Predictors of cognitive change in cognitively healthy older women in Panama: the PARI-HD study

BackgroundEvidence suggests that a combination of biological and social factors influence risk of dementia differently for women and men. In healthy older women, several factors may contribute to changes in cognition.ObjectiveDescribe the characteristics associated with variation in cognition in a sample of cognitively healthy older Panamanian women.MethodsThe study includes cross-sectional analyses of cognitive domains at baseline (n = 357) and 17-month (SD = 2.0) follow-up (n = 200) for women aged 60 years and older enrolled in the Panama Aging Research Initiative-Health Disparities (PARI-HD) study. Instruments included clinical questionnaires, physiological measures, and a neuropsychological test battery assessing global cognition and seven cognitive domains. Multiple regression analyses examined the associations between demographic and clinical characteristics and cognition at baseline. Repeated measures analyses were used to investigate changes in cognition from baseline to follow-up.ResultsOn average, participants were 68.6 years of age (SD = 5.9) with 16.1 years of education (SD = 4.7). Age, income, and education showed robust associations with baseline cognition. Subjective cognitive impairment was associated with lower performance in global cognition, verbal learning, and memory domains. Only performance in the attention domain decreased at follow-up, and subjective health state and depressive symptoms significantly predicted the change in attention.DiscussionOur study findings contribute to the investigation of cognitive health in older Hispanic women and to the understanding of sociodemographic and health-related factors associated with cognitive decline and the progression to cognitive impairment and dementia

Influencia de la red de apoyo en la salud mental de jóvenes embarazadas

Maternity implies a series of biopsychosocial changes that can lead to the appearance of alterations in mental health, especially when the pregnancy is not planned, and mothers do not have emotional support. The objective of this study was to analyze the influence of support networks on the mental health of pregnant adolescents and young women between 18 and 24 years old in Panama. This was a descriptive, cross-sectional pilot study with mixed methodology. The sample was made up of young women between 18 and 24 years old who attended medical care at the Panamanian Association for Family Planning in San Miguelito, Panama, during the first semester of 2022. The Self-Esteem Scale of Rosenberg, the Beck Anxiety Inventory, the Beck Depression Inventory and a sociodemographic questionnaire were included. The mean age of the sample was 22.6 years. All participants claimed to have at least one support network. Regarding the mental health scales applied, it was found that 33.3% had high self-esteem and 88.9% showed few anxiety and depression symptoms. Significant correlations were found between the results of anxiety and self-esteem (p= 0.029), depression and self-esteem (p= 0.041), and anxiety and depression (p= 0.007). The qualitative interview evidenced that all participants considered it relevant to be able to count on the support of their partner and/or family. Having support networks helps enhance the well-being of young mothers; in turn, this can serve as a protective factor against the onset of anxiety and depression.La maternidad implica una serie de cambios biopsicosociales que pueden propiciar la aparición de alteraciones en la salud mental, especialmente cuando el embarazo no es planificado y las madres no cuentan con soporte emocional. El objetivo del estudio fue analizar la influencia que tienen las redes de apoyo en la salud mental de adolescentes y adultas jóvenes embarazadas de 18 años a 24 años en Panamá. Este fue un estudio piloto con metodología mixta, descriptivo y transversal. La muestra estuvo compuesta por mujeres jóvenes entre 18 años y 24 años que asistieron a la clínica de la Asociación Panameña para el Planeamiento de la Familia de San Miguelito, Panamá, durante el primer semestre del 2022. Se utilizó la Escala de Autoestima de Rosenberg, el Inventario de Ansiedad de Beck, el Inventario de Depresión de Beck y un cuestionario sociodemográfico. La media de edad de la muestra fue de 22.6 años. El 100% de la muestra aseguró contar con al menos una red de apoyo. El 33.3% obtuvo una autoestima elevada y 88.9% obtuvo niveles bajos de ansiedad y depresión. Se encontraron relaciones significativas entre los resultados de ansiedad y autoestima (p= 0.029), depresión y autoestima (p= 0.041), y ansiedad y depresión (p= 0.007). El análisis cualitativo arrojó que todas las participantes consideraron relevante contar con el apoyo de su pareja y/o familia. Las redes de apoyo ayudan a potenciar el bienestar de las madres jóvenes; a su vez, esto puede servir como factor protector ante la aparición de ansiedad y depresión

Hallazgos preliminares sobre la eficacia del programa Crianza Reflexiva para cuidadores de niños entre 4 y 12 años de edad

