Título del artículo:

Renal Impairment and Risk of Acute Stroke: The INTERSTROKE Study

Background: Previous studies reported an association of renal impairment with stroke, but there are uncertainties underpinning this association. Aims: We explored if the association is explained by shared risk factors or is independent and whether there are regional or stroke subtype variations. Methods: INTERSTROKE is a case-control study and the largest international study of risk factors for first acute stroke, completed in 27 countries. We included individuals with available serum creatinine values and calculated estimated glomerular filtration rate (eGFR). Renal impairment was defined as eGFR <60 mL/min/1.73 m2. Multivariable conditional logistic regression was used to determine the association of renal function with stroke. Results: Of 21,127 participants, 41.0% were female, the mean age was 62.3 ± 13.4 years, and the mean eGFR was 79.9 ± 23.5 mL/min/1.73 m2. The prevalence of renal impairment was higher in cases (22.9% vs. 17.7%, p < 0.001) and differed by region (p < 0.001). After adjustment, lower eGFR was associated with increased odds of stroke. Renal impairment was associated with increased odds of all stroke (OR 1.35; 95% CI: 1.24-1.47), with higher odds for intracerebral hemorrhage (OR 1.60; 95% CI: 1.35-1.89) than ischemic stroke (OR 1.29; 95% CI: 1.17-1.42) (pinteraction 0.12). The largest magnitudes of association were seen in younger participants and those living in Africa, South Asia, or South America (pinteraction < 0.001 for all stroke). Renal impairment was also associated with poorer clinical outcome (RRR 2.97; 95% CI: 2.50-3.54 for death within 1 month). Conclusion: Renal impairment is an important risk factor for stroke, particularly in younger patients, and is associated with more severe stroke and worse outcomes.

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Neuroepidemiology

Título del artículo:

Bench-scale bubbling fluidized bed systems around the world - Bed agglomeration and collapse: A comprehensive review

Thermochemical conversion by gasification process is one of the most relevant technologies for energy recovery from solid fuel, with an energy conversion efficiency better than other alternatives like combustion and pyrolysis. Nevertheless, the most common technology used in the last decades for thermochemical conversion of solid fuel through gasification process, such as coal, agriculture residues or biomass residues are the fluidized bed or bubbling fluidized bed system. For these gasification technologies, an inert bed material is fed into reactor to improve the homogenization of the particles mixture and increase the heat transfer between solid fuel particles and the bed material. The fluidized bed reactors usually operate at isothermal bed temperatures in the range of 700–1000 °C, providing a suitable contact between solid and gas phases. In this way, chemical reactions with high conversion yield, as well as an intense circulation and mixing of the solid particles are encouraged. Moreover, a high gasification temperature favours carbon conversion efficiency, increasing the syngas production and energy performance of the gasifier. However, the risk of eutectic mixtures formation and its subsequent melting process are increased, and hence the probability of bed agglomeration and the system collapse could be increased, mainly when alkali and alkaline earth metals-rich biomasses are considered. Generally, bed agglomeration occurs when biomass-derived ash reacts with bed material, and the lower melting temperature of ash components promotes the formation of highly viscous layers, which encourages the progressive agglomerates creation, and consequently, the bed collapse and system de-fluidization. Taking into account the relevance of this topic to ensure the normal gasification process operating, this paper provides several aspects about bed agglomeration, mostly for biomass gasification systems. In this way, chemistry and mechanism of bed agglomeration, as well as, some methods for in-situ detection and prediction of the bed agglomeration phenomenon are reviewed and discussed.

