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OBJECTIVE: To evaluate predictive validity of the Academy of Nutrition and Dietetics/American Society for Parenteral and Enteral Nutrition Indicators to diagnose pediatric malnutrition (AAIMp) and the Screening Tool for Risk on Nutritional Status and Growth (STRONGkids) in regard to pediatric patient outcomes in US hospitals. STUDY DESIGN: A prospective cohort study (Clinical Trial Registry: NCT03928548) was completed from August 2019 through January 2023 with 27 pediatric hospitals or units from 18 US states and Washington DC. RESULTS: Three hundred and forty-five children were enrolled in the cohort (n = 188 in the AAIMp validation subgroup). There were no significant differences in the incidence of emergency department visits and hospital readmissions, hospital length of stay (LOS), or health care resource utilization for children diagnosed with mild, moderate, or severe malnutrition using the AAIMp tool compared with children with no malnutrition diagnosis. The STRONGkids tool significantly predicted more emergency department visits and hospital readmissions for children at moderate and high malnutrition risk (moderate risk - incidence rate ratio 1.65, 95% CI: 1.09, 2.49, P = .018; high risk - incidence rate ratio 1.64, 95% CI: 1.05, 2.56, P = .028) and longer LOS (43.8% longer LOS, 95% CI: 5.2%, 96.6%, P = .023) for children at high risk compared with children at low risk after adjusting for patient characteristics. CONCLUSIONS: Malnutrition risk based on the STRONGkids tool predicted poor medical outcomes in hospitalized US children; the same relationship was not observed for a malnutrition diagnosis based on the AAIMp tool.

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This study examined New Mexico home-based child care provider perspectives (n = 75) on barriers to and facilitators of Child and Adult Care Food Program (CACFP) participation. Two thirds of the sample were Spanish speakers. Providers reported that CACFP reimbursement does not cover actual food costs and the time-and-effort costs of obtaining qualifying foods and completing required documentation. They noted that additional reimbursed meals are needed for children in care for extended hours and that linguistically competent CACFP sponsor staff facilitated their participation. (Am J Public Health. 2023;113(S3):S215-S219. https://doi.org/10.2105/AJPH.2023.307402).

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The potential of chicken eggs as a nutritionally complete protein and source of key micronutrients during the first 1000 days post-conception has been progressively recognized across the globe, particularly in resource-poor settings. Fluctuation of egg nutrient content by season is relatively unknown, which may influence international food composition databases and outcomes in intervention studies using egg supplementation. To better interpret the findings of The Saqmolo' Project, we conducted comprehensive nutrient analyses on eggs produced during the wet and dry seasons in the highlands of central Guatemala. We randomly collected 36 shell eggs from a local farm during both seasons, hard-boiled, and prepared them for transport to the United States, where they were pooled and assessed for their nutrient composition. Methods of the Association of Official Analytical Chemists, the American Oil Chemists Society, and the American Association of Cereal Chemists were utilized to determine total energy, moisture, ash, total protein, total fat, fatty acids, total carbohydrates, 12 vitamins, 11 minerals, and carotenoids, by season, in some instances with modifications. Differences in nutrient composition between de-shelled hard-boiled eggs collected between seasons were assessed using an analysis of variance (ANOVA) and Tukey's family error rate comparison test. Most nutrients in eggs produced in the highlands of central Guatemala differed negligibly (but statistically significantly) based on seasonality. Only vitamins A and E, folate, choline, and calcium fluctuated at clinically significant levels relative to the AI/RDA for infants 7-12 months. Total energy, protein, trans fatty acids, moisture, and vitamin D3 levels did not differ between seasons (p > .05). Further multi-year sampling is needed to examine how seasonal variation affects the nutrient composition of eggs. These data may be used to supplement existing national and regional food composition databases.

