Synthesis, characterization and stability of crosslinked chitosan-maltodextrin pH-sensitive nanogels.

Polysaccharide-based nanogels offer a wide range of chemical compositions and are of great interest due to their biodegradability, biocompatibility, non-toxicity, and their ability to display pH, temperature, or enzymatic response. In this work, we synthesized monodisperse and tunable pH-sensitive nanogels by crosslinking, through reductive amination, chitosan and partially oxidized maltodextrins, by keeping the concentration of chitosan around the overlap concentration, i.e. in the dilute and semi-dilute regime. The chitosan/maltodextrin nanogels presented sizes ranging from 63 ±â€¯9 to 279 ±â€¯16 nm, showed quasi-spherical and cauliflower-like morphology, reached a ζ-potential of +36 ±â€¯2 mV and maintained a colloidal stability for up to 7 weeks. It was found that the size and surface charge of nanogels depended both on the oxidation degree of maltodextrins and chitosan concentration, as well as on its degree of acetylation and protonation, the latter tuned by pH. The pH-responsiveness of the nanogels was evidenced by an increased size, owed to swelling, and ζ-potential when pH was lowered. Finally, maltodextrin-chitosan biocompatible nanogels were assessed by cell viability assay performed using the HEK293T cell line.

[Digital health in Latin America: current legislation and ethical aspectsSaúde digital na América Latina: legislação atual e aspectos éticos]. / Salud digital en América Latina: legislación actual y aspectos éticos.

Objectives: Describe the current legislation on electronic medical records (EMR) and telehealth in Latin American countries and analyze the treatment of confidentiality and professional secrecy. Methods: Between March and September 2022, a survey of the regulations in force in 21 Latin American countries was conducted at two levels: the existence of legislation on EMR and telehealth, and the treatment of confidentiality and professional secrecy in EMR and telehealth. A data extraction form was prepared for each country. Data were collected from official on-line sources. The information was analyzed qualitatively and synthesized in tables when possible. Results: The use of EMR is legally regulated in 16 countries. Nineteen countries have legislation on telehealth. All the countries analyzed safeguard confidentiality and professional secrecy through regulations. However, confidentiality and professional secrecy are mentioned in 11 countries in the context of telehealth, and in only nine countries in the context of EMR. Conclusions: Since the start of this century, Latin America has made progress in the legislation of digital tools for health care, such as EMR and telehealth. There is also interest in ethical issues related to the use of EMR and telehealth, particularly confidentiality and professional secrecy, aspects that should be strengthened in digital health.

Objetivo: Descrever a legislação vigente sobre prontuários eletrônicos e telessaúde nos países da América Latina e analisar o tratamento da confidencialidade e do sigilo profissional. Métodos: Entre março e setembro de 2022, realizou-se um levantamento sobre a regulamentação vigente nos 21 países latino-americanos incluídos no estudo, em dois níveis: i) existência de legislação sobre prontuários eletrônicos e telessaúde; e ii) tratamento da confidencialidade e do sigilo profissional em prontuários eletrônicos e telessaúde. Uma planilha para extração de dados foi elaborada para cada país. Os dados foram coletados de fontes oficiais disponíveis on-line. Foi realizada uma análise qualitativa das informações, que foram resumidas em tabelas, quando possível. Resultados: O uso dos prontuários eletrônicos é legalmente regulamentado em 16 países. Quanto à telessaúde, 19 países têm legislação sobre essa ferramenta. Todos os países analisados protegem a confidencialidade e o sigilo profissional por meio de regulamentação. No entanto, no contexto da telessaúde, eles são mencionados em 11 países; já no contexto dos prontuários eletrônicos, em apenas 9 países. Conclusões: Desde o início dos anos 2000, a América Latina vem avançando em relação à legislação sobre ferramentas digitais na atenção à saúde, como prontuários eletrônicos e telessaúde. Há também interesse nas questões éticas relacionadas ao uso de prontuários eletrônicos e telessaúde, especialmente em relação à confidencialidade e ao sigilo profissional, embora esses aspectos precisem ser reforçados na saúde digital.

Functional roles of microRNAs in vasculogenic mimicry and resistance to therapy in human cancers: an update.

