Doença falciforme: cuidado com pessoas com úlcera da perna nos serviços de atenção à saúde / Sickle cell disease: caring for people with leg ulcers in heal-thcare services / Enfermedad falciforme: cuidado de personas con úlcera de pierna en los servicios de atención a la salud

Objetivo: identificar o local e os cuidados diretos recebidos por pessoas com úlceras da perna por doença falciforme nos serviços de atenção à saúde. Método: estudo transversal, realizado em 11 centros, no período de agosto de 2019 a abril de 2020. Fizeram parte do estudo 72 pessoas com úlcera da perna ativa. O estudo foi aprovado pelo Comitê de Ética em Pesquisa. Resultado: apresentavam anemia falciforme 91,7% dos participantes, com mediana de três anos de existência da úlcera; 77,8% eram redicivantes; 40,3% compravam os insumos; 66,7% trocavam o próprio curativo no domicílio; 52,8% realizavam uma ou mais trocas diárias; 45,8% dos tratamentos foram prescritos pelo médico; 37,5% eram pomada (colagenase ou antibiótico); 89% não utilizavam compressão para o manejo do edema. Conclusão: a maioria dos participantes não estava inserida na Rede de Atenção à Saúde para o tratamento da úlcera, e não recebia assistência sistematizada e nem insumos apropriados.

Objective: to identify the location and direct care received by people with leg ulcers due to sickle cell disease in health care services. Method: a cross-sectional study carried out in 11 centers from August 2019 to April 2020. The study included 72 people with active leg ulcers. The study was approved by the Research Ethics Committee. Results: a total of 91.7% of the participants had sickle cell anemia, with a median of three years of ulcer existence; 77.8% were recurrent; 40.3% bought the supplies; 66.7% changed their own dressings at home; 52.8% did one or more changes a day; 45.8% of the treatments were prescribed by physician; 37.5% were ointments (collagenase or antibiotics); and 89% did not use compression to manage edema. Conclusion: most of the participants were not included in the Health Care Network for ulcer treatment and did not receive systematized care or appropriate supplies.

Objetivo: identificar el lugar y los cuidados directos recibidos por personas con úlceras de pierna por enfermedad falciforme en los servicios de atención a la salud. Método: estudio transversal, realizado en 11 centros, en el período de agosto de 2019 a abril de 2020. Participaron 72 personas con úlcera de pierna activa. El estudio fue aprobado por el Comité de Ética en Investigación. Resultado: presentaban anemia falciforme 91,7% de los participantes, con una mediana de tres años de existencia de la úlcera; 77,8% eran recidivantes; 40,3% compraban los insumos; 66,7% cambiaban su propio vendaje en el domicilio; 52,8% realizaban uno o más cambios diarios; 45,8% de los tratamientos fueron prescritos por el médico; 37,5% eran pomada (colagenasa o antibiótico); y 89% no utilizaban compresión para el manejo del edema. Conclusión: la mayoría de los participantes no estaba integrada en la Red de Atención a la Salud para el tratamiento de la úlcera, y no recibía asistencia sistematizada ni insumos apropiados.

Low-power red laser and blue LED modulate telomere maintenance and length in human breast cancer cells.

Cancer cells have the ability to undergo an unlimited number of cell divisions, which gives them immortality. Thus, the cancer cell can extend the length of its telomeres, allowing these cells to divide unlimitedly and avoid entering the state of senescence or cellular apoptosis. One of the main effects of photobiomodulation (PBM) is the increase in the production of adenosine triphosphate (ATP) and free radicals, mainly reactive oxygen species (ROS). Existent data indicates that high levels of ROS can cause shortening and dysfunctional telomeres. Therefore, a better understanding of the effects induced by PBM on cancer cell telomere maintenance is needed. This work aimed to evaluate the effects of low-power red laser (658 nm) and blue LED (470 nm) on the TRF1 and TRF2 mRNA levels and telomere length in human breast cancer cells. MCF-7 and MDA-MB-231 cells were irradiated with a low-power red laser (69 J cm-2, 0.77 W/cm-2) and blue LED (482 J cm-2, 5.35 W/cm-2), alone or in combination, and the relative mRNA levels of the genes and telomere length were assessed by quantitative reverse transcription polymerase chain reaction. The results suggested that exposure to certain red laser and blue LED fluences decreased the TRF1 and TRF2 mRNA levels in both human breast cancer cells. Telomere length was increased in MCF-7 cells after exposure to red laser and blue LED. However, telomere length in MDA-MB-231 was shortened after exposure to red laser and blue LED at fluences evaluated. Our research suggests that photobiomodulation induced by red laser and low-power blue LED could alter telomere maintenance and length.

