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Introducción: el SARS-CoV-2 desde el 2020 generó innumerables desafíos. El decúbito prono se utilizó para mejorar la oxigenación, y la terapia nutricional se adaptó para cubrir los requerimientos y reducir complicaciones. Objetivos: evaluar la tolerancia de la nutrición enteral y su adecuación energética en pacientes ventilados en decúbito prono con infección por SARS-CoV-2, en sala respiratoria del Departamento de Cuidados Intensivos Adultos del Hospital de Clínicas-Facultad de Ciencias Médicas - Universidad Nacional de Asunción, de marzo a julio 2021. Metodología: estudio observacional, descriptivo, retrospectivo, de corte transversal, de casos consecutivos, con información obtenida de fichas de pacientes de terapia intensiva, que recibieron soporte nutricional en posición prona. Se tomaron datos demográficos, clínicos y nutricionales. Se evaluó la tolerancia nutricional durante la posición prona, definiéndola como la presencia de un volumen de residuo gástrico < 500 mL cada 6 h.. La adecuación energética fue determinada teniendo en cuenta el porcentaje cumplido de la prescripción nutricional. Resultados: se reclutaron 41 pacientes. El 60,9 % eran hombres; la mediana de edad fue 55 años (RIC=23). Las principales comorbilidades fueron obesidad (57,3 %) e hipertensión arterial (43,9 %). El 85,4 % presentó buena tolerancia gástrica en posición prono, con residuo gástrico menor a 500 ml. El porcentaje de adecuación energética fue de 84 %. Conclusión: la terapia nutricional enteral en decúbito prono fue bien tolerada por la mayoría de nuestros pacientes, posibilitando alcanzar los requerimientos nutricionales indicados.

Introduction: SARS-CoV-2 since 2020 has generated countless challenges. Prone position was used to improve oxygenation, and nutritional therapy was adapted to meet requirements and reduce complications. Objectives: evaluate the tolerance of enteral nutrition and its energetic adequacy in ventilated patients in the prone position with SARS-CoV-2 infection, in the respiratory room of the Adult Intensive Care Department of the Hospital de Clínicas - Facultad de Ciencias Médicas - Universidad Nacional de Asunción, from March to July 2021. Methodology: observational, descriptive, retrospective, cross-sectional study of consecutive cases, with information obtained from records of intensive care patients, who received nutritional support in a prone position. Demographic, clinical and nutritional data were taken. Nutritional tolerance was evaluated during the prone position, defining it as the presence of a volume of gastric residue < 500 mL every 6 h. Energy adequacy was determined taking into account the percentage fulfilled of the nutritional prescription. Results: 41 patients were recruited. 60.9 % were men; the median age was 55 years (IQR=23). The main comorbidities were obesity (57.3 %) and high blood pressure (43.9 %). 85.4 % had good gastric tolerance in the prone position, with gastric residue less than 500 ml. The percentage of energy adequacy was 84 %. Conclusion: enteral nutritional therapy in the prone position was well tolerated by the majority of our patients, making it possible to achieve the indicated nutritional requirements.

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BACKGROUND: The health crisis due to Covid-19 led to the search for therapeutics that could improve the evolution of the disease. Remdesivir, an antiviral that interferes with viral replication, was one of the first to be used for the treatment of this pathology. OBJECTIVE: To determine clinical course and mortality of patients with severe SARS-CoV-2 pneumonia treated with remdesivir, in comparison of those who didn't receive the medication. PATIENTS AND METHODS: Retrospective cohort study, with medical records review of COVID-19 patients, between August 2020 and August 2021. The subjects were divided into two groups, those who received remdesivir before or after admission to intensive care and those who didn't. The primary outcome variable was mortality in intensive care. RESULTS: Of 214 subjects included, 109 (50,9%) received remdesivir. The median of days for the drug administration was 8 (2-20), IQR: 3. The bivariate analysis prove that the use of remdesivir was related with lower risk of develop Acute Respiratory Distress Syndrome (ARDS) (p = 0,019; OR: 0,521) and lower requirement of mechanical ventilation (p = 0,006; OR:0,450). Additionally, patients treated with remdesivir develop less kidney injury (p = 0,009; OR: 0,441). There was a total of 82 deaths, 29 (26,6%) in the remdesivir group and 53 (50,5%) in the control group [p < 0,001; OR: 0,356 (0,201-0,630)]. All the risk factors associated with mortality in the bivariate analysis were entered into the multivariate analysis by logistic regression, the use of remdesivir remained associated as an independent protective factor to mortality (p = 0.034; OR: 0.429). CONCLUSION: Critically ill patients with SARS-CoV-2 pneumonia treated with remdesivir had a lower risk of death and need for mechanical ventilation and develop less ARDS as compared to the control group. No differences were found in the presentation of adverse effects.