INTRODUCTION: Vasculogenic mimicry (VM) alludes to the ability of cancer cells to organize on three-dimensional channel-like structures to obtain nutrients and oxygen. This mechanism confers an aggressive phenotype, metastatic potential, and resistance to chemotherapy resulting in a poor prognosis. Recent studies have been focused on the identification of microRNAs (miRNAs) that regulate the VM representing potential therapeutic targets in cancer. AREAS COVERED: An overview of the roles of miRNAs on VM development and their functional relationships with tumor microenvironment. The functions of cancer stem-like cells in VM, and resistance to therapy are also discussed. Moreover, the modulation of VM by natural compounds is explored. The clinical significance of deregulated miRNAs as potential therapeutic targets in tumors showing VM is further highlighted. EXPERT OPINION: The miRNAs are regulators of protein-encoding genes involved in VM; however, their specific expression signatures with clinical value in large cohorts of patients have not been established yet. We considered that genomic profiling of miRNAs could be useful to define some hallmarks of tumors such as stemness, drug resistance, and VM in cancer patients. However, additional studies are needed to establish the relevant role of miRNAs as effective therapeutic targets in tumors that have developed VM.

Salud digital en América Latina: legislación actual y aspectos éticos / Digital health in Latin America: current legislation and ethical aspects / Saúde digital na América Latina: legislação atual e aspectos éticos

RESUMEN Objetivo. Describir la legislación vigente respecto a historia clínica electrónica (HCE) y telesalud de los países latinoamericanos y analizar el tratamiento de la confidencialidad y el secreto profesional. Métodos. Entre marzo y septiembre de 2022, se realizó un relevamiento de la reglamentación vigente en los 21 países latinoamericanos en estudio, en dos niveles: i) la existencia de legislación respecto a la HCE y la telesalud, y ii) el tratamiento de la confidencialidad y el secreto profesional en la HCE y la telesalud. Se confeccionó una ficha de extracción de datos por país. Se recolectaron datos a partir de fuentes on-line oficiales. Se analizó cualitativamente la información y se sintetizó en forma de tablas cuando fue posible. Resultados. El uso de la HCE está reglamentado legalmente en 16 países. Para el caso de telesalud, son 19 países los que cuentan con legislación en referencia a esta herramienta. Todos los países analizados resguardan la confidencialidad y el secreto profesional a través de reglamentaciones. Sin embargo, en el contexto de telesalud se mencionan en 11 países, en tanto en el contexto de la HCE, solo en 9 países. Conclusiones. Desde el inicio del segundo milenio América Latina ha avanzado respecto a la legislación de herramientas digitales en la atención en salud como la HCE y la telesalud. Se observa a su vez un interés por las cuestiones éticas relacionadas con el uso de la HCE y la telesalud, en particular de la confidencialidad y secreto profesional, aunque dichos aspectos deben ser fortalecidos en la salud digital.

ABSTRACT Objectives. Describe the current legislation on electronic medical records (EMR) and telehealth in Latin American countries and analyze the treatment of confidentiality and professional secrecy. Methods. Between March and September 2022, a survey of the regulations in force in 21 Latin American countries was conducted at two levels: the existence of legislation on EMR and telehealth, and the treatment of confidentiality and professional secrecy in EMR and telehealth. A data extraction form was prepared for each country. Data were collected from official on-line sources. The information was analyzed qualitatively and synthesized in tables when possible. Results. The use of EMR is legally regulated in 16 countries. Nineteen countries have legislation on telehealth. All the countries analyzed safeguard confidentiality and professional secrecy through regulations. However, confidentiality and professional secrecy are mentioned in 11 countries in the context of telehealth, and in only nine countries in the context of EMR. Conclusions. Since the start of this century, Latin America has made progress in the legislation of digital tools for health care, such as EMR and telehealth. There is also interest in ethical issues related to the use of EMR and telehealth, particularly confidentiality and professional secrecy, aspects that should be strengthened in digital health.

RESUMO Objetivo. Descrever a legislação vigente sobre prontuários eletrônicos e telessaúde nos países da América Latina e analisar o tratamento da confidencialidade e do sigilo profissional. Métodos. Entre março e setembro de 2022, realizou-se um levantamento sobre a regulamentação vigente nos 21 países latino-americanos incluídos no estudo, em dois níveis: i) existência de legislação sobre prontuários eletrônicos e telessaúde; e ii) tratamento da confidencialidade e do sigilo profissional em prontuários eletrônicos e telessaúde. Uma planilha para extração de dados foi elaborada para cada país. Os dados foram coletados de fontes oficiais disponíveis on-line. Foi realizada uma análise qualitativa das informações, que foram resumidas em tabelas, quando possível. Resultados. O uso dos prontuários eletrônicos é legalmente regulamentado em 16 países. Quanto à telessaúde, 19 países têm legislação sobre essa ferramenta. Todos os países analisados protegem a confidencialidade e o sigilo profissional por meio de regulamentação. No entanto, no contexto da telessaúde, eles são mencionados em 11 países; já no contexto dos prontuários eletrônicos, em apenas 9 países. Conclusões. Desde o início dos anos 2000, a América Latina vem avançando em relação à legislação sobre ferramentas digitais na atenção à saúde, como prontuários eletrônicos e telessaúde. Há também interesse nas questões éticas relacionadas ao uso de prontuários eletrônicos e telessaúde, especialmente em relação à confidencialidade e ao sigilo profissional, embora esses aspectos precisem ser reforçados na saúde digital.