Unraveling the Role of JMJD1B in Genome Stability and the Malignancy of Melanomas.

Genome instability relies on preserving the chromatin structure, with any histone imbalances threating DNA integrity. Histone synthesis occurs in the cytoplasm, followed by a maturation process before their nuclear translocation. This maturation involves protein folding and the establishment of post-translational modifications. Disruptions in this pathway hinder chromatin assembly and contribute to genome instability. JMJD1B, a histone demethylase, not only regulates gene expression but also ensures a proper supply of histones H3 and H4 for the chromatin assembly. Reduced JMJD1B levels lead to the cytoplasmic accumulation of histones, causing defects in the chromatin assembly and resulting in DNA damage. To investigate the role of JMJD1B in regulating genome stability and the malignancy of melanoma tumors, we used a JMJD1B/KDM3B knockout in B16F10 mouse melanoma cells to perform tumorigenic and genome instability assays. Additionally, we analyzed the transcriptomic data of human cutaneous melanoma tumors. Our results show the enhanced tumorigenic properties of JMJD1B knockout melanoma cells both in vitro and in vivo. The γH2AX staining, Micrococcal Nuclease sensitivity, and comet assays demonstrated increased DNA damage and genome instability. The JMJD1B expression in human melanoma tumors correlates with a lower mutational burden and fewer oncogenic driver mutations. Our findings highlight JMJD1B's role in maintaining genome integrity by ensuring a proper histone supply to the nucleus, expanding its function beyond gene expression regulation. JMJD1B emerges as a crucial player in preserving genome stability and the development of melanoma, with a potential role as a safeguard against oncogenic mutations.

An explainable Artificial Intelligence software system for predicting diabetes.

Implementing diabetes surveillance systems is paramount to mitigate the risk of incurring substantial medical expenses. Currently, blood glucose is measured by minimally invasive methods, which involve extracting a small blood sample and transmitting it to a blood glucose meter. This method is deemed discomforting for individuals who are undergoing it. The present study introduces an Explainable Artificial Intelligence (XAI) system, which aims to create an intelligible machine capable of explaining expected outcomes and decision models. To this end, we analyze abnormal glucose levels by utilizing Bi-directional Long Short-Term Memory (Bi-LSTM) and Convolutional Neural Network (CNN). In this regard, the glucose levels are acquired through the glucose oxidase (GOD) strips placed over the human body. Later, the signal data is converted to the spectrogram images, classified as low glucose, average glucose, and abnormal glucose levels. The labeled spectrogram images are then used to train the individualized monitoring model. The proposed XAI model to track real-time glucose levels uses the XAI-driven architecture in its feature processing. The model's effectiveness is evaluated by analyzing the performance of the proposed model and several evolutionary metrics used in the confusion matrix. The data revealed in the study demonstrate that the proposed model effectively identifies individuals with elevated glucose levels.

Association of uric acid with body adiposity and biochemical parameters in kidney transplant patients.

