Infiltrative Treatment of Morton's Neuroma: A Systematic Review.

BACKGROUND: Morton's neuroma (MN) is one of the most frequent neurological pathologies in feet, affecting approximately 4% of the general population. The treatment of MN can be surgical, conservative, and infiltrative, with different substances used in the injections for MN, as steroids, sclerosing solutions, and others. This review aims to evaluate the efficacy of current infiltrative therapy for Morton's neuroma and, additionally, to define adverse effects of this therapy. MATERIAL AND METHODS: A literature search was performed in PubMed, Embase, CINHAL, Epistemonikos, Web of Science (WOS), SPORTSDiscus and Cochrane Library. This search involved the application of all types of infiltrative treatment applicable to MN. The search was limited to original data describing clinical outcomes and pain using the Visual Analogue pain Scale (VAS) or the Johnson Satisfaction Scale, between February and June 2023. RESULTS: Twelve manuscripts were selected (six randomized controlled trials and six longitudinal observational studies) involving 1,438 patients. Capsaicin was reported to produce a VAS score reduction of 51.8%. Corticosteroids also reported a high level of efficacy. Alcohol and Hyaluronic Acid injections are well tolerated, but the effects of their application need further research. There were no serious adverse events. CONCLUSIONS: Corticosteroids, sclerosant injections, hyaluronic acid and capsaicin have been shown to be effective in reducing the pain related to MN.

COVID-19 in patients with haematologic malignancies: effect of RNAemia on clinical outcome in vaccinated patients.

OBJECTIVES: Patients with haematologic malignancies (HM) COVID-19 have more severe disease, with increased risk of mortality. Therefore, this study aimed to evaluate the effect of SARS-CoV-2 RNAemia and the specific humoral immune responses on the clinical outcomes of patients with HM and COVID-19. METHODS: Interferon-α/γ (IFN-α/IFN-γ) serum levels, neutralizing antibodies (NAb), and RNAemia at COVID-19 diagnosis, and persistent RNAemia during the follow-up were evaluated. RESULTS: Overall, 63 (58.9%) out of 107 patients had RNAemia, which was persistent in 26 (41.3%) patients. RNAemia at diagnosis and persistent RNAemia were associated with the need for high-flow nasal oxygen therapy during admission. Persistent RNAemia, age >70 years, and CURB-65 score ≥2 in patients with pneumonia were associated with increased 90-day mortality (p = 0.009, p = 0.030, and p = 0.001, respectively). The 90-day overall survival was lower (p = 0.006) in patients with persistent RNAemia. In addition, dexamethasone administration was associated with a COVID-19 episode with persistent RNAemia. CONCLUSIONS: Our results suggest that in patients with HM, RNAemia at the time of COVID-19 diagnosis and during the follow-up can be used to stratify patients with HM according to their clinical evolution and to guide clinical decisions tailored to the specific needs of each patient.

The brittle star genome illuminates the genetic basis of animal appendage regeneration.

Species within nearly all extant animal lineages are capable of regenerating body parts. However, it remains unclear whether the gene expression programme controlling regeneration is evolutionarily conserved. Brittle stars are a species-rich class of echinoderms with outstanding regenerative abilities, but investigations into the genetic bases of regeneration in this group have been hindered by the limited genomic resources. Here we report a chromosome-scale genome assembly for the brittle star Amphiura filiformis. We show that the brittle star genome is the most rearranged among echinoderms sequenced so far, featuring a reorganized Hox cluster reminiscent of the rearrangements observed in sea urchins. In addition, we performed an extensive profiling of gene expression during brittle star adult arm regeneration and identified sequential waves of gene expression governing wound healing, proliferation and differentiation. We conducted comparative transcriptomic analyses with other invertebrate and vertebrate models for appendage regeneration and uncovered hundreds of genes with conserved expression dynamics, particularly during the proliferative phase of regeneration. Our findings emphasize the crucial importance of echinoderms to detect long-range expression conservation between vertebrates and classical invertebrate regeneration model systems.

The Acoel nervous system: morphology and development.