A systematic review of coastal zone integrated waste management for sustainability strategies.

Coastal areas stand out because of their rich biodiversity and high tourist potential due to their privileged geographical position. However, one of the main problems in these areas is the generation of waste and its management, which must consider technical and sustainable criteria. This work aims to conduct a systematic review of the scientific literature on integrated solid waste management (ISWM) by considering scientific publications on the scientific basis for the proposal of sustainability strategies in the context of use and efficiency. The overall method comprises i) Search strategy, merging and processing of the databases (Scopus and Web of Science); ii) Evolution of coastal zone waste management; iii) Systematic reviews on coastal landfills and ISWM in the context of the circular economy; and iv) Quantitative synthesis in integrated waste management. The results show 282 studies focused on coastal landfills and 59 papers on ISWM with the application of circular economy criteria. Systematic reviews allowed for the definition of criteria for the selection of favorable sites, such as i) sites far from the coastline, ii) impermeable soils at their base to avoid contamination of aquifers, iii) use of remote sensing and geographic information system tools for continuous monitoring, iv) mitigation of possible contamination of ecosystems, v) planning the possibility of restoration (reforestation) and protection of the environment. In coastal zones, it is necessary to apply the ISWM approach to avoid landfill flooding and protect the marine environment, reducing rubbish and waste on beaches and oceans. Therefore, applying the circular economy in ISWM is critical to sustainability in coastal environments, with the planet's natural processes and variations due to climate change.

Salud digital en América Latina: legislación actual y aspectos éticos / Digital health in Latin America: current legislation and ethical aspects / Saúde digital na América Latina: legislação atual e aspectos éticos

[RESUMEN]. Objetivo. Describir la legislación vigente respecto a historia clínica electrónica (HCE) y telesalud de los países latinoamericanos y analizar el tratamiento de la confidencialidad y el secreto profesional. Métodos. Entre marzo y septiembre de 2022, se realizó un relevamiento de la reglamentación vigente en los 21 países latinoamericanos en estudio, en dos niveles: i) la existencia de legislación respecto a la HCE y la telesalud, y ii) el tratamiento de la confidencialidad y el secreto profesional en la HCE y la telesalud. Se con- feccionó una ficha de extracción de datos por país. Se recolectaron datos a partir de fuentes on-line oficiales. Se analizó cualitativamente la información y se sintetizó en forma de tablas cuando fue posible. Resultados. El uso de la HCE está reglamentado legalmente en 16 países. Para el caso de telesalud, son 19 países los que cuentan con legislación en referencia a esta herramienta. Todos los países analizados resguardan la confidencialidad y el secreto profesional a través de reglamentaciones. Sin embargo, en el contexto de telesalud se mencionan en 11 países, en tanto en el contexto de la HCE, solo en 9 países. Conclusiones. Desde el inicio del segundo milenio América Latina ha avanzado respecto a la legislación de herramientas digitales en la atención en salud como la HCE y la telesalud. Se observa a su vez un interés por las cuestiones éticas relacionadas con el uso de la HCE y la telesalud, en particular de la confidencialidad y secreto profesional, aunque dichos aspectos deben ser fortalecidos en la salud digital.

[ABSTRACT]. Objectives. Describe the current legislation on electronic medical records (EMR) and telehealth in Latin Ame- rican countries and analyze the treatment of confidentiality and professional secrecy. Methods. Between March and September 2022, a survey of the regulations in force in 21 Latin American countries was conducted at two levels: the existence of legislation on EMR and telehealth, and the treatment of confidentiality and professional secrecy in EMR and telehealth. A data extraction form was prepared for each country. Data were collected from official on-line sources. The information was analyzed qualitatively and synthesized in tables when possible. Results. The use of EMR is legally regulated in 16 countries. Nineteen countries have legislation on telehealth. All the countries analyzed safeguard confidentiality and professional secrecy through regulations. However, confidentiality and professional secrecy are mentioned in 11 countries in the context of telehealth, and in only nine countries in the context of EMR. Conclusions. Since the start of this century, Latin America has made progress in the legislation of digital tools for health care, such as EMR and telehealth. There is also interest in ethical issues related to the use of EMR and telehealth, particularly confidentiality and professional secrecy, aspects that should be strengthened in digital health.