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Hand gesture recognition (HGR) based on electromyography signals (EMGs) and inertial measurement unit signals (IMUs) has been investigated for human-machine applications in the last few years. The information obtained from the HGR systems has the potential to be helpful to control machines such as video games, vehicles, and even robots. Therefore, the key idea of the HGR system is to identify the moment in which a hand gesture was performed and it's class. Several human-machine state-of-the-art approaches use supervised machine learning (ML) techniques for the HGR system. However, the use of reinforcement learning (RL) approaches to build HGR systems for human-machine interfaces is still an open problem. This work presents a reinforcement learning (RL) approach to classify EMG-IMU signals obtained using a Myo Armband sensor. For this, we create an agent based on the Deep Q-learning algorithm (DQN) to learn a policy from online experiences to classify EMG-IMU signals. The HGR proposed system accuracy reaches up to [Formula: see text] and [Formula: see text] for classification and recognition respectively, with an average inference time per window observation of 20 ms. and we also demonstrate that our method outperforms other approaches in the literature. Then, we test the HGR system to control two different robotic platforms. The first is a three-degrees-of-freedom (DOF) tandem helicopter test bench, and the second is a virtual six-degree-of-freedom (DOF) UR5 robot. We employ the designed hand gesture recognition (HGR) system and the inertial measurement unit (IMU) integrated into the Myo sensor to command and control the motion of both platforms. The movement of the helicopter test bench and the UR5 robot is controlled under a PID controller scheme. Experimental results show the effectiveness of using the proposed HGR system based on DQN for controlling both platforms with a fast and accurate response.

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In recent years, hand gesture recognition (HGR) technologies that use electromyography (EMG) signals have been of considerable interest in developing human-machine interfaces. Most state-of-the-art HGR approaches are based mainly on supervised machine learning (ML). However, the use of reinforcement learning (RL) techniques to classify EMGs is still a new and open research topic. Methods based on RL have some advantages such as promising classification performance and online learning from the user's experience. In this work, we propose a user-specific HGR system based on an RL-based agent that learns to characterize EMG signals from five different hand gestures using Deep Q-network (DQN) and Double-Deep Q-Network (Double-DQN) algorithms. Both methods use a feed-forward artificial neural network (ANN) for the representation of the agent policy. We also performed additional tests by adding a long-short-term memory (LSTM) layer to the ANN to analyze and compare its performance. We performed experiments using training, validation, and test sets from our public dataset, EMG-EPN-612. The final accuracy results demonstrate that the best model was DQN without LSTM, obtaining classification and recognition accuracies of up to 90.37%±10.7% and 82.52%±10.9%, respectively. The results obtained in this work demonstrate that RL methods such as DQN and Double-DQN can obtain promising results for classification and recognition problems based on EMG signals.

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Hand gesture recognition systems (HGR) based on electromyography signals (EMGs) and inertial measurement unit signals (IMUs) have been studied for different applications in recent years. Most commonly, cutting-edge HGR methods are based on supervised machine learning methods. However, the potential benefits of reinforcement learning (RL) techniques have shown that these techniques could be a viable option for classifying EMGs. Methods based on RL have several advantages such as promising classification performance and online learning from experience. In this work, we developed an HGR system made up of the following stages: pre-processing, feature extraction, classification, and post-processing. For the classification stage, we built an RL-based agent capable of learning to classify and recognize eleven hand gestures-five static and six dynamic-using a deep Q-network (DQN) algorithm based on EMG and IMU information. The proposed system uses a feed-forward artificial neural network (ANN) for the representation of the agent policy. We carried out the same experiments with two different types of sensors to compare their performance, which are the Myo armband sensor and the G-force sensor. We performed experiments using training, validation, and test set distributions, and the results were evaluated for user-specific HGR models. The final accuracy results demonstrated that the best model was able to reach up to 97.50%±1.13% and 88.15%±2.84% for the classification and recognition, respectively, with regard to static gestures, and 98.95%±0.62% and 90.47%±4.57% for the classification and recognition, respectively, with regard to dynamic gestures with the Myo armband sensor. The results obtained in this work demonstrated that RL methods such as the DQN are capable of learning a policy from online experience to classify and recognize static and dynamic gestures using EMG and IMU signals.

