Ring-opening polymerization of emulsion-templated deep eutectic system monomer for macroporous polyesters with controlled degradability.

Biodegradable polyesters with interconnected macroporosity, such as poly(l-lactide) (PLLA) and poly(ε-caprolactone) (PCL), have gained significant importance in the fields of tissue engineering and separation. This study introduces functional macroinitiators, specifically polycaprolactone triol (PCLT) and polyethylene glycol (PEG), both OH-terminated, in the solventless ring-opening polymerization (ROP) of a liquid deep eutectic system monomer (DESm) composed of LLA and CL at a 30 : 70 molar ratio, respectively. The macroinitiators selectively initiate the organocatalyzed ROP of LLA in the DESm during the first polymerization stage, thereby modifying the PLLA architecture. This results in the formation of either branched or linear PLLA copolymers depending on the macroinitiator, PCLT and PEG, respectively. In the second stage, the ROP of the CL, which is a counterpart of the DESm, produces PCL that blends with the previously formed PLLA. The insights gained into the PLLA architectures during the first stage of the DESm ROP, along with the overall molecular weight and hydrophobicity of the resulting PLLA/PCL blend in bulk, were advantageously used to design polymerizable high internal phase emulsions (HIPEs) oil-in-DESm. By incorporating a liquid mixture of DESm and macroinitiators (PCLT or PEG), stable HIPE formulations were achieved. These emulsions sustained the efficient organocatalyzed ROP of the continuous phase at 37 °C with high conversions. The resulting polymer replicas of the HIPEs, characterized by macroporous and interconnected structures, were subjected to a degradation assay in PBS at pH 7.4 and 37 °C and remained mechanically stable for at least 30 days. Notably, they exhibited the capability to sorb crude oil in a proof-of-concept test, with a rate of 2 g g-1. The macroporous and interconnected features of the polyHIPEs, combined with their inherent degradation properties, position them as promising degradable polymeric sorbents for efficient separation of hydrophobic fluids from water.

Resultados de un programa educativo orientado a la promoción de la independencia y autonomía funcional

Introducción: El envejecimiento es un proceso fisiológico que genera cambios en la salud de los adultos mayores. Una de las esferas que con mayor frecuencia se afecta es la psicosocial, en la cual se presenta pérdida de la independencia y autonomía funcional. Objetivo: Evaluar los resultados de un programa educativo orientado a la promoción de la independencia y autonomía funcional. Métodos: Se realizó un estudio cuasiexperimental de intervención antes - después. El universo fue de 697 adultos mayores residentes en las parroquias rurales del cantón Penipe, en la provincia Chimborazo. La muestra quedó conformada por 249 ancianos. Se aplicó un programa educativo durante 8 meses que incluyó como variable el nivel de conocimiento sobre hábitos y estilos de vida saludables y la dependencia. Se utilizó la prueba de McNemar para identificar cambios en el nivel de conocimiento sobre hábitos y estilos de vida. Resultados: Promedio de edad de 68,32 años, predominio del sexo femenino (55,02 %) y con comorbilidades (73,49 %). En el 42,97 % de los sujetos se identificó algún tipo de dependencia, con predominio de la dependencia escasa (45,79 %). Durante el pretest se identificó un nivel de conocimiento bajo en el 63,05 %, durante el postest solo el 15,66 % mantenía un nivel bajo (p= 0,02). Conclusiones: El programa educativo mejora el nivel de conocimiento sobre la importancia de adoptar hábitos y estilos de vida saludables para promocionar la independencia y la autonomía funcional.

Introduction: Aging is a physiological process that generates changes in the health of people over 60 years of age. One of the spheres that is most frequently affected is psychosocial, in which there is loss of independence and functional autonomy. Objective: To evaluate the results of an educational program aimed at promoting independence and functional autonomy. Methods: A quasi-experimental before-after intervention study was carried out. The universe was 697 older adults residing in the rural parishes of the Penipe canton in the Chimborazo province. The sample was made up of 249 elderly people. An educational program was applied for 8 months that included as a variable the level of knowledge about healthy habits and lifestyles and dependency. The McNemar test was used to identify changes in the level of knowledge about habits and lifestyles. Results: Average age of 68.32 years, predominance of female sex (55.02%) and with associated comorbidities (73.49%). Some type of dependency was identified in 42.97% of the subjects, with a predominance of low dependency (45.79%). During the pretest, older adults with a low level of knowledge about healthy habits and lifestyles predominated (63.05%). During the posttest, the average level of knowledge predominated (51.81%). Conclusions: The educational program improves the level of knowledge about the importance of adopting healthy habits and lifestyles to promote independence and functional autonomy.