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OBJECTIVE: Describe Child and Adult Care Food Program (CACFP) sponsor perspectives on barriers and facilitators to home-based provider CACFP eligibility, enrollment, and participation and ways to improve provider support. METHODS: Semistructured interviews were conducted with 11 New Mexico CACFP sponsor staff representing 9 out of 13 agencies (69% response rate) from August to September, 2020. Interviews were analyzed using thematic analysis with an essentialist/realist epistemological approach. RESULTS: Sponsor-perceived barriers to provider CACFP: eligibility (costs, background checks, fear/stigma, and delays in becoming state-approved providers); enrollment (lack of translated/low-literacy materials and cumulative systems requirements); and participation (challenges maintaining qualifying menus and documentation and accessing qualifying food, inadequate reimbursements, and unannounced visits). Sponsors suggested systems changes to improve provider support (eg, more assistance with becoming state-approved and for start-up costs and accessible, progressive nutrition training opportunities). CONCLUSIONS AND IMPLICATIONS: Sponsors noted CACFP barriers for home-based providers and identified corresponding systems changes that could be tested.

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BACKGROUND: Home gardening is a strategy to improve nutrition and food security. More information is needed about optimizing gardens in different contexts. OBJECTIVE: The aim was to identify implementation barriers and facilitators for a home gardening intervention in rural Guatemala and inform future larger-scale interventions in the region. DESIGN: A mixed-methods implementation study using the RE-AIM (Reach, Effectiveness, Adoption, Implementation, Maintenance) framework was conducted from January 2019 to July 2020. PARTICIPANTS/SETTING: Families (n = 70) in rural Guatemala participated in the intervention. Staff (n = 4), families (n = 6), and community stakeholders (n = 3) participated in interviews or focus groups. INTERVENTION: Participating households received seeds and seedlings for 16 crops, garden construction materials, agronomist-delivered education and assistance, and a standard-of-care nutrition program. MAIN OUTCOME MEASURES: Implementation data were collected from program records and observations, participant surveys, and interviews and focus groups. Crop count and nutritional functional diversity of home gardens were assessed. STATISTICAL ANALYSES PERFORMED: Descriptive statistics were calculated for quantitative outcomes. Qualitative data were double-coded and organized into overarching themes. RESULTS: Reach: Ninety percent of eligible households participated. Child nutritional eligibility criteria was a barrier to reach. EFFECTIVENESS: Participants and stakeholders felt the intervention improved access to diverse foods. Cultivated crops increased an average of five species (95% confidence interval [CI], 4-6) at 6 months, although not all were consumed. Adoption: The main community adoption barrier was water sourcing for garden irrigation. IMPLEMENTATION: Raised beds were the most common gardening method, with good adoption of agricultural best practices. Gray water filters and flexible implementation were important for participation. Maintenance: Crops failure rates were low. Seed availability was a sustainability challenge. Direct costs were 763 USD per household. CONCLUSIONS: Interest and engagement with a home garden intervention in Guatemala were high. Gaps between garden production and consumption, access to water, and seed sourcing should be addressed in future work.

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Home gardens may help address childhood malnutrition in low- and middle-income countries. In this quasi-experimental pilot study, the Academy of Nutrition and Dietetics, in collaboration with Maya Health Alliance, evaluated the feasibility of augmenting a standard-of-care nutrition-specific package for Maya children with length-for-age z score ≤-2 (stunting) in rural Guatemala with a nutrition-sensitive home garden intervention. Two agrarian municipalities in Guatemala were included. Families of 70 children with stunting from 1 municipality received the standard-of-care package (food supplementation, multiple micronutrient powders, monthly nutrition home visits, group nutrition classes). Families of 70 children with stunting from another municipality received the standard-of-care package plus a home garden intervention (garden materials, monthly agricultural home visits, agriculture classes). Maternal and child dietary diversity, household food insecurity, child growth, and agricultural indicators were collected at baseline and 6 months later and were analyzed using mixed linear and logistic regression models. Compared with the standard-of-care group, the garden intervention group had improved child (odds ratio [OR] 3.66, 95% CI 0.89-15.10, P = 0.07) and maternal dietary diversity (OR 2.31, 95% CI 0.80-6.65, P = 0.12) and decreased food insecurity (OR 0.38, 95% CI 0.11-1.35, P = 0.14); however, these effects were not statistically significant. Participation in gardens predicted a higher length-for-age z-score (change difference [CD] 0.22 SD, 95% CI 0.05-0.38, P = 0.009), greater crop species count (CD 2.97 crops, 95% CI 1.79-4.16, P < 0.001), and greater nutritional functional diversity (CD 0.04 points, 95% CI 0.01-0.07, P = 0.006) than standard-of-care alone. Home garden interventions are feasible in rural Guatemala and may have potential benefits for child growth when added to other nutrition-specific interventions.