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International Journal of Hydrogen Energy

Título del artículo:

Novel arylidene malonate derivative, KM-34, showed neuroprotective effects on in vitro and in vivo models of ischemia/reperfusion

Cerebral ischemia constitutes the most frequent type of cerebrovascular disease. The reduction of blood supply to the brain initiates the ischemic cascade starting from ionic imbalance to subsequent glutamate excitotoxicity, neuroinflammation and oxidative stress, eventually causing neuronal death. Previously, the authors have demonstrated the in vitro cytoprotective and antioxidant effects of a new arylidene malonate derivative, KM-34, against oxidizing agents like hydrogen peroxide, glutamate or Fe3+/ascorbate. Here, we examined for the first time the neuroprotective effect of KM-34 on ischemia/reperfusion models. In vitro, treatment with 10 and 50 μM KM-34 reduced the cellular death (propidium iodide incorporation) induced by oxygen glucose deprivation (OGD) in rat organotypic hippocampal slices cultures. In vivo, stroke was induced in male Wistar rats through middle cerebral artery occlusion (MCAO), followed by 23 h of reperfusion. KM-34 was orally administered 105 min after MCAO onset. We noticed that 1 mg/kg KM-34 reduced infarct volume and neurological score, and increased the latency to fall in the Hanging Wire test compared to vehicle-treated ischemic animals. While ischemic and sham-operated groups showed similar horizontal locomotor activity, vertical counts decreased after MCAO, suggesting that vertical movements are more sensitive to the ischemic injury. Treatment with KM-34 also alleviated the mitochondrial impairment (ROS generation, swelling and membrane potential dissipation) induced by transient MCAO but not significant alterations were found in oxidative stress parameters. Overall, the study provides preclinical evidences confirming the neuroprotective effects of a novel synthetic molecule and paved the way for future investigations regarding its therapeutic potential against brain ischemia/reperfusion injury.

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European Journal of Pharmacology

Título del artículo:

Nanoemulsions with chloroaluminium phthalocyanine and paromomycin for combined photodynamic and antibiotic therapy for cutaneous leishmaniasis

Background: Photodynamic therapy (PDT) using chloroaluminium phthalocyanine (ClAlPc) and paromomycin sulfate (PM) can be effective against New World Leishmania species involved in cutaneous leishmaniasis (CL). The aim of this study is to assay the skin permeation and the antileishmanial effects of a nanoemulsion (NE) containing both ClAlPc and PM in experimental CL by Leishmania (Viannia) braziliensis. Material and Methods: Cremophor ELP/castor oil-based NEs were prepared by a low-energy method and characterized for their physicochemical parameters. The NEs were used to deliver both ClAlPc and PM to leishmania cells. The in vitro toxicity of NEs were tested in vitro against L. (V.) braziliensis and THP-1 cells. The in vivo toxicity was assessed in non-infected BALB/c mice. Ex-vivo permeation and retention studies using healthy mice skin were also conducted. Finally, the in vivo activity of NE-PM+ClAlPc after PDT was tested in BALB/c mice infected with parasites. Results: NEs are colloidally stable with average droplet diameter of 30 nm, polydispersity index (PDI) below 0.2, and zeta potential near zero. Both promastigotes and intracellular amastigotes treated with NE-PM, NE-ClAlPc and NE-PM+ClAlPc were inhibited at >50%, >95%, >88%, respectively, after PDT with a phototoxic index (PI) >1.2. No skin ClAlPc permeation was observed. In contrast, PM skin permeation was 80-fold higher using PM-loaded NE formulation in comparison to aqueous PM solution. Topical treatment with NE formulations showed no signs of local toxicity or genotoxicity. In addition, concentrations of PM between 27.3 - 292.5 μM/25 mg of tissue were detected in different organs. In vivo, the NE-PM+ClAlPc treatment did not reduce skin lesions. Conclusion: The Cremophor ELP/castor oil NE formulation increases the permeation of PM through the skin and can be used to co-deliver PM plus ClAlPc for combined PDT protocols. However, the lack of efficacy in the in vivo model evidences that the therapeutical scheme has to be improved.