[RESUMO]. Objetivo. Descrever a legislação vigente sobre prontuários eletrônicos e telessaúde nos países da América Latina e analisar o tratamento da confidencialidade e do sigilo profissional. Métodos. Entre março e setembro de 2022, realizou-se um levantamento sobre a regulamentação vigente nos 21 países latino-americanos incluídos no estudo, em dois níveis: i) existência de legislação sobre prontuários eletrônicos e telessaúde; e ii) tratamento da confidencialidade e do sigilo profissional em prontuários eletrônicos e telessaúde. Uma planilha para extração de dados foi elaborada para cada país. Os dados foram coletados de fontes oficiais disponíveis on-line. Foi realizada uma análise qualitativa das informações, que foram resumidas em tabelas, quando possível. Resultados. O uso dos prontuários eletrônicos é legalmente regulamentado em 16 países. Quanto à telessaúde, 19 países têm legislação sobre essa ferramenta. Todos os países analisados protegem a confidencialidade e o sigilo profissional por meio de regulamentação. No entanto, no contexto da telessaúde, eles são mencionados em 11 países; já no contexto dos prontuários eletrônicos, em apenas 9 países. Conclusões. Desde o início dos anos 2000, a América Latina vem avançando em relação à legislação sobre ferramentas digitais na atenção à saúde, como prontuários eletrônicos e telessaúde. Há também interesse nas questões éticas relacionadas ao uso de prontuários eletrônicos e telessaúde, especialmente em relação à confidencialidade e ao sigilo profissional, embora esses aspectos precisem ser reforçados na saúde digital.

Synergistic antibacterial effects of exopolysaccharides/nickel-nanoparticles composites against multidrug-resistant bacteria.

The need for an alternative treatment to fight infectious diseases caused by antibiotic-resistant bacteria is increasing. A possible way to overcome bacterial resistance to antibiotics is by reintroducing commonly used antibiotics with a sensitizer capable of enhancing their antimicrobial effect in resistant bacteria. Here, we use a composite composed of exopolysaccharide capped-NiO NPs, with antimicrobial effects against antibiotic-resistant Gram-positive and Gram-negative bacteria. It potentiated the antimicrobial effects of four different antibiotics (ampicillin, kanamycin, chloramphenicol, and ciprofloxacin) at lower concentrations than their minimal inhibitory concentrations. We observed that the Ni-composite synergistically enhanced, fourfold, the antibacterial effect of kanamycin and chloramphenicol against multidrug-resistant Staphylococcus aureus and Pseudomonas aeruginosa, as well as ampicillin against multidrug-resistant Staphylococcus aureus, and ciprofloxacin against multidrug-resistant Pseudomonas aeruginosa by eightfold. We also found that Ni-composite could not inhibit biofilm synthesis on the tested bacterial strains. Our results demonstrated the possibility of using metal nanoparticles, like NiO, as a sensitizer to overcome bacterial antibiotic resistance.

Synthesis of mesoporous zeolite Y using Sapindus rarak extract as natural organic surfactant for deoxygenation of Reutealis trisperma oil to biofuel.

Saponin is a plant-derived chemical with an amphiphilic glycoconjugate structure extracted from sapindaceae plants like Sapindus rarak. This study investigated saponin extract of Sapindus rarak as a natural template for formation of mesoporous zeolite Y. Surface area and mesoporosity of zeolite Y were improved with optimization of Sapindus rarak extract (SRE) concentration (Y-Ln; n = 2, 5, 10 or 15 mL), reaching 216.26 m2 mesoporous area and 0.214 cm3 g-1 mesoporous volume for Y-L10 samples. A different loading of Ni was impregnated onto Y-L10 zeolite to improve Lewis/Brønsted acidity as catalysts in the deoxygenation of Reutealis trisperma oil (RTO) into hydrocarbon fuels. Impregnating 15% Ni on NaY zeolite enhanced Lewis acidity to 0.4556 mmol g-1, producing 48.8% liquid oil with 85.43% degree of deoxygenation. A high selectivity towards C15 and C17 hydrocarbon was analyzed from liquid yield, indicating the contributing factor from Lewis acidity and mesoporosity to enhance deoxygenation and prevent the hydrocracking reaction.

Flowered Grain Quality and Phytochemical Content of Non-Conventional Maize Hybrids from the Mexican Subtropics across Three Growing Cycles.