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Adequate nutrition during the complementary feeding period is critical for optimal child growth and development and for promoting long-term educational attainment and economic potential. To prioritize limited public health resources, there is a need for studies that rigorously assess the influence of multicomponent integrated nutrition interventions in children younger than age 2 years in different contexts. This study aimed to describe the rationale and protocol for the Saqmolo' Project using the Standard Protocol Items: Recommendations for Interventional Trials (SPIRIT) guidelines. The Saqmolo' (ie, "egg" in the Mayan language, Kaqchiquel) Project is an individually randomized, partially blinded, controlled comparative effectiveness trial to evaluate the influence of adding delivery of a single whole egg per day to local standard nutrition care (ie, growth monitoring, medical care, deworming medication, multiple micronutrient powders for point-of-use food fortification [chispitas], and individualized complementary and responsive feeding education for caregivers) for 6 months, compared with the local standard nutrition care package alone, on child development, growth, and diet quality measures in rural indigenous Mayan infants aged 6 to 9 months at baseline (N = 1,200). The study is being executed in partnership with the Wuqu' Kawoq/Maya Health Alliance, a primary health care organization located in central Guatemala. Primary outcomes for this study are changes in global development scores, assessed using the Guide for Monitoring Global Development and the Caregiver Reported Child Development Instruments. Secondary outcomes include changes in infant hemoglobin, anthropometric measures (including z scores for weight for age, length for age, weight for length, and head circumference for age), and diet quality as measured using the World Health Organization's infant and young child feeding indicators. The results of the Saqmolo' Project may help to inform public health decision making regarding resource allocation for effective nutrition interventions during the complementary feeding period.

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BACKGROUND: Small-quantity (SQ) lipid-based nutrient supplements (LNSs) provide many nutrients needed for brain development. OBJECTIVES: We aimed to generate pooled estimates of the effect of SQ-LNSs on developmental outcomes (language, social-emotional, motor, and executive function), and to identify study-level and individual-level modifiers of these effects. METHODS: We conducted a 2-stage meta-analysis of individual participant data from 14 intervention against control group comparisons in 13 randomized trials of SQ-LNSs provided to children age 6-24 mo (total n = 30,024). RESULTS: In 11-13 intervention against control group comparisons (n = 23,588-24,561), SQ-LNSs increased mean language (mean difference: 0.07 SD; 95% CI: 0.04, 0.10 SD), social-emotional (0.08; 0.05, 0.11 SD), and motor scores (0.08; 95% CI: 0.05, 0.11 SD) and reduced the prevalence of children in the lowest decile of these scores by 16% (prevalence ratio: 0.84; 95% CI: 0.76, 0.92), 19% (0.81; 95% CI: 0.74, 0.89), and 16% (0.84; 95% CI: 0.76, 0.92), respectively. SQ-LNSs also increased the prevalence of children walking without support at 12 mo by 9% (1.09; 95% CI: 1.05, 1.14). Effects of SQ-LNSs on language, social-emotional, and motor outcomes were larger among study populations with a higher stunting burden (≥35%) (mean difference: 0.11-0.13 SD; 8-9 comparisons). At the individual level, greater effects of SQ-LNSs were found on language among children who were acutely malnourished (mean difference: 0.31) at baseline; on language (0.12), motor (0.11), and executive function (0.06) among children in households with lower socioeconomic status; and on motor development among later-born children (0.11), children of older mothers (0.10), and children of mothers with lower education (0.11). CONCLUSIONS: Child SQ-LNSs can be expected to result in modest developmental gains, which would be analogous to 1-1.5 IQ points on an IQ test, particularly in populations with a high child stunting burden. Certain groups of children who experience higher-risk environments have greater potential to benefit from SQ-LNSs in developmental outcomes.This trial was registered at www.crd.york.ac.uk/PROSPERO as CRD42020159971.

