Lonesome plants: How isolation affects seed set of a threatened dioecious shrub.

Plant reproductive failure is a critical concern for conserving rare and endangered species that typically have low-density and sparse populations. One important factor contributing to reproductive failure is the spatial arrangement of plants within a population, which can lead to isolation and negatively affect seed production, particularly in obligate outcrossers. Additionally, plant size can compound this effect, influencing seed production via multiple processes. Here, we investigate how spatial distribution and size influence the reproductive success of Vasconcellea chilensis, an endemic-threatened papaya species in Chile. We first examined whether V. chilensis can produce seeds via apomixis using pollinator exclusion experiments. We then used Spatial Point Pattern Analysis (SPPA) in three populations to explore the spatial arrangement of plants. Finally, we assessed whether plant size and neighbor distance influence the reproductive success V. chilensis is a dioecious shrub unable to produce fruits through apomixis. The SPPA revealed significant clustering of female and male plants at different spatial scales, indicating a non-random distribution. Moreover, a significant spatial association between the sexes was observed. In two populations, closer proximity to male plants was linked to higher seed production. Our study revealed that the reproductive system of V. chilensis is susceptible to distance-dependent reproductive failure due to pollen limitation. While the species' spatial structure may partially mitigate this risk, female plants isolated from male counterparts will likely experience reduced seed set.

Simple and cost-effective pH and T sensors from top to bottom: New chemical probes based on sonogel-carbon transducers for plasma analyses.

The present work introduces two novel approaches to fabricate simple and cost-effective pH and temperature probes. Sinusoidal voltage methodologies were employed to electrodeposit polyaniline (PANI) at different growth times (10-20 min) on the surface of an affordable Sonogel-Carbon electrode to conform a robust pH sensor. The presence of PANI and its phases were corroborated by electrochemical means. The sensibility, reversibility and selectivity of the produced sensor were very adequate to apply it in physiological samples. In this regard, the proposed sensor was evaluated in artificial blood serum as well as untreated plasma samples obtaining outstanding results in comparison with a gold reference technique (error <2 %). In addition, a new composite sonogel material, intrinsically modified with multiwalled carbon nanotubes, was attached on top of an electrode couple to one-step fabricate a new temperature probe, relating resistance of the probe with the surroundings temperature. In this case, an optical microscopy characterization was performed to study the sturdiness of the layer. Remarkably, suitable results in terms of sensitivity and selectivity were obtained. The probes were assessed in artificial and untreated plasma samples as well, with the corresponding validation step (error <1 %) by using a commercial temperature probe.

Development of a molecularly imprinted membrane for selective, high-sensitive, and on-site detection of antibiotics in waters and drugs: Application for sulfamethoxazole.

Sulfonamides are among the widespread bacterial antibiotics. Despite this, their quick emergence constitutes a serious problem for ecosystems and human health. Therefore, there is an increased interest in developing relevant detection method for antibiotics in different matrices. In this work, a straightforward, green, and cost-effective protocol was proposed for the preparation of a selective molecularly imprinted membrane (MIM) of sulfamethoxazole (SMX), a commonly used antibiotic. Thus, cellulose acetate was used as the functional polymer, while polyethylene glycol served as a pore-former. The developed MIM was successfully characterized through scanning electron microscopy (SEM), atomic force microscopy (AFM), Fourier transform infrared spectroscopy (FT-IR), X-ray diffraction (XRD), and thermogravimetric analysis (TGA). The MIM was used as a sensing platform in conjunction with a smartphone for optical readout, enabling on-site, selective, and highly sensitive detection of SMX. In this way, a satisfactory imprinting factor of around 3.6 and a limit of detection of 2 ng mL-1 were reached after applying response surface methodologies, including Box-Behnken and central composite designs. Besides, MIM demonstrated its applicability for the accurate and selective detection of SMX in river waters, wastewater, and drugs. Additionally, the MIM was shown to be a valuable sorbent in a solid-phase extraction protocol, employing a spin column setup that offered rapid and reproducible results. Furthermore, the developed sensing platform exhibited notable regeneration properties over multiple cycles and long shelf-life in different storage conditions. The newly developed methodology is of crucial importance to overcome the limitations of classical imprinting polymers. Furthermore, the smartphone-based platform was used to surpass the typically expensive and complicated methods of detection.

Design of a Tension Infiltrometer with Automated Data Collection Using a Supervisory Control and Data Acquisition System.