El Programa Crianza Reflexiva es un método para fomentar en los cuidadores, una mejor conexión, una mayor curiosidad en el mundo interno de los niños y un mayor disfrute de las interacciones con sus hijos. Los cuidadores, al estar conscientes de los estados mentales de sus hijos y de los suyos propios, cultivan la función reflexiva y/o mentalización y la seguridad emocional de ellos. El objetivo de esta investigación es medir la efectividad del programa Crianza Reflexiva en cuidadores de niños de 4 a 12 años, en la ciudad de Panamá. Se realizó un ensayo controlado aleatorizado con tres mediciones, un pre-test, una post-test y un follow-up a tres meses. Una muestra de cuarenta cuidadores de niños entre 4 y 12 años de edad, fueron incluidos en el estudio y asignados de manera aleatoria a uno de dos grupos: control (n=20) y experimental (n=20). En los tres momentos de medición los participantes completaron cuestionarios de autoreporte para medir el estrés parental (PSI-SF), la eficacia parental (BPES), la función reflexiva parental (PRFQ) y la regulación emocional de niños (SDQ y ERC). Los resultados preliminares obtenidos mediante modelos de efectos mixtos permiten identificar que el programa de crianza reflexiva tuvo un efecto significativo, sobre el interés y curiosidad de los padres acerca de los estados mentales de sus hijos, sobre el estrés parental, y sobre los problemas externalizantes de sus hijos. Los efectos se mantuvieron a los tres meses de seguimiento. Estos hallazgos aportan evidencia sobre la efectividad del programa Crianza Reflexiv

Inflammatory Biomarkers, Depressive Symptoms and Falls Among the elderly in Panama

Background: Falls are common among elderly adults, and are predictors of hospitalization, institutionalization and mortality. Objective: The objective of the present study was to examine the relationship between blood-based markers of inflammation and fall events in a sample of elderly Hispanic adults. Method: Data were collected from 190 participants enrolled in the Panama Aging Research Initiative study who completed baseline clinical and cognitive assessments. A non-fasting blood sample was obtained. Self-reported falls were classified as no falls, single falls or recurrent (two or more) falls reported in the 12 months prior to baseline evaluations. Serum levels of C Reactive Protein (CRP), T-lymphocyte secreting protein (I-309), interleukin 10 (IL-10), interleukin 6 (IL-6) and interleukin 7 (IL-7) were measured. Global cognition was assessed with the Mini Mental State Examination and depressive symptoms were assessed with the Geriatric Depression Scale (GDS-30). Multinomial logistic regression was used to assess the link between inflammation and fall events. Results: Depressive symptoms, limitations in Instrumental Activities of Daily Living (IADL), IL-7 and I-309 were significantly related to fall events. Elevated levels of IL-7 increased the likelihood of single and recurrent falls, while increased levels of I-309 were associated only with recurrent falls. Greater IADL limitations and depressive symptoms were associated with an increased likelihood of recurrent falls. Conclusion: There is a lack of research investigating the relationship between inflammatory biomarkers and fall events. These results provide evidence of risk factors for falls in Hispanic older adults, and could serve to guide public health professionals to establish clinical guidelines to reduce fall risks.Background: Falls are common among elderly adults, and are predictors of hospitalization, institutionalization and mortality. Objective: The objective of the present study was to examine the relationship between blood-based markers of inflammation and fall events in a sample of elderly Hispanic adults. Method: Data were collected from 190 participants enrolled in the Panama Aging Research Initiative study who completed baseline clinical and cognitive assessments. A non-fasting blood sample was obtained. Self-reported falls were classified as no falls, single falls or recurrent (two or more) falls reported in the 12 months prior to baseline evaluations. Serum levels of C Reactive Protein (CRP), T-lymphocyte secreting protein (I-309), interleukin 10 (IL-10), interleukin 6 (IL-6) and interleukin 7 (IL-7) were measured. Global cognition was assessed with the Mini Mental State Examination and depressive symptoms were assessed with the Geriatric Depression Scale (GDS-30). Multinomial logistic regression was used to assess the link between inflammation and fall events. Results: Depressive symptoms, limitations in Instrumental Activities of Daily Living (IADL), IL-7 and I-309 were significantly related to fall events. Elevated levels of IL-7 increased the likelihood of single and recurrent falls, while increased levels of I-309 were associated only with recurrent falls. Greater IADL limitations and depressive symptoms were associated with an increased likelihood of recurrent falls. Conclusion: There is a lack of research investigating the relationship between inflammatory biomarkers and fall events. These results provide evidence of risk factors for falls in Hispanic older adults, and could serve to guide public health professionals to establish clinical guidelines to reduce fall risks

Association between convalescent plasma treatment and mortality in COVID-19: a collaborative systematic review and meta-analysis of randomized clinical trials.

