Green Synthesis for Carbon Quantum Dots via Opuntia ficus-indica and Agave maximiliana: Surface-Enhanced Raman Scattering Sensing Applications.

In this study, we present an alternative method for synthesizing carbon quantum dots (CQDs) using a green synthesis approach via extracts from Agave maximiliana and Opuntia ficus-indica(Ofi). The extracts from both plants were used as the carbon source for the CQDs. The synthesis method employs mesoporous zeolite 4A as a refractory for the thermal treatment of the samples. Transmission electron microscopy analysis established that the size of the CQDs shows a narrow distribution centered around 2 nm with a maximum size of less than 3 nm for both cases. The CQDs exhibit absorption bands associated with π-π* transitions located around 220 nm. In both cases, photoluminescence (PL) phenomenon was detected by irradiating the samples with a UV wavelength and detecting emissions close to the blue wavelength. Additionally, both kinds of CQDs were tested as surface-enhanced Raman scattering (SERS) substrates against methylene blue (MB), indicating an enhancement associated with ring deformation and stretching modes of the v(C-C) and v(C-N) bonds located around 1400 and 1620 cm-1, respectively. Complementarily, in the framework of density functional theory, H2nC2(2m+1) structures (with n = 3-5 and m = 1-3) were used as a theoretical representation of CQDs in interaction with the MB molecule. It is used for developing the analysis of charge transfer effects between both systems and for specifying elements that generate the SERS effect associated with the chemical enhancement mechanism.

Impact of Delivering a Healthy Lifestyle Intervention: Promotora Findings from Familias Sanas y Activas II.

Background: Community health workers, promotoras, have been identified as effective change agents of their community members' health behaviors and health status. However, few studies have examined the effects of delivering an intervention on the promotoras themselves. Objectives: This study assessed whether promotoras delivering a healthy lifestyle intervention for adults improved their health behaviors and health status from baseline to 6- and 12-months post-baseline. Methods: Volunteer promotoras were trained to promote healthy lifestyles including physical activity through workshops and free group exercise classes throughout their communities. Twenty completed all required trainings and delivered at least one class during the period between baseline and 12-month assessments. The promotoras were measured on the following variables: Systolic and diastolic blood pressure, waist circumference, weight, and height. Additionally, they reported their health behaviors and status including moderate-to-vigorous physical activity, beverage consumption, sleep duration, and depressive symptoms. Results: Repeated measures ANOVAs showed statistically significant decreases from baseline to 6 months for systolic blood pressure (p ≤ 0.05), diastolic blood pressure (p ≤ 0.001) and body mass index (p ≤ 0.05). Changes in self-reported measures were not statistically significant although trends were observed with increases in water consumption. Conclusions: Findings from this study suggest positive effects associated with delivery of a PA intervention. This is one of the first studies to focus on a cohort of promotoras to examine health outcomes from delivering a healthy lifestyle intervention. It is important to further explore these impacts on the community health workers as they have become increasingly essential to the health of some communities.

Facilitators of peer leader retention within a Type 2 diabetes intervention trial for US Latinos/Hispanics of Mexican origin.

Peer support is effective in improving self-management behaviors and health outcomes among individuals with Type 2 diabetes. Volunteer peer support programs offer a cost-effective resource for diabetes self-management support; however, factors affecting the retention of volunteer peer leaders remain understudied. Herein, we examined factors associated with volunteer retention and satisfaction among 34 predominantly Mexican-origin peer leaders who assisted patients from a Federally Qualified Health Center located on the US/Mexico border with their diabetes management. Peer leaders completed surveys with open- and close-ended questions at baseline, 6 months and 12 months. Quantitative and qualitative data analyses were guided by the Volunteer Process Model. Using nonparametric Mann-Whitney U tests, self-efficacy as a peer leader at 6 months was most associated with interest to continue volunteering (P = 0.01), and satisfaction with support from the program at 12 months was most associated with interest to continue volunteering (P = 0.01). The qualitative data indicated that the relationship between the peer leaders and their patients was the primary factor for a satisfying volunteer experience. Future research should focus on increasing peer leaders' self-efficacy and satisfaction with program support and examine how organizations can support the development of the patient-peer relationship. Practitioners should consider appealing to volunteer peers' motivations to promote their retention.

Bending forces and nucleotide state jointly regulate F-actin structure.

ATP-hydrolysis-coupled actin polymerization is a fundamental mechanism of cellular force generation1-3. In turn, force4,5 and actin filament (F-actin) nucleotide state6 regulate actin dynamics by tuning F-actin's engagement of actin-binding proteins through mechanisms that are unclear. Here we show that the nucleotide state of actin modulates F-actin structural transitions evoked by bending forces. Cryo-electron microscopy structures of ADP-F-actin and ADP-Pi-F-actin with sufficient resolution to visualize bound solvent reveal intersubunit interfaces bridged by water molecules that could mediate filament lattice flexibility. Despite extensive ordered solvent differences in the nucleotide cleft, these structures feature nearly identical lattices and essentially indistinguishable protein backbone conformations that are unlikely to be discriminable by actin-binding proteins. We next introduce a machine-learning-enabled pipeline for reconstructing bent filaments, enabling us to visualize both continuous structural variability and side-chain-level detail. Bent F-actin structures reveal rearrangements at intersubunit interfaces characterized by substantial alterations of helical twist and deformations in individual protomers, transitions that are distinct in ADP-F-actin and ADP-Pi-F-actin. This suggests that phosphate rigidifies actin subunits to alter the bending structural landscape of F-actin. As bending forces evoke nucleotide-state dependent conformational transitions of sufficient magnitude to be detected by actin-binding proteins, we propose that actin nucleotide state can serve as a co-regulator of F-actin mechanical regulation.