This study highlights the importance of water infiltration in hydrological basin management, emphasizing its role in water services, water quality regulation, and temporal patterns. To measure this crucial function, this study introduces a portable and user-friendly tension infiltrometer designed for easy assembly and data collection. The tension infiltrometer, based on the 2009 design by Spongrová and Kechavarzi, offers a comprehensive characterization of the soil properties related to water flow. It eliminates the influence of preferential flow, providing accurate data. Additionally, it accommodates changes in pore size distribution within the soil, which is crucial for understanding water movement. This study discusses the challenges associated with traditional infiltration measurement tools, like double-ring infiltrometers and single rings, which are not easily transported and can lead to inaccuracies. In response, the proposed infiltrometer simplifies data collection, making it accessible to a broader range of users. This study also explores the use of the VL53L0X distance sensor in the infiltrometer, providing an innovative solution for measuring the water column height. The system's user interface allows real-time data collection and analysis, significantly reducing the processing time compared to that of the manual methods. Overall, this work demonstrates the potential for advancement in hydrological basin management using user-friendly instrumentation and automated data collection, paving the way for improved research and decision making in environmental services, conservation, and restoration efforts within these ecosystems.

Bioactive Luminescent Silver Clusters Confined in Zeolites Enable Quick and Wash-Free Biosensing.

The simultaneous capture and detection of biomolecules is crucial for revolutionizing bioanalytical platforms in terms of portability, response time and cost-efficiency. Herein, we demonstrate how the sensitivity to external stimuli and changes in the local electronic environment of silver clusters lead to an advantageous biosensing platform based on the fluorometric response of bioactive luminescent silver clusters (BioLuSiC) confined in faujasite X zeolites functionalized with antibodies. The photoluminescence response of BioLuSiC was enhanced upon immunocomplex formation, empowering a wash-free and quick biodetection system offering optimal results from 5 min. Proteins and pathogens (immunoglobulin G and Escherichia coli) were targeted to demonstrate the biosensing performance of BioLuSiC, and a human serum titration assay was also established. BioLuSiC will pave the way for innovative bioanalytical platforms, including real-time monitoring systems, point-of-care devices and bioimaging techniques.

High resting energy expenditure, less fat-free mass, and less muscle strength in HIV-infected children: a matched, cross-sectional study.

Background and aims: Many improvements have been made in the treatment of human immunodeficiency virus (HIV) in pediatric patients; however, challenges remain in terms of achieving normal growth, body composition, and metabolism during treatment, etc. Current nutritional recommendations are based on studies performed in adults, with limited data on the HIV-infected pediatric population. Therefore, this study aimed to compare the resting energy expenditure (REE) of asymptomatic HIV-infected pediatric patients with healthy counterparts and to compare body composition, dietary intake, and physical activity between the two groups. Methods: This was a cross-sectional study of asymptomatic HIV-infected children who were receiving antiretroviral therapy; the infected group was compared with the uninfected group, matched by age (± 6 months), sex, and body mass index (± 0.5 z-score). Participants were recruited between 2021 and 2022, as outpatients. In both groups, REE was determined by indirect calorimetry and body composition by bioelectrical impedance analysis and hand strength, measured using a hydraulic hand dynamometer. Results: Seventy-eight participants were enrolled, where n = 39 HIV-infected children and n = 39 controls, with a mean age of 11.6 ± 3.4 years old. REE was significantly higher in the HIV group (1254.4 ± 334.7 kcal/day vs. 1124.7 ± 321 kcal/day, p = 0.013) than in the control group. Fat-free mass (FFM) was lower in the HIV group (28.2 ± 10.5 kg vs. 32 ± 11.2 kg, p = 0.001); this trend continued when the index skeletal muscle was evaluated (7.2 ± 1.2 vs. 7.6 ± 1.5, p = 0.04). The strength of the dominant hand was also lower in the HIV group (12 (8-18) kg vs. 20 (10.5-26) kg, p < 0.0001). Conclusions: Children with asymptomatic HIV infection have higher REE than their uninfected peers. They also present decreased FFM, skeletal muscle mass index, and muscle strength. These parameters should be considered during nutritional assessment in this population to have a favorable impact on nutritional status and growth.

Selection and Characterization of Phosphate-Solubilizing Fungi and Their Effects on Coffee Plantations.

