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Leishmania mexicana is one of the causal agents of cutaneous leishmaniasis. Current antileishmanial chemotherapeutics have demonstrated adverse side effects; thus, alternative treatments are needed. In this study, we performed in silico and in vitro analyses of the leishmanicidal potential of the most abundant phenolic compounds identified in black sesame sprouts biostimulated with Bacillus clausii. The molecular docking analysis showed strong interactions (binding free energies between -6.5 and -9.5 kcal/mol) of sesaminol 2-O-triglucoside, pinoresinol dihexoside, isoverbascoside, and apigenin with the arginase, leishmanolysin, cysteine peptidase B, and pyruvate kinase leishmanial enzymes. Furthermore, almost all phenolic compounds interacted with the active site residues of L. mexicana enzymes. In vitro, the B. clausii-biostimulated sprout phenolic extracts and apigenin inhibited the growth of promastigotes with IC50 values of 0.08 mg gallic acid equivalent/mL and 6.42 µM (0.0017 mg/mL), respectively. Additionally, in the macrophage infection model, cells treated with B. clausii-biostimulated sprout phenolic extracts and infected with L. mexicana exhibited significantly (P < 0.05) reduced nitric oxide production and decreased parasite burden. Altogether, our study provides important data related to high efficacy and less toxic natural antileishmanial candidates against promastigotes of L. mexicana.

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Abstract: Introduction: The use of incremental exercise tests (IET) to evaluate the individual's acute responses is an essential tool in Physical Activity Science. Objective: This paper aims to analyze the behavior between biochemical and physiological variables as aerobic-anaerobic transition indicators during two incremental exercise tests, which measure the maximum oxygen uptake in healthy subjects. Methodology: The sample consisted of two individuals, who were thirty-three and twenty-five years old, respectively. During the execution of the tests, the following materials and tools were used: a portable glucometer, a portable lactometer, reactive tapes, a treadmill, a stationary Cycle Ergometer Monark®, a heart rate monitor Polar®, a gas analyzer, software Breeze®, a computer, tools for recording data, and a pencil. Results: the high inverse correlation between the Glycemic index and VO2 (r: -0,853) and the Glycemic and CO2 (r: -0,851) are notable. Moreover, the detection of thresholds for each subject through blood lactate invasive and non-invasive methods, such as heart rate (HR), is also shown. Conclusion: A clear explanation of Respiratory Quotient (RQ) behavior is given during the Cycle-ergometer test, concluding that this type of protocol is safe for the group under study and that the validity of the results is in accordance with theoretical expectations.

Resumen: Introducción: La ejecución de pruebas físicas incrementales para evaluar las respuestas agudas del individuo, representa una herramienta fundamental en el área de las ciencias de la actividad física. Objetivo: En este sentido, el presente trabajo tiene como objetivo el análisis del comportamiento entre variables bioquímicas y fisiológicas como indicadores de la transición aerobio-anaeróbica en la ejecución de dos test incrementales que miden el consumo máximo de oxígeno, en sujetos sedentarios. Metodología: La muestra se conformó por dos individuos, los cuales presentan edades de treinta y tres y veinticinco años, respectivamente. En el desarrollo de la prueba se utilizaron los siguientes materiales e instrumentos: un glucómetro portátil, un lactómetro portátil, cintas reactivas, treadmill, cicloergomertro Monark ®, pulsometro marca polar ®, analizador de gases, software Breeze ®, computador, instrumentos de registro de datos y lápiz. Resultados: destacan la alta correlación inversa presente entre los valores de glicemia y VO2 (r: -0,853), así como Glicemia y CO2 (r: -0,851) del mismo modo se muestra la detección de los Umbrales para cada sujeto mediante métodos invasivos del lactacidemia y no invasivos como la frecuencia cardíaca. Conclusión: También se ejecuta una explicación clara del comportamiento del cociente respiratorio en la prueba ejecutada con el cicloergómetro, concluyendo que este tipo de protocolos son seguros para el grupo en estudio y la validez de los resultados es acorde con las expectativas teóricas.