Randomized trial to assess the efficacy and safety of xyloglucan for the treatment of acute gastroenteritis in children.

Acute gastroenteritis is one of the most common diseases in children and an important cause of morbidity and mortality worldwide. No specific treatment is available; therefore, management is exclusively symptomatic. Xyloglucan has been approved in Europe as a class IIa medical device for restoration of the physiological functions of the intestinal wall. Our objective was to assess efficacy and safety of xyloglucan for the treatment of acute gastroenteritis in children. We performed a triple-blind, randomized placebo-controlled clinical trial in four primary care centers and one continued care hospital center. The study population comprised children with acute gastroenteritis aged >3 months and <5 years. Our primary endpoint was time (in hours) of resolution of diarrhea, defined as the time to resolution of stool consistency (Bristol Stool Form Scale ≤5 or Amsterdam Stool Form Scale B or C) or time until deposition frequency resumes to normality, whichever occurred first. We also recorded intravenous rehydration, hospitalization, stools per day, Vesikari scale, vomiting, relapse, weight loss, drugs prescribed, and adverse events. Eighty children were included in the intention-to-treat population (43 xyloglucan and 37 placebo) and 74 (93%) in the per-protocol population. Time to resolution of diarrhea was similar in both groups with (median, 95% CI) 24, 17-24 h in the xyloglucan group versus 24, 19-24 h in the placebo group, p = .680. Significant differences were observed for patients with moderate-to-severe diarrhea (Vesikari scale ≥9): xyloglucan group (20 [15-24] h) versus placebo group (85 [51-120] h) (p = .04). No other significant differences were found. Xyloglucan can be considered safe and other studies should be performed to confirm the usefulness in patients with moderate-to-severe diarrhea.

Permeation Protection by Waterproofing Mucosal Membranes.

The permeability of the oral or nasal mucosa is higher than that of the skin. Mucosa permeability depends mainly on the thickness and keratinization degree of the tissues. Their permeability barrier is conditioned by the presence of certain lipids. This work has the main aim of reinforcing the barrier effect of oral mucosa with a series of formulations to reduce permeation. Transmembrane water loss of different formulations was evaluated, and three of them were selected to be tested on the sublingual mucosa permeation of drugs. Caffeine, ibuprofen, dexamethasone, and ivermectin were applied on porcine skin, mucosa, and modified mucosa in order to compare the effectiveness of the formulations. A similar permeation profile was obtained in the different membranes: caffeine > ibuprofen~dexamethasone > ivermectin. The most efficient formulation was a liposomal formulation composed of lipids that are present in the skin stratum corneum. Impermeability provided by this formulation was notable mainly for the low-molecular-weight compounds, decreasing their permeability coefficient by between 40 and 80%. The reinforcement of the barrier function of mucosa provides a reduction or prevention of the permeation of different actives, which could be extrapolated to toxic compounds such as viruses, contaminants, toxins, etc.

The Role of Bronchoalveolar Lavage in the Diagnosis of COVID-19 Pneumonia: A Report of Three Cases.

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) initially infects and replicates in epithelial cells of the nasopharynx where there are relatively high levels of angiotensin-converting enzyme 2 receptor, which correlates with the highest sensitivity time point of the nasopharyngeal swab (NPS) real-time polymerase chain reaction (RT-PCR) during the first week, with subsequent decline thereafter. As viral shedding progresses throughout the respiratory tract, the virus can be detectable for up to 30 days in bronchoalveolar fluids. This report presents three cases of acute respiratory distress in the setting of multifocal pneumonia, with multiple false-negative NPS SARS-CoV-2/RT-PCR but positive SARS-CoV-2/RT-PCR in bronchoalveolar lavage (BAL) samples. Molecular RT-PCR testing remains the gold standard in the diagnosis of SARS-CoV-2 infection. However, the diagnostic accuracy of NPS RT-PCR may be affected by several factors. SARS-CoV-2/RT-PCR in BAL samples increases the diagnostic yield for coronavirus disease 2019 pneumonia; however, it is not widely available in many institutions and can be clinically challenging to perform. A multimodal approach is required for prompt diagnosis, especially in patients with a progressive disease, where a delay in therapy can be clinically detrimental.