Trace metals and metalloids in Andean flamingos (Phoenicoparrus andinus) and Puna flamingos (P. jamesi) at two wetlands with different risk of exposure in the Bolivian Altiplano.

Birds are widely used as bioindicators in monitoring programs in wetlands. We compare concentrations of seven trace metals and metalloids (TMM) As, Cd, Cu, Fe, Hg, Pb, Znin both feathers and blood in two flamingo species in two high-altitude wetlands in Bolivia, with different levels of anthropogenic point source pollution. Lake Uru Uru (LUU) receives discharges from mining operations, and also effluents from the nearby city of Oruro, while Laguna Colorada (LCo) does not receive contaminants from anthropogenic sources. We sampled water and sediments at each site, as well as flamingos in three age classes in an effort to establish a benchmark for long-term monitoring. Metal concentrations in water did not differ between sites, whereas Zn and Pb concentrations of TMM in sediments were higher at LUU, and Hg higher at LCo. TMM concentrations were highly specific for all separate elements, but results point to differences between Andean flamingo (Phoenicoparrus andinus) chicks and the rest of the classes considered. As flamingo chicks did not molt before sampling, we pose that TMM concentrations in their blood and feathers may respond mainly to local conditions. Eggshells provide additional information, since adults transfer some TMM during egg development. Long-term monitoring in these species should include different age classes and sample both feathers and eggshells to monitor the environmental conditions and bioaccumulation of TMM in these species. Future studies should include sites devoid of natural sources of TMM to help distinguish sources of contamination, since some TMM (As and Pb) may be naturally in high concentrations in remote areas, like Laguna Colorada.

PEG-crosslinked-chitosan hydrogel films for in situ delivery of Opuntia ficus-indica extract.

In the present study, chitosan-based wound dressings loaded with the extract of Opuntia ficus-indica (OPU) were prepared. OPU is known for its capability to accelerate skin injury repair. Chitosan (Ch) was crosslinked with a low molecular weight diepoxy-poly(ethylene glycol) (diePEG), and hydrogel films with different Ch/PEG composition and OPU content were prepared by casting. The occurrence of crosslinking reaction was confirmed by FTIR spectroscopy. FTIR and DSC analysis suggested that ionic interactions occur between chitosan and OPU. Tensile tests evidenced that the crosslinking caused a decrease of Young's modulus, which approaches the value of the human skin modulus. Swelling characteristics, water vapor transmission rate, and release kinetics demonstrated that these films are adequate for the proposed application. Finally, a scratch test on a keratinocytes monolayer showed that the rate of cell migration in the presence of OPU-loaded samples is about 3-fold higher compared to unloaded films, confirming the repairing activity of OPU.

Narrow-Spectrum Antibiotic Targeting of the Radical SAM Enzyme MqnE in Menaquinone Biosynthesis.

Antibiotic resistance continues to spread at an alarming rate, outpacing the introduction of new therapeutics and threatening to globally undermine health care. There is a crucial need for new strategies that selectively target specific pathogens while leaving the majority of the microbiome untouched, thus averting the debilitating and sometimes fatal occurrences of opportunistic infections. To address these challenges, we have adopted a unique strategy that focuses on oxygen-sensitive proteins, an untapped set of therapeutic targets. MqnE is a member of the radical S-adenosyl-l-methionine (RS) superfamily, all of which rely on an oxygen-sensitive [4Fe-4S] cluster for catalytic activity. MqnE catalyzes the conversion of didehydrochorismate to aminofutalosine in the essential menaquinone biosynthetic pathway present in a limited set of species, including the gut pathogen Helicobacter pylori (Hp), making it an attractive target for narrow-spectrum antibiotic development. Indeed, we show that MqnE is inhibited by the mechanism-derived 2-fluoro analogue of didehydrochorismate (2F-DHC) due to accumulation of a radical intermediate under turnover conditions. Structures of MqnE in the apo and product-bound states afford insight into its catalytic mechanism, and electron paramagnetic resonance approaches provide direct spectroscopic evidence consistent with the predicted structure of the radical intermediate. In addition, we demonstrate the essentiality of the menaquinone biosynthetic pathway and unambiguously validate 2F-DHC as a selective inhibitor of Hp growth that exclusively targets MqnE. These data provide the foundation for designing effective Hp therapies and demonstrate proof of principle that radical SAM proteins can be effectively leveraged as therapeutic targets.

EPDR1 up-regulation in human colorectal cancer is related to staging and favours cell proliferation and invasiveness.