Resumo: Introdução: A execução de testes físicos incrementais para avaliar as respostas agudas do indivíduo representa uma ferramenta fundamental na área das ciências da atividade física. Objetivo: Neste sentido, o presente trabalho visa analisar o comportamento entre as variáveis bioquímicas e fisiológicas como indicadores da transição aeróbico-anaeróbica na execução de dois testes incrementais que medem o consumo máximo de oxigênio em sujeitos sedentários. Metodologia: A amostra consistiu de dois indivíduos, com trinta e três e vinte e cinco anos de idade, respectivamente. Os seguintes materiais e instrumentos foram utilizados no desenvolvimento do teste: um glicosímetro portátil, um lactômetro portátil, tiras de teste, esteira, cicloergômetro Monark®, pulsômetro polar®, analisador de gás, software Breeze®, computador, instrumentos de registro de dados e lápis. Resultados: A alta correlação inversa entre glicemia e VO2 (r: -0,853), assim como glicemia e CO2 (r: #0,851) e a detecção dos limiares para cada sujeito usando métodos invasivos como lactacidemia e métodos não-invasivos como a frequência cardíaca. Conclusão: Uma explicação clara do comportamento do quociente respiratório no teste executado com o cicloergômetro também é executada, concluindo que este tipo de protocolos são seguros para o grupo em estudo e a validade dos resultados está de acordo com as expectativas teóricas.

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This research aimed to evaluate the antimicrobial activity of essential oils (EOs) against clinically and environmentally isolated Salmonella serotypes. Oregano, thyme, and grapefruit EO compounds were identified, and the antimicrobial activity was evaluated against the S. Saintpaul, Oranienburg, and Infantis serotypes. In addition, molecular docking was performed to explore the possible mechanisms between compounds of EOs with microbial enzymes. Thymol was the main compound identified in oregano (44.0%) and thyme (31%) EOs, while d-limonene was present in a greater proportion in grapefruit EO. Oregano EO had the highest antimicrobial activity, followed by thyme and grapefruit EOs. Oregano and thyme EOs illustrated a greater inhibitory capacity to all serotypes, particularly with the environmental S. Saintpaul. Oregano EO presented values of minimum inhibitory concentration (MIC) and minimum bactericidal concentration of 0.1 µL/mL for all serotypes, while thyme and grapefruit EOs presented MIC values of 0.1 µL/mL for the clinical serotypes S. Infantis and S. Oranienburg, respectively. Molecular docking analysis showed the optimal binding free energies for thymol and carvacrol with glucokinase, ATP-dependent-6-fructokinase, outer membrane porin C, and topoisomerase IV. Our results indicate that these EOs can inhibit clinically and environmentally isolated Salmonella serotypes and can be used as alternatives for developing natural food preservatives.

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Surgery has been historically the preferred primary treatment for patients with well-differentiated thyroid carcinoma and for selected locoregional recurrences. Adjuvant therapy with radioactive iodine is typically recommended for patients with an intermediate to high risk of recurrence. Despite these treatments, locally advanced disease and locoregional relapses are not infrequent. These patients have a prolonged overall survival that may result in long periods of active disease and the possibility of requiring subsequent treatments. Recently, many new options have emerged as salvage therapies. This review offers a comprehensive discussion and considerations regarding surgery, active surveillance, radioactive iodine therapy, ultrasonography-guided percutaneous ablation, external beam radiotherapy, and systemic therapy for well-differentiated thyroid cancer based on relevant publications and current reference guidelines. We feel that the surgical member of the thyroid cancer management team is empowered by being aware and facile with all management options.