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Infection and Chemotherapy

Título del artículo:

Hamman’s syndrome in an adolescent with asthma crisis

BACKGROUND: Pneumomediastinum is defined as the presence of air in the mediastinum. It may appear after surgical procedures, trauma, or spontaneous. This last one is related with situations where the intra-alveolar pressure is increased, as in the Valsalva maneuvers, coughing, vomiting, among others. Asthma is a very frequent factor associated with spontaneous pneumomediastinum. It is developed due to the distension of the airways to the bronchial obstruction where the alveolar rupture occurs. It is a rare disease with a lot of differential diagnoses. The most common symptoms are chest pain, dyspnea and pain in the neck. The physical examination can show edema in the neck and subcutaneous emphysema. The initial study should be performed with chest radiography but up to the 30% could be normal, in this case it must be confirmed with chest tomography. The evolution is good and the treatment is generally conservative. CLINICAL CASE: A 17-year-old female patient with moderate asthmatic attack, acute bronchitis with pneumomediastinum, pneumopericardium, for which it was indicated bronchodilator, corticosteroid and antibiotic treatment. CONCLUSIONS: Spontaneous pneumomediastinum is a rare condition, with signs and symptoms that may suggest various diagnostic options, so clinical suspicion and diagnostic guidance are vital to prescribe the effective treatment.

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Medicina Interna de Mexico

Título del artículo:

Educational alternation: A challenge to protect the health and life of the school community

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Revista Cuidarte

Título del artículo:

In vitro antimicrobial effect of chloroaluminum phthalocyanine nanoemulsion on periodontal bacteria

Context: Nowadays, complementary therapies are necessary for a major removal of microbial subgingival biofilm in the conventional treatment of periodontitis. Research has suggested the use of photodynamic therapy (PDT) as a promising therapy to manage oral cavity infections. This project proposes a new combination of photosensitizer chloroaluminum phthalocyanine and nanoemulsion as a strategy for improving bioactivity. The main purpose of this in vitro study was to evaluate the antimicrobial activity of nanoemulsion ClAlPc (ClAlPc-NE) on relevant periodontal bacteria before and after PDT. Materials and Methods: The phototoxic and antibacterial effect of ClAlPc-NE was evaluated against epithelial cells derived from an African green monkey kidney using the colorimetric method with salt tetrazolium 3-(4.5-dimethylthiazolyl-2)-2.5-Diphenyltetrazolium bromide (Merck) and periodontopathogen bacteria (Porphyromonas gingivalis (ATCC 33277), Aggregatibacter actinomycetemcomitans (ATCC 33384), and Prevotella intermedia (ATCC 25611) using the plate microdilution method according to Tavares et al., 2018, respectively. The light source used for the PDT was a LED laser (400-700 nm); the cells were irradiated for 2 min using 4.83 joules/cm2. Results: Antibacterial effect of NE-PcAlCl against P. intermedia with minimum inhibitory concentration (MIC) 0.63 μM after TFD was determined. In the case of P. gingivalis and A. actinomycetemcomitans, no biological activity was found after PDT (MIC > 20 μM) under-evaluated experimental conditions. On the other hand, the ClAlPc-free and ClAlPc-NE cells were phototoxic on epithelial cells. Conclusion: The results helped to identify the potential use of ClAlPc-NE to inhibit the periodontal bacterial and additional studies are being developed.

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Journal of Indian Society of Periodontology

Título del artículo:

Generalized anxiety disorder scale (GAD-7) has adequate psychometric properties in Colombian general practitioners during COVID-19 pandemic

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General Hospital Psychiatry

Título del artículo:

Associations of Fish Consumption with Risk of Cardiovascular Disease and Mortality among Individuals with or without Vascular Disease from 58 Countries

