempos gastos em quatro comportamentos sedentários (horas/dia): total de tempo sentado e tempo assistindo televisão, usando computador e dirigindo. Os participantes eram classificados como casos incidentes de depressão quando relatavam um diagnóstico de depressão feito por médico em pelo menos uma das avaliações de seguimento após os primeiros dois anos de seguimento. Foram usados modelos de regressão Cox para avaliar a relação entre comportamentos sedentários e depressão. Foram identificados 560 casos incidentes de depressão durante o seguimento. Não encontramos associação entre total de tempo sentado, tempo assistindo TV ou dirigindo e risco de depressão. Por outro lado, o uso de computador mostrou associação direta com o risco de desenvolver depressão durante o seguimento (valor de p para tendência = 0,020), no qual os participantes no quartil mais alto de uso de computador (entre 3,64 e 10 horas/semana) tiveram o risco maior de desenvolver depressão (HR = 1,33; IC95%: 1,05-1,70) comparados com aqueles no quartil mais baixo (0 a 0,25 horas/semana), depois de ajustar para potenciais fatores de confusão. O uso prolongado do computador esteve associado de maneira independente com risco aumentado de desenvolver depressão em adultos de meia idade com nível universitário em uma coorte espanhola.

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Introducción: El avance de las nuevas tecnologías ha contribuido a elevar las opciones de interacción de las personas con los productos a partir del empleo de las interfaces de usuario. El uso de dispositivos con interfaces de usuario, diseñados como soportes orientados a la rehabilitación neurológica, puede potenciar y diversificar este proceso en contextos intra hospitalarios y extra hospitalarios. Objetivo: Identificar los criterios que determinan la aceptabilidad de estos dispositivos en la rehabilitación motora de pacientes con enfermedades neurológicas. Métodos: La muestra estuvo conformada por 31 pacientes del Instituto de Neurología y Neurocirugía tributarios de rehabilitación motora y un grupo control (N = 62) con sujetos sanos. Se construyó un cuestionario con 32 ítems que exploran los criterios de aceptabilidad de las interfaces de usuario. La versión final del cuestionario se obtuvo de la evaluación según criterio de expertos y el cálculo de la consistencia interna mediante el alfa de Cronbach. A los valores obtenidos durante la aplicación del cuestionario se les realizó un análisis factorial usando como método de rotación el varimax normalizado. El criterio para extracción de factores fue el método de autovalores de Scree. Resultados: La aceptabilidad del uso de dispositivos con interfaces de usuario está condicionada por tres categorías fundamentales: seguridad, expectativas y facilidad de asimilación. Conclusiones: La aceptabilidad de estos dispositivos depende de garantizar la seguridad en su uso, cumplir con las expectativas de una rehabilitación autónoma y hacer evidente y viable su facilidad de asimilación. Contar con estos criterios redunda en la obtención de requerimientos ergonómicos para el diseño de estos dispositivos(AU)

Introduction: The advance of new technologies has contributed to raising the interaction options of people with products from the use of user interfaces. The use of devices with user interfaces, designed as supports aimed at neurological rehabilitation, can enhance and diversify this process in intra-hospital and extra-hospital contexts. Objective: Identify the criteria that determine the acceptability of these devices in the motor rehabilitation of patients with neurological diseases. Methods: The sample consisted of 31 patients from the Institute of Neurology and Neurosurgery who needed motor rehabilitation and a control group (N = 62) with healthy individuals. A questionnaire with 32 items was created and it explored the acceptability criteria of user interfaces. The final version of the questionnaire was obtained from the evaluation according to expert criteria and the calculation of internal consistency using Cronbach's alpha. To the values obtained during the application of the questionnaire, there was performed a factor analysis using the normalized varimax as the rotation method. The criterion for factor extraction was the Scree eigenvalue method. Results: The acceptability of the use of devices with user interfaces is conditioned by three fundamental categories: security, expectations and ease of assimilation. Conclusions: The acceptability of these devices depends on guaranteeing safety in their use, meeting the expectations of an autonomous rehabilitation and making evident and viable their ease of assimilation. Having these criteria, results in obtaining ergonomic requirements for the design of these devices(AU)

