Solubility, (micro)structure, and in vitro digestion of pea protein dispersions as affected by high pressure homogenization and environmental conditions.

In this work, dispersions were prepared with commercial pea protein isolate (PPI) and subjected to different (i) high pressure homogenization (HPH) intensities (0 - 200 MPa) (room temperature, pH 7) or (ii) environmental conditions (60 °C, pH 7 or pH 12) to generate dispersions with distinct protein molecular and microstructural characteristics, impacting protein solubility. Besides, protein digestion was analyzed following the static INFOGEST in vitro digestion protocol. Generally, increasing pressure of the homogenization treatment was linked with decreasing particle sizes and enhanced protein digestion. More specifically, the dispersion that did not undergo HPH (0 MPa) as well as the dispersion treated at 60 °C, pH 7, had highly similar microstructures, consisting of large irregular particles (10 - 500 µm) with shell-like structures, and exhibited low solubility (around 15 % and 28 %, respectively), which resulted in limited proteolysis (35 % and 42 %, respectively). In contrast, the dispersion subjected to HPH at 100 MPa and the dispersion treated at 60 °C, pH 12 also had similar microstructures with small and homogeneous particles (<1 µm), and exhibited relatively good solubility (54 % and 31 %, respectively), which led to enhanced protein digestion levels (87 % and 74 %, respectively). This study highlights the potential of food processing on macronutrient (micro)structure and further gastrointestinal stability and functionality.

Systematic review and network meta-analysis of hydrosalpinx treatment before in vitro fertilization.

OBJECTIVES: To compare different methods to treat hydrosalpinx, based on both ablative and non-ablative approaches, in infertile patients before undergoing IVF-ET. METHODS: Systematic review and network meta-analysis (NMA) of comparisons between different treatments of hydrosalpinx in infertile patients undergoing IVF. DATA SOURCES: structured searches in common citation databases. Study inclusion criteria: peer-reviewed randomized trials (RCT) or cohort studies comparing effects of salpingectomy, laparoscopic proximal tubal occlusion (LTO), insertion of intratubal device (ITD), sclerotherapy, ultrasound-guided aspiration and no treatment, on live birth, ongoing pregnancy, clinical pregnancy as main outcomes, considering also miscarriage, ectopic pregnancy and complications as secondary outcomes. Principal NMA included RCT, and aggregated NMA of RCT and observational studies was carried out. Pooled effects have been estimated by Odds Ratio (OR) and its 95% confidence interval (CI) for direct and indirect-mixed comparisons, derived from random-effects models. Imprecision and heterogeneity of NMA estimations was assessed by comparison of its 95% CI with predefined intervals for clinically relevant size of effect (OR <0.9 or >1.1). Surface under the cumulative ranking curve (SUCRA) were used to predict treatment rankings for each outcome. RESULTS: Nine RCT were included in main analysis, plus 17 additional observational studies in additional analysis. NMA of RCT did not identify significant differences in the effect of compared treatments on live birth rate, and LTO was the option with the highest value of SUCRA (0.92, mean rank: 1.2). Salpingectomy and US-aspiration associated to a significant increase of ongoing pregnancy rate compared to no treatment, according to NMA results (NMA OR: 4.35; 95% CI: 1.7, 11.14 and 2.8; 95% CI: 1.03, 7.58 respectively). Salpingectomy had the highest SUCRA value (0.88, mean rank: 1.4). NMA estimated significant increase of clinical pregnancy rate for salpingectomy compared with no treatment (NMA OR: 2.24; 95% CI: 1.3, 3.86) as well as for LTO versus no treatment (NMA OR: 2.55; 95% CI: 1.2, 5.41). Both comparisons were affected by a high grade of heterogeneity. For clinical pregnancy, LTO was the intervention with highest SUCRA (0.85; mean rank: 1.6). Regarding secondary outcomes, feasible NMA estimates did not support significant differences between treatments effects. According to aggregated NMA including randomized and observational studies, sclerotherapy showed significant beneficial effects on live birth rate compared to no treatment (NMA (OR: 4.6; 95% CI: 1.21, 17.46). Compared with untreated patients, the aggregated NMA estimates a higher ongoing pregnancy rate in patients treated with salpingectomy (NMA OR: 3.35; 95% CI: 2.12, 5.12), US-aspiration (NMA OR: 2.16; 95% CI: 1.28, 3.65) and LTO (NMA OR: 2.46; 95% CI: 1.11, 5.43). Salpingectomy and LTO produced a higher beneficial effect compared to ITD, based on both direct and indirect comparisons. Salpingectomy obtained the highest SUCRA value in rank of effects on ongoing pregnancy (0.94; mean rank: 1.2). NMA found significant effects on clinical pregnancy for comparisons between the different active management procedures compared with no treatments, with the exception of ITD insertion. LTO had more increasing effect on clinical pregnancy rate compared with US-aspiration (NMA OR: 2.04; 95% CI: 1.05, 3.97), while for the rest of the comparisons between procedures no significant differences were identified. NMA ranked LTO as the treatment with a highest SUCRA value (0.91; mean rank: 1.5). NMA prediction models identified LTO as best intervention to reduce miscarriage (SUCRA value: 0.84; mean rank: 1.8), as sclerotherapy as safer option in terms of ovarian response to IVF stimulation. CONCLUSIONS: The present NMA fails to support the effectiveness of any option to treat hydrosalpinx before IVF in order to improve live birth rates, although the beneficial effect of salpingectomy and US aspirations on ongoing pregnancy rates and of both salpingectomy and LTO on clinical pregnancy rates emerges from our analysis, which reinforces current recommendations. Based on the aggregated analyses, sclerotherapy could be a promising alternative to conventional laparoscopic techniques, combined with a favorable safety profile. This article is protected by copyright. All rights reserved.