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Malassezia spp. are lipid-dependent yeasts that have been related to skin mycobiota and dermatological and systemic diseases. Study of lipid droplets (LDs) is relevant to elucidate the unknown role of these organelles in Malassezia and to gain a broader overview of lipid metabolism in Malassezia. Here, we standardized two protocols for the analysis of LDs in M. pachydermatis and M. globosa. The first describes co-staining for confocal laser-scanning fluorescence microscopy, and the second details extraction and purification of LDs. The double stain is achieved with three different neutral lipid fluorophores, namely Nile Red, BODIPY™ 493/503, and HCS LipidTOX™ Deep Red Neutral, in combination with Calcofluor White. For LD extraction, cell wall rupture is conducted using Trichoderma harzianum enzymes and cycles of vortexing with zirconium beads. LD purification is performed in a three-step ultracentrifugation process. These standardizations will contribute to the study of the dynamics, morphology, and composition of LDs in Malassezia. © 2021 Wiley Periodicals LLC. Basic Protocol 1: Lipid droplet fluorescence staining Basic Protocol 2: Lipid droplet extraction and purification Support Protocol: Malassezia spp. culture conditions.

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Vergence eye movements are movements of both eyes in opposite directions. Vergence is known to have a role in binocular vision. However recent studies link vergence eye movements also to attention and attention disorders. As attention may be involved in dyslexia, it is sensible to guess that the presence of reading difficulties can be associated with specific patterns in vergence responses. Data from school children performing a word-reading task have been analysed. In the task, children had to distinguish words from non-words (scrambled words or row of X's), while their eye positions were recorded. Our findings show that after stimulus presentation eyes briefly converge. These vergence responses depend on the stimulus type and age of the child, and are different for children with reading difficulties. Our findings support the idea of a role of attention in word reading and offer an explanation of altered attention in dyslexia.

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Fundamento: los círculos de interés de Estomatología constituyen espacios que contribuyen a la formación vocacional de los escolares a la vez que promueven su salud bucodental. Objetivo: elaborar un programa educativo para círculo de interés de Estomatología que contribuya a la orientación vocacional y hábitos saludables en escolares. Métodos: se realizó una investigación de desarrollo en la Universidad de Ciencias Médicas de Villa Clara. Se utilizaron métodos teóricos: histórico-lógico, análisis-síntesis e inductivo-deductivo; y empíricos: análisis documental, encuesta en forma de cuestionario a los escolares y la observación. El producto fue valorado por criterios de especialistas. Resultados: la mayoría de los escolares expresó su disposición a participar en el círculo de interés, se detectaron sus carencias acerca de la higiene bucodental y su importancia; y casi todos estaban desinformados sobre temas relacionados con la Estomatología. El programa educativo elaborado ofrecía solución a estas insuficiencias; después de su aplicación se corroboró su efectividad. Conclusiones: fue valorado como pertinente, útil, factible y de adecuado valor metodológico por los especialistas consultados. Con su aplicación, los escolares mejoraron su información e higiene bucodental y se motivaron por los temas relacionados con la Estomatología.

Background: Dentistry vocational training groups are spaces that contribute to the vocational training of school children while promoting their oral health. Objective: to develop an educational program for the Dentistry vocational training groups, that contributes to the vocational guidance and healthy habits in school children Methods: a development research was carried out at Villa Clara University of Medical Sciences. Theoretical methods were used: historical-logical, analysis-synthesis and inductive-deductive; and empirical: documentary analysis, survey in the form of a questionnaire to schoolchildren and observation. The product was evaluated by specialists' criteria. Results: the majority of the students expressed their willingness to participate in the vocational training groups, their shortcomings about oral hygiene and its importance were detected; and almost everyone was uninformed about issues related to Dentistry. The educative program elaborated offered solution to these insufficiencies; after its implementation, its effectiveness was corroborated. Conclusions: it was assessed as pertinent, useful, feasible and of adequate methodological value by the specialists consulted. With its implementation, school children improved their oral hygiene and were motivated by the topics related to Dentistry.