The use of phosphate-solubilizing fungi in coffee cultivation is an alternative to the use of traditional fertilizers. The objective of this study was to analyze the mechanisms involved in the phosphorus solubilization of fungal strains and to evaluate the effect of a phosphate-solubilizing strain on coffee plants. For this, phosphorus-solubilizing fungal strains were selected for evaluation of their solubilization potential and phosphatase activity. Coffee plants were inoculated in the field with a phosphate-solubilizing strain, and the soil and foliar soluble phosphorus contents, as well as coffee bean yield, were quantified. Of the 151 strains analyzed, Sagenomella diversispora, Penicillium waksmanii, and Penicillium brevicompactum showed the highest solubilization. Aspergillus niger and P. waksmanii presented the highest soluble phosphorus values; however, P. brevicompactum showed the highest phosphatase activity. The P. brevicompactum strain inoculated on the coffee plants did not favor the foliar phosphorus content but increased the soil soluble phosphorus content in two of the coffee plantations. The plants inoculated with the phosphate-solubilizing strain showed an increase in coffee bean weight on all plantations, although this increase was only significant in two of the three selected coffee plantations.

Dormancy-break and germination requirements for seeds of the threatened Austral papaya (Carica chilensis).

Seed dormancy is one of the most important adaptive mechanisms in plants, optimizing germination, seedling emergence, and establishment to ensure these processes occur when environmental conditions are favorable for plant survival and growth. Endemic to rocky environments of the southern Atacama Desert, the Austral papaya (Carica chilensis) is the papaya species with the southernmost distribution within the Caricaceae, thriving in the most extreme environmental conditions. This threatened plant exhibits low natural regeneration, primarily attributed to low germination, yet no information regarding seed dormancy release is available. In this study, we investigated the dormancy-break and germination requirements of C. chilensis. We hypothesized that if C. chilensis seeds exhibit physiological dormancy, then seeds with reduced moisture content and those treated with chemicals or growth hormones would exhibit higher germination percentages and faster germination than control seeds akin to other members of Caricacea. Our results confirmed this prediction and revealed that ultra-drying (< 3% moisture content) and treating seeds with sulfuric acid, gibberellic acid, or potassium nitrate are the most effective methods for germinating C. chilensis. Consequently, we suggest using these treatments to propagate this threatened papaya species.

Magnetic Molecularly Imprinted Chitosan Combined with a Paper-Based Analytical Device for the Smartphone Discrimination of Tryptophan Enantiomers.

The separation of enantiomers plays a critical role in pharmaceutical development, ensuring therapeutic efficacy, safety, and patent protection. It enables the production of enantiopure drugs and enhances our understanding of the properties of chiral compounds. In this study, a straightforward and effective chiral detection strategy was developed for distinguishing between tryptophan (TRP) enantiomers. The approach involved the preparation of a magnetic molecularly imprinted chitosan (MMIC) for preparation of the sample, which was combined with a nitrocellulose membrane (a paper-based analytical device, PAD) integrated with D-TRP covalently grafted with polymethacrylic acid (PAD-PMA_D-TRP). Discriminating between the TRP enantiomers was achieved using AuNPs as a colorimetric probe. Indeed, the presence of D-TRP rapidly induced the aggregation of AuNPs due to its strong affinity to PAD-PMA_D-TRP, resulting in a noticeable change in the color of the AuNPs from red to purple. On the other hand, L-TRP did not induce any color changes. The chiral analysis could be easily performed with the naked eye and/or a smartphone. The developed method exhibited a detection limit of 3.3 µM, and it was successfully applied to detect TRP in serum samples, demonstrating good recovery rates. The proposed procedure is characterized by its simplicity, cost-effectiveness, rapidity, and ease of operation.

Controlling Hypertension through Education and Coaching in Kidney Disease (CHECK-D): protocol of a cluster randomised controlled trial.

INTRODUCTION: Chronic kidney disease (CKD) affects 30 million Americans. Early management focused on blood pressure (BP) control decreases cardiovascular morbidity and mortality. Less than 40% of patients with CKD achieve recommended BP targets due to many barriers. These barriers include a lack of understanding of the implications of their diagnosis and how to optimise their health.This cluster randomised control trial hypothesises that the combination of early primary care CKD education, and motivational interviewing (MI)-based health coach support, will improve patient behaviours aligned with BP control by increasing patient knowledge, self-efficacy and motivation. The results will aid in sustainable interventions for future patient-centric education and coaching support to improve quality and outcomes in patients with CKD stages 3-5. Outcomes in patients with CKD stages 3-5 receiving the intervention will be compared with similar patients within a control group. Continuous quality improvement (CQI) and systems methodologies will be used to optimise resource neutrality and leverage existing technology to support implementation and future dissemination. The innovative approach of this research focuses on the importance of a multidisciplinary team, including off-site patient coaching, that can intervene early in the CKD care continuum by supporting patients with education and coaching. METHODS AND ANALYSIS: We will test impact of BP control when clinician-delivered education is followed by 12 months of MI-based health coaching. We will compare outcomes in 350 patients with CKD stages 3-5 between intervention and control groups in primary care. CQI and systems methodologies will optimise education and coaching for future implementation and dissemination. ETHICS AND DISSEMINATION: This study was approved by the University of Michigan Institutional Review Boards (IRBMED) HUM00136011, HUM00150672 and SITE00000092 and the results of the study will be published on ClinicalTrials.gov, in peer-reviewed journals, as well as conference abstracts, posters and presentations. TRIAL REGISTRATION NUMBER: NCT04087798.