Impact of congenital uterine anomalies on obstetric and perinatal outcomes: systematic review and meta-analysis.

Background: Congenital uterine anomalies (CUA) can be associated with impairments of early and late pregnancy events. Objective: To assess the impact of CUA on reproductive outcomes in pregnancies conceived spontaneously or after assisted reproduction. Materials and Methods: Systematic review and meta-analysis of cohort studies comparing patients with CUA versus women with normal uterus. A structured literature search was performed in leading scientific databases to identify prospective and retrospective studies. The Newcastle-Ottawa scale, adapted to AHRQ standards, was used to assess the risk of bias. Pooled odds ratios (OR) were calculated. Publication bias and statistical heterogeneity were assessed, and meta-regression was used to analyse the heterogeneity. Main outcome measures: Miscarriage, ectopic pregnancy, placental abruption, term, and premature rupture of membranes (PROM), malpresentation at delivery, preterm delivery prior to 37, 34 and 32 weeks, caesarean delivery, intrauterine growth restriction/small for gestational age, foetal mortality and perinatal mortality. Results: 32 studies were included. CUAs increased significantly the risk of first/second trimester miscarriage (OR:1.54;95%CI:1.14-2.07), placental abruption (OR:5.04;3.60-7.04), PROM (OR:1.71;1.34-2.18), foetal malpresentation at delivery (OR:21.04;10.95-40.44), preterm birth (adjusted OR:4.34;3.59-5.21), a caesarean delivery (adjusted OR:7.69;4.17-14.29), intrauterine growth restriction/small for gestational age (adjusted OR:50;6.11-424), foetal mortality (OR:2.07;1.56-2.73) and perinatal mortality (OR:3.28;2.01-5.36). Conclusions: CUA increases the risk of complications during pregnancy, delivery, and postpartum. Complications most frequent in CUA patients were preterm delivery, foetal malpresentation, and caesarean delivery. What is new?: Bicornuate uterus was associated with the highest number of adverse outcomes, followed by didelphys, subseptate and septate uterus.

Production, Extraction, and Solubilization of Exopolysaccharides Using Submerged Cultures of Agaricomycetes.

Macrofungi, also known as mushrooms, can produce various bioactive compounds, including exopolysaccharides (EPS) with distinct biological properties and subsequent industrial applications in the preparation of cosmetics, pharmaceuticals, and food products. EPS are extracellular polymers with diverse chemical compositions and physical properties secreted by macrofungi in the form of capsules or biofilms into the cellular medium. Submerged cultivation is an industrially implemented biotechnological technique used to produce a wide variety of fungal metabolites, which are of economic and social importance due to their food, pharmaceutical, and agronomic applications. It is a favorable technique for cultivating fungi because it requires little space, minimal labor, and low production costs. Moreover, it allows for control over environmental variables and nutrient supply, essential for the growth of the fungus. Although this technique has been widely applied to yeasts, there is limited knowledge regarding optimal growth conditions for filamentous fungi. Filamentous fungi exhibit different behavior compared to yeast, primarily due to differences in cell morphology, reproductive forms, and the type of aggregates generated during submerged fermentation. Furthermore, various growing conditions can affect the production yield of metabolites, necessitating the development of new knowledge to scale up metabolite production from filamentous fungi. This protocol implements the following culture conditions: an inoculum of three agar discs with mycelium, agitation at 150 rpm, a temperature of 28 °C, an incubation time of 72 h, and a carbon source concentration of 40 g/L. These EPS are precipitated using polar solvents such as water, ethanol, and isopropanol and solubilized using water or alkaline solutions. This protocol details the production procedure of EPS using submerged culture; the conditions and culture medium used are described. A detailed description of the extraction is performed, from neutralization to lyophilization. The concentrations and conditions necessary for solubilization are also described. Key features • Production and extraction of EPS from submerged cultures of mycelial forms of macrofungi. • Modification of the method described by Fariña et al. (2001), extending its application to submerged cultures of mycelial forms of the macrofungi. • Determination of EPS production parameters in submerged cultures of mycelial forms of macrofungi. • EPS solubilization using NaOH (0.1 N). Graphical overview.

Studying semi-dynamic digestion kinetics of food: Establishing a computer-controlled multireactor approach.