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DISCOVER is a 3-year observational study program of 15,983 people with type 2 diabetes initiating second-line glucose-lowering therapy in 38 countries. We investigated the association between socioeconomic status and both the availability of a baseline glycated hemoglobin (HbA1c) measurement and poor glycemic control (HbA1c level ≥ 9.0%) in participants enrolled in DISCOVER. Factors associated with a lack of baseline HbA1c measurement or an HbA1c level ≥ 9.0% were assessed using three-level hierarchical logistic models. Overall, 19.1% of participants did not have a baseline HbA1c measurement recorded. Lower-middle country income (vs. high) and primary/no formal education (vs. university education) were independently associated with a reduced likelihood of having a baseline HbA1c measurement (odds ratio [95% confidence interval]: 0.11 [0.03-0.49] and 0.81 [0.66-0.98], respectively. Of the participants with an available HbA1c measurement, 26.9% had an HbA1c level ≥ 9.0%; 68.7% of these individuals were from lower- or upper-middle-income countries. Factors associated with an increased likelihood of poor glycemic control included low country income, treatment at a site with public and/or governmental funding (vs. private funding) and having public or no health insurance (vs. private). A substantial proportion of DISCOVER participants did not have an HbA1c measurement; more than one-quarter of these participants had poorly controlled type 2 diabetes. Both individual- and country-level socioeconomic factors are associated with the quality of care regarding glycemic control. Awareness of these factors could help improve the management of patients with type 2 diabetes.

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Non-communicable diseases (NCD), are not transmitted from person to person, are long-lasting and usually of slow evolution. Worldwide cause 71% deaths, in Mexico during 2016 were the cause of 80% of registered deaths; population in socioeconomic disadvantage is more vulnerable. It is urgent to develop strategies that can prevent NCD, thus, the objective of this study was to design, implement and evaluate an educational intervention strategy (EI), to prevent and control risk factors for the development NCD in families of two vulnerable communities. The research design was mixed, the stages were developed based on a risk communication (RC) model and was performed in three stages: 1) EI Design, 2) Implementation and 3) Evaluation of the intervention. In the contextualization, risk factors were found in the participants who were integrated in the design of the educational strategy. The EI implemented was effective in increasing knowledge about NCD and practice of healthy habits, such as increasing the consumption of fruits and vegetables. Additionally, the guidance of EI at the family level has the advantage of creating a support network for these changes. However, pending issues remain, such as the design of effective strategies to reduce the consumption of sugars and sugary drinks.

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Most cases of thyroid carcinoma are classified as low risk. These lesions have been treated with open surgery, remote access thyroidectomy, active surveillance, and percutaneous ablation. However, there is lack of consensus and clear indications for a specific treatment selection. The objective of this study is to review the literature regarding the indications for management selection for low-risk carcinomas. Systematic review exploring inclusion and exclusion criteria used to select patients with low-risk carcinomas for treatment approaches. The search found 69 studies. The inclusion criteria most reported were nodule diameter and histopathological confirmation of the tumor type. The most common exclusions were lymph node metastasis and extra-thyroidal extension. There was significant heterogeneity among inclusion and exclusion criteria according to the analyzed therapeutic approach. Alternative therapeutic approaches in low-risk carcinomas can be cautiously considered. Open thyroidectomy remains the standard treatment against which all other approaches must be compared.

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Introducción: Las investigaciones sobre el entrenamiento funcional de alta intensidad son escasas a pesar de su popularidad. Objetivo: Establecer la asociación del consumo máximo de oxígeno y el rendimiento del WOD Pukie (150 burpees por tiempo) en sujetos físicamente activos. Metodología: Se realizó un estudio descriptivo-correlacional con enfoque cuantitativo de diseño no experimental y con una muestra no probabilística conformada por 14 hombres y 6 mujeres, las evaluaciones fueron realizadas en 2 días con una diferencia de 48 horas en las cuales el primer día se evaluó el consumo máximo de oxígeno a través del test de Course-Navette y el segundo día se aplicó el WOD Pukie, el análisis estadístico se aplicó en el IBM SPSS V.22 (Demo) (95% de confianza y un p-valor de 0,05) en el cual se aplicó la prueba de normalidad de Shapiro-Wilk, el coeficiente correlacional de Pearson (p > 0,05) y Spearman (p 0,05). Conclusión: En conclusión, el consumo máximo de oxigeno no es un predictor significativo del rendimiento en el WOD Pukie en sujetos físicamente activos(AU)

