Implicaciones del consumo de bebidas azucaradas en la salud de los adolescentes / Implications of sugary beverage consumption on adolescent health

Fundamentos: La ingesta de bebidas azucaradas constituye un problema de salud pública, este estudio tuvo como objetivo explorar la literatura científica existente sobre los efectos que ocasiona el consumo de estas bebidas en la salud de los adolescentes. Métodos: A través de una revisión integrativa de la literatura (2016 y junio 2022), se realizó búsquedas en bases de datos, como Google Scholar, PubMed, LILACS, Science Direct, Web of Science y Scopus, empleando términos MeSH y DeCS. La revisión se centró en responder a la pregunta sobre los efectos del consumo de bebidas azucaradas en la salud de los adolescentes. Resultados: De 114 artículos recopilados se eliminaron los duplicados y se excluyeron 60 artículos tras la revisión de títulos y resúmenes. Después del análisis exhaustivo de 25 artículos, 15 se excluyeron por no cumplir con los criterios de elegibilidad, resultando en la selección final 10 artículos. El análisis reveló que el consumo de bebidas azucaradas se relaciona con alteraciones mentales y exceso de peso en adolescentes. Conclusiones: El consumo de bebidas azucaradas causa efectos perjudiciales en la salud de los adolescentes, aumentando el riesgo de exceso de peso y alteraciones en la salud mental como depresión, comportamientosagresivos y conductas suicidas. (AU)

Background: The intake of sugary drinks constitutes a public health problem. This study aimed to explore the existing scientific literature on the effects caused by the consumption of these drinks on the health of adolescents. Methods: Through an integrative review of the literature (2016 and June 2022), searches were carried out in databases, such as Google Scholar, PubMed, LILACS, Science Direct, Web of Science and Scopus, using MeSH and DeCS terms. The review focused on answering the question about the effects of consuming sugary drinks on the health of adolescents. Results: From 114 articles collected; Duplicates were removed and 60 articles were excluded after reviewing titles and abstracts. After an exhaustive analysis of 25 articles, 15 were excluded for not meeting the eligibility criteria, resulting in the final selection of 10 articles. The analysis revealed that the consumption of sugary drinks is related to mental disorders and excess weight in adolescents. Conclusions: The consumption of sugary drinks causes harmful effects on the health of adolescents, increasing the risk of excess weight and alterations in mental health such as depression, aggressive behaviors and suicidal behaviors. (AU)

People in Ecuador and the United States conceptualize compassion differently: The role of avoided negative affect.

Even people from frequently studied cultural contexts differ in how they conceptualize compassion, partly because of differences in how much they want to avoid feeling negative. To broaden this past work, we include participants from an understudied cultural context and start to examine the process through which culture shapes compassion. Based on ethnographic and empirical studies that include Ecuadorians, we predicted that Ecuadorians would want to avoid feeling negative less compared to U.S. Americans. Furthermore, we hypothesized that because of these differences in avoided negative affect, compared to U.S. Americans, for Ecuadorians, a compassionate response would contain more emotion sharing, which in turn would be associated with conceptualizing a compassionate face as one that mirrors sadness more and expresses happiness (e.g., a kind smile) less. Using a reverse correlation task, participants in the United States and Ecuador selected the stimuli that most resembled a compassionate face. They also reported how much they wanted to avoid feeling negative and described what a compassionate response would entail. As predicted, compared to U.S. Americans, Ecuadorians wanted to avoid feeling negative less, they conceptualized a compassionate response as one that focused more on emotion sharing, and visualized a compassionate face as one that contained more sadness and less happiness. Furthermore, exploratory analyses suggest that wanting to avoid feeling negative and conceptualizations of a compassionate response as emotion sharing partly sequentially explained the cultural differences in conceptualizations of a compassionate face. What people regard as compassionate differs across cultures, which has important implications for cross-cultural counseling. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Pulse Spray Drying for Bovine Skimmed Milk Powder Production.