In this work, a multireactor system to study digestion (MuReDi) kinetics is introduced. For this, a custom-made automated system with four independent syringe pumps (BioXplorer 100, H.E.L Group) was acquired. This system consists of multiple, small-scale reactors allowing to study digestion as a function of time and thus to determine digestion kinetics. The different digestion conditions used in the oral, gastric, and small intestinal phase were based on the digestion protocols published by the INFOGEST consortium. We showed that the minimum working volume of a reactor is 30 mL. Besides, repeatability of the digestion kinetics was shown for two food systems: a liquid Ensure® Plus Vanilla drink, and a solid, cooked lentil sample. When comparing static digestion kinetics with semi-dynamic ones, a significantly different digestion pattern was observed. In the static case, a relatively fast hydrolysis rate was observed until a clear plateau was reached. Oppositely, for the semi-dynamic case, a delayed start of the hydrolysis process was noticed. In the gastric phase, this was explained by the decreasing pH and the large pH dependency of pepsin activity. In the small intestine, the lag phase was relatively shorter, yet clearly present. Here we related it to the gradual enzyme (and bile salt) secretion that had to diffuse towards the substrate before hydrolysis could start. Generally, this work showed that the MuReDi system could be used to perform a semi-dynamic digestion approach which largely impacted the overall digestion kinetics. This is important to consider in future in vitro food digestion simulation work to come closer to physiologically relevant digestion kinetics.

Digestion kinetics of lipids and proteins in plant-based shakes: Impact of processing conditions and resulting structural properties.

In this work, plant-based shakes were prepared (5% oil, 6% protein, 1% lecithin, 88% water) (w/w) using two processing techniques (i) only mixing versus (ii) mixing followed by high pressure homogenisation, as well as two processing sequences (i) adding all ingredients together versus (ii) stepwise addition of ingredients. Shakes only mixed consisted of large, irregular particles (1-100 µm). Eventually, this resulted in a relatively low lipid and protein digestion extent after 2 h of gastric pre-digestion (9% and < 1%, respectively). In contrast, shakes that were subjected to high pressure homogenisation displayed small, homogeneous particles (<10 µm). Besides, lipids and proteins were digested to a high extent in the stomach (40% and 10%, respectively). The small intestinal digestion kinetics indicated a significant impact of proteins on lipid digestion kineticsbutno significant effect of lipids on protein digestion kinetics. The results highlighted the relevance of food processing on macronutrient (micro)structure and further gastrointestinal functionality.

Enzymatic and chemical conversions taking place during in vitro gastric lipid digestion: The effect of emulsion droplet size behavior.

This investigation reports the effect of droplet size behavior on the overall lipolysis profile and molecular lipolysis mechanisms under in vitro gastric conditions. O/W emulsions (5% triolein, 1% sodium taurodeoxycholate) with different initial droplet sizes (fine: 0.58 µm; medium: 1.82 µm; and large: 4.00 µm) were subjected to static in vitro digestion. For the first time, multiple lipolysis products including diolein and monoolein regioisomers were quantified within a single HPLC run. An inverse relation was found between the droplet size and the initial rate and final extent of lipolysis based on the digested triolein. Furthermore, a mechanistic gastric lipolysis model was established based on a reaction scheme including enzymatic and chemical isomerization conversions. The estimated rate of the sn-1/3 hydrolysis was around two- to thirty-fold faster compared to the rates of sn-2 cleavage and isomerization, respectively. These findings resulted in a profound insight in in vitro gastric molecular lipolysis mechanisms.

Social anxiety disorder among patients with multiple sclerosis: a population-based case-control study in Ecuador. / Trastorno de ansiedad social en pacientes con esclerosis múltiple: estudio poblacional de casos y controles en Ecuador.

INTRODUCTION: Several studies have found that individuals with multiple sclerosis (MS) experience relatively high rates of anxiety and depression; however, there are few reports about social anxiety in individuals with MS. AIM: To analyze the prevalence of social anxiety disorder and other psychiatric comorbidities in MS patients compared to matched controls. SUBJECTS AND METHODS: We included 50 patients with MS that were seen during regularly scheduled visits and 50 sex- and age-matched participants from the general population within a six-month interval. All included participants completed the Social Phobia Inventory (SPIN) and the Depression, Anxiety and Stress Scale with 21 items (DASS-21). We defined clinically significant social anxiety symptoms as SPIN scores = 19. RESULTS: The MS patients' mean age was 41.9 years (54% female). The self-reported psychosocial assessments showed that MS participants were more likely to present positive social anxiety symptoms (OR = 7.37; 95% CI = 1.99-27.30; p < 0.001), depression (OR = 3.76; 95% CI = 1.41-10.10; p = 0.006), stress (OR = 2.67; 95% CI = 1.09-6.52; p = 0.029), and general anxiety (OR = 4.70; 95% CI = 1.93-11.40; p < 0.001) than the general population. There were moderate correlations between social anxiety and depression (p = 0,006), general anxiety (p = 0,001), and stress (p < 0,001) in MS patients. CONCLUSIONS: Patients with MS had a higher risk of presenting social anxiety symptoms than a matched control group in a Hispanic population.

