Nutritional supplements in psychomotor and cognitive development in childhood : a literature review

Introducción: en los últimos años, la malnutrición y su impacto en el desarrollo cognitivo y psicomotor de las personas ha cobrado interés, así como el uso de suplementos nutricionales en la dieta regular con el fin de evitar o disminuir los efectos negativos de una alimentación inadecuada en el desarrollo global de una persona. Dado que se conocen los requerimientos de elementos como el ácido docosahexaenoico (DHA) durante el desarrollo neurológico en las etapas más tempranas de la vida, resulta de gran importancia evaluar el alcance de la suplementación de estos componentes y su relación con la cognición en población pediátrica. Métodos: se realizó una revisión de la literatura en las bases de datos Embase y Pubmed teniendo en cuenta estudios que relacionaran la suplementación nutricional con ácidos grasos, hierro y zinc y las funciones cognitivas en niños. Resultados: se encontró evidencia que sugiere que los suplementos nutricionales con ácidos grasos poliinsaturados (DHA y omega 3), hierro y zinc mejoran el desarrollo cognitivo de los niños. Conclusiones: Los suplementos nutricionales con Omega 3, DHA, hierro y zinc podrían proporcionar beneficios en el desarrollo cognitivo, principalmente en lactantes y escolares sin efectos adversos de importancia.Q4Revisión de tema24-30Introduction: in recent years, malnutrition and its impact on the cognitive and psychomotor development has been rising interest, as well as the use of nutritional supplements in the regular diet in order to avoid or lower the negative effect of an inadequate nutrition in the global development of a person. Taken into account that the requirements of docosahexaenoic acid (DHA) during the neurologic development in the first stages of life is well known, it is of the uttmost importance to assess the reach of supplementation of these components and its relationship with cognition in the pediatric population. Methods: A review of the literature in Pubmed and Embase databases, which took into account studies relating supplements with fatty acids, zinc and iron and cognitive functions in children, was conducted. Results: Evidence suggests that nutritional supplements with Poly- Unsaturated Fatty Acids (DHA and omega 3), iron and zinc improve cognitive development in children. Conclusions: Nutritional supplements with Omega 3, DHA, iron and zinc could provide benefits in cognitive development, especially in infants and schoolchildren without significant adverse effects

Perfil epidemiológico de la infección por SARS-COV-2 en pediatría

Objetivo: Describir el perfil epidemiológico y clínico de los pacientes pediátricos que fueron atendidos por sospecha de infección de COVID-19, entre marzo y octubre del 2020, en el Hospital Universitario San Ignacio (HUSI), en Bogotá, Colombia. Materiales y métodos:Diseño de corte transversal. Descripción de los pacientes con edades comprendidas entre 1 mes de vida hasta 1 día antes de cumplir 18 años, valorados entre en marzo y octubre del 2020, que fueron abordados por cualquier servicio de atención pediátrica de un hospital universitario por sospecha de infección por COVID-19, según los protocolos nacionales e institucionales vigentes. Se registraron variables demográficas y el motivo de consulta de todos los individuos con sospecha de infección. Únicamente cuando se confirmó la infección por SARS-CoV-2 se registraron las variables relacionadas con aspectos clínicos de la enfermedad y su evolución. Resultados: Se evaluaron 920 registros médicos de pacientes pediátricos con sospecha de infección por SARS-CoV-2, de los cuales hubo 157 casos confirmados con infección por COVID-19. El principal motivo de consulta para sospechar infección fue fiebre en un 50% de los casos. En los pacientes con confirmación virológi-ca el 32.48% de los casos atendidos requirieron manejo hospitalario. Se sospechó MIS-C en 5 pacientes que requirieron manejo en unidad de cuidados intensivos. En el lapso evaluado no hubo fallecimientos asociados a la infección por COVID-19. Conclusiones: La infección por SARS-CoV-2 se relaciona en la mayoría de los casos con un espectro de enfermedad leve en la población pediátrica. Este estudio sugiere que podrían ser mayores los pacientes pediátricos que debutan con síntomas gastrointestinales que respiratorios, y que la frecuencia de complicaciones renales debe ser tenida en cuenta en los pacientes en quienes se sospecha el síndrome inflamatorio sistémico asociado al COVID-19Objective: To describe the epidemiological and clinical profile of pediatric patients who were treated for suspected COVID-19 infection, between March and Octo-ber 2020, at the Hospital Universitario San Ignacio (HUSI), in Bogotá, Colombia. Materials and methods: Cross-sectional design. Description of patients aged 1 month to 1 day before their 18th birthday, assessed between March and October 2020, who were approached by any pediatric care service of a university hospital for suspected COVID-infection. 19, according to current national and institutional protocols. Demographic variables and the reason for consultation of all individuals with suspected infection were recorded. Only when SARS-CoV-2 infection was confirmed were variables related to clinical aspects of the disease and its evolution recorded. Results: 920 medical records of pediatric patients with suspected SARS-CoV-2 infection were evaluated, of which there were 157 confirmed cases with COVID-19 infection. The main reason for consultation to suspect infection was fever in 50% of the cases. In patients with virological confirmation, 32.48% of the cases at-tended required hospital management. MIS-C was suspected in 5 patients who required intensive care unit management. In the evaluated period, there were no deaths associated with COVID-19 infection.Conclusions: SARS-CoV-2 infection is related in most cases to a spectrum of mild disease in the pediatric population. This study may be larger than pediatric patients presenting with gastrointestinal rather than respiratory symptoms, and the frequency of renal complications should be taken into account in patients in whom the systemic inflammatory syndrome associated with COVID-19 is suspected.Revista Nacional - IndexadaS

