A Multidisciplinary Journey towards Bone Tissue Engineering

Millions of patients suffer yearly from bone fractures and disorders such as osteoporosis or cancer, which constitute the most common causes of severe long-term pain and physical disabilities. The intrinsic capacity of bone to repair the damaged bone allows normal healing of most small bone injuries. However, larger bone defects or more complex diseases require additional stimulation to fully heal. In this context, the traditional routes to address bone disorders present several associated drawbacks concerning their efficacy and cost-effectiveness. Thus, alternative therapies become necessary to overcome these limitations. In recent decades, bone tissue engineering has emerged as a promising interdisciplinary strategy to mimic environments specifically designed to facilitate bone tissue regeneration. Approaches developed to date aim at three essential factors: osteoconductive scaffolds, osteoinduction through growth factors, and cells with osteogenic capability. This review addresses the biological basis of bone and its remodeling process, providing an overview of the bone tissue engineering strategies developed to date and describing the mechanisms that underlie cell–biomaterial interactions

Desorption of Lipases Immobilized on Octyl-Agarose Beads and Coated with Ionic Polymers after Thermal Inactivation. Stronger Adsorption of Polymers/Unfolded Protein Composites

Lipases from Candida antarctica (isoform B) and Rhizomucor miehei (CALB and RML) have been immobilized on octyl-agarose (OC) and further coated with polyethylenimine (PEI) and dextran sulfate (DS). The enzymes just immobilized on OC supports could be easily released from the support using 2% SDS at pH 7, both intact or after thermal inactivation (in fact, after inactivation most enzyme molecules were already desorbed). The coating with PEI and DS greatly reduced the enzyme release during thermal inactivation and improved enzyme stability. However, using OC-CALB/RML-PEI-DS, the full release of the immobilized enzyme to reuse the support required more drastic conditions: a pH value of 3, a buffer concentration over 2 M, and temperatures above 45 °C. However, even these conditions were not able to fully release the thermally inactivated enzyme molecules from the support, being necessary to increase the buffer concentration to 4 M sodium phosphate and decrease the pH to 2.5. The formation of unfolded protein/polymers composites seems to be responsible for this strong interaction between the octyl and some anionic groups of OC supports. The support could be reused five cycles using these conditions with similar loading capacity of the support and stability of the immobilized enzyme

La actividad física organizada en las personas mayores, una herramienta para mejorar la condición física en la senectud

ABSTRACT Background. An adequate level of fitness is critical to achieving healthy ageing. The aim of this study was to evaluate the impact of organized physical activity (PA) and the number of hours of practice on the fitness levels of the elderly. Method. A total of 3104 people over 65 years old from Spain, belonging to the EXERNET Multicenter Project (722 men and 2382 women, mean age: 72.1 ± 5.3 years) participated in the study. Fitness was evaluated by 8 specific tests for this population. Participation in organized PA was recorded through a questionnaire. Differences in fitness values depending on the participation in PA and the number of hours were measured with ANCOVA adjusting for age, hours of walking and sitting time. Results. Those who did not participate in this type of activity increased their risk of having a low level of fitness in most variables evaluated, with some differences between sexes (OR: from 1.6 to 2.6 in men and from 1.4 to 2.2 in women). In men, no significant differences were observed between practicing less than 2, 2-4 or more than 4 hours (P>0,05), with an exception in the strength of the left arm. However, women who performed more than 2 hours a week in organized PA had better balance, strength of lower and upper extremities, flexibility of lower extremities, walking speed and aerobic capacity than those who performed less than 2 hours of PA a week (P0,05), a excepción de la fuerza del brazo izquierdo; sin embargo, las mujeres que realizaban más de 2 horas de AF organizada a la semana tenían mayor equilibrio, fuerza de piernas y de brazos, flexibilidad de piernas, velocidad al caminar y resistencia aeróbica que aquellas que asistían a este tipo de sesiones menos de 2 horas a la semana (P<0,05). Conclusiones. La práctica de AF organizada produce un efecto beneficioso sobre la CF de las personas mayores independientemente de la edad, las horas que estén sentados o el tiempo que dediquen a caminar

