Nutritional Patterns, Anthropometric and Sociodemographic Aspects Associated with Gestational Diabetes Mellitus

Diabetes is the most frequent metabolic disorder during pregnancy. Its development is related to multiple factors and is associated with maternal and perinatal adverse effects. This study aims to determine the association of nutritional patterns, anthropometric and sociodemographic aspects with gestational diabetes mellitus (GDM), and perinatal results. A prospective cohort study was conducted on 237 pregnant women with the application of questionnaires: structured, global physical activity (GPAQ), 24-hour recall, and review of the perinatal medical history. Exploratory factor analysis was performed to determine the nutritional patterns; descriptive, bivariate, and multivariate analysis between the groups of patients with GDM and without GDM in users of the Centro de salud de Puengasí 2, and the Hospital Gineco Obstetrico Isidro Ayora in the city of Quito, from January to September 2021. Three nutritional patterns were identified in pregnant women. There was a difference in the variables, such as age, years of study, previous pregnancies, weight, and body mass index (BMI) for gestational age at the beginning of pregnancy between pregnant women diagnosed with GDM and those without GDM. Multivariate analysis confirms the association of GDM with BMI for gestational age at the start of pregnancy RR 0.293 (0.08-0.970) and passive smoking RR 0.037 (0.00196-0.701). No association with nutritional patterns was found. In conclusion,the affinity for nutritional patterns and physical activity does not show an association with GDM. The association between BMI for gestational age at the beginning of pregnancy and passive smoking with GDM is confirmed. Keywords: gestational diabetes mellitus, pregnancy, nutritional pattern, exercise. Resumen Introducción: La Diabetes es el trastorno metabólico mas frecuente durante la gestación, su desarrollo está relacionado a múltiples factores, y asociada a efectos adversos maternos y perinatales. Objetivo: Determinar la asociación de patrones nutricionales, aspectos antropométricos y sociodemográficos con el diagnóstico Diabetes Mellitus Gestacional (DMG) y resultados perinatales. Metodología: Estudio de cohorte prospectivo en 237 gestantes con la aplicación de cuestionarios: estructurado, global de actividad física (GPAQ), Recordatorio de 24 horas, y revisión de la historia clínica perinatal. Se realizó análisis factorial exploratorio para determinar los patrones nutricionales; análisis descriptivo, bivariado y multivariado entre los grupos de pacientes con DMG y sin DMG en usuarias del centro de salud Puengasí 2 y del Hospital Gineco-Obstétrico Isidro Ayora de la ciudad de Quito desde enero a septiembre 2021. Resultados: Se identificaron 3 patrones nutricionales en las gestantes. Hay diferencia en las variables: edad, años de estudio, gestas previas, peso e índice de masa corporal (IMC) para la edad gestacional al inicio del embarazo entre las gestantes con diagnóstico de DMG y sin DMG. El análisis multivariado confirma la asociación de DMG con el IMC para la edad gestacional al inicio del embarazo RR 0,293 (0,08- 0,970), y el tabaquismo pasivo RR 0,037 (0,00196-0,701). No se encontró asociación con los patrones nutricionales. Conclusiones: La afinidad por los patrones nutricionales y la actividad física no muestran asociación con DMG. Se confirma la asociación entre el IMC para la edad gestacional al inicio del embarazo y el tabaquismo pasivo con DMG. Palabras Clave: diabetes mellitus gestacional, gestación, patrón nutricional, ejercicio

La rotación del personal en los Gobiernos Autónomos Descentralizados Municipales y su impacto en el clima organizacional/The rotation of personnel in the Municipal Decentralized Autonomous Governments and their impact on the organizational climate