Importance: Cohort studies report inconsistent associations between fish consumption, a major source of long-chain ω-3 fatty acids, and risk of cardiovascular disease (CVD) and mortality. Whether the associations vary between those with and those without vascular disease is unknown. Objective: To examine whether the associations of fish consumption with risk of CVD or of mortality differ between individuals with and individuals without vascular disease. Design, Setting, and Participants: This pooled analysis of individual participant data involved 191558 individuals from 4 cohort studies - 147645 individuals (139827 without CVD and 7818 with CVD) from 21 countries in the Prospective Urban Rural Epidemiology (PURE) study and 43413 patients with vascular disease in 3 prospective studies from 40 countries. Adjusted hazard ratios (HRs) were calculated by multilevel Cox regression separately within each study and then pooled using random-effects meta-analysis. This analysis was conducted from January to June 2020. Exposures: Fish consumption was recorded using validated food frequency questionnaires. In 1 of the cohorts with vascular disease, a separate qualitative food frequency questionnaire was used to assess intake of individual types of fish. Main Outcomes and Measures: Mortality and major CVD events (including myocardial infarction, stroke, congestive heart failure, or sudden death). Results: Overall, 191558 participants with a mean (SD) age of 54.1 (8.0) years (91666 [47.9%] male) were included in the present analysis. During 9.1 years of follow-up in PURE, compared with little or no fish intake (≤50 g/mo), an intake of 350 g/wk or more was not associated with risk of major CVD (HR, 0.95; 95% CI, 0.86-1.04) or total mortality (HR, 0.96; 0.88-1.05). By contrast, in the 3 cohorts of patients with vascular disease, the HR for risk of major CVD (HR, 0.84; 95% CI, 0.73-0.96) and total mortality (HR, 0.82; 95% CI, 0.74-0.91) was lowest with intakes of at least 175 g/wk (or approximately 2 servings/wk) compared with 50 g/mo or lower, with no further apparent decrease in HR with consumption of 350 g/wk or higher. Fish with higher amounts of ω-3 fatty acids were strongly associated with a lower risk of CVD (HR, 0.94; 95% CI, 0.92-0.97 per 5-g increment of intake), whereas other fish were neutral (collected in 1 cohort of patients with vascular disease). The association between fish intake and each outcome varied by CVD status, with a lower risk found among patients with vascular disease but not in general populations (for major CVD, I2= 82.6 [P =.02]; for death, I2= 90.8 [P =.001]). Conclusions and Relevance: Findings of this pooled analysis of 4 cohort studies indicated that a minimal fish intake of 175 g (approximately 2 servings) weekly is associated with lower risk of major CVD and mortality among patients with prior CVD but not in general populations. The consumption of fish (especially oily fish) should be evaluated in randomized trials of clinical outcomes among people with vascular disease.

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JAMA Internal Medicine

Título del artículo:

Resistance to beta-lactam antibiotics and quinolones in Escherichia coli isolated from broilers

The aim of this study was to determine the antimicrobial resistance of 176 Escherichia coli strains isolated from broiler chicken organs. The strains were challenged with beta-lactam, quinolones and fluoroquinolones, observing resistance to beta-lactam antibiotics (97.7%) and quinolones (86.7%). The results showed that 71.6% of the isolates phenotypically expressed the production of extended spectrum beta-lactamases (ESLB). By PCR, resistance genes for beta-lactams blaTEM, blaSHV, blaCTX-M1 and Amp-C and resistance genes for quinolones qnrA, qnrB, qnrS were determined. The genes AmpC (74%), blaCTX-M (65%), blaSHV (65%), blaTEM (50%), qnrB (86.4%) and qnrS (11.9%) were found. The qnrA gene was not evident in the samples analysed. The results obtained revealed a large percentage of resistance to the studied antibiotics and the presence of resistance genes in isolates from poultry for human consumption, which constitutes a risk for Public Health.

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Revista de Investigaciones Veterinarias del Peru

Título del artículo:

Effect of ibuprofen on the establishment of the gestation of in vitro produced bovine embryos

The aim of this study was to evaluate the effect of the administration of ibuprofen in the establishment of the gestation of bovine embryos produced in vitro. In total, 85 Bos taurus x B. indicus heifers were used as embryo recipients, which were subjected to a protocol of synchronization of oestrus and ovulation with the insertion of an intravaginal progesterone implant (Sincrogest®) for eight days, plus the application of 2 mg of oestradiol benzoate (Sincrodiol®). To the removal of the implant, 500 µg sodium cloprostenol (Sincrocio®), 300 IU of equine chorionic gonadotropin (Sincro eCG®), plus the administration of 1 mg of oestradiol cypionate (SincroCP®,) were applied. One hour before embryo transfer, 5 mg/kg of ibuprofen IM was applied. No significant difference was observed in the gestation rate of the control group (47.5%) and the ibuprofen group (35.5%). It is concluded that the administration of ibuprofen in B. taurus x B. indicus heifers one hour before the transfer of the embryos in vitro had no effect on the establishment of gestation.