TITLE: Trastorno de ansiedad social en pacientes con esclerosis múltiple: estudio poblacional de casos y controles en Ecuador.Introducción. Varios estudios han encontrado que individuos con esclerosis múltiple (EM) presentan tasas altas de ansiedad y depresión; sin embargo, hay pocos informes sobre ansiedad social en individuos con EM. Objetivo. Analizar la prevalencia del trastorno de ansiedad social y otras comorbilidades psiquiátricas en pacientes con EM en comparación con los controles pareados. Sujetos y métodos. Durante un intervalo de seis meses, incluimos a 50 pacientes con EM que fueron observados durante visitas programadas regularmente y a 50 participantes de la población general pareados por sexo y edad. Todos los participantes completaron el inventario de fobia social (SPIN) y la escala de depresión, ansiedad y estrés de 21 ítems. Definimos síntomas de ansiedad social clínicamente significativos los que tenían un resultado en el SPIN mayor o igual a 19. Resultados. La edad media de los pacientes con EM era de 41,9 años (el 54%, mujeres). Las evaluaciones psicológicas notificadas demostraron que los participantes con EM tenían más probabilidad de presentar síntomas positivos de ansiedad social (OR = 7,37; IC 95% = 1,99-27,30; p < 0,001), depresión (OR = 3,76; IC 95% = 1,41-10,10; p = 0,006), estrés (OR = 2,67; IC 95% = 1,09-6,52; p = 0,029) y ansiedad general (OR = 4,70; IC 95% = 1,93-11,40; p < 0,001) que la población general. Se observaron correlaciones moderadas entre ansiedad social y depresión (p = 0,006), ansiedad general (p = 0,001) y estrés (p < 0,001) en los pacientes con EM. Conclusiones. Los pacientes con EM tienen un riesgo más elevado de presentar síntomas de ansiedad social que la población hispana en general.

Full-scale comparison of N2O emissions from SBR N/DN operation versus one-stage deammonification MBBR treating reject water - and optimization with pH set-point.

To be able to fulfill the Paris agreement regarding anthropogenic greenhouse gases, all potential emissions must be mitigated. Wastewater treatment plants should aim to eliminate emissions of the most potent greenhouse gas, nitrous oxide (N2O). In this study, these emissions were measured at a full-scale reject water treatment tank during two different operation modes: nitrification/denitrification (N/DN) operating as a sequencing batch reactor (SBR), and deammonification (nitritation/anammox) as a moving bed biofilm reactor (MBBR). The treatment process emitted significantly less nitrous oxide in deammonification mode 0.14-0.7%, compared to 10% of total nitrogen in N/DN mode. The decrease can be linked to the changed feeding strategy, the lower concentrations of nitrite, a lower load of ammonia oxidized, a shorter aeration time, the absence of non-optimized ethanol dosage or periodic lack of oxygen as well as the introduction of biofilm. Further, evaluation was done how the operational pH set point influenced the emissions in deammonification mode. Lower concentrations of nitrous oxide were measured in water phase at higher pH (7.5-7.6) than at lower pH (6.6-7.1). This is believed to be mainly because of the lower aeration ratio and increased complete denitrification at the higher pH set point.

[Primary central nervous system lymphoma: clinical experience in a neurological center]. / Linfoma primario del sistema nervioso central: experiencia clinica en un centro neurologico.

INTRODUCTION: Primary lymphoma of the central nervous system is a variety of non-Hodgkin's lymphoma that accounts for 4-5% of intracranial tumours and 5% of all lymphomas. It has its origin in the brain, the eyes, the leptomeninges and the spinal cord with no systemic evidence of lymphomatoid activity; the subtype of lymphoma is predominantly of B-type cells. PATIENTS AND METHODS: We conducted a descriptive study of the patients diagnosed with primary brain lymphoma who were attended to at third-level centres in Mexico between the years 1980 and 2016. Patients who had been screened for systemic lymphoma were included. The results were analysed by means of simple frequencies, and disease-free and overall survival time was analysed by Kaplan-Meier curves; the differences among curves were analysed by means of log rank. RESULTS: Of a total of 215 patients, there were only 74 cases. By sex, 45% were females and 55% were males. Regarding age, 36.7% were over 60 years old. The most frequent clinical manifestations were motor loss (60%) and cognitive disorders (52%). Most patients received some form of chemotherapy (89%). The only significant factor for radiological response and clinical prognosis was the combined use of radiochemotherapy (p = 0.04493). CONCLUSION: Lymphoma is a tumorous condition with a high clinicoradiological response to treatment, although the response is not long-lasting. Its early identification and multidisciplinary management are essential for a more favourable prognosis in these patients.