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The transition from controlled to partial support ventilation is a challenge in acute respiratory distress syndrome (ARDS) patients due to the risks of patient-self-inflicted lung injury. The magnitude of tidal volume (VT) and intrapulmonary dyssynchrony (pendelluft) are suggested mechanisms of lung injury. We conducted a prospective, observational, physiological study in a tertiary academic intensive care unit. ARDS patients transitioning from controlled to partial support ventilation were included. On these, we evaluated the association between changes in inflammatory biomarkers and esophageal pressure swing (ΔPes), transpulmonary driving pressure (ΔPL), VT, and pendelluft. Pendelluft was defined as the percentage of the tidal volume that moves from the non-dependent to the dependent lung region during inspiration, and its frequency at different thresholds (- 15, - 20 and - 25%) was also registered. Blood concentrations of inflammatory biomarkers (IL-6, IL-8, TNF-α, ANGPT2, RAGE, IL-18, Caspase-1) were measured before (T0) and after 4-h (T4) of partial support ventilation. Pendelluft, ΔPes, ΔPL and VT were recorded. Nine out of twenty-four patients (37.5%) showed a pendelluft mean ≥ 10%. The mean values of ΔPes, ΔPL, and VT were - 8.4 [- 6.7; - 10.2] cmH2O, 15.2 [12.3-16.5] cmH2O and 8.1 [7.3-8.9] m/kg PBW, respectively. Significant associations were observed between the frequency of high-magnitude pendelluft and IL-8, IL-18, and Caspase-1 changes (T0/T4 ratio). These results suggest that the frequency of high magnitude pendelluft may be a potential determinant of inflammatory response related to inspiratory efforts in ARDS patients transitioning to partial support ventilation. Future studies are needed to confirm these results.

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BACKGROUND: The processes involved in this study were 2-fold. First, we analyzed the levels of resilience and internalized problems (defined as group of emotional symptoms) in children aged 9 to 12 years. Second, we examined whether the relationship between them varies according to the low or high vulnerability of school communities. METHODS: About 1460 students from schools in northern Chile participated. A total of 52.6% were girls, and 47.4% were boys. The scales of internalizing problems of the System of Evaluation of Children and Adolescents (SENA) and the short scale of resilience (CYRM-12) were applied. Correlations in each group and differences between groups were analyzed using a MANOVA. A 2-level path analysis was also performed. RESULTS: Resilience was higher in the context of low vulnerability while depression, social anxiety, and posttraumatic stress symptomatology were greater in the context of high vulnerability. A 2-level path analysis showed that the slope of gender, anxiety, and depression symptomatology varies between schools and an interaction effect between vulnerability and anxiety symptomatology. CONCLUSION: There are differences in the relationship between internalized problems and resilience according to whether the students belong to low or high vulnerability establishments. This study contributes to a better understanding of the relationship between internalizing problems and resilience.

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Genetic diversity and relatedness of accessions for coconut growing in Colombia was unknown until this study. Here we develop single nucleotide polymorphisms (SNPs) along the coconut genome based on Genotyping by Sequencing (GBS) with the goal of analyze the genetic diversity, population structure, and linkage disequilibrium (LD) of a diverse coconut panel consisting of 112 coconut accessions from the Atlantic and Pacific coasts of Colombia. A comprehensive catalog of approximately 40,000 SNPs with a minor allele frequency (MAF) of > 0.05 is presented. A total of 40,614 SNPs were found but only 19,414 anchored to chromosomes. Of these, 10,338 and 4606 were exclusive to the Atlantic and Pacific gene pools, respectively, and 3432 SNPs could differentiate both gene pools. A filtered subset of unlinked and anchored SNPs (1271) showed a population structure at K = 4, separating accessions from the Pacific and Atlantic coasts that can also be distinguished by palm height, as found in previous studies. The Pacific groups had a slow LD decay, low Fixation Index (Fst) and low nucleotide diversity (π), while the Atlantic group had slightly higher genetic diversity and faster LD decay. Genome-wide diversity analyses are of importance to promote germplasm conservation and breeding programs aimed at developing new cultivars better adapted to the region.

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A partir del año 2012 el Hospital Psiquiátrico San Lázaro cierra el servicio de hospitalización. La propuesta de esta institución fue implementar un programa de psicoeducación dirigida a la familia para el manejo de los pacientes con trastornos mentales. La participación de los cuidadores primarios en el manejo de pacientes con trastornos mentales crónicos, incluida la esquizofrenia; sin embargo, visibilizó diversos niveles de sobrecarga. Objetivo: Determinar los niveles de sobrecarga en cuidadores primarios, y los efectos atribuibles al Programa de Clínica de Apoyo a Familiares de Personas con Esquizofrenia. Materiales y Métodos: Se diseñó un estudio de evaluación pre y post intervención, en 108 expedientes seleccionados para extraer las variables socio demográficas disponibles y los puntajes de sobrecarga obtenidos con la Escala de Sobrecarga del Cuidador de Zarit. Se describieron los resultados y se analizaron mediante el test de McNemar. Resultados: La mayoría de cuidadores fueron mujeres 67,5 %. El parentesco más frecuente fue el de padres con 44,4 % seguido de hermanos 25,9 %. El rango de edad más común fue el de 51- 60 años. El 71,1 % de los cuidadores presentaron algún tipo de sobrecarga. Para la evaluación de los cambios en los niveles de sobrecarga pre y post intervención se aplicó la prueba de McNemar, cuyo resultado fue de 27,4 mostrando diferencia significativa con valor de p <0,005. Conclusión: La intervención con cuidadores primarios, mediante programas psicoeducativos puede ser una opción viable para reducir los niveles de sobrecarga en familiares de personas con esquizofrenia(AU)

