Inter-institutional laboratory standardization for SARS-CoV-2 surveillance through wastewater-based epidemiology applied to Mexico City.

Objectives: Wastewater-based surveillance applied to SARS-CoV-2 viral load quantification for COVID-19 has become one of the most relevant complementary tools in epidemiologic prevention programs worldwide. However, this valuable decision-making tool still requires fine-tuning to produce comparable results between laboratories, especially when applied to the surveillance of megacities. Methods: Six laboratories across Mexico and one from the United States executed an interlaboratory study to set up a singular standardized protocol considering method cost, installed infrastructure, materials available, and supply availability for SARS-CoV-2 quantification from five Mexico City sampling sites across this megacity. Results: Comparable data from processing outcomes in the Mexican laboratories and in the external international laboratory serve as a validating data source. The Bland-Altman comparison showed consistency, with cycle threshold values within ±1.96 SD of SARS-CoV-2 genetic copies for the standard curve quantification, with a mismatch of two laboratories. In addition, MS2 bacteriophage recovery rates varied between 35% and 67% among all participating laboratories. Finally, the efficiency of viral genetic material recovered from all participating laboratories varied between 65% and 93% for the participating laboratories. Conclusion: This work lays the foundation for extensive and continuous wastewater-based surveillance application across independent Mexican laboratories in a time- and resource-effective manner.

Development of biomaterial composite hydrogel as a passive sampler with potential application in wastewater-based surveillance.

Nowadays, the need to track fast-spreading infectious diseases has raised due to the recent COVID-19 disease pandemic. As a response, Wastewater-based Surveillance (WBS) has emerged as an early detection and disease tracking method for large populations that enables a comprehensive overview of public health allowing for a faster response from public health sector to prevent large outbreaks. The process to achieve WBS requires a highly intensive sampling strategy with either expensive equipment or trained personnel to continuously sample. The sampling problem can be addressed by passive sampler development. Chitosan-based hydrogels are recognized for their capability to sample and remove various contaminants from wastewater, including metals, dyes, pharmaceuticals, among others. However, chitosan-based hydrogels unique characteristics, can be exploited to develop passive samplers of genetic material that can be a very valuable tool for WBS. This study aimed to develop a novel chitosan hydrogel formulation with enhanced characteristics suitable for use as a passive sampler of genetic material and its application to detect disease-causing pathogens present in wastewater. The study evaluates the effect of the concentration of different components on the formulation of a Chitosan composite hydrogel (Chitosan, Glutaraldehyde, Microcrystalline cellulose (MCC), and Polyethylene glycol (PEG)) on the hydrogel properties using a Box Hunter & Hunter experimental matrix. Hydrogels' weight, thickness, swelling ratio, microscopic morphology (SEM), FTIR assay, and zeta potential were characterized. The resulting hydrogel formulations were shown to be highly porous, positively charged (Zeta potential up to 35.80 ± 1.44 mV at pH 3) and with high water swelling capacity (up to 703.89 ± 15.00 %). Based on the results, a formulation from experimental design was selected and then evaluated its capacity to adsorb genetic material from a control spiked water with Influenza A virus synthetic vector. The adsorption capacity of the selected formulation was 4157.04 ± 64.74 Gene Copies/mL of Influenza A virus synthetic vector. The developed hydrogel showed potential to be used as passive sampler for pathogen detection in wastewater. However, deeper research can be conducted to improve adsorption, desorption and extraction techniques of genetic material from chitosan-hydrogel matrices.

Environmental factors related to the origin and evolution of differentiated thyroid cancer: a narrative review.

