Bio-guided isolation of aromatic abietane diterpenoids from Salvia canariensis as biopesticides in the control of phytopathogenic fungi.

BACKGROUND: Biofungicides arise as a promising alternative to the indiscriminate use of harmful synthetic fungicides in crop management. RESULTS: The present study reports the bio-guided fractionation of an endemic plant from the Canary Islands, Salvia canariensis against the phytopathogens, Alternaria alternata, Botrytis cinerea, and Fusarium oxysporum. This procedure allowed identifying a series of diterpenoids with an abietane skeleton (1-5), which exhibited remarkable activity against the phytopathogenic fungi assayed. Their structures were established by means of spectroscopic and spectrometric methods, as well as comparison with reported data. Compounds 2 (carnosic acid), 4 (11-acetoxy carnosic acid) and 5 (11,12-diacetoxy carnosic acid) showed significant mycelium growth inhibition (%GI > 50 at 0.1 mg/mL concentration) on all the assayed fungi, and with a potency also higher than the positive control, Fosbel-Plus, a fungicide commonly used in agriculture. A preliminary structure-activity relationship is also discussed. CONCLUSIONS: These findings underline the aromatic abietane diterpenoids as promising eco-friendly alternatives to conventional fungicides to use in integrated pest management. © 2024 The Authors. Pest Management Science published by John Wiley & Sons Ltd on behalf of Society of Chemical Industry.

Enhanced Participation in Diabetes Screening and Care After Gestational Diabetes Through Community Health Workers: Results from the Es Mejor Saber Randomized Controlled Trial.

Gestational diabetes mellitus (GDM) is a strong risk factor for type 2 diabetes mellitus, but many women with GDM do not return for postpartum diabetes screening. Interventions utilizing community health workers have demonstrated improvements in health knowledge and participation in other disease settings. The objective of this study was to therefore determine whether bilingual, bicultural community health workers (i.e., promotoras) increase participation in postpartum disease screening and referral for diabetes prevention or care in an urban, low-resource Hispanic community. Ninety-four women with GDM were recruited from the postpartum ward of a safety-net hospital and randomized equally to receive either standard-of-care alone or standard-of-care with a promotora-based intervention consisting of education, appointment reminders, and assistance navigating the healthcare system. Adherence to diabetes screening visits by 12 weeks postpartum and referral for preventive or diabetes care by 18 weeks postpartum was assessed through electronic medical record review. Compared to controls, women in the promotora group completed more diabetes screening visits (74% vs. 96%; relative risk [RR] 3.9; 95% Confidence Interval [CI] 1.1-14.1; p = 0.04). Among those who completed diabetes screening visits, women in the promotora group were also more likely to complete a subsequent referral visit for preventive or diabetes care (17% vs. 83%; RR 4.0; 95% CI 2.1-7.4; p < 0.01). A promotora-based intervention consisting of bilingual, bicultural community health workers improved diabetes screening, prevention, and treatment visits in a resource-limited community of Hispanic women with GDM. ClinicalTrials.gov Identifier: NCT00998595.

Effectiveness of Sotrovimab in Preventing COVID-19-Related Hospitalizations or Deaths Among US Veterans During Omicron BA.1.

Background: The real-world clinical effectiveness of sotrovimab in preventing coronavirus disease 2019 (COVID-19)-related hospitalization or mortality among high-risk patients diagnosed with COVID-19, particularly after the emergence of the Omicron variant, needs further research. Method: Using data from the US Department of Veterans Affairs (VA) health care system, we adopted a target trial emulation design in our study. Veterans aged ≥18 years, diagnosed with COVID-19 between December 1, 2021, and April 4, 2022, were included. Patients treated with sotrovimab (n = 2816) as part of routine clinical care were compared with all eligible but untreated patients (n = 11,250). Cox proportional hazards modeling estimated the hazard ratios (HRs) and 95% CIs for the association between receipt of sotrovimab and outcomes. Results: Most (90%) sotrovimab recipients were ≥50 years old, and 64% had ≥2 mRNA vaccine doses or ≥1 dose of Ad26.COV2. During the period that BA.1 was dominant, compared with patients not treated, sotrovimab-treated patients had a 70% lower risk of hospitalization or mortality within 30 days (HR, 0.30; 95% CI, 0.23-0.40). During BA.2 dominance, sotrovimab-treated patients had a 71% (HR, 0.29; 95% CI, 0.08-0.98) lower risk of 30-day COVID-19-related hospitalization, emergency room visits, or urgent care visits (defined as severe COVID-19) compared with patients not treated. Conclusions: Using national real-world data from high-risk and predominantly vaccinated veterans, administration of sotrovimab, compared with contemporary standard treatment regimens, was associated with reduced risk of 30-day COVID-19-related hospitalization or all-cause mortality during the Omicron BA.1 period.