As of 2012, the San Lázaro Psychiatric Hospital closes the hospitalization service. The proposal of this institution was to implement a psychoeducation program aimed at the family for the management of patients with mental disorders. The involvement of primary caregivers in the management of patients with chronic mental disorders, including schizophrenia; however, it made visible various levels of overload. Objective: To determine the levels of burden in primary caregivers, and the effects attributable to the Program of Support Clinic for Family Members of People with Schizophrenia. Methods: A pre and post intervention evaluation study was designed in 108 selected files to extract the available socio-demographic variables and the burden scores obtained with the Zarit Caregiver Burden Scale. The results were described and analyzed using the McNemar test. Results: The majority of caregivers were women, 67.5%. The most frequent relationship was that of parents with 44.4% followed by siblings 25.9%. The most common age range was 51-60 years. 71.1% of the caregivers presented some type of overload. McNemar's test was applied to assess the changes in the levels of pre- and post-intervention overload, the result of which was 27.4, showing a significant difference with a p value <0.005. Conclusion: Intervention with primary caregivers, through psychoeducational programs, may be a viable option to reduce the levels of burden in relatives of people with schizophrenia

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Resumen: Se realizó un ensayo clínico controlado, prospectivo, comparativo, aleatorizado, ciego simple. Objetivo: Determinar la correlación y valor predictivo de las escalas de evaluación de vía aérea e intubación difícil, obesidad, hoja McCoy y videolaringoscopio tipo Airtraq®. Material y métodos: 152 pacientes programados para cirugía, con antecedentes de obesidad y factores de riesgo de ventilación e intubación difícil sometidos a anestesia general. Se formaron dos grupos: grupo 1 intubación con hoja McCoy y grupo 2 videolaringoscopio Airtraq®. Resultados: En la estadística de contraste de ventilación difícil se obtuvo significancia estadística con p < de 0.05 para todos los factores, excepto el ronquido. En predictores de intubación difícil, la clasificación de Mallampati y Cormack-Lehane obtuvo p < 0.05, con sensibilidad de 63 y 68% respectivamente, con valor predictivo negativo alto para todos los factores. El promedio de intentos fue uno y duración de 55-59 segundos en ambos grupos. No hubo diferencias con el uso de hoja McCoy y Airtraq®. Conclusiones: La intubación orotraqueal fue exitosa en 97% de los casos gracias al uso de predictores de intubación difícil y de dispositivos para manejo de la misma.

Abstract: A controlled, prospective, comparative, randomized, simple blind clinical trial was conducted. Objective: Determine the correlation and predictive value of the airway assessment and difficult intubation scales, obesity, McCoy sheet and Airtraq® type videolaryngoscope. Material and methods: 152 patients scheduled for surgery, with a history of obesity and risk factors for difficult ventilation and intubation under general anesthesia. Two groups were formed: group, intubation with McCoy sheet and group 2, Airtraq® videolaryngoscope. Results: In the contrast statistics of difficult ventilation, statistical significance was obtained with p < 0.05 for all factors except snoring. In predictors of difficult intubation, the Mallampati and Cormack-Lehane classification obtained p < 0.05, with sensitivity of 63 and 68% respectively, with a high negative predictive value for all factors. The average of attempts was 1 and duration 55-59 seconds, in both groups. There were not differences with the use of McCoy sheet and Airtraq®. Conclusions: Orotracheal intubation was successful in 97% of cases, thanks to the use of difficult intubation predictors and devices for managing it.

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Together with their undeniable role in the ecology of arid and semiarid ecosystems, Agave species are emerging as a model to dissect the relationships between crassulacean acid metabolism and high efficiency of light and water use, and as an energy crop for bioethanol production. Transcriptome resources from economically valuable Agaves species, such as Agave tequilana and A. salmiana, as well as hybrids for fibers, are now available, and multiple gene expression landscape analyses have been reported. Key components in molecular mechanisms underlying drought tolerance could be uncovered by analyzing gene expression patterns of roots. This study describes an efficient protocol for high-quality total RNA isolation from phenolic compounds-rich Agave roots. Our methodology involves suitable root handling and collecting in the field and using saving-time commercial kits available. RNA isolated from roots free of lignified out-layers and clean cortex showed high values of quality and integrity according to electrophoresis and microfluidics-based platform. Synthesis of long full-length cDNAs and PCR amplification tested the suitability for downstream applications of extracted RNA. The protocol was applied successfully to A. tequilana roots but can be used for other Agave species that also develop lignified epidermis/exodermis in roots.