INTRODUCTION: The global incidence of thyroid cancer (TC) has increased in the last decades. While improvements in diagnosis may contribute, overdiagnosis is also a possibility. This review focuses on the epidemiology, risk factors, and immune microenvironment associated with differentiated TC (DTC). AREAS COVERED: A search was conducted in Scielo, Scopus, and EMBASE databases, involving 72 articles. TC is the most common endocrine neoplasm, with DTC form being predominant. Its incidence has globally risen, particularly among women aged over 45. Endogenous risk factors for DTC include genetic disorders, race, age, female gender, obesity, and type 2 diabetes mellitus. Environmental risks involve ionizing radiation, whether through therapeutic treatment or environmental contamination from nuclear accidents, iodine deficiency, endocrine disruptors, residence in volcanic areas, environmental pollution, and stress. The use of anti-obesity medications remains controversial. The tumor's immune microenvironment is the histological space where tumor cells interact with host cells, crucial for understanding aggressiveness. Immunotherapy emerges as a promising intervention. EXPERT OPINION: Recent advances in DTC management offer transformative potential, requiring collaborative efforts for implementation. Emerging areas like precision medicine, molecular profiling, and immunotherapy present exciting prospects for future exploration, shaping the next era of diagnostic and therapeutic strategies in thyroid cancer research.

The global incidence of thyroid cancer (TC) has significantly increased, attributed partly to improved diagnosis and potentially to overdiagnosis. This review focuses on the epidemiology, risk factors, and immune microenvironment associated with differentiated TC (DTC). DTC is the most common endocrine neoplasm, and predominantly affects women over 45 years old. Endogenous risk factors include genetic disorders, race, age, female gender, obesity, and type 2 diabetes mellitus (T2DM). Environmental risks encompass ionizing radiation, iodine deficiency, endocrine disruptors, volcanic residence, pollution, and stress. The use of glucagon-like peptide 1 agonists remains controversial. The tumor's immune microenvironment is crucial for understanding aggressiveness, with immunotherapy showing promise. Understanding both macro and microenvironmental factors is crucial for devising effective prevention and treatment strategies for DTC.

Generation rate of hospital solid waste from different services: A case study in the province of Bagua, northern Peru.

The objective of this research was to evaluate the unit generation rate of solid hospital waste at the Gustavo Lanatta Lujan Bagua Support Hospital (HAB). The calculations were based on the weights of hospital waste disposed periodically to the biosafety cell located 7 km from the city of Bagua since 2015. Nineteen services were identified and grouped into three areas: hospitalization area, emergency area and gynecology area, studied according to the group classification of Peruvian regulations. The results show that 92.77 kg/day-1 are generated, 62.26 % are biocontaminated waste, 26.45 % are common waste, 7.7 % are sharp-sharp waste and 3.6 % are special waste. It was also found that only 73.56 % is disposed of in the hospital's biosafety cell. In this sense, this study will contribute to promote the reduction of the entry of hazardous substances into the stream of an adequate waste management and save workers and the environment in the Amazon Region. Therefore, awareness should be raised at all levels of society through various means of communication and education, so that the risks of spreading health hazards can be minimized by improving hospital waste management. In addition, healthcare waste management should be implemented, taking into account the parameters to be monitored, the economic resources to be managed and the national plans for healthcare waste.

Calcitonin-producing Duodenal Neuroendocrine Tumor: A Case Report and Literature Review.

INTRODUCTION: Neuroendocrine tumors [NETs] exhibit a wide range of clinical presentations, including the production of various hormones. Calcitonin, a sensitive marker for medullary thyroid cancer [MTC], is nonspecific and may be elevated in extra-thyroidal NETs. CASE REPORT: We present the case of a 64-year-old female patient who underwent total thyroidectomy due to a nodule in the isthmus, with a fine-needle aspiration biopsy indicating follicular neoplasia. Pathological examination revealed macro- and micro-nodular thyroid hyperplasia, along with a parathyroid adenoma. During postoperative follow-up, a progressive elevation of calcitonin was observed, reaching 64.2 pg/ml, while carcinoembryonic antigen levels remained normal. Since no MTC foci were found upon reviewing the thyroidectomy specimen, an investigation into the origin of the elevated calcitonin was initiated. Serum chromogranin A and specific neuronal enolase levels were within normal ranges. Tc-99m HYNIC-TOC scintigraphy yielded negative results. Additionally, an upper gastrointestinal endoscopy revealed a submucosal lesion in the second portion of the duodenum, with a biopsy confirming a grade 1 NET. The patient underwent Whipple surgery and hepatic metastasectomy. Postoperatively, a decrease in baseline serum calcitonin levels was observed. Seven years after surgery, she continues specialized monitoring with no biochemical or imaging evidence of disease. CONCLUSION: Serum calcitonin contributes to the diagnosis and monitoring of anterior intestine NETs.