Modelo de co-construcción intergeneracional de cápsulas comunicacionales en base a comidas tradicionales

Introducción: La valoración de las comidas tradicionales resulta esencial para mantener el patrimonio gastronómico, sin embargo, su divulgación es limitada, por lo que se requiere de estrategias comunicacionales que promuevan la difusión de las culturas inmateriales. Objetivo: Elaborar un modelo de co-construcción de cápsulas comunicacionales intergeneracionales para difundir preparaciones culinarias significativas de personas mayores. Material y métodos: El estudio se enmarca en la investigación aplicada del tipo tecnológico. Se realizó una búsqueda teórica de aspectos relevantes en el uso de cápsulas comunicacionales (videos), así como el uso de TICs en personas mayores, siguiendo los lineamentos del diseño cualitativo a través de un análisis de contenido temático. Luego se construye un modelo, que es validado por profesionales del área gerontológica, para ser aplicado en un proyecto piloto que incluyó a una diada constituida por una persona mayor y un descendiente, los que guiaron y grabaron una entrevista en profundidad focalizada. Resultados: Se co-construyeron 6 videos con preparaciones culinarias tradicionales en el que participaron 5 mujeres y 1 hombre, de las Regiones del Biobío y Metropolitana. Se siguió modelo teórico que incorporó 7 pasos para su elaboración: identificación de diada intergeneracional, capacitación, realización del video, primera edición del video, presentación del video a la diada, edición final y difusión del video en redes sociales. Conclusiones: Como estrategia para un envejecimiento saludable, la realización de un video intergeneracional con una receta preferida se visualiza como una oportunidad para entrelazar cultura, patrimonio y emociones entre los participantes y la comunidad.

Introduction: The appreciation of traditional foods is essential in the maintenance of gastronomic heritage; however, its dissemination is limited, which is why communication strategies are required to promote the dissemination of intangible cultures. Objective: To develop a model for the co-construction of intergenerational communication capsules that allow the dissemination of significant culinary preparations for the elderly. Material and methods: The study is part of an applied technological research. In order to consolidate knowledge and use it for educational purposes, a theoretical search of relevant aspects in the use of communication capsules (videos) was carried out, following the guidelines of qualitative design through thematic content analysis. Then, a model is constructed and validated by professionals from the gerontological area to be applied to a pilot project that included a dyad made up of an elderly person and a descendant, who guided and recorded an in-depth focused interview. Results: A total of 6 videos about traditional culinary preparations made by 5 women and 1 man from the Biobío and Metropolitana Regions were co-constructed. A theoretical model that incorporated 7 steps for its elaboration was followed: identification of intergenerational dyad, training, making of the video, first edition of the video, presentation of the video to the dyad, final edition, and dissemination of the video on social networks. Conclusions: As a strategy for healthy aging, making an intergenerational video with a favorite recipe is seen as an opportunity to intertwine culture, heritage and emotions between participants and the community.

Effectiveness of Cerium Oxide Nanoparticles in Non-Alcoholic Fatty Liver Disease Evolution Using In Vivo and In Vitro Studies: A Systematic Review.

Nonalcoholic fatty liver disease (NAFLD) describes a spectrum of liver abnormalities, from benign steatosis to nonalcoholic steatohepatitis (NASH). Because of their antioxidant capabilities, CeNPs have sparked a lot of interest in biological applications. This review evaluated the effectiveness of CeNPs in NAFLD evolution through in vivo and in vitro studies. Databases such as MEDLINE, EMBASE, Scopus, and Web of Science were looked for studies published between 2012 and June 2023. Quality was evaluated using PRISMA guidelines. We looked at a total of nine primary studies in English carried out using healthy participants or HepG2 or LX2 cells. Quantitative data such as blood chemical markers, lipid peroxidation, and oxidative status were obtained from the studies. Our findings indicate that NPs are a possible option to make medications safer and more effective. In fact, CeNPs have been demonstrated to decrease total saturated fatty acids and foam cell production (steatosis), reactive oxygen species production and TNF-α (necrosis), and vacuolization in hepatic tissue when used to treat NAFLD. Thus, CeNP treatment may be considered promising for liver illnesses. However, limitations such as the variation in durations between studies and the utilization of diverse models to elucidate the etiology of NAFLD must be considered. Future studies must include standardized NAFLD models.

Isolation and Identification of 12-Deoxyphorbol Esters from Euphorbia resinifera Berg Latex: Targeted and Biased Non-Targeted Identification of 12-Deoxyphorbol Esters by UHPLC-HRMSE.