Variability in the management of infants under 3 months with minor head injury in paediatric emergency departments.

INTRODUCTION: In the assessment of infants younger than 3 months with minor traumatic head injury (MHI), it is essential to adapt the indication of imaging tests. The Pediatric Head Injury/Trauma Algorithm (PECARN) clinical prediction rule is the most widely used to guide clinical decision making. OBJECTIVES: To analyse the variability in the performance of imaging tests in infants under 3 months with MHI in paediatric emergency departments (PEDs) and the adherence of each hospital to the recommendations of the PECARN rule. POPULATION AND METHODS: We conducted a prospective multicentre observational study in 13 paediatric emergency departments in Spain between May 2017 and November 2020. RESULTS: Of 21 981 children with MHI, 366 (1.7%) were aged less than 3 months; 195 (53.3%) underwent neuroimaging, with performance of CT scans in 37 (10.1%; interhospital range, 0%-40.0%), skull X-rays in 162 (44.3 %; range, 0%-100%) and transfontanellar ultrasound scans in 22 (6.0%; range, 0%-24.0%). The established recommendations were followed in 25.6% (10/39) of infants classified as high-risk based on PECARN criteria (range, 0%-100%); 37.1% (36/97) classified as intermediate-risk (range, 0%-100%) and 57.4% (132/230) classified as low-risk (range, 0%-100%). CONCLUSION: We found substantial variability and low adherence to the PECARN recommendations in the performance of imaging tests in infants aged less than 3 months with MHI in Spanish PEDs, mainly due to an excessive use of skull X-rays.

Variabilidad en la atención en urgencias al lactante menor de 3 meses con un traumatismo craneoencefálico leve / Variability in the management of infants under 3 months with minor head injury in paediatric emergency departments

Introducción: En la valoración de los lactantes menores de 3 meses con un traumatismo craneoencefálico (TCE) leve es imprescindible adecuar la indicación de pruebas radiológicas. La regla de predicción clínica PECARN es la más utilizada para ayudar en la toma de decisiones clínicas. Objetivos: Evaluar la variabilidad en la realización de pruebas radiológicas en los menores de 3 meses con un TCE leve en los servicios de urgencias pediátricos y la adherencia de cada hospital a las recomendaciones de la regla de predicción clínica PECARN. Población y métodos: Estudio de cohortes prospectivo en<3 meses con un TCE leve que consultaron en 13 servicios de urgencias pediátricos españoles entre mayo de 2017 y noviembre de 2020. Resultados: Se atendieron 21.981 pacientes con un TCE leve, de los que 366 (1,7%) eran menores de 3 meses. Se realizaron pruebas de imagen al 53,3% (195): TC craneal a 37 (10,1% [rango entre hospitales 0-40%]), radiografía de cráneo a 162 (44,3% [rango 0-100%]) y ecografía transfontanelar a 22 (6,0% [rango 0-24%]). Se siguieron las recomendaciones PECARN en el 25,6% (10/39) de los lactantes con criterios de alto riesgo (rango 0-100%); el 37,1% (36/97) de los de riesgo intermedio (rango 0-100%) y el 57,4% (132/230) de los de bajo riesgo (rango 0-100%). Conclusiones: Existe gran variabilidad, con un bajo cumplimiento de las recomendaciones PECARN, en la realización de pruebas radiológicas en los menores de 3 meses que consultan por un TCE leve en los servicios de urgencias pediátricos españoles, a expensas fundamentalmente de un exceso en el empleo de radiografías de cráneo. (AU)