Pulse Spray Drying (PSD) has potential as a sustainable means of skimmed milk powder (SMP) production. In this study, powders were obtained from PSD using different drying outlet temperatures (70, 80, 90 and 100 °C), and their characteristics were compared to those of traditional Spray Drying (SD). Native whey proteins were well preserved and Solubility Indexes were over 98% in all cases, despite powders obtained by PSD displaying lower solubility than the SD ones. No visual difference was observable in the powders (ΔE < 2); however, PSD powders were found to be yellower with a higher Browning Index. The drying technology did not have a significant effect on powder moisture content and bulk density. Particle size distribution and scanning electron microscopy images confirmed the presence of fine particles (<10 µm) in all samples that might have provided poor flowability and wetting behavior (overall Carr Index and Hausner ratio were 33.86 ± 3.25% and 1.52 ± 0.07, respectively). Higher amounts of agglomerated particles were found at low temperatures in the products processed with both technologies, but PSD samples showed a narrower particle size distribution and hollow particles with more wrinkles on the surface (probably due to the fast evaporation rate in PSD). Overall, PSD provided SMP with comparable physicochemical characteristics to SD and, once optimized at the industrial level, could offer significant advantages in terms of thermal efficiency without significant modification of the final product quality.

Oncological outcomes in robot-assisted radical prostatectomy: the value of PSA density as a preoperative predictive factor.

Background: Pretreatment assessment of patients diagnosed with localized prostate cancer (PCa) is essential for therapeutic decision-making. Currently available staging systems based on prostate-specific antigen (PSA), Gleason score, and clinical stage allow for determining the prognostic characteristics of these patients. Several studies have evaluated the preoperative use of prostate-specific antigen density (PSAD) as a prognostic factor for further risk stratification. To date, the role of PSAD in this setting is still an object of debate. Objectives: The present analysis aimed to assess the predictive potential of PSAD for adverse oncological outcomes after robot-assisted radical prostatectomy (RARP) and to compare its accuracy to preoperative PSA (pPSA). Design and methods: We retrospectively reviewed 427 patients diagnosed with localized PCa who underwent RARP at a single institution between January 2015 and January 2020. Generating receiver operator characteristic (ROC) curves, calculating areas under the curves (AUCs), and using a linear regression model, we analyzed the association of PSAD and pPSA with postoperative positive surgical margins (PSM), Gleason score ⩾ 7, persistent PSA, and biochemical recurrence (BCR), with a median follow-up of 47 months. Results: PSAD showed a significant association with PSM (p < 0.0001), PSA persistence (p < 0.0001), and Gleason ⩾ 7 (p < 0.0001), without being statistically significant in predicting BCR (p = 0.098). The predictive value of PSAD was comparable to pPSA for outcomes of PSA persistence (AUC 0.727 versus 0.771) and Gleason ⩾ 7 (AUC 0.683 versus 0.649). Conclusion: PSAD is a predictive factor for postoperative oncological outcomes of PSM, Gleason score ⩾ 7, and persistence of PSA. Despite the need for further studies, PSAD could be useful as a prognostic parameter in conjunction with established staging systems.

Oncological outcomes in robot-assisted radical prostatectomy: the value of PSA density as a preoperative predictive factor Prostate-specific antigen density (PSAD) has an established role in the diagnostic process of prostate cancer (PCa). However, controversy remains on the assessment of its value as a pretreatment prognostic factor. The aim of our study was to evaluate the predictive ability of PSAD for oncological outcomes in PCa patients treated with robot-assisted radical prostatectomy (RARP) and to compare with the value of preoperative PSA (pPSA). The present analysis showed a significant association of PSAD with positive surgical margins (PSM), Gleason Score >=7 and prostate-specific antigen (PSA) persistence after RARP. Moreover, PSAD demonstrated to perform comparably to pPSA in predicting the outcomes of clinically significant PCa (csPCa) and post-RARP PSA persistence. Therefore, PSAD is considered a preoperative predictive factor potentially useful in conjunction with other previously established prognostic criteria and clinical features.

Comparative study of two retrograde locked intramedullary nail designs for ankle arthrodesis: A finite element analysis.