From liver to hormones: The endocrine consequences of cirrhosis.

Hepatocrinology explores the intricate relationship between liver function and the endocrine system. Chronic liver diseases such as liver cirrhosis can cause endocrine disorders due to toxin accumulation and protein synthesis disruption. Despite its importance, assessing endocrine issues in cirrhotic patients is frequently neglected. This article provides a comprehensive review of the epidemiology, pathophysiology, diagnosis, and treatment of endocrine disturbances in liver cirrhosis. The review was conducted using the PubMed/Medline, EMBASE, and Scielo databases, encompassing 172 articles. Liver cirrhosis is associated with endocrine disturbances, including diabetes, hypoglycemia, sarcopenia, thyroid dysfunction, hypogonadotropic hypogonadism, bone disease, adrenal insufficiency, growth hormone dysfunction, and secondary hyperaldosteronism. The optimal tools for diagnosing diabetes and detecting hypoglycemia are the oral glucose tolerance test and continuous glucose monitoring system, respectively. Sarcopenia can be assessed through imaging and functional tests, while other endocrine disorders are evaluated using hormonal assays and imaging studies. Treatment options include metformin, glucagon-like peptide-1 analogs, sodium-glucose co-transporter-2 inhibitors, and insulin, which are effective and safe for diabetes control. Established standards are followed for managing hypoglycemia, and hormone replacement therapy is often necessary for other endocrine dysfunctions. Liver transplantation can address some of these problems.

Capsaicin as a Dietary Additive for Dairy Cows: A Meta-Analysis on Performance, Milk Composition, Digestibility, Rumen Fermentation, and Serum Metabolites.

This study aimed to evaluate the effects of dietary supplementation with capsaicin (CAP) on productive performance, milk composition, nutrient digestibility, ruminal fermentation, and serum metabolites of dairy cows using a meta-analytical approach. The database included 13 studies, from which the response variables of interest were obtained. Data were analyzed using a random effects model, and results were expressed as weighted mean differences between treatments supplemented with and without CAP. Dietary supplementation with CAP increased (p < 0.05) dry matter intake, milk yield, feed efficiency, milk fat yield, and milk fat content. However, CAP supplementation did not affect (p > 0.05) milk protein and lactose yield, milk urea nitrogen, or milk somatic cell count. Greater (p < 0.05) apparent digestibility of dry matter and crude protein was observed in response to the dietary inclusion of CAP. Likewise, supplementation with CAP increased (p < 0.05) the rumen concentration of total volatile fatty acids. In contrast, CAP supplementation did not affect (p > 0.05) ruminal pH or the ruminal concentration of ammonia nitrogen, acetate, propionate, and butyrate. In blood serum, CAP supplementation increased (p < 0.05) the glucose concentration and decreased (p < 0.05) the concentration of non-esterified fatty acids. However, CAP supplementation did not affect (p > 0.05) the serum concentration of urea and beta-hydroxybutyrate. In conclusion, capsaicin can be used as a dietary additive to improve the productive performance, milk composition, and nutrient digestibility in dairy cows and, at the same time, improve the ruminal concentration of total volatile fatty acids and serum levels of glucose and non-esterified fatty acids.