Introduction: Few studies have been conducted about high intensity functional training, despite the popularity of this form of exercise. Objective: Establish the association between maximal oxygen consumption and Pukie WOD performance (150 burpees per time unit) in physically active subjects. Methods: A non-experimental correlational-descriptive quantitative study was conducted of a nonprobability sample of 14 men and 6 women. The evaluations were performed in two days, with a separation of 48 hours between them. Maximal oxygen consumption was measured on the first day using the Course-Navette test, and the Pukie WOD was applied on the second day. Statistical analysis was performed with the software IBM SPSS V.22 (Demo) (95% confidence and a p-value of 0.05), the Shapiro-Wilk normality test, Pearson's chi-squared test (p > 0.05) and Spearman's correlation coefficient (p 0.05). Conclusion: Maximal oxygen consumption is not a significant predictor of Pukie WOD performance in physically active subjects(AU)

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In this work, the analytical research performed by the Raman Laser Spectrometer (RLS) team during the ExoFiT trial is presented. During this test, an emulator of the Rosalind Franklin rover was remotely operated at the Atacama Desert in a Mars-like sequence of scientific operations that ended with the collection and the analysis of two drilled cores. The in-situ Raman characterization of the samples was performed through a portable technology demonstrator of RLS (RAD1 system). The results were later complemented in the laboratory using a bench top RLS operation simulator and a X-Ray diffractometer (XRD). By simulating the operational and analytical constraints of the ExoMars mission, the two RLS representative instruments effectively disclosed the mineralogical composition of the drilled cores (k-feldspar, plagioclase, quartz, muscovite and rutile as main components), reaching the detection of minor phases (e.g., additional phyllosilicate and calcite) whose concentration was below the detection limit of XRD. Furthermore, Raman systems detected many organic functional groups (-C≡N, -NH2 and C-(NO2)), suggesting the presence of nitrogen-fixing microorganisms in the samples. The Raman detection of organic material in the subsurface of a Martian analogue site presenting representative environmental conditions (high UV radiation, extreme aridity), supports the idea that the RLS could play a key role in the fulfilment of the ExoMars main mission objective: to search for signs of life on Mars.

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BACKGROUND: Larynx cancer is a common site for tumors of the upper aerodigestive tract. In cases with a clinically negative neck, the indications for an elective neck treatment are still debated. The objective is to define the prevalence of occult metastasis based on the subsite of the primary tumor, T classification and neck node levels involved. METHODS: All studies included provided the rate of occult metastases in cN0 larynx squamous cell carcinoma patients. The main outcome was the incidence of occult metastasis. The pooled incidence was calculated with random effects analysis. RESULTS: 36 studies with 3803 patients fulfilled the criteria. The incidence of lymph node metastases for supraglottic and glottic tumors was 19.9% (95% CI 16.4-23.4) and 8.0% (95% CI 2.7-13.3), respectively. The incidence of occult metastasis for level I, level IV and level V was 2.4% (95% CI 0-6.1%), 2.0% (95% CI 0.9-3.1) and 0.4% (95% CI 0-1.0%), respectively. For all tumors, the incidence for sublevel IIB was 0.5% (95% CI 0-1.3). CONCLUSIONS: The incidence of occult lymph node metastasis is higher in supraglottic and T3-4 tumors. Level I and V and sublevel IIB should not be routinely included in the elective neck treatment of cN0 laryngeal cancer and, in addition, level IV should not be routinely included in cases of supraglottic tumors.