The finding of novel molecular markers for prediction or prognosis of invasiveness in colorectal cancer (CRC) constitutes an appealing challenge. Here we show the up-regulation of EPDR1 in a prospective cohort of 101 CRC patients, in a cDNA array of 43 patients and in in silico analyses. EPDR1 encodes a protein related to ependymins, a family of glycoproteins involved in intercellular contacts. A thorough statistical model allowed us to conclude that the gene is significantly up-regulated in tumour tissues when compared with normal mucosa. These results agree with those obtained by the analysis of three publicly available databases. EPDR1 up-regulation correlates with the TNM staging parameters, especially T and M. Studies with CRC cell lines revealed that the methylation of a CpG island controls EPDR1 expression. siRNA knocking-down and overexpression of the gene following transient plasmid transfection, showed that EPDR1 favours cell proliferation, migration, invasiveness and adhesion to type I collagen fibres, suggesting a role in epithelial to mesenchymal transition. Both statistical and functional analysis correlated EPDR1 overexpression with invasiveness and dissemination of tumour cells, supporting the inclusion of EPDR1 in panels of genes used to improve molecular subtyping of CRC. Eventually, EPDR1 may be an actionable target.

A randomized controlled trial to prevent obesity among Latino paediatric patients.

BACKGROUND: Obesity disproportionately affects Latino youth. Community clinics are an important resource, yet there is little evidence for the efficacy of clinic-based approaches in this population. OBJECTIVE: The purpose of this study was to test the efficacy of a clinic-based intervention to lower body mass index (BMI) and improve body composition among overweight Latino children. METHODS: A randomized trial (2 group × 3 repeated measures) was conducted among 297 randomly sampled, overweight paediatric patients (5-10 years old) and their parents. The 12-month family-based culturally tailored behavioural intervention (Luces de Cambio) was based on the 'traffic light' concepts to address behaviour change and was delivered by clinic health educators and mid-level providers. The primary study outcome was child BMI (kg m-2 ) assessed at baseline, 6-month (n = 191) and 12-month (n = 201) post-baseline. A subsample of the children was examined for overall and site-specific adiposity using dual-energy X-ray absorptiometry (n = 79). RESULTS: There were no significant intervention effects on child BMI (p > 0.05); however, intervention children showed significantly (p < 0.05) lower total and trunk per cent fat compared with the usual care condition. CONCLUSIONS: The Luces intervention did not reduce child BMI, yet small but significant reductions were observed for child per cent body fat. Further research is needed to identify and reduce barriers to recruitment and participation among Latino families.

Lactato sérico como factor predictivo de mortalidad en pacientes con sangrado del tubo digestivo alto / Serum lactate as predictive factor of mortality in upper digestive tract bleeding

Resumen ANTECEDENTES: Según el reporte de Upper Gastrointestinal Bleeding de Gastroenterology Clinics of North America, en 2008 se registraron 863,000 admisiones hospitalarias por hemorragia gastrointestinal, con mortalidad reportada de 15 a 20%. En México la mortalidad por sangrado del tubo digestivo alto es de 8.5%, pero aumenta hasta 63% cuando coexiste con otras enfermedades. El lactato se ha validado para el pronóstico de mortalidad en distintas áreas. OBJETIVO: Determinar la utilidad del lactato como pronóstico de mortalidad en pacientes con sangrado del tubo digestivo alto. MATERIAL Y MÉTODO: Estudio de cohorte retrospectivo, ambilectivo, observacional, analítico y unicéntrico, en el que de 2015 a 2016 se midió el lactato de pacientes admitidos por sangrado del tubo digestivo alto al momento del ingreso a la sala de urgencias del Hospital General Xoco, Ciudad de México; posteriormente se correlacionó con el diagnóstico de egreso, se buscó correlación entre sangrado del tubo digestivo alto y egreso por defunción. Se evaluaron como objetivos secundarios la relación entre lactato y hemoderivados transfundidos. RESULTADOS: Se incluyeron 30 pacientes. La media de lactato en hombres fue de 5.33 ± 0.53 mmol/L y en mujeres fue de 1.2 ± 3.84 mmol/L con p < 0.01. El tiempo de hospitalización fue de 6.43 ± 5.13 días. El análisis de supervivencia tomó como referencia la media de lactato de 4.78; 29 pacientes egresaron por mejoría, mientras que un paciente falleció sin encontrar relación entre las concentraciones de lactato y defunción como diagnóstico de egreso; sin embargo, no encontramos relación estadísticamente significativa. CONCLUSIONES: Tras realizar el análisis de nuestra población no encontramos una relación estadísticamente significativa entre las concentraciones de lactato a 4.78 mmol/L y la mortalidad. Se buscó también asociación entre las concentraciones de lactato y las complicaciones durante el internamiento; sin embargo, esto tampoco tuvo relación significativa. A pesar de los resultados obtenidos, consideramos que es necesario replantear el estudio con un enfoque distinto ajustando las características de población y el tamaño de la misma con el fin de aportar datos definitivos respecto a este biomarcador.