BACKGROUND: Obesity and various biochemical parameters, including triglycerides, cholesterol, glucose, C-reactive protein, and estimated glomerular filtration rate, have been linked to elevated uric acid (UA) levels in populations with normal kidney function due to decreased UA excretion and/or increased UA synthesis. However, it remains unclear whether all these factors exhibit similar associations with UA levels in clinical populations characterized by compromised renal function, such as kidney transplant patients (KTPs). OBJECTIVE: To evaluate whether serum UA levels are associated with body adiposity and biochemical parameters in KTPs. METHODS: A cross-sectional study involving 113 KTPs was conducted. Body fat was estimated using bioelectrical impedance, and waist circumference was measured using an inelastic tape. Serum levels of UA, creatinine, glucose, triglycerides, total cholesterol, and its fractions were measured using the colorimetric method. C-reactive protein levels were assessed using the immunoturbidimetric method, and urea levels were determined via enzymatic kinetics. Glomerular filtration rate was estimated using the chronic kidney disease epidemiology collaboration equation. Linear regression analyses were employed to assess the association between serum UA levels and body adiposity as well as biochemical parameters, while adjusting for confounders. RESULTS: Serum UA levels exhibited a positive association with creatinine (ß = 0.402; p = 0.013) and urea (ß = 0.024; p = 0.001), while demonstrating an inverse association with estimated glomerular filtration rate (ß = -0.030; p < 0.001). However, serum UA levels were not significantly associated with fat mass (both in kilograms and as a percentage), waist circumference, triglycerides, C-reactive protein, glucose, HDL cholesterol, LDL cholesterol, VLDL cholesterol, or total cholesterol. CONCLUSION: Serum UA levels are only associated with biochemical parameters linked to renal function in KTPs. Consequently, in individuals with suboptimal renal function, such as KTPs, UA does not exhibit associations with other biochemical parameters and body adiposity, as commonly observed in non-renal disease populations.

Properties and environmental quality of the overburden and tailings of manganese mining in the Eastern Amazon.

Knowledge about the characteristics of overburden and tailings from manganese (Mn) mining is essential for defining their levels of potentially toxic elements (PTEs) and appropriate environmental management. This study aimed to assess the total and bioavailable contents of PTEs in Mn mining areas in the Eastern Amazon, as well as the associated environmental risks. The samples were collected in areas of overburden and tailings deposition, in addition to forest soils in the Azul mine, Carajás Mineral Province, Brazil. These samples were characterized in terms of fertility, granulometry, and total and bioavailable PTE contents. The pH values of the forest soil were more acidic than those of the overburden and tailings, and the organic matter contents were considerably higher in the forest soil. All PTEs, especially Mn, Ba, Cu, Zn, and Pb, presented higher contents in the overburden and tailings. However, chemical fractionation revealed that PTEs were predominantly in the residual fraction, with percentage contents above 60% of the total content. These results suggest a low risk of environmental contamination. The findings of this study may support more efficient environmental rehabilitation in Mn mining areas in the Amazon.

l-Arginine supplementation for pregnant and lactating sows may improve the performance of piglets: A systematic review.

The objective was to conduct a systematic review to clarify the effects of l-arginine supplementation in pregnant and lactating sows on plasma hormone levels, milk production and composition, the body condition of sows and piglet performance. In April 2023, an online search and a systematic search were performed in the following databases: Embase, Scopus, SciELO, Web of Science, PubMed and Science Direct. The combinations of keywords used were sow and arginine and lactation; sow and arginine and lactating; sow and arginine and gestation; sow and arginine and gestating; sow and arginine and pregnancy; sow and arginine and reproduction; piglet and arginine; and sow and arginine and mammary gland. In total, 21 scientific articles with original data were selected according to preestablished criteria. Among the 21 articles, seven (33%) reported measurements of some plasma hormones, and among these, six reported an increase in the levels of at least one hormone, namely, estradiol, insulin-like growth factor 1 (IGF-1), insulin, follicle stimulating hormone, growth hormone or prolactin, with l-arginine supplementation. The parameters of milk were evaluated in 11 studies (52%), one reported an increase in protein content, and one reported an increase in IGF-1 content in milk with supplementation of this amino acid. Of the 14 studies that evaluated the performance parameters of piglets, only four reported improvements in some parameters of piglets from sows that received supplementation. Dietary supplementation of arginine for sows in the final third of gestation and/or lactation may alter the plasma levels of some hormones, which may reflect in greater development of the mammary gland tissue and, consequently, promote benefits on the performance of piglets. However, more studies are needed to evaluate the real impact of this amino acid supplementation on the physiology of the sows, in general, and the performance of suckling piglets.

