Definite and indeterminate nonalcoholic steatohepatitis share similar clinical features and prognosis: A longitudinal study of 1893 biopsy-proven nonalcoholic fatty liver disease subjects

[Background and Aim] Histological score systems may not fully capture the essential nonalcoholic steatohepatitis (NASH) features, which is one of the leading causes of screening failure in clinical trials. We assessed the NASH distribution and its components across the fibrosis stages and their impact on the prognosis and their relationship with the concept of metabolic-associated fatty liver disease (MAFLD).[Methods] Spanish multicenter study including 1893 biopsy-proven nonalcoholic fatty liver disease (NAFLD) patients from HEPAmet registry. NASH was diagnosed by NAS score ≥4 (including steatosis, ballooning and lobular inflammation) and fibrosis by Kleiner score. The presence of MAFLD was determined. Progression to cirrhosis, first episode of decompensated cirrhosis and death were collected during the follow-up (4.7 ± 3.8 years).[Results] Fibrosis was F0 34.3% (649/1893), F1 27% (511/1893), F2 16.5% (312/1893), F3 15% (284/1893) and F4 7.2% (137/1893). NASH diagnosis 51.9% (982/1893), and its individual components (severe steatosis, ballooning and lobular inflammation), increased from F0 (33.6%) to F2 (68.6%), and decreased significantly in F4 patients (51.8%) (P = .0001). More than 70% of non-NASH patients showed some inflammatory activity (ballooning or lobular inflammation), showing a similar MAFLD rate than NASH (96.2% [945/982] vs. 95.2% [535/562]) and significantly higher than nonalcoholic fatty liver (NAFL) subjects (89.1% [311/349]) (P < .0001). Progression to cirrhosis was similar between NASH (9.5% [51/539]) and indeterminate NASH (7.9% [25/316]), and higher than steatosis (5% [14/263]) (logRank 8.417; P = .015). Death and decompensated cirrhosis were similar between these.[Conclusions] The prevalence of steatohepatitis decreased in advanced liver disease. However, most of these patients showed some inflammatory activity histologically and had metabolic disturbances. These findings should be considered in clinical trials whose main aim is to prevent cirrhosis progression and complications, liver transplant and death.This project has been partially funded by the ‘Consejería de Salud de la Junta de Andalucía’ (PI-0075-2014) and the ‘Spanish Ministry of Economy, Innovation and Competition, Instituto de Salud Carlos III’ (PI19/01404, PI16/01842, PI17/00535 and GLD19/00100).Peer reviewe

Efecto de la educación nutricional individualizada en el control metabólico de pacientes diabéticos tipo 1 con tratamiento intensificado de insulina

Tesis (Nutricionista, Licenciado en Nutrición y Dietética)En los últimos años se ha expandido en niños y adolescentes principalmente el tratamiento de la diabetes con insulinas rápidas aplicadas varias veces al día, previo automonitoreo de la glucosa sanguínea. Esta modalidad de tratamiento permite, en algunos casos, variar la ingestión de hidratos de carbono de unos días o de unas comidas a otras, inyectándose entonces la cantidad adecuada de insulina, siempre de acuerdo con la cantidad de hidratos de carbono que se van a consumir. Esta modalidad requiere contar la cantidad de carbohidratos presente en cada comida, sobre todo cuando se cambia el plan de alimentación habitual o se realizan transgresiones alimentarias con comidas muy abundantes o altas en carbohidratos. En el presente estudio se comparó la mejoría en el control metabólico de 36 pacientes diabéticos tipo 1 con esquema de dosis múltiples de insulina que reciben educación nutricional individualizada en relación al conteo de carbohidratos. Estos pacientes se dividen en tres grupos de acuerdo al nivel de aprendizaje en: Nivel Básico, Intermedio y Avanzado. Además, en cada grupo se evaluaron los conocimientos adquiridos y la percepción individual de cada paciente en relación a la flexibilidad, adaptación y particidad del tratamiento en su diario vivir

Microplastics in Ecuador: A review of environmental and health-risk assessment challenges