Abstract BACKGROUND: According to Upper Gastrointestinal Bleeding of Gastroenterology Clinics of North America, in 2008 there were 863,000 hospital admissions for gastrointestinal bleeding, with reported mortality of 15-20%. In Mexico, mortality from upper digestive tract bleeding represents 8.5%, but increases up to 63% when it coexists with other diseases. Lactate has been validated for the prognosis of mortality in different areas. OBJECTIVE: To determine the usefulness of lactate as prognosis factor of mortality in upper digestive tract bleeding. MATERIAL AND METHOD: A retrospective, ambilective, observational, analytical and unicenter cohort study was done measuring lactate in patients admitted for upper digestive tract bleeding at admission to the emergency room of Hospital General Xoco, Mexico City, from 2015 to 2016 later it was correlated with the diagnosis of discharge, seeking a correlation between upper digestive tract bleeding and discharge due to death. Lactate ratio and blood products transfused were evaluated as secondary objectives. RESULTS: There were included 30 patients. The mean lactate in men was 5.33 ± 0.53 mmol/L and in women were 1.2 ± 3.84 mmol/L with a p < 0.01. The hospitalization time was 6.43 ± 5.13 days. The survival analysis was based on the mean lactate of 4.78; 29 patients graduated for improvement, while one patient died without finding a relation between lactate and death levels as a diagnosis of discharge; however, we did not find statistically significant relationship. CONCLUSION: After analyzing our population we did not find a statistically significant relation between lactate levels at 4.78 mmol/L and mortality. We also looked for an association between lactate levels and complications during hospitalization; however, this either had significant relation. Despite of the obtained results, it is necessary to reconsider the study with a different approach adjusting the population characteristics and its size in order to obtain definitive data about this biomarker.

Eficacia de la profilaxis con haloperidol vs placebo en la prevención de delirio en pacientes con alto riesgo de padecerlo hospitalizados en el servicio de Medicina Interna / Efficacy of prophylaxis with haloperidol vs placebo in the prevention of delirium in patients with risk of suffering it hospitalized in an Internal Medicine service

Resumen ANTECEDENTES: el delirio es un síndrome clínico transitorio y reversible, ocurre frecuentemente en el marco de un proceso de enfermedad aguda, se caracteriza por la alteración de la conciencia que se acompaña de un cambio en las funciones cognoscitivas, sobreviene a lo largo de un breve periodo, habitualmente horas o días, y tiende a fluctuar a lo largo del día. El delirio constituye un problema de salud pública importante, se considera predictor independiente de resultados clínicos negativos con incremento de la mortalidad, la estancia hospitalaria, el costo de la atención y el deterioro cognitivo a largo plazo. La evidencia disponible no apoya la administración de medicamentos para prevenir el delirio en el paciente con enfermedad aguda. OBJETIVO: comprobar la seguridad y eficacia de haloperidol para el tratamiento y profilaxis del delirio. MATERIAL Y MÉTODO: ensayo clínico controlado, prospectivo, transversal, comparativo, en el que se estudiaron pacientes hospitalizados en el servicio de Medicina Interna del Hospital General Xoco de la Secretaría de Salud de la Ciudad de México, se calculó la escala PREDELIRIC al ingreso de los pacientes; se incluyeron en el estudio los pacientes con riesgo alto de delirio (PREDELIRIC >50%). Los pacientes se distribuyeron al azar en dos grupos, en el grupo 1 se aplicaron medidas no farmacológicas de prevención de delirio más la administración de haloperidol profiláctico y el grupo 2 recibió medidas no farmacológicas de prevención de delirio más placebo. RESULTADOS: se incluyeron 84 pacientes, distribuidos en dos grupos, cada uno con 42 pacientes, de los que 33 (40%) eran hombres. El 42% padeció delirio, el tipo mixto fue el más común. La profilaxis con haloperidol no demostró disminuir la incidencia de delirio (54 vs 46%, p=0.51) en comparación con el grupo control. El haloperidol profiláctico no ofreció diferencias significativas comparado con placebo en retrasar el inicio del delirio (media de 6.3 vs 6.8 días, p=0.98), en los días de estancia hospitalaria (mediana 9.5 vs 12 días, p=0.56) o en la duración del delirio (media 3 vs 3.5 días, p=0.32); tampoco tuvo efecto en la mortalidad (20 vs 10%, p=0.21). No se informaron efectos secundarios con la administración de haloperidol. CONCLUSIONES: la administración de haloperidol para la prevención del delirio en pacientes con riesgo alto de padecerlo no demostró diferencia significativa en comparación con el placebo en disminuir la incidencia de delirio, en retrasar el inicio de los síntomas, en la reducción de su duración, en reducir los días de estancia hospitalaria ni en la mortalidad. De acuerdo con nuestros resultados, por el momento no es posible recomendar la administracion de haloperidol en la profilaxis de delirio en pacientes con riesgo alto de padecerlo.