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Revista de Investigaciones Veterinarias del Peru

Título del artículo:

Reliability of the scale of barriers for cardiac rehabilitation in the colombian population

Cardiac rehabilitation is supported by the highest level of scientific evidence. However, less than 25% of those eligible to participate in a cardiac rehabilitation program initiate it; and of these, 50% drop out prematurely. A modified Spanish Cardiac Rehabilitation Barriers Scale (CRBS) has been translated, culturally adapted and validated in Colombia, however, the reliability remains to be evaluated. This study aimed to determine the internal consistency and test–retest reliability of the CRBS in a Colombian population. In total, 193 patients (67% men, average age = 65 ± 12 years) completed the scale twice, with an average of eight days between applications. Cronbach’s Alpha and intraclass correlation coefficients (ICC) were calculated. The internal consistency of the Colombian version of the CRBS was acceptable (Cronbach’s alpha = 0.84). The ICC of the CRBS was 0.69 (95% CI 0.61–0.76); 0.78 (95% CI 0.71–0.84) when the CRBS was completed by interview; and 0.47 (95% CI 0.21–0.67) when the CRBS was self-reported. The reliability of the interview version of the CRBS was substantial in the Colombian population; however, the reliability of the self-report version was lower. The use of this scale will allow developing strategies to increase participation and adherence to cardiac rehabilitation programs.

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International Journal of Environmental Research and Public Health

Título del artículo:

Genotypic and functional characterization of mutations in the reverse transcriptase domain of the hepatitis B virus P gene in patients coinfected with human immunodeficiency virus receiving antiretrovirals

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Iatreia

Título del artículo:

Determination of molecular markers for hepatitis B through deep sequencing of the viral genome and the miRNA expression in samples obtained from blood banks in Colombia

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Iatreia

Título del artículo:

Development of an aptamer-based electrochemical biosensor for the detection of PSA and its isoform p2PSA

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Iatreia

Título del artículo:

Clinical characteristics and findings on computed tomography of the thorax in patients with COVID-19

The pandemic generated by COVID-19 has generated an enormous medical and socioeconomic cost, which has led the scientific field and the different medical associations to make all their resources available to find a prompt solution to face this pathology. The objective of this review is to describe the most relevant clinical characteristics and chest computed tomography findings in patients with COVID-19; By identifying scientific articles in databases. Fifteen studies were included that met the inclusion criteria defined by the authors. The most relevant findings show us that SARS-CoV-2 has a rapid and generalized transmission, with the involvement of multiple systems, but with a predominance of the respiratory tract. Most patients have mild symptoms; the main manifestations are fever, cough, shortness of breath, muscle pain, headache, etc. Patients with more severe diseases and requiring admission to the ICU are older and have more comorbidity compared to the general population. The current recommendations of the American College of Radiology for the use of chest CT, we propose to reserve it for hospitalized patients when it is necessary to determine their treatment. In conclusion, due to the great variety of clinical manifestations and the involvement of multiple organs, there are no specific clinical characteristics that allow distinguishing COVID-19 from other respiratory infections of viral etiology.

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Gaceta Medica de Caracas

Título del artículo:

Urinary Sodium and Potassium, and Risk of Ischemic and Hemorrhagic Stroke (INTERSTROKE): A Case-Control Study