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In Colombia, coffee growers use a traditional method of fermentation to remove the cherry pulp surrounding the beans. This process has a great influence on sensory quality and prestige of Colombian coffee in international markets, but has never been studied. Here we use an Illumina-based amplicon sequencing to investigate bacterial and fungal communities associated with spontaneous coffee-bean fermentation in Colombia. Microbial-derived metabolites were further analysed by high-performance liquid chromatography and gas chromatography-mass spectrometry. Highly diverse bacterial groups, comprising 160 genera belonging to 10 phyla, were found. Lactic acid bacteria (LAB), mainly represented by the genera Leuconostoc and Lactobacillus, showed relative prevalence over 60% at all sampling times. The structure of the fungal community was more homogeneous, with Pichia nakasei dominating throughout the fermentation process. Lactic acid and acetaldehyde were the major end-metabolites produced by LAB and Pichia, respectively. In addition, 20 volatile compounds were produced, comprising alcohols, organic acids, aldehydes, esters, terpenes, phenols, and hydrocarbons. Interestingly, 56 microbial genera, associated with native soil, seawater, plants, insects, and human contact, were detected for the first time in coffee fermentation. These microbial groups harbour a remarkable phenotypic diversity and may impart flavours that yield clues to the terroir of Colombian coffees.

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The effect of Micrurus mipartitus snake venom as a therapeutic alternative for T-acute lymphoblastic leukemia (ALL) is still unknown. This study was aimed to evaluate the cytotoxic effect of M. mipartitus snake venom and a new L-amino acid oxidase (LAAO), named MipLAAO, on human peripheral blood lymphocytes (PBL) and on T-ALL cells (Jurkat), and its mechanism of action. PBL and Jurkat cells were treated with venom and MipLAAO, and morphological changes in the cell nucleus/DNA, mitochondrial membrane potential, levels of intracellular reactive oxygen species and cellular apoptosis markers were determined by fluorescence microscopy, flow cytometry and pharmacological inhibition. Venom and MipLAAO induced apoptotic cell death in Jurkat cells, but not in PBL, in a dose-response manner. Additionally, venom and MipLAAO increased dichlorofluorescein fluorescence intensity, indicative of H2O2 production, increased DJ-1 Cys106-sulfonate, as a marker of intracellular stress and induced the up-regulation of PUMA, p53 and phosphorylation of c-JUN. Additionally, it increased the expression of apoptotic CASPASE-3. In conclusion, M. mipartitus venom and MipLAAO selectively induces apoptosis in Jurkat cells through a H2O2-mediated signaling pathway dependent mostly on CASPASE-3 pathway. Our findings support the potential use of M. mipartitus snake venom compounds as a potential treatment for T-ALL.

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El objetivo de la presente investigación fue evaluar el valor nutrimental, actividad antioxidante e inhibición de la enzima α-glucosidasa de brownies libres de gluten enriquecidos principalmente con leguminosas. Los brownies fueron elaborados principalmente con leguminosas cocidas de frijol pinto (Phaseolus vulgaris L.), alubia chica (Phaseolus vulgaris L.), garbanzo (Cicer arietinum L.) o lenteja (Lens culinaris L.) (300 g de producto). Cada producto fue dividido en porciones de 100 g cada uno. Posteriormente, se determinó su composición nutrimental, y de los extractos etanólicos libres y ligados obtenidos, se evaluó el contenido de fenólicos totales, flavonoides, actividad antioxidante y el potencial inhibitorio de la enzima α-glucosidasa. Los brownies a base de leguminosas cocidas fueron significativamente mejores que los comerciales, y presentaron un contenido de proteínas entre 6.2 y 6.9%, 1.6-4.2% de lípidos, 1.2-5.8% de fibra dietaria soluble y 11.7-21.5% de fibra dietaria insoluble. Los productos presentaron en mayor proporción a los ácidos grasos linolénico y linoleico, además fueron ricos en minerales. El contenido de fenólicos totales, y flavonoides varió dependiendo de la leguminosa con la cual se desarrolló el producto, así como de la fracción que se evaluó. La actividad antioxidante total fue mayor en los brownies de alubia. La mayor inhibición de α-glucosidasa la presentaron los extractos de brownies elaborados a base de lenteja (fracción libre) y garbanzo (fracción ligada). Los brownies elaborados con lenteja fueron sensorialmente los más aceptados. La introducción de este tipo de productos promoverá un consumo nutritivo de alimentos por personas de diferentes edades y con efectos benéficos en la salud(AU)