Funder: laura and john arnold foundationBACKGROUND: Convalescent plasma has been widely used to treat COVID-19 and is under investigation in numerous randomized clinical trials, but results are publicly available only for a small number of trials. The objective of this study was to assess the benefits of convalescent plasma treatment compared to placebo or no treatment and all-cause mortality in patients with COVID-19, using data from all available randomized clinical trials, including unpublished and ongoing trials (Open Science Framework, https://doi.org/10.17605/OSF.IO/GEHFX ). METHODS: In this collaborative systematic review and meta-analysis, clinical trial registries (ClinicalTrials.gov, WHO International Clinical Trials Registry Platform), the Cochrane COVID-19 register, the LOVE database, and PubMed were searched until April 8, 2021. Investigators of trials registered by March 1, 2021, without published results were contacted via email. Eligible were ongoing, discontinued and completed randomized clinical trials that compared convalescent plasma with placebo or no treatment in COVID-19 patients, regardless of setting or treatment schedule. Aggregated mortality data were extracted from publications or provided by investigators of unpublished trials and combined using the Hartung-Knapp-Sidik-Jonkman random effects model. We investigated the contribution of unpublished trials to the overall evidence. RESULTS: A total of 16,477 patients were included in 33 trials (20 unpublished with 3190 patients, 13 published with 13,287 patients). 32 trials enrolled only hospitalized patients (including 3 with only intensive care unit patients). Risk of bias was low for 29/33 trials. Of 8495 patients who received convalescent plasma, 1997 died (23%), and of 7982 control patients, 1952 died (24%). The combined risk ratio for all-cause mortality was 0.97 (95% confidence interval: 0.92; 1.02) with between-study heterogeneity not beyond chance (I2 = 0%). The RECOVERY trial had 69.8% and the unpublished evidence 25.3% of the weight in the meta-analysis. CONCLUSIONS: Convalescent plasma treatment of patients with COVID-19 did not reduce all-cause mortality. These results provide strong evidence that convalescent plasma treatment for patients with COVID-19 should not be used outside of randomized trials. Evidence synthesis from collaborations among trial investigators can inform both evidence generation and evidence application in patient care

Global disparities in surgeons’ workloads, academic engagement and rest periods: the on-calL shIft fOr geNEral SurgeonS (LIONESS) study

: The workload of general surgeons is multifaceted, encompassing not only surgical procedures but also a myriad of other responsibilities. From April to May 2023, we conducted a CHERRIES-compliant internet-based survey analyzing clinical practice, academic engagement, and post-on-call rest. The questionnaire featured six sections with 35 questions. Statistical analysis used Chi-square tests, ANOVA, and logistic regression (SPSS® v. 28). The survey received a total of 1.046 responses (65.4%). Over 78.0% of responders came from Europe, 65.1% came from a general surgery unit; 92.8% of European and 87.5% of North American respondents were involved in research, compared to 71.7% in Africa. Europe led in publishing research studies (6.6 ± 8.6 yearly). Teaching involvement was high in North America (100%) and Africa (91.7%). Surgeons reported an average of 6.7 ± 4.9 on-call shifts per month, with European and North American surgeons experiencing 6.5 ± 4.9 and 7.8 ± 4.1 on-calls monthly, respectively. African surgeons had the highest on-call frequency (8.7 ± 6.1). Post-on-call, only 35.1% of respondents received a day off. Europeans were most likely (40%) to have a day off, while African surgeons were least likely (6.7%). On the adjusted multivariable analysis HDI (Human Development Index) (aOR 1.993) hospital capacity > 400 beds (aOR 2.423), working in a specialty surgery unit (aOR 2.087), and making the on-call in-house (aOR 5.446), significantly predicted the likelihood of having a day off after an on-call shift. Our study revealed critical insights into the disparities in workload, access to research, and professional opportunities for surgeons across different continents, underscored by the HDI

Exploration adhesion properties of Liquorilactobacillus and Lentilactobacillus isolated from two different sources of tepache kefir grains.