TITLE: Linfoma primario del sistema nervioso central: experiencia clinica en un centro neurologico.Introduccion. El linfoma primario del sistema nervioso central es una variedad de linfoma no Hodgkin que representa el 4-5% de los tumores intracraneales y el 5% de todos los linfomas. Se origina en el encefalo, los ojos, la leptomeninge y la medula espinal sin evidencia sistemica de actividad linfomatoide; el subtipo de linfoma mayoritariamente es de celulas de tipo B. Pacientes y metodos. Estudio descriptivo de los pacientes diagnosticados con linfoma cerebral primario que fueron atendidos en centros de tercer nivel en Mexico entre los años 1980 y 2016. Se incluyo a los pacientes que contaran con cribado para busqueda de linfoma sistemico. Los resultados se analizaron mediante frecuencias simples; en el caso del tiempo libre de enfermedad y supervivencia global, mediante curvas de Kaplan-Meier, y las diferencias entre curvas, mediante log rank. Resultados. En un total de 215 pacientes solo hubo 74 casos. El 45% fueron mujeres y el 55%, hombres. El 36,7% eran mayores de 60 años. Las manifestaciones clinicas mas frecuentes fueron deficit motor (60%) y alteraciones cognitivas (52%). La mayoria recibio alguna forma de quimioterapia (89%). El unico factor significativo para respuesta radiologica y pronostico clinico era el uso combinado de radioquimioterapia (p = 0,04493). Conclusion. El linfoma representa una patologia tumoral con alta respuesta clinicorradiologica al tratamiento, aunque la respuesta no es duradera. Es fundamental su identificacion temprana y el tratamiento multidisciplinario para el mejor pronostico de estos pacientes.

Radiotherapy plus temozolomide or PCV in patients with anaplastic oligodendroglioma 1p19q codeleted. / Radioterapia mas temozolomida o PCV en pacientes con oligodendroglioma anaplasico con codelecion 1p19q.

INTRODUCTION: Radiotherapy with procarbazine, lomustine, and vincristine (PCV) improves overall survival in patients with anaplastic oligodendroglioma 1p19q codeleted. PATIENTS AND METHODS: This retrospective analysis investigated outcomes in patients with anaplastic oligodendroglioma 1p19q codeleted compared two different protocols (radiotherapy plus temozolomide or PCV). The primary end points were overall survival and progression-free survival. Secondary endpoint was the radiological response. RESULTS: A total of 48 patients were included. Mean age was 43 years (range: 19-66 years), 26 were male (54.1%). Twenty-one patients received PCV and 27 temozolomide. The baseline characteristics were not difference between the groups. The progression-free survival and overall survival in the PCV group were 7.2 and 10.6 years respectively and temozolomide were 6.1 and 9.2 years, both statistically significant. The radiological response was present in 80.9% in PCV arm and 70.2% in temozolomide arm there was not statistical differences. The multivariate Cox model showed only the significant parameters the use of PCV protocol. The toxicity grade 3 or 4 was present in 42.8% in PCV arm and 11.1% in temozolomide arm. CONCLUSIONS: The most common strategy in the Latin America community is the substitution of the PCV for temozolomide. This retrospective study showed superior efficacy of PCV than temozolomide. The Latin American community effort must be made to be able to have the drugs to available for using as a first line of treatment.

TITLE: Radioterapia mas temozolomida o PCV en pacientes con oligodendroglioma anaplasico con codelecion 1p19q.Introduccion. La radioterapia con procarbacina, lomustina y vincristina (PCV) mejora la supervivencia global en pacientes con oligodendroglioma anaplasico con codelecion 1p19q, pero no esta disponible en America Latina. Pacientes y metodos. Analisis retrospectivo comparando dos protocolos diferentes, radioterapia mas temozolomida o PCV, en pacientes con oligodendroglioma anaplasico con codelecion 1p19q. Los objetivos primarios fueron la supervivencia global y la supervivencia libre de progresion, y el objetivo secundario, la respuesta radiologica. Resultados. Se incluyo a 48 pacientes, 26 de ellos varones (54,1%), con una edad media de 43 años (rango: 19-66 años). Veintiun pacientes recibieron PCV, y 27, temozolomida. Las caracteristicas iniciales no tuvieron diferencias entre los grupos. La supervivencia libre de progresion y la supervivencia global en el grupo con PCV fueron de 7,2 y 10,6 años, y en el grupo de temozolomida, de 6,1 y 9,2 años, respectivamente, unos resultados estadisticamente significativos. Hubo respuesta radiologica en el 80,9% en el brazo de PCV y el 70,2% en el brazo de temozolomida. El analisis multivariado de Cox mostro como unico parametro significativo el uso del protocolo PCV. El grado de toxicidad 3-4 estuvo presente en el 42,8% en el brazo de PCV y en el 11,1% en el brazo de temozolomida. Conclusiones. La estrategia mas comun en America Latina es la sustitucion de PCV por temozolomida. Este estudio retrospectivo mostro una eficacia superior de PCV que de la temozolomida. La diferencia obliga a la comunidad latinoamericana a hacer un esfuerzo colectivo para poder tener acceso a los medicamentos para su uso como primera linea de tratamiento.

Anaerobic co-digestion of sludge and microalgae grown in municipal wastewater - a feasibility study.