The aim of the present study was to evaluate the nutritional value, antioxidant activity and inhibition of α-glucosidase enzyme of gluten-free brownies enriched mainly with legumes. The brownies were elaborated mainly with cooked legumes of pinto (Phaseolus vulgaris L.), haricot bean (Phaseolus vulgaris L.), chickpea (Cicer arietinum L.) or lentils (Lens culinaris L.) (300 g of product). Each product was divided into portions of 100 g and the chemical and nutritive composition were determined. From the free and bound ethanolic extracts obtained, the content of total phenolics, flavonoids, antioxidant activity and the potential inhibitor of the α-glucosidase enzyme were evaluated. Brownies based on cooked legumes were significantly better than commercial brownies, with a protein content between 6.2 and 6.8%, 1.6-4.2% lipids, 1.2-5.8% soluble dietary fiber and 11.7-21.5% insoluble dietary fiber. The products had a higher proportion of linolenic and linoleic fatty acids, and they were rich in minerals. The content of total phenolics and flavonoids varied depending on the legume as well as the fraction that was evaluated. Total antioxidant activity was higher in haricot bean-brownies. The highest inhibition of α-glucosidase was detected in extracts obtained from lentil (free fraction) and chickpea (bound fraction) brownies. Brownies based on lentil were the most accepted in the sensory test. The introduction of this type of products promotes a nutritious consumption of foods by people of different ages with beneficial effects on health(AU)

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Metarhizium rileyi (Farlow) Samson is an important entomopathogenic fungus of more than 30 species of Lepidoptera larvae. The aim of this research was to characterize isolate of M. rileyi from Quivicán, Cuba on the basis of morphological and molecular approaches. The fungus was isolated from samples of S. frugiperda larvae collected from maize fields of Quivicán municipality, Mayabeque province, Cuba, and it was cultured on PDA + Ampicillin solid media for morphological characterization. The DNA was isolated using CTAB method and internal transcribed spacer (ITS1, ITS4) were used as the primers for the amplification. The amplified products of 1335 bp were purified and sequenced at CINVESTAV-IPN in both the directions using the above primers. A consensus sequence was obtained by alignment of the forward and reverse sequences for this region and deposited in GenBank (MG637450). The fungus produced slightly cottony colony of pale green color and dispersed conidia and septal mycelium were observed under the optical microscope. A BLAST search of the sequence in GenBank revealed a 99% of identity with several strains of N. rileyi (e.g., AF368501.1, AB268359.1 and EU553337.1) and M. rileyi (e.g., KY436756.1). This is the first report of M. rileyi isolate from maize fields of Quivicán in Cuba and this is important for biodiversity studies and is another possibility for Integrated Pest Management.

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Itaconic acid is a promising chemical that has a wide range of applications and can be obtained in large scale using fermentation processes. One of the most important uses of this biomonomer is the environmentally sustainable production of biopolymers. Separation of itaconic acid from the fermented broth has a considerable impact in the total production cost. Therefore, optimization and high efficiency downstream processes are technological challenges to make biorefineries sustainable and economically viable. This review describes the current state of the art in recovery and purification for itaconic acid production via bioprocesses. Previous studies on the separation of itaconic acid relying on operations such as crystallization, precipitation, extraction, electrodialysis, diafiltration, pertraction, and adsorption. Although crystallization is a typical method of itaconic acid separation from fermented broth, other methods such as membrane separation and reactive extraction are promising as a recovery steps coupled to the fermentation, potentially enhancing the overall process yield. Another approach is adsorption in fixed bed columns, which efficiently separates itaconic acid. Despite recent advances in separation and recovery methods, there is still space for improvement in IA recovery and purification.