Ankle arthrodesis is the gold standard for treatment of end-stage arthritis. The goal of ankle arthrodesis is to obtain bony union between the tibia and the talus. Retrograde intramedullary nailing is typically reserved for ankle and subtalar joints arthrodesis. The purpose of this study is to evaluate the effect of two different materials, two locking pin configurations and two nail designs of a retrograde locked intramedullary nail used for ankle arthrodesis. Using the finite element analysis, a numerical study of ankle arthrodesis was developed to evaluate the effect of materials: TI-6Al-4V and stainless steel AISI 316 LVM; two locking pin configurations: five and six pins, on two intramedullary nails: Ø10 × 180 mm and Ø11 × 200 mm. A model of a healthy foot was created from tomographic scans. It was found that the mechanical stimulus required to achieve bone fusion were higher for Ø10 × 180 nails (6.868 ± 0.047) than the Ø11 × 200 nails (5.918 ± 0.047; p < 0.001; mean ± SEM). We also found that six-pin configuration had a higher mechanical stimulus (6.470 ± 0.047) than the five-pin configuration (6.316 ± 0.046; p = 0.020). Similarly, it was higher for titanium (6.802 ± 0.047) than those for stainless steel (5.984 ± 0.046; p < 0.001). Finally, the subtalar zone presented higher values (7.132 ± 0.043) than the tibiotalar zone (5.653 ± 0.050; p < 0.001). The highest mechanical stimulus around the vicinity of tibiotalar and subtalar joint was obtained by Ø10 × 180 nails, made of titanium alloy, with 6P.

Sindrome de burnout, estado nutricional y conducta alimentaria en trabajadores de la salud / Burnout syndrome, nutritional status and eating behavior in health workers

Introducción: El síndrome de Burnout o agotamiento profesional aparece como una respuesta al estrés crónico en eltrabajo, con secuelas negativas a nivel individual y general. Objetivo: Determinar la presencia del síndrome de bur-nout, estado nutricional y conducta alimentaria en los traba-jadores de la salud. Materiales y Métodos: Estudio transversal, descriptivo y observacional. Para identificar la presencia del síndrome de Burnout se aplicó el cuestionario Maslach Burnout Inventory.La evaluación del estado nutricional se realizó por medio dela toma de datos antropométricos y la conducta alimentaria se identificó con el cuestionario semi-cuantitativo de frecuen-cia de consumo de alimentos. Resultados: La muestra de investigación estuvo constituida por 142 mujeres y 91 varones que representaron el60,9% y 39,1% respectivamente. La conducta alimentaria secaracterizó por un consumo insuficiente de lácteos, hortalizas,frutas, carnes, panes y cereales. Con respecto a las caracte-rísticas antropométricas relacionadas al estado nutricional seencontró que el mayor porcentaje de investigados presentanuna prevalencia de exceso de peso del 78% y un riesgo car-diovascular del 91%. En las 3 subescalas que valora la pre-sencia del síndrome de burnout se pudo observar que tantoen los componentes de cansancio emocional y despersonali-zación son bajos, reflejando un 60,9% y 53,6% respectiva-mente. Mientras que la dimensión de realización personal esalta, evidenciando un 63,1%.Conclusiones: En la población de estudio no existen indicios de presencia de síndrome de burnout, sin embargo, un menor porcentaje de trabajadores de la salud presentan can-sancio emocional (19,3%), despersonalización (25,8%) ybaja realización personal (19,7%). Por lo cual se recomienda, buscar estrategias para reducir la carga administrativa y disminuir el nivel de agotamiento laboral en quienes lo padeceny prevenirlo en aquellos que presenten factores de riesgo (AU)

Introduction: Burnout syndrome or professional exhaustion appears as a response to chronic stress at work, withnegative consequences at an individual and general level. Objective: Determine the presence of burnout syndrome, nutritional status and eating behavior in health workers. Materials and methods: Cross-sectional, descriptive and observational study. To identify the presence of Burnout syndrome, the Maslach Burnout Inventory questionnaire was applied. To assess the nutritional status, anthropometric datawere taken and eating behavior was identified with the semi-quantitative questionnaire on frequency of food consumption. Results: The research sample consisted of 142 womenand 91 men who represented 60.9% and 39.1% respectively. The eating behavior was characterized by an insufficient con-sumption of dairy products, vegetables, fruits, meats, breadsand cereals. Regarding the anthropometric characteristics re-lated to nutritional status, it was found that the highest per-centage of those investigated had a prevalence of excessweight of 78% and a cardiovascular risk of 91%. In the 3 sub-scales that assess the presence of burnout syndrome, it wasobserved that both the emotional exhaustion and deperson-alization components are low, reflecting 60.9% and 53.6%respectively. While the dimension of personal fulfillment ishigh, evidencing 63.1%.Conclusions: In the study population there are no indica-tions of the presence of burnout syndrome, however, a lowerpercentage of health workers present emotional exhaustion(19.3%), depersonalization (25.8%) and low personal fulfillment (19.7%). Therefore, it is recommended to seek strategies to reduce the administrative burden and reduce the levelof job burnout in those who suffer from it and prevent it inthose who present risk factors (AU)

Fusion crystallization reveals the behavior of both the 1TEL crystallization chaperone and the TNK1 UBA domain.