In this study a natural mix of microalgae grown in wastewater of municipal character was co-digested with sewage sludge in mesophilic conditions, in both batch and semi-continuous modes. The semi-continuous experiment was divided into two periods with OLR1 (organic loading rate) of 2.4 kg volatile solids (VS) m-3 d-1 and HRT1 (hydraulic retention time) of 15 days, and OLR2 of 3.5 kg VS m-3 d-1 and HRT2 of 10 days, respectively. Results showed stable conditions during both periods. The methane yield was reduced when adding microalgae (from 200 ± 25 NmL CH4 g VSin-1, to 168 ± 22 NmL CH4 g VSin-1) but VS reduction was also decreased by 51%. This low digestibility was confirmed in the anaerobic batch test. However, adding microalgae improved the dewaterability of the digested sludge. The high heavy metals content in the microalgae resulted in a high heavy metals content in the digestate, making it more difficult to reuse the digestate as fertilizer on arable land. The heavy metals are thought to originate from the flue gas used as a CO2 source during the microalgae cultivation. Therefore the implementation of CO2 mitigation via algal cultivation requires careful consideration regarding the source of the CO2-rich gas.

TNF as marker of oral candidiasis, HSV infection, and mucositis onset during chemotherapy in leukemia patients.

OBJECTIVE: To assess changes in the salivary expression of IL-1α, IL-1ß, IL-2, IL-6, IL-10, IL-17, and TNF in acute leukemia (AL) patients before and during chemotherapy, and its association with HSV infection, oral candidiasis (OC), and oral mucositis (OM) onset. METHODS: Cohort study in AL patients >15 years starting induction chemotherapy at a Mexican oncological center (2013-2014). Onset of oral lesions (OLs) was assessed during follow-up, and saliva was obtained at baseline, at visit 2 (days 4-12), and at visit 3 (days 13-21) after chemotherapy, treated with a protease inhibitor and stored at -70°C. An enzyme-linked immunosorbent assay was performed. Cox proportional hazards regression models were constructed to estimate hazard ratios and its 95% CI (HR, 95% CI) for OL development. RESULTS: Forty-one patients were followed up, and 17 (41.5%) developed OLs. OL patients had higher baseline salivary IL-1α than those without lesions (p = 0.040). During visit 2, OL patients had higher levels of IL-1α (p = 0.033), IL-1ß (p = 0.016), IL-6 (p = 0.035), and TNF (p = 0.019) than those who did not develop OLs. Patients with HSV infection, OC, and OM showed higher salivary TNF levels during follow-up (HR: 3.52, 95% CI: 1.35-9.14, p = 0.010). CONCLUSION: AL patients undergoing chemotherapy with high salivary TNF levels were more likely to develop HSV infection, OC, and OM.

Infective capacity of Cryptococcus neoformans and Cryptococcus gattii in a human astrocytoma cell line.

Pathogenesis of cryptococcosis in the central nervous system (CNS) is a topic of ongoing research, including the mechanisms by which this fungus invades and infects the brain. Astrocytes, the most common CNS cells, play a fundamental role in the local immune response. Astrocytes might participate in cryptococcosis either as a host or by responding to fungal antigens. To determine the infectivity of Cryptococcus neoformans var. grubii and Cryptococcus gattii in a human astrocytoma cell line and the induction of major histocompatibility complex (MHC) molecules. A glioblastoma cell line was infected with C. neoformans var. grubii and C. gattii blastoconidia labelled with FUN-1 fluorescent stain. The percentage of infection and expression of HLA class I and II molecules were determined by flow cytometry. The interactions between the fungi and cells were observed by fluorescence microscopy. There was no difference between C. neoformans var. grubii and C. gattii in the percentage infection, but C. neoformans var. grubii induced higher expression of HLA class II than C. gattii. More blastoconidia were recovered from C. neoformans-infected cells than from C. gattii infected cells. Cryptococcus neoformans var. grubii may have different virulence mechanisms that allow its survival in human glia-derived cells.

Induction of cellular proliferation in a human astrocytoma cell line by a Trypanosoma cruzi-derived antigen: a mechanism of pathogenesis?

Trypanosoma cruzi can compromise the human central nervous system (CNS) during acute infection or reactivation in immune-suppressed hosts. Astrocytes have been identified as targets of T. cruzi's CNS infection in humans. Despite a high degree of parasitism and cellular lysis by T. cruzi in vitro the number of astrocytoma cells did not change when compared to uninfected cultures. This work evaluated cellular proliferation, changes in Major Histocompatibility Complex (MHC) expression as a reflection of antigen processing, and cytokine (IL-6 & IL-8) secretion in a human astrocytoma cell line exposed to a trypomastigote-derived antigen. Light microscopy was used to evaluate the number of cells; MHC molecule expression, cell cycle and cytokine secretion were assessed by flow cytometry. The number of astrocytoma cells increased proportional to the amount of antigen used and the percentage of cells in G2/M phase was higher when compared to control cultures. Antigen exposure increased expression of MHC class II, but not MHC class I in comparison to cultures incubated without antigen. Astrocytoma cell secretion of IL-6 and IL-8 was unaffected by antigen exposure. These results suggest the participation of a trypomastigote-derived mediator that induces astrocytoma cell proliferation without an inflammatory response; which may contribute to the pathogenesis of neurologic Chagas disease.