La Pregunta de Investigación y su Asociación con los Niveles de Evidencia y Grados de Recomendación en Estudios de Investigación Clínica / The Research Question and its Association with the Levels of Evidence and Grades of Recommendation in Clinical Research Studies

La mayoría de las preguntas de investigación (PI), conducirán a un proyecto que apunta a generar nuevo conocimiento, sin embargo el escenario, la población a estudio y la metodología pueden ser muy diferentes, lo que determinará que los resultados obtenidos y por ende, el nivel de evidencia (NE) y el grado de recomendación (GR) puedan variar notablemente. El objetivo de este artículo fue proporcionar recomendaciones para formular una PI asociada al NE y respectivos GR que se pueden desprender a partir de los resultados generados. Este artículo entregará algunos conocimientos sobre la PI y su relación con los NE y GR de la evidencia generada a partir de resultados obtenidos por un proceso de investigación en diferentes escenarios de investigación.

SUMMARY: Most research questions (RQ) will lead to a project that aims to generate new knowledge. However, the setting, study population and methodology may be very different, which will determine the results obtained and therefore, the level of evidence (LOE) and the grade of recommendation (GOR) may vary significantly. The aim of this study was to provide recommendations to formulate a RQ associated with the LOE and respective GOR that can be derived from the generated results. This article will provide some knowledge about the RQ and its relationship with the LEO and GOR of the generated evidence from results obtained by a research process in different research scenarios.

Differential dietary intake and contribution of ultra-processed foods during pregnancy according to nutritional status.

Introduction: Frequent consumption of ultra-processed foods (UPFs) during pregnancy is linked to excess intake of added sugar, fat, and sodium and inadequacy of several micronutrients. Diet quality during pregnancy should be maximized as inadequate levels of key nutrients and excessive intake of energy and added sugar might influence mother-child health. We aimed to estimate the contribution (% of total calories) of ultra-processed products to the total energy intake by pre-gestational body mass index (BMI) categories and Hb status during pregnancy in participants from the MAS-Lactancia Cohort. Methods: Pre-gestational weight, hemoglobin levels, 24-h dietary intake recall interviews, and sociodemographic data were collected during the second and third trimesters of pregnancy. Reported consumed foods were categorized using the NOVA classification, and the contribution of calories from each NOVA category was estimated using the Mexican Food Database. We estimated medians and interquartile ranges (p25 and p75) for dietary intake and energy contributions. The comparison of intake between the second and third trimesters was done using the Wilcoxon test. In addition, a quantile regression model with an interaction between pre-gestational BMI and Hb levels status in tertiles over the percentage of energy from UPFs was adjusted by age and socioeconomic status. Results: The contribution to total energy intake from UPFs was 27.4% in the second trimester and 27% in the third trimester (with no statistical difference). The percentage of energy intake from UPFs was higher in women who started pregnancy with obesity and presented the lowest levels of Hb (1st tertile), 23.1, 35.8, and 44.7% for the 25th, 50th, and 75th percentiles, respectively, compared to those with normal BMI and the highest tertile of Hb levels: 18, 29.0, and 38.6% for the 25th, 50th, and 75th percentiles, respectively. Conclusion: In conclusion, UPF intake in pregnant women is similar to the general population and was higher for those with pre-gestational obesity and the lowest tertile of Hb levels. UPF contributes also to sugar, saturated fat, and sodium, which may adversely affect the health of mothers and their offspring.

Circulating levels of galectin-9 are a potential biomarker of survival in advanced non-small-cell lung cancer.