Although low sodium intake (<2 g/day) and high potassium intake (>3.5 g/day) are proposed as public health interventions to reduce stroke risk, there is uncertainty about the benefit and feasibility of this combined recommendation on prevention of stroke. METHODS: We obtained random urine samples from 9,275 cases of acute first stroke and 9,726 matched controls from 27 countries and estimated the 24-hour sodium and potassium excretion, a surrogate for intake, using the Tanaka formula. Using multivariable conditional logistic regression, we determined the associations of estimated 24-hour urinary sodium and potassium excretion with stroke and its subtypes. RESULTS: Compared with an estimated urinary sodium excretion of 2.8-3.5 g/day (reference), higher (>4.26 g/day) (odds ratio [OR] 1.81; 95% confidence interval [CI], 1.65-2.00) and lower (<2.8 g/day) sodium excretion (OR 1.39; 95% CI, 1.26-1.53) were significantly associated with increased risk of stroke. The stroke risk associated with the highest quartile of sodium intake (sodium excretion >4.26 g/day) was significantly greater (P < 0.001) for intracerebral hemorrhage (ICH) (OR 2.38; 95% CI, 1.93-2.92) than for ischemic stroke (OR 1.67; 95% CI, 1.50-1.87). Urinary potassium was inversely and linearly associated with risk of stroke, and stronger for ischemic stroke than ICH (P = 0.026). In an analysis of combined sodium and potassium excretion, the combination of high potassium intake (>1.58 g/day) and moderate sodium intake (2.8-3.5 g/day) was associated with the lowest risk of stroke. CONCLUSIONS: The association of sodium intake and stroke is J-shaped, with high sodium intake a stronger risk factor for ICH than ischemic stroke. Our data suggest that moderate sodium intake - rather than low sodium intake - combined with high potassium intake may be associated with the lowest risk of stroke and expected to be a more feasible combined dietary target.

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American Journal of Hypertension

Título del artículo:

Comparison between five coprological methods for the diagnosis of Balantidium coli cysts in fecal samples from pigs

Background and Aim: Balantidium coli is a protozoan that can infect humans and non-human primates, being the domestic pigs the animals most affected by this parasite. This study aimed to compare the performance of five coprological methods for diagnosis of Balantidium coli cysts in fecal samples from pigs. Materials and Methods: From September to December 2019, 558 fecal samples were collected from the rectum of backyard pigs in the Bucaramanga metropolitan area, Colombia. The average age of the sampled animals was 3-4 months. Fecal samples collected were tested using the following coprological techniques: Direct examination with Lugol\'s iodine solution, buffered saline, centrifugation/flotation and McMaster techniques, and Ziehl-Neelsen method. Results: The results indicate that B. coli cysts were diagnosed most frequently through direct examination with Lugol\'s iodine solution (52.7% of the samples) followed by direct examination with a buffered saline solution (37.6%). Moderate concordance (k=0.41; p<0.05) was determined between direct method with Lugol\'s iodine and buffered saline solution, McMaster and buffered saline (k=0.35; p<0.05), and centrifugation/flotation and buffered saline (k=0.28; p<0.05) showed a fair degree of concordance. The rest of the comparisons were classified as poor. The flotation techniques (centrifugation/ flotation and McMaster) did not show good recovery of cysts. Conclusion: It is concluded that the most efficient method for diagnosing this parasitosis was to an association between direct examination with Lugol\'s iodine solution and buffered saline.

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Veterinary World

Título del artículo:

Rabies and the Heart

As one of the neglected diseases, rabies is as a highly fatal viral infection, most prevalent in low-and middle-income regions, which produces a substantial health and economic burden. It mainly affects the central nervous system causing encephalitis, however extraneuronal involvement has been documented. Cardiac structures may be involved and can play a role in the severity of the disease. Most of the existing literature comes from case reports and case series where cardiac involvement results in myocarditis and cardiac arrhythmias. As part of the “Neglected Tropical Diseases and Other Infectious Diseases Involving the Heart” (NET-HEART Project), the objective of this article is to review all the information available on the cardiac involvement of this disease.

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Cardiology Research

Título del artículo:

The SIMAC study: A randomized controlled trial to compare the effects of resistance training and aerobic training on the fitness and body composition of Colombian adolescents