Steady-state analysis of activated sludge processes with a settler model including sludge compression.

A reduced model of a completely stirred-tank bioreactor coupled to a settling tank with recycle is analyzed in its steady states. In the reactor, the concentrations of one dominant particulate biomass and one soluble substrate component are modelled. While the biomass decay rate is assumed to be constant, growth kinetics can depend on both substrate and biomass concentrations, and optionally model substrate inhibition. Compressive and hindered settling phenomena are included using the Bürger-Diehl settler model, which consists of a partial differential equation. Steady-state solutions of this partial differential equation are obtained from an ordinary differential equation, making steady-state analysis of the entire plant difficult. A key result showing that the ordinary differential equation can be replaced with an approximate algebraic equation simplifies model analysis. This algebraic equation takes the location of the sludge-blanket during normal operation into account, allowing for the limiting flux capacity caused by compressive settling to easily be included in the steady-state mass balance equations for the entire plant system. This novel approach grants the possibility of more realistic solutions than other previously published reduced models, comprised of yet simpler settler assumptions. The steady-state concentrations, solids residence time, and the wastage flow ratio are functions of the recycle ratio. Solutions are shown for various growth kinetics; with different values of biomass decay rate, influent volumetric flow, and substrate concentration.

Adherencia, satisfacción al tratamiento y calidad de vida de pacientes con cáncer de mama en el Hospital Universitario del Caribe. (Cartagena, Colombia) / Adherence, treatment satisfaction and quality of life in patients with breast cancer at the Hospital Universitario del Caribe. (Cartagena, Colombia)

Objetivos: Determinar la adherencia, satisfacción al tratamiento y calidad de vida de pacientes con cáncer de mama. Materiales y métodos: Estudio descriptivo, prospectivo, trasversal, desarrollado en el Hospital Universitario del Caribe, entre agosto de 2014 y abril de 2015. La muestra fueron 23 pacientes, diagnosticadas de cáncer de mama. La adherencia, satisfacción al tratamiento y calidad de vida se determinaron con los instrumentos siguientes: Cuestionario simplified medication adherence questionnaire (SMAQ), registro de dispensación del hospital (RD), test de satisfacción ESTAR del Estudio ARPAS adaptado y el cuestionario WHOQOL BREF respectivamente. El cuestionario ESTAR fue validado por expertos y mediante alfa de Cronbach. Resultados: El 54,78% de las pacientes (según SMAQ), fueron no adherentes a quimioterápicos, la satisfacción fue de 3,94 (rango 0-6). La calidad de vida estuvo en un promedio de 3.2 (rango 1-5), con valores de 14,5% y 7,14% en el nivel 5 del rango. La mayoría de dimensiones del cuestionario de calidad de vida guardan una correlación directamente proporcional con el nivel total de satisfacción al tratamiento; arrojando un dato negativo (-0,3207) únicamente en la dimensión de satisfacción con la eficacia al tratamiento Conclusiones: La calidad de vida fue media y baja, la adherencia y satisfacción al tratamiento fueron bajas y se presentó una correlación inversa entre calidad de vida y la satisfacción al tratamiento, probablemente a causa de reacciones adversas indeseables que se constituyen en disminución de la calidad de vida

Objective: To determine the adherence, treatment satisfaction and quality of life of patients with breast cancer. Materials and methods: A descriptive, prospective, cross-sectional study, developed at the Hospital Universitario del Caribe, between August 2014 and April 2015. The sample consisted of 23 patients, diagnosed with breast cancer. Adherence, Treatment Satisfaction and quality of life were determined with the following instruments: Simplified Medication Adherence Questionnaire ( SMAQ ) , Dispensing Record (DR) , satisfaction test ESTAR of ARPAS Study adapted and WHOQOL BREF respectively. The ESTAR questionnaire was validated by experts using Cronbach’s alpha. Results: 54.78 % of patients (according SMAQ) were no adherent to chemotherapy, satisfaction was 3.94 (range 0-6) . Quality of life was on average 3.2 (range 1-5), with values of 14.5% at level 1 and 7.14% at level 5 range . Most dimensions of QoL questionnaire bear a direct correlation with the overall level of satisfaction to treatment; casting a negative figure (-0.3207 ***) only in the dimension of satisfaction with treatment effectiveness. Conclusions: The quality of life was medium and low, adherence and treatment satisfaction the decreased treatment and an inverse correlation between quality of life and treatment satisfaction, probably because of undesirable adverse reactions are in declining quality of life

ATAD control goals through the analysis of process variables and evaluation of quality, production and cost.