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BACKGROUND: Plasma concentrations of some lysophospholipids correlate with metabolic alterations in humans, but their potential as biomarkers of insulin resistance (IR) is insufficiently known. We aimed to explore the association between plasma linoleoylglycerophosphocholine (LGPC) and objective measures of IR in adults with different metabolic profiles. METHODS: We studied 62 men and women, ages 30 to 69 years, (29% normal weight, 59% overweight, 12% obese). Participants underwent a 5-point oral glucose tolerance test (5p-OGTT) from which we calculated multiple indices of IR and insulin secretion. Fifteen participants additionally underwent a hyperinsulinemic-euglycemic clamp for estimation of insulin-stimulated glucose disposal. Plasma LGPC was determined using high performance liquid chromatography/time-of-flight mass spectrometry. Plasma LGPC was compared across quartiles defined by the IR indices. RESULTS: Mean LGPC was 15.4±7.6 ng/mL in women and 14.1±7.3 ng/mL in men. LGPC did not correlate with body mass in-dex, percent body fat, waist circumference, blood pressure, glycosylated hemoglobin, log-triglycerides, or high density lipoprotein cholesterol. Plasma LGPC concentrations was not systematically associated with any of the studied 5p-OGTT-derived IR indices. However, LGPC exhibited a significant negative correlation with glucose disposal in the clamp (Spearman r=-0.56, P=0.029). Despite not being diabetic, participants with higher plasma LGPC exhibited significantly higher post-challenge plasma glucose excursions in the 5p-OGTT (P trend=0.021 for the increase in glucose area under the curve across quartiles of plasma LGPC). CONCLUSION: In our sample of Latino adults without known diabetes, LGPC showed potential as a biomarker of IR and impaired glucose metabolism.

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Caesalpinia coriaria (C. coriaria), also named cascalote, has been known traditionally in México for having cicatrizing and inflammatory properties. Phytochemical reports on Caesalpinia species have identified a high content of phenolic compounds and shown antineoplastic effects against cancer cells. The aim of this study was to isolate and identify the active compounds of a water:acetone:ethanol (WAE) extract of C. coriaria pods and characterize their cytotoxic effect and cell death induction in different cancer cell lines. The compounds isolated and identified by chromatography and spectroscopic analysis were stigmasterol, ethyl gallate and gallic acid. Cytotoxic assays on cancer cells showed different ranges of activities. A differential effect on cell cycle progression was observed by flow cytometry. In particular, ethyl gallate and tannic acid induced G2/M phase cell cycle arrest and showed interesting effect on microtubule stabilization in Hep3B cells observed by immunofluorescence. The induction of apoptosis was characterized by morphological characteristic changes, and was supported by increases in the ratio of Bax/Bcl-2 expression and activation of caspase 3/7. This work constitutes the first phytochemical and cytotoxic study of C. coriaria and showed the action of its phenolic constituents on cell cycle, cell death and microtubules organization.

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OBJECTIVE: To evaluate the accuracy of pre- and postfeeding weights to estimate enteral feeding volumes in preterm infants. STUDY DESIGN: Single-center prospective cohort study of infants 28-36 weeks' corrected age receiving gavage feedings. For each test weight, 3 pre- and 3 postgavage feeding weights were obtained by study personnel, blinded to feeding volume, via a specific protocol. The correlation between test weight difference and actual volume ingested was assessed by the use of summary statistics, Spearman rho, and graphical analyses. The relationship between categorical predictive variables and a predefined acceptable difference (±5 mL) was assessed with the χ2 or Fisher exact test. RESULTS: A total of 101 test weights were performed in 68 infants. Estimated and actual feeding volumes were highly correlated (r = 0.94, P < .001), with a mean absolute difference of 2.95 mL (SD: 2.70; range: 0, 12.3 mL; 5th, 95th percentile: 0, 9.3); 85% of test weights were within ±5 mL of actual feeding volume and did not vary significantly by corrected age, feeding tube or respiratory support type, feeding duration or volume, formula vs breast milk, or caloric density. With adherence to study protocol, 89% of test weights (66/74) were within ±5 mL of actual volume, compared with 71% (19/27, P = .04) when concerns about protocol adherence were noted (eg, difficulty securing oxygen tubing). CONCLUSIONS: Via the use of a standard protocol, feeding volumes can be estimated accurately by pre- and postfeeding weights. Test weighing could be a valuable tool to support direct breastfeeding in the neonatal intensive care unit.