Feather-like Gold Nanostructures Anchored onto 3D Mesoporous Laser-Scribed Graphene: A Highly Sensitive Platform for Enzymeless Glucose Electrochemical Detection in Neutral Media.

The authors present a novel sensing platform for a disposable electrochemical, non-enzymatic glucose sensor strip at physiological pH. The sensing material is based on dendritic gold nanostructures (AuNs) resembling feather branches, which are electrodeposited onto a laser-scribed 3D graphene electrode (LSGE). The LSGEs were fabricated via a one-step laser scribing process on a commercially available polyimide sheet. This study investigates several parameters that influence the morphology of the deposited Au nanostructures and the catalytic activity toward glucose electro-oxidation. The electrocatalytic activity of the AuNs-LSGE was evaluated using cyclic voltammetry (CV), linear sweep voltammetry (LSV), and amperometry and was compared to commercially available carbon electrodes prepared under the same electrodeposition conditions. The sensor demonstrated good stability and high selectivity of the amperometric response in the presence of interfering agents, such as ascorbic acid, when a Nafion membrane was applied over the electrode surface. The proposed sensing strategy offers a wide linear detection range, from 0.5 to 20 mM, which covers normal and elevated levels of glucose in the blood, with a detection limit of 0.21 mM. The AuNs-LSGE platform exhibits great potential for use as a disposable glucose sensor strip for point-of-care applications, including self-monitoring and food management. Its non-enzymatic features reduce dependence on enzymes, making it suitable for practical and cost-effective biosensing solutions.

Pharmaceutical Design of a Formulation of Enrofloxacin-Alginate and its Strategic Dosage to Achieve Mutant Prevention PK/PD Ratios in Broiler Chickens.

INTRODUCTION: The comparative pharmacokinetics (PK) and PK/pharmacodynamics (PD) ratios of a new pharmaceutical design of enrofloxacin-alginate in dried beads (EADBs) and the reference enrofloxacin 10% solution was determined in broiler chickens. Also, the same parameters were determined after administering enrofloxacin with a double dosing scheme (through drinking water and as an in-feed medication of EADBs). 500 Arbor-Acres broiler chickens were randomly divided into five groups (n=100), adjusting in all cases, a dose of 10 mg/kg based on water and feed intake as follows: group EADBsad-lib receiving enrofloxacin through EADBs added to their feed as dressing; group EADBsbolus forcing the beads into the proventriculus using a semi-rigid gavage; group Enroad-lib dosed through their drinking water; group Enrobolus also administered into the proventriculus by gavage; group Enrow&f administering 5 mg/kg as EADBs in their feed, plus 5 mg/kg of enrofloxacin through their drinking water. METHODS: The PK parameters and the key PK/PD ratios were determined (Cmax/MIC and AUC0-24/MIC). Only group Enrow&f could achieve the PK/PD ratios regarded as mutant-prevention. RESULTS: This trial is the first one in which an in-feed medication of enrofloxacin, combined with water dosing, can result in PK/PD parameters superior to those obtained after administering the drug through drinking water at a dose of 10 mg/kg. CONCLUSION: Contrary to expectations, groups Enroad-lib and Enrobolus failed to achieve the desired PK/PD ratios when the breakpoint was established at 0.5 µg/mL but did so when MIC was set at 0.1 µg/mL. In contrast, EADBsbolus and Enrow&f achieved an adequate AUC0-24/MIC ratio for both MIC levels.

Association between phase angle and the nutritional status in pediatric populations: a systematic review.