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BACKGROUND: Choroid plexus papilloma represents 1-4% of pediatric brain tumors, mostly located in the ventricular atrium.[1] Intraventricular tumors represent a challenge due to the poor visualization of the surgical field and damage to surrounding structures.[2] Use of tubular retraction reduces cerebrovascular trauma to the surrounding parenchyma by distributing pressure uniformly, allowing less invasive corticotomy, and more stability on surgical corridors that allow the surgeon to use both hands and external visualization devices.[2-5]. CASE DESCRIPTION: We present the case of a 3-year-old boy with progressive headache, vomiting, and loss of control in the left hand for 3 months, with a history of ventricular shunt placement for acute obstructive hydrocephalus. The MRI revealed large lobulated lesion, which was hypointense on T1, hyperintense on T2, marked enhancement on T1 C+ (Gd) within the atrium of the right lateral ventricle, and spectroscopy with a peak of choline. Written consent for the use of photos and videos on this work was obtained from the patient's mother. A high-definition two-dimensional exoscope (VITOM® Karl Storz, Tuttlingen) was used during the surgical approach and throughout tumor removal, which was aided by ViewSite Brain Access System (VBAS®; Vycor Medical Inc.).[3] We performed a transparietal minimally invasive transsulcal parafascicular approach through the Frazier point for direct access to the ventricular atrium. Histological examination confirmed atypical choroid plexus papilloma. Postoperative imaging shows no residual tumor. The postoperative course was satisfactory with improvement of the headache and control of the left hand, leading to discharge home 1 week after surgery. CONCLUSION: The tubular transparietal minimally invasive approach obviates the need for traditional approaches to the atrium. This technique is safe and effective for the treatment of intraventricular and periventricular lesions, thus making this challenging target in more accessible to neurosurgeons, avoiding structure damage and any associated morbidity or mortality.

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Este artículo presenta una historia general de las epidemias históricas y de las nuevas enfermedades emergentes, señalando sus factores desencadenantes. Se afirma que las epidemias son inevitables, y que su riesgo aumenta en proporción al tamaño, la complejidad y el poder tecnológico de nuestras sociedades. La historia enseña que las epidemias han sido casi siempre desencadenadas por cambios en el ambiente ocasionados por las propias actividades humanas. Las enfermedades infecciosas son manifestación de una interacción ecológica entre la especie humana y otra especie de microorganismos. Y las epidemias son resultado del cambio en algún factor ambiental capaz de influir en esa interacción. Las catástrofes epidémicas son inevitables: en primer lugar, porque no podemos evitar formar parte de cadenas tróficas en las que comemos y somos comidos por los microbios; en segundo lugar, porque las infecciones son mecanismos evolutivos y factores reguladores del equilibrio ecológico, que regulan sobre todo el tamaño de las poblaciones; y, en tercer lugar, porque las intervenciones técnicas humanas, al modificar los equilibrios previos, crean equilibrios nuevos que son más vulnerables. De este modo las sociedades humanas son más vulnerables cuanto más complejas. Y los éxitos humanos en la modificación de condiciones ambientales conservan, o más bien aumentan, el riesgo de catástrofes epidémicas. Todas las necesarias medidas de vigilancia y control epidemiológico imaginables pueden disminuir los daños que producen las epidemias, pero nunca podrán evitarlas.

This article presents a general history of historical epidemics, and new emerging diseases, pointing out their triggers. It is claimed that epidemics are inevitable, and that their risk increases in proportion to the size, complexity, and technological power of our societies. History teaches that epidemics have almost always been triggered by changes in the environment caused by human activities themselves. Infectious diseases are manifestations of an ecological interaction between the human species and another species of microorganisms. And epidemics are the result of a change in some environmental factor capable of influencing that interaction. Epidemic catastrophes are inevitable: firstly, because we cannot help but be part of trophic chains in which we eat and are eaten by microbes; secondly, because infections are evolutionary mechanisms and regulatory factors of ecological balance, which regulate especially the size of populations; and thirdly, because human technical interventions, in changing previous balances, create new balances that are more vulnerable. In this way human societies are more vulnerable the more complex. And human successes in modifying environmental conditions retain, or rather increase, the risk of epidemic catastrophes. All necessary epidemiological surveillance and control measures imaginable can lessen the damage caused by epidemics, but they can never prevent them.