Abstract BACKGROUND: Delirium is a clinical transitory and reversible syndrome, occurs frequently in a setting of an acute disease process, it is characterized by the disorder of the consciousness accompanied by a change in the cognitive functions, it occurs throughout a brief period, usually hours or days and tends to vary during the day. Delirium is an important public health problem and it is considered independent predictor of negative clinical results with increased mortality, hospital stay, attention cost and cognitive damage to long-term. The available evidence does not support the administration of drugs to prevent delirium in patients with acute disease. OBJECTIVE: To prove the safety and efficacy of haloperidol for the treatment and prophylaxis of delirium. MATERIAL AND METHOD: A clinical, controlled, prospective, cross-sectional, comparative study was done, in which patients hospitalized at Internal Medicine service of General Hospital Xoco, Mexico City, were included. Scale PREDELIRIC was calculated at the entering of patients, including in the study those with high risk of delirium (PRE-DELIRIC >50%). Patients were randomly distributed into two groups, in the group 1 non pharmacological measures of delirium prevention were applied plus the administration of prophylactic haloperidol and group 2 was given non pharmacological measures of delirium prevention plus placebo. RESULTS: There were included 84 patients, distributed into two groups, each one with 42 patients, from which 33 (40%) were male; 42% suffer delirium, mix type was the most common. Prophylaxis with haloperidol did not show to reduce the incidence of delirium (54% vs 46%, p=0.51) compared with control group. Prophylactic haloperidol did not show significant differences compared to placebo in delaying the beginning of delirium (mean of 6.3 days vs 6.8 days, p=0.98), in days of hospital stay (mean 9.5 vs 12 days, p=0.56), or in the lasting of delirium (mean 3 vs 3.5 days, p=0.32). Prophylaxis with haloperidol did not show either effect on mortality (20% vs 10%, p=0.21). There were not secondary effects with haloperidol. CONCLUSIONS: Haloperidol administration to prevent delirium in patients with high risk of having it did not show significant difference compared to placebo in reducing delirium incidence, delaying the starting of symptoms, in reducing their lasting, in reducing the hospital stay nor in reducing mortality. According to our results, by now it is not possible to recommend the administration of haloperidol in the prophylaxis of delirium in patients with high risk of having it.

Diferencias en las concentraciones de ácido úrico en pacientes hipertensos, normotensos y prehipertensos / Differences in levels of uric acid in hypertensive, normotensive and prehypertensive patients

Resumen ANTECEDENTES: la prehipertensión es una condición que aumenta el riesgo de padecer hipertensión arterial. Las concentraciones séricas elevadas de ácido úrico se asocian con hipertensión arterial y dificultan su control. OBJETIVO: evaluar las concentraciones circulantes de ácido úrico en pacientes prehipertensos en comparación con las de sujetos normotensos e hipertensos. MATERIAL Y MÉTODO: estudio clínico transversal en el que de enero a junio de 2016 las concentraciones séricas de ácido úrico se determinaron por método enzimático en pacientes con prehipertensión (de acuerdo con los criterios del JNC VII), así como en sujetos normotensos y sujetos hipertensos. Los métodos estadísticos usados fueron ANOVA y prueba exacta de Fisher. RESULTADOS: se incluyeron 90 pacientes con prehipertensión, 90 sujetos normotensos y 90 sujetos hipertensos. Encontramos que el grupo de prehipertensos tuvo valores significativamente mayores de ácido úrico que los normotensos (6.24±1.5 mg/dL vs 5.4±1.2 mg/dL, p=0.000206), mientras que aunque los valores en hipertensos fueron superiores (6.7±2 mg/dL), no alcanzaron significación estadística con los prehipertensos (p=0.99). Encontramos asociación significativa entre hiperuricemia con prehipertensión (p=0.015 IC 95%; 1.18-3.99). CONCLUSIONES: los pacientes prehipertensos mostraron concentraciones de ácido úrico superiores a las de los normotensos y aunque los valores mencionados fueron menores que en los hipertensos, esto no fue significativo. La hiperuricemia puede contribuir, al menos en parte, a mayor progresión hacia hipertensión arterial observada en los prehipertensos.

Abstract BACKGROUND: Prehypertension increases the risk of hypertension, serum uric acid levels are also associated with increased risk of hypertension. Increased levels of resistin and/or decreased levels of adiponectin are associated with cardiovascular mortality and the development of hypertension. OBJECTIVE: To evaluate uric acid serum levels in normotensive, prehypertensive and hypertensive patients. MATERIAL AND METHOD: A clinical, cross-sectional study was made from January to June 2016 in which circulating levels of uric acid were measured (enzymatic method) in normotensive, prehypertensive and hypertensive patients. Statistical analysis was performed with ANOVA and Fisher test. RESULTS: Ninety normotensive, 90 prehypertensive and 90 hypertensive patients were included. Prehypertensive patients have significantly greater levels of uric acid than normotensive subjects (6.24±1.5 mg/dL vs 5.4±1.2 mg/dL, p=0.000206). We also observed that hypertensive patients had increased, although non-significantly, values of uric acid than prehypertensive subjects (6.7±2 mg/dL, p=0.99). We also found a significantly association between hyperuricemia and prehypertension (p=0.015 IC 95%; 1.18-3.99). CONCLUSIONS: Prehypertensive patients had greater levels of uric acid when compared with normotensive subjects, this may explain why prehypertensive patients shown increased risk for hypertension than normotensive patients.