Background and aims: Malnutrition is prevalent in pediatric populations with any disease, and it is also related to changes in body composition. In addition, recent studies have documented relationships between these changes and phase angle (PhA), an important parameter of functional nutritional assessment. PhA could be a new marker of nutritional status. Many studies have generated information about the association between PhA and malnutrition in various pathologies, although the vast majority of this information is from adult populations. In this systematic review, we answered the following question: What is the association between PhA and the nutritional status in pediatric populations? Methods: We performed a systematic search of the Medline/PubMed and Latin American and Caribbean Health Sciences Literature databases (LILACS) databases for studies published up to October 2022. The inclusion criteria were pediatric subjects, which reported the relationship between PhA and the nutritional status with any objective nutritional indicator, and PhA was measured by electric impedance and reported at 50 kHz. We synthesized data from the studies that reported cutoff analysis of PhA with receiver operating characteristic (ROC) curves, mean PhA values presented by nutritional status strata, and correlations between PhA and nutritional status indicators. We assessed the risk of bias by using the Quality Assessment Tool for Observational Cohort and Cross-Sectional Studies and the Quality Assessment for Diagnostic Accuracy Studies. Results: Of the 126 studies we identified, 15 met the inclusion criteria. The included studies reported the association between PhA and objective indicators of nutritional status, including weight-for-age z-score (WAZ) <-1 standard deviation (SD) for malnutrition, height-for-age z-score (HAZ) for malnutrition-stunting, body mass index (BMI) for the starvation state, body mass index z-score (BMIz) and BMI for malnutrition, mid-upper arm circumference (MUAC) <11 cm for severe acute malnutrition (SAM), and fat-free mass index z-score (FFMIz) <-2 z-score for moderate malnutrition, among others. The report of these associations between PhA and nutritional status was based on cutoff points generated with ROC curve analysis or comparison of mean PhA values, which were reported stratified by the presence or absence of malnutrition, and correlations between PhA and anthropometric indicators for the evaluation of the nutritional status in the pediatric population. It was difficult to compare the studies due to the heterogeneity of the bioelectrical impedance analysis models used, how PhA was reported (standardized, percentiles, or degrees), and the anthropometric indicators used to diagnose malnutrition. Conclusion: The early identification of malnutrition is relevant to establish the correct nutritional treatment; PhA appears to be a sensitive indicator of nutritional status and is easy to obtain. Although the results of this review are inadequate to establish PhA cutoff points associated with malnutrition in pediatric populations, in most of the studies, there was an association between PhA and objective indicators of nutritional status. Systematic review registration: https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42022362413, identifier: PROSPERO 2022 CRD42022362413.

Geographical Classification of Saffron (Crocus Sativus L.) Using Total and Synchronous Fluorescence Combined with Chemometric Approaches.

There is an increasing interest in food science for high-quality natural products with a distinct geographical origin, such as saffron. In this work, the excitation-emission matrix (EEM) and synchronous fluorescence were used for the first time to geographically discriminate between Moroccan saffron from Taroudant, Ouarzazate, and Azilal. Moreover, to differentiate between Afghan, Iranian, and Moroccan saffron, a unique fingerprint was assigned to each sample by visualizing the EEM physiognomy. Moreover, principal component analysis (LDA) and linear discriminant analysis (LDA) were successfully applied to classify the synchronous spectra of samples. High fluorescence intensities were registered for Ouarzazate and Taroudant saffron. Yet, the Azilal saffron was distinguished by its low intensities. Furthermore, Moroccan, Afghan, and Iranian saffron were correctly assigned to their origins using PCA and LDA for different offsets (Δλ) (20-250 nm) such that the difference in the fluorescence composition of the three countries' saffron was registered in the following excitation/emission ranges: 250-325 nm/300-480 nm and 360-425 nm/500-550 nm. These regions are characterized by the high polyphenolic content of Moroccan saffron and the important composition of Afghan saffron, including vitamins and terpenoids. However, weak intensities of these compounds were found in Iranian saffron. Furthermore, a substantial explained variance (97-100% for PC1 and PC2) and an important classification rate (70-90%) were achieved. Thus, the non-destructive applied methodology of discrimination was rapid, straightforward, reliable, and accurate.

Fungemia in Hospitalized Adult Patients with Hematological Malignancies: Epidemiology and Risk Factors.