The aim of this paper is to establish and quantify different operational goals and control strategies in autothermal thermophilic aerobic digestion (ATAD). This technology appears as an alternative to conventional sludge digestion systems. During the batch-mode reaction, high temperatures promote sludge stabilization and pasteurization. The digester temperature is usually the only online, robust, measurable variable. The average temperature can be regulated by manipulating both the air injection and the sludge retention time. An improved performance of diverse biochemical variables can be achieved through proper manipulation of these inputs. However, a better quality of treated sludge usually implies major operating costs or a lower production rate. Thus, quality, production and cost indices are defined to quantify the outcomes of the treatment. Based on these, tradeoff control strategies are proposed and illustrated through some examples. This paper's results are relevant to guide plant operators, to design automatic control systems and to compare or evaluate the control performance on ATAD systems.

Patrón de caries dental en indígenas residentes en corozal, maniapure, Estado Bolívar, Venezuela / Dental caries pattern in indigenous residing in corozal, maniapure, Bolívar State, Venezuela

Evaluar el patrón de caries dental en indígenas residentes en la comunidad de Corozal, Maniapure, Estado Bolívar, Este es un estudio descriptivo y transversal del status de caries dental en indígenas Panares que residen en Corozal, comunidad ubicada en la región de Maniapure, Municipio Cedeño del Estado Bolívar, Venezuela, realizado durante el año 2011. La edad de los sujetos evaluados oscilo entre 2 y 60 años de edad (n= 31), el examen clínico fue realizado por dos estudiantes de odontología previamente calibrados usando los criterios reportados por Radike (1972), modificado por Acevedo et al., (2005). El examen clínico se llevó a cabo con el explorador N°23, espejo bucal N°5 y luz natural. Los resultados se analizaron mediante el test no paramétrico de la U de Mann-Whitney y Kruskal-Wallis. El 100% de los sujetos evaluados estaban afectados por la caries dental. No obstante, de las 3.682 superficies dentarias evaluadas 3.016 se encontraban libres de la enfermedad (81,9%) y 306 estaban afectados por la caries dental (8,3%). Con respecto a la severidad de las lesiones, las no cavitadas fueron las menos frecuentes (3,8%), mientras que el 96,1% tenían al menos un signo de cavitación. De las lesiones cavitadas en la dentición permanente el 62,2% correspondían a lesiones con micro-cavitación en el esmalte, 7,3% fueron lesiones que abarcaban el 50% de la estructura dentaria sin compromiso pulpar y solo 0,5% presentaron compromiso pulpar. Por el contrario, en la dentición primaria el 69.2% de las lesiones presentó compromiso del órgano dentino-pulpar, de las cuales el 6.5% correspondían a cavidades que abarcaban el 50% de la estructura dentaria con compromiso pulpar, 36,8% con destrucción total de la estructura coronaria y 25,9% de restos radiculares.

The aim of this study was to evaluate the epidemiological status of dental caries in Indigenous residing in Corazal, Maniapure, Bolivar State, Venezuela. A cross-sectional study of dental caries condition in indigenous Panare residing in Corozal, community located in Maniapure, Cedeño Municipality, Bolivar State, Venezuela was undertaken in 2011. Subjects from 2 to 60 years of age (N=31) allow to be examined by two dental students previously calibrate using the criteria reported by Radike (1972) as modified by Acevedo et al., (2005). The clinical examination was conducted with explorer N° 23 and dental mirror N°5 using natural light. The results were analyzed using the non-parametric test of U- Mann-Whitney and Kruskal-Wallis. One hundred percent of the evaluated subjects were affected by caries (100%). However, from the total of 3.682 surfaces evaluated, 3.016 were sound (81.9%) and 306 were affected by caries (8.3%). From the total of caries lesion detected the non-cavitate lesion were the least frequent (3.8%) and 96.1% have at least one sign of cavitations. From the cavitated lesion in the permanent dentition 62.2% of lesions showed early enamel breakdown, 17.3% were to lesion that cover 50% of the tooth surface without reaching the pulp and only 0,5 % of the lesion had reach the pulp. In contrast, in the primary dentition 69.2% of the cavities advanced into the pulp. From this group 6.5% were cavities that cover 50% of tooth surface and reach the pulp, 38.6% showed complete destruction of the crown and 25.9% corresponded to remaining root. The mean DMFS and defs were 17.08±26.18 and 5.70±12.61 respectively. The DMFS in the female group (29.07±32.06) was significantly higher as compared to the male (6.75±6.51) (p=0.001), in contrast the defs was higher in the males (12.40± 14.52) as compare to the female (5.63±6.63) (p=0.012).

[Confidence assessment among medical students trained with an obstetric simulator]. / Confianza de los estudiantes de medicina en el aprendizaje de la exploración obstétrica con simuladores.

BACKGROUND: To determine the degree of confidence of students regarding obstetric examination before and after training with simulators, and assess their satisfaction with the use of simulation as a tool for acquiring skills. METHODS: Training groups involved 10 students per lecturer. Students learned how to perform Leopold's manoeuvres and measure uterine height with a simulator. The instructor supervised each physical exam. Surveys by those students who had previously done an internship at the Department of Obstetric & Gynecology were not taken into account. RESULTS: Students' confidence in performing the procedures improved significantly (p≤0.001) after the intervention.