Development of non-conventional hybrids responds to the demand for the Elotes Occidentales land-race for production of pozole. The effect of growing cycle (2019, 2020, and 2021) on physical characteristics, flowered grain quality, and phytochemical content of two non-conventional hybrids of pozolero maize, as well as the effect of the presence or absence of pedicel, type of pollination (open and controlled, 2019), and parents (female and male, 2020) on flowered grain quality and content of phytochemical compounds, were evaluated. Size, hardness, color, total phenols, and anthocyanins in unprocessed grain were determined. Yield, volume, and puncture force were measured in flowered grain. Results were analyzed with a factorial arrangement in a completely randomized design. There were significant differences (p ≤ 0.05) in most of the variables studied by effect of crop cycle and hybrid. Non-conventional hybrids had large grains (40 g 100 grains-1), soft endosperm (flotation index > 60), pink-purple color, and phenol and anthocyanin contents similar to those reported for the Elotes Occidentales land-race. The presence or absence of the pedicel did not affect flowered grain quality. Controlled pollination favored anthocyanin synthesis. The female parent determined the anthocyanin content of non-conventional hybrids. Thermal processing reduced anthocyanins by 60%; however, they leached into the flowering broth, so that the pozole made from non-conventional hybrids can have improved nutraceutical value, relative to that of pozole made with Cacahuacintle land-race.

Composition and Flowering Quality of Cacahuacintle Maize Populations from the High Valleys of Mexico.

Cacahuacintle is one of the maize types with great demand for pozole preparation; however, little is known about the variation in chemical composition and flowered grain quality among populations. Physicochemical characteristics, flowered grain quality, pasting properties, and starch microstructure were evaluated in 33 populations of Cacahuacintle maize collected in Valles Altos, Mexico. The seeds samples of corn were obtained in 2017 from local farmers in the states of Mexico, Puebla, and Tlaxcala. Results were analyzed under a completely randomized design, and the ANOVA, Tukey test, and principal components were obtained. The ANOVA showed significance (p ≤ 0.05) in 18 of the 22 variables evaluated. The TE-6, AM-7, and CA-6 populations were outstanding for the good quality of their protein, pasting viscosity, and flowered grain quality. Nine populations collected in Calimaya, estate of Mexico, and Serdan Valley, state of Puebla, presented excellent physical, pasting, and flowery grain characteristics, with reduced protein content and lysine and tryptophan values typical of maize with normal endosperm. The softness of the endosperm grain, starch microstructural, and pasting characteristics of Cacahuacintle maize populations have a fundamental role in reducing the time and increasing the flowered grain volume, properties that were different from those observed in the Chalqueño, included as dent maize check. Variations in grain quality among Cacahuacintle maize populations is an important genetic resource for the improvement of the nutritional and flowering quality of Cacahuacintle maize.

Reprogramming of the Genome-Wide DNA Methylation Landscape in Three-Dimensional Cancer Cell Cultures.

During the last century, 2D cell cultures have been the tool most widely used to study cancer biology, drug discovery, genomics, and the regulation of gene expression at genetic/epigenetic levels. However, this experimental approach has limitations in faithfully recreating the microenvironment and cellular processes occurring in tumors. For these reasons, 3D cell cultures have recently been implemented to optimize the conditions that better recreate the biological and molecular features of tumors, including cell-cell and cell-extracellular matrix (ECM) interactions, growth kinetics, metabolic activities, and the development of gradients in the cellular microenvironment affecting the availability of oxygen and nutrients. In this sense, tumor cells receive stimuli from the local environment, resulting in significant changes in their signaling pathways, gene expression, and transcriptional and epigenetic patterns. In this review, we discuss how different types of 3D cell culture models can be applied to characterize the epigenetic footprints of cancer cell lines, emphasizing that DNA methylation patterns play an essential role in the emergence and development of cancer. However, how 3D cancer cell cultures remodel the epigenetic programs is poorly understood, with very few studies in this emerging topic. Here, we have summarized the studies on the reprogramming of the epigenetic landscape of DNA methylation during tumorigenesis and discuss how it may be affected by microenvironmental factors, specifically in 3D cell cultures.

Corea como primera manifestación de lupus eritematoso sistémico sin síndrome de anticuerpos antifosfolipídicos: reporte de caso y revisión de la bibliografía / Chorea as the first clinical manifestation of systemic lupus erythematosus without anti-phospholipid syndrome: case report and literature review