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Abstract Introduction: adverse socioeconomic conditions may cause food intake characterized by inequality that derives in malnutrition increases. Objective. To identify inequalities in food consumption among the Colombian population according to socioeconomic status and the food security classification for households. Methods. The data were obtained from the 2005 National Survey of Nutritional Status, and the analysis used the first 24-hour recall n=39,413 Colombians. The statistical analysis took into account descriptive statistics and 95% confidence intervals. A multivariate analysis was performed through multinomial logistic regression models, with each of the food groups as a dependent variable. Finally, a latent class analysis was performed to understand the heterogeneity of the inequalities in food consumption in the households. Results. Low-socioeconomic status households showed higher consumption of cereals, tubers and plantains, non-alcoholic beverages, and fats. I contrast, higher socioeconomic status households showed higher consumption of dairy products, fruit, vegetables, and sugars/sweets. The food security classification found that food-secure households had a higher consumption of meat, dairy, vegetables, fruit, and sugars/sweets. Households classified as food-insecure showed a higher consumption of cereals, tubers and plantains, and non-alcoholic beverages. The consumption of tubers and plantains showed a clear social gradient, in higher socioeconomic status there was lower consumption probability of those products. Conclusion. There are inequalities in food consumption in Colombia according to socioeconomic status and the food security classification; therefore, people and families with the most unfavorable socioeconomic status have diets with less nutritional value.

Resumen Objetivo: Identificar las inequidades en el consumo de alimentos según nivel socioeconómico y clasificación de seguridad alimentaria de los hogares colombianos. Métodos: Los datos provienen de la Encuesta Nacional de la Situación Nutricional de 2005, y se utilizó el primer recordatorio de 24 horas n=39,413 colombianos. El análisis estadístico tuvo en cuenta estadística descriptiva e intervalos de confianza del 95%. Se realizó un análisis de regresión logística multinomial, con cada uno de los grupos de alimentos como una variable dependiente. Finalmente, se realizó un análisis de clases latentes para capturar la heterogeneidad de las inequidades en el consumo de alimentos en los hogares. Resultados: Los hogares clasificados con un nivel socioeconómico bajo mostraron un mayor consumo de cereales, tubérculos/plátanos, bebidas no alcohólicas y grasas. Por otro lado, se observó que un nivel socioeconómico alto conllevó un mayor consumo de lácteos, frutas, verduras y azúcares/postres. Según clasificación de seguridad alimentaria, los hogares considerados en seguridad tenían un mayor consumo de carne, lácteos, verduras, frutas y azúcares/postres. Los hogares clasificados en inseguridad alimentaria mostraron mayor consumo de cereales, tubérculos/plátanos, y bebidas no alcohólicas. El consumo de tubérculos y plátanos mostró un gradiente social, con menor probabilidad de consumo a mayor nivel socioeconómico. Conclusión: Existen inequidades en el consumo de alimentos en Colombia según nivel socioeconómico y clasificación de seguridad alimentaria, por tanto, las personas y familias en estado socioeconómico más desfavorable tienen dietas con menor valor nutricional.

Resumo Objetivo: Identificar as desigualdades no consumo de alimentos segundo o nível socioeconômico e classificação de segurança alimentar dos lares colombianos. Métodos: Os dados provêm da Enquete Nacional da Situação Nutricional de 2005, e se utilizou o primeiro lembrete de 24 horas n=39,413 colombianos. A análise estatístico levando em conta Estatísticas descritiva e intervalos de confiança de 95%. Realizou-se uma análise de regressão logística multinominal, com cada um dos grupos de alimentos como uma variável dependente. Finalmente, realizou-se uma análise de classes latentes para capturar a heterogeneidade das desigualdades no consumo de alimentos nos lares. Resultados: Os lares classificados com um nível socioeconómico baixo amostraram um maior consumo de cereais, tubérculos/ banana da terra, bebidas não alcoólicas e gorduras. Por outro lado, observou-se que um nível socioeconómico alto tem um maior consumo de lácteos, frutas, verduras e açúcares/sobremesas. Segundo a clasificação de segurança alimentar, os lares considerados em segurança tinham um maior consumo de carne, lácteos, verduras, frutas e açúcares/sobremesas. Os lares classificados em insegurança alimentar evidenciaram maior consumo de cereais, tubérculos/banana da terra, e bebidas não alcoólicas. O consumo de tubérculos e banana da terra evidenciou uma desigualdade social, com menor probabilidade de consumo no nível socioeconômico mais alto. Conclusão: Existem desigualdades no consumo de alimentos na Colômbia de acordo com o nível socioeconômico e classificação de segurança alimentar. Deste modo, as pessoas e famílias em condições socioeconômicos mais desfavoráveis têm dietas com menor valor nutricional.

