A comprehensive study from the micro- to the nanometric scale: Evaluation of chilling injury in tomato fruit (Solanum lycopersicum).

Tomato fruit is susceptible to chilling injury (CI) during its postharvest handling at low temperature. The symptoms caused by this physiological disorder have been commonly evaluated by visual inspection at a macro-observation scale on fruit surface; however, the structure at deeper scales is also affected by CI. This work aimed to propose a descriptive model of the CI development in tomato tissue under the micro-scale, micro-nano-scale and nano-scale approaches using fractal analysis. For that, quality and fractal parameters were determined. In this sense, light microscopy, Environmental Scanning Electron Microscopy (ESEM) and Atomic Force Microscopy (AFM) were applied to analyse micro-, micro-nano- and nano-scales, respectively. Results showed that the morphology of tomato tissue at the micro-scale level was properly described by the multifractal behaviour. Also, generalised fractal dimension (Dq=0) and texture fractal dimension (FD) of CI-damaged pericarp and cuticle were higher (1.659, 1.601 and 1.746, respectively) in comparison to non-chilled samples (1.606, 1.578 and 1.644, respectively); however, FD was unsuitable to detect morphological changes at the nano-scale. On the other hand, lacunarity represented an appropriate fractal parameter to detect CI symptoms at the nano-scale due to differences observed between damaged and regular ripe tissue (0.044 and 0.025, respectively). The proposed multi-scale approach could improve the understanding of CI as a complex disorder to the development of novel techniques to avoid this postharvest issue at different observation scales.

Caracterización del tabaquismo en una unidad de cuidados intermedios de un hospital de referencia

Introducción: Las enfermedades crónicas no transmisibles (ECNT), como el cáncer, enfermedades cardiovasculares y respiratorias, son la epidemia del siglo XXI, siendo el tabaquismo un factor de riesgo común. Objetivo: Caracterizar a los pacientes tabáquicos de la Unidad de Tratamientos Intermedios (UTI) del Instituto Nacional del Tórax. Material y Método: Estudio observacional, analítico y descriptivo. Se evaluaron 150 ingresos consecutivos a la UTI desde el 01 de septiembre al 01 de diciembre de 2022. Resultados: La prevalencia de tabaquismo fue de un 56%, incluyendo exfumadores. La media de edad fue de 64 años. La exposición a humo de segunda mano resultó significativa con un 41,7% en fumadores activos. Las asociaciones con hipertensión arterial, EPOC y cáncer pulmonar resultaron significativas. Un 20,2% de los pacientes con cáncer pulmonar tenían tabaquismo activo. No fueron significativos los días de estadía en la unidad, hospitalaria general ni fallecimientos. Conclusiones: En nuestra cohorte la prevalencia de tabaquismo fue más alta que la nacional y se confirmó su vínculo con las ECNT. Identificamos que la exposición de segunda mano fue significativa, por lo que los esfuerzos para el cese del tabaquismo deben ir enfocados tanto al paciente como su entorno cercano. A pesar que algunos pacientes tenían el diagnóstico de cáncer pulmonar, un porcentaje no menor seguía fumando, por lo que es relevante incorporar a este grupo de pacientes a programas especializados para reducir morbilidad. Con nuestro estudio reafirmamos la importancia de continuar con los esfuerzos nacionales por reducir el tabaquismo como acción preventiva de las ECNT y sus complicaciones.

Introduction: Chronic non-communicable diseases (NCDs), such as cancer, cardiovascular and respiratory diseases, are the epidemic of the 21st century, smoking being a common risk factor. Objective: To characterize smoking patients in the Intermediate Treatment Unit (ICU) of the Chilean National Thorax Institute. Material and Method: Observational, analytical and descriptive study. 150 consecutive admissions to the ICU were evaluated from September 1 to December 1, 2022. Results: The prevalence of smoking was 56%, including former smokers. The average age was 64 years-old. Exposure to secondhand smoke was significant with 41.7% in active smokers. The associations with high blood pressure, COPD and lung cancer were significant. 20.2% of patients with lung cancer were active smokers. The days of stay in the unit, general hospital stay, or deaths were not significant. Conclusions: In our cohort the prevalence of smoking was higher than the national average and its link with NCDs is confirmed. We identified that secondhand exposure was significant, so efforts to stop smoking must be focused on both the patient and their immediate environment. Although some patients had a diagnosis of lung cancer, a significant percentage continued to smoke, making it important to incorporate this group of patients into specialized programs to reduce morbidity. With our study we reaffirm the importance of continuing national efforts to reduce smoking as a preventive action for NCDs and their complications.