La Atención Primaria en Salud, un camino inconcluso en Colombia: Lecciones aprendidas de la Primera Ola de la Pandemia por COVID-19 / Primary Health Care, an unfinished road in Colombia: Lessons learned from the First Wave of the COVID-19 Pandemic

RESUMEN Introducción: En 2020, Colombia adoptó diferentes medidas para mitigar el impacto de la pandemia por Covid-19, principalmente medidas de aislamiento social y fortalecimiento en la prestación de servicios hospitalarios. Sin embargo, el país no contempló acciones para abordar los otros problemas en salud, como tampoco consideró la relevancia de la Atención Primaria en Salud (APS) para responder a la pandemia. Por lo cual se realizó una investigación para indagar por la oferta y posicionamiento de la APS entre los tomadores de decisiones para atender la emergencia de Covid-19 durante la primera ola de la pandemia y los aprendizajes para las siguientes. Metodología: De abril a junio de 2020 se realizó un estudio descriptivo exploratorio mixto en 2 fases: (1) Encuesta a tomadores de decisiones, prestadores y académicos, y (2) Grupo focal a informantes clave. Resultados: La encuesta fue respondida por 227 participantes, 41 % académicos, 34.8 % prestadores y 17.6 % funcionarios de direcciones locales de salud; el 28.2 % consideró que la APS estuvo adaptada en los territorios para diferentes programas de salud por ciclo vital y entre el 80 al 98 % que la APS debía instaurarse en el territorio para vigilancia de casos, atención ambulatoria, manejo de pacientes crónicos, atención de otros programas y educación sanitaria. En el grupo focal participaron 12 informantes claves, quienes concluyeron que desde la autoridad sanitaria se debía promover la integración de la APS de forma urgente en los territorios, y garantizar una gobernanza eficaz para lograrlo; igualmente, recomendaron intensificar la alfabetización en salud y el empoderamiento de la población para la adopción de medidas individuales y colectivas. Conclusiones: Se concluye que la APS era una oportunidad para responder a la primera ola de la pandemia, como también para subsanar los problemas actuales y anticiparse a problemas futuros. Por lo cual, la APS debe convertirse en una política de Estado.

ABSTRACT Introduction: In 2020, Colombia adopted different measures to mitigate the impact of the Covid-19 pandemic, social isolation measures and strengthening the provision of hospital services. However, the country did not contemplate actions to address other health problems, nor did it consider the relevance of Primary Health Care (PHC) to respond to the pandemic. Therefore, an investigation was done to investigate the offer and positioning of PHC among decision-makers to address the Covid-19 emergency during the first wave of the pandemic and the learning for the following ones. Methodology: From April to June 2020, a mixed exploratory descriptive study was conducted in two phases: (1) a survey of decision-makers, providers, and academics, and (2) a focus group of key informants. Results: The survey was answered by 227 participants, 41 % academics, 34.8 % providers, and 17.6 % officials from local health directorates; 28.2 % considered that PHC was adapted in the territories for different life cycle health programs, and between 80 and 98 % that PHC should be established in the territory for case surveillance, outpatient care, management of chronic patients, care of other programs and health education. Twelve key informants participated in the focus group, who concluded that the health authority should urgently promote the integration of PHC in the territories, and guarantee effective governance to achieve it; Likewise, they recommended intensifying health literacy and the empowerment of the population for the adoption of individual and collective measures. Conclusions: It is concluded that PHC was an opportunity to respond to the first wave of the pandemic, as well as to correct current problems and anticipate future problems. Therefore, PHC must become a state policy.