BACKGROUND: The immune system is recognized to have therapeutic potential to destroy cancer cells. Soluble T-cell immunoglobulin mucin domain-3 (sTIM-3) and its ligand galectin 9 (Gal-9) cause suppression of cytokine production, cell cycle arrest and cell death. sTIM-3 and Gal-9 levels may have prognostic implications in non-small-cell lung cancer (NSCLC) patients. METHODS: This prospective cohort study was performed at Instituto de Medicina Integral Prof. Fernando Figueira, Recife, Pernambuco, Brazil. Fifty-eight patients were diagnosed with advanced NSCLC from January 2019 to January 2020. RESULTS: The age median was of 64.0 years. Soluble galectin-9 (sGal-9) levels in the smokers compared to nonsmoker patients (p < 0.0001). By using the receiver operating characteristic curve, we found that a baseline of 1694 pg/mL (cutoff). sGAL9 with specificity (72.2%), sensitivity (83.2%) and area under the curve = 0.8497 (p < 0.0004). Until 18.2 months, 46.8% and 72.9% were alive in the sGAL9low and sGAL9high groups, respectively (log-rank test; p = 0.02). The median survival was 15.9 months for sGAL9low (≤1694 pg/mL). CONCLUSION: This study indicated an association of tobacco with the release of circulating sGal-9 levels and the accuracy of sGal-9 as a potential biomarker predictive of survival time in advanced NSCLC patients. Furthermore, sGal-9 has may be a potential therapeutic target in the advanced NSCLC.

An Assessment of the Effects of Guanidinoacetic Acid on the Performance and Immune Response of Laying Hens Fed Diets with Three Levels of Metabolizable Energy.

Different levels of metabolizable energy (ME) and the inclusion of guanidinoacetic acid (GAA) in the diet of 53-week-old Lohmann LSL-CLASSIC hens were used to evaluate its effect on reproductive parameters, egg quality, intestinal morphology, and the immune response. Six diets were used in a 3 × 2 factorial design, with three levels of ME (2850, 2800, and 2750 kcal/kg), and with (0.08%) or without the inclusion of GAA. The addition of GAA to diets with low levels of ME increased (p < 0.05) egg production and egg mass. Moreover, hens fed with 2800 kcal/g without GAA had the highest concentration (p < 0.05) of serum interleukin IL-2, while those fed diets with the same amount of ME but supplemented with 0.08% GAA had the lowest concentration. Finally, the inclusion of 0.08% GAA increased (p < 0.05) the concentration of vascular endothelial growth factor (VEGF), regardless of the ME level in the diet. This study highlights the potential role of GAA in decreasing the energy level of ME (50-100 kcal/g) in the feeding of hens and in the modulation of specific immune responses. Further research is recommended to fully understand the mechanisms of action of GAA on the mechanism target of rapamycin and its relationship with the immune response.

Imidazole Carbamates as a Promising Alternative for Treating Trichomoniasis: In Vitro Effects on the Growth and Gene Expression of Trichomonas vaginalis.

Metronidazole (MTZ) is the most common drug used against Trichomonas vaginalis (T. vaginalis) infections; however, treatment failures and high rates of recurrence of trichomoniasis have been reported, suggesting the presence of resistance in T. vaginalis to MTZ. Therefore, research into new therapeutic options against T. vaginalis infections has become increasingly urgent. This study investigated the trichomonacidal activity of a series of five imidazole carbamate compounds (AGR-1, AGR-2, AGR-3, AGR-4, and AGR-5) through in vitro susceptibility assays to determine the IC50 value of each compound. All five compounds demonstrated potent trichomonacidal activity, with IC50 values in the nanomolar range and AGR-2 being the most potent (IC50 400 nM). To gain insight into molecular events related to AGR-induced cell death in T. vaginalis, we analyzed the expression profiles of some metabolic genes in the trophozoites exposed to AGR compounds and MTZ. It was found that both AGR and MTZ compounds reduced the expression of the glycolytic genes (CK, PFK, TPI, and ENOL) and genes involved in metabolism (G6PD, TKT, TALDO, NADHOX, ACT, and TUB), suggesting that disturbing these key metabolic genes alters the survival of the T. vaginalis parasite and that they probably share a similar mechanism of action. Additionally, the compounds showed low cytotoxicity in the Caco-2 and HT29 cell lines, and the results of the ADMET analysis indicated that these compounds have pharmacokinetic properties similar to those of MTZ. The findings offer significant insights that can serve as a basis for future in vivo studies of the compounds as a potential new treatment against T. vaginalis.