Resumen ANTECEDENTES: La corea gravídica es un padecimiento poco común, caracterizado por movimientos espontáneos irregulares, no predecibles, de duración breve, que cambian de localización sin secuencia definida, y que poseen la particularidad de ser involuntarios. En la actualidad, su incidencia se estima en 1 caso por cada 2275 embarazos. CASO CLÍNICO: Paciente de 30 años, 45 kg, talla 1.65 m, IMC 16.5, tensión arterial 110-78 mmHg, frecuencia cardiaca de 136 lpm, frecuencia respiratoria de 19 rpm, saturación de oxígeno 98%. Inició con movimientos coreicos a las 12 semanas de embarazo y titulación de anticuerpos antinucleares 1:320, anticuerpos anti-ADN de 150 UI/mL, C3 en 126 mg/dL y C4 en 31 mg/dL. Se estableció el diagnóstico de lupus eritematoso sistémico con base en los criterios de EULAR/ACR. A las 32 semanas tuvo amenaza de parto pretérmino y progresión, a pesar de la útero-inhibición, preeclampsia con criterios de severidad y manifestaciones neuropsiquiátricas con exacerbación de los movimientos coreicos. La resonancia magnética no reportó hallazgos patológicos y se descartó el síndrome de anticuerpos antifosfolipídicos secundario. Luego de la finalización del embarazo remitieron los movimientos involuntarios característicos de la corea gravídica. CONCLUSIÓN: El control prenatal en el primer trimestre es fundamental para un de-senlace favorable de las pacientes; el inicio temprano de la inmunoterapia es decisivo en los desenlaces perinatales pues disminuye la morbilidad y mortalidad asociadas. La corea es una manifestación clínica incapacitante, de ahí la importancia de identificar su causa e iniciar el tratamiento oportuno.

Abstract BACKGROUND: Chorea gravidarum is a rare condition characterised by irregular, unpredictable, spontaneous movements of short duration, changing location without defined sequence, and with the peculiarity of being involuntary. Currently, its incidence is estimated at 1 case per 2275 pregnancies. CLINICAL CASE: Patient aged 30 years, 45 kg, height 1.65 m, BMI 16.5, blood pressure 110-78 mmHg, heart rate 136 bpm, respiratory rate 19 rpm, oxygen saturation 98%. She started with choreic movements at 12 weeks of pregnancy and titration of antinuclear antibodies 1:320, anti-DNA antibodies 150 IU/mL, C3 at 126 mg/dL and C4 at 31 mg/dL. The diagnosis of systemic lupus erythematosus was established based on EULAR/ACR criteria. At 32 weeks she had threatened preterm labour and progression, despite utero-inhibition, preeclampsia with severity criteria and neuropsychiatric manifestations with exacerbation of choreic movements. MRI reported no pathological findings and secondary antiphospholipid antibody syndrome was ruled out. After termination of pregnancy the involuntary movements characteristic of chorea gravidarum subsided. CONCLUSION: Prenatal monitoring in the first trimester is essential for a favourable patient outcome; early initiation of immunotherapy is crucial for perinatal outcomes as it decreases associated morbidity and mortality. Chorea is a disabling clinical manifestation, hence the importance of identifying its cause and initiating timely treatment.

Frecuencia de mordida abierta en niños de 6 a 12 años en escuelas públicas de Gran Asunción en el año 2019

La mordida abierta se define como aquella situación de la oclusión en la que uno o más dientes superiores o inferiores, no alcanzan el plano de la oclusión por no hacer contacto con los antagonistas. El objetivo fue determinar la frecuencia de mordida abierta en niños entre 6 a 12 años de escuelas públicas de Gran Asunción. Estudio descriptivo observacional, de corte transversal que abarcó 1095 niños de ambos sexos, de 6 a 12 años, de escuelas públicas de Gran Asunción- Paraguay en el 2019 que cumplían con los criterios de inclusión. Se realizaron evaluaciones odontológicas para determinar por medio de observación la presencia de mordida abierta y los datos fueron asentados en planillas Excel para su posterior análisis. Del total de 1095 alumnos, 242 presentan mordida abierta (22,1%). El 57,8% presentó mordida abierta anterior, el 35,5% presenta mordida abierta posterior y un 6.6% mordida abierta completa. Los datos que aporta esta investigación contribuyen para implementar y promover tratamientos a edades tempranas, lo que es de vital importancia por las múltiples consecuencias negativas de este tipo de maloclusiones en el niño, debido a que no sólo afecta a la boca, sino también a la funcionalidad de todo el sistema en el cuerpo humano.

Open bite is defined as that occlusion situation in which one or more upper or lower teeth do not reach the occlusion plane because they do not make contact with the antagonists. The objective was to determine the frequency of open bite in children between 6 and 12 years of public schools in Great Asunción. Descriptive observational, cross-sectional study that included 1095 boys and girls from 6 to 12 years old, from public schools in Greater Asunción-Paraguay in 2019 who met the inclusion criteria. Dental evaluations were carried out to determine the presence of open bite by observation and the data was recorded in Excel spreadsheets for later analysis. Of the total of 1095 students, 242 presented open bite (22.1%), 57.8% presented anterior open bite, 35.5% presented posterior open bite and 6.6% complete open bite. The data provided by this research contribute to implement and promote treatments at an early age, which is of vital importance due to the multiple negative consequences of this type of malocclusion in children, because it not only affects the mouth, but also the functionality of the entire system in the human body.