The aim of this study was to evaluate the impact on muscle strength, aerobic fitness and body composition, of replacing the physical education (PE) class of Colombian adolescents with resistance or aerobic training. 120 tanner stage 3 adolescents attending a state school were randomized to resistance training, aerobic training, or a control group who continued to attend a weekly 2- hour PE class for 16 weeks. The resistance training and aerobic training groups participated in twice weekly supervised after-school exercise sessions of 1 hour instead of their PE class. Sum of skinfolds, lean body mass (bioelectrical impedance analysis), muscular strength (6 repetition maximum (RM)) bench press, lateral pulldown and leg press) and estimated cardiorespiratory fitness (multistage 20 meter shuttle run) were ssessed at pre and post intervention. Complete data were available for n = 40 of the resistance training group, n = 40 of the aerobic training group and n = 30 PE (controls). Resistance raining attenuated increases in sum of skinfolds compared with controls (d = 0.27, [0.09–0.36]). We found no significant effect on lean body mass. Resistance training produced a positive effect on muscle strength compared with both controls (d = 0.66 [.49-.86]) and aerobic training (d = 0.55[0.28–0.67]). There was a positive effect of resistance training on cardiorespiratory fitness compared with controls (d = 0.04 [-0.10–0.12]) but not compared with aerobic training (d = 0.24 [0.10–0.36]). Replacing a 2-hour PE class with two 1 hour resistance training sessions attenuated gains in subcutaneous adiposity, and enhanced muscle strength and aerobic fitness development in Colombian youth, based on a median attendance of approximately 1 session a week. Further research to assess whether adequate stimuli for the development of muscular fitness exists within current physical education provision is warranted.

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PLoS ONE

Título del artículo:

Environmental risk factors associated with respiratory diseases in children with socioeconomic disadvantage

Children are more vulnerable to environmental exposures determinant of respiratory diseases due to their dynamic developmental physiology. Whereas social determinants of health are also associated with a higher risk of these diseases in children exposed to environmental risk factors, most studies incorporate them as covariates in the statistical analysis rather than focusing on specific vulnerable populations. In this study a systematic review searched and selected studies of respiratory diseases in children with socioeconomic disadvantage to identify the environmental risk factors associated with these diseases. The review followed the PRISMA protocol to identify eleven eligible studies of children with socioeconomic conditions that included low income and low socioeconomic status, overcrowding, adults with low education level and Indigenous status. Infectious respiratory diseases, asthma, rhinitis and mortality due to respiratory diseases were associated with risk factors such as biomass fuel use, tobacco smoking, particulate matter, coal dust and other pollutants including ozone, nitrogen dioxide and sulphur dioxide. The most common associations were between respiratory infections and household air pollution and asthma with indoor and outdoor air pollution. The findings support previous reports on these associations and suggest that specific vulnerabilities such as indigenous children and living with adults with low socioeconomic status and education level increase the risk of respiratory diseases. These populations can be given special attention to prioritize public health interventions to lower the burden of disease of respiratory diseases in children.

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Heliyon

Título del artículo:

Fungal Endophytes of Tahiti Lime (Citrus citrus × latifolia) and Their Potential for Control of Colletotrichum acutatum J. H. Simmonds Causing Anthracnose

Colletotrichum acutatum is one of the causal agents of anthracnose in several crops, and of post-flowering fruit drop (PFD) in citrus and key lime anthracnose (KLA). The pathogen normally attacks flowers, causing lesions only in open flowers. Under very favorable conditions, however, it can also affect flower buds and small fruits, causing complete rotting of the fruit and a premature fall, resulting in major economic crop losses. We isolated endophytic fungi from Tahiti lime to evaluate its diversity, verify its antagonistic capacity against the phytopathogen Colletotrichum acutatum C-100 in dual tests, and evaluate the ability of various endophytic agents to control flowers with induced anthracnose. 138 fungal isolates were obtained from 486 fragments of branches, leaves, and fruit; from which 15 species were identified morphologically. A higher isolation frequency was found in branches and leaves, with a normal level of diversity compared to other citrus species. Of the 15 morphospecies, 5 were trialed against C. acutatum in antagonism tests, resulting in a finding of positive inhibition. 2 endophytic fungi from the antagonism tests demonstrated high inhibition of the phytopathogen, and were thus used in in vivo tests with Tahiti lime flowers, applied in a spore solution. Spore solutions of two molecularly identified species, Xylaria adscendens, and Trichoderma atroviride, reduced the lesions caused by the phytopathogen in these in vivo tests. The finding that these endophytes react antagonistically against C. acutatum may make them good candidates for further biological control research in an agroindustry that requires environmental sustainability.