Human thirty-eight-negative kinase-1 (TNK1) is implicated in cancer progression. The TNK1 ubiquitin-associated (UBA) domain binds polyubiquitin and plays a regulatory role in TNK1 activity and stability. No experimentally determined molecular structure of this unusual UBA domain is available. We fused the UBA domain to the 1TEL variant of the translocation ETS leukemia protein sterile alpha motif (TELSAM) crystallization chaperone and obtained crystals diffracting as far as 1.53 Å. GG and GSGG linkers allowed the UBA to reproducibly find a productive binding mode against its host 1TEL polymer and crystallize at protein concentrations as low as 0.2 mg/mL. Our studies support a mechanism of 1TEL fusion crystallization and show that 1TEL fusion crystals require fewer crystal contacts than traditional protein crystals. Modeling and experimental validation suggest the UBA domain may be selective for both the length and linkages of polyubiquitin chains.

Increasing the bulk of the 1TEL-target linker and retaining the 10×His tag in a 1TEL-CMG2-vWa construct improves crystal order and diffraction limits.

TELSAM-fusion crystallization has the potential to become a revolutionary tool for the facile crystallization of proteins. TELSAM fusion can increase the crystallization rate and enable crystallization at low protein concentrations, in some cases with minimal crystal contacts [Nawarathnage et al. (2022), Open Biol. 12, 210271]. Here, requirements for the linker composition between 1TEL and a fused CMG2 vWa domain were investigated. Ala-Ala, Ala-Val, Thr-Val and Thr-Thr linkers were evaluated, comparing metrics for crystallization propensity and crystal order. The effect on crystallization of removing or retaining the purification tag was then tested. It was discovered that increasing the linker bulk and retaining the 10×His purification tag improved the diffraction resolution, likely by decreasing the number of possible vWa-domain orientations in the crystal. Additionally, it was discovered that some vWa-domain binding modes are correlated with scrambling of the 1TEL polymer orientation in crystals and an effective mitigation strategy for this pathology is presented.

Fusion crystallization reveals the behavior of both the 1TEL crystallization chaperone and the TNK1 UBA domain.

Human thirty-eight-negative kinase-1 (TNK1) is implicated in cancer progression. The TNK1-UBA domain binds polyubiquitin and plays a regulatory role in TNK1 activity and stability. Sequence analysis suggests an unusual architecture for the TNK1 UBA domain, but an experimentally-validated molecular structure is undetermined. To gain insight into TNK1 regulation, we fused the UBA domain to the 1TEL crystallization chaperone and obtained crystals diffracting as far as 1.53 Å. A 1TEL search model enabled solution of the X-ray phases. GG and GSGG linkers allowed the UBA to reproducibly find a productive binding mode against its host 1TEL polymer and to crystallize at protein concentrations as low as 0.1 mg/mL. Our studies support a mechanism of TELSAM fusion crystallization and show that TELSAM fusion crystals require fewer crystal contacts than traditional protein crystals. Modeling and experimental validation suggest the UBA domain may be selective for both the length and linkages of polyubiquitin chains.

Separation of α-Lactalbumin-Enriched Fractions from Caprine and Ovine Native Whey Concentrate by Combining Membrane and High-Pressure Processing.

Whey from goat and sheep have been gaining attention in the last few years for their nutritional properties. Unfortunately, ß-Lg, not found in human milk, may trigger infant allergies if used in infant food formulations, so there is a growing interest in developing ingredients derived from whey with higher α-La/ß-Lg ratios. The objective of this work was to study the effect of high-pressure processing (HPP) on caprine and ovine native whey concentrates (NWC) in order to obtain α-Lactalbumin (α-La)-enriched fractions. NWCs were treated at 600 MPa (23 °C) for 2, 4, and 15 min and two pH conditions were studied (physiological pH and pH 4.60). The concentration of ß-Lg in supernatant fraction after HPP significantly decreased after 2 min of treatment, while the concentration of α-La was unchanged in both goat and sheep samples. Longer HPP processing times (up to 15 min) progressively increased α-La purification degree but also decreased the α-La yield. Caprine and ovine NWCs treated at physiological pH provided better α-La yield, α-La purification degree, and higher ß-Lg precipitation degrees than the corresponding acidified samples, while the corresponding NWC supernatant (NWCsup) showed lower values for both surface hydrophobicity and total free thiol indices, suggesting a higher extent of protein aggregation. Effects of sample acidification and the HPP treatment were opposite to those previously reported on bovine NWC, so further characterization of caprine and ovine ß-Lg should be carried out to understand their different behavior.