Fungemia in hematologic malignancies (HM) has high mortality. This is a retrospective cohort of adult patients with HM and fungemia between 2012 and 2019 in institutions of Bogotá, Colombia. The epidemiological, clinical, and microbiological characteristics are described, and risk factors related to mortality are analyzed. One hundred five patients with a mean age of 48 years (SD 19.0) were identified, 45% with acute leukemia and 37% with lymphomas. In 42%, the HM was relapsed/refractory, 82% ECOG > 3, and 35% received antifungal prophylaxis; 57% were in neutropenia, with an average duration of 21.8 days. In 86 (82%) patients, Candida spp. was identified, and other yeasts in 18%. The most frequent of the isolates were non-albicans Candida (61%), C. tropicalis (28%), C. parapsilosis (17%), and C. krusei (12%). The overall 30-day mortality was 50%. The survival probability at day 30 in patients with leukemia vs. lymphoma/multiple myeloma (MM0 group was 59% (95% CI 46-76) and 41% (95% CI 29-58), p = 0.03, respectively. Patients with lymphoma or MM (HR 1.72; 95% CI 0.58-2.03) and ICU admission (HR 3.08; 95% CI 1.12-3.74) were associated with mortality. In conclusion, in patients with HM, non-albicans Candida species are the most frequent, and high mortality was identified; moreover, lymphoma or MM and ICU admission were predictors of mortality.

Incorporation of carbon black into a sonogel matrix: improving antifouling properties of a conducting polymer ceramic nanocomposite.

A new electrochemical sensor device has been developed through the modification of a polyaniline-silicon oxide network with carbon black (CB). Enhanced electrical conductivity and antifouling properties have been achieved due to the integration of this cheap nanomaterial into the bulk of the sensor. The structure of the developed material was characterized using Fourier transform infrared spectroscopy, energy-dispersive X-ray spectroscopy, and scanning electron microscopy techniques. Cyclic voltammetry was used to characterize electrochemically the Sonogel-Carbon/Carbon Black-PANI (SNG-C/CB-PANI) sensor device. In addition, differential pulse voltammetry was employed to evaluate the analytical response of the sensor towards sundry chlorophenols, common environmental hazards in aqueous ecosystems. The modified sensor material showed excellent antifouling properties, which led to a better electroanalytical performance than the one displayed with the bare sensor. Notably, a sensitivity of 5.48 × 103 µA mM-1 cm-2 and a limit of detection of 0.83 µM were obtained in the determination of 4-chloro-3-methylphenol (PCMC) at a working potential of 0.78 V (vs. 3 M Ag/AgCl/KCl), along with proficient values of reproducibility and repeatability (relative standard deviation < 3%). Finally, the analysis of PCMC was carried out in multiple validated water samples using the synthesized SNG-C/CB-PANI sensor device, obtaining excellent results of recovery values (97-104%). The synergetic effect of polyaniline and carbon black leads to novel antifouling and electrocatalytic effects that improve the applicability of this sensor in sample analysis versus complex conventional devices.

Validación del instrumento Infant Malnutrition and Feeding Checklist for Congenital Heart Disease, una herramienta para identificar riesgo de desnutrición y dificultades de alimentación en lactantes con cardiopatías congénitas / Validation of the instrument “Infant Malnutrition and Feeding Checklist for Congenital Heart Disease”, a tool to identify risk of malnutrition and feeding difficulties in infants with congenital heart disease

Introducción: actualmente, se han diseñado diversas herramientas para detectar oportunamente el riesgo de desnutrición en niños hospitalizados. En aquellos con diagnóstico de cardiopatías congénitas (CC), solo existe una herramienta desarrollada en Canadá, llamada Infant Malnutrition and Feeding Checklist for Congenital Heart Disease (IMFC:CHD), la cual fue diseñada en idioma inglés. Objetivo: evaluar la validez y confiabilidad de la adaptación en español de la herramienta IMFC:CHD en lactantes con CC. Métodos: estudio transversal de validación realizado en dos etapas: la primera, de traducción y adaptación transcultural de la herramienta; y la segunda, de validación de la nueva herramienta traducida, donde se obtuvieron las evidencias de confiabilidad y validez. Resultados: en la primera etapa se obtuvo la herramienta traducida y adaptada al idioma español; para la segunda etapa se incluyeron 24 lactantes con diagnóstico de CC. Se evaluó la validez de criterio concurrente entre la herramienta de tamizaje y la evaluación antropométrica, obteniéndose un acuerdo sustancial (κ = 0,660, IC 95 %: 0,36-0,95). Para la validez de criterio predictiva, la cual fue comparada con los días de estancia hospitalaria, se obtuvo un acuerdo moderado (κ = 0,489, IC 95 %: 0,1-0,8). La confiabilidad de la herramienta se evaluó mediante consistencia externa, midiendo la concordancia interobservador, y se obtuvo un acuerdo sustancial (κ = 0,789, IC 95 %: 0,5-0,9); la reproducibilidad de la herramienta mostró un acuerdo casi perfecto (κ = 1, IC 95 %: 0,9-1,0). Conclusiones: la herramienta IMFC:CHD mostró una adecuada validez y confiabilidad, por lo que podría considerarse un recurso útil para la identificación de desnutrición grave. (AU)