Introduction: In the assessment of infants younger than 3 months with minor traumatic head injury (MHI), it is essential to adapt the indication of imaging tests. The Pediatric Head Injury/Trauma Algorithm (PECARN) clinical prediction rule is the most widely used to guide clinical decision making. Objectives: To analyse the variability in the performance of imaging tests in infants under 3 months with MHI in paediatric emergency departments and the adherence of each hospital to the recommendations of the PECARN rule. Population and methods: We conducted a prospective multicentre observational study in 13 paediatric emergency departments in Spain between May 2017 and November 2020. Results: Of 21,981 children with MHI, 366 (1.7%) were aged less than 3 months; 195 (53.3%) underwent neuroimaging, with performance of CT scans in 37 (10.1%; interhospital range, 0%–40.0%), skull X-rays in 162 (44.3%; range, 0%–100%) and transfontanellar ultrasound scans in 22 (6.0%; range, 0%–24.0%). The established recommendations were followed in 25.6% (10/39) of infants classified as high-risk based on PECARN criteria (range, 0%–100%); 37.1% (36/97) classified as intermediate-risk (range, 0%–100%) and 57.4% (132/230) classified as low-risk (range, 0%–100%). Conclusion: We found substantial variability and low adherence to the PECARN recommendations in the performance of imaging tests in infants aged less than 3 months with MHI in Spanish paediatric emergency departments s, mainly due to an excessive use of skull X-rays. (AU)

Evaluation of the PECARN rule for traumatic brain injury applied to infants younger than 3 months and creation of a modified, age-specific rule.

Infants < 3 months with minor head trauma (MHT) are a particularly vulnerable group, though few studies have focused specifically on these patients. We aimed to evaluate the application of the PECARN prediction rule, designed for clinically important traumatic brain injury (ciTBI) in children < 2 years in infants < 3 months, and create a specific prediction rule for this population. We conducted a prospective multicenter observational study in 13 pediatric emergency departments (PEDs) in Spain. The PECARN rule was applied to all patients. A new specific prediction rule for infants < 3 months of age was created. The main outcome measures were (1) ciTBI, (2) TBI evidenced on computed tomography (CT) scan, and (3) isolated skull fracture (ISF). Telephone follow-up was conducted for all patients over the 4 weeks after the initial PED visit. Of 21,981 children with MHT, 366 (1.7%) were < 3 months old and 195 (53.3%) underwent neuroimaging, including 37 (10.1%) with CT scan. The sensitivity and negative predictive value (NPV) of the PECARN prediction rule for ciTBI were 100% (95% CI, 20.7-100) and 99.7% (95% CI, 98.4-100%), respectively. Of the 230 infants (62.8%) who met the PECARN low-risk criteria, none had ciTBI, 1 (0.4% overall, 95% CI, 0-2.4) had TBI on CT, and 2 (0.9% overall; 95% CI, 0.1-3.1) had an ISF. Among the 136 infants (37.2%) who did not meet the PECARN low-risk criteria, 1 (0.3% overall; 95% CI, 0-1.5) had ciTBI, 11 (8.1% overall; 95% CI, 4.1-14.0) had TBI on CT, and 18 (13.2% overall; 95% CI, 8-20.1) had an ISF. The sensitivity and NPV of the Spanish prediction rule for ciTBI were 100% (95% CI, 20.7-100) and 100% (95% CI, 98.4-100%), respectively. No infants in the registry developed complications during follow-up. CONCLUSION: The PECARN rule for infants < 2 years old accurately identified infants < 3 months old at low risk for ciTBI in our population, although the adapted Spanish rule presented here could be even more accurate. WHAT IS KNOWN: • Infants younger than 3 months are vulnerable to minor blunt head trauma due to their age and to difficulties in assessing the subtle symptoms and minimal physical findings detected on examination. • A low threshold for CT scan is recommended in this population. WHAT IS NEW: • PECARN rule for infants < 2 years old is an adequate tool with which to identify infants < 3 months old at low risk for clinically important traumatic brain injury. • Spanish rule could identify even more low-risk infants without overlooking important outcomes but it should be validated to confirm its predictive capacity.

Incidence of hypertension in young transgender people after a 5-year follow-up: association with gender-affirming hormonal therapy.