Diterpenes from the Euphorbia genus are known for their ability to regulate the protein kinase C (PKC) family, which mediates their ability to promote the proliferation of neural precursor cells (NPCs) or neuroblast differentiation into neurons. In this work, we describe the isolation from E. resinifera Berg latex of fifteen 12-deoxyphorbol esters (1-15). A triester of 12-deoxy-16-hydroxyphorbol (4) and a 12-deoxyphorbol 13,20-diester (13) are described here for the first time. Additionally, detailed structural elucidation is provided for compounds 3, 5, 6, 14 and 15. The absolute configuration for compounds 3, 4, 6, 13, 14 and 15 was established by the comparison of their theoretical and experimental electronic circular dichroism (ECD) spectra. Access to the above-described collection of 12-deoxyphorbol derivatives, with several substitution patterns and attached acyl moieties, allowed for the study of their fragmentation patterns in the collision-induced dissociation of multiple ions, without precursor ion isolation mass spectra experiments (HRMSE), which, in turn, revealed a correlation between specific substitution patterns and the fragmentation pathways in their HRMSE spectra. In turn, this allowed for a targeted UHPLC-HRMSE analysis and a biased non-targeted UHPLC-HRMSE analysis of 12-deoxyphorbols in E. resinifera latex which yielded the detection and identification of four additional 12-deoxyphorbols not previously isolated in the initial column fractionation work. One of them, identified as 12-deoxy-16-hydroxyphorbol 20-acetate 13-phenylacetate 16-propionate (20), has not been described before.

Assessment of symptoms in COMET-ICE, a phase 2/3 study of sotrovimab for early treatment of non-hospitalized patients with COVID-19.

BACKGROUND: The COMET-ICE trial demonstrated that sotrovimab clinically and statistically significantly reduces the risk of all-cause > 24-h hospitalization or death due to any cause among patients with COVID-19 at high risk of disease progression. Patient-reported outcomes are important to capture symptom burden of COVID-19 and assess treatment effectiveness. This study investigated symptoms and their impact over the acute phase of COVID-19 infection among patients on sotrovimab versus placebo. METHODS: Randomized (1:1), double-blind, multicenter, placebo-controlled, phase 2/3 study in 57 centers across five countries. Participants were non-hospitalized patients with symptomatic, mild-to-moderate COVID-19 and ≥ 1 baseline risk factor for disease progression (aged ≥ 55 years or ≥ 1 of the following: diabetes requiring medication, obesity, chronic kidney disease, congestive heart failure, chronic obstructive pulmonary disease, or moderate-to-severe asthma). An intravenous infusion of sotrovimab 500 mg or placebo was administered on Day 1. The FLU-PRO Plus questionnaire was administered once-daily with 24-h recall from Day 1-21, and at Day 29. Intensity and duration of COVID-19 symptoms were determined from area under the curve (AUC) and mean change in total and individual domain scores through Days 7, 14, and 21. Time to symptom alleviation was assessed. RESULTS: In total, 1057 patients were randomized to sotrovimab (n = 528) or placebo (n = 529). At Day 7, mean decrease in FLU-PRO Plus total score (measured by AUC) was statistically significantly greater for patients on sotrovimab (-3.05 [95% confidence interval (CI) -3.27 to -2.83]) than placebo (-1.98 [95% CI -2.20 to -1.76]; difference -1.07 [95% CI -1.38 to -0.76]; p < 0.001). Significant differences were also observed at Days 14 and 21. A more rapid decline in symptom severity was observed with sotrovimab versus placebo through Week 1 and the first 21 days post-treatment. By Day 21, 41% of patients on sotrovimab and 34% on placebo reported symptom resolution. In a post-hoc analysis, median time to symptom alleviation was 4 and 6 days, respectively. CONCLUSIONS: Sotrovimab provides significant and rapid improvements in patient-reported COVID-19 symptoms, as measured by the FLU-PRO Plus. These results further show the benefits of sotrovimab in alleviating symptoms among high-risk patients with COVID-19. Trial registration ClinicalTrials.Gov: NCT04545060 ( https://clinicaltrials.gov/ct2/show/NCT04545060 ). Date of registration: September 10, 2020 (retrospectively registered).

Rugulopteryx-Derived Spatane, Secospatane, Prenylcubebane and Prenylkelsoane Diterpenoids as Inhibitors of Nitric Oxide Production.

This study aimed to evaluate the anti-inflammatory potential of the different classes of diterpenoids produced by algae of the genus Rugulopteryx. First, sixteen diterpenoids (1-16), including spatane, secospatane, prenylcubebane, and prenylkelsoane metabolites, were isolated from the extract of the alga Rugulopteryx okamurae collected at the southwestern Spanish coasts. Eight of the isolated diterpenoids are new compounds whose structures were determined by spectroscopic means: the spatanes okaspatols A-D (1-4); the secospatane rugukamural D (8); the prenylcubebanes okacubols A (13) and B (14); and okamurol A (16), which exhibits an unusual diterpenoid skeleton featuring a kelsoane-type tricyclic nucleus. Second, anti-inflammatory assays were performed on microglial cells Bv.2 and macrophage cells RAW 264.7. Compounds 1, 3, 6, 12, and 16 caused significant inhibition of the NO overproduction induced by LPS in Bv.2 cells, and compounds 3, 5, 12, 14, and 16 significantly decreased levels of NO in LPS-stimulated RAW 264.7 cells. The most active compound was okaspatol C (3), which completely suppressed the effects of LPS stimulation, both in Bv.2 and in RAW 264.7 cells.