Pan-Cancer Analysis of lncRNA Regulation Supports Their Targeting of Cancer Genes in Each Tumor Context

Long noncoding RNAs (lncRNAs) are commonly dys-regulated in tumors, but only a handful are known toplay pathophysiological roles in cancer. We inferredlncRNAs that dysregulate cancer pathways, onco-genes, and tumor suppressors (cancer genes) bymodeling their effects on the activity of transcriptionfactors, RNA-binding proteins, and microRNAs in5,185 TCGA tumors and 1,019 ENCODE assays.Our predictions included hundreds of candidateonco- and tumor-suppressor lncRNAs (cancerlncRNAs) whose somatic alterations account for thedysregulation of dozens of cancer genes and path-ways in each of 14 tumor contexts. To demonstrateproof of concept, we showed that perturbations tar-geting OIP5-AS1 (an inferred tumor suppressor) andTUG1 and WT1-AS (inferred onco-lncRNAs) dysre-gulated cancer genes and altered proliferation ofbreast and gynecologic cancer cells. Our analysis in-dicates that, although most lncRNAs are dysregu-lated in a tumor-specific manner, some, includingOIP5-AS1, TUG1, NEAT1, MEG3, and TSIX, synergis-tically dysregulate cancer pathways in multiple tumorcontexts

Pan-cancer Alterations of the MYC Oncogene and Its Proximal Network across the Cancer Genome Atlas

Although theMYConcogene has been implicated incancer, a systematic assessment of alterations ofMYC, related transcription factors, and co-regulatoryproteins, forming the proximal MYC network (PMN),across human cancers is lacking. Using computa-tional approaches, we define genomic and proteo-mic features associated with MYC and the PMNacross the 33 cancers of The Cancer Genome Atlas.Pan-cancer, 28% of all samples had at least one ofthe MYC paralogs amplified. In contrast, the MYCantagonists MGA and MNT were the most frequentlymutated or deleted members, proposing a roleas tumor suppressors.MYCalterations were mutu-ally exclusive withPIK3CA,PTEN,APC,orBRAFalterations, suggesting that MYC is a distinct onco-genic driver. Expression analysis revealed MYC-associated pathways in tumor subtypes, such asimmune response and growth factor signaling; chro-matin, translation, and DNA replication/repair wereconserved pan-cancer. This analysis reveals insightsinto MYC biology and is a reference for biomarkersand therapeutics for cancers with alterations ofMYC or the PMN