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Frontiers in Bioengineering and Biotechnology

Título del artículo:

Mapping stages, barriers and facilitators to the implementation of HEARTS in the Americas initiative in 12 countries: A qualitative study

The World Health Organization (WHO) Global Hearts Initiative offers technical packages to reduce the burden of cardiovascular diseases through population-wide and targeted health services interventions. The Pan American Health Organization (PAHO) has led implementation of the HEARTS in the Americas Initiative since 2016. The authors mapped the developmental stages, barriers, and facilitators to implementation among the 371 primary health care centers in the participating 12 countries. The authors used the qualitative method of document review to examine cumulative country reports, technical meeting notes, and reports to regional stakeholders. Common implementation barriers include segmentation of health systems, overcoming health care professionals\' scope of practice legal restrictions, and lack of health information systems limiting operational evaluation and quality improvement mechanisms. Main implementation facilitators include political support from ministries of health and leading scientific societies, PAHO\'s role as a regional catalyst to implementation, stakeholder endorsement demonstrated by incorporating HEARTS into official documents, and having a health system oriented to primary health care. Key lessons include the need for political commitment and cultivating on-the-ground leadership to initiate a shift in hypertension care delivery, accompanied by specific progress in the development of standardized treatment protocols and a set of high-quality medicines. By systematizing an implementation strategy to ease integration of interventions into delivery processes, the program strengthened technical leadership and ensured sustainability. These study findings will aid the regional approach by providing a staged planning model that incorporates lessons learned. A systematic approach to implementation will enhance equity, efficiency, scale-up, and sustainability, and ultimately improve population hypertension control.

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Journal of Clinical Hypertension

Título del artículo:

Association of bedtime with mortality and major cardiovascular events: an analysis of 112,198 individuals from 21 countries in the PURE study

Objectives: This study aimed to examine the association of bedtime with mortality and major cardiovascular events. Methods: Bedtime was recorded based on self-reported habitual time of going to bed in 112,198 participants from 21 countries in the Prospective Urban Rural Epidemiology (PURE) study. Participants were prospectively followed for 9.2 years. We examined the association between bedtime and the composite outcome of all-cause mortality, non-fatal myocardial infarction, stroke and heart failure. Participants with a usual bedtime earlier than 10PM were categorized as ‘earlier’ sleepers and those who reported a bedtime after midnight as ‘later’ sleepers. Cox frailty models were applied with random intercepts to account for the clustering within centers. Results: A total of 5633 deaths and 5346 major cardiovascular events were reported. A U-shaped association was observed between bedtime and the composite outcome. Using those going to bed between 10PM and midnight as the reference group, after adjustment for age and sex, both earlier and later sleepers had a higher risk of the composite outcome (HR of 1.29 [1.22, 1.35] and 1.11 [1.03, 1.20], respectively). In the fully adjusted model where demographic factors, lifestyle behaviors (including total sleep duration) and history of diseases were included, results were greatly attenuated, but the estimates indicated modestly higher risks in both earlier (HR of 1.09 [1.03–1.16]) and later sleepers (HR of 1.10 [1.02–1.20]). Conclusion: Early (10 PM or earlier) or late (Midnight or later) bedtimes may be an indicator or risk factor of adverse health outcomes.

Acerca de la revista donde se publicó este artículo:

Sleep Medicine

Título del artículo:

A proposal for the transformation of fossil fuel energy economies to hydrogen economies through social entrepreneurship

The world is growing at an ever-increasing rate, but this growth has occurred alongside an energy model based onfossilfuels, which presents serious sustainability problems. The current study seeks to illustrate one of the new alternative energy schemes which could replace fossil fuels in the future: Hydrogen. The promise of hydrogen fuel has led large nations to invest in transitioning their fossil fuel economies to a hydrogen-based model. This will result in significant social impacts, leading to the question, How should it be done? Social entrepreneurship can integrate socio-economic actors and agents and help them to devise and implement new forms of energy innovation, which will open spaces for new business models. The current study conceptualizes within a present-day context the connotations of the hydrogen economy at an international level, its implications to society, and its synergy with social entrepreneurship. The authors observed the rapid growth that these entrepreneurship initiatives are generating and how the models used to manage these undertakings play a vital role.

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Entrepreneurial Innovation for Securing Long-Term Growth in a Short-Term Economy