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Associations between food insecurity and overweight/obesity, feeding behaviors, and public food assistance utilization have been explored to a greater extent among adults and adolescents than among young children. This cross-sectional study examines a subset of pre-intervention implementation data (n = 347) among families participating in the Child Health Initiative for Lifelong Eating and Exercise (CHILE) study conducted in rural New Mexico among predominantly Hispanic and American Indian Head Start centers. No significant relationships emerged between food insecurity and child overweight/obesity, certain feeding behaviors, or public food assistance utilization. Additional research is necessary to understand relationships between food insecurity and child overweight/obesity status, use of public assistance benefits, and certain feeding behaviors among rural preschool-aged children in predominantly Hispanic and American Indian communities.

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PURPOSE: We describe the recruitment strategies and personnel and materials costs associated with two community-based research studies in a Mexican-origin population. We also highlight the role that academic-community partnerships played in the outreach and recruitment process for our studies. We reviewed study documents using case study methodology to categorize recruitment methods, examine community partnerships, and calculate study costs. RESULTS: We employed several recruitment methods to identify and solicit 154 female caregivers for participation in qualitative interviews and quantitative surveys. Recruitment approaches included using flyers and word of mouth, attending health fairs, and partnering with nonprofit community-based organizations (CBOs) to sponsor targeted recruitment events. Face-to-face contact with community residents and partnerships with CBOs were most effective in enrolling caregivers into the studies. Almost 70% of participants attended a recruitment event sponsored or supported by CBOs. The least effective recruitment strategy was the use of flyers, which resulted in only 7 completed interviews or questionnaires. Time and costs related to carrying out the research varied by study, where personal interviews cost more on a per-participant basis ($1,081) than the questionnaires ($298). However, almost the same amount of time was spent in the community for both studies. IMPLICATIONS: Partnerships with CBOs were critical for reaching the target enrollment for our studies. The relationship between the University of California-Los Angeles (UCLA) Resource Center for Minority Aging Research/Center for Health Improvement for Minority Elderly and the Department of Aging provided the infrastructure for maintaining connections with academic-community partnerships. Nevertheless, building partnerships required time, effort, and resources for both researchers and local organizations.

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Se investigaron las patologías quirúrgicas más frecuentes en pacientes VIH positivos en el Hospital Miguel Pérez Carreño durante los años 1987-1997; en forma retrospectiva se revisaron las historias clínicas en los diferentes servicios quirúrgicos del hospital. Se trató de apendicitis aguda y colecistitis aguda; las cuales, en algunos casos, han sido asociados con infecciones oportunistas como el sarcoma de kaposi, linfoma no hodgkin e infección por citomegalovirus y micobacterias

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Se analizan algunas técnicas de análisis de costos en salud y se propone introducir la perspectiva económica dentro de los estudios de costos, como complemento necesario en el contexto de la reforma del sector salud. Se revisan brevemente algunos cambios específicos que se requiere introducir en los estudios tradicionales y se concluye que dichos cambios son en sí mismos costo-beneficiosos, pues sólo requieren elevar levemente la complejidad de los estudios para incrementar significativamente su utilidad

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El estudio analiza las estadísticas de patronos, trabajadores y masa cotizante generadas por la CCSS, desde una perspectiva macroecómica, relacionando la evolución del nivel de empleo, de los salarios promedio cotizantes y del número de empresas con la evolución de la economía nacional. Las estrechas relaciones encontradas entre algunas de estas variables pueden constituirse en un insumo de utilidad en el diseño de modelos para la proyección de corto y mediano plazo de las variables analizadas, partiendo de hipótesis sobre la evolución futura de la actividad macroeconómica en el país, lo que constituirá una segunda etapa de la investigación, por realizar en un futuro cercano.

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