Genomic, Pathway Network, and Immunologic Features Distinguishing Squamous Carcinomas

This integrated, multiplatform PanCancer Atlas study co-mapped and identified distinguishing molecular features of squamous cell carcinomas (SCCs) from five sites associated with smokin

Spatial Organization and Molecular Correlation of Tumor-Infiltrating Lymphocytes Using Deep Learning on Pathology Images

Beyond sample curation and basic pathologic characterization, the digitized H&E-stained images of TCGA samples remain underutilized. To highlight this resource, we present mappings of tumorinfiltrating lymphocytes (TILs) based on H&E images from 13 TCGA tumor types. These TIL maps are derived through computational staining using a convolutional neural network trained to classify patches of images. Affinity propagation revealed local spatial structure in TIL patterns and correlation with overall survival. TIL map structural patterns were grouped using standard histopathological parameters. These patterns are enriched in particular T cell subpopulations derived from molecular measures. TIL densities and spatial structure were differentially enriched among tumor types, immune subtypes, and tumor molecular subtypes, implying that spatial infiltrate state could reflect particular tumor cell aberration states. Obtaining spatial lymphocytic patterns linked to the rich genomic characterization of TCGA samples demonstrates one use for the TCGA image archives with insights into the tumor-immune microenvironment

Cabbage and fermented vegetables : From death rate heterogeneity in countries to candidates for mitigation strategies of severe COVID-19

Large differences in COVID-19 death rates exist between countries and between regions of the same country. Some very low death rate countries such as Eastern Asia, Central Europe, or the Balkans have a common feature of eating large quantities of fermented foods. Although biases exist when examining ecological studies, fermented vegetables or cabbage have been associated with low death rates in European countries. SARS-CoV-2 binds to its receptor, the angiotensin-converting enzyme 2 (ACE2). As a result of SARS-CoV-2 binding, ACE2 downregulation enhances the angiotensin II receptor type 1 (AT(1)R) axis associated with oxidative stress. This leads to insulin resistance as well as lung and endothelial damage, two severe outcomes of COVID-19. The nuclear factor (erythroid-derived 2)-like 2 (Nrf2) is the most potent antioxidant in humans and can block in particular the AT(1)R axis. Cabbage contains precursors of sulforaphane, the most active natural activator of Nrf2. Fermented vegetables contain many lactobacilli, which are also potent Nrf2 activators. Three examples are: kimchi in Korea, westernized foods, and the slum paradox. It is proposed that fermented cabbage is a proof-of-concept of dietary manipulations that may enhance Nrf2-associated antioxidant effects, helpful in mitigating COVID-19 severity.Peer reviewe

Nrf2-interacting nutrients and COVID-19 : time for research to develop adaptation strategies

There are large between- and within-country variations in COVID-19 death rates. Some very low death rate settings such as Eastern Asia, Central Europe, the Balkans and Africa have a common feature of eating large quantities of fermented foods whose intake is associated with the activation of the Nrf2 (Nuclear factor (erythroid-derived 2)-like 2) anti-oxidant transcription factor. There are many Nrf2-interacting nutrients (berberine, curcumin, epigallocatechin gallate, genistein, quercetin, resveratrol, sulforaphane) that all act similarly to reduce insulin resistance, endothelial damage, lung injury and cytokine storm. They also act on the same mechanisms (mTOR: Mammalian target of rapamycin, PPAR gamma:Peroxisome proliferator-activated receptor, NF kappa B: Nuclear factor kappa B, ERK: Extracellular signal-regulated kinases and eIF2 alpha:Elongation initiation factor 2 alpha). They may as a result be important in mitigating the severity of COVID-19, acting through the endoplasmic reticulum stress or ACE-Angiotensin-II-AT(1)R axis (AT(1)R) pathway. Many Nrf2-interacting nutrients are also interacting with TRPA1 and/or TRPV1. Interestingly, geographical areas with very low COVID-19 mortality are those with the lowest prevalence of obesity (Sub-Saharan Africa and Asia). It is tempting to propose that Nrf2-interacting foods and nutrients can re-balance insulin resistance and have a significant effect on COVID-19 severity. It is therefore possible that the intake of these foods may restore an optimal natural balance for the Nrf2 pathway and may be of interest in the mitigation of COVID-19 severity