Relación entre el nivel educativo y la composición corporal en personas mayores no institucionalizadas: Proyecto Multi-céntrico EXERNET

ABSTRACT Background: There is an inverse association between educational level and body composition; however this association has strongly focused in young and adults population. The aim of this study was to analyze the educational levels attained in overweight and obesity Spanish elderly and to investigate if there was a correlation between having a low educational level and the risk of having overweight, central obesity or excess fat mass during the aging process. Methods: A representative sample of 2706 elderly (629 men and 2077 women; mean age of 72.1 ± 5.3 years) from Spain were assessed in the elderly EXERNET multi-center study between 2008 and 2009. Body composition was assessed in all subjects by bioelectrical impedance. ANCOVA was used to compare the averages between the groups. Logistic regression was used to calculate the association between educational level and the risk of having overweight, central fat or obesity. Results: We observed significances between waist circumference and educational level in both sex (men 96.6 cm, women 86.3 cm); (p<0.05 and p<0.01, respective). There is an inverse association between the academic level, fat mass (29.5 kg) and percentage of body fat (40.8%) in women (p<0.05, p<0.01, respectively). No differences were observed in men. Conclusions: A low educational level increases the possibility of having overweight or obesity in women and to have an increased waist circumference in both sexes.RESUMEN Fundamentos: El nivel educacional se ha relacionado inversamente con la composición corporal, sin embargo esta asociación ha sido evidenciada mayoritariamente en población joven y adulta. El objetivo del presente estudio fue evaluar la relación entre la composición corporal de las personas mayores de 65 años y su nivel educativo, y determinar si tener un nivel educativo alto puede prevenir el riesgo de padecer sobrepeso, obesidad central o exceso de grasa durante la senectud. Métodos: El estudio se realizó entre los años 2008-2009, sobre una muestra representativa de personas mayores de España (n= 2,706; 629 varones, 2,077 mujeres; edad media 72,1 ± 5,3 años), pertenecientes al Proyecto Multi-céntrico EXERNET. La composición corporal se evaluó mediante bio-impedancia eléctrica. Se utilizó ANCOVA para determinar las diferencias entre grupos. La asociación entre el nivel educativo y el riesgo de padecer sobrepeso, obesidad central o exceso de grasa se analizó mediante regresión logística. Resultados: En el perímetro de cintura, los hombres y mujeres con mayor nivel de estudios presentaron 96,6 cm y 86,3 cm, respectivamente (p<0,05 y p<0,01, respectivamente). Las mujeres con menor nivel de estudios presentaron 29,5 kg de masa grasa total y 40,8% de masa grasa (p<0,05 y p<0,01, respectivamente). Los varones no presentaron diferencias en estas mediciones. Conclusiones: Poseer un bajo nivel de estudios aumenta las posibilidades de padecer sobrepeso y obesidad en las mujeres y de tener mayor perímetro de cintura en ambos sexos

Dietary patterns and their relationship with the perceptions of healthy eating in European adolescents : the HELENA study