Las misiones médicas al Policlínico PAMS en Chincha: evolución del modelo de misión / The medical missions to the PAMS Polyclinic in Chincha: evolution of the mission's model

RESUMEN Presentamos la experiencia del Policlínico de la Peruvian American Medical Society (PAMS) en Chincha, en la ejecución de misiones médico-educativas en la región Chincha. El Policlínico PAMS presta atención médica general y especializada a la población de la zona, seis días a la semana. Además, recibe misiones médicas que vienen generalmente de los EE. UU. Desde 2011, se han recibido 43 misiones médicas. La composición y la naturaleza de las misiones han cambiado con el tiempo. Los primeros años se atraía a especialistas con el énfasis de traer equipos e insumos para mejorar la infraestructura del Policlínico. Ahora estamos limitados por la renuencia de voluntarios de venir al Perú en parte debido a que el gobierno americano considera que viajes al Perú son de alto riesgo. Esta limitación nos ha brindado la oportunidad de hacer misiones médicas juntamente con dos excelentes universidades peruanas. La experiencia ha sido positiva.

ABSTRACT We present the experience of the Polyclinic of the Peruvian American Medical Society (PAMS) in Chincha, in the execution of medical educational missions in the Chincha region. The PAMS Polyclinic provides general and specialized medical care to the population of the area, six days a week. In addition, the Polyclinic receives medical missions generally coming from the EE.UU. Since 2011, we have received 43 medical missions. The composition and nature of the missions have changed over time. The first years attracted specialists with the emphasis on bringing equipment and supplies to improve the infrastructure of the Polyclinic. We are now limited by the reluctance of volunteers to come to Peru in part because the U.S. government considers travel to Peru to be high-risk. This limitation has given us the opportunity to do medical missions together with two excellent Peruvian universities. This experience has been positive.

Laccase-based catalytic microreactor for BPA biotransformation.

A laccase-based catalytic reactor was developed into a polydimethylsiloxane (PDMS) microfluidic device, allowing the degradation of different concentrations of the emergent pollutant, Bisphenol-A (BPA), at a rate similar to free enzyme. Among the immobilizing agents used, 1-Ethyl-3-(3-dimethylaminopropyl) carbodiimide (EDC) was capable of immobilizing a more significant amount of the laccase enzyme in comparison to glutaraldehyde (GA), and the passive method (2989, 1537, and 1905 U/mL, respectively). The immobilized enzyme inside the microfluidic device could degrade 55 ppm of BPA at a reaction rate of 0.5309 U/mL*min with a contaminant initial concentration of 100 ppm at room temperature. In conclusion, the design of a microfluidic device and the immobilization of the laccase enzyme successfully allowed a high capacity of BPA degradation.

Urine biomarkers for Alzheimer's disease: A new opportunity for wastewater-based epidemiology?

While Alzheimer's disease (AD) diagnosis, management, and care have become priorities for healthcare providers and researcher's worldwide due to rapid population aging, epidemiologic surveillance efforts are currently limited by costly, invasive diagnostic procedures, particularly in low to middle income countries (LMIC). In recent years, wastewater-based epidemiology (WBE) has emerged as a promising tool for public health assessment through detection and quantification of specific biomarkers in wastewater, but applications for non-infectious diseases such as AD remain limited. This early review seeks to summarize AD-related biomarkers and urine and other peripheral biofluids and discuss their potential integration to WBE platforms to guide the first prospective efforts in the field. Promising results have been reported in clinical settings, indicating the potential of amyloid ß, tau, neural thread protein, long non-coding RNAs, oxidative stress markers and other dysregulated metabolites for AD diagnosis, but questions regarding their concentration and stability in wastewater and the correlation between clinical levels and sewage circulation must be addressed in future studies before comprehensive WBE systems can be developed.

A meta-analysis of essential oils as a dietary additive for weaned piglets: Growth performance, antioxidant status, immune response, and intestinal morphology.