Pollution from plastic debris and microplastics (MPs) is a worldwide issue. Classified as emerging contaminants, MPs have become widespread and have been found not only in terrestrial and aquatic ecosystems but also within the food chain, which affects both the environment and human health. Since the outbreak of COVID-19, the consumption of single-use plastics has drastically increased, intensifying mismanaged plastic waste in countries such as Ecuador. Therefore, the aim of this review is to 1) summarize the state of MP-related knowledge, focusing on studies conducted with environmental matrices, biota, and food, and 2) analyze the efforts by different national authorities and entities in Ecuador to control MP contamination. Results showed a limited number of studies have been done in Ecuador, which have mainly focused on the surface water of coastal areas, followed by studies on sediment and food. MPs were identified in all samples, indicating the lack of wastewater management policies, deficient management of solid wastes, and the contribution of anthropogenic activities such as artisanal fishing and aquaculture to water ecosystem pollution, which affects food webs. Moreover, studies have shown that food contamination can occur through atmospheric deposition of MPs; however, ingredients and inputs from food production, processing, and packaging, as well as food containers, contribute to MP occurrence in food. Further research is needed to develop more sensitive, precise, and reliable detection methods and assess MPs' impact on terrestrial and aquatic ecosystems, biota, and human health. In Ecuador specifically, implementing wastewater treatment plants in major cities, continuously monitoring MP coastal contamination, and establishing environmental and food safety regulations are crucial. Additionally, national authorities need to develop programs to raise public awareness of plastic use and its environmental effects, as well as MP exposure's effects on human health

Relación entre la ingesta dietética de calcio y adiposidad en adolescentes mujeres

[spa] Antecedentes y objetivo: La prevalencia y magnitud de la obesidad en ninos ¿ y adolescentes se incrementa aceleradamente. Aparte de los factores genéticos y ambientales, se ha identificado recientemente la ingesta de calcio dietético como uno de los factores que se correlaciona inversamente con el índice de masa corporal y con el desarrollo de sobrepeso y obesidad. El objetivo del presente estudio es determinar la correlación entre la ingesta dietética de calcio con el índice de masa corporal y la distribución de la grasa en adolescentes mujeres. Materiales y métodos: Es un estudio de corte transversal en el cual se realizó la evaluación antropométrica (peso, talla, índice de masa corporal, circunferencia de cintura, circunferencia de cadera) en 244 adolescentes mujeres, para establecer la adiposidad corporal total y la distribución de la grasa. Se utilizó el recordatorio de 24 h y un cuestionario de frecuencia de consumo para determinar la ingesta calórica total, ingesta de calcio y consumo de lácteos. Resultados: La ingesta de calcio se correlacionó inversamente con el índice de masa corporal (p < 0,05), circunferencia de cintura (p < 0,05), circunferencia de cadera (p > 0,05) e índice cintura cadera (p < 0,05). Las adolescentes con sobrepeso (8,3%) y obesidad (0,7%) tuvieron una ingesta promedio de calcio inferior al de las adolescentes de peso normal (p = 0,06) Conclusiones: La ingesta dietética de calcio y en menor grado el consumo de productos lácteos se relaciona inversamente con la adiposidad total y abdominal así como con la prevalencia de sobrepeso en las adolescentes estudiadas. © 2015 SEEN. Publicado por Elsevier España, S.L.U. Todos los derechos reservados

Novel biosynthesis of Ag-hydroxyapatite: Structural and spectroscopic characterization

Silver-doped hydroxyapatite (Ag-HAP) was obtained by green synthesis route. The dopant silver nanoparticles (AgNPs) were obtained by biosynthesis based on Melissa officinalis extract. This research is focused on the characterization and the use of the nontoxic and environment-friendly Ag-HAP nanocomposite. The structural and morphological characterization of Ag-HAP nanocomposite was carried out by scanning electron microscopy (SEM), X-ray diffraction, Fourier-transform infrared (FT-IR) and Raman spectroscopy. The obtained nanoparticles exhibited a great interaction with the HAP matrix, performing an Ag-HAP nanocomposite. Changes in the structure of the Ag-HAP nanocomposite were corroborated by the different characterization techniques. Additionally, a homogeneous distribution of the AgNPs on the HAP structure was observed. The heterogeneous nucleation process employed to doping the HAP, offer a functional route to obtain a green composite with potentials applications in multiple fields, such as tissue engineering, bone repair as well as protein. These properties can be evaluated in subsequent studies. Keywords: Green synthesis, Ag nanoparticles, Hydroxyapatite, Structural characterization, Spectroscop

Next Directions in Measurement of the Home Mathematics Environment

This paper synthesizes findings from an international virtual conference, funded by the National Science Foundation (NSF), focused on the home mathematics environment (HME). In light of inconsistencies and gaps in research investigating relations between the HME and children’s outcomes, the purpose of the conference was to discuss actionable steps and considerations for future work. The conference was composed of international researchers with a wide range of expertise and backgrounds. Presentations and discussions during the conference centered broadly on the need to better operationalize and measure the HME as a construct – focusing on issues related to child, family, and community factors, country and cultural factors, and the cognitive and affective characteristics of caregivers and children. Results of the conference and a subsequent writing workshop include a synthesis of core questions and key considerations for the field of research on the HME. Findings highlight the need for the field at large to use multi-method measurement approaches to capture nuances in the HME, and to do so with increased international and interdisciplinary collaboration, open science practices, and communication among scholars