Decreasing the flexibility of the TELSAM-target protein linker and omitting the cleavable fusion tag improves crystal order and diffraction limits.

TELSAM crystallization promises to become a revolutionary tool for the facile crystallization of proteins. TELSAM can increase the rate of crystallization and form crystals at low protein concentrations without direct contact between TELSAM polymers and, in some cases, with very minimal crystal contacts overall (Nawarathnage et al ., 2022). To further understand and characterize TELSAM-mediated crystallization, we sought to understand the requirements for the composition of the linker between TELSAM and the fused target protein. We evaluated four different linkers Ala-Ala, Ala-Val, Thr-Val, and Thr-Thr, between 1TEL and the human CMG2 vWa domain. We compared the number of successful crystallization conditions, the number of crystals, the average and best diffraction resolution, and the refinement parameters for the above constructs. We also tested the effect of the fusion protein SUMO on crystallization. We discovered that rigidification of the linker improved diffraction resolution, likely by decreasing the number of possible orientations of the vWa domains in the crystal, and that omitting the SUMO domain from the construct also improved the diffraction resolution. Synopsis: We demonstrate that the TELSAM protein crystallization chaperone can enable facile protein crystallization and high-resolution structure determination. We provide evidence to support the use of short but flexible linkers between TELSAM and the protein of interest and to support the avoidance of cleavable purification tags in TELSAM-fusion constructs.

Spirometry and respiratory oscillometry: Feasibility and concordance in schoolchildren with asthma.

OBJECTIVE: The purpose of this study was to describe the feasibility of respiratory oscillometry (RO) in schoolchildren with asthma, and the concordance of its results with those of spirometry, to determine its clinical usefulness. METHODS: RO and spirometry were performed in 154 children (6 to 14-year-old) with asthma, following strict quality criteria for the tests. Their feasibility (probability of valid test, time of execution, number of maneuvers needed to achieve a valid test, and perceived difficulty) was compared. The factors that influence feasibility were analyzed with multivariate methods. FEV1, FEV1/FVC, FVC and FEF25-75 for spirometry, and R5, AX and R5-19 for RO, were converted into z-scores and their concordance was investigated through intraclass correlation coefficients (ICC) and kappa indices for normal/abnormal values. RESULTS: There were no differences in the probability of obtaining a valid RO or spirometry (83.1% vs. 81.8%, p = 0.868). RO required a lower number of maneuvers [mean (SD) 4.2 (1.8) versus 6.0 (1.6), p < 0.001] and less execution time [5.1 (2.7) versus 7.6 (2.4) minutes, p < 0.001], and patients considered it less difficult. Age increased the probability of obtaining valid RO and spirometry. The concordance of results between RO and spirometry was low, and only between zFEV1 and zAX could it be considered moderate (ICC = 0.412, kappa = 0.427). CONCLUSION: RO and spirometry are feasible in children with asthma. RO has some practical advantages, but the concordance of its results with spirometry is low.

Separation of α-Lactalbumin Enriched Fraction from Bovine Native Whey Concentrate by Combining Membrane and High-Pressure Processing.

Whey exhibits interesting nutritional properties, but its high ß-Lactoglobulin (ß-Lg) content could be a concern in infant food applications. In this study, high-pressure processing (HPP) was assessed as a ß-Lg removal strategy to generate an enriched α-Lactalbumin (α-La) fraction from bovine native whey concentrate. Different HPP treatment parameters were considered: initial pH (physiological and acidified), sample temperature (7-35 °C), pressure (0-600 MPa) and processing time (0-490 s). The conditions providing the best α-La yield and α-La purification degree balance (46.16% and 80.21%, respectively) were 4 min (600 MPa, 23 °C), despite the significant decrease of the surface hydrophobicity and the total thiol content indexes in the α-La-enriched fraction. Under our working conditions, the general effects of HPP on α-La and ß-Lg agreed with results reported in other studies of cow milk or whey. Notwithstanding, our results also indicated that the use of native whey concentrate could improve the ß-Lg precipitation degree and the α-La purification degree, in comparison to raw milk or whey. Future studies should include further characterization of the α-La-enriched fraction and the implementation of membrane concentration and HPP treatment to valorize cheese whey.