Prevalence of Burnout Syndrome and Fear of COVID-19 among Adolescent University Students.

This study aimed to estimate the prevalence of burnout syndrome in adolescents entering university studies, to detect differences in burnout levels, personality factors and fear of coronavirus in a pandemic context due to COVID-19. A cross-sectional predictive study was performed with a sample that comprised 134 individuals in their first year of a Psychology degree at Spanish universities. The Maslach Burnout Inventory Student Survey, the NEO Five-Factor Inventory and the Fear of COVID-19 Scale were applied. The prevalence of burnout is estimated according to three methods: Maslach and Jackson's severity classification, Golembiewski's phase model and Maslach et al.'s profile model. The estimates show significant differences. The results indicated that between 9 and 21% of students were at risk of developing burnout. On the other hand, students who reported having suffered psychological consequences of the pandemic showed greater emotional exhaustion, neuroticism and fear of COVID-19, and a lower level of personal accomplishment than those who did not suffer such consequences. Neuroticism was the only significant predictor for all burnout dimensions, and fear of COVID-19 did not contribute to any of them.

DDR1 and Its Ligand, Collagen IV, Are Involved in In Vitro Oligodendrocyte Maturation.

Discoidin domain receptor 1 (DDR1) is a tyrosine kinase receptor expressed in epithelial cells from different tissues in which collagen binding activates pleiotropic functions. In the brain, DDR1 is mainly expressed in oligodendrocytes (OLs), the function of which is unclear. Whether collagen can activate DDR1 in OLs has not been studied. Here, we assessed the expression of DDR1 during in vitro OL differentiation, including collagen IV incubation, and the capability of collagen IV to induce DDR1 phosphorylation. Experiments were performed using two in vitro models of OL differentiation: OLs derived from adult rat neural stem cells (NSCs) and the HOG16 human oligodendroglial cell line. Immunocytofluorescence, western blotting, and ELISA were performed to analyze these questions. The differentiation of OLs from NSCs was addressed using oligodendrocyte transcription factor 2 (Olig2) and myelin basic protein (MBP). In HOG16 OLs, collagen IV induced DDR1 phosphorylation through slow and sustained kinetics. In NSC-derived OLs, DDR1 was found in a high proportion of differentiating cells (MBP+/Olig2+), but its protein expression was decreased in later stages. The addition of collagen IV did not change the number of DDR1+/MBP+ cells but did accelerate OL branching. Here, we provide the first demonstration that collagen IV mediates the phosphorylation of DDR1 in HOG16 cells and that the in vitro co-expression of DDR1 and MBP is associated with accelerated branching during the differentiation of primary OLs.

Real-World Effectiveness of Sotrovimab for the Early Treatment of COVID-19 During SARS-CoV-2 Delta and Omicron Waves in the USA.

INTRODUCTION: Sotrovimab, a recombinant human monoclonal antibody (mAb) against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) had US Food and Drug Administration Emergency Use Authorization for the treatment of high-risk outpatients with mild-to-moderate coronavirus disease 2019 (COVID-19) from 26 May 2021 to 5 April 2022. Real-world clinical effectiveness of sotrovimab in reducing the risk of 30-day all-cause hospitalization and/or mortality was evaluated for the period when the prevalence of circulating SARS-CoV-2 variants changed between Delta and Omicron in the USA. METHODS: A retrospective analysis was conducted of de-identified patients diagnosed with COVID-19 between 1 September 2021 to 30 April 2022 in the FAIR Health National Private Insurance Claims database. Patients meeting high-risk criteria were divided into two cohorts: sotrovimab and not treated with a mAb ("no mAb"). All-cause hospitalizations and facility-reported mortality ≤ 30 days of diagnosis ("30-day hospitalization or mortality") were identified. Multivariable and propensity score-matched Poisson and logistic regressions were conducted to estimate the adjusted relative risk (RR) and odds of 30-day hospitalization or mortality in each cohort. RESULTS: Compared with the no mAb cohort (n = 1,514,868), the sotrovimab cohort (n = 15,633) was older and had a higher proportion of patients with high-risk conditions. In the no mAb cohort, 84,307 (5.57%) patients were hospitalized and 8167 (0.54%) deaths were identified, while in the sotrovimab cohort, 418 (2.67%) patients were hospitalized and 13 (0.08%) deaths were identified. After adjusting for potential confounders, the sotrovimab cohort had a 55% lower risk of 30-day hospitalization or mortality (RR 0.45, 95% CI 0.41-0.49) and an 85% lower risk of 30-day mortality (RR 0.15, 95% CI 0.08-0.29). Monthly, from September 2021 to April 2022, the RR reduction for 30-day hospitalization or mortality in the sotrovimab cohort was maintained, ranging from 46% to 71% compared with the no mAb cohort; the RR estimate in April 2022 was uncertain, with wide confidence intervals due to the small sample size. CONCLUSION: Sotrovimab was associated with reduced risk of 30-day all-cause hospitalization and mortality versus no mAb treatment. Clinical effectiveness persisted during Delta and early Omicron variant waves and among all high-risk subgroups assessed.