Objective: The aim of this study was to identify dietary patterns (DPs) in European adolescents and to examine the association between perceptions of healthy eating and the obtained DPs. Method: A multinational cross-sectional study was carried out in adolescents aged 12.5 to 17.5?years and 2,027 (44.9% males) were considered for analysis. A self-reported questionnaire with information on food choices and preferences, including perceptions of healthy eating, and two 24-hour dietary recalls were used. Principal component analysis was used to obtain sex-specific DPs, and linear analyses of covariance were used to compare DPs according to perceptions of healthy eating. Results: Three and four DPs for boys and girls were obtained. In boys and girls, there were significant associations between some perceptions about healthy food and the Breakfast-DP (p?<?0.05). In boys, Breakfast-DP and Healthy Beverage-DP were associated with the perception of the own diet as healthy (p?<?0.05). Healthy Beverage-DP was associated with those disliking fruits and vegetables (p?<?0.05). Girls considering the own diet as healthy were associated with Mediterranean-DP, Breakfast-DP, and Unhealthy Beverage and Meat-DP (p?<?0.05). The perception of snacking as a necessary part of a healthy diet was associated with Breakfast-DP in both genders (p?<?0.05). Conclusions: In European adolescents, perceptions of healthy eating were mainly associated with a DP characterized by foods consumed at breakfast. Future studies should further explore these findings in order to implement health promotion programs to improve healthy eating habits in adolescents

Effect of the COVID-19 pandemic on surgery for indeterminate thyroid nodules (THYCOVID): a retrospective, international, multicentre, cross-sectional study

Background: Since its outbreak in early 2020, the COVID-19 pandemic has diverted resources from non-urgent and elective procedures, leading to diagnosis and treatment delays, with an increased number of neoplasms at advanced stages worldwide. The aims of this study were to quantify the reduction in surgical activity for indeterminate thyroid nodules during the COVID-19 pandemic; and to evaluate whether delays in surgery led to an increased occurrence of aggressive tumours. Methods: In this retrospective, international, cross-sectional study, centres were invited to participate in June 22, 2022; each centre joining the study was asked to provide data from medical records on all surgical thyroidectomies consecutively performed from Jan 1, 2019, to Dec 31, 2021. Patients with indeterminate thyroid nodules were divided into three groups according to when they underwent surgery: from Jan 1, 2019, to Feb 29, 2020 (global prepandemic phase), from March 1, 2020, to May 31, 2021 (pandemic escalation phase), and from June 1 to Dec 31, 2021 (pandemic decrease phase). The main outcomes were, for each phase, the number of surgeries for indeterminate thyroid nodules, and in patients with a postoperative diagnosis of thyroid cancers, the occurrence of tumours larger than 10 mm, extrathyroidal extension, lymph node metastases, vascular invasion, distant metastases, and tumours at high risk of structural disease recurrence. Univariate analysis was used to compare the probability of aggressive thyroid features between the first and third study phases. The study was registered on ClinicalTrials.gov, NCT05178186. Findings: Data from 157 centres (n=49 countries) on 87 467 patients who underwent surgery for benign and malignant thyroid disease were collected, of whom 22 974 patients (18 052 [78·6%] female patients and 4922 [21·4%] male patients) received surgery for indeterminate thyroid nodules. We observed a significant reduction in surgery for indeterminate thyroid nodules during the pandemic escalation phase (median monthly surgeries per centre, 1·4 [IQR 0·6-3·4]) compared with the prepandemic phase (2·0 [0·9-3·7]; p&lt;0·0001) and pandemic decrease phase (2·3 [1·0-5·0]; p&lt;0·0001). Compared with the prepandemic phase, in the pandemic decrease phase we observed an increased occurrence of thyroid tumours larger than 10 mm (2554 [69·0%] of 3704 vs 1515 [71·5%] of 2119; OR 1·1 [95% CI 1·0-1·3]; p=0·042), lymph node metastases (343 [9·3%] vs 264 [12·5%]; OR 1·4 [1·2-1·7]; p=0·0001), and tumours at high risk of structural disease recurrence (203 [5·7%] of 3584 vs 155 [7·7%] of 2006; OR 1·4 [1·1-1·7]; p=0·0039). Interpretation: Our study suggests that the reduction in surgical activity for indeterminate thyroid nodules during the COVID-19 pandemic period could have led to an increased occurrence of aggressive thyroid tumours. However, other compelling hypotheses, including increased selection of patients with aggressive malignancies during this period, should be considered. We suggest that surgery for indeterminate thyroid nodules should no longer be postponed even in future instances of pandemic escalation. Funding: None