Exploring Dengue Dynamics: A Multi-Scale Analysis of Spatio-Temporal Trends in Ibagué, Colombia.

Our study examines how dengue fever incidence is associated with spatial (demographic and socioeconomic) alongside temporal (environmental) factors at multiple scales in the city of Ibagué, located in the Andean region of Colombia. We used the dengue incidence in Ibagué from 2013 to 2018 to examine the associations with climate, socioeconomic, and demographic factors from the national census and satellite imagery at four levels of local spatial aggregation. We used geographically weighted regression (GWR) to identify the relevant socioeconomic and demographic predictors, and we then integrated them with environmental variables into hierarchical models using integrated nested Laplace approximation (INLA) to analyze the spatio-temporal interactions. Our findings show a significant effect of spatial variables across the different levels of aggregation, including human population density, gas and sewage connection, percentage of woman and children, and percentage of population with a higher education degree. Lagged temporal variables displayed consistent patterns across all levels of spatial aggregation, with higher temperatures and lower precipitation at short lags showing an increase in the relative risk (RR). A comparative evaluation of the models at different levels of aggregation revealed that, while higher aggregation levels often yield a better overall model fit, finer levels offer more detailed insights into the localized impacts of socioeconomic and demographic variables on dengue incidence. Our results underscore the importance of considering macro and micro-level factors in epidemiological modeling, and they highlight the potential for targeted public health interventions based on localized risk factor analyses. Notably, the intermediate levels emerged as the most informative, thereby balancing spatial heterogeneity and case distribution density, as well as providing a robust framework for understanding the spatial determinants of dengue.

The coculture of in vitro produced porcine embryos and oviductal epithelial cells improves blastocyst formation and modify embryo quality.

The efficiency of in vitro embryo production in mammals is influenced by variables associated with culture conditions during maturation, fertilization, and embryonic development. The embryos obtained often exhibit low quality due to suboptimal in vitro culture conditions compared to the in vivo environment. Co-culturing gametes and embryos with somatic cells has been developed to enhance in vitro culture conditions. This study aimed to assess the impact of coculturing in vitro-produced porcine embryos with porcine oviductal epithelial cells (POEC) on embryo development and quality. Firstly, a pure culture of POEC suitable for coculture systems was established. The epithelial origin of the cells was confirmed by the expression of E-cadherin and cytokeratin. The expression pattern of hormone receptors aligned with the diestrous oviduct, and POEC also secreted oviductal glycoprotein type 1 (OVGP-1). Secondly, POEC from passage 1 (POEC-1) were used to coculture with in vitro-produced porcine embryos. A successful coculture system was established without the addition of fetal bovine serum as a supplement. Coculturing POEC-1 in monolayers with in vitro-produced porcine embryos during the initial two days of culture enhanced the percentage of blastocysts and their hatching. Although the coculture did not alter the number of cells in the blastocysts or apoptosis assessed by TUNEL, it significantly reduced reactive oxygen species (ROS) levels in cleaved porcine embryos. This study represents the first report evaluating the quality of porcine embryos produced by IVF in coculture systems and assessing ROS levels in cleaved porcine embryos obtained by IVF.

Impact of Vancomycin trough levels monitoring on uncomplicated methilcillin-resistant Staphylococcus aureus bacteremia in chronic kidney disease on hemodialysis, retrospective cohort.