Acoel flatworms have played a relevant role in classical (and current) discussions on the evolutionary origin of bilaterian animals. This is mostly derived from the apparent simplicity of their body architectures. This tenet has been challenged over the last couple of decades, mostly because detailed studies of their morphology and the introduction of multiple genomic technologies have unveiled a complexity of cell types, tissular arrangements and patterning mechanisms that were hidden below this 'superficial' simplicity. One tissue that has received a particular attention has been the nervous system (NS). The combination of ultrastructural and single cell methodologies has revealed unique cellular diversity and developmental trajectories for most of their neurons and associated sensory systems. Moreover, the great diversity in NS architectures shown by different acoels offers us with a unique group of animals where to study key aspects of neurogenesis and diversification od neural systems over evolutionary time.In this review we revisit some recent developments in the characterization of the acoel nervous system structure and the regulatory mechanisms that contribute to their embryological development. We end up by suggesting some promising avenues to better understand how this tissue is organized in its finest cellular details and how to achieve a deeper knowledge of the functional roles that genes and gene networks play in its construction.

Psychometric Properties of the Gastrointestinal Symptom Severity Scale in a Sample of Adolescents and Young Adults.

Background: Functional gastrointestinal disorders (FGIDs) are a set of chronic or recurrent gastrointestinal symptoms (GS) with great psychobiological complexity. The appearance of FGIDs harms quality of life and drains medical resources. Methods: Psychometric properties of the Gastrointestinal Symptom Severity Scale (GSSS) based on Rome IV criteria were examined in a sample of 1247 individuals with typical development. Observations were randomly divided into two subsets, namely, subsample 1 (n = 624) and subsample 2 (n = 623). Exploratory factor analysis (EFA) was performed with data from subsample 1, whilst confirmatory factor analysis (CFA) was performed with data from subsample 2. Internal consistency of the scale was assessed for the whole dataset according to ordinal alpha, whilst four-week reliability was measured according to the intraclass correlation coefficient (ICC). Measurement invariance as a function of sex was also examined, and discriminant-convergent validity of the GSSS was examined through hypothesis testing. Results: EFA revealed a two-factor structure with a moderate percentage of explained variance (51.3%), whilst CFA exhibited an excellent fit of the data to the model. A one-factor CFA model demonstrated an acceptable but slightly lower fit. Internal consistency was moderate and test-retest reliability was deemed adequate. Metric invariance was demonstrated as a function of sex. Hypothesis testing demonstrated strong convergent-discriminant validity with measures of sensory sensitivity, obsessive-compulsive symptoms, and pain. Conclusions: The GSSS is a tool with acceptable and promising psychometric properties when administered to neurotypical adolescents and young adults. The self-report GSSS may promote better understanding of GS involvement in the gut microbiota-brain axis in the general population.

Molecular and phylogenetic characterization of the monkeypox outbreak in the South of Spain.

Background and Aim: Until the May 2022 Monkeypox (MPXV) outbreak, which spread rapidly to many non-endemic countries, the virus was considered a viral zoonosis limited to some African countries. The Andalusian circuit of genomic surveillance was rapidly applied to characterize the MPXV outbreak in the South of Spain. Methods: Whole genome sequencing was used to obtain the genomic profiles of samples collected across the south of Spain, representative of all the provinces of Andalusia. Phylogenetic analysis was used to study the relationship of the isolates and the available sequences of the 2022 outbreak. Results: Whole genome sequencing of a total of 160 MPXV viruses from the different provinces that reported cases were obtained. Interestingly, we report the sequences of MPXV viruses obtained from two patients who died. While one of the isolates bore no noteworthy mutations that explain a potential heightened virulence, in another patient the second consecutive genome sequence, performed after the administration of tecovirimat, uncovered a mutation within the A0A7H0DN30 gene, known to be a prime target for tecovirimat in its Vaccinia counterpart. In general, a low number of mutations were observed in the sequences reported, which were very similar to the reference of the 2022 outbreak (OX044336), as expected from a DNA virus. The samples likely correspond to several introductions of the circulating MPXV viruses from the last outbreak. The virus sequenced from one of the two patients that died presented a mutation in a gene that bears potential connections to drug resistance. This mutation was absent in the initial sequencing before treatment.

Development and validation of the Gastrointestinal Symptom Severity Scale in Spanish children and adolescents.

Functional gastrointestinal disorders (FGIDs) are characterized by chronic or recurrent gastrointestinal symptoms (GS) that are not explained by structural or biochemical abnormalities. FGIDs are related to lower quality of life, increased demands on medical resources, and greater somatization and emotional instability. Furthermore, GS appears to be an indicator of dysbiosis in gut-microbiota, affecting the gut-microbiota-brain relationship. To develop and evaluate the psychometric properties of a new instrument called the Gastrointestinal Symptom Severity Scale (GSSS) using a web-based survey in a sample of neurotypical children and adolescents from Spain. Instrument development and validation processes were applied to the GSSS following its administration as part of an online survey. The sample included 1242 neurotypical children and adolescents. The mean age of participants was 13.95 years, with a standard deviation of 1.37 years. Overall, 13.8% suffered infectious diarrhea, 12.6% suffered abdominal pain, 5% suffered dyspepsia and 2.6% suffered gastro-esophageal reflux. A single-factor model produced good fit indices. Furthermore, internal consistency and test-retest reliability outcomes were acceptable. The GSSS was found to have acceptable metric measurement invariance. Significant correlations with other instruments were produced and were of expected direction and magnitude, confirming scale validity for hypothesis testing.     Conclusions: The GSSS shows promising psychometric properties for assessing GS in neurotypical Spanish adolescents and children. What is Known: • To the best of our knowledge, instruments assessing the severity of gastrointestinal symptoms in children and adolescents are still too few. What is New: • The GSSS shows promising psychometric properties for assessing GS in neurotypical adolescents and children. The GSSS may help improve understanding of GS involvement in the gut-brain microbiota axis in children and adolescents.

North-south pathways, emerging variants, and high climate suitability characterize the recent spread of dengue virus serotypes 2 and 3 in the Dominican Republic.

We employ a multidisciplinary approach, integrating genomics and epidemiology, to uncover recent dengue virus transmission dynamics in the Dominican Republic. Our results highlight a previously unknown north-south transmission pathway within the country, with the co-circulation of multiple virus lineages. Additionally, we examine the historical climate data, revealing long-term trends towards higher theoretical potential for dengue transmission due to rising temperatures. These findings provide information for targeted interventions and resource allocation, informing as well towards preparedness strategies for public health agencies in mitigating climate and geo-related dengue risks.

Fístula arterioileal: experiencia en un hospital terciario y revisión de la literatura / Arterial-ileal fistula: experience from a tertiary referral center and literature review

Introducción y objetivo: la fístula entre la arteria ilíaca y el conducto ileal (Bricker) es una patología con un elevado riesgo vital. El objetivo de este artículo es dar a conocer esta entidad, describir su presentación, sus métodos diagnósticos y su tratamiento basados en los casos en un hospital terciario y en la revisión de la literatura. Material y métodos: presentamos los casos de fístulas arterioileales ocurridos en nuestro centro entre 2016 y 2020. Se realizó una exhaustiva revisión de la literatura publicada hasta la fecha mediante la búsqueda en PubMed de artículos publicados entre 1971 y 2020, incluyendo las palabras claves “arterial ileal conduit fistula” y seleccionando únicamente los artículos en español e inglés. Resultados: se identificaron 4 casos en nuestro centro. Se reconocieron en la búsqueda bibliográfica 13 artículos que describían 16 casos de fístulas arterioileales. La mayoría compartía factores comunes de riesgo y el abordaje quirúrgico fue mayoritariamente la cirugía abierta. El abordaje adecuado parece ser la combinación de cirugía abierta y endovascular, efectiva en 3 de nuestros 4 casos. Conclusión: la fístula entre la arteria ilíaca y el conducto ileal es una complicación infrecuente y grave, con una mortalidad en torno al 44 %. Resulta difícil de diagnosticar, salvo que exista alta sospecha clínica, con pocos casos descritos en la literatura. Es fundamental tener en cuenta la historia clínica previa del paciente. (AU)

Introduction and objective: the presence of a fistula between the iliac artery and the ileal conduit is a live-threatening condition that must be known and, therefore, suspected after a massive bleeding through the ileal conduit. The objective of this article is to present the arterial-ileal fistula, describe its presentation, diagnostic methods, and treatments, based on the cases presented in a tertiary referral center and literature review. Material and methods: all cases of arterial-ileal fistulas collected at our center from 2016 through 2020 are presented here. A comprehensive literature review published to date was also conducted based on a search for articles published from 1971 through 2020 on the PubMed database with the keywords “arterial ileal conduit fistula”, including studies only published in English and Spanish languages. Results: a total of 4 cases were identified in our center. A total of 13 articles describing 16 cases of arterial-ileal fistula were identified from the medical literature, most of them with some risk factors in common. The approach followed was mainly open surgery. The proper treatment seems to be a combination between open surgery and endovascular approaches, which turned out to be effective in 3 of our 4 cases. Conclusion: a fistula between the artery and the ileal conduit is a rare but serious complication, with a 44% mortality rate. It is difficult to diagnose unless there is clinical suspicion involved, with only a few cases reported in the medical literature. We should consider the patient’s pathological history to identify this entity. (AU)

Elaboration of Thermally Performing Polyurethane Foams, Based on Biopolyols, with Thermal Insulating Applications.

In this work, biobased rigid polyurethane foams (PUFs) were developed with the aim of achieving thermal and fireproofing properties that can compete with those of the commercially available products. First, the synthesis of a biopolyol from a wood residue by means of a scaled-up process with suitable yield and reaction conditions was carried out. This biopolyol was able to substitute completely the synthetic polyols that are typically employed within a polyurethane formulation. Different formulations were developed to assess the effect of two flame retardants, namely, polyhedral oligomeric silsesquioxane (POSS) and amino polyphosphate (APP), in terms of their thermal properties and degradation and their fireproofing mechanism. The structure and the thermal degradation of the different formulations was evaluated via Fourier Transformed Infrared Spectroscopy (FTIR) and thermogravimetric analysis (TGA). Likewise, the performance of the different PUF formulations was studied and compared to that of an industrial PUF. From these results, it can be highlighted that the addition of the flame retardants into the formulation showed an improvement in the results of the UL-94 vertical burning test and the LOI. Moreover, the fireproofing performance of the biobased formulations was comparable to that of the industrial one. In addition to that, it can be remarked that the biobased formulations displayed an excellent performance as thermal insulators (0.02371-0.02149 W·m-1·K-1), which was even slightly higher than that of the industrial one.

The role of funded partnerships in working towards decreasing COVID-19 vaccination disparities, United States, March 2021-December 2022.

During the COVID-19 vaccination rollout from March 2021- December 2022, the Centers for Disease Control and Prevention funded 110 primary and 1051 subrecipient partners at the national, state, local, and community-based level to improve COVID-19 vaccination access, confidence, demand, delivery, and equity in the United States. The partners implemented evidence-based strategies among racial and ethnic minority populations, rural populations, older adults, people with disabilities, people with chronic illness, people experiencing homelessness, and other groups disproportionately impacted by COVID-19. CDC also expanded existing partnerships with healthcare professional societies and other core public health partners, as well as developed innovative partnerships with organizations new to vaccination, including museums and libraries. Partners brought COVID-19 vaccine education into farm fields, local fairs, churches, community centers, barber and beauty shops, and, when possible, partnered with local healthcare providers to administer COVID-19 vaccines. Inclusive, hyper-localized outreach through partnerships with community-based organizations, faith-based organizations, vaccination providers, and local health departments was critical to increasing COVID-19 vaccine access and building a broad network of trusted messengers that promoted vaccine confidence. Data from monthly and quarterly REDCap reports and monthly partner calls showed that through these partnerships, more than 295,000 community-level spokespersons were trained as trusted messengers and more than 2.1 million COVID-19 vaccinations were administered at new or existing vaccination sites. More than 535,035 healthcare personnel were reached through outreach strategies. Quality improvement interventions were implemented in healthcare systems, long-term care settings, and community health centers resulting in changes to the clinical workflow to incorporate COVID-19 vaccine assessments, recommendations, and administration or referrals into routine office visits. Funded partners' activities improved COVID-19 vaccine access and addressed community concerns among racial and ethnic minority groups, as well as among people with barriers to vaccination due to chronic illness or disability, older age, lower income, or other factors.

A broad-taxa approach as an important concept in ecotoxicological studies and pollution monitoring.

Aquatic invertebrates play a pivotal role in (eco)toxicological assessments because they offer ethical, cost-effective and repeatable testing options. Additionally, their significance in the food chain and their ability to represent diverse aquatic ecosystems make them valuable subjects for (eco)toxicological studies. To ensure consistency and comparability across studies, international (eco)toxicology guidelines have been used to establish standardised methods and protocols for data collection, analysis and interpretation. However, the current standardised protocols primarily focus on a limited number of aquatic invertebrate species, mainly from Arthropoda, Mollusca and Annelida. These protocols are suitable for basic toxicity screening, effectively assessing the immediate and severe effects of toxic substances on organisms. For more comprehensive and ecologically relevant assessments, particularly those addressing long-term effects and ecosystem-wide impacts, we recommended the use of a broader diversity of species, since the present choice of taxa exacerbates the limited scope of basic ecotoxicological studies. This review provides a comprehensive overview of (eco)toxicological studies, focusing on major aquatic invertebrate taxa and how they are used to assess the impact of chemicals in diverse aquatic environments. The present work supports the use of a broad-taxa approach in basic environmental assessments, as it better represents the natural populations inhabiting various ecosystems. Advances in omics and other biochemical and computational techniques make the broad-taxa approach more feasible, enabling mechanistic studies on non-model organisms. By combining these approaches with in vitro techniques together with the broad-taxa approach, researchers can gain insights into less-explored impacts of pollution, such as changes in population diversity, the development of tolerance and transgenerational inheritance of pollution responses, the impact on organism phenotypic plasticity, biological invasion outcomes, social behaviour changes, metabolome changes, regeneration phenomena, disease susceptibility and tissue pathologies. This review also emphasises the need for harmonised data-reporting standards and minimum annotation checklists to ensure that research results are findable, accessible, interoperable and reusable (FAIR), maximising the use and reusability of data. The ultimate goal is to encourage integrated and holistic problem-focused collaboration between diverse scientific disciplines, international standardisation organisations and decision-making bodies, with a focus on transdisciplinary knowledge co-production for the One-Health approach.

Predictors of physical activity in older adults 65 years and older: findings in health survey of the Valencian Community.

Background: Physical activity is part of a healthy lifestyle in the older adult and is related to multiple variables that promote this behavior. Objective: To identify the relationship and predictive power of sociodemographic variables, multimorbidity, severity index, risk of poor mental health, social support, affective support and confidential support with the time devoted to physical activity in the population over 65 years of age in the Valencian Community. Methods: Cross-sectional descriptive analytical study of the data collected in the Health Survey of the Valencian Community on a total of 3,199 people over 65 years of age. The study variables were age, sex, educational level, marital status, social class, multimorbidity, severity index collected with the EQ-5D-5L tool, risk of poor mental health collected with the Goldberg general health questionnaire (GHQ-12), and perceived social, affective and confidential support collected with the Duke-Unc social support scale (Duke-UNC-11). Results: All variables, except affective support, are significantly related to the time of physical activity performed by people older than 65 years. The severity index has a predictive capacity of 13.7% of physical activity performed and age is able to predict 1.2% of this variable. Conclusion: Sex, age, education, social class, marital status, multimorbidity, risk of poor mental health or social support and confidentiality are related to the physical activity time of the Valencian population over 65 years of age. On the other hand, the variables severity index and age have been identified as variables capable of predicting up to 14.8% of the variance of the physical activity time variable in our study population.

Síndrome genitourinario de la menopausia en mujeres del policlínico universitario Dr. Cosme Ordoñez EECarceller, Cuba / Genitourinary syndrome in women at the Dr. Cosme Ordoñez Carceller university polyclinic, Cuba

Resumen Objetivo: Determinar la frecuencia e intensidad del síndrome genitourinario de la menopausia en las mujeres atendidas en la consulta de climaterio y menopausia del Policlínico Universitario "Dr. Cosme Ordoñez Carceller. Materiales y métodos: Investigación tipo observacional, descriptiva y transversal, realizada en el período comprendido entre enero 2018 y diciembre de 2022. El universo de trabajo quedó constituido por 2962 mujeres de edad mediana del policlínico universitario Dr. Cosme Ordoñez Carceller. La muestra fue de 353 mujeres seleccionada mediante un muestreo estratificado simple. Para la recogida de los datos se empleó un modelo de Historia Clínica, de la cual se extrajeron los aspectos referidos a los datos sociodemográficos, la edad de inicio de los síntomas climatéricos y de la menopausia, las alteraciones genitourinarias y su intensidad en relación a la etapa del síndrome climatérico. Resultados: La edad promedio de las mujeres estudiadas fue de 49,4 +/- 5,18 años. La mayor cantidad de ellas se encontraban en la perimenopausia (60,1%), mientras que el porcentaje en las posmenopáusicas alcanzaba el 39,9%. La edad promedio de inicio de los síntomas fue de 45,8 +/- 6,2 años, la mayor frecuencia ocurrió entre los 45 y 49 años (61,5%). La edad promedio de aparición de la menopausia de 48,4+/- 3,7 años, lo que representa que más de dos tercios (81,6%) de las mujeres tuvieron su última menstruación por encima de los 45 años. Las alteraciones genitourinarias predominaron en la perimenopausia y la intensidad leve. Conclusiones: El síndrome genitourinario de la menopausia constituye un grupo de manifestaciones clínicas frecuentes en la mujer en etapa climatérica y afecta a más de dos tercios de las mujeres del policlínico, aparecen con mayor periodicidad entre los 45 y 49 años, en la perimenopausia y con intensidad leve.

Abstract Objective: To determine the frequency and intensity of genitourinary syndrome of menopause in womens treated in the climacteric and menopause consultation of the University Polyclinic 'Dr. Cosme Ordonez Carceller. Methods: Observational, descriptive and cross-sectional research, carried out in the period between January 2018 and December 2022. The universe of work was made up of 2962 middle-aged women from the Dr. Cosme Ordoñez Carceller university polyclinic. The sample consisted of 353 women selected by simple stratified sampling. For data collection, a Clinical History model was used, from which aspects related to sociodemographic data were extracted, the age of onset of climacteric symptoms and menopause, genitourinary disorders and their intensity in relation to the stage of climacteric syndrome. Results: The average age of the women studied was 49.4 +/- 5.18 years. The largest number of them were in perimenopause (60.1%), while the percentage in postmenopausal women reached 39.9%. The mean age of onset of symptoms was 45.8 +/- 6.2 years, the highest frequency occurring between 45 and 49 years (61.5%). The average age of onset of menopause of 48.4+/- 3.7 years, which represents that more than two thirds (81.6%) of the women had their last menstruation over 45 years of age. Genitourinary alterations predominated in perimenopause and mild intensity Conclusions: The genitourinary syndrome of menopause constitutes a group of frequent clinical manifestations in women in the climacteric stage and affect more than two thirds of the women al the policlinic, appearing more frequently between the ages of 45 and 49, in perimenopause and with mild intensity.

Foot Pain and Disability in Women with Rheumatoid Arthritis, Ehlers-Danlos Syndrome and Systemic Lupus Erythematosus: Relationship with Quality of Life.

The aim of this work was to investigate the relationship foot pain and foot disability have with HRQoL in groups of women with RA, SLE and EDS, in comparison with a control group. A cross-sectional study was carried out with females with one of these conditions and a control group. The SF-12 questionnaire was used to collect data about quality of life. The type of foot was classified according to the footprint and the foot posture index. A total of 156 patients and 47 controls participated in the study (N = 203). Neither pain nor foot posture were different between groups. The physical and mental components of SF-12 were worse in rheumatoid arthritis and Ehlers-Danlos syndrome patients, and the physical component was worse in systemic lupus erythematosus patients, compared to controls. A significant difference was also observed in the mental component between systemic lupus erythematosus and Ehlers-Danlos syndrome patients, the latter having the lowest values among the groups. We can conclude that women with rheumatoid arthritis, Ehlers-Danlos syndrome, systemic lupus erythematosus and foot pain perceive a worse quality of life. There are no significant changes in foot posture. Pain and health-related quality of life are independent of foot posture.

Public policies strengthen the relationship between family farming and food security in Brazilian schools - A case study of Paraíba state.

We reviewed the historical pathway that paved the way for the creation and implementation of public policies for food security in Brazilian schools. We then analyzed the implementation of such policies in Paraíba state (northeastern Brazil) in terms of the investment in purchasing food from familiar agriculture, i.e. agricultural production in small farm units where the labor comes from the owner's family that lives on the farm and receives gross income from agriculture. We conducted this study to determine the extent to which public policies for food security in schools promote income to family farmers in Paraíba state. We obtained data from the Management and Accountability System (SIGPC) to quantify the municipalities in Paraíba state that comply with the national school feeding program denominated Programa Nacional de Alimentação Escolar (PNAE). The fiscal years from 2015 to 2017 were used as a reference period because no data is available for the upcoming years. PNAE has been created to underpin programs offering free meals to school-age children, thus allowing for basic learning conditions while tackling hunger among social groups in poverty. PNAE became a public policy subsidiary of familiar agriculture through the Law 11,947 of 2009 which requires the minimal investment of 30% of PNAE funds to purchase food from family farmers. In Paraíba state, 80% of the municipalities buy food through PNAE. However, nearly 40% of the municipalities do not apply the minimum investment to purchase food from family farmers during the evaluated period (2011-2017). We identified that logistics and transportation of food coordinated by the school feeding councils are the main constraints for greater efficiency of the program. Despite such constraints, PNAE offers a unique opportunity to enhance human wellbeing by fostering family farmers to adopt conservation practices and provide healthy, local food to school-aged children.

Relationship between Physicochemical, Techno-Functional and Health-Promoting Properties of Fiber-Rich Fruit and Vegetable By-Products and Their Enhancement by Emerging Technologies.

The preparation and processing of fruits and vegetables produce high amounts of underutilized fractions, such as pomace and peel, which present a risk to the environment but constitute a valuable source of dietary fiber (DF) and bioactive compounds. The utilization of these fiber-rich products as functional food ingredients demands the application of treatments to improve their techno-functional properties, such as oil and water binding, and health-related properties, such as fermentability, adsorption, and retardation capacities of glucose, cholesterol, and bile acids. The enhancement of health-promoting properties is strongly connected with certain structural and techno-functional characteristics, such as the soluble DF content, presence of hydrophobic groups, and viscosity. Novel physical, environmentally friendly technologies, such as ultrasound (US), high-pressure processing (HPP), extrusion, and microwave, have been found to have higher potential than chemical and comminution techniques in causing desirable structural alterations of the DF network that lead to the improvement of techno-functionality and health promotion. The application of enzymes was related to higher soluble DF content, which might be associated with improved DF properties. Combined physical and enzymatic treatments can aid solubilization and modifications, but their benefit needs to be evaluated for each DF source and the desired outcome.

Influence of type of household on prognosis at one year in patients ≥65 years attending hospital emergency departments in Spain. The EDEN-6 study.

OBJECTIVE: To investigate whether the type of household is associated with prognosis at one year in patients ≥65 years of age discharged after medical consultation requiring emergency department care. METHODS: Data from the Emergency Department and Elder Needs (EDEN) cohort were used. This retrospective cohort included all patients ≥65 years of age seen in 52 Spanish emergency departments over one week (April 1-7, 2019) in whom the type of household was recorded and categorized as living at home alone, with relatives, with professional caregivers, or in a nursing home. Patient demographic and other baseline characteristics and management during the index emergency department episode were recorded and used to adjust the following 1-year outcomes: all-cause mortality, hospitalization and emergency department revisit. Associations between type of household and outcomes are expressed as adjusted hazard ratios with 95% confidence intervals using living alone as the reference category. RESULTS: 13,442 patients with a median age of 79 years (interquartile range 72-86) were included; 56% were women, 12.2% of patients lived alone, 74.9% with relatives, 3.9% with a professional caregiver, and 9.1% in a nursing home. During the year following discharge, the mortality rate was 14.0%, the hospitalization rate 29.7%, and the emergency department revisit rate 59.3%. In the fully adjusted model, the risk of death was associated only with living in a nursing home (hazard ratio 1.366 (1.101-1.695)). On the other hand, the risk of hospitalization was lower in individuals living in nursing homes (hazard ratio 0.783 [0.676-0.907]) and at home with relatives (hazard ratio 0.897 [0.810-0.992]), while the risk of emergency department revisit was lower in individuals living in nursing homes (hazard ratio 0.826 [0.742-0.920]) or at home with caregivers (hazard ratio 0.856 [0.750-0.976]). CONCLUSION: The type of household was modestly associated with the one-year prognosis of patients ≥65 years of age discharged after attendance at an emergency department. Living in a nursing home is associated with an increased risk of death but a decreased risk of rehospitalization or emergency department revisit, while living at home with relatives or professional caregivers is associated only with a decreased risk of hospitalization and emergency department revisit, respectively.

Near-Unity Emitting, Widely Tailorable, and Stable Exciton Concentrators Built from Doubly Gradient 2D Semiconductor Nanoplatelets.

The strength of electrostatic interactions (EIs) between electrons and holes within semiconductor nanocrystals profoundly affects the performance of their optoelectronic systems, and different optoelectronic devices demand distinct EI strength of the active medium. However, achieving a broad range and fine-tuning of the EI strength for specific optoelectronic applications is a daunting challenge, especially in quasi two-dimensional core-shell semiconductor nanoplatelets (NPLs), as the epitaxial growth of the inorganic shell along the direction of the thickness that solely contributes to the quantum confined effect significantly undermines the strength of the EI. Herein we propose and demonstrate a doubly gradient (DG) core-shell architecture of semiconductor NPLs for on-demand tailoring of the EI strength by controlling the localized exciton concentration via in-plane architectural modulation, demonstrated by a wide tuning of radiative recombination rate and exciton binding energy. Moreover, these exciton-concentration-engineered DG NPLs also exhibit a near-unity quantum yield, high photo- and thermal stability, and considerably suppressed self-absorption. As proof-of-concept demonstrations, highly efficient color converters and high-performance light-emitting diodes (external quantum efficiency: 16.9%, maximum luminance: 43,000 cd/m2) have been achieved based on the DG NPLs. This work thus provides insights into the development of high-performance colloidal optoelectronic device applications.

Mapping of emerging contaminants in coastal waters research: A bibliometric analysis of research output during 1986-2022.

This bibliometric analysis provides the first overview of the literature on emerging contaminants in coastal waters. Bibexcel, Microsoft Excel, VOSviewer and the bibliometix R package software were used for bibliometric analysis and science mapping. 556 publications, published between 1986 and 2022, were retrieved from the Web of Science (WoS) database. The results showed that this field of research follows Price's law of exponential growth and has exploded since 2001. Authors, journals and institutions followed Lotka's law, and Price's index (43.4 %) showed that the field is far from being obsolete. The most influential institution is the Chinese Academy of Sciences, while authors from China, USA, Japan and Singapore have the most publications and international co-authorships. The leading journal is Marine Pollution Bulletin, with a focus on Environmental Science WoS category. Hot research areas focus on risk assessment of PCBs, organochlorine compounds and personal care products in surface water and wastewater.