Marine Actinobacteria a New Source of Antibacterial Metabolites to Treat Acne Vulgaris Disease-A Systematic Literature Review.

Acne vulgaris is a multifactorial disease that remains under-explored; up to date it is known that the bacterium Cutibacterium acnes is involved in the disease occurrence, also associated with a microbial dysbiosis. Antibiotics have become a mainstay treatment generating the emergence of antibiotic-resistant bacteria. In addition, there are some reported side effects of alternative treatments, which indicate the need to investigate a different therapeutic approach. Natural products continue to be an excellent option, especially those extracted from actinobacteria, which represent a prominent source of metabolites with a wide range of biological activities, particularly the marine actinobacteria, which have been less studied than their terrestrial counterparts. Therefore, this systematic review aimed to identify and evaluate the potential anti-infective activity of metabolites isolated from marine actinobacteria strains against bacteria related to the development of acne vulgaris disease. It was found that there is a variety of compounds with anti-infective activity against Staphylococcus aureus and Staphylococcus epidermidis, bacteria closely related to acne vulgaris development; nevertheless, there is no report of a compound with antibacterial activity or quorum-sensing inhibition toward C. acnes, which is a surprising result. Since two of the most widely used antibiotics for the treatment of acne targeting C. acnes were obtained from actinobacteria of the genus Streptomyces, this demonstrates a great opportunity to pursue further studies in this field, considering the potential of marine actinobacteria to produce new anti-infective compounds.

Successful control of Serratia marcescens outbreak in a neonatal unit of a tertiary-care hospital in Spain.

OBJECTIVE: Serratia marcescens is a Gram-negative bacterium that is found in hospital environments and commonly associated with outbreaks in neonatal units. One S. marcescens isolate was detected from a bloodstream culture from a neonate in our hospital that was followed by an outbreak. The aim of this study was to describe the molecular epidemiology of a S. marcescens outbreak in the neonatal unit. METHODS: In order to investigate the outbreak, weekly surveillance rectal swabs were submitted for culture from all patients admitted in this unit from August to September 2018. Environmental samples were obtained from potential sources in September 2018. Typing of isolates was performed by pulsed field gel electrophoresis (PFGE). In addition, we studied the in vitro activity of chlorhexidine against S. marcescens. RESULTS: During this period, 146 infants were hospitalised in our neonatal unit, of which 16 patients had a S. marcescens-positive sample. A total of 36 environmental surveillance samples were collected, and one sample from a stethoscope from an incubator of a colonized baby was positive for S. marcescens. All the 18 isolates, including the isolate from the stethoscope, belonged to a single PFGE cluster. We found that very low concentrations of chlorhexidine, even with application times close to 0 achieved significant reductions in the amount of S. marcescens. CONCLUSION: A unique clone of S. marcescens caused this outbreak, including isolates from patients and from one stethoscope. The outbreak was controlled with the early implementation of specific control measures.

Usefulness of Tissue Tracking by Cardiac Magnetic Resonance to Predict Events in Patients With Hypertrophic Cardiomyopathy.

Hypertrophic cardiomyopathy (HC) is the most common cardiovascular inherited disease, and it is associated with arrhythmic events, heart failure, and death. Strain analysis by tissue tracking (TT) techniques on cardiac magnetic resonance (CMR) is a novel noninvasive diagnostic tool. However, the usefulness of CMR-TT to identify patients with HC at risk of adverse outcomes remains unknown. CMR strain parameters by CMR-TT were prospectively measured in a cohort of 136 consecutive patients with HC. Clinical (death or readmission for heart failure) and arrhythmic (any ventricular tachycardia) events during follow-up were prospectively recorded. Global radial systolic strain rate and global radial diastolic strain rate showed the best area under the receiver operating characteristic curve (ROC curve) to predict adverse clinical events. On Cox multivariate regression models, a global radial systolic strain rate value <1.4/s and a global radial diastolic strain rate value ≥ -1.38/s were independently associated with clinical events at follow-up (adjusted hazard ratio 6.57, 95% confidence interval [CI] 2.01 to 21.49, p = 0.002; adjusted hazard ratio 5.96, 95% CI 1.79 to 19.89, p = 0.004, respectively). Regarding arrhythmic events, global radial peak strain <27% showed the best area under the ROC curve and remained independently associated with ventricular tachycardia after adjustment for confounders (odds ratio 7.33, 95% CI 1.07 to 50.41, p = 0.043). CMR strain parameters by TT predict clinical and arrhythmic events in patients with HC.