BACKGROUND: CKD patients on hemodialysis (HD) with Staphylococcus aureus (SA) bacteremia present high morbidity, mortality and increased risk of MRSA. Vancomycin is the antibiotic of choice in these cases, it has a narrow therapeutic margin and inadequate dosage generates a risk of toxicity, therefore, the recommendation is to dosage it through serum levels. METHODS: This is a retrospective cohort study in 3 hospitals of third level of complexity in the city of Medellin in which there were differences in the measurement and implementation of vancomycin25 dosage based on trough levels (VL) in patients with chronic kidney disease on hemodialysis (CKD- HD) with uncomplicated bacteremia based infection by methilcillin-resistant Staphyloccocus aureus (MRSA). The primary outcome was the composite of hospital mortality, clinical response (fever, hemodynamic instability and altered consciousness), complications associated with bacteremia, or bacteriological response failure (positive cultures at first week follow-up) at 7 days. The composite variables were analyzed individually as secondary outcomes. RESULTS: The main unadjusted outcome (OR 1.3, CI 0.6 - 2.7) and adjusted for age, Charlson index, loading dose, initial dose, dosing frequency and MIC to vancomycin (OR 1.2, CI 0.5 - 2.7). Regarding adjusted secondary outcomes: clinical response (OR 1.4 CI 0.3 - 5.8), death (OR 1.3 CI 0.3 - 4.6) and complications (OR 0.9, CI 0.37 - 2.2). CONCLUSIONS: We conclude that the measurement of trough levels in patients with HD-CKD does not modify the composite outcome. The main limitation is the sample size and type of study, randomized control trials may be required to confirm the results presented.

Pre-and post-surgical non-functional pituitary adenomas and their relationship with high levels of serum glucose.

OBJECTIVES: This clinical, analytical, retro-prospective, auto-controlled, not randomized, and not blinded study, aimed to investigate the association of changes in the serum glucose levels with the pre-and-post changes in the size tumor in mm3 in the Non-Functional pituitary adenomas. METHODS: Pre-and post-surgical MRI, as well as the measurements in the serum glucose levels and immunohistochemical techniques were performed in all the patients in the study, with a mean followed-up until 208.57 days. A comparison was made between the reductions in tumor size of hormonally active pituitary adenomas (HSPAs) vs NFPAs. RESULTS: Seventy-four patients were included in this study, of whom, 46 were NFPAs. The decrease in the NFPAs tumor size after surgery was statistically significant (P ≤ 0.0001). The Mean of the differences of both type of tumors in mm3 were -9552 ± 10287. Pre-surgery, the mean of the HSPAs were 8.923 ± 2.078; and the NFPAs were 14.161 ± 1.912. The differences in the tumor size were statistically significant (p = 0.039). Post-surgical, the mean of the HSPAs were 2.079 ± 971, with a (p = 0.14): and the NFPAs were 4.609 ± 1.205. After surgery of the NFPAs, most of the patients-maintained serum levels ≤ 100 mg/dL, with a statistical significance (P ≤ 0.0003). CONCLUSION: This study demonstrates for the first time the correlation between the presence of pre-and post- surgical changes in the NFPAs, with modifications in the levels of serum glucose, and the comparison, pre- and post-surgical between the tumor size of HSPAs and NFPAs.

Ecological risk of metals in Andean water resources: A framework for early environmental assessment of mining projects in Peru.

Metallic contaminants in Andean water resources influenced by mining activities poses risks to aquatic ecosystems and a challenge to regulatory agencies responsible for environmental compliance. In this study, the Ecological Risk Assessment (ERA) framework was adapted to assess dissolved heavy metal concentrations at 283 surface water monitoring stations near to six mining projects during the dry and wet seasons. Reports from OEFA-Peru on Early Environmental Assessment (EEA) were used to apply various criteria and non-parametric statistical tests. They included ecological, ecotoxicological, chemical, and regulatory factors. The main goal of this research was to identify, analyze, characterize, and compare the risks present at different trophic levels. These levels were categorized as T1 (Microalgae), T2 (Zooplankton and Benthic invertebrates), and T3 (Fish). Individual risk (IR) was estimated using the quotient model, while total risk (TR) was assessed using the additive probability rule. Rainbow trout (Oncorhynchus mykiss), representing trophic level T3, showed the highest sensitivity to Fe and Cu. Statistical tests ranked the IR as Fe > Cu > Zn > Mn > Pb (p < 0.01). The TR was more prevalent during the wet season compared to the dry season (p < 0.01). Notably, around 50 % of the monitoring stations (n = 142) were classified as high risk, and 9 % (n = 13) showed extremely high-risk values for Cu and Fe. The adapted ERA framework demonstrated great effectiveness in identifying critical points of metal contamination in high Andean aquatic ecosystems under mining influence. However, specialized studies are suggested that allow the sources of pollution to be associated with specific regulatory actions.