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The oil palm empty fruit bunches (EFB) are an attractive source of carbon for the production of biochemical products, therefore, the aim of this work is to analyze the effect of the steam explosion (SE) pretreatment under autocatalytic conditions on EFB using a full experimental design. Temperature and reaction time were the operational variables studied. The EFB treated at 195°C for 6 min showed an increase of 34.69% in glycan (mostly cellulose), and a reduction of 68.12% in hemicelluloses, with increased enzymatic digestibility to 33% producing 4.2 g L(-1) of glucose. Scanning electron micrographs of the steam treated EFB exhibited surface erosion and an increased fiber porosity. Fourier transform infrared spectroscopy showed the solubilization of hemicellulose and modification of cellulose in treated EFB.

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Lignin is an important raw material for the sustainable biorefineries and also the forerunner of high-value added products, such as biocomposite for chemical, pharmaceutical and cement industries. Oil palm empty fruit bunches (OPEFB) were used for lignin preparation by successive treatment with 1% (w/w) H2SO4 at 121°C for 60 min and 2.5% NaOH at 121°C for 80 min resulting in the high lignin yield of 28.89%, corresponding to 68.82% of the original lignin. The lignin obtained was characterized by gel permeation chromatography (GPC), Fourier transform infrared spectroscopy (FTIR) and nuclear magnetic resonance (NMR). The results indicated a lignin with molecular masses ramping from 4500 kDa to 12,580 kDa. FTIR and NMR of these lignins showed more syringyl and p-hydroxyphenyl than guaiacyl units. Moderate acid/alkaline treatment provided lignin with high industrial potential and acid hydrolyzates rich in fermentable sugars and highly porous cellulosic fibers.

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El síndrome de Treacher Collins es también conocido como síndrome de Berry-Franceschetti-Klein o Franceschetti-Zwahlen-Klein. Disostosis mandibulofacial o síndrome del primer arco, se corresponde con un desorden autosómico dominante del desarrollo craneofacial, y puede mostrar innumerables manifestaciones clínicas. En el caso presentado se pudieron observar múltiples malformaciones craneofaciales así como una severa escoliosis, atresia del conducto auditivo externo, papilomas preauriculares bilaterales y polidactilia preaxial en la mano derecha.

Treacher-Collin syndrome, also known as Berry-Franceschetti-Klein or Franceschetti-Zwahlen-Klein, mandibulo-facial dysostosis or first arc syndrome, is a dominant autosomic disorder of the craniofacial development and may have innumerous clinical manifestations. In the case we present with this syndrome, we observed multiple craniofacial malformations, and also a severe scoliosis, external auditive duct atresia, bilateral preauricular papilomas and right hand pre axial polydactilia.

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Among patients with head and neck squamous cell carcinoma with a negative neck who are initially treated with (chemo)radiotherapy, a number of cases will recur locally without obvious neck recurrence. There is little information available as to the most efficacious management of the neck in these cases. We have reviewed the literature to see what conclusions can be drawn from previous reports. We conducted a bibliography search on MEDLINE and EMBASE databases. Studies published in the English language and those on squamous cell carcinoma of the oral cavity, nasopharynx, oropharynx, larynx and hypopharynx were included. Data related to neck management were extracted from the articles. Twelve studies satisfied the inclusion criteria. Five studies reported only one treatment plan (either neck dissection or observation), while the others compared neck dissection to observation. The rate of occult metastases ranged from 3.4 to 12 %. The studies included a variable distribution of primary sites and stages of the recurrent primary tumors. The risk of occult neck node metastasis in a clinically rN0 patient correlated with tumor site and T stage. Observation of the neck can be suggested for patients with T1-2 glottic tumors, who recurred with less advanced tumors (rT1-2). For patients with more advanced laryngeal recurrences or recurrence at other high-risk sites, neck dissection could be considered for the rN0 patient, particularly if the neck was not included in the previous radiation fields.

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