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OBJECTIVE: To assess whether higher adherence to the traditional Mediterranean diet (MedDiet) was associated with lower consumption of ultra-processed foods (UPF) and lower free sugar intake. DESIGN: Cross-sectional analysis of baseline information among participants in the SENDO project, a Spanish paediatric cohort. Dietary information was collected through a semi-quantitative FFQ. Food items were classified according to the NOVA classification. Adherence to the MedDiet was evaluated through the KIDMED index. SETTING: Spain. PARTICIPANTS: Three hundred eight-six children (52 % boys) with a mean age of 5·3 years old (sd 1·0) were included in the analysis. RESULTS: 74·4 % of the children had moderate adherence to the MedDiet (mean KIDMED score: 5·9 points; sd 1·7) and overall, 32·2 % of the total energy intake came from UPF. Each two additional points in the KIDMED score was associated with 3·1 % (95 % CI 2·1, 4·0) lower energy intake from UPF. Compared to those with low adherence to the MedDiet, children with medium and high adherence reported 5·0 % (95 % CI 2·2, 7·7) and 8·5 % (95 % CI 5·2, 11·9) lower energy intake from UPF, respectively. We also found that 71·6 % of the variability in free sugar intake was explained by the variability in UPF consumption. CONCLUSIONS: Adherence to the traditional MedDiet was inversely associated with energy intake from UPF. Furthermore, most of the variability in free sugar intake was explained by the variability of UPF consumption. Public health strategies are needed to strengthen the adherence to the MedDiet in pre-schoolers while regulating the production, marketing and advertising of UPF.

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Introducción Las fracturas de cadera reportan una incidencia en aumento; representan un reto para la salud publica por el alto costo socioeconómico y elevada morbimortalidad. Es importante documentar las complicaciones en la población de Colombia, así como los motivos de reingreso para poder plantear estrategias que contribuyan a disminuirlas. Materiales & Métodos Se realizó un estudio descriptivo, de cohorte transversal, entre enero 2015 y diciembre 2017. Se incluyeron todos los pacientes con fractura de cadera mayores de 65 años. Se excluyeron aquellos con fracturas patológicas y pacientes con antecedente de fractura en esa cadera. Se recolectaron las variables de edad, sexo, antecedentes patológicos, uso de anticoagulantes, manejo farmacológico para osteoporosis, tipo de fractura, complicaciones intraquirúrgicas y postoperatorias, así como el tiempo total desde la fractura hasta el manejo quirúrgico. Resultados Se incluyeron 155 fracturas de cadera con edad promedio de 81.6 años. 74.8% mujeres. El subtipo de fractura más frecuente fue la intertrocantérea (46.5%). El 93.6% de los casos recibió manejo quirúrgico, siendo la artroplastia el procedimiento más realizado. Se realizó manejo quirúrgico en el 85.16% de los pacientes antes de 48 horas y al 40% antes de las 24 horas desde el momento de la fractura. El reingreso fue 20% y la principal causa fueron nuevas fracturas (5.8%). Discusión Se considera el abordaje de los pacientes desde un punto multidisciplinario que maneje sus comorbilidades, fragilidad ósea, debilidad muscular y alteraciones en la esfera mental de forma integral, ya que esto puede afectar positivamente el estado de salud de estos pacientes.

Background Hip fractures are a pathology with an increasing incidence, represent a challenge for public health due to the high socioeconomic cost and high morbidity and mortality. It is important to document the complications in our population, as well as the reasons for readmission to be able to propose strategies that contribute to reducing them. Method A descriptive, cross-sectional, retrospective study was conducted in the period between January 2015 and December 2017. All patients with hip fractures older than 65 years were included. Those with pathological fractures and patients with a history of fracture in that hip were excluded. The variables of age, sex, pathological antecedents, use of anticoagulants, type of fracture, intra-surgical and postoperative complications and total time from fracture to surgical management were collected. Results 155 hip fractures were properly documented, mean age 81.6 years, 74.8% were women. The most frequent fracture was the intertrochanteric (46.5%). 93.6% of the cases received surgical management, being hip arthroplasty the most performed procedure. Surgical management was performed in 85.16% of patients before 48h and 40% before 24h from the time of fracture. The readmission rate was 20% and the main cause was new fractures 5.8% Discussion We consider the approach of patients from a multidisciplinary standpoint that treat the comorbidities, bone fragility, muscle weakness and alterations in the mental sphere, because that may possibly affect the outcome of patients in a positive way.

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Insects are considered as alternative sources of chitosan; however, studies about the functional film-forming properties of insect chitosan are scarce. Insect chitosan films were made from Tenebrio molitor and Brachystola magna and were compared with commercial chitosan of different molecular weights (Mw). Mechanical properties (tensile strength, TS; elastic modulus, EM; elongation at break, %E), water vapor permeability (WVP) and physicochemical properties were characterized. The film properties of both commercial and insect chitosan were affected by Mw. Commercial chitosan films showed that at lower Mw, the TS (from 59 to 48 MPa) and EM (from 1471 to 1286 MPa) decreased; whereas WVP (from 2.9 × 10-11 to 3.4 × 10-11 g m-1s-1Pa-1), % E (from 38 to 41%) and solubility (from 30 to 33%) increased. Chitosan insect films showed lower TS and EM, and higher WPV, %E and solubility than commercial films. SEM revealed that chitosan insect films had lower porosity than commercial films. FTIR and X-ray diffraction showed not difference between insect and commercial chitosan films. These results showed that T. molitor and B. magna chitosan films could be used as a packaging material in several food products.