Content validity and psychometric properties of the inFLUenza Patient-Reported Outcome Plus (FLU-PRO Plus©) instrument in patients with COVID-19.

PURPOSE: A well-defined and reliable patient-reported outcome instrument for COVID-19 is important for assessing symptom severity and supporting research studies. The InFLUenza Patient-Reported Outcome (FLU-PRO) instrument has been expanded to include loss of taste and smell in the FLU-PRO Plus, to comprehensively cover COVID-19 symptoms. Our studies were designed to evaluate and validate the FLU-PRO Plus among patients with COVID-19. METHODS: Two studies were conducted: (1) a qualitative, non-interventional, cross-sectional study of patients with COVID-19 involving hybrid concept elicitation and cognitive debriefing interviews; (2) a psychometric evaluation of the measurement properties of FLU-PRO Plus, using data from COMET-ICE (COVID-19 Monoclonal antibody Efficacy Trial-Intent to Care Early). RESULTS: In the qualitative interviews (n = 30), all 34 items of the FLU-PRO Plus were considered relevant to COVID-19, and participants determined the questionnaire was easily understood, well written, and comprehensive. In the psychometric evaluation (n = 845), the internal consistency reliability of FLU-PRO Plus total score was 0.94, ranging from 0.71 to 0.90 for domain scores. Reproducibility (Day 20-21) was 0.83 for total score, with domain scores of 0.67-0.89. Confirmatory factor analysis with the novel smell/taste domain demonstrated an acceptable fit to the data. CONCLUSION: The content, reliability, validity, and responsiveness of the FLU-PRO Plus in the COVID-19 population were supported. Our results suggest that FLU-PRO Plus is a content- and psychometrically-valid, fit-for-purpose measure which is easily understood by patients. FLU-PRO Plus is a suitable PRO measure for evaluating symptoms of COVID-19 and treatment benefit directly from the patient perspective. TRIAL REGISTRATION: ClinicalTrials.Gov: NCT04545060, September 10, 2020; retrospectively registered.

Development and Validation of a Clinical Risk Score to Predict Hospitalization Within 30 Days of Coronavirus Disease 2019 Diagnosis.

INTRODUCTION: Early identification of patients with coronavirus disease 2019 (COVID-19) who are at risk for hospitalization may help to mitigate disease burden by allowing healthcare systems to conduct sufficient resource and logistical planning in the event of case surges. We sought to develop and validate a clinical risk score that uses readily accessible information at testing to predict individualized 30-day hospitalization risk following COVID-19 diagnosis. METHODS: We assembled a retrospective cohort of U.S. Veterans Health Administration patients (age ≥ 18 years) diagnosed with COVID-19 between March 1, 2020, and December 31, 2020. We screened patient characteristics using Least Absolute Shrinkage and Selection Operator logistic regression and constructed the risk score using characteristics identified as most predictive for hospitalization. Patients diagnosed before November 1, 2020, comprised the development cohort, while those diagnosed on or after November 1, 2020, comprised the validation cohort. We assessed risk score discrimination by calculating the area under the receiver operating characteristic (AUROC) curve and calibration using the Hosmer-Lemeshow (HL) goodness-of-fit test. This study was approved by the Veteran's Institutional Review Board of Northern New England at the White River Junction Veterans Affairs Medical Center (Reference no.:1473972-1). RESULTS: The development and validation cohorts comprised 11,473 and 12,970 patients, of whom 4,465 (38.9%) and 3,669 (28.3%) were hospitalized, respectively. The independent predictors for hospitalization included in the risk score were increasing age, male sex, non-white race, Hispanic ethnicity, homelessness, nursing home/long-term care residence, unemployed or retired status, fever, fatigue, diarrhea, nausea, cough, diabetes, chronic kidney disease, hypertension, and chronic obstructive pulmonary disease. Model discrimination and calibration was good for the development (AUROC = 0.80; HL P-value = .05) and validation (AUROC = 0.80; HL P-value = .31) cohorts. CONCLUSIONS: The prediction tool developed in this study demonstrated that it could identify patients with COVID-19 who are at risk for hospitalization. This could potentially inform clinicians and policymakers of patients who may benefit most from early treatment interventions and help healthcare systems anticipate capacity surges.