Successful control of Serratia marcescens outbreak in a neonatal unit of a tertiary-care hospital in Spain / Control exitoso de un brote de Serratia marcescens en la unidad neonatal de un hospital terciario en España

ObjectiveSerratia marcescens is a Gram-negative bacterium that is found in hospital environments and commonly associated with outbreaks in neonatal units. One S. marcescens isolate was detected from a bloodstream culture from a neonate in our hospital that was followed by an outbreak. The aim of this study was to describe the molecular epidemiology of a S. marcescens outbreak in the neonatal unit.MethodsIn order to investigate the outbreak, weekly surveillance rectal swabs were submitted for culture from all patients admitted in this unit from August to September 2018. Environmental samples were obtained from potential sources in September 2018. Typing of isolates was performed by pulsed field gel electrophoresis (PFGE). In addition, we studied the in vitro activity of chlorhexidine against S. marcescens.ResultsDuring this period, 146 infants were hospitalised in our neonatal unit, of which 16 patients had a S. marcescens-positive sample. A total of 36 environmental surveillance samples were collected, and one sample from a stethoscope from an incubator of a colonized baby was positive for S. marcescens. All the 18 isolates, including the isolate from the stethoscope, belonged to a single PFGE cluster. We found that very low concentrations of chlorhexidine, even with application times close to 0 achieved significant reductions in the amount of S. marcescens.ConclusionA unique clone of S. marcescens caused this outbreak, including isolates from patients and from one stethoscope. The outbreak was controlled with the early implementation of specific control measures.

ObjetivoSerratia marcescens(S. marcescens) es una bacteria gramnegativa que se encuentra en ambientes hospitalarios y comúnmente aparece asociada a brotes en unidades neonatales. En agosto de 2018 se detectó un aislado de esta bacteria a partir de un hemocultivo de un paciente neonatal en nuestro hospital. El objetivo de este estudio fue describir la epidemiología molecular del brote de S. marcescens en la unidad neonatal.MétodosCon el fin de investigar el brote, se enviaron semanalmente para cultivo muestras rectales de todos los pacientes ingresados en estas unidades de agosto a septiembre de 2018. Asimismo, se obtuvieron muestras ambientales de potenciales orígenes del brote en septiembre de 2018. Los aislados se genotipificaron mediante electroforesis de campo pulsado (PFGE).ResultadosDurante este período, 146 lactantes fueron hospitalizados en nuestra unidad neonatal, de los cuales 16 pacientes tenían una muestra positiva para S. marcescens. Se recogieron un total de 36 muestras de vigilancia ambiental. Una muestra de un estetoscopio de una incubadora de un bebé colonizado resultó positiva para S. marcescens. Los 18 aislamientos, incluido el aislado de la muestra ambiental, pertenecían a un solo patrón de PFGE. Se realizaron experimentos in vitro con clorhexidina y se encontró que concentraciones muy bajas incluso con tiempos de aplicación cercanos a 0 lograban reducciones significativas en la cantidad de S. marcescens.ConclusiónEstos datos confirmaron un único clon de S. marcescens en la unidad neonatal con aislamientos tanto de pacientes como ambientales. La implementación temprana de medidas de control específicas fue eficaz para limitar la transmisión nosocomial.

Crystals of TELSAM-target protein fusions that exhibit minimal crystal contacts and lack direct inter-TELSAM contacts.