Mortality and pulmonary complications in patients undergoing surgery with perioperative SARS-CoV-2 infection: an international cohort study

Background: The impact of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) on postoperative recovery needs to be understood to inform clinical decision making during and after the COVID-19 pandemic. This study reports 30-day mortality and pulmonary complication rates in patients with perioperative SARS-CoV-2 infection. Methods: This international, multicentre, cohort study at 235 hospitals in 24 countries included all patients undergoing surgery who had SARS-CoV-2 infection confirmed within 7 days before or 30 days after surgery. The primary outcome measure was 30-day postoperative mortality and was assessed in all enrolled patients. The main secondary outcome measure was pulmonary complications, defined as pneumonia, acute respiratory distress syndrome, or unexpected postoperative ventilation. Findings: This analysis includes 1128 patients who had surgery between Jan 1 and March 31, 2020, of whom 835 (74·0%) had emergency surgery and 280 (24·8%) had elective surgery. SARS-CoV-2 infection was confirmed preoperatively in 294 (26·1%) patients. 30-day mortality was 23·8% (268 of 1128). Pulmonary complications occurred in 577 (51·2%) of 1128 patients; 30-day mortality in these patients was 38·0% (219 of 577), accounting for 81·7% (219 of 268) of all deaths. In adjusted analyses, 30-day mortality was associated with male sex (odds ratio 1·75 [95% CI 1·28–2·40], p\textless0·0001), age 70 years or older versus younger than 70 years (2·30 [1·65–3·22], p\textless0·0001), American Society of Anesthesiologists grades 3–5 versus grades 1–2 (2·35 [1·57–3·53], p\textless0·0001), malignant versus benign or obstetric diagnosis (1·55 [1·01–2·39], p=0·046), emergency versus elective surgery (1·67 [1·06–2·63], p=0·026), and major versus minor surgery (1·52 [1·01–2·31], p=0·047). Interpretation: Postoperative pulmonary complications occur in half of patients with perioperative SARS-CoV-2 infection and are associated with high mortality. Thresholds for surgery during the COVID-19 pandemic should be higher than during normal practice, particularly in men aged 70 years and older. Consideration should be given for postponing non-urgent procedures and promoting non-operative treatment to delay or avoid the need for surgery. Funding: National Institute for Health Research (NIHR), Association of Coloproctology of Great Britain and Ireland, Bowel and Cancer Research, Bowel Disease Research Foundation, Association of Upper Gastrointestinal Surgeons, British Association of Surgical Oncology, British Gynaecological Cancer Society, European Society of Coloproctology, NIHR Academy, Sarcoma UK, Vascular Society for Great Britain and Ireland, and Yorkshire Cancer Research

Search for dark matter produced in association with bottom or top quarks in √s = 13 TeV pp collisions with the ATLAS detector

A search for weakly interacting massive particle dark matter produced in association with bottom or top quarks is presented. Final states containing third-generation quarks and miss- ing transverse momentum are considered. The analysis uses 36.1 fb−1 of proton–proton collision data recorded by the ATLAS experiment at √s = 13 TeV in 2015 and 2016. No significant excess of events above the estimated backgrounds is observed. The results are in- terpreted in the framework of simplified models of spin-0 dark-matter mediators. For colour- neutral spin-0 mediators produced in association with top quarks and decaying into a pair of dark-matter particles, mediator masses below 50 GeV are excluded assuming a dark-matter candidate mass of 1 GeV and unitary couplings. For scalar and pseudoscalar mediators produced in association with bottom quarks, the search sets limits on the production cross- section of 300 times the predicted rate for mediators with masses between 10 and 50 GeV and assuming a dark-matter mass of 1 GeV and unitary coupling. Constraints on colour- charged scalar simplified models are also presented. Assuming a dark-matter particle mass of 35 GeV, mediator particles with mass below 1.1 TeV are excluded for couplings yielding a dark-matter relic density consistent with measurements