Los cambios constantes en el nivel de las organizaciones públicas hacen que estas expandan su visión y la competitividad permanente lleva a los Gobiernos Autónomos Descentralizados (GAD) Municipales a desarrollar estrategias para alcanzar sus objetivos, es así como, la contratación y la continuidad de los despidos del personal representa un problema de gran magnitud para las instituciones, pues sin duda, limita el desarrollo eficiente que se desearía tener, ya que la productividad de la institución se ve significativamente afectada, evidenciándose un mal clima organizacional, restando la eficiencia eficacia y efectividad en los procesos, influyendo directamente en los resultados Esta investigación determina un análisis de las causas del clima organizacional en una institución pública. Debido a la alta tasa de rotación evidenciada dentro de los municipios según se constata en las encuestas realizadas, principalmente en el personal operativo, que son aquellos que trabajan directamente con los usuarios y pueden tener los efectos causados por el servicio ofrecido. En consecuencia, esta investigación conlleva aumentar el servicio al usuario proporcionado por los colaboradores públicos. Y una relación muy estrecha entre el clima organizacional medido y la rotación de personar también se define al analizar la premisa de que si el clima organizacional mejora la rotación de personal se reducirá el malestar entre compañeros de trabajo, ya que puede haber razones que no se conocen o están fuera del control y, por lo tanto, no se pueden mejorar el lineamiento de prestigio institucional. Constant changes at the level of public organizations mean that they expand their vision and permanent competitiveness leads the Municipal Autonomous Decentralized Governments (GAD) to develop strategies to achieve their objectives, such as hiring and continuity of layoffs The staff represents a problem of great magnitude for the institutions, because without a doubt, it limits the efficient development that one would like to have, since the productivity of the institution is significantly affected, evidencing a bad organizational climate, subtracting the efficiency effectiveness and effectiveness in the processes, directly influencing the results This research determines an analysis of the causes of the organizational climate in a public institution. Due to the high rate of turnover evidenced within the municipalities as found in the surveys carried out, mainly in the operating personnel, which are those that work directly with users and can have the effects caused by the service offered. Consequently, this research entails increasing the user service provided by public collaborators. And a very close relationship between the measured organizational climate and the turnover of people is also defined when analyzing the premise that if the organizational climate improves staff turnover, discomfort among coworkers will be reduced, since there may be reasons that are not they know or are out of control and, therefore, the institutional prestige guidelines can not be improved. Palabras Clave: desempeño, talento humano, rotación, clima laboral, decisiones. Keywords: performance, human talent, rotation, labor climate, decisions

Regression Models Comparison for Efficiency in Electricity Consumption in Ecuadorian Schools: A Case of Study

Consumption forecast models with their proper billing allow establishing strategies to avoid overloads in systems and penalties for high consumption. This paper presents a comparison of multivariate data prediction models that allow detecting the final monthly cost of electricity consumption in relation to the different billing parameters. As relevant results, it was obtained that the models based on decision support machines have a better sensitivity when compared with different metrics that evaluate the prediction error with training set improved by backward elimination criteria.Uise

Cross-Clade Protective Immune Responses to Influenza Viruses with H5N1 HA and NA Elicited by an Influenza Virus-Like Particle

Background. Vaccination is a cost-effective counter-measure to the threat of seasonal or pandemic outbreaks of influenza. To address the need for improved influenza vaccines and alternatives to egg-based manufacturing, we have engineered an influenza virus-like particle (VLP) as a new generation of non-egg or non-mammalian cell culture-based candidate vaccine. Methodology/Principal Findings. We generated from a baculovirus expression system using insect cells, a non-infectious recombinant VLP vaccine from both influenza A H5N1 clade 1 and clade 2 isolates with pandemic potential. VLPs were administered to mice in either a one-dose or two-dose regimen and the immune responses were compared to those induced by recombinant hemagglutinin (rHA). Both humoral and cellular responses were analyzed. Mice vaccinated with VLPs were protected against challenge with lethal reassortant viruses expressing the H5N1 HA and NA, regardless if the H5N1 clade was homologous or heterologous to the vaccine. However, rHA-vaccinated mice showed considerable weight loss and death following challenge with the heterovariant clade virus. Protection against death induced by VLPs was independent of the pre-challenge HAI titer or cell-mediated responses to HA or M1 since vaccinated mice, with low to undetectable cross-clacle HAI antibodies or cellular responses to influenza antigens, were still protected from a lethal viral challenge. However, an apparent association rate of antibody binding to HA correlated with protection and was enhanced using VLPs, particularly when delivered intranasally, compared to rHA vaccines. Conclusion/Significance. This is the first report describing the use of an H5N1 VLP vaccine created from a clade 2 isolate. The results show that a non-replicating virus-like particle is effective at eliciting a broadened, cross-clade protective immune response to proteins from emerging H5N1 influenza isolates giving rise to a potential pandemic influenza vaccine candidate for humans that can be stockpiled for use in the event of an outbreak of H5N1 influenza