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RATIONALE: Cyclic strain may be a determinant of ventilator-induced lung injury. The standard for strain assessment is the computed tomography (CT), which does not allow continuous monitoring and exposes to radiation. Electrical impedance tomography (EIT) is able to monitor changes in regional lung ventilation. In addition, there is a correlation between mechanical deformation of materials and detectable changes in its electrical impedance, making EIT a potential surrogate for cyclic lung strain measured by CT (StrainCT ). OBJECTIVES: To compare the global StrainCT with the change in electrical impedance (ΔZ). METHODS: Acute respiratory distress syndrome patients under mechanical ventilation (VT 6 mL/kg ideal body weight with positive end-expiratory pressure 5 [PEEP 5] and best PEEP according to EIT) underwent whole-lung CT at end-inspiration and end-expiration. Biomechanical analysis was used to construct 3D maps and determine StrainCT at different levels of PEEP. CT and EIT acquisitions were performed simultaneously. Multilevel analysis was employed to determine the causal association between StrainCT and ΔZ. Linear regression models were used to predict the change in lung StrainCT between different PEEP levels based on the change in ΔZ. MAIN RESULTS: StrainCT was positively and independently associated with ΔZ at global level (P < .01). Furthermore, the change in StrainCT (between PEEP 5 and Best PEEP) was accurately predicted by the change in ΔZ (R2 0.855, P < .001 at global level) with a high agreement between predicted and measured StrainCT . CONCLUSIONS: The change in electrical impedance may provide a noninvasive assessment of global cyclic strain, without radiation at bedside.

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A healthy Human Gut Microbial Ecosystem (HGME) is a necessary condition for maintaining the orderly function of the whole body. Major alterations in the normal gut microbial composition, activity and functionality (dysbiosis) by an environmental or host-related disruptive event, can compromise metabolic, inflammatory, and neurological processes, causing disorders such as obesity, inflammatory bowel disease, colorectal cancer, and depressive episodes. The restore or the maintaining of the homeostatic balance of Gut Microbiota (GM) populations (eubiosis) is possible through diet, the use of probiotics, prebiotics, antibiotics, and even Fecal Microbiota Transplantation (FMT). Although these "classic methods" represent an effective and accepted way to modulate GM, the complexity of HGME requires new approaches to control it in a more appropriate way. Among the most promising emergent strategies for modulating GM are the use of engineered nanomaterials (metallic nanoparticles (NP), polymeric-NP, quantum dots, micelles, dendrimers, and liposomes); phagotherapy (i.e., phages linked with the CRISPR/Cas9 system), and the use of antimicrobial peptides, non-antibiotic drugs, vaccines, and immunoglobulins. Here we review the current state of development, implications, advantages, disadvantages, and perspectives of the different approaches for manipulating HGME.

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Spines are key plant modifications developed to deal against herbivores; however, its physical structure and chemical composition have been little explored in plant species. Here, we took advantage of high-throughput chromatography to characterize chemical composition of Agave fourcroydes Lem. spines, a species traditionally used for fiber extraction. Analyses of structural carbohydrate showed that spines have lower cellulose content than leaf fibers (52 and 72%, respectively) but contain more than 2-fold the hemicellulose and 1.5-fold pectin. Xylose and galacturonic acid were enriched in spines compared to fibers. The total lignin content in spines was 1.5-fold higher than those found in fibers, with elevated levels of syringyl (S) and guaiacyl (G) subunits but similar S/G ratios within tissues. Metabolomic profiling based on accurate mass spectrometry revealed the presence of phenolic compounds including quercetin, kaempferol, (+)-catechin, and (-)-epicatechin in A. fourcroydes spines, which were also detected in situ in spines tissues and could be implicated in the color of these plants' structures. Abundance of (+)-catechins could also explain proanthocyanidins found in spines. Agave spines may become a plant model to obtain more insights about cellulose and lignin interactions and condensed tannin deposition, which is valuable knowledge for the bioenergy industry and development of naturally dyed fibers, respectively.

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Hand gesture recognition (HGR) systems using electromyography (EMG) bracelet-type sensors are currently largely used over other HGR technologies. However, bracelets are susceptible to electrode rotation, causing a decrease in HGR performance. In this work, HGR systems with an algorithm for orientation correction are proposed. The proposed orientation correction method is based on the computation of the maximum energy channel using a synchronization gesture. Then, the channels of the EMG are rearranged in a new sequence which starts with the maximum energy channel. This new sequence of channels is used for both training and testing. After the EMG channels are rearranged, this signal passes through the following stages: pre-processing, feature extraction, classification, and post-processing. We implemented user-specific and user-general HGR models based on a common architecture which is robust to rotations of the EMG bracelet. Four experiments were performed, taking into account two different metrics which are the classification and recognition accuracy for both models implemented in this work, where each model was evaluated with and without rotation of the bracelet. The classification accuracy measures how well a model predicted which gesture is contained somewhere in a given EMG, whereas recognition accuracy measures how well a model predicted when it occurred, how long it lasted, and which gesture is contained in a given EMG. The results of the experiments (without and with orientation correction) executed show an increase in performance from 44.5% to 81.2% for classification and from 43.3% to 81.3% for recognition in user-general models, while in user-specific models, the results show an increase in performance from 39.8% to 94.9% for classification and from 38.8% to 94.2% for recognition. The results obtained in this work evidence that the proposed method for orientation correction makes the performance of an HGR robust to rotations of the EMG bracelet.