Interactions between individual and perceived environmental factors on Latinas' physical activity.

Background: Latinas have disproportionately low levels of physical activity (PA) and the ecological correlates of their PA remain unclear. This study aims to test interactions between individual and environmental factors on Latinas' PA. Methods: We analyzed baseline data from 436 Latinas participating in a PA randomized controlled trial in San Diego, CA [Fe en Acción/Faith in Action]. Measures included demographics, perceived environment, PA and anthropometrics. Mixed effects models examined interactions between individual and environmental factors on self-reported leisure-time and transportation, and accelerometer-assessed PA. Results: Significant positive associations were found between neighborhood aesthetics and leisure-time moderate-to-vigorous PA (MVPA) and between having destinations within walking distance from home and transportation PA (P < 0.05). We found significant interactions of income with aesthetics and sidewalk maintenance as well as between weight status and safety from crime. Favorable aesthetics was related to more leisure-time MVPA only among lower income women (odds ratio (OR) = 1.57; 95% confidence interval (CI): 1.18, 2.08); however, higher income women reporting better sidewalk maintenance reported more leisure-time MVPA (OR = 1.51; 95% CI: 1.06, 2.15). Higher perceived safety from crime was positively related to transportation PA only among overweight/obese women. Conclusions: Subgroup differences should be considered when developing interventions targeting the neighborhood environment to promote Latinas' PA.

Does the social environment moderate associations of the built environment with Latinas' objectively-measured neighborhood outdoor physical activity?

Favorable perceptions of the built and social neighborhood environment may promote outdoor physical activity (PA). However, little is known about their independent and interactive effects on neighborhood-specific outdoor PA. We examined associations of perceived built and social neighborhood environment factors, and their interactions, with objectively-measured neighborhood outdoor moderate-to-vigorous physical activity (MVPA) among a sample of Latina women in San Diego, CA. Analyses included baseline data collected in 2011-2013 from 86 Latinas with ≥ 2 days of combined accelerometer and global positioning system data and complete survey measures. We examined objective neighborhood outdoor MVPA within 500-meter home buffers. Generalized linear mixed models examined associations of 3 perceived built (e.g., sidewalk maintenance) and 3 social environmental (e.g., safety from crime) factors with engaging in any daily neighborhood outdoor MVPA. Models tested interactions between the built and social environmental factors. Although the perceived neighborhood environmental factors were not significantly related to daily neighborhood outdoor MVPA, we found 2 significant interactions: perceived sidewalk maintenance x safety from crime (p = 0.05) and neighborhood aesthetics x neighborhood social cohesion (p = 0.03). Sidewalk maintenance was positively related to daily neighborhood outdoor MVPA only among Latinas that reported low levels of safety from crime. Neighborhood aesthetics was positively related to daily neighborhood outdoor MVPA only among Latinas with high neighborhood social cohesion. Findings suggest several built and social environmental factors interact to influence Latinas' neighborhood outdoor MVPA. Interventions are needed targeting both built and social neighborhood environmental factors favorable to outdoor PA in the neighborhood.

Circulating Adipokine Levels in Non-diabetic Subjects with High Normal Blood Pressure.

OBJECTIVE: This study aimed to evaluate the levels of the adipokines, resistin and adiponectin in normotensive and high normal blood pressure patients. METHODS: Circulating levels of the adipokines, resistin and adiponectin were measured by enzyme-linked immunosorbent assay (ELISA; R'D Systems, Minneapolis) in 20 high normal blood pressure patients and in 20 age-matched normotensive non-diabetic subjects. Statistical analysis was performed with analysis of variance (ANOVA). RESULTS: The control group showed non-significantly decreased levels of resistin when compared with patients with high normal blood pressure [systolic 130-139 mmHg; diastolic 85-89 mmHg] (12.25 vs 14.38 pg/mL, p = 0.40). There were significantly higher levels of adiponectin in the control group when compared with high normal blood pressure patients (11.3 vs 7.51 µg/mL, p = 0.028). CONCLUSIONS: High normal blood pressure patients have increased levels of resistin and lower values of adiponectin when compared with age-matched non-diabetic normotensive subjects. This may explain why those patients showed more progression to hypertension, atherosclerosis and cardiovascular risk than normotensive subjects.

Análisis del nivel de ansiedad en el paciente adulto con cardiopatía congénita en una institución de alta especialidad / Analysis of the anxiety level in adult patients with congenital heart disease in a highly specialized institution", "_i": "