While conducting pilot studies into the usefulness of fusion to TELSAM polymers as a potential protein crystallization strategy, we observed novel properties in crystals of two TELSAM-target protein fusions, as follows. (i) A TELSAM-target protein fusion can crystallize more rapidly and with greater propensity than the same target protein alone. (ii) TELSAM-target protein fusions can be crystallized at low protein concentrations. This unprecedented observation suggests a route to crystallize proteins that can only be produced in microgram amounts. (iii) The TELSAM polymers themselves need not directly contact one another in the crystal lattice in order to form well-diffracting crystals. This novel observation is important because it suggests that TELSAM may be able to crystallize target proteins too large to allow direct inter-polymer contacts. (iv) Flexible TELSAM-target protein linkers can allow target proteins to find productive binding modes against the TELSAM polymer. (v) TELSAM polymers can adjust their helical rise to allow fused target proteins to make productive crystal contacts. (vi). Fusion to TELSAM polymers can stabilize weak inter-target protein crystal contacts. We report features of these TELSAM-target protein crystal structures and outline future work needed to validate TELSAM as a crystallization chaperone and determine best practices for its use.

Aprotinin treatment against SARS-CoV-2: A randomized phase III study to evaluate the safety and efficacy of a pan-protease inhibitor for moderate COVID-19.

BACKGROUND: SARS-CoV-2 virus requires host proteases to cleave its spike protein to bind to its ACE2 target through a two-step furin-mediated entry mechanism. Aprotinin is a broad-spectrum protease inhibitor that has been employed as antiviral drug for other human respiratory viruses. Also, it has important anti-inflammatory properties for inhibiting the innate immunity contact system. METHODS: This was a multicentre, double-blind, randomized trial performed in four Spanish hospitals comparing standard treatment versus standard treatment + aprotinin for patients with COVID-19 between 20 May 2020 and 20 October 2021. The primary efficacy outcomes were length of hospital stay and ICU admission. The secondary endpoints were each of the primary efficacy outcomes and a composite of oxygen therapy, analytical parameters and death. Safety outcomes included adverse reactions to treatment during a 30-day follow-up period. Treatment was given for 11 days or till discharge. RESULTS: With almost identical analytical profiles, significant differences were observed in treatment time, which was 2 days lower in the aprotinin group (p = .002), and length of hospital admission, which was 5 days shorter in the aprotinin group (p = .003). The incidence of discharge was 2.19 times higher (HR: 2.188 [1.182-4.047]) in the aprotinin group than in the placebo group (p = .013). In addition, the aprotinin-treated group required less oxygen therapy and had no adverse reactions or side effects. CONCLUSION: Inhaled aprotinin may improve standard treatment and clinical outcomes in hospitalized patients with COVID-19, resulting in a shorter treatment time and hospitalization compared with the placebo group. The administration of aprotinin was safe.

Hemicellulolytic bacteria in the anterior intestine of the earthworm Eisenia fetida (Sav.).

Tropical agriculture produces large amounts of lignocellulosic residues that can potentially be used as a natural source of value-added products. The complexity of lignocellulose makes industrial-scale processing difficult. New processing techniques must be developed to improve the yield and avoid this valuable resource going to waste. Hemicelluloses comprise a variety of polysaccharides with different backbone compositions and decorations (such as methylations and acetylations), and form part of an intricate framework that confers structural stability to the plant cell wall. Organisms that are able to degrade these biopolymers include earthworms (Eisenia fetida), which can rapidly decompose a wide variety of lignocellulosic substrates. This ability probably derives from enzymes and symbiotic microorganisms in the earthworm gut. In this work, two substrates with similar C/N ratios but different hemicellulose content were selected. Palm fibre and coffee husk have relatively high (28%) and low (5%) hemicellulose contents, respectively. A vermicomposting mixture was prepared for the earthworms to feed on by mixing a hemicellulose substrate with organic market waste. Xylanase activity was determined in earthworm gut and used as a selection criterion for the isolation of hemicellulose-degrading bacteria. Xylanase activity was similar for both substrates, even though their physicochemical properties principally pH and electrical conductivity, as shown by the MANOVA analysis) were different for the total duration of the experiment (120 days). Xylanolytic strains isolated from earthworm gut were identified by sequence analysis of the 16S rRNA gene. Our results indicate that the four Actinobacteria, two Proteobacteria, and one Firmicutes isolated are active participants of the xylanolytic degradation by microbiota in the intestine of E. fetida. Most bacteria were more active at pH 7 and 28 °C, and those with higher activities are reported as being facultatively anaerobic, coinciding with the microenvironment reported for the earthworm gut. Each strain had a different degradative capacity.