This study aimed to evaluate the effects of dietary supplementation with EOS on growth performance, blood serum antioxidant status, immune response, and intestinal morphology of weaned piglets using a meta-analytical approach. The database included 31 studies from which the response variables of interest were obtained. All data were analyzed using a random effects model, and results were expressed as weighted mean differences between treatments supplemented with and without EOS. EOS supplementation increased (P < 0.001) average daily feed intake, average daily gain, and final body weight and decreased (P < 0.001) feed conversion ratio and diarrhea incidence. Lower (P = 0.001) serum malondialdehyde content and higher (P < 0.05) serum concentrations of superoxide dismutase, catalase, glutathione peroxidase, and total antioxidant capacity were observed in response to the dietary inclusion of EOS. EOS supplementation increased (P < 0.001) the serum concentration of immunoglobulins A, G, and M and decreased (P < 0.05) the serum concentration of tumor necrosis factor-α, interleukin-1ß, and interleukin-6. Greater (P ≤ 0.001) villus height (VH) was observed in the jejunum and ileum in response to the dietary inclusion of EOS. However, EOS supplementation did not affect (P > 0.05) crypt depth (CD) and decreased (P < 0.001) the VH/CD ratio in the duodenum, jejunum, and ileum. In conclusion, essential oils can be used as a dietary additive to improve growth performance and reduce the incidence of diarrhea in weaned piglets and, at the same time, improve the antioxidant status in blood serum, immune response, and intestinal morphology.

A comprehensive review of genetic causes of obesity.

BACKGROUND: Obesity is a multifactorial chronic disease with a high, increasing worldwide prevalence. Genetic causes account for 7% of the cases in children with extreme obesity. DATA SOURCES: This narrative review was conducted by searching for papers published in the PubMed/MEDLINE, Embase and SciELO databases and included 161 articles. The search used the following search terms: "obesity", "obesity and genetics", "leptin", "Prader-Willi syndrome", and "melanocortins". The types of studies included were systematic reviews, clinical trials, prospective cohort studies, cross-sectional and prospective studies, narrative reviews, and case reports. RESULTS: The leptin-melanocortin pathway is primarily responsible for the regulation of appetite and body weight. However, several important aspects of the pathophysiology of obesity remain unknown. Genetic causes of obesity can be grouped into syndromic, monogenic, and polygenic causes and should be assessed in children with extreme obesity before the age of 5 years, hyperphagia, or a family history of extreme obesity. A microarray study, an analysis of the melanocortin type 4 receptor gene mutations and leptin levels should be performed for this purpose. There are three therapeutic levels: lifestyle modifications, pharmacological treatment, and bariatric surgery. CONCLUSIONS: Genetic study technologies are in constant development; however, we are still far from having a personalized approach to genetic causes of obesity. A significant proportion of the affected individuals are associated with genetic causes; however, there are still barriers to its approach, as it continues to be underdiagnosed. Video Abstract (MP4 1041807 KB).

Omicron and Delta variant prevalence detection and identification during the fourth COVID-19 wave in Mexico using wastewater-based epidemiology.

Objectives: To identify the SARS-CoV-2 variants Delta and Omicron during the fourth wave of the COVID-19 pandemic in Mexico using samples taken from 19 locations in 18 out of the 32 states. Methods: The genetic material concentration was done with PEG/NaCl precipitation, SARS-CoV-2 presence was confirmed by reverse transcriptase-quantitative polymerase chain reaction assay, the variant detection was carried out using a commercial mutation detection panel kit, and variant/mutation confirmation was done by amplicon sequencing of receptor-binding domain target region. The study used 41 samples. Results: The Delta variant was confirmed in two samples during August 2021 (Querétaro and CDMX) and in three samples during November 2021 (Aguascalientes, Ciudad Juárez campuses, and Nuevo Leon). In December 2021, another sample with the Delta variant was confirmed in Nuevo Leon. Between January to March 2022 only the presence of Omicron was confirmed, (variant BA.1). Additionally, in this period six samples were identified with the status "Variant Not Determined". Conclusion: To our knowledge, this study is one of the first to identify Omicron and Delta variants with polymerase chain reaction in Mexico and Latin America and its distribution across the country with 56% Mexican states making it a viable alternative for variant detection without conducting a large quantity of sequencing of clinical tests.

Consensus on pharmacological treatment of obesity in Latin America.