Predictors of Incident Severe Acute Respiratory Syndrome Coronavirus 2 Positivity in a Veteran Population.

OBJECTIVES: We explored factors related to testing positive for severe acute respiratory coronavirus 2 (SARS-CoV-2) to identify populations most at risk for this airborne pathogen. METHODS: Data were abstracted from the medical record database of the U.S. Department of Veterans Affairs and from public sources. Veterans testing positive were matched in a 1:4 ratio to those at a similar timepoint and local disease burden who remained negative between March 1, 2020, and December 31, 2020. Multivariable logistic regression was used to calculate odds ratios for the association of each potential risk factor with a positive test result. RESULTS: A total of 24,843 veterans who tested positive for SARS-CoV-2 were matched with 99,324 controls. Cases and controls were similar in age, sex, ethnicity, and rurality, but cases were more likely to be Black, reside in low-income counties, and suffer from dementia. Multivariable analysis demonstrated highest risk for Black veterans, those with dementia or diabetes, and those living in nursing homes or high-poverty areas. Veterans living in counties likely to be more adherent to public health guidelines were at the lowest risk. CONCLUSIONS: Our results are similar to those from studies of other populations and add to that work by accounting for several important proxies for risk. In particular, this work has implications for the value of infection control measures at the population level in helping to stem widespread outbreaks of this type.

Aneurismas múltiples de arteria esplénica / Multiple splenic artery aneurysm / Aneurismas múltiplos de artéria esplénica

Introducción: los aneurismas de la arteria esplénica son los más frecuentes de aquellos que asientan en arterias viscerales. La existencia de múltiples aneurismas esplénicos es rara, existiendo pocos casos publicados. Generalmente son asintomáticos y constituyen un hallazgo, es poco frecuente la presentación en nuestra paciente, con dolor inespecífico de hemiabdomen superior. Existen diferentes alternativas terapéuticas, son de primera línea la angio-embolización y colocación de stent endovasculares, tienen como principales limitantes el tamaño del aneurisma y la tortuosidad de la arteria esplénica que dificultan acceso endovascular. El tratamiento quirúrgico queda reservado, para situaciones especiales. Puede realizarse con conservación esplénica (actuando únicamente sobre el aneurisma) o mediante esplenectomía. Descripción de contenido: el video presenta un caso clínico, de aneurismas múltiples de arteria esplénica. El mismo expone presentación clínica, diagnóstico, opciones terapéuticas y la optada en este caso: esplenectomía laparoscópica. Conclusiones: se trata de una entidad poco frecuente, por lo que consideramos fundamental la comunicación del caso. Si bien generalmente constituyen un hallazgo imagenológico, resulta de vital importancia el tratamiento oportuno a fin de prevenir complicaciones graves como la rotura del aneurisma. Ver video en: https://www.youtube.com/watch?v=5IS2BxgeuxY

Introduction: splenic artery aneurysms are the most frequent kind among aneurysms in visceral arteries. The existence of multiple aneurysms is rather unusual, there being few cases published. In general they constitute findings as they are asymptomatic. The presentation of the patient in the study, with non-specific upper abdominal pain is rather infrequent. Among the different therapeutic options, angio-embolization and the collocation of endovascular stents are the front line approaches, the main limitations being the size of the aneurysm and the tortuous nature of the splenic artery which makes endovascular access difficult. Surgical treatment is reserved for special situations and it May preserve the spleen (only acting on the aneurysm) or may involve a splenectomy. Content description: the video presents a clinical case of multiple splenic artery aneurysms covering clinical presentation, diagnosis and therapeutic options - the chosen one in this case being laparoscopic spenectomy. Conclusions: it is rather an unusual condition, and therefore dissemination of the case is key. Despite their generally being image studies findings, it is of the essence to apply timely therapy to prevent serious complications like the rupture of the aneurysm. Watch video at: https://www.youtube.com/watch?v=5IS2BxgeuxY