Altering an Artificial Gagpolnef Polyprotein and Mode of ENV Co-Administration Affects the Immunogenicity of a Clade C HIV DNA Vaccine

HIV-1 candidate vaccines expressing an artificial polyprotein comprising Gag, Pol and Nef (GPN) and a secreted envelope protein (Env) were shown in recent Phase I/II clinical trials to induce high levels of polyfunctional T cell responses; however, Env-specific responses clearly exceeded those against Gag. Here, we assess the impact of the GPN immunogen design and variations in the formulation and vaccination regimen of a combined GPN/Env DNA vaccine on the T cell responses against the various HIV proteins. Subtle modifications were introduced into the GPN gene to increase Gag expression, modify the expression ratio of Gag to PolNef and support budding of virus-like particles. I.m. administration of the various DNA constructs into BALB/c mice resulted in an up to 10-fold increase in Gag- and Pol-specific IFNγ+ CD8+ T cells compared to GPN. Co-administering Env with Gag or GPN derivatives largely abrogated Gag-specific responses. Alterations in the molar ratio of the DNA vaccines and spatially or temporally separated administration induced more balanced T cell responses. Whereas forced co-expression of Gag and Env from one plasmid induced predominantly Env-specific T cells responses, deletion of the only H-2d T cell epitope in Env allowed increased levels of Gag-specific T cells, suggesting competition at an epitope level. Our data demonstrate that the biochemical properties of an artificial polyprotein clearly influence the levels of antigen-specific T cells, and variations in formulation and schedule can overcome competition for the induction of these responses. These results are guiding the design of ongoing pre-clinical and clinical trials

The message on the bottle: Rethinking plastic labelling to better encourage sustainable use

Plastic pollution continues to worsen globally in volume and complexity. The complexity in plastic production, use and disposal is significant, highlighting the importance of clear communication to consumers. Yet despite this, poor plastic labelling is clear, evident from poor waste management metrics even in the most equipped countries. Plastic labelling must change to contribute to a holistic intervention on global plastic mismanagement. Discussion on this topic leads to three key recommendations: 1. An accurate and clear “sustainability scale” to empower consumers to make decisions informed by environmental and human health implications; 2. Directions for appropriate disposal action in the region of purchase; 3. A comprehensive list of plastic composition, including additives

COVID-19-related mortality in kidney transplant and haemodialysis patients: A comparative, prospective registry-based study

Background: Coronavirus disease 2019 (COVID-19) has exposed haemodialysis (HD) patients and kidney transplant (KT) recipients to an unprecedented life-threatening infectious disease, raising concerns about kidney replacement therapy (KRT) strategy during the pandemic. This study investigated the association of the type of KRT with COVID-19 severity, adjusting for differences in individual characteristics. Methods: Data on KT recipients and HD patients diagnosed with COVID-19 between 1 February 2020 and 1 December 2020 were retrieved from the European Renal Association COVID-19 Database. Cox regression models adjusted for age, sex, frailty and comorbidities were used to estimate hazard ratios (HRs) for 28-day mortality risk in all patients and in the subsets that were tested because of symptoms. Results: A total of 1670 patients (496 functional KT and 1174 HD) were included; 16.9% of KT and 23.9% of HD patients died within 28 days of presentation. The unadjusted 28-day mortality risk was 33% lower in KT recipients compared with HD patients {HR 0.67 [95% confidence interval (CI) 0.52-0.85]}. In a fully adjusted model, the risk was 78% higher in KT recipients [HR 1.78 (95% CI 1.22-2.61)] compared with HD patients. This association was similar in patients tested because of symptoms [fully adjusted model HR 2.00 (95% CI 1.31-3.06)]. This risk was dramatically increased during the first post-transplant year. Results were similar for other endpoints (e.g. hospitalization, intensive care unit admission and mortality >28 days) and across subgroups. Conclusions: KT recipients had a greater risk of a more severe course of COVID-19 compared with HD patients, therefore they require specific infection mitigation strategies