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This paper aims to understand the meanings of food and nutrition policies for beneficiary mothers and for technicians designing and implementing said policies. The Grounded Theory method was employed. The data collection techniques adopted were the semi-structured interview and the focus group. The participants were beneficiaries of food and nutrition programs, with a minimum two-year experience, and technicians with five-year experience in designing or implementing these policies and programs. Food and nutrition policies are conceived and managed under a market logic, which has required an institutional framework that adopted this commercial model to provide public services, which is implemented in the scheme of outsourcing third parties, especially private companies, who implement these policies to achieve financial profitability. The market is imposed as the benchmark for the State's actions, and, therefore, the State's action is limited the oversight of outsourced actions, and food policies become devices for the diversion of public resources to the private sector.

El propósito de este artículo es comprender los significados de las políticas alimentarias para madres beneficiarias y, para técnicos que diseñan e implementan dichas políticas. Se utilizó el método de la teoría fundamentada. Las técnicas de recolección fueron la entrevista semi-estructurada y el grupo focal. Los participantes fueron beneficiarias de algún programa de alimentación y nutrición, con una experiencia mínima de dos años y; los técnicos con cinco años o más de desempeño en el diseño y/o implementación de las políticas. Las políticas alimentarias se conciben y se gestionan bajo una lógica de mercado, la cual requiere de una institucionalidad que le sea funcional al modelo mercantil para proveer servicios públicos, lo cual se materializa en el esquema de la subcontratación a terceros, especialmente empresas privadas, quienes implementan estas políticas con el propósito de lograr la rentabilidad financiera. El mercado se impone como el referencial de las acciones del Estado, por tanto, se configura un Estado que limita su función a la fiscalización de las acciones subcontratadas, y las políticas de alimentación se constituyen en dispositivos para la desviación de recursos públicos hacia el sector privado.

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RESUMO

Resumen El propósito de este artículo es comprender los significados de las políticas alimentarias para madres beneficiarias y, para técnicos que diseñan e implementan dichas políticas. Se utilizó el método de la teoría fundamentada. Las técnicas de recolección fueron la entrevista semi-estructurada y el grupo focal. Los participantes fueron beneficiarias de algún programa de alimentación y nutrición, con una experiencia mínima de dos años y; los técnicos con cinco años o más de desempeño en el diseño y/o implementación de las políticas. Las políticas alimentarias se conciben y se gestionan bajo una lógica de mercado, la cual requiere de una institucionalidad que le sea funcional al modelo mercantil para proveer servicios públicos, lo cual se materializa en el esquema de la subcontratación a terceros, especialmente empresas privadas, quienes implementan estas políticas con el propósito de lograr la rentabilidad financiera. El mercado se impone como el referencial de las acciones del Estado, por tanto, se configura un Estado que limita su función a la fiscalización de las acciones subcontratadas, y las políticas de alimentación se constituyen en dispositivos para la desviación de recursos públicos hacia el sector privado.

Abstract This paper aims to understand the meanings of food and nutrition policies for beneficiary mothers and for technicians designing and implementing said policies. The Grounded Theory method was employed. The data collection techniques adopted were the semi-structured interview and the focus group. The participants were beneficiaries of food and nutrition programs, with a minimum two-year experience, and technicians with five-year experience in designing or implementing these policies and programs. Food and nutrition policies are conceived and managed under a market logic, which has required an institutional framework that adopted this commercial model to provide public services, which is implemented in the scheme of outsourcing third parties, especially private companies, who implement these policies to achieve financial profitability. The market is imposed as the benchmark for the State's actions, and, therefore, the State's action is limited the oversight of outsourced actions, and food policies become devices for the diversion of public resources to the private sector.