The Nutraceutical Antihypertensive Action of C-Phycocyanin in Chronic Kidney Disease Is Related to the Prevention of Endothelial Dysfunction.

C-phycocyanin (CPC) is an antihypertensive that is not still wholly pharmacologically described. The aim of this study was to evaluate whether CPC counteracts endothelial dysfunction as an antihypertensive mechanism in rats with 5/6 nephrectomy (NFx) as a chronic kidney disease (CKD) model. Twenty-four male Wistar rats were divided into four groups: sham control, sham-treated with CPC (100 mg/Kg/d), NFx, and NFx treated with CPC. Blood pressure was measured each week, and renal function evaluated at the end of the treatment. Afterward, animals were euthanized, and their thoracic aortas were analyzed for endothelium functional test, oxidative stress, and NO production. 5/6 Nephrectomy caused hypertension increasing lipid peroxidation and ROS production, overexpression of inducible nitric oxide synthase (iNOS), reduction in the first-line antioxidant enzymes activities, and reduced-glutathione (GSH) with a down-expression of eNOS. The vasomotor response reduced endothelium-dependent vasodilation in aorta segments exposed to acetylcholine and sodium nitroprusside. However, the treatment with CPC prevented hypertension by reducing oxidative stress, NO system disturbance, and endothelial dysfunction. The CPC treatment did not prevent CKD-caused disturbance in the antioxidant enzymes activities. Therefore, CPC exhibited an antihypertensive activity while avoiding endothelial dysfunction.

Analysis of Flexible Ureteroscopic Motion and Kinematic Efficiency: A Simulation-Based Pilot Study.

Introduction: Flexible ureteroscopy (fURS) is the most common surgical procedure for treatment of urolithiasis. Various surgical disciplines and subspecialties have examined surgeon kinematics to improve assessment and generate measures of skill. Despite frequency of utilization, there is no undisputed method for evaluating fURS skills. Our pilot study utilized kinematic evaluations of fURS simulation to determine whether specific surgeon movements, techniques, and strategies correlate with measures of ureteroscopic (URS) efficiency. Methods: A motion capture system and standard video camera were employed to characterize surgeon movement variables. A URS simulation box was used by practicing urologists at various skill levels to perform a series of simple and complex URS movement tasks. Two tasks were chosen for this initial pilot analysis. Body kinematics, time to task completion, and URS movements were analyzed. Task efficiency was defined as quicker time to task completion and smaller ureteroscope end effector travel distance. A combined performance efficiency score (PES) was calculated using the root sum square of these two measures. Results: Twelve practicing urologists were enlisted. Average urologist age was 37 years with an average of 10.1 years of training; 50% were women, 50% were residents; and 33% had completed an Endourology fellowship. For the simple task, no kinematic data correlated with PES; for the complex task, participant head and torso movement correlated with PES (r = 0.60, p = 0.04 for head; r = 0.65, p = 0.02 for torso), with decreased body movement associated with higher efficiency. Conclusion: Our findings suggest that movement economy measures are associated with efficient URS manipulation for complex tasks. Decreased head and torso movement were associated with higher efficiency, suggesting that excess body movement may signal extraneous or improper URS movements. Additional assessment of these variables, including analysis in a clinical setting, is warranted as this may serve as a basis for improvement in endoscopic training and evaluation.

Bull sperm selection by attachment to hyaluronic acid semi-interpenetrated hydrogels.

We report the development of a hydrogel-based approach to select bull spermatozoa, a crucial step for successful assisted reproductive techniques (ARTs). Hyaluronic acid (HA) semi-interpenetrated N-isopropylacrylamide (PNIPAM) co-20% N-Tris (hydroxymethyl) methyl acrylamide (HMA) hydrogels were synthetized on glass surfaces and cultured in presence of frozen-thawed bull spermatozoa. A fraction of motile bull spermatozoa population strongly attached to hydrogels and was partially released by treatment with hyaluronidase. Fifty-nine (59 ± 7.24) per cent of sperm cells attached to PNIPAM-HMA-HA hydrogels and 31.16 ± 4.81% of them were released upon treatment with medium containing hyaluronidase. This attached-released sperm fraction has acceptable characteristics of progressive motility (50.0 ± 5.0%), vigour (4), high viability (58.7 ± 11.7%) and low percentage of acrosome reacted spermatozoa (23.36 ± 4.1%). Our findings indicate that PNIPAM-HMA-HA hydrogels are non-toxic and allow the selection of high-quality sperm cells for ART.