Introducción: Gracias a los adelantos científico-tecnológicos, cada vez son más las personas con algún tipo de cardiopatía congénita que alcanzan la edad adulta, sin embargo, esta condición supone un impacto significativo en la esfera emocional; por ello, en el presente estudio se hace referencia a la ansiedad. Objetivo: Analizar el nivel de ansiedad que presentan los pacientes adultos con cardiopatía congénita en una institución de alta especialidad. Material y métodos: Estudio no experimental, analítico, prospectivo y transversal. Se aplicó previo consentimiento informado, un instrumento validado sobre ansiedad State and Trait Anxiety Inventory. Se determinó una muestra estadística aleatorizada simple (n = 248) con personas mayores de 17 años que tuvieran cardiopatía congénita cianógena o acianógena. Se analizaron los datos sociodemográficos con frecuencias, porcentajes y medidas de tendencia central; se compararon y asociaron variables ordinales con U de Mann Whitney, Pearson y Spearman; se aceptó como significativa p ‹ 0.05. Resultados: Edad media de 26.9 años; 71.4% tienen CC acianógena; a 50% le han realizado cirugía cardiaca; 74% tuvo nivel medio de ansiedad. Existe asociación directa entre ansiedad y escolaridad (rs = -0.163, p = 0.010). Comparación de ansiedad entre cianógena y acianógena (Z = -0.590, p = 0.555), entre mujeres y hombres (Z = -2.603, p = 0.009). Conclusiones: A pesar de que no existe diferencia entre las personas con cardiopatía cianógena y acianógena, la ansiedad está presente con mayores niveles en las mujeres.

Introduction: Thanks to scientific and technological advances, more and more people with some type of congenital heart disease reach adulthood, however, this condition has a significant impact on the emotional sphere. Therefore, in the present study anxiety reference is made. Objective: To analyze the level of anxiety that present adult patients with congenital heart disease in a highly specialized institution. Material and methods: Non-experimental, analytical, prospective cross-sectional study. A validated instrument on State and Trait Anxiety Inventory was applied previous informed consent. A simple random statistical sample (n = 248) in people over 17 who have cyanotic congenital heart disease or acianogena was determined. Sociodemographic data frequencies, percentages and measures of central tendency were analyzed; were compared and ordinal variables associated with a U of Mann Whitney, Pearson and Spearman; was accepted as significant p ‹ 0.05. Results: Mean age of 26.9 years; 71.4% had cyanotic CC; 50% have undergone cardiac surgery; 74% had medium level of anxiety. There is a direct association between anxiety and schooling (rs = -0.163, p = 0.010). Comparison between cyanotic and acyanotic anxiety (Z = -0.590, p = 0.555) between women and men (Z = -2.603, p = 0.009). Conclusions: Although there is no difference between people with a cyanotic and acyanotic heart disease, anxiety is present at higher levels in women

Childhood obesity prevention and control in city recreation centres and family homes: the MOVE/me Muevo Project.

BACKGROUND: Interventions to prevent and control childhood obesity have shown mixed results in terms of short- and long-term changes. OBJECTIVES: 'MOVE/me Muevo' was a 2-year family- and recreation centre-based randomized controlled trial to promote healthy eating and physical activity among 5- to 8-year-old children. It was hypothesized that children in the intervention group would demonstrate lower post-intervention body mass index (BMI) values and improved obesity-related behaviours compared with the control group children. METHODS: Thirty recreation centres in San Diego County, California, were randomized to an intervention or control condition. Five hundred forty-one families were enrolled and children's BMI, diet, physical activity and other health indicators were tracked from baseline to 2 years post-baseline. Analyses followed an intent-to-treat approach using mixed-effects models. RESULTS: No significant intervention effects were observed for the primary outcomes of child's or parent's BMI and child's waist circumference. Moderator analyses, however, showed that girls (but not boys) in the intervention condition reduced their BMI. At the 2-year follow-up, intervention condition parents reported that their children were consuming fewer high-fat foods and sugary beverages. CONCLUSIONS: Favourable implementation fidelity and high retention rates support the feasibility of this intervention in a large metropolitan area; however, interventions of greater intensity may be needed to achieve effects on child's BMI. Also, further research is needed to develop gender-specific intervention strategies so that both genders may benefit from such efforts.

Evaluation of the registration of temporal series of contrast-enhanced perfusion magnetic resonance 3D images of the liver.

The registration of 2D and 3D images is one of the key tasks in medical image processing and analysis. Accurate registration is a crucial preprocessing step for many tasks; consequently, the evaluation of its accuracy becomes necessary. Unfortunately, this is a difficult task, especially when no golden pattern (true result) is available and when the signal values may have changed between successive images to be registered. This is the case this paper deals with: we have a series of 3D images, magnetic resonance images (MRI) of the liver and adjacent areas that have to be registered. They have been taken while a contrast is diffused through the liver tissue, so intensity of each observed point changes for two reasons: contrast diffusion/perfusion and deformation of the liver (due to body movement and breathing). In this paper, we introduce a new method to automatically compare two or more registration algorithms applied to the same case of a perfusion magnetic resonance dynamic image so that the best of them can be chosen when no ground truth is available. This is done by modeling the function that gives the intensity at a given point as a functional datum, and using statistical techniques to assess its change in comparison with other functions. An example of the application is shown by comparing two parametrizations of a B-spline based registration algorithm. The main result of the proposed method is a suggestive evidence to guide the physician in the process of selecting a registration algorithm, that recommends the algorithm of minimal complexity but still suitable for the case to be analyzed.