In order to assess the risk of hypertension development, we performed a retrospective analysis of the clinical records of consecutive transgender patients who began gender-affirming hormonal therapy in our Outpatient Gender Identity Clinic with <30 years of age and had a follow-up >5 years. 149 transgender women treated with estradiol and 153 transgender men treated with testosterone were included; 129 of the transgender women received also androgen blockers (54 spironolactone, 49 cyproterone acetate and 26 LHRH agonists). The annual incidence of hypertension in young transgender men (1.18%) seemed comparable to that of the general population. In young transgender women, it seemed higher (2.14%); we found that the choice of androgen blocker had a remarkable effect, with a highly significant increase in patients treated with cyproterone acetate (4.90%) vs. the rest (0.80%); the adjusted hazard-ratio was 0.227 (p = 0.001). Correlation, logistic regression and mediation analyses were performed for the associations of the available clinical variables with the increase in systolic blood pressure and the onset of hypertension, but besides the use of cyproterone acetate, only the ponderal gain was found significant (Spearman's r: 0.361, p < 0.001); with a 36.7% mediation effect (31.2-42.3%). Cyproterone acetate has additional known risks, such as meningioma; although we cannot conclusively prove that it has a role in the development of hypertension, we conclude that the use of cyproterone acetate for this indication should be reconsidered.

Glucose-6-Phosphate Dehydrogenases: The Hidden Players of Plant Physiology.

Glucose-6-phosphate dehydrogenase (G6PDH) catalyzes a metabolic hub between glycolysis and the pentose phosphate pathway (PPP), which is the oxidation of glucose-6-phosphate (G6P) to 6-phosphogluconolactone concomitantly with the production of nicotinamide adenine dinucleotide phosphate (NADPH), a reducing power. It is considered to be the rate-limiting step that governs carbon flow through the oxidative pentose phosphate pathway (OPPP). The OPPP is the main supplier of reductant (NADPH) for several "reducing" biosynthetic reactions. Although it is involved in multiple physiological processes, current knowledge on its exact role and regulation is still piecemeal. The present review provides a concise and comprehensive picture of the diversity of plant G6PDHs and their role in seed germination, nitrogen assimilation, plant branching, and plant response to abiotic stress. This work will help define future research directions to improve our knowledge of G6PDHs in plant physiology and to integrate this hidden player in plant performance.

Vascular smooth muscle ion channels in essential hypertension.

Hypertension is a highly prevalent chronic disease and the major risk factor for cardiovascular diseases, the leading cause of death worldwide. Hypertension is characterized by an increased vascular tone determined by the contractile state of vascular smooth muscle cells that depends on intracellular calcium levels. The interplay of ion channels determine VSMCs membrane potential and thus intracellular calcium that controls the degree of contraction, vascular tone and blood pressure. Changes in ion channels expression and function have been linked to hypertension, but the mechanisms and molecular entities involved are not completely clear. Furthermore, the literature shows discrepancies regarding the contribution of different ion channels to hypertension probably due to differences both in the vascular preparation and in the model of hypertension employed. Animal models are essential to study this multifactorial disease but it is also critical to know their characteristics to interpret properly the results obtained. In this review we summarize previous studies, using the hypertensive mouse (BPH) and its normotensive control (BPN), focused on the identified changes in the expression and function of different families of ion channels. We will focus on L-type voltage-dependent Ca2+ channels (Cav1.2), canonical transient receptor potential channels and four different classes of K+ channels: voltage-activated (Kv), large conductance Ca2+-activated (BK), inward rectifiers (Kir) and ATP-sensitive (KATP) K+ channels. We will describe the role of these channels in hypertension and we will discuss the importance of integrating individual changes in a global context to understand the complex interplay of ion channels in hypertension.

Involvement of sugar and abscisic acid in the genotype-specific response of rose to far-red light.