Introduction: currently, various tools have been designed to timely detect the risk of malnutrition in hospitalized children. In those with a diagnosis of congenital heart disease (CHD), there is only one tool developed in Canada: Infant Malnutrition and Feeding Checklist for Congenital Heart Disease (IMFC:CHD), which was designed in English. Objective: to evaluate the validity and reliability of the Spanish adaptation of the IMFC:CHD tool in infants with CHD. Methods: cross-sectional validation study carried out in two stages. The first, of translation and cross-cultural adaptation of the tool, and the second, of validation of the new translated tool, where evidence of reliability and validity were obtained. Results: in the first stage, the tool was translated and adapted to the Spanish language; for the second stage, 24 infants diagnosed with CHD were included. The concurrent criterion validity between the screening tool and the anthropometric evaluation was evaluated, obtaining a substantial agreement (κ = 0.660, 95 % CI: 0.36-0.95) and for the predictive criterion validity, which was compared with the days of hospital stay, moderate agreement was obtained (κ = 0.489, 95 % CI: 0.1-0.8). The reliability of the tool was evaluated through external consistency, measuring theinter-observer agreement, obtaining a substantial agreement (κ = 0.789, 95 % CI: 0.5-0.9), and the reproducibility of the tool showed an almost perfect agreement (κ = 1, CI 95 %: 0.9-1.0). Conclusions: the IMFC:CHD tool showed adequate validity and reliability, and could be considered as a useful resource for the identification of severe malnutrition. (AU)

[Validation of the instrument "Infant Malnutrition and Feeding Checklist for Congenital Heart Disease", a tool to identify risk of malnutrition and feeding difficulties in infants with congenital heart disease]. / Validación del instrumento Infant Malnutrition and Feeding Checklist for Congenital Heart Disease, una herramienta para identificar riesgo de desnutrición y dificultades de alimentación en lactantes con cardiopatías congénitas.

Introduction: Introduction: currently, various tools have been designed to timely detect the risk of malnutrition in hospitalized children. In those with a diagnosis of congenital heart disease (CHD), there is only one tool developed in Canada: Infant Malnutrition and Feeding Checklist for Congenital Heart Disease (IMFC:CHD), which was designed in English. Objective: to evaluate the validity and reliability of the Spanish adaptation of the IMFC:CHD tool in infants with CHD. Methods: cross-sectional validation study carried out in two stages. The first, of translation and cross-cultural adaptation of the tool, and the second, of validation of the new translated tool, where evidence of reliability and validity were obtained. Results: in the first stage, the tool was translated and adapted to the Spanish language; for the second stage, 24 infants diagnosed with CHD were included. The concurrent criterion validity between the screening tool and the anthropometric evaluation was evaluated, obtaining a substantial agreement (κ = 0.660, 95 % CI: 0.36-0.95) and for the predictive criterion validity, which was compared with the days of hospital stay, moderate agreement was obtained (κ = 0.489, 95 % CI: 0.1-0.8). The reliability of the tool was evaluated through external consistency, measuring the inter-observer agreement, obtaining a substantial agreement (κ = 0.789, 95 % CI: 0.5-0.9), and the reproducibility of the tool showed an almost perfect agreement (κ = 1, CI 95 %: 0.9-1.0). Conclusions: the IMFC:CHD tool showed adequate validity and reliability, and could be considered as a useful resource for the identification of severe malnutrition.