Diagnósticos de enfermería más frecuentes por necesidad en la persona con afección cardiovascular / The most frequent nursing diagnoses by necessity in the person with cardiovascular disease", "_i": "

Introducción: Los diagnósticos de enfermería describen problemas de salud reales, potenciales o de bienestar, son un juicio clínico de la persona, familia o comunidad que se obtiene tras la valoración. Objetivo: Identificar los diagnósticos de enfermería más frecuentes por necesidad en la persona con afección cardiovascular. Material y métodos: Estudio descriptivo, transversal y prospectivo de octubre del 2007 a diciembre del 2008. Muestra por conveniencia de n = 667 valoraciones exhaustivas de enfermería cardiovascular con el enfoque de Virginia Henderson; incluyó valoraciones realizadas a las personas de todas las edades y hospitalizadas en el Instituto Nacional de Cardiología Ignacio Chávez y se eliminaron aquéllas donde no se registró el diagnóstico de enfermería o éste era ilegible. Análisis de datos en Excel 2003 con frecuencias y porcentajes. Resultados: Del total de valoraciones; 54% corresponden al sexo masculino. Necesidad alterada de mayor frecuencia: oxigenación con 68%. Se obtuvieron un total de 113 etiquetas diagnósticas, 81% pertenecen a la taxonomía Nursing Diagnosis: Definitions & Classification (NANDA) y 19% redactadas en formato: Problema, Etiología, Signos y Síntomas (PESS). De manera general, el insomnio, el riesgo de caída y el deterioro de la movilidad física son las etiquetas más frecuentes en el paciente cardiópata. Para la necesidad de oxigenación, las etiquetas más frecuentes son: patrón respiratorio ineficaz (35.7%) y deterioro del intercambio gaseoso (31.8%). Conclusión: Las etiquetas diagnósticas se encuentran directamente relacionadas con las manifestaciones clínicas cardiovasculares y son aplicables para el desarrollo de los planes de cuidado de enfermería. También existe una correspondencia directa de la entidad clínica cardiovascular con el deterioro de la necesidad de oxigenación y seguridad.

Introduction: Nursing diagnoses described problems of health, real, potential or welfare; a clinical trial of the person, family or community, which is obtained after the assessment they are. Objective: Identify the most frequent nursing diagnoses by necessity in the person with cardiovascular condition. Material and methods: descriptive, transversal and prospective study from October 2007 to December 2008. Sample for convenience of n = 667 comprehensive assessments of cardiovascular nursing Virginia Henderson approach; It included all assessment to people of all ages and hospitalized at the National Institute of Cardiology Ignacio Chavez and eliminated those where there was the nursing diagnosis or this was the unreadable. Data analysis in Excel 2003 with frequencies and percentages. Results: Of the total of valuations; 54% are male. Altered more often need: oxygenation with 68%. Were a total of 113 diagnostic labels, 81% belong to the taxonomy Nursing Diagnosis: Definitions & Classification (NANDA) and 19% in format: problem, etiology, signs and symptoms. In general, the insomnia, the risk of falling and the deterioration of physical mobility are more common in the patient with cardiovascular alteration labels. For the need of oxygen, most frequent labels are: ineffective breathing pattern (35.7%) and impairment of gas exchange (31.8%). Conclusion: The diagnostic labels are directly related to cardiovascular clinical manifestations and are applicable for the development of nursing care plans. There is also a direct correspondence of cardiovascular clinical entity with the deterioration of the oxygenation and security need.

Investigating prostate cancer tumour-stroma interactions: clinical and biological insights from an evolutionary game.

BACKGROUND: Tumours are made up of a mixed population of different types of cells that include normal structures as well as ones associated with the malignancy, and there are multiple interactions between the malignant cells and the local microenvironment. These intercellular interactions, modulated by the microenvironment, effect tumour progression and represent a largely under-appreciated therapeutic target. We use observations of primary tumour biology from prostate cancer to extrapolate a mathematical model. Specifically, it has been observed that in prostate cancer three disparate cellular outcomes predominate: (i) the tumour remains well differentiated and clinically indolent--in this case the local stromal cells may act to restrain the growth of the cancer; (ii) early in its genesis the tumour acquires a highly malignant phenotype, growing rapidly and displacing the original stromal population (often referred to as small cell prostate cancer)--these less common aggressive tumours are relatively independent of the local microenvironment and (iii) the tumour co-opts the local stroma--taking on a classic stromagenic phenotype where interactions with the local microenvironment are critical to the cancer growth. METHODS: We present an evolutionary game theoretical construct that models the influence of tumour-stroma interactions in driving these outcomes. We consider three characteristic and distinct cellular populations: stromal cells, tumour cells that are self-reliant in terms of microenvironmental factors and tumour cells that depend on the environment for resources, but can also co-opt stroma. RESULTS: Using evolutionary game theory we explore a number of different scenarios that elucidate the impact of tumour-stromal interactions on the dynamics of prostate cancer growth and progression, and how different treatments in the metastatic setting can affect different types of tumours. CONCLUSION: The tumour microenvironment has a crucial role in selecting the traits of the tumour cells that will determine prostate cancer progression. Equally important treatments like hormone therapy affect the selection of these cancer phenotypes making it very important to understand how they impact prostate cancer's somatic evolution.