Plant architecture determines yield (fruit or flowers) and product quality in many horticultural species. It results from growth and branching processes and is dependent on genetic and environmental factors such as light quality. Highly significant genotype and light quality effects and their interaction have been demonstrated on the architecture of rose. Far-red (FR) light is known for its favourable effect on plant growth and development. We evaluated the effect of FR on rose growth and development and its interaction with the genotype through architectural, eco-physiological (net photosynthesis rate) and biochemical (sugar and hormone concentrations) approaches. Two cultivars ('The Fairy' - TF - and Knock Out® Radrazz - KO) with contrasting architectures were grown in a climate chamber under FR or in the absence of FR at an average photosynthetic photon flux density (400-700 nm) of 181.7 ± 12.8 µmol m-2 s-1 for 16 h. A significant effect of FR on the architecture of TF was demonstrated, marked by greater stem elongation, shoot branching and flowering, while KO remained insensitive to FR, supporting a genotype x FR interaction. The response of TF to FR was associated with improved photosynthetic capabilities, while KO exhibited an elevated level of abscisic acid (ABA) in its leaves. FR-dependent ABA accumulation might inhibit photosynthesis and prevent the increased plant carbon status required for growth. From a practical perspective, these findings argue in favour of a better reasoning of the choice of the cultivars grown in lighted production systems. Further investigations will be necessary to better understand these genotype-specific responses to FR and to unravel their molecular determinants.

Polystyrene Macroporous Magnetic Nanocomposites Synthesized through Deep Eutectic Solvent-in-Oil High Internal Phase Emulsions and Fe3O4 Nanoparticles for Oil Sorption.

In this work, we report a nonaqueous one-step method to synthesize polystyrene macroporous magnetic nanocomposites through high internal phase emulsions (HIPEs) formulated with the deep eutectic solvent (DES) composed of urea:choline chloride (U:ChCl, in a 2:1 molar ratio) as the internal phase and co-stabilized with mixtures of Span 60 surfactant and non-functionalized magnetite nanoparticles (Fe3O4 NPs). The porous structure and the magnetic and lipophilic properties of the nanocomposite materials were easily tailored by varying the amount of Fe3O4 NPs (0, 2, 5 and 10 wt %) and the surfactant Span 60 (0, 5, 10, and 20 wt %) used in the precursor emulsion. The resultant nanocomposite polyHIPEs exhibit high sorption capacity toward different oils (hexane, gasoline, and vegetable oil) due to their high porosity, interconnectivity, and hydrophobic surface. It was observed that the oil sorption capacity was improved when the amount of surfactant decreased and Fe3O4 NPs increased in HIPE formulation. Therefore, polyHIPE formulated with 5 and 10 wt % Span 60 and Fe3O4 NPs, respectively, showed the highest oil sorption capacities of 4.151, 3.556, and 3.266 g g-1 for gasoline, hexane, and vegetable oil, respectively. In addition, the magnetic monoliths were reused for more than ten sorption/desorption cycles without losing their oil sorption capacity.

Neuroticism and Emotional Intelligence in Adolescence: A Mediation Model Moderate by Negative Affect and Self-Esteem.

Different studies have revealed that high scores in neuroticism relate to feelings of guilt, flustering, low self-esteem, and insecurity in relationships with others. The main objective of this work is to analyze the relationship between neuroticism and emotional intelligence in the adolescent stage and try to go one step further in the study of that relationship through the formulation of a moderate mediation model in which negative affect participates as a mediating variable and self-esteem as a moderating variable. METHOD: The total number of adolescents amounted to 742, with a very similar sample in both sexes, 45.1% boys and 51.5% girls. They were between 13 and 19 years old (M = 15.63, SD = 1.244) and lived in the province of Almería, Spain. RESULTS: First, our main results significantly reflected that the neuroticism personality trait increased negative affect as self-esteem decreased. Second, statistical analyzes showed that the effect of neuroticism on attention and emotional repair was mediated by negative affect, the effect being greater when self-esteem was lower. Therefore, negative affect was presented as a mediating variable in the relationship between neuroticism and attention and emotional repair, with self-esteem acting as a moderating variable in the model. CONCLUSIONS: These findings have implications for professional practice with adolescents, since they highlight the importance of carrying out interventions that contribute to the development of self-esteem in the prevention of neuroticism since these actions can help moderate the effect exerted by the negative affect on emotional attention and repair, improving the emotional intelligence of the adolescent and, therefore, their psychological health.