A panel of 10 experts in obesity from various Latin American countries held a Zoom meeting intending to reach a consensus on the use of anti-obesity medicines and make updated recommendations suitable for the Latin American population based on the available evidence. A questionnaire with 16 questions was developed using the Patient, Intervention, Comparison, Outcome (Result) methodology, which was iterated according to the modified Delphi methodology, and a consensus was reached with 80% or higher agreement. Failure to reach a consensus led to a second round of analysis with a rephrased question and the same rules for agreement. The recommendations were drafted based on the guidelines of the American College of Cardiology Foundation/American Heart Association Task Force on Practice. This panel of experts recommends drug therapy in patients with a body mass index of ≥30 or ≥27 kg/m2 plus at least one comorbidity, when lifestyle changes are not enough to achieve the weight loss objective; alternatively, lifestyle changes could be maintained while considering individual parameters. Algorithms for the use of long-term medications are suggested based on drugs that increase or decrease body weight, results, contraindications, and medications that are not recommended. The authors concluded that anti-obesity treatments should be individualized and multidisciplinary.

Inspiratory muscle training in patients with obesity: a systematic review and meta-analysis.

Introduction: Obesity is a chronic medical condition that affects, among others, the cardiovascular and respiratory systems. Interventions for its treatment focus on sustained weight reduction and general health improvement, leaving respiratory management aside. Our objective was to determine the effects of inspiratory muscle training (IMT) in patients with obesity. Methods: A systematic review was performed in Embase, Cochrane Library (CENTRAL), CINAHL, Web of Science, and PubMed/MEDLINE on June 26, 2023. Randomized clinical trials (RCTs), and quasi-randomized clinical trials investigating the effects of IMT in people with obesity were included. Selected studies were screened by two independent reviewers who extracted data and assessed the quality of the evidence. Results: The initial search returned 705 potential studies were included. Ultimately, eight studies met the criteria for eligibility and were included in the review. IMT improves physical capacity [6-minute walk test (6MWT): 44.5 m, 95% CI: 30.5 to 58.5; p < 0.0001] and the strength of the inspiratory muscles [maximal inspiratory pressure (MIP): -28.4 cm H2O, 95% CI: -41.9 to -14.8; p < 0.0001] compared to the controls, without differences in the pulmonary function, body mass index (BMI) and metabolic parameters. Conclusion: Inspiratory muscle training improves physical capacity and inspiratory muscle strength without significant changes in lung function, BMI, and metabolic parameters.Systematic review registration: PROSPERO, identifier CRD42023439625, https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42023439625.

IGF2 prevents dopaminergic neuronal loss and decreases intracellular alpha-synuclein accumulation in Parkinson's disease models.

Parkinson's disease (PD) is the second most common late-onset neurodegenerative disease and the predominant cause of movement problems. PD is characterized by motor control impairment by extensive loss of dopaminergic neurons in the substantia nigra pars compacta (SNpc). This selective dopaminergic neuronal loss is in part triggered by intracellular protein inclusions called Lewy bodies, which are composed mainly of misfolded alpha-synuclein (α-syn) protein. We previously reported insulin-like growth factor 2 (IGF2) as a key protein downregulated in PD patients. Here we demonstrated that IGF2 treatment or IGF2 overexpression reduced the α-syn aggregates and their toxicity by IGF2 receptor (IGF2R) activation in cellular PD models. Also, we observed IGF2 and its interaction with IGF2R enhance the α-syn secretion. To determine the possible IGF2 neuroprotective effect in vivo we used a gene therapy approach in an idiopathic PD model based on α-syn preformed fibrils intracerebral injection. IGF2 gene therapy revealed a significantly preventing of motor impairment in idiopathic PD model. Moreover, IGF2 expression prevents dopaminergic neuronal loss in the SN together with a decrease in α-syn accumulation (phospho-α-syn levels) in the striatum and SN brain region. Furthermore, the IGF2 neuroprotective effect was associated with the prevention of synaptic spines loss in dopaminergic neurons in vivo. The possible mechanism of IGF2 in cell survival effect could be associated with the decrease of the intracellular accumulation of α-syn and the improvement of dopaminergic synaptic function. Our results identify to IGF2 as a relevant factor for the prevention of α-syn toxicity in both in vitro and preclinical PD models.