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RESUMO

Las uniones estrechas (UE) son estructuras altamente complejas que se localizan en la porción más apical de la membrana basolateral y están compuestas por una serie de proteínas, como claudinas, ocludinas y proteínas de la familia ZO. Las UE restringen el paso de sustancias potencialmente dañinas o microorganismos a lo largo del espacio paracelular, y participan de manera importante en procesos de mecanotransducción y señalización intercelular. Aunque la ultraestructura de las UE les permiten funcionar como una barrera en varios tejidos, como en la barrera hematoencefálica y la barrera hematotesticular, estas son propensas a cambios en su composición, lo cual podría disminuir sus características de permeabilidad. En este sentido, se ha demostrado que ciertos microorganismos enteropatógenos son capaces de desensamblar o modificar las propiedades de permeabilidad de las UE en las barreras hematotisulares. En particular, se ha estudiado cómo la microbiota contribuye a la formación, la función y el mantenimiento de las UE en varios nichos inmunitariamente privilegiados, tales como el tracto gastrointestinal, el sistema nervioso central y los testículos. Por lo tanto, resulta primordial comprender los mecanismos fisiológicos por los cuales la microbiota puede modificar la función de las barreras hematotisulares, con el -objetivo de diseñar nuevas estrategias terapéuticas que mejoren los efectos dañinos de varias enfermedades sobre nichos inmunitariamente privilegiados en el humano.Tight-junctions (TJ) are a highly complex structure located in the most apical portion of the basolateral membrane, composed of series of proteins, such as claudins, occludins and proteins of the ZO family. TJ restrict the passage of potentially harmful substances or microorganisms through paracellular space and participate importantly in the mecanotransduction and intercellular signaling processes. Although the complex structure of TJ, allow them function as barrier in various tissues, such as brain-blood-barrier and testicular-blood-barrier, these barriers are prone to changes decreasing its permeability features. The contribution of microbiota in the formation, function and maintenance of TJ in various immunologically privileged niches, such as gastrointestinal tract, central nervous system and testicles have been recently studied. Nevertheless, it has been demonstrated that certain pathogenic microorganisms are able to disassemble or modify the permeability of TJ in blood-tissue barrier. Thereby, it is central to understand the physiological mechanisms of how microbiota could modify the function of epithelial blood barriers in order to design new therapeutic strategies to ameliorate harmful effects of many human diseases.

RESUMO

BACKGROUND: The skin prick test is recognized as the gold standard for the specific diagnosis of allergy. OBJECTIVE: To determine the sensitivity and specificity of the epicutaneous patch test that has been modified for the diagnosis of respiratory allergy to Dermatophagoides pteronyssinus. METHODS: An observational, interpretative, prolective, and transversal study. The included patients were between 6 and 49 years old, with symptoms of a respiratory allergy, and a skin test was performed on them by using the European standardized prick test and a modified epicutaneous patch test with the variable of the scarification that occurred before the antigen was applied, and its homogenization with a wooden applicator, which occurred after the antigen was applied. The levels of sensitivity, specificity, and prevalence influence and positive and negative predictive values were calculated. RESULTS: 104 patients were included, of which 72 (69.2%) were women. The age category of the patients was 24 ± 11.3 years of age. 78.9% of the patients were diagnosed with allergic rhinitis, 1.9% were diagnosed with asthma, and 19.2% were diagnosed with both rhinitis and asthma. The prevalence of the respiratory allergy to Dermatophagoides pteronyssinus was of 62.5%; 94.23% with a correct diagnosis. The sensitivity and specificity of the test was of 93.85% and 94.87%; the positive and negative predictive values were of 96.83% and 90.24%, and the positive and negative likelihood ratios were of 18.30 and 0.06. CONCLUSIONS: The modified epicutaneous patch test was highly sensitive and specific; it decreased the risk of allergen carryover and it lowered the cost of the material that was used.

Antecedentes: La prueba por punción cutánea es el estándar de oro en el diagnóstico específico de alergia. Objetivo: Determinar sensibilidad y especificidad de la prueba epicutánea modificada para el diagnóstico de alergia respiratoria a Dermatophagoides pteronyssinus. Métodos: Estudio observacional, interpretativo, prolectivo y transversal. Se incluyeron pacientes de seis a 49 años de edad, con cuadro clínico de alergia respiratoria, en quienes se realizó punción cutánea con técnica europea y prueba epicutánea con la variante de escarificación previa a la aplicación del antígeno y posterior homogenización del mismo con aplicador de madera. Se calculó sensibilidad, especificidad, influencia de la prevalencia, valores predictivos positivo y negativo. Resultados: Se incluyeron 104 pacientes, 72 (69.2 %) del sexo femenino. La edad fue de 24 ± 11.3 años, 78.9 % tuvo diagnóstico de rinitis alérgica, 1.9 % de asma y 19.2 % de rinitis y asma. La prevalencia de alergia respiratoria a Dermatophagoides pteronyssinus fue de 62.5 %; 94.23 % estaba correctamente diagnosticado. La sensibilidad y especificidad de la prueba fue de 93.85 y 94.87 %, los valores predictivos positivo y negativo de 96.83 y 90.24 % y los cocientes de probabilidades positivo y negativo de 18.30 y 0.91. Conclusiones: La prueba epicutánea modificada fue altamente sensible y específica, disminuyó el riesgo de contaminación por arrastre de alérgenos y los costos en el material utilizado.

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