Recovery of dialysis patients with COVID-19 : health outcomes 3 months after diagnosis in ERACODA

Background. Coronavirus disease 2019 (COVID-19)-related short-term mortality is high in dialysis patients, but longer-term outcomes are largely unknown. We therefore assessed patient recovery in a large cohort of dialysis patients 3 months after their COVID-19 diagnosis. Methods. We analyzed data on dialysis patients diagnosed with COVID-19 from 1 February 2020 to 31 March 2021 from the European Renal Association COVID-19 Database (ERACODA). The outcomes studied were patient survival, residence and functional and mental health status (estimated by their treating physician) 3 months after COVID-19 diagnosis. Complete follow-up data were available for 854 surviving patients. Patient characteristics associated with recovery were analyzed using logistic regression. Results. In 2449 hemodialysis patients (mean ± SD age 67.5 ± 14.4 years, 62% male), survival probabilities at 3 months after COVID-19 diagnosis were 90% for nonhospitalized patients (n = 1087), 73% for patients admitted to the hospital but not to an intensive care unit (ICU) (n = 1165) and 40% for those admitted to an ICU (n = 197). Patient survival hardly decreased between 28 days and 3 months after COVID-19 diagnosis. At 3 months, 87% functioned at their pre-existent functional and 94% at their pre-existent mental level. Only few of the surviving patients were still admitted to the hospital (0.8-6.3%) or a nursing home (∼5%). A higher age and frailty score at presentation and ICU admission were associated with worse functional outcome. Conclusions. Mortality between 28 days and 3 months after COVID-19 diagnosis was low and the majority of patients who survived COVID-19 recovered to their pre-existent functional and mental health level at 3 months after diagnosis

Anti-Spike antibodies 3 months after SARS-CoV-2 mRNA vaccine booster dose in patients on hemodialysis: the prospective SENCOVAC study

Background: Patients on hemodialysis are at high-risk for complications derived from coronavirus disease 2019 (COVID-19). The present analysis evaluated the impact of a booster vaccine dose and breakthrough severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infections on humoral immunity 3 months after the booster dose. Methods: This is a multicentric and prospective study assessing immunoglobulin G anti-Spike antibodies 6 and 9 months after initial SARS-CoV-2 vaccination in patients on hemodialysis that had also received a booster dose before the 6-month assessment (early booster) or between the 6- and 9-month assessments (late booster). The impact of breakthrough infections, type of vaccine, time from the booster and clinical variables were assessed. Results: A total of 711 patients [67% male, median age (range) 67 (20-89) years] were included. Of these, 545 (77%) received an early booster and the rest a late booster. At 6 months, 64 (9%) patients had negative anti-Spike antibody titers (3% of early booster and 29% of late booster patients, P =. 001). At 9 months, 91% of patients with 6-month negative response had seroconverted and there were no differences in residual prevalence of negative humoral response between early and late booster patients (0.9% vs 0.6%, P =. 693). During follow-up, 35 patients (5%) developed breakthrough SARS-CoV-2 infection. Antibody titers at 9 months were independently associated with mRNA-1273 booster (P =. 001), lower time from booster (P =. 043) and past breakthrough SARS-CoV-2 infection (P <. 001). Conclusions: In hemodialysis patients, higher titers of anti-Spike antibodies at 9 months were associated with mRNA-1273 booster, lower time from booster and past breakthrough SARS-CoV-2 infectionThe present project has been supported by Fresenius Medical Care, Diaverum, Vifor Pharma, Vircell, Fundación Renal Iñigo Álvarez de Toledo and ISCIII FEDER funds RICORS2040 (RD21/0005