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Introducción: se mantiene el debate sobre qué tipos de intervenciones para la recuperación del ictus ofrecen mejores resultados para el paciente. Objetivo: evaluar el efecto de una intervención integral durante seis meses sobre la recuperación funcional en pacientes con ictus. Métodos: la muestra estuvo compuesta por 42 participantes con ictus: un grupo experimental (N = 22) con una media de edad de 52,68 años (DE = 14,39) que recibió una intervención integral, intensiva y multidisciplinar, y un grupo control (N = 20) con una media de edad de 56,20 años (DE = 14,82) que no recibió este tipo de intervención. Se valoraron los siguiente índices de severidad del ictus: Escala de Coma de Glasgow, Escala Canadiense, estancia en Unidad de Cuidados Intensivos, signos de enclavamiento uncal, signos de hipertensión endocraneal, volumen del hematoma/área isquémica, desplazamiento de línea media, necesidad de cirugía y tiempo total de hospitalización. Ambos grupos eran equivalentes en estos índices de gravedad. El grado de funcionalidad fue medido con la aplicación de la escala Functional Independence Measure and Functional Assessment Measure. Esta prueba se aplicó al inicio de la intervención y 6 meses después. Resultados: se observó una evolución positiva en ambos grupos en todas las áreas de la escala. La intervención integral y un menor tiempo total de hospitalización se relacionaron con una mejor recuperación funcional en el ictus. Conclusiones: se sugiere la necesidad de realizar estrategias de rehabilitación integral en los pacientes con ictus(AU)

Introduction: debate is currently underway about what types of stroke recovery interventions are more beneficial for patients. Objective: evaluate the effect of a six-month comprehensive intervention on the functional recovery of stroke patients. Methods: the study sample was 42 stroke patients: an experimental group (N = 22), mean age 52.68 years (SD = 14.39), who received a comprehensive intensive multidisciplinary intervention, and a control group (N = 20), mean age 56.20 years (SD = 14.82), who did not receive this type of intervention. The following stroke severity indices were applied: Glasgow Coma Scale, Canadian Scale, intensive care unit stay, uncal latching signs, endocranial hypertension signs, hematoma volume / ischemic area, midline displacement, need for surgery and total hospital stay time. These severity indices were similar in the two groups. Degree of functionality was gauged with the scales Functional Independence Measure and Functional Assessment Measure. This test was applied at the start of the intervention and 6 months later. Results: both groups had a positive evolution in all the areas of the scale. The comprehensive intervention and a shorter total hospital stay were associated to better functional recovery from stroke. Conclusions: the need is suggested to implement comprehensive rehabilitation strategies in stroke patients(AU)

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OBJECTIVES: The aim of this study was to evaluate the independent association of the dietary inflammatory index (DII®) score with overweight and obesity in Brazilian participants of the Cohort of Universities of Minas Gerais (CUME project). METHODS: This was a cross-sectional study consisting of 3,151 graduates and postgraduates (2197 women) with a mean (SD) age of 36.3 y (±9.4 y). Sociodemographic characteristics, lifestyle, and anthropometric data were assessed via online self-reported questionnaire. Additionally, a validated food frequency questionnaire with 144 food items was used to generate energy-adjusted DII (E-DIITM) scores, which evaluated the inflammatory potential of the diet. RESULTS: The prevalence of overweight and obesity were 28.2% and 11%, respectively. Participants in the highest E-DII quartile (most proinflammatory diet) were more likely to be smokers/former smokers; sedentary; and consumers of red and ultra-processed meats, fats and oils (excluding olive oil), bottled fruit juices and soft drinks, sugars, sweets, and higher overall caloric intake, compared with the first quartile of E-DII. Both men and women in the fourth E-DII quartile had the highest prevalence of overweight and obesity (prevalence ratio [PR], 1.35; 95% confidence interval [CI], 1.14-1.59 and PR, 1.97; 95% CI, 1.20-3.22, respectively, in men; PR, 1.38; 95% CI, 1.17 to 1.65 and PR, 1.95; 95% CI, 1.31-2.90, respectively, in women). CONCLUSION: The most proinflammatory dietary pattern was associated with a higher prevalence of overweight and obesity and other unhealthy lifestyles including being sedentary, smoking, and consuming a obesogenic diet.

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