Introducción: Introducción: actualmente, se han diseñado diversas herramientas para detectar oportunamente el riesgo de desnutrición en niños hospitalizados. En aquellos con diagnóstico de cardiopatías congénitas (CC), solo existe una herramienta desarrollada en Canadá, llamada Infant Malnutrition and Feeding Checklist for Congenital Heart Disease (IMFC:CHD), la cual fue diseñada en idioma inglés. Objetivo: evaluar la validez y confiabilidad de la adaptación en español de la herramienta IMFC:CHD en lactantes con CC. Métodos: estudio transversal de validación realizado en dos etapas: la primera, de traducción y adaptación transcultural de la herramienta; y la segunda, de validación de la nueva herramienta traducida, donde se obtuvieron las evidencias de confiabilidad y validez. Resultados: en la primera etapa se obtuvo la herramienta traducida y adaptada al idioma español; para la segunda etapa se incluyeron 24 lactantes con diagnóstico de CC. Se evaluó la validez de criterio concurrente entre la herramienta de tamizaje y la evaluación antropométrica, obteniéndose un acuerdo sustancial (κ = 0,660, IC 95 %: 0,36-0,95). Para la validez de criterio predictiva, la cual fue comparada con los días de estancia hospitalaria, se obtuvo un acuerdo moderado (κ = 0,489, IC 95 %: 0,1-0,8). La confiabilidad de la herramienta se evaluó mediante consistencia externa, midiendo la concordancia interobservador, y se obtuvo un acuerdo sustancial (κ = 0,789, IC 95 %: 0,5-0,9); la reproducibilidad de la herramienta mostró un acuerdo casi perfecto (κ = 1, IC 95 %: 0,9-1,0). Conclusiones: la herramienta IMFC:CHD mostró una adecuada validez y confiabilidad, por lo que podría considerarse un recurso útil para la identificación de desnutrición grave.

Molecular and Clinical Data of Antimicrobial Resistance in Microorganisms Producing Bacteremia in a Multicentric Cohort of Patients with Cancer in a Latin American Country.

Patients with cancer have a higher risk of severe bacterial infections. This study aims to determine the frequency, susceptibility profiles, and resistance genes of bacterial species involved in bacteremia, as well as risk factors associated with mortality in cancer patients in Colombia. In this prospective multicenter cohort study of adult patients with cancer and bacteremia, susceptibility testing was performed and selected resistance genes were identified. A multivariate regression analysis was carried out for the identification of risk factors for mortality. In 195 patients, 206 microorganisms were isolated. Gram-negative bacteria were more frequently found, in 142 cases (68.9%): 67 Escherichia coli (32.5%), 36 Klebsiella pneumoniae (17.4%), and 21 Pseudomonas aeruginosa (10.1%), and 18 other Gram-negative isolates (8.7%). Staphylococcus aureus represented 12.4% (n = 25). Among the isolates, resistance to at least one antibiotic was identified in 63% of them. Genes coding for extended-spectrum beta-lactamases and carbapenemases, blaCTX-M and blaKPC, respectively, were commonly found. Mortality rate was 25.6% and it was lower in those with adequate empirical antibiotic treatment (22.0% vs. 45.2%, OR: 0.26, 95% CI: 0.1-0.63, in the multivariate model). In Colombia, in patients with cancer and bacteremia, bacteria have a high resistance profile to beta-lactams, with a high incidence of extended-spectrum beta-lactamases and carbapenemases. Adequate empirical treatment diminishes mortality, and empirical selection of treatment in this environment of high resistance is of key importance.

Cancer-targeted photoimmunotherapy induces antitumor immunity and can be augmented by anti-PD-1 therapy for durable anticancer responses in an immunologically active murine tumor model.

The complex immunosuppressive nature of solid tumor microenvironments poses a significant challenge to generating efficacious and durable anticancer responses. Photoimmunotherapy is a cancer treatment strategy by which an antibody is conjugated with a non-toxic light-activatable dye. Following administration of the conjugate and binding to the target tumor, subsequent local laser illumination activates the dye, resulting in highly specific target cell membrane disruption. Here we demonstrate that photoimmunotherapy treatment elicited tumor necrosis, thus inducing immunogenic cell death characterized by the release of damage-associated molecular patterns (DAMPs). Photoimmunotherapy-killed tumor cells activated dendritic cells (DC), leading to the production of proinflammatory cytokines, T cell stimulation, priming antigen-specific T cells, and durable memory T cell responses, which led complete responder mice to effectively reject new tumors upon rechallenge. PD-1 blockade in combination with photoimmunotherapy enhanced overall anticancer efficacy, including against anti-PD-1-resistant tumors. The combination treatment also elicited abscopal anticancer activity, as observed by reduction of distal, non-illuminated tumors, further demonstrating the ability of photoimmunotherapy to harness local and peripheral T cell responses. With this work we therefore delineate the immune mechanisms of action for photoimmunotherapy and demonstrate the potential for cancer-targeted photoimmunotherapy to be combined with other immunotherapy approaches for augmented, durable anticancer efficacy. Moreover, we demonstrate responses utilizing various immunocompetent mouse models, as well as in vitro data from human cells, suggesting broad translational potential.