Mathematical modeling for operative improvement of the decoloration of Acid Red 27 by a novel microbial consortium of Trametes versicolor and Pseudomonas putida: A multivariate sensitivity analysis.

In this work, it is presented a first approach of a mathematical and kinetic analysis for improving the decoloration and further degradation process of an azo dye named acid red 27 (AR27), by means of a novel microbial consortium formed by the fungus Trametes versicolor and the bacterium Pseudomonas putida. A multivariate analysis was carried out by simulating scenarios with different operating conditions and developing a specific mathematical model based on kinetic equations describing all stages of the biological process, from microbial growth and substrate consuming to decoloration and degradation of intermediate compounds. Additionally, a sensitivity analysis was performed by using a factorial design and the Response Surface Method (RSM), for determining individual and interactive effects of variables like, initial glucose concentration, initial dye concentration and the moment in time for bacterial inoculation, on response variables assessed in terms of the minimum time for: full decoloration of AR27 (R1 = 2.375 days); maximum production of aromatic metabolites (R2 = 1.575 days); and full depletion of aromatic metabolites (R3 = 12.9 days). Using RSM the following conditions improved the biological process, being: an initial glucose concentration of 20 g l-1, an initial AR27 concentration of 0.2 g l-1 and an inoculation moment in time of P. putida at day 1. The mathematical model is a feasible tool for describing AR27 decoloration and its further degradation by the microbial consortium of T. versicolor and P. putida, this model will also work as a mathematical basis for designing novel bio-reaction systems than can operate with the same principle of the described consortium.

Hemicelluloses hydrogel: Synthesis, characterization, and application in dye removal.

Novel materials using biowaste as adsorbents in wastewater treatment have been allocated considerable interest. Herein, we present the synthesis of different hydrogels of crosslinked polyacrylamide in presence of hemicelluloses with/ without bentonite, using a soft reaction condition. The structure of new hydrogels was characterized by spectroscopic, thermal and microscopic experiments. The semi-interpenetrated network with hemicelluloses: 10 %; acrylamide 79 %; bentonite 10 %; N,N,N',N'-tetramethylethylenediamine: 1 % allows reducing 20 % the use of non-renewable acrylamide, without changing its decomposition temperatures and keeping its water absorption capacity. This hydrogel was applied to dye removals, such as rhodamine B, methylene red and methylene blue in aqueous solutions. In the case of methylene blue, highest removal is observed with maximum adsorption of qmax = 140.66 mg/g, compared to material without hemicelluloses that only a qmax = 88.495 mg/g. The adsorption kinetics and equilibrium adsorption isotherms are in accordance with the pseudo-second-order kinetic model and Langmuir isotherm model, respectively. The developed hydrogel from hemicelluloses represents a potential alternative adsorbent for a sustainable system of sewage treatment.

The Asociación Mexicana de Gastroenterología consensus on the diagnosis and treatment of acute pancreatitis in children and adolescents.

Acute pancreatitis (AP) and recurrent acute pancreatitis (RAP) are conditions, whose incidence is apparently on the rise. Despite the ever-increasing evidence regarding the management of AP in children and adults, therapeutic actions that could potentially affect having a poor prognosis in those patients, especially in the pediatric population, continue to be carried out. Therefore, the Asociación Mexicana de Gastroenterología convened a group of 24 expert pediatric gastroenterologists from different institutions and areas of Mexico, as well as 2 pediatric nutritionists and 2 specialists in pediatric surgery, to discuss different aspects of the epidemiology, diagnosis, and treatment of AP and RAP in the pediatric population. The aim of this document is to present the consensus results. Different AP topics were addressed by 6 working groups, each of which reviewed the information and formulated statements considered pertinent for each module, on themes involving recommendations and points of debate, concerning diagnostic or therapeutic approaches. All the statements were presented and discussed. They were then evaluated through a Delphi process, with electronic and anonymous voting, to determine the level of agreement on the statements. A total of 29 statements were formulated, all of which reached above 75% agreement in the first round of voting.

Refractory hypotension secondary to chronic treatment with high doses of quetiapine.

Quetiapine is an atypical antipsychotic used in the treatment of depressive, schizophrenic, or bipolar disorders. It acts on dopamine D1 and D2, histamine, and 5HT1A and 5HT2 receptors. However, it also acts as an antagonist for α1 receptors causing cardiovascular side effects, including hypotension. We present the case of a patient chronically medicated with Quetiapine who developed hypotension refractory to vasoconstrictors and intraoperative fluid therapy. Noradrenalin has a strong α1 effect with lower affinity for ß2 receptors unlike adrenalin. This translates into peripheral vasoconstriction and an improved clinical picture. Therefore, it should be considered the vasoactive drug of choice in patients on high doses of Quetiapine.

Effect of exogenus protease on performance, nutrient digestibility, intestinal histomorphometric, meat quality characteristics, carcass yield in broilers fed low protein diets.

The objective of the present study was to evaluate the effects of increasing doses of protease on broilers from 1 to 42 days of age. A total of 1290 Ross AP broilers were used, distributed among five treatments: positive control diet, negative control diet (NC), NC + 50 ppm of protease, NC + 100 ppm of protease, and NC + 200 ppm of protease. Each treatment contained six replicates of 43 animals each. The inclusion of proteases in the diet had effects (P < 0.05) on body weight, feed intake, weight gain, and feed conversion in the 12 to 21 day period; body weight, weight gain, and feed intake in the 29 to 42 day period; nutrient digestibility (energy metabolizability coefficient and crude protein at 28 days); and intestinal parameters (crypt and muscle width of jejunum and ileum at 28 days and villus length, crypt length, and jejunum thickness muscle layer at 42 days). These results indicate that the inclusion of protease in broiler feed can improve production parameters when the amount of crude protein in the diet is reduced.

Hipotensión refractaria secundaria a tratamiento crónico con altas dosis de quetiapina / Refractory hypotension secondary to chronic treatment with high doses of quetiapine

La quetiapina es un antipsicótico atípico que se usa en el tratamiento del trastorno depresivo, esquizofrénico o bipolar. Su acción reside en su acción sobre los receptores de la dopamina D1 y D2, histamina y serotonina 5HT1A y 5HT2. Sin embargo, también tiene antagonismo para los receptores α1, provocando efectos secundarios cardiovasculares, entre ellos la hipotensión. Presentamos el caso de un paciente medicado crónicamente con quetiapina que presentó hipotensión refractaria a vasoconstrictores y fluidoterapia intraoperatoria. La noradrenalina tiene un fuerte efecto α1 con una menor afinidad para los receptores β2 a diferencia de la adrenalina. Esto se traduce en una vasoconstricción periférica y la resultante mejoría del cuadro clínico. Por lo tanto, se debe considerar el fármaco vasoactivo de elección en la hipotensión refractaria en pacientes que tomen altas dosis de quetiapina.(AU)

Quetiapine is an atypical antipsychotic used in the treatment of depressive, schizophrenic, or bipolar disorders. It acts on dopamine D1 and D2, histamine, and 5HT1A and 5HT2 receptors. However, it also acts as an antagonist for α1 receptors causing cardiovascular side effects, including hypotension. We present the case of a patient chronically medicated with quetiapine who developed hypotension refractory to vasoconstrictors and intraoperative fluid therapy. Noradrenalin has a strong α1 effect with lower affinity for β2 receptors unlike adrenalin. This translates into peripheral vasoconstriction and an improved clinical picture. Therefore, it should be considered the vasoactive drug of choice in patients on high doses of quetiapine.(AU)

Neck dissection for head and neck malignancies with concurrent carotid endarterectomy.

Head and neck malignancies share similar risk factors as carotid artery stenosis and these can often present together. Patients who require external beam radiotherapy are at a higher risk of developing significant worsening stenosis. The workup of the oncologic patient often includes computed tomography, which can reveal underlying carotid artery stenosis, offering an opportunity to address both conditions in one operation and prevent the need for a complicated carotid endarterectomy (CEA) in irradiated and previously operated tissue. It was postulated that these two operations can be combined safely. The surgical protocol, surgical technique, and outcomes of a case series of four patients with head and neck cancer who underwent neck dissection and CEA for carotid artery stenosis during the same operation is presented. CEA was performed safely, simultaneously with neck dissection. CEA did not affect the surgical outcomes or postoperative course of the patients, and no minor or major complications were observed related to this procedure. Carotid endarterectomy performed by a vascular surgeon can be safely combined with oncologic neck dissection in the same procedure to avoid future complications in head and neck cancer patients.

Cytomegalovirus reactivation in patients diagnosed with severe COVID-19: A point prevalence study in a general hospital.

OBJECTIVE: To determine the prevalence of CMV reactivation in a population admitted for severe COVID-19 to a general hospital. METHODS: Point prevalence study in all hospitalized patients with severe COVID-19 (admitted either to general wards or ICU). Determination of the presence of CMV DNA in circulating blood. COVID-19 was confirmed in patients with compatible clinical manifestations, usually with pneumonia and a positive nasopharyngeal PCR test. RESULTS: We included 140 hospitalized patients with COVID-19 who consented to participate. A total of 16 patients (11.42%), had circulating CMV-DNA in peripheral blood at the time of the study. Patients with positive CMV viral load were mainly ICU patients (11/37 -29,7%) and only 5/103 cases (4,85%) were hospitalized into general wards. The accumulated doses of corticosteroids (prednisone equivalents) in the study day were (median and IQR) 987.50 mg (396.87-2,454.68) and 187.50 mg (75.00-818.12) respectively in CMV positive and negative patients (p < 0.001). A significant proportion of CMV positive patients were discovered because of the study and were clinically unsuspected by their physicians. The coinfected COVID-CMV positive population had a higher risk of accumulated secondary nosocomially-acquired infections and a worse prognosis. CONCLUSIONS: CMV reactivation should be systematically searched in patients in COVID-19 cases admitted to the ICU.

Efecto del ejercicio terapéutico en personas con disfunción de la articulación sacroiliaca: revisión sistemática y metanálisis / Effect of therapeutic exercise in persons with sacroiliac joint dysfunction: a systematic review and meta-analysis

Antecedentes y objetivo: La disfunción de la articulación sacroilíaca puede explicar el 40 % de los casos de dolor lumbar inespecífico. El ejercicio terapéutico (ET) es una modalidad de tratamiento recomendada para la rehabilitación de estos casos. El objetivo de este estudio fue evaluar el efecto del ET comparado con otras intervenciones, sobre la discapacidad y la intensidad del dolor en personas con disfunción o dolor sacroilíaco.Materiales y métodos: Revisión sistemática y metanálisis de ensayos clínicos aleatorios en los que se comparara el efecto de cualquier modalidad de ejercicio terapéutico sobre la intensidad del dolor o la discapacidad. Se determinó el riesgo de sesgo con la escala PEDro y la calidad de la evidencia según GRADE.Resultados: Se analizaron ocho estudios con 422 participantes en total. El ET se comparó con la terapia manual, la fijación quirúrgica de la articulación sacroilíaca, las modalidades físicas, la educación y el uso de cinturón pélvico. En general, el riesgo de sesgo en las publicaciones fue moderado. En el análisis cuantitativo, se encontró baja calidad de evidencia de que el ejercicio y la terapia manual logran el mismo efecto sobre la intensidad del dolor (MD-0,25 [IC 95 % -2,60 a 2,09]); asimismo, se registró baja calidad de evidencia para el efecto superior estimado a favor del ET comparado con la terapia manual sobre la discapacidad (MD -8,74 [IC 95 % -10,92 a - 6,67]).Conclusión: Existe evidencia de calidad baja y muy baja que sugiere que el ET es efectivo para reducir el dolor y la discapacidad en personas con DASI o dolor sacroilíaco.(AU)

Background and objective: Sacroiliac joint dysfunction can explain 40 % of the cases of non-specific low back pain. Therapeutic exercise (TE) is a recommended treatment modality for the rehabilitation of this cases. The objective was to assess the effect of TE versus another interventions, on disability and pain intensity in people with sacroiliac pain or dysfunction.Methods: Systematic review and meta-analysis of randomized clinical trials comparing the effect of any therapeutic exercise modality on pain intensity and/or disability. The risk of bias was determined with PEDro scale and the level of evidence according to GRADE.Results: Eight studies with 422 participants were analyzed. TE was compared with manual therapy, surgical fixation of the sacroiliac joint, physical modalities, education, and the use of a pelvic belt. Overall, the risk of bias was moderate. In the quantitative analysis, low quality of evidence was found about whether the exercise and manual therapy achieve the same effect on pain intensity (MD -0.25 [IC 95 % -2.60 a 2.09]); likewise, low quality of evidence was observed for the estimated superior effect in favor of ET compared to manual therapy on disability (MD -8,74 [IC 95 % -10.92 a - 6.67]).Conclusion: Low and very low-quality evidence suggests that TE is effective in reducing pain and disability in people with DASI or sacroiliac pain.(AU)

Impact of SARS-CoV-2 variants on mobility and air pollution in the United Kingdom.

During the two years following the first case of COVID-19 in the United Kingdom, cycles of social restrictions were imposed to control the spread of the virus. These measures curtailed social contact and halted commercial and recreational activities affecting levels of air pollutants. As society adapted, restrictions eased and pollution gradually returned to baseline levels. However, resurgence in COVID-19 cases from new variants created a protracted and challenging path back to 'normality'. In this study, we retrospectively look back at the two years of COVID-19 and its prevalent variants, and examine the government response and its impact on mobility and air pollution. Results from a peak detection algorithm show peak events in mobility and COVID-19 deaths during variants periods decreased significantly from the wildtype COVID-19, despite the high contagiousness of these variants. Pollution levels remained below baseline with periods of significant increase for O3, while NO2 levels remained depleted, likely as a result of reduced traffic congestion as home office schemes have been maintained. Our findings suggest mobility and pollution return to baseline levels as immunity to COVID-19 increases.

Cellular mechanisms involved in the pathogenesis of airway remodeling in chronic lung disease.

Background: Airway epithelial cells and lung fibroblasts play an important role in the development of chronic lung disease, but the exact mechanisms responsible have not been clarified. Our objective was to investigate the involvement of these cells in the inflammatory response associated to chronic lung disease. Methods: Human lung fibroblasts and airway epithelial cells were challenged with Interleukin-1ß and hypoxia, and with inhibitory (simvastatin) stimuli of the inflammatory response. Expression of markers of local inflammation ((IL-8, monocyte chemoattractant protein-1 (MCP-1), factor-κB1 (NF-κB1)), systemic inflammation ((C-reactive protein (CRP) and serum amyloid A (SAA)) and proteases matrix metalloproteinase (MMP) 9 and 12 were assessed by PCR and ELISA. Apoptosis/necrosis was analyzed by flow cytometry. Results: Our results showed that the lung fibroblasts had a higher expression of local and systemic inflammation and protease activity markers when they were treated with IL-1ß compared to airway epithelial cells. Under hypoxic conditions, we observed a decrease in systemic inflammation in lung fibroblasts, which was further attenuated by simvastatin. Conclusion: The lung fibroblasts seem to be the main initially stimulated cells that could potentially trigger the inflammatory response, and be responsible for the eventual onset of chronic lung disease. The involvement of IL-1ß stimulation in systemic inflammatory and proteinase imbalance biomarkers is higher in lung fibroblasts. Apoptosis is not a predominant mechanism in these cells.