Examining the Moderating Role of Parental Stress in the Relationship between Parental Beliefs on Corporal Punishment and Its Utilization as a Behavior Correction Strategy among Colombian Parents.

Understanding beliefs about corporal punishment is crucial, as evidence suggests that positive beliefs in its effectiveness predict its use. High parental stress, especially in those valuing corporal punishment, increases the potential for child abuse. Factors such as having many children or low education and socioeconomic status contribute to parental tensions, leading to the use of corporal punishment for behavior correction. We posit that the accumulation of such variables results in heightened stress levels. Our focus aimed to determine the moderating role of stress levels among parental beliefs about corporal punishment and its reported use through quantitative research. In our study, 853 Colombian parents of low, middle, and high socioeconomic status, and from four different regions of Colombia, with children aged 0 to 17 participated. They provided information about their beliefs on corporal punishment, using the Beliefs and Punishment Scale. Correlations indicated that older parents with better socioeconomic status were less inclined to believe that strictness improves children. Regressions suggested that increased belief in corporal punishment modifying behavior, along with higher parental stress, increases corporal punishment use. Moderation models highlighted that when more stressors were present, corporal punishment was used due to stress rather than parental beliefs. Ultimately, stress emerged as a crucial factor influencing corporal punishment use among Colombian parents.

Hair cortisol levels are associated with overweight and obesity in the ELSA-Brasil cohort.

Introduction: Hair cortisol level has recently been identified as a promising marker for detecting long-term cortisol levels and a marker of hypothalamic-pituitary-adrenal cortex (HPA) axis activity. However, research on the association between obesity and an altered cortisol metabolism remains controversial. Objective: This study aimed to investigate the relationship between hair cortisol levels and overweight and obesity in participants from the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil). Methods: This was a cross-sectional study involving 2,499 participants from the second follow-up (visit 3, 2017-2019) attending research centers in Rio de Janeiro and Rio Grande do Sul states. Hair samples were collected, and cortisol levels were analyzed using enzyme-linked immunosorbent assay (ELISA) kits. Cortisol levels were classified as low (< 40 pg/mg), medium (40-128 pg/mg), or high (> 128 pg/mg). The participants were classified as eutrophic, overweight, or obese according to their weight (kg) and height (m2). Odds ratios (ORs) with 95% confidence intervals (95%CI) were estimated. Results: Of the 2499 individuals, 30% had eutrophic weight, 40% were overweight, and 30% were obese. Notably, cortisol levels gradually increased with increasing body weight. Among participants with high hair cortisol levels, 41.2% were classified as overweight and 34.2% as obese. Multinomial logistic regression analysis indicated that participants with high cortisol levels were 43% (OR =1.43; 95%CI: 1.02-2.03) more likely to be overweight and 72% (OR =1.72; 95%CI:1.20-2.47) more likely to be obese than participants with low hair cortisol levels. After adjustment for all covariates, high cortisol levels remained associated with obesity (OR = 1.54; 95%CI:1.02-2.31) and overweight (OR =1.33; 95%CI:0.91-1.94). Conclusion: In the ELSA-Brazil cohort, hair stress were positively associated with overweight and obesity. These results underscore the importance of considering stress and cortisol as potential factors in obesity prevention and intervention efforts, and highlight a novel aspect of the complex relationship between stress and obesity in the Brazilian population.