Reflexividad ética de un traspié: niñez y adolescencia migrantes no acompañadas / Ethical Reflexivity of a Stumble: Unaccompanied Migrant Children and Adolescents

(analítico) El objetivo de este artículo es sistematizar un proceso de reflexividad ética surgido en un proyecto de investigación (Fondecyt) cuyo fin era conocer la situación de la niñez y la adolescencia migrantes no acompañadas en Chile. El proyecto fue aprobado con reparos éticos que hacían difícil poner en práctica métodos participativos. Este «traspié» dio paso a la reflexividad. Mediante una metodología de panel de expertos, creamos un comité de ética autoconvocado (profesionales en derecho y psicología especialistas en infancia) que capacitó al equipo y elaboró recomendaciones y protocolos. En los resultados exponemos algunos dilemas éticos (en torno al consentimiento informado, los derechos de autoría y un balance entre riesgos y beneficios) identificados en las distintas instancias evaluativas, así como los aprendizajes derivados de ello; finalizamos con futuras líneas de investigación.

(analytical) The objective of this article is to systematize a process of ethical reflexivity that emerged in a research project (Fondecyt) whose purpose was to know the situation of unaccompanied migrant children and adolescents in Chile. The project was approved with ethical qualms that made it challenging to implement participatory methods. This «stumble» gave way to reflexivity. Through a Panel of Experts methodology, we created a self-convened ethics committee (professionals in Law and Psychology specializing in childhood) that prepared entry and exit reports with recommendations and protocols and trained the team. In the results, we expose some ethical dilemmas -around informed consent, copyright, and a balance between risks and benefits- identified in the different evaluation instances and the learning derived from it. We end with future lines of research.

(analítico) O objetivo deste artigo é sistematizar um processo de reflexão ética que surgiu em um projeto de pesquisa (Fondecyt) cujo objetivo era conhecer a situação de crianças e adolescentes migrantes desacompanhados no Chile. O projeto foi aprovado com observações éticas que dificultaram a implementação de métodos participativos. Essa dificuldade inesperada impulsionou a reflexividade. Por meio da metodologia de Painel de Especialistas, foi criado um comitê de ética autoconvocado (com profissionais de Direito e Psicologia especializados na infância) que treinou a equipe e desenvolveu recomendações e protocolos. Nos resultados se expõem alguns dilemas éticos -em torno do consentimento informado, direitos autorais e o equilíbrio entre riscos e benefícios- identificados nas diferentes instâncias de avaliação, bem como as aprendizagens delas derivadas; sendo finalizado com futuras linhas de pesquisa.

How to repel a killer; chemical identification and effective repellent activity of commercial essential oils against kissing bugs.

Triatomines are haematophagous insects, some species are vectors of Trypanosoma cruzi, the aetiological agent of Chagas disease. The main strategy for interrupting T. cruzi transmission is to avoid contact of the vector populations with humans. Volatiles from commercial essential oils are excellent candidates to serve as repellents of kissing bugs. We used an exposure device to assess the repellence effect of eight commercial essential oils on Triatoma pallidipennis. The most effective oils were blended and evaluated against T. infestans, T. pallidipennis and Rhodnius prolixus. The blend was also evaluated on parasitised T. pallidipennis. Data were compared with the commercial repellent NN-diethyl-3-methylbenzamide. We recorded the time the insects spent in the proximity of the host and determined if any of the evaluated oils served as kissing bug repellent. We found commercial essential oils and a blend that significantly reduced the time spent in the proximity of the host. The blend was effective for use by human males and females, repelling infected and non-infected insects. The study of essential oils as repellents of blood-sucking disease-vector insects could shed light on the development of new control strategies.