Due to the distinctive characteristics of probiotics, it is essential to pinpoint strains originating from diverse sources that prove efficacious in addressing a range of pathologies linked to dysfunction of the intestinal barrier. Nine strains of lactic acid bacteria were isolated from two different sources of tepache kefir grains (KAS2, KAS3, KAS4, KAS7, KAL4, KBS2, KBS3, KBL1 and KBL3), and were categorized to the genus Lacticaseibacillus, Liquorilactobacillus, and Lentilactobacillus by 16S rRNA gene. Kinetic behaviors of these strains were evaluated in MRS medium, and their probiotic potential was performed: resistance to low pH, tolerance to pepsin, pancreatin, bile salts, antibiotic resistance, hemolytic activity, and adhesion ability. KAS7 strain presented a higher growth rate (0.50 h-1) compared with KAS2 strain, who presented a lower growth rate (0.29 h-1). KBS2 strain was the only strain that survived the in vitro stomach simulation conditions (29.3%). Strain KBL1 demonstrated significantly higher viability (90.6%) in the in vitro intestine simulation conditions. Strain KAS2 demonstrated strong hydrophilic character with chloroform (85.6%) and xylol (57.6%) and a higher percentage of mucin adhesion (87.1%). However, strains KBS2 (84.8%) and KBL3 (89.5%) showed the highest autoaggregation values. In terms of adhesion to the intestinal epithelium in rats, strains KAS2, KAS3 and KAS4 showed values above 80%. The growth of the strains KAS2, KAS3, KAS4, KBS2, and KBL3 was inhibited by cefuroxime, cefotaxime, tetracycline, ampicillin, erythromycin, and cephalothin. Strains KBS2 (41.9% and 33.5%) and KBL3 (42.5% and 32.8%) had the highest co-aggregation values with S. aureus and E. coli. The results obtained in this study indicate that lactic acid bacteria isolated from tepache can be considered as candidates for potentially probiotic bacteria, laying the foundations to evaluate their probiotic functionality in vivo and thus to be used in the formulation of functional foods

S1 Graphical abstract -

Due to the distinctive characteristics of probiotics, it is essential to pinpoint strains originating from diverse sources that prove efficacious in addressing a range of pathologies linked to dysfunction of the intestinal barrier. Nine strains of lactic acid bacteria were isolated from two different sources of tepache kefir grains (KAS2, KAS3, KAS4, KAS7, KAL4, KBS2, KBS3, KBL1 and KBL3), and were categorized to the genus Lacticaseibacillus, Liquorilactobacillus, and Lentilactobacillus by 16S rRNA gene. Kinetic behaviors of these strains were evaluated in MRS medium, and their probiotic potential was performed: resistance to low pH, tolerance to pepsin, pancreatin, bile salts, antibiotic resistance, hemolytic activity, and adhesion ability. KAS7 strain presented a higher growth rate (0.50 h-1) compared with KAS2 strain, who presented a lower growth rate (0.29 h-1). KBS2 strain was the only strain that survived the in vitro stomach simulation conditions (29.3%). Strain KBL1 demonstrated significantly higher viability (90.6%) in the in vitro intestine simulation conditions. Strain KAS2 demonstrated strong hydrophilic character with chloroform (85.6%) and xylol (57.6%) and a higher percentage of mucin adhesion (87.1%). However, strains KBS2 (84.8%) and KBL3 (89.5%) showed the highest autoaggregation values. In terms of adhesion to the intestinal epithelium in rats, strains KAS2, KAS3 and KAS4 showed values above 80%. The growth of the strains KAS2, KAS3, KAS4, KBS2, and KBL3 was inhibited by cefuroxime, cefotaxime, tetracycline, ampicillin, erythromycin, and cephalothin. Strains KBS2 (41.9% and 33.5%) and KBL3 (42.5% and 32.8%) had the highest co-aggregation values with S. aureus and E. coli. The results obtained in this study indicate that lactic acid bacteria isolated from tepache can be considered as candidates for potentially probiotic bacteria, laying the foundations to evaluate their probiotic functionality in vivo and thus to be used in the formulation of functional foods.</div

Assessment of viability of the isolated strains after exposure to conditions simulating the human GI tract.

Assessment of viability of the isolated strains after exposure to conditions simulating the human GI tract.</p

Phylogenetic relationships of kefir isolates based on 16S rRNA gene sequences.

The tree was constructed by the neighbour-joining method. Leuconostoc mesenteroides was used as an outgroup.</p