Hearing Their Voices: Exploring the Patient Narratives of Adolescent and Young Adults Who Have Undergone Metabolic and Bariatric Surgery-A Case Series.

BACKGROUND: Severe obesity in adolescence and young adulthood is undertreated which leads to obesity-related chronic diseases that progress into adulthood. Many organizations including the American Academy of Pediatrics (AAP) support early consideration of metabolic and bariatric surgery (MBS) in the pediatric population to reduce morbidity and mortality. METHODS: Five diverse patients who underwent metabolic and bariatric surgery (MBS) in the form of a Roux-en-Y gastric bypass (RYGB) and vertical sleeve gastrectomy (VSG) contributed patient narratives that captured their life, with a focus on health related quality of life, before and after MBS. RESULTS: MBS leads to significant improvement in health status via decreased mortality and improved health related quality of life. CONCLUSION: The perspectives of those patients who have undergone surgery in adolescence and young adulthood are not adequately captured in the medical literature. While the featured voices are not representative of all, their narratives may increase awareness and utilization of MBS in the treatment of severe obesity in the pediatric population.

Secondary azoospermia after sleeve gastrectomy: a case report.

OBJECTIVE: To report the first case of secondary azoospermia after sleeve gastrectomy. DESIGN: Case report. SETTING: Academic male infertility clinic. PATIENTS: A 33-year-old man with secondary azoospermia and primary testicular failure with testosterone deficiency after laparoscopic sleeve gastrectomy. INTERVENTIONS: Hormonal therapy with anastrozole for 10 months and diagnostic testicular biopsy. MAIN OUTCOME MEASURES: Semen analyses and testicular histopathology. RESULTS: Non-obstructive azoospermia persisted at 20 months after surgery despite hormonal therapy with anastrozole. Testicular histopathology revealed the presence of Sertoli cells only. CONCLUSIONS: Although further research is need to determine the relationship between sleeve gastrectomy and secondary infertility, men should be informed of the potentially deleterious effects of this surgery on semen parameters.

Preliminary Results of the Planet Nutrition Program on Obesity Parameters in Mexican Schoolchildren: Pilot Single-School Randomized Controlled Trial.

School-based obesity prevention programs are key to promoting healthy habits. The aim of this study was to evaluate the effect of the Planet Nutrition program on BMI z-score and other parameters compared to a control group of Mexican schoolchildren after 9 weeks of intervention. The effect of the summer holidays on the BMI z-score was also evaluated at 23 weeks. A pilot randomized controlled trial design was used and 41 schoolchildren were randomized (21 intervention group and 20 control). The program included 18 nutrition education sessions, 20 physical activity classes and six brochures for parents. At 9 weeks, no significant differences were found between the intervention and control groups in the change in BMI z-score (-0.11, 95% CI -0.23, 0.01). Significant differences were observed in some secondary outcomes: body fat percentage (-1.72, 95% CI -3.42, -0.02), waist circumference (-3.45, 95% CI -5.55, -1.36), physical activity (0.44, 95% CI 0.01, 0.88) and nutrition knowledge (1.15, 95% CI 0.27, 2.03). Summer holidays negatively affected the BMI z-score in both groups, reducing the difference observed between groups at 9 weeks (-0.07, 95% CI -0.22, 0.07). The Planet Nutrition program showed favorable effects in some obesity and lifestyle parameters in the short term.

Antimicrobial activity of a silver-microfibrillated cellulose biocomposite against susceptible and resistant bacteria.

Antibiotic Microbial Resistance (AMR) is a major global challenge as it constitutes a severe threat to global public health if not addressed. To fight against AMR bacteria, new antimicrobial agents are continually needed, and their efficacy must be tested. Historically, many transition metals have been employed, but their cytotoxicity is an issue and hence must be reduced, typically by combination with organic polymers. Cellulose of natural origin, especially those derived from unavoidable residues in the food supply chain, appears to be a good capping agent for the green synthesis of silver nanoparticles. Herein, we describe a green synthesis method to produce a novel biocomposite, using ascorbic acid as reducing agent and microfibrillated cellulose as a capping agent and demonstrate this material to be an efficient antimicrobial agent. Silver nanoparticles were obtained in the cellulose matrix with an average size of 140 nm and with antimicrobial activity against both sensitive and resistant Gram positive (using 1500 ppm) as well as sensitive and resistant Gram negative (using 125 ppm) bacteria. Also, an inverted disk-diffusion methodology was applied to overcome the low-solubility of cellulose compounds. This novel silver nanoparticle-cellulose biocomposite synthesized by a green methodology shows the potential to be applied in the future development of biomedical instruments and therapeutics.