Introdução: os aneurismas da artéria esplênica são os mais comuns nas artérias viscerais. A existência de múltiplos aneurismas esplênicos é rara, com poucos casos publicados. Geralmente são assintomáticos e constituem um achado acidental, sendo rara a apresentação observada na nossa paciente, com dor inespecífica no hemiabdome superior. Existem diferentes alternativas terapêuticas sendo a angioembolização e a colocação de stent endovascular as de primeira linha, suas principais limitações são o tamanho do aneurisma e a tortuosidade da artéria esplênica que dificultam o acesso endovascular. O tratamento cirúrgico é reservado para situações especiais. Pode ser realizada com preservação esplênica (atuando apenas no aneurisma) ou por esplenectomia. Descrição do conteúdo: o vídeo apresenta um caso clínico de múltiplos aneurismas de artéria esplênica. Expõe apresentação clínica, diagnóstico, opções terapêuticas e a escolhida neste caso: esplenectomia laparoscópica. Conclusões: é uma entidade rara, pelo que consideramos essencial a comunicação do caso. Embora geralmente constituam um achado de imagem, o tratamento oportuno é de vital importância para evitar complicações graves, como a ruptura do aneurisma. Veja o vídeo em: https://www.youtube.com/watch?v=5IS2BxgeuxY

Ambientes alimentarios y su rol en la seguridad alimentaria y la malnutrición por exceso

El incremento de la malnutrición por exceso fundamenta la necesidad de revalorar el rol de los ambientes alimentarios en el bienestar y la seguridad alimentaria de la población. La presente revisión bibliográfica tiene como objetivo realizar una búsqueda descriptiva de los ambientes alimentarios y de cómo estos condicionan los estados de malnutrición por exceso y la seguridad alimentaria de la población. A través de una indagación narrativa en motores de búsqueda y bases de datos (Medline, Scielo, Scopus, Biblioteca Virtual de Salud, Medes y Google Académico), se identificaron artículos originales o revisiones en castellano e inglés publicadas entre los años 2017 al 2021 que respondieron a los propósitos del estudio. Se incluyeron 56 artículos, los cuales permitieron profundizar en las cinco categorías teóricas: ambiente alimentario institucional y organizacional, de restauración, vía pública, abastecimiento y domiciliario; así como en el modo en que estos entornos potencian la malnutrición por exceso y tensionan la seguridad alimentaria de la población. Los distintos ambientes o entornos alimentarios direccionan los estilos de vida y el bienestar de las personas y comunidades, además de influir en la etiología y mantención de la malnutrición por exceso y la seguridad alimentaria de la población.

The increase in malnutrition due to excess supports the need to reassess the role of food environments in the well-being and food security of the population. The objective of this bibliographic review is to carry out a descriptive search of food environments and how these condition states of malnutrition due to excess and the food security of the population. Through a narrative investigation in search engines and databases (Medline, Scielo, Scopus, Virtual Health Library, Medes and Google Scholar), original articles or reviews in Spanish and English published between 2017 and 2021 were identified, served the purposes of the study. 56 articles were included, which allowed to study in more detail the five theoretical categories: institutional and organizational food environment, restoration, public thoroughfare, supply and home; as well as in the way in which these environments enhance malnutrition due to excess and put pressure on the food security of the population. The different environments or food environments direct the lifestyles and well-being of people and communities, in addition to influencing the etiology and maintenance of malnutrition due to excess and the food security of the population.

Antifungal Potential of Canarian Plant Extracts against High-Risk Phytopathogens.

Phytopathogens are responsible for great losses in agriculture. In particular, Fusarium, Alternaria and Botrytis are fungal diseases that affect crops worldwide. In the search for eco-friendly solutions to pest control, plants and their chemo-biodiversity are promising sources of biopesticides for integrated pest management. The aim of the present study is to report the evaluation of sixteen plant species from the Canary Islands Archipelago against the phytopathogenic fungi Botrytis cinerea, Fusarium oxysporum, and Alternaria alternata. The plants were selected on the basis of their traditional uses in medicine and/or pest control, as well as on scientific studies reporting their uses in crop protection. Their growth inhibition (% I), in an in vitro test-assay on mycelium, was used to identify six ethanolic plant extracts displaying activity (% I > 30% at 1 mg/mL) against at least one of the assayed fungi. The most effective plant extracts were further fractionated by liquid−liquid partition, using solvents of increasing polarity. This procedure led to an improvement of the bioactivity against the phytopathogens, even affecting the hexane fraction from S. canariensis and achieving an 83.93% of growth inhibition at 0.5 mg/mL on B. cinerea. These findings identified five plant-derived extracts as potential candidates for the future development of new biofungicides, which could be applied in integrated pest management.

Personality Factors as Predictors in Burnout Level Changes for Surgical Area Nurses.

Surgical area nurses provide comprehensive care to patients throughout the surgical process. Increases in life expectancy lead to the appearance and development of diseases, translating into an increase in the number of necessary interventions. Increases in the workload can be another risk factor for the development of burnout in professionals in this area. Knowledge of psychological and personality-related variables provides relevant information of level changes in the dimensions of burnout syndrome. Three logistic regression models, based on a cross-sectional study with 214 nurses working in the surgical area in the Andalusian Health Service, Spain, were built for each dimension. These models included different variables related to depression and personality, with some being significant at the population level and consequently true risk or protection factors. Friendliness, responsibility and extraversion are protection factors for the personal accomplishment dimension, whilst neuroticism is a risk factor for this dimension. Friendliness is also a protection factor for depersonalization, whilst depression is a risk factor. Finally, neuroticism, responsibility and depression are risk factors for the emotional exhaustion dimension of burnout. These findings provide relevant information that makes anticipation of this syndrome in this group easier.

Burden of influenza hospitalization among high-risk groups in the United States.

BACKGROUND: Seasonal influenza poses a substantial clinical and economic burden in the United States and vulnerable populations, including the elderly and those with comorbidities, are at elevated risk for influenza-related medical complications. METHODS: We conducted a retrospective cohort study using the IQVIA PharMetrics® Plus claims database in two stages. In Stage 1, we identified patients with evidence of medically-attended influenza during influenza seasons from October 1, 2014 to May 31, 2018 (latest available data for Stage 1) and used a multivariable logistic regression model to identify patient characteristics that predicted 30-day influenza-related hospitalization. The findings from Stage 1 informed high-risk subgroups of interest for Stage 2, where we selected cohorts of influenza patients during influenza seasons from October 1, 2014 to March 1, 2019 and used 1:1 propensity score matching to patients without influenza with similar high-risk characteristics to compare influenza-attributable rates of all-cause hospital and emergency department (ED) visits during follow-up (30-day and in the index influenza season). RESULTS: In Stage 1, more than 1.6 million influenza cases were identified, of which 18,509 (1.2%) had a hospitalization. Elderly age was associated with 9 times the odds of hospitalization (≥65 years vs. 5-17 years; OR = 9.4, 95% CI 8.8-10.1) and select comorbidities were associated with 2-3 times the odds of hospitalization. In Stage 2, elderly influenza patients with comorbidities had 3 to 7 times higher 30-day hospitalization rates compared to matched patients without influenza, including patients with congestive heart failure (41.0% vs.7.9%), chronic obstructive pulmonary disease (34.6% vs. 6.1%), coronary artery disease (22.8% vs. 3.8%), and late-stage chronic kidney disease (44.1% vs. 13.1%; all p < 0.05). CONCLUSIONS: The risk of influenza-related complications is elevated in the elderly, especially those with certain underlying comorbidities, leading to excess healthcare resource utilization. Continued efforts, beyond currently available vaccines, are needed to reduce influenza burden in high-risk populations.

Cocultivation of White-Rot Fungi and Microalgae in the Presence of Nanocellulose.

Cocultivation of fungi and algae can result in a mutualistic or antagonistic interaction depending on the species involved and the cultivation conditions. In this study, we investigated the growth behavior and enzymatic activity of two filamentous white-rot fungi (Trametes versicolor and Trametes pubescens) and two freshwater algae (Chlorella vulgaris and Scenedesmus vacuolatus) cocultured in the presence of TEMPO (2,2,6,6-tetramethylpiperidine-1-oxyl radical) oxidized cellulose nanofibrils (CNF) and cellulose nanocrystals (CNC). The growth of fungi and algae was studied in liquid, agar medium, and 3D-printed nanocellulose hydrogels. The results showed that cocultures grew faster under nutrient-rich conditions than in nutrient-depleted conditions. Key cellulose-degrading enzymes, including endoglucanase and laccase activities, were higher in liquid cocultures of T. versicolor and S. vacuolatus in the presence of cellulose compared to single cultures of fungi or algae. Although similar results were observed for cocultures of T. pubescens and C. vulgaris, laccase production diminished over time in these cultures. Fungi and algae were capable of growth in 3D-printed cellulose hydrogels. These results showed that cellulase enzyme production could be enhanced by cocultivating white-rot fungi with freshwater algae under nutrient-rich conditions with TEMPO-CNF and CNC. Additionally, the growth of white-rot fungi and freshwater algae in printed cellulose hydrogels demonstrates the potential use of fungi and algae in hydrogel systems for biotechnological applications, including biofuel production and bio-based fuel cell components. IMPORTANCE Depending on the conditions used to grow fungi and algae in the lab, they can interact in a mutually beneficial or negative way. These interactions could stimulate the organisms to produce enzymes in response to the interaction. We studied how wood decay fungi and freshwater algae grew in the presence and absence of cellulose, one of the basic building blocks of wood. How fungi and algae grew in 3D-printed cellulose hydrogels was also tested. Our results showed that fungi and algae partners produced significantly larger amounts of enzymes that degraded cellulose when grown with cellulose than when grown alone. In addition, fungi and algae were shown to grow in dense nanocellulose hydrogels and could survive the shear conditions during gel structuring while 3D-printing. These cultures could potentially be applied in the biotech industry for applications like energy production from cellulose